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One of the important attributes of a medical specialty is the availability of the specialized scientific and practical journal that allows professionals to conduct an open scientific discussion. The osteopaths of Russia have such a journal appeared in 2010 — the Russian Osteopathic Journal (ROJ). The development p of the journal and its achievements to date has been traced in detail in the article. The content and scientometric indicators of erysipelas were compared with Russian and foreign medical journals, including those publishing articles on osteopathy. ROJ has become the mouthpiece of the specialty and meets the high international and Russian standards.

Introduction. Osteopathic correction (OC) is aimed to eliminate somatic dysfunctions, which are reversible structural and functional disorders of tissue mobility. Adaptation mechanisms of the organism imply structural The aim of the study is to investigate the fundamental possibility of using functional (not nosological) autoimmunological indicators to evaluate the results of osteopathic correction.Materials and methods. The prospective study was conducted on the basis of the Department of Osteopathy of the Mechnikov NWSMU and the Institute of Osteopathy (Saint-Petersburg) in 2020–2021. 10 young and middle-aged people (20–52 years old) were examined. Patients underwent osteopathic correction in the amount of 2–3 sessions. Patients were examined according to the algorithms of osteopathic diagnostics; the ratio of antibody titers to 24 autoantigens of various body tissues and organs was evaluated using the ELI-Viscero-Test-24 method before and after the OC courses.Results. The relative content of autoantibodies to the main connective tissue protein collagen significantly (p=0,037) increased from a median value of 6 % (Q1–Q3 2–9 %) to 11 % (Q1–Q3 2–22 %). The other autoimmunological indicators varied in different directions.Conclusion. It is likely that OC triggers the processes of connective tissue restructuring, which are reflected in an increase in the indicators of auto-AT to collagen. Changes in other autoimmunological indicators require more detailed studies on a larger sample.

The article describes the main objects of osteopathic influence in the body and the caused effects. The effects of osteopathic correction can occur at different times after the session and can be recorded using various clinical and instrumental methods. This should be taken into account when prescribing a re-examination of the patient to confirm the treatment results. A brief review of randomized controlled trials proving the efficacy of osteopathic correction in various diseases is also presented.

The editorial article discusses the main modern concepts and terms of osteopathy, including the concepts of preillness, somatic dysfunction and components of somatic dysfunction, and the principles of osteopathic diagnosis. The place of the «5P» concept of modern medicine in osteopathy is also considered.

The formation and development of osteopathy as a scientific discipline is considered. Despite its one and a half century history, osteopathy is a relatively young medical specialty. At the same time, throughout the history of the existence of osteopathy, its supporters carried out an active search for scientific evidence of its effectiveness. Currently, osteopathy is going through the stage of scientification, its formation as a scientific discipline. However, even now even the term osteopathy itself is often interpreted quite loosely and, in some cases, tendentiously. In this regard, the purpose of this work is to trace the development of osteopathy — from the earliest works of its founders to the latest stage of development, when osteopathy has become more and more consistent with the basic requirements of evidence-based medicine. To achieve this goal, much attention is paid to all stages of the formation and development of osteopathy, both abroad and in Russia. There are considered such problems as the formation of the basic terminology, the development and change of the basic concepts of osteopathy, including the concept of osteopathic lesion and the concept of somatic dysfunctions, the development of modern methods of evidence-based medicine, the dynamics of publication activity of osteopathic researchers. It concludes that new ways of obtaining the data about the health effects of osteopathy will continue to emerge, and the level of evidence and the number of quality clinical trials are likely to change.

