Vibration disease is one of the leading in the structure of occupational diseases. A more detailed study of the pathogenesis, expanding the possibilities of diagnosis of vibration disease, is necessary. The aim of the study is to determine the diagnostic value of stabilometry, quantitative sensory testing and neuroenergocarting in vibration disease associated with the combined effects of local and general vibration. Materials and methods. Two groups of patients were examined: with the diagnosis of vibration disease associated with the combined effect of local and general vibration – 50 people (age 48.7 ± 3.1 years), not in contact with vibration – 30 people (age 49.1 ± 2.8 years). The study of the equilibrium function, the determination of the level of the constant potential of the brain by 12 standard leads and the determination of temperature and pain sensitivity. Statistical processing of the results was carried out using the software package “Statistica 6.0” (StatSoft Inc., USA). Differences were considered statistically significant at p < 0.05. Results. In vibration disease, the vertical stance of patients is more unstable than in patients with no contact with vibration. In patients with vibration disease, there is a decrease in the threshold of cold sensitivity and an increase in the threshold of thermal sensitivity and thermal pain compared to the control group. According to our data, the increased level of permanent potential in patients with vibration disease is observed in the central (22.7 (12.6; 30.7) mV) and right central (20.4 (11.5; 27.1) mV), also the average level of permanent capacity in this group is increased – 17.1 (8.4; 25.8) mV.Conclusion. The results obtained indicate the involvement of the neurosensory complex united by single thalamic and cortical centers in the pathological process and confirm the diagnostic value of the methods used.
Когнитивные нарушения (КН) сопровождают много-численные заболевания головного мозга. При заболева-ниях с преимущественным поражением подкорковых ба-зальных ганглиев (токсические поражения головного мозга, сосудистая мозговая недостаточность) на первый план в клинической картине когнитивных расстройств выходят подкорково-лобные КН в виде изменения пла-нирования и переключения деятельности, снижения ско-рости реакции и умственной работоспособности, импуль-сивного поведения. Такие нарушения обычно сопрово-ждаются симптомами депрессии и неврологическими расстройствами в виде оживления примитивных рефлек-сов, олигобрадикинезии и лобной дисбазии [1,2]. Выде-ляют легкие, умеренные и тяжелые КН. Исторически проблема когнитивных расстройств изучалась преимуще-ственно в рамках деменции, означающей наиболее тяже- Цель исследования -выявление особенностей когнитивных нарушений у пациентов с токсической (ртутная и алкогольная) энцефалопатией. Материал и методы. Обследовали 36 пациентов с хронической ртутной интоксикацией и 30 с хроническим алкоголизмом. В контрольную группу были включены 30 здоровых мужчин репрезентативного возраста, не имеющих контакта с токсическими веществами и не злоупотребляющих алкоголем. Всем пациентам проводилось нейропсихологическое исследование, включающее комплекс нейропсихологической системы по А.Р. Лурия, оценивающий состояние памяти, праксиса, гнозиса и речи. Для диагностики умеренно выраженных когнитивных расстройств использовались тесты MMSE и FAB. Также проводились компьютерная ЭЭГ и исследование когнитивных вызванных потенциалов. Результаты и заключение. Обследование выявило диффузность мозгового поражения при токсической энцефалопатии по результатам как ЭЭГ, так и нейропсихологического обследования. Изменения аналитико-синтетического мышления, слухоречевой, долговременной, зрительной памяти, реципрокной координации, пальцевого гнозиса, импрессивной речи отмечались при ртутной энцефалопатии. Выявлена функциональная недостаточность лобной доли и премоторной области левого полушария при алкогольной энцефалопатии. Ключевые слова: когнитивные нарушения, токсическая энцефалопатия,Objective. To identify features of cognitive impairment in patients with toxic (mercury or alcohol) encephalopathy. Material and methods. The study involved 36 patients with chronic mercury intoxication and 30 people with chronic alcoholism. A control group included 30 age-matched healthy men who were not exposed to toxic substances and alcohol abuse. All patients underwent neuropsychological examination, which involved a set of neuropsychological Luria rated memory status, praxis, gnosis and speeches. MMSE and FAB were used for the diagnosis of moderate cognitive impairment. Computer electroencephalography and cognitive evoked potentials method were used as well. Results and conclusion. The diffuse brain injury in toxic encephalopathy (alcohol and mercury) on EEG, and according to the results of neuropsychological testing was identified. Changes in analytical and synthetic thinking, audio-verbal, long-term, visual memo...
