RESUMEN
OBJECTIVE: Based on a retrospective analysis, to evaluate technical results and functional outcomes at discharge after endovascular thrombectomy (EVT) in anterior circulation out of 6-hours «therapeutic window¼ in patients with stroke. MATERIAL AND METHODS: The retrospective analysis of EVT in 594 acute stroke patients (303 male, 291 female, median age 69 years) with the anterior circulation large vessel occlusion was performed. EVT was carried out before 6 hrs in 550, later in 44 patients. Time to artery puncture was defined as a cut point. Patients were included in the study if they met the criterion for 0-6 hours «therapeutic window¼. RESULTS: No significant differences in functional outcomes at discharge assessed with the Rankin scale (mRs 0-2 29.8% and 20.5% p<0.19; mRs 3-5 38.7% and 38.6% p<0.99; mRs 6 31.5% and 40.9% p<0.2) and the rates of intracranial haemorrhage, haemorrhagic transformation and symptomatic haemorrhagic transformation (4% and 0% p<0.17; 20.9% and 29.5% p<0.49; 10.1% and 11.4% p<0.78) were observed in patients exposed to EVT before 6 hrs and later. CONCLUSION: EVT in anterior circulation stroke over 6 hrs «therapeutic window¼ based on the criterion for 0-6 hrs provides comparable functional outcomes at discharge without the increase in the frequency of intracranial haemorrhages, haemorrhagic and symptomatic haemorrhagic transformations.
Asunto(s)
Isquemia Encefálica , Procedimientos Endovasculares , Accidente Cerebrovascular , Anciano , Circulación Cerebrovascular , Femenino , Humanos , Masculino , Estudios Retrospectivos , Federación de Rusia , Trombectomía , Resultado del TratamientoRESUMEN
The prevalence of various kidney diseases in children remains high in recent decades. Adequate nutrition management can enhance the effectiveness of drug treatment, slow the frequency of relapses andprevent the progression of the disease. The article is devoted to modern approaches to diet therapy in various kidney diseases in children with the defeat of tubular and glomerular appa ratus. For the first time the therapeutic diets for children with various kidney diseases are presented. Particular attention is paid to diet therapy in nephrotic syndrome (steroid-responsive and steroid-refractory). Dietary approaches with modern formulas for enteral nutrition in cases of steroid therapy complications in children with renal insufficiency (in predialysis stage and on dialysis) are described. Differentiated nutritional approaches for patients with different types of crystalluria are separately presented.
Asunto(s)
Lesión Renal Aguda/dietoterapia , Glomerulonefritis/dietoterapia , Nefrolitiasis/dietoterapia , Síndrome Nefrótico/congénito , Necesidades Nutricionales/fisiología , Insuficiencia Renal Crónica/dietoterapia , Lesión Renal Aguda/orina , Adolescente , Niño , Preescolar , Dietoterapia/métodos , Glomerulonefritis/orina , Humanos , Lactante , Nefrolitiasis/orina , Síndrome Nefrótico/dietoterapia , Síndrome Nefrótico/orina , Diálisis Renal , Insuficiencia Renal Crónica/orinaAsunto(s)
Anticonvulsivantes/administración & dosificación , Antineoplásicos/administración & dosificación , Astrocitoma , Neoplasias Encefálicas , Epilepsia del Lóbulo Temporal , Complicaciones Neoplásicas del Embarazo , Radiocirugia/métodos , Adulto , Astrocitoma/complicaciones , Astrocitoma/diagnóstico , Astrocitoma/terapia , Neoplasias Encefálicas/complicaciones , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/terapia , Electroencefalografía/métodos , Epilepsia del Lóbulo Temporal/diagnóstico , Epilepsia del Lóbulo Temporal/etiología , Epilepsia del Lóbulo Temporal/fisiopatología , Epilepsia del Lóbulo Temporal/terapia , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Examen Neurológico/métodos , Tomografía de Emisión de Positrones/métodos , Embarazo , Complicaciones Neoplásicas del Embarazo/patología , Complicaciones Neoplásicas del Embarazo/terapia , Resultado del Embarazo , Primer Trimestre del Embarazo , Resultado del TratamientoRESUMEN
The review analyzes the major epidemiological and clinical aspects of Dengue fever, by providing the clinical examples of using its imported cases. It gives algorithms for examining patients who have come from tropical countries with the fever of unknown origin. Based on the extensive data available in the literature and international guidelines, the authors present treatment algorithms for out- and inpatients with Dengue fever. Promising studies of vaccination against Dengue fever are analyzed.
