[The impact of antiepileptic therapy on sleep disorders in women with epilepsy]. / Vliyanie protivoepilepticheskoi terapii na narusheniya sna u zhenshchin s epilepsiei.

OBJECTIVE: To analyze the frequency of various sleep disorders in patients with epilepsy receiving antiepileptic therapy. MATERIAL AND METHODS: Sixty-four women were selected from the register of patients with epilepsy and other paroxysmal conditions. The group consisted of young and middle-aged women (36.9±13.5 years), all patients received antiepileptic therapy. To diagnose sleep disorders, we used a sequential algorithm for clinical examination supplemented by instrumental methods according to indications (polysomnography, respiratory monitoring). RESULTS: The duration of epilepsy was 15.7±7.6 years, the disease was represented by three forms: structural (n=15, 23.4%), genetic (n=32, 50%) and unspecified (n=17, 26.6%). Sleep disorders were common among female patients with epilepsy (43.7%), they are most frequently combined with genetic epilepsy (18.7%), and represented by: insomnia (43%) mild to moderately severe breathing disorders (32%) and sleep movement disorders (25%). Sleep disorders were combined with symptoms of depression in the majority of patients (71%). A 6-month follow-up evaluation of nighttime sleep parameters after treatment showed a decrease in the frequency of sleep disorders to 25%; scores on the Epworth Sleepiness Scale significantly decreased to 6.7±3.6. A change in antiepileptic therapy in patients with sleep breathing disorders resulted in a marked regression of the Apnea-Hypopnea Index (9.2±2.5 points; p=0.003). However, there were no significant changes in the severity of sleep movement disorders. CONCLUSION: Sleep disorders are common in patients with epilepsy, in most cases they are associated with mood disorders, and may regress after optimization of antiepileptic therapy.

[The psychological factors of renunciation of antitumoral therapy by women with breast cancer (international publications review)].

The article presents analytical review of studies considering problem of patient refusal from antitumoral treatment, in particular of women with breast cancer. The analysis of main results of empirical studies describes factors associated with patient refusal from treatment. Among factors affecting decision making related to patient voluntarily refuse of treatment are toxicity of treatment (nausea and vomiting), senile age, disease stage, availability and type of medical insurance, characteristics of family status. Besides objective factors, such subjective factors as beliefs, values ​​of patients are described. The deficiency of research studies concerning psychological factors of patient refusal of antitumoral treatment is established. However, patient loyalty to antitumoral treatment plays decisive role in prognosis of survival and favorable course of disease. In connection with that, studies covering such areas as psychological characteristics of personality of patients refusing of antitumoral treatment, verification of psychological factors of this voluntary refusal are required in order to organize continuum of oncological care of patients, their psychological maintenance and increasing of commitment to treatment.

[Possibilities of optimizing therapy in COVID-19 survivors with focal epilepsy]. / Vozmozhnosti optimizatsii terapii u patsientov s fokal'noi epilepsiei, perenesshikh COVID-19.

OBJECTIVE: To study the effect of phenosanoic acid therapy on the frequency of seizures, asthenia and quality of life of adult patients with focal epilepsy who had a new coronavirus infection caused by SARS-CoV-2. MATERIAL AND METHODS: The data of 20 patients with focal epilepsy who suffered COVID-19 and received therapy with phenosanic acid (Dibufelon) were studied. The frequency of epileptic seizures, the severity of asthenia and the quality of life were evaluated according to clinical scales. RESULTS: Significant decrease in the frequency of bilateral tonic-clonic seizures and focal seizures with loss of consciousness was recorded. There was a significant improvement in the quality of life. There was no significant dynamics of asthenia against the background of taking the drug phenosanic acid in patients. CONCLUSION: The preparation of phenosanic acid can be an effective means of add-on therapy in patients with epilepsy who have undergone COVID-19.

[The psychological and environment risk factors of development of breast cancer in women residing in industrial megalopolis and rural locality].

