Pub Date : 2023-07-03DOI: 10.14412/2074-2711-2023-3-16-21
V. Gafarov, E. Gromova, I. Gagulin, D. Panov, V. Maksimov, А. V. Gafarova
Objective: to study associations between personal anxiety (PA) and single nucleotide polymorphism rs2278749 of the ARNTL gene among individuals aged 25–64 years living in Novosibirsk.Material and methods. Under the WHO program “MONICA-psychosocial (MOPSY)”, a random representative sample of the population aged 25–64 years in Novosibirsk was studied (725 men, mean age – 43.4±0.4 years, response – 71.3%; 710 women, mean age – 44.8±0.4 years, response – 72%). The general examination was carried out according to standard methods included in the protocol of the WHO program. To assess PA, a form of Spielberger self-assessment scales was proposed. Every second respondent underwent genotyping of the studied polymorphisms of the ARNTL gene.Results. The C/C genotype of the ARNTL gene was found in the general population in 60.7% of individuals (in 61.2% of men and 60.5% of women); the C/T genotype was found in 34.1% of individuals (in 35.1% of men and 33.5% of women) and the T/T genotype in the general population was found in 5.2% of individuals (in 3.7% of men and 6% women). The probability of PA development among carriers of the CT+TT genotypes of the ARNTL gene was 2 times higher (p<0.05) in the general population and 2.4 times (p<0.05) among women; among T allele carriers, it was 1.8 times higher (p<0.05) in the population and 2.1 times (p<0.05) among women. Carriers of the C/T genotype of the ARNTL gene were 30.3% more likely to believe that they almost always take everything too personally (p=0.024). Carriers of the C/T genotype (21%) almost always, and carriers of the T/T genotype (27.8%) often would like to be as happy as others (p=0.031). The answer “I often feel satisfaction” prevailed (38.2%) among the carriers of the C/C genotype, and the answer “Almost never feel satisfaction” among the carriers of the C/T genotype (5.9%) of the ARNTL gene (p=0.044) .Conclusion. It was found that the C/C genotype of the ARNTL gene was the most common in the population; the probability of PA occurrence among carriers of CT+TT genotypes, carriers of the T allele is 2 times higher than in carriers of other genotypes of the ARNTL gene.
{"title":"Association of the circadian rhythm gene ARNTL/BMAL1 with personal anxiety among people aged 25–64 (WHO international program “MONICA-psychosocial (MOPSY)”)","authors":"V. Gafarov, E. Gromova, I. Gagulin, D. Panov, V. Maksimov, А. V. Gafarova","doi":"10.14412/2074-2711-2023-3-16-21","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-3-16-21","url":null,"abstract":"Objective: to study associations between personal anxiety (PA) and single nucleotide polymorphism rs2278749 of the ARNTL gene among individuals aged 25–64 years living in Novosibirsk.Material and methods. Under the WHO program “MONICA-psychosocial (MOPSY)”, a random representative sample of the population aged 25–64 years in Novosibirsk was studied (725 men, mean age – 43.4±0.4 years, response – 71.3%; 710 women, mean age – 44.8±0.4 years, response – 72%). The general examination was carried out according to standard methods included in the protocol of the WHO program. To assess PA, a form of Spielberger self-assessment scales was proposed. Every second respondent underwent genotyping of the studied polymorphisms of the ARNTL gene.Results. The C/C genotype of the ARNTL gene was found in the general population in 60.7% of individuals (in 61.2% of men and 60.5% of women); the C/T genotype was found in 34.1% of individuals (in 35.1% of men and 33.5% of women) and the T/T genotype in the general population was found in 5.2% of individuals (in 3.7% of men and 6% women). The probability of PA development among carriers of the CT+TT genotypes of the ARNTL gene was 2 times higher (p<0.05) in the general population and 2.4 times (p<0.05) among women; among T allele carriers, it was 1.8 times higher (p<0.05) in the population and 2.1 times (p<0.05) among women. Carriers of the C/T genotype of the ARNTL gene were 30.3% more likely to believe that they almost always take everything too personally (p=0.024). Carriers of the C/T genotype (21%) almost always, and carriers of the T/T genotype (27.8%) often would like to be as happy as others (p=0.031). The answer “I often feel satisfaction” prevailed (38.2%) among the carriers of the C/C genotype, and the answer “Almost never feel satisfaction” among the carriers of the C/T genotype (5.9%) of the ARNTL gene (p=0.044) .Conclusion. It was found that the C/C genotype of the ARNTL gene was the most common in the population; the probability of PA occurrence among carriers of CT+TT genotypes, carriers of the T allele is 2 times higher than in carriers of other genotypes of the ARNTL gene.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76726653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-03DOI: 10.14412/2074-27112023-3-22-26
