The article deals with the history of the origin of Hippocratic Oath, the main issues of professional medical (medical) ethics (bioethics) from the standpoint of modern trends in the development of medicine: euthanasia, induced abortion, gender relations and transgender transition.

The article contains brief information about the origin and development of therapeutic care in the Russian Army and Navy. The transition from the “army clinic” of prof. M.Ya. Mudrov to the medical discipline “Military fi eld therapy” (“Naval therapy”) is described.

Glucocorticosteroids are widely used in clinical and ophthalmic practice, but their unjustifi ed and uncontrollable use is unacceptable. Prescription of steroids has to be controlled strictly and the level of intraocular pressure must be diagnosed, because one of the signifi cant side eff ect of steroids is increased intraocular pressure level and, as a result, the development of glaucomatous optic neuropathy. This review deals with the pathogenesis of an increase in the level of intraocular pressure against various forms of glucocorticosteroids intake, describes the time and duration of their ocular-hypertensive eff ect. The available data on the features of the clinical picture of steroid glaucoma, depending on the routes of their entry, have been studied in detail. The tactics of treating patients with ocular hypertension or a proven case of steroid glaucoma are described.

The disease caused by new coronavirus infection (COVID-19) is a global problem not only because of its wide spread occurrance, but also due to the high incidence of post-COVID syndrome. The literature review presents the results of numerous observations of patients, who undergone COVID-19. The most common symptoms are: general weakness, impaired cognitive functions, memory loss, depression, anosmia, dysgeusia, shortness of breath, cough, chest pain, abdominal pain, anorexia, nausea, vomiting, diarrhea, less often — alopecia, skin rashes, etc. The most frequent symptoms of the post-COVID syndrome are described; the reasons and risk factors for its development are analyzed. The lack of views sameness on the term “postCOVID syndrome” makes it diffi cult to evaluate the frequency of certain symptoms development. Variants of the post-COVID syndrome are considered. It is proposed to distinguish between the post-COVID syndrome, developed after acute COVID-19 that lasts up to 12 weeks, and a prolonged variant of post-COVID clinical symptoms that last longer than 12 weeks, which should be distinguished from lingering COVID-19, its complications, and the consequences of intensive care. The questions of prognosis, diagnostics, and treatment of post-COVID syndrome are discussed.

The article presents data on the level and structure of neuroendocrine tumors in a group of patients under observation by
the Central Military Clinical Hospital named after Mandrykа P.V. of the Ministry of Defense of the Russian Federation. Information about gender and age characteristics of the group of patients is provided.

Objective. To evaluate the clinical and demographic characteristics of a group of patients under 35 years old admitted with acute coronary syndrome, as well as the features of coronary bed damage and endovascular treatment.

Material and methods. A retrospective analysis of the group of patients aged 30 to 35, admitted to the Regional Vascular Center with a diagnosis of acute coronary syndrome in the period from 2019 to June 2021, was carried out. The study included 72 patients with ACS, regardless of the ST segment changes on the electrocardiogram, were admitted to the hospital by the emergency medical service referral. Positive troponins were detected in all the patients by qualitative analysis. Upon admission, they were sent to a catheterization laboratory. An examination was carried out according to the recommendations of medical care, as well as selective coronary angiography and, if indicated, stenting of the coronary arteries was performed.

Results. When analyzing the clinical and demographic characteristics of the group, attention has been drawn to the absolute predominance of males — 71 (98.7%), urban residents — 64 (88.9%), low frequency of bad habits: tobacco smoking in 13 (18.1%) and alcohol abuse in 2 (2.8%) patients, the absence of concomitant pathology, a signifi cant time from the onset of symptoms to calling an ambulance (165 [90; 263]). According to the results of angiography, it should be noted the possibility of acute coronary syndrome with intact coronary arteries is 9 (27.3%) among all ACS cases with ST segment elevation and 29 (74.3%) with ACS without ST segment elevation, while in one third of the above episodes (13 (34.2%)) ACS was caused by the presence of a muscle “bridge” in the basin of the anterior descending artery, a concomitant phenomenon of slowed blood fl ow. The attention has been also drawn to the almost equal proportions of acute thrombotic occlusion (19 (55.9%)) and haemodynamically signifi cant hemadostenosis (14 (41.2%)) as the cause of ACS.

Conclusion. In patients under 35 years old with a typical clinical. picture, positive troponins, with a qualitative analysis, there is a high probability of pathological changes in the coronary bed, regardless of the ST segment changes, which requires X-ray endovascular methods of diagnosis and treatment. Angiographic features of the coronary artery lesion in young people are the discreteness of the lesion in the proximal or middle sections of the arteries, the high frequency of thrombotic occlusions, the predominant lesion of the anterior descending or right coronary arteries, the low frequency of calcifi cation of the coronary arteries.

Aim. To study the dependence of cardiovascular diseases mortality on geophysical and seismic indicators in the Sheki region of the Azerbaijan Republic.

Material and methods. In 2013, seismological information was obtained from 35 telemetry stations, which included a review of the seismic setting of the republic, the distribution of seismic waves, the dynamics of seismic processes, the intensity of earthquakes, magnitude, etc. Based on the spatial distribution of the focal zones identifi ed by weak seismicity and the magnitudes of the maximum possible earthquakes in them, a map of the seismic hazard of the territory of Azerbaijan was compiled. To analyze the connection with diseases in the Sheki region, 742 case histories of patients (48.8% — 362 men and 51.2% — 380 women) who died in 2013 from various diseases, were analyzed.

