RESUMEN
The literature review presents approaches to the management of patients with vestibular disorders. The principles of organization of vestibular rehabilitation in peripheral vestibular hypofunction, indications for appointment, factors influencing its implementation, technique, methods of evaluating effectiveness are considered in detail. Attention is drawn to the fact that the selection of exercises and the duration of vestibular rehabilitation is carried out individually and depends on many factors, including the nature of vestibular deficiency and the specific characteristics of the patient. The possibilities of using additional pharmacological therapy with histamine preparations, which can accelerate the onset of vestibular compensation, are shown. It is noted that vestibular rehabilitation is a safe and effective method of treating peripheral vestibular hypofunction and should be recommended to patients of all ages with vestibular disorders leading to limited social and physical activity.
Asunto(s)
Enfermedades Vestibulares , Vestíbulo del Laberinto , Humanos , Consenso , Enfermedades Vestibulares/tratamiento farmacológico , Terapia por Ejercicio/métodos , Histamina/uso terapéuticoRESUMEN
Aim Improvement of quality of life is one of the most important goals for the treatment of patients with chronic heart failure (CHF). This study searched for ways to increase the efficiency of CHF treatment based on parameters of quality of life in CHF patients during and after the treatment with exogenous phosphocreatine (EP).Material and methods The effect of a single course of EP treatment on quality of life of patients with functional class (FC) II-IV CHF with reduced or mid-range left ventricular ejection fraction was studied as a part of the all-Russia prospective observational study BYHEART. The presence of FC II-IV CHF and a left ventricular ejection fraction <50â% were confirmed by results of 6-min walk test (6MWT) and findings of echocardiography after stabilization of the background therapy.Results An interim data analysis showed that the course of EP treatment was associated with a significant improvement of quality-of-life indexes as determined by the Minnesota Living with Heart Failure Questionnaire (LHFQ) total score. These indexes significantly increased and remained at a satisfactory level for 6 mos. following completion of the treatment course. Also, the treatment significantly beneficially influenced the clinical condition of patients (heart failure severity scale), results of 6MWT, and the increase in left ventricular ejection fraction.Conclusion The conclusions based on results of the interim analysis should be confirmed by results of the completed study. Complete results are planned to be published in 2022.
Asunto(s)
Insuficiencia Cardíaca , Calidad de Vida , Enfermedad Crónica , Insuficiencia Cardíaca/tratamiento farmacológico , Humanos , Fosfocreatina , Volumen Sistólico , Función Ventricular IzquierdaRESUMEN
The prevalence of subclinical hypothyroidism (SH) is large and according to various studies is from 3 to 21%. In the Russian Federation to date, there are no major epidemiological studies assessing the functional state of the thyroid gland. It seems relevant to study the TSH level in patients who turned to the clinical units of a large hospital in the North-West region to determine the prevalence of thyroid dysfunction in patients of different sex and age. 5,303 patients were examined, who applied to the I.P. Pavlov SPbSMU clinics for 2017. In all patients the level of TSH and free T4 was determined. SH was considered to increase the level of TSH more than 4.0 mIU/l at a normal level of free T4. Patients were divided into groups by age and TSH level in accordance with existing recommendations. Among the examined patients were 29.26% of men and 70.73% of women. The mean age was 55.08 ± 17.07 years. The TSH level had an abnormal distribution and averaged 2.77 mIU/l (TSH median 1.73 mIU/l). In women the level of TSH was significantly higher in all studied groups of patients (p = 0.0001). Among women, significant differences in the level of TSH between the elderly and young patients (p = 0.015) were found. The incidence of SH in the total group of patients was 10.1%. In the men surveyed, the incidence of SH was 7.3%, and in the female group - 11.3%. In the elderly patients, the incidence of subclinical hypothyroidism in women was 2 times higher than that of men. In most cases (77.4%) in patients with SH, the TSH level was in the range of 4.0-6.9 mIU / L. The clinical significance of minimal thyroid insufficiency requires further study.
Asunto(s)
Hipotiroidismo/diagnóstico , Tirotropina/sangre , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Federación de Rusia , Pruebas de Función de la TiroidesRESUMEN
Preclinical studies are studies using experimental models of stroke in animals as well as on neurons, cell neuronal cultures and surviving brain slices. They directed both towards testing the efficacy and evaluation of the mechanisms of action of drugs, and the study of the mechanisms of ischemic damage to search for new targets for stroke treatment. This article shows the basic principles of the organization and planning of animal models of ischemic stroke. Modeling of cerebral ischemia on the different models and animal species, the modern principles of assessment of brain damage are considered as well.
Asunto(s)
Isquemia Encefálica , Infarto Cerebral , Accidente Cerebrovascular , Animales , Modelos Animales de Enfermedad , NeuronasRESUMEN
The results of application of the fluorescent antibodies method (MFA) with the diagnostic purpose of detecting pox antigen in specimens from smallpox patients are presented, The method was found highly effective for the examination of material taken directly from the patients (smears) in the early stages of disease (maculo-papular and vesicular). The results of examination of smears from pustular fluid and scabs were not reliable in 44% of cases due to the presence of nonspecific fluorescence of tissue fragments and leukocytes. The technique of preliminary accumulation of the virus in a sensitive cell culture made the MFA suitable for the examination of material taken at any stage of disease. Results of the assessment of sensitivity of MFA in comparison with other methods of rapid diagnosis of smallpox are presented.