Current Approaches to Assessing the Safety and Efficacy of Lamotrigine in Children and Adolescents with Epileptic Syndromes Associated with Focal Seizures

Scientific relevance. Epileptic syndromes associated with focal seizures often develop in children and adolescents and may be accompanied by cognitive impairment, mental disorders, and endocrine disorders, which require additional medication apart from anti-epileptic medicinal products. Currently, the selection of safe and effective therapies for epileptic syndromes, especially in paediatric populations, is a pressing challenge for epileptology.Aim. This study aimed at a comprehensive assessment of the safety and efficacy of lamotrigine in therapeutic doses for children and adolescents with epileptic syndromes associated with focal seizures.Materials and methods. A total of 53 patients aged 3 to 18 years with various epileptic syndromes associated with focal seizures were under observation in 2020–2023. During this period, 37 patients (69.8%) received monotherapy with lamotrigine, and 16 patients (30.2%) received combination therapy including lamotrigine and two or more other medicinal products. When evaluating the safety and efficacy of pharmacotherapy in adolescent patients, the authors selectively used the Software for Post-marketing Studies of Anti-epileptic Medicinal Products developed at the Scientific Centre for Expert Evaluation of Medicinal Products.Results. With lamotrigine, the highest rate of complete clinical remission was observed in patients with focal epilepsy with onset in childhood and adolescence (90.9% of cases). For structural focal epilepsy, 16.7% of patients achieved complete freedom from seizures, and 50% demonstrated a pronounced response to treatment. However, patients with epilepsy due to local structural changes in the neocortex (33.3% of cases) had a prognosis of severe epilepsy. For epileptic encephalopathies with onset in childhood, 66.7% of patients achieved a ≥50% reduction in the frequency of seizures. Seizure reduction improved the quality of life of patients and their parents, especially of those with a long history of unsuccessful treatment attempts. There were no adverse reactions associated with lamotrigine except those listed in the summary of product characteristics. The Software for Post-marketing Studies of Anti-epileptic Medicinal Products provided a means for scoring and plotting the changes in the condition of adolescents without severe cognitive and memory impairment undergoing lamotrigine treatment.Conclusions. According to the study results, lamotrigine is highly effective and has a favourable safety profile in patients with early-onset epileptic syndromes associated with focal seizures. Moreover, lamotrigine is applicable to the treatment of attention, memory, expressive speech disorders, and aggressive behaviour. Therefore, lamotrigine may be recommended for treating children and adolescents with comorbid epileptic syndromes and cognitive and emotional disorders. Specialised software improves the quality of real-world evidence regarding the safety and efficacy of anti-epileptic medication

Genetic Aspects of Pathogenesis of Congenital Spastic Cerebral Paralysis

Congenital spastic cerebral palsy (СР) is a large group of non-progressive disorders of the nervous system. The basis of the pathogenesis of these conditions is considered the impact of many factors. The clinical diversity of the disease and the syndromic principle of classification determine the existing uncertainties in the diagnosis of these diseases. The multifactorial nature of the underlying brain lesions is obvious and beyond doubt. The volume of information accumulated to date does not allow one to exclude the role and significance of the direct effect of acute asphyxiation in childbirth on a fetus normally formed during pregnancy, the role of infectious brain lesions, and disorders of neuronal migration. It is impossible to ignore the dependence of the clinical picture of the disease on what stage of ontogenesis the impact of the damaging agent occurs. As one of the pathogenetic factors, the genetic determinism of the phenotype of the clinical picture of a disease is fairly considered. This review focuses on the genetic aspects of the pathogenesis of this pathology. The information on monogenic mechanisms of inheritance is analyzed in detail. Such genetically determined mechanisms of pathogenesis as the inheritance of prerequisites for brain trauma in the perinatal period are considered separately. The new clinically significant variants of chromosomal mutations found in patients with CР are reviewed in detail,  the evidence of the influence of genetic factors on the development of cerebral palsy in the absence of a pronounced monogenic cause of the disease, obtained through twin studies, is reviewed.  Lit search of polymorphisms markers of predisposition to the development of cerebral palsy genes of the folate cycle, genes of glutamate receptors, the gene of apolipoprotein and of the gene for the transcription factor of oligodendrocytes (OLIG2) in Detail the role of epigenetic effects on the activity of genes coding for mitochondrial proteins

The Scale of Quantitative Assessment Adherence to Treatment «QAA-25»: Updating of Formulations, Constructive and Factor Validity and a Measure of Consent

