Th e aim of the research. To review the main factors of the adverse eff ects of alcohol on the body of the mother and the fetus. Th e review was compiled using the following databases: Scopus, MedLine, the Cochrane Library, Cyberleninka, RSCI, etc.
Material and methods. Th e analysis of Russian and foreign scientific literature used the following keywords: “fetal alcoholic syndrome”, “fetal alcohol spectrum disorder”, “partial alcoholic fetal syndrome”, “alcohol-related disorder”, “neururoperative disorder associated with the prenatal effects of alcohol”, “congenital developmental defects associated with alcohol”. The material was compiled from the references of review articles and the selection was carried out based on the scientific value with formation of the final list of literature according to the relevance of the analysed material.
Results. The review presents the results of studies confirming the adverse effects of alcohol on the mother’s and foetus’s organism, indicating the need to continue research to develop diagnostic criteria necessary for the diagnosis of fetal alcohol syndrome. The negative effect of alcohol intake on the fetus during intrauterine development manifesting in future neurological and behavioural disorders, mental and physical development delay, congenital defects and the stigma of facial skull dysembryogenesis has been proved.
Conclusion. Numerous studies on the effect of alcohol on the mother’s and foetus’s body indicate a negative impact on the latter exerted by alcohol intake in the period of intrauterine development. All this confirms the need to improve the quality of medical care for pregnant women, the need to carry out sanitary and educational events for general practitioners, obstetricians-gynaecologists and medical staff in medical prevention and/or health facilities, as well as in families and the society as a whole.

Abstract. In the Russian Federation, approximately 5 % of births are complicated by postpartum haemorrhage. Postpartum haemorrhage is the leading cause of maternal morbidity and mortality worldwide. Most maternal deaths associated with bleeding can be prevented. Identifi cation of risk factors, methods of prediction and timely recognition of postpartum haemorrhage remain serious problems in obstetrics.
The aim of the research was to analyse modern methods for prediction and diagnosis of postpartum haemorrhage.
Material and methods. Th e aim of the research was achieved through the analytical method: a detailed systematic analysis of modern Russian and foreign literature on methods for predicting and diagnosing postpartum hemorrhage was carried out. The study used such databases as e-library, Scopus, PubMed, MEDLINE, ScienceDirect, Cochrane Library and FIIP for search of publications dated January 2015 to December 2021.
Results. Postpartum haemorrhage, despite the widespread implementation of clinical guidelines in obstetric practice, remains a serious medical problem.
Modern prediction methods are based on risk stratifi cation and do not provide for accurate prediction of development of such a formidable complication.
Today, a method for automatic monitoring of postpartum uterus volume for early diagnosis of postpartum haemorrhage has been developed. However, such a technology has only been implemented in a number of scientific studies.
Conclusion. Methods for diagnosing postpartum haemorrhage are diverse and each of them has its own advantages and disadvantages, i.e. they can only be
effective when used in combination. Also, an important role in prediction and timely diagnosis of postpartum haemorrhage is played by the level of training
of medical personnel and their teamwork skill.

The aim of this review article is a comprehensive systematic review of peer-reviewed literature data on the methods for olfactory dysfunction
diagnosis in patients with chronic rhinosinusitis with consideration for anatomy and pathomorphology. Additionally, we have assessed the reliability and
informative value of various methods. The search was carried out in PubMed, Web of Science and Google Scholar databases using the following keywords:
“smell” AND “rhinosinusitis” OR “polyps”. As a rule, the presented methods of olfactory function diagnosis for patients with chronic rhinosinusitis only
allow determining of quantitative disorders. It is required to select a universal diagnostic method which will make it possible to determine the location of the
olfactory nerve lesion, the quantitative and qualitative impairment of the function taking into account the olfactory nerve fatigue and the time of adaptation.

