Nosological Forms Of Diseases Research Articles

National Mortality Tendencies of Population in Ukraine and the Kharkiv Region

The purpose of the study was to determine national tendencies of mortality in Ukraine and the Kharkiv region. Materials and methods. Data from official sources of statistical information of Ukraine were used and systematic analysis and generalization of the obtained data was performed and tendencies of mortality in Ukraine were calculated. Results and discussion. According to the dynamics of mortality rates of the population of Ukraine in 2010–2019, there was a decrease in almost all nosological forms of disease. For some groups of diseases there was a tendency of increasing mortality per 100 thousand population with tendencies for the general population +3.0% and +3.9%, for men +3.4% and +1.1% and women +2.2% and 8.3%. Obtained results on the overall dynamics of declining tendencies in mortality due to major diseases in recent years and their growth due to some nosologies and structural characteristics of the main causes of mortality are in complete agreement with other studies. The study noted an increase in tendencies of mortality of population of Ukraine in 2010–2019 (per 100 thousand population) in several disease groups: neoplasms (tendency +3.0%: males +3.4 %, females +2.2%) and diseases of digestive system (respectively +3.9%: +1.1% and +8.3%). The Kharkiv region leads among other regions in 2019 in such classes: overall – 3rd place (40,611 cases), diseases of the circulatory system – 2nd (28,079), coronary heart disease – 2nd (21,154), diseases of the digestive system – 2nd (1,624), external causes of death – 2nd (2,225), neoplasms – 3rd (5,714), cerebrovascular disease – 4th (5,009), diseases of the respiratory system – 4th (810), diseases of the genitourinary system – 4th (196) and congenital malformations, deformities and chromosomal abnormalities – 4th (69). Significant increase in tendencies found in the Kharkiv region during 2018–2019 both in absolute counts and per 100 thousand: complications of pregnancy, childbirth and postpartum period (+300.0 and +293.8%), certain conditions that occur in the perinatal period (+14.3 and +24.3%), other causes (+13.8 and +14.5%) and urolithiasis (+12.0 and +12.9%) with defined structural characteristics of mortality in diseases of the circulatory system (69.09%), neoplasms (14.04%) and accidents and trauma (5.26%). Conclusion. The obtained results of the general dynamics of decreasing mortality tendencies due to major diseases and their growth due to some nosologies and structural characteristics of the main causes of mortality in Ukraine completely coincide with the data of other studies

Fundamentals of photodynamic therapy, clinical practice and prospects for use in pediatric surgery. Review

The paper provides a review of domestic and foreign literature on photodynamic therapy, which is mainly used by oncologists in the treatment of adult patients and is little known to pediatric surgeons. The aim of this work is to describe the history of the formation, principles and mechanisms of photodynamic therapy, the main groups of photo sensitizers, areas of clinical application and prospects for wider use in pediatric surgery.
 Literature sources were searched in the databases in Russian eLibrary and English Medline and PubMed. The following keywords were specified for the search: photodynamic therapy, dysplasia, metaplasia, angiodysplasia, Barretts syndrome, children. 865 papers were found, of which 66 were fully consistent with the purpose of our study and were analyzed.
 The data presented in the review of the literature indicate the high efficiency of the method of photodynamic therapy in the treatment of a number of diseases, mostly in oncology. In addition, the work contains theoretical calculations and separate reports on the effectiveness of the method in the treatment of dysplasia of varying degrees in children.
 Taking into account the minimally invasiveness of the technique, the relative cheapness of photosensitizers and equipment for generating laser radiation, it is possible to create a basis for conducting research on the treatment of children with various dysplasias, epithelial metaplasia, and vascular malformations. Another promising direction is the development of technologies for the use of photodynamic methods for the treatment of severe forms of pyoinflammatory diseases in children.
 In childhood surgery, there are nosological forms of diseases where the method of photodynamic therapy has the prospect of effective use. Limitations on the scope of this article do not allow for a detailed analysis of the existing experience in the use of photodynamic therapy in children, which will need to be done in subsequent works.

