RUDN Journal of Medicine

Editor-in-Chief: KOBALAVA Zhanna D., Corresponding Member of the Russian Academy of Sciences, MD, Professor, Head of Department of Propaedeutics of Internal Medicine, RUDN University, Moscow, Russia

ISSN: 2313-0245 (Print) ISSN: 2313-0261 (online)

Founded in 1997. Publication frequency: quarterly.

Open Access: Open Access. APC: no article processing charge

Peer-Review: double blind. Publication language: Russian, English

PUBLISHER: Peoples’ Friendship University of Russia (RUDN University)

Journal History

Indexation: Russian Index of Science Citation, Google Scholar, Ulrich's Periodicals Directory, WorldCat, East View, Dimensions, DOAJ, Lens, Research4Life, EBSCOhost, ResearchBib, JournalTOCs, British Library, Bodleian Libraries (University of Oxford), Ghent University Library 

 

RUDN journal of Medicine is published since 1997 with a periodicity of 4 issues per year. Publishing mission - to make the results of scientific researches of Russian scientists available for foreign academics. The editorial board includes recognized in the medicine and health care professionals in Russia and abroad.

Themes of articles are largely varied. They reflect the results of scientific work in the performance of master's and doctoral theses, as well as other relevant research, including search and reflecting the improvement and expansion of existing preventive, diagnostic, treatment and rehabilitation methods.

The journal publishes articles both university staff and authors from other medical schools and medical faculties of universities in the country, as well as various medical institutions in Russia, CIS and far abroad.

Announcements

 

Publication schedule of issues of the journal “Bulletin of Peoples' Friendship University of Russia. Series: MEDICINE" in 2023:

Posted: 10.12.2022

The plan for publishing issues of the journal in 2023:

No. 1 - March 2023. The theme of the issue is "Gynecology"

No. 2 - June 2023

No. 3 - September 2023

No. 4 - December 2023

 
More Announcements...

Current Issue

Vol 26, No 4 (2022): GINECOLOGY

GINECOLOGY

Placenta: an organ with high energy requirements
Shestakova M.A., Vishnyakova P.A., Fatkhudinov T.K.
Abstract

Placenta is a unique organ, without which the very phenomenon of human pregnancy is impossible. Semiallogeneous nature, localization of the placenta, complex and heterogeneous cellular composition determines its complex and multifaceted role in the course of physiological pregnancy, indicates the importance of studying this organ in a number of reproductive pathologies. The purpose of this review was to analyze the literature sources illustrating the importance of energydependent processes in placental metabolism and to determine the molecular basis of placental energy conversion. Publications of foreign and Russian authors from PubMed database and scientific electronic library eLIBRARY.ru were used when writing the review. The review highlights the main functions of the placenta: transport and synthetic functions in terms of their place in the structure of energy expenditure of the organ. The systems by which the transport of ions and gases from maternal blood through the placental barrier is performed, are considered. The role of the placenta in the synthesis of steroid hormones and glucocorticoids is detailed. The main bioenergetic systems are also considered: placental glucose metabolism, the functional activity of mitochondria and the creatine kinase system of the placenta. These data allow us to put the placenta on a par with other organs with high energy requirements (brain, transverse striated skeletal muscles, heart, kidneys, liver), which are most susceptible to metabolic disorders. Maintaining a balance between expenditure and synthesis of macroergic compounds in the placenta is critical for an adequate course of physiological pregnancy, and imbalances can lead to such pathologies as fetal retardation syndrome or preeclampsia. Further study of placental energy supply systems seems important for understanding the mechanisms of intrauterine development disorders and developing their pathogenetic treatment.