Asunto(s)
Antivirales/uso terapéutico , Dengue/etnología , Viaje , Adulto , Dengue/tratamiento farmacológico , Femenino , Humanos , Federación de Rusia/epidemiología , Tailandia/etnologíaRESUMEN
Production of NO, sVCAM-1, Et-1, FV, PAI- 1 was measured in blood sera of children with different forms of chronic glomerulonephritis. Endothelial dysfunction (ED) occurred in the active phase of the disease and persisted during remission regardless of the clinical form of glomerulonephritis. Severity of ED and involvement of its markers depended on morphological type of the disease. Production of endothelin-1 was highest in patients with sclerotic glomerulonephritis and accompanying arterial hypertension. ED caused activation of hemostasis with the prevalence of prothrombotic condition. ED contributed to the progress of glomerulonephritis acting via sclerotization and cell proliferation. Selected markers ED are shown to be of prognostic value in children with chronic glomerulonephritis.
Asunto(s)
Endotelio Vascular/fisiopatología , Glomerulonefritis/fisiopatología , Adolescente , Niño , Preescolar , Femenino , Humanos , MasculinoAsunto(s)
Acidosis Tubular Renal/complicaciones , Enfermedades Renales Quísticas/etiología , Médula Renal/patología , Acidosis Tubular Renal/diagnóstico , Niño , Ácido Cítrico/administración & dosificación , Ácido Cítrico/uso terapéutico , Diagnóstico Diferencial , Humanos , Enfermedades Renales Quísticas/diagnóstico , Enfermedades Renales Quísticas/patología , Imagen por Resonancia Magnética , Masculino , Nefrocalcinosis/diagnóstico , Nefrocalcinosis/etiología , Osteoporosis/diagnóstico por imagen , Osteoporosis/etiología , Radiografía , Bicarbonato de Sodio/administración & dosificación , Bicarbonato de Sodio/uso terapéutico , Resultado del Tratamiento , Rayos XRESUMEN
Diminution of reperfusion and re-oxygenation lesions is an important task in the treatment of patients with severe injury and blood loss. From this standpoint the influence of perforan on the condition of the oxidant-antioxidant system was studied in patients with severe combined trauma. The application of perftoran in the early post-trauma period was found to intensify the processes of lipid peroxidation and, simultaneously, to normalize the parameters of the antioxidant-protection system.
Asunto(s)
Fluorocarburos/uso terapéutico , Hemorragia/metabolismo , Peroxidación de Lípido/efectos de los fármacos , Traumatismo Múltiple/metabolismo , APACHE , Adulto , Ceruloplasmina/metabolismo , Coloides/administración & dosificación , Soluciones Cristaloides , Transfusión de Eritrocitos , Femenino , Fluorocarburos/administración & dosificación , Hemorragia/complicaciones , Hemorragia/terapia , Humanos , Infusiones Parenterales , Soluciones Isotónicas , Lactoferrina/sangre , Masculino , Malondialdehído/sangre , Traumatismo Múltiple/complicaciones , Traumatismo Múltiple/terapia , Intercambio Plasmático , Sustitutos del Plasma/administración & dosificación , Índices de Gravedad del Trauma , Resultado del TratamientoRESUMEN
Interference currents improve peroxide homeostasis of erythrocytic membranes by a stabilizing action on cytomembranes. Normalization of the biochemical processes at the cell level entails a decline of clinical symptoms of chronic pyelonephritis in children.
Asunto(s)
Terapia por Estimulación Eléctrica/métodos , Membrana Eritrocítica/metabolismo , Peroxidación de Lípido , Pielonefritis/terapia , Niño , Enfermedad Crónica , Hemólisis , Humanos , Peróxidos Lipídicos/sangre , Pielonefritis/sangreRESUMEN
AIM: To specify clinical and laboratory characteristics of minimal change disease (MCD), focal mesangioproliferative glomerulonephritis (MPGN), focal-segmental glomerulosclerosis (FSGS). MATERIAL AND METHODS: A retrospective analysis of 45 case histories of children (renal biopsy for nephrotic syndrome) has shown that morphologically 13 of them had MCD, 15--FSGS and 17--focal MPGN. Clinical, laboratory, immunofluorescent and electron microscopy findings typical for each of the morphological types were studied. RESULTS: The data obtained suggest that MCD, FSGS and focal MPGN may represent independent forms of glomerulonephritis. CONCLUSION: If a differential diagnosis by renal biopsy is difficult, information from the disease history and clinico-laboratory evidence should be used.
