Features of psychoemotional disorders in patients with multiple sclerosis in different clinical and demographic groups

Purpose: to conduct an analysis of psychoemotional disorders in patients with multiple sclerosis, who are not receiving any treatment for these disorders. Material and Methods. A cohort of patients with a reliable diagnosis of multiple sclerosis, according to the criteria of С Poseur, consisting of 163 people, was selected for the research. A four-dimensional symptomatic questionnaire was used to assess distress, depression, anxiety and somatization (4DSQ) and a self-questionnaire for evaluating the symptoms of fibromyalgia with quantitative measures (WPI, SS, FS). Re-sults. Differences in the average values of the level of distress, depression, anxiety and somatization in patients with multiple sclerosis of different sex, age, with different type of course and duration of the disease are shown. Conclusion. The neuropsychological status of patients depends on the type of course of the disease, the level of distress — from age and sex, the level of somatization —from the age of this category of patients. In the complex treatment of this category of patients it is necessary to use symptomatic treatment in addition to pathogenetic therapy, which has not only neurotrophic and vasoactive effects, but also affects the psychoemotional background of patients.</p

Public knowledge of risk factors, signs and treatment of stroke: Analysis of the survey results in 2014 and 2017

Aim. This study was conducted to establish levels of knowledge in the general population, and also to determine the impact of educational sessions on stroke knowledge. Material and Methods. Two groups (2014 and 2017 years) completed a stroke knowledge questionnaire (435 respondents). Results. Overall, most of respondents could list 2 or more risk factors, but only 50% in 2014 could list 3 warning signs. More than 80% would call emergency number in response to stroke, but only 25% had heard of thrombolytic therapy. Overall stroke knowledge scores decreased in 2017 despite the public awareness in the media. Conclusion. Currently the knowledge of stroke risk factors, warning signs, and treatment is poor in Saratov. Our study demonstrates that more educational campaigns should be conducted for improve knowledge of stroke symptoms, and therapy.</p

ИММУНОГЕНЕТИЧЕСКИЕ АСПЕКТЫ РАННЕГО РЕВМАТОИДНОГО АРТРИТА

The study is aimed to investigate the distribution of alleles of HLA-DRB1 gene in patients with early rheumatoid arthritis and healthy individuals in Russian population, and evaluate their significance as molecular genetic markers of rheumatoid arthritis predisposition and protection. The association between alleles of HLA-DRB1 genes, antibodies to cyclic citrullinated peptides and IgM rheumatoid factor was also studied. Low and high resolution HLA-DRB1 genotyping were compared. In the cohort of patients with early rheumatoid arthritis, the alleles of HLA-DRB1 gene were found to be markers of rheumatoid arthritis protection/risk, especially in the homozygous state. They determined production of antibodies to cyclic citrullinated peptides but were not associated with rheumatoid factor IgM levels. These findings support different autoimmune mechanisms of rheumatoid arthritis pathogenesis. Изучено распределение аллелей гена HLA-DRB1 у больных ранним ревматоидным артритом и здоровых лиц контрольной группы российской популяции и оценена их значимость в качестве молекулярно-генетических маркеров предрасположенности и протекции ревматоидного артрита. Определена сила ассоциативной связи аллелей гена HLA-DRB1 с продукцией антител к циклическим цитруллинированным пептидам и ревматоидному фактору класса М. В исследовании проведено сравнение методов высоко- и низкоразрешающего генотипирования аллелей HLA-DRB1. У больных ранним ревматоидным артритом обнаружены аллели гена HLA-DRB1, являющиеся маркерами риска и протекции ревматоидного артрита, детерминирующие продукцию антител к циклическим цитруллинированным пептидам, но не ассоциированные с антителами класса M к ревматоидному фактору. Полученные данные могут свидетельствовать о различных аутоиммунных механизмах патогенеза ревматоидного артрита. 

