Non-developing pregnancy is an urgent obstetric problem, which is included in the structure of reproductive losses and. The authors performed a systematic analysis of the data presented in the modern scientifi c literature on the epidemiology, etiology, pathogenesis, and diagnosis of non-developing pregnancy. Th e review includes data from foreign and domestic articles on this topic found in PubMed over the past 7 years.

Brucellosis remains the most widespread zoonotic infection in the world. Th e spread of the infection is controlled by animals vaccination because the high morbidity rate of the population is associated with the spread of infection among livestock. Th e research is ongoing on a commercial preparation of an eff ective and safe vaccine for immunization of humans and animals against brucellosis. Th e review is devoted to the prospects and problems of improving the specifi c prevention of brucellosis. Th e authors analyzed scientifi c publications from various databases of electronic libraries, such as PubMed, e-library, CyberLeninka, etc.

The most common extragenital pathology during pregnancy is urinary tract infection (UTI) of various localization. In some cases, untreated UTI can contribute to the development of obstetric, urological, and perinatal pathologies. Factors predisposing to the UTI manifestation may include increased progesterone, delayed peristalsis, urine retention in the ureters, uterine growth, bladder displacement, and increased residual urine volume. Asymptomatic bacteriuria (ASB) during pregnancy can increase the risk of pyelonephritis and subsequent maternal and fetal complications. Pregnant women should be screened for ASB at least once at the beginning of pregnancy (aft er 14 weeks). E.coli is the dominant uropathogen in 70 – 95% of UTI cases in pregnant women. The main treatment for ABT and pyelonephritis in pregnancy (PiP) is antibiotic therapy (ABT), which is prescribed empirically in most cases. There is currently no consensus on the choice of ABT and the duration of treatment for UTI in pregnant women. In the case of ineff ective drug therapy of PiP, it is necessary to raise the issue of the upper urinary tract drainage promptly.

This literature review addresses the effi cacy and safety of atypical antipsychotics in patients with bipolar depression. Th e results of randomized studies and systematic meta-analyses of recent years were revised in detail. The effi cacy of the drug intake was reviewed for the following key research points: Clinical General Impression of Condition Severity Scale (CGI-S) and Montgomery-Asberg Depression Rating Scale (MADRS). A systematic literature search was carried out using Scopus, Web of Science, MedLine, elibrary, and other databases.

Objective: To study the frequency and features of the clinical course of cardiovascular pathology in patients with diff erent clinical forms of primary hyperparathyroidism (PHPT).

Materials and Methods: A retrospective analysis of case histories of 48 patients who received inpatient treatment for PHPT in the endocrinological or surgical departments of two large hospitals in Arkhangelsk from 2005 to 2015 was performed.

Results: Among the revealed cases of PHPT, the symptomatic form of PHPT was the most common (88%). Th e analysis showed a high frequency of arterial hypertension (AH) (69%) with a more severe course in patients with a mixed form of PHPT. Th e level of parathyroid hormone (PTH) was higher in patients with AH compared with patients without hypertension and PHPT (p = 0.008). Left ventricular hypertrophy was detected in 60% of patients with a mixed form of PHPT. In a mild form, this complication was not observed. Th e relationship between the level of total blood calcium and PTH and the interventricular septum thickness was revealed by the results of echocardiography (p = 0.036 and p = 0.012). Th e inverse relationship between the duration of the QT interval and the level of ionized blood calcium was shown (p = 0.022).

Conclusions: Changes in phosphorus-calcium metabolism provoked by PHPT aff ect the state of the cardiovascular system, which determines the need for increased attention of various specialists to this type of complications in PHPT, timely indication of treatment, and improvement of the quality of patient’s life.

Objective: To analyze the factors of the course and outcome of pregnancy in women with pubic joint dysfunction (DLS).
Materials and Methods: Th e authors performed a retrospective analysis of the course of pregnancy and the outcome of childbirth in women with pubic joint dysfunction (DLS) observed in 2016 – 2019. As a result, data on the clinical course of pregnancy and childbirth in 75 women with DLS were obtained. All women underwent routine clinical and biochemical examinations, ultrasound diagnostics (US), dopplerometry (DPM), and cardiotocography (CTG). Th e analysis of all the above parameters was carried out according to the data of birth histories for 2016-2018. Statistical processing of the obtained results was carried out using the programs Statistica 10 and Microsoft Excel 2013.
Results: Clinical manifestations, as well as changes in ultrasound data, became the main factor in deciding on the method of delivery. All patients with second-degree DLS delivered by elective Caesarean section at 39 – 40 weeks of gestation. Women with the fi rst degree of DLS had a vaginal birth. Ultrasound examination in the postpartum period did not reveal an increase in the diastasis of the pubic joint in any woman. All the postpartum women had no complications during the postpartum period.
Conclusion: DLS is a serious complication, which can lead to serious consequences in some cases in the postpartum period. It may require surgical treatment and subsequent long-term rehabilitation. For early diagnostics of DLS, it may be advisable to conduct a mandatory ultrasonic examination of the pubic joint, which is the “gold standard” for the diagnosis of this pathology, to all patients during screening ultrasonic examination.

