In this article, we generalize the results a research study into natural healing resources in the Far East. The regions of the Russian Far East possess a significant and unique natural potential for comprehensive medical rehabilitation. The main therapeutic resources of the area, including its climate, mineral waters, and therapeutic muds, are characterized. Issues associated with the task of integrated use of natural and physical resources in effective spa treatment and comprehensive rehabilitation are discussed. The major action mechanisms of natural therapeutic factors widely used in spa treatment are outlined, and the possibilities of their integration with the system of medical rehabilitation are substantiated.

The question of enhancing treatment effectiveness in managing respiratory diseases based on physiotherapeutic methods remains highly relevant. We consider the possibility of using pulsed low-frequency electrostatic massage therapy in the rehabilitation treatment of patients with chronic obstructive heart disease, bronchial asthma, pneumonia, and cystic fibrosis. The biological action and therapeutic effects of low-frequency electrostatic therapy are presented. Effects of low-frequency electrostatic therapy on muscle tone, as well as its decongestion, trophic, and regenerative action, are demonstrated. The mechanisms of pathogenetic action in respiratory pathologies require further research and elucidation.

Aim. To assess the prospects for the use of mineral waters and therapeutic muds (peloids) of the Sakhalin region for treatment and prophylactic purposes on the basis of their balneological properties.

Materials and methods. The results of balneological analyses of mineral waters and therapeutic muds of the island areas of the Sakhalin region and regulatory documents were used.

Results. The mineral waters and therapeutic muds of the Sakhalin region as its major therapeutic resources are characterized. The main groups of mineral waters for internal and external use include siliceous thermal, iodobromic, arsenic, and boric waters. It is noted that unique deposits of Sakhalin-type mineral waters, such as acidic waters with a high content of metals, petroleum products, and organic substances, require additional research. The Sakhalin region is rich in all available types of therapeutic muds– silt sulfide, mound, peat, and sapropel.

Conclusion. The Sakhalin region possesses a wide variety of balneological resources for health resort treatment and rehabilitation. Among them are the deposits of mineral waters and therapeutic muds that are promising for research and use in medical and wellness organizations.

Aim. To evaluate the efficacy of functional electrical stimulation of the lower extremities in stroke patients at different stages of motor rehabilitation.

Materials and methods. The study involved 80 patients with motor disorders after stroke. The studied treatment methods included passive and passive-active functional electrical stimulation (FES) in combination with the THERATrainer Tigo and active FES (neuro-orthosis) WalkAide.

Results. The analysis of motor status indicators, namely the Berg Balance Scale, 6-minute walk test, and dynamic walking index showed the maximum efficacy of active FES with biofeedback.

Conclusion. When prescribing and selecting a method of electrical stimulation, preference in neurorehabilitation should be given to methods of passive-active and active functional stimulation.

Aim. To assess the content of CO and COHb in exhaled air and the level of blood pressure (BP) in the working-age population of Yuzhno-Sakhalinsk when using various means of nicotine delivery.

Materials and methods. The study participants (n = 503) were surveyed using a questionnaire. The BP and oxygen saturation parameters were assessed. The content of CO and COHb content in exhaled air was measured using a smokerlyzer. Statistical processing was performed using nonparametric methods.

Results. The study group was dominated by males (58.3%). A high incidence of smoking was observed among females, with up to 42% in the general group and 48.8% in the group of consumers of alternative nicotine delivery systems (ANDS). A correlation between the content of CO and COHb and the smoking experience of more than 10 years was established, regardless of the means of nicotine delivery. Arterial hypertension was registered among 39.8% of the surveyed participants, with a higher frequency in cigarette smokers (28.8%, p = 0.02). This was associated with a greater proportion of individuals (62%) with a long smoking experience of more than 10 years (p = 0.003). A weak direct correlation was established between an increase in blood pressure and the content of CO and COHb (p < 0.001).

Conclusion. The share of females as active consumers of tobacco products has grown, particularly in the form of ANDS. Among smokers, the average high level of CO and COHb prevails, which correlates with the smoking experience of more than 10 years and does not depend on the means of nicotine delivery. A direct relationship between the intensity of smoking and the risk of hypertension was established.

Aim. To study the efficacy of personalized combined rehabilitation of PCS patients in the setting of a day hospital.