Assessment level of anxiety and depression in patients with multiple sclerosis

&lt;p&gt;In patients with multiple sclerosis observed polymorphism of the emergency psychiatric disorders with a wide range of psychopathological phenomena — from neurotic and personality disorders to psychotic states and epileptiform syndrome. However, the problems of mental health problems in people with MS for a long time little attention was paid. The aim of our study was to analyze the level of anxiety and depression severity in patients with multiple sclerosis. According to this objective have been identifed objectives of the study: to determine the level of depression and anxiety in MS patients according to sex, age, course, duration of disease. For our work was selected group of patients with documented diagnosis of multiple sclerosis, Charles Poser criteria, consisting of 79 persons, with a disease duration of more than 2 years. We used a specially designed questionnaire, which included a table to assess complaints, anamnesis, the neurological status of the patient, and standard questionnaires (test anxiety, Taylor Depression Scale Research psychoneurology them. Spondylitis, the index of overall psychological well-being). The study found that mood disorders such as anxiety, depression, often occurs in patients with multiple sclerosis. However, they are expressed in groups of patients receiving and not receiving DMD, in many ways. Thus, it should be recommended&amp;nbsp; Vat practical neurologists in the treatment of multiple sclerosis patients to pay attention to whether or not they have a certain range of mental disorders, and above all, anxious-depressive syndrome, which is in need of medical and non-pharmacological correction.&lt;/p&gt

Headache features in persons with anxiety disorders

The aim of the article is to estimate the impact of anxiety on personality characteristics of headache in young adults studying full-time. Material and Methods. We observed 92 people aged from 15 to 25 years old, socially adapted, students in schools, colleges and universities on a full-time offices. Results. The perception of headache strongly depends on the emotional state of the individual, so it is very important to take this into account in the analysis of complaints and anamnesis of patients. Conclusion. Anxiety personality disorders hinder objectifying cephalgia, leading to misdiagnosis and incorrect treatment tactically with the possible development of abuse headaches. Therefore, it is necessary to convey to the patient the importance of reducing the impact of modifiable risk factors to explain the relationship of his condition with these factors and create a positive attitude to treatment

The role of transient ischemic attacks in the occurrence of cognitive impairment

The information about cognitive impairment of patient, suffered from transient ischemic attack (TIA) is summarized on the base of Russian and foreign literature. There were considered primary risk factors and pathogenesis of the occurrence of TIA and cognitive impairment. The algorithm of examination of patients with TIA was presented

Редкий случай дуодено-ободочного свища у ребенка 3 лет

Intraintestinal fistula is an unnatural communication between the intestinal cavity and other parts of the gut. Duodenocolic fistulas are common in adult patients with duodenal peptic ulcer or colon malignancies. In children, the formation of intraintestinal fistulas is possible as a rare complication of necrotizing enterocolitis of the newborn, after swallowing of several (two and more) magnetic foreign bodies localized in different parts of the digestive tract, as well as a complication of Crohn's disease at an older age. The article presents a clinical case of a duodenocolic fistula in a 3-year-old child. The patient Sh., 3 years and 2 months old, was admitted to the Pediatric Department of our clinic with a malabsorption syndrome and complaints of periodic vomiting after meals, weakness, tiredness, unstable light grayish stools, flatulence, periodic abdominal pains, and weight loss. There were clinical signs of stage II hypotrophy, protein and energy insufficiency. Laboratory tests showed low protein, albumin, and cholesterol levels, hypochromic anemia; fecal steatorrhea, creatorrhea, and amilorrhea. The differential diagnosis included intestinal malabsorption syndrome, presumably of a secondary origin, intestinal infection, congenital pancreatic disease, hereditary metabolic disorders, cystic fibrosis, celiac disease, lambliosis, and tumor. Multiple endoscopic and radiological examinations of the gastrointestinal tract were performed, but the intraintestinal fistula was identified only after repeated examinations. The patient's medical history from the first referral to the final diagnosis lasted about 9 months. The mechanism of the fistula formation in this patient is unclear. The clinical manifestation corresponded to the location of the fistula. In the long-term, the functioning of pathological intraintestinal communication could have a negative impact on the growth and development of the child; mucosal atrophy of the descending part of the intestine would have been possible, with progressive cachexy that could have become fatal.Межкишечный свищ – неестественная коммуникация, соединяющая полость кишки с другими отделами кишечника. Дуоденально-ободочные свищи обычно встречаются у взрослых пациентов с язвенной болезнью двенадцатиперстной кишки либо при злокачественных опухолях толстой кишки. У детей формирование межкишечных свищей возможно как редкое осложнение перенесенного некротизирующего энтероколита в периоде новорожденности, при проглатывании нескольких магнитных инородных тел (два и более), когда они распределяются в разных отделах пищеварительного тракта, а также как осложнение болезни Крона в более старшем возрасте. В статье описано собственное наблюдение дуодено-ободочного свища у  ребенка трех лет. Пациент Ш., 3 года 2 месяца, поступил в  педиатрическое отделение клиники с  синдромом нарушенного кишечного всасывания и жалобами на периодическую рвоту после еды, слабость, вялость, неустойчивый стул светло-серого цвета, метеоризм, периодическую боль в животе, снижение веса. Отмечались признаки гипотрофии II степени, белково-энергетической недостаточности. По данным лабораторных исследований крови выявлены гипопротеинемия, гипоальбуминемия, гипохолестеринемия, гипохромная анемия, в кале – стеаторея, креаторея, амилорея. Проводилась верификация диагноза между синдромом нарушенного кишечного всасывания, предположительно вторичного генеза, кишечной инфекцией, врожденной патологией поджелудочной железы, наследственным нарушением обмена веществ, муковисцидозом, целиакией, лямблиозом, опухолевым процессом. Неоднократно осуществлялись эндоскопическое и  рентгенологическое исследования желудочно-кишечного тракта, однако выявить межкишечный свищ удалось лишь при повторном обследовании. Анамнез заболевания от момента первого обращения за медицинской помощью до постановки окончательного диагноза составил около 9 месяцев. Генез формирования свища у данного больного не ясен. Особенности клинических проявлений обусловлены уровнем локализации свищевого хода. Длительное функционирование патологического межкишечного сообщения могло бы оказать негативное влияние на рост и развитие ребенка в будущем: возможно развитие атрофии слизистой отводящего отдела кишечника, прогрессирующее истощение могло бы привести к смерти пациента

