scholarly journals The experience of application of prolonged craniopuncture in acute period of ischemic stroke

2020 ◽  
Vol 17 (3) ◽  
pp. 153-156
Author(s):  
Elena Evgenievna Molchanova
Keyword(s):  
Ischemic Stroke ◽  
Neurological Deficit ◽  
Classical Method ◽  
Main Group ◽  
Fear Of Failure ◽  
Control Group ◽  
Acute Period ◽  
Test Motivation ◽  
Level Of Motivation ◽  
Failure Monitoring

The purpose of this research was to study the effect of prolonged craniopuncture on the rate of regression of the neurological deficit, the degree of adaptation to daily life, and the level of motivation among patients in the acute period of ischemic stroke. All patients (60 people) were divided into 2 groups, identical by sex, age and severity of the stroke. In the main group of patients (n=30) prolonged scalp therapy was performed simultaneously with classical acupuncture. The peculiarity of this modification of craniopuncture is the use of seven main areas of the scalp with their symmetrical stimulation and duration of exposure for up to 4 hours. Patients of the control group (n=30) underwent acupuncture in combination with scalp therapy according to the classical method. Assessment of the severity of neurological deficit was carried out on the scale NIHSS, while Barthel ADL index was used to assess the patient's daily live activities after stroke. The level of motivation among the patients was studied by using the questionnaire test Motivation for Success and Motivation for Fear of Failure. Monitoring was carried out on the 1st and 15th day from the start of treatment. In the main group of patients, the reduction in the severity of the neurological deficit occurred on the 15th day according to the data NIHSS scale was 5.0 (64,9%), the Barthel index increased by 31.0 points (55,1%). In the control group, similar indicators were 3.5 (50,7%) (on the NIHSS scale) and 23.5 points (40,5%) (Barthel's index). Both groups of patients experienced an increase in the level of motivation and were already oriented to success, but in the main group, these changes appeared to be more significant. Thus, the use of prolonged craniopuncture significantly accelerates the restoration of lost functions and the adaptation of patients to everyday life, in comparison with the classical method of scalp therapy, and has a beneficial effect on increasing the level of patients motivation.

scholarly journals Experience of Using Amantadine Sulfate (PK-Merz) in Patients with Ischemic Stroke

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
Viktoria Anatoliivna Gryb ◽  
Ivan Ivanovych Titov ◽  
Galyna Stepanivna Chmyr ◽  
Galyna Ivanivna Khlibeychuk
Keyword(s):  
Ischemic Stroke ◽  
Combination Treatment ◽  
Neurological Deficit ◽  
Conventional Therapy ◽  
Main Group ◽  
Control Group ◽  
Dopamine Concentration ◽  
Significant Regression ◽  
Recovery Of Consciousness ◽  
Amantadine Sulfate

The article presents the results of combination treatment of patients with acute ischemic stroke (the NIH Stroke Scale – 12.04±0.57). The efficacy of conventional therapy (the control group) was compared with treatment regimen using amantadine sulfate (PK-Merz) (the main group). In patients undergoing combination treatment lost functions were restored quite promptly and 2 months after the observation their functional state was satisfactory (the NIH Stroke Scale: the main group – 2.49±0.78, the control group – 5.53±0.69, p=0.009); moreover, the subscale “language” differed significantly from that in patients receiving basic therapy only (р<0.05). Due to the blockade of NMDA receptors, which contributes to the reduction in the intensity of the “excitotoxicity cascade” preserving the penumbral area as well as due to the increase in dopamine concentration both by increasing the release and blocking the re-uptake in presynaptic nerve cells, the use of amantadine sulfate is a pathogenetically justified means of cerebroprotection in the acute phase of ischemic stroke. The use of PK-Merz is proven to contribute to rapid recovery of consciousness, significant regression of neurological deficit resulting in disability reduction.

scholarly journals The role of neurotrophic proteins as prognostic markers of neurological, functional and cognitive impairments in the acute period of cerebral infarction in patients with sleep apnea

2021 ◽  
Vol 24 (3) ◽  
pp. 14-21
Author(s):  
Ekaterina V. Serebrova ◽  
Natalia N. Usova
Keyword(s):  
Sleep Apnea ◽  
Cerebral Infarction ◽  
Functional Outcome ◽  
Neurological Deficit ◽  
Prognostic Markers ◽  
Comparison Group ◽  
Cognitive Impairments ◽  
Main Group ◽  
Control Group ◽  
Acute Period

