The study aims to review modern scientific literature on the use of negative pressure wound therapy for patients with wound infection. Material and methods. A comprehensive review of modern medical literature describing the use of vacuum assisted closure for patients with wound infection is carried out. The databases eLIBRARY.RU, PubMed, Embase, Scopus, Cochrane, Ovid MEDLINE, and Clinical trials.gov are used for the research. The search is carried out using keywords: negative pressure wound therapy, vacuum assisted closure, vacuum therapy. Results. Vacuum assisted closure allows treating effectively purulent-septic diseases, accelerating wound healing, reducing the number of surgical interventions and the length of hospital stay, which makes this method the most promising.

The study aims to analyze the scientific literature on etiology, pathogenesis, diagnosis of bronchial asthma in children of early and preschool age, as well as approaches to the basic therapy of the disease. Material and methods. Publications of foreign and Russian authors, reviews of randomized controlled trials from various sources of scientific literature, including PubMed, CyberLeninka, and eLIBRARY.RU are studied. The search depth is ten years. The literature search is conducted using the following keywords: bronchial asthma, etiology, pathogenesis, diagnosis, treatment, children. Results. Within these age ranges, asthma is an emerging disease. Therefore, timely diagnosis requires a reassessment of symptoms during dynamic observation of the child to identify the most significant predictors of the disease. Age restrictions on the use of long-acting bronchodilators, anti-IgE therapy, and allergy-specific immunotherapy complicate the implementation of basic asthma therapy. A promising direction for optimizing the basic therapy of asthma in children of early and preschool age is to study the possibility of including immunomodulatory drugs in the complex of pathogenetic treatment for virus-induced asthma, the use of prolonged bronchodilators (primarily tiotropium bromide) at a young age, as well as the prolonged use of shortacting bronchodilators together with inhaled steroids.

The study aims to investigate the patients’ profile with acute bleeding from the upper gastrointestinal tract. Material and methods. The causes of upper gastrointestinal bleeding in 1,299 patients treated in Nizhnevartovsk Regional Clinical Hospital, Khanty-Mansi Autonomous Okrug – Ugra, Russia, during 2018–2020 are analyzed. Results. Тhis pathology accounted for 18.5% of the total number of patients with acute surgical pathology who were admitted urgently to a surgical unit. The average age of the patients was 53 ± 14.3 years, and 72.3% of those hospitalized are men. It was found that the proportion of peptic ulcer bleeding reaches 48.7%, less often the causes of bleeding are erosive lesions of the gastrointestinal mucosa (27.6%), Mallory–Weiss syndrome (8.3%), esophageal and gastric varices (7,6%), neoplasia (6.7%), angiodysplasia (1.1%). In 33.7% of patients with primary esophagogastroduodenoscopy, prolonged bleeding was revealed. Preliminary gastric lavage and sedation made it possible to increase the information content of primary esophagogastroduodenoscopy to 93.7%.

The study aims to determine the possible connection between the lead and mercury content in blood and early pregnancy losses in pregnant women living in an area with high anthropogenic pollution. Material and methods. In the period from 2017 to 2019, random blood samples of 67 women, divided into two groups, are obtained for analysis. The data is received from the Consultative and Diagnostic Polyclinic of the Golikov Research Clinical Center of Toxicology under the Federal Medical Biological Agency, Saint Petersburg, Russia. In 22 patients from the study group, a non-developing pregnancy is established, and 45 pregnant women from the control group had favorable pregnancy outcomes. Results. During the assessment of the level of mercury in pregnant women in the study group, the median indicator was 0.925 μg/l (IQR 0.640–1.55 μg/l), and in the control group, it was 0.990 μg/l (IQR 0.69–1.28 μg/l). There were no statistically significant differences between the groups. During the assessment of the level of lead, the median indicator in the study group was 80.0 μg/ml (IQR 76.2–97.2 μg/ml), in the control group it was 76.4 μg/ml (IQR 69, –82.6 μg/ml). The differences in indicators were statistically significant (p = 0.024).

