Vol 27, No 1 (2026): Опубликован 27.03.2026

Rhabdomyosarcoma (RMS) is one of the most aggressive soft tissue tumors in children. RMS accounts for 4% of all malignant neoplasms in children aged 0-14 years and about 50% of all soft tissue sarcomas. RMS develops from embryonic mesenchymal precursors and, therefore, can be localized in any part of the body.

It is believed that the head and neck region, genitourinary tract, and extremities are common sites of primary disease. Stein et al. report that approximately 13%-20% of all cases of rhabdomyosarcoma are most commonly located in the bladder and prostate gland. The mortality rate for rhabdomyosarcoma varies greatly depending on age, location, and histology. Alterio and his colleagues reported the highest five-year survival rate in children aged one to four years, which was 77%. Our study presents a clinical case with a fatal outcome.

Aim. To analyze the association between the number of blood transfusions and the development of severe stages of retinopathy of prematurity (ROP) and to propose a holistic pathogenetic model based on P.K. Anokhin's theory of functional systems.

Materials and methods. A retrospective analysis of 92 newborns with very low and extremely low birth weight (<1500 g, gestational age <29 weeks) who received one or more transfusions of red blood cell-containing components was performed. The relationship between the number of transfusions and the maximum stage of ROP (ICROP classification) and the need for laser photocoagulation was assessed. Statistical analysis was performed using Student's t-test, ANOVA, χ² test (IBM SPSS Statistics 26).

Results. A statistically significant direct association was found between the number of blood transfusions and the severity of ROP. The mean number of transfusions in stage 3 ROP was 3.83 compared to 1.63 in stage 1 (p<0.001). Among children who underwent laser photocoagulation, 56.7% received ≥4 transfusions, compared to 25.5% in the group without intervention (p<0.001). All cases of aggressive posterior ROP were recorded in children with extremely low birth weight who received multiple transfusions.

Conclusion. Low gestational age and extremely low birth weight remain basic risk factors for ROP. Multiple blood transfusions act as a key iatrogenic factor contributing to disease progression. Within the framework of the theory of functional systems, transfusions are considered as an intervention leading to destabilization of the immature oxygenation system and the formation of a pathological system with abnormal angiogenesis. Based on the model, principles of personalized transfusion strategy and holistic homeostasis support are proposed.

The article analyzes the role of disadaptive trained immunity in the pathogenesis of chronic obstructive pulmonary disease and the formation of antibiotic resistance during infectious exacerbations of the disease. The results of a prospective comparative study involving 60 patients with stage II–III COPD, divided into a main group and a control group of 30 people each, are presented. It was shown that the inclusion of sodium deoxyribonucleate in the standard treatment regimen was accompanied by a more pronounced clinical improvement: an increase in saturation to 97% versus 95% in the control (p=0.015), a decrease in cough intensity (p=0.001), and normalization of sputum rheology. A significant correction of the immune response was noted, manifested by a decrease in IL-8 levels from 12.5±2.3 to 5.4±1.36 pg/ml (p<0.001) and an increase in α-interferon from 6.6±0.8 to 8.8±1.1 pg/ml (p<0.01). The proportion of resistant strains decreased from 40% to 10.3% (p<0.001), and the microbial load decreased from 10⁶ to

5.5×10³ CFU/ml (p<0.001). The obtained data confirm the effectiveness of the immunocorrective approach in the complex therapy of COPD.

As part of implementing a comprehensive career routing system for students enrolled in the higher education program—specifically, the Dentistry (31.05.03) specialist program—Voronezh N.N. Burdenko State Medical University (VSMU) ensures continuous support for future professionals at all stages of their career development, from choosing a career path to professional integration. Key to this process is feedback from students and employers to align outcomes with expectations and inform management decisions. Surveys have revealed high levels of student satisfaction with the quality of education, technical facilities, and the socio-psychological environment at the university. Employer feedback confirms that graduates’ competencies meet professional standards. The existing model of collaboration between VSMU and employers within the career guidance trajectory of “Applicant – Student – Graduate” demonstrates continuity across all stages of professional development. It aligns workforce training with industry demands and enhances graduates’ competitiveness in the job market. However, there is a need to emphasize practice-oriented training and mentorship.

Aim. To assess the effectiveness of multicomponent rehabilitation programs with diet therapy as a core element for the management of treatable traits (including obesity) for patients with asthma and multimorbidity.

Materials and methods. 70 patients with asthma, multimorbidity and obesity were divided into two groups: the main group (n=35, rehabilitation program) and the control group (n=35). The rehabilitation program included interventions aimed at weight reduction and correction of eating behavior. Assessments included waist circumference, height, weight, body mass index (BMI), asthma control (Asthma Control Questionnaire-5, ACQ-5), exercise tolerance (6-minute walk test), and levels of Vitamin D, interleukin-6, interleukin-4, tumor necrosis factor alpha, leptin.

Results. The groups were comparable at baseline in all parameters. Following the rehabilitation program, group 1 demonstrated a significant reduction in BMI and waist circumference, along with improved asthma control: the ACQ-5 score decreased by 0.60±0.16 (p<0.05), which was associated with increased exercise tolerance (6-minute walk test). In Group 2, no significant changes in these parameters were observed. Vitamin D levels increased in Group 1, while pro-inflammatory cytokine levels (IL-6, TNF-α) and leptin decreased significantly (p<0.05). No significant changes in these parameters were noted in the control group.

Conclusion. A multicomponent rehabilitation program focusing on diet therapy as part of a treatable traits strategy significantly improves asthma control for patients with obesity and multimorbidity compared to standard care. The integration of personalized dietary interventions with exercise and physiotherapy is warranted to achieving asthma control and prevent exacerbations.

Objective: to evaluate the results of the work of the diabetic retinopathy (DR) office in the Voronezh regional endocrinology center (REC). Methods: 2012 patients with type 1 and type 2 diabetes mellitus were examined. All patients underwent a standard ophthalmological examination, also OCT, OCT-angiography, and fundus photography were additionally performed. Retinal laser coagulation was performed as indicated. Results: In 2025, ophthalmologists in REC performed 365 OCT examinations (18.1% of patients), including 210 fundus photographs (10.4%, respectively) using an optical coherence tomograph and 32 fundus photographs using a fundus camera (1.6%, respectively). 111 retinal laser coagulations were performed (5.5% of patients). Conclusion: multimodal ophthalmological diagnostics makes a significant contribution to the monitoring and treatment of patients with diabetes. A joint monitoring of patients by physicians of various specialties enables timely correction of carbohydrate metabolism and reduces the risk of severe diabetes complications, including proliferative diabetic retinopathy.