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. 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. 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. 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. 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.

Conservative treatment of patients with scoliosis and kyphoscoliotic spinal deformities is the most affordable and safe method of treatment. Non-surgical treatment of such patients takes a long period of time and includes the complex use of various factors, including physiotherapy, therapeutic gymnastics, swimming, massage, manual therapy, and the use of various types of functional corrective corsets. They are used on a regular basis until the bone growth zones are closed and/or deformity is sufficiently corrected. To evaluate the prospects of using traction therapy in patients with significant static spinal deformities using a functionally corrective corset to facilitate the period of adaptation to regular wearing of a functionally corrective corset, and to reduce pain and discomfort from pressure exerted by the pressure zones of the corset; to increase spinal mobility. The publication describes the experience of using traction therapy in 52 adolescent patients undergoing inpatient conservative treatment for severe static spinal deformities at the stage of using a functional corrective corset. As a result of the work, the following conclusions can be drawn: the use of traction therapy significantly reduces pain and discomfort associated with the use of a functionally corrective corset. There were no negative reactions or complications from the use of traction therapy. Traction therapy should be used in the complex conservative treatment of patients with scoliosis and kyphoscoliosis as an additional method at the stage of using functionally corrective corsets, including difficulties in adapting to corset treatment. Traction therapy can also be used to prepare a patient for an orthosis.

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.

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. 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. 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. 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. In the rehabilitation of patients with vertebrogenic muscular-tonic and radicular syndromes, the most effective treatment method is courses of manual therapy and acupuncture.

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. 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. 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). 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. 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.

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.

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.

To analyze the validity and informativeness of statistical methods of premature aging and predictors of the effectiveness of combined physiotherapy. The research was conducted on the basis of the Scientific and Clinical Center 1 of the Russian National Research Center named after BV. Petrovsky Academy with the participation of 40 patients (19 men and 21 women) aged from 20 to 90 years. After signing a voluntary informed consent to conduct a special study with the processing of their personal data, all patients underwent a comprehensive clinical, laboratory and functional examination, patients with moderate physical activity, reduced calorie intake and vitamin therapy received a physiotherapy complex 2 times a year, which included multimodal effects using the Alpha LED Ohu Light-Spa device, hyper-hypoxytherapy, pressotherapy, dry carbon dioxide baths. The preventive courses were repeated twice with an interval of 6 months. All studies were conducted before and 6, 12 and 18 months after the completion of each preventive course. Multiple linear regression analysis was used to identify the predictors. It was found that active longevity is determined by telomere length, inhibited by an increasing index of insulin resistance and a high concentration of malondialdehyde in the blood, although correlation adaptometry largely identified the index of insulin resistance and the coefficient of atherogenicity as predictors of premature aging. An analysis of the predictors of the effectiveness of combined physiotherapy associated with the dynamics of biological age showed that their role is mostly claimed by the insulin resistance index, atherogenicity coefficient, malondialdehyde; the index of systemic inflammation and the relative length of telomeres. It has been proven that insulin resistance, atherogenicity coefficient, and telomere length reduction are the leading predictors of premature aging, which emphasizes the importance of optimizing hormonal regulation of carbohydrate and lipid metabolism and, ultimately, energy supply for sanogenetic processes that characterize premature aging in patients. The analysis of dynamic processes in the application of combined physiotherapy has expanded the number of predictors of the effectiveness of inhibiting premature aging, apparently due to the polymodal therapeutic effect of factors of various physical nature.

Comparative analysis of the efficiency of the course use of non-drug technologies (physical exercises, psychocorrection, general air cryotherapy, general magnetic therapy, hypoxic-hyperoxytherapy, hydrogen therapy and their combinations) in the correction of stress resistance and manifestations of professional burnout in medical workers. The studies were conducted on the basis of the Federal State Budgetary Scientific Institution Russian Scientific Center of Surgery named after academician B.V. Petrovsky with the participation of 150 patients from among medical personnel aged 30 to 60 years. Using the simple fixed randomization method, all patients were divided into 6 groups: control (n=25), comparison groups 1-4 (n=25 each), and the main group (n=25). Patients in all groups received a course of physical exercises and psychological correction. For the control group, this type of correction was exhaustive. In comparison group 1, a course of general air cryotherapy was additionally carried out; comparison group 2 additionally received a course of general magnetic therapy procedures; comparison group 3 additionally received a course of hypoxic-hyperoxytherapy; comparison group 4 additionally received a course of hydrogen therapy; in the main group, patients received a course of complex exposure to therapeutic physical factors. The study design provided for a double examination of patients in all groups using the MBI questionnaire and the DASS and PSM-25 scales. Conducting a course of correction of the state of professional burnout made it possible to establish that its effectiveness was largely determined by the type of physical factor used. Less pronounced changes were noted in the control group with the use of physical exercises and psychological correction. Additional course application of therapeutic physical factors in the monofactorial impact mode (general air cryotherapy, general magnetic therapy, hypoxic-hyperoxytherapy and hydrogen therapy; respectively comparison groups 1-4) was accompanied by an increase in the positive dynamics of the assessed indicators by 12-23%. The complex use of all physiotherapeutic effects, implemented in the main group, caused the development of the most pronounced corrective effect. The use of non-drug technologies allows achieving high efficiency in the correction of stress resistance and manifestations of professional achievement in medical workers. The maximum corrective effect, manifested with the complex use of physical factors, is the result of the synergistic interaction of various physiotherapeutic technologies, implemented in the form of potentiation of sanogenetic mechanisms aimed at normalizing the psycho-emotional status of individuals with an extreme profile of service activity.

To assess the severity of phantom pain syndrome in patients with amputated limbs following mine blast injury using a course of bioacoustic correction. The study was conducted at Branch No. 2 of the A.A. Vishnevsky National Medical Research Center for Military-Mechanical Engineering of the Russian Ministry of Defense. 60 patients with phantom pain syndrome participated in the study. Using a simple fixed randomization method, all patients were divided into 2 groups: a control group (n=30) and an intervention group (n=30). The control group received only basic drug therapy (BMT) according to the protocol. Patients in the intervention group, in addition to BMT, received BAC procedures (10 25-minute sessions daily). The effectiveness of phantom pain syndrome therapy and concomitant psychophysiological status disorders was assessed based on the dynamics of the following parameters: neurological examination data, phantom pain syndrome severity, visual analog pain scale (VAS); DN4 questionnaire; Pain Detect questionnaire; McGill Pain Questionnaire short form; Epworth sleep quality questionnaire. The treatment regimen in the control and study groups demonstrated significant positive dynamics across all pain assessment scales. However, a comparative analysis of the obtained results revealed a significant advantage of additional BAC therapy. The use of this non-drug technology contributed to a significant reduction in the severity of neuropathic pain and the proportion of patients with abnormal sleepiness. The use of the BAC technique promotes a more pronounced analgesic effect, which is achieved through adaptive reorganization of thalamocortical detectors in the affected limbs by modulating neuroplasticity processes.