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Background. Assessing nutritional status at the start of treatment for patients with diffuse large B-cell lymphoma allows us to plan adequate accompanying treatment for patients in whom early nutritional support can improve the results of antitumor treatment.Aim. To assess the prevalence of nutritional deficiency, features of usual diet energy and protein composition in patients with diffuse large B-cell lymphoma who are starting antitumor treatment.Materials and methods. The study included 96 adult patients (m = 61), average age 38.9 ± 16.8 years, with newly diagnosed diffuse large B-cell lymphoma of various localization and prevalence. Additional laboratory screening (total protein, albumin, C-reactive protein (CRP), total cholesterol, triglycerides, daily urea excretion), anthropometric measurements (height, body weight (BW), weight loss over 6 months, body mass index), questionnaire (considering the intake of nutrients during the previous 3 days, calculating the intake of protein and energy, nitrogen balance) were performed in all patients before the first course of antitumor treatment. GLIM (Global Leadership Initiative on Malnutrition) criteria were used to diagnose protein-energy malnutrition (PEM).Results. In studied patients, energy intake was 27.92 ± 6.47 kcal/kg BW per day, protein 0.91 ± 0.18 g/kg BW per day, and nitrogen balance was –3.57 ± 2.94 g/day. Moderate PEM was diagnosed in 37 (38.5 %) patients. Differences in some laboratory parameters were revealed in patients with PEM and without nutritional disorders: CRP level (20.38 ± 14.69 mg/L versus 12.52 ± 5.66 mg/L; p = 0.0004), glucose (5.07 ± 1.09 mmol/L versus 4.57 ± 0.62 mmol/L; p = 0.005), total cholesterol (4.35 ± 1.27 mmol/L versus 5.36 ± 1.45 mmol/L), triglycerides (1.22 ± 0.51 mmol/L versus 2.02 ± 0.78 mmol/L; p = 0.001).Conclusion. Moderate PEM is detected in more than a third of patients with diffuse large B-cell lymphoma who begin antitumor treatment. The leading symptom in this case is unintentional weight loss over the past 6 months. An increased CRP level, moderate hyperglycemia, and lower concentrations of total cholesterol and blood triglycerides also characterize PEM in this cohort of patients. With sufficient energy supply, the amount of protein in the natural diet of patients with PEM turned out to be low, and the nitrogen balance was negative, which in the future can lead to the development of sarcopenia and requires nutritional support.

The article discusses one of the problematic issues of operating nuclear power plants - revenue losses caused by staff mistakes. Existing methods and approaches to reducing the number of such incidents are analyzed. Despite the efforts made, the problem remains relevant. One of the directions for reducing the number of equipment failures is the study and use of internal and external operational experience. A description is given of a system for preventing the recurrence of negative operating experience, developed at the Novovoronezh Nuclear Power Plant, which is used in preparation for switching equipment. The system is an information base, the information in which is structured by types of equipment used at the Novovoronezh Nuclear Power Plant, allowing only the information directly related to the upcoming switches to be communicated to the operational staff. Suggestions for its further improvement, taking into account the recommendations of the International Atomic Energy Agency, are considered. A forecast is given for the dynamics of reducing the number of violations after the introduction of this system into industrial operation.​

The high prevalence of pharmacoresistant epilepsy requires the use of nonpharmacological, including surgical approaches to the treatment of this disease. The surgical methods currently used to treat epilepsy (resection, stimulation, and disconnection) carry certain risks of developing intra- and postoperative complications. The technique of magnetic resonance-guided focused ultrasound (MRgFUS) may be an alternative to traditional neurosurgical interventions. Currently, MRgFUS is successfully used in the treatment of essential tremor and Parkinson’s tremor. As the literature data show, the use of focused ultrasound is a promising method in the treatment of epilepsy. It has been reported about successful FUS application for neuromodulation in animal epilepsy models. Studies related to FUS ablation of epileptogenic foci, neuromodulation in humans with epilepsy are currently underway. The technique of locally increased permeability of the blood-brain barrier after FUS, used for the treatment of brain oncological diseases and neurodegenerative disorders is also of interest in the targeted delivery of antiepileptic drugs. However, some experimental works are contradictory, and the lack of large-scale studies of MRgFUS in patients with epilepsy requires further investigation of this technique and its effectiveness.

