[A comparative study of the efficacy of deep brain stimulation of the subthalamic nucleus and pharmacological treatment in advanced Parkinson's disease]. / Sravnitel'noe issledovanie éffektivnosti neirokhirurgicheskogo lecheniia (élektrostimuliatsiia subtalamicheskogo iadra) i medikamentoznoi terapii na razvernutoi stadii bolezni Parkinsona.

Objective. To assess the clinical efficacy of deep brain stimulation (DBS STN) of the subthalamic nucleus in patients with Parkinson´s disease (PD) compared to pharmacological treatment. Material and methods. DBS STN was applied to 22 patients (mean age 53.2 years, mean disease duration 9,6 years). The control group included 28 patients (mean age 54.2 years, mean disease duration 9,6 years) with PD who received pharmacological treatment. Patients were examined in OFF-medication and ON-medication conditions at 3, 6, 9, 12, 24, 36 months. The Unified Parkinson's Disease Rating Scale (UPDRS) part II, III, IV, the Hoehn and Yahr scale, the Schwab and England Scale, PDQ-39, the Hamilton Rating Scale for depression and the Spielberger Anxiety Scale were administered. All patients had motor fluctuations and dyskinesias. Results and conclusion. We demonstrated that DBS STN improved UPDRS II, III scores, reduced dyskinesias and motor fluctuations. After surgery, dopaminergic therapy was reduced by approximately 54.5%. In the control group, levodopa dose was increased by 20.5% to 36th month.

[The analysis of complications of surgical treatment of brain aneurysms in patients operated on in the late posthemorrhagic period].

UNLABELLED: Most patients with brain aneurisms were operated on in the late posthemorrhagic period at the Burdenko Neurosurgical Institute. OBJECTIVE: To investigate the rate and structure of complications of microsurgical and endovascular surgery for different topographic anatomic variants of cerebral aneurysms in patients operated on in the late posthemorrhagic period in order to assess the risk of intervention in these patients. MATERIAL AND METHODS: The study group comprised 1074 patients with single brain aneurysms who had been treated at the Burdenko Neurosurgical Institute (Russian Academy of Medical Sciences) for the period from 2005 to 2012. The exclusion criterion for the study was the acute stage--21 days after the date of hemorrhage. Age of patients ranged from 18 to 75 years, with the mean of 45.3 years. The number of female patients was 552 (51.4%); the number of male patients was 522 (48.6%). Microsurgical operations were performed in 887 (82.6%) patients, endovascular--in 187 (17.4%). RESULTS: Postoperative complications were observed in 163 (15.2%) patients. Most of the complications (14.2%) were associated with cerebral disorders. Pronounced deterioration was noted in 6% of cases, death--in 0.9%. Cerebral complications were revealed in 13.8% of the patients after microsurgery and in 16% after endovascular treatment; mortality was observed in 1% and 0.5%, respectively. CONCLUSION: The overall risk of disability and death associated with recurrent hemorrhage from the aneurysm, especially at young age, is significantly higher than risks of surgical intervention in patients in the late posthemorrhagic period. Thus, the presence of a brain aneurysm that caused hemorrhage is an indication for surgical treatment, regardless of the time of its rupture.

[Cognitive functions in patients with primary torsion dystonia treated with pallidal deep brain stimulation].

Forty-three patients with primary dystonia underwent neuropsychological assessment according to the method of A.R. Luria. Twenty-three patients with generalized dystonia and 20 with local forms (cervical and craniocervical) were included in the study. All patients were evaluated before pallidal deep brain stimulation (DBS GPi), 32 patients were examined 3-6 days after surgery, and 26 patients - during the first two years of the postoperative follow-up. The evaluation before surgery revealed cognitive impairment in 41 patients. The most common were mnemonic impairment, inertness and preservation in different tests, and spatial function decline. Thus, patients with local forms more frequently had troubles with performance memory tests, whereas spatial function disorders were more common in patients with generalized forms. The deterioration of cognitive functions was observed in 28 patients in the early postoperative period. Moreover, the group of patients with local forms had poorer results. The neuropsychological evaluation after 3-6 months of the postoperative follow-up showed the restoration of cognitive functions to the preoperative level. Neuropsychological syndrome observed in patients with dystonia was generally similar to that found in patients with lesions of the frontal lobe, the caudate nucleus, and the cerebellum.

