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Vol 33, No 8 (2022)

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Topical Subject

The role of metabolic syndrome and current approaches to the treatment and rehabilitation of patients with recurrent atypical endometrial hyperplasia and endometrial cancer

Sandzhieva L.N., Solopova A.G., Blinov D.V., Achkasov E.E., Korabelnikov D.I., Petrenko D.A.


Fertile age patients tend to have an increased prevalence of malignant neoplasms of the reproductive system. Metabolic syndrome (MS) is the main factor of endometrial hyperplasia with atypia, followed by possible tumor transformation. Obesity as part of MS supports chronic inflammation, metabolic disorders, oxidative stress, hyperestrogenemia, and persistent stimulation of endometrial cells. An integrated treatment approach should involve radical or organ-sparing surgery in reproductive-aged women, followed by hormonal therapy, as well as the comprehensive medical rehabilitation stage based on a multidisciplinary approach to prevent irreversible functional and mental disorders due to aggressive treatment methods and the disease itself.

Vrach. 2022;33(8):5-10
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Post-COVID-19 lesions of the musculoskeletal system in adolescents: approaches to pharmacotherapy

Evert L.S., Potupchik T.V., Kostyuchenko Y.R., Chudinova O.V., Panicheva E.S.


A review of information on the most common violations of various organs and systems in adults and children who have had a coronavirus infection has been conducted. Etiopathogenetic aspects and the main clinical manifestations of post-COVID-19 syndrome (PCS) in people of different ages are highlighted. The results of our own study are included, which showed a high incidence of disorders of the musculoskeletal and other body systems in COVID-19 convalescents. Various strategies for the treatment of bridge-like disorders are highlighted. As a pharmacological correction, the possibility of therapy using of nonsteroidal anti-inflammatory drugs; central muscle relaxants; coanalgesics: anticonvulsants and antidepressants; vitamin and mineral complexes; osteoprotectors is being considered. Therapy and prevention of PCS should include correction of functional disorders, pain control, consistent physical, psychological and social rehabilitation.

Vrach. 2022;33(8):11-18
pages 11-18 views


Pelvic inflammatory diseases and their therapy in outpatient settings

Skvortsov V.V., Skvortsova E.M., Statsenko I.Y., Razvalyaeva O.V., Durnoglazova K.A.


Pelvic inflammatory diseases (PIDs) are a collective term embracing infectious and inflammatory diseases of the upper female genital tract involving the uterine (fallopian) tubes, ovaries, and surrounding tissues. The paper considers the classification, etiology, and pathogenesis of PID, describes the clinical presentation of the disease, and also provides the main methods of diagnosis and drug therapy.

Vrach. 2022;33(8):19-22
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Subgaleal hemorrhage from birth trauma: from the first stage of labor to the baby’s discharge: a clinical case at the intersection of specialties

Shestak E.V., Svetlakova D.V., Desyatnik K.A.


Neonatal subgaleal hemorrhage (SH) is a common complication of vacuum extraction delivery. The baby’s condition after SH can progressively worsen up to death in 22% of cases. The basis for SH is a large blood accumulation volume in the subgaleal space, resulting in hemorrhagic shock and coagulopathy. The paper describes a clinical case of female patient M. who has undergone operative vaginal vacuum extraction done to deliver a baby, if clinically indicated. It analyzes the labor activity of Patient M, by providing a rationale for obstetric care tactics. The paper depicts the further worsening severity of neonatal infants condition in the presence of progressive bleeding into the subgaleal space, as well as neonatologists’ treatment policy, with a detailed description of instrumental and laboratory data up to the moment the patients discharge from hospital. An analysis of the clinical case showed that medical personnel alertness regarding the detection of SH after vacuum extraction delivery was a predetermining factor in the prognosis of the baby’s health and life. A particularly important step is to make a correct differential diagnosis of conditions similar to SH. Intensive infusion-transfusion therapy is in the first place while providing assistance and stabilizing the baby’s condition, since ongoing bleeding and hemorrhagic shock are the main causes of mortality in SH.

Vrach. 2022;33(8):23-27
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For Diagnosis

Adenomyosis: modern diagnostic possibilities

Klinyshkova T.V., Chernyshova N.P., Soveyko E.E.


