Ivanovo State Medical Academy

Background : Magnesium deficiency is a significant risk factor that can aggravateborderline personality disorders (BPDs). Aim : to evaluate the roleof low magnesium levels in plasma and red blood cells as a significant factor for BPDs and to explore the possibility of reducing the need for antidepressants with magnesium therapy. Methods: this study included 62 patients with BPDs treated in a psychiatric department. the analysis utilized new mathematical approaches to establish intervals of informative values for numerical parameters, identify metric aggregations in the parameter space of biomedical research, and construct heatmaps. Results: the study demonstrated a high prevalence of extremely low red blood cell magnesium levels among patients with BPDs. a course of magnesium citrate and pyridoxine resulted in a significant increase in magnesium levels in plasma and erythrocytes, alleviation of anxiety and depressive symptoms, improvement of sleep and other indicators of the neuropsychiatric state of patients, and a 30% reduction in the need for antidepressants. Conclusion: the comprehensive picture of BPDs was examined using standard statistics and modern mathematical methods of data mining.

Background : In recent years, there has been an intensive search for anticonvulsants with fewer adverse effects. the study of micronutrients that can potentiate the action of anticonvulsants, and in particular myoinositol (vitamin B 8 ), seems promising. Methods: an experimental study of the neurotropic and anticonvulsant effects of a myoinositol-based drug was conducted using a thiosemicarbazide seizure model. the study was conducted on male rats. the animals were divided into groups pre-treated with the anticonvulsants sodium valproate and gabapentin, and in combination with myoinositol and folic acid. In the experimental groups, the seizure model was simulated by administering the convulsant. Myoinositol levels in the blood plasma of the experimental animals were determined. Results: a course of administration of an inositol-containing preparation to a thiosemicarbazide-induced seizure model significantly increased the latency to the first seizure, reduced seizure severity (p <0.05), and decreased mortality. an enhanced anticonvulsant effect of sodium valproate and gabapentin was observed, and the neuroprotective effect of myoinositol preparations was confirmed. administration of anticonvulsants resulted in a significant decrease in plasma inositol concentrations. a course of administration of an inositol-containing preparation maintained and significantly increased plasma inositol concentrations in animals treated with the anticonvulsants gabapentin and sodium valproate. Conclusion : a drug containing myoinositol and folic acid modulates the effects of drugs with both convulsant and anticonvulsant effects.

Relevance. Medicines can cause the body to lose magnesium and pyridoxine (vitamin B 6 ), which leads to the formation of side effects and worsens the course of the underlying disease. Objective. Evaluation of the antimicronutrient effect of all drugs registered in the ATX rubricator using chemoreactome screening. Materials and methods. Using methods of topological data analysis and labeled graph analysis, a systematic computer analysis of databases (SIDER, FAERS, PubChem, HMDB) was performed, algorithms for predicting magnesium-excreting and pyridoxine-excreting properties of drugs were developed, followed by screening of 2527 ATC drugs. Results. The accuracy of the algorithms in cross-validation was 94–98 % for magnesium deficiency and 88 % for vitamin B 6 deficiency. On average, each drug accounts for 8.5±6.5 antimicronutrient effects. Only 4 % of drugs did not show a negative effect on micronutrient metabolism. Pyridoxine deficiency is caused by 1701 drugs (68 % of ATC), magnesium deficiency — by 1064 drugs (42 %). The most negative impact on the homeostasis of both micronutrients is exerted by antibiotics (J01), psychotropic drugs (N05, N06), antineoplastic agents (L01), hormones (G03), diuretics (C03), analgesics (N02) and antiinflammatory drugs (M01). Conclusion. The results of chemoreactome screening will allow us to reasonably recommend accompanying various pharmacotherapy with drugs based on pyridoxine and organic magnesium salts.

Objective . To demonstrate the role of a primary care specialist, a district therapist, in the diagnosis and subsequent monitoring of a rare and difficult-to-recognize disease, eosinophilic granulomatosis with polyangiitis (EGPA), characterized by multiple organ damage, using a clinical case example. Materials and methods . This article presents a clinical case of a 72-year-old patient with EGPA. The stages of diagnostic search are described, including the patient's initial visit to a district therapist, analysis of the patient's medical history, physical examination, laboratory and instrumental tests, verification of the diagnosis by a rheumatologist, as well as the treatment and monitoring of the patient's condition. Results . A case of a patient with ECPA manifestation after a long remission of bronchial asthma, with a predominance of neurological symptoms (ischemic stroke, polyneuropathy), subclinical damage to the heart (complete blockade of the left bundle branch, hydropericard), and kidneys is described. Presented case demonstrates the role of a primary care specialist – a district therapist – in the diagnosis and subsequent monitoring of a rare and difficult-to-recognize disease, eosinophilic granulomatosis with polyangiitis (EGPA), characterized by multiple organ damage. Timely and adequate therapy led to clinical and laboratory remission. Conclusion . This clinical case demonstrates the importance of the district therapist's alertness regarding rare diseases such as EGPAs, especially in the presence of bronchial asthma and eosinophilia. The need for a comprehensive examination of patients with multiple organ pathology is emphasized. Timely diagnosis and adequate therapy contribute to achieving remission. In the future, it is important to monitor the patient to prevent relapses and treat associated diseases. Despite the fact that the diagnosis and treatment of EGPAs are the responsibility of a rheumatologist, the early diagnosis and referring the patients to a specialist depend largely on the district therapist.

