Vol 28, No 5 (2022)

BACKGROUND: The negative effect of sexual dysfunction on the quality of life is often underestimated, although it is one of the determinants of antidepressant tolerance. According to the results of international studies, the prevalence of sexual dysfunction in patients with depression treated with selective serotonin reuptake inhibitors or selective serotonin and norepinephrine reuptake inhibitors is 27–65% in women and 26–57% in men. Treatment with fewer adverse sexual effects should be considered a potential first-line option in patients with psychiatric condition interested in maintaining a sexual life.

AIM: To study the effects of vortioxetine and citalopram on the sexual function of outpatients with non-psychotic depression.

MATERIALS AND METHODS: The study was conducted based on the Center for Psychosomatic Medicine and Psychotherapy. We examined 134 patients (mean age, 35.8±7.6 years) who underwent outpatient treatment by a psychiatrist. Among them, 71 patients received vortioxetine, 45 patients had depressive states of endogenous origin (15 patients with affective disorders and 30 patients with schizotypal disorder), and 26 patients had adjustment disorder. Citalopram was administered in 63 patients: 39 with depressive conditions within endogenous diseases (18 with affective disorders and 21 with schizotypal disorder) and 24 patients with adjustment disorder. The study lasted for 6 weeks, after which sexual function was assessed.

RESULTS: In the groups taking vortioxetine and citalopram, significant differences were found in the incidence of sexual dysfunction: the use of vortioxetine compared with citalopram allowed patients to maintain libido and orgasmic function and, in some cases, helped restore the sexual sphere.

CONCLUSION: The data obtained showed that vortioxetine was statistically significantly more favorable in relation to sexual function.

BACKGROUND: The main factor that determines the priority direction in the development of a medical organization and the health system as a whole is the optimization of personnel. This study analyzed the provision of medical organizations of the Krasnodar Territory with individual medical dental personnel. This study is quite relevant because the present socio-economic formation is based on the personal qualities and experience of highly qualified personnel of the organization, which is the basis for the competitive advantage of medical organizations in the market of goods and services.

AIMS: To analyze the main indicators of staffing by orthodontists, dentists, and pediatric dentists of medical organizations in the Krasnodar Territory for 2019–2021.

MATERIALS AND METHODS: The study participants were selected medical dental personnel with Krasnodar Krai specialties, namely, orthodontics, dentistry, and pediatric dentistry for 2019–2021. The association between the need for the effective use of healthcare personnel resources and the potential needs of the population in dental medical care was determined. The study analyzed the statistical data of reporting forms of medical organizations of Krasnodar Krai “Information about medical organization” (p. N 30) during the study period. The statistical analysis of data was conducted using Microsoft Office software package. Analytical, logical, and statistical methods of research were used.

RESULTS: The analysis of the availability of separate medical dental personnel of medical organizations of Krasnodar Territory for 2019–2021 revealed an increase in the number of regular and occupied positions of orthodontic doctors and dentists and a decrease in the number of staff and employed pediatric dentists. The number of orthodontists and dentists in pediatrics decreased slightly, whereas the number of dentists increased. The number of certified and accredited doctors in all specialties has increased.

CONCLUSIONS: This study revealed the main indicators of staffing by orthodontic doctors, dentists, doctors, and pediatric dentists of medical organizations of the Krasnodar Krai health system for 2019–2021.

To date, the most widely used biomarkers are natriuretic peptides and cardiac troponins. Many other biomarkers have also been identified, but only a few of them have found application in actual clinical practice. This review focuses on the Klotho protein and its role in cardiovascular diseases.

