Доктор.ру最新文献

{"title":"Premature Ovarian Insufficiency: Long-Term Health Consequences and Hormone Replacement Therapy Strategies","authors":"V.G. Averkova, A.E. Donnikov","doi":"10.31550/1727-2378-2023-22-5-49-53","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-5-49-53","url":null,"abstract":"Aim: analysis of modern views on the pathogenesis of complications and long-term consequences of sex hormone deficiency among patients with premature ovarian insufficiency (POI), as well as the possibilities and strategies of hormone replacement therapy (HRT) for their treatment and prevention. Key Points. The consequences of a sex hormones deficiency in women with POI are not only short-term clinical manifestations similar to menopause, but also long-term negative outcomes for general health and life. HRT has therapeutic and prophylactic potential for all clinical aspects of the disease. However, the currently developed standard therapeutic strategies do not always allow to completely stop the symptoms of POI and ensure reliable prevention of complications in the future. Conclusion. The choice of adequate doses and composition of HRT, along with an interdisciplinary approach to the treatment of this pathology, will make it possible to level the associated risks and ensure a high quality of life for patients. Keywords: premature ovarian insufficiency, hormone replacement therapy, cardiovascular diseases, osteoporosis, genitourinary menopausal syndrome.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"250 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":"135562004","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":"Infectious and Inflammatory Diseases of the Female Genital Organs: a Course Towards Rational Antimicrobial and Antiprotozoal Therapy","authors":"I.A. Apolikhina, D.S. Makovskaya","doi":"10.31550/1727-2378-2023-22-5-101-104","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-5-101-104","url":null,"abstract":"Aim: to provide the key trends in the use of a modern combined medicinal product of ciprofloxacin and ornidazole. Key points. The product has a combined antimicrobial and antiprotozoal effect; its pharmacological action is a result of the properties of the active ingredients — ciprofloxacin and ornidazole. The article describes the efficacy of this combination against gynaecological infections. Conclusion. The use of the ciprofloxacin and ornidazole combination demonstrates therapeutic effect against a majority of urinogenital gynaecological conditions. The product is beneficial in case of concurrent infections, various vaginitis, pelvic inflammations and for prevention of post-surgery complications. Keywords: ornidazole, ciprofloxacin, combination, infections, concurrent infections, pelvic inflammations, sexually transmitted infections.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"11 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":"135561997","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":"Inflammatory Markers in Schizophrenia Patients: Scientific and Practical Significance","authors":"S.A. Zozulya, Z.V. Sarmanova, I.N. Otman, T.P. Klyushnik","doi":"10.31550/1727-2378-2023-22-6-7-14","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-6-7-14","url":null,"abstract":"Objective: To present literature data and results of own studies of inflammatory biomarkers identified in schizophrenia patients for diagnostic and forecasting purposes. Key points. Special attention is paid to the medical technique called Neuroimmunotest developed at the Scientific Centre for Mental Health and its use in the study of schizophrenia pathogenesis, immune system status in various psychopathologic disorders, as well as for disease monitoring, forecasting and therapy efficiency assessment. Conclusion. The literature data and results of own studies demonstrate the key role of immune mechanisms, primarily of inflammation, in the development of psychopathologic disorders in schizophrenia patients. Classification of schizophrenia patients not only on the basis of clinical manifestations, but also using the immune marker profile makes it possible to objectify their condition and forecast the efficiency of personified therapy; therefore, this approach is of interest for practical application in clinical psychiatry. Keywords: inflammation, biomarkers, neuroimmunotest, level of immune system activation, schizophrenia","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"43 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":"135508308","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":"Multimodal Stimulation in Impaired Gait and Balance Correction in Post-Stroke Patients","authors":"A.G. Kashezhev, G.M. Lutokhin, M.A. Rassulova, I.V. Pogonchenkova, E.A. Turova, Yu.V. Utegenova, R.I. Samokhvalov","doi":"10.31550/1727-2378-2023-22-6-72-77","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-6-72-77","url":null,"abstract":"Aim: To assess the effect of multimodal virtual reality stimulation on gait and balance restoration in patients in acute and early recovery ischemic stroke. Design: Comparative randomised clinical study. Materials and methods. This study enrolled 67 patients with primary ischemic stroke which occurred during past 6 months, complicated with hemiparesis or lower limb monoparesis. Patients included 47 men and 20 women aged 44 to 75 years old. Patients were divided into two groups: in the study group (n = 36), the primary rehabilitation was supplemented with multimodal stimulation exercises on a training virtual reality set; controls (n = 31) had only primary therapy. Rehabilitation efficiency was assessed using the Montreal Cognitive Assessment, Hospital Anxiety and Depression Scale, National Institutes of Health Stroke Scale (NIHSS), Medical Research Council Scale (MRCS), Tinetti Test, Rivermead Mobility Index. Results. In the study group, a course of rehabilitation resulted in marked improvement in motor functions and functional independence. NIHSS symptoms intensity decreased from 5.5 [4.0; 7.0] to 4.0 [3.0; 5.0] points in the study group and from 6.0 [5.0; 7.0] to 5.0 [4.5; 6.0] points in the control group (p = 0.019). Rivermead Mobility Index increased from 7.0 [6.0; 10.0] to 10.0 [8.0; 12.0] points in the study group and from 7.0 [5.0; 7.5] to 8.0 [6.5; 10.5] points in the control group (p = 0.049). When multimodal stimulation was added, also a more prominent increase in the MRCS muscle strength of the lower limb was observed: an increase was 0.7 [0.3; 0.9] points in the study group and 0.4 [0.2; 0.7] points in controls (p = 0.046). Conclusion. Multimodal stimulation is an efficient adjuvant approach to rehabilitation of patients shortly after an ischemic stroke. Keywords: virtual reality, medical rehabilitation, neurorehabilitation, ischemic stroke, pneumatic stimulation.