ELECTRON-MICROSCOPE DIFFERENTIATIVE DIAGNOSIS OF BRAIN TUMOURS. HISTOLOGICALLY DETERMINED MENINGEOMA WITH ULTRASTRUCTURAL CHARACTERISTICS OF EPENDYMOBLASTOMA

No abstrac

THERAPEUTIC EFFECT OF MILGAMMA N IN SYMPTOMATIC NEURALGIA IN THE COURSE AND AFTER HERPES ZOSTER GANGLIONITIS

Herpes zoster is a dermatovirosis that occurs at different age. However, with the patients aged over 60 years it presents with a painful syndrome preceded, accompanied or lasting up to one year after fading away of the eruptions. Intake of B-group vitamins favourably influences on the restoration of sensory nerves being mainly affected and causing the protracted painful syndrome. Milgamma N preparation in the shape of capsules is a combination of 40mg of vit. Bi, of 90mg of vit. Вб, and of 250 у of vit. Bn and ensures an optimal intestinal resorption. The authors followed-up dynamically the therapeutic effect of Milgamma N in capsules on the development of skin lesions and painful syndrome in 15 patients (7 males and 8 females) with herpes zoster. The duration of the therapy was 4 weeks long. The following protocol was made use of: week one - two capsules three times daily and weeks two through four - three times one capsule daily. The dermatologic and neurologic status as well as the subjective evaluation of the therapeutic effect was monitored in all the patients. There was a complete or an almost complete remission in 13 patients (86,7% of the cases) after one-month treatment. The skin lesions underwent an involution during a period of 10-17 days. The one-month schedule for treatment of herpes zoster with Milgamma N proved to be effective in a moderate degree of a painful syndrome and most common localization of the eruptions

Assessment of the Subjective Visual Dysfunction of Patients With Multiple Sclerosis Using Specialized Questionnaires

Recently, the questions of the limited opportunities for measurement of the subjective and often subclinical visual dysfunction are very topical. NEI-VFQ, the questionnaire of the National Eye Institute in the USA and VFQ-25, its short version (25-item Vision Function Questionnaire) are validated for visual-specific assessment of the quality of life of multiple sclerosis (MS) patients. MSVQ-7, a specific 7-item MS Vision Questionnaire is proposed, too. The authors used the VFQ-25 translated into Bulgarian, the MSVQ-7 and their correlation with the binocular visual acuity. These questionnaires were administered to 108 MS patients without history of optic neuritis and after optic neuritis as well registered in the MS Centre in Varna and to 30 healthy subjects. There was a statistically significant difference (p<0,0001) between MS patients and controls in all sub-scales and in the overall results from VFQ-25. The analysis of MSVQ-7 showed a statistically significant difference between the answers of question Nos 1, 2, 3 and 5  p<0,001 to p=0,015). The correlation of the results from VFQ-25 and the binocular visual acuity was moderate (Spearman's r=0,6;  <0,01). The application of questionnaires for assessment of visual function may contribute to the identification of less known and sought subclinical visual dysfunctions that appear in normal visual acuity. Our data confirm the possible usage of VFQ-25 and MSVQ-7 for effective measurement of the subjective visual deficit in MS diagnosis

ANALOGIES BETWEEN APHASIC AND POETIC SPEECH PHENOMENA WITHIN THE RANGE OF THEIR THEORETICAL PROBABILITY

It is generally comprehended that pathological phenomena have their analogies in the norm. Performing a study of poetical speech allows for certain identification of formal analogy between paronyms, neologisms (coinages?), new word groups, iterations, etc, as well as well known aphasic phenomena. Such a comparison suggests their consideration (examining) as manifestations of specific prevalence and disbalance, in one case (the poetic speech), and dysfunction in the other case (the aphasic speech), of certain speech-forming and brain mechanics. This kind of study does not concern the radical difference in the subject and product of speech, and the communication resultant in poetic and aphasic speech

Clinical, Instrumental and Immunological Follow-Up of Patients with Brain Tumors

Dynamic assessment of 66 patients with different brain tumours was carried out. The clinical, immunological and instrumental (electrophysiological and neuroimaging) follow-up included three groups of cases with stable clinical course, tumour progression and recurrence. Our results confirm that the changes in the functional and immune status of the patients with cerebral neoplasms as well as the alterations in the cerebral function and structure reflect the tumour development and the corresponding therapeutic behaviour. Monitoring of patients status and tumour growth provides opportunity for better disease control and prognosis

Uroflowmetry and Ultrasound Measurement of Residual Urine in Early Parkinson`s Disease

