Saratov JOURNAL of Medical and Scientific Research

2018, volume 14

Dynamics of acetylcholine receptors antibody titer in myasthenia gravis

Year: 2018, volume 14 Issue: №1 Pages: 164-168
Heading: Neurology Article type: Original article
Authors: Romanova T.V., Poverennova I.E., Zakharov A.V.
Organization: Samara State Medical University
Summary:

The aim was to examine the longitudinal association between myasthenia gravis clinical severity and concentration of acetylcholine receptor (AChR) antibodies to evaluate if AChR-antibody variations correlate to disease severity. Material and Methods. Antibodies were determined by enzyme immunoassay. The International Clinical Classification (MGFA) was used to grade the severity of the disease. The level of antibodies was compared with the severity of the condition and the form of the disease at the stage of diagnosis in 65 patients, as well as in repeated studies in 26 patients. Results. The titer of AChR-antibodies did not correlate with the severity of the condition, however, a direct relationship between the change in the level of acetylcholine receptor antibodies and the change in the clinical state during the course of the disease was obtained. Conclusion. Repeated AChR-antibody measurements will help to predict the clinical state of the patient and can be used to correct immunosuppressive therapy.

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Use of the scale of clinical expression of the stroke for determining the rehabilitation prediction

Year: 2018, volume 14 Issue: №1 Pages: 161-164
Heading: Neurology Article type: Original article
Authors: Repina L.A., Romanova T.V., Poverennova I.E.
Organization: Samara State Medical University
Summary:

The aim is to study the relationship between the parameters of neurological status and quality of life of patients who first underwent ischemic strokes in the carotid basin to predict the outcome of an acute cerebrovascular accident. Material and Methods. 73 patients with ischemic stroke in the carotid artery basin were examined. Analyzed indices of the scales, reflecting the severity of motor deficit (NIHSS, Rankin, Rivermead, Fugl-Meyer), the initial evaluation and parameters of quality of life using the questionnaire SF-3624-36 months after inpatient treatment. Patients were divided into groups of favorable and unfavorable outcome according to the questionnaire SF-36. Results. A direct correlation between the level of physical and psychological health and indicators Of the Fugl-Meyer scale and a negative correlation between the level of psychological health and the severity of stroke on the NIHSS scale in a group with an adverse outcome was revealed. Conclusion. Indicators scales Fugl-Meyer, and NIHSS obtained in the acute period of ischemic stroke can be used to build a predictive model of outcome of stroke.

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Multimodal evoked potential in monitoring activity relapsing and remitting multiple sclerosis

Year: 2018, volume 14 Issue: №1 Pages: 157-160
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Zakharov A.V., Khivintseva E.V.
Organization: Samara State Medical University
Summary:

The aim of the study was to examine multimodal evoked potential in patients with or without relapse
multiple sclerosis during 12 month. Material and Methods. The study included 32 patients with
established diagnosis of clinically significant multiple sclerosis, a relapsing-remitting course. The EDSS
score was evaluated. All patients underwent a study of multimodal evoked potential. All examined
patients were divided into 2 groups depending on the relapse multiple sclerosis by the end of the year.
Results. Multimodal evoked potentials show ambiguous data on the activity of multiple sclerosis. The
greatest correlation with subsequent activity of multiple sclerosis is shown by stem evoked potentials.
Conclusion. This study is the initial stage in the search for a tool for predicting the course of the disease
in patients with multiple sclerosis. An increase in the group of subjects and inclusion in the analysis of
structural changes in the central nervous system according to magnetic resonance imaging probably will
increase the information content of predictions.

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"Benign" multiple sclerosis: a variant of favorable disease course and the result of effective treatment

Year: 2018, volume 14 Issue: №1 Pages: 153-156
Heading: Neurology Article type: Review
Authors: Makarov N.S., Kolokolov O.V.
Organization: Saratov State Medical University
Summary:

The article provides an overview of data on isolated demyelination syndromes that may precede multiple sclerosis, and on the peculiarities of the so-called "benign" form of multiple sclerosis. Clinical and anamnestic criteria for establishing the fact of a "benign" form of multiple sclerosis are presented, as well as trends in the number of these patients in the general population of patients with multiple sclerosis, including in connection with the improvement of treatment methods for this disease.

