[Efficacy of the energy-modifier cytoflavin in the treatment of patients with hypertensive encephalopathy].

AIM: To evaluate the efficacy of cytoflavin in the treatment of patients with hypertensive encephalopathy (HE). SUBJECTS AND METHODS: One hundred and forty patients aged 39 to 73 years, diagnosed with HE, were examined and randomized to 2 groups. A study group (n = 74) received cytoflavin in a dose of 2 tablets b.i.d. on days 1 to 25 days inclusive during standard basic therapy. A comparison group (n = 66 persons) had standard basic therapy only. A control group consisted of 30 apparently healthy individuals. The investigators studied the frequency of headache, dizziness, and other complaints and the intensity of cephalalgic syndrome, by using a visual analog scale, the quality of life by the Medical Outcomes Study 36-Item Short-Form Health Survey (MOS SF-36) questionnaire, that of sleep by the subjective sleep characteristics questionnaire elaborated at the Moscow City Somnological Center, the level of asthenia by a subjective asthenia rating scale (Multidimensional Fatigue Inventory (MFI-20), and autonomic status, by applying objective and subjective scales on days 1 and 25 of therapy. RESULTS: The study has shown that cytoflavin used in the above dose for 25 days reduces the frequency and magnitude of complaints of headache, dizziness, "venous" complaints, the degree of autonomic and asthenic disorders, and impairments in the quality of sleep and life in the patients with HE at all disease stages. A stepwise discriminant analysis has indicated that the degree of cephalgic syndrome, and autonomic disorders, and worse sleep quality are the most effective points for using the energy-modifier cytoflavin. CONCLUSION: HE treatment based on the current pathogenetic principles may have a preventive impact on the development of HE or slow down the rate of its progression.

[The course of pregnancy in women with mitral valve prolapse].

The paper is devoted to the study of the course of pregnancy in women with mitral valve prolapse of various severity. With progression of pregnancy (especially the period from II to III trimester) symptoms increase. This is manifested as appearance or intensification of signs of neuro-circulatory dystonia (characteristic for patients with mitral valve prolapse irrespective of pregnancy). However these signs do not interfere with normal delivery.

[Hemodynamic correlation between the reaction of circulatory system on physical activity and exogenic adrenaline in liquidators of Chernobyl accident with neurocirculatory dystonia syndrome].

The article presents a correlation analysis between hemodynamic changes occurred after performing submaximum physical activity using bicycle ergometer (physical stress) and intravenous injection of adrenalin (pharmacological stress) in 30 liquidators of Chernobyl accident and who have a neurocirculatory dystonia syndrome. It enables to establish interrelations for a number of maximal values of parameters of hemodynamics which is determined by the same shifts in circulatory system with sympathoadrenal direction during these two kinds of stress influence.

[Efficacy of bemithyl and pyrazidol in patients with cerebroasthenia due to brain injury].

The article is dedicated to therapeutic efficacy of a combination of the antihypoxant bemithyl and the antidepressant pyrazidol in patients with asthenoneurotic and asthenovegetative syndromes after moderate isolated brain injury (BI). The combined therapy was shown to reduce long-term sequences of BI such as asthenic symptoms, stabilize both lipid peroxidation processes and serum antioxidative systems.

[Changes in the autonomic status in vegetovascular dystonia syndrome during exposure to permanent magnetic field ]. / Izmenenie vegetativnogo statusa pri sindrome vegetososudistoi distonii pod vliianiem postoiannogo magnitnogo polia.

Permanent magnetic field was applied by placing two magnetic discs (induction 60 mT) in the projection of great arteries on both sides symmetrically. The treatment was given to hypertensive patients with vegetovascular asthenia. A course of such magnetic treatment affects pathogenetic mechanisms of vegetative disorders due to the ability of permanent magnetic field to restore vegetative homeostasis, normalize sympathicotony and vegetative regulation.

[The role of opisthorchiasis in development of the secondary neurocirculatory dystonia and myocardial metabolic changes]. / Rol' opistorkhoza v razvitii vtorichnoi neirotsirkuliatornoi distonii i metabolicheskikh izmenenii miokarda.

AIM: Clarification of opisthorchiasis role in development of secondary neurocirculatory dystonia (NCD) and assessment of myocardial condition in patients with chronic opisthorchiasis (CO) with consideration of the disease duration and intensity of opisthorchotic invasion. MATERIAL AND METHODS: The trial enrolled 120 patients with CO, 35 patients with cardial NSD and 33 healthy controls. RESULTS: In long history of opisthorchiasis and severe invasion, autonomic cardiovascular regulation was abnormal. If CO patients have NCD, myocardial 99mTc-pyrophosphate scintigraphy reveals diffuse metabolic lesion of the myocardium. Long-term autonomic dysregulation of the cardiovascular system in CO and absence of adequate therapy lead to formation of progressive autonomic imbalance syndrome with sympathetic hypertonicity provoking metabolic disturbances of the myocardium.