RUDN Journal of Medicine. 2022;26(4):353-363
pages 353-363 views
Clinical and genetic aspects of menopausal hormone therapy - a modern paradigm. What changed COVID-19 pandemic?
Zhuravleva I.S., Khamoshina M.B., Orazov M.R., Dmitrieva E.M., Azova M.M.
Abstract

In the modern paradigm of public health protection, much attention is paid to the health of women in peri- and postmenopause, and a personalized approach prevails. It is generally recognized that the pathogenetic therapy of menopausal disorders is hormone therapy. But the COVID-19 pandemic has made its own adjustments to the routine strategy of choosing menopausal hormone therapy (MHT). The purpose of this review was to analyze studies on the dependence of the effectiveness of MHT on clinical and genetic aspects in the context of the ongoing COVID-19 pandemic. The review highlights the main risks of MHT for thromboembolic diseases and coagulation complications characteristic of COVID-19, discusses genetic predispositions that aggravate the course of the post-COVID period, as well as the effectiveness of estrogens in protecting the vascular endothelium and increasing the number of CD4+ T cells, providing an adequate immune response when infected with SARS-CoV-2. Numerous studies show that the complications characteristic of the severe course of COVID-19 are multifactorial in nature and cannot be unambiguously explained only by genetic predisposition. However, with the development of personalized medicine, special attention should be paid to the study of genetic aspects that can equally contribute to the occurrence of menopausal disorders in healthy women and aggravate the course of the post-pregnancy period. The data presented allow us to conclude that in the context of the ongoing COVID-19 pandemic at the population level, MHT can bring significant benefits to women during menopause due to the beneficial effect of estrogens on vascular walls. Additional study of the relationship between the course of the postcovid period in MHT users and polymorphisms of candidate genes that determine the risks of thrombotic complications and metabolic consequences is required.

RUDN Journal of Medicine. 2022;26(4):364-372
pages 364-372 views
New aspects in the surgical correction of pelvic organ prolapse
Vardanyan V.G., Alekhin A.I., Mezhlumova N.A., Pevgova G.Y., Alekhin A.A.
Abstract

Relevance . The relevance of the problem of pelvic prolapse is due to the prevalence of the disease, the tendency to rejuvenation and progression. This, according to the survey, affects the quality of life of women, leads to disruption of sexual functioning, and reduces the ability to work. The methods of surgical treatment that exist in the arsenal of modern operative gynecology can contribute to the development of cicatricial adhesions, infectious complications and recurrence of prolapse, which creates the need for repeated interventions. The development and introduction into practice of new methods of treatment is a natural necessity. The most effective technique for the surgical treatment of genital prolapse is laparoscopic sacrocolpopexy using titanium silk implants. Materials and Methods. A prospective cohort study of 30 patients aged 37 to 74 years with clinical manifestations of grade II-IV prolapse, statistical data analysis and analysis of the results of a survey of patients in the postoperative period in dynamics over 3-6-12 months from 2019 to 2021 was carried out. The study used a three-stage method of surgical assistance (patent dated September 15, 2020 No. 2020130382/14 (054923) in the volume - laparoscopic promontofixation, MacCoul sacro-uterine ligament plasty, colporrhaphy, colpoperineorrhaphy, levatoroplasty. Results and Discussion. It has been established that pregnancy and childbirth are among the main factors provoking the development of pelvic floor muscle failure. The duration of postoperative follow-up in our study was 3-14 months. No complications were diagnosed during this period. In 12 patients (40.0 %) during the first month there were periodic pulling pains in the lower abdomen and perineum, in 2 (6.6 %) - urinary incontinence. Titanium silk has a lower affinity for surrounding tissues compared to polypropylene scaffold systems, which makes it possible to consider it as an alternative material to synthetic analogues and reduce the risk of mesh-associated complications. The resistance of the titanium endoprosthesis to antiseptics and microbial agents predisposes to its long-term use and the absence of the need for replacement. Conclusion. The data obtained make it possible to judge the high efficiency of the developed technique for the surgical treatment of pelvic prolapse of pelvic floor defects in patients with rectocele and cystocele, minimizing the recurrence of the disease and the risk of developing mesh-associated complications, which allows choosing a personalized management strategy for this cohort of patients.

