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Nemkova SA, Boldyrev VG. [Early differential diagnosis and restorative treatment of cerebral palsy]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:24-37. [PMID: 38261281 DOI: 10.17116/jnevro202412401124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
The article is devoted to an urgent problem of modern neurology - early diagnosis and complex restorative treatment of cerebral palsy (cerebral palsy). Etiological factors and pathogenetic aspects of the formation of various forms of cerebral palsy are considered in detail, as well as modern possibilities of differential diagnosis in children of the first years of life of cerebral palsy and a wide range of pathological conditions (somatic, endocrine, hereditary-conditioned, including hereditary-metabolic and neuromuscular diseases). The leading directions of complex rehabilitation of cerebral palsy are widely presented, taking into account modern standards and clinical recommendations. The high efficacy of the drug Cortexin has been shown, due to its positive multimodal action (stimulation of the processes of neuropreparation, neuroprotection, neuroplasticity) in the treatment of motor, cognitive and autonomic disorders in children with perinatal lesions of the central nervous system and cerebral palsy.
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Affiliation(s)
- S A Nemkova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - V G Boldyrev
- Pirogov Russian National Research Medical University, Moscow, Russia
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Putilina MV, Shabalina NI. [Results of a pilot study of the structure and evaluation of the therapy for chronic sleep disorders in comorbid patients with chronic cerebral ischemia]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:118-126. [PMID: 38676686 DOI: 10.17116/jnevro2024124041118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
OBJECTIVE To evaluate the effect of the drug Cortexin on the clinical course and treatment of comorbid insomnia. MATERIAL AND METHODS The study included 50 patients, average age 50.4±2.26 years, with CHI stage 1-2. with concomitant diseases arterial hypertension, atherosclerosis, diabetes mellitus (study CHRONAS). All patients were examined on the day of treatment, 11-15 days and 30-31 days after the end of therapy. At all visits, complaints, neurological status, and changes in physiological and laboratory parameters were assessed. The condition was assessed using the following scales: mental status assessment (MMSE), quality of life questionnaire (EQ-5D), assessment of general health, Pittsburgh Sleep Quality Index (PSQI), Epworth daytime sleepiness assessment, hospital anxiety and depression (HADS)).: Patients with additional diabetic polyneuropathy were assessed using the Central Sensitization Inventory (CSI). RESULTS A high percentage of the prevalence of comorbid insomnia in patients was revealed. The structure of sleep disturbances in patients with chronic cerebral ischemia consisted of disturbances in sleep duration, difficulty falling asleep, frequent awakenings at night, and daytime sleepiness. After treatment, there was a regression of the main complaints, the severity of symptoms, including anxiety and depression, decreased, and a significant stabilization of cognitive status was observed. The positive dynamics persisted 1 month after the end of therapy. An additional normalizing effect of the drug on a number of biochemical parameters was revealed. Clinical dynamics were recorded already by the 11-15th day of treatment and persisted for up to 1 month. During observation, no patient had adverse drug interactions with other drugs (hypotensives, antiplatelet agents, statins). CONCLUSIONS The clinical effectiveness of the drug Cortexin has been proven for all types of sleep disorders. The clinical effectiveness of the drug Cortexin at a dose of 10 mg IM for 10 days has been proven in patients with chronic sleep disorders due to CHI.
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Affiliation(s)
- M V Putilina
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - N I Shabalina
- Central Clinical Hospital «RZD-Medicine», Moscow, Russia
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Cherdak MA, Mkhitaryan EA. [Post-COVID syndrome in the neurological practice]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:124-129. [PMID: 37490677 DOI: 10.17116/jnevro2023123071124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Postcovid syndrome (PCS) is a complex multifactorial clinical condition that is a frequent complication of COVID-19. The development of PCS does not depend on the severity of the initial infectious disease, it has a pronounced effect on the quality of life and is characterized by a tendency to a protracted course. In the context of the ongoing COVID-19 pandemic, the emergence of new variants of the SARS-CoV-2 virus, it is important to develop common approaches to the diagnosis and management of patients suffering from this medical condition. The review presents current data on the epidemiology, pathogenesis, clinical presentation, and diagnosis of the PCS. The approaches to therapy of PCS are discussed, as well as the role of Cortexin, taking into account both theoretical and accumulated clinical data.
