[The results of the multicenter pharmaco-epidemiological observational project on the use of mydocalm in the treatment of pain syndromes with the muscle spasm].

The prospective multicenter open noncomparative pharmaco-epidemiological observational project on the use of mydocalm in real clinical practice has been completed in 2013. The project has been performed in 2090 clinical/rehabilitation settings in 284 cities of 13 countries using the results of 35,383 patients. The project aimed to assess the safety of treatment (percentage of patients with adverse-effects) and pain relieving efficacy as well as patient's satisfaction with the treatment. In total, 6603 (19%) adverse-effects were recorded. Their severity was evaluated as mild in 84,48%, no serious adverse-effects were noted. The high efficacy of mydocalm in the treatment of pain syndromes with the muscle spasm has been demonstrated. The high level of tolerability and absence of the clinically significant increase of adverse effects in the combination with nonsteroidal anti-inflammatory drugs have been confirmed.

[Epidemiology and climate and geographic risk factors of stroke in the South Kazakhstan region].

Stroke is a most frequent life threatening neurological disease and one of the most important causes of disability in Kazakhstan as well as in the whole world. Among CIS, the Kazakh Republic holds the second place after Moldova in mortality from cardiovascular diseases. Some researchers assume that official statistical data do not reflect completely the state of the problem in Kazakhstan due to the lack of representative population epidemiological studies. Optimization of primary and secondary prevention of acute disturbances of cerebral blood circulation in the South Kazakhstan oblast depends, in many respects, on the regional characteristics (a complex of natural, climate, social, everyday and ethnic factors).

[The preventive treatment of stroke in patients with discirculatory encephalopathy with a depressive syndrome].

We studied the clinical efficacy of cytoflavin in 30 patients (group 1) with I and II stages of discirculatory encephalopathy (DE) and a depressive syndrome associated with arterial hypertension. Cytoflavin was added to standard treatment intravenously in drops in dose 10 ml per 200 ml of 0,9% NaCl during 10 days and then in dose 2 tablets twice a day during 25 days. The control group (n=29 patients) received placebo. The treatment duration was 35 days but patients were followed up for 90 days with control visits at 5, 10, 20-35 and 65-90 days of treatment. After the treatment, there was the reduction of neurological symptoms and subjective disorders in patients of group 1. The improvement of attention concentration, reasoning and speech activity as well as the gradual restoration of memory were noted at 20-35 days. The positive impact of cytoflavin on depression was dependent on its severity. The effect was higher in mild depression, also, the treatment decreased the severity of depression from "moderate" or "severe' to "mild". Cytoflavin may be recommended for patients with DE and a depressive syndrome associated with arterial hypertension as a preventive medication from the progression of cerebrovascular pathology and development of stroke.

[Efficacy of the anti-edema drug L-lysine aescinat in stroke].

Forty-nine patients with ischemic hemispheric stroke admitted within 48 hours of stroke onset were studied. Twenty-nine patients (the main group) received L-lysine aescinat as an anti-edema drug. The efficacy was evaluated clinically and by EEG and autonomic testing. The rapid recovery of wakefulness and reduction in neurological deficit as well as the improvement of brain electrical activity and autonomic functions were observed. L-lysine aescinat can be recommended to control the syndrome of intracranial hypertension in stroke.

[Comparative characteristics of clinical and pathogenetic features of first and recurrent cerebral stroke].

Based on the data of clinical and laboratory-instrumental study of 81 patients with recurrent stroke, including 63 cases after the first ischemic stroke and 18 cases after the first hemorrhagic stroke, we compared clinical-pathogenetic correlations between first and recurrent strokes. A trend towards the localization of a focus of secondary stroke in the same hemisphere in case of the similar to the first stroke clinical form and in the other hemisphere in case of changing the clinical form (ischemic to hemorrhagic and vice versa) was found. Among the pathogenetic types of ischemic stroke, lacunar and hemoreologic types were most stable in the secondary stroke compared to the first one. In other variants, the pathogenesis of recurrent stroke changed more often. The authors concluded that further research in this direction would help to solve issues in prediction of secondary stroke and improvement of secondary prophylaxis.

[Cortexin in the complex treatment of post stroke epilepsy].

Forty-six patients with post stroke epilepsy were examined. The basic treatment included depakine-chrono in the mean dosage of 750 mg per day, along with vascular drugs, Cortexin was used as an add-on therapy in 29 patients intramuscular in the dosage of 10 mg during 15 days. Other 17 patients received only basic therapy. The addition of cortexin to the complex treatment significantly enhanced clinical effects reflected by positive changes on EEG.

[An experience of intra-arterial thrombolytic therapy of ischemic stroke in Uzbek republic center of emergency care].

Acute period of stroke is a crucial stage of the disease. The differential therapy in the first 3-6 h from the onset of acute ischemic stroke, so-called "therapeutic window", is of special importance. Obviously, favorable clinical outcome in such patients is largely depends on the early recanalization during "therapeutic window". Presented, are the results of intra-arterial thrombolysis in patients with ischemic stroke, which reveal its high therapeutic effectiveness. Though there was limited clinical evidence for a high effect of recanalization of intra-arterial thrombolysis, this approach opens new perspectives for large scale clinical investigations using endovascular methods in thrombolytic therapy of patients with ischemic stroke.

[Clinical and pathogenetical peculiarities and treatment policy in ischemic stroke of elderly and old age]. / Kliniko-patogeneticheskie osobennosti i voprosy lechebnoi taktiki pri ishemiskom insul'te v pozhilom i starcheskom vozraste.