The article discusses the specificity of constructing pedagogical research within the tradition of Russian Neo-Kantianism. The emphasis is placed on two aspects: 1) philosophy and pedagogy complement each other within the framework of practical philosophy in determining the teleological reason for learning and upbringing, and 2) spiritual and moral foundations determine the efficiency of the process of forming a free and creative individual. The specific features of S.I. Hessen’s concept of moral education in relation to Natorp’s theory of social pedagogy are identified. A comparative analysis of methodological approaches of A.I. Vvedensky and A.V. Veideman to the identification of the purpose of education and upbringing is conducted. The novelty of the study is presented through the actualization of insufficiently studied scientific works of Russian Neo-Kantians, who shared the same field of philosophical discourse with Western European philosophical questions. The relevance of the study is determined by the significance of spiritual and moral values in the context of institutional education. Based on the complex examination as well as the historical and philosophical reconstruction, the general trend of pedagogical research of Russian Neo-Kantians toward the formation of distinct awareness of freedom and its limits is outlined. In the conclusion of the article the authors formulate the statements that have potential for historical and philosophical research, as well as for identification of effective models of correlation of scientific knowledge and spiritual and moral values.

The article considers those aspects of the development of sociological knowledge in Russia that were determined by the scientific and organizational activities of A.S. Lappo-Danilevsky (1863-1919). His contribution to the development of the Russian social and humanitarian thought is associated mainly with the development of the foundations of history, historiography and source studies, which is widely admitted in scientific works. However, Lappo-Danilevskys contribution to the development of sociology, to the identification of the specifics of its subject and to the creation of a model of systemic courses on the historical reconstruction of sociological knowledge are still widely discussed. The authors consider the creative component of Lappo-Danilevskys legacy and the strategy he developed for creating an interdisciplinary methodology for social sciences. The article aims at describing his contribution to the institutionalization of Russian sociology, which allows not only to clarify the origins of social knowledge in Russia, but also to actualize Lappo-Danilevskys legacy. The authors pose new questions and problematize the research potential of the works of Russian scientists at the turn of the 20th century, which has prospects for supplementing the history and methodology of sociology. The description of the activities of Lappo-Danilevsky - from the development of the institutional foundations of Russian sociology to the clarification of the methodological principles of social knowledge - raises the question of the influence of positivism and neo-Kantianism on the scientific community. On the other hand, the study of the scientific and organizational activities of Lappo-Danilevsky allow to expand the field of history and methodology of sociology by supplementing it with a description of the institutionalization of sociology in Russia. The study of the foundations of sociological knowledge emphasizes three points: creation of methodology, separation from related disciplines, and acceptance of the historical component in the development of academic sociology. The article also mentions contemporary discussions which consider the sociological legacy of Lappo-Danilevsky not only as a historical reconstruction of the development of social knowledge, but also in the interdisciplinary perspective of contemporary sociology.

Introduction. Carcinoid syndrome is the most common functional syndrome in patients with neuroendocrine tumors. More than 40 biochemical factors are responsible for the manifestation of carcinoid syndrome, among which serotonin is the most important. The study of biochemical markers of carcinoid syndrome and associated carcinoid heart disease is an important aim of laboratory examination in neuroendocrine tumors patients.Aim. Analysis of levels and diagnostic efficiency evaluation of chromogranin A (CgA), serotonin, pro-brain natriuretic peptide (proBNP) and platelet-derived growth factor (PDGF-BB) in the blood serum of neuroendocrine tumors patients with various clinical manifestations, including carcinoid syndrome and carcinoid heart disease.Materials and methods. 66 patients with neuroendocrine tumors of various localizations were examined (pancreas – 24 cases, small intestine – 21, large intestine – 6, lungs – 10, unkown primary focus – 5). 38 patients had liver metastases. In 43 patients, a clinic of carcinoid syndrome was observed, 16 had signs of carcinoid heart disease. The control group consisted of 30 practically healthy people. Serum levels of CgA, serotonin, and PDGF-BB were determined by enzyme immunoassay in microplate format: Chromogranin A NEOLISA (Eurodiagnostica, Sweden), Serotonin ELISA (IBL, German), and PDGF-BB ELISA Kit (Invitrogen, USA). The proBNP analysis was performed on a Cobas e601 automated analyzer (Roche, Switzerland).Results. In carcinoid syndrome, the medians of CgA, serotonin, and proBNP were the highest, differing statistically significantly from the control group. In patients with G3 tumors, the median PDGF-BB was statistically significantly higher than in controls, in contrast to G1 and G2. The highest diagnostic sensitivity in the general neuroendocrine tumors group was in CgA – 63.6 %, with a specificity of 100 %. In patients with carcinoid syndrome, the highest diagnostic sensitivity was characteristic of serotonin and chromogranin A (79 %), while in patients with CAD clinic, proBNP had the highest sensitivity – 93.8 %.Conclusion. The study revealed the high efficiency of СgA, with the highest sensitivity in common forms and tumors with high biological activity. Serotonin can be used in the diagnosis of carcinoid syndrome, associated with cardiofibrosis development. Pro-brain natriuretic peptide is a highly sensitive and specific marker of carcinoid heart disease. The highest levels of PDGF-BB are associated with a high grade of neuroendocrine tumors malignancy.

