bluuebunny/crossref_metadata_2025 huggingface dataset:
#108 Padrões de cuidados de higiene oral em pacientes internados – Domicílio vs internamento
Authors:   Faculdade de Medicina Dentária da Universidade de Porto, EPIUnit – Unidade de Investigação em Epidemiologia, Instituto de Saúde Pública da UP, Martins Cláudia , Pereira Maria ,   Faculdade de Medicina Dentária da Universidade de Porto, EPIUnit – Unidade de Investigação em Epidemiologia, Instituto de Saúde Pública da UP
Published: January 2025

Objetivos: Os pacientes internados sentem-se, de um modo geral, vulneráveis e focados no seu processo de doença. Alguns pacientes, nomeadamente na faixa etária idosa, não possuem hábitos de higiene oral no domicílio. Todavia, com o internamento, há uma negligência dos cuidados orais colocando em risco a saúde geral dos próprios. Isto pode também ser potenciado pela perda de autonomia. Este estudo teve como objetivo conhecer e comparar os hábitos de higiene oral dos pacientes no domicílio e durante o internamento. Métodos: Foi realizada uma entrevista estruturada numa unidade de internamento de um hospital público onde, para além dos dados sociodemográficos, pretendeu-se caracterizar os hábitos de higiene oral, comparando-os com os praticados durante o internamento. Foram incluídos pacientes com idades superiores a 25 anos que se encontravam auto e alo-psiquicamente orientados, e que, de forma consentida, manifestaram interesse em participar neste estudo. Utilizou-se o teste de McNemar para comparação de comportamentos antes e durante o internamento. Foi utilizado um nível de significância de 0,05. Resultados: Obteve-se um total de 45 participantes. A maioria do sexo masculino e com média de idades de 71,2 ± 11,78 anos, tendo o mais novo 47 anos e o mais velho 99 anos. A frequência adequada da higiene oral, no domicílio, é realizada por 48,9% dos participantes, mas no internamento, é de 17,7%. A escovagem no período noturno, durante o internamento é negligenciada, sendo realizada por 21,6%. No domicílio, o fio dentário somente é utilizado diariamente por 4,4%; no internamento, ninguém referiu. Quanto à auto-perceção geral de saúde oral, 48,9% dos participantes avaliaram a capacidade mastigatória como regular a má. Contudo, 64,4% e 66,6% avaliaram como muito boa a boa a capacidade em falar e a saúde geral da cavidade oral, respetivamente. Conclusões: Conclui- se que, na generalidade, a higiene oral é inadequada e desvalorizada no dia-a-dia dos pacientes com idade avançada apesar de a maioria percecionar a sua saúde oral como boa. Quando internados, os seus cuidados orais pioram. Assim, os internamentos hospitalares devem ser aproveitados pelos profissionais de saúde para desenvolver programas de educação para a saúde, de forma a criar hábitos saudáveis nos pacientes. Como a saúde oral não pode ser exceção, é essencial dotar profissionais de saúde qualificados para identificar, instruir e treinar sobre os cuidados orais junto dos pacientes internados.
The Epidemiology of Undiagnosed Illnesses A Call to Action in Saudi Arabia
Authors: Hussein Mohammed , Alqaed Hamad , Alhejeili Alhejeili , A Alboraa , Alkathery Faisal , Alharbi Abdulrahman , Aloraini Hassan , Alhassar Alhassar , Ali Abdullah , Sarhan Fatema , Alfaraj Abdullah , Alhai Saleh , Lashit Abbas
Published: January 2025

The prevalence of undiagnosed illnesses in Saudi Arabia presents a significant public health challenge, impacting individuals and the healthcare system. Epidemiological studies indicate that conditions such as diabetes, hypertension, and mental health disorders often go unnoticed due to a lack of effective screening protocols and public awareness. The rising burden of these chronic diseases can be traced to lifestyle changes, urbanization, and increased risk factors such as obesity and sedentary behavior. Current health initiatives may not adequately address unrecognized diseases, leading to late diagnoses and poorer health outcomes, emphasizing the urgent need for comprehensive screening programs and community education. To combat the growing issue of undiagnosed illnesses in Saudi Arabia, a multifaceted approach is essential. This includes enhancing healthcare infrastructure by incorporating advanced diagnostic tools and training healthcare professionals to recognize atypical symptoms. Public health campaigns should focus on raising awareness about common undiagnosed conditions, integrating mental health screenings into routine healthcare visits, and promoting healthy lifestyle choices. Collaboration between government entities, healthcare providers, and community organizations will be crucial to establish a sustainable framework for early detection and intervention. By prioritizing research and preventive measures, Saudi Arabia can improve health outcomes and reduce the burden of undiagnosed illnesses on its population.
Relationship Between Placenta Accreta Index Score and Management in Placenta Accreta Patients in RSUP Dr. M. Djamil Padang
Authors: Azhari Nabilah , Defrin Defrin , Nurhayati Nurhayati
Published: January 2025

