13 research outputs found
The Impact of Revascularization in a Patient with Atypical Manifestations of Hypoperfusion
Publisher Copyright: Ā© 2022 by the authors.Background and Objectives: Carotid revascularization is one of the most effective treatment options in patients with severe carotid artery stenosis causing hypoperfusion in basal ganglia. Atypical manifestations include hyperkinetic movements, noted as extremely rare. We report a case about a patient with 2-months-long complaints of Uncontrollable movements in his right side of the body subsided after carotid revascularization. Case presentation: A 71-year-old male was admitted to Pauls Stradins Clinical University Hospital with the main complaints of 2-months-long uncontrollable movements in his right hand and his right leg. When performing coordination tasks, slight inaccuracy was noted with the right-side extremities. Hyperkinetic movementsāchoreoathetosis in the right side of the patientās face, arm, and legāwere seen. Computed tomography angiography revealed subocclusion in the proximal segment of the left internal carotid artery and 30% stenosis in the proximal segment of the right internal carotid artery. The patient was consulted by a vascular surgeon. Eversion endarterectomy of the left internal carotid artery was performed. The early postoperative period occurred without complications. The patient was discharged from the hospital 2 days after the surgery in good overall health condition. Two months later, choreoathetotic movements in his right side of the body had markedly decreased. No focal neurologic deficits were noted. Conclusions: Revascularization may be effective by eliminating emboli and stenosis, leading to hypoperfusion in watershed territories. A case of a 71-year-old male patient with the main complaints of 2-months-long uncontrollable movements in his right side of the body subsiding after carotid revascularization was demonstrated. It is vital to recognize atypical manifestations of hypoperfusion, associated with stenosis in internal carotid arteries, to early make a diagnosis, to perform an appropriate treatment, and to reduce the risk of cerebral infarction in the future, resulting in a longer high-quality life for the patient.publishersversionPeer reviewe
Carotid Artery Stenosis Correlation with Hyperhomocysteinemia in Stroke Patient Group: a Prospective Study
Introduction. Stroke is the second most common cause of death worldwide and one of the major causes of long-term disability. Carotid artery stenosis is an independent risk factor for ischemic stroke and related forms of atherosclerotic vascular disease. Aim of the Study was to examine plasma homocysteine (tHcy) levels in the stroke patient's group with significant carotid artery stenosis, to determine hyperhomocysteinemia correlation with degree of carotid artery stenosis. Materials and methods. This study was prospective and all patients (n=102) included in the study were hospitalized in Pauls Stradins Clinical University hospital in Clinic of Neurology with diagnosis of acute ischemic stroke. In the group of significant carotidal stenosis we included 48 patients with various degree of stenosis ranging from 50% to total occlusion. Evaluations of stenosis of extracranial carotid arteries were done by duplex ultrasonography method. The blood of these patients was tested for homocysteine level by ELISA (IMMULITE 2000). Results. Study did not demonstrated statistically significant difference between levels of tHcy in all groups. Mean homocysteine level was not significantly higher in the symptomatic carotid stenosis patient's group. Also there were no significant differences between levels of homocysteine in patient group with different degree of stenosis. Conclusions. We found no meaningful association between a high tHcy level and extent of carotid stenosis.publishersversionPeer reviewe
Cytomegalovirus chronic infection as a risk factor for stroke : A prospective study
Funding Information: This research was supported by European Social Fund.Stroke is the second most common cause of death in the world and a major cause of long-term disability. Chronic infection is an independent risk factor for ischemic stroke and related forms of atherosclerotic vascular disease. The aim of our study was to compare the plasma Cytomegalovirus (CMV) immunoglobulin G antibody level in a patient and control group, and to determine the association of CMV chronic infection with ischemic stroke, and with stroke subtype. The present study does not present a cogent demonstration that cytomegalovirus chronic infection is a risk factor of stroke. Further studies are necessary to clarify the effective prophylactic measures to determine other significant risk factors for stroke.publishersversionPeer reviewe