Introduction. Immunoenzyme assay of biochemical markers is one of the most important methods for examination of pa- tients with neuroendocrine tumors (NETs). Along with the generally accepted NET marker chromogranin A (CgA), another member of the granin family, chromogranin B (CgB), can serve as a complementary marker.Objectives. Analysis of CgB as an additional to CgA biochemical marker in the blood serum of patients with gastric and pancreatic neuroendocrine tumors.Materials and methods. We examined 79 patients with gastic (n = 14) and pancretic (n = 65) NETS, and 42 particularly healthy people, who were included in the control group. CgB and CgA were determined with ELISA method using the Human Chromogranin B (USCN, China) and Chromogranin A NEOLISA (Eurodiagnostica, Sweden) test systems., Results. CgB levels in gastric and pancreatic NETs were significantly higher than in control group. CgB concentrations were independent of tumor spread and its biological activity. ROC analysis in common group of NETs relative to control group showed AUC for CgB = 0.869 and for CgA AUC = 0.82. According to results in common group of NET patients when used isolated, CgA and CgB have comparable diagnostic sensitivity, which increases in complex use to 82.5 %. In the group of NET patients with low levels of CgA (15.7 ng/ml) was observed in 53.6 % of cases.Conclusion. The combination of CgB and CgA in gastric and pancreatic NETs could increase the diagnostic efficacy of bio- chemical diagnostics. The received data confirms the significance of CgB as a complementary biomarker of NETs.

Here we provide a literature-based definition as well as etiological factors, clinical picture, prognosis, diagnostic algorithm, and treatment for the New-Onset Refractory Status Epilepticus (NORSE syndrome). In addition, we also present our personal experience by describing a female patient with refractory focal epilepsy associated with the cryptogenic new-onset refractory status epilepticus.

Objective: to investigate the efficacy and safety of citicoline (Ceresil® Canon) in patients with post-stroke cognitive impairment.Patients and methods. Examinations were made in 33 patients aged 45 years and older who had experienced primary ischemic hemispheric stroke with complaints of a decline in memory or other cognitive functions. The cognitive status was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). The presence of anxiety-depressive spectrum disorders was determined on the Hospital Anxiety and Depression Scale. All the patients received citicoline (Ceresil® Canon) oral solution at a dose of 1000 mg/day for 3 months.Results and discussion. Citicoline administration showed a statistically significant reduction in the severity of cognitive impairment (p

Within a field meeting of experts from the Russian branch of the League Against Epilepsy (RLAE), diagnostic and treatment aspects of epilepsy were discussed with the emphasis on the female population (girls, women of childbearing and older ages). All experts underscored the special features and unique needs of female patients with epilepsy. Experimental and clinical studies on efficacy and safety of traditional and novel antiepileptic drugs (AEDs) applied to women with epilepsy were discussed. It was commonly agreed that the new generation of AEDs did not yet find an appropriate place in the clinical practice, and that they were mainly used as add-on therapy in order to overcome drug resistance. The current use of AEDs in the treatment of epilepsy is, by large, not gender-specific and is not related enough to age, sociodemographic characteristics, and comorbid disorders. It should be noted that the new AEDs are addressed specifically to individual, socio-demographic, gender and clinical features of the patient. The potential of some AEDs (lamotrigine), in fact, remains underestimated by practitioners. Due to the current restrictions in using valproic acid, lamotrigine is the alternative medication for women with epilepsy. Having a balanced profile of efficacy and safety, lamotrigine is recommended as the first choice drug for initial therapy, as well as an alternative monotherapy for epilepsy in women.These data were presented at the Russian League Against Epilepsy (RLAE) on-site meeting “Epilepsy and Woman” 18 September 2019 (Ohrid, Makedonia).

