scholarly journals Pharmacotherapy of insomnia in patients with occupational chronic mercury intoxication

2020 ◽  
Vol 99 (10) ◽  
pp. 1132-1138
Author(s):  
E. H. Korchuganova ◽  
E. V. Katamanova ◽  
N. V. Slivnitsyna
Keyword(s):  
Sleep Disorders ◽  
Statistical Processing ◽  
Sleep Time ◽  
Efficiency Index ◽  
Treatment Regimens ◽  
Falling Asleep ◽  
Mercury Intoxication ◽  
Leading Position ◽  
Chronic Mercury Intoxication

Introduction. Among occupational poisoning, chronic mercury intoxication (CMI) in the Irkutsk region occupies a leading position. Objective. To give a comparative analysis of the methods of pharmacotherapy of sleep disorders in patients in the long-term CRI. Material and methods. The study included 60 patients with long-term CRI, divided into two equal groups of 30 cases: in the first, the average age was 56.0 ± 0.7, in the second, the average age was 57.1 ± 3.0. Questionnaires were conducted using the hospital scale of anxiety and depression, electroencephalographic, polysomnographic studies before and after treatment. During the study, two treatment regimens for sleep disorders were implemented: the first regimen included the administration of an antidepressant (trazodone) and the chemical analog of melatonin (melaxen), and the second regimen was zolpidem. Statistical processing of the research results was carried out using the software package “Statistica 6.0”. Results. After treatment, in the first group there was an increase in the duration of the total sleep time (p = 0.0008), a decrease in the time of falling asleep (p = 0.004), a decrease in the total number of activations (p = 0.00005), and the time of wakefulness in bed (p = 0.0018), an increase in the representation of delta sleep (p = 0.03), and REM sleep (p = 0.004), an increase in the sleep efficiency index (p = 0.0008), and a decrease in the integrative sleep quality index (p = 0.001). In the second group, only a decrease in the latent period of stage 1 (time of falling asleep) was established (p = 0.05). Discussion. After treatment with trazodone in combination with melaxen, a decrease in the severity of presomnic and intrasomnic disorders was found, and in patients taking zolpidem, only the severity of presomnic disorders was reduced. The results confirm the hypothesized cause of dissominal disorders in CRI (changes in the activity of the limbic-reticular complex). Conclusion. The use of trazodone in combination with melaxen proves the improvement of the qualitative and quantitative indices of the structure of night sleep in patients in the long-term postexposure period of CRI.

scholarly journals DIAGNOSTIC CRITERIA OF SLEEP DISORDERS IN PATIENTS WITH LONG-TERM CHRONIC MERCURY INTOXICATION

2019 ◽  
Vol 98 (10) ◽  
pp. 1155-1160 ◽  
Author(s):  
Elena V. Katamanova ◽  
N. V. Slivnitsyna ◽  
E. N. Korchuganova ◽  
O. I. Shevchenko
Keyword(s):  
Sleep Disorders ◽  
Diagnostic Criteria ◽  
Sleep Disturbances ◽  
Comparison Group ◽  
Total Sleep Time ◽  
Behavioral Therapy ◽  
Sleep Time ◽  
Mercury Intoxication ◽  
Chronic Mercury Intoxication

Introduction. In the Irkutsk region, chronic mercury intoxication (CRI) occupies a leading place among occupational neurointoxications. An organic personality disorder with insomnia is one of the manifestations of brain damage in CRI. The aim of the study was to establish diagnostic criteria for secondary insomnia in patients with professional CRI for the selection of effective treatment. Material and methods. The study involved 30 people in the long-term CRI and 30 people in the comparison group with sleep disorders that are not in contact with harmful factors. Electroencephalographic, polysomnographic research and questioning were carried out with the assessment of the subjective characteristics of sleep. Information was processed using the Statistika 6.0 application package. Results. It was shown that CRI patients were shown to complain statistically significantly more frequent sleep disturbances than in the comparison group (p = 0.0003), difficulty in maintaining sleep (p = 0.004). As a result of EEG in the group of patients in the long-term CRI, the integral index and the ratio α/β were statistically significantly different from those in the comparison group, and according to the results of polysomnography, more pronounced qualitative and quantitative violations of the night sleep pattern were found in CRI patients; as a decrease in total sleep time (p = 0.0001), increase in sleep time (p = 0.008), number of activations and total wakefulness inside sleep (p = 0.03), decrease in sleep efficiency index (p = 0.006) and increase in an integrative sleep quality index (p = 0.03). According to the discriminant analysis, 4 criteria for diagnosing insomnia in CRI were established: total sleep time (min.), duration of the first stage of slow sleep (%), rhythm ratio α/β, EEG (%) and integral EEG index (%). Conclusion. Considering the data obtained, it is possible to improve approaches to treating insomnia in CRI by prescribing a complex of treatment, including cognitive-behavioral therapy, antidepressants with a sedative effect, as well as alpha training using biofeedback.