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"233 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":"135508304","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":"Non-invasive Neuromodulation as a Pain Management Method in a Combined Therapy of Chronic Lower Back Pain","authors":"E.A. Melnikova, E.Yu. Starkova, M.R. Makarova, D.A. Somov","doi":"10.31550/1727-2378-2023-22-6-60-66","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-6-60-66","url":null,"abstract":"Aim: To describe the Russian and foreign experience in the use of non-invasive neuromodulation for pain management in patients with chronic lower back pain (LBP); to present various neuromodulation techniques and other rehabilitation methods which can be used in combination with neuromodulation in patients with LBP; to describe neuromodulation parameters and programs for an optimal analgesic effect. Key points. LBP is a common (affecting 7.5 % of the world population) and socially significant condition (one of the leading causes of disability worldwide). The efficiency of drug pain management in chronic LBP is approximately 40 %, therefore, non-drug treatment options are required. The neuropathic component of chronic LBP is associated with reorganization in cortex brain structures Hence, neural stimulation is a most promising approach to chronic LBP management, while transcranial direct current electrotherapy stimulation (TEdC) and rhythmic transcranial magnetic stimulation (rTMS) are the most efficient and safest neural stimulation methods. rTMS is an efficient and safe approach to the management both of nociceptive and neuropathic pain, which is a common component of chronic conditions, in particular of LBP. The main area of exposure is motor cortex areas (М1). As compared to TEdC, rTMS is better tolerated by patients and demonstrates better pain management results. Conclusion. Pain syndrome is a significant limitation to rehabilitation in patients with LBP, and drug pain management is inefficient. We suggest that anaesthetic neuromodulation be included into a complex therapy of such patients. The most widely used and efficient neuromodulation techniques are TEdC and rTMS. Keywords: lower back pain, rehabilitation, transcranial magnetic stimulation, neuropathic pain.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"33 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":"135508306","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":"Depressive Disorders in Survivors of COVID-19: Clinical Observation","authors":"D.A. Golovkina, A.K. Vasyuta, Yu.G. Tikhonova, T.I. Avdeeva, M.A. Kinkulkina","doi":"10.31550/1727-2378-2023-22-6-44-48","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-6-44-48","url":null,"abstract":"Aim: To present a case study of patient S., who came to the psychiatric clinic because of a depressive episode after COVID-19 infection. Key points. COVID-19 can cause various complications that last several weeks to several months after initial recovery. Young, healthy individuals can have post-COVID disorders even after mild COVID-19. Depression and anxiety disorders are among the consequences of past coronavirus infection. Conclusion. This case study demonstrates that post-COVID patients develop persistent depres-sive disorders causing patient maladaptation and requiring drug therapy. Keywords: COVID-19, post-COVID-19 condition, depressive disorder, anxiety disorder.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"32 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":"135508312","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":"Clinical and Neurochemical Characteristics of Mentally Ill Patients with Aggressive Misconduct","authors":"O.A. Makushkina, O.I. Gurina, A.V. Frolova, V.A. Golenkova","doi":"10.31550/1727-2378-2023-22-6-15-20","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-6-15-20","url":null,"abstract":"Aim: To analyse clinical, biochemical and social characteristics of patients with severe mental disorders and aggressive behaviour. Design: observational cross-sectional study. Materials and methods. We examined 110 patients of 18–60 years of age with severe mental disorders and persistent aggressive behavior who committed acts of violence. For examination, we used clinical psychopathologic, psychometric, laboratory, mathematical and statistical methods. Results. The subjects had disturbed upbringing with signs of violence, undereducation, family and occupational maladaptation, conflict relations with people around them, financial insecurity. Clinically, they demonstrated marked behavioural disorders with explosive episodes associated with hetero-aggressive trends, with decreased intellectual and volitional control and lack of compliance. There were statistically significant (p < 0.05) differences in biological parameters of a majority of patients vs. reference values and correlation between psychometric and biochemical data. Conclusion. The results contribute to the identification of predictors of socially dangerous violent behaviour in persons with severe mental disorders. Keywords: severe mental disorders, aggressive behaviour, violent misconduct, predictors of social danger.","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":"135508310","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":"Correction of Hypomimia Through Activation of Gait Function in Patients with Parkinson`s