Evaluation of the Antioxidant Effectiveness in Reduction of the Dry Eye Syndrome among Patients with Relevant Toxicoallergic Component and a Severe Case of Corneal-Conjunctival Xerosis

Currently the ophthalmologists meet with corneal-conjunctival xerosis more often in their daily practice. The objective of this research is identifying a new alternative method of treatment of the dry eye syndrome of different severity. In this work there will be a demonstration and the results of usage of BAA Delphanto® in treatment of different cases of the dry eye syndrome. The data collected from a dynamic research of groups of patients reveals the effectiveness of the comprehensive therapy with the use of BAA Delphanto®. Consequently, the research results demonstrate an improvement of the initial data from the biomicroscopy, OSDI index, Schirmer-1 test and the tear break up time. The statistically significant results were received reveal the effectiveness of the use of BAA Delphanto® with a significant improvement of the quality of life. It can be used widely by ophthalmologists for the treatment of corneal-conjunctival xerosis of different severity.

Magnetic stimulation in the treatment of postherpetic neuralgia – a case report

Herpes zoster (shingles) is an acute infectious viral disease that may develop in individuals who have previously had chickenpox. Unlike chickenpox, shingles is more likely to occur in adults, with the risk increasing with age. The paper presents treatment outcomes in a 63-year-old patient with severe thoracic pain persisting for 5 weeks. The treatment included 15 sessions of magnetic stimulation using a low induction variable magnetic field, performed once a day, which allowed to significantly reduce pain, as assessed using the Laitinen Pain Scale. The inclusion of magnetic stimulation as an element of comprehensive therapy also improved the patient’s quality of life, as assessed with EuroQol (a score of 25 before the therapy vs. 65 after the therapy).

Comprehensive therapy with myoinositol and D-chiroinositol in a 5:1 ratio for abnormal uterine bleeding in overweight and obese women

Background. Abnormal uterine bleeding (AUB) occurs in one-third of women of reproductive age and has a significant impact on women's lives, causing anemia, impaired social adaptation and professional activity. AUB-O (ovulatory dysfunction) is often caused by an excessive body mass (BM) and obesity (especially visceral). The most effective option for restoring menstrual cycle (MC) in obese women is BM reduction. There is evidence that the combination of inositols myoinositol (MI) and D-chiroinositol (DCI) has a beneficial effect on BM loss, ovulation frequency and getting pregnant in women with polycystic ovary syndrome. Aim. To study the effect of MI and DHI in a 5:1 ratio in combination with diet and exercise on the regulation of MC in overweight and obese women. Materials and methods. The study has been conducted in clinics of Moscow, Kazan and Tyumen for 20202021. It is a descriptive study assessing an efficacy of lifestyle modification (diet and exercise) plus a nutritional support with a combination of 1000 mg MI and 200 mg DCI (ratio 5:1) for 24 months in 353 women of reproductive age with AMK-O and overweight or obesity. Efficacy criteria include: MC regularity, BM index (BMI), waist circumference (WC), levels of serum glucose, free testosterone, follicle-stimulating hormone, luteinizing hormone. Results. The study showed a significant shortening of MC to its physiological duration 3112.04 days (vs 4419.51 days at the 1st visit; p=0.001), a decrease in the rate of heavy bloody vaginal discharge by 2.57 times (p=0.001), an increase in the rate of moderate bloody vaginal discharge by 1,62 times (p=0.001), an increase in the proportion of patients with regular MC by 2.69 times (p=0.001). These changes were accompanied by a decrease in BM (-3 kg; p=0.001), a decrease in WC (-2.5 cm; p=0.001). Laboratory tests revealed a decrease in serum glucose (-1.3 mmol/L; p0.05), free testosterone (-0.4 pg/L; p0.05), luteinizing hormone (-0.8 mIU/ml; p0.05), and an increase in follicle-stimulating hormone (+0.1 mIU/ml; p0.05) levels. Conclusion. The results obtained (a decrease in BM, a decrease in BMI, WC, as well as MC restoration; p0.05) make it possible to recommend Dikirogen containing MI and DCI in a 5:1 ratio as a part of comprehensive therapy for overweight and obese women with AUB-O.

