Vol 14 (2025): Материалы XXI Международного Бурденковского научного конгресса 24-26 апреля 2025

The article examines the contribution of Zinaida Ermolyevato the production of penicillin during the Great Patriotic War.The study is relevant because it highlights the importance of scientific achievements in saving soldiers' lives. The purpose of the work is to analyze the scientist's contribution to thedevelopment of domestic antibiotic production technology andto assess its impact on the medical care of the army during thewar years. During World War II, Ermolyeva fought the choleraepidemic in Stalingrad by organizing the production of bacteriophage in the basement. She also created domesticpenicillin "custosin" in 1942, which began mass production in1943. Successful tests were conducted on the Baltic Front in1944. Ermolyeva was called the "marshal of the invisible front"for her achievements. In the course of the work, it was found outthat thanks to Ermolyeva's scientific discoveries, mortalityamong wounded soldiers decreased by more than half, and the created methods of using antibiotics became the basis for the development of domestic antibiotic therapy after the war. Inconclusion, it was concluded that Zinaida Ermolyeva made a huge contribution not only to the development of medicine, butalso to the victory in the Great Patriotic War. The soldiers shesaved returned to the battlefields, selflessly moving towardsvictory over fascism.

During the Great Patriotic War medical workers played a decisive role in saving the lives of frontline soldiers and civilians. Astrakhan became an important rear centre where evacuation hospitals were organised and medical research wasconducted. The contribution of local doctors such as N.G. Lychmanov and L.L. Sluvko remains insufficiently studied, although their activity contributed not only to saving thousands of lives, but also to the development of surgery in the post-war years. Objective. To analyse the contribution of the Astrakhan doctors N.G. Lychmanov and L.L. Sluvko to the organisation of medical aid during the war years and to the development of public health care after it. Materials and Methods. We used archival materials, memoirs, scientific publications, documents of the Astrakhan Museum-Reserve. Historical-biographical and comparative analyses were applied. Results. N.G. Lychmanov, the leading surgeon of the evacuation hospital No. 1589 of the II Ukrainian Front, saved thousands of lives and after the war continued to work in Astrakhan, being engaged in science and pedagogy. L.L. Sluvko, surgeon of the 159th separate brigade, head of the surgical department of the hospital of the Stalingrad Front, proved himself in the most difficult combat conditions. After the war he continued his medical and scientific activity. Conclusion. It is important to preserve the memory of the contribution of Astrakhan doctors to military medicine, emphasising the importance of their work. Creation of educational programmes and online resources will help to pass on the knowledge about the heroism of medics to future generations.

Abstract. During the Great Patriotic War in the USSR, medical workers had an acute problem with the widespread prevalence of infectious diseases among both military personnel and civilians. There were no highly effective medicines for the treatment of such diseases at that time, so a large number of scientists tried to discover a drug that would be able to suppress the pathogenic effect of microorganisms on the human body. After numerous experiments, an outstanding Soviet scientist, Georgy Frantsevich Gause and his wife Maria Georgievna Brazhnikova, succeeded in isolating an active component from a bacterium of the genus Bacillus brevis, which had a bactericidal effect against many strains of various bacteria. The drug was named Gramicidin C. The new antibiotic is widely used in military field hospitals, having a high therapeutic effect. To this day, Gramicidin C is used for the manufacture of various pharmacological preparations. The discovery of this drug marked the beginning of the development of new antibacterial drugs, which were subsequently discovered by Gause and Brazhnikova in their laboratory.

The article provides information about Mikhail Mikhailovich Mayevsky (1894-1977), a Soviet microbiologist and immunologist who made a significant contribution to the development of microbiology, especially during the Great Patriotic War.During the war, Soviet scientists faced the task of developing effective means of preventing typhus, which posed a serious threat to the army and the civilian population.( Typhus is an acute infectious disease caused by bacteria of the genus Rickettsia prowazekii. It is transmitted through the bites of lice (Pediculus humanus), which become infected by feeding on the blood of an infected person.) Majewski developed a method of infecting white mice with typhus through the respiratory tract, which made it possible to obtain material for creating a vaccine.Already in 1942, its production began, which significantly reduced the incidence of typhus among the population and military personnel. The significance of Mayevsky's work: the vaccine was quickly introduced into production.This helped prevent outbreaks of typhus, reducing the incidence among the military and civilian population.The Mayevsky method became the basis for further research on rickettsia vaccines and played an important role in the epidemiological protection of the USSR. For this contribution, Mayevsky was awarded the Stalin Prize in 1943. His work in the field of microbiology and immunology played a key role in ensuring epidemiological security during the war.

The issue of anatomical variability the thyroid gland structure remains controversial. There is no generally accepted anatomic standard for comprehensive evaluation of ultrasonography findings. Objective. To determine the average values of ultrasonic parameters the thyroid gland, to carry out a comparative analysis the obtained results. To determine and verify the possibility of correlation between the peculiarities ultrasonic anatomy the organ and sex the subject. Materials and Methods. Ultrasonography of the thyroid gland 26 people was performed, the group of subjects included men and women the first period mature age. The linear parameters of the organ were determined by the method ultrasonography, the volumetric parameters were calculated on the basis linear parameters. Results. The total volume of the thyroid gland in women the first period mature age was 9.58±2.8 cm3, in men 12.7±1.3 cm3. Comparative analysis of linear and volumetric parameters showed a reliable predominance the values these parameters in men. Conclusions. A direct correlation dependence of the values linear and volumetric ultrasound parameters the thyroid gland on the sex the subject was revealed. In men of the 1st period mature age, a reliable predominance ultrasound dimensions was recorded in comparison with the results obtained in women.

One of the important tasks of modern morphology is the creation of anatomical preparations. Their further application is possible for both scientific and educational purposes. Despite the rather rich history of museum business in anatomy and the variety of existing classical methods of preserving biomaterials, the development of new methods remains relevant. Effective conservation methods make it possible to preserve the integrity of tissues and organs, their topographic and anatomical location, providing an opportunity for their detailed study over a long period of time. The aim of the work was to describe classical methods of anatomical preparation, their comparison with our own modern modifications, providing a re-actualization of anatomical preparation at a new technological level. This paper examines both classical and modern modified and proposed methods of manufacturing and preserving anatomical preparations, including corrosion casting, the "Ice Anatomy" method, the use of epoxy resins and preservation in gelatin or agar-agar medium. The possibilities of studying ready-made drugs using radiation diagnostic methods are also being considered. Special attention is paid to the historical development of classical techniques, their modification and testing at the Department of Normal Anatomy of Petrovsky Medical University. The practical significance of preservation of anatomical preparations in the educational process and morphological research is considered. The results obtained can contribute to further improvement of the proposed technologies: preparation, fixation, preservation and further research of biological materials, as well as the creation of new techniques.

Goal. The aim of the work is to develop a method for studying the kinetics of Na-Ca metabolism by continuously recording the contractile activity of an isolated rat heart, as well as studying the effect of certain cardioactive drugs on this process.

Materials and methods of research. The experiments were performed on isolated hearts of white rats perfused through the aorta using the Langendorff method.

The results of the study. Immediately after switching on the solution containing a high concentration of potassium (15 mmol/l), a complete cardiac arrest was observed. 5 minutes after cardiac arrest, cardiac perfusion was transferred to solution No. 3, which contained a reduced concentration of NaCI (30 mmol/l) and a high level of CI (15 mmol/l). An increase in heart tone was immediately observed. Registration of an increase and then decrease in tone in the stopped rat heart caused by a decrease and then restoration of the previous concentration of NaCI in the perfusion solution. However, immediately after reaching the max

In recent years, metabolic disorders such as type 2 diabetes and obesity have become a significant global issue. The role of chaperones, specifically HSP70 and HSP27, in the pathogenesis of these diseases warrants thorough investigation. The objective of our study was to examine the activity of chaperones HSP70 and HSP27 in patients with type 2 diabetes and obesity to understand their impact on metabolic disturbances. The study involved 158 patients, and the levels of HSP70 and HSP27 were determined using enzyme-linked immunosorbent assay (ELISA). Concurrently, clinical and laboratory assessments were conducted to evaluate metabolic status. The results revealed a significant reduction in the levels of HSP70 and HSP27 in patients with type 2 diabetes compared to the control group. This decrease in chaperone activity correlated with worsened insulin resistance and increased inflammatory markers. Thus, our findings suggest that reduced chaperone activity may contribute to the development of metabolic disorders in patients with type 2 diabetes and obesity. Investigating chaperones opens new avenues for developing therapeutic strategies in the fight against these diseases.

Heavy metals that enter the human body with drinking water or when inhaling air polluted by emissions contribute to damage to cell membranes, initiating processes of free radical lipid peroxidation, under the influence of which osmotic resistance can change. Objective: to evaluate the effect of barium, manganese and strontium salts on the osmotic resistance of erythrocytes. Materials and methods: the object of the study was a suspension of washed erythrocytes. The experimental samples containing 10 mM solutions of barium, manganese and strontium salts contained 0.01 ml of erythrocyte suspension, 5 ml of 0.5% (or 0.9%) sodium chloride solutions. After incubation (37 °C, 30 min), the optical density of the solutions (540 nm) was measured on a PE-5400 UV spectrophotometer. The number of cells subjected to hemolysis was determined as a percentage of complete hemolysis. Results: it was found that in samples containing physiological sodium chloride solution, with the addition of 10 mM barium solution, the number of hemolyzed cells increased by 9.6 times, with manganese by 2.4 times, with strontium - by 8 times compared to the control. In samples with a hypotonic sodium chloride solution, the number of hemolyzed cells after 30 minutes of incubation reached 90% in samples with barium, 52% with manganese, 97% with strontium. Comparative analysis of the effect of heavy metals on the osmotic resistance of erythrocytes in vitro showed that barium salts have the greatest hemolytic effect, and manganese salts have the least. The data obtained indicate a damaging effect of heavy metal salts on erythrocytes, characterized by deterioration of the properties of the erythrocyte membrane due to the initiation of lipid peroxidation processes in it.

This scientific paper examines the relationship between vitamin D status and the development and course of type 2 diabetes mellitus (T2DM), one of the most common endocrine pathologies characterized by insulin resistance and impaired carbohydrate metabolism. In recent years, there has been increasing interest in the role of vitamin D not only in maintaining the skeletal system, but also in regulating metabolic processes, including glucose metabolism. The aim of the study is to investigate the effect of vitamin D levels on the development and course of T2DM in patients of different ages and genders. The study involves patients diagnosed with T2DM who undergo a clinical examination, including determination of vitamin D levels. Biochemical blood test data (HbA1c), including lipid profile (TC, HDL, non-HDL, LDL, TG) are analyzed. The results of clinical studies assessing the effectiveness of restoring vitamin D levels in patients with T2DM and its effect on blood glucose levels and other metabolic parameters are also considered.  The study highlights the need for monitoring vitamin D levels in patients with type 2 diabetes and the prospects for its use as an additional therapeutic strategy to improve metabolic control and reduce the risk of complications.

ncreasing knowledge about HIV infection in the population helps to reduce the risk of infection. The study of awareness through surveys is used in different groups, including students. The purpose of the study is to assess the awareness of current HIV infection issues among medical and other university students. Materials and methods: an online survey was conducted using Yandex Forms, with the distribution of the questionnaire via a social network. The survey covered 241 students from several faculties of VSMU and other universities in Voronezh. Results. The level of awareness among medical students in general was higher (80.1%) than in other universities (71.0%). There is a lack of knowledge on certain issues. More than 70% of medical students and about half of non-medical specialties demonstrated a tolerant attitude towards HIV-infected people. Conclusion. The data obtained will be used to adjust preventive measures.

The flood in Krymsk in July 2012 became one of the most devastating natural disasters in the modern history of Russia. As a result of the abnormally heavy precipitation that fell in a short period of time, there was a sharp increase in the water level in the rivers, which led to the sudden flooding of the city. The disaster claimed the lives of more than 170 people, destroyed thousands of homes and left tens of thousands of residents homeless.
Medical care in an emergency situation included the provision of emergency assistance to the injured, evacuation of the wounded, the organization of temporary medical facilities and the fight against infectious diseases. Mechanical injuries, hypothermia, drowning, and psychological disorders were among the most common problems among the victims. Medical services provided assistance on the spot, carried out resuscitation measures and hospitalized the victims in the nearest hospitals.
One of the most important areas of work was the prevention of outbreaks of infectious diseases caused by the deterioration of sanitary conditions. For this purpose, vaccination of the population, disinfection of water and sanitary control of temporary accommodation of victims were organized. Considerable attention was paid to providing psychological assistance, especially to children and the elderly.
The experience of flood relief in Krymsk has demonstrated the importance of an early warning system, prompt evacuation and the readiness of medical services for large-scale emergencies. The lessons learned have contributed to the improvement of disaster response mechanisms in the future.

Chickenpox is of great socio-economic importance. The purpose of the study is to determine the patterns of development of the epidemic process of chickenpox in the Voronezh region during 2014-2023. Materials and methods: official statistics data were used in a retrospective epidemiological analysis. The cyclical development of the epidemic process has been revealed. The most affected group are children aged 3-6 years. Schoolchildren aged 7-14 and children aged 1-2 also contribute to the incidence rates. Rural residents suffer from chickenpox 5 times less often. Insufficient vaccination volumes have not yet had a noticeable effect on reducing the incidence of children.

The article considers a three-stage system of medical care during terrorist attacks: on-site, in hospital and rehabilitation. Particular attention is paid to the medical rehabilitation of victims at the scene. One of the key aspects of medical and sanitary support during terrorist attacks is careful planning and preparation. Modern mobile applications and platforms can significantly improve the coordination and interaction between medical services and victims. The materials help medical students understand modern approaches to medical support during terrorist threats. Objective. The purpose of this research work is to analyze modern methods of medical and sanitary support during terrorist attacks. Materials and methods. To write this paper, various articles devoted to the study of medical care in terrorist attacks were studied. Conclusion. Modern methods of medical and sanitary support allow to minimize the consequences of terrorist attacks and provide effective medical care to victims. It is important to continue to develop and improve these methods to improve readiness and effectiveness of response to terrorist threats in the future.

