Introduction. Statins reduce the risk of recurrence of cardiovascular events and improve the survival of patients with atherosclerosis, including survival in patients after heart and vascular surgery. However, no more than 10% of patients after heart and vascular surgery are in the target range of low-density lipoproteins. The purpose of the study was to conduct a clinical and economic analysis of the intensification of lipid-lowering therapy in patients who underwent heart and vascular surgery. Materials and methods. The total mortality was modeled for 10 years in patients who underwent surgery for heart and vascular diseases in the Russian Federation. Next, the calculations of the number of lives saved and the total number of years of life saved for 1, 5 and 10 years after heart and vascular surgery were carried out. Based on the approximated survival function, the expected number of deaths in the cohort during the 10-year follow-up period was estimated for each group under consideration. The number of lives saved was calculated as the difference between the expected number of deaths in the baseline scenario and in the intervention scenario over the corresponding time horizon. The number of life years saved was defined as the area under the survival curve during the simulation period (10 years). The additional life years saved were calculated as the difference between the results in the intervention scenario and in the baseline scenario. Then, based on the data obtained, a clinical and economic analysis of the expansion of lipid-lowering therapy was carried out by adding rosuvastatin 10–40 mg and ezetimibe 10 mg to the list of vital and essential medicines for secondary prevention after heart and vascular surgery. Results. Intensification of lipid-lowering therapy through the use of high-intensity statins (including rosuvastatin) and their combination with ezetimibe in patients undergoing surgery for heart and vascular diseases will save 17,165 lives within 10 years, which will save 97,553 years of life. An assessment of the economic costs showed that providing ten years of intensive lipid-lowering therapy for patients undergoing heart and vascular surgery would require additional funds in the amount of 14,356.725 million rubles. Conclusion. Expanding the possibilities of secondary prevention after heart and vascular surgery by enhancing lipid-lowering therapy (including rosuvastatin 20–40 mg in combination with ezetimibe) leads to a long-term reduction in postoperative mortality. An increase in costs per patient by an average of 4,046.97 rubles per year will save 97.5 thousand years of life for 10 years. At the same time, the amount of additional costs per saved year of life is significantly lower than the current Russian threshold for willingness to pay per saved year of quality life.

Introduction. Antimicrobial resistance is one of the leading threats to public health and to the sustainability of healthcare systems, and its containment has been designated a national priority of the Russian Federation. The purpose of the study: to systematize modern ideas about the scale and driving factors of antimicrobial resistance in the Russian Federation and to justify the transition from a list of disparate measures to an integrated model of its containment. Materials and methods. The analytical review is based on domestic and foreign publications for 2017–2025, regulatory legal acts and data from the national multicenter sustainability monitoring. The sources were searched in the repositories PubMed, CyberLeninka, eLibrary.RU, as well as through the Google search engine. Logical, comparative, structural methods and content analysis were used to study the generated array of relevant publications. Results. According to the data obtained, there is a tendency to increase the resistance of pathogens, mainly gram-negative ones, in hospital settings. At the same time, the key limitation remains not the lack of scientific knowledge, but the gap between evidence-based approaches and their actual implementation in practice, which is mainly behavioral and organizational in nature. National surveillance information infrastructure and specific vaccine prevention are considered as underestimated, but complementary points of application that can reduce the need for antimicrobials and limit the selection of resistant strains. Conclusion. Antimicrobial resistance cannot be contained by a single instrument; a sustainable outcome is provided by a systemic loop combining resistance monitoring, rational pharmacotherapy, vaccination and a managed digital environment for their implementation, individual elements of which are already being created in the Russian Federation and require organisational and informational integration.