Objective. To assess comprehensive examination results in patients with adenomyosis. Subjects and methods. The investigation enrolled 59 reproductive-aged and premenopausal (40.5±6.2 years) patients with adenomyosis verified in 42 (71.2%) cases, with no concurrent uterine myoma, as well as 20 control group patients. The investigation used traditional methods, such as 3D ultrasound, magnetic resonance imaging, hysteroscopy and biopsy of the endometrium and myometrium, histological examination, and statistical methods. Results. The patients with adenomyosis were found to include persons who were younger than 35 years (28.8%), nulliparous (25.4%), and infertile (19.1%); those who had undergone peritoneal endometriosis (11.9%) or uterine (28.8%) surgeries; and those who had predominant dysmenorrhea (96.6%). The uterine volume was higher in 83.1% of adenomyosis patients than that in the control group (103.35±13.01 and 42.4±2.96 cm3, respectively; p=0.000); the myometrial wall asymmetry with a difference in the anterior and posterior wall thickness was 7.01±1.8 mm in 47.6% of patients; and the myometrial junctional zone thickness was >12 mm in 62.5%. There was an increased uterine radial and basal artery resistance index and reduced myometrial vascularization indices in comparison with the control (p<0.05). Conclusion. The presented diagnostic possibilities of traditional clinicomorphological studies and modern myometrial imaging techniques allow the timely detection of characteristic signs of adenomyosis.

Vrach. 2022;33(8):28-32
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Mathematical program for predicting the risk for progression of atrial fibrillation and its possible complications in patients with hypertension and concomitant extracardiac diseases

Khidirova L.D., Osmieva Z.M., Lukinov V.L.


Objective. To elaborate a personalized algorithm for predicting the progression of atrial fibrillation (AF) and the development of its complications in essential hypertension concurrent with extracardiac diseases. Subjects and methods. An observational cohort study involved 308 males aged 45-60 years with AF and hypertension concurrent with extracardiac diseases: diabetes mellitus (n=40), diffuse toxic goiter (n=42); hypothyroidism (HT; n=59), abdominal obesity (n=64), and chronic obstructive pulmonary disease (n=47). A comparison group consisted of 56 patients without extracardiac disease. The study assessed clinical, laboratory, and anthropometric data and 24-hour ECG monitoring and echocardiography readings. All statistical calculations were performed using the Rstudio program (USA). Results. Significant predictors of AF progression have been established, which include remodeling indicators: a 1-ng/l elevation of galectin-3 increases the risk of AF progression by 1.003 times (p=0.016); a 1-cm left atrial (LA) enlargement does by 2.67 times (p<0.001); a 1-cm increase in end-diastolic dimension reduces the risk of recurrent AF by 0.13 times (p=0.025); a 1-g/m2 elevation of the left ventricular mass index enhances the risk of AF progression by 0.9 times; which also include inflammation indicators: a 1-pg/l elevation of interleukin-6 increases the risk of AF progression by 0.6 times; a 1-n/ml increase in matrix metalloproteinase-9 as a marker of vascular stiffness does by 0.16 times. Emergency hospitalization for the progression of chronic heart failure (CHF) within 1 year in patients with AF was significantly higher in all the clinical groups than in the controls, except for the HT group. There were statistically significant predictors of hospitalization for CHF progression: a 1-cm LA enlargement increases the risk of CHF by 5.04 times; a 1-pg/l elevation of NT-proBNP does by 1.01 times. A comparative assessment of the incidence of cardiac embolism in the examined groups showed no statistically significant difference; however, it was on percentage terms higher in patients with AF than in those without the latter (11.2 and 6%, respectively). Conclusion. The elaborated personalized algorithm can assist in assessing the prognosis of the progression of AF and the development of its complications in essential hypertension concurrent with extracardiac diseases.

Vrach. 2022;33(8):32-36
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From Practice

Risk factors in the early diagnosis and prevention of osteoporosis in children: a rationale for pharmacological correction of calcium and vitamin D deficiency

Strukov V.I., Shcherbakova Y.G., Elistratov D.G., Vikhrev D.V., Alekseeva N.Y., Radchenko L.G., Musatova L.A., Kuptsova T.A.


The paper considers the role of risk factors (RFs) in the formation of low bone mineral density, starting with the prenatal period, early childhood and school age periods. An analysis has shown the characteristics of RFs in the examined children aged 9-17 years and their total negative effect on the development of osteoporosis and fractures in this category of patients. The paper also indicates a relationship of the frequency of bone fractures to the number of RFs risk factors and the presence of comorbidities. It provides a rationale for the pharmacological correction of vitamin D and calcium deficiency in children.

