ABSTRACT
Perfusion computed tomography (CT) allows to evaluate brain perfusion and provides additional information about local cerebral hemodynamics in stroke patients. Twenty-seven patients underwent CT-perfusion in the early acute phase of ischemic stroke. Significant differences between ischemic lesion and contralateral hemisphere on CBF and MTT scans during the first 3 hours after stroke were revealed. In the following 24 h, the differences were seen in all perfusion parameters. CT-perfusion allows to reveal perfusion parameters associated with stroke severity and outcome that is relevant for prescription of reperfusion treatment beyond the boundaries of 3-4.5h "therapeutic window".
Subject(s)
Cerebrum/blood supply , Cerebrum/diagnostic imaging , Perfusion Imaging/methods , Stroke/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle AgedABSTRACT
In the review we present detailed analysis of antihypertensive action of 3-nd generation sympatholytic moxonidine. Due to selective interaction with imidazoline I1-receptors moxonidine diminishes sympathetic activity causing lowering of peripheral vascular resistance. This leads to significant lowering of systolic and diastolic arterial pressure. Efficacy and safety of the drug has been shown both for the management of uncomplicated hypertensive crises and long term treatment of arterial hypertension (AH). Appropriateness of the use of moxonidine in patients with AH combined with diabetes mellitus, metabolic syndrome, chronic obstructive pulmonary disease has been confirmed. Moxonidine is well tolerated; its bioavailability after oral intake reaches 90%. The drug produces neither hypotensive "first dose" nor rebound effects.
Subject(s)
Blood Pressure/drug effects , Hypertension, Malignant/drug therapy , Imidazoles , Imidazoline Receptors/metabolism , Sympathetic Nervous System/drug effects , Vascular Resistance/drug effects , Administration, Oral , Antihypertensive Agents/administration & dosage , Antihypertensive Agents/adverse effects , Biological Availability , Humans , Hypertension, Malignant/metabolism , Hypertension, Malignant/physiopathology , Imidazoles/administration & dosage , Imidazoles/adverse effects , Imidazoles/pharmacokinetics , Severity of Illness Index , Treatment OutcomeABSTRACT
Clinicostatistical analysis of arterial hypertension complicated with hypertensive crisis using data of Moscow A.S.Puchkov Station of Urgent and Emergent Medical Aid revealed 14% rise in number of hypertensive crises during the period from 2005 to 2009. Number of hypertensive crises increased among persons of young age (18-35 years). Frequency of cerebrovascular complications of hypertensive crises was age dependent with maximal values among men aged 36-74 years and women older than 75 years.
Subject(s)
Hypertension/epidemiology , Adolescent , Adult , Age Distribution , Aged , Data Interpretation, Statistical , Disease Progression , Female , Follow-Up Studies , Humans , Hypertension/physiopathology , Male , Middle Aged , Morbidity/trends , Moscow/epidemiology , Retrospective Studies , Risk Factors , Sex Distribution , Young AdultABSTRACT
Butylaminohydroxypropoxyphenoxymethyl methyloxadiazole was used in prehospital treatment of 40 patients (15 women, 25 men aged 63+/-17.1 years) with complicated hypertensive crises (HC) characterized by acute involvement or high risk of progression of damage of internal organs. The drug was administered as intravenous bolus injection of 10-50 mg (1-5 ml of 1% solution) under control of arterial pressure (AP) and heart rate (HR). The patients noted alleviation of symptoms by 15th min and disappearance of main manifestations of HC by 30th min. Systolic and diastolic AP were significantly lowered from baseline 190.0+/-24.4 and 105.0+/-13.5 mm Hg to 153.3+/-20,1 and 85.0+/-12,6 mm Hg, respectively. Mean dynamics of lowering of systolic and diastolic AP was 19.5 and 19%, respectively. This was accompanied by 15.4% lowering of HR (from 90.3+/-12.0 to 76.4+/-9.4 bpm). Myocardial ischemia in those patients who had it diminished or disappeared. Thus in patients with complicated HC the study drug exerted effective antihypertensive and antiischemic actions. It was well tolerated and did not cause significant side effects.