The aim of the research. To summarise all available information about the bundle structure of the brachial plexus and the nerves of the upper limb. Th is
systematic review aims to provide a viable basis for fascicular repair of damaged peripheral nerves.
Material and methods. The search for papers was carried out using Google Scholar, Medline and PubMed electronic databases using the following keywords: “bundle structure of the brachial plexus and nerves of the upper limb”, “fascicular anatomy”, and “fascicular restoration of damaged nerves”. A total of 187 articles were reviewed and 104 articles were deemed relevant according to the inclusion criteria.
Results. Th is review gives a detailed description of the five stages of search for knowledge and general features of the bundle structure of the brachial plexus and peripheral nerves of the upper limb. Th e role of connective tissue in formation of plexuses and stabilisation of the bundle structure has been shown. The variant anatomy of the distal peripheral nerve bundles (shape, size, number and topography) has been described in detail. Th e role of knowledge about the bundle structure in the fascicular restoration of damaged peripheral nerves of the upper limb is shown.
Conclusion. Over the past 250 years, a difficult path has been passed to reveal knowledge and form the idea of the bundle structure of the brachial plexus and peripheral nerves of the upper limb. Th e knowledge gained has formed the basis for numerous methods of fascicular restoration of damaged nerves. Despite the results achieved, it is required to carry out further research on the organ features and variant anatomy of the bundle structure of all upper limb nerves all the way to the spinal cord.

Abstract. A comparison of surgical techniques (SILS, NOTES, Da Vinci robotic system, 3D modeling, Radius Surgical System) showed that they will provide
endovideosurgery with new ways of performing surgical interventions in the near future.
The aim of the research. Conducting a comparative analysis of minimally invasive surgical methods of treatment used in modern gynecological practice,
as well as identifying their advantages and disadvantages, indications and contraindications for use, possible complications.
Material and methods. A review of the data in PubMed, eLibrary, Cyberleninka, Scopus and WoS on the keywords “minimally invasive surgery”, “NOTESsurgery”, “SILS-surgery”, “Da Vinci system”, “3D modeling”, “gynecology” for 2016-2021 was performed. In addition, a manual search for articles in journals was carried out. Exclusion criteria from the analysis: description of individual clinical cases, books and documents. Th e fi nal analysis included 60 sources out of 127 initially identified.
Results. Minimally invasive surgical technologies have become the method of choice in the diagnosis and treatment of many gynecological pathologies.
Conclusion. It is with the help of minimally invasive techniques that there are prerequisites for carrying out such manipulations at a high level.

Th e aim of the research. To study structural and functional parameters of the heart in patients with polycythemia vera.
Material and methods. A total of 63 patients with stage I-IIB polycythemia vera (27 male and 36 female) and 52 healthy subjects underwent echocardiography, dopplerography, tissue dopplerography of fi brous rings of atrioventricular valves as well as evaluation of longitudinal strain of the left ventricular myocardium.
Results. In patients with polycythemia vera, there is enlargement of heart chambers, interventricular septum hypertrophy develops in 20.6% of the cases, pulmonary hypertension in 39.7% of the cases, global diastolic dysfunction of the left ventricle in 84.1% of the cases, as well as diastolic dysfunction of the fibrous rings of the mitral and tricuspid valves and a decrease in longitudinal strain parameters of the left ventricle indicating impairment of its contractile function.
Conclusion. Th e decline in parameters of tissue dopplerography of the fibrous rings of the atrioventricular valves and longitudinal strain of the left ventricular myocardium may serve as early criteria for diagnosis of myocardial dysfunction in patients with polycythemia vera.