Asunto(s)
Glomerulonefritis Membranoproliferativa/diagnóstico , Glomeruloesclerosis Focal y Segmentaria/diagnóstico , Nefrosis Lipoidea/diagnóstico , Síndrome Nefrótico/diagnóstico , Adolescente , Niño , Preescolar , Diagnóstico Diferencial , Glomerulonefritis Membranoproliferativa/complicaciones , Glomeruloesclerosis Focal y Segmentaria/complicaciones , Humanos , Lactante , Nefrosis Lipoidea/complicaciones , Síndrome Nefrótico/complicacionesRESUMEN
Allelic and genotypic distributions of the polymorphic markers C1167T and Pro197Leu of the genes of catalase (CAT) and glutathione peroxidase (GPX1), respectively, were studied in patients with non-insulin-dependent diabetes mellitus (NIDDM) and hypertension without complications (the control group, n = 52) and with complications: myocardial infarction (MI, n = 53) or stroke (n = 50). No significant differences were found between complicated and uncomplicated patients with respect to the allelic or phenotypic distribution. Thus, there were no association between these polymorphic regions and either MI or stroke in hypertensive NIDDM patients.
Asunto(s)
Enfermedades Cardiovasculares/complicaciones , Catalasa/genética , Diabetes Mellitus Tipo 2/enzimología , Glutatión Transferasa/genética , Hipertensión/complicaciones , Polimorfismo Genético , Diabetes Mellitus Tipo 2/complicaciones , Humanos , FenotipoRESUMEN
Ceruloplasmin and laprote based on natural protein antioxidants were used in the treatment and prevention of postoperative complications in 174 patients after extensive interventions for cancer. Development of pyoseptic complications during the postoperative period is associated with activation of lipid peroxidation, decreased functional activity of the antioxidant component of detoxication, suppressed T-cellular immunity, and development of polyorgan failure in the presence of endogenous toxemia. Systemic treatment with laprote (50 pts) and ceruloplasmin (33 pts) after surgical cleansing and draining of purulent focus stimulated activation of antioxidant defense, decreased the intensity of oxidative processes, normalized the lymphocytic component of immunity, and promoted resolution of polyorgan, primarily hepatic failure. Local therapy with laprote (60 pts) promoted rapid regression of local pyoinflammatory processes. Intraoperative blood loss complicated by hemorrhagic shock had a deep impact on the oxidative/antioxidant system, which correlated with the severity of hypoxia. Addition of ceruloplasmin, a potent antioxidant, to therapy of these patients (n = 31) optimized the course of recovery by stimulating the resolution of posthypoxic polyorgan failure, recovery of the oxidant/antioxidant balance, and decreasing the incidence of postoperative pyoinflammatory complications.
Asunto(s)
Antioxidantes/uso terapéutico , Ceruloplasmina/uso terapéutico , Lactoferrina/uso terapéutico , Neoplasias/cirugía , Complicaciones Posoperatorias/prevención & control , Adulto , Anciano , Interpretación Estadística de Datos , Humanos , Peroxidación de Lípido , Linfocitos/inmunología , Persona de Mediana Edad , Insuficiencia Multiorgánica/prevención & control , Insuficiencia Multiorgánica/terapia , Neoplasias/inmunología , Complicaciones Posoperatorias/tratamiento farmacológicoRESUMEN
The use of ceruloplasmin in the intensive therapy of oncological patients has been shown to optimize the course of the rehabilitative period promoting dissipating of polyorgan failure, restoration of oxidant-antioxidant balance, reduction in the incidence of pyo-septic complications. Ceruloplasmin is found out to have an apparent detoxicating and antiinflammatory effect, it activities the bodily antioxidant defence, favors normalization of the condition of the immunity lymphocytic link.
