The aim of this review was to analyze domestic and foreign publications reflecting the main existing theories of tension-type headache (TTH) development and the search for common pathogenetic links of TTH with arterial hypertension (AH) as potential triggers for the development of the clinical TTH and AH phenotype.Methods. We searched for articles in databases (eLibrary.ru, Web of Science, Scopus, PubMed, Clinical Case) by keywords. Search depth – 2006–2021.Results. The analysis allowed us to identify the leading theories underlying the development of TTH: psychogenic, vascular, myofascial, biochemical and neurogenic. At the same time, a neurobiological theory has been considered: it combines some of the mechanisms of previously studied pathogenetic theories of TTH. In addition, there are the most important (from the clinical point of view) mechanisms of the comorbidity of TTH and AH, which underlie the development of the TTH + AH phenotype. In terms of these mechanisms, in recent years, it is of scientific interest to study the role of nitric oxide (NO) and NO-synthases, since they play an important role not only in the development of the comorbidity of two diseases simultaneously existing in one patient (phenotype «TTH and AH», but also in modulating the response to drugs for the treatment of TTH and AH. Modulators of NO and NO-synthases, which have been developed in recent years, can improve the efficacy and safety of therapy for this phenotype.Conclusion. New approaches to predicting and disease-modifying therapy of the TTH and AH phenotype can increase the efficiency and safety of treatment, and improve the quality of life of patients, and reduce the risk of cardiovascular complications.
Cognitive dysfunction is one of the manifestations of the neurological complications in coronavirus infection. In this article, we have collected material on the state of cognitive functions aft er suff ering a coronavirus infection with aspects of possible pathogenetic mechanisms and a discussion on the prospects for treatment and rehabilitation. The COVID-19 pandemic, having manifested itself in December 2019, remains one of the most controversial topics in the world to the day. Th e growing number of reports about damage to the nervous system during coronavirus infection suggests that the virus is neurotropic. In the clinical picture of the disease, less attention is paid to such symptoms as severe weakness, fatigue, memory impairment. At the same time, it is this symptomatology that most oft en accompanies patients in the postcovid period and signifi cantly reduces their quality of life, thereby making it difficult to adapt to social and work activities. Th e search was conducted for literatures published within the period from 2020 to the third quarter of 2021, domestic and foreign sources from the Web of Science, PubMed databases were analysed. The search queries were the following ones: “COVID-19”, “cognitive impairment”, “postcovid syndrome”.
The aim of the research is to study the structure of cardiovascular continuum within comorbid pathology within outpatient clinic of Krasnoyarsk; to evaluate the quality of out-patients management in accordance with modern clinical guidelines. Material and methods. To conduct a single retrospective analysis, 1928 medical records of Krasnoyarsk cardiovascular out-patients were taken. All the patients consulted local therapists in 2018. Differences were statistically significant at p <0.05. Results. Comorbid pathology is observed in patients with CVD in 87% of cases, and its growth is noted with age. It was revealed that ischemic heart disease (CHD) and obesity are associated with type 2 diabetes mellitus (DM-2). When using antihypertensive therapy, 43.2% of patients achieved blood pressure (BP) values <140/80 mm Hg. In 46.8% of cases, patients who were prescribed statins had total cholesterol (TC) values <5.0 mmol / L. Only 18.5% of patients with DM-2, following lipid-lowering therapy had a total cholesterol level <4.5 mmol / L, that was also registered only in 15.9% of patients with chronic kidney disease (CKD). Heart rate (HR) <80 beats / min was observed in 75% of patients taking drugs of b-blocker group. Conclusion. Cardiovascular comorbidity among patients is widespread and its rates are evidenced to increase with age. Antihypertensive, lipid-lowering and antithrombotic therapy do not fully comply with current clinical guidelines. It is necessary to individualize the approach to patients with combined pathology; to provide comprehensive diagnosis, treatment, and to inform the population on primary and secondary prevention adequately
Study Objective: To identify the impact from the pneumonia-complicated COVID-19 coronavirus infection over patients’ cognitive functions. Study design: Perspective study. Materials and Methods. We examined 32 patients with COVID from the study group on days 2–3, 8–10 in inpatient settings, after 2 months of hospitalisation vs 30 healthy controls. Cognitive functions were evaluated using the following neuropsychologic tests: Montreal Cognitive Assessment (MoCA), Mini Mental State Examination (MMSE), Frontal Assessment Battery (FAB), The Clock-drawing Test (CDT). Signs of anxiety and depression were screened using the Hospital Anxiety and Depression Scale (HADS). Study Results. During the acute and recovery periods, patients from the study group demonstrated statistically significant cognitive disorders as per MMSE, MoCA, FAB vs controls (p < 0.001). On days 2–3 and 8–10 in inpatient settings, MMSE was 22 [22; 29] and 22 [19.2; 23.7] points; MoCA — 26 [21; 28] and 21 [18; 23] points, FAB — 13 [10; 18] and 10 [8; 12] points; in 2 months after hospitalisation, MMSE was 29 [26.8; 30] points (р = 0.008 vs days 2–3 and 8–10), MoCA — 25 [22; 27] points (р = 0.03 vs days 8–10), FAB — 16 [14.5; 17] points (р = 0.004 and р = 0.02). The condition of cognitive functions measured during the acute period of the disease worsened even more by days 8–10 of hospitalisation and tended to normalise in 2 months. As per HADS, there were no abnormal findings; therefore, the patients were neither anxious, nor depressed, and the median was 8 points. СDT values were normal as well, both in acute period and during recovery. Conclusion. The coronavirus infection impacts the cognitive status. For cognitive dysfunctions, neuroprotectives and non-drug cognitive rehabilitation can be recommended. Cognitive dysfunctions are quite an expected independent syndrome, the course of which is not directly associated with somatic recovery. Keywords: COVID-19, cognitive disorders, coronavirus infection, pandemic.
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