Materials and methods. The study involved 68 patients with PCS (49 women and 19 men) aged from 36 to 76 years. Bronchial asthma (BA) was detected in 26 patients, chronic obstructive pulmonary disease (COPD)– in 9 patients, and stage II hypertension– in 12 patients. Depending on severity of PCS, the treatment program included drug therapy and physiotherapeutic treatment. The rehabilitation course lasted for 14 days. The efficacy of medical rehabilitation was assessed by the dynamics of clinical and functional indicators.

Results. After the rehabilitation course, asthenic syndrome decreased in all patients. The majority of patients reported improvement in dyspnea according to the mMRC scale. In COPD patients, the CAT test score decreased by 26%. After rehabilitation, the asthma patients showed a decrease in the ACQ test score by 45%, with the peakflowmetry indicators having improved. Improvements in spirometry and peripheral oxygen saturation of capillary blood were recorded.

Conclusion. Personalized medical rehabilitation of patients after coronavirus infection can reduce the severity of PCS signs. The rehabilitation methods used contributed to the restoration of external respiratory function, stabilization of the patients’ emotional state, reduction of shortness of breath, hypoxemia, and other impaired functions in patients after COVID-19.

Aim. To study the indicators of external respiration function in older patients after coronavirus pneumonia (COVID-19) with the purpose of creating personalized rehabilitation programs.

Materials and methods. A study of respiratory function after coronavirus pneumonia (COVID-19) was conducted in 109 patients with the average age of 63.7 ± 2.2 (51.3% men and 48.7% women) and the lung damage of more than 25%.

Results. The patients after coronavirus pneumonia (COVID-19) show a decrease in respiratory function indicators, such as VC, FVC, FEV₁, and SPO₂, as well as an increased Tiffeneau –Pinelli index.

Conclusion. Timely detection of respiratory disorders in patients after COVID-19 pneumonia allows timely diagnosis of respiratory failures and selection of adequate rehabilitation measures.

In this article, we discuss the current state and future directions in the field of forensic genetics. The DNA analysis of biological traces found at a crime scene, which was first used in a criminal investigation in 1987, did revolutionize forensic science. Over the past three decades, significant advances have been made in the recognition capacity, speed, and sensitivity of DNA profiling methods, as well as in their capability of typing increasingly complex patterns. Creation of DNA databases of criminals and crime scenes, as well as population allele frequencies, allows suspects to be identified from crime scene samples and DNA evidence to be statistically processed to verify its reliability. At present, it has become possible to identify even single cells left at a crime scene and to successfully analyze ancient human remains. Forensic DNA profiling can be used to identify not only individuals known to the investigating authorities. Experts are increasingly applying new genetic markers that can expand the scope of DNA profiling methods. Modern developments enable extraction of new types of forensically significant information from biological traces, e.g., using molecular approaches to searching for individuals previously unknown to investigators. New methods have been proposed to identify the relationship between the donors of forensic samples and the crimes committed. Modern advances in the decoding of the human genome, as well as the availability of genome-wide analysis and sequencing techniques, pave the way for new forensic DNA tools capable of enhancing the quality of forensic science in the near future.

Aim. To determine the role of personalized approaches in the rehabilitation of patients with neurogenic dysphagia after acute disorders of cerebral circulation (ADCC) in the early recovery period.

Materials and methods. The study included 97 patients (53 men and 44 women with the mean age of 69.5) in the early recovery period after ADСС. All the patients were at the second stage of medical rehabilitation. The treatment program included the following methods of logopedic rehabilitation: disinhibition of the act of swallowing; stimulation of the sensitivity of the mucous membranes of the oral cavity; recovery of respiratory and speech functions; selection of the consistency of liquid and solid foods to ensure the safety of swallowing during feeding; selection of the feeding method and appropriate portions to facilitate the patient’s eating.

Results. When developing a personalized program of logopedic rehabilitation, the following aspects were considered: the severity of swallowing dysfunctions; the primary speech defect; patient compliance; the degree of cognitive dysfunctions; motivation for recovery.

Conclusion. The application of logopedic rehabilitation methods in combination with specialized multidisciplinary care based on personalized approaches can significantly improve patients’ quality of life and reduce the risk of undesired complications.