S. Y. Lavrik, A. S. Borisov, V. Shprakh, I. M. Mikhalevich
The spectrum of diseases manifested by positional vertigo includes benign paroxysmal positional vertigo (BPPV), vestibular migraine, brain tumors, demyelinating and some other diseases.Objective: to study the common practice of managing patients with positional vertigo.Material and methods. 64 patients with complaints of positional vertigo were examined. Clinical and neurological examination, otoneurological examination, including positional diagnostic tests, assessment of spontaneous nystagmus in Frenzel video glasses, tests of smooth tracking, saccades, head shaking, Fukuda test were carried out.Results. In the majority (70%) of cases, the referral diagnoses for vertigo were chronic cerebral ischemia, vertebral artery syndrome, and vegetative-vascular dystonia. However, none of these diagnoses was confirmed as the leading cause of vertigo. The most common mistake (62.5%) was making a diagnosis only on the basis of complaints, without an otoneurological examination and positional tests. The most common causes of vertigo were BPPV (64.6%), vestibular migraine (20.3%) and vestibular neuronitis (12.5%).Conclusion. In the diagnosis of positional vertigo, the evaluation of clinical manifestations, otoneurological tests and characteristics of positional nystagmus plays a leading role.
{"title":"Managing patients with positional vertigo: diagnostic pitfalls and treatment","authors":"S. Y. Lavrik, A. S. Borisov, V. Shprakh, I. M. Mikhalevich","doi":"10.14412/2074-27112023-3-22-26","DOIUrl":"https://doi.org/10.14412/2074-27112023-3-22-26","url":null,"abstract":"The spectrum of diseases manifested by positional vertigo includes benign paroxysmal positional vertigo (BPPV), vestibular migraine, brain tumors, demyelinating and some other diseases.Objective: to study the common practice of managing patients with positional vertigo.Material and methods. 64 patients with complaints of positional vertigo were examined. Clinical and neurological examination, otoneurological examination, including positional diagnostic tests, assessment of spontaneous nystagmus in Frenzel video glasses, tests of smooth tracking, saccades, head shaking, Fukuda test were carried out.Results. In the majority (70%) of cases, the referral diagnoses for vertigo were chronic cerebral ischemia, vertebral artery syndrome, and vegetative-vascular dystonia. However, none of these diagnoses was confirmed as the leading cause of vertigo. The most common mistake (62.5%) was making a diagnosis only on the basis of complaints, without an otoneurological examination and positional tests. The most common causes of vertigo were BPPV (64.6%), vestibular migraine (20.3%) and vestibular neuronitis (12.5%).Conclusion. In the diagnosis of positional vertigo, the evaluation of clinical manifestations, otoneurological tests and characteristics of positional nystagmus plays a leading role.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84426141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-03DOI: 10.14412/2074-2711-2023-3-4-10
A. Kulesh, S. N. Yanishevsky, D. A. Demin, L. Syromyatnikova, O. Vinogradov
Non-cardioembolic ischemic stroke (IS) of high and very high risk includes three groups of patients: with severe extracranial atherosclerosis, with any intracranial atherosclerosis, and with aortic arch atheromatosis. This risk is also characteristic of patients with aggressive transient ischemic attack (TIA) phenotypes. Effectiveness of secondary prophylaxis can be raised by these strategies: short-term dual antiplatelet therapy using a combination of acetylsalicylic acid with clopidogrel or ticagrelor in minor IS or high-risk TIA; long-term dual antithrombotic therapy with acetylsalicylic acid and low doses of rivaroxaban for multifocal atherosclerosis with low hemorrhagic risk and non-lacunar stroke; early surgical revascularization (carotid endarterectomy or stenting) for non-disabling IS and urgent revascularization for high-risk TIA; intensive, including combined, lipid-lowering therapy with high doses of statins, ezetimibe, PCSK9 inhibitors, or inclisiran to achieve low-density lipoprotein levels <1.4 mmol/L ; antidiabetic therapy using type 2 glucose-sodium cotransporter inhibitors and type 1 glucagon-like peptide agonists with glycosylated hemoglobin level of <7%; prescribing antihypertensive therapy and achieving target blood pressure level.