Introduction : Placenta acreta index is a scoring system using ultrasound parameters used to diagnose placenta accreta. Parameters included are the number of previous caesarean section, location of the placenta, grading of lacunae, presence of bridging blood vessels, thickness of the myometrium. The management of placenta accreta is conservative and definitive management, where the definitive management performed is hysterectomy. The purpose of this study was to determine the relationship between PAI score and placenta accreta management in patients with placenta accreta at Dr. M. Djamil Hospital Padang.
Method : This type of research was observational analytic with cross sectional research design. This study was conducted in the medical record section uses a total sampling technique of 184 patients. Data analysis used univariate analysis, bivariate with Chi square test.
Result : The results of this study showed that 67.9% of patients with PAI≥4 scores, 56.5% of patients who underwent hysterectomy, and after the statistical test obtained a p value <0.001, then H0 was rejected, meaning that there was a relationship between placenta accreta index scores and placenta accreta management.
Conclusion : It is conclude from the results of this study there is a significant relationship between PAI score and placenta accreta management (P<0.05) in placenta accreta patients.
Keywords: Hysterectomy, placenta accreta, PAI score
Association Between Mode of Delivery and Incidence of Overactive Bladder (OAB) in Community Health Centers in Padang
Authors: Diniy Miftahul Muthmainah  , Utama Bobby Indra , Yetti Husna
Published: January 2025

Background: Overactive bladder (OAB) is a syndrome characterized by unstable bladder contractions and significantly impacts the quality of life. Risk factors such as age, pregnancy, and childbirth are often associated with lower urinary tract symptoms. While national epidemiological data on OAB in Indonesia is unavailable, a small study at a public health center in Padang revealed a high prevalence of OAB among pregnant women (97.14%). This study aims to analyze the association between mode of delivery and the incidence of OAB.
Method: This study employed a cross-sectional design conducted at community health centers in Padang. Data were collected through structured interviews and medical records. The inclusion criteria were women aged 20–45 years who had experienced at least one delivery. OAB was assessed using the Overactive Bladder Symptom Score (OABSS). Statistical analysis was performed to determine the association between delivery methods (vaginal or cesarean) and the incidence of OAB.
Result: Out of the total participants, 65.4% reported OAB symptoms. The incidence was significantly higher in women with a history of vaginal delivery compared to those with cesarean delivery (p < 0.05). Furthermore, age and parity were found to be contributing factors to OAB symptoms.
Discussion: The findings suggest that the mode of delivery is associated with the incidence of OAB, with vaginal delivery posing a higher risk. These results underscore the importance of counseling pregnant women about potential long-term urinary health outcomes associated with childbirth techniques. Further studies with larger samples and more diverse populations are recommended to validate these findings.
Keywords: overactive bladder, vaginal delivery, caesarean section
PENYULUHAN ANEMIA DEFISIENSI BESI PADA REMAJA PUTRI DI DESA NAGRAK KABUPATEN BOGOR
Authors: Mashabi Yasmine , Alvina Alvina , Ferina Mutiara , Amalia Husnun , Zalfa Afifah , Yuliarsa Cyntha Nasyanda , Ferdhian Farrel
Published: January 2025

Anemia adalah suatu keadaan di mana jumlah sel darah merah dan kapasitas pengangkutan oksigennya tidak mencukupi untuk memenuhi kebutuhan tubuh secara fisiologis. Penyebab anemia pada remaja sering dikaitkan dengan kebiasaan makan, menstruasi, dan pengetahuan. Selain itu, perhatian pada remaja dan wanita dewasa tidak secukup perhatian yang diberikan pada wanita hamil dan balita. Oleh karena itu, langkah-langkah efektif harus diambil untuk memberantas masalah gizi ini terutama untuk meningkatkan kualitas hidup dengan cara memberikan edukasi dengan metode penyuluhan serta menilai keberhasilannya dengan memberikan pre tes sebelum edukasi serta post tes setelah edukasi. Hasil dari edukasi ini sendiri berhasil meningkatkan pengetahuan remaja putri yaitu dengan adanya peningkatan pengetahuan hampir pada semua responden 21 orang (70%). Gambaran hasil pengetahuan menunjukkan bahwa kategori baik pada pre-test menunjukkan sebesar 77% responden, dan pada kategori baik pada post-test sebesar 97% responden. Dari hasil tersebut, terlihat adanya kenaikan pada kategori pengetahuan, baik sebelum dilakukan dan sesudah dilakukan edukasi Tujuan dari penyuluhan ini sendiri agar remaja putri dapat menerapkan perilaku pencegahan anemia sejak dini untuk dapat mempersiapkan diri sebaik mungkin dalam menghadapi kehamilan dan persalinan.
Роль проактивного підходу в інтегрованому управлінні соціальною відповідальністю бізнесу
Authors:   Чернівецький національний університет імені Юрія Федьковича, Лопащук Інна , Равлюк Андрій ,   Чернівецький національний університет імені Юрія Федьковича, Русінко Антон ,   Чернівецький національний університет імені Юрія Федьковича
Published: January 2025

У статті обґрунтовано необхідність розвитку соціальної відповідальності бізнесу в умовах загроз, викликаних війною і в повоєнному відновленні економіки та соціальної інфраструктури. Зазначено на актуальності використання саме проактивного підходу в управлінні соціальною відповідальністю бізнесу, який на відміну від реактивного підходу дає змогу завдяки стратегічному прогнозуванню та плануванню ухвалювати ефективні управлінські рішення, спрямовані на передбачення можливих проблем у майбутньому та їх уникнення. Досліджено принципи співпраці соціально відповідального бізнесу із зацікавленими особами. Розроблено концепцію використання проактивного підходу в управлінні соціальною відповідальністю бізнесу та обґрунтовано її складові, а саме сферу застосування, методи, перспективні напрями використання, ризики.
Формування структурно-логічної моделі вдосконалення стратегічного управління
Authors:   ЗВО «Міжнародний науково-технічний університет імені академіка Юрія Бугая», Урбанський Максим
Published: January 2025

