Modern medicine has come a long way and achieved impressive results. At the same time, one cannot help but notice a certain crisis of official medicine: the task of saving human life is increasingly successful, while the elimination of unpleasant symptoms is not so simple. In addition, there are unfavourable side effects of medicines. Many problems of modern medicine come primarily from a mechanistic understanding of the human body, based on the principles of Newtonian mechanics. Integrative approach is a direction in medicine, which is based on the idea of man in the unity of biological, psychological, and social manifestations. Integrative medicine is a project of a new type of medical knowledge and practice, which aims to unite the positive aspects of different medical systems and schools, not just mechanically connecting them with each other, but offering a new theoretical basis from which the positive aspects of different medical systems and practices could be derived as their own particular cases. Our body is a single system in which everything is interconnected and interdependent. Disturbances in one system or at one level affect all others, and any intervention must be done in an integrated manner. An essential part of integrative medicine is the interaction between patient and physician and ideally the physician should view the patient as a unity of body, mind and spirit and address all these aspects of human nature.

Introduction. Carpal tunnel syndrome occurs in 5–10 % of the total population, develops at working age between 35 and 65 years, women are affected 3–6 times more often than men, and the prevalence and severity of the disease increase with age. Ultrasound examination of peripheral nerves is quite widely used in medical practice but remains an underestimated diagnostic method in the practice of an osteopathic doctor. Despite the data on the use of osteopathy in the treatment of tunnel neuropathy of the median nerve, the available literature does not contain information on the objectifi cation of the results of osteopathic correction of the pathology of this nerve using ultrasound.
The aim of the study: to study the direct (immediately after the session) effect of osteopathic correction on the condition of the median nerve in the carpal tunnel using ultrasound diagnostics.
Materials and methods. Ultrasound and osteopathic correction sessions of patients with CTS were carried out at the Primorsky Institute of Vertebroneurology and Manual Medicine (Vladivostok). On the basis of voluntary informed consent, the study included 6 patients, women aged 38 to 64 years with a diagnosis of carpal tunnel syndrome. The ultrasound was performed using the SAMSUNG MEDISON HS50-RUS device with a LA3–14AD linear transducer with a frequency of 12 MHz. Transverse and longitudinal scanning was carried out sequentially. Measurements of the median nerve were carried out according to the generally accepted method. The patient underwent osteopathic diagnostics in order to identify the currently dominant somatic dysfunctions, in accordance with clinical guidelines. After that, he underwent a standard and dynamic ultrasound. Then the osteopathic doctor corrected the identifi ed somatic dysfunctions and again performed an ultrasound. Statistical processing was not carried out due to the lack of a representative sample.
Results. Research conducted in accordance with the suggested methodological approach, focusing on the direct impact of an osteopathic session, has shown evident signs of the infl uence of osteopathic correction, resulting in signifi cant changes in structural parameters among almost all patients, including a reduction in compression zone length, decreased pathological nerve hypertrophy, and improved differentiation of intrastem nerve structures, thereby indicating a decrease in nerve edema and intracanal pressure, alongside a reduction in fl exor retainer thickness, which further contributes to enhanced nerve nutrition and mobility. After undergoing a session of osteopathic correction, along with the restoration of nerve morphology, its mobility improved, as revealed by longitudinal and transverse dynamic analysis, manifesting in the form of an increase in unilateral horizontal movement, the occurrence of translational and return movement, as well as the appearance of vertical dorsal displacement, horizontal or vertical movement (initially absent), an increase in the values of horizontal and vertical displacement, and a change in the type of movement of the median nerve in the canal.
Conclusion. Ultrasound examinations provide objective (morpho-physiological) confi rmation of palpatory patterns in the diagnosis of median nerve somatic dysfunctions in carpal tunnel syndrome. The revealed effect of osteopathic correction on the structure and mobility of the median nerve in the carpal tunnel allows a more objective understanding of the mechanism of osteopathic correction and substantiates the possibility of its use in the treatment and rehabilitation of patients with compression-ischemic neuropathy.

