ON SOME CEREBROSPINAL FLUID CHANGES DURING THE ACUTE STAGE OF СEREBRAL INFARCTION

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ELECTROPHORETIC CHANGES OF PATIENTS WITH BLUNT ACUTE CRANIOCEREBRAL TRAUMA

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INDIVIDUAL PROTEINS - STUDY OF ALPHA2 MACROGLOBULIN AND ITS CHANGES IN PATIENTS WITH ACUTE CLOSED CRANIOCEREBRAL TRAUMA (ACCCT)

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GASTROINTESTINAL DISORDERS IN PATIENTS WITH ACUTE DISTURBANCE OF CEREBRAL BLOOD CIRCULATION

The authors performed parallel investigations between the nature of gastrointestinal complications and the nature and localization of vascular accidents in 40 patients hospitalized in the Division of Intensive Care of the Clinic of Neurology, Medical University, Varna, with a proved diagnosis of acute disturbance of cerebral blood circulation. The pathophysiological mechanisms leading to these complications were discussed. The data obtained were of practical value with a view to prevention and management of these complications in cases with acute cerebral circulatory disorders

COMPUTER TOMOGRAPHY IN PATIENTS WITH TRANSITORY DISORDER OF BRAIN CIRCULATION (TDBC)

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ON THE INFORMATIVE VALUE OF CEREBROSPINAL-FLUID SYNDROME IN LATERAL AND MEDIAN DISCAL HERNIA

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Monitoring of acute stroke patients with suppressed consciousness by using transcranial Doppler sonography

Introduction: Dynamic monitoring of the patients presenting with suppressed consciousness during the acute stage of stroke plays an important role in the diagnostic and therapeutic process as a whole.  Aim: The objective of the present study was to analyze the initial results from the twofold transcranial Doppler sonography application in acute stroke patients with suppressed consciousness aiming at optimizing their timely treatment.Materials and Methods: The histories of 46 patients, 21 males and 25 females, at a mean age of 75 years with acute stroke and a different degree of suppressed consciousness hospitalized during the period from January 1, 2018 to January 31, 2019 were analyzed. All the patients were examined by means of transcranial Doppler sonography. The degree of suppressed consciousness was evaluated by means of Glasgow-Liége Coma Scale.Results: Thirty-four patients presented with acute ischemic stroke and 12 ones with acute hemorrhagic one. Several accompanying cardiovascular diseases that aggravated the course of the acute cerebrovascular accident were diagnosed. Considerable differences in terms of the mean values according to the Glasgow-Liége Coma Scale were observed. The intervals of the maximal, minimal and average sonographic parameters of four cerebral arteries such as left and right middle cerebral artery and left and right vertebral artery varied within broad limits, too.   Conclusion: The application of a constellation of various neuroimaging methods in the patients with acute cerebrovascular diseases could identify essential relationships between the parameters analyzed and risk factors as well as to give assistance to the individualized therapeutic approach

FEELING OF HAPPINESS IN PATIENTS WITH MULTIPLE SCLEROSIS AND COMORBIDITY

Purpose: As the feeling of happiness in multiple sclerosis (MS) is not investigated in Bulgaria yet, we decided to reveal some essential features of this non-motor symptom in multiple sclerosis patients with and without comorbidity. Material/Methods: We examined 80 MS patients, 56 females and 24 males, at a mean age of 49 years. Forty of them presented with multiple sclerosis alone, and 40 did with multiple sclerosis and accompanying diseases. Health-related quality of life was assessed by means of Short Form-36 questionnaire and Multiple Sclerosis Quality of Life Questionnaire with 54 items. Results: We established a lower frequency of feeling of happiness reported in MS patients with comorbidity. There were statistically significant positive correlations between the health status self-assessment and MS influence upon the feeling of happiness (R=0.428; p<0.01) as well as between MS influence upon social activities and the feeling of happiness (R=0.539; p<0.01). There were statistically reliable negative correlations between depression and feeling of happiness (R=-0.591; p<0.01) as well as between health-related quality of life scores and feeling of happiness in MS patients (R=-0,565; p<0,01). There was a statistically significant difference concerning the feeling of happiness (p<0.001) between the patients with MS only and those with MS and comorbidity. Conclusion: Multiple sclerosis alone and with comorbidity exerts an unfavourable influence on individual patient’s feeling of happiness. The presence of this common non-motor symptom in MS patients needs more comprehensive research

Impact of diabetes mellitus and admission hyperglycemia on outcomes after intravenous thrombolysis in acute ischemic stroke patients

Diabetes mellitus (DM) is a major risk factor for stroke, which is associated with unfavorable outcomeafter acute ischemic stroke (AIS) and disability. The potential harmful effect of DM, and the role and importance of blood glucose(BG) at admission are currently unclear for clinical outcome after АIS. Aim of this study is to look for correlations between the presence of DM and theinitial level of BG and the clinical outcome after an intravenous thrombolysis (IVT) in patients with acute AIS.Material and methods. IVT with Astylise has been conducted to 170 patients with AIS for the period 09.2011- 09.2015, from which 20% (n = 34) are with DM, 80% without DM (n = 136). According to the values of the BG at admission they have been divided into three groups: I group- (n = 34) 8,1 mmol/l.Results With mRs (0-2) at 3 months are 60.2% of patients without DM and 40% respectively, p= 0,05(OR-1,5, 95% CI 0,91-2,49). With mRs (0-1) are 35% and 24% respectively (p= 0.196). The probability of this outcome is 1.47 times higher in those without DM (OR 1,47, 95% CI: 0,7-3,09). Mortality about the third month is 20% in patients with DM and 8.8% in those without DM, p 0.05); With mRs (0-1) are respectively 38.2%, 32.3% and 30.8% (p> 0.05). Mortality is 15.4% in the III group compared to 9.2% in the II and 8.8% in the I (p> 0.05). With mRs(3-5) are 38.4% of the III group and 26.5% in the I (p> 0.05).Conclusion. Patients with DM have significantly higher mortality and lack of favorable functional outcome at third monthcompared to those without DM, which can not be explained by the presence of ICH. The initial HG not significantly associated with unfavorable clinical outcome, but she quickly identify patients with an increased risk of such an outcome in which blood sugar levels should be closely monitored

Sexual Disturbances in Patients with Multiple sclerosis

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system that is accompanied by different concomitant diseases. We have investigated the frequency of sexual disorders as an element of individual quality of life with a questionnaire (MSQOL-54) in 80 MS patients at an average age of 42.95 ± 10.39 for the period between 2002 and 2015. Forty of them had between one and seven accompanying diseases. There were problems in both group of patients concerning specific indicators of sexual function expressed to varying degrees. Sexual disturbances further aggravate the vitality not only of MS patients, but also of those with MS and concomitant diseases and require timely diagnosis and treatment