Immunotherapy is becoming an increasingly popular cancer treatment method due to its high specificity and potential to be more effective than traditional approaches. The problem of the use of concomitant rehabilitation measures remains in the highlight, as they can help reduce unwanted side effects of the main treatment and improve the overall quality of life of patients. Purpose of the study. To expand the comparative analysis of the quality of life of patients diagnosed with melanoma and receiving immunotherapy, as well as the overall response rate during treatment with the use of accompanying rehabilitation magnetotherapy. Materials and methods. The study included 128 patients diagnosed with melanoma and receiving immunotherapy with pembrolizumab or nivolumab. The patients of the study group (n = 67) underwent a course of immunotherapy and an accompanying course of rehabilitation magnetotherapy. The patients in the control group underwent a course of immunotherapy without accompanying rehabilitation magnetotherapy. Treatment efficacy was assessed according to iRECIST 1.1 criteria. The EORTC QLQ-C30 questionnaire was used to study the quality of life. The degree of adverse events was assessed according to CTCAE 5.0 criteria. Results. The use of accompanying rehabilitation magnetotherapy during the course of immunotherapy led to an improvement in the overall quality of life of patients and a decrease in treatment side effects. Further research in this area is needed in order to determine the potential of magnetotherapy as an additional rehabilitation method.

The effectiveness of conservative therapy in patients with urinary incontinence depends on a variety of factors. There are no clinical guidelines for the use of pharmacological and non-pharmacological treatment concepts for women of reproductive and menopausal age. The aim of the study was evaluating the efficacy of various combinations of treatment for patients with urinary incontinence, based on electrical stimulation of the pelvic floor muscles with biofeedback, fractional photothermolysis with a CO₂‑laser, and medications (antimuscarinics, selective β₃‑agonist). The prospective randomized study included 105 patients, of whom 20 were of reproductive age and 85 were of menopausal age. The patients were divided into three groups: group 1 included the patients who underwent a course of electrical stimulation of the pelvic floor muscles and photothermolysis (with fractional CO₂‑laser); in group 2, the patients received a combination of non-drug treatment and medications; in group 3, the patients received only pharmacological treatment. In group 1, there were 7 patients of reproductive age and 28 menopausal patients, in group 2–5 and 30, and in group 3–8 and 27 patients, respectively. Results. The bladder diary scores improved significantly. Increasing the urinary flow rate was more effective with non-pharmacological treatment in young patients, and reducing the frequency of urination was more efficient with drug therapy in menopausal patients. The probability of achieving a urinary frequency of less than 8 times per day in the combination treatment group was 80% higher than that in the non-drug treatment group and 62% higher than that in the drug treatment group. The effectiveness of non-pharmacological therapy in increasing urinary flow rate is higher in patients of reproductive age. Pharmacological treatment is more effective for three months in menopausal women. The combination treatment is equally effective in patients aged 35 to 65 years and is superior in total effect to drug and non-drug treatment, with the effect maintaining for up to 6 months in menopausal patients.

Due to the increasing prevalence of bronchial asthma in children and a more severe course of the disease, prevention, treatment, and medical rehabilitation of such children becomes relevant. Reduced resistance of the organism to changing meteorological conditions is accompanied by the development of pathological meteotropic (meteoropathic) reactions. Meteoprophylaxis using the method of interval hypoxic training contributes to reducing the frequency and severity of meteoropathic reactions and improving the functional state of the respiratory system and psychological status. Materials and methods. 80 children with increased weather sensitivity were examined: the main group consisted of 40 children who received normobaric hypoxia therapy; the comparison group consisted of 40 children who did not receive normobaric hypoxia therapy. The study of the influence of normobaric hypoxia therapy in dynamics on the clinical course of bronchial asthma, indicators of the pulmonary function (computer flowmetry), and psychoemotional status was carried out. Results and discussion. The beneficial effect of normobaric hypoxia therapy on the clinical course (reduction of dry paroxysmal cough and dry wheezing) was revealed. A statistically significant increase in the indices of the pulmonary function was obtained (peak expiratory flow rate, MEF75 (p < 0.05)). The data from the results of psychological testing revealed a decrease in irritability, emotional lability, and anxiety, normalization of activity levels, and increased performance in children under the influence of normobaric hypoxia therapy. In most children, the manifestations of weather sensitivity decreased, and the severity structure of weather-related exacerbations changed: reactions of moderate severity decreased, while severe manifestations of meteoropathology practically disappeared. Conclusions. Based on the conducted studies, the types and seasonal patterns in the formation of biotropic weather conditions in the Moscow metropolis, which are a risk factor in the development of weather-related exacerbations and manifestations of increased weather sensitivity in children with bronchial asthma, were identified, and the frequency of formation of increased meteorolability in such patients was determined. The effectiveness of normobaric hypoxia therapy as a method of preventing meteoropathic reactions in children with bronchial asthma has been established.

