[Features of cognitive impairment in individuals with paranoid schizophrenia combined with alcohol dependence syndrome]. / Osobennosti kognitivnykh narushenii u lits s paranoidnoi shizofreniei v sochetanii s sindromom zavisimosti ot alkogolya.

OBJECTIVE: To compare the cognitive functioning of patients with paranoid schizophrenia with alcohol dependence syndrome and patients with this disease without comorbid alcohol pathology. MATERIAL AND METHODS: The study included 34 patients with a diagnosis of schizophrenia, paranoid form, aged 24 to 39 years (22 men and 12 women). The experimental group included 17 patients with paranoid schizophrenia combined with alcohol dependence syndrome with diagnosed symptomatic alcoholism. The comparison group included 17 patients with a similar diagnosis without a comorbid disorder. The duration of the disease in both groups was 5-10 years. The main research tool was a neuropsychological examination, which included the Benton test, the pathway test, the Mini-Mental State Examination (MMSE), and the constructive praxis test. RESULTS: Moderate cognitive impairments were found in patients with schizophrenia in combination with comorbid pathology, combined with disorders of intellectual flexibility and cognitive control. Also, in the experimental group, marked disorders of constructive praxis and visual memory were noted, which indicates a lesion of the occipital-parietal parts of the brain. Thus, in the course of the study, cognitive disorders were identified in patients with schizophrenia in combination with alcohol addiction: disturbances of perceptual organization, cognitive flexibility and attention switching, visual memory. CONCLUSION: Concomitant alcohol dependence is a significant factor for changing cognitive functions in patients with schizophrenia: control functions suffer, visual memory is disturbed and constructive apraxia is noted.

[Metacognition as a pathway to the study and treatment of fragmentation in schizophrenia]. / Izuchenie i lechenie fragmentatsii pri shizofrenii s primeneniem kontseptsii metapoznaniya.

This paper explores the potential of recent research on metacognition to offer new avenues to assess and address the phenomenon of fragmentation in schizophrenia, which was described by E.Bleuler as «splitting¼. The concepts of metacognition characterize and quantify alterations or decrements in the processes by which fragments or pieces of information are integrated into a coherent sense of self and others. A method for assessing metacognition is presented along with research examining the presence and importance of metacognitive deficits in schizophrenia. Greater levels of metacognitive deficits have been detected in different phases of schizophrenia and linked to poorer psychosocial outcomes. These data were obtained both in foreign and preliminary Russian studies. The authors suggest that treatments, which successfully target metacognitive capacity, may uniquely promote wellness and recovery in schizophrenia.

[Laryngectomy: clinical aspects of preceding tracheostomy].

The objective of this study was to compare results of combined and surgical treatment in 114 patients with stage III-IV T3-4N0M0 laryngeal cancer. Fifty eight patients were treated by laryngectomy without preceding tracheostomy; in the remaining 56 laryngectomy followed tracheostomy (control group). The two groups were matched for all major characteristics, such as age and sex of the patients, histological structure of the tumour, its growth rate and localization, dose and schedule of radiotherapy, extent of surgical intervention. The data obtained were used to evaluate oncological and functional outcomes of the treatment.

[Clinical aspects of tracheostomy as a stage of anterolateral laryngeal resection].

We analysed medical histories of 68 patients with T2-3N0M0 laryngeal cancer who had received combined or surgical treatment. All the patients given the organ preservation treatment were divided into two groups one of which included 36 patients after laryngeal resection without tracheostomy, the other consisted of 32 patients who had undergone laryngectomy with tracheostomy (control). The two groups were matched for age and sex of the patients, the degree of advancement and histological structure of the tumour, its growth rate and localization, dose and schedule of radiotherapy, extent of surgical intervention. The data obtained were used to analyse oncological and functional outcomes of the treatment. Oncological result was estimated based on the survival rate expressed in percentage terms.

[Tracheostomy in patients with locally advanced laryngeal cancer].

The authors present the results of treatment of 62 patients with locally advanced laryngeal cancer (LALC) stage III-IV (T3-4NOMO) treated in 1986-2000. The study was made of tracheostomy effects in laryngostenosis following radical operation (not tracheostomy as a stage of laryngectomy) on regional and distant metastasizing as well as on further growth, tumor recurrence and survival in treated patients with LALC. The authors conclude that tracheostomy conducted before radical surgery has a negative effect on heeling the postoperative wound, promotes regional metastasizing and tumor recurrence in patients with LALC, lowers 5-year survival.

[Potentialities of histological examinations of the spleen in the diagnosis of alcoholic and narcotic intoxication]. / Vozmozhnosti gistologicheskogo issledovaniia selezenki dlia diagnostiki otravleniia alkogolem i narkotikami.

Qualitative changes observed in the spleen in chronic narcotic and alcoholic intoxication are described. The below signs are recommended for use in the diagnosis of chronic exogenous intoxication: an increased thickness and sclerosis of the splenic connective structures and myelosis of the red pulp. The diagnostic criteria of chronic intoxication with intravenous opiates are the below changes in the spleen: hyperplasia of the splenic follicles, germinative foci in the follicles' stases and folds in vessels, edema of the vascular wall, hyperemia of follicular arteries and diapedetic hemorrhages. Hypoplasia of the follicles and venous hyperemia of the spleen should be regarded as signs of chronic alcoholic intoxication. The data obtained within the case study can be used by forensic medical experts in the diagnosis of narcotic and alcoholic intoxication.

[The forensic medical significance of morphometry of the spleen in drug addiction and chronic alcoholic intoxication]. / Sudebno-meditsinskoe znachenie morfometrii selezenki pri narkomanii i khronicheskoi alkogol'noi intoksikatsii.

Data on histomorphologic damage to the spleen in chronic narcotic and alcoholic intoxication are described. The below features are recommended for the diagnosis of chronic exogenous intoxication: thickening and sclerosis of the spleen connective structures and a lower count of lymphocytes in the white pulp. The diagnosis criteria of chronic intoxication by intravenously administered opiates are: hyperplasia of the spleen follicles as well as a higher quantity of plasmocytes and of eosinophiles in the white pulp. Hypotrophy of the spleen lymphoid follicles and higher counts of monocytes and macrophages in the lymphoid follicles should be also regarded as a sign of chronic alcoholic intoxication. The obtained data can be used by forensic medical experts in the diagnosis of chronic narcotic intoxication and in its differential diagnosis versus alcoholic intoxication.