Pub Date : 2023-03-27DOI: 10.22363/2313-0245-2023-27-1-57-64
E. Y. Aleynikova, A. V. Solovyeva
The state of the reproductive system by women with uterine fibroids is considered as a part of this literature review. The main clinical manifestations of myomatous nodes were identified by writing the review: abnormal uterine and heavy menstrual bleeding, infertility, miscarriage, chronic pelvic pain, dysfunction of adjacent organs, which are indications for surgical treatment. It is noted that approximately 30 % of women with uterine fibroids suffer from abnormal uterine bleeding, leading to anemia and reduced quality of life. Chronic pelvic pain significantly reduces the quality of life of patients, worsening their functional and mental state and disrupting sexual function. This review focuses on reproductive problems in women with leiomyoma. Taking into consideration the high prevalence of this nosology and the need to preserve the fertility of patients, the review describes modern methods of treating patients with uterine myoma, including drug therapy surgical treatment and alternative methods. Currently, in order to stop the symptoms of uterine fibroids, as well as for preoperative preparation, conservative therapy is used, which allows to reduce pain, restore hemoglobin levels, reduce intraoperative blood loss and reduce surgery time. Reproductive disorders associated with uterine fibroids, such as infertility, recurrent miscarriage, and adverse obstetric outcomes, are a significant reason to improve organ-preserving therapies or develop new ones. Although hysterectomy is a radical treatment for uterine fibroids, it is unacceptable for patients who have not realized their reproductive function. Therefore, the most justified intervention is myomectomy with various surgical approaches, and as an alternative treatment, uterine artery embolization, radiofrequency ablation or high-intensity focused ultrasound treatment of uterine fibroids. These data allow us to conclude that the high prevalence and versatility of symptoms of uterine fibroids among patients of reproductive age determine the relevance of searching for optimal methods of treatment.
{"title":"Uterine fibroids: modern methods of treatment, advantages and complications","authors":"E. Y. Aleynikova, A. V. Solovyeva","doi":"10.22363/2313-0245-2023-27-1-57-64","DOIUrl":"https://doi.org/10.22363/2313-0245-2023-27-1-57-64","url":null,"abstract":"The state of the reproductive system by women with uterine fibroids is considered as a part of this literature review. The main clinical manifestations of myomatous nodes were identified by writing the review: abnormal uterine and heavy menstrual bleeding, infertility, miscarriage, chronic pelvic pain, dysfunction of adjacent organs, which are indications for surgical treatment. It is noted that approximately 30 % of women with uterine fibroids suffer from abnormal uterine bleeding, leading to anemia and reduced quality of life. Chronic pelvic pain significantly reduces the quality of life of patients, worsening their functional and mental state and disrupting sexual function. This review focuses on reproductive problems in women with leiomyoma. Taking into consideration the high prevalence of this nosology and the need to preserve the fertility of patients, the review describes modern methods of treating patients with uterine myoma, including drug therapy surgical treatment and alternative methods. Currently, in order to stop the symptoms of uterine fibroids, as well as for preoperative preparation, conservative therapy is used, which allows to reduce pain, restore hemoglobin levels, reduce intraoperative blood loss and reduce surgery time. Reproductive disorders associated with uterine fibroids, such as infertility, recurrent miscarriage, and adverse obstetric outcomes, are a significant reason to improve organ-preserving therapies or develop new ones. Although hysterectomy is a radical treatment for uterine fibroids, it is unacceptable for patients who have not realized their reproductive function. Therefore, the most justified intervention is myomectomy with various surgical approaches, and as an alternative treatment, uterine artery embolization, radiofrequency ablation or high-intensity focused ultrasound treatment of uterine fibroids. These data allow us to conclude that the high prevalence and versatility of symptoms of uterine fibroids among patients of reproductive age determine the relevance of searching for optimal methods of treatment.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43885762","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}
Pub Date : 2023-03-27DOI: 10.22363/2313-0245-2023-27-1-39-45
I.A. Samsonova, R. F. Gaifulin, L. Toktar, M. Orazov, Z.N. Kamarova, K. Li, V. E. Pak
Relevance. Pelvic floor dysfunction and pelvic organ prolapse are a significant problem today - even the initial manifestations of pelvic floor dysfunction can lead to reduced quality of sexual life, decreased activity, and then to social isolation and decreased self-esteem of women. Due to the growth of general life expectancy, the incidence rate is also increasing. One of the most popular conservative treatments for pelvic floor dysfunction is pelvic floor muscle training. The aim of this literature review is to consolidate the scattered information about the effectiveness of pelvic floor muscle training as a prevention and treatment of pelvic floor dysfunction. Materials and Methods. In writing the review, publications from the PubMed and Google Scholar databases from January 2019 were analyzed and systematized. Results and Discussion. Pelvic floor muscle training is one of the most prospective methods of non-invasive treatment for pelvic organ prolapse. It can take many forms and is represented by a range of different techniques: from the simple short-term muscle contraction and Kegel exercises to more complex and high-tech methods using electromyostimulation and biofeedback. However, timing of introduction and method for pelvic floor muscle training must be carefully considered in order to gain the maximum result. Conclusion. Based on the study, it can be concluded that the introduction of pelvic floor muscle training as part of prenatal care and in the antenatal period is the most appropriate way to prevent pelvic floor failure and genital prolapse. Further research is required to confirm the hypothesis.