Introduction . Psychosomatic disorders (PSR) develop as a result of somatization of psychogenic factors. In osteopathy, PSRs are reflected in the so-called psychoviscerosomatic disorder which is a variant of a global neurodynamic functional disorder characterized by poly-regional disorders of tissue mobility that are associated with psychoemotional overloads. In most cases of PSR, neurotization of patients is obligate due to the involvement of a number of nervous structures in the pathological process and the subsequent general decrease in the body's adaptive reserves. According to the polyvagal theory of S. Porges (1995), the vagus nerve is divided into two functionally different branches: nucl. dorsalis n. vagi and n. ambigius. Third core nucl. tractussolitarii is the endpoint of many afferent pathways through n. vagus from peripheral organs, which forms the central regulator of the vagal system. In the process of phylogenesis, the vagus nerve system became more complex due to the inclusion of the pathways of the trigeminal, facial, accessory and glossopharyngeal nerves. S. Porges distinguishes the autonomic vagus nerve associated with passive regulation of visceral functions and the social or intellectual vagus, which is responsible for the processes of attention, movement and communication. The auditory sensory system provides encoding and evaluation of acoustic stimuli that determine the ability to adapt. We suggested that by affecting the auditory system, it is possible to affect the autonomic nervous system and reduce the severity of individual symptoms of PSR. The goal of research — is to study the effect of white noise (WN) stimulation of the auditory sensory system on the manifestations of the disease in patients with cervicalgia (CA). Materials and methods . In the period from 03.2020 to 07.2020 on the basis of the «Professor Novikov'sFamily Osteopathy Clinics», an analytical one-stage (cross-sectional) study was conducted, which involved 109 patients with an established clinical diagnosis of CA, who were divided into two groups: an experimental group (76 people) exposed to WN, and a control group (33 people), in which there was no such exposure. To irritate the auditory sensory system, a WN with a frequency of 1-22,05 kHz was used. Patients of the experimental group were divided into 3 groups depending on the level of neuroticism: low (13 people), medium (49 people), high (14 people). The examination included an assessment of the level of neuroticism, biomechanical indicators that characterize the volume of movements in the cervical region, and the level of pain. The L. I. Wasserman questionnaire was used to assess the level of personal neuroticism. The volume of movements in the cervical spine in degrees was determined using an original device for determining the mobility of the cervical spine. Subjective assessment of pain was performed using the VAS scale. To obtain a quantitative assessment of the achieved result, a «B-A-analysis» method is proposed, based on the evaluation of the modules of 6-timer (by the number of analyzed indicators) vectors A (after the study) and B (before the study) and pairwise analysis of the corresponding components of these vectors. Results . Patients of the main group in subgroups with high, medium and low levels of neuroticism irritation auditory system has led to increased range of motion in the cervical spine that best identified patients with low levels of neuroticism, and minimally high. No significant changes were registered in the control group. There was no convincing difference in the dynamics of VAS indicators. Conclusion . The study showed the possibility of influencing biomechanical parameters when the auditory sensory system is irritated by WN in patients with CA, and the result differed depending on the level of neuroticism — high, medium, low. The subjective assessment of the pain syndrome in VAS case is significantly influenced by the emotional component. Thus, if the nervous system is exposed, the biomechanical parameters changes take place, and it indirectly confirms the integrity and interdependence of the neurodynamic and biomechanical components of functional disorders. The results suggest further study of the possibilities of using WN in patients with various somatic dysfunctions accompanying PSR.

The article considers current issues of epidemiology, etiology and pathogenesis of chronic pyelonephritis in pregnant women at the present stage, and demonstrates its effect on the gestational process and perinatal outcomes. The article presents classification of chronic pyelonephritis in pregnant women, the main clinical manifestations, as well as the possibilities for diagnosis of the disease. Both medical and non-medical treatment methods are considered. Particular attention is paid to osteopathic diagnosis and correction of somatic dysfunctions in pregnant women in order to prevent exacerbations of chronic pyelonephritis and reduce the risk of obstetric complications.

The existing classifier of qualifications appears to be replaced by professional standards (PS) for specialists of preventive medicine, approved by the order of the Ministry of labor of RF № 399n from 25.06.2015. This is a multifunctional regulatory document setting requirements for the content, quality and conditions of the work, qualifications and competencies, professional education and training for skills required to meet this qualification, as well as a description of the ethical standards that are obligatory for the acceptance and respect of all members of the professional community. The standard includes the main type of professional activity of specialists of preventive medicine direction - ensuring sanitary and epidemiological welfare of the population and protection of consumers, identifies summarized working functions and corresponding qualification levels for the specialist, as well as requirements for education and practical activities which are necessary for their implementation. For the each working function included into the standard there are identified required knowledge and skills. The Federal educational-methodical Association in the field of the science of health and preventive medicine prepared a new educational standard in which the professional tasks and competences of the future specialist were both harmonized with the labor functions described in the standard and aligned with the major employer of graduates - Federal Service on Surveillance for Consumer rights protection and human well-being. Conclusion. The implementation of the professional standard provides a number of advantages for specialists of preventive medicine, its employers and professors of universities. Continuous updating of professional standards will allow to assess the quality and level of employee competencies, mainstream vocational training programs at all levels, aimed at creating and improving the professionalism of preventive medicine direction.

