The article reports the analysis of territorial and gender differences in cardiovascular (CVD) mortality among the population of the Sakha (Yakutia) Republic aged 15 and older.

We have established substantial differences in the mortality rates and age of death from CVD between the municipalities of the republic. The highest standardised CVD mortality rates were in Zhigansky, Olenyoksky, and Nizhnekolymsky districts, the lowest in Verkhnevilyuysky, УдК 314.482; 314.422.6 ПередОВаЯ СТаТьЯ Even-Bytantaisky, and Abyisky districts. The lowest median death age values were observed in the Even-Bytantaisky and Abyisky districts, the largest in the Olenyokskiy and Churapchinsky districts.

Men’s mortality rate was 1.7 times higher than that of women. Median age of death in men was 13 years less than in women.

To manage the demographic situation in the region, it is necessary to search for the causes of existing differences in the death rates of the population.

The article analyzes the morbidity of children in the Republic of Sakha (Yakutia) for 1995-2015. There is an increase in the morbidity rate of the child population, identified by referral to medical and preventive institutions, for many groups of diseases.

In this paper we presented the results of the study of clinical outcomes in patients with gastroduodenal diseases in Yakutia depending on the presence of the cytotoxin-associated gene A (cagA) in Helicobacter pylori genome. The relationship between cagA+ strains and more severe clinical outcomes (erosion and ulcers) in patients with gastroduodenal diseases associated with Helicobacter pylori in Yakutia has been shown.

In this paper, we present the results of an analysis of the resistance of heterozygous carriers of the с.-23+1G>A mutation in GJB2 gene to diarrhea in Yakutia. It was shown that in individuals with c.-23 + 1G> A mutation in the heterozygous state, cases of diarrhea for the last year were registered less frequently (p < 0.05) than in individuals without mutation. The research results support evidence that heterozygous carriers of GJB2 gene mutations may have increased resistance to gastrointestinal diseases, in particular to diarrhea.

In order to study the distribution frequency of the polymorphism alleles rs9939609 of the FTO gene and polymorphism rs738409 of the PNPLA3 gene among the Yakuts, DNA samples of type 2 diabetes patients and healthy volunteers were tested.

The study of the distribution frequency of the polymorphism alleles rs9939609 of the FTO gene and polymorphism rs738409 of the PNPLA3 gene in both groups showed no significant differences. Analysis of the distribution frequency of alleles and genotypes of the polymorphic variant of the FTO gene (rs9939609) in the group of patients with type 2 diabetes and healthy revealed a predominance of the T allele and a homozygous genotype of TT, except for a group of practically healthy men, which despite the prevalence of the T allele was characterized by the highest level of the heterozygous genotype AT. At analyzing the distribution frequency of the alleles and genotypes of the polymorphic version of the PNPLA3 gene (rs738409), the allele G and the homozygous genotype GG prevailed in both groups. In the studied men of both groups the G allele significantly prevailed over the C allele (p <0.05).

During experiments on white rats of the Wistar line, anti-inflammatory activity of the extract of dry complex herbal remedy (Juglans regia L. Rich ex Kimth., Corylus avellana L., Agrimonia eupatória L., Bidens tripartita L., Xanthium strumarium L., Urtica dioica L. Lemna minor L., Cichorium intybus L., Onopordum acanthium L.) was examined on models of acute exudative (carrageenan and formalin), chronic alterative and proliferative inflammation. It is found that phytoextract has antiexudative activity, reducing the exudation caused by phlogogenic agents. The tested extract has an anti-alterative effect, limiting the alteration of tissues with acetic acid and enhancing regenerative processes.

The article reports the study on the influence of low temperatures on the intensity of free radical lipid oxidation and antioxidant protection in the tissues of internal organs (liver, kidneys, lungs, heart) in experimental animals, depending on the exposure time. We noted an increase in the concentration of low-molecular antioxidants in the organs of animals, whose exposure time in the cold lasted 1 hour. An increase in exposure timeof rats in the cold to 3 hours is associated with an increase in catalase activity.

The authors have analyzed the results of cytological study of cervix in women aged 18 to 88 years as a method of early diagnosis of background and precancerous diseases of the cervix uteri. The obtained results confirm the high predictive value of this method. Early detection and treatment of background and precancerous diseases of the cervix will contribute to a real reduction in the morbidity and mortality from cervical cancer.

