In this work we searched for pathogenic variants of the mtDNA MT-TS1 gene in patients with hearing impairments in Buryatia. One rare variant m.7445A>C was found in the MT-TS1 gene out of five investigated variants in one patient (1/165; 0.6%). This variant is localized in the coding region of two genes the MT-CO1 (H-chain) and MT-TS1 (L-chain), but on different mtDNA chains. However, a pathogenetic role for the m.7445A>C substitution has been shown for the MT-TS1 gene, but not for the MT-CO1 gene. In databases, the m.7445A>C variant is associated with non-syndromic hearing loss, including those caused by aminoglycoside antibiotics. A comparative genotype-phenotypic analysis of our case and four cases with m.7445A>C of the MT-TS1 gene described earlier in the literature showed that hearing loss in all cases is not congenital, but at the same time varies in severity with low penetrance. The results obtained indicate the involvement of other modulating factors in the clinical manifestation of hearing impairment associated with this variant. Thus, further study of rare variants of MT-TS1 gene will contribute to our understanding of the pathogenetic mechanisms of mitochondrial forms of hearing loss.

An analysis of polymorphic variants of the serotonin receptor genes HTRD rs674386, HTR1F rs56398417, HTR2A rs6313, HTR3A rs1062613, HTR2C rs6318 and the GABRA2 rs279845 gene in T2D patients living in the Republic of Belarus was carried out. As a result of the study of 6 loci of neurotransmitter genes, protective markers CT and CC genotypes of the rs1062613 locus of the HTR3A gene (OR= 0.73, P_{cor_FDR}=0.0007) and GC and CC risk genotypes of the rs6318 locus of the HTR2C gene (OR=2.21, P_{cor_FDR}=0.0045) among women, the CC genotype is also risky for men (R=4.05, P_{cor_FDR}=0.0045). Analysis of combinations of genotypes and alleles revealed combinations of increased and decreased risk of T2D. The analysis of ROC curves showed that the studied loci and such variables as sex, age of the examined and BMI can be used to assess the prognostic significance of T2D AUC=83.4% (95% CI 83.5-87.4).

Histological assessment of calcification patterns in different sites of the ascending aorta in patients with thoracic aortic aneurysm has been performed using alizarin red S staining. Biopsy specimens from 67 patients (47 males, 20 females, mean age 56,9±11,1 years) with thoracic aortic aneurysm from three different sites of ascending aorta were taken intraoperatively. Calcific precipitates were diffusely distributed mainly in the tunica media of the vessel. The mean calcium percentage was: for the sinotubular junction (zone 1) - 7.85 [2.2; 15.4]%, mid-ascending aorta (zone 2) – 10.45 [3.83; 22.35]%, proximal aortic arch (zone 3) – 10.95 [4.65; 18.63]% (p=0.216). Patients with maximum calcification level in zone 3 were younger (53 [41; 62] years) than patients in whom the maximum calcification was detected in zone 2 and zone 1.

The study is devoted to a comparative analysis of the results of the effect of COVID-19 coronavirus infection on hematological blood parameters in patients who have been ill after three, six, nine and twelve months. Monitoring of hematological parameters is important for the identification and control of patients who have undergone COVID-19, who need additional assistance, and stratification of the risk of severe course of the disease. The study involved 161 residents of Yakutsk aged 20 to 72 years who had suffered COVID-19 in different periods of the pandemic. The study of hematological parameters showed that the average indicators of the morphological composition of red and white blood in people who have had COVID-19 correspond to generally accepted standards, with the exception of the tendency to increase monocytes, basophils, ESR and a slight decrease in MCHC indicators, which indicates a recently transmitted infectious disease

A pilot study was conducted in the expeditionary conditions of the working population of the Anabar and Aldan districts of the Republic of Sakha (Yakutia). Arterial hypertension was registered equally frequently in more than half of the respondents. More than half of the respondents had abdominal obesity, and it was more often detected in non-indigenous men and women of indigenous nationality. Abdominal obesity and arterial hypertension are associated with atherogenic dyslipidemia in the indigenous population, most often in women. In non-indigenous people, regardless of gender, obesity correlated with TG levels and blood glucose, arterial hypertension with the same indicators in non-indigenous women.