{"title":"Pelvic floor muscle training as a method of prevention and treatment of pelvic floor dysfunction and genital prolapse","authors":"I.A. Samsonova, R. F. Gaifulin, L. Toktar, M. Orazov, Z.N. Kamarova, K. Li, V. E. Pak","doi":"10.22363/2313-0245-2023-27-1-39-45","DOIUrl":"https://doi.org/10.22363/2313-0245-2023-27-1-39-45","url":null,"abstract":"Relevance. Pelvic floor dysfunction and pelvic organ prolapse are a significant problem today - even the initial manifestations of pelvic floor dysfunction can lead to reduced quality of sexual life, decreased activity, and then to social isolation and decreased self-esteem of women. Due to the growth of general life expectancy, the incidence rate is also increasing. One of the most popular conservative treatments for pelvic floor dysfunction is pelvic floor muscle training. The aim of this literature review is to consolidate the scattered information about the effectiveness of pelvic floor muscle training as a prevention and treatment of pelvic floor dysfunction. Materials and Methods. In writing the review, publications from the PubMed and Google Scholar databases from January 2019 were analyzed and systematized. Results and Discussion. Pelvic floor muscle training is one of the most prospective methods of non-invasive treatment for pelvic organ prolapse. It can take many forms and is represented by a range of different techniques: from the simple short-term muscle contraction and Kegel exercises to more complex and high-tech methods using electromyostimulation and biofeedback. However, timing of introduction and method for pelvic floor muscle training must be carefully considered in order to gain the maximum result. Conclusion. Based on the study, it can be concluded that the introduction of pelvic floor muscle training as part of prenatal care and in the antenatal period is the most appropriate way to prevent pelvic floor failure and genital prolapse. Further research is required to confirm the hypothesis.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43006387","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}
Pub Date : 2023-03-27DOI: 10.22363/2313-0245-2023-27-1-110-118
A. Yatsuk, K. Sivolapov
Relevance. According to statistical observations, the pathology of the temporomandibular joints (TMJ) is often found in dental practice, and is accompanied not only by a pronounced pain syndrome, but also by the occurrence of internal disorders in the structure of the joints themselves. The article discusses the causes of diseases of the temporomandibular joints, gives a physiological justification for the principles of treatment of this pathological condition, indicating further principles of rehabilitation. The aim of the study is to develop principles for the treatment and rehabilitation of patients with TMJ. Materials and Methods. The condition of patients was determined on the basis of a comprehensive examination, including functional diagnostic tests, collection of anamnestic data, study of models of biomechanical occlusions, axonography, psycho-emotional state of patients using the SCL-90-R scale, quality of life. Results and Discussion. The pathology of the temporomandibular joint is considered as a disorder of its functioning, both in the absence of morphological changes and in their presence. In the absence of changes, the psychosomatic factor plays a decisive role against the background of stressful conditions (20-27 %). In the presence of pathological changes in the elements of the joint, the violation of occlusion comes first, which leads to a decrease in the elasticity of the articular surfaces, due to a change in the state of the synovial fluid. Conclusion. To prescribe therapeutic measures for the pathology of the temporomandibular joint, a specific triad of clinical manifestations is necessary: severe pain syndrome, limitation of movements of the lower jaw, internal disorders of the joint (detected using MRI). Rehabilitation of patients with TMJ diseases, according to our research, should be carried out in a complex of gnathological, conservative and surgical treatment. As a surgical treatment, we recommend: prosthetic synovial fluid, arthrocentesis, arthrolavage and prosthetics of the head and articular cavity of the condylar process.
