[Clinical and neuroimaging signs of cardioembolic stroke laboratory in children]. / Klinicheskie i neirovizualizatsionnye priznaki kardioémbolicheskogo insul'ta u detei.

AIM: To study clinical and neuroimaging signs of cardioembolic stroke (CES) in children. MATERIAL AND METHODS: Ten children (mean age 3.5±3.5 years) were examined. Eight children met the diagnostic criteria of CES CASCADE, two children were diagnosed with CES based on the complex of symptoms. A comparison group consisted of 90 children with other subtypes of ischemic stroke (IS). The diagnosis was confirmed by MRI and magnetic-resonance angiography; symptom severity was assessed with PedNIHSS and PSOM. RESULTS AND CONCLUSION: The PedNIHSS score in the acute stage of CES was higher (18.4±9.34) compared to patients with other subtypes of IS (12.6±6.2; p=0.0065). Six patients had large cerebral infarctions with the involvement of basal ganglia, internal capsule, white matter and cerebral cortex. In two patients, the infarction affected the cerebral cortex and underlying white matter, in one patient it affected the cortex from one side and the basal ganglia from the other. A damage of the cortex was noted in one patient. The frequency of recurrent CES was 30%, of fatal cases 20%. Recurrent IS and severe residual neurological deficit were more frequent in CES. CONCLUSION: Early disease onset, acute development and progression of neurological deficit up to the maximal level in the first 5 min, marked severity of the acute stage (PedNIHSS score >15), early onset of neurological function recovery, marked residual neurological deficit (PSOM score >2) are the additional signs of CES.

[Clinical and neuroimaging signs of cardioembolic stroke in children]. / Klinicheskie i neirovizualizatsionnye priznaki kardioémbolicheskogo insul'ta u detei.

AIM: To study clinical and neuroimaging signs of cardioembolic stroke (CES) in children. MATERIAL AND METHODS: A group of 100 patients with arterial ischemic stroke (AIS), aged from 1 month to 15 years, was stratified into the main group (10 patients with CES) and the comparison group (90 patients with other subtypes of AIS). CT and MRI, MR-angiography, ultrasound study as well as assessment of clinical symptoms on PedNIHSS were performed. The duration of follow-up was from 2 month to 14 years. The follow-up allowed the assessment of occurrence of secondary strokes, severity of residual neurological symptoms on the PSOM and fatal outcomes. Special attention was drawn to the use of CASSADE criteria for CES. RESULTS AND CONCLUSION: Clinical features that help to diagnose CES, even in the absence of adequate neuroimaging, in patients with heart disease, which is a potential high risk factor for cardioembolia, were established. These factors include early disease onset, acute development and progression of neurological deficit to the maximal level in the first 5 min., marked severity of the acute period (PedNIHSS > 15), early recovery of neurological functions, significant residual neurological symptoms (PSOM > 2). These symptoms should be used in addition to the CASCADE criteria in the diagnosis of CES of AIS type in children.

[Autonomic cardiovascular regulation in patients with tics and Tourette syndrome].

Autonomic cardiovascular regulation has been assessed in patients aged 4-15 years with Tourette syndrome (n = 22) and other tic disorders (n = 48). Symptom significance was estimated by a number of hyperkinetic episodes per 20 minutes, tic scale and variants of the disease course. The functional condition of autonomic nervous system was studied clinically and using spectral analysis of heart rate variability in both upright and supine positions. Negative correlation between the ratio of sympathetic and vagus influences and severity of the disease was found: the severer were tic symptoms, the stronger was a trend to vagotonia (beta = -0.36; p < 0.0025; F > 4.0). In orthostatic test, patients with Tourette syndrome demonstrated an unfavorable hypersympathicotonic type of cardiovascular system reaction. Patients were treated during 4 weeks with glycinum (0.2 +/- 0.1 mg/day), phenibutum (0.5 +/- 0.25 mg/day), clonazepam (1.5 +/- 0.5 mg/day), tiapride (200 +/- 100 mg/day), haloperidol (1-1.5 mg/day), rispolept (2 mg/day). There was no negative effect of the drugs on heart rate variability. On the contrary, the therapy reduced hyperkinetic symptoms and corrected autonomic influences on the sinus rhythm. It is suggested that changes in autonomic cardiovascular regulation might be of secondary character and do not need any special correction.

