Saratov JOURNAL of Medical and Scientific Research

Privolzhskiy Research Medical University

Plasma thiamine level and thiamine-deficient neurological disorders in patients on program hemodialysis

Year: 2020, volume 16 Issue: №1 Pages: 389-393
Heading: Neurology Article type:
Authors: Khrulev А.Е., Shiyanova N.A., Golubeva D.V., Vorobyova O.A., Melnikova N.B.
Organization: Privolzhskiy Research Medical University
Summary:

Objective: to study the level of thiamine in the blood plasma of patients undergoing long-term program hemodialysis, and the variability of dialysis-associated thiamine losses, to study possible thiamine-deficient neurological disorders in dialysis patients. Material and Methods. 85 patients who did not take vitamin-containing preparations for 1 year or more were examined. Patients were divided into a main group and a control group. The main group consisted of 45 patients with the dialysis stage of chronic kidney disease (dialysis experience of 75.2±59.0 months), the control group (n=40) is divided into 2 subgroups: 20 patients of the pre-dialysis period and 20 relatively healthy individuals. Blood plasma thiamine levels were analyzed by high performance liquid chromatography. Results. An analysis of the thiamine content in the blood plasma of patients of the main group revealed low levels of thiamine in all patients. The studied indicator did not exceed 54% of the norm. The frequency of detecting severe thiamine deficiency was 53.3%, moderate deficiency of 40% of cases, and plasma thiamine deficiency was observed in 6.7%. In the 1st control subgroup, a less pronounced decrease in thiamine content was detected, the average value was 73.7±11.1%. The average thiamine content in plasma in the 2nd control subgroup was 92.2±4.1 %. Conclusion. Among patients on program hemodialysis, there was a deficiency of thiamine and a neurological spectrum of disorders, including thiamine-deficient encephalopa-thy and polyneuropathy.

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Hand dysfunction and its recovery in the acute period of lacunar ischemic stroke

Year: 2020, volume 16 Issue: №1 Pages: 380-383
Heading: Neurology Article type: Original article
Authors: Semenova T.N., Grigoryeva V.N., Novosadova O.A.
Organization: Privolzhskiy Research Medical University
Summary:

Objective: to establish the frequency of occurrence of impaired hand function and evaluate the dynamics of its recovery in patients with lacunar ischemic stroke (LS). Material and Methods. 137 patients with acute LS were examined. All patients underwent clinical and neurological examination with a quantitative assessment of strength, sensitivity, coordination, praxis and hand function according to the use of Action Research Arm Test and 9-Hole Peg Test. Results. Hand dysfunction was revealed in 79% of patients with LS. The most pronounced disorders were observed with purely motor and sensorimotor variants of LS. In the first two weeks after the development of LS, a significant improvement, including complete restoration of upper limb function, was observed in 79% of patients and was associated with the initial severity of disorders. «Dysarthria — clumsy hand» syndrome more often than other variants of LS was characterized by a complete recovery of manual capacity. Conclusion. Hand function is impaired in most patients with acute lacunar stroke. The rate of its recovery depends on the initial severity of hand dysfunction and the lacunar stroke clinical variant. The obtained data can be used in the development of individual rehabilitation programs for this category of patients

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Pain syndrome and comorbidity in adult patients with cerebral palsy: a modern view on the problem (review)

Year: 2020, volume 16 Issue: №1 Pages: 357-359
Heading: Neurology Article type: Review
Authors: Komshina K.S., Antipenko Е.А.
Organization: Privolzhskiy Research Medical University
Summary:

The review is devoted to the analysis of studies on the problem of pain syndrome in adult patients with cerebral palsy. The authors studied the literary sources contained in the databases PubMed, eLibrary, Scopus, Web of Science, MEDLINE and published over the past ten years. Modern views on the prevalence, etiology, pathogenesis, structure and treatment of pain in adult patients with cerebral palsy are presented. The main comorbid diseases that contribute to the development of chronic pain syndrome in these patients are described. The review focuses on the relevance of the problem, its medical and social significance.

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The results of femtolaser scleropuncture in experiments on isolated animal tissue (preliminary report)

Year: 2019, volume 15 Issue: №2 Pages: 536-539
Heading: Ophtalmology Article type: Original article
Authors: Smetankin I.G., Vasilyeva A.E.
Organization: Privolzhskiy Research Medical University
Summary:

The purpose of the study is to evaluate the results of femtolaser sclerotomy in the experiment on isolated eye of animal, as well as the prospects of applying the method of laser transscleral puncture of the sinus canal of sclera. Material and Methods. We performed a series of experiments on fresh scleral tissue of isolated pig eyes using industrial femtosecond laser PH-1SP with a wavelength of 1028 nm, pulse energy of 0.5–1.5 MJ, frequency of 1–20 kHz. Series of 10–15 pulses with duration less than 100 FS were performed. In order to assess the depth of femtosecond laser exposure to scleral tissue, as well as the quality of the obtained punctured holes, histological preparations were made, studied using routine light microscopy with multiplicity of magnifying up to ×400. Serial sagittal and frontal sections 15 µm thick and hematoxilin eosin staining were used. Results. Puncture channels of diferent confgurations with a minimum marginal coagulation of no more than 5 microns were obtained due to the efect of ablation of the scleral tissue. The maximum depth of the formed channels is 500 microns at a power of 1.5 MJ and a frequency of 10 kHz. Since the thickness of the scleral tissue of the human eye in the limbal zone is 600–800 µm, there is prospect of using a femtosecond laser for the laser transscleral puncture of the schlemm channel. Conclusion. The infuence of femtosecond laser on tissue of sclera is characterized by the almost complete absence of heat, the coagulation efect and the pronounced depth of the ablation, thus it is possible to discuss the use of femtosecond laser for the laser transscleral puncture of the sclera sinus channel.

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Pathophysiological evaluation of common neonatal factors of the pathogenesis of hemolytic anemia and infammation

Year: 2019, volume 15 Issue: №2 Pages: 372-376
Heading: Physiology and Pathophysiology Article type: Original article
Authors: Geraskin V.A., Potemina T.E., Geraskin I.V., Komlev D.Yu.
Organization: Privolzhskiy Research Medical University
Summary:

Objective: to determine the damage of blood elements as tissue damage — to study hemolytic anemia from the position of infammation. Material and Methods. Clinical and laboratory data of 187 neonatal patients were included in the examination group. The dynamics of blood erythrocyte indices was studied taking into account the dependence on age, anthropometric parameters, the severity of diseases and the intensity of oxygenotherapy. The composition and features of oxidative modifcations of lipid structures of biological membranes of erythrocytes were investigated. Results. The values of the elements of alteration in the pathogenesis of hemolysis were determined. Changes of erythrocyte membranes in oxidative hemolysis were investigated. The review and comparison of the information contained in the classical and periodicals on pathological physiology, Hematology. Conclusion. The study damage to the blood elements as tissue damage allows you to apply for the study of hemolytic anemias the concept of development of infammation.

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Specific features of rehabilitation potential in adult patients with cerebral palsy

Year: 2019, volume 15 Issue: №1 Pages: 187-190
Heading: Neurology Article type: Original article
Authors: Shulyndin A.V., Antipenko Е.А.
Organization: Privolzhskiy Research Medical University
Summary:

Objective: to determine the specific features of rehabilitation potential in adult patients with cerebral palsy (CP). Material and Methods. Fifty patients with a confirmed diagnosis of cerebral palsy established in childhood were studied. Level of development of gross motor skills according to GMFCS classification was evaluated in all patients; functions were assessed using the International Classification of Functioning (ICF, version 2.1a, clinical form). Results: In patients with level 2 GMFCS, dysfunctions of muscle tone, muscle strength, implementation and capacity for raising and transferring objects of moderate and severe degree (p<0.05) were more common. The frequency of restricted implementation of precise manual movements is comparable in patients with GMFCS levels 1 and 2 Restricted non- assisted walking was significantly more common in patients with 2nd functional level. The moderately significant positive impact of personal mobility assistive products is more common among level 2 patients, while the importance of communication tools was greater for level 1 GMFCS patients. Conclusion. In adult patients with cerebral palsy it is necessary to assess the rehabilitation potential using ICF. Indicators of activity and participation are of key importance to the rehabilitation potential of adult cerebral palsy patients and should be considered in terms of the possibility of full or partial recovery to a level at which the performance of a certain task will meet the needs of the patient.

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Current state and prospects of antibiotic prophylaxis in patients after burn injury

Year: 2019, volume 15 Issue: №1 Pages: 108-113
Heading: Parmacology Article type: Review
Authors: Barsuk A.L., Lovtsova L.V., Nekaeva E.S., Sorokina Yu.A.
Organization: Privolzhskiy Research Medical University
Summary:

The review is devoted to antibiotic prophylaxis of infectious complications in burns. Severe burn injury often results in death. Infectious complications are the most common cause of mortality in these patients. Systemic antibiotic prophylaxis is actively used in practical medicine, but is not recommended by national and international clinical guidelines for the treatment of patients affected by burns. The principles of such prevention have not been developed yet. The data of studies of systemic antibiotic prophylaxis are inconsistent. A number of studies confirm the rationality of use of systemic antibiotic prophylaxis in persons on artificial ventilation with severe burns. This approach has been reported to reduce mortality and incidences of pneumonia significantly. There are evidences of perioperative antibiotic prophylaxis effectiveness in some surgical procedures associated with burn injury. Studies also demonstrate antibiotic prophylaxis and intestine decontamination combination effectiveness in preventing from complications in burn patients. Besides antibiotic prophylaxis, other pharmacological approaches currently are being developed in order to reduce the incidence of infectious complications in burns. Preclinical studies have shown the effectiveness of statins and topical probiotics in the prevention of burn sepsis in the experiment. The development and implication of early diagnostic methods for infectious complications is one another possible way to prevent severe infections in patients with burn injury.