Introduction. In recent years, the number of measles cases has been increasing in the world among various population groups. The Voronezh Region, like other regions of the Russian Federation, is no exception. Of particular concern are cases of infection among medical personnel as one of the most vulnerable groups. Objective. To characterize the manifestations of the measles epidemic process in the Voronezh Region for the period 2012-2024 and to assess the contribution of individual population groups to the spread of infection. Methods: general scientific, epidemiological. Results. Analysis of the incidence of measles infection among medical personnel of healthcare institutions in the Voronezh Region for 2012-2024. showed its uneven distribution: cases were registered in 2012 (2.51 cases per 100 thousand contingent), 2014 (9.42 cases per 100 thousand contingent), 2023 (3.94 cases per 100 thousand contingent) and 2024 (2.60 cases per 100 thousand contingent). It is noted that despite the high vaccination coverage during the study period, 3 measles outbreaks were recorded among health care workers. Conclusion. The incidence of measles among medical personnel over the past twelve years had an uneven distribution. The structure of cases included both unvaccinated (57.14%) and immunized persons (42.86%).

The discussion of radiation safety of the population covers measures to protect humans from the effects of ionizing radiation, which is critically important for the health of both current and future generations. Progress in this discipline is closely intertwined with the expansion of the nuclear industry and the introduction of nuclear technology in a variety of areas, including electricity generation, radiation therapy, and industry. The contribution of the Soviet Union and Russia to the development of fundamental principles of protection against radiation exposure and the establishment of legal standards for maintaining radiation safety remains significant. Objective. Identification of structures ensuring radiation safety and their methods of work. Materials and methods. Analysis of literary sources revealing the problem of control and ensuring radiation safety. Results. One of the most important international organizations in this area is the IAEA, which is engaged in the development of cooperation in the field of peaceful uses of atomic energy, monitoring compliance by states with their obligations, and ensuring the safety of nuclear energy. On the territory of the Russian Federation, there are many organizations divided into three main groups: regulatory bodies, scientific institutions, and enterprises working with sources of ionizing radiation. An important element of radiation safety is the activity of Rospotrebnadzor and other agencies that monitor compliance with norms and standards. Conclusion. Radiation safety of the population is ensured by the comprehensive activities of various state and private organizations, which include supervision, control and development of standards aimed at minimizing the risks associated with radiation incidents.

Cardiovascular diseases (CVDs) remain the leading cause of death worldwide, including in Russia. Risk factors such as improper nutrition, hypodynamia, smoking and alcohol consumption contribute to the development of these diseases already at a young age. Students, especially medical students, are exposed to additional risks due to high psycho-emotional stress, irregular diet and lack of physical activity. The aim of this study was to investigate the prevalence of CVD risk factors among the students of N.N. Burdenko VSMU. Materials and Methods. 128 students (109 women and 19 men) aged 19.66 ± 1.80 years participated in the survey. The results showed that 65.63% of the respondents had a normal body mass index (BMI), but 17.18% were found to be overweight and 1.56% had obesity of the 1st degree. Majority of the students (81.25%) do not smoke but 18.75% have this habit. Alcohol is consumed by 46.87% of the respondents. 45.31% of students have no family history of CVD, but 35.17% of relatives suffered from CVD at the age of 40-50 years. 49.22% of the respondents were exposed to stress. Physical activity in the form of brisk walking for at least 30 minutes per day was observed in 80.47% of the students. Elevated blood pressure was recorded in 21.87% of the respondents. Conclusion. The obtained data emphasise the need to strengthen preventive work among students, including promotion of a healthy lifestyle, early detection of risk factors and individual preventive measures.

The topic of hepatitis A morbidity has not lost its relevance for many years. Recently, the epidemic process has intensified: the structure of morbidity has changed, the priority route of transmission has been determined, and the situation with incidence has changed. The aim of the study is to analyze the incidence of hepatitis A in the Russian Federation and Voronezh region and the effectiveness of preventive measures. Materials and Methods. The materials used were statistical forms No. 2 of the Federal State Statistics Service (Rosstat) for 2017-2023, state reports “On the state of sanitary and epidemiologic well-being of the population in the Russian Federation” and “On the state of sanitary and epidemiologic well-being of the population in the Voronezh region”; the method used was retrospective epidemiologic analysis. Results. During the study period, there was no clear trend towards a decrease or increase in the incidence of hepatitis A, more characterized by cyclicality. Incidence peaked in 2017-2018 in both pediatric and adult populations, with increased flooding intensity playing a role. In the epidemic process, both contact and waterborne routes of transmission are relevant. In epidemiologic terms, the water route has significant consequences. Conclusions. As it is known, of great importance in reducing morbidity rates is specific prophylaxis - vaccination against hepatitis A, which is carried out according to epidemic indications on the territory of our country through the use of inactivated vaccines of domestic and foreign production. It should be noted that the most important role in improving the quality of drinking water was played by preventive measures aimed at its purification and disinfection, as evidenced by the results of microbiological studies.

Introduction. Improving the level of health of workers is an urgent problem. In the country, along with large bakeries, small capacity enterprises are actively created, which leads to significant changes in the working conditions and organization of labor of workers. There are various harmful factors (heat and moisture emissions, noise, vibration, gases, dust, etc.) that cause occupational diseases. At the same time new technologies of confectionery products manufacturing appear, the influence of which on the health of workers is insufficiently studied. The aim of the work was to conduct a hygienic examination of the confectionery shop of Yatskova L.A., located in the Rostov region. Materials and methods of research. The method of sanitary observation and description, physical laboratory methods, timekeeping method of research and method of statistical processing of results were used. Results of the study. The microclimate of the production room of the enterprise in the warm period of the year is characterized as heating, class of working conditions 3.2. The intensity of heat radiation from convection furnaces exceeds the standardized level. Illumination of the production room is insufficient, class of working conditions 3.1. Heating microclimate and heavy physical labor are of main hygienic importance. Conclusion. In order to protect the health of workers of the enterprise, a set of measures is necessary. Thus, to normalize the microclimate it is recommended to use modern technological equipment with reduced heat generation; to equip artificial ventilation of production facilities. To improve the organization of working conditions it is required to reduce the length of the working day and organize a regulated break for the employees of the enterprise.

The article provides an overview of the most promising developments and clinical trials in the field of vaccine prevention and vaccine therapy, the results of which the world will expect as early as 2025. The list includes vaccines against HIV, malaria, rotavirus, tuberculosis, and whooping cough, an mRNA vaccine against cancer, and broad-spectrum vaccines

In the modern world, the problem of medical and sanitary provision during the evacuation of the population is one of the priorities of the All-Russian Disaster Medicine and Healthcare Service. Due to the increase in interethnic, political, ethnic and military conflicts, as well as the increase in terrorist attacks, this topic is very relevant. According to news agencies, 110 armed conflicts were recorded in 2024, in which more than 200,000 people died. In Russia alone, over the past year, the Ministry of Emergency Situations has managed to rescue and evacuate 400,000 people. The probable reason for such a large-scale evacuation was floods, fires, and the military conflict in Ukraine. Every year, the Emergency Center improves its first aid skills and develops ways to quickly and evenly sort victims at all stages of evacuation. Goal. To analyze the specifics of the types of first aid at the stages of evacuation of the population during the war. Materials and methods. We have analyzed the standards for first aid, an archive of materials on evacuation of the population over the past few years, and a report on the results of improving medical and sanitary evacuation. Results. New patterns have been established for the provision of medical care during the evacuation stages. Conclusion. Nowadays, the population should pay direct attention to how to behave during evacuation, and how to provide first aid to themselves and their loved ones. 

The relevance of the work is related to the high prevalence of traumatic brain injuries in different regions of our country. In case of head injuries, the provision of qualified assistance by an ambulance team is very important: proper assessment of the victim's condition, emergency care at the scene and prompt hospital delivery. The purpose of the work was to analyze traumatic brain injuries in the Republic of Crimea. Materials and methods of the study: A retrospective analysis was carried out on the basis of statistical data from State Budgetary Healthcare Institution of the Republic of Crimea "Crimean Republican Center for Disaster Medicine and Emergency Medical Care" for 2023-2024, as well as data from medical literature selected for the period 2019-2024. To analyze the provision of emergency care for head injuries in the period 2023-2024, cases of calls with the specified injury were selected. 7 cases of head injuries were studied, with different clinical pictures and course. The results of the study clearly showed a tendency towards a decrease in the frequency of complaints about head injuries, however, there was no such decrease in the number of cases of head injuries. In conclusion, we assume that such indicators are associated with an increase in the frequency and severity of cases requiring specialized medical care in a hospital setting (i.e., hospitalization).

Introduction: The accumulation of pathological forms of hemoglobin in the blood, including carboxyhemoglobin (HbCO), disrupts the gas transport function of hemoglobin and the oxygen supply to organs and tissues. This leads to the development of hemic hypoxia, with an increased risk of its occurrence. Objective: To assess the risk of hemic hypoxia in workers of the metallurgical industry by determining the concentration of HbCO. Methods: Venous blood samples were collected from metallurgical workers (n = 90). The concentration of HbCO and total hemoglobin was determined. Results: It was found that the concentration of HbCO does not depend on the concentration of total hemoglobin. One-third of the examined individuals exhibited a high risk of developing hemic hypoxia. Conclusion: Carbon monoxide (CO) has both exogenous and endogenous origins. Its accumulation occurs due to the formation of HbCO and its derivatives with myoglobin, as well as its binding to the cytochrome system, particularly in cardiomyocytes. The effects of CO, due to its accumulation, may manifest over a long period. The consequences of exposure can include the development of cardiovascular and nervous system diseases. At least 30% of the examined individuals are at risk of developing hemic hypoxia.

The impact of technogenic pollution on the environment and public health is one of the pressing problems faced by many regions of Russia, including the Lipetsk region. Industrial production, high density of motor transport and inefficient waste management are becoming the main sources of pollutants. Statistics of diseases associated with technogenic pollution in the Lipetsk region indicate serious problems in the field of public health. Statistics of the impact on the environment covers several key aspects, such as emissions of pollutants, the state of water bodies, air quality, as well as the impact on biodiversity and climate change. Objective. The purpose of this research work is to determine the impact of technogenic pollution on the environment and public health in the Lipetsk region. Materials and methods. This work used statistical data from Rosstat and the Health Department of the Lipetsk region. Results. As a result of the analysis of the data obtained, it was concluded that technogenic impact on the environment and human health in the Lipetsk region has an adverse effect, so measures must be taken to reduce the impact of harmful factors. Conclusion. The man-made impact on the environment and human health in the Lipetsk region has an adverse effect, so measures must be taken to reduce the impact of harmful factors.

        The article analyzes the key aspects of technosphere safety in the context of providing medical equipment and materials. The authors consider the relationship between safety in the technosphere and the availability of high-quality medical resources. Goal is to consider the role of import substitution   Special attention is paid to the issues of import substitution in the field of medical equipment production, as well as the development of completely new drugs, materials, devices for healthcare. Communication with manufacturers and suppliers of medical equipment at different levels of the organization allowed us to draw up a real picture of the prospects and problems for the further development of all industries in this segment. The directions in the field of laboratory research and the development of innovative alloys for the manufacture of prostheses of various complexity are evaluated. The prospects for cooperation with other countries in healthcare and in the provision of various types of medical equipment were also studied. The problems of import substitution and how they affect the economy and specialists were analyzed. The results of the study are of practical importance for specialists in the field of technosphere safety, medical professionals, developers and manufacturers of medical equipment. They can be used to improve existing practices and create new safety standards, ultimately improving the quality of medical care and patient protection.

Medical evacuation support (MES) has always been an important topic in the health care system.

From the 60s to the 80s, disasters of various kinds caused the deaths of a huge number of people. Before the creation of the International Society of Disaster Medicine (ISDM) in 1975 in Geneva, people did not have enough information about the organization and operation of various subsystems.

The health care system was actively developing in various fields, and active scientific research conducted in the areas of emergency medical care, evacuation of victims and their treatment. It is also worth noting the gradual development of algorithms for providing assistance in the presence of life-threatening conditions in victims, such as external bleeding, cardiac arrest, etc.

All these developments have created a solid framework for a modern medical evacuation system in Russia.

Currently, the topic of MES is widely studied at all levels and is of increasing interest to medical and preventive institutions. Each medical institution strives to develop its own measures to provide emergency care in conditions of mass admission, since all hospitals have different possibilities for receiving and examining victims in an emergency. A pre-organized LEO process in healthcare institutions makes their work during an emergency more efficient and operational, because all health care providers already know the procedure for each formation. We analyzed and interpreted the work of one of the healthcare institutions of the Voronezh region and identified the features characteristic of this institution.

In the modern world, environmental issues are becoming increasingly relevant. One of the key aspects of environmental conservation is the quality of atmospheric air and water facilities. Environmental pollution poses a serious threat to human, animal, and plant health, as well as to the entire ecosystem. The environmental situation in the Rossoshansky district of the Voronezh Region is of particular concern. Air pollution by the industrial enterprise of JSC "Minudobreniya" occurs during the production of technical liquid ammonia, calcium carbonate, technological chalk, nitroammophoski (azofoski), ammonium nitrate and gaseous oxygen. The company annually emits more than 5,500 tons of harmful substances (93.2% of all city emissions). Goal. To study the characteristics of the environmental impact of the production of JSC "Minudobreniya" on the environment, to analyze the pollution of atmospheric air and the water basin in the Rossoshansky district of the Voronezh region. Materials and methods. An analysis of the reporting "on the state of sanitary and epidemiological welfare of the population in the Voronezh region" for 2017-2023 was carried out. Results. The analysis of the data obtained makes it possible to establish that the maximum permissible concentrations of harmful substances in the atmospheric air in the area of JSC "Mineral Fertilizers" are not exceeded. Conclusion. Exceeding the permissible concentrations of harmful substances can have a negative impact on human health and the environment.  Measures must be followed to maintain the environmental situation.: reducing pollutant emissions, observing sanitary protection zones, and monitoring air quality.

Introduction. The development of the Arctic is accompanied by an increase in the number of workers in extreme conditions, which requires effective solutions in the field of medical care. Remoteness, harsh climate and personnel shortage create significant challenges for healthcare in the region. Objective. To analyze the specifics of providing medical care in the Arctic regions of Russia, identify key problems and search for promising solutions to improve the availability and quality of medical care. Materials and methods. Review and analysis of scientific publications and analysis of modern technologies used for medical care in the Arctic. Results. The main problems are related to hypothermia, injuries, limited availability of medical institutions and lack of adapted equipment. Innovative solutions are considered: mobile medical complexes, telemedicine, automatic resuscitation devices, unmanned aerial vehicles, cold-resistant medications. Conclusion. Effective provision of medical care requires comprehensive implementation of innovative technologies, adaptation of equipment to low temperatures, development of telemedicine and personnel training. These measures will improve the level of medical care in the Arctic.