{"title":"Patient with non-cardioembolic ischemic stroke or high-risk transient ischemic attack. Part 2. Secondary prophylaxis","authors":"A. Kulesh, S. N. Yanishevsky, D. A. Demin, L. Syromyatnikova, O. Vinogradov","doi":"10.14412/2074-2711-2023-3-4-10","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-3-4-10","url":null,"abstract":"Non-cardioembolic ischemic stroke (IS) of high and very high risk includes three groups of patients: with severe extracranial atherosclerosis, with any intracranial atherosclerosis, and with aortic arch atheromatosis. This risk is also characteristic of patients with aggressive transient ischemic attack (TIA) phenotypes. Effectiveness of secondary prophylaxis can be raised by these strategies: short-term dual antiplatelet therapy using a combination of acetylsalicylic acid with clopidogrel or ticagrelor in minor IS or high-risk TIA; long-term dual antithrombotic therapy with acetylsalicylic acid and low doses of rivaroxaban for multifocal atherosclerosis with low hemorrhagic risk and non-lacunar stroke; early surgical revascularization (carotid endarterectomy or stenting) for non-disabling IS and urgent revascularization for high-risk TIA; intensive, including combined, lipid-lowering therapy with high doses of statins, ezetimibe, PCSK9 inhibitors, or inclisiran to achieve low-density lipoprotein levels <1.4 mmol/L ; antidiabetic therapy using type 2 glucose-sodium cotransporter inhibitors and type 1 glucagon-like peptide agonists with glycosylated hemoglobin level of <7%; prescribing antihypertensive therapy and achieving target blood pressure level.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82029261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.14412/2074-2711-2023-2-134-146
A. Danilov, A. Lila, Y. N. Majidova, O. Gromova, O. Tkacheva, I. Sarvilina, A. Kochish, A. Nazarenko, N. Zagorodniy, T. Minasov, L. Alekseeva, E. Taskina, Y. Kotovskaya, E. Dudinskaya, A. V. Rozanov, E. Solovieva, O. A. Shavlovskaya, M. Sharov, P. Kamchatnov, A. P. Rachin, E. Barantsevich, D. Iskra, E. Yakupov, F. I. Devlikamova, A. Barulin, M. V. Nesterova, T. G. Sakovets, A. Barinov, I. Dolgova, N. Zabolotskikh, E. Zonova, L. Shchepankevich, V. A. Parfenov, A. T. Dzhurabekova, S. Z. Khakimova
In recent decades, there has been an increase in the prevalence and medical and social burden of osteoarthritis (OA) and nonspecific back pain in all countries of the world. The First Multidisciplinary Bilateral Russia-Uzbekistan Expert Council presented innovations in the prognosing, personalized prevention and adjuvant therapy of degenerative-dystrophic diseases of the joints and spine, the evidence base for the effectiveness and safety of the use of drugs that modify the course of OA (Disease-modifying osteoarthritis drugs, DMOADs): chondroitin sulfate, glucosamine sulfate, undenatured type II collagen for adjuvant pharmaconutraceutical support – prevention and adjuvant therapy (treatment) of OA and nonspecific lumbosacral pain. The expert counsil resolution presents an optimized algorithm for the management, prevention and adjuvant therapy of OA and non-specific back pain, maintaining the function of healthy joints after intense physical activity with the inclusion of the drug Chondroguard solution for intra-articular and intramuscular administration (INN – chondroitin sulfate) and a new pharmaconutraceutical from the DMOADs group – TRIO trademark Chondroguard® (Chondroguard®TRIO).