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Oculomotor abnormalities in Huntington's disease patients and premanifest gene carriers

Year: 2018, volume 14 Issue: №4 Pages: 922-928
Heading: Ophtalmology Article type: Original article
Authors: Svetozarskiy S.N., Kopishinskaya S.V., Smetankin I.G.
Organization: Privolzhskiy Research Medical University, Volga District Medical Center of FMBA
Summary:

Purpose: to establish oculomotor features in manifest Huntington's disease (HD) patients and premanifest gene carriers compared with controls. Material and Methods. The study involved 23 manifest HD patients, 21 premanifest gene carriers and 31 healthy volunteers. Binocular vision was evaluated using the four-point test. Direct and indirect pupil light reaction, convergence and accommodation response, head position, eye mobility and deviation were assessed. Slow eye movements, saccades and convergence were assessed. The criterion for clinical convergence insufficiency was defined as the near point of convergence of more than 5 cm. Patients from the target groups underwent DNA testing with an estimation of the CAG-repeats (cytosine-adenine-guanine) length in the huntingtin gene, an examination on the UHDRS motor scale (Unified Huntington's Disease Rating Scale) and had the duration of their disease determined. Results. The study showed that slow eye movements, initiation, speed and volume of saccades are disturbed in more than a half of manifest HD group. A high frequency (33%) of vertical slow eye movements disturbances was revealed in the premanifest HD group. Convergence insufficiency was found in manifest patients and HD carriers significantly more often than in the control group (p<0.001). Convergent eye movements were interrupted by uncontrolled saccades in 35% of manifest patients. A positive correlation was found between the distance to the near point of convergence and the UHDRS motor score, as well as with the number of CAG repeats. Conclusion. The study added new insights to the well-known picture of oculomotor disturbances in manifest HD patients, especially considering convergence characteristic. The leading symptoms of oculomotor abnormalities in premanifest HD carriers were identified. To designate the discussed complex of symptoms, a descriptive term "hyperkinetic oculomotor disorder" was proposed.

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The role of chronic inflammation in the formation of dentigerous (follicular) cysts of the jaws in children

Year: 2018, volume 14 Issue: №4 Pages: 657-660
Heading: Stomatology Article type: Original article
Authors: Slesareva О.А., Potemina Т.Е.
Organization: Privolzhskiy Research Medical University, Nizhny Novgorod Regional Children's Hospital
Summary:

Purpose: to determine the role of chronic inflammation in deciduous teeth data in the formation of dentigerous (follicular) cysts of the jaws in children; to considerthe pathophysiological mechanism of follicular cysts formation. Material and Methods. Case histories of 134 patients of the department of maxillofacial surgery (dentistry) "Nizhny Novgorod regional children's hospital" from 2003 to 2013 with a diagnosis of "follicular jaw cyst" with different localization. Results. The dental status, specifically centers of chronic inflammation, in the area of follicular cyst formation was assessed. The connection with the ecological situation of the residence area of patients with the prevalence of follicular cysts of the jaws in children was found. Conclusion. The key role of chronic inflammation in the form of complicated forms of caries of temporary teeth for the development of follicular cysts of the jaws. The data of the study (the important role of chronic inflammation of the deciduous teeth in the formation of follicular cysts of the jaws in children) adverse environmental conditions of the place of residence will help to develop principles of prevention and examination for early detection of pathological changes.

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Тhe efficiency of complex treatment of different variants of myasthenia gravis

Year: 2018, volume 14 Issue: №1 Pages: 145-148
Heading: Neurology Article type: Original article
Authors: Lapshina O.V., Antipenko Е.А., Gustov A.V.
Organization: Privolzhskiy Research Medical University
Summary:

The aim: to evaluate the effect of complex restorative treatment on clinical manifestations and the state of oxidative homeostasis in patients with different variants of myasthenia gravis. Material and Methods. The analysis of indicators of biochemiluminescence, muscle strength according to the scales QMGS and MG-ADL, instrumental methods of research (ENMG and respiratory function) before and after treatment in 117 patients with myasthenia gravis is carried out. For comparative analysis of independent samples was used Mann — Whitney U-test, and for paired comparisons was used the Wilcoxon test. Results. The dynamics of oxidative homeostasis, clinical picture, indicators of instrumental methods of research (ENMG, respiratory function) in patients with myasthenia gravis, without thymoma and underwent thymectomy on the background of complex treatment with the use of antioxidant therapy is presented. In all studied groups against the background of complex treatment with application of antioxidant therapy increase in activity of antioxidant protection of organism and decrease in activity of free radical oxidation that correlates with clinical improvement in all groups of patients is noted. Conclusion. The use of antioxidant therapy in complex rehabilitation of patients with myasthenia gravis is pathogenetically justified, especially in patients without thymoma.

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