Positive Dynamics Research Articles

The basic aspects of social support of parents bringing up disabled children

The article presents analysis of National Federal and Regional legislation regarding social support of parents bringing up disabled children as exemplified by Moscow and Moscow Oblast. It is concluded that despite active legislative activity of the state concerning amelioration of quality of life and income levels of families bringing up disabled children. Consequently, there is certain positive dynamics trend. However, caring from the state and society is not yet at higher level due to both negative nature of various economic processes and tense foreign-policy situation that does not allow state and regional authorities to fully focus on acceptable legislative support of families bringing up disabled child.

Myocardial function in cardiac resynchronization therapy and factors significant for its improvement

Aim. To analyze myocardial work in cardiac resynchronization therapy (CRT) and to determine the factors influence its positive dynamics. Materials and methods. Global longitudinal strain (GLS) and myocardial work parameters including global constructive work (GCW), global wasted work (GWW), global work index (GWI) and global work efficiency (GWE) were analyzed in addition to standard transthoracic echocardiography (TTE) in 60 patients (mean age 61±10 years, 36 male) with left bundle branch block (LBBB), chronic heart failure (HF 2 [2; 3] FC (NYHA), decreased left ventricular ejection fraction (LF EF=28 [23; 31] %) before and 6 months after CRT implantation.. In all patients the segments with maximum and minimum WI value were determined and the difference in segments with maximal and minimal WI (Max-Min WI), as the indicator of myocardial work asymmetry was calculated. Results. CRT led to reverse cardiac remodeling in 44 (73.3%) patients; clinical stabilization without positive TTE dynamics – in 11 (18.3%) patients, worsening or death – in 5 (8.3%) patients. In both groups of reverse remodeling and clinical stabilization CRT resulted in GWW reduction and thus GWE and GWI enhancement. However, the decrease in GWW in these patients is not accompanied by an increase in GCW and GLS, in contrast to patients with reverse remodeling, who developed statistically significant change in GCW and GLS during CRT. Patients with worsening or death were characterized by a minimal decrease in GWW in CRT (62,0 [9,7; 133,7] vs 149,5 [92.8; 206,2] mmHg% in patients with reverse remodeling and clinical stabilization; p=0,035). Max-Min WI turned out to be directly related to the LV EF change in CRT (rxy=0,336; p=0,017) that makes this value to be one of possible predictors of reverse remodeling during CRT. Conclusion. Wasted myocardial work can serve a contractile reserve, which represent a target for CRT. Its mobilization and decrease can lead to stable clinical status in patients even in the absence of reverse myocardial remodeling.

Steroid-sparing effect of levilimab in rheumatoid arthritis in real practice

Aim. Evaluation in real clinical practice steroid-sparing effect of levilimab therapy in patients with highly and moderately active rheumatoid arthritis (RA). Materials and methods. Retrospective observational study (1 year) held at the Republican Clinical Diagnostic Center for the period from November 2022 to July 2023. All patients received corticosteroids (CS) at the time of levilimab (LVL) administration. The assessment of the decrease in the dosage of CS was carried out at 12, 24 and 52 weeks from the start of LVL-therapy. Results. The analysis included 73 patients with RA (60 women and 13 men, average age – 56.3±10.5 years), the average dose of CS at the time of LVL initiation was 5.7±2 mg/day with an average duration of CS intake of 87.5 months [7; 137]. Twenty patients included in the follow-up received CS at a dosage of ≥5 mg. Of the 73 patients, by the end of the study, it was possible to achieve a reduction in the dosage of CS in 22 (30.1%) patients, and complete elimination of CS in 36 patients (49.3%). Only 3 patients received CS at a dosage of ≥5 mg after 52 weeks. Against the background of taking LVL, patients showed a decrease in clinical and laboratory activity of RA according to the Disease Activity Score in 28 joints with C-reactive protein indices by 47.1% and Disease Activity Score in 28 joints with Erythrocyte Sedimentation Rate by 48.2%. The positive dynamics of laboratory parameters was noted – a decrease in the level of C-reactive protein by 90.5% and ESR by 72%. During the observation a favorable safety profile of LVL was noted. The most frequently reported adverse event was an increase in alanine aminotransferase and aspartate aminotransferase, recorded in 41 patients (56.1%). One adverse event met the criteria of severity 3 according to Common Terminology Criteria for Adverse Events version 5.0 – lung carcinoma with unspecified cell type, stage 1. Conclusion. Levilimab is a highly effective therapy option for patients with RA with a favorable tolerability and safety profile, against which an effective dose reduction and complete elimination of steroids is possible.

