Individual neuropsychological characteristics in patients with juvenile myoclonic epilepsy

Background. An association between juvenile myoclonic epilepsy (JME) and nonpsychotic psychiatric and cognitive disorders has been described in recent years. Scientists are trying to link JME with certain personality traits marked by emotional instability. Objective. The goal of our research was to assess the state of cognitive functions in young adult patients with JME–excluding the adverse side effects (ASEs) of antiepileptic drugs (AEDs)–and analyze the level of personality and situational anxiety, neuroticism, and depression in young adult patients with JME. Design. We tested 26 patients with JME and 26 healthy adults with the computer program NS-PsychoTest (Neurosoft Company, RF), a program which is aimed at studying and evaluating neuropsychological characteristics. Results. Our study showed that the frequency of depressive symptoms, according to the cognitive-affective subscale (Beck’s Depression Inventory), in patients with JME was statistically significantly higher than among people without epilepsy. Comorbid personality and nonpsychotic psychiatric disorders are common interdisciplinary problems in JME management. Most practitioners pay attention only to the treatment of seizures caused by JME, and their patients, accordingly, do not receive adequate psychotherapeutic help. Conclusion. Cognitive disorders are often associated with epilepsy, and are a result of a combination of factors. According to our study, in the presence of statistically significant differences in short-term memory and mental performance in patients with JME, compared to healthy young adults, the main indicators of cognitive function in patients with JME generally correspond to the norm. Our findings highlight the etiological heterogeneity of cognitive disorders in JME and the importance of early screening for them

Determine the effectiveness of lipid-lowering therapy in patients with chronic obstructive pulmonary disease combined with coronary heart disease

Introduction: In complex treatment of chronic obstructive pulmonary disease (COPD) combined with ischemic heart disease (IHD) more and more attention is drawn to pleiotropic effect of statins. The aim of our researches became determining the effectivity of utilization of rosuvastatin (Crestor®, IPR Pharmaceuticals, Inc.) in complex treatment of COPD combined with IHD. Materials and methods: Basing on pulmonology department of Poltava regional clinical hospital, 30 patients with COPD combined with IHD have been examined (stable effort angina FC II) aged from 51 to 67 y.o. (average age was 57,03±3,51). The patients were divided into two age compatible groups. Patients of the main group (n=15) underwent regular COPD and IHD treatment, addind 20 mg of rosuvastatin per night. The observed group (n=15) didn't receive rosuvastatin. The examination of patients was held before and half year of treatment, included the estimation of respiratory symptoms of the disease, the degree of intensity of dyspnea (Medical Research Council Dyspnea Scale). The tolerance to physical exercise was studied with 6 minute walking test. The cholesterine level, HDL, LDL, function of ventilation have been tested as well. The average frequency of aggravations during the year was estimated through retrospective examination of anamnesis. Results: After the treatment the improvement of clinical state has been noticed at both groups due to decrease of intensity of respiratory symptoms of the disease, such as cough, amount of expectoration, dyspnea and also increase of tolerance to physical exercise and improvement of laboratory-instrumental indexes. Though the patients of the main group were noticed to have significantly less amount of expectoration and cough. The distance covered in 6 minutes was positively longer (р<0,05). It has to be noted that the patients of the main group had positive decrease of wheezing after treatment, due to increase of FEV1, GI (р<0,01). The retrospective studying of the anamnesis revealed that the frequency of arrogations during the year was 1-2 times a year (1,6±0,48). Conclusions: Including rosuvastatin into the treatment scheme allows to decrease and stabilize the main clinical symptoms of this constellation of diseases, improving the quality of life, reduce the frequency of exacerbations

Modernization of therapy in patients with chronic obstructive pulmonary disease and ischemic heart disease

During the combination treatment of chronic obstructive pulmonary disease in association with ischemic heart disease, the increasing attention is paid to pleiotropic effects of statins. Inclusion of rosuvastatin in the treatment regimen allows reducing and stabilizing the main clinical manifestations of this disease constellation, improving the quality of life

Improved functionalization of oleic acid-coated iron oxide nanoparticles for biomedical applications

Superparamagnetic iron oxide nanoparticles can providemultiple benefits for biomedical applications in aqueous environments such asmagnetic separation or magnetic resonance imaging. To increase the colloidal stability and allow subsequent reactions, the introduction of hydrophilic functional groups onto the particles’ surface is essential. During this process, the original coating is exchanged by preferably covalently bonded ligands such as trialkoxysilanes. The duration of the silane exchange reaction, which commonly takes more than 24 h, is an important drawback for this approach. In this paper, we present a novel method, which introduces ultrasonication as an energy source to dramatically accelerate this process, resulting in high-quality waterdispersible nanoparticles around 10 nmin size. To prove the generic character, different functional groups were introduced on the surface including polyethylene glycol chains, carboxylic acid, amine, and thiol groups. Their colloidal stability in various aqueous buffer solutions as well as human plasma and serum was investigated to allow implementation in biomedical and sensing applications.status: publishe

Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes

BACKGROUND: Data are lacking on the long-term effect on cardiovascular events of adding sitagliptin, a dipeptidyl peptidase 4 inhibitor, to usual care in patients with type 2 diabetes and cardiovascular disease. METHODS: In this randomized, double-blind study, we assigned 14,671 patients to add either sitagliptin or placebo to their existing therapy. Open-label use of antihyperglycemic therapy was encouraged as required, aimed at reaching individually appropriate glycemic targets in all patients. To determine whether sitagliptin was noninferior to placebo, we used a relative risk of 1.3 as the marginal upper boundary. The primary cardiovascular outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. RESULTS: During a median follow-up of 3.0 years, there was a small difference in glycated hemoglobin levels (least-squares mean difference for sitagliptin vs. placebo, -0.29 percentage points; 95% confidence interval [CI], -0.32 to -0.27). Overall, the primary outcome occurred in 839 patients in the sitagliptin group (11.4%; 4.06 per 100 person-years) and 851 patients in the placebo group (11.6%; 4.17 per 100 person-years). Sitagliptin was noninferior to placebo for the primary composite cardiovascular outcome (hazard ratio, 0.98; 95% CI, 0.88 to 1.09; P<0.001). Rates of hospitalization for heart failure did not differ between the two groups (hazard ratio, 1.00; 95% CI, 0.83 to 1.20; P = 0.98). There were no significant between-group differences in rates of acute pancreatitis (P = 0.07) or pancreatic cancer (P = 0.32). CONCLUSIONS: Among patients with type 2 diabetes and established cardiovascular disease, adding sitagliptin to usual care did not appear to increase the risk of major adverse cardiovascular events, hospitalization for heart failure, or other adverse events

THE CONTROLLER OF FUZZY LOGIC IN THE MANAGEMENT OF TECHNOLOGICAL PROCESSES

Introduction. The current stage of progress is associated with the development and implementation of intelligent systems and technologies that provide the formation of clear solutions based on fuzzy rules, fuzzy conclusion and fuzzy control. However, the classical control methods work well only with a completely deterministic control object and deterministic environment, but for fuzzy information systems and highly complex control object, fuzzy control methods are optimal. Material and methods. Moreover, the process of decision-making by a person in the management of technological processes is modeled and simulated by a fuzzy controller with a base of rules. In recent years, “fuzzy” control has been successfully used to manage and operate a number of systems. Discussion and results. Therefore, this article is devoted to the consideration of fuzzy logic controller’s application in management systems and existing research methods’ analysis in the field of intelligent control technologies for solving the problems of adaptation of applied models and algorithms to various objects and systems, particularly to the systems for maintaining the microclimate parameters of the building’s life support environment, and also to the basic parameters of increasing the economic efficiency of using the fuzzy logic controller in the control system.Conclusion. Analyzed control methods based on fuzzy logic are applicable to various technological objects and systems. As a further study, it is planned to consider the issues of fuzzy control of various life support systems of a modern building

PARP INHIBITORS IN OVARIAN CANCER: TOXICITY PROFILE

Today, the role of the genetic factor in the etiology of ovarian cancer is unquestionable. Genetic disorders in low-differentiated serous adenocarcinoma of ovaries in about 50 per cent of cases occur in the form of a lack of homologous DNA reparation. About 2/3 of these cases are associated with mutations in BRCA genes. The use of PARP inhibitors is a promising direction in the treatment of BRCA-mutated ovarian cancer, and a number of studies have proven their advantage. But because they are used in supporting mode, one of the basic requirements for this group of drugs is the toxicity profile. The most common complications in taking PARP-inhibitors are nausea, fatigue, vomiting, anaemia, thrombocytopenia. Olaparib has the lowest toxicity range of all the PARP inhibitors known today in the treatment of ovarian cancer

RELAPSING POLYCHONDRITIS IN RHEUMATOLOGY PRACTICE

The paper provides a clinical description of relapsing polychondritis, a rare systemic immunoinflammatory disease that was characterized by fever episodes, cartilage damage, and reactive arthritis. Diagnostic searching could rule out an infectious disease (by determining a wide variety of potential pathogens), as well as a septic condition due to a pronounced leukemoid reaction of the myeloid type, and the presence of toxigenic neutrophil granulation in peripheral blood and bone marrow. All available clinical, functional, and radiological studies were used to make a differential diagnosis with paraneoplastic syndrome due to blood disease, primarily with myeloma. The data obtained could interpret the changes only as reactive. No increased autoantibody titers were identified. Clinical symptoms and the good effect of prednisolone therapy allowed a diagnosis of relapsing polychondritis, a rare disease that belongs to the group of immunoinflammatory diseases according to the current ideas. It is suggested that autoinflammation plays a role in its pathogenesis

