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1.
Artigo em Russo | MEDLINE | ID: mdl-37994888

RESUMO

Demyelinating disease of the central nervous system associated with antibodies to myelin oligodendrocyte glycoprotein (MOGAD) has been proposed to be distinguished from neuromyelitis optica spectrum disorders (NMOSD) into a separate nosological form. The basis for the recognition of nosological independence was the presence of clinical features of this disease and the detection of a specific biomarker in the blood serum of patients - IgG class antibodies to MOG. The article summarizes the current data on the clinical and radiological phenotypes of MOGAD in children and adults and the features of the course of the disease. The requirements for the laboratory diagnosis of the disease and diagnostic criteria for MOGAD proposed by an international group of experts in 2023 are given.


Assuntos
Sistema Nervoso Central , Neuromielite Óptica , Adulto , Criança , Humanos , Glicoproteína Mielina-Oligodendrócito , Imunoglobulina G , Neuromielite Óptica/diagnóstico por imagem , Fenótipo
2.
Artigo em Russo | MEDLINE | ID: mdl-37796076

RESUMO

The coexistence of optic neuritis and Guillain-Barré syndrome is a rare combination of neurological diseases. The trigger of an autoimmune inflammatory process is often a respiratory mycoplasma infection. Ignorance of such combination can lead to diagnostic and therapy mistakes. This article describes the case of a rare combination of overlapping optic neuritis and Guillain-Barré syndrome, associated with Mycoplasma pneumoniae and provides the short literature review. Further studies are required to identify common pathogenetic mechanisms of combined inflammatory lesions of the optic nerves and peripheral nervous system.


Assuntos
Síndrome de Guillain-Barré , Neurite Óptica , Humanos , Síndrome de Guillain-Barré/complicações , Síndrome de Guillain-Barré/diagnóstico , Mycoplasma pneumoniae , Nervo Óptico , Neurite Óptica/diagnóstico , Neurite Óptica/tratamento farmacológico , Neurite Óptica/etiologia
3.
Artigo em Russo | MEDLINE | ID: mdl-37490664

RESUMO

OBJECTIVE: Evaluation of the efficacy and safety of Prospect in the treatment of cognitive, behavioral and mental disorders in patients with vascular dementia (VSD). MATERIAL AND METHODS: In a double-blind, placebo-controlled, parallel-group randomised clinical trial, 406 patients aged 60-85 years old with a diagnosis of mild/moderate vascular dementia (10-24 on the Mini-Mental State Examination (MMSE)) and without signs of depression (Cornell Scale for Depression in Dementia (CSDD) scores ≤10) were included. At Visit 1, complaints and medical history were collected, vital signs were recorded, cognitive impairment was assessed using MMSE and MoCA, NPI-C and CSDD were completed, and an MRI brain scan was performed. Patients were randomised into two groups: patients in group 1 received Prospekta in a dosage of 2 tablets two times a day for 24 weeks, and patients in group 2 received Placebo according to the study drug regimen. RESULTS: Patients in both groups had no differences in demographic and baseline clinical characteristics. Administration of Prospekta for 24 weeks reduced cognitive impairment in patients with vascular dementia compared to the placebo group. The mean MoCA score increased from 17.0±3.6 [17.1±3.6] to 20.5±4.7 [20.4±4.7] in patients treated with Prospekta, whereas it increased from 17.3±3.7 [17.3±3.8] to 19.2±4.9 [19.2±5.0] in the Placebo group. Treatment with the medication also reduced the severity of neuropsychiatric symptoms as measured by the NPI-C scale. The mean score on this scale decreased from 57.0±26.7 [56.7±25.4] to 39.8±23.6 [39.8±23.5] in the Prospekta group and from 55.5±25.5 [55.3±24.4] to 42.8±27.6 [42.3±25.3] in the Placebo group. The difference in mean MoCA and NPI-C scores between the Prospekta and Placebo groups was statistically significant. CONCLUSION: Prospekta is an effective and safe drug for treating cognitive, behavioural and mental disturbances in patients with vascular dementia.


