scholarly journals Strategies for patient therapy with chronic brain ischemia

2020 ◽  
pp. 86-93
Author(s):  
O. V. Kurushina ◽  
A. E. Barulin ◽  
Yu. S. Vorobjeva
Keyword(s):  
Brain Ischemia ◽  
Pathological Condition ◽  
Clinical Manifestations ◽  
Cerebrovascular Diseases ◽  
Pathogenetic Mechanisms ◽  
Treatment And Prevention ◽  
Therapy Strategy ◽  
Chronic Brain Ischemia ◽  
History Of ◽  
Therapeutic Problem

The article is devoted to the analysis of various pathogenetic mechanisms involved in the formation of chronic brain ischemia. The authors discuss current trends in society, leading to a wide spread of cerebrovascular diseases: an increase in life expectancy and a constantly increasing level of psychosocial stresses. The paper considers the variety of clinical manifestations, course options, the pace of development of this pathology, diagnostic and therapeutic difficulties encountered by doctors treating this category of patients. Particular attention is paid to symptoms that prevent a full course of treatment and prevention of chronic cerebral ischemia, such as asthenia and impaired statolocomotor function. The leading pathogenetic mechanisms that play a role in the formation of these syndromes are discussed. Various approaches to the treatment of this pathological condition are considered. The possibility of using drugs with a multimodal effect is discussed. An analysis of a clinical case involving a patient with a long history of chronic brain ischemia is presented. The main factors that are obstacles to a full pathogenetically directed treatment are identified and ways to solve this therapeutic problem are given. The authors conclude that it is necessary to formulate a wellthought- out therapy strategy for this pathological condition, including timely, well-considered use of drugs with a neurotrophic, neuromodulating effect, which allows further measures, including non-pharmacological approaches. Particular attention is paid to the role of social support and physical activity for the prevention of cerebrovascular diseases.

scholarly journals The role of the new coronavirus infection (COVID-19) in the progression and development of cerebrovascular diseases. A competent choice of pathogenic treatment is the key to success in treatment and prevention. An expert’s view from the ‘red zone’

2021 ◽  
Vol 13 (1) ◽  
pp. 57-66
Author(s):  
V. V. Kovalchuk
Keyword(s):  
Emotional Disorders ◽  
Clinical Manifestations ◽  
Cerebrovascular Diseases ◽  
Recent Experience ◽  
Treatment And Prevention ◽  
State Recovery ◽  
Group 2 ◽  
State Examination ◽  
Group 1

COVID-19 worsens the course of cerebrovascular diseases (CVD), including chronic cerebral ischaemia (CCI). The Actovegin drug, which has long been widely used in CCI treatment, has an antioxidant and endothelium protective effect. It makes sense to study the effect of Actovegin therapy on the clinical manifestations of CCI in patients with a recent experience of COVID-19.Objective: to evaluate Actovegin efficacy in the treatment of CCI in patients with a recent experience of COVID-19.Patients and methods. The study included 440 patients (234 female; 206 male) with a recent experience of COVID-19, suffering from CCI, their average age being 67.8 years (from 54 to 85 years). All patients were broken down into two groups of 220 people (the patients in Group 1 were administrated Actovegin, the ones in Group 2 – were not). All patients were followed up for 90 days; their condition was assessed by the severity of clinical manifestations of CCI, using special scales and questionnaires.Results and discussion. After 90 days of follow-up, the frequency of complaints of cognitive impairment, sleep disorder, dizziness, fatigue, emotional disorders, and headache in Group 1 was significantly lower than in Group 2 (p<0.05). According to Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), Multidimensional Fatigue Inventory (MFI-20), and Spiegel Sleep Questionnaire (SSQ), the average indicators improved significantly more in Group 1 than in Group 2 (p<0.05). The absence of quality of life impairment and their minimal severity were observed in Group 1 in 77.9%; in Group 2 – in 33.7% (p<0.001). Statistically significant differences between the groups of patients were also observed in relation to emotional state recovery according to the Wakefield Questionnaire and the Spielberger State Trait Anxiety inventory.Conclusion. The observational study demonstrated the efficacy of Actovegin in the treatment of main clinical manifestations of CCI in patients with recent COVID-19 experience.

scholarly journals Cognitive impairment, dizziness, and unsteadiness in hypertensive patients

