The features of reproductive health in women with multiple sclerosis

Introduction. The incidence of multiple sclerosis (MS) is two times higher in women, and the debut of the disease falls on young reproductive age, which makes the problem urgent. Purpose: to assess the characteristics of the reproductive health of women with MS in different age periods. Material and methods. A prospective study was carried out in parallel groups and a case-control study of women of early and late reproductive age with a reliable diagnosis of MS. Results. During pregnancy, there was a significant decrease in the frequency of exacerbations of MS in comparison with the pre-gravity period; voluntary infertility and childlessness is registered in 21.3 % and 32 % of women, respectively. An increase in the concentration of follicle stimulating hormone (FSH) means an increase in the degree of disability on the Expanded Disability Status Scale (EDSS) and the duration of the disease. The decrease in the concentration of dehydroepiandrosterone sulfate (DHEA-S) corresponds to a higher degree of disability on the EDSS scale and the duration of the disease. Conclusion. Pregnancy has a protective effect on the clinical course of MS. Infertility in most cases is voluntary, but at the same time hypergonadotropic condition and hypoandrogenia are observed in women with MS already in the early reproductive age, which interferes with the steroid synthetic function of the ovaries and can cause impaired fertility

Comparative analysis of clinical and electroneuromyographic indicators in patients with secondary polyneuropathy

Analysis of clinical and electroneuromyographic performance of two groups of patients with secondary polyneuropathy showed that diabetic neuropathy affects the peripheral nerves of the lower extremities, whereas in polyneuropathy of mixed etiology (paraneoplastic and toxic) in the pathological process involved both nerve fibers, the low and upper extremities

Эпидемиологические показатели инсультов в г. Северске Томской области

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Clinical evaluation of different treatment strategies for motor recovery in poststroke rehabilitation during the first 90 days

Background: Motor recovery after stroke is based on neuronal plasticity and the structural reorganization of the brain. Questions are debated about the proper moment to start rehabilitation in the acute period of stroke, the significance of rehabilitation interventions during the so-called “plastic window”, and the advantages of modern and traditional programs. The aims of this study were to evaluate the role of different rehabilitation strategies and their combinations for motor recovery and the impact on functional disability by way of neurological and functional outcomes 3 months after ischemic stroke. Methods: We used three rehabilitation approaches: early rehabilitation from the first day of stroke (Phase I), traditional exercise programs (Phase II), and an author’s new method of biofeedback rehabilitation using motion sensors and augmented reality (AR) rehabilitation (Phase III). Clinical and functional outcomes were measured on the 90th day after stroke. We developed algorithms for quantifying the quality of movements during the execution of tasks in the motor domains of the AR rehabilitation program. Results: Phase I of rehabilitation led to an improvement in functional independence, and the recovery of motor functions of the extremities with an absence of mortality and clinical deterioration. AR rehabilitation led to significant improvement both with respect to clinical and functional scores on scales and to variables reflecting the quality of movements. Patients who were actively treated during Phases II and III achieved the same final level of motor recovery and functional outcomes as that of participants who had only received AR rehabilitation during Phase III. Patients who underwent outpatient observation after Phase I showed a deficit of spontaneous motor recovery on the 90th day after stroke. Conclusions: Early rehabilitation was successful but was not enough; rehabilitation programs should be carried out throughout the entire “sensitive period” of poststroke plasticity. The newly developed AR biofeedback motion training is effective and safe as a separate rehabilitation method in the early recovery period of moderately severe, hemiparalytic, and ischemic stroke. These two rehabilitation approaches must be applied together or after each other, not instead of each other, as shown in clinical practice

ТОМСКАЯ НАУЧНАЯ ШКОЛА НЕВРОЛОГОВ. К 120-ЛЕТИЮ КАФЕДРЫ НЕВРОЛОГИИ И НЕЙРОХИРУРГИИ СИБИРСКОГО ГОСУДАРСТВЕННОГО МЕДИЦИНСКОГО УНИВЕРСИТЕТА

The history of the development of the Tomsk Scientific School Neurologists and the past and current events in the Department of Neurology and Neurosurgery of Siberian State Medical University are described. The Department of Neurology was established in 1881–1882. At a different times the department was headed by many great Russian physicians such as Michail G. Kurlov, Leonid I. Omorokov, Nikolay V. Schubin, Nikolay I. Komandenko. In addition to the academic work the department leads research in many fields of neurology, including movement disorders, cerebrovascular diseases, demyelinating and paroxysmal diseases. Описаны история развития томской научной школы неврологов, прошлое и настоящее кафедры неврологии и нейрохирургии Сибирского государственного медицинского университета. Кафедра неврологии была организована в 1881–1882 гг. В разное время ее возглавляли такие выдающиеся российские врачи, как Михаил Георгиевич Курлов, Леонид Иванович Омороков, Николай Васильевич Шубин, Николай Иванович Команденко. Кроме академической работы сотрудники кафедры ведут научные исследования по многим направлениям неврологии, включая двигательные расстройства, сосудистые поражения головного мозга, пароксизмальные состояния и демиелинизирующие заболевания.