Introduction. The MRI method has revolutionized the diagnosis of epilepsy. However, the widespread adoption of MRI in clinical practice is slowed by an insufficient number of high-field MRI scanners, a shortage of trained specialists, and the lack of standard examination protocols. The aim of this article is to present the Recommendations of the Russian League Against Epilepsy (RLAE) on the use of magnetic resonance imaging in the diagnosis of epilepsy.Materials and methods. As a structural element of the International League Against Epilepsy (ILAE), the RLAE considers it important to adapt the Protocol developed by ILAE for specialists in Russia and EAEU countries. The working group analyzed and generalized the clinical practice existing in the Russian Federation, the Republic of Kazakhstan, the Republic of Belarus and the Republic of Uzbekistan. These recommendations are intended for doctors in specialized centers of epilepsy surgery, and for doctors in general medical centers. The recommendations are applicable primarily to adult patients, but the general principles are relevant to children as well.Results. In all patients with convulsive seizures shortly after the first seizure, or patients diagnosed with epilepsy who have an unexplained increase in the frequency of seizures, rapid decrease in cognitive functions or the appearance / worsening of neuropsychiatric symptoms, the RLAE recommends using a unified MR protocol for the neuroimaging of structural sequences in epilepsy with three-dimensional pulse sequences T1 and T2 FLAIR with isotropic voxel 1 × 1 × 1 mm3 and two-dimensional T2- weighted pulse sequences with a pixel size of 1 × 1 mm2 or less. The MRI examination should be combined with EEG or EEG-video monitoring. Using this protocol allows one to set a unified standard for examining patients with epilepsy in order to detect (with high sensitivity) brain lesions playing a key role in the occurrence of seizures. Here, all 13 recommendations are presented.Conclusion. Implementation of these recommendations in clinical practice will improve the access to high-tech medical care and optimize health care costs.

For more than half a century, valproic acid (VA) has been a first-line drug to control seizures in various forms of epilepsy and status epilepticus; VA is also used in bipolar disorders. However, the accumulated clinical evidence indicates negative outcomes of pregnancies in women receiving valproate. Thus, babies born to mothers receiving VA for their epilepsy or bipolar disorder had an increased risk of serious congenital malformations. In addition, VA was found to affect the development of the CNS in a fetus that may result in attention-deficit hyperactivity syndrome (ADHD), autism spectrum disorder (ASD), childhood autism, and other diseases. The data on teratogenic effects of VA have led the regulatory authorities and the manufacturer to adopt restrictive recommendations regarding the use of VA in female patients of reproductive age. The Russian League Against Epilepsy (RLAE) presents this article to inform the medical community about the consequences of using valproic acid in pregnancy and also recommends a number of preventive measures. The article elaborates on the evidence of teratogenic risks associated with VA and reviews documents from the regulatory authorities (EMA, MHRA, Roszdravnadzor of the Russian Federation), which specify the measures needed to prevent the adverse effects of VA during pregnancy. According to these documents, medications containing VA should no longer be used in female patients of childbearing potential, except in cases where other treatments for epilepsy are ineffective or contraindicated. The changes made by the manufacturer in the official instructions for using the reference drug, and the unified instructions of the RF regulatory bodies on the reproduced (generic) drugs containing VA are also presented. The Pregnancy Prevention Program is proposed to minimize individual risks for women using VA. The article also addresses the international clinical practice on the prevention of VA-associated adverse effects during pregnancy and the recommendations of RLAE on alternative anti-epileptic therapy using minimally teratogenic drugs: lamotrigine, levetiracetam, and oxcarbazepine.

At present, treatment recommendations are developed considering the principles of evidence-based medicine. General practitioners (GP) are offered a choice of different medications with the known characteristics of efficacy and tolerance. For a GP, the right choice of the optimal drug from the proposed list may become a problem. Therefore, it is important not only to provide complete information on all treatment options for a patient with epilepsy, but also discuss a scheme of the proposed therapy (“key”) so to guide a GP through the treatment options and assess the possibility of alternative treatment strategies. Contrary to the trial and error method, when the drug efficacy and safety is assessed during the treatment, the proposed optimized approach allows for achieving a maximal therapeutic effect in patients with epilepsy.