Development and application of a multicomponent film biocoating based on sodium carboxymethylcellulose to study the antibacterial activity of microflora in the oral fluid of patients with pemphigus vulgaris <i>in vitro</i>

BACKGROUND: A special place among dermatological diseases is occupied by dermatoses affecting the oral mucosa, in particular pemphigus vulgaris. Constant damage to the mucous membrane, combined with the presence of abundant microflora in the oral cavity, leads to rapid variability in the primary or pathognomonic manifestations of specific diseases, making them look similar. Erosion and ulcers in the oral cavity are very difficult to treat and are accompanied by severe pain. The role of the oral microflora in the development and progression of pemphigus vulgaris has not been fully studied, however, it is known that the microflora of patients differs significantly from that of healthy individuals. Today, much attention is paid to studying the composition, properties and role of the microflora of the oral mucosa in the manifestation and course of pemphigus vulgaris. AIM: determination of the most effective combination of a three-component film biocoating based on sodium carboxymethylcellulose for patients with pemphigus vulgaris, by assessing and comparatively in vitro comparison of quantitative and qualitative characteristics of the oral microflora, as well as local oral protective factors (lysozyme titer, phagocytosis index neutrophils and the level of the secretory fraction of immunoglobulin class A) MATERIALS AND METHODS: A cross-sectional single-center study was performed among patients with pemphigus vulgaris (n=12). Oral fluid was collected by washing (rinsing) 4.5 ml of physiological solution from the oral mucosa. Subsequently, in the laboratory, a series of serial dilutions were prepared, some of which were inoculated by quantitative sectoral sowing on media intended for the cultivation of aerobic and anaerobic microbes. Microbiological and immunological sensitivity to films with different concentrations of mometasone furoate (20–40–80 mg) and propolis (2.5–5–7.5–10%) was determined. RESULTS: The most pronounced antibacterial activity was observed in the following 2-component forms (gel film and propolis at a concentration of 7.5%; gel film and mometasone furoate in an amount of 20 mg) and in 3-component gel films (gel film, propolis at a concentration of 5% and mometasone furoate 20 mg). According to the results of a comparative quantitative assessment of local factors protecting the oral cavity in patients with pemphigus vulgaris, their positive dynamics, characterized by the restoration of immunodeficiency, were most influenced by the three-component composition, including a gel film, propolis 5% and mometasone furoate 80 mg. CONCLUSION: The three-component composition of the film biocoating based on carboxymethylcellulose significantly reduces the quantitative and improves the qualitative indicators of microorganisms in the oral cavity, thereby having a positive effect on the treatment process for patients with pemphigus vulgaris.

EVALUATION OF THE EFFECTIVNESS OF THE COMBINED ANTIBACTERIAL DRUG IN THE TREATMENT OF BACTERIAL DISEASES IN CALVES

In the context of the constantly increasing resistance of microorganisms to antibiotics, the study of combined antibacterial drugs is relevant, since, due to their synergistic action, they have the potential to reduce the probability of developing bacterial resistance, providing a more pronounced therapeutic effect. The high synergistic bactericidal effect of the drug «Riketron N» (injection solution) is ensured by its active ingredients – sodium sulfadimidine and trimethoprim, which block consecutive stages of tetrahydrofolic acid synthesis, essential for the growth of microorganisms. This allows it to be used for the treatment of diseases of the digestive, respiratory, genitourinary systems, skin and hooves, the pathogens of which are gram-positive and gram-negative bacteria, as well as Eimeria. The article presents the results of a clinical study on the effectiveness and safety of the drug «Riketron N» (injection solution), produced by LIVISTO S.A. de C.V. (Spain), in the treatment of cattle diseases, caused by pathogens sensitive to the drug's active ingredients. The study was conducted on Simmental calves, in which signs of inflammatory respiratory tract damage was detected. An analysis of anamnesis data, clinical-diagnostic examination, and microbiological examination of the selected nasal exudate confirmed a diagnosis of pasteurellosis in calves. Based on the analysis of anamnestic data, clinical-diagnostic examination and microbiological study of nasal discharges in sick calves, bronchopneumonia of bacterial etiology caused by Pasteurella multocida, Diplococcus pneumoniae, Staphylococcus aureus was diagnosed. In the vast majority of cases, the disease occurred as a monoinfection. Animals of the experimental group received the study drug intramuscularly for 5 days: on the first day - 1 ml of the drug per 10 kg of body weight, on the following days – 1 ml of the drug per 15 kg of body weight; the control group – healthy animals that didn’t receive treatment. Within a month from the beginning of the experiment, the clinical state condition of the calves was observed. Morphological and biochemical blood parameters of the blood of animals of both groups were examined before and on the 7th day after the treatment. Hematological tests were conducted using the automatic analyzer Mythic 18, while biochemical tests were carried out using the semi-automatic biochemical analyzer HumaLyzer 3000 and test kits from Human. The obtained results were analyzed statistically. The drug «Riketron N» (injection solution) demonstrated its effectiveness in the treatment of bronchopneumonia of bacterial etiology in calves caused by microorganisms sensitive to the drug’s active ingredients. In the animals of the experimental group, positive dynamics of clinical symptoms and normalization of morphological and biochemical blood parameters were observed after the end of the treatment course. When using the studied drug in the method of administration and dosage recommended by the manufacturer, no adverse reactions, hepatotoxic or nephrotoxic effects were detected.

