The lecture presents some modern insights into structural and functional organization of epileptic focus, as the main element in pathogenesis of epilepsy. We consider basics of electroencephalographic semiotics in epilepsy. The graph elements of ictal/ interictal continuum are considered. it is shown that the video-EEG monitoring provides an opportunity of simultaneous analysis of bioelectric activity and clinical pattern of the epileptic seizure, thus allowing to localize the initiation area of epileptic seizure.

In the article, clinical cases of epilepsies with continuous spike waves during slow sleep are described. This problem is topical in the modern medical literature due to the polymorphism of the clinical and EEG picture of the patients. The authors emphasize the necessity of application of the modern long-term video EEG-monitoring in cases of children with neuropsychological regression. The article also describes the experience of application of new classification of epilepsies ILAE2017 with this group of diseases.

We set the task to study the variants of frequency and spatial fluctuation of alpha rhythms based on new objective methods analisis EEG in conditionally healthy children and adults and patients with certain variants of mental disorders. it was found that the limits of frequency fluctuation of the occipital alpha rhythm in healthy individuals depend on age (it is equal in average to children ± 0.24 Hz and in adults ± 0.21 Hz) it depends on the predominance of personal characteristics of the child’s psyche. Zonal fluctuation of alpha rhythm in healthy individuals is more pronounced in the anterior regions than in the posterior ones. Patients who have astheno-neurotic reactions, panic attacks with anxiety affect, there is a weakening of the expression of frequency fluctuation, both in the occipital and anterior parts.

Coronary artery anomalies can cause myocardial infarction and sudden cardiac death (SCD) in young people and athletes with a frequency of 3 % to 17% of all cases of SCD. The aim: definition of the most informative signs characterizing longitudinal systolic function in patients with coronary artery (CA) anomaly - muscle bridge (MB); comparison of the obtained data of tissue dopplerography (TD) in patients with a MB of the CA, in patients with atherosclerotic stenosis of the CA and in patients with angiographically unchanged CA. Material, results: 44 patients were examined with the help of TD, who were referred to a coronary angiography (CAG) with the diagnosis of «Coronary artery disease: angina pectoris». These patients were divided into 3 groups. The first group consisted of 12 patients with isolated MM with systolic narrowing of SC 71-100 % (in the middle third of the anterior interventricular branch of the left CA). The second group included 16 patients with haemodynamically significant atherosclerotic stenosis (AS). The third group included 16 patients with pain in the chest and unaffected CA according to CAG data. in our study, the global longitudinal systolic function in patients with an isolated muscular bridge without myocardial infarction were comparable to that data of patients with «normal» coronary arteries. The indices of the local longitudinal systolic function of LV in the middle septal segment in patients with isolated MM were lower than in patients without muscular bridge over the coronary artery. The parameters of global and local longitudinal systolic functions of the left ventricle in patients with an isolated muscular bridge were significantly higher than those parameters measured in patients with atherosclerotic stenosis of the coronary artery.

Objektive: the study was comparison indicators of 2D Echocardiography and structural, and functional data of the right ventricle on the results of MRI in patients with multiple coronary artery lesions without taking into account angiographic characteristics. The signs of functional and structural remodeling of the right ventricle from the MRI. Routinely used Echoparameters (RV size, FAC RV, MPI, TAPSE) in patients with ischemic RV dysfunction of little informative for its verification. The parameters of deformation and strain rate of the RV are closely correlated both with structural parameters according to MRI data (with the number of segments with accumulation of contrast) and functional data (EF RV). Longitudinal deformation of the right ventricle more than «-»17,8 % is determined the right ventricular ejection fraction is less than 45 %. Longitudinal deformation of the RV can be considered as a universal echocardiographic marker as a RV dysfunction, and structural and functional remodeling of the RV.

