Treatment of bone pathologies and severe fractures is an urgent healthcare problem that requires effective and innovative approaches to ensure complete restoration of bone tissue and improve the quality of life of patients. Traditional methods of bone tissue regeneration, such as transplantation of bone autografts and allografts, have a number of limitations, including a shortage of donor material and the risk of complications. In this regard, it is of interest to use osteoinductive materials that promote accelerated healing and restoration of bone structures. The article discusses modern osteoinductive materials, their types, mechanisms of action and clinical application. Particular attention is paid to their role in the treatment of complex fractures and bone pathologies, such as osteoporosis and osteomyelitis. Data from clinical studies have been analyzed demonstrating the high effectiveness of osteoinductive materials in the treatment of complex fractures, osteomyelitis, osteonecrosis and other bone pathologies. Benefits of using these materials include accelerated healing, reduced risk of complications, minimized need for autografts, and improved integration with bone tissue.

Sarcopenia is a pathological condition found in elderly patients that impairs their quality of life and increases the risks of disability. Objective. To assess the functional state of the cardiovascular system in elderly patients with sarcopenia. Materials and methods. The main group included patients with sarcopenia diagnosed according to the criteria of EWGSOP-2 (European Working Group on Sarcopenia in Older People 2) supplemented by the screening questionnaire SARC-F (Strength, Assistance with walking, Rising from a chair, Climbing stairs and Falls). The state of the cardiovascular system was assessed based on the results of ECG, echocardiography and duplex examination of vessels at rest. Results. The features of the functional state of the cardiovascular system in sarcopenia were determined, which manifested themselves in the form of impaired repolarization processes and arrhythmic dysfunction, lower parameters of cerebral perfusion, and the presence of an early sign of latent heart failure. Conclusions. The treatment of cardiovascular diseases in the elderly population requires special attention due to the polymorbidity of patients and sarcopenia should be taken into account, among other things, as a factor affecting the state of the cardiovascular system.

The prevention of visual impairment in people with uncontrolled use of computers and electronic gadgets, the study of clinical manifestations of their negative effects on the body and, especially, on the organ of vision, is an urgent problem of modern medicine. The purpose of the work was to substantiate the need for the prevention and treatment of visual impairment in adolescents with uncontrolled smartphone use. The article describes the negative effects of irrational use of computer gadgets on users' eyesight, clinical manifestations of computer vision syndrome and its component – dry eye syndrome, and describes in detail approaches to the prevention and treatment of visual impairment associated with uncontrolled use of computers and electronic gadgets. The results of our own research revealed the general prevalence of problematic smartphone use in 15.2% of adolescents, its more frequent occurrence in girls (21.2%) than boys (5.0%), and a higher prevalence of vision problems (computer vision syndrome, dry eye syndrome) in smartphone-dependent adolescents compared with independent ones. The authors conclude that the approach to the prevention and treatment of pathological changes in the body (primarily from the organ of vision) caused by the irrational use of modern gadgets should be comprehensive, including recommendations for optimizing the regime and working conditions with electronic computer devices, as well as the use of various ophthalmological measures in a complex of preventive and therapeutic measures funds.

The article analyzes literature data (15 Russian and 45 foreign literature sources) on the issue of rehabilitation of patients after anterior cruciate ligament (ACL) arthroscopic reconstruction. The need to develop effective methods for rehabilitation after ACL arthroscopic surgery is due to the need to quickly improve the patient's quality of life and reduce the risk of re-injury and possible complications. The key rehabilitation period after surgery is the first six months. The main goal of rehabilitation measures after ACL arthroscopic reconstruction is to restore healthy biomechanics in the knee joint, eliminate the negative consequences of injury and surgery, and return to the previous activity level. The effectiveness of medical rehabilitation after ACL surgical reconstruction depends on the correct loading at each stage of rehabilitation, as well as on the quality of exercise performance. Each stage requires an individual approach to the patient, an assessment of the restoration of the strength of the injured limb and careful attitude to the quality of the exercises. Different periods of postoperative joint healing, the complexity of assessing the internal state of the joint and the action of mechanical forces inside it, do not allow us to focus only on the terms of rehabilitation protocols and numerical criteria. It is necessary to pay attention to the quality of exercise performance and biomechanics in the process of basic daily activities

The article presents the results of a comparative analysis of clinical and anamnestic data and laboratory parameters in autoimmune liver diseases, depending on the combination with opisthorchiasis invasion. It has been determined that chronic opisthorchiasis has a negative impact on laboratory parameters and also complicates the diagnosis of autoimmune liver diseases, which leads to a late start of therapy and the development of irreversible complications.