Idiopathic pulmonary fibrosis (IPF) is a chronic progressive interstitial lung disease of unknown origin with an average life expectancy of 3-5 years after diagnosis. The disease is accompanied by progressive pulmonary fibrosis, decreased lung function, poor response to therapy and early mortality. Various biomarkers, including serum biomarkers, are used for timely and differential diagnosis of idiopathic pulmonary fibrosis (IPF) and COVID-19-associated pulmonary fibrosis (PF), predicting the course of the disease and assessing the effectiveness of specific therapy. Target was to investigate the features of pulmonary fibrosis based on serum biomarkers in patients with ILF and COVID-19-associated fibrosis. Methods. Changes in serum concentrations of biomarkers CA15-3, LOXL2, TGFBR3 and periostin in patients with ILF (n=10), COVID-19-associated pulmonary fibrosis and controls were investigated. Results. Significant differences were found between LOXL2 concentrations in the control and ILF groups (p=0.003), ILF and COVID-19-associated fibrosis groups (p=0.036) and between periostin concentrations in the control and ILF groups (p=0.042). ROC analysis for LOXL2 revealed: in the ILF and control groups AUC=0.854 (95% CI 0.693-1.0; p<0.0001), with a sensitivity of 80.0% and specificity of 76.9%; in the ILF and COVID-19-associated LF groups AUC=0.773 (95% CI 0.556-0.989; p=0.014) with a sensitivity of 99.0% and specificity of 63.6%. For periostin: AUC=0.692 (95% CI 0.469-0.916; p=0.092) with a sensitivity of 50.0% and specificity of 84.6%. Correlation analysis in the pooled group showed a significant correlation for CA15-3 and periostin (rs=0.383; 95% CI 0.042-0.645; p=0.025), LOXL2 and periostin (rs=0.509; 95% CI 0.196-0.727; p=0.002), TGFBR3 and CA15-3 (rs=0.347; 95% CI 0.0-0.62; p=0.044). Conclusions. We found significant differences between serum levels of LOXL2 in ILF group and CG, ILF group and COVID-19-associated LF. ROC analysis yielded the values of the optimal points of group separation by serum LOXL2 and periostin levels. This allows differential diagnosis of different pulmonary fibrosis.

Aim. To determine the diagnostic value of the vertical lines of lateral teleradiographs in the analysis of the gnathic section of the face and the position of the front teeth. Material and methods. A pilot retrospective study of 74 museum teleradiographs in the lateral projection was conducted. It is proposed to use the nasal-subnasal vertical. Parallel to the nasal-subnasal line, lines were drawn through the anterior superior alveolar point prosthion (Pr) and the anterior inferior point of the infradentale (Id). The position of the cutting edge of the incisors relative to the vertical diagnostic lines and the position of the contact point between the upper and lower incisors were evaluated. A visual analysis of the location of the anatomical details of the gnathic part of the face was carried out. Results. The result of the analysis of radiographs with a mesotrusion type of dental arches showed that in most cases the anterior alveolar vertical, crossing the prosthion point (Pr), passed through the cutting edge of the upper medial incisor, and the interstitial contact point was located in the middle, between the anterior and posterior alveolar lines. Regardless of the typological features of the dental arches in physiological occlusion, equality of vertical dimensions was noted, which was analyzed along five lines that passed perpendicular to the studied diagnostic verticals of the face. The upper horizontal line passed near the apical base of the upper jaw (point "A"), and the lower - through the point "B", which determines the position of the apical base of the lower jaw. Conclusion. Thus, the use of the proposed vertical diagnostic lines allows for a comparative analysis of dental arches of various trusion types, to assess the proportionality of parts of the gnathic section of the face and can be useful for diagnosing malocclusion in various directions, including vertical forms of occlusion and disocclusion.

The results of laboratory and instrumental diagnostic methods in newborns with a history of intrauterine hypoxia were analyzed. Electrocardiographic features were revealed in the form of prolongation of the QT interval; diffuse secondary metabolic-hypoxic changes in the myocardium, such as myocardial hypertrophy, increased myocardial biopotentials from the right and left ventricles; severe overload of both atria. An important role in assessing the state of the cardiovascular system is assigned to the determination of markers for assessing the severity of damage: such as malondialdehyde (MDA) and brain natriuretic peptide (BNP) in the blood serum. As a result of the study, a significantly higher (1.2 times) MDA level was determined in newborns with antenatal hypoxia with NT-proBNP values 4 times higher than the reference laboratory values for the reagent kit. The results obtained suggest the importance of further research into the role of antenatal hypoxia in assessing the state of the cardiovascular system of children.

