EFFECT OF INVESTIGATIONAL COMBINATIONS OF NEUROPROTECTANTS ON THE LEVEL OF S 100 AND NSE PROTEIN IN THE BLOOD SERUM OF PATIENTS WITH MODERATE AND SEVERE ISCHEMIC STROKE.

Ischemic cerebral stroke (ICS) is a devastating neurological pathology associated with enormous comorbidity and mortality. Preliminary experimental screening of cerebroprotective agents with different mechanisms of action was performed: Edaravone, Cerebrolysin, Choline alfoscerate, Citicoline, Mexidol, the most effective combinations of cerebroprotectors were identified, followed by their screening for efficacy in clinical conditions by neuron-specific enolase (NSE) and S100 protein, as one of the main biochemical markers of brain damage in acute ischemic stroke. Different combinations of neuroprotectants identified as the most effective in experimental screening differed in their ability to correct serum levels of S100 and NSE protein in ischemic stroke in clinical settings. The lowest effectiveness in the correction of neuroglioproliferative processes was recorded when using only conventional therapy (CT), which was determined according to the Order of the Ministry of Health of Ukraine of 03.08.2012 №602, without the use of neuroprotectors. Whereas, the use of a neuroprotective combination/complex (NPC) (cerebrolysin+citicoline) in the treatment of ischemic strokes in terms of the effectiveness of correction of neuroglioproliferative processes was 1,7-2,7 times (p<0.01) higher than conventional therapy, and 1,2-1,4 times (p<0.05) higher than treatment that included the use of a neuroprotective combination - cerebrolysin+mexidol.

RISK FACTORS OF IN-HOSPITAL INFECTIONS OCCURRENCE IN HEALTHCARE INSTITUTIONS IN UKRAINE AND EU COUNTRIES.

The rapid development of modern scientific medicine and practice (development of genetic engineering, coronary angiography, use of microprocessors (microminiature implant in eye retina, 3D-print of implants, prostheses) is connected with the scientific-technical progress in recent years, which gave impetus to introduction of extremely complex treatment and diagnostic methods. The use of high-tech medical equipment requires the implementation of modern sanitary and anti-epidemic measures of disinfection and sterilization after each manipulation to prevent in-hospital infection/infectious diseases which are related to the grant of medicare (IHI/IPNMD). Every year in the USA, up to 2 million patients who received medical services are registered with IHI/IPNMD cases. IHI/IPNMD is the cause of increased mortality, disability, lengthens stay period of patients in hospitals, increases the financial burden on both patients and healthcare system. According to WHO data mortality from IHI/IPNMD among adult patients ranges from 18.5% to 29.6% and in countries with low- and middle-income level fluctuate in the range of 8.8%-88.9%. Thus, the vital issue today is to strengthen the control system over IHI/IPNMD at all stages of its spread, namely: early detection of sick persons and carriers among patients and medical personnel, monitoring resistance to antibiotics and control over their use in patients treatment, expanding the range of scientific research in the development of new groups of antibacterial drugs, compliance with the sanitary-epidemic regime in hospitals, including the elaboration of modern disinfectants and sterilization agents.