The high incidence of thrombotic complications has led to the widespread use of anticoagulant therapy and prophylaxis in patients with COVID-19 after recovery. One of the most vulnerable groups of the population in relation to COVID-19 are elderly and senile people. The purpose of the study – analysis of literature data on the study of the effectiveness of the use of anticoagulant drags in elderly patients who have had a viral infection COVID-19, with a history burdened by concomitant pathology. The review presents literature data on the effectiveness of the use of anticoagulant therapy in elderly patients after mild or moderate COVID-19 against the background of various somatic diseases. To correct coagulation hemostasis disorders in clinical practice, both time-tested «classic» drags (heparin, warfarin), which require periodic monitoring of the international normalized ratio, and new oral anticoagulants from the group of direct thrombin inhibitors (dabigatran or Pradaxa^®) and the group of oral inhibitors of activated factor ten (Xa) activity – rivaroxaban (Xarelto^®), apixaban (Eliquis^®) and edoxaban (Lixiana^®, Savaysa^®, Roteas^®) – which have gained wide popularity. The article describes options for anticoagulant and antiplatelet therapy for elderly patients who have had coronaviras infection with various concomitant pathologies (hypertension, coronary heart disease, atherosclerotic cardiosclerosis, thrombosis of cerebral vessels, deep veins of the lower extremities, atrial fibrillation, conditions after stent placement). An analysis of the literature shows that doctors are concerned about the increased risk of thrombotic complications in the new coronaviras infection COVID-19. Early initiation and correct administration of anticoagulant therapy for COVID-19 are an undoubted factor in improving the prognosis in a group of elderly, somatically compromised patients. It has been established that direct oral anticoagulants for the treatment of thrombotic complications after COVID-19 in elderly patients with various comorbidities have a number of advantages over classic drags of this group. They are available, have a convenient method of administration, a regimen for determining and adjusting the dose, and do not require periodic monitoring of the international normalized ratio.

The article presents a review of studies elucidating the mechanisms by which the gut microbiota, its metabolites, and the brain interact to influence the pathogenesis and clinical presentation of autism spectrum disorders. A deeper understanding of gut-brain axis interactions could provide the basis for new therapies aimed at alleviating symptoms in children with autism spectrum disorders.

The aim – to study the interrelation of cord blood level of vitamin D3 and interleukins (IL) -4, -8, -10 with the dose of vitamin D3 supplementation during pregnancy. The cord blood level of IL-4, -8, -10 and vitamin D3 have been studied in 119 newborns. Data have been analysis separately in dependence on taking of vitamin D3 –containing drags during pregnancy (group I - did not receive vitamin D3, group II-l received <400-500 UE/ml irregularly, II-2 and II-3 had 400-500 UE/ml and 800-120 UE/ml daily during pregnancy respectively). It has been shown refusal of vitamin D3 is associated with less it’s cord blood level and concentration of anti-inflammatory cytokines than in group II while proinflammatory IL-8 was significantly higher. It has been shown that refusal of vitamin D3 during pregnancy is associated the decrease of cord blood of it and proinflammatory cytokines. At the same time, there were higher dose-dependent increase of concentration of anti-inflammatory IL-4 and IL-10 in group II. The last is the key cytokine associated with immune tolerance requiring for maintenance of pregnancy, but activation of proinflammatory mechanisms may lead to pregnancy interruption.

The use of 3D computer technologies allows obtaining detailed images of the anatomical structures of the kidneys, including the renal arteries, their branches, and the calyx-pelvic system, and contributes to the development of innovative algorithms aimed at preoperative examination of patients and planning surgical interventions. In this connection, the goal was determined: to study the 3D anatomy of the branches of the renal artery and elements of the renal collecting system in women. A comprehensive morphological assessment of the arterial kidney system and the calyx-pelvic kidney system of women (41-80 years old) was performed on 64 corrosive preparations. A detailed analysis of the structure of the division variants of the renal arteries of the kidneys in women according to age indicators allows us to assume that age does not have a significant effect on the division variants of the renal arteries, which indicates significant stability of their branching variants. The obtained results of the study became the basis for creating a model of arterial blood supply to the excretory sections of the kidney, allowing the creation of 3D software for tridimensional visualization of the pelvicalyceal system and arterial vessels using elements of Virtual, Augmented and Mixed Reality. This use of approach allows surgeons to get a more accurate idea of the topography of blood vessels, which minimizes the risk of damage during surgical intervention. The proposed software, integrated with modem diagnostic methods such as multispiral computed tomography, has high potential for improving the efficiency and safety of urological surgeries.

