The aim of the research: to identify and analyze student expectations regarding elements of corporate health promotion programs.

   Materials and methods. Using the Kano method, we studied the attitudes of students at technical and medical universities and colleges toward individual components (attributes) of corporate health promotion programs. For each attribute, a Kano classification category was assigned, and a satisfaction index and a dissatisfaction index were calculated. The results were processed using a proprietary Python program.

   Results. A significant portion of the attributes were categorized as "Indifferent" by the majority of students, regardless of their educational institution or work experience. This indicates that students lack well-developed expectations and a strong value proposition for health promotion programs at their future workplaces. The authors analyzed the obtained results from a salutogenic perspective.

   Conclusion. The authors believe that the lack of a salutogenic environment at their places of study and work is a factor behind students' indifference to corporate wellness programs. In the field of youth health, it is necessary to move from promoting a healthy lifestyle to creating a salutogenic infrastructure.

   The aim of the research: to evaluate the influence of individual clinical and organizational factors on the length of hospitalization in adult patients with burn injuries.

   Materials and methods. The inpatient medical records of 150 adult patients at the Burn Center of Tyumen Regional Clinical Hospital No. 1 were analyzed. Nonparametric statistics were used to present the results and perform statistical analysis.

   Results. The etiology of the burn has the greatest impact on the length of hospitalization: the longest hospitalization was observed for flame burns (28,5 hospital days), while the shortest was observed for water and steam burns (10 hospital days). Thermal inhalation injury significantly prolonged hospitalization (40 hospital days versus 13 hospital days). A direct correlation was found between patient age and the length of hospitalization (p < 0,001). Patients with HIV infection and viral hepatitis have increased hospitalization duration (49,5 and 54 bed days, respectively). The peak incidence of complicated burns occurs in October, while the lowest incidence occurs in June.

   Conclusion. The burn etiology, the presence of thermal inhalation injury, comorbidities, patient age, and seasonality determine the duration of inpatient treatment. These results allow us to optimize hospital bed utilization, improve the effectiveness of surgical interventions, and plan the distribution of material and technical resources in specialized institutions.

   Objective of the study: to identify preoperative and intraoperative risk factors associated with complicated postoperative outcomes in patients who underwent coronary artery bypass grafting.

   Materials and methods. A single-center retrospective analysis was conducted on 249 random cases of coronary artery bypass grafting from a total registry of 1,392 patients for the years 2019–2025. Propensity score matching was used to create comparable groups, resulting in balanced comparable paired groups.

   Research results and discussion. The frequency of early postoperative complications after coronary artery bypass grafting is 12,2 %. The most significant predictors of complication development are permanent atrial fibrillation (OR 3,75; 95 % CI 1,65–8,50; p < 0,01) and hyperlactatemia (OR 1,68; 95 % CI 1,02–2,75; p = 0,04).

   Conclusion. The identified risk factors can be used to predict complicated courses and optimize perioperative management of patients undergoing CABG.

   Background. Prolonged mechanical ventilation (MV) in patients with acute stroke is associated with ventilator-induced diaphragmatic dysfunction (VIDD). Diaphragm function dynamics may depend on the indication for MV and ventilatory parameters, including positive end-expiratory pressure (PEEP).

   Objective: to evaluate the dynamics of diaphragm function and respiratory mechanics in critically ill stroke patients according to the indication for initiating MV.

   Methods. A single-center prospective observational study included 113 patients (aged 40–80 years) on MV ≥ 48 hours. Patients were stratified by MV indication: non-pulmonary (group A, n = 67) and pulmonary (group B, n = 46). Diaphragm function was assessed by ultrasound using diaphragm thickening fraction (DTF) on days 1, 3, 5, and 7. Ventilatory parameters included driving pressure (ΔP), static compliance (Cstat), and PEEP. Data were analyzed using Friedman ANOVA, correlation analysis, and multivariable regression.

