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№3' 2014


Clinical activity risk factors and long−term prognosis of relapsing−remitting multiple sclerosis
6 - 11
The paper presents the data of 9−year follow−up of 145 patients with relapsing−remitting multiple sclerosis. Based on the study of the features of relapsing−remitting multiple sclerosis course, basic correlations between clinical and neuroimaging properties of disease activity were shown. Increased lactate levels in demyelinating lesions had a strong correlation with relapse frequency. The presence and number of T1 foci identified at the disease onset is an adverse prognostic factor for disease progression. Prognostic value of relapse development using timing by Kaplan Meier was influenced by such factors as the size of lesions and reduced NAA/Cr, Cho/Cr indices.
Essential tremor
12 - 17
Literature data about the variations of classification, pathogenesis of essential tremor, its prevalence and clinical differential features as well as treatment protocol were summarized. The problem of neurodegeneration in patients with essential tremor was featured. Essential tremor and tremor in Parkinson disease were differentiated. The original clinical findings on evaluation of anaprilin and topiramat effectiveness in patients with essential tremor were analyzed.
Anomalies of intracerebral and precerebral arteries and their role in ischemic stroke in young adults
17 - 20
The study involved 107 patients aged 34−59 with ischemic stroke. Abnormalities of cerebral arteries were detected. A significant role of hypoplasia of the right posterior cerebral artery, aplasia of the posterior communicating, the left anterior cerebral and anterior communicating artery as well as S−shaped pathological tortuosity of the internal carotid, vertebral artery and their combinations in the development of acute disorders of cerebral circulation predominantly in young patients was determined.
Clinical mimicry of acute ischemic cerebrovascular accidents of ischemic type
21 - 25
The frequency and structure of states, which clinically mimic ischemic stroke and transient ischemic attacks were investigated in patients admitted to the neurology department with this diagnosis. The characteristic features that distinguish these states from true disorders of cerebral circulation were determined.
Endothelial dysfunction and cerebrovascular pathology in patients with diabetes mellitus
26 - 30
The basic mechanisms of endothelial dysfunction development against a background of type 2 diabetes mellitus were analyzed. Its markers (increased blood content of damaged circulating endothelial cells and endothelin 1 level) were revealed. Correlation analysis confirmed association between endothelial dysfunction development and cerebrovascular disorders in patients with type 2 diabetes mellitus.
The rare case of generalized musculodystonic and hyperkinetic syndromes in nervous diseases clinic
31 - 34
The contemporary scientific data about extrapyramidal disorders are reported. A clinical case of combined generalized hyperkinetic and musculodystonic syndrome in a young patient with the history of traumatic brain injury is discussed.
Clinical features of ischemic stroke in patients with polymorphism of 5G/4G gene of type 1 plasminogen activator inhibitor
35 - 39
Allelic polymorphism of 5G/4G gene of type 1 plasminogen activator inhibitor was investigated in patients with ischemic stroke. The peculiarities of clinical course, dynamics of neurological deficiency and consequences of cerebral infarction were studied. It is shown that in patients with abnormal homozygote option of 4G/4G gene PAI−1, which determines insufficient activity of the fibrinolytic system, more pronounced neurological deficit is registered, high mortality rate and insufficient recovery of neurological function are observed.
Clinical pattern of neurological manifestations of pituitary microprolactinomas in women of reproductive age
39 - 44
Fifty−two cases of pituitary miсroprolactinomas in patients of reproductive age were analyzed. The clinical picture of neurological manifestations in this group of patients was described depending on the extent of the defect in hormonal status.
The means of drug correction of homocysteine levels and lipid blood profile in patients with ischemic stroke within early recovery period
45 - 49
Efficiency of diagnosis with the use of clinical neurological, laboratory, neuroimaging methods of investigation and treatment for post−stroke neurological disorders in the early period of rehabilitation with addition of vitamin complex Milgamma was analyzed. Positive dynamics in the state of the patients in the form of leveling neurological symptoms and normalization of laboratory parameters was observed.
Analysis of the surface and superficial stimulation electroneuromyography in patients with different forms of Parkinson’s disease
49 - 53
Electroneuromyography findings were analysed in patients with Parkinson’s disease. Reduction of oscillation frequency during coordination tests, increased rate of pulse conduction along motor fibers of peripheral nerves was diagnosed in patients with tremor with different form of the disease. The patients with akinetic−rigid form demonstrated “dystonic phenomenon” typical for early parkinsonism with tremor component.
