Journal «MEDICINA» 1/2026

Introduction. Reducing the impact of key risk factors (RFs) for circulatory diseases has the potential to increase life expectancy, but unique target organ tissue-specific indicators of their impact remain unclear. The aim of the study: To find out distinctive manifestations of the influence of RFs at the cellular level in the chain of events of the cardiorenal continuum (CRC) using the example of a group of initially healthy 7.959 male using the methods of applied statistics. Materials and methods. The data of the CRC created in the process of studying cardiovascular outcomes in workers of locomotive crews of the Trans-Baikal Railway established over 6 years of observation were used to clarify the specific feature of the implementation of each predictor in the endothelial cell (EC) of the CRC. Results. The formation of endothelial dysfunction (ED) under the influence of the same predictors has significant differences in different areas of the vascular bed. The differences lie in the dynamics of ED progression at different stages the formation of a specific final outcome of the CRC. The first stage of ED does not change, which may be due to the production of the same ED markers by the endothelium under the influence of a specific RF. Conclusion. To neutralize the effect of pathogenic risk factors before irreversible changes in the EC and prevent CRC events, targeted studies are needed to clarify the quantitative and qualitative values ​​of morpho-biochemical markers of ED.

Key words: chronic kidney disease, interaction, cardiorenal continuum, sudden cardiac death, risk factors, endothelial dysfunction, predictors

The issue of psychoactive substance (PAS) consumption in the Russian Federation requires modern monitoring approaches to develop an adequate state policy. Official medical statistics data do not reflect the full picture, necessitating the development of systems that operate with objective laboratory data.

To describe the experience of creating and developing an information-analytical system for monitoring PAS consumption in Moscow, based on chemical-toxicological testing data using domestic software under import substitution conditions.

The research is based on data from the Laboratory Information System of the Moscow Research and Practical Centre of Narcology. Initially, the foreign BI platform Tableau was used for data visualization and analysis. Due to sanctions restrictions, a transition was made to the Russian analogue – the Visiology platform. The methodology included integration of disparate data, creation of interactive dashboards and reports, as well as comparison of laboratory data with information from the Unified City Register of Narcological Patients in Moscow.

The developed information-analytical system for monitoring PAS consumption allows for near real-time visualization and analysis of key indicators: dynamics and structure of positive chemical-toxicological test results across Moscow's administrative districts, socio-demographic profiles of consumers, and the correlation between laboratory monitoring data and official morbidity indicators. Integration with the Moscow narcological patient register made it possible to supplement their profiles with objective laboratory data.

The creation of an information-analytical system based on domestic software has proven its effectiveness for the operational monitoring of the drug situation. The system provides healthcare management and law enforcement agencies with a tool for analyzing the real, not just registered, picture of PAS consumption, which is critically important for planning preventive, therapeutic, and rehabilitation measures. Moscow's experience demonstrates the potential for scaling this approach to create a federal monitoring system. 

Key words: real-time monitoring of psychoactive drug use, information-analytical system, chemical-toxicological testing, laboratory information system, import substitution, domestic software, data visualization, Moscow drug addiction service

The article presents the results of an observational cross-sectional study in the field of adolescent addiction psychiatry. It provides up-to-date information on substance use among adolescents and its association with the DRD2 gene polymorphism (rs1800497), which encodes the type 2 dopamine receptor. The study aimed to investigate the association between this genetic marker and the development of substance use disorders in adolescents. The study included 188 adolescents aged 15 to 18 years. An analysis of genotype and allele frequency distributions was conducted, and the association of the A1 allele carriage with qualitative and quantitative indicators of various classes of substance use, as well as the need for inpatient treatment, was evaluated. The results established that carriers of the A1 allele (A1/A1 and A1/A2 genotypes) were significantly more likely to try and subsequently misuse synthetic cannabinoids, synthetic cathinones, hallucinogens, and volatile organic substances compared to A2/A2 homozygotes. A dose-dependent effect of the A1 allele was identified regarding the use of synthetic cathinones. The presence of at least one A1 allele was associated with higher odds of admission to an addiction treatment hospital. The findings suggest that the A1 allele of the DRD2 gene can be considered a significant risk marker for the development of substance use disorders in adolescents.

