[Efficacy of cereton in acute ischemic stroke: results of the trial SOLNTSE].

We studied 95 patients with acute (no later than 24h after onset) carotid ischemic stroke. Patients of the main group (50 patients) received cereton in dose 4 ml (1000 mg) intravenously during 10 days in the combination with traditional treatment; 45 patients of the control group received only traditional treatment. Neurological deficit on NIHSS and vigilance on The Glasgow Coma Scale were assessed at baseline and in 5th, 7th and 19-21th days. The Barthel index was used to measure functional independence of the patient at the discharge from a hospital (21th day). The "cost-effectiveness" ratio, the cost of one score on the NIHSS and Barthel scales were calculated. The reduction in neurological deficit (p<0.05) and higher extent of functional independence were seen in the main group compared to the controls. Based on the "cost-effectiveness" analysis, the use of cereton was shown to be more effective for treatment of patients with acute ischemic stroke: the cost of the achievement of positive effect in patients of the control group receiving only traditional treatment was significantly higher (p<0.05).

[Autoantibodies to glial fibrillary acid protein in patients with different forms of cerebral vascular pathology].

Autoantibodies to neurospecific proteins are currently reported to play a role in the development of organic brain damage. To study a diagnostic value of concentration of autoantibodies to glial fibrillary acid protein (AAB to GFAP), the latter was determined in the blood serum of patients with different forms of cerebral vascular damage. The 1st group included 22 patients with cerebral vascular insufficiency, stage II, the 2nd - 14 patients with ischemic heart disease without sings of cerebral damage and the 3rd - 27 patients with acute ischemic carotid stroke. A control group consisted of 35 healthy volunteers. AAB to GFAP level was determined using ELISA. The maximal concentration of AAB to GFAP was found in patients with stroke (2,27+/-0,30 mkg/ml) that was significantly higher compared to the controls (0,95+/-0,03 mkg/ml, p<0,05) and the 2nd group (0,95+/-0,04 mkg/ml, p<0,05). The AAB to GFAP concentration was higher (2,98+/-0,45 mkg/ml, p<0,05) in patients with favorable outcome of stroke than in those with fatal outcome or severe debilitation (1,29+/-0,08 mkg/ml, p<0,05). The data obtained show a correlation of AAB to GFAP concentration with character and severity of cerebral vascular pathology that allows to suggest their assessment as a predictive factor.

[Patogenetic therapy of patients with diabetes mellitus type 2 and cerebral vascular insufficiency].

Effectiveness of halidor preparation was assessed in a randomized open 8-weeks study in 44 patients with diabetes mellitus type 2 and chronic cerebral blood circulation disorders. A control group included 15 patients with the same pathologies who did not receive halidor. Administration of halidor in doses 100 mg 3 times daily led to the improvement of clinical state in 32 (72,7%) patients that was confirmed by statistically better performance (p<0,05) on the neuropsychological tests: MMSE by 14,7%, clock-drawing test by 16,8%, the Schult test by 23,5%. The blood flow in middle and posterior cerebral arteries was increased by 21 and 23%, respectively (p<0,05), and the vascular tonus was reduced. The possibility of halidor administration to patients with diabetes mellitus with concomitant chronic cerebral blood circulation disorders is discussed.

[Pneumonia in patients with acute brain stroke].

One hundred and thirty-two patients, 86 men and 46 women, aged from 46 to 78 years, mean age 67 +/- 9 years, with ischemic stroke have been studied, the diagnosis confirmed using CT or section study. Pneumonia was developed in 15 (11%) of patients, its frequency was significantly higher in patients with hemorrhage stroke and brain infarction of the complex genesis as compared with other types of stroke (chi2 = 10.42, p < 0.05). Pneumonia was developed more often in patients with total infarction in the system of inner carotid artery than in patients with partial infarction in the carotid system (26.9 and 4.8%, respectively, p < 0.05) as well as in patients with consciousness and swallowing disorders in the acute period of disease. The correlation between the frequency of pneumonia and neurologic deficit has been studied. Higher mortality and disability rates were observed in the group of patients with pneumonia.

[Clinical and pathogenetical features of ischemic stroke of young age]. / Kliniko-patogeneticheskie osobennosti ishemicheskogo insul'ta v molodom vozraste.

A clinico-instrumental study of 78 young patients (mean age 41.3 +/- 4.2 years) with ischemic stroke was carried out. A prevalence of such risk factors as severe arterial hypertension, innate and acquired heart valvular disease, familial loading were characteristic of these patients, while ischemic heart disease and diabetes mellitus occurred less often. Comparing to elderly patients, no significant differences in dynamics of neurological deficit were found in young patients with ischemic stroke. The data of neuroimaging examination indicated less frequency of the signs of cerebral atrophy and leucoareosis in young patients. The results obtained confirm the presence of modifying risk factors for ischemic stroke in young patients that grounds realization of preventive measures.