[Epidemiology and features of statistical accounting of in-hospital ischemic stroke (St. Petersburg experience)]. / Epidemiologiya i osobennosti statisticheskogo ucheta vnutrigospital'nogo ishemicheskogo insul'ta (na primere Sankt-Peterburga).

OBJECTIVE: To evaluate the effectiveness of the existing registration system and propose an epidemiological model for statistical accounting of the frequency of development of in-hospital ischemic stroke (IHS) in medical organizations of the Russian Federation on the example of St. Petersburg. MATERIAL AND METHODS: The design of the study, conducted in the period 2014-2021, included two stages. At the first (retrospective) stage (from 01.09.14 to 31.03.16) an initiative analysis of the quality of care for 243 patients (5 medical institutions) was carried out in order to determine the relevance of the issues of IHS for the healthcare of St. Petersburg. At the second (prospective) stage, based on the data of the city stroke registry and sample control of reported cases of IHS during initiative visits and as part of annual audits, an epidemiological analysis of the frequency of occurrence of IHS in city hospitals (11 medical institutions) was performed. At the second stage, 1253 reported cases of IHS were studied: 805 (64.2%) in hospitals providing endovascular care for stroke and 448 (35.8%) in primary stroke centers (PSC). The second stage included 2 chronologically consecutive periods (from 04.01.16 to 31.12.18 and from 01.01.19 to 31.12.21) with testing of 3 different methodological approaches to accounting for the IHS. RESULTS: The share of IHS in the structure of all ischemic strokes (IS) in hospitals with PSC and regional vascular centers (RVC) in St. Petersburg in the period 2016-2021 was 1.4-2.0%. There were no significant differences in the ratio of IHS in the overall structure of IS between typical hospitals with PSC and RVC. In the general structure of IS, initially diagnosed in hospitals, the proportion of IHS is about 1/3 (~30%), the remaining 2/3 (~70%) of cases are cases of late diagnosis of out-of-hospital vascular events (in various periods), other causes of acute cerebral pathology, cases of illegally established in-hospital vascular events. CONCLUSION: The proposed calculation model is able to bring closer to understanding the real number of IHS in a large metropolis, but does not reflect its exact number, because is based on accounting for the work of only a part of the city hospitals included in the city's program of care for patients with stroke.

[Low-molecular-weight DNA in blood plasma and cerebrospinal fluid of patients with acute stroke]. / Soderzhanie nizkomolekuliarnoĭ DNK v plazme krovi i tserebrospinal'noĭ zhidkosti u bol'nykh s ostrym narusheniem mozgovogo krovoobrashcheniia.

AIM: To characterize the value of low-molecular-weight DNA in blood plasma and cerebrospinal fluid for the diagnosis of acute stroke of ischemic and hemorrhagic types early after the onset of the disease. MATERIAL AND METHODS: DNA from plasma and cerebrospinal fluid was isolated by phenol deproteinization, analyzed by gradient polyacrylamide electrophoresis. Content of low-molecular-weight DNA was determined on the electrophoregram by comparison with standards. RESULTS: Authors discovered the differences in the changes in the content of low-molecular-weight DNA in the blood plasma of patients with acute ischemic and hemorrhagic types of cerebrovascular accident within 3 days after onset. Patients with hemorrhagic stroke were characterized by an increase in low-molecular-weight DNA after 3 hours, while patients with ischemic stroke after 24 hours from onset. Low-molecular-weight DNA was also detected in the cerebrospinal fluid of patients with ischemia during the first day of the disease. CONCLUSION: The results indicate a role of apoptosis in the formation of ischemic lesion.