Treatment of ischemic stroke caused by dissection and occlusion of internal carotid artery in a young patient

The type and etiology of stroke in young patients are known to differ from those in elderly patients, that influences the diagnosis and treatment. Dissection of cerebral arteries holds the top position in the structure of the causes of ischemic stroke in children and young people below 45 years. Currently no clear guideline on the proper treatment of this pathology exists. The article presents the case of acute ischemic stroke in a young patient (the stroke was caused by the occlusion due to dissection of the internal carotid artery) successfully treated with radiosurgical method - stenting of the cervical part of the artery with the transition to petrous segment of the left carotid artery using combined proximal and distal protection of cerebral vessels. The control of patient's state and results of angiography and ultrasound demonstrate the favourable immediate and medium-term prognosis for the patient

Clinical use of various endovascular stenting techniques in challenging coronary interventions

Aim. Development of an algorithm of actions for stenting of artery stenosis during challenging percutaneous coronary interventions (PCI) based on the analysis of the results of different endovascular techniques. Methods. We analyzed the experience of the department of radiologic endovascular diagnosis and treatment of Stavropol regional clinical hospital for endovascular surgical treatment of atherosclerosis of coronary arteries. The study included 317 cases of coronary interventions with technically impossible stent delivery to stenosis by standard method along the front-line guidewire and standard choice of the guide in case of distal TIMI 3 flow. For the study the patients were divided into 3 groups comparable by the number of subjects: 104, 113 and 100 respectively. For each group we determined different stages of enhancing support with consistent step-wise transition. The groups differed by the used methods of enhancing support and consistency of their use. Among other methods of support group 2 included the method of guide change and delivery of the second guidewire of enhanced support. At the same time groups 1 and 3 used these methods separately. Results. The smallest number of unsuccessful interventions was observed in group 2 compared to those of groups 1 and 3. The relative risk indicators also demonstrate the high effectiveness of tactics used in the group 2. Conclusion. The most preferable method for the necessary support when stent delivery distal to stenosis is impossible, is a choice of optimal guide and use of the second guidewire of enhanced support

Dilation of the Infarct-Related Coronary Artery to Reduce the Incidence of the No-Reflow Phenomenon in STEMI Patients

Background: The pathogenesis of slow/no-reflow phenomena is a critical socio-medical problem due to high mortality and work disability rates in patients with ST-segment elevation myocardial infarction (STEMI). Slow/no-reflow phenomena are multifactorial involving 4 key elements: 1) distal embolization of the coronary bed of the infarct-related coronary artery; 2) ischemic damage to the myocardium; 3) reperfusion injury of the heart muscle; 4) individual (genetic) susceptibility of the microcirculation to injury.   Objective: To analyze the outcomes of percutaneous coronary interventions (PCI) in patients with STEMI and TIMI 0 blood flow of an infarct-related coronary artery based on the strategy to restore antegrade blood flow (balloon predilation or dilation of an infarctrelated artery).   Materials and methods: We analyzed treatment outcomes of 209 patients with STEMI and TIMI 0 blood flow. The patients were grouped based on the PCI strategy: group 1 included 147 patients who underwent balloon angioplasty to restore antegrade blood flow, and group 2 included 62 patients who underwent dilation of an infarct-related coronary artery.   Results: Our study found that direct stenting in STEMI patients was associated with statistically significantly lower risk of slow/noreflow phenomena (P = 0.001, Pearson’s χ2) and, as a result, better functional outcomes of treatment (chronic heart failure grade classified according to Strazhesko-Vasilenko and by left ventricular ejection fraction) that were also statistically significant (P = 0.001, Pearson’s χ2).   Conclusions: Our study demonstrated that the risk of slow/no-reflow phenomena in patients with TIMI 0 blood flow of an infarctrelated coronary artery was statistically significantly lower (P = .001, Pearson’s χ2) in the group of patients who underwent dilation of an infarct-related coronary artery to restore antegrade blood flow. Functional outcomes (chronic heart failure grade and overall survival) were also better in this group of patients (P = .001, Pearson’s Chi-square). Moreover, dilation of an infarct-related coronary artery was associated with preserved left ventricular ejection fraction compared with the group of patients who underwent balloon angioplasty to restore antegrade blood flow (P < 0.001, Pearson’s χ2)

The charge-assisted hydrogen-bonded organic framework (CAHOF) self-assembled from the conjugated acid of tetrakis(4-aminophenyl)methane and 2,6-naphthalenedisulfonate as a new class of recyclable Brønsted acid catalysts

The acid–base neutralization reaction of commercially available disodium 2,6-naphthalenedisulfonate (NDS, 2 equivalents) and the tetrahydrochloride salt of tetrakis(4-aminophenyl)methane (TAPM, 1 equivalent) in water gave a novel three-dimensional charge-assisted hydrogen-bonded framework (CAHOF, F-1). The framework F-1 was characterized by X-ray diffraction, TGA, elemental analysis, and 1H NMR spectroscopy. The framework was supported by hydrogen bonds between the sulfonate anions and the ammonium cations of NDS and protonated TAPM moieties, respectively. The CAHOF material functioned as a new type of catalytically active Brønsted acid in a series of reactions, including the ring opening of epoxides by water and alcohols. A Diels–Alder reaction between cyclopentadiene and methyl vinyl ketone was also catalyzed by F-1 in heptane. Depending on the polarity of the solvent mixture, the CAHOF F-1 could function as a purely heterogeneous catalyst or partly dissociate, providing some dissolved F-1 as the real catalyst. In all cases, the catalyst could easily be recovered and recycled