The objective: to evaluate the diagnostic efficacy of neurotrophic proteins BDNF, NGF, NT3 as prognostic markers of neurological, functional and cognitive impairments in the acute period of cerebral infarction in patients with and without sleep apnea. Materials and methods. 52 patients were examined in the first 72 hours from the onset of cerebral infarction (CI). The survey included an assessment on the NIHSS, mRs and MOSA scales (in the first 72 hours and after a month); study of the concentration of proteins BDNF, NGF, NT3 in plasma by enzyme immunoassay and respiratory polygraphy. The patients were divided into the main group (32 patients with sleep apnea (SA)) and the comparison group (20 patients without SA). The control group consisted of 32 patients without CI and SA. Results. In patients of main group at the end of the acute period of CI threshold concentrations of BDNF ≤1605.2 pg/ml (AUC - 80%), NGF ≤697.37 pg/ml (AUC - 78%) and NT3 ≤400.7 pg/ml (AUC - 70%) were established as effective prognostic markers of an unfavorable functional outcome (MRs≥3); BDNF ≤1994.8 pg/ml (AUC - 75%) - of severe neurological deficit (NIHSS> 4); BDNF ≤1724.7 pg/ml (AUC - 76%) and NGF ≤858.55 pg/ml (AUC - 73%) - of the presence of cognitive impairments (MOCA <26). In patients of the comparison group the threshold concentration of BDNF protein ≤1189.6 pg/ml was established as an effective prognostic marker of unfavorable functional outcome (AUC - 85%) and severe neurological deficit (AUC - 80%). Conclusion. Neurotrophic proteins have good indicators of diagnostic accuracy as prognostic markers of neurological, functional, and cognitive impairments at the end of the acute period of CI in patients with and without SA.

scholarly journals ANTIOXIDANT STATUS IN VARIOUS PATHOGENIC SUBTYPES OF ISCHEMIC STROKE IN ACUTE PERIOD

2016 ◽  
Vol 1 (6) ◽  
pp. 76-81
Author(s):  
Лукьянова ◽  
Yuliya Lukyanova
Keyword(s):  
Ascorbic Acid ◽  
Ischemic Stroke ◽  
Antioxidant Capacity ◽  
Antioxidant Status ◽  
Control Group ◽  
Blood Levels ◽  
Cell Recovery ◽  
Stroke Subtype ◽  
Acute Period ◽  
Group 5

The aim of the study was to detect significant biochemical changes in antioxidant status during acute period of ischemic stroke in its various pathogenic subtypes in patients aged 45–74years. The most important results were blood levels of ascorbic acid, malondialdehyde and free/ oxidized glutathione ratio. Cardioembolic stroke was associated with: the reduced ascorbic acid level of 62–74% comparable to control group; 5-times increased malondialdehyde level at the end of the first week of the disease; and also 50% decreasing of cell antioxidant capacity comparable to control group and other stroke subtypes. In lacunary stroke minimal changes in antioxidant status were measured, possibly because of small size of brain damage. Positive clinical dynamics was followed by decreasing of free glutathione levels. It could be related with its previous significant expenditure in process of cell recovery in penumbra area. In case of favorable outcome all of the markers return to the levels which were comparable to control group. The differences in the dynam-ics of the cells antioxidant capacity and consumption of native antioxidants, the time from the onset of the disease, the severity of the clinical picture, depending on the stroke subtype, were revealed. Further research of this problem may help to create new methods of diagnostics and selective pharmacological correction of this pathology.