Aim. To evaluate the efficacy of a combined rehabilitation program for infants with perinatal lesions of the central nervous system in the form of hypoxic-ischemic encephalopathy (HIE).

Materials and methods. In total, 173 six-month-old children who underwent hypoxia were included in the observational study. The rehabilitation program included medical massage and hydrokinesotherapy; myostimulation of the muscles of the back and limbs; dry immersion method; treatments on a Grosso simulator; ergotherapy; therapy with an elastic pseudo-boiling layer; speech therapy massage. The Griffith mental development scale was used to assess the psychomotor development of infants.

Results. Following a course of combined rehabilitation, a positive dynamic in improving functional disorders in children of the first year of life who underwent perinatal HIE was revealed. This effect was associated with improvements in motor and sensory functions, indicators of speech development and understanding speech, emotions and communication, thinking and play activity. A reduction in the backlog of psychomotor development by 1–2 checkup periods and a reduction in the risk of obtaining the status of a disabled child by 12 months was established.

Conclusion. Combined programs of long-term rehabilitation for infants with perinatal lesions of the central nervous system were confirmed to be effective due to the pos itive dynamics of functional activity indicators, acceleration of the formation of life support skills, and a threefold reduction in the level of disability.

Aim. To study the indicators and regional features of circulatory disease morbidity among the able-bodied population in the Far Eastern Federal District for the 2012–2021 period.

Material and methods. A descriptive statistical study was conducted. The indicators of incidence and prevalence rates of circulatory system diseases, including ischemic heart diseases and cerebrovascular diseases, were calculated according to the data published by the Russian Research Institute of Health. To assess the statistical significance of differences in the incidence rate in 2020 and 2021 relative to the 2012–2019 period, a 95% CI for the average incidence rate in 2012–2019 was used by generating repeated samples. Differences in the incidence and prevalence rates in 2020 and 2021 above the upper or below the lower CI boundary for the average values in 2012–2019 were considered statistically significant.

Results. An analysis of the incidence and prevalence rates of circulatory system diseases among the working-age population in the Far Eastern Federal District in 2012–2021 was carried out. The obtained data are characterized by a significant variability and heterogeneity of indicators, showing significant differences from the all-Russian data for the 2012–2019 period. Changes in the incidence and prevalence rates of circulatory system diseases in the Far Eastern Federal District during the spread of COVID-19 in 2020–2021 were found to be multidirectional. In general, the statistically significant increase in the incidence of coronary heart disease in the Far Eastern Federal District in 2020 and 2021 is largely associated with the growth of indicators in the Khabarovsk Krai.

Conclusions. The obtained characteristics of the incidence and prevalence rates of circulatory system diseases, including ischemic heart diseases and cerebrovascular diseases, indicate the presence of pronounced regional characteristics. The revealed multiple differences in the morbidity rates in the subjects of the Far Eastern Federal District require further research to determine their priority and significance for monitoring the health of the population.

Aim. Search for new effective methods of physical rehabilitation for patients with ischemic stroke.

Materials and methods. In total, 60 ischemic stroke patients aged from 51 to 80 years in the acute period were included in the rehabilitation program. All patients showed motor and speech disorders, problems with self-care and mobility, and reduced quality of life indicators. The program of early rehabilitation included the combination of reflexotherapy (RT) and differentiated choice of exercise therapy (ET).

Results. The comparative analysis of the results of three therapeutic programs for rehabilitation of patients with acute cerebral circulation disorders (ACCD) in the acute period showed the high efficacy of a combined use of RT and ET with a differentiated approach to method selection.

Conclusions. The combined application of neurorehabilitation methods for ischemic stroke patients has confirmed its high efficacy. The developed rehabilitation programs may improve the quality of life of patients after acute cerebral circulation disorders and increase their independence in everyday life.

