208 research outputs found
Cerebrolysin improves symptoms and delays progression in patients with alzheimer's disease and vascular dementia
Dementia is the result of various cerebral disorders, leading to an acquired loss of memory and impaired cognitive ability. The most common forms are AlzheimerΒ΄s disease(AD) and vascular dementia (VaD). Neurotrophic factors are essential for the survival and differentiation of developing neurons and protecting them against damage under pathologic conditions. Cerebrolysin is a peptide preparation that mimics the pleiotropic effects of neurotrophic factors Several clinical trials investigating the therapeutic efficacy of Cerebrolysin in AD and VaD have confirmed the proof of concept. The results of these trials have shown statistically significant and clinically relevant treatment effects of Cerebrolysin on cognitive, global and functional domains in mild to moderately severe stages of dementia. Doses of 10 and 30 mL were the most effective, but higher doses of up to 60 mL turned out to be most effective in improving neuropsychiatric symptoms, which become relevant at later stages of the disease. Combining treatment with cholinesterase inhibitors and Cerebrolysin indicated long-term synergistic treatment effects in mild to moderate AD. The efficacy of Cerebrolysin persisted for up to several months after treatment suggesting Cerebrolysin has not merely symptomatic benefits, but a disease-delaying potential. This paper reviews the clinical efficacy of Cerebrolysin in the treatment of dementia. Data were obtained from international, multicenter, randomized clinical trials performed in compliance with Good Clinical Practice and the principles of the Declaration of Helsinki (1964) and subsequent revisions.Fil: Allegri, Ricardo Francisco. FundaciΓ³n para la Lucha Contra las Enfermedades NeurolΓ³gicas de la Infancia. Instituto de Investigaciones NeurolΓ³gicas "RaΓΊl Carrea"; ArgentinaFil: Guekht, A.. Russian National Research Medical University; Rusi
ΠΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ Ρ ΠΎΠ»Π΅ΡΡΠ΅ΡΠΈΠ½Π° ΠΈ ΡΡΠΈΠ³Π»ΠΈΡΠ΅ΡΠΈΠ΄ΠΎΠ² Π² ΡΠΊΡΡΡΠ°ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΡ Π²Π΅Π·ΠΈΠΊΡΠ»Π°Ρ ΡΡΠ²ΠΎΡΠΎΡΠΊΠΈ ΠΊΡΠΎΠ²ΠΈ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΊΠΎΠΌΠΌΠ΅ΡΡΠ΅ΡΠΊΠΈΡ Π½Π°Π±ΠΎΡΠΎΠ²
Exosomes and microvesicles, collectively referred to as small extracellular vesicles (sEV) are vesicles with an average size of about 100-150 nm. Currently, the role of sEV in various aspects of signaling in the body is being actively investigated; in addition, sEV can often serve as markers of various pathologies. The active study of the sEV composition is continuing. In this study we have demonstrated that in sEV it is possible to determine cholesterol and triglycerides concentration by using commercial kits designed for serum. The technique was tested on sEV from the blood of patients diagnosed with depression and on healthy volunteers. No differences were found in the concentration of cholesterol and triglycerides in mEV from the blood serum of depressed patients and the control group. The concentration of cholesterol and triglycerides in the samples is several times higher than the sensitivity threshold of the methods set by the manufacturer of the kits.ΠΠΊΠ·ΠΎΡΠΎΠΌΡ ΠΈ ΠΌΠΈΠΊΡΠΎΠ²Π΅Π·ΠΈΠΊΡΠ»Ρ, ΡΠΎΠ²ΠΌΠ΅ΡΡΠ½ΠΎ Π½Π°Π·ΡΠ²Π°Π΅ΠΌΡΠ΅ ΠΌΠ°Π»ΡΠ΅ ΡΠΊΡΡΡΠ°ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠ΅ Π²Π΅Π·ΠΈΠΊΡΠ»Ρ (ΠΌΠΠ), ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΡΡ ΡΠΎΠ±ΠΎΠΉ Π²Π΅Π·ΠΈΠΊΡΠ»Ρ ΡΠΎ ΡΡΠ΅Π΄Π½ΠΈΠΌ ΡΠ°Π·ΠΌΠ΅ΡΠΎΠΌ ΠΎΠΊΠΎΠ»ΠΎ 100-150 Π½ΠΌ. Π Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ Π°ΠΊΡΠΈΠ²Π½ΠΎ ΠΈΡΡΠ»Π΅Π΄ΡΠ΅ΡΡΡ ΡΠΎΠ»Ρ ΠΌΠΠ Π² ΡΠ°ΠΌΡΡ
