[Injection of incobotulinum toxin A for the prevention of postoperative salivary fistula and sialocele]. / Primenenie botulotoksina tipa A v profilaktike posleoperatsionnykh slyunnykh svishchei i sialotsele.

The aim of the clinical study was to improve prevention of postoperative sialocele and fistulas of parotid glands. MATERIALS AND METHODS: The study included 100 patients with tumors of parotid glands treated by superficial parotidecthomy. Fifty patients received incobotulinum toxin A preoperatively, while control group consisted of 50 patients without preoperative injections. RESULTS: Salivary fistulas formed in 17% of cases in control group. Discharging of saliva through the postoperative wound for 6 days after surgical treatment were noticed in the control group in 30% of cases. There were no complications such as forming of salivary fistula and sialocele and no saliva flow from the postoperative wound on the 4th day after surgical treatment in the main group. Conclusion. The use of botulinum toxin type A proved an efficient and effective way for prevention of postoperative salivary fistulas and sialocele.

[Tardue scales in the diagnostic of spasticity]. / Shkala Tard'e v diagnostike spastichnosti.

Diagnosis, treatment and rehabilitation of patients with spasticity remain a challenge, in which standard methodological approaches have not yet been developed. One of the most promising solutions to this problem is the use of the Modified Tardieu scale (MTS). The article describes the method of working with MTS tested in the examination, treatment and rehabilitation of patients with acute cerebrovascular accident (n=112) and patients with multiple sclerosis (n=17). The original version of MTS has been translated into Russian. The use of MTS assessment system allows the diagnosis of the main elements of the clinical picture of the damage to the central nervous system, such as paresis, spasticity, violation of proprioception, as well as the qualitative and quantitative assessment of the dynamics of rehabilitation and treatment of spasticity with botulinum neurotoxin (BoNT).

[Botulinum toxin in treatment of lower limb spasticity in patients with brain damage]. / Botulinicheskii toksin v lechenii spastichnosti nizhnei konechnosti pri povrezhdeniiakh golovnogo mozga.

AIM: To develop and test a method of examination of patients with lower limb spasticity, to describe lower limb spasticity patterns in patients with brain damage and to assess the efficacy of abobotulinumtoxin A (dysport) in the rehabilitation of patients with stroke. MATERIAL AND METHODS: Spasticity rating scales (MAS and Tardieu), the Barthel index, the Rankin scale , the Rivermead Mobility Index, the Hauser Ambulation Index, a comfortable walking test were used. Treatment satisfaction was assessed with the Visual analogue scale. Abobotulinumtoxin A (dysport) was used for treatment of lower limb spasticity. RESULTS AND CONCLUSION: Two most common patterns (dynamic and static) were identified in patients with post-stroke spasticity and the method of testing spasticity was developed. The prevalence of spasticity in individual muscles of the lower extremity was estimated as well. An analysis of the efficacy of dysport and a sensitive analysis of the scales used in the study were carried out.

[Scales and tests in the rehabilitation and treatment of patients with spasticity of the lower limbs]. / Shkaly i testy dlia otsenki éffektivnosti lechebno-reabilitatsionnykh meropriiatii u patsientov so spastichnost'iu nizhnei konechnosti.

The problem-oriented approach in the rehabilitation of patients with spasticity requires careful assessment of the situation in the concept of The International Classification of Functioning, Disability and Health (ICF): impairment of the structure, functions and limitation of activity in specific environmental factors. Standardized tools in the assessment of muscle tone allow to get objective data about motor function. The use of the Modified Ashworth scale (MAS) and the Tardieu Scale are discussed. The standardized assessment of independent mobility is an important issue in outcome measuring. The ultimate goal of intervention, including the use of botulinum toxin therapy in the case of spasticity, is to support patient's daily activities. The article presents scales and tests for assessment of mobility: The Hauser Test, the Rivermead Mobility Index and functional assessment walking tests. The authors describe a clinical case of lower limb spasticity treatment with abobotulinumtoxin A and its assessment with these scales.

[Mapping of motor-points in the flexor muscles of the arm for the optimization of botulinum toxin injections in treatment of spasticity]. / Kartirovanie motornykh tochek myshts-sgibatelei ruki dlia optimizatsii vvedeniia botulinicheskogo toksina pri lechenii spastichnosti.

AIM: To study the location and verification of motor points (MP) of the upper limbs for targeting botulinum toxin (BT) type A injections in the treatment of spasticity. MATERIAL AND METHODS: Twenty healthy people were examined. Using electromyography a complete study of the muscles of the upper limbs was conducted. RESULTS: Anatomical localization of MP was performed. The location of MP is identical and does not depend on sex, age and the dominant limb. Tables and maps of MP locations are presented. CONCLUSION: MP in the flexor muscles of the arm were identified. A surface map with MP location was created. This data may improve the clinical efficacy and feasibility of MP targeting, when injecting BT in spasticity.

[Achievements and prospects of clinical abzymology].

Catalytic autoantibodies (abzymes) are autoantibodies that are potentially ready to realize certain effects in the organism, first of all antibody-mediated catalysis and cytotoxicity. Natural abzymes with protolytic (protabzymes) and DNA-hydrolyzing DNA-abzymes) activity are of the greatest interest. The most impressive example of the catalytic activity of protabzymes is hydrolysis of specific proteins, revealed in patients with autoimmune diseases, such as bronchial asthma (vasoactive intestinal neuropeptide), autoimmune thyroiditis (thyroglobulin), multiple sclerosis (myelin basic protein), and autoimmune myocarditis (cardiomyosin). The pathogenic role of DNA-abzymes is not quite clear yet. However, it has been proven that they present a powerful regulator of apoptosis and other cytotoxicity mechanisms in systemic autoimmune diseases and tumors. The most promising is use of abzymes as illness activity markers, and as therapeutic agents capable of catalyzing specific proteins or activating antitumoral chemotherapeutic preparations.

Catalytic autoantibodies in multiple sclerosis: pathogenetic and clinical aspects.

The significance of catalytic autoantibodies abzymes in the pathogenesis of multiple sclerosis was evaluated in patients with different disease patterns and severity of disability.