[Features of the clinical and neuroimaging picture in patients with early-onset Alzheimer's disease]. / Osobennosti klinicheskoi i neirovizualizatsionnoi kartiny u patsientov s bolezn'yu Al'tsgeimera s rannim nachalom.

The most common cause of severe cognitive impairment in adults is Alzheimer's disease (AD). Depending on the age of onset, AD is divided into early (<65 years) and late (≥65 years) forms. Early-onset AD (EOAD) is significantly less common than later-onset AD (LOAD) and accounts for only about 5-10% of cases. However, its medical and social significance, as a disease leading to loss of ability to work and legal capacity, as well as premature death in patients aged 40-64 years, is extremely high. Patients with EOAD compared with LOAD have a greater number of atypical clinical variants - 25% and 6-12.5%, respectively, which complicates the differential diagnosis of EOAD with other neurodegenerative diseases. However, the typical classical amnestic variant predominates in both EOAD and LOAD. Also, patients with EOAD have peculiarities according to neuroimaging data: when performing MRI of the brain, patients with EOAD often have more pronounced parietal atrophy and less pronounced hippocampal atrophy compared to patients with LOAD. The article pays attention to the features of the clinical and neuroimaging data in patients with EOAD; a case of a patient with EOAD is presented.

[The relationship between the development of post-stroke cognitive impairment and changes in the coagulation component of hemostasis]. / Svyaz' postinsul'tnykh kognitivnykh narushenii i izmenenii koagulyatsionnogo zvena gemostaza.

OBJECTIVE: To evaluate the relationship between the severity of post-stroke cognitive impairment (PSCI) and coagulation parameters assessed using the dynamic thrombophotometry. MATERIAL AND METHODS: Thirty-five patients with hemispheric ischemic stroke (IS) with moderate neurological deficit at admission were included. All patients underwent a comprehensive clinical and instrumental assessment according to the current guidelines. On days 10-14, the cognitive status of patients was assessed using the Montreal Cognitive Assessment (MoCA). Coagulation parameters were assessed using the dynamic thrombophotometry at admission, on 6-8th days and 13-15th days from the onset of the disease. A database of laboratory studies of 30 apparently healthy volunteers was used as a comparison group. RESULTS: Data analysis revealed that a number of spatial and temporal parameters were within the reference values, and there were no significant changes over time. Nevertheless, though the optical density of the fibrin clot (D) was within the reference values, it showed a steady increase from the admission by the end of the 1st week of the disease (p=0.007) and by 13-15th days (p=0.009). Correlation and multivariate linear regression, including baseline stroke symptom severity, showed significant associations (p<0.01 in all tests) between the higher optical density of the fibrin clot (D) on days 6-8 and 13-15 and lower MoCA score, confirming the negative effect of altered hemostatic parameters on cognitive function in IS patients. CONCLUSION: The increase of optical density of the fibrin clot (D) by 6-8th and 13-15th days is a potential prognostic biomarker for the early development of PSCI.

[Features of neuropsychological status and results of magnetic resonance morphometry in patients with Alzheimer's disease and glaucoma]. / Osobennosti neiropsikhologicheskogo statusa i rezul'taty magnitno-rezonansnoi morfometrii u patsientov s bolezn'yu Al'tsgeimera i glaukomoi.

OBJECTIVE: To identify the relationship of neuropsychological changes in patients with Alzheimer's disease (AD) and primary open-angle glaucoma (POAG) and to evaluate the results of magnetic resonance (MR)-morphometry in patients with these diseases. MATERIAL AND METHODS: We examined 32 patients (median age 67 [61.25; 76.75] years, 78.1% women) diagnosed with AD and POAG. The patients were divided into the AD group (n=16) and the POAG group (n=16). Complaints and anamnesis were collected for all patients, neurological status and neuropsychological status were assessed. MRI of the brain, followed by morphometry, was performed. RESULTS: Cognitive impairments (CI) were revealed in patients of both groups. The severity of CI in patients with AD was more pronounced than in patients with POAG (p<0.001). Alzheimer's type of CI was detected in both groups. MR-morphometry revealed a decrease in the volume of the left hippocampus, the volume of the right and left amygdala as well as a decrease in the thickness of the right and left entorhinal cortex in the AD group compared with the POAG group (p<0.05). A significant decrease in the thickness of the right medial orbitofrontal cortex was found in the POAG group compared with the AD group (p<0.05). CONCLUSION: In AD and POAG, there is a similarity of the neuropsychological profile, which reflects the neurodegeneration characteristic of these diseases. MRI morphometry requires an assessment of both volumes and thickness of brain structures. A neuroimaging pattern identified in patients with POAG can be regarded as an indicator of the glaucomatous process.

