Anticoagulant drugs play an important role in reducing the risk of complications and mortality that are associated with thrombotic events. Vitamin K antagonists have been used for prolonged oral therapy until recently, but their use has a number of limitations. These are a high percentage of hemorrhagic events, a high threat of interaction with other drugs and food, as well as the need for continuous monitoring of laboratory parameters of patients. That is why, due to the great limitations of these drugs, new direct oral anticoagulants such as dabigatran, rivaroxaban, apixaban and edoxaban are now an integral part of practical healthcare. Because of their widespread use in cardiology, surgery, dermatology, neurology and many other branches of medicine for the prevention of thrombosis, as well as their differences in pharmacokinetics, it is crucial to study the genetic determinants for the possibility of effective and safe prescribing of these drugs. This will help in predicting the dosage of the drugs and using them as monotherapy or in combination with other drugs. They have several advantages over traditional drugs: they have a lower likelihood of drug-drug interactions and no need for continuous monitoring. However, polymorphisms of genes (CYP2C9, ABCB1, CES1) responsible for the metabolism of anticoagulants can affect the pharmacokinetics and pharmacodynamics, which significantly affects the efficacy and safety of drugs. In this regard, it is necessary to adjust dosing to achieve the necessary effect and reduce the risk of undesirable effects. The aim of this work is to review the current data on the influence of genetic polymorphism on the efficacy and safety of anticoagulant therapy, as well as to consider the prospects of personalized approach in the treatment of patients. Materials and methods: articles were searched in Google Scholar, PubMed and Medline databases by key terms and their combinations in titles, abstracts and keywords: pharmacogenetics of anticoagulants, gene polymorphisms, pharmacogenetic studies of NPOAC, dabigatran, apixaban, warfarin, pharmacogenetics of anticoagulants, gene polymorphisms, adverse effects of anticoagulants, DOAC. The literature search and selection of literature sources was performed from September 2024 to December 2024.

Work activities of the nurse are associated with general and static endurance, contributing to many work hours, bearing heavy physical exertion. Today's students majoring in Nursing need to develop their physical traits that are specific to their future professional activities. The aim is a hygienic assessment of the morphofunctional status of female students of medical colleges in Volgograd majoring in the specialty ―Nursing‖. Materials and methods. The functional state of the respiratory system of female students of medical colleges in Volgograd was analyzed using anthropometric and physiometric parameters. Results. The anthropometric indicators of female students correspond to the average parameters of girls of this age group in the Volgograd region. Differences in the function of external respiration related to the anthropometric characteristics of girls are revealed. There was found a decrease in the proper values of vital capacity of lungs in female students with body weight deficiency, reflecting, in general, the presence of respiratory system dysfunction. At the same time, in girls with normal body mass index values, compared with students with excess body weight, the indicators of respiratory function were almost the same. It was revealed a decrease in the functional capacity of female students due to the low indices of hand muscle strength. Conclusions. These indicators are necessary to optimize the conditions of training and organization of health saving of female nursing students, increase the functional capabilities of the body of girls through the implementation of various wellness programs and individualization of physical education classes, which should include elements of professional applied training that enhance the physical qualities of the body.

Prevention of zoonotic infections is an urgent problem of modern epidemiological science and is one of the directions of the ―One Health‖ concept. The purpose of the work is to study the influence of climatic and environmental indicators in the Central Karakum on the population of the great gerbil, ectoparasites and their connection with the possibility of developing epizootics caused by Yersinia pestis within the framework of the ―One Health‖ concept. Materials and methods. Long-term (1990–2024) own materials from zooparasitological and bacteriological research obtained during annual expeditions conducted during the periods March-November in the Central Karakum are presented. Results. Studies have shown that wave-like climate changes in the western part of the Central Karakum lead to changes in the duration of the growing season with disruption of the phenological phases of the main desert plants. As a result, the number of the great gerbil changes, as a result of which the number of its ectoparasites changes. Conclusion. For the development of epizootics among rodents caused by Ye. pestis requires conditions that include a period of high temperature, sufficient rainfall, a long growing season of plants, and a high density of the great gerbil and their ectoparasites.