Influence of insulin resistance on the course of ischemic stroke in the acute period

2020 ◽  
Vol 18 (5) ◽  
pp. 93-98
Author(s):  
L. B. NOVIKOVA ◽  
◽  
G. I. IZHBULDINA ◽  
Keyword(s):  
Insulin Resistance ◽  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Carbohydrate Metabolism ◽  
Neurological Deficit ◽  
Glucose Metabolism Disorders ◽  
C Peptide ◽  
Acute Period

Among the reasons that increase the risk of stroke, its severity and outcome, a special place is given to disorders of carbohydrate metabolism. However, to date, there is no consensus on the role of hyperglycemia in stroke, whether it is physiological or pathological. The purpose to study the effect of insulin resistance on the course and clinical outcome of ischemic stroke (IS) in the acute period. Material and methods. A total of 862 patients with IS (370 men, 492 women), mean age was 66,1 ± 10,8 years. The degree of neurological deficit (NIHSS scale) and clinical outcome were assessed. When admitted to hospital, the level of glycemia, insulin, and C-peptide in the fasting blood were found. Results. In 186 (21,6%) patients type 2 diabetes mellitus (DM) was diagnosed. In 27,8% of patients without DM and 76,3% of patients with DM hyperglycemia was detected. In patients without DM with hyperglycemia, compared with patients with normoglycemia, a higher representation of severe neurological deficit (by 14,7%), a lower frequency of noticeable positive dynamics (by 14,8%), and a higher mortality rate (by 11,5%) were found. In patients with DM, hyperglycemia was associated with a lower incidence of noticeable positive dynamics (by 27,7%). The development of IS is accompanied by an increase in the blood level of C-peptide more than twice. High values of the C-peptide/insulin ratio are associated with a higher frequency of severe neurological deficit in patients with DM (by 32,4%) and without DM (by 23,8%), and a decrease in the incidence of noticeable positive dynamics (by 23,5% and 20,9%, respectively). Conclusion. Development of IS is characterized by high representation of disorders of carbohydrate metabolism. The severity of glucose metabolism disorders is interrelated with the severity and clinical outcome of the disease.

scholarly journals THE IMPORTANCE OF CENTRAL CHOLINERGIC SYSTEMS ACTIVATION IN TRAUMATIC BRAIN INJURY

2020 ◽  
Vol 16 (3) ◽  
pp. 3-8
Author(s):  
S.V. Ziablitsev ◽  
S.O. Khudoley
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Neurological Deficit ◽  
Physiological Saline ◽  
Neurological Deficits ◽  
Control Group ◽  
Post Traumatic Stress ◽  
Acute Period ◽  
Cholinergic Systems ◽  
Release Of Acetylcholine

Relevance. It is known that in traumatic brain injury (TBI), the activity of the central cholinergic systems (CChS) is inhibited, the release of acetylcholine and the expression of cholinergic receptors decrease. The restoration of cholinoreactivity is an urgent area of research and a possible therapeutic direction. Objective – to determine the effect of CChS activation on mortality, neurological disorders, and the activity of the pituitary-corticoadrenal system (PCAS) in the acute period of TBI. Material and methods. TBI was simulated with a free load’s fall on a fixed animal head. To activate the CChS, rats were injected with choline alfoscerate (gliatilin, 6 mg/kg) before the injury, physiological saline was injected in the control group. Neurological deficits were assessed using the 100-point Todd scale. In blood plasma, 3, 24, 48, and 72 hours after injury, the content of adrenocorticotropic hormone and corticosterone was determined by the enzyme immunoassay method (DSL; USA). The results were statistically processed using the SPSS 11.0, MedStat, MedCalc software. Results. Mortality in the control group was 25.0%, in the group with activation of the CChS there were no lethal cases (p<0.05). The neurological deficit in the group with CChS activation was significantly less pronounced compared to the control at all periods of observation. The hormone content had a similar dynamics: it reached a maximum after 24 hours and recovered after 72 hours, however, upon activation of the CChS, the increase was 1.4-1.5 times less (p<0.05). Thus, the use of choline alfoscerate for modeling the CChS activity led to a decrease in mortality and neurological deficit in the acute period of TBI, which was accompanied by a stabilizing PCAS function. Conclusion. The important role of CChS in the implementation of post-traumatic stress reaction of PCAS, as well as the possibility of its pharmacological correction with choline alfoscerate, was established.

scholarly journals COMPARISON OF THE DYNAMIC CHANGES OF AMINO ACID BLOOD PLASMA SPECTRUM IN PATIENTS WITH THE PRIMARY CEREBRAL ISCHEMIC STROKE DEPENDING ON THE POSTAPOPLECTIC SPASTICITY DEVELOPMENT IN THE RECOVERY PERIOD

