[Psychoneurological disorders in acute intoxications by psychotropic drugs and their correction using hyperbaric oxygenation].

The paper presents the results of a study of the clinical features of psychoneurological disorders in 178 patients with acute intoxications by various psychotropic drugs. Hyperbaric oxygenation showed positive changes in psychopathological syndromic kinesis. A sanogenetic rationale is provided for the method of choice in treating this category of patients.

[The specific features of the development and course of toxicohypoxic encephalopathy in acute poisoning by neurotoxic agents].

The time course of changes in the development of toxicohypoxic encephalopathy in acute poisoning by neurotoxic agents was studied. Programmed treatment using efferent detoxifying, physio- and chemohemotherapy, and hyperbaric oxygenation and cytoflavin was proposed.

[Transcranial electrical stimulation in the treatment of toxicohypoxic encephalopathy at the early stage of inpatient rehabilitation].

The authors studied the time course of clinical and neuropsychological changes in the use of transcranial mesodiencephalic modulation in the complex treatment of patients with acute poisoning by neurotropic toxicants, which were complicated by toxicohypoxic encephalopathy. The findings suggest the beneficial impact of this technique on the autonomic functions of the brain stem, on the body's adaptive capacities and the psychoemotional sphere, which makes it possible to recommend the programmed use of this method in such patients.

[General issues of medical care in multiple trauma]. / Obshchie voprosy okazaniia meditsinskoi pomoshchi pri sochetannoi travme.

Experience in diagnosis and treatment of patients with combined trauma is presented. The clinicoanatomic classification of combined traumas with their division into 7 groups is proposed. The process of medical care is subdivided in 4 stages - prehospital, critical care, specialized clinical and rehabilitation. The number of patients and their qualitative characteristics at each stage are different. The majority of the lethal outcomes occur at prehospital and critical care stages. Improvement of medical care at the prehospital stage may be realized trough creation of diagnostic and treatment algorithms, at critical care stage - by adequate infusion-transfusion therapy and determination of surgical care priority. Prophylaxis and treatment of complications are very important at the second and third stages. At the rehabilitation stage 84,6% patients need treatment of locomotor lesions, 14.5% - damages of the brain, 0.5% - damages of the spinal cord. Traumas of the thorax and the abdomen don't require long rehabilitation.

[Time course of toxic hypoxic encephalopathy during combined therapy including hyperbaric oxygenation]. / Dinamika toksikogipoksicheskoi éntsefalopatii pod vozdeistviem kompleksnogo lecheniia s primeneniem giperbaricheskoi oksigenatsii.

The mechanisms of action of hyperbaric oxygenation (HBO) in toxic hypoxic encephalopathy (THE) were studied using clinical psychopathological examinations, functional and laboratory tests in 268 patients with THE treated by a therapeutic complex including HBO and 75 patients with THE treated routinely (controls). The earliest possible addition of HBO to a complex of treatment of THE patients led to involution of signs of brain edema shown by computer tomography (CT) and improvement of its functional activity, while in patients exposed to HBO later the psychoorganic symptoms and CT signs of cerebral ischemia did not disappear. Detoxifying, neuroimmunomodulating, and neuroimmunostimulating effects of HBO in THE were demonstrated. Early HBO treatment decreased the dysfunction of various compartments of the brain characteristic of THE. The technology of HBO developed by the authors prevented the development of socially dysadapting psychoneurological disorders and reduced the mortality of THE patients.

[Hyperbaric oxygenation as a method of intensive therapy in acute exogenous poisoning]. / Giperbaricheskaia oksigenatsiia kak metod intensivnoi terapii pri ostrykh ékzogennykh otravleniiakh.

Hyperbaric oxygenation (HBO) was used in intensive care of patients with acute exogenous poisonings. Impaired oxygen homeostasis was pathogenetically significant, irrespective of the toxic agent. HBO added to a complex of intensive care measures was pathogenetically justified and promoted normalization of clinical and biochemical parameters of homeostasis.

[Role of hyperbaric oxygenation in the treatment of posthypoxic encephalopathy of toxic etiology]. / Rol' giperbaricheskoi oksigenatsii v lechenii postgipoksicheskoi éntsefalopatii toksicheskogo geneza.

Hyperbaric oxygenation (HBO) was used in the treatment of 475 patients with toxic encephalopathy (TE) developing as a result of exo- and endotoxicosis. HBO promoted correction of all components of homeostasis, decreased endotoxicosis, reduced psychopathological and neurological disorders, and promoted social adaptation.

[Hyperbaric oxygenation in the treatment of patients with drug addiction, narcotic addiction and alcoholism in the post-intoxication and abstinence periods]. / Giperbaricheskaia oksigenatsiia v lechenii bol'nykh narkomaniei, toksikomaniei i alkogolizmom v postintoksikatsionnom i abstinentnom periode.

Hyperbaric oxygenation was used in the treatment of 340 patients with narcomania, toxicomania, and alcoholism in the post-intoxication and abstinence periods; 223 of these were alcoholics, 68 toxicomaniacs, and 49 opium narcomaniacs. A group of 185 patients administered drug therapy alone were controls. Exposure to hyperbaric oxygenation had a favorable effect on the patient's status during sessions and persisted for some time after them. Patients with different premorbid symptoms and initial status experienced tranquilizing or bioenergizing effects of hyperbaric oxygen. A comparative clinical and psychopathological examination of patients in both groups showed accelerated reduction of psychoneurological and somatovegetative disorders, this bringing about an approximately twofold decrease of treatment duration and preventing the development of complications. The parameters of central hemodynamics normalized and myocardial status improved, which helped prevent the development of cardiovascular decompensation. Such a favorable time course of events appears to be due to the antihypoxic detoxifying and bioenergetic effects of hyperbaric oxygen.

[Effect of hyperbaric oxygenation on the dynamics of the alcohol abstinence syndrome]. / Vozdeistvie giperbaricheskoi oksigenatsii na dinamiku alkogol'nogo abstinentnogo sindroma.

Hyperbaric oxygenation (HBO) was used in 40 patients with the alcoholic abstinence syndrome (AAS), Stages I and II severity, either as a component of multiple modality (in combination with drugs) or the only treatment. The results of clinico-psychoneurological examination have demonstrated that the use of HBO in the treatment of patients with the AAS significantly accelerates the time of AAS elimination as compared with the control group receiving drug therapy alone. An HBO session markedly reduces psychoneurological and somatovegetative symptomatology which is attended by a reduction in systolic blood pressure and in the heart rate. Analysis of the electrocardiographic findings obtained in patients with alcoholic involvement of the heart at the height of the AAS has shown that HBO helps improve the myocardial status. The best results are achieved in patients with Stage II AAS when HBO therapy (two sessions daily) is started at early stages of the syndrome.

[Clinical effectiveness of hyperbaric oxygenation in the combined treatment of patients with schizophrenia]. / Klinicheskaia éffektivnost' giperbaricheskoi oksigenatsii v kompleksnom lechenii bol'nykh shizofreniei.

Hyperbaric oxygenation (HBO) was employed in 50 schizophrenic patients showing resistance to the conducted drug therapy. Thirty-two patients had shift-like and 18, sluggish, moderately and slowly progressive forms of schizophrenia. HBO treatment was always combined with psychopharmacotherapy. The results of the study have shown the advisability of inclusion of HBO into the multiple-modality treatment of patients with asthenic and apathetic depressions encountered during a shift-like or sluggish, schizophrenia with hysteric-hypochondriac disturbances and obsessions. The maximum therapeutic effect was observed after 10-12 sessions of HBO.