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Vol 29, No 1 (2023)

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Original Research Articles

Role of monocytes in the development of psychovegetative disorders in young people with undifferentiated connective tissue dysplasia

Malceva I.V., Sheremetieva I.I., Kotovshchikova E.F., Selezneva A.A., Buylova E.V.


BACKGROUND: The immune system plays an important role in the development of neuropathology. Dysfunction of monocytes/macrophages can contribute to environmental health and the development of neuroinflammatory and neurodegenerative diseases. Two subpopulations of monocytes are distinguished, namely, anti-inflammatory and activated pro-inflammatory monocytes, producing cytokines interleukin (IL)-1, IL-6, IL-2, IL-8, and tumor necrosis factor (TNF)-α, which are involved in immune inflammation in mental diseases. Violations of cellular, phagocytic, and/or humoral immunity are often found in patients with undifferentiated connective tissue dysplasia (UCTD). Monocytes are assumed to be involved in the development of psychovegetative disorders in patients and connective tissue insufficiency.

AIM: To study the relationship between the number of monocytes and pro-inflammatory cytokines (IL-1, IL-6, and TNF-α) in the peripheral blood with possible non-psychotic diseases and autonomic dysfunction syndrome in UCTD in young people.

MATERIALS AND METHODS: We examined 95 people aged 18–22 years. Neuropsychological examination, general clinical blood tests, pro-inflammatory cytokines (IL-1, IL-6, TNF-α), markers of neurodegeneration (neuron-specific enolase) and cerebral ischemia (antibodies to NR2) were sent.

RESULTS: An increase in the absolute monocyte count in the peripheral blood is accompanied by a lesser severity of psychovegetative, ischemic, and neurodegenerative cases. An inverse correlation was found between the level of monocytes in the peripheral blood and the number of UCTD indicators, a direct correlation between UCTD and autonomic dysfunction syndrome (ADS), asthenic condition, personal anxiety, depression, neurosis, Internet addiction, and headache research index for everyday life. Severe UCTD leads to a change in the proportion of monocytes in the use of the pro-inflammatory subpopulation, which is probably one of the reasons for the numerous non-psychotic diseases and autonomic nervous system diseases in these patients.

CONCLUSION: An increase in the pro-inflammatory monocyte count in severe UCTD plays an important role in the development of psychovegetative disorders. The correction of the dysplastic process can become an important role in the prevention and detection of various neurological and non-psychotic diseases, such as ADS and anxiety–depressive syndrome in young people.

Medical Journal of the Russian Federation. 2023;29(1):5-16
pages 5-16 views

Complex rehabilitation of children and adolescents with dysfunction of the sacroiliac joints

Zadorina-Negoda G.N., Novoselova I.N.


BACKGROUND: Back pain (BP) is encountered by physicians in many specialties. Sacroiliac joint (SIJ) dysfunction is one of the most common causes of non-specific BP (NBP). Many approaches have been accepted for the treatment of this pathology, including drug correction, physiotherapy, therapeutic blockade, and manual therapy (MT). In most cases, these methods help reduce the severity of the pain syndrome and restore the physiological mobility of the SIJ. Despite ongoing therapy, BP persists in some cases. The most likely reason for the ineffectiveness of MT is impaired muscle balance. The correction of this impairment is carried out with the help of other rehabilitation techniques.

AIM: To develop a comprehensive program for the rehabilitation of patients with NBP associated with SIJ dysfunction.

MATERIALS AND METHODS: A prospective study included 54 patients aged 7–18 years who complained of pain in the lumbosacral spine. The patients were divided into two groups: the first group underwent manual correction of dysfunction, followed by mechanotherapy on block simulators, and the second group underwent correction of articular dysfunction using specially selected movements performed asymmetrically depending on the identified disorders, and the therapeutic gymnastics program included mechanotherapy and postural workout. At all stages of rehabilitation treatment according to the progression system, training for muscle control was carried out. According to indications, all children underwent mild MT.

RESULTS: A dynamic step-by-step system for assessing the biomechanics of movements and tonic–phasic balance has been developed. A technique for the rehabilitation treatment of NBP with concomitant SIJ dysfunction has been developed, which was selected individually depending on the identified disorders and features of motor activity.

CONCLUSION: The proposed rehabilitation system simplifies and systematizes work in patients who complained of BP associated with osteoarticular dysfunction. The effectiveness of rehabilitation increased due to the precisely selected methods, depending on the root cause of NBP associated with acute or recurrent SIJ dysfunction. A rehabilitation technique aimed at preventing recurrent SIJ dysfunctions helps prevent relapses of BP and minimize the risk of developing articular pathology of the lower extremities.

Medical Journal of the Russian Federation. 2023;29(1):17-28
pages 17-28 views


Coronary heart disease in patients with human immunodeficiency virus infection

Alieva A.M., Batov M.A., Skripnichenko E.A., Teplova N.V., Baykova I.E., Valiev R.K., Akhmedova M.F., Kotikova I.A., Melikulov A.A., Nikitin I.G.


