иабетическая автономная кардиоваскулярная нейропатия (ДАКН) при появлении клинической симптоматики не только резко снижает качество жизни, приводя к инвалидизации, но в ряде случаев является непосредственной причиной летальных исходов. Выявление признаков автономной дисфункции на доклинической стадии позволяет замедлить дальнейшее прогрессирование вегетативных нарушений. Выделение группы риска развития этой патологии даст возможность предотвратить ее формирование путем воздействия на модифицируемые факторы риска. Цель нашего исследования-установить факторы риска развития ДАКН, оптимизировать диагностику данного осложнения у детей и подростков с сахарным диабетом 1 типа (СД1). Mатериалы и методы На базе отделения эндокринологии ДРКБ МЗ РТ проведено обследование 101 ребенка с СД1. Все пациенты находились на базисно-болюсной инсулинотерапии в режиме многократных инъекций или постоянной

Aim. To study correlation between sleep disorders, cognitive impairment and emotional state in patients suffering from chronic brain ischemia and artreial hypertension. Methods. The study included 65 patients of Kazan City clinical hospital №7: 35 males and 30 females aged 21 to 92. Self-Administered Gerocognitive Exam test, Spielberg-Hanin scale, questionnaire developed by the authors, Pittsburgh sleep quality assessment were used. Results. It was shown that reduced sleep quality in patients with chronic brain ischemia is associated with worsening cognitive impairment. Among responders with poor subjective sleep quality only 21% had cognitive function within normal limits, while in 88% of patients with good subjective sleep quality cognitive function was normal. High level of anxiety was found to cause poor sleep quality. 57% of patients were diagnosed with high level of situational anxiety combined with poor subjective sleep quality and among patients with good sleep quality in only 12% of responders high level of situational anxiety was found. In patients increase of the level of anxiety is associated with more frequent cognitive impairment. Only 38% of patients with high level of anxiety had normal cognitive function compared to 85% of responders with low level of anxiety and normal function. Conclusion. Sleep quality and level of anxiety influence the development of cognitive disorders in patients with chronic brain ischemia.

The aim of this study is to research the structure of acute vestibular disorders at the stage of the emergency room and to determine the frequency of occurrence of life-threatening conditions. Material and methods. It was made the analysis of acute vestibular disorders at the stage of emergency room of the Neurology department of Clinical Hospital No. 7, City Clinical Hospital No. 18 and stroke center of Interregional Clinical Diagnostic Center in Kazan, Tatarstan Republic, Russian Federation, for the period 20162020. The diagnosis of vestibular disorders was established on the basis of clinical data. There were additional instrumental researches made in doubtful cases. Statistical data processing was made using Microsoft Excel 10.0 program. Results. The study included 106 patients in total with reliably established pathology of the peripheral or central vestibular system. The peripheral or functional nature of vestibular disfunctions were identified in 84% patients. 57% patients had benign paroxysmal positional vertigo. 42% of these patients had repeated benign paroxysmal positional vertigo attack. Vestibular neuronitis and Ramsey Hunt syndrome were detected in 15% patients. Acute cerebrovascular origin was diagnosed in 10% patients (10 ischemic strokes and 1 transient ischemic attack). 1 patient had an ArnoldChiari malformation with the development of occlusive hydrocephalus. So, 12 patients had a life-threatening cause of vestibular pathology, among them only 2 patients had isolated vestibular symptoms. Vestibular migraine was diagnosed in another 5% patients. Conclusions. Life-threatening causes of vestibular pathology account for 11% of all cases. Focal neurological symptoms are the main red flags of systemic vertigo. Benign paroxysmal positional vertigo is detected in 57% of cases of vertigo in the emergency room.