To study the microflora of the oral cavity, children and adolescents living in Yakutsk were examined. Smears from the mucous throat and tonsils were used to conduct a microbiological analysis of the oral microflora in frequently ill children, as well as in children with acute tonsillopharyngitis, acute pharyngitis, and angina, also using the express-diagnosis method Streptatest for the presence of beta-hemolytic streptococcus group A (BHSA). In the frequently ill children, yeast fungi of the genus Candida, bacteria of the genuses Staphylococcus, Streptococcus and Klebsiella were found. As a result of the treatment in children, the anaerobic index is shifted to the normal range. According to the rapid test for BHSA, a positive result was detected in 37% of patients. Timely establishment of BHSA allowed conducting eradication antibacterial therapy, which led to recovery without complications.

The character of clinical endoscopic features of gastropathies, induced by the intake of non-steroidal anti-inflammatory drugs, was evaluated in patients with cardiac pathology.

The clinical picture of NSAIDs-gastropathies in patients with IHD was characterized by a mismatch of symptoms and endoscopic changes. This manifested itself in the fact that in the presence of a bright endoscopic picture (erosion, ulcer), NSAIDs-gastropathies were often asymptomatic. In contrast, in most patients who have noticed pain or other dyspeptic disorders, endoscopic examination revealed minimal changes in the mucosa of the gastroduodenal zone. Therefore, carrying out endoscopic control, preferably in the early stages of treatment, is the most necessary and mandatory method of preventing serious complications.

The degree of the correlation between the level of oncomarkers and the rigidity of consumed water among residents of 6 different regions of Yakutia was assessed. The conducted analysis established significant direct correlation between water hardness and the level of oncomarkers: alfa-fetoprotein, cancer-embryonic antigen, prostate-specific antigen for men and carbohydrate antigen CA-125 for women.

The article presents the results of the study of the etiological, clinical features of secondary pyelonephritis in children, depending on the type of abnormalities of kidney and urinary tract development. We’ve revealed that secondary pyelonephritis most often develops against the background of neurogenic dysfunction of the bladder and vesicoureteral reflux. In this case, children more often recorded neurogenic dysfunction of the bladder in a hyporeflective type. And among children with vesicoureteral reflux, the prevalence of vesicoureteral reflux on the left was more often noted. The main complication of secondary pyelonephritis is reflux-nephropathy with the development of chronic renal failure. Recently, the concept of obstruction of the urinary tract has undergone significant changes and has become more capacious.

The article presents an analysis of social readiness of pregnant women from families, burdened with a widespread in Yakutia neurodegenerative monogenic disease spinocerebellar ataxia type 1 (SCA1), to pass the program of prenatal DNA diagnostics. This work opens some social problems of pregnant women with risk of SCA1 for generation that will allow defining further competent tactics of the medical-genetic and social help to burdened families.

The authors report a survey of respondents on reproductive health of girls. According to the results of the study, it was revealed that young people had insufficient knowledge of contraception, as well as psychological readiness for the artificial termination of pregnancy. The study identified the main factors in reducing the reproductive potential of girls of fertile age.

A biochemical study was conducted among athletes - freestyle wrestlers of Yakutia in different seasons of the year. The clinical and biochemical indices, reflecting the state of the body of the wrestlers, show that there were no abnormalities in the surveyed athletes. At the same time in the part of the sportsmen in our research, the activity of enzymes (except APF) was moderately increased in all seasons of the year, especially in the autumn-winter period.

Meningitis continues to be the most common form of central nervous system damage in children. The article analyzes the clinical and laboratory features of meningitis in children and their outcomes according to the data of the State Institution of the Republic Sakha (Yakutia) «Children’s Infectious Clinical Hospital». The clinical manifestations, etiological landscape of meningitis in children and the demonstrators of laboratory analyzes were studied. In the etiologic structure serous meningitis with enterovirus etiology (90%) predominated among meningitis with refined etiology, which was confirmed by laboratory tests

To reveal the regularity of distribution of diselementoses and the elemental profile of pathology the content of chemical elements in the hair of women from various regions of the Republic of Sakha (Yakutia) was investigated.

