False Aneurysm of the Proximal Sano Shunt in a Patient With Hypoplastic Left Heart Syndrome After Bidirectional Superior Cavopulmonary Connection.

The case describes the surgical treatment of a patient with a false aneurysm of the proximal anastomosis of the Sano shunt in a patient with hypoplastic left heart syndrome midterm after bidirectional cavo-pulmonary anastomosis. The diagnostic algorithm included a physical examination, echocardiography, and multispiral computed tomography. Surgical treatment included closure of the right ventricular defect and removal of blood clots from the cavity of the false aneurysm.

[Ladasten, the new drug with psychostimulant and anxiolytic actions in treatment of neurasthenia (results of the comparative clinical study with placebo)].

An aim of a randomized blind study was to assess therapeutic efficacy and safety of ladasten used as an antiastenic drug in patients with neurasthenia. Tasks of the study included the investigation of characteristics of therapeutical actions, efficacy of the drug comparing to placebo, possible side-effects and probability of the development of "withdrawal syndromes". The design of the study included a wash-out period, a monotherapy with ladasten and placebo during 28 days and a final 1-week period of receiving placebo. Standartisized objective and subjective methods of mental state evaluation in patients were administered. The results obtained suggest that a combination of psychostimulant and anxiolytic actions in the spectrum of psychotropic activity of ladasten determines the its high therapeutic efficacy in asthenic disorders. It has been found that ladasten is superior in the rate and degree of reduction of main symptoms of asthenic syndrome compared to placebo. The absence of "withdrawal syndrome" after the drug withdrawal reveals the lack of addictive potential in this drug.

[Characteristics of ladasten effect in neurasthenia patients with various EEG parameters].

Clinical and electroencephalographic (EEG) analysis ofladasten action in anxiety-asthenic patients with respect to their EEG-defined individual typological characteristics was carried out. Primary psychopathologic disorders and ladasten effects were assessed by objective classification methods (factor and cluster analyses), and individual EEG types characterized by marked or reduced alpha rhythm were determined. No significant correlations between baseline EEG results and the initial mental condition indices were found. Significant differences ofladasten action in patients with different EEG types were found. It was established that, in patients with marked alpha rhythm corresponding to asthenic personal traits, ladasten exhibits predominantly a psychostimulant action assessed by clinical rating scales, which is accompanied by high frequencies of alpha rhythm increase and beta 1 and beta 2 rhythms decrease. In patients with reduced alpha rhythm and the EEG type corresponding to asthenic personal traits, ladasten action was characterized by an increase of alpha-rhythm low frequencies and the opposite reaction of beta 1 and beta 2 rhythms, whose are typical for the EEG pattern of anxiolytic effect. These results may indicate that the effect of ladasten depends on the initial brain activity level, which varies in patients with different individual typological traits.

[Pilot clinical trial of ladasten].

The psychotropic actibn and efficacy of ladasten, a new psychostimulant with anxiolitic activity, was studied in a standard clinical trial involving therapy of patients with psychogenic asthenic disorder. Ladasten exhibits a unique combination of therapeutically significant stimulant and anxiolytic effects, which is unusual of psychostimulants. At the same time, the results of ladasten action upon single administration on the dynamics of psychopatological disorders and psychological self-test indexes show that the psychostimulant action is predominating. The established combination of the psychostimulant and anxiolytic effects of ladasten is optimal for the therapy of patients with psychogenic asthenic disorders. Ladasten shows high efficacy in the treatment of these disorders testify and has good prospects for practical application.