With the development of technologies, and discovery of new methods of diagnostics and treatment of diseases, a shift of the disease towards chronic disease is observed. Growth in prosperity will increase average life expectancy and mean age of population. Year after year, the elderly sector grows, with several chronic diseases per person. This is especially true for St. Petersburg, where 25 % of the populations of over working age. Thus, the demand for specialized medical care, particularly outpatient, will increase. Given that outpatient care is more profitable than hospital care, particular attention should be paid to its organization and expansion (increase in area, number of personnel, logistics, and so on). The article attempts to analyze changes in the volume of specialized outpatient medical care delivered at the outpatient Advisory Department of St. Petersburg state establishment of healthcare Mariinsky hospital in the period from 2008 through 2013.

Metabolic impairment of alpha-synuclein protein is considered to be the central event in PDpathogenesis. Recent studies explored usage of alpha-synuclein in peripheral fluids as a biomarker of PD, however alpha-synuclein level in the CSF and plasma is considered to be affected by hemolysis. In order to avoid contamination of a lymphocyte fraction by erythrocytes, we have proposed an algorithm based on measurements of alpha-synuclein levels in the homogeneous CD45+ cell blood fraction. For this study we formed a group of PD patients (N=14) and a control group without the neurological disorders (N=17). We found an increase in the level of the total alpha-synuclein in CD45+ cells of PD patients compared to controls (p = 0,04), and revealed a direct correlation between the level of dopamine in plasma and level of total alpha-synuclein in CD45+ cells in the control group (r=0,71, p = 0,007).The level of alpha-synuclein in CD45+ cells could be suggested as possible PD biomarker.

To evaluate plasma concentration of apelin and its correlation with structural and functional heart parameters in patients with abdominal obesity. 93 patients with abdominal obesity (criteria IDF, 2005) and 21 healthy people at the ages from 25 to 57 years old were investigated. Weight, height, waist circumference, and plasma apelin concentration were measured. Dimensions and volume of the cardiac chambers, systolic and diastolic functions of the ventricles were measured with echocardiographic method. Plasma apelin concentration was higher in patients with abdominal obesity as compared to healthy people (0.70 (0.55 - 0.94) ng/ml and 0.55 (0.42 - 0.72) ng/ml, respectively; p = 0.04). There is significant negative correlation between apelin level and longitudinal size of the left ventricle (r=-0.307; p = 0.003); index of the left atrial volume (r=-0.201; p = 0.05); longitudinal size of the left atrium (r=-0.248; p = 0.02); right atrium volume (r=-0.261; p = 0.01); right atrium area (r=-0,251; p = 0,02); basal size of the right ventricle (r=-0,202; p = 0,05); longitudinal size of the right ventricle (r=-0.234; p = 0.02). Plasma apelin concentration was higher in patients with abdominal obesity as compared to healthy people. There were revealed significant negative correlation between apelin level and longitudinal size of left ventricle, index of left atrial volume, longitudinal size of left atrium, right atrium volume, right atrium area, basal size of right ventricle, and longitudinal size of right ventricle.

We observed 140 patients with abdominal obesity (AO) (IDF, 2005), the residents of St. Petersburg (44.6 ± 0.6 years). Metabolic syndrome (MS) (IDF, 2005) was diagnosed in 49.2% of patients with AO. The most frequent component of MS in patients with AO was arterial hypertension (AH). The distribution of genotypes and -alleles of the aldosterone-synthase gene in patients with AO and in the comparison group (56 subjects without AO, 41.0 ± 1.1 years) didn't differ (p> 0.05). Levels of both systolic and diastolic blood pressure (BP) were higher in carriers of -344T allele of aldosterone-synthase gene. Plasma renin activity, plasma aldosterone and glucose levels, anthropometric parameters, serum blood lipids and carbohydrate metabolism indices in obese patients with different genotypes of aldosterone-synthase gene didn't differ. -344T allele of aldosterone-synthase gene in patients with AO is associated with the increased risk of AH.

In the anabolic phase of postoperational period, restoration of the structure of the blood-thymic thymus barrier, reduced edema of perivascular and interstitial spaces in in the thymus barrier, and emergence of a large number of epithelial cells with signs of unmodified structural organization are observed, indicating weakening of the destructive processes and increasing drainage of interstitial spaces in the body.

The paper suggests characteristics of the disease course in 193 adult acute diarrhea (AD) severe cases hospitalized in 2002-2004. Following the pathomorphological study records, the structures of AD cases hospitalized in 2002 - 2004 and in 2008-2010 has been compared. It is shown that adult AD severe cases are rather more than likely to have lethal outcome in case of comorbidity and hospital admission later than on the 3^rd disease day. In the period of dysentery high-incidence level in structure of AD with lethal outcome, shigellosis (including that diagnosed morphologically) dominates, as compared to the period of dysentery low-incidence level when the burden of salmonellosis and AD of unknown etiology has been seen to grow.

Warfarin remains the drug of choice for the prevention of ischemic stroke, thus optimization of methods of control of dosing this preparation becomes more topical. The aim of our study was to test computer software for monitoring anticoagulant therapy with warfarin in patients with atrial fibrillation based on the day anticoagulant hospital. A total of 6 people with atrial fibrillation undergoing treatment with warfarin in specialized outpatient clinics were monitored with the software for 3 to 6 months. At the same time, comparable 11 patients with atrial fibrillation were followed by experienced clinician. Both groups were matched by sex, age and clinical diagnosis. The comparison group consisted of 11 patients diagnosed with the same disease, of the same gender and age. We have found that in patients followed by anticoagulation software the time spent in the therapeutic INR range was twice the time in therapeutic range of patients in which the dosing and follow-up was done by experienced doctor (p<0.05). The data indicate the possibility of using software to monitor warfarin therapy, which increases the clinical safety of its use.

