Vol 30, No 9 (2019)

The paper considers possible neuropsychological prerequisites for common sleep disorders detected in adolescence. Attention is paid to the brain morphological and functional rearrangements during puberty, which are accompanied by a decline in the number of synapses and interneuronal connections. The above phenomena lead to decreased slow-wave activity on the electroencephalogram that reflects sleep pressure, a homeostatic process that causes the onset of sleep. The changes are observed in the circadian process, which are associated with decreased melatonin production during puberty, increased retinal sensitivity to light exposure during evening hours, and the longer circadian period of the sleep-wake cycle. The aforementioned contributes to an increased risk for a delayed sleep disorders. The continuing need for a teenager in 8-9-hour sleep with early awakenings on weekdays results in sleep deprivation that is accompanied by a risk for emotional and behavioral problems. The risk of sleep disorders is exacerbated by increased emotional reactivity and stress sensitivity, which are typical of adolescents, by hygiene violations, higher school workloads, and an irrationally designed school timetable. Possible approaches to reducing the risk of sleep disorders in adolescence are considered.

Cardiovascular diseases remain the main cause of high death rates worldwide. Great attention is paid to the early detection and diagnosis of pathological conditions and to the improvement of treatment policy. The advent of high-sensitivity clinical and laboratory studies have made it possible to identify new biological markers for cardiovascular risk, to assess their physiological and pathogenetic role, and to create evidence-based prognostic risk models in addition to the already existing and well-established prognostic scales, which certainly can contribute to the quality of medical care. Today, there are more than 100 new surrogate cardiovascular disease biomarkers, most of which have yet to be studied in detail. The review presents general principles and approaches to assessing biomarkers, key statistical aspects of their study with an emphasis on clinical relevance before any potential biomarker can be put into practice.

Представлен обзор клинических исследований препарата Мельдоний, которые показали его эффективность в лечении сердечно-сосудистой патологии. Мельдоний широко применяют в комплексной терапии при ИБС, хронической сердечной недостаточности, острых и хронических цереброваскулярных заболеваниях. Описаны результаты исследования биоэквивалентности препарата Мельдоний Органика, капсулы 500 мг (АО «Органика», Россия) и препарата Милдронат®, капсулы 500 мг (АО Grindex, Латвия), по данным которого препараты являются биоэквивалентными, что свидетельствует о возможности применения препарата Мельдоний Органика в клинической практике.

The authors show the efficiency of using oral anticoagulants, such as rivaroxaban, dabigatran, and warfarin, to treat pulmonary embolism (PE) and to prevent its recurrences; they recommend that the Geneva score should be employed to predict PE when a patient is being admitted to hospital.

Infantile cerebral palsy (ICP) occupies the first place in the structure of neurological disability in children. The authors identify whether movement disorders can be more effectively corrected through selective electrotherapy in combination with biomechanotherapy during the use of botulinum toxin type A while rehabilitating children with spastic forms of ICP. The incorporation of new methods for correcting movement disorders into a comprehensive rehabilitation program for spastic forms of ICP can considerably increase both the effectiveness and sustainability of treatment results, which will be able to substantially reduce the time and frequency of hospital admissions and the financial costs for the rehabilitation of this category of patients.

The efficacy and safety of atosiban used as a tocolytic agent versus other tocolytic drugs were studied.

Myocardial infarction (MI) morbidity and mortality rates in women remain high. After successful hospital treatment, the patients are discharged for outpatient treatment, but there are few studies of their further prognosis. The author compares the annual prognosis after MI in women who have normal menstrual function and in those who were postmenopausal.

Chronic prostatitis is treated using the device MAVIT® (ULP-01-ELAT) made in Russia; it exerts a local (transrectal) effect on the prostate gland by several physical factors, such as heat, magnetic field, and vibration massage. Its clinical efficacy was evaluated by the results of studies: microscopy of pancreatic secretion, general urinalysis and urine culture, uroflowmetry, transrectal ultrasonography of the pancreas. The investigators determined the subjective state and time course of changes in clinical symptoms according to the I-PSS scale and quality of life (QOL) by the QOL scale. They noted positive changes, such as pain abatement or relief, dysuric disorders, and reduced pancreatic volume, which significantly improved quality of life in patients.

Demand for pharmaceuticals of preferential drug provision under the program «7 high-cost nosologies» is satisfied by imports on 63% in Russia. The share of domestic biotechnological products is not more than 10% of the total market of medicines. In order to stimulate the development and production of domestic innovative medicines, the state program of the Russian Federation «development of the pharmaceutical and medical industry» for 2013-2020 was approved. Example of successful implementation of this program is development, research and industrial production of the full range of recombinant blood coagulation factors VII, VIII and IX (Coagil-VII®, Octofactor®, Innonafactor®) for the treatment of all types of hemophilia A, B and hemophilia with inhibitors. Biotechnological features of the production of blood clotting factors, the results of clinical and observational studies and the modern role of recombinant blood clotting factors in the treatment of hemophilia in the Russian Federation are analyzed.