AB0 and rhesus blood groups as a risk factor for ARVI COVID-19.

The frequency of AB0 and Rhesus blood groups was studied in 12120 patients with COVID-19, 5180 convalescent plasma donors and 118801 healthy donors from Moscow, Smolensk, Yakutsk, Minsk and Gomel. In infected individuals, the frequency of blood group A was significantly higher than in uninfected individuals (41,54 % and 34,39 % respectively, p<0,05), and the frequency of blood group 0, on the contrary, was significantly lower (27,69 % and 36,71 %, p<0,05). The frequency of blood group A was particularly high among patients who died from ARVI COVID-19 - 45,51 % vs. 34,39 %, p=0,008. In some groups of patients, there was a decrease in the frequency of Rh-negative individuals (2,23 % vs. 8,30 %, p<0,001).

[The use of cluster analysis and logistic regression for assessing the risk of Alzheimer's disease in patients with mild cognitive impairment, amnestic type]. / Ispol'zovanie klasternogo analiza i logisticheskoi regressii dlia otsenki riska bolezni Al'tsgeimera u patsientov s sindromom miagkogo kognitivnogo snizheniia amnesticheskogo tipa.

AIM: The evaluation of the risk of Alzheimer disease (AD) in patients with cognitive impairment, amnestic type (aMCI) on the basis of cluster analysis and logistic regression with the use of such markers of inflammation as enzymatic activity of leukocyte elastase (LE) and the functional activity of α1-proteinase inhibitor (α1-PI). MATERIAL AND METHODS: The study object of statistical analysis was the database, including the results of LE activity and functional α1-PI activity in blood plasma of 78 outpatients with aMCI (25 men and 53 women, aged 44 to 89 years (69.1±9.95). RESULTS AND CONCLUSION: Clustering by k-means and classification by logistic regression indicate a high probability of AD in patients with aMCI depending on the activity of LE and α1-PI in blood plasma. The total coincidence of objects included in the clusters and in the AD risk group was 94%. The high coincidence of two different methods of grouping confirms the previously stated notion of the possibility of identifying patients with the high risk of AD among patients with aMCI by the activity of LE and α1-PI in the blood.

[Memantine (akatinol) in the treatment of vascular dementia]. / Memantin (akatinol) v lechenii sosudistoi dementsii.

The literature on the results of the therapeutic efficacy of memantine in treatment of cerebrovascular diseases with cognitive impairment of different severity is analyzed. The results of randomized and observational studies justified the wide use of memantine in clinical practice.

[Inflammatory markers in schizophrenia in aged].

OBJECTIVE: To identify inflammatory markers in schizophrenia in aged. MATERIAL AND METHODS: The main group included 29 patients with schizophrenia, mean age 72.1 ± 6.9 years. A comparison group comprised 34 patients with Alzheimer's disease, mean age 73.4 ± 7.9 years. Seven plasma inflammatory indicators were determined. RESULTS: There was a significant increase in the activity/content of acute inflammation stage proteins: α1-proteinase inhibitor and C-reactive protein as well as anti-inflammatory interleukin-10 compared to the controls while the activity of other inflammatory molecules (leukocyte elastase, tumor necrosis factor alpha, interleukin-1 receptor antagonist) was not changed. No correlations between immunological parameters and clinical presentations were found. CONCLUSION: The results suggest that inflammation does not play a significant role in the remote stages of schizophrenia, in contrast to earlier stages of the disease, and the activity of the pathological process decreased in the late stages. These characteristics can reflect the body reactivity in elderly patients.

[Neuropsychological features of mixed Alzheimer's and vascular dementia].

Neuropsychological syndrome was defined in 94 patients with mixed Alzheimer's/vascular dementia, 75 patients with vascular dementia and 114 patients with Alzheimer's disease (AD) without clinical signs of cerebrovascular disease. Based on this data, the authors singled out main components of neuropsychological disorders in mild and moderate mixed dementia. The comparison of results of the quantitative assessment of neuropsychological functions (total parameters of three blocks of the brain according to A.R. Luria) in mixed dementia and AD revealed significant between-group differences at the stage of mild dementia. No differences was found between AD and moderate dementia. It has been concluded that the assessment of neuropsychological functions should be used for differential diagnosis of different forms of late-onset dementia and may help in understanding of the contribution of risk vascular factors to the development of dementia.

[Efficacy of actovegin in the treatment of elderly patients with vascular mild cognitive impairment].

