[The problem of formation of new risks of medicinal resistance of patients with tuberculosis in condition of active use of antibiotics by population under COVID-19].

In pandemic conditions, situation of active and uncontrolled use by population of antimicrobial preparations treating COVID-19 occurs. So, new risks of development of medication resistance among patients with various infectious diseases, tuberculosis included, appear. The purpose of the study is to characterize prevalence of antimicrobial preparations use by population in relationship with development of medication resistance in patients with tuberculosis during COVID-19 pandemic. Material and methods. The analysis of sales of antimicrobial medicines was implemented on the basis of published official data from the joint-stock company DSM Group presenting monthly audit of the Russian pharmaceutical market. The determination of primary antibiotic resistance was carried out in 2018-2020 on 3312 patients with tuberculosis. The modified method of proportions on liquid nutrient medium in system with automated accounting of microorganisms growth, the method of absolute concentrations and the method of polymerase chain reaction with real-time detection were applied. The results of the study. It was established that the most demanding antimicrobial medications among population were ceftriaxone, azithromycin, levofloxacin, moxifloxacin, azithromycin. At the same time, the maximum increase in sales in 2020 up to 150% as compared with of 2019 was determined in medications derived from quinolone moxifloxacin, levofloxacin, which began to be used in treatment of coronavirus infection. At the same time, these medications are traditionally used in tuberculosis treatment. But in 2020, alarming trend was established that limits treatment of tuberculosis patients. The primary resistance of mycobacteria was also established in newly diagnosed tuberculosis patients, also for the same antimicrobial medications of quinolone derivatives, and increasing in proportion of patients with primary medication resistance to levofloxacin, moxifloxacin in 2020 as compared to 2018 was 189-480%. At the same time, increasing of resistance to other antibiotics made up to 60.8% on average. Conclusion. The study results imply alarming scenario of medication resistance shifts towards very virulent and highly medication-resistant genotypes. This trend can result in conditions of successful transmission of deadly medication-resistant mutants that can seriously undermine effectiveness of implemented programs of struggle with tuberculosis worldwide.

[The quality of life of adolescents as integral characteristic of pre-nosologic health condition].

The purpose of the study is to establish characteristics of quality of life of adolescents and substantiate it as a reference criterion of pre-nosologic condition of health for mass screening observations of adolescent population. During puberty, in adolescents, mainly in girls, deterioration of quality of life is established. At that, minimal indices of quality of life were registered in adolescents 12 years old, that is probably conditioned by decreasing of level of functioning of central and respiratory systems against the background of vegetative balance disorders in this age group as compared with students of other age groups. The dependence of scales of mental component of quality of life of adolescents is established from following functional indices of central nervous system: stability of nervous reaction (r = 0.4) and level of functional capabilities of formed functional system (r = 0.4-0.5); physical component of quality of life of students from functional level of nervous system (r = 0.4-0.5), from integral indices of autonomic nervous system (r = -0.4-0.5); from indices of functional state of respiratory system (r = 0.4-0.6). The obtained data allows to consider quality of life as a reference diagnostic tool for assessing pre-nosologic health condition in mass screening observations of adolescent population.

[Hygienic estimation of functional reserves and adaptive capabilities of students].

In the article there are presented data on characteristics ofpeculiarities of the functional state of medical 1-6 years students of higher educational institutions. The results were obtained with the aid of variation pulsometry. Students were shown to have typical elevated tone of the sympathetic nervous system, especially for students of the 1, 3, 5 and 6 courses, that is confirmed by the amplitude mode (AMo), characterizing the sympathetic activity of autonomous nervous system (ANS), which is an average of the students 1 year accounted for 38.6 ± 1.89%, for students of the 3 course - 38.5 ± 1.72%, for students of the 5 year (40.9 ± 3.25 %) and the students of 6 course (46.7 ± 2.59%). There was determined the trend to the centralization of the heart rate control, as evidenced by a reduced proportion of high-frequency waves (HF) by 29.2% to 35.2%, exceeding by 3.6 to 14.4 times in waves of the very low frequency (VLF) relative to the average standard values; the high proportion of students from 41% to 52%, with a mismatch of the sympathetic and parasympathetic compartments of the autonomic nervous system in the regulation of biological processes of adaptation. For medical students of higher education institutions there are typical functional reserves reduced from 20.5 % to 97.6% and a decrease in the proportion of students with a satisfactory adaptation by 40.4% from the 1 to the 6th year.

[Evaluation of occupational risk for health of operators of petrochemical production and their physiological and hygienic stipulation].

The modernization of the technological process in the petrochemical industry has reduced the degree of influence of adverse factors of the production environment, but not eliminated the adverse impact of industrial environmental factors on the health ofworkers. Factors failed to meet hygienic standards in the workplace of operators were shown to be are electromagnetic radiation, chemicals (ammonium, nitrogen dioxide), industrial lighting. In addition operators ' work is characterized by high intensity of the labor process. Therewithal the labor of operators is characterized by the high intensity of the working process. For the operators ofpetroleum industry there is typical the risk from the combined exposure of the complex of chemical substances and noise, this risk proves both to be both potentially dangerous and increase in dependence on doses offactors and length of service. The level of individual professional risk in 32% of the operators is high; risk group for the profession is defined as high. In most cases, in operators of both small and long experience there was established the decline in the functional state of the central nervous system, the predominance of sympathetic tone in the regulation of adaptive processes, reduced reactivity of the autonomic nervous system and the more the length of service among operators the more the number of cases with poor adaptation and its breakdown.

[Organization of medical and psycho-educational services for first-grader's under condition of gymnasium education secondary education].

In this paper a model of organization of medical-psychological-pedagogical service for first graders not ready for systematic teaching in secondary education has been suggested. The results of study of the effectiveness of the introduction of medical, psychological and educational services in school are presented. Based on the dynamics of the autonomic balance, and functional reserve of biological adaptation in children at risk--not ready for medical and psycho-physiological criteria for the systematic training the need for such services on the basis of modern educational institutions has been proven in order to prevent deterioration of the health of students.

[Formation of adaptation capacities in the first graders of a gymnasium].

The paper presents the data of a study of biological and sociopsychological adjustment in the first graders of a gymnasium. It is shown that is less strained regulatory processes due to the enhanced activity of the parasympathetic part of the autonomic nervous system and to reduced impacts of the sympathetic nervous system, as well as increased functional reserves, better biological adjustment, and a larger number of children with normal sociopsychological adjustment during an academic year.