Introduction: The sanatorium-resort complex of Sochi, which accounts for 75% of the municipal gross product, underwent a fundamental transformation following the 2014 Olympic Games. Cumulative tourist flow over the post-Olympic decade totaled 72.2 million visitors, while the municipal budget potential increased from 10.6 to 64.0 billion rubles. Despite massive public investment, a comprehensive assessment of the effectiveness of municipal support programs remains fragmented. Objective: To evaluate the effectiveness of municipal programs supporting the sanatorium-resort complex of Sochi in the post-Olympic period (2014–2024) using integrated quantitative indicators. Materials and methods: The study is based on panel data from Rosstat, Sochi city administration reports, BusinesStat analytics, and the Association of Health Tourism for 2014–2024. Data Envelopment Analysis (DEA) using the BCC model, index method, and correlation-regression analysis were applied. A system of 12 performance indicators across three dimensions (infrastructure, economic, and balneological) was developed. Results: The integrated program effectiveness index was 0.87 in 2024 (threshold value: 0.75). The compound annual growth rate (CAGR) of tourist flow reached +4.5%, while collective accommodation facility occupancy increased from 72 to 89%. The fiscal multiplier of the resort sector was 1.34 rubles of tax revenue per 1 ruble of program expenditure. A statistically significant correlation (r=0.91; p<0.01) was found between program expenditures and tourist flow growth. However, only 38% of sanatorium facilities completed modernization, and the share of balneological procedures in the service structure declined from 24 to 17%. Conclusions. Municipal programs demonstrate high effectiveness in infrastructure and tourist flow segments, yet the therapeutic component of the resort product remains underfunded. Program priority adjustment toward strengthening the balneological specialization is required.
Introduction: The sanatorium and resort industry of the North Caucasus Federal District (NCFD) is undergoing accelerated transformation following the approval of the Spatial Development Strategy of the Russian Federation until 2030. Despite the growth of the tourist flow in the NCFD to 3.3 million people in 2024 (+8% compared to 2023) and the increase of the national sanatorium services market to 220.08 billion rubles (+18%), there remains a deficit of comprehensive assessments of the industry's investment potential considering territorial priorities and cluster development mechanisms. Objective: To assess the investment potential of the NCFD sanatorium and resort industry through calculation of integral indicators of investment attractiveness and determination of multiplicative effects of capital investments in the context of spatial development objectives. Materials and methods: The study is based on data from Rosstat, the Ministry of Economic Development of the Russian Federation, and Kavkaz.RF JSC for 2019–2025 across seven NCFD constituent entities. Comparative economic-statistical analysis, calculation of the integral index of investment attractiveness using 12 indicators, cluster analysis, and investment multiplier calculations were applied. Statistical processing was performed using SPSS Statistics 27.0 with the Kruskal—Wallis test (p<0.05). Results: The integral index of investment attractiveness across NCFD entities ranges from 0.28 (Republic of Ingushetia) to 0.79 (Stavropol krai). The investment multiplier for the NCFD sanatorium and resort industry was 2.41, exceeding the national tourism average (1.85) by 30.3%. The tourism share in NCFD GRP reached 4.7% versus the national average of 2.5%. Conclusions: The NCFD sanatorium and resort industry possesses significant investment potential requiring a differentiated approach to the district's constituent entities. The creation of a special economic zone in Kavminvody with planned investments of 160 billion rubles is a key driver of the macroregion's spatial development.