Russian-made pharmpreparation semaglutide in the experience of de-intensification of diabetes mellitus treatment: A clinical case

The actual concept of type 2 diabetes mellitus (T2DM) treatment includes optimizing the management of metabolic health, primarily glycemia and body weight, as well as preventing the development of cardiovascular diseases (CVD), chronic kidney disease (CKD), and metabolically associated fatty liver disease (MAFLD). Reduction of fat mass contributes to stable compensation of carbohydrate and lipid metabolism, control of blood pressure and reduction of cardiovascular risk, CKD and MAFLD. Glucagonlike peptide-1 (GLP-1Ap) receptor agonists are a highly effective class of drugs for the treatment of patients with T2DM, both by increasing the effectiveness and safety of glycemic control, and by having additional positive effects on the cardiovascular system and body weight. Studies have revealed numerous positive pleiotropic effects of semaglutide, which allows for better management of type 2 diabetes. For the first time in 2019 The Russian clinical guidelines and Algorithms for specialized medical care for patients with diabetes mellitus included information on the proven priority treatment of T2DM with CVD of atherosclerotic origin with GLP-1Ar class drugs. The development of a domestically reproduced drug, Semavik®, has made it possible to increase the availability of semaglutide preparations in the Russian Federation and expand the possibilities of pathogenetically based therapy providing cardiometabolic and other pleiotropic benefits in patients with T2DM. This clinical example presents the results of the efficacy and safety of the Russian semaglutide Semavik® in a patient suffering from long–term uncompensated T2DM, morbid obesity and receiving insulin therapy. Against the background of the addition of domestic GLP-1Ar to therapy, significant positive dynamics of glycemia and other metabolic parameters, weight loss, and improvement in objective examination indicators were achieved. The appointment of a domestic semaglutide made it possible to de-intensify insulin therapy in the form of its cancellation. The use of domestic semaglutide shows and proves its effectiveness not only in achieving the target values of blood glucose levels, but also in reducing body weight and normalizing the lipid profile.

Formation of the motivational component of psychological readiness to study in middle school in schoolchildren with mental retardation

Introduction. The period of transition from elementary school to the basic stage of education is one of the most difficult and has some specific features in schoolchildren with mental retardation (MR) compared to those with normal mental development (NMD). The complete formation of the motivational component of psychological readiness to study in middle school in schoolchildren with MR should be regarded as one of the essential prerequisites for the successful course of this period, as well as for schoolchildren’s socialization and integration into the inclusive educational space at all subsequent education stages. The present study aims to experimentally investigate the efficiency of the formation of the motivational component of psychological readiness to study in middle school in schoolchildren with MR in the process of providing psychological support. Materials and methods. The study involved 302 younger adolescents who studied in 4 general education classes; 86 children out of 302 had MR. The motivational component as a systemic concept was investigated by the method of diagnostics of study motivation and emotional attitude toward studying in middle and senior school (developed by Spielberg, modified by A.D. Andreeva); conversation with schoolchildren «The 5th grade is ahead»; and the mathematical statistics method «Pearson's χ2 criterion». Results. The results of the summative experiment exposed differences in the formation level of the motivational component of psychological readiness to study in middle school and each of its components (cognitive activity, level of anger, level of anxiety, and structure of motivation for studying) of younger adolescents with MR and their peers with NMD, which were statistically significant (the most pronounced differences were noted in the level of anger: χ2emp. = 85.75; p ≤ 0.05), confirming that the examined components of motivational readiness for studying in the 5th grade in schoolchildren with MR were formed insufficiently. At the stage of the control experiment, statistically reliable positive shifts in the level of anger, anxiety, and study motivation of younger adolescents with MR were noted. The following results deserve special attention: KEYWORDS • the presence of reliable positive dynamics in the level of anger formation (the most pronounced «negative» component in the motivational readiness of schoolchildren with MR compared to their peers with NMD), χ2emp. = 7,454; р ≤ 0.05; • the presence of «high» and «above average» levels of study motivation in schoolchildren with MR at the control stage of the experiment, absent in the summative stage of the study, which was confirmed statistically (χ2emp. = 38.9; p ≤ 0.05); • the presence of more pronounced positive dynamics in the levels of anger, anxiety, and study motivation in younger adolescents with MR who attended the classes of an educational psychologist during the summer camp. Conclusion. Motivational readiness to study in the 5th grade in schoolchildren with MR is not sufficiently formed for their successful socialization and integration into an inclusive educational space. The work of an educational psychologist with pupils with MR in the stage of transition from primary to middle school aimed at forming motivational readiness for studying contributed to positive dynamics in the development of most of its components: the level of anger, the level of anxiety, and study motivation.

