The data about clinical signs, laboratory features and obstetrical complications in women with inherited blood coagulation defects are presented in the survey article. Multidisciplinary approach, including hematologist, obstetrician, laboratory technician, anesthesiologist, neonatologist and midwife, is needed in treatment and patient management. The delivery had to be planned in specialized institutions with clinical experience of managing women with birth defects of blood-coagulation factors.

Hypolipidemic therapy is one of the essential components for the management of patients with cardiovascular diseases (CVD). In this regard, the main task of modern research is to find new targets for creating additional effective groups of hypolipidemic medications. Canadian and French research groups led by N. Seidah and M. Abifadel discovered a new enzyme — proprotein convertase subtilisin-kexin type 9 (PCSK9) in 2003. It turned out to play an important role in lipid metabolism later. The main mechanism of action of PCSK9 is to regulate the density of low-density lipoprotein receptors (LDLR) in the cell membrane of hepatocytes. Increased activity of PCSK9 accelerates the degradation of LDL significantly, and leads to an increase in the concentration of atherogenic classes of lipoproteins — low-density lipoproteins (LDL). In contrast, reduced PCSK9 activity is accompanied by a decrease in LDL concentrations and a reduced risk of developing atherosclerosis and CVD. The second of the recently discovered and less studied mechanism of PCSK9 protearogenic action is an increase in inflammatory processes in the atherosclerotic plaque. Considering this adverse contribution of PCSK9 to the development and progression of atherosclerosis and CVD, the main task of the researchers was to develop medications that inhibit THIS enzyme. Several new groups of medications that target the stages of biosynthesis and the function of PCSK9 have been developed by now. In this article, we will focus on details discussing the mechanisms of action and effectiveness of the following groups of hypolipidemic medications: anti-PCSK9 monoclonal antibodies (alirocumab, evolocumab), small interfering ribonucleic acids (incliciran), and antisense nucleotides.

Adverse cutaneous drug reactions are skin manifestations resulting from systemic drug administration. Toxicoderma under medication treatment is the most common adverse cutaneous reaction with difficulty to diagnose, especially at early stages. The development and active introduction of new drugs into practice, uncontrolled self-medication of patients, polypharmacy, and repeated contact with one and the same preparation, contribute to the growth of toxicoderma. Doctors should treat patients with toxicoderma carefully, as it can be developed at any time and have different clinical manifestations. The pathogenesis of toxicoderma is not fully understood, which limits the possibility of the diagnosis, treatment and prevention. The benefit/risk ratio evaluation of prescribing medications is the basis of pharmacological safety and doctors, especially of primary health care (general practitioners), should always put it into practice.

There is no consensus regarding the operation of choice for pathological changes in the proximal stomach, distal esophagus and the area of the cardio-esophageal junction to the present day. In addition to malignancy and peptic ulcer disease, a refractory course of gastroesophageal reflux disease (GERD) and the absence of any effect from primary antireflux surgery may be an indication for performing cardiectomy with reconstruction. To make a choice of the surgical treatment for pathologies of the distal esophagus and proximal stomach method, it is necessary to compare the efficiency and safety profiles of these techniques in many parameters. The main indicators of the effectiveness of reconstructive operations after cardiectomy, are the frequency and severity of a large group of functional disorders characterized as “dumping syndrome” or “postgastrectomy syndrome”. A huge number of different types of anastomosis after cardiectomy has been proposed and studied. Nevertheless, an an objective evaluation of the results of these anastomosis types’ use, indicates that the hopes placed on them did not come true in most cases. It indicates insufficient coverage of this problem in scientific literature, despite the continuing interest of surgeons.

The review represents evaluation of the ectopic fatty depots effect on the development of cardiovascular diseases (CVD) in patients with nonalcoholic fatty liver disease (NAFLD). Nowadays, NAFLD is the most common cause of chronic liver disease in most countries of the world. A number of studies have confirmed the important role of NAFLD in the formation and progression of CVD, which is manifested by an increased risk of cardiovascular events in patients with NAFLD according to Framingham Risk Score. The statement that NAFLD should be recognized as an independent risk factor for CVD, in addition to other metabolic disorders, is often confirmed. One of the possible mechanisms of interrelation between NAFLD and CVD is the paracrine activity of visceral adipose tissue; the possibility of local effects of various ectopic depots of visceral fat is being discussed. There is no doubt that epicardial adipose tissue plays an important role in the formation of the hepato-cardiac continuum. Тhere are more and more studies evaluating the effect of other ectopic depots on the development of CVD in patients with NAFLD. The article provides an analysis of publications devoted to the interrelation between fatty ectopic depots and CVD risks in patients with NAFLD. MedLine and PubMed databases in English and Russian languages were used for the search. The review includes articles published from 2000 to 2020.

Coronary heart disease (CHD) remains one of the main causes of morbidity, early disability and mortality in the adult population, despite significant achievements in the diagnosis and correction of coronary blood flow disorders. An undoubted achievement at the present stage is the improvement of conservative and X-ray endovascular methods of treatment, but it has led to an increase in the number of patients with diffuse coronary disorders. We have developed a method of combined treatment of coronary heart disease through direct myocardial revascularization (CABG) in combination with the program YurLeon III, which allows to improve the results in this group of patients.

Aim. To compare the immediate and end results of combined surgery (CABG + YurLeon III) with isolated direct myocardial revascularization.