Introduction. Need of carrying out a research is defined by insufficient study of retsiprokny relationship of psychological features with the course of insomnichesky frustration taking into account psychopathological symptomatology and features of displays of neurointoxication for the purpose of prevention of sleep disorders at patients with the chronic mercury intoxication (CMI). A research objective was identification of psychological features of formation of dissomnichesky frustration at patients in the remote post-contact period of HRI. Material and methods. Kliniko-diagnostic, polisomnografichesky and experimental and psychological examinations to 40 patients from HRI and to 15 healthy men of group of comparison which didn't have in professional activity of contact with harmful substances are conducted. Results. The Polisomnografichesky research of patients with HRI has revealed rough changes of indicators of structure of a night dream in comparison with control group in the form of reduction of duration of a dream, increase in the latent period of the first stage of a dream, the general time of wakefulness in a dream from time of its duration, total of activation shifts. Essential changes of structure of a dream were noted in his first cycle - in the form of reduction of duration. Reduction of duration of a cycle, time of the second stage, reduction representation of a delta dream is noted. The indicators characterizing the mnestiko-attentsionny sphere and an emotional condition of patients considerably differed from standard levels that demonstrated personal disintegration, formation of mental defect of asthenic, disturbing and hypochondriac, sensitive types with prevalence of affects of disturbing and depressive and explosive character. Discussion. The established correlation connection demonstrates negative impact of time of duration of a dream on levels of uneasiness, a depression, morbid depression, social disadaptation, intelligence quotient, indicators of short-term, figurative memory, concentration of attention Increase in duration of a somnolence promotes aggravation of paranoyalny manifestations and decrease in concentration of attention and is regarded as sign of strengthening of activity of stem structures. Conclusion. It is established that at professional neurointoxications permanent changes of polisomnografichesky activity in the form of insomnichesky violations of the mixed character are a consequence of chronic influence of vapors of metal mercury and also the reason of psychopathological violations.
Introduction. Issues of studying the central origins and development of оccupational pathology in the faces of flight personnel define a need for the application of neurophysiological and neuropsychological methods of research. Material and methods. The levels of constant potential (LCP), characteristics the somatosensory caused potentials (SSVP), neuropsychological features in 95 patients with оccupational neurosensory deafness (ONSD) and 35 cases in a group of comparison are studied. Methods of the statistical analysis with a definition of W-of criterion of Shapiro-Uilka, Mann-Whitney›s U-criterion, coefficient of correlation of Spirmen, the discriminant analysis are applied. Results. in ONSD at patients the quantity of cases with the increased values of average LCP were established to prevail significantly in comparison with those in patients of a group of comparison (39% and 13% respectively, р = 0.03), strengthening of neuropower exchange in right and left frontal, central, left central, left parietal, right temporal assignments, increase in duration of the latent period of N18, N30 components are registered (р < 0.05). The condition of the cognitive sphere was characterized by the easily expressed violations of functions of analytical and synthetic thinking, оral-aural memory, visual, long-term memory, reciprocal coordination, impressive speech. Correlation connection between the index of N13-N20 and indices characterizing a condition of long-term memory, reciprocal coordination, the expressional speech is established (rs=0.45; 0.28; 0.28 at р =0.008; 0.04; 0.03 respectively), an index the between hemispheres of the relations Fd-Fs and latency of P25 and N30 (rs = 0.53 and 0.29 at р =0.009; 0.02 respectively). Diagnostic signs of brain deficiency at patients with ONSD were indices of visual gnosis, reciprocal coordination, LCP in right central, central parietal assignments of a brain, duration of the latent period of N30, N18-N20 (F=9.14; 5.43; 6.08; 4.41 4.77; 4.34 respectively). Conclusions. Violations of power metabolism in the frontal and central and parietal and temporal assignments of a brain, a functional condition of the central carrying-out structures, disorganization of cognitive activity were established to be a consequence of the impact of aviation noise and the reason of brain deficiency.
This paper presents a quantitative assessment of the aging process in the occupational neurotoxicosis. Acceleration rate of biological aging has been demonstrated in trained workers of a chemical factory exposed to vinylchloride, metallic mercury vapor in patients with newly proven diagnosis - chronic elemental mercury intoxication and chronic elemental mercury intoxication in the long-term period in 1.9; 2.8; 7.2; 7.5 times compared to the rate of a control group. Six-time increase in the proportion of patients with acceleration rate of aging compared to the norm (70 % vs. 12 %) has been found out among fireman-liquidators. To study the interdependence of indicators characterizing the state of cognitive sphere and the rate of biological aging in patients with occupational neurointoxication a correlation analysis of the data of neuropsychological and clinical and physiological studies has been carried out. Raising of biological age and acceleration rate of biological aging in patients with neurointoxications are accompanied by disorders of categoric, conceptual, analytical - synthetical thinking, audio-verbal (short-term) and the visual image memory, spatial and dynamic praxis, objective gnosis, impressive and expressive speech, caused by deficiency of functioning of the frontal, parietal-temporal, parietal-occipital lobes, premotor and parietal regions of the left brain, overlap zone (tertiary temporo-parietal-occipital cortex).
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