Currently, the search for effective methods of reconstructive interventions aimed at increasing alveolar ridge height and thickness remains a pressing issue in dentistry. However, the results of studies on the comparative assessment of the effectiveness of the use of autogenic bone from various donor sites are extremely small and ambiguous. Aim. Substantiate the effectiveness of using the optimal composition of autogenic bone chips (ABC) and xenogenic bone material (XBM) taking into account the anatomical localization of the donor zone in guided bone regeneration (GBR) according to the data of microhemodynamics of the experiment. Research materials and methods. The object of the study in the research was 84 sexually mature male rabbits of the chinchilla breed weighing 2500-3200 g. The materials of Cardioplant LLC (Penza) with registration certificates: Xenogenous bone material (XBM) “Xenograft Mineral” (medical device registration certificate No. RZN 2015/3086 dated 16.09.2015) and bioresorbable membrane “BioPLATE Barrier” (medical device registration certificate No. RZN 2016/4808 dated 26.01.2021). A defect in the mandible area was formed in the animals under study, which was then filled with osteoplastic material. Laser Doppler flowmetry (LDF) was used to monitor the state of microhemodynamics of gingival tissues in the area of surgery using a laser analyzer of capillary blood flow "LAKK-02," (NPP "Lazma," Moscow). Results and discussion. It was established that within the first two weeks after the intervention, optimal rates of microcirculation recovery in the surgical area are characteristic of osteoplasty using a mixture of XBM (75%) and ABC (25%) from the oral donor zone. On the 14th day after the operation, capillary blood flow was stabilized, which was manifested by a decrease in the studied parameters in all observation groups. However, the normalization of microvessel functioning was not the same in the study groups. At the same time, the normalization of capillary blood flow was optimal in animals of subgroup 3 in group II, with the microcirculation indicator at the level of 20,59±1,18 perf. units, and its intensity at the level of 2,31±0,12 perf. units by the 14th day. Starting from the 30th day of observation, microcirculation recovery proceeded at the same pace in all groups of animals, with the exception of a slight lag in animals of subgroup 3 in group III, however, by the 90th day and by the end of the observation period, significant differences in capillary blood flow levels could not be found.

Conclusion. The obtained results should be taken into account in outpatient dental practice when performing manipulations related to the use of the GBR technique

Oral Lichen Planus (OLP) is a common chronic inflammatory disease with a high risk of malignization. Early diagnostic tests of erosive and ulcerative form (ECF) of the LP, timely pharmacotherapy are the key to success in the treatment of this form of dermatosis. The cytologic research method is one of the methods by means of which it is possible to obtain the results and adjust the scheme of medication symptomatic treatment in the future. The aim of research is to determine the effect of local treatment on the frequency of cells with nuclear abnormalities in the cytogram of buccal epithelium obtained from the reticular mesh area and from the surface of erosions in patients with the erosive and ulcerative form of the Lichen Planus in the oral cavity mucosa lining. Materials and methods. In the cytogram of buccal epithelium, cytogenetic indicators (micronucleus, tongue-type protrusion, and broken egg-type protrusion), indicators of nucleus destruction (karyopyknosis, karyorrhexis, karyolysis), and indicators of nuclear proliferation (notching) were assessed. Results. The developed method of local treatment of the erosive and ulcerative form of the Lichen Planus contributed to a more significant decrease in the frequency of cells with nuclear proliferation in the form of notches, compared to the group of patients treated according to clinical recommendations (p=0.05), and significantly decreased the frequency of cells with micronuclei (p<0.01), the frequency of degenerative change of the nucleus at p<0.05. Both methods of local treatment were effective, however, in clinical subgroups of patients with high titers of Candida spp. detected in the oral microbiota, the effect of local treatment in the form of ozone therapy, contributed to a decrease in the frequency of the cytogenetic indicator in the form of micronucleus protrusion (at p<0.1), nucleus notching (at p<0.01), the indicator of completion of nuclear destruction (p<0.1). Cytologic examination of the buccal epithelium is a non-invasive method that provides clear information about the status of the epithelial cells, in particular their DNA damage, the proliferative potential of basal cells and cell death, which are considered basic principles of cancer alertness.

The dynamics of the incidence of chickenpox and herpes zoster in the population of the Irkutsk region and the city of Irkutsk against the background of ongoing selective vaccination was studied. A descriptive epidemiological study was conducted according to state statistical reporting based on materials from the Irkutsk region and the city of Irkutsk for 2013-2022. The calculation of predictive values was made using regression equations, the statistical significance of differences in intensive indicators was assessed by 95% CI. Against the background of a decrease in the incidence of chickenpox, in 2021-2022. There was an increase in the indicator among different age groups of the population, the most significant among children under 6 years of age. According to the forecast, in 2023 the incidence rate will not change significantly. Selective vaccination tactics do not significantly affect the incidence of chickenpox (p = -0.217; -0.7; p>0.05). The incidence of shingles in the region exceeds the national level. Taking into account the continuing epidemiological trouble for chicken pox in the region and the data of forecast calculations, it is necessary to adjust the existing vaccination programs, including gradually expanding the contingents to be vaccinated.