scholarly journals Features and patterns of changes in neurochemical parameters at different stages of chronic mercury intoxication

2021 ◽  
Vol 100 (12) ◽  
pp. 1462-1466
Author(s):  
Irina V. Kudaeva ◽  
Viktor S. Rukavishnikov ◽  
Oleg L. Lakhman
Keyword(s):  
Neurotrophic Factors ◽  
Initial Period ◽  
General Pattern ◽  
Statistical Processing ◽  
Mercury Intoxication ◽  
Group 3 ◽  
Group 2 ◽  
Chronic Mercury Intoxication ◽  
Group 1

Introduction. At present, the features of the clinical picture and pathogenesis of the formation and progression of chronic intoxication under the influence of mercury remain insufficiently studied. Purpose. To study the features and patterns of changes in the neurotransmitters and neurotrophic factors concentration at different stages of chronic mercury intoxication (CMI). Materials and methods. A cohort examination of 69 workers (group 1) exposed to mercury, 18 individuals in the initial period of CMI (group 2), and 55 patients in the long-term period (group 3) were carried out. The content of neurotransmitters and neurotrophic factors was determined by enzyme immunoassay. The statistical processing included Wilcoxon, Kruskal-Wallis and Mann-Whitney tests. Results. Higher levels of histamine were found in group 2, low levels of metanephrine in group 1, and normetanephrine in group 3. An increase in the BDNF concentration was revealed in group 2 compared with groups 1 and 3. The content of neurotrophin-3 in group 3 was statistically significantly lower than in group 2. Conclusion. The general pattern for all stages is an increase in the norepinephrine and CNTF concentration. Mercury neurointoxication at all stages is characterized by high serotonin levels. A distinctive feature for trained workers is a compensatory increase in the normetanephrine level and a low BDNF and NT-3. For the initial period of CMI, an increase in the histamine, BDNF and NT-3 content is characteristic. The long-term period is characterized by an imbalance in the concentration of the studied neurotransmitters and neurotrophic factors.

The interrelation of neurophysiological, psychological, and biochemical indicators in patients with occupational chronic mercury intoxication suffering from insomnia

2020 ◽  
Vol 60 (12) ◽  
pp. 904-910
Author(s):  
Elena V. Katamanova ◽  
Elena N. Korchuganova ◽  
Natalia V. Slivnitsyna ◽  
Irina V. Kudaeva ◽  
Oleg L. Lakhman
Keyword(s):  
Cerebral Cortex ◽  
Work Experience ◽  
Sleep Time ◽  
Serotonin Level ◽  
Complex Activity ◽  
Equivalent Dipole ◽  
Mercury Intoxication ◽  
Psychological Examination ◽  
Reticular System ◽  
Chronic Mercury Intoxication

