Introduction. Currently, the frequency of cesarean section (CS) in the world is at least 25 %, in Russia — at least 30 %. It is known that newborns after CS are a special risk group for the development of somatic dysfunctions (SD), which should be considered comprehensively, taking into account their somatic and neurological status.

The aim is to study the effect of emergency CS on the somatic, neurological and osteopathic status of newborns and on the course of the early neonatal period.

Materials and methods. 60 patients of the Department of Neonatal Physiology, aged 3–5 days of life, without structural pathology or malformations, born by cesarean section, were examined. Children are divided into 2 groups of 30 people. Group 1 — children born by emergency caesarean section (ECS). Group 2 — children born by planned (elective) caesarean section (PCS). A complex of examination methods was used in both groups. The anamnestic method included an assessment of the main risk factors during pregnancy and features of the early neonatal period. The clinical method included assessment of the somatic status of newborns; neurological assessment. Assessment of osteopathic status according to clinical guidelines. Assessment of functional disorders — using neuro-sonography, ultrasound of the hip joints, ultrasound of the abdominal organs. Statistical data processing was carried out using Microsoft Excel and the Medstatistic statistical software package. To study the relationships between the characteristics, a comparison of the populations was carried out based on qualitative characteristics. Fisher′s exact test was used for statistical processing of data. The analysis used a significance level of p<0,05, which reflects the strength of the dependence of the characteristics being compared. Pearson′s coefficient was used as a criterion for the strength of connection.

Results. When analyzing risk factors in both groups, a predominance of women over 30 years of age with a complicated pregnancy was noted among mothers. Extragenital pathology (most often pathology of the endocrine system) was detected in 70 % of mothers. In the ECS group, early and more intense jaundice was observed significantly more often (p<0,05) (12 out of 30 children versus 4 out of 30 children in the PCS group); muscular dystonia with a tendency to increase muscle tone in the upper extremities and decrease in the lower extremities (in 22 out of 30 children in this group versus 12 out of 30 children in the PCS group); SD of the head region (13 cases in this group versus 4 cases in the second group). In the PCS group, autonomic disorders were observed significantly more often (p<0,05) (12 out of 30 children versus 2 out of 30 children in the ECS group); SD of the pelvic region (visceral component, 9 cases versus 2 in the ECS group). In children of the ECS group, a statistically significant (p<0,05) relationship was revealed between breech presentation and SD of the pelvic region (somatic component) — contingency coefficient 0,44; structural features of the chest (asymmetry, protruding xiphoid process) and SD of the thoracic region (visceral component) — 0,43; characteristics of the neurological status (hyperexcitability syndrome) and SD of the head region — 0,45. In children of the PCS group, a statistically significant (p<0,05) relationship was revealed between morpho-functional immaturity and SD of the thoracic region (visceral component) — contingency coefficient 0.39; features of the skeletal system of the skull (Gothic palate, combination of Gothic palate and suture entry) and SD of the dura mater — 0,5; structural features of the chest (asymmetry, protruding xiphoid process) and SD of the thoracic region (somatic component) — 0,6; characteristics of the hip joints (asymmetry of the gluteal folds, difficulty in abduction, hypermobility) and SD of the pelvic region (somatic component) — 0,45; postural disorders (flexion, extension, latero-flexion to the right, latero-flexion to the left) and SD of the pelvic region (somatic component) — 0,49; increased muscle tone of the arms and SD of the thoracic region (visceral component) — 0,41.

Conclusion. A comparative assessment of the osteopathic status of children born by cesarean section in a planned manner and for emergency indications was carried out, and an analysis of the possible connection of the identified somatic dysfunctions with risk factors for pregnancy and features of the early neonatal period was carried out. Based on the identified relationships between the somatic, neurological and osteopathic statuses of newborns in the first day of life, in the future it is possible to develop optimal timing for consultation with an osteopath for the purpose of earlier diagnosis and correction of somatic dysfunctions.

