[Vestibular rehabilitation for peripheral vestibular hypofunction: an interdisciplinary consensus]. / Vestibulyarnaya reabilitatsiya pri perifericheskoi vestibulyarnoi gipofunktsii: mezhdistsiplinarnyi konsensus.

The literature review presents approaches to the management of patients with vestibular disorders. The principles of organization of vestibular rehabilitation in peripheral vestibular hypofunction, indications for appointment, factors influencing its implementation, technique, methods of evaluating effectiveness are considered in detail. Attention is drawn to the fact that the selection of exercises and the duration of vestibular rehabilitation is carried out individually and depends on many factors, including the nature of vestibular deficiency and the specific characteristics of the patient. The possibilities of using additional pharmacological therapy with histamine preparations, which can accelerate the onset of vestibular compensation, are shown. It is noted that vestibular rehabilitation is a safe and effective method of treating peripheral vestibular hypofunction and should be recommended to patients of all ages with vestibular disorders leading to limited social and physical activity.

[Difficulties in diagnosing the chronic course of tick-borne encephalitis in children]. / Trudnosti diagnostiki khronicheskogo techeniya kleshchevogo entsefalita u detei.

Infections transmitted by ixodic ticks in childhood account for about 20%, and tick-borne encephalitis accounts for up to 25% of cases. A feature of the course of tick-borne encephalitis is unpredictability and the possibility of chronization in 1-3% of cases with late diagnosis and inadequate therapy. The article presents a clinical observation of the disease in a child whose chronically progressive course of amyotrophic form was diagnosed 1 year and 8 months after the onset of the disease. The presence of anamnestic data, features of clinical manifestations in the dynamics and typical neurovirualization picture of the disease, even with negative results of serological and molecular genetic studies of blood and cerebrospinal fluid, allowed to make a diagnosis, prescribe etio-pathogenetic therapy and thereby stabilize the patient's condition. The use of complex drugs in the treatment, such as Cytoflavin, allows to optimize the course of the disease.

Motor Decision-Making as a Common Denominator in Motor Pathology and a Possible Rehabilitation Target.

Despite the substantial progress in motor rehabilitation, patient involvement and motivation remain major challenges. They are typically addressed with communicational and environmental strategies, as well as with improved goal-setting procedures. Here we suggest a new research direction and framework involving Neuroeconomics principles to investigate the role of Motor Decision-Making (MDM) parameters in motivational component and motor performance in rehabilitation. We argue that investigating NE principles could bring new approaches aimed at increasing active patient engagement in the rehabilitation process by introducing more movement choice, and adapting existing goal-setting procedures. We discuss possible MDM implementation strategies and illustrate possible research directions using examples of stroke and psychiatric disorders.

[Functional state of the mesenteric arteries with higt fat intake in rats with streptozotocin-induced diabetes].

