Introduction. Sleep disturbances represent one of the factors that reduce the likelihood of successful rehabilitation in patients during the acute phase of stroke. Objective: To study the structure of sleep disorders in patients during the acute phase of ischemic stroke and to evaluate the effectiveness of reflexotherapy compared to pharmacological treatment.

Material and Methods. The Group 1 (n=20) received phenazepam 500 µg before bedtime; the second group (n=20) underwent acupuncture therapy (points from the Heart, Pericardium, Liver, Kidney, Spleen, Stomach, and auricular meridians were used); and the third group (n=20) received a combination of phenazepam and acupuncture.

Results. Among 60 patients reporting sleep disturbances, the most common complaint was frequent nocturnal awakenings — 32 (53.3%) patients, followed by difficulty falling asleep — 19 (31.7%), early morning awakening with poor sleep quality — 14 (23.3%), snoring — 15 (25.0%), and daytime sleepiness — 5 (8.3%). All patients exhibited moderate sleep disturbances (12–18 points on the Spiegel scale), with a mean score of 16.1±0.56 (16.1±0.52 in Group 1, 16.3±0.50 in Group 2, and 16.9±0.61 in Group 3). After 15 days, all three groups reported subjective improvement in well-being and normalization or significant improvement in sleep quality. The total sleep quality score increased to 20.2±0.56 (p<0.05) in Group 1, 20.67±0.61 (p><0.01) in Group 2, and reached 21.67±0.61 in Group 3, indicating the most pronounced positive dynamics (p><0.001). Conclusion. The inclusion of reflexotherapy methods demonstrated high efficacy in treating sleep disorders, comparable to the effects of sedative medications.> <0.05) in Group 1, 20.67±0.61 (p<0.01) in Group 2, and reached 21.67±0.61 in Group 3, indicating the most pronounced positive dynamics (p <0.001).

Conclusion. The inclusion of reflexotherapy methods demonstrated high efficacy in treating sleep disorders, comparable to the effects of sedative medications.

The aim of this study was to investigate features of neuroimmune adaptation in high school seniors based on an examination of 43 adolescents aged 16–17 years.

Material and metods. Students performed self-assessment of stress levels using the Reader's Psychological Stress Scale. Participants were divided into two groups: Group 1 (n=14, 32.6%) scored 1–2 points, corresponding to a state of distress; Group 2 (n=29, 67.4%) scored 3 or more points, indicating eustress. In both groups, moderate levels of reactive anxiety predominated. High levels of personal anxiety were observed only in adolescents experiencing distress. Assessment of autonomic tone revealed a predominance of “eutonia” in both Group 1 and Group 2 – 57.1±17.7% and 33.6±11.4%, respectively (p>0.05), which is characteristic of satisfactory adaptive capacity. Regardless of baseline autonomic status, the intensity of autonomic response to stress was reflected by sympathetic tension, as demonstrated by indicators of autonomic reactivity: hyper-sympathetic reactivity predominated in both groups with an IN2/IN1 ratio of 2.7±0.5 and 2.5±0.6, respectively (p>0.05).

Result. Only in the main group (28.6%) was asympathicotonic autonomic reactivity identified, suggesting limited adaptive capacity of the sympathetic division of the autonomic nervous system. To evaluate immune adaptation, integral hematological indices reflecting immune homeostasis were analyzed. A statistically significant difference was found for the neutrophil-to-monocyte ratio index, which was lower in the main group – 5.69±1.5 (p=0.02).

Conclusion. This decrease reflects reduced phagocytic activity, indicating impairment of the cellular component of immunity. Thus, among graduating students, there is a tendency toward diminished macrophage-mediated defense.

A toxicological and hygienic assessment was conducted of a mixture composed of processed antler products and dihydroquercetin, aimed at enhancing organism resistance to low and high temperature conditions. It was established that this biologically active mixture possesses potent antioxidant and hepatoprotective properties and demonstrates high actoprotective activity under pathogenic exposure to environmental temperature factors. Furthermore, the mixture enhances the body’s adaptive capacity to both low and high temperatures.