Introduction. Chronic pyelonephritis occupies one of the fi rst places in the structure of extragenital pathologies of pregnant women. The approach to the treatment of pyelonephritis in pregnancy consists in the use of both pharmacological and non-pharmacological methods of treatment. One of the non-medicamentous methods is osteopathic correction of somatic dysfunctions. However, the structure of these functional disorders is virtually unexplored.Goal of research — to describe somatic dysfunctions (SDs) in pregnant women with chronic pyelonephritis before and after osteopathic correction, as well as to defi ne its effect on the intensity of subjective indices.Materials and methods. A simple longitudinal randomized study conducted in 2016–2018 on the clinical basis of the St. Petersburg Institute of Osteopathy — LLC «Mokhov Institute of Osteopathy» included 120 pregnant women aged 25–45 years with a gestation period of 13–27 weeks. All pregnant women with chronic pyelonephritis were divided into two groups with the use of random number generator. The two groups of 30 people each were comparable in age, parity, presence of concomitant pathology and the duration of the disease. The main group received pharmacological and osteopathic treatment, the control group received only pharmacological treatment. In a similar way, a comparison group of women comparable in age and parity was formed. It included 60 pregnant women in the second trimester of pregnancy without clinical, instrumental and laboratory data of chronic kidney diseases; the patients of this group underwent dynamic observation. All patients were subjected to clinical obstetrical and osteopathic examination. The severity of the pain syndrome was assessed with the use of the visual analogue scale.Results. In the course of osteopathic diagnostics, the following dominant SDs have been revealed: in patients with chronic pyelonephritis, a global rhythmogenic disorder of the development of the cranial rhythmic impulse (GRD (C)) — 26,7 %, a global neurodynamic disorder (psycho-viscero-somatic) — 25 %, regional SDs: the lumbar region — 33,3 %, the pelvic region — 6,7 %, and the thoracic region — 5 %; in healthy pregnant women, GRD (C) — 6,7 %, GNDD (PVS) — 6,7 %, and regional SDs: the pelvic region — 28,3 %, the thoracic region — 23,3 % and the duramatral region — 26,7 %. As a result of osteopathic correction of SDs in patients with chronic pyelonephritis, there was a decrease in the total number of SDs (from 174 to 30) and a change in their structure (global before the treatment and local after the treatment). The severity of the pain syndrome in accordance with the VAS has also decreased from 29±3,16 to 11±0,79 points in the main group, whereas in the control group it has increased from 20±1,78 to 26±1,53.Conclusion. In pregnant women with chronic pyelonephritis, the majority of SDs manifest themselves at the global level, whereas in healthy pregnant women, most dysfunctions are regional. Osteopathic correction of SDs in complex therapy of pregnant women with chronic pyelonephritis signifi cantly contributes to the reduction of the pain syndrome according to the VAS compared with isolated traditional pharmacological therapy.

Ntroduction. Celiac disease is a genetically determined disease, which is often associated with the dysplasia of the connective tissue, and may be considered as one of the causes of the secondary biliary dysfunction. Functional alterations play a signifi cant role in the formation of chronic pathology. The basis for osteopathic treatment is the correction of functional alterations, aimed at amelioration of work of the basic elements of the biliary system.Goals of research - to evaluate the clinical effectiveness of osteopathic correction in treatment of biliary dysfunction in patients with celiac disease.Materials and methods. 48 patients (23 men and 25 women) diagnosed with celiac disease aged from 18 to 35 took part in the research. Their average age was 26,5±2,1 years old. All the patients underwent clinical and osteopathic examination, I. A. Alexeev-Berkman coprological examination, ultrasound examination «SonolinePrima LC» («Siemens», Germany) performed according to the standard methodology with the determination of the fraction and the coeffi cient of the evacuation. Patients received osteopathic treatment during two months. Results. The assessment of the diagnostic fi ndings showed that among 48 patients with biliary disorders with a background of different anomalies of the gall bladder 41 (85,4 %) patients suffered from clinical manifestations of the disease. During the osteopathic examination of patients typical somatic dysfunctions were found: regional biomechanical disorders (cervical, thoracic, lumbar and pelvic regions) and local biomechanical disordes (cupula of the diaphragm on the right, lower ribs on the right, ligamentous apparatus of the liver, gall bladder, duodenum). The ultrasound examination of the abdominal organs revealed different anomalies of gall bladder in combination with the alteration of the colloidness of the content of the gall bladder. Statistically signifi cant contingency between the presence of the biliary sludge and the type of anomalies of the gall bladder was determined (χ2=8,12; р=0,017; С=0,55). After the course of osteopathic treatment the main clinical manifestations signifi cantly reduced, the mobility improved in all the regions of the spine, and in the thoracic diaphragm, the importance and the manifestation of somatic dysfunctions decreased in the liver, in the bile ducts, in the stomach, in the duodenum, and in the bone structures of the pelvis (р