The Follow-up of the digestive system (for primary care specialists: internist, general practitioner, paramedic) The experience of the Perm region

These recommendations are intended for primary care professionals: internists, general practitioners, paramedics and include a statement of the basic requirements for the follow-up of patients with a number of diseases of the digestive system. The main material of the methodological recommendations is presented by adapted sections from modern clinical recommendations of specialized societies on certain nosological forms of diseases and current regulatory federal documents on dispensary supervision of the adult population. The guidelines were approved by the Perm Regional United Organization “Professional Medical Community of the Perm Region” and the Ministry of Health of the Perm Region. Also, the main provisions of the recommendations were presented and approved at the National Congress of the Society of Therapists (November 19, 2021).

Оказание медицинской помощи пациентам с острой глазной патологией в условиях пандемии

Purpose. Comparative assessment of frequency and structure of patients who underwent inpatient treatment for acute eye pathology before and during the coronavirus infection (COVID-19) pandemic. Material and methods. A quantitative analysis was carried out in 826 patients treated for various acute eye pathologies in the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution (the Branch) for the time periods: from May 2018 to February 2020 (the first) and from March 2020 to the end of December 2021 (the second). An assessment of frequency and nosological forms of diseases was carried out, examples of most severe cases of diseases and injuries were given.Results. For the first period, 318 patients were treated, for the second period - 508 patients. In the second period, there was significant increase in number of patients with acute eye pathology by 1.6 times. In both periods, patients with inflammatory lesions of tuveal tract prevailed: before the pandemic - 179 eyes, during the pandemic - 243 eyes. Also in the second period, 29 cases of severe burns of the cornea - II and III degrees were registered. Conclusion. All patients who applied to the Branch during study periods and needed emergency ophthalmic care were provided in timely manner and in full. The COVID-19 pandemic has made significant adjustments to work of the entire Branch, including work of Complex Rehabilitation Treatment Department in form of increase in number of patients with acute eye pathology by 1.6 times.

Research of the microscopic structure of adhesive splinting constructions containing different chemical nature of reinforcing tapes in their structure

Relevance. The questions of research of physical and chemical characteristics of reinforcing tapes, peculiarities of chemical connection of composite material and reinforcing component of the splint, physical indicators of strength of their connection, optimal thickness of composite material for reinforcing tape covering remain not fully studied and require further work in this direction in order to optimize splinting stages of mobile teeth in various clinical situations and nosological forms of diseases. The aim of the study - to study the microscopic structure of splinting constructions containing in their structure reinforcement tapes based on organic and inorganic matrices. Material and research methods. 10 groups of 10 specimens of splinting construction, with different chemical composition of reinforcing tapes, 8 of which were made using tapes based on inorganic matrix, 2 - based on organic. Results of the study. Microscopic examination of the splinting samples showed good integration of the composite polymer matrix into the structure of the tapes in the samples using inorganic matrix-based tapes. Peripheral layer delamination was not detected, pores in the splint thickness were absent or were single, which may be due to silanization of glass fibers incorporated into the thermoplastic polymer and light-curing composite matrix. Conclusion. Resin-impregnated inorganic parallel fiberglass tapes impregnated in the factory showed an advantage compared to woven and braided tapes and unimpregnated tapes.

THE ADVANCEMENT OF NONSPECIFIC PROPHYLAXIS AND THERAPY PSEUDOTUBERCULOSIS AND INTESTINAL YERSINIOSIS

Recent years have witnessed the development and clinical implementation of the new approaches to prophylaxis and treatment of different nosological forms of diseases - combination of conventional therapy and immunocorrection. The review analyzes present-day state of nonspecific prophylaxis and treatment of pseudotuberculosis and intestinal yersiniosis. Information is presented on the effectiveness of immunomodulators, products of vital activity of plant cells and sea creatures, prebiotics, immunoglobuline complex (CIP) in prophylaxis and therapy of these diseases.

