[Determination of neurometabolism in patients with mild and moderate cognitive impairments].

OBJECTIVE: To estimate the diagnostic value of neuropower mapping (NPM) and positron emission tomography (PET) and their relationships in the evaluation of neurometabolism in patients with predementia cognitive impairments. MATERIAL AND METHODS. The investigation enrolled 125 patients wvith clinical signs of cognitive impairments. The patients were divided into 4 groups: 1) predementia cognitive impairments (PCI) in the presence of cerebrovascular disease (CVD); 2) PCI in the presence of psychoautonomic syndrome (PAS); 3) PCI in the presence of sequels to acute cerebrovascular accident (SCVA); 4) PCI in the presence of toxic, dysmetabolic, hypoxic encephalopathies (TDHEP). All the patients underwent NPM and 55 patients had PET. RESULTS AND DISCUSSION: NPM and PET revealed neurometabolic disturbances in 100 and 46.3% of cases, respectively. The sensitivity of NPM was significantly higher than that of PET. The highest number of diffuse and diffuse-focal hypometabolism cases (n = 19 (63.3%)) were seen in the CVD and SCVA groups. CONCLUSION. 1. NPM and PET assess two aspects of brain neurometabolism. 2. PET hypometabolism characterizes either structural organic abnormalities in the brain in the presence SCVA or initial manifestations of the neurodegenerative process. 3. NPM readings characterize the activity, strength of metabolic responses, that is to say, cerebral reactivity. 4. PET readings are important in determining the prognosis of disease and NPM ones are essential in defining drug treatment policy.

[Value of various criteria of assessment of a test in stress echocardiography in diagnosis of ischemic heart disease].

Aim of investigation was to study significance of electrocardiographical and echocardiographical criteria of development of angina attack, and their combination in assessment of results of stress echocardiographical tests (stress-echo) with various stress-agents. Stress echocardiography, coronary angiography and left ventriculography were carried out in 928 patients (805 men and 123 women) aged 31 - 72 years with suspected ischemic heart disease (IHD). Attack of angina (AA) was registered in 324 cases, 1.5 mm ST-segment depression (Scapital TE, Cyrillic) -- in 448 tests, disturbances of local myocardial contractility (DLC) at piece exercise -- in 625 patients. Coronaro-ventriculography did not reveal hemodynamically significant coronary artery lesions in 235 patients. Accuracy, sensitivity, and specificity of assessment of stress-echo result were for criterion "ST" 62.1, 56.9, 77.4%, respectively, for criterion "AA" - 50.0, 40.7, 87.0%, respectively, for criterion DLC - 90.7%, 88.9%, 96.2%, respectively, for combinations of criteria "ST+DLC" - 46.1, 30.6, 91.9%, "ST+AA" -- 66.7, 56.1, 97.8, respectively, for "DLC+AA" -- 54.9, 40.5, 97.4%, respectively. Echocardiographic criterion DLC appears to be determinant in assessment of results of stress-echo tests.