Central nervous system manifestations in rheumatic diseases.

As the role of neurologists in managing patients with rheumatic diseases expands, collaboration between rheumatologists and neurologists becomes increasingly vital. This literature review provides an overview of the central nervous system (CNS) manifestations of major autoimmune rheumatic disorders, which may include parenchymal brain and meningeal disease (stroke, meningoencephalitis, meningitis), myelopathies, psychosis, chorea, seizure disorders, and various forms of cephalea. Novel findings linking specific autoimmune markers to CNS damage reveal a direct, previously underestimated link between systemic inflammation and neural injury.

THE NEUROLOGICAL MANIFESTATIONS AND FUNCTIONAL INDEPENDENCE IN PATIENTS WITH ENCEPHALOPATHIES OF DIFFERENT TYPES.

Objective: Aim: To access the neurological manifestations and activities of daily living in patients with encephalopathy of one of the following types: post-infectious, chronic traumatic encephalopathy, alcohol-induced, and microvascular ischemic disease of the brain.

Patients And Methods: Materials and Methods: In the period of 2021-2022 we examined 520 patients, who signed the informed consent, taking into account their age, sex, occupation, the cause, and the disease duration. Such parameters were evaluated, as the data of neurological manifestations, the activities of daily living (Barthel index), cognitive functioning (MoCA-test), and statistical methods (Statistica 13.

OPTІC NEUROMYELІTІS: CASE REPORT AND REVІEW.

Neuromyelіtіs optіca (Devіc dіsease) іs a demyelіnatіng dіsease of the central nervous system. Thіs dіsease іs progressіve and mіght be fatal. Objective - to accentuate the importance of differential diagnosis of demyelіnatіng diseases of central nervous system.

The comprehensive evaluation of patients' condition in recovery and residual periods of aneurysmal subarachnoid hemorrhage.

Objective: The aim: is to evaluate peculiarities of clinical and neurological characteristics, quality of life, brain morphometry changes and metabolic deviations of patients, who suffered from aneurysmal subarachnoid hemorrhage.

Patients And Methods: Materials and methods: In the period of 2016-2019 we examined 114 patients, who signed the informed consent, taking into account their age, clinical and anatomical form of hemorrhage, disease duration, Hunt-Hess severity grade, complications of acute period. Such parameters were evaluated, as clinical and neurological characteristics, the degree of the Barthel index and the modified Rankin scale, cognitive functioning (MoCA), psycho-emotional sphere and quality of life (HADS, SF-36), morphometric parameters based on brain computed tomography measurements, explored the indicators of apoptosis, mitochondrial dysfunction, intracellular oxidative stress.

Safety and efficacy of satralizumab monotherapy in neuromyelitis optica spectrum disorder: a randomised, double-blind, multicentre, placebo-controlled phase 3 trial.

Background: Satralizumab, a humanised monoclonal antibody targeting the interleukin-6 receptor, reduced the risk of relapse in patients with neuromyelitis optica spectrum disorder (NMOSD) when added to immunosuppressant therapy. This study assessed the safety and efficacy of satralizumab monotherapy in patients with the disorder.

Methods: In this phase 3, double-blind, placebo-controlled, parallel-group trial, we enrolled adults aged 18-74 years with aquaporin-4 antibody seropositive or seronegative NMOSD at 44 investigational sites in 13 countries.

[Clinical and laboratory predictors of outcome in acute period of atherothrombotic ischemic stroke].

Aim: To clarify clinical and pathogenetic predictors of outcome in acute period of atherothrombotic stroke (ATS).

Material And Methods: One hundred and nineteen patients with ATS were examined. Characteristics of the clinical picture, a number of white blood cells in peripheral blood in the stage of apoptosis, necrosis as well as the state of intracellular antioxidant protective system were studied.

[CLINICAL-HEMODYNAMIC PECULIARITIES OF THE COURSE OF HEMODYNAMIC ISCHEMIC STROKE IN ACUTE PERIOD].

Unlabelled: The aim of the research is to study the peculiarities of cardiac morphometric parameters, the parameters of central hemodynamics and their impact on the course of hemodynamic ischemic stroke in acute period. 116 patients were performed Echo-Doppler-cardiography in acute period of hemodynamic ischemic stroke in order to evaluate cardiac morphometric parameters. These patients were also performed transcranial duplex scanning.