2016 ◽  
Vol 3 ◽  
pp. 17-23
Author(s):  
Anzhelika Payenok ◽  
Maria Bilobryn ◽  
Iryna Mitelman
Keyword(s):  
Ischemic Stroke ◽  
Blood Plasma ◽  
Recovery Period ◽  
Control Group ◽  
Cerebral Stroke ◽  
Early Recovery ◽  
Dynamic Changes ◽  
Acute Period ◽  
Cerebral Ischemic Stroke ◽  
Cerebral Ischemic

The aim of research was to reveal the dynamic changes of the level of excitatory and inhibitory neuroamino acids in patients with the primary cerebral ischemic stroke depending on postapoplectic spasticity presence at the end of the early recovery period. For this aim was studied the concentration of excitatory and inhibitory neuroamino acids in the blood plasma in first 72 hours in 97 patients with the primary ischemic cerebral stroke depending on postapoplectic spasticity on the sixth month after ischemic event. The control group included 15 patients with diagnosed chronic cerebral ischemia. In the result of research we revealed that the common sign for the two groups (with spasticity on the sixth month and without it) was the reliable rise of the level of excitatory amino acids comparing with the control. In patients without spasticity the heightened level of excitatory neurotransmitters in the most acute period of ischemic cerebral stroke was attended with the heightened level of inhibitory neuroamino acids. The distinctive feature of patients with postapoplectic spasticity was the decreased or stable level of transmitters of inhibitory action. During 6th moth after ischemic stroke was detected the rise of all studied neuroamino acids in patients with spasticity unlike to the ones without spasticity who were characterized only with the rise of taurine level and decrease of glycine and aspartate levels. So, the received results allow assume the insufficient activation of the inhibitory neuroamino acids system in the most acute period of the ischemic stroke in certain category of patients that in future are inclined to the spasticity development after stroke.

scholarly journals EFFICACY OF USING VIRTUAL REALITY IN POST-STROKE UPPER LIMB PARESIS

2018 ◽  
Vol 35 (1) ◽  
pp. 60-67 ◽  
Author(s):  
M V Dolganov ◽  
M I Karpova
Keyword(s):  
Virtual Reality ◽  
Upper Limb ◽  
Standard Therapy ◽  
Main Group ◽  
Control Group ◽  
Limb Function ◽  
Acute Period ◽  
Training Course ◽  
Assessment Scores ◽  
Upper Limb Function

Aim. To estimate the efficacy of using training by means of virtual reality in restoration of the upper limb function in patients during the acute period of stroke. Materials and methods. 48 patients in the acute period of stroke (average time from the onset of stroke 4.5 ± 1.3 days, mean age 67 (45; 72.1) years were randomized into 2 groups: the main group (standard therapy + virtual reality) and the control (standard therapy alone). Patients of the main group underwent a course of virtual reality training, lasting for 15 minutes, twice a day for 10 days. The functional status before the onset of training course and after it was evaluated using Fugl-Meyer Assessment Scores (FMA), Motor Assessment Scale (MAS), Ashworth Scale, Modified Barthel Index Score (MBI), Action Research Arm Test (ARAT), 9-Hole Peg Test, Rankin Scale, Function Independence Measure (FIM) and dynamometry. Results. When assessing FMA of “upper limb” ( p = 0.029), “wrist” ( p = 0.04), “hand speed” ( p = 0.02); MAS ( p = 0.042), 9-Hole Peg Test ( p = 0.028), paretic hand dynamometry ( p = 0.03) and FIM ( p = 0.045), patients of the main group demonstrated statistically significant improvement versus the control group. Conclusions. The results detected that inclusion of a short training course, using virtual reality, improves the upper limb function in patients during the acute period of stroke.

scholarly journals Risk of Cardiovascular Complications in Patients with Persistent Atrial Fibrillation after Dissolution of a Thrombus in the Left Atrial Appendage

Kardiologiia ◽  
2021 ◽  
Vol 61 (5) ◽  
pp. 17-22
Author(s):  
E. S. Mazur ◽  
V. V. Mazur ◽  
N. D. Bazhenov ◽  
Yu. A. Orlov
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Persistent Atrial Fibrillation ◽  
Cardiovascular Complications ◽  
Main Group ◽  
Atrial Appendage ◽  
Control Group