Introduction: The Black Sea coast of Greater Sochi is the largest climate-balneological cluster in the Russian Federation, generating over 26 billion rubles in annual revenue from health resort organizations. The accident involving the tankers Volgoneft-212 and Volgoneft-239 in the Kerch Strait in December 2024, resulting in a spill of approximately 4,000 tonnes of fuel oil, highlighted the financial vulnerability of health resorts operating under conditions of systematically declining recreational water quality. Mean annual pollutant concentrations in the Sochi – Adler coastal zone consistently exceed maximum permissible values for several parameters; however, the economic consequences of this phenomenon for the health resort sector remain insufficiently quantified. Objective: To assess the financial consequences of deteriorating recreational water quality on the Black Sea coast for climate-balneological sanatoriums of Greater Sochi through a comprehensive technical-economic analysis for 2019–2025. Materials and methods: A retrospective analysis of hydrochemical monitoring data from FSBI SCGMS BAM across 8 stations in the Sochi – Adler coastal zone was conducted (23 hydrochemical parameters, 13 regulated). Financial indicators of 47 climate-balneological sanatoriums were aggregated from Rosstat and the Unified State Register of Legal Entities for 2019–2024. Regression analysis, the Water Pollution Index (WPI), and an original model for estimating revenue losses through demand elasticity with respect to recreational water quality were applied. Statistical processing was performed using R 4.3.2 (R Foundation, Austria). Results: A statistically significant negative correlation (r=−0.78; p<0.01) was established between WPI and mean annual sanatorium occupancy. A 0.1-unit increase in WPI was associated with a 2.3 percentage point decrease in occupancy. Total foregone revenue for Greater Sochi sanatoriums during the elevated pollution period of 2022–2024 amounted to 3.74 billion rubles. Additional operational costs for water treatment and alternative balneological procedures reached 418 million rubles per year. The financial resilience coefficient of health resorts decreased from 0.42 to 0.29 when WPI exceeded 1.5. Conclusions: Deteriorating recreational water quality has a pronounced negative impact on the financial performance of climate-balneological sanatoriums in Greater Sochi. Losses amount to 5.7–8.2% of aggregate revenue when WPI exceeds the critical threshold. The findings substantiate the need for an environmental risk insurance system for health resort organizations and investment in coastal protection infrastructure.
Introduction: The Kaliningrad region, as an exclave territory of the Russian Federation on the Baltic Sea coast, possesses significant sanatorium and resort potential; however, its positioning in the cross-border medical tourism market remains insufficiently studied from an economic competitiveness perspective. The region's exclave status and proximity to Poland and Lithuania, which constitute the competitive field of Baltic spa services, necessitate a quantitative assessment of price, infrastructure, and institutional competitiveness parameters. Objective: To develop and validate a methodology for the integrated economic assessment of sanatorium competitiveness in the Kaliningrad region compared with Baltic resort destinations (Kołobrzeg, Świnoujście, Palanga, Druskininkai, Jūrmala). Materials and methods: A comparative economic analysis of 14 sanatoriums in the Kaliningrad region and 22 foreign sanatoriums in the Baltic region was conducted for the period 2022–2025. Benchmarking methods for tariff policy, calculation of the price competitiveness index (PCI), resource provision coefficient (RPC), and construction of a "price – quality" matrix based on multi-criteria analysis were employed. Statistical processing included Spearman's correlation analysis and cluster analysis (Ward's method) using SPSS Statistics 27.0. Results: The average cost per bed-day with treatment in the Kaliningrad sanatoriums was 4,280 RUB (≈44 EUR), which is 38.6% lower than in Kołobrzeg (≈72 EUR) and 57.9% lower than in Druskininkai (≈105 EUR). The PCI of Kaliningrad sanatoriums equals 1.64 (high price attractiveness). Peak season occupancy reaches 94.2%, although the annual average (68.7%) lags behind Polish resorts (76.3%). The integrated competitiveness index (ICI) of Kaliningrad sanatoriums was 0.61, corresponding to the "moderate competitiveness" zone, with leading price positions but deficits in transport accessibility and international certification. Conclusions: Kaliningrad sanatoriums possess a pronounced price advantage and unique natural resource potential (amber therapy, peat mud), yet the realization of competitive opportunities in the cross-border Baltic market is constrained by the exclave's logistical limitations and a deficit of international quality standards.
