№4, 2025, volume 21

Objective: to reveal the problems of practical participation of sanatorium-resort organizations in the system of medical rehabilitation of the population. Review methodology. Using the standardized PRISMA (Preferred reporting items for systematic reviews and meta-analyses methodology), 1263 articles were identified for the period 2015–2025. The articles included in the study were 39. Conclusion. Organizational, legal, technological, and personnel problems of practical participation of sanatorium-resort organizations in the system of medical rehabilitation of the population have been identified.

Оbjective: to identify problems in the analgesic market by studying consumer behavior regarding drugs of this group. Material and methods. An anonymous online survey was conducted using the author’s questionnaire to study consumer behavior (n=306). Results. 14.1% of respondents regularly use analgesics, primarily to relieve chronic pain of various origins, 43.8% of respondents were generally satisfied with the existing range of analgesics. The main problems arising when purchasing and using drugs of the analgesic group were the number of possible adverse reactions of drugs (34.6%) and unsatisfactory price-quality ratio (32.7%). When choosing an analgesic, the most important factors are the rapid onset of therapeutic effect from the moment of administration (79.7%) and a low number/frequency of adverse reactions (50.3%). The majority of respondents (67.3%) were ready to try a new analgesic. Conclusion. Difficulties in selection and use, as well as low consumer satisfaction with the range of analgesics, have been identified, which justifies the relevance of developing a new drug capable of providing more effective and safe pain relief.

Objective: to analysis of the quality of life associated with the characteristics of the medical and social portrait of patients with cancer in the later stages of the disease. Material and methods. According to the method developed by Academician of the Russian Academy of Sciences A.V. Reshetnikov, the socio-demographic characteristics of 417 patients 61±1 years old suffering from cancer of stages III and IV were assessed; 57.4% are women. Quality of life was assessed according to the World Health Organization (WHO QoL 100) international questionnaire, the value of religious beliefs was assessed according to the Yu.Yu. Sinelina scale. Results. The total quality of life score of the respondents was reduced to 74.73 points. To a greater extent, the indicators are reduced in the subspheres "Physical", "Psychological", "Level of independence", "Social relations", "Environment". The decline in quality of life is associated with gender, age, level of education, territory of residence, marital status, level of financial restrictions, duration of illness, value of religious beliefs for the respondent. For 87.8% of respondents, religious beliefs are important. For respondents who regularly pray, the average values of quality of life indicators in the sub-sphere "Physical safety and security" and in the sphere "Environment" were higher. Conclusion. There was a decrease in the average values of quality of life indicators in all areas and subspheres of the WHO QoL 100 questionnaire. Somatically and socially determined differences in quality of life associated with the characteristics of the medical and social portrait of cancer patients in the later stages of the disease were established. Religious beliefs will contribute to improving the quality of life of patients, provided that spiritual needs are taken into account when organizing palliative care.

Objective: hygienic parameterization and integral analysis of the priority factors of the educational and industrial environment in vocational training organizations. Material and methods. The actual values of the educational and working environment factors were determined in accordance with the requirements of Russian Federation sanitary regulations 2.4.3648–20 and hygienic rules and sanitary norms 1.2.3685–21. Parameterization of the educational and working environment factors was carried out using factor analysis method, integral analysis of priority factors according to N.I. Novichkova's methodology. Results. The contribution of the leading production factors to the total variance of the indicators of the educational and industrial environment of the vocational school amounted to 23.8, 19.4 and 18.9%. The total accumulated contribution of the factors to the total variance was 65%. The first component included indicators of chemical air pollution in the work area, the second and third factors were sound pressure and vibration levels in the workplace, respectively. The integral score of the three factors was: 2.4–2.02, 1.18–1.46 and 1.17–1.2 points, respectively. Noise and vibration were categorized as conditionally significant factors, and the "chemical" factor had an "unsatisfactory" degree of compliance with modern hygienic requirements. Conclusion. Comprehensive studies of learning conditions in vocational training organizations allowed us to determine the structure of educational and production factors. The roles of chemical and physical factors in the framework of the indication of the leading unfavorable production parameters of the educational environment are established.

Objective: to study the dynamics of motor imagery skill acquisition during the use of a brain – computer interface providing visual and vibrotactile biofeedback. Material and methods. The pilot study included 10 healthy volunteers aged 29–34 years. All subjects were right-handed. Within a five-day protocol, two feedback channels were used: visual and vibrotactile. Detection of moments of imagined movements was performed in real time using a classifier based on the analysis of EEG activity patterns. The success rate (proportion) of recognizing imagined movements of the left and right hand was assessed over the course of five experimental sessions. Results. It has been shown that learning is characterized by a U-shaped trajectory: after a short-term decrease in success rate in the middle of the training sessions (from initial values of 76 and 80% to 66 and 71% for the right and left hand, respectively), the performance significantly improves by the 4–5th session, reaching the maximum values for the entire experimental period (approximately 85 and 90%, respectively). This reflects the formation of stable neural patterns. Conclusion. The formation of motor imagery skill using a brain – computer interface with visual and vibrotactile feedback follows a U shaped trajectory, peaking on day 5 of training.