[fMRI study of the dominant hemisphere for language in patients with brain tumor].

THE AIM OF THE STUDY: Paper describes a study of language lateralization of patients with brain tumors, measured by preoperative functional magnetic resonance imaging (fMRI) and comparison results with tumor histology and profile of functional asymmetry. METHODS: During the study 21 patient underwent fMRI scan. 15 patients had a tumor in the left and 6 in the right hemisphere. Tumors were localized mainly in the frontal, temporal and fronto-temporal regions. Histological diagnosis in 8 cases was malignant Grade IV, in 13 cases--Grade I-III. fMRI study was perfomed on scanner "Signa Exite" with a field strength of 1.5 As speech test reciting the months of the year in reverse order was used. fMRI scan results were compared with the profile of functional asymmetry, which was received with the results of questionnaire Annette and dichotic listening test. RESULTS: Broca's area was found in 7 cases in the left hemisphere, 6 had a tumor Grade I-III. And one patient with glioblastoma had a tumor of the right hemisphere. Broca's area in the right hemisphere was found in 3 patients (2 patients with left sided tumor, and one with right-sided tumor). One patient with left-sided tumor had mild motor aphasia. Bilateral activation in both hemispheres of the brain was observed in 6 patients. All of them had tumor Grade II-III of the left hemisphere. Signs of left-handedness were revealed only in half of these patients. Broca's area was not found in 4 cases. All of them had large malignant tumors Grade IV. One patient couldn't handle program of the research. CONCLUSIONS: Results of fMRI scans, questionnaire Annette and dichotic listening test frequently were not the same, which is significant. Bilateral activation in speech-loads may be a reflection of brain plasticity in cases of long-growing tumors. Thus it's important to consider the full range of clinical data in studying the problem of the dominant hemisphere for language.

[Analysis of efficacy and safety of preventive analgesia with transdermal therapeutic system Duragesic Matrix in spine surgery].

The survey studies analgesic effect of postoperative therapy in two groups of patients with spinal disorders. In the first group the standard scheme with NSAID on demand was used. In the second group transdermal therapeutic system Duragesic Matrix was applied. The pain level (by pain level scale) as well as psychological status and IL-6 rate (a reliable indicator of surgical trauma and pain severity) were assessed before and after surgery. Transdermal therapeutic system Duragesic Matrix applied before surgery appeared to be more effective for analgesic therapy than standard scheme with NSAID on demand.

[Experience in the use of equipment for ECG system analysis in municipal polyclinics].

Two electrocardiographs, an analog-digital electrocardiograph with preliminary analog filtering of signal and a smart cardiograph implemented as a PC-compatible device without preliminary analog filtering, are considered. Advantages and disadvantages of ECG systems based on artificial intelligence are discussed. ECG interpretation modes provided by the two electrocardiographs are considered. The reliability of automatic ECG interpretation is assessed. Problems of rational use of automated ECG processing systems are discussed.

[The problems of the modern electrocardiography (to the 100th anniversary of electrocardiography, 1903-2003)]. / Problemy sovremennoi élektrokardiografii (100-letiiu élektrokardiografii posviashchaetsia, 1903-2003 gg.).

Elucidated in the paper are the key issues of modern electrocardiography (ECG). The negative results of large-scale use of automated ECG interpretation programs are under discussion. The possibility of removing the analogue filters from the electrophysiological apparatus and replacing them with the digital signal processing equipment is contemplated. The modern ECG examinations can not exist without simple automation the program security of information processing. The results of introducing the or apparatus-program complexes (APC) into practice as auxiliary analysis instruments in ECG are analyzed. The effects of APC introduction into daily ECG practice are shown to be advantageous. Finally, there is an analysis of issues related with global computerization in clinical examinations.

[Flea Ceratophyllus fasciatus as the vector of the Altai-mountain strain of plague microbe]. / Blokha Ceratophyllus fasciatus kak perenosnik gornoaltaiskogo shtamma chumnogo mikroba.

The work was conducted with a typical strain of the plague agent, which is virulent to white mice and little virulent to guinea pigs (subcutaneous infection), and with C. fasciatus. The fleas of this species can be infected, form the block of proventriculus within 4 to 35 days, transmit the agent during bloodsucking to healthy animals and cause the death both white mice and guinea pigs.