Based on the analysis of the results of preventive examinations of children and adolescents of the Astrakhan region for the period from 2015 to 2021, it was revealed that, despite the steady increase in detected cases of diseases of musculoskeletal system (MSS), the percentage of those placed on dispensary registration is constantly decreasing, which violates the target requirements of current regulatory documents at both federal and regional levels. Together with the negative impact of covid restrictions on the volume of preventive examinations, it seriously worsens the situation with the timely implementation of rehabilitation measures for MSS diseases. The negative consequences for the health of the sick will progress as they grow up, which will lead to serious economic damage to society as a whole.

It is proposed to increase the percentage of children being registered at the dispensary with MSS diseases, even if at the time of the examination they have the form of functional abnormalities with the risk of transition to the chronic phase; to expand the rehabilitation infrastructure by creating a specialized center, or significantly improving the equipment of existing medical institutions, to promote measures of self rehabilitation and prevention of MSS diseases among children and youth.

It is proposed to increase the proportion of children with MSS diseases taken under observation at the early stages of the disease, even if at the time of preventive examination they have only the form of functional abnormalities with the risk of transition to the chronic phase; to expand the rehabilitation infrastructure by creating a specialized center, or significantly improving the equipment of existing medical institutions, to promote measures of self-rehabilitation and prevention of MSS diseases among children and youth

The article presents a content analysis of the epidemiology of infectious diseases in the Republic of Sakha (Yakutia) in the period from 2020-2023. An increase in the incidence of infectious pathology in the Republic of Sakha (Yakutia) by 20 nosological forms was revealed. Taking into account the epidemiological situation, as well as the available capacities of medical facilities and staffing, recommendations are proposed to improve the organization of specialized medical care for infectious diseases in the Republic of Sakha (Yakutia).

One of the most challenging and unresolved problems in modern oncology is the provision of medical care to incurable patients. Chronic pain syndrome is one of the most common phenomena causing severe and agonizing suffering to patients with malignant neoplasms.

 As part of the implementation of the comprehensive national program for the development of palliative care in the Russian Federation (Order of the Ministry of Health of the Russian Federation and the Ministry of Labor and Social Protection of the Russian Federation dated May 31, 2019, No. 345n/372n), the authors have developed a project for the establishment of a Pain Management Center at the Yakutsk Oncological Dispensary and pain management rooms at the Ambulatory Oncology Center (AOC).

 The regulatory and legal framework has been studied, and a calculation of patients requiring adequate pain relief at the end of life for the year 2022 has been conducted. In this project, the relevance of the topic is demonstrated, and the medical and social significance is justified. A SWOT analysis of the project has been carried out, evaluating the main risks of the project and proposing methods to eliminate and minimize negative consequences.

The article presents an analysis of the primary morbidity of the population in the Republic of Sakha (Yakutia). The purpose of the study was to conduct a comparative assessment of primary morbidity indicators for the entire population of the Republic of Sakha (Yakutia) by disease class with similar average Russian indicators. At the same time, the morbidity rate for the period 2005-2021 was analyzed. The percentile method was used to determine morbidity levels. As a result, classes of diseases were identified that had high levels throughout the Russian Federation during the period under review. In this regard, the following classes of diseases are distinguished: diseases of the nervous system, eyes and its appendages, diseases of the respiratory and digestive organs, diseases of the skin and subcutaneous tissue, injuries, poisoning and some other consequences of external causes. The points for applying the efforts and resources of health care authorities and medical organizations of the republic to improve public health indicators are becoming obvious.

A study of the level of hormones in the blood serum was carried out in 173 residents of the Aldan region aged from 22 to 75 years, of which 65 (39.8%) were men and 108 (60.2%) women, the average age was 44.0 (35. 0; 52.0) years. In the working population, there is functional tension of the pituitary-thyroid link, characterized by a higher frequency of occurrence of thyroid hormone levels below the normal T3total. in 27.2%, T3f. in 19.3% and T4f. in 11.6% of people, more pronounced in women. Increased concentrations of thyroid hormones T3f., T4f. and T4tot. observed with age, T3total and T4total in people with an increased body mass index. The presence of increased levels of antibodies to thyroid peroxidase in 18 (10.4%) people indicates a strained immune system, therefore it is recommended to include endocrinological examinations in periodic medical examinations.