[Health status of railway workers using magnetic powder flaw detectors]. / Sostoianie zdorov'ia zheleznodorozhnikov, rabotaiushchikh s magnitoporoshkovymi defektoskopami.

The rates of morbidity with temporary working incapacity (TWI) of magnetic-powder defectoscopic operators are discussed. The incidence of diseases with TWI and the days of disability in the study group of workers are greater than the average industrial rates. A comprehensive physical examination detected asthenic vegetative syndrome. This shows it necessary to improve methodological approaches to medical examinations of workers exposed to electromagnetic waves.

[Characteristics of secondary immunodeficiency in patients with neurocirculatory dystonia]. / Kharakteristika vtorichnogo immunodefitsita u bol'nykh tsirkuliatornoi distoniei.

AIM: Investigation of clinical-laboratory parameters of secondary immunodeficiency (SID) in patients with neurocirculatory dystonia (NSD). MATERIALS AND METHODS: Vegetative and immunological statuses were assessed in 104 males aged 30 to 57 years with NSD exposed to 0.01-0.1 Gy radiation after the Chernobyl accident. RESULTS: The patients were diagnosed to have SID the types and forms of which differed with NSD type. Symptoms of SID were evident in 29, 18, 13 and 83% of patients with mixed, hypotonic, hypertonic NSD, NSD without somatic disorders, respectively. CONCLUSION: As 85% of the examinees had SID, it is necessary to treat NSD with immunomodulation adjusted to each NSD type.

[Liver cirrhosis and cardiovascular system]. / Cirrosi epatica ed apparato cardiovascolare.

The patient with hepatocellular disease shows marked vasodilatation, accompanied by hyperdynamic circulation and opening of arteriovenous shunts. The effect of these circulatory changes and especially the profound vasodilation has only recently been investigated in detail. In patients with hepatocellular failure the extremities are flushed, the pulses bounding, the cardiac output increased and the blood pressure low. The circulation resembles what found with systemic arteriovenous fistulae. The peripheral vasodilatation and splanchnic venous pooling reduce the effective blood volume so activating baroreceptors. The secondary events which follow the vasodilation include stimulation of the sympathetic nervous system. This serves to counteract the tendency to arterial hypotension and probably contributes to renal hypoperfusion and to the hepatorenal syndrome development. The nature of the concerned vasodilators remains speculative, but is likely to be multiple. Whatever its nature, the substance might be formed by the sick hepatocyte, fail to be inactivated by it or bypass it through intra- or extra-hepatic portal systemic shunts. In cirrhosis the cardiac index and reduced systemic vascular resistance correlate with the Child's grade of liver failure. This article provides an overview of the general vasodilatory state and its effects on various organs. The mechanisms and the different vasoactive substances that might be responsible are also discussed.

The rise and fall of the chronic fatigue syndrome as defined by Holmes et al.

This paper is a sequel to my monograph on neurocirculatory asthenia and chronic fatigue syndrome. It pays special attention to the nature of chronic fatigue syndrome, to the forms of neurocirculatory asthenia, and above all to the 6th form in which profound fatigue is the dominant symptom. All forms including the 6th are characterized by the presence of concomitant symptoms due to dysfunction of the autonomic nervous system. Chronic fatigue syndrome as defined by Holmes et al is devoid of these symptoms. Up till the present day no case histories of it have been published. It is argued that chronic fatigue syndrome sensu Holmes et al does not exist, the 6th form of neurocirculatory asthenia having to take up its place.

[Probable effect of hemofiltration on hemodynamics and tissue oxygenation in shock secondary to severe malaria]. / Rôle probable de l'hémofiltration sur l'hémodynamique et l'oxygénation tissulaire lors d'un état de choc au décours d'un paludisme grave.

The authors report a case of severe Plasmodium falciparum malaria in a French Guyana endemic area with secondary myocardial dysfunction treated by usual symptomatic therapy and continuous veno-venous haemofiltration (CVVH). Haemodynamic investigations revealed hyperkinetic shock and oxygen supply dependence. Haemodynamic remained critical under conventional therapy and CVVH was introduced. Haemodynamic parameters improved rapidly with reduced oxygen debt. In the absence of associated bacterial, viral and fungal infections, the systemic inflammatory response syndrome with shock and impairment of consciousness seems to be linked to severe Plasmodium falciparum malaria. The benefits and the probable mechanisms of action of CVVH are discussed.