ВЛИЯНИЕ КОНСЕРВАТИВНОЙ ТЕРАПИИ ГЕМОРРОИДАЛЬНОЙ БОЛЕЗНИ НА СОСТОЯНИЕ СОСУДОВ ПАРОДОНТА

Relevance. Inflammatory periodontal diseases have a tendency towards annually increasing prevalence worldwide. Treatment does not always yield the desired result, and the emergence of antibiotic and antibacterial-resistant microorganism forms in patients necessitates the search for alternative means and methods that increase treatment effectiveness and provide stable remission of periodontal diseases. Aim of the study: to examine the microcirculation of periodontal tissues in patients with hemorrhoids during therapy with diosmin and hesperidin flavonoids (DHF). Materials and methods. The study included 62 patients (35–50 years old) with hemorrhoidal disease and chronic inflammatory periodontal disease. A coloproctologist prescribed systemic DHF according to clinical guidelines. Indicators were compared in two stages: Stage I – before DHF prescription (comparison group), Stage II – on day 14 of DHF administration. All patients provided informed consent to participate. Results. Statistically significant differences were obtained among the Kulazhenko test indicators. After 2 weeks of DHF medication use as prescribed by the coloproctologist, vacuum hematoma formation within the normal time range of the Kulazhenko test (50–70 seconds) was recorded in more than half of the patients (58.06% ± 0.07). These values characterize the positive dynamics of microcirculation restoration in periodontal tissues and represent statistically significant results compared to indicators at the first stage of the study (8.07% ± 0.03, p < 0.05) before the use of systemic DHF medications. Conclusion. According to the study of patients with inflammatory periodontal diseases during treatment of hemorrhoidal disease with systemic medications based on diosmin and hesperidin flavonoids, improvement in Kulazhenko test indicators, periodontal indices, and subjective patient data was recorded. This provides grounds to conclude that there is a beneficial effect of this medication combination on the microcirculation of periodontal tissues.

Assessing The Efficacy of Inclusive Education in Kerala: A Mixed-Methods Analysis of Academic Performance and Skill Acquisition Among Differently-Abled Students

ABSTRACT This study critically examines the efficacy of inclusive education in Kerala through a mixed-methods analysis of academic performance and skill acquisition among differently-abled students. Drawing from a sample of 300 differently-abled students, alongside 50 teachers and 50 parents, the research integrates quantitative assessments with qualitative insights to present a comprehensive evaluation of inclusive practices. Statistical analysis, including t-tests and multiple regression models, revealed that students in inclusive settings performed significantly better academically than those in specialised institutions, with teacher support, peer interaction, and resource availability emerging as key determinants of success. Thematic analysis of interviews and classroom observations further highlighted the role of differentiated instruction and positive peer dynamics in enhancing cognitive, social, and vocational skills. However, systemic barriers such as inadequate infrastructure, limited assistive technology, and gaps in teacher preparedness persist. The study concludes by recommending targeted interventions in teacher training, infrastructure development, community engagement, and policy reinforcement to strengthen the inclusivity and effectiveness of Kerala’s educational landscape. These findings contribute valuable insights for policymakers, educators, and stakeholders committed to fostering equitable educational opportunities for all learners. Keywords: Inclusive Education, Differently-Abled Students, Skill Acquisition, , Kerala Education, Teacher Support, Educational Equity, Special Needs Education, Disability Rights, Assistive Technology, Holistic Development, Inclusive Pedagogy

