Pirogov Russian National Research Medical University (formerly known as Russian State Medical University or RSMU) is a medical education institute in Moscow, Russia founded in 1906. It is fully accredited and recognized by Russia's Ministry of Education and Science and is currently under the authority of the Ministry of Health and Social Development.Named after Russian surgeon and pedagogue N.I. Pirogov (1810-1888), it is one of the largest medical institutions and the first university in Russia to allow women to acquire degrees. It is especially notable in comparison to Moscow's other two premier medical universities in that it focuses on gearing students for careers in medical and scientific research, rather than medical practice.
The quest for advanced hard materials with enhanced ductility drives the exploration of novel ternary borides. In this study, we use evolutionary algorithm USPEX combined with ab initio calculations to systematically investigate the ternary W–Nb–B system. Our results successfully reproduce all known stable binary compounds and reveal a new structural motif for NbB2 (space group R 3̅ m). Building on this motif, we predict a series of thermodynamically stable and metastable ternary compounds forming a continuous WxNb1 – xB24 solid solution, with the 50
The paper presents the results of a study of the outflow of non-wetting liquids: distilled water (water) and 0.9
Asthenic disorder in children and adolescents is a polyetiological condition characterized by a varied clinical picture with the dominant complaint of increased fatigue and rapid exhaustion, both mental and physical, which are persistent and last for a long period of time. It is reported that medical aid appealability rates due to asthenic symptoms achieve up to 64%. The prevalence of asthenic disorder in children and adolescents is extremely difficult to determine, as the numerous clinical symptoms are often viewed within the context of other diseases rather than as a single, hallmark pathology. The development of this condition is driven by challenging-to-differentiate functional and organic disorders that arise secondary to other, diverse pathologies. Dysfunction of the reticular activating system (RAS) is one of the primary mechanisms underlying asthenic syndrome. Severe manifestations of asthenic disorder which result in the significant impairment of daily activities and considerable deterioration of the patient's quality of life for more than 6 months are considered as a separate nosological entity — chronic fatigue syndrome (CFS). Genes regulating the hypothalamic-pituitary-adrenal (HPA) axis that is the body's main way of responding to stress are believed to be involved in the development of CFS. A single component failure can disrupt the entire system and contribute to the development of increased fatigue. Asthenic disorders are one of the common symptoms in patients who have suffered a traumatic brain injury (TBI). N-acetylaspartate (NAA) is seen as one of the markers of nerve tissue damage and repair in traumatic brain injury. Research on the role of NAA in the development of asthenic disorders is of great interest. Brain magnetic resonance spectroscopy (MRS) has found specific neurochemical abnormalities that can potentially be treated with agents targeting metabolic disturbances identified in the central nervous system. The search for new physiological and biochemical markers of asthenic syndrome will expand our understanding of the pathogenesis and treatment options for these disorders.
Arterial hypertension (AH) remains a leading risk factor for cardiovascular complications and cognitive impairment. Effective control of blood pressure (BP) significantly reduces the risk of stroke and coronary artery disease (CAD). However, in real-world clinical practice, achieving target BP levels is often complicated by comorbidities, poor treatment adherence, and neglect of the circadian BP profile, particularly morning BP surges, which are an independent predictor of cardiovascular events. Among antihypertensive drugs, angiotensin II receptor blockers (ARBs) hold a special place due to their proven cerebroprotective effects. Candesartan, one of the most extensively studied representatives of this class, not only effectively lowers BP but also slows the progression of cognitive impairment and significantly reduces the risk of stroke. The presented clinical case demonstrates the potential for treatment optimization in a patient with long-term uncontrolled AH, CAD, obesity, and established cognitive impairment. Given the presence of morning BP surges and cognitive dysfunction, the patient was prescribed candesartan 16 mg/day in combination with bisoprolol, indapamide, and atorvastatin. For secondary prevention of thrombotic complications, acetylsalicylic acid (ASA) combined with magnesium hydroxide was chosen, which preserves the high bioavailability of the immediate-release ASA formulation while simultaneously providing gastric mucosal protection. After 9 months of therapy, target BP levels were achieved, morning BP surges were eliminated, and improvements in cognitive function and regression of left ventricular hypertrophy were observed. Thus, candesartan, due to its cerebroprotective properties and ultra-long duration of action, is the drug of choice in comorbid patients with AH and cognitive impairment. The combination of ASA with magnesium hydroxide provides an optimal balance of antiplatelet efficacy and gastroprotection.
