Успешное развитие трансплантологии определяет не правовая модель, а позитивное общественное мне- ние в отношении донорства органов. Цель. Анализ отношения белорусского населения к посмертному донорству и трансплантации органов и выявление факторов, наиболее на него влияющих. Материал и методы. Сбор данных проводился методом анкетирования при помощи Google формы, объем выборки – 286 респондентов. Обработка данных осуществлялась с помощью программы SPSS Statistics путем CHAID анализа. Результаты. 94,4% опрошенных позитивно относятся к донорству органов и трансплантации, но лишь 50% респондентов согласны на изъятие своих органов после смерти. Больше всех к этому склонны люди, имеющие позитивное отношение к донорству, а также обладающие минимальной осведомленностью и изучающие научную литературу по данному вопросу. Основной мотив людей, согласных на забор органов – желание спасти кому-то жизнь, основной мотив неготовности дать такое согласие – опасения врачебной ошибки или злого умысла со стороны медработников. Выводы. Для развития трансплантологии необходимо создать позитивное общественное мнение в отношении донорства органов и трансплантации, повысить правовую грамотность населения.

Acute renal graft rejection (ARGR) may be the cause of its dysfunction and loss in the postoperative period. Objectives. To identify possible predictors of ARGR based on the analysis of the alleged risk factors on the part of a recipient. Material and methods. A retrospective study of medical cards of 248 patients who underwent cadaveric kidney allotransplantation (CKA) was carried out. The influence of the following factors on the probability of developing ARGR was assessed: weight, age, blood group, Rh factor, gender of a recipient, duration of renal replacement therapy (RRT). Data processing was carried out by CRT analysis for the “decision tree” method (SPSS Statistics 22 program), and also using Pearson’s chi-square test (Statistica software package). Results. The study has revealed that being on RRT for more than 9.5 months statistically significantly increases the likelihood of developing ARGR in the postoperative period, especially in the group of patients with IV (AB) blood type. Conclusions. Factors such as the duration of RRT for more than 9.5 months and the IV(AB) blood group a type of a recipient, both individually and in combination, can be considered as predictors of ARGR development. Therefore, measures to reduce the incidence of ARGR should be aimed at reducing the duration of RRT, as well as restrictions of recipients with IV(AB) blood group type on being under RRT for more than 9.5 months.

The successful development of transplantation is not determined by the legal model, but by the positive public opinion regarding organ donation. Purpose: to analyze the attitude of the Belarusian population towards posthumous donation and organ transplantation and to identify the factors that affect it most. Material and methods: data collection was carried out through a questionnaire survey using a Google form; the sample size was 286 respondents. Data processing was carried out using the SPSS Statistics program by CHAID analysis. Results. 94.4% of the respondents have a positive attitude towards organ donation and transplantation, but only 50% of the respondents agree to the removal of their organs after death. People who have a positive attitude towards donation, as well as those who have minimal awareness and study the scientifi literature on this issue, are most inclined to do this. The main motive of people who agree to organ harvesting is the desire to save someone's life, the main motive for unwillingness to give such consent is fear of a medical error or malicious intent on the part of health workers. Conclusions. For the development of transplantation, it is necessary to create a positive public opinion regarding organ donation and transplantation and to increase the legal literacy of the population

Objectives. To study the impact of participation in the work of medical institutions providing assistance to patients with COVID-19 on the professional self-identification of students. Material and methods. The study was carried out on the basis of the educational institution «VSMU». Inclusion group: medical students of the 4th-6th years who took part in the work of medical teams providing assistance to patients during the period of an epidemic rise in the incidence of respiratory infections, including SARS-CoV-2 coronavirus one. The survey was conducted in the form of an anonymous questionnaire. To segment the respondents according to certain criteria, depending on their answers, the «decision tree» method was used. Results. In the course of the study, it has been found that 1.8 times more often the question «To what extent did you manage to combine your work and studies?» the answer «everything turned out well» was given by the students who indicated that they had a curator who helped them to cope with their professional adaptation difficulties. The higher the self-esteem of the personal level of knowledge and skills was, the more often students chose the answer that they were definitely not going to leave medicine and change their profession. Conclusions. Based on the survey data, one of the most significant factors influencing the adaptation and development of practical skills is the high-quality work of university teaching staff and a physician-curator. An important role in professional adaptability is played by the solution of psychoemotional problems of working students through the establishment of their close interaction with the social, pedagogical and psychological service of the university, professional training centers.

