Saratov JOURNAL of Medical and Scientific Research

Romanova T.V.

Professor, Doctor of Medical Sciences; T. V. Romanova — Samara State Medical University, Department of Neurology and Neurosurgery, Assistant Professor, Doctor of Medical Sciences

Rehabilitation potential of patients with myasthenia gravis

Year: 2020, volume 16 Issue: №1 Pages: 371-377
Heading: Neurology Article type: Original article
Authors: Romanova T.V., Kalashnikova V.V., Romanov D.V.
Organization: Samara State Medical University
Summary:

Objective: to identify individual psychological characteristics that determine the rehabilitation potential of patients with myasthenia gravis. Material and Methods. A homogeneous group of patients was included in the examination in order to level the effect of the severity of the condition on the results obtained. We examined 25 patients with a generalized form of myasthenia gravis who were in a stable compensated state. The methodology "Rehabilitation Potential of Personality" was used. Quality of life was investigated using the SF-36 questionnaire. Results. Patients were divided into two subgroups according to their subjective assessment of quality of life. First subgroup consisted of patients with low values of the psychological component of quality of life (15 people); second subgroup consisted of patients with indicators on this scale similar to control group (10 people). Main indicators of "Rehabilitation Potential of Personality" questionnaire were compared in two subgroups and a correlation analysis of parameters of SF-36 questionnaire and indicators of rehabilitation potential was carried out. Conclusion. The psychological component of quality of life of patients with myasthenia is most dependent on internal picture of disease and emotional state. By providing targeted psychocorrectional effects, it is possible to increase patient's rehabilitation potential.

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Dynamics of acetylcholine receptors antibody titer in myasthenia gravis

Year: 2018, volume 14 Issue: №1 Pages: 164-168
Heading: Neurology Article type: Original article
Authors: Romanova T.V., Poverennova I.E., Zakharov A.V.
Organization: Samara State Medical University
Summary:

The aim was to examine the longitudinal association between myasthenia gravis clinical severity and concentration of acetylcholine receptor (AChR) antibodies to evaluate if AChR-antibody variations correlate to disease severity. Material and Methods. Antibodies were determined by enzyme immunoassay. The International Clinical Classification (MGFA) was used to grade the severity of the disease. The level of antibodies was compared with the severity of the condition and the form of the disease at the stage of diagnosis in 65 patients, as well as in repeated studies in 26 patients. Results. The titer of AChR-antibodies did not correlate with the severity of the condition, however, a direct relationship between the change in the level of acetylcholine receptor antibodies and the change in the clinical state during the course of the disease was obtained. Conclusion. Repeated AChR-antibody measurements will help to predict the clinical state of the patient and can be used to correct immunosuppressive therapy.

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Use of the scale of clinical expression of the stroke for determining the rehabilitation prediction

Year: 2018, volume 14 Issue: №1 Pages: 161-164
Heading: Neurology Article type: Original article
Authors: Repina L.A., Romanova T.V., Poverennova I.E.
Organization: Samara State Medical University
Summary:

The aim is to study the relationship between the parameters of neurological status and quality of life of patients who first underwent ischemic strokes in the carotid basin to predict the outcome of an acute cerebrovascular accident. Material and Methods. 73 patients with ischemic stroke in the carotid artery basin were examined. Analyzed indices of the scales, reflecting the severity of motor deficit (NIHSS, Rankin, Rivermead, Fugl-Meyer), the initial evaluation and parameters of quality of life using the questionnaire SF-3624-36 months after inpatient treatment. Patients were divided into groups of favorable and unfavorable outcome according to the questionnaire SF-36. Results. A direct correlation between the level of physical and psychological health and indicators Of the Fugl-Meyer scale and a negative correlation between the level of psychological health and the severity of stroke on the NIHSS scale in a group with an adverse outcome was revealed. Conclusion. Indicators scales Fugl-Meyer, and NIHSS obtained in the acute period of ischemic stroke can be used to build a predictive model of outcome of stroke.

