Introduction. An important task in the prevention and treatment of chronic rhinosinusitis in patients living in megacities and exposed to anthropogenic pollution is to identify trigger factors, analyze key aspects that increase the risks of refractory course formation and timely take corrective measures. In this context, an in-depth analysis of the epidemiological indicators of chronic rhinosinusitis and its clinical course in patients, with an emphasis on the length of stay (accommodation, work, study, etc.) in various areas of the metropolis with a large number of heavy industry enterprises is of key importance. Aim. To increase the effectiveness of prevention and treatment of chronic rhinosinusitis based on the study of the influence of local anthropogenic pollution of the metropolis on the refractory course of chronic rhinosinusitis. Materials and methods. A retrospective analysis of the frequency of registration of chronic rhinosinusitis in patients who spend most of the day in places with increased anthropogenic pollution of the city was carried out. In total, the study involved more than 20 thousand residents living in different districts of the city of Chelyabinsk, discussed by medical organizations, according to annual report form No. 12 (from 2020 to 2024). The results were analyzed using data from literary sources in specialized libraries and high-tech databases Web of Science, Medline, Scopus. Results and discussion. In the structure of treatment of patients with chronic rhinosinusitis for 2020‑2023, women prevailed (from 59 to 67% of all cases), in 2024 the ratio of men to women was 1:1. The peak of treatment of patients in all areas of the industrial metropolis was recorded in spring and summer. The highest incidence of chronic rhinosinusitis, out of the total number of referrals, was observed in young patients (39,7‑73%). In the studied years, residents of an industrial metropolis aged 45 to 59 years accounted for an average of 22,7% of visits to an otorhinolaryngologist with this diagnosis. The maximum indicators and the highest growth rates were observed in the areas adjacent to industrial enterprises. Conclusion. The results obtained are of great scientific and practical importance for improving the diagnosis of chronic rhinosinusitis and patient routing.

This article presents analyzed data from psychological tests in a study cohort with occupational respiratory diseases. Key changes in psychological status parameters are described, based on the Toronto Alexithymia Scale and an analysis of the attitude to illness type.

Background. Lower extremity edema (LEE) is a common symptom in chronic non-communicable diseases (CNCD), impairing quality of life and increasing economic burden. Materials and methods. Data from 45 sources (2018-2024), including national registries, clinical trials, and meta-analyses (n > 1,000 patients), were analyzed. The inclusion criteria: presence of LEE diagnostic criteria; stratification by sex, age, and disease. Results. LEE prevalence varies: it accounts for 30-80% in chronic heart failure, 15-50% in chronic kidney disease, and 30-80% in chronic venous insufficiency. The risk factors include age >70 years (OR 3.5), female sex (OR 2.0), and low socioeconomic status (OR 1.5). Economic burden is 0.5-2.5% of healthcare expenditures. Conclusion. Unified diagnostic and preventive protocols taking into account regional features are necessary.

Introduction. The prevalence of end-stage renal disease continues to grow, while access to renal replacement therapy remains limited. while access to renal replacement therapy (RRT) remains limited. Kidney transplantation is the most effective treatment modality; however, its implementation is significantly constrained by donor shortages and organizational challenges, particularly at the regional level. Aim. The aim of the study was to analyze the results of the kidney transplant system in the Samara region. Materials and Methods. A retrospective analysis of kidney transplantations (n=734) performed in the Samara region from 2006 to 2024 was conducted. The availability of donor resources was assessed, and a clinical profile of patients on the kidney transplant waiting list (n=127) was compiled. Results and Discussion. Between 2006 and 2024, a total of 734 kidney transplants were performed in the region, with the majority from deceased donors (97.8%). Graft function was preserved in 84.2% of cases, and impaired in 6.0%. Postoperative complications occurred in 26.7% (n=196) of patients, predominantly non-urological (surgical, infectious, hemorrhagic, etc.) in 17.3% (n=127), urological in 6.7% (n=49), and mixed in 2.7% (n=20). Repeat surgical interventions were required in 24.8% of cases. The overall post-transplant mortality rate was 12.3%, with infectious complications, including sepsis, being the leading cause of death. Analysis of the waiting list (n=127) revealed a predominance of middle-aged males (mean age: 45 years), with chronic glomerulonephritis, chronic kidney disease, and polycystic kidney disease being the most common underlying conditions. Donor shortage remains a critical issue: more than two potential recipients per one effective donor. The estimated donor rate was 9.0 per million population, compared to a required rate of 41 per million. Conclusion. Despite the high clinical effectiveness of kidney transplantation, access to it remains limited. The experience of the Samara Region demonstrates positive dynamics, but reveals a shortage of donors and the need to improve organizational solutions in the transplantation care system. Despite the high clinical efficacy of kidney transplantation, access remains limited. The experience of the Samara region demonstrates positive progress but underscores the persistent shortage of donors and the need to improve organizational frameworks for transplant care.

The world is currently experiencing a period of significant change, characterized by several key features. This includes accelerated socioeconomic development, which is reflected in rapid technological progress, the globalization of economic processes, and the digitalization of all spheres of life. Increased life expectancy, a changing age structure, and a growing proportion of the elderly population are driving demographic shifts. All these changes pose new challenges for the healthcare system, including the need to adapt medical services to the needs of the population. Contemporary societal trends dictate the needs of both the medical and patient communities. These trends result in increased demands for the quality of medical care, the need to optimize the use of healthcare resources, and a stronger role for preventive medicine. In this context, telemedicine and remote monitoring technologies are particularly relevant, enabling effective solutions for maintaining public health, including blood pressure monitoring.

Physical activity has a complex effect on the human neuroendocrine system. In professional sports, regular physical activity can both stimulate adaptive processes and provoke violations of regulatory mechanisms when the adaptive capabilities of the body are exceeded. This article examines the key aspects of neuroendocrine regulation during sports: changes in hormonal status, the functioning of the hypothalamic-pituitary-adrenal and thyroid axes, as well as the effect of physical exertion on humoral immunity. Comparative data between athletes and non-athletes are presented, the peculiarities of the body’s responses depending on the degree of fitness are shown. The emphasis is placed on the importance of monitoring hormonal and immune parameters to improve the effectiveness of the training process and prevent adaptation disorders.