Assuntos
Demência Vascular , Humanos , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Demência Vascular/complicações , Demência Vascular/tratamento farmacológico , Escalas de Graduação Psiquiátrica , Cognição , Método Duplo-Cego
5.
Sovrem Tekhnologii Med ; 15(1): 74-85, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37388756

RESUMO

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder developing after a traumatic event like participation in combat activities. Objective diagnosis of combat PTSD and effective rehabilitation of war veterans is a current multifaceted problem with particularly high social costs. This review aims to evaluate the potential of virtual reality technique used as exposure therapy tool (VRET) to rehabilitate combat veterans and service members with PTSD. The review was written following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The final analysis includes 75 articles published in 2017-2022. VRET therapeutic effect mechanisms were examined along with protocols and scenarios of VRET combined with other interventions influencing PTSD treatment like pharmacotherapy, motion-assisted multi-modular memory desensitization and reconsolidation (3MDR), transcranial magnetic stimulation. The necessity is substantiated of psychophysiological measurements for objectification of PTSD clinical criteria and its dynamics during treatment. It was shown that inclusion of VRET to the package of PTSD rehabilitation interventions positively affects the results due to the enhanced effect of presence and greater experience personalization. Thus, VRET may be an effective, controlled, and cost-effective alternative for PTSD treatment in combatants, including those not responding to conventional therapy.


Assuntos
Terapia Implosiva , Medicina , Transtornos de Estresse Pós-Traumáticos , Veteranos , Realidade Virtual , Humanos , Transtornos de Estresse Pós-Traumáticos/terapia
6.
Artigo em Russo | MEDLINE | ID: mdl-36538402

RESUMO

Kinesiophobia (KP), or an irrational fear of physical activity, significantly hinders the active rehabilitation of patients with joint pathology. PURPOSE OF THE STUDY: To study the severity and risk factors of KP in patients requiring total hip and knee endoprosthetics (EP). MATERIAL AND METHODS: We examined 50 patients requiring total EP of the hip and knee joints. Pain syndrome was assessed in the preoperative and early postoperative periods in all patients using a visual analog scale, as well as the levels of kinesiophobia, anxiety, and depression using the Hospital Anxiety and Depression Scale and the Tampa Scale for Kinesiophobia (TSK). Quality of patients life was studied in the preoperative period (RAND SF36 questionnaire). RESULTS: In the majority of cases, both before and after EP, the level of KP corresponded to an average degree of severity. Both in the preoperative and in the early postoperative periods, not a single case of the absence of KP was detected (≤17 points according to the TSK); at the same time, a very high level of KP (≥55 points according to TSK) was also rarely recorded - in 3 patients in the postoperative period after EP of the hip joint. KP level significantly correlated with the duration of the pain syndrome, while the mental component of the KP, in addition to the duration of the pain syndrome, was influenced by the social status: in patients who had a steady job, the psychological component of the KP was expressed in a less degree. KP level was negatively correlated with such indicators of quality of life as vitality and physical functioning. In addition, the physical component of the KP significantly correlated with the pain intensity, the mental component - with role-playing behavior. CONCLUSION: Early detection of KP and timely correction of distorted ideas about physical activity are necessary for successful rehabilitation of patients requiring total joint endoprosthetics of the lower limb.


Assuntos
Cinesiofobia , Transtornos Fóbicos , Humanos , Transtornos Fóbicos/diagnóstico , Transtornos Fóbicos/psicologia , Qualidade de Vida , Articulação do Joelho/cirurgia , Dor , Extremidade Inferior
7.
Artigo em Russo | MEDLINE | ID: mdl-34874655