Th e aim of the research. To analyse the structure of complications in patients with coronary artery disease and diff erent musculoskeletal disorders (MSD)
undergoing elective coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass.
Material and methods. From 2019 to 2020, a single-centre cohort study was conducted on 387 stable coronary artery disease patients aged over 50 before
elective CABG. Th e following MSD were assessed: sarcopenia, osteopenia, and osteosarcopenia. Patients were divided into four groups according to the MSD type: group I included 52 (13.4 %) patients with sarcopenia, group II included 28 (7.2 %) patients with osteopenia, group III was composed of 25 (6.5 %) patients with osteosarcopenia, and group IV included 282 (72.9 %) patients without MSD. Patients underwent CABG using cardiopulmonary bypass. Cardiovascular, infectious and non-infectious complications, death, a composite endpoint including cardiovascular complications and death, as well as the total number of complications were analysed.
Results. Infectious complications were revealed in 23 (5.9 %) patients. Th e highest frequency of infectious complications was noted in patients with osteosarcopenia while the lowest frequency was found in patients without MSD (24 % vs 5.8 % in group I, 7.1 % in group II, 4.3 % in group IV). Th e highest number of surgical complications was noted in patients with sarcopenia and osteosarcopenia (17.3 % in group I, 7.1 % in group II, 12 % in group III, 5.3 % in group IV; p = 0.002). Th e composite endpoint was significantly more prevalent in patients with osteopenia (32.1 vs. 9.6 % in group I, 12 % in group III, and 12.8 % in group IV). Th ere were no statistically significant differences in the total number of complications between the groups of patients with MSD. Th e complications were 2-fold more likely to occur in patients with osteopenia and osteosarcopenia compared to patients without MSD. Moreover, MSD increased the risk of the composite endpoint by 1.7 times (odds ratio (OR) 1.73, 95 % confi dence interval (CI) 1.04-2.89; p = 0.035); osteopenia increased the risk of the combined endpoint by 3 times (OR 3.01, 95 % CI 1.02-8.9; p = 0.046). Surgical complications were associated with baseline MSD (OR 1.71, 95 % CI 1.06-2.76; p = 0.026); sarcopenia increased the risk of surgical complications by 2 times (OR 2.02, 95 % CI 1.05-3.88; p = 0.034).
Conclusion. Th e frequency of complications in patients with MSD was 1.79-fold higher compared with patients without MSD. Cardiovascular and infectious complications as well as complications associated with surgical treatment were more common in patients with MSD. MSD can be used as a risk factor for the development of in-hospital complications because the presence of these disorders increases the risk of cardiovascular complications, non-infectious complications and death by 1.7 times. Moreover, osteopenia was associated with a threefold increase in the composite endpoint risk, while sarcopenia doubled the risk of non-infectious complications

Th e aim of the research. To evaluate the features of ultrasound markers of adipose tissue in individuals with coronary artery disease, to identify a relationship with the presence of carotid artery stenosis.
Material and methods. The study included 125 coronary artery disease patients hospitalised in the emergency cardiology department (41.6% females, 58.4 % males). Th e mean age of the surveyed was 68 (61.0; 74.0) years.
Results. According to the results of the study, it has been found that the risk of carotid artery stenosis is associated with increasing age and IAFT thickness
(OR=1.02, 95 % CI: 1.0-1.04, p=0.035). Th e traditional obesity index (BMI) showed no statistically significant associations (OR=0.73, 95 % CI: 0.25-2.09,
p=0.548). Apart from that, in individuals with normal body weight and carotid stenosis, IAFT values were higher compared to the group with normal body
weight without stenosis (p=0.029). It has also been determined that the value of ultrasonic parameters of adipose tissue has age and gender differences.
Th us, women have 1.5 times higher SATmin than men, while men have 1.4 times higher WFA as compared to women. With increasing age, a decrease in the thickness of the IAFT and PFT was observed.
Conclusion. The data obtained dictate the need for further study of ultrasonic markers of adipose tissue in diff erent gender, age and nosological groups in
order to identify the most sensitive parameters.