Introduction. The specifi c object of osteopathic treatment is somatic dysfunction (SD). However, if previously all osteopathic diagnosis and correction was reduced to the isolation of certain local dysfunctions, now there are signifi cant changes in the paradigm of osteopathy. SD in the body can manifest at different levels — local, regional and global. And from the position of physiology, three components can be conditionally distinguished in SD — biomechanical, hydrodynamic and neurodynamic. At the same time, it seems extremely necessary to conduct a number of studies that would not only confi rm the validity of the allocation of SD at different levels of the whole organism but also allow to objectify palpatory fi ndings of the doctor.
The aim of the study: to evaluate the level of induced pain in the areas of local and regional SD in patients with cervical dorsopathy.
Materials and methods. The cross-sectional study was conducted on the basis of the medical clinic LLC «Mokhov Institute of Osteopathy» (Saint-Petersburg) in the period from September 2018 to September 2022. 230 patients diagnosed with dorsopathy were under observation. All patients were assessed for osteopathic status, degree of pain syndrome severity using visual analogue scale (VAS), pressor algometry with assessment of the level of induced pain and degree of pain tolerance.
Results. According to the results of osteopathic diagnostics the patients were divided into three groups: with regional SD (structural component) at the level of the neck (group 1 — 105 people), with local SD of separate vertebromotor segments at the level of the cervical spine (group 2 — 68 people) and without SD of the musculoskeletal system at the level of the neck (group 3 — 57 people). It turned out that in patients with regional SD (neck region, structural component) the level of local pain (induced pain) was statistically signifi cantly higher (p<0,01) than in patients with local SD at this level or without it at all. According to the rest of the obtained data, the studied groups of patients in terms of pain severity (VAS) as well as pain tolerance had no signifi cant differences.
Conclusion. The results of pressor algometry showed that in the area of regional biomechanical disturbance at the level of the neck in patients with dorsopathy there is an increase in pain compared to patients with local SD at this level or without it at all. The obtained data confi rm the validity of different levels of dysfunction and also indirectly objectify the neurodynamic component of SD.

Introduction. It is relevant to develop and implement innovative methods for identifying the initial stages of functional stress in modern children and adolescents, determining the reserve capabilities of the body using regional evaluation centile tables, calculating integral standardized indices, to optimize the level of both medical and pedagogical control and population monitoring.
The aim of the study: is to assess the functional reserves of children and adolescents in the Nizhniy Novgorod region in different exoenvironments using the index of the body′s reserve capabilities.
Materials and methods. Determination of the index of reserve capacity of the body (IRCB) of 5034 children and adolescents aged 7–17 years (2 332 boys, 2 702 girls), based on the results of measuring physiometric indicators with the conversion of their absolute values into the range of centile intervals of the regional standard, logarithmization according to the innovative formula.
Results. The presented physiometric indicators of children and adolescents signifi cantly (p<0,05) correlate with the index of reserve capabilities of the body IRCB: weak connections (r=0,2–0,3) with vital capacity of the lungs, hand dynamometry, negative averages (r=–0,4–0,5) with functional tests of Stange, Genchi, body weight. Dispersion analysis of IRCB showed average values of the IRCB index in the range of 0,6–0,81, a signifi cant difference (p<0,05) between age was revealed, homogeneity of this characteristic was shown between sex groups (p=0,861). Good and excellent IRCB indices were found in 55,78 and 20,44 % of cases, satisfactory in 20 % and unsatisfactory in 5 % of cases, respectively. IRCB indices signifi cantly (p<0,05) rank with the level of environmental stress in the areas of residence, their values are reduced in 7,38 % of children of all ages in areas with critical environmental stress. Signifi cant (p<0,001) differences in IRCB index values were found in the context of areas of residence, according to social (urban/rural: χ²=40,29; Df=3; p=0,001) and geographical (north/south: χ²=41,54; Df=3; p=0,001) characteristics.
Conclusion. The results of the study showed that a comprehensive assessment of the body′s functional reserve characterizes the physical development of children and adolescents as a refl ection of the combined manifestation of their hereditary properties, living environment conditions, Frequency distributions of IRCB scores in the range from unsatisfactory to excellent demonstrate the sensitivity of the index to a complex of environmental factors. IRCB as a unifi ed normalized index complements the standard arsenal of indicators, improves the quality of assessing the level of functional state of modern students in real time, without the use of additional instrumental examinations when conducting scientifi c population monitoring and in the implementation of current medical and pedagogical control.

