Vol 33, No 4 (2022)

The review examines the clinical and psychodynamic aspects of somatoform cardiovascular disorder. The role of biological, psychological and social prerequisites in disease manifestation is analyzed. Particular attention is paid to the importance of the effect of anxiety and depression as cognitive factors that modulate the course of somatoform disorder. Options for correction of the considered pathology are presented.

The paper considers the molecular mechanisms of emergence of short-term and long-term memory in the human cerebral cortex. It shows that short-term memory is due to an increase in the function of synaptic connections in the cerebral cortex, while long-term memory is due to the emergence of additional duplicate synaptic connections. Forgetting and remembering various concepts occurs due to the disruption and subsequent restoration of synaptic connections in the cyclic neuronal circuits of the neocortex. The principles of drug exposure in the development of dementia are assessed.

Hemophilia is one of the most common genetically determined blood clotting disorders. The disease manifests itself in early childhood and clinically has two of the most common variants of the disease: hemophilia A - deficiency of factor (F) VIII, and hemophilia B - deficiency of FIX. Diagnostics requires obligatory laboratory confirmation of the genetic absence or decrease in the concentration of FVIII for hemophilia A and FIX for hemophilia B. Introduction in recent years into practice of domestic recombinant coagulation factors - moroctocog alfa (BDDrFVIII), nonacog alfa (rFIX) and eptacog alfa (activated) (rFVIIa) made it possible to significantly optimize substitution therapy in children with hemophilia, and in the face of growing Western sanctions, to provide Russian children with the necessary means of emergency care and prevention, which are not inferior to the best foreign analogues. Their high therapeutic efficacy and low immunogenicity have been proven. New therapeutic principles include non-factorial drugs and gene therapy options for both hemophilia A and hemophilia B.

The paper discusses the vaso-, neuro- and cardioprotective effects of a cytoprotective drug from a class of partial inhibitors of fatty acid β-oxidation (meldonium) and the possibility of its use in patients with multimorbidity. Meldonium is currently recommended for use as part of combination therapy for a number of cardiovascular diseases as a cytoprotector that affects cellular energy metabolism during ischemia and improves the use of oxygen by cells, including cardiomyocytes. Meldonium has a good safety and tolerability profile, increases exercise tolerance, performance in patients with coronary heart disease, stable exertional angina, heart failure, and improves quality of life. The additional immunomodulatory effects of meldonium allow the use of this drug to be expanded in clinical practice. The authors present their own observation of a middle-aged female patient with concomitant diseases who has taken meldonium as part of combination pathogenetic therapy. The paper discusses the possibilities of using meldonium that affects the neurometabolic processes in order to enhance the efficiency of therapy, to reduce the manifestations of asthenic syndrome, and to improve quality of life in the patients.

Due to the high prevalence of dementia in older age groups, a search is underway for effective and safe treatments for cognitive impairment (CI). Objective: to study the impact of magnetic therapy on cognitive functions (CF), sleep, and anxiety in elderly and senile patients. Subjects and methods. The investigation enrolled 60 elderly and senile patients (27 males; 33 females; mean age, 76.2±9.4 years). According to preliminary neuropsychological tests, the patients were divided into 3 groups: 1) mild CI; 2) moderate CI; and 3) mild dementia. The patients in each group were also randomized to 2 subgroups of 10 people: a no-treatment control group and a magnetic therapy study group. Magnetic therapy was performed using the Almag-03. The therapy cycle involved fourteen 15-20-minute sessions for 14 days. After 14 days, neuropsychological tests were carried out in the control and study groups. Results. After a magnetic therapy cycle, the clock drawing test and the Luria “10 words" test showed that their scores in Group 1 patients increased by 15 and 24%, respectively, as compared to those in the control subgroup. These tests in Group 2 indicated that magnetic therapy caused a rise in the number of scores by 45 and 28%, respectively, compared to those in the control subgroup. Magnetic therapy had no impact on CF in Group 3 patients. After magnetic therapy, the patients of all the study groups showed a significant sleep improvement by 9, 7 and 8%, respectively, compared to the control subgroup. In Group 3 patients, magnetic therapy decreased the number of geriatric depression scale scores by 19% compared to that in the control subgroup. After a magnetic therapy cycle, in Groups 2 and 3 patients anxiety decreased by 32 and 21%, respectively, compared to the control subgroup. Conclusion. Patients over 65 years of age who had mild to moderate CI were found to have better CF and sleep quality and decreased anxiety after magnetic therapy. The latter is a promising treatment option for elderly and senile patients with cognitive impairment and emotional disorders.

The results of numerous studies demonstrate the heterogeneity of the causes of congenital malformations (CMs) (genetic, chromosomal, teratogenic, etc.), although the nature of CMs remains unknown and is multifactorial in a significant proportion (65-70%) of cases. At least 2-3% of all CMs are known to be associated with the use of drugs. The paper gives the results of the authors’ own study evaluating the impact of ABCB1 gene polymorphism on the risk of CMs in the Russian population of pregnant women.