RESUMO

OBJECTIVE: To study the efficacy and safety of using a new original synthetic antioxidant - phenosanic acid as an adjunct therapy in patients with focal epilepsy. MATERIAL AND METHODS: A randomized, double-blind, placebo-controlled, parallel-group study evaluated the efficacy and safety of phenosanic acid as an adjunct therapy to basic antiepileptic drugs in 120 patients with focal epilepsy. Primary purpose: to study the dynamic of seizure frequency. Secondary purposes: to study the dynamic of seizure-free days, the dynamics of bilateral tonic-clonic seizures, the results of questionnaires and scales (General Dynamics Assessment, Visual Analogue Scale (VAS), Quality of Life in Epilepsy (QOLIE-31-P), European Quality of Life Questionnaire (EQ-5D), Hospital Anxiety and Depression Scale (HADS), Frontal Asstssment Battery (FAB), Mini-Mental State Examination (MMSE)). RESULTS: Phenosanic acid (Dibufelon) showed statistically significant benefit over placebo in the primary indicator of efficacy (reduction in the frequency of epileptic seizures by at least 50%) and in the secondary indicators. The drug was safe and well tolerated by the patients. CONCLUSION: The addition of phenosanic acid (Dibufelon) to base antiepileptic drugs seems to be perspective because of its positive effect on reducing the number of epileptic seizures, as well as on comorbid disorders in the emotional and cognitive spheres.


Assuntos
Epilepsias Parciais , Epilepsia , Anticonvulsivantes/uso terapêutico , Epilepsias Parciais/tratamento farmacológico , Epilepsia/tratamento farmacológico , Humanos , Qualidade de Vida , Convulsões/tratamento farmacológico
8.
Artigo em Russo | MEDLINE | ID: mdl-34965698

RESUMO

Transcranial photobiomodulation (tPBM) is a form of light therapy that uses monochromatic visible and infrared light from non-ionizing radiation sources (lasers, LEDs) placed on the scalp, forehead, or intranasally to project light directly to target areas of the brain. Accumulated experimental and clinical data indicate the safety and potential efficacy of tPBM in some central nervous system diseases.This article briefly reviews the general concepts of tPBM, the results of experimental and clinical studies on the efficacy of tPBM in Alzheimer's disease, Parkinson's disease, and brain stroke. The possible mechanisms of the tPBM therapeutic effect and the need to choose optimal exposure parameters are discussed. Although the evidence base regarding the efficacy of tPBM in neurodegenerative and vascular brain diseases is still insufficient, analysis of the published data justifies considering tPBM as a promising method of adjuvant therapy for some central nervous system diseases.


Assuntos
Doença de Alzheimer , Terapia com Luz de Baixa Intensidade , Doenças Neurodegenerativas , Doença de Parkinson , Encéfalo , Humanos , Doenças Neurodegenerativas/terapia , Doença de Parkinson/terapia , Resultado do Tratamento
9.
Artigo em Russo | MEDLINE | ID: mdl-34184475

RESUMO

OBJECTIVE: To assess the efficacy and safety of prospecta in the treatment of moderate cognitive impairment in the early recovery period of ischemic stroke. MATERIAL AND METHODS: The study included 275 patients (mean age 64.0±8.1 years) with a history of single ischemic stroke from 3 to 6 months, with moderate cognitive impairment, and moderate activity in everyday life, who were randomized in two groups. During the screening phase, the severity of cognitive impairment was assessed with the Mini-Mental State Examination and Montreal Cognitive Assessment scales; the level of activity in everyday life was evaluated with the Barthel Scale; and quality of life was assessed with the Stroke Specific Quality of Life Scale. Patients took 2 tablets of prospecta or placebo 2 times a day for 24 weeks. The follow-up period was 4 weeks. The primary endpoint of the study was the proportion of patients with improvement in cognitive function (+1 or more on the MoCA test) after 24 weeks of treatment. The occurrence and type of adverse events (AEs), their severity, relationship to the drug, outcome, changes in vital signs, and the proportion of patients with clinically significant abnormality in laboratory tests were analyzed to assess the safety. RESULTS: A clinically significant improvement in cognitive function was obtained in 91.9% of patients in the prospecta group vs 82.,1% in the placebo group, (p=0.02). There were 57 AEs in 37 (27.4%) Prospecta group patients and 53 AEs in 39 (27.9%) Placebo group participants (p=1.00). No AEs were certainly associated with taking the medication. No clinically significant changes in vital signs or abnormal laboratory results were detected during the study. CONCLUSION: Prospecta is an effective and safe treatment option for patients with moderate cognitive impairment in the early recovery period of ischemic stroke.