The study of the biodiversity of the colon microbiota in residents of the Arctic regions is currently of particular interest. The combination of cultural and molecular genetic methods allows for a comprehensive assessment of the microbiota spectrum. Purpose of the study – to assess the colon microbiota in young, healthy residents of Arkhangelsk. The material for the study was feces from healthy residents (n = 43). Analysis of the nature of the microbiota was carried out using cultural methods and PCR with the determination of 33 indicators. Research results. According to PCR data, 100 % of the subjects had a deficiency of lactobacilli; Roseburia inulinivorans was present in 20.9 %, Blautia spp. in 72.1 %, Agathobacter rectalis in 37.2 %, E. coli in 60.46 %, and there was an excess of Fusobacterium nucleatum in 16.28% of cases, Streptococcus spp. in 13.95 %, Acinetobacter spp. in 6.97 %, and opportunistic representatives of the order Enterobacteriales in 32.58 %. According to the results of the cultural research method, a deficiency of lactobacilli was recorded in 97.67 % of cases, enterococci in 51.16 %, Bacteroides in 27.91 %, typical (lactose +) E. coli in 72.09 %, bifidobacteria in 13.95 %, as well as detection of an excess of Klebsiella spp. in 32.58 % and Staphylococcus aureus in 4.65%. The average amount of lactobacilli by the cultural method was 4.81 lg CFU/g, Enterococci 5.0 lg CFU/g, S. aureus 5.12 lg CFU/g, K. pneumoniae 4.75 lg CFU/g, K. oxytoca 5.62 lg CFU/g, E. coli 6.52 lg CFU/g, Bifidobacterium spp. 9.0 lg CFU/g, and Bacteroides spp. 9.0 lg CFU/g. Statistically significant differences in the identification of microorganisms were found for Lactobacillus spp., Enterococcus spp., Bifidobacterium spp., and Bacteroides spp. (p < 0.001). An imbalance of the colon microbiota in healthy residents of Arkhangelsk was revealed through cultural and molecular genetic research methods.

The admission of a child to school is accompanied by a change in his lifestyle and an increase in workload. During this period, it is especially important to assess and strengthen the health of the student in a timely manner. In modem literature, the issues of morbidity, resistance, adaptation processes depending on the physical fitness of children are widely covered, while the problems associated with different levels of cognitive capabilities remain in the shadows. The aim of the study was to study the frequency of registration of health groups, morbidity, success and difficulties of younger schoolchildren depending on intellectual giftedness. The study included 573 children of grades 14 in Rostov-on-Don. After determining the IQ coefficients (D. Wexler test, Stanford-Binet intelligence scale, E. Torrens creativity test), the children were divided into 2 groups. The main group included 82 primary school students with high cognitive development. The control group included 491 children with average cognitive development. To determine the groups of health and morbidity, an analysis of individual medical records (form № 026/y) was carried out R. Goodman's standardized questionnaire «Strengths and Difficulties» was used to assess the behavior of children and their psychological problems. It was found that children of the main group already from the 2^nd grade are 2 times less likely to have the 1^st health group and 1.2 times more likely to have the 2^nd health group from the 3^rd grade. With reduced physical activity, diseases of the respiratory system, digestion, musculoskeletal system, decreased visual acuity were more often observed, and from the 4^th grade – diseases of the nervous system, mental disorders. In the main group of children, there is a high frequency of issues and difficulties in the areas of peer relations, behavior, emotions, activity, which causes a higher overall assessment of problems (1.6-2 times). The results obtained require the development and implementation of recreational activities for intellectually gifted children.