   Results. On day 1, median DTF was higher in group A (51,6 % [37,5–64,6]) than in group B (33,6 % [26,1–41,1]; p < 0,05). DTF progressively decreased in both groups (p < 0,001), with values in group B falling below the clinically significant threshold of 30% by days 3–5. ΔP was higher and Cstat lower in group B throughout observation. Correlation analysis showed negative associations of DTF with PEEP (r = −0,41, p < 0,001) and ΔP (r = −0,45, p < 0,001), and positive association with Cstat (r = 0,39, p < 0,001). Multivariable regression demonstrated independent associations of DTF with PEEP (β = −0,28, p = 0,004), ΔP (β = −0,34, p < 0,001), Cstat (β = 0,21, p = 0,006), and pulmonary MV indication (β = −0,31, p = 0,002).

   Conclusions. In stroke patients on prolonged mechanical ventilation, diaphragm function progressively declines, particularly in those with pulmonary-origin respiratory failure. ΔP, PEEP, and respiratory system
mechanics are independently associated with dysfunction severity. Ultrasound assessment of DTF may facilitate early identification of patients at risk and guide individualized ventilatory management.

   Objective. To investigate the anthropometric characteristics of patients with various types of dilated cardiomyopathy compared to healthy individuals.

   Materials and Methods. This case-control study was conducted at the Federal Center for Cardiovascular Surgery in Krasnoyarsk, Russia. It included 224 patients diagnosed with dilated cardiomyopathy and 101 healthy controls. Anthropometric measurements were performed using standard techniques. We calculated several anthropometric indices including body mass index (BMI), Risse–Eysenck index, Tanne r’s sex-dimorphic index, body form index (BFI), body roundness index (BRI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHTR). Statistical analysis used nonparametric tests.

   Results. Significant differences were found between patients with dilated cardiomyopathy and healthy controls across multiple anthropometric parameters. These include chest dimensions, breast circumference, hip size, buttocks girth, and skinfold thickness. Both Risse–Eysenck index and Tanne r’s sex-dimorphic index were higher in patients with cardiomyopathy. BMI, BRI, BFI, WHR, and WHTR also showed significantly elevated levels compared to controls. Hyperstenic somatype predominated in over 60 % of cases.

   Conclusion. Our findings highlight substantial variations in anthropometric profiles between patients with dilated cardiomyopathy and healthy subjects. Higher values of certain anthropometric indices, particularly BMI and BRI, may serve as potential markers for increased risk of developing cardiomyopathy. Further investigations are needed to explore how constitutional features influence the onset and progression of this condition.

   This paper presents a comparative study of the use of the analgesic Tafalgin in the first 24 hours after carotid endarterectomy.

   The aim of the research. Analysis and comparison of the safety of analgesia with Tafalgin and trimeperidine in patients after carotid endarterectomy.

   Materials and methods. The study included 80 patients who underwent eversion carotid endarterectomy. Patients were divided into two groups: Group I (Trimeperidine) and Group II (Tafalgin). The incidence of side effects in the early postoperative period was analyzed. Pain intensity was assessed using the Visual Analog Scale (VAS). Patient satisfaction with pain relief and physician satisfaction with the quality of pain relief (Likert scale) were analyzed.

   Results. Thirty minutes after anesthesia, a reduction in pain sensations was achieved from the initial values (Group I – 60 ± 5 mm, Group II – 55 ± 5 mm) to 40 ± 5 mm and 35 ± 5 mm, respectively. The difference in the analgesic effect between the groups was not significant. After 2 hours, the VAS score was 25 ± 5 mm in the Tafalgin group and 30 ± 5 mm in the Trimeperidine group. After 6, 12, and 24 hours, patients reported virtually no pain. In the Trimeperidine group, the incidence of side effects was higher. An analysis of physician satisfaction with the pain relief provided in the Tafalgin group showed better results compared to the Trimeperidine group. In the Tafalgin group, all patients were satisfied with the quality of analgesia, while in the Trimeperidine group, 5 patients gave an unsatisfactory rating.

   Conclusion. The new peptide analgesic Tafalgin has demonstrated its efficacy and safety in postoperative pain relief in patients with stenotic lesions of the carotid arteries.

   The aim of the study: to conduct a comparative analysis and evaluate the significance of quantitative growth dynamics parameters for the differential diagnosis of benign and malignant lung lesions up to 20 mm in size.

