PubMed Health⌕ Search

Biomedical subjects

M A Piradov

Publications and source records attributed to M A Piradov.

At least 19 recordsLinked to original sources
PubMed2001

Diphtheritic polyneuropathy: clinical analysis of severe forms.

BACKGROUND: Diphtheritic polyneuropathy (DP) is a dangerous complication of diphtheria, especially its severe forms with bulbar, respiratory tract, and circulatory disturbances. However, the clinical picture of severe forms of DP is practically unknown. OBJECTIVE: To investigate the clinical features and peculiarities of the course of severe forms of DP. PATIENTS: Thirty-two patients with severe forms of DP. RESULTS: The first symptoms of DP developed in most patients 3 to 5 weeks after the onset of diphtheria. The cranial nerves were involved in all patients, most frequently nerves IX and X (32 patients); VII (28 patients); III, IV, and VI (27 patients); and XI (27 patients). One third of the patients had quadriplegia. The remaining patients had quadripareses. Of the 32 patients, 24 underwent artificial ventilation. All patients had sensory signs, proprioceptive more often than superficial. Autonomic disturbances were observed also in all patients. Only 2 of the 32 patients died. CONCLUSIONS: A direct indication for tracheotomy and artificial ventilation in patients with DP is a decrease of the vital capacity of the lungs below the traditional 16 mL/kg body weight or the development of the paralytic closure of the larynx against the background of the increasing weakness of the respiratory muscles. Characteristic of severe forms of DP is the phenomenon of the oppositely directed change in the neurological symptoms in the second month of the disease: the restoration of the function of the cranial nerves against the background of the further increase of the motor disturbances in the extremities and trunk. Special attention and care should be taken of patients during the period of the appearance of the episodes of vascular collapses-between the fourth and seventh weeks of DP.

Adult↗
PubMed2001

[Progress in neurosciences: initiatives within the framework of the program "Brain Decade (1990-2000)"].

The paper describes basic scientific and practical results obtained in the past decade at the Research Institute of Neurology, Russian Academy of Medical Sciences, in the following areas: cerebrovascular diseases, degenerative and demyelinating diseases of the nervous system. Particular attention is paid to the development of national criteria for brain death, a concept of structural and functional levels of the vascular system, that of brain pathology in atherosclerosis and essential hypertension, rapid methods for evaluating neuronal apoptosis, a new method for diagnosing prionic diseases caused by a classical viruses, and a new method for histochemical diagnosis of the degree of reparative peripheral nerve processes in polyneuropathies and to the discovery of two new hereditary nervous system diseases, to direct DNA diagnosis of torsion dystonia, Wilson-Konovalov disease, Friedreich's disease, to the setting up of a national representative family register and DNA data bank for monogenous hereditary diseases, to the development of indications for craniocerebral bypass of cerebral vessels in multiple occlusions of great cerebral arteries and indications for programmable plasmapheresis in a number of autoimmune diseases of the nervous system, to the development of rehabilitative programmes for stabilogram biocontrol, markers of an active embologenous atherosclerotic plaque in the arteries supplying blood to the brain, etc.

Academies and Institutes↗
PubMed2000

[Pathology of the brain in Creutzfeldt-Jakob disease].

The autopsy cases of Creitsfeldt-Jacob disease (a sporadic form) are reported which were diagnosed clinically and supported by the data of biopsy and autopsy of the brain (classic triad: death of neurons, astrogliosis and spongiform degeneration of the gray substance of the cortex of brain hemispheres, preferentially), followed by clinical morphologic comparisons. The focal character of the disease was observed on the early stages of the disease, while diffuse alterations were found on the late stages.

Basal Ganglia Diseases↗
PubMed1996

[The achievements of the Institute of Neurology of the Russian Academy of Medical Sciences over 50 years].