У статті досліджено процес формування структурно-логічної моделі вдосконалення стратегічного управління як важливого інструменту для підвищення адаптивності та ефективності організації в умовах динамічних змін та невизначеності. Представлена модель інтегрує ключові компоненти стратегічного планування, управлінського аналізу та ухвалення рішень, що сприяє досягненню стратегічних цілей. Особливу увагу приділено ролі цифрових технологій та корпоративної культури в оптимізації управлінських процесів, підвищенні прозорості та мінімізації ризиків. Результати дослідження можуть бути застосовані для розробки адаптивних управлінських стратегій у різних галузях, забезпечуючи організаціям можливість зміцнити свої конкурентні позиції.
Acute Small Bowel Obstruction Due to Entrapment Under Appendices Epiploicae Tourniquet – Laparoscopic Management
Authors: Nagula1 Mounish Raj , Joshi1 Abhijit S
Published: January 2025

Epiploic appendagitis is a rare condition in which there is inflammation of the appendices epiploicae (AE). It is rare to see small bowel obstruction due to herniation of the small intestine through adhesion between two adjacent AEs forming a loop. We, herein, present the case of a 64-year old male patient who had presented to us with acute small bowel obstruction. During laparoscopy, the culprit was found to be an internal herniation of an ileal loop between the two AE of the sigmoid colon, which were adherent at their tips. Laparoscopic transection of the tourniquet and excision of the AE was performed, and the patient had an uneventful postoperative recovery.
Total Anomalous Pulmonary Venous Connection with Right Pulmonary Artery Stenosis
Authors: Bharath V. , Hote Milind P.
Published: January 2025

Total anomalous pulmonary venous connection (TAPVC) is a cyanotic congenital anomaly where all 4 pulmonary veins open into the right atrium directly or indirectly, instead of opening into the left atrium. Patients with this condition present in neonatal and infancy period with symptoms of breathing difficulty, rapid breathing, and bluish coloration. The association of TAPVC with branch pulmonary artery stenosis is a rare condition and is not described in literature.
Evaluation of biocide effects of Aloysia gratissima (Gillies & Hook.) Tronc. essential oils
Authors: Souza Caio Marins Rodrigues de , Oliveira Lara Zaine Silva de , Vaz Carolina Ferreira , Bazon José Norberto , Vieira Tatiana Manzini , Groppo Milton , Crotti Antônio Eduardo Miller , Dias Polianna Alves Silva , Dias Herbert Júnior
Published: January 2025

Description of the subject. Essential oils are volatile fractions produced through the special metabolism of plants. One significant biological application of essential oils in recent years has been their use as bioherbicides, due to their important biocide effect. Objectives. This study aims to identify the chemical constituents of Aloysia gratissima (Gillies & Hook.) Tronc. essential oil and assess its biocide potential. Method. This study describes, for the first time, the chemical constitution of the essential oils from seeds of A. gratissima. To verify possible biocide effect, lettuce seeds were submitted to different concentrations of essential oils from A. gratissima leaves (AG-LE-EO), flowers (AG-FL-EO), and seeds (AG-SE-EO) to evaluate germination percentage, mean germination time, synchrony of germination, and seedling length. Results. At concentrations of 800 μl·l-1, synchrony was positively influenced by (AG-LE-EO), increasing from 0.38 to 0.54. On the other hand, AG-SE-EO at concentrations of 800 μl·l-1 reduced lettuce germination from 90.8% to 64.4% and seedling length from 1.35 to 0.8 cm, besides increasing mean germination time, indicating biocide effects. Conclusions. These results are expected to lead to further trials to understand how the constituents of A. gratissima essential oils inhibit germination, making them a potential bioherbicide.
Adhesion molecules in patients with severe atherothrombotic stroke
Authors: Okhtova Fatima R. , Mikhal'chenko Vladimir N. , Maksimova Marina Yu.
Published: January 2025

Abstract
Introduction. Atherothrombotic stroke represents 34% of stroke cases among all the subtypes of ischemic stroke. Adhesion molecules are proteins associated with the basal membrane. They contribute to the intensification of adhesion processes, hyperaggregation of blood cells and microcirculation disorders.
Objective. To investigate the blood levels of adhesion molecules in patients with severe atherothrombotic stroke.
Materials and methods. For the study, we recruited 21 patients (mean age, 67 [61; 73] years) with atherothrombotic stroke in the carotid system who were observed for the initial 48 hours since the development of neurological symptoms. The patients were categorized as severe stroke based on the total NIHSS score (Me 15 [14; 18]) at the time of admission. The spectrum of soluble cellular adhesion molecules as immunological markers of endothelial dysfunction was studied.
Results. Increased levels of sICAM-1, sPECAM-1, sР-selectin, sЕ-selectin and sVCAM-1 were revealed at the beginning of the acute period of atherothrombotic stroke. By the day 21, a decrease of sPselectin, sE-selectin and sVCAM-1 was seen, and this phenomenon was probably caused by effects of blood antiplatelet therapy and statins on cellular adhesion. Positive correlation was established between the VCAM-1 during the first 48 hours of atherothrombotic stroke and the severity of neurologic deficit by the day 21. In the subgroup of patients with lethal outcomes, sICAM-1 and sVCAM-1 levels were higher in comparison with patients with severe disability.
Conclusion. Elevated expression of sVCAM-1 in the first 48 hours of atherothrombotic stroke is associated with severe neurologic deficit by the day 21 of stroke. The high levels of sICAM-1 and sVCAM-1 upon admission may be regarded as risk factors for lethal outcomes.
Pain syndrome in degenerative spine conditions
Authors: Gushcha Artem O. , Gerasimova Elizaveta V. , Poltorako Yekaterina N.
Published: January 2025

