[Intravenous thrombolytic therapy of ischemic stroke with the drug Revelisa in real clinical practice: results of the IVT-AIS-R study]. / Vnutrivennaya tromboliticheskaya terapiya ishemicheskogo insul'ta preparatom Reveliza v real'noi klinicheskoi praktike: rezul'taty issledovaniya IVT-AIS-R.

OBJECTIVE: Evaluation of the safety and effectiveness of thrombolytic therapy (TLT) with the drug Revelisa (alteplase) in patients with ischemic stroke (AI) in real clinical practice. MATERIAL AND METHODS: An open prospective multicenter non-interventional register study was conducted, which included 550 patients with AI - 259 (47.1%) women and 291 (52.9%) men; average age 67.7±12.6 years. All included patients underwent TLT with the drug Revelisa within 4.5 hours from the onset of the disease and, according to the protocol of reperfusion therapy of AI, clinical, instrumental and laboratory examinations were performed. Symptomatic hemorrhagic transformation (GT) was determined in accordance with the criteria of the ECASS 3 study. RESULTS: The majority of patients (95.8%) suffered from hypertension, 69.6% had chronic heart failure, 53.8% had coronary heart disease, 38.7% had various cardiac arrhythmias, 20.7% of patients suffered from type 2 diabetes mellitus. A day after TLT, an improvement of 4 points or more on the NIHSS scale was noted in 45% of patients. The average dynamics index on the NIHSS stroke scale after a day was -3.2±4.7 and -4.4±6.1 per 7 females (p<0.0001). GT of the lesion of the brain developed in 10.9% of cases, symptomatic GT was diagnosed in 12 (2.3%) patients. The hospital mortality rate was 12.7%. The proportion of patients with good functional recovery (0-2 points on the modified Rankin scale (mRS)) at discharge, on days 30 and 90 was 44.7%, 59.2% and 68.5%, respectively. CONCLUSION: Performing TLT with the drug Revelisa in patients with AI leads to a statistically significant regression of neurological symptoms. A significant proportion of patients achieve a favorable clinical outcome upon discharge from the hospital and in the long term. The obtained data on the efficacy and safety profile correlate with previously published register studies of alteplase in AI.

CHOLESTASIS OF PREGNANCY.

The article presents data concerning the prevalence, clinical manifestations, methods of diagnostics, treatment and prevention of cholestasis of pregnancy, as well as the case management depending on the gestation and the cholestasis severity. A clinical case of a typical course of cholesrasis of pregnancy is presented.

PANCREATITIS IN PREGNANCY: CASE MANAGMENT.

The purpose of the review is to summarise the current data on chronic and acute pancreatitis with the goal to improve the diagnostics and treatment of women during pregnancy, which complicates differential diagnosis of hepatopancreatobiliary system pathology. The features of the incidence, etiology, parhogenesis and evaluation of the severity of the clinical manifestations of acute pancreatitis in pregnant women are given, It is emphasis that the most frequent its reason is the gallstones following by the biliary pancreatitis. The experience of use in pregnant patients imaging methods - endoscopic ultrasound, magnetic resonance cholangiopancrearography and endoscopic retrograde cholangiopancreatography, as well as treatments that include endoscopic sphincterotomy, stone extraction from the common bile duct and laparoscopic cholecystectomy. The recommendations are based on expert opinions and are not supported by randomized controlled trials. Nevertheless more active clinical management allows to diagnose and treat effectively pancreatitis, including biliary etiology, which contributes to a sharp decline in maternal and perinatal mortality.

[Phycotoxins of ASP, PSP and DSP groups in aquaris organisms].

In this article the results of analysis of ASP, PSP and DSP phycotoxins content in aquatic organisms are presented. Methods of determination of toxins were ELISA and HPLS.

[Optimization of a method of solid-phase immunoenzyme analysis for determination of chloramphenicol in milk]. / Optimizatsiia metoda tverdofaznogo immunofermentnogo analiza dlia opredeleniia khloramfenikola v moloke.

The method of solid-phase enzyme linked immunosorbent assay (ELISA) for quantitative detection of chloramphenicol (CAP) in milk was developed. Peculiarities of the adsorption on the microtitre plates surface of CAP-ovalbumin conjugate were investigated. Different conditions of competition stage of the analysis were studied. Conditions providing CAP monitoring in human blood serum in the clinical range were optimized. Matrix effect on the assay results was studied. The specificity of the analytical system was investigated and the reagents stability was examined. The method developed permits CAP concentration to be determined in human blood serum, diluted 1/100, in the linear range from 0.1 to 100 ng/ml. The assay is characterized by high sensitivity (0.08 ng/ml) and good reproducibility (CV < 10.8%), assay time is about 3 hours. The correlation coefficient with HPLC is 0.977.