An increase in the incidence of diabetes mellitus (DM) is associated with excessive consumption of fats and carbohydrates, while DM leads to the development of cardiovascular diseases. The aim of the research was to evaluate the effect of a high-fat diet (HFD) on the functional state of the mesenteric arteries in vivo in Wistar rats with DM. Material and methods. The study was conducted on 45 male Wistar rats with an initial body weight of 220-240 g, which were divided into 3 equal groups. Animals of the control group received a standard diet for 3 months. Rats of the second group (STZ) were fed a standard diet, after 8 weeks the animals were intraperitoneally injected with streptozotocin (STZ, 35 mg/kg body weight). Animals in the STZ+HFD group received HFD (50% beef tallow), and an injection of STZ (35 mg/kg). We assessed the effect of HFD on endothelium-dependent and endothelium-free reactions of phenylephrine (PE) precontracted mesenteric arteries under the action of agonists in the absence and use of blockers of NO-synthase (L-NAME), cyclooxygenase (indomethacin), and K+-channels (tetraethylammonium), using microphoto- and videorecording of vessel diameter in vivo. Results. DM in rats led to an increase in the constrictor reaction to FE; in animals of the STZ+HFD group, the diameter of the vessel decreased by 63.7±4.7%; in the STZ group, by 60.4±3.8%; and in the control group, by 48.9±4.1%. HFD and DM induction had no effect on the amount of relaxation under the action of sodium nitroprusside. The amplitude of acetylcholine-induced relaxation of the mesenteric arteries of rats with DM in the absence of blockers was significantly lower (by 27.1% on average in the STZ+HFD group, by 14.6% in the STZ group) compared with control animals. After NO synthase inhibition, the relaxation amplitude decreased in the STZ+HFD group by 48.6±3.2%, in the STZ group by 56.1±2.8%, and in control animals by 58.3±3.1% compared with the dilatation amplitude without the use of a blocker. Acetylcholine-induced vascular dilatation under conditions of simultaneous use of a complex of three blockers - L-NAME, indomethacin and tetraethylammonium was reduced in rats with DM treated with HFD by an average of 18.9% and in animals of the STZ group by 22.1% compared with control animals. Conclusion. Thus, excessive fat intake in rats with STZ-induced DM enhances the impairment of the functional state of the mesenteric arteries compared to animals with DM that received a standard diet. In HFD in rats with DM, a decrease in endotheliumdependent vasodilation was mediated as a failure of NO-dependent relaxation mechanisms and a decrease in the efficiency of the mechanism of endothelial hyperpolarization, whereas in rats with DM fed a standard diet, it was predominantly a disturbance in the mechanism of endothelial hyperpolarization.

[Postgenomic and structural changes in the myocardia of Wistar rats fed a high-salt diet].

The relationship between dietary sodium, hypertension, and cardiovascular injury is far from clear. One of the important links in this process can be microRNAs that have the ability to modulate gene expression at the post-transcriptional level. However, their role in this process has not been fully studied. In addition, further studies require the identification of structural changes in the myocardium in conditions of long-term consumption of a high-salt diet. The aim of the study was to evaluate the expression levels of nuclear transcription factor κB (NFκB), microRNA (miRNA)-21 and structural changes in the myocardium during long-term consumption of a diet containing 8% (high) sodium chloride in Wistar rats. Material and methods. 20 Wistar rats with initial body weight 280.5±42.7 g were divided into two equal groups. The high salt (HS) group received 8% NaCl in the diet, the control (NS) group received the standard diet (0.34% NaCl). After 4 months, systolic blood pressure was measured in rats using the cuff method on the tail; the myocardial mass index was assessed after dissection; histological and electron microscopic examination of the myocardium was performed, and the expression levels of miRNA-21 and NFκB in the myocardium were determined. Results and discussion. Consumption of a diet high in sodium chloride for 4 months did not significantly affect the level of systolic blood pressure in normotensive Wistar rats, but led to an increase in myocardial mass index by 25.0% (p<0.05). In the HS group, hypertrophy of cardiomyocytes and an increase in the wall thickness of arterial vessels were revealed. The area of perivascular fibrosis in rats of the HS-group was almost 1.8 fold higher than in the NS-group. In animals of HS-group, the relative levels of expression of NFκB (more than 2 times) and miRNA-21 (almost 6 times) increased compared with the control. It can be assumed that the negative impact on the cardiovascular system of high-salt diets is partially realized through NFκB-associated signaling pathways and miRNA-21 activation. Conclusion. In Wistar rats, long-term use of a high-salt diet results in myocardial remodeling that is not associated with changes in blood pressure. At the same time, the adverse effects of high salt intake on the myocardium are mediated, in particular, by postgenomic mechanisms, namely an increase in the expression levels of NFκB and microRNA-21.

[Modern concepts on the pathogenesis of neuroborreliosis]. / Sovremennye predstavleniya o patogeneze neiroborrelioza.