Introduction. The number of children born early in gestation and with low body weight and associated health disorders require the search for effective methods of rehabilitation treatment. The development of new effective non-invasive methods of rehabilitation/rehabilitation of premature infants is one of the priority tasks of national health care.

Aims — to evaluate the effect of a single osteopathic procedure on the regulatory processes of the body (an indicator of the activity of regulatory systems and an index of nervous system tension) in premature infants.

Materials and methods. In the clinic 30 premature infants with a gestation period of 24 to 37 weeks were monitored on the terms of voluntary written informed consent (the average gestation period was 31,35±0,45 weeks). The children were aged from 2 to 12 months (the average age was 4,93±0,45 months), of which 53,3 % (16 people) were boys and 46,6 % (14 people) were girls. On admission, parents most often complained about sleep disorders: sleep is not long, the child often wakes up at night or cries in his sleep, often sleeps only in the arms of his mother. It is difficult to feed the child, he does not eat the daily norm of food. During wakefulness, the child is restless, and when crying, calms down only in the arms. Osteopathic examination and correction were performed according to the clinical recommendations «Somatic Dysfunctions» and patent № 2739128 «Method of treatment of pain syndrome on the background of somatic dysfunctions in newborns». The procedures are carried out, as a rule, in the first half of the day, lasting 20 minutes. A methodical technique in the form of a single osteopathic procedure was used, when first the patient is examined, immediately after that the procedure and again the examination. The state of nervous system tension was assessed using cardiointervalography, the index of activity of the body′s regulatory systems and the index of tension of the autonomic nervous system were evaluated. The FLACC-SS pain assessment scale for infants, which we modified, was used to assess pain. Psychomotor development was assessed using the Griffiths developmental scale. The Statistica-10 software package was used for statistical analysis of the obtained data.

Results. Upon admission, the pain level on the FLACC-SS scale was 2,35±1,35 points, which indicates, on average, moderate pain intensity in children. The Griffiths score was 31,64±3,57 points, which indicates a delay in psychomotor development in children. In the study of CIG before osteopathic correction, the IN was 597,77±89,99 units, and the PARS was 5,10±0,85 points. This is a pronounced functional stress of the body and is characterized by a decrease in its functional reserves and an inadequate response to environmental factors. During the initial osteopathic examination, somatic dysfunctions were detected mainly at the global level (changes in skeletal muscle tone, changes in cranial, cardiac and respiratory rhythms). After a single osteopathic correction procedure, the tension index decreased statistically significantly, and there was also a tendency to decrease the level of tension of regulatory systems. The pain level in children decreased to 0,16 points, which means.

Conclusion. Somatic dysfunctions play an important role in the development of disorders of body regulation and pain syndrome. Correction of somatic dysfunctions in premature infants by osteopathy methods helps to reduce pain syndrome and improve the adaptive mechanisms of the body. Thus helps to prevent energy-consuming increased work of regulatory mechanisms, to adjust sleep and wakefulness, to improve appetite and, ultimately, the quality of life of the infant and the whole family. Restoring the energy balance of the child′s body, optimizing the work of regulatory systems, reducing the intensity of pain syndrome makes it possible to start early rehabilitation of premature infants.

Introduction. According to the World Health Organization, the natural and human-transformed natural environment affects the health of urban residents. In modern socio-economic conditions of megapolis there are unfavorable trends of deterioration of health and quality of life indicators of urban population. Pregnancy is a crisis state for both the woman herself and her family as a whole, so it is during this period that a woman needs to ensure a high level of quality of life, which is often not given due attention due to the high rhythm of life in megacities. The course of pregnancy is determined by the development of structural and functional changes in a woman′s body, which in turn affect not only physical well-being, but also mental health, thus changing the level of quality of life of a woman. Along with this physiological changes during pregnancy can serve as a background for the formation of somatic dysfunctions, the clinical manifestations of which are determined by the compensatory capabilities of the body of the pregnant woman. Pregnancy support at the present stage dictates the necessity of timely detection of functional changes and quality of life disorders in order to prevent complications during pregnancy.

