Alcoholic polyneuropathy. Clinical forms and pathogenetically based approaches to therapy

The number of cases of alcoholism in Russia is gradually decreasing, but still significantly affects the overall health indicators of the population. One of its frequent complications is alcoholic polyneuropathy. The article deals with the pathogenetic mechanisms of the occurrence and development of the disease, its forms, classification, and clinical picture. The damage to the nervous system in patients with alcoholism depends on the frequency of alcohol consumption, the dose, the type of drinks that were consumed, malnutrition, genetic predisposition and individual characteristics that determine the level of alcohol dehydrogenase and aldehyde dehydrogenase. In the clinical picture, a toxic form of alcoholic polyneuropathy is currently distinguished, associated with the direct effect of toxic alcohol metabolites on somatic and autonomic nerve fibers, thiamine deficiency, resulting from a deficiency of B vitamins, and mixed forms. According to the rate of development of clinical manifestations, there are acute forms of alcoholic polyneuropathy (thiamine deficiency) and chronic forms (toxic). The article discusses the possibilities of diagnostics using modern instrumental and laboratory methods of research, primarily electroneuromyography. With the help of this method of investigation, in alcoholic polyneuropathy, signs of axonal damage are most often detected, and in the thiamine-deficient form, it is possible to determine signs of secondary demyelination. The authors emphasize the importance of differential diagnosis with other pathologies. The article highlights the current understanding of the main therapeutic strategies, treatment options for patients with alcoholic polyneuropathy. Therapy of patients suffering from alcoholic polyneuropathy includes refusal of alcohol abuse, normalization of nutrition, medication. For drug therapy, B vitamins and antioxidants are used. The drug with a recognized antioxidant effect is alpha-lipoic acid. A clinical case was analyzed on the basis of our own clinical observation of a mixed form of alcoholic polyneuropathy

Puzzling asteroid 21 Lutetia: our knowledge prior to the Rosetta fly-by

A wide observational campaign was carried out in 2004-2009 aimed to complete the ground-based investigation of Lutetia prior to the Rosetta fly-by in July 2010. We have obtained BVRI photometric and V-band polarimetric measurements over a wide range of phase angles, and visible and infrared spectra in the 0.4-2.4 micron range. We analyzed them together with previously published data to retrieve information on Lutetia's surface properties. Values of lightcurve amplitudes, absolute magnitude, opposition effect, phase coefficient and BVRI colors of Lutetia surface seen at near pole-on aspect have been determined. We defined more precisely parameters of polarization phase curve and showed their distinct deviation from any other moderate-albedo asteroid. An indication of possible variations both in polarization and spectral data across the asteroid surface was found. To explain features found by different techniques we propose that (i) Lutetia has a non-convex shape, probably due to the presence of a large crater, and heterogeneous surface properties probably related to surface morphology; (ii) at least part of the surface is covered by a fine-grained regolith with particle size less than 20 microns; (iii) the closest meteorite analogues of Lutetia's surface composition are particular types of carbonaceous chondrites or Lutetia has specific surface composition not representative among studied meteorites

New opportunities of increase of complex therapy productivity with the symptomatic locally-caused epilepsy with the resistant current

Efficiency of Phenotropili preparation was studied in jugulating of asthenia among patients with resistant symptomatic localization related epilepsy. Some patients (62 persons) against the basic antiepileptic therapies put on Phenotropili in a dose 100 mg (18 persons) and 200 mg (22 persons) a day in a continuous course, during 3 months. The assessment of this therapy influence was conducted in relation to the group accepting a placebo (22 persons). It was specified an authentic decrease of all types of asthenia, and efficiency of a preparation in a dose of 100 mg a day practically didn't concede efficiency of 200 mg a day.Изучалась эффективность препарата Фенотропил® при купировании астении у пациентов с резистентной симптоматической локально-обусловленной эпилепсией. Пациентам (62 человека) на фоне базисной антиэпилептической терапии назначался Фенотропил® в дозе 100 (18 человек) и 200 мг (22 человека) в сутки непрерывным курсом, длительностью 3 месяца. Оценка влияния этой терапии велась по отношению к группе, принимающей плацебо (22 человека). Отмечено достоверное снижение всех типов астении, причем эффективность препарата в дозе 100 мг в сутки практически не уступала эффективности 200 мг в сутки

Количественная оценка магнитной восприимчивости (QSM) в подкорковых структурах головного мозга как маркер нейродегенерации при ремиттирующем и вторично-прогрессирующем рассеянном склерозе