Nosological profile of infectious pig diseases in the Krasnodar region

The authors analyzed the main indicators of nosological profile and epizootic manifestations of infectious diseases of pigs in the Krasnodar territory for the period from 1990 to 2019. As a result of the analysis of pig diseases of infectious etiology, 24 nosological forms of diseases were established. During the study period, 3006 disadvantaged areas were registered in the province, where 472.6 thousand heads of pigs of various age and sex groups fell ill, of which 131.3 thousand fell ill. In the nosological structure of infectious diseases of pigs, bacterial, viral and chlamydial infections occupy a significant share: colibacteriosis-34.0 %, salmonellosis-20.3, pseudomonosis-9.9, streptococcosis-7.9, pasteurellosis-5.6, viral gastroenteritis-4.2, erysipelas-3.4, African swine fever-2.3, chlamydia-0.5 %. The largest number of points that were affected by infectious diseases of pigs was registered in 1999 - 354; of these, 4.8% were viral diseases: aujeski disease, viral gastroenteritis; 94.9 - for bacterial: streptococcosis, diplococcosis, colibacteriosis, edema, leptospirosis, pasteurellosis, salmonellosis, erysipelas, pseudomonosis; 0.3 % - for chlamydia. The smallest number of points with problems related to infectious diseases of pigs was registered in 2013: in 1 point with problems related to African swine fever (ASF), 3 heads fell ill. The number of sick animals was the highest in 1994: 66.9 thousand animals fell ill in 80 disadvantaged areas, of which 23.4 thousand died. The greatest economic damage to pig farms was caused by ASF. This infection led to a reduction in the number ofpigs in the Krasnodar territory from 1200.0 to 300.0 thousand heads. In the period from 2008 to 2019, ASF was registered on the territory of the province in 33 out of 44 municipalities, in 79 disadvantaged localities, including 13 among the wild boar population. In total, 7.4 thousand heads of domestic pigs and 157 wild boars fell ill in the centers of ASF, 33 objects infected with the ASF virus were identified.

Обеспеченность витамином D у детей при воспалительных заболеваниях кишечника

Objective. To study vitamin D status in children with inflammatory bowel diseases (IBD) depending on the diagnosis, gender, age and a season of examination. Patients and methods. The study included 244 children (130 boys and 114 girls) aged 3 to 18 years. The patients were divided into 2 groups depending on the nosological form of disease: Crohn’s disease (CD) – 130 children, ulcerative colitis (UC) – 114 children. Blood vitamin D levels were determined by the method of competitive electrochemiluminescence. Results. Normal levels of vitamin D (>30 ng/ml) were found only in 11.1% of children with IBD (in 11.5% with CD and 10.5% with UC). Vitamin D status corresponded to deficiency levels in 65.9% of cases, of them 15.2% had deep deficiency (<10 ng/ml). Vitamin D status decreased with increasing age of the patients (ρ = -0.2686). No statistically significant differences were found in vitamin D levels that would be dependent on the season of examination, neither were they found in groups of patients with CD and UC. Conclusion. The study showed an extremely low vitamin D status in patients with IBD. The problem of assessing vitamin D levels in children with IBD and its monitoring as well as development of individual algorithms for supplementation remains topical. Key words: vitamin D, inflammatory bowel disease, Crohn’s disease, ulcerative colitis, children

Combined pathologies of liver, kidneys and pancreas in domestic cats

Various infectious and invasive diseases, as well as individual metabolic disorders caused by poisoning and non-infectious diseases lead to multiple organ pathologies. The pathogenesis of combined lesions in parenchymal organs is due to their anatomical and functional relationship. The aim of the research was to study the nosological forms of non-infectious diseases of liver, kidneys and pancreas in domestic cats, to establish the proportion of multiple organ pathologies and to compare their clinical indicators. The article presents the results of multiple organ pathologies spreading in domestic cats, describes the main nosological forms of diseases, their clinical picture, biochemical and ultrasound indicators. 234 animals of different sexes and different ages were studied in the experiment. Diseased animals were diagnosed based on the results of clinical, biochemical and ultrasound studies. Liver diseases were diagnosed in 18.3 % of cats, kidney - 16.3 %, pancreas - 11.5 % of cats. Multiple organ pathologies were established in 28.7 % of animals, including hepatonephritis in 16.7 %, hepatopancreatitis - 9.0 %, hepatopancreonephritis - 3.0 %. Among nosological forms of diseases in sick cats, hepatonephritis, chronic glomerulonephritis, chronic hepatitis, and fatty degeneration of liver were more common, and only in one case - cirrhosis.

