The study of microorganisms of the Arctic paleoecosystems, their biopotential for biotechnologies development, and their use in medicine are promising and urgent issues. These organisms are most sensitive to the climate change, and they play a crucial ecological role in their natural habitat. In this regard, the main research topic is the influence of relict microbiota on modern biological objects, primarily on their cytogenetic apparatus. The purpose of our study was to estimate the influence of microorganisms of the genus Bacillus from dispersed soils that passed into a frozen state during the Holocene on the cytogenetic apparatus of Allium cepa. The research task was to study the cytotoxicity of microorganisms of the genus Bacillus on the differentiation of Allium cepa cells. The Allium test was used for this research. The experts from the World Health Organization (WHO) have recommend this test system to study the influence of microorganisms on the cytogenetic apparatus of plants. Moreover, this test is one of the few direct and unique methods that allow estimating the effect of mutagens or carcinogens by monitoring chromosomal changes. During the experiment, we found that bacteria of the genus Bacillus can change the mitotic activity of the meristematic root tissue of Allium cepa. The influence of the studied strains from the frozen rocks manifests at the cellular level. It is expressed both in the mitosis-stimulating effect and in the limitation of the proliferative capability of Allium cepa cells. It was found that some strains of the genus Bacillus can inhibit mitosis, and some, on the contrary, stimulate it. The research was carried out in laboratory conditions using standard morphometric, microscopic, and statistical methods. The practical significance and prospects of further research lie in the fact that by assessing the cytotoxic effect of bacterial strains isolated from permafrost, it is possible to create biologically active preparations of targeted complex action for use in medical practice. The study of microorganisms from permafrost provides a better understanding of the evolution of adaptive characteristics to cold. Also, research allows the widespread use of microorganisms adapted to cold weather and their cellular components in biotechnology. It requires fundamental interdisciplinary research.

Vilyui encephalomyelitis (VE) is a unique endemic disease of the central nervous system, in which neurodegenerative processes are initiated by chronic aseptic subclinical inflammation of the brain. Recent research suggests that the gut microbiome play an important role in immune activation and inflammation in a variety of neurological conditions, including multiple sclerosis, Parkinson’s disease, and Alzheimer’s disease. The article discusses the results of a pilot study of the intestinal microbiome of healthy representatives of the Sakha ethnic group (Yakuts) and VE patients, carried out in collaboration with the Institute of Gene Biology of the Russian Academy of Sciences and the Atlas-Biomed Group - Knomics LLC. In the stool samples of VE patients, the level of generas Prevotella, Faecalibacterium, unclassified members of family Ruminococcaeae, as well as other Clostridiaceae was reduced. A significant increase in the proportion of bacteria Akkermansia, archaea Methanobrevibacter, and, on the verge of significance, of the families Christensenellaceae and Mogibacteriaceae was revealed. An analysis of the associations of the gut microbiome and the disease using the selbal algorithm showed a tendency for the association of VE with Methanobrevibacter, which is represented by M. smithii and with the normalized log-ratio between Methanobrevibacter and one or more unclassified genera from the Coriobacteriaceae family. The revealed features of the taxonomic composition of intestinal microbiome in VE patients contribute to the development of a chronic subclinical inflammatory process, as well as pathological lipogenesis.

Diagnosing Vilyui encephalomyelitis is complicated by its clinical polymorphism, lack of reliable and specific laboratory diagnostic tests, as well as the presence in Yakutia of other neurodegenerative diseases with clinical manifestations that partially overlap the manifestations of Vilyui encephalomyelitis. The article presents the history of the discovery and organizational forms of work with a previously unknown disease: Vilyui encephalomyelitis. The study determined the roles of the disease discoverer Prokopy Andreevich Petrov, of prominent Russian and foreign scientists: Elena Semyonovna Sarmanova, Mikhail Petrovich Chumakov, Afanasy Vladimirovich Vladimirtsev, and a Nobel Prize winner Carlton Gajdusek. The persistent efforts of doctors to isolate patients with acute and slowly progressive forms of Vilyui encephalomyelitis in specialized medical institutions helped to contain the further spread of this deadly disease to other parts of the Russian Federation and around the world.

We conducted a retrospective analysis of 130 dispensary records of women who were on a dispensary examination in the State Medical Institution of the Republic of Sakha (Yakutia) “Polyclinic No. 1” in Yakutsk in order to study the frequency of arterial hypertension (AH) and its complications in various age groups. The middle age was 49.95±1.18 years. All women underwent the following laboratory and instrumental methods of examination: general blood analysis, general urine analysis, biochemical blood analysis (total cholesterol, glucose, creatinine, urea), tonometry, and electrocardiography. AH was detected in 32 examined patients, which made 24.6 % of the total number of the examined. There was found a moderate positive correlation of systolic blood pressure (SBP) and total cholesterol with age. In the studied group with hypertension, the most common complications were ischemic heart disease - 28.1 %, and stroke - 1 %. Thus, we revealed the frequency of hypertension according to the results of clinical examination among women of various ages living in the city of Yakutsk: 24.6 %, which is slightly lower than the national average (30.6 %). The earliest manifestations of target organ damage in hypertension are changes in the heart: hypertrophy of the left ventricle, enlargement of the left atrium, various rhythm and conduction disorders. Unlike other authors, we did not find any pronounced shifts and interrelations of hemodynamic and metabolic indicators during medical examination. Consequently, clinical examination of the organized and unorganized population is a necessary measure for the detection of hypertension and cardiovascular complications.

