Background. Health anxiety is considered to be a specific psychological construct, that determines the individual health behavior making a crucial impact on the treatment adherence and prevention strategies. All mentioned above defines its interdisciplinary importance. The task of every medical doctor is to attract patients attention to the necessity of taking care of one’s health using all available professional communication skills. The recent active development of the digital technologies makes a serious impact on the ones information seeking behavior, including medical information search, creating an internal model of the illness and modern health anxiety manifestation highlighting in this article. Digital space and AI creation capable of big data speedy analyzation open for the professional’s new options of social listening. Today we have the opportunity of new evaluation of patient’s treatment choices and their mindset networks development. The accumulated data can be used for the targeted psychosocial interventions development aimed to improve the treatment adherence.

Conclusion. In the internists routine practice there is a high rate of patients with nosogenic anxiety disorders associated with the internal illness model, fear of the disease progress and also with the typical anxiety disorders manifesting in the somatic sphere, nosophobias, hypochondriac states. Their complex treatment should include combination of psychotherapy and pharmacotherapy, where anxiolytics can be considered as the treatment choice.

Background. Asthenia is usually considered not as a disease, but as a syndrome characterized, on the one hand, by fatigue and weakness, decreased physical and mental performance, and, on the other hand, by abnormally easy excitability with excessively rapid exhaustion of nervous functions. This process is always pathological, not directly related to or dependent solely on overwork. Symptoms of asthenia are found in 45-90% of patients with serious somatic diseases, being an independent reason for seeking medical attention in 30% of cases. Hypochondria is considered to be an unfounded or exaggerated fear for one's health, which in modern interpretation has been given a special name – anxiety disorder associated with illness. The prevalence of this condition among the adult population is estimated to range from 2.1% to 13.1%, and among patients receiving medical care, it can reach 19.9%. Health anxiety has a significant impact on patients suffering from it, worsening their quality of life. Currently, there is growing evidence that conditions associated with fatigue and anxiety (especially chronic ones), such as apathy and hypochondriacal disorders, may occur or be associated with iron deficiency.

Results. The article reviews current understanding of the manifestations, causes, pathogenesis, and approaches to treating conditions such as asthenia and hypochondria, as well as the problem of their possible connection with iron deficiency. An overview of current literature on research into the combination of these conditions is presented. The role of iron deficiency in the formation of congenital and acquired diseases of the nervous system and pathologies of psycho-emotional development is considered separately. Examples of successful treatment of a number of mental and neurological diseases are given, and the role of iron preparations in the effective correction of mood disorders, anxiety, and other pathological manifestations of asthenia and hypochondria is described.

Background. Hypochondriasis, including that with an affinity for the skin, remains a serious diagnostic and treatment challenge. As the outer boundary of the body, the skin is involved in the formation of psychopathological perception disorders. With its obvious ability to quickly heal itself and its accessibility, unlike internal organs, the skin can often become the target of self-harm in a number of selfdestructive disorders (neurotic excoriations, artificial dermatitis, etc.). As an integral component of appearance, the skin becomes part of the clinical manifestations of mental disorders related to body image pathology.The publication provides an analysis of both theoretical and practical aspects of the problem based on a model of non-delusional hypochondriasis with presentations of somatoform and obsessive itch, skin health anxiety, and cutaneous autonomic dysfunction ("skin organ neurosis").

Materials and methods. Analysis of the main scientific concepts of non-delusional hypochondriasis, related to skin; description of a clinical case, i.e. a patient with "skin organ neurosis"; evaluation of the results of therapy with Alimemazine supplemented by a psychotherapeutic intervention.

Results. The ambiguity of the clinical qualification of non-delusional hypochondriasis in relation to disorders in dermatology is shown; a dimensional model of non-delusional hypochondriasis extending previous concepts is proposed; the model includs the intersection of several psychopathological axes; the provisions of the proposed model are illustrated by the clinical case; the high effectiveness of alimemazine in relation to symptoms derived from various psychopathological dimensions is demonstrated.

Conclusions. The set of clinical phenomena labeled in the literature by the term "non-delusional hypochondriasis" is a multidisciplinary construct that includes associated coenesthetic, personality and ideatory (anxious and obsessive) hypochondriac phenomena characterized by a differentiated response to psychopharmacologic intervention and psychotherapy.

