Одним из наиболее часто встречающихся заболеваний зубо-челюстной системы является хронический генерализованный пародонтит. Значительную роль в развитии хронического генерализованного пародонтита играет взаимосвязь разнообразных местных факторов и общего состояния организма. Исследования последних лет, посвященные вопросам воспалительно-дистрофического процесса в пародонте при данном заболевании, показали, что определяющая роль отводится микробиологическому мониторингу и изменениям местного иммунитета полости рта. При этом среди последних важное место занимают гуморальные механизмы и факторы иммунитета.

Parkinson’s disease (PD) is one of the most common neurodegenerative diseases in the world. While until recently MRI was used exclusively for the diagnosis of symptomatic forms of parkinsonism, recent advances in neuroimaging allow the detection of signs of nigral degeneration (MR biomarkers of PD). The article discusses the possibilities of modern MRI modes sensitive to iron (SWI, T2*) and neuromelanin (neuromelanin-sensitive MRI); emphasis is placed on identifying false-negative and false-positive results of the study. The imaging of nigrosome-1 in the dorsal substantia nigra (SN) in MRI-SWI has been discussed since 2013. In the absence of nigral degeneration, this area is defi ned as a hyperintense ovoid area within the dorsolateral border of the hypointense SN (“swallow’s tail” sign). If the optimistic results of the fi rst studies testifi ed to the high sensitivity and specifi city of this technique in PD (the absence of the “swallow’s tail” sign), then in subsequent studies, similar changes were detected in patients with other neurodegenerations with parkinsonism. In addition, the diagnostic value of this technique occurs when using tomographs with a magnetic fi eld strength of at least 3 Tc. Similar conclusions can be drawn about the use of neuromelanin-sensitive MRI, since it is necessary to use high-fi eld magnetic tomographs of 3 Tc or more to detect nigral degeneration, and results similar to PD can also be found in atypical forms of parkinsonism. However, the search for signs of nigral degeneration may be useful in the diff erential diagnosis of PD and non-neurodegenerative disorders. In addition to MRI in the diagnosis of PD, the article discusses neuroimaging in various types of multisystem atrophy, progressive supranuclear palsy, and dementia with Lewy bodies. The article is illustrated with own MRI scans of the brains of patients with PD and other forms of parkinsonism.

РЕЗЮМЕАктуальность.Нарушение метаболических процессов печени в результате воздействия алкогольной интоксикации снижает когнитивное функционирование и индуцирует когнитивные расстройства.С выраженностью метаболических расстройств связана тяжесть осложнений алкоголизма.У больных алкоголизмом с коморбидным поражением печени признаки когнитивных нарушений наблюдаются уже на ранних стадиях заболевания и сопровождаются расстройствами внимания, памяти, восприятия, что в дальнейшем зачастую приводит к социальной дезадаптации и инвалидизации.Цель.Выявление взаимосвязи показателей нарушения детоксицирующей функции печени и когнитивных расстройств у больных с алкогольной зависимостью для разработки алгоритма персонализированной терапии.Материалы и методы.На базе отделения аддиктивных состояний НИИ психического здоровья сформирована исследовательская выборка (n=40) из лиц мужского пола, средний возраст которых составил 42,4±11,9 года, с диагностированными по МКБ-10 психическими расстройствами и расстройствами поведения, связанными с употреблением алкоголя (F10), нарушениями детоксицирующей функции печени и когнитивными расстройствами.Для оценки динамики психического состояния у пациентов с алкогольной зависимостью дважды (при поступлении и после комплексной терапии) проведено психологическое тестирование с использованием шкалы тревоги Гамильтона.Скрининг когнитивных нарушений осуществляли по Монреальской когнитивной шкале (MoCA), оценку кратковременной и долговременной памяти -по психодиагностическим тестам (Пиктограммы, Заучивание 10 слов).Обсессивно-компульсивная шкала (ОКШ) влечения к алкоголю использовалась для самооценки идеаторных проявлений отношения к алкоголю.Исследовались в динамике биохимические показатели крови (АЛТ, АСТ, общий билирубин, прямой и непрямой билирубин, холестерин, щелочная фосфатаза

