Chronic obstructive pulmonary disease (COPD) is a global problem. The prevalence of COPD varies from country to country: for example, in Mexico it is about 6%, while in Chile it exceeds 20%. This is due to differences in lifestyle and exposure to harmful factors. According to the BOLD study, among people over 40 years of age, the prevalence of COPD stage II and higher is 10.1% (11.8% among men and 8.5% among women). In Russia, according to the GARD program, COPD occurs in 15.3% of the population, and in 21.8% among people with respiratory symptoms. According to the WHO, COPD is the third leading cause of death worldwide, killing approximately 2.8 million people (4.8% of all deaths) each year. Mortality rates vary widely in Europe, from 0.2 per 100,000 in Greece, Sweden, Iceland, and Norway to 80 per 100,000 in Romania. Global COPD mortality remained stable between 1990 and 2010, fluctuating between 3 million and 2.8 million cases annually [1].

Bronchial asthma (BA) is a heterogeneous disease characterized by chronic inflammation of the airways and the presence of respiratory symptoms such as wheezing, shortness of breath, chest tightness, and cough, which vary in time and intensity, and occur together with variable airway obstruction [1].

The work compares the knowledge of medical students on the issue of emergency therapy during an asthma attack. This disease is heterogeneous and characterized by chronic inflammation of the respiratory tract and the presence of respiratory symptoms, which vary in time and intensity and occur together with variable airway obstruction. Asthma currently remains a pressing issue in modern healthcare.

Bronchial asthma is a heterogeneous disease and is characterized by chronic inflammation of the respiratory tract and the presence of respiratory symptoms, which vary in time and intensity and occur together with variable airway obstruction. Asthma still remains a pressing issue in modern healthcare, as does the level of knowledge of specialists about asthma.

Obstructive jaundice is a clinical syndrome that occurs due to a violation of the outflow of bile. In conditions of obstructive jaundice, vasodilation is activated, which causes deterioration of the microcirculatory system and reduces tissue hypoxia. Thus, the analysis of microcirculation changes in obstructive jaundice is a key point in understanding pathophysiological processes, which opens up new horizons for possible therapeutic methods. The purpose is to study the effects of low-intensity laser blood irradiation on microcirculatory changes in patients with obstructive jaundice. Materials and methods: The study analyzed microcirculatory parameters in patients with mild (first and second groups) and severe (third and fourth groups) obstructive jaundice against the background of low-intensity laser blood irradiation and standard therapy. The classification is based on the level of total bilirubin: mild – up to 100 mmol/L, severe – more than 200 mmol/L. The norm values were determined in 15 healthy volunteers. The observation was carried out on days 1, 3, 7, and 9. Low-intensity laser blood irradiation consisted of daily sessions for 9 days. The procedure lasted 15 minutes in the cubital vein projection and 5 minutes in the projection area of the common carotid and vertebral arteries on each side. The Matrix device with a CLOZ head, which emits light with a wavelength of 635 nm and a power of 2 MW, was utilized. The method of laser Doppler flowmetry was employed to assess microcirculatory changes. The study was conducted using the laser blood microcirculation analyzer LAKK-2 at the active point E-36 against the background of therapy. Results and discussion: According to the analysis of microcirculatory changes, an excess of normal values was noted during the entire follow-up period in patients with mild and severe obstructive jaundice. These data emphasize the importance of monitoring microcirculation parameters during treatment to assess the dynamics of the disease and the effectiveness of therapeutic measures. Conclusions: A comparative analysis of the conducted studies makes it possible to assess the degree of microcirculation disorders in patients with obstructive jaundice. The data presented above indicate a beneficial effect of laser therapy on microcirculation. It should be noted that in cases of mild and severe obstructive jaundice, low-intensity laser blood irradiation helps to reduce the severity of microcirculation disorders.

Warfarin is an anticoagulant with proven efficacy in preventing thromboembolic complications in patients with mechanical heart valves. Genetic characteristics of the patient, such as carriage of polymorphisms responsible for its pharmacokinetics (CYP2C9) and pharmacodynamics (VKORC1) are significant when selecting doses of this drug.

Cancer is a public health problem and the leading cause of death for patients worldwide. In 2018, about 18 million new cases of cancer and 9.6 million deaths were registered in the world. Platinum-based drugs, as the main drugs in chemotherapy for cancer patients, are widely used in the treatment of various malignant tumors. Oxaliplatin is a third-generation cytotoxic platinum compound, widely utilized in the treatment of various oncological diseases. It is known that the main spectrum of adverse reactions (AR) of oxaliplatin includes neuro- and hematotoxicity, toxic manifestations from the gastrointestinal tract, and hypersensitivity reactions. The most significant manifestation of oxaliplatin neurotoxicity is peripheral nerve damage, the frequency of which accounts for ≥10%, according to the results of safety assessment in clinical trials [1–4] and meta-analyses [5]. There are two forms of neurotoxicity: acute and chronic. Acute neurotoxicity occurs in more than 90% of patients, may debut even during drug infusion, and usually spontaneously resolves in a short time. Chronic neurotoxicity is cumulative, and it is more often observed in patients who received oxaliplatin in a course dose of >540 mg/m2. Despite the sensory nature of neuropathy, it can lead to impairment of physical functions and significantly reduce the quality of life of patients [6]. The safety of oxaliplatin in the Russian Federation has been assessed only in the framework of clinical trials with a small number of participants (less than 100 subjects in each) [7,8]; large-scale clinical trials have not been conducted. Spontaneous reports (SRs) of ADRs are one of the effective systems for assessing the current safety status of drugs without time and sample size restrictions. In addition, analysis of the spectrum of ADRs in SRs can allow assessing the effectiveness of routine measures to prevent the risks of pharmacotherapy, which, in relation to oxaliplatin, includes peripheral nerves injury.