The aim of the study: to evaluate the osteopathic status and the level of quality of life of pregnant women in megacities

Materials and methods. In a cross-sectional cohort study conducted in the period from 03.2018 to 05.2023g on the basis of medical clinics in St. Petersburg (LLC «Institute of Osteopathy Mokhov»), in Moscow (Balashikha Maternity Hospital), in Kazan (City Clinical Hospital № 16) and Medical Clinic «Medexpert» (Kazan) were included 225 somatically healthy pregnant women at different stages of pregnancy, aged 25–45 years. The mean age of the subjects was 34±3,8 years at the time of follow-up. A unified osteopathic examination was performed in all pregnant women with the formation of an osteopathic report and the level of quality of life was assessed according to the criteria of the SF-36 questionnaire.

Results. The analysis of the results of the conducted studies demonstrated that as pregnancy progresses, somatic dysfunctions of the pelvic region come to the forefront (p<0,05), and the indicators of the level of both physical and psychological components of the quality of life significantly decrease (p=0,02) with increasing gestational age. At the same time, a significantly lower level of quality of life indicators at baseline and as pregnancy progresses is observed in the residents of Moscow compared to pregnant women living in St. Petersburg and Kazan.

Conclusion. Healthy pregnant women are characterized by the presence of somatic dysfunctions of regional and local level, and the frequency of their detection, degree of severity and level of manifestation depends on the term of pregnancy and does not statistically differ in the residents of the cities of St. Petersburg, Moscow and Kazan. As pregnancy progresses, the inhabitants of megacities are characterized by a decrease in both physical and psychological components of quality of life. The fact that we have revealed a statistically significantly lower level of quality of life indicators in women living in Moscow compared to those living in St. Petersburg and Kazan needs further study by specialists.

Introduction. In recent decades, a lot of new materials about etiology and pathogenesis of biliary system diseases have been obtained and new effective drugs have been introduced. But, despite this, there remains much unrecognized and controversial in etiopathogenesis and principles of treatment of the disease. Moreover, the frequency of complicated forms of the disease and the overall incidence of biliary pathology continues to grow, which clearly shows the need to search for new approaches to diagnosis and treatment of these conditions. The leading causes of biliary tract pathology formation, actual problems of pharmacotherapy (allergic reactions, side effects, polypragmasy), certain aspects of comorbid pathology make clinicians pay closer attention to non-medicament treatment methods, including osteopathic correction. Previous studies have already demonstrated a good clinical effect of osteopathic correction in the treatment of patients with biliary disorders. At the same time, most studies in osteopathy present an assessment of the possibility of using osteopathic correction in the treatment of certain nosological forms. But no less important, in our opinion, is to conduct studies aimed at evaluating the clinical effectiveness (efficiency) of individual osteopathic approaches and techniques.

The aim of the study: to investigate the clinical effectiveness of osteopathic techniques of gallbladder drainage.

Materials and methods. The study was conducted in 2022–2023 on the basis of Polyclinic of the Federation of Independent Trade Unions of Russia (Moscow) and City Mariinsky Hospital (St. Petersburg). There were 30 people (9 men and 21 women) aged 18 to 59 years (mean age was 40,4±2,3 years) without pathology of the gastrointestinal tract and gallbladder (biliary tract) who agreed to participate in the study. All participants underwent a fasting gallbladder volume study, followed by a gallbladder volume study one hour after eating a trial breakfast (TB). One week after the first study, the same patients underwent another fasting gallbladder volume study, then a gallbladder volume study after osteopathic correction (OC) techniques. Thus two observation groups were formed: observation 1 (TB) — study of gallbladder function before and after taking a trial breakfast; observation 2 (OC) — study of gallbladder function before and after gallbladder drainage techniques. Participants did not receive other treatments during the study. All respondents underwent clinical osteopathic examination and biliary ultrasound with motor function score (MFS) was performed. Outcomes in this study were defined as changes in gallbladder size and motility.