2020 ◽  
Vol 12 (5) ◽  
pp. 92-97
Author(s):  
L. M. Antonenko ◽  
N. V. Vakhnina ◽  
D. O. Gromova
Keyword(s):  
Cognitive Impairment ◽  
Cerebrovascular Disease ◽  
Brain Damage ◽  
Early Stage ◽  
Clinical Manifestations ◽  
Vascular Cognitive Impairment ◽  
Cerebrovascular Diseases ◽  
Treatment And Prevention ◽  
Cerebral Microangiopathy ◽  
Selection Of

Hypertension is a widespread disease related to modifiable vascular risk factors for stroke and chronic cerebrovascular diseases. The pathogenetic basis of brain damage in hypertension is cerebral microangiopathy that leads to vascular cognitive impairment (CI), instability, and falls. Microcirculatory changes in the presence of hypertension at the initial stages of cerebrovascular disease occur without visible clinical manifestations of brain damage. Pathogenetically justified treatment used at an early stage of the disease makes it possible to achieve good results in the prevention of vascular brain damage. An important aspect of selecting effective therapy is the competent diagnosis of the causes of dizziness and instability, which can be caused not only by brain damage, but also by peripheral vestibular system diseases. Early diagnosis of vascular CI, selection of adequate therapy, and prevention of their further progression are of great importance. The studies performed have shown the high efficacy of vinpocetine (Cavinton®) that has a multifactorial mechanism of action in the treatment and prevention of CI, dizziness, and instability caused by cerebrovascular disease.

scholarly journals The etiology, manifestations, and therapy of chronic cerebrovascular diseases

2020 ◽  
Vol 12 (5) ◽  
pp. 84-91
Author(s):  
A. G. Gogoleva ◽  
V. V. Zakharov
Keyword(s):  
Cognitive Impairment ◽  
Pathological Condition ◽  
Clinical Manifestations ◽  
Vascular Cognitive Impairment ◽  
Cerebrovascular Diseases ◽  
International Standards ◽  
Amyloid Angiopathy ◽  
Neuroradiological Diagnosis ◽  
Genetically Determined

The paper presents the current etiopathogenetic classification of chronic cerebrovascular diseases (CVD) and discusses the role of hypertension, cerebral amyloid angiopathy, and genetically determined syndromes in the development of this pathological condition. It gives recommendations for the neuroradiological diagnosis of chronic CVD in accordance with the international standards. The paper discusses the clinical manifestations of chronic CVD, primarily vascular cognitive impairment. It discusses international guidelines for the examination and treatment of patients with chronic CVD, as well as the rules for stroke prevention in this patient cohort. The possibilities of pathogenetically based therapy in decreasing the severity of vascular cognitive impairment in the presence of chronic CVD are also highlighted.

scholarly journals Molecular Mechanisms of Curcumin in COVID-19 Treatment and Prevention: A Global Health Perspective

2020 ◽  
Vol 8 (10) ◽  
Author(s):  
Nathan Roberts ◽  
Robert Brown ◽  
L. Buja ◽  
Priya Weerasinghe
Keyword(s):  
Molecular Mechanisms ◽  
Curcuma Longa ◽  
Clinical Manifestations ◽  
Free Radical Scavenger ◽  
Radical Scavenger ◽  
Respiratory Disorder ◽  
Therapeutic Effects ◽  
Electron Transfer Mechanism ◽  
Treatment And Prevention ◽  
History Of

Turmeric (Curcuma Longa) has a near 4000-year history of extensive medical use in South Asia. Its main physiologically active phytochemical is curcumin (diferuloylmethane), derived from the rhizome of turmeric. Curcumin is a hydrophobic polyphenol with a diketone moiety connecting two phenoxy rings. It is widely available, and exerts systemic and pleiotropic effects via several key mechanisms. Most famously, it is known to inhibit pro-inflammatory pathways such as PI3k/akt/NF-kB activation. It is also a potent antioxidant and free radical scavenger via a sequential proton loss electron transfer mechanism in ionizing solvents due to its extended conjugating ability across the entire molecule, and its ability to induce NRF-2. It has been implicated in the treatment of diseases ranging from asthma to various cancers, and is also a broad spectrum anti-microbial. COVID-19 is a novel beta-coronavirus that was declared a pandemic by the WHO in March, 2020. It is primarily a respiratory disorder, but it can spread hematogenously and effect many other organs such as the heart, nervous system, and kidneys. There is a significant intersection between the clinical manifestations of COVID-19 and curcumin’s therapeutic effects. In addition, curcumin has been shown to inhibit initial viral infectivity. Thus, there is potential for curcumin to safely both prevent and treat COVID-19 infection across the globe.