The study was conducted in 2022 as part of the implementation of the second stage of the pilot project "ОНКОПОИСКСАХА.РФ" (ONCO-SEARCH) at the Yakut Republican Oncology Dispensary, which is part of the national project "Healthcare". The project involved 798 women from 10 districts of the Republic of Sakha (Yakutia). The comprehensive examination included cytological testing, detection and genotyping of high carcinogenic risk human papillomavirus (HСR-HPV) using polymerase chain reaction, and assessment of viral load. The territorial distribution of HСR-HPV types was demonstrated. The overall infection rate among women ranged from 6.9% (Tomponsky district) to 25.0% (Oymyakon district), with an average of 14.8%. The majority of infections were of the episomal - non-integrated form of HPV. Differences in infection rates among women of different age groups were observed. The highest pro-portion of HCR-HPV carriers, including integrated forms, was found in the age groups of 20-30 and 31-40 years. High-grade squamous intraepithelial lesions (HSIL) were diagnosed in 2.5% of the examined women, while low-grade squamous intraepithelial lesions (LSIL) were found in 1.8%. One woman was diagnosed with squamous cell carcinoma. The study showed a correlation between viral load, integrated forms of HPV, and cervical intraepithelial neoplasia (CIN). The integrated form of genotype 16 made the largest contribution (50%) to CIN lesions among HCR-HPV-infected individuals.

The analysis was conducted of 14,578 patients vaccinated against coronavirus infection in Krasnoyarsk and Zelenogorsk. As a result of the study, the effectiveness of vaccination against the SARS-Cov-2 coronavirus was proven. It was found that of all vaccinated people, 49.5% did not get sick with COVID, and the majority of vaccinated patients had a mild course of the disease. Mortality in the study group from a new coronavirus infection was 3.9% in Krasnoyarsk, 2.9% in Zelenogorsk (p = 0.0005). The median age of patients who died from a new coronavirus infection in Krasnoyarsk was 68.0 [61.0; 72.5] years, among women 68.5 [61.5; 77.0] and in Zelenogorsk among men 72.5 [62.0; 83.0] years, among women 78.0 [71.0; 83.0] years.

Among patients with severe and extremely severe severity, 24 patients were vaccinated, which accounted for 7.9% of all patients with severe and extremely severe severity. Among the deceased patients, 21 (7.8%) patients were vaccinated. In 18 (6.8%) patients who died, infection with a new coronavirus infection occurred within 10 days from the date of vaccination.

COVID-19 is a severe acute respiratory infection caused by the SARS-CoV-2 coronavirus primarily affecting the respiratory system and leading to pathological changes in the cardiovascular system. The aim of the research is to analyze the clinical course of the new coronavirus infection in patients with comorbid conditions and the development of heart damage associated with COVID-19.

Materials and Methods: A clinical case of a patient belonging to a high-risk group is described, having comorbidities (such as chronic heart failure, type 2 diabetes mellitus, arterial hypertension), an age of 77 years, and female gender. Despite the patient's late presentation for medical assistance, resulting in worsening of myocardial infarction, which occurred in combination with severe acute respiratory distress syndrome, timely identification of the risk of cardiovascular complications was carried out during the hospitalization stage, and specific targeted therapy was initiated. However, 11 months after discharge, the patient experienced a second myocardial infarction, followed by a third one after 3.5 months (both with favorable outcomes).

Results of the Study: The presented clinical case confirms the existence of pathogenetic interaction between cardiovascular diseases and COVID-19, wherein the SARS-CoV-2 virus penetrates lung cells, heart, and other organs, affecting the endothelium of blood vessels, leading to partial destruction and damage to cardiac tissue.

Accumulating evidence indicates a high prevalence of long-term negative consequences of COVID-19. Their final assessment is possible only after their complete disappearance, which, given the ongoing registration of negative assessments of the health status of some hospitalized COVID-19 patients, is impossible in the near future. Taking this into account, further study of post-Covid consequences in dynamics is relevant. The purpose of the study was to determine the quality of life and health of patients in the long-term period (24 months) after hospitalization for COVID-19-associated pneumonia. Material and methods. The study was conducted on data from 158 patients with moderate and severe severity who were hospitalized during the first wave of coronavirus infection in the period 09/01/2020-11/30/2020. To assess the quality of life in the post-Covid period the VR-12 questionnaire was used. The study involved conducting structural and frequency analysis, assessing the consistency of answers to the questionnaire using Cronbach's alpha and the chi-square test, calculating the nonparametric Spearman rank correlation coefficient, and non-serial correlation coefficients. To identify factors influencing health assessments, a linear regression model was built. Ordered logistic regression was estimated to identify factors influencing the distribution of responses to additional questions. Results. The analysis showed an significant difference between the physical component summary (PCS) and mental component summary (MCS) of the respondents. A connection was found between age and the risk of deterioration in self-esteem of health. It was possible to identify a significant difference in the self-assessment of the quality of physical and mental health in men and women, taking into account adjustment for age, two years after suffering from pneumonia, and also to substantiate the non-significance of RDS during hospitalization, given the significance of a high percentage of lung damage for the lower self-assessment of health of persons who had suffered coronavirus infection of moderate and severe severity. Conclusion. The results are largely consistent with studies conducted in other countries, indicating an uneven change in post-Covid consequences and emphasizing the importance of individual recovery programs taking into account the severity of the disease, age and gender of patients.