Introduction. Despite the apparent connection of the existing neurological disorders and changes in the psycho-emotional sphere with sleep disorders in patients with chronic mercury intoxication (CRI), these relationships remain the least studied in the clinic neurointoxications. The study aimed to establish a connection between neurophysiological, biochemical, and psychopathological indicators in patients with occupational chronic mercury intoxication and insomnia. Materials and methods. Thirty-six patients took part in the examination in the remote period of CRI. The average age of patients in this group was 50.7±1.05 years, with an average work experience of 14.7±1.05. The authors carried out a psychological examination to determine the levels of depression, anxiety, asthenic state, computed electroencephalography (EEG), cognitive evoked potentials (CEP), polysomnography, the level of neurotransmitters. Results. The study showed that asthenization, when exposed to mercury, occurs due to a decrease in the limbic-hypothalamo-reticular complex activity (the presence of equivalent dipole sources of pathological activity in the area of diencephalic formations (thalamus, hypothalamus) in 56.2±5.6% of cases. The study showed a decrease in activity cerebral cortex, confirmed by weakening the coherent connections of the α-range in the occipital, central and frontal leads according to the data of coherent EEG analysis and changes on the part of the CEP. There was a direct correlation between the level of total sleep time and the serotonin level (rs=0.45), an inverse relationship between the level of depression and histamine level (rs=-0.56). Conclusion. The studies carried out to make it possible to establish the mechanisms of insomnia disorders in chronic mercury intoxication, which cause a weakening of the tone of the cerebral cortex and changes in neurotransmitter metabolism, as well as disorders of the reticular system with limbic structures. The study showed a close direct relationship between neurophysiological, psychological, and biochemical parameters in implementing insomnia in patients with chronic mercury intoxication.

scholarly journals PHENOTYPIC COMPOSITION OF PERIPHERAL BLOOD LYMPHOCYTES AND THEIR COOPERATION IN PATIENTS WITH CHRONIC MERCURY INTOXICATION IN A POST-CONTACT PERIOD

2019 ◽  
Vol 98 (10) ◽  
pp. 1091-1095
Author(s):  
Elena V. Boklazhenko ◽  
G. M. Bodienkova
Keyword(s):  
Immune System ◽  
Peripheral Blood ◽  
Peripheral Blood Lymphocytes ◽  
Contact Period ◽  
Blood Lymphocytes ◽  
Mercury Intoxication ◽  
System Functioning ◽  
Therapeutic Measures ◽  
Chronic Mercury Intoxication

Introduction. Based on the current understanding of the progression of professional chronic mercury intoxication, it is extremely important to study the regulatory activity of immunocompetent cells after the cessation contact with mercury to develop effective therapeutic measures. The purpose of the study was to study the population and subpopulation spectrum of peripheral blood lymphocytes and their cooperation in patients with chronic mercury intoxication in a distant postexposure period. Material and methods. Phenotyping of lymphocytes in the blood of the subjects was carried out by the method of indirect immunofluorescence using monoclonal antibodies to the molecules CD3+, CD4+, CD8+, CD9+, CD16+, CD20+, CD21+, CD23+, CD25+, CD95+. Results. In patients with chronic mercury intoxication in the long-term postexposure period, there were revealed features of the immune system functioning, indicating hyperactivation of both T- and B-components of the immune system. An increase in the total population of T-lymphocytes was established due to an increase in cells with receptors CD4+ (T-lymphocyte-helper cells) and CD16+ (killer cells), as well as an increase in the number of mature B-lymphocytes (CD20+) and pre-B-immature-lymphocytes (CD9+). Changes in the system of lymphocyte apoptosis, characterized by an increase in the number of cells expressing receptors for readiness for Fas-dependent apoptosis (CD95+), have been recorded. The established relationships between populations and subpopulations of lymphocytes indicate their importance in the implementation of the immune response, high activity and contingency between the components of the immune system in persons with chronic mercury intoxication after the termination of contact with the toxicant. Conclusion. The results obtained are the basis for long-term monitoring of the health status and improvement of the tactics of treating patients with neurointoxication with mercury in the postexposure period.

scholarly journals Role of intercellular adhesion molecules and antibodies to oxidized LDL in pathogenesis of cardiovascular diseases under mercury exposure

2020 ◽  
Vol 99 (10) ◽  
pp. 1120-1126
Author(s):  
Olga V. Naumova ◽  
Irina V. Kudaeva ◽  
Lyudmila B. Masnavieva ◽  
Olga A. Dyakovich
Keyword(s):  
Cardiovascular Diseases ◽  
Adhesion Molecules ◽  
Oxidized Ldl ◽  
Intercellular Adhesion ◽  
Cardiovascular Pathology ◽  
Mercury Intoxication ◽  
Intercellular Adhesion Molecules ◽  
Chronic Mercury Intoxication