Capillaroscopy is a non-invasive method for visualizing microcirculation that possesses significant potential for cost-effectiveness. Its application is most extensively studied in rheumatology for diagnosing systemic sclerosis and Raynaud's phenomenon, where the method enables the detection of specific microangiopathies at a pre-clinical stage. Key economic advantages include the low capital cost of equipment (10—15 times lower than an MRI machine), the absence of consumable materials, and the ability to perform the examination in an outpatient setting without requiring additional staff. Analysis of the literature indicates that integrating capillaroscopy into diagnostic algorithms can reduce the volume of costly laboratory and instrumental tests (MRI, ultrasound) by 25—30% through more accurate patient routing. In neurology, the method shows promise for optimizing the diagnosis of migraine and neuropathies, although the economic aspects in this field require further study. The implementation of capillaroscopy into clinical practice appears to be an economically justified strategy that enhances the quality of medical care while reducing overall costs.
Introduction. Bruxism is a common and significant disorder that occurs in 8-13% of the adult population and has a pronounced effect on dental health, sleep quality, and mental and emotional state. Despite the effectiveness of classical mouth guard therapy and psychological correction methods, a significant proportion of patients experience incomplete regression of symptoms, which underscores the need to find additional non-medicinal methods of treatment. One of the potentially effective strategies is the inclusion of physical therapy and physiotherapy, but their effect on the clinical manifestations of bruxism has not been sufficiently studied, which creates an urgent research gap. Objective. To evaluate the effectiveness of a complex of physical therapy and physiotherapy as part of the combined treatment of bruxism in adult patients. Materials and methods. The study included 20 18—45-year-old patients with confirmed nocturnal bruxism, divided into two equal groups: a control group (n=10), who received standard treatment (night kappa and psychocorrection), and an experimental group (n=10), where an additional course of physical therapy was performed. The follow-up period was 3 months. The effectiveness was assessed according to three indicators: the tooth erasability index (PSI), anxiety level (Spielberger–Khanin scale) and sleep quality (PSQI). The Wilcoxon criterion (p<0.05) was used for statistical processing. Results. The experimental group demonstrated a more pronounced decrease in PSI (up to 1.7±0.3), improved sleep quality, and a 45% reduction in anxiety. The control group showed less pronounced but statistically significant improvements. No adverse reactions to the intervention were registered. Conclusions. The integration of physical therapy into standard treatment regimens contributes to the improvement of clinical indicators of bruxism and can be considered as a safe and effective component of complex treatment.
Introduction. Post-traumatic scars (PTS) are an extremely common problem among the population of all countries. A feature of scar localization in the facial area is the frequent development of functional disorders and a decrease in self-esteem of patients due to a visible cosmetic defect. Currently, there is a need to develop effective rehabilitation methods based on the principle of evidence-based medicine. Objective. To evaluate the dynamics of clinical, functional and psychological indicators, as well as the quality of life in patients with post-traumatic scars of the facial skin during the implementation of comprehensive rehabilitation programs. Materials and methods. A prospective, randomized, comparative clinical study was conducted from January 2024 to March 2025. Ninety patients with post-traumatic facial scars were included and randomly divided into two groups of 45 people. The first was the study group, in which patients received treatment using a comprehensive rehabilitation method. The second was the control group, which received a standard rehabilitation regimen (facial massage courses and the introduction of lidase into the lesions using the phonophoresis method). All included patients completed the study. No adverse events were recorded during the study. Control examinations were carried out before the start of treatment (visit 1), as well as after 1 (visit 2), 2 (visit 3) and 4 (visit 4, study completion visit) months. At visits 1, 2, 3 and 4, the main physical data were recorded, instrumental examinations were performed, and the severity of cicatricial lesions was assessed using special indices (IACSL — index of assessment of cicatricial skin lesions, VS — Vancouver scale, POSAS scales assessment by a doctor and a patient, Stony Brook scale). At visits 1 and 4, psychophysiological indices (well-being, activity, mood, personal and situational anxiety) were assessed, and the patients' quality