S. A. Zanin

The objective of this study is to assess the efficacy of transcranial electrostimulation in the management of phantom pain syndrome. Material and methods. This study involved 117 male patients (mean age 36 ± 3.74 years) who experienced phantom pain syndrome following traumatic limb amputation. The participants were assigned to two groups. The control group consisted of patients receiving standard analgesic pharmacotherapy (n = 60). In the transcranial electrical stimulation group (n = 57), patients received the same pharmacotherapy and transcranial electrical stimulation, administered over 20 sessions, comprising two sessions per day – one in the morning (monopolar mode) and another in the evening (bipolar mode) – over a period of 10 days. To evaluate the intensity and characteristics of pain over time, a visual analog scale and clinical questionnaires DN4, PainDETECT, and LANSS were employed. Assessments were conducted on days 1, 10, and 17 of the study. Results and Discussion. The application of transcranial electrical stimulation was associated with a more pronounced and statistically significant reduction in the assessed parameters on the tenth day of the study compared to the control group. In contrast to the comparison group, pain intensity decreased to a complete absence or mild pain (1 to 3 points on the visual analog scale) in most patients. By day 17, the differences between the groups had somewhat smoothed out, but the transcranial electrical stimulation group retained a statistically significantly lower pain intensity on the visual analog scale. Сonclusion. The therapeutic application of transcranial electrostimulation in the management of phantom pain syndrome has been demonstrated to be associated with a marked improvement in the clinical manifestations of phantom pain syndrome. This finding offers a compelling rationale for the continued investigation of the effects of transcranial electrostimulation in this setting.

Down syndrome is attributed to congenital chromosome 21. Its pathogenesis is driven by a range of cytopathic effects associated with aneuploidy, an area that has been the focus of extensive recent investigation. Objective : To analyze and present, in the form of a narrative review, the molecular mechanisms underlying the detrimental effects of chromosome 21 on the cell. The first of these is a primary imbalance in gene expression caused by increased dosage of chromosome 21 genes and the hyperfunction of the encoded enzymatic, transport, receptor, structural, and regulatory proteins. In addition, the presence of an extra chromosome leads to secondary global dysregulation of gene expression driven by a range of cytopathic mechanisms, resulting in the development of an aneuploidy-associated phenotype. Among these mechanisms are features of proteotoxicity (stoichiometric imbalance; overload of the systems responsible for protein synthesis, folding, post-translational modifications, and degradation; inhibition of ribosomal biogenesis; and activation of integrated cellular stress response programs), disruption of the spatial organization of genetic material, and genome instability (in particular chromosomal instability), which is associated with the accumulation of errors in a wide range of genes and activation of autoinflammatory processes.

Подходы к моделированию диет-индуцированного ожирения и малоподвижного образа жизни у грызунов

Background. Interleukin-1β plays an important role in the pathogenesis of coronavirus disease (COVID-19) and may also be informative as a prognostic marker of infection. Other widely used diagnostic and prognostic markers include C-reactive protein and ferritin. Objective. To evaluate the effect of transcranial electrical stimulation on the serum levels of interleukin-1β, C-reactive protein, and ferritin in moderate to severe COVID-19 patients who do not receive targeted anti-cytokine therapy. Methods. The conducted randomized prospective study included patients treated at the Regional Clinical Hospital No. 2 (Ministry of Health of the Krasnodar Krai) in the period from June 24, 2021 to February 23, 2022. The patients diagnosed with moderate to severe COVID-19 were divided into two groups: comparison group (n = 20) receiving standard treatment as per the current guidelines and a group (n = 15) in which, in addition to standard therapy, the patients received transcranial electrical stimulation (one session per day until day 7 of stay in the COVID ward). The study excluded patients receiving specific anti-cytokine therapy (monoclonal antibodies, kinase inhibitors, and recombinant cytokine receptor antagonists). The levels of interleukin-1β, C-reactive protein, and ferritin were assessed prior to treatment and at the end of the first week of therapy. Statistical analysis and data visualization were performed in the R environment (The R Foundation, Austria). Differences were considered statistically significant at p < 0.05. Results. Prior to treatment, no statistically significant differences were observed in the levels of interleukin-1β, C-reactive protein, and ferritin between the groups. By the end of the first week, the level of interleukin-1β decreased by 11.8% (p = 0.7) in the comparison group, which was not statistically significant. In the group receiving transcranial electrical stimulation, interleukin-1β levels exhibited a significant decrease (by 71%) from the baseline (p = 0.007). In addition, interleukin-1β levels in this group were 52% lower than in the comparison group (p = 0.005). Also, C-reactive protein levels decreased significantly in both groups, while ferritin levels did not exhibit any statistically significant changes. Conclusion. The use of transcranial electrical stimulation in combination therapy for moderate to severe COVID-19 patients results in a more pronounced decrease in serum interleukin-1β levels as compared to standard therapy, which may indicate the anti-inflammatory potential of this method.

