ROLE AND PARTICIPATION OF THE MULTIDISCIPLINARY TEAM IN PROVIDING MEDICAL CARE TO PATIENTS WITH ACUTE CEREBRAL BLOOD CIRCULATION DISORDERS AT THE LEVEL OF A MULTIDISCIPLINARY HOSPITAL

Нами изучены и проанализированы годовые отчеты инсультных центров многопрофильных стационаров города Алматы с 2018 года по 2019 год включительно. За данный период было пролечено всего 8783 пациентов. Поступившие и пролеченные случаи инсульта были распределены по возрастному признаку в 2018 году (средний возраст составил 60,5±1,17 лет %) и половому признаку (мужчины - 46,6±6,4%, женщины - 53,3±6,4%). В 2019 году по возрасту было 61,30±5,8% пациентов, а по полу - 58,4±6,1% составляли женщины, а 41,5±6,1% - мужчины, следовательно, тенденция преобладание инсульта у женщин. Мультидисциплинарная бригада на уровне стационара в полном объеме выполняет свои функциональные обязанности, своевременно диагностируя вид инсульта, определяя тяжесть пациентов, перенесенные инсульт в остром периоде. Роль и место невролога при в мультидисциплинарной бригаде огромная и неоценима. We have studied and analyzed the annual reports of stroke centers of multidisciplinary hospitals in the city of Almaty from 2018 to 2019 inclusive. During this period, a total of 8783 patients were treated. Stroke cases received and treated were distributed by age in 2018 (average age was 60.5 ± 1.17 years%) and gender (men - 46.6 ± 6.4%, women - 53.3 ± 6, 4%). In 2019, by age there were 61.30 ± 5.8% of patients, and by gender - 58.4 ± 6.1% were women, and 41.5 ± 6.1% were men, therefore, the trend is the prevalence of stroke in women. The multidisciplinary team at the hospital level fully fulfills its functional duties, diagnosing the type of stroke in a timely manner, determining the severity of patients suffering from a stroke in the acute period. The role and place of a neurologist in a multidisciplinary team is enormous and invaluable.

HEMORHEOLOGIC PROFILE AND MICROCIRCULATORY HEMOSTASIS IN PATIENTS WITH CEREBROVASCULAR DISEASE IN DIABETES MELLITUS

Diabetes mellitus is one of the most serious issues faced nowadays both by medicine and society in general, which is due to the wide spread of endocrine issues affecting nearly every country globally, the growing incidence rate, as well as the severity of complications that are hard to treat. Type 2 diabetes mellitus increases significantly the risk of developing acute cerebral blood circulation disorders, which urges further comprehensive studies focusing on the role played by the vascular-platelet relation and coagulation hemostasis in the development and progression of diabetic vascular complications. The results of our study, which involved 74 patients with acute cerebral circulation disorders against type 2 diabetes mellitus revealed alterations affecting the hemostasis system. This could be seen from activated vascular-platelet and coagulation links, decreased anticoagulant activity, and a slowdown in fibrinolysis. The severity of disorders induced by the alterations in the hemorheological profile and the microcirculatory hemostasis are associated with the duration of type 2 diabetes mellitus and the carbohydrate metabolism indicators (hyperglycemia, increased HbA1c levels and glycation end products).

CELLULAR COMPOSITION STATE AND MICROFLORA OF ORAL MUCOSAL EPITHELIUM OF PATIENTS WITH CHRONIC CEREBRAL ISCHEMIA

The cell composition and microflora of oral mucosal epithelium smearsand the hormonal composition of oral fluid in patients with chronic cerebral ischemiawere studied. We examined 54 patientsaged 45-65 years suffering from cerebral blood circulation disorders caused by atherosclerosis of cerebral vessels and under outpatient observation. In patients with chronic cerebral ischemia, a decrease in the size of the neutrophil pool and epithelial cell pool was noted in saliva smears, against the background of an increase in the number of lymphocytes (threefold) and “bare nuclei” -more than ten times, which indicates a weakening of local protection and is considered as a pathogenetically significantindicator. Smears of buccal epithelial cells revealed yeast-like fungi of the Candida genus (C.albicans), whose content reached 105CFU/ml in 61.44% of cases and averaged 82.5±6.4% of strains in CCI patients. Free progesterone increased 1.9-fold in oral fluid, whereas estradiol levels decreased 5-fold and cortisol increased 1.6-fold.Keywords: chronic cerebral ischemia, buccal cells, candidiasis, sex hormones.