Results. No global level somatic dysfunction was identified in the study participants. Regional biomechanical disorders and separate local somatic dysfunctions were more typical for them. However, it was not possible to identify any predominant dysfunctions, as all of them were detected in single cases. After the exposure was completed, the osteopathic status was re-evaluated. The analysis showed that there were no statistically significant changes in the frequency of detection of the main somatic dysfunctions in both observations (p>0,05). In the observed respondents, no abnormalities in the basic size and volume of the gallbladder at the beginning of the study were revealed. After the conducted stimulation no statistically significant differences in gallbladder size (length and width) both within and between the observation groups were registered (p>0,05), but statistically significant dynamics was obtained in the form of gallbladder volume decrease in response to the effect (p<0,05) both when using TB and after OC. All participants were assessed with a measure of gallbladder motor function (MFS). In case of observation 1 (TB), the MFS value was 0,66±0,09 and observation 2 (OC) was 0,58±0,07, which corresponds to normal gallbladder functional activity. Compared to the use of a trial breakfast, osteopathic correction demonstrated a slightly less pronounced effect on gallbladder motor function, but these differences between the groups were not statistically significant (p>0,05).

Conclusion. Osteopathic manipulations on the gallbladder and biliary tract have an effect on the gallbladder volume and motor activity comparable to the effect of the trial breakfast.

Introduction. Myofascial pain syndrome (MFPS) is one of the most frequent musculoskeletal pathologies causing chronic pain. This type of pain reaches the peak of prevalence in middle-aged individuals, women are affected 2,5 times more often than men. The disease leads to significant disability and is not only a medical but also a social problem. At the same time, a number of authors still note the low clinical efficacy of the applied therapy schemes. In this situation, further study of the pathogenesis of MFPS, in particular, genetic aspects of realization of this condition.

The aim of the study was to perform full genomic profiling of gene expression (transcriptome study) in selected muscle tissue biopsy specimens of individual patients and control individuals.

Materials and methods. To study the genetic aspects of MFPS realization, gene expression profiling in muscle tissue samples by full genome RNA sequencing (RNA-Seq) was performed in 5 patients suffering from myofascial brachial pain syndrome (2 patients with active form of MFPS, 3 — with latent form).

Results. The transcriptome analysis of muscle tissue samples from the MFPS area revealed a statistically significant 6-10-fold increase in the expression of the ENSG00000148677:ANKRD1 (ankyrin repeat domain 1) gene in the subgroup of patients with latent form of MFPS compared to active form of MFPS.

Conclusion. The results of the studies allowed to suggest that one of the factors of the latent form of MFPS realization may be adaptive hyperexpression of the gene encoding ANKRD1 protein, which regulates myofibrils tension, myoblasts differentiation, lipid metabolism, affects the development of neuronal connections.

Introduction. The period of adolescence accounts for the completion of the growth processes of the body, and the beginning of stabilization of functional indicators, which, as more plastic factors, are more sensitive to environmental conditions. Measuring, evaluating, and predicting morphofunctional parameters of the body of medical university students, taking into account regional standards of physical development, is one of the priorities of modern medicine and scientific research in general.

The aim of the study is to study the features of anthropometric and functional characteristics, vegetotype of medical university students in comparison with the current regional standard.

Materials and methods. Anthropometric and functional parameters were measured in 300 medical students (77 males, 223 females), aged 19,1±0,88 years.