The data on randomized study of 2 groups of patients with ischemic brain hemisphere stroke of elderly and old (over 70 years) as well as middle (under 60 years) age are presented. In elderly and old age, stroke develops on the basis of common affection of major vessels, with a great role of the "steal syndrome" in its pathogenesis. In authors' opinion, in treatment of ischemic stroke of elderly and old age attention should be paid to metabolic therapy, in particular to using high dosages of Cerebrolysin. Basing on clinical and paraclinical study, efficacy of this medication is revealed.

The diagnostic significance of electrophysiological analysis of an orientational reflex in hemispheric ischemic stroke.

This report presents data from studies of the diagnostic significance of an orientational reflex (OR) to indifferent sound stimuli in hemispheric ischemic stroke. The following electrophysiological measures of the orientational reflex were studied: the desynchronization reaction, the non-specific EEG vertex potential, and spontaneous electrodermographic activity (skin galvanic reactions, SGR) in response to presentation of repeated sudden indifferent sound stimuli. Studies were performed during the course of illness, starting with the acute period of stroke. The results obtained from these studies showed that the severity of stroke correlated with preservation of the OR while the rate of extinction of individual components in the early recovery period correlated with the hemispheric lateralization of the pathological focus and the severity of the neurological defect.

[The diagnostic significance of electrophysiological analysis of orientation reflex in hemispheric ischemic stroke]. / Diagnosticheskaia znachimost' élektrofiziologicheskogo analiza orientirovochnogo refleksa pri polusharnom ishemicheskom insul'te.

Diagnostic significance of orientation reflex in response to neutral sound stimuli in hemispheric ischemic cerebral stroke is discussed. The following electrophysiological indices for orientation reflex were analysed: desynchronization reaction, non-specific vertex EEG potential and spontaneous electrodermographic activity--galvanic skin reflex to repeated sudden neutral audio stimuli were analysed. Beginning from the acute period of stroke, a follow-up study was carried out. Correlations between stroke severity and orientation reflex stability as well as between a rate of some pattern diminution in the early rehabilitation period and hemispheric lateralization of the pathological focus and severity degree of the neurological deficit were found.

[Autonomic system disorders in patients with myasthenia gravis]. / Psikhovegetativnye rasstroistva u bol'nykh miasteniei.

Using a set of techniques, segmentary and nonsegmentary autonomic nervous system compartments were studied at rest and under stress. Parasympathicotonia, on the background of general deficit of ascending nonspecific brain activity, was found to characterize myasthenia in general. A decrease of nonspecific brain activity level is combined with elevated anxiety. However, one may distinguish a generalized type of the disease by the presence of dissociation of the autonomic nervous system compartments due to sympathicotonia.

[Role of autonomic dysfunction syndrome in the etiology of pre-stroke forms of cerebrovascular pathology in women of young age]. / Rol' sindroma vegetativnoi distonii v geneze doinsul'tnykh form tserebrovaskuliarnoi patologii u zhenshchin molodogo vozrasta.

30 women aged 30-45 years with the diagnosis "initial manifestations of insufficiency of cerebral circulation" were examined. These disorders were observed on the background of the syndrome of autonomic dysfunction. Correlative analysis was performed by means of methods which permitted quantitative estimations on the basis of investigation of the severity of the syndrome, peculiarities of the patients' mental state and cerebral hemodynamics. Pronounced correlation was found between hemodynamic indices and the degree of anxieties. Anxiety plays an inducing role in the development of either autonomic dysfunction or the main vascular disorders. The syndrome of autonomic disfunction was considered as the realising factor.

[Psychoautonomic disorders in bronchial asthma patients]. / Psikhovegetativnye narusheniia u bol'nykh bronkhial'noi astmoi.

The results of psychological and vegetative investigations in 142 patients with bronchial asthma (BA) demonstrated that BA gives rise to psychovegetative syndrome resultant from parasympathetic orientation of the vegetative tone and reactivity, weak vegetative support of muscular and mental activity. These vegetative shifts occur in line with enhanced ascending nonspecific activation and anxious-hypochondriac traits of personality.

The influence of stimulation of the hypothalamus on the choice of food during maintenance of rats on various salt and water diets.

Electrical stimulation of the lateral hypothalamus of rats maintained on a normal or salty diet with water deprivation leads to an increase in drinking excitability and to a decrease in the thresholds for salty food consumed. The stimulation promotes attenuation of the effects of the "mental" desalting of food that is achieved by a spatial co-placement of the nonsaltiness signal with salty reinforcement, and accelerates the conversion of the signal significance of the conditional stimuli associated with nonsalty and salty reinforcement as well. Electrical stimulation of the hypothalamus accelerates the formation of conditioned reflex aversion to salty food and the inhibition of conditioned reflexes in the direction of the corresponding food dispenser, and intensifies the existing state of thirst as well, imparting to it characteristics of a dominant motivation.

[The participation of the posterolateral area of the hypothalamus in rats in the conditioned-reflex choice of food with different rations]. / Uchastie zadnelateral'noi oblasti gipotalamusa krys v uslovnoreflektornom vybore pishchi pri raznykh ratsionakh.

A week salt load and partial water deprivation of rats lead to disturbance of conditioned activity: decrease of adequate runs to the feeder with salted food and disinhibition of differentiations. In cases of shift of insipid signal to the feeder with salted food the animal ate alimentary reinforcement of such a degree of salinity which was rejected by the animal at realization of run in response to the salt signal. Against the background of thirst a trans-switching of signal role of the conditioned signals was performed in accordance with the new quality of the alimentary reinforcement (the feeders changed their places). The role is discussed of the external and internal signalization in regulation of gustatory thresholds and participation of the lateral hypothalamus in these mechanisms.