Background. Comorbid disorders in epilepsy are an urgent problem in modern epileptology. In clinical practice, specialists encounter various psychopathological disorders in patients with epilepsy, among which anxiety and depressive states are especially common. No less significant are conversion (dissociative) disorders. These violations seem difficult to resolve due to the presence of a complex of factors leading to their development.

Objective. The aim is to study the prevalence of affective and conversion disorders and their treatment methods in patients with epilepsy.

Materials and methods. The analysis of scientific studies on the relationship between epilepsy, affective and conversion disorders and their treatment methods has been carried out.

Results. Despite the wide diagnostic and therapeutic possibilities, 25-30% of patients do not achieve seizure control with the help of pharmaco therapy. In 60-80% of patients, seizures persiston the background of antiepileptic therapy (PET). It is known that 60% of patients with persistent seizures have affective disorders. Depressive symptoms occupy a leading place and occur in 7.6-41.4% of patients, and with pharmacoresistance – up to 86%. Also, patients with pharmacoresistant epilepsy (PE) have conversion (dissociative) disorders, manifested in the form of psychogenic non-epileptic seizures (PNEP). However, patients with PNEP have "pseudo pharmacoresistance" – patients are prescribed PET, which does not have the desired effecton PNEP, worsening the clinical prognosis. Up to 40% of patients admitted to clinics with a diagnosis of "pharmacoresistant epilepsy" have a combination of epileptic seizures and NEP.

Conclusion. When choosing PET, you should considernotonly the types of seizures, but also the concomitant mental disorders. Anticonvulsant drugs with anormothymic effect, for example, lacosamide, are the most preferred for affective and conversion disorders. This drug has a wide range of effects in epileptic seizures and has a pronounced normothymic effect.

Background. Generalized anxiety disorder is characterized by constant, excessive, and unfounded worry about everyday things. It is extremely difficult to control and is often accompanied by a variety of nonspecific psychological and physical symptoms. Without proper treatment, generalized anxiety disorder becomes chronic. Its manifestations are complicated by comorbidity with other mental disorders, which further worsen the outcome and contribute to poor response to treatment.

Results. The review covers the epidemiology of generalized anxiety disorder, the formation of the concept, representation in modern classifications of mental disorders, diagnostic criteria, comorbidity issues, approaches to the treatment of generalized anxiety disorder with an emphasis on psychopharmacotherapy, including the features of the treatment of generalized anxiety in old age. It has been demonstrated that generalized anxiety is one of the most common mental disorders, often beginning in adolescence, characterized by a chronic course. Generalized anxiety is characterized by high comorbidity with other mental disorders, including depression, panic disorder and addictions. The review presents the evolution of the definition of the disorder in the DSM classifications, describes the diagnostic criteria for generalized anxiety disorder in the ICD. Consideration of generalized anxiety from the standpoint of RDoC is discussed. The article provides a detailed description of the use of antidepressants, buspirone and benzodiazepines, atypical antipsychotics and mood stabilizers in generalized anxiety disorder. Particular attention is paid to a new domestic non-benzodiazepine anxiolytic, licensed for use in generalized anxiety disorder and included in the Clinical Guidelines Aviandr (maritupirdine). General principles of psychopharmacotherapy of generalized anxiety are given.

Background. Skin cancer is one of the most common cancers in the world, but its prevention and early diagnosis remain insufficiently effective.

Objective. This research aims to find ways to improve the effectiveness of prevention and screening programs for skin cancer and precancerous conditions, especially among high-risk groups.

Materials and methods. The work analyzed data on the incidence and mortality from skin cancer in different countries for the period from 2010 to 2023, and assessed various approaches to the prevention and early detection of skin tumors.

The results showed that the most effective are comprehensive preventive programs, including education of the population, regular screening of risk groups, and the use of modern non-invasive diagnostic methods. A risk-based skin cancer screening algorithm has been proposed, which allows for an 18-23% increase in the detection of tumors in the early stages (p < 0.05).

Conclusion. It is concluded that a differentiated approach to the prevention and early diagnosis of skin cancer is necessary, taking into account individual risk.