[Modern possibilities of early diagnosis of Alzheimer's disease in patients with primary open-angle glaucoma]. / Sovremennye vozmozhnosti rannei diagnostiki bolezni Al'tsgeimera u patsientov s pervichnoi otkrytougol'noi glaukomoi.

The article presents data on biomarkers for the early diagnosis of Alzheimer's disease (AD). Particular attention is paid to potential neuroimaging and ophthalmological markers, such methods of early diagnosis of AD as MRI with post-processing data processing and assessment of the volume of brain structures and cortical thickness - MRI morphometry, as well as optical coherence tomography are described. The article shows the relationship between AD and primary open-angle glaucoma and considers a case of AD in a patient with primary open-angle glaucoma.

[Factors Affecting the Stability of the Trimer of 2'-Deoxyuridine 5'-Triphosphate Nucleotide Hydrolase from Escherichia coli].

2'-Deoxyuridine 5'-triphosphate nucleotide hydrolase (Dut) hydrolyzes dUTP to dUMP and pyrophosphate to prevent erroneous incorporation of dUMP from the dUTP metabolic pool into DNA. Dut is considered as a promising pharmacological target for antimetabolite therapy. Enzymatically active Dut is a trimer that binds the substrate at the interface between the subunits. High-speed nanoscale differential scanning fluorimetry (nanoDSF) was used to study how various physicochemical factors affect the stability of the Escherichia coli Dut trimer. Unlike with monomeric proteins, thermal unfolding of Dut occurred in two steps, the first one corresponding to dissociation of the trimer into monomeric subunits. Hydrophobic interactions and hydrogen bonds at the interfaces between the subunits were found to contribute most to trimer stabilization. The binding of nucleotide ligands partly stabilized the Dut trimer. In general, nanoDSF is a convenient assay for screening low-molecular-weight compounds for their ability to destabilize the active Dut trimer.

[Focused ultrasound as a non-invasive method with therapeutic potential in patients with Alzheimer's disease]. / Terapevticheskii potentsial fokusirovannogo ul'trazvuka u patsientov s bolezn'yu Al'tsgeimera.

Alzheimer's disease (AD) is a common, progressive neurodegenerative disease characterized by abnormal deposition of ß-amyloid (Aß) and hyperphosphorylated tau protein. Despite the fact that biomarkers and methods of treating AD are currently being actively studied, there is still no therapy that can significantly reduce the progression of this disease. Therefore, the search for therapeutic disease-modifying strategies is becoming increasingly popular. One such strategy is the use of focused ultrasound (FUS) under MRI guidance using a contrast agent (microbubbles). Under the influence of low-intensity FUS, the blood-brain barrier (BBB) is temporarily opened, which is the main obstacle to the effective delivery of therapeutic compounds to the brain, imposing dimensional and biochemical restrictions on the passage of molecules. One of the processes associated with AD is BBB dysfunction, and therefore the study of the effects of FUS in patients with AD is of interest. The literature data show the effectiveness of FUS in animal models of AD. The researchers attribute the effectiveness of the method to the fact that exposure to FUS induces the opening of BBB and reduces the number of amyloid plaques. It has also been demonstrated that FUS can facilitate the delivery of therapeutic drugs to the brain. This allows considering FUS as a new non-invasive method of treatment. Further research is needed to assess the effectiveness of this method in patients with AD.

[Potential biomarkers of early diagnosis of Alzheimer's disease]. / Potentsial'nye biomarkery rannei diagnostiki bolezni Al'tsgeimera i pervichnoi otkrytougol'noi glaukomy.

Alzheimer's disease (AD) is a progressive neurodegenerative disease of the brain, in which there are cognitive and behavioral disorders, but also visual impairment can occur. Deposits of beta-amyloid (Aß) were also found in the retina of AD patients. At the same time, primary open-angle glaucoma (POAG) occupies the first place among geronto-ophthalmic pathologies in patients with AD. POAG, like AD, is a neurodegenerative disease. AD and POAG have common symptoms, and therefore several common principles for their early diagnosis can be developed. Therefore, a promising direction is the search for biomarkers for the early detection of AD and POAG. Currently, the diagnosis of early AD biomarkers in cerebrospinal fluid and biomarkers in the brain (imaging of amyloid plaques and tau positron emission tomography) are well studied, while data in literature on using these biomarkers in patients with POAG is scarce. However, the above diagnostic methods are not considered in routine clinical practice due to their invasiveness and high cost. There is a growing need for conventional, affordable biomarkers for AD and POAG, as it is necessary to start treatment of prodromal conditions from symptoms to onset of symptoms. In this connection, biomarkers such as Aß and tau protein in blood serum and plasma are actively evaluated in patients with AD. In patients with POAG, there is no published data on studies of these biomarkers, which requires scientific research. Many authors discover the role of sirtuins (SIRT) in aging and age-related diseases, such as AD, glaucoma, age-related macular degeneration, and others. Possibly, SIRT could become potential biomarkers of neurodegenerative diseases.

