Аннотация. Цель работы-в экспериментальных условиях in vivo оценить комбинированное воздействие эритропоэтина (ЭПО) и лазерного излучения (ЛИ) на неврологический статус и микроциркуляцию при ишемии коры головного мозга (ИКГМ). ИКГМ моделировали у крыс диатермокоагуляцией пиальных сосудов в проекции сагиттального шва между лобно-теменным и теменно-затылочным швами. Через 2 часа после индукции ИКГМ проводили облучение области ишемии диод-ным лазером (длина волны 970 нм) в течение 2 мин; через 3, 24 и 48 ч вводили ЭПО в дозе 5000 МЕ/кг. Неврологический статус животных оценивали по шкале Garcia J. H. Микроциркуляцию в тканях коры головного мозга определяли с помощью лазерной допплеровской флуориметрии. Установлено, что при экспериментальной ИКГМ на 1, 3, 7, 14 и 30 сутки наблюдения развивается неврологический дефицит в виде двигательных, чувствительных и стато-координаторных расстройств, на 7, 14 и 30 сутки снижается микроциркуляция в области ишемии. Комбинированное однократное применение ЛИ области ишемии коры головного мозга и ЭПО приводит к частичному восстановлению неврологического статуса у животных на 1, 3, 7, 14 и 30 сутки наблюдения, а также полному восстановлению микроциркуляции в области ишемии головного мозга на 7, 14 и 30 сутки. Ключевые слова: ишемия головного мозга, эритропоэтин, лазерное излучение. Annotation: The steady increase in number of patients with ischemic brain lesions and the insufficient effectiveness of the therapeutic approaches used are the prerequisites for the search and preclinical evaluation of the effectiveness of new neuroprotective agents and techniques. The aim of the study was to evaluate the combined effect of erythropoietin (EPO) and laser radiation (LR) on neurological status and microcirculation in cerebral ischemia (CI) under experimental conditions in vivo. The study was performed on 70 nonlinear rats. CI was modeled on rats by diathermocoagulation of the pial vessels in the projection of the sagittal seam between the fronto-parietal and parieto-occipital sutures. Two hours after CI induction, the area of ischemia was irradiated with a diode laser (wavelength 970 nm) for 2 min; After 3, 24 and 48 hours, EPO was administered at a dose of 5000 IU / kg. Neurological status of the animals was assessed according to the Garcia J.H scale. Microcirculation in the tissues of the cerebral cortex was determined using laser Doppler fluorimetry. It was established that at the 1st, 3rd, 7th, 14th and 30th day of the observation, the neurologic deficit develops in the form of motor, sensory and stato-coordinative disorders, microcirculation in the ischemic region decreases on 7, 14 and 30 days. Combined application of the LR and EPO to the cerebral cortex ischemia leads to partial restoration of the neurological status in animals on the 1st, 3rd, 7th, 14th and 30th day of observation, as well as complete recovery of microcirculation in the brain ischemia on the 7th, 14th and 30th days.
Пароксизмальний перебіг синдрому вегетативної дисфункції Резюме. У статті розглянуті особливості клінічної к артини пароксизмального перебігу синдрому вегетативної дисфункції, лікувальної тактики при купіруванні кризу, а також терапії у міжкризовому періоді. Особлива увага приділена питанням профілактики виникнення вегетативних кризів.
Background Sepsis is a severe disease characterized by a systemic inflammatory response syndrome (SARS) associated with infection. Sepsis is registered in 1–2% of all hospitalized patients. IBD patients receiving immunosuppressive therapy have a high risk of developing sepsis. Diagnosis of sepsis is based on internationally agreed criteria. Predicting the course and outcomes of sepsis is evaluated on the MEDS (Mortality in Emergency Department Sepsis) scale. Clinical studies of a new biomarker called presepsin have shown that it is a promising early and predictive marker of sepsis Aim to establish the role of presepsin as a marker of sepsis development in patients with inflammatory bowel diseases (IBD) receiving therapy with genetically of TNF-α blockers. Methods The clinical status of 128 IBD patients receiving of TNF-α blockers therapy (without immunosuppressive drugs) was evaluated in the Department of IBD. 68 patients with ulcerative colitis (UC) and 60 patients with Crohn’s disease (CD). Presepsin level (PSP) was determined in all IBD patients (100.0%). To stratify patients, the following criteria were used for baseline PSP levels (pg/ml): < 200 – very low risk of sepsis; - 200 - 300– low risk of sepsis; - 300 - 500– moderate risk of sepsis; - 500 - 1000 – sepsis; - ≥ 1000-severe sepsis, septic shock Results The distribution among 128 IBD patients receiving of TNF-α blockers by presepsin level was as follows: < 200 -75 (58,6%); - 200 – 300 – 34 (26,6%); - 300 – 500 – 19 (14,8%); - 500 - 1000 – 0 (0%); ≥ 1000 – 0 (0%). Of the 75 IBD patients receiving gibp and having a very low risk, none of the patients developed sepsis; of the 34 IBD patients with a low risk, one patient developed septicemia (2.9%). Among 19 patients with IBD with a moderate risk, the development of a septic condition occurred in 4 (21.0%) patients (HR-0.140, 95% CI 0.017 - 1.162; x2-2,800; p= 0.04997). Conclusion IBD patients receiving of TNF-α therapy, it is advisable to determine the level of presepsin in order to identify risk groups for the development of sepsis. Patients with IBD who receive of TNF-α therapy and have presepsin values in the range of 300–500 pg/ml have a significantly higher risk of developing sepsis.
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