Duodenal Perforation due to Inferior Vena Cava Filter in a Multi-morbid Young Patient: First Clinical Case Report in Latvia
ABSTRACT Introduction: The inferior vena cava filter is known to be a safe and effective method for preventing fatal pulmonary artery thromboembolism. We report a case report of inferior vena cava filter perforation on duodenum in a multimorbid young patient undergoing full midline laparotomy and cavotomy. Case presentation: A 37-year-old male was admitted to a tertiary university hospital following recurrent episodes of epistaxis. In 2008, the patient developed traumatic subarachnoid haemorrhage with a following decompressive trepanation and bilateral pulmonary artery thromboembolism. An inferior vena cava filter was implanted. In 2021, due to suspected duodenal perforation, an urgent fibrogastroscopy was performed, revealing duodenal perforation caused by the inferior vena cava filter and aortic pseudoaneurysm. Vena cava filter evacuation was indicated; to date, no such operation has been performed in Latvia. The early postoperative period occurred without any complications. The patient was discharged 15 days after the surgical treatment in good overall health. Results: This was a clinical case report about a 37-year-old multimorbid patient with positive anamnesis of traumatic subarachnoid haemorrhage following decompressive trepanation and bilateral pulmonary artery thromboembolism and inferior vena cava filter implantation due to absolute contraindications to anticoagulant therapy. Conclusion: Inferior vena cava filters are generally safe but can cause clinically significant complications. The case of 37-year-old multimorbid patient with the main complaints of pain around the left ear and recurrent nose bleeds was discussed. On fibrogastroscopy, duodenal perforation caused by the inferior vena cava filter and aortic pseudoaneurysm were seen. Full midline laparotomy and cavotomy was performed. The patient was discharged in good overall health. Detailed assessment of the radiological findings, fibrogastroscopic studies and the novel treatment of a complicated disease occurring for the first time in Latvia proved successful for both patient recovery and outcome. Keywords: Cavotomy; Laparotomy; Multimorbidity; Inferior vena cava filter; Duodenal perforationpublishersversionPeer reviewe
CARDIOEMBOLIC STROKE IN LATVIA : PREVENTION AND LONG-TERM OUTCOME
NTRODUCTION:Untreated non-valvular atrial fibrillation is one of major causes of stroke. The goalof the study was to evaluate the use of antithrombotic medication stroke prevention and assess long-term stroke outcome.METHODS:This study involved 531 cardio embolicstroke patients of thePaulāsStradins Clinical University Hospital, Riga, Latvia,in 2014. After dischargethe patients or their relatives were interviewed by phone after 30, 90, 180, and 365 days. Standardized questions were asked about the patientsāabilities and use of prescribed secondary prevention medication. Theresults were compared between patient groups, assigned according to prescribed medications. RESULTS:Of all the patients included in the study,8.9% were using oral anticoagulants before stroke onset. One year after discharge,1.44% of patients were not using any preventivemedication, 23.56%were using antiplatelet agents, 43.27% warfarin,and 31.73% target-specificoralanticoagulants. The one-year mortality ratewas 40.7%. The mortality rate was significantly higher in the patient group using no secondary preventivemedication or antiplatelet agents compared to the patient group that used oral anticoagulants. CONCLUSION:Cardio embolicstroke primary and secondary prevention in Latvia islacking. The study outcomes suggest that action is neededto increase the use of oral anticoagulants in primary stroke prevention in patients with atrial fibrillation. Poor function outcomes, dementia,and patientsāincompliance limits the use of oral anticoagulants in secondary preventionpublishersversionPeer reviewe
Is Anticoagulation Necessary for Severely Disabled Cardioembolic Stroke Survivors?