[The assessment of the efficacy of Ethoxidol treatment in patients with chronic cerebral ischemia]. / Otsenka effektivnosti primeneniya preparata Etoksidol u patsientov s khronicheskoi ishemiei mozga.

OBJECTIVE: To evaluate the clinical effects of ethylmethylhydroxypyridine malate (Ethoxidol) in patients with chronic cerebral ischemia in an outpatient practice. MATERIAL AND METHODS: 60 patients were examined, 58 patients with a diagnosis of cerebrovascular disease (chronic cerebral ischemia) completed the participation in the program. The average age of the patients is 61.2±8.2 years. Neurological complaints typical of patients with chronic cerebral ischemia were recorded. To assess the dynamics of neurological disorders during therapy were used: The Montreal Cognitive Assessment (MoCA), Multidimensional fatigue inventory (MFI-20), Berg Balance Scale (BBS), Tinnitus Handicap Inventory (THI), Clinical Global Impression of Improvement Scale (CGI). The doctors and the patients satisfaction with therapy was assessed using the Visual Analogue Scale (VAS); quality of life - by the VAS of the European Quality of Life Group (EQ-VAS). The course of therapy lasted 60 days. All patients received daily Ethoxidol chewable tablets 400 mg/day (2 tablets (200 mg) in the morning and 2 tablets (200 mg) in the evening). RESULTS: The results of the observational program showed high efficacy and good tolerability of Ethoxidol in patients with chronic cerebral ischemia. A statistically significant decrease in the severity of the clinical manifestations of chronic cerebral ischemia was noted as early as the 30th day of therapy, followed by maintaining a positive trend until the end of the course of treatment with the drug (60th day). On the therapy, the severity of asthenia, cognitive impairment, dizziness, balance disorders, and tinnitus decreased. There was a decrease in the severity of the condition and the presence of clinical improvement on the CGI scale; there was an increase in the quality of life of patients on the EQ-VAS scale. The majority of the patients and the doctors rated the therapy as effective and safe and were satisfied with it. No serious adverse events were reported. CONCLUSION: The data obtained allow us to consider Ethoxidol as an effective drug in the treatment of patients with chronic cerebral ischemia in an outpatient practice.

[Topical drugs for the treatment of non-streptococcal acute tonsillopharyngitis in children: results of a multicenter study]. / Topicheskie preparaty dlya lecheniya nestreptokokkovogo ostrogo tonzillofaringita u detei: rezul'taty mnogotsentrovogo issledovaniya.

INTRODUCTION: Acute tonsillopharyngitis (ATP) is a very common disease in children. In non-streptococcal ATP, systemic antibiotics are usually not indicated, but topical antimicrobial therapy is advisable. OBJECTIVE: To evaluate the effectiveness of the combination of cetylpyridinium chloride with gramicidin C in the form of a spray in children with ATP in a prospective multicenter non-interventional study.Patients and methods. The study included 94 patients aged 6-15 years with non-streptococcal ATP. A standard examination, assessment of the pain intensity in the throat using a visual analogue scale, assessment of the pain frequency during swallowing and a score assessment of objective manifestations were carried out. Sixty-eight patients of the main group received a combination of cetylpyridinium chloride with gramicidin C (Grammidin for children) in the form of a spray, 26 patients of the control group received throat irrigation with saline solution (based on sea water) for 7 days. Therapy was assessed after 1 day (by phone), 4 and 8 days (by examination). RESULTS: The groups of patients did not differ significantly in terms of demographic indicators and initial clinical manifestations. Body temperature initially did not differ, but was significantly lower in the main group after 1 (p=0.003) and 4 (p=0.04) days. The sore throat pain intensity decrease in the main group significantly exceeded this indicator in the control group after 1 (p<0.001) and 4 (p <0.001) days. Initially, swallowing pain was observed in all patients, after 4 days the complaint was significantly less frequent in the main group (p<0.001). The total assessment of objective data was significantly lower in the main group after 4 (p<0.001) and 8 (p<0.001) days. No adverse effects of pharmacotherapy were observed. CONCLUSIONS: The study showed high efficacy and safety of the cetylpyridinium chloride and gramicidin C (in the form of a spray) combination for non-streptococcal ATP in children aged 6-15 years.