Results. It is shown that anthropometric characteristics of students significantly exceed the regional standard, in boys it is body length (p<0,01), and weight-height ratio (p<0,05), in girls it is body length, chest circumference and weight-height ratio (p<0,01). Cardiointervalography parameters revealed 4,01 % vagotonics, 88,33 % eutonics and 7,62 % sympathotonics, a significant difference (p<0,01) was also found in linear cardiointervalogram parameters in cohorts of these vegetotypes. Functional indices in absolute terms revealed compliance with the regional standard only in vital capacity of lungs, carpal dynamometry is significantly lower than the standard, in girls (p<0,01), boys (p<0,05), haemodynamics in terms of diastolic blood pressure and heart rate significantly (p<0,01) exceeds the reference values. Integral functional indices: vital index, vegetative index, minute volume of respiration differ significantly by sex (p<0,05); Kerdo index, minute volume of blood circulation showed a significant difference by vegetotype (p<0,05); pulse pressure showed a significant difference by sex and vegetotype (p<0,01).

Conclusion. The studies showed statistically significant excesses relative to the regional standard in young men in body length (p<0,01) and mass-height ratio (p<0,05), in chest circumference in girls (p<0,01); in diastolic blood pressure and heart rate in boys and girls (p<0,01). Absolute and integral indices of cardio-respiratory system are significantly higher in sympathotonics than in vagotonics. Young men, relative to girls, demonstrate higher absolute, linear values of cardiointervalogram (p<0,01), in the whole population these indices are within the range of norm of the regional standard. Among students the majority 88,33 % have normotonic type of ANS. The obtained results, in our opinion, show the need for systematic monitoring of objective morphofunctional state of modern youth.

Introduction. Gingival recession is a highly relevant and common dental pathology. The prevalence of recession ranges from 45,5 to 99,3 % in people of different ages, with the risk of gingival recession increasing with age. The true etiology of gingival recession, its components and the degree of their influence, jointly or separately; the influence of the environment and lifestyle on the development of pathology are poorly understood. In the literature, for example, there is no classification of etiological factors according to the degree of their influence as triggers of gingival recession. It is of scientific interest to study the causes of gingival recession, their systematisation and assessment of the degree of influence of each factor separately and together.

The aim of the study is to develop a classification system of etiological factors taking into account their significance and degree of influence on the formation of gingival recessions.

Materials and methods. Analysis of scientific literature, methods of classification and structuring; methods of decomposition, integration and determination of cause-and-effect relationships.

Results. A model of classification of factors of the etiology of gingival recessions was proposed, elements of the structure of etiological factors of gingival recessions were determined by the degree of their influence on pathogenesis.

Conclusion. Conclusions. The study and understanding of the etiology of gingival recessions allows the clinician to select a personalised treatment taking into account individual characteristics that influence the recession occurrence and its condition: congenital and acquired factors; living conditions, habits, level of hygiene, as well as other components that aggravate or compensate for the degree and level of complexity of any recession - single, multiple or generalised. It is advisable to continue the study of literature data to expand the classification and detail the structure of etiological factors.

Introduction. Perception is a holistic reflection of objects and phenomena, in which all perception channels — auditory, visual, kinesthetic — are present. The degree of expression of each channel in the general structure of perception differs. Psychological studies usually show the specific weight of perception channels in its general structure in a one-stage «slice» of a certain group of people. No data on the peculiarities of the perception channels of physicians were found in the available literature. There are very few data on the changes of perception channels in one group of subjects over a long period of time.

The aim of the study is to research studying the characteristics of perceptual channels in doctors of different specialties and in the students of professional retraining in the specialty «Osteopathy» in the process of training.

Materials and methods. The cohort, prospective study was conducted during 2022–2023 on the basis of the Institute of Osteopathy, St. Petersburg. The object of the study was the students of the professional retraining cycle in the specialty «Osteopathy» — 32 people aged 30–68 years (median — 46,4 years), 13 men and 19 women. The examination was carried out 3 times, at the end of the 2nd course, at the 3rd course and at the 4th course. Twenty-three subjects completed the 3-fold survey. Also during 2023, a cohort, one-time survey of physicians was conducted on the basis of Samara City Polyclinic № 1: gynecologists — 27 people 27–68 years old (median 42,37 years old), dentists — 25 people 24–61 years old (median 42,5 years old), pediatricians — 26 people 24–70 years old (median 43,6 years old), therapists — 23 people 24–64 years old (median 39 years old). All subjects had completed higher medical education and more than 1 year of work experience. The questionnaire S. A. Efremtseva′s questionnaire «Diagnostics of the dominant perceptual modality» was used, which consists of 48 questions aimed at identifying the predominant perceptual channel in three directions: auditory, visual or kinesthetic. The maximum number of points for each of the three modality channels is 16 and the minimum is 0. The survey was anonymous. In the questionnaire, participants provided data on their gender, age, work experience, and date of the study.

