Mikhail A. Rumyantsev

Late-stage gonarthrosis (Kellgren-Lawrence grades III-IV, Kosinskaya grade III) is a common cause of persistent pain and dysfunction in the lower extremities. Total knee arthroplasty (TKR) is an effective surgical procedure; however, rehabilitation outcomes in the early postoperative period are not always predictable. Existing prognostic models rely primarily on questionnaires and scales, while objective biomechanical parameters—gait characteristics and postural stability—remain understudied in their relationship with psychosocial status. The aim of this study was to determine the prognostic significance of the initial psychosocial status of female patients after TKR in relation to the dynamics of clinical, functional, podometric, and stabilometric parameters in the early postoperative period. Material and methods. A prospective cohort study included 29 female patients (median age 65.5 years) undergoing primary TKA for stage III–IV gonarthrosis. Entry testing was performed on the third postoperative day, and final testing was conducted after 7–12 days of inpatient rehabilitation. Quality of life (SF 36), clinical and functional status (KSS, WOMAC), spatiotemporal gait parameters on the C-Mill treadmill, and postural stability on the D-Wall platform were assessed. Statistical analysis included nonparametric tests, calculation of the summary psychosocial index (mean Z scores for subscales) and summary motor index, the Wilcoxon signed-rank test for assessing the dynamics of indicators, and partial rank correlation with control for the baseline motor level. Results. During the rehabilitation period, significant improvement was recorded in the WOMAC scale (from 39.5 to 26.5 points; p <0.001), KSS (clinical from 79.0 to 88.5 points; p <0.001), decreased stance phase asymmetry (p=0.041) and double support (p=0.024), improved postural stability with eyes open (decreased rate of shift of the center of pressure, p=0.016–0.042). The summary psychosocial index positively correlated with the final motor index (ρ=0.748; p=0.005); the relationship remained after statistically accounting for the initial motor level (partial rank correlation ρ=0.734; p=0.0065). Patients with a higher initial psychosocial index achieved significantly better motor results (p=0.009). Conclusion. The obtained results demonstrate that initial psychosocial status is an independent predictor of final motor recovery early after TKA. The identified relationships substantiate the need for preoperative psychological screening and targeted optimization of psychosocial functioning to improve the effectiveness of rehabilitation programs.

In recent years, there has been an increase in the number of people with transplanted organs in Russia leading an active lifestyle; however, issues related to their participation in organized sports, including football, remain insufficiently studied and systematized. The lack of unified approaches to medical support, the training process, and psychological assistance hinders the development of inclusive sports programs for this category of athletes, which determines the relevance of the present search-and-analytical study. The article presents an analysis of the current state and prospects for the development of football for individuals with transplanted organs in the Russian Federation. Particular attention is paid to the problems of medical and biological support and psychological assistance, as well as to the issues of developing specialized sports training programs, financing, and infrastructure development. Possible ways to address these problems are considered, including the development of adapted training programs, the organization of specialized tournaments, the implementation of psychological support, and the enhancement of public awareness regarding organ donation. In conclusion, the importance of developing inclusive sports programs is emphasized, and practical recommendations are presented for creating safe conditions for playing football, improving infrastructure, and training specialized professionals, which makes it possible to expand opportunities for the social integration of people with transplanted organs into active sports life.

Knee osteoarthritis in its late stages (stages III–IV) is a socially significant problem leading to patient disability. Total knee arthroplasty has become the gold standard of treatment and is performed annually in large numbers worldwide and in Russian orthopedic practice. Approaches to early postoperative rehabilitation have been widely reflected in scientific and practical work; however, certain gaps remain in the study and analysis of abnormal motor patterns in patients when assessing the biomechanics of movement in the preoperative period. The aim of this study was to determine the role of biopsychosocial factors as predictors of gait disturbances in women with stages III–IV gonarthrosis during preoperative preparation for total knee arthroplasty. Material and Methods. This study, conducted at Clinical Hospital No. 1 of Medsi Group of Companies, involved 20 patients who underwent a preoperative examination, including functional testing, quality-of-life and psychological health assessment, and instrumental diagnostic methods for podometric assessment of gait stereotypes. The results obtained were statistically processed using correlation analysis. Results. The constructed correlation network revealed 30 statistically significant relationships between variables. The greatest number of correlations were found for the WOMAC overall, TUG (Turn Up and Go) and 10‑meter walk test. Among the psychosocial variables, the SF-36 physical and social functioning scales demonstrated the highest degree of centrality. Strong positive correlations were found between weight distribution asymmetry and gait timing asymmetry: with single-support asymmetry and double-support asymmetry in timing, as well as a negative correlation between gait speed and weight distribution asymmetry. These results indicate the need for a comprehensive approach to preoperative preparation of patients with gonarthrosis, including not only an assessment of functional status but also psychosocial support. Conclusion. The identified relationships substantiate the advisability of integrating psychological diagnostics, correction, and social adaptation into the «School of Endoprosthetics» program to improve the recovery period after surgery.