scholarly journals MODERN VIEWS REGARDING THE ETIOPATHOGENESIS, DIAGNOSTIC, TREATMENT AND PREVENTION OF APERT SYNDROME

2020 ◽  
Vol 16 (4) ◽  
Author(s):  
V.V. Antsupva ◽  
I.V. Lastivka ◽  
D.V. Kolubakin ◽  
I.A. Ushko ◽  
О.V. Nahornyi
Keyword(s):  
Congenital Malformations ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Practical Interest ◽  
Apert Syndrome ◽  
Congenital Defects ◽  
Comprehensive Treatment ◽  
Pathogenetic Mechanisms ◽  
Treatment And Prevention ◽  
Surgical Methods

Relevance. Acrocephalosyndactyly – a group of syndromes of multiple congenital malformations (MCM), the main components of which are acrocephaly and syndactyly. The most common nosological form of this group is Apert syndrome. Given the manifestation of the syndrome at birth and severe congenital defects of the musculoskeletal system, brain, cardiovascular system, and others, this disease is of practical interest to doctors of many specialties. Objective: to generalize modern ideas about the pathogenetic mechanisms, diagnostic, treatment, and prevention of Apert syndrome. Materials and methods. Clinical case of Apert syndrome. Clinical and genealogical, biochemical, cytogenetic, instrumental methods of examination. Results. The paper presents a clinical case of Aper syndrome in a newborn girl with multiple malformations. Modern information on pathogenetic mechanisms, diagnostic, treatment, and prevention of Aper's syndrome is provided. Conclusions. Apert syndrome belongs to a group of syndromes of multiple congenital malformations that require the attention of doctors of various specialties. The main clinical manifestations of the disease are quite specific which allows establishing the diagnosis at birth. At the core of Aper's syndrome are mutations in the FGFR2 gene. There is a prenatal diagnostic of the disease. Reconstructive surgical methods of treatment have been developed. Timely comprehensive treatment and rehabilitation allow such patients to adapt to society.

scholarly journals Possibilities of chronic brain ischemia manifestations correction in outpatient practice

2021 ◽  
pp. 61-68
Author(s):  
O. A. Shavlovskaya ◽  
N. I. Shavlovskiy ◽  
Yu. D. Yukhnovskaya
Keyword(s):  
Brain Ischemia ◽  
Motor Coordination ◽  
Medicinal Preparation ◽  
Cerebrovascular Diseases ◽  
Glutamate Excitotoxicity ◽  
Energy Status ◽  
Permanent Disability ◽  
Energy Deficiency ◽  
Adaptive Capabilities ◽  
Chronic Brain Ischemia

Cerebrovascular diseases (CVD) are one of the main causes of mortality and permanent disability in patients. Chronic brain ischemia (CBI) is a slowly progressive dysfunction of the brain with gradually increasing defects in its functioning, which is accompanied by energy deficiency. Early use of energy correctors, one of the representatives of which is ethylmethylhydroxypyridine succinate (EMHPS), is recommended to preserve the viability of nervous tissue in patients with CBI. A number of experimental, clinical, and randomized studies have shown that medicinal preparation (MP) containing EMHPS improve brain metabolism and blood supply, improve microcirculation, and reduce platelet aggregation. The main mechanisms of action are: antioxidant and membranotropic effects, the ability to reduce glutamate excitotoxicity, modulate the functioning of receptors and membrane-bound enzymes, restore neurotransmitter balance, and increase the energy status of the cell. The liberal MP EMHPS included in the standards of medical care for patients with stroke, angina pectoris, acute myocardial infarction. The presented data from the results of numerous studies and our own observation indicate that it is possible to correct cognitive, motor, coordination, and adaptive capabilities while taking EMGPS. Used for today the scheme of appointment of EMHPS in patients with CBI: starting from 500 mg once a day intravenously (i/v) in drip for 14 days, followed by a transition to oral reception (o/r) at a dose of 250 mg 3 times a day, a course of 60 days.

scholarly journals A Review on the Hypotheses about Arterial Hypertension from the Viewpoint of Traditional Persian Medicine