Цель исследования. Оценить эффективность разработанного нами авторского компрессионного шва на матку для остановки акушерского
гипотонического кровотечения.
Материал и методы. Проведено ретро- и проспективное исследование по типу «случай-контроль». Когорта обследованных (n=100) была разделена на две группы: I – пациентки с оригинальным авторским наложением компрессионного шва (n=21), II – женщины с наложением компрессионного шва по A. Pereira et al. (n=79). Статистическая обработка данных была выполнена с помощью программы IBM SPSS Statistics 25. Сравнивались лабораторные показатели, объем кровопотери, востребованность экстирпации матки, лигирование яичниковых и внутренних подвздошных артерий, температурные кривые и количество дней госпитализации. Проводилась эхографическая оценка состояния матки, маточных и яичниковых сосудов в послеоперационном периоде.
Результаты. Проведенный анализ выявил сопоставимость обеих групп по основным показателям (возраст, рост, вес, срок родоразрешения,
результаты клинико-лабораторного обследования). Востребованность выполнения перевязок яичниковых и внутренних подвздошных артерий
в I группе составила 4,8 %, а во II – 11,4 %. Удаление матки в I группе не было проведено ни у одной пациентки, тогда как во II группе процент
экстирпации составил 1,26 %. В I группе не встречались кровопотери, составляющие 45-50 % ОЦК, в свою очередь во II группе у 6,3 % пациенток определялась кровопотеря, равная 45-50 % ОЦК. При эхографии в послеоперационном периоде (с 1-х по 7-е сутки) отмечена адекватная динамика инволюции матки у всех пациенток обеих групп.
Заключение. Таким образом, применение предлагаемого авторского компрессионного шва на матку при гипотоническом кровотечении высоко
эффективно и в 95,2 % случаев достаточно для остановки кровотечения. Интраоперационных и отсроченных осложнений в послеродовом периоде не было, что позволяет рекомендовать метод к клиническому применению.

Th e aim of the research. To study the molecular eff ects of water treated with spark-discharge plasma on tissues of the cyst wall of the ovarian endometrium
in vitro.
Material and methods. Tissues of the ovarian endometrial cyst capsule obtained during the surgical treatment of women through laparoscopic access were incubated in various modes in plasma acid, ethanol and physiological solution at room temperature. Plasma acid was produced by treating water for injection with spark-discharge plasma to a decrease in pH<2.0. Aft er the immunohistochemical study of the preparations, a comparative analysis of ablative and apoptogenic action via TUNEL was performed, as well as analysis of proangiogenic action (VEGFA), endothelial progenitor cells (CD133), protein damage (NT), DNA damage (8-OHdG) and proliferation activity (Ki67) of different treatment methods from the standpoint of potential plasma acid efficacy for sclerotherapy of ovarian endometrioma as compared to standard sclerosant: ethanol.
Results. Th e study has demonstrated a more pronounced ablation and pre-apoptogenic effect of plasma acid on tissues of the ovarian endometrium capsule than ethanol. In addition, a decrease in neoangiogenesis and protein damage from active forms of nitrogen (protective action) compared to ethanol was shown.
Conclusion. Water treated with spark-discharge plasma can be considered an effective alternative to ethanol for ovarian endometrioma sclerotherapy. The
sequential action of plasma acid and ethanol increases the sclerosing action of ethanol.

The aim of the research. To develop a technique for correction of occlusal contacts using digital technology.
Material and methods. Th is clinical study included 30 (16 male and 14 female) patients aged 33 to 69. Th e patients were divided into three groups. The first group consisted of 10 patients whose orthopaedic treatment was carried out with fixed prostheses made of the E.max CAD material. Digital modelling of complete anatomical orthopaedic structures was carried out using a virtual articulator. In the patients of the second group, the frames of all-ceramic fixed prostheses were made in the KaVo ARCTICA CAD/CAM system from the ARCTICA ZS-Blank zirconium oxide. Th en, the dental technician plastered the jaw models into a fully adjustable articulator Artex CR and applied the facing ceramic mass VM9. For the patients of the third group, the frames of all-ceramic fixed prostheses were made in the KaVo ARCTICA CAD/CAM system from zirconium oxide ARCTICA ZS-Blank. Th en, the dental technician plastered the jaw models into a STRATOS 100 medium anatomical articulator and applied a VM9 ceramic facing mass. Occlusion was registered using T-ScanIII. Statistical analysis of the results obtained was carried out in the R soft ware environment using Fisher’s exact test.
Results. Regarding the occlusal balance, the technique for manufacturing of fi xed prostheses using a virtual articulator is distinguishable from the methods for manufacturing of orthopedic structures using patient-specifi c and average-value articulators at a signifi cance level of p<0.0167. At this level of signifi cance, there was no statistically signifi cant diff erence between the methods of fi xed prostheses manufacturing using patient-specifi c and average-value anatomical articulators.
Conclusion. Th e use of digital intraoral scanning technology, modeling of dentures using a virtual articulator and manufacturing of orthopedic structures in CAD/CAM systems makes it possible to obtain non-removable dentures that do not require correction of occlusal contacts at the stage of fi tting in the oral
cavity. Th e proposed method for correction of occlusal contacts with digital technology is highly effective.

