Therapy for epilepsy in women: Additional sanogenetic effect caused by the intake of topiramate

Objective: to investigate the efficacy/tolerability of topiramate in reproductive-aged women.Subjects and methods. A group of 58 patients in fertile age (18–35 years) with a long history of focal (n=44) or idiopathic generalized (n=14) epilepsy (FE and IGE) who received mainly combined therapy with 2 antiepileptic drugs (AEDs) was analyzed. 82.8% of the patients were overweight; 51.7% had one or other menstrual cycle disorders; however, the women had been followed up by a gynecologist in exceptional cases.Results. Switch from one of the parent AEDs to topiramate or its incorporation into a treatment regimen as an additional drug substantially improved the course of the disease: remission at 12 months was achieved in 59.1% of the patients with FE and 78.6% of those with IGE. 29.3% of the patients receiving dual therapy, the second medication of which was topiramate, were observed to have lost weight not only if those had high baseline body mass index (BMI), but also if those had normal BMI at baseline. 8.6% of all the patients and 16.7% of those with menstrual cycle disorder achieved normalization of menstrual function. Topiramate was discontinued only in 1 (1.7%) patient because of critical weight loss (BMI<15). In addition to substantial improvement, topiramate used in mono- or dual therapy for FE and IGE may normalize weight and a menstrual cycle. Menstrual function is indicated to be monitored in epileptic women

Association between atopic and non-atopic diseases at children.

Ассоциация между атопическими и неатопическими аллергическими болезнями у детей. Абатуров А.Е., Дитятковский В.А., Науменко Н.В., Кулиева А., Бовсуновская К., Филатова И.А. В статье приведены данные анализа ассоциации между болезнями, составляющими атопический марш (АМ) у детей – атопическим дерматитом (АД), сезонным аллергическим риноконьюнктивитом (САРК) и круглогодичным аллергическим ринитом (КАР), бронхиальной астмой (БА) – с неатопическими аллергическими болезнями – острой и рецидивирующей крапивницей (ОК/РК), отёком Квинке (ОКв), а также болезнями пищеварительной системы (ПС) – функциональными расстройствами билиарной системы (ФРБС) и реактивным панкреатитом (РП). Определены ассоциации между АД, АМ и пищевой аллергией (ПА) у детей, что зафиксировано в виде прямой корреляционной связи. Определена прямая ассоциация между хроническими инфекционными заболеваниями верхних дыхательных путей и САРК, КАР и БА. Подтверждено отсутствие связи между атопическими и неатопическими аллергическими болезнями. Выявлены ассоциации между ФРБС, РП и неатопическими аллергическими болезнями у детей – ОК/РК, ОКв

Association between atopic and non-atopic diseases at children.

The paper presents the data of the association analysis bet­ween the diseases composig the atopic march (AM) in children – atopic dermatitis (AD), seasonal rhinoconjunctivitis (SARC) and perennial allergic rhinitis (PAR), bronchial asthma (BA), with non-atopic allergic diseases – acute and recurrent urticaria (AcU/RecU), Quincke edema (QE), and also with diseases of the digestive system (DS) – functional disorders of the biliary system (FDBS) and reactive pancreatitis (RP). The association between AD and food allergy (FA) in children has been determined, which is recorded as a direct association. A direct association was established between chronic infectious diseases of the upper respiratory tract and the PAR as well as BA. The lack of association between atopic and non-atopic allergic diseases had been confirmed. The association between FDBS and RP and non-atopic allergic diseases in children had been determined – AcU/RecU, QE

Algunos problemas prácticos de traducción relacionados con el concepto de “traducción filológica” (en el ejemplo de la traducción de las obras de C. Simon del francés al ruso)