ΡΠ°Π·Π½ΡΡ
Π°ΡΠΏΠ΅ΠΊΡΠ°Ρ
ΡΠΈΠ³Π½Π°Π»ΠΈΠ½Π³Π° Π² ΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠ΅, ΠΊΡΠΎΠΌΠ΅ ΡΠΎΠ³ΠΎ, ΡΠ°ΡΡΠΎ ΠΌΠΠ ΠΌΠΎΠ³ΡΡ ΡΠ»ΡΠΆΠΈΡΡ ΠΌΠ°ΡΠΊΠ΅ΡΠ°ΠΌΠΈ ΡΠ°Π·Π½ΡΡ
ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΉ. ΠΡΠΎΠ΄ΠΎΠ»ΠΆΠ°Π΅ΡΡΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΈΠ·ΡΡΠ΅Π½ΠΈΠ΅ ΡΠΎΡΡΠ°Π²Π° ΠΌΠΠ. Π Π΄Π°Π½Π½ΠΎΠΉ ΡΠ°Π±ΠΎΡΠ΅ ΠΌΡ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΈ, ΡΡΠΎ Π² ΠΌΠΠ ΠΌΠΎΠΆΠ½ΠΎ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡ Ρ
ΠΎΠ»Π΅ΡΡΠ΅ΡΠΈΠ½Π° ΠΈ ΡΡΠΈΠ³Π»ΠΈΡΠ΅ΡΠΈΠ΄ΠΎΠ² Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΠΊΠΎΠΌΠΌΠ΅ΡΡΠ΅ΡΠΊΠΈΡ
Π½Π°Π±ΠΎΡΠΎΠ², ΠΏΡΠ΅Π΄Π½Π°Π·Π½Π°ΡΠ΅Π½Π½ΡΡ
Π΄Π»Ρ ΡΡΠ²ΠΎΡΠΎΡΠΊΠΈ ΠΊΡΠΎΠ²ΠΈ. ΠΠ΅ΡΠΎΠ΄ΠΈΠΊΠ° Π±ΡΠ»Π° ΠΎΠΏΡΠΎΠ±ΠΎΠ²Π°Π½Π° Π½Π° ΠΌΠΠ ΠΈΠ· ΠΊΡΠΎΠ²ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΡ ΠΈ Π½Π° Π·Π΄ΠΎΡΠΎΠ²ΡΡ
Π΄ΠΎΠ±ΡΠΎΠ²ΠΎΠ»ΡΡΠ°Ρ
. Π Π°Π·Π»ΠΈΡΠΈΠΉ Π² ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ Ρ
ΠΎΠ»Π΅ΡΡΠ΅ΡΠΈΠ½Π° ΠΈ ΡΡΠΈΠ³Π»ΠΈΡΠ΅ΡΠΈΠ΄ΠΎΠ² Π² ΠΌΠΠ ΠΈΠ· ΡΡΠ²ΠΎΡΠΎΡΠΊΠΈ ΠΊΡΠΎΠ²ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π΄Π΅ΠΏΡΠ΅ΡΡΠΈΠ΅ΠΉ ΠΈ ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ Π½Π°ΠΉΠ΄Π΅Π½ΠΎ Π½Π΅ Π±ΡΠ»ΠΎ. ΠΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡ Ρ
ΠΎΠ»Π΅ΡΡΠ΅ΡΠΈΠ½Π° ΠΈ ΡΡΠΈΠ³Π»ΠΈΡΠ΅ΡΠΈΠ΄ΠΎΠ² Π² ΠΎΠ±ΡΠ°Π·ΡΠ°Ρ
Π² Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΎ ΡΠ°Π· ΠΏΡΠ΅Π²ΠΎΡΡ
ΠΎΠ΄ΠΈΡ ΠΏΠΎΡΠΎΠ³ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ², ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½Π½ΡΠΉ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΡΠ΅Π»Π΅ΠΌ Π½Π°Π±ΠΎΡΠΎΠ²
The impact of COVID-19 quarantine on mental health: an observational study from an outpatient service for non-psychotic patients in Russia (Moscow)
We aimed to compare psychiatric hospital visits during the COVID-19 quarantine period with the same period in 2019, to reveal the predictors of underutilization of mental health services. We then investigated the fluctuation of telemedicine service during the quarantine period. The retrospective study included patients with non-psychotic mental disorders who consecutively visited the Moscow clinic. The number of outpatient visits, inpatient admissions, sociodemographic factors were analyzed. We assessed the sample within two periods -the "quarantine period" (March 30 -June 9, 2020) and "control period" (March 30 -June 9, 2019). Psychiatric visits decreased in older, retired and disabled persons, and increased among the unemployed. In multivariate analysis, the reduction became significant for the number of inpatient admissions. Telemedicine calls gradually increased from the start of the service, but decreased towards the end of the quarantine. In conclusion, referrals to outpatient and inpatient psychiatric services decreased during the quarantine period, with newly established TMS potentially compensating for that decrease. The strongest factor associated with visits during the pandemic is employment status
PNP13 QUALITY OF LIFE (QOL) AND PHARMACOECONOMICAL ASPECTS IN PATIENTS WITH SYMPTOMATIC LOCALIZATION-RELATED EPILEPSIES (SLE) IN MOSCOW
Educational needs of epileptologists regarding psychiatric comorbidities of the epilepsies: a descriptive quantitative survey.