Background. Onychocryptosis is damage to the surrounding tissue caused by the nail. The etiopathogenesis of the disease remains poorly understood. Both external factors (poor nail hygiene, tight shoes, mechanical nail trauma) and internal factors (congenital anomalies of the nail plate and bone structures of the phalanges) are believed to play a role in its development. The epidemiological data of the disease are also not fully understood. It is known that onychocryptosis most often develops on the big toes. The clinical presentation of onychocryptosis depends on the severity of the disease, but the main complaint of patients at all stages of the disease is pain, which most often prompts them to seek medical attention. Swelling of the affected lateral nail fold is also characteristic of the clinical picture of onychocryptosis, as well as the presence of discharge and/or oozing in later stages of the disease. Diagnosis of onychocryptosis is usually straightforward and is based on the patient's medical history and clinical presentation. In most cases, diagnosis is made without the use of additional diagnostic methods. Currently, there are numerous approaches to correcting onychocryptosis, including both conservative and surgical methods. Among the conservative treatments for onychocryptosis, orthonyxia stands out. This method can be effective in treating the disease, ensuring minimal impact on the patient's quality of life and not requiring a lengthy rehabilitation period after treatment. Other practical advantages of orthonyxia include its virtually complete painlessness and the ability to adjust it during treatment. Orthonyxia is a relatively new method. Despite this, it is gradually finding its place in surgical, orthopedic, and dermatological practice, as evidenced both in clinical medicine and in scientific publications.

Results. This article presents clinical cases of successful orthonyxia in correcting mild to moderate onychocryptosis. It also highlights the potential role of orthonyxia as the most optimal treatment option for onychocryptosis in the early stages. 

Background. West Nile fever is a viral disease transmitted to humans through the bites of infected mosquitoes. This virus belongs to the flavivirus family and is widespread in warm climates. West Nile fever may be asymptomatic, but some patients develop serious complications such as meningitis, encephalitis, and polio.Early and accurate diagnosis of West Nile fever is crucial for timely initiation of treatment and prevention of the spread of infection. Without timely intervention, the disease can lead to serious consequences, especially in people with weakened immune systems. In this regard, the study of the diagnostic capabilities of West Nile fever is an urgent task for medical specialists.

Results. As part of this work, a comprehensive study of diagnostic methods for determining West Nile fever was conducted. Special attention was paid to laboratory diagnostic methods, their effectiveness and specificity. The research methods included the analysis of scientific publications and studies on the topic of West Nile fever, the study of modern laboratory diagnostic methods such as serological tests, polymerase chain reaction (PCR), as well as the assessment of the sensitivity and specificity of various diagnostic approaches. Based on the analysis, the key features of the diagnosis of West Nile fever were identified. Serological tests, such as enzyme immunoassay (ELISA) and complement binding reaction (CSC), can determine the presence of antibodies to the virus in the patient's blood serum. However, these methods can produce false positive or false negative results, especially in the early stages of the disease. Polymerase chain reaction (PCR) is a more accurate method of diagnosing West Nile fever. PCR makes it possible to directly detect the presence of viral RNA in biological samples such as blood, cerebrospinal fluid, or nasopharyngeal swabs. This method has high sensitivity and specificity, which makes it preferable for early diagnosis of the disease.The combination of various diagnostic methods, such as serological tests and PCR, can significantly improve the accuracy and speed of West Nile fever detection. For example, the use of serological tests for initial assessment and PCR to confirm the diagnosis can reduce the risk of false positive and false negative results.It is also important to take into account that the diagnosis of West Nile fever should be comprehensive and include not only laboratory methods, but also clinical data. Symptoms of the disease, such as fever, headache, weakness, muscle pain, and rash, may serve as additional signs for diagnosis.

