New coronavirus infection (COVID-19) – a serious medical and social problem. Despite the achievement of certain successes in the treatment of patients with COVID-19, there is a need to develop special clinical and organizational approaches in patients with CKD who are on renal replacement therapy and are at special risk due to the course of the underlying disease and concomitant pathology. The article presents the experience of the Samara Regional Center of Nephrology and Dialysis of the Samara Regional Clinical Hospital named after V.D. Seredavin during the pandemic, as well as the features of the management of patients with stage 5 chronic kidney disease undergoing renal replacement therapy in the infectious department to provide MP to patients with COVID-19. Patients with CKD require increased attention, treatment of coronavirus infection (both specific and concomitant) should be carried out in full, while observing the regimens and dosage regimens of drugs and their combinations.

This article is devoted to a review and study of literary sources concerning information about anatomical surgery and the peculiarities of the blood supply to the femoral neck. The prevalence of hip fractures in the structure of injuries, the lack of a unified treatment strategy and a high percentage of complications of this injury requires the traumatologist to have accurate knowledge of the anatomy of the vascular structure of the proximal femur and its features, which helps to avoid the occurrence of iatrogenic avascular necrosis of the femoral head in the event of an injury and subsequent fixation of femoral neck fractures, since the subsequent consolidation in the damaged area and nutrition of the femoral head depend on the degree of preservation and restoration of blood flow.

The article describes the experience of carotid stenting use in asymptomatic cerebral atherosclerosis. The study included 147 patients with unilateral asymptomatic carotid artery disease. The evaluation of mid-longterm results of carotid stenting in patients with asymptomatic stenosis was carried out in comparison with the use of conservative treatment in this category of patients (“optimal drug treatment”). In the course of the work, no significant intergroup difference was revealed in the incidence of adverse outcomes (TIA/stroke, death from 
stroke,) within a year from the moment of surgical treatment or the beginning of complex correction of risk factors.  

 The article analyzes the existing methods of inguinal hernioplasty from the standpoint of existing and developing Russian and international clinical guidelines. The authors discuss the problems in the treatment of inguinal hernias that exist in regional health care, and present their experience in the treatment of inguinal hernias according to the data of the Reaviz Multidisciplinary Teaching Hospital. 

Performing classical methods of plasty in patients with femoral hernia is possible if Cooper's ligament – the pubic periosteum – is preserved. Patients with a long history of femoral hernia develop thinning and atrophy of the pubic periosteum. The aim of the study was to establish the possibilities of instrumental research methods to determine the preservation or atrophy of the pubic periosteum in patients with femoral hernia. It was found that using the X-ray method and CT before the operation, it was not possible to establish the preservation or atrophy of the pubic periosteum in the area of the femoral canal. With ultrasound, it is possible to visualize the pubic periosteum in young patients. 

 Relevance of the topic: Appendectomy is one of the most frequently performed operations in abdominal surgery. Laparoscopic access is gradually replacing open surgery for acute appendicitis. The aim of this study was to assess the technical feasibility and safety of the laparoscopic technique for acute appendicitis and compare its results with open appendectomy. A total of 120 patients with acute appendicitis were operated on, 
60 with laparoscopic appendectomy and 60 with open surgery. For three years from June 2018 to January 2021. The two groups were compared for the duration of surgery, length of hospital stay, postoperative pain, complication rate, time spent resuming daily activities, and cosmetic satisfaction of patients. The results were found to be significantly better when using the  laparoscopic technique. In the postoperative period, there was a 
lower level of pain, faster recovery, early resumption of work, a decrease in postoperative complications and better cosmetic satisfaction of patients operated on by the method of laparoscopic appendectomy, compared with open surgery. Conclusions: Laparoscopic appendectomy is a safe and feasible technique for treating acute appendicitis with results comparable to open appendectomy, without an obvious increase in complications and is clearly the procedure of choice for treating acute appendicitis. 