Vrach. 2022;33(8):37-40
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Functional activity of the gut microbiota, adipose tissue, and incretins in childhood obesity

Samoilova Y.G., Sagan E.V., Oleynik O.A., Kudlay D.A., Matveeva M.V., Podchinenova D.V., Kovarenko M.A., Vorozhtsova I.N., Pavlenko O.A.


Obesity is a multifactorial disease. The action of the gut microbiota on human metabolic health is currently being actively studied. The literature describes many mechanisms of this action, the main mechanism is the synthesis of short-chain fatty acids (SCFA) that are ligands of GPR41 and GPR43 receptors for the synthesis of many hormones (insulin, glucagon, leptin, and irisin). Objective: to study the metabolic activity of the colonic microbiota and its relationship to the secretion of adipose tissue hormones, incretins in obese and overweight children. The investigation involved 74 children and adolescents with overweight and obesity, as well as 44 healthy children matched for age and sex. Over the course of the investigation, data were obtained on a decrease in the activity of hormones (irisin, resistin, glucagon, GLP-1, and GLP-2) in the presence of the lower metabolic activity of the microbiota, while the overweight and obese children showed a positive correlation with the main hormones and incretins. The reduced metabolic function of the microbiota, largely in synthesizing butyric acid, may be associated with a low indigestible fiber diet for obese and overweight children and also indirectly suggests that there may be a small number of butyrate-producing bacteria and/or their low activity. The mechanisms and direction of correlations between the functional activity of the gut microbiota, the gastrointestinal system, and some adipokines require further understanding and research.

Vrach. 2022;33(8):41-45
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Relationship between the type of body composition and the course of chronic erosive gastroduodenitis in children

Kharitonov D.V., Sapozhnikov V.G., Osiptsov N.V., Nikishina Y.I.


The paper presents the results of a study of the relationship between the type of body composition and the course of chronic erosive gastroduodenitis (CEGD) in children. The study involved 54 patients (34 boys, 20 girls) aged 12 to 18 years with CEGD. The body composition type of a child was determined using the Pinier index according to the procedure designed by M.V. Chernorutsky. All the patients underwent esophagogastroduodenoscopy with biopsy material sampling, followed by histopathological examination, a breathing test for Helicobacter pylori (Hp), a serological test for Hp IgG and IgM, and an objective examination. Among the children with CEGD, asthenics (68.5%) prevailed; hypersthenics (18.5%) and normosthenics (13%) were less common.

Vrach. 2022;33(8):47-49
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Community-acquired pneumonias in children: clinical features, therapy compliance with clinical practice guidelines

Lekomtseva O.I., Subbotina Y.Y., Meryaseva M.A., Mikhaleva A.T., Agliullina D.R., Kuzmina N.G.


Therapy for community-acquired pneumonia in children is an urgent public health problem, which is due to the substantial spread of this disease in them, to the severity of its course, to the chronicity of the process in the bronchopulmonary system, and to the remaining high mortality in this group of patients. The article presents the results of a retrospective study of the features of the clinical course and treatment of community-acquired pneumonia in children of different ages.

Vrach. 2022;33(8):50-52
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On the necessity and safety of treatment for asthma during pregnancy

Lavrova O.V., Petrova M.A., Lukyanova M.Y.


Therapy for patients with asthma during pregnancy provides a combination of maximizing benefits and minimizing risks for the mother and her baby. However, the number of studies dealing with therapy with different types of inhaled drugs is extremely scarce. Objective. To analyze the nature of the course of asthma during pregnancy, the incidence of complications of pregnancy and childbirth, as well as the health status of newborns in female patients with asthma treated with a combination of formoterol and budesonide. Subjects and methods. A clinical and functional examination and a follow-up were made in 2557 pregnant asthmatic women of childbearing age, as well as in their babies under 1 year old. Results. Among the patients taking the combination drug, the degree of asthma control was significantly higher and moderate and severe preeclampsia developed significantly less frequently than in the group as a whole. There was no impact of therapy with the combination drug of formoterol and budesonide on the timeliness of delivery. The weight and height and Apgar scores of the babies born to the mothers who used the combination drug were not different from the normal values. The incidence of atopic dermatitis in babies under the age of 1 year was significantly (p=0.029) lower in the babies whose mothers received therapy with the combination of formoterol and budesonide. Conclusion. The findings suggest the absence of a negative impact of therapy with the combination of formoterol and budesonide on the development of pregnancy complications, the timeliness of delivery, weight and height, and Apgar scores of newborns, as well as the presence of a positive impact on the controllability of the disease, on a decrease in the incidence of preeclampsia in patients with asthma and in that of atopic dermatitis in their babies.