{"title":"Treatment and rehabilitation of patients with temporomandibular joints pathology","authors":"A. Yatsuk, K. Sivolapov","doi":"10.22363/2313-0245-2023-27-1-110-118","DOIUrl":"https://doi.org/10.22363/2313-0245-2023-27-1-110-118","url":null,"abstract":"Relevance. According to statistical observations, the pathology of the temporomandibular joints (TMJ) is often found in dental practice, and is accompanied not only by a pronounced pain syndrome, but also by the occurrence of internal disorders in the structure of the joints themselves. The article discusses the causes of diseases of the temporomandibular joints, gives a physiological justification for the principles of treatment of this pathological condition, indicating further principles of rehabilitation. The aim of the study is to develop principles for the treatment and rehabilitation of patients with TMJ. Materials and Methods. The condition of patients was determined on the basis of a comprehensive examination, including functional diagnostic tests, collection of anamnestic data, study of models of biomechanical occlusions, axonography, psycho-emotional state of patients using the SCL-90-R scale, quality of life. Results and Discussion. The pathology of the temporomandibular joint is considered as a disorder of its functioning, both in the absence of morphological changes and in their presence. In the absence of changes, the psychosomatic factor plays a decisive role against the background of stressful conditions (20-27 %). In the presence of pathological changes in the elements of the joint, the violation of occlusion comes first, which leads to a decrease in the elasticity of the articular surfaces, due to a change in the state of the synovial fluid. Conclusion. To prescribe therapeutic measures for the pathology of the temporomandibular joint, a specific triad of clinical manifestations is necessary: severe pain syndrome, limitation of movements of the lower jaw, internal disorders of the joint (detected using MRI). Rehabilitation of patients with TMJ diseases, according to our research, should be carried out in a complex of gnathological, conservative and surgical treatment. As a surgical treatment, we recommend: prosthetic synovial fluid, arthrocentesis, arthrolavage and prosthetics of the head and articular cavity of the condylar process.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46110707","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}
Pub Date : 2022-12-23DOI: 10.22363/2313-0245-2022-26-4-373-381
Vardan G. Vardanyan, A. Alekhin, N. A. Mezhlumova, Galina Yu. Pevgova, A. Alekhin
Relevance . The relevance of the problem of pelvic prolapse is due to the prevalence of the disease, the tendency to rejuvenation and progression. This, according to the survey, affects the quality of life of women, leads to disruption of sexual functioning, and reduces the ability to work. The methods of surgical treatment that exist in the arsenal of modern operative gynecology can contribute to the development of cicatricial adhesions, infectious complications and recurrence of prolapse, which creates the need for repeated interventions. The development and introduction into practice of new methods of treatment is a natural necessity. The most effective technique for the surgical treatment of genital prolapse is laparoscopic sacrocolpopexy using titanium silk implants. Materials and Methods. A prospective cohort study of 30 patients aged 37 to 74 years with clinical manifestations of grade II-IV prolapse, statistical data analysis and analysis of the results of a survey of patients in the postoperative period in dynamics over 3-6-12 months from 2019 to 2021 was carried out. The study used a three-stage method of surgical assistance (patent dated September 15, 2020 No. 2020130382/14 (054923) in the volume - laparoscopic promontofixation, MacCoul sacro-uterine ligament plasty, colporrhaphy, colpoperineorrhaphy, levatoroplasty. Results and Discussion. It has been established that pregnancy and childbirth are among the main factors provoking the development of pelvic floor muscle failure. The duration of postoperative follow-up in our study was 3-14 months. No complications were diagnosed during this period. In 12 patients (40.0 %) during the first month there were periodic pulling pains in the lower abdomen and perineum, in 2 (6.6 %) - urinary incontinence. Titanium silk has a lower affinity for surrounding tissues compared to polypropylene scaffold systems, which makes it possible to consider it as an alternative material to synthetic analogues and reduce the risk of mesh-associated complications. The resistance of the titanium endoprosthesis to antiseptics and microbial agents predisposes to its long-term use and the absence of the need for replacement. Conclusion. The data obtained make it possible to judge the high efficiency of the developed technique for the surgical treatment of pelvic prolapse of pelvic floor defects in patients with rectocele and cystocele, minimizing the recurrence of the disease and the risk of developing mesh-associated complications, which allows choosing a personalized management strategy for this cohort of patients.
