[Efficacy and tolerability of long-term using of glatimer acetate (copaxone): a 10 year-study in the Moscow Municipal Multiple Sclerosis center].

Experience of 10-year administration of glatimer acetate (copaxone) in 74 patients with active remitting multiple sclerosis is summarized. The significant decrease in the frequency of exacerbations was seen over these ten years. Disease severity on the EDSS was stable and decreased only to the end of the 10-year period. The positive stable clinical dynamics did not depend on the disease severity at baseline. The drug was well-tolerated that allowed to control the course of multiple sclerosis: 64.8% of patients had no more than one exacerbation over 10 years and in 71.6% patients, the disease progression was absent or minimal (less than one score on EDSS). It has been concluded, that the long-term 10-year treatment with copaxone enables to control the development of disease in many patients.

[Data of MRI and neuropsychological tests predict the course of typical remitting multiple sclerosis during five years].

A complex study of 50 patients with active typical remitting multiple sclerosis (MS) was carried out. Neuropsychological testing using Wechsler and Stroop tests and MRI of the brain with the morphometric analysis of focal and diffusive changes were used in the study. Patients were stratified into two subgroups by the changes in the performance of neuropsychological tests. The disease course was assessed during five years. In all cases, the natural course of the disease, i.e. when patients did not receive disease modifying drugs, was analyzed. The transition to secondary progressive MS and the marked increase in MS severity on the EDSS were found in the subgroup of patients who demonstrated changes in the neuropsychological test performance. The strongest correlation was observed between EDSS scores and the diffusive atrophy of the brain white matter on MRI. The data of neuropsychological testing and some brain MRI parameters may be recommended as a predictive test in remitting MS.

[Instrumental methods of the rehabilitation of motor disorders in patients with multiple sclerosis].

Motor and coordination disorders are the most prominent clinical presentations of multiple sclerosis. Currently, good results were achieved in the pathogenetic treatment of the disease. However methods of treatment of motor and coordination disorders are not widely used. The positive experience in the treatment of motor disorders using the apparatus Moto-med is presented. The use of this treatment led to positive changes in the state of motor functions, i.e. the decrease of neurologic deficit and improvement of quality of life, of patients.

[The use of emakor in arterial ischemia of the lower extremities in outpatient practice]. / Primenenie émakora pri arterial'noi ishemii nizhnikh konechnostei v ambulatornoi praktike.

Overall 43 outpatients with arterial ischemia of the lower limbs were treated by emakor, a new Soviet drug that exerts a concomitant alpha- and beta-blocking action. The treatment resulted in a remarkable positive effect which manifested itself in amelioration of circulation in the lower limbs, positive time-course of changes in peripheral hemodynamics and in computer-aided tomography data. The use of emakor is contraindicated in exacerbation of gastrointestinal diseases, chronic pulmonary diseases associated with the obstructive syndrome, and marked signs of venous outflow obstruction in the lower limbs.

[Role of hemorheologic and hemodynamic factors for the efficacy of therapeutic plasmapheresis in patients with ischemic heart disease]. / Rol' gemoreologicheskikh i gemodinamicheskikh faktorov v éffektivnosti lechebnogo plazmafereza u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Changes in blood rheological properties and central hemodynamic parameters were studied in patients with Functional Classes III-IV angina pectoris who had undergone therapeutical plasmapheresis. Drastic baseline changes in blood rheological properties, a reduction in myocardial contractility, and high total peripheral vascular resistance (hypokinetic circulation) were found to be indications for plasmapheresis supplemented to antianginal therapy. A positive clinical effect of this therapeutical method may be, to a definite extent, predicted in these patients. The first plasmapheresis procedure improved blood rheology due to the plasma component, making the high baseline levels of fibrinogen and total protein normal, lowered increased platelet aggregation, repeated procedures enhanced the electric superficial charge of red blood cells and the stroke index of the left ventricle.

[Effect of therapeutic plasmapheresis on rheological properties of blood in patients with ischemic heart disease]. / Vliianie lechebnogo plazmafereza na reologicheskie svoistva krovi u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Patients with angina pectoris, functional classes III-IV, were examined for changes in the rheological blood properties (red blood cell aggregation ratio, fluidity limit, apparent viscosity, electrophoretic mobility of red blood cells, fibrinogen, total plasma protein and ADP, induced platelet aggregation) under the effect of continuous plasmapheresis (PA). PA was established to produce a selective effect on the rheological blood properties depending on the initial level of its disorders. The most remarkable clinical effect was produced by PA in patients with initially high characteristics of hemorheology. The first PA session ameliorated hemorheology at the expense of the plasma component, reduced high platelet aggregation whereas the repeated sessions largely affected red blood cell function.

[Metabolic responses to ergometry and their role in the development of physical work capacity in patients with ischemic heart disease and different types of hemodynamics]. / Metabolicheskie reaktsii pri érgometrii i ikh rol' v formirovanii fizicheskoi rabotosposobnosti u bol'nykh ishemicheskoi bolezn'iu serdtsa s razlichnymi tipami gemodinamiki.

Blood coagulation and fibrinolysis, lipid and lactate levels and some enzyme activities were measured in 283 coronary patients during bicycle ergometry. Hemodynamic type was established on the basis of the cardiac index. A negative correlation is demonstrated between the cardiac output and blood lipids. Fibrinolytic reserve was intact in 32.3% of patients with eu- and hyperkinetic hemodynamic types and in just 9.3% of patients with hypokinetic hemodynamics. The latter type was associated with the greatest disturbance of aerobic/anaerobic metabolism ratios. The extent of disturbance in lipid metabolism and blood coagulation is closely correlated with hemodynamic types that reflect the state of myocardial contractility.