The purpose of this paper is to put forward a hypothesis about the “philological translation” of literary texts of increased complexity and test it on the material of specific works. Based on the material of Russian and foreign translation studies, this paper formulates the concept of “philological translation” in the appendix to a specific publishing project within the series “Literary monuments” published by the Institute of World Literature of the Russian Academy of Sciences, and considers the most important practical aspects of the problem of adequate translation of literary texts of increased complexity. The analysis of the translation of two works by the representative of the French New Novel Claude Simon illustrates clearly the example of a “philological translation”. In the course of the study, the authors came to the conclusion that a philological translation implies an appeal to a text that is classical in its richness, complexity, and significance in world literature. The commercial potential of translating such a text is not obvious and requires the publisher to give up short-term profitability, the translator to give up routine work that fits into a predetermined time frame, and the reader to give up focusing on non-problematic (non-conflict, uncomplicated), linear, one-time reading/consumption of the book in favor of re-reading/savoring.El propósito de este trabajo es presentar una hipótesis sobre la “traducción filológica” de textos literarios de mayor complejidad y probarla en el material de obras específicas. Basado en el material de los estudios de traducción rusa y extranjera, el documento formula el concepto de "traducción filológica" en el apéndice de un proyecto editorial específico dentro de la serie "Monumentos literarios" publicada por el Instituto de Literatura Mundial de la Academia de Ciencias de Rusia, y considera los aspectos prácticos más importantes del problema de la traducción adecuada de textos literarios de mayor complejidad. El análisis de la traducción de dos obras por el representante de la Nueva Novela francesa Claude Simon ilustra claramente el ejemplo de una “traducción filológica”. En el curso del estudio, los autores llegaron a la conclusión de que una traducción filológica implica una apelación a un texto que es clásico en su riqueza, complejidad y significado en la literatura mundial. El potencial comercial de traducir un texto de este tipo no es obvio y requiere que el editor renuncie a la rentabilidad a corto plazo, que el traductor renuncie al trabajo de rutina que se ajusta a un marco de tiempo predeterminado y que el lector deje de centrarse en lo no problemático (no conflicto, sin complicaciones), lineal, lectura / consumo de una sola vez del libro a favor de volver a leer / saborear

Depression is not the only cause of cognitive impairment in chronic migraine

Background. Patients with the chronic migraine frequently present with memory and attention complaints. However, the prevalence and phenotype of such impairment in chronic migraine have not been studied.Objective – to evaluate the prevalence of the objective cognitive deficit in patients with chronic migraine and factors underlying its etiology. Materials and methods. We recruited 62 subjects with chronic migraine and 36 genderand age-matched controls with low-frequency episodic migraine (not more, then 4 headache days per month) aged 18–59. All patients filled in the Hospital Anxiety and Depression Scale (HADS) and Sheehan Disability Scale. Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), Digital Symbol Substitution Test (DSST), Rey Auditory Verbal Learning Test (RAVLT), and the Perceived Deficits Questionnaire (PDQ-20).Results. In this study 58 % of patients with chronic migraine complained of memory loss. Cognitive impairment was also found with PDQ-20. Objectively, we found a significant decrease in 90-second DSST results and RAVLT total recall and learning rate. In 40 % of subjects with chronic migraine scored lower than 26 points on MoCA. Patients with chronic migraine more frequently had lower DSST rates as compared to episodic migraine (odds ratio 5.07 (95 % confidence interval – 1.59–16.17); p = 0.003). Depression and anxiety did not correlate with performance on cognitive tests. Chronic migraine (frequent headache) and longer headache history, but not depression, anxiety or medication overuse were independent predictors of cognitive impairment.Conclusion. Subjective and objective cognitive deficits are prevalent in the chronic migraine population. Most often memory and attention are impaired. Longer headache history and presence of chronic migraine are independent risk factors for cognitive impairment in patients with chronic migraine

HEMOGRAM INDICATORS ASSESSMENT FOR EARLY PREDICTING THE MIXED INFECTION OF THE ERYTHEMA MIGRANS FORM OF LYME BORRELIOSIS AND TICK-BORNE ENCEPHALITIS

Background. It is difficult to confirm the diagnosis of the mixed infection of the erythema migrans form of Lyme borreliosis and tick-borne encephalitis at the onset of the disease because of delayed seroconversion. Purpose. Assessment of hemogram predictors to develop a model for early diagnosis of the mixed infection of the erythema form of Lyme borreliosis and tick-borne encephalitis. Materials and methods. The study involved 21 patients with the mixed infection of the erythema form of Lyme borreliosis and tick-borne encephalitis (Group 1) and 25 patients with the erythema form of borreliosis monoinfection (Group 2), who were hospitalized no later than the 7th day of the disease. The hemogram parameters, the leukocyte intoxication index and the body resistance index were analyzed. ROC analysis was used. The logistic regression model was developed using STATISTICA 12.0 modules. Results. The Group 1 patients compared with Group 2 demonstrated significant increases in the levels of the leukocyte intoxication index, and neutrophils, but decreases in the levels of the body resistance index, eosinophils, basophils and platelets. The leukocyte intoxication index was a “very good” predictor of the mixed infection, and the body resistance index, the number of eosinophils, basophils, neutrophils and platelets in peripheral blood had a “good” predictive values. The model included the body resistance index, the number of eosinophils and basophils. Conclusion. The developed model had a “very good” predictive value for the mixed infection early diagnosis of the erythema migrans form of Lyme borreliosis and tick-borne encephalitis

