Vol 36, No 10 (2025)

Gait impairment is one of the most severe and socially significant consequences of both orthopedic pathology (total knee arthroplasty – TKA) and neurological diseases (acute cerebral circulation disorder – ACCD). Restoring safe and independent locomotion is a central task of medical rehabilitation, determining patients' quality of life and their reintegration into society.

The anti-gravity treadmill (AGT), based on Differential Air Pressure technology, allows for early, dosed, and physiological gait training with precise control of axial load (from 1% to 100% of body weight). The use of AGT contributes to a significant improvement in spatiotemporal gait parameters (speed increases by 25–40%, endurance by 30–45%, step symmetry by 15–25%), reduction of pain syndrome by 35–50% on visual analogue scale, overcoming kinesiophobia, and improvement of quality of life by 20–30% on SF-36 questionnaire in patients after TKA and ACCD. The technology demonstrates high efficiency for other nosology’s: multiple sclerosis (balance improvement by 40%), Parkinson's disease (step length increases by 25%), sports rehabilitation (reduction of recovery time by 30%).

Glutathione (GSH) is a central component of the body's antioxidant system involved in protection against oxidative stress, detoxification, regulation of immune response and metabolic stability. GSH deficiency is associated with a multitude of pathologic conditions including neurodegenerative and cancer diseases, HIV, inflammatory and metabolic disorders. This review considers nutrient strategies for increasing glutathione levels: vitamins (C, E, B6), selenium, magnesium, omega-3, alpha-lipoic acid, amino acids (glutamine, glycine, cysteine, serine, taurine), and protein sources. Data on the efficacy of various forms of GSH delivery – oral, liposomal, sublingual, and intravenous - are highlighted. The influence of genetic polymorphisms and dietary patterns (Mediterranean diet, DASH, vegetarianism) on glutathione metabolism is reviewed. The presented data emphasize the importance of an integrated approach to the maintenance of redox homeostasis and the need for a personalized strategy of glutathione status correction taking into account nutrient saturation, genetics and clinical background of the patient.

In modern personalized medicine, there is a transition from the phenomenological description of clinical cases to the predictive modeling of individual patient trajectories. In this context, the concept of medical digital twins seems to be not so much a technological innovation as a qualitatively new epistemological tool that requires rethinking traditional approaches to the organization and structuring of medical data. In this regard, the fundamental challenge is not the very possibility of computational modeling of physiological processes, which is technically feasible in one way or another, but the formation of an adequate information infrastructure capable of ensuring the representativeness and validity of the source data for predictive algorithms. The methodology of forming databases of potential digital counterparts in medicine is currently under development. Our research has allowed us to develop an approach to the formation of a database of medical digital twins and formulate several fundamental provisions that determine the directions for further development of the information infrastructure for predicting the condition of patients based on them.

Objective. To compare the structure of causes of death at home among 20–60 year-olds in 2019 and 2024 in the Moscow Region and discuss possible reasons for the changes.

Materials and methods. Data on medical death certificates (MDC) from the electronic database of the Moscow Region International Analytical Center for 2019 and 2024. The years for comparison were selected taking into account the COVID-19 pandemic (2020–2023). In total, 88,156 people died in 2019, of which 6,529 (7.4%) died at home among 20–60 year-olds, in 2024 – 94,645, at home – 5,872 (6.2%). Almost all MDCs were issued by forensic medical examination bureaus.

Results. A change in the structure of causes of death by ICD-10 classes was revealed (p < 0.0001); The number of deaths from nervous and mental diseases (classes G and F) has significantly decreased: such causes as alcohol dependence syndrome (F10.2), degeneration of the nervous system caused by alcohol (G31.2), unspecified encephalopathy (G93.4) have practically disappeared. A sharp increase in the number of deaths was noted from cardiomyopathies (I42.0-9) and unknown cause of death (R99). The share of deaths from the class of diseases of the circulatory system, for which emergency medical care is likely needed, decreased by 6.1% (29.6% in 2019 and 23.6% in 2024). The discussion section presents a number of reasons for the changes.

Conclusion. The reduction in the number of deaths at home from tuberculosis, cancer, and especially from causes for which emergency medical care was likely needed, indirectly indicates an improvement in the system of organizing medical care in the Moscow Region. A significant change in the structure of causes of death indicates problems with determining the underlying cause of death.

The article presents a clinical case of patient S. 36 years old with a diagnosis of acute occlusive PAS-induced (psychostimulants) mesenteric ischemia, thrombosis of the superior mesenteric artery, subtotal necrosis of the small intestine, widespread diffuse serous fibrinous peritonitis.