The analysis of publications on the websites PubMed, ClinicalKey, devoted to the pathogenesis of neuroborreliosis (NB), using keywords for search: «pathogenesis of neuroborreliosis¼, «neuroborreliosis in children¼, «pathogenesis of Lyme disease¼, as well as an analysis of the results of the published research results of the staff of the Research Institute of Pediatric Infections, St-Petersburg, Russia is presented. Syndromes of early and late NB are more often observed among the forms without migrating erythema, and their development can be caused by all representatives of the species B. burgdorferi s.l. (B.b.), but more often - B. garinii, since it most effectively suppresses the factors of innate and adaptive immune response, reducing interferon production, phagocytosis and complement synthesis. The cause of immunosuppression with the development of NB may be simultaneous infection with several genovids and borrelia species or pathogens of other infections transmitted by Ixodes ticks, for example, infection with B.b. and tick-borne encephalitis virus. The ability to move along peripheral nerves, the change of surface antigens of the VlsE protein, as well as the formation of atypical cysts and granular forms allows B.b. to affect different structures of the peripheral and central nervous system, avoid an immune response and persist for a long time, causing chronic neuroinfection. Both the B.b. themselves, capable of being outside and inside glial cells and neurons, and inflammatory reactions developing in response to their introduction and associated with the synthesis of cytokines and chemokines and mimicry, cause damage to the vascular endothelium, vasculitis and impaired blood supply to the brain, demyelination, autoimmune inflammation and degeneration, leading to the development of NB syndromes, the spectrum of which varies depending on the duration of neuroinfection. In the development of NB and its outcomes, the following are also important: early initiation of treatment, the effectiveness of antibacterial drugs, the use of immunotropic agents that optimize the patient's immune response to the fight against neuroinfection, as well as the timely use of pathogenetic drugs, such as Cytoflavin, which have a complex effect on the vascular endothelium.

[Urinary miRNA expression in cynomolgus macaques (Macaca fascicularis) fed high salt rations].

High food intake of sodium chloride is associated with damage not only the cardiovascular system, but also the kidneys. The mechanisms of the potential negative effects of high-salt diets on the kidneys have not been established. The aim of the study was to trace the changes in relative expression of miRNA-21, 203 and 133 in urine of cynomolgus macaques (Macaca fascicularis) fed high-salt diet with and without isolated soy proteins. Material and methods. The object of the study was 18 male cynomolgus macaques (Macaca fascicularis) aged 6-8 years with a body weight of 5.1-9.7 kg. The animals were divided in 3 groups (6 individuals each). The animals of the first (control) group received a standard diet (2 g NaCl/kg feed). The animals of the second group were fed high-salt diet (8 g NaCl/kg feed), of the third - high-salt diet combined with SUPRO 760 isolated soy protein (200 g/kg feed; instead of milk and egg proteins, corn gluten). Access to water was free. The follow-up period in this study was 4 months. In animals blood pressure (BP) and relative level of microRNA (miRNA) expression in urine were measured. Results and discussion. Keeping monkeys on the studied diets for 4 months did not lead to significant changes in systolic or diastolic BP compared with the initial level. In the control group, there were no distinct changes in the expression of miRNA-21 in urine during observation. In the other two groups, there was a significant increase (approximately equally) of this parameter in comparison with the initial values. Both high-salt diets resulted in a significant increase in the relative level of expression of miRNA-133 and miRNA-203 in urine compared to basal values. However, the increase in these parameters in the group of animals fed a high-salt diet in combination with soy isolate was significantly less than in monkeys fed only a high-salt diet. Conclusion. Possible, potentially negative effects of high-salt diets on kidney may be mediated by epigenomic mechanisms and partially modulated by the inclusion of isolated soy proteins in the diet.

[Pathophysiological mechanisms of the therapeutic action of alternating electromagnetic fields in the treatment of osteoarticular pathology]. / Patofiziologicheskie mekhanizmy terapevticheskogo deistviya peremennykh elektromagnitnykh polei v lechenii kostno-sustavnoi patologii.

Treatment of osteoarticular pathology with an alternating electromagnetic field (AEMF) is used today as a promising, non-invasive and safe strategy of physiotherapy. It has been shown that the action of alternating electromagnetic fields on the musculoskeletal system triggers signaling cascades that effectively contribute to the restoration of bone and articular tissue. The pathophysiological mechanisms underlying the cellular and subcellular effects of stimulation by an alternating electromagnetic field during the restoration of bone and articular tissue are considered. It was pointed out the several key signaling pathways involved in the restoration of bone and articular tissue under the influence of electromagnetic fields with an analysis of the potential for therapeutic application of electromagnetic fields alone or in combination with other available therapies.