The historical review of the main research fields of Institute of Neurology of Rus. Acad. Med. Sci. from 1945 to nowadays is presented, some of them are: the investigations of both traumatic and infectious damages to nervous system, cerebrovascular pathology (angioneurology), neurogenetics, neuroreanimatology and neurosurgery (angioneurosurgery, in particular). The peculiarities of the development of approaches mentioned above as well as of corresponding problems are described in the review.

Academies and Institutes↗
PubMed1992

[The therapy of severe forms of acute polyradiculoneuritis: corticosteroids, plasmapheresis or their combination?].

A comparative examination was made of 62 patients with acute polyradiculoneuritis using hormonal therapy (HT), plasmapheresis (PA), their combination (HTPA) and maintenance therapy (MT). All the patients were distributed into 2 groups: group A (requiring artificial ventilation of the lungs--AVL) and group B (incapable of moving). Group A consisted of subgroups HT; HTPA; PA. Group B consisted of subgroups HT; MT; PA. The hormones (prednisolone or metipred) were applied in the doses 1 mg/kg according to the regressing scheme. The duration of AVL, the rate of the recovery of walking to the distance over 5 m both with and without support appeared in group A significantly higher (by 2-2.5 times), using PA alone. The analogous results were obtained in group B. At the same time, no significant differences were discovered between subgroups HT and HTPA (group A) and HT and MT (group B). It is recommended that MT be used in severe forms of acute polyradiculoneuritis in the stage of the increment of the neurological symptomatology. The volumes should not be less than 35-40 ml plasma/kg per operation and 120-160 ml plasma/kg per treatment course. The hormones may exert a "smoothing" action on the efficacy of PA.

Acute Disease↗
PubMed1992

[Peripheral autonomic insufficiency in the Guillain-Barré syndrome].

Overall 11 patients with acute inflammatory demyelinating polyradiculoneuropathy or Guillain-Barre syndrome were examined for the status of the peripheral part of the autonomic nervous system. Methods used in the study permit estimating the status of vegetative fibers in different systems: in the cardiovascular system, in the pupil, and in sweat glands. Part of the patients were examined over time for all the vegetative and electroneuromyographic characteristics. Based on the data obtained the conclusion is made about a slow recovery of the function of vegetative fibers in the cardiovascular system. It is emphasized that the degree of vegetative fibers injury and, therefore, the gravity of the clinical manifestations and the course of vegetative polyneuropathy are determined in many respects by the degree of axon impairment.

Acute Disease↗
PubMed1991

[Mild forms of multi-infarct dementia: effectiveness of cerebrolysin].

The randomized double-blind placebo-controlled study of the effectiveness of cerebrolysin in a mild form of multi-infarct dementia was carried out. Sixty patients were divided in two equal groups differing significantly at the beginning of the study by none of the compared parameters. They received for 28 days daily drop intravenous doses of cerebrolysin (15 ml of the drug in 200 ml of a 0.85% NaCl solution: 10 ml in the morning and 5 ml in the evening) or placebo in the same amount of the solution. The control of the therapy effectiveness was instituted clinically (by means of a special scale), electroencephalographically, and using the psychological test of Arnold-Kohlmann and the test for response time. The study found a significant improvement of the memory (p-0.01), abstract thinking and time of reaction in the patients on cerebrolysin, confirmed also by the EEG-mapping. It is believed advisable to use the drug cerebrolysin in mild forms of multi-infarct dementia.

Aged↗
PubMed1990

[A comparative evaluation of the efficacy of methods of determining osmolality and middle molecules in the prognosis of the course of strokes].

The authors compare the efficacies of methods for assessing osmolality (OSM) and analysis of medium molecules (MM) in the prediction of the post-stroke period course in the first 7 days from the stroke onset. Prognostically unfavorable MM and OSM values were found, predicting the possible lethal outcome. On the whole the MM index was found 1.7 times more sensitive for this prediction than the OSM index; the possibility of predicting a lethal outcome from the MM value within the first 24 hrs was 3 times higher and within the first 48 hrs 4 times higher vs. the OSM value.

