Driving a motor vehicle and psychogenic nonepileptic seizures: ILAE Report by the Task Force on Psychogenic Nonepileptic Seizures

Objectives This International League Against Epilepsy (ILAE) Report: (a) summarizes the literature about “driving and psychogenic nonepileptic seizures (PNES)”; (b) presents the views of international experts; and (c) proposes an approach to assessing the ability of persons with PNES (PwPNES) to drive. Methods Phase 1: Systematic literature review. Phase 2: Collection of international expert opinion using SurveyMonkey®. Experts included the members of the ILAE PNES Task Force and individuals with relevant publications since 2000. Phase 3: Joint analysis of the findings and refinement of conclusions by all participants using email. As an ILAE Report, the resulting text was reviewed by the Psychiatry Commission, the ILAE Task Force on Driving Guidelines, and Executive Committee. Results Eight studies identified by the systematic review process failed to provide a firm evidence base for PNES‐related driving regulations, but suggest that most health professionals think restrictions are appropriate. Twenty‐six experts responded to the survey. Most held the view that decisions about driving privileges should consider individual patient and PNES characteristics and take account of whether permits are sought for private or commercial driving. Most felt that those with active PNES should not be allowed to drive unless certain criteria were met and that PNES should be thought of as “active” if the last psychogenic seizure had occurred within 6 months. Significance Recommendations on whether PwPNES can drive should be made at the individual patient level. Until future research has determined the risk of accidents in PwPNES a proposed algorithm may guide decisions about driving advice

PNES around the world: Where we are now and how we can close the diagnosis and treatment gaps-an ILAE PNES Task Force report

An international consensus clinical practice statement issued in 2011 ranked psychogenic nonepileptic seizures (PNES) among the top three neuropsychiatric problems. An ILAE PNES Task Force was founded and initially charged with summarizing the current state of the art in terms of diagnosis and treatment, resulting in two publications. The first described different levels of diagnostic certainty. The second summarized current knowledge of management approaches. The present paper summarizes an international workshop of the ILAE PNES Task Force that focused on the current understanding and management of PNES around the world. We initially provide a knowledge update about the etiology, epidemiology, and prognosis of PNES-in adults and in special patient groups, such as children, older adults, and those with intellectual disability. We then explore clinical management pathways and obstacles to optimal care for this disorder around the world by focusing on a number of countries with different cultural backgrounds and at very different stages of social and economic development (United Kingdom, U.S.A., Zambia, Georgia, China, and Japan). Although evidence-based methods for the diagnosis and treatment of PNES have now been described, and much is known about the biopsychosocial underpinnings of this disorder, this paper describes gaps in care (not only in less developed countries) that result in patients with PNES not having adequate access to healthcare provisions. A range of challenges requiring solutions tailored to different healthcare systems emerges. Continued attention to PNES by the ILAE and other national and international neurologic, psychiatric, and health organizations, along with ongoing international collaboration, should ensure that patients with PNES do not lose out as healthcare services evolve around the world

The COVID-19 pandemic and its global effects on dental practice. An international survey

Objectives A multicentre survey was designed to evaluate the impact of COVID-19 outbreak on dental practice worldwide, estimate the COVID-19 related symptoms/signs, work attitudes and behaviour and the routine use of protective measures and personal protective equipment (PPE). Methods A global survey using a standardized questionnaire with research groups from 36 countries was designed. The questionnaire was developed and pretested during April 2020 and contained three domains: 1) personal data; 2) COVID-19 positive rate and symptoms/signs presumably related to the coronavirus; 3) working conditions and PPE adopted after the outbreak. Countries’ data were grouped by the country positive rate (CPR) during the survey period and by Gross-National-Income per capita. An ordinal multinomial logistic regression model was carried out with COVID-19 self-reported rate referred by dental professionals as dependent variable to assess the association with questionnaire items. Results A total of 52,491 questionnaires were returned with a male/female ratio of 0.63. Out of the total respondents, 7,859 dental professionals (15%) reported symptoms/signs compatible with COVID-19. More than half of the sample (n=27,818; 53%) stated to use FFP2/N95 masks, while 21,558 (41.07%) used eye protection. In the bivariate analysis, CPR and N95/FFP2 were significantly associated (OR=1.80 95%CI=1.60/2.82 and OR=5.20 95%CI=1.44/18.80, respectively), while Gross-National-Income was not statistically associated with CPR (OR=1.09 95%CI=0.97/1.60). The same significant associations were observed in the multivariate analysis. Conclusions Oral health service provision has not been significantly affected by COVID-19, although access to routine dental care was reduced due to country-specific temporary lockdown periods. While the dental profession has been identified at high-risk, the reported rates of COVID-19 for dental professionals were not significantly different to those reported for the general population in each country. These findings may help to better plan oral health care for future pandemic events