Introduction. Nowadays osteopathy is an offi cial medical specialty. Many years of experience accumulated by osteopathic physicians in our country have proven its effectiveness. The analysis of research papers of those countries where osteopathy is widely used allows to draw the following conclusion: osteopathy is one of the least dangerous therapeutic methods provided that patients deal with well-trained and certifi ed specialists who work in the frame of possibilities of osteopathy. Due to the intensive development of this specialty in Russia it is necessary to provide scientifi c justifi cation to organizational and methodological approaches aimed at ensuring effective and high-quality osteopathic care to the population.Goal of research - to develop proposals in order to improve the quality and effectiveness of osteopathic care provision for the population, taking into account the current situation in health care.Materials and methods. Authors used the following research methods: historical and medico-organizational analysis, literary data analysis, content analysis as well as methods of descriptive statistics.Results. The research presents characteristics of clinics declaring osteopathic care provision, as well as qualities of osteopathic physicians. It also describes patients seeking osteopathic care, and sources of information they use.Conclusion. Authors propose a number of measures aimed at improving the availability and effectiveness of osteopathic care for patients such as training of doctors, creating of regulatory documents, developing quality criteria for osteopathic care provision and popularization of osteopathy among patients.

The article explores the issues in applying state risk-oriented oversight (supervision) approach over the activity of business entities and individuals providing medical services, including those of osteopathic medicine. The authors describe the models used by the Russian Federal Service for Surveillance in Healthcare and Social Development (Roszdravnadzor) and the Russian Federal Service for Surveillance on Consumer Rights Protection and Wellbeing (Rospotrebnadzor). The article defi nes the goals of the Russian Osteopathic Association to improve quality management system and risk assessment system. The study examines the laws and legislations of the Ministry of Health of the Russian federation, and research papers. The authors use different research methods: method of scientifi c hypothetico-deductive cognition, general logic methods and methods of research - analysis, synthesis, abstraction, generalization, induction.