Low back pain is the leading cause of disability, ahead of such socially important diseases such as HIV infection, tuberculosis, and lung cancer. The pain syndrome in degenerative spine conditions may originate from different damaged structures, such as intervertebral disc, joints, ligaments, and muscles, that requires detailed examination before the beginning of treatment. Furthermore, pain should be classified as being either nociceptive or neuropathic. There are several approaches to treatment of low back pain: physical therapy, pharmacological and interventional treatment, and surgery. The present paper summarizes modern views on possible sources of low back pain related to degenerative spine conditions, as well as existing therapeutic options.
Diagnostics and management techniques in respiratory disorders in amyotrophic lateral sclerosis
Authors: Vasil’yev Aleksey V. , Eliseyeva Dariya D. , Ivanova Maria V. , Kochergin Ivan A. , Zakroyshchikova Inessa V. , Brylev Lev V. , Shtabnitskiy Vasily A. , Zakharova Maria N.
Published: January 2025

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive disease characterized by relentless increase in weakness of limb and respiratory muscles. Whereas the etiology is still not clear, there have been a remarkable progress in understanding ALS pathogenesis and pathophysiology over the last years. In 2017 the second drug that can alter ALS progression rate has been registered. Nevertheless, the prognosis remains very poor and the average life expectancy in ALS does not exceed 5 years. The most common causes of death in ALS are respiratory complications and respiratory failure. Consequently, monitoring of the respiratory system function in ALS patients by neurologists and pulmonologists is crucial for survival and prolongation of life in this condition. Currently the most available diagnostic tool for the assessment of the respiratory profile in ALS is spirometry. Other methods, such as measurement of sniff nasal pressure, overnight oximetry and polysomnography, are also important but, due to technical complexity, their use in routine practice is limited. The principal method of respiratory support used in ALS is noninvasive lung ventilation (NIV). It can increase the average life expectancy and improve the patients quality of life. Invasive lung ventilation with endotracheal tube is another technique that can increase life expectancy and improve quality of life. However, the number of patients accepting this type of mechanical ventilation is very low. Multidisciplinary approach involving different medical specialists including neurologists, pulmonologists and critical care physicians is the key to successive management of ALS patients with respiratory disorders.
Electrical stimulation of the “cribriform” subthalamic nucleus in Parkinson’s disease. Clinical case and review of the literature
Authors: Tomsky Alexey A. , Gamaleya Anna A. , Asriyanz Svetlana V. , Sedov Alexey S. , Belova Elena M. , Batalov Artem I. , Pronin Igor N.
Published: January 2025

Perivascular spaces (VirchovRobin spaces, VRS) surround the walls of vessels along their route from the subarachnoid space through the brain parenchyma. Dilated VRS are often observed by MRI in healthy people. They can be a rare cause of neurological disorders. In the literature there are a small number of cases with VRS being a probable cause of the parkinsonian syndrome or affecting the course of Parkinsons disease (PD). We report our observation of the PD patient with complications of antiparkinsonian therapy who underwent bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN). The localization of VRS in the STN projection probably changed the clinical course of the disease but didn`t influence the outcomes of stimutation of the cribriform STN.
Аssociation of parameters of energy metabolism and levels of stress hormone cortisol with cognitive characteristics of patients with vascular encephalopathy
Authors: Fokin Vitaly F. , Shabalina Alla A. , Ponomareva Natalia V. , Medvedev Roman B. , Lagoda Olga V. , Tanashyan Marine M.
Published: January 2025

Introduction. In patients with vascular encephalopathy (VE), the performance of cognitive tasks may be accompanied by stress and an increase in the level of cortisol affecting the regulation of insulin and glucose metabolism. It is known that an elevated level of cortisol may cause neurodegenerative changes in the hippocampus, and it also can lead to insulin resistance and hyperglycemia, which negatively affects cognitive function.
Objective: to evaluate the association of parameters of cortisol, insulin and glucose levels and their reactivity with the cognitive results in patients with VE.
Methods. Eighty four patients with VE (60 women and 24 men) aged 4387 years were examined. Patients with type 2 diabetes and metabolic syndrome were excluded from the cohort. All patients performed 3 cognitive tasks (corrective, verbal fluency and verbal memory assessment, the Luria test). Cortisol and insulin in saliva, and glucose in peripheral capillary blood before and after testing of cognitive functions were examined.
Results. In women, the level of salivary cortisol and insulin after the cognitive tasks increased significantly, and the blood glucose level decreased. In men, similar reactive changes of these hormones and glucose were observed, but the changes did not reach statistical significance. In men and women the higher reactivity of cortisol was accompanied by lower, and insulin and glucose by higher results of cognitive performance.
Conclusion. In patients with VE, the cognitive performance is accompanied by reactive changes in cortisol, insulin and glucose levels associated with higher results in cognitive tests.
The effect of modulation of Na+/К+-АТPase activity on viability of cerebellar granule cells exposed to oxidative stress in vitro
Authors: Stelmashook Elena V. , Isaev Nikolay K. , Genrikhs Elizaveta E. , Khaspekov Leonid G.
Published: January 2025