The influence of CYP1A1 and CYP1A2 polymorphisms on stroke risk in the Chinese population

Backgrounds Stroke is a sudden disorder of cerebral blood circulation. Many studies have illustrated that dyslipidemia, hypertension, diabetes, smoking and excessive drinking are the traditional risk factors for stroke. This study aimed to observe the relationship between CYP1A1 and CYP1A2 variants and stroke risk in the Chinese population. Methods Agena MassARRAY Assay was used to genotype four single nucleotide polymorphisms (SNPs) in 477 cases and 480 controls. The chi-square test and logistic-regression analysis were used to explore the relationship between CYP1A1 and CYP1A2 variants and stroke risk. Results Individuals with CYP1A2 rs762551 C was associated with a lower risk of stroke than that of allele A. Age stratification analysis showed that rs762551 was only observed to be associated with a lower risk of stroke in ≤64ys age group. After gender stratification analysis, a significant association between rs762551 and stroke risk was found in males, but not in females. The four SNPs were found to be correlated with stroke risk in patients with hypertension, coronary heart disease, cerebral infarction and lacunar infarction. Conclusion In this study, the results first showed that CYP1A1 and CYP1A2 variants were associated with stroke risk. Larger and well-designed studies are needed to confirm the results.

Justification of a New Solution in the Field of Stroke Rehabilitation

This research consists in the creation of a hardware-software complex for the rehabilitation of stroke patients. The device is designed for rehabilitation of patients after acute disorders of cerebral blood circulation with severe neurotraumas. The device is based on two existing rehabilitation technologies: the method of transcranial brain stimulation with the help of a magnetic neurostimulator, and the development of hand motility with the help of gloves. The combination of these two methods will allow patients to recover effectively, even at home, after they was suffering from neurotrauma. Keywords: stroke, ischemic, rehabilitation, biofeedback, paresis, brain, computer, mechanized glove, hardware, and software complex, CNS diseases, integration, TMS, magnetic neurostimulator

Clinical neurological and neuro-orthopedic characteristics of patients with vertebral artery syndrome of extravasal genesis

The article presents the results of clinical neurological and neuro-orthopedic examination of 48 patients with symptoms of vertebrobasilar insufficiency associated with complications of osteochondrosis. The main clinical syndromes that were observed in this group of patients were highlighted, the general characteristics of cardiovascular pathology, changes in brain during MRI examination and the severity of arterial sclerotic disease during ultrasound examination of the main arteries of the head and neck was given. On the basis of neuro-orthopedic examination of the cervical spine, specifically during examination of the active and passive range of movements, functional disorders in the form of restriction of movements were defined. By means of palpation, provocative and specific tests for certain motor segments, the main etiopathogenetic mechanisms of these disorders were identified. The program of clinical treatment was based on medical history, assessment of factors in the diagnosis of heart disease, analysis of cerebral blood circulation disorders in anamnesis, as well as provocative factors, which were overwhelmed by development. Surrounding the neuro-orthopedic examination of the neuro-orthopedic examination. The withers, they swallowed respect for a volume of rugs in the sheer ridge, conducted the Glison test, provocative tests on movements segments, palpation and percussion. The main types of postural disorders in patients with vertebral artery syndrome of extravasal origin have been investigated. As a result of clinical and neuro-orthopedic comparison, a higher frequency of Barre-Lieou syndromes, vestibulo-ataxic and vestibulo-cochlear disorders in patients with round posture was found, while the syndrome of ophthalmic disorders was observed with equal frequency in patients with round (70,8%) and round-incurvate (74,0%) posture and significantly more often compared to the group of patients with normal posture (49,9%). Vestibulo-ataxic syndrome was significantly more frequent at suspicion on facet syndrome or uncovertebral arthrosis (58,8%) in comparison with the group of patients with suspicion on protrusion / herniated intervertebral disc (11,8%).