The study of the human corpses who died from the coronavirus infection COVID-19 allows to define the exact cause of death, which helps clinicians in choosing a timely and effective treatment to reduce mortality. The study analyzed the current literature with the results of studies of cadaveric material and described macro- and microscopic autopsy findings we observed. The description of autopsy cases of those who died from COVID-19 is certainly important for a comprehensive analysis of this problem and is of high clinical and epidemiological interest.

The interaction of warm-blooded organisms with the environment is always reflected in the homeostatic equilibrium of metabolic processes. The dynamics of redox processes occurring in the body is primarily reflected in hematological indices. The aim of the investigation was to study reactive changes of morphological and biochemical blood composition in rats against the background of quercetin load. Objectives: to analyze the dynamics of morphological and biochemical composition of animal blood at the background of intragastric loading with quercetin in the form of oil solution during 30 days. The study was performed on 80 white mongrel male rats weighing 190-210 g, which were divided equally into control (intact) and experimental groups. The study of reactive changes in the morphological and biochemical composition of the blood of rats under the influence of quercetin was conducted in the dynamics before the experiment, as well as on 1, 3, 5, 7, 10, 15, 20, 25 and 30 days of experiment. It was found that against the background of additional loading with oil solution of quercetin in rats there were reactive changes in the morphological composition of the blood, which are reflected in the increased number of red blood cells, concentration of hemoglobin and leucocytes within the physiological norm, as well as changes in the biochemical composition of the blood, expressed in increased concentration of albumin and decreased concentration of albumin fractions in the rats of the experimental group compared with intact animals.

The manuscript provides clinical and anatomical rationale for interventions on hard-to-reach skull base aneurysms from transcavernosal access. The impact of basal surgery improved the capabilities of the accesses used in vascular neurosurgery, provided an overview of the hard-to-reach segment of the ACBM and the quality of aneurysm clipping. The low location of the BA apex, fetal type of structure, short size of the VAS and anatomical characteristics of the aneurysm (AA with dome direction to intercostal fossa, calcified AA walls, aneurysm with wide neck) complicate the use of pterional access. For anterolateral accesses the problem of surgical target view from the selected interspace, one of the boundaries of which is the ACA (optico-carotid, carotid-oculomotor interspace) remains. The problem of temporal lobe traction damage during surgical intervention has not been solved for lateral accesses. The proposed variant of trans-mechanteric transcavernosal access with resection of lateral parts of the upper scape, the apex of the temporal bone pyramid and destruction of the Dorello channel in the area of the described "postero-medial triangle of the skull base" opens the scape I zone and allows basal approach to the BA trunk and apex, especially at its low location.

Timely diagnosis and treatment of patients with acute aortic dissection continues to be one of the most important and discussed problems in emergency medicine. Due to accurate diagnosis and an effective surgical approach, the results of interventions for acute aortic dissection have improved, at least in specialized centers. However, for patients suffering from malperfusion against the background of acute dissection, the prognosis in some cases remains unfavorable. The cause of malperfusion can be stenosis or occlusion of the main branches of the aorta, which can be detected using computed tomography aortography (CT-AG). Today, it is the method of choice in the diagnosis of not only acute aortic dissection, but also its complications, including malperfusion ones. The purpose of this article is to analyze the capabilities of CT-AG in detecting various types of stenosis arising in the transition of dissection to the main branches of the aorta, as well as the actual manifestations of malperfusion in organs and tissues in acute aortic dissection, according to various authors.

The study included 30 patients who were diagnosed with acute bacterial prostatitis. The average age of the patients was 32 ± 2 years. The study included patients who gave their consent to participate, who did not have concomitant pathology, which was documented, whose age ranged from 18 to 40 years. Patients over 40 years of age with chronic diseases, patients with an established diagnosis of chronic prostatitis were excluded. All patients were divided into two groups of 15 people. The first (group 2) included patients with OBP who were treated with antibacterial drugs in combination with photodynamic therapy and magnetolaser exposure. The second group (group 1) included 15 patients who received antibacterial therapy and magnetolaser exposure without photodynamic therapy. As a result of the study, it was found that the use of combination therapy leads to faster (on the third day) changes in the microflora and relief of symptoms of acute bacterial prostatitis.

Relevance. Due to lifestyle changes, the prevalence of diabetes mellitus is increasing worldwide. Diabetes can affect the nervous system in various forms in the form of cognitive disorders, mono- or polyneuropathies ending in trophic disorders and "diabetic foot"; and distal symmetrical sensory-motor polyneuropathy. In the modern literature there is a significant amount of research in the field of methods of prevention, treatment and rehabilitation of patients with diabetes mellitus, accompanied by damage to the nervous system, but there is no generalized information on a comprehensive analysis of currently available techniques.

The purpose of study. To study the available and most modern methods of rehabilitation of patients with diabetic damage to the nervous system with subsequent systematization of information.

Materials and methods. The most relevant domestic and foreign literature sources containing information on the types of diabetic lesions of the nervous system, pathogenesis and rehabilitation of patients with these pathologies were analyzed.