of life was assessed using the questionnaire of the World Health Organization, including 100 questions on the main spheres of human activity. Results. In the first group, the rehabilitation results were significantly better, which was reflected in a significant difference in a number of indicators at the final visit of the study. The severity of cicatricial lesions at visit 4: IACSL1group=26.0 points, IACSL2group=52.0 points at p<0.001; VS1group=3.0 points, VS2group=9.0 points at p<0.001; POSAS physician assessment1group=21.0 points, POSAS physician assessment2group=52.0 points at p<0.001; POSAS patient assessment1group=21.0 points, POSAS patient assessment2group=54.0 points at p<0.001; Stony Brook1group=4.0 points, Stony Brook2group=3.0 points at p<0.001. Scar stiffness decreased significantly (Group 1 — 22.7 kPa, Group 2 — 31.1 kPa at p<0.001) and skin texture improved (Group 1 — 0.15 U, Group 2 — 0.23 U at p<0.001). In the study group, psychophysiological indicators normalized (personal and situational anxiety) or significantly improved during rehabilitation (well-being, activity, mood), while in the control group they remained unchanged or slightly worsened. Also, after the rehabilitation course, a higher level of quality of life was achieved in the study group. Conclusions. The developed complex method of rehabilitation of patients with PTR is highly effective and allows to significantly improve the results in comparison with standard therapy.
Introduction. The Sustainable Development Goals (SDGs), also known as the Global Goals, were adopted by the United Nations in 2015 as a universal call to action to end poverty, protect the planet and ensure that by 2030 all people enjoy peace and prosperity. Physiotherapy (PT) being one of the crucial parts of healthcare system have addressed SDG in their practices but only limited studies have been conducted to examine them. Physiotherapy has been long addressing Good Health and Well-being, Quality Education, Gender Equality, Industry, Innovation, and Infrastructure, Reduced Inequalities, Responsible Consumption and Production, Climate Action. Objective. The aim of the study is to investigate the contribution of physiotherapy in achieving the sustainable development goals. Materials and methods. A scoping review was conducted following the Prisma-Scr guidelines. Databases such as PubMed, Scopus and Google Scholar were used. Keywords like “physiotherapy”, “sustainable development goals”, “rehabilitation”, and “global health” were used for a refined search. Studies included were articles which discussed physiotherapy’s link with SDG’s. Studies were excluded if they were outdated (before 2013), not related to sustainability, non-English publications. Data extraction from the articles focused on physiotherapy practices that aligns with the SDG. A PRISMA flow diagram illustrates study selection. Results. A total of 33 studies were included. All studies were related to physiotherapy intervention which is relevant with sustainable development goals (SDG). Results highlights physiotherapy’s contributions to reduce carbon footprint, ensuring sustainable health practices and global health. Conclusions. The results have concluded that Physiotherapy practices has been long addressing SDG’s. The dependency on pharmaceuticals have been reduced and rehabilitative care has been highlighted by PT, which is the core principle of sustainable development. The study underscores the necessity for merging sustainability into physiotherapy education, research and practice to enhance its role in achieving SDG’s.
Introduction. Until recently, the field of posture analysis relied almost exclusively on manual procedures. However, recent advancements promoted app-based format, which is more convenient, time-efficient, and user-friendly. Still, there are hardly any detailed comparisons available in the existing literature. Objective. The study suggests the first qualitative comparison between app-based and manual whole-body posture analysis in terms of its effectiveness, user experience, and practicality. Materials and methods. This scoping review, guided by PRISMA guidelines, explored mobile application-based posture assessment techniques. A systematic search across PEDro, Cochrane, PubMed, and Scopus identified studies from 2000 to present that examined smartphone- and iPhone-based postural analysis. After screening 158 articles, 17 studies met the inclusion criteria, highlighting validated and reliable app-based methods. Non-app and review studies were excluded. Key findings, participant profiles, and study characteristics are summarized to reflect advancements in digital posture evaluation. Results. A particular study highlights the applicability of app-based procedures due to its usability under almost every condition and opportunity to get real-time feedback. Conclusions. App-based posture analysis tools have emerged as reliable and valid methods for detecting postural abnormalities and deformities, including via radiographic integration.