[Cholesterol metabolism in patients with ischemic heart disease with varying supplies of omega-3 polyunsaturated fatty acids]. / Obmen kholesterina u bol'nykh ishemicheskoi bolezn'iu serdtsa pri razlichnom obespechenii polinenasyshchennymi zhirnymi kislotami semeistva omega-3.

Patients with ischemic heart disease and with hyperlipidemia of the IIa, IIb and IV types as well as not exhibiting any pronounced alterations in cholesterol metabolism were treated with various amounts of omega-3 polyunsaturated fatty acids (PUFA) introduced into the basic antiatherosclerotic diet: 1 group--content of the essential factor 0.2 g/day, 2 group--increased content of natural products with PUFA up to 1 g/day, 3 group--increased PUFA content due to the drug "euconol" 5 g/day. Administration of the PUFA omega-3 into the basic antiatherosclerotic diet contributed to development of adequate clinico-biochemical alterations; under these conditions content of alpha-cholesterol in blood correlated directly to concentration of polyunsaturated cholesterol esters and PUFA omega-3 (eicosapentaenate and docosahexaenate) as well as reverse correlation was found between content of total cholesterol and these molecular forms of cholesterol esters studied. Enrichment of the diet with PUFA omega-3 did not cause any alterations in content of primary bile acids in blood thus suggesting that PUFA omega-3 did not affect the cholesterol catabolism. These data enabled us to plot the graph for individual evaluation of cholesterol metabolism in patients with ischemic heart disease involving alterations in the spectrum of esterified cholesterols in blood before and after the treatment course.

[The formalized diagnosis of acute suppurative pyelonephritis]. / Formalizatsiia diagnostiki ostrogo gnoinogo pielonefrita.

Using mathematical analysis methods, the authors try to develop algorithm of the diagnosis and early treatment of acute purulent pyelonephritis (APP). On the basis of 107 case histories (84 surgical, 12 conservative APP cases, 11 patients without the inflammation) characteristic symptoms were established. These may serve as parameters for the classification analysis and plotting curves indicative of the kidney involvement in the pyodestructive process. The analysis of the curves elicited that the pattern of the parameter changes reflects stages of purulent pyelonephritis in the kidney.

[Characteristics of lipids of microbial origin with regard to triglyceride composition and comparison of them to plant oils]. / Kharakteristika lipidov mikrobnogo proiskhozhdeniia po triatsilglitserinovomu sostavu i ikh sravnenie s rastitel'nymi maslami.

The triacylglycerol composition of lipids isolated from the yeasts Candida guilliermondii and C. humicola and of food vegetable oils was investigated by HPLC. The triacylglycerol composition of samples was compared using the program "Nearest neighbour" and by plotting images with the help of the software package STATGRAPHICS. The methods used allow us to conclude that microbial lipids are rather promising.

[Triacylglycerols in human milk and milk mixtures for infant feeding]. / Triatsilglitseriny zhenskogo moloka i molochnykh smesei dlia detskogo pitaniia.

High-performance liquid chromatography and computer program for identification of individual triacylglycerols (TAG) were employed for investigation of TAG composition of mature breast milk and 8 specimens of dry milk food for infants. The comparison was made by 15 molecular types of breast milk TAG using methods "close neighbour" and "star symbol plot" (Statgraphics). The composition appeared quite different. The design of artificial nutrition for infants basing on identity of fatty acids is believed inadequate as it cannot reproduce Tag composition of natural breast milk.

[Molecular types of breast milk triacylglycerols at various stages of lactation]. / Molekuliarnye tipy triatsilglitserinov zhenskogo moloka na razlichnykh stadiiakh laktatsii.

The composition of individual triacylglycerols was studied in women milk in various periods of lactation. The spectra of triacylglycerols were studied in the early lactation milk, in the mature milk and in the late lactation milk using a method of "main components", the program of "immediate neighbour" as well as by construction of graphic plot (by means of a set "Statgraphics"). The methods of calculation used enabled one to find great differences in the triacylglycerol spectrum of mature milk as compared with those of milk in the early and late periods of lactation.