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Biomedical subjects

A B Gekht

Publications and source records attributed to A B Gekht.

At least 19 recordsLinked to original sources
PubMed2005

[Clinico-neurological and stabilometric analysis of betahistine (betaserc) efficacy in the patients with vertigo in the rehabilitation period of ischemic stroke].

A study of betahistine (betaserc) in 65 patients aged 59,48 +/- 8,63 years with vertigo in early rehabilitation period of ischemic stroke has been carried out. Thirty-five patients got atiplatelet and antihypertensive therapy and were also treated by betaserc--8-16 mg 3 times per day for 14 days per os, after meals. The control group of 30 patients received only atiplatelet and antihypertensive therapy. Both groups were similar in demographic and clinical characteristics. The treatment with betahistine reduced the intensity and duration of vertigo, led to improvement of coordination and equilibrium, increase stability of a vertical posture that was accompanied by significant (p<0,05) improvement of the values on the Hoffenberth and Bohannon scales. Betahistine treatment also resulted in marked authentic (p<0,05) improvement of stabilometric parameters in biological feedback task that might be explained by activation of the mechanisms maintaining vertical balance. An improvement of clinical and neurophysiologic traits was more pronounced in the group treated with betaserc as compared to the control group.

Aged↗
PubMed2004

Dialectics and implications of natural neurotropic autoantibodies in neurological disease and rehabilitation.

The role of natural idiotypic (Id-Abs) and anti-idiotypic (AId-Abs) autoantibodies against neuroantigens observed in different neurological disorders is not fully understood. In particular, limited experimental evidence has been provided concerning the qualitative and quantitative serological response after acute injuries of the central nervous system or during chronic mental diseases. In this study, we analyzed the specific Id-Abs and AId-Abs serological reactivities against 4 neuro-antigens in a large population of patients with ischemic stroke, schizophrenia, as well as healthy individuals. Patients with ischemic stroke were tested at different time points following the acute stroke episode and a correlation was attempted between autoantibodies response and different patterns of functional recovery. Results showed variable and detectable Id-Abs and AId-Abs in different proportions of all three populations of subjects. Among patients with different functional recovery after ischemic stroke, a difference in time-related trends of Id-Abs and AId-Abs was encountered. Our observations suggest that changes in the production of natural neurotropic Abs may engender a positive homeostatic, beside a possible pathogenic effect, in specific neurological disorders.

Aged↗
PubMed2004

[Possibilities and perspectives of berlition usage in the treatment of alcohol polyneuropathy].

A comparison study of efficacy and tolerability of the drug berlition 300 oral and berliton 300 U and vitamin B1 has been conducted in 56 patients with alcohol polyneuropathy (15 female, 41 male, mean age 42.6 years). The key mechanisms of berlition action are increasing of endoneural blood flow, strengthening of antioxidant system functioning and reduction of "oxidative stress" intensity; improvement of glucose consumption and restoring of nerve energetic balance as well as intensification of nerve growth factor releasing and nerve growth acceleration after its experiment cutting or squeezing. Usage of berlition in the cohort studied was accompanied by a positive dynamics of both subjective and objective clinical symptoms. Comparing to vitamin B1, the drug was significantly more effective by clinical and electrophysiological indices. Berlition therapy is tolerable and safe. The results of the study confirm an assumption of berlition efficacy in alcohol polyneuropathy and allow to recommend the drug for a wide clinical application.

Adult↗
PubMed2004

[Cost-effect estimation of dopamine agonist (mirapex) application in patients with Parkinson's disease].

Parkinson's disease is a neurodegenerative disorder with a growing social significance. Currently, dopamine agonists are considered as first-line medication used before levodopa treatment. High cost of dopamine agonists makes it necessary to estimate their cost efficacy by means of pharmacoeconomical studies. We studied efficacy of mirapex evaluated by UPDRS and PDQ-39 scores before and after 1-year treatment in 44 patients with Parkinson's disease: 18 patients non-pretreated with levodopa and 26 patients pretreated with levodopa. Treatment cost was estimated separately for two patients groups with subsequent cost-effectiveness analysis. Early use of mirapex as a dopamine agonist for patients non-treated with levodopa seems to be beneficial from clinical well as from pharmacieconomical points of view.