[Some features of morphometric characteristics of the brain in patients with lacunar stroke].

Objective. To determine the structural-morphometric peculiarities of the brain in patients with lacunar ischemic stroke and their influence on cognitive functions. Material and methods.

[Mechanisms of therapeutic efficacy of magnetic laser irradiation of patients with neurological symptoms of lumbar osteochondrosis].

Effects are studied of conventional treatments options and those used with a combined magnetolaser irradiation on clinical symptomatology, regional hemodynamics, and peripheral microcirculation in 254 patients presenting with neurological symptoms of lumber osteohondrosis. It is found out that employment of generally accepted treatment options permit achieving complete clinical remission in 38 percent of cases, with 28.7 percent improved, but parameters associated with hemocirculation fail to return back to normal.

[The effect of vasoactive preparations on the systemic and cerebral hemodynamics and on the blood rheological properties in patients with cerebrovascular insufficiency with a background of an atherosclerotic lesion of the precerebral arteries].

Vasoactive preparations (cavinton, corinfar, phinoptin, pentoxyphylline and sermion) were studied for their effect on systemic and cerebral hemodynamics in 232 patients with cerebrovascular insufficiency in the presence of atherosclerotic lesion of the precerebral arteries, and for that on rheologic properties of blood in 91 of them. It has been established that the highest effect from the use of calcium antagonists and sermion with respect of the blood flow linear velocity (BFLV) increase occurs predominantly in stenotic precerebral arteries; the normalization of the platelet-erythrocyte homeostasis is also considerably influenced by these. Calcium antagonists and sermion are capable of lowering arterial pressure, diminishing the volume of circulating blood and cardiac index thereby making for more economic heart performance.

[The effect of nicergoline on the systemic and cerebral hemodynamics of patients with circulatory encephalopathy and an atherosclerotic lesion of the major cerebral arteries].

The Evans blue dilution method and ultrasound dopplerography were used to study the effect of nicergolin on the systemic and cerebral hemodynamics in 31 patients with dyscirculatory encephalopathy against the background of atherosclerotic lesions of the major head arteries. It was established that nicergolin reduces the arterial pressure, diminishes the minute blood volume, cardiac and stroke indices, increases the specific peripheral vascular resistance, the linear blood flow velocity prevailingly in the stenosed major head arteries, results in a regression of the subjective and objective neurological symptomatology. Considering the cardiodepressive effect of nicergolin, this agent is indicated in patients with the hyperkinetic type of the systemic hemodynamics.

[Cardiogenic disorders of the systemic hemodynamics in lesions of the major cerebral arteries].

Evans blue dilution and ultrasound dopplerography was used to examine 170 atherosclerosis patients with initial manifestations of insufficient cerebral blood supply (77 patients) and transient disorders of the cerebral blood circulation (93 patients) with occlusive and stenotic involvements of the major brain arteries. The authors revealed characteristic aspects of responses of the systemic-hemodynamic mechanisms in initial manifestations of insufficiency of the cerebral blood supply and transient disorders of the cerebral blood circulation with stenosis and occlusions of the major brain arteries and without involvement of the brain vessels. Treatment aspects are discussed.

[Treatment of patients with transient disorders of cerebral circulation in occlusive diseases of major blood vessels of the head using vasoactive and cardiotonic drugs].

Transient circulatory disorders of the brain arising in response to stenosis and occlusion of the major head arteries in 111 patients were treated with cardiotonic and vasoactive drugs (corglycon, strophanthin, sulfocamphocain, euphylline++, cavinton, finoptin). The treatment was controlled by monitoring systemic and cerebral hemodynamic parameters. An appreciable clinical response was achieved in more patients (by 16.

[Vasoactive and cardiotonic drugs in the treatment of initial manifestations of cerebrovascular insufficiency in occlusive diseases of major blood vessels of the head].

Patients (n = 118) with initial manifestations of brain blood supply failure induced by stenoses and occlusions of the main vessels of the head were treated by cardio- and vasoactive drugs (corglycon, strophanthin, sulfocamphocaine, euphylline, cavinton, verapamil) under control of the systemic (by Evans blue dilution according to Stewart-Hamilton) and cerebral (by rheoencephalography and ultrasound dopplerography) hemodynamics. As a result of such treatment policy, the number of cases with a complete reverse development of the symptomatology was 16.8% greater than in analogous situations where no therapy with the method proposed was carried out.