In patients with rhinosinusitis polyposa, activation of type 2 eosinophilic inflammation with an increase in serum concentrations of interleukins 4, 5, and 13 and immunoglobulins A, M, G, and E is noted. At the same time, the relationship between these indicators and the quality of life of the patient is sharply intensified, which indicates the appearance of pathological correlation pleiades. The drug Dupilumab has a normalizing effect on the inflammatory component of the disease and optimizes the cytokine regulation of humoral immunity. The additional use of an alternating magnetic field somewhat enhances these effects, whereas the maximum therapeutic effect was provided by the use of the drug, an alternating magnetic field, and low‑intensity infrared laser therapy.

The main theories of striae pathogenesis are the following: mechanical — an atrophic scar as a result of excessive skin stretching, hormonal — increased expression of genes for receptors of various hormones, and genetic theory — striae as a consequence of congenital structural disorders in the formation of epidermal and dermal structures of the skin. Purpose of the study: to analyze the increased risk of formation of hormone-dependent atrophic scars by studying the polymorphism of the genes for estrogen receptor 1, matrix metalloproteinase type-3, and COL1A1. Material and methods. In order to identify genetic factors of increased risk of striae formation, 20 patients with atrophic scars and 15 healthy patients were examined. The work examined the polymorphism of the COL1A1, ESR1, and MMP-3 genes. Results. Comparative analysis of gene polymorphism in patients with hormone-dependent scars determined a statistically significant difference in the distribution of alleles compared to the control group and showed high values of high-risk TT genotypes for COL1A1 (rs 1800012). High values of the mutation/mutation allele CC for ESR1 (rs 2234693) were observed, as well as high values of intermediate risk genotypes 5A/6A for MMP-3 (rs3025058) were detected. The data obtained can be considered as potential risk factors for the development of atrophic scars of the striae phenotype.

In patients with cystocele, the effectiveness of conservative therapy is contradictory and does not allow making recommendations for clinical practice. The aim of the study was to evaluate the efficacy of combination therapy for patients with cystocele based on electrical stimulation of the pelvic floor muscles with biofeedback and fractional photothermolysis with a CO₂‑laser, alone or in combination with medications (antimuscarinics and selective β₃‑agonist). The prospective randomized study included 105 patients, of whom 60 had cystocele. The patients were divided into three groups: group 1 included the patients who underwent a course of electrical stimulation of the pelvic floor muscles and photothermolysis (with fractional CO₂ laser) (Physiotherapy group); in group 2, the patients received a combination of physiotherapeutic exposure and pharmacological treatment (Combination group); in group 3, the patients received only pharmacological treatment (Pharmacology group). The stimulation of the pelvic floor muscles was carried out for 10 days, the fractional CO₂‑laser was used 2 times, and pharmacological treatment continued for 3 months. The bladder diary was analyzed. In group 1 there were 25 patients with cystocele, in group 2–10 patients, in group 3–25 patients with cystocele. The indicators of the bladder diary improved significantly in all groups. Increasing the urinary flow rate was more effective with physiotherapy treatment, and reducing the frequency of urination was more efficient with drug therapy. The combination therapy was the most effective. The OAB-q SF score after 3 months may be a predictor of urination frequency less than 8 times per day 6 months after therapy, and the urinary flow rate greater than 14.5 ml / sec before treatment may be a predictor of a high urinary flow rate after 3 months of therapy. Thus, in women with cystocele, the effectiveness of physiotherapy is comparable to drug therapy, and the combination therapy contributes to a better result.

Comprehensive studies of the influence of binaural beats on the effectiveness of the treatment of patients with post-traumatic stress disorders have been carried out. It has been established that this physiotherapeutic factor contributes to a decrease in the activity of stress-initiating systems, including the normalization of heart rate variability and the regression of hormonal and biochemical stress markers with an improvement of psychophysiological parameters. It has been revealed that bioacoustic impact on the brain has an antinociceptive effect. It has been proven that post-traumatic stress disorders initiate the formation of pathological correlation pleiades, which are destroyed when binaural beats are applied. The development of more effective rehabilitation programs for patients suffering from post-traumatic stress disorder, taking into account the complex mechanism of the formation of this disease, should be based on highly informative technologies of digital medicine and the construction of multifactorial prognostic information models with the selection of predictor biomarkers.