The aim of the research. To conduct a cluster analysis of the assessment profile of students who participated in work of medical organisations providing care to COVID-19 patients to develop recommendations for its correction. Material and methods. The study was carried out at the premises of Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University (KrasSMU). The study group was constituted by 66 students in 3-6 years of study of the Medical and the Paediatric faculties of the University who took part in activities of medical organisations providing healthcare to patients with COVID-19. The items were presented in the form of binary questions and ranking scales. The analysis of qualitative attributes was carried out in the form of relative values with calculation of the standard error of the proportion. For ranking and nonparametric quantitative characteristics, the mode, median, centiles (Me [P25; P75]) and other nonparametric criteria for comparative statistics and communication statistics were used. For segmentation of respondents according to some criteria, depending on the answers, the method “two-step cluster analysis” and the method of “decision tree” were used. Results. The results of the study indicate a high motivational component related to practical medical activity of medical students during the difficult epidemiological situation since 94.1% of the respondents declared the readiness to support practical healthcare. Almost half of the surveyed 47.0% of students included in cluster 2, in contrast to students of clusters 1 and 3, are characterised by a high opinion on the degree of their contribution to the struggle against the COVID-19 epidemic and a high level of knowledge and skills, rating themselves at about 9.0 points out of 10 possible. In addition, the results of the study indicate an association between the level of students’ self-esteem in regard to their contribution to the fight against COVID-19 with the level of the students’ self-esteem of knowledge and skills and the duration of work in a medical organisation. Conclusion. The analysis performed has made it possible to formulate guidelines for support of medical students’ professional attitudes within the framework of practice-oriented education, including distance learning.

The article devoted to consideration of ethnic feature of primary choice of subjects of health preservation by residents of the Republic of Khakassia. It is established that at equal consumption of medical care in out-patient and polyclinic organizations, among the ethnic population of there is higher demand of services of traditional healers, especially representatives of shaman practices. The primary effecting on decision making in choosing health care institutions is provided by folk customs and family traditions received from senior relatives that is especially expressed among the Khakass ethnos.

Considering the tendency for the increasing number of elderly people, the problem of improving life quality of this category of population become more relevant. Senile asthenia (“frailty”) is one of the key clinical conditions that is currently the most common and age-associated (geriatric syndromes) one leading to loss of autonomy, increased hospitalization, as well as to disability and mortality in elderly people. The article reviews domestic and foreign literature data on issues related to the peculiarities of this condition, tactics of managing patients with SAS, as well as existing measures to prevent the development and progression of “frailty” in elderly patients.

Стратегии и направления организации медико-психологической помощи в пост-пандемийный период О. В. Волкова, П. А. Шестерня Красноярский государственный медицинский университет имени профессора В. Ф. Войно-Ясенецкого, Красноярск 660022, Российская Федерация Резюме.В статье представлен анализ актуальной ситуации периода пандемии COVID-19 с точки зрения клинической психологии и общей врачебной практики.Описаны потенциальные негативные последствия, касающиеся психологического состояния и связанных с особенностями соматического здоровья населения.Систематизированы последние данные, представленные в зарубежных исследованиях за первый квартал 2020 года, затрагивающие проблему пандемии коронавирусной инфекции с позиции психологии и биомедицины.Проведен сравнительный анализ психологических трудностей с которыми встречается население в настоящий момент времени, со структурой феномена выученной беспомощности.С учетом глобального опыта

The article considers analysis of possibilities of eliminating deficiency of competence in health care system based on of specific models and algorithms. One of the dominating problems in Russian health care is determined the deficiency of medical workers, especially keen in the primary medical care. The systemic view of present modes of solving the given problem considering legislation currently in force and social psychology. Particular attention is paid to development of strategy and tactics of training population in medical sanitary competences preserving principle "Do no harm" because modern technologies permit patients to self-control their health but at that the risks of negative consequences of self-treatment are augmenting. The presented results can support health care specialists in development of strategy of elimination of manpower deficiency.

The purpose of this study was to explore the relationship between psycho-physiological markers of human health and dermatoglyphic indicators in young people. Materials and Methods: The study included 920 healthy volunteers aged between 18 and 21 years. All volunteers underwent the following examinations: EEG, an assessment of the anxiety level according to the BAI, and dermatoglyphic scanning. Results: According to the data obtained. there was a statistically significant strong negative correlation between the stress load indicator and dermatoglyphic data, such as the summary' delta index (DI) and summary ridge count. A strong positive correlation was found between the percentage of whorls and stress (r=0.88). The predominant increase in anxiety is characteristic of persons with total ridge count (TRC) on the thumb of the right hand in the range from 19 to 23. Conclusion: Results demonstrate the interrelationships (association) between psycho-physiological (anxiety level, stress load indicator) and dermatoglyphic markers (DI, TRC and whorl pattern type) in young healthy people.