Conclusion. The diagnosis of West Nile fever requires the use of modern and accurate laboratory diagnostic methods, as well as an integrated approach that includes clinical and laboratory data. The combination of various methods, such as serological tests and PCR, improves the accuracy and speed of disease detection, which contributes to the timely initiation of treatment and prevention of the spread of infection

Background. Pathology of ENT organs has an important medical and social significance, which is explained by the impact on a number of indicators characterizing the level of quality of life. The increase in life expectancy of the population leads to the fact that otolaryngological complaints come to the forefront in the practice of doctors. Analysis of ENT diseases, conducted by a number of domestic and foreign researchers, indicates a high level of both acute and chronic diseases: in 1st place – diseases of the throat, in 2nd place – diseases of the nose and paranasal sinuses, in 3rd place – diseases of the ear, in 4th place – diseases of the larynx. A tendency was noted for more frequent registration of diseases of the ear, throat, nose in men compared to women. Most often, patients who received medical care were in the age range of 18-30 years. Thus, diseases of the throat occupy the first place in the structure of ENT diseases. There is an annual increase in infectious and inflammatory diseases of the pharynx, and despite the fact that most of these diseases do not require systemic antibacterial therapy, they significantly reduce the quality of life of patients and require treatment. Local drugs for the treatment of sore throat are preferable for both patients and doctors due to their ease of use and fewer side effects. A separate large group consists of patients who have undergone surgical treatment of pharyngeal diseases (tonsillectomy, adenotomy, various types of uvulopalatoplasty), who have severe pain syndrome persists in the early postoperative period and who need local treatment.

Conclusion. This article discusses the main diseases of the pharynx, diagnostic and treatment methods. Particular attention is paid to promising new methods of topical treatment. The pharmacological properties, mechanism of action, indications for use, as well as clinical aspects and prospects for the use of the topical antiseptic ambazone monohydrate in the practice of an otolaryngologist are considered.

Background. Inflammatory bowel diseases, which include Crohn's disease and ulcerative colitis, are immune-mediated inflammatory diseases with a complex pathogenesis. In addition to the involvement of the intestinal wall in the pathological process, systemic extraintestinal manifestations are observed in Crohn's disease and ulcerative colitis, and there is also often an association with psoriasis and psoriatic arthritis.

Objective. Purpose of the study was to analyze the nature of the articular syndrome in children with inflammatory bowel diseases associated with juvenile psoriatic arthritis.

Materials and methods. A retrospective analysis of the nature of the articular syndrome was carried out in a group of children with inflammatory bowel diseases associated with juvenile psoriatic arthritis (20 patients, mean age 12.7 years (95% CI [11.01; 14.29]). The diagnosis of juvenile psoriatic arthritis was established according to the Vancouver diagnostic criteria (1989). The diagnosis of Crohn's disease was established in accordance with Clinical recommendations for Crohn's disease for pediatric patients, 2025. The diagnosis of ulcerative colitis was established in accordance with Clinical guidelines for ulcerative colitis for pediatric patients, 2025. Statistical processing was performed using parametric methods and exact formulas for percentages.

Results. 17/20 (85%) of our patients were diagnosed with Crohn's disease, inflammatory form, 3/20 patients (15%) – ulcerative colitis. The diagnosis of definite juvenile psoriatic arthritis, according to the Vancouver diagnostic criteria, was made in 11/20 patients (55%), probable – in 9/20 (45%). Boys predominated in the group – 14/20 (70%). The mean disease duration was 5.0 years (95% CI [3.21, 6.79] years). 13/20 (65%) patients had relatives 1 and 2 degrees of relatives suffered from psoriasis. All children with definite psoriatic arthritis (11/20 children) had plaque (vulgar) psoriasis. In 15/20 (75%) patients, the onset of articular syndrome was asymmetrical oligoarthritis. At the height of the disease, the oligoarticular variant was observed in 10/20 (50%) children, rheumatoid-like (polyarticular) in 3/20 (15%), spondyloarthritis with damage to peripheral joints in 7/20 (35%). The most commonly affected joints were the knee (15/20 (75%)), ankle (5/20 (25%)), and hip (8/20 (40%)) joints.

Conclusions. The articular syndrome in inflammatory bowel diseases associated with juvenile psoriatic arthritis is characterized by a frequent onset of the disease with joint damage (in 40%), asymmetric oligoarthritis at the onset and at the height of the disease, while isolated juvenile psoriatic arthritis is characterized by a pattern of development of the articular syndrome from oligo- to polyarthritis. The association of inflammatory bowel diseases and juvenile psoriatic arthritis is characterized by a high percentage of spondyloarthritis with damage to peripheral joints (35%). The most common joints involved are the knee and hip joints (75% and 40%), with a high incidence of enthesitis (55%), while in isolated juvenile psoriatic arthritis the knee and ankle joints are most often affected. The course of inflammatory bowel diseases against the background of psoriatic arthritis requires an individual approach to patient management and selection of therapy aimed at the common links in the pathogenesis of these conditions.