Сучасні проблеми та перспективи застосування продукції на основі безперевного базальтового волокна

The progress of science and technology significantly depends on the success in creating new materials. Composite materials are a heterogeneous structure formed by a combination of reinforcing elements and isotropic binder (binder) material, currently widely used in various fields of technology. but for the economy is more important mass application. For this purpose, more thorough and long-term research and experimental implementations are carried out, which require significant intellectual and material costs. Development of structural elements using basalt fiber began in NDIBV since 1987. and experimental samples of prestressed concrete structures with basalt-plastic reinforcement. Research to identify the interaction of cement with basalt fiber and the design of effective concrete structures using basalt reinforcement. Concrete beams with basalt reinforcement were successfully tested. Unfortunately, the results of research have not been widely implemented. Therefore, this article is devoted to the problems of mass introduction into construction practice of various types of composite materials, including basalt reinforcement. The advantages and disadvantages of composite reinforcement in comparison with steel are discussed. During the theoretical and experimental studies, both positive and negative aspects of the use of basalt reinforcement were identified. So experiments have shown that basalt fiber loses strength in the environment of Portland cement stone. But this shortcoming has been overcome by the efforts of scientists, it is important to use certain defects of basalt fibers for specific conditions. There are the following main types of basalt fibers: 1) basalt continuous fibers with a diameter of 8 - 11 microns, 12 - 14 microns, 16 - 20 microns with a fiber length of 25 - 50 mm and more; 2) staple short fibers with a diameter of 6 - 12 microns and a length of 5 - 10 mm and several diameters; 3) basalt superthin fibers with a diameter of 0.5 - 1 microns with a length of 10 - 50 mm; 4) coarse basalt fibers with a diameter of 100 - 400 microns. To create structures with certain properties for specific conditions, appropriate basalt fibers are selected. According to the research results, recommendations and normative documents have been developed. Suggestions for measures to improve and successfully widely use composite elements for reinforcement of concrete structures.Від успіхів у створенні нових матеріалів істотно залежить прогрес науки і техніки. Композиційні матеріали являють собою неоднорідну структуру, утворену поєднанням армуючих елементів і ізотропного в’яжучого (сполучного) матеріалу, в даний час широко використовуються в різних областях техніки.Відомі різного роду нові композитні матеріали з досить цікавими корисними властивостями і навіть мають певні впровадження на практиці, але для економіки має більш вагоме значення масове застосування.Для цього проводяться більш ретельні і довготривалі дослідження і експериментальні впровадження, які потребують значних інтелектуальних і матеріальних витрат.Розробка конструктивних елементів із застосуванням базальтового волокна почалась в НДІБВ починаючи з 1987 р. Почав створюватись композиційний матеріал базальтофібробетон та експериментальні зразки попередньо напружених бетонних конструкцій з базальто-пластиковою арматурою. Дослідження з метою виявлення взаємодії цементу з базальтовим волокном і конструювання ефективних бетонних конструкцій із застосуванням базальтової арматури. Успішно пройшли випробування бетонні балки з базальтовою арматурою. Нажаль результати досліджень широкого впровадження не набули. Тому дана стаття присвячена проблемам масового впровадження в будівельну практику різних видів композиційних матеріалів, у тому числі базальтової арматури. Обговорюються переваги та недоліки композитної арматури в порівнянні зі сталевою. За час проведення теоретичних і експериментальних досліджень було виявлено як позитивні, так і негативні сторони застосування базальтової арматури. Так експерименти показали, що базальтове волокно втрачає міцність в середовищі портландцементного каменя. Але цей недолік був подоланий зусиллями вчених, має велике значення використання певних вадів базальтових волокон для конкретних умов..Існують наступні основні види базальтових волокон: 1) базальтові неперервні волокна діаметром 8 – 11 мк, 12 – 14 мк, 16 – 20 мк довжиною волокна 25 – 50 мм і більше; 2) штапельні короткі волокна діаметром волокон 6 – 12 мк і довжиною 5 – 10мм та кілька діаметрів; 3) базальтові супертонкі волокна діаметром 0,5 – 1 мк довжиною 10 – 50 мм; 4) грубі базальтові волокна діаметром 100 – 400 мк. Для створення конструкцій з певними властивостями для конкретних умов вибираються відповідні базальтові волокна. За результатами досліджень напрацьовані рекомендації і нормативні документи. Висловлено пропозиції щодо заходів щодо вдосконалення та успішного широкого застосування композитних елементів для армування бетонних конструкцій

