The study aims to analyze the data of modern scientific literature on the constitutional and ethnic characteristics of skin aging in women of the second period of mature age. Materials and methods. The information search was carried out using keywords combined into groups to identify various aspects of constitutional characteristics affecting aging processes in women of different ethnicities. Scientific publications of domestic and foreign literature, namely reviews of randomized controlled and clinical trials published in PubMed database, with data from Medline and PreMedline, and on the eLibrary platform, were analyzed. The search depth was 10 years. Results. Internal and external factors of the development of involution processes result in several variants of anatomical and functional scenario according to which the aging process proceeds. External conditions determine the phenotypic signs of skin aging, but they affect representatives of various ethnic groups with different intensity.

The study aims to analyze a structure of metabolically associated comorbidity and its effect on number of rehospitalizations of patients with cardiovascular pathology in order to provide measures for improving the prognosis. Materials and methods. A combined cohort retrospective study was carried out using continuous sampling method for the period of 2015–2018. The study analyzed a clinical state of 122 cardiac patients who were compared by their structure of diseases, sex and age. The first group included 73 patients with median number of hospitalization 3 (from 2 to 17 times). The comparison group included 49 patients hospitalized for the first time. The study assessed the course of cardiovascular and comorbid pathology by the frequency of its exacerbations, as well as decompensations, which led to rehospitalizations in four years. A nosological structure of comorbidity, frequency of hospitalizations of patients with cardiovascular pathology with metabolically associated comorbidity, and their interrelation were studied. Results. In the study of cohort, patients with metabolically associated comorbidity, such as hypertension, chronic coronary heart disease, chronic heart failure, atrial fibrillation, diabetes mellitus, obesity, and atherosclerosis of brachiocephalic vessels, prevailed according to the structure of the comorbidity. A direct statistically significant interrelation of number of rehospitalizations with the comorbidity index was detected. The risk group included cardiological patients with metabolically associated diseases and the comorbidity index of more than 4.

The study aims to evaluate the efficacy and safety of laser thermal ablation for the treatment of benign thyroid nodules. Materials and methods. The study analyzes the results of applying laser thermal ablation for the treatment of benign thyroid nodules in 548 patients. Results. The decrease in volume by more than 50 % was observed in benign nodules up to 2 cm³. In average, the volume decreased by 28.8 % in large nodules with a volume of more than 8 cm^3. Repeated laser thermal ablation was required in 69 patients (12.6 %), surgical treatment – in 7 patients (1.3 %), and 6 patients (1.1 %) suffered from complications. High efficacy and safety of laser thermal ablation was shown.

The study aims to examine the general and local immunity and study prevalence and intensity of dental caries in native and immigrant children of school age when adapting in conditions of the Far North. Materials and Methods. 2170 samples of general and local immunity indicators were examined. The prevalence and intensity of dental caries were analyzed in 155 native and immigrant school-age children of the Far North. The statistical data processing was carried out with Statistica 8 software package. Results. Immigrant children failed to adapt to a long period of living in Salekhard, Yamalo-Nents Autonomous Okrug, which caused violations in their general and local immunity and high risk of getting dental caries.