Организация детской эпилептологической службы в Томской области

This article shows the analysis of working of the child epileptological room for 2002—2007. The goals of the room are determinate, the groups of the children, examined in the room and being registrating, are selected. Learning the example of 650 children with epilepsy, who are registrating, we found out the domination of focal symptomatic or probably symptomatic form (62,2%). Idiopathic generalized epilepsies made 13,3% with predominance of child absence epilepsies — 39,8%. Epileptic encephalopathy made 3,46% with predominance of West syndrome — 64,3%. In treatment monotherapy were used in 75% of cases, the polytherapy took 25%.В статье проведен анализ работы детского эпилептологического кабинета за 2002-2007 гг. Определены задачи кабинета, выделены группы детей, находящихся на учете в кабинете. На примере 650 больных эпилепсией детей, состоящих на учете, показано преобладание фокальных симптоматических или вероятно симптоматических форм (62,2%). Идиопатические генерализованные эпилепсии составили 13,3% с преобладанием детской абсансной эпилепсии - 39,8%. Эпилептические энцефалопатии составили 3,46% от числа всех эпилепсий с преобладанием синдрома Веста - 64,3%. В лечении монотерапия использовалась в 75% случаях, на политерапии находились 25% детей

Современное состояние последипломного образования в Сибирском государственном медицинском университете

In the article the modern situation of the post degree courses of the medical workers in the Siberian State Medical University are presented, also the problems of the post degree medical education and the achievements of SSMU in this sphere of this activity are considered and pointed out.Представлено современное состояние последипломной подготовки работников здравоохранения в Сибирском государственном медицинском университете, рассмотрены проблемы медицинского образования, отмечены достижения СГМУ в данной сфере деятельности

НОВЫЕ МЕТОДЫ ДИАГНОСТИКИ ДИАБЕТИЧЕСКОЙ НЕВРОПАТИИ

Diabetic neuropathy is the most common complications of diabetes and is a leading cause of disability of patients. According to epidemiological studies, depending on the methods of examination frequency of diabetic neuropathy among the patients ranged from 5 to 100%. The disease significantly reduces the quality of life of patients and is one of the major risk factors for foot ulcers, burns, frostbite, gangrene and diabetic foot syndrome.The main objective of this publication – to make a review of the literature in recent years to a wider circle of local doctors with the most modern methods of early diagnosis of diabetic neuropathy.Диабетическая невропатия относится к наиболее распространенным осложнениям сахарного диабета и является одной из главных причин инвалидизации больных. По данным эпидемиологических исследований, в зависимости от используемых методов обследования частота развития диабетической невропатии среди больных варьирует от 5 до 100%. Данное заболевание значительно снижает качество жизни больных и является одним из основных факторов риска развития язвенных дефектов стоп, гангрены и развития синдрома диабетической стопы.Представлен обзор научных публикаций последних лет для ознакомления широкого круга отечественных врачей с наиболее информативными современными методами ранней диагностики диабетической невропатии

Сопоставление данных МРТ-исследования головного мозга при рассеянном склерозе и системной красной волчанке

It appears that sometimes it is difficult to perform differential diagnostics of multiple sclerosis and autoimmune illness. 29 patients were surveyed with lupus erythematosus and 29 patients hue suffer from multiple sclerosis. Here are presented our own results of magnetic resonance imaging of the brain of there patients. It is discovered that existence of nidus of T2 signal increase doesn’t appear to be a specific sign.В ряде случаев возникают трудности при дифференциальной диагностике рассеянного склероза и аутоиммунных заболеваний. Обследовано 29 больных с системной красной волчанкой и 29 больных, страдающих рассеянным склерозом. Приведены собственные данные магнитно-резонансных исследований головного мозга у этих больных. Установлено, что наличие очагов усиления Т2-сигнала не является специфическим признаком