Summary: The relevance of the study is due to the need for theoretical, methodological and practical justification of the formation of effective prevention of major noncommunicable diseases. Prevention of non-communicable diseases is possible through the development and implementation of a system of legal, economic and social measures. The aim of this study was to make a comparative assessment of the quality of life of patients with CHF, depending on whether they attend the appropriate health School or refused to attend it.

Materials and methods: The study was conducted with the involvement of 600 patients, who were divided into three groups: patients with CHF attending School of health, who refused to attend it and patients with other somatic pathology. The quality of life assessment was conducted by interviewing and included the study of activity in everyday life, clinical and functional disorders, cognitive dysfunction and psychological comfort in patients with CHF. As a result, it was found that patients with CHF, who refused to attend the School of health, are more likely to be expressed violations of activity in everyday life, 2.38 times more often than patients with CHF, attending School, found weighting clinical and functional class of CH, more often revealed cognitive impairment and psychological dysfunction, manifested depression and anxiety. Thus, it is necessary to develop comprehensive therapeutic and preventive measures carried out on the basis of polyclinic health care institutions and aimed at preserving and strengthening the health of patients suffering from CHF.

Calf augmentation is a quite popular surgery in Russia. However, there is insufficient data on complications after the implants’ installation, its analysis is missing, and methods for correction and prevention of complications are not developed.

The author has the experience of 53 re-surgeries after calf plasty with implants. The incorrect selection of implants was the cause of correction in 36 patients, the surgeon’s errors in their installation — in 7, the implant displacement — in 4, and its contouring — in 6 women. The analysis of each group of complications was performed.

The author considers the installation of implants under the medial head of the gastrocnemius muscle as the method of choice for secondary surgery, which prevents implant displacement and isolates it from the previously formed cavity. The result of the correction directly depends on the proper selection of implants. The author recommends using his own method of implant selection, considering the length of the gastrocnemius muscle and the harmony of the leg contour. Sufficient knowledge of the anatomy of the lower leg is necessary to eliminate technical errors.

Implant visualization after calf augmentation for aesthetic reasons was observed in 26 out of 561 cases, and in 3 of those cases an implant replacement surgery was required. To a large extent, contouring of the implant is observed due to its design. The advantage of custom-made implants of improved shape is shown.

Adequate debridement of the abdominal cavity has primary importance in treatment of the patient with peritonitis. In inadequate cases, the problem of endotoxicosis arises that many organ systems are affected. The purpose of the study: to study the functional state of the heart and respiratory activity in using of the various planned debridement ways of the abdominal cavity. Depending on the surgical tactics, the patients were divided into 2 groups. The main group consisted of 45 (47.4%) patients, whom after primary laparotomy underwent laparoscopic debridement using an irrigation-aspiration method, followed by abdominal treatment with low-frequency ultrasound. The control group included 50 (52.6%) patients, whom were made programmed relaparotomies. As a result, it was noted that the patients of the main group had the best dynamics of decrease of the leukocytosis and leukocyte index of intoxication, and also normalization of cardiac activity was faster, therefore the technique can be recommended as the main selection

The parameters of a single incision laparoscopic surgery (SILS) to the base of the vermiform process, the neck of the gallbladder and the duodenal bulb were assessed using spiral computed tomography (CT) in 101 patients and in an anatomical study on 98 unfixed corpses. Four median approaches and access in the left iliac region to the base of the vermiform process, umbilical and epigastric accesses to the neck of the gall bladder, the vertical subcostal, left subcostal and umbilical accesses to the duodenal bulb were evaluated. According to the CT and anatomical data, it has been established that the umbilical access to the appendix provides the optimal conditions for performing surgical interventions using the SILS - technology. In addition, access “2” by individual criteria has the most advantageous spatial characteristics and can also be used for minimally invasive access to the appendix. When comparing the umbilical and epigastric accesses to the neck of the gallbladder, it was found that the epigastric approach is appropriate for the introduction of a manipulation trocar, the umbilical approach is for extracting the gallbladder and visualizing it in minimally invasive surgery. According to the CT and anatomical studies, it was found that the vertical subcostal access to the duodenal bulb has the characteristics sufficient to perform surgical interventions using a SILS - technology.