Background and Objectives: Oral anticoagulants are the hallmark of cardioembolic stroke prevention, but they are frequently underused, especially in elderly patients and patients with paroxysmal atrial fibrillation. In our paper, we analyzed the long-term outcome of severely disabled cardioembolic stroke survivors depending on the prescribed antithrombotic secondary prevention medication. Materials and Methods: In our study, we retrospectively collected data for ischemic stroke (IS) patients treated in P. Stradins Clinical University hospital, Riga, Latvia, from 2014 until 2017. Patientsā clinical data were collected using local stroke registry, including patientsā demographic data, vascular risk factors, clinical findings, and laboratory results. Severely disabled stroke survivors were followed up by phone at 30/90/180/365 days after discharge. Patientsā functional outcomes were assessed using the adapted version of The Rankin Focused AssessmentāAmbulation. The collected data were compared in 4 groups according to prescribed secondary prevention medication. Results: A total of 682 (91.42%) patients were followed up and included in data analysis. The median age of patients was 80 (IQR = 75ā85) years. Of these patients, 231 (31%) were males and 515 (69%) were females. One-year probability of survival of patients not taking any preventive medication was 53% (IQR = 29ā76), while in patients taking antiplatelet agents it was 57% (IQR = 37ā78), 78% (IQR = 68ā88) of patients on Vitamin K antagonists (VKA) and 81% (IQR = 72ā90) in patients on direct oral anticoagulants (DOACs). One year after discharge 73 (31%) had mRS 0ā2, 50 (20.9%), 29 (12.1%) were still severely disabled, and 87 (36.4%) had died. Conclusions: Anticoagulant use in secondary prevention predicts better functional outcome and higher survival rate in patients with severe cardioembolic stroke due to non-valvular atrial fibrillation (NVAF), therefore severe neurological deficit must not be a reason of restriction of anticoagulatioPeer reviewe
Problems of Cardioembolic Stroke Primary and Secondary Prevention in the Latvian Population
Publisher Copyright: Ā© 2015 by Kristaps Jurjns.Atrial fibrillation is one of major risk factors of cerebral infarction. The use of oral anticoagulants is the only evidence-based method of reducing the risk of cardioembolic accidents. The guidelines of oral anticoagulant admission and usage have been available since 2012. The results of this study show that of 550 stroke patients that were admitted to Pauls StradiÅÅ” Clinical University Hospital, Riga, Latvia, from 1 January 2014 until 1 July 2014, atrial fibrillation was diagnosed in 247 (45%) cases, and of these patients, only 8.5% used oral anticoagulants before the onset of stroke. Six months after discharge of 111 (44.9%) stroke survivors, five (4.5%) used no secondary prevention medication, 27 (24.3%) used antiplatelet agents, 54 (48.6%) warfarin, and 25 (22.5%) used target specific oral anticoagulants (TSOACs). The mortality rate was significantly higher in the patient group that used no secondary prevention medication or antiplatelet agents compared to the patient group that used oral anticoagulants. The use of oral anticoagulants for primary stroke prevention in Latvia is insufficient. The mortality of cardioembolic stroke in 180 days is very high-40.4%. Secondary prevention is essential to prevent recurrent cardioembolic accidents.publishersversionPeer reviewe
