[Determination of homocysteine by tandem mass spectrometry with chemical ionization].

Homocysteine (Hcy) is an intermediate of methionine metabolism. High plasma Hcy concentrations are an independent risk factor for stroke, peripheral vascular disease, deep venous thrombosis, coronary disease, and cognitive deficiency. Apparently, it is a great importance to measure Hcy levels in human blood. A new method for the quantification of Hcy by means of reversed-phase LC/atmospheric pressure chemical ionization mass spectrometry has been developed. The MRM ion transition, m/z 136.0 ® 90.0 was used for Hcy quantification. The limit of detection was 0.4 mM, quantification was performed from 1 mM to 40 mM with coefficient of determination of R2=0,997. The method was applied successfully to Hcy determination in human blood.

[Neurophysiological characteristics of treatment efficacy in late onset depression].

To reveal neurophysiological correlates of treatment efficacy of late onset depression, EEG spectral power, peak latencies of the "late" components of auditory cognitive evoked potentials, and sensorimotor reaction time have been analyzed in two groups of elderly patients, aged 53-72 years, with prolonged psychogenic depressive reaction (F43.21 by ICD-10) and with endogenous depression (F33.1 and F31.3 by ICD-10) during the treatment with antidepressants. Baseline depression severity has been associated with the EEG signs of the decreased functional state of anterior areas of the left hemisphere, and of the increased activation of the right hemisphere (especially, of its temporal regions). The pronounced improvement of clinical condition of patients after psychopharmacotherapy with antidepressants led to the decrease of peak latencies of the "late" components (Р2, N2 и Р3) of auditory cognitive evoked potentials, and to the acceleration of sensorimotor reaction time that have been associated with the EEG signs of the improvement of the functional state of posterior brain areas, and of the facilitation of inhibitory processes in the right hemisphere (especially, in its frontal, central and temporal regions), and of the more pronounced activation of frontal areas of the left hemisphere. The results are in line with the views on systemic character of brain functioning impairment in depression, as well as on the preferential role of the left hemisphere in the control of positive emotions, and of the right hemisphere role in the control of negative emotions as well as in the pathogenesis of depression.

[Use of tianeptine (coaxil) in the treatment of late-life depression]. / Ispol'zovanie tianeptina (koaksila) pri lechenii pozdnikh depressii.

Efficacy and safety of tianeptine (coaxil) for treatment of depressions in old age were studied in 15 depressed patients at the age of 54-78 years meeting ICD-10 criteria for depressive episode. Open method with a set of rating scales was employed. After the 28-day treatment relief of depressive symptoms was registered by all the scales since the therapy day 7. The degree of improvement on HAMD-scale was 50%, amount of responders--60%. The improvement of cognitive functions by the end of therapy was noted. Clinical predictors of Coaxil efficacy were determined by means of correlation and factor analyses. Relationship between the therapy efficacy and severity of some symptoms in the structure of depression were analyzed. The greatest efficacy of Coaxil was found in depression with prevalence of asthenic and somatovegetative symptoms, in patients with mild anxiety opposite the decrease of the effect in those with severe agitated depressions. The analysis of both frequency and severity of the side-effects has shown good tolerance to Coaxil. The adverse effects manifested with mild gastrointestinal disturbances and drowsiness during daytime.

[Specific features of cellular immunity of pulmonary tuberculosis in patients with diabetes mellitus]. / Osobennosti kletochnogo immuniteta pri tuberkuleze legkikh u bol'nykh sakharnym diabetom.

The parameters of cellular immunity were studied in 64 patients with pulmonary tuberculous developed in the presence of type 1 diabetes mellitus and compared with those in 36 patients with pulmonary tuberculosis alone. Patients with concomitant abnormalities showed higher depression of cellular immunity appeared as fewer T lymphocytes and their decreased capacity for blast-cell transformation than those with tuberculosis alone. Immunological parameters became normal only due to complex chemo- and immunotherapies (with T-activin). In addition, treatment outcomes improve and more rapid and frequent abacillation occurs. The development of tuberculosis in patients with diabetes mellitus is an additional indication for immunostimulant therapy with T-activin.

[Cognitive disorders in the structure of endogenous depression in old age]. / Kognitivnye narusheniia v strukture éndogennykh depressii pozdnego vozrasta.

