VESTIBULAR DYSFUNCTIONS IN CHRONIC BRAIN ISCHEMIA IN THE POST COVID PERIOD.

OBJECTIVE: The aim: The aim of the study is the clinical-pathogenetic reasoning of vestibular dysfunctions (VD) development against the background of chronic brain ischemia in the presence of degenerative changes in the cervical spine (CS) in the post COVID period. PATIENTS AND METHODS: Materials and methods: 82 patients, in the conditions of the clinical base of the Odessa National Medical University in 2019-2021 were examined. Group I with VD against the background of chronic brain ischemia (CBI) at the compensated phase; Group II with VD against the background of CBI at the subcom¬pensated phase (33 men; 49 women), aged from 18 to 55 years. The control group (CG) consisted of 20 patients of the corresponding gender and age. The condition of the state of the autonomic nervous system, vestibular functions, cervical spine, cerebral arteries and emotional condition were examined. RESULTS: Results: Vestibulo-ataxic disorders were higher compared to CG and increased along with the degree of brain damage. An important aspect of the development of VD is autonomic dysfunction against the background of pathological autonomic characteristics with predominant parasympathetic orientation of autonomic tone, especially in the case of insufficiency of autonomic recativity (AR) and pathological autonomic support of activity. Such changes significantly increased in the presence of subcompensation of CBI. The correlation between psychoemotional disorders and changes in autonomic characteristics with VD against the background of CBI with initial regularities depending on the degree of brain damage was defined. The progression of CBI is facilitated by coronavirus infection and manifested in autonomic and psychoemotional dysfunctions. A characteristic hemodynamic feature in groups with compensated and subcompensated CBI is the presence of reduced perfusion in basilar (BA) and vertebral (VA) arteries. Changes in cerebral vascular reactivity with a decrease in cerebrovascular reactivity indicators were characteristic of the subcompensated phase of CBI. Hyperactivity to rotational functional loads in both clinical groups has a high correlation with the presence of stair descent and, to a lesser extent, isolated instability in CS. CONCLUSION: Conclusions: 1. The occurrence of VD is facilitated by the presence of autonomic dysfunction and degenerative-dystrophic changes in the CS, especially in case of subcompensation of CBI. 2. Psychoemotional changes were a characteristic feature of patients with VD against the background of CBI and had certain regularities depending on the phase of CBI. 3. Suffered coronavirus infection contributes to the progression of VD and further decompensation of CBI due to direct damage to the autonomic and vascular systems of the brain. 4. Changes in cerebral hemodynamics in the form of reduced perfusion in BA and VA, a decrease in cerebrovascular reactivity, and an increase in reactivity to rotational functional load were determined in patients with VD against the background of subcompensated CBI.

STATE OF AUTONOMIC REGULATION AND CEREBROVASCULAR REACTIVITY IN PATIENTS WITH HEADACHE WITH ARTERIAL HYPERTENSION.

OBJECTIVE: The aim: A comprehensive assessment of the state of the autonomic nervous system and cerebrovascular reactivity of the cerebral blood flow in the patients with the headache accompanied by arterial hypertension (AH) and somatoform autonomic dysfunction (SAD). PATIENTS AND METHODS: Materials and methods: We conducted the clinical, autonomic regulation and Doppler sonography examination of 124 young patients (18-45 years old), including 51 men and 73 women in the conditions of the clinical base of the Kharkiv Medical Academy of Postgraduate Education in 2018-2021. All patients with cephalgias were divided into three groups: with AH stage II (Group I - 41 patients), AH stage I (Group II - 40 patients), SAD (Group III - 43 patients). The control group consisted of 50 patients of the corresponding gender and age. RESULTS: Results: The intensity of cephalalgia in patients with SAD was maximum. The autonomic tone (AT) was changed in 68.5%examined patients. It had a pronounced shift towards sympathicotonia. According to the visual analogue scale the maximum intensity of cephalgias was against the sympathicotonia. In the groups with organic lesions of the cerebral vessels the latent period delay was registered with the progression of the organic pathology. The regularity was revealed - the shortening of the evoked skin sympathetic potentials latency with the severity of cephalalgia, which can be interpreted as an increase in ergotropic effects with the realisation of the pain syndrome. The obtained data on the state of the AT indicate the depletion of the ergotropic processes with the progression of cerebral ischemia with a known increase in parasympathicotonia. In the patients of SAD group the CrCO2 and KrFNTvalues were significantly increased, in AH stage I group they slightly exceeded the standard values , in AH stage II group they were reduced. The reactivity to the orthostatic loads and functional metabolic test in all groups exceeded the control values. CONCLUSION: Conclusions: 1. The cephalgic syndrome is one of the main symptoms of the autonomic dysfunction and arterial hypertension; the frequency and intensity of the headache increases with the hyperreactivity of the sympathetic system. 2. The SSP data indicate that the sympathetic activity triggers and maintains the pain syndrome, and can also be realized in the form of arterial hypertension. 3. The dysfunction of the central link of the GSR indicates the instability of the autonomous regulation, the work of the limbic-reticular complex, which is clinically manifested by the changes in the cerebral vascular tone. 4. The cerebrovascular hyperreactivity as a sign of the search for the optimal sanogenetic variant of the cerebral hemodynamics in patients with SAD and AH stage I occurs predominantly due to the vasodilatory component. 5. In the patients with AH stage II the vasoconstrictor reactions are observed with the depletion of the vasodilation reserves, which is a marker of the autoregulation failure.

