Saratov JOURNAL of Medical and Scientific Research

Samara State Medical University

Preliminary results of study on efficacy of a virtual reality technique for restoration of lower extremity motor function in patients in acute stage of stroke

Year: 2019, volume 15 Issue: №1 Pages: 172-176
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Zakharov A.V., Khivintseva E.M., Pyatin V.F., Kolsanov A.V., Chaplygin S.S., Osminina E.A., Lahov A.S.
Organization: Samara State Medical University
Summary:

Objective: to study efficacy of using immersive virtual reality with proprioceptive sensory effects in the rehabilitation of static locomotor function in patients in acute stage of ischemic stroke. Material and Methods. The study included 33 patients in the acute stage of ischemic stroke in the carotid system. Patients were randomized into two groups, the main group additionally took exercises in immersive virtual reality with sensory stimulation. The course includes 10 sessions 15 minutes each. The comparison group received standard rehabilitation assistance. Results. According to Berg balance scale an improvement in static locomotor function was noted in the main group on the 6th day of exercises (p=0.03). The differences between both groups on the last day of rehabilitation course showed an

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Autonomic dysfunction in patients with chronic cerebral ischemia

Year: 2019, volume 15 Issue: №1 Pages: 167-172
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Khivintseva E.V., Zakharov A.V., Vasemazova E.N., Ananyeva S.A.
Organization: Samara State Medical University
Summary:

Various autonomic nervous system (ANS) disorders exist in 25-80% of the general population. Seniors affected by chronic cerebral ischemia (CCI) are subject to the development of autonomic disorders. Purpose: to carry out the analysis of autonomic dysfunction in subjects with CCI. Material and Methods. Autonomic status was evaluated using autonomic function tests. All patients underwent cardiointervalography. Heart rhythm variability was estimated by mode, amplitude, variation range, power of waves of various frequency, coefficient of vagosympathetic balance etc. as measured by "Rhythm-MET" system. One hundred fifty one patients aged 48-93 years were examined and distributed to three groups depending on the degree of severity of CCI. Results were statistically processed using Statistica 6 software. Results. Patients with CCI had differences in autonomic function parameters which had multidirectional character and were dependent on sympathetic-parasympathetic balance and CCI stage. The obtained data demonstrate that prevalence of sympathetic influence was observed in 52.8% patients with I grade CCI, in 64.8% patients with II grade CCI and prevalence of parasympathetic

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Migraine and epilepsy: comorbidity and problems in diagnostics

Year: 2019, volume 15 Issue: №1 Pages: 154-158
Heading: Neurology Article type: Review
Authors: Kalinin V.A., Poverennova I.E., Yakunina A.V., Myakinina A.E.
Organization: Samara State Medical University
Summary:

The purpose of this review is to carry out the analysis of published data on comorbidity of migraine and epilepsy. The review is based on results of epidemiological and genetic studies. Clinical manifestations of two diseases are in many respects similar, which sometimes leads to considerable difficulties in diagnostics. Differential diagnosis is based on careful analysis of clinical manifestations, electroencephalography and neuroimaging data. Genetic forms of epilepsy are often accompanied by migrainous headaches. The unity of some pathophysiological mechanisms of epilepsy and migraine predefines comorbidity and directions of diagnostics and treatment for both diseases. Nevertheless, there is a number of questions which demand more precise answers to improve diagnostics and treatment.

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Influence of drinking behavior on the content of alpha-amylase of oral fluid in students with and without predictor of inflammation on the background of educational stress

Year: 2019, volume 15 Issue: №1 Pages: 9-13
Heading: Physiology and Pathophysiology Article type: Original article
Authors: Baisheva GM, Melnik KN.
Organization: Togliatti Clinical Hospital №5, Samara State Medical University
Summary:

 The aim: to study the content of a-amylase in oral fluid in healthy young people (mean age 18 years), depending on the presence of a predictor of inflammatory diseases of the oral cavity in physiologically adjusted drinking behavior against the background of educational stress. Material and Methods. For three months, we studied three groups: the main group (30 people, consumed water 30-35 ml per 1 kg of body weight treated with the electromagnetic device), a placebo group (30 people used water 30-35 ml per 1 kg of body weight, but consumed water with a placebo device that does not have an electromagnetic base) and a control one (25 people who do not change their water drinking behavior). To identify the features of sAA oscillations, all groups were divided into subpopulations with predictors of inflammatory diseases of the oral cavity (IL-1(3>212 pg/ml) and without such status (IL-1(3<212 pg/ml). The level of a-amylase activity was determined by a colorimetric method on Cobas C111 automated equipment (Roche), the concentration of IL-1J3 was detected by ELISA on an Infinity F50 photometer (Tecan). Results. Secretory alpha-amylase activity by the end of the study decreased in the main group; in the placebo and control groups, baseline values were exceeded. In the subpopulations with predictors of inflammatory dental diseases (IL-1(3<212 pg/ml) of the main group, the sAA activity decreased by 2.5 times; in the subpopulations without predicates of inflammatory changes (IL-1(3 <212 pg/ml), a significant decrease in enzyme activity in the main group was observed and an increase in the control. The percentage of sympathotonics at the end of the experiment in the main group was lower than in the placebo and control groups. Conclusion. A relation was found between a decrease in the level of a-amylase activity in the oral fluid and corrected water drinking behavior in a subgroup of people without predictors of inflammatory diseases of the oral cavity, using water in an amount of at least 30-35 ml/kg body weight that was purified by an electromagnetic method.