Структурные изменения слизистой оболочки тонкого кишечника у собак при паразитировании Cystoisospora sp. и Giardia sp

The protozoa are often the cause of development in dogs of the pathologies of the gastrointestinal tract. At the same time in the early stages there may be no clinical signs of the disease. The aim of our work was to study the structural changes in the mucous membrane of the small intestine in dogs with infection Cystoisospora sp. and Giardia sp. After studying the obtained biopsy specimens in dogs with Cystoisospora sp. duodenitis was established with moderate changes in accordance with the recommendations of the WSAVA Gastrointestinal Standardization Group. The villi of the duodenal mucosa are shortened, unsharply expanded, the epithelial lining is represented by one layer of cells with signs of degenerative changes, the lamina propria is swollen, with moderate infiltration by inflammatory cells - single lymphocytes, single plasma cells, neutrophils, single eosinophils. Infection with Giardia sp. causes disorders of the gastrointestinal tract with signs of moderate and severe inflammatory process. Histoarchitecture of the mucous and muscular membranes of the intestinal tube is partially broken, the epithelial lining is represented by one layer with significant signs of degenerative changes, its own plate is swollen, with marked infiltration by inflammatory cells - lymphocytes, plasma cells, neutrophils, eosinophils. Outside the muscle plate infiltration is practically not distributed. We did not get a direct connection between the severity of the small intestinal lesion during infection with Giardia sp. and clinical manifestations, especially with the severity and frequency of diarrhea.Простейшие нередко становятся причиной развития у собак патологий желудочно-кишечного тракта. При этом на ранних стадиях клинических признаков заболевания может не быть. Целью нашей работы стало изучить структурные изменения слизистой оболочки тонкого кишечника у собак при паразитировании Cystoisospora spM Giardia sp. Проведя изучение полученных биопсийных образцов у собак с Cystoisospora sp. был установлен дуоденит с умеренными изменениями в соответствии с рекомендациями WSAVA Gastrointestinal Standardization Group. Ворсинки слизистой оболочки двенадцатиперстной кишки укорочены, нерезко расширены, эпителиальная выстилка представлена одним слоем клеток с признаками дегенеративных изменений, собственная пластинка отечна, с умеренной инфильтрацией клетками воспаления - единичными лимфоцитами, единичными плазмоцитами, нейтрофилами, единичными эозинофилами. Паразитирование Giardia sp. становится причиной развития нарушений работы желудочно-кишечного тракта с признаками умеренного и выраженного воспалительного процесса. Гистоархитектоника слизистой и мышечной оболочек кишечной трубки частично нарушена, эпителиальная выстилка представлена одним слоем со значительными признаками дегенеративных изменений, собственная пластинка отечна, с выраженной инфильтрацией клетками воспаления - лимфоцитами, плазмоцитами, нейтрофилами, эозинофилами. За пределы мышечной пластинки инфильтрат практически не распространяется. У животных, инвазированных Giardia sp., мы не получили прямой связи тяжести поражения тонкого кишечника при паразитировании простейших и клиническими проявлениями, особенно с тяжестью и частотой протекающей диареи

Polyneuropathy: clinical polymorphism and the algorithms of diagnostics

The information about epidemiology and clinical polymorphism of neuropathies is summarized on the base of Russian and foreign literature. The algorithm of clinical observation in patients with polyneuropathy is presented