The issues of stimulation of regeneration and prevention of intestinal anastomosis failure are still relevant in abdominal surgery. Suture failure of intestinal anastomoses is most often observed in the early postoperative period and can lead to purulent-septic processes in the abdominal cavity, the lethality of which reaches 70 %. The aim of this study was to obtain new data for the results of a comparative macro- and microscopic morphological assessment of the intestinal anastomosis zone in the early and late postoperative period with local injection of platelet-rich autoplasma and without the use of autoplasma. The experiment was performed on 30 sexually mature laboratory rabbits. All animals underwent the imposition of a small-intestinal digestive anastomosis «end to end» (control anastomosis) with a singlelayer intestinal suture at a distance of 15 cm proximal to the ileocecal angle. Having retreated 30 cm proximally from the imposed control anastomosis, enterotomy was performed, followed by injection of platelet-rich autoplasma into the muscular layer of the intestinal wall, with subsequent formation of an intestinal anastomosis. On days 3, 7, 14, relaparotomy, macroscopic assessment of the anastomosis zone, revision of the abdominal cavity, and collection of biopsy material (intestinal wall at the anastomosis site) were performed under general anesthesia. The state of the anastomosis zone, adhesion genesis, and the degree of stenosis of the intestinal anastomosis area were assessed macroscopically. Signs of the regenerative process were examined microscopically. Macroscopic examination showed a significant decrease in the degree of stenosis in the intestinal anastomosis, as well as the absence of signs of an increase in the level of adhesion formation when using autoplasma. Microscopic examination revealed an acceleration of the reparation dynamics, angiogenesis, cellular cooperation, organization of connective tissue, as well as a reduction in the duration of the inflammatory phase in the experimental group (use of platelet autoplasma). The use of intraoperative injection method of autoplasma administration contributes to the acceleration of morphological signs of intestinal anastomosis regeneration, neoangiogenesis and reduction of the period of manifestation of signs of inflammatory response in the zone of intestinal anastomosis, demonstrating the potential of using this method to reduce the incidence of possible complications associated with its failure.

The problem of connective tissue dysplasia is caused by the widespread spread among the population, the progressive nature of the disease, the involvement of various organs and systems in the lesion, a sufficiently high disability of patients and a decrease in working capacity. The aim – of the study was to study the serum content of certain pro- and anti-inflammatory cytokines in adolescent girls with undifferentiated connective tissue dysplasia and menstrual cycle disorders. 245 adolescent girls aged 11 to 17 years were examined (14.0 ± 0.15 years). Among them, 176 patients assigned to the main group were characterized by menstrual irregularities and the presence of UCTD. The control group was represented by conditionally healthy females of the same age in the number of 69 people. The content of interleukins - IL-1β (1. -4, -6, -10, -17A, and tumor necrosis factor-а were determined in blood serum samples using commercial enzyme immunoassay systems. It was found that in UCTD with menstrual cycle disorders in adolescent girls, the concentration of proinflammatory IL-6 in the blood serum increased (p = 0.002), at the same time, no changes in the content of IL-1β (IL-4, IL-10, IL-17A and tumor necrosis factor-ɑ (p > 0.05) were detected. The obtained data characterize the features of cytokine status, in menstrual disorders against the background of undifferentiated connective tissue dysplasia in adolescent girls and can be used to develop effective individualized schemes of diagnostic and therapeutic, and preventive measures.

In patients with infective endocarditis, the type and genus of microorganisms influence the course of the postoperative period. Objective – to study the structure of microorganisms isolated from blood in patients with acute infective endocarditis associated with COVID-19 and its relationship with the development of early postoperative complications. We retrospectively analyzed the case histories of 14 patients (11 men and 3 women) with acute infective endocarditis associated with COVID-19. On admission to the hospital, all patients underwent 3-fold blood sampling for microbiological studies, which were performed on bacteriological analyzers. The frequency of microorganisms’ isolation amounted to 28.57 %. The detected pathogens were represented by Gram-positive (Enterococcus faecalis) and Gramnegative bacteria (Klebsiella pneumonia and Escherichia coli). In all patients with isolated microflora the postoperative period was complicated by pneumonia and sepsis against the background of progressive cardiac and respiratory failure, its outcome was unfavorable. When comparing our own data with literature data, it was found that the frequency of microorganism’s isolation in our patients was 28.57 %, in foreign authors – 100 %; gram-positive and gram-negative bacteria were isolated in our patients, in foreign literature – gram-positive bacteria; in our patients with positive culture in 100% of cases the postoperative period was unfavorable, in foreign authors – in 40 % of cases.