During treatment, there was an improvement in neurophysiological parameters in both groups, which was more pronounced in patients treated with cytoflavin: their P300 amplitude increased by1.3 times in the left hemisphere (from 9.21 (8.36, 10.11) to 12.41 (10.23, 13.37 μV) and 1,7 times in the right hemisphere (from 6.48 (5.26, 7.35) to 11.04 (9.29, 12.18) μV). Our study confirms the advisability of using drugs that have complex cytoprotective and energy-correcting mechanism in patients with cognitive impairment. Cytoflavin has shown the high efficacy and safety and can be recommended as part of complex therapy for cognitive disorders. Using simple and inexpensive instrumental methods (assessment of cognitive P300 evoked potential) along with diagnostic scales in patients with cognitive impairment can significantly objectify the assessment of treatment dynamics.
Introduction: We assessed best available data on access and delivery of acute stroke unit (SU) care, intravenous thrombolysis (IVT) and endovascular treatment (EVT) in the European region in 2019 and 2020. Patients and methods: We compared national data per number of inhabitants and per 100 annual incident first-ever ischaemic strokes (AIIS) in 46 countries. Population estimates and ischaemic stroke incidence were based on United Nations data and the Global Burden of Disease Report 2019, respectively. Results: The estimated mean number of acute SUs in 2019 was 3.68 (95% CI: 2.90–4.45) per one million inhabitants (MIH) with 7/44 countries having less than one SU per one MIH. The estimated mean annual number of IVTs was 21.03 (95% CI: 15.63–26.43) per 100,000 and 17.14% (95% CI: 12.98–21.30) of the AIIS in 2019, with highest country rates at 79.19 and 52.66%, respectively, and 15 countries delivering less than 10 IVT per 100,000. The estimated mean annual number of EVTs in 2019 was 7.87 (95% CI: 5.96–9.77) per 100,000 and 6.91% (95% CI: 5.15–8.67) of AIIS, with 11 countries delivering less than 1.5 EVT per 100,000. Rates of SUs, IVT and EVT were stable in 2020. There was an increase in mean rates of SUs, IVT and EVT compared to similar data from 2016. Conclusion: Although there was an increase in reperfusion treatment rates in many countries between 2016 and 2019, this was halted in 2020. There are persistent major inequalities in acute stroke treatment in the European region. Tailored strategies directed to the most vulnerable regions should be prioritised.
В статье рассмотрены этиологические факторы и патофизиологические механизмы развития и прогрессирования сосудистой мозговой недостаточности. Приведены основные направления лечения этих больных, включая комбинированное назначение полимодальных препаратов, имеющих нейропротективное, метаболическое и сосудистое действие. Ключевые слова: хроническая сосудистая мозговая недостаточность, церебральный кровоток, нейропротективная терапия.
Eosinophilic granulomatosis with polyangiitis - EGPA (Churg-Strauss syndrome) is a rare autoimmune disorder. The pathogenesis of the disease includes production of anti-neutrophil cytoplasmic antibodies directed against myeloperoxidase with the development of small-vessel necrotizing vasculitis and eosinophilic infiltration of organs. The involvement of peripheral and central nervous system is observed in more than 3/4 of cases. The authors describe three patients with EGPA. In a 53-year-old male patient, EGPA manifested with multiple neuropathies, which regressed after treatment with corticosteroids and cytostatics. In a 34-year-old woman, cerebral sinus thrombosis and cerebral infarction developed in the non-active period of long-term EGPA. The patient was treated with anticoagulants. A 77-year-old woman with a newly diagnosed EGPA, confirmed by bone marrow examination for eosinophilia, developed ischemic stroke and polyneuropathy. The causes and mechanisms of development as well as dynamics and outcomes of neurological disorders, differential diagnosis, treatment and prognosis of eosinophilic granulomatosis with polyangiitis are discussed.
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