Results. The peculiarity of the structure of dominant channels of perception in doctors (gynecologists, therapists, pediatricians) was revealed: the kinesthetic channel was most often dominant (36–50 %), the visual channel was second (19–30 %), and the polymodal channel was third (19–22 %). The auditory channel as the dominant channel was the most rare, but at least 11 %. Among dentists, the visual channel of perception was predominant in the dominant structure, 40 %, and 4 % less frequently the kinesthetic channel, with polymodal perception dominant in only 4% of cases. In doctors working in the specialties of «Gynecology», «Dentistry», «Pediatrics» and «Therapy» there was no statistically significant difference in the expression of all perception channels (p>0,05). The general structure of perception of primary retraining trainees in the specialty «Osteopathy» underwent changes as the training progressed. The specific weight of the polymodal channel in the general structure of perception increased annually and increased almost 7 times in the 4^th course in comparison with the 2nd course (in 43 % of cases the dominance of the kinesthetic channel was combined with the auditory channel, in 57 % — the kinesthetic channel was combined with the visual channel). The specific weight of the auditory channel decreased, and by the 4th course there were no listeners with a dominant auditory channel left. The expression of the kinesthetic channel in the students of the course «Osteopathy» in the course of training systematically increased (p=0,0008). In the 2nd year of training future osteopaths did not differ from doctors of other specialties, in the 4th year they began to differ by greater expression of the kinesthetic channel (p=0,0001). There were no statistically significant dynamics and differences in other channels.

Conclusion. In doctors, the kinesthetic channel of perception most often dominates. In the students of professional retraining in the specialty «Osteopathy», as the training progressed, there was a further increase in the expression of the kinesthetic channel of perception. Its greatest increase occurred in the 4th year of training, and future osteopaths began to differ from doctors of other specialties by this indicator.

Dorsopathies are large and disparate group of diseases of the musculoskeletal and articular-ligamentous apparatus of the spine, which are united by the presence of pain syndrome in the trunk and extremities. Pain as a clinical phenomenon is one of the most diffi cult to interpret complaints encountered in medical practice. Despite the signifi cance of the problem, there are still diffi culties in objectivising and assessing the severity of the pain syndrome. Currently, methods of pain status assessment can be divided into objective, based on the analysis of the level of induced pain and instrumental registration of results; and subjective, such as the use of visual analogue pain scale. At the same time, the assessment of pain and painfulness from the position of osteopathic methodology is an important link in the course of distinguishing the prevalent component of DM, as well as in the framework of differential diagnosis. However, in practice, there may be some diffi culties in objectifying the degree of pain severity and assessing its change on the background of treatment. If for pain it is possible to use the analogue scales already mentioned, there is no such possibility to assess painfulness. We have described a clinical case to study the possibility of using pressor algometry in a patient with cervical dorsopathy to assess pain sensitivity (painfulness) and select correction techniques.

An analysis of the stages in the development of scientific research on the use of evidence-based medicine in osteopathy is presented. A search was conducted for scientific publications in the entire Medline database of the US National Center for Biotechnology Information (NCBI), starting in 1984. The main directions aimed at improving the quality and reliability of scientific research in osteopathy are described. As a discussion, it is proposed to use an assessment method that allows you to record three types of body reactions to the treatment — immediate, fast and delayed.