The study aims to investigate the role of perinatal factors in the formation of child disability. Material and methods. A retrospective analysis of the incidence of children is carried out according to report forms of the State Statistics Committee of the Republic of Tajikistan on medical care provided to children, pregnant women, women in labor, and parturient women between 2014 and 2018. Results. Assessment of childhood morbidity showed that over the past 10 years the indicators have increased and the structure of morbidity in newborns has changed. The frequency of congenital malformations has increased more than 1.6 times, traumatization during childbirth more than 1.5 times, intrapartum hypoxia and asphyxia during childbirth more than 1.7 times, respiratory distress syndrome more than 1.5 times, and intrauterine pneumonia more than 3.6 times. Births with complications account for more than 40.2%, while the main risk factor for the development of cerebral palsy includes various complications in childbirth.

The study aims to study the features of the X-ray morphological picture of inflammatory changes in the lungs in COVID-19 patients according to multispiral computed tomography, and to assess the effectiveness of treatment. Material and methods. The study is carried out according to the data of dynamic examination of X-ray computed tomography of the thoracic cavity of 990 patients with COVID-19 who were treated at a multidisciplinary clinical hospital in Surgut from March to July 2020. Radiation diagnosis of the disease consisted in identifying
pathognomonic X-ray morphological signs of COVID-19, the degree of damage, as well as assessing the dynamics of inflammatory changes in the lung tissue. Results. The study revealed a different course of inflammatory changes in the lungs in dynamics after the peak stage of consolidation: the development of recurrent “ground glass”, varying degrees of severity of fibrosis, as well as a lingering course of the consolidation of lung tissue.

The study aims to assess the significance of the results of electroneuromyography and spiral computed tomography in the diagnostics and surgical treatment of cervical rib syndrome. Material and methods. The analysis of examination and surgical treatment of 72 patients, aged 16 to 46 years, operated for cervical rib syndrome for the period 2013–2019 is carried out. Results. In patients of group I (n = 48), the following postoperative complications were found: brachioplexitis in 16.7% (n = 8) of cases, phrenic nerve injury in 4.1% (n = 2) of cases, hemothorax and pneumothorax in two (4.1%) patients. Patients of group II (n = 24) additionally underwent electroneuromyography and spiral computed tomography for selection of the optimal surgical approach, which made it possible to reduce the incidence of early postoperative complications. It was possible to eliminate anomalies of the scalene muscles in 58% (n = 14) of cases; fibrous cords compressing the neurovascular bundle in 42% (n = 10) of cases. Brachioplexitis was observed in 4.2% of cases, which is less than in group I. There were no other complications in group II, as well as deaths in both groups.

The study aims to present a clinical case with an essential diagnosis of coronavirus disease. Material and methods. The analysis of the management of myocardial infarction is made. The patient was initially admitted to a temporary hospital for COVID-19 patients of a level 3 medical organization with a suspected severe course of coronavirus disease. Results. The described clinical case, which required an interdisciplinary approach to diagnosis and treatment, with correct routing, helped to avoid many mistakes, to provide accurate and timely medical care to the patient, and save his life.

The study aims to analyze modern ideas about the phenomenon of field cancerization, the mechanisms of its pathogenesis and morphogenesis, its importance for the clinical findings, preventive care, early diagnosis, and promising approaches to the treatment of tumors. Material and methods. The literature search is carried out using the following databases: CyberLeninka, PubMed, Nature Pathology, MEDLINE, and PLOS ONE. The search depth does not exceed ten years and is determined by the fundamental nature of the work. The keywords used in the search are tumor field, field cancerization, tumor-stroma interaction. Results. In the works of recent years, the tumor field or the field cancerization is considered to be a tissue with accumulated genetic and epigenetic changes. These changes provide cells with clonal differences and proliferative dominance with a gradual evolution of their phenotype from normal to precancerous (focal hyperplasia, metaplasia and dysplasia, cancer in situ) and tumor, characterized by the appearance of the ability to epithelial-mesenchymal transition, invasion, and metastasis. Among the most important determinants of the formation of the tumor field are aging, the action of chemical and physical mutagens, and chronic inflammation. Whereas among the mechanisms of field formation, DNA methylation and microRNA dysregulation are of great importance. Changes in the stromal compartment of the tissue (extracellular matrix, connective tissue cells) can play a leading role in the initiation of the tumor process, which is determined by the appearance of a special tumor-associated phenotype of fibroblasts and macrophages, as well as changes in the immune status of the tissue. Understanding the concept of the tumor field is of high significance for the early detection of precancerous changes, the prevention of cancer development and its early diagnosis, as well as the development of new tactics of targeted therapy.