{"title":"New aspects in the surgical correction of pelvic organ prolapse","authors":"Vardan G. Vardanyan, A. Alekhin, N. A. Mezhlumova, Galina Yu. Pevgova, A. Alekhin","doi":"10.22363/2313-0245-2022-26-4-373-381","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-4-373-381","url":null,"abstract":"Relevance . The relevance of the problem of pelvic prolapse is due to the prevalence of the disease, the tendency to rejuvenation and progression. This, according to the survey, affects the quality of life of women, leads to disruption of sexual functioning, and reduces the ability to work. The methods of surgical treatment that exist in the arsenal of modern operative gynecology can contribute to the development of cicatricial adhesions, infectious complications and recurrence of prolapse, which creates the need for repeated interventions. The development and introduction into practice of new methods of treatment is a natural necessity. The most effective technique for the surgical treatment of genital prolapse is laparoscopic sacrocolpopexy using titanium silk implants. Materials and Methods. A prospective cohort study of 30 patients aged 37 to 74 years with clinical manifestations of grade II-IV prolapse, statistical data analysis and analysis of the results of a survey of patients in the postoperative period in dynamics over 3-6-12 months from 2019 to 2021 was carried out. The study used a three-stage method of surgical assistance (patent dated September 15, 2020 No. 2020130382/14 (054923) in the volume - laparoscopic promontofixation, MacCoul sacro-uterine ligament plasty, colporrhaphy, colpoperineorrhaphy, levatoroplasty. Results and Discussion. It has been established that pregnancy and childbirth are among the main factors provoking the development of pelvic floor muscle failure. The duration of postoperative follow-up in our study was 3-14 months. No complications were diagnosed during this period. In 12 patients (40.0 %) during the first month there were periodic pulling pains in the lower abdomen and perineum, in 2 (6.6 %) - urinary incontinence. Titanium silk has a lower affinity for surrounding tissues compared to polypropylene scaffold systems, which makes it possible to consider it as an alternative material to synthetic analogues and reduce the risk of mesh-associated complications. The resistance of the titanium endoprosthesis to antiseptics and microbial agents predisposes to its long-term use and the absence of the need for replacement. Conclusion. The data obtained make it possible to judge the high efficiency of the developed technique for the surgical treatment of pelvic prolapse of pelvic floor defects in patients with rectocele and cystocele, minimizing the recurrence of the disease and the risk of developing mesh-associated complications, which allows choosing a personalized management strategy for this cohort of patients.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44070122","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}
Pub Date : 2022-12-23DOI: 10.22363/2313-0245-2022-26-4-441-450
Ravi Saini, S. Kacker, Reshu Gupta, A. Rao
Relevance. Сardiovascular status could be assessed by maximal aerobic capacity (VO2max) through direct analysis of the gases involved in pulmonary ventilation and monitoring fluctuations in intervals between beats over time as heart rate variability. The aim of the study was to investigate the relationship between VO2max and heart rate variability in young adults. Materials and Methods. A total of 100 young adults between the ages of 18 and 25 were included in observational study, who did not engage in any strenuous physical activity, 50 of whom were male and 50 of whom were female.There were measured Heart rate variability in the frequency domain; LF, HF, LF/HF, and time domain; SDNN, RMSSD, pNN 50, and VO2max were assessed using a treadmill test according to Graded Exercise Protocol. Results and Discussion. There was weak positive correlation of VO2max with LF ( r = 0.177) and weak negative correlation with HF ( r = -0.141). Male participants had a weak negative relationship between VO2 max and LF ( r = -0.075), whereas female respondents had a weak positive relationship(r = 0.286). There was weak negative correlation of VO2max with LF/HF ratio for male subjects but weak positive correlation ( r = -0.101) for female subjects. For male and female participants, there was a weak negative association of VO2max with SDNN ( r = -0.170) and ( r = -0.301), respectively. Male and female participants had a weak negative association of VO2max with RMSSD, with ( r = -0.154) and ( r = -0.284) respectively. Male and female participants had a slight negative association of VO2max with pNN 50, with ( r = -0.062) and ( r = -0.441) respectively. Conclusion. Significant variations were found in the time domain and frequency domain indices including HF and LF/HF ratio which represents the balance between sympathetic and parasympathetic responses.