[Current issues of treatment and rehabilitation of patients with neurological disorders and the consequences of COVID-19. Resolution of Advisory Board]. / Osnovnye napravleniya lecheniya i reabilitatsii nevrologicheskikh proyavlenii COVID-19. Rezolyutsiya soveta ekspertov.

Last year the global medical community faced the pandemic of the new coronavirus infection caused by SARS-CoV-2. To date, there is considerable expert experience, which indicates that the brain, along with the corresponding respiratory system, is a target organ for a new coronavirus infection. Moreover, a number of symptoms from the central and peripheral nervous system can persist for several weeks, months, and even tens of months. To designate such protracted clinical conditions, a new definition was introduced: «Post-COVID-19 Condition¼. Advisory Board of Neurologists and Rehabilitation Therapists met to, discuss of practical experience and taking into account scientific information about COVID-19, which was available at the time of the meeting, to develop unified approaches for the management of patients with neurological complications and the consequences of a new coronavirus infection. The Advisory Board worked out a resolution in which formulated the tactics of managing patients with neurological manifestations of COVID-19. The substantiation of the importance and expediency of the development and implementation of a special program of clinical examination of patients who have undergone COVID-19, which would include a clinical examination with a detailed assessment of cognitive functions to early identification and diagnosis of neurodegeneration and subsequent therapy, is given.

[Clinical-etiological and MRI parallels of encephalitis in children]. / Kliniko-etiologicheskie i MRT paralleli entsefalitov u detei.

OBJECTIVE: Improving the diagnosis of encephalitis (EF) in children by establishing clinical, etiological and MRI parallels. MATERIAL AND METHODS: 364 children aged from 1 month to 17 years with EF were examined. MRI of the brain and spinal cord, blood and CSF examination for herpes viruses type 1-6 (HHV), enteroviruses (EV), tick-borne encephalitis viruses (TBEV), Borrelia burgdorferi (BB), varicella zoster (VVZ), herpes simplex (HSV1) and Epstein-Barr (EBV) were performed. RESULTS: The etiological structure was dominated by HHV types 1-6, tick-borne infections (19%), EV (14.6%), and other agents (6%). Clinical and topical variants of EF: leukoencephalitis (leukoePH) - 68.4%, polyoencephalitis (polioePH) - 22.8% and panencephalitis (panePH) - 8.8%. LEUKOEPH was more often caused by VVZ, EBV and BB, foci in the white matter of the large hemispheres, sensitive, cerebellar and pyramidal symptoms, acute course followed by complete recovery (65.8%), the risk of exacerbations and progression with the development of multiple sclerosis in 6% were observed in 80.7%. POLIO in 71.1% were caused by TBEV or EV, lesions were located in the thalamus, basal ganglia, cortex, manifested by deep depression of consciousness, epilepsy, central paralysis and speech disorders, in 83.1% there was a chronic course with the development of brain atrophy. PanEF was caused by cytomegalovirus in more than 1/2 of cases, with subtotal-total white matter damage, in 1/3 of cases - with the involvement of other structures, there was a chronic course with polymorphism of neurological symptoms, rare complete recovery (15.6%). The cerebellar form of EF in 88.7% was associated with VZV, subcortical and stem - with TBEV and EV, cortical and limbic - with HSV-1 and 2 and HHV-6. The outcomes of EF depend both on the timeliness of etiological and neuroimaging diagnostics, and on the adequacy of early therapy already with EF, including the use of acyclovir in combination with recombinant interferons alpha-2-ß with antioxidants, and the immediate appointment of Cytoflavin infusions upon admission to the hospital. CONCLUSIONS: Clinical and topical variants and forms of EF in children are associated with etiology, have different rates of complications, the nature of the course and outcomes, the knowledge of which makes it possible to optimize the diagnostic process.

