Cognitive impairments as a universal clinical syndrome in a therapist’s practice
Author:
V.N. SHISHKOVA
Center for Speech Pathology and Neurorehabilitation, Moscow Healthcare Department, Russia
Summary:
The problem of cognitive dysfunctions in patients with somatic diseases occupies a prominent place now since they are one of the most common manifestations of organic brain lesions. The early detection of potentially cured cognitive impairments is one of the important tasks of a present-day therapist, cardiologist, endocrinologist, and family doctor as the patients with early-stage cognitive impairments constitute the majority of those who have sought medical advice. In the modern world, primary health care physicians’ actions are decisive in predicting the development of dementia since the detection of early non-dementia forms of cognitive impairments and neuroprotective therapy with mexidol in particular are frequently quite sufficient to considerably reduce the degree of the impairments and to improve the prognosis of dementia.
Keywords: cognitive impairments, dementia, mexidol.
Neuroprotection in hypertensive patients: Minimization of poor prognosis
Author:
V.N. SHISHKOVA
Center for Speech Pathology and Neurorehabilitation, Moscow
Summary:
The paper discusses approaches to optimizing pharmacotherapy in patients with hypertension associated with cerebrovascular diseases. Possible indications for neuroprotectors and a pathogenetic rationale for their mechanism of action in patients with prior cerebral stroke are detailed.
Keywords: cerebral stroke, hypertension, neuroprotection.
Neuroprotection of cerebral accidents in ambulance phase
Author:
V. L. RADUSHKEVICH, A. I. OKUNEVSKY
Voronezh State Medical University n. a. N. N. Burdenko, Voronezh, Russia
Summary:
Relevance. Neuroprotection is a required component of intensive therapy of cerebral catastrophes on pre-hospital and hospital phases of care. The purpose of the study. Identification features and the effect of neuroprotection of different cerebral accidents. Materials and methods. For determination the level of knowledge and practical skills of neuroprotection of different cerebral accidents were conduct an anonymous voluntary questioning doctors Voronezh city ambulance station. The effectiveness of the use of neuroprotection of cerebral accidents was study by special protocols in practice on Voronezh ambulance station. The results. More good theoretical training believe 75 % doctors. Using mexidolum in complex intensive therapy on the prehospital neuroprotection of cerebral accidents has expressed a positive clinical effect.
Keywords: cerebral accident, neuroprotection, ambulance.
Oxidative stress and its pharmacological correction mexidol in traumatic brain injury
Author:
N.V. GOVOROVA
State budget institution of higher professional education «Omsk State Medical Academy» of Ministry for health care of Russia, Omsk, Russia
Summary:
Abstract. Examined and treated 114 patients with isolated severe head injury at the age of 18 to 55 years. Group I included 61 patients who survived, in group II — 53 patients who died on the 3–15th day post-traumatic period. Patients I and II groups had complex intensive therapy according to existing protocols. 15 patients (subgroup I1) was prepared in the complex therapy meksidol 1200 mg per day for 7–10 days. Against the background of mexidol decreased intensity of lipid peroxidation, maintained at a sufficient level power antioxidant defense system cells, there was an earlier resolution of post-traumatic encephalopathy and recovery of consciousness. The treatment mexidol noted more favorable during the early post-traumatic period, a reduction of complications (χ2=55,4; p<0,0001) — syndrome of acute lung injury, disseminated intravascular coagulation, acute cardiovascular failure, and pneumonia.
Keywords: traumatic brain injury, oxidative stress, mexidol.
Contemporary aspects of diagnostics and treatment of post-traumatic stress disorder in patients with brain injury
Author:
M.L. CHUKHLOVINA
State Pediatric Medical Academy, St. Petersburg
Summary:
Abstract. Thirty four patients (14 females and 20 males, 18 to 44 years old) with a post-traumatic stress disorder (PTSD) after mild brain injury were under observation. To perform scoring of cognitive functions and severity of anxious state, appropriate specific scales - Mini-Mental State examination – MMSE and Covi anxiety scale were employed. Levels of patients’ recovery motivation for their own disease were assessed with a special questionnaire (Recovery Locus of Control). Cognitive functions were decreased, showing mild to moderate disorders in patients with PTSD after brain injury. The levels of motivation for recovery from own disorder proved to be significantly decreased, and an inverse correlation was found between this parameter, and a degree of anxious condition in these patients. Treatment of the patients with Mexidolum improved cognitive functions, motivation, decreased the degree of anxious condition in PTSD. The results of study argue for a necessity of early detection PTSD after mild brain injury and inclusion of modern antioxidant and antianxiety drugs into combined therapy of the disease.
Keywords: post-traumatic stress disorder, brain injury, cognitive functions, anxious condition, Mexidolum.
Rehabilitation in stroke patients
Author:
V.V. KOVALCHUK, A.O. GUSEV
Summary:
The present article is devoted to the problems of the organization and carrying out of rehabilitation in post stroke patients. The features of stroke patient’s management with the help of multidisciplinary team are discussed. Main principles and rules of physical, psychotherapeutic and medication rehabilitation are reviewed.
Keywords: rehabilitation, stroke, multidisciplinary team, physical therapy, mexidol.