   Material and methods. From 2022 to 2025, 170 patients with lung lesions ≤ 20 mm and verified morphological diagnosis were recruited. Dynamic growth assessment was performed in 72 patients before morphological verification. Based on CT data, the maximum increase in diameter per unit of observed time was calculated, and the diameter doubling time was calculated using the Schwartz formula for calculating VDT (volume doubling time), where the diameter of the lesion was used instead of a unit of volume. Patients were divided into two groups: Group C (malignant, n = 40) and Group D (benign, n = 32). Within the groups, subgroups were identified with documented growth (C+, B+) and without it (C-, B-). Student's t-test was used to compare quantitative parameters between groups C+ and D+.

   Results and discussion. Growth was observed in 23 (57,5 %) patients in group C and in 15 (46,9 %) patients in group D. The average follow-up time was 12,7 months in group C+ and 6.6 months in group D+. The average diameter doubling time was 29,66 in group C+ and 31,10 in group D+. No statistically significant differences were found between the groups (t = 0,19; p = 0,85).

   Conclusions. Quantitative parameters of growth dynamics (diameter increase and diameter doubling time) did not reveal statistically significant differences between malignant and benign small lung tumors and cannot be used as an independent criterion for differential diagnosis.

   Overcoming therapeutic resistance in chronic polypous rhinosinusitis (CRS) is directly linked to the recognition of its immunological heterogeneity. The modern paradigm views CRS as a spectrum of distinct endotypes (Th1, Th2, Th17), each requiring a specific targeted approach, making detailed immune profiling the cornerstone of personalized treatment strategies.

   Objective. To study the numerical composition and functional activity of T-regulatory lymphocytes at different stages of differentiation depending on the immune response type in patients with chronic polypous rhinosinusitis.

   Materials and Methods. The study included 44 patients suffering from chronic polypous rhinosinusitis. The control group consisted of 20 patients without chronic rhinosinusitis and concomitant pathology who underwent septoplasty. Using cluster analysis (k-means), all patients were divided into three clusters: 1^st – patients with T helper 1 type immune response, 2^nd – T helper 2 type, 3^rd – T helper 17 type immune response. The content of Treg cells with the CD4+CD25hiCD127low phenotype in the venous blood of the subjects and the levels of cytokines (IL-2, IL-6, IL-10, TGF-β1, TNF-α) in blood serum and tissue homogenates were studied using the multiplex analysis system "Human Essential Immune Response Panel" by Biolegend (USA).

   Results. The total number of Treg was increased in Th-2 and Th-1 immune responses, while it was minimal in the Th-17 response. The pool of naive Treg was preserved only in the Th-2 immune response. A progressive decrease in memory Treg was observed from the Th-1/Th-2 to the Th-17 response. Systemic disturbances in cytokine balance have been identified, explaining various mechanisms of pathogenesis of nasal polyps formation with different types of immune response.

   Conclusion. Differences in the state of the immune regulatory system were established in patients with various immune endotypes of chronic polypous rhinosinusitis, manifested both at the level of cellular composition and the functional activity of T regulatory lymphocytes, which have a divergent nature depending on the CRS immune endotype. The concordance of changes in the cellular and cytokine profiles in peripheral blood and polyp tissue confirms the systemic nature of immunopathological disorders in CRS.

 

   The purpose of the literature review is to analyze existing medical criteria and methods for determining children's readiness for first-grade education for the subsequent development and implementation of effective measures to prevent adaptation disorders in future first-graders.

   This article examines the stages of preparing children for school, assessing their readiness for learning, and medical and psychophysiological criteria for assessing their adaptation to school. A child's level of readiness for first-grade schooling is determined by their health and previous development.

   The authors emphasize that adaptation in first grade will be successful if the preschooler's body is properly prepared.

   A key factor influencing subsequent adaptation in first grade is the child's health, which is monitored by a pediatrician and paramedical staff in children's clinics and educational institutions.

   In this regard, the joint role of health professionals and teachers in the timely identification and correction of health problems in children at an early age is equally important.