Cost-Benefit Analysis↗
PubMed2003

[Neurological disturbances in heroin addicts in acute withdrawal and early post-abstinence periods].

Neurological examination was performed in 79 heroin addicts (mean age 24.4 +/- 6.3 years; heroin abusing duration 16.6 +/- 12.4 months; heroin dose per day 0.48 +/- 0.42 grams). During the first week after withdrawal, "physical dependency" symptoms, mild hypomimia and hypokinesia, low muscle tone, low tendon reflexes and facilitated nociceptive reflexes were observed in more than 70% of the patients. Non-specific microneurological signs as nystagm, limited convergence, tremor and dynamic ataxia etc, were found in more than 35% of the cases. Previously reported meningeal irritation or polyneuropathy symptoms were not determined in the patients population. Most of the symptoms disappeared after 10 days of abstinence as the follow-up examination of the 34 patients revealed. Mild hypomimia and hypokinesia persisted along with characteristic psychopathological changes. The most abundant neurological disturbances were observed in patients abusing heroin for more than 6 months in dosages more than 0.4 grams per day. Heroin withdrawal symptoms include reversible decrease in muscle tone and tendon reflexes as well as facilitation of nociceptive reflexes and reversible non-specific neurological microsigns. Heroin encephalopathy is characterized by ventral striatum insufficiency signs.

Acute Disease↗
PubMed2003

[Brain bioelectrical activities in heroin addicts during early abstinence period].

Standard 19-channel EEG registration was performed in 30 heroin addicts (mean age 21.7 +/- 2.8 years, daily heroin abusing duration--12.2 +/- 8.0 months, heroin dose per day--0.42 +/- 0.29 g, abstinence duration--12.3 +/- 8.1 days). Qualitative EEG changes, being observed in more than 70% of the cases, included low voltage of background activity with depression of alpha rhythm and increase in beta activity; large amount of low amplitude waves in central regions; low reactivity to stimulation. The patients with daily heroin doses more than 0.5 g demonstrated slowing of alpha rhythm in comparison to those with lower doses (8.9 +/- 0.8 Hz vs 10.3 +/- 2.0 Hz, p < 0.05). In follow-up study, obvious or even complete normalization of the EEG was observed in most of the cases during the first months of abstinence.

Adolescent↗
PubMed2003

[Experience with ixel (milnacipran hydrochloride) use in the treatment of patients with post-stroke depression].

AIM: To evaluate antidepressive efficacy of ixel in patients with poststroke depression (PSD). MATERIAL AND METHODS: The study included 59 PSD patients aged 43-79 years divided into two groups: the test group (31 patients) treated with antidepressive drugs and the control group (28 patients) was not treated with such drugs. The test group took a two-month treatment with oral ixel in a dose 100 mg/day. The neurological status was assessed by Lindmark scale (LS), severity of depression-by Hamilton scale (HS). RESULTS: On ixel treatment day 10-14 the patients felt better, by the treatment day 60 depression disappeared in 60.9%, only borderline conditions were seen in 39.1%. Mean score by HS fell from 15.8 to 5.7. The controls showed moderate reduction of some symptoms of depression, mean score by HS decreased insignificantly (from 14.5 to 13.4). By LS, significant differences between the groups were not registered. Side effects arose in 10 patients, 6 of them withdrew. CONCLUSION: Ixel is an effective drug against depression in stroke survivors.

Adult↗
PubMed2002

[Post-stroke depression: an experience in using cipramil].

