Ryazan State Medical University

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have transformed the management of obesity, demonstrating significant efficacy in inducing weight loss and improving metabolic parameters. However, emerging clinical and paraclinical evidence suggests that these agents may also contribute to an unintended reduction in skeletal muscle mass, potentially exacerbating or precipitating sarcopenic obesity, particularly in older or frail individuals with limited muscular reserves. This review critically examines current data on the effects of GLP-1 RAs on body composition, explores the underlying pathophysiological mechanisms of skeletal muscle wasting, and offers evidence-based strategies for attenuating these potential adverse outcomes. While GLP-1 RAs therapy remains central to obesity management, optimizing its use through early recognition and management of associated risks is essential to preserve muscular health, patient functional status and quality of life.

Despite the success of cognitive behavioural therapy for insomnia and recent advances in pharmacotherapy, many patients with insomnia do not sufficiently respond to available treatments. This review article aims to present the state of science regarding the use of physiotherapy approaches in treating insomnia. To this end, we searched MedLine, Embase and PsycINFO from inception to 30 May 2024. We evaluated studies that compared conditions of active physiotherapy with a control condition or group. Outcome measures included standardized insomnia questionnaires and/or polysomnography in adults with a clinical diagnosis of insomnia. The search results have been translated accordingly and adapted to Russian evaluation conditions. Many foreign methods correspond to Russian developments, and are even inferior to them in some characteristics, but the lack of evidence often made it impossible to mention them as procedures with proven effectiveness.