NEUROLOGICAL DISORDERS AMONG THE USERS OF HOMEMADE ARTISANAL EPHEDRONE PSYCHOSTIMULANTS AND INVESTIGATION OF THIOGAMMA EFFICACY IN THEIR TREATMENT.

60 patients of the Narcological Clinic "Neogene" were enrolled into the study. The following participation criteria were used: a diagnosis of mental and behavioral disorders associated with ephedrone use; withdrawal state. Toxic encephalopathy; age - 20-65 years; gender - male. Patients were selected and diagnosed for the study according to ICD-10 criteria. The study was conducted in compliance with bioethical principles, based on informed consent. The main study group (Group I) consisted of 45 patients and the control group (Group II) - of 15 patients. The study strictly observed anonymity and confidentiality of the participants. Thiogamma drug (alpha-lipoic acid, meglumine salt, manufacturer WÖRWAG PHARMA) with a daily dose of 600 mg was added for a duration of one month, to the standard treatment regimen of the patients of the Group I in both inpatient and outpatient settings. The patients (both inpatient and outpatient) in the Group II were treated with placebo drug along with standard treatment for the same period. Clinico-neurological disorders of the patients were evaluated before and after a one-month therapy course. Neurological examination and Unified Parkinson Disease Rating Scale - UPDSR - were used. Based on the study materials it can be reported that the users of homemade ephedron group psychostimulants ("Jeff") had neurological disorders, mainly manifested with the symptoms of Parkinson's disease; with well-expressed dystonia, postural instability, pseudobulbar and vegetative syndromes. As a result of the treatment, a decrease in the scores on the UPDSR was observed (improved condition) in patients of both groups, however, the improvement was greater expressed in the patients of Group I where Thiogamma (alpha-lipoic acid meglumine salt) drug was added to the standard treatment protocol. The above results clearly speak to the effectiveness of "Thiogamma" in the treatment of neurological disorders caused by the use of homemade psychostimulants ("Jeff").

CLINICAL-DIAGNOSTIC PECULIARITIES OF WITHDRAWAL SYNDROME CAUSED BY CONSUMPTION OF HOME-MADE DRUG SYNTHESIZED FROM EPHEDRA PLANT "VINT".

According to the above-mentioned, the study aiming at description of clinico-diasgnostical peculiarities of withdrawal states caused by consumption of Ephedra plant home-made drug - "Vint" has been conducted. 50 patients 20-65 of age, hospitalized with ephedrone withdrawal effect (withdrawal effect caused by consumption of the drug prepared from Ephedra plant or classic "Vint"), were involved in the study conducted at Narcological Clinic "Neogeni". The patients were divided into two main groups: in the first group were united the patients with the withdrawal effect caused by consumption of the drug prepared from Ephedra plant and in the second group -"classical pharmaceutical "Vint" consumers. Patients were selected and diagnosed according to the ICD-10 criteria. The study was conducted on the basis of informed consent, keeping with the bioethical principles. The withdrawal state, particularly expression of its individual symptoms has been evaluated in patients of both groups. Intensity of withdrawal state was assessed before treatment and after 2 weeks of stationary/inpatient treatment according to Amphetamine Withdrawal Assessment Scale (Amphetamine Withdrawal Assessment Scale, Drug & Alcohol Services Council, SA, 2002). The affective anxieties in patients of the study group were assessed on the base of Beck Anxiety Inventory scale/scoring and Spielberger State-Trait Anxiety Inventory (STAI). The craving intensity was measured according to the Brief Substance Craving Scale. As a result of the study, it was concluded that after termination consuming the Ephedra plant-produced preparation "Vint" the patients had developed: more severe withdrawal state and relatively less - moderate and mild withdrawal states. The rate of craving for drug, depression, personal and situational anxiety were high as well. The Patients of the first group developed a relatively severe withdrawal state, the rates of depression and craving were high as well; as for the indicators of individual and situational anxiety no substantial changes were revealed. 2-week complex treatment resulted in expressed positive dynamics in regards to the above-mentioned disorders. It is noteworthy to mention that after treatment no suicidal ideation or psychotic disorders were observed in any patient. The severity of withdrawal state, as well as the indicators of depression and anxiety were significantly decreased.

[Severe asthma: Characteristics of patients in clinical practice].

