Introduction Total knee arthroplasty (TKA) is the gold-standard surgical intervention for end-stage knee osteoarthritis. With the widespread adoption of Enhanced Recovery After Surgery (ERAS) protocols, the selection of an optimal surgical approach has become increasingly relevant to achieving rapid functional recovery. The aim of this study was to evaluate the efficacy of the subvastus (SV) and midvastus (MV) approaches compared to the medial parapatellar approach (MP) in terms of the rate and ultimate outcomes of functional recovery following TKA. Materials and Methods This systematic review was conducted in accordance with the PRISMA 2020 guidelines. A literature search was performed across PubMed, Science Direct, Google Scholar, and eLibrary for the period 2020–2025. Eligible studies included original clinical investigations of primary TKA in patients with knee osteoarthritis. Of 607 initially identified publications, 12 studies were included in the final analysis. Results SV and MV were associated with significantly earlier achievement of active straight leg raise (by 1.3–1.8 days), reduced pain intensity on the VAS during the first 1–3 postoperative days, and greater ROM during the first 3–6 weeks compared with the MP approach ( p < 0.05). The rate of intraoperative lateral release was significantly lower in the SV and MV groups. Use of the SV approach was associated with longer operative time by 10–13 minutes. By 3–6 months of follow-up, intergroup differences in KSS, WOMAC, and OKS scores were no longer significant, and at 10–15 years the groups demonstrated full functional equivalence. Discussion These findings are consistent with the conclusions of major meta-analyses confirming the transient nature of the functional advantages associated with quadriceps-sparing approaches. Heterogeneity in outcomes related to blood loss and length of hospital stay is largely attributable to variability in rehabilitation protocols and discharge criteria across institutions. Conclusion The choice of surgical approach determines the rate, but not the ultimate outcome, of functional recovery. The SV approach is preferable within ERAS frameworks; however, an individualised strategy accounting for patient-specific anatomy, surgical expertise, and institutional rehabilitation capacity remains the most evidence-based strategy.
The article explores the systemic problems of intellectual property (IP) management within the Russian healthcare sector in the context of technological sovereignty and the digital transformation of the industry. It examines methodological, administrative, and technical barriers that hinder the transformation of scientific developments into protected IP and their subsequent implementation in practice. Special attention has been paid to the lack of a coherent regulatory framework, fragmented infrastructure, and shortages of personnel and financial resources, which reduce the effectiveness of existing mechanisms for protecting and transferring technologies. The study substantiates the need for comprehensive digitalization of the life cycle of IP through a unified platform that ensures transparency of processes, control of deadlines, and integration with scientific reporting systems and regulatory databases. The importance of educational training for researchers in the field of IP and the development of sustainable mechanisms has been emphasized.
Atherosclerosis, which begins early in life, accounts for a significant share of cardiovascular diseases in adulthood. At the same time, the prevalence of obesity, high blood pressure and dyslipidemia among children in certain regions of the Russian Federation reaches double figures. New order No. 211n of the Ministry of Health of Russia provides for the targeted lipid screening of children aged 6 and 10 years, however specific clinical and anamnestic grounds and criteria for being qualified as children at risk have not yet been regulated. This paper presents an analytical review of federal regulatory acts, current clinical guidelines and national multicenter studies (2014–2024), which gave rise to a list of indications for targeted screening for lipid profile in children and adolescents. The proposed checklist includes 17 clinical, anamnestic and phenotypic criteria grouped into eight blocks: (1) hereditary predisposition, (2) phenotypic markers for hyperlipidemia, (3) the presence of overweight/obesity, (4) resistant hypertension, (5) severe metabolic and systemic diseases, (6) congenital and acquired valvular heart diseases, (7) modifiable behavioural factors, (8) earlier cardiotoxic conditions. The presence of one key or two additional symptoms serves as a basis for an extended lipid panel testing and subsequent follow-up care. The presented model does not have a regulatory status and reflects the point of view of the authors' team; it is intended for expert discussion, improvement and further clinical validation. The proposed tool can be easily integrated into electronic health records, automating patient routing and creating the groundwork for prospective studies of Russian pediatric cohorts.
The relevance of this study stems from the global challenge of population aging. This review, conducted according to PRISMA methodology based on the analysis of 45 scientific articles (2019-2025), systematizes key social and medical determinants of aging. Evidence indicates that socioeconomic status (SES) is a fundamental factor: low SES increases the risk of dementia, multimorbidity, and accelerated biological aging by limiting access to healthcare and healthy lifestyle choices. Conversely, education serves as a powerful protective factor, increasing vitality indicators by 15-30% through programs like «Universities of the Third Age». Social isolation shows a significant correlation with cognitive impairment and depression, as evidenced, for example, by a 23% decrease in the Active Longevity Index (ALI) observed in rural regions of the Russian Federation. Lifestyle factors, including nutrition and physical activity, are equally critical, as is the detrimental impact of environmental pollution in accelerating aging. Among medical determinants, chronic diseases (cardiovascular disease, diabetes) and frailty/sarcopenia, affecting 52% of individuals over 80, play a leading role. Access to geriatric care remains limited (lt; 10% in low-income countries); however, telemedicine and the integration of geriatricians into primary care settings demonstrate efficacy. Genetic and environmental factors also exert a significant, unconditional influence on aging processes. Thus, the principal determinants influencing the quality of life of older adults inform the direction of efforts aimed at developing a comprehensive policy framework to combat premature aging.
Purpose. The article analyzes modern strategies for vaccination information support regarding society digital transformation and misinformation spreading. The author examines the key areas of increasing vaccination population coverage: targeted campaigns, medical community partnership, public leaders and bloggers involvement, methods of storytelling and visual communication usage. Results. The article emphasizes the necessity of a personalized approach to different groups and the importance of sustainable trust, dialogue and interdisciplinary collaboration. The conclusion is based on analyzing foreign and Russian experience, regulatory framework and empirical data, it demonstrates the need for a systematic communication policy in public health.