The pathological changes in the cervical spine frequently result in the disturbances of the blood supply in the vertebral-basiliar system. The degenerative-dystrophic processes in the cervical spine occupy the leading place in the pathogenesis of the vertebral artery syndrome (VAS) causing disorders of the microcirculation and innervation, as well as the restriction of mobility and the development of somatic dysfunctions. It can be assumed that the manual methods applied to manage this condition can be effective in the removal the functional abnormalities in the blood flow.The objective of the present study was to evaluate the effectiveness of the osteopathic treatment as a component of combined therapy of the patients presenting with the vertebral artery syndrome.This experimental prospective controlled randomized study was conducted during the period from January 2015 till January 2017. A total of 106 patients with VAS, aged from 20 to 60 (the average age was 43.1±1.0 years) took part in the study. The patients were divided into three groups. The experimental group was comprised of 40 patients who received the medicamentous and osteopathic treatment. The control group consisted of 40 patients given the medicamentous treatment alone. The group of comparison contained 26 patients treated with the use of pharmacotherapy and massage. The methods finding application in clinical neurology, clinical osteopathy, and ultrasonic diagnostics of the brachiocephalic vessels were employed to evaluate the health status of the patients and evaluate the effectiveness of their treatment.The combined treatment of the patients comprising the experimental group with the use of osteopathic correction and pharmacotherapy produced the positive effect and resulted in the normalization of the neurological status of the patients; specifically, the incidence of both subjective and objective (neurological) symptoms was reduced. Simultaneously, the incidence of somatic dysfunctions at all levels of their manifestation decreased as compared with their frequency in the patients of the control and comparison groups. The results of the ultrasound examination of the great vessels of the neck and the brain in the experimental group made possible the evaluation of the dynamics in the incidence of the major pathological changes in the vessels of the vertebral-basiliar basin (VBB). It was shown that the occurrence of such serious changes as venous dishemia, reduction of the vasoconstriction and vasodilation reserves in VBB, in the patients of the experimental group vessels fell down by 32.1% (p0.001), in comparison with only 12% (p0.05), in the control group and 6,27% in the group of comparison (p0.05).The osteopathic manipulative treatment included in the combined therapy of patients with VAS based on the personified approach to the management of individual cases, detection and correction of each clinically significant functional disorder accompanying the pathological process greatly contributes to the regression of the neurological symptoms, elimination of somatic dysfunctions at different levels of the body, normalization of the blood flow in the vessels of the vertebral-basilar system. Taken together, these effects prolong the beneficial results of the combined rehabilitative treatment of the patients with the vertebral artery syndrome based on the application of standard pharmacotherapy and correction of the functional disorders with the use of the osteopathic methods.Обоснование. Патология шейного отдела позвоночника часто приводит к нарушению кровоснабжения в вертебрально-базилярной системе. Ведущее место в патогенезе синдрома позвоночной артерии (СПА) занимают дегенеративно-дистрофические процессы в шейном отделе позвоночного столба, сопровождающиеся нарушением микроциркуляции, иннервации, ограничением подвижности и формированием соматических дисфункций. Можно предположить, что мануальные методы воздействия могут быть эффективными в устранении функциональных нарушений кровотока. Цель исследования - оценить эффективность остеопатической коррекции в комплексной терапии пациентов с СПА. Методы. Экспериментальное контролируемое рандомизированное исследование проводили с января 2015 г. по январь 2017 г., оно носило проспективный характер. В исследовании участвовали 106 пациентов с СПА в возрасте от 20 до 60 лет, средний возраст 43,1±1,0 года. Пациенты были разделены на 3 группы: в основной (n=40) группе применяли комплексную терапию (медикаментозные препараты и остеопатическая коррекция); в контрольной (n=40) - только медикаментозные препараты; в группе сравнения (n=26) - медикаментозные препараты и массаж. Использовали следующие методы исследования: клинический неврологический, клинический остеопатический, метод ультразвуковой диагностики брахиоцефальных сосудов. Результаты. Применение остеопатической коррекции вместе с медикаментозной терапией оказало позитивный эффект на нормализацию неврологического статуса: уменьшение частоты встречаемости как субъективных, так и объективных (неврологических) симптомов. На фоне проведенного лечения в основной группе по сравнению с контролем и группой сравнения отмечено уменьшение частоты диагностирования соматических дисфункций всех уровней проявления. Контрольное ультразвуковое исследование магистральных сосудов шеи и головного мозга позволило оценить динамику основных патологических изменений сосудов вертебрально-базилярного бассейна (ВББ). В основной группе на фоне проводимой терапии частота встречаемости основных патологических изменений сосудов (венозная дисгемия, сужение резерва вазоконстрикции и вазодилатации) ВББ уменьшилась на 32,1% (p0,001), в контрольной группе - на 12% (p0,05), а в группе сравнения - на 6,27% (p0,05). Заключение. Остеопатическая коррекция, основанная на персонифицированном подходе к пациенту, выявлении и коррекции при каждом его обращении наиболее значимого функционального нарушения, которое сопровождает патологический процесс, способствует регрессу неврологической симптоматики, устранению соматических дисфункций на различных уровнях организма, нормализации показателей кровотока в сосудах ВББ. Комплексный подход к реабилитации пациентов с СПА, в основе которого лежат стандартное медикаментозное лечение и коррекция функциональных нарушений остеопатическими методами, способствует достижению более длительного терапевтического результата.

Complex sanitary hygienic and sociologic evaluation of high school factors enabled to assign work conditions of medical institute lecturers according to P 2.2.2006 - to 05 for jeopardy and to 2 degree 3 class for hardiness and intensity of work, to define psychosocial risks as main hazards. The authors specified and suggested prophylactic system aimed to increase work efficiency of medical institute lecturers.