S 100 proteÄ«ns un neironu specifiskÄ endolÄze kÄ cerebrÄlÄ infarkta diagnostiskie un prognostiskie biomarÄ·ieri. Promocijas darba kopsavilkums
Promotion work was done at RÄ«ga StradiÅÅ” University, Neurology and Neurosurgery Departments of P.Stradins Clinical University Hospital, Neurology Clinic. Defence: on 18th February 2013 at 17.00 of Riga StradiÅÅ” University Fundamental Sciences open meeting of Promotion Council in Riga, Dzirciema street 16, Hippocrate auditorium.The promotion work is addressing one of the most topical current neurological problems ā diagnostics of cerebral infarction in its acute phase. Cerebral infarction is the most common cerebrovascular pathology and one of the main mortality, demence and disability causes worldwide. Treatment of cerebral infarction is known to progress nowadays and the modern treatment methods ā intravenous thrombolysis, intrarterial thrombolysis and thrombectomy ā are the most effective therapeutic possibilities, despite it, the risk of possible complications is still high. Correctly chosen specific cerebal infarction therapy for the patient can reduce the development of possible complication risk after the manipulation, therefore extra diagnostic methods are needed. Biomarkers are one of the additional diagnostic possibilities in cerebral infarction cases. Biomarkers which are specific for cerebral tissue lesions, can relieve the assessment of ischemic damage in patients in an acute cerebral infarction phase, when imaging diagnostics, especially computer tomography possibilities are not great. Prognosing cerebral infarction size, one can more precisely plan the patientās treatment, envisaging the prognosis of the disease and the effectivity of the method applied at the very beginning of the disease, reducing the development of the complication risk. Up to now several studies have been described in scientific literature, investigating the relationship of biomarkers with cerebral tissue ischemic damage, demonstrating various degree sensitivity, specificity and prognostic value, and concluding, that there is lack of a longer time observation data, therefore further studies are needed. The aim of the study was to assess S100 protein and neuron specific enolase (NSE) as cerebral infarction diagnostic and prognostic biomarkers, drawing conclusions on the usefulness of their application in daily practice. In the prospective study there were analyzed the data on 336 patients with cerebral infarction and 168 control group patients who had undergone treatment at P.Stradins State University Hospital, Neurology clinic in the period from October 2008 till March 2011. All studied patients with cerebral infarction were stated S100 and NSE level in blood by 24 hours since the onset of cerebral infarction symptoms. Laboratory tests were done at the accredited and certified laboratory of the Clinical Immunology Centre. Patientsā radiological imaging diagnostic examinations were done at Radiology Institute. For the statistical analysis of the study data a specialized programme ā SPSS 15 for Windows, SPSS, Chicago, IL was used. As a result of the work, the patients with cerebral infarction were found S100 protein and NSE level being higher in comparison to the control group, as well as finding