Assuntos
Isquemia Encefálica , Disfunção Cognitiva , AVC Isquêmico , Acidente Vascular Cerebral , Idoso , Isquemia Encefálica/complicações , Isquemia Encefálica/tratamento farmacológico , Disfunção Cognitiva/tratamento farmacológico , Disfunção Cognitiva/etiologia , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológico
10.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(7. Vyp. 2): 89-96, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32844637

RESUMO

Levamisole (L) is an anthelmintic agent that is widely used in clinical practice. L can enter the human organism during the treatment of helminthiasis as well as during the using the contaminated cocaine. Multifocal inflammatory levamisole-induced leukoencephalopathy (MILL) is one of the most serious complications of L use. The article discusses the clinical and radiological features of MILL which have a number of similarities of multiple sclerosis (MS) appearance. The disease has a favorable prognosis if started early, but the diagnosis of this rare form of leukoencephalopathy can cause difficulties. The case of MILL in patient with mistaken diagnosis of MS is descrThe case of MILL in patient with mistaken diagnosis of MS is descraibed.ibed.


Assuntos
Leucoencefalopatias , Leucoencefalopatia Multifocal Progressiva , Esclerose Múltipla , Humanos , Levamisol
11.
Artigo em Russo | MEDLINE | ID: mdl-32678556

RESUMO

Autoimmune encephalitis with antibodies to NMDA receptors (anti-NMDAR encephalitis), is the most common form of autoimmune encephalitis. The disease is curable, however, the lack of timely therapy can lead to the disability of patients or to the death. Difficulties in the diagnosis of anti-NMDAR encephalitis are caused by the heterogeneity of its manifestations, a possible overlapping with other autoimmune diseases and insufficient awareness about this form of encephalitis. This article describes the case of anti-NMDAR encephalitis associated with recurrent optic neuritis which might be an atypical manifestation for this disease. Optic neuritis could not be explained by overlapping with multiple sclerosis or neuromyelitis optica spectrum disorders.


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato , Neurite Óptica , Autoanticorpos , Doença de Hashimoto , Humanos , Recidiva Local de Neoplasia
12.
Plasmid ; 106: 102442, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31669286

RESUMO

Helicobacter pylori, a human pathogen linked to many stomach diseases, is well adapted to colonize aggressive gastric environments, and its virulence factors contribute this adaptation. Here, we report the construction of two novel H. pylori vectors, pSv2 and pSv4, carrying a reporter gene fused to the promoters of virulence factor genes for monitoring the response of single H. pylori cells to various stresses. H. pylori cryptic plasmids were modified by the introduction of the Escherichia coli origin of replication, chloramphenicol resistance cassette, and promoterless gfp gene to produce E. coli/H. pylori shuttle vectors. The promoter regions of vacA and ureA genes encoding well-characterized H. pylori virulence factors were fused to the promoterless gfp gene. Recording the GFP fluorescence signal from the genetically modified H. pylori cells immobilized in specifically designed microfluidic devices revealed the response of transcriptional reporter systems to osmotic stress, acidic stress, elevated Ni2+ concentration or iron chelation. Our observations validate the utility of the pSv2 and pSv4 vectors to monitor the regulation of virulence factor genes in diverse strains and clinical isolates of H. pylori.


