Specifics of cerebral haemodynamics in patients with the hemispheric ischemic stroke

Ап inspection is conducted 112 patients with hemispheric ischemic stroke (IS) in age from 40 to 84 years, part on the degree of expressed of neurological deficit in obedience to the Scandinavian scale (35,7+8,1) - 1 group (54), (53,8+4,2 points) is II a group (58). The comparative analysis of neurological deficit is given, level neuron - specific enolase (NSE) in blood, hemodynamic indexes, character of atherosclerotic name-plates. We compared the hemodynamic features of carotid and vertebrobasilar region. Dependence is exposed between expressed of neurological defect, degree of damage of fabric of brain, characterized by the change of level of NSE and degree of disturbances of hemodynamic. The highest degree of severity of neurological symptoms of hemispheric IS was observed in significant concomitant carotid lesions and vertebrobasilar region extravasal compression of vertebral arteries dynamic nature, combined with little hemodynamically significant carotid stenosis predominated in patients with hemispheric IS with a lesser degree of ischemic damage and neurological deficits. Character of atherosclerotic name-plates reflected pathogenic of ischemic stroke.Проведено клиническое и ультразвуковое дуплексное обследование 112 пациентов с атеротромботическим подтипом полушарного ишемического инсульта (ИИ) в возрасте от 40 до 84 лет, разделенных по степени выраженности неврологического дефицита согласно скандинавской шкале (35,7+8,1) - 1 группа (54); (53,8+4,2 баллов) - II группа (58). У пациентов обеих групп дан сравнительный анализ неврологического дефицита, уровня нейрон - специфической енолазы (НСЕ) в крови, гемодинамических показателей, характера атеросклеротических бляшек, особенностей гемодинамики в каротидном и вертебро-базилярном бассейнах. Установлена зависимость между выраженностью неврологического дефекта, повышением уровня НСЕ и степенью нарушения гемодинамики. Наибольшая степень тяжести неврологической симптоматики полушарного ИИ наблюдалась при значимом сочетанном поражении каротидного и вертебробазилярного бассейнов, экстравазальная компрессия позвоночных артерий динамического характера в сочетании с гемодинамически значимыми (65-70%) стенозами сонных артерий преобладала у больных ИИ с меньшей степенью ишемического поражения и неврологического дефицита. Характер атеросклеротических бляшек отражал патогенез ишемического инсульта

Systematic Review of Potential Health Risks Posed by Pharmaceutical, Occupational and Consumer Exposures to Metallic and Nanoscale Aluminum, Aluminum Oxides, Aluminum Hydroxide and Its Soluble Salts

Aluminum (Al) is a ubiquitous substance encountered both naturally (as the third most abundant element) and intentionally (used in water, foods, pharmaceuticals, and vaccines); it is also present in ambient and occupational airborne particulates. Existing data underscore the importance of Al physical and chemical forms in relation to its uptake, accumulation, and systemic bioavailability. The present review represents a systematic examination of the peer-reviewed literature on the adverse health effects of Al materials published since a previous critical evaluation compiled by Krewski et al. (2007). Challenges encountered in carrying out the present review reflected the experimental use of different physical and chemical Al forms, different routes of administration, and different target organs in relation to the magnitude, frequency, and duration of exposure. Wide variations in diet can result in Al intakes that are often higher than the World Health Organization provisional tolerable weekly intake (PTWI), which is based on studies with Al citrate. Comparing daily dietary Al exposures on the basis of “total Al”assumes that gastrointestinal bioavailability for all dietary Al forms is equivalent to that for Al citrate, an approach that requires validation. Current occupational exposure limits (OELs) for identical Al substances vary as much as 15-fold. The toxicity of different Al forms depends in large measure on their physical behavior and relative solubility in water. The toxicity of soluble Al forms depends upon the delivered dose of Al+ 3 to target tissues. Trivalent Al reacts with water to produce bidentate superoxide coordination spheres [Al(O2)(H2O4)+ 2 and Al(H2O)6 + 3] that after complexation with O2•−, generate Al superoxides [Al(O2•)](H2O5)]+ 2. Semireduced AlO2• radicals deplete mitochondrial Fe and promote generation of H2O2, O2 • − and OH•. Thus, it is the Al+ 3-induced formation of oxygen radicals that accounts for the oxidative damage that leads to intrinsic apoptosis. In contrast, the toxicity of the insoluble Al oxides depends primarily on their behavior as particulates. Aluminum has been held responsible for human morbidity and mortality, but there is no consistent and convincing evidence to associate the Al found in food and drinking water at the doses and chemical forms presently consumed by people living in North America and Western Europe with increased risk for Alzheimer\u27s disease (AD). Neither is there clear evidence to show use of Al-containing underarm antiperspirants or cosmetics increases the risk of AD or breast cancer. Metallic Al, its oxides, and common Al salts have not been shown to be either genotoxic or carcinogenic. Aluminum exposures during neonatal and pediatric parenteral nutrition (PN) can impair bone mineralization and delay neurological development. Adverse effects to vaccines with Al adjuvants have occurred; however, recent controlled trials found that the immunologic response to certain vaccines with Al adjuvants was no greater, and in some cases less than, that after identical vaccination without Al adjuvants. The scientific literature on the adverse health effects of Al is extensive. Health risk assessments for Al must take into account individual co-factors (e.g., age, renal function, diet, gastric pH). Conclusions from the current review point to the need for refinement of the PTWI, reduction of Al contamination in PN solutions, justification for routine addition of Al to vaccines, and harmonization of OELs for Al substances