[Current approaches to the use of robotic devices in rehabilitation complex of children with cerebral palsy]. / Sovremennye podkhody k primeneniyu robotizirovannykh ustroistv v komplekse reabilitatsii detei s tserebral'nym paralichom.

Cerebral palsy is a neurological disease that is associated with multiple motor impairments and dysfunctions in children. The effective recovery of motor activity in both the upper and lower limbs is an important condition for the patient's social independence throughout his life. Robotic systems are new devices which are becoming increasingly popular as a part of the treatment of cerebral palsy. They have become a good addition to comprehensive rehabilitation therapy, including conducted at the sanatorium-resort stage. Further research is needed to clarify and prove the extent to which these devices help in treatment of children with cerebral palsy.

[A prognosis scale for functional outcome at discharge after endovascular thrombectomy in the carotid artery territory]. / Shkala prognozirovaniya rannego funktsional'nogo iskhoda posle vnutrisosudistoi tromboembolektomii pri karotidnom ishemicheskom insul'te.

OBJECTIVE: To develop a method for early (24 hrs after intervention) prognosis of functional outcome at discharge in patients after endovascular thrombectomy (EVT) in anterior cerebral circulation based on NIHSS. MATERIAL AND METHODS: A retrospective analysis of endovascular treatment in 362 acute stroke patients (189 men, 173 women, median age 69 years) with anterior circulation large vessel occlusion was performed in the regional vascular centers of St. Petersburg. RESULTS: The original scale (S10-10) developed for prognosis of functional outcome at discharge is based on total scores on 3 patterns: NIHSS 24 hrs after EVT (10 and less - 1, greater than 10 - 2), NIHSS improvement 24 hrs (greater than 10 - 0, 1-10 - 1, 0 and less - 2), older than 78 yr - 1. According to the total score, 5 grades are determined: 1 (good, mRs 0-2 75%, mRs 3-5 25%, mRs 6 0%), 2 (favorable, mRs 0-2 66%, mRs 3-5 26%, mRs 6 8%), 3 (unfavorable, mRs 0-2 14%, mRs 3-5 68%, mRs 6 18%), 4 (unfavorable with high mortality, mRs 0-2 1%, mRs 3-5 52%, mRs 6 47%), 5 (highly negative, mRs 0-2 0%, mRs 3-5 16%, mRs 6 84%). S10-10 greater than 2 indicates unfavorable prognosis. The scale allows accurate prognosis of functional outcome at discharge (AUC 0.89; AUC 0.84 in a validation cohort) and length of in-patient staying and time to death for S10-10 greater than 2. CONCLUSION: Accurate prognosis of functional outcome at discharge can be done 24 hrs after EVT in anterior cerebral circulation based on the widely used neurological scale (NIHSS) taking into account patient age.

[Retrospective analysis of endovascular thrombectomy in anterior cerebral circulation out of 6-hours «therapeutic window¼ in regional vascular centers of Saint-Petersburg]. / Retrospektivnyi analiz rezul'tatov vnutrisosudistoi tromboembolektomii v karotidnom basseine za predelami 6-chasovogo «terapevticheskogo okna¼ v regional'nykh sosudistykh tsentrakh Sankt-Peterburga.

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.

[Specifics of spa-based rehabilitation of severe forms of spastic mobility loss of patients with cerebral palsy]. / Osobennosti sanatorno-kurortnoi reabilitatsii tiazhelykh form spasticheskikh dvigatel'nykh rasstroistv u bol'nykh detskim tserebral'nym paralichom.

AIM: To study the efficacy of the developed approach to the specialized Spa-rehabilitation of motor disorders in patients with cerebral palsy (spastic diplegia). MATERIAL AND METHODS: The study included 86 patients (45 (52,33%) women and 41 (47.67%) men), aged from 10 to 16-years, mean 13,02±2,13. All patients were divided into 2 groups depending on the method of treatment. RESULTS AND CONCLUSION: Administration of minimally invasive procedures during the course of rehabilitation can effectively restore the volume of movements in the limbs, stimulate motor development in children and form a new stereotype of walking. An analysis of the follow-up data one year after the treatment confirms the efficacy of the proposed approach to rehabilitation.

[S100B protein in the blood of children with autism spectrum disorders]. / Belok S100V v krovi detei s rasstroistvami autisticheskogo spektra.

AIM: To evaluate the plasma content of S100B protein in children with autism spectrum disorders (ASD). MATERIAL AND METHODS: Forty-five children with autism (item F84 of ICD-10), aged from 6 to 15 years, were examined. The control group (KG) consisted of 25 healthy children. The study included examination by specialists, an assessment of the severity of the disease using the Children's Rating Scale of Autism scale (CARS), evaluation of S100B in blood serum. RESULTS: The content of S100B in children with autism was significantly higher in comparison with KG. The level of S100B in children with ASD with abnormal development of brain structures (MRI) was significantly higher compared with KG and a group of children without signs of disturbance of brain structures. S100B levels were higher in children with severe ASD, and differed from controls in children with moderate ASD. CONCLUSION: The majority of children with ASD show signs of stress of neuroprotective mechanisms, and children with anomalies of brain structures have signs of hypoxia of the brain and damage of the blood-brain barrier.

[The efficacy of cellex combined with sanatorium-based rehabilitation scheme in patients with cerebral palsy]. / Vliianie sanatorno-kurortnogo lecheniia s vkliucheniem preparata tselleks na éffektivnost' reabilitatsii bol'nykh detskim tserebral'nym paralichom.