Results and discussion. Statistically signifi cant (p < 0.001), more deaths among men were from acute coronary syndrome (63.3%), from acute heart failure (46.0%) and from hypertensive crisis (HС) (45.3%). 59.3% died from acute cerebrovascular accident, 54.7% died from a hypertensive crisis and 54,0% from acute heart failure among women. Statistically signifi cant number of deaths was in the age range of 70–79 years old and 80–89 years old.The largest number of deaths was at a depth of 11–20 km — 20.6%, 21–30 km — 16.7%, less than 10 km — 10.5%. When the depth of the process was less than 10 km, the largest percentage of mortality was from acute coronary syndrome — 24.4%, with the depth of 11–20 km — from hypertensive process (40.5%); 24.2% died from heart failure.

Conclusion. Thus, there is a close correlation between geomagnetic changes and CVD mortality in Sheki region of Azerbaijan. It is realized in the form of an increase in the frequency of cases and deaths, and the number of these cases is highly dependent on patients’ age.

The aim of the study: is to analyze the immediate results of surgical treatment of high-and intermediate-risk PE in a group of elderly and senile patients. Material and methods. The study included 43 patients operated on for high-and intermediate-risk pulmonary embolism between 2008 and 2019. In the general group of patients, the number of women prevailed and amounted to 67.4%. The average age was 65.4 ± 4.23 years old. The Miller index in the general group was 29.1 ± 1.42. The Geneva Index was 8.4 ± 1.12. The average pressure in the pulmonary artery at the time of operation was 54 ± 1.4 mm Hg, and the peak pressure was 68 ± 3.43 mm Hg. Results. 5 patients died at the hospital stage. Thus, the hospital survival rate of patients was 88.4%. Among nonlethal complications, cardiovascular and respiratory failure prevailed. According to the statement, the calculated pressure gradient in the pulmonary artery was 29.0 ± 3.1 mm Hg. Conclusion. Surgical treatment is a highly eff ective and reliable method of treatment in the group of older patients.

The aim of this work was to provide a critical analysis of the ten-year experience of using transpapillary interventions in an urgent surgical hospital with a detailed study of all groups of registered complications.

Material and methods. In the period from 2008 to 2018, 1188 retrograde endoscopic transpapillary grafts were performed on the bile ducts with dissection of the major duodenal papilla in a typical and atypical way on the basis of our clinic. The group of observed patients included 1188 patients with endoscopic papillosphincterotomy, including 839 women (70.6%) and 349 men (29.4%). The average age was 63.2 ± 1.25.

Results. During the period, 25 complications (2.1%) were revealed when performing transpapillary interventions with dissection of the major duodenal papilla: acute pancreatitis — 10 patients (0.8%); bleeding from the opening of the major duodenal papilla — 4 (0.33%), perforation 12p. intestines — 4 (0.33%), breakage of the basket cable with wedging — 1 (0.08%), cholangitis — 1 (0.08%), overlapping with a stent of the lobar duct — 1 (0.08%). The overall mortality associated with complications is 0.25%. Based on the analyzed material, the iatrogenic index was calculated. It was 0.044. After the analysis of complications, on the basis of the data obtained, we proposed an algorithm of actions when performing transpapillary interventions.

Conclusion. Based on the study, we come to the conclusion that it will not be possible to completely level the risk and avoid possible papillotomic-induced complications. In this regard, the early, preferably intraoperative diagnosis of the latter and the prompt implementation of correlating therapeutic measures are of great importance, which will undoubtedly improve the treatment results and have a positive eff ect on the outcome of the disease.

The article discusses the algorithm for diagnosing of centrally mediated abdominal pain syndrome (CAPS), formerly called functional abdominal pain syndrome, contained in the Rome Criteria of the IV revision (2016). Recommendations for the diagnosis of CAPS, mainly based on the compliance of the signs available in patients with the developed diagnostic criteria with a minimum of additional laboratory tests, are criticized, since such an approach is fraught with possible errors. The author considers the diagnosis of CAPS as a “diagnosis of exclusion”, which can be made only after a thorough examination of patients using laboratory and instrumental research methods (including ultrasound and endoscopic), confi rming the absence of organic diseases in patients.

Studying and improving the theory of errors of doctors has always been important, and today it has become especially relevant.
The article lists the main provisions of the advanced version of the theory of errors of doctors. The main content of the article
is devoted to four important aspects of the problem of physician errors. The article states the main contradiction of the problem
of errors in medicine. The structure of general objective and subjective causes of medical errors is shown. The main options
for doctors to experience errors that complicate doctors’ mutual understanding in this problem are formulated. For the fi rst
time, the reasons for the denial of errors by doctors are summarized. These aspects and conclusions on them are the result of
an analysis of publications on the problem of errors in medicine, repeated discussions of the problem on professional medical
sites. The content of these aspects was based on its own material on error analysis and observation from practice. The above
aspects and their conclusions need not so much to be confi rmed by special studies, but rather to refl ect on their role and place
in the problem of errors. The general objective and subjective reasons for the occurrence of medical errors are shown in
connection with their possible "guilt". Lack of experience is presented as the most common cause of medical errors. Various
option for doctors to experience errors are presented as a reason that makes it diffi cult for doctors to understand this problem.

The article presents data on the origin and development of dissecting rooms in the history of hospital schools, medical and surgical schools and academies. The names of the first anatomy professors of Moscow and St. Petersburg are presented; information about the development of the Department of anatomy of the Medical and Surgical Academy is given.

The article presents an outline of the research work of outstanding scientists, representatives of the Moscow neurological school.