{"title":"Association between maximal aerobic capacity and heart rate variability","authors":"Ravi Saini, S. Kacker, Reshu Gupta, A. Rao","doi":"10.22363/2313-0245-2022-26-4-441-450","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-4-441-450","url":null,"abstract":"Relevance. Сardiovascular status could be assessed by maximal aerobic capacity (VO2max) through direct analysis of the gases involved in pulmonary ventilation and monitoring fluctuations in intervals between beats over time as heart rate variability. The aim of the study was to investigate the relationship between VO2max and heart rate variability in young adults. Materials and Methods. A total of 100 young adults between the ages of 18 and 25 were included in observational study, who did not engage in any strenuous physical activity, 50 of whom were male and 50 of whom were female.There were measured Heart rate variability in the frequency domain; LF, HF, LF/HF, and time domain; SDNN, RMSSD, pNN 50, and VO2max were assessed using a treadmill test according to Graded Exercise Protocol. Results and Discussion. There was weak positive correlation of VO2max with LF ( r = 0.177) and weak negative correlation with HF ( r = -0.141). Male participants had a weak negative relationship between VO2 max and LF ( r = -0.075), whereas female respondents had a weak positive relationship(r = 0.286). There was weak negative correlation of VO2max with LF/HF ratio for male subjects but weak positive correlation ( r = -0.101) for female subjects. For male and female participants, there was a weak negative association of VO2max with SDNN ( r = -0.170) and ( r = -0.301), respectively. Male and female participants had a weak negative association of VO2max with RMSSD, with ( r = -0.154) and ( r = -0.284) respectively. Male and female participants had a slight negative association of VO2max with pNN 50, with ( r = -0.062) and ( r = -0.441) respectively. Conclusion. Significant variations were found in the time domain and frequency domain indices including HF and LF/HF ratio which represents the balance between sympathetic and parasympathetic responses.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49585477","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}
Pub Date : 2022-12-23DOI: 10.22363/2313-0245-2022-26-4-431-440
S. Haque
Biomarkers are molecules that behave as of biological states. Ideally, they should have high sensitivity, specificity, and accuracy in reflecting the total disease burden. The review discusses the current status of biomarkers used in neurological disorders. Neurodegenerative diseases are a heterogeneous group disorders characterized by progressive loss of structure and function of the central nervous system or peripheral nervous system. The review discusses the main biomarkers that have predictive value for describing clinical etiology, pathophysiology, and intervention strategies. Preciseness and reliability are one of important requirement for good biomarker. As a result of the analysis of literature data, it was revealed that beta-amyloid, total tau protein and its phosphorylated forms are the first biochemical biomarkers of neurodegenerative diseases measured in cerebrospinal fluid, but these markers are dependent upon invasive lumbar puncture and therefore it’s a cumbersome process for patients. Among the various biomarkers of neurodegenerative diseases, special attention is paid to miRNAs. MicroRNAs, important biomarkers in many disease states, including neurodegenerative disorders, make them promising candidates that may lead to identify new therapeutic targets. Conclusions. Biomarkers of neurological disease are present optimal amount in the cerebrospinal fluid but they are also present in blood at low levels. The data obtained reveal the predictive value of molecular diagnostics of neurodegenerative disorders and the need for its wider use.
{"title":"Biomarkers in the diagnosis of neurodegenerative diseases","authors":"S. Haque","doi":"10.22363/2313-0245-2022-26-4-431-440","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-4-431-440","url":null,"abstract":"Biomarkers are molecules that behave as of biological states. Ideally, they should have high sensitivity, specificity, and accuracy in reflecting the total disease burden. The review discusses the current status of biomarkers used in neurological disorders. Neurodegenerative diseases are a heterogeneous group disorders characterized by progressive loss of structure and function of the central nervous system or peripheral nervous system. The review discusses the main biomarkers that have predictive value for describing clinical etiology, pathophysiology, and intervention strategies. Preciseness and reliability are one of important requirement for good biomarker. As a result of the analysis of literature data, it was revealed that beta-amyloid, total tau protein and its phosphorylated forms are the first biochemical biomarkers of neurodegenerative diseases measured in cerebrospinal fluid, but these markers are dependent upon invasive lumbar puncture and therefore it’s a cumbersome process for patients. Among the various biomarkers of neurodegenerative diseases, special attention is paid to miRNAs. MicroRNAs, important biomarkers in many disease states, including neurodegenerative disorders, make them promising candidates that may lead to identify new therapeutic targets. Conclusions. Biomarkers of neurological disease are present optimal amount in the cerebrospinal fluid but they are also present in blood at low levels. The data obtained reveal the predictive value of molecular diagnostics of neurodegenerative disorders and the need for its wider use.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45508070","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}
Pub Date : 2022-12-23DOI: 10.22363/2313-0245-2022-26-4-382-395
M. Khamoshina, Yu.S. Artemenko, Ayshan A. Bayramova, Valentina A. Ryabova, M. Orazov
Polycystic ovary syndrome is a heterogeneous endocrine disease that affects women of childbearing age. The pathogenesis of polycystic ovary syndrome has not been fully studied to date, its paradigm considers the genetic determinism of the manifestation of hormonal and metabolic disorders, which are considered to be criteria for the verification of the disease (hyperandrogenism, oligo/anovulation and/or polycystic ovarian transformation during ultrasound examination (ultrasound). This review discusses the main ways of interaction between hyperandrogenism, insulin resistance and obesity and their role in the pathogenesis of polycystic ovary syndrome, as well as possible methods of treatment for this category of patients. The review analyzes the role of hyperandrogenism and insulin resistance in the implementation of the genetic scenario of polycystic ovary syndrome and finds out the reasons why women with polycystic ovary syndrome often demonstrate the presence of a «metabolic trio» - hyperinsulinemia, insulin resistance and type 2 diabetes mellitus. It is noted that obesity is not included in the criteria for the diagnosis of polycystic ovary syndrome, but epidemiological data confirm the existence of a relationship between these diseases. Obesity, especially visceral, which is often found in women with polycystic ovary syndrome, enhances and worsens metabolic and reproductive outcomes with polycystic ovary syndrome, as well as increases insulin resistance and compensatory hyperinsulinemia, which, in turn, stimulates adipogenesis and suppresses lipolysis. Obesity increases the sensitivity of tech cells to luteinizing hormone stimulation and enhances functional hyperandrogenism of the ovaries, increasing the production of androgens by the ovaries. Excess body weight is associated with a large number of inflammatory adipokines, which, in turn, contribute to the growth of insulin resistance and adipogenesis. Obesity and insulin resistance exacerbate the symptoms of hyperandrogenism, forming a vicious circle that contributes to the development of polycystic ovary syndrome. These data allow us to conclude that bariatric surgery can become an alternative to drugs (metformin, thiazolidinedione analogs of glucagon-like peptide-1), which has shown positive results in the treatment of patients with polycystic ovary syndrome and obesity.