{"title":"New pharmaconutraceutical Chondroguard®TRIO for the prevention of musculoskeletal diseases and nutritional support for patients with osteoarthritis and nonspecific back pain: an assessment of clinical options. Resolution of the Multidisciplinary Expert Council","authors":"A. Danilov, A. Lila, Y. N. Majidova, O. Gromova, O. Tkacheva, I. Sarvilina, A. Kochish, A. Nazarenko, N. Zagorodniy, T. Minasov, L. Alekseeva, E. Taskina, Y. Kotovskaya, E. Dudinskaya, A. V. Rozanov, E. Solovieva, O. A. Shavlovskaya, M. Sharov, P. Kamchatnov, A. P. Rachin, E. Barantsevich, D. Iskra, E. Yakupov, F. I. Devlikamova, A. Barulin, M. V. Nesterova, T. G. Sakovets, A. Barinov, I. Dolgova, N. Zabolotskikh, E. Zonova, L. Shchepankevich, V. A. Parfenov, A. T. Dzhurabekova, S. Z. Khakimova","doi":"10.14412/2074-2711-2023-2-134-146","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-134-146","url":null,"abstract":"In recent decades, there has been an increase in the prevalence and medical and social burden of osteoarthritis (OA) and nonspecific back pain in all countries of the world. The First Multidisciplinary Bilateral Russia-Uzbekistan Expert Council presented innovations in the prognosing, personalized prevention and adjuvant therapy of degenerative-dystrophic diseases of the joints and spine, the evidence base for the effectiveness and safety of the use of drugs that modify the course of OA (Disease-modifying osteoarthritis drugs, DMOADs): chondroitin sulfate, glucosamine sulfate, undenatured type II collagen for adjuvant pharmaconutraceutical support – prevention and adjuvant therapy (treatment) of OA and nonspecific lumbosacral pain. The expert counsil resolution presents an optimized algorithm for the management, prevention and adjuvant therapy of OA and non-specific back pain, maintaining the function of healthy joints after intense physical activity with the inclusion of the drug Chondroguard solution for intra-articular and intramuscular administration (INN – chondroitin sulfate) and a new pharmaconutraceutical from the DMOADs group – TRIO trademark Chondroguard® (Chondroguard®TRIO).","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80989223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-01DOI: 10.14412/2074-2711-2023-2-126-133
G. Tabeeva, A. V. Amelin, L. Akhmadeeva, A. Danilov, O. Doronina, M. Koreshkina, N. Latysheva, E. Mendelevich, I. Sarvilina, A. Sergeev, K. Skorobogatykh, E. Filatova
On December 24, 2022, in Moscow an interdisciplinary Council of Headache Experts, held under the auspice of the interregional public organization “Russian Society for the Study of Headache”, discussed the key problems of effective treatment of a migraine attack and the possibilities of a specific drug Kaporiza® (rizatriptan). Despite the development of strategies for the relief of migraine attacks and the effectiveness of triptans as first-line therapy, the choice of a specific drug in accordance with the individual clinical profile of the patient is difficult due to the existence of drugs in various forms (standard tablets, oral dispersible forms, injections, nasal sprays, rectal suppositories). Rizatriptan in the form of an orally dispersible tablet (ODT) has a number of advantages: high bioavailability, fast onset of action, and ease of use. Therefore, Kaporiza® (rizatriptan ODT) may be recommended as a priority therapy for all migraine patients who prefer the dispersible tablet form and who experience symptoms of nausea and vomiting, as well as for patients who have experience of poor efficacy and/or poor tolerability of other triptans. The Expert Council recommends to include rizatriptan ODT in the next edition of the clinical guidelines for the diagnosis and treatment of migraine as a first-line agent with Level A evidence.