Aim      To compare the incidence of cardiovascular complications (CVC) in patients with persistent atrial fibrillation (AF) following thrombus dissolution in the left atrial appendage (LAA) and in patients with persistent AF without preceding LAA thrombosis.Material and methods  The main group included 43 patients who had been diagnosed with LAA thrombosis on the first examination, transesophageal echocardiography, and who showed dissolution of the thrombus on a repeated study performed after 7.1+2.0 weeks of the anticoagulant treatment. The control group consisted of 123 patients with a risk score >0 for men without LAA thrombosis and score >1 for women without LAA thrombosis according to the CHA2DS2‑VASc scale. The patients were followed up for 47.3±17.9 months. The following unfavorable outcomes were recorded: all-cause mortality, ischemic stroke or systemic thromboembolism, hemorrhagic stroke or severe bleeding, and myocardial infarction (MI).Results Unfavorable clinical outcomes were observed in 39.5 % of patients in the main group and in 3.3 % of patients in the control group (p<0.001). Furthermore, the incidence of ischemic stroke (relative risk (RR), 12.9; 95 % confidence interval (CI), 2.89–57.2), and MI (RR, 5.72; 95 % CI, 1.09–30.1) was higher in the main group. However, the number of MI cases in both groups and the number of stroke cases in the control group increased during the entire follow-up period, while the number of stroke cases rapidly increased only during the first year of follow-up.Conclusion      In patients with persistent AF, the risk of CVC after LAA thrombus dissolution remains significantly higher than in patients with AF without LAA thrombosis.

scholarly journals Comparative Characterization of Candidate Molecular Markers in Ischemic and Hemorrhagic Stroke

2021 ◽  
Vol 17 (5) ◽  
pp. 23-34
Author(s):  
A. M. Golubev ◽  
A. V. Grechko ◽  
V. E. Zakharchenko ◽  
M. M. Kanarsky ◽  
M. V. Petrova ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Molecular Markers ◽  
Neurotrophic Factor ◽  
Hemorrhagic Stroke ◽  
Recovery Period ◽  
Control Group ◽  
Early Recovery ◽  
Acute Period ◽  
S 100 ◽  
Early Recovery Period

According to epidemiological studies, the leading cause of morbidity, disability and mortality are cerebrovascular diseases, in particular ischemic and hemorrhagic strokes. In recent years considerable attention has been given to the study of molecular markers of ischemic and hemorrhagic strokes. These studies are relevant because brain-specific protein biomarkers of neurons and glial cells can provide valuable and timely diagnostic information necessary for clinical decision-making.The aim of the study was to reveal the differences in the serum level of molecular markers in acute, subacute and early recovery periods of ischemic and hemorrhagic strokes.Material and methods. The study included 59 patients. Twenty patients were diagnosed with hemorrhagic stroke and 39 had ischemic stroke. The control group included 20 volunteers. Serum levels of molecular CNS markers were determined in acute, subacute, and early recovery stages of stroke. The serum levels of CNS molecular markers of patients with ischemic and hemorrhagic stroke was measured quantitatively by enzyme immunoassay. Statistical analysis was performed by nonparametric Mann-Whitney method.Results. The level of brain-derived neurotrophic factor (BDNF) in the control volunteers was 574.5 [455.5; 615] pg/ml. Significant differences were found for acute and subacute periods of hemorrhagic stroke: it was 674 [560; 749] pg/ml (P=0.003) and 664 [616; 762] pg/ml (P=0.0001).The level of neuron-specific enolase was significantly increased in all periods of the study: it was 4.15 [3.53; 4.8] ng/ml in the control group, 5.4 [4.4; 6.4] ng/ml in acute period of ischemic stroke (P<0.001), 5.4 [4.4; 6.4] ng/ml in early recovery period of ischemic stroke (P=0.001), 5.1 [4.6; 6.4] ng/ml in acute period of hemorrhagic stroke (P=0.014), 664 [616; 762] ng/ml in subacute period of hemorrhagic stroke (P=0.003).In the control group, the serum S-100 protein level was 4.5 [3.8; 5.4] ng/ml. In the acute and early recovery periods of ischemic stroke, S-100 protein level has significantly fallen down to 4.1 [3.4; 4.6] ng/ml (P<0.031) and 3.9 [3.4; 6] ng/ml (P=0.014), respectively. Glial-cell derived neurotrophic factor level was 1.98 [1.64; 2.1] ng/ml in the controls and increased up to 2.4 [2.2; 5] ng/ml (P=0.002) in the acute period and 2.4 [2.3; 2.6] ng/ml (P<0.001) in the subacute period of hemorrhagic stroke.The vascular endothelial growth factor receptor-1 (VEGFR-1) was significantly lower in the subacute period of hemorrhagic stroke: 485 [211; 945] pg/ml in the subacute period vs 903.5 [626; 1115] pg/ml in the controls (P=0.001).Conclusion. We found differences in the serum level of molecular markers in patients with ischemic and hemorrhagic strokes. In the acute period, early recovery period of ischemic stroke, and subacute period of hemorrhagic stroke, there was an increase in the serum level of neuron-specific enolase. The level of brain-derived neurotrophic factor increased significantly in the acute and subacute periods of hemorrhagic stroke. In the acute and early recovery periods of ischemic stroke, the level of S-100 protein decreased. The level of glial cell-derived neurotrophic factor increased in the acute and subacute periods of hemorrhagic stroke. In the subacute period of hemorrhagic stroke, the level of endothelial growth factor receptor-1 significantly decreased. Moreover, there was significant difference between values of this parameter in the subacute period of hemorrhagic stroke and in the early recovery period of ischemic stroke.

