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Biomedical subjects

E I Gusev

Publications and source records attributed to E I Gusev.

At least 73 records · Page 4Linked to original sources
PubMed2001

[Barotherapy in cerebrovascular diseases].

It has been shown that the main problem of treating patients with cerebral ischemia using minimal excessive pressures is the choice of the optimum therapeutic dose. We propose a new method of treatment for cerebral vascular disorders with an application for minimum high pressure doses (< 1.1 ata with oxygen a air mixture). The aim of the present report is to summarize clinical results of this method and to estimate the mechanisms of its action. The main feature of the method described (barotherapy) is to bring external and cell respiration and recovery of oxygen autoregulation of cell respiration to normal values in patients with increased CO2 inner production. The administration of antioxidants transporting electrons on mitochondrial respiratory chain significantly improves the clinical outcome after barotherapy and leads to stabilization of lipid peroxidation.

Cerebrovascular Disorders↗
PubMed2001

[Peculiarities of depressive syndrome in patients with ischemic stroke].

42 patients with post-stroke depression were investigated in the follow-up study in different periods after stroke. Hamilton scale was used for diagnosis and evaluation of depression. In such depression moderate somato-autonomic disorders predominated. The most prominent were dissomnia, general somatic symptoms and sexual dysfunction. There was no clear dependance between degree of depression and age of patients, lesion location and severity of focal neurological deficit. Symptoms of depression greatly influenced on cognitive functions.

Adult↗
PubMed2000

[Control and assessment of the quality of professional competence among physicians and students].

The paper presents a new test method of control which permits to estimate objectively both formal knowledges of students, hospital physicians, post-graduates, physicians and their ability for logical reasoning, for determination of cause-effect relationships between separate phenomena. The list of the standards generally accepted for the test's tasks is proposed as well as recommendations for the users are given. 6 variations of the test's tasks are presented as the examples.

Education, Medical↗
PubMed2000

Clinico-immunogenetic characteristics of multiple sclerosis with optic neuritis in children.

The frequency of multiple sclerosis (MS) with clinical onset before 16 years of age in different regions of Russia fluctuates from 2 to 10% of all MS patients. One of the most frequent signs of MS manifestation and/or exacerbation at this age is optic neuritis (ON). Forty-seven children with MS were observed in Moscow. Diagnosis of MS in every case was clinically definite and proved by serial MRI. Clinico-tomographic dissociation was noticed: numerous large lesions, typical for MS on T2 images were often seen in children with mild or moderate residual neurological symptoms. All patients had relapsing/remitting MS course, mean EDSS was 2.24+/-0.26. Thirty-eight children (80%) had ON at least once, ten (21.3%) - twice or more times. In several cases ON had subclinical course or might be missed and the damage of the optic nerve with partial atrophy was found only after complex ophthalmological investigation including visual evoked potentials. Thus, the clinical course of MS and ON have some peculiarities in children and may be genetically based. Analyses of allelic polymorphisms of HLA-DR and TNF loci on chromosome 6 was performed. Data from children with MS were compared with data from their parents, healthy controls and other MS patients from the same ethnic group. Children with MS had increased frequency of DR2(15) and TNF-a11, but not TNF-a9 as adult MS patients from the same ethnic group. The presence of TNF-a7, rare in adult patients, could be proposed as a marker of early MS onset.

Adolescent↗
PubMed2000

[Comparative clinico-immuno-chemical analysis of remittent and secondary-progressive course of multiple sclerosis].

Immunochemical monitoring of remittent and secondary-progressive course of multiple sclerosis (MS) was performed. Examination of 61 patients was performed during 3 years. Inflammatory cytokines: (IL-1, IL-2, IL-6, TNF-alpha), were measured in supernatants of the peripheral blood mononuclear cells while some neurospecific proteins (GFAP and alpha 2-GP), vesicular-cellular molecules of the adhesion (sVCAM-1) were estimated in blood serum. 50 healthy donors entered the control group. The results demonstrated a remaining functional tension of cell immunity and a decrease of the resistance of hematoencephalic barrier (HEB) at all MS stages. However, in secondary-progressive MS concentration of the sVCAM-1 in blood serum was elevated as compared with the control group, patients with remittent course and in clinical improvement. It is suggested that some functional alteration of HEB endothelium, manifest in constant pathologic expression of sVCAM-1 molecule, is one of the pathochemical mechanisms promoting progression of MS process.

Adolescent↗
PubMed2000

[The possibility of the use of several clinical, genetic and MRI characteristics for the prognosis of effects of beta-interferon-1beta treatment in multiple sclerosis].

Recently, beta-interferons have become the first line medicine of pathogenic treatment of multiple sclerosis (MS). 75 MS patients from Moscow received the treatment with beta-interferon-1b (betaferon). Clinical, genetic and MRI data on 48 of them were included in detailed statistical analyses. High basic frequency of relapses, absence of atrophy of the brain at the first MRI scans and the presence of HLA-DRB1*15 (less significant DRB1*0301 and DRB1*04) were associated with better clinical effects of one year Betaferon course--decrease of relapses frequency and delay in EDSS progression.

Adjuvants, Immunologic↗
PubMed2000

[Spectrum of neuropsychological changes in multiple sclerosis].

Early disability of patients with multiple sclerosis at the able-bodied age is often caused by both a neurological disorder and the difficulties of their social and psychological adaptation that is aggravated significantly by higher cortical dysfunctions and by behavioral problems. The paper presents the results of the dynamic neuropsychological observation of 124 patients with multiple sclerosis and of their first degree relatives. Even at the early stage of the disease there were some cognitive disorders as worse transitent verbal, semantic, visual memory active attention and slower sensomotor reactions; difficulties in conceptual mentality. The cognitive functions, the activity of the disease, an actual psychological state, depression for example, and the expression of brain atrophy and the localization of the foci are bound by the certain way. The personality traits of patients and their close relatives testified a possible psychosomatic nature of this disease.