Assessment of the incidence of diseases of the skin and subcutaneous tissue in students studying in the Kaliningrad enclave

During the analysis of morbidity by nosological forms of diseases of the class «Diseases of the skin and subcutaneous» cellulose in cadets of two higher military educational institutions for 2012–2017, studying in the Kaliningrad enclave, the features were revealed. Diseases included in only three blocks were registered: infections of the skin and subcutaneous tissue; dermatitis and eczema; other diseases of the skin and subcutaneous tissue. The share of the first block reached 80.4–73.4 %; the second — 18.2 – 20 %, the third 1.4 – 5.8 %. The level and duration of the period of prevalence of the first block of diseases over the second was 4 among cadets at the university № 1, in the university № 2–3 years. The leading diseases were pyoderma (at university No. 1 – 120.9 ± 5.6‰, No. 2 – 42.5 ± 4.3‰), skin abscess, furuncle and carbuncle (No. 1 – 40.2 ± 3.4‰, No. 2 – 15.2 ± 2.6‰). The incidence of pyoderma in each university prevailed among cadets of the first three years of study over abscess, boil and carbuncle. Pyoderma in the university № 1 in each year of study was recorded reliably less often from 1 to 4 courses. Abscess, furuncle and carbuncle were registered significantly more often in the first course than in the second, in the second or fourth courses — the same, and only in the fifth course significantly less often than in previous courses. Pyoderma among cadets of 1 – 2 years of study at the university № 2 was registered in the same way, in the third-fifth courses — 2.8 – 4.4 times less often. Abscess, furuncle and carbuncle were registered by years of study without significant differences. Differences in the incidence of skin and subcutaneous tissue infections among cadets of the two universities indicated the presence of specific health risk factors. This necessitates further retrospective studies and full-scale (microbiological, immunological, etc.) tests.

Issues of the effects of lead on circulatory and respiratory diseases

Introduction. At the present economic stage of development of the industry there is a technological modernization of productions, decrease in operating concentrations of chemical substances in this connection reduction of frequency of occurrence of classical forms of intoxications is observed. Th is applies to the lead, occupying the leading position among industrial and environmental contaminants, which has one of the highest indexes of technological social and environmental significance.The aim of the study was to assess the impact of metal (lead) as a trigger of various nosological forms of diseases of the circulatory and respiratory organs.Materials and methods. Clinical and functional, laboratory examinations of 130 persons were carried out: among them 90 employees of the plant for the processing of lead batteries and cables. Th e comparison group included workers who had no contact with lead (40 people), comparable in age and experience.Results. Analysis of the structure of non-professional diseases of internal organs showed that the leading place is occupied by diseases of the upper and lower respiratory tract (58% and 26%), circulatory organs (40%).Conclusions. Th e results of the clinical and laboratory examination of workers of the lead batt ery recycling plant indicate the importance of combined exposure to lead as an important risk factor for cardiovascular diseases, pathology of the upper and lower respiratory tract.

The modern characteristics of occupational morbidity of agriculture workers

On the basis of updated data from 82 subjects of the Russian Federation multivariate analysis of occupational diseases of agricultural workers was implemented. It is established that in unhealthy work conditions are characteristic for 30% of workers in the agricultural sector. In the enterprises of agriculture, the percentage of workplaces not meeting sanitary hygienic standards made up to 35%. The high etiologic pathogenic relationship between nosological form of disease and working conditions in the profession is established. Most often, the occupational pathology was developed in agricultural workers in case of conditions of physical overload (37.2%), effecting of physical factors (26.8%) and contact with infected animals (14.6%). In nosological structure of accumulated occupational diseases the first place took radiculopathy of cervical and lumbar sacral levels (23%), the second - vibration disease (15.3%), followed by brucellosis (14.6%), the fourth - neuro-sensory deafness (11.5%). The regions of the Russian Federation are characterized by pronounced heterogeneity both related to general level of registered occupational diseases and its nosological spectrum. In the whole, in Russia during 2011-2015 persistent trend of decreasing of occupational diseases morbidity of agricultural workers was marked.