Objective: To study the transcription factor FoxP3 in children with acute and chronic spontaneous urticaria as a possible predictor of the severity and chronicity of urticaria.
Materials and Methods: A total of 264 children of both sexes aged from 6 to 16 years old with diff erent variants of urticaria course were examined. Clinical methods of the study included the analysis of anamnestic data and an objective examination of the child with the determination of the severity of urticaria. Immunological methods of the study included the identifi cation of T-regulatory lymphocytes with the CD4+CD25+ Foxp3+CD45+immunophenotype.
Results: A signifi cant decrease in the level of transcription factor FoxP3 was found in children with severe acute urticaria and chronic urticaria compared to the control group.
Conclusion: Th e degree of reduction in the level of FoxP3 signifi cantly aff ected the likelihood of the development of a severe course of acute urticaria and possible chronization of the disease.

Objective: To study the eff ectiveness of medical and preventive schemes of spa rehabilitation of children with biliary tract diseases living in ecologically unfavorable areas of the Krasnodar region.
Materials and Methods: The study was conducted among children aged 7 to 14 years old burdened with gallbladder pathology (dysfunctional disorders of the biliary tract (DRBT)). In 2017-2020, the eff ectiveness of the therapeutic-resort stage of rehabilitation was studied in 127 children. The children permanently resided in Krasnodar and were admitted to the therapeutic spa-resort center of mother and child “Diluch” in the resort city of Anapa. The authors selected 93 (73.2%) children with hypofunctional gallbladder disorder (GI) and 34 (26.8%) children with hyperfunctional GI disorder for spa treatment. The control group included children with the 1st group of health. The eff ectiveness of the applied methods of rehabilitation was evaluated based on laboratory and instrumental studies, as well as periodic dynamic medical examinations, which included the collection of complaints, physical examination, and palpation of the abdominal cavity.
Results: Therapeutic spa-rehabilitation of children with DRBT included balneotherapy, physiotherapy, and aerophytotherapy without the use of pharmacological drugs. At the same time, there was an improvement in the condition of both children with DRBT of the hypertensive type (94.1%) and among the subjects with DRBT of the hypotonic type (90.1). There were no cases of the condition worsening in the observed children with DRBT that permanently resided in unfavorable conditions of the Krasnodar Region.
Conclusions: Based on the obtained results, it can be suggested that diff erentiated comprehensive rehabilitation in the conditions of the balneological complex of the resort city of Anapa performed aft er the main treatment of gastrointestinal pathology is feasible for children and adolescents experiencing adverse environmental impacts at a permanent place of residence in the Krasnodar region.

Objective: To compare the genomic diversity of SARS-CoV-2 strains that were spread in the Rostov region and the Republic of Crimea in the period from March to June 2021.
Materials and Methods: A total of 194 samples were sequenced and 186 genovariants were recognized among them using the Pangolin program. Multiple alignment was performed and dendrograms were constructed for the samples belonging to the alpha and delta genovariants.
Results: Changes of the predominant genovariants were revealed for territories of the Rostov Region and the Republic of Crimea from March to June. An increasing percent of the alpha variant was observed in both regions during the spring followed by the rapid emergence of the delta variant, which became predominant in June.
Conclusion: It was shown that alpha variant samples from the Rostov region share a pool of common mutations, while in contrast, alpha variant samples from the Republic of Crimea are closer to those sampled from Moscow and Moscow region. At the end of May, the delta gene variant begins to be revealed, which is rapidly replacing other lines in all the territories considered in this study.