2020 ◽  
Vol 9 ◽  
pp. 1065
Author(s):  
Davoud Hasani ◽  
Mohsen Bahrami ◽  
Hassan Ahanghar ◽  
Mohammad Kamalinejad ◽  
Soghrat Faghihzadeh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Cerebrovascular Diseases ◽  
Main Risk Factor ◽  
Persian Medicine ◽  
History Of ◽  
Traditional Persian Medicine ◽  
Artery Disease

Hypertension is one of the most common chronic diseases in recent decades worldwide. It has been distinguished as the main risk factor of coronary artery disease, aortic dissection, heart failure, renal failure, cerebrovascular diseases, and death. In recent years, the global attention has been paid to complementary medicine to preventive, diagnostic and treatment strategies for hypertension, in previous studies, the history of hypertension from the viewpoint of traditional Persian medicine have been reviewed and several hypotheses raised. In this article, we present the concept of an Iranian physician namely Ali ibn Sahl Rabban al-Tabari on hypertension, which has not been considered properly until now. He defined a state called “Hayajan al-dam” that has clinical manifestations similar to hypertension, although these are not the same, also, we reviewed the viewpoint of other Persian medicine scholars namely Rhazes, Haly Abbas, Akhawayni and Avicenna for this topic. [GMJ.2020;9:e1065]

scholarly journals Treatment of comorbid patients with chronic brain ischemia and vertebrogenic pain syndromes

2019 ◽  
pp. 15-20
Author(s):  
V. V. Zakharov ◽  
V. V. Grinyuk ◽  
N. V. Vakhnina ◽  
E. Yu. Kalimeeva
Keyword(s):  
Chronic Pain ◽  
Brain Ischemia ◽  
Cerebrovascular Diseases ◽  
Emotional Disturbances ◽  
Chronic Cerebral Ischemia ◽  
Ischemic Brain ◽  
Pain Syndromes ◽  
Chronic Brain Ischemia ◽  
Microcirculatory Disturbances ◽  
Common Risk Factors

Chronic brain ischemia and chronic pain both appear to be an extremely wide-spread disease. The reasons of widespread comorbidity of ischemic brain disease and chronic pain are common risk factors: old age, decrease of physical activity, syndrome of systemic inflammation and emotional disturbances. Treatment of patients with cerebrovascular diseases and chronic pain should influence common mechanisms of these disorders. Correction of microcirculatory disturbances pays particular important role, because this is the mechanism not only of chronic cerebral ischemia but compressive-ischemic radiculo- and neuropathy also.

scholarly journals MECHANISMS OF DEVELOPMENT, OPPORTUNITIES FOR DIAGNOSTICS, TREATMENT, AND PREVENTION OF ALLERGIC RESPONSES TO DRUGS

2019 ◽  
Vol 22 (1) ◽  
pp. 42-50
Author(s):  
V. A. Bulgakova ◽  
T. I. Eliseeva ◽  
I. I. Balabolkin ◽  
I. E. Smirnov
Keyword(s):  
Drug Allergy ◽  
Pathological Condition ◽  
Clinical Manifestations ◽  
Underlying Disease ◽  
Cross Reactivity ◽  
Drug Of Choice ◽  
Treatment And Prevention ◽  
Wide Range

Drug allergy includes a wide range of immunological hypersensibility responses with various pathogenesis mechanisms and clinical manifestations. This is a serious type of adverse responses to drugs, which not only affects the quality of life of patients, complicates the treatment of the underlying disease, but in some cases is a potentially life-threatening pathological condition. Given the polymorphic symptoms of drug allergy, its diagnosis is often very difficult. The diagnosis is based on a thorough clinical examination of patients, in some cases, a special allergological examination may be required using in vitro and in vivo tests. An effective strategy for treating drug allergy is to prevent or block the action of a causally important drug. In the presence of alternative preparations, drugs that may cause allergies in a particular patient should be replaced with drugs with a fundamentally different chemical structure. When choosing alternative medications, possible cross-reactivity that occurs among drugs should be considered. Additional therapy in the management of patients with drug hypersensibility responses may include systemic and local corticosteroids, systemic antihistamines. In the case of anaphylaxis, the starting drug of choice is adrenaline. If in the presence of drug allergy to a certain preparation, it is not possible to find an adequate alternative and it is not possible to cancel this type of treatment, then the possibility of carrying out specific immunotherapy with this drug to induce tolerance to a causative drug may be considered.

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