Urovesical dysautonomic symptoms are present in 27-97% of the patients with Parkinson's disease (PD) dependingon patients' selection criteria and methods used. The micturitional disturbances are typical of patients with more severe PD. The authors studied the urovesical function in 23 PD patients aged 41-60 years and without subjective micturitional complaints by uroflowmetry and ultrasound measurement of residual urine. Urovesical disturbances were established in 30,4% of the patients. The average results for Max Flow Rate (MFR) were 21,85 ±5,49 ml/sec and for residual urine 27,83 ±25,58 ml. The most influencing factor was the severity of the disease measured by the UPDRS. Our results were important additions to the existing information on the urovesical function in PD. Dysautonomic micturitional disturbances were found even in patients without subjective complaints in the early stages of the disease. Their degree correlated most closely to the severity of PD. The necessity of specialized examiantions of dysautonomic urovesical symptoms imposes the presence of a tailor-made patient approach for their early detection and adequate treatment

PAPER ON PATENT RIGHTS FOR A DEVICE FOR INVESTIGATION OF ALTERNATING AREAS

A device and a method for investigation of the visual assessement of alternating luminous areas (VAALA) (1) was created and patented by a group of the Departement of Neurology, Medical University of Varna: Assoc. Prof. D. Mintchev, MD, PhD, Assoc. Prof. N. Deleva, MD, PhD, A. Tzukeva, MD, together with Assoc. Prof. Eng. S. Slavchev, PhD, of the Technical University ofVarna

INVESTIGATION OF VISUAL ASSESSMENT OF ALTERNATING LUMINOUS AREAS IN NEUROOPHTHALMOLOGICAL DIAGNOSIS OF PATIENTS WITH INTRA - AND PARASELLAR TUMORS

The method for investigation of visual assessment of alternating luminous areas (VAALA) enables to establish visual disorders in different diffusive and local brain lesions including brain tumours. In this study the applicability of VAALA in the complex neuroophtalmological investigations in patients with intra- and pa nisei I ar tumours was analyzed. VAALA, peripheral vision, and visual acuity were assessed in 9 patients with extrasellar tumours and in 5 patients with intrasellar ones. VAALA showed changes in all the patients without any significant difference between both patients' groups. Routine neuroophthalmological examination even in patients with extrasellar tumours indicated some typical abnormalities in a part of the cases only while in single cases of intrasellar tumours only initial changes could be detected. Perimetria and especially visual acuity and VEP possessed a lower diagnostic value in perichiasmatic lesions than contemporary psychophysical tests, VAALA inclusive. The high sensitivity of VAALA concerning the visual disturbances in pathological processes in these areas enables its integration into the complex neuroophthalmological examination

A Growing Journey From Neurotrophins To Metabotrophins In Cardiometabolic Diseases

Currently, obesity has been recognized as a prime risk in the development of car-diometabolic diseases (CMD) and neurodegenerative diseases (NDD). The patho-genesis and therapy of CMD are immensely complex at the cellular and molecular levels. This scenario raises the question of how such a complexity may be grappled in a more tangible manner. Since 2003, we have been thinking “what nobody has yet thought about that everybody sees”, namely, matabotrophic factors (MTF, metabotrophins). The latter include mainly (i) the neurotrophins nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), and (ii) the adipomyo-kines adiponectin, irisin, BDNF, fibroblast growth factor-21 alike as adipose- and skeletal muscle-derived signaling proteins (these latter discussed in another review in the present volume of Adipobiology). Herein, we argue that obesity and related CMD and NDD, particularly Alzheimer’s disease, may be viewed as MTF-deficient diseases. Further studies on MTF signatures and ramifications in these diseases are required. These would provide greater insights on how we can make MTF work for the improvement of physiological and psychological quality of human life

A concept for integrated care pathways for atopic dermatitis-A GA2 LEN ADCARE initiative

INTRODUCTION: The integrated care pathways for atopic dermatitis (AD-ICPs) aim to bridge the gap between existing AD treatment evidence-based guidelines and expert opinion based on daily practice by offering a structured multidisciplinary plan for patient management of AD. ICPs have the potential to enhance guideline recommendations by combining interventions and aspects from different guidelines, integrating quality assurance, and describing co-ordination of care. Most importantly, patients can enter the ICPs at any level depending on AD severity, resources available in their country, and economic factors such as differences in insurance reimbursement systems. METHODS: The GA2 LEN ADCARE network and partners as well as all stakeholders, abbreviated as the AD-ICPs working group, were involved in the discussion and preparation of the AD ICPs during a series of subgroup workshops and meetings in years 2020 and 2021, after which the document was circulated within all GAL2 EN ADCARE centres. RESULTS: The AD-ICPs outline the diagnostic procedures, possible co-morbidities, different available treatment options including differential approaches for the pediatric population, and the role of the pharmacists and other stakeholders, as well as remaining unmet needs in the management of AD. CONCLUSION: The AD-ICPs provide a multidisciplinary plan for improved diagnosis, treatment, and patient feedback in AD management, as well as addressing critical unmet needs, including improved access to care, training specialists, implementation of educational programs, assessment on the impact of climate change, and fostering a personalised treatment approach. By focusing on these key areas, the initiative aims to pave the way for a brighter future in the management of AD