Role of endothelial dysfunction in the pathogenesis of diabetic retinopathy in patients with type 2 diabetes

The reason for the progressive vision reduction at diabetes mellitus (DM) is diabetic retinopathy (DR). When type 2 diabetes combined with hypertension (Ht), it increases the risk of vision loss by 25 times. In the pathogenesis of DR is important to endothelial dysfunction and a variety of biochemical processes (an excess of intracellular sorbitol, non-enzymatic glycation of proteins, oxidative stress). there is a decrease in generation vasodilating factors, nitric oxide, with a simultaneous increase of endothelin, which causes vasoconstriction. Key processes underlying the development of DR, such as increased vascular permeability, edema, neovasculariza- tion, inflammation and associated with the effects of kallikrein-kinin system. In the pathogenesis of DR can be involved independent intraocular renin-angiotensin system, which is an important mediator of angiogenesis and increased vascular permeability. Damage to the endothelium of retinal vessels leads to ischemia of the retina. there is growth and development of newly formed blood vessels, which may provoke recurrent bleeding

The results of correction of endothelial dysfunction in type 2 diabetes mellitus in patients with diabetic retinopathy and associated hypertension

<strong>Purpose:</strong>Studying the dynamics of clinical functional and morphological status of the retina against the metabolic and antiischemic therapy of retinopathy in type 2 diabetes associated with hypertension based on indicators in the tear fluid and serum nitric oxide metabolites.<p><strong>Methods:</strong> Following a standard ophthalmologic examination of 50 patients, among which are the two groups are similar in age and<br />sex. The main group (n = 37) with Cd 2, DR and DR I and II hypertension II, III stage, the average age was 62,2±1,2 years, antihypertensive therapy — an ACE inhibitor Prestarium (5 mg). Patients of the group were divided into two subgroups: the first subgroup (n = 19)<br />who underwent parabulbarnom Mildronate (10 injections), the second subgroup (n = 18), which the drug was administered intranasally Semaks (20 days). The control group (n = 13) healthy (n = 6), and patients with type 2 diabetes without DR and GB (n = 7). Quantitative determination of the stable NO metabolites was determined in biochemical method samples of serum and lacrimal fluid.</p><p><br /><strong>Results:</strong> After completing a course of therapy for patients of the first subgroup marked decrease in retinal thickness (p ≤ 0,05) in f.centralis, temporal lobe, the upper and lower bands parafovea and temporal area perifovea, while in the second group — in 9 areas of the macular area (p ≤ 0.05). It is also noted a significant increase in sensitivity to light in the macular area in patients of both subgroups (MAIA). On the background of the treatment observed reduction of NOx in the lacrimal fluid and serum of patients in both clinical groups. Thus, reduction of NOx in the lacrimal fluid was statistically significant in the subgroup of patients receiving anti-ischemic therapy semaks (p &lt;0,05). In both clinical subgroups after treatment revealed correlation between systolic blood pressure and the level of NOx in the serum (r = 0,4; p &lt;0,05).</p><p><br /><strong>Conclusion:</strong> The positive effect (p &lt;0,05) antioxidant (Mildronat) and ischemic (Semaks) therapy on clinical and functional and morphological parameters of the retina in patients with retinopathy in type 2 diabetes in combination with GB. NOx reduction in the tear fluid and serum was associated with decreased severity of clinical symptoms DR I and II, the resulting vascular endothelial dysfunction. This allows us to consider this as an effective therapeutic intervention aimed at preventing the onset and progression of retinopathy in the combined course of type 2 diabetes and hypertension.</p