Introduction. Exposure to mercury and its compounds can be a risk factor for the development of cardiovascular diseases. The aim of the study is to investigate the levels of antibodies to oxidized LDL, intercellular adhesion molecules sICAM-1, sVCAM-1, and VEGF in individuals exposed to mercury. Material and Methods. A cross-sectional examination was carried out using biochemical methods in persons who have come into contact with metallic mercury with a work experience of more than five years, persons with a first established diagnosis of chronic mercury intoxication, and patients with chronic mercury intoxication in the long-term postexposure period. Results. In persons exposed to mercury with concomitant cardiovascular diseases, the level of sVCAM-1 differed depending on the presence/absence of intoxication and acquired maximum values in its long-term period, while the concentrations of sICAM-1 and antibodies to oxidized LDL did not differ significantly. In the groups without cardiovascular pathology exposed to mercury, the concentration of sVCAM-1 was higher in patients with intoxication, and sICAM-1 was 1.5-2 times lower when compared with experienced individuals, the level of antibodies to oxidized LDL was maximum in the presence of intoxication in its initial period. Discussion. The progression of chronic mercury intoxication is accompanied by an increase in the level of sVCAM-1, and a gradual decrease in the content of sICAM-1 to reference values. Trained workers were found to have elevated sICAM-1 levels. Conclusion. The role of antibodies to oxidized LDL, intercellular adhesion molecules is their multidirectional participation in the mechanisms that inhibit or contribute to the formation of cardiovascular pathology in individuals exposed to mercury.

Evaluation of an integrated approach to the treatment of sleep disorders in patients with occupational occupational chronic mercury intoxication

2019 ◽  
pp. 291-296 ◽  
Author(s):  
Elena N. Korchuganova ◽  
Elena V. Katamanova ◽  
Natalya V. Slivnitsyna ◽  
Polina V. Kazakova
Keyword(s):  
Quality Of Life ◽  
Sleep Disorders ◽  
Comparison Group ◽  
Health Related Quality ◽  
Production Factors ◽  
Mercury Intoxication ◽  
Related Quality ◽  
Health Related ◽  
Chronic Mercury Intoxication

Introduction. The issues of studying the central nervous system (CNS) damage under the influence of mercury remain relevant at the present time.The aim of the study was to identify the relationship of dissomnic and psychological disorders in patients in the remote post-exposure period of chronic mercury intoxication (ChMI) and to substantiate the effectiveness of the proposed scheme of their therapy.Materials and methods. The study involved 30 patients in the long-term period with occupational chronic mercury intoxication (CHMI) and 30 patients in the control group (CG), with complaints of sleep disorders without chronic expressed diseases, not in contact with toxic production factors in professional activity, 84 men — residents of the Irkutsk region from the comparison group to assess the health-related quality of life comparable with patients in social and living conditions and not in contact with harmful production factors. A set of clinical, neurophysiological, psychological and statistical methods was used in study.Results. Based on the data of polysomnographic examination revealed differences in the nature and severity of insomnia in patients of these groups. Confirmed the mixed nature of insomniatic disorders in patients with chronic mercury intoxication. Patients CG revealed changes in the structure of night sleep has focused on intracomesa violations. It was found that patients with CHMI suffer from a more severe form of insomnia compared to patients with CG, which is confirmed by the data of medical and psychological testing. High rates of reactive and personal anxiety, moderate levels of depression and asthenic state, as well as low values of estimates on all scales of health-related quality of life (HRQL), including the total physical and mental components, were revealed in patients with CRMI. Research’s scales HRQL in patients CG with sleep disorders did not reveal any significant differences compared with those in the comparison group, indicating medium and high levels of overall quality of life.Conclusions. The adequacy of the use of a complex of therapeutic and preventive measures, including two main methods of treatment of insomnia disorders, is proved by improving the quality and quantity of sleep structure and emotional and personal sphere.

scholarly journals Comparative assessment of cardiac-specific autoantibodies levels in persons with occupational pathology caused by exposure to physical and chemical factors