Results. An analysis of modern literature has shown a great variability in the prevention, treatment and rehabilitation of patients with distal diabetic polyneuropathy. Drug therapy is effective, however, with long-term use, it can be accompanied by complications from the body systems. Physiotherapeutic therapy is not inferior in variety, affecting the nervous, vascular and epithelial tissue by various methods – electric current, magnetic field, laser beams or photochromo-radiation, you can get the desired analgesic effect. The need for lifestyle is also an important part of patient therapy: maintenance of normoglycemia, smoking cessation and special physical activity.

Conclusion. Treatment and rehabilitation of patients with diabetic distal painful polyneuropathy is a big problem for a neurologist-clinician. In modern sources, there is a significant variety of methods for correcting this condition, both medication and physiotherapy. Drugs as the first line of correction of somatosensory disorders are a necessary point in the treatment plan, but it is necessary to remember the side effects of any prescribed drug, the slow onset of the desired analgesic effect. This is necessary for the competent preparation of the patient for a difficult and lengthy rehabilitation process. Among the most effective drugs are gabapentin and prebagalin, drugs of the anticonvulsant group and thioctic acid. A possible bypass of side effects from drug therapy is the appointment of physical therapy, adjusting drug treatment. A significant effect, based on the presented studies, is observed when using magnetotherapy in combination with infrared radiation, transcutaneous electrical nerve stimulation and impulse current with vacuum exposure.

Metabolic syndrome is considered as a polyetiological disease that makes a significant contribution to the increase in mortality from vascular accidents. The combination of metabolic syndrome and arterial hypertension is a complex pathogenetic duet, the diagnosis and treatment of which continues to be actively discussed.

The aim of the study was to study the metabolic syndrome in patients with arterial hypertension permanently residing in the Far North, the frequency of occurrence of the main variants of the metabolic syndrome depending on the degree of hypertension in comparison between men and women.

Material and methods. The study was conducted in the Khanty-Mansiysk Autonomous Okrug – YUGRA, the study period: September 2017 – November 2018. The study involved 205 patients permanently residing in the Far North: men – 82 people (40 %), women – 123 people (60 %). By age, patients are represented by two groups: group 1 – 38–43 years old (n = 98), of which 46 men (46.9 %), women – 52 people (53.1 %); group 2 – 44–50 years old (n = 107), of which 46 men (43 %), women – 61 people (57 %). By degree of AH: 1st degree AH (n = 38), including 14 men (36.84 %), 24 women (61.16 %); 2nd degree AH (n = 115), men – 53 people (46.1 %), women – 62 people (53.9 %); 3 degree AH (n = 52), men – 21 people (40.38 %), women – 31 people (59.62 %).

Results – statistically significant variants of the metabolic syndrome were identified for patients with arterial hypertension living in harsh climatic and geographical conditions, an analysis of these variants was carried out in comparison between men and women, depending on the age and degree of arterial hypertension. 

Based on the analysis of numerous studies, the authors summarized the current understanding of the problem of cerebellar ataxia. Issues related to the cause of the development of coordinating disorders, pathophysiological mechanisms of their occurrence, depending on trigger factors, are consistently covered. The features of the clinical course of acquired and congenital ataxias are systematized, their differential diagnostic differences are presented. Methods for diagnosing cerebellar ataxia are highlighted, diagnostic information content of laboratory, genetic, instrumental research methods is shown. The main directions of drug and non-drug methods of treatment of cerebellar ataxia are considered, their effectiveness is given. The main principles of rehabilitation of this group of patients are formulated.

We examined 38 patients (35 women and 3 men aged 30–40 years) with stage 2 and 3 hallux valgus in the department of traumatology and orthopedics of the Irkutsk Scientific Centre of Surgery and Traumatology to study the electroneuromyographic parameters during stimulation of the peripheral nerves of the lower extremities. All patients underwent electroneuromyographic study of peripheral nerves (n. tibialis and n. peroneus) to clarify the nature of their injuries. In 10 patients, the parameters of the monosynaptic H-reflex were additionally studied. Analysis of electroneuromyographic parameters in patients with hallux valgus demonstrated a deterioration in the peripheral nerves functioning, which was more pronounced for the tibial nerve (n. tibialis). At the same time, the parameters of the monosynaptic H-reflex obtained in patients with hallux valgus indicate the presence of a neurological deficit observed in the compression of the L5–S1 roots of the spinal cord in lumbar osteochondrosis. The results of the study suggest the presence of a single pathogenetic mechanism for the development of degenerative processes in the spinal joints (osteochondrosis) and limbs (deforming osteoarthrosis of large and small joints).

Relevance. Currently, one of the most informative specific methods for diagnosing damage to the spinal cord and peripheral nervous system is electroneuromyography. This complex electrophysiological method is based on the registration, analysis and evaluation of the obtained potentials that arise during the work of the studied skeletal muscles of the patient during the passage of impulses along the peripheral nerve fibers. A feature of this method is the variety of parameters obtained: from the characteristics of the evoked potential itself – its latent period, shape, amplitude and duration, to obtaining the number of functioning motor units of the muscle fiber, the speed of the impulse of both motor and sensory innervation.