This paper presents clinical cases of diabetic retinopathy (DR) progression in pregnant women with type 1 diabetes. In preproliferative DR, the formation of focal macular edema in both eyes with nonperfusion areas of perimacular localization was observed. Both eyes were subjected to laser coagulation of the retina. After one month, a regression of macular edema in the left eye and hemorrhagic phenomena in both eyes was established with the emergence of new nonperfusion zones. DR progression during pregnancy and in the postpartum period is determined by a number of factors, including diabetes mellitus compensation, retinopathy stabilization, and the presence of concomitant pathologies. In the aggressive course of proliferative DR, local traction retinal detachment and partial hemophthalmos of the left eye were revealed. In this case, three stages of panretinal laser coagulation of both eyes and endovitreal intervention with silicone tamponade on the left eye were performed. At 28 weeks of gestation, progression of retinal neovascularization was observed in the right eye, extensive areas of nonperfusion in the posterior pole. The areas of laser coagulation of the retina were compacted in the right eye.

Aim. To identify trends in the primary morbidity of children and adolescents in the Far Eastern Federal District.

Materials and methods. A retrospective analytical study of the dynamics of primary morbidity in children and adolescents by disease class was conducted.

Results. Among the children population, a very high and high stability of the decrease in morbidity rates was established (R = -0.714– (-1.0)) for all classes of diseases. Among the adolescent population, a weak stability in the decrease in morbidity rates was characteristic of VII Diseases of the eye and adnexa (R = -0.262) and X Respiratory diseases (R = -0.262); a moderate stability of IV Diseases of the endocrine system, nutritional disorders, and metabolic disorders (R = -0.333); a moderate stability of IX Diseases of the circulatory system (R = -0.623); and a high stability among all other classes (R= -0.738 – (-0.928)). In the older age group, weak resistance to growth dynamics was determined in classes III Diseases of the blood, hematopoietic organs, and certain disorders involving the immune mechanism (R = 0.024) and VIII Diseases of the ear and mastoid process (R = 0.095).

Conclusion. The data obtained forms a basis for further research into regional risk factors that contribute to poor health of the population. The findings can also be used to predict the health status of younger generations.

Aim. To evaluate the efficacy and safety of various pharmacotherapy regimens in patients with urination disorders and type 2 diabetes mellitus during their preparation for surgery.

Materials and methods. In total, 130 people (56 men and 74 women) aged from 18 to 81 years (average 65 years) were included in the research. All the patients were on standardized hypoglycemic therapy in combination with alpha1-blockers (doxazosin, terazosin) and vitamin-like drugs (alpha-lipoic acid, levocarnitine). Patients were divided into male and female subgroups, as well as into age subgroups, including under 65 years and over 65 years. Tabular methods of assessing the clinical symptoms of urinary disorders were used, along with instrumental, laboratory, and statistical methods (Mann-Whitney test, Spearman rank correlation coefficient).

Results. The duration of therapy averaged 16± 2 months. The observation found that alpha1-blockers lead to a number of positive changes in the composition of carbohydrate metabolism, i.e., the level of serum glucose and insulin. In the general observation group, a significant decrease in blood glucose from 6.64 to 6.27 mmol/L, insulin from 18.07 to 14.03 mU/mL, and C-peptide from 3.67 to 2.98 ng/mL was detected. In the male subgroup, glucose levels decreased from 6.45 to 6.00 mmol/L, insulin from 18.92 to 13.99 mU/mL, and C-peptide from 3.76 to 2.97 ng/mL. In the female subgroup, blood glucose levels decreased from 6.98 to 6.77 mmol/L, insulin from 16.41 to 14.1 mU/mL, and C-peptide from 3.51 to 2.99 ng/mL. In the group of patients younger than 65 years of age, a decrease in glucose from 6.22 to 5.93 mmol/L, insulin from 17.87 to 14.36 mU/mL, and C-peptide from 3.49 to 3.01 ng/mL were also observed. In the group of patients older than 65 years of age, similar dynamics of the above parameters was established.

Conclusions. The data obtained suggest that alpha1-blockers in combination with vitamin-like drugs contribute to reducing the level of serum glucose, insulin, and C-peptide during a long-term (at least 1 year) therapy, which may be promising in the correction of metabolic disorders during preparation of patients for surgery.

Aim. To compare the effectiveness of two methods for indoor air disinfection, i.e., those based on ultraviolet (UV) irradiation sources of open and closed types.

Material and methods. Two main indoor air disinfection methods were compared – an open-type UV irradiator and a closed-type recirculating irradiator– based on the parameters of total bacterial contamination and the content of staphylococci and mold spores in the air (n = 30).