Introduction. Oxidative stress is an important pathogenic factor in cerebral ischemia, which occupies one of the leading places among various forms of cerebral pathology in mortality and disability of the working-age population and is recognized as an actual problem of experimental and clinical neurology. Naturally, modeling of neurodestructive processes and their correction under the action of oxidative stress in vitro contributes to the study of protective mechanisms that counteract ischemic damage of neurons.
Objective. To reveal the influence of chemical preconditioning induced by transient inhibition of Na+/K+-ATPase activity on tolerance of cultured cerebellar granule neurons to oxidative stress at different stages of their differentiation in vitro.
Materials and methods. The activity of Na+/K+-ATPase was inhibited with ouabain, which was added at 34 and 78 days in vitro to cerebellar cell cultures of 7-day rats at a concentration of 0.1 mM for 24 hours before induction of oxidative stress by hydrogen peroxide (0.05 and 0.075 mM, 4 hours) or paraquat (0.15 and 0.2 mM, 24 hours).
Results. Oxidative stress induced by paraquat causes the most pronounced death of cultured granular neurons in immature (34 days) cultures, in which survival was 442,5% of neurons, compared to mature (78 days) cultures, in which survival was 615,4%. Pretreatment of cultures with ouabain has a protective effect, the most significant in mature cultures. The exposure of mature cultures with hydrogen peroxide kills more than 90% of neurons, whereas pretreatment with ouabain increases the survival rate by 44%. At the same time in the immature cultures the damaging effects of H2O2 and the protective effect of ouabain is less pronounced.
Conclusion. The increased tolerance of cultured cerebellar granule cells to oxidative stress after transient inhibition of Na+/K+-ATPase activity by ouabain is shown. The direct dependence of the efficiency of the ouabain protection on the degree of neuronal morphochemical differentiation in vitro is revealed.
Progressive multifocal leukoencephalopathy as a complication of disease-modifying treatment of multiple sclerosis
Authors: Zakharova Maria N. , Lysogorskaia Elena V. , Ivanova Maria V. , Kochergin Ivan А. , Korzhova Yulia E.
Published: January 2025

The review provides modern understanding of the pathogenesis of progressive multifocal leukoencephalopathy (PML), a severe and potentially fatal form of multiple-lesion disorder of the brain white matter. Information about the frequency of its development in patients with disease-modifying treatment of multiple sclerosis is analyzed. The algorithms of optimization of PML risks in this category of patients with multiple sclerosis are described in detail. Summarized are the data on most significant PML biomarkers, the search for which is currently under way in many centers across the world. The first case of PML in Russia is briefly described.
Neurovascular coupling and cerebral perfusion in aging, cerebral microangiopathy and Alzheimer’s diseases
Authors: Dobrynina Larisa A.
Published: January 2025

Integrity of neurovascular unit (NVU) and interaction of its components is the basis for brain function. Exceptional role of NVU for providing metabolism of all cerebral processes substantiates obligate participation in pathophysiology of wide range of neurological disorders. Established similarity of structural changes in NVU at early stages of aging and hypertensive cerebral microangiopathy (CMA) suggests common pathogenic mechanisms of its damage and, in view of reversibility of early changes in neurovascular coupling (NVC), allows considering several forms of CMA as variants of early accelerated vascular wall aging. Understanding small vessel damage as a significant risk factor for Alzheimers disease and mixed dementias has encouraged revision of the current concept of the development of cognitive decline. A universal role of early NVC impairments in the development of various dementias has been shown. Further studies should improve our understanding of mechanisms of NVC impairment, role of classical and newly specified risk factors in their development and perspectives for preventive strategies. Apparently, success can be achieved through collaboration of neuroscience researchers, which allows translation of advantages of fundamental studies into clinical practice
Neurotransplantation: the time has come?
Authors: Illarioshkin Sergey N.
Published: January 2025

Problems in curing disorders of the brain are caused by several characteristic features of the nervous tissue, such as postmitotic nature of neurons, their limited reparative potential, significant energy dependence, etc. Because of special vulnerability and extremely high specialization, neurons are very sensitive to the action of any pathological factors, while existing possibilities of their trophic and metabolic support are scanty. Therefore, the creation of new reparative strategies, including substitutive cell technologies, is immediate task in neurology. Neurodegenerative disorders, Parkinsons disease (PD), Huntingtons disease and others, are an ideal model for elaborating such strategies. As main motor symptoms of PD are related to degeneration of the dopaminergic nigrostriatal pathway, treatment of these patients, theoretically, may be based on transplantation of dopamine-producing neurons into the striatum. In the paper, analyzed are the results of many-year experimental (on models of parkinsonism) and preliminary clinical trials of neurotransplantation with the use of fetal tissues (dopaminergic cells of the ventral midbrain) and dopaminergic neurons differentiated from embryonal stem cells and induced pluripotent. Newest scientific achievements in this field, improvement of cell protocols and successful resolving of a number of technical and medical problems allow saying that neurotransplantation becomes clinical reality just before our eyes.
Autonomic support of cognitive functions and functional asymmetry in normal aging and chronic cerebrovascular disorders
Authors: Fokin Vitaly F. , Ponomareva Natalia V. , Medvedev Roman B. , Shabalina Alla A. , Tanashyan Marine M. , Lagoda Olga V.
Published: January 2025