The paper considers the evaluation of the performance of the physiotherapy service of the SBHI Leningrad Regional Center of Specialized Types of Medical Care (SBHI LenoblCenter) for the last five years. The results of the analysis of the work of the physiotherapy unit of the SBHI LenoblCenter from 2018 to 2022 are presented. The methodology for calculating the structure of physiotherapy procedures is presented, and intensive, extensive, and basic physiotherapy ratio indices are estimated. The problems of the legal and regulatory framework of physiotherapy service in the field of dermatovenerology are outlined. The impossibility of purchasing high-tech physiotherapy equipment for phototherapy (phototherapy cabin) in current conditions is displayed. Positive trends in the development of physiotherapy service of the SBHI LenoblCenter are shown.

The article presents a systematic review of 35 Russian and foreign sources on laser therapy and describes the classification of lasers, the mechanisms of action of laser therapy on the human body and the main therapeutic effects, as well as the results of scientific research on the use of laser therapy in medicine and dentistry. Based on the analysis of the literature, it has been concluded that low-intensity laser therapy is a highly effective method of rehabilitation of patients in the treatment of various pathologies, including after surgical interventions, which has a number of advantages over symptomatic drug therapy, since it does not cause allergic reactions or side effects. It has a pronounced anti-inflammatory, antibacterial, analgesic, vaso-, psycho- and immunocorrective effects and promotes faster wound healing and improvement of bone tissue structure, which justifies its widespread use in dental surgery.

Purpose of the study: to analyze the content and systematize the scientific and methodological materials on research in recovery and rehabilitation in the medical and biological support (MBS) of elite sports. Materials and methods. The research included content analysis of literature sources. Articles included in the PubMed, Scopus, Google Scholar, and Russian Science Citation Index databases were examined. Total of 97 articles were analyzed, and 44 were selected. Results and discussion. Recovery and rehabilitation in sport includes a set of medical, professional, psychological, and pedagogical measures aimed at the restoration or compensation of impaired body functions and sports performance. Among the existing set of means and methods of rehabilitation used in medical practice in the medical and biological support of sports at the present time, the methods that allow quickly eliminating signs and consequences of physical and psychoemotional tension (stress) observed during sports activities, and restoring psychofunctional state through direct impact on regulatory systems (nervous, humoral, and hormonal systems) of the human body are of particular interest. There are active studies on the use of transcranial methods of electrical and magnetic stimulation, as well as biofeedback, which allow the development of the ability to control one’s psychophysiological functions. The analysis of recovery and rehabilitation methods of local impact on the musculoskeletal system has shown that there are very few developments and studies associated with the use of modern physiotherapy and mechanotherapy equipment adapted for application in sports. The use of natural healing resources for recovery and rehabilitation of the human body is sufficiently studied and substantiated by research conducted over the years. However, there are few studies on the influence of natural healing factors on the functional state of the body and the performance ability of athletes. Conclusion. The study has shown various recovery and rehabilitation technologies with application of total and local impact methods. However, there are gaps regarding a lack of studies on the scientific justification of applying natural healing resources and modern mechanotherapy measures with great possibilities for recovery and rehabilitation of the human body’s functional systems, adapted for use in sports, as well as the absence of a formed system for recovery and rehabilitation of athletes in conditions of training in middle altitude.

The article presents the results of a literary review on the problem of the organization of differentiated psychological support at the second stage of medical rehabilitation of patients with the consequences of motor disorders that arose as a result of stroke or developed against the background of degenerative and dystrophic diseases of large joints and spine. The psychological consequences of motor disorders, patients’ characteristics, and possible approaches to psychocorrection are analyzed. It was revealed that regardless of the nosology of motor disorders, the targets of psychocorrection at the second stage of medical rehabilitation of patients are signs of anxiety and depression in the current emotional state, while the specific targets in the case of stroke are disorders of higher mental functions, and in the case of degenerative and dystrophic diseases of large joints and spine — subjective perception of pain syndrome. As the main guidelines for the systematic work of a psychologist as part of a multidisciplinary rehabilitation team at the second stage of medical rehabilitation of the studied contingent of patients, the following are indicated: determining the basic targets of psychocorrection, selecting relevant and nosology-sensitive motor disorders correction methods, and increasing the effectiveness of psychocorrection through the use of high-tech virtual and augmented reality tools.