Alexithymia in patients with left-hemispheric cerebral infarction in the late recovery period
Author:
N.A. ANTONOVA, E.B. KUZNETSOVA, I.I. SHOLOMOV
Razumovsky Saratov State Medical University, Saratov
Summary:
Objective. To study emotional status, including alexithymia, anxiety and depression, in patients with cerebral infarction in the area of the middle cerebral artery (on the left side) in the late recovery period and to develop a method for correction of the damage. Material and methods. The study included 30 patients with cerebral infarction in the area of the middle cerebral artery (on the left side). A comparison group consisted of 10 patients with chronic brain ischemia. Results and conclusion. The results have demonstrated the correlation between the level of alexithymia and the severity of neurological deficit, sex-related level of anxiety and depression. The cerebral infarction impacts on the level of alexithymia. Alexithymia in patients with cerebral infarction affects the adequate self-esteem of physical and mental condition that may complicate the rehabilitation of these patients and demands correction as a combination of pharmacotherapy and psychotherapeutic intervention.
Keywords: alexithymia, cerebral infarction, anxiety, depression.
Modern methods of rehabilitation for poststroke patients
Author:
I.V. SIDYAKINA, M.V. VORONOVA, P.S. SNOPKOV, T.V. SHAPOVALENKO, K.V. LYADOV
Medical Rehabilotation Center, Moscow
Summary:
The article reviews the problem of complex post stroke rehabilitation. Special attention is drawn to neurorehabilitation aspect of patient’s state, restorative treatment in the acute stage of stroke, peculiarities of working up individualized rehabilitation programs, innovations and medicament support of rehabilitation process.
Keywords: stroke, rehabilitation, technical means of rehabilitation, medication support of rehabilitation process.
Side effects of psychopharmacotherapy in patients with the syndrome of dementia and the ways of its correction
Author:
S.N. DUMA
Summary:
The purpose of the study. Analysis of side effects of treatment with neuroleptics in patients with the syndrome of dementia of Alzheimer’s type. Evaluation of the effectiveness of the correction of side effects of treatment with neuroleptics with the additional use in the treatment of ethylmethylhydroxypiridine succinate (Mexidol®). Materials and methods. The study included 150 patients with Alzheimer’s disease with behavioral and psychotic disorders. The average duration of disease was 4.8 years. The average age of patients was 79,8±3,2 years. All patients received basic anti-dementia therapy for 2,6±1,4 years. Additionally patients were getting neuroleptic therapy within 4,2 ±1,2. The analysis of the character and intensity of the newly appeared side effects was based on the complaints of the relatives who were taking care e of patients and results of neurological examination. The comparative analysis of effectiveness of dose=reduction correction of side effects of neuroleptics was performed in two groups of patients. In the main group (n=76) the therapy included of Mexidol® 5,0–10,0 ml (250–500 mg), by parenteral route, No. 10–15. In the control group (n=74) the medicine was not administered. Evaluation of the effectiveness of treatment was based on a scale of Global Clinical Impression (CGI-I) after treatment. The results and conclusion. Side effects associated with neuroleptic therapy included the following most frequent and early appearing: reversible extrapyramidal disturbances such as akathisia and parkinsonism. They disappeared with a dose reduction of the antipsychotic medicine. While choosing pharmacotherapy it’s necessary to give preference to low doses of atypical neuroleptics. Additional parenteral therapy with ethylmethylhydroxypiridine succinate (Mexidol®) 5,0–10,0 ml (250–500 mg) No. 10–15 effectively (p<0,05) provides a more rapid reduction of side effects from neuroleptic therapy.
Keywords: Alzheimer’s Disease, dementia, psychotic symptoms, antipsychotics, Mexidol®.
The efficacy of mexidol in carotid endarterectomy procedure in patients with cerebral atherosclerotic stenosis
Author:
V.I. GOLOVKIN, A.V. SVETLIKOV, A.S. SHAPOVALOV, L.O. POPOVA
North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg
Summary:
Objective - to determine the antihypoxic efficacy of mexidol in carotid endarterectomy (CE) procedure in patients with cerebral atherosclerotic stenosis using cerebral oximetry. Material and methods. Clinical/psycho/neurological monitoring was performed in 109 patients with internal carotid artery stenosis of 69±7.0% and neurological symptoms of cerebral ischemia, 2-3 degree, in pre- and postoperative periods. Cerebral oximetry was carried out perioperatively. Fifty-four patients were treated with mexidol in a dose of 1000 mg/day for 14-15 days and 55 patients did not received mexidol. Results and conclusion. The difference in initial brain oxygenation (rSO2) between the main and comparison groups was shown (60.8±5.0 and 47.29±5.5%, respectively). During operation, the degree of blood oxygenation in these groups decreased by 57% and 41%, respectively. On day 7, significant differences in the Schulte test in two groups of patients with similar neurological status were found considering efficiency of work and mental stability before and after operation. No differences were found in the comparison group. Mexidol used for antihypoxic brain protection in carotid endarterectomy of patients with cerebral atherosclerotic stenosis significantly reduces the degree of cerebral hypoxia, decreases the duration of surgery, improves neurological status of patients and performance of psychological tests in postoperative period.
Keywords: cerebral stenosis, cerebral ischemia, carotid endarterectomy, cerebral oximetry, mexidol.