The increase in life expectancy is accompanied by an increase in the number of patients suffering from chronic cerebrovascular diseases with progressive cognitive decline, up to dementia. Therefore, the search for new approaches to studying the disease pathogenesis, prevention and treatment is relevant. We analysed the data on correlation of cognitive characteristics with reactions of the autonomic nervous system (ANS) and ANS-regulated systems in normal aging and in patients with vascular encephalopathy (VE). Reactivity of cerebral blood flow as a result of cortical-ANS interaction was studied, characteristics of cerebral blood flow influencing the interhemispheric energetic processes (studied with direct current potentials of the brain) were analyzed, and correlation of blood pressure and heart rate with cognitive characteristics were assessed. Since the signs of cognitive decline are observed during normal aging and VE, an attempt was made to analyze the dependence of cognitive and ANS functions not only on VE, but also on the age. We showed some specific features of cortical-ANS interaction in groups of patients divided in accordance with small criteria of functional asymmetry. The obtained results are of value for studying VE pathogenesis and for prognosing cognitive impairment in patients with VE.
Current problems of synaptic plasticity
Authors: Skrebitsky Vladimir G. , Sharonova Irina N.
Published: January 2025

The present review focuses on the results of modern studies confirming the last century ideas about the effect of neuron discharge on the effectiveness of its synaptic inputs. This concept is being developed now at the receptor, channel and intracellular levels, which allows to reveal the special role of calcium ions in the activation of a number of cascades leading to transient or long-lasting changes in synaptic transmission. An important role of various physiologically active compounds that affect synaptic plasticity and, through it, the cognitive processes in humans is emphasized, which has not only fundamental, but also applied significance. Cellular and receptor targets of nootropic drugs aimed at the correction of various types of cognitive impairment are specifically considered
Current situation of diagnostics and management of patients with primary headaches in the Republic of Armenia
Authors: Vekilyan Hasmik R. , Sahakyan Anahit E. , Manvelyan Hovhannes M.
Published: January 2025

Introduction. Headache is one of the most common complaints of patients seeking for medical care. Headaches affect people of all ages, races, income levels, and geographical areas. They form a substantial burden on personal and social lives of patients, diminish their quality of life, and cause financial losses. The problem of headaches (primary ones, in particular) has not been previously studied in Armenia. We aimed to focus on several types of primary headaches (tension-type headache, migraine, trigeminal autonomic cephalalgias (particularly, cluster headaches). The prevalence of headaches in the adult population is 47%, however, many people do not receive proper treatment.
Objective of the study was to investigate the prevalence of different types of primary headaches (tension type, migraine, trigeminal autonomic cephalalgias), and assess quality of life of patients with headaches who sought for medical care.
Materials and methods. According to study inclusion and exclusion criteria, 150 patients with headache, who visited the Neurology Department of YSMU during the past 4 years, were selected for further analysis. All patients were asked to complete three questionnaires: (1) A questionnaire which was compiled by us based on diagnostic criteria of International Headache Society (2-nd edition and 3-rd edition beta versions), (2) Headache Impact Test, and (3) SF-36. All studied patients were examined by a neurologist.
Results. In the analyzed population, tension-type headache was found in 31% of patients, migraine in 60% of patients, and trigeminal autonomic cephalalgias in 9% of participants. More than the half of the analyzed patients have seen physicians before (75% of them were examined by a neurologist), and in 37% of cases there were multiple referrals to a physician.
Conclusion. Data analysis showed significant underestimation (both by patients and physicians) and misdiagnosis of primary headaches in our region, especially in respect to cluster headache. That leads to chronification of headaches, ineffective treatment, and development of medication-overuse headaches. It is necessary to increase public awareness about the possibilities of headache treatment, as well as to increase the competence of the medical specialists.
Daily profile of arterial pressure and brain microstructural changes in patients with hypertension-related cerebral small vessel disease
Authors: Dobrynina Larisa A. , Shamtieva Kamila V. , Kremneva Еlena I. , Kalashnikova Lyudmila A. , Krotenkova Marina V. , Gnedovskaya Elena V. , Berdalin Aleksandr B.
Published: January 2025

Introduction. Application of modern antihypertensive medications has improved the course of arterial hypertension (AH), but has not led to the expected decreasein small vessel disease (SVD) incidence and its complications. This fact encourages further investigation of hypertension-related mechanisms of brain damage.Objective: to study the relation between daily profile of blood pressure and brain microstructure changes in patients with both SVD and AH.Material and methods. The study included 64 patients (38 59.4%) female, mean age 59.45.4 years) with both SVD and AH. Ambulatory blood pressuremonitoring and diffusion-tensor MRI were obtained for all participants. The relation between studied parameters was estimated using the multivariate statisticalanalysis method linear regression analysis.Results. Сhanges in daily profile of blood pressure according to ambulatory blood pressure monitoring data was associated with microstructure abnormalities ofthe juxtacortical white matter hyperintensities (jWMH) of anterior frontal lobes, temporal-parietal regions and left posterior cingulate cortex. An increase andvariability of diastolic blood pressure were of primary importance in brain microstructural damage in mentioned areas leading to mean diffusivity and radialdiffusivity increase.Conclusion. The revealed relation between daily profile of blood pressure and brain microstructural changes indicating increase of free water diffusivity andmyelin damage in jWMH and posterior cingulate cortex corresponds to the experimental data on the breakdown of the autoregulation reaction in cortex arteriesand further increase of brain-blood barrier permeability with descending vasogenic edema in brain damage in hypertensive patients. An increase and variability ofdiastolic blood pressure have primary importance to microstructural damage of white matter in patients with SVD receiving antihypertensive treatment.
Sensory ataxic neuropathy, dysarthria and ophthalmoparesis (SANDO syndrome): characteristics of a series of clinical observations in Russia
Authors: Nuzhniy Yevgeny P. , Klyushnikov Sergey A. , Seliverstov Yury A. , Krylova Tatiana D. , Tsygankova Polina G. , Zakharova Yekaterina Yu. , Kasatkin Dmitriy S. , Spirin Nikolai N. , Abramycheva Natalia Yu. , Illarioshkin Sergey N.
Published: January 2025