The study aims to review the current evidence of the effects of vitamin D on immunity and coronavirus disease 2019 (COVID-19). Material and methods. The analysis of scientific literature sources in the databases PubMed,
eLIBRARY.RU, etc. is made. The keywords used are vitamin D, immunity, and COVID-19. Results. Vitamin D affects innate cellular and acquired immunity. Its immunomodulatory effect is associated with the activation of antiviral
activity, the influence on the differentiation of T-lymphocytes, and a decrease in the synthesis of pro-inflammatory cytokines. Research confirms a clear link between low vitamin D levels and a range of infectious diseases, including
severity and mortality from the COVID-19. One of the promising areas in the prevention and treatment of COVID-19 can be the administration of vitamin D, which supports antiviral immunity and reduces the effects of the cytokine
storm.

The study aims to analyze the literature data on the causes and mechanisms of ovarian apoplexy and the development of recurrence of pathology in women, including those living in unfavorable climatic conditions of the
subarctic region. Material and methods. A literature search is carried out in international and Russian databases such as MEDLINE, PubMed, CyberLeninka, eLIBRARY.RU, Scopus, and Web of Science. The search depth averaged out ten years. For the literary search, the following keywords are used: ovarian apoplexy, adaptation diseases, functional neuroendocrine disorders, menstrual disorder, metabolic syndrome, hemostasis, nonspecific protection. During the search, eighty articles are selected on the topic of research. Only forty of them, counting thirteen foreign ones, are included in this systematic review. Results. Despite the frequency of occurrence of this pathology, the scientific literature has not revealed convincing data on the causes and mechanisms of its formation, which would make it possible to offer personalized methods of treatment and prevention of recurrence of ovarian apoplexy in women living in unfavorable climatic conditions of the Middle Ob region. The need for further research in this direction is obvious.

The study aims to assess the significance of capillary blood gas indicators in premature infants with extremely low body weight in combination with the rigidity of artificial ventilation parameters as markers of the persisting hemodynamic significance of the patent ductus arteriosus. Material and Methods. A retrospective cohort study of clinical and anamnestic data, indicators of the capillary blood gas composition, parameters of artificial ventilation of the lungs of newborns with extremely low body weight with hemodynamically insignificant and hemodynamically significant patent ductus arteriosus is carried out. Results. In the group of newborns with hemodynamically significant patent ductus arteriosus from the 7th to the 10th day of life, more stringent parameters of artificial ventilation were revealed. By the 9th day, higher values of the total content of carbon dioxide, bicarbonate, and standard bicarbonate were noted. Signs of respiratory acidosis requiring a tightening of the parameters of mechanical ventilation and persisting in the second week of life in infants with extremely low body weight, that is, in the period when uncomplicated respiratory distress syndrome of newborns should already be stabilized, can be markers of the persisting hemodynamic significance of patent ductus arteriosus. The use of indicators of the gas composition of capillary blood in combination with the rigidity of the parameters of artificial ventilation in infants with extremely low body weight for the assessment of respiratory disorders with a functioning arterial duct is pathogenetically substantiated.

The study aims to present a clinical case of acute pancreatitis that developed secondary to a confirmed coronavirus disease and to discuss the alleged mechanisms of pathogenesis and the results of radiation diagnostics. Materials and methods. The case of patient T., 47 years old, admitted to the infectious diseases department of the Surgut Regional Clinical Hospital with suspected coronavirus disease is presented. He subsequently developed clinical symptoms suggestive of acute pancreatitis. In a hospital setting, the patient underwent laboratory and imaging diagnostic methods. Results. As a result of diagnostic measures, acute pancreatitis was confirmed. Given the absence of other objective reasons for the development of inflammation of the pancreas, a conclusion was made about the viral etiology of pancreatitis.