Parkinsons disease (PD) is an age-related neurodegenerative disease associated with the loss of dopamine-producing neurons in the substantia nigra. The disease is manifested by motor disorders and a variety of non-motor symptoms (NMS). NMS may reduce the quality of life (QoL) of people with Parkinsons disease (PD) more than motor manifestations, but their ultimate contribution has not been fully established. AIM. To determine the impact of motor, cognitive and affective disorders and social factors on the quality of life of patients with PD in the Republic of Sakha (Yakutia). MATERIAL AND METHODS. The study included 35 patients with PD, HoehnYahr stage 13 (60% women and 40% men), mean age 64.42.0 years. We used scales: UPDRS, MoCA, HADS, NMSQuest, Epward Sleepiness Scale, PDQ39. The analysis of clinical signs and social factors in the studied group of patients was carried out. RESULTS. The decrease in QoL was moderately associated with disease stage (r=0.56, p=0.009), the severity of motor manifestations (r=0.65, p 0.001) and the total number of NMS (r=0.46, p=0.008). Age and disease duration did not affect on QoL. The decrease in QoL was influenced by the presence of depression (r=0.83, p 0.001), anxiety (r=0.69, p 0.001) and cognitive decline (r=0.46, p=0.008). Low levels of QoL were found in individual PD patients and in people with disabilities. QoL was not influenced by ethnicity, gender, employment or education. Three groups of patients with PD were identified: those with mild, moderate and severe decrease in QoL. Their clinical and social portraits are presented. CONCLUSION. The dependence of the quality of life of patients with PD on the form of the disease, the stage of the disease, the severity of depression, social factors has been demonstrated, which requires attention not only from neurologists, but also from psychotherapists and social workers.

A study of the level of hormones in the blood serum was carried out in 173 residents of the Aldan region aged from 22 to 75 years, of which 65 (39.8%) were men and 108 (60.2%) women, the average age was 44.0 (35. 0; 52.0) years. In the working population, there is functional tension of the pituitary-thyroid link, characterized by a higher frequency of occurrence of thyroid hormone levels below the normal T3total. in 27.2%, T3f. in 19.3% and T4f. in 11.6% of people, more pronounced in women. Increased concentrations of thyroid hormones T3f., T4f. and T4tot. observed with age, T3total and T4total in people with an increased body mass index. The presence of increased levels of antibodies to thyroid peroxidase in 18 (10.4%) people indicates a strained immune system, therefore it is recommended to include endocrinological examinations in periodic medical examinations

Introduction. Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by cognitive decline, primarily loss of memory for recent events. Despite the widespread prevalence of AD in the world, in Russia there is a high level of deficiency in diagnosing the disease. The Republic of Sakha (Yakutia) is a large subject of the Russian Federation; at the beginning of 2023, the population of the Republic was 997,565 people, and over the past 20 years, the share of elderly people (60 years and older) has increased 1.86 times (from 8.3% to 15,5%). The aim of the research: to assess the level of diagnosis of Alzheimer's disease and predict the likely number of patients in the Republic of Sakha (Yakutia). Materials and methods: to estimate the number of patients with AD, reports from neurologists of the Republic of Sakha (Yakutia) and official data on the disease provided by the Yakut Republican Medical Information and Analytical Center were analyzed (YRMIAC). To predict the number of patients in the city of Yakutsk and the regions of the Republic of Sakha (Yakutia) for each age group of the population, the maximum and minimum proportions of people who could potentially suffer from AD were calculated. Based on various epidemiological studies, three forecast scripts have been identified: "Chinese", "Japanese" and "American". Results and discussion. According to official data, 45 patients diagnosed with AD are registered in the Republic of Sakha (Yakutia), of which 36 (80%) people live in Yakutsk. According to reports from neurologists for 2022, only 7 people are registered at the dispensary with a diagnosis of Alzheimer's disease. If we extrapolate world data for the Republic Sakha (Yakutia), then the minimum number of patients with Alzheimer's disease should be 4,166.4 people and observed under the "Chinese" script, and the maximum number of patients - 8,428.5 people - under the "American" script. The largest number of patients is predicted in the industrial districts of the republic (Neryungri, Mirny and Aldan). The smallest number of patients with Alzheimer's disease is predicted in the Arctic and Northern districts, especially in Eveno-Bytantaysky and Anabarsky. Conclusion. Alzheimer's disease is one of the leading medical and social problems of the modern world. At this stage in the Republic of Sakha (Yakutia), improved diagnosis of the disease is required for the timely initiation of symptomatic therapy. The predicted number of patients determined by us in the city of Yakutsk and the districts of the Republic can serve as a guideline when screening patients for cognitive impairment.