Objective. The purpose of the study was to analyze the synergistic effect of negative air ions and sulfide mineral waters on the antioxidant defense system of lung tissue in healthy rats and in an experimental model of contusion injury of the musculoskeletal system. Materials and methods. A controlled experimental study was conducted on 66 male Wistar rats (36 healthy and 30 with a modeled contusion injury to the musculoskeletal structures), which underwent courses of balneotherapy (using sulfur-containing (10 mg/L) mineral water (mineralization — 5.3 g/L) from Pyatigorsk source No 2 and artificial aeroionization using a light aeroion generator (“Ion-effect” ionizer) at a concentration of 4 × 104 per cm³ (high-density exposure) both as single factors (monofactors) and in their combinations. In rat lung tissue (the contact zone of gaseous components of factors) and muscle tissue (the injury zone during injury modeling), malondialdehyde levels were determined in vivo and in vitro during induced and spontaneous lipid peroxidation in tissue homogenates. The level of superoxide dismutase and glutathione peroxidase enzymes in rat blood serum was determined by solid-phase enzyme immunoassay and species-specific reagents. Statistical data processing was carried out using nonparametric analysis criteria. Multivariate analysis and visualization of experimental data were performed using the R programming language version 4.5.0 with the ggplot2 and GGally packages. Results. Data have been obtained indicating a more pronounced synergistic effect of the studied factors on the intensity of lipid peroxidation in tissues when they are combined in an experimental model of contusion injury of the musculoskeletal system. When applying a course of artificial aeronization to healthy animals, a dose-dependent effect was obtained on the level of lipid peroxidation in lung tissue (the zone of contact with the factor). Conclusions. The combined use of the studied factors shows significantly better functioning of the antioxidant system in the muscle tissue of the hind limb in the injury zone, as evidenced by a lower level of induced lipid peroxidation relative to the control group.
Introduction. One of the essential links in the pathogenesis of gonarthrosis, in addition to degenerative-degenerative phenomena in bone tissue, is a violation of blood circulation of bone tissue and pain. Existing methods of conservative treatment do not solve this problem. Objective. To assess the effect of interstitial electrostimulation (IES) on bone circulation and pain in the treatment of gonarthrosis and compare its effectiveness with existing conservative therapy. Materials and methods. Singlecentered randomized blinded clinical trial involving 82 patients at the age of 52—68 with I—III stages of gonarthrosis during exacerbation with persistent pain syndrome. The studied group received IES at the sites of attachment of capsules of the knee joint to the femur and tibia. The control group received standard pharmacological and physiotherapy. Studies of blood supply to bone tissue, subchondral portions of the condyles, bones, and adjacent soft tissues were performed with the use of needle rheography and polarography. Results. In a clinical and experimental study, it was shown that, the electric current of the given parameters is able to improve blood circulation and relieve pain in the knee joint. Based on this, a method of interstitial electrostimulation (IES) was proposed by applying an electric current to the subchondral zone of bone tissue. The obtained positive results, designated as good, were observed 2.5 times more often after IES, and unsatisfactory 3 times less than after the traditional complex of treatment for gonarthrosis. Long-term results showed that 12 months after the use of IES in patients with stage I gonarthrosis no relapse was noted, with stage II relapse was 2.5 times less than with traditional treatment. Complications and adverse reactions from the use of interstitial electrical stimulation were not observed. Conclusions. The intensity of the pain syndrome with gonarthrosis largely depends on the degree of participation in the inflammatory reaction of the deterioration of blood microcirculation in the tissues adjacent to the joint, with their edema, the degree of development of hypoxia, acidosis and activation of free radical oxidation. IES contributes to the rapid elimination of pain by improving blood circulation of the subchondral bone tissue and surrounding tissues, eliminating the biomechanics of movements in the lower extremities and, in general, clinical manifestations. The positive effect of IES was generally achieved in 77% of cases.