[The role of pre-stroke cognitive disorders in the formation of post-stroke cognitive impairment]. / Predshestvuiushchie insul'tu kognitivnye narusheniia i ikh rol' v formirovanii postinsul'tnogo kognitivnogo defitsita.

AIM: To identify pre-stroke cognitive disorders and assess their influence on the post-stroke neuropsychological status of the patient. MATERIAL AND METHODS: The study included 103 patients in an acute state of ischemic stroke in the carotid system. Cognitive functions were assessed with MoCA and IQCODE. All patients are evaluated for the presence of vascular risk factors and their relationship to the cognitive impairment. RESULTS AND CONCLUSION: According to the MoCA, 89 (86.4%) patients in the acute state of ischemic stroke had cognitive impairment of varying severity. Out of 103 patients, 55 (53.4%) had cognitive impairment prior to onset of stoke, mostly of mild severity. Among the main risk factors that correlated with the presence of pre-stroke cognitive impairment were age, heart rhythm disturbances and heart failure.

[Extracellular lectins from saprophytic strains of bacteria of the genus Bacillus (review)].

The present review summarizes both the authors' own and other researchers' reports concerning the synthesis and properties of sialic acid-specific extracellular lectins from saprophytic bacteria of the genus Bacillus. Bacilli of this genus isolated from different ecological niches differ with regard to the ability to synthesize lectins. The biphasic temporal pattern of lectin synthesis in culture and the effect of cultivation conditions on lectin production have been demonstrated. The advantages of the technological procedure used for the isolation and purification of these biopolymers have been characterized. Specificity towards sialic acid, which is characteristic only of a small number of lectins from bacilli and underlies a wide range of biological effects of these proteins, receives particular attention. Adaptation mechanisms involving lectins--carbohydrate-recognizing proteins--are suggested to have developed in saprophytic bacilli to ensure the survival of these organisms in a constantly changing environment.

[Determination of carbofuran in the biological material for the purpose of forensic medical examination].

It is proposed to use the mixture of acetone and ethylacetate (1:1) as an universal solvent for the extraction of carbofuran from cadaveric tissues and fluids. Extracted carbufuran can be purified from endogenous admixtures on KSS No 3 Silica Gel columns (80/120 mcm) and identified using TLC, electron spectrophotometrty, HPLC, and GC-MS. The proposed method of forensic chemical analysis of carbofuran was applied for the purpose of forensic medical expertise.

[Patient care in programmed relaparotomy].

The authors have analyzed the results of treatment of 35 patients, in whom theylaparostoma put on. The mortality have constituted 45.7%. The attention was drawn on technical aspect of laparostomy establishment and closure, the issues of intestinal tubage and quantity of laparosanation conduction were discussed.

[Characteristic of extracellular lectin in Bacillus subtilis IMV B-7014].

The monosaccharide and fatty acid composition of water and organic phase of lectin was studied. It was established that extracellular lectin contains 15.0% of protein, 4.6% of carbohydrates, 1.0% of nucleic acids and 16.14% of lipids. The following monosaccharides were presented in the lectins: mannose, ribose, glucose and ramnose. It was established that both native lectin and its lipophylic fraction were composed of fatty acids from C15 to C19. During aggressive methanolysis anti-iso-C15 quantity was increased with a synchronous decrease of the content of all octadecanoic acid types.

[Sclerotherapy in surgical correction of varicocele].

The method of intraoperative sclerotherapy, using 40% glucose solution, for varicocele surgical treatment was proposed. Diathermocoagulation of all visible accompanying veins was conducted for reduction of the varicocele recurrence rate. The recurrence is reduced to 6.6%.

[Gangrene of Fournier, treatment, classification].

The experience of treatment with favorable outcome of 3 patients, in whom gangrene of Fournier was diagnosed, was summarized.The necessity of application of "agressive" surgical tactics in early terms of the disease was stressed.

[Characteristics of heritability and effect of selection on prevalence of diffuse-toxic goiter in population].

On genealogic data about 242 Gravers disease patients, fertility parameters of 2105 healthy and 369 Grave's disease women peculiarities of genetic determination and natural selection of disease were studied. Results of the genetic analysis have revealed conformity of Grave's disease inheritance to alternative model parameters. Homozygote penetrance within the framework of this model was 78.8%, heterozygote--17.3%. For one generation in the Kharkov area population frequency of a gene to Grave's disease predisposition increases 0.8%.