Adhesive dentistry is the foundation on the basis of which there have been global changes in the concept of adhesion of composite materials in therapeutic dentistry, protocols for fixing ceramic restorations in orthopedic dentistry. But a number of unsolved problems remained – the adhesion of composite materials to sclerosed dentin and tooth root cement, the sensitivity of the components of the adhesive systems to the wet environment of the oral cavity and spatial stability in the presence of dentinal fluid moving centrifugally in the dentinal tubules, the lack of restoration of periodontal attachment to the defect that occurs during tooth root caries. The review analyzes the results of studies on the use of self-etching adhesive systems in the treatment of root caries. The physician's ability to choose an adhesive system in a particular clinical case demonstrates his fundamental knowledge and minimizes the percentage of errors that he can make during the treatment phase. 

 The widespread prevalence of acute cerebrovascular accidents (ACVA) around the world (up to 30 million annually), high disability draw close attention of doctors to the system of care for patients with strokes. Rehabilitation is of great importance in it, the main task of which is to  restore impaired body functions and return patients to a full life. The best way to organize rehabilitation is considered to be an integrated approach with the formation of a multidisciplinary team of doctors. An individual approach to each patient is also important: his age, medical history, social status, relationships with family, lifestyle. Doctors carry out rehabilitation measures to restore the patient's motor, social, household and psychoemotional functions. The results of rehabilitation and restoration of health of people who have suffered a stroke depend on many factors, but to a large extent on a favorable attitude and the persistent desire of the patients themselves to return to health. The aim of the study was, based on the results of studying the case histories of patients with ischemic and hemorrhagic stroke of the neurological department on the basis of the BUZ UR of the First Republican Clinical Hospital of the Ministry of Health of the UR, to assess the effectiveness of rehabilitation of patients who underwent stroke.

 The research was aimed at the investigation of systemic symptoms of primary knee osteoarthrosis in patients with the early stage of the disease. We examined 42 patients with no clinical symptoms but at high risk of knee osteoarthrosis, and 12 donors with no musculoskeletal pathologies. It was established that systemic abnormalities featured by the negative change in the cell immunity along with pro-inflammatory cytokine activation were detectable even in the early stage of primary osteoarthrosis. These had probably facilitated the progress of the immune response followed by the inflammatory reaction that  led to the progress of destructive changes in the connective tissue structures of the knees4 the process was proven by the increase in cartilage oligomeric matrix protein as well as cartilage glycoprotein-39. 

Relevance. Currently, all over the world, antibacterial therapy is widely used as a prophylaxis after surgical interventions. Currently, some data indicate the benefits of a short course, while others, in turn, indicate the benefits of a long course of antibacterial drugs as a prevention of postoperative complications. The problem of pan-resistance of bacterial strains in relation to almost all available groups of antibacterial drugs forces us to look for ways to overcome resistance, to look for new potential bases for the creation of antimicrobial drugs. New antibacterial drugs: odilorhabdins, tridecapeptins and malacidins, arilomycins and others will help to overcome the existing difficulties.

The purpose of this study is to analyze the domestic and foreign literature for the period 2017–2021 in order to study the current approach to antibacterial therapy in surgical practice.

Material and methods. In the course of this study, publications were selected according to the topic for the period from 2017 to 2021. The information was obtained from foreign and domestic sources: the Russian scientific electronic library, integrated with the Russian Science Citation Index (eLibrary.ru), Medline database (via Pubmed.gov), Scopus database, ScienceDirect database.

Results. One of the significant difficulties in the treatment of wounds with antibacterial drugs of various localizations is the persistence of resistant strains of Staphylococcus aureus. In the studied studies, the high effectiveness of tedizolide phosphate in the treatment of this type of infection was noted. It is also possible to use other new drugs as epmiric therapy in the presence of risk factors for MRSA infection: daptomycin (lipopeptides), ceftaroline (cephalosporins), tigecycline (glycylcyclines), telavancin (glycopeptides)[41]. The use of biocides in the treatment of prostheses for hernioplasty as an antibacterial prophylaxis significantly reduces the adhesion of staphylococci and prevents postoperative complications. Suture material with antimicrobial activity, which would allow to fully reduce the risk of infections in the field of surgical intervention, is not yet available on the pharmaceutical market, but the increasing attention of scientists is attracted by chitosan, a derivative of the natural polymer chitin. The combined use of bacteriophages with low doses of antibiotics leads to better results in the treatment of surgical soft tissue infection. Bacteriophages are one of the ways to overcome antibiotic resistance.