Asunto(s)
Antioxidantes/uso terapéutico , Ceruloplasmina/uso terapéutico , Cuidados Críticos , Insuficiencia Multiorgánica/tratamiento farmacológico , Servicio de Oncología en Hospital , Resucitación , Adulto , Anciano , Humanos , Persona de Mediana Edad , Insuficiencia Multiorgánica/etiología , Insuficiencia Multiorgánica/prevención & control , Neoplasias/complicaciones , Neoplasias/tratamiento farmacológico , Rehabilitación , Resucitación/métodos , Sepsis/complicaciones , Sepsis/tratamiento farmacológicoAsunto(s)
Diabetes Mellitus Tipo 2/genética , Hipertensión/genética , Polimorfismo Genético , Sistema Renina-Angiotensina/genética , Presión Sanguínea/fisiología , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/fisiopatología , Marcadores Genéticos , Predisposición Genética a la Enfermedad , Humanos , Hipertensión/metabolismo , Hipertensión/fisiopatologíaRESUMEN
The results of the determination of the level of antitoxic antibodies (Ab) to diphtheria and tetanus toxoids in children with glomerulonephritis and pyelonephritis are presented. The influence of the form of the disease and the kind of medicinal therapy on level of specific Ab has been studied. As shown in this study, the injection of adsorbed DT toxoid with reduced antigen content leads to the formation of the protective titers of antidiphtheria and antitetanus Ab, but a lower level than after the injection of adsorbed DPT vaccine.
Asunto(s)
Vacuna contra Difteria, Tétanos y Tos Ferina/inmunología , Difteria/prevención & control , Inmunización , Enfermedades Renales/inmunología , Tétanos/prevención & control , Adolescente , Anticuerpos Antibacterianos/sangre , Especificidad de Anticuerpos , Niño , Preescolar , Clostridium tetani/inmunología , Corynebacterium diphtheriae/inmunología , Difteria/inmunología , Humanos , Inmunización/estadística & datos numéricos , Inmunización Secundaria/estadística & datos numéricos , Tétanos/inmunologíaRESUMEN
Amino acid analysis and investigation of nitrogen, calcium and phosphorus balance were done in two groups of patients with renal failure and osteodystrophy on vitamin D metabolites and analogues treatment. The results of the investigation confirm vitamin D metabolites influence on free amino acid metabolism and on nitrogen, calcium, phosphorus balance. We observed significant decreases of blood amino acids and good influence on renal osteodystrophy in patients treated with vitamin D metabolites. Vitamin D metabolites didn't influence retention, urinary and fecal excretion of endogenous nitrogen in patients with renal failure.
Asunto(s)
Calcifediol/uso terapéutico , Ácidos Grasos no Esterificados/sangre , Hidroxicolecalciferoles/uso terapéutico , Fallo Renal Crónico/metabolismo , Fallo Renal Crónico/terapia , Adolescente , Calcifediol/administración & dosificación , Calcio/metabolismo , Niño , Trastorno Mineral y Óseo Asociado a la Enfermedad Renal Crónica/sangre , Trastorno Mineral y Óseo Asociado a la Enfermedad Renal Crónica/metabolismo , Trastorno Mineral y Óseo Asociado a la Enfermedad Renal Crónica/terapia , Humanos , Hidroxicolecalciferoles/administración & dosificación , Fallo Renal Crónico/sangre , Nitrógeno/metabolismo , Fósforo/metabolismo , Factores de TiempoRESUMEN
Protease activities in serum and urine of 116 children with glomerulonephritis and 16 healthy children were tested using chromogenic peptide substrates Z-Dala_Leu-Arg-pNA and Glp-Ala-ALa-Leu-pNa. We found the dependence between activity of serine proteinases and clinical, morphological forms of primary glomerulonephritis and hypertension.
Asunto(s)
Quimotripsina/metabolismo , Glomerulonefritis/enzimología , Tripsina/metabolismo , Adolescente , Niño , Preescolar , Quimotripsina/sangre , Quimotripsina/orina , Glomerulonefritis/sangre , Glomerulonefritis/complicaciones , Humanos , Hipertensión/complicaciones , Hipertensión/enzimología , Especificidad por Sustrato , Tripsina/sangre , Tripsina/orinaRESUMEN
Amino acid analysis and investigation of nitrogen, calcium and phosphorus balance were done in two groups of the patients with renal failure and osteodystrophy on the Vitamin D metabolites and analogues treatment. The results of the investigation confirm vitamin D metabolites influence on free amino acid turnover and on nitrogen, calcium, phosphorus balance. We observed significant decreases of blood amino acids and good influence on renal osteodystrophy in patients treated with the vitamin D metabolites. Vitamin D metabolites didn't influence on the retention, urinary and fecal excretion of endogenous nitrogen in patients with renal failure.