Aim: To update the definitions of selected questions of the "QAA-25" (quantitative adherence assessment) scale and evaluate it according to the criteria of validity and measure of agreement.Materials and Methods. In a descriptive cross-sectional study including 200 patients with coronary heart disease, adherence was determined using traditional and alternative versions of selected questions of the QAA-25 scale, followed by assessment of construct validity, factor validity, and measure of agreement.Results. Alternative question versions did not significantly affect test results, with 81% of respondents in the outpatient sample and 69% in the inpatient sample rating them as "more acceptable." The QAA-25 scale has good construct and internal validity (α – 0.818, αst – 0.832), with moderate agreement (κ – 0.562) and demonstrates high reliability of internal validity – when scale items are consistently excluded, α values remain in the 0.801-0.839 range.Conclusion. The QAA-25 scale with modified question definitions should be used instead of the previous version of the scale. Good construct validity and factor validity, sufficient measure of agreement and specificity, high sensitivity and reliability of the QAA-25 scale allow to recommend it as a tool for assessing adherence to drug therapy, medical support, lifestyle modification and integral adherence to treatment in scientific and clinical practice

The surface electric potential, internal electric bias field, pyroelectric and piezoelectric effects in the non-poled piezoelectric ceramics with a stationary gradient of deformation in the near-electrode layers

Специальной обработкой создан градиент механических деформаций противоположных поверхностей сегнетокерамических пластин, обеспечивший генерацию напряжения 0.2-0,55 В при воздействии гармонического трехточечного механического нагружения. Обнаружена возможность создания внутреннего электрического поля смещения устойчивого до 400 оС.Using a special treatment a gradient of mechanical deformations of the opposite surfaces of ferroelectric ceramic plates was formed, enabling the generation of a 0.2-0.55 V voltage under the action of harmonic three-point mechanical loading. The possibility of creating an internal electric ias field sta le up to 400 °C was esta lished.Работа выполнена при поддержке Проектной части Госзадания Минобрнауки № 3.1649.2017/П

ЕЛЕКТРИЧНІ ХАРАКТЕРИСТИКИ НАНОРОЗМІРНИХ ПЛІВОК SNО2 , СТРУКТУРОВАНИХ З ВИКОРИСТАННЯМ ПОЛІМЕРІВ

The electrical characteristics of nanoscale tin dioxide layer were studied. They showed the significant differences in the conductivity values of films in vacuum and in air, which indicates a visible influence of adsorption interaction with oxygen in the air. The dark current temperature dependence activation character was established due to different donors type centers contribution to the conductivity which are “shallow” at low temperatures and are more “deep” at high temperatures. The values of the energy depth of these levels were calculated. The films’ conductivity changes at their heating at vacuum and at the subsequent cooling at vacuum till the initial temperature are reversible and repeatable many times, which testifies the stability of the electrical characteristics of the SnO2 films and is perspective for use of the layers as adsorptive-sensitive elements of gas sensors.Проведенные в работе исследования электрических характеристик наноразмерных слоев диоксида олова позволили выявить существенные отличия в значениях проводимости пленок в вакууме и на воздухе, что свидетельствует о заметном влиянии адсорбционного взаимодействия с кислородом воздуха. Установлен активационный характер кривых ТЗТТ образцов, что обусловлено вкладом в проводимость различных типов донорных центров – более «мелких» при низких температурах и более «глубоких» при высоких температурах. Рассчитаны значения глубины залегания этих энергетических уровней. Изменение величины проводимости пленок при прогреве в вакууме и последующем охлаждении в вакууме до исходной температуры является обратимым и многократно воспроизводимым, что свидетельствует о стабильности электрических характеристик исследуемых пленок SnO2 и перспективно для использования слоев в качестве адсорбционно-чувствительных элементов газовых сенсоров.Проведені в роботі дослідження електричних характеристик нанорозмірних шарів діоксиду олова дозволили виявити істотні відмінності в значеннях провідності плівок у вакуумі й на повітрі, що свідчить про помітний вплив адсорбційної взаємодії з киснем повітря. Встановлено активаційний характер кривих ТЗТТ зразків, що обумовлено внеском у провідність різних типів донорних центрів - більше «дрібних» при низьких температурах і більше «глибоких» при високих температурах. Розраховано значення глибини залягання цих енергетичних рівнів. Зміна величини провідності плівок при прогріві у вакуумі й наступному охолодженні у вакуумі до вихідної температури є оборотним і багаторазово відтворюваним, що свідчить про стабільність електричних характеристик досліджуваних плівок SnО2 і перспективно для використання шарів в якості адсорбційно-чутливих елементів газових сенсорів