Objective: To study the morphological features and subpopulation composition of immunocompetent cells of adhesion tissue in women with adhesions of the pelvic organs.
Materials and Methods: Th e study was carried out using surgical material obtained from 70 women aged 23 to 40 years. Of these, 50 tissue samples of peritoneal adhesions from patients with adhesions of organs in the small pelvis of I – II degree who underwent adhesiolysis and 20 samples of parietal peritoneum from healthy women who underwent endoscopic sterilization for contraception or completion of generative function. Th e authors used histological, immunohistochemical, and morphometric research methods.
Results: Immunological changes in adhesion tissue were characterized by the activation of the T-cell link of immunity. It was confi rmed by a signifi cant increase in the content of CD4+ (p <0.001), CD8+ (p <0.001), a shift in the balance of immunoregulatory subpopulations towards CD8+, a lower indicator of the immunoregulatory index (p = 0.015), and insuffi ciency of the humoral link of immunity, namely, the absence of CD20+ content against the background of a slight increase in the CD138+ pool.
Conclusion: To prevent the postoperative adhesion process in the small pelvis in patients of reproductive age, it is necessary to apply immunomodulatory therapy in the early postoperative period, which will improve the results of surgical treatment and is pathogenetically justifi ed.

Objective: To perform a comparative analysis of the linear dimensions of the facial skull that are the most signifi cant in determining asymmetry in persons of diff erent sex on spiral computed tomograms (SCT).
Materials and Methods: The CT scan of 104 people of both sexes (women – 52%, n = 54, men – 48%, n = 50) were studied. Measurements were made using a standard digital ruler of a computer tomograph workstation, and the asymmetry of the skulls was assessed using the “fan” method. The results were processed using the Excel program.
Results: In the male and female series of SCT, according to the size of the intervals of sigma of linear dimensions of the facial skull, the occurrence rate of asymmetry of varying severity was determined.
Conclusion: In the male series of SCT, right-sided asymmetry of the linear dimensions of the facial skull prevails in all “fans”, in the female – right-sided asymmetry in the upper and lateral “fans”, but left -sided asymmetry in the lower “fan”. Statistically signifi cant linear dimensions of the facial skull were revealed to determine the severity of asymmetry in both sexes. In the upper “fan”, these are the distances from the nasion to the zygomaxilar (N-Zm), from the nasion to the frontonazale (N-Fn), prevailing on the right in both sexes. In the lower “fan”– the distance from the supraspinal to the zygomaxilar (Ss-Zm), and in the lateral “fan” – the distance from the zygomaxilar to the frontonasal (Zm-Fn), prevailing on the right in both sexes. An insignifi cant or physiological and moderate degree of asymmetry in the size of the facial skull depending on gender was revealed, which did not require correction.

Objective: To monitor the outcome of surgical delivery of pregnant women with two or more uterine scars aft er Cesarean section.
Materials and Methods: A retrospective study was performed based on the Krasnoyarsk Regional Clinical Center for Maternal and Child Health. The analysis of birth histories and histories of newborns in pregnant women who delivered by Caesarean section with two or more scars on the uterus within 2020 was carried out. Inclusion criteria: single pregnancy of 22 weeks or more, the presence of two or more scars aft er Cesarean section. Exclusion criteria: pregnancy less than 22 weeks, one scar on the uterus, and a scar on the uterus aft er other operations. Pregnant women with multiple pregnancies.
Results: The severity of the adhesive process in the abdominal cavity was noted only in patients with three or more uterine scars. An increase in the duration of the Cesarean section operation of more than 60 minutes was observed in the group with three uterine scars and more (40%). Low risk of injuries to neighboring organs, intestines, ureters, and bladder was observed in groups of patients with both two and three uterine scars. More oft en, intraoperative massive blood loss was noted in the group with three scars on the uterus and more (16.67%). Moderate and severe asphyxia in newborns was registered in the group with three or more uterine scars (16.65%).
Conclusion: Th e presence of one and/or two scars on the uterus aft er Cesarean section allowed the authors to classify these pregnant women as a low-risk group. The presence of three or more scars on the uterus aft er Cesarean section classifi ed these pregnant women as a high-risk group.

Hundreds of thousands of bariatric surgeries are performed worldwide every year. Th ey have long been proven to be safe and eff ective in treating obesity and type 2 diabetes. Along with an unconditional positive eff ect, these interventions, especially shunting ones, are characterized by specifi c complications. In the absence of proper correction, they can become fatal for patients. One of these complications is malabsorption leading to a defi ciency of vitamins and microelements, which in most cases, is amenable to timely correction in the postoperative period. However, there are situations when it is not possible to carry out an eff ective correction and it becomes necessary to perform reconstructive interventions with the reverse inclusion of the small intestine in the digestion, which is associated with great diffi culties. Th e authors demonstrated this situation in the description of clinical observation of a patient with postoperative hypothyroidism and history of postoperative hypoparathyroidism, who underwent bariatric surgery. Impaired absorption of drugs (L-thyroxine, calcium, and vitamin D), and therefore, uncompensated hypothyroidism and hypocalcemia was an indication for reconstructive surgery.