CLINICAL AND NEUROIMAGING STUDIES IN PATIENTS WITH ACUTE SPONTANEOUS INTRACEREBRAL HEMORRHAGE.

Objective: To define the prognostic value of clinical and neuroimaging parameters on the 30-th day mortality and clinical outcome after spontaneous intracerebral hemorrhage (sICH). Materials and methods: we examined 88 patients with sICH admitted to Neurology Clinic, UMHAT Pleven within 48 hours after clinical symptoms onset. Glasgow Coma Scale (GCS) score was used to assess the primary stroke severity; neurological deficit on admission was assessed by National Institute of Health Stroke Scale (NIHSS); clinical outcome at discharge was evaluated by modified Rankin Scale (mRS) and by Glasgow Outcome Scale (GOS) on the 30-th day after sICH onset. Hematoma volume was measured by the formula of Kothari: AxBxC/2 in ml. The statistical analysis was performed by SPSS 19.0 and Statgraphics plus 4.1 for Windows. Results: Initial assessment of primary stroke severity and neurological deficit by GCS и NIHSS, hematoma localization and volume were found strongly correlated with the clinical outcome on the 30-th day after the sICH onset. Age and vascular risk factors did not correlate with the clinical outcome. Male patients had better survival on the 30-th day compared with the female ones. Discussion: Neurological deficit on admission, hematoma localization and volume were found reliable predictors of the 30-th day clinical outcome that could serve for early stratification of patients and optimal choice of therapeutic approach

IL-6, D-DIMER AND HIGH-SENSITIVITY C-REACTIVE PROTEIN IN HIV INFECTION – PRELIMINARY STUDY

Combined antiretroviral therapy (cART) provides HIV-infected people life expectancy comparable with HIV-uninfected people and turns the disease into a manageable chronic condition necessitating the need for innovative inflammatory markers. Our purpose was to determine the correlation between IL-6, D-dimer and high-sensitivity C-reactive protein (hsCRP) levels among HIV-infected and the presence of chronic inflammation during general and immunological aging and drug exposure. Material and methods: Comparative prospective study was conducted at 37 HIV-positive persons from the Center for Monitoring and Treatment of HIV-positive Patients at the Clinic for Infectious Diseases, UMBAL “Dr. G. Stranski” – Pleven (target group) and 18 HIV-negative individuals from outpatient practice (control group), aged ≥18 years. Results: The median age of seropositive persons was 40 years (24÷70 years), of the control group – 51 years (29÷72 years); 78% of the target group and 61% of the controls are men. The average duration of ART is 4 years (1÷9 years). The study of specified biomarkers in the target group found increased IL-6 in 8.11% of patients (mean 3.67±1.86 pg/mL; range 1.5÷8.62; 95% CI 3.11-5.02), increased D-dimer in 8.11% (mean 0.37±0.28 µg/mL; 0.21÷1.96; 95% CI 0.3691-0.37459) and increased hsCRP in 10.81% (mean 2.10±1.99 µg/mL; 0.19÷7.0; 95% CI 1.89-2.31). In the control group IL-6 was not increased (mean 2.75±1.67 pg/mL; 1.5÷6.91), D-dimer was increased in 16.67% (mean 0.37±0.17 µg/mL; 0.09÷0.8) and increased hsCRP – in 5.56% (mean 1.76±1.75 µg/mL; 0.19÷5.66). Il-6 was significantly higher in the target group. Conclusion: The implementation of sensitive biomarkers is crucial in the general diagnostic-therapeutic approach in aging with HIV