[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.

[Intravenous thrombolytic therapy with Revelisa of ischemic stroke in real-world clinical practice: interim results of an open-label, prospective, multicenter, non-interventional study IVT-AIS-R]. / Vnutrivennaya tromboliticheskaya terapiya ishemicheskogo insul'ta preparatom Reveliza v real'noi klinicheskoi praktike: promezhutochnye rezul'taty issledovaniya IVT-AIS-R.

OBJECTIVE: To assess the safety and efficacy of Revelisa in patients with ischemic stroke in real-world clinical practice. MATERIAL AND METHODS: The interim analysis of an open-label, prospective, multicenter, non-interventional study IVT-AIS-R included 223 patients (50.2% women and 49.8% men, mean age 66.6 (13.5) years) with ischemic stroke who were admitted to the study sites since July 2019 and who, in the absence of contraindications, underwent thrombolytic therapy (TLT) with Revelisa within the first 4.5 hours from the onset of stroke. Data were collected as a continuous sample. According to the reperfusion therapy protocol for ischemic stroke, all patients included in the study underwent clinical examination, investigations and laboratory tests before TLT and within the first days after it. Symptomatic hemorrhagic transformation was determined in accordance with the ECASS 3 criteria. RESULTS: Most of the patients (96%) had hypertension, 74% of patients had chronic heart failure, 57.4% had coronary artery disease, of which 8.5% were patients with a previous myocardial infarction. Various cardiac arrhythmias were observed in 33.2% of cases, 21.5% of patients had type 2 diabetes, 18.4% had a history of previous acute cerebrovascular accidents. Hemorrhagic transformation (HT) of a cerebral lesion developed in 7.1% of cases, with the frequency of symptomatic HT being 3.1% (7 patients). The hospital mortality rate was 13.9%. The median NIHSS score was 4 points (p<0.0001) on day 7 versus baseline. The proportion of patients with good functional recovery (the modified Rankin scale score 0-2) at discharge was 48.2%. CONCLUSION: The data obtained with the use of Revelisa in patients with ischemic stroke in real-world clinical practice allow drawing conclusions about a comparable safety and efficacy profile to that in previously published registry studies of alteplase.

[Possibilities of pharmacotherapy of diabetes acute complications when delivering urgent and emergency aid].

The authors give a description of acute complications when delivering urgent and emergency pharmacotherapy. The authors examined normative legal basis, regulating urgent and emergency aid delivery at the army level of the medical service of the Armed Forces of the Russian Federation, and determine the list of medications. Comparative description of pharmacotherapy of acute complications of diabetes is given and determined its possibilities.

[Quality of life of the patients who had an atherotrombotic stroke in the carotid artery territory]. / Kachestvo zhizni bol'nykh, perenesshikh aterotromboticheskiĭ insul't v karotidnoĭ sisteme.

AIM: To assess quality of life of patients with first-ever atherothrombotic stroke in the carotid artery territory 2 years after the disease onset. MATERIAL AND METHODS: Authors examined 119 patients. Quality of life was measured with the «SF-36 Health Status Survey¼ using two parameters: level of mental (MH) and physical (PH) health. A control group consisted of 20 sex- and age-matched healthy persons without neurological diseases. RESULTS: After two years, 67% of the patients assessed their health condition as satisfactory. In the patients, a decrease in PH was greater compared to MH than in controls. CONCLUSION: In post-stroke period, patients for a long time had lower quality of life indices with marked physical impairment. Elimination of or reduction in the focal neurological deficit that led to the decrease in the level of physical wellbeing may be considered as a significant rehabilitation reserve.

[Prospects of IT usage in the field of military psychiatry].