AIM: To study the efficacy of the drug cellex combined with sanatorium treatment in the rehabilitation of patients with cerebral palsy. MATERIAL AND METHODS: The study included 59 patients, mean age 17.06±0.7 years, with spastic form of cerebral palsy who were administered a course of sanatorium-spa treatment in a specialized spa-resort. All patients underwent complex clinical and neurological examinations and electroencephalography. The main group (n=23) received cellex (a course of 10 injections) in addition to traditional treatment. RESULTS AND CONCLUSION: The efficacy of treatment assessed by the level of hand functioning and cognitive abilities was higher in the main group compared to the patients of control and comparison groups. Besides, the higher academic performance and positive dynamics of EEG (higher alpha rhythm amplitudes and decreased activity of pathological rhythms) were observed.

[A complex sanatorium-resort rehabilitation of patients with cerebral palsy with spastic diplegia]. / Kompleksnaia sanatorno-kurortnaia reabilitatsiia bol'nykh DTsP so spasticheskoi diplegiei.

AIM: To study an influence of combined methods of rehabilitation for recovery of motor functions in patients with cerebral palsy with spastic diplegia (CPSD). MATERIAL AND METHODS: Seventy-six patients with CPSD, aged from 14 to 19 years (mean age 18.7±4.63 years), were under observation. A comprehensive clinical and instrumental examination was conducted. Patients of the main group received a course of underwater spinal traction with the introduction of the drug cellex along with Spa treatment. Patients of the comparison group received only Spa treatment. RESULTS AND CONCLUSION: Signs of involvement of segmental structures of the nervous system in the pathological process and their role in the formation of motion pathology are established. It is shown that the inclusion of underwater traction according to the original technique and simultaneous introduction of cellex in the complex of rehabilitation measures allows to achieve a pronounced positive dynamics in the form of expansion of motor capabilities of patients with cerebral palsy. There was a significant decrease in spastic muscle tone, restoration of the volume of movements in the joints, improved walking. Positive clinical dynamics was correlated with EMG data.

[The effect of cellex on regenerative processes in cerebral parenchymal hemorrhage under experimental condition]. / Izuchenie vliianiia preparata tselleks na regeneratornye protsessy v tkani golovnogo mozga pri modelirovanii parenkhimatoznogo krovoizliianiia u zhivotnykh.

AIM: To study an effect of the protein-peptide preparation cellex on the cerebral tissue processes in case of parenchymal hemorrhage breed under experimental conditions. MATERIAL AND METHODS: The research involved the morphological examination of fragments of cerebral tissues of 57 rabbits of Chinchilla breed in artificially-provoked hemorrhagic stroke. Animals were divided into 2 groups: the first group received cellex once a day during 10 days, the second group received physiological solution in the same doses. The cerebral tissue was examined macroscopically and with histological, immunocytochemical and morphometric methods with subsequent data analysis. RESULTS AND CONCLUSION: A much more pronounced regression of the neurological deficit was observed in the group of animals which were administered cellex. There was a significant increase in volume of active movements in the limbs. No connective tissue changes were observed macroscopically in rabbits of the first group. Besides, the area of destruction decreased in size in comparison with initially diagnosed one. A decline in the rate of the formation of connective tissue was observed in damaged parts of the brain. The microscopic study of the first group showed that the degree of inflammatory and hemodynamic disturbances was much lower and necrosis foci were not detected, however small foci of neoangiogenesis were found.

[Growth factors and neurotrophic control in the 'motoneuron - muscular fiber' system in children with cerebral palsy]. / Rol' rostovykh faktorov i neirotroficheskogo kontrolia v sisteme 'motoneiron-myshechnoe volokno' pri detskom tserebral'nom paraliche.

The article deals with the role of neurotrophic and growth factors in the development and functioning of the nervous system. The authors present general information on neurotrophic control and its role in the interaction of motor neurons and innervated muscle fibers.

[Outcomes of endovascular thrombectomy for acute stroke in regional vascular centers of a metropolis (St.-Petersburg)]. / Rezul'taty lecheniia ishemicheskogo insul'ta s primeneniem vnutrisosudistoi tromboémboléktomii v usloviiakh regional'nykh sosudistykh tsentrov v megapolise (Sankt-Peterburg).

AIM: To assess technical results and close functional outcomes of acute ischemic stroke (AIS) in patients treated with endovascular thrombecomy (ET) in regional vascular centers (RVC) of St-Petersburg. MATERIAL AND METHODS: Retrospective analysis of 183 patients with AIS, including 143 patients with AIS due to a large intracranial vessel occlusion in anterior (AC) and 25 patients in posterior cerebral (PC) circulation, 15 with isolated extracranial carotid occlusion treated in 6 RVC in 2017 was performed. All patients underwent ET. RESULTS AND CONCLUSION: Effective reperfusion (mTICI 2b-3) was achieved in 71.5% (71.3% AC, 72% PC). On discharge, 35,7% patients had good (mRs 0-2) functional outcome (37.1% AC, 28% PC). The incidence of symptomatic intracranial hemorrhage (according to ECASS II criteria) was 10.7% (9.1% AC, 20% PC), the mortality was 29.2% (22.4% AC, 68% PC).). The results of our study show the possibility of effective and safe application of ET in patients with AIS in the anterior and posterior cerebral circulation in regional vascular centers of St.-Petersburg.

[Roentgenomorphological features of coronary artery lesions and coronary shunts in patients with relapse of myocardium ischemia after coronary bypass surgery].

The relapse of ischemia was detected in 127 patients in clinical series after coronary bypass surgery. It was noted in terms from 1 month till 204 months. The basic clinical manifestation or the relapse of ischemia was the recurrence of heart stroke in 74.8%. According to the data of coronary bypass angiography, the main cause of the ischemia relapse appears to be the dysfunction of early formed shunts in 64.6% patients. The development of early thrombosis of autografts is substantially determined by the pool and degree of stenosis of shunt coronary arteries.