Assuntos
Genes Reporter , Infecções por Helicobacter/genética , Infecções por Helicobacter/microbiologia , Helicobacter pylori , Estresse Fisiológico/genética , Transcrição Gênica , Dosagem de Genes , Vetores Genéticos/genética , Humanos , Plasmídeos/genética , Regiões Promotoras Genéticas , Transformação Bacteriana
13.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(10. Vyp. 2): 137-146, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31934999

RESUMO

Autoimmune encephalitis with antibodies to NMDA receptors, or anti-NMDAR encephalitis, is the most common form of autoimmune encephalitis. The disease is curable, however, the lack of timely therapy can lead to the disability of patients or to the death. Difficulties in the diagnosis of anti-NMDAR encephalitis are caused by the heterogeneity of its manifestations, a possible overlapping with other autoimmune diseases and insufficient awareness about this form of encephalitis. This article presents the literature review and describes the case of anti-NMDAR encephalitis associated with recurrent optic neuritis, which might be an atypical manifestation for this disease. Optic neuritis could not be explained by overlapping with multiple sclerosis or neuromyelitis optica spectrum disorders.


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato/complicações , Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico , Neurite Óptica/complicações , Diagnóstico Diferencial , Humanos , Esclerose Múltipla/complicações , Esclerose Múltipla/diagnóstico , Neuromielite Óptica/complicações , Neuromielite Óptica/diagnóstico , Neurite Óptica/diagnóstico
14.
Zh Nevrol Psikhiatr Im S S Korsakova ; 118(8. Vyp. 2): 10-17, 2018.
Artigo em Russo | MEDLINE | ID: mdl-30160662

RESUMO

Anemia is one of the common diseases comorbid with multiple sclerosis (MS). This article reviews the prevalence and types of anemia in MS patients. It has been shown that anemia is often accompanied by a decrease in serum iron level. The authors present the data on iron metabolism in patients with MS and MRI findings concerning deposits of iron in the gray matter of the brain. The causal relationship between abnormalities in iron metabolism and MS remains unclear; this study allows to approach the understanding of the MS pathogenesis and to increase the efficacy of therapy for this disease.


Assuntos
Anemia , Esclerose Múltipla , Substância Cinzenta , Humanos , Ferro , Imageamento por Ressonância Magnética
15.
Geohealth ; 2(6): 182-194, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32159014

RESUMO

The U.S. Global Climate Change Research Program has identified climate change as a growing public health threat. We investigated the potential effects of changes in ambient daily maximum temperature on hyperthermia and cardiovascular emergency department (ED) visits using records for patients age 64 and younger from a private insurance database for the May-September period for 2005-2012. We found a strong positive relationship between daily maximum temperatures and ED visits for hyperthermia but not for cardiovascular conditions. Using the fitted relationship from 136 metropolitan areas, we calculated the number and rate of hyperthermia ED visits for climates representative of year 1995 (baseline period), as well as years 2050 and 2090 (future periods), for two climate change scenarios based on outcomes from five global climate models. Without considering potential adaptation or population growth and movement, we calculate that climate change alone will result in an additional 21,000-28,000 hyperthermia ED visits for May to September, with associated treatment costs between $6 million and $52 million (2015 U.S. dollars) by 2050; this increases to approximately 28,000-65,000 additional hyperthermia ED visits with treatment costs between $9 million and $118 million (2015 U.S. dollars) by 2090. The range in projected additional hyperthermia visits reflects the difference between alternative climate scenarios, and the additional range in valuation reflects different assumptions about per-case valuation.

16.
Bull Exp Biol Med ; 163(4): 570-573, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28853083

RESUMO

We studied the role of hydrogen peroxide in the response of tumor cells to treatment with ozonated culture medium. Changes of the level of hydrogen peroxide in tumor cells incubated in ozonated medium were detected by using fluorescence microscopy and genetically-encoded sensor HyPer2. Modifications of fluorescent properties of the sensor reflecting accumulation of hydrogen peroxide in the cell cytoplasm were detected within 70 min from the start of exposure. The concentration of hydrogen peroxide continued to increase until 375 min. The revealed changes support the involvement of hydrogen peroxide in the cell response to ozone treatment.