Introduction. In the context of increasing levels of anxiety, the introduction of digital technologies with an emphasis on artificial intelligence as key tools to improve the situation by increasing the effectiveness of diagnosis and control of treatment of mental illnesses is of particular importance. The purpose of the study is to systematize data on the current state, prospects and limitations of the applicability of AI systems in the diagnosis of mental disorders, primarily depressive states, and to assess the maturity of existing technologies in order to implement them in real clinical practice. Materials and methods. The literature was searched in the PubMed (MEDLINE) database. The systematic review includes 74 original articles published in English between January 2021 and March 2026. Thematic blocks of search queries were used to identify publications exploring the possibilities of diagnosing depression using speech, voice, acoustics, facial expressions, and computer vision. The articles were subjected to a multi-stage selection: elimination of repetitions, preliminary rapid analysis by titles and annotations, and a detailed study of selected articles. Results. The conducted research demonstrates the prospects of using AI, especially multimodal approaches, in the field of detecting mental disorders, including depressive states. At the same time, a number of critical limitations have been identified that hinder the widespread clinical implementation of this technology. These include: the lack of research performed in real-world clinical practice, the potential bias of algorithms against different gender, age and ethnic groups, the difficulty in interpreting AI recommendations, and the lack of direct comparisons with the professional assessment of qualified specialists. It is also necessary to take into account the geographical concentration of research in the Asian region, which underlines the importance of conducting further research with more representative samples in order to ensure generalizability of the results. Conclusion. A promising direction is the development of hybrid models that integrate AI capabilities with the experience and knowledge of clinicians. Successful solution of these tasks will allow us to realize the potential of AI for early detection of diseases, personalization of therapy and improvement of the quality of life of patients with depression.

Introduction. The increasing incidence of gestational diabetes mellitus and other first-time diagnosed carbohydrate metabolism disorders during pregnancy, along with the associated obstetric and perinatal risks, represents a significant medical and social challenge. The current stage of healthcare development in the Russian Federation is characterized by active modernization of clinical protocols and the regulatory framework governing medical care in the field of endocrinology. However, documents specifying the organization of medical care for pregnant women with gestational diabetes mellitus have not been developed. The purpose of the study: to study and systematize the literature data and regulatory documents reflecting the organization of medical care for pregnant women with impaired carbohydrate metabolism, including to assess the current routing situation of patients with gestational diabetes mellitus. Materials and methods. An analysis was conducted of 106 international (PubMed, Scopus, Medline) and Russian publications (2012–2025), as well as 9 key regulatory documents of the Russian Federation governing care for patients with carbohydrate metabolism disorders. Data systematization was performed using Microsoft Excel. Results. The article examines current regulatory documents reflecting the organization of medical care for pregnant women with carbohydrate metabolism disorders. A detailed analysis of medical care procedures, several orders of the Ministry of Health of Russia, and federal laws was carried out to identify gaps and contradictions in the legal regulation of this group of diseases. In particular, issues of routing patients with established gestational diabetes mellitus are discussed in terms of diagnosis, treatment, delivery, and postpartum management. Detailed data are presented indicating limitations in the existing regulatory framework concerning pregravid preparation of patients with carbohydrate metabolism disorders. The problem caused by untimely consultations with endocrinologists and other specialists is separately characterized. Conclusion. Improving the medical and economic efficiency of managing pregnant women with carbohydrate metabolism disorders and minimizing the risks caused by hyperglycemia during pregnancy, including long-term complications, can only be achieved through the development of regulatory documents on the organization of medical care for this population group and their implementation nationwide. 

Introduction . The rise of social isolation and the deterioration of psychological health in the population increase the significance of the problem of negative loneliness and the search for effective ways to overcome it. Therefore, the creative process is considered a promising way to transform loneliness into a source of inner growth. This understanding requires thorough theoretical and empirical research. The purpose of the study: to study the creative process as a model for overcoming negative loneliness for theoretical and applied research in the field of accessible psychological support for people with a pronounced sense of loneliness based on the analysis of fiction and scientific literature. Materials and methods. The materials used were scientific publications from the Web of Science, PsycINFO, eLIBRARY.RU, PubMed, Google Scholar, and ProQuest databases, as well as works of fiction by Antoine de Saint-Exupéry, Haruki Murakami, Irvin Yalom, and Oscar Wilde, supplemented by the theoretical concepts of Carl Gustav Jung. The research methods included a review, systematization, and comparative analysis of theories of loneliness, literary texts, and the results of empirical research in the field of creativity and psychotherapy. Results. An analysis of the artistic and scientific literature on the creative process as a promising way to transform loneliness into a source of inner growth revealed the theoretical foundations and practical mechanisms linking creativity and the reduction of loneliness. It demonstrated the impact of creativity on the social, emotional, and cognitive levels, reducing loneliness and improving quality of life. Practical mechanisms linking creativity and the reduction of loneliness (organizing group creative projects, using art therapy practices, and creating creative workshops) help create a sense of community and strengthen social connections, provide an opportunity to safely express inner experiences, support self-esteem, and expand social circles. Forming new connections reduces feelings of social isolation. Conclusion. The key finding of this study is that the creative process is effective as a means of combating negative loneliness. Using the creative process as a means of combating negative loneliness opens new horizons for personal growth and emotional health.

