[Structural-functional approach to chronic cerebral ischemia in elderly people.]

The aim of the study - experience in implementing a structural-functional approach to chronic brain ischemia (CCI) in elderly people by combining simultaneously produced measurements. Object of research - elderly patients with CCI 1 stage. As a result of the study, the methodological experience of the system study of CCI from the standpoint of the structural and functional approach in the elderly is shown. Thus, it has been demonstrated that the progression of chronic cerebral-dygemical morphological changes in the form of periventricular and subcortical leukoaareosis (according to magnetic resonance imaging) correlates with the degree of expression of cognitive dysfunction syndrome (according to the brief indicative test). Hyperhomocysteinemia are typical for patients with CCI 1 stage, what correlates with mild cognitive dysfunction. The identified biochemical, neuroimaging, neuropsychological correlates should be taken into account during medical and psychological rehabilitation of these people.

[Biopsychosocial concept of the chronic ischemia of the brain in elderly.]

The aim of the study was to optimize the strategies of diagnosis and treatment of chronic cerebral ischemia (CCI) in the elderly by using a multidimensional integrated approach in determining the role of biological, individual psychological and social factors in the occurrence and course of the disease. The object of study - patients with CCI. As a result of the study, a methodology for systematic research of CCI was developed for the first time. It promotes an understanding of not only psychosomatic and somatopsychic relationships, but also mechanisms of an individual's adaptation to the disease and optimization of the patient's quality of life. The author proposes a diagnostic and treatment diagnostic algorithm for elderly people with CCI, which can be used to build comprehensive programs for the primary prevention of stroke in the population scale. The idea was expressed about the correspondence of the stages of dyscirculatory encephalopathy (neurological manifestations of the disease) and the variants of the course of the psychoorganic syndrome, reflecting the severity of cerebral dyshemia and impaired cognitive status.

[Modeling of an influence of indicators of social stress on demographic processes in regions of the Russian Federation]. / Modelirovanie vliianiia indikatorov sotsial'nogo stressa na demograficheskie protsessy v regionakh Rossiiskoi Federatsii.

AIM: To assess an impact of indicators of social stress on demographic processes in regions of the Russian Federation using statistical methods. MATERIAL AND METHODS: The data of Rosstat «Regions of Russia¼ and «Health care in Russia¼ were used as information base. Indicators of about 80 subjects of the Russian Federation (without autonomous areas) for the ten-year period (2005-2014) have been created in the form of the database consisting of the following blocks: medico-demographic situation, level of economic development of the territory and wellbeing of the population, development of social infrastructure, ecological and climatic conditions, scientific researches and innovations. In total, there were about 70 indicators. Panel data for 80 regions of Russia in 10 years, which combine both indicators of spatial type (cross-section data), and information on temporary ranks (time-series data), were used. Various models of regression according to the panel data have been realized: the integrated model of regression (pooled model), regression model with the fixed effects (fixed effect model), regression model with random effects (random effect model). RESULTS AND CONCLUSION: Main demographic indicators (life expectancy, birth rate, mortality from the external reasons) are to a great extent connected with socio-economic factors. Social tension (social stress) caused by transition to market economy plays an important role. The integral assessment of the impact of the average per capita monetary income, incidence of alcoholism and alcoholic psychoses, criminality, sales volume of alcoholic beverages per capita and marriage relations on demographic indicators is presented. Results of modeling allow to define the priority directions in the field of development of mental health and psychotherapeutic services in the regions of the Russian Federation.

[Clinical and pathologic aspects of the impairment of cerebral blood flow in atherosclerotic carotid stenosis]. / Kliniko-patogeneticheskie aspekty rannikh narushenii mozgovogo krovoobrashcheniia pri stenoze sonnykh arterii ateroskleroticheskogo geneza.

Based on clinical and neurophysiological investigations, triplex scanning of the carotid arteries the authors make a conclusion that early clinical forms of the ischemic diseases of the brain (IDB) in hemodynamically significant atherostenosis of the carotid arteries are characterized by certain neuropsychological and neurological complexes of symptoms dependent on the impairments of blood flow at the main and regional levels. The leading role of hypoperfusion was shown in the development of early forms of the cerebral blood flow impairments in patients with IDB. A significantly increased number of atherosclerotic plaques was shown with the increasing degree of carotid artery stenosis. Specific alterations of the central hemodynamics were determined in early impairments of the cerebral circulation against the background of atherosclerotic stenosing lesion of BCA. A complex comparative investigation of these parameters at the pre- and postoperative stages (after carotid endarterectomy) has shown a practically complete regress of hemodynamic impairments and clinical manifestations of ischemia of brain structures. According to the investigations performed, the timely correction of hemodynamically significant atherostenoses of carotid arteries during revascularization of the brain in such patients allows to carry out primary prophylactics of acute impairments of cerebral blood flow and to increase effectiveness of the treatment.

[Dynamics of higher mental functions in surgical therapy of internal carotid artery stenosis]. / Dinamika vysshikh psikhicheskikh funktsii pri khirurgicheskom lecheniia stenoza vnutrennei sonnoi arterii.

To reveal typical changes of higher mental functions in patients with atherosclerotic lesion of internal carotid artery and to estimate influence of operative and non-operative treatment of carotid stenosis upon cognitive function. 42 patients who had undergone carotid endarterectomy (CEA) due to high grade carotid stenosis, and 31 patients treated conservatively were examined. A battery of neuropsychological tests was used to evaluate a state of higher mental functions. The neuropsychological syndrome in patients with carotid stenosis manifests with impairment of verbal and visuospatial memory, attention, disorders of impressive speech and constructive praxis. The degree of cognitive impairment was most severe in patients with bilateral stenosis. CEA performed at early stages of cerebral ischaemia has beneficial effect on cognitive functions. Non-operative treatment and late CEA do not prevent further cognitive decline in patients with carotid stenosis.

[The problem of representiveness in epidemiological research in psychiatry]. / Problema reprezentativnosti pri épidemiologicheskikh isslevovaniiakh v psikhiatrii.

A group of schizophrenic patients registered by the city psychoneurological center (Petrozavodsk) is compared to a standard sample. It is shown that there is a possibility of defining to what extent the test group differs from the representative one and by what the differences are determined. In accordance with this, the limits of the use of the research data are outlined.

[Prognosis in the social and occupational adaptation of patients with slowly progressive schizophrenia]. / Prognoz sotsial'no-trudovoi adaptatsii bol'nykh maloprogredientnoi shizofreniei.

A series of 190 patients with slowly progressive schizophrenia have been examined with the aim of studying the prognosis of their social and occupational adaptation. The authors have analyzed the dynamics of the mental status and adaptation over years. Criteria of the prognosis of social and occupational adaptation have been identified. The adaptive behaviour and prognosis in patients with slowly progressive schizophrenia have been found to depend on the type of the personality abnormality in the premorbid period, age at the disease onset, its pattern, and clinical characteristics of the active period of the disease.