Abstract. This study is dedicated to the analysis of the phenomenon of "physician-truants" — individuals with medical education who do not pursue their professional activities in the medical field. Many renowned individuals worldwide, having received medical education, have chosen different paths of self-development and have achieved outstanding success not only in professional medical activities but also in other areas. Researching the phenomenon of "truancy," and understanding the reasons why doctors leave their specialty to actively develop in other fields, can help develop effective strategies to retain doctors in medicine and thus influence the functioning of the healthcare system. The issues of stress and burnout among medical personnel have become increasingly relevant in recent times, so investigating the reasons why talented and creative individuals, as evidenced by their subsequent activities, change careers may assist in developing programs to enhance resilience to stress. All of the above has determined the relevance of our work.

This article examines the importance of using artificial intelligence in the educational process of higher education institutions, including in learning foreign languages, through an explanation of its various functions. Foreign languages play an important role in the education of students of various universities, as it contributes to the development of intercultural communication and professional development of young professionals. The trends towards personalizing learning and adapting to the individual needs and interests of students have a significant impact on their professional development. The prospects for the use of artificial intelligence technologies are manifested in improving the effectiveness of teaching foreign languages using language bots, programs and services, online tests, machine translation systems and other forms. The importance of a balanced approach to integrating neural networks into the educational process is of great importance, due to the fact that in addition to the advantages provided by technological progress, there are certain problems and potential risks associated with the use of artificial intelligence. This creates the prerequisites for the development of combined approaches to learning that will include traditional methods, taking into account accumulated experience and the introduction of modern technologies.

Prostate stromal cells are key participants in maintaining its homeostasis, actively influencing epithelial cells, the immune microenvironment, and the neurovascular network. Despite this, the complex role of the stroma in chronic inflammatory diseases of the prostate, such as chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), is not fully understood. The relevance of the work is due to the increasing prevalence of CP/CPPS and the limited effective treatments, which requires a deeper understanding of the pathogenetic mechanisms underlying these diseases. This review systematizes current knowledge about the multicomponent contribution of stromal cells to the functioning of the prostate gland in normal conditions and in chronic inflammation, analyzes the interaction of stromal cells with various cell populations and signaling pathways, and also considers potential therapeutic targets for the development of new treatment strategies for CP/CPPS based on modulation of stromal cell activity.

Today, mitochondria are the key organelles in the cells of a living organism responsible for energy production through the process of oxidative phosphorylation. They are a two-membrane intracellular organoid in eukaryotes, inside which there are numerous comb-like folds- crystals to accommodate the respiratory chain. These structures provide heat generation, metabolic functions, biomolecule synthesis, cell growth, division, and death. Even the slightest deviation in the structure of this organelle can lead to pathogenic processes. The article provides an overview of the structure of mitochondria, their special functions, regulatory mechanisms, and the role of mitochondrial DNA, based on Russian and foreign works. Special attention will be paid to mitochondrial diseases, a group of genetic disorders associated with mitochondrial dysfunction. The main pathogenetic mechanisms, clinical symptoms, frequency of manifestation among the current generation, and modern approaches to the diagnosis and treatment of these diseases will be considered. The information collected is aimed at in-depth understanding of the importance of these double-membrane organelles for cellular metabolism and their significance in pathology, which may contribute to the development of new therapeutic strategies to combat mitochondrial disorders.

At the stage of preclinical research of drugs, tests are carried out on laboratory animals. For scientific purposes, Wistar rats are most often used due to their small mass, relative simplicity of housing and breeding. To obtain the most reliable and correctly interpreted results, it is important to create bases of health-associated reference intervals (RI) of biometric parameters of laboratory animals depending on the sex and age of animals, season of research and reaction to external influences. Objective. To study micromorphometric indices of hepatocytes of male and female Wistar rats in normals at the age of 3 months. Materials and methods. 80 Wistar rats were kept in standard conditions in accordance with GOST R 53434-2009 for 3 weeks with subsequent euthanasia and evisceration of the liver, as well as determination of its absolute and relative weight Morphometric analysis was carried out on liver micropreparations stained with hematoxylin and eosin. Micromorphometry was performed only on interphase hepatocytes without signs of pathological changes. Results. We obtained data of micromorphometric parameters of hepatocytes characteristic for male and female Wistar rats at the age of 3 months. As a result, a clear gender dimorphism of these values is observed.

An important period in the formation and development of the forensic medical service in the country was the 985 Resolution of the Council of People's Commissars of the USSR dated July 4, 1939 "On measures to strengthen and develop forensic medical examination", which provided for many important aspects of the organization, improving the quality of examinations and teaching forensic medicine in medical universities. But the execution of the Decree was interrupted – the Great Patriotic War began, which affected all spheres of life in the Soviet Union, and the medical field, in particular, forensic medical examination, was no exception. Zinaida Ivanovna Zhuravleva was one of the outstanding representatives of the profession who was drafted into the Army, who showed her fortitude, heroism and high professionalism. Zinaida Ivanovna, who participated in combat operations as part of the troops of the 3rd Baltic Front, received a memorable award - the Sword of Victory from the grateful residents of the liberated Estonian town of Gaubene, gained invaluable experience as First Deputy Chief Medical Examiner of the 3rd Baltic Front, returned to her hometown of Astrakhan after the end of World War II, where she passed on her knowledge to young specialists – doctors and forensic medical experts.

This study examines the structural features of limb bone injuries in modern mine-explosion trauma. Clinically significant pathological changes in tissues at varying distances from the immediate detonation site were identified.

In the context of the latest technology, many unmanned vehicles have been developed that are used by people in various fields of activity. Unmanned underwater drones may become popular in forensic medicine. Their use in civil and military times to search for bodies of drowned people in the aquatic environment, including large rivers and coastal seas, can be of great benefit. Goal. To consider the prospects of introducing an underwater drone to explore aquatic ecosystems in order to search for bodies of drowned people. Materials and methods. Scientific articles by Russian and foreign authors devoted to this topic were used as sources of information. Various models of underwater drones designed to search for drowned people have been studied. Results. During the study, it was found out that the use of underwater drones at the present stage in order to search for bodies of drowned people is a promising method in forensic medical examination. The individual functions of the underwater drone: high-resolution photo and video shooting, diving to a depth of 200 m, maneuverability, the ability to swim into hard-to-reach places of reservoirs without risk to scuba divers, the ability to examine the body of a drowned person on the spot without removing it from the water and examining the scene increase the likelihood of establishing the true cause of drowning. Conclusion. Underwater drones have a number of advantages that allow them to be used in improving the quality of crime investigation.

Virtopsy, literally formed by the fusion of the words “virtual” and “autopsy”, is an innovative system of postmortem radiation diagnostics based on the use of radiography and computer scanning methods to identify pathological conditions that developed as a result of diseases and injuries sustained as a result of traumatic impact with a high degree of visualization. Currently, this technique is actively developing and applied in the field of pathological anatomy and forensic medical examination. Unlike classical autopsy, virtopsy provides a practical and highly informative non-invasive method for examining the body or its parts without violating the integrity of tissues. It allows obtaining more accurate data due to 3D reconstruction and the ability to study the human body in various planes. In addition, virtopsy is a safer diagnostic method for medical personnel and easier to implement. The aim of the work was to develop and apply a set of original methods for macroscopic study of biological samples with soft tissue and bone components using elements of virtopsy research. In this article, the authors examined the use of virtopsia elements using soft tissue neoplasms of the extremities as an example and reconstructed bone fragment samples from 3 upper and 13 lower extremities, as well as reconstructed bone fragment material enclosed in insulating media. The study allows us to assess the potential for developing the use of computed tomography methods in postmortem diagnostics of soft tissue and bone structure pathologies and injuries.

During the Great Patriotic War forensic doctors conducted research on the actual features of wartime mechanical injuries, damage caused by grenade explosions and their fuses, and examinations of soldiers, which gave a huge impetus to the study and development of forensic medicine.

The spleen is a parenchymatous organ of the abdominal cavity that performs many important functions in the human body. Absence of the spleen leads to the development of hyposplenism with corresponding metabolic and immune disorders.  During injuries or surgeries on this organ, the structural integrity of the tissue is violated with subsequent bleeding. As one of the modern methods of haemostasis bipolar diathermocoagulation is used - cauterisation of damaged tissue by high-precision electric current. Objective. To study experimentally the peculiarities of diathermocoagulation influence on the spleen tissue at microscopic level 7 and 30 days after traumatic injury. Materials and methods. Operative intervention using laboratory rats. Injury of the spleen parenchyma and subsequent haemostasis using bipolar diathermocoagulation. Withdrawal of animals from the experiment after 7 and 30 days with the subsequent histological examination of the taken material. Results. Experimentally revealed differences at microscopic levels at the coagulator exposure with different amount of time. Conclusion. It is established that bipolar diathermocoagulation is a modern and effective method of local haemostasis at surgical interventions on the spleen. The peculiarities of the course of reparative processes in the organ tissue 7 and 30 days after the operation were revealed.

Gastrointestinal bleeding (GIB) represents a well-known clinical problem, related both to the risks of developing chronic pathological conditions due to the predominantly recurrent nature of GIB and with life-threatening conditions in cases of acute and severe bleeding. Thus, the necessity of recognizing and addressing hidden sources of bleeding poses new challenges to medicine. For example, the etiopathogenetic and clinical-diagnostic aspects of GIB associated with the formation of abnormal vessels are still not fully studied. One of the most well-known pathological conditions of this type is Dieulafoy's disease – the presence of a large vessel of constant diameter, localized in the submucosal or subepithelial layer of a hollow organ, leading to damage to the mucosa, followed by prolapse of the vessel and the development of massive bleeding. Nevertheless, despite the apparent simplicity of the pathogenesis of hemorrhagic syndrome of this type of bleeding, unresolved questions remain related to the development of conditions preceding bleeding, namely, the pathogenesis of vascular malformation and further pathomorphological changes in both the vascular wall itself and the environment of the vessel involved in the pathological process.

Currently, malignant neoplasms of the cervix occupy the fourth position in the list of the most common oncological diseases among women in Russia. In our country, in 2023, more than 16.4 thousand patients were diagnosed with cervical cancer (cervical cancer) for the first time in their lives. Mast cells (TC) are one of the frequent representatives of the microenvironment with the potential for local regulation at the tissue and cellular levels. However, the role of TC in tumor morphogenesis is not fully understood and is sometimes contradictory. Goal. The study of the role of TC in the morphogenesis of breast cancer and their prognostic significance. Materials and methods. The study performed a morphometric analysis of biopsies of squamous cell carcinoma of the cervix taken from 21 patients aged 25-74 years. Chymase and tryptase in TK were immunohistochemically detected using monoclonal mouse antibodies to the corresponding enzymes. Results. Comparing chymase and tryptase TK in the tumor and separately in the periphery, we found that the difference between the number of cells in both cases is not significant. This means that they are in approximately the same number at a given location. However, after conducting a statistical analysis individually for each of the enzymes, depending on the localization, we obtained statistically significant differences in the number of cells. Conclusions. TCS tend to congregate on the periphery. The number of cells decreased linearly as the depth of invasion and the number of mitoses increased. The lower the degree of tumor differentiation, the more TC increases. It becomes obvious that an increase in the number of TCS along the periphery of the tumor signals an unfavorable prognosis of the underlying disease.

The current policy of the Russian Federation focuses on the digitalization of the healthcare system, making the modernization of pharmacovigilance processes crucial to improve drug safety monitoring. The aim. To explore the prospects of applying modern information technologies in the Russian pharmacovigilance system. Materials and methods. An analysis of publications in Russian databases (CyberLeninka, Elibrary, Scholar.ru) and the international platform PubMed from 2015 to 2025 was conducted, along with additional data from online sources. Results. Internationally, the use of modern information technologies in pharmacovigilance is extensive, including the application of artificial intelligence (AI) for identifying adverse drug reactions and generating safety reports. In Russian publications, there is still a lack of practical information on these technologies, but the field is rapidly developing. Existing projects focus on using AI to process electronic medical records and identify suspected adverse reactions. Another promising area is the integration of chatbots into the state monitoring system for collecting spontaneous reports from consumers. Conclusion. The application of modern information technologies in the pharmacovigilance system will ensure more comprehensive data collection on drug safety with minimal human resource costs. However, further research, optimization of duplicate data management systems, and public awareness are necessary.

Keywords: pharmacovigilance; artificial intelligence; automation; digitalization; chatbots

Relevance

A wide range of biological activity of mast cells (MCs) determines their role as regulators of morphofunctional parameters of connective tissue in physiological conditions and is important in the pathogenesis of most typical pathologic processes. Numerous membrane receptors allow MCs to be activated not only in the in response to antigens, but also to many non-immunogenic influences. The nature of structural changes of MCs under conditions of hyperthermia of various genesis remains insufficiently studied insufficiently studied.

Objective

To analyze the structural parameters of tongue TK of white mature male rats in conditions of fever and overheating.

Materials and methods

The study was carried out on  mature male rats (n=35) and included 3 experimental groups: “Control” (intact animals), ‘Fever’ (intravenous induced of pyrogenal, 50 µg/100 g weight), “Overheating” (one-time overheating in air ,body temperature 41 - 41,5° С).

The animals were taken out of the experiment 1 hour after hyperthermia. Histotopographic paraffin sections of the tongue with a thickness of 8 micrometers thick were stained for mast cells according to Shubich and counterstained with Ehrlich hematoxylin. The number of MCs, granule saturation and the number of degranulations in the muscular and submucosal layers of the tongue was estimated. Statistical processing of the obtained data was performed in Statistica 10.0 program.

Conclusions

Under conditions of fever a statistically significant increase in the level of MCs degranulation, which was accompanied by the redistribution of MCs from the muscular to submucosal layers of the tongue. A possible mechanism of active migration of MCs is associated with antigenic stimulation under the action of pyrogenal. Specific antigen-containing immune complexes are fixed on the cytoplasmic membrane of MCs, adhesion of which leads to the release of leading inflammatory mediators.

MCs activity under exogenous overheating is significantly lower than under fever: the number of degranulating MCs in the submucosal layer decreased not only in comparison with the control, but also with the “Fever” group. The result demonstrates the impaired migration of tongue MCs from the center under the epithelium in fever, which may be related to the destabilizing effect of elevated temperature on the biological membranes of MCs. The obtained data may form the basis for the methodology of differentiation of hyperthermia at the cellular level depending on the structural parameters of MCs.

