Changes in clinical characteristics and outcomes of patients hospitalized with COVID-19 during two years of the pandemic: experience in a venezuelan hospital.

Objectives.: To determine changes in the clinical characteristics and in-hospital outcomes of patients hospitalized for COVID-19 in a private hospital in Caracas during two years of the pandemic.

Materials And Methods.

[Vertical nystagmus].

The review article provides a definition and classification of different nystagmus types, a comparative description of the central and peripheral vestibular nystagmus. The pathogenetic patterns of up-beating and down-beating nystagmus are accurately described. The features of nystagmus formation in various diseases are discussed, such as Wernicke encephalopathy, Arnold-Chiari anomaly, spinocerebellar ataxia and vestibular migraine.

[Tinnitus: clinical and pathogenetic aspects].

The article discusses the pathogenetic and clinical features of tinnitus. It is emphasized that various causes contribute to the appearance of tinnitus, including somatic diseases, excess body weight, iatrogenies, otological diseases with an outcome in hearing loss. The anatomical and physiological features of the structure of the central part of the auditory system are considered.

[Positional vertigo variant].

The article describes case history and multiphase treatment of the patient with attacks of vertigo, initially regarded as the onset of Meniere's disease, but later qualified as secondary positional attacks with combined musculoskeletal pathology of the craniovertebral region and temporomandibular joint. Medicinal, local and surgical treatment led to the perfect result. Thus, the team work of neurologist, otolaryngologist, maxillofacial surgeon and orthodontist led to the successful elimination of vertigo attacks.

[Comprehensive treatment of Costen syndrome].

Objective: To develop an integrated therapy for the combination of pain syndrome and cochleovestibular syndrome (CVS) in patients with temporomandibular joint (TMJ) dysfunction.

Material And Methods: Forty-five patients (42 women and 3 men), aged from 23 to 54 years, with TMJ dysfunction, signs of CVS and complaints of pain in the ear area were stratified into three groups (15 patients each). Patients received pharmacological and osteopathic therapy (group 1); splint therapy followed by orthodontic treatment (group 2) and a combination of the abovementioned methods (group 3).

[Possibilities of digital fluorography and other X-ray methods in the detection of carotid atherosclerosis].

Aim: To evaluate possibilities of routine X-ray methods for the diagnosis of atherosclerosis of carotid arteries.

Material And Methods: At the initial stage of the study, 468 X-ray radiograms of the cervical spine with the detailed description of soft tissues and projections of the neck vessels were studied. The next stage included evaluation of 'screening' abilities of digital fluorography of lungs (886 X-ray radiograms were analyzed).

[Prevention of venous thrombosis of the lower extremities and pulmonary embolism in neurological patients in the intensive care unit using intermittent pneumatic compression].

Aim: To assess the efficacy of intermittent pneumatic compression (IPC) in the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) in neurological patients.

Material And Methods: The study included 101 patients with acute disorders of cerebral circulation: 52 patients underwent IPC for prevention of DVT of the lower extremities, 49 patients received only basic treatment. Clinical examination, venous duplex scan of the lower extremities and telethermography were performed.

[Migraine and Ménière's disease].

The article describes a series of seven cases characterized by a change in the type of attack in the perimenopausal period: migraine attacks before menopause and cochleovestibular paroxysms after the onset of menopause. Clinical data and results of diagnostic tests are presented and the possible link of both attack variants with cervical pathology is discussed. The authors explain this dynamics by stem neural integrator dysfunction during hormonal changes.

[The dynamics of cerebral vascular reserve in sleep apnea patients during continuous positive airway pressure therapy].

Aim: To explore the possibility of cerebral hemodynamic reserve (CHR) normalization in patients with obstructive sleep apnea syndrome (OSAS), aged over fifty, who received continuous positive airway pressure (CPAP) therapy.

Material And Methods: The main group (20 patients, aged 50-65 years, with severe OSAS) and the control group (20 volunteers without snoring and OSAS matched for age and physical status) were studied. Diagnosis included cardio-respiratory monitoring of nocturnal sleep and ultrasound examination of cerebral blood flow with functional tests (breath holding and hyperventilation) and calculating the coefficient of vasomotor reactivity (CVMR) before the start of CPAP-therapy and after one month therapy.

[Cervical vertigo: a neurologist's point of view].

Cervical vertigo (CV) hasn't yet been recognized by many neurologists, as it has no specific clinical symptoms and reliable diagnostic criteria. However, over the past 150 years, there has been accumulated numerous experimental and clinical evidence to support the legitimacy of CV allocation as a separate nosology. This review presents data regarding the vertigo associated with neck pathology: possible evidence of CV existence and the description of its type as well.

