Background. In modern gastroenterology, ulcerative lesions of the gastrointestinal tract are the subject of increased attention. In the Russian Federation, digestive diseases occupy the 5th-6th place in the general population in terms of prevalence, and the annual incidence of peptic ulcer disease is 0.1-0.3%. Research in this area is focused, among other things, on the search for biomarkers associated with the processes of regeneration of the mucous membrane in ulcerative pathology, due to the fact that the processes of regeneration of the mucous membrane play an important role the role in treatment. Ulcer healing mechanisms such as cell differentiation, proliferation, migration, re-epithelialization, granulation tissue formation, angiogenesis, vasculogenesis, interaction between various cells and the matrix, and tissue remodeling are coordinated by cytokines: tumor necrosis factor, interleukins (IL-1β, IL-6), growth factors (epidermal growth factor, hepatocyte growth factor). Perspectwin sees the study of the possibility of using biomarkers in the diagnosis, control of the course of the disease, the choice of therapies and the prediction of complications.
Objective. To systematize modern data on biomarkers related to the processes of regeneration of the mucous membrane in gastric ulcer, as well as to determine the prospects for their use to improve existing diagnostic and treatment methods. Materials and methods. Within the framework of this scientific article, a comprehensive analysis of the medical literature devoted to the verification and treatment of peptic ulcer pathology was carried out. The research included original scientific papers published over the past 7 years (2018-2025).
Results. The analysis of modern literature data has shown that biomarkers such as specific cytokines and growth factors, markers of inflammation and tissue regeneration are becoming important tools for assessing regenerative processes in the focus of the pathological process. Their role in the pathogenesis of the disease and ensuring regeneration processes emphasizes the importance of determining their level in patient management.
Conclusion. The study of new biomarkers of gastric ulcer contributes to improving the effectiveness and quality of therapy, preventing the occurrence of complications, including carcinogenesis of the ulcerative focus.

Background. Colorectal cancer is one of the most common oncological diseases both worldwide and in our country. In the Russian Federation, this pathology accounts for 12% of all malignant neoplasms. The development of modern strategies for the diagnosis and treatment of patients with colorectal cancer has contributed to increased survival in this patient group. Consequently, mortality from non-cancer causes, particularly cardiovascular diseases is rising. Aggressive anti-tumor therapy increases the risk of cardiotoxicity, which, when it occurs, significantly worsens the prognosis of the primary disease.
Objective. To examine current studies and articles on the prevention and treatment of cardiotoxicity in patients with colorectal cancer.
Materials and methods. This study analyzed publications on the prevention and treatment of cardiotoxicity in patients with colorectal cancer using Scopus, PubMed, elibrary.ru, and Google Scholar databases.
Results. This article presents data on the frequency of cardiovascular complications in patients receiving various chemotherapeutic drugs for colorectal cancer (fluoropyrimidines, platinum derivatives, vascular endothelial growth factor inhibitors, epidermal growth factor receptor inhibitors, multikinase inhibitors). It emphasizes the importance of cardiovascular risk assessment before initiating anti-cancer therapy and reviews various risk stratification scales for cardiotoxicity. However, no validated scales have been developed to specifically determine the cardiotoxic risk in patients with colorectal cancer. The article discusses key strategies for preventing the most common cardiovascular complications (ischemic heart disease, arterial hypertension, heart failure, arrhythmias) during treatment for colorectal cancer. Special attention is paid to the need for correction of traditional cardiovascular risk factors and the potential use of various cardioprotective drugs for prophylactic purposes. Necessary laboratory and instrumental monitoring methods for the early detection of signs of cardiotoxicity are outlined. The main approaches to the treatment of cardiotoxicity in this patient group are also considered.
Conclusions. Prevention and treatment of cardiotoxicity in colorectal cancer are important aspects of improving the overall effectiveness of therapy, prolonging survival, and improving quality of life for patients. Particular attention should be paid to a multidisciplinary approach when managing this group of patients.

