[Experience in copaxon treatment in Russia].
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Biomedical subjects
Publications and source records attributed to A S Niiazbekova.
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The results of multicenter study of Rebif 22 micrograms in Russia have been reported. 167 multiple sclerosis patients have received Rebif 22 micrograms three times a week for 1 year. This study provides evidence for reduction of the relapse rate in patients with relapsing/remitting and secondary progressive multiple sclerosis. The tendency to the decrease of the severity of relapses, less need for steroid use and the decrease of EDSS score in patients with relapsing/remitting multiple sclerosis have been shown. In general Rebif 22 micrograms was tolerated well.
Results of the 2-year open postregistration study of Copaxone (glatiramer acetate), conducted in 3 Moscow leading medical centres are given. 32 MS patients with remitting-relapsing MS were investigated in accordance with international requirements (neurological scales, MRI of the brain, multimodal evoked potential). Significant reduction of annual relapse rate for 70.3%, stabilization of neurological status and benign safety profile were demonstrated during Copaxone treatment. Practical recommendations for Copaxone use are given.
32 patients (21-55 years old) with multiple sclerosis (MS) were treated. Remittent form of the disease was observed in 24 patients, secondary progressive one--in 8 individuals; the degree of disability was characterised as scores 0-3 (the first group) and scores 5-6 (the second one) according to scale EDSS. Betaferon was administered subcutaneously in the dose of 8 MIU every other day during the period from several months to 1 year and more. Improvement of the state was observed in 5 patients with remittent form, stop of the development of disease (absence of either aggravations or signs of MS progression) was found in 26 cases (21 with remittent form, 4 with secondary progressive form). The conclusion was made: betaferon cannot cure but can stop progression of the disease. Indications and contraindications for betaferon therapy were established and recommendations were given concerning regimen of the treatment prophylaxis and therapy of side-effects.
Ceruloplasmin (CP) preparations have been used as the reference agents in transition of this protein oxidase activity to blood serum concentrations; the mean concentrations of serum CP varied from 175 to 310 mg/l, depending on the biochemical characteristics of the preparations. Adjustment by the blood serum copper level has proved adequate for clinical studies. CP activity has been found increased in some patients with disseminated sclerosis and lateral amyotrophic sclerosis. CP activity grows with age in normal subjects and in the patients with hereditary extrapyramidal and cerebellar diseases and phenocopies thereof (except hepatocerebral dystrophy). CP activity is higher in women than in men.
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Twenty-six patients including 12 with lateral amyotrophic sclerosis, 7 with multiple sclerosis, 5 with the Creutzfeld-Jakob disease and 2 with Alzheimer's disease were examined. Antibodies to neurofilaments in the blood serum were detected in all cases of the Creutzfeld-Jakob disease and Alzheimer's disease and in 8 patients with lateral amyotrophic sclerosis with clinical evidence of supranuclear structure involvement. A conclusion is drawn about a certain similarity of pathogenic mechanisms of these diseases, as well as about heterogeneity of the cytoskeleton of neurons in the brain and the spinal cord.
The authors studied concentrations of cyclic nucleotides (cAMP and cGMP), as well as their ratio in the blood plasma and cerebrospinal fluid (CSF) of 83 patients with disseminated sclerosis of different forms and variants. An elevation in cAMP concentrations in the plasma and CSF detected in all the patients was more expressed in cases of a long standing and disseminated process. Blood levels of cAMP showed greater variability in the period of exacerbation versus remission of the disease.
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A description of 2 cases of disseminated sclerosis during exacerbations and paroxysms of dysarthria and ataxia in the clinical picture is given. These attacks are connected with processes of demyelinization and are differentiated with epilepsy. On the basis of neurophysiological studies the mechanisms of paroxysmal dysarthria and ataxia are discussed. The attacks were arrested under the influence of carbamazepine. The action of the drug is explained by its manifold properties.
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The blast transformation test revealed a high level of lymphocyte sensitization to human acute encephalomyelitis virus in 12 out of 29 (41.9%) patients with multiple sclerosis in the early stages of the disease and in the period of exacerbation in patients with long-term disease. The pattern of the blast transformation test in response to herpes simplex and measles viruses did not depend on the duration of the disease. High, moderate, and low levels of lymphocyte blast transformation reaction to herpes and measles viruses were observed in patients with multiple sclerosis with similar average durations of the disease.
Protein composition of human skeletal muscle impaired with lateral amyotropic sclerosis was studied by means of two-dimensional electrophoresis. Some protein fractions were altered. Characteristic property of all the preparations studied proved to be disappearance of three protein fractions of 35 kDa molecular mass and with pI 5.9, 6.0 and 6.1.