S100 protein level in serum also correlating with cerebral infarction size which could be considered the prognostic factor in the hemorrhagic transformation development. In patients with cerebral infarction S100 protein correlates with the effectivity of thrombolytic and thrombectomy therapy and the incidence of the development of hemorrhagic complications. Comparing the studies described in the literature, our study results in relation to biomarker level changes in acute cerebral infarction cases are similar to the before described, however, one cannot find the literature data on the biomarker correlation to the effectivity of thrombectomy, thus, there are no studies to compare to our acquired data. As a result of work, practical recommendations were developed, in which S100 protein level determination can be recommended as a diagnostic and prognostic indicator, especially in clinics where there are not available sensitive radiological investigation methods for patients with cerebral infarction in an acute disease phase.Promotion work has been done with the financial support of European Social Fund project "Support to doctoral students in acquiring the study programme and getting a scientific degree at RÄ«ga StradiÅÅ” University
S 100 Protein and Neuron Specific Enolase as Diagnostic and Prognostic Biomarkers of Cerebral Infarction. Summary of the Doctoral Thesis
Promocijas darbs izstrÄdÄts RÄ«gas StradiÅa universitÄtes NeiroloÄ£ijas un neiroÄ·irurÄ£ijas katedras klÄ«niskajÄ bÄzÄ ā VSIA Paula StradiÅa KlÄ«niskÄs universitÄtes slimnÄ«cas NeiroloÄ£ijas klÄ«nikÄ. AizstÄvÄÅ”ana: 2013. gada 18. februÄrÄ« plkst. 17.00 RÄ«gas StradiÅa universitÄtes TeorÄtiskÄs medicÄ«nas promocijas padomes atklÄtÄ sÄdÄ RÄ«gÄ, Dzirciema ielÄ 16, HipokrÄta auditorijÄ.Promocijas darbs ir veltÄ«ts vienai no aktuÄlÄkajÄm mÅ«sdienu neiroloÄ£ijas problÄmÄm ā cerebrÄla infarkta diagnostikai akÅ«tÄ periodÄ. CerebrÄls infarkts ir visbiežÄk sastopamÄ cerebrovaskulÄrÄ patoloÄ£ija un ir viens no galvenajiem mirstÄ«bas, demences un invaliditÄtes cÄloÅiem pasaulÄ. ZinÄms, ka cerebrÄla infarkta ÄrstÄÅ”ana Å”odien strauji progresÄ, un mÅ«sdienÄ«gas ÄrstÄÅ”anas metodes ā intravenozÄ trombolÄ«ze, intraarteriÄla trombolÄ«ze un trombektomija ā ir visefektÄ«vÄkÄs ÄrstÄÅ”anas iespÄjas, tomÄr iespÄjamo komplikÄciju attÄ«stÄ«bas risks ir augsts. Pacientam pareizi izvÄlÄta specifiska cerebrÄla infarkta terapija samazinÄs iespÄjamo komplikÄciju attÄ«stÄ«bas risku pÄc manipulÄcijas, tÄdÄļ ir nepiecieÅ”amas papildu diagnostiskÄs metodes. BiomarÄ·ieri ir viena no papildu diagnostikas iespÄjÄm cerebrÄla infarkta gadÄ«jumÄ. BiomarÄ·ieri, kas ir specifiski smadzeÅu audu bojÄjumam, var atvieglot iÅ”ÄmiskÄ bojÄjuma novÄrtÄÅ”anu pacientiem akÅ«tÄ cerebrÄla infarkta fÄzÄ, kad attÄldiagnostikas, Ä«paÅ”i datortomogrÄfijas, iespÄjas nav lielas. PrognozÄjot cerebrÄla infarkta plaÅ”umu, ir iespÄjams precÄ«zÄk plÄnot pacienta ÄrstÄÅ”anu, paredzot slimÄ«bas prognozi un pielietojamo terapijas metodes efektivitÄti jau slimÄ«bas sÄkumÄ, mazinot terapijas komplikÄciju attÄ«stÄ«bas risku. LÄ«dz Å”im literatÅ«rÄ aprakstÄ«ti vairÄki pÄtÄ«jumi, kuros tiek pÄtÄ«ti biomarÄ·ieri saistÄ«bÄ ar smadzeÅu audu iÅ”Ämisku bojÄjumu ā tie demonstrÄ dažÄdu jutÄ«bu, specifiskumu un prognostisko vÄrtÄ«bu, secinot, ka trÅ«kst ilgÄku laika novÄrojumu datu un ir nepiecieÅ”ami turpmÄki pÄtÄ«jumi. PÄtÄ«juma