Psychiatric disorders are relatively frequent comorbidities in epilepsy and they have an impact on morbidity, mortality, and quality of life. This is a report from the Task Force on Education of the ILAE Commission on Neuropsychiatry based on a survey about educational needs of epileptologists regarding management of the psychiatric comorbidities of epilepsy. The Task Force designed a quantitative questionnaire to survey the self-perceived confidence of child and adult epileptologists and psychiatrists in managing major psychiatric comorbidities of epilepsy to identify: (1) critical areas of improvement from a list of skills that are usually considered necessary for effective management of these conditions, and (2) the preferred educational format for improving these skills. A total of 211 respondents from 36 different countries participated in the survey. Confidence and usefulness scores suggest that responders would most value education and training in the management of specific clinical scenarios. Child neurologists identified major Axis I disorders, such as mood and anxiety disorders, while adult neurologists identified attention deficit hyperactivity disorder, intellectual disabilities, and autistic spectrum disorder as key areas. Both adult and child neurologists identified screening skills as the priority. Psychiatrists mainly valued specific training in the management of psychiatric complications of epilepsy surgery or psychiatric adverse events of antiepileptic drugs. Sessions during congresses and face-to-face meetings represent the preferred educational format, while e-learning modules and review papers were chosen by a minority of respondents. Results of this survey identify key areas for improvement in managing the psychiatric comorbidities of epilepsy and suggest specific strategies to develop better training for clinicians involved in epilepsy care
ΠΠ»Π΅ΠΉΠΎΡΡΠΎΠΏΠ½ΡΠΉ Π½Π΅ΠΉΡΠΎΠΏΡΠΎΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΉ ΠΈ ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΡΡΠ΅ΠΊΡΡ Π°ΠΊΡΠΎΠ²Π΅Π³ΠΈΠ½Π°