In the mechanically ventilated patient, the single greatest cause of imposed work of breathing (WOB) is the resistance caused by the endotracheal tube (ETT). However, a special mode of ventilatory support called automatic tube compensation (ATC) delivers exactly the amount of pressure necessary to overcome the resistive load imposed by the ETT for the flow measured at the time (so-called variable pressure support). Materials and methods: 21 patients were included in our study who were on mechanical ventilation CPAP/PSV with tracheostomy tube of 8.0 mm. Pulse, BP, SpO₂, Ppeak, PS, PEEP, FiO , VO₂, VCO₂ , EE, RQ, RSBI were monitored. 100% ARC compensation was given. Duration of observation was 60 minutes for each patient. Observation study was 2 stopped if patients’ condition deteriorated. Results: it was observed that mean BR before ARC was 20.3 ± 4.6 & mean BR after ARC was 20.8 ± 5.4, mean VO₂ before ARC was 238 ± 72.5 & mean VO₂ after ARC was 235.6 ± 70.7, in addition to that we observed that there was a rise in Ppeak of about 3 mm water column. Conclusion: ATC mode did not reduce the work of breathing as all the other measured parameters such as pulse, BR, RSBI, VO₂, VCO₂ didn’t have a significant change.

Currently, there are many methods to eliminate fecal incontinence. Using the material of the pelvic floor muscles, it is possible to physically recreate the neosphincter, but its functionality does not always correspond to the needs of the patient. The use of microsurgical techniques in reconstructive surgery has led to the emergence of new techniques, which include neuroticization of muscles.

Osteoporosis is a systemic disease characterized by decreased bone mass, deterioration of bone tissue and increased susceptibility to fracture. Today the most of osteoporosis cases are diagnosed by x-ray measuring of bone density. However, there is a tendency of using potential biomarkers for bone formation and degradation diagnostics. The current review observes the main biomarkers of bone remodeling and analyze their possible clinical use. According to the collected data, the most cited markers of bone remodeling was N- and C- collagen telopeptide, showing resorption processes and bone-specific alkaline phosphatase, which reflected the osteoblasts activity, which is increased usually after the fractures. There also was noticed a significant increase in number of published articles. Thus, further studies need to be conducted in order to create and develop new diagnostic techniques and implementing them into clinical practice. Provided with enough attention and resources, future findings will be able to rise the quality of prevention and treatment of osteoporosis.

Recently, cases of conflict situations at a polyclinic reception have become much more frequent. Analyzed the causes of the development of interrelated conflicts at the stage doctor-patient-health system. The purpose of this publication is to show the need for adaptive methods of communication with the patient when working in a conflict situation at a medical reception. The role of personality traits and painful behavior in the formation of a conflict, the influence of biopsychosocial factors on the formation of a conflict personality has been determined. We consider the technology of speech communication in the collision of interests and the development of conflict situations. The review may be useful for studying standardized situations in medical conflict management.

In our time, the problem of obesity is relevant to the population of the entire planet. The purpose of the article is to analyze the experience of using laparoscopic “sleeve” gastrectomy in the conditions of the district hospital of the city of Nartkala “Interdistrict multi-field hospital.” During the study, 27 laparoscopic “sleeve” resections of the stomach were performed in patients with morbid obesity. As a result, the patients showed a decrease in body weight and a steady decrease in weight over the next two years. This article will be useful to those interested in low-impact methods of bariatric surgery to reduce body mass index.

Oncourological diseases are considered one of the most complex medical and social problems in the structure of clinical oncology. The article presents data on the morbidity and mortality of certain, often diagnosed diseases of the male population as cancer of the prostate and bladder, with an emphasis on the collapse of the USSR. The article presents data and dynamics of oncourological diseases of the mentioned contingent. The article presents data and dynamics of oncourological diseases in men. Oncourological morbidity in Kyrgyzstan as a whole was analyzed for the period from 1988 to 2000, which coincided with the onset of the economic crisis and the population census years (1989 and 1999), which is important for obtaining reliable indicators. The incidence data are compiled from notices (Form 281 u), case histories, outpatient records, and mortality data borrowed from the National Statistic Service of the Kyrgyz Republic. In this regard, in general, imbalances in the main indicators of the oncological health service of the republic were revealed.

The study of the immediate and long-term results of surgical treatment of diseases of the stomach, conducted by many authors, shows that a certain number of patients have a number of functional and organic disorders that not only reduce the quality of life of the patient, but can also cause disability or even death. It is considered that one of the most important pathogenetic factors in the development of the disease of the operated stomach is a way to restore gastroin-testinal continuity. A major role is played by the elimination of the pylorus and duodenal passage, which “is, - as Ivan Petrovich Pavlov wrote, a grave violation of the unity of the digestive system.”