[Effect of finoptin on systemic and cerebral hemodynamics in patients with early cerebrovascular disorders in arteriosclerotic stenosis of major arteries of the head].

Blood Evans Blue dilution and ultrasound Doppler cardiography were used to examine systemic and cerebral hemodynamic changes after a single intravenous administration of finoptin (5 mg) and its course treatment (a daily dose of 120-240 mg) in 30 patients with initial signs of cerebrovascular insufficiency and 30 patients with transient cerebrovascular disorders in the presence of atherosclerotic stenoses of the cephalic great arteries. Finoptin was found to increase the linear velocity of blood flow mainly in stenotic arteries, without causing intracerebral steal. The agent also exerted a clear-cut cardiodepressive action which was levelled off by its vasodilating effect by the end of its course therapy.

[Effect of cavinton and sulfocamphocain on systemic and cerebral hemodynamics in patients with early forms of cerebrovascular diseases].

In a study involving 33 patients with initial manifestations of inadequate cerebral blood supply and in 22 patients with transient disorders of the cerebral circulation in the presence of atherosclerosis (n = 45) and atherosclerosis with arterial hypertension (n = 8) the authors studied the effect of intravenous administration of cavinton in combination with sulfocamphocain on the clinical manifestations and on the systemic (using the method of Evans' dilution) and cerebral (using Doppler ultrasonography) hemodynamics. It has been demonstrated that both a single intravenous administration of cavinton in conjunction with sulfocamphocain and a course of treatment with these drugs reduce the volume of the circulating blood, lower the stroke and cardiac indices, increase the linear velocity of blood flow along the carotid and vertebral arteries, and decrease neurological symptomatology. The authors discuss the questions related to indications for the administration of cavinton in combination with sulfocamphocain to patients with inadequate cerebral blood supply and transient disorders of the cerebral circulation.

[Clinico-hemodynamic evaluation of the efficacy of vasoactive and cardiotonic agents in the combined treatment of arteriosclerosis patients with chronic cerebral circulatory insufficiency].

In 370 atherosclerotic patients with chronic cerebrovascular insufficiency (CCVI) the authors have investigated the cerebral (by rheoencephalography) and the systemic (by diluting Evans blue) haemodynamics before and after correcting it with papaverine, euphylline, complamin, cavinton, corglycon, strophanthin, and sulfocamphocaine. They have also specified the characteristics of the action of the drugs studied, as well as indications and contraindications for their use in chronic CCVI treatment. The given therapy optimizes the current methods of rehabilitation of patients with chronic cerebrovascular insufficiency, ensures clinical improvement in 89.

[Effect of cavinton on systemic and cerebral hemodynamics of patients with chronic cerebral circulatory insufficiency].

The effect of cavinton on the systemic (by the method of diluting Evans blue according to Stewart-Hamilton) and cerebral (by the method of rheoencephalography) hemodynamics was examined in 38 patients with chronic insufficiency of the cerebral circulation (CICC) in the presence of either atherosclerosis alone (n = 22) and its combination with arterial hypertension (n = 16). Cavinton decreased the peripheral vascular resistance and the tone of the small and median vessels of the brain, increased the cardiac output and improved the rheological properties of the blood (it lowered the globular volume, viscosity and hematocrit). The best results were attained with the parenteral administration of the drug.

[Changes in systemic and cerebral hemodynamics in patients with chronic cerebral circulatory insufficiency of atherosclerotic origin].

Fifty atherosclerotic patients with chronic disorders of the cerebral blood circulation (CDCBC) were involved in this study of both systemic hemodynamics (by diluting Evans blue) and rheoencephalographic parameters of the cerebral circulation with regard to the stage of the CDCBC. Compensated vascular-cerebral insufficiency was associated with a significant rise in the arterial pressure, acceleration of the blood flow in the hand-ear region and with an increase in the heart rate. Visual and amplitude-frequency characteristics of REGs in a compensatory stage of the CDCBC deepened only slightly; in a remitting stage they deepened significantly in the left carotid and vertebral-basal basins; in a subcompensated stage, in both basins bilaterally; and in a decompensated stage, predominantly in the carotid basin.