In medicine, the issues of hypothermia and “revival” of the body remain open. Insufficient study of the features of the mechanisms of dying at ultra-low temperatures gives grounds to supplement the understanding of the cellular and molecular mechanisms of the process of fatal hypothermia. The aim of this study was to evaluate the morphology of erythrocytes in fatal hypothermia at extremely low temperatures (below -40°C) using atomic force microscopy and scanning electron microscopy. The object of the study was blood smears of persons who died of hypothermia and of gunshot wounds. The study was conducted using the atomic force microscope NT-MDT, SolverNext model, in the semi-contact mode and the high-resolution scanning electron microscope JSM-7800F. In the man who died of hypothermia in conditions of ultra-low temperatures (-42°C), whose smear was made within 1 day, red blood cells were characterized by minimal changes than in the dead from a gunshot wound. The discocytic form of red blood cells with a flat surface was preserved, but we found an increase in the depth of the central concavity of red blood cells, which may be associated with an increase in the volume of red blood cells. It was found that even a small difference in body temperature (∆ 2.°C) at the time of blood collection affects the ratio of different forms of red blood cells after complete thawing: the lower the temperature, the more pronounced degenerative forms of red blood cells. After complete thawing of the corpse for 4 days, all red blood cells (100 %) had a different degree of dysmorphy, a flattened surface, an increase in the diameter and heterogeneity and plasma roughness, indicating signs of hemolysis.

To establish the anthropo-ecological portrait of the current population of Yakutia, it is necessary to study the regularities of the variability of physical status in different sex groups and develop regional standards of the physical development of different age-sex groups of the population with regard to the peculiarities of the environment. The aim of this study was to do research on the sex features of anthropometric, cephalometric and bioimpedance parameters in ethnic Yakut students. The measures of 228 Yakut girls and 168 Yakut youths born and permanently residing in Yakutia were analyzed. The anthropometric measurements were performed using the V.V. Bunak’s method (1941), somatotypingones - using the Rees-Eysenck index (1945). The head type was determined by the cephalic index, the face type - by the upper facial index. The bioelectrical impedance analysis with the use of ABC-01 Medass analyzer was performed to estimate body composition. The adipose tissue mass (AM), skeletal muscle mass (SMM), lean mass (LM), active cell mass (ACM) and phase angle (PA) were determined. The obtained data were processed by the method of variation statistics with the use of SPSS 17.0 software package. Overall measures of the soma of the examined groups had sex features of body organization that were expressed in significantly higher values of all measured parameters in the youths of Yakutia. In our study, the sexual dimorphism in the distribution of somatotypes by the Rees-Eysenck index was not identified. The analysis of the cephalometric measures revealed reliably higher parameters of absolute head sizes in the youths. Sex differences in the distribution of head and face types were not found in the examined ethno-age group. Significantly larger absolute amount of AM was established in the girls. The measures of SMM, ACM and LM were reliably higher in the youths. The values of active and reactive tissue resistance were reliably higher in the girls. Sex features of the anthropometric, cephalometric and bioimpedance parameters of the students were established. The conducted study presents the anthropo-ecological image of this age-sex group of the population of Yakutia.

One of the main indicators characterizing the state of adaptation of the organism to environmental changes is the physical development and functional state of the cardio-respiratory system. In this connection, the purpose of this work was to study the state of physical development and functional parameters of the cardiovascular system among students aged 17-21 years old in the process of adaptation to student life using modern research methods and equipment (Diamant-AIST-IRGT complex) Russia, a portable device for registration of ECG-Shiller AT-1 (Switzerland), Quark CPET bicycle ergospirometer, Italy). According to the results of the research, it was found that the main indicators of physical development and circulatory system in the majority of the students surveyed correspond to the physiological norm and indicate satisfactory adaptation of the organism, however, in 2 overweight students, a decrease in the adaptive capacity of the cardiovascular system was registered, which is a factor risk of developing CHD and AH in the future.

The analysis of the influence of natural and anthropogenic factors on human health living in the northern territories of Russia using the example of the Sakha Republic (Yakutia) was carried out. The author presents the results of the long-term expeditionary research of the staff of the Institute of medicine, NEFU, under her leadership in studying the health of the population in various districts of Yakutia. The study of morphofunctional and physiological features of the organism, in addition to clinical examination, was carried out by laboratory studies of immunological and biochemical parameters, determination of micro-and microelement composition in blood and hair, collection of anthropometric indicators, as well as genetic studies of polymorphisms of genes associated with common diseases in the country. In addition, the official static data were used in the works and an analysis of the level of medical provision with the quality of medical care provided to the population was carried out. According to the results of the many years of research, the interrelation between environmental pollution and clinical and morphological manifestations of tension in the adaptation mechanisms of an organism of children and adults in industrialized territories was revealed.