[Predictors of remote outcomes of brain injury].

Aim: To determine predictors of remote outcomes of complex combat brain injury.

Material And Methods: A survey of 145 combatants with long-term combat injury (from 1 to 10 years) was conducted. Responses were received from 30 people from 18 regions of the Russian Federation.

[Factors influencing the detection of ischemic stroke in neuroimaging].

Aim: To determine the detectability of foci of acute ischemic stroke (AI) using neuroimaging methods depending on the localization, timing and severity of stroke.

Material And Methods: A retrospective evaluation of 100 case histories of patients hospitalized for ischemic stroke (IS) with determination of the timing of neuroimaging study, fibrinogen level, glucose, INR, NIHSS scores on admission to the hospital, assessment of stroke localization (hemispheric or brainstem), the severity of atherosclerosis of the brachiocephalic arteries (BCA) and presence of atrial fibrillation (AF) was performed. During the stay in the hospital, 54 patients were re-examined to clarify the diagnosis.

[Active thermolocation probing as a promising rapid diagnostic test of carotid atherosclerosis].

Aim: To study the possibility of active thermolocation probing for the diagnosis of stenotic lesions of carotid arteries (CA).

Material And Methods: Eighteenpatients without symptoms of cardiovascular diseases were examined using ultrasound. The patients had isoechogenic stable atherosclerotic plaques (AP).

[Combined prosopalgia with acute onset].

Complexity of facial anatomy and its rich innervation complicate the diagnosis of prosopalgias. An acute syndrome, including trigeminal, myofascial and cervical pains, is described. Authors discuss algesic interrelations, combined therapeuric effect and peculiarities of diagnosis.

[Clinical and instrumental diagnosis of concomitant venous dysfunction of the brain and extremities].

Objective: to compare the frequency, preferential localization, severity of disturbances of venous circulation in the brain and limbs.

Material And Methods: Authors examined 140 people during 2009-2014: 20 apparently healthy people without clinical manifestations of extra-intracerebral venous insufficiency; 70 patients with clinical and instrumental signs of venous encephalopathy; 50 patients with varicose disease. History and clinical status were studied for all patients.

[Influence of acupuncture on cerebral hemodynamic reserve during the preoperative period in patients with associated brachiocephalic stenosis].

Objective: To evaluate the possibility of acupuncture, as an element of preoperative preparation of the patient to carotid endarterectomy, for increasing the tolerance of patients with brachiocephalic stenosis to cerebral ischemia.

Material And Methods: We studied 40 inpatients with low tolerance to carotid compression test. Ultrasound examination of brachiocephalic and intracranial blood flow was carried out, including carotid compression, apneic and hyperventilation tests.

[Transcranial dopplerography in the combination with echopulsography in the assessment of intracranial and cerebral perfusion pressure in patients with intracranial hemorrhages].

Objective: To study the possibilities of common ultrasound diagnostic methods in the evaluation of intracranial pressure (ICP) and central perfusion pressure (CPP) and to search for the ways of increasing the accuracy of these methods.

Material And Methods: Thirty-eight patients, aged 28-66 years admitted to a neuroreanimation department of a hospital due to acute intracranial vascular and traumatic hemorrhages were examined. An instrumental study included transcranial dopplerography (TCDG) and digital echoencephalography.

[Complex types of vertigo: diagnostic possibilities].

Objective: To study diagnostic possibilities of a complex vestibular examination of patients with hard curable vertigo.

Material And Methods: We studied 312 patients with complex types of vertigo. Neurologic and othoneurologic examination and some audio- and vestibulometry tests were carried out.

[A new clinical sign - asymmetrical pulsation of neck vessels with a predominance in the right supraclavicular area in healthy people at supine position].

This is a report on a new clinical symptom manifested in the form of an asymmetrical pattern of pulsation in the cervical vessels in healthy people. A study included 820 healthy people of different sex and age, including 40 children. The physiological asymmetry of the jugular veins was demonstrated.

[Basilar type migraine: clinical features, differential diagnosis].

The work is devoted to the description of neurological, vestibulometric and audiologic data obtained in the examination of 11 patients with basilar type migraine. The features of the disease (neck injuries before the disease, prolonged aura, protracted attacks, similarity with the clinical picture of stroke, occipital pain, cervical root syndrome, muscle-tonus phenomena and others) are described. A role of cervical pathology and labyrinthine hydrops in the disease pathogenesis as well as difficulties of differential diagnosis with Ménière's disease and Barre-Lieou syndrome are discussed.