Conclusions. The modern approach to antibacterial therapy in surgical practice involves the correct and timely appointment of starting therapy, taking into account the sensitivity of microorganisms, the use of antibacterial preoperative prevention, determining the optimal duration of use and dose selection of an antibiotic, the use of sensitive bacteriophages together with them, overcoming antibiotic resistance due to the competent use of new antibacterial drugs based on peptides, a comprehensive approach to the treatment of surgical infection.

The wound process is a set of stages that successively replace each other and as a result lead to epithelization of the skin and closure of the wound defect. The development of the wound process is influenced by the pH value of the wound contents, which determines the rate of all biochemical reactions occurring in the wound. In the course of the study, patients were measured for wound exudate in the postoperative period. It was noted that in patients with the initial values of the hydrogen index, which was 7, a more effective healing process of the postoperative wound was observed, while in patients with the initial pH value of 8, the wound process took a protracted character. 

 At present, the question of the influence of climatogeographic and meteorological factors on human health continues to be relevant and causes discussions among scientists and clinicians around the world. The aim is to study the manifestations and causes of pathological meteosensitivity in patients with arterial hypertension permanently residing in the Far North. For the period from June 2017 to March 2018, 138 patients with a confirmed diagnosis of arterial hypertension (AH) were included in the study based on generally accepted criteria (ESH/ESC, 2018), permanently living in the Far North. Men – 42 people (30.4 %), women – 96 people (69.56 %). The age of the study participants ranged from 18 to 65 years, averaging 45 ± 5.6 years. 32 people smoked (23.19 %). The condition for inclusion in the study was the presence of complaints about meteosensitivity, the manifestation of meteopathies against the background of changes in meteorological conditions, the short duration and relativity of these disorders in the same patient in the same weather conditions. The main meteorological elements that can be considered predictors of meteopathies have been determined, and the main manifestations  of  pathological  meteosensitivity  in  patients with  AH  permanently residing in the Far North have been identified. The presence of pathological meteosensitivity should probably be considered as an additional risk factor for the development of cardiovascular events. At present, details such as the manifestation of the metabolic syndrome in patients with hypertension, the degree of hypertension and the duration of the underlying disease, changes in biochemical parameters, and their associations with meteopathies require detail. 

Mucosits of the oral mucosa as a complication of cancer treatment remains an urgent problem. The risk of developing mucosits is classically directly related to the type, intensity of anticancer treatment, and type of psychological response. Combination therapy increases the severity of mucosits. The frequency of mucosits 3–4 degrees according to the WHO scale reaches 85 % and is considered severe among patients receiving high-dose radiation therapy to the head and neck area. In squamous cell carcinoma of the oral mucosa, oral mucosits is the main limiting factor in chemo radiation therapy.It is often necessary to resort to enteral nutritional support and the use of morphine-type analgesics to complete the planned exposure, or to interrupt therapy. In order to prevent mucosits, we studied the correlation between its degree and psychological reactions. The studied psychosomatic status of patients with squamous cell carcinoma of oral mucosa, who are at the stage of chemoradiation therapy, complicated by mucosits, showed a direct relationship between these indicators. 

The results of the diagnosis of cognitive impairments in patients with endocrinological and cardiological profiles are presented. The Montreal MoCA test was used to assess cognitive functions. 

The aim of the study was to study the role of allogeneic transplantation of hematopoietic stem cells in a patient with the classic course of Hodgkin's lymphoma.

Materials and methods. The work was carried out on the basis of the analysis of a clinical case of the clinic of occupational pathology and hematology of the University Clinical Hospital No. Professor V.Ya. Shustov. Examinations, a course of chemotherapy in conjunction with surgery and analysis of the results of a patient with a diagnosis of classic Hodgkin's lymphoma were carried out. 

Results. An unfavorable prognostic effect of a large amount of previous chemotherapy on overall survival after allogeneic HSC transplantation was revealed. According to the results of PET-CT, the patient achieved PETnegative remission of the disease after all the stages of treatment. Compared to the presented PET / CT scan of 02/07/2020, there is a positive trend in the form of the disappearance of metabolic activity in the 3rd rib on the right, the body of Th 11 and the body of the left ilium.

Conclusion. The use of high-dose chemotherapy with hematopoietic stem cell transplantation makes it possible to achieve success in the treatment of patients in cases where the results of chemotherapy are unsatisfactory.