[Clinical and anamnestic data that affect the outcome of rehabilitation on virtual reality in patients with stroke]. / Kliniko-anamnesticheskie dannye, vliyayushchie na iskhod reabilitatsii v virtual'noi real'nosti u patsientov, perenesshikh tserebral'nyi insul't.

OBJECTIVE: To determine the impact of clinical and anamnestic data of stroke patients on the rehabilitation process's outcome in virtual reality (VR). To study parameters of postural stability, gait, daily activity and affective functions during motor training in the immersive high-tech polymodal VR system. MATERIAL AND METHODS: We examined 34 patients (16 women, 18 men, mean age 51.9±12.5) who had a stroke at least 2 weeks ago and had a degree of disability no more than 3 points on the Rankin scale, mainly due to movement disorders. The patients underwent training in the VR system (Grail, Motekforce) for 10 sessions. Before and after the end of the training, the patient's condition was diagnosed, including indicators of motor and daily activities, affective functions, as well as an instrumental assessment of balance and gait in VR. RESULTS: After training up to 62% of patients showed improvements in physical activity, up to 41% - in daily living activities, up to 73% - in the affective sphere. The results of multiple linear regression analysis showed that gender, the type of stroke and the side of the brain lesion are significant predictors for the rehabilitation of postural stability, while the type of stroke and the period of recovery after stroke predict the restoration of the affective sphere. CONCLUSION: Groups of patients stratified by gender, the type of stroke, the side of the brain lesion and recovery period, for whom training in the VR system was most effective, are identified. Based on the results of the study, the authors suggest the criteria of inclusion of VR in the individual rehabilitation program of patients with stroke.

[Current issues in the rehabilitation of stroke patients against the background of a new coronavirus infection (COVID-19). Resolution of the Council of Experts]. / Aktual'nye voprosy reabilitatsii patsientov s insul'tom na fone novoi koronavirusnoi infektsii (COVID-19). Rezolyutsiya Soveta ekspertov.

The pandemic of the new coronavirus infection caused by SARS-CoV-2 has forced to reconsider the methods of rehabilitation of patients with emergency conditions, including neurology. The Council of Experts of Neurologists and Rehabilitation Therapists gathered to develop unified approaches to manage stroke patients based on a discussion of practical experience and, taking into account the scientific information on COVID-19 that was available by the time of the meeting. Stroke is a serious disabling condition that requires maximum rehabilitation efforts at all stages of medical care. In the context of the SARS-CoV-2 coronavirus epidemic, the process of medical rehabilitation and the routing of patients with stroke is undergoing major changes. Combining COVID-19 and stroke requires new approaches to rehabilitation and patient management. During the meeting, a resolution was developed in which the experts formulated the tactics of medical rehabilitation of patients with stroke and COVID-19 at the first and second stages. The arguments of the importance and practicability of carrying out measures of medical rehabilitation at the third stage is given and the need to continue consultations on the indicated topic is revealed.

[The efficacy of anti-viral therapy and serotherapy of tick-borne encephalitis in children]. / Effektivnost' protivovirusnoi terapii i seroterapii kleshchevogo entsefalita u detei.