Introduction. Currently, there is an exponential growth in the number of scientific publications in various branches of science. According to the proliferation theory, a significant increase in the number of scientific articles in a particular scientific field should lead to an increase in the amount of knowledge in this field. This increase can be indirectly estimated by the dynamics of the number of dissertations defended. However, this hypothesis requires statistical confirmation, despite the fact that neither the number of articles nor the number of defenses are classical scientometric indicators. The purpose of the study is to identify the relationship between the explosive growth of publication activity in recent decades and the growth of scientific knowledge, which is recorded by the scientific community in defended dissertation research using the example of medical psychology. Materials and methods. The material for solving this problem was doctoral and candidate dissertations, the obligatory copies of which were sent to the Russian State Library. The Google Scholar academic search engine, or Google Academy, with a high degree of coverage of scientific articles, was used to quantify publication activity over a similar period of time. The study covered publications on psychological topics over a thirty-year period (1995–2024). The sample consisted of 12,033 dissertation studies on psychological sciences in general during the period under review, of which 772 related to medical psychology. Additionally, 274,006 articles and other works on medical psychology were studied. The methodological basis of the analysis was the sociological approach, the systematization of the material, content analysis and its visualization by mapping. Results. The analysis showed a multiple increase in publication activity in the field of medical psychology: the number of papers increased tenfold. Nevertheless, the dynamics of the increment of scientific knowledge showed significantly lower growth rates. In the absence of alternative metrics, this indicator was estimated by the number of defended dissertations, a key indicator of the recognition of research contributions by the scientific community. The data obtained indicate that there is no direct correlation between the growth of publication activity and the generation of new scientific ideas. Consequently, quantitative metrics of the number of publications have an extremely indirect relation to the assessment of the researcher’s real contribution to the increment of scientific knowledge. Conclusion. A slight but steady increase in doctoral dissertations was noted, which suggests that there is a more active accumulation of materials for theoretical generalizations.

Introduction. The Global Burden of Disease study of morbidity and mortality from coronary heart disease in different countries in 1990–2017 showed that about 126 million people worldwide suffered from this disease (1,655 thousand cases per 100,000 population), which is 1.72% of the population. By 2030, the incidence of coronary heart disease is expected to increase to 1,845 thousand cases per 100,000 population. In the Russian Federation in 2023, 7,886,843 patients with coronary heart disease (5,385.4 cases per 100,000 population) were registered, 735,779 people died, which accounted for 53.5% of all deaths from diseases of the circulatory system and 24.7% of all deaths in the country. The incidence of myocardial infarction in 2023 was 160.4 cases per 100,000 adults. The high prevalence of coronary heart disease provokes an expansion of comorbid conditions, a decrease in the working capacity and quality of life of the population, an increase in disability, mortality and the social burden of diseases. In the context of demographic aging and staff shortages, healthcare is faced with the task of improving organizational models of care, taking into account regional specifics, as exemplified by the analysis of the situation in the Amur Region as a basis for evaluating the effectiveness of medical interventions. The purpose of the study: to study the specifics of demographic processes and the general incidence of coronary heart disease and acute myocardial infarction in the Amur region to establish trends and influencing factors. Materials and methods. Materials and methods. Materials of official collections of the Ministry of Health of the Russian Federation, the Department of monitoring, analysis and strategic development of healthcare and the Federal State Budgetary Institution “Central Research Institute of Healthcare Organization and Informatization” of the Ministry of Health of the Russian Federation, scientific articles on the relevant diseases were studied. Continuous statistical observation was performed, methods of statistical analysis (data processing, identification of trends using time series methods), comparative analysis (comparison of the values of indicators) were applied, completeness and reliability of statistical data were estimated. Data processing in the Microsoft Excel 2010 program was carried out. Results. In the Amur region, there is a decrease in the population, its aging, and an increase in the demographic burden, which affects the incidence of coronary heart disease, which is higher than the average in the Russian and Far Eastern Federal Districts. Some settlements in areas with extremely low population density are difficult to access. The above creates the need to modernize existing approaches to the organization of medical care for such patients. The implementation of a set of measures, including preventive measures for residents of isolated rural areas with interdepartmental cooperation between regional executive authorities, bringing medical care closer to the patient through the use of remote technologies, as well as the introduction of digital systems for collecting patient data at the outpatient stage aimed at improving the healthcare system, will increase accessibility, improve the quality and timeliness of medical care. Conclusion. The results of the study revealed a number of regional factors that increase the risk of cardiovascular diseases. An increase in the incidence of coronary heart disease has been established, which necessitates the modernization of the medical care system. A target model has been developed for regions with low population density, the implementation of which will increase the availability and quality of cardiological care, reduce the burden on medical institutions and increase patient satisfaction. Conducting such studies is an important tool for assessing the state of the healthcare system, analyzing the impact of factors on the incidence of coronary heart disease and the basis for sound management in healthcare. The results of this work will help healthcare organizers in finding the best approaches to organizing medical care aimed at increasing its accessibility.

