The study of the cardiovascular system functional indicators in the population of Yakutia living in an extreme continental climate is a relevant issue for the prevention of complications, diagnosis and treatment of patients with cardiovascular diseases. The aim of the study was to identify the indicators of the cardiovascular system of men in Yakutia depending on the age and type of hemodynamics. A morphological-functional examination of 634 men aged 24-55 years was carried out. Of these, 129 men belonged to the first period (21-35 years), 505 men - to the second period of adulthood (36-60 years). The overall dimensions of the body and the functional state of the cardiovascular system were determined. To assess the functional state of the cardiovascular system in the men, we calculated the index of functional changes, the double product, the Allgover index, the A. Kvaas coefficient of endurance, the Kerdo vegetative index, circulatory efficiency, systolic blood volume, blood volume per minute, total peripheral vascular resistance, and the cardiac index. The statistical analysis was carried out using parametric and nonparametric methods using the SPSS 17.0 application software package. The predominance of persons with the hypokinetic type of hemodynamics in the men of the first and second mature age was revealed. The indicators of central hemodynamics of the hypokinetic men were characterized by increased values of BMI, diastolic blood pressure, total peripheral vascular resistance, reduced heart rate, blood volume per minute and the cardiac index. The functional state of the circulatory system of the hypokinetic men of the second mature age had more negative characteristics compared to the men of the first mature age.

Sepsis is an extremely common cause of maternal mortality, as well as mortality of newborns and children under five years of age. Neonatal sepsis is detected with a frequency of 0.5-8.0 per 1,000 newborns. The highest rates are found in children with low birth weight, infants with depressed function at birth, expressed in low Apgar scores, and infants with maternal perinatal risk factors. According to the WHO resolution, sepsis still causes an estimated six million deaths worldwide every year, most of which are preventable. It is noted that sepsis as a syndromic response to infection is the ultimate common cause of death from most infectious diseases in the world; that sepsis has a special and time-critical clinical course, which in the early stages is largely treatable due to early diagnosis and timely and appropriate clinical management. Currently, sepsis caused by bacteria of the genus Salmonella is extremely rare, especially in newborns. The septic form of salmonellosis is extremely rare, more often at an early age - premature babies, newborns, often in weak, bottle-fed. The main symptoms are symptoms of purulent meningitis, pneumonia, and otitis media. The disease is very severe, with high fever and intoxication for a long time. This article considers a rare case of neonatal sepsis in a 20-day-old child caused by Salmonella enteritidis. We think that the observation presented by us will be of interest to a wide range of specialists: neonatologists, pediatricians, infectious disease specialists.

The Eastern regions of the Russian Federation are characterized by high suicidal activity and in most cases are national entities. In these regions, the situation with child and adolescent suicides remains extremely poor. The scale of the problem of child and adolescent suicides, especially its growing trend, indicates the need to develop effective prevention of suicidal behavior in minors. The purpose of this study is to analyze preventive work to reduce the number of suicides of minors in the Sakha Republic (Yakutia) and develop recommendations for the prevention of suicidal behavior in minors. Results. In 2018, the national suicide rate for children per 100,000 population reached 6.8, with the average Russian rate being 2.6 in the same year. Consequently, children and adolescents in the Sakha Republic (Yakutia) were at risk of suicide 2.6 times more often than their peers in the Russian Federation. Methodological recommendations “Prevention to reduce the risk of suicide in children and adolescents”, developed by the Ministry of Education and Science of the Sakha Republic (Yakutia), have shown low effectiveness, since they do not pay attention to the prevention of suicide in children of senior preschool and primary school age and do not take into account the peculiarities of the emotional sphere of indigenous youth of the Sakha Republic (Yakutia). Among indigenous youth, Russian suicide researchers have identified features of the emotional and personal sphere in the form of increased levels of anxiety, uncertainty, suspiciousness, and increased feelings of guilt. When analyzing the nosological affiliation of underage patients with suicidal manifestations in 2011-2018, researchers found a significant predominance of patients with «age-related» diagnoses from category F 90-98 «Behavioral and emotional disorders that usually begin in childhood and adolescence». Therefore, prevention of suicidal behavior of indigenous youth of the North should begin not in adolescence, but in preschool and primary school age, since in the adolescent stage of development, characterological features have already been formed. The paradoxically low suicide rate in the republics of the North Caucasus proves the above. From the age of seven, the upbringing of boys in the Caucasus passed into the hands of men and these children were instilled such personal traits as perseverance and selflessness. The basis for early prevention of suicidal behavior is creating conditions that will permit normal development of not only adolescents, but also children at an earlier age, as well as timely identification of the specific characteristics of the emotional-personal sphere in the form of anxiety, insecurity, and suspicion. Conclusion. The analysis of the problem of suicidal behavior in minors in the Sakha Republic (Yakutia) shows that the social disadaptation of a child begins not in adolescence, but earlier - in preschool and primary school age. In this regard, prevention of suicidal behavior in minors includes the identification of specific for suicidal behavior of emotional and personal disorders in children of preschool and primary school age and psychological correction of detected disorders in minors.

