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{"title":"The Effect of Wrist Tapping on the Frequency of Epileptic Seizures and Quality of Life in a 30-Year-Old Man with Structural Focal Epilepsy","authors":"E.A. Narodova, N.A. Shnayder, V.V. Narodova","doi":"10.31550/1727-2378-2023-22-6-83-88","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-6-83-88","url":null,"abstract":"Aim: To present a clinical case of the use of the wrist tapping method in a 30-year-old patient with structural focal epilepsy (SFE). Key points. During 4 visits, we examined patient N., 30 years old, suffering from SFE, which developed against the background of a gunshot wound to the skull, with frequent focal seizures (FS) and bilateral tonic-clonic seizures (BTCS). After 6 months from the start of wrist tapping sessions (4th visit), using the application, the patient noted a 55% increase in quality of life due to the ability to stop AF and prevent the development of BTK. In 87.5% of cases, he was able to stop incipient motor hemifacial FS and prevent its transformation into BTCS. With regular use of the application by the patient, the incidence of FS decreased by 65.4% on the 4th visit compared to that on the 2nd visit. The patient highly rated the effectiveness and safety of the wrist tapping method (97.6%). Conclusion. The use of the application allowed a young man with treatment-resistant post-traumatic SFE, without changing the dosage regimen and dose of the antiepileptic drug, to reduce the frequency of FS by 65.4% from baseline and significantly reduce the number of BTCS, significantly improving the quality of life. Keywords: structural focal epilepsy, wrist tapping.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135508305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Therapy in Psychiatry and New Forms of Cooperation with Patients","authors":"N.D. Semenova","doi":"10.31550/1727-2378-2023-22-6-40-43","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-6-40-43","url":null,"abstract":"Aim: To consider new approaches to psychosocial therapy in psychiatry and cooperation with patients. Key points. The review describes a new direction of research in psychiatry and clinical psychology associated with new forms of collaboration with patients — those receiving mental health care. Among the foundations of this direction are the concept of personal and social recovery and the “Open Dialogue” approach to psychosocial therapy. The movement's leaders are patients and clinicians who involve patients in research as colleagues. Conclusion. New forms of collaboration with patients — those receiving mental health care, involving them in actual participation in research as colleagues are the basis for establishing trust and therapeutic alliance for developing and selecting diagnostic and therapeutic methods. Expanding the scope of collaboration with patients directly or indirectly increases the availability of psychosocial interventions and psychosocial support and promotes disease prevention and mental health care. Keywords: experience of mental illness, recovery, personal and social restoration, “Open dialogue”, cooperation with the patient as an expert.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135508307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menopausal Transition — Time for Early and Effective Targeting of Cardiometabolic Risks","authors":"S.V. Yureneva, Ya.A. Orlova","doi":"10.31550/1727-2378-2023-22-5-40-48","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-5-40-48","url":null,"abstract":"Aim: to examine the features of risk factors and cardiovascular diseases in middle-aged women with a focus on period of the menopausal transition, which is of key importance to early prevention. Key Points. The studies showed distinct patterns of adverse changes in fat distribution, lipid profile, structural and functional indicators of vascular health during the menopausal transition regardless of aging. Conclusion. The cardiometabolic health of middle-aged women is systematically underestimated; the period of menopausal transition may be a critical window of opportunity for initiation of early preventive interventions based on a multidisciplinary approach and menopausal hormone therapy. Keywords: healthy aging, menopause, menopause transition, cardiovascular risks, preventive strategies, menopausal hormone therapy.