No abstract

Relevance. Mnestic functions in patients after stroke and coronavirus infection are not restored completely. Nowadays, the search for ways to overcome in such patients is actual. Objective: to find out the possibility of cognitive deficiency’ overcoming in persons after stroke who have suffered from COVID-19 by Phenibut pharmacocorrection and magnetic therapy. Materials and methods. 46 patients aged 40-60 years who had COVID-19 in anamnesis and ischemic stroke in the post-covid period were divided into 3 groups at the stage of comprehensive rehabilitation. In the 1st group (n=15) - the control group - no nootropic drugs and physiotherapeutic procedures were not asdministered; in group 2 (n=15), magnet stimulation procedures were performed for 20 days (frequency of basic impulses 180-195 Hz, frequency of a group of impulses 12,5-29 Hz, average induction of magnetic fields within 100 μT); group 3 (n=16) took Phenibut (β-Phenyl-GABA) one tablet (250 mg) 3 times a day for three months. The study of cognitive functions was carried out with the help of a short mental state scale - MMSE, a set of tests for the study of frontal dysfunction - FAB, a test for memorizing of 10 words according to the A.R. Luria’s method and clock drawing testing All groups were tested twice: at the beginning of the study and after three months. The obtained data were processed statistically; an ordinal logistic regression model was applied, in particular logistic regression with a cumulative relationship. The results. In group 2 the result of the subtest "Voluntary attention" improved (3,8±0,3 points vs. 3,1±0,2 in the control) and the FAB test (15, 2±1,2 points vs. 11,3±0,4 in control). In group 3, the cognitive functions in the MMSE (26,1±0,8 points vs. 21,2±0,6 in the control) and FAB (16,3±0,6 points vs. 11,3±0,4) tests probably improved. The results of the subtests "Discretionary attention" (3,8±0,1 points vs. 3,1±0,1) and "Memory" (2,6±0,2 points vs. 2,0±0,1) improved. In the test for 10 words memorizing, the difference in indicators, compared to the control, was in each subsequent presentation: 1,0±0,05; 1,1±0,09; 1,7±0,10 words, in delayed presentation 1,75±0,05 (in all cases p<0.05). Conclusions. The use of Phenibut and magnetic therapy in patients who have suffered a stroke after COVID-19 leads to regression of cognitive deficiency and depressive symptoms. The effect of Phenibut turned out to be better - the odds ratio, compared to the control, was 13,1.

The response to perinatal hypoxia, developing in stimulating generic activity, is the activation of microglia, which induces the development of local inflammation of the brain and leads to the death of neurons. The formation of the hippocampus supports important physiological and behavioral functions, including spatial learning and memory, and is part of the brain, which is especially vulnerable to changes in blood glucose and oxygen. Thus, the study of the features of the development of hippocampal formation in the postnatal period after stimulating generic activity is relevant. The purpose of the study was to study the features of Glial fibrillary acidic protein and NeuN expression in the hippocampal formation in posterity of female rats after PgE2 injection for labor induction. Materials and methods. Pregnant females of the experimental group on the twenty-second day of pregnancy were injected intravaginally with PGE2 in the form of a gel to stimulate the generic activity. Birth occurred on the twenty-third day after conception. Birth in the intact group of rats occurred on the 23-24th day after conception. The large hemispheres of the rat brain were fixed in a 10% neutral formal solution, dehydrated in an ascending alcohol battery. For immunohistochemical studies, paraffin sections were used with 3 microns with a thickness of 3 microns. Glial fibrillary acidic protein Mouse Monoclonal Antibody (Santa Cruz Biotechnology, Inc.) is used to detect astrocytes (Santa Cruz Biotechnology, Inc.). NeuN Mouse Monoclonal Antibody (Santa Cruz Biotechnology, Inc.) was used to identify neurons on the 1st, 7th, 14th, 45th days after birth in histological cuts of hippocampus and gear, using a program for analyzing and processing images Image J, studied the relative area occupied by Glial fibrillary acidic protein + NeuN + cells. Data is processed by variation statistics. The results are reliable at p <0.05. All animal experiments were performed according to international principles of the European Convention for the Protection of Vertebrate Animals Used for Experimental and Other Scientific Purposes” (Strasbourg, 18.03.86) and the Law of Ukraine No. 1759-VI (15.12.2009) On the Protection of Animals from Cruelty. Results and discussion. We identified that by the changes in the hippocampus and the toothed gyrus of the rats after induction of labor, increased Glial fibrillary acidic protein expression on the first day after birth and reducing the NeuN expression on the 14th and 45th day of life in experimental animals compared to the control group were included. Conclusion. The density of the distribution of Glial fibrillary acidic protein + cells in the hippocampus and the dentate gyrus of rats changes wavily throughout the first month and a half of postnatal life. In the offspring of rats, after stimulation of labor on the first day of life, a reliable increase in the relative area occupied by Glial fibrillary acidic protein + astrocytes is determined compared to the control (49.3±2.6% and 36.8±5.9%, respectively). In the hippocampus and the dentate gyrus of rats after stimulation of labor during the first 45 days after birth, the gradual decrease in the relative area occupied by NeuN + neurons is determined, in contrast to the control animals, in which this index practically does not change. On the 14th and 45th days, the index of the relative area occupied by NeuN + neurons in experimental rats is reliably lower than in control (p <0.05).