The relevance of the problem of cerebral stroke remains due to the high prevalence according to WHO data. The aim of the research was to study the ethnic and gender characteristics of the course of ischemic stroke in elderly people. A study was carried out at the Regional Vascular Center of the Republic’s Hospital No. 2 in 154 patients aged 75-89 years with ischemic stroke, which were divided into groups by ethnicity and gender. Most of the patients, regardless of their ethnicity and gender, were admitted from home. The analysis of the time of admission of the patients to the hospital was carried out. Among those arriving after 12 hours since first symptoms, there were more men. Cardioembolic stroke was more common among ethnic Russians. A stroke of another type was more common in men. An improvement in the level of consciousness was observed only among the Yakuts. The examination was carried out according to the NIHSS, Glasgow Coma Scale, and Rankin scale. The severity of focal neurological symptoms according to the NIHSS in both Yakuts and Russians decreased at the end of treatment, and a significant regression of focal symptoms was also observed in women and men. On the Rankin scale, there was good functional recovery in patients of both ethnic and gender groups. The level of consciousness on the Glasgow scale improved significantly among the Yakuts, while among the Russians - slightly. A significant improvement in the level of consciousness was also observed in women and men. In addition, there was a positive correlation between the NIHSS and Rankin scale and a negative correlation between the Glasgow scale and the number of inpatient days spent. The patients who had the highest score (5.0) on the Rankin scale upon admission were fatal. Thus, in our study, ethnic differences were observed in the incidence of cardioembolic stroke and in the improvement in the level of consciousness. There were gender differences in the incidence of another type of stroke, which was more common in men, and in the time of hospitalization, men were admitted later. The NIHSS and Rankin scale are the most appropriate tool for predicting mortality in patients with ischemic stroke in old age.

The aim of this research was an experimental and clinical study measuring stability of the orthodontic miniscrews “Turbo” (Russia) and “BioRay” (Taiwan). Four self-drilling orthodontic miniscrews of each manufacturer, i.e. “BioRay”, Taiwan, (10-mm length, 2-mm diameter) and “Turbo”, Russia, (9-mm length, 2-mm diameter), a total of 8 items, were inserted into native pig mandible sample. Their stability was estimated by torques using a dynamometer (Zahoransky AG, Germany). In the clinical study, 62 orthodontic miniscrews were used: 16 “Turbo” (Russia) and 46 “BioRay” (Taiwan). Their stability was clinically evaluated by the criterion of the presence or absence of mobility of the orthodontic miniscrew after the application of the load. It was established that the orthodontic miniscrew “Turbo” (Russia) were not inferior to “BioRay” (Taiwan) miniscrews in the primary stability, stability after 7 days under loading and in resistance to the load in clinical case. In this regard, Russian orthodontic mini-screws can be successfully applied in clinical practice as well as foreign counterparts for studies of primary stability and loads resistance in clinical conditions.

At the end of December 2019, an outbreak of unknown pneumonia caused by the new coronavirus SARS-CoV-2 began in the People’s Republic of China. On February 11, 2020, the World Health Organization assigned the official name of SARS-CoV-2 infection - COVID-19 (“CoronaVirus Disease 2019” - a disease caused by the new coronavirus 2019). Pneumonia is the leading clinical form of COVID-19. However, as the COVID-19 pandemic spread and the analysis of clinical data, the patients began to emit symptoms that are not characteristic of “abnormal” pneumonia. Neurological manifestations, skin changes, eye lesions, etc. have been described. The generalized accumulated data and clinical experience indicate that elderly patients and persons with chronic diseases such as diabetes mellitus, cardiovascular diseases and liver diseases, obesity may be susceptible to higher risks of developing more severe forms of the disease COVID-19 [1]. Among the possible factors of liver damage, a virus-induced effect, systemic inflammation (“cytokine storm”), hypoxia, hypovolemia, hypotension in shock, drug hepatotoxicity, etc. are considered. Acute hepatitis develops very rarely.

Marketing research of the Russian and regional (Oryol Oblast) pharmaceutical markets for antiviral drugs included in the list of VED (vital and essential drugs) in 2020 is presented. Marketing characteristics of the assortment by pharmacological and ATC classification groups, the composition of active ingredients, trade names, production characteristics, types of dosage forms are determined. The following assortment indicators were calculated: breadth, depth, completeness, and degree of renewal. Based on the results of the marketing analysis, a macro-outline of the Russian pharmaceutical market of antiviral drugs included in the list of VED in 2020 was compiled, which is characterized by the presence of mainly mono-component drugs (82.50 %) from the J05AB group (nucleosides and nucleotides, except for reverse transcriptase inhibitors) (27.70 % ) according to the ATC classification, with the largest share by the number of drugs falling on acyclovir - 23.38 %, 70.40 % of drugs are produced in Russia in the form of solid dosage forms (74.00 %). A meso-contour of antiviral drugs on the pharmaceutical market of Oryol Oblast was formed: in terms of composition, these are mono-component drugs (100.00 %); produced in the form of solid dosage forms (71.42 %), produced in Russia (91.80 %); nucleosides and nucleotides of J05AB group, except for reverse transcriptase inhibitors according to the ATC classification (62.29 %); acyclovir accounts for the largest share in terms of the number of drugs (62.29 %). Based on the results of the comparative analysis of the Russian and regional markets for antiviral drugs in the VED list in 2020, an assortment profile of drug availability in the pharmaceutical market of Oryol Oblast was built, which clearly shows a low level of correlation of this parameter of the studied drugs with the needs of the population.

