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Biomedical subjects

A N Boĭko

Publications and source records attributed to A N Boĭko.

At least 19 recordsLinked to original sources
PubMed2006

[Clinical and epidemiological study of multiple sclerosis in Volgograd city].

Descriptive and analytical study of multiple sclerosis (MS) has been first-ever carried out in population of Volgograd city, South region of Russian Federation. At the period of the study (1996-2000) the population was estimated as 814 100 adult persons. An average age-adjusted level of MS prevalence was 31.9 per 100,000, MS incidence--9.8, mortality 1,8. Thus, the city is at a moderate risk for MS, however the incidence of the disease appeared to be rather high that indicates a further increase of MS patients number in this population. The highest level of MS prevalence was registered in two districts with poor ecological characteristics and numerous industries: Krasnoarmeysky (52.4 per 100,000 persons) and Krasnooktiabrsky (46.4). An analytical case-control study included data collected from 178 pairs (73.6% female) of MS patients and controls matched for age, sex and ethnic origin. Significant differences between patients and controls were detected as follows: patients more often had blue eyes as compared to dark ones; in the patient group mother's age at birth was above 30 years; patients more often lived near chemical and/or oil factories at age before 15 years; they more often reported a presence of stress factors in the family and chronic tonsillitis. Association with other factors, including infections, nutrition, acute and chronic diseases, poisoning, traumas, family history of different diseases, contact with animals etc, has not been found. A possible association between environmental factors and features of MS course were analyzed. Living near chemical factories at age before 15 was associated with more active MS course, i.e. high frequency of progressive course, short period from MS onset to confirmed EDSS=3, short duration of first remission. The same, though less significant, influence may exert the presence of herpes infection and chronic tonsillitis at age under 15.

Adult↗
PubMed2006

[Epidemiology of multiple sclerosis in Tiumen' region].

Prevalence of multiple sclerosis (MS) was evaluated in the pilot study of 731 patients living in Tyumen city and a southern part of Tyumen region as well as in Khanty-Mansi (KMAO) and Yamal-Nenets (YNAO) autonomic okrugs. An index of MS prevalence was 22,4 per 100,000 in Tyumen region as a whole. This index was higher--29.1 per 100 000 - in the southern part. In KMAO and YNAO, the MS prevalence was 14,3 and 27,8 respectively. Women prevailed among patients in all the regions, their number being twice higher (461 and 270). However, if in the southern part and in KMAO this ratio was approximately equal, in YNAO percentage of men was significantly higher. It should be noted that these data need further study. We revealed that using of current diagnostic criteria may often lead to misunderstanding of diagnosis of "definite" MS. Essential difference in MS prevalence in different regions may be explained by ethnical stratification. In particular, there are many newly migrated people in the okrugs and MS occurs more often in that group. At the same time, there is no any information on the prevalence of "definite" MS among the native-born population of KMAO and YNAO.

Adolescent↗
PubMed2006

[The possibilities of adaptation of patients with multiple sclerosis: the results of clinical and psychological study].

A complex clinical and psychological examination of three groups of patients with stable neurological deficit (113 subjects, 77 men and 76 women, aged from 19 to 67 years) included those with multiple sclerosis (MS), chronic cerebral vascular disorders and chronic dorsopathy with illness duration 5-7 years has been carried out. Neuropsychological status and quality of life were assessed using the following tests: Medical Outcomes Study Short Form 36 Health Survey (SF-36); the method of E.B. Fantalova "Level of Ratio of "Values" to "Availability" in Different Life Spheres", Integrative Anxiety Test, Manual for the Constructive Thinking Inventory, Coping test (Lazarus), Beck depression scale. In total, 42 traits on 6 tests have been studied. The study was conducted before and after treatment (21 +/- 2 days). The results revealed that patients with chronic neurological disorders, in particular with MS, often had subclinical depression, which negatively influenced the disease course, and needed treatment. A high level of anxiety was found in MS patients that was related to situational social defensive reaction. Low ability to positive reevaluation of life situations, one of the causes of anxiety states, was observed in all the groups, especially in MS. In MS patients, their real state was not consistent with their perception of this state. They also were featured by personal superstitious thinking. Most of the patients with MS had a good constructive thinking, preserved ability to emotional and behavioral self-control that indicated favorable prognosis in future complex rehabilitation. After the course of symptomatic vascular and metabolic therapy, with the exception of antidepressants and neuroleptics, the appearances of depression and anxiety as well as expression of social defensive reactions and situational phobic component of anxiety were decreased that suggested the necessity of inclusion of individual psychotherapy as a part the complex rehabilitation therapy.