[Diagnosis of urogenital chlamydiosis using rapid immunoenzyme method: Abbott TestPack Chlamydia]. / Diagnostika urogenital'nogo khlamidioza s ispol'zovaniem immunofermentnogo ékspress-metoda Testpack Chlamydia firmy "Abbott".

Twenty women suffering from chronic genital inflammations were screened for urogenital chlamydiosis using Abbott Testpack Chlamydia kit for enzyme immunoassay (EIA) and NIARmedik Chlamoscan kit for immunofluorescent method. The cells were scraped off from the cervical canal during the second phase of the cycle. In addition, smears were taken from the vagina and cervical canal to be screened for microflora using Romanowsky-Giemsa staining. EIA detected C. trachomatis antigens in 3 (15%) out of 20 examinees, whereas direct immunofluorescence revealed these antigens in only 2 (10%) patients. The results differed in a patient with urogenital candidiasis. Evidently, the system of special filters in the Testpack Chlamydia releases the cell suspension from concomitant cell dendrites, blood, mucus, and thus increases the sensitivity of the test.

[An in-vitro leukocytolysis method for the diagnosis of a drug allergy]. / Metod leikotsitoliza in vitro dlia diagnostiki lekarstvennoi allergii.

The authors analyze published data on various modifications of the specific leukocyte lysis test (SLLT) and their own findings on in vitro osmotic leukocytolysis caused by low-molecular nonelectrolytes (urea, glycerol, and glucose), and present the estimation of osmotic pressure of these agents' solutions in equimolar concentrations. In contrast to the specific effect of allergens, an osmotic component of nonspecific leukocyte lysis is considered. A universal approach to the choice of working doses of drug in SLLT is proposed: equimolar solutions of the allergens (chemical and medicinal compounds). The necessity of further theoretical and practical research of SLLT is validated.

[The determination of leukocyte osmotic resistance in hypertonic solutions of low-molecular nonelectrolytes]. / Opredelenie osmoticheskoi stoikosti leikotsitov v gipertonicheskikh rastvorakh nizkomolekuliarnykh neélektrolitov.

A method for in vitro assessment of blood leukocyte osmotic stability has been developed. A characteristic feature of this method is assessment of qualitative and quantitative parameters in hypo- and hypertonic solutions of low-molecular nonelectrolytes characterized by erythrocytolytic properties (glycerol, urea, dimexide). The error is +/- 10%. The results of the method are compatible and reproducible, it gives sufficient volume of information about leukocyte osmotic stability as an integral indicator of these cells physicochemical properties. A parabolic type of osmotic stability relationship with concentrations in the 0.04 to 5.0 M range has been detected. The optimal concentrations at which the highest leukocyte intactness is observed are 2.0 M for glycerol, 0.5 M for urea, and 5.0 M for dimexide.

[Leukocytolysis and phagocytosis under hyperosmotic conditions]. / Leikotsitoliz i fagotsitoz v giperosmoticheskikh usloviiakh.

PAN and leukocytolysis were measured in dog blood placed in hypo- and hypertonic solutions of glycerin and glucose (1:10). It was found that leukocytolytic activity of the substances depends on equimolar concentrations of nonelectrolytes. It is more pronounced in hypo- than in hypertonic conditions. Glycerin is 3-5-times more active than glucose. In concentrations 2.0 M for glycerin and 0.5 M for glucose leukocytolysis is less active. Mononuclears are more resistant than neutrophils in strong solutions. PAN increased by 11-16% in hypotonic solutions. Strong glycerin solutions reduce PAN less than glucose which stimulates the digestive activity. The results can be of use in specific leukolysis tests to diagnose drug allergy.