MOLECULAR TYPING OF METHICILLIN-SUSCEPTIBLE STAPHYLOCOCCUS AUREUS (MSSA), ISOLATED FROM MONKEYS, BASED ON COAGULASE GENE POLYMORPHISM

Staphylococcus aureus is a very dangerous microorganism that causes more than 100 nosological forms of disease in humans and animals, including pneumonia, skin and soft tissue infections, food toxicoinfections, wound abscess, etc. Numerous studies on genotyping Staphylococcus aureus, isolated from humans, food and bovine mastitis have been carried out. The lack of information on the genotyping of these pathogens detected in monkeys living in captivity served as a stimulus to conduct a similar research, since staphylococcal infections in the primates are widespread. The present study is devoted to the study of the polymorphism of a variable region of the coagulase gene and to the typing of Staphylococcus aureus isolates from monkeys of different species kept at Adler monkey farm. 115 Staphylococcus aureus isolates were studied using phenotypic and molecular genetic methods. Genotyping was performed using PCR, real-time PCR and PCR with subsequent restriction fragment length polymorphism analysis (PCR-RFLP). A real-time PCR analysis allowed to classify all Staphylococcus aureus as methicillin-susceptible staphylococci (MSSA). After amplification of a variable region of the coagulase gene, 4 types of amplicons of 600, 700, 800, and 900 bp were generated. This data demonstrates structural differences of this gene in the studied isolates. The coagulase gene of 900 bp prevailed. The use of the Cfo1 endonuclease allowed to identify 23 different restriction profiles of the coa gene, but only three of them predominated. Staphylococcus aureus bacteria with seven types of coagulase gene were found only in the lungs of monkeys that died of pneumonia. The results obtained suggest that these isolates have tropism for lung tissue. Among Staphylococcus aureus isolated from pneumonia cases, isolates with three types of the coa gene prevailed. Staphylococcus aureus of eleven types of coagulase gene can be attributed to the invasive isolates, since they were detected in the tissues of various organs. Staphylococcal infection in monkeys kept at the monkey farm is caused by genotypically heterogeneous population of Staphylococcus aureus.

Analysis of the states of the activity of the laboratory service of the industrial region of Ukraine and the ways of it optimization.

The purpose of the study is to analyze the activity of the laboratory service of the Dnepropetrovsk region, to develop and substantiate the concept of optimizing its work. We have carried out in dynamics the analysis of the laboratory service of the Dnepropetrovsk region: its structure; staffing level of doctor-laboratory assistants, biologists and laboratory assistants; carrying out laboratory researches, their structure and quality, as well as the state of laboratory equipment and reagent base. The methods of research used: bibliosemantic – systematic and historical analysis of domestic and world literary sources on the organization of laboratory service; reports and legislative documents on the activities of the laboratory service of the region; systematic analysis – to identify the existing shortcomings and positive experience in the training system, the formation of an effective team of employees, quality of the provided laboratory services, ways to optimize the work of the clinical-diagnostic laboratories (CDL); medical statistics for the analysis and interpretation of research results, logical mode­ling – for the development of the concept. The article covers the state of the laboratory service of the region: changes of its structure due to restructuring of the treatment-prophylactic institutions (TPI), the reforming of primary medical-sanitary care; development of family medicine – the number of hospital decreased by 39,8% in 2017 as compared to 1995, the number of hospital – by 38% beds per 10 thousand population; At the same time, the number of outpatient cl­inics increased by 70,1% during this period, which is in line with the WHO recommendations for provision of out­patient care to 80% of patients. Coefficient of provision of population of the region with doctor-laboratory assistants per 10 thousand of population is 0,68; staffing level of doctor-laboratory assistants with of medical doctors by natural persons is 25,9% with tendencies to decrease. The staffing level of specialists with higher non-medical education is 63.6%. Clinical and diagnostic laboratories in most cases have a minimum of equipment that is often outdated, without means for automatization equipment. Problems of the laboratory service of the region consist in the presence of a large number of low-power CDLs, performing the minimum set of diagnostic tests, lack of programs of research in the framework of separate nosological forms of diseases at different stages of medical care provision, acute shortage of high-tech equipment; lack of a systematic approach; the high turnover of personnel due to unsatisfactory material and technical and economic condition of the service and low wages. The main ways of optimization of laboratory services are offered.