HYPERTROPHIC CARDIOMYOPATHY IN MULTIMORBIDITY

Aspects of diagnosis, difficulties in the diagnosis and optimal therapeutic strategies in patient with hypertrophic cardiomyopathy and comorbid conditions such as arterial hypertension, ischemic heart disease, dyslipidemia, diabetes mellitus type 2, stenosis of the left renal artery, obesity are reviewed on the example of clinical case. Hypertrophic cardiomyopathy combined with multimorbidity conditions requires a high-quality medical management, where the main goal is to improve the quality and duration of patient's life. This goal is being achieved by optimizing patient's lifestyle and assigning only the minimum amount of medications. Necessity of careful diagnosis of hypertrophic cardiomyopathy, evaluation of the risk of sudden death and search of optimal treatment in patients with multimorbidity pathology are demonstrated in clinical case

Formalized description of dynamics of an emotional reaction

The reported study was funded by RFBR according to the research project № 17-01-00742

Migraine and neck pain: Mechanisms of comorbidity

Neck pain and migraine are common diseases. Neck pain seldom occurs in a patient with migraine. However, the relationship between migraine and neck pain has been inadequately investigated.Objective: to analyze neck pain in patients with migraine to determine possible comorbidity mechanisms of these diseases.Patients and methods. The investigation enrolled 63 patients with chronic migraine (CM) and 40 with episodic migraine (EM) diagnosed in accordance with the International Classification of Headache Disorders, 3rd edition (ICHD-3). Winking reflex (WR) and nociceptive flexion reflex (NFR) were examined to evaluate the function of antinociceptive systems.Results. In the patients with CM, neck pain was more common than in those with EM (53.03% versus 14.02%); and panful tenderness, sensitivity, and tension of neck muscles were more marked. There was also a significant reduction in WR and NFR thresholds. Neck pain was noted to be an integral component of the pathogenesis of CM in a large number of patients with this condition. The authors proposed several pathophysiological mechanisms of a relationship between migraine and neck pain. Neck muscles and craniovertebral junction areas serve as a source for the arrival of nociceptive pain pulses in the central nervous system (peripheral sensitization), promoting pain chronization. Muscle dysfunction in this area may be, in turn, a reflection of central sensitization and impaired descending pain control

Combination treatment of patients with metabolic phenotype of osteoarthritis: an exploratory study

Treatment of osteoarthritis (OA) patients with comorbidities can be challenging due to adverse events and non-sufficient efficacy of modern drugs. A safe and effective alternative could be the methods of traditional medicine and their combinations. The aim of this study was to evaluate efficacy and safety of combination of curcuma-based parapharmaceutical preparation and acupuncture in metabolic phenotype of OA (MPOA). The trial design was pilot open-label “before – after” study with the duration of 12 weeks. The patients with MPOA received parapharmaceutical preparation Epigenorm Antivir in a daily dose of 1000 mg and underwent 15-20 sessions of classical acupuncture. We enrolled twenty three women with metabolic syndrome (MS), clinical and radiographic signs of gonarthrosis, mean age 66.5 years, mean body mass index 34.5. At the end of treatment there was a decrease in pain levels according to visual analogue scale (VAS) (before 65 (12.7), after 24.6 (21.0), р=0.001), WOMAC pain scale (before 210.6 (102.2), after 103 (80.8), p = 0.014), KOOS (before 47.8 (12.1), after 66.7 (16.2), р = 0.001). The treatment resulted in statistically significant improvement of daily and social activities, role functioning, and quality of life. The results were clinically significant as evidenced by the moderate (Cohen d > 0.5) and large (Cohen d > 0.8) effect sizes of most outcome changes in accordance with the Cohen classification. The clinical improvement was accompanied by the decrease in MS components – LDL cholesterol (before 3.26 (0.26) mmol/l, after 2.43 (0.2) mmol/l, р = 0.001), triglycerides (before 2.02 (0.16) mmol/l, after 1.31 (0.1) mmol/l, р = 0.005). The treatment resulted in the reduction of systemic inflammation as evidenced by the decrease in the concentrations of TNFα (before 15.9 (1.2) pg/ml, after 12.4 (0.8), р = 0.002), histamine (before 1.6 (0.2) ng/ml, after 0.7 (0.2) pg/ml, р = 0.034), IL-18 (before 208.8 (32.6 ) pg/ml, after 160.0 (26.0) pg/ml, р = 0.002) and CRP (before 6.05 (1.3) mg/l, after 3.2 (0.7) mg/l, р = 0.022). At the same time there was an increase of concentration of IL-10 (before 1.5 (0.7) pg/ml, after 3.8 (1.2), р = 0,006) and adiponectin (before 34.0 (5.6) pg/ml, after 40.0 (6.9), р = 0.034). The treatment was well tolerated, no serious adverse events were registered. The pleiotropic actions of combination treatment occured probably due to synergistic effects of herbal therapies and acupunctures. The results provide a rationale for larger scale, randomized controlled double-blind clinical trials