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Affiliation(s)
- M A Cherdak
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - E A Mkhitaryan
- Pirogov Russian National Research Medical University, Moscow, Russia
- Russian Clinical and Research Center of Gerontology Pirogov - Russian National Research Medical University, Moscow, Russia
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Putilina MV, Mutovina ZY, Kurushina OV, Khalilova DM, Saverskaya EN, Stepanova SB, Khoreva MA, Starikov AS. Determination of the Prevalence of Postcovid Syndrome and Assessment of the Effectiveness of the Drug Cortexin in the Treatment of Neurological Disorders in Patients with Postcovid Syndrome. Results of the CORTEX Multicenter Clinical and Epidemiological Observational Program. NEUROSCIENCE AND BEHAVIORAL PHYSIOLOGY 2022; 52:836-841. [PMCID: PMC9596337 DOI: 10.1007/s11055-022-01307-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 12/31/2021] [Indexed: 11/24/2022]
Abstract
Objectives. To study the prevalence and clinical manifestations of postcovid syndrome (PCS) in out-patients and to assess the efficacy of treatment with the drug Cortexin at doses of 10 and 20 mg i.m. for 10 days. Materials and methods. A total of 979 patients with PCS from regions of the Russian Federation, Azerbaijan, Kyrgyzstan, and Kazakhstan were studied; mean age was 54.6 ± 4.5 years; duration of COVID-19 was from one month upwards. Investigations involved three visits. The first was on the day of consultation (assessment of complaints, analysis of scale indicators, prescription of drug Cortexin at a dose of 10 or 20 mg i.m. for 10 days). The second visit (telephone consultation) was on day 10–14. The third visit was on day 30 of out-patient treatment. Assessment of patients’ status used an asthenia assessment scale (MFI-20), a brief mental state assessment scale (MMSE), the Schulte test, and the Subjective Treatment Quality Assessment Scale. Results. The proportion of patients with PCS was up to 30% of all neurological admissions. The commonest manifestations were: fatigue, general weakness, decreased memory and concentration of attention, vertigo, sleep impairment, irritability, and aggression; less frequent were breathlessness, pain, increased sweating, anosmia, hyposmia, dysgeusia, paresthesia, hair loss, degradation of vision, tachycardia, allergic reactions, menstrual cycle impairments, erectile dysfunction, panic attacks, suicidal ideation, depression and refusal to eat meat. Conclusions: No associations were found between clinical symptomatology and the severity of COVID-19, the volume of lung tissue affected, or different periods of postcovid syndrome. Cortexin was found to be effective at doses of 10 and 20 mg for correcting the cognitive and asthenic manifestations of PCS. Cortexin was found to have anti-anxiety, antidepressant, and anxiolytic effects, which were more marked at the 20-mg dose.
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Affiliation(s)
- M. V. Putilina
- Pirogov Russian National Research Medical University, Russian Ministry of Health, Moscow, Russia
| | - Z. Yu. Mutovina
- City Clinical Hospital No. 52, Moscow Health Department, Moscow, Russia
| | - O. V. Kurushina
- Volgograd State Medical University, Russian Ministry of Health, Volgograd, Russia
| | | | | | - S. B. Stepanova
- South Ural State Medical University, Russian Ministry of Health, Chelyabinsk, Russia
| | - M. A. Khoreva
- Altai State Medical University, Russian Ministry of Health, Barnaul, Russia
| | - A. S. Starikov
- Pitirim Sorokin Syktyvkar State University, Syktyvkar, Russia
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Putilina M. Pathogenetic approaches to the treatment of sleep disorders in comorbid patients. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:11-16. [DOI: 10.17116/jnevro202212211111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Putilina M, Mutovina Z, Kurushina O, Khalilova D, Saverskaya E, Stepanova S, Khoreva M, Starikov A. Determination of the prevalence of postcovid syndrome and assessment of the effectiveness of the drug Cortexin in the treatment of neurological disorders in patients with postcovid syndrome. Results of the multicenter clinical and epidemiological observational program CORTEX. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:84-90. [DOI: 10.17116/jnevro202212201184] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Fedin A. Neurological disorders in the postcovid period. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:31-37. [DOI: 10.17116/jnevro202212210131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Putilina M, Teplova N. Drug synergism as a basis for rational neuroprotection. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:17-22. [DOI: 10.17116/jnevro202212205117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Saverskaya EN. [Of neurological disorders in extreme conditions and emergency situations]. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:57-62. [PMID: 36537632 DOI: 10.17116/jnevro202212212157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The review examines the features of neurological disorders that develop in a contingent of people staying in war zones, extreme conditions and emergency situations. The structure of combat injuries is currently dominated by shrapnel and mine-explosive head injuries, craniocerebral trauma, compression and concussion of the brain. Traumatic wounds and features of military service in conditions of high risk and extreme physical exertion are accompanied by asthenia, cognitive disorders and mental disorders of varying severity. Substantiated is the use of Cortexin in craniocerebral and combined combat injuries received by military personnel and civilians in the centers of hostilities; with asthenic and anxiety-depressive disorders, cognitive impairment, sleep disorders, as well as to increase the body's resistance to adverse and extreme effects.
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Affiliation(s)
- E N Saverskaya
- Medical Institute of Continuing Education - Russian Biotechnological University, Moscow, Russia
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Nemkova S. Neurological aspects of the consequences of COVID-19 in children. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:23-30. [DOI: 10.17116/jnevro202212204123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Drug Synergism as the Basis of Rational Neuroprotection. NEUROSCIENCE AND BEHAVIORAL PHYSIOLOGY 2022; 52:1207-1211. [PMID: 36748019 PMCID: PMC9893192 DOI: 10.1007/s11055-023-01349-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 02/05/2023]
Abstract
Optimization of the choice of neuroprotective therapy regimens in patients with cerebrovascular diseases (CVD), taking into account the synergism of drug interactions, is a basic approach in clinical practice. Unfortunately, modern pharmacology has no unified way of establishing synergistic spectra of drug actions, which would allow systematic investigation of the effects of combinations of drugs. An approach based on studying detailed mechanisms of action suggested combinations of drugs with the greatest possible synergism (by summation and potentiation of effects) for various directions in the treatment of neurological diseases. Examples of rational neuroprotection are considered, using Cortexin, citicoline, and antioxidants.