ASSESSMENT OF THE CURRENT ECONOMIC EFFICIENCY OF TREATMENTOF PATIENTS WITH OSTEOARTHRITIS IN SAINT-PETERSBURG AND ITS PERSPECTIVES

The article analyzed the features of the existing system of treatment’s payment in patients with osteoarthritis. The main features of the billing during the transition of the patients hospitalization pay- ment to the system using diagnostic-related groups defines. The main advantages and disadvantages of these systems are analyzed, ways of the economic results optimization of osteoarthritis patients treat- ment are determined with in connection with the planned transition to payment using the clinical- statistical groups. Presented method of the economic efficiency evaluation of paying for treatment can be recommended for use in any other nosological forms of diseases.

Assessment of Non-Carcinogenic Risk and Body Responses for Oil Refinery Staff

The study is relevant due to the lack of methods for assessing risk to the staff health from exposure to various substances in the production environment, which would take into account the responses of the body. To date, the procedure for special assessment of working conditions allows assessing the risk only at the level of establishing a class of working conditions in order to subsequently establish an additional payment for harmful working conditions, but not quantify the risk to the staff health. In this regard, this paper aims to assess non-carcinogenic risk to the health of the oil refinery staff and to identify dependencies between the magnitude of the risk and incidence of this staff. The leading approach to study this problem is to take into account both separate action of non-carcinogenic substances on individual organs and systems of the human body, and their combined effect to consider the effect of the chemical factor and take into account the effect of potentiation. The paper provides information on substances present in the work area, information about their danger, detailed analysis of their effects on the human body. Three scenarios for calculating non-carcinogenic risk for the workplace of the technician pump operator are considered as an example, an algorithm for the dose-effect model was provided, 26 risk groups for the staff of oil refinery were formed, information was provided on incidence of the staff, groups of diseases were identified by unidirectional action of the substances, dependence equations of non-carcinogenic risk and four nosological forms of diseases (respiratory diseases, diseases of kidneys and genitourinary system, eyes and its appendages, cardiovascular system) were obtained, reliability of the obtained dependences was assessed. The materials of the paper are of practical value for the researchers of this issue, employees of the occupational safety departments of enterprises for assessing the risk from exposure to the chemical factor, establishing relation of working conditions with occupational diseases of the staff, identifying risk groups among the staff of the enterprise workshops, and developing measures to improve working conditions

PSEUDOTUBERCULOSIS AND INTESTINAL YERSINIOSIS: THE ADVANCEMENT OF NONSPECIFIC PROPHYLAXIS AND THERAPY

Recent years have witnessed the development and clinical implementation of the new approaches to prophylaxis and treatment of different nosological forms of diseases – combination of conventional therapy and immunocorrection. The review analyzes present-day state of nonspecific prophylaxis and treatment of pseudotuberculosis and intestinal yersiniosis. Information is presented on the effectiveness of immunomodulators, products of vital activity of plant cells and sea creatures, prebiotics, immunoglobuline complex (CIP) in prophylaxis and therapy of these diseases.