The breast cancer hold leading position in the structure of oncological morbidity of women worldwide. The purpose of the study is to analyze contribution of psychological and environmental factors to risk of development of breast cancer in women residing in industrial metropolis and rural locality. The actuality of the study is conditioned by acquisition of new knowledge about risk factors of breast cancer. The study covered psychological factors (basic beliefs, life orientations, locus of control, coping behavior strategies, subjective assessment of quality of life, subjective age indicator, personal helplessness-independence, resilience) and environmental factor (place of urban of rural residence of women with breast cancer). The study established that in women residing in industrial metropolis the psychological risk factors are reduced indicators of basic beliefs, of quality of life and of resilience, rare application of coping strategy "Escape-Avoidance", external locus of control. Alternatively, in women residing in rural areas, psychological risk factors for breast cancer are rare application of coping strategies, reduced quality of life indicators, increased vital activity, internal level of subjective control and personal helplessness. The study results can be included in development of personalized breast cancer screening protocols and as well as considered in assessing risk of development of disease when classifying women by breast cancer risk groups.

[The cough variant asthma].

Cough variant asthma (CVA) was first described by W. Corrao. CVA was described as the isolated chronic cough as the only presenting symptom responsive to bronchodilator therapy.This phenotype of asthma is present with airway hyperresponsiveness, eosinophilic inflammation airways and bronchodilator responsive coughing without typical manifestation of asthma such as wheezing or dyspnea. CVA shares common features with classic asthma such as eosinophilic inflammation and airway remodeling. Because of that, CVA is clinically considered as a variant type of asthma.

[New possibilities of pharmacological treatment of adult epilepsy].

OBJECTIVE: To study an effect of cortexin on epilepsy course and electroencephalographic pattern in stopping the symptoms concomitant to epilepsy. MATERIAL AND METHODS: A study included 64 patients with epilepsy (22 men and 42 women, aged from 20 to 85 years). Along with standard treatment, the patients received cortexin (three 10-day courses during 12 months intramuscular in dose 10 mg daily). RESULTS AND CONCLUSION: There were the significant decrease in the frequency of seizures and the absence of failure of remission, the positive dynamics of electroencephalographic pattern as well as stopping of such symptoms as headache, non-systemic vertigo, asthenia, cognitive impairment, anxiety and depression, arterial hypertension.

[On the issue of the enhancement of high-specialized emergency medicine].

The negative trends in population health of Russia, the decline in well-being, the decrease of the availability of medical and pharmaceutical care, the increase of technogeneous accidents and disasters, the international terrorism cause the need in the structural reorganization of health care, especially in developing high-specialized emergency medical care. The specific solution of this problem is the establishment of medical districts with the multifield centers of emergency acute medical care (district hospitals) and selecting of the provision of emergency medical care, the quick diagnosis and immediate specialized medical care rendering as the priority direction. To establish the medical district with the district hospital it is necessary to develop corresponding normative legal base, accounting and reporting documentation, to provide the material, technical and trained personnel maintenance and to elaborate the algorithm of rendering the emergency medical care on pre-admission and hospital levels.

[Complex treatment of epilepsy with phenotropil].

Effect of phenotropil in combination with anticonvulsant drugs on the course of different forms of epilepsy and EEG parameters has been studied. Patients of a main group (31 patients) received phenotropil, along with antiepileptic drugs (AEP), in dosage 100 mg daily during 2 months. Effect of the therapy was compared to the patients of comparison group (30 patients) treated with AEP only. In the main group, the significant decrease of seizures and positive changes on the EEG with the reduction of the index of epileptiform changes was observed.

[Lipoprotein oxidation in the blood of women with pregnancy complications]. / Okislenie lipoproteinov v krovi zhenshchin pri patologicheskom techenii beremennosti.

The level of lipoprotein oxidation in blood sera of pregnant women with obstetrical abnormalities is studied. Lipid peroxides were measured by a modified thiobarbituric acid test. The level of lipoprotein oxidation was increased, which may be one of the pathogenetic mechanisms of vascular disease in fetoplacental insufficiency and gestosis.

[Antibodies against nerve tissue proteins S100, GFAP, and MP65 and pregnant women with early toxemia]. / Antitela k belkam nervnoi tkani S100, GFAP, MP65 u beremennykh s rannim toksikozom.

Serum levels/affinities of natural autoantibodies to proteins S100, GFAP and MP65 in patients with physiological pregnancy are usually constant and may vary among individuals within relatively narrow range. In patients with early toxicosis in pregnancy dispersion of serum autoantibodies levels were often found beyond the normal range. This group includes cases with significantly elevated as well as abnormally decreased immunoreactivity parameters. Percent of newborns with different deviations from women with abnormal serum levels/affinities of autoantibodies to proteins S100, GFAP and MP65 was higher 1,5-2 fold compared with population.