Introduction. Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by cognitive decline, primarily loss of memory for recent events. Despite the widespread prevalence of AD in the world, in Russia there is a high level of deficiency in diagnosing the disease. The Republic of Sakha (Yakutia) is a large subject of the Russian Federation; at the beginning of 2023, the population of the Republic was 997,565 people, and over the past 20 years, the share of elderly people (60 years and older) has increased 1.86 times (from 8.3% to 15 ,5%). The aim of the research: to assess the level of diagnosis of Alzheimer's disease and predict the likely number of patients in the Republic of Sakha (Yakutia). Materials and methods: to estimate the number of patients with AD, reports from neurologists of the Republic of Sakha (Yakutia) and official data on the disease provided by the Yakut Republican Medical Information and Analytical Center were analyzed (YRMIAC). To predict the number of patients in the city of Yakutsk and the regions of the Republic of Sakha (Yakutia) for each age group of the population, the maximum and minimum proportions of people who could potentially suffer from AD were calculated. Based on various epidemiological studies, three forecast scripts have been identified: “Chinese”, “Japanese” and “American”. Results and discussion. According to official data, 45 patients diagnosed with AD are registered in the Republic of Sakha (Yakutia), of which 36 (80%) people live in Yakutsk. According to reports from neurologists for 2022, only 7 people are registered at the dispensary with a diagnosis of Alzheimer’s disease. If we extrapolate world data for the Republic Sakha (Yakutia), then the minimum number of patients with Alzheimer's disease should be 4,166.4 people and observed under the “Chinese” script, and the maximum number of patients – 8,428.5 people – under the “American” script. The largest number of patients is predicted in the industrial districts of the republic (Neryungri, Mirny and Aldan). The smallest number of patients with Alzheimer's disease is predicted in the Arctic and Northern districts, especially in Eveno-Bytantaysky and Anabarsky. Conclusion. Alzheimer's disease is one of the leading medical and social problems of the modern world. At this stage in the Republic of Sakha (Yakutia), improved diagnosis of the disease is required for the timely initiation of symptomatic therapy. The predicted number of patients determined by us in the city of Yakutsk and the districts of the Republic can serve as a guideline when screening patients for cognitive impairment.

The article presents materials of the coloproctology department of the Republic hospital №2 - Emergency Medical Center for the last five years (2018-2022). Diagnosis and treatment of 399 patients with complicated colorectal cancer admitted by emergency indications were analyzed. 115 patients (28.8%) were delivered from the districts of the Republic by air ambulance. The remaining 284 patients (71.2%) were hospitalized from Yakutsk and its suburbs. 90% of patients were operated by emergency. The mortality rate after emergency surgical interventions amounted to 20.2%.

Introduction. Tumours affecting the reproductive organs are diagnosed in women of fertile age in 20–40% of cases. Therefore, the current situation not only affects the quality and life expectancy of patients, but also leads to a decrease in the reproductive potential of the country. Relevance of Research. The authors’ research aims to obtain new theoretical data regarding the risks of malignant neoplasms in the female genital system correlated with various ratios of risk factors at the territorial level. Materials and Methods. During the initial research stage, the authors employed the analytical method to gather data on risk factors for oncological malignancies identified through content analysis of both domestic and foreign literature sources. During the second research stage, data were collected regarding the incidence of cancer risk factors classified as social and hygienic factors. The data were collected retrospectively for the period of 1995–2020 (n = 36935). The data processing programme comprised the calculation of the prevalence rate of the risk of malignant neoplasms of the reproductive system in women of reproductive age. Research methodical specifics involved constructing parallel chronograms of each cancer risk factor and new onsets of malignant cancer diseases broken down by years of the research period. These data were used as evidence of effectiveness of cancer risk management procedures within the territory. Conclusion. The data obtained bolster the correlation between malignant reproductive diseases in women and social and hygienic risk factors. This substantiates the suggestion to incorporate such risk factors as maternal smoking, late first pregnancy and maternal age over 40 years, early sexual activity and large number of sexual partners in the set of indicators for assessing the risk burden in the territory

An assessment was made of the biological constant, consisting of the sum of glucose and total cholesterol levels in 161 residents of Yakutsk aged 20 to 72 years who had recovered from COVID-19.

