[Use of modern classification systems for complex diagnostics of Alzheimer's disease]. / Primenenie sovremennykh klassifikatsionnykh sistem dlya kompleksnoi diagnostiki bolezni Al'tsgeimera.

OBJECTIVE: To compare the content of ß-amyloid (Aß) peptides Aß40, Aß42, total and threonine phosphorylated 181 tau-protein in cerebrospinal fluid (CSF) of patients with the clinical diagnosis of Alzheimer's disease (AD). MATERIAL AND METHODS: The study was performed on 64 patients with a diagnosis of dementia and MMSE scores of 24 or lower. All patients underwent lumbar puncture. Aß40, Aß42, Aß42/40 ratio, total tau, phosphorylated tau at threonine 181 were determined in the CSF using a multiplex assay according to the manufacturer's protocol, the concentration was determined in pkg/ml. RESULTS: The preliminary diagnosis of AD was made in 3 patients (5%). As a result of the study of protein content in the CSF, signs of AD were detected in 48 (75%) people. The findings suggest that the diagnosis of AD is made 10-14 times less frequently than it should be according to the World Health Organization data. The discrepancy between clinical diagnosis and laboratory findings is confirmed by our study. CONCLUSION: Differences in the therapy of dementias and the development of new drugs targeting specific links in the pathogenesis of different types of dementias require accurate and complete diagnosis of dementias, especially AD, as the most common type of dementia.

[Stress, asthenia and cognitive disorders]. / Stress, asteniya i kognitivnye rasstroistva.

Asthenia is a clinical syndrome that nearly any somatic and neurological pathologies can manifest with. Being is essence a defense mechanism that signals the depletion of energy resources, asthenia can become a pathological, extremely disabling condition, and even transform into a nosology of its own - the chronic fatigue syndrome, an immune-mediated disease. Besides, asthenia is often combined with affective and cognitive disorders, which facilitates difficulties in the establishing of the primary diagnosis. In this article we examine the complicated weave of asthenia, chronic fatigue syndrome, cognitive, and affective disorders.

Stress, Asthenia, and Cognitive Disorders.

Asthenia is a clinical syndrome that can be manifest in almost all somatic, infectious, and neurological diseases. Initially a protective mechanism indicating depletion of energy resources, asthenia can become a pathological and extremely disabling condition, and can even progress to an independent immune-mediated disease - chronic fatigue syndrome. Asthenia is often combined with affective and cognitive disorders, producing diagnostic difficulties. The article addresses the complex interweaving of asthenia, chronic fatigue syndrome, and cognitive and affective disorders.

[Erectile dysfunction in Parkinson's disease]. / Érektil'naia disfunktsiia pri bolezni Parkinsona.

Erectile dysfunction (ED) significantly deteriorates the quality of life of patients with Parkinson's disease (PD). Until recently, treatment of ED received insufficient attention. Management of ED in patients with PD requires an integrated and multidisciplinary approach. Pharmacotherapy with apomorphine or sildenafil (or other inhibitors of phosphodiesterase-5) has shown encouraging results in most patients with PD and ED. This review of literature addresses problems of ED in patients with PD.

[The efficacy and safety of naproxen in the treatment of nonspecific lumbalgia: the results of an open multi-center study (NEST)]. / Éffektivnost' i bezopasnost' naproksena v lechenii nespetsificheskoi liumbalgii: rezul'taty otkrytogo mnogotsentrovogo issledovaniia (NEST).

AIM: To assess the efficacy and safety of naproxen in patients with nonspecific low back pain. MATERIAL AND METHODS: Ninety patients with nonspecific low back pain were enrolled in the study. Patients took 550 mg of naproxen twice a day. All patients were assessed with VAS, the Oswestry questionnaire, Schober's test and clinical global impression scale. The treatment lasted from 7 to 14 days depending on the pain relief (VAS ≤10 mm). RESULTS: The pain syndrome relief was observed in 77 patients (88.5%) during the first week of the treatment and in 81 (93.1%) by the end of the study. The average value of VAS was reduced by 6.2 times (by 52.9 mm) in comparison to the baseline. According to the Oswestry questionnaire the influence of pain syndrome on the life quality was reduced by 4,78 times in comparison to the baseline. Schober's test revealed an increase in the amplitude of movements during therapy by 27% in comparison to the baseline. Only 5 (5.7%) drug-related adverse reactions were observed during the whole study, 80% of those were mild. CONCLUSION: Naproxen in the dose of 550 mg twice a day demonstrates the high efficacy and safety in patients with non-specific pain in lumbosacral spine.

[The addition of memantine to galantamine increases treatment efficacy in patients with moderate dementia with Lewy bodies]. / Dobavlenie memantina k galantaminu povyshaet éffektivnost' lecheniia u patsientov s umerennoi stepen'iu tiazhesti dementsii s tel'tsami Levi.

Dementia with Lewy bodies (DLB) is the most frequent cause of dementia in the elderly. Both open and few placebo-controlled studies have demonstrated the efficacy of monotherapy with cholinesterase inhibitors (CI) and memantine in the treatment of these patients. However the efficacy and safety of combined therapy with CI and memantine are poorly studied. AIM: To assess the efficacy of modern antidementia drugs (memantine and galantamine). MATERIAL AND METHODS: Thirty-eight patients with DLB were studied. Monotherapy with galantamine in the dose of 16 mg/day was used during the first 6 months in according with current therapeutic recommendations. Then 19 patients who responded to treatment received in addition memantine in the dose of 20 mg/day. Patients' state was assessed using a battery of scales and tests. RESULTS AND CONCLUSION: The combination of memantine and galantamine significantly improved attention, memory, speech functions and behavior. Therefore, the early treatment with the combination of CI and memantine may be effective in treatment of DLB.

[Possibilities of retention of work capacity in patients with Parkinson's disease]. / Vozmozhnosti sokhraneniia trudosposobnosti u patsientov s bolezn'iu Parkinsona.

AIM: To study the efficacy of replacement of the single daily dose of two-component levodopa by three-component levodopa in work capable patients with Parkinson's disease with motor fluctuations during the most active working hours. MATERIAL AND METHODS: The study included 157 patients from 19 Russian centers specialized in extrapyramidal pathology. The period of highest working activity was analyzed in all patients. In these patients, the previous treatment with two-component levodopa was replaced by three-component levodopa in the equivalent dose. Other antiparkinsonian treatment remained unchanged during the study period. The duration of the study was 1 month. RESULTS AND CONCLUSION: The single replacement of two-component levodopa by stalevo allows increasing the optimal working activity by 19% and improving patient's state.

[Pramipexole in Parkinson's disease]. / Primenenie pramipeksola pri bolezni Parkinsona.

Pramipexole is non-ergoline dopamine receptor agonist. There is accumulating evidence for the efficacy of pramipexole in treatment of Parkinson's disease (PD). Authors have summarized the results concerning the optimal start treatment, the using of pramipexole in early and advanced PD stages, effects of pramipexole on tremor, cognitive impairment, affective functions and safety pramipexole.