Key words: addiction, adolescents, genetics, narcology, substance use, DRD2, rs1800497

Abstract. Over the past few years, they have been intensively developing new promising nano-, micro-, and macro-dimensional biomaterials containing natural polysaccharides for use in order to eliminate bone tissue damage. The interest of researchers in this field is confirmed by the increasing number of publications every year. Objective. To analyze modern scientific research works devoted to the study of the effect of biomaterials containing natural polysaccharides on the restoration of bone tissue. Materials and Methods. The literature review is based on the analysis of data from databases eLibrary.ru, PubMed, Google Scholar, Scopus. Keywords used for the search: «natural polysaccharides» (native polysaccharides), «biomaterials» (biomaterials), «marine polysaccharides» (marine polysaccharides), «plant polysaccharides» (plant polysaccharides), «glycosaminoglycans» (glycose-minoglycans), «osteoconduction» (osteoconduction), «osteoinduction», «bone regeneration». Query dates are March-May 2025, query depth is 2020-2025. The results. According to the results of the publications, it is shown that the effectiveness of the in vitro and in vivo effects of biomaterials on bone tissue repair is associated not only with natural polysaccharides, the basis of the mold structure, but also with the introduction of biologically active compounds and cells into the structure. The forms of composite biomaterials with natural polysaccharides containing nanoparticles, nanocrystals, fibers, films, membranes, hydrogels, frameworks, sponges and affecting the regeneration of bone tissue are systematized. New experimental data show that the use of natural polysaccharides that mimic the bone matrix as the basis or components of biomaterials is a promising way to stimulate the restoration of bone defects and fractures, which contributes to further research in the field of developing new biomaterials for bone tissue repair. Conclusions. The creation of biomaterials containing natural polysaccharides is a promising direction for the development of therapeutic agents used to increase the efficiency of regeneration of bone tissue defects.

Key words: natural polysaccharides, biomaterials, bone tissue regeneration

The article examines the role and impact of Private Label (PL) products in the modern Russian pharmacy retail sector. Based on a comprehensive analysis of market data, interviews with pharmacy staff, customer surveys, and a review of the regulatory framework, key trends and contradictions are identified. It is established that the share of PL products in pharmacy turnover does not exceed 2–3%, primarily concentrated in the categories of para-pharmaceuticals and dietary supplements. The main driver for their introduction is the economic benefit for retail chains through increased margins (up to 100–300%). However, the study, using the example of PL analogues of the drug «Teraflex®», reveals significant issues: the lack of a clinical evidence base, substantial discrepancies in dosages, composition, and instructions for use, as well as the registration status of dietary supplements. The conclusion is drawn that the aggressive promotion of PL products, especially through the substitution of physician-prescribed medications, creates serious regulatory, ethical, and reputational risks for pharmacies, undermining patient trust. Long-term loyalty should be built on the professionalism of staff and a balanced product assortment, where PL products play a supplementary, not a substitutive, role.

Key words: pharmacy chains, retail, own brand, pro-movement, risks

This paper analyzes and compares approaches to extracting information and knowledge from medical data. The paper examines the key principles for selecting analytical methods, statistical methods, and the use of neural networks, and compares them. It demonstrates that each approach has its own scope of application, advantages, and disadvantages. For medical data analysis, in cases where the structure of the object model is known, relatively simple, or can be reasonably assumed, standard statistical methods are appropriate. In complex cases, the use of more labor-intensive neural network methods is justified. Furthermore, the use of neural networks significantly expands the capabilities of medical data analysis, improving the accuracy of diagnostics and predictions.

Key words: medical data, information extraction, statistical methods, neural networks, method’s selection, validation

Introduction: Medical informatics plays an increasingly important role in improving the quality of rehabilitation of children with special needs, providing a personalized approach and effective health monitoring. Objective: To evaluate the effectiveness of using medical informatics systems in monitoring and evaluating rehabilitation programs for children with special needs. Methods: A 6-month longitudinal study was conducted involving 30 children diagnosed with cerebral palsy, visual impairment, and autism spectrum disorders. Electronic medical records, remote monitoring modules, and a telerehabilitation platform were used. The data were analyzed using descriptive statistics, Student's t-test, and thematic analysis. Results: Statistically significant improvements were noted in functional indicators: GMFM-88 (+17.4%), cognitive index (+12.8%), and social skills according to the Vineland scale (+15.1%). The study participants noted the convenience of the systems, increased parental involvement, and the ability to promptly adjust rehabilitation programs. Conclusion: The integration of medical informatics systems into pediatric rehabilitation helps to increase the effectiveness of therapy, improve interaction between specialists and families, and ensures continuous monitoring of the patient's condition.

Key words: medical informatics, pediatric rehabilitation, electronic medical record, remote monitoring, telerehabilitation

This article presents an analysis of key aspects related to childhood disabilities in Crimea, focusing on the incidence and prevalence of childhood disability, the nosological structure of childhood disability, as well as the reasons for changes in these indicators. The method of dynamic series analysis was employed. Data obtained from the Federal State Institution «Main Bureau of Medical and Social Expertise for the Republic of Crimea» of the Ministry of Labor of Russia, specifically the «Information on medical and social expertise of children under 18 years of age for 2019-2023» (Form N 7-D), and data from the Federal State Statistics Service of the Russian Federation were analyzed. The dynamics of the incidence of childhood disability doubled; the prevalence of childhood disability over the past five years has remained almost unchanged. The leading nosologies in the structure are mental and behavioral disorders, diseases of the endocrine system, nutritional and metabolic disorders, diseases of the nervous system, and congenital anomalies (malformations), deformations, and chromosomal abnormalities. The increase in the incidence and prevalence rates of disability is driven by the share of mental and behavioral disorders, among which autism occupies the main place. These are the calculated data for Crimea for 2019-2023.

