[Medical and socio-economic effects of early rehabilitation of patients with acute cerebral vascular accidents].

Acute ischemic brain injury (stroke, stroke), a leader among the causes of morbidity and mortality in the world. This pathology is one of the most pressing health and social problems that cause enormous economic damage to society, due to the high fatality rate, significant disability and social maladjustment of patients, which is based in most cases are the motor and cognitive impairment. Despite the fact that, currently established risk factors and pathophysiological basis of this disease, the availability of effective methods of diagnosing illness, still a practicing neurologist in some cases difficult to find adequate therapy that could effectively reach a well-established neurological deficit. Therefore the search for treatments that effectively reduce the health and social consequences of vascular damage to the brain, is one of the priority areas of neurology.

[Optimization of medical-diagnostic process in patients with traumatic brain injury during early rehabilitation].

The problem of cardiovascular disease and cancer, the effects of traumatic brain injury is now one of the major health and social problems. Every year in Ukraine registered 200 thousand cases of the victims of traumatic brain injury. Of these, 30% of people then have persistent signs of disability that results in a disability, sometimes painful existence the patient and his relatives. Therefore, in order to bring man back into society after a traumatic brain injury, to the rehabilitation phase of treatment, immediately after the stabilization of the patient.

[Treatment and outcome of chronic hepatitis B in children]. / Techenie i iskhody khronicheskogo gepatitia B u detei.

225 children at the age from 6 months to 15 years with chronic hepatitis type B (CHB) were under observation. In addition to clinical biochemical evaluation and morphological recording, there also was the serologic monitoring of the pathologic process condition by means of determination of hepatitis type B and other hepatitis viruses markers. The patients were observed during 1-10 years. It was found that almost all of the patients, with the exception of 3 children (1.3%), had no acute onset of the disease. According to the morphological study data, changes in the liver varied from minimal to apparent activity, up to the formation of hepatocirrhosis in single cases. The clinical presentation of CHB in children included mainly the enlargement and induration of the liver, enlargement of the spleen and anhepatic signs (capillaritis and telangiectasia). After 4 years from the onset of CHB stable and prolonged remission was formed in most of the patients (64.6%); in 35.4% of cases clinical biochemical activity of the disease remained for a longer period of time (5-10 years or longer). The gradual cessation of the disease activity correlates with seroconversion of HBeAg on anti-Hbe. Children with the continuous pathologic process in the liver have HBV DNA in their blood. The main outcome of CHB in children is a prolonged remission with permanent HBs-antigenemia in 89% of cases. The recovery was recorded in 9.68% of cases (disappearance of HbsAg and acquisition of anti-HBs). Hepatocirrhosis was formed in 3 children (1.32%).

[The clinico-pathogenetic importance of evaluating monocyte phagocytic activity in viral hepatitis in children]. / Kliniko-patogeneticheskoe znachenie otsenki fagotsitarnoi aktivnosti monotsitov pri virusnykh gepatitakh u detei.

The phagocytic activity of blood monocytes in healthy donors and in children having virus hepatitis was studied. The cytological analysis of preparations made it possible to identify several variants of phagocytosis. Monocytes in children having the moderate form of acute virus hepatitis at the primary stage of the disease proved to be most active. The phagocytic activity of monocytes was low in chronic virus hepatitis. The treatment of children having acute virus hepatitis B with recombinant alfa-2 interferon restored the capacity of monocytes to phagocytose zymosan, which preceded the clinical manifestations of remission.

[Chronic hepatitis C in children]. / Khronicheskii gepatiti C u detei.

The clinico-laboratory manifestations and outcomes of chronic hepatitis C have been studied in 49 children. The proportion of chronic hepatitis C in the structure of chronic viral hepatitides in children is 20.5%. Among chronic hepatitis C patients, in 18.4% chronic persisting hepatitis, in 20.4% chronic active hepatitis and in 61.4% chronic active hepatitis with transition to cirrhosis of the liver have been diagnosed. In patients with chronic hepatitis C manifested as chronic persisting hepatitis or chronic active hepatitis the course of the disease is characterized by intermittent periods of prolonged exacerbations and short remissions. In cases of chronic active hepatitis with cirrhosis of the liver the signs of the active process can be constantly detected in the course of prolonged observations. In some patients with chronic active hepatitis the lethal outcome is possible as the consequence of progressing liver insufficiency. The data obtained in this investigation indicate that autoimmune chronic hepatitis in children, extensively described in Russian and foreign literature, may be etiologically linked with hepatitis C virus.

[The pathogenetic significance of disorders in macrophage function in viral hepatitis B and delta in children]. / Patogeneticheskoe znachenie narushenii funktsional'nogo sostoianiia makrofagov pri virusnykh gepatitakh B i del'ta u detei.

Overall 180 children aged 3 months to 12 years with acute and chronic hepatitis B and delta were examined for macrophagal function. Chemotaxis, saturation with esterase, the content of nuclear RNA were estimated, antigens of HB virus in these cells were identified as well. The data obtained attest to the correlation between the degree of macrophagal function disorders and the gravity of acute virus hepatitis. The chronic disease is characterized by stable depression of mononuclear cells with a tendency toward deeper depression of their function in patients with virus hepatitis delta as well as a higher rate of HBsAg and HBeAg demonstration in these cells. The authors provide evidence for advisability of the use of BCG vaccine and tactivin in patients with the chronic disease, since they improve macrophagal function, promote the inhibition of HB-virus replication and the onset of a stable remission in patients with chronic hepatitis B and delta.

[The detection of hepatitis B virus DNA in the blood serum of children with chronic HBsAg-positive hepatitis]. / Vyiavlenie DNK virusa gepatita B v syvorotke krovi u detei s khronicheskim HBsAg-pozitivnym gepatitom.

The presence of HBV DNA in the blood serum of 50 children with HBsAg-positive chronic hepatitis (36 with chronic hepatitis B, 14 with chronic hepatitis delta) was determined by molecular hybridization method. No significant differences were observed between the frequency of HBV DNA detection and clinicomorphological type of chronic HBsAg-positive hepatitis. In chronic HBV infection, HBV DNA was shown to be detected more frequently than in chronic hepatitis delta. A correlation was confirmed between the frequency of HBV DNA detection and demonstration of HBeAg in the blood. With the increase in the duration of the disease and age of the patients the HBV DNA detection rate was found to diminish.