Introduction. Hydronephrosis associated with uropelvic junction anomalies (N13.0) is a pathological condition leading to progressive urinary outflow obstruction and renal tissue atrophy, which can result in chronic kidney failure and various complications. Early diagnosis and timely intervention are crucial for preventing complications such as urinary tract infections, pyelonephritis, and renal hypertension. The aim of this study is to analyze the clinical presentation and symptoms of hydronephrosis caused by uropelvic junction anomalies, as well as to review modern diagnostic and treatment methods, including surgical intervention. The study utilizes data from relevant scientific publications, prenatal ultrasound screenings, and clinical observations, which help in developing effective patient management algorithms. Hydronephrosis in (N13.0) can be asymptomatic or present with symptoms such as urinary tract infections, abdominal pain, hematuria, and elevated blood pressure. In severe cases, progression of kidney failure and development of urosepsis are observed, requiring surgical correction. Treatment includes conservative observation with regular monitoring and surgical intervention when indicated. Early diagnosis and timely surgical intervention are essential measures to prevent irreversible renal tissue changes and preserve kidney function.

The G protein-coupled receptor (GPCR) family includes bitter taste receptors (TAS2R), which play an important role not only in the recognition of bitter substances, but also in the body's defense mechanisms. In humans, 25 functional TAS2R genes and 11 pseudogenes have been identified. TAS2R expression has been detected in the respiratory tract, immune cells, and bronchial smooth muscles, indicating their involvement in the regulation of physiological processes beyond taste perception. The aim. To summarize data on the role of TAS2R in the pathophysiology of respiratory diseases, such as bronchial asthma (BA), chronic obstructive pulmonary disease (COPD), COVID-19, and chronic rhinosinusitis. Materials and methods. We analyzed publications of current studies on the role of TAS2R in the pathophysiology of respiratory diseases. Results. An analysis of studies has shown that TAS2R is involved in maintaining the barrier function of the mucous membrane and antimicrobial protection. In bronchial asthma, TAS2R expression increases, which can modulate inflammatory processes. TAS2R gene polymorphisms are associated with a predisposition to bronchial asthma and affect bronchial patency. TAS2R agonists, such as chloroquine and quinine, exhibit anti-inflammatory effects by reducing collagen deposition and mucus hypersecretion. In airway smooth muscle cells, TAS2R mediates relaxation and bronchodilation, which may be useful in the treatment of bronchial obstruction. In experimental models of COPD, TAS2R activation improved airway patency and reduced inflammation. In COVID-19, TAS2R38 gene polymorphisms are associated with an increased risk of infection and severity of the disease. In chronic rhinosinusitis, genetic variations in TAS2R38 affect mucociliary clearance and local immune response, contributing to chronic inflammation. Conclusions. TAS2R play a key role in the defense mechanisms of the respiratory system, making them promising targets for the treatment of respiratory diseases. However, their role in viral infections and other pathologies requires further study

Relevance. Reparative regeneration is the most important biological process necessary to restore the structure and function of tissues after injury, and its pathology reduces the reparative potential, which is of great importance for certain groups of patients, primarily the surgical profile. Such patients especially need to stimulate their reparative potential, one of the methods of which is PRP therapy. However, there is a necessity of research to adapt this method to elderly patients. Aim. This research is aimed to study in vitro the effect of PRP in elderly patients on the reparative potential of human skin fibroblasts. Materials and methods. We determine the reparative potential by assessing the metabolic (MTT test, ROS test), proliferative and migratory (scratch assay) activity of cells, as well as assessing their viability and type of cell death (fluorescence microscopy). Results. The results of the study demonstrates that PRP obtained from the biomaterial of elderly patients has a number of negative effects on human skin fibroblasts in vitro: there is a significant decrease in metabolic activity, including the production of reactive oxygen species, decreased viability and increased frequency of cell apoptosis, while no changes in proliferative and migratory activity is detected. Conclusion. The identified effects are occured and/or they are most pronounced on the first day, and they are an adaptive response of cells to PRP. Nevertheless, it is obvious that the adaptation of cells to the PRP of elderly patients is more difficult than to the PRP of young patients.

Proper oral care, the use of dental floss and irrigators play a key role in maintaining hygiene. Despite the availability of a lot of information about dental practices, many people do not have sufficient knowledge about the proper use of these products. This study is unique in that it aims to assess the level of knowledge and skills of the Voronezh city population in the field of proper use of dental floss and oral irrigators. The study includes a survey of residents aged 15 to 35 years of various specialties. The study will analyze various aspects of this problem, including awareness of the benefits and harms of these devices, as well as practical skills in their use. The collected data will help identify typical mistakes that the population makes in daily hygiene. The results of the study will allow us to develop recommendations for improving the level of knowledge and skills in this area, which will contribute to improving health.

Introduction. Parkinson's disease (PD) is a common neurodegenerative disorder that affects dopaminergic neurons of the substantia nigra, causing movement disorders and deterioration in quality of life. Chronic inflammation in the central nervous system, in particular microglia activation, contributes to neurodegeneration. Microglia, which perform protective functions under normal conditions, begin to produce proinflammatory cytokines (IL-1β, TNF-α, IL-6) under pathology. Studying these mechanisms opens the way to developing new therapeutic approaches to slow down the progression of PD. Objective. To analyze current scientific studies on the role of microglial inflammation in the pathogenesis of Parkinson's disease and to evaluate promising therapeutic approaches. Materials and methods. Search and analysis of current publications on this topic. Results. It was found that increased levels of proinflammatory cytokines (IL-1β, IL-6, TNF-α) and chronic neuroinflammation play a key role in the progression of PD. The NLRP3 inflammasome supports the inflammatory process, promoting a cascade of neuronal damage. Promising therapeutic strategies are considered, including inflammasome inhibitors, monoclonal antibodies to proinflammatory cytokines, neuroimmunomodulators, and macrolide antibiotics with anti-inflammatory properties. Conclusion. Chronic neuroinflammation contributes to the progression of Parkinson's disease, accelerating the death of neurons. Imbalance of proinflammatory cytokines and long-term activation of the NLRP3 inflammasome enhance degenerative processes. Targeted modulation of microglia, inhibition of inflammatory cascades, and regulation of the cytokine response can slow down the progression of the disease and improve the quality of life of patients. Further research is needed to develop effective treatments.

Purpose: The peculiarity of the psychoemotional reactions of Belgorod schoolchildren under prolonged stress under the blows of the Ukrainian Armed Forces.

Materials and methods. An original questionnaire for high school students was developed during the study of the influence of the geopolitical situation on the psycho-emotional state of 13-17-year-olds in the Belgorod region. The sample consisted of 153 students in grades 9-11.

153 high school students were surveyed; 88 (57.5%) of them were girls and 65 (42.5%) boys: 13 years old (3.3%), 14 years old (20.3%), 15 years old (17.6%), 16 years old (30.7%), 17 years old (28.1%).

Research results: the questionnaire was offered online to 20 schools in Belgorod, of which 15 educational institutions participated in the survey.

Since the end of December 2023, Belgorod has been repeatedly subjected to massive terrorist attacks by the Ukrainian Armed Forces, and we decided to ask high school students how and why their quality of life has changed

Figure 1. "Lifestyle changes after the start of massive terrorist attacks by the Ukrainian Armed Forces"The reactions of high school students to the mass shelling of the Belgorod region are shown in the figure.

As can be seen in Figure 1, 97 (63%) respondents' lifestyle has changed for the worse in this geopolitical situation.

The information about their education that teenagers received came from various sources (Figure 2)

As can be seen in the figure, the largest number of children in the study group were shelled by the Ukrainian Armed Forces in their settlements/districts of the city.

Panic, fear, anxiety, excitement, indifference, and calmness were emotions that high school students had to evaluate in different situations (Fig. 3).

As can be seen in the diagram, respondents experienced more negative emotions during an air raid while on the street far from shelters: panic – 13 (8.5%), fear – 16 (10.5%), anxiety – 30 (19.6%), excitement – 49 (32%). Neutral emotions (calmness, indifference) During the alarm, dangers prevail among high school students who are at home, at school or on the street near a shelter, which is explained by their awareness of the algorithms of actions in such situations implemented at all educational levels by the government of the Belgorod region. Due to the systematic work of the Governor of the Belgorod Region and his assistants to provide public spaces with modular shelters and a centralized access control system.

Conclusions:Based on the data obtained, it can be concluded that the quality of life of 97 (63%) schoolchildren deteriorated after the start of massive terrorist attacks by the Armed Forces of Ukraine on Belgorod.

Active involvement in the geopolitical situation is directly related to being in populated areas that are subjected to massive shelling by the Ukrainian Armed Forces.

A low degree of negative emotions was revealed among the schoolchildren of the study group, which is explained by the high level of security measures promptly taken by the regional government. The majority (49%) do not experience emotions such as panic and fear when being shelled by the Ukrainian Armed Forces if they are close to shelters.

We would like to express our gratitude to Vyacheslav Vladimirovich Gladkov, Governor of the Belgorod Region, Andrey Aleksandrovich Ikonnikov, Minister of Health of the Belgorod Region, and Andrey Viktorovich Milekhin, Minister of Education of the Belgorod Region.

Introduction. Relevance: Background breast cancer is diagnosed in approximately 50% of women.

It is advisable to develop drugs with antiproliferative activity against pathological breast cells.

Objective: To analyze clinically described cases of using Indole-3-carbinol (anelective modulator of estrogen receptors) in complex treatment of mastodynia.

Methods: 37 articles describing clinical trials of this drug were analyzed.

The research materials were 5 most cited scientific articles on this issue.

Results: After 6 months of Indinol Forto therapy, mastodynia/mastalgia disappeared in more than half of the women. 1 year after treatment, the condition was stabilized (no mastalgia or mastodynia) in the vast majority of patients.

Conclusion: Indinol Forto is an effective pathogenetically justified drug for the treatment of benign mammary dysplasia (BMD) and can be recommended as a first-line drug in the treatment of cyclic mastalgia.

. Relevance. According to statistics, breast cancer (BC) is the main oncological disease among women. In Russia, 81,784 new cases of this disease were registered in 2023.Objective. Analysis of scientific studies devoted to the use of the drug Trastuzumab and confirming its effectiveness in the treatment of breast cancer.Materials and methods. Study of available resources, including official statistics and archival sources on the selected topic.Results. Having studied the clinical guidelines, we found that an integrated approach is used to treat breast cancer. Treatment regimens for breast cancer are formed based on the stage and prevalence of the disease, as well as on the basis of genetic and immunohistochemical studies, laboratory test results and the presence of concomitant diseases.

We found that at the moment, there are several molecular subtypes of diseases, the determination of which is necessary for the correct strategy for treating BC. HER2 is one of the genes responsible for the control of cell division. Its dysfunction is detected in many cases of breast cancer development and leads to increased production (amplification) of the protein of the same name (HER2), which contributes to accelerated cell division. One of the drugs acting on the described gene is Trastuzumab. Today, it is one of the most effective drugs used in the treatment of HER2-positive breast cancer. This paper presents evidence of the clinical efficacy of Trastuzumab and its role in breast cancer therapy. Conclusion. According to modern scientifically proven data, Trastuzumab is highly effective for patients with HER-2-positive breast cancer. Its use is possible both in combinations, and the drug is active in monotherapy at different stages of the disease. Despite its high efficiency, when taking Trastuzumab, some side effects may occur, which are typical of many antitumor drugs.

In 2023, the most common malignant tumor in Russia among women was breast cancer (22.5%), and among men - prostate cancer (19.1%). Due to the fact that currently existing anticancer drugs for the treatment of malignant tumors have a number of disadvantages, the search for and development of new drugs with antitumor activity is extremely important. The scientific acticles contains information on the antitumor properties of licorice root triterpenoids - glycyrrhizic acid and its metabolite glycyrrhetic acid. The aim of this article is to study the antiproliferative properties of glycyrrhizic and glycyrrhetic acids on the HeLa, PC-3, MCF-7  human tumor cells. Antitumor activity was evaluated by the MTT test with exposure of cells with these substances for 72 hours. As a result of the study, glycyrrhetic acid showed dose-dependent growth inhibitory activity against prostate cancer and breast cancer cells in the concentration ranges of 1-100 μg/ml and 0.1-100 μg/ml, respectively, as well as an antiproliferative effect against a cervical adenocarcinoma cell line only at a concentration of 100 μg/ml.

Abstract. It is known that during electrical excitation, during the opening of sodium channels, there is an intense flow of sodium ions into cardiomyocytes. Excess intracellular sodium is immediately involved in the process of Na-Ca metabolism. In this case, sodium ions are released outside in exchange for extracellular calcium. It is believed that this additional amount of calcium in the cells is directly involved in the process of releasing the main portion of calcium from the sarcoplasmic reticulum, which causes muscle contraction. It is also known that the working condition of the reticulum is significantly affected by caffeine, which has the property of stimulating heart contractions. Caffeine weakens the return of calcium into the reticulum after contraction. Therefore, the positive inotropic effect of caffeine is explained by the effect of excess calcium on the reduction of the actomyosin complex. It is also known that caffeine, under certain conditions, can weaken rather than stimulate the force of heart contractions. Perhaps the Na-Ca metabolism system and caffeine can act unidirectionally under certain conditions – to increase the ionized fraction of calcium in the cytosol of cardiac cells. However, the ability of the Na-Ca exchange mechanism to sufficiently increase the level of calcium in the cytoplasm of myocytes and enhance contractions in the presence of caffeine remains unclear.In this regard, the aim of this study was to solve the problem of the interaction of caffeine with sodium-dependent calcium fluxes in an isolated rat heart.

Studying at medical universities requires a huge amount of concentration and brain strain. Not every student can cope with overexertion and stress during their studies. Currently, cognitive stimulants are understood as a group of nootropics, which unites various classes of drugs. Objective. The purpose of the study: to identify students' tolerance to taking nootropic drugs and determine their impact on academic performance. Results. The survey showed that most of the respondents take this group of drugs, which for the majority have a positive effect on their neurological health and academic performance. Also, the established data indicate that there are students who self-medicate. In this case, such approaches to treatment are inappropriate. You should always resort to doctor's prescriptions, as an individual approach is required in prescribing nootropic drugs.

