ABSTRACT
AIM: The study was aimed at developing a surgical policy for patients presenting with acute ischaemic stroke induced by lesions of the intra- and extracranial arteries. PATIENTS AND METHODS: The patients were enrolled into the study resulting from the current practice of the Department of Emergency Neurosurgery of the Research Institute of Emergency Medicine named after N.V. Sklifosovsky. Sampling of patients was carried out from 1st January, 2014 to 10th October, 2017, eventually comprising all those (n=160) operated on for verified pathology of brachiocephalic arteries and acute impairment of cerebral circulation. RESULTS: During the examination, 101 (63.1%) patients were found to have unilateral or bilateral stenosis of the internal carotid artery, 22 (10.7%) patients were diagnosed with occlusion of the internal carotid artery, and 36 (17.6%) had acute thrombosis of the internal carotid artery. All this was the cause of acute impairment of cerebral circulation. Also, 1 patient was found to have occlusion of the 1st segment of the vertebral artery. Depending on the type of the lesion to the internal carotid artery, the patients were subdivided into 3 groups: 1) patients with internal carotid artery stenosis who received carotid endarterectomy; 2) patients with occlusion of the internal carotid artery, subjected to creation of an extra-intracranial microanastomosis, and 3) those with thrombosis of the internal carotid artery, who depending on the degree of occlusion of the internal carotid artery and patency of the intracranial arteries underwent thrombintimectomy or an extra-intracranial microanastomosis. The indications for and contraindications to interventions were defined based on the existing symptomatic pathology of brachiocephalic arteries, the terms of acute impairment of cerebral circulation, perfusion of the brain, the risk for the development of malignant stroke and cerebral oedema, possible haemorrhagic transformation of the focus of ischaemia, the rehabilitational potential of the patient and the analysis of the current literature. The results of our work demonstrated that surgical treatment of patients in the cute period of ischaemic stroke makes it possible to improve the neurological outcomes in patients as compared with the preoperative status and is not accompanied by a high risk of surgical complications (with the haemorrhagic complication rate amounting to 0.6%). CONCLUSION: Surgical revascularization of the brain in the acute period of ischaemic stroke is a safe and effective method of treatment in patients with different haemodynamically significant damage of brachiocephalic arteries, once the patients were correctly selected for the operation.
Subject(s)
Brain Ischemia/etiology , Carotid Stenosis/surgery , Cerebral Revascularization/adverse effects , Endarterectomy, Carotid/adverse effects , Stroke/etiology , Brain/diagnostic imaging , Carotid Artery, Internal/surgery , HumansABSTRACT
AIM: To study function of the segmental part of the autonomic nervous system as shown by mm interossei dorsalis excitability threshold (ET) in patients with rheumatoid arthritis (RA) of different activity and under morning stiffness. MATERIAL AND METHODS: The ET was studied in 38 healthy subjects (control group) and 111 RA patients using a diagnostic electric acupuncture device "Prognosis-6". RESULTS: Mm. interossei dorsalis ET rise was registered in 84.7% RA patients. A step-by-step (4 clusters) increase in hand muscle rheobase was seen demonstrating influence of inflammation activity on muscular ET. In morning stiffness, weak current failed to register ET of the studied muscles in RA patients. CONCLUSION: The disturbed neuromuscular transmission present segmental vegetative mechanisms of morning stiffness formation in RA.
Subject(s)
Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/physiopathology , Autonomic Nervous System Diseases/complications , Autonomic Nervous System Diseases/physiopathology , Circadian Rhythm/physiology , Acupuncture Points , Autonomic Nervous System Diseases/diagnosis , Electromyography/instrumentation , Female , Hand , Humans , Male , Muscle, Skeletal/physiopathology , Severity of Illness IndexABSTRACT
It was shown that exogenous inorganic phosphate can be incorporated into newly synthesized phosphatidylinositol-4,5-bisphosphate without any participation of ATP.
Subject(s)
Phosphates/metabolism , Phosphatidylinositol 4,5-Diphosphate/biosynthesis , Retina/metabolism , Adenosine Triphosphate/metabolism , Animals , Autoradiography , CattleABSTRACT
As everybody knows, human saliva contains a huge variety of different proteins. The protein composition of the mixed saliva was found to depend to a certain extent on a psycho-emotional condition. The main elements of mechanisms of the psychophysiologic regulation of the protein composition of the mixed saliva are under discussion in the paper. A hypothesis is put forward, which envisages a possible different-type joint activity of the vegetative nervous centers controlling the saliva glands as triggered by emotions. Besides, issues related with the fundamental research as well as outlooks for using the analysis of the protein composition of the mixed saliva for the purpose of investigating the human psychophysiology and of coping with practical medical tasks are also under discussion.