OBJECTIVE: To evaluate the efficacy of different methods of antivirus therapy of tick-borne encephalitis (TBE) in children in the acute period and during chronic infections. MATERIAL AND METHODS: During 1 year, 130 children, aged 7-17 years, with TBEV received therapy in the acute period (an average in 3.5±1.3 days) in groups 1 (n=84) and 2 (n=20), and in the chronic infection in groups 3 (n=15) and 4 (n=11). Ribavirin orally, recombinant interferon-α2 (IFN-α2) i/m or in suppositories and anaferon orally were prescribed to children of groups 1 and 3. Children of groups 2 and 4 received tick-borne immunoglobulin (IgG)i/m and ribonuclease i/m. At admission, all patients received infusions of cytoflavin in the drip at the rate of 0.6 ml/kg per day. Etiological diagnosis included ELISA (IgM, G, viral antigen), and virus RNA by PCR in the blood and CSF. MRI of the brain and cervical spinal cord using standard programs was performed. All studies were performed prior to and in the course of treatment. RESULTS AND CONCLUSION: In patients of group 1, the period of increase in symptoms was reduced by ~ 4 days, and the duration of impairment of consciousness and pleocytosis in CSF ~ by 5 days, which was accompanied by a faster clearance of the virus in CSF, compared with group 2. In group 1, recovery without neurological deficit was observed in 83.3% (n=70), all patients had no progression of infection. In group 2, 30% of children (n=6) acquired TBEV chronic infection, and in 55% (n=11) there was a neurological deficit without progression. In patients of group 3 with chronic TBEV, the improvement was observed in 86.7% of cases, and complete regression of symptoms occurred in 1 patient, and replication of the virus was arrested in all of them. In group 4, symptoms increased in 72.7%, while virus replication was preserved and atrophic changes in the CNS increased on MRI. Antiviral therapy (ribavirin, IFN-α2 and release of active antibodies to gamma interferon -anaferon children) has the highest efficacy when prescribed for the first 5 days, while IgG and ribonuclease have insufficient efficacy in TBEV.

[Panencephalitis in children in modern conditions: clinical, etiological and mri-aspects]. / Panéntsefality u detei v sovremennykh usloviiakh: kliniko-étiologicheskie i MRT-aspekty.

AIM: To characterize the clinical picture, infectious etiology and MRI results of panencephalitis (PANE) in children, depending on the duration of the disease. MATERIAL AND METHODS: Children (n=32) with PANE at the age from 3 months up to 17 years were examined for a group of actual viral and bacterial infections. The inclusion criterion was a diffuse lesion of white matter hemispheres on MRI. MRI of the brain and spinal cord, CSF study (pleocytosis, oligoclonal IgG, the main myelin protein (MBP) were performed. The follow-up was 5-10 years. The complex therapy included etiotropic (antiviral) and pathogenetic agents, with priority given to cytoflavin as a drug with a multimodal effect. RESULTS: In 84.4% of cases, PANE in children are recorded under the age of 3 years and in 71.9% of cases, are associated with congenital infections with the prevalence of herpes viruses, especially cytomegalovirus (37,8%) and herpes type 6 (21.9%). In 78.3% of cases, PANE have chronic gradual development more often with a delay in the formation of motor and speech/prespeech skills, and manifested with pyramidal, cerebellar and other symptoms in the future. PANE is accompanied by a lesion of the white matter of the hemispheres in 1/2 cases with periventricular localization, less often in infratentorial structures (46.9%) and spinal cord (21.9%). With the duration of symptoms up to 3 months (n=22) PANE are characterized by inflammatory-demyelinating changes, signs of mass effect, contrast+, pleocytosis in CSF and the increase in MBP (average 4.2±0.8 ng/ml), and, with the duration of more than 3 months, by degenerative-sclerosing changes (n=10) and CSF oligoclonal IgG in 90% of cases. CONCLUSION: In almost 2/3 of cases, PANE are associated with congenital infections, accompanied by extensive symmetrical foci of demyelination in the CNS, and their clinical and laboratory parameters and outcomes depend on the start of treatment, with the positive dynamics in 75% of cases.

[Peculiarities of affective disorders in residual cerebral insufficiency]. / Osobennosti affektivnykh rasstroistv pri tserebral'noi rezidual'no-organicheskoi nedostatochnosti.

AIM: To determine clinical and psychopathological features of anxiety-depressive disorders in patients with cerebral residual organic insufficiency. MATERIAL AND METHODS: One hundred and fourteen patients with anxiety-depressive disorders and cerebral residual-organic insufficiency were studied. Psychopathological, psychometric, statistical methods were used. RESULTS AND CONCLUSION: Asthenia was identified as a core syndrome in anxiety-depressive disorders developed in patients with cerebral residual-organic insufficiency. Severe anxiety and depression with somatization of symptoms were characteristic of the structure of affective pathology. The somatization of affect, interpersonal sensitivity, marked asthenic and autonomic disorders as well as negative attitudes about their own condition, abilities and activity were main features of affective disorders in patients with cerebral residual-organic insufficiency. Clinical characteristics of cerebral residual-organic insufficiency and the diversity of its manifestations, including the combination with mental disorders, determine the relevance of further research.