In recent years, the problem of game addiction has become more and more urgent. The life of a person addicted to gambling is different from normal life and is completely subordinated to the new super value. People involved in gambling seriously spoil their lives. Huge spending on gambling activities leads to significant debts. Unable to pay off their debts, gamblers may decide to commit suicide. In June 2018, the World Health Organization added gambling disorder to the 11th list of the International Classification of Diseases, effective January 1, 2022. German research scientists from Charité University conducted experiments in which they showed a group of 20 people screenshots from popular games. They noticed that the reaction caused by these screenshots was similar to that of alcoholics or drug addicts when they saw the object of their passion. A larger experiment was also conducted in which among a sample of 7,000 people, 12% of people showed signs of addiction to games. The aim of the study: to investigate the effect of the drug on rats prone to game addiction and to evaluate their condition and behavior under the influence of the drug IEM - 1460. Materials and methods: a critical analysis of foreign and domestic literature sources: eLibrary, PubMed, CyberLeninka, the method of development of conditioned place preference reaction (CPPR) was performed. Results: highly alcohol-preferring individuals (#3, #8, #9, #10, #12, #13, #14, #16) were selected. According to the URPM technique, when alcohol was administered to rats intraperitoneally, the following results were obtained: #3 - number of buried balls under the influence of alcohol: 5, #8 - 13, #9 - 15, #10 - 15, #12 - 15, #13 - 10, #14 - 11, #16 - 14. When IEM - 1460 was administered, the results were #3 - 12 buried balls, #8 - 9, #9 -12, #10 - 18, #12 - 6, #13 - 13, #14 - 16, #16 - 16. Conclusions: during the experiment, 37.5% of rats showed a decrease to play with buried balls. Additional clinical trials are required to more accurately assess the effects on the human body. The hypothesis about the effect of the drug IEM - 1460 and its potential use for the treatment of game addiction was confirmed.

Keywords: gambling addiction; gambling addiction; IEM-1460; Glua1 AMPA receptors

The paper reviews current trends and advances in rational approaches to pharmacotherapy of dermatitis.The key mechanisms of dermatitis pathogenesis and their impact on treatment efficacy are discussed.Multidisciplinary approaches integrating dermatology and other fields of medicine are reviewed to achieve better symptom control and improve patients' quality of life. The conclusion highlights the importance of an individualised approach to each patient and the need for further research to optimise the treatment of dermatitis within modern healthcare.

Introduction. In modern medicine, various strategies have been developed for the treatment of influenza and acute respiratory viral infections. The clinical validity of the effectiveness of these drugs varies. Objective: review and analysis of scientific studies of the effectiveness of antiviral and immunomodulatory drugs in the treatment of influenza and acute respiratory viral infections. Materials and methods. The research methods were the search, systematization and analysis of scientific articles (178) describing clinical studies of drugs with direct and indirect antiviral action. The study materials included 18 of the most cited scientific articles on this issue. Results. Drugs with direct and indirect antiviral action were identified and characterized from the standpoint of pros and cons. The first group of drugs includes M2-channel blockers (amantadine and rimantadine), neuraminidase inhibitors (oseltamivir and zanamivir), nitrogenous base analogs (riamilovir), fusion blockers (umifenovir, enisamium iodide). The second group includes interferons and interferon inducers. Conclusions. The most effective drugs are direct antiviral drugs - neurominidase inhibitors. This is consistent with numerous experimental studies in vitro and in vivo. Immunomodulators are also used as part of complex therapy. Riamilovir, umifenovir, enisamium iodide have insufficiently proven effectiveness, in addition, active intervention of marketing forces in the promotion of these drugs is obvious. The ineffectiveness of adamantates in the treatment of influenza and acute respiratory viral infections has been clinically proven.

The aim of the study was to evaluate the effectiveness of omalizumab in the treatment of severe atopic bronchial asthma in adolescents with high levels of immunoglobulin E (IgE). Methods: A 14-year-old patient with severe asthma and elevated IgE levels (1195 IU/ml) was examined in a clinical trial. Treatment included the use of omalizumab in combination with basic therapy. To assess the effectiveness of therapy, key parameters were analyzed: indicators of lung function (spirometry), serum IgE level, frequency of asthma attacks, and a subjective assessment of the patient's quality of life before and after treatment. Results: After the application of omalizumab, a significant improvement in the patient's condition was recorded. The IgE level decreased from 1195 to 47 IU/ml, which indicates a pronounced immunological response to therapy. The frequency of asthma attacks decreased, and respiratory function improved. The patient also noted an improvement in her quality of life, including a reduction in symptoms and an improvement in overall well-being. Conclusions: The data obtained confirm the effectiveness of omalizumab in the treatment of severe atopic bronchial asthma in adolescents with high IgE levels. Further studies with a large number of participants are needed to confirm the results obtained and evaluate the long-term efficacy and safety of omalizumab.

Introduction. The coronavirus infection COVID-19 has undoubtedly had a great impact on both the population and the healthcare system worldwide. According to the World Health Organization (WHO) as of February 2025, over 777 million cases of COVID-19 have been confirmed worldwide, of which about 20% had depressive symptoms of varying severity. Also, numerous studies conducted around the world have shown that a depressive episode can be associated with elevated levels of proinflammatory cytokines, which will undoubtedly be present during the course of COVID-19, playing a causal role. Therefore, it has become very important to evaluate the combined use of selective serotonin and norepinephrine reuptake inhibitors SNRIs with anti-inflammatory drugs, such as non-steroidal anti-inflammatory drugs NSAIDs in the treatment of depressive episodes. In this regard, the authors set a goal: to evaluate the combined effect of NSAIDs with SNRIs on the body. A retrospective analysis of the medical history of patients of a certain age group of 30-45 years, with a registered depressive episode, who had a history of coronavirus infection, was conducted. The patients were divided into 2 groups of 20 people each.

The study results show the usefulness of co-administering SSRIs with NSAIDs to improve treatment outcomes in patients with depression.

Introduction. Alcohol abuse is one of the main causes of deterioration in human health. In Russia, the number of people diagnosed with alcoholism and alcoholic psychosis is changing dynamically - from 2003 to 2021, there was a gradual decrease, reaching its minimum in 2021. Starting from 2022, there has been an increase in the number of people diagnosed for the first time [1]. According to Rosstat, the following patients with a diagnosis made for the first time in their life were taken under observation: 2020 - 54.9 thousand, 2021 - 53.3 thousand, 2022 - 54.2 thousand, 2023. – 54.8 thousand [2] The increase in the incidence rate necessitates the development of drugs aimed at combating this disease.

Objective of the work To study the effects of the experimental drug "IEM - 1460" and the likelihood of its use for the treatment of alcohol dependence in a series of experiments with rats in the Department of Neuropharmacology of the Institute of Experimental Medicine (St. Petersburg)

Materials and methods of research. A critical analysis of foreign literary sources was performed: eLibrary, PubMed, Medscape, ACOG, the method of developing a conditioned response of place preference (CRPP).

Research results. Individuals with a high preference for alcohol were selected (No. 3, No. 8, No. 9, No. 10, No. 12, No. 13, No. 14, No. 16). According to the URPM method, when alcohol was administered to rats intraperitoneally, the following results were obtained: No. 3 - time spent in the preferred compartment: 13.5 min, No. 8 - 12.2 min, No. 9 - 1.8 min, No. 10 - 1.5 min, No. 12 - 14.9 min, No. 13 - 2 min, No. 14 - 1.4 min, No. 16 - 1.9 min. The following results were obtained when administering the drug IEM-1460: No. 3 - 0.9 min in the preferred compartment, No. 8 - 15 min, No. 9 - 2.33 min, No. 10 - 0.75 min, No. 12 - 2.7 min, No. 13 - 0.75 min, No. 14 - 15 min, No. 16 - 1.3 min.

Conclusion. Based on the results of the experiment, it was found that 62.5% of rats showed a noticeable decrease in preference for alcohol. The high percentage of the drug's effect on rats is of interest and requires further study to clarify how similar mechanisms could act on the human body. This will require additional clinical trials to determine how effectively this intervention can indicate its safety and effectiveness in the treatment of alcohol addiction. The study also confirmed the hypothesis that the drug IEM-1460 could potentially be used in the treatment of this addiction, which opens up new prospects in the field of medicine and the development of therapeutic approaches to the treatment of alcoholism.

Introduction. Atherosclerosis is the leading cause of cardiovascular disease and mortality in the world. Due to the high prevalence of the disease and limited effectiveness of existing therapeutic methods, new approaches to the treatment of atherosclerosis are needed. Objective. To evaluate the possibilities of using naringin, a flavonoid contained in citrus fruits, for the treatment of atherosclerosis. Materials and methods. To achieve the goal, a review of modern publications describing the biological activity of naringin, its effect on lipid metabolism, inflammation and endothelial function was conducted. Results. Naringin demonstrated antioxidant, anti-inflammatory and lipid-lowering properties that can help reduce the level of "bad" cholesterol and prevent atherosclerotic changes. It regulates lipid metabolism through apolipoprotein B, activates antioxidant enzymes, and reduces inflammation, reducing the risk of vascular damage. Conclusion. Naringin is a promising agent for the prevention and treatment of atherosclerosis, but additional studies, including in vivo experiments, are needed for a final assessment of its efficacy and safety.

Combined oral contraceptives (COCs) are the drugs of choice as a contraceptive method in the modern world. However, the prescription of COCs may be based on a number of reasons. It is known that one of the most common is polycystic ovary syndrome (PCOS). Estrogens and their receptors have different cellular and tissue-specific effects, which causes different results of estrogen therapy and side effects on other body systems. Objective. To analyze the frequency of detection of side effects of combined oral contraceptives in the treatment of PCOS. Materials and methods. Search and analysis of literary sources on the Elibrary, PubMed, CyberLeninka, Scopus platforms. Results. We found that when choosing PCOS therapy, along with the restoration of reproductive function, it is necessary to carry out measures aimed at preventing metabolic syndrome and hyperplastic processes in the endometrium. When assessing the safety of using COCs in PCOS, it is necessary to take into account the risks of developing cardiovascular catastrophes. There is no convincing evidence to justify not using COCs in patients with PCOS with metabolic disorders. It is important not only to follow lifestyle modification recommendations for all women with PCOS, but also to perform diagnostic measures before and after prescribing COCs. Conclusion. It is important to note that side effects depend not only on the dose of the drug, but also on hereditary factors and concomitant diseases. That is why COCs are the first-line drugs of choice for achieving the goals of regulating menstruation and improving the symptoms of hyperandrogenism.

Bronchial asthma is a prevalent chronic disease characterized by inflammation of the airways triggered by exposure to allergic antigens. It is marked by increased mucus production and heightened sensitivity of the respiratory tract, which manifests through the severity of symptoms, bronchial obstruction, as well as the intensity, timing, and frequency of episodes. The primary cause of this condition is allergic inflammation. The inflammatory process in bronchial asthma is initiated by the activation of T-lymphocytes, which produce interleukins that promote inflammation and the synthesis of IgE. Allergens provoke an IgE-dependent response, resulting in the release of inflammatory mediators and the degranulation of effector cells. Without effective treatment, individuals across all age groups may experience various limitations in their daily lives, a decline in quality of life, and in severe cases, even death. To  develop an anti-asthmatic treatment plan effectively, it is crucial to identify the disease phenotype, the predominant type of inflammation, and its biological markers. To facilitate this, the Global Initiative for Asthma (GINA) was established in 1993 to create guidelines aimed at reducing asthma prevalence. Inhaled glucocorticosteroids are central to asthma treatment; however, this approach may not be suitable for all patients. Medications such as monoclonal antibodies have proven effectiveness for severe bronchial asthma and represent a promising avenue in asthma management. The objective of this literature review is to examine and analyze the existing monoclonal antibodies utilized in the treatment of bronchial asthma. To achieve this goal, we first gathered relevant literature from biomedical information sources (PubMed and eLIBRARY.RU). We then analyzed incidence statistics from the Omsk region, explored the main variants of bronchial asthma, examined treatment approaches, and reviewed current and promising monoclonal antibodies in use, along with ongoing clinical trials. Ultimately, we drew conclusions regarding the current landscape of asthma treatment and evaluated both the advantages and disadvantages of monoclonal antibody therapy.

The quality of medical care depends on the qualifications of doctors and nursing staff. In the Russian Federation, there are more than 2.5 million employees in state and municipal institutions, of which about 595 thousand doctors, while about 40 thousand doctors are missing. There are 48,000 medical workers in the Voronezh Region, including 9219 doctors. Government institutions are experiencing a shortage of 723 doctors and 637 specialists with secondary medical education.
The purpose of the study is to analyze the effectiveness of the employment of graduates of a medical university, taking into account the needs of the labor market.
Methodology: systematic, comparative, content analysis, expert assessments, questionnaires, structural, factor and correlation regression analysis.
Results: the most effective measures to attract doctors to primary care are salary increases (71%), housing (61%), increased benefits (35%), and improved working conditions (8%).
Conclusion: Graduates of medical schools are in demand, but face employment problems, especially in rural areas. Measures are needed to improve working conditions, raise salaries, and engage universities with employers.

Research in the field of nutrition psychology and sociology shows that the environment and social factors play an important role in the formation of a healthy lifestyle: healthy eating habits. The study of this process is becoming increasingly relevant, since it is during the student period that the formation of an independent lifestyle takes place. Understanding and identifying the main factors that have the greatest impact on the formation of healthy eating habits makes it possible to develop effective strategies to promote healthy eating and improve students' health. Goal. To study the factors that influence the regime and diet, the choice of foods and form a healthy lifestyle among students. To assess changes in students' health status. Materials and methods. Literature analysis (monographs, textbooks, scientific electronic libraries – Elibrary.ru ), analysis of the survey results using Microsoft Excel software through the calculation of relative large values with an assessment of their reliability. Results. The survey data show that the formation of students' eating habits is a complex process influenced by both social and psychological factors. The key points are neurobiological mechanisms, emotional stress, circadian rhythms, hormonal imbalance, and metabolic disorders. Conclusion. The main factors contributing to the formation of healthy eating habits contribute to the development of effective strategies for a healthy lifestyle.