The objective of this study was to analyze the prevalence of risk factors (RFs) for cardiovascular diseases (CVDs) among working-age individuals attending an urban outpatient clinic.

Material and Methods. A survey and analysis of 100 medical records of patients aged 18 to 70 years were conducted, including evaluation of anamnestic data, anthropometric parameters, blood pressure, lipid profile, blood glucose levels, other significant RFs, and psychological status influencing the onset, progression, and prognosis of CVDs.

Results. Five percent of examined individuals had no RFs, 17% had one RF, and 78% had two or more RFs. The study revealed high prevalence rates of hypodynamia (77%), excess weight (61%), dyslipidemia (57%), arterial hypertension (51%), alcohol consumption (49%), smoking (45%), and hereditary predisposition (28%). The prevalence of RFs and their combinations significantly increased with age, reaching 49% in individuals over 51 years compared to 2% and 12% in younger and middleaged groups, respectively. In the male population, higher prevalence was observed for excess body weight (62%), hypodynamia (60%), alcohol consumption (58%), hypercholesterolemia (54%), and smoking (54%). Among women, hypercholesterolemia (66%), hypodynamia (64%), arterial hypertension (64%), and excess body weight (52%) were predominant. Combinations of RFs were more prevalent in men (47%) than in women (31%). Psychoemotional factors (stress, anxiety, depression, chronic fatigue) played a significant role in CVD development, present in 82% of cases. Higher stress levels were noted in males (45%) compared to females (37%).

Conclusion. The analysis highlights the necessity of a comprehensive approach to assessing and correcting RFs, incorporating both medical and psychosocial interventions to preserve and strengthen cardiovascular health in the working-age population.

The introduction of Bruton’s tyrosine kinase inhibitors (BTKis) into the treatment of chronic lymphocytic leukemia (CLL) has not only enabled disease remission but also contributed to immune system normalization.

Objective: To assess the clinical significance of the immunomodulatory effect of BTKis in patients with CLL during the COVID-19 pandemic.

Material and Methods. A retrospective study was conducted analyzing outpatient records and medical histories of CLL patients who developed pneumonia associated with COVID-19 infection. Group 1 included 35 patients receiving immunochemotherapy. Group 2 consisted of 17 patients receiving monotherapy with ibrutinib at a dose of 420 mg/day.

Results. Both groups showed a high incidence of pneumonia associated with COVID-19 and severe progression of pulmonary inflammatory processes. However, none of the patients receiving ibrutinib required mechanical ventilation, whereas 18 patients in the immunochemotherapy group did. Mortality in Group 1 was 42.8%. In the ibrutinib-treated group, no fatal outcomes occurred either due to superimposed pneumonia or progression of hematologic malignancy.

Conclusion. BTKi therapy is the most effective and safest option for CLL patients during the COVID-19 pandemic. This advantage is attributed to the immunomodulatory properties of BTKis, higher probability of achieving complete response compared to regimens involving monoclonal antibodies, and the feasibility of outpatient administration, thereby minimizing exposure to healthcare settings where viral infections may be present.

The aim of this study was to conduct a comparative analysis of clinical manifestations of novel coronavirus infection (COVID-19) according to the degree of respiratory system involvement and to assess the frequency of persistent respiratory symptoms during long-term follow-up.

Material and Methods. A prospective cohort study included 177 individuals treated on an outpatient basis at the Amur Regional Healthcare Institution “City Polyclinic No. 4”, Blagoveshchensk, between 2020 and 2025. Three groups were formed: Group 1 – patients with mild viral pneumonia (CT-1, lung parenchyma involvement <25%) associated with COVID-19 (n=67); Group 2 – patients with confirmed SARS-CoV-2 infection and isolated upper respiratory tract involvement without radiological signs of pneumonia (n=60); control group – presumably healthy individuals (n=50). Data collection included symptom assessment, medical history, and physical examination within the first 72 hours of illness, with repeat monitoring after 2 weeks. At 3 and 12 months, patients completed a structured selfassessment questionnaire on post-COVID health status. Dyspnea was evaluated using the modified Medical Research Council (mMRC) scale. Statistical analysis was performed using Pearson’s χ² test and Fisher’s exact test (p <0.05).