Introduction. The course of pregnancy in women with chronic pyelonephritis is associated with a high risk of exacerbation of the underlying disease, which is accompanied by impaired urine flow. This complicates pregnancy and increases the likelihood of purulent-septic complications during the perinatal period. Long-term use of antibacterial drugs to treat or prevent complications may adversely affect fetal development and increase the risk of allergic reactions in pregnant women. Additionally, the use of instrumental methods for renal pelvis drainage (e. g., ureteral stenting) carries a high risk of postoperative complications and stent-associated symptoms in 80 % of women, which are difficult to manage during pregnancy due to contraindications for pharmacological therapies. Managing pregnancy in women with chronic pyelonephritis requires a multidisciplinary approach to prevent complications and reduce perinatal risks for both mother and fetus. This necessitates the search for nonpharmacological methods to improve urodynamics.
The aim of the study: to evaluate the effect of osteopathic correction on urodynamic parameters in pregnant women with chronic pyelonephritis.
Materials and methods. In a prospective controlled randomised study conducted between January 2018 and January 2024 on the basis of the medical clinic LLC «Mokhov Institute of Osteopathy», 180 pregnant women with chronic pyelonephritis without renal failure aged 25–45 years, whose gestational age was 13–27 weeks, were included. All pregnant women with chronic pyelonephritis, depending on the correction technique used, were divided into three groups using a random number generator: the main group (60 patients) and two control groups of 60 patients each. Patients of the main group received standard drug therapy and osteopathic correction (3 procedures with an interval of 10–14 days). Patients in the first control group received standard drug therapy according to approved clinical recommendations. Patients in the second control group, along with drug therapy, used physical exercises 2 times a week for 1,5 months, as prescribed by a physical therapy doctor. In all pregnant women, before the beginning and after completion of correction, osteopathic examination was performed with the formation of an osteopathic report and the size of the renal calyx-lochanous system was assessed by ultrasound.
Results. Osteopathic correction, when combined with standard drug therapy, demonstrated statistically greater improvement in urodynamics compared to isolated drug therapy or drug therapy combined with therapeutic exercises. This was evidenced by a reduction in renal calyceal-pelvic system dimensions on ultrasound (p<0,01).
Conclusion. Incorporating osteopathic correction into the comprehensive treatment of chronic pyelonephritis in pregnant women significantly improves urodynamic parameters. These findings may contribute to optimizing medical care for this patient population.

Introduction. Diffuse alopecia accounts for up to 40 % of all alopecia cases, making it one of the most common reasons patients consult dermatologists and cosmetologists. The pathogenesis of chronic telogen hair loss (CTHL) remains incompletely understood, and the changes occurring in hair follicles are heterogeneous in both pathogenetic and histological terms, rendering the treatment of this condition a significant challenge for clinicians. This underscores the importance of further research in this fi eld and the search for effective therapies, one of which may involve osteopathic correction.
The aim of the study: to evaluate the feasibility of incorporating osteopathic correction into the combined treatment of female patients with CTHL.
Materials and methods. A prospective controlled randomized study was conducted at the «Vash Doctor» Clinic (Moscow region, Odintsovo) from January 2024 to September 2024. The study included 58 female patients diagnosed with telogen alopecia. Using randomization envelopes, participants were divided into two equal groups of 29 patients each: the main group and the control group. Patients in both groups received conventional combined conservative treatment as prescribed by a dermatologist. Patients in the main group additionally underwent osteopathic correction — 3 sessions at 14-day intervals.
Results. In patients with CTHL, a reduction in hair density per cm² and hair diameter was observed, accompanied by decreased mechanical strength. Subclinical levels of depression and anxiety were also recorded. Despite the diverse etiological factors of CTHL no predominant somatic dysfunctions were identified in the osteopathic status of the study group. Both treatment regimens demonstrated clinical efficacy, with statistically significant increases in hair diameter and mechanical strength (p<0,01). However, the inclusion of osteopathic correction resulted in a statistically significant increase in hair density per cm² (p<0,01) and significantly higher mechanical strength values (p<0,05).
Conclusion. Incorporating osteopathic correction into the combined treatment of female patients with CTHL yields statistically more significant improvements in hair density per cm², mechanical strength, and reductions in depression and anxiety levels compared to conventional therapy alone. Further research in this area appears promising.