{"title":"Optimization of migraine attacks relief","authors":"G. Tabeeva, A. V. Amelin, L. Akhmadeeva, A. Danilov, O. Doronina, M. Koreshkina, N. Latysheva, E. Mendelevich, I. Sarvilina, A. Sergeev, K. Skorobogatykh, E. Filatova","doi":"10.14412/2074-2711-2023-2-126-133","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-126-133","url":null,"abstract":"On December 24, 2022, in Moscow an interdisciplinary Council of Headache Experts, held under the auspice of the interregional public organization “Russian Society for the Study of Headache”, discussed the key problems of effective treatment of a migraine attack and the possibilities of a specific drug Kaporiza® (rizatriptan). Despite the development of strategies for the relief of migraine attacks and the effectiveness of triptans as first-line therapy, the choice of a specific drug in accordance with the individual clinical profile of the patient is difficult due to the existence of drugs in various forms (standard tablets, oral dispersible forms, injections, nasal sprays, rectal suppositories). Rizatriptan in the form of an orally dispersible tablet (ODT) has a number of advantages: high bioavailability, fast onset of action, and ease of use. Therefore, Kaporiza® (rizatriptan ODT) may be recommended as a priority therapy for all migraine patients who prefer the dispersible tablet form and who experience symptoms of nausea and vomiting, as well as for patients who have experience of poor efficacy and/or poor tolerability of other triptans. The Expert Council recommends to include rizatriptan ODT in the next edition of the clinical guidelines for the diagnosis and treatment of migraine as a first-line agent with Level A evidence.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"740 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88010451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14412/2074-2711-2023-2-83-90
A. N. Bogolepova
Cerebral microangiopathy (CMA) is one of the significant causes of depression in the elderly. Close associations of the risk of developing depression with white matter hyperintensity, the presence of lacunar infarcts, and other markers of vascular disease are shown. The available data suggest that various vascular mechanisms, in particular, involvement of small vessels of the brain, generalized microvascular and endothelial dysfunction, metabolic risk factors, – are risk factors for the development of depression. Pathogenetic mechanisms include cerebral hypoperfusion and immune dysregulation. Depression is also a common complication of coronavirus infection, occurring both in the acute and postCOVID periods. The same mechanisms as in vascular depression are involved in the pathogenesis of the development of post-COVID depressive disorders. Given the complexity of the mechanisms of development of depressive disorders in patients with CMA, the presence of severe comorbid vascular pathology, antidepressants with an optimal ratio of efficacy and safety should be preferred. Agomelatine (Valdoxan) is one of such drugs.
{"title":"Depression in patients with cerebral microangiopathy","authors":"A. N. Bogolepova","doi":"10.14412/2074-2711-2023-2-83-90","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-83-90","url":null,"abstract":"Cerebral microangiopathy (CMA) is one of the significant causes of depression in the elderly. Close associations of the risk of developing depression with white matter hyperintensity, the presence of lacunar infarcts, and other markers of vascular disease are shown. The available data suggest that various vascular mechanisms, in particular, involvement of small vessels of the brain, generalized microvascular and endothelial dysfunction, metabolic risk factors, – are risk factors for the development of depression. Pathogenetic mechanisms include cerebral hypoperfusion and immune dysregulation. Depression is also a common complication of coronavirus infection, occurring both in the acute and postCOVID periods. The same mechanisms as in vascular depression are involved in the pathogenesis of the development of post-COVID depressive disorders. Given the complexity of the mechanisms of development of depressive disorders in patients with CMA, the presence of severe comorbid vascular pathology, antidepressants with an optimal ratio of efficacy and safety should be preferred. Agomelatine (Valdoxan) is one of such drugs.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80911202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14412/2074-2711-2023-2-106-113
A. B. Lokshina, D. Grishina, V. Zakharov
Vascular brain diseases are one of the leading causes of death and disability in developed countries. Along with acute disturbance of cerebral circulation, chronic cerebrovascular diseases, which manifest as vascular cognitive impairment (VCI), are of great medical and social importance. VCIs include a wide range of cognitive impairments (CI) ranging from subjective CI to vascular and mixed dementia. The article discusses pathogenetic and clinical variants, approaches to the diagnosis of VCIs, and provides their modern classification. The features of CI, typical for chronic cerebrovascular insufficiency, are described, such as a slowdown in the rate of mental activity and disorders of frontal executive functions in combination with behavioral and emotional disorders. The issues of treatment of VCI are discussed, which should be comprehensive and include correction of the underlying vascular disease, non-drug (regular physical activity, smoking cessation, cognitive training) and drug treatments aimed at improving cognitive functions. The possibilities of modern neuroprotective and symptomatic therapy of CI, including the use of Cellex®, are shown.
