Pregnancy rates are rapidly increasing among women of reproductive age diagnosed with multiple sclerosis (MS). Over the past decades, several studies have proven that MS does not affect the course of pregnancy, and pregnancy does not negatively affect the long-term course of the disease. The results of numerous studies have shown that the frequency of exacerbations in MS patients decreases during pregnancy, but increases after childbirth. According to the summary of product characteristics (SmPC) of disease modifying drugs (DMD) most of them are contraindicated during pregnancy. To prevent possible neonatal risks, it is necessary to use contraception before pregnancy planning for a certain period of time after their last use. Medical data of MS pregnancy registries of patients receiving DMD before, during pregnancy and postpartum provide important information for the formation of further therapeutic approaches. The most valuable are the data from prospective studies with clearly selected points for analysis, including both pregnancy outcomes and newborns health. In the group of anti-CD20 drugs, ocrelizumab has the largest database of use during pregnancy. In February 2025, an expert Advisory Council (AC) was held to review and analyze data on the use of anti-CD20 therapy in family planning. According to AC expert’s opinion the use of ocrelizumab 4.5 months before the planned pregnancy does not have an increased risk of adverse neonatal outcomes and allows effectively to control disease activity during pregnancy and in the postpartum period.

Introduction. Surgical treatment of patients with ronchopathy and obstructive sleep apnea syndrome (OSAS) is a topical issue of modern medicine. The velopharyngeal muscle injury of various intensity due to surgical interventions on the soft palate leads to inflammation, tissue necrosis or partial rejection and wound healing with a fibrous scar, muscle hypotrophy and hypotonia, palatal ptosis and, as a consequence of this, disease recurrence.

Aim. To evaluate the effectiveness of laser surgery on the soft palate in patients with ronchopathy and obstructive sleep apnea syndrome.

Materials and methods. The results of examination and treatment of 523 patients with ronchopathy and obstructive sleep apnea syndrome of varying severity aged from 23 to 78 years (men 299, women 224) are presented. Surgical intervention on the soft palate was performed in 352 (67.3%) patients: 309 underwent laser sculptural uvulopalatoplasty, 43 underwent surgery using the Remacl method M. et al. (comparison group).

Results and discussion. A comparative analysis of subjective and objective indicators obtained in the same patients according to monitoring computer pulse oximetry, polysomnography and computer somnography before and at different times after laser sculptural uvulopalatoplasty demonstrates persistent and significant (p ≥ 0.005) positive changes. The data from the study of patients in the comparison group demonstrate a positive trend in the results obtained at different times after Remacl surgery M. et al. only if they have uncomplicated snoring and mild OSA.

Conclusion. Laser sculptural uvulopalatoplasty is a highly effective method of treating patients with ronchopathy, regardless of the presence and degree of obstructive sleep apnea syndrome. With high-quality and adequate selection for surgery, accurate determination of the levels of obstruction, shape and degree of collapse of the soft tissues of the upper respiratory tract, careful consideration of the individual characteristics of the structure of the soft palate and pharynx and minimization of surgical trauma to the palatine curtain, it is possible to achieve a positive effect of surgery in the vast majority of patients.

Chronic shoulder pain (CSP) is an urgent problem, mainly due to the high prevalence of this pathology among the population. Until recently, there were no unified approaches to the management of patients with CSP. Currently, such recommendations have been developed by a group of experts, which includes doctors of various specialties. Based on these recommendations, the article presents approaches to diagnosing the causes of CSP, which are quite diverse. The most common causes of pain in the region are syndrome of compression of tendons of muscles rotating the shoulder (SCTMR), calcifying tendinitis (CT), adhesive capsulitis (AС), osteoarthritis of the shoulder joint (OA SJ), osteoarthritis of the acromioclavicular joint (OA ACJ). The article presents the main clinical manifestations of SCTMR, СТ, AС, OA PJ, OA ACJ, describes the necessary laboratory and instrumental research methods necessary to diagnose the specific cause of, as well as to exclude other diseases associated with shoulder pain. Treatment of CSP should be comprehensive and begin only after determining the cause of pain and functional disorders in this area. The first-line drugs are nonsteroidal anti-inflammatory drugs prescribed taking into account the patient’s concomitant diseases. If they are ineffective, local injection therapy (glucocorticosteroids, hyaluronic acid, autologous platelet-rich plasma) should be connected to therapy. In case of OA PJ, OA ACJ, it is advisable to include symptomatic slow-acting antiarthritis drugs in complex therapy. All patients are shown various methods of physiotherapy and rehabilitation. If conservative therapy is ineffective, surgical treatment should be considered.