Objective : The aim of the study was to study the clinical features of essential tremor (ET) in residents of the Republic of Sakha (Yakutia) in various ethnic groups. Material and methods . The study involved 53 patients with an established diagnosis of essential tremor. All patients underwent a detailed neurological examination with a quantitative assessment of the severity and severity of tremor, as well as the degree of maladjustment and activity in everyday life using unified scales. Results and Discussions . It was revealed that the clinical variant of essential tremor-plus, associated with a more severe course and disability of patients. In the representatives of the Russian ethnic group, with the classic version of essential tremor, a combination of head tremor and hand tremor is observed, as well as a more rapid progression of disease symptoms. Representatives of the Yakut ethnic group in the clinical picture of essential tremor-plus are statistically significantly more likely to have a dystonic head position. Conclusion . Clinical variability of essential tremor with differences in the ethnic aspect in the rate of progression and in the frequency of the combination of action tremor with dystonic head position was demonstrated.

A radiological and medical-biological study of the population of Aldan and Tommot of the Aldan region of South Yakutia, located in the zone of increased natural radiation, was carried out. The annual individual effective exposure dose to the population turned out to be 2 times higher in the city of Aldan (6.22 mSv). The contribution of radon and its decay products in the city of Aldan was 59.5%, in the city of Tommot -48.3%. Assessment of the adaptive potential (AP) of the circulatory system of the population showed a high percentage of the occurrence of functional stress of adaptation mechanisms, especially among residents of the city of Aldan (86.5%). The correlation showed a negative role of an increase in the level of triglycerides, urea, the activity of LDH, CK, and a decrease in the activity of alkaline phosphatase on AP. The presence of GBL dys-function and, especially, fatty hepatosis was also associated with a decrease in AP.

We have analyzed the impact of herpes virus infection on the course of a new coronavirus infection (NCVI). Infection of the examined contingent with herpes family viruses reached 95.3-100%. An association of NCVI with herpes simplex viruses 1, 2 types (HSV 1, 2 types) was found, but no correlation was found between the positivity coefficient (CP) of HSV 1, type 2 and the severity of NCVI. This can be explained by the fact that the sampling was carried out in the remote period after the transferred NKVI. Considering that both herpes viruses and the SARS-CoV-2 virus cause multiple organ damage and can aggravate each other, the study of co-infection seems to be very relevant.

An analysis of the main biochemical parameters of the population living in the territory with unfavorable natural radioactivity of 222Rn revealed changes in the biochemical spectrum of blood serum in the population of the Aldan region, indicating the presence of signs of disadaptation. Lipid profile changes are associated with gender and smoking. The shift of lipid metabolism towards atherogenicity is more pronounced in men due to an increase in the atherogenic fractions of lipids in the blood that are susceptible to peroxidation and a decrease in the level of the antiatherogenic fraction of lipids. The shift of metabolic flows towards catabolism, activation of glycolysis, dyslipidemia indicate the tension of carbohydrate and lipid metabolism, which is a sign of disadaptation of the body and the risk of developing environmentally conditioned diseases, including neoplasms.

Dementia is a chronic cognitive decline affecting all domains of cognition with an unfavorable outcome, observed in both dementia with Lewy bodies (DLB) and Parkinson's disease (PD). These two conditions belong to the group of alpha-synucleinopathies. In DLB and PD, attention, goal-directed activity, visual-spatial orientation, visual-constructive ability, and memory are affected. The similarity of the profile of cognitive impairment in PD with dementia and DTL leads to some difficulties in the diagnosing of these two diseases. Using their own observations, the authors have demonstrated that an important aspect in making the correct diagnosis is objective information from relatives and analysis of the available medical records.

