Vol 28, No 2 (2026)

Chronic obstructive pulmonary disease ranks third among the leading causes of death worldwide, yet less than 15% of cases are diagnosed in Russia. Nurses play a crucial role in COPD prevention, early symptom detection, and patient education on proper inhalation therapy technique. The article examines the epidemiological situation of COPD in Russia, major risk factors for disease development including tobacco smoking and occupational hazards, and the role of nurses in combating smoking among patients and pregnant women. Particular attention is given to the importance of spirometry for early diagnosis, multidisciplinary approach to managing patients with comorbid conditions, and the significance of adherence to combined inhalation therapy for preventing exacerbations. Modern approaches to pharmacological and non-pharmacological COPD therapy are discussed, including dual and triple combination inhalers demonstrating reduced exacerbation rates and mortality. The authors emphasize the necessity of advanced training for nursing staff in the field of diagnosis, prevention, and management of COPD patients.

The article presents the pathophysiological foundations of cough in children and practical recommendations for nursing staff on parental counseling. Issues of microclimate as the basis of therapy, current epidemiological situation with the dominance of rhinovirus infection, mechanisms of bronchial hyperreactivity formation and cough chronicity are discussed. Special attention is paid to the physiology of the respiratory center and principles of rational pharmacotherapy. Aspects of nebulizer therapy are analyzed in detail, including the problem of equipment contamination and drug bioavailability. Recommendations on nutrition, physical activity, and thermal procedures are presented. The pharmacology of herbal preparations using the example of Thermopsis lanceolata is described. The material is intended for nurses of pediatric and neonatology departments and aims to improve the quality of educational work with parents.

Introduction. Phlebotomy, being one of the most common invasive procedures, is a critical component of the pre-analytical phase, which accounts for up to 60–70% of all errors in laboratory diagnostics.

Aim. The aim of this theoretical review is to conduct a systematic analysis of the causes, types, and consequences of errors occurring during phlebotomy, as well as to assess the potential of the regulatory framework for their minimization.

Materials and methods. An analytical review of current national (GOST R 59778-2021, GOST R ISO 20658-2025) and international (ISO 20658:2023) standards, scientific literature, and guidelines dedicated to the problems of the pre-analytical stage was conducted.

Results. It was established that errors are systemic in nature, with root causes being a lack of specialized staff training, non-compliance with regulations, and organizational stress. Technical factors directly affecting specimen quality were detailed: choice of needle and collection system, tourniquet application time, skin preparation technique. It is shown that the consequences of errors form a cascade from direct harm to the patient (complications) through the risk of diagnostic errors to significant economic losses for the healthcare system.

Conclusions. Despite the development of a detailed regulatory framework, the key challenge remains its implementation in practice. To minimize risks, coordinated actions are required: integration of standard requirements into the quality management system of healthcare organizations, implementation of mandatory specialized training modules for nurses within the framework of continuing medical education, and creation of conditions for safe work and regular auditing of the procedure quality.

Dizziness and headache are the most common and maladaptive subjective complaints among outpatients. Their high prevalence, diagnostic difficulties due to the absence of obvious neurological symptoms, and significant social and economic consequences due to direct and indirect costs determined the relevance of this study. This article presents an analysis of factors contributing to the chronicity of functional dizziness and the reasons for the ineffectiveness of treatment measures. Experience in the diagnosis and successful treatment of dizziness, associated headaches, anxiety-depressive symptoms, and insomnia is presented.

Objective: to determine the frequency of comorbid pathology (migraine, tension type headache, affective disorders, and insomnia) in patients with persistent postural-perceptual dizziness (PPPD) and to identify the reasons for treatment failure in this patient cohort.

Materials and methods: The study included 119 patients aged 19 to 73 years with persistent postural-perceptual dizziness, the severity of which was assessed using the NPQ (Niigata Persistent Postural-Perceptual Dizziness Questionnaire). Before inclusion in the study, patients received vasoactive, neuroprotective and nootropic therapy due to persistent symptoms of dizziness. Patients were divided into 3 groups: the first group included patients with PPPD without comorbid headache, n=28 (23,.5%), the second group – with a concomitant diagnosis of episodic migraine, n=38 (32,.0%), the third – patients with a concomitant diagnosis of tension-type headache, n=53 (44.5%). All patients underwent clinical, neurological, ultrasound (duplex scanning of arteries and veins of the head and neck) and neuroimaging (MRI of the brain) examination. The HADS questionnaire (Hospital Anxiety and Depression Scale) was used to assess the severity of anxiety and depression.

Results: Brain MRI revealed Chiari malformation type 0-1 in 36.1% of patients. The highest incidence of this anatomical feature was found in the migraine group (44.7%), while the lowest incidence was found in the group without comorbid headache (17.9%), p < 0.05. Duplex scanning of the head and neck vessels revealed obstructed venous outflow from the cranial cavity in 58.0% of patients, with statistically significant differences between the groups without headache (28.6%) and with comorbid headache (78.9% in the group with comorbid migraine and 58.5% in the group with comorbid tension-type headache), p < 0.05. According to the HADS scale, anxiety was detected in 94.7% of patients before treatment (mean score 13.1), and depression in 68.4% (mean score 9.5). After comprehensive treatment (medication, including antidepressants, and psychotherapy), a significant reduction in the frequency and severity of anxiety (to 4.3 points, p < 0.05) and depression (to 2.4 points, p < 0.05) was noted. The severity of dizziness symptoms significantly regressed (from 38.3 points to 8.3 points on the NPQ, p < 0.05), and sleep quality improved.

Conclusion: This study allowed us to identify the comorbid pathology that caused the ineffectiveness of dizziness treatment and to develop optimal treatment strategies.

This paper reviews current understanding based on the latest comprehensive global research on the multi-component etiology and pathogenesis of atherosclerosis, including the role of the liver, modern diagnostic criteria, and patient management strategies for this condition, taking into account new data.