[Outcomes of reconstructive operations on carotid arteries in acute period of ischaemic stroke].

Analysed herein are the results of surgical treatment of 55 patients who from June 2013 to August 2014 underwent a total of 56 reconstructive operations on carotid arteries during an acute period of ischaemic stroke. The operations were performed within the terms varying from 24 hours to 18 days after the onset of first symptoms of ischaemic stroke. The neurological status was assesses by the neurologist according to the NIH Stroke Severity Scale (USA) and the Modified Rankin Scale. Prior to operation neurological deficit in 18 patients corresponded to 4 points by the Rankin Scale. Carotid endarterectomy was performed in 55 patients, of these in 24 according to the eversion technique. In 10 patients eversion carotid endarterectomy was performed in combination with ICA resection. One patient was simultaneously subjected to eversion carotid endarterectomy and carotid-subclavian shunting bypass grafting. Carotid endarterectomy with autovenous-patch plasty was performed in 11 patients. Resection of the occluded internal carotid artery with plasty of the external carotid artery was carried out in 7 patients and resection of the internal carotid artery for pathological tortuosity was carried out in 2 patients. At discharge from hospital, regression of neurological symptomatology was noted in 46 (83%) patients. Nine (20%) patients showed complete restoration of neurological deficit, two (4%) patients were found to have increased manifestations of neurological deficit. In the postoperative period two patients died: one on postoperative day 24 from augmenting respiratory and cardiac failure, the other one on day 29 from augmenting renal insufficiency followed by cardiac failure. In both cases, autopsy revealed no signs of secondary impairment of cerebral circulation. Surgical interventions on carotid arteries performed at a multimodality vascular centre during the first 18 days after the development of ischaemic stroke in the majority of cases are accompanied and followed by regression of neurological deficit, being safe concerning the development of haemorrhagic transformation.

[Distributions of polymorphisms of genes of some components of hemostasis in patients with ischemic heart disease].

We have studied structure of polymorphisms of genes of blood clotting factors II, V, VII, platelet membrane glycoprotein IIIa (GPIIIa) and enzyme methylenetetrahydrofolate reductase (MTHFR) in patients with ischemic heart disease (IHD). In this cohort of patients most prevalent are polymorphism PLAA1/A2 of GPIIIa gene and 677T/T polymorphism of MTHFR gene. Inconsistency of existing evidence on effect of R/Q genotype of FVII gene on early development of IHD and myocardial infarction (MI) is underlined, and data on the absence of protective effect of Q allele on early development of MI are presented. Activating effect of PLAA1/A2 polymorphism of GPIIIa gene and 677T/T polymorphism of MTHFR gene on morphofunctional state of platelets is proved.

[Peculiarities of gastroesophageal reflux disease course in children with diseases of the upper respiratory ways].

UNLABELLED: Data about patogenesis, clinical characteristics, diagnostics, treatment and the forecast of diseases of the upper departments of respiratory ways at children in a combination with gastroesophageal reflux disease (GRD) are presented proceed on the literature and own experience data. The purpose of ours research consisted in revealing of correlation dependence between GRD and chronic diseases of a throat at children. 77 children at the age of 5-16 years with the nonheritable cicatricial stenosis of a throat and cervical department of a trachea (n = 12), with small knots of vocal folds (n = 17), with dysphonia (n = 20) and with anticipate respiratory papillomatosis (n = 28) are surveyed. Reflux disease is diagnosed by means of the developed technique of pH-monitoring at which electrodes were established in hypopharynx, average and bottom departments of a gullet. RESULTS: at definitive rare frequency of clinical GRD signs at children with various variants of reflux disease in 74 cases (96,1%): GRD in a combination with pharyngolaryngeal a reflux (FR)---at 48 children (62,3 %), isolated FR---at 18 children (23,4 %), isolated GRD--in 8 cases (10,4 %). CONCLUSIONS: 1) correlation between chronic diseases of a throat at children and GRD is established; 2) in case of isolated FR often works protective alkalize gullet mechanism; 3) with chronic diseases of a throat it is expedient to include carrying out of daily pH-monitoring in the plan of inspection of children; 4) prospective FR participation in pathogenesis of chronic throat diseases demands carrying out of the further researches.

Modulatory effects of autologous plasma on functional activity of human immunocompetent cells.

Blast transformation of peripheral blood lymphocytes stimulated with phytohemagglutinin and concanavalin A was studied in children with pyelonephritis and glomerulonephritis. Activity of natural killer cells from children with pyelonephritis was estimated before and after treatment with 50% autologous plasma. The autologous plasma modulated blast transformation of lymphocytes and activity of natural killer cells, which depended on the stage of diseases.

[Clinico-pathogenetic substantiation of the immunocorrective treatment of pyelonephritis in infants]. / Kliniko-patogeneticheskoe obosnovanie immunokorrigiruiushchei terapii pielonefrita u detei rannego vozrasta.

The results of the treatment of 47 babies treated with the immunocorrecting drugs (t-activin, levamisole, sodium nucleinate, prodigiozan, lysozyme) together with antimicrobial remedies are described. The babies were selected from 120 patients suffering from pyelonephritis. Indications for use of the immunomodulators included the deficiency of the T component of immunity, of phagocytosis and, more rarely, of B lymphocytes, an unfavourable premorbed condition, severe lingering disease course as well as low efficacy of antibacterial therapy. Two control groups consisted of 120 patients who were not given the immunocorrecting remedies and 30 normal children of the first year of life. The immunostimulation therapy minimized the duration of the active phase of pyelonephritis, decreasing the rate of relapses and the probability that the disease may progress to a chronic course. The positive influence of the above drugs on the clinical picture of pyelonephritis enabled the duration of antibacterial therapy, the dosage and the frequency of antibiotic use to be reduced. The favourable outcome of pyelonephritis was followed by gradual normalization of the immunological parameters.

[Immunocorrective therapy of pyelonephritis in children]. / Immunokorrigiruiushchaia terapiia pielonefrita u detei.

A total of 40 children who suffered from acute or chronic pyelonephritis underwent immunological treatment with polypeptide drug tactivin. There was an evidence of clinical and laboratory improvement in 82.5 per cent of treated persons, first manifest in decreased proteinuria and normalized urinary sedimentation, and then in lower levels of bacteriuria due to the developing resistance to infectious agents. In 15 per cent of tactivin-treated children leukocyturia persisted though the disease progression was hindered. In the course of the treatment no side-effects were noted. In line with the stimulation of humoral immune response and activation of the complement system, tactivin administration evoked the competence of T-lymphocytes and potentiated the development of this link of immune system. As part of combined treatment the above preparation favourably affected the disease pathogenesis in children.