Development of effective information support for monitoring of internal health, based on the principles of complex diagnostics, provides the necessary tools objektive evaluation and prediction of mental health in servicemen. Effectiveness of psychiatric prophylaxys technologies depends on compliance with a number of fundamental principles, the main of which should be considered as a multidimensional assessment of mental health in servicemen and real cooperation of different specialists (commanders, specialists of medical and psychological service) for its implementation. In this case, an introduction of information and communication technologies on the basis of the district (fleet) and the Central Military Hospital, as well as other bodies of military control will be almost justified only when creating a full-fledged "information field of military psychiatry" that implements the basic principles of the monitoring system of mental health and includes necessary infrastructure. The practical implementation of this system will allow to personjfyfy medical and psychological assistance to military personnel, to improve early diagnosis of mental disorders, addictive .and suicidal behaviour, and thus increase the effectiveness throughout psychiatric prophylaxis in the army.

[Combined burn trauma in the array of modern civilian and combat burns].

The current article positions the combined burn and non-burn injuries in the general array of civilian and combat burns. For that purpose the official state statistics and scientific medical publications, domestic as well as foreign, have been analyzed. It has been shown that in peace time the combined burn/trauma injuries are infrequent. But the same type of injury becomes routine especially among the civilian population in the conditions of the modern so called "hybrid war". And the medical service should be prepared for it.

[The experience of medical information system implementation into multi-field outpatient facility].

The main prospective line of development of information technologies implemented into medical facilities is working out and approbation of complex solutions for work automatiozation. It is necessary to mention the experience of implementation of industrial integrated medical information system into the 9h diagnostic and treatment centre of the Ministry of Defence of the Russian Federation. In 2008 implementation of the information systems was funded by extra budgetary accounts of the facility. The basis of medical information system for the diagnostic and treatment centre was "Interin PROMIS". The article presents the main tasks, stages and difficulties that emerged in the process of implementation. One of the main tasks was to create the database of attached contingents. Conducted work allowed to increase access to healthcare, to develop transparent technologies for providing the healthcare to patients in different subunits. Implemented system is a very prospective for other military-medical facilities and has a unique functional capacity, system customizability, provides access to all activities of the medical facility.

[The basic directions and experience of use of telemedical technologies in military-medical service].

The authors showed that a promising solution for emergency telemedicine advisory assistance issues in the Armed Forces of the Russian Federation is the implementation of technical opportunity of direct advisory support to any functional unit and specialists from main and central military hospitals. But at the present stage, the current task of the military telemedicine should be regarded as the implementation of several advisory centres focused on the implementation of a separate topic of telemedicine cooperation. In this regard, a complex of activities carried out by establishing a network of tele-consulting centres at the Kirov Military Medical Academy in one of the admission departments, in the department of military surgery and in the hall of the Academic Council of the Academy.

[Problematic issues and prospects of development of information and telecommunication technologies in the medical service of the Armed Forces].

Medical information systems composed of many specialized modules help in synchronous solving of diagnostic, therapeutic, administrative, financial, statistical, and other tasks. According to the authors, the creation of a single information space of the medical service, integrating it into a single information space of the Defense Ministry of the Russian Fedaration, development and widespread use of telemedicine technology will significantly accelerate the integration in the daily activities of military hospitals of the latest achievements in medical science and practices consistent with the objectives of improving the military health care and improvement of the quality and accessibility of health care.

[Current problems of information technologies application for forces medical service].

The modern information technologies are the key factors for the upgrading of forces medical service. The aim of this article is the analysis of prospective information technologies application for the upgrading of forces medical service. The authors suggested 3 concepts of information support of Russian military health care on the basis of data about information technologies application in the foreign armed forces, analysis of the regulatory background, prospects of military-medical service and gathered experience of specialists. These three concepts are: development of united telecommunication network of the medical service of the Armed Forces of the Russian Federation medical service, working out and implementation of standard medical information systems for medical units and establishments, monitoring the military personnel health state and military medical service resources. It is noted that on the assumption of sufficient centralized financing and industrial implementation of the military medical service prospective information technologies, by the year 2020 the united information space of the military medical service will be created and the target information support effectiveness will be achieved.