Background: Periodontitis, a prevalent chronic inflammatory disease, can lead to severe dental complications, including secondary adentia. It is closely associated with numerous life-threatening pathologies, including atherosclerosis, type 2 diabetes mellitus, and Alzheimer’s disease. A promising direction for developing new treatments for periodontitis is the implementation of approaches successfully used in other fields of medicine in dental practice.Objective: To analyze and summarize the results of preclinical studies, observational research, and randomized controlled trials of drugs with pleiotropic effects that may positively influence disease mechanisms. Among the potential therapeutic approaches considered are anti-inflammatory agents (monoclonal antibodies, kinase inhibitors, proteasome inhibitors), as well as drugs used ininternal medicine that possess anti-inflammatory, immunomodulatory, antibacterial, antibiofilm, and osteoprotective properties (e.g., metformin, incretinmimetics, pirfenidone, and statins).

This review discusses the role of capsule endoscopy in diagnosing suspected small bowel bleeding and compares guidelines of the European Society of Gastrointestinal Endoscopy (ESGE), the American College of Gastroenterology (ACG), the American Society for Gastrointestinal Endoscopy (ASGE), the Canadian Association of Gastroenterology (CAG), and the consensus document of 4 Japanese medical societies. European and North American experts recommend capsule endoscopy as a first-line diagnostic modality for suspected small bowel bleeding without life-threatening signs in adult patients when ileocolonoscopy and esophagogastroduodenoscopy failed to be informative. Japanese experts, on the contrary, prefer cross-sectional imaging “from the chest to the pelvis” and consider capsule endoscopy as an alternative.

The modern cardiology has a wide range of medications which affect various pathogenetic links of atherosclerosis, but even the best of them still obtain disadvantages causing intolerance and medicine discontinuation. The development of new hypolipidemic medications will allow not only to introduce alternative therapies into the cardiology practice, but also to completely execute the strategy of residual risk reduction by utilizing rational combinations of medications. One of such alternatives could be bempedoic acid, which can have a positive effect on a number of endpoints as the results of third phase trials have shown. These effects are also confirmed in Mendelian randomization studies. The mechanism of action of bempedoic acid is presumably associated with inhibition of the activity of ATP citrate lyase – the enzyme responsible for the breakdown of citrate into acetyl-CoA and oxaloacetate. Acetyl-CoA, in turn, is used by the cell to synthesize cholesterol and fatty acids. Thus, bempedoic acid affects in the same metabolic pathway as statins, but at an earlier stage. According to this, it is possible that medications of these classes will have similar side effects and pleiotropic effects associated with modulation of the mevalonic pathway, such as prenylation regulatory proteins (small GTPases) or reduction of coenzyme Q synthesis. However, there are also some specific features of the pharmacodynamics and pharmacokinetics of bempedoic acid to be considered. In particular, once entered the body, it must be activated via esterification by very long-chain acyl-CoA synthetase-1. The enzyme isoform required for this process is expressed in a tissue-specific manner and, for example, is absent in skeletal myocytes. In addition, citrate, oxaloacetate, and acetyl-CoA are important regulators of many intracellular processes: metabolism, growth and proliferation, mechanotransduction, posttranslational modifications of histones and other proteins. The levels of all three substances are altered by bempedoic acid, although no firm conclusions about the effects of these changes can be drawn at this time. The mentioned features probably have a significant impact on the clinical profile of bempedoic acid and underlie the differences from statins already observed in third phase trials, including, for example, a reduced risk of the onset or worsening of diabetes mellitus while taking bempedoic acid.

Background. Urinary incontinence is associated with chronic psycho-emotional stress. Stress management should be part of a comprehensive treatment for urinary incontinence.Objectives. An assessment of hypercatecholaminaemia severity and dynamics in repeated courses of TES therapy for stress urinary incontinence.Methods. A total of 100 stress urinary incontinence patients were divided between a comparison and two main cohorts. Main cohort 1 (n = 30) received a modern standard treatment in combination with TES therapy. TES therapy was performed in three courses (1 session per day for 7 days): course 1 on admission, course 2 in 3 months after course 1, course 3 in 6 months after course 1. Main cohort 2 (n = 40) received a modern standard treatment in combination with two short courses of TES-therapy (2 sessions per day for 7 days): course 1 on admission, course 2 in 6 months after course 1. The comparison cohort (n = 30) only had standard treatment. Catecholamine concentrations were assessed over time in each cohort.Results. Catecholamine concentrations were >2 times higher before treatment in all cohorts vs. healthy volunteers. The comparison cohort revealed adrenaline and noradrenaline concentrations 71.2% (p < 0.05) and 84.0% (p < 0.05) higher vs. healthy volunteers, respectively, by month 6 of the trial. Main cohort 1 had the concentrations of adrenaline and noradrenaline 2.1 (p < 0.05) and 1.5 (p < 0.05) times higher, respectively, vs. healthy volunteers. Main cohort 2 showed an adrenaline concentration 12.5% (p < 0.05) and noradrenaline — 2.4% higher (p = 0.15) vs. healthy volunteers.Conclusion. TES therapy affects urinary incontinence hypercatecholaminaemia, demonstrating a favourable homeostatic impact on neuroimmunoendocrine regulation.