Introduction. The International Classification of Functioning (ICF) has been proposed for a unified assessment of rehabilitation effectiveness. However, the practical application of the ICF has limitations due to the lack of research on the informativeness and criterion validity of its qualifiers. Objective. To determine the informativeness of the basic domain of the International Classification of Functioning for assessing the effectiveness of rehabilitation in patients with coronary artery disease (CAD). Materials and methods. A prospective, single-center study was conducted on patients with CAD (n=86) at the stage of medical rehabilitation. Tolerance to physical activity was assessed by the 6-minute walk test (6MWT) and the ICF domain b455 (qualifiers 0—4). The frequency of b455 transitions “before-after”, the consistency of b455 with functional classes by the 6MWT and the predictive validity of the change in b455 regarding the achievement of Δ6MWT ≥25 m based on ROC-analysis (AUC) for models: 6MWT, Δb455 and 6MWT+b455. Correlation selection of efficiency predictors was performed based on the results of discriminant analysis. Results. The average TSHH distance increased from 345.1 to 384.0 m (average increase of 38.8 m); clinically significant improvement (ΔTSHH ≥25 m) was achieved in 63/86 (73.3%) people. According to the ICF, a one-step improvement in the b455 qualifier (Δb455=−1) was verified in 24/86 (27.9%) patients, and no improvement was observed in 62/86 (72.1%) patients. The correlation model based on Δb455 for detecting ΔTSH ≥25 m had extremely poor discrimination ability (AUC=0.542) compared to the model based on TSH (AUC=0.844), and the combined model (TSH+b455) did not improve the concordance index (AUC=0.844). Discussion. The identified discrepancy between the continuous dynamics of TSHH and the categorical assessment of b455 is due to the non-linearity and significant intervals of the reference points of the ICF qualifiers. An additional source of limitations is the absence of natural clinical thresholds in the ICF and the intersection of the boundaries of functional classes based on TSHH with the thresholds of the qualifiers (25 and 50%), which means that the same values of TSHH can be interpreted as different categories of b455 and vice versa. The weak discriminatory ability of the C-statistic model for Δb455 and the lack of an increase in the sensitivity of its combination in the TSH+b455 model show that determining physical activity tolerance based on the b455 domain does not add predictive information for an objective assessment of the effectiveness of medical rehabilitation. Conclusions. The ICF domain b455 is an element of a standardized description of functioning in patients with IHD, but it has poor criterion validity and demonstrates low sensitivity to clinically significant effects of rehabilitation in patients with IHD. It is preferable to use continuous linear qualifiers of basic indicators of physical activity tolerance to assess the effectiveness of rehabilitation.
Lactate, as the end product of anaerobic glycolysis, serves as a crucial marker of impaired tissue oxygenation and metabolic imbalance. Measuring its concentration in capillary blood is considered the gold standard for diagnosing lactic acidosis. In this study, lactate levels were determined in capillary blood using a rapid analyzer, which is a validated and convenient screening method for outpatient practice. The article presents a comparative assessment of lactate levels in two main types of microcirculatory dysfunction—spastic and spastic-atonic—in the context of lactic acidosis with an increase in blood lactic acid levels to 5 mmol/L, type A (associated with hypoperfusion and hypoxia) and type B (developing without global tissue hypoxia). The pathophysiological mechanisms, etiological factors, diagnostic criteria, and clinical features of each type are discussed, which is essential for selecting appropriate therapeutic strategies and assessing patient prognosis.
Book review: M.A. Khan, A.N. Razumov, I.V. Pogonchenkova, M.S. Petrova (and others). Children’s balneology: a guide for doctors. Moscow: GEOTAR-Media, 2024.