{"title":"Vascular cognitive impairment: issues of diagnosis and treatment","authors":"A. B. Lokshina, D. Grishina, V. Zakharov","doi":"10.14412/2074-2711-2023-2-106-113","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-106-113","url":null,"abstract":"Vascular brain diseases are one of the leading causes of death and disability in developed countries. Along with acute disturbance of cerebral circulation, chronic cerebrovascular diseases, which manifest as vascular cognitive impairment (VCI), are of great medical and social importance. VCIs include a wide range of cognitive impairments (CI) ranging from subjective CI to vascular and mixed dementia. The article discusses pathogenetic and clinical variants, approaches to the diagnosis of VCIs, and provides their modern classification. The features of CI, typical for chronic cerebrovascular insufficiency, are described, such as a slowdown in the rate of mental activity and disorders of frontal executive functions in combination with behavioral and emotional disorders. The issues of treatment of VCI are discussed, which should be comprehensive and include correction of the underlying vascular disease, non-drug (regular physical activity, smoking cessation, cognitive training) and drug treatments aimed at improving cognitive functions. The possibilities of modern neuroprotective and symptomatic therapy of CI, including the use of Cellex®, are shown.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"162 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86366500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14412/2074-2711-2023-2-34-40
E. Klocheva, V. V. Goldobin, F. Olimova
Cerebral venous thrombosis (CVT) is a form of cerebrovascular disorders that is difficult to recognize, it is potentially a life threatening condition and requires timely anticoagulant therapy. In the era of the COVID-19 pandemic, there is a steady increase in CVT (4.2% vs. 0.5–1%). At the same time, mortality in patients with CVT on the background of COVID-19 significantly exceeds the mortality in patients with CVT without COVID-19 (45.5% vs. 15%). Objective: to study the clinical course of CVT, to determine the diagnostic value of radiological methods and the significance of genetic risk factors for thrombosis in the development of CVT in young and middle-aged patients against the background of COVID-19. Material and methods. Seven patients were examined: six women (five of them of reproductive age) and one man, aged 26 to 57 years (mean age 37 years). The main clinical and neurological manifestations of CVT, the results of laboratory examination, neuroimaging, and the data of molecular genetic analysis of risk factors for thrombosis were analyzed. Results. The course of COVID-19 was severe in one case, and moderate in the rest of cases. The interval between the onset of COVID-19 symptoms and the development of CVT ranged from 7 to 25 days. In three cases CVT had an acute course and was accompanied by the development of a stroke (in two cases, hemorrhagic stroke was noted, in one case, multifocal ischemic stroke), in other cases, a subacute course of CVT was noted. Genetic risk factors for thrombosis were identified in all patients.Conclusion. The diagnosis of CVT in the era of the COVID-19 pandemic is particularly difficult, since the most common symptom of CVT – headache (90%) – can be regarded as a manifestation of COVID-19. At the same time, timely diagnosis of CVT and immediate initiation of anticoagulant therapy are associated with a relatively favorable prognosis.
脑静脉血栓形成(CVT)是一种难以识别的脑血管疾病，是一种潜在的危及生命的疾病，需要及时的抗凝治疗。在2019冠状病毒病大流行时期，CVT稳步上升(4.2%对0.5-1%)。同时，COVID-19背景下CVT患者的死亡率明显超过无COVID-19 CVT患者的死亡率(45.5% vs. 15%)。目的:研究新冠肺炎背景下中青年CVT的临床病程，探讨影像学检查的诊断价值及血栓形成的遗传危险因素在CVT发展中的意义。材料和方法。检查了7例患者:6名女性(其中5名育龄)和1名男性，年龄26至57岁(平均37岁)。分析CVT的主要临床和神经学表现、实验室检查结果、神经影像学检查结果以及血栓形成危险因素的分子遗传学分析数据。结果。1例病例病程为重症，其余病例病程为中度。COVID-19症状出现和CVT发展之间的间隔为7至25天。3例CVT有急性病程，并伴有卒中的发展(2例为出血性卒中，1例为多灶性缺血性卒中)，其他病例为亚急性病程CVT。所有患者均确定了血栓形成的遗传危险因素。在COVID-19大流行时代，CVT的诊断尤其困难，因为CVT最常见的症状-头痛(90%)-可视为COVID-19的表现。同时，及时诊断CVT，立即开始抗凝治疗，预后相对较好。
{"title":"Clinical course and diagnosis of cerebral vein and sinus thrombosis associated with COVID-19 in young and middle-aged patients","authors":"E. Klocheva, V. V. Goldobin, F. Olimova","doi":"10.14412/2074-2711-2023-2-34-40","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-34-40","url":null,"abstract":"Cerebral venous thrombosis (CVT) is a form of cerebrovascular disorders that is difficult to recognize, it is potentially a life threatening condition and requires timely anticoagulant therapy. In the era of the COVID-19 pandemic, there is a steady increase in CVT (4.2% vs. 0.5–1%). At the same time, mortality in patients with CVT on the background of COVID-19 significantly exceeds the mortality in patients with CVT without COVID-19 (45.5% vs. 15%). Objective: to study the clinical course of CVT, to determine the diagnostic value of radiological methods and the significance of genetic risk factors for thrombosis in the development of CVT in young and middle-aged patients against the background