APPLICATION OF THROMBOLYSIS THERAPY FOR ACUTE CEREBRAL CIRCULATION IN THE REPUBLIC OF KAZAKHSTAN, COUNTRIES OF THE FAR AND NEAR FOREIGN COUNTRIES.

In the world, stroke suffers 5.6-6 million people a year. Stroke deaths are predicted to rise to 6.7 million in 2015 and to 7.8 million in 2030. Stroke is the leading cause of disability worldwide. The provision of specific therapy to patients with stroke in the form of thrombolytic therapy and neurosurgical operations are recognized international standards in the provision of medical care. The advent of computed tomography (CT) in the early 1980s made it possible to further study TLT. In 2014 Joanna M WardlawVeronic, MurrayEivind, Berge Gregory, J del Zoppo searched the Cochrane Stroke Trial Registry (Last November 2013), MEDLINE (1966 to November 2013) and at EMBASE (from 1980 to November 2013). We concluded that thrombolytic therapy administered within six hours of a stroke reduces the proportion of deaths or disability. The dependence of the efficacy and safety of fibrinolytic therapy on the time of its initiation has been demonstrated in a number of large studies. A pooled analysis of the results of the NINDS, ECASS I and II, ATLANTIS studies (n = 2775) showed that the odds ratio (OR) of a favorable outcome of the disease when thrombolysis was initiated in the first 90 minutes of a stroke. Thus, time is the most important condition for the effectiveness of TLT. In addition to the time factor, it is important to take into account the age of patients during TLT. F. Mateen et al. analyzed data from the Canadian TLT registry for patients aged 80 to 89 years and 90 to 99 years. Thus, thrombolysis in patients of various age groups, including those aged 80 to 89 years and older, is equally safe and effective.

Interventricular interaction as a possible mechanism for the presence of a biphasic systolic velocity profile in normal left ventricular free walls.

BACKGROUND: In normal subjects, systolic longitudinal regional velocity profiles (SVP) (measured both based on pulsed or tissue Doppler) have a non-uniform pattern. SVP from the right ventricle (RV), the septal (Sep) and the inferior wall are similar in shape and tend to be monophasic. Their shape differs markedly from the lateral wall (LW), the posterior wall and the anterior wall, which are biphasic. We studied the hypothesis that the double-peaked SVP in the left ventricular free walls are caused by interventricular interaction. This might have additional implication in understanding the measurements of the timing of SVP maxima in pathology as, for example, used to determine intraventricular dyssynchrony in heart failure. METHODS: 38 healthy individuals underwent a standard echo examination and a tissue Doppler study. SVP from the RV, Sep and LW basal segments were acquired in an apical four-chamber view. The amplitude and timing of the peak velocities were measured. If a double peak was present, the amplitude and timing of the dip was calculated. RESULTS: RV and Sep had a single systolic velocity peak, while the LW had two peaks with a clear dip between both peaks. The first peak in the LW was the earliest event in the cycle (119 (19) ms) followed by the peak Sep (123 (20) ms; p = 0.34). Peak RV velocity occurred at the same time as the dip in the LW (200 (30) vs 203 (30) ms, respectively; p = 0.53). CONCLUSION: Our study suggests that the biphasic SVP in the free walls is probably caused by interventricular interaction. Therefore the timing of maxima on SVP should be used with great caution when looking for intraventricular dyssynchrony as the peaks are influenced by RV function.