2022, volume 18

Objective: to improved diagnosis and treatment of asthenic-vegetative syndrome in those who have undergone COVID-19 on the basis of studying the peculiarities of its course. Material and methods. Included in the study were 54 outpatient patients aged 21 to 59 years who underwent symptomatic laboratory-confirmed COVID-19. All patients underwent electrocardiography and laboratory studies. A questionnaire was used on the Wein Vegetative Dysfunction Scale, the Beck Depression Questionnaire, the Spielberg — Hanin Situational and Personality Anxiety Scale, the Brief Mental Status Assessment Scale (MMSE) at the first visit, and again at 1 and 3 months on the background of neuropro-tective therapy. Results. It was revealed that those who underwent COVID-19 develop asthenic-vegetative syndrome with asthenic and vegetal-dystonic manifestations and pronounced anxiety-depressive disorders in 100% of patients. Against the background of therapy, there was a significant decrease in the number and severity of asthenic manifestations (from 74.1 % of patients to 5.6%) and mental disorders (from 20.4% of patients to 3.7%), but the level of anxiety remained quite high (in 40.7% of patients). Conclusions. Treatment of patients with post COVID-19 asthenic-vegetative syndrome gives a faster effect in terms of stopping asthenic and cognitive impairment, and a delayed positive dynamics in relation to anxiety-depressive manifestations.

Objective: to evaluate changes in the concentration of 41 cytokines in patients with multiple sclerosis (MS) in comparison with healthy donors (HD). Material and methods. For the study, 55 blood serum samples from MS patients and 36 from healthy donors were used. The concentration of 41 cytokines was determined using a Human Cytokine/Chemokine Magnetic Bead Panel (HCYTMAG-60K-PX41) manufactured by Merck Millipore (Darmstadt, Germany). Statistical analysis of the obtained results (Mann —Whitney l/-test, Bonferroni correction for multiple hypothesis testing) was carried out in Origin 2021. Results. Of the 41 cytokines studied, the concentration of 12 was significantly lower than in healthy donors: GRO (p=0.003); MDC, Eotaxin (p=0.002); EGF, PDGF-AA, TGF-a, PDGF-AB/BB, VEGF, IL-8, MIP-1b, MCP-1, sCD40L (p<0.001), other cytokines did not change significantly. Conclusion. In patients with MS, a decrease in the concentration of twelve cytokines was found compared with HD. Altered cytokines can be classified into two functional groups: growth factors and "monocyte-macrophage" cytokines.

Objective: to conduct a clinical and morphological analysis of the state of the medulla oblongata of patients who died from an infection caused by SARS-CoV-2. Material and methods. The work is based on a morphological study of the medulla oblongata of 10 patients who died from the coronavirus infection COVID-19, who did not appear symptoms and signs of damage to the nervous system during their lifetime, with the exception of ageusia. Results. In the structure of neurons in the medulla oblongata, changes characteristic of infectious diseases (the "mulberry" phenomenon, chromatolysis, eosinophilic inclusions of a protein nature) were revealed. Conclusion. The results obtained indicate that when SARS-CoV-2 enters the brain structures, it triggers the process of destruction of the nuclei of neurons and the penetration of viral inclusions into the cell, which indicates a lesion of the central nervous system directly associated with SARS-CoV-2.

Objective: to analyze the clinical, psychological and methodological aspects of forming specialist's and the public's opinion about risk factors and predictors of nervous system's damage in infections. Publications in the electronic databases Google Scholar, PubMed, Springer and Elsevier for the period from 1933 to April 2022 using the keywords: «Infections», «Nervous system», «Risk factor», «Predictor», «COVID-19» were researched 39 literary sources were satisfying the search conditions. As a result of the analysis, it can be stated that there is currently no reliable information about the predictors of damage to the nervous system in COVID-19, and information about risk factors is contradictory. Previously accumulated experience (for example, during studying the infection caused by Treponema pallidum subsp. pallidum) can be useful in the analysis of information about new infections, in particular, caused by SARS-CoV-2. It is important to use the terms correctly to avoid cognitive bias. The interaction of doctors and psychologists is especially important during the pandemic period.

Objective: to study the influence of various kinds of kinesiotherapy on the formation of motor skills in children with ASD, as well as the influence of motor activity on social interaction, communication abilities, stereotypical behavior based on the analysis of published scientific data. A search was made for studies in the scientific databases MEDLINE® (Ovid), AMED, Embase, CINAHL и АРА PsyclNFO® in the period from 1995 to 2021. Key words and phrases were used for the search: "autism spectrum disorders", "autism", "physical activity", "physical exercise". 26 studies were included. The data demonstrated the positive impact of various types of motor rehabilitation not only on motor, but also social, emotional, cognitive and behavioral characteristics of children with ASD. However, more thorough studies are needed, which should include a comprehensive description of the population understudy, a larger sample size, and a thorough assessment of the effectiveness of the rehabilitation impact. Methods of physical rehabilitation should be considered as methods that have a multifactorial effect on the manifestations of ASD.