Adult↗
PubMed2000

[Modern approaches to beta-interferon application in therapy of multiple sclerosis].

Recently a disease-modifying treatment of multiple sclerosis (MS) became possible. The first choice in this kind of treatment is the use of beta-interferons. The longest history has the studies of beta-interferon-1b, which has a beneficial effect on the course of MS reducing the annual exacerbation rate and slowing the disability progression. This kind of treatment is very expensive and has only a moderate influence on the disease course, only slowing its progression, but still are widely used and causes attention all over the world. The most important question is the appropriate selection of MS patients for this kind of treatment. Numerous regional neurological community has elaborated special recommendations for the use of this treatment. These recommendations are usually base on the data of clinical trials, own experience and current financial situation (to cover the high cost of this treatment). Analyses of the last data on the mechanisms of beta-interferons treatment showed several specific and nonspecific effects. In recently published studies beta-interferon-1b was shown to slow the progression of confirmed disability in secondary progressive MS and delay the switch from relapsing/remitting to secondary progressive MS. Still the most beneficial clinical effect is seen in relapsing/remitting cases. The problem of neutralizing antibodies (NAT) and treatment of possible side effects seem now not to be so principle. Recommendations for the selection of patients with MS for treatment with beta-interferon were proposed.

Adjuvants, Immunologic↗
PubMed1999

[Neuroprotective effects of glycine in the acute period of ischemic stroke].

Both the efficiency of glycine in the acute period of hemispheric ischemic stroke and mechanisms of its action were studied in a double blind placebo-controlled trial including 200 patients. Orgogozo's and Scandinavian scales for objective assessment of the condition severity and of a degree of neurologic deficiency, and Bartel's scale--for evaluation of functional recovery were used and measurements were made of the levels of autoantibodies to the structural component of glutamate NMDA-receptors in blood serum and concentrations of neurotransmitter amino acids and of the products of lipid peroxidation in cerebrospinal fluid. Sublingual glycine application in daily dose of 1-2 g was found effective beginning with the first 6 hours of the stroke development during 5 days. Multicomponent neuroprotective action of glycine was established directed at correction of the unbalance between stimulating and inhibiting aminoacidergic neurotransmitters, as well as at a decrease of excitotoxicity and oxidant stress.

Acute Disease↗
PubMed1999

[Levels of neurotransmitter amino acids in the cerebrospinal fluid of patients with acute ischemic stroke].

The dynamics of the levels of both excitatory (aspartate, glutamate) and inhibitory (GABA, glycine) neurotransmitter amino acids was estimated in cerebrospinal fluid of 110 patients with hemispheric ischemic stroke. A significant increase of the contents of glutamate and aspartate was found beginning with the first 6 hours of the disease onset. The degree and duration of such elevation correlated with severity of the stroke. Maximal GABA and glycine levels were registered to the end of the 1st day of the stroke, that reflected delayed triggering of the protective inhibitory mechanisms. It was established that insufficiency of GABA-mediation in hemispherical location of the stroke was much responsible for both the severity of its clinical manifestations and potential of the restorative processes. Early significant biochemical criteria for objective assessment of the severity of cerebral ischemia as well as of the stroke course and outcome were defined. The most unfavourable prognostic signs were low GABA concentration (or impossibility of its evaluation) during the first days of the stroke, progredient elevation of the aspartate level until the 3d day of the disease and the severe fall of glutamate concentration (in spite of its initial increase on the 1st day).

Acute Disease↗
PubMed1999

[Clinico-immunobiochemical monitoring of factors of focal inflammation in the acute period of hemispheric ischemic stroke].

The changes of cytokinis status and C-reactive protein were evaluated in cerebrospinal fluid of 50 patients in the acute period of ischemic hemispheric stroke with consideration of influence of the remote consequences of the ischemia, established experimentally, on the mechanisms of cerebral infarction development as well as on the progression of both atherogenesis and vascular encephalopathy in the period after the stroke. Significance both of a surplus releasing of the proinflammatory cytokines and deficiency of the protective antiinflammatory and trophotropic factors in the development of an inflammatory response was established. Immunobiochemical criteria were proposed for grading of process for stroke course prediction and for recovery of the altered neurologic functions. More favourable prognosis was anticipated in the patients in which a the treatment started within of the "therapeutic window".

Acute Disease↗
PubMed1999

[Risk factors of multiple sclerosis in Moscow population. I. Exogenous risk factors].

Descriptive epidemiologic investigations revealed the necessity of the exogenous influence for the development of multiple sclerosis (MS). By means of "case-control" method the relations of MS with exogenous factors were studied. On the first stage there were analysed questionnaire data on 250 "patient-control" pairs matched by age, sex, nationality and birth in Moscow or out of it. The questionnaire was elaborated on the basis of the epidemiologic one recommended for the epidemiologic studies in the countries of South-East Europe. Significant correlations were found between MS and exogenous factors, namely: "tonsillitis at the age under 15 years" and "predominance of meat in the diet at the age under 15 years". These associations were confirmed by the data of both stratificative, discriminative analysis and logic regression. More detailed questionnaire was used on the second stage in 110 "patient-control" pairs. The second study confirmed such associations and found the most significant connection between MS and both tonsillitis at the age of 7-15 years and consumption of smoked meat. The influence of both exogenous factors were probably conditioned by permanent antigenic stimulation of the immune system in predisposed individuals.

Adult↗