The exploration of the Northern regions is accompanied by a labor migration of people. However, climate and social stress after moving to the Northern regions can induce a wide range of mental and psychosomatic pathologies, including depression and anxiety disorder. Timely detection and prevention of such disorders requires modern methods of diagnosing stress-induced violations in neurophysiological states of the brain. The aim of the article is to discuss methodological problems related to the application of neurophysiological techniques for the diagnosis of stress-induced behavioral disorders in conditions of climate adaptation. The concept of “behavioral cognitive control,” which includes the ability to voluntarily activate or suppress actions aimed at achieving life goals in changing environments, is applied in the context of this paper. Approaches to analysis of brain activity associated with cognitive control are discussed. Based on the literature review, conclusions are drawn on the possibility of using psychogenetic techniques that allow assessing the risk of psychopathology before stress conditions occur. We assume that methods of assessing behavioral indicators of cognitive control combined with the application of neurophysiological and psychogenetic methods will allow developing a strategy of diagnosis of the psychosomatic states of migrants and to carry out timely prevention of the development of diseases related to change of living conditions

Viliuisk encephalomyelitis (VE) is a neurodegenerative disease that is common only among the indigenous inhabitants of Yakutia, in whose pathogenesis immunopathological processes play a significant role. VE patients demonstrate an increased level of soluble sCD40L ligand, expressed on immune cells and blood platelets, and which can affect the development of vascular pathology and inflammatory processes in the brain. It is suggested that metalloproteinase enzymes with increased protease activity can contribute to this process. The aim of the work was an experimental verification of the hypothesis of endoprotease activity of serum of VE patients. The results of the study during platelet incubation of a healthy donor with serum of VE patients confirmed the increase in the level of soluble sCD40L ligand in peripheral blood in VE patients due to protease activity. Increased activity in the blood of metalloproteinases that cleave sCD40L ligand from platelets can lead to microvascular pathology of the brain and be a major factor in the pathogenesis of primary chronic VE.

Ichthyosis (from the Greek ichthys ‘fish’) is a heterogeneous group of skin diseases characterized by a generalized keratinization disorder, which is clinically manifested by diffuse hyperkeratosis with a frequency of occurrence from 1:250 to 1:100,000. The most severe form of ichthyosis is autosomal recessive congenital ichthyosis (ARCI). For the first time, we presented a clinical observation of ARCI of the “collodion fetus” type in a newborn in the Sakha Republic (Yakutia). The article describes the clinical and anamnestic features of the newborn, the results of laboratory and instrumental studies, and the effectiveness of the therapy and skin care for the child at different stages of nursing at the Perinatal Center.

The paper presents the data obtained in a three-year observation of patients with arterial hypertension (AH) at a clinic for the period 2015-2017. A total of 108 patients with AH were examined, including 48 (44.4 %) men and 60 (55.6 %) women. The average age of men and women in 2015-2017 was 58.3 ± 1.9, 58.9 ± 1.9; 59.5 ± 1.9, 63.5 ± 1.6; and 64 ± 1.6, 64.5 ± 1.6, respectively. The three-year dynamics of the stages of hypertension disease (HD) showed a significant increase in the severity of changes in target organs in women. A significantly high increase in the frequency of chronic heart failure (CHF) of stage 2a was found in 2017 in men and women. Men and women had a significant increase in the risk of cardiovascular complications (RCCO) of the 4th degree in 2017, which was obviously due to the predominance of second-line drugs in terms of treatment of hypertension in the clinic. By their frequency of use. the used basic antihypertensive drugs were distributed as follows: beta-blockers, angiotensin converting enzyme inhibitors (ACEs), calcium channel blockers, diuretics, and angiotensin receptor antagonists 2. Second-line drugs were used more often than basic antihypertensive drugs. Obviously, this was associated with the increased RCVC of degree 4 in 2017. This situation dictates the need to revise approaches to the treatment of hypertension in a clinic.

Suicidal behavior in minors (0-17 years old) is the most dramatic and, at the same time, one of the least studied aspects of suicidology. The purpose of the study: obtaining information on the prevalence of suicides in minors in the districts of the Sakha Republic (Yakutia) and a comparative analysis of these data with indicators of suicides in mnors in the Russian Federation. Methods. A systematic analysis of scientific articles and statistical databases covering the issues of prevalence, causes and risk factors of suicides in minors was carried out. To search for scientific literature, we used the databases pubmed and medline, electronic resources of official state websites, data from the territorial body of the State Statistics Service for the Sakha Republic (Yakutia) on the child mortality for the period 2013-2018 (нет в русском варианте аннотации). Results. According to the state statistics, in Russia in 2017, the frequency of completed suicides in the age group of 10-14 years was 1.6 cases per 100,000 population of the corresponding age, which was 2 times higher than the global average. The frequency of suicides in children for the period 2013-2018 in the Sakha Republic (Yakutia) ranged from 3.0-8.2 per 100,000, which was 2-3 times higher than the Russian indicator. The most suicidal districts of the Sakha Republic (Yakutia) were identified. Among them, Verkhnevilyuysky District ranked first. In this district, in 2018, the suicide rate in children aged 0-14 years was 16.3 per 100,000 population of the corresponding age - 12 times higher than the national average of 1.3. The average suicide rate in the Verkhneviluysky District for teenagers aged 15-17 years was 268.1 per 100,000, which was 6.7 times higher than the national average of 39.8. Here are other districts with a high frequency of suicide in minors: Amginsky, Namsky, Neryungrinsky, Srednekolymsky, and Khangalassky. It should be noted that the districts with the highest rate of suicide in minors do not fall under the category of the regions of the Far North. The prevalence of suicide in minors living in rural districts was 2 times higher than the corresponding indicator for urban residents. Conclusions. 1. The suicidal situation in minors in the Sakha Republic (Yakutia) is extremely unfavorable. 2. Districts with the highest rates of suicide in minors were identified. 3. There is a higher risk of suicides in minors living in rural settlements. Recommendations: 1. In the districts with the highest rates of suicides in minors, it is necessary to study the complex of reasons that determine such a dysfunctional suicidal situation; 2. It is necessary to develop and implement a comprehensive program for the prevention of suicidal behavior in minors; 3. Educational institutions and, above all, schools should be the main place for strengthening mental health and conducting preventive measures among minors; 4. Special attention should be paid to preventing suicides in minors living in rural areas.