Association of carriers of single nucleotide polymorphisms rs206787 and rs516535 in gene BRD2 and rs3743123 in gene GJD2 with juvenile myoclonic epilepsy of Caucasian patients in the Siberia

This article outlines recent findings on genetics of juvenile myoclonic epilepsy (JME), where JME occurrence is associated with polymorphic allelic variants in BRD2 gene (locus EJM3) and GJD2 gene (locus EJM2).Objective: To establish risk factors for development of JME in the context of genetic predisposition; specifically, polymorphic allelic variants rs206787 and rs516535 in the BRD2 gene and rs3743123 in the GJD2 gene.Materials and Methods: Using RT-PCR, we identified carriers of single nucleotide polymorphisms (SNPs) rs206787 and rs516535 in gene BRD2 and rs3743123 in gene GJD2, from samples of 79 JME patients and 150 healthy volunteers of European descent residing in the Siberian Federal District.Results: We found complete linkage disequilibrium between studied loci in patients with JME and healthy controls, however there was no association between SNPs rs206787 and rs516535 and JME development in our study population (р &gt; 0,05). Haplotype TT/TT for SNPs rs206787 and rs516535 in the BRD2 gene associated with photoparoxysmal response (OR = 3,6; 95% CI 1,37 – 9,48; p = 0,02) in JME patients. Homozygosity of allele T (rs3743123) in the GJD2 gene was associated with risk of JME development in our study population (OR = 2,66; 95% CI 1,24 – 5,74; р = 0,04).Conclusion: These results strongly suggest that genotyping JME patients of European descent living in Siberia to identify carriers of haplotype TT/TT in BRD2 SNPs (locus EJM3) and T allele (rs3743123) in the GJD2 gene will enable personalised approach to JME diagnosis and management, as well as identification of high-risk individuals in affected families

Association of the carriage of <i>BRD2</i> rs206787 and rs516535 and <i>GJD2</i> rs3743123 polymorphisms with juvenile myoclonic epilepsy in Caucasian patients of Siberia

In recent years, the genetics of juvenile myoclonic epilepsy (JME) has been actively studied; the association of JME with the carriage of polymorphic allelic variants of the BRD2 (EJM3 locus) and GJD2 (EJM2 locus) genes has been established. Objective: to establish risk factors for JME in terms of a genetic predisposition; specifically, polymorphic allelic variants rs206787 and rs516535 in the BRD2 gene and rs3743123 in the GJD2 gene. Patients and methods: Examinations were made in 79 patients with JME and in 150 healthy volunteers, who were Caucasian and resided in the Siberian Federal District (SFD) and underwent determination of the carriage of single nucleotide polymorphisms (SNPs) rs206787 and rs516535 in the BRD2 gene and rs3743123 in the GJD2 gene by real-time polymerase chain reaction. Results and discussion. In 2003, American scientists from New York showed that the alleles associated with the development of JME with an autosomal recessive inheritance pattern might be located in the BRD2 gene. Patients with JME are assumed to have an autosomal dominant inheritance pattern of mutations in the BRD2 gene. British scientists revealed that different populations were found to have an association of SNP rs3918149 and no relationship of BRD2 rs206787 to the development of JME in Caucasians, as well as ascertained local linkage disequilibrium in the BRD2 gene. Our investigation has established complete linkage disequilibrium between the loci in patients with JME and in healthy individuals and no association of the carriage of SNPs rs206787 and rs516535 in the BRD2 gene with the development of JME in the patients residing in the SFD (p &gt;0.05). German scientists studied the impact of SNP in the BRD2 gene on a predisposition to a photoparoxysmal response in patients with JME/genetic generalized epilepsy. Our investigation has indicated the association of the carriage of TT/TT haplotype for SNP rs206787 and rs516535 in the BRD2 gene with a photoparoxysmal response in patients with JME (odds ratio (OR), 3.6; 95% confidence interval (CI), 1.37–9.48; p=0.02). We have confirmed that in the studied sample, the carriage of the T allele in the GJD2 gene (rs3743123) in the homozygous form is associated with the development of JME in Caucasian patients residing in the SFD and is a risk factor for JME (OR, 2.66; 95% CI, 1.24–5.74; p=0.04). The clinically significant association of this SNP in the GJD2 gene with the development of JME had been also previously demonstrated in two independent studies conducted in the European populations in the UK and Germany. There is a rise in the proportion of homozygotes in JME patients versus the control group, suggesting that the 588T allele under consideration increases the risk for JME in the homozygous state in the autosomal recessive inheritance pattern. Conclusion. The findings suggest that it is necessary to genotype Caucasian patients with JME, who reside in Siberia, for determination of the carriage of the TT/TT haplotype in terms of the investigated SNPs in the BRD2 gene (EJM 3 locus) and the carriage the T allele (rs3743123) in the GJD2 gene via a personalized approach to predicting the course of JME, as well as for identification of persons at risk for JME in the families having a history of this disease