Vrach. 2022;33(8):52-56
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The reproductive health of adolescent girls living in the Khanty-Mansiysk Autonomous Okrug - Yugra

Solovyeva A.V., Chegus L.A., Kuznetsova O.A., Aleynikova E.Y.


Objective. To study the features of reproductive health in adolescent girls residing in the Far North. Subjects and methods. A prospective study was conducted in 112 outpatient records of adolescent girls aged 16-17years. Group 1 included 31 indigenous minority (Khanty and Mansi) girls living in a North rural area (the urban-type settlement of Beryozovo, KhMAO-Yugra); Group 2 consisted of 28 indigenous girls residing in Khanty-Mansiysk; Group 3 comprised of 53 Slavic girls living in Khanty-Mansiysk. The statistical map for each teenage girl included anamnestic, clinical, and laboratory data. Results. Menarche occurred in Groups 2 and 3 (urban populations) earlier at 11.1 and 11.8 years of age, respectively; and in Group 1 (a rural population) at 12.3 years of age. This is due to overweight and obesity in Groups 2 and 3 urban populations (67.85 and 47.17% of the girls). In Group 1, overweight and obesity were observed only in 22.58%. In this group, the menstrual cycle began at 13-14 years; in Groups 2 and 3, the menstruation periods were irregular until 16-17 years of age. Heavy menstruations during puberty were more often noted in Groups 2 and 3 (53.6 and 35.8%, respectively) than in Group 1 (19.4%) (x2=7.50; р=0.02). Secondary dysmenorrhea occurred significantly more frequently in Group 3 (41.5%) than in Groups 1 and 2 (19.4 and 17.9%, respectively) (x2=7.04; p=0.03). Iron deficiency anemia (IDA) during menstrual dysfunction, was more often diagnosed in the girls of Groups 2 and 3 (14.3 and 35.8%, respectively). Inflammatory diseases of the lower genital tract were more common in the urban populations of Groups 2 and 3 (67.85 and 76.19%); while those were in Group 1 (only 38.7%). Conclusion. Urbanization has a negative impact on the menstruation function period formation in the urban girls; menarche occurred earlier among both the indigenous minorities and the Russian population. This is due to the high prevalence of overweight and obesity (>50% of the surveyed). Menstrual irregularities, heavy menstrual blood loss, and IDA were also much more common in the urban population. Earlier onset of sexual activity in the urban population leads to the widespread of inflammatory diseases of the lower genital tract (cervical inflammatory disease, vulvitis, and vaginitis), which requires further investigations and development of a health promotion and rehabilitation program for the urban population.

Vrach. 2022;33(8):56-61
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The experience of using therapy of inflammatory diseases of the women’s pelvic organs in reproductive age

Krutova V.A., Bolotova E.V., Dudnikova A.V., Prosolupova N.S.