{"title":"Polycystic ovary syndrome and obesity: a modern paradigm","authors":"M. Khamoshina, Yu.S. Artemenko, Ayshan A. Bayramova, Valentina A. Ryabova, M. Orazov","doi":"10.22363/2313-0245-2022-26-4-382-395","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-4-382-395","url":null,"abstract":"Polycystic ovary syndrome is a heterogeneous endocrine disease that affects women of childbearing age. The pathogenesis of polycystic ovary syndrome has not been fully studied to date, its paradigm considers the genetic determinism of the manifestation of hormonal and metabolic disorders, which are considered to be criteria for the verification of the disease (hyperandrogenism, oligo/anovulation and/or polycystic ovarian transformation during ultrasound examination (ultrasound). This review discusses the main ways of interaction between hyperandrogenism, insulin resistance and obesity and their role in the pathogenesis of polycystic ovary syndrome, as well as possible methods of treatment for this category of patients. The review analyzes the role of hyperandrogenism and insulin resistance in the implementation of the genetic scenario of polycystic ovary syndrome and finds out the reasons why women with polycystic ovary syndrome often demonstrate the presence of a «metabolic trio» - hyperinsulinemia, insulin resistance and type 2 diabetes mellitus. It is noted that obesity is not included in the criteria for the diagnosis of polycystic ovary syndrome, but epidemiological data confirm the existence of a relationship between these diseases. Obesity, especially visceral, which is often found in women with polycystic ovary syndrome, enhances and worsens metabolic and reproductive outcomes with polycystic ovary syndrome, as well as increases insulin resistance and compensatory hyperinsulinemia, which, in turn, stimulates adipogenesis and suppresses lipolysis. Obesity increases the sensitivity of tech cells to luteinizing hormone stimulation and enhances functional hyperandrogenism of the ovaries, increasing the production of androgens by the ovaries. Excess body weight is associated with a large number of inflammatory adipokines, which, in turn, contribute to the growth of insulin resistance and adipogenesis. Obesity and insulin resistance exacerbate the symptoms of hyperandrogenism, forming a vicious circle that contributes to the development of polycystic ovary syndrome. These data allow us to conclude that bariatric surgery can become an alternative to drugs (metformin, thiazolidinedione analogs of glucagon-like peptide-1), which has shown positive results in the treatment of patients with polycystic ovary syndrome and obesity.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44884142","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}
Pub Date : 2022-12-23DOI: 10.22363/2313-0245-2022-26-4-422-430
M. H. Hammouri, Karina M. Salekh
The successful use of surgical and medical methods of jaw bone tissue restoration has been convincingly confirmed in clinical practice. At the same time, technologies are being developed to improve the osseointegration of dental implants in patients with osteoporosis. The use of various implant coatings, as well as systemic therapy, demonstrate the emergence of new directions in the treatment of patients with partial or complete secondary edentulism with concomitant osteoporosis. This trend is relevant in modern medicine . Information was obtained from the PubMed database, using the keywords «osteoporosis» and «osseointegration» and «dental implantation» and «zoledronic acid» from 2016 to 2022. Articles were selected based on experimental work. Numerous studies have shown that bone tissue is an effective indicator of osteoporotic changes. The main changes in bone tissue in osteoporosis are emphasized - a decrease in bone volume, deterioration of the microarchitecture of the trabecular bone and processes that prevent osseointegration - loss of bone mass, a significant decrease in the percentage of contact in the implant-bone complex. Methods of dealing with the negative impact on the operation of dental implantation have been identified. In a review of studies on the systemic administration of drugs based on bisphosphonates, an increase in the osseointegration of dental implants was revealed, the systemic administration of zoledronic acid preparations significantly increased the formation of new bone, which in turn contributed to the elimination of such a negative effect of osteoporosis as bone resorption. In addition to the systemic administration of bisphosphonates, experimental studies describe the topical application of bisphosphonates in the form of various implant coatings. Topical application of bisphosphonates also contributed to increased osseointegration. Microstructured coated implants showed less marginal bone loss compared to uncoated implants. Conclusion. The use of dental implants with modified macro- and microrelief, as well as systemic drug therapy, remains the main direction of scientific research that contributes to the optimization of osseointegration of dental implants.