Patient S. underwent hybrid surgery – angiography of the celiac trunk, endovascular thromboextraction from the superior mesenteric artery, diagnostic laparoscopy, laparotomy, small intestine resection, sanitation, drainage of the abdominal cavity. After 34 hours, the patient underwent programmed relaparotomy ("second look"), revision of the abdominal organs, resection of a section of the small intestine with necrotic changes, the formation of an enteroenteroanastomosis "side-to-side", sanitation, drainage of the abdominal cavity. In the early postoperative period, the patient developed the following complications: intoxication syndrome, sepsis, water-electrolyte disorders, hypoalbuminemia, anemia of moderate severity, suppuration of a laparotomy wound. During therapy all postoperative disorders regressed. The length of hospital stay was 18 days.

The use of hybrid surgical access allowed to operate with a reduction in the volume of the resected intestine, giveв the possibility of creating an anastomosis and discharge the patient.

The effectiveness of the treatment of injury depends not only on the quality of the operation or reposition, but also on post -traumatic rehabilitation. The main methods of rehabilitation in patients with an excess body weight after an injury are therapeutic physical education, manual therapy, massage, physiotherapy, mechanotherapy, labor therapy, psychotherapy, diet therapy and drug therapy. The combination of several rehabilitation techniques gives the best restoration result. The basis of modern treatment of obesity is the recognition of the chronic nature of this disease and, therefore, the need for long -term treatment. The selection of a diet and rehabilitation methodology is the basis of a personalized approach in the treatment of patients with mechanical trauma and an excess body weight.

The steady increase in the prevalence of diabetes mellitus contributes to an increase in its complications and, in terms of problems, attracts the attention of many specialists. Epidemiology of diabetic foot syndrome (DFS), negative trends, clinical features of the disease, lack of effective prevention, disability, decreased quality of life and high mortality rate from amputations justify the medical, social and economic significance of SDS. According to official data, the prevalence of this complication among all patients with diabetes in different countries ranges from 4 to 50%. According to literature data, the number of lower limb amputations in patients with diabetes mellitus is 20–30 times higher number of amputations in patients without diabetes. After the first amputation, up to 30% of patients with DFS, undergo amputation of a second limb within 1–3 years, and after 5 years their number reaches 51%. The mortality rate among these patients is also puzzling. The objective of the presented literature review is to assess the usefulness of the available information for taking effective measures to improve the situation with regard to DFS.

Objective. To systematize rehabilitation measures for patients with temporomandibular myofascial pain syndrome of mild, moderate and high severity.

Materials and methods. A survey of 86 people was conducted, randomized into 3 groups depending on the severity of temporomandibular myofascial pain syndrome. A clinical and electromyographic examination of the condition of the chewing muscles was performed during 3 months of follow-up against the background of active rehabilitation measures.

Results. It has been proved that for patients with temporomandibular myofascial pain syndrome of mild severity, it is sufficient to perform a complex of hardware myohymnastics, with moderate and high severity, the number and effectiveness of measures should be increased, since only the performance of isokinetic exercises is not effective enough. During the dispensary observation and analysis of the clinical situation, it is possible to switch from one dispensary group to another.

Conclusion. The clinician should remember that small episodes of soreness cannot be the basis for therapy, in some cases, observation is indicated. When the disease is regressed during a follow-up examination, the symptoms are often less pronounced. The appointment of treatment may be an example of overdiagnosis and the cause of a false positive result with various methods of influencing the functional activity of the chewing muscles.

Most people actively use dishwashing detergents, often without wearing gloves. Regular contact with household detergents can disrupt the skin’s structure, altering its biophysical parameters.

Purpose. To evaluate the relationship between the pH of dishwashing detergent solutions and key parameters of hand skin condition: moisture, softness, and oiliness after exposure to detergents.

Material and methods. The experiment involved 11 participants. Skin parameters (moisture, oiliness, and softness) were measured using a digital analyzer. Five dishwashing detergents were tested: Bio Mio, Detstvo, Eco, Mama, and Fairy. Aqueous solutions with a concentration of 0.5% were prepared and applied to the inner forearm; after rinsing, skin parameters were re-measured.

Results. Pearson’s linear correlation coefficients (r) were determined. A strong positive correlation was found between the pH of detergent solutions and hand skin parameters such as moisture (r=0.82) and softness (r=0.86), indicating that alkaline detergents create a pronounced moisturizing and softening effect immediately after use. A moderate inverse correlation was observed between the pH of the solutions and skin oiliness (-0.53), suggesting that alkaline detergents more intensively strip away sebum.

Conclusion. The experimental data obtained in this study can serve as a basis for ensuring effective hand skin protection, provided that dishwashing detergents are chosen consciously, taking into account their composition and pH.

The use of tobacco products for a long time leads not only to a violation of bronchial dysfunction, but also to a change in the hormonal background in women of fertile age. In a prospective randomized trial of patients attending a prenatal pregnancy clinic, statistically significant changes in progesterone were revealed depending on smoking in different trimesters of gestation, with the maximum sensitivity of the model (p ≤ 0.05) detected in the third trimester of gestation.