The study aims to determine the predictors of the development of gastric cancer in residents of the Far North to form a group of factors that can document the possibility of the disease early on. Materials and methods. A retrospective analysis of gastric cancer cases verified by the clinical and histological parameters was conducted over a 4-year period (2016–2019). These cases were detected in 145 outpatients using a continuous
sampling method. The gastric cancer was diagnosed in compliance with current clinical guidelines using the entire complex of diagnostic and therapeutic equipment. The data was processed using Statistica 10.0. Results. Based on the clinical parameters, a gender and age composition of patients was defined: an average age from 28 to 92 years was 58.3 years [52; 65] (95 % CI: 56.4–60.1); a male/female ratio was 1.5:1, 95.2 % (n = 138). The majority of patients were diagnosed with comorbidity: up to 13 concurrent diseases, with Charslon Comorbidity Index in average of 6.01 ± 0.26 points (95 % CI: 5.5–6.52). Manifestations of gastric cancer clinical picture include dyspepsia
(n = 129, 89 %), postprandial distress syndrome (n = 75, 51.7 %), paraneoplastic signs such as thrombocytosis, anemia, weight loss, asthenia (n = 16, 11 %), syndrome of small features (n = 80, 55.2 %), and a 10-year or less
anamnesis of chronic gastritis without its etiological verification (n = 82, 56.6 %). All 145 patients lived on the territory of the Far North for 34.5 years. The majority of patients (51.7 %) received medical treatment only at the stage IV of the disease and suffered from polymorbidity, heredity, Hp-associated pathology, gastric polyps, malnutrition, alcoholism, and smoking.

The study aims to analyze the results of retrograde perfusion of the pulmonary artery during open pulmonary thromboembolectomy in a group of patients with high and intermediate-high risk. Materials and methods. The study presents the practice of performing retrograde pulmonary artery perfusion following pulmonary embolectomy on 10 patients. The study describes technical equipment for surgery, which included a single-use system for injecting cold cardioplegia solution and two pumps of a heart-lung machine. The equipment was used for continuous intake of perfusate from the oxygenator tank and for intake of used combined protective solution, which was mixed during the surgery. The solution contained 800 ml of saline solution, 100 ml of 15 % mannitol solution, 400 ml of actovegin, as well as 12–16 ml of dexamethasone and was mixed with the blood perfusate at the ratio 3:1. It was injected into the pulmonary vein ostia under a pressure
of 15–20 mm Hg via its isolated cannulation with a 6–6.5 cm endotracheal tube, preliminarily connected with the system for retrograde perfusion. The injection was carried out for 4 minutes. Results. Despite the initial severity
of the patients’ condition, as well as the amount of surgical intervention performed, the hospital survival rate was 100 %. The proposed technique has demonstrated excellent clinical and hemodynamic results, neither specific
complications nor aggravation of the course of the intraoperative and early postoperative periods.

The study aims to determine optimal approaches for selecting a tension-free method of inguinal hernia repair based on a comparative analysis of clinical and economic efficiency. Materials and methods. A comparative study of the results of treatment of 128 male patients with primary unilateral inguinal hernia was carried out using the Lichtenstein technique, total extraperitoneal repair and laparoscopic transabdominal preperitoneal repair. Prior to surgery and a year later, the EQ-5D questionnaire was used to assess the parameters
of the quality of life of patients and further calculate Quality-Adjusted Life Years. The questionnaire served as a criterion for the efficiency of the analyzed surgical technologies. An analysis of cost-effectiveness ratio was carried
out using direct costs. Results. The analysis of cost-effectiveness ratio showed that, regardless of fluctuations in costs and changes in the patients’ quality of life, more expensive endoscopic interventions are economically justified. In addition to that, total extraperitoneal repair proved to be the technique of choice, and transabdominal preperitoneal repair – a profitable investment.

The study aims to determine the influence of psychological factors on the effectiveness of asthma therapy in children and their quality of life. Materials and methods. An analysis and statistical processing of the results of a survey of 38 children with bronchial asthma (13–17 years old) and their mothers was carried out. The survey consisted of standardized questionnaires on situational and personal anxiety, quality of life, level of disease control, and level of treatment adherence. Results. A high level of situational and personal anxiety was detected in children with asthma and their mothers. The contingency of their psychological characteristics and the relation of asthma exacerbations and an unfavorable psychological state of children and their mothers were found. The study determines a negative impact of high level of personal and situational anxiety on adherence to basic asthma treatment, as well as the impact of the level of disease control on quality of life of children and their mothers. The necessity of psychological rehabilitation of children with bronchial asthma and their parents is substantiated in order to achieve a controlled state and improve the quality of life by forming a high level of adherence to the basic therapy.

