Vol 29, No 4 (2023)

BACKGROUND: Cognitive disorders are a relevant problem in an aging population. Research shows a wide range of data on the prevalence of cognitive disorders in the general population. Thus, more studies on the prevalence of cognitive disorders and assessment of the risks of their development are necessary, which will determine the burden on the regional healthcare system.

AIM: To examine the prevalence of cognitive impairment in an outpatient multidisciplinary clinic setting and determine the risk ratios for cognitive deficits in different age groups.

MATERIALS AND METHODS: The Montreal Cognitive Assessment Scale was used in the screening of people aged 45–90 years.

RESULTS: Cognitive dysfunction was noted in 20.0% of patients in the group aged 45–59 years, 33.1% in the group aged 60–74 years, and 79.6% in the group aged 75–90 years. The average results on the assessment of cognitive functions of persons aged 45–59 (27.1±0.3) and 60–74 (26.2±0.2) years corresponded to the norm, and the value in persons aged 75–90 (23.6±0.3) years was below the norm. In groups aged 60–74 and 75–90 years, the prevalence of cognitive dysfunction was comparable between men and women. Cognitive impairments in men aged 45–59 years were recorded 2.5 times more often than that in women. The risk of cognitive disorders in the second group (aged 60–74 years) relative to that in the first group (aged 45–59 years) is insignificant (relative risk [RR], 1.21). In the third group (aged 75–90 years), the probability of cognitive disorders is significantly higher than that in the second group (RR=2.40) and nearly five times higher than that in the first group (RR=4.86).

CONCLUSION: Sex- and age-stratified screening indicators for assessing cognitive functions and the RRs of developing cognitive disorders in older age groups make it possible to plan for diagnostic, therapeutic, and preventive measures in mental health.

BACKGROUND. An urgent issue of modern medicine is the study of the quality of life of people with post-COVID syndrome. Particular emphasis is placed on patients with various forms of allergic rhinitis associated with comorbid conditions such as polyposis rhinosinusitis. These diseases are still common and tend to increase. In this context, the study of the effect of conservative methods of treatment of allergic rhinitis and polyposis rhinosinus on the quality of life of patients will improve the effectiveness of the therapy.

 AIMS: To assess the impact of post-COVID syndrome on the quality of life of patients with various forms of allergic rhinitis and eosinophilic phenotype of chronic polyposis rhinosinusitis and to determine the effectiveness of conservative therapy.

MATERIALS AND METHODS: In the period from May to December 2021, a study was conducted on the quality of life in the treatment of 62 patients against the background of post-covid syndrome, of which 32 patients suffered from polypous rhinosinusitis and 30 patients with allergic rhinitis. The disease of coronavirus infection was registered 2-3 months before the visit to the otorhinolaryngologist. The comparison groups included 65 people, including 33 patients with polypous rhinosinusitis and 32 with various forms of allergic rhinitis. The Russian version of the standard SF-36 questionnaire was used to collect anamnesis. A visual analogue scale was used to measure the intensity of rhinological symptoms. All patients were examined three times: before treatment, 1 and 3 months after the course of therapy.

RESULTS: A comparative analysis of the quality of life indicators of patients with various forms of allergic rhinitis and polyposis rhinosinusitis showed a direct dependence on the condition of patients after a coronavirus infection. 

CONCLUSIONS: The use of the assessment of quality of life indicators at the stages of treatment of patients with various forms of allergic rhinitis and polypous rhinosinusitis against the background of post-covid syndrome makes it possible to determine the effectiveness of conservative therapy and timely adjust the treatment.

BACKGROUND: In patients with osteoarthritis, the long course of synovitis changes the nature of the inflammatory process, it becomes more resistant and resistant to a number of therapeutic techniques. In the arsenal of a practicing doctor, there are no reliable and affordable therapeutic methods that reliably provide relief of synovitis in the knee joint and objectively monitor the effectiveness of the therapy. Among the numerous methods of application in the treatment of diseases and injuries of the musculoskeletal system, low-molecular technologies with anti-inflammatory and analgesic effects are distinguished. One of these methods is local deep hypothermia.

AIM: To substantiate the use of different low-temperature modes of local deep hypothermia in patients with knee osteoarthritis aggravated by synovitis, to study clinical efficacy and safety.

MATERIALS AND METHODS: The study included 90 patients with osteoarthritis of the knee joints, burdened with synovitis. To determine the therapeutic parameters of local deep hypothermia, all patients were divided into three groups of 30 people. The effectiveness of the performed local deep hypothermia was assessed by the dynamics of the algofunctional Leken index, the intensity of joint pain on a 100-point Visual Analogue Scale (VAS) in millimeters and a decrease in the need for nonsteroidal anti-inflammatory drugs (NSAIDs).

RESULTS: Technical and clinical parameters have been developed for carrying out the local deep hypothermia technique: area, cooling depth, rate of heat removal from the joint, duration of reproduction and number of procedures. Against the background of the performed local deep hypothermia, patients in three groups showed significant positive dynamics on the VAS and algofunctional Leken index, and in all three groups the difference between the initial and final values of these parameters was statistically significant (p <0.001). The use of local deep hypothermia allowed a significant part of patients to refuse to take NSAIDs, or to reduce the need to 50 mg and take episodically according to need. In our study, we did not record a recurrence of synovitis in all three groups during the first 3 months, which was 100%. After 12 months, the duration of remission in group I was 10.0%, in group II patients — 73.3% and in group III patients — 86.6%.

CONCLUSION: Local deep hypothermia improves the effectiveness of synovitis treatment and can be recommended as an independent method for the treatment of patients with osteoarthritis of the knee aggravated by synovitis. The recommended local deep hypothermia exposure is 90 min, which allows for the longest period of remission of synovitis in the knee joint.

Recently, miRNAs are being used as diagnostic markers for various pathological conditions. This review analyzed the main studies devoted to the role of miRNA-125 in the development of cardiovascular diseases. Members of the miRNA-125 family are involved in cell differentiation, proliferation, and apoptosis by targeting mRNAs associated with these cellular processes. This miRNA can enhance or inhibit pathological processes such as oncogenesis, muscle abnormalities, neurological disorders, and others. Members of the miRNA-125 family also influence the development and function of immune cells and are involved in immunological defense. Research shows that the miRNA-125 family is associated with cardiac development. They also play an important role in pathophysiological conditions of the cardiovascular system. However, the same miRNA-125 family members play different roles in different pathological processes. For example, miRNA-125b overexpression in cardiomyocytes can inhibit their apoptosis and inflammatory response. However, miRNA-125b is also a regulator of cardiac fibrosis; its overexpression in cardiac fibroblasts can enhance their proliferation. Therefore, in pathological conditions, miRNA-125b excess aggravates myocardial fibrosis and remodeling, destroys the original morphological structure of the heart, disrupts neovascularization processes, and aggravates apoptosis of cardiomyocytes in the damaged area. Thus, to avoid adverse reactions, the optimal dose and timing of therapeutic intervention using members of the miRNA-125 family, their inhibitors, and mimetics must be carefully determined. An expanded and accurate understanding of miRNA-125 functions in gene regulatory networks associated with cardiovascular pathology will enable the development of novel and innovative therapeutic strategies.