The purpose of the study: to evaluate the effectiveness of the use of the drug bovgialuronidase azoximer in the complex therapy of inflammatory diseases of the pelvic organs in women of reproductive age. Material and methods. A comprehensive prospective clinical trial «Double-blind placebo-controlled multicenter randomized comparative study of the efficacy and safety of drugs, vaginal and rectal suppositories bovgialuronidase azoximer (NPO Petrovax Pharm LLC, Russia) in the complex therapy of patients with exacerbations of chronic inflammatory diseases of the pelvic organs» was conducted on the basis of the Clinic of FSBEI at KubSMU in 2017, which included 112 patients (average age 30.1±6.2 years). The patients were divided into 2 groups: group 1 - 58 women received the drug bovgialuronidase azoximer at a dose of 3000IU according to the scheme: 1 suppository rectally 1 time in 3 days 10 injections, then 1 suppository 1 time in 5 days 5 injections (total course - 15 suppositories); patients in the control group (n=54) received placebo suppositories, which were administered according to a similar scheme. Dynamic observation of the patients was carried out over the next three years. Results. In the patients of the main group, on the background of the treatment on day 5-7, subjective improvement was statistically significantly more frequent (50% vs 16.7%, respectively, x2=12.52, p=0.04). On the 10th-12th day, statistically significantly more often in the main group, positive dynamics of laboratory data (96.6% vs 68.5%, respectively, x2=15.5, p=0.04), normalization of vaginal biocenosis (96.6% vs 66.7%, respectively, x2=17.2, p=0.025) and subjective sensations (100% vs 87%, respectively,x2=7,906, p=0.04). With dynamic follow-up, the patients of the control group compared with the main group had a statistically significantly higher frequency of relapse of exacerbation of PID (31.5% vs 5.2%, x2=13.2, p=0.01) during the first 6 months of follow-up and during the first year of follow-up (40.7% vs 8.6%, x2=15.8, p=0.025), the onset of pregnancy is statistically significantly lower (25.9% vs 55.2%, x2=9.5, p= 0.04). Conclusion. The data revealed by us indicate that in women with PID who received, along with standard methods of treatment, the drug bovgialuronidase azoximer, there was a faster (3-5 days compared to the control group) disappearance of the main clinical symptoms, the number of pregnancies that occurred.

Vrach. 2022;33(8):62-66
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Difficulties in the treatment of rheumatoid arthritis in the presence of cardiovascular events

Sagitova E.R., Kravtsova O.N.


Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular events (CVEs). The main factors of cardiovascular mortality in RA are considered to be the rapid progression of atherosclerosis and the development of chronic heart failure. Traditional risk factors, such as hypertension, hyperlipidemia, and obesity, play an important role in the development of CVEs. The paper considers a clinical case of diagnosing RA and difficulties in selecting adequate therapy in the presence of cardiovascular disease.

Vrach. 2022;33(8):67-70
pages 67-70 views

The effectiveness of a comprehensive rehabilitation program including interactive balance therapy with biofeedback and kinesihydrotherapy in on the balance function in patients with obesity

Vasileva V.A., Marchenkova L.A., Eryomushkin M.A., Kollshenkov V.A.


Objectives: the study of the influence of a new complex method of physical therapy with the inclusion of balance therapy with biofeedback and kinesihydrotherapy on the human balance function. Material and methods: the study included men and women aged 40 to 65 years with a body mass index >30 kg/m2. Research methods included anthropometry, stabilometry. The patients were further divided into two groups by simple randomization. Patients of both groups underwent a two-week course of medical rehabilitation. Patients of the main group received 4 methods of physical therapy: balance therapy, group classes in kinesihydrotherapy, group classes in a special complex of therapeutic exercises in the hall, aerobic exercises on a stationary bike or treadmill. The patients of the comparison group were treated only with the use of aerobic exercises and therapeutic exercises in the hall according to the same methodology and with the same number of procedures as in the main group. Dynamic observation was carried out at the beginning and after 14 days. Results: according to the data, we obtained an improvement in the balance function on the 14th day of the study in terms of spread along the front(p=0.028) and the spread along the sagittal (p=0.043). Significantly improved indicators in the main group in terms of the average speed of movement of the center of pressure (p=0.018) and the speed of movement of the statokinesiogram (p=0.028), indicators of the area of the ellipse (p=0.018). Conclusions: the new comprehensive program, including aerobic and strength physical training, kinesihydrotherapy and balance therapy, showed a more significant effect on the balance function after completion of the rehabilitation, rather than the standard rehabilitation method.

Vrach. 2022;33(8):71-74
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The results of the use of a sterile gauze bandage Proteox-TM in the complex treatment of abscessing facial furuncle

Petrova T.V., Borodulina I.I., Chernegov V.V.


