Vol 34, No 7 (2023)

The paper summarizes literature data on the rheumatological manifestations of the novel coronavirus infection, mainly within the post-COVID syndrome (PCS). Patients after COVID-19 may be observed to have symptoms of rheumatic diseases; those with already existing rheumatological diseases may frequently have an exacerbation of their course in the PCS period. These patients should be referred to a rheumatologist for advice to expand a differential diagnostic search to make a final diagnosis and to prescribe adequate pathogenetic therapy. The authors describe a clinical case from their own practice.

The scientific paper presents a literature update on carotid paraganglioma, a rare tumor. The initial manifestation of a carotid body tumor is a painless lump in the neck. The paper gives data on its prevalence, classification, clinical presentations, the applicability of various diagnostic methods, as well аs on the efficiency of treatment for this disease and emerging complications. Ultrasound, multispiral computed tomography, magnetic resonance imaging, and direct angiography are usually used for the diagnosis of the disease. Complete surgical excision of the carotid body tumor is the method of choice, as the results of radiation and chemotherapy are unsatisfactory.

Changing the paradigm has led to the gradual replacement of the concept “chronic prostatitis in the scientific literature with the generally accepted one “chronic pelvic pain syndrome (CPPS), which could be the reason for misunderstanding between the physicians of different specialties. The review gives information about the role of individual sexually transmitted infections in the etiology of CPPS. According to the present views, in addition to prostatic diseases, the pattern of this syndrome can embrace gastrointestinal tract diseases, neurological and infectious diseases.

Along with opportunistic mycoplasmas, sexually transmitted infections should be taken into account when managing males with chronic prostatitis/CPPS. The detection of these microorganisms requires the prescription of antibacterial therapy.

Botulinum therapy is the most popular medical cosmetology procedure in the world. At the moment 9 preparations of botulinum toxin type A-hemagglutinin complex are officially registered in Russia, only Miotox^® is available in liquid form as a solution for intramuscular injection. The study of pharmacoepidemiology of botulinum toxin preparations in cosmetology practice and studies to evaluate their efficacy and safety will allow to specify their clinical and pharmacological advantages.

Objective. To study the pharmacoepidemiology, safety, tolerability and efficacy of Miotox^® in cosmetology practice.

Materials and methods. In 2021–2022, a pharmacoepidemiologic study based on questionnaire survey of 288 cosmetologists from 28 cities of Russia was conducted to study the use of botulinum toxin preparations in cosmetology practice. 42 female patients were included in the prospective clinical study on the efficacy and safety of Miotox^® for the correction of wrinkles of the upper third of the face. The FACE-Q questionnaire was used to assess the quality of life, satisfaction, attitude of the patients to their appearance, to expression wrinkles in the interbrow and forehead area before and after the procedure. Objective assessment of wrinkle dynamics in the interbrow and forehead areas was performed using the ANTERA 3D^® computerized technique (Miravex, Ireland).

Results. The analysis of the pharmacoepidemiologic study showed an increase in the share of domestic preparations in the structure of prescriptions of botulinum toxin type A-hemagglutinin complex preparations for temporary correction of hyperkinetic facial wrinkles.

The maximum effect of Miotox^® administration in participants with interbrow wrinkles was observed after 14–21 days for all parameters (total size, depth and width); the total size of wrinkles in the interbrow decreased by 65%, on the forehead – by 79%, wrinkle depth – by 58% and 69%, respectively. Despite the decrease in the effect after 150 days after the drug application, the effect of the drug administration remained: the total size of wrinkles in the interbrow decreased by 25%, on the forehead – by 19%, wrinkle depth – by 25% and 26%, respectively, wrinkle width – by 3% and 1%, respectively.

Conclusion. The findings confirm the good tolerability, efficacy, and a high safety profile of Miotox^® in patients with hyperkinetic (facial) wrinkles.

Objective. To analyze research of the problem of occurrence and prevention of erectile dysfunction in men with cardiovascular diseases.

Material and methods. Analysis of the literature data reflecting investigations of the problem of erectile dysfunction in men with cardiovascular diseases was carried out.

Results and discussion. Erectile dysfunction is a fairly common disease in men. It is manifested by an inability to achieve or maintain an erection, sufficient to have sexual intercourse for more than 3 months. In the Russian Federation, erectile dysfunction occurs in 48.9% of men aged 20–77 years. Erectile dysfunction and cardiovascular disease share common pathogenetic mechanisms. A combination of these pathologies is often seen in the same patient. Age and cardiovascular disease are associated with an increased risk of erectile dysfunction.

Conclusion. The Russian drug Eromax (Parafarm company) is able to increase sexual desire, improve the duration of an erection and mood, stabilize the vegetative system and may be recommended for the prevention of erectile dysfunction and for improving the quality in men with cardiovascular diseases, taking into consideration the existing comorbid pathology and an individual approach to each patient.

The tasks of the state strategy of counteraction to the spread of HIV infection in the Russian Federation for the period until 2030 are the development and implementation of individual approaches and targeted programs of HIV prevention in each region, raising the awareness of specialized specialists, especially primary health care doctors, on HIV prevention and diagnosis in order to detect persons with HIV infection at the early stages of the disease. The 2022 standard of primary health care for adults with HIV infection (diagnosis, treatment and follow-up) clearly defines a wide range of specialists involved in the diagnosis of the disease.