Introduction. Mitochondrial ataxias are an extremely heterogeneous group of diseases, which include the SANDO (an acronym stands for sensory ataxic neuropathy, dysarthria and ophthalmoparesis) syndrome. SANDO syndrome is one of the characteristic phenotypes associated with mutations in the POLG gene.
Study objective. To analyse the clinical picture and the results of clinical and laboratory tests in a Russian case series of genetically confirmed SANDO syndrome.
Materials and methods. Nine patients (4 men and 5 women aged 33.411.3 years) with SANDO syndrome and identified mutations in the POLG gene were examined. A clinical evaluation using the SARA and ICARS (for ataxia) and MoCA (cognitive function) scales, laboratory study of liver function, electrocardiography, stimulation electromyography and brain MRI were performed; 6 patients underwent electroencephalography. MLPA analysis and the original multigene NGS panel were used for genetic screening.
Results. The average age of disease onset was 27.78.2 years, with significant variability (from 14 to 49 years). The disease was characterized by a rather typical clinical picture, which included sensory ataxia, polyneuropathy, dysarthria and external ophthalmoparesis in all patients; the median score was 13.5/40 [11; 25] points on the SARA scale, 39.5/100 [33; 63] points on the ICARS scale, and 22 [20; 25] points on the MoCA scale. Two patients showed signs of frontal lobe dysfunction. In most patients, MRI revealed changes in the white matter of the cerebellar hemispheres, brainstem, thalamus and semioval centres, but no pathology was detected on MRI in 3 patients. The p.W748S mutation in the POLG gene made up 83% of the mutant alleles, while the p.L931R and p.L311P pathogenic mutations found in 2 patients are new variants and have not been described in international databases.
Conclusion. Our findings suggest that the true frequency of SANDO syndrome in the population may be higher than previously thought. Therefore, a suspicion of this disease should be maintained even in the absence of characteristic changes on neuroimaging. For the timely detection of SANDO syndrome, we propose an appropriate diagnostic algorithm, which should be followed when examining patients with ataxia.
The migration of multipotent mesenchymal stromal cells after systemic and local administration in an experimental model of Parkinson’s disease
Authors: Zafranskaya Marina M. , Nizhegorodova Daria B. , Aleynikova Natalia E. , Kuznetsova Tatiana E. , Vanslav Margarita I. , Ignatovich Tatiana V. , Boiko Alexander V. , Ponomarev Vladimir V.
Published: January 2025

Parkinsons disease is an important medico-social problem worldwide, with a lot of attention paid to preclinical studies to assess the efficacy of new treatments, including cell therapy.
Study objective. To assess the migratory ability of multipotent mesenchymal stromal cells (MMSC) using different methods of administration in an experimental model of Parkinsons disease in laboratory rats.
Materials and methods. MMSC, stained with the PKH26 fluorescent dye, were systemically (intravenously) or locally (intranasally and intrathecally) administered to experimental animals with rotenone-induced Parkinsons disease. The migratory ability of MMSC was assessed on days 1 and 21 after administration, using immunofluorescence microscopy.
Results. The migratory ability of MMSC after both systemic and local administration was more pronounced in the animal group with the experimental model of Parkinsons disease compared with the control group. It was characterized by maximum accumulation of cells in the brain on the first day after administration, with viability preserved in the area of neuronal inflammation throughout 21 days.
Conclusion. Local administration (intranasal and intrathecal) leads to faster accumulation of MMSC in the brain of both the animals with the experimental model of Parkinsons disease and healthy rats. Intravenous administration of cell cultures also helps to reveal the migratory properties of MMSC and can form the basis for planning further studies of cell therapy in Parkinsons disease.
The haemorrhagic transformation of cerebral infarction: classification; pathogenesis; predictors and effect on the functional outcome
Authors: Khasanova Dina R. , Kalinin Mikhail N. , Ibatullin Мurat M. , Rakhimov Ilnur Sh.
Published: January 2025

Using specific keywords; we searched for articles from the last 10 years on haemorrhagic transformation (HT) of cerebral infarction (CI); which were available on the PubMed database. This article provides an analysis and a summary of the information on the classification; pathogenesis and predictors (clinical; laboratory; neuroimaging; including the use of integrative assessment scales) of HT; as well as its impact on the functional outcome of the condition. It is emphasized that HT is a multifactorial pathological process in its phenomenology; including brain ischaemia; the development of coagulopathy; disturbances in the integrity of the bloodbrain barrier and reperfusion injury. The emphasis is placed on careful monitoring of patients with acute ischaemic infarct after intravenous thrombolytic therapy and/or endovascular intervention; as well as those patients with a high predicted risk of HT. Timely and regular neuroimaging should be carried out to detect HT as soon as possible. Type 2 parenchymal haematomas; the most severe type of HT; are most often associated with high mortality and an unfavourable functional outcome.
Sacroiliac joint syndrome: aetiology, clinical presentation, diagnosis and management
Authors: Yarikov Anton V. , Morev Anton V. , Shpagin Мaxim V. , Fryerman Aleksandr P.
Published: January 2025