{"title":"Dental implants osseointegration in patients with osteoporosis","authors":"M. H. Hammouri, Karina M. Salekh","doi":"10.22363/2313-0245-2022-26-4-422-430","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-4-422-430","url":null,"abstract":"The successful use of surgical and medical methods of jaw bone tissue restoration has been convincingly confirmed in clinical practice. At the same time, technologies are being developed to improve the osseointegration of dental implants in patients with osteoporosis. The use of various implant coatings, as well as systemic therapy, demonstrate the emergence of new directions in the treatment of patients with partial or complete secondary edentulism with concomitant osteoporosis. This trend is relevant in modern medicine . Information was obtained from the PubMed database, using the keywords «osteoporosis» and «osseointegration» and «dental implantation» and «zoledronic acid» from 2016 to 2022. Articles were selected based on experimental work. Numerous studies have shown that bone tissue is an effective indicator of osteoporotic changes. The main changes in bone tissue in osteoporosis are emphasized - a decrease in bone volume, deterioration of the microarchitecture of the trabecular bone and processes that prevent osseointegration - loss of bone mass, a significant decrease in the percentage of contact in the implant-bone complex. Methods of dealing with the negative impact on the operation of dental implantation have been identified. In a review of studies on the systemic administration of drugs based on bisphosphonates, an increase in the osseointegration of dental implants was revealed, the systemic administration of zoledronic acid preparations significantly increased the formation of new bone, which in turn contributed to the elimination of such a negative effect of osteoporosis as bone resorption. In addition to the systemic administration of bisphosphonates, experimental studies describe the topical application of bisphosphonates in the form of various implant coatings. Topical application of bisphosphonates also contributed to increased osseointegration. Microstructured coated implants showed less marginal bone loss compared to uncoated implants. Conclusion. The use of dental implants with modified macro- and microrelief, as well as systemic drug therapy, remains the main direction of scientific research that contributes to the optimization of osseointegration of dental implants.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46442834","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}
Pub Date : 2022-12-23DOI: 10.22363/2313-0245-2022-26-4-404-421
Alexey A. Korzhenevsky, N. P. Korzhenevskaya
The sum of the effects of all negative factors on the human body is manifested, including in the form of an imbalance in the work of the immune system, which leads to a violation of the recognition and elimination of foreign substances of the most diverse origin. This is manifested in an increase in the frequency of development of inflammatory processes, the risk of their chronicity and the development of complications, the identification of opportunistic or conditionally pathogenic flora as a pathogen, including those with atypical biological properties and antibiotic resistance. The use of etiotropic chemotherapy alone in the treatment does not allow achieving sufficient control over many infectious diseases. The purpose of this review was to investigate additional, alternative approaches to influencing anti-infective immunity. An analysis of the strategy based on the use of modulation of the immune response in the treatment of patients was carried out and its advantages over traditional antimicrobial treatment were determined. The concept of «immunotherapy» is discussed, which implies a variety of effects on the immune system in order to stop the pathological process. The review highlights the main types of immunotherapy - local, general, combined and monoimmunotherapy, as well as active and passive, specific and nonspecific. The review provides convincing data on the need for immunomodulators to meet a number of requirements, analyzes various ways of classifying them and their areas of application. The necessity of using immunotropic drugs on the basis of a comprehensive examination is emphasized, taking into account the correspondence between the nature of clinical manifestations and the severity of changes in immunological parameters. The analyzed data allow us to conclude that immunomodulatory therapy can be used to restore the function of the immune system to the physiological norm after a severe inflammatory process at the stage of immunorehabilitation.