BACKGRAUND:Rehabilitation of patients with vertebrogenic muscular-tonic and radicular syndromes allows not only to get rid of pain, but also to return a person's ability to move, restore working capacity and significantly improve the quality of life, minimizing the risk of future exacerbations. AIMS:Development of scientifically based approaches to comprehensive rehabilitation of patients with vertebrogenic muscular-tonic and radicular syndromes aimed at restoring lost functions, reducing pain syndrome and returning patients with DDZP to active everyday life. MATERIAL AND METHODS:A total of 89 patients with vertebrogenic muscular-tonic and radicular syndromes with dorsopathy were examined. The average age and duration of the disease in patients were 52.1±7.34 years and 5.0±1.12 years, respectively. The dynamics of the clinical and objective state of patients with DDZP was assessed using various treatment regimens. Statistical processing of the study results was carried out using the Statistica 10.0 software package. Differences were considered significant at p<0.05. RESULTS:The results of the study demonstrate a significant improvement in the clinical and objective condition of patients with DDD when using various treatment regimens, especially when using therapy according to regimens III and IV. Evaluation of the dynamics of complaints showed that treatment according to these regimens is more effective than according to regimen I. Objective indicators, which include radiographic signs of scoliosis and MRI data, also indicate positive dynamics when using therapy regimens III and IV. In most patients who received therapy according to these regimens, signs of disc deformation disappeared. The identified improvements in ENMG signs during therapy according to III and IV regimens show a decrease in radicular and neuromuscular disorders. CONCLUSIONS:In the rehabilitation of patients with vertebrogenic muscular-tonic and radicular syndromes, the most effective treatment method is courses of manual therapy and acupuncture.
BACKGROUND:In recent years, special attention has been paid to the role of endotoxemia in the pathogenesis of chronic inflammatory processes and vascular complications of type 1 diabetes mellitus (DM1) - increased levels of circulating bacterial lipopolysaccharide (LPS). Endotoxemia occurs due to increased permeability of the intestinal barrier ("leaky gut syndrome") and/or decreased activity of its elimination systems. Correction of endotoxemia is a promising direction in the complex therapy of DM1. Traditional approaches include strict glycemic control and the use of certain pharmacological agents, however, the search for effective non-pharmacological methods, such as the use of natural mineral waters, remains relevant. Despite the theoretical background, data on the effect of a course of mineral water intake on markers of endotoxemia and systemic inflammation in patients with DM1 are extremely limited. AIMS:to evaluate the effect of mineral waters on the state of LPS-binding systems, the level of circulating lipopolysaccharide and markers of inflammation in patients with type 1 diabetes mellitus. MATERIAL AND METHODS:The study included 53 patients with a verified diagnosis of type 1 diabetes mellitus. The intervention group (n=25), in addition to standard DM1 therapy, received non-carbonated therapeutic table mineral water "Krymskaya mineralnaya" produced by JSC "Beer and Alcohol Plant "Crimea" for 150-200 ml 3 r/d. The second group was a control group, and consisted of 28 patients who were comparable in gender and age to the experimental group. ELISA kits were used to determine the level of C-reactive protein (CRP), interleukin-6 (IL-6), zonulin, lipopolysaccharide (LPS), lipopolysaccharide-binding protein (LBP), and low-density lipoproteins (LDL), including apolipoprotein B-100 (apoB-100) manufactured by Cloud Clone Corp. (Wuhan, Hubei, China). RESULTS:In patients of group 1, after the use of mineral waters, a significant decrease in circulating LPS (p=0.029) and apoB-100 (p=0.002) was detected, as well as a statistically significant increase in LBP (p=0.009). There were no significant changes in the studied indicators in the control group. CONCLUSIONS:The study demonstrates that a 30-day course of taking "Krymskaya" mineral water in addition to standard insulin therapy in patients with type 1 diabetes mellitus leads to a statistically significant decrease in the level of circulating lipopolysaccharide (LPS), a key trigger of endotoxemia and chronic inflammation. The results obtained justify the expediency of further studying the use of mineral waters, in particular bicarbonate-chloride-sodium, as a component of complex non-pharmacological therapy aimed at correcting endotoxemia and improving the metabolic profile in patients with type 1 diabetes mellitus.