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Features of psychoemotional disorders in patients with multiple sclerosis in different clinical and demographic groups

Year: 2018, volume 14 Issue: №1 Pages: 151-153
Heading: Neurology Article type: Short message
Authors: Lukina E.V., Chernysheva О.А., Eliseeva V.A.
Organization: Saratov State Medical University
Summary:

Purpose: to conduct an analysis of psychoemotional disorders in patients with multiple sclerosis, who are not receiving any treatment for these disorders. Material and Methods. A cohort of patients with a reliable diagnosis of multiple sclerosis, according to the criteria of С Poseur, consisting of 163 people, was selected for the research. A four-dimensional symptomatic questionnaire was used to assess distress, depression, anxiety and somatization (4DSQ) and a self-questionnaire for evaluating the symptoms of fibromyalgia with quantitative measures (WPI, SS, FS). Re-sults. Differences in the average values of the level of distress, depression, anxiety and somatization in patients with multiple sclerosis of different sex, age, with different type of course and duration of the disease are shown. Conclusion. The neuropsychological status of patients depends on the type of course of the disease, the level of distress — from age and sex, the level of somatization —from the age of this category of patients. In the complex treatment of this category of patients it is necessary to use symptomatic treatment in addition to pathogenetic therapy, which has not only neurotrophic and vasoactive effects, but also affects the psychoemotional background of patients.

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The possibility of using low-intensity helium-neon laser radiation in the treatment of patients with trigeminal neuralgia

Year: 2018, volume 14 Issue: №1 Pages: 149-150
Heading: Neurology Article type: Original article
Authors: Lukina Е.М., Kolesov V.N., Skulovich S.Z., Chernysheva O.A.
Organization: Saratov State Medical University
Summary:

Purpose: to evaluate the effectiveness of low-intensity helium-neon laser radiation in patients with trigeminal neuralgia. Material and Methods. With the help of low-intensity helium-neon laser radiation, 76 patients with trigeminal neuralgia were treated. For this purpose, helium-neon laser devices AFL-1 and AFDL-1 with a wavelength of laser radiation of 0.63 microns were used, the power flux was 20-25 mW. Results. It is shown that as a result of treatment with this type of radiation in most cases, both nociceptive and neuropathic components of the pain syndrome are stopped. Conclusion. For the management of pain syndrome in trigeminal neuralgia, it is advisable to use low-intensity laser radiation in complex treatment.

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Тhe efficiency of complex treatment of different variants of myasthenia gravis

Year: 2018, volume 14 Issue: №1 Pages: 145-148
Heading: Neurology Article type: Original article
Authors: Lapshina O.V., Antipenko Е.А., Gustov A.V.
Organization: Privolzhskiy Research Medical University
Summary:

The aim: to evaluate the effect of complex restorative treatment on clinical manifestations and the state of oxidative homeostasis in patients with different variants of myasthenia gravis. Material and Methods. The analysis of indicators of biochemiluminescence, muscle strength according to the scales QMGS and MG-ADL, instrumental methods of research (ENMG and respiratory function) before and after treatment in 117 patients with myasthenia gravis is carried out. For comparative analysis of independent samples was used Mann — Whitney U-test, and for paired comparisons was used the Wilcoxon test. Results. The dynamics of oxidative homeostasis, clinical picture, indicators of instrumental methods of research (ENMG, respiratory function) in patients with myasthenia gravis, without thymoma and underwent thymectomy on the background of complex treatment with the use of antioxidant therapy is presented. In all studied groups against the background of complex treatment with application of antioxidant therapy increase in activity of antioxidant protection of organism and decrease in activity of free radical oxidation that correlates with clinical improvement in all groups of patients is noted. Conclusion. The use of antioxidant therapy in complex rehabilitation of patients with myasthenia gravis is pathogenetically justified, especially in patients without thymoma.