FEATURES OF HEMODYNAMICS IN HEAD MAGISTRAL AND CEREBRAL ARTERIES IN THE PATIENTS WITH MIGRAINE.

OBJECTIVE: The aim of the study was to Doppler sonography study of the structural and functional state of head magistral arteries (HMA) and cerebral arteries in the patients with various forms of migraine. PATIENTS AND METHODS: Materials and methods: We conducted the clinical Doppler examination of 124 young patients (18-45 years old), including 55 men and 69 women in the conditions of the clinical base of the Kharkiv Medical Academy of Postgraduate Education in 2017-2019. The criteria for involvement of patients in the study were: migraine without aura (group 1 - 63 patients), migraine with aura (group 2 - 61 patients) The control group consisted of 45 patients of the corresponding gender and age. The condition of HMA and cerebral arteries was studied using the ultrasound device. RESULTS: Results: The presence of extravasal compressions of vertebral arteries (VA) is typical for the patients with migraine, as well as for some cases of the hypoplasia of the VA in the group of the patients with migraine with aura. In the patients with migraine with aura, there was a decrease in the velocity values in the extracranial VA segments. The velocity values in the external carotid arteries (ECA) were slightly reduced in both groups. The most significant were the changes in the hemodynamics in the middle cerebral arteries (MCA), which were manifested by the pattern of the excessive perfusion in the patients of the migraine without aura and the pattern of the hampered perfusion in the MCA in the patients of the migraine with aura. CONCLUSION: Conclusions: 1. In the patients with migraine with aura, a decrease in the velocity values in the extracranial segments of the VA was observed, in some cases combined with the hypoplasia of the vertebral artery, the hampered perfusion in middle cerebral arteries. 2. The excessive perfusion in middle cerebral arteries is the most critical hemodynamic pattern in the patients with migraine without aura. 3. The extravasal compression of vertebral arteries, combined with the hyperperfusion in posterior cerebral arteries, is a typical hemodynamic pattern both in the group of the patients with migraine with aura, and in the group of the patients with migraine without aura.

FEATURES OF CEREBROVASCULAR REACTIVITY IN PATIENTS OF YOUNG AGE WITH MIGRAINE.

OBJECTIVE: The aim of the study was to Doppler sonography study of cerebrovascular reactivity in young patients with migraine and comparison of autoregulation patterns between groups of migraine patients with aura and migraine without aura. PATIENTS AND METHODS: Materials and methods: We conducted the clinical Doppler examination of 124 young patients (18-45 years old), including 55 men and 69 women in the conditions of the clinical base of the Kharkiv Medical Academy of Postgraduate Education in 2017-2019. The criteria for involvement of patients in the study were: migraine without aura (group 1-63 patients), migraine with aura (group 2-61 patients) The control group consisted of 45 patients of the corresponding gender and age. The indicators of CVR were studied using the ultrasound device. RESULTS: Results: A hyperreactive response to tests with CO2 and photoreactivity were more pronounced in the patients with migraine without aura. The patients with migraine with aura showed hyperreactivity in the test with O2, which was an indicator of the tendency to hyperconstriction. The hyperreactivity in the functional nitroglycerin test and the carotid compression test shows the state of the myogenic mechanism of changes in vascular tone. Insignificant hyperreactivity to orthostatic load detected in both groups shows the interest of the neurogenic regulatory link. CONCLUSION: Conclusions: 1. The most important hemodynamic patterns in the patients with migraine are excessive perfusion with migraine without aura and difficult perfusion with migraine with aura. 2. For the patients with migraine without aura, a characteristic criterion for autoregulation is the pattern of hyperreactivity hypercapnic load and photostimulation. 3. The most important difference in the autoregulatory response in the patients with migraine with aura compared with migraine without aura is the hyperresponse to hyperventilation load, compression carotid and nitroglycerin tests.

The total content of toxic elements in horsehair given the level of essential elements.