Background. Chronic laryngitis (CL) is an inflammation of the mucous membrane of the larynx with a long course and periodic exacerbations. Chronic laryngitis in adults accounts for up to 50% of all laryngeal diseases and up to 10% of all ENT pathologies. Despite modern diagnostic methods, chronic laryngitis remains one of the most unexplored ENT pathologies.
Results. The article presents an overview of modern data on the etiology, approaches to diagnosis and treatment of chronic laryngitis, especially chronic hypertrophic laryngitis. A total of 28 articles from elibrary.ru and pubmed.com databases were analyzed for the period from 2015 to 2025.
Conclusion. The results of the study highlight the multifactorial nature of the disease, in which infectious, household and professional factors, as well as hormonal changes, immune changes and gastrointestinal diseases, in particular gastroesophageal reflux disease, play an important role. Despite significant progress in the study of pathogenesis, diagnostics and treatment methods, many questions remain open, which emphasizes the need for further research to develop more effective strategies for the prevention and treatment of chronic laryngitis.

Background. The impact of obstructive sleep apnea syndrome on the cardiovascular system includes a negative impact on blood pressure, cardiac myocardial remodeling, and the progression of arterial atherosclerosis in patients. All these factors contribute to the earlier development and progression of cardiovascular diseases, including arterial hypertension.
Results. Existing data on the impact of obstructive sleep apnea syndrome in patients with various comorbid conditions allow us to draw several conclusions. Sympathetic nervous system activation in obstructive sleep apnea syndrome significantly constricts blood vessels, increases blood pressure and heart rate, which significantly impacts vascular endothelial dysfunction and contributes to the development of hypertension, cardiac arrhythmias, and heart failure. CPAP (Continuous Positive Airway Pressure) therapy in patients with obstructive sleep apnea syndrome has convincingly demonstrated a life-saving effect based on the elimination of dominant cardiovascular risk factors. It has been determined that the main therapeutic measures currently used in the treatment of hypertension include lifestyle modification, dietary interventions, and the use of antihypertensive medications in various combinations. However, in the presence of concomitant obstructive sleep apnea syndrome in such patients, achieving optimal blood pressure without proper treatment of sleep-disordered breathing is extremely difficult, especially in patients with resistant hypertension. Therefore, treatments for sleep-disordered breathing should complement and be actively used in patients with hypertension and concomitant obstructive sleep apnea syndrome. CPAP therapy is one of the most effective treatments for moderate to severe obstructive sleep apnea syndrome.
Conclusion. In the Russian Federation, there are still few reliable, randomized, large-scale studies identifying patients with snoring and obstructive sleep apnea syndrome, monitoring the progression of the disease, and evaluating the effectiveness of treatment methods. This problem intersects with many specialties, including otolaryngology, internal medicine, cardiology, and neurology, and requires an interdisciplinary approach and further study.

Background. Currently, the importance of physical and rehabilitation medicine has increased dramatically. Functional changes in the body arising after injuries of the musculoskeletal system and structures of the central and peripheral nervous system are one of the most common pathological conditions resulting from wounds and contusions. The search for new rehabilitation methods and scientific substantiation of their effectiveness is one of the most promising areas of military medicine. Therapeutic mechanical effects in the form of thermal roller massage and autoreclination in combination with the effect of electrical impulses on skeletal muscles cause a mutually reinforcing therapeutic effect according to the synergetic principle.
Objective. To analyze literature sources on the subject of application of technology of combined effects of physical factors in relation to pathological conditions obtained during heavy physical loads and traumatic mechanical effects on the body when performing actions that carry a risk to life.
Materials and methods. A search was performed and subsequent analysis of secondary studies of high methodological quality in the PubMed, Elibrary, and CENTRAL Cochrane databases published between 2018 and 2024. The search was carried out by keywords: massage, spinal injuries, roller massage, myostimulation.
Results. In the studied material, the predominant samples on studies of spinal and limb injuries, herniated discs, osteochondrosis of the spine, and dorsopathy were selected. The results of the data analysis indicate the presence of significant therapeutic effects, expressed in reducing pain and improving physical functioning.
Conclusion. The analyzed database of scientific information contains information on numerous clinical studies of the positive therapeutic effect due to the combined effects of hardware roller massage with spinal autorectination and electrical stimulation of skeletal muscles in patients with clinical manifestations of functional and organic lesions of the peripheral and central parts of the nervous system in diseases of the spine or other structures of the musculoskeletal system.