The presented clinical case of neonatal listeriosis demonstrates the consequences of delayed diagnosis in the absence of concern regarding congenital infection during monitoring of a pregnant woman. Attention is drawn to the difficulties in diagnosing congenital listeriosis due to insufficient motivation among obstetricians when providing care for a pregnant woman, despite the presence of risk factors for anthroponosis. As a result, the diagnosis was only established after identification of the pathogen using bacteriological examination. Delayed diagnosis led to generalized infection in the newborn, necessitating intensive therapy. The chosen therapeutic and diagnostic approaches contributed to a favorable outcome, despite the threat to the child's life.

The article examines the clinical case of an 11-year-old patient diagnosed with cystic fibrosis, which was established with a significant delay. Taking into account the genetic examination, a patient with a severe course of the disease was prescribed targeted therapy with the CFTR modulator drug ivacaftor/tezacaftor/elexacaftor. The authors present an analysis of the dynamics of the patient's condition, including according to functional tests and laboratory tests, one year after the start of this therapy. Positive changes in physical development indicators, respiratory function indicators, a significant decrease in sweat chloride indicators, and an improvement in the X-ray picture in the lungs and paranasal sinuses were noted. In addition, the frequency of forced courses of systemic antibacterial therapy per year decreased from 4-5 to 1. No significant side effects or adverse events were recorded against the background of this therapy.

Objective: to evaluate the prognostic significance, sensitivity, and specificity of the short-term NCDR CathPCI, CADILLAC, ACEF, EuroSCORE II, and SYNTAX risk scales in patients with non-ST-elevation acute coronary syndrome undergoing percutaneous coronary intervention (PCI). Material and methods. The study included 363 patients diagnosed with non-ST-elevation acute coronary syndrome, who underwent primary PCI during hospitalization and a questionnaire based on short-term scales to determine the prognosis of early fatal complications. Results. 28,4% of patients on the ACEF scale, 14,6% on the SYNTAX scale, 13,8% on the CADILLAC scale, 9,9% on the EuroSCORE II scale and only 4.1% on the NCDR-CathPCI scale were classified as high-risk. The CADILLAC (sensitivity: Se=1,000, specificity: Sp=0,907, χ2=118,56; p<0,001) and SYNTAX (Se=1,000, Sp=0,899, χ2=110,78; p<0,001) scales showed maximum sensitivity and high specificity. The ACEF scale showed absolute sensitivity (Se=1,000), but the specificity was 0,754 (χ2=47,81; p<0,001). The EuroSCORE II and NCDR-CathPCI scales showed low sensitivity (Se=0,444 for both scales), but high specificity (EuroSCORE II: Sp=0,919, χ2=25,27; p<0,001, odds ratio: OR=9,06; NCDR-CathPCI: Sp=0,980, χ2=77,69; p<0,001, OR=38,63). Conclusion. The CADILLAC and SYNTAX scales showed the most prognostically significant scales that determine a high prognosis of early fatal complications in patients with – non-ST-elevation acute coronary syndrome in this study.

Objective: to conduct a comparative analysis of the spectral indices of heart rate (HR) during the six-minute walk test (6MWT), depending on β-blocker intake, and to identify parameters capable of characterizing the contractile function and chamber sizes of the heart in chronic heart failure (CHF). Materials and Methods. The study included patients with compensated CHF of ischemic or hypertensive origin: patients taking β-blockers (main group) and patients who had not taken β-blockers for more than 1 month prior to the 6MWT (comparison group). All participants underwent Doppler echocardiography and the 6MWT. At each stage of the 6MWT, spectral indices of HR were assessed in the frequency band [0; 1] Hz. The following were evaluated: the ratio of the most prominent frequencies in the spectrum for stages II and I (fII/I), stages II and IV (fII/IV) of the 6MWT, and the average HR recovery time. Results. In the main group of patients, no significant correlations were found between the ratios of the HR frequency composition, Doppler echocardiography parameters, and the functional class (FC) of CHF. In the comparison group, a higher left ventricular ejection fraction was associated with a greater fII/I ratio and a shorter HR recovery time. Conclusion. The frequency composition of HR during the 6MWT can serve as a marker of adherence to β-blocker therapy and can also indirectly characterize the contractile function and heart chamber sizes in CHF in the absence of β-blocker intake.

Objective: to determine the duration of the learning curve in laparoscopic and robot-assisted colorectal surgery and to assess its impact on surgical outcomes. Review methodology. A systematic review was conducted using PubMed and eLibrary databases covering the period from 2000 to 2024 that included information about learning curves in colorectal surgery performed with laparoscopic and robot-assisted techniques. Twenty-four articles were selected where surgical outcomes were evaluated based on surgeon experience. Conclusion. The learning curve affects both operation time and surgical outcomes in laparoscopic and robot-assisted interventions: as experience accumulates, intervention durations decrease along with conversion rates and complication frequencies. In robot-assisted technique, the learning curve is shorter than in laparoscopy and depends on prior surgeon experience.