Prevalence of Heart Failure in a Megalopolis.

Aim      To assess the prevalence of heart failure (HF) in St. Petersburg from 2019 through 2021 based on medical reports.Material and methods  Medical records of 146 912 patients with HF who were managed in St. Petersburg from 2019 through 2021 were analyzed. Prevalence of HF was assessed using a standard ICD-10 I 50.x code for this disease. Also, expanded HF coding was used with ICD-10 codes I09.9, I11.0, I13.0, I13.2, I25.5, I42.0, I42.9, I43.0, I43.1, I43.8, I42.5, I42.7, and I42.8. An additional analysis was performed for mortality from cardiovascular diseases (CVD) as a whole and from HF in particular (n=192 133).Results From 2019 through 2021, the number of both male and female patients with HF increased by 18.14 %. The greatest number of HF patients was in the age group of 75-89 years in 2019-2020 and 60-74 years in 2021, with females prevailing. The HF incidence increased in the age group of 45-59 years with a peak morbidity at age of 60-74 for men and 75-89 for women, which was consistent with the life expectancy of each gender. The expanded coding allowed a more complete presentation of HF prevalence and also to take into account patients with HF caused not only by myocardial infarction or acute cardiac pathology but also by rheumatic heart disease, arterial hypertension, myocarditis, and cardiomyopathies. Cardiovascular mortality significantly increased by 20.1% during the period from 2019 through 2021. The HF prevalence for deceased patients also was steadily increasing during 3 years. Analysis of associated pathology in HF patients revealed, in most cases, hypertension, ischemic heart disease, cerebrovascular diseases, diabetes mellitus, and obesity.Conclusion      The increase in HF prevalence and mortality draws attention and calls for managing measures to change the current situation in health care. A registry is required to characterize a typical patient with HF and to present an unbiased picture of HF prevalence. It is also necessary to develop programs for outpatient follow-up of patients in this category and for providing current, highly effective medicines. Education of patients and improving the knowledge of therapists in diagnosis and treatment of HF are most relevant for enhancing the quality and duration of patients' life and for reducing the number of hospitalizations and the HF mortality.

[Cerebral complications in cardiac myxomas]. / Tserebral'nye oslozhneniia pri miksomakh serdtsa.

The authors analyze injuries to the central nervous system in patients with heart myxomas due to tumorous embolism of brain vessels with the development of acute or "delayed" cerebral symptomatology. Stress the difficulty of correct interpretation of acute disorders of cerebral circulation with no other signs of intracavitary heart neoplasm and the possibility of the asymptomatic form of cerebrovascular embolism or its consequences in association with a remarkable clinical picture of heart myxoma. Emphasis is laid on the necessity of carrying out all-round examination of the brain to reveal injuries that may occur under such conditions, to determine the prognosis and treatment policy in the given patients' group, especially in the long-term period after resection of intracavitary heart neoplasm.

[Neurophysiological mechanisms of aphasia in epilepsy]. / Neirofiziologicheskie mekhanizmy afazii pri épilepsii.

The EEG, visual and auditory evoked potentials were examined in 4 patients with aphasia-epilepsy. All the examined manifested focal discharges of high-amplitude acute waves, peaks and peak-wave complexes in the temporal leads on the left or on the side of assumed dominance according to speech. The same leads showed transformation of auditory and visual evoked potentials to peak-wave complexes. The intensity of epileptic focal discharges on the EEG correlated with the gravity of aphasia, whereas effective treatment bringing about suppression of epileptic discharges in the temporal parts favoured speech recovery. Obviously, speech disorders in patients with aphasia-epilepsy are caused by neurodynamic disorders of information transfer and processing in the speech zones of the temporal lobe.

[Features of the polygraphic picture of natural sleep in patients with subacute sclerosing panencephalitis]. / Osobennosti poligraficheskoi kartiny estestvennogo sna u bol'nykh podostrym skleroziruiushchim panéntsefalitom.

The results of electropolygraphic examinations of 6 patients suffering from subacute sclerosing panencephalitis are presented. The polygraphic examination of sleep revealed a pronounced disorganization of the latter, the degree of which depended on the disease duration (the EEG of awakeness was abnormal, too). An importance of electromyographic changes (within the polygram) for differentiating the states of the sleep and awakeness is demonstrated. The sleep duration, the frequency of Radermaker's complexes, and the heartbeat rate were analyzed. An inverse relationship between the latter two parameters was revealed. A prognostic significance of somnological examinations is demonstrated: a particular importance in this respect is attached to the state of vegetative functions.

[Neuropsychological analysis of higher mental functions in acute leuko- and panencephalitis]. / Neiropsikhologicheskii analiz narushenii vysshikh psikhicheskikh funktsii pri podostrykh leiko- i panéntsefalitakh.

A neuropsychological analysis was used as one of the supplementary methods for diagnosing subacute leuko- and panencephalititdes in 42 patients. This method permitted to detect multifocal lesions, the fluctuation in the degree of marked defects, the secondary character of disturbed higher mental functions (due to defects in the organization of activity). Consideration of these data promotes, to a significant extent, the diagnosis of leuko- and panencephalitides differentiating them from brain tumors and leuko-dystrophy.

[Clinical picture and dynamics of psychopathologic disorders in subacute leuko-and panencephalitis]. / Klinika i dinamika psikhopatologicheskikh rasstroistv pri podostrykh leiko-i panéntsefalitakh

The report contains the results of clinico-dynamic studies of mental disorders in patients with Schilder's leukoencephalitis and subacute sclerosing panencephalitis after van-Bogart. The authors come to the conclusion that only parallel comparisons of the psychopathological symptomatology with focal neurological signs and a simultaneous study of the EEG and other paraclinical indices may facilitate the differential diagnosis of encephalitis.