31 aged inpatients (60-88 years) with major depressive episode (DSM-III-R) have been investigated in order to study the dynamics and reversion of cognitive disorders in late depression and their relation to the course and outcome of depressive phases. The dynamic evaluation was achieved by 4-times testing with HAM-D and MMSE within the phase. All patients had some cognitive disfunction at the crucial of the phase, which in most cases (90.3%) was completely reversible during the therapy. It was found that cognitive disorders were partly associated with depression and where party related to the aging processes. The degree of cognitive impairments at the crucial stage of the phase depended upon the severity (t = 0.73; p < 0.001) and complexity (t = 0.71; p < 0.001) of the depressive syndrome. It also correlated with the duration of active therapy (t = 0.53; p < 0.005) and quality of the following remission (t = 0.48; p < 0.01). The dynamic assessment of the cognitive disorders may be used for the differentiation of pure depression from the states with the beginning degenerative disease, for the prediction of the course and outcome of depression and response to the therapy.

[Clinical symptoms and course of pulmonary tuberculosis in patients with various types of diabetes mellitus]. / Osobennosti klinicheskoi simptomatiki i techeniia tuberculëza lëgkikh u bolnykh s raznymi tipami sakharnogo diabeta.

Clinical symptoms and progress of pulmonary tuberculosis (PT) were compared for 110 patients with insulin-dependent diabetes mellitus (IDDM) and 40 patients with non-insulin-dependent diabetes mellitus (NIDDM). PT in IDDM patients is characterized with acute onset and manifest clinical symptoms. The lung involvement becomes rapidly advanced with exudation and multiple small-size foci of destruction. PT in NIDDM runs often asymptomatically and torpidly, specific changes in the lungs seem limited, foci of destruction are solitary and large. More favourable course and outcomes of the disease are registered in IDDM patients which can be related to younger age and early diagnosis of PT.

[Clinical aspects of pulmonary tuberculosis in patients with borderline disorders of carbohydrate metabolism]. / Osobennosti kliniki i techeniia tuberkulëza lëgkikh u bolnykh s pogranichnymi narusheniiami uglevodnogo obmena.

Clinical symptoms and running of tuberculosis of the lungs were compared for matched patients with the presence of borderline disturbances of carbohydrate metabolism (group 1) or their absence (group 2). Group 1 patients were distinguished for more acute onset, severe intoxication, rapid development of advanced bilateral lesions with multiple destructions. Side effects in group 1 were more frequent and chemotherapy results worse than in control group 2. It is emphasized that derangements of carbohydrate metabolism should be verified to make adequate corrections in treatment programs of tuberculosis.

[Interhemispheric correlations of electric activity of the brain in late depression]. / Mezhpolusharnye sootnosheniia élektricheskoi aktivnosti mozga pri pozdnikh depressiiakh.

A chronometric EEG analysis was made in 60 patients aged 50 to 86 years with affective psychosis in different stages of the depressive phase. It has been demonstrated that the development of depressive conditions gives rise not only to changes in the frequency and amplitude characteristics of the EEG but also in the ratios of interhemispheric asymmetry of the parameters of brain electric activity, attesting to a higher tone of the right hemisphere. This interhemispheric asymmetry was determined to a considerable measure by the presence in the reference EEG of generalized discharges of slow-wave activity. The use of the dipolar analysis of the EEG permitted detecting foci of maximum generation of discharges in the left temporal area and brain stem structures. These areas of generation were preserved after removing the depressive symptomatology with antidepressants. It is suggested that the superstem generators of discharges exert a more appreciable effect on right hemisphere function, which is specified by cortico-diencephalic relations.

[Comparative age-related studies of mono- and bipolar forms of late affective psychoses]. / Sravnitel'no-vozrastnoe issledovanie mono- i bipoliarnykh form techeniia pozdnykh affektivnykh psikhozov.

As many as 38 patients with the bipolar and 70 patients with the monopolar types of affective psychosis manifesting at an age over 45 years were examined. A comparative age-associated examination of the given patients has demonstrated that the differences in the clinical characteristics and regularities of the mono- and bipolar disease forms are age-restricted and can be elucidated more frequently in the involutional period (from 45 to 59 years). In the senile age proper (after 60 years) there is a tendency towards approximation of both the types of late affective psychosis in terms of their main clinical parameters.

[Clinical characteristics of late manifestations of recurrent depressive psychoses]. / Klinicheskie osobennosti pozdno manifestiruiushchego rekurrent- nogo depressivnogo psikhoza.

A total of 70 patients with recurrent depression manifested at the age over 45 were under investigation. Major clinical types of depressions were: adynamic, anxious, senesto-hypochondric, combined depressive-paranoic, endoreactive. Major types of the course of these disorders were: stereotype phases (cliché type), and polymorphic endogenous episodes. The impact of ageing factor increased with age, hence the modification of depressive phases, and changed interrelations of the types in different age periods, increased recurrence rates, shortened remissions and their worsening due to persisting residual depression.