Cardiolipin and phosphatidylethanolamine role in dibucaine interaction with the mitochondrial membrane.

Mitochondrial membranes are pointed out as the site of cardiotoxic action of local anaesthetics. Its three main phospholipids components are phosphatidylcholine, phosphatidylethanolamine and cardiolipin. Cardiolipins, in eukaryotes, are only found in mitochondria and are essential for the maintenance of its integrity and dynamics. Fluorescence and nuclear magnetic resonance spectroscopy were used to study the interactions of a local anaesthetics, Dibucaine (DBC), with different mitochondrial membrane models constituted by combinations of its three main lipid components in which cardiolipin was a natural extract (CLmix). Both CLmix presence/absence and its percentage in the model membranes were evaluated. Fluorescence spectroscopy showed that DBC lowered the transition temperature of all membrane models understudy. DBC partition showed to be dependent of CLmix presence and phosphatidylethanolamine:CL ratio. Furthermore, the maximum emission wavelength (λmax) exhibited a notorious decreased with increasing phospholipid to DBC ratio, in all the membrane models containing CLmix. Nevertheless, it remained approximately the same in the membrane without CLmix. This indicates a differential membrane localization of the anaesthetics, dependent on the membrane models used. NMR results showed that DBC interaction and location in the membrane models is mainly influenced by CLmix presence, and DBC can significant alter lipid systems properties e.g. percentage and type of lipid phase present. Taken all together it was shown that DBC interaction and location are largely dependent on the membrane model system. Furthermore, DBC is able to produce significant changes in the lipidic systems which might help to explain its high toxicity.

[Brain-computer interface-based motor imagery training for patients with neurological movement disorders]. / Pilotnoe issledovanie ideomotornogo treninga v konture interfeisa mozg-komp'iuter u patsientov s dvigatel'nymi narusheniiami.

AIM: To study the electric brain activity during motor imagery task in the brain-computer interface (BCI) in motor-disabled patients to determine the optimal ways for using BCI-based ideomotor training in medical rehabilitation. MATERIAL AND METHODS: The study included 26 patients with arm motor dysfunction caused by a stroke or a spinal cord injury. They were involved in motor imagery training in the BCI. The power and localization of electroencephalographic (EEG) event-related desynchronization during imagery of different arm movements were measured. The accuracy in the two-command BCI was assessed. RESULTS AND CONCLUSION: The pattern of imagery-related EEG desynchronization showed the typical localization for such tasks. Despite the fact that the power of EEG reactions during motor imagery in motor-disabled patients was on average lower than in healthy subjects during a similar task, all the patients were able to achieve high accuracy in the two-command BCI system after several (at least three) training sessions. Our results demonstrate the great potential for using BCI-based motor imagery training for neurorehabilitation of patients with motor dysfunctions.

Human umbilical cord blood plasma as an alternative to animal sera for mesenchymal stromal cells in vitro expansion - A multicomponent metabolomic analysis.

Mesenchymal Stromal cells (MSCs) have a potential role in cell-based therapies. Foetal bovine serum (FBS) is used to supplement the basal cell culture medium but presents several disadvantages and risks. Other alternatives have been studied, including human umbilical cord blood plasma (hUCBP), aiming at the development of xeno-free culturing protocols. A comparative characterization of multicomponent metabolic composition of hUCBP and commercial FBS based on Nuclear Magnetic Resonance (NMR) spectroscopy and multivariate statistical analysis was performed. The analysis of 1H-NMR spectra revealed both similarities and differences between the two proposed supplements. Similar metabolites (amino acids, glucose, lipids and nucleotides) were found in the hUCBP and FBS NMR spectra. The results show that the major difference between the metabolic profiles of the two proposed supplements are due to the significantly higher levels of glucose and lower levels of lactate, glutamate, alanine and branched chain amino acids in hUCBP. Similar or slightly different levels of important proteinogenic amino acids, as well as of nucleotides, lipids were found in the hUCBP and FBS. In order to validate it's suitability for cell culture, umbilical cord-MSCs (UC-MSCs) and dental pulp stem cells (DPSCs) were expanded using hUCBP. In both hMSCs, in vitro culture with hUCBP supplementation presented similar to improved metabolic performances when compared to FBS. The two cell types tested expressed different optimum hUCBP percentage content. For DPSCs, the optimum hUCBP content was 6% and for UC-MSCs, 4%. Cultured hMSCs displayed no changes in senescence indicators, as well as maintained characteristic surface marker's expression. FBS substitution was associated with an increase in early apoptosis events, in a dose dependent manner, as well as to slight up- and down-regulation of targeted gene's expression. Tri-lineage differentiation capacity was also influenced by the substitution of FBS by hUCBP.