Efficacy of actovegin was investigated in the treatment of mild cognitive impairment (MCI) of cerebrovascular genesis. Thirty patients (7 men and 23 women, mean age 71.2 years) received actovegin intramuscularly in dosage 5 ml (200 mg) daily during 4 weeks. Patient's were assessed before and after treatment using CGI and MMSE, verbal association test, scale of frontal dysfunction, clock drawing test, Boston naming test, Mattis dementia scale, test to remember 10 words, the Hamilton depression scale. An improvement was seen in all measures. A positive therapeutic effect, including increased speed of mental processes, reduction of bradiphrenia and memory disorders as well as positive impact on asthenic and depressive symptoms, was identified. Side-effects and adverse events of actovegin were not observed. It is concluded that actovegin could be recommended for elderly patients with early manifestations of cognitive decline.

[Inflammatory markers in Alzheimer's disease and vascular dementia].

The following markers of inflammation: enzymatic activity of leukocyte elastase (LE), functional activity of alpha-1-proteinase inhibitor (α1-PI), levels of C-reactive protein (CRP) and interleukin-6 (IL-6) were measured in the blood plasma of patients with Alzheimer's disease (AD) and vascular dementia (VD). The results confirm the presence of an inflammatory component in the pathogenesis of AD and VD. The high level of CRP may be considered as a marker of VD in the early stages of disease. There was an elevation of α1-PI activity in AD patients compared to age-matched controls. The α1-PI activity, levels of CRP and IL-6 increased with the severity of dementia while the LE activity significantly decreased compared to controls (p<0.01). In patients with AD, the IL-6 level was negatively correlated with MMSE scores (Spearman r = -0.46, p=0.0077) and, therefore, can be considered as a biological marker of the severity of the pathological process. Positive correlations between CRP and IL-6 may plausibly reflect an ability of IL-6 to induce the synthesis of CRP.

[Effect of revascularization of on therapeutic outcomes of treatment for lower-limb chronic critical ischaemia in neuroischaemic form of diabetic foot syndrome].

The article deals with diabetic foot syndrome defined as a multidisciplinary problem. A reconstructive vascular operation in critical ischaemia on the background of diabetic foot syndrome is herein shown to be an efficient and justified intervention. Revascularization makes it possible to carry out sparing resections on the foot, to appropriately cope with the events of lower-limb critical ischaemia, and to reliably decrease the rate of high amputations.

[Biologic characteristics of new Bacillus subtilis isolates].

Characteristics of new Bacillus subtilis isolates from the environment and had high antagonistic activity were studied. Absence of virulence and toxin production allows to regard them as potential probiotic cultures. Growth media for cultivation of B.subtilis were chosen according to the principle of individual adequacy in system, which give the ability to optimize processes of cultivation, obtaining of inhibitory substances and antagonistic activity spectrum determination.

[Pronoran in the treatment of mental organic syndrome in the elderly]. / Lechenie pronoranom psikhoorganicheskogo sindroma v pozdnem vozraste.

Efficacy and tolerability of pronoran (piribedil) was investigated in an open clinical trial including 21 patients, aged 61-85 years, with initial cognitive disturbances of cerebral vascular genesis. Along with a clinical and somatic examination, the Clinical Global Impression (CGI) scale, the Mini Mental State Examination (MMSE) test, the Sandoz Clinical Assessment Geriatric (SCAG) scale and a scale for side-effects were used. Pronoran was prescribed in a dosage 50-100 mg/day during 3 months. Patients were examined at base line and on the treatment day 14, 42 and 90. A positive clinical effect on mild cognitive impairment was achieved after 1.5 months and maintained to the end of 3 month therapy. Pronoran improves ability to sustain attention, learning and memory, organization of thinking and executive mental function. It also has a mild antidepressive and antianxiety action, being safe for elderly patients.

[Subclinical mental disorders in middle-aged and elderly persons living alone]. / Subklinicheskie psikhicheskie narusheniia u odinoko prozhivaiushchikh lits pozhilogo i starcheskogo vozrasta.

The syndrome-nosological spectrum of subclinical mental disorders in lonely outpatients (198) was analyzed in comparison with a group of lonely old subjects (112) identified in the course of epidemiological study of elderly population. It is established that mild depressive disorders occur more frequently in connection with a lonely-dweller situation that old people find themselves in. The expediency is recognized of setting-up district services of medico-psychological aid for the aged to prevent mental disorders and perform psychological correction for social dysadaptation of the elderly persons experiencing stressful life events common for this age group.

[EEG-mapping in Alzheimer-type dementias]. / EEG-kartirovanie pri dementsiiakh al'tsgeimerovskogo tipa.

EEG topographic correlates of the severity and type of Alzheimer-type dementias have been studied in 21 patients with senile dementia (SD) and 18 with Alzheimer's disease (AD) who were subdivided into smaller groups by MMSE grades for the severity of dementia, as well as in 15 mentally normal elderly persons. EEC maps in SD and AD patients differed from those in normal subjects in increased theta-delta EEG spectral power and suppressed alpha-band power that was more pronounced in the left hemisphere in AD than in SD patients. AD and SD patients had also different EEG topographical changes with intensified cognitive dysfunctions. The results suggest that there is a great cholinergic deficiency and cortical rather than subcortical impairments in patients with AD than in those with SD.