mÄrÄ·is bija izvÄrtÄt S100 proteÄ«nu un neironu specifisko enolÄzi (NSE) kÄ cerebrÄla infarkta diagnostiskus un prognostiskus biomarÄ·ierus, izdarot secinÄjumus par to pielietoÅ”anas lietderÄ«bu ikdienas praksÄ. ProspektÄ«vÄ pÄtÄ«jumÄ tika analizÄti dati 336 pacientiem ar cerebrÄlu infarktu un 168 kontroles grupas pacientiem, kas ÄrstÄjuÅ”ies VAS P. StradiÅa KlÄ«niskÄs universitÄtes slimnÄ«cas NeiroloÄ£ijas klÄ«nikÄ periodÄ no 2008. gada oktobra lÄ«dz 2011. gada martam.Visiem pÄtÄ«juma pacientiem ar cerebrÄlu infarktu noteica S100 proteÄ«na un NSE lÄ«meni asinÄ«s lÄ«dz 24 stundÄm kopÅ” cerebrÄla infarkta simptomu sÄkuma. LaboratoriskÄs analÄ«zes veiktas akreditÄtÄ un sertificÄtÄ KlÄ«niskÄs imunoloÄ£ijas centra laboratorijÄ. Pacientu radioloÄ£iskÄs attÄldiagnostikas izmeklÄjumi veikti RadioloÄ£ijas institÅ«tÄ. PÄtÄ«juma statistiskÄs analÄ«zes datu aprÄÄ·iniem izmantota specializÄta programmatÅ«ra ā SPSS 15 for Windows, SPSS, Chicago, IL. Darba rezultÄtÄ noskaidrots, ka pacientiem ar cerebrÄlu infarktu S100 proteÄ«na un NSE lÄ«menis ir augstÄks, salÄ«dzinot ar kontroles grupu, kÄ arÄ« S100 proteÄ«na lÄ«menis serumÄ korelÄ ar pacientu funkcionÄlo stÄvokli, cerebrÄla infarkta plaÅ”umu, un var tikt uzskatÄ«ts par hemorÄÄ£iskas transformÄcijas veidoÅ”anÄs prognostiski lietderÄ«gu faktoru. Pacientiem ar cerebrÄlu infarktu S100 proteÄ«ns korelÄ ar trombolÄ«tiskÄs un trombektomijas terapiju efektivitÄti, hemorÄÄ£isko komplikÄciju attÄ«stÄ«bas biežumu. SalÄ«dzinot ar literatÅ«rÄ apskatÄ«tajiem pÄtÄ«jumiem, mÅ«su pÄtÄ«juma rezultÄti saistÄ«bÄ ar biomarÄ·ieru lÄ«meÅa izmaiÅÄm akÅ«ta cerebrÄla infarkta gadÄ«jumÄ ir lÄ«dzÄ«gi iepriekÅ” aprakstÄ«tajiem, tomÄr literatÅ«rÄ nav pieejami pÄtÄ«jumi par biomarÄ·ieru saistÄ«bu ar trombektomijas efektivitÄti ā tÄdejÄdi nav pÄtÄ«jumu, ar kuriem salÄ«dzinÄt mÅ«su pÄtÄ«jumÄ iegÅ«tos datus. Darba rezultÄtÄ tika izstrÄdÄtas praktiskÄs rekomendÄcijas, kurÄs S100 proteÄ«na lÄ«meÅa noteikÅ”anu var rekomendÄt kÄ diagnostisko un prognostisko rÄdÄ«tÄju, Ä«paÅ”i klÄ«nikÄs, kur nav peejamas jutÄ«gas radioloÄ£iskÄs izmeklÄÅ”anas metodes pacientiem ar cerebrÄlu infarktu akÅ«tajÄ slimÄ«bas periodÄ.Promocijas darbs veikts ar Eiropas SociÄlÄ fonda projekta "Atbalsts doktorantiem studiju programmas apguvei un zinÄtniskÄ grÄda ieguvei RÄ«gas StradiÅa universitÄtÄ" finansiÄlu atbalst
S 100 Protein and Neuron Specific Enolase as Diagnostic and Prognostic Biomarkers of Cerebral Infarction. Doctoral Thesis
Promocijas darbs izstrÄdÄts RÄ«gas StradiÅa universitÄtes NeiroloÄ£ijas un neiroÄ·irurÄ£ijas katedras klÄ«niskajÄ bÄzÄ ā VSIA Paula StradiÅa KlÄ«niskÄs universitÄtes slimnÄ«cas NeiroloÄ£ijas klÄ«nikÄ. AizstÄvÄÅ”ana: 2013. gada 18. februÄrÄ« plkst. 17.00 RÄ«gas StradiÅa universitÄtes TeorÄtiskÄs medicÄ«nas promocijas padomes atklÄtÄ sÄdÄ RÄ«gÄ, Dzirciema ielÄ 16, HipokrÄta auditorijÄ.Promocijas darbs ir veltÄ«ts vienai no aktuÄlÄkajÄm mÅ«sdienu neiroloÄ£ijas problÄmÄm ā cerebrÄla infarkta diagnostikai akÅ«tÄ periodÄ. CerebrÄls infarkts ir visbiežÄk sastopamÄ cerebrovaskulÄrÄ patoloÄ£ija un ir viens no galvenajiem mirstÄ«bas, demences un invaliditÄtes cÄloÅiem pasaulÄ. ZinÄms, ka cerebrÄla infarkta ÄrstÄÅ”ana Å”odien strauji progresÄ, un mÅ«sdienÄ«gas ÄrstÄÅ”anas metodes ā intravenozÄ trombolÄ«ze, intraarteriÄla trombolÄ«ze un trombektomija ā ir visefektÄ«vÄkÄs ÄrstÄÅ”anas iespÄjas, tomÄr iespÄjamo