[Difficulties of differential diagnosis of organic injury of the nervous system in children]. / Trudnosti differentsial'noi diagnostiki organicheskogo porazheniia nervnoi sistemy u detei.

The growth of organic lesions of the central nervous system (CNS) in children, clinical polymorphism, the similarity of clinical and laboratory parameters in inflammatory, demyelinating and oncological diseases necessitate careful differential diagnosis. The clinical case presented in the article confirms the difficulties of differential diagnosis of organic CNS lesion in children, and therefore it is urgent to expand the indications for a brain biopsy, which will allow to timely diagnose correctly, avoid an erroneous diagnostic search and develop adequate tactics.

[The restoration of the shoulder joint function in the patients presenting with hemiparesis during the acute phase of hemispheric stroke]. / Vosstanovlenie funktsii plechevogo sustava u patsientov s gemiparezom v ostryi period polusharnogo insul'ta.

The impaired function of the shoulder joint resulting from cerebral stroke is a common disorder involving permanent total disability as well as impaired capability of self-care. The functional pathological changes in the shoulder joint and the dynamics of the patients' health status during the acute period of cerebral stroke remain virtually unexplored. AIM: The objective of the present study was to obtain a deeper insight into the process of recovery of the movements in the shoulder joint of the patients presenting with hemiparesis during the acute period of hemispheric stroke based on the results of the analysis of the biomechanical data and the targeted training with biofeedback (BFB). MATERIAL AND METHODS: The study included three groups comprised of 25 subjects each. One (control) group included the subjects having neither neurological nor orthopedic pathology. The second group consisted of the patients receiving the conventional treatment in the combination with therapeutic physical exercises (TPE). Group 3 was composed of the patients given the standard course of conventional and physical (TPE) therapy complemented by biofeedback training (the TPE/BFB group). The study included clinical investigations and biomechanical registration of the movements of the shoulder joints and trunk. RESULTS: The results of the study gave evidence that the patients presenting with hemiparesis during the acute period of hemispheric ischemic stroke including those treated with the application of the active means and methods of rehabilitation, such as BFB training, showed no appreciable dynamics of the parameters being evaluated with the use of the relevant clinical scales. The biomechanical study has demonstrated that the movements in the shoulder joints (in a single plain) of the patients comprising the control group are characterized by the presence of the main component with a maximum amplitude in the plane of this movement and additional components (in other planes with a significantly lower amplitude); they are accompanied by the ancillary movements of the trunk. Functionally, the condition of paresis at the level of the shoulder joint is characterized by a decrease in the amplitude of the primary movement and the increase of one of the additional amplitudes, with the growing amplitude of the auxiliary movements of the trunk. The biomechanical methods for the objective assessment have revealed the following functional changes in the shoulder joints: the 6% improvement of flexion in the group of the patients treated with the use of therapeutic physical exercises and the 10% improvement in those treated with the combination of TPE and BFB. Moreover, abduction in the patients of these two groups improved by 4% and 9% respectively. CONCLUSIONS: The method for the study of kinematics of the movements in the shoulder joints appears to be most sensitive and informative for the purpose of diagnostics of disorders of the motor function and assessment of the process of its restoration in the patients presenting with hemiparesis during the acute period of hemispheric stroke.