The review presents current data on the prevention of thromboembolic events in operative gynecology. Specifi c attention is paid to the determination of the clinical expectancy of thrombotic events, the stratifi cation of patients by risk groups, taking into account surgical and extragenital pathology, the peculiar features of surgical intervention, the use of laboratory and instrumental techniques, as well as the duration and the extent of pharmacological prevention of thromboembolic events after surgery.

The article discusses the application of software and information technologies that form a comfortable environment for the work of a physician. Due to the great complexity and insuffi cient knowledge of diseases, a large amount of constantly updating knowledge, as well as often limited resources, it is extremely important to provide help in making decisions with the use of modern computer technologies. Decision Support Systems make it possible to improve the diagnostics and the approach to treatment, to reduce the frequency of errors and non-optimal decisions, and also to help in individualization of therapeutic programs. It is most eff ective to use DSS implemented in the form of programs for mobile devices that allow using tools anywhere and anytime.

NETosis, a new form of cell death, has attracted close attention of researchers in recent years due to its dual eff ect on the pathological process. Being initially a defense reaction of the innate immune defenсe aimed at trapping and neutralizing pathogens (bacteria, viruses and fungi) that have invaded the body, NETosis, in case of excessive activation, has an opposite eff ect. It can contribute to the progression of the disease, causing autoimmunization, damage to surrounding tissue, or the occurrence of atherothrombotic events. This review presents data dealing with the formation of extracellular traps of neutrophils, called NETs. NETosis plays an important role in the pathogenesis of diabetes mellitus (DM) and its microvascular complications. For example, in type 1 DM, β-cell death promotes sequestration of neutrophils into the pancreas and is clearly correlated with increased NETosis. In patients with type 2 DM, the release is also signifi cantly increased. High levels of dsDNA, a marker of NETosis, are correlated with the development of cardiovascular disease and DM caused kidney disease, which is also consistent with the contributing role of NETosis in the pathogenesis of diabetic complications such as impaired wound healing and diabetic retinitis. The mechanisms linking NETosis with high glucose levels are not clearly understood, as NETosis is also increased in diabetic patients strictly controlling glucose levels. One can only assume that NETosis is not a consequence of impaired glycemic control. On the contrary, it causes hyperglycemia, which further increases the initially high level of NETosis in patients with DM.

The article provides a review of specialized literature in order to generalize and systematize data on modern ideas about endometrioid disease in the clinical practice of doctors of various specialties. The social signifi cance of this disease is indicated. The article refl ects the main modern ideas about etiology and pathogenesis of endometriosis. Although there are a number of issues, they are not studied completely. The crucial role of the immune system malfunction in the formation of endometrioid disease is highlighted. The genetic ideas about the development of endometriosis are refl ected. Modern approaches to the treatment of endometriosis and the place of cholecalciferol in modern complex therapy of endometriosis are presented.

The article represents brief information about the origin and development of therapeutic care in the Russian Army and Navy. The gradual transformation from the «Army Clinic» of Prof. M.Ya. Mudrov to the medical discipline «Military fi eld therapy» («Naval therapy») is described. The data on the development of military fi eld therapy during the military confl icts of the late 1930s, the Great Patriotic War and the post-war period are presented.

Objective of the study: To determine the disease incidence and mortality from recurrent myocardial infarction (RMI) in Tomsk for twenty years (2001–2020), to carry out a gender and clinical-anamnestic analysis of MI episodes registered in 2019 and 2020.

Material and methods. Materials for the study were taken from the data of the WHO epidemiological program «Register of acute myocardial infarction». RMI meant a new ischemic attack that occurred 28 days later and in the fi rst 12 months after index acute myocardial infarction (AMI). For 20 years, 1660 cases of RMI were registered. In 2019–2020, 1748 cases of AMI were noted, including 1078 men (61.7%) and 670 women (38.3%), 148 (13.7%) patients with RMI were identifi ed. This group consisted of 97 men (65.5%) and 51 (34.5%) women. To determine the statistical signifi cance of the diff erences in nominal features, the Pearson criterion for was used. The critical level of signifi cance was taken less than 0.05 (p is the achieved level of signifi cance).

Research results. During the period analyzed, the incidence rate of RMI in Tomsk fluctuated within the range of 0.09–0.28 cases per 1000 inhabitants (for men 0.09–0.35, for women 0.06–0.23 cases per 1000 inhabitants). In dynamics, after a long decline in the incidence of RMI in Tomsk, this indicator increased again, especially among men, although it remained signifi cantly lower than in 2001. During the same period, death was registered in 562 (33.9%) patients with RMI. The mortality rate of patients with RMI did not change notably. Its level was identical in men and in women. In terms of gender, it was more common in men younger than 60 years old — 19.6%, in women it was only 3.9% (p < 0.001). Speaking about people older than 60 years, in men — 80.4%, in women — 96.1% (p < 0.001). Men underwent stenting of coronary arteries more often (51.5% and 33.3%, respectively; p < 0.001). As for the rest parameters, no signifi cant diff erences could have been identifi ed. Patients with RMI are older than patients with primary infarction and usually have comorbidities.