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"2018 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135562000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the Danger of Psychological Stress for Pregnant Women and How to Reduce its Impact on the Course of Pregnancy and Perinatal Outcomes","authors":"T.P. Zefirova, R.R. Mukhametova","doi":"10.31550/1727-2378-2023-22-5-34-39","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-5-34-39","url":null,"abstract":"Aim: assess the impact of psycho-emotional stress on the course of pregnancy at various times, as well as consider the possibility of reducing it with the help of vitamin-mineral complexes. Key Points. Pregnant women, like all others, are influenced by a variety of stress factors, and about 30% of them at different stages of gestation realize clinical manifestations of psychological stress. The article considers issue related to the causes of psychological stress before and during pregnancy, identifies the most vulnerable categories of women. Data on the influence of psychological stress on pregnancy outcomes and postnatal development are presented. Attention is paid to modern ideas about the pathogenesis of the damaging effect of psychological stress on various body systems, including the microbiome. Emphasis is placed on the role of an obstetrician-gynecologist as an attending physician in the timely identification of women with signs of psychological stress, in the organization of non-drug care and rational pharmacological support. Pathogenetically justified possibilities of using vitamin and mineral complexes to compensate for the negative effects of psychological stress at the preconception stage and during pregnancy were discussed. Conclusion. Stress before and during pregnancy affects the offspring in the long term, disrupting their physical condition, negatively affecting the functions of the central nervous system. In modern obstetric practice, medical alertness, timely consultation with specialists and the full use of all the possibilities of non-drug and pharmacological support aimed at overcoming anxiety and stress at each stage of gestation will be relevant. Key words: psychological stress, pregnancy, perinatal complications, anemia, vitamin and mineral complexes.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135562002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain Activity Elicited by Negative Stimuli in Males with Recurrent and Bipolar Depression","authors":"E.V. Mnatsakanian, V.V. Kryukov, V.N. Krasnov","doi":"10.31550/1727-2378-2023-22-6-28-34","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-6-28-34","url":null,"abstract":"Aim: To study the characteristics of brain activity in male patients with recurrent and bipolar depression. Design: This was a comparative controlled non-randomized experimental clinical study. Materials and Methods: 59 male patients took part in this study before their medication started: 30 with bipolar and 29 with unipolar (recurrent) depression. Control group consisted of 27 healthy male volunteers. All investigated persons were aged 20 to 59 years. The participants had to sort photos of people and animals, of which 80 were neutral images and 80 showed angry/aggressive people or animals. Simple patterns (cues) were displayed two seconds prior to the pictures, and their relationship was not explained. A 128-channel EEG was recorded and brain responses were analyzed in 0–700 ms from cue onset. Differences between the neutral and emotional conditions (emotional modulation, EM) were statistically evaluated. Results: All components in this study (P100, N170/VPP, P200, P380, and LPC/LPP) in various degrees showed EM dependent on the group and on the type of threatening stimuli. Topography of EM for N170/VPP in all groups and both types of stimuli was quite similar. None of the components unambiguously distinguished between the controls and nosographically different depressions. Conclusion: Our results show that in the study of affective disorders and the search for markers for diagnosis, it is necessary not only to take into account the gender of patients, but also to use various cognitive tasks when recording EEG, and also to consider a set of neurophysiological parameters. Keywords: emotional modulation, electroencephalogram, recurrent depression, bipolar depression, visual evoked potentials.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"278 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135508311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Health Status of Newborns in Mothers with the Manifestation of SARS-CoV-2 Infection at Different Gestation Period","authors":"A.A. Yakubina, A.N. Aksenov, I.I. Bocharova, A.A. Kossova, E.B. Efimkova, E.V. Dulaeva","doi":"10.31550/1727-2378-2023-22-5-20-25","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-5-20-25","url":null,"abstract":"Aim: to study the health status of newborns in mothers who have undergone a new coronavirus infection (NCI, COVID-19) at different gestation period. Design: a prospective cohort uncontrolled study. Materials and methods. 