[Cognitive and psychoemotional changes in menopausal transition: The possibility of medical correction].

The increasing of older age group in the population determines studying of age related diseases and emergence of new investigations in this area. In Female body, entering the menopausal transition is the start of «aging¼ of reproductive function and linked with decreasing of sex hormons levels. A direct connection between changes of estrogen, progesterone, androgen ratios and cognitive function of women was revealed. The anatomical localization of sex hormone receptors, the mechanisms of interaction of hormones with these receptors determine the ways of implementing biological effects of steroids on the CNS. Modern theories of «healthy nerve cells¼ and «eu-estrogenemia¼ explains the role of additional criteria, such as the absence of neurological diseases history and the duration of hypoestrogenia, to the outcome of menopausal hormone therapy. Additional factors that can affect to MHT action include: the composition of hormone therapy, administration methods, regimens (cyclic, continuous), duration of treatment, history of endocrine diseases, diabetes mellitus, gynecological history (parity, menarche age, COC use), heredity. The sections present the effect of menopausal transition on the development of depression, mood changes, sleep disturbances and mental disabilities. The explanation of negative effects of menopausal hormone therapy to cognitive health is also described by modern point of view. The ambivalent opinions of researchers, the potential of new reading of the results of earlier studies, confirms the necessity of continuing study of this topic.

[Guillain-Barre syndrome associated with COVID-19]. / Sindrom Giiena­Barre, assotsiirovannyi s COVID-19.

This paper reports two cases of Guillain-Barre syndrome associated with coronavirus infection COVID-19. The clinical symptoms and neurological status of patients, the data of the additional examination and the features of the prescribed therapy are described in detail. The issue of the tropicity of the SARS-CoV-2 virus to human nervous tissue and its possible ways of affecting the peripheral nervous system is discussed.

[Therapy of moderate cognitive impairment and asthenia in patients with cerebrovascular pathology: results of a prospective observational study]. / Terapiya umerennykh kognitivnykh narushenii i astenii u patsientov s tserebrovaskulyarnoi patologiei: rezul'taty mnogotsentrovoi otkrytoi prospektivnoi nablyudatel'noi programmy.

OBJECTIVE: Obtaining additional data on the efficacy and safety of the drug Prospekta in the treatment of moderate cognitive impairment (MCI) and asthenia in patients with cerebrovascular disease (CVD). MATERIAL AND METHODS: A prospective observational study in more than 40 Russian cities enrolled 232 patients (mean age 61.5±10.0 years) with mild cognitive impairment (MCI), asthenia on ongoing basic nootropic therapy. The presence of MCI was confirmed by the Montreal Cognitive Assessment Scale (MoCA), asthenia - by 10-point Visual Analog Scale (VAS). All patients were prescribed the nootropic medication Prospekta 2 tablets 2 times a day for 8 weeks in addition to the therapy they received. Ultrasound Doppler sonography of the main arteries of the head and magnetic resonance imaging (MRI) of the brain were also assessed. At the end of treatment, the Clinical Global Impression Efficacy Index (CGI-EI) was assessed and the safety of the treatment was evaluated. RESULTS: The baseline severity of cognitive impairment according to the MoCA scale was 21.6 points, severity of asthenia according to the VAS was 6.3 points. According to Doppler flowmetry findings, hemodynamically significant stenosis was revealed in 105 (49.3%) patients, and narrowing of the main vessels without changes in hemodynamic parameters was revealed in 108 (50.7%) patients. According to MRI results, single vascular lesions in the brain matter were detected in 102 (44.0%) patients. The medications with nootropic effect were administered to 144 (62.1%) patients. A positive therapeutic response as improvement of cognitive functions was seen in 93.3% of patients after 8 weeks of taking Prospekta, including 39.4% of patients who had cognitive functions restored to the normal level. No side effects were registered during the observational study. CONCLUSIONS: The nootropic medication Prospekta is effective and safe in treatment of MCI in patients with asthenia with CVD, and improves cognitive function in patients with asthenia with CVD, both in monotherapy and in combination with other nootropic agents.

[Rehabilitation of patients with chronic low back pain]. / Reabilitatsiya patsientov s khronicheskoi bol'yu v nizhnei chasti spiny.

