Medical Journal of the Russian Federation

BACKGROUND: Recent research is increasingly focusing on the development of novel cognitive stimulation approaches that can be applied in the early post–cardiac surgery period. The wider use of these approaches may be facilitated by evaluating their effectiveness and testing them in clinical settings.

AIM: This study aimed to investigate changes in the cognitive status of patients after coronary artery bypass grafting (CABG) with cardiopulmonary bypass under a dual-task cognitive stimulation program, as well as to assess the feasibility of using this program in the early postoperative period.

METHODS: The study included 25 patients: a training group (n = 9) who underwent 5 to 7 sessions of the cognitive stimulation program and a non-training group (n = 16) who received standard postoperative care. The inclusion criteria were elective CABG with cardiopulmonary bypass and an age range of 45–75 years. Patients had to provide informed consent. Patients with dementia, depression, acute cerebrovascular accidents, or a history of traumatic brain injury were excluded. The cognitive stimulation program was administered daily from post–CABG day 3 until discharge and consisted of two tasks performed simultaneously: a complex visual-motor task and a verbal one. All patients underwent two extended neuropsychological assessments, including assessments of neurodynamics, memory, and attention: 2 or 3 days before CABG, and on post–CABG day 11 or 12. Postoperative cognitive dysfunction was assessed using the 20–20 criterion defined as a 20% decline in at least 20% of the tests administered during the extended neuropsychological assessment.

RESULTS: On day 11–12 after surgery, postoperative cognitive dysfunction was reported in 44.4% of patients in the training group and 75% of patients in the non-training group (p = 0.06). Patients who underwent the cognitive stimulation program made fewer errors on the complex sensorimotor reaction test (p = 0.04) and were more likely to recall more words and figures. They also showed better results in attention span (p = 0.04) compared with the non-training group. Additionally, the training group showed lower rates of a 20% decline in attention (p = 0.04) and short-term visual memory scores (p = 0.02).

CONCLUSION: Patients who underwent the cognitive stimulation in the early post–CABG period demonstrated lower rates of cognitive decline in attention and short-term memory. These findings could be used to develop and implement cognitive stimulation methods in clinical practice.

Rheumatoid arthritis is a severe chronic disease affecting the joints. It is associated with autoimmune imbalance and synovial inflammation. Despite the use of biological agents, a significant proportion of patients remain refractory to standard therapy. Consequently, the development of monoclonal antibodies against novel targets and the application of nanotheranostics to improve therapeutic efficacy and selectivity are of particular interest.

This work aimed to critically review promising future therapeutic targets for monoclonal antibody–based treatments—interferon gamma, granulocyte–macrophage colony-stimulating factor, interleukin-7 receptor alpha, bile salt–stimulated lipase, and programmed cell death receptor-1—and to assess nanotheranostic approaches as a means to improve the treatment of rheumatoid arthritis.

Novel monoclonal antibodies against inflammatory effectors, including emapalumab, otilimab, OSE-127, SOL-116, and peresolimab, may reduce rheumatoid arthritis progression and improve clinical outcomes. However, the nonspecific action of monoclonal antibodies toward autoreactive cells can cause severe adverse effects, necessitating more advanced approaches such as nanotheranostics. Current trends in the treatment of rheumatoid arthritis show increasing use of nanomaterials, particularly liposomes, delivered via monoclonal antibodies. The efficacy of such combinations may be improved by drugs encapsulated within liposomes, such as small noncoding RNAs capable of suppressing specific genes responsible for the development and persistence of rheumatoid arthritis. Targeted localization and internalization of liposomal contents can be activated by physical factors, including infrared radiation and ultrasound, or achieved through targeting receptors overexpressed on autoreactive cells that are capable of internalization into the cellular compartment.

The integration of monoclonal antibodies with nanomaterials as drug carriers represents a promising direction in the treatment of rheumatoid arthritis, providing greater selectivity, safety, and potential for personalized treatment. Further development of these strategies may significantly improve outcomes and quality of life in patients resistant to standard therapies.

Medical clearance for sports serves not only as a measure to protect the athlete’s health and life, but also as a legal act that requires compliance with a range of legislative and advisory documents. Lack of awareness of these regulations can lead to adverse consequences for the athlete, coach, sports team, and physician.

A search and analysis of current (as of August 2025) regulatory and legal documents concerning medical clearance for sports at various stages of athletic training, as well as for national team athletes of the Russian Federation, were conducted.

Sources were identified using the legal reference service with expert support Kontur.Normativ, the Russian scientific electronic library eLIBRARY.RU, and the biomedical research database PubMed. Additionally, the results of an anonymous online survey of 205 sports medicine physicians—subscribers of the Telegram channel Medical Office of the Sports Physician—were analyzed.

The review addresses the following issues: which institutions and specialists are authorized to issue medical clearance for different sports and stages of athletic training; the scope of examination required for clearance; and the established forms of medical authorization for training and competition. The article also discusses the issue of improper medical clearance, including cases involving specialized physicians, which, according to the online survey of 205 sports medicine doctors, significantly complicates the work of sports physicians.

It was found that in Russia, medical clearance for training and competition falls under interdepartmental regulation and is governed by federal laws; presidential decrees and directives; orders of the Ministry of Health of the Russian Federation, the Federal Medical-Biological Agency, the Ministry of Labor and Social Protection of the Russian Federation; the Labor Code of the Russian Federation; as well as 20 advisory documents.

BACKGROUND: Urticaria remains a relevant issue in modern medicine, including pediatric practice. The prevalence of chronic urticaria among children under 15 years of age is approximately 1.1%. A rare form of chronic inducible urticaria is solar urticaria, which accounts for about 0.5% of chronic urticaria cases. Solar urticaria most often manifests with typical symptoms such as erythema and wheals. However, severe cases have been described, accompanied by headache, dizziness, nausea, bronchospasm, hypertension, tachycardia, and pronounced allergic reactions up to anaphylactic shock—particularly when large areas of the skin are exposed to the provoking light spectrum. Despite the distinctive clinical manifestations, diagnosing solar urticaria poses a challenge, especially in infants and young children. An additional difficulty in pediatric patients is the lack of standardized provocation diagnostic tests, which use is limited by ethical and legal considerations. This clinical case of solar urticaria in an infant underscores the importance of early diagnosis for timely management of this rare form of chronic urticaria.

CASE DESCRIPTION: This article presents a clinical case of solar urticaria in an infant. From the first weeks of life, the mother noted facial redness after walks in sunny weather. At the age of 1.5–2 months, erythema was accompanied by wheals and itching on the face, prompting consultation with a pediatrician and subsequently an allergist-immunologist. The therapeutic approach included laboratory testing, differential diagnosis, and treatment measures. After diagnosing solar urticaria, implementing appropriate elimination measures, and providing adequate symptomatic therapy, a stable remission was achieved.

CONCLUSION: This rare clinical case of solar urticaria in a 2-month-old infant confirms the need for timely differential diagnosis and referral to a specialist for verification of the diagnosis and initiation of appropriate treatment measures. Adherence to therapy by the child’s parents plays a crucial role in disease management.