Currently in the literature there are more than 70 names and terms denoting the manifestation of the disease of the operated stomach: dumping syndrome, afferent loop syndrome, agastral asthenia, hypoglycemic syndrome, etc. However, it should be recognized that all of them reflect only a part of the problem are postgastrectomy and postgastrectomy disorders.

The importance of this problem is also due to the fact that in some patients, after gastrectomy, severe digestive disorders develop, leading in almost 25% of cases to permanent disability. In this case, often the only possible method of treatment is reconstructive surgery performed at various times after the initial intervention.

This article fully describes the process of detection and treatment of localized periodontitis with recessionary gums. The analysis of the sources found among the scientific works and theses will allow to fully disclose the problem of treatment of periodontitis.

Due to the dramatic demographic shifts occurring in the composition of the population, an increase in the average life expectancy, the need has arisen for new principles of treatment and preventive services for the population, taking into account the characteristics of an aging organism.

Gerontologists adopted an age classification, according to which the age up to 40 - 45 years old is considered young, from 45 to 60 years old - average, from 60 to 75 - old, from 75 to 90 - old. People over 90 years old are considered long-lived.

One of the most characteristic features of the global aging of the population of the planet is the pronounced growth of people 75 years and older in the population of the elderly. Experts of the WHO Committee point out that “the problem is not only that the population grows, but also that its further“ aging ”is noted as the number of people living longer grows. The group of “elderly” creates additional difficulties for the health and social services.

This article describes the relevance and methods of providing neuro-orthopedic rehabilitation to elderly people in gerontological centers.

In the article devoted to the 90th anniversary of the birth of Professor, Honored Scientist of the RSFSR Anatoly Leonovich Gushcha, he briefly describes the main stages of his life and work, achievements and contribution to the development of the Department of Hospital Surgery of the Ryazan Medical Institute and surgery in general. Under his leadership, the department actively developed the issues of endoscopic diagnostics and surgery, x-ray studies, extracorporeal methods of detoxification, treatment of purulent-destructive diseases, the use of low-intensity laser radiation and other advanced technologies in surgery. Reconstructive operations on the biliary tract, pancreas, esophagus, gastric passage, stomach and many others were improved.

Also, the professor was engaged in educational activities and wrote a number of methodical manuals on all program questions of surgery, as well as over 180 scientific papers. Under the guidance of the professor eight doctoral and 15 candidate dissertations were prepared. Five of his students have the title of professor.

Anatoly Leonovich conducted a great deal of public work. For 10 years he headed the department of postgraduate and residency, he was the chairman of the board of the Regional Society of Surgeons, a board member of the All-Russian and All-Union Society of Surgeons.

He was awarded the Order of the Badge of Honor, the Order of Friendship, the badges of the Honored Health Career and the Higher School of the USSR, the diploma of the Ryazan Regional Executive Committee and the Minister of Health of the USSR in 1997 he was awarded the honorary title «Honored Worker of Science of the Russian Federation». His work left a mark not only in the history of surgery, but also in the memory of his students and many grateful patients.

In the article devoted to the 90th anniversary of the birth of Professor, Honored Scientist of the RSFSR Anatoly Leonovich Gushcha, he briefly describes the main stages of his life and work, achievements and contribution to the development of the Department of Hospital Surgery of the Ryazan Medical Institute and surgery in general. Under his leadership, the department actively developed the issues of endoscopic diagnostics and surgery, x-ray studies, extracorporeal methods of detoxification, treatment of purulent-destructive diseases, the use of low-intensity laser radiation and other advanced technologies in surgery. Reconstructive operations on the biliary tract, pancreas, esophagus, gastric passage, stomach and many others were improved.

Also, the professor was engaged in educational activities and wrote a number of methodical manuals on all program questions of surgery, as well as over 180 scientific papers. Under the guidance of the professor eight doctoral and 15 candidate dissertations were prepared. Five of his students have the title of professor.

Anatoly Leonovich conducted a great deal of public work. For 10 years he headed the department of postgraduate and residency, he was the chairman of the board of the Regional Society of Surgeons, a board member of the All-Russian and All-Union Society of Surgeons.

He was awarded the Order of the Badge of Honor, the Order of Friendship, the badges of the Honored Health Career and the Higher School of the USSR, the diploma of the Ryazan Regional Executive Committee and the Minister of Health of the USSR in 1997 he was awarded the honorary title «Honored Worker of Science of the Russian Federation». His work left a mark not only in the history of surgery, but also in the memory of his students and many grateful patients.