[Possibilities of preventive treatment of Alzheimer's disease: results of the 3-year open prospective comparative study on efficacy and safety of the course therapy with cerebrolysin and cavinton in elderly patients with the syndrome of mild cognitive impairment].

The study was conducted in 3 Russian centers (Moscow, St. Petersburg and Nizhniy Novgorod). The total sample included 110 patients whose mental state met the definition of <> (MCI). Patient's status was assessed with widely used scales (MMSE, GDS, CDR etc) and a battery of neuropsychological tests. Genotyping for the APOE polymorphism was performed as well. Patients were stratified into 2 comparable groups in compliance with the specifics of therapy: 55 patients were treated with cerebrolysin and 55 - with cavinton. The superiority of cerebrolysin over cavinton in slowing down of the cognitive deficit progression and delaying the time or transition of patients to the diagnostic category of Alzheimer's disease was demonstrated. Cerebrolysin was particularly effective in MCI patients with the ApoE(+) genotype, i.e. in those with higher risk for Alzheimer's disease. Adverse effects during the treatment were rare in both groups.

Bronchiolitis obliterans organizing pneumonia in a patient with AIDS.

A 35-year-old homosexual man who had a remote history of cocaine abuse presented to the hospital with fever, chills, drenching night sweats, and progressive dyspnea of 3 months' duration. His condition had been diagnosed as AIDS 1 1/2 years before presentation. Multiple blood cultures and serological tests failed to yield an infective etiology. Bronchoscopy with transbronchial biopsy, both performed twice, also failed to reveal an etiology. Empirical treatment for infection with the Mycobacterium avium complex yielded no response; empirical treatment, based on abnormalities revealed by gallium scanning, for Pneumocystis carinii pneumonia led to some clinical improvement. Because of rapid respiratory deterioration at the end of this treatment course, a thoracoscopic lung biopsy was performed; this procedure demonstrated classic bronchiolitis obliterans organizing pneumonia. Corticosteroid therapy resulted in a rapid salutary response. It is important to aggressively pursue a definitive diagnosis for selected patients with a nonidentifiable infectious cause so that patients receive the correct treatment.