BACKGRAUND:The investigation of potential treatment methods for post-COVID syndrome with neurological manifestations within the framework of randomized controlled trials remains one of the priority tasks. OBJECTIVE:To compare the effects of pharmacotherapy alone versus pharmacotherapy combined with transcranial electrical stimulation on neurological status measures and plasma levels of pro-inflammatory cytokines in patients with post-COVID syndrome. MATERIAL AND METHODS:The study included 150 patients with PCS and randomized them into 2 groups (75 patients each): the main group received transcranial electrical stimulation (TES) in addition to monopharmacotherapy, the comparison group received monopharmacotherapy only. The effectiveness of the treatment was analyzed using the MFI-20, MoCa, CGI-S scales and plasma levels of TNF-α, IL-1β, IL-6. RESULTS:The study included 150 patients with post-COVID syndrome presenting neurological symptoms, who were randomized into two groups (75 patients each): the main group received transcranial electrical stimulation in combination with pharmacotherapy, while the comparison group received pharmacotherapy alone. In both groups, Cortexin was used as the pharmacotherapy. The effectiveness of the treatment was evaluated using the MFI-20, MoCA, and CGI-S scales, as well as plasma levels of TNF-α, IL-1β, and IL-6. CONCLUSION:The results of the study support considering transcranial electrical stimulation as an effective and pathogenetically justified component of complex therapy for post-COVID syndrome with neurological symptoms, accompanied by chronic fatigue and cognitive impairment.
Non-pharmacological intervention in mental diseases is of interest to researchers as an opportunity to reduce the number of side effects from psychopharmacotherapy. One of the central issues is the possibility of physically influencing brain wave activity in order to affect its functioning. For a long time, this issue remained unstudied. The situation has changed dramatically with the recent development of noninvasive brain stimulation techniques that open up new perspectives for neuroscience, allowing researchers to confirm their correlation theories for the first time by directly manipulating brain function through external influences. One of the methods of such exposure is transcranial electrical stimulation (tACS), a method of electrical stimulation of the brain in which currents act on the intact human scalp to directly interfere with the electrical activity of the brain. It is assumed that neural involvement and plasticity mediate the behavioral effects of tACS in patients with mental pathology. The purpose of this review was to study the current state of the problem, describe the latest developments in the field of tACS, and provide observations of the online and offline effects of tACS use in the treatment of mental disorders. To achieve this goal, we analyzed 180 publications In Russian and foreign libraries, descriptions of inventions related to electrotherapy, and reviewed the results of randomized controlled trials on this topic. Most of the described methods have a strong evidence base and might be included in guidelines for treatment of mental disorders in the near future.
Sleep disorders (short sleep duration, insomnia, obstructive sleep apnea and circadian rhythm disorders) negatively affect microcirculation, causing endothelial dysfunction, decreased capillary density, and increased inflammation. Nailfold capillaroscopy can detect structural changes in microvessels (tortuosity, avascular zones) and serves as an early marker of vascular impairment. The correction of sleep disorders (e.g., CPAP therapy, sleep schedule normalization) improves microcirculation, and capillaroscopy can be used to monitor treatment effectiveness.
Capillaroscopy is a non-invasive method for visualizing the microcirculatory system using modern digital equipment. This review presents the historical development of the method-from the first microscopic observations of nailfold capillaries in the 17th century to the creation of high-precision videocapillaroscopes. Special attention is paid to the clinical application of the method in rheumatology for diagnosing systemic sclerosis and the differential diagnosis of Raynaud's phenomenon. The prospects of using capillaroscopy in neurological practice for assessing microcirculatory disorders in migraine and neuropathies are discussed. The importance of standardizing the method according to EULAR recommendations and the integration of artificial intelligence technologies for automating the analysis of capillaroscopic images is emphasized. Capillaroscopy demonstrates potential as an effective diagnostic tool in various fields of medicine.