Π ΠΎΠ±Π·ΠΎΡΠ΅ ΡΠ°ΡΡΠΌΠ°ΡΡΠΈΠ²Π°ΡΡΡΡ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΡ Π΄Π΅ΠΉΡΡΠ²ΠΈΡ Π°ΠΊΡΠΎΠ²Π΅Π³ΠΈΠ½Π° Π² ΠΊΠΎΠ½ΡΠ΅ΠΊΡΡΠ΅ ΠΈΠ·ΡΡΠ΅Π½ΠΈΡ Π΅Π³ΠΎ ΡΡΡΠ΅ΠΊΡΠΎΠ² Π½Π° Π΄ΠΎΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΡΡΠΎΠ²Π½Π΅ ΠΈΒ Π½ΠΎΠ²ΠΎΠΉ ΠΊΠΎΠ½ΡΠ΅ΠΏΡΠΈΠΈ ΡΠ°ΡΠΌΠ°ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΠ°ΡΡΡΡΠΎΠΉΡΡΠ². ΠΠΊΡΠΎΠ²Π΅Π³ΠΈΠ½, ΠΏΠΎΠ»ΡΡΠ°Π΅ΠΌΡΠΉ ΠΏΡΠΈ ΡΠ»ΡΡΡΠ°ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΠΈΒ ΠΊΡΠΎΠ²ΠΈ ΡΠ΅Π»ΡΡ, ΡΠΎΡΡΠΎΠΈΡ ΠΈΠ· Π±ΠΎΠ»Π΅Π΅ ΡΠ΅ΠΌ 200 Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡΠ±ΡΡΠ°Π½ΡΠΈΠΉ. ΠΡΠ΅ΠΏΠ°ΡΠ°Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΠ΅ΡΡΡ ΠΏΡΠΈ ΡΠΈΡΠΎΠΊΠΎΠΌ ΡΠΏΠ΅ΠΊΡΡΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ,Β Π²ΠΊΠ»ΡΡΠ°Ρ Π½Π°ΡΡΡΠ΅Π½ΠΈΡ ΠΏΠ΅ΡΠΈΡΠ΅ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈ ΠΌΠΎΠ·Π³ΠΎΠ²ΠΎΠ³ΠΎ ΠΊΡΠΎΠ²ΠΎΠΎΠ±ΡΠ°ΡΠ΅Π½ΠΈΡ, ΠΎΠΆΠΎΠ³ΠΈ, ΠΏΠ»ΠΎΡ
ΠΎΠ΅ Π·Π°ΠΆΠΈΠ²Π»Π΅Π½ΠΈΠ΅ ΡΠ°Π½, ΡΠ°Π΄ΠΈΠ°ΡΠΈΠΎΠ½Π½ΡΠ΅ ΠΏΠΎΡΠ°ΠΆΠ΅Π½ΠΈΡ ΠΈΒ Π΄ΠΈΠ°Π±Π΅ΡΠΈΡΠ΅ΡΠΊΡΡ ΠΏΠΎΠ»ΠΈΠ½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΡ. ΠΠΊΡΠΎΠ²Π΅Π³ΠΈΠ½ ΡΠΎΡΡΠΎΠΈΡ ΠΈΠ· ΠΌΠΎΠ»Π΅ΠΊΡΠ» ΠΌΠ°Π»ΠΎΠ³ΠΎ ΡΠ°Π·ΠΌΠ΅ΡΠ°, ΠΊΠΎΡΠΎΡΡΠ΅ Π½Π°Ρ
ΠΎΠ΄ΡΡΡΡ Π² ΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠ΅ Π² Π½ΠΎΡΠΌΠ°Π»ΡΠ½ΡΡ
Β ΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΡΡΠ»ΠΎΠ²ΠΈΡΡ
, ΠΈ ΠΏΠΎΡΡΠΎΠΌΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΈΡ
ΡΠ°ΡΠΌΠ°ΠΊΠΎΠΊΠΈΠ½Π΅ΡΠΈΠΊΠΈ ΠΈ ΡΠ°ΡΠΌΠ°ΠΊΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΠΊΠΈ Π΄Π»Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΠΉ ΡΡΠ±ΡΡΠ°Π½ΡΠΈΠΈ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° Π·Π°ΡΡΡΠ΄Π½Π΅Π½Ρ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΏΡΠ΅ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΈ, ΡΡΠΎ Π°ΠΊΡΠΎΠ²Π΅Π³ΠΈΠ½ ΡΠ»ΡΡΡΠ°Π΅Ρ ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΈΠΉΒ Π±Π°Π»Π°Π½Ρ ΠΏΡΡΠ΅ΠΌ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΡ ΡΡΠ²ΠΎΠ΅Π½ΠΈΡ Π³Π»ΡΠΊΠΎΠ·Ρ ΠΈ ΠΏΠΎΡΡΠ΅Π±Π»Π΅Π½ΠΈΠ΅ ΠΊΠΈΡΠ»ΠΎΡΠΎΠ΄Π° Π² ΡΡΠ»ΠΎΠ²ΠΈΡΡ
ΠΈΡΠ΅ΠΌΠΈΠΈ. ΠΠΊΡΠΎΠ²Π΅Π³ΠΈΠ½ ΡΠ°ΠΊΠΆΠ΅ ΠΏΠΎΠ²ΡΡΠ°Π΅Ρ ΡΡΡΠΎΠΉΡΠΈΠ²ΠΎΡΡΡ ΠΊ Π³Π°ΠΌΠΌΠ°-ΡΠ°Π΄ΠΈΠ°ΡΠΈΠΈ ΠΈ ΡΡΠΈΠΌΡΠ»ΠΈΡΡΠ΅Ρ ΡΠ°Π½ΠΎΠ·Π°ΠΆΠΈΠ²Π»Π΅Π½ΠΈΠ΅. Π Π±ΠΎΠ»Π΅Π΅ ΠΏΠΎΠ·Π΄Π½ΠΈΡ