ОПЫТ РАБОТЫ КАБИНЕТА ПО ПРОФИЛАКТИКЕ ИНСУЛЬТА В КРАЕВОЙ КЛИНИЧЕСКОЙ БОЛЬНИЦЕ Г. КРАСНОЯРСКАИ

The attempts were made to analyze the causes of deficiency of the medical personnel in the Krasnoyarsk kraii and to study possible means of amelioration of situation in the region. The graduates of the Krasnoyarsk state medical university considered as a potential resource for elimination of medical personnel deficiency in regional health care system. The study of opinions of graduates of 2016 on specialty of «Medical business» on the basis of questionnaire survey. The development of questionnaire was implemented on the basis of pilot interviews. The data processing was implemented using licensed statistical software IBM SPSS Statistica 22.0. The methods of cluster analysis were applied alongside with calculations of descriptive statistics. The study was targeted to detecting factors effecting will of young specialists to work in districts of the Krasnoyarsk kraii and also establishing their ideas about further professional activities. All graduates were divided between 5 specific groups depending on their ideas about preferable conditions and place of employment. The respondents wishing to work in polyclinics are the only group where not salary nor conditions of work nor time of working under guidance of tutor are important and it's not easy to motivate them with anything else. More than one third of respondents perceive their own future without the limits of Krasnoyarsk. The key factors effecting wish to work in rural area are housing habitation, salary (higher than 5060 000 rubles), well-developed infrastructure and availability of competent physicians of narrow specialization at the given settlement.

The aim of the study is to demonstrate morphological reconstruction of the main arteries of rabbit hind limbs by perivascular implantation of sulfated chitosan in an atherosclerosis model. Materials and Methods. The study was performed on 24 rabbits divided into four groups of 6 animals. The rabbits in the experimental group kept on intensive cholesterol diet for 110 days were implanted 1% water-soluble sulfated chitosan gel in the perivascular fascial compartment of the saphenous artery and the femoral artery of the left hind limb. Some animals that were also kept on cholesterol diet did not undergo implantation. The group of rabbits fed with normal vivarium diet were subjected to perivascular implantation of the biopolymer, while a group of 6 rabbits also kept on normal diet served as the intact control. We estimated wall thickness of the femoral artery and the saphenous artery, their average lumen diameter, the mean lumen area of the newly formed vessels in the adventitia. Results. Daily intensive cholesterol diet for 3.5 months in rabbits leads to vivid signs of atherogenic inflammation forming in the intimal and medial layers of the main arteries of the hind limbs. Introduction of 1% water-soluble sulfated chitosan gel into the paravasal compartment of the saphenous and femoral arteries promotes formation of a large number of microvessels at the polymer resorption site increasing the specific area of new vessels. Morphological reconstruction of the main arteries is achieved through reducing the vascular wall thickness, increasing the vessel lumen and the number of para-adventitial microvessels. Conclusion. Implantation of sulfated chitosan into the perivascular compartment allows achieving the effect of therapeutic paravasal angiogenesis and inhibiting the early signs of atherogenic inflammation.

The article reviews foreign and Russian literature on the organization of headache (HA) treatment. The economic burden of HA has been convincingly proven. The medical aid appealability of patients with HA has been established to be low (20–60%). This is frequently due to a lack of confidence in the success of a doctor's advice. The paper considers various models for the management of patients with HA in foreign countries. There is a low reliability of the diagnosis established during questionnaire surveys. Whether the patients can be managed using telecommunications, such as telephone and online counseling, is described. In Russia, there are substantially fewer treatment options for patients with HA; at the same time the available models are inclined to foreign ones. The paper describes world and Russian practices in educating the physicians and underlines the need for patients with HA to have educational classes. The sites where both the doctor and the patient can receive relevant information about HA are considered.

Министерство образования, науки и молодежной политики Забайкальского края, Чита

ОЦЕНКА СОМАТОНЕЙРОПСИХОЛОГИЧЕСКОГО ЗДОРОВЬЯ ЧЕЛОВЕКА Н. Н. Медведева, В. Г. Николаев, С. Н. Деревцова, Л. В. Синдеева, А. А. Романенко, М. М. Петрова, Н. А. Шнайдер, А. В. Шульмин ГБОУ ВПО Красноярский государственный медицинский университет имени проф. В. Ф. Войно-Ясенецкого Министерства здравоохранения РФ, ректор – д. м. н., проф. И. П. Артюхов; кафедра анатомии и гистологии человека, зав. – д. м. н., проф. Н. Н. Медведева; кафедра поликлинической терапии, семейной медицины и ЗОЖ с курсом ПО, зав. – д. м. н., проф. М. М. Петрова; кафедра медицинской генетики и клинической нейрофизиологии ИПО, зав. – д. м. н., проф. Н. А. Шнайдер; кафедра общественного здоровья и здравоохранения с курсом социальной работы, зав. – д. м. н. А. В. Шульмин.

In the article the characteristic of medico-demographic deaths caused by renal cancer among the population of Krasnoyarsk region is given. There are results of research with use of modern approaches of losses of health definition. The evaluation of medico-demographic deaths caused by renal cancer among the population of Krasnoyarsk region for the period 2010–2012 with using DALY method was produced. The largest difference in values of the indicator DALY was observed between male and female population in 2011 by a factor of 4,7. The maximum gap in DALY indicator between male and female population was observed in the group of 55–59 years. More than half of DALY deaths among male involve working age