Relevance. Gonarthrosis is a progressive disease accompanied by constant joint pain and functional limitations significantly reducing the patients’ quality of life and leading to disability. Hyaluronic acid preparations play an important role in the treatment of this pathology. The range of hyaluronic acid preparations is quite wide: they differ in molecular structure, method of synthesis, injection volume, number of procedures, and combination with other active substances. Traditionally, most preparations contain a linear hyaluronic acid molecule. Currently, implants based on cross-linked hyaluronic acid are available on the pharmaceutical market. One of the most advanced processes is cross-linking with BDDE using the innovative patented Crosslinked Hyaluronic Acid Platform (CHAP) technology.

Objective. The aim of the study is to assess the effectiveness of cross-linked sodium hyaluronate hydrogel in gonarthrosis treatment.

Materials and methods. Twenty patients diagnosed with stage II gonarthrosis have been examined and treated. 2% cross-linked sodium hyaluronate preparation, 3 ml bionic crosslink, was administered to the patients intraarticularly. The patients' condition was assessed using generally accepted scales and questionnaires: before the treatment start, and in seven and in forty days after the drug administration.

Results. It has been established that cross-linked sodium hyaluronate does not provide a quick symptomatic effect, but significantly increases all the possible effects in 40 days after its administration. The decrease in pain compared to baseline values was 46%, and the dynamics of the WOMAC index was 36%. 40 days later, 93% of patients observed significant improvement. No complications associated with intra-articular administration of the drug have been revealed.

Conclusion. The results of the research indicate the long-term efficacy and safety of cross-linked sodium hyaluronate in the treatment of gonarthrosis.

Background. The problem of iron deficiency and iron deficiency anemia as its severe manifestation is urgent due to its prevalence, clinical, social and economic significance. World Health Organization experts regard anemia not only as a disease, but also as a public health problem and identify a number of socio-economic factors as the cause of anemia: education level, financial capabilities, access to medical care, quality and food safety. Despite attempts by the world community to reduce the incidence of anemia in a group of women of reproductive age, the prevalence of anemia is not decreasing. Demographic changes towards an increase in the proportion of elderly people lead to the formation of a new risk group, for which a decrease in hemoglobin is associated with an unfavorable prognosis for health and life. The most common anemia in all categories of patients is iron deficiency anemia, the leading cause of which is considered to be iron deficiency in the diet. Diagnosis of anemia is based primarily on laboratory parameters. A decrease in hemoglobin levels below 130 g/L in men and 120 g/L in women is the main criterion for anemia. To confirm GI and differential diagnosis with other anemias, it is necessary to evaluate iron metabolism indicators - ferritin, iron transferrin saturation ratio, total iron-binding capacity of serum and transferrin.

Results. To prevent iron deficiency, as well as other deficiency conditions, it is necessary to implement individual and population preventive measures. This was dedicated to the Council of Experts, held 15.04.2025 in Moscow. It should be noted that this event was an important step in terms of organizational and clinical decisions for the possibility of implementing the World Health Organization program to reduce the burden of anemia in our country.

Background. The treatment of chronic wounds is a significant clinical, social, and economic problem. Given the aging population, the continuing threat of diabetes and obesity worldwide, and the ongoing problem of infections, this issue is expected to remain relevant, requiring a paradigm shift in approaches to diagnosis and treatment. To date, the medical community has struggled to agree on uniform terminology, diagnose the causes of chronic wounds, and select the optimal treatment tactics. The optimal approach to treating chronic wounds is based primarily on diagnosing the causes of slow healing and using agents that effectively and safely accelerate it. It is known that collagen and its compounds, located in the extracellular matrix, influence all key stages of the wound healing process. At the same time, disturbances in the regulation of collagen metabolism in the wound lead to pathological conditions such as fibrosis and chronicity. In this regard, the balance between the activity of proteolytic enzymes (collagenases) and their inhibition is also necessary for normal wound healing. Collagen-based dressings are coverings that meet all the basic requirements of modern dressing materials: atraumaticity, moisture balance, protection against infection, biodegradability, ease of use, cost-effectiveness, etc. Collagen dressings can be used effectively at all stages of the wound healing process: hemostasis, inflammation, proliferation, and remodeling, as collagen influences healing processes at all stages. When additional drugs are added, the collagen dressing acquires hemostatic properties, can be used to clean the wound with enzymes, and promotes harmonious proliferation in the wound in conditions of excessive production of proteolytic enzymes.

