[The effect of ozone therapy on the activity of the autonomic nervous system].

We studied 48 patients, mean age 57 years, 14 men, 34 women, with chronic cerebrovascular disease and autonomic dysfunction. Patients had different types of autonomic response (sympathicotonic or normotonic). Autonomic tone at baseline, autonomic reactivity and autonomic supply of activity were determined. Patients were divided into 2 groups. Patients of the main group received ozone therapy along with standard medications. Patients of the control group received standard medications. Disturbances of vascular-autonomic regulation with the domination of ergotropic sympathetic effects were identified in 69.7% of patients with chronic cerebrovascular disease. Ozone therapy caused a shift of the autonomic balance towards the parasympathetic activity as well as the decrease in the activity of the vasomotor center and the central regulation circuit that indicates the increase in the power of defense mechanisms associated with the normalization of autonomic balance.

[Acute toxic encephalopathy in patients with tuberculosis]. / Ostraia toksicheskaia éntsefalopatiia u bol'nykh tuberkulezom.

A hundred and thirty five patients admitted to Moscow Tuberculosis Hospital No. 7 for disseminated and progressive forms of tuberculosis were examined. Among neurological disorders in tuberculosis, acute toxic encephalopathy (ATE) should be placed in the first place in terms of their severity, problems of diagnosis and treatment. In patients with acutely progressive forms of tuberculosis, the development of ATE is brought about by two factors: 1) significant tuberculous toxemia concurrent, in 37% of cases, with severe alcoholic intoxication that leads to generalized toxic and allergic vasculitis and as a result DIC syndrome; 2) cerebral hypoxia with dyscirculatory disorders due to progressive cardiopulmonary failure. The status of patients with tuberculosis and ATE is generally critical or extremely critical. These are actually resuscitative patients. Most patients have disseminated bilateral lung lesions with multiple decay cavities, with massive bacterial isolation found at sputum bacterioscopy. With this, mycobacterial resistance to at least one antituberculous drug was found in 83% of cases. Primary multidrug resistance was detected in 29.6% of patients. The diagnosis of ATE in patients with tuberculosis is difficult and requires that tuberculous meningitis shall be excluded. Acute progression, no spinal fluid changes, significant signs of cooagulopathy and thrombcytopathy with multiorgan failure and progressive DIC syndrome may diagnose ATE in patients with acutely progressive tuberculosis. The specific features of treatment in patients with tuberculosis and ATE are intensive antituberculous therapy with predominantly parenteral administration of drugs and intensive therapy for the DIC syndrome. Despite the treatment, 48 (35.6%) patients died from progressive tuberculosis and ATE, in 40 (29.6%), therapeutic efficiency was low due to multidrug myobacterial resistance.

[Clinical aspects, diagnosis and treatment of neurological complications of tuberculosis]. / Klinika, diagnostika i lechenie nevrologicheskikh oslozhnenii tuberkuleza.

Data on 1112 tuberculosis patients with various neurological complications who were treated at Moscow Tuberculosis Clinical Hospital No. 7 during 1997-1999 are analyzed. A working classification of neurological complications in tuberculosis, which may be recommended to therapeutists, phthisiologists, and neurologists, is proposed. The leading neurological complications in nonspecific tuberculosis are described. The acute toxic encephalopathy syndrome that is characterized by a combination of impaired consciousness, meningeal syndrome without spinal fluid changes, epileptic seizures, disseminated neurological symptoms, disseminated intravascular coagulation syndrome, and high death rates holds the lead. Mono- and polyneuropathies of predominantly the lower extremities are frequently detectable in tuberculosis. Concomitant alcoholism, diabetes mellitus, and isoniazid treatment make their course poorer. Vascular abnormalities of the nervous system in patients with tuberculosis run much more favourably that in those without it. Mild forms of parkinsonism were observed in 3% of patients with tuberculosis, vascular dementia is detectable rarely (0.2%), strokes run without severe overall cerebral symptoms. The high incidence of neurological diseases in patients with tuberculosis requires that specialized departments of neurology should be set up at the institutes of tuberculosis and at multidisciplinary related hospitals. The tuberculosis curricula for students and postgraduate physicians should envisage additional sections to study diseases of the nervous system in tuberculosis.

[Brain function before and after sleep deprivation in patients with primary generalized epileptic seizures]. / Funktsional'noe sostoianie mozga do i posle deprivatsii sna bol'nykh s pervichno-generalizovannymi pripadkami.

A clinical analysis covers 11 patients with primary-generalized spastic epilepsy aged 15-43 (9 males and 2 females). Sleep deprivation showed EEG-recorded extreme stress of the brain activating structures necessitating corresponding vascular response. Rheography records cerebral hemodynamics and provides control of vascular drugs effect in relevant patients.

[Experience with using extremely high frequency radiotherapy of the millimeter wave range in cerebrovascular disorders]. / Opyt primeneniia KVCh-terapii millimetrovogo diapazona pri sosudistykh zabolevaniiakh golovnogo mozga.

Vascular diseases of the brain (functional transient and ischemic apoplexy, circulatory encephalopathy) in 79 patients were treated by UHF electromagnetic field of millimetric wave range. 14 patients entered the control group. The treatment results are indicative of clear-cut trend to a decrease of arterial pressure, normalization of blood glucose level, arrest of DIC syndrome development.