[Effectiveness of the treatment of endogenous subdepressive conditions in polyclinical geriatric-psychiatry practice]. / Ob effektivnosti terapii éndogennykh subdepressivnykh sostoianii v poliklinicheskoi gerontopsikhiatricheskoi praktike.

Seventy-six patients with endogenous subdepression were observed and treated by a regional out-patient gerontopsychiatric unit. Roughly a half of those seeing the doctor had subdepression. General principles of therapy are designed for endogenous subdepression in senile patients. The data suggest their efficient treatment with antidepressants and tranquilizers depending on syndromal or nosologic origin of the depression.

[Cyclothymia of advanced age (based on data from observations at the geriatric psychiatry office of a general-type polyclinic)]. / O tsiklotimii pozdnego vozrasta (po materialam nabliudenii v gerontopsikhiatricheskom kabinete polikliniki obshchego tipa).

Cyclothymia was studied in 129 patients aged over 60 in the gerontology unit of an outpatient clinic in Moscow. Premanifest period of the disease was analyzed clinically to single out the functional and somatic disorders. The typology of the first cyclothymic phases and conditions of their development are described as related to the ages of the disease manifestation under 60 vs over 60. The data evidencing the polar nature of the affective disorders are presented to characterize the natural history of the ailment in senile cyclothymic patients.

[Endogenous subdepressions among late middle-aged patients at a general-somatic polyclinic]. / Endogennye subdepressii u pozhilykh patsientov obshchesomaticheskoi polikliniki.

Endogenic subdepressions were studied in psychogeriatric rooms at three territorial polyclinics. They constituted a considerable portion of all mental abnormalities of the borderline level among all the patients treated in these rooms. The psychopathologic structure of these states was similar to the picture of masked depressions of the elderly age. Such peculiarities explain the erroneous diagnosis of these conditions as vascular (atherosclerotic) psychoorganic syndromes. The authors consider the data about a pathoplastic influence of the "age factor" reflected in both form and essence of the psychopathologic picture.

[Clinico-epidemiologic characteristics of a contingent of patients from the geriatric psychiatry clinic of a territorial polyclinic]. / Kliniko-épidemiologicheskaia kharakteristika kontingenta bol'nykh gerontopsikhiatricheskogo kabineta territorial'noi polikliniki.

The authors have studied the syndromal, nosological, sex and age characteristics of the patients registered at the gerontopsychiatric room of a general somatic district polyclinic as compared with the same parameters in mental outpatients of late age. It has been demonstrated that a new organizational form of specialized help (gerontopsychiatric consultations at the primary level of health care) makes it possible to ascertain mental disturbances of a borderline nature in old people and to expand the provision of therapeutic and rehabilitative measures to people not registered at outpatient psychiatric institutions.

[Noveril treatment of patients with treatment-resistant depressions (comparative evaluation of technics of intravenous drip administration)]. / Lechenie noverilom bol'nykh s terapevticheski rezistentnymi depressiiami (sravnitel'naia otsenka metodik vnutrivenno kapel'no vvedeniia).

Patients with manic-depressive psychosis, schizophrenia and traumatic encephalopathy were treated with noveril to control prolonged therapy resistant depressions. Noveril was used in the form of intravenous infusions given in courses in a dose of 720 ml/day with the subsequent transition to oral administration. In 21 patients (Group I), noveril was infused for two days while in another 14 patients (Group II), the course of intravenous infusions lasted ten days. The clinical effect of noveril was found to vary considerably depending on the regimen utilized. Positive clinical effect of the drug in group II manifested itself earlier and was higher than in group I, being 64.3% and 38.1%, respectively. The higher psychotropic activity of noveril with the ten-day intravenous infusion, major indications for its use and associated side effects are discussed. The question is raised concerning the specification of the notion of therapeutic resistance.

[Personality dynamics during prolonged lithium prevention]. / O lichnostnoi dinamike v protsesse dlitel'noi litievoi profílaktiki.

The preventive lithium therapy of paroxysm-like endogenic psychoses is associated with a change in the personality responses, in particular to the patient's own mental disease which makes it possible to speak about certain personality changes that manifest themselves phenomenologically by the formation of the adequate criticism of the disease, the psychological dependence on the lithium therapy and by peculiar reduction of emotional responses. The pathogenetic treatment of the described phenomena is sophisticated and calls for the consideration of both therapy and features of the endogenous process.