According to the World Health Organization, more than 38 million people are carriers of the human immunodeficiency virus (HIV). The relative risk of cardiovascular events in patients with HIV infection is 1.5–2 times higher than those without it. An HIV-positive status is associated with a 50% increased risk of acute myocardial infarction. The mechanisms of CVD development caused by HIV activity are not fully understood, and the contribution of traditional risk factors cannot fully explain such a high potential for coronary heart disease (CHD) in patients with HIV infection. Data suggest that HIV-associated chronic inflammation and immune system activation may lead to progressive endothelial dysfunction and vascular damage. The pathogenesis of atherosclerosis and, consequently, CHD in HIV infection is extremely versatile and poorly studied. The key mechanisms in HIV-associated CHD include the effect of HIV proteins on immunocompetent cells and vascular endothelium, immunodeficiency, translocation of microorganisms from the gut, and chronic inflammation with platelet activation. Despite considerable progress in understanding HIV-associated cardiovascular disease, many unresolved questions remain. Even with effective viral suppression, inflammation and immune dysregulation appear to increase the risk of cardiovascular complications. The lack of large-scale clinical studies on the prevention and treatment of cardiovascular disease in HIV is very important. Nevertheless, some important features should be considered in the management of patients with HIV infection.

Medical Journal of the Russian Federation. 2023;29(1):29-42
pages 29-42 views

Immunology of post-COVID syndrome

Sсherbak S.G., Sarana A.M., Vologzhanin D.A., Kamilova T.A., Golota A.S., Makarenko S.V.


COVID-19, the disease caused by SARS-CoV-2, has diverse long-term consequences of varying severity after recovery from the acute phase. As survivorship and therefore the number of individuals with “long COVID” continue to increase, the prevalence, origins, and mechanisms of post-acute sequelae manifestation must be critically elucidated. The inappropriate and unique inflammatory response in the acute phase of COVID-19 causes severe respiratory symptoms, which can be subsequently accompanied by multiple-organ damage, affecting the brain, heart, kidneys, etc. This review examines the role of an unregulated antigen-specific immune response to COVID-19 in the onset and development of its consequences. We discuss the potential role of virus persistence in tissue reservoirs, unresolved inflammation, cytokine hyperproduction, tissue damage, and molecular mimicry and autoimmunity in the pathogenesis of post-COVID syndrome — the induction and maintenance of imbalanced immune responses after the resolution of acute COVID-19.

Medical Journal of the Russian Federation. 2023;29(1):43-58
pages 43-58 views

Side effects of drugs recommended for the treatment of harmful alcohol use

Romanov B.K., Dibirova G.O., Dmitrieva N.B., Kalinina E.V., Kirillova A.V., Markina E.V., Mileshina S.E., Sokolov A.S., Tsitsuashvili M.D., Yurov D.E.


This brief report provides an overview of pharmacovigilance information on adverse reactions during post-registration use of medicines recommended for the treatment of mental and behavioral disorders caused by alcohol consumption in the Russian Federation, and its reports were included in the database of the World Health Organization’s international drug monitoring program as of January 1, 2023. The safety indicators of benzodiazepines, phenobarbital, butyrophenones, anticonvulsants, thiamine, and magnesium preparations were analyzed. The article may be of interest to pharmacovigilance specialists, doctors, researchers, developers and health regulators, pharmacologists, and clinical pharmacologists.

Medical Journal of the Russian Federation. 2023;29(1):59-65
pages 59-65 views

Modern clinical, functional, and ophthalmo-ergonomic features of phacoemulsification in patients with visual-intense labor with bilateral cataract: a systematic review

Kozhukhov A.A., Ovechkin N.I., Kumar V., Eskina E.N.


A systematic review was performed using databases of RSCI and PubMed, and the following keywords were used for the literature search: “Cataract,” “Phacoemulsification,” “PEC,” “Visual-stress work,” “VSW,” “Anisometropia,” and “Quality of life.” Articles were selected based on the criteria for prospective or retrospective studies. A total of 684 sources were analyzed, further using systematic review filters and authors’ knowledge of the topic. The retrospective analysis covered the period from 2016 to 2022. Data indicate that the current state of the problem of PEK in patients with VSW with bilateral cataracts during traditional sequential (on different days) surgery (especially if the interval between operations increased by more than 7–10 days) is accompanied by the emergence of clinical, functional (pain syndrome, anisometropia, diplopia, and impaired stereoscopic vision), and ophthalmo-ergonomic (insufficient level of visual performance) adverse manifestations after the first surgery. To eliminate them, sequential bilateral cataract surgery received increasing attention (both operations within the same day), characterized by fewer hospital visits for the patient, faster recovery of vision, and lower healthcare costs. Thus, the stated provisions in the dispensary observation of patients with VSW with bilateral cataracts must be considered.

Medical Journal of the Russian Federation. 2023;29(1):66-74
pages 66-74 views


Alexander N. Yavorsky (to the 75th anniversary of his birth)

Romanov B.K.


This year marks the 75th anniversary of the famous pharmacologist Alexander Nikolaevich Yavorsky.

Medical Journal of the Russian Federation. 2023;29(1):75-76
pages 75-76 views


Аnatoly D. Klimiashvili

Polunina N.V., Alexandrov O.V., Sviridov S.V.


On January 24, 2023, a member of the editorial board of the Russian Medical Journal, Candidate of Medical Sciences, Associate Professor of the Department of Faculty Surgery of the Medical Faculty of the N.I. Pirogov (Moscow, Russia), Anatoly Davidovich Klimiashvili, died.

Medical Journal of the Russian Federation. 2023;29(1):77-78
pages 77-78 views

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