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Putilina MV. [Asthenic disorders as a manifestation of chronic fatigue syndrome]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:125-130. [PMID: 34481448 DOI: 10.17116/jnevro2021121081125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The article explains the changes in terminology and diagnostic criteria for asthenic disorders as manifestations of chronic fatigue syndrome CFS (myalgic encephalomyelitis). Chronic fatigue syndrome is defined as neuroimmune endocrine dysfunction with a purely clinical diagnosis. Probably, viral infections can play a leading role in the pathogenesis. Published diagnostic criteria reveal possible correlations between chronic fatigue syndrome and COVID-19 disease. A promising strategy for the therapy and rehabilitation of patients is the use of smart peptides, a representative of which is the drug cortexin.
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Affiliation(s)
- M V Putilina
- Pirogov Russian National Research Medical University, Moscow, Russia
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Putilina MV, Grishin DV. SARS-CoV-2 (COVID-19) as a Predictor of Neuroinflammation and Neurodegeneration: Potential Treatment Strategies. ACTA ACUST UNITED AC 2021; 51:577-582. [PMID: 34176996 PMCID: PMC8219508 DOI: 10.1007/s11055-021-01108-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 09/14/2020] [Indexed: 02/07/2023]
Abstract
The SARS-CoV-2 (COVID-19) pandemic has attracted attention to the challenge of neuroinflammation as an unavoidable component of viral infections. Acute neuroinflammatory responses include activation of resident tissue macrophages in the CNS followed by release of a variety of cytokines and chemokines associated with activation of oxidative stress and delayed neuron damage. This makes the search for treatments with indirect anti-inflammatory properties relevant. From this point of view, attention is focused on further study of the treatment of patients with COVID-19 with dipyridamole (Curantil) which, having antiviral and anti-inflammatory effects, can inhibit acute inflammatory activity and progression of fibrosis, is a drug with potential, especially among patients with early increases in the D-dimer concentration and severe signs of microangiopathy.
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Affiliation(s)
- M V Putilina
- Pirogov Russian National Research Medical University, Russian Ministry of Health, Moscow, Russia
| | - D V Grishin
- Pirogov Russian National Research Medical University, Russian Ministry of Health, Moscow, Russia.,Filatov City Clinical Hospital No. 15, Moscow Health Department, Moscow, Russia
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Fedin A, Saverskaya E, Badalyan K. Multimodal therapeutic strategies in the treatment of cerebrovascular disease. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:112-118. [DOI: 10.17116/jnevro2021121121112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Putilina M, Vechorko V, Grishin D, Sidelnikova L. Acute cerebrovascular accidents associated with SARS-CoV-2 coronavirus infection (COVID-19). Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:109-117. [DOI: 10.17116/jnevro2020120121109] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Putilina M, Grishin D. SARS-CoV-2 (COVID-19) as a predictor of neuroinflammation and neurodegeneration: potential therapy strategies. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:58-64. [DOI: 10.17116/jnevro202012008258] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Putilina MV, Ermoshkina NY, Sigitov IS, Sidelnikova LV. [Progressive multifocal encephalopathy in neurological practice]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 117:95-105. [PMID: 29376991 DOI: 10.17116/jnevro201711712195-105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Progressive multifocal leukoencephalopathy (PML) is considered so far as a rare rapidly progressive demyelinating CNS disease caused by the JC virus activation. Current data suggest that PML developed in people with impaired immunity. However, in some cases PML developed in the absence of severe immunological deficit. In clinical practice, the early diagnosis of PML is difficult because symptoms are mild and, therefore, the physician should be familiar with diagnostic criteria of this disease to make the correct diagnosis and start the symptomatic therapy as soon as possible. This will help to improve patient's state though there is no effective treatment of PML so far. Up to the present moment, antiviral medications, cytostatic drugs, serotonin receptor antagonists, plasmapheresis are widely used. These methods can be used only if the causes of PML have been identified while the patient needs urgent help. Thus, the schemes of pathogenetic treatment with the drugs with pleiotropic effects should be used.
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Affiliation(s)
- M V Putilina
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - N Yu Ermoshkina
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - I S Sigitov
- Pirogov Russian National Research Medical University, Moscow, Russia
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Zykov VP, Serebrennikova EB, Panchenko TN, Sycheva YB, Presnyakova SN, Mazur EL, Salova MN, Golubeva ES, Khromova SK. Results of a multicenter study on the efficacy of cortexin in treatment of cognitive dysfunction in children. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:27-31. [DOI: 10.17116/jnevro20181183127-31] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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