The need for a comprehensive diagnostic approach to the patients suffering osteoporosis is determined by high medical and social significance and disabling nature of complications. The objective of this research is to estimate features of calcium and bone metabolism depending on functional status of parathyroid glands. The study involved 150 post-menopausal women with a low bone mineral density. All patients underwent clinical and laboratory examination including a functional test for evaluating the enteral absorption of calcium. More expressed disorders of calcium and bone metabolism have been identified in patients with the development of secondary hyperparathyroidism in conjunction with the violation of enteral calcium absorption.

This article deals with the possibilities of laboratory assessment of the state of the connective tissue. It contains brief information about its structure, functions and roles of the various components in the development of pathological processes, and provides laboratory diagnostic methods of these changes.

The article resents the results of developing a system of assessing the quality of orthodontic treatment of patients with various forms of dento-alveolar and facial anomalies, consisting of 3 parts: main and supplementary parts, and auxiliary section, allowing for conduct of comprehensive automated quality assessment of orthodontic dental care.

To date, the traditional methods of instrumental diagnosis of occlusion and TMJ - quite time consuming and difficult to perform.Requires a very high qualification of experts capable of conducting such a diagnosis. In this regard, the existing and evolving digital technologycan not only producevarious removable and nonremovableorthodonticand orthopedicdesign, but also allow for a precise and easier to perform, diagnoseocclusion of dentition with the biomechanicsof the temporomandibular joint and the aesthetics of the patient's face.

The paper presents a comprehensive study identifying the key issuesand giving the mathematical, and clinical and microbiological substantiation of modern principles of providing orthopedic dental care to patients with acquired defects of the upper jaw of cancer genesis.

It is believed that odontogenic sinusitisiscaused by spread of infection from periapical tissues of teeth. Importance of clinical topographic ratio between bottom of the maxillary sinus and apexes of chewing teeth» is referred to quite often, but usually the data proposed are received by describingrelatively small samples from collections ofmacerated skulls, which makes it impossible to determine anyregularities in structure of the facial skull and in location of the alveolar bone and teeth

Based on the long-term observation period (1986 through 2012) the properties of endogenous mental disorders premorbid period in 107 persons (of mean age 21.5±1.5 years) were studied. In 41.2% of the cases, premorbid period was characterized by premorbid disorders, which included disorders of development, deviation of behavior and motor skills, behavioral abnormalities, affective and somatic disorders combined with quantitative changes in personality, and decline of cognitive indicators. Premorbid disorders in 56.2% of cases were preceded by clinical features of endogenous mental disorders such as a progressive or continuous-attack-like progressive course, low severity of positive symptoms in period of manifestation.

Epidemiological and clinical presentation of acute myocardial infarction based upon the data collected in Regional Vascular Centre of Saint-Petersburg Scientific Research Institute of Emergency Care n. a. I. I. Dzhanelidze in 2009-2012 years. In the article, 4697 cases have been analyzed. Specific features of epidemiology and clinical presentation of acute myocardial infarction at the present stage have been considered.

The article deals with genetic aspects of the influence of S19W polymorphic variants of apolipoprotein A5 gene, on the blood lipids in patients with type 2 diabetes mellitus, as well as influence of various clinical and anamnestic parameters on the blood lipids determining the development f atherogenic dyslipidemia.. The study revealed interrelation between 19W allele and hypertriglyceridemia development in patients with type 2 diabetes mellitus.

The article describes design and implementation of a new personalized database to solve the problems of classification of test results in microbiology. The practice of design and implementation of the database «Microbes» based on the database management system FileMAkerPro has been described. The resulting database allows not only for control and for amalysis of large amounts of heterogeneous data, but also for dynamic comparison of the data generated throgh collaboration of multidisciplinary research teams.

The article examines possible medical errors during the interalveolar osteotomy that may negatively affect the effectiveness of the treatment. It also analyses the basic techniques that provide adequate vitality of the tissues in the place of surgery. It also demonstrates the necessity of the reconstruction of the full thickness of the gum in order to achieve long-term esthetic results in the area of dental implantation.

The therapeutic and diagnostic activity is a collective work that is carried out jointly by specialists in different directions of dentistry and support units. The main goal of this type of activity is to improve the dental health by preventing dental diseases. It includes the treatment and rehabilitation using various ways of replacement of the lost integrity of the dentition and restoration of the teeth using a prosthetic. In order to do this, it is necessary to prepare the teeth and the pulp of the oral cavity for prosthetics. The sequence of preparatory activities includes a series of steps carried out in sequence: preventive, hygienic, therapeutic (including periodontal), surgical and orthopedic (including orthodontics). Each of these stages includes a series of manipulations, the sequence and number of which is determined by the individual dental status of each patient. The inspection and preparation of a comprehensive plan for the treatment involves a sequence of all these actions carried out by a team of experts in agreement with the patient, evidenced by the «informed consent» subscription. After the preparatory activities, it is possible to go to the final stage, that is to make a prosthetic appliance to the patient. The total duration of all phases of preparatory activities preceding the prosthetics depends on the complexity of the steps themselves, and is determined by the severity of the related dental diseases. The treatment of these diseases is the main part of the preparatory activities.

The article presents a modification of the colorimetric method for the preliminary establishment of presence of blood in the stainson the material evidences using benzidine test. The proposed modification is accompanied by photometric accounting and computer processing of the results. Performance, objectivity, as well as other features and advantages of this method when used in forensic practice are described in detail.