AIM: To provide clinical characteristics of severe asthma (SA) patients encountered in clinical practice. SUBJECTS AND METHODS: A cross-sectional cohort study was performed to cover 119 outpatients aged 22-82 years. SA was diagnosed according to the ERS/ATS criteria (2014). Spirometry and bronchodilator reversibility testing were carried out; fractional exhaled nitric oxide (FeNO) was measured; inhalant allergen hypersensitivity (skin prick and blood specific IgE testing) and peripheral blood eosinophil counts were estimated. Asthma control and asthma-related quality of life were assessed. RESULTS: 77% of the patients were found to have allergic asthma; in this case, house dust mites were leading allergens in the spectrum of sensitization. 82% of the patients were observed to have uncontrolled asthma and 76% had incompletely reversible bronchial obstruction. The airway eosinophilic inflammation markers (FeNO more than 25 ppb and eosinophil counts of more than 150 cells/µ) were elevated in 63% of the patients. Good compliance was noted in 61% of the patients. There were 27% of active smokers who had lower lung function and FeNO levels. The smokers showed a low compliance with inhaled glucocorticosteroid treatment. SA was concurrent with chronic obstructive pulmonary disease in 37% of the cases. CONCLUSION: SA is a heterogeneous disease. Traditional treatment is not always effective, as many patients, despite their treatment, have uncontrolled SA and continuously increased markers of airways eosinophilic inflammation. Monoclonal antibody therapy may promote success in treating this cohort of patients.

[Features of the process of chromatin denaturation in leukemic tissue and murine spleen cells]. / Osobennosti protsessa denaturatsii khromatina leikemicheskikh tkanei i kletok selezenki myshei.

It was shown by the method of differential scanning microcalorimetry that an additional peak, at about 57 degrees C appears on heat absorption curves of the whole spleen tissue and cells of BalB/c mouse injected with Rausher virus. It is supposed that this peak is due to the melting of AT-rich regions of internucleosomal DNA in chromatin fibers of tumor cells, which results from the partial loss of proteins or the modification of H1 histone.

[Clinical aspects of the residual disturbances in a favorable course of obsessive neurosis]. / Klinika rezidual'nykh rasstroistvi pri blagopriiatnom techenii nevroza naviazchivykh sostoianii.

Using the clinico-catamnestic method the authors examined residual neurotic states in 36 patients with a history of obsessional neurosis. The residual neurotic disorders manifested psychopathologically in the form of isolated rudiments of the obsessive-phobic syndrome combined frequently with some effaced vegetative, asthenic, and affective disturbances. Despite their inertness and many-year persistence the residual neurotic disorders showed a tendency to subsidence. Clinical differentiation between the residual states on the one hand, and neurotic development, slowly-progressing schizophrenia, and cyclothymia with obsessions on the other was carried out.

[Role of psychotherapy in the complex treatment of children who stutter]. / Rol' psikhoterapii v protsesse kompleksnogo lecheniia detei s zaikaniem.

In 30 preschool children the efficacy of various psychotherapeutic methods in the treatment of spasmophemia was estimated. The effect of group psychotherapy, play therapy and age-modified variants of autogenous training is described. Importance of family psychotherapy is determined, and attempts at specifying the most typical pathological family situations are made. It is noted that the psychotherapy plays an important role in the treatment of spasmophemia at the preschool age, and contributes to a stable social adaptation of the child.

[Clinico-physiologic study of several aspects of the pathogenesis of stuttering]. / Kliniko-fiziologicheskoe izuchenie nekotorykh storon patogeneza zaikaniia.

Data on a comparative clinico-physiological study of children with neurotical and pseudoneurotic stuttring are presented. Clinically 60 patients from 2.5 to 6 years were studied, among them the articulatory and respiratory component of expressive speech formation was studied in 30 cases. The data indicate the complication and deepening of the neurotical and pseudoneurotic symptomatology in the age group from 5 to 6 years. A correlation of clinical and physiological parameters showed that neurotical stuttering appears against the background of a normally formed speech stereotype. In treating neurotical stuttering more attention should be paid to medicamental tranquilizing therapy and a correct psychotherapeutical approach, along with logopedical lessons. In pseudo-neurotical stuttering there is a pathological onthogenesis of the speech functioning--an abnormal formation of the speech stereotype. In both cases durative logopedical correlational work and an active goal-directed medicamental treatment are required.

[Residual states in the clinical picture of neuroses]. / Rezidual'nye sostoianiia v klinike nevrozov.

A study of the clinical picture of residual disturbances in 90 patients with various forms of neuroses showed that residual neurotic states are a regular stage of the timecourse of protracted neuroses with a favourable course. At this stage the differences between individual forms of neuroses become less conspicuous. Mild, fragmented clinical manifestations are presented in the form of two types: a monosymptomatic and a more complicated polysymptomatic one. The latter type of residual states is more dynamic which is reflected in both a tendency to their reduction and transformation into a monosymptomatic state and a possibility of a neurotic relapse.

