[Hemispherectomy in the treatment of pediatric symptomatic epilepsy of children]. / Gemisferektomiya v lechenii simptomaticheskoi epilepsii u detei.

INTRODUCTION AND PURPOSE: Hemispherectomy is a recognized option in the treatment of symptomatic forms of intractable focal epilepsy in patients with developmental brain malformations and some acquired lesions of one the hemispheres. The prognosis for an outcome of the technique is important in terms of the indications for surgical treatment. MATERIAL AND METHODS: We described the hemispherectomy technique and its variants and analyzed our own experience of surgery in 40 children. The most common (27 cases) brain pathology was extended unilateral cortical dysplasia with polymicro- or pachygyria and consequences of perinatal stroke. Six children had Rasmussen encephalitis; 6 patients had hemimegalencephaly; 1 child with Sturge-Weber syndrome had angiomatosis of the soft meninges. The patients' mean age was 3 years. Functional hemispherectomy (hemispherotomy) was used in most cases (37); 3 patients underwent anatomical hemispherectomy. RESULTS: At the time of discharge, seizures resolved in all patients; later, no seizure recurrence was observed in 25 out of 29 cases with known follow-up (the follow-up median was 2.5 years), which corresponded to class 1 outcomes on the ILAE scale (86%). Serious complications developed in 2 cases; 1 patient died; hydrocephalus and the need for bypass surgery occurred in other 2 children. These results are discussed along with the literature data, and the indications for hemispherectomy are provided. CONCLUSION: Hemispherectomy is a reliable and effective technique for treatment of symptomatic hemispheric forms of epilepsy in children. More than in 80% of patients with congenital or acquired pathology of one of the cerebral hemispheres, its deafferentation or resection leads to persistent elimination of seizures. Children with severe forms of intractable epilepsy should be promptly referred to dedicated centers to address the issue of advisability of surgical treatment.

[Comparison of electrocorticographic patterns with focal cortical dysplasia types in children with epilepsy].

OBJECTIVE: the objective of the study was to determine significant differences in electrocorticographic patterns for various types of focal cortical dysplasias. MATERIAL AND METHODS: 42 patients diagnosed with drug-resistant focal epilepsy were operated on at the Burdenko Neurosurgical Institute in the period from 2006 to 2013. Patients who were histologically diagnosed with focal cortical dysplasia (FCD) and underwent video-electroencephalography and electrocorticography were analyzed. RESULTS: The classification of epileptiform patterns proposed by Palmini in 1995 was used. The sporadic epileptiform activity pattern was predominant in electrocorticographic studies. The continued pattern was more frequent in the case of type II focal cortical dysplasias (FCDs), both combined and isolated; burst and sporadic activity patterns prevailed in combinations in the case of type III FCDs. A uniform distribution of all pattern types of the epileptiform activity was observed in type I FCDs. The data are statistically significant for groups with sporadic and continued patterns. CONCLUSION: The continued epileptiform activity pattern is predominant in type II focal cortical dysplasia that corresponds to the most pronounced epileptogenesis processes of brain tissue with the presence of pathological forms of neurons. A uniform pattern distribution is observed for type I FCD. Patterns of the epileptiform activity and sporadic spike bursts are predominant in the case of type III FCDs. The sporadic activity is likely to be non-specific and almost uniformly distributed in all types of cortical dysplasias.

[THE QUALITY OF EXAMINATION OF PATIENTS WITH ARTERIAL HYPERTENSION BASED AT OUTPATIENT FACILITIES].

AIM: To analyze the quality of application of diagnostic methods in patients with arterial hypertension (AH) based at outpatient facilities in comparison with equipments of national clinical recommendations. MATERIALS AND METHODS: The study was conducted in the framework of the outpatient registry of cardiovascular diseases (REKVAZA). It included analysis of outpatient medical cards of 2850 patients with AH examined in two municipal polyclinics. Men accounted for 27.8% of the total. Patients with associated clinical conditions for 79.6%. Age median (interquartile range) for men and women was 64.8 (56.8; 74.8) and 70.6 (60.1; 77.6) years respectively. RESULTS: It was shown that the scope of real physical examination (measurements of height, mass, waist circumference, BMI) was below the target level (p < 0.001). Results of complete blood cell count for the previous 12 months could be found only in 71.7% of the cards, data on blood glucose level in 61/7%, total cholesterol in 42.7%, creatinine in 45.4%, results of ECG in 59.9%, echoCG in 9.5%, 24hr AP monitoring in 0.3%. Instrumental and laboratory studies were more often performed in patients with associated clinical conditions (p < 0.05). CONCLUSION: This study revealed poor quality of examination (physical, Instrumental and laboratory) of patients with arterial hypertension based at outpatient facilities.

[Rapid analysis of suppositories by quantitative 1H NMR spectroscopy].

Rapid analysis of suppositories with ibuprofen and arbidol by quantitative 1H NMR spectroscopy was performed. Optimal conditions for the analysis were developed. The results are useful for design of rapid methods for quality control of suppositories with different components

[Scientific approaches to development of medicinal formulation based on biotechnological substance].

The study demonstrated possible design of a medicinal formulation in the form of suppositories comprising human recombinant interferon-alpha2 and dry aloe extract. The approaches to the development of the suppositories were technology-derived. No interaction between the active and auxiliary components was proved by solid state 1H-NMR spectroscopy. The specific activity of the drug was investigated.

[Prophylactic effect of enteral feeding preparations during the chemotherapy of oncology patients]. / Profilakticheskoe vliianie énpitov pri khimioterapii onkologicheskikh bol'nykh.

Altogether 124 patients were followed up for disseminated breast cancer (82) and hematosarcoma (42). The patients were divided into two groups: the main group was given 500 ml of 20% protein or low-lactose enteral feeding in addition to the hospital diet; the control group received only the hospital diet. Chemotherapy lasted 3 weeks. The patients on chemotherapy received enteral feeding every day throughout the entire treatment period. In the course of treatment, the patients were examined for blood characteristics, size of the tumor and affected lymph nodes, body weight, major metabolism, protein metabolism, vitamin metabolism, osmotic and peroxide resistance of red cells, and liver function. The research program covered more than 150 characteristics. The data obtained were processed by computer. It has been disclosed that inclusion of protein and low-lactose enteral feeding into the diet of cancer patients improves the alimentary status, decreases the leukopenia and thrombocytopenia incidence. It is advisable that specialized milk concentrates (enteral feeding) should be included into the diet of cancer patients as a necessary component of a complex of therapeutic measures used during chemotherapy.