CC BY
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DOI: 10.22448/AMJ.2016.15-16.61-62
UDC 616.74-009.17
CLINICAL FEATURES OF MYASTHENIA IN THE AMUR REGION
Konkova D.Y., Karnaukh V.N.
Amur State Medical Academy, Blagoveshchensk, Russia
Abstract The clinical features of the disease - age, the debut features and the course were analyzed in patients with myasthenia. The revealed clinical features conformed to the literature data: the prevalence of women among the patients, generalized form, oculomotor disorders and ptosis as the first symptoms, the debut at a young age.
Key words: myasthenia gravis, clinical features, generalization, thymus gland.
Myasthenia gravis is a serious autoimmune neurological disease associated with impaired neuromuscular transmission. The main clinical manifestations are fatigue and progressive weakness of striated muscles.
The purpose of the research was to identify some clinical features of myasthenia gravis in the Amur region.
Materials and methods. The out-patient's cards and the case histories of patients with myasthenia gravis, being on the dispensary in the Amur regional polyclinics and inpatient treatment in the neurology department
AMypcKMM Meg^MHCKMM wypHa^ №3 - 4 (15 - 16)
61
of the Amur regional clinical hospital, were analyzed. The clinical features of the disease - age, the debut features and the course were determined.
Results and discussions. The average age of the debut of myasthenia gravis in the Amur region was 38,5 ± 5,6 years (17 to 73). Most of our patients became ill at the age of 40 years - 52.3%. Another moderate peak was observed in elderly patients. The disease debut in women was often at the young age (before 40 years), in men - at the mature (41 to 55 years). In 22 patients debut age had not been elucidated.
The first symptoms were ocular manifestations in 36 (59%) patients, musculoskeletal - in 8 (13.1%). 14 (22.9%) patients had primary generalization. Isolated pharyngoesophageal-facial symptoms wasn't observed at the onset of the disease, however, in conjunction with other symptoms, bulbar was found in 10 patients (16.4%), combined with the weakness of facial muscles in two cases (3.3%) and with the weakness of chewing muscles in two cases (3.3%). The data about the early symptoms were not found in 25 of patients. There are similar data in literature [6].
Generalization of the process in the vast majority of patients (96.2%) occurred during the first 4 years, in 76.9% - during 2 years, which coincides with the data of other authors [4, 5]. According to the out-patient's cards generalization was observed at 8 and 10 years from the onset of the disease only in two patients.
The pathology of the thymus gland, confirmed by imaging studies (CT, MRI) and histologically, was diagnosed in 29 (32.95%) patients, including thymoma - in 12 (13.6%), hyperplasia of the thymus gland - in 14 (15.9% ), malignant neoplasm - in 2, the heterogeneity of the thymus gland - at 1. By the beginning of 2013 year the duration of the disease was 22 ± 2.69 years (range 1 to 32 years) on average.
Most of patients, currently observed, had generalized form - in 86.3% of cases, ophthalmic form - in 13.7%, which was conformed to the literature data [4, 6]. At the time of examining the light heaviness degree (I-II on MGFA) was diagnosed in 43.8%, the average degree (III on MGFA) - in 27.4%, and heavy (IV-V) - in 18.7% of patients. The percentage of the light and heavy degree was slightly higher than according to other authors [1].
In our study among the patients with generalized myasthenia form with predominance of weakness in the skeletal muscle and the patients with kraniobulbar pattern was 1: 1.1, agreeably.
Conclusions. On the whole, the revealed clinical features conformed to the literature data: the prevalence of women among the patients, generalized form, oculomotor disorders and ptosis as the first symptoms, the debut at a young age [2, 3, 6].
Literature
1.Combination of myasthenia gravis and thymoma frequency. Flow features and efficiency of thymectomy in myasthenia / M.A. Barabanov, A.S. Mikhalev, T.A. Petropavlovskaya e al. // Materials of the X All-Russian Congress of Neurology with international participation. Nizhny Novgorod, 2012. P. 427.
2.Bondarenko L.A., Penina G.O. Epidemiology, clinical and functional characteristics and quality of life of patients with myasthenia of North European population. // International Neurological Journal. Original research. 2009. №1. P.71-75.
3.Likhachev S.A., Kulikova S.L., Ostapenko A.V. Epidemiology of myasthenia in Belarus // Journal of Neurology and Psychiatry. 2014. №1. P.54-57.
4.Neretin V.J., Agafonov B.V., Fedorov O.P., Kildushevsky A.V. Causes and treatment of myasthenia gravis. M.: Medicine. 2009.
5.Ponomareva E.N. Myasthenia gravis: Clinic, pathogenesis, differential diagnosis, management tactics. Minsk: MET. 2002.
6.Romanova T.V. Ways of optimization of diagnostic and medical care of patients with myasthenia gravis (analysis of the experience of the regional myasthenic center). Neurology. 2012. № 2. P.92-95.
DOI: 10.22448/AMJ.2016.15-16.62-64
UDC 614.1-618.19-006.6; 616.055.2-614.1
THE INCIDENCE OF BREAST CANCER FOR THE URBAN AND RURAL POPULATION OF THE AMUR REGION
Korobkova T.N., Pisareva L.F., Odintsova I.N.
Amur State Medical Academy, Blagoveshchensk, Russia, Tomsk Cancer Research Institute, Tomsk, Russia
Abstract Breast cancer is part of the concept of reproductive health of women. At present breast cancer is the most common tumor in women, being the leading cause of death among women of reproductive age, which is actively making irreparable contribution to the demographic situation of the country as a whole, and the region in particular. These negative trends in epidemiological indicators for breast cancer continue to be a relevant topic of search of risk factors for possible development in the subsequent effective means of prevention. It is known that there is varying incidence of rural and urban population with predominance of the latter.
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Амурский медицинский журнал №3 - 4 (15 - 16) 2016