The authors have presented the results of their study of the features of the epidemiological process and the clinical picture in children and adolescents with chronic hepatitis B (CHB), representatives of the Mongoloid race. A comparative analysis of the data of patients of Mongoloid and Caucasoid races (Yakuts, representatives of small indigenous peoples of the North, Russians residing in the territory of Yakutia) is carried out. The researchers have found out that in children and adolescents of the Mongoloid race the CHB morbidity is significantly higher, there is a tendency to a more severe course of the disease than in the representatives of the Caucasoid race.

The article presents the analysis of frequency indicators: primary morbidity, mortality in acute leukemia in children of the RS (Y) for the period from 2000 to 2016. The incidence of acute leukemia, acute lymphoblastic leukemia, acute non-lymphoblastic leukemia in children’s population of the RS (I) are average and comparable with that of other regions of the Russian Federation. In dynamics there is a decrease in mortality from leukemia and this is due to the improvement of therapy and the quality of accompanying therapy.

The article analyzes the incidence of cancer in children and adolescents of the Republic of Sakha (Yakutia) from 2000 to 2015 according to the data of appeal and hospitalization in medical institutions.

The article discusses the priorities of cochlear implantation (CI) in the RS (Ya). The results of the CI in Yakutsk to 11 children are presented. The need for further introduction of high-tech care for children to improve the quality of life was noted.

The prevalence and intensity of parodontium diseases among the population of the Far East of Russia has been studied. At the same time, an unfavorable morbidity situation was identified, associated with an increase in the severity of the clinical course of periodontal disease with age. The high prevalence of pathological processes of periodontal tissues of inflammatory-destructive nature dictates the need to develop and implement a comprehensive program for the prevention of periodontal diseases.

Actual nutrition of pregnant women was studied on a basis of epidemiological research. It is established that rations of a majority of the pregnant women are profoundly deficient in an energy value and all nutrients. Parameters of «red blood» (RBC, HGB, Ht, MCH, MCHC, MCV, RDW and PLT) and iron metabolism (serum iron, ferritin and transferrin) of the pregnant women, puerperas and newborns were studied. A high frequency of iron deficiency states among the pregnant women, puerperas and their newborns is determined. It is proved that the iron deficiency negatively affects a course of the pregnancy, childbirth, a condition of a fetus and newborn. A conducted canonical correlation analysis revealed a significant interrelation between the blood parameters in the first and second trimesters with protein content and minerals (iron, sodium, potassium, calcium, magnesium and phosphorus) in the mother’s ration.

Data on the high frequency of arterial hypertension in the indigenous population of the Arctic zone of Yakutia were obtained. It is established that the 10-year risk of death from cardiovascular complications increases in people with arterial hypertension.

The article presents historical and modern ideas about Graves’ disease (GD), new approaches in treatment and diagnostics and the results of studies of foreign and domestic scientists on the role of genetic factors in the development of GD. In the Republic of Sakha (Yakutia), the share of GD in the structure of endocrine pathology ranks 2.3%. The Arctic regions are in the first places by the frequency of occurrence of GD.

The article presents the results of the study of the frequencies of occurrence of single nucleotide polymorphisms of the genes ADD1α (1378 G> T), AGT (704 T> C and 521 C> T), AGTR1 (1166 A> C) and AGTR2 (1675 G> A) groups of residents of the Arctic zone of the RS (Ya), suffering from essential arterial hypertension. To reveal the above mentioned polymorphisms, a real-time PCR method was used with detection of the melting temperature of duplexes. In the course of the study statistically significant differences between the study groups were identified by the points ADD1α 1378 G> T; AGT 521 C> T and AGTR1 1166 A> C.

