[DETERMINANTS OF QUALITY OF LIFE AND MORBIDITY IN THE ADULT POPULATION].

In the Russian Federation, the number of working-age population is growing annually: in 2014, the number of able-bodied population was 33.8 million people(23.5%), while in 2018 this figure increased to 37.3 million (25.9%) [6]. In the Republic of Tatarstan, at the beginning of 2019 the number of able-bodied citizens reached 986 thousand people(26.0%). The purpose of this study was to analyze the determinants of the adult living standarts and the impact of these determinants on morbidity rates. A survey of 897 people using the SF-36 international questionnaire "SF-36 Health Status Survey". The majority of the working-age population under study was aged 60-64 (30%) and 65-69 (26%), aged 55-59 and 70-74 were 12% and 18% respectively. The smallest number of those under study was aged 75-79 (8%) and 80 and older (6%). Thus, our research has shown that the living standarts of over working-age population living in a large metropolis tends to significantly decrease depending on the age and gender. There was discovered a high level of prevalence of medical and social risk factors in these individuals, which are involved in the formation of the determinant of living standarts. For the first time, it was revealed that in people over the working age, the intensity of morbidity depends on the level of determinants of living standarts. The data obtained make it possible to develop measures to improve the quality of life of people over the working age and reduce their morbidity.

[The Indices of Morbidity of Main Socially Significant Noninfectious Diseases of Population of the Republic of Tatarstan].

Socially significant diseases cause enormous damage to entire modern society and require higher expenses for prevention, treatment and rehabilitation. The most studied socially significant diseases include cardiovascular diseases, diabetes mellitus, mental disorders, alcoholism, and oncologic diseases. The study purpose is to assess incidence of major socially significant diseases, including malignant nephropathy, mental disorders and alcoholism in the Republic of Tatarstan during 1997-2017. The discussion. According to the analysis results, there was gradual increasing of incidence of malignant necrosis in the Republic of Tatarstan during the analyzed period i.e. from 240.5 cases to 412.9 cases per 100 thousand of population. The incidence of mental disorders in males was significantly higher than in females. The maximal discrepancy of indices, amounting up to 252.6 cases per 100 thousand of population, was different in 1998. The gap gradually decreased and by 2017 made up to to 62.6 cases per 100 thousand of population. The dynamics of the incidence of alcoholism characterized by increasing up to to 2001. Since 2004, gradual decreasing of indicator was in 2011-2017. The incidence of alcoholism ranged from 123.5 to 129.6 cases per 100 thousand of population. Conclusion. The decreasing in the incidence of mental disorders and alcoholism was established during study period, as well as gradual increasing of incidence of cancer in the Republic of Tatarstan.

[Evaluation of population's commitment to healthy nutrition and physical culture (by results of the questionnaire)].

One of the main tasks in implementing the foundations of state policy in the field of a healthy lifestyle of the population is the formation of optimal nutritional status and the preservation of public health. In this regard, issues of a comprehensive self-assessment of health by the population are becoming particularly relevant. The aim of the research was to identify the degree of commitment of the population to a healthy lifestyle, including maintaining a balanced diet and the presence of physical activity, as well as the relationship between the respondents' lifestyle and the presence of non-communicable diseases. Material and methods. A random survey of the adult population of the Rybno-Slobodsky district of the Republic of Tatarstan has been conducted. In total, 2346 respondents aged 21 to 74 (women - 71.7%, people with higher education - 33.2%) took part in the survey. For this study, a questionnaire was developed to identify the attitude of the population to a healthy lifestyle (HLS), which included questions regarding the physical activity of respondents, their commitment to healthy eating and diet, the existence of pernicious habits (drinking, smoking), and the presence of noncommunicable diseases. In the framework of this article, two factors were analyzed: the population's commitment to a balanced diet and physical activity, as well as the relationship of these factors with the presence of non-communicable diseases among respondents. Results and discussion. Data analysis showed that 18.8% of women and 14.1% of men always adhere to healthy eating and proper diet. Women are more committed to healthy eating than men (p<0.001). Regularly (2-3 times a week), 21.4% of women and 18.1% of men are engaged in exercise (a sport or physical activity), that is only 20.6% of respondents (p<0.001). The percentage of people committed to healthy nutrition was almost equal, both in the group of those with and without cardiovascular diseases (CVD) (19.5 and 17.4%, respectively). Among people who regularly engage in physical activity and sports (2-3 times a week), 27.5% of respondents have CVD, while among those who do not engage in exercise, 64.2% of individuals have CVD (p<0.001). Among those who adhered to a balanced diet, gastrointestinal diseases were observed in 14.1% of the respondents, while among the respondents who did not adhere to healthy eating, gastrointestinal diseases were observed in 83.7% (p<0.001). Conclusion Among respondents who adhere to healthy eating and diet and physical activity, non-communicable diseases and stress are less common (according to the respondents' answers). The results of a self-assessment (questionnaire) of public health can be used to develop targeted program of treatment and preventive measures to build community commitment in the Rybno-Slobodsky district of the Republic of Tatarstan to healthy lifestyle.

