Coronavirus infection is a systemic pathology resulting in impairment of the nervous system. The involvement of the central nervous system in COVID-19 is diverse by clinical manifestations and main mechanisms. The mechanisms of interrelations between SARS-CoV-2 and the nervous system include a direct virus-induced lesion of the central nervous system, inflammatory-mediated impairment, thrombus burden, and impairment caused by hypoxia and homeostasis. Due to the multi-factor mechanisms (viral, immune, hypoxic, hypercoagulation), the SARS-CoV-2 infection can cause a wide range of neurological disorders involving both the central and peripheral nervous system and end organs. Dizziness, headache, altered level of consciousness, acute cerebrovascular diseases, hypogeusia, hyposmia, peripheral neuropathies, sleep disorders, delirium, neuralgia, myalgia are the most common signs. The structural and functional changes in various organs and systems and many neurological symptoms are determined to persist after COVID-19. Regardless of the numerous clinical reports about the neurological and psychiatric symptoms of COVID-19 as before it is difficult to determine if they are associated with the direct or indirect impact of viral infection or they are secondary to hypoxia, sepsis, cytokine reaction, and multiple organ failure. Penetrated the brain, COVID-19 can impact the other organs and systems and the body in general. Given the mechanisms of impairment, the survivors after COVID-19 with the infection penetrated the brain are more susceptible to more serious diseases such as Parkinson’s disease, cognitive decline, multiple sclerosis, and other autoimmune diseases. Given the multi-factor pathogenesis of COVID-19 resulting in long-term persistence of the clinical symptoms due to impaired neuroplasticity and neurogenesis followed by cholinergic deficiency, the usage of Neuroxon® 1000 mg a day with twice-day dosing for 30 days. Also, a long-term follow-up and control over the COVID-19 patients are recommended for the prophylaxis, timely determination, and correction of long-term complications.
Роль холинергического дефицита в патогенезе психоневрологических заболеваний Резюме. Сделан обзор литературы, посвященной роли дисфункции холинергической системы в формировании различной патологии центральной нервной системы. Представлены данные о патогенетических механизмах нарушений сознания и когнитивных дисфункций. Описаны современные подходы к коррекции холинергической недостаточности.
головокружения в клинической практике определяется высоким уровнем распространенности и значительным ухудшением качества жизни пациентов с этой патологией. В статье рассмотрено и проанализировано головокружение, его причины и патогенетически обоснованные дифференцированные подходы к лечению. Целью данной работы явилось изучение эффективности применения препарата Тагиста (бетагистин) в сравнении с плацебо у пациентов с поражениями вестибулярной системы на разных уровнях, вызванными различными причинами. Материалы и методы. В исследование было включено 200 человек, 105 из них были рандомизированы в группу изучаемого препарата, 95-в группу плацебо. Все больные основной группы, кроме стандартной терапии, получали курс лечения препаратом Тагиста (24 мг 2 раза в день) в течение 14 дней. Параллельно с оценкой эффективности препарата Тагиста выполнена сравнительная оценка его безопасности. К первичным критериям эффективности были отнесены: оценка выраженности и длительности головокружения (Dizziness Handicap Inventory), определение двигательной активности (шкала Тинетти), оценка по шкале качества жизни (SF-36, EQ-5D). Результаты и выводы. Статистически значимых различий в эффективности препарата Тагиста при центральном и периферическом вестибулярных синдромах выявлено не было. Анализ действия препарата Тагиста свидетельствует о его разностороннем влиянии на различные патогенетические механизмы головокружения и, следовательно, о патогенетической обоснованности применения препарата при разных типах вестибулярного головокружения. Статистически достоверная положительная динамика при терапии препаратом Тагиста в дозировке 48 мг в сутки у больных основной группы сопровождалась минимальным количеством побочных эффектов.
Objective ‒ to develop a technique for endovascular treatment of symptomatic ostial stenosis of the vertebral arteries, which allows to minimize risks of delayed stent breakage and restenosis. Materials and methods. This is analysis of prospectively collected data from patients presenting from 2016 to 2019 in the endovascular center of the Dnepropetrovsk Regional Clinical Hospital named after I.I. Mechnikov. One hundred four stents were placed in 99 patients using the author’s complex method, which is based on our modification of Szabo technique. The principles of the method were developed based on a literature review and in vitro tests using 7 silicone models of the initial segments of the subclavian and vertebral arteries with different angles of divergence of the vertebral arteries (30, 45, 60, 90, 120, 135, 150°) and 9 balloon mounted drug-eluting stents with open-cell design Resolute (Medtronic).Results. There were no cases of displacement of the stent proximally or distally during implantation. In all cases, stents were implanted in the affected segment exactly and did not prolapse more than 1 mm beyond the ostium of the vertebral artery into the subclavian artery. There were no «clinical» ischemic complications in the early postoperative period. In 5 cases, isolated subclinical ischemic lessions in the carotid circulation were revealed during one-session stenting of ostial stenosis of the vertebral arteries and carotid stenting. In the posterior circulation, ischemic lessions on MRI in the early postoperative period were not detected in any observations.Conclusions. Developed complex stenting method based on our modification of Szabo technique allows us to achieve optimal long-term results of stenting of symptomatic ostial stenosis of the vertebral arteries.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.