Adult↗
PubMed1990

[Endogenous toxemia in acute disorders of cerebral circulation].

Critical conditions that develop because of hypoxia of different genesis are accompanied by endogenous intoxication induced to a considerable degree by the appearance in the blood of an excess amount of medium-sized molecules (MSM). An appreciable increase of the content of MSM was demonstrated since the very first days after the brain stroke as a result of examining 100 patients who suffered brain stroke, including 83 patients during the first week of the disease and 17 patients of the reference group with a history of acute impairment of cerebral circulation which had occurred over a month before. A reverse correlation was established between the level of endogenous intoxication and the clinical status of the patients which could be observed every day during the acute disease phase. The critical level of MSM was determined in the patients' blood plasma. In the majority of cases, the attainment of the above level resulted in a lethal outcome irrespective of the pattern of acute impairment of cerebral circulation. The data obtained make it possible to recommend using the level of MSM as one of the simple and rapid quantitative methods for assessment of the patients' status gravity and monitoring of persons with acute impairment of cerebral circulation.

Acute Disease↗
PubMed1989

[Plasmapheresis and hormone therapy in severe forms of Guillain-Barré syndrome].

Patients with severe Guillain-Barre syndrome were entered into 2 groups: group I was treated with hormones alone, group II with hormones plus plasmapheresis. The results were not significantly different. In view of recognized effectiveness of plasmapheresis for treatment of the syndrome, corticosteroid addition is inappropriate.

Adolescent↗
PubMed1987

[Methods of angiography and cerebral blood flow determination in evaluating the status of the collateral circulation].

It is a known fact that the value of the cerebral blood flow (CBF) in the hemisphere where the internal carotid artery (ICA) is occluded may serve as a quantitative parameter of the collateral blood supply (CBS). Comparison of the findings obtained by cerebral panangiography (CPAG) versus inhalational studies of the CBF in 38 patients with occluded ICA has demonstrated that although CPAG is quite adequate for assessing the status of the collateral blood circulation routes, a more optimal method for evaluating the status of the CBS is measurement of the CBF since in at least half the cases CPAG yields inaccurate information about the CBS in patients with impaired cerebral blood circulation. The studied methods are not competitive but should be used in conjunction for obtaining the most complete information about the cerebral hemodynamics which is particularly important to consider in making decisions about the advisability of surgical intervention.

Adult↗
PubMed1986

[Hemodynamic risk factors of secondary brain infarcts in patients with occlusion of the internal carotid artery].

Study of the cerebral hemodynamics in 52 patients with occlusion of the internal carotid artery made it possible to ascertain the factors responsible for a bilateral decrease in the cerebral blood flow. The identification of the causes of a decreased cerebral blood supply in this pathology may contribute to timely rational treatment of patients and to reducing the risk of repeated cerebral infarction.

Adult↗
PubMed1983

[Normal values for regional cerebral blood flow using the 133Xe-inhalation method].

Using the 32-detector system and the inhalation method after W. Obrist, the authors determined normal values of the regional cerebral blood flow (RCB) in 20 healthy subjects. The method demonstrated good reproducibility which warrants its wide clinical application for RCB determination for studying the pathogenetic mechanisms of cerebral blood flow changes.

Cerebrovascular Circulation↗
PubMed1983

[Radioisotope (133Xe) inhalation method of determining regional cerebral blood flow].

The modern 133(Xe) inhalational method of regional blood flow evaluation is described first in the Soviet literature. Examples of brain blood flow studied in patients with brain vascular diseases are reviewed. The data obtained illustrate the method possibilities in diagnostical and clinical problems as well as in problems of affected brain regions blood supply and function accordance. The use of a safe method with 133(Xe) in regional brain blood supply study will help solving hemodynamic and brain function problems in health and disease.

Brain Ischemia↗