AIM. To evaluate the effectiveness of using a rehabilitation glove in patients with central paresis of the arm and motor aphasia due to ischemic stroke, and also to study the rate of motor production in the upper limb in these patients. MATERIALS AND METHODS. We examined 49 patients with hemiparesis and motor aphasia in the early recovery period of ischemic stroke in the left middle cerebral artery. Depending on the fact of conducting training with the use of a rehabilitation glove, patients were randomly distributed into two groups (1, where this training option was implemented, and 2 — without it), comparable in the severity of motor and speech disorders. Within each of them, patients were additionally divided into subgroups, depending on the degree of paresis in the distal part of the affected upper limb: L-mild (in group 1L — 18 people, 2L — 16) and U-moderate (in group 1U — 8, and 2U — 7 patients). On days 1 and 10 of training, all patients underwent functional testing. Treatment and rehabilitation were carried out according to the order of care. Patients of groups 1L and 1U additionally received a course of 10 sessions, including 2 exercises of 15 minutes each for a paretic arm 5 times a week. RESULTS. Patients of groups 1L and 1U demonstrated statistically significant improvements in the Medical Research Committee Scale, the ARAT Arm Motor Activity Test, the Wasserman Speech Impairment Rating Scale, and the Montreal Cognitive Function Rating Scale. According to amplitude indicators, there was a tendency towards their increase in all groups. A decrease in the number of errors and an increase in the percentage of correct task completion accompanied the development of a motor act. They stabilized in patients with mild paresis of the hand by 5–6 sessions and in patients with moderate paresis by 6–7 sessions. CONCLUSION. In patients with mild to moderate paresis of the right hand in combination with motor aphasia in the early recovery period of ischemic stroke, when using a rehabilitation glove, there was an improvement in the strength and motor activity of the paretic hand, cognitive functions and speech. Stabilization of task performance indicators should be taken into account when determining the duration of training and timely correction of the motor rehabilitation program.

Objective. On the basis of the study of clinical and anamnestic data in women of reproductive age with abnormal uterine bleeding due to endometrial hyperplasia, to establish risk factors for the development of this pathology. Material and methods. The study involved 179 patients of reproductive age, among whom 47 women who applied for pregravidal preparation formed the control group and 132 women with abnormal uterine bleeding due to endometrial hyperplasia formed the main group. Results. It was found that the risk of endometrial hyperplasia development increases with age in the presence of excessive body weight, medical abortions in the anamnesis, gastrointestinal tract diseases, irregular menstrual cycle in the anamnesis, infertility, uterine myoma, genital endometriosis, chronic endometritis, as well as in women with peculiarities of social status (unmarried). Conclusion. A more detailed study and identification of affectable risk factors for the development of infertility in women with chronic endometriosis.

General positions on the nature and principles of self-cognition, based upon the views of ancient philosophers and St. Ignatius (Bryanchaninov) as a representative of the Eastern Christian theology are considered in the present article. It proven that despite many similarities in form and and ideas,

Background. Prediction of breast cancer (BC) progression is important for the timely correction of patient therapy.Objective: to assess a relationship between BC progression and degree of vitamin D deficiency.Material and methods. A retrospective controlled study was performed. The results of examining 67 women aged 29–48 years with histologically verified BC and vitamin D deficiency are presented. All patients were divided into two groups: the main group – 34 women administered with vitamin D, comparison group – 33 patients not taking vitamin D.Results. It was shown that 25(OH)D3 level less than 18.9 ng/ml was significantly associated with prominent disease progression, regardless of the tumor molecular subtype. Additional criteria were developed allowing to predict BC progression.Conclusion. In order to detect secondary changes (distant metastases in ВС patients) and improve patient monitoring, it is recommended to use additional diagnostic methods and determine the intermediate metabolite of vitamin D – 25(OH)D3 in peripheral blood.