162 newborns were examined, born to women who had had NCI during pregnancy and had no clinical manifestations of the disease at the time of delivery. Group 1 included 38 children whose mothers had NCI in the 1st trimester of pregnancy; group 2 — 74 children with the manifestation of infection in mothers in the 2nd trimester; group 3 — 50 children whose mothers had NCI in the 3rd trimester. Results. In children of groups 1 and 3, clinical and laboratory manifestations of intrauterine infection were detected in 42.1% and 32% of cases, perinatal lesions of the central nervous system (CNS) 15.8% and 36%, respectively, respiratory disorders — 10.4% and 20%, intrauterine development delay (IVD) in 10.4% and 12% of cases. The most frequent pathological condition of group 2 newborns was transient disorders of carbohydrate metabolism — 32.4%. Congenital malformations were more common in children of group 1, 15.8%. Discussion. The analysis of the literature data and the results of our study dictates the need for further study of the mechanisms of influence of the SARS-CoV-2 virus on the course of pregnancy and the health of newborns. Conclusion. In the absence of statistically significant differences in the frequency of pathological conditions in newborns of the selected groups, their severity was higher in children whose mothers underwent NCI in the 1st or 3rd trimesters of pregnancy, which is confirmed by the nature of the pathology, the need for transfer to specialized neonatal units. Keywords: new coronavirus infection, COVID-19, pregnancy, newborns.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135561993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Patients with Genital Endometriosis: New Strategies","authors":"N.V. Ermolova, Yu.A. Petrov, M.A. Levkovich, A.V. Savchenko, K.V. Slesareva","doi":"10.31550/1727-2378-2023-22-5-89-94","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-5-89-94","url":null,"abstract":"Aim: To analyze modern approaches to the diagnosis and treatment of genital endometriosis. Key points. Endometriosis is one of the most common gynecological diseases, affecting mainly women of reproductive age, the main manifestations of which are chronic pelvic pain and infertility. Constant pelvic pain, which reduces the quality of life, leads to the fact that patients are in a state of prolonged stress, and they have behavioral disorders. According to the latest world recommendations, drug treatment is the first line of therapy for endometriosis, if pregnancy is not a priority at this stage. There are many imaging methods for diagnosing this disease, but the search for non-invasive markers of endometriosis that can reliably confirm the diagnosis is still ongoing. Conclusion. An interdisciplinary approach and the choice of adequate treatment for endometriosis at each stage of a woman's life can limit unnecessary surgery and better meet the needs of patients. Keywords: endometriosis, adenomyosis, chronic pelvic pain, progestins, dienogest, endometriosis markers.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135561996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features of the Fetoplacental Complex and Perinatal Outcomes in Pregnant Women Who Suffered COVID-19","authors":"I.V. Ignatko, A.D. Megrabyan, T.E. Kuzmina, F.N. Alieva, M.I. Melek","doi":"10.31550/1727-2378-2023-22-5-7-13","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-5-7-13","url":null,"abstract":"Aim: Analysis of the features of a comprehensive laboratory and instrumental assessment of the state of the fetoplacental complex and perinatal outcomes in the be-radiation, which have undergone a new coronavirus infection caused by SARS-COV-2, at different stage of gestation. Design. The one-central prospective cohort comparative study for the period from April 2020 to March 2023 conducted a survey of 625 pregnant women who underwent COVID-19 of varying severity at different gestation periods observed in the Moscow Hospital named after S.S. Yudin. Materials and methods. The study included 700 pregnant women: 625 women who have undergone COVID-19 of varying severity at different gestation periods (main group) and 75 with a normal pregnancy without COVID-19 (comparison group). Pregnant women who have undergone a new coronavirus infection were divided into groups depending on the gestation period: I trimester — 32 (5.1%), II trimester — 168 women (26.9%), III trimester — 425 (68.0%). All patients conducted an ultrasound examination, including echography with biometria in accordance with the adopted protocols for the gestation, 1 and 2 screening studies under the Astraia program and on protocols adopted in Moscow; Dopplerometry in the uterine arteries, the arteries of the fetal-placental, the middle cerebral artery, the venous duct of the fetus; assessment of localization, thickness and structurality of the placenta; the amount and quality of amniotic fluid; cardiotocography. Based on the results of the primary ultrasound examination according to the indications, non -invasive prenatal testing, therapeutic amniocentesis and amniodrainage were carried out. Results. The frequency of almost all parameters of violation of the state of the fetoplacental complex was statistically distinguished, the differences in the frequency of violations of the uterine-placental blood