Cancer incidence and mortality is rising rapidly around the world. In the 21st century, cancer is expected to become the main cause of death and the single most important obstacle to increasing life expectancy in every country. One of the main problems in assessing cancer incidence and mortality is the use of different methods and models that fail to provide the required accuracy to make comparisons, for example, between groups of the population or in the same group in time. Created and distributed by the International Agency for Research on Cancer (IARC), the cancer statistics database GLOBOCAN 2018 largely meets the researchers need in using similar methods and models for different population groups to obtain comparable indicators in cancer research. The methods used in GLOBOCAN 2018 can be attributed to statistical models of increased flexibility. The use of methods and models of GLOBOCAN 2018 for cancer statistics in the Sakha Republic (Yakutia) can open up additional possibilities for determining the characteristics of cancer incidence and mortality in the region. Therefore, the purpose of this research was to establish data sources, the methods and models used in GLOBOCAN 2018 for the Russian Federation.

Acute respiratory diseases are the most frequent in the structure of the overall incidence of children. Thus, in 2005-2006, according to the Federal Center for Sanitary and Epidemiological Surveillance of the Russian Federation, the incidence of acute respiratory infections (ARI) in children was slightly less than 50 thousand cases per 100 thousand children, accounting for over 70 % of the registered infectious pathology of childhood. Almost every fifth child belongs to the group of ‘often-sick’ children. The main criterion for selection of patients in the OSC group is the incidence rate of acute respiratory infections, the maximum incidence of which occurs between 6 months and 6 years of age and averages from 4 to 6 diseases per year. This article presents the results of a single-stage retrospective study - an analysis of 60 outpatient cards of young children. The study included outpatient records of patients observed in the group of often-sick children. Among the main risk factors for the increased incidence of this contingent of children were identified: the burdened history of mothers, which is one of the forerunners of the development of immunological deficiency and contributes to the occurrence of recurrent inflammatory diseases in children; early transfer to artificial or mixed feeding, also gives grounds to attribute this fact to one of the further risks of developing frequent respiratory diseases; The most common nosological form of the disease was respiratory pathology of the upper and middle respiratory tract. In all children, violations of microbial colonization of the mucous membranes of the upper respiratory tract and oropharynx, which were manifested by a decrease in indicators of environmental significance and the dominance of normal symbionts, were found. This fact makes it necessary to include in the rehabilitation programs of frequently ill children preparations that restore the normal microflora of the upper respiratory tract. In addition, the often-sick children needs to be examined not only by the pediatrician, but also by the ENT doctor, including an assessment of the condition of the tonsils, adenoids, nasal cavities and the eardrum.

The authors performed retrospective analysis of 120 medical records of patients aged 65 and older. The patients received inpatient care in trauma or orthopedic department of a multidisciplinary hospital. The studies included demographic data, the main diagnosis, comorbidities according to the International Classification of Diseases, 10th revision. The risk of venous thromboembolic complications was estimated using Caprini Score. The study demonstrated that the most common causes of hospitalization included arthrosis of large joints (40%, 48/120) and fractures of femur, lumbar spine and bones of pelvis (21.7%, 18/120). Surgical interventions with an average duration of 87 ± 31.4 minutes were performed in 85% of cases (102/120), of which major surgery were 68.6% (70/102), minor surgery made 31.4% (32/102). Elderly patients, admitted to a multidisciplinary hospital because of pathology of musculoskeletal system, had comorbid conditions in 90% of the cases (108/120). Bone diseases in elderly and senile patients most frequently were accompanied by cardiovascular diseases (81.7%, 49/60): arterial hypertension in 73.3% patients, ischemic heart disease in 46.7% and other cerebrovascular diseases in 22.5%. In 75% of cases (90/120), the patients had a high risk of developing venous thromboembolic complications. The main risk factors of venous thromboembolic complications include type and duration of surgery, age and comorbidity. Comorbidity should be taken into account during diagnostics and treatment of surgery patients, which could contribute to decreased postoperative complications.

The article analyzes the results of treatment of gastroschisis in newborns according to the data from the Surgical Department, Pediatric Center, Republic’s Hospital No. 1 -National Center of Medicine, from 2000 to 2018. During this period, 43 newborns with gastroschisis were treated, the malformation was diagnosed antenatally in all cases. Half of the infants - 21 newborns underwent primary plastic surgery of the anterior abdominal wall defect. According to our data, children with step-by-step immersion of the organs in the abdominal cavity through the method of chiloplasty showed a better outcome, less mortality, they were able to get enteral nutrition earlier, and their period of inpatient treatment was shorter. While the majority of gastroschisis patients did not survive before 2010, in recent years, the mortality rate in gastroschisis decreased by 5 times and amounted to 15%. This was facilitated not only by a change in the treatment algorithm in newborns with gastroschisis, but also by the introduction of organizational measures such as prenatal consultation, antenatal transfer to a level III hospital, operative delivery before the onset of severe inflammation of the wall of the emerged organs. Today, gastroschisis is an absolutely correctable pathology; the follow-up surveys show that the quality of life of children operated on gastroschisis in neonatal period is not inferior to their healthy peers.

