ABSTRACT
Recent years have witnessed several studies concerning optimal terms of performing carotid endarterectomy after endured acute cerebral circulation disorder (ACCD). However up to now there is no common opinion regarding feasibility and safety of performing carotid endarterectomy in the acute period of ischaemic stroke. The 2013 Russian National Guidelines on surgical management of diseases of extracranial arteries point to feasibility of performing carotid endarterectomy at terms within up to 2 weeks after endured ischaemic stroke (level B evidence). At the same time, there is no data concerning possibility of performing this type of operation in patients with neurological deficit scoring 4 points according to the Rankin scale. Analysing the results of 110 carotid endarterectomies performed in patients with haemodynamically meaningful stenosis of carotid arteries at terms varying from 2 to 14 days after the development of ipsilateral ACCD showed safety of the operation (the rate of postoperative cerebral circulation disorders amounted to 0.9% - 1 patient) and its efficacy in prevention of recurrent ischaemic complications, also determining regression of neurological symptomatology in the overwhelming majority - 86 (78%) patients. Despite the absence of recommendations on possibility to perform carotid endarterectomy in patients after endured ACCD with neurological deficiency scoring 4 points according to the modified Rankin scale we proved efficiency and feasibility of performing this type of operation in the cohort of patients concerned. There was not a single case of transformation of the ischaemic focus into haemorrhagic one. One patient developed fatal ACCD. During the follow up period (12 months) regression of neurological symptomatology was observed in 16 (66.7%) patients of 24 operated patients with baseline deficit of stage 4 according to the Rankin scale.
Subject(s)
Brain Ischemia , Endarterectomy, Carotid , Postoperative Complications/prevention & control , Stroke , Aged , Brain Ischemia/complications , Brain Ischemia/diagnosis , Brain Ischemia/physiopathology , Brain Ischemia/surgery , Carotid Stenosis/complications , Carotid Stenosis/diagnosis , Carotid Stenosis/surgery , Cerebral Hemorrhage/etiology , Cerebral Hemorrhage/prevention & control , Cerebrovascular Circulation , Endarterectomy, Carotid/adverse effects , Endarterectomy, Carotid/methods , Female , Humans , Male , Middle Aged , Outcome Assessment, Health Care , Patient Acuity , Retrospective Studies , Russia , Secondary Prevention , Stroke/complications , Stroke/diagnosis , Stroke/physiopathology , Stroke/surgery , Time FactorsABSTRACT
Respiration hydrogen analyzer H2Rate has been used in pilot examinations of a group of students. This method for noninvasive diagnosis of small intestinal diseases promotes proper interpretation of the results. Free hydrogen level in the exhaled air increases as a result of lactulose (diagnostic agent) cleavage by enteric microflora within about 3 h. Based on the experimental data, the main groups with characteristic curves reflecting the time course of hydrogen concentrations have been distinguished. Excessive bacterial colonization of the intestine can correspond to emergence of characteristic peaks of hydrogen concentrations in the curve. Hydrogen concentrations in exhaled air can also be analyzed to evaluate the rate of the substrate propulsion in the middle compartment of the intestine.
Subject(s)
Hydrogen/metabolism , Intestine, Small/microbiology , Adolescent , Adult , Breath Tests , Exhalation , Humans , Lactulose/metabolism , Microbiota , Pilot Projects , Young AdultABSTRACT
The incidence of Helicobacter pylori infection is analyzed by the results of screening of first- and fourth-year students of Moscow Institute of Foreign Affairs using HelicoSense Scientific breath test system. Age-related dynamics of the infection in patients examined for the first time has been traced. The data on infection rates in patients after eradication therapy are presented.
Subject(s)
Breath Tests/methods , Helicobacter Infections/diagnosis , Helicobacter Infections/epidemiology , Helicobacter pylori , Age Factors , Electrochemical Techniques/methods , Female , Humans , Immunoassay , Incidence , Male , Prevalence , Russia/epidemiology , Young AdultABSTRACT
This clinical and laboratory study was designed to evaluate the influence of an ozone-oxygen mixture on the characteristics of blood oxygen supply in pregnant women presenting with chronic placental insufficiency. The study has demonstrate that dosed ozone application modulates the oxygen-transporting function of the blood and promotes adaptive capacities of the organism by activation of aerobic metabolism and stabilization of cellular membranes. It is concluded that the proposed method can be recommended for the treatment of women with the complicated course of pregnancy in order to improve their endurance of and resistibility to the action of hypoxemia.