Vol 67, No 9 (2012)

PROCEEDINGS OF THE RAMS SESSION
MECHANISMS OF CEREBRAL DAMAGE IN PATIENTS WITH HIV-INFECTION
Belyakov N.A., Medvedeva S.V., Trofimova T.N., Rassokhin V.V., Dement'eva N.E., Shelomov S.A.
Abstract

Mechanisms of HIV transportation through blood-brain barrier, vascular plexus and interaction with cerebral cells having CD-4-receptors, ССR-5- and CXCR-4-coreceptors were studied. Cerebral damage developed through latent and acute periods also known as HIV-encephalopathy, HIV-associated neurocognitive dysfunction etc. Cerebral lesions are caused by a variety of chemical agents from pro-inflammatory cytokines to toxic HIV-proteins resulting in development of HIV-dementia through several years. Even early stage of this process revealed significant disturbances of glucose metabolism and evoked potentials EEG alterations which can serve as a marker of HIV-infection. Genetic differences of HIV in blood and spinal liquor with different drug resistance were revealed implying a new approach to therapy development.

 

Annals of the Russian academy of medical sciences. 2012;67(9):4-12
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THE APPLICATION OF NUCLEAR MEDICINE IMAGING IN NEUROLOGY, NEUROSURGERY AND PSYCHIATRY
Granov A.M., Tyutin L.A., Stanzhevskii A.A.
Abstract

Analysis of use of nuclear medicine imaging (positron emission tomography and single photon emission computed tomography) in diagnosis, differential diagnosis and evaluation of treatment efficacy of central nervous system diseases is presented in this review. The possibility of radionuclide imaging techniques in different variants of dementia, Parkinson's disease, brain tumors is demonstrated on the basis of personal authors experience and recent literature data. Results of PET application in evaluating of the effecacy of stereotactic interventions in patients with anxiety obsessive disorders are also described in the review.

 

Annals of the Russian academy of medical sciences. 2012;67(9):13-18
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NEW TECHNOLOGIES IN SURGERY OF NON-TRAUMATIC INTRACRANIAL HEMORRHAGES
Krylov V.V.
Abstract

The new possibilities in therapy of cerebral aneurysms, arteriovenous malformations and hypertensive intracranial hematomas recently have come into the neurosurgical sphere due to development of neurovisualization and neurophysiology methods and widely usage of microsurgical principles as well as neuroendoscopy, neuronavigation systems and methods of intraoperative control for operative radicality in surgery of non-traumatic intracranial hemorrhages. Besides this progress was not possible without extensive development of several aspects of anesthesiology and reanimatology focused on anesthetic management and intensive care of neurosurgical patients in particular. Timely diagnostics and optimal choice of treatment methods in patients with non-traumatic intracranial hemorrhages allow to achieve good functional outcomes with trend to mortality minimization.

 

Annals of the Russian academy of medical sciences. 2012;67(9):19-26
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DEVELOPMENT OF NEUROCRITICAL CARE
Piradov M.A., Moroz V.V.
Abstract

In this review we provide the definition, goals and objectives of neurocritical care, evaluation of brief history of its development. Mechanical ventilation, intracranial hypertension, neuromonitoring as underlying basics of neurocritical care approaches are discussed. The main types of pathology and specific methods used in neurocritical care units are discussed. The results of our own research on brain death — the development of national criteria; for Guillain-Barre syndrome — a double decrease in the length of mechanical ventilation and in 2.5 times of the recovery time for independent walking ability; on diphteric polyneuropathy — reduced by 11 times mortality compared with nation-wide indicators of non-traumatic persistent vegetative state — the development of diagnostic and predictive neurophysiologic criteria are demonstrated. Research data of multiple organ disfunction syndrome in severe stroke are described. Further development of neurocritical care is being discussed.

Annals of the Russian academy of medical sciences. 2012;67(9):27-30
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MODERN TECHNOLOGY IN THE SURGICAL TREATMENT OF HEAD INJURY SEQUELAE
Potapov A.A., Kornienko V.N., Kravchuk A.D., Likhterman L.B., Okhlopkov V.A., Eolchiyan S.A., Gavrilov A.G., Zakharova N.E., Yakovlev S.B., Shurkhai V.A.
Abstract

The paper presents main types of surgically relevant posttraumatic lesions in 4136 patients with skull vault as well as skull base defects, craniofacial deformities, recurrent CSF leaks, arterio-venous fistulas, aneurysms and pseudoaneurysms etc. Classification of TBI sequelae and complications as well as its clinical course grading is presented. The use of modern neuroimaging techniques for studying pathophysiologic mechanisms and complications of TBI has been demonstrated. Special emphasis was given to minimally invasive and reconstructive surgery; computer modeling with subsequent full-copy stereolitographic laser implant setup was shown which is of great importance in cases of large and complex skull base and craniofacial deformities. Patient selection for transcranial and endonasal CSF leak closure techniques was justified. Treatment of post-traumatic vascular injuries using Serbinenko balloon-catheters as well as modern techniques such as stents, coils and embolization has been demonstrated.