The article reviews the use of antiepileptic drugs in various forms of epilepsy. We present a complex case of juvenile myoclonic epilepsy, the diagnostic process and antiepileptic therapy. Our own data and the results of others demonstrated a high efficacy and tolerability of valproate drugs, and a low aggravation potential in all types of epileptic seizures.

The International League Against Epilepsy (ILAE) has developed and approved the Operational classification of seizure types 2017 and the Classification of the Epilepsies 2017 . According to the ILAE 2017 Operational classification of seizure types, seizures can be initially divided into focal or generalized; and the seizure onset is of crucial importance in this case. Focal seizures are optionally subdivided into focal aware seizures and focal impaired awareness seizures. Several new types of generalized-onset seizures were implemented. Specific motor and non-motor classifiers may be added. Unknown onset seizures are placed separately. Three levels of diagnostics are specified in the 2017 ILAE Classification of the Epilepsies: seizure type (defined in accordance with the 2017 ILAE Operational classification of seizure types), epilepsy type (focal, generalized, combined generalized and focal, unknown), and epilepsy syndrome. An etiologic diagnosis should be considered at each step along the diagnostic pathway. A patient ’s epilepsy may be classified into more than one etiological category. The term “benign” is replaced by the terms “self-limited” and “pharmacoresponsive” to be used where appropriate. The term “developmental and epileptic encephalopathy” can be applied in whole or in part where appropriate. The 2017 Operational classification of seizure types and the 2017 ILAE Classification of the Epilepsies can be helpful both in routine clinical practice and scientific research that will assist in improving epilepsy care and quality of life of patients with epilepsies.

The article considers the key issues of the clinical pattern, diagnosis and treatment of chronic cerebral ischemia. The results of the observation program "Thiocetam for focal neurological, mild cognitive, asthenic and emotional disorders accompanying chronic organic disease of the central nervous system - discirculatory encephalopathy." The article demonstrates that Thiocetam has a beneficial effect against mild cognitive impairment, asthenic disorders, light and moderate emotional disorders in the studied population.

Results of Depakine Chronosphere use in Moscow city out-patient clinics are demonstrated in the article. 48 patients with focal forms of epilepsy (cryptogenic and symptomatic) were examined: 32 men and 16 women in age of 16 - 59 years with different duration of disease and different types of seizures. Depakine Chronosphere was indicated to patients who were already taking antiepileptic drugs in monotherapy with efficacy of 50% and more, and also to patients with drug remission, but with side effects, requiring changes of current indications. Results of the observation demonstrated high efficacy of Depakine Chronosphere in adult patients with different forms of focal epilepsy in monotherapy and also its use possibility in case of noneffective or poor tolerability of other valproates and carbamazepine.

Nonconvulsive epileptic seizures make the most part of all attacks which are registered in patients with mostly a focal epilepsy, the status of nonconvulsive seizures (NCSE) represents the most difficultdiagnostics problem for neurologist, epileptologist or reanimatologist. However, the given problem is insufficiently studied till now, not numerous data on diagnostics and treatment of NCSE are presented in literature.According to literature more than 30 % of patients of emergency care departments with infringement of consciousness of unknown reason are patients with NCSE.»New» antiepileptic drugs for intravenous introduction (valproates, levetiracetam,lacosamid) may give us new opportunitiesand perspectives in treatment of patients with serial nonconvulsive seizuresand NCSE.

Current work is dedicated to analysis of treatment with generic topiramate in mono- as well as in polytherapy in patients with different forms of epilepsy. Forclinical assessmentsHospital Anxiety and Depression Scale (HADS), quality of life questionnaire for patients with epilepsy (QOLIE-10) and efficacy primary assessment based on decrease in frequency of seizures and adverse events before and after switching to generic topiramate were used. As a result of focus investigation switch to Topsaver was associated with maintenance of stable therapeutic effect in more, than 80% of cases. No negative dynamics in changes of HADS and QOLIE-10 points were observed.