New Approach in Investigating the Role of Interaction between an Organism and Physical Factors in Complex Patient Therapy

This work is dedicated to the new approach in applying physical factors in complex patient therapy. Based on experimental research data the author believes it is necessary to reconsider technical characteristics and exposition of physiotherapeutic factor influencing on the organism taking into account nosological form of disease and individual patient’s specifics. In this regard the author developed new tasks of the clinical physiotherapy and suggested seven principles of new classification of physical factors in complex patient therapy. On the basis of the research the author provided new concepts in medicine: 1) human organism as “biological scanning tunneling microscope”; 2) human as a part of “Nature” corresponds to universe general law: “singularity and indivisibility of time, matter and form”, as well as the forces of their interaction under constant endless motion.

Разработка экспертной системы диагностики острых заболеваний глотки портретным методом

The diagnostics of acute pharyngeal diseases is an actual problem nowadays. The use of informative systems presents new possibilities for differential diagnostics of these diseases. The expert system of accepting decisions supporting on the basis of the portrait method was developed. At the first stage of this study (including 297 patients), the authors ranked the major nosological forms of diseases; "paratonsillar abscesses", "parapharyngeal abscesses", dividing them into the following clinical options: right-sided paratonsillar abscess, left-sided paratonsillar abscess, right-sided paratonsillitis, left-sided paratonsillitis, bilateral paratonsillar abscess, left-sided parapharyngitis, right-sided parapha-ryngitis, left-sided parapharyngeal abscess, right-sided parapharyngeal abscess.
 
 To systematize the presented nosologies, the authors used the developed electronic manuals "The form of the examination of the patients with pharyngeal diseases", "The editor of the knowledge base of pharyngeal diseases", "The semiotics of pharyngeal diseases". Further, in accordance with the significance of symptoms, the authors determined the coefficients [0.75; 1.0; 1.5] and tested expert system, presenting it in the form of three integrations showing the percentage of wrong diagnoses.
 
 179 patients were included in the second part of this study. The authors used the major nosological forms: "paratonsillitis, parapharyngitis, acute pharyngitis and acute tonsillitis". Thus, the authors combined two samples of patients in one larger (496 patients), they empirically exhibited coefficients significance [0.75; 1.0; 1.5; 2.0] in the portraits of the newly included diseases, calculated a new selection, presenting it in two integrations with lower proportion of incorrect diagnoses in comparison with the previous diagnoses.

ABOUT THE NEED OF PATIENTS WITH MALIGNANT TUMORS IN HOSPITAL PALLIATIVE CARE DURING LAST YEAR OF LIFE

In 2012, the State program of development of health care in the Russian Federation included a program of palliative care (PC), the result of the implementation of which should be a creation of a full infrastructure in the regions to provide PC to patients requiring active symptomatic treatment and psychosocial support in the later stages of incurable progressive disease. The aim of this study was to investigate the volume and location of inpatient medical care to patients who died from malignant neoplasms during the last year of life to determine their needs in the PC on the actual use of health services. Patients who died from cancer at home, in the last year of life received inpatient care at different levels of the health system (69.5 admissions per 100 patients per year), mostly in the MO Ministry of Healthcare (79.77 of all hospitalizations (CI 78, 9% -80.6%)), and 20,23 ± 3,0% in the regional oncologic center. Two hundred and twenty beds, which are used today to provide medical care for cancer patients during the last year of life, can be regarded as the minimum volume requirements in the palliative care for cancer patients, including a specialized hospitals (33.54 beds) at the existing levels of morbidity and mortality from cancer in the region, as well as the functioning and effectiveness of the health care system, primarily of outpatient care. The number of beds used by cancer patients for palliative care during the last year of life, made up 80.12% of the total number of beds for palliative care, calculated according to the standard recommended by the State Program of Health of the Russian Federation until 2020. We must bear in mind that in accordance with the standard of palliative care 80% of the number deployed beds should be used for cancer patients, and only 20% - for patients with other nosological forms of diseases. This underscores the relevance of developing and using practical criteria for the selection of patients with chronic progressive disease, and non-cancer diseases to provide specialized palliative care.