   Pediatric acute respiratory distress syndrome (PARDS) remains one of the most complex and clinically significant forms of acute respiratory failure (ARF) in pediatric intensive care. High variability of the clinical course, limited effectiveness of standard respiratory strategies, and unfavorable outcomes in a subset of patients indicate the insufficiency of traditional pathogenetic concepts predominantly based on the alveolar-inflammatory model. This article considers PARDS as a systemic pathological process driven by the sequential involvement of microcirculatory, energetic and regulatory mechanisms.

   Particular attention is paid to endothelial dysfunction, impaired tissue perfusion, and mitochondrial dysfunction as key factors underlying the development of energy deficiency and the limitation of process reversibility.

   It is shown that hypoxemia and ARF within this paradigm represent clinical manifestations of a deeper hypoxic-ischemic cascade affecting both the lungs and the central nervous system. The proposed concept has practical significance for improving the understanding of pathogenesis, stratifying disease severity, and assessing prognosis in PARDS.

   The primary etiological factor for the onset and progression of periodontitis is biofilm, an organized accumulation of microorganisms within a complex intercellular matrix. Multispecies biofilms demonstrate sophisticated communication between bacteria and maintain symbiotic relationships via quorum sensing (QS) within the microbiome [1].

   Bacterial extracellular vesicles (BEVs) are considered key mediators of communication among bacteria themselves and with host cells [2, 3].

   Bacterial vesicles provide a selective advantage to parent cells, promote biofilm formation and expansion, participate in the transport of virulence factors and genetic information, transform immune cells, can disseminate over long distances, and play a crucial role in disease development. This review analyzes the role of BEVs in the communication between bacteria and host cells and examines key pathways of inflammation and immune resistance.

   This review discusses the role of coinfection in the development of chronic gastritis associated with Helicobacter pylori. Coinfection with Epstein-Barr virus, herpes simplex virus types 2 and 6, and opisthorchiasis aggravates the course of gastritis and reduces the effectiveness of eradication. High hopes are placed on artificial intelligence, which can compare endoscopic images of the stomach with photographs depicting various pathological processes in real time and provide a diagnosis with 82 % accuracy. According to the Maastricht VI consensus, four lines of eradication are recommended, of which the third and fourth lines are considered salvage therapy. The use of plant foods containing terpenoids, polyphenols, and alkaloids, as well as the use of probiotics in combination with antibiotics, increases the effectiveness of eradication. The development of vaccines against Helicobacter pylori holds promise

   This review systematizes current data on the pivotal role of platelets in cancer progression. It details mechanisms beyond hemostasis: platelet activation by tumor cells (TCIPA) and their contribution to a procoagulant state; stimulation of angiogenesis via the secretion of VEGF, PDGF, and other factors; and the direct promotion of metastasis through the formation of protective aggregates with circulating tumor cells and ATP/P2Y2-mediated disruption of the endothelial barrier.

   Specific focus is given to the molecular basis of cancer-associated thrombosis, including the role of platelet-derived microparticles (PDMP) and Trousseau's syndrome.

   The positive feedback loop of the "tumor-platelet axis", mediated by IL-6 and thrombopoietin production, is discussed.

   It is concluded that platelets are active participants in tumor progression, and their targeting represents a promising avenue for adjuvant therapy.

   Contrast-induced nephropathy (CIN) is a serious iatrogenic problem of modern medicine that occurs after parenteral administration of radiopaque agents. This complication has a significant negative prognosis, associated with an increase in cardiovascular and neurological morbidity, an increase in mortality rates, an extension of hospitalization and, as a result, an increase in the financial burden on the healthcare system. The highest incidence of CIN is observed in the cohort of patients with baseline renal disease or decreased glomerular filtration rate due to other reasons. The combination of several predisposing factors leads to their cumulative effect and a multiple increase in the likelihood of developing nephropathy. Timely risk stratification and implementation of preventive measures are considered key element in the fight against CIN. Adequate intravenous hydration with isotonic sodium chloride remains the most proven and widely used prevention strategy. The effectiveness of the use of a number of pharmacological agents for this
purpose remains the subject of scientific debate and has no unambiguous confirmation.