Sacroiliac joint (SIJ) syndrome is a relevant disorder to study because of the high prevalence of back pain conditions in people of working age. SIJ syndrome is a cause of pain in 1530% of people with chronic pain in the lower lumbar spine. This review describes the anatomical structure of the SIJ and the aetiological factors that can lead to its dysfunction. Pathogenetic links in the development of this condition are identified separately. The issue of differential diagnosis with other vertebrogenic pain syndromes is considered in detail, and diagnostic tests are presented. The main current approaches to treating SIJ syndrome are described. Interventional methods for treating SIJ dysfunction are described in detail, including radiofrequency neuroablation as an alternative to conservative management.
Cluster analysis of immunological serum markers in patients with Parkinson’s disease
Authors: Klyushnik Tatyana P. , Simonov Anatoly N. , Androsova Lyubov V. , Ponomareva Natalia V. , Illarioshkin Sergey N.
Published: January 2025

Introduction. The study of patients biological features, including their immune responses, in specific diseases, is an important step towards personalized diagnosis and treatment. Parkinsons disease (PD) is thus of particular interest as one of the most common age-related neurodegenerative diseases.
Study aim to determine the immunophenotypes of patients with PD using cluster analysis.
Materials and methods. Mathematical analysis was conducted on a database of 46 patients with PD. The levels of the following functionally related inflammatory markers were used as the classification characteristics: the enzymatic activity of leukocyte elastase (LE), the functional activity of 1-proteinase inhibitor (1-PI), the auto-antibody levels to S-100b and myelin basic protein.
Results. Based on the immunological markers, the use of multiple algorithms in the cluster analysis of the PD database allowed to obtain two consistent clusters. The patients in cluster 1 were characterized by a high level of LE activity and a low level of functional 1-PI activity, which indicates insufficient serum antiproteolytic capacity and is an unfavourable prognostic indicator for further development of the inflammation-associated pathological process in the brain tissue. The patients in cluster 2 were characterized by increased functional 1-PI activity in the serum, increased S-100b antibody levels and a decreased LE activity as compared with cluster 1, which indicates dysregulation of the inflammatory response, associated with insufficient neutrophil degranulation, whereas elevated autoantibody levels to the neural antigen S100b characterize the most severe lesions in the nervous system.
Conclusion. The results of the cluster analysis enable the identification of two immunophenotypes in patients with PD, indicating that a phenotypically similar presentation can be due to a different spectrum of immune markers. The obtained data will serve as a basis for development of an immunological approach to personalized diagnosis and treatment.
Analysis of factors affecting adherence to treatment in post-stroke patients
Authors: Bogolepova Anna N. , Kovalenko Ekaterina A.
Published: January 2025

Introduction. The effectiveness of secondary stroke prevention depends not only on the prescribed medications but also on patients compliance with doctors recommendations in general. Adherence to therapy among post-stroke patients remains insufficient. This is due to factors that negatively affect compliance with medical recommendations. Among those factors, post-stroke cognitive impairment deserves particular attention.
Study aim to identify the main factors that determine adherence to long-term therapy in patients after stroke and to assess the impact of post-stroke cognitive impairment on compliance with medical recommendations.
Materials and methods. A total of 56 patients (mean age 64.6710.19 years), who experienced a hemispheric ischaemic stroke 6 months ago, were examined. Cognitive function was evaluated using the Montreal Cognitive Assessment tool, the battery of tests to assess frontal dysfunction, drawing and clock copying tests, and tests of phonetic and semantic speech activity. Adherence to long-term therapy after stroke was determined using the MoriskyGreen test. We also studied the role of sociodemographic and vascular risk factors, that determine treatment adherence.
Results. More than half (51.8%) of post-stroke patients did not comply with medical recommendations. The main barriers to optimal adherence were the male gender, engagement in physical labour throughout life, and the presence of left ventricular hypertrophy, chronic heart failure or bad health habits. The presence of post-stroke cognitive impairment had a negative impact on the adherence to medical recommendations (r=0.49; p0.001). The results of the survey showed that regular visits to medical specialists were one of the main requirements for maintaining optimal adherence to treatment. Most patients (59.6%) thought that forgetfulness is a key factor affecting adherence to therapy.
Summary. Treatment adherence should be evaluated in all patients after stroke, especially in those with post-stroke cognitive impairment. The identification and correction of modifiable risk factors is a way to increase adherence to treatment
The role of micro-RNA in cerebrovascular disease
Authors: Raskurazhev Anton A. , Tanashyan Marine M.
Published: January 2025

The article touches upon micro-RNA as new, potentially significant diagnostic, prognostic and therapeutic biomarkers in cerebrovascular pathology. Synthesis processes and effector mechanisms of micro-RNA are described. The micro-RNA that play an important role in the pathogenesis of major risk factors for cerebrovascular pathology (atherosclerosis, arterial hypertension, atrial fibrillation, diabetes mellitus) and the micro-RNA in acute cerebrovascular disorders are reviewed in detail. The need for thorough replication studies to justify the choice of micro-RNA and methods for micro-RNA detection is substantiated.