[Neurotic development in the clinical picture of stuttering]. / Nevroticheskoe razvitie v klinike zaikaniia.

On the basis of a clinical study of neurotic development in 79 patients suffering from stammering, the authors present a psychopathological analysis of the polymorphic picture of the disease with stable neurotic and pathocharacterological disturbances and with the presence of peculiar superworship formations. Five clinical variants of the neurotic development in stammering have been identified: astheno-depressive, sensitive, superworshiphypochondriac, obsessive-phobic and hysterical. The formation of the neurotic development is considered in the ontogenetic aspect. The authors analyze a complex interrelationship of constitutional, evolutional-biological and psychogenic factors.

[Control and correction of the blood sugar in diabetes with concomitant ischemic heart disease using the artificial beta-cell apparatus employing glucose oxidase as the enzyme]. / Kontrol' i korrektsiia glitsemii pri diabete s soputstvuiushchei ishemicheskoi bolezn'iu serdtsa apparatom "iskusstvennaia beta-kletka" s ispol'zovaniem fermenta gliukozooksidazy.

The apparatus "Artificial Beta-Cell" or "Biostator" was used in treatment of 115 patients with diabetes mellitus and concomitant ischemia of the heart. At the same time 30 patients with diabetes mellitus and ischemia of the heart were treated for diabetes mellitus with the routine methods. Hormones such as ACTH, STH, hydrocortisone, immunoreactive insulin and S-peptide, lipid metabolism and glycosylated hemoglobin were investigated in the time course of the treatment. It was shown that adequate correction of glycemia with the "Biostator" promoted renormalization of the levels of ACTH and hydrocortisone. The results were especially favourable in the group of patients with myocardial infarction and chronic ischemia of the heart with the signs of cardiac insufficiency. Moreover, in the patients of the main group there was a tendency for normalization of lipid metabolism and glycosylated hemoglobin. The results of carbohydrate metabolism compensation in patients of the control group were not always satisfactory and the periods of compensation were longer. The clinico-biochemical indices reflected the favourable effect of the use of the "Biostator" and its advantages over the routine methods in treatment of diabetes mellitus.

Application of capillary electrophoresis to the analysis of soluble chromatin.

Capillary electrophoresis (CE) has been applied to study DNA-protein complexes using as the test system soluble chromatin from chicken erythrocytes and rapidly proliferated cultured Chinese hamster fibroblast-like cells B11-dii-FAF-28. Separation was performed with home-made CE apparatus, using a regulated high-voltage power supply, UV-detector and fused silica capillaries with inner diameter 75 microm. The heterogeneity of nucleosomal particles with different DNA lengths after micrococcal nuclease digestion was detected.

Twinning project: Israel and Georgia--the birth of a diabetes-in-pregnancy centre in Georgia.

AIMS: To determine the effectiveness of a joint Israeli-Georgian twinning project aimed at introducing modern methods of perinatal care to Georgian women with pregestational diabetes mellitus. METHODS: A Diabetes-in-Pregnancy Centre was established in Georgia (in the former USSR). Thirty-two women with Type 1 diabetes mellitus participated in the first stage of the study (January 1997-June 1998). All were maintained under strict metabolic surveillance starting at least three months prior to conception and were given organized instruction in methods of self-monitoring of glucose levels, insulin dose adjustment, dietary management and close fetal surveillance throughout pregnancy. A second stage of the project was started in January 1998 and aimed at the diagnosis of gestational diabetes mellitus (GDM). RESULTS: Of the 32 women, 20 had had a total of 44 prior pregnancies without proper perinatal care (1990-96); only five (11.3%) ended in the birth of a healthy infant. On entry to the study, all 32 patients had unsatisfactory metabolic indices. HbA1c levels decreased significantly from the preconception period (P<0.001) and were maintained at the lower level throughout pregnancy; insulin doses decreased significantly until the third trimester (P<0.01) and then increased (P<0.001). Since January 1997, 21 women have become pregnant. Eighteen have given birth, 12 (67%) by Caesarean section and six (33%) by vaginal delivery. Gestational age at birth was 36-39 weeks, and birth weight ranged from 2300 to 4100 g. The only neonatal complications were mild respiratory distress syndrome and hypoglycaemia. There were no significant maternal complications in the 236 women screened, eight were diagnosed as having GDM and 12 impaired glucose tolerance. They were actively managed to a successful outcome. CONCLUSIONS: The establishment of the Diabetes-in-Pregnancy Centre in the Republic of Georgia has significantly reduced the prior high pre-programme perinatal morbidity and mortality as well as the incidence of maternal complications in pre-GDM as well as in GDM.