The increase in this biological constant in the post-Covid period is most acutely expressed in individuals with morbid obesity. At the same time, there was a statistically significant tendency to increase the constant, as the disease worsened. Its significant increase to 12.25 mmol/l was not[1]ed in the post-ovoid period, in the group of patients with severe lung damage. The imbalance of harmony occurs due to an increase in glucose concentration, i.e. it is associated with a violation of carbohydrate metabolism. The results of our study indicate that patients who have suffered from SARS-CoV-2 coronavirus infection are at high risk of developing cardiovascular diseases in the postcovid period.

The article presents data on the content of transport proteins of the blood system in relation to the state of the immune system in people living in extremely unfavorable conditions of the Svalbard archipelago. It has been established that the inhabitants of Spitsbergen have an activation of cell migration into tissues in case of insufficient oxygenation of tissues. A decrease in the level of lymphocytes in the circulation causes a violation of the regulation of immune reactions with the accumulation in the blood of extracellular forms of receptors, circulating immune complexes. People living in Svalbard have an increased need for transport components of the blood system: haptoglobin, transferrin and IgM.

The analysis of the main medical and demographic indicators of maternal and child health care in 13 Arctic regions of the Republic of Sakha (Yakutia) is presented in the article. It is demonstrated that the studied period is marked by a decrease in population size, and despite this, there are high birth rates, as well as high rates of total mortality, a significant decrease in the infant mortality rate, and high rates of child morbidity.

To date, there is a worldwide trend of increasing morbidity and mortality in patients with chronic kidney disease. Given the secondary nature of kidney damage, prevention and early detection of risk factors are the main priority of modern medicine.

The purpose of our work was to conduct a screening study of the population of the Momsky district (5 settlements) of the Republic of Sakha (Yakutia) for early detection of damage and decreased kidney function.

Results. The study involved 222 people, of whom 14 (6,3%) had chronic kidney disease (GFR less than 60 ml/min/1.73 m2). An early predictor of the development of chronic kidney disease, albuminuria was found in 70 (31.5%) of the examined patients. The main risk factors affecting the development of chronic kidney disease were hypertension (54.3%), burden of cardiovascular diseases (50%) and obesity (37.1%), burden of kidney diseases were in 11 (15.7%) of the examined patients.

А correlation between the levels of blood biomarkers and clinical manifestations of SMA in patients of the main regional healthcare institution of the Samara region was carried out. Differences in creatinine, creatine phosphokinase, and lactate dehydrogenase levels among patient groups and their association with motor impairment did not show statistical significance.

Differences in CPK levels between groups may be related to age, weight, gender, and levels of physical activity of patients. The data obtained from the study of the history of repeated hospitalizations do not provide reliable information due to the limited sample and heterogeneity of the data. The results of this work indicate the ineffectiveness of assessing the levels of creatinine, CPK and LDH in order to monitor and predict the course of SMA, as well as the inappropriateness of repeating these laboratory studies in patients with SMA 5q.

An analytical review of literature data of modern studies of monocyte migration (movement) in tumor microenvironment using various three-dimensional models of monocyte migration in tumor microenvironment is presented. The given literature data can serve as a characteristic of three-dimensional models as an optimal platform for studying the functions of both individual cell populations of immune cells and whole cell ensembles in the development and therapy of malignant neoplasms. One of the most important characteristics of a three-dimensional model, which has a significant impact on its prognostic ability, is the cellular composition used. The given data clearly demonstrate the importance of the diversity of cell types of the used models, including the introduction of stromal cells (in particular, fibroblasts). Various cell types form a complex system of interactions, thus forming three-dimensional models closest to native organismal conditions. Different types of tumor cells and their individual cell lines are of no less high importance for prognostic ability. For example, tumor spheroids that contain different types of cancer cells show a different secretory profile. As such, the pattern of monocyte infiltration and polarization may differ depending on the type of tumor cell line. In addition to the components themselves used to create the 3D model, the nature of the organization of the above components (different cell types and populations, as well as structural extracellular components) is important. Therefore, this analytical review contains a separate structural section including the analysis of the diversity of structural groups of three-dimensional tumor models. Among the variety of the mentioned structural groups the following should be mentioned: suspensions of multicomponent cancer spheroids, various variants of microfluidic systems and a separate group of organoids - miniature models of native organs and tissues. Thus, this analytical review demonstrates the importance of further optimization of three-dimensional tumor models in order to obtain even more effective means of reproducing the native structure of the tumor microenvironment.

The purpose of this review is to update the knowledge of neurologist doctors about the role of pro-inflammatory cytokines in the evelopment and chronicity of discogenic pain syndrome in patients with intervertebral disc degeneration.