Key words: incidence childhood disability, prevalence childhood disability, structure of childhood disability, Republic of Crimea

Introduction. The leading reasons for the current relevance of whooping cough infection include the high mortality rate among infants. According to the World Health Organization (WHO), whooping cough kills approximately 160,000 children annually. Current vaccination against whooping cough in the Russian Federation fails to provide lasting immunity to this disease, contributing to an increase in the incidence of the disease among schoolchildren and adolescents, who in turn become sources of infection for younger children. Equally important is the changing clinical features of whooping cough, which today are primarily represented by atypical forms such as latent and carrier states. This circumstance contributes to the low detection rate of whooping cough, despite the advanced state of laboratory diagnostics for this disease. Changes in the genetic properties of the whooping cough pathogen are associated with the aforementioned changes in the clinical presentation of this disease, as well as the low diagnostic value of bacteriological methods, which are considered the «gold standard» for diagnosing whooping cough. The pertussis vaccination rate for 12–month–old children across Russia in 2022 was 96.62 %. However, despite achieving the required vaccination coverage, the continued increase in incidence among vulnerable groups and the involvement of adults in the epidemic indicate the need for additional pertussis booster vaccinations for children aged 6–7 years, adolescents aged 14 years, and adults every 10 years. The purpose of the study: to study the patterns of the epidemiological process of whooping cough in the Russian Federation and the Altai Territory for the period 2013–2024. Materials and methods of research: a retrospective analysis of the incidence of whooping cough in the population of the Russian Federation and the Altai Territory was carried out on the basis of data from statistical reporting forms of the Federal State Statistical Observation No. 2: «Information on infectious and parasitic diseases», and No. 5 «Information on preventive vaccinations» for 2013–2024. A statistical one-dimensional analysis was performed. Intensive, extensive indicators (fractions, %) and their 95% confidence intervals were calculated (using the Clopper-Pearson method. The analysis was performed using the Microsoft Excel program. The results of the study and their discussion: Based on the conducted research, it was concluded that the persistence of high levels of morbidity among young children and an increase in morbidity among schoolchildren, adolescents and adults is associated with a low duration of immunity after vaccination or after a previous illness. To reduce the incidence of whooping cough, it is necessary both to maintain vaccination coverage at a level of at least 95 %, so is the introduction of additional scheduled revaccinations for children and adults into the regional calendar of preventive vaccinations in the Altai Territory.

Key words: retrospective analysis, pertussis infection, vaccination

Background. Comorbidity of schizophrenia and alcohol dependence is associated with a more severe clinical course, frequent relapses, and reduced adherence to treatment. The choice of antipsychotic therapy in patients with a dual diagnosis remains challenging. Comparative data on the relationship between different antipsychotic treatment regimens, psychopathological symptoms, and alcohol-related behavior remain limited. Objective. To examine psychopathological symptoms, severity of alcohol dependence, and alcohol craving in patients with schizophrenia and comorbid alcohol dependence receiving different antipsychotic treatments. Materials and Methods. A cross-sectional observational study included 49 patients with paranoid schizophrenia (ICD-10: F20.0) and alcohol dependence syndrome. According to their main antipsychotic treatment, patients were divided into four groups: long-acting injectable antipsychotics, first-generation antipsychotics (haloperidol), second-generation atypical antipsychotics, and third-generation antipsychotics (aripiprazole or cariprazine). Psychopathological symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), severity of alcohol dependence using the Alcohol Use Disorders Identification Test (AUDIT), and current alcohol craving using a visual analog scale (VAS). Nonparametric statistical methods were used for data analysis. Results. Differences between treatment groups were observed in AUDIT scores, alcohol craving (VAS), and the PANSS positive symptom subscale. Patients receiving haloperidol showed higher levels of alcohol dependence, stronger alcohol craving, and more pronounced positive symptoms. The lowest AUDIT and VAS scores were observed in patients treated with third-generation antipsychotics. Patients receiving long-acting injectable formulations and second-generation antipsychotics demonstrated intermediate values. Conclusions. Differences in psychopathological symptoms, alcohol dependence severity, and alcohol craving were observed across antipsychotic treatment regimens in patients with schizophrenia and comorbid alcohol dependence. Given the cross-sectional observational design, these findings reflect associations rather than causal effects and should be confirmed in prospective studies.

Key words: schizophrenia, alcohol dependence, dual diagnosis, antipsychotics, psychopathological symptoms, PANSS, AUDIT