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Features of the medical and social characteristics and anxiodepressive disorders in patients with little brain insult in the early recovery period

Year: 2018, volume 14 Issue: №1 Pages: 141-144
Heading: Neurology Article type: Original article
Authors: Kutashov V.A., Ulyanova O.V., Zakharov O.P.
Organization: Voronezh State Medical Academy
Summary:

The aim of the study was to study medical and social and anxiodepressive disorders (ADR) in patients with little brain insult (LBI) in the early recovery period. Materials and Methods. 140 patients were examined, the mean age of which was 57.2±2.2 years. The patients were examined in the early recovery period. Among the 140 patients with LBI, 62% were men and 38% women. The level of anxiety and depression was assessed using the Hamilton psychometric scales (HPMS). Results. In 6% of patients there are relatives who have undergone an acute cerebrovascular acident. 50% of patients live with their families, 27.2% lived with relatives and 22.8% lived alone. Only 25.5% of patients had a daily monitor blood pressure (BP), 17.8% of patients — several times a week and 17.8% of people — several times a month. In addition, 16.4% of patients are forced to measure BP in the health facility, since they do not have a personal tonometer. 26.4% of patients did not measure their BP. 16.4% measure blood pressure once a year. A high level of depression occurred in 3.57% of patients, an average level in 27.86% of patients, mild depression in 33.57% of patients and absence of depressive symptoms in 35% of patients. A high level of anxiety was found in 17.50% of patients with Ml, moderate anxiety level in47.86% of patients, low anxiety level in 45.00%, no anxiety in 1.43% of patients. Conclusion. In patients with LBI in the early recovery period a rather high level of ADR severity was revealed. That causes as early as possible the identification and administration of specific therapy for ADR with LBI.

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Clinical and epidemiological features of neuro-syphilis in Altai Territory (1999-2016)

Year: 2018, volume 14 Issue: №1 Pages: 136-140
Heading: Neurology Article type: Original article
Authors: Komkina N.G., Nazarenko N.V., Mikheyeva T.V., Ivanova Yu.A., Kazantsev I.V.
Organization: Altai Regional Diagnostic Center, Altay state medical university, The Altai Regional Clinic of Skin and Venereal Diseases
Summary:

Purpose: identification of tendencies of development of incidence of a neurosyphilis and structures of clinical forms of a late neurosyphilis in Altai Territory. Material and Methods. Materials of forms of the state statistical overseeing of 1999-2016 across Altai Territory, official statistical materials of the Department of monitoring, the analysis and strategic development of health care, Federal State Budgetary Institution Central Research and Development Institute of the Organization and Informatization of Health Care, contemporary records of medical institutions of Altai Territory are analysed. Results. The carried-out retrospective analysis of incidence of a lues in Altai Territory for the 18-year period of observations revealed tendencies to decrease in primary incidence of a lues with simultaneous increase in structure of late forms, including a late neurosyphilis that completely confirmed the model of development of epidemic process constructed earlier by authors. In structure of forms of a late neurosyphilis without symptomless neurosyphilis, symptomless meningitis and meningovascular forms of neurosyphilis came to light more often. Conclusion. The clinical picture of late forms of a neurosyphilis is mainly without symptoms character now. Among demonstrative forms the meningovascular forms as a predictor of cerebrovascular pathology at working-age is registered more often.

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Investigation of the oxidative status in patients with Parkinson's disease

Year: 2018, volume 14 Issue: №1 Pages: 132-135
Heading: Neurology Article type: Original article
Authors: Goncharova Z.A., Kolmakova T.S., Okseniuk O.S., Gelpey M.A., Isachkina N.S.
Organization:
Summary:

Currently, much attention is paid to the search for laboratory diagnostic tests for Parkinson's disease, which can be used to create a screening diagnostic panel. The aim of the research was to study markers of oxidative status in blood plasma and to correlate these indicators with the main clinical characteristics of Parkinson's disease. Material and Methods. The study included 32 patients of the main group and 21 patients as a control group. Blood was collected for the evaluation of total oxidative activity and general antioxidant status of the organism (OOAand OAA): determination of the activity of catalase, superoxide dismutase (SOD), malonic dialdehyde (MDA) in the blood serum by spectropho- tometric method. Results. The parameters of SOD, catalase, ОАА, OOA in patients with early stage of Parkinson's disease significantly differed from those of the control group Conclusion. Reduction of oxidative activity could slow down the development of the disease.

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