Assessment on the Prognostic Validity of Dissected and Positive Lymph Node Counts and Lymph Node Ratio in Patients with Gastric Cancer: A Multi-central Cohort Study

Background: Adequate treatment for all resectable early gastric cancers (EGCs) is gastrectomy with regional lymphadenectomy. The number of positive resected lymph nodes during lymphadenectomy can be a reliable predictor of survival of GC. Objectives: We aimed at assessing the prognostic significance of Dissected Lymph Node Count (DLNC), positive LNC (PLNC), and Lymph Node Ratio (LNR) in patients with EGC. Methods: In the current retrospective cohort, 201 patients with resectable EGC were included. Demographic variables, clinicopathological characteristics of tumors (including numbers of total dissected nodes and positive, negative nodes), history of receiving adjuvant cancer therapies, and 1- and 5-year survivals were noted. Results: DLNC, PLNC, and LNR were associated with differentiation and depth of tumor, lymph node status, and risk of death (P-value for all < 0.05). There was no correlation between either of these measures with preoperative symptoms, lymphovascular invasion, and recurrence. DLNC, PLNC, and LNR showed prognostic significance only in patients, who did not receive comprehensive therapy (P-value < 0.001 for all). A significantly higher LNR was seen in patients with more than 1-year survival compared to others (P-value = 0.011). A significantly lower DLNC and higher PLNC were seen in patients, who survived over 5 years (P-value of 0.002 and 0.047, respectively). Conclusions: LNR, DLNC, and PLNC are significant prognostic factors for EGC. According to our findings, choosing the optimal approach, through which fewer negative lymph nodes are dissected, is crucial in increasing overall survival and extended lymphadenectomy cannot necessarily benefit patients.

Placental Cryoextract and Renin-Angiotensin-Aldosterone System Blockade Mitigate Renal Failure in Rats

Here, we have studied the impact of administration of rat placental cryoextract (PCE), drug blockade of the renin-angiotensin-aldosterone system (RAAS) with enalapril and spironolactone and their combination on the rat kidney tissue structure and excretory function at different stages of chronic renal failure (CRF) development using the glycerol model. In 3 weeks after glycerol introduction, the animals from all the groups showed low values of glomerular filtration rate, impaired blood flow in renal cortex, tubular epithelial dystrophy, inflammation and edema of interstitium, indicating the onset of CRF development. Tubulo-interstitial nephritis and nephrosclerosis were dominated in untreated rats 16 weeks later. The use of RAAS drug blockade, as well as a comprehensive therapy with RAAS blockers and placental cryoextract stopped the inflammatory processes in renal tissue, restored blood circulation and normalized excretory function, which persisted for up to 16 weeks of observation.

The role and place of glucocorticosteroids in treatment of COVID-19 pneumonia without hypoxemia

Introduction. The article presents the problems of the use of glucocorticosteroids in the treatment of patients with coronavirus– associated pneumonia (COVID-19) without hypoxemia. The experience of the preemptive use of low doses of glucocorticosteroids in the treatment of such patients in a hospital is described. Simplification of a unified scheme of pathogenetic therapy with glucocorticosteroids in the above patients is urgent. The article highlights the effectiveness of the early use of low doses of glucocorticosteroids in the treatment of a specific cohort of patients with COVID-19.Objective. To assess the clinical efficacy and safety of early use of small doses of methylprednisolone in the comprehensive therapy of patients with moderate to severe COVID-19 pneumonia to prevent the development of complications and improve the outcomes of the disease.Materials and methods. The study included 40 hospitalized patients from 37 to 68 years (average age 52. years) with a diagnosis of moderate to severe COVID-19 pneumonia. Patients were randomized into two groups: the main group (n = 20) and the control group (n = 20). The main group additionally received methylprednisolone: 4 mg tablets, 7 tablets per day, divided into 2 doses (4 tablets in the morning and 3 tablets at lunchtime). The effectiveness of the therapy was evaluated based on the primary combined endpoint of the study, which included progression of the disease to an extremely severe form or the occurrence of pulmonary and extrapulmonary complications that required transfer to the intensive care unit, or death of the patient during the followup period. The secondary combined endpoint of the study was resolution of clinical symptoms of the disease or achievement of reference values of laboratory and instrumental indicators.Results. No lethal outcomes were observed in the compared groups, there were no cases of development of an extremely severe course, complications requiring transfer to the intensive care unit in the main group.Conclusion. Early use of small doses methylprednisolone of in comprehensive therapy of patients with moderate and severe COVID-19 pneumonia reduces the incidence of life-threatening complications and improves the outcomes of the disease.