of COVID-19. Material and methods. Seven patients were examined: six women (five of them of reproductive age) and one man, aged 26 to 57 years (mean age 37 years). The main clinical and neurological manifestations of CVT, the results of laboratory examination, neuroimaging, and the data of molecular genetic analysis of risk factors for thrombosis were analyzed. Results. The course of COVID-19 was severe in one case, and moderate in the rest of cases. The interval between the onset of COVID-19 symptoms and the development of CVT ranged from 7 to 25 days. In three cases CVT had an acute course and was accompanied by the development of a stroke (in two cases, hemorrhagic stroke was noted, in one case, multifocal ischemic stroke), in other cases, a subacute course of CVT was noted. Genetic risk factors for thrombosis were identified in all patients.Conclusion. The diagnosis of CVT in the era of the COVID-19 pandemic is particularly difficult, since the most common symptom of CVT – headache (90%) – can be regarded as a manifestation of COVID-19. At the same time, timely diagnosis of CVT and immediate initiation of anticoagulant therapy are associated with a relatively favorable prognosis.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90239260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14412/2074-2711-2023-2-91-97
Y. A. Starchina, O. V. Kosivtsova, E. Sokolov
Cerebrovascular disease is one of the most common pathologies in the practice of a neurologist. Vascular cognitive impairment is the earliest and most objective sign of cerebrovascular pathology. The correction of vascular risk factors – antihypertensive, antiplatelet, lipid-lowering therapy, have the leading role in the treatment of patients with cerebrovascular diseases. It is necessary to pay special attention to non-drug methods of therapy, such as quitting smoking and alcohol abuse, regular physical activity. The possibilities of using dipyridamole for symptomatic and pathogenetic therapy are discussed.
{"title":"Management of patients with chronic cerebrovascular disease","authors":"Y. A. Starchina, O. V. Kosivtsova, E. Sokolov","doi":"10.14412/2074-2711-2023-2-91-97","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-91-97","url":null,"abstract":"Cerebrovascular disease is one of the most common pathologies in the practice of a neurologist. Vascular cognitive impairment is the earliest and most objective sign of cerebrovascular pathology. The correction of vascular risk factors – antihypertensive, antiplatelet, lipid-lowering therapy, have the leading role in the treatment of patients with cerebrovascular diseases. It is necessary to pay special attention to non-drug methods of therapy, such as quitting smoking and alcohol abuse, regular physical activity. The possibilities of using dipyridamole for symptomatic and pathogenetic therapy are discussed.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86412121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.14412/2074-2711-2023-2-114-119
M. A. Isaikina, A. I. Isaikin, L. T. Akhmedzhanova
Musculoskeletal system pathology is one of the main causes of morbidity and disability worldwide. Inflammation plays the leading role in the genesis of these diseases. Pain is the most important factor leading to a critical decrease in the quality of life and limitation of daily activities. Most current international guidelines for the treatment of acute and chronic low back and neck pain, osteoarthritis, rheumatoid arthritis and other diseases recommend oral non-steroidal anti-inflammatory drugs as first-line therapy. The article presents data from the latest domestic and international studies, including the results of the largest SOS study, which demonstrated the high efficacy and safety of aceclofenac (Aertal) in acute and chronic neck and back pain.
{"title":"Efficacy and safety of aceclofenac in musculoskeletal diseases","authors":"M. A. Isaikina, A. I. Isaikin, L. T. Akhmedzhanova","doi":"10.14412/2074-2711-2023-2-114-119","DOIUrl":"https://doi.org/10.14412/2074-2711-2023-2-114-119","url":null,"abstract":"Musculoskeletal system pathology is one of the main causes of morbidity and disability worldwide. Inflammation plays the leading role in the genesis of these diseases. Pain is the most important factor leading to a critical decrease in the quality of life and limitation of daily activities. Most current international guidelines for the treatment of acute and chronic low back and neck pain, osteoarthritis, rheumatoid arthritis and other diseases recommend oral non-steroidal anti-inflammatory drugs as first-line therapy. The article presents data from the latest domestic and international studies, including the results of the largest SOS study, which demonstrated the high efficacy and safety of aceclofenac (Aertal) in acute and chronic neck and back pain.","PeriodicalId":19252,"journal":{"name":"Neurology, neuropsychiatry, Psychosomatics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88069501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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