RESUMO
GOAL: Presentation of the first Russian computer program (www.carotidscore.ru) for risk stratification of postoperative complications of carotid endarterectomy (CEE). MATERIAL AND METHODS: The present study is based on the analysis of a multicenter Russian database that includes 25,812 patients after CEE operated on from 01/01/2010 to 04/01/2022. The following types of CEE were implemented: 6814 classical CEE with plastic reconstruction of the reconstruction zone with a patch; 18,998 eversion CEE. RESULTS: In the hospital postoperative period, 0.18% developed a lethal outcome, 0.14%-myocardial infarction, 0.35%-stroke. The combined endpoint was 0.68%. For each factor present in patients, a predictive coefficient was calculated. The prognostic coefficient was a numerical indicator reflecting the strength of the influence of each factor on the development of postoperative complications. Based on this formula, predictive coefficients were calculated for each factor present in patients in our study. The total contribution of these factors was reflected in "%" and denoted the risk of postoperative complications with a minimum value of 0% and a maximum of 100%. On the basis of the obtained calculations, a computer program CarotidSCORE was created. Its graphical interface is based on the QT framework (https://www.qt.io), which has established itself as one of the best solutions for desktop applications. It is possible not only to calculate the probability of developing a complication, but also to save all data about the patient in JSON format (for the patient's personal card and his anamnesis). The CarotidSCORE program contains 47 patient parameters, including clinical-demographic, anamnestic and angiographic characteristics. It allows you to choose one of the four types of CEE, which will provide an accurate stratification of the risk of complications for each of them in person. CONCLUSION: CarotidSCORE (www.carotidscore.ru) is able to determine the likelihood of postoperative complications in patients undergoing CEE.
RESUMO
The specific features of the action of combinations of immunostimulants (levamisole, prodigiozan, methyluracil) on a primary immune response to EB, GST and resistance to experimental infection have been studied. It has been shown that levamisole eliminates stimulation by methyluracil and prodigiozan of a primary immune response, lithium carbonate is also an antagonist of prodigiozan. Vitamin E increases the stimulating effect of prodigiozan rather than oxymethacil. The effect of vitamin A depends on the dose. Levamisole does not change the influence of prodigiozan and methyluracil on GST and, like prodigiozan, suppresses GST stimulated by lithium carbonate. The combination of prodigiozan and methyluracil to a large extent than the agent given alone increases resistance to an infection and efficiency of antibiotic therapy. The combination of methyluracil and levamisole increases only the effect of the antibiotic.
