[Serum brain damage biomarkers as a diagnostic and prognostic tool in ischemic stroke]. / Syvorotochnye biomarkery porazheniya mozga kak diagnosticheskii i prognosticheskii instrument pri ishemicheskom insul'te.

OBJECTIVE: To study serum quantities of neuron specific enolase (NSE), glial fibrillary acidic protein (GFAP) and NR2-antibodies (NR2-ab) in various cerebrovascular pathology and assess their value as a panel used as a diagnostic and predictive tool for stroke. MATERIAL AND METHODS: NSE, GFAP and NR2-ab serum levels were measured twice for 84 patients with ischemic stroke (IS) and 8 patients with hemorrhagic stroke (HI), once for 8 patients with transient ischemic attack (TIA), 26 patients with chronic brain ischemia (CBI), 27 healthy volunteers (HV). RESULTS: NSE and GFAP levels were significantly higher in IS than in CBI and HV patients, and NR2-ab levels in IS were higher than in TIA and lower than in HV. In patients with more pronounced neurological deficiency and less favorable functional outcome by day 10-14 of IS, the levels of NSE, GFAP and NR2-ab were higher. Sensitivity and specificity of biomarker panel was higher than with their separate application. CONCLUSION: The NSE, GFAP and NR2-ab biomarkers have a diagnostic and predictive value for IS.

[Transverse myelitis syndrom as a result of neuromyelitis optica spectrum disorders, systemic lupus erythematosus and myasthenia gravis combination]. / Sindrom perechnogo mielita v rezul'tate sochetaniya zabolevaniya spektra neirooptikomielita, sistemnoi krasnoi volchanki i miastenii gravis.

Neuromyelitis optica spectrum disorders (NMOSD) - autoimmune condition characterized by an inflammatory lesions mainly of the spinal cord with the development of longitudinally extensive transverse myelitis (LETM) and/or involvement of the optic nerve with the development of usually bilateral optical neuritis (ON). In recent years, there has been increased awareness that NMOSD can be combined with other autoimmune diseases, including myasthenia gravis (MG), systemic lupus erythematosus (SLE) et al. The simultaneous presence of several autoimmune diseases in one patient can adversely affect the course of each of the diseases, causing the so-called mutual burden or «overlap syndrome¼. In this article, we describe our own clinical observation of a 51-year-old woman of European origin who developed acute relapsing TM seropositive for AQP4-IgG, by 23 years after the diagnosis of generalized MG seropositive for antibodies to acetylcholine receptors (AChR-Ab) and the occurrence of SLE, criterially confirmed, several months after the initial TM attack. During the fourth TM attack, partial positive dynamics was achieved only against the background of the combined use of intravenous methylprednisolone (pulse therapy), high-volume plasma exchange, rituximab and cyclophosphamide. The NMOSD is a rare disease leading to severe disability. In patients with MG, when symptoms of damage to the central nervous system appear, an analysis should be performed for AQP4-IgG and possibly for antibodies to myelin glycoprotein of oligodendrocytes (MOG-Ab), as well as markers characteristic of systemic connective tissue diseases (SCTD). In patients with STDD, when symptoms of involvement nervous systemappear, testing for AQP4-IgG (and, if necessary, for MOG-Ab) should be performed to exclude NMOSD, as well as AChR-Ab (and, if necessary, antibodies against muscle specific kinase (MuSK-Ab)) to exclude MG.

[The possibility of using neuron-specific enolase as a biomarker in the acute period of stroke]. / Vozmozhnost' ispol'zovaniia neiron-spetsificheskoi enolazy kak biomarkera v ostrom periode insul'ta.

The article presents a review of the literature on neuron-specific enolase (NSE) as a biomarker of stroke. It is shown that NSE does not allow differentiation of the ischemic and hemorrhagic process in stroke, but is suitable for determining the extent of brain tissue destruction both in the first hours of stroke and in the dynamics. The HSE analysis can be useful for monitoring the course of the disease, control of the dynamics of the pathological process, including when the size of the lesion increases, for evaluating the effectiveness of therapy and as a prognostic biomarker.

[The role of autonomic dysfunction in the pathogenesis of lipid and lipoprotein metabolic disorders in patients with metabolic-alimentary obesity]. / Rol' vegetativnoi disfunktsii v patogeneze narushenii lipidnogo i lipoproteidnogo obmena u bol'nykh obmenno-alimentarnym ozhireniem.

Obesity is a "disease of civilization" that leads to the formation of vascular pathology. Vegetodystonia, a heterogeneous syndrome both as regards the type and clinical course, is a pronounced clinical manifestation of obesity. The role of vegetodystonia in the formation of atherogenic potential of obesity has not been studied yet. 77 patients with metabolic alimentary obesity were examined for blood lipidograms as compared to the vegetative status and anthropometric data. Based on a correlation analysis performed, a relationship was discovered between the changes in the parameters indicated. The character of the correlation was determined by the type of vegetodystonia. The leading part in the formation of atherogenic potential is played by sympathoadrenal influences which are most manifest is permanent vegetovascular dystonia of the vagoinsular type. The treatment of obesity should be carried out with regard to the concrete variety of vegetative dysfunction.