IMPACT OF STATE HEALTH PREVENTION FINANCING PROGRAMS ON THE ACTIVITIES OF HEALTH PROTECTION ENVIRONMENTS IN UKRAINE

The article examines the features of the application of correlation-regression analysis to identify the impact of state health prevention financing programs on the activities of health protection entities in Ukraine. The study used single-factor cubic regression models, which allow for a more flexible representation of the nonlinear relationship between the independent variable (the amount of state funding or net profit) and the dependent variable (the amount of preventive services provided). The least squares method was used to calculate the model parameters that minimize the sum of the deviations of empirical data from theoretical values. The results obtained confirm the high level of correlation between the increase in the volume of public investments and the positive dynamics of preventive measures, which indicates the effectiveness of the targeted allocation of funds. Analysis of the Fisher criterion made it possible to establish the adequacy of the constructed regression models and their predictive capabilities. It was found that the growth of the net profit of medical institutions also contributes to improving the quality and expanding the range of preventive services. At the same time, in situations of insufficient profitability, public funding acquires special importance, compensating for limited resources and ensuring the basic level of preventive measures. The results of the study can become the basis for the formation of effective public policies aimed at optimizing financial resources and improving the overall health of the population. In particular, the application of these methods allows for identifying points of maximum and minimum impact, determining possible threshold values ​​of indicators and adjusting investment strategies in prevention accordingly. Thus, the presented methodological tools contribute to a more complete understanding of the impact of economic variables on the spheres of health care and form the basis for further research. This allows for better integration of preventive initiatives into strategic planning for the development of the healthcare sector.

Stenting of critical aortic coarctation in newborn: a case series

Introduction: Critical neonatal coarctation of the aorta is one of the most formidable heart defects due to the high risk of ischemic organ injury and the development of multiple organ failure. Such a cohort of patients always requires a search for alternative treatment methods that will reduce the risk of fatal postoperative complications and achieve optimal results of radical correction. Objective: The study aimed to assess the results of staged surgical treatment of critical coarctation of the aorta in newborns in a series of three cases. Methods: The present research is a prospective one. A series of three cases of staged surgical treatment of newborn children with critical coarctation of the aorta was performed at the Research Institute for Complex Problems of Cardiovascular Diseases in 2024. Due to the severity of the conditions caused by multiple organ failure or the infectious process, the first stage in all cases was stenting of the coarctation of the aorta through the access of the common femoral artery on the right, followed by radical correction within one hospitalization. Results: All children were full-term and had normal birth weight, but the severity of the condition did not allow performing the initial radical correction of abnormality. Considering the comorbidity, all children underwent stenting of the aortic coarctation as the first stage of correction. Positive dynamics were observed in all 3 cases and included a decrease in the pressure gradient on the isthmus of the aorta, normalization of clinical and paraclinical indicators that allowed performing radical correction in the shortest time possible. Postoperative complications were not observed in all 3 cases, and all children were discharged home in a satisfactory condition after the rehabilitation stage. Conclusion: The choice of surgical tactics in favor of stenting of critical coarctation of the aorta in newborn children with a severe comorbid background, even with good weight and height indicators, can be the key to salvation, which allows stabilizing the patients and preparing them for subsequent radical correction to achieve the best results. Received 9 December 2024. Revised 23 December 2024. Accepted 25 December 2024. Informed consentThe patients’ legal representatives informed consent to use the records for medical purposes is obtained. FundingThe work was supported by a comprehensive program of basic scientific research of the Russian Academy of Sciences within the framework of the fundamental theme of the Research Institute for Complex Issues of Cardiovascular Diseases No. 0419-2024-0002 “Perioperative neuroprotective strategies in the surgery of congenital heart defects” with financial support from the Ministry of Science and Higher Education of the Russian Federation within the framework of the national project “Science and Universities”. State registration number: 124041800039-2. Conflict of interestThe authors declare no conflict of interest. Contribution of the authorsLiterature review: A.A. Rumyantseva, R.S. Tarasov, E.O. GrishachevaDrafting the article: A.A. RumyantsevaCritical revision of the article: R.S. Tarasov, I.K. Khalivopulo, P.A. ShushpannikovSurgical treatment: R.S. Tarasov, I.K. Khalivopulo, P.A. ShushpannikovFinal approval of the version to be published: A.A. Rumyantseva, R.S. Tarasov, I.K. Khalivopulo, P.A. Shushpannikov, E.O. Grishacheva

Chinese traditional medicine in the comprehensive rehabilitation of children with cerebral palsy

It is relevant to search for new opportunities for comprehensive rehabilitation of children with cerebral palsy in order to create highly effective rehabilitation programs based on the methods of Chinese traditional medicine.The purpose of the study: to increase the effectiveness of comprehensive rehabilitation of children with spastic forms of cerebral palsy by including traditional Chinese methods in the rehabilitation program.Methods: the study included 59 children with spastic forms of cerebral palsy. The average age was 2.9 ± 0.17 years. There were 30 girls (50.8%). In the main group, standard rehabilitation was used and additionally used methods of Chinese traditional medicine; in the comparison group there was only standard rehabilitation. To determine the effectiveness of complex medical rehabilitation, a modified Ashworth scale and a gross motor function scale (GMFCS) were used, and the adaptive potential of the circulatory system and the type of adaptive reactions were studied.Results. When comparing adaptive potential after rehabilitation, no statistically significant difference was obtained (p=0.913). Stress reactions were not detected in any of the subgroups (p=0.927). In the main group, a statistically significant decrease in muscle tone was revealed (p=0.001), and improvement in motor functions according to the GMFCS scale was expressed (p=0.04).Conclusion. The presence of positive dynamics of muscle tone in children with spastic forms of cerebral palsy allows us to conclude that the inclusion of methods of Chinese traditional medicine in comprehensive rehabilitation increases the effectiveness of rehabilitation measures.

