No abstract

Introduction. Living in urban and rural areas can affect the risk of developing and the course of alcohol dependence and comorbid conditions. The aim of the work was to evaluate the degree of depressive symptoms and socio-demographic characteristics of patients with alcoholism in the Republic of Dagestan, depending on the territorial features of residence. Materials and methods. The study involved 104 patients aged 51.2±9.9 years (27 to 74 years), registered in the State Budgetary Institution «Republican narcological dispensary» of the Republic of Dagestan with a diagnosis of alcohol dependence. The patients were divided into 2 groups depending on the territorial features of their residence: 62 (59.6%) patients residing in urban areas and 42 (40.4%) residing in rural areas. In order to evaluate socio-demographic characteristics all patients were questioned. The degree of severity of depressive symptoms was assessed with the Beck scale. Results. Analysis of alcohol dependence characteristics revealed no differences between the groups (p>0.05). The degree of depression was found to be more pronounced in patients living in rural areas than in those living in urban areas: mild depression was 7.3% and 29.0% (p<0.05), moderate depression was 9.8% and 1.6% (p<0.05), and severe depression was 39.0% and 25.8% (p<0.05), respectively. The severity of depression correlated with  the presence of work in patients (r=0.324; p<0.001). Discussion. Alcohol consumption leads to a more severe manifestation of depression, contributing to physiological changes in the body. Conversely, depressed people are more prone to uncontrolled alcohol consumption, which in their subjective opinion alleviates psychosocial suffering. The connection between alcohol abuse and depressive symptoms is bidirectional, meaning that both of these disorders influence the development and course of the other and simultaneously exacerbate the risk of developing the other disorder. Conclusions. Alcohol-dependent individuals living in rural areas of the Republic of Dagestan are characterized by unemployment that correlates with anxiety-depressive symptoms, as well as a more severe degree of depression severity.

No abstract

Purpose is to identify the features of the clinical picture, course and outcomes of Haff disease in the Tyumen region. Materials and methods. a retrospective study was conducted. There were included nine patients (7 men and 2 women) with a diagnosis of “Alimentary-toxic paroxysmal myoglobinuria (Haff disease) (T62.8)”. Were collected original demographics (age, gender), symptoms, time to onset of initial symptoms, time to hospitalization, and laboratory tests (general blood analysis, biochemical analysis of blood, analysis of blood coagulation functions and of arterial blood gases). Results. 4 (44.4%) patients had stage 3 severity, in 3 (33.3%) — stage 2 severity and in 2 (22.3%) — stage 1 severity of alimentary-toxic paroxysmal myoglobinuria. The main complaints presented by patients at the moment admissions were pain in the leg muscles (n = 6; 66.7%) and lower back (n = 6; 66.7%), dark urine (n = 5; 55.5%) and weakness (n = 4; 44.4%). Myoglobin, ALT, AST, LDH, CPK and CPK-MB were increased in all patients, the average level of these indicators was 4691.4 ± 2831.5 ng/ml, 1572.0 ± 547.5 U/L, 547.3 ± 158.2 U/L, 1555.7 ± 420.6 U/L, 33662.4 ± 15195.7 U/L and 1848.8 ± 692.6 U/L, respectively. The main complications developed in patients with stage 3 severity include acute renal and hepatic insufficiency and cardiomyopathy. Milder degrees of the disease (1–2 stages) were characterized by such complications as hepatitis and myocarditis. Also 1 death was observed, the analysis of this clinical case is analyzed in detail. Limitations. The main limitation of the study is the small group of patients due to the rare occurrence of Huff disease. In addition, there are no data on the amount of eaten fish, while there is evidence of a direct relationship between the severity of the disease and the amount of eaten food. The results are obtained in this region, and may differ from the results of other territories. Conclusion. with the development of myalgia or weakness of unknown etiology, it is necessary to ask patients if they have eaten fish in the previous 24 hours.

Objective: to study the clinical efficacy and tolerability of omberacetam in comparison with piracetam/cinnarizine and aminophenylbutyric acid in non-demented patients with vascular cognitive impairment (VCI).Patients and methods. The study included 150 patients with VCI that does not meet dementia, randomized into three groups of 50 patients. In addition to the basis therapy, patients of the 1st group recieved omberacetam 10 mg 2 times per day, the 2nd group – piracetam/cinnarizine 400/25 mg (1 tablet) 3 times per day, the 3rd group – aminophenylbutyric acid 250 mg 3 times per day. The duration of the treatment course was 45 days. In 50 patients of the 1st group and another 50 patients with VCI from other groups, the duration of the nootropic effect of omberacetam was evaluated 3.5 months after the end of follow-up. Cognitive functions and emotional state of patients were assessed using: 1) Montreal Cognitive Assessment (MoCA); 2) Hamilton Anxiety Rating Scale (HAM-A); 3) Subjective assessment of asthenia scale; 4) Modified subjective sleep characteristics scale. Evaluation of treatment effectiveness and tolerability was carried out.Results and discussion. During omberacetam treatment a significant improvement in well-being and regression of patient complaints were observed. After 45 days of therapy an increase in the mean MoCA score from 19.8 to 23.3 points (p≥0.001) was observed in the omberacetam group. In other groups, an increase in the mean MoCA score was also noted, but it was less significant. A decrease in asthenic symptoms, anxiety, and dissomnic disorders was present in all studied groups. Anxiety level, assessed by the HAM-A, decreased by 16.9; 19.9 and 20.0 points (p≥0.001) in groups 1, 2 and 3, respectively. Sleep characteristics, assessed by the subjective sleep characteristics scale, improved by 4.6; 5.0 and 5.3 points (p≥0.001), respectively. 4.5 months after the completion of the omberacetam treatment course, the mean MoCA score was 0.8 points higher compared to baseline (p=0.061).Conclusion. The results showed high efficacy and safety of omberacetam in patients with VCI. A long-term positive effect of omberacetam was observed.