Background. Food allergy is a serious, life-threatening condition that negatively impacts the quality of life of patients and their families, especially among children. In Europe, approximately 7 million people suffer from food allergy, while in Russia, the prevalence varies from 5% to 30%. Accurate diagnosis and treatment of food allergy are crucial to preventing complications and improving quality of life. Primary diagnostic methods include medical history, laboratory tests, and elimination diets, though each has its limitations. Globally, oral food challenges are considered the "gold standard" for food allergy diagnosis. It helps to establish a precise connection between the allergen and the reaction, reducing anxiety for patients and their families. Objective. To evaluate the feasibility of using oral food challenges as a diagnostic method for food allergies in children. Materials and methods. This single-center, prospective, interventional, non-randomized, uncontrolled study is being conducted from January 1, 2022, to December 31, 2024, at the G. N. Speransky Children’s Hospital No. 9 in Moscow. Children aged 6 months to 17 years, suspected of having an immediate allergic reaction to cow's milk protein and/or egg protein by a doctor or legal guardian, were invited to participate. The study involves using an open food challenge for diagnosing food allergies. An open food challenge involves consuming increasing amounts of the suspected allergen (milk, egg, etc.) in its natural form under medical supervision. To determine the necessity of a provocation test, a consultation is conducted, including a physical examination, medical history, and allergy testing (specific IgE blood tests, component diagnostics for milk and egg, and a prick test with the native allergen). Additionally, during the consultation, questionnaires on anxiety and quality of life were completed. Our patient selection and test procedure algorithm is an adapted version of existing protocols from international allergology organizations. Conclusions. Preliminary results indicate that the provocation test is a safe diagnostic method when following a strict patient selection and test procedure algorithm. Notably, parents of children undergoing these tests exhibit high anxiety levels. We plan to continue this study and assess personal and situational anxiety levels over time post oral food challenges.

Introduction. The state of children had suffered from COVID-19 causes various persistent symptoms affecting on patient well-being and quality of life which is a significant healthcare issue. The aim of the work. To assess health and well-being of children following COVID-19 and other acute respiratory infections. Materials and methods. This is a case-control study including children with history of PCR-confirmed COVID-19 (n = 261) and other acute respiratory infections (n = 198). Patients were assessed 6 months and 1 year after the infection using the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) COVID-19 questionnaire for children. The prevalence of symptoms including fatigue, weakness, lack of energy, as well as the emotional well-being, social relationships, and social activity of children was evaluated. Results. Children with history of COVID-19 in six months had significantly higher rates of weakness and decreased school attendance compared to children with other acute respiratory infections. 12 months after infection, children in the case group were significantly more likely to experience poor concentration, weakness, a decreased sense of belonging and school attendance. However, 12 months after infection, control group had significantly higher rates of fatigue. Conclusion. Children with a history of mild COVID-19 and other acute respiratory infections may experience ongoing health problems for 1 year after the infection, requiring greater attention from healthcare professionals and family members.

Despite the impressive progress in diagnosis and management of acute COVID-19, data regarding the consequences of this infection are just emerging. The World Health Organization has proposed the term post-COVID condition (PCC) to describe the wide range of sequelae of acute COVID-19. With more than 200 million confirmed cases of COVID-19, PCC may develop into a major problem for many years to come for the millions of COVID-19 survivors worldwide. Few studies were conducted in primary care, and very few studies have focused exclusively on children and adolescents.Objective. To review existing data on PCC. Analysis of manuscripts published in peer-reviewed journals and clinical protocols. PCC is characterized by a wide range of systemic, cardio-pulmonary, gastrointestinal, neurological, and psychosocial symptoms.Conclusion. Although PCC prevalence is difficult to estimate due to methodological limitations of the existing studies, there is no doubt that this problem is a significant healthcare burden. There is a need for further observational and interventional studies to establish optimal PCC prevention and management strategies.