Purpose. The aim of the study was to investigate changes in iron distribution in the brain of patients with multiple sclerosis (MS) using magnetic resonance imaging (MRI) technique – quantitative susceptibility mapping (QSM) – in comparison with clinical data.Materials and methods. Three groups of patients were included in this prospective study: 47 patients with relapsing-remitting MS (RRMS), 20 patients with secondary progressive MS (SPMS) and 39 healthy controls. For all patients we collected clinical data, including history of present illness (H&P) and disability degree, and performed brain MRI followed by QSM maps obtaining and assessing relative magnetic susceptibility in subcortical structures.Results. We found an increase in magnetic susceptibility in the heads of the caudate nuclei and in putamen in patients with SPMS as compared to RRMS. At the same time, a decrease in magnetic susceptibility in the thalamic pulvinar was detected in patients with MS in the long term, but a sharp hyperintensity in conjunction with decreasing volume was observed in some patients.Conclusion. Increased magnetic susceptibility on the QSM in subcortical structures of the brain, reflecting iron content, is more typical for patients with SPMS, which may indicate the prognostic value of these changes.Цель исследования: изучение изменений в распределении железа в веществе головного мозга с помощью методики магнитно-резонансной томографии (МРТ) – количественного картирования восприимчивости (quantitative susceptibility mapping – QSM) – в сопоставлении с клиническими данными у пациентов с рассеянным склерозом (РС).Материал и методы. В данное проспективное исследование вошло три группы пациентов: 47 пациентов с ремиттирующим РС (РРС), 20 – с вторично-прогрессирующим РС (ВПРС) и 39 здоровых добровольцев (группа контроля). Для всех пациентов были собраны анамнестические данные и проведена МРТ головного мозга, включающая последовательность мульти-эхо 3D Т2* GRE, после чего были получены карты QSM и рассчитана относительная магнитная восприимчивость в области подкорковых структур.Результаты. Были выявлены более высокие показатели магнитной восприимчивости в скорлупе у пациентов с ВПРС по сравнению с РРС, что может отражать избыточное накопление железа в данных структурах. При этом было выявлено понижение магнитной восприимчивости в подушке таламуса у пациентов с ВПРС, однако у части пациентов отмечалось ее резкое повышение при уменьшении объема подушки таламуса.Заключение. Повышение магнитной восприимчивости на карте QSM в области подкорковых структур головного мозга, преимущественно в области скорлупы, отражающее накопление железа, а также ее снижение в области подушки таламуса, являются более характерными для пациентов с ВПРС, что может иметь прогностическую значимость в оценке прогрессирования заболевания

Intellectual decline in patients with schizophrenia with comorbid type ii diabetes mellitus and alcoholism

Comorbid conditions in general psychopathological practice need equally research in the field of psychiatry and narcology, as well as the development of issues of social practice in relation to mental patients. There is an opinion that comorbid mental pathologies are even more common than “pure” forms of diseases. In most cases of comorbid conditions, the medical community increasingly encounters clinical situations where “classic” symptoms and syndromes are deformed, mutually intertwined and, superimposed on the actual social situation of the patient, acquire an “unreal fancy character”.Schizophrenia remains one of the most urgent problems at the stage of modern psychiatry formation. Up to date there are 1.1% of men and 1.9% of women in the general population of patients. Schizophrenic spectrum disorders are often combined with a number of chronic pathologies that increase the negative impact on the neuro-cognitive sphere of a person. One of the main problems of modern urbanized society is type II diabetes and alcoholism. By increasing the negative impact on a person’s cognitive abilities, they accelerate the process of disintegration of personality and its social functioning. The intellectual level of patients with those chronic diseases that require patients to actively and consciously participate in the treatment process and social functioning can significantly affect the patient’s ability to learn, independently manage the disease, establish a high level of compliance and, as a result, the effectiveness of therapy. An attentive study of the issue of the state of intelligence of patients with comorbid pathology will lead to an improvement in the patient’s social adaptation, a more careful attitude to their somatic health and reduce the risk of disability of the able-bodied population

Анализ возможностей использования тепловых насосов при проведении вакуум-выпарной кристаллизации

The possibility of using heat pumps of the open and closed type when carrying out vacuumevaporating (adiabatic) crystallization is analysed. The influence of technological parameters on the efficiency of the use of thermal pumps is considered. Thus, areas of change of technological parameters in which it is profitable to use such heat pumps are established. It is shown that the power efficiency of using closed-type heat pumps is higher than that of open-type heat pumps when carrying out adiabatic crystallization.Проанализирована возможность использования тепловых насосов открытого и закрытого типа при проведении вакуум-выпарной кристаллизации. При этом установлены области изменения технологических параметров, в которых выгодно применять такие тепловые насосы. Показано, что при проведении рассматриваемого процесса кристаллизации энергетическая эффективность использования закрытых тепловых насосов выше, чем тепловых насосов открытого типа