Subject(s)
Catecholamines/analysis , Hydrocortisone/analysis , Monoamine Oxidase Inhibitors/analysis , Saliva , Stress, Psychological/metabolism , Stress, Psychological/physiopathology , Testosterone/analysis , Adult , Child , Electrophoresis , Humans , Saliva/chemistry , Saliva/immunology , Saliva/metabolismABSTRACT
AIM: To study types of anxious disorders (AD) in patients with rheumatoid arthritis (RA) and AD correlations with clinicolaboratory indices. MATERIAL AND METHODS: 80 RA patients and 38 healthy subjects have undergone MMPI test. RESULTS: 95% of the examinees were found to have AD which seem to form in active participation of psychoemotional factors. Development of AD was characterised by internal strain, emotional stress, anxiodepressive conditions. Psychological profiles of AD patients were analysed. No correlations were found with clinicolaboratory indices: Additional correlations exist between the MMPI scales in AD. CONCLUSION: AD in RA patients may result in vegetative dysfunctions.
Subject(s)
Anxiety Disorders/psychology , Arthritis, Rheumatoid/psychology , Adult , Anxiety Disorders/complications , Arthritis, Rheumatoid/complications , Female , Humans , MMPI , Male , Middle Aged , PersonalityABSTRACT
AIM: To study biochemical indicators of the hematosalivary barrier operation in varying activity of articular inflammation and their correlations. MATERIAL AND METHODS: Biochemical indices of mixed saliva and peripheral blood were studied in 38 healthy subjects and 99 patients with rheumatoid arthritis (RA). RESULTS: Optimal composition of the saliva was abnormal. It lost its buffer function. In RA, permeability of the hematosalivary barrier for cholesterol, calcium, phosphorus, magnesium declines with growing activity of the process with resultant lowering of their content in the saliva, their blood levels being unchanged. CONCLUSION: Decreased permeability of the hematosalivary barrier results from growing sympathetic influence on the salivary glands reflecting the presence of the autonomic dysfunction in RA. It is pathogenetically related to the process activity.
Subject(s)
Arthritis, Rheumatoid/blood , Arthritis, Rheumatoid/metabolism , Saliva/chemistry , Adult , Aged , Arthritis, Rheumatoid/physiopathology , Autonomic Nervous System/physiopathology , Calcium/analysis , Cholesterol/analysis , Female , Humans , Iron/analysis , Magnesium/analysis , Male , Middle Aged , Phosphorus/analysisABSTRACT
The paper deals with specific characteristics of pain sensitivity, types of anxiety disorders in patients with rheumatoid arthritis and their correlation.
Subject(s)
Arthritis, Rheumatoid/physiopathology , Pain Threshold/physiology , Adolescent , Adult , Anxiety Disorders/etiology , Anxiety Disorders/physiopathology , Arthritis, Rheumatoid/complications , Female , Humans , Male , Middle Aged , Pain MeasurementABSTRACT
Mixed saliva contains numerous biological molecules which participate in regulation of the functions of the major physiological systems or are products of their work. Therefore, salivary components reflect the status of body systems and can provide diagnostic information about their abnormalities.
Subject(s)
Diagnostic Techniques and Procedures , Saliva/metabolism , Biomarkers/analysis , Humans , Saliva/chemistry , Saliva/immunology , Salivary Proteins and Peptides/analysisABSTRACT
Salivary protein spectrum was studied by polyacrylamide gel electrophoresis in 80 patients with psychogenic affective disorders, 80 with rheumatic and 10 with reactive arthritis, and 9 patients with chronic renal insufficiency in the presence of depression. Control group consisted of 60 healthy subjects. The results indicate that depression is associated with decreased content of protein in different fractions of the spectrum, the most marked decrease being observed for the fraction with molecular weight of about 55 kD. The optical density of this fraction decreases to 0.11 units in depression (versus 0.17 +/- 0.02 in the control), which suggests that this method can be used for the diagnosis of depressions.