komplikÄciju attÄ«stÄ«bas risks ir augsts. Pacientam pareizi izvÄlÄta specifiska cerebrÄla infarkta terapija samazinÄs iespÄjamo komplikÄciju attÄ«stÄ«bas risku pÄc manipulÄcijas, tÄdÄļ ir nepiecieÅ”amas papildu diagnostiskÄs metodes. BiomarÄ·ieri ir viena no papildu diagnostikas iespÄjÄm cerebrÄla infarkta gadÄ«jumÄ. BiomarÄ·ieri, kas ir specifiski smadzeÅu audu bojÄjumam, var atvieglot iÅ”ÄmiskÄ bojÄjuma novÄrtÄÅ”anu pacientiem akÅ«tÄ cerebrÄla infarkta fÄzÄ, kad attÄldiagnostikas, Ä«paÅ”i datortomogrÄfijas, iespÄjas nav lielas. PrognozÄjot cerebrÄla infarkta plaÅ”umu, ir iespÄjams precÄ«zÄk plÄnot pacienta ÄrstÄÅ”anu, paredzot slimÄ«bas prognozi un pielietojamo terapijas metodes efektivitÄti jau slimÄ«bas sÄkumÄ, mazinot terapijas komplikÄciju attÄ«stÄ«bas risku. LÄ«dz Å”im literatÅ«rÄ aprakstÄ«ti vairÄki pÄtÄ«jumi, kuros tiek pÄtÄ«ti biomarÄ·ieri saistÄ«bÄ ar smadzeÅu audu iÅ”Ämisku bojÄjumu ā tie demonstrÄ dažÄdu jutÄ«bu, specifiskumu un prognostisko vÄrtÄ«bu, secinot, ka trÅ«kst ilgÄku laika novÄrojumu datu un ir nepiecieÅ”ami turpmÄki pÄtÄ«jumi. PÄtÄ«juma mÄrÄ·is bija izvÄrtÄt S100 proteÄ«nu un neironu specifisko enolÄzi (NSE) kÄ cerebrÄla infarkta diagnostiskus un prognostiskus biomarÄ·ierus, izdarot secinÄjumus par to pielietoÅ”anas lietderÄ«bu ikdienas praksÄ. ProspektÄ«vÄ pÄtÄ«jumÄ tika analizÄti dati 336 pacientiem ar cerebrÄlu infarktu un 168 kontroles grupas pacientiem, kas ÄrstÄjuÅ”ies VAS P. StradiÅa KlÄ«niskÄs universitÄtes slimnÄ«cas NeiroloÄ£ijas klÄ«nikÄ periodÄ no 2008. gada oktobra lÄ«dz 2011. gada martam.Visiem pÄtÄ«juma pacientiem ar cerebrÄlu infarktu noteica S100 proteÄ«na un NSE lÄ«meni asinÄ«s lÄ«dz 24 stundÄm kopÅ” cerebrÄla infarkta simptomu sÄkuma. LaboratoriskÄs analÄ«zes veiktas akreditÄtÄ un sertificÄtÄ KlÄ«niskÄs imunoloÄ£ijas centra laboratorijÄ. Pacientu radioloÄ£iskÄs attÄldiagnostikas izmeklÄjumi veikti RadioloÄ£ijas institÅ«tÄ. PÄtÄ«juma statistiskÄs analÄ«zes datu aprÄÄ·iniem izmantota specializÄta programmatÅ«ra ā SPSS 15 for Windows, SPSS, Chicago, IL. Darba rezultÄtÄ noskaidrots, ka pacientiem ar cerebrÄlu infarktu S100 proteÄ«na un NSE lÄ«menis ir augstÄks, salÄ«dzinot ar kontroles grupu, kÄ arÄ« S100 proteÄ«na lÄ«menis serumÄ korelÄ ar pacientu funkcionÄlo stÄvokli, cerebrÄla infarkta plaÅ”umu, un var tikt uzskatÄ«ts par hemorÄÄ£iskas transformÄcijas veidoÅ”anÄs prognostiski lietderÄ«gu faktoru. Pacientiem ar cerebrÄlu infarktu S100 proteÄ«ns korelÄ ar trombolÄ«tiskÄs un trombektomijas terapiju efektivitÄti, hemorÄÄ£isko komplikÄciju attÄ«stÄ«bas biežumu. SalÄ«dzinot ar literatÅ«rÄ apskatÄ«tajiem pÄtÄ«jumiem, mÅ«su pÄtÄ«juma rezultÄti saistÄ«bÄ ar biomarÄ·ieru lÄ«meÅa izmaiÅÄm akÅ«ta cerebrÄla infarkta gadÄ«jumÄ ir lÄ«dzÄ«gi iepriekÅ” aprakstÄ«tajiem, tomÄr literatÅ«rÄ nav pieejami pÄtÄ«jumi par biomarÄ·ieru saistÄ«bu ar trombektomijas efektivitÄti ā tÄdejÄdi nav pÄtÄ«jumu, ar kuriem salÄ«dzinÄt mÅ«su pÄtÄ«jumÄ iegÅ«tos datus. Darba rezultÄtÄ tika izstrÄdÄtas praktiskÄs rekomendÄcijas, kurÄs S100 proteÄ«na lÄ«meÅa noteikÅ”anu var rekomendÄt kÄ diagnostisko un prognostisko rÄdÄ«tÄju, Ä«paÅ”i klÄ«nikÄs, kur nav peejamas jutÄ«gas radioloÄ£iskÄs izmeklÄÅ”anas metodes pacientiem ar cerebrÄlu infarktu akÅ«tajÄ slimÄ«bas periodÄ.Promocijas darbs veikts ar ESF projekta āAtbalsts doktorantiem studiju programmas apguvei un zinÄtniskÄ grÄda ieguvei RÄ«gas StradiÅa universitÄtÄā atbalst