The review presents the current state of diagnostics and clinical therapy of chronic obstructive lower extremity artery disease in diabetes mellitus patients. It is shown that in spite of significant therapy and surgery advances the syndrome is still a big issue for modern clinical medicine.

The study objective is assessing the results of groin hernia surgical treatment in premature born infants at the second development care stage and identifying the most suitable treatment period and preventive surgery technique. A retrospective analysis of 55 “ex-” premature born infants with groin hernia has been performed. A comparative analysis of surgery outcomes for several time periods (2009 to 2013 and 2014 to 2016). Different surgical approaches and techniques were used. The implementation of new surgical treatment patterns has doubled the number of infants receiving laparoscopic surgery (90.47 %, p < 0.01). The second group patients have been discharged with higher body mass (3 410,00 g) compared to the first group (body mass upon discharging is 2 890.00 g, p < 0.05).

The study objective is the improvement of ENT treatment available to Surgut, KhMAO - Ugra residents, and providing prompt lavage therapy to ENT patients. The paper covers the stages of outpatient ENT surgery introduction and optimization under the “one day hospitalization program” available at Surgut City Clinical Polyclinic No. 3 in 2010-2016. Since 2010 the number of operations has increased by 670 %. In 2016 the number of operations was 756. The ENT treatment has included radio wave HF-assisted surgery (532 operations in 2016), endoscopic surgery (73 in 2016), and shaver-assisted operations (61 in 2016). No complications requiring full-time hospitalization have been found.

The study objective is assessing the efficiency of proposed AVL removal criteria in newborns with multi-organ failure. Oxygen delivery factor, PO₂/FO₂ index, oxygenation index, average airway pressure, central nervous system activity estimated with the modified Thompson scale have been investigated. 62 newborns with multi-organ failure have been monitored. The patients have been divided into two groups 31 patient each: one has been removed from AVL without using the proposed indicator, and the other has used it. It has been found that in the first group the number of patients required reintubation has exceeded that for the second group (p < 0.001). The mortality rate in the first group has also been significantly lower than in the second (p < 0.001).

The study objective is the safety and efficiency assessment of an oxytocin receptor antagonist (Atosiban) to treat premature childbirth in progress. All cases of administering Atosiban at Surgut Clinical Perinatal Center in 2014-2016 have been analyzed. Out of 34 female patients who have been under tocolysis with Atosiban the pregnancy has been extended by at least 48 h in 26 patients (76.5 %). Childbirth delay over 48 h has been more common when tocolysis begins at 28⁺⁰-30⁺⁶ weeks into pregnancy.

The study objective is the assessment of autoimmune thyroiditis indicators at the decease onset in the Middle Ob residents. The antibody level and thyroid hormones have been measured in 150 patients with autoimmune thyroiditis patients. They have been living in the Middle Ob region for 20 more years. It has been found that most autoimmune thyroiditis cases are accompanied with hypothyroidism. Hypothyroidism in patients with autoimmune disorders is accompanied with type 1 diabetes, hyper synthesis of autoantibodies to parietal gastric cells and insulin. These conditions aggravate autoimmune thyroid inflammation.

The paper is an original study of cardiovascular risk factor effects (demographics, medical history, comorbid deceases and conditions, specific myocardial infarction features) on hospital mortality in patients with acute myocardial infarction after urgent coronary bypass surgery.

The paper offers a social-oriented public health care model implemented through joint health management in the government - physician - citizen system. It is mandatory to permanently include an educational component into the control loop due to advance of medicine and age-related changes in the patient’s organism. Besides achieving the highest possible personal health level, only such a model provides outcome responsibility sharing between physicians and patients. Theoretical and managerial aspects of the proposed system approach are presented “as simple as possible but not too simple” (A. Einstein) and are accompanied with the authors’ case studies.

The study objective is the estimation of complication rate after various sclerotherapy options. The data have been acquired through a Russian practicing vascular surgeon survey. The study is based on an anonymous survey by the Russian Association of Vascular Surgeons. 200 forms, 7 questions each, have been mailed, 71 filled forms have been returned. The survey shoes that a set of certain complications routinely accompanies sclerotherapy surgeons. The leading complications are metting (reported by 96.8 % survey respondents) and hyperpigmentation (reported by 96.1 % survey respondents). Out of the stochastic complications the most common one is deep vein thrombosis reported by 30.2 % respondents.

The study objective is to determine the public opinion of Surgut residents concerning the ambulance service performance. 6,380 patients of Surgut Ambulance Service have been surveyed. Out of then 97.9 % are fully satisfied with the ambulance performance. Out of those who have called the ambulance due to acute chronic disease exacerbation 77 % respondents opt for the ambulance service, not the local polyclinic. The results indicate that the population treats the Ambulance Service as an express alternative to a visit to their local polyclinic. It emphasizes the need to further improve the ambulance service coordination.

The study objective is the assessment of forensic examination procedures applied to poor treatment outcome cases. 272 forensic examinations have been performed to investigate medical personnel negligence (6.2 % of the total number of examinations). The paper includes major reasons for performing forensic examinations. The examinations identify whether there is a cause/effect link between the treatment flaws and their consequences. In 56 cases (20.6 %) the flaws have been identified as a direct cause and in 22 cases (8 %) as an indirect cause of the outcomes. Under these cases the compensation claims ranged from 6,000 to 2,700,000 RUB.

The review is a general and systematic representation of the comorbidity concept, cover the key aspects of the problem being currently studied: epidemiologic, clinical, medical, economic, and genetic. Among the many aspects of comorbidity we focus on its clinical and general pathological significance, particularly, using this phenomenon as a marker, and on the key pathogenic mechanisms that can cause both syntropy and dystropy. Among the major comorbidity pathogenic mechanisms, we consider systemic inflammation, oxidative stress, mesenchimal dysplasia, molecular and genetic mechanisms that involve signaling cellular pathways. We also consider the significance of comorbidity for certain pathologies such as cardiovascular and oncological diseases.

A heart rate variation analysis in male and female teenage Middle Ob residents under rated exercise increase has been performed. 96 teenage male and female Middle Ob residents have been surveyed. The ECGs and HRs have been registered with a 12-channel ECG recorder (cycle ergometer mode) prior to exercise, at 50 W, 100 W, 150 W, 200 W loads, in the recovery period, and after the test. It has been found that the chronotropic reaction to graduated exercise is higher in females than in males at 50 W, 100 W. The 150 W exercise has been completed by 28 % of the girls and 85 % of the boys. It has also been recorded that exercise tolerance in boys is higher than in girls; also it is higher in teenagers who exercise regularly.

The microbial content of the affected skin areas in acne patients has been studied prior and after a shortwave UV treatment course at 150-280 nm. 103 patients have been monitored. The UV treatment has been annual; each treatment course has included up to 20 exposures. The treatment has resulted in 62 % positive outcomes. The microbial content of the affected areas has been reduced by a factor of 2-4. This indicates that shortwave UV treatment is efficient, and that microbial content plays a significant role in acne pathogenesis.