[The role of dysfunction of the autonomic nervous system in idiopathic overactive urinary bladder in women].

A complex urological and neurological examination of female patients with idiopathic overactive bladder (IOAB) has detected clinical signs and neurophysiological correlates of vegetative dysfunction in the form of disturbed sympatho-parasympathic interrelations, failure of segmental and compensatory enhancement of suprasegmental mechanisms of regulation of lower urinary tract activity. The treatment with selective inhibitors of serotonin re-entry reduced severity ofpsychovegetative syndrome and symptoms of the lower urinary tract. This confirms an essential role of the autonomic nervous system in pathogenetic mechanisms of IOAB development and gives grounds for recommending selective inhibitors of serotonin re-entry for combined treatment of IOAB patients.

[Hand motor dysfunctions in computer users].

It were studied 239 female typists aged from 16 to 62 years (mean age 20,1±7,8 years) using author's questionnaire for computer typists to assess hand function and develop preventive measures of disturbances revealed. Indirect signs of tunnel hand neuropathy (27,2%), focal hand dystonia (21,4%) and muscular-tonic syndromes of different localization (18%) have been found. Typists are a risk group of fine hand motor dysfunctions. As preventive measures, authors recommend to use computer auxiliary devices, to change a motor stereotype during the day, to make hand "motor holidays", to organize working place.

[Autonomic imbalance in patients with metabolic syndrome: role in the development of hyperfiltration--an early marker of renal lesions].

AIM: to study the impact of the autonomic nervous system on the development of renal lesion in patients with metabolic syndrome (MS). SUBJECTS AND METHODS: One hundred and nine patients (45 females and 54 males) aged 29 to 72 years who had MS were examined. Glomerular filtration rate (GFR) was estimated using the Cockroft-Gault formula, by correcting the obtained result on the body surface. According to the level of GFR, the patients were divided into 3 groups: 1) 30 MS patients with hyperfiltration (GFR > 110 ml/min/1.73 m2); 2) 55 patients with normal GFR (110-60 ml/min/1.73 m2); 3) 24patients with lower GFR ( < 60 ml/min/1.73 m2). All the patients underwent physical examination; autonomic tonus was examined by 24-hour cardiac rhythm variability (CRV) study using the Holter monitoring system, by applying the time analysis. The presence of autonomic dystonia syndrome (ADS) and its degree were determined by a questionnaire to detect autonomic nervous system (ANS) dysfunction. RESULTS: Each of 3 groups was found to have signs of autonomic imbalance with a preponderance of sympathetic activity with decreased parasympathetic activity, these impairments being more pronounced in Group 1. The obtained regulation reflects the entire decrease in autonomic actions on the cardiovascular system in patients with MS and suggests the maximum hyperactivation of the sympathetic ANS in early-stage renal lesion--hyperfiltration CONCLUSION: When the first signs of renal lesion (hyperfiltration) occur in patients with MS, there is significant hypersympaticotonia that promotes the progression of target organs, including the kidneys.

[The role of clinical-electrophysiological indices in therapy for late-stage residual stroke by dynamic correction of proprioception]. / Rol' kliniko-élektrofiziologicheskikh pokazatelei v terapii pozdnei rezidual'noi stadii insul'ta metodom dinamicheskoi propriokorrektsii.

The new method dynamic proprioceptive correction using a medical loading costume was included into complex therapy in patients with late-stage residual stroke. Application of the costume promoted normalization of complex locomotor acts of walking by correcting proprioceptive pulsation resulted from the system of elastic draughts. Thus, a new motor stereotype was forced upon the patients. Clinical observation, computer analysis of the motor potential, spectrum of heart rhythm variabilities before and after therapy, and psychological testing were performed in 120 patients with motor disorders (pareses, paralyses) resulted from acute cerebral circulatory disorders. A steady-state clinical effect (p < 0.05) was found in 71.9% of the patients after 15 sessions of therapy. The patients became to walk independently, a possibility to self-attendance appeared, their speech became better. Lateralization of a damage and preservation of both the most significant homeostatic vasomotor mechanisms and the cerebral mechanisms of preparation of a movement with the minimal manifestations of emotional-affective disorders were shown to have impact on the patients' rehabilitation and on the early clinical features of pyramidal defect.

[Headache syndrome in children with autonomic dysfunction]. / Tsefalgicheskii sindrom pri vegetativnoi disfunktsii u detei.