Adaptation, Psychological↗
PubMed2006

[A wide support of patients with multiple sclerosis promotes success of long-term therapy].

The diagnosis of multiple sclerosis (MS) is a life-altering experience that has far-reaching and diverse implications for newly diagnosed patients and their families. Since the disease is complex and highly variable, it places physical, emotional and social challenges on everyone concerned. A number of responsible decisions must be made, the most difficult one being the consent to long-term therapy. Joint effort of both physicians and patients allow the latter to take up properly new life circumstances, get adequate motivation, right and regular implementation of the long-term treatment plan aiming to prevent the disease progression. The management of many chronic diseases involves medications that must be injected on the frequent basis. In MS, such injections can reduce the frequency of relapses and slow the disease progression. Pretreatment injection self-efficacy expectations, injection anxiety, therapeutic expectations and ability to self-inject are significantly related to adherence. Poor patient adherence to long-term therapy severely compromises the treatment effectiveness.

Adjuvants, Immunologic↗
PubMed2006

[The results of longitudinal use of copaxone and betaferon in Moscow Multiple Sclerosis Center: issues of efficacy and adherence to therapy].

In last decades, practical neurologists are able to use DMT in multiple sclerosis (MS) in every day practice. This paper presents data of 3-year study of DMT (copaxone and betaferon) treatment of 280 patients with definite diagnosis of multiple sclerosis (MS), 166 patients regularly receiving DMT (104--copaxone and 62--betaferon) for, at least, 3 years. Clinical symptoms of the patients, reasons of treatment withdrawal (48--copaxone and 31--betaferon) and the features of MS course after the withdrawal are analyzed. Patients who received betaferon previously had more severe MS course with frequent relapses, half of them had secondary progressive MS course (SPMS) with relapses. This made impossible a direct comparison of the data of two treatment groups. Treatment with copaxone reduced 5 times annual relapse rate, from 1.45 before DMT to 0.27 during these 3 years (p < 0.001), and this reduction remained stable. For 36 months, 40.4% of patients were relapse-free though all of them had, at least, one relapse per year before the treatment. No EDSS progression was observed in 80% of these patients. Treatment with betaferon caused the reduction of relapse rate from 1,84 to 0,69 per year (2.7 times), 8 patients (26%) with previously active RMS being relapse-free for 36 months. In 31 patients with SPMS, the reduction of relapse rate was also significant, from 1.89 to 0.49 (3.8 times, p < 0.001). Twenty-two patients (71%) with previous SPMS did not have EDSS progression for 36 months that indicate the positive effect of the therapy. Side-effects were moderate and were not the main cause of the treatment withdrawal. The latter was caused mainly by clinical un efficacy, most frequently by the increase of EDSS due to transformation of the MS course to SPMS without relapses and poor understanding by the patient of the goals and the possibilities of DMT. These facts stress the significance of improving compliance, motivation and adherence to DMT in everyday neurological practice.

Adjuvants, Immunologic↗
PubMed2006

[Effective treatment of multiple sclerosis with rebif-22 mcg in children and adolescences: results of a long-term study].