The characteristics of cognitive dysfunction syndrome in patients with brain posttraumatic cystic formations
54 - 57
The characteristics of cognitive dysfunction syndrome in patients with brain posttraumatic cystic formations are reported. The incidence, severity of cognitive disorders depending on previous brain injury, epidemiological and morphological characteristics of posttraumatic cystic formations of the brain are given.
Efficacy of complex treatment of acute pain syndrome caused by discogenic lumbosacral radiculopathy using psychotherapy methods
58 - 62
The efficacy of psychotherapeutic method of autogenic relaxation in complex treatment of acute pain caused by discogenic lumbosacral radiculopathy is shown. Reduction of pain intensity, improved qualitative characteristics of pain due to sensory and affective (emotional) components, reduced levels of state and trait anxiety and level of depression were noted. Positive clinical dynamics promoted increased level of life quality of the patients.
Early diagnosis of postoperative septic complications in patients with rectal cancer
63 - 66
The results of treatment of 124 patients operated on for colorectal cancer were analyzed. It was determined that the complex of diagnostic measures allowed to reduce the period of diagnosis from development of complications to the therapeutic measures that, in turn, contributed to reduction in overall mortality.
Application of vascular liver exclusion during liver resection
67 - 71
An algorithm of afferent liver vascular exclusion application, which improved the results of surgical treatment of patients with voluminous formations mainly due to the reduction of intraoperative blood loss (from 902 ml to 478 ml) and minimizing the manifestations of ischemia−reperfusion syndrome, was suggested. This resulted in reduction of postoperative complications (from 32,7 % to 21,6 %) and mortality rate (from 5,8 % to 1,96 %).
Surgical treatment of trophic ulcers at chronic venous insufficiency: individual approach
72 - 75
The results of treatment of 102 patients with decompensated forms of chronic venous insufficiency, who were performed subfascial dissection of perforated veins from mini−approach (52 patients), endoscopic dissection of perforated veins (50 patients) were analyzed. The majority had hemodynamically insignificant relapse of varicose veins. Trophic disorders did not progress.
Problems of theory of diaphysis fractures treatment
76 - 80
Based on the original research and scientific data, the regularities of fracture healing, the role of regeneration factors and rigid fragment fixation for fracture healing are presented. Osteosyntheis Association concept of relative stability of fragment fixation was analyzed critically. The original view point is presented.
Optimization of surgical treatment of posttraumatic cervical spine deformities
81 - 86
The efficiency of the developed protocols of surgical treatment of patients with posttraumatic deformities of the cervical spine was determined in comparison with existing methods. Increase in excellent treatment outcomes by 17 %, reduction of satisfactory and unsatisfactory ones were determined.
Clinical hormonal characteristics and therapy of girls with endometrial hyperplasia and anemia
87 - 91
The study involved 128 girls aged 11−18 years with pubertal uterine bleeding. The complex investigation included clinical, gynecological examination, echosonography, analysis of endometrium pathomorphology, hormonal profile. Conservative therapy of pubertate uterine bleeding included dietary supplement Indole−F®, which demonstrated its high efficiency.
Some aspects of pathogenesis of fibrocystic breast disease with prevalence of cystic component
92 - 96
Sex steroid level in the blood serum and cystic content was determined in patients with fibrocystic breast disease with prevalence of cystic component. In patients with macrocystic changes in the breast tissue with absence of absolute hyperestrogeny, accumulation of estradiol in the cystic content was noted.
Hyposexuality and sexual dysadaptation in women at depressive disorders of different origin
97 - 101
The urgency of research on sexuality in women with depression of various origins is shown. Clinical manifestations of these disorders in patients with health problems of the family were described and analyzed. The mechanisms of sexual dysfunction in women and developing sexual dysadaptation of the couple were described.
Anxiety and phobiac disorders: clinical features, diagnosis, treatment principles
102 - 106
Most important mechanisms of psychosomatic relationships were analyzed. The necessity of careful taxonomy of anxiety disorders was shown. Options for their clinical manifestations, diagnosis and principles of pathogenetic therapy were determined. The questions of staged organization of psychotherapeutic process in modern conditions were featured.
Professor Pavel G. Kravchun (to the 70th birthday)
107 - 108
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