Results. UV disinfection using an open-type bactericidal lamp, both for 15 and 30 min, is significantly more effective than disinfection using a recirculating irradiator in terms of reducing the total bacterial contamination (p < 0.001), the content of viable staphylococci (p < 0.001 – p = 0.026), and mold spores (p < 0.001) in the air.

Conclusion. The use of bactericidal lamps of open type is a more effective tool for indoor air disinfection compared to the use of closed-type recirculating irradiators. It is advisable to use UV disinfection with open type sources in the absence of people followed by ventilation and subsequent use of recirculating irradiators in the presence of people.

Aim. To develop a software application for determining the rehabilitation potential and predicting the efficacy of rehabilitation treatment in elderly and senile patients with stage III discirculatory encephalopathy (DE).

Methods. A database of 185 patients with stage III DE was used. The indicators were assessed in dynamics, i.e., prior to the rehabilitation treatment and following three and six months from the onset of treatment course. The software application was developed using the Visual Basic for Applications (VBA) programming language built into Microsoft Excel 2010.

Results. The developed application comprises several first-order subroutines to assess the patient’s neurological status, memory, attention, functional activity in everyday life, as well as second-order subroutines to calculate the rehabilitation potential and predict the treatment efficacy. At the first stage, personal data and characteristics of neurological disorders, cognitive functions, scale of instrumental activities in daily living (IADL) are entered. At the second stage, the indicator of rehabilitation potential is automatically calculated and its qualitative assessment is provided. On the basis of prediction of the efficacy of the three complexes, further rehabilitation tactics for a particular patient is determined.

Conclusions. The developed software application is useful for automating and optimizing the work of rehabilitation neurologists.

The development of modern treatment technologies in oncology has reduced the mortality of children and adolescents from malignant neoplasms and hematological diseases. As a result, the issue of organizing rehabilitation care has become urgent. In this article, we describe the experience of organizing and developing pediatric rehabilitation in the oncology/hematology profile in Primorsky Krai for the period from 1995 to 2022. Various medical, psychological, social, and environmental aspects are outlined along with rehabilitation technologies used. The effectiveness of rehabilitation and the peculiarities of its implementation in children with oncological and hematological diseases are shown. The expediency of carrying out stages of rehabilitation in the region of residence of patients is substantiated.

This article describes the experience of training primary care physicians in the field of medical rehabilitation. The existing procedure for the arrangement of medical rehabilitation prescribes its rules and order of implementation in medical primary health care organizations both in outpatient and day patient settings. The Pacific State Medical University (PSMU) runs training programs for primary care physicians within the 31.05.01 educational program “General Medicine”, direction “02 Healthcare”. In accordance with the curriculum, a training program “Medical Rehabilitation” that includes both lectures and training sessions was developed. This program is aimed at forming the necessary competencies of future primary care physicians in implementing and monitoring the effectiveness of the patient’s medical rehabilitation. Training is carried out at the facilities of the PSMU Institute of Clinical Neurology and Rehabilitation Medicine by specialists having experience in medical rehabilitation and having completed the program “Modern aspects of specialist training in the field of physical and rehabilitation medicine”.

Aim. Тo train future specialists to effectively apply the methods of pathophysiological research (ultrasound diagnostics) in solving situational problems within the course of clinical pathophysiology.

Materials and methods. The 2^nd and 3^rd year students were trained to use stationary and portable ultrasound machines Phillips CX50 and Chison Sonotouch 80. The students were trained to master ultrasound B and M modes, Doppler ultrasonography, as well as elastography of the most common diseases of the endocrine, digestive, and urinary systems. At the first stage, students worked in tandem with the lecture, observing the process of sensor manipulation. At the second stage, each student conducted a study on his or her fellow student.

Results. When conducting ultrasound scanning of the hepatoduodenal zone and kidneys, 65% and 55% of students, respectively, failed to obtain an optimal image and to measure anatomical structures during the assigned time interval. Echocardioscopy was established to be the most difficult method to master when solving situational problems within the topic of “Impaired Systemic Circulation”. This task was successfully performed only by 20% of the students. The optimal student-lecturer ratio was established to be 6:1.

Conclusion. The use of new ultrasound technologies in the training process is important for forming students’ professional competencies and increasing their motivation.