Currently, infants are sent to the hospital immediately when clinical manifestations occur, without the formation of a pronounced weight deficit. In this connection, it became necessary to develop non-invasive methods of confirming the diagnosis in the conditions of the admission department of the clinic, but at the same time having sufficient reliability. In recent years, with the use of endovideosurgery in the treatment of congenital pyloric stenosis, there has been a rapid adaptation of the patient in the postoperative period and early restoration of the function of the digestive tract, which leads to an early transfer from the intensive care department to the ward and a significantly decreased duration of inpatient treatment. Pyloromyotomy is the standard and effective surgical treatment for infants with congenital hypertrophic pyloric stenosis. The study included 82 infants who were admitted to the surgical department of the Pediatric Center, Sakha Republic (Yakutia) Hospital No. 1 - National Center of Medicine in 2010-2020 with the referral diagnosis of congenital hypertrophic pyloric stenosis. The diagnosis of malformation was started with less invasive methods (ultrasound of the pylorus and general X-ray of the abdominal cavity), the reliability of which in our study was 75 %. When a negative result was obtained during these studies in children with a clinical picture of hypertrophic pyloric stenosis, more complex diagnostic methods were prescribed: fibroesophagogastroscopy and barium sulfate passage. A clinical case of reoperation in an infant with congenital hypertrophic pyloric stenosis was considered.

Psoriasis is a chronic immune-associated disease of a multifactorial nature with a dominant role in the development of genetic factors, characterized by accelerated proliferation of keratinocytes and a violation of their differentiation, an imbalance between pro-inflammatory and anti-inflammatory cytokines, with frequent pathological changes in the musculoskeletal system. In the territory of the Sakha Republic (Yakutia) in 2020, the incidence rate of psoriasis was 4.3 per 1,000 population, including 0.3 with psoriatic arthritis. The aim of the study was to evaluate the effectiveness of the mPEST questionnaire for the early diagnosis of psoriatic arthritis in patients with psoriasis who are registered at a dispensary in a polyclinic. Materials and methods. The study included 73 patients (44 men and 29 women) with psoriasis who are registered at the State Medical Institution of the SR (Ya) “Yakut Skin and Venereological Dispensary”. The average age of the examined patients was 42.4±11.47 years. The duration of psoriasis ranged from 4 years to 63 years (18.2±14.1 years). All patients underwent a standard dermatological examination. All patients included in the study completed a modified mPEST screening questionnaire to detect psoriatic arthritis. Depending on the results of the questionnaire, patients were referred for examination to a rheumatologist. Results and discussion. As a result of using the mPEST questionnaire, psoriatic arthritis was suspected in 27 (36.9 %) patients out of 73 respondents. At the same time, only 26 (96.2 %) patients met the CASPAR classification criteria. The frequency of diagnosed psoriatic arthritis was 36.2 %. Conclusions. The use of the mPEST questionnaire in patients with psoriasis can significantly improve the early diagnosis of psoriatic arthritis.

Diseases of the blood, hematopoietic organs and individual disorders involving the immune mechanism occupy a stable position in the overall structure of significant diseases, without a tendency to decrease, significantly impairing the quality of life and its duration in the population. In this regard, it is relevant to analyze the economic availability of the range of drugs used for the treatment of diseases of this class included in the restrictive lists of medicines. Since the availability of medicines can be influenced by the state policy in the field of price regulation in the pharmaceutical market, for the purposes of the study, the range of medicines for the studied class of diseases was determined, included in the lists of Vital and essential medicines (VED) in 2019 and the Minimum Range of Medicines (MALP) for pharmacy organizations in 2019. The price ranges of the studied medicines were established and a pharmacoeconomical cost-effectiveness analysis was carried out using integral indicators relative to the average salary and the subsistence minimum established in the Russian Federation for 2019. The results of the study showed that almost half of the drugs used in therapy are in the category “over 1,000 rubles”, and that there is a discrepancy between the standard of living of the population and the cost of drug therapy necessary for patients suffering from diseases of the blood, hematopoietic organs and individual disorders involving the immune mechanism.

To achieve the proper level of accessibility and quality of medical care, the issues of providing the municipalities of the republic with the necessary resources (material and technical, financial, personnel, information, etc.) are of no small importance. In this work, we analyzed the resource availability in the Oymyakonsky, Tomponsky and Ust-Maysky Districts (Eastern economic zone of the Sakha Republic (Yakutia)) according to the indicators included in the official statistical reporting: the availability of medical personnel (doctors, paramedical workers), round-the-clock hospital beds ( per 10,000 population) and the capacity of outpatient clinics (in visits per shift).