Preventive anti-inflammatory therapy during the acute respiratory infections in children with mild and moderate bronchial asthma

2020 ◽  
Vol 15 (6) ◽  
pp. 35-41
Author(s):  
V.A. Revyakina ◽  
◽  
I.A. Larkova ◽  
E.D. Kuvshinova ◽  
◽  
...  
Keyword(s):  
Bronchial Asthma ◽  
Respiratory Infections ◽  
Average Duration ◽  
Clinical Manifestations ◽  
Main Group ◽  
Control Group ◽  
External Respiration ◽  
Acute Respiratory Infections ◽  
Acute Period ◽  
Anti Inflammatory

Objective. To evaluate the efficacy and safety of using anti-inflammatory drugs based on ammonium glycyrrhizinate (AG) (Reglisam, CJSC “VIFITECH”, Russia) in children with BA in the acute period of ARI. Patients and methods. Under observation there were 42 children (from 6 to 10 years old) with a diagnosis of BA in the acute period of ARI (1–2 days from the beginning of clinical manifestations). Patients were randomized into the main group – 20 patients who were prescribed the drug ammonium glycyrrhizinate (Reglisam) in addition to symptomatic ARI therapy, and the control group – 22 children who were prescribed only symptomatic ARI therapy. The observation period was 14 days with 2 checkpoints (1st and 14th days), when the following parameters were evaluated: general clinical examination; asthma symptoms; PCR diagnostics of acute respiratory viral infection and influenza pathogens; external respiration and BA control test (C-ACT), administration of additional medications and development of adverse events. Results. There was a decrease in the average scores of daily and night symptoms of BA in the study group, both in dynamics and in comparison with the control group at visit 2 (p < 0.05). The average duration of ARI in the main group was 6.34 ± ± 1.15 days and was less than that in the control group of patients (10.95 ± 1.45 days) (p < 0.05). The average duration of the use of short-acting β2-agonists in the main group was 3.37 ± 1.05 days and was less in comparison with the control group (6.75 ± 1.6) (p < 0.05). On the 14th day of observation in the main group, the median of C-ACT parameters increased and corresponded to good control of BA, and the level of blood eosinophils decreased to normal values; in the control group, no such dynamics was found. In 78% of patients in the main group, on the 14th day of observation, the persistence of previously detected respiratory viruses and influenza was not determined, the proportion of such patients in the control group was more than 2 times less. Conclusion. The data obtained indicate the feasibility and effectiveness of the inclusion of the drug AG as a preventive therapy for children with asthma in the acute period of ARI to improve control over the course of the disease. Key words: bronchial asthma, children, therapy, ammonium glycyrrhizinate, acute respiratory infections

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