The purpose of the work was to study the state of the components of the prooxidant-antioxidant system and indicators of protein metabolism in animals after a long period after exposure to weak electromagnetic fields. Materials and methods. The experiment was carried out on three-month-old white outbred rats. The animals were exposed to low-intensity electromagnetic radiation in the centimeter range for 2 months, 4 hours daily. The study of biochemical parameters of blood serum was carried out 3 months after the end of the experimental exposure. When conducting the research, an emitter in the form of a rectangular horn with a base area of 875 cm was used. Energy radiation was expressed in the power flow density in the area where the experimental animals were located. In the comparison group (n=10), animals were placed in a similar chamber every day, but were not exposed to electromagnetic radiation. Research was conducted in the first half of the day, taking into account circadian rhythms. The analysis of biochemical parameters of blood serum was carried out 3 months after the end of exposure, that is, for rats aged 8 months. Results and discussion. It was revealed that in animals exposed to weak electromagnetic radiation, after a long period after the cancellation of the action, there is an imbalance in the prooxidant-antioxidant system; activation of the non-enzymatic link of antioxidant protection is observed – an increase in the level of s-nitrosothiols against the background of a decrease in the level of lipid peroxidation, which, in addition to a destructive effect on the cell membrane, is a necessary element in maintaining the system of renewal of functionally important component of the lipid layer of cell membranes. The experimentally established dysproteinemia (decrease in the α1 fraction and increase in the α2 fraction of globulins) in animals of the main group may indicate a specific change in the enzymatic spectrum of the synthesis of these proteins in the liver. The activation of antioxidant defense components that we discovered is probably a protective measure aimed at maintaining homeostasis after prolonged exposure to electromagnetic radiation. Conclusion. A decrease in the level of final products of protein metabolism was revealed: creatinine and urea, which suggests a decrease in the rate of protein catabolism. It is concluded that in animals, after a long period after exposure to weak electromagnetic fields of the centimeter range, the level of lipid peroxidation is reduced, specific changes in the indicators of protein metabolism are noted, indicating a decrease in the level of their catabolism. It is suggested that this may be related to a decrease in total muscle mass

Cognitive impairments are one of the leading problems of neurology and psychiatry due to their wide prevalence, especially in the elderly and senile age, the difficulty in diagnosis and treatment. In addition, the increase in life expectancy of the population in Russia and in the world will undoubtedly cause a rapid increase in patients with dementia and other cognitive impairments. However, dementia in most cases does not develop overnight; its development is preceded by a long period of time when the existing cognitive impairments do not yet disrupt the patient's household and professional activity. Cognitive impairment of this degree is called "pre-dementia" and is divided into subjective cognitive decline, subtle and mild cognitive impairments. This article discusses the key problems of subjective cognitive decline and subtle cognitive impairment, the interpretation and diagnosis of which raises the most frequent questions among clinicians. So, based on a review of Russian and foreign literature, the authors substantiate how it is possible to distinguish between subjective cognitive decline and subtle cognitive impairment, and discuss where the line with moderate cognitive impairment is. Separately, diagnostic algorithms and treatment tactics for subjective cognitive decline and subtle cognitive impairment are presented.

Cognitive impairment and dementia are an relevant problem of modern neurology and psychiatry, which is explained by their wide prevalence, as well as the predicted increase in the number of patients in the future. However, dementia in most cases does not occur acutely, its development is preceded by a long period when cognitive impairments do not disrupt the patient’s everyday and professional life yet. Such cognitive impairments are called “pre-dementia” and are divided into subjective, subtle, and mild. With subjective cognitive impairment, patients present complaints; however, neuropsychological testing does not reveal decreased cognitive functions. Subtle cognitive impairment is accompanied by a decrease in cognitive functions when using highly sensitive scales. This article provides an overview of current data on the definition, classification, diagnosis, and treatment of mild cognitive impairment (MCI) from the point of view of the evidence-based medicine for timely diagnostics of the state and its effective correction. In patients with MCI, in addition to complaints of cognitive deficit, it is detected during screening neuropsychological testing; but unlike dementia, it does not impair the patient’s functionality. MCI is a leading risk factor for future dementia. However, according to research, cognitive deficits can not only progress, but also stabilize and even regress. In this regard, it is important to identify patients with MCI on time, establish nosological affiliation for correcting risk factors and prescribing treatment. The most common causes of MCI can be neurodegenerative disorders (primarily Alzheimer’s disease) and cerebrovascular diseases. The authors present the diagnostic value of popular scales such as the Mini-Mental State Examination, the Montreal Cognitive Assessment Scale and the 3-CT test in the diagnosis of MCI. The possibilities of using biomarkers, such as the determination of beta-amyloid and tau-protein in the cerebrospinal fluid, and the detection of signs of neuronal damage during neuroimaging of the brain, are discussed. It is stated that the most proven methods of influencing cognitive deficits in MCI are non-drug measures.