1Запорожская медицинская академия последипломного образования МЗ Украины, 2 Национальный институт хирургии и трансплантологии имени А. А. Шалимова НАМН Украины, г. Киев, 3 Запорожский государственный медицинский университет Integrative monitoring of systemic hemodynamics and the oxygen-transport status and the choice of the intensive therapy tactics in patients, suffering an ischemic cerebral insult Реферат Цель. Разработать тактику интенсивной терапии у пациентов с ишемическим мозговым инсультом (ИМИ) в зависимости от изменений показателей системной гемодинамики и кислородно-транспортного статуса. Материалы и методы. У 42 пациентов с ИМИ средней тяжести в возрасте от 45 до 88 лет проводили интегративный мониторинг тяжести неврологического состояния, системной гемодинамики и кислородно-транспортного статуса на фоне целенаправленной интенсивной терапии. Результаты. У больных с исходной гипоксемией выявлены гипокинетический сердечный индекс (СИ) -(2,0±0,1) л мин -1 м -2 и сниженная системная доставка кислорода (DO 2 ) -(356±21) мл мин -1 м -2 . Если значения содержания кислорода в артериальной крови (SаO 2 ) больше 95% и DO 2 меньше 520 мл мин -1 м -2 , необходима профилактическая оксигенация. С целью достижения эукинетических значений СИ коррекцию сосудистого спазма и антигипертензивную терапию проводили селективным альфа-адреноблокатором (урапидилом) до стабилизации показателей DO 2 на уровне 520-600 мл мин -1 м -2 . При гипероксическом состоянии выявлены гиперкинетический СИ -(3,6±0,1) л мин -1 м -2 и повышенная DO 2 -(699±14) мл мин -1 м -2 . Если показатели SаO 2 больше 95% и DO 2 больше 600 мл мин -1 м -2 , профилактическая оксигенация не показана. С целью достижения эукинетических значений СИ следует проводить антигипертензивную терапию альфа-бета-адреноблокатором (лабеталолом). Выводы. Целенаправленная интенсивная терапия, ориентированная на соответствие с общей оксигенацией тканей организма, нормализует кислородно-транспортный гомеостаз в кратчайшие сроки, что непосредственно отражается на результатах лечения пациентов с ИМИ. Ключевые слова: ишемический мозговой инсульт; интегративный мониторинг; целенаправленная интенсивная терапия; кислородно-транспортный статус. AbstractObjective. To elaborate the intensive therapy tactic in patients, suffering ischemic cerebral insult (ICI) depending on changes in the systemic hemodynamics indices and the oxygen-transportation status. Маterials and methods. In 42 patients, suffering the ICI of middle severity, ageing 45 -88 years old, the integrative monitoring of the neurological state severity, systemic hemodynamics indices and the oxygen-transportation status on background of targeted intensive therapy was conducted. Results. In the patients, suffering initial hypoxemia, a hypokinetic heart index (HI) -(2,0±0,1) l min -1 m -2 and the lowered systemic delivery of oxygen (DO 2 ) -(356±21) ml min -1 m -2 were revealed. Prophylactic oxygenation is needed if the value of the oxygen content in arterial blood (SаO 2 ) exceeds 95% and DO 2 is lesser than 520 ml min -1 m ...

No abstract