Objective: to study heart rate variability, QT interval dispersion and late ventricular potential of patients with chronic renal failure, depending on the stage of the disease and the presence of ventricular extrasystole. Materials and methods: 50 patients with terminal chronic renal insufficiency, on hemodialysis, 38 patients with stage III of chronic kidney disease and 20 healthy people have had 24-hour ECG monitoring with heart rate variability analysis, QT interval duration, QT interval variance and late potentials ventricles. Results: Patients with chronic renal insufficiency have shown a decrease in the overall heart rate variability, an increase in the activity of the sympathetic nervous system, an increase in the duration of the corrected QT interval, variance of the QT interval, and the presence of late ventricular potentials. The revealed disorders were increased in patients with terminal renal insufficiency and in patients with frequent ventricular extrasystole. Parameters of heart rate variability were closely correlated with the duration and variance of the QT interval, the indicators of late ventricular potentials. Gamma-correlation has established a direct relationship of frequent ventricular extrasystole with changes in electrophysiological indicators. Conclusion: vegetative imbalance, increased dispersion of the QT interval, and the presence of late ventricular potentials can be the predictors of ventricular rhythm disturbances of patients with chronic renal insufficiency.

The impulse oscillometry (lOS) is noninvasive method of studying of lung mechanical properties based on analysis of sound oscillations reflected by airways of the patients. lOS allows to measure respiratory impedance (Zrs) and its components: resistance (Rrs) and reactance (Xrs). The lOS parameters are measured at quiet breath during 30-60 s and do not require an active cooperation of the patient. The aim of our study was to research the opportunities of lOS for diagnostics of moderate obstructive ventilatory disorders. We analyzed the lOS and PFTs (spirometry, body plethysmography, diffusion test) data of 80 patients which were divided to two groups: 30 patients with moderate obstruction (FEV₁ in the range 60-70%pred, 27 (90%) males and 3 (10%) females, mean age 57 ± 15 years (21-78 years)), 50 patients with mild obstruction (FEVj more than 70 %pred, 38 (76 %) males and 12 (24 %) females, mean age 54 ± 16 years (19-82 years)). Conclusions: 1) 57 % of patients with moderate obstruction diagnosed with spirometry had obstructive disorders in accordance with the traditional lOS interpretation algorithm. 2) The change in AX (areas under the Xrs-curve in the frequency range from 5 Hz to f_res) was more often detected in patients with moderate obstruction than with mild obstruction (80 % and 64 %, respectively), as well as changes in the absolute frequency dependence (Rrs5-Rrs20) (76 % and 54 %, respectively). This indicates the possibility of including these parameters to the algorithm of the lOS interpretation. 3) The severity of airway obstruction lOS-diagnosed does not always coincide with the severity of the disorders determined by spirometry: 37 % of patients with moderate obstruction, spirometry-diagnosed, had more severe obstruction determined by lOS.

Since the early days of thermography in 1960-ies, from bulky boxes - to elegant devices with speedy sensors, from enthusiasm to skepticism and again to the high level of interest, covering new fields in medicine - this is the modern history of medical thermography. The reasons, present conditions and perspectives are discussed in this paper.

Relevance: In conditions of living in hard-to-reach areas and with diseases requiring urgent medical and medical assistance, the urgency of organizing emergency medical care units is increasing. The analysis of the activities of specialists is necessary for planning their rational workload and calculating the need for specialists. The aim of the study. To study the activities of the specialists of the sanatorium brigade in the Vologda region to make organizational decisions on the staffing schedule. Material and methods: the data of medical documentation on the frequency of medical care to the population of the Vologda region with the involvement of various specialists of the health aviation brigade for the period from 2012 to 2017. The results and their discussion: the analysis of the number of appeals to the department of emergency medical advisory services in sanatorium showed that in the last six years the number of applications increased by 23.8 %. The number of calls made with the help of health aviation was also unstable, by the end of the analyzed period it increased by 39.5 %. Conclusions: Provision of medical assistance using land transport decreased by 1.4 times, health aviation - increased by 2.4 times.