Disease","authors":"A.A. Khomchenkova, S.V. Prokopenko, S.B. Ismailova, Yu.N. Ashikhmina, E.S. Denisova","doi":"10.31550/1727-2378-2023-22-6-78-82","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-6-78-82","url":null,"abstract":"Aim: To assess the influence of gait function activation on manifestations of hypomimia in patients with Parkinson's disease (PD). Design: A comparative clinical study. Materials and methods. The study enrolled 18 patients with stage of 2–3 PD according to Hoehn — Yahr Rating Scale aged 70 [65; 76] years. Analysis of facial expression in PD patients was analysed by using a proprietary method of computer video-analysis of facial muscle movement. Activation of the gait function used another proprietary method: the apparatus for functional foot therapy that mechanically activates the rear push of the foot at the moment of the lift of the foot from the supporting surface. Results. Activation of the gait function has statistically significantly improved the mimic function of the face, in particular the blink frequency (p = 0.022), eyebrow movement amplitude along the Y axis in the «brow furrow» test (p = 0.048) and the amplitude of mouth movement while reading a text along the axis X (p = 0.012). Conclusion. The confirmation of the decrease of hypomimia manifestations through affecting the condition of general hypokinesia creates the prerequisites for appearance of rehabilitation methods making it possible to perform simultaneously correction of these two symptoms. Keywords: Parkinson’s disease, hypomimia, hypokinesia, gait function activation.","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":"135508554","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":"Factors in the Formation of Neoplastic Processes in the Cervix","authors":"O.I. Artemova","doi":"10.31550/1727-2378-2023-22-5-75-80","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-5-75-80","url":null,"abstract":"Aim: Review the literature data on the pathogenetic aspects of the formation of squamous intraepithelial lesions and the role of immunological mechanisms in the formation of this group of cervical diseases. Key Points. Cervical cancer (CC) is a multi-stage process that is often preceded by human papillomavirus (HPV)-associated intraepithelial lesions. The establishment of causal interactions between the virus and malignancy, as well as the study of epidemiological data, leads to the formation of models of cervical carcinogenesis: infection, persistence, progression to the precancerous stage, and finally, cervical cancer. Despite the clear and obvious path of malignancy, as well as the availability of generally available diagnostic methods in the arsenal of a practicing obstetrician-gynecologist, the assessment and prediction of the further development of cervical pathologies in patients of active reproductive age remains difficult. In general, cervical cancer can be considered an excellent model for understanding the staging of malignancy processes, which will be primarily associated with the impact of human papillomavirus infection and changes in the immunological aspects of endo-and exo-cervix. Conclusion. An analysis of sources published in the Cochrane Librare, Google Scolare and PubMed systems was carried out. In recent years, the understanding of human papillomavirus-associated tumor interaction with the host immune system has improved, so the development of new approaches targeting immune checkpoints has sparked interest in the use of immunotherapy in cervical cancer. CC is curable if detected at an early stage. However, reliable diagnostic and prognostic markers related to the physiological and pathological regulation of cervical cancer are currently not available. Therefore, the approach to the treatment of cervical cancer has remained unchanged for several decades, and new diagnostic strategies are currently required, due to the interaction of the immune system and the virus. Keywords: genotyping, apoptosis, cervical neoplasia, polymerase reaction, interleukin-18, tumor necrosis factor alpha, viral load.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"14 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":"135562252","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 Hormone Therapy and the Course of COVID-19","authors":"M.V. Averyanova, O.V. Yakushevskaya, S.V. Yureneva","doi":"10.31550/1727-2378-2023-22-5-69-74","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-5-69-74","url":null,"abstract":"Aim: To assess the symptoms and severity of the coronavirus infection caused by the SARS-CoV-2 virus in peri-and postmenopausal patients on the background of various types of MHT (oral and transdermal) and in its absence. Design: a retrospective, cohort study. Materials and methods. The study included 93 postmenopausal patients who had an infection caused by the SARS-CoV-2 virus, against the background of oral MHT -group 1, transdermal MHT -group 2 at standard and low doses, without MHT -group 3 comparison. A survey of patients was conducted, including information about the symptoms, severity of the course and ongoing therapy for COVID-19. Results. Duration of COVID-19 illness, as well as the frequency of various symptoms of the disease in patients (cough, rhinitis, sore throat, weakness, muscle pain, fever, diarrhea, nausea, headaches) not using MHT and using various forms of MHT (oral and transdermal) did not differ significantly. When patients using oral and transdermal MHT were combined into one group and compared with the group not taking MHT, it was found that severe COVID-19 was significantly more common in the group not taking MHT. Conclusions. In our study, individuals who took MHT had a significantly significantly milder course of coronavirus infection compared to women who did not use MHT. More research is needed to find protective mechanisms of sex steroids against coronavirus infection in order to continue to be ready to localize and manage this infection as soon as possible. Keywords: Menopausal hormone therapy, COVID-19, coronavirus infection, immune system, estrogens.","PeriodicalId":494981,"journal":{"name":"Доктор.ру","volume":"64 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":"135561999","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}