The purpose of study. To analyze the current understanding of the possibilities of using the electroneuromyography method in clinical practice.

Materials and methods. In the course of this study, an analysis was made of foreign and domestic literature of recent years on the possibility of using the method of electroneuromyography in adult and pediatric neurological practice.

Results. The rapid development of electroneuromyography in recent years makes it possible to use two main areas: stimulation electroneuromyography (ENMG) and needle, which is currently mainly used abroad. ENMG is a method that does not require invasive intervention, which allows you to assess the state of the studied nerve in different areas, giving an understanding of the nature of the nerve lesion, as well as the degree of its damage. At the moment, there are clear indications for the use of this particular method in clinical practice, namely for polyneuropathies of any genesis, plexopathies, neuropathies and neuritis of any genesis, neural amyotrophies, tunnel syndromes, myasthenia gravis and osteochondrosis of the spine with radicular syndrome. In turn, needle electroneuromyography is an invasive method, but more accurate and highly informative, allowing to assess the functional state of the peripheral neuromotor apparatus. At the same time, this method allows you to identify the disease at an early stage of development, the localization of the pathology, the nature and degree of activity, as well as to indicate the degree of damage to the muscle fiber and the possibility of its further recovery. It is recommended to use this method as a specific diagnosis of amyotrophic lateral sclerosis, spinal amyotrophy, myotonia, myopathy of various origins, hereditary muscle diseases, paraneoplastic myopathies, and so on.

Conclusion. The possibilities of using electroneuromyography currently continue to expand due to the popularity of the method as a diagnostic of the state of the neuromuscular system due to the specificity of indicators, the possibility of diagnosing many diseases at the subclinical stage, the ease of monitoring parameters in dynamics, the possibility of non-invasive use and an accurate assessment of the effectiveness of therapy.

Myocardial infarction without coronary artery obstruction, according to Russian authors, occurs from 4.1 to 10.3% of cases of all myocardial infarctions. Despite a fairly complete description of the term "acute myocardial infarction", there are often situations when the diagnosis may cause doubts and the cause of the condition cannot be found out. The article demonstrates a clinical case of a 26-year-old young man whose genesis of myocardial infarction after a detailed examination turned out to be unclear.

The article presents a clinical observation of successful treatment of a patient with intrahospital hemodynamically significant pulmonary embolism, which frolicked in the first 35 hours after bone-plastic trepanation in the right temporal-parietal region for the purpose of microsurgical excision of arteriovenous malformation of the right parietal lobe.

Introduction. Currently, most orthopedic traumatologists consider surgical treatment as the method of choice for fractures of the femoral neck. However, despite the constant modernization of the available methods of osteosynthesis, the proportion of unsatisfactory outcomes of surgical intervention and the occurrence of early postoperative complications remains quite high (from 28 to 45%) [1]. One of the main directions for solving the problem of unsatisfactory outcomes of osteosynthesis is the improvement and strict control of measures taken in the postoperative period, including early activation of the patient. Despite the importance of the recovery period, there are still no unified standards for managing patients with hip fractures, and the available treatment protocols contain only a generalized plan for further therapeutic measures that do not take into account the individual characteristics of the patient. We have proposed a method for calculating the optimal load on the limb in the postoperative period. The purpose of this publication is to describe a clinical case of the effective application of the method for determining the optimal range of loads on a limb after surgical treatment of femoral neck fractures.

Materials and methods: the study used materials from medical records and instrumental studies of the traumatology department of the TOGBUZ "City Clinical Hospital of Kotovsk", the results of dynamic observation for 12 months in a patient with a transcervical fracture of the femoral neck, for which the method we developed for determining the optimal range was applied. load on the limb after surgical treatment of injury.

Results: 12 months after the operation, the patient who used the method for determining the safe load range in the recovery period achieved full functional and anatomical recovery of the operated limb. Full body weight bearing was allowed from the 6th month.

Conclusion: the method for determining the safe range of load on the limb after a femoral neck fracture has been tested in practice and led to a positive result, which may indicate its effectiveness.

The quality of life of the urban population of the working-age population (Internet users) of the Sverdlovsk region aged 16 to 60 years was studied using the WHOQOL-BREF standardized questionnaire (Russian version) and the author's questionnaire in June-July 2021. The study showed that the average subjective final assessment of quality of life was 69.1% (standard deviation 10.3%). The quality of life is closely related to the commitment to a healthy lifestyle. Adherence to a healthy lifestyle, in turn, depends on age. The indicator for assessing the quality of life of the population is comparable to the regional ones obtained in other studies.

These recommendations were approved at the meeting of the Samara regional branch of the Society of Transplantologists, protocol № 6, 2022. They contain recommendations for the actions of health authorities at the beginning of multiorgan transplantation programs.