Material and methods. The study included 730 patients diagnosed with coronary heart disease, exertional angina pectoris (stages III, IV), who underwent surgical revascularization of the myocardium in Pirogov National Medical and Surgical Center, Russian Federation. There were 445 men (60.96%) and 285 (39.04%) women, aged 50 to 73. 580 patients underwent coronary bypass surgery (CABG). 150 patients underwent coronary bypass surgery supplemented with indirect revascularization of YurLeon III (CABG + YurLeon III). Patients underwent gated-SPECT, echocardiography, computer tomography, and quality of life evaluation with  the use of SF-36 questionnaire.

Results. At the intraoperative stage in the early postoperative period, there were no significant differences in complication rates between t two groups (p > 0.05). 1 year after surgery, statistically significant differences in EF were noted: 55.10 ± 5.98% (after CABG + YurLeon III), 50.07 ± 6.54% (after CABG)(p < 0.05); perfusion defect:18.56 ± 9.56%(after CABG) and 8.38 ± 5.79% (after CABG + YurLeon III) (p < 0.05); quality of life: increased in PF, BP, and RE indicators — by 39, 64, and 30 points (after CABG + YurLeon III); by 30, 29, and 26 points (after CABG) (p < 0.05).

Conclusion. Coronary bypass surgery, supplemented with YurLeon III, is an effective and safe method of surgical treatment of patients with coronary heart disease, especially with diffuse disorders of the coronary arteries. It allows to additionally supply myocardium with the blood.

One of the approaches to the formation of adherence to long-term treatment of patients with bronchial asthma, the basis of which is the introduction of a learning factor into their therapeutic complex, is considered. The cognitive strategy of individual and group education of patients in the Asthma School environment helps to awaken the patient’s activity at the level of competence in the management of the illness, and cooperation with the attending physician. The patient consistently acquires the necessary knowledge, useful skills and confidence in the importance of personal participation in the treatment of this disease, moving from compliance to informed adherence to treatment. The significant advantages of long-term treatment of bronchial asthma, in which trained patients are involved, are shown.

A large number of studies deal with the study of the etiology and pathogenesis of scoliotic disease, since it is the most common disease among all the pathologies of the supporting-motor system. Scoliosis is more common in patients aged 4 to 17. Its frequency in the adult population reaches 18.2 cases per 1000 of population. The developed and widely applicable non-surgical therapy of moderate, progressive, and severe extent of disease do not always lead to positive outcomes. A variety of surgical methods for treating scoliosis is successfully used nowadays. Modern types of fixing hardware, including two-leg growing systems, most often used in practice, allow simultaneous correction of vertebral deformity in three planes and reliably stabilize the spinal column in a position closest to the physiological one. Since most organs and systems of the body are affected by scoliosis, it is necessary to take into account the characteristics of the comorbid background of patients for successful surgical treatment and effective postoperative rehabilitation. Comorbidity creates special requirements for surgical and rehabilitation approach to achieve biomechanically correct fitting of the structure and its rigid fixation on the supporting osseous structures.

The aim of the study was to identify the most common comorbidities in patients with scoliosis admitted for surgical treatment, to highlight the features of surgical treatment and rehabilitation of these groups of patients.

Material and methods. We studied 118 case histories of patients admitted for surgical treatment of scoliosis, monitoring characteristics of the periods of treatment and rehabilitation after surgical correction of vertebral deformity.

Results. Degenerative vertebral diseases, cardiovascular development abnormalities and diseases of the gastrointestinal tract were noted with the highest frequency as diseases associated with scoliosis. The characteristics of surgical approach in the correction of vertebral deformity depending on the identified comorbidity are generalized.

Conclusions. The revealed comorbidity pattern indicates the fundamental generality of the etiology of scoliosis and these diseases, as well as the pathogenetic role of vertebral deformities in the development of a number of diseases. This fact must be taken into account when planning approaches to surgical interference and individual rehabilitation program in the early postoperative period.

Currently, there is a serious increase in citizens’ complaints to the Investigative Committee of the Russian Federation. Accordingly, there has been an increase in criminal cases initiated against health professionals. The group of specialists of maximum risk includes, first of all, doctors of surgical specialties: surgeons; anesthesiologists-resuscitators; obstetricians-gynecologists.

Purpose of the study. To analyze the criminal cases against surgeons initiated under the second part of Article 109 of the Criminal Code of the Russian Federation.

Material and methods. The search for criminal cases was carried out in the following electronic databases: Court decisions of the Russian Federation (https://court decisions.rf) and the state automated system of the Russian Federation "Justice" (https://bsr.sudrf.ru/bigs/portal.html); the search covers the last 5 years period.

Results. 235 court decisions in cases open under Part 2. Art. 109 of the Criminal Code of the Russian Federation have been found. The evaluation of territorial and gender characteristics has been carried out. Defects in the delivery of health care identified by the courts and incriminated to doctors are presented. The attitude of surgical specialties doctors to the charges brought, and the applied terms of the main types of punishment are presented: supervised release and denial of the right to practice. Attention is drawn to the aggravating and mitigating circumstances used by the courts.

Materials on medical examination and dispensary observation of patients with surgical pathology, groups of observation, frequency rate of surveys are represented. Recommendations concerning treatment are marked, as well as questions of efficiency of dispensary observation are considered.

The article represents data on the history of medicine in Russia in the XVIII–XIX centuries. Data on Peter I medical reforms, the foundation of Moscow, St. Petersburg and Kronshtadt land and sea hospitals, Hospital schools are presented. The names of the first teachers of Hospital schools are presented.