Low back pain occupies one of the leading places among pain syndromes and is an urgent medical, social, and economic problem of our time. A review of modern domestic and foreign literature data on the features of diagnosis, treatment and rehabilitation of chronic dorsalgia in patients with comorbid pathology was carried out. The article reflects the main etiological factors, describes the types of back pain: non-specific (musculoskeletal), radiculopathy, pain associated with potentially dangerous diseases, in addition, issues of the pathogenesis of pain syndromes are highlighted with an indication of nociceptive, neuropathic, psychogenic components. The most common comorbidity in patients with chronic pain in the lower back is characterized. Diagnostic algorithms for the problem under study, measures of drug and non-drug therapy, the possibility of practicing yoga for chronic lower back pain from the standpoint of evidence-based medicine are considered. It was stated that the treatment of chronic pain in the lower back should be individual, with an impact on different links in the pathogenesis of the pathological process. At the same time, the practice of yoga allows you to comprehensively influence the body at various levels: physical, psychological, mental. However, further research is required in this area.

[Study of the efficacy and safety of sequential use of the drugs Mexidol and Mexidol FORTE 250 in the treatment of stroke]. / Issledovanie effektivnosti i bezopasnosti posledovatel'nogo primeneniya preparatov Meksidol i Meksidol Forte 250 pri lechenii bol'nykh s ostrym ishemicheskim insul'tom.

OBJECTIVE: To evaluate the effect of Mexidol on the recovery of cognitive functions in patients after ischemic stroke (IS). MATERIAL AND METHODS: We examined 70 patients with acute IS, who were randomized into 2 groups by random sampling; The 1st group consisted of patients who, against the background of the main standard therapy for 14 days, received Mexidol intravenously, 500 mg 1 time per day, followed by oral administration of Mexidol FORTE 250, 750 mg per day for 60 days (40 patients; 28 men, 12 women). Group 2 consisted of 30 patients (21 men, 9 women) who received only standard therapy. RESULTS: Baseline scores on the MoCA and MMSE scales did not differ between the two groups. Retesting showed that the improvement on these scales was statistically more significant in the 1st group. The analysis of indicators of the evoked potential P300 confirmed a more pronounced positive trend in the 1st group (p<0.01). CONCLUSION: The use of sequential therapy with Mexidol is accompanied by a more complete recovery of cognitive functions in patients who have undergone IS.

[Cytoflavin in the complex therapy of multiple sclerosis]. / Tsitoflavin v kompleksnoi terapii rasseiannogo skleroza.

AIM: To evaluate the efficacy of cytoflavin inclusion in the complex therapy of patients with multiple sclerosis in the remitting form during the period of exacerbation. MATERIAL AND METHODS: The results of therapy of 41 patients matched for sex, age and parameters of clinical and laboratory data were analyzed. Depending on the scheme of therapy, patients were divided into 2 groups: patients of the first group (n=22) received hormonal therapy with methylprednisolone. Patients of group II (n=19) received cytoflavin. The efficacy of treatment was assessed by a set of clinical and laboratory indicators in dynamics - before the start of therapy, with a 10-day interval and after treatment. The neurological status was assessed with the most commonly used scales (functional system scale (FS), EDSS scale), also neuroimaging data were assessed. RESULTS AND CONCLUSION: The inclusion of cytoflavin as an antioxidant and neuroprotective agent in the therapy of patients with multiple sclerosis in the acute phase increased the efficacy of basic (hormonal) therapy, which is manifested in a significant decrease in the severity of neurologic symptoms and visual system disorders and fewer cases of non-response to treatment.

[Neurotrauma as a factor of epileptogenesis]. / Travma golovnogo mozga kak faktor épileptogeneza.

The presented article deals with traumatic brain injury, which can cause convulsive seizures with the subsequent development of epilepsy, which is especially characteristic of young people. The problems of classification of posttraumatic epileptic seizures, development of their mechanisms, characteristics of diagnosis, as well as the stages of epileptogenesis leading to the development of traumatic epilepsy are considered. The variants of therapy are given in view of traumatic brain injury. It is noted that the use of electrical stimulation during individual phases of paroxysmal oscillations can be an effective method in preventing the development of homeostatic plasticity that is involved in the development of epileptogenesis.

[Structure and specific diagnostic features of neurologic deficiencies in patients with maxillofacial injuries admitted to Stavropol Maxillofacial Surgery Unit].

The purpose of the study was to evaluate the structure of maxillofacial trauma associated with brain injury in Stavropol to elaborate the diagnostic approach. We analyzed 2,604 case records of patients with maxillofacial trauma in the Stavropol region in the period from 2008 to 2012. Only 345 (13.2%) cases were diagnosed with maxillofacial trauma associated with mild brain injury. The analysis of case records showed that the incidence of brain damage depends on the location and type of fracture of the facial bones. It is noted that emotional and stress factors often mask neurological symptoms that are important in the diagnosis of traumatic brain injury. To ensure the treatment success and reduce the duration of disability patients with maxillofacial trauma must be provided with special treatment with a more thorough analysis of possible neurological deficit followed by mandatory therapy for neurological symptoms.