Introduction. The diaphragm is the main respiratory muscle and performs many non-respiratory functions. Somatic dysfunction of the diaphragm, as identifi ed by osteopathic physicians, is associated with a variety of clinical symptoms: pain, abnormalities of breathing pattern, posture, venous outfl ow from the lower extremities, etc. There are very few computed tomography (CT) studies of the diaphragm, although the diaphragm is well visualised in CT studies of the thoracic and abdominal cavities. CT is an accessible diagnostic method with few limitations.
The aim of the study: to investigate the structure and topography of the diaphragm using computed tomography in patients with and without a history of cancer.
Materials and methods. The cross-sectional study was performed by a continuous sampling of patients who applied to the clinic of MC «Admiralty Shipyards» from May to August 2024. The patients were examined using a Toshiba Aquilion PRIME computed tomography scanner in the supine position, breath hold on deep inhalation. Visualisation of the diaphragm was performed on CT of the chest and abdomen in axial, coronal and sagittal planes — multiplanar reconstructions. All patients aged 25–90 years were included in the study and distributed according to nosological groups: 1st — 7 patients 26–49 years old who were referred for control examination; 2nd — 34 patients 50–90 years old with respiratory diseases; 3rd — 30 patients 50–83 years old with abdominal and retroperitoneal diseases; 4th — 87 patients 42–88 years old with verifi ed malignant neoplasm (MN) of various localisations in anamnesis; 5th — 18 patients 54–78 years old with suspected MN of various localisations who had not undergone surgical treatment. Inclusion criteria: operations on lungs, liver, oesophagus and stomach, anomalies of diaphragm development; injuries of diaphragmatic nerve. Disturbances of the structure and topography of the diaphragm and liver were evaluated in points: 2 points — pronounced changes; 1 point — weakly pronounced changes; 0 points — no changes. The presence or absence of partial loss of contact between the diaphragm and the liver was also evaluated.
Results. All subjects of group 1 had no disorders of the structure and topography of the diaphragm and liver. Relaxation of the left dome of the diaphragm (70,6 %) was characteristic of patients with respiratory diseases and was statistically signifi cantly more frequent than in patients with abdominal diseases (40 %), p=0,026. Relaxation of the right dome of the diaphragm was most common in patients with suspected MN (78,2 %). There may be concomitant deformation of the contour of the adjacent part of the liver. A high degree of correlation ρ=0,8 (p<0,001) was found between these pathological features. Deformation of the diaphragm in the form of its uneven thickening due to spasm of separate muscle fi bres was typical for patients with MN (87,3 %) and with suspected MN (94,4 %). Partial loss of connection of the diaphragm with the liver was most often observed in patients with suspected MN (72,2 %). The pathological signs observed were not related to the localisation of MN, suggesting that they were caused by the severe stress experienced by these patients.
Conclusion. This study demonstrates a high frequency of detecting deformations of the diaphragm and liver contours, as well as abnormalities of their topography on CT in different groups of patients. These abnormalities are especially frequent in cancer patients and patients with suspected MN, which may be associated with a state of severe stress. It is recommended to include the description of the diaphragm in the CT protocol of the thoracic and abdominal cavities. This information can be used for diagnostics and control of treatment results in patients with various diseases, including confi rmation of the results of osteopathic correction of diaphragm dysfunction.

The article is devoted to the signifi cance and peculiarities of forming a personal brand of an osteopathic doctor. The authors studied extensive material on this topic, made a terminological distinction of concepts close to the word «brand», formed the main recommendations for taking into account modern trends in the process of forming a personal brand, revealed the presence of an acute shortage of scientifi c and business publications on this topic. 

The article presents a clinical case of a 3,5-year-old child with neuralgia of the supraorbital nerve, caused by its compression, with an aggravated premorbid background, with positive tests for SARS-COV2 and cytomegalovirus. Osteopathic treatment gave good results, markedly improved the patient′s  condition. Osteopathic treatment is safe, has few contraindications, not only complements the complex of treatment and rehabilitation measures, but can also contribute to the diagnosis of diseases. 

Urolithiasis and its symptomatic recurrences are one of the most common urological diseases in people of working age and is characterised by a high prevalence of complicated forms, in some cases leading to disability of the patient. Despite the fairly high study of the problem, the treatment of urolithiasis is still quite a serious task for clinicians. Optimal is a combination of medication and non-medication methods of treatment. The questions of introduction of new methods of pain syndrome correction and improvement of stone excretion in uncomplicated form of urolithiasis in order to reduce the medication load on the organism, prevent further increase in the size of concrements, and, as a consequence, the development of complications requiring surgical intervention, as well as the search for ways to prevent complications is of interest to the medical community. A case from practice is described, dedicated to the isolated use (monotherapy) of osteopathic correction in a patient with urolithiasis.

Currently, Russia continues to actively integrate osteopathy into the scientific framework, which includes adherence to evidence-based medicine principles. The gold standard for confirming the efficacy of therapeutic interventions is double-blind placebo-controlled randomized trials, originally designed for testing new pharmaceutical drugs. However, there are no precise guidelines on how to conduct such studies in osteopathy. This lecture describes types of placebo interventions and blinding techniques, as well as protocol variations for double-blind placebo-controlled trials employed in osteopathic research, which can be utilized when planning scientific projects.