The article presents a rare case of a combination of two paraneoplastic syndromes at the stage of preclinical detection of neoplasm. This example is a vivid illustration of the complexity of the diagnosis of paraneoplastic syndromes at an early stage, associated with the appearance of neurological symptoms prior the detection of the primary tumor.

Forestier's disease is a rare degenerative-dystrophic disease of the spine and surrounding prevertebral tissues, manifested by secondary dysphagia against the background of significant ossification of the anterior longitudinal ligament in the cervical spine. Objective: to analyze the clinical course of Forestier's disease, diagnostic errors and the results of surgical treatment in order to improve patient outcomes. Material and methods. From 2010 to 2020, 5 patients with a verified diagnosis of Forestier's disease were treated, who underwent surgical intervention in the scope of ventral osteophytectomy Previously, patients were examined to exclude other causes of dysphagia. Results. All patients (100%) had swallowing disorders, movement restriction, and cervical pain syndrome. The average duration of swallowing disorders was 2.8±0.7 years. In the postoperative period, swallowing disorder was resolved in all patients, postoperative complications and recurrence of dysphagia were not observed. Conclusion. In a number of clinical cases, the diagnosis is delayed due to difficulties in diagnosing dysphagia and clinical interpretation of symptoms. In clinical and instrumental diagnostics, radiography of the cervical spine and a contrast study of the esophagus with barium play a leading role. Surgical correction by ventral osteophytectomy is an effective, low-traumatic and reliable method of radical treatment.

In this paper, we present three clinical cases of patients whom we observed with genetically proven familial cases of hereditary spastic paraplegia caused by mutations in SPG4 gene. We give detailed clinical descriptions, pedigrees and discuss these patients comparing them with data published in Russian and international journals. The considered clinical cases attract attention with manifestations that are not often encountered in practice (cognitive deficiency, limbs malformations), and demonstrate additional possibilities for symptomatic relief using botulinum toxin therapy to alleviate muscle spasticity in the legs. All patients registered a positive effect.

The article presents the biography of the famous scientist — pediatrician, doctor of medical sciences, professor Alexander Semyonovich Eiberman. His labor and scientific activity as a professor, head of the department of hospital pediatrics and neonatology at the V. I. Razumovsky Saratov State Medical University was investigated. The work is dedicated to the 80th anniversary of the birth of A.S. Eiberman. Reveals the main milestones of his activities, the content of his main scientific works.

Objective: to conduct a comparative analysis of mitochondrial respiration in brain homogenates of rats with step-wise incomplete cerebral ischemia (SICI) with varying duration between ligations of both common carotid arteries (CCA). Material and methods. The experiments were performed on 24 male mongrel white rats weighing 260±20 g. All rats were distributed among three subgroups. Cerebral ischemia was simulated under intravenous thiopental anesthesia (40-50 mg/kg). The control group (n=6) comprised sham-operated rats of similar gender and weight. To study mitochondrial respiration, the brain was extracted in the cold environment (0-4 °C), dried with filter paper, weighed and homogenized sensu the modified technique in an isolation medium containing 0.32 M sucrose, 10 mM Tris-HCI, 1 mM EDTA, pH of 7.4 (in a ratio of 1:10), using Potter— Elvehjem homogenizer with Teflon pestle. Results. SICI with an interval of 1 and 3 days between ligation of both CCA led to neuronal damage in the parietal cortex and hippocampus of rats, which manifested itself in a reduction of the neuron size, deformation of the perikaryons, an increase in the number of shrunken neurons and shadow cells. The most pronounced changes were observed in the subgroup with one-day interval between ligations. These changes were similar to the changes in incomplete cerebral ischemia (ICI) (p=0.07), except for the absence of cells with pericellular edema in the hippocampus and a smaller number of those in the parietal cortex. ICI with seven-day interval between CCA ligations, on the contrary, was manifested by less pronounced histo-logical changes, especially in the hippocampus. Conclusion. Comparative analysis of mitochondrial respiration in brain homogenates revealed that the severity of brain damage in SSIC depended on the interval between blood flow arrest in both CCA. At the same time, the highest level of energy metabolism disorder was observed during CCA ligation with an interval of one day, which implied insufficient implementation of compensatory mechanisms.