A Center of Nutrition of a SRI of Health of the M.K. Ammosov NEFU has carried out monitoring epidemiological studies since 2001 on actual nutrition and eating habits among children and adolescents of Yakutia aged 10-18. The study uses a food questionnaire developed by a Federal State Budgetary Institution of Science «Federal Research Center of Nutrition, Biotechnology and Food Safety» (FSBIS «FRC of Nutrition, Biotechnology and Food Safety») and Federal State Budgetary Institution «National Medical Research Center for Preventive Medicine» (FSBI «National Medical Research Center for Preventive Medicine») of the Ministry of Health of Russia, adapted in accordance with peculiarities of culture and traditions of the nutrition of peoples of the North. Using a method of frequency analysis of consumption of certain products and daily nutrition reproduction from memory, main parameters of consumption of the particular food products including the Yakut national foods and dishes were studied. Daily rations of children and adolescents were studied and evaluated by the method of daily nutrition reproduction in accordance with norms of nutrition. On average, only 62.2% of examined subjects corresponded to an energy value of the rations, almost everyone had a deficiency of micronutrients (vitamins and minerals).

The article examines the results of scientific research on the analysis of clinical and laboratory indicators of bronchial asthma (BA) in obese patients. The analysis of literary data concerning pathophysiological mechanisms of influence of excess amount of fatty tissue on character of a course of bronchial asthma is carried out. It has been established that significant volumes of adipose tissue are a source of pro-inflammatory cytokines, aggravating the course of asthma.

The authors made a review of domestic and foreign literature on the molecular and genetic causes of multiple hereditary exostosis. The main molecular genetic causes of multiple hereditary exostosis are mutations in the genes of exostozin 1 (EXT1) (OMIM 608177) and exostozin 2 (EXT2) (OMIM 608210).

The article presents the clinical case of management of a child with a genetic metabolic disease until setting a correct diagnosis propionic acidemia. The full – term child aged 11 days had developed metabolic crisis, which was taken as an expression of neonatal pathology, such as neonatal jaundice, perinatal CNS lesion. On a background of detoxification the patient had the clinical positive dynamics, but a bright period lasted only two weeks. Due to a main disease the child had secondary immunodeficiency, which resulted in recurrent pneumonias. The patient was examined in three ways: changes of peripheral blood – leukopenia, thrombocytopenia, anemia; neurological symptoms – soporous condition, lethargy, refusal of meals, oppression of all reflexes, muscular hypotension; in view of anamnesis, impossibility of a comparison all the clinical symptoms to one diagnosis tap genetic research. The lack of the methodology of tandem mass spectrometry extended the time of correct diagnosis and timely treatment.

The article represents the results of medical and statistical analysis of abortion in the Sakha Republic (Yakutia) for the long-term period (1991– 2015). A decrease in the incidence of abortion and transformation of its structure has been noted. The level of abortions due to social indications and registered criminal abortions has decreased the most. An increase in the proportion of spontaneous and unspecified abortions in total ratio of abortion has been found out. The results of the correlation analysis confirm the influence of the women reproductive behavior on demographic processes in the Sakha Republic (Yakutia).

The article reflects the experience of transfusion therapy in major obstetric bleeding during cesarean section among women with placenta percreta from 2016 to 2018. A comparative analysis of the applied blood components and blood products is presented in the article. The analysis has shown that integration of The European guidelines on management of major bleeding allows decreasing of the average volume of blood loss, reducing postoperative transfusions, reducing the frequency of postoperative mechanical ventilation, as well as reducing the time of stay in the resuscitation department.

In order to study the features of immunity in children with multiple papillomas and the effectiveness of therapy with groprinosin and lycopid drugs, a group of children with multiple papillomas and a group of healthy children, comparable in age, were examined. All children showed a positive PCR for HPV, a histological examination of the papillomas, as well as an examination of the immune status were done. It was revealed that in children with papillomas the content of IgA, CD19 + and CD16 + lymphocytes was reduced. The therapy with groprinosin and lycopid medications leads to normalization of the lowered immune status indicators, as well as to the cessation of the appearance of new papillomas in children.

The effect of dihydroquercetin (DHA) bioflavonoid in a dose of 50 mg/kg on DNA synthesis and the state of the nucleo-nucleolar apparatus of white rat cardiomyocytes on an intact background and under conditions of oxidative stress was studied. The corrective effect of DHA on biosynthetic processes in the myocardium of white rats in the presence of oxidative stress was revealed. The effect of DHA on an intact background inhibits DNA synthetic processes in the myocardium of newborn animals and reduces the size of nuclei and nucleoli in cardiomyocytes of sexually mature animals. The obtained data make it possible to recommend the use of antioxidants in cardiology only in the presence of pronounced oxidative stress.