To explain the more productive isolation of HPV DNA from the blood component compared to plasma in cervical cancer patients, using scanning electron microscopy images of venous blood were studied. It was revealed that there are more nanosized bioparticles on the erythrocytes surface than in plasma. It has been suggested that among them there may be tumor extracellular vesicles carrying HPV DNA. To confirm that the erythrocyte fraction of blood is a more productive biological sample for isolating HPV DNA, continued studies are needed.

Glycogenosis type III (Cori disease) is one of the most common glycogen storage diseases in the world. The disease is associated with a disorder of carbohydrate metabolism: glycogen metabolism, leading to disruption of its synthesis or breakdown and is characterized by excessive accumulation of this polysaccharide in the organs and tissues of the body, most often in the liver or muscles. This article presents a clinical case of glycogen storage disease type III.

Patients with drug-resistant epilepsy (DRE) due to an arteriovenous malformation (AVM) located in a functionally significant area of the brain experience a significant decrease in quality of life and require additional non-drug rehabilitation methods aimed at controlling epileptic symptoms.

Aim. To present a clinical observation of the use of the Epi-Tapp® application in a 29-year-old patient with an AVM. Materials and methods. We used the author's wrist tapping method EpiTapp® (RF patent No. 2606489 dated January 10, 2017). Results. Using the EpiTapp® application allowed a 29-year-old man with an AVM to reduce the severity and duration of focal seizures in 85% of cases and prevent secondary bilateral transformation of incipient bilateral tonic-clonic seizures in more than 50% of cases. Conclusions. This clinical case demonstrates the possibility of effectively using the EpiTapp® application in a patient with drug-resistant epilepsy as an element of a rehabilitation program aimed at controlling epileptic seizures.

The article presents a clinical case of CHARGE syndrome in a 4-year-old child. Literature data and a description of the clinical observation of CHARGE syndrome are given. CHARGE syndrome (Hall–Hittner syndrome; ICD-10:Q87.8) is a rare hereditary disease. The name of the syndrome is made up of the first letters of the main malformations characteristic of the disease. CHARGE: Coloboma (coloboma — a defect of the membranes of the eye), Heart disease (heart disease), choanal Atresia (hoan atresia — overgrowth of the posterior parts of the nasal cavity), growth and mental Retardation (delay in physical and mental development), Genital anomalies (anomalies of the genitourinary system)

The article presents a clinical case of elimination of obstructive jaundice caused by Ascaris lumbricoides. The patient was admitted with a clinic of obstructive jaundice, presumably caused by choledocholithiasis against the background of a long history of cholelithiasis, chronic calculous cholecystitis. After two attempts of lithoextraction in the lumen of the common bile duct, a round parasite was detected, which extracted and sent for laboratory was testing, where the diagnosis of ascariasis was confirmed. The clinic of obstructive jaundice was dropped out.

Measles is a highly contagious acute viral infectious disease with an airborne and transplacental transmission mechanism caused by an RNA-containing measles virus (genus morbilliviruses, family paramyxoviruses). Vaccination against measles is included in the National Calendar of Preventive Vaccinations of the Russian Federation and is carried out at the age of 12 months, followed by revaccination at 6 years. Immunity after measles is usually lifelong. Post-vaccination immunity is less prolonged: after 10 years, protective antibody titers remain only in 36% of vaccinated. In this regard, in the conditions of an epidemiological outbreak, there is a shift in morbidity to older age groups. Several cases of measles in pregnant women have been described. However, congenital measles is an extremely rare diagnosis. Our article describes a case of congenital measles in a newborn from a 34-year-old woman. At 28 weeks gestation, the woman was diagnosed with pneumonia, then a typical rash appeared. The diagnosis was confirmed by serological method. Thus, the birth occurred in the acute period of the disease. The baby was born prematurely at 28 weeks gestation by Caesarean section. The child's condition at birth was extremely severe. Apgar score is 5/7. The condition of the newborn was extremely severe due to prematurity and multiple pathology. The child was diagnosed with Respiratory distress syndrome of a newborn with respiratory insufficiency of the III degree. On the ninth day of life, a rash appeared. The diagnosis of measles was confirmed by the determination of antibodies to Measilis virus IgM. The course of measles in the exanthemic period was atypical (spotty rash elements on the first day, not characteristic dynamics of rash appearance). However, the presence of perinatal contact, the appearance of rashes made it possible to suspect such a rare diagnosis as congenital measles, and serological diagnostics confirmed this diagnosis. Against the background of the therapy, the patient's condition stabilized on the 7th day of the exanthemic period, the rash regressed. At the age of 1 month and 23 days, the child was discharged home in a satisfactory condition.