flow, especially among women who transferred COVID-19 to the first half of gestation, were most significant in comparison with the control group (among the gestational-hay diabetes (among all groups of women with NCI), anemia of varying severity. The frequency of low water also turned out to be significant, and in 19 observations of 118 (16.1%) — this was a pronounced inexumpit and anhydramnion in the III trimester of gestation. The large frequency of thrombotic complications in women who have been the COVID-19 in terms of 22–38 weeks of pregnancy is noteworthy, which requires the expansion of indications for the prevention of a given type of pathology in women, including with the use of NMGs who have suffered even easy and moderate forms of the disease. 3 women with multi-guide (3/56 (5.4%)) required amnio-adiralization. Conclusion. Based on the data we have received and the analysis of the literature, we can conclude that short-term and long-term consequences for the development of children from mothers who have arisen during pregnancy COVID-19 are alarming, requiring an additional diag","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135561995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Functions in Acute Ischemic Stroke Period","authors":"S.S. Kabysh, S.V. Prokopenko, А.V. Golikova-Chereshkevich, L.V. Nikolaeva, I.M. Platunova","doi":"10.31550/1727-2378-2023-22-6-67-71","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-6-67-71","url":null,"abstract":"Aim: to assess the dynamics of the state of cognitive functions in the acute period of ischemic stroke. Design: prospective study. Material and methods. The study included a group of observation of patients in the acute period of ischemic stroke in the amount of 26 people. The cognitive sphere was assessed twice: on admission to the hospital on days 2-3, and on discharge on days 8-10. Scales used to assess the cognitive sphere: Mini Mental State Examination (MMSE) Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), The Clock-drawing Test (CDT). The emotional-volitional sphere was assessed using the Hospital Anxiety and Depression Scale (HADS). Data were considered statistically significant at p < 0.05. Results. In a dynamic assessment, cognitive disorders in the observed group were most pronounced upon admission to the hospital. By discharge on days 8-10, according to the MMSE test, there was a positive trend, the increase was by 2b, MoCA by 2b, FAB by 1b, respectively, the results were significant (p < 0.001, p < 0.001, p = 0.001). In the analysis of subscales according to the MMSE test, improvements to the extract were according to word reproduction (p = 0.005), speech functions (p = 0.04). According to MoCA, the improvement in total scores was due to subscales: memory (p = 0.01), attention (p = 0.05), speech (p = 0.04), abstraction (p = 0.005). Changes in the FAB test were driven by the conceptualization function (p = 0.04) and the simple choice response (p = 0.008). Anxiety and depression were not detected in the studied patients. Conclusion. During the acute period of ischemic stroke, the degree of cognitive impairment significantly decreases by 8-10 days against the background of ongoing treatment. Keywords: stroke, cognitive impairment, dementia, post-stroke cognitive impairment, mild cognitive impairment.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135508315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Look at the Tactics of Managing Patients with Obstructive Uropathies in Fetus","authors":"N.V. Kosovtsova, E.S. Kuklin, N.A. Fedorova","doi":"10.31550/1727-2378-2023-22-5-26-33","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-5-26-33","url":null,"abstract":"Aim: to describe modern methods of diagnosis, therapy and surgical correction of urinary system obstruction in the fetus, as well as gestational outcomes for the fetus with various options for intrauterine correction or without it. Key points. Obstructive uropathy in fetuses is a complex of intrauterine morphological and functional changes in the urinary tract, which develop as a result of a violation of the passage of urine of various origins. The authors studied modern approaches to the management of patients with obstructive fetal uropathy and methods of intrauterine correction of this pathology. The pathogenesis, emerging complications, key diagnostic biomarkers are considered based on the materials of domestic and foreign articles on this topic, posted in the eLibrary and PubMed databases. Conclusion. Conducting intrauterine bypass surgery in obstructive fetal uropathology can help reduce the risk of adverse perinatal outcomes, prevent the development of complications from other organs and systems and prevent disability of children. Keywords: obstructive fetal uropathies, bypass surgery, urinary system.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135562003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}