Objective. To compare the effectiveness of two methods of local application of essential oils in complex rehabilitation programs for patients with lumbosacral dorsopathies. Materials and methods. The study involved 90 patients with lumbosacral dorsopathies who were divided into 3 groups: Group 1 (n=30; comparison group) – patients were given segmental massage with a 1% blend of oils (rosemary, cajaput and pearlberry diluted in 100 ml of base oil) recommended for dorsopathies; Group 2 (n=30; main) – patients were given biopuncture with this blend of oils; Group 3 (n=30; control) – patients were given biopuncture with sesame oil as a placebo. All patients also received standard therapy. Results. Local application of essential oils to reflexogenic points in the main group was shown to reduce pain syndrome, improve the amplitude of movement in the lumbar spine, reduce anxiety, and increase tolerance to psychological stress in comparison with the segmental massage group (comparison group) and the control group.

A clinical case of a young patient with idiopathic pulmonary arterial hypertension (iPAH) is reviewed, showing the importance of timely escalation and modification of treatment tactics after each functional status assessment. The main goal of PAH therapy is to maintain a low-risk profile. Modern approaches to PAH therapy are based on a regular comprehensive assessment of the risk of mortality and disease progression in order to carry out timely escalation. Early administration of double/triple combination therapy is the key to improving the prognosis in patients with PAH. It is especially important to consider choosing a drug with a proven effect on the long-term prognosis, which can improve the treatment results of patients with PAH.

The article presents a brief review of the literature, as well as the results of our own observations and the results of surgical interventions in patients with a rare and insufficiently studied disease – Eagle’s syndrome or stylohyoid syndrome (SHS). According to modern concepts, the disease is quite rare (in 4% of the population) and is accompanied by chronic orofacial pain syndrome. There are certain difficulties in diagnosing this disease and determining the optimal treatment tactics. The article presents the results of successful surgical treatment of 7 patients with SHS, discusses indications for surgical treatment, and reflects aspects of diagnosis and management of patients.

Aging is a process affecting various organ and tissue systems. The development of age-related changes occurs at the molecular, genetic, cellular, organ and organizational levels. At the population level, accelerated aging can manifest itself as an unfavorable upward dynamics of the incidence of age-associated diseases, an early manifestation of pathology. Рurpose. To study the features of the cellular composition of the blood depending on the sequence of manifestation of a number of diseases. Materials and methods. Statistical collections for 2015–2019 acted as materials, clinical blood test (cellular composition of blood) of 17 957 patients hospitalized in Saint-Petersburg City Hospital No 2 from 01.01.2015 to 31.12.2019 with the following diagnoses (ICD-10 codes) is also analyzed: E05, E10, E11, G20, H25, H40, I10, I10–I15, I20, M80–M81, N20–N23. Results. The analysis established a significant correlation with the priority of disease manifestation for only two indicators: lymphocyte count (r=-0.675; p=0.022) and red blood cells (r=-0.639; p=0.033). Correlation analysis demonstrated a significant association between age-specific incidence index (ASII) and absolute lymphocyte and erythrocyte counts. The sequence of manifestation of the considered diseases, compiled on the basis of ASII ranking, is closely related to the age characteristics of the cellular composition of the blood. Conclusion. Thus, features of the cellular composition of the blood were found depending on the manifestation of diseases. The identified patterns corresponding to age-related changes will allow the development of new approaches in the study of the pathophysiological gerontological continuum.

SARS-CoV-2 coronavirus has the ability to affect the nervous system and cause various neurologic disorders, both in the acute period and after recovery or during the development of post-coital syndrome. Among the nosologic forms of peripheral nervous system lesions after a new coronavirus infection are mononeuropathies, multineuropathies, multiple neuropathies, and noninflammatory polyneuropathies. Both the debut of neurological disease with varying degrees of severity of symptoms, including disabling, and progression of the existing pathology, requiring a change in treatment tactics, are possible. The article presents the results of a prospective study evaluating the effect of COVID-19 on the peripheral nervous system. Recommendations for physicians on the management of patients with peripheral nervous system damage against the background of coronavirus infection developed on the basis of the obtained information are presented.