The summer season is the most striking example of injury, as children spend more time outdoors, and the number of car accidents related to travel and tourism is increasing. The most common limb fractures are: sprains of the ligamentous apparatus, fractures of the lower limb, as well as the radius, fractures of the collarbone, pelvic bones. The problem of childhood injuries cannot be confined exclusively to the health system, because the occurrence of trauma in a child is caused by a combination of unfavorable conditions and factors, among which the leading place is given to the social component. Goal. Analysis of ankle joint injuries in children and adolescents. Materials and methods. During the study, the statistics of visits to the emergency room of the OGBUZ of Belgorod for ankle injuries in children during summer activity in 2023 were analyzed. 383 cases were selected for the study group. Conclusion. The most common injury to the ankle joint is a sprain, damage to the ligamentous apparatus – 331 (86%), which is explained by the peculiarities of the structure and biomechanics of the joint. The widest age group is the group of 7-12 years – 171 (45%), which is explained by the high and diverse activity of children, as well as periods of active separation from adults and the peculiarities of the psycho-emotional component. Boys are more often injured – 200 (52%), but the difference in the ratio is insignificant, which suggests that ankle injuries are not associated with specific types of children's activities, but are a common problem.

Education and inculcation of healthy lifestyle among adolescents is an independent and very important task of the state [1].

Adolescence is a critical period of development, associated with specific difficulties. The intensity and tension of modern school life leads to the emergence of negative emotional experiences that can lead to the formation of pronounced stress states [2]. 

  The health of modern children in Russia is an acute problem due to the fact that there are multiple data on the decline in the level of schoolchildren's health in a number of indicators, including the state of the psycho-emotional sphere. Particular attention is drawn to the mental health of high school students in connection with active preparation for the USE and USE [5].

The aim of the work was the degree of awareness and interest of high school students in healthy lifestyle. In the course of work we developed a questionnaire including 2 blocks of questions touching upon the topics of healthy lifestyle, disease prevention, mental health of adolescents.  The questionnaire survey of schoolchildren studying in 15 lyceum of Voronezh was conducted. Pupils of ninth (52) and eleventh (47) grades took part in the study. A total of 99 people.

Based on the analysis of the first block of questions, pupils' general awareness of healthy lifestyle principles is quite high.

According to the results obtained in the second block of the questionnaire, the level of schoolchildren's anxiety, in general, can be assessed as satisfactory, except for the questions related directly to exams.

Rational nutrition is a human diet that takes into account his physiological needs for energy value, as well as contains foods rich in useful and nutritious substances. Such nutrition is based on age, gender, employment, and the presence of chronic diseases. The composition and properties of food products affect the functioning of the body. When spending energy on one's activities and getting it from food, a balance is needed to prevent excessive energy reserves in the form of fat deposits or, conversely, switching to the consumption of internal reserves. Rational nutrition includes compliance with the regime, maintaining a balance of energy value, proper and safe heat treatment. It is possible to preserve health and youth only if you follow simple rules for a healthy diet. Malnutrition leads to the development of various chronic non-communicable diseases (CKD). The most common complications are diseases of the gastrointestinal tract, nervous system, and endocrine system. The most dangerous are disorders in the work of the cardiovascular system, as they occupy the first place among NCDs in terms of mortality. It is optimal to have four meals a day with an interval of 4-5 hours between meals, 3 hours before bedtime. It is important to remember about proper heat treatment, a variety of diets, as well as the aesthetic component of food intake. Proper nutrition involves the acquisition and assimilation of knowledge about how to maintain one's health, the development of skills and abilities for a safe, healthy life, and the education of a culture of nutrition. It is very important to create an environment that promotes health and healthy eating, the development of healthy habits and the formation of the need for a healthy lifestyle. With constant adherence to the basic principles of a healthy diet, you will make sure that this makes you feel better and have increased working capacity. All this has a beneficial effect on your body.

Adolescence and adolescence is an important period in the formation of children's bodies. In order to stay healthy, it is necessary to constantly monitor one's health. Currently, young people are at risk of various bad habits, one of which is smoking electronic cigarettes and vape. The purpose of the work is to study the impact of electronic cigarettes on the health of students and to propose measures to combat smoking. Materials for the study: survey and questionnaire survey of students 14 - 24 years old, study of scientific literature, mathematical analysis of the results. Results of the study. 53 people were surveyed. Of them 58,5% were non-smokers of whom 13,2% had smoked before, 41,5% were smokers. The majority of smokers - 84.3% use electronic cigarettes or vape. Almost all students started smoking at the age of 13-16 years, which corresponds to adolescence, 96.2% know about the harm of smoking, and 50% of smokers noticed changes in the respiratory system after smoking. Effective smoking prevention among students requires a comprehensive approach that includes education and support from all stakeholders. Conclusion. Vape smoking is significantly prevalent among the younger generation with harmful effects on youth health. Creating a healthy environment and informing children and their parents about the harms of smoking and the risks of using e-cigarettes will help to create a healthy and happy society.

Neurosyphilis has a historically complex reputation, but in recent decades, due to improvements in diagnostics and medical technologies, its diagnosis and treatment have gained importance. The aim. To conduct a comprehensive analysis of the clinical features of mental disorders in neurosyphilis, as well as to evaluate modern diagnostic methods of this disease in the context of its epidemiological significance, particularly in the Russian Federation. Materials and methods. The review was prepared using data from domestic and international studies, including epidemiological reports, works in neurology, psychiatry, and laboratory diagnostics. Special attention was paid to recent publications reflecting the specifics of neurosyphilis in Russia, as well as studies describing the association of the disease with HIV infection and the variability of clinical manifestations (from asymptomatic forms to severe dementia and psychoses). Results. Neurosyphilis manifests a wide range of mental disorders, including progressive dementia, psychoses with delusions and hallucinations, manic-depressive states, and neurotic disorders. Diagnosis is complicated by the lack of a unified standard. Conclusions. Neurosyphilis remains a relevant interdisciplinary problem requiring the integration of neurological, psychiatric, and laboratory diagnostic methods. Early detection and antibiotic therapy are critically important to prevent irreversible cognitive and mental impairments. Physicians are recommended to consider neurosyphilis in the differential diagnosis of mental disorders, especially in patients with atypical symptoms or concomitant infections.

Currently, drug-related morbidity is characterized by a transition from adolescence to peak rates among students and working youth. Anti-drug education is aimed at reducing drug demand and is enshrined in the Strategy of the State Anti-Drug Policy. Conducted research was carried out in order to analyze the indicators of drug addiction prevention measures among working youth in the Kursk region, based on data from a survey of 413 people. Results. The coverage of working youth with anti–drug education activities was 68%, with the most common form being the demonstration of video materials (34.9%). Social, legal and psychological education events (29.3%), lectures and consultations of doctors (23.7%), use of Internet resources of medical organizations (23.7%) were also significant. Study of specialized literature, the educational process, and the activities of thematic discussion platforms proved to be less effective. The final conclusion showed that working youth are unevenly covered by anti-drug education and much less than students. This indicates the need to improve anti-drug education among the working population, both in large groups and among the self-employed and employees of small groups.

Summary. Relevance. Music therapy is an effective method of correcting the psycho-emotional state of patients with mental illness. At the same time, the influence of music therapy on the emotional state of different groups of patients is poorly studied. The aim of the work was to evaluate the changes in the psycho-emotional state of patients with mental disorders during group psychotherapeutic sessions of music therapy. Methods and materials. The study included the psycho-emotional state of patients, adults and children, participating in regular group music therapy sessions in dispensary. Dynamic assessment of patients' emotional state was carried out by means of psychological testing, verbal questioning and observational method. Results. In the group of adults and children suffering from mental disorders, short-term positive psychotherapeutic effects during music therapy sessions were noted. The group of adult patients showed more interest in the communicative and educational side of the sessions. Conclusions. Music therapy sessions in combination with medication and rehabilitation have a positive effect on the psycho-emotional state of patients, both adults and children. However, it is necessary to develop differentiated programmes for adults and children, taking into account their age, nature of mental disorder and stages of the disease.

Ankylosing spondylitis (AS) is a chronic inflammatory disease from the group of spondyloarthritis characterized by obligatory damage to the sacroiliac joints and/or spine with their potential outcome in ankylosis, with frequent involvement of entheses and peripheral joints in the pathological process. Cardiac dysfunction and lung damage are well-known and common extraarticular manifestations associated with AS. This review presents a clinical case of a 56-year-old patient with lung damage in AS. The purpose of the study was to describe a clinical case to improve the effectiveness of medical care. Materials and methods. The material of the study was the medical history of this patient, who underwent examination and treatment at the Higher Medical School of the Russian Academy of Medical Sciences No. 1. Results. A clinical case of the development of pulmonary manifestations on the background of ankylosing spondylitis is described. Upon admission to the hospital, the patient complained of shortness of breath with minimal physical exertion, swelling of the feet and shins, pain in the hands, feet, and lower back. It is known from her medical history that since 2003 she has been seen by a rheumatologist at the Higher School of Medicine No. 20 with a diagnosis of Ankylosing spondylitis, and also periodically consulted at the rheumatology center at the Higher School of Medicine No. 1. In recent years, there has been no dynamics from NSAID treatment. In November 2024, she was hospitalized in the cardiology department at the VGKBSMP No. 1 with the above complaints. Lung damage was mistakenly interpreted as chronic heart failure and the patient was prescribed appropriate therapy for heart failure. During a comprehensive examination by cardiologists and staff of the Department of Faculty Therapy at N.N. Burdenko VSMU, pulmonary manifestations were suspected against the background of AS, and the patient was referred to the MRC.Moscow, where this relationship was confirmed and treatment with methotrexate was prescribed. Conclusion. AS is a dangerous disabling disease with a variety of clinical manifestations and requires a multidisciplinary approach not only by rheumatologists, but also by specialists in other specialties. The presented clinical case demonstrates the lack of awareness of doctors about possible pulmonary manifestations of systemic connective tissue diseases, which subsequently causes an incorrect diagnosis. Thus, it is necessary to raise doctors' awareness of extra-articular manifestations of systemic connective tissue diseases for timely diagnosis, differential diagnosis and appropriate treatment.

Takotsubo cardiomyopathy, also known as «broken heart» syndrome, is a temporary condition resulting from severe emotional or physical stress. This article discusses the etiology, clinical manifestations of this pathology, pathophysiological mechanisms, modern diagnostic methods and the main aspects of treatment. Particular attention is paid to the differences between takotsubo and coronary heart disease, as well as risk factors that can contribute to the development of this syndrome. To study the main aspects of takotsubo cardiomyopathy, including clinical manifestations, pathogenesis, diagnosis and treatment. A review of the existing literature and clinical data was conducted, as well as an analysis of the cases of patients hospitalized with a diagnosis of takotsubo cardiomyopathy. Takotsubo cardiomyopathy is characterized by an acute onset resembling acute coronary syndrome, with typical symptoms such as chest pain and shortness of breath. The main risk factors are intense emotional or physical stresses. Diagnosis of the disease is based on clinical presentation, echocardiography and angiography. Treatment includes supportive care and management of precipitating factors. The prognosis is favorable in most cases, although relapses and complications are possible. Conclusion: Takotsubo cardiomyopathy represents an important clinical condition that requires timely diagnosis and appropriate treatment. Further research is needed to better understand the pathophysiological mechanisms of the disease and to develop optimal treatment strategies.

Currently, there is no gold standard for the choice of dose and method of administration (intramuscular, oral, sublingual, intranasal) of vitamin B12 (VB12) in the case of vitamin B12 deficiency. In 2022, the Expert Council of the Russian Scientific Expert Council of the Russian Scientific Medical Society of Therapists (RSMOT) adopted a resolution on the need to develop and introduce into practice a clear algorithm for the management of patients with established VB12 deficiency. Objective. Comparison of the dynamics of patients' life quality by treatment groups depending on the applied schemes of pharmacocorrection of VB12 deficiency. Materials and methods. Assessment of the quality of life before and after treatment using the EQ-5D questionnaire. Results. Among the patients the most significant dynamics was noted in “Mobility” and “Pain/discomfort”, especially in groups 1 and 3, taking metformin daily orally and intramuscularly, respectively. There were no significant changes in “Self-care” and “Anxiety/depression” qualities. The subjective state of health of patients increased most significantly in groups 1 and 3. Conclusion. The greatest positive effect on the patients' quality of life was observed with daily oral intake of 1 mg of cyanocobalamin for 8 weeks and daily intramuscular injection of 0.5 mg during the 1st week and then 500 mcg once a week for 16 weeks; weekly oral administration of 1 mg cyanocobalamin for 16 weeks resulted in 2-3 times less pronounced subjective improvement of quality of life.

In the Russian Federation, there is a high prevalence of anemia, while iron deficiency anemia (IDA) accounts for about 75% of all cases of anemia. Effective pharmacotherapy of IDA is very relevant. In most clinical cases, oral iron medications are preferred. Aim of the study. Analysis of drugs used for the treatment of patients with IDA on an outpatient basis. Materials and methods. The analysis of 45 outpatient medical records of non-pregnant women aged 18-65 years observed on an outpatient basis with a diagnosis of mild IDA was carried out. The distribution of patients by age categories, anthropometric data, clinical manifestations of IDA and the nature of iron therapy was assessed. For the treatment of IDA on an outpatient basis, both iron medications of various groups and biologically active supplements (BAS) were prescribed. Drugs containing iron (Fe2+) compounds were received by 64.1% of patients, drugs containing iron (Fe3+) compounds – by 35.9%. Combined iron drugs were received by 69.2%. The duration of therapy with iron medications was 8 – 270 days. The absence of pronounced positive dynamics of complaints and standard indicators of assessment of the erythrocyte link required a change of therapy in 61.1% of cases. Conclusion. Pharmacotherapy of patients with mild severity IDA on an outpatient basis is not carried out effectively enough in terms of prescribing iron therapy, duration of treatment and normalization of indicators.

Larone syndrome is a rare genetic disease characterized by the body's resistance to somatotropic hormone (HGH) due to mutations in the GHR (growth hormone receptor gene) gene, which leads to a decrease in the level of insulin-like growth factor 1 (IFG-1, IGF-1).

The clinical manifestations of the disease are growth retardation, disproportions of the craniofacial skeleton and other characteristic features. The main approach in the treatment of a patient with Laron syndrome is recombinant IGF-1 replacement therapy, which promotes tissue growth and development. During therapy, a number of side effects may develop, in particular, hypoglycemia, allergic reactions, headache, nausea, vomiting, hypertension, edematous syndrome and the development of IGF-1 resistance, which makes IGF-1 preparations unavailable for prescribing for a significant number of patients. In connection with the above, the issues of diagnosis and treatment of Laron syndrome remain relevant in modern endocrinology, and require new approaches in studying the pathogenesis and choosing therapeutic strategies for the treatment of the disease.