Monitoring of Immune Recovery After Hematopoietic Stem Cell Transplantation in Patients with Aplastic Anemia by Quantitative Determination of TREC and KREC

Background and Aims Analysis of T- and B-lymphocyte recovery after hematopoietic stem cell transplantation (HSCT) is important for assessing the positive dynamics of treatment. Flow cytometry is informative enough to monitor immune recovery in the post-transplant period. However, the determination of the number of TREC and KREC can be used to assess T and B cell neogenesis. Methods We describe 15 patients with aplastic anemia after allogeneic HSCT (HLA-matched-related [n = 8], transplantation from unrelated healthy donors [n = 7]). The age of patients was 15.0 (1.9-17.0) yrs. Monitoring points were 30, 45, 60, 100, 180, 245, 365 days after HSCT. Reconstitution of T and B lymphocytes was assessed based on the results of flow cytometry. Quantitative of TREC and KREC was performed using the multiplex RQ-PCR. Results KREC are detected by day 45 and reach the threshold of normal values by day 100. By day 245, the number of KREC begins to slowly decrease, which is not a sign of transplant rejection, but indicates an increase in the total number of CD19+ cells and the effect of dilution of KREC-positive lymphocytes. T-lymphocyte recovery begins later. TREC are determined by day 145 and by day 180 the median of TREC-positive lymphocytes is 800 copies per 1 × 106 lymphocytes without a dynamic decline up to a year after transplantation. In turn, according to immunophenotyping data, CD3+ begins to appear after day 30, which indicates that the number of activated T lymphocytes then decreases and the number of naive ones increases. This picture is due to the peripheral expansion of T lymphocytes, which predominate in the donor transplant, and the beginning of the production of the recipient's own cells. CD19+ lymphocytes appear by day 60 and reach the norm by day 100, which indicates that the newly formed pool of B lymphocytes mainly consists of naive cells. No statistical differences were found between the groups with related and unrelated HSCT in the dynamics of TREC reconstitution. For KREC, significant differences in the increase in quantity are observed by day 100 (p < 0.05). Conclusions Quantitative determination of TREC and KREC allows assessment of T and B cell neogenesis without the use of additional research methods such as flow cytometry. This method can be used as a predictor of reconstitution of T and B cell function.

A scoping review on the contribution of interprofessional collaborative practices on preventing and managing post-partum haemorrhage in the health care system

BackgroundPostpartum haemorrhage (PPH) is a complication associated with increased morbidity and mortality. Effective management of PPH relies on the interdependent roles of various healthcare professions to ensure safe, high quality outcomes. This scoping review aims to explore and synthesise literature of the contribution of interprofessional collaboration in preventing and managing postpartum haemorrhage.DesignThe review adopted a scoping review methodology underpinned by Arksey and O’Malley’s five stage framework. Four databases (CINHAL, Scopus, PubMed, and Medline) were searched for sources. The inclusion criteria consisted of full-text articles published in English between 2000 and 2024, across various research designs.ResultsThe review demonstrates that effective interprofessional collaboration has the potential to ensure prompt diagnosis and management of PPH, while also promoting positive patient and team dynamics outcomes. Moreover, interprofessional collaboration optimises resource utilisation and team synergy, with an awareness of each healthcare professional’s role, mutual trust and respect, and shared leadership.ConclusionPreventing and managing PPH depends on highly effective interprofessional collaboration. To promote safe healthcare delivery during PPH emergencies, strengthening interprofessional collaboration practices is encouraged through various measures. These include interprofessional collaborative quality improvement initiatives, team-based PPH protocols, interprofessional situ simulation training, and PPH mock drills. These strategies provide healthcare systems with structures for better preparedness and swift interprofessional collaborative intervention to prevent complications of postpartum haemorrhage.