The multiplicity of HIV-associated dermatoses explains the role of dermatovenerologists in the diagnostic algorithm. This article describes clinical cases of HIV-associated psoriasis. The attention of specialists is focused on the peculiarities of the clinical picture and course of psoriasis de novo on the background of HIV-infection. The influence of social factors on comorbidity formation was demonstrated. The article mentions the importance of thorough history taking, complex assessment of clinical and social status and psychological characteristics of a patient, development of clear individual diagnostic search upon establishment of final clinical diagnosis. This example points to the need to develop new interdisciplinary algorithms of medical care.

To date, the study of comorbidity from the skin and gastrointestinal tract is a very important task. In recent years, there have been more and more works confirming the role of intestinal microflora in the development of various diseases of the human body, including skin diseases. Thus, the "gut–skin" axis reflects the influence of the intestinal microbiota on the functionality and composition of the innate and adaptive immune system, and vice versa. The mechanisms by which the gut microbiome affects skin health are still not fully understood. To find new ways to treat human skin diseases, it is necessary to deepen our understanding of the relationship between the skin and gut microbiome. Our work is dedicated to this global task.

The paper describes rare clinical cases of patients with oral mucosal and dental hard tooth tissue diseases associated with chronic renal failure. In order to diagnose and to choose a treatment policy, a dentist should make a thorough differential diagnosis and attract other specialists for additional examinations of the patient.

The course and progression of type 2 diabetes mellitus (DM2) is often accompanied by the development of various ophthalmological complications, among which diabetic retinopathy (DR) is the most studied. However, other ophthalmological complications of DM2 in patients are presented in isolated publications and are not considered in dynamics.

Objective. Investigation of the structure of ophthalmic complications of DM2 over a long time period.

Subjects and methods. The study of ophthalmological complications of DM2 was carried out according to official medical statistics among the adult population of the Tambov region for 2016–2021. All complications of the organ of vision identified by ophthalmologists were analyzed by a retrospective method. For comparison, non-ophthalmological complications of DM2 were also considered.

Results. Ophthalmological complications of DM2 among adults in the Tambov region amount to 22,9±2,5%, which is significantly lower than the proportion of neophthalmological complications of DM2 over the same period of time. The share of ophthalmic complications during the studied years significantly increased and, first of all, due to an increase in DR in the structure of complications from 11,5±2,1% in 2016 to 15,1±1,8% in 2021 (p<0,01). Among ophthalmological complications in 2016–2021 the proportion of another ophthalmological complications, diabetic cataract, also increased statistically significantly from 4.3±0.7% to 6.9±0.8%, respectively (p<0,01).

Conclusion. An increase in the proportion of ophthalmic complications of DM2 indicates the relevance of screening patients with DM2.

In the Russian Federation, there is an increase in patients with pulmonary tuberculosis in combination with comorbid pathologies, including Crohn's disease. There is also a tendency to increase the combination of pulmonary tuberculosis and non-tuberculosis mycobacteriosis, which makes it difficult to select adequate therapy and reduces the effectiveness of treatment. Bronchial tuberculosis is one of the complications of the tuberculosis process and often masks the onset of this disease. In this connection, the diagnosis of the tuberculosis process in the bronchi is difficult.

A young patient with a history of Crohn's disease was diagnosed with pulmonary and bronchial tuberculosis in combination with non-tuberculosis mycobacteriosis. Upon admission, the presence of intoxication syndrome and bacterial excretion in sputum was noted. Taking into account the presence of comorbid pathology, anti-tuberculosis therapy was carried out according to an individual chemotherapy regimen with predominant parenteral administration of drugs. Against the background of the ongoing treatment, the patient noted the addition of a coronavirus infection with the development of viral pneumonia. Thanks to an individual approach in the treatment of the tuberculosis process in combination with non-tuberculosis mycobacteriosis and the presence of Crohn's disease, it was possible to achieve the relief of intoxication syndrome, the cessation of bacterial excretion in sputum and positive X-ray and endoscopic dynamics.

This clinical example demonstrates the high effectiveness of an integrated approach in the treatment of tuberculosis in the presence of concomitant diseases. Due to the early endoscopic diagnosis, the patient revealed a tuberculous process in the bronchi. Given the presence of these diseases, complex chemotherapy was aimed at treating tuberculosis and mycobacteriosis simultaneously. Taking into account mainly parenteral administration of chemotherapy drugs, there was no exacerbation of Crohn's disease. The addition of coronavirus infection with the development of viral pneumonia did not affect the course of the tuberculosis process and non-tuberculosis mycobacteriosis.

The influence of climacteric osteoporosis on the process of osseointegration of dental implants is considered. Particular attention is paid to the relationship between menopause, osteoporosis and the success of osseointegration. In this regard, strategies for optimizing osseointegration are discussed, including the use of drugs to increase bone density and leveling of menopause symptoms in the period of preparation for implantation, the use of agents to improve the quality of osseointegration during and after implantation. Prospects and directions for further research in this area are determined.