RUDN Journal of Medicine. 2022;26(4):373-381
pages 373-381 views
Polycystic ovary syndrome and obesity: a modern paradigm
Khamoshina M.B., Artemenko Y.S., Bayramova A.A., Ryabova V.A., Orazov M.R.
Abstract

Polycystic ovary syndrome is a heterogeneous endocrine disease that affects women of childbearing age. The pathogenesis of polycystic ovary syndrome has not been fully studied to date, its paradigm considers the genetic determinism of the manifestation of hormonal and metabolic disorders, which are considered to be criteria for the verification of the disease (hyperandrogenism, oligo/anovulation and/or polycystic ovarian transformation during ultrasound examination (ultrasound). This review discusses the main ways of interaction between hyperandrogenism, insulin resistance and obesity and their role in the pathogenesis of polycystic ovary syndrome, as well as possible methods of treatment for this category of patients. The review analyzes the role of hyperandrogenism and insulin resistance in the implementation of the genetic scenario of polycystic ovary syndrome and finds out the reasons why women with polycystic ovary syndrome often demonstrate the presence of a «metabolic trio» - hyperinsulinemia, insulin resistance and type 2 diabetes mellitus. It is noted that obesity is not included in the criteria for the diagnosis of polycystic ovary syndrome, but epidemiological data confirm the existence of a relationship between these diseases. Obesity, especially visceral, which is often found in women with polycystic ovary syndrome, enhances and worsens metabolic and reproductive outcomes with polycystic ovary syndrome, as well as increases insulin resistance and compensatory hyperinsulinemia, which, in turn, stimulates adipogenesis and suppresses lipolysis. Obesity increases the sensitivity of tech cells to luteinizing hormone stimulation and enhances functional hyperandrogenism of the ovaries, increasing the production of androgens by the ovaries. Excess body weight is associated with a large number of inflammatory adipokines, which, in turn, contribute to the growth of insulin resistance and adipogenesis. Obesity and insulin resistance exacerbate the symptoms of hyperandrogenism, forming a vicious circle that contributes to the development of polycystic ovary syndrome. These data allow us to conclude that bariatric surgery can become an alternative to drugs (metformin, thiazolidinedione analogs of glucagon-like peptide-1), which has shown positive results in the treatment of patients with polycystic ovary syndrome and obesity.

RUDN Journal of Medicine. 2022;26(4):382-395
pages 382-395 views
Рrediction of infertility in patients with uterine leiomyoma
Semyatov S.M., Leffad L.M.
Abstract

Infertility is an important socio-economic problem due to the fact that planned childbearing occurs much later than three decades ago. In recent years, more attention has been paid to the role of uterine leiomyoma in the development of infertility. Uterine leiomyoma is a benign monoclonal, well-demarcated encapsulated tumor originating from the smooth muscle cells of the cervix or body of the uterus. Uterine leiomyoma is the most common uterine tumor in the reproductive age group, affecting 20-50 % of women. With conceptual changes in marriage and childbearing, the number of women over 35 with leiomyoma who want to have children has also increased significantly. The need to treat submucosal fibroids is widely recognized, but fibroids of other locations and sizes remain a clinical mystery. The purpose of the literature review was to determine the role of uterine fibroids in predicting infertility. It has been established that the incidence of uterine leiomyoma in women of reproductive age is on average about 40 %, infertility associated with this pathology occurs in 5-10 % of women. In 10 % of cases of infertility, uterine leiomyoma is the only established cause of infertility. Uterine leiomyoma is common among women of reproductive age, and as women continue to delay childbearing, an increasing number of patients will require fertility-preserving treatment options. Leiomyoma affects not only fertility but also obstetric outcomes. Women with intramural fibroids without cavity deformity have a 21 % reduction in live birth rates after in vitro fertilization compared with controls without fibroids. Despite advances in fundamental understanding of the biology of leiomyomas, the role of different fibroid variants remains a matter of discussion. The question of the negative impact of submucosal nodes on infertility today is not in doubt, and the effect of subserous and intramural nodes requires further study.

