[Innovative technologies and multimodal correction in medical rehabilitation of motor and neuropsychological disturbances due to stroke]. / Innovatsionnye tekhnologii i vozmozhnosti mul'timodal'noi korrektsii postinsul'tnykh dvigatel'nykh i neiropsikhologicheskikh narushenii.

The article presents an overview of innovative technologies based on the methods of sensorimotor retraining of the patient using various types of biofeedback (BFB) as the most promising in the medical rehabilitation (MR) of patients with cerebral stroke (CS). The works of a high level of evidence (RCTs, national and international clinical guidelines, meta-analyses, systematic reviews) of the Medline, Pubmed, PubMed Cochrane Library databases are analyzed, ClinicalTrials.gov. It is emphasized that training with multisensory effects on visual, auditory, vestibular and kinesthetic analyzers have a beneficial effect on cognitive-motor training and retraining, neuropsychological status of the patient and increase the level of motivation to achieve success in the rehabilitation process. The synergy of multimodal effects of digital technologies, BFB, virtual reality, and the brain-computer interface will expand the capabilities and improve the efficiency of MR of after stroke-patients.

[Urinary biomarkers for podocyte injury: Significance for evaluating the course and prognosis of chronic glomerulonephritis].

AIM: To estimate the degree of podocyte injury in patients with different types of chronic glomerulonephritis (CGN) from the urinary level of podocyte markers and to determine the significance of these indicators as criteria for disease activity and prognosis. SUBJECTS AND METHODS: Seventy-three patients with CGN, including 20 with inactive nephritis (Group 1), 23 with obvious urological syndrome (Group 2), 30 with nephrotic syndrome (NS) (Group 3), among them there were 7 patients with severe NS and 7 with NS concurrent with acute nephritic syndrome, were examined. A control group consisted of 8 healthy individuals. In the examined groups, the degree of podocyturia (PCU) was investigated by flow cytometry using podocalyxin-labeled antibodies and the levels of nephrinuria (NU), heat shock protein 27 (HSP27) in urine, interleukin 6 (IL-6), caspase 9, and vascular endothelial growth factor (VEGF) were estimated by ELISA. RESULTS: The patients with active CGN were found to have a high level of markers for podocyte injury: PCU and NU, which correlate with the magnitude of proteinuria, severity of NS, and degree of podocytopenia. Those with the severest NS, that concurrent with renal dysfunction in particular, were observed to have a progressive imbalance of inflammatory (IL-6), apoptotic (caspase-9), and defensive (HSP27 and VEGF) factors, which displays the incompetence of self-defense mechanisms in podocytes and contributes to the torpid course of CGN. Progressive PCU and NU are a poor prognostic sign indicating the risk of glomerulonephritis. CONCLUSION: The indicators considered are universal for all patients with CGN running with proteinuria and may be used to monitor the course of the disease; moreover, the damaging factors should be considered in conjunction with the defensive factors.

[Investigation of 70-kDa heat shock protein in the serum and urine of patients with chronic glomerulonephritis].

AIM: To determine the levels of 70-kDa heat shock protein (HSP70) in urine and anti-HPS70 antibodies (Abs) in serum and to assess their clinical and prognostic value in patients with different forms of chronic glomerulonephritis (CGN). SUBJECTS AND METHODS: Seventy-nine patients with CGN, including 15 with inactive nephritis (Group 1), 35 with active CGN and preserved renal function (Group 2), 14 with the highest CGN activity and transient creatininemia (Group 3), and 15 with persistent proteinuria and chronic renal failure (Group 4) were examined. ELISA was used to estimate urinary HSP70 levels and serum anti-HSP70 Abs in the examined groups. RESULTS: The patients with active CGN were found to have higher excretions of urinary HSP70 and serum anti-HSP70 Abs. Urinary HSP70 excretion was significantly higher in the patients with transient renal function (Group 3) than in those from the other groups. At the same time, there was a decrease in serum anti-HSP70 Abs, which was a poor factor of persistent nephrotic syndrome despite immunosuppressive therapy (IST). Despite long-term IST, the nephrotic syndrome was persistent in 9 (60%) of the 15 patients with low serum Ab titers. At the same time, 8 (80%) of the 10 patients with higher serum Ab titers responded to IST during 9 months. CONCLUSION: The investigation demonstrates the great value of HSP70 as an index of the severity of lesion and the activation of kidney self-defense mechanisms in patients with CGN. Determination of serum anti-HSP70 Abs may be used to assess the prognosis of CGN.