Despite the low population density and the measures taken by the government of the republic, the COVID-19 infection is continuing to spread in the Sakha Republic (Yakutia). As of the end of January 2021, more than 30 thousand cases of infection were registered in the republic. According to WHO, the effectiveness of preventive measures, such as maintaining social distance, using medical masks, isolating sick people, etc., is critically dependent on compliance of the public with them. The purpose of our study was to establish the level of awareness of the population about measures to combat and prevent the spread of COVID-19 in the Sakha Republic (Yakutia) using the cases of Tattinsky, Megino-Kangalassky, and Amginsky Districts, as well as the city of Yakutsk. The survey covered 264 respondents over 18 years of age (55 men ( 20.83 %), 209 women (79.17 %)), including 118 residents of Amginsky District, 42 residents of Tattinsky District, 60 residents of Megino-Kangalassky District, and 44 residents of Yakutsk. The questionnaire included 23 questions (gender, age, place of residence, questions about the preventive measures taken at work or place of study of a respondent, sources of information on the situation with COVID-19, compliance with preventive measures during the pandemic, medications taken without a doctor’s leave, traditional methods used to prevent COVID-19). The results of the analysis did not find any statistically significant relationship between the awareness of respondents and their age; however, women were significantly more likely to be aware of COVID-19 prevention measures (p = 0.011). In Amginsky District, the awareness of the residents was higher (62.71 %) than in other districts; it is noteworthy that Yakutsk accounted for the lowest share of informed people (40.9 %). As expected, individuals who were briefed at work showed better awareness. It was found that respondents predominantly receive information about the COVID-19 preventive measures on TV. 59.8 % of the respondents regularly receive information from Instagram. 75.7 % of all the respondents received information from WhatsApp (most of all in Megino-Kangalassky District - 87 %). Reliable sources of information, such as local medical organizations, the websites of the Ministry of Health and WHO, are not very popular among the population. Antiviral drugs were taken by 75 people (29.4 %) without a doctor’s prescription. The survey revealed that 53.41 % of the respondents were well aware of the methods of preventing the new coronavirus infection, and the effectiveness of instructions at work or school was also proven. The role of television in disseminating information on COVID-19, as well as instant messengers, was shown. Only 29.4 % of the respondents took medicines on their own for prevention or treatment without a doctor’s prescription, which can lead to negative consequences in the form of overdose and allergic reactions.

The analysis of indicators of general and primary morbidity of the population of the Vilyuisk group of districts of the Sakha Republic (Yakutia) for the period 1992-2019 was carried out. The relevance of the study is dictated by the need to study the health of the population living in Mirninsky, Suntarsky, Nyurbinsky, Verkhnevilyuysky and Vilyuysky Districts, which are parts of this group, in order to find out possible negative effects on health due to a man-made accident that occurred on the territory of Mirninsky District in 2018. These districts are united not only in geographical terms, but also by the fact that they are located in the Vilyu River basin, the pollution of which could cause certain pathological changes in the body of the population. The official statistical materials of the Territorial Body of the Federal State Statistics Service for the Sakha Republic (Yakutia) and the State Budgetary Institution of the Sakha Republic (Yakutia) “Yakut Republic’s Medical Information and Analytical Center” were used. Taking into account the availability of relevant statistical materials, we analyzed data for the period from 1992 (2005) to 2019 inclusive. Using the percentile method, the levels of general and primary morbidity of the population in these districts were revealed in a comparative aspect with other administrative-territorial entities of the republic. According to all 6 indicators that characterize the morbidity of the entire population of the Vilyui group of districts and depending on the age gradation, the negative dynamics was observed only in Nyurbinsky District. The results of the study will make it possible to detect adverse changes in health status at an early stage and implement appropriate preventive measures.

Lean Laboratory is a lean production management and organization approach whose main goal is to optimize processes while maximizing resource utilization. The aim of the study was to assess the effectiveness of implementing the lean production principles in the clinical diagnostic laboratory of a multidisciplinary medical center. For the audit, two METLER TOLEDO check lists developed for medical laboratories were used: "List of 5S questions for assessing the organization of jobs in the laboratory," and "8 typical types of losses in the laboratory." The response was received from 53 employees of the Clinical Diagnostic Laboratory (CDL), Consulting and Diagnostic Center, Sakha Republic’s Hospital No. 1 - National Center of Medicine. The analysis of the obtained audit data indicated the following features: an insufficient level of knowledge and principles for the introduction of lean technologies at the workplace was noted more often in laboratory paramedics than in laboratory doctors; in young professionals aged 20-29 years than in their older colleagues; in express laboratories than in planned departments of the CDL. Optimization of the workplace based on the method of these check lists is a promising