2020 ◽  
Vol 99 (10) ◽  
pp. 1086-1092
Author(s):  
Liudmila B. Masnavieva ◽  
Irina V. Kudaeva ◽  
Olga V. Naumova ◽  
Nadezhda P. Chistova ◽  
Olga A. Dyakovich
Keyword(s):  
Endothelial Dysfunction ◽  
High Frequency ◽  
Comparison Group ◽  
Vascular Endothelial Cell ◽  
Exposure Period ◽  
Comparative Assessment ◽  
Post Exposure ◽  
Mercury Intoxication ◽  
Chronic Mercury Intoxication

Introduction. The pathology of the cardiovascular system is one of the dominant causes of mortality. It has been established that exposure to vibration and mercury is associated with the development of heart and vascular diseases. Specific autoantibodies can be used as markers of exposure effects. The aim of the work was a comparative assessment of the levels of cardiac-specific autoantibodies in individuals with vibrational disease (VD) and chronic mercury intoxication. Material and methods. We examined VD patients, with chronic mercury intoxication (CMI), who work in contact with a toxicant and in the long-term post-exposure period, and the comparison group. The relative content of specific autoantibodies to nitric oxide synthase (NOS), platelet membrane components (PMC), neutrophil cytoplasm, and vascular endothelial cell antigens (c-ANCA), plasminogen, collagen, and PAPP-A protein were studied in the patient’s blood serum. Results. In individuals with CMI, the levels of autoantibodies PCM, c-ANCA are lower for plasminogen and higher for collagen than in the comparison group and in VD patients. Elevated levels of anti-collagen antibodies were found in 70% of individuals with CMI. Among patients with CMI, elevated levels of antibodies to NOS were found in 60% of persons exposed to mercury and were not detected in the long-term post-exposure period. Discussion. The high frequency of elevated levels of antibodies to collagen and correlations between their level and the rest of the indices may indicate its important role in the development of endothelial dysfunction in persons with CMI. Elevated levels of autoantibodies to NOS in patients exposed to mercury are accompanied by a decrease in NO levels and may be an important part of the pathogenesis of endothelial dysfunction. Conclusion. The profile of cardiac-specific autoantibodies in VD patients is similar to that in the comparison group. Elevated levels of antibodies to collagen and decreased levels of antigens of platelets and plasminogen play an important role in the development of endothelial dysfunction in patients with CMI. The high frequency of hyper immunoreactivity of autoantibodies to NOS and c-ANCA, which is observed in patients with CMI who are in contact with a toxicant, decreases in the long-term post-exposure period.

scholarly journals A SYSTEMATIC ANALYSIS OF RELATIONSHIPS BETWEEN BIOCHEMICAL INDICES IN PERSONS EXPOSED TO MERCURY

2018 ◽  
Vol 97 (10) ◽  
pp. 990-994
Author(s):  
Irina V. Kudaeva ◽  
L. B. Masnavieva ◽  
O. V. Naumova ◽  
O. A. Dyakovich
Keyword(s):  
Nervous System ◽  
Lipid Metabolism ◽  
Mercury Vapor ◽  
Systematic Analysis ◽  
Lipid Metabolism Disorders ◽  
Mercury Intoxication ◽  
Chronic Mercury Intoxication ◽  
Biochemical Indices ◽  
The Relationship

Introduction. Changes in biochemical indices characterizing the state of lipid peroxidation processes - antioxidant protection and lipid metabolism are observed during the occupational contact with mercury. These changes play a certain pathogenic role in the formation of disorders in the nervous system during mercury intoxication. In this regard, the aim was to study the relationship between biochemical indices at different stages of the development of mercury intoxication to justify approaches to therapeutic and preventive measures. Material and methods. A prospective cohort examination of persons exposed to the mercury vapor with signs of disorders in the nervous system, patients with chronic mercury intoxication and working in contact with mercury more than 5 years without signs of pathology was carried out. To study the relationship of features between biochemical indices, the sum of the square of correlation relations between the indices was calculated, the ranks of the influence of the system components on other factors and their dependencies were determined. Results. The decline in the level of nitric oxide metabolites was found to be one of the initial, long-term persisting in the pathogenesis of biochemical abnormalities, formed due to the contact with mercury. The development of the nervous system pathology under the mercury influence is accompanied by a change in the ratio of pro- and anti- oxidative processes, lipid metabolism disorders have an independent pathogenic significance. The long-term period of the chronic mercury intoxication is characterized by the formation of complex relationships in the biochemical system, the presence of several closed subsystems, which include nitrogen oxide metabolites. Conclusion. Given peculiarities of systemic interactions between biochemical indices, determining the role of certain factors in the overall system, as well as the presence/absence and composition of subsystems, pathogenic approaches to the correction of metabolic disorders at various stages of the mercury intoxication formation should be different.