Background. Currently, gastropathy (band and punctate erosions) caused by the use of nonsteroidal anti-inflammatory drugs are the most common complications of drug therapy for acute respiratory viral infections and rheumatoid diseases. With prolonged use of nonsteroidal anti-inflammatory drugs and when treated in high doses, erosions of the gastric mucosa very often progress and transform into chronic gastric ulcers, which, in terms of pathophysiological mechanisms, are identical to gastric ulcer disease with the involvement of Helicobacter pylori. Currently, there are no effective means for the prevention of drug-induced gastropathy. Attempts to create nonsteroidal anti-inflammatory drugs that do not cause gastropathy have also been unsuccessful. The authors of the article propose the use of low molecular weight chitosan as a gastroprotective agent.
Objective. To evaluate the effectiveness of low molecular weight chitosan (50 kDa) as a means of preventing damage to the gastric mucosa during the administration of nonsteroidal anti-inflammatory drugs in a model of indomethacin gastropathy in rats.
Materials and Methods. The study was performed on 14 male Wistar rats, 3 months old with an average body weight of 240-250 g. Under light ether anesthesia, the animals were administered an intragastrically indomethacin suspension at a dose of 60 mg per 1 kg of body weight. One hour after the administration of the indomethacin suspension, the animals of the control group were administered intragastrically 2 ml of a 0.9% sodium chloride solution, and the animals of the experimental group were administered 2 ml of a 0.2% aqueous solution of low-molecular chitosan (50 kDa). Twenty-four hours after the administration of the test substances, all rats were euthanized by an overdose of ether anesthesia. The stomachs of the animals of the experimental and control groups were removed, cut along the lesser curvature, washed with saline, and the gastric mucosa was scanned at a resolution of 1200 dpi. The area of erosions in the gastric mucosa (ribbon and punctate) in mm2 and the area of the mucosa in mm2 were calculated in Corel Draw 13.
Results. The studies showed that low-molecular chitosan (50 kDa) has a pronounced cytoprotective effect and significantly reduces the percentage of damage to the gastric mucosa in the indomethacin gastropathy model in rats. The most likely mechanism of the described therapeutic effect of low-molecular chitosan is the activation of gastric mucosal macrophages and the expression of the synthesis of antiinflammatory cytokines by them. Moreover, with intragastric administration of low-molecular chitosan, not only the total area of erosive damage to the stomach decreases, but also a significant (more than fivefold) decrease in the area of ribbon erosions.
Conclusion. Low-molecular chitosan has a distinct gastroprotective effect when administered with indomethacin and can be considered as a promising drug for the prevention of non-steroidal gastropathy. At the same time, low-molecular chitosan may be a very promising additional component in the production of nonsteroidal anti-inflammatory drugs dosage forms with reduced side effects on the gastric mucosa.

Background. Varicella in adults in the Russian Federation represents a serious public health problem requiring a comprehensive approach, since in adults it is generally considerably more severe than in children and is associated with a high risk of serious complications. In the last decade, a trend has been noted toward an increase in the proportion of adults among those affected, with the registration of epidemic outbreaks of infection in adult communities. According to WHO estimates, each year 4.2 million severe and complicated cases of varicella result in hospitalization, and 4,200 cases lead to death worldwide.
Objective. To study the clinical and laboratory features of the course of varicella in adults in Voronezh and the Voronezh Region in 2023, 2024, and the first half of 2025.
Materials and methods. The article summarizes data from 123 patients with varicella who received inpatient treatment at Voronezh City Clinical Emergency Hospital No. 8 in Voronezh. The diagnosis of varicella was established on the basis of clinical and epidemiological data. All patients underwent general clinical tests: complete blood count and urinalysis, biochemical blood tests (with mandatory measurement of C-reactive protein, ferritin, and lactate dehydrogenase), as well as a coagulation profile. Instrumental studies included ECG for all patients, and ultrasound and CT scans as indicated.
Results. Analysis showed that the incidence of varicella remains at a fairly high level throughout the year, with a decrease in the autumn period. Varicella predominantly affects young adults (Me: 28 years), with men and women affected with equal frequency. Analysis of the course of the main clinical symptoms of varicella in adults revealed that in 89.4% of cases the disease had a moderately severe course. Complications were recorded in 15% of patients. Moderate intoxication was observed in 89% of patients, and in most cases (66.4%) the body temperature was lowgrade. Analysis of laboratory data showed that in 73.4% of patients there were no deviations from the reference values in the complete blood count for all parameters except the platelet count. The observed thrombocytopenia (in 41.5% of patients) is associated with an autoimmune response in varicella. The increase in ESR ranged from 25 to 80 mm/h in 32.9% of patients and averaged 41.94 mm/h. Notably, a marked increase in this parameter was more often observed in young patients without comorbidities. When evaluating biochemical parameters, the increase in C-reactive protein levels (from 6 to 200 mg/L) in 73.4% of hospitalized patients is noteworthy. It should be noted that a significant increase in CRP from 51 to 200 mg/L was observed in 37.7% of patients against the background of a moderately severe course and in the absence of complications.
Conclusion. The results of the study made it possible to analyze the features of the clinical course, epidemiological characteristics, and laboratory parameters of varicella in adults over two and a half years of observation. Thus, the data obtained may have practical significance for the diagnosis of varicella and for predicting the disease course in adults.