Hematotoxicity of zinc carbonate nanoparticles in the Wistar rat model

Nanomicroelementology is the modern science of trace elements obtained using nanotechnology. Over the past 20 years, its achievements have led to the emergence of many food additives and medicines containing metal nanoparticles (NPs). The leading role here belongs to the discovery of zinc oxide NPs. They are widely used in the cosmetic and food industries and biomedical research, and their annual synthesis has the highest values among all nanomaterials. However, zinc-based NPs exhibit toxic effects, especially with prolonged administration. This occurs due to the action of high doses but does not depend on the route of administration of NPs (oral, intratracheal, intraperitoneal). To obtain low-toxic, safe NPs, the authors of this article developed zinc carbonate NPs (ZnCN) obtained by coprecipitation and stabilized with polyvinylpyrrolidone. Therefore, this work aimed to determine the ZnCN hematotoxic effect. For this purpose, a chronic toxicological experiment was conducted on male Wistar rats (n = 25), which were administered from 25 to 200 mg/kg b. w. for 30 days. On the 15th, 30th and 45th days of the experiment, blood samples were taken for evaluation on an automatic hemanalizer. Hematological parameters (hemoglobin level, number of erythrocytes, leukocytes, platelets, and hematocrit and thrombocrit) examined during the 45 days of the experiment did not reveal pronounced signs of toxicity of the studied compound. When high doses (100–200 mg/kg b. w.) of ZnCN were administered to animals of experimental groups 3 and 4, leukocytopenia was observed. At the same time, in experimental group 3, on the 30th day of the study, the leukocyte content was lower than the control by 18.3% (P < 0.05), and in experimental group 4 – by 25.7 % (P < 0.01). At the end of the experiment on the 45th day, the leukocyte content in rats of experimental group 4 remained significantly lower by 17.9% (P < 0.05). In contrast, in experimental group 3, this indicator only tended to decrease. It is worth noting that some indicators (hemoglobin, erythrocytes) after administering 25–50 mg/kg b. w. ZnCN showed positive dynamics in the changes, which indicates an improvement in the metabolic profiles of experimental groups 1 and 2 rats. Therefore, the ZnCN studied in this experiment did not show pronounced signs of hematotoxicity.

New federal standards in accounting for budgetary institutions

The budgetary sphere, despite the remaining problems, demonstrates positive dynamics, sustainable development and the ability to adapt to modern conditions. Thus, in the context of dynamic development of legislation and significant complication of monitoring changes in the field of accounting of public finances, it seems appropriate to conduct a detailed analysis of the changes taking place. The study is relevant, since legislative changes in the field of accounting of budgetary institutions, coming into force in 2026, have high practical value. The following methods were used in the study: analysis and synthesis, comparison, logical and systems approaches. The article contains an analysis of changes in the accounting of institutions and, in particular, considers the features of the implementation of new federal accounting standards. In addition, it is assumed that from 2026 the procedure for implementing internal financial control by institutions will be standardized. At the same time, the growing importance of state financial control is due to the fact that its effective application in the management of state financial resources contributes to the implementation of effective economic policy. It is concluded that due to the adopted innovations aimed at optimizing interaction and increasing the transparency of accounting, an increase in the efficiency of public. The results of the study will be of interest to practicing specialists in the field of accounting of budgetary institutions, as well as to the scientific community engaged in research in the budgetary sphere.

Therapeutic possibilities of vitamin-mineral complexes in improving statokinetic stability in athletes of aesthetic gymnastics

The observed imbalance of trace elements and vitamins in the body of female athletes of rhythmic gymnastics during intensive training needs to be replenished. In this context, the rational use of vitamin and mineral complexes by athletes is essential. Purpose. To improve the coordination of young athletes in aesthetic gymnastics by including multivitamin complexes in the diet. Materials and methods. The work was carried out on the basis of the Department of Otorhinolaryngology, FSBEI HE South Ural State Medical University of the Ministry of Health of the Russian Federation, from August 2024 to January 2025. The clinical study included 43 young female athletes engaged in aesthetic gymnastics with a mean age of 11.2±0.6 years. Depending on the inclusion of multivitamin complexes in the training process, all gymnasts were divided into the study and the control groups. Results and discussion. According to the data of a 4-month step-by-step observation using computer stabilometry, the most pronounced dynamics in optimizing the "balance function quality" indicator was observed in the study group of young athletes in aesthetic gymnastics in a sample with their eyes open up to 87.59% and in the absence of visual control up to 85.42%. The registration of the stabilometric parameter "motion assessment" under visual control decreased evenly over 2 months by 13.6 and 7.8, respectively, followed by a decrease by 8.6 and 3.85 in the study and control groups, respectively, by the end of the 4th month. Conclusion. The inclusion of multivitamin complexes in addition to standard aesthetic gymnastics training makes it possible to improve the coordination of young athletes. The analysis of the parameters of computer stabilometry allowed assessing the positive dynamics in the field of coordination and equilibrium.

Evaluation of the Disinfection Efficacy of Er-YAG Laser Light on Single-Species Candida Biofilms: Systematic Review.