 

Annals of the Russian academy of medical sciences. 2012;67(9):31-38
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THE FUNDAMENTS OF NEURONAL PLASTICITY
Skrebitskii V.G., Shtark M.B.
Abstract

 Plasticity of the nervous system  is determined by the modification of efficacy of synaptic transmission: long- term potentiation and long- term depression. Different modern technical approaches such as: registration of ionic currents in single neuron, molecular- genetic analysis, neurovisualization, and others reveal the molecular mechanisms of synaptic plasticity. The understanding of these mechanisms, in its turn, stimulates the development of methods of pharmacological correction of different forms of brain pathology such as Alzheimer disease, parkinsonism,  alcoholism, aging and others.      

 

Annals of the Russian academy of medical sciences. 2012;67(9):39-44
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GENOMIC INSTABILITY IN THE BRAIN: ETIOLOGY, PATHOGENESIS AND NEW BIOLOGICAL MARKERS OF PSYCHIATRIC DISORDERS
Tiganov A.S., Yurov Y.B., Vorsanova S.G., Yurov I.Y.
Abstract

The latest advances in molecular medicine, medical genetics and neurobiology have provided for a new look at processes occurring in cells of the brain and have allowed to discover previously unknown phenomena associated with mental traits and to propose new biomedical direction which include genomics, psychiatry and neurobiology ― brain genomics. The application of modern molecular and cellular technologies of genome analysis in the brain in common psychiatric disorders (autism, schizophrenia and Alzheimer’s disease) has shown that genomic instability is a phathogenetic mechanism of central nervous system abnormalities and plays a role in the brain development. Genomic disbalance alters neural homeostasis leads to cell death and is an important biological marker of psychiatric disorders which determine genomic pathways. These alterations lead to synaptic disfunction and neurodegeneration. In the present review, the main advances of brain genomics and potential application in diagnostic, clinical and therapeutic practice.

 

Annals of the Russian academy of medical sciences. 2012;67(9):45-53
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CHRONIC PAIN: MEDICO-BIOLOGIC AND SOTSIO-ECONOMIC ASPECTS
Yakhno N.N., Kukushkin M.L.
Abstract

In this article the role of neurobiological, psychological and social factors in pathogenesis of chronic pain is analyzed. The chronic pain is considered not as a symptom of damage of tissue and as independent illness due to non-adequate neuroplasticity of systems involved into regulation of pain sensitivity. The major role in development and maintenance of chronic pain is devoted to the primary genetically determined and/or secondary disturbance of interaction between nociceptive and antinociceptive systems at various levels - from peripheral neuron to central structures – that provides pain perception and painful behaviour development.

 

Annals of the Russian academy of medical sciences. 2012;67(9):54-58
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STATE OF MEDICAL SCIENCES
THE REPRESENTATION OF SCIENTIFIC PUBLICATIONS OF RAMS IN WEB OF SCIENCE: EVALUATION OF CURRENT INDICATORS AND PROSPECTS OF THEIR INCREASING
Starodubov V.I., Kuznetsov S.L., Kurakova N.G., Tsvetkova L.A.
Abstract

The contribution scientific publications of Russian Academy of Medical Sciences (RAMS) in the national publication stream, indexed by Web of Science over the past thirty years, was estimated. The indicators of publication activity that are necessary for the institutions of RAMS to achieve in short-term period the conformity with bibliometric indicators, established by Presidential Decree of May 7, 2012 (to increase the share of Russian publications in Web of Science to 2.44% in 2015) were calculated. It is shown that the current structure of global science, where publications in medicine make up for approximately one third of scientific publications in the world, set for RAMS scientists particularly difficult task: to double in three years the number of publications in Web of Sci. In the article are proposed the priorities and the necessary steps to fulfill this task.

 

Annals of the Russian academy of medical sciences. 2012;67(9):59-64
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SCIENTIFIC, PRACTICAL AND EDUCATIONAL ASPECTS OF CLINICAL EPIDEMIOLOGY
Briko N.I.
Abstract

This article defines clinical epidemiology and describes its goal and objectives. The author claims that clinical epidemiology is a section of epidemiology which underlies the development of evidence-based standards for diagnostics, treatment and prevention and helps to select the appropriate algorithm for each clinical case. The study provides a comprehensive overview of the relationship between clinical epidemiology and evidence-based medicine. Epidemiological research is shown to be methodological basis of clinical epidemiology and evidence-based medicine with randomized controlled trials being the “gold standard” for obtaining reliable data. The key stages in the history of clinical epidemiology are discussed and further development of clinical epidemiology and the integration of courses on clinical epidemiology in education is outlined for progress in medical research and health care practice.

 

Annals of the Russian academy of medical sciences. 2012;67(9):65-69
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