RUDN Journal of Medicine. 2022;26(4):396-403
pages 396-403 views

IMMUNOLOGY

Immunotherapy at the modern stage: types and tactics of application
Korzhenevsky A.A., Korzhenevskaya N.P.
Abstract

The sum of the effects of all negative factors on the human body is manifested, including in the form of an imbalance in the work of the immune system, which leads to a violation of the recognition and elimination of foreign substances of the most diverse origin. This is manifested in an increase in the frequency of development of inflammatory processes, the risk of their chronicity and the development of complications, the identification of opportunistic or conditionally pathogenic flora as a pathogen, including those with atypical biological properties and antibiotic resistance. The use of etiotropic chemotherapy alone in the treatment does not allow achieving sufficient control over many infectious diseases. The purpose of this review was to investigate additional, alternative approaches to influencing anti-infective immunity. An analysis of the strategy based on the use of modulation of the immune response in the treatment of patients was carried out and its advantages over traditional antimicrobial treatment were determined. The concept of «immunotherapy» is discussed, which implies a variety of effects on the immune system in order to stop the pathological process. The review highlights the main types of immunotherapy - local, general, combined and monoimmunotherapy, as well as active and passive, specific and nonspecific. The review provides convincing data on the need for immunomodulators to meet a number of requirements, analyzes various ways of classifying them and their areas of application. The necessity of using immunotropic drugs on the basis of a comprehensive examination is emphasized, taking into account the correspondence between the nature of clinical manifestations and the severity of changes in immunological parameters. The analyzed data allow us to conclude that immunomodulatory therapy can be used to restore the function of the immune system to the physiological norm after a severe inflammatory process at the stage of immunorehabilitation.

RUDN Journal of Medicine. 2022;26(4):404-421
pages 404-421 views

Stomatology

Dental implants osseointegration in patients with osteoporosis
Hammouri M.H., Salekh K.M.
Abstract

The successful use of surgical and medical methods of jaw bone tissue restoration has been convincingly confirmed in clinical practice. At the same time, technologies are being developed to improve the osseointegration of dental implants in patients with osteoporosis. The use of various implant coatings, as well as systemic therapy, demonstrate the emergence of new directions in the treatment of patients with partial or complete secondary edentulism with concomitant osteoporosis. This trend is relevant in modern medicine . Information was obtained from the PubMed database, using the keywords «osteoporosis» and «osseointegration» and «dental implantation» and «zoledronic acid» from 2016 to 2022. Articles were selected based on experimental work. Numerous studies have shown that bone tissue is an effective indicator of osteoporotic changes. The main changes in bone tissue in osteoporosis are emphasized - a decrease in bone volume, deterioration of the microarchitecture of the trabecular bone and processes that prevent osseointegration - loss of bone mass, a significant decrease in the percentage of contact in the implant-bone complex. Methods of dealing with the negative impact on the operation of dental implantation have been identified. In a review of studies on the systemic administration of drugs based on bisphosphonates, an increase in the osseointegration of dental implants was revealed, the systemic administration of zoledronic acid preparations significantly increased the formation of new bone, which in turn contributed to the elimination of such a negative effect of osteoporosis as bone resorption. In addition to the systemic administration of bisphosphonates, experimental studies describe the topical application of bisphosphonates in the form of various implant coatings. Topical application of bisphosphonates also contributed to increased osseointegration. Microstructured coated implants showed less marginal bone loss compared to uncoated implants. Conclusion. The use of dental implants with modified macro- and microrelief, as well as systemic drug therapy, remains the main direction of scientific research that contributes to the optimization of osseointegration of dental implants.