Sexually transmitted infections (STIs) are widespread in the world and lead to serious consequences, including pelvic inflammatory diseases, infertility, ectopic pregnancy, and increased susceptibility to the human immunodeficiency virus. STIs are one of the main factors in the unfavorable course of pregnancy. This paper presents the results of a survey of pregnant women, mainly students of M.K. Ammosov North-Eastern Federal University. In this work, we used the PCR method with real-time DNA detection. The study used biomaterial scraping from the urethra, cervical canal, posterior vaginal fornix. The frequency of detection of STIs by PCR was 90.7 %. The most common infections in the examined women were Gardnerella vaginalis (81.9 %) and Ureaplasma urealyticum + Ureaplasma parvum (77.7 %). The high prevalence of STIs among students is associated not only with lifestyle, but also with a decrease in nonspecific and immunological resistance of pregnant women. It is necessary to strengthen preventive work among students to explain the dangers and consequences of STIs, the need for timely medical attention and the importance of undergoing preventive medical examinations.

Myofibroma is a rare benign neoplasm of spindle-shaped cells, which is mainly found in infants and young children. The low growth rate and the tendency to thinning of cortical plates imitate the behavior of odontogenic tumors and tumor-like lesions. Clinically and microscopically, myofibroma may be mistaken for another benign tumor. In the classic version, these lesions are described in children younger than 2 years of age, and are rarely found in adults. Most lesions are localized on the lip, mucous membrane of the cheek and tongue; however, lesions occurring in the jaws are very rare. There are contradictions regarding autosomal dominant, recessive inheritance or sporadic occurrence. The rarity of this disease makes diagnosis difficult for clinicians, radiation diagnosticians and morphologists. Myofibroma has an aggressive clinical picture and is often undergoing radical treatment due to an incorrect diagnosis. Excochleation is the treatment of choice for children with lower jaw myofibroma. A case of myofibroma in the lower jaw is presented in a 3-year-old patient who clinically imitated ameloblastoma and had no classic signs of damage. The diagnosis was established only after a histopathological examination, and a 6-month follow-up did not reveal a relapse.

The article presents a retrospective analysis of Cesarean section operations in 385 pregnant women with placental presentation in the period 2013-2019 which were conducted at the Perinatal Center, Sakha Republic’s Hospital No. 1. The first group with fused placenta (117 cases) and the second group without fused placenta (268 cases). With the introduction of organ-preserving operations, the number of complications decreased threefold from 28.8 to 6.4%, and it was possible to reduce the number of organ-resecting operations by 10 times from 37.2 to 3.8%. In 2016-2019, 35 pregnant women with placenta growth were operated on using this technique. From June 2019, a new method of integrated approach to the delivery of pregnant women with placenta growth, which includes the use of a double-balloon catheter with bilateral dressing of the uterine arteries and the imposition of assembly seams on the placental surface. It was shown that one of effective way to reduce blood loss and the organ-preserving method during surgical delivery in patients with placental presentation is a complex method using a double-balloon catheter with ligation of the uterine arteries and the uterine compression suturing technique on the placental surface. The use of this method opens up new prospects for massive obstetric bleeding management.

Based on integral indices (II), a rating of economic zones of the Sakha Republic (Yakutia) is presented for some indicators of public health (medical-demographic, morbidity) and resource provision of healthcare (provision with medical personnel, round-the-clock hospital beds and outpatient clinics). The integral analysis was first carried out for each district and for each selected indicator separately. It was established that the Central and Western economic zones have the best indicators in terms of public health, and the Arctic and Eastern ones - in terms of resource provision. It turned out that our methodology of integral indices as a whole does not contradict other II methods proposed by other authors. For example, the technique of L.E. Polyakova and D.M. Malinsky. In our opinion, the calculation of integral indices allows us to carry out a reliable comparative characteristic for various indicators of public health and healthcare, including that depending on the distribution of districts by economic zones.

The purpose of the study: to analyze the age dynamics of the need for medical care provided in outpatient settings for neoplasms. Materials and Methods. We used data on the reasons for the treatment of 720,000 patients of both sexes within one year in medical organizations that provide outpatient medical care. The analysis was performed for class II ICD-10. We studied the probability of visits and appeals depending on age in six five-year age groups: 30-35 years, 36-40 years, 41-45 years, 46-50 years, 51-55 years, and 56-60 years. The results allowed us to determine the critical periods of the beginning of an increase in the frequency of medical treatment for the main localization of neoplasms in accordance with gender characteristics. This makes it possible to carry out timely planning for the start of active early detection activities 3-5 years before the identified period. It is extremely important to ensure close attention not only to malignant neoplasms, but also to benign neoplasms. It should be noted that for the most part this area of responsibility is not for oncologists, but for primary care physicians. In this regard, they must have sufficient competence to prevent, diagnose early stages of the cancer process, treat (primarily benign neoplasms), and control the healing of the pathological process (benign). The results of age-related dynamics of the need for outpatient medical care for neoplasms obtained in the course of this study can be used to improve organizational technologies for planning medical care.