[PUBLIC AWARENESS ABOUT INTELLECTUAL DISABILITY, ITS CAUSES AND EFFECTIVENESS OF INTERVENTIONS BY SPECIALISTS].

The purpose of the study is to analyze perception of the adult population about intellectual disability (ID), its causes and effectiveness of specialist interventions. MATERIAL AND METHODS: 1119 people were interviewed (men - 441, women - 678) aged 18 to 85 years (mean age - 34.3 ± 14.5 years). Urban residents - 851 people (76.1%), rural dwellers - 268 (23.9%). Each respondent was offered one vignette describing a sick child aged 8-10 with ID: typical, dyslalic, bradypsychic and dysphoric. Mathematical and statistical processing included descriptive statistics and calculation of the χ2 distribution. RESULTS: 49.1% of the respondents have correctly recognized ID in vignettes. Out of the incorrect answers, various psychological characteristics prevailed (25.3%) of the child; negative character traits with pessimistic assessments (23.2%); illness, including mental disorders (18.6%); defects in education and upbringing (15.6%). The respondents most often (38.5%) suggested assistance by psychologists, especially to patients with a bradypsychic variant of ID, a speech therapist - with a dyslalic one, teachers - with a typical one, psychiatrists - with a dysphoric one. 85.3% of the respondents expected improvement in the child's condition after the specialist intervention. The probable causes of ID included improper upbringing and disharmonious family relations, more often in case of a typical variant, hereditary burden and early childhood diseases - in dyslalic, alcohol consumption, poverty - in dysphoric, all of the above - in case of a bradypsychic variant. CONCLUSION: The study has identified an insufficient level of public awareness of ID, reflecting its delayed diagnosis in children, peculiarities of the "channels" for seeking assistance with excessively high expectations of the condition improvements.

[FUNCTIONAL DIAGNOSTICS FOR THE NEEDS OF MEDICAL AND SOCIAL EXAMINATION OF THE RUSSIAN FEDERATION].

The problems of licensing and licensing control of medical activities in the Russian Federation are related to the fundamental responsibility of healthcare - to comply with federal standards of safety, quality and accessibility. The introduction of special diagnostic equipment into the activities of the institutions of medical and social expertise of the Russian Federation and the obligation to use it for expert needs from 2022 has become the time to answer the questions: what are the safety and quality requirements when carrying out work using special diagnostic equipment; whether the organizational and managerial schemes of the activities of institutions of medical and social expertise should change; whether this is a new level of development of medical and social expertise or an expansion of the competencies of functional diagnostics; Are we standing at the origins of a new type of medical activity, and is there much new in this? Answers to these questions should not be expected from the future, putting at risk, in a period of uncertainty and searching for solutions, the life and health of patients, but it is advisable to look in the history of domestic medicine and science, their best practices, adapting them to the strict compliance with the legal field of our country today today.

[The organization or personified treatment of diseases of coronary arteries considering analysis of bifurcation modifications].

The characteristics of development of vascular lines are important for development and improvement of of surgical treatment, decreasing risk of complications and development of personalized approach to treatment of patients. The purpose of the study is to reveal prevalence of different variants of development of common carotid artery bifurcation and to assess their significance for clinical medicine. The sample included 70 volunteers of average age 43.4 ± 10.7 years. The 3D reconstructions of MRI data 1.5 T Brivo 355 were evaluated. The observation data was grouped and processed using software Microsoft Excel 2007 and IBM SPSS Statistics 20. To summarize the data, 5 main variants of location of great vessels were identified. The most rare types of development and course of carotid arteries in bifurcation area were variants "II" and "III" (8.2% of all observations). The most common development options were "I" (51.4%) and "IV" (31.4%). The variants "I" and "IV" were determined relatively evenly.The variants "II" and "III" were found on the right in 60% and 66.7% correspondingly and "V" option was found on the left in 61.5%. The typical options of location of carotid arteries near the bifurcation (variants "I" and "IV"), 82.8% in total. The cases of ventral position of external carotid artery (variants "II" and "V") were established in 12.9%. The variant III was found in 4.3% of all cases. The distribution of vascular development options depending on the gender of patients was investigated. The study did not reveal significantly pronounced deviations in distribution of variants of vascular development, taking into account the age factor. The mentioned data permits to judge with confidence about necessity of developing personalized treatment of diseases of carotid arteries, considering their anatomical features of development in bifurcation area.

[FEATURES OF THE MANIFESTATION OF REHABILITATIVE ACTIVITY IN PATIENTS WITH PRINCIPAL DISABLING PATHOLOGIES].

The article presents the results of a psychological study of patients with principal disabling pathologies that form the main structure of disability in the Russian Federation due to malignant neoplasms: diseases of the circulatory system; diseases of the musculoskeletal system and connective tissue; diseases of the endocrine system and metabolic disorders (diabetes mellitus of the first and second types). The article presents the results of studying a sample of patients by various psychological parameters, provides statistical comparisons of psychological characteristics of patients depending on the specifics of their social situation, in which patients either claim to be disabled and are under conditions of medical and social expertise, implying the possibility of changing social status, or patients of the same nosological categories, who do not claim to be disabled and who are rehabilitating on the basis of their own personal and socio-environmental resources outside of the "disabled" status. Psychological techniques are presented, the specificity of emotional and personal parameters is analyzed and characterized, including personality frustration and experience of the significance of the disease in the spheres of life, self-esteem indicators, identification characteristics, strategies that provide rehabilitation adherence, which characterize the activity of patients in the compared groups in many ways. The conceptual position that defines the activity of patients as «rehabilitative¼ has been substantiated. The results of the study revealed statistically significant differences in psychological indicators in the compared groups of patients rehabilitating outside the "disabled" status and patients claiming to be disabled. The indicators obtained in the study indicate that the personal self-regulation of patients rehabilitating outside the «disabled¼ status qualitatively differs from the self-regulation of patients claiming disability, in terms of stable self-esteem and belief in the ability to realize life in significant areas of social functioning, in the ability of perspective planning of the future, in active self-realization of social roles, active participation in interpersonal, leisure, professional, household and other spheres, high responsibility for one's health, against the background of stable emotional perception of the current social situation of the disease.