Introduction. Although men’s reproductive health is critically important for demographic stability and social well-being of the state, the problem of male infertility remains underestimated. The purpose of the study was to assess the prevalence of male infertility in the federal cities of Moscow and St. Petersburg. Materials and methods. Based on statistical data, a comparative analysis of the prevalence of male infertility in the cities of Moscow and St. Petersburg over a ten-year period (2014–2024) was carried out. Dynamic series methods and Student’s t-test were used to assess the significance of the differences (p<0.05). The generated pool of statistical information was processed in the MS Office-2019 and StatSoft-Statistica 10.0 programs. Results. In the structure of male infertility incidence in the Russian Federation, the two largest cities Moscow and St. Petersburg accounted for an average of 5.9±0.56% of cases during the study period, their dynamics was –0.3 percentage points (p>0.05). The incidence of male infertility in cities of federal significance differs markedly from the national values. In Moscow, the average prevalence was 14.3±1.2 cases per 100,000 adult male population, which is 5.1 times lower than the national average. In St. Petersburg, the average rate was 78.6±10.1 cases per 100,000 adult males, which is 7.4% higher than in the whole country and 5.5 times higher than the Moscow level. At the same time, there is a downward trend in these parameters in the capital, while in St. Petersburg, despite their initially higher level, there is an increase. Nevertheless, the changes in 2014–2024 are not statistically significant (p>0.05). Conclusion. With the high availability of medical care in megacities, the rates of male infertility remain disproportionately low (especially in Moscow), which indicates both the low number of men applying to medical organizations in the city and the imperfection of statistical accounting of cases of this disease. It should be noted that official statistics data include only information obtained from medical organizations of the state and municipal health systems (private clinics are not taken into account). As a result, these restrictions and socio-cultural barriers do not allow us to reliably assess the scale of the existing problem, which indicates the need for further study in order to develop effective measures to improve men’s reproductive health.

Introduction. Limb amputation causes stress and anxiety, which affects patients’ rehabilitation and quality of life. Anxiety, assessed using the Spielberg-Khanin scale (1976), is an important indicator of the perioperative period, especially in the early postoperative stage. Cognitive-behavioral and motivational techniques, mindfulness, emotional support, rapid testing, and modern pain management techniques are used to reduce anxiety. Multidisciplinary rehabilitation reduces the risk of complications and helps patients adjust. The methods for psychocorrection of phantom pain and psychological state during reconstructive surgery are also studied. Prevention of anxiety requires comprehensive assessment and combination of psychotherapeutic and medical approaches, taking into account individual and social factors. The purpose of the study: to study the effectiveness of an integrated approach to reducing anxiety in patients after limb amputation and its impact on the rehabilitation process by assessing the dynamics of anxiety in the early postoperative period, as well as to develop and test a multidisciplinary psychological support program and analyze the relationship between anxiety levels, pain intensity and the quality of the rehabilitation process. Materials and methods. The research methodology involved the use of the Spielberger-Khanin self-assessment scale to assess psychoemotional state, and a visual analog scale to quantify pain syndrome. Medical and rehabilitation treatment included drug therapy, psychological support, and specialized rehabilitation measures. A study sample of 56 patients was used. Results. A statistically significant decrease in the level of situational and personal anxiety was observed in patients during the first week of therapy. The best results were observed in patients with toe amputations, while the worst results were seen in patients with hip amputation. There was a positive trend towards reducing pain and improving sleep quality. Conclusion. The results obtained confirm the importance of multidisciplinary interaction between specialists and the need for an individual approach to each patient, taking into account the degree of limb loss and associated factors. The developed program can be recommended for implementation in rehabilitation centers.