[Postoperative applications of the fast track technology in patients with herniated intervertebral discs of the lumbosacral spine]. / Primenenie tekhnologii bystrogo vosstanovleniya posle khirurgicheskikh vmeshatel'stv u patsientov s gryzhami mezhpozvonkovykh diskov poyasnichno-kresttsovogo otdela pozvonochnika.

TOPICALITY: The fast track technology means a complex of targeted measures involving rational preoperative preparation, minimally invasive surgery, regional anesthesia and short-acting anesthetics, and early postoperative rehabilitation. Elucidating the possibility of applying the fast track technology in neurosurgery, in particular in spinal surgery, is extremely topical. This is associated with the epidemiological data and the fact that minimally invasive techniques used in neurosurgery are highly expensive. AIM: The study objective was implementation of the fast track technology and subsequent analysis of its use after surgery in patients with herniated intervertebral discs of the lumbosacral spine. MATERIAL AND METHODS: The fast track technology following spinal surgery was implemented at the Clinical Hospital of the Presidential Administration of the Russian Federation and the Neurosurgical Department of the Clinical Hospital № 1 of the Presidential Administration of the Russian Federation using an algorithm of technology application. The study included 48 patients who underwent surgical treatment for herniated intervertebral discs of the lumbosacral spine between January and July 2015. RESULTS: An analysis of pain severity using the Visual Analog Scale demonstrated a slight decrease (10%) in a group of patients who were subjected to the fast track technology, at discharge and at 1 month after surgery; there was no difference in longer follow-up. An analysis of the functional status using the Oswestry index and Roland-Morris scale demonstrated that patients of the study group had faster and more efficient recovery and an improvement of the functional activity by 20% (p<0.05) compared to those in the control group. An analysis of patient-reported assessment of treatment quality revealed that indicators, such as awareness and pain control, in the study group were highest and amounted to 95% and higher. An analysis of the hospital stay duration showed a decrease in the number of bed-days in an integrated group by 39%, which saved 34 bed-days. CONCLUSION: The fast track technology reduces the degree of surgical aggression, increases surgery safety, and decreases the number of intraoperative complications and hospital stay duration.

[Vertebrology 2.0: an automatic virtual consultation system].

UNLABELLED: The use of computer information and Internet technologies to solve clinical problems becomes trivial but is still a topical and promising direction closely related to the «Healthcare 2.0¼ concept. The methodology for developing virtual patient consultation systems is associated with the capabilities to process obtained data and optimize the choice of optimal tactics for further treatment, taking opportunities of the Internet. The study objective was to develop an automatic virtual consultation system for patients with spine and spinal cord diseases on the basis of the online vertebrologi.ru portal. MATERIAL AND METHODS: 33 signs with different answer variants were selected for advising. On the basis of these signs, an expert advised more than 170 patients. RESULTS AND CONCLUSION: On the basis of consultation analysis, a set of rules was developed to automatically generate a consultation text, depending on selected sign values. Currently, the automatic virtual consultation system, which was developed jointly by the Institute for Systems Analysis, Burdenko Neurosurgical Institute, and Volynskaya Clinical Hospital №1, operates online on the vertebrologi.ru portal as one of its modules.

[The role of genetic predisposition in the development of cardiovascular diseases (myocardial infarction, ischemic stroke, unstable stenocardia) and its interaction with conventional risk factors].

To assess the risk of cardiovascular events, the diagnostic effectiveness of molecular-genetic markers (polymorphisms in APOE, ACE (I/D) and MTHFR (C677T) genes) in combination with conventional risk factors has been studied. The prognostic effectiveness of common algorithms (the Framingham scale) is not sufficient for evaluation of risk factors for cardiovascular diseases. The combination of results of molecular-genetic testing with conventional risk factors allows to increase the predictability of cardiovascular risks.

[The metabolic therapy of ischemic stroke: the use of nootropil]. / Metabolicheskaia terapiia ishemicheskogo insul'ta: primenenie nootropila.

54 patients were treated by notropil (pyracetam). The results of therapy were evaluated statistically according to a number of clinical scales and neurophysiologic indices (EEG and evoked potentials with mapping of bioelectric activity). The results were compared with the data about 56 patients of the control group which were treated by traditional method without application of notropil. Notropil was applied by two ways: small doses (4-12 g daily) during 5 days or high doses (10-12 g daily) during 30 days from the moment when the patient admitted to the hospital. Intravenous injections of the drug were used in all cases as well as its internal administration. It was showed either efficiency of the drug, especially in high doses, in early beginning of the treatment and its duration for at least 30 days or good tolerance of the drug. Authors supposed that application of pyracetam is not adequate in strokes with severe disorders of consciousness and cerebral edema.