Methods of camouflage vitiligo (literature review)

Vitiligo significantly affects the quality of life of patients, their social and psychological adaptation in society. It has been noted that patients with vitiligo are more likely to develop anxiety and depressive disorders, suicidal thoughts. Standard therapy regimens today often take a long time, are not enough effective and do not always meet the expectations of the patient and the dermatologist, reduces compliance to treatment. In this regard, comprehensive therapy for vitiligo remains a pressing issue to this day. Medical camouflage is a promising adjunctive or alternative therapy for vitiligo, as it allows to control the clinical manifestations of the disease. The purpose of this review is to consider the main types of medical camouflage in the Russian and foreign markets, their availability and principles of action. The PubMed database and the Internet were used to identify the most effective, affordable, and easy-to-use products available in the Russian and foreign markets. The research identified the most significant products that are most convenient to apply to the skin and are easily available for purchase by vitiligo patients in Russia. Parameters such as shape, texture, composition and effect duration were evaluated. Each group of preparations was described in detail, as well as the technique for their correct application. Thus, this review will be useful to all practicing dermatologists in controlling the clinical course of vitiligo as well as its skin manifestations.

ЗАСТОСУВАННЯ Α-ГЛІЦЕРИЛФОСФОРИЛХОЛІНУ В СХЕМІ КОМПЛЕКСНОГО ЛІКУВАННЯ ДЛЯ ФУНКЦІОНАЛЬНОГО ВІДНОВЛЕННЯ ПІСЛЯ МОЗКОВОГО ПІВКУЛЬОВОГО ІШЕМІЧНОГО ІНСУЛЬТУ

The article considers the influence of α-glycerylphosphorylcholine in the scheme of comprehensive therapy on the dynamics of functional recovery in patients with cerebral hemispheric ischemic stroke. Against the background of the progressive growth of acute cerebral infarction, the problem of timely care is relevant. Timely treatment of stroke, based on evidence-based medicine, along with early activation and rehabilitation of patients is designed to reduce mortality and subsequent disability of patients. Given that cholinergic insufficiency and structural and functional damage of neurons play an important role in the pathogenesis of post-stroke disorders, the use of medicines for their correction, in particular α-glycerylphosphorylcholine, is justified. Choline alfoscerate, a precursor of acetylcholine and phosphatidylcholine, is broken down by enzymes into choline and glycerophosphate when ingested, and the choline thus obtained is able to improve neuronal functionality in patients with neurodegenerative and vascular diseases. The study revealed a significantly better recovery of impaired motor and cognitive functions after cerebral hemispheric stroke under the influence of comprehensive therapeutic and rehabilitation measures using active rehabilitation methods in conjunction with α-glycerylphosphorylcholine. The results obtained during the study allow us to report the advantage of a combination of methods of active rehabilitation and the use of the pharmacological agent α-glycerylphosphorylcholine. The feasibility and efficacy of α-glycerylphosphorylcholine are related to its ability to reduce motor and cognitive deficits after ischemic stroke. The scheme of comprehensive treatment of patients in acute and restorative periods of cerebral hemispheric ischemic stroke with the use of α-glycerylphosphorylcholine helps to increase the effectiveness of functional recovery after an acute cerebral accident, and can be used in the use of therapeutic and rehabilitation programs for patients after cerebral hemispheric ischemic stroke to reduce the post-stroke deficit.