Background. Spontaneous pneumothorax is a rare disease that requires timely diagnosis and emergency specialized care, which directly affects the survival of the patient. The most common symptoms of spontaneous pneumothorax, such as shortness of breath and chest pain, are not strictly specific and are characteristic of many diseases, so a general practitioner may have difficulty diagnosing spontaneous pneumothorax during the initial examination of a patient, which is mostly secondary and occurs against the background of existing respiratory diseases, such as bronchial asthma or chronic obstructive pulmonary disease, especially in the acute phase.
Objective. The purpose of this analysis is to identify the difficulties that a general practitioner encounters during an outpatient appointment when detecting pneumothorax.
Materials and methods. An analysis of medical records of outpatients who sought medical care at the Budgetary Healthcare Institution of the Voronezh Region "Voronezh City Clinical Polyclinic No. 4" was performed. Patient complaints upon admission, anamnesis data, physical examination data, laboratory and instrumental research methods, and conclusions obtained during consultations with specialist doctors were examined.
Results. The conducted analytical assessment of medical documentation demonstrated the leading role of the physician's alertness regarding the detection of pneumothorax, as well as the importance of timely and complete examination of patients for the purpose of diagnosing spontaneous pneumothorax, which made it possible to achieve good results in treatment.
Conclusion. The importance of timely diagnosis of pneumothorax by a primary care physician cannot be overestimated, as the patient's life depends on it. However, diagnosis of spontaneous pneumothorax presents certain difficulties, as the symptoms of pneumothorax (chest pain, shortness of breath, tachycardia) are non-specific, occur in other diseases, and can mimic, disguising themselves as manifestations of another pathology. The physician must be especially vigilant when detecting pneumothorax that has developed as a complication of exacerbation of obstructive pulmonary diseases, such as bronchial asthma and chronic obstructive pulmonary disease.

Background. Skin is the largest organ in the human body, closely intertwined anatomically and physiologically with all other organs and systems. The thyroid gland, as one of the largest endocrine glands, is no exception. The thyroid-skin connection is morphologically determined by the presence of thyroid hormone receptors in virtually all cell populations. Clinically, this connection is confirmed by the involvement of one organ in the pathological process when the other is affected. In addition to the general clinical symptoms of skin and adnexal lesions associated with thyroid disease, such as thyroid dermopathy, there are many eponymous symptoms and signs named after the researchers who first described them. Some of these are variants of well-described general skin changes associated with thyroid disease. Others can be considered stages in the development of the same pathological process over the course of a chronic disease. Also, some of the described symptoms are nonspecific, in which thyroid disease is one of many underlying causes. The recognition and accurate interpretation of such clinical manifestations may be crucial for prompt diagnosis by a dermatologist, as well as by an endocrinologist, especially in cases of marked cutaneous manifestations.
Objective. The purpose of this article was to describe existing eponymous symptoms of skin and adnexal lesions associated with thyroid disease, with an emphasis on their correct interpretation. In our study we have reviewed Pemberton's sign, Enroth's sign, Ber's sign, Jellinek's sign, Hertoghe's sign, Plummer's nails and have evaluated their correlation with a thyroid pathology. This paper also addresses the specificity of some symptoms described in thyroid diseases and their proper assessment by a dermatologist and endocrinologist.