Amyotrophic lateral sclerosis (ALS) is an incurable chronic progressive neurodegenerative disease with the progressive degeneration of motor neurons in the motor cortex and lower motor neurons in the spinal cord and the brain stem. The etiology and pathogenesis of ALS are being actively studied, but there is still no single concept. The study of ALS risk factors can help to understand the mechanism of this disease development and, possibly, slow down the rate of its progression in patients and also reduce the risk of its development in people with a predisposition toward familial ALS. The interest of researchers and clinicians in the protective role of nutrients in the development of ALS has been increasing in recent years. However, the role of some of them is not well-understood or disputed. The objective of this review is to analyze studies on the role of nutrients as environmental factors affecting the risk of developing ALS and the rate of motor neuron degeneration progression. Methods: We searched the PubMed, Springer, Clinical keys, Google Scholar, and E-Library databases for publications using keywords and their combinations. We analyzed all the available studies published in 2010–2020. Discussion: We analyzed 39 studies, including randomized clinical trials, clinical cases, and meta-analyses, involving ALS patients and studies on animal models of ALS. This review demonstrated that the following vitamins are the most significant protectors of ALS development: vitamin B12, vitamin E > vitamin C > vitamin B1, vitamin B9 > vitamin D > vitamin B2, vitamin B6 > vitamin A, and vitamin B7. In addition, this review indicates that the role of foods with a high content of cholesterol, polyunsaturated fatty acids, urates, and purines plays a big part in ALS development. Conclusion: The inclusion of vitamins and a ketogenic diet in disease-modifying ALS therapy can reduce the progression rate of motor neuron degeneration and slow the rate of disease progression, but the approach to nutrient selection must be personalized. The roles of vitamins C, D, and B7 as ALS protectors need further study.

Alzheimer’s disease (AD) is the most common cause of dementia in the population. Late onset AD has a classic clinical picture with short-term memory deficit, apraxia and agnosia. Patients with early-onset AD may have an atypical clinical picture which complicates diagnosis. Atypical AD variants include the logopenic variant of primary progressive aphasia, posterior cortical atrophy, behavioral, biparietal, and cortico-basal variants. These variants have pathomorphological signs similar to classical AD, but at an early stage they are characterized by focal atrophy which explains their clinical polymorphism. This article provides a review of the current literature on atypical types of AD and presents a clinical case of a 62-year-old patient in whom the disease debuted with prosopagnosia due to focal atrophy of the temporo-occipital regions of the non-dominant hemisphere.

Levodopa is the "gold" standard of pharmacotherapy for Parkinson's disease (PD). Levodopa has its own advantages, such as high efficiency at all stages of the disease, low incidence of side effects, availability, at the same time, long-term levodopa therapy is associated with the development of levodopa-induced dyskinesias (LID). Approximately one third of patients in the fifth year of illness already have LID; by the 10th year of illness, almost all patients have this disorder. LID can be associated with gene polymorphisms, the products of which are involved in the metabolism of levodopa. The aim was to study the association of single nucleotide variants (SNV) rs6280 (DRD3 gene) and rs9652490 (LINGO1 gene) with the development LID in PD. The study included 47 patients with PD, 21 (44.7%) men and 26 (55.3%) women. The average age was 69.0 +/- 7.67 years. Patients with a mixed form of PD predominated (72.3%). The average duration of the disease was 5.94 +/- 4.09 years. Results. Patients with PD in both groups (with and without LID) did not differ in age, gender and ethnicity, stage of disease, non-motor symptoms, and degree of cognitive impairment. At the same time, patients with LID showed frequent development of motor fluctuations, a longer duration of levodopa therapy, and a higher levodopa equivalent daily dose. Analysis of the effect of DRD3 (Ser9Gly, or rs6280) and LINGO1 (rs9652490) polymorphisms on the development of LID in PD was not found. Conclusion. The results of a pilot study indicate the absence of a predictive role of the carriage of SNV rs6280 (DRD3 gene) and rs9652490 (LINGO1 gene) on the development of LID in PD patients living in the Republic of Sakha (Yakutia). However, the authors do not exclude the influence of a small sample size on the results of the associative genetic study.