Thermal injury to the hand (TIH) is one of the most common burn injuries among adults, including the consequences of exposure to domestic, industrial
and military thermal damaging factors. Th e study of the epidemiological indicators of TIH is important for a realistic assessment of the economic burden on non-surgical and surgical treatment of TIH and its consequences, as well as the indirect economic costs of the rehabilitation of patients who had TIH.
The aim of the research. To analyze the results of epidemiological studies of TIH carried out in Russia and abroad and to update current knowledge of the
frequency of occurrence of TIH among adults.
Material and methods. We have analyzed domestic and foreign epidemiological studies published in the eLibrary, Google Scholar, PubMed, Springer, Scopus, Elsevir, Oxford Press, Clinical Case, Cochrane databases. Th e depth of research is 10 years (2011-2021). The full-text articles in Russian and English have been analyzed, including: original articles, thematic and system reviews, and Cocrane reviews.
Results. Th e valuation of the results of the epidemiological studies of TIH among adults is difficult due to the lack of a consistent approach to the design and duration of the previous studies. Besides, studies analyzed included not only TIH, but also thermal injuries of the upper limbs in general. It has been done this way due to the lack of consistent approaches to the classification of TIH. Th e incidence of TIH varied from 0.34 % to 79 % in the world, the average incidence was 32.9 %

Th e aim of the research. To develop an individual approach to diagnosis of the fulminant form of acute pancreatitis based on laboratory and instrumental
research methods.
Material and methods. Th e retrospective phase of the study (2016-2018) enrolled 31 patients diagnosed with severe acute pancreatitis (SAP) – the control group. These patients underwent analysis of the results of surgical treatment in order to determine the factors of adverse outcome of the disease. On this basis, a special category of patients was identified, requiring changes in existing diagnostics and surgical tactics depending on the course of the disease. At the prospective stage (2018-2020), a total of 27 patients diagnosed with SAP (the main group) were included.
Results. For these patients, we introduced an individualised approach to diagnosis and performed comparative analysis of its effectiveness. Th e comparative analysis of both groups was carried out based on the main indicators of the patients’ initial condition. The distribution of patients between the compared groups had no statistical difference in the gender composition (χ 2 = 0.141, p> 0.05). Th e age of patients ranged from 24 to 83 years. The average age was 44.3 ± 12.6 years in the control group and 43.7 ± 14.4 years in the main group (Student’s t-test = 0.7, p > 0.05). No statistically significant differences were revealed between groups in each age category.
Conclusion. In our study on patients with fulminant progression, we emphasised a combination of additional attributes. Th e analysis has revealed statistically significant differences between the “fulminant” and the “typical” progression in the occurrence rate of the combination of attributes.