RUDN Journal of Medicine. 2022;26(4):422-430
pages 422-430 views

BIOCHEMISTRY

Biomarkers in the diagnosis of neurodegenerative diseases
Haque S.S.
Abstract

Biomarkers are molecules that behave as of biological states. Ideally, they should have high sensitivity, specificity, and accuracy in reflecting the total disease burden. The review discusses the current status of biomarkers used in neurological disorders. Neurodegenerative diseases are a heterogeneous group disorders characterized by progressive loss of structure and function of the central nervous system or peripheral nervous system. The review discusses the main biomarkers that have predictive value for describing clinical etiology, pathophysiology, and intervention strategies. Preciseness and reliability are one of important requirement for good biomarker. As a result of the analysis of literature data, it was revealed that beta-amyloid, total tau protein and its phosphorylated forms are the first biochemical biomarkers of neurodegenerative diseases measured in cerebrospinal fluid, but these markers are dependent upon invasive lumbar puncture and therefore it’s a cumbersome process for patients. Among the various biomarkers of neurodegenerative diseases, special attention is paid to miRNAs. MicroRNAs, important biomarkers in many disease states, including neurodegenerative disorders, make them promising candidates that may lead to identify new therapeutic targets. Conclusions. Biomarkers of neurological disease are present optimal amount in the cerebrospinal fluid but they are also present in blood at low levels. The data obtained reveal the predictive value of molecular diagnostics of neurodegenerative disorders and the need for its wider use.

RUDN Journal of Medicine. 2022;26(4):431-440
pages 431-440 views

Physiology

Association between maximal aerobic capacity and heart rate variability
Saini R., Kacker S., Gupta R., Rao A.
Abstract

Relevance. Сardiovascular status could be assessed by maximal aerobic capacity (VO2max) through direct analysis of the gases involved in pulmonary ventilation and monitoring fluctuations in intervals between beats over time as heart rate variability. The aim of the study was to investigate the relationship between VO2max and heart rate variability in young adults. Materials and Methods. A total of 100 young adults between the ages of 18 and 25 were included in observational study, who did not engage in any strenuous physical activity, 50 of whom were male and 50 of whom were female.There were measured Heart rate variability in the frequency domain; LF, HF, LF/HF, and time domain; SDNN, RMSSD, pNN 50, and VO2max were assessed using a treadmill test according to Graded Exercise Protocol. Results and Discussion. There was weak positive correlation of VO2max with LF ( r = 0.177) and weak negative correlation with HF ( r = -0.141). Male participants had a weak negative relationship between VO2 max and LF ( r = -0.075), whereas female respondents had a weak positive relationship(r = 0.286). There was weak negative correlation of VO2max with LF/HF ratio for male subjects but weak positive correlation ( r = -0.101) for female subjects. For male and female participants, there was a weak negative association of VO2max with SDNN ( r = -0.170) and ( r = -0.301), respectively. Male and female participants had a weak negative association of VO2max  with RMSSD, with ( r = -0.154) and ( r = -0.284) respectively. Male and female participants had a slight negative association of VO2max with pNN 50, with ( r = -0.062) and ( r = -0.441) respectively. Conclusion. Significant variations were found in the time domain and frequency domain indices including HF and LF/HF ratio which represents the balance between sympathetic and parasympathetic responses.

RUDN Journal of Medicine. 2022;26(4):441-450
pages 441-450 views
Aspects of myocardial heterogeneity in assessment its remodeling
Minina E.N., Stepura E.E.
Abstract

The influence of sports activity on the cardiovascular system is accompanied by physiological adaptation of the organism. Intense physical activity, far exceeding the body’s capabilities, can lead to structural changes or remodeling of the athlete’s myocardium. The review is devoted to the study of myocardial heterogeneity and is aimed at attracting attention of physicians, physiologists, biologists, researchers and developers of ECG computer analysis programs to prognostically significant indicators. Based on the mechanisms of electrical heterogeneity of the ventricular myocardium, the review considers the results of clinical studies by Russian and foreign specialists. The high predictive capabilities of indicators for the detection of fatal and non-fatal cardiovascular events and sudden cardiac death are discussed. It was found that the speed indicators of the electrical activity of the heart are the earliest marker of cardiac arrhythmias and conduction disorders. Risk factors - arterial hypertension, smoking, hypercholesterolemia and overweight - are associated with a decrease in the rate of electrical activity of the heart and an increase in myocardial heterogeneity. The data presented allow us to conclude that myocardial electrical heterogeneity is a prognostically significant indicator for the detection of fatal and non-fatal cardiovascular events; it is widely discussed in foreign literature, but is not used by domestic specialists.

RUDN Journal of Medicine. 2022;26(4):451-460
pages 451-460 views

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