ΡΠ°Π±ΠΎΡΠ°Ρ
Π±ΡΠ»ΠΎ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ Π°Π½ΡΠΈΠΎΠΊΡΠΈΠ΄Π°Π½ΡΠ½ΡΠΉ ΠΈΒ Π°Π½ΡΠΈΠ°ΠΏΠΎΠΏΡΠΎΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΡ Π΄Π΅ΠΉΡΡΠ²ΠΈΡ Π»Π΅ΠΆΠ°Ρ Π² ΠΎΡΠ½ΠΎΠ²Π΅ Π½Π΅ΠΉΡΠΎΠΏΡΠΎΡΠ΅ΠΊΡΠΈΠ²Π½ΡΡ
ΡΠ²ΠΎΠΉΡΡΠ² Π°ΠΊΡΠΎΠ²Π΅Π³ΠΈΠ½Π°, ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½Π½ΡΡ
Π² ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°Ρ
Π½Π° ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΡΡ
Π½Π΅ΠΉΡΠΎΠ½Π°Ρ
Π³ΠΈΠΏΠΏΠΎΠΊΠ°ΠΌΠΏΠ° ΠΊΡΡΡ ΠΈ ΡΡΡΠ΅ΠΏΡΠΎΠ·ΠΎΡΠΎΡΠΈΠ½ΠΈΠ½Π΄ΡΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΌΠΎΠ΄Π΅Π»ΠΈ Π΄ΠΈΠ°Π±Π΅ΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠΎΠ»ΠΈΠ½Π΅ΠΉΡΠΎΠΏΠ°ΡΠΈΠΈΒ Ρ ΠΊΡΡΡ. ΠΠΎΡΠ»Π΅Π΄Π½ΠΈΠ΅ Π΄Π°Π½Π½ΡΠ΅ ΡΠ²ΠΈΠ΄Π΅ΡΠ΅Π»ΡΡΡΠ²ΡΡΡ ΠΎ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΠΌ Π²Π»ΠΈΡΠ½ΠΈΠΈ Π°ΠΊΡΠΎΠ²Π΅Π³ΠΈΠ½Π° Π½Π° ΡΠ°ΠΊΡΠΎΡ NF-ΞΊB, Π½ΠΎ ΠΏΡΠΈ ΡΡΠΎΠΌ ΠΌΠ½ΠΎΠ³ΠΈΠ΅ ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΡΠ΅ ΠΈ ΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠ΅ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΡ Π΅Π³ΠΎ Π΄Π΅ΠΉΡΡΠ²ΠΈΡ ΠΎΡΡΠ°ΡΡΡΡ Π½Π΅ΠΈΠ·Π²Π΅ΡΡΠ½ΡΠΌΠΈ. Π ΠΏΠ΅ΡΠ²ΡΡ ΠΎΡΠ΅ΡΠ΅Π΄Ρ ΡΡΠΎ ΠΊΠ°ΡΠ°Π΅ΡΡΡ Π²Π»ΠΈΡΠ½ΠΈΡ Π°ΠΊΡΠΎΠ²Π΅Π³ΠΈΠ½Π°Β Π½Π° Π½Π΅ΠΉΡΠΎΠΏΠ»Π°ΡΡΠΈΡΠ½ΠΎΡΡΡ, Π½Π΅ΠΉΡΠΎΠ³Π΅Π½Π΅Π· ΠΈ ΡΡΠΎΡΠΈΡΠ΅ΡΠΊΡΡ ΡΡΠ½ΠΊΡΠΈΡ Π½Π΅ΡΠ²Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ, ΠΈ Π΄Π°Π½Π½ΡΠΉ Π°ΡΠΏΠ΅ΠΊΡ ΡΡΠ΅Π±ΡΠ΅Ρ Π΄Π°Π»ΡΠ½Π΅ΠΉΡΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ. Π’Π΅ΠΌ Π½Π΅ ΠΌΠ΅Π½Π΅Π΅ ΡΡΠ°Π½ΠΎΠ²ΠΈΡΡΡ ΠΎΡΠ΅Π²ΠΈΠ΄Π½ΡΠΌ, ΡΡΠΎ ΠΌΡΠ»ΡΡΠΈΡΠ°ΠΊΡΠΎΡΠΈΠ°Π»ΡΠ½Π°Ρ ΠΈ ΠΌΠ½ΠΎΠ³ΠΎΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠ½Π°Ρ ΠΏΡΠΈΡΠΎΠ΄Π° Π°ΠΊΡΠΎΠ²Π΅Π³ΠΈΠ½Π° ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅Ρ Π΅Π³ΠΎΒ ΠΏΠ»Π΅ΠΉΠΎΡΡΠΎΠΏΠ½ΡΠΉ Π½Π΅ΠΉΡΠΎΠΏΡΠΎΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΉ ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌ Π΄Π΅ΠΉΡΡΠ²ΠΈΡ ΠΈ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ
Testing blood and CSF in people with epilepsy: a practical guide.