[FEATURES OF HEART RATE VARIABILITY IN PATIENTS WITH ASSOCIATIVE COURSE OF GASTROESOPHAGEAL REFLUX DISEASE AND HYPERTENSION].

The paper presents the results of a study of 83 patients with gastroesophageal reflux disease, hypertension and in their comorbidial course. The purpose of the study is to examine the characteristics of heart rate variability (HRV) in the given cohort of patients. Materials and Methods: The main group consisted of 68 patients with a mean age of 35,37 ± 10,34 years. Patients with isolated pathologies: 20 - with gastroesophageal reflux disease (GERD), 25 - with arterial disease (hypertension) without concomitant diseases. 23 patients had a combination of hypertension and GERD. The comparison group consisted of 15 healthy men. All the subjects were comparable in terms of age, sex, duration of Arterial hypertension and GERD. Results: Patients with associated course of arterial hypertension and GERD were found to have distinctions in HRV parameters, which indicate an increase in sympathetic nervous system activation and a decrease in parasympathetic influence. HRV was non-uniform in patients with different clinical and endoscopic GERD variants. In patients with endoscopically positive GERD (EPRD), there was a significant increase in both time (SDNN, SDANN, SDNN-index), and spectral parameters of HRV (VLF, HF). Conclusion: In associated course of acid dependent diseases (GERD) and hypertension, time and spectral parameters of heart rate variability significantly reduce, reaching the lowest values in patients with signs of reflux esophagitis. Comorbidity of GERD and hypertension exacerbates originally existing excessive influence of the sympathetic nervous system in patients with hypertension, leading to parasympathetic failure, and, ultimately, significantly weakening adaptive capabilities. Revealed changes in HRV parameters among patients with the given sintropy defines such a combination of diseases as undesirable, both for cardiovascular and autonomic nervous systems.

[The use of antistax in the treatment of discirculatory encephalopathy].

Authors have studied the effect of antistax on the cerebral venous discirculation (VD) in patients with discirculatory encephalopathy. Forty-three patients (mean age 46,8±1,8 years) received antistax in daily dose 720 mg during 2 months. Efficacy of treatment was assessed using the Visual Analogous Scale, Doppler ultrasound data, result of a non-invasive study of peripheral arterial tonus (PAT). After the completion of treatment course, the significant decrease of complaints, intensity of VD by the ultrasound data and parameters of arterial hardness by PAT data was observed. The excellent tolerability was reported by 61,1% patients; good one - by 38,9%. The results confirm the possibility of using antistax in neurological practice for treatment cerebral VD.

[Amantadine sulfate (PK-Merz) in the treatment of ischemic stroke: a clinical-experimental study].

A rat model of big brain ischemia with the middle brain artery occlusion was used for the study of amantadine sulfate (PK-Merz) effect on the expression of Hsp70 measured with immunohistochemical method and Western blot 12 h and 4 days after surgery. The neuroprotective effect of PK-Merz associated with the enhancement of Hsp70 expression in ischemic stroke in rats. To confirm the multivector neuroprotective action of the drug, a comparative study of clinical effectiveness of PK-Merz and magnesium sulfate was carried out in 40 patients (20 patients in each group) in the most acute period of atherothrombotic and cardioembolic strokes. Patients treated with PK-Merz exhibited the more significant restoration of consciousness and better dynamics (regress) of neurological deficit with the most intensive restoration of neurological deficit in the first day that allows to recommend the use of amantadine sulfate in the first hours of ischemic stroke and for the prevention of reperfusion damage in recanalisation therapy of ischemic stroke.