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Early detection of cognitive impairment in patients with multiple sclerosis

Year: 2017, volume 13 Issue: №1 Pages: 164-168
Heading: Neurology Article type: Original article
Authors: Poverennova I.E., Romanova T.V., Zakharov A.V., Khivintseva E.V.
Organization: Samara State Medical University
Summary:

The aim of the study was to examine cognitive impairment in patients with multiple sclerosis with an emphasis on the speed and efficiency of information processing. It was supposed to reveal the patterns of these disorders depending on the duration and severity of the disease. Material and methods. The study included 50 patients with established diagnosis of clinically significant multiple sclerosis, a relapsing-remitting course. The EDSS score was evaluated. Cognitive functions were assessed using SDMT and PASAT-3 tests. All patients underwent a study of cognitive evoked potential. All examined patients were divided into 2 groups depending on the duration of the disease. Results. Cognitive screening tests PASSAT and SDMT showed no correlation with the duration of the disease severity and cannot serve as a tool for screening early signs of cognitive impairment in young patients with multiple sclerosis. A significant increase in latency of the P300 potential was obtained with increasing duration and severity of the disease, which correlates with the severity of cognitive dysfunction. Conclusion. This study is the initial step in the search for a tool for screening early manifestations of cognitive impairment in patients with multiple sclerosis. In the future it is planned to expand the research with the modernization of its design.

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Early and late myasthenia gravis

Year: 2016, volume 12 Issue: №2 Pages: 287-292
Heading: Neurology Article type: Original article
Authors: Romanova T.V., Poverennova I.E.
Organization: Samara State Medical University
Summary:

The aim: the hypothesis testing of the existence of two different groups of patients with different age at disease onset in a large population of patients with methods multidimensional constellation. Materials and Methods. Analysis of 444 patients enrolled in the register of patients with myasthenia in the Samara region. The duration of disease was more than 1 year. Statistical results of the study was carried out using a multi-dimensional grouping by cluster analysis Checking the quality of the classification was carried out using discriminant analysis. Results. Transient age between the two groups was defined as 40 years. The most important criteria of distinction patients group was sex of the patient and the presence of thymic hyperplasia. Conclusion. These clinical and immunologic patterns of early-onset and late-onset myasthenia gravis can serve as a basis of formation flow forecast model of myasthenia gravis and to create an algorithm of patient management.

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Factors affecting the quality of life in patients with myasthenia gravis

Year: 2012, volume 8 Issue: №2 Pages: 517-521
Heading: Neurology Article type: Original article
Authors: Romanova T.V., Poverennova I.E.
Organization: Samara State Medical University
Summary:

The goal of the research is to study clinical and social factors affecting the quality of life at patients with myasthenia gravis. To assess the quality of life (QOL) questionnaires: SF-36, MFI-20, EQ-5D were used. These data suggest that successful treatment, which signifcantly reduced the severity of the disease, essentially improves QOL. The degree of compensation process has a greater infuence than the nature of the treatment itself. Patients who achieved drug-free remission approached average QOL rate. Duration of disease was not a signifcant factor in of QOL worsening. Conclusion. Factors affecting the quality of life at patients with myasthenia gravis, will allow to plan and correct the treatment program more effectively, and to achieve patients and their families’ better quality of life.

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Samara epidemiological research of myasthenia gravis

Year: 2012, volume 8 Issue: №1 Pages: 091-095
Heading: Neurology Article type: Original article
Authors: Т.V. Romanova
Organization: Samara State Medical University
Summary:

The aim of the study was to analyze epidemiological and demographic characteristics of patients with myasthenia gravis in the Samara region. Material and methods. Data of electronic register of Regional myasthenic center containing information about 340 patients were used. Prevalence of myasthenia gravis in area made up 9,7; average annual disease over the last 10 years — 0,73 per 100000. Results. The data obtained are comparable with the global characteristics of the disease, but higher than the figures of some domestic researches. Conclusion. Confirms the fact that in regions where work specialized myasthenic centers, epidemiological parameters are always higher.

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Efficacy Evaluation of Thymectomy in Myasthenia Patients

Year: 2009, volume 5 Issue: №2 Pages: 234-237
Heading: Neurology Article type: Original article
Authors: T.V. Romanova, M.J. Belyakova, S.J. Pushkin, A.P. Reshetov
Organization: Samara State Medical University
Summary:

The condition of 71 patients with myasthenia after thymectomy has been analyzed. Supervision has been carried out from 6 months till 9 years. Thymic hyperplasia has been marked at histological research of operational material in 46,5% of patients. Thymic tumors have been revealed in 50,7% of cases, thymomas have been noticed in 16,7% of cases. In 2 cases (2,8%) atrophy of the thymus gland has been revealed. The excellent and good effects of surgical treatment have been received at 73,8 % of patients, in case of thymic hyperplasia in 76,7 %, and at thymic tumors — in 69,7%. Efficiency dependence includes surgery term according to the disease onset and the age of patients by the moment of operation. Thus, the excellent and good results have been received in 82 % of patients operated within the first two years after the onset of the disease.

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