Analysis of relationships between biochemical markers of endothelial dysfunction in chronic mercury exposure

2020 ◽  
Vol 60 (11) ◽  
pp. 834-836
Author(s):  
Olga V. Naumova ◽  
Olga A. Dyakovich
Keyword(s):  
Endothelial Dysfunction ◽  
Occupational Disease ◽  
Work Experience ◽  
Exposure Period ◽  
Biochemical Indicators ◽  
Production Factors ◽  
Mercury Intoxication ◽  
Chronic Mercury Intoxication ◽  
The Relationship

Introduction. The cause of the development of endothelial dysfunction (ED) and, as a result, the pathology of the cardiovascular system may be exposure to mercury. The aim of study is to study the relationship between ED markers in individuals exposed to mercury. Materials and methods. A survey was carried out using biochemical and statistical methods in persons exposed to mercury with more than five years of work experience, and in patients with chronic mercury intoxication in the long-term post-exposure period. Results. Relationships of biochemical indicators of ED of various directions have been established, indicating the presence of pathological changes in the endothelium of vessels in which its different links are involved. Conclusions. Associations were established between the exposition load and the concentration of ED markers in workers without occupational disease, which indicates the contribution of production factors to its formation during contact with the toxicant. The results of the study of the correlation of biochemical indicators of ED indicate the presence of complex associations that form a closed system between its markers at the stage before the formation of occupational disease, and their disunity in the distant period of chronic mercury intoxication, especially in the presence of CVD.

scholarly journals Differential diagnostic method of initial implications and degree I of the chronic mercury intoxication

2019 ◽  
Vol 95 (8) ◽  
pp. 769-773
Author(s):  
Irina V. Kudaeva ◽  
E. V. Katamanova ◽  
O. V. Popkova ◽  
L. B. Masnavieva ◽  
O. A. Dyakovich
Keyword(s):  
Evoked Potentials ◽  
Auditory Evoked Potentials ◽  
Statistical Processing ◽  
Mercury Vapor ◽  
Long Latency ◽  
Initial Symptoms ◽  
Mercury Intoxication ◽  
Standard Values ◽  
Chronic Mercury Intoxication ◽  
V Wave

Currently available methods for diagnosis of chronic mercury intoxication (CMI) are applied at the any stage of the disease. Changes in these indices sometimes have no the specificity for any CMI stage, and a conclusion on them has the descriptive character. In addition, the above mentioned methods possess not sufficiently high accuracy in the diagnosis of intoxication at early stages of the development of the disease. The purpose of the research is the development of the method permitting to make the differential diagnosis between the initial symptoms of mercury poisoning and its first degree. 118 men who work/worked in the contact with mercury vapor were examined. There were evaluated electroencephalogram, long-latency auditory and cognitive evoked potentials, cerebral hemodynamics, noradrenaline (NA)content in the blood plasma. Statistical processing was performed with the use of «Statistica 6.0» software. The levels of NA in the development of CMI were shown to increase, by the time of the shaping of this disease the noted change was decompensated in the nature. The study of reactivity of cerebral vessels revealed the presence of abnormal responses during hypercapnic load in 14 - 24% of examined cases. In the analysis of auditory evoked potentials there was established the change in indices of latency and amplitude of the V- wave, which pronounced in the prolong response time, significant elongation in the P1 peak latency and the gain in the latency of N1 peak. There was established the presence of the wave-like change in the index of the latency of P300. In workers without an occupational disease, there was noted the marked elongation of the latent period of cognitive potential, while in patients with the newly made diagnosis the latency of P300 corresponded to standard values, and in the long term there was observed a sharp deterioration in this index. With the aid of the discriminant analysis with the calculation of canonical value there were revealed the most informative neurobiochemical indices, reoencephalogric ones and evoked potentials. The developed method of diagnosis allows to distinguish between the initial symptoms of mercury intoxication and the first stage of the disease.

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