   This study focuses on the etiology and pathogenesis of contrast-induced acute renal injury.

   The article systematizes the main risk factors for the development of this complication, analyzes in detail the pathophysiological mechanisms of its occurrence, and also evaluates the effectiveness of modern diagnostic algorithms and preventive measures.

   This article addresses the complex challenge of managing penetrating neck injuries, a problem of heightened relevance in modern armed conflicts. The high density of vital structures in this area results in significant mortality, which is directly dependent on the speed of diagnosis and choice of surgical strategy.

   Injuries to major veins pose a particular danger, as they can manifest clinically after a delay, creating a "lucid interval" or period of false stability.

   The core of the work is a clinical case of a 27-year-old serviceman with a stab wound to zone I of the neck.

   Following initial wound management and seven days of stable condition, the patient experienced bleeding triggered by coughing. Emergency duplex ultrasound scanning revealed a defect in the wall of the brachiocephalic vein, a paravascular hematoma, and a floating thrombus, necessitating urgent surgical intervention. An open surgical procedure was performed: the injured vein and its tributaries were isolated, the hematoma was evacuated, the floating thrombus was removed, and the venous wall defect was repaired with a primary suture. Postoperative management included antibiotic therapy and anticoagulants. The patient was discharged fit for duty on day 30. The discussion emphasizes that this case illustrates key aspects of contemporary combat surgery: 1. Diagnosis: a high index of suspicion is essential, as stable hemodynamics do not rule out severe underlying injury. Duplex ultrasound is a critically important screening tool in field conditions. 2. Tactics: for a
confirmed major venous injury with a floating thrombus, open surgery with thrombectomy remains the treatment of choice, ensuring a definitive and radical solution. 3. Organization: success was driven by a multidisciplinary team-based decision-making approach and an effective two-stage evacuation system adhering to "damage control" principles. 4. Management: comprehensive postoperative therapy, including anticoagulation, is mandatory for preventing thromboembolic complications.

   The article's conclusions affirm the efficacy of current protocols, which are founded on early instrumental diagnostics, timely specialized surgery, and interdisciplinary collaboration across all stages of medical evacuation.

   Idiopathic pulmonary fibrosis (IPF) is a severe disease with an unfavorable prognosis, requiring a comprehensive, multidisciplinary approach to diagnosis and treatment.

   Its clinical presentation is dominated by nonspecific symptoms, primarily progressive dyspnea and cough, which clinicians may attribute to similar conditions (COPD, CHF, and others), thereby delaying verification of the diagnosis. Early diagnosis and the timely initiation of targeted therapy are crucial for improving patient outcomes.

   Antifibrotic medications (pirfenidone and nintedanib) are essential in IPF treatment, slowing pulmonary function decline and improving survival, particularly when initiated early.

   They exhibit comparable safety and efficacy profiles.

   Justification. Obesity is a multifactorial disorder that has become one of the most serious and widespread pediatric problems, with an incidence ranging from 1.7% to 6.3 %. Genetically determined forms are difficult to diagnose and distinguish from each other, with Prader-Willi syndrome being the most common of these disorders. Accurate differentiation from other syndromic forms of obesity is essential and requires the use of genetic diagnostic methods. We present the first description in Russia of a girl initially observed with suspected Prader–Willi syndrome in whom whole-genome sequencing revealed a 1p36 deletion. The girl had been followed by a neurologist since the age of 7 months because of muscular hypotonia. At the age of 2 years, she was evaluated for a suspected syndromic disorder (hypotonia, obesity, and developmental delay) and was hospitalized at the Institute of Pediatrics of PIMU. Based on the results of further clinical evaluation, Prader–Willi syndrome was suspected; however, methylation analysis of the SNRPN gene did not confirm the diagnosis. Subsequent whole-genome sequencing identified a 1p36 deletion, a syndrome with a phenotype that may resemble Prader–Willi syndrome. This case highlights the challenges of the differential diagnosis of syndromic obesity in children and provides a detailed comparison of these nosological entities.