{"title":"Immunotherapy at the modern stage: types and tactics of application","authors":"Alexey A. Korzhenevsky, N. P. Korzhenevskaya","doi":"10.22363/2313-0245-2022-26-4-404-421","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-4-404-421","url":null,"abstract":"The sum of the effects of all negative factors on the human body is manifested, including in the form of an imbalance in the work of the immune system, which leads to a violation of the recognition and elimination of foreign substances of the most diverse origin. This is manifested in an increase in the frequency of development of inflammatory processes, the risk of their chronicity and the development of complications, the identification of opportunistic or conditionally pathogenic flora as a pathogen, including those with atypical biological properties and antibiotic resistance. The use of etiotropic chemotherapy alone in the treatment does not allow achieving sufficient control over many infectious diseases. The purpose of this review was to investigate additional, alternative approaches to influencing anti-infective immunity. An analysis of the strategy based on the use of modulation of the immune response in the treatment of patients was carried out and its advantages over traditional antimicrobial treatment were determined. The concept of «immunotherapy» is discussed, which implies a variety of effects on the immune system in order to stop the pathological process. The review highlights the main types of immunotherapy - local, general, combined and monoimmunotherapy, as well as active and passive, specific and nonspecific. The review provides convincing data on the need for immunomodulators to meet a number of requirements, analyzes various ways of classifying them and their areas of application. The necessity of using immunotropic drugs on the basis of a comprehensive examination is emphasized, taking into account the correspondence between the nature of clinical manifestations and the severity of changes in immunological parameters. The analyzed data allow us to conclude that immunomodulatory therapy can be used to restore the function of the immune system to the physiological norm after a severe inflammatory process at the stage of immunorehabilitation.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48642098","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}
Pub Date : 2022-12-23DOI: 10.22363/2313-0245-2022-26-4-364-372
I. S. Zhuravleva, M. Khamoshina, M. Orazov, E. Dmitrieva, M. Azova
In the modern paradigm of public health protection, much attention is paid to the health of women in peri- and postmenopause, and a personalized approach prevails. It is generally recognized that the pathogenetic therapy of menopausal disorders is hormone therapy. But the COVID-19 pandemic has made its own adjustments to the routine strategy of choosing menopausal hormone therapy (MHT). The purpose of this review was to analyze studies on the dependence of the effectiveness of MHT on clinical and genetic aspects in the context of the ongoing COVID-19 pandemic. The review highlights the main risks of MHT for thromboembolic diseases and coagulation complications characteristic of COVID-19, discusses genetic predispositions that aggravate the course of the post-COVID period, as well as the effectiveness of estrogens in protecting the vascular endothelium and increasing the number of CD4+ T cells, providing an adequate immune response when infected with SARS-CoV-2. Numerous studies show that the complications characteristic of the severe course of COVID-19 are multifactorial in nature and cannot be unambiguously explained only by genetic predisposition. However, with the development of personalized medicine, special attention should be paid to the study of genetic aspects that can equally contribute to the occurrence of menopausal disorders in healthy women and aggravate the course of the post-pregnancy period. The data presented allow us to conclude that in the context of the ongoing COVID-19 pandemic at the population level, MHT can bring significant benefits to women during menopause due to the beneficial effect of estrogens on vascular walls. Additional study of the relationship between the course of the postcovid period in MHT users and polymorphisms of candidate genes that determine the risks of thrombotic complications and metabolic consequences is required.
{"title":"Clinical and genetic aspects of menopausal hormone therapy - a modern paradigm. What changed COVID-19 pandemic?","authors":"I. S. Zhuravleva, M. Khamoshina, M. Orazov, E. Dmitrieva, M. Azova","doi":"10.22363/2313-0245-2022-26-4-364-372","DOIUrl":"https://doi.org/10.22363/2313-0245-2022-26-4-364-372","url":null,"abstract":"In the modern paradigm of public health protection, much attention is paid to the health of women in peri- and postmenopause, and a personalized approach prevails. It is generally recognized that the pathogenetic therapy of menopausal disorders is hormone therapy. But the COVID-19 pandemic has made its own adjustments to the routine strategy of choosing menopausal hormone therapy (MHT). The purpose of this review was to analyze studies on the dependence of the effectiveness of MHT on clinical and genetic aspects in the context of the ongoing COVID-19 pandemic. The review highlights the main risks of MHT for thromboembolic diseases and coagulation complications characteristic of COVID-19, discusses genetic predispositions that aggravate the course of the post-COVID period, as well as the effectiveness of estrogens in protecting the vascular endothelium and increasing the number of CD4+ T cells, providing an adequate immune response when infected with SARS-CoV-2. Numerous studies show that the complications characteristic of the severe course of COVID-19 are multifactorial in nature and cannot be unambiguously explained only by genetic predisposition. However, with the development of personalized medicine, special attention should be paid to the study of genetic aspects that can equally contribute to the occurrence of menopausal disorders in healthy women and aggravate the course of the post-pregnancy period. The data presented allow us to conclude that in the context of the ongoing COVID-19 pandemic at the population level, MHT can bring significant benefits to women during menopause due to the beneficial effect of estrogens on vascular walls. Additional study of the relationship between the course of the postcovid period in MHT users and polymorphisms of candidate genes that determine the risks of thrombotic complications and metabolic consequences is required.","PeriodicalId":21324,"journal":{"name":"RUDN Journal of Medicine","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68273173","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}
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