Among non-odontogenic purulent-inflammatory diseases of the maxillofacial region, abscessing furuncle is more common. One of the points of the standard of medical care is its opening and drainage, followed by the appointment of conservative therapy. It is important to eliminate the manifestations of the boil on the face in a fairly short time. Therefore, in addition to drainage of a purulent wound, for the rejection of a purulent-necrotic rod, it is promising to use proteolytic enzymes, such as trypsin, chymotrypsin, immobilized on various tissue carriers. The aim of the work is to evaluate the effectiveness of using the Proteox-TM gauze bandage in the complex treatment of abscessing facial furuncle by analyzing the dynamics of the local status and cytomorphological data. Materials and methods. 53 patients with abscessing facial furuncle were examined and treated. When examined on the 1st, 3rd and 7th day after the operation, the following were evaluated: the amount of infiltration and perifocal edema, the intensity of the pain syndrome, the area of the wound surface, the cytomorphological characteristics of the purulent wound. Results. At admission, patients had pronounced perifocal edema, inflammatory infiltrate (2-3 points) and pain syndrome. In the course of treatment, when using the bandage Proteox-TM, a more pronounced positive dynamics was observed: the absence of purulent discharge on day 3.56±0.11, in the control group -on day 4.38±0.16 (p<0.0002); wound cleansing 5.67±0.17 days, in the control -7.58±0.21 (p<0.001); hospital stay 7.26±0.17 days, in the control group -8.96±0.18. Starting from the 3rd day after the use of the modified drainage with the bandage Proteox-TM in smears from the surface of the wound, a macrophage reaction was observed, the appearance of single fibroblasts earlier than in patients of the control group. Conclusions. Sterile gauze bandage Proteox-TM with proteolytic enzyme trypsin immobilized on its surface has a complex effect on the wound: it optimizes the phase of cleansing from the purulent-necrotic rod, helps to relieve inflammation and stimulates regeneration processes, as well as reduces the duration of hospitalization and reduces the risk of developing complications.

Vrach. 2022;33(8):75-80
pages 75-80 views

Long-term results of mesodiencephalic modulation therapy in patients with diabetic distal polyneuropathy

Kuzminov G.G., Marchenkova L.A., Kiyatkin V.A.


Diabetic polyneuropathy is one of the most common and significant complications of type 2 diabetes mellitus (DM2). The multicomponent pathogenesis of the development of diabetic polyneuropathy requires an integrated approach using both pharmacological and non-drug therapy. Objectives: to investigate the long-term results of the use of mesodiencephalic modulation in patients with diabetic distal polyneuropathy on the background of type 2 diabetes mellitus (DM2). Material and methods. The study included 120 patients aged 30 to 70 years with an established diagnosis of DM2, glycosylated hemoglobin level <8.5%, and diagnosed with severe or severe diabetic polyneuropathy of the lower extremities (more than 5 points on the NSS scale), who were simple randomization were divided into main and control groups. Patients of the main group received 13 procedures of mesodiencephalic modulation against the background of standard medical therapy for type 2 diabetes. In the control group, only standard therapy for DM2 was used. Examination of patients included the measurement of height, weight, body mass index, pain syndrome, severity of symptoms of diabetic polyneuropathy and fasting glycemia and was carried out at baseline, immediately after completion of therapy and dynamics after 3, 6 and 12 months after completion of treatment. Results. In patients of the main group, after a course of mesodiencephalic modulation, the achieved regression of neurological symptoms persisted for 8.04±0.27 months. Indicators of the dysfunctional score scale (NDS) 12 months after the end of treatment indicated a negative trend in patients of both groups. In patients of the control group, the manifestations of pain returned to the original (before treatment) values after 4.76±0.14 months, in the main group this period was 7.88±0.25 months. In contrast to the control, in patients of the main group, the body mass index returned to baseline after 3 months, and the level of fasting glycemia - after 6 months after completion of treatment. Conclusion. Data were obtained on the long-term preservation of the achieved effect after the use of mesodiencephalic modulation in patients with DM2 and the presence of diabetic polyneuropathy of the lower extremities.

Vrach. 2022;33(8):80-84
pages 80-84 views

Chaga birch mushroom: anti-inflammatory, antioxidant, immunomodulatory, antiviral effects, the possibility of using the Russian drug BioChaga in patients with novel coronavirus infection (COVID-19)

Dedov D.V., Usolceva O.N.


In the work performed: analysis of 28 publications from the People’s Republic of China, the Russian Federation, the United States, Great Britain, the Republic of Poland, Hungary, Serbia, the Republic of Korea, Portugal, the Netherlands, Saudi Arabia, Egypt, the Republic of South Africa. Reflected: anti-inflammatory, antioxidant, immunomodulatory, antiviral effect of birch chaga mushroom. Showed: a wide range of antiviral action of birch chaga mushroom. Presented: research on the effectiveness of the use of chaga in coronovirus infection. Studied: the possibility of using the Russian drug BioChaga in patients with novel coronavirus infection (COVID-19).

Vrach. 2022;33(8):85-87
pages 85-87 views

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