Management from an early age and availability of new treatment options have changed the outcome of paediatric patients with multiple sclerosis (MS). Currently available for treatment of MS in adults, such drugs as interferons beta and copolymer-1 are not widely used in paediatric neurological practice. The present long-term study of the effect of interferon beta la (rebif-22 mcg) included 20 children with MS from Moscow population. The data of this open-label study were compared with our previously reported data from the prospective population-based study of 67 ethnically-matched children with MS. The results revealed early formation of stable neurological deficit at late-onset treatment, high therapeutic efficacy when the drug was timely used and good tolerability of the treatment. So, it is necessary to use immunomodulating therapy with these drugs in children and adolescents as early as possible.

Adjuvants, Immunologic↗
PubMed2006

[The peculiarities of formation and approaches to the treatment of chronic fatigue syndrome in young patients with focal brain damage].

Chronic fatigue (CF) is a syndrome manifesting in cases with focal brain damage. It is frequent in multiple sclerosis (MS) and encephalopathies (post-traumatic, cerebrovascular, etc). Treatment of this syndrome remains problematic. The study aimed to analyze the genesis of CF in patients with different non-active neurological diseases with brain damage and possibility of its treatment with the complex drug fezam (piracetam plus cinnarizin) in dosage 2 capsules 3 times per day. Before the treatment, all the patients had CF, which was directly associated with severity of depression in patients with encephalopathies. In MS patients, changes in the valuable-and-sense sphere that plays a significant role in human behavior and activity underlying self-regulation in critical situations were found. Neuropsychological data revealed that in patients with encephalopathies psychological and behavioral aspects were more significant in regard with CF genesis than in patients with MS. Fesam caused significant decrease of the CF severity, which was more prominent in the MS group, while in another group it was associated with a decrease of depression severity. Mild side-effects were observed in 6 patients (12%) and appeared mainly as sleep disorders. This trial allows recommending Fezam for complex treatment of CF syndrome in MS and in combination with psychocorrective medicines in cases of encephalopathies.

Adult↗
PubMed2006

[The use of katadolon in patients with spondylogenic dorsalgia].

The open non-comparative study of the efficacy of katadolon (100 mg 3 times daily during 2 weeks) in 90 out-patients with spondylogenic dorsalgia has been carried out. A good effect, i.e. the complete relief of the pain syndrome, rehabilitation of the ability to self-service and regress of neurological symptoms, was observed in 59 (65.6%) patients, a satisfactory effect, i.e. the complete relief of the pain syndrome with elements of restricted daily activity and symptoms of radiculopathy-- in 24 (26.7%) patients and a moderate effect, i.e. the presence of the residual pain syndrome, restricted daily activity and symptoms of radiculopathy,--in 7 (7.8%) patients. After the therapy, the intensity of the pain syndrome decreased by 4 times, from 69.7 +/- 4.3 to 17.6 +/- 0.11 according to the numerical scale of pain (p < 0.01), and by 2.5 times, from 2.51 +/- 0.27 to 1.04 +/- 0.09 (p < 0.0001), according to the verbal scale of pain. At the same time, the ability to self-service increased by 3 times on the daily living scale (2.6 +/- 0.28; p < 0.0001). At the end of the treatment, the intensity of the pain syndrome was associated with illness duration (r = 0.538; p < 0.01) and the presence of the root pain syndrome (r = 0.266; p < 0.03). The drug was well-tolerable and caused minimal side-effects.

Adult↗
PubMed2005

[Phezam efficacy in patients with chronic cerebral ischemic disease].

