Lewy body dementia (LBD) is a progressive brain disease manifest as dementia and parkinsonism, along with psychotic and autonomic disorders. Although studies in recent years have demonstrated the positive effects of cholinesterase inhibitors in LBD, the search for therapeutic agents with other mechanisms of action remains relevant. An open, controlled, 16-week study was performed with the aim of evaluating the efficacy and safety of memantine in patients with clinically diagnosed LBD (criteria of McKeith et al., 1999). The study included 23 patients (mean age 69.2 +/- 5.9 years), who were divided into two groups: 14 patients received memantine at a dose of 20 mg/day and nine patients constituted the control group. Efficacy was evaluated using a battery of quantitative neurospychological tests, clinical scales for assessment of fluctuations in mental states, scales for assessment of behavioral and psychotic disorders, and the general clinical impression scale. The results demonstrated that memantine had positive effects on the patients' general status and cognitive functions (increases on the mini mental state examination by 1.5 points), mainly because of improvements in attention and control functions. There were also reductions in the severity of fluctuations in mental state, aggressivity, lack of spontaneity, and disinhibition. The severity of psychotic and motor disorders did not change significantly. Tolerance of the agent was good, only two patients withdrawing from the study because of episodes of confusion during the dose titration period.

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Introduction. The incidence of respiratory system involvement in patients with rheumatoid arthritis (RA) has currently increased; thereby new diagnostic methods have been developed actively. Meanwhile role of vascular disorders in pathogenesis of lung injury is almost unknown and single-photon emission computed tomography (SPECT) isn't used as method of lung assessment in RA. The detector of endothelial glycocalyx damage syndecan-1 is little known but potentially perspective serum marker of lung injury in RA. Objective. The purpose of the study was to investigate the role of vascular disorders in lung injury in patients with RA. Materials and methods. 61 patients with RA without comorbid lung diseases were enrolled in the study. Control group consisted of 26 healthy persons. Patients underwent survey and physical examination, high-resolution computed tomography (HRCT) and SPECT of the lungs and pulmonary function tests (PFTs). Also serum levels of rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (ACCP) and syndecan-1 were measured. Results. All patients developed microcirculation impairment on SPECT. Vascular disorders were according to changes of lung structure detected by HRCT (r = 0.434; p = 0.044). Areas of hypoperfusion matched with ground glass opacities, lung fibrosis, branching linear structures and airway obstruction on HRCT-SPECT fusion scans. Syndecan-1 level was higher in patients with RA compared with healthy controls (р = 0.019). Conclusion. Vascular disorders are important in pathogenesis of lung injury in RA, and SPECT has high sensitivity in lung assessment. Perfusion impairment in lungs correlates with syndecan-1 level, thus syndecan-1 could be used as marker of lung injury in RA thereafter.

To analyze reasons of death, medical death certificates and postmortem records as well as official results of the Federal state statistics service were used. According to the register of Parkinson's disease (PD) patients during 2009-2012, the total mortality was 9.9%. The average age of patients died from the disease was 74.3 ± 2.4 years. The main reasons of death were PD (36.2%), circulatory illnesses (27.6%), respiratory diseases (12.1%), malignant neoplastic diseases (12.1%), other reasons (12.0%). Direct reasons of death in patients with PD were the complications of underlying disease in connection with the development of immobility and comorbidities. Timely correction of complications and comorbidities is a main strategy to extend life expectancy in patients with PD.

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