The study aims to present a clinical case of pure gonadal dysgenesis in a female patient. Materials and methods. A clinical case of Swyer syndrome in a 16-year-old girl is presented. The anamnestic and clinical data, the results of laboratory and instrumental examinations, postoperative results and the effect of hormone replacement therapy were analyzed. Results. During the examination of a teenager with a female phenotype, tall stature and primary amenorrhea, an increase in gonadotropins and uterine hypoplasia were recorded. Cytogenetic examination revealed a 46,XY karyotype. Laparoscopic removal of bilateral gonadoblastoma was performed, followed by the selection of hormone replacement therapy.

The study aims to present the pathogenetic reasoning for using Montelukast in treatment of a new coronavirus infection. Materials and methods. The publications of foreign and Russian authors, reviews of randomized controlled trials from various sources of scientific literature, including PubMed, CyberLeninka, eLibrary, etc., were studied using such keywords as SARS-CoV-2, COVID-19, leukotriene receptor, leukotriene receptor antagonist, and Montelukast. The search depth was 10 years. Results. A wide variety of modern research is focused on the development of various therapeutic approaches for treatment of COVID-19 (coronavirus infection) that has affected many people all around the world. Thus, the study pays special attention to Montelukast. Both its performance as a safe drug for bronchial asthma and as a potential antiviral drug for severe acute respiratory syndrome caused by SARS-CoV-2 should be studied.

The study aims to determine the differential diagnostic signs of acute abdominal pain syndrome in ischemic abdominal disease in conditions of co- and polymorbidity in order to optimize medical care of patients. Materials and methods. An analysis of the clinical case of an 82-years-old patient is presented. His Charlson Comorbidity Index was 12 points: multisystem atherosclerosis (heart vessels damage, brain damage, mesenteric arteries damage), metabolically associated pathology, and oncological disease (rectal cancer). The patient was diagnosed with acute abdominal syndrome. Results. The acute abdominal pain was a manifestation of thrombosis of mesenteric arteries, with 70 % of stenotic arterial sclerotic damage confirmed after patient’s death. Multisystem atherosclerosis with abdominal vessels damage is no longer a rare pathology due to aging of population, prevalence of obesity, diabetes mellitus, cardiovascular pathology, as well as pharmacological load on patients with cancer diseases. Thus, ischemic abdominal disease should be considered during the diagnostic search in abdominal pain syndrome.

The study aims to assess the state of functional reserves of the cardiovascular system in athletes with normal blood pressure and hypertension. Materials and methods. In the course of the study, anthropometry, daily monitoring of blood pressure, assessment of the functional reserves of the body, echocardiography were examined in 117 professional male combat athletes. They were divided into two groups: group 1 (control group) included 72 athletes with a normal level of blood pressure, and group 2 included 45 athletes with hypertension. Results. Athletes with hypertension showed signs of impaired adaptation to physical activity, namely, high indications of myocardial oxygen demand and energy expenditure index, an increase in the volume of escalating physical activity due to an increase in heart rate, and not in stroke volume.

The study aims to conduct a differential diagnosis of acute arterial syndrome in dissecting aortic
aneurysm in order to optimize medical care for patients. Materials and methods. The study presents an analysis
of the clinical case of an elderly patient with high comorbidity: acute aortic syndrome secondary to metabolically
associated pathology and oncological disease. Results. In the diagnosis, variants of unstable coronary artery
disease, pulmonary embolism, pericarditis and myocarditis were excluded. The patient suffered from thoracalgia,
hypotension, anemia, the clinical picture of ischemic hepatitis and acute kidney injury with chronic kidney disease
for 5.5 days and died due to cardiac tamponade. No magnetic resonance imaging and computed tomography
led to postmortal diagnosis of dissecting aneurysm, complicated by its rupture, and multisystem atherosclerosis.
Multisystem atherosclerosis with lesions of the aorta is no longer a rare pathology and should be included in the
diagnostic search.