The relevance of the current study is to increase the resistance of fungal biofilms to traditional disinfection methods. The aim of the study was to determine how effectively Er:YAG laser light inhibits single-species Candida biofilms. The study involved a systematic review of 57 scientific publications (2015-2024) selected according to specific criteria, followed by an assessment of quantitative and qualitative indicators of colony-forming unit reduction. The results show that under optimal parameters (power 1.5-3.9 W and duration 60-90 s), the Er:YAG laser can reduce the number of viable Candida albicans cells by an average of 70-90%, and when combined with sodium hypochlorite or chlorhexidine solutions, this figure can exceed 90%. Separate in vitro tests show that Candida glabrata and Candida tropicalis require higher power or longer exposure to achieve a similar effect, while the use of the Er:YAG laser on titanium and dental surfaces minimizes damage to the substrate and effectively removes the biofilm matrix. In addition, laser treatment accelerates tissue regeneration and helps reduce the number of cases of reinfection, which is confirmed by the positive dynamics in clinical practice. Data analysis using confocal microscopy and microbiological seeding indicates a significant disruption of the biofilm structure and increased permeability to antimycotics after laser exposure. Er:YAG laser disinfection method is promising in counteracting fungal biofilms, especially for surfaces with a high risk of microbial colonization. The practical value lies in the possibility of developing standard protocols for the clinical use of the laser, which will increase the effectiveness of treatment and prevention of Candidal lesions.

Using horseback riding exercises to improve walking skills and develop balance in children with cerebral palsy

Importance. Despite the high value of hippotherapy as a means of rehabilitation, currently in the available scientific literature there is very little information about targeted studies aimed at studying the influence of horse biomechanics on the patient and the walking and balance skills’ formation in the hippotherapy process. The aim of the study is to experimentally substantiate and evaluate the effectiveness of using a set of exercises on horseback to improve walking skills and balance development in children with cerebral palsy.Materials and Methods. Analysis of scientific and methodological literature and medical documentation, pedagogical observation, pedagogical experiment, functional testing using the “Habilect” method, methods of mathematical and statistical data processing.Results and Discussion. A hippotherapy course for children with cerebral palsy allows for positive dynamics in gait pattern indicators and brings them closer to the level of healthy children. Moreover, the maximum positive effect is recorded in such indicators as step length, step speed and step cycle. A significant corrective effect of hippotherapy for cerebral palsy has been proven.Conclusion. Horseback riding not only creates the basis for the correct motor act formation, but also comprehensively develops the child, making him brave, agile, resilient, determined and resourceful, which allows us to recommend the hippotherapy use, both in comprehensive rehabilitation programs and as an independent means for cerebral palsy.

The Effectiveness of the Biofeedback Complex in the Treatment of Children with Cerebral Palsy: a Randomized Controlled Study

INTRODUCTION. The consequences of perinatal lesions of the central nervous system (CNS) are one of the leading causes of childhood disability. Spasticity plays a leading role in the formation of motor disorders. An important aspect of the medical rehabilitation of children with perinatal CNS lesions, including premature infants, remains the minimal use of drug therapy, in this regard, the main task is to develop and scientifically substantiate new non-drug technologies for medical rehabilitation. AIM. To study the dynamics of motor activity of patients with cerebral palsy in the postoperative period using a robotic complex based on functional scales. MATERIALS AND METHODS. The main 1 group (n = 30) consisted of 20 boys and 10 girls, the control 2 group (n = 30) consisted of 17 boys and 13 girls. The patients received comprehensive rehabilitation treatment: robotic mechanotherapy procedures at the Lokomat complex, individual therapeutic gymnastics procedures, physiotherapy, massage, in addition, some patients received botulinum therapy for the lower extremities. In the main group, in addition to the standard rehabilitation program, classes were held at the DIEGO complex. The functional scales of muscle strength scale (MRC), Manual Ability Classification System (MACS), and the Ashworth scale were used to assess the effectiveness of treatment. RESULTS AND DISCUSSION. On the scale of muscle strength, the proportion of patients with an increase of 1 point was 40 % among the patients of the main group, 3.3 % among the control group; on the Ashworth scale, with a decrease of 2 points — 20 % and 10 %, respectively. The volume of movements in the affected limb after a course of treatment using DIEGO complex training in the main group increased statistically significantly in the shoulder joint during extension (p = 0.0197), retraction (p = 0.0216) and reduction (p = 0.0232). CONCLUSION. The inclusion of additional classes on the DIEGO robotic complex in the treatment program for patients with cerebral palsy (GMFCS II–III art.) due to the positive dynamics of motor skills on the muscle strength and Ashworth scales allows us to recommend this method as an auxiliary for use in an individual rehabilitation program for such patients.