Оценка эффективности и безопасности комбинации хондроитина сульфата и глюкозамина сульфата при остеоартрите коленного и тазобедренного суставов в реальной клинической практике

A combination of chondroitin and glucosamine is widely used in clinical practice as both a symptomatic and structure-modifying agent for the treatment of osteoarthritis (OA). The emergence of new drugs based on this combination substantially expands treatment options for OA therapy.Objective: to evaluate the efficacy and safety of Artroflex® that is a combination of chondroitin sulfate 400 mg and glucosamine sulfate 500 mg (CS + GS) to support joint health in patients with knee and/or hip OA.Patients and methods. When implementing an open observational research program, the results of using the CS + GS complex were assessed in 644 OA patients (74.7% women) (mean age, 58.0±14.6 years) who experienced moderate/severe pain and required to continuously take non-steroidal anti-inflammatory drugs (NSAIDs). The CS + GS complex was prescribed in a dose of 2 capsules per day for 3 months. The investigators estimated changes in pain on movement by a 0 to 10 verbal pain scale, general health (GH) by a 0–10 visual analogue scale), the Lequesne index, the need for NSAIDs, and patient satisfaction with treatment and its tolerance.Results and discussion. After 3-month therapy, there were decreases in pain intensity by 49.2±16.8%, GH scores by 45.6±18.1%, the Lequesne index from 9.0 [6.0; 13.0] to 5.0 [3.0; 9.0]; less than half (45.2%) of the patients still needed for NSAIDs. 82.2% of patients were satisfied or completely satisfied with treatment results; 89.6% reported good treatment tolerance.Adverse events (apparently associated with NSAID use) were recorded in 2.2% of cases. There were no serious complications that required CS + GS treatment discontinuation or hospitalization.Conclusion. The findings have indicated that Artroflex® used to support joint health is an effective agent that controls OA symptoms and has a good safety level.Комбинация хондроитина и глюкозамина широко применяется в клинической практике как симптоматическое и структурно-модифицирующее средство для лечения остеоартрита (ОА). Появление новых препаратов на основе данной комбинации существенно расширяет возможности терапии ОА.Цель исследования – оценка эффективности и безопасности комплекса для поддержания здоровья суставов Артрофлекс®, представляющего собой комбинацию хондроитина сульфата 400 мг и глюкозамина сульфата 500 мг (ХС + ГС), у пациентов с ОА коленного и/или тазобедренного суставов.Пациенты и методы. В ходе наблюдательной открытой исследовательской программы были оценены результаты применения комплекса ХС + ГС у 644 больных ОА (средний возраст 58,0±14,6 года, 74,7% женщины), испытывающих умеренную/выраженную боль и нуждающихся в постоянном приеме нестероидных противовоспалительных препаратов (НПВП). Комплекс ХС + ГС назначали в дозе 2 капсулы в сутки сроком на 3 мес. Оценивали динамику боли при движении (по вербальной шкале боли 0–10), общего состояния здоровья (ОСЗ, по визуальной аналоговой шкале 0–10), индекса Лекена, потребность в приеме НПВП, удовлетворенность больных лечением и переносимостью терапии.Результаты и обсуждение. Через 3 мес применения выраженность боли снизилась на 49,2±16,8%, оценка ОСЗ – на 45,6±18,1%, индекс Лекена – с 9,0 [6,0; 13,0] до 5,0 [3,0; 9,0], необходимость в приеме НПВП осталась менее чем у половины больных (45,2%). Удовлетворены или полностью удовлетворены результатами лечения были 82,2% больных, хорошую переносимость терапии отметили 89,6%. Нежелательные явления (по-видимому, связанные с приемом НПВП) зафиксированы в 2,2% случаев. Серьезных осложнений, потребовавших прерывания лечения ХС + ГС или госпитализации, не выявлено.Заключение. Согласно полученным данным, комплекс для поддержания здоровья суставов Артрофлекс® – эффективное средство для контроля симптомов ОА, обладающее хорошим уровнем безопасности

Cytological, Molecular-Genetic and Silvicultural-Selection Research of Polyploid Poplars

The results of cytological, silvicultural and selection research and DNA analysis of polyploid poplars are discussed in the article. Poplar clones were studied for productivity, the number of chromosomes, selection and testing of microsatellite loci for genetic certification of planting material. The study showed a high diagnostic performance of species, of individual genotypes and clones within species and hybrids on the basis of gene markers of polymorphism of microsatellite DNA

THE CASE OF SUCCESSFUL APPLICATION OF EMBOLIZING SYSTEM IN DISTAL PERFORATION OF CORONARY ARTERY

THE CASE OF SUCCESSFUL APPLICATION OF EMBOLIZING SYSTEM IN DISTAL PERFORATION OF CORONARY ARTERY