[On the need to train medical specialists to work in the conditions of the introduction of remote technologies].

The development of telemedicine and the provision of medical care using remote technologies requires appropriate competencies and skills from medical specialists, the formation of which is an important task of adapting educational systems to modern challenges and responding to requests from both medical staff and patients. Based on the analysis of foreign scientific publications, the paper considers the assessment of the need to train medical workers in remote work with patients and the prospects for the introduction of telemedicine consultations into everyday professional practice. It is concluded that having more knowledge about which aspects of medicine are best combined with telemedicine, it is important to train future medical professionals in the use of these technologies and the provision of these types of medical care. Doctors should not only be trained in the use of telemedicine, but also learn how to do it professionally, safely and on the basis of evidence.

[Clinical observation experience of a pediatric patient with primary progressive multiple sclerosis in the Moscow office for the treatment of children and adolescents with multiple sclerosis]. / Opyt kuratsii pediatricheskogo patsienta s pervichno-progressiruyushchim rasseyannym sklerozom v usloviyakh kabineta po lecheniyu detei i podrostkov s rasseyannym sklerozom Departamenta zdravookhraneniya goroda Moskvy.

OBJECTIVE: To demonstrate the experience of a personalized approach to the treatment of pediatric patients with multiple sclerosis using the example of the Moscow patient population. MATERIALS AND METHODS: The authors describe the clinical follow-up of 79 pediatric patients with demyelinating diseases of the nervous system during 2019, including 39 patients with multiple sclerosis, including one patient with a primary progressive course of the disease (clinical case). RESULTS: The experience of the Moscow office for the treatment of multiple sclerosis in children and adolescents demonstrates the effectiveness of the personalized approach to the treatment of pediatric cases confirmed by the case report of biological therapy by recombinant humanized monoclonal antibody directed against CD20-expressing B-cells for early treatment of the adolescent patient with primary progressive multiple sclerosis. CONCLUSION: The identification of patient's groups with different levels of disease activity and different risks of disability progression is highly relevant in the pediatric population of patients with multiple sclerosis, especially in the context of expanding therapeutic opportunities.

[The efficacy of active physical exercises in comprehensive cognitive rehabilitation of pediatric and adult patients with multiple sclerosis]. / Effektivnost' aktivnykh fizicheskikh uprazhnenii v kompleksnoi kognitivnoi reabilitatsii vzroslykh i detei s rasseyannym sklerozom.

Cognitive dysfunction in multiple sclerosis (MS) is a disabling factor and extends to the processes of memory, attention, verbal and logical thinking, visual-spatial, and motor skills. 40-70% of patients have a decrease in the rate of information processing, dysfunction of executive functions, and decrease in the quality of training. Cognitive dysfunction is also often reduced quality of life with MS. The most common methods of non-drug cognitive function correction are cognitive rehabilitation and exercise. This article reviews current research on the positive effects of regular physical activity on the cognitive functions of adults and children with MS.

[Epileptic syndromes in childhood associated with secondary generalized tonic-clonic seizures]. / Épilepticheskie sindromy v detskom vozraste, assotsiirovannye s vtorichno-generalizovannymi sudorozhnymi pristupami.

AIM: To study a group of patients with secondary generalized tonic-clonic seizures (SGTCS) in view of nosology, medical history, clinical, electroencephalographic and neuroimaging features. MATERIAL AND METHODS: The study included 471 patients, 244 (51.8%) men and 227 (48.2%) women. RESULTS: SGTCS were observed in many epileptic syndromes. The most frequent were symptomatic focal epilepsy (33.8%), cryptogenic focal epilepsy (23.8%), rolandic epilepsy (12.6%), FEBL-BEDC syndrome (12.3%). Other forms of epilepsy were less frequent. The onset of epilepsy ranged over a wide age range from the first month of life to 18 years. The average age of onset was 5.7±4.96 years. SGTCS as the only type of paroxysms were observed in 28.3% of cases. Two or more types of seizures were observed in 71.7% of patients, three or more types in 39.3%. Epileptiform activity on EEG during long VEM was detected in 91.3% of patients with SGTCS. In 37.2% of patients, benign epileptiform discharges of childhood were recorded. Treatment with antiepileptic drugs (AEP) led to complete remission in 57.1% of cases of epilepsy associated with SGTCS. A reduction of the frequency of seizures by 50% or more was found in 33.6% of patients treated with AEP. No effect was observed in 9.3% of patients. CONCLUSION: Significant differences in the prognosis and therapeutic approaches to specific epileptic syndromes associated with SGTCS necessitate the use of the entire spectrum of diagnostic measures, which should include careful history taking, clinical examination, video-EEG monitoring with the inclusion of sleep dynamics, MRI / CT brain, genetic testing.