Focused observational study on efficacy, tolerability and quality of life in adult patients with different forms of epilepsy taking combined therapy with lamotrigine (Sazar). 32 patients (19 men and 13 women), 23-79 years old with focal forms (cryptogenic and symptomatic) epilepsy with different disease duration and presence of of different type and etiology seizures were enrolled into the study. Patients having been taken various antiepileptic drugs in monotherapy with different efficacy degree were observed. Patients sample included 20 patients, receiving valproic acid in various dosages and 12 patients, receiving topiramate. Sazar was added as a second drug with initial dosage of 25 mg daily. Results of focused observation allow us to make conclusion of possible expedience of Sazar indication, especially in patients in whom therapy with valproic acid is less effective.

This paper presents experience of using Vimpat in outpatient health care chain of Moscow. In the observational study were attended 49 patients with difficult for treatment focal forms of epilepsy (cryptogenic and symptomatic forms). Vimpat used in complex therapy in the mean effective dose of 300-400 mg per day. As a result, the data on a cohort of Russian patients showed that Vimpat demonstrate a sufficiently high clinical efficacy (55%, p

Abstract: In this article the results of the study of focal observations of interchangeability of generic Konvuleksa to retard and original probe Depakine chrono on Valparin XR (production Torrent Pharmaceuticals, India) in patients with various forms of epilepsy. In focal observations was attended by 30 patients with focal forms of epilepsy: 17 men and 13 women aged 23 to 62 years with different disease duration and the presence of seizures, which differ according to the type and etiology. Based on these results it can be concluded that the transfer of patients with previous therapy Valparin XR generally accompanied by a stable level of seizure control.

Abstract: cognitive impairment of varying degrees of severity identified in patients with focal epilepsy in 40-50% of cases. The incidence and severity of cognitive impairment depends on the cause epileptic seizures, localization of the lesion, antiepileptic therapy, and other factors. It should be noted that the correction capability of cognitive disorders in patients with epilepsy are somewhat limited because number of drugs used for the treatment are in the instructions for use as contraindications and indications of use ostoozhnostyu in patients with epilepsy. This work reflects the results of a prospective uncontrolled focal observations efficiency NMDA-receptor antagonist: This drug memantine (Noodzheron). The study involved 50 patients with focal epilepsy and having symptoms of cognitive deficits of varying severity. Evaluating the effectiveness carried out in 2 months from the start of the reception, the dosage of 5.10 mg × 1 time per day. After the treatment, a statistically significant improvement in cognitive function based on the results of tests: Mini-mental state examination, clock drawing test, the test Luria test “symbols and numbers.” Noodzheron taking the drug had no effect on the frequency of epileptic seizures.

The paper considers the basic mechanisms for the occurrence of asthenic syndrome in chronic neurological diseases. It shows the significance ofthis problem in nosological entities, such as stroke sequels, multiple sclerosis, and Parkinson’s disease. The main asthenia diagnostic scales aredescribed. Possible therapeutic strategies aimed at reducing the degree of asthenia in neurological patients are also presented.

Aim: Clinical case of successful two-stage surgical treatment of a 1-year-old child with congenital heart disease and biliary cirrhosis is represented in this article. At the first day of life laparotomy was performed because of high intestinal obstruction. Kasai procedure and Roux-en-Y choledochojejunostomy were per- formed on 12th day and at the end of second month of life, respectively. Liver biopsy showed the signs of biliary cirrhosis. At the same time ventricular septal defect and atrial septal defect with pulmonary hyper- tension were diagnosed. The first step of treatment was the surgical septal defects closure. No complications during procedure, cardiopulmonary bypass and post-operative period were registered. There were no nega- tive effects on liver function after cardiac surgery. 11 months later living-donor liver transplantation was performed without any complications. Patient was discharged at 35th post-transplant day with stable graft function.