Morbidity analysis of 350 children from somatic hospital has revealed clinical manifestations of autonomic dystonia syndrome (ADS) in 36% of the cases in the form of gastrointestinal, cardiovascular disorders, headache syndrome, etc. It was found that in the patients with a prevalence of vagotonia clinical manifestations of ADS rose at earlier age and differed by more variety than in combined and sympathotonic types of autonomic homeostasis. Headache syndrome was rather frequent in ADS and was observed in 35% of the patients. In children with vagotonic type of ADS, a headache syndrome presented most frequently (43%) in the forms of migraine and headache of tension (HAT). Clinical manifestations of autonomic dystonia were more pronounced in children with HAT. Meanwhile, autonomic dysfunction had hereditary origin and was milder in periods between the attacks in cases of migraine.

[Clinical manifestations of migraine in children]. / Klinicheskie proiavleniia migreni u detei.

100 case records of children aged 2.5 to 15 years with main complaints of headache (HA) examined and treated in Children's Neurologic Department were analyzed. For making the diagnosis more precise, diagnostic criteria of International Society for HA Investigation (1988) were used. Migraine was diagnosed in 25 children (10 boys, 15 girls), the age of its debute was from 2.5 to 13 years. Migraine with aura was found in 36% of the children. Clinical picture of the attack was characterized by polymorphism, the HA attacks were more severe, but shorter, than in adults. HA attacks were arrested quite frequently by sleep or rest without any drugs. Hereditary analysis revealed migraine in 36% of the parents. CNS damage was found in the anamneses of 64% of the patients, a closed craniocerebral trauma in 40% of the cases. Clinical and neurophysiologic study didn't reveal any specific disturbances, though pronounced psychoautonomic disorders were quite frequent in children with migraine.

New approaches to the rehabilitation of patients with neurological movement defects.

Results were obtained using a new method, based on the "Adeli-92" therapeutic space suit, for the rehabilitation of patients with movement disorders due to acute lesions of the cerebral circulation, head trauma, and other causes. A variety of methods was used to assess the state of patients before and after treatment, including clinical studies, psychological tests, EEG recordings, evoked potential studies, stabilography, and heart rhythm analysis. The results obtained demonstrate the high efficacy of this new method.

[New approaches to the rehabilitation of patients with neurological motor defects]. / Novye podkhody k reabilitatsii bol'nykh s nevrologicheskimi dvigatel'nymi defektami.

The results of the application of medical space suit "Adelie-92" for rehabilitation of patients with motor disorders are presented. Brain circulation acute disturbances as well as craniocerebral traumas were the main causes of these motor disorders. The complex estimation of patients condition was carried out both before and after the treatment. It included clinical data, physiological tests, EEG and evoked potentials investigations, stabilography and cardiorhythm analysis. The results proved the high effectiveness of the new therapeutical method.

[The epidemiology of autonomic disorders in Moscow schoolchildren]. / Epidemiologiia vegetativnykh narushenii u moskovskikh shkol'nikov.

Epidemiological survey of 2076 schoolchildren in the city of Moscow aged 7-15 revealed vegetative disorders in 63.8% of the examinees. Sex- and age-specific features of clinical presentation, complaints are described. An original questionnaires were used to enable physicians to distinguish normal children with vegetative lability from patients with vegetative dystonia.

[Clinico-physiological characteristics of syncopal conditions in the long QT syndrome (Romano-Ward syndrome)]. / Kliniko-fiziologicheskaia kharakteristika sinkopal'nykh sostoianii pri sindrome udlinennogo intervala Q-T (sindrom Romano-Uorda).

A complex of methods including clinical analysis, ECG, and exercise EEG was used to examine 52 patients aged 2 to 20 years with Romano-Ward syndrome. There were two groups: group I with syncopal attacks, group II without them. The patients with Romano-Ward syndrome had dysfunction of the suprasegmental systems regulated autonomously in the form of functional insufficiency of the mesencephalic activating system. In the patients without syncopal attacks, there was hyperproduction of the theta-rhythm, which may reflect the mechanisms of compensation. According to the EEG readings, criteria for the syndrome gravity and sudden death risk factors were distinguished.

[Psycho-autonomic correlations in neurocirculatory asthenia in young age]. / Psikhovegetativnye sootnosheniia pri vegetososudistoi distonii v iunosheskom vozraste.