[THE PREVALENCE OF SLEEPINESS IN THE POPULATION OF ONE OF THE REGIONS OF RUSSIA].

The aim of the study was to study excessive daytime sleepiness (EDS) among the residents of Chuvashia. 2161 residents of the republic were interviewed (men - 1007, women - 1154) aged 18 to 70 (average - 36.5 ± 13.8 years old). The Epworth Sleepiness Scale and NoSAS test were used to assess the risk of obstructive sleep apnea syndrome (OSAS). Mathematical and statistical processing included descriptive statistics, one-way analysis of variance and calculation χ2-distribution. EDS was detected in 846 people (39.2%), without any gender difference and their place of residence. The respondents with EDS were older and had a larger body mass index. With age, the number of individuals with EDS rate increased, reaching the maximum in the age group of 61-70 years. EDS was more often observed in respondents with diseases, sleep disturbances, regular alcohol consumption, smokers, as well as snoring, respiratory arrest in sleep, increased blood pressure and/or treatment for it, and tiredness during the day. The probability of OSAS by NoSAS was determined in 295 people (13.7%), in 21.4% of men and 6.9% of women; EDS was present in 45.4% of the respondents with OSAS. The spread of EDS in the population makes it possible to recommend doctors of various specialties to pay attention to this act as well as to the described risk factors in patients as highly probable grounds for qualifying OSAS, its targeted diagnosis and treatment, as well as comorbid pathology.

[MODERNIZATION OF SOCIAL PROTECTION IN THE RUSSIAN FEDERATION: PROBLEMS AND PROSPECTS OF TELEMEDICINE IN THE PRACTICE OF MEDICAL-SOCIAL EXPERTISE].

One of the main duties of the Russian Federation is to respect and protect the rights and freedoms of its citizens. In addition, the Russian Federation as a social state the activities of which are designed to provide a decent life and a high level of social protection for all categories of the citizens, without exception, by regulating social, economic and other spheres of society provides social support to all segments of the population, paying special attention to certain categories of citizens which, due to life circumstances or health conditions, need social assistance and special support from the state. The main massif in the category of socially unprotected layers of the population are people with physical disabilities. Comprehensive support for the above category of citizens is carried out, among other things, based on the decision of the medical and social examination. However, the current situation has greatly complicated the on-site examination of disabled people and predetermined the correspondence order as the only possible mechanism for medical and social examination during the coronavirus pandemic. Thus, in fact, conditions close to emergency sent medical and social expertise to the path of telemedicine.

[Organization integrated approach in treatment patients with aggravated comorbid background and lung abscess complicated by recurrent pulmonary bleeding].

The purpose of the demonstration of this clinical case was to show the effectiveness of an integrated approach to treating a patient with bacterial pulmonary destruction complicated by recurrent pulmonary bleeding. A patient with a complicated course of abscessed pneumonia of the left lung against a background of severe concomitant pathology, after a long course of antibacterial therapy for the underlying disease. Upon admission to the hospital the patient standard examination was carried out according to national clinical recommendations, non-specific antibiotic therapy was continued, indications for planned surgical intervention were determined. Against the background of the controlled treatment with broad-spectrum antibiotics for 4,5 months, the patient retained the clinical manifestations of the disease and decay cavity in the left lung, which was an indication for surgical treatment. After short-term preoperative preparation, tracheobronchial catheterization of an abscess of the upper lobe of the left lung was performed. When examining the patient 1,5 months after the operation, his absence of complaints and the closure of decay cavities in the lung were recorded, which is a criterion for effective treatment. The clinical example demonstrates the high effectiveness of the personalized approach to treating patients with a burdened comorbid background and complicated pulmonary destruction, which are threatened both by the development of surgical complications and by the occurrence of postoperative complications when using resection methods of treatment.

[TREATMENT AND DIAGNOSTIC ALGORITHM WITH THE APPLICATION OF MODERN BRONCHOLOGICAL POSSIBILITIES IN THE TREATMENT OF A PATIENT WITH INCREASING RESPIRATORY OBSTRUCTION OF UNKNOWN ETHIOLOGY].

More and more often, medical workers have to provide assistance to patients with HIV infection with acute disorders of vital functions who require intensive care and resuscitation. The main task of clinicians is to quickly stop the symptoms of secondary diseases that have led to the complications (specific and nonspecific) so that the patient can start or continue antiviral therapy. The aim of this work was to present the first experience of successfully treatment of a patient with progressive HIV infection using stenting of the main bronchi with their critical tumor stenosis in complex treatment. Conducting temporary endoscopic recanalization of the lumen of the large airways made it possible to avoid transferring the patient to artificial ventilation of the lungs, to carry out the necessary complex of diagnostic and therapeutic procedures, to restore ventilation and aeration of the lungs, which led to an increase in blood oxygenation and some improvement in the patient's general well-being.

[Tubal pregnancy: the experience of early rehabilitative treatment]. / Trubnaia beremennost': opyt rannego vosstanovitel'nogo lecheniia.

The surgical treatment for tubal pregnancy including laparoscopy and antibacterial therapy were combined in 30 females with early start (on postoperative day 1) of rehabilitation: psychotherapy, diet, therapeutic exercise, low-frequency magnetotherapy. Hysterosalpingography and dynamic dopplerography assessed the effect as good.