Objective: to evaluate the efficacy of injectable valproate (convulex) in patients with serial epileptic seizures and status epilepticus (SE) at the prehospital stage.Patients and methods. Thirty-two adult patients, including 17 (53%) men and 15 (47%) women, were examined. Most patients were aged over 40 years (mean age 54.7±9.4 years). To define the required dose of the drug, the authors estimated the patient's weight that averaged 76.8±1.9 kg, i.e. there was a preponderance of patients who needed convulex, more than 500 mg, to achieve a therapeutic effect.Results. It was impossible to reliably and validly evaluate the type of a seizure as the medical emergency team (MET) generally observed the patient with a just evolving seizure and the medical history data were not always valid therefore the type of convulsions and the type of a seizure were evaluated. In most cases, solitary convulsive attacks (tonic and/or clonic convulsions) and/or serial seizures were observed in 12 (37.5%) and 14 (43.7%) patients, respectively; SE was recorded in 6 (8.8%) patients. Generalized seizures (without a clear focal onset) were prevalent in 24 (75%) patients while 8 (25%) patients were found to have partial seizures (seizure onset lateralization, a focal onset). According to the pattern of convulsions, seizures may be classified into three types: tonic-clonic, clonic, and tonic in 22 (68.8%), 7 (21.9%), and 3 (9.3%) patients, respectively. Analysis of the efficacy of intravenously injectable valproate (convulex) in the group of patients with SE and epileptic seizures indicated that complete cessation of seizures could be achieved in 68.8%, their rate decreased in other 9.4% of the patients. Seizures were preserved in 7 (21.8%) cases, which required additional administration of drugs. Conclusion. Injectable valproic acid (convulex) has a high efficacy and may be preclinically used as the drug of choice to arrest SE and serial seizures caused by both epilepsy and other diseases of the brain. Convulex is easy-to-use (a ready-to-use solution), particularly in the work of MET. The ready-to-use formulation allows for its bolus administration within minutes, the drug does not affect hemodynamic parameters, which is particularly important for elderly patients and children. The administration of convulex makes it possible to prevent respiratory depression and fails to affect the level of patient consciousness.

Objective: to evaluate the efficacy, tolerability, and safety of citalopram (pram, «Lannacher Heilmittel, Austria) used to treat depressive disorders in adult patients with symptomatic or cryptogenic (presumptively symptomatic) focal epilepsy.Subjects and methods. One hundred and twenty-one patients with symptomatic or cryptogenic (presumptively symptomatic) focal epilepsy were examined; 24 patients were found to have varying symptoms of depression. The Hospital Anxiety and Depression Scale (HADS) was used as a screening test for the symptoms of depression and anxiety. Citalopram was given orally for the treatment of depressive disorder. The Hamilton Depression Rating Scale (HDRS) was used to evaluate the efficiency of the performed therapy and to estimate the time course of changes in parameters. Quality of life was estimated by the special QOLIE-31 questionnaire. The duration of the follow-up was 12 weeks.Results. The study enrolled 24 patients (14 women and 10 men). Their mean age was 47.5±7.6 years; the duration of epilepsy was 9.71±3.15 years. The first visit showed a pronounced preponderance of the symptoms of anxiety according to the HADS: the mean scores for anxiety and depression were 13.38±2.15 and 11.19±3.28, respectively. After citalopram therapy, the mean scores for anxiety and depression decreased to 6.19±2.60 and 7.58±1.86, respectively. During the first visit, the mean Hamilton depression score was 21.73±3.19 and that was 14.60±2.19 and 11.18±2.33 after 30 days and 12 weeks of citaloprom therapy, respectively. Analysis of the time course of changes in quality of life indicators during citalopram therapy, by applying the QOLIE-31 scale, revealed a significant increase in their total scores 2 and 3 months following the treatment with unchanged antiepileptic therapy. There was an inverse correlation between the total QOLIE-31 score for quality of life and the degree of depression rated by HDRS (r=-0.94, p

Aim. То assess endothelial function (EF) and lipid peroxidation (LPO) in patients with arterial hypertension (AH) and its cerebral complications.Material and methods. In total, 49 patients with ischemic stroke (IS), 37 patients with uncomplicated essentialAH (EAH) and 25 blood donors as controls were examined. NO concentration (its stable metabolites, nitrates and nitrites) was measured by Griss method; citrulline (C) and malonic dialdehyde (MDA) levels were assessed with photocolorimetric method. Desquamated endotheliocytes (DE) were counted according to the method by J. Hladovec. LPO and plasma antioxidant activity (AOA) were studied with biochemiluminescence analysis.Results. In IS patients, NO and C concentrations were lowerthan inAH patients and controls, while DE numbers were higher in the former. These parameters were combined into one factor, “integral index of endothelial dysfunction” (IIED), with values of -0,86±0,19, 0,12±0,09, and 1,21±0,23 units in patients with IS, AH and in controls, respectively (p