КОЛОНКА ГЛАВНОГО РЕДАКТОРА
ЭЛЕКТРОНЕЙРОФИЗИОЛОГИЯ
Non-convulsive status epilepticus (NCSE) in case of severe traumatic brain injury is the reason for the persistence of a long unconscious state in the postcomatose period. Currently, there are no unified EEG-criteria for the diagnosis of non-convulsive status epilepticus. The proposed diagnostic criteria do not provide the neurodynamics of the damaged brain. The results, obtained in this work, allow us to clarify the relationship between the duration of the postcomatose period and the severity of pathological changes on the EEG. Diagnostic criteria for NCSE are proposed for the different periods of the acute period of traumatic brain damage. In the first 3–5 days of a postcomatose unconscious state, NCSE is diagnosed with an epileptiform activity index of at least 50 %. When the unconscious state lasts more than 7–10 days, the registration of epileptiform activity with an index of more than 25–30 % is a sufficient criterion for the diagnosis of NCSE. It has been shown that the formation of non-convulsive epileptic status can occur “delayed”, after more than 10–14 days from the moment of restoration of spontaneous respiration, which necessitates EEG monitoring throughout the entire period of the unconscious state in patients with severe brain injury.
The goal is to study the dynamics of the inter-hemispheric coherence coefficient of the cortex according to the main rhythms of the electroencephalogram before and after the BOS-therapy based on the wrist tapping on the author’s method and the effect of subclinical anxiety on the characteristics of wrist tapping in healthy adults.
Materials and methods. The conduct of this study was approved by the ethical committee of KrasSMU. prof. V. F. Voyno-Yasenetsky (protocol No. 77/2017 dated June 26, 2017).The study was conducted in two stages. The first stage is the study of standards and the influence of wrist tapping according to the author’s method on the characteristic of the “internal” rhythm in healthy adults without anxiety and with subclinical anxiety (n1 = 60). The second stage is the study of the influence of wrist tapping according to the author’s method on the coefficient of hemispheric coherence in the frontal areas of the cerebral cortex in healthy volunteers (n2 = 63). Study of wrist tapping was carried out using the original technique (RF patent № 2606489 from 10.01.2017). Anxiety level testing was performed using a scale (HADS hospital anxiety and depression scale [1]). Analysis of interhemispheric coherence in Fp1 — Fp2, F3 — F4, T3 — T4 pairs was performed using a computer encephalographic complex (Neurokartograf, MBN Moscow).
Results and discussions. The main characteristics of the “internal” rhythm according in healthy adults are statistically significant depending on the absence or presence of subclinical anxiety (1.13 Hz vs. 1.53 Hz, respectively). According to the author’s method, wrist tapping statistically significantly reduces the coefficient of interhemispheric coherence in Fp1-Fp2, F3-F4, C 3-C 4 pairs located above the convexital surface of the frontal cortex, which can be used as a method of non-pharmacological correction of anxiety disorders in the future.
Conclusion. Subclinical anxiety affects the indicators of the “internal rhythm”, which is studied using wrist taping according to the author’s method. Wrist tapping in healthy adults leads to a decrease in the interhemispheric integration of frontal cortex neurons and interhemispheric coherence coefficients in beta1- (predominantly) and alpha rhythms, without affecting the coefficients of coherence in theta rhythm. Wrist tapping according to the author’s method is a promising option for BOS-therapy in adults to reduce the level of anxiety in normal and pathological conditions.
ИСТОРИЯ МЕДИЦИНСКИХ ОТКРЫТИЙ
The article presents a summary of figurative comparisons and eponyms that are used in modern cardiology and functional diagnostics. Links are given to the sources in which these names were first used.
There are a lot of great scientists leaving their names in the name of the medical terms they discovered. The contribution of this scientists is reflected: Einthoven, Wilson, Pardee, Cabrera, Chapman, de Winter, Prinzmetal, Bazett and others. Syndromes of Wellens, Brugada, Romano-Ward, Wolff-Parkinson-White, Clerc-Levy-Critesco, Chatterjee and others, and figurative comparisons are briefly described: “cat back”, “death wing”, “bull terrier muzzle”, “torsades de pointes”, “epsilon-wave”, “Salvador Dali’s mustache”, “saw teeth”, “shield and sword”, etc. All the terms given in the article have not only scientific, but also, most important, applied meaning. The article will be useful not only for students of medical universities, residents and graduate students, but also to practical doctors, whom it will help test her knowledge.
ЭХОКАРДИОГРАФИЯ
Allocation of three levels of an echocardiography with corresponding levels of algorithms for optimum integration into multilevel diagnostic process is offered. Express, clinical and expert division corresponds to preventive, standard medical-diagnostic and highly technological directions of public health services. Three-level gradation should not cause decrease in its quality at the expense of the differentiated direction of conditionally healthy faces — on screening, the diseased — on clinical, cardiological patients — on expert ultrasonic cardiac diagnostics.
ЭЛЕКТРОКАРДИОЛОГИЯ
ISSN 2949-2807 (Online)