Assuntos
Peróxido de Hidrogênio/farmacologia , Ozônio/química , Meios de Cultura , Células HeLa , Humanos , Microscopia Confocal , Microscopia de Fluorescência
17.
Zh Nevrol Psikhiatr Im S S Korsakova ; 117(2. Vyp. 2): 74-84, 2017.
Artigo em Russo | MEDLINE | ID: mdl-28617365

RESUMO

More and more multiple sclerosis patients have been receiving treatment with new immunomodulatory drugs. Its discontinuation because of side-effects, lack of efficacy or pregnancy has been increasing as well. This paper reviews such severe complications of natalizumab and fingolimod cessation as immune reconstitution inflammatory syndrome (IRIS) and rebound. The short history, immunopathogenesis and diagnostic criteria of IRIS in individuals with human immunodeficiency virus infection are covered. Clinical and radiological presentations as well as possible pathogenic mechanisms of IRIS in patients treated with natalizumab and fingolimod are discussed. The authors also report the case of a woman with multiple sclerosis treated with fingolimod, who experienced a severe relapse when she stopped treatment. Diagnostic criteria and prognostic factors for IRIS and rebound are needed in patients with multiple sclerosis who discontinue the new disease modification therapy.


Assuntos
Síndrome Inflamatória da Reconstituição Imune , Fatores Imunológicos , Esclerose Múltipla , Feminino , Cloridrato de Fingolimode/uso terapêutico , Humanos , Síndrome Inflamatória da Reconstituição Imune/etiologia , Fatores Imunológicos/uso terapêutico , Esclerose Múltipla/tratamento farmacológico , Natalizumab/uso terapêutico , Gravidez , Recidiva
18.
Mol Biol (Mosk) ; 51(1): 94-103, 2017.
Artigo em Russo | MEDLINE | ID: mdl-28251971

RESUMO

Metastatic prostate cancer is often associated with either primary or intractable castration-resistant prostate cancer (CRPC), thus justifying the search for entirely new ways of treatment. Oncolytic viruses are able to selectively induce the death of tumor cells without affecting normal cells. A murine Sendai virus has potential to be used as an oncolytic agent. However, tumors vary in their sensitivity to different viruses, prompting us to attempt to identify corresponding biomarkers that reflect the interaction of cancer cells and the virus. Here, we show that the sensitivity of primary prostatic adenocarcinoma cell lines to Sendai virus strain (SeVM) vary substantially. Using quantitative PCR, we evaluated expression levels of genes that encode RIG-1-like and Toll-like receptors (TLRs) in cell lines and showed that the levels of mRNAs that encode TLR3 and TLR7 correlate with a degree of sensitivity of the cells to Sendai virus. The lines with lower levels of TLR3 and TLR7 expression are more sensitive to the virus.


Assuntos
Vírus Oncolíticos , Neoplasias de Próstata Resistentes à Castração/terapia , Vírus Sendai , Animais , Biomarcadores Tumorais , Linhagem Celular Tumoral , Humanos , Masculino , Camundongos , Metástase Neoplásica , Neoplasias de Próstata Resistentes à Castração/genética , Receptor 3 Toll-Like/genética , Receptor 7 Toll-Like/genética
20.
Zh Nevrol Psikhiatr Im S S Korsakova ; 116(2 Pt 2): 32-40, 2016.
Artigo em Russo | MEDLINE | ID: mdl-27070359

RESUMO

The review is devoted to revised international diagnostic criteria for neuromyelitisoptica spectrum disorders (NMOSD).Current diagnostic criteria allow NMOSD diagnosis not only for serum aquaporin-4 immunoglobulin G antibodies (AQP4-IgG)-seropositive patients but for AQP4-IgG-seronegative patients as well. New criteria are expected to make NMOSD diagnosis earlier and more accurate as well as to facilitate the differentiation with multiple sclerosis. Furthermore, unify international criteria should help to perform comparable epidemiologic studies and clinical trials of new drugs for NMOSD.


Assuntos
Aquaporina 4/análise , Imunoglobulina G/análise , Esclerose Múltipla/diagnóstico , Autoanticorpos/análise , Humanos , Esclerose Múltipla/imunologia , Neuromielite Óptica/diagnóstico
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