Atrial fibrillation (AF) is a rhythm disorder that significantly increases the risk of severe cardiovascular events (acute cerebrovascular accident, heart failure, and acute coronary syndrome), and significantly reduces the patient's quality of life. The search for modern therapeutic approaches to AF remains a difficult and urgent task, despite significant advances in the electrophysiology of rhythm disturbances. In the course of our study, the effectiveness of modern AF treatment methods was analyzed and the factors determining the long-term prognosis were identified. AF is the most common cardiac arrhythmia. Current recommendations give preference to a rhythm control strategy (TFR) – restoring normal rhythm with the help of antiarrhythmics (propafenone, amiodarone, flecainide, etc.) or ablation, which reduces the risk of severe cardiovascular complications. Heart rate (HR) is controlled by beta blockers, calcium channel blockers, and digoxin.

Inhaled delivery of antiarrhythmics (flecainide, metoprolol) and inhibition of TASK-1 potassium channels (for example, doxapram) remain promising treatment methods. To date, AF treatment is based on heart rate control. However, new approaches, including inhalation therapy and drugs that target specific cellular targets (for example, TASK-1 channels), promise to improve the effectiveness of therapeutic tactics chosen by the attending physician in the future.

Introduction. Viruses prevail in the etiological structure of acute intestinal infections in Europe, but bacterialagents do not lose their relevance. Changes in the epidemiological situation in the region affect the incidence of intestinalinfections and their etiological structure. The aim of the study was to analyze the etiological structure of acute intestinalinfections in children from 2018 to 2024, based on data from the Voronezh Regional Children’s Clinical Hospital No. 2 (VRCCH No.2). Methods and materials: a retrospective analysis of the etiological structure of acute intestinal infectionsin children was conducted based on an electronic database of patients hospitalized at VRCCH No. 2 from 2018 to 2024. Results: The number of hospitalizations of children with acute intestinal infections tends to decrease. Changes in the agestructure are associated with a decrease in hospitalization of infants, especially in the first year of life, and an increase of schoolchildren and adolescents. The proportion of acute intestinal infections of unspecified etiology decreased by 1.7times and reached 46.6% due to the etiological interpretation of viral diarrhea from 22.9% to 39.6%, with rotavirusgastroenteritis remaining the leading cause. The percentage of identified bacterial intestinal infections averages 12.8%.The number of children with escherichosis and salmonellosis tended to decrease during the COVID-19 pandemic,followed by a recovery in the post-COVID period. There is a noticeable increase in campyloacteriosis by more than 6times, which can be attributed to improved laboratory diagnostics.

. A large and heterogeneous group of space-occupying lesions of the mediastinum are represented by both benign (cysts, cyst-like mediastinal lesions, benign tumors) and malignant neoplasms. Most of them are benign, but still carry a risk of malignancy and require careful clinical, serological and radiological monitoring or surgical removal. Dermoid cysts occupy a leading place among mediastinal lesions. Space-occupying lesions of the mediastinum begin to pose a danger and manifest clinically due to compression and invasion into nearby organs. However, in some cases they are detected accidentally during examination due to other reasons. Among the recommended methods of instrumental examination one can find polypositional radiography, ultrasound diagnostics, bronchoscopy, the most accurate and frequently used methods are computed tomography and magnetic resonance imaging. The aim of the study was to analyze the literature on volumetric neoplasms of the mediastinum, to study modern methods of diagnosing mediastinal cysts using the example of a clinical case of detection of this pathology in a 9-year-old child. Material and methods - data from ultrasound and CT examination of an anterior mediastinal cyst in a 9-year-old child. Results. During an ultrasound examination of the mediastinum in a 9-year-old child, an asymptomatic cyst of the anterior mediastinum was detected, the presence of a neoplasm was confirmed by computed tomography, after a three-year observation period, successful surgical treatment was performed. Conclusion. For the diagnosis of anterior mediastinal cysts, it is recommended to use ultrasound diagnostics, computed and / or magnetic resonance imaging, which allows the most accurate visualization of this type of volumetric mediastinal lesions.

Sphygmography is an important tool for diagnosing the functional state of the arterial bed. This method allows you to assess the elasticity of the walls of the arteries, identify the presence of pathologies, such as atherosclerosis, and determine the effectiveness of the treatment. The article is devoted to the study of the possibilities of sphygmography in the diagnosis of diseases of the cardiovascular system. Data on the principles of the study, interpretation of the results and the clinical significance of the method are provided. Particular attention is paid to the advantages of sphygmography over other methods of studying the vascular system. Purpose. The study of the principle of operation of the sphygmograph and the application of the sphygmography method for the diagnosis of a number of diseases. Materials and methods. A general overview of the sphygmography method, its principles of work and the prospects for its use in the diagnosis of diseases of the cardiovascular system was made. In the course of the work, it was found that sphygmography remains one of the most important methods of functional diagnostics, constantly improving due to the development of technology. The method has wide possibilities of application in various fields of medicine and continues to develop in the direction of increasing the accuracy and informativeness of research.

Human cytomegalovirus is considered one of the causes of serious complications in people with weakened immune systems and congenital infection. According to statistics conducted by Canadian colleagues based on the study of blood serum of patients with cytomegalovirus, its seroprevalence varies from 60-80% in developed countries and from 80 to 100% in developing countries. For example, in Switzerland, Norway, Sweden and Iceland, the prevalence of cytomegalovirus infection among women of optimal reproductive age will be 50-85%. The greatest seroprevalence at an earlier age is observed in developing countries, which in turn is associated with low socio-economic status, high sexual activity and belonging to black races. CMV is a member of the Herpesviridae family, which causes latent or persistent infections in people with damage to the nervous system and internal organs. An important public health task at this stage is the prevention of active cytomegalovirus infection, particularly in pregnant women and newborns. Thus, one of the recognized strategies for the prevention of congenital CMV infection is considered to be the immunization of boys and girls before sexual activity. Over the past 10 years, most of the vaccines being developed in some European countries, the United States, and Japan have already passed phase 2 of a placebo-controlled trial. Currently available ganciclovir and its oral prodrugs are limited by polymerase inhibitors and have a variety of side effects, including hematological toxicity and nephrotoxicity. In the presence of multidrug resistance, as well as for the prevention and treatment of congenital CMV infection, the search for new antiviral drugs remains a critical task.

Measles is a highly contagious, potentially severe but vaccine-preventable disease caused by a virus This infectious disease has been the cause of epidemics for over 5,000 years. Despite the availability of a safe and effective vaccine since 1963, the measles virus continues to circulate, with increasing incidence and mortality in recent years. The rise in measles outbreaks and associated deaths is alarming but is a predictable consequence of declining vaccination rates, partly driven by the COVID-19 pandemic.. The aim. To assess the clinical and laboratory characteristics of measles in adult patients in the context of long-term prior vaccination. Materials and methods. A retrospective analysis was conducted on 90 patients hospitalized at the Minsk City Infectious Diseases Hospital from November 2023 to September 2024. All patients have the standard case definition for measles and have a laboratory-confirmed diagnosis of measles, verified by PCR or by detecting IgM and IgG levels in blood serum using ELISA. Conclusions. The measles outbreak in Belarus in 2023-2024 primarily affected young adults and was associated with complications in two-thirds of the patients. Some cases exhibited atypical disease progression, lacking distinct catarrhal symptoms and the characteristic sequential appearance of the rash, which may complicate timely diagnosis. Half of the patients developed measles-associated hepatitis, characterized by varying degrees of cytolytic syndrome, highlighting the necessity of monitoring liver function indicators in measles patients.

Introduction. The spread of HIV infection in the Russian Federation remains a serious public health problem. Despite numerous preventive programs, the number of new cases of infection remains high. One of the most effective tools in the fight against the HIV epidemic is antiretroviral therapy (ART). This article is devoted to the analysis of the role of ART as a factor in preventing the spread of HIV in Russia and maintaining reproductive health in the population. The aim of the work is to study data on the spread of the HIV virus in the Russian Federation, to update information on the principles of modern antiretroviral therapy, which can significantly reduce the viral load in infected individuals. Materials and methods: search and analysis of modern medical research and literature, including materials from domestic and foreign sources. Results: The main advantages of modern ART are the ability to interrupt the chain of virus transmission, maintaining the full functioning of patients with HIV immune system. With a properly selected ART regimen, patients remain able-bodied members of society, which has a positive effect on the demographic situation in the country. Conclusion: Availability of quality antiretroviral drugs and adherence to the correct choice of antiretroviral therapy regimen is crucial for the quality of life and health of patients with HIV. ART allows for a full life, including the possibility of family planning, protecting the health of future generations.

The diagnosis of HIV infection is possible only based on the results of a laboratory examination. The purpose of the study was to assess the coverage of the population of the Voronezh region by medical examination for HIV and the effectiveness of HIV infection detection. The materials were the official reports on Rosstat form No. 4 "Information on the results of blood tests for HIV antibodies" for the period 2014-2023. The coverage of surveys in the region in 2022-2023 exceeded the recommended criteria. The analysis of individual contingents showed that the identification corresponds to their risks. A positive fact is the low detection of donors and pregnant women, and their dynamic decrease. HIV detection is uneven in the districts of the region, and it is higher in 9 municipalities than the regional average. Further tactics for increasing survey coverage should be based on individual territorial contingents of "risk".

The COVID-19 pandemic has become a major challenge to global health, exposing systemic vulnerabilities: fragmentation of control measures, digital inequalities and ethical dilemmas. Its consequences call for rethinking infection control strategies to increase resilience to future threats. Objective. To analyse the changes in infectious disease management approaches caused by the pandemic and identify key areas for enhancing global security. Materials and Methods. A retrospective analysis of scientific publications (ELIBRARY, PubMed) was carried out. Analytical and comparative evaluation methods were used. Results. Key changes were identified: transition to digital surveillance, accelerated development of mRNA vaccines (reduction of time to 300 days) and introduction of telemedicine (40% reduction of hospital workload). However, imbalances persisted: 65% of the EU population faced misinformation. Antibiotic abuse (70% of patients) exacerbated antimicrobial resistance. Conclusion. The pandemic has actualised the need for proactive strategies based on technology, ethics and global cooperation. Equitable resource allocation, integration of One Health principles and infodemic control should be priorities. The success of future measures depends on a combination of scientific innovation, confidence-building and interdisciplinary co-operation.

In 2024, thanks to the discovery of microRNA and the determination of its role in the post-transcriptional regulation of genes by American scientists Victor Ambros and Gary Ravkan, a radical rethink of protein synthesis processes took place in the field of molecular biology. Due to the verification of microRNAs and other markers that play a key role in regulating gene expression, as well as the revision of some genetic relationships, it was possible not only to better understand the mechanisms of development of dilated cardiomyopathy (DCM), but also to begin developing new therapeutic strategies in the treatment of DCM.

The study of new biomarkers for the diagnosis of DCM, the determination of genetic factors for the development of DCM is currently considered a promising cardiological field. In the course of the work, an analysis of domestic and foreign sources of information was carried out using medical databases (Pubmed, elibrary.ru, "CyberLeninka"), new clinical research. During the analysis of literature sources, we identified the genetic heterogeneity of DCM, the key role of BAG3 (Bcl-2-related atanogen 3) in the pathogenesis of DCM, especially in the regulation of TGF-β signaling and the initiation of fibrosis. It was found that a malfunction of BAG3 leads to an increase in fibrosis processes in the myocardium. From the point of view of new therapeutic approaches, cyclic RNAs and micro-RNAs isolated in the course of some studies from exosomes, participating in the regulation of gene expression, were considered promising biomarkers for the diagnosis of CMP. DCM is a genetically complex disease where BAG3 and FKBP12 dysfunction play a key role. Cyclic RNAs from exosomes and microRNAs are promising biomarkers for the diagnosis of CMP.

The study aimed to examine patients' attitudes toward pharmacotherapy with nonsteroidal anti-inflammatory drugs (NSAIDs). Data were collected in two stages. At the first stage, the target audience was identified and a questionnaire consisting of 19 questions was developed. At the second stage, a survey was conducted among 60 patients of the therapeutic, cardiology, endocrinology, pulmonology, neurology and gastroenterology departments hospitalized at the Voronezh State Healthcare Institution "CH - Medicine of Russian Railways" in December 2024. The questionnaire included questions on various aspects of NSAIDs - the effectiveness of drug use, concerns about adverse drug reactions, level of availability, doctors' recommendations, personal treatment experience. Based on the data obtained, the features of patients' ideas about the use of NSAIDs, the frequency of prescribing various drugs, taking NSAIDs for self-medication and as prescribed by a doctor, and the choice of drugs depending on the pain syndrome were demonstrated. The surveyed patients noted the frequency of dyspeptic manifestations and the patients' attitude to manifestations of adverse drug reactions.

Diabetes mellitus poses a significant risk to both the mother and fetus, which requires a special approach to its treatment. Insulin therapy is the "gold standard" in the correction of hyperglycemia in gestational diabetes mellitus (DM), type 1 and type 2 diabetes. Human insulin analogues are the safest drugs. The selection of doses should be carried out individually, taking into account the level of glycemia. The purpose of the study. - to study the structure of insulin administration in pregnant women with diabetes mellitus in the endocrinology department of one of the hospitals in Kursk for 2022-2023. Materials and methods of research. The medical records of 14 patients with diabetes in one of the hospitals in Kursk for 2022-2023 were analyzed by continuous sampling. The average age of the patients was 30±4  years. The results of the study. In 2022-2023, 2 patients were treated in the endocrinology department of one of the hospitals in Kursk in 2022 and 12 patients in 2023. All patients received short- and long-acting insulin during the study period. The most preferred were insulin aspart and detemir. Conclusion: the choice of safe therapy during pregnancy, taking into account current clinical recommendations, helps to stabilize the condition of the pregnant woman, significantly reduce the risk of complications and improve the prognosis for mother and child.

Respiratory distress syndrome (RDS) in preterm infants is associated with surfactant deficiency, which impairs gas exchange and requires urgent intervention. Prevention of RDS with glucocorticosteroids (GCS) promotes lung maturation and reduces the risk of RDS, but their use requires study due to possible side effects. A study of 90 preterm infants showed that antenatal prophylaxis with corticosteroids leads to higher Apgar scores at birth, a reduction in the dose of surfactant administered, a reduced need for mechanical ventilation, a reduction in intensive care time and the incidence of bronchopulmonary dysplasia. Children with GCS had stable metabolic parameters, in contrast to the group without prophylaxis, where metabolic acidosis was more often observed. The results support the importance of studying antenatal GCS prophylaxis to improve clinical outcomes in preterm infants.