Laboratory investigations, whilst not essential to the diagnosis of seizures or of epilepsy, can be fundamental to determining the cause and guiding management. Over 50% of first seizures have an acute symptomatic cause, including a range of metabolic, toxic or infectious cause. The same triggers can precipitate status epilepticus, either de novo or as part of a deterioration in control in individuals with established epilepsy. Some, such as hypoglycaemia or severe hyponatraemia, can be fatal without prompt identification and treatment. Failure to identify seizures associated with recreational drug or alcohol misuse can lead to inappropriate AED treatment, as well as a missed opportunity for more appropriate intervention. In individuals with established epilepsy on treatment, some laboratory monitoring is desirable at least occasionally, in particular, in relation to bone health, as well as in situations where changes in AED clearance or metabolism are likely (extremes of age, pregnancy, comorbid disorders of renal or hepatic function). For any clinician managing people with epilepsy, awareness of the commoner derangements associated with individual AEDs is essential to guide practice. In this article, we review indications for tests on blood, urine and/or cerebrospinal fluid in patients presenting with new-onset seizures and status epilepticus and in people with established epilepsy presenting acutely or as part of planned monitoring. Important, but rare, neurometabolic and genetic disorders associated with epilepsy are also mentioned
Action Plan for Stroke in Europe 2018β2030
Two previous pan-European consensus meetings, the 1995 and 2006 Helsingborg meetings, were convened to review the scientific evidence and the state of current services to identify priorities for research and development and to set targets for the development of stroke care for the decade to follow. Adhering to the same format, the European Stroke Organisation (ESO) prepared a European Stroke Action Plan (ESAP) for the years 2018 to 2030, in cooperation with the Stroke Alliance for Europe (SAFE). The ESAP included seven domains: primary prevention, organisation of stroke services, management of acute stroke, secondary prevention, rehabilitation, evaluation of stroke outcome and quality assessment and life after stroke. Research priorities for translational stroke research were also identified. Documents were prepared by a working group and were open to public comments. The final document was prepared after a workshop in Munich on 21β23 March 2018. Four overarching targets for 2030 were identified: (1) to reduce the absolute number of strokes in Europe by 10%, (2) to treat 90% or more of all patients with stroke in Europe in a dedicated stroke unit as the first level of care, (3) to have national plans for stroke encompassing the entire chain of care, (4) to fully implement national strategies for multisector public health interventions. Overall, 30 targets and 72 research priorities were identified for the seven domains. The ESAP provides a basic road map and sets targets for the implementation of evidence-based preventive actions and stroke services to 2030
Epilepsy care during the COVID-19 pandemic
The coronavirus disease 2019 (COVID-19) pandemic has affected the care of all patients around the world. The International League Against Epilepsy (ILAE) COVID-19 and Telemedicine Task Forces examined, through surveys to people with epilepsy (PWE), caregivers, and health care professionals, how the pandemic has affected the well-being, care, and services for PWE. The ILAE included a link on their website whereby PWE and/or their caregivers could fill out a survey (in 11 languages) about the impact of the COVID-19 pandemic, including access to health services and impact on mental health, including the 6-item Kessler Psychological Distress Scale. An anonymous link was also provided whereby health care providers could report cases of new-onset seizures or an exacerbation of seizures in the context of COVID-19. Finally, a separate questionnaire aimed at exploring the utilization of telehealth by health care professionals since the pandemic began was available on the ILAE website and also disseminated to its members. Seventeen case reports were received; data were limited and therefore no firm conclusions could be drawn. Of 590 respondents to the well-being survey (422 PWE, 166 caregivers), 22.8% PWE and 27.5% caregivers reported an increase in seizure frequency, with difficulty in accessing medication and health care professionals reported as barriers to care. Of all respondents, 57.1% PWE and 21.5% caregivers had severe psychological distress (k score >13), which was significantly higher among PWE than caregivers (p<0.01). An increase in telemedicine use during the COVID-19 pandemic was reported by health care professionals, with 40% of consultations conducted by this method. Although 74.9% of health care providers thought that this impacted positively, barriers to care were also identified. As we move forward, there is a need to ensure ongoing support and care for PWE to prevent a parallel pandemic of unmet health care needs
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