Headache is one of the most frequent complaints of patients in neurological practice. According to epidemiological studies, 79 % of the population of Europe, 75 % - Latvia, and 62 % - Russia suffer from cephalgia. Headache is one of the common causes of disability, and the cost of treating one patient in the United States reaches more than $ 8,000 a year. This circumstance determines the social and economic burden of the headache. In 2018, the International Headache Society adopted the 3rd edition of the classification of disorders with headache. According to this classification, all headaches are divided into primary, secondary and cranial neuralgia. Despite the achievement of modern medicine, hypodiagnosis of primary headaches persists in Russia. The most common forms of headaches are migraine, tension type headache and trigeminal (vegetative) cephalgia. This article presents the modern criteria for the diagnosis of primary headaches, discusses the role of new drugs, such as CGRP antagonists, innovative neuromodulation methods (vagus stimulation, stimulation of the occipital nerve, Cefaly devices). own clinical observation of a patient with a headache is presented.

The article presents a review of the literature on the description of the non-classical form of congenital adrenal cortex dysfunction. Non-classical form of congenital adrenal cortex dysfunction is a group of inherited autosomal recessive disorders of steroidogenesis. According to our data, the most widely mutated V281L, which causes the emergence of a non-classical form of congenital dysfunction of the adrenal cortex, is common in the population of Chukchi and Yukagir living in the Sakha Republic (Yakutia). Clinical manifestations of non-classical forms of 21-hydroxylase deficiency in childhood and adolescence mistakenly identification as idiopathic precocious puberty, ovarian cysts, tumors of the testicles, of tumor of the adrenal cortex, ovarian hyperandrogenism, more low-end growth. In adult women - dysmenorrhea-type oligo-opalneria, hypertrichosis, ASPE vulgaris and oily seborrhea, secondary amenorrhea, primary amenorrhea, first discovered polycystic ovaries, recurrent solitary ovarian cysts, infertility, miscarriage, obesity, persistent headaches, hypertension; men - overweight, hypertension, headaches, infertility in marriage. The problem of timely diagnosis of non-classical forms of congenital adrenal hyperplasia is of particular importance and is within the competence of both General practitioners and specialists.

Pregnancy is a special condition during which the physiology of the internal organs and systems of the female body undergoes numerous changes aimed at maintaining the viability and normal development of the fetus. Sleep disturbances are common in pregnant women. 60-90 % of pregnant women develop sleep difficulties during gestation, especially in the third trimester of gestation. They arise both in physiological (restructuring of all functions and systems) and various pathological (extragenital diseases) conditions. The pathogenesis of sleep disorders in pregnant women is complicated. Sleep is affected by hormonal, physical and psychological changes. Under the influence of sex hormones, the mucosa of the upper respiratory tract swells, the lumen of the upper respiratory tract narrows. The enlarged uterus puts pressure on the diaphragm, reducing the functional residual lung volume by 20 % and increasing the risk of developing breathing disorders during sleep. There is an increase in inflammatory activation, an increase in the circulation of proinflammatory cytokines: interleukin-6, tumor necrosis factor and C-reactive protein. In addition, the excitability of the cerebral cortex and the activation of the reticular structures of the midbrain are increased. Sleep is associated with activation of the parasympathetic division of the autonomic nervous system, circulatory shifts and reduction of cerebral blood flow, where biogenic amines and mediators play an important role. Insomnia, sleep apnea and restless legs syndrome are among the most common forms of insomnia. Insufficiently studied, sleep disorders are associated with difficulties of clinical interpretation and treatment, directly affecting the outcome of pregnancy. Insomnia in pregnant women affect not only the quality of life and health of patients, increasing the risk of obstetric complications, but also the normal development of the fetus. At the same time, the issues of epidemiology, etiopathogenesis, clinical evaluation, treatment of insomnias in pregnant women are not well understood, fraught with organizational, ethical and legal difficulties. All this makes this problem very relevant and promising for study.

The probability of complications of infectious and inflammatory etiology and the lack of effectiveness of surgical treatment when using U-shaped staples as a suture material determines the need for their improvement. One possible solution to this problem is the immobilization of antibacterial agents on a modified surface of the staple. In the framework of this study, the dynamics of reparative regeneration of an experimental “conditionally aseptic wound” in rats were investigated by stitching the muscle incision with U-shaped staples with calcium phosphate coating and ciprofloxacin incorporated in it. For the study, we used tissue fragments from wound sites adjacent to the staples. The samples were prepared from the microtome samples, which, after staining with hematoxylin and eosin, were morphometrically evaluated. The comparison group consisted of microscopic preparations of animals whose wound was closed with U-shaped staples without calcium phosphate coating and the drug. During the formation of the scar, manifestations of typical stages of the wound process - traumatic inflammation, development of granulation tissue, formation and the beginning of remodeling of the scar - were recorded. In the group of experimental animals, for stitching wounds which used U-shaped staples without calcium phosphate coating and ciprofloxacin, we observed a pronounced picture of exudative inflammation and slowing the maturation of granulation connective tissue, which ultimately led to the formation of a noticeable scar. The use of the staples with calcium phosphate coating and ciprofloxacin immobilized on it (0.045 % per a staple) reduced the severity of the inflammatory response. In the case of using implants with a ciprofloxacin content of 0.09 %, a lower rate of connective tissue regenerative reactions was noted per brace: the formation of relatively more pronounced scars was observed at the wound site.