Conclusion. The obtained data indicate the absence of numerous gender diff erences in patients with RMI. Comparison of clinical and anamnestic parameters in patients with primary and recurrent infarction showed that patients with RMI should be considered as more diffi cult cases than those with primary infarction, both in terms of age and case history. The urgency of the RMI problem is indicated by the tendency for an increase in morbidity alongside with maintaining the level of mortality of patients at a fairly high and stable level.

During the pandemic caused by the SARS-CoV-2 virus, patients with cardiovascular diseases (CVD), which are often found in the population, are a special risk group. Cardiovascular complications after COVID-19 can occur at diff erent periods of the disease. This research describes cardiovascular complications in patients after recovery.

The aim of the study was to identify the incidence of new CVD and complications of existing cardiac pathology in patients who recovered from COVID-19.

Material and methods. A retrospective, observational study including 370 patients was conducted. All patients underwent telephone consultations within 6 months after the infectious diseases hospital discharge. When new CVDs, complications or anabasis were identifi ed, follow-up visits were initiated.

Results. Among 370 patients under the study, concomitant CVD was registered in 249 (67.29%) people, 121 (32.71%) patients had no case history of cardiovascular pathology. In patients with concomitant CVD during the fi rst 6 months after the infectious diseases hospital discharge, 25 (10.04%) new cardiovascular events were registered, which is signifi cantly more frequent than in patients without case history of CVD (n = 1; 0.83%). The number of events described above was more often observed in the fi rst 3 months after discharge, which is statistically signifi cant (p ˂ 0.05). BP destabilization was most often observed (n = 67; 27.2%) as anabasis, which may be associated with an increased level of anxiety in patients. It was also noted that new CVDs, as well as anabasis, developed because of the timely specialized cardiological medical care absence, which probably led to undesirable events due to inability to correct CVD risk factors in time.

Conclusions. In patients with concomitant CVD, who have had COVID-19, in contrast to patients without case history of CVD, the risk of developing new cardiovascular events is signifi cantly higher. Patients with CVD deserve the closest attention during the fi rst 3 months after discharge from the infectious diseases hospital.

The article presents the legal aspects of providing medical care to a patient, taking into account possible bodily injury in accordance with the consent given by the patient on the basis of the provided information and existing legal restraint, in the absence of criminal intent.

The aim. Analysis of data from medical certifi cates of death, in which the diagnosis of new coronavirus infection (COVID-19) is indicated as the primary cause of death or the contributing cause factor of death.

Material and methods. The study was carried out on the basis of the electronic database of the Main Directorate of the Civil Registry Office of the Moscow Region, based on medical death certificates for 2020. All cases (13,356), in which the diagnosis of COVID-19 is indicated as the primary cause of death or the contributing cause factor of death, were selected. The analysis included deaths registered in the hospital (12,960). 3 groups were formed: group 1 — deaths from COVID 19, without concomitant pathology — 5620 (43.4%), group 2 — deaths from COVID-19 with concomitant pathology — 5706 (44%), and group 3, in which COVID-19 was indicated as the contributing cause factor of death — 1634 (12.6%).

Results. In addition to COVID-19, 100% of deaths were caused by pneumonia. At the age group of up to 30 years, the number of deaths was 0.4%, among people of 31–50 years old — 6.6%, 51–70 years old — 36.9%, and over the age of 70 years old — 56.1%. In the group of those who died from COVID-19 (group 2), coronary heart disease (CHD) and/or arterial hypertension (AH), diabetes mellitus and obesity were registered more often than in the group of those who died from other primary cause (group 3). Oncopathology, miocardial infarction (MI), acute cerebrovascular accident (ACV), bleeding, HIV were registered less often. There were no diff erences in the incidence of thrombosis (6.4% and 5.7%) and COPD (2.4% and 2.9%) in the 2nd and 3rd groups. As the primary cause of death, acute respiratory failure or acute respiratory distress syndrome was indicated most often — 77.3% (93.4% — in the 1st group, 76.6% — in the 2nd and 10.0% — in the 3rd), cardiopulmonary ineffi ciency — 12.3% (5.6%, 18.3% and 15.9% in groups 1–3, respectively), wet brain — 5.2% (0.4%, 3.3% and 33.6% in groups 1–3, respectively).

Conclusions. 43% of medical certifi cates of death did not list other diseases/conditions except COVID-19 and pneumonia. In other cases the analysis did not allow to determine whether COVID-19 had been the main cause of death and the contributing cause factor of death in the absence of clear criteria. More than 90% of deaths were registered in people over 50.

The article deals with rise and development of field surgery during the Great Patriotic War. The success of the treatment of the wounded in medical battalions, medical institutions of army and front-line hospital bases, as well as on the home front , was ensured by the implementation of a system of staged treatment with evacuation according to the destination. The creation and use of this fundamentally new, advanced system of medical and evacuation support for troops in the conditions of the last war was a major achievement of the national health care and military medical service.

The article presents new information about army medical officers of the Russian Imperial Army and Navy who were killed, taken prisoner or reported missing during battlefield engagements of the Russian-Japanese War of 1904–1905.

The article presents the events of 1912–1913 that took place during the restructuring of the Military Medical Academy and the formation of the status of an army medical officer. The historical information about the role and duties of army medical officers in the Russian Imperial Army before the First World War is given.