Comorbidity of infantile cerebral palsy and benign epileptiform EEG discharges of childhood in dizygotic twins

The article presents a clinical case of infantile cerebral palsy combined with BEDC (with no epileptic seizures) in dizygotic twins. The case supports the hypothesis of genetic nature of the BEDC patterns. The variety of EEG characteristics and clinical courses of the disease in children with cerebral palsy and BEDC are reviewed. Correct interpretation of the EEG findings provides an accurate prognosis of seizures and cognitive functions, as well as the patient management tactics. In these patients, continuous video EEG monitoring (both awake and sleeping) is recommended for a long-time follow-up

ВПЛИВ ВОЛОГИ І СТРУКТУРУЮЧОЇ ДОБАВКИ НА ЕЛЕКТРОФІЗИЧНІ ХАРАКТЕРИСТИКИ ПЛІВОК ДІОКСИДУ ОЛОВА

The structuring additive concentration and humidity influence on the electrophysical properties of tin dioxide films was studied. The growth of SnO2 films, interelectrode resistance with the growth of polyvinyl acetate concentration in the initial solution is due to the porosity increase caused by the PVA increase in the films under study. The section of dark current temperature dependence, in vacuum from 110 °C with an activation energy ~ 0.7 eV, is due to the water molecules desorption. The resistance decrease of tin dioxide films in a wet atmosphere due to the dissociative adsorption of water molecules on the SnO2 layers surfaces has been established.Исследовано влияние концентрации структурирующей добавки и влажности на электрофизические свойства пленок диоксида олова. Возрастание межэлектродного сопротивления пленок SnO2 при увеличении концентрации поливинилацетата в исходном растворе обусловлено увеличением пористости исследуемых пленок с ростом количества ПВА. Участок ТЗТТ, в вакууме от 110 о С с энергией активации ~0,7 эВ обусловлен десорбцией молекул воды. Установлено снижение сопротивления пленок диоксида олова во влажной атмосфере, обусловленное диссоциативной адсорбцией молекул воды на поверхности слоев SnO2 .Досліджено вплив концентрації структуруючої добавки і вологості на електрофізичні влас- тивості плівок діоксиду олова. Зростання межелектродного опору плівок SnO2 при збільшенні концентрації полівінілацетату в вихідному розчині обумовлено збільшенням пористості досліджуваних плівок із зростанням кількості ПВА. Ділянка ТЗТТ в вакуумі від 110 о С з енергією активації ~ 0,7 еВ обумовлена десорбцією молекул води. Встановлено зниження опору плівок діоксиду олова у вологій атмосфері, обумовлене дисоциативною адсорбцією молекул води на поверхні шарів SnO2

Numerical simulation of the experiment on pulsed excitation of stack type piezoelectric generator

The numerical modeling results of the full-scale experiment with low-frequency pulse excitation of the stack-type piezoelectric generator (PEG) for the energy storage device are described. PEG is a multilayer axisymmetric piezoceramic package. The dependence of the output voltage on the active load rate under the harmonic and non-stationary mechanical action of the PEG is studied. A finite element device model is developed in ANSYS , and a simplified one-dimensional analytical model is analyzed. The experimental results-to-numerical calculation correlation has shown their good convergence which allows using the analyzed numerical models to optimize the PEG design at the given external action frequency and active resistance value of the external electric circuit. In addition, it is found that the frequency dependence of the output voltage of the axial-type PEG is of a complex nature depending both on the compressive pulse loading level and the piezoelectric modulus value of the PEG sensitive element, and on the electrical load resistance

ACTIVATION OF POLYGLYCOLMALEATEPHTHALATE SYNTHESIS PROCESSES BY COMPOUNDS OF TITANIUM, TIN AND GERMANIUM WITH HYDROXYCARBOXYLIC ACIDS

The compositions of Ti4+, Sn4+, Ti3+ chlorides with a number of hydroxycarboxylic acids: citric, tartaric, malic and complexes of Ge4+ with these acids have been investigated as activators of polycondensation of maleic and phthalic acids with ethyleneglycol. The systems for industry use by production of polyesters of dicarboxylic acids with glycols have been proposed