Сравнительная оценка параметров безопасности на доклиническом и клиническом этапах исследования лекарственного препарата Реамберин® (ООО «НТФФ «ПОЛИСАН»)

Relevance. Interpretation of the preclinical trials data is fundamental importance. The correctness of extrapolation of data obtained from animals to humans is due to the qualitative and quantitative diversity of the systems tested the recorded parameters and approaches to their interpretation, as well as statistical methods in determining the possible risk to humans. Aim. Comparative assessment of the safety and tolerability parameters obtained during the preclinical and clinical trials of the Reamberin® (LLC «POLYSAN») and the development of approaches to improving clinical trial planning processes for assessing safety and tolerability, taking into accounts the results of preclinical studies. Materials and methods. A comparative analysis of the safety parameters that arose during a clinical study involving healthy volunteers and deviations from the control levels of clinical and laboratory parameters established at the stage of a preclinical study on outbred rats and rabbits of the chinchilla breed of a drug with an international non-proprietary name (INN): meglumine sodium succinate (trade name (TN) Reamberin® (LLC «POLYSAN»)). Results. Unidirectional deviations from normal (control) values were established. Isolated cases of adverse events among healthy volunteers (increased activity of hepatic transaminases, changes in blood pressure) were identified. This facts didn't correlate with the preclinical study. The number of comparable indicators in laboratory animals, for which statistically significant differences were established between the experimental and control groups, significantly exceeded the number of signs in the form of adverse events among healthy volunteers.Актуальность. Интерпретация данных доклинических испытаний лекарственных средств имеет принципиальное значение. Кор­ректность экстраполяции данных, полученных на животных, на человека обусловлены, в том числе, качественным и количественным разнообразием тестируемых систем, регистрируемых параметров и подходов к их интерпретации, а также статистических методов при определении возможного риска для человека.Цель. Сравнительная оценка параметров безопасности и переносимости, полученных в ходе доклинического и клинического ис­следования лекарственного препарата Реамберин® (ООО «НТФФ «ПОЛИСАН»), и выработка подходов к совершенствованию процессов планирования клинических исследований по оценке безопасности и переносимости с учётом результатов доклинических исследований.Материалы и методы. Был проведён сравнительный анализ параметров безопасности, возникших в ходе клинического исследования с участием здоровых добровольцев, и отклонений от контрольных уровней клинико-лабораторных показателей, установленных на этапе доклинического исследования на беспородных крысах и кроликах породы шиншилла лекарственного препарата с международным непатентованным наименованием (МНН) - меглюмина натрия сук­цинат (торговое наименование (ТН) Реамберин® (ООО «НТФФ «ПОЛИСАН»)).Результаты. Установлены однонаправленные отклонения от нормальных (контрольных) значений, выявленные единичные случаи нежелательные явления у добровольцев (повышение активности печёночных трансаминаз, изменения артериального давления), которые не соотносились с данными доклинического исследования. Количество сопоставляемых показателей у лабораторных животных, для которых были установлены статистически значимые различия между опытными и контрольными группами, значительно превышало численность признаков в виде НЯ у добровольцев

Temperature- and field-induced transformation of the magnetic state in Co2.5Ge0.5BO5

A tetravalent-substituted cobalt ludwigite Co2.5Ge0.5BO5 has been synthesized using the flux method. The compound undergoes two magnetic transitions: a long-range antiferromagnetic transition at TN1 = 84 K and a metamagnetic one at TN2 = 36 K. The sample-oriented magnetization measurements revealed a fully compensated magnetic moment along the a- and c-axes and an uncompensated one along the b-axis leading to high uniaxial anisotropy. A field-induced enhancement of the ferromagnetic correlations at TN2 is observed in specific heat measurements. The DFT+GGA calculation predicts the spin configuration of (↑↓↓↑) as a ground state with a magnetic moment of 1.37 μB/f.u. The strong hybridization of Ge(4s, 4p) with O (2p) orbitals resulting from the high electronegativity of Ge4+ is assumed to cause an increase in the interlayer interaction, contributing to the long-range magnetic order. The effect of two super–superexchange pathways Co2+-O-B-O-Co2+ and Co2+-O-M4-O-Co2+ on the magnetic state is discussed.This work has been financed by the Russian Foundation for Basic Research (project no. 20-02-00559). The authors acknowledge financial support from the Spanish Agencia Estatal de Investigación, through projects MAT2017-83468-R (AEI/FEDER, UE) and PID2020-115159GB-I00/AEI/10.13039/501100011033, the Aragonese project RASMIA E12_20R (co-funded by Fondo Social Europeo), and of the European Union FEDER (ES).Peer reviewe