Glutathione-S-transferase (GST) genes of the xenobiotic biotransformation system GSTT1 and GSTM1 are involved in the metabolism of endogenous and exogenous compounds, including drugs, by combining glutathione with electrophilic substrates. GST genetic polymorphism contributes to variability in the safety and efficacy of drugs.

Gastrointestinal peptides, incretins, and their influence on the development of metabolic disorders, as well as new approaches to incretinotropic therapy, are currently being actively studied. Gastrointestinal peptides are considered as potential drugs that can play an essential role in the treatment of various human diseases. Numerous studies confirm the important properties of these peptides and their impact on obesity, non-alcoholic fatty liver disease, type 2 diabetes, and other metabolic disorders. Liraglutide, an analogue of human glucagon-like peptide-1 (GLP-1), which is a physiological regulator of appetite and food intake, is approved for use in pediatrics. By mimicking the action of GLP-1, liraglutide slows down the digestion of food, regulates its movement in the gastrointestinal tract, has a positive effect on the functioning of pancreatic cells, reduces blood glucose levels, and helps reduce the amount of fat and decrease body weight.

P450 (CYP 2C8, CYP 2C9) is involved in the biotransformation of antihypertensive drugs and NSAIDs. For individuals with known cytochrome P450 enzyme activity, it is possible to select a drug and its dosage regimen to achieve a clinical effect [Zhestovskaya A. S., Kukes V. G., Sychev D. A. 2013]. In studies by foreign authors [Jang J. H., Jeong S. H., Lee Y. B. 2023], it has been found that the pharmacokinetics of meloxicam depends on the allelic variant of CYP2C91/1 and CYP2C91/3. In the work by Boyarko A.V. et al. 2021, the detection of CYP2C92 and CYP2C93 in a patient is associated with an increase in the dose of losartan, in contrast to that in patients with the CYP2C91/1 genotype. In contrast, according to studies, the CYP2C92 and CYP2C93 alleles do not affect the antihypertensive effect of losartan [Yasar Ü. et al. 2002]. With regard to drugs from the calcium channel blocker (CCB) group, a previously conducted study revealed a dependence of the activity of the 3A4 and 3A5 isoenzyme in patients receiving amlodipine [M.N. Dorofeeva, E.V. Shikh, 2020]. For further research, it is essential to determine the activity of CYP2C9 and 3A4 enzymes when prescribing drugs of various pharmacological groups (ARB, CCB, NSAID) in patients with a combination of hypertension and pain syndrome. The development of algorithms for personalized selection of antihypertensive therapy in patients with a combination of hypertension and chronic pain syndrome against the background of dorsopathy is of current importance.

Microbiological monitoring in multidisciplinary hospitals is a critical component of ensuring the safety of patients and medical personnel. In hospital settings, there is a high risk of developing and spreading healthcare-associated infections (HAI), which can significantly complicate the treatment of patients and increase the length of their stay in the hospital [1]. Antimicrobial resistance undermines modern medicine and puts the lives of millions of people at risk [2]. The risk of colonization with ESKAPE microorganisms in hospital patients is due to the likelihood of progression to healthcare-associated infection. This is due to a disruption of the immune system, invasive procedures, deteriorated nutrition, a high level of concomitant diseases, the possibility of cross-infection, as well as the presence of mechanisms for penetration through epithelial barriers and the ability of microorganisms to become persistent [3,4].

Protein deficiency often occurs in the postoperative period, in infectious diseases, and in elderly age. Ensuring adequate nutrient intake helps activate reparative processes and increases the rehabilitation potential of patients, but in real clinical practice, insufficient attention is paid to issues of effective nutritional support, especially when treating GP patients. The recovery of patients after cardiac surgery, as well as after acute myocardial infarction (AMI) at the rehabilitation stage must be carried out comprehensively and include correction of the patient’s nutritional status. For this purpose, in order to carry out somatometry in patients hospitalized in the intensive care unit, the hardware and software somatometry complex “Medik” (Russia) was developed. The device allows physicians to assess nutritional deficiencies by body mass index (BMI), identify somatic and visceral protein deficiency, and calculate individual needs for specialized nutrition products. Recommendations for the intake of enteral nutrition mixtures are based on the data stored in the device memory. The assessment of the possibility of adapting the results of the examination of the nutritional status of patients obtained with the device to the current situation on the pharmaceutical market is relevant. It is necessary to determine the choice of drugs for enteral nutrition taking into account their composition and cost and the results of patient examination.

Clinical data analysis is a cornerstone of evidence-based medicine and a key to improving the effectiveness of therapy. This article reviews various methods of statistical processing of clinical data - from classical statistical tests to modern machine learning methods - and their comparative effectiveness in interpreting results to improve therapeutic outcomes. We will discuss examples of real-life studies demonstrating the application of these methods, as well as approaches to summarizing data (meta-analysis, analysis of real-world data) to make better informed treatment recommendations.