In 1997, a gene that slows down the aging process was identified. It was named Klotho (Greek, Κλωθώ, “spinning”; Latin, Clotho; English, Klotho) in honor of the goddess of ancient Greek mythology, spinning the thread of life and being the personification of the steady, calm course of fate. Mice with an insertional mutation in the region of the Klotho gene promoter were characterized by premature aging processes. Three families of Klotho are known: α-Klotho, β-Klotho, and γ-Klotho, and the most studied is α-Klotho. The Klotho protein consists of a large extracellular domain and a short C-terminal intracellular region. The extracellular domain consists of two repeat sequences called KL1 and KL2. α-Klotho and β-Klotho contain the KL1 and KL2 domains, respectively, and γ-Klotho contains only the KL1 domain. The Klotho gene in humans is located on chromosome 13q12 and consists of five exons. The Klotho protein is mainly expressed in the distal convoluted tubules of the kidneys and the vascular epithelial plexus of the cerebral ventricles. At lower concentrations, the Klotho gene is also found in other organs and tissues, particularly in the heart.

Many studies have demonstrated the protective role of the Klotho protein in cardiovascular pathology. The pleiotropic properties of this protein are reflected in the diversity and interaction of cardioprotective mechanisms. The regulation of the concentrations of the Klotho protein in the blood and its expression in heart cells with the help of drugs can play a significant role in cellular metabolism and represent a promising target for the treatment of heart and vascular pathologies.

The theoretical and methodological bases of the present study are scientific works, theoretical and methodological developments, current publications of domestic scientists, official normative legal acts, and description of their application in the practical activities of medical organizations providing cosmetology services. This study aimed to examine studies that have focused on the most pressing issues of the legal regulation of medical care to the population of the Russian Federation in the field of «cosmetology», identify the main problems associated with the legal regulation of the industry, and summarize the proposals of medical organizations for its improvement.

In the study, a survey study was conducted, which allowed researchers to identify and summarize the known literature on this topic, regardless of the publication type and study design. The study presents an analysis of the regulatory and legal regulations of the activities of employees and medical organizations providing services in the field of cosmetology. After completing the initial literature search, the authors analyzed, compared, summarized, and systematized the published information.

The analysis made it possible to distribute the data obtained in several key areas of regulatory and legal regulation of domestic cosmetology, i.e., an excursion into history, regulatory and legal support for the activities of a cosmetology medical organization at the present stage, modern requirements for the activities of a doctor, in relation to medical cosmetology care. A content analysis was conducted on the use by medical organizations in the regions of the Russian Federation of the regulatory framework of the cosmetology industry, assessed its effect on the system of providing cosmetological care to the population at the present stage, identified several problems related to the legal regulation of the activities of medical cosmetology organizations and summarized proposals for its improvement.

BACKGROUND: To date, several debatable aspects of cataract phacoemulsification (PEC) in the literature exist, one of which is the study of the surgical features in patients with visually stressful work (VLT) and binocular cataract.

CLINICAL CASE DESCRIPTION: In this case, we evaluated the effectiveness of surgical treatment of binocular cataract in a patient with VLT from the standpoint of the occurrence of postoperative anisometropia (A). The patient complained of decreased visual acuity in both eyes. The patient is a chief accountant, and the time of daily visual work is at least 6 h a day. The results of the examination were as follows: A –0.1 relative units; quality of life (QOL) according to the questionnaire «KZS-22» — 152 points, which corresponds to the compensation stage of asthenopia. The patient underwent a standard PEC, and the target refraction was ±0.5 diopters. The operation on the second eye was performed on day 18 after the operation on the first. The results of the examination 7 days after the first operation were A of –0.2 relative; units and QOL of 176 points («normal»). The results of the examination before the second operation (18 days after the first) were A of –0.4 relative units and QOL of 138 points «decompensation of asthenopia»). The results of the examination 7 days after the second operation were A of 0.1 relative units and QOL of 189 points («normal»).

CONCLUSION: The surgical treatment of binocular cataract in patients with VLT is based on an earlier (7–10 days) operation on the second eye to reduce the adverse effects of anisometropia, manifested by severe asthenopia. If a second operation is possible within the specified timeframe, a one-stage binocular PEC should be considered.