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Analysis of working conditions of employees of Samara medical institutions

Year: 2018, volume 14 Issue: №3 Pages: 427-433
Heading: Hygiene Article type: Original article
Authors: Tupikova D.S.
Organization: Samara State Medical University
Summary:

Objective: an analysis of the conditions and nature of the work of public health workers in the city of Samara, according to their own research and the results of a special assessment of working conditions for the development of preventive measures. Material and Methods. The study analyzed the results of assessing the factors of the production environment, such as microclimate and illumination in 70 rooms of two large medical institutions of the city of Samara. An estimation of the qualitative and quantitative microbial composition of the air medium in the analyzed rooms was carried out. The analysis of registration cards for a special assessment of the working conditions of workplaces in the same organizations was carried out between 2012 and 2017. Results. In analyzing the conditions and nature of the work of medical workers, it was revealed that the final class of working conditions for doctors and nurses of surgical departments was 3.3, therapeutic 3.2 as a result of biological factors. At the same time, the air in the working area of the study rooms of the surgical and therapeutic sections differed significantly in the structure of the conditionally pathogenic microflora. Physical and chemical factors did not exceed the level of class 3.1-3.2. Conclusion. An analysis of the results of the studies showed the need to optimize ventilation in the residents and nurses, as well as the need to improve the quality of natural and artificial lighting. The expediency of standardization of the conditionally pathogenic microflora of the air environment in class «B» premises is shown.

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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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Analysis of the coagulates intensity in laser treatment of diabetic macular edema in a Navilas robotic laser system

Year: 2017, volume 13 Issue: №2 Pages: 375-378
Heading: Ophtalmology Article type: Original article
Authors: Zamytskiy Е.А., Zolotarev A.V., Karlova E.V., Zamytskiy P.A.
Organization: Samara Regional Clinical Ophthalmological Hospital n.a. T. I. Broshevskiy, Samara State Medical University
Summary:

The aim ofthisworkwasto analyze the intensity of the laser coagulates in the treatment of diabetic macular edema conducted in navigation mode on robotic laser system Navilas. Material and Methods. Retrospective analysis of outpatient cards and photographs of the fundus 20 patients (28 eyes) had been done. The patients had type II diabetes mellitus. We performed laser treatment of diabetic macular edema. There were evaluated 4260 coagulates, of which 0 degree 2166 (50.85%), I degree —525 (12.32%), II degree —747 (15.74%), III degree—498 (11.96%), grade IV — 324 (7.6 per cent). Result. The thickness of the retina before treatment in the area of edema was made 339.72±45.3 urn, and after treatment 346±70 urn, student's t-test 0.7124, a difference of 6.5±57.4. Visual acuity before treatment 0.532±0.3, after— 0.521±0.3mm, student's t-test 0,889. Conclusion. The facts obtained in the analysis suggests that the algorithm of selection of power and the way it adjustments in the course of treatment are the weak point of this technique. Development of new methods, giving the possibility to adjust the power depending on the height of the swelling region of the retina, thereby gaining coagulates strictly necessary for the specific case of intensity, will enable to increase the efficiency and safety of laser treatment.

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Early detection of cognitive impairment in patients with multiple sclerosis

Year: 2017, volume 13 Issue: №1 Pages: 164-168
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Romanova T.V., Zakharov A.V., Khivintseva E.V.
Organization: Samara State Medical University
Summary:

The aim of the study was to examine cognitive impairment in patients with multiple sclerosis with an emphasis on the speed and efficiency of information processing. It was supposed to reveal the patterns of these disorders depending on the duration and severity of the disease. Material and methods. The study included 50 patients with established diagnosis of clinically significant multiple sclerosis, a relapsing-remitting course. The EDSS score was evaluated. Cognitive functions were assessed using SDMT and PASAT-3 tests. All patients underwent a study of cognitive evoked potential. All examined patients were divided into 2 groups depending on the duration of the disease. Results. Cognitive screening tests PASSAT and SDMT showed no correlation with the duration of the disease severity and cannot serve as a tool for screening early signs of cognitive impairment in young patients with multiple sclerosis. A significant increase in latency of the P300 potential was obtained with increasing duration and severity of the disease, which correlates with the severity of cognitive dysfunction. Conclusion. This study is the initial step in the search for a tool for screening early manifestations of cognitive impairment in patients with multiple sclerosis. In the future it is planned to expand the research with the modernization of its design.

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