Results. The publication presents the results of clinical observation of the use of preparations: the biological dressing with natural collagenases and the collagen wound healing dressing, which contain non-hydrolyzed collagen. The use of the studied products had a significant effect on the healing rate of chronic wounds in patients included in the clinical observation.

Background. Diffuse cutaneous systemic sclerosis is a multisystem disease of connective tissue characterized by symmetrical thickening of the skin and subcutaneous tissue, combined with fibrous and degenerative changes in the synovial membrane of joints, digital arteries and internal organs (esophagus, intestines, heart, lungs, kidneys). The key factor in systemic scleroderma is a violation of microcirculation, covering the entire body on a global level. This deviation occurs due to excessive synthesis of antibodies in combination with intense reactions of cellular immunity, which leads to significant damage to the vascular endothelium, a fundamental stage in the development of pathology. Damage to the microcirculatory bed provokes the formation of microthrombi due to increased thrombotic activation and proliferation of the inner lining (intima) of small arteries, which causes vasoconstriction and the occurrence of local hypoxic conditions. In the long term, this leads to chronic insufficiency of blood supply to the affected organs. There is a tendency towards an increase in connective tissue diseases, including scleroderma. Thus, in the Russian Federation in 2021, the number of reported cases among adults amounted to 17,667.7 thousand people, which is an increase compared to 2020, when there were 17,360.5 thousand people. In 2022, this number increased to 18,864.1 thousand people. The primary incidence of systemic scleroderma in children is 0.27 per 1 million children per year. Among patients with systemic scleroderma, the proportion of children under the age of 10 does not exceed 2%, and among all patients aged 10 to 20 years varies from 1.2% to 9%. The average age of morbidity is 8.1 years, the peak of the disease is observed in the period from 10 to 16 years. Among the cases, girls account for a significantly higher number, the ratio with boys is 4:1.

Objective. The aim of the study was to present a clinical case of mixed systemic scleroderma in a 16-year-old teenager. Materials and methods. Patient R., born in 2008, was examined in June 2024 at the State Autonomous Healthcare Institution Regional Children's Clinical Hospital.

The child was examined using the clinical and genealogical method, functional research methods (ultrasound examination of the abdominal cavity and retroperitoneal space, ECHO-CS + Doppler, CT of the chest, EGDS), clinical and biochemical blood tests, ENA profile: RNP/Sm, Scl-70, ANF; coagulogram: APTT (APTT), the percentage of prothrombin by Quick, ferritin.

Conclusion. Systemic scleroderma in children is a complex and polysystemic disease that requires a deep understanding of its pathogenesis, clinical manifestations, and treatment approaches. To date, the urgency of the problem is confirmed by an increase in morbidity among both adults and children.

Background. The Third All-Russian Neurocongress with international participation brought together neurologists, neurosurgeons, and specialists from related fields, including, general practitioners, physical and rehabilitation medicine specialists, speech therapists, occupational therapists, specialists in endovascular diagnostic and treatment methods, and others. The Congress program included thematic sessions with the participation of doctors with scientific and practical experience in neurology and related fields.

Results. Today, modern medicine has a large number of approaches and opportunities for the recovery of stroke patients. The most effective ways to rehabilitate patients in the first days after a stroke were discussed at a satellite symposium held as part of the congress by Nutricia LLC "Innovations in ACVA Rehabilitation: Opportunities in the First 90 Days," held as part of the congress, focusing mainly on nutritional support to help cope with protein-energy malnutrition and dysphagia and improve patients' ability to self-care.