Fifteen patients, 12 males, 3 females, aged 59.6 +/- 9.6 years, with depression after stroke, occurred 9 months--1 year and 3 months before, were treated with cipramil in dose 20 mg/day during 2.5 months. Control group comprised 10 patients matched for demographic and clinical characteristics and been not assigned to cipramil. All patients were fully examined by clinical methods, including computer tomography. Besides, for patient's state evaluation, Hamilton rating scale for depression and Lindmark scale for focal neurologic deficit measuring have been administered. The initial scores on these scales were 22.8 +/- 4.5 and 381.4 +/- 33.4 in the basic group and--22.2 +/- 6.3 and 390.6 +/- 29.8 in the controls, respectively. While cipramil using, an improvement was observed rather quickly--after 2-3 weeks, being stable during the whole treatment course. After treatment finishing, depression scores on Hamilton scale decreased to 15.8 +/- 5.2 (p < 0.001) in the basic group and did not change in the control one. The neurological deficit expression has not been changed. Side effects were mildly expressed in 20% of the patients. In one-third of the patients, antidepressant effect diminished in 1.5 months after treatment finishing. A need for longer antidepressant treatment of post stroke patients is discussed.

Antidepressive Agents, Tricyclic↗
PubMed2002

[Premorbid psychological status in heroin abusers: impact of treatment compliance].

UNLABELLED: Heroin abusers who performed two "prefrontal" psychological tests (WCST and Delayed Alternation test--DIAT) with unusual amount of perseverative responses, reached i.v. doses of 0.5-1.0 g of heroin per day during the first year of heroin intake and continued out-patient treatment after discharge from hospital. Patients with "ideal" performance on two tests injected 0.1-0.3 g of heroin per day during the first year of heroin intake and stopped treatment after discharge, sometimes returned for treatment after several months of remission because of relapse. The latter patient group had lower verbal intelligence in comparison with education-matched normal controls. Percent of normal controls who made unusually many perseverative responses on WCST was the same as in the patient group (chi 2 = 5.5, p = 0.24). CONCLUSIONS: a) Performance of WCST and partially DAT can characterise of premorbid psychological status in heroin abusers; b) premorbid dysfunction of prefrontal cortex that mediates perseverative responses to WCST and DAT may contribute to drug abusing severity; c) low verbal intelligence may poorly influence treatment compliance in heroin abusers.

Adult↗
PubMed2001

[Neuropsychological deficit in chronic heroin abusers].

Neurological consequences of chronic heroin exposure are poorly known. 38 male patients with current heroin abuse or dependence were examined in withdrawal period that lasted more than 10 days, and were compared with 19 healthy controls. Wisconsin Card Sorting Test (WCST), "Delayed Alternation" Test (DAT), "Tower of London" Test (TLT), Russian version of WAIS (1995) were used. Patients were medicated and medication status was evaluated by psychomotor speed level. Patients with the duration of daily heroin abuse more than 1.5 years performed significantly less effectively TLT solutions as compared with the healthy controls (after Bonferroni correction, p = 0001). Patients with shorter duration of daily heroin abuse had a trend to perform TLT solutions poorer as compared to healthy controls and better than group with longer duration (after Bonferroni correction, p = 0.07 and 0.08). Three groups did not differ by WCST and DAT significantly, and general intelligence was in normal range in three groups. Multiple regression analysis confirmed significant influence of daily heroin abuse duration on TLT performance efficiency in our population (beta = -0.426, p < 0.05) without effect of age, education, IQ, dosage of heroin per day, withdrawal duration and current medication status (psychomotor speed level). Perseverative responses on DAT were significantly related to daily heroin dosages before treatment (beta = 0.405, p < 0.05) and negatively correlated with the withdrawal duration. These data give grounds to suppose, that chronic heroin exposure impairs planning functions of prefrontal cortex (TLT), that can be explained by cumulative neuronal damages of prefrontal cortex and VTA dopamine neurons. That was demonstrated in experimental and morphological studies of opiate addicts who died after opiate overdose. Large doses of heroin can induce more extensive functional impairment with possible involvement of orbit frontal cortex. The latter deficit may be partially reversible during short-term withdrawal.

Adult↗