Results. During the acute phase, patients in Group 1 experienced significantly higher rates of dyspnea (83.58% vs. 6.67%, p <0.001) and general weakness (100% vs. 86.67%, p <0.01) compared to Group 2. After 2 weeks, dyspnea persisted in 62.69% of Group 1 patients versus 6.67% in Group 2 (p <0.001). Group 2 (p >0.05); at 12 months, these figures were 26.87% and 25%, respectively. Conclusion. The extent of lung tissue involvement during the acute phase of COVID-19 determines the severity of clinical symptoms and the dynamics of respiratory impairments. A phenomenon of increasing dyspnea at 3 months was observed in patients without pneumonia, followed by regression by 12 months.

Burn disease remains one of the most pressing challenges in modern medicine and surgical practice. This article outlines the main stages of burn disease, diagnostic methods, and presents treatment outcomes based on a clinical case of a 6-month-old infant who survived severe burn injury.

This article describes the clinical features, diagnosis, treatment, and prevention of drug-induced lung injury resulting from iatrogenic exposure to medications.

Using a clinical case of a 6-year-old patient, pulmonary damage caused by anti-tuberculosis drugs – isoniazid, ethambutol, and rifampicin – is analyzed. This case highlights the necessity for timely diagnosis and preventive strategies to avoid the development of interstitial lung disease in pediatric patients.

This article presents a comprehensive analytical review of adverse effects associated with physiotherapeutic treatments. Potential complications of major physiotherapy modalities – including electrotherapy, phototherapy, and ultrasound therapy – are systematically categorized, with detailed descriptions of their underlying pathophysiological mechanisms. Particular emphasis is placed on classifying complications according to the level of tissue involvement, ranging from local tissue reactions to systemic disturbances. A three-tiered prevention framework is proposed, encompassing pre-treatment risk assessment, intra-procedural monitoring, and post-procedural observation. Regulatory and legal aspects of physiotherapy safety are analyzed with reference to current clinical guidelines and standards.

Conclusion. The majority of adverse effects in physiotherapy are predictable and preventable, provided that prescription and procedural protocols are strictly adhered to and a comprehensive risk management approach is implemented in clinical practice.

In 2019, a novel coronavirus infection (COVID-19) emerged globally and was declared a pandemic by the World Health Organization. Early studies of COVID-19 revealed that even after resolution of acute symptoms, patients continued to experience a wide range of nonspecific complaints that significantly impaired quality of life for prolonged periods. This condition became known as “postCOVID syndrome” (PCS).

Objective of the review is to analyze and summarize data from Russian and international studies focusing on the pathogenetic mechanisms and clinical manifestations of PCS. ,

Main findings. Initial reports of persistent nonspecific symptoms following recovery from COVID-19 appeared in early 2020. Subsequently, healthcare providers increasingly noted that nonspecific complaints – such as unexplained general weakness, fatigue, pain syndromes, and dyspnea – were becoming common reasons for patient visits. Initially thought to primarily affect older adults, further research indicated that children and adolescents are similarly susceptible to developing PCS. A comprehensive investigation into the pathogenesis of PCS has revealed multiple underlying mechanisms contributing to its development. Conclusion. Understanding the phenomenon of PCS requires acknowledging the complexity of its pathogenetic mechanisms and the multisystem nature of its manifestations. Researchers still face numerous unresolved questions in establishing a unified, comprehensive understanding of the disease and identifying effective therapeutic strategies for patients with PCS.