[Immunoenzyme analysis in the determination of antibodies to main classes of cell phospholipids in human blood]. / Immunofermentnyi analiz dlia opredeleniia antitel k osnovnym klassam kletochnykh fosfolipidov v syvorotke krovi cheloveka.

A modified ELISA is proposed for detecting antiphospholipid antibodies of the IgM and IgG isotypes, including antibodies to cardiolipin, phosphatidylserine, phosphatidylethanolamine, phosphatidylinositol, phosphatidylcholine, and sphingomyelin in human blood serum. The degree of phospholipid saturation, its phase (lamellar or hexagonal), purity, oxidation index of the phospholipid preparation, and conditions of solid phase treatment are important factors providing a sufficiently high sensitivity and reliability of measurements. The clinical value of the method was demonstrated in examinations of 70 patients with habitual abortions. The method can be used in studies of the spectrum of antiphospholipid antibodies in different diseases involving an increase of their blood serum level.

[Immune system in pregnant women exposed to extreme climate conditions of the Aral coast line]. / Kharakteristika immunnoi sistemy u beremennykh zhenshchin, prozhivaiushchikh v ékstremalnykh usloviiakh Priaralía.

Fifty-eight women aged 18 to 38 with preserved reproductive function were examined, 42 of them with a normal course of gestation and 16 nonpregnant ones. Cellular and humoral immunity parameters were studied: absolute and relative counts of T-lymphocytes and levels of serum IgA, IgG, and IgM. The immunity status of women living near the Aral sea was changed: the absolute and relative counts of T-lymphocytes were reduced in both groups. Pregnant women had a trend to reduction of T-lymphocyte count in the first gestation trimester and a reliable increase of the levels of T-lymphocytes and theophyllin-sensitive cells in the third trimester (p < 0.001). The lowest counts of T-lymphocytes and theophyllin-sensitive cells were observed in primigravidas vs. multigravidas and multiparas.

[Present trends in the development of radiotherapy]. / Sovremennye napravleniia sovershenstvovaniia luchevoi terapii.

New potentialities of radiotherapy of cancer patients are associated with three scientific directions: investigations in clinical radiology, the use of advantages of radiation advanced technology and guarantees of therapeutic quality. The first direction includes scientifically substantiated regimens of non-classic dose fractionation, various radiomodifiers and their combinations, and individual prognosis of a tumor response to ionizing radiation. This direction based on 3000 cases, holds promise. The second direction is associated with the advantages of modern technology used for diagnosis, topometry and radiotherapy design. The third direction is intended to reduce differences in radiotherapy quality between research institutes and cancer hospitals.

[Prospects of development of radiotherapy in an oncological clinic]. / Perspektivy razvitiia luchevoi terapii v onkologicheskoi klinike.

It is believed that new anticancer potential of radiotherapy lies in further research efforts in the fields of: clinical radiobiology, utilization of the last developments in radiological equipment, overall high quality of radiological service. Research in radiobiology should be aimed at the design of nonstandard dose fractionation, introduction of various modifiers and their combinations, prediction of individual responses of the tumor to ionizing radiation. First-hand clinical data on 3000 cases support the promise of such approach. The advantages of modern equipment could be successfully realized at the stage of confirming the diagnosis and topography++, design of the treatment schedule and in the process of radiotherapy. To warrant the same quality of radiological service rendered in large cancer research centers and provincial hospitals, the latter should be provided with relevant equipment, methodological instructions, participate in current cooperative programs.

[Influenza viruses studied by fluorescent immunoassay with temporary resolution]. / Issledovanie virusov grippa metodom fliuorestsentnogo immunoanaliza s vremennym razresheniem.

Monoclonal antibodies, epidemic strains of influenza A and B viruses, conjugates were studied by fluorescence immunoassay with temporary resolution using equipment of different companies. Differences and specificity of monoclonal antibodies to influenza A and B viruses were demonstrated. The highest sensitivity of the method with the test system used was determined, being 20 ng/ml of viral protein. The method was shown to be useful for influenza virus detection both in solutions containing purified virions and in virus-containing allantoic preparations. It was established that virological studies could be carried out using conjugates and knock-down microplates of the national make alongside with foreign ones.