Primary specialized accreditation of a specialist is a mandatory procedure that determines admission to professional activities of all specialists working in the healthcare system. Objective: development of a system for training specialists to undergo primary specialized accreditation for the position of ―Biologist‖. Material and methods: specialists who applied for accreditation for the position of ―Biologist‖ were included in the study, 112 people. A refresher course was organized, during which the accreditation procedure itself, the algorithm of actions at the stations, and practical classes with work on simulation and medical equipment in accordance with the station passport were analyzed. Results: we compared two groups of accredited persons, dividing them according to the training principle in the course. Thus, among those trained in the course, 11 % failed accreditation, and among those who did not train, 54 % did not, a reliable difference was obtained (p < 0.001). Conclusion. This model of training specialists for accreditation can be taken as a basis for accreditation of other non-medical specialties, while working out not only the main points of the stations, but also the key areas of work in this position.

Hemangiomas of the spine are a problem that often does not require surgical intervention. This pathology occurs in every tenth person, especially among older women. Hemangiomas are most often localized in the thoracic and lumbar spine and are asymptomatic. Goal. To present several cases of successful surgical treatment of aggressive spinal hemangiomas using various methods generally accepted in the neurosurgical community. Materials and methods. In 2022 Nine patients with spinal hemangiomas underwent surgical treatment at the Alexander-Mariinsky Regional Clinical Hospital in Astrakhan. Six of them underwent puncture vertebroplasty under radiation control, and three underwent open spinal cord decompression and microsurgical removal of the neoplasm. This paper presents two clinical cases demonstrating different tactics of surgical treatment. Results. Surgical treatment of 9 patients with aggressive spinal hemangiomas demonstrated the effectiveness of various tactics, including minimally invasive puncture vertebroplasty and open decompression interventions. The application of an individualized approach helped to preserve the quality of life of patients and prevent the increase of neurological deficits. Conclusion. In conclusion, based on clinical experience and analysis of generally accepted techniques, optimal approaches to the treatment of aggressive vertebral hemangiomas with neurological manifestations can be identified. Bone cement vertebroplasty has proven to be a highly effective and minimally invasive method that eliminates the need for radiation therapy if successfully performed. This method remains the most preferred in the regions of the Russian Federation. At the same time, laminectomy and microsurgical removal of the intracanal part of the tumor are associated with a high risk of intraoperative blood loss. Nevertheless, it was possible to minimize surgical trauma even in the presence of a profusely vascularized component of the neoplasm, which allows achieving satisfactory clinical results.

Iron deficiency anemia anemia due to insufficient body iron stores. The following laboratory findings are typical for iron deficiency anemia: microcytic anemia, hypochromia and decreased ferritin. In Russia separately there is an increase in anemia in women of reproductive age year to year. The objective of this study is establishing the effect of iron deficiency anemia to the outcomes and complications of childbirth in patients with infertility after in embryo transfer and vitro fertilization programs. Materials and Methods. The retrospective cohort study was conducted from 2018 to 2020 in the conditions of the Multidisciplinary Clinic of ―AVA-PETER‖ (―SCANDINAVIA‖), Kazan. 38 outpatient records of women who became pregnant after vitro fertilization and embryo transfer programs were analyzed. The patients were divided into two groups: group 1 (main) – patients with a diagnosis of iron deficiency anemia; group 2 (control) – patients without a diagnosis of iron deficiency anemia. Results. The study of pregnancy outcomes revealed that patients with and without iron deficiency anemia have a high percentage of cesarean sections – 76.4 % and 80.5 %. Spontaneous childbirth in 37–41,6 weeks‘ pregnancy is higher in women without iron deficiency anemia – 9.5 %. In women with iron deficiency anemia – 5.8 %. Spontaneous childbirth in premature pregnancy in women with iron deficiency anemia – 17 % and in women without – 9.5 %. The study also analyzed fetus complications. The results indicated that the babies with diagnosis small for gestation age were more common in women with iron deficiency anemia – 41.2 %. The babies with diagnosis large for gestation age were found in both groups. Conclusion. The study revealed that women from 24 to 42 years old with iron deficiency anemia have more comorbidities. The results indicated the large percentage of surgical deliveries for women in both groups. Spontaneous childbirth in premature pregnancy is prevalent in women with iron deficiency anemia. The possibility of a correlation between anemia during pregnancy and fetus complications such as small for gestation age may not be excluded.