[The multidirectional effects of thrombin and the possibility of their control in neurology]. / Raznonapravlennye effekty trombina na protsessy gemokoagulyatsii i vozmozhnost' ikh kontrolya v nevrologii.

The review presents the main physiological functions of thrombin. The procoagulant and anticoagulant activities of the key serine protease are discussed in both physiological and pathological conditions of hemostasis. The involvement of thrombin in atherogenesis, as well as its role as a mediator of vascular dysfunction and inflammation in both the peripheral and central nervous system, is highlighted. A pronounced imbalance between the pro- and anticoagulant systems leads to an increase in thrombin formation and creates conditions for the development of thrombosis. Tests that allow direct or indirect assessment of thrombin's functional activity are presented. The potential applications of direct thrombin inhibitors and direct blockers of thrombin PAR receptors in vascular neurology are also considered.

[Season fluctuations of carbamazepine and valproate concentration in patients with epilepsy].

We studied 107 patients with epilepsy who received monotherapy with valproic acid drugs (58) and carbamazepine (49). The seasonal distribution of number and severity of seizures assessed with the NHS3 scale in dependence of Cmin and Cmax content of antiepileptic drugs carbamazepine and valproates in the serum of patients was estimated. There was a significant increase in the number of seizures and their severity in the cycle spring>autumn>summer>winter. The serum content of carbamazepine and valproates was significantly lower in spring compared to autumn.

[Concentrations of urine 6-sulfatoxymelatonin during the treatment of patients with epilepsy: a pilot clinical trial].

The effect of the epiphysis hormone melatonin on the brain bioelectrical activity is understudied: the data of experimental and clinical studies of melatonin effects are inconclusive and related mostly to exogenous administration. We studied 43 patients with focal epilepsy, 25 patients with cryptogenic epilepsy and 18 with symptomatic epilepsy. Carbamazepine and valproate were used as anticonvulsive drugs. Morning and evening urine concentrations of 6-sulfatoxymelatonin (6-COM), the main melatonin metabolite, were determined twice using immunoassay method: in autumn at the inclusion in the study and beginning of the anticonvulsant treatment and after 6 months, in spring, when anticonvulsant doses had been adjusted. The presence of epileptic seizures was associated with the reduction of melatonin concentration in the body that was supported by the decrease of urine 6-COM, in particular in the morning, in non-treated patients. Prescription of anticonvulsant treatment resulted in the increase of 6-COM. The concentration of the morning urine 6-COM was higher in patients with focal epilepsy receiving anticonvulsant treatment with valproate compared to those receiving carbamazepine: 49.28±6.71 and 37.09±5.43 ng/ml versus 20.00±3.6 and 13.11±2.08 ng/ml in patients treated with valproate and carbamazepine, respectively, before and after the adjustment.

[Autochronometry in patients with focal epilepsy].

A study included 163 patients with focal cryptogenic and symptomatic forms of epilepsy and 47 sex- and age-matched controls. Disturbances of autochronometry in epileptic patients were studied with regard to character, duration, severity, seasonality of seizures and localization of pathological activity in EEG. The elongation of internal count of chronominutes and the ratio of individual chronominute to duration of daylight hours suggest either the approach of a seizure or the early post seizure period, the effect of the completed seizure. The right hemisphere lesion mostly impacts on the patient's perception of time making it longer.