The aim of the research.To evaluate the effectiveness of endoscopic ultrasonographic (EUS) elastometry in preoperative prediction of the risk of postoperative pancreatic fi stulas (PPF) in patients undergoing resection interventions on the pancreas (P).
Material and methods. A two-center prospective controlled study was conducted. Th e study included 30 patients, all of whom were operated on (distal resection of the pancreas or pancreatoduodenal resection). EUS elastometry was performed with the calculation of the coefficient of deformation (CD) equal to the ratio of the stiffness of the parapancreatic tissue (reference area) to the stiffness of the pancreatic parenchyma in the area of the proposed resection. Patients were divided into two groups: 1) patients whose postoperative period proceeded without the development of PPF, and 2) patients with the presence of clinically signifi cant PPF. To assess the significance of diff erences, the Mann-Whitney U test or the Student’s test were used. Th e χ2 criterion was used when comparing groups on a qualitative basis. ROC analysis was performed to calculate optimal cutoff points. Static processing of results using Statistica 10.0.
Results. Clinically significant PPF were observed in 7 (23.4 %) cases (type B – 6, type C – 1). The difference in the mean deformation coeffi cient (CD) between the groups of patients without and with the presence of pancreatic fistulas was statistically significant (36.7±4.1 versus 15.8±2.3, p<0.01, respectively). When conducting ROC analysis, the optimal cut-off point of elastometric СD in predicting the risk of developing PPF was determined, which was 23.3. With a value of D ≤ 23.3, the risk of developing PPF is assessed as high, with a СD > 23.3, the risk of developing PPF is low. Th e sensitivity, specificity and overall accuracy of the developed model are 85.7 %, 82.6 % and 83.3 %, respectively. 
Conclusion. Ultrasonographic elastometry is an applicable technique in predicting the risk of developing PPF, which has a fairly high accuracy

The aim of the research. To evaluate the therapeutic eff ect of modifi ed nanodiamonds (MND) of explosive synthesis for treatment of allergic contact dermatitis induced by cobalt ions.
Material and methods. Th e study was performed on guinea pigs. Th e animals were divided into 3 groups (6 animals in each group). Allergic contact dermatitis was initiated using 2% aqueous solution of cobalt nitrate applied to the animals’ skin for 14 days according to the common procedure. For allergic contact dermatitis treatment, glycerol and MND suspension with the nanoparticle concentration of 5g · l-1 prepared in glycerol were used. MND with high colloidal stability in water suspensions and the average nanoparticle cluster size of d50 = 50nm was used in the work. Th e animals of group I were controls: aft er allergic contact dermatitis development, their skin was not treated by any means for 7 days. The animals in groups II and III were experimental: aft er allergic contact dermatitis initiation, their skin was treated for 7 days using glycerol and MND suspension, respectively. Upon experiment completion, biopsy of skin sample was performed on all animals for histological and spectral examination. The content of cobalt in skin samples was determined through atomic adsorption spectroscopy.
Results. The results of histological and morphometric analysis indicate that, in the case with dermatitis modelled in guinea pigs using cobalt ions, treatment
of the animals’ skin with MND suspension reduces allergic inflammation intensity. The therapeutic effect of MND is caused by adsorption of cobalt ions onto nanoparticles and their subsequent elimination from the skin, which complies with the atomic adsorption spectroscopy data.
Conclusion. Th e prospects of MND as a new therapeutic agent for binding and elimination of chemical allergens (particularly, cobalt ions inducing the
allergic contact dermatitis development) are discussed.

Surgical care in a mono-hospital for patients with COVID-19 leads to a number of organisational problems due to the lack of specialised departments.
The article presents the experience of surgical treatment in a mono-hospital obtained from one and a half years of work in this mode. In total, approximately 400 surgeries were performed. Th e experience of treatment of 7 patients with acute intestinal obstruction has been summarised. In the abdominal cavity, a significant number of hematomas of varied localisation were found under the parietal and visceral peritoneum, as well as in the subcutaneous fat. This is possibly associated with anticoagulant therapy included in the treatment regimen for patients with COVID-19 according to the methodical recommendations by the Ministry of Health of the Russian Federation. As an illustration, a successful case of treating COVID-19 patient with strangulated hernia of the abdominal white line complicated by acute intestinal obstruction is presented.