This study aimed to investigate the effect of the OPRM1 (rs1799971) polymorphism on pain perception, morphine requirements, and plasma morphine concentration in cancer patients. The study included 86 patients receiving morphine for pain management and 100 individuals in the control group. Genotyping was performed using PCR, and plasma morphine concentration was measured using liquid chromatography.

The results demonstrated that carriers of the G allele (AG/GG) exhibited more severe pain on the visual analog scale (VAS) and required higher morphine doses compared to patients with the AA genotype. Additionally, AG/GG carriers showed lower plasma morphine concentrations at the same dosage. These findings support the significance of a pharmacogenetic approach in personalized pain management for cancer patients.

Diagnosis and treatment of scoliosis are among the most urgent and important issues in the field of traumatology and orthopedics. Despite the large number of currently existing methods for diagnosing scoliosis, the search for new methods and the improvement of old ones continues to this day. Goal. Investigation of the possibility of using infrared thermography as a screening method for idiopathic scoliosis. Materials and methods. In the course of this study, using the resources of the electronic libraries Pub Med and Elibrary. A study was also conducted in which 56 people participated, of which 28 were female and 28 were male, aged from 18 to 23 years, height from 157 to 190 cm. Results. The indicators of temperature fluctuations in symmetrical areas of the back in groups of patients with each of their established degrees of severity of scoliosis were considered separately. For this, the indicators were evaluated from the points L1, R1; L2, R2; L3, R3; L4, R4 in each group, respectively. Conclusions. The reliability of thermography has been confirmed by many other authors, as well as by this study. According to the results of the indicators obtained during thermography, the presence of scoliosis in the subjects is confirmed (the average value in each of the symmetrical points is above 0.3 degrees).

Relevance: it is well known that cerebellar functions are very diverse. Habitual motor functions are carried out by the anterior lobe of the cerebellum. Less studied functions are associated with the activity of its posterior lobe: cognitive, affective, and participation in the autonomic nervous system. To study the functioning of the autonomic nervous system (ANS) in patients, the technique of heart rate variability (HRV) analysis is used; HRV analysis is very relevant, because autonomic dysfunction can have a significant impact on the course of stroke in patients. The study of Schmahmann cognitive-affective syndrome in patients with cerebellar lesions may be of importance for further rehabilitation of patients. Objective: to study and compare the data on heart rate variability (HRV) and non-motor neurological disorders in patients with acute cerebral circulatory failure, vertebrobasilar stroke in cerebellar artery basins. Materials and methods: literature review, analysis of medical records, clinical examination of patients, completion of scales and questionnaires, HRV study, statistical analysis of the results. Results of the study: the majority of patients with  acute vertebrobasilar stroke with focal cerebellar lesions often have nausea, vomiting, the presence of these symptoms correlates with a lower level of sodium in the blood; the majority of patients have a decrease in the overall heart rate variability with activation of suprasegmental regulation of HRV and depletion of segmental activity of segmental apparatus of the ANS. All patients showed a significant cognitive-affective Schmahmann-Sherman syndrome, the severity of which correlates with the severity of ANS dysfunction. Conclusions: both motor and non-motor disorders are noted in patients with acute vertebrobasilar stroke with focal cerebellar lesions. Non-motor symptoms are usually represented by disorders of autonomic regulation of heart rhythm, gastrointestinal symptoms, as well as cognitive decline and affective disorders. In patients with more preserved autonomic regulation, cognitive-affective disorders are less pronounced.

Objective. To study the presence of signs of pathology of the nervous system in patients with psoriasis, their relationship to the activity of the disease, the presence of psoriatic arthritis (PsA), and the impact on quality of life.Research materials and methods. An analysis of the data of 72 patients (aged 18-76 years) with a diagnosis of psoriasis who were treated at UCB No. 2 of the SSMU (Saratov) was carried out. Validated questionnaires and scales were used to assess clinical parameters: the visual analog pain scale (VAS of pain), the hospital anxiety and Depression scale (HADS), the diagnostic neuropathic pain questionnaire (DN4), the multidimensional fatigue questionnaire MFI-20 and the quality of life questionnaire EQ-5D-3L. Disease activity was also assessed using the PASI index (Psoriasis Area and Severity Index).The primary data is organized in tabular format using Microsoft Excel version 16.0 (Microsoft Corporation, USA). Statistical processing was performed using Microsoft Excel version 16.0 (Microsoft Corporation, USA).The results of the study. The average age of the patients was 49±14 years. The average PASI is 42.3±10.1. PsA was detected in 14% of patients. Patients with PsA had higher rates of VAS pain (60±25 vs 40±20) and fatigue (MFI-20: 45±12 vs 30±10) compared with patients without PsA. A moderate (r=0.32; p<0.05) correlation was found between PASI and anxiety indicators (HADS-A).  Neuropathic pain was noted in 22% of patients. The quality of life, according to EQ-5D-3L data, is reduced in 68% of patients, especially in the presence of PsA (index 0.6±0.2 vs 0.8±0.1 in the group without PsA).Conclusions. The findings indicate that pain is a predictor of deterioration in the physical and psychosocial well-being of patients suffering from psoriasis. The involvement of a neurologist is a prerequisite for the successful treatment of patients with psoriasis.

Mild traumatic brain injury (MTBI) is the most common type of TBI. MTBI includes concussion, mild brain contusion and accounts for up to 83% of all TBI cases. Moderate traumatic brain injury is second only to mild traumatic brain injury. TBI is accompanied by headache, nausea, vomiting, dizziness, fatigue, and cognitive impairment (CI). The above symptoms in most cases disappear within 3 months, with rare exceptions, persistent post-concussion syndrome may be observed. CI in the acute phase of TBI depend on the severity of the injury, the localization of the process and the presence of concomitant pathological processes. Impaired CI is directly related to traumatic brain injury. These include memory impairment, attention, information processing speed, difficulty concentrating.Objective: to assess cognitive impairment in the acute phase of mild and moderate traumatic brain injury. Assessment of remote consequences. Research methods: A literature review was conducted to identify the impact of acute traumatic brain injury on cognitive functions. The results show that the severity of CI directly correlates with the severity of injury. Neuroimaging methods allow us to substantiate these results by identifying structural and functional changes in the brain. Even mild TBI can lead to cognitive impairment, which affects a person’s quality of life. Thus, early detection and assessment of cognitive functions are important for the timely development of a treatment program aimed at minimizing long-term cognitive deficits, as well as improving the patient’s quality of life after TBI.

Relevance. Based on statistical data and literature, in almost 50% of patients with complaints of pain in the lumbar region, the cause of pain syndrome is stenosis of the lumbar spine [1].

The purpose of this work is to reveal the main aspects of the etiology, pathogenesis, classical symptoms, diagnosis of spinal stenosis, as well as to analyze the clinical picture, course and surgical treatment of this disease using the example of a clinical case.

Methods and results: based on the analysis of the literature, the causes, mechanisms of development, classical clinical manifestations, diagnosis and treatment methods of lumbar vertebral stenosis are considered. A clinical case describes the clinical picture of a patient with severe pain and neurological disorders who underwent microsurgical decompression and stabilization of the spinal canal, as a result of which the patient's disability was prevented.

Conclusion: lumbar stenosis, as a common cause of pain and neurological status disorders in patients, requires an integrated approach to diagnosis and treatment. Surgical intervention is the most effective method of treatment in complex cases, which is confirmed by both literature data and the presented clinical case.

Hemolytic disease of the fetus and newborn (HBPN) is an isoimmune hemolytic anemia that occurs in cases of incompatibility between the blood of the mother and fetus for erythrocyte antigens, with antigens localized on the fetal erythrocytes and antibodies to them produced in the mother's body. In Russia, in recent years, approximately 1% of newborns with GBPN have been detected [1]. Also HBPN can lead to the formation of neurological disorders (bilirubin encephalopathy) and be the cause of perinatal mortality, so the study of this disease remains relevant. The aim of the work is to analyze the peculiarities of the course, examination results, as well as methods of treatment of newborns with hemolytic disease. A retrospective analysis of 102 case histories of newborns diagnosed with hemolytic disease of newborns was carried. The results of the study revealed more frequent development of HBN in repeated pregnancy, more severe course of the disease with predominance of jaundiced forms and significantly more pronounced anemia when immunized by Rh factor than by AB0 system. Characteristic laboratory changes in the blood of newborns with GBN were also noted: decreased hemoglobin and hematocrit, erythropenia, reticulocytosis, increased bilirubin, as well as reactive thrombocytosis in more than half of cases. The basic principles of treatment of the disease are outlined.

Obstructive sleep apnea syndrome is one of the most common sleep-related disorders. The incidence of obstructive sleep apnea syndrome according to literature data is approximately 10% in the population. Various risk factors for obstructive sleep apnea contribute to this, such as obesity, cardiovascular disease, age, and gender. At the same time, due to the low awareness of the population about this problem, the number of patients with undiagnosed obstructive sleep apnea syndrome is quite high.

Therefore, the urgency of the problem of obstructive sleep apnea is due not only to the frequency of occurrence in the population, but also to the large number of patients with undiagnosed obstructive sleep apnea syndrome. In addition, due to the severity of clinical manifestations, the quality of life and health of not only the patients themselves, but also their loved ones deteriorate.  In this regard, the problem of identifying risk factors and diagnosing obstructive sleep apnea remains urgent.

Conclusion: The study highlights the high prevalence of people with undiagnosed obstructive sleep apnea syndrome, the importance of identifying risk factors for effective treatment of obstructive sleep apnea in this group of patients for timely diagnosis, identification of risk factors for obstructive sleep apnea syndrome and the choice of an effective treatment method.

Key words: Obstructive sleep apnea syndrome, Upper respiratory tract.

A district hospital is a part of the healthcare system that is an independent medical organization and was created to provide, in particular, primary health care. In order to improve the hospital's performance in this direction, the Federal State Budgetary Institution National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation has developed a "New model of a medical organization providing primary health care." The purpose of this work is to analyze the discrepancy between the State Healthcare Institution Borzinskaya Central District Hospital and the criteria of the basic level of the new model of a medical organization providing primary health care. To achieve this goal, empirical research methods were used, in particular, observation, patient interview, examination of documents such as outpatient patient records, documents on the activities of the central district hospital. According to the results of the study, it was found that the State Healthcare Institution Borzinskaya Central District Hospital does not meet all the criteria specified in the methodological recommendations: the fact of the intersection of patient flows has been established, there are no properly equipped comfortable waiting areas in the required number, there are no specialized specialists in children. In this connection, the author of the scientific work put forward proposals for its improvement.

The institution of surrogacy is a phenomenon that is characterized very ambiguously in society. The contradictions are based on a complete denial of moral and ethical principles, presenting surrogacy as human trafficking. The flip side is surrogacy in the role of assisted reproductive technology, which is legal both free of charge and on a paid basis.  The problems of moral, social, and legislative aspects in the field of surrogacy concern the public due to the fact that cases of child trafficking are becoming more frequent, and the surrogate mother is increasingly being exploited. The purpose of the study is to examine whether there is a risk of human trafficking through the use of a surrogacy program, as well as to identify measures that could minimize this risk. Materials and methods of research. The study was carried out on the basis of Kursk State Medical University and the College of Medicine and Pharmacy among students of 1-6 courses of medical, pediatric, dental, preventive medicine, pharmaceutical faculties, as well as IFC Dentistry orthopedic. 107 respondents participated in the study, 78 of them were women and 29 were men. The results of the study have been processed and presented in a text version. The results of the study. The main objective of the study was to identify measures that could minimize the risk of human trafficking through surrogacy. Confirming all the above assumptions, 72% of respondents believe that the creation of laws regulating the rights of all participants in the surrogacy program, as well as amendments to existing projects, will help improve control over the surrogacy program at all stages. Conclusion. Thus, it can be concluded that the risk of human trafficking through the surrogacy program exists today and it is quite high. This problem arises due to the ambiguity of the issue of surrogacy, and therefore insufficient legal regulation. Changes and amendments in legislation can significantly affect the situation and minimize the risks of child trafficking.

Artificial intelligence (AI) is becoming an integral part of modern medical technologies, significantly improving the diagnosis, treatment and management of healthcare. The article examines the main areas of AI application in medicine, including disease diagnosis, personalized medicine, robotic surgery and data management. The prospects and challenges associated with the introduction of AI in healthcare, as well as the ethical, legal and social aspects of its use, are discussed.

In recent years, personal mobility aids suitable for leisure activities and transportation in urban environments have been gaining popularity. Injuries sustained during the use of scooters and bicycles are regularly encountered in the practical activities of physicians of many specialties.  

This study details the injuries occurring in children when using SIMs, their main types, and analyzes the age of injury.

The aim of this study was the frequency of various injuries in children and adolescents when using SIM.

An analysis of visits to the trauma center of the OGBUZ Dokb in Belgorod was conducted; 391 cases of traumatization during SIM use were included in the study group.

Children and adolescents are most often injured when using bicycles (x=54%) and scooters (y=40%), which is explained by the greatest popularity and accessibility of these types of SIM, as well as sites for their use.

Children and adolescents aged 7-12 years old are most often injured (x=57%), which is explained by reduced parental control in this age period, psychological characteristics of children at this age, and periods of rapid growth.  Boys are subjected to the greatest traumatization, which is determined by the characteristic features of their motor activity.

When determining the structure of traumatization, the most common injuries were bruises (x=46%) and fractures (y=38%). There are also other injuries, such as bruised wounds, ligamentous apparatus damage, as well as, in rare cases, traumatic brain injury.

Introduction. Clinical guidelines play a key role in the healthcare system. However, although they have become an integral part of modern Russian healthcare, their legal status continues to be a matter of dispute, since, on the one hand, they are not normative legal acts, but their legal status and binding application have been confirmed by the Supreme Court of the Russian Federation. Starting from January 1, 2025, clinical recommendations will become mandatory. This caused a mixed reaction from the medical community, as medical organizations are not always equipped with the necessary equipment, personnel and drugs, which makes it impossible to apply high-quality clinical recommendations in medical practice. Goal. To consider what problems medical organizations and medical professionals may face when providing medical care based on clinical recommendations from January 1, 2025. Materials and methods. A search for relevant sources on this topic has been performed. As the main material, you will