Elemental status of 214 mares aged 3-7 years from 11 breeds was studied: Arabian purebred (n = 20), Bashkir (n = 20), Kabarda (n = 20), Vyatka (n = 20), Tuva (n = 19), Yakutsk (n = 30), Mezenskaya (n = 20), Thoroughbred (n = 20), Akhal-Teke (n = 20), Russian trotter (n = 15), Soviet Heavy Draft (n = 10) bred in 13 regions of Russia. The research objective is to study the content of chemical elements in hair from the horse's mane, depending on the sum of toxic elements in animal hair expressed in moles. The elemental composition of the hair was defined by atomic emission and mass spectrometry (AES and MS). Elemental composition of biosubstrates was studied by 25 indicators (Al, As, B, Ca, Cd, Co, Cr, Cu, Fe, I, K, Li, Mg, Mn, Na, Ni, P, Pb, Se, Si, Sn, Hg, Sr, V, Zn). In the studies, an estimate of the total toxic load of the horse's body (∑tox) was given as the sum of mmoles of Al, Cd, Pb, Sn, Hg, and Sr in horsehair. Based on ∑tox percentile calculations, animals were divided into three groups up to 25 percentile (n = 54) with concentrations up to 1.09 mmol/kg, within the 25 and 75 percentile limits (n = 105) and over 75 percentile (n = 55) with a concentration above 6.08 mmol/kg. As follows from the obtained results, the ∑tox indicator in the mane's hair is closely connected with the total hair mineralization. For the studied range of ∑tox values, the relationship of this indicator with 13 essential and conditionally essential chemical elements is described. Moreover, as ∑tox increases, it indicates an increase in the concentration of eleven (Ca, P, Co, Cr, Fe, I, Mn, Li, Ni, V, As) and a decrease of two elements in hair (B, Si); for six elements (K, Mg, Na, Cu, Zn, Sn), such a connection was not revealed. At ∑tox values higher than 75 percentile, a critical increase in the exchange pools of two or more toxic elements in the body was observed in 85% of cases. Intensive exchange of selenium and iodine is observed; it is expressed by an increase in the number of animals with the content of these elements in hair beyond the "physiological standard," estimated as the range of 25-75 percentile.

Assessment of Gender Effects and Reference Values of Mane Hair Trace Element Content in English Thoroughbred Horses (North Caucasus, Russia) Using ICP-DRC-MS.

The objective of the present study was assessment of gender differences in hair trace element content in English Thoroughbred horses (North Caucasus, Russia) using ICP-DRC-MS and calculation of the reference values. Trace element content in mane hair of 190 stallions and 94 mares (3-7 years old) bred in North Caucasus (Russia) was assessed using inductively coupled plasma mass spectrometry. Mane hair Co, Cr, Mn, Li, Si, and Sr levels in mares exceeded those in stallions by 77%, 63%, 64%, 42%, 39%, and 64%, respectively. Hair Fe and Si content was nearly twofold higher in female horses as compared to the males. Only hair Zn content was 5% higher in stallions as compared to mares. In addition, mares were characterized by 63%, 65%, 29%, and 40% higher levels of As, Pb, Sn, and Ni levels in hair as compared to the respective values in stallions. In turn, hair Al and Hg were more than twofold higher in mares than in stallions. The reference intervals of mane hair content (µg/g) for Co (0.006-0.143), Cr (0.028-0.551), Cu (4.17-6.84), Fe (10.11-442.2), I (0.026-3.69), Mn (0.551-12.55), Se (0.108-0.714), Zn (97.43-167), Li (0.011-0.709), Ni (0.060-0.589), Si (0.665-29.12), V (0.006-0.584), Al (1.98-168.5), As (0.006-0.127), Cd (0.002-0.033), B (0.494-16.13), Pb (0.018-0.436), Sn (0.002-0.144), Sr (1.0-9.46), and Hg (0.0018-0.017) in the total cohort of horses were estimated using the American Society for Veterinary Clinical Pathology Quality Assurance and Laboratory Standard Guidelines. The reference intervals were also estimated for stallions and mares bred in North Caucasus (Russia) and may be used for interpretation of the results of hair trace element analysis in horses.

The content of essential and toxic elements in the hair of the mane of the trotter horses depending on their speed.

A study on the Russian trotting breeds was conducted to assess the impact of horses' sporting results and the degree of accumulation of chemical elements in the hair. In the first phase of the research, the elemental composition of the mane hair of trotter horses (n = 215) was studied. Based on these studies, percentile intervals for the distribution of concentrations of chemical elements in the hair have been established, and the values of 25 and 75 percentile adopted as a "physiological standard" have been defined. In the second stage of the research into clinically healthy Russian trotting breeds (n = 56), it was estimated that the sporting results were dependent on the elemental status defined by the hair. The elemental composition of the hair was defined by 25 chemical elements using atomic emission and mass spectrometry. It is established that the mane hair is closely related to the sporting results of trotter horses. Thus, in animal wool with the highest sporting achievements, there were reliably less I, Cr, Co, Li, V, Al, Pb, and Cd, and reliably more Si than the low ones. Differences in individual elements exceeded 200%. As sporting performance diminished, the number of elements within the standard increased. For example, for mares with average speed, there were deviations from the physiological standard by 6 elements (P, Fe, Mn, I, Co, Si), with the low one by 13 elements (P, Fe, Cu, Mn, I, Co, Si, K, Cr, Ni, V, Al, Pb). A comparative estimate of the mineralization of the horses' mane measured by the sum of the amount of substances showed that there was a negative correlation between the accumulation of toxic elements and the speed (r = - 0.59). On the basis of the above, a conclusion is reached on the future use of the mane hair to assess the speed qualities of trotter horses.