The efficacy of combined medication which comprised compounds with nootropic (piracetam) and vasoactive (cinnarisin) effects, was studied in patients with cerebral blood flow insufficiency. The main inclusion criterion was a diagnosis of chronic brain ischemia (CI). The study consisted of two stages: (1) a randomized comparative trial in neurological clinic (60 patients) and (2) estimation of the drug efficacy in routine practice (60 patients). The clinical examination was accompanied by neuropsychological tasks, kinetic tests and ultrasound investigation of brain vessels. At the first stage, a positive neurological and neuropsychological dynamics was found after 8 weeks of phezam treatment. Also a statistically significant positive dynamics was observed for a number of blood flow velocity parameters in the middle brain artery. In routine medical practice, a positive effect of phezam was seen after 2 months of the treatment for all but CI main symptoms and confirmed by the data of kinetic investigation. The patients reported good tolerability and convenience of the drug intake (one capsule instead of two tablets of nootropic and vasoactive drugs).

Aged↗
PubMed2004

[Modeling of focal ischemia of the brain].

Methods of modeling and criteria of evaluating the pathological process in the central nervous system (CNS) as well as modern technologies of provoking the focal ischemia of the brain in experimental animals are under discussion. The results were analyzed comparatively from the viewpoint of efficiency and adequacy of certain models as well as of the clinical specificity of ischemic strikes in man and of set research goals. A literature analysis confirms that the existing arsenal of methodical schemes provides for choosing the most adequate model of focal ischemia of the brain and to ensure a cerebral infarction of a preset scope and localization; it makes possible also an objective evaluation of pathological processes occurring in the cerebral tissues both at the earliest stages of ischemic lesion and during a relatively long time period comparable with rehabilitation time period. Achievements in the sphere of experimental modeling of focal ischemia of the brain pave the way to further promotion of experimental therapy in acute stroke and open up new research priorities; it concerns primarily research of mechanisms timing the neurodegenerative process after ischemic stroke as well as searching-for and testing of means of stroke prevention and of patients' rehabilitation.

Animals↗
PubMed2004

[Multiple sclerosis in children and adolescents: history and current experience of immunomodulating treatment].

An agreement accepted worldwide for treatment of multiple sclerosis (MS) in adult patients has not been achieved so far for children and adolescents, mostly due to the insufficient information on the features of MS with early age-at-onset. New methods of immunomodifying treatment and the conception of early MS treatment have changed the attitude to prognosis of MS with early onset. In such cases, a course of the disease is less aggressive and characterized by more intensive remyelination as well as brain plasticity and less neurological deficit that may predict highest efficacy of the disease modifying treatment timely started in these patients. Such drugs, as beta-interferons, glatiramer acetate and high-dosage intravenous immunoglobulines G, which are able to decrease MS relapse frequency and disability progression in adult patients, are poorly studied in children and adolescents. Preliminary positive results of international and Russian investigations on the efficacy and tolerability of immunomodulating therapy of MS with early age-at-onset require further investigations in this field.

Adjuvants, Immunologic↗
PubMed2004

[Clinical peculiarities of optic neuritis and alterations of local immune response in patients with multiple sclerosis].

Multiple sclerosis (MS) is a severe organic disease of the central nervous system (CNS) affecting mostly young people. Optic neuritis (ON) is one of the first manifestations of the disease in approximately 75% of cases. The autoimmune reactions to myelin antigens play a key role in ON pathogenesis of MS. The pro- and anti-inflammatory unbalance is the most important factor of the origin, development and stabilization of CNS changes. Presented are the data on alterations of the levels of pro- and anti-inflammatory cytokines TNF-alpha, IF-gamma and antibodies to MBP and anti DNA in patient's tears. The clinical peculiarities of ON in MS correlating with immunological alterations are established.

Adolescent↗
PubMed2004

[Functional characteristics of gait and standing posture in poststroke patients in residual period].

Using biomechanic method, gait and standing posture were studied in 17 stroke patients in a remote poststroke period. The locomotor system was found to have non-specific compensatory changes to optimize motor functions and reduce functional disturbances. Symptoms of the triceps surae muscle insufficiency as well as a balance deficit at standing posture and displacement of the center of pressure towards the non-affected side were characteristic of the given stage of rehabilitation stroke period that should be taken into account during the rehabilitation treatment.

Aged↗