As many as 91 patients aged 17-25 years seen at the students' outpatient hospital for autonomic disorders, namely for vegetovascular dystonia (VVD) were examined. The data of somatovegetative and psychiatric examinations were compared. It has been shown that the symptomatic diagnosis of VVD may mask both vegetative lability common to the mentally normal and practically healthy subjects and vegetative dystonia syndrome proper, which is a component of psychovegetative syndromes. The statistically significant diagnostic somatovegetative and electrophysiological signs were distinguished, which make it possible to supposedly distribute groups with psychopathological syndromes and mentally healthy subjects.

[Chronic nonparoxysmal supraventricular tachycardia in children and adolescents]. / Khronicheskaia neparoksizmal'naia supraventrikuliarnaia takhikardiia u detei i podrostkov.

An examination was performed in 111 children and adolescents with recurrent and sustained chronic nonparoxysmal tachycardias (CNPT). ECG and electrophysiological studies showed that ante- and retrograde conduction along the accessory atrioventricular junction was the most common mechanisms of arrhythmia. Holter monitoring revealed a high rigidity of cardiac rhythm in patients with sustained CNPT. Criteria for the development of arrhythmogenic cardiac dilatation were developed. In recurrent CNPT, there was a correlation between the paroxysms of ECG slow-wave activity and the "salvos" of tachycardia and a predominance of vagal effects on the heart. A new approach to the treatment of children with CNPT was proposed, which involved the correction of pathogenetic mechanisms. Indications for the usage of antiarrhythmic agents such as cordarone and a cardiac surgeon's advice were formulated. The efficiency of the therapy was achieved in 82% of the children as shown by a follow-up.

[Clinico-psychopathologic and somato-autonomic studies of functional hyperthermia in adolescents]. / Kliniko-psikhopatologicheskoe i somatovegetativnoe issledovanie funktsional'nykh gipertermii u podrostkov.

In a non-psychiatric clinic a combined psychiatric and somato-autonomic investigation was performed in 75 prepuberty and puberty children with functional hyperthermia . Syndromal and nosological characterization was performed on a spectrum of psychic disorders in these patients. Some correlations were found between syndromal and nosological distributions and grouping based on somato-autonomic++ picture.

[Status of the autonomic nervous system and reflexotherapy in children with vasomotor rhinitis]. / Sostoianie vegetativnoi nervnoi sistemy i refleksoterapevti- cheskoe vozdeistvie pri vazomotornom rinite u detei.

Different variants of vegetative nervous system dysfunction were identified during the examination of 86 children with vasomotor rhinitis. Based on the findings of the examination a pathogenetically-based method of acupuncture was proposed for the management of this patients' group. Acupuncture with regard to vegetative dysfunction attenuated the latter's manifestations and corrected associated psychoemotional disorders. As a result the clinical manifestations of vasomotor rhinitis were eliminated.

[Psychoautonomic syndrome in non-infectious subfebrile conditions in children]. / Psikhovegetativnyi sindrom pri neinfektsionnykh subfebrilitetakh u detei.

To ascertain the cerebral organization and the importance of its specific levels in the occurrence of the thermopathological syndrome associated with vegetovascular dystonia, 40 children aged 8-15 years with non-infectious subfebrile conditions of long standing were examined. The children's status was marked by polysystemic shifts common to the neurogenous disorders. Of crucial significance was dysfunction of the structures of the suprasegmental level (the limbic-reticular complex) of vegetative regulation with the involvement of the specialized hypothalamic centers of thermoregulation, with excessive sympathetic influences at the periphery and formation of the psychovegetative syndrome. An individual analysis of the psychovegetative syndrome makes it possible to define the contribution of the concrete endo- and exogenous factors to the pathogenesis of non-infectious subfebrile conditions and to develop a differential approach to the treatment.

[Status of cerebral structure and hemodynamics in healthy children and those with autonomic-vascular dystonia]. / Sostoianie tserebral'nykh struktur i mozgovoi gemodinamiki u zdorovykh detei i detei s vegetososudistoi distoniei.

From the standpoint of traditional neurology an attempt has been made to evaluate the function of the cerebral structures in 50 children with vegetovascular dystonia and 30 normal ones. On the basis of the data obtained a working hypothesis is advanced about a special role of the defect in the right cerebral hemisphere in the pathogenetic mechanisms of hypertension in the presence of vegetovascular dystonia.