RESUMEN
OBJECTIVE: To study the effectiveness of common neuropsychological tests for the verification of the diagnosis of cerebral ischemia (CE) and a role of polymorphisms in SERT, ApoE and BDNF genes in its development. MATERIAL AND METHODS: We studied 272 inpatients, aged from 37 to 70 years, with CE of the first stage (58 patients), CE of the second stage (121 patients) and CE of the third stage (93 patients). A set of neuropsychological tests, as well as biochemical and molecular-genetic studies were performed. RESULTS AND CONCLUSION: Reitan test was the most effective test for the diagnosis of cognitive impairment. The results of the Clock Drawing Test and MMSE were correlated with the disease severity but did not distinguish between the first and second stages of CE. Arterial hypertension and stenosing atherosclerosis of brain vessels were significant predictors of CE. SERT gene was a marker of the CE risk in men. The genotype SS was associated with the risk of CE with early age-at-onset. No association of ApoE and BDNF genes with CE was found.
Asunto(s)
Apolipoproteínas E/genética , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/genética , Factor Neurotrófico Derivado del Encéfalo/genética , Proteínas de Transporte de Serotonina en la Membrana Plasmática/genética , Adulto , Anciano , Enfermedad Crónica , Femenino , Marcadores Genéticos , Humanos , Hipertensión/genética , Arteriosclerosis Intracraneal/genética , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Polimorfismo Genético , Factores SexualesRESUMEN
Overcoming polyresistance of pathogens of infectious endocarditis (IE) is only possible through the use of new antibiotics, such as daptomycin, that was successfully used in 4 patients. The clinical features of endocarditis caused by Enterococcus faecalis resistant to penicillin, gentamicin, and streptomycin are described. Cases of IE with negative blood cultures and a failure of previous antibacterial therapy are considered. The literature data on the use of daptomycin in IE caused by oxacillin-resistant S. aureus are presented along with the information on valve prosthetics, peculiarities of IE in pregnant women and patients on hemodialysis.
Asunto(s)
Antibacterianos/uso terapéutico , Daptomicina/uso terapéutico , Endocarditis Bacteriana/tratamiento farmacológico , Enterococcus faecalis/efectos de los fármacos , Anciano , Farmacorresistencia Bacteriana/efectos de los fármacos , Ecocardiografía , Endocarditis Bacteriana/microbiología , Enterococcus faecalis/patogenicidad , Humanos , Imagen por Resonancia Magnética , Masculino , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
We studied the blood and plasma viscosity and hematocrit in patients with ischemic stroke and in a control group. Patients with ischemic stroke had a marked hyperviscosity and elevated hematocrit levels which were correlated with arterial hypertension, alcohol consumption and tobacco smoking. In women aged 45-55 years, viscosity and hematocrit were correlated with age that may be explained by the hormonal changes. People with ischemic stroke had three variants of circadian patterns of viscosity and hematocrit with peaks at 9 am, 3 pm and 9 pm. In some patents a strong correlation between the time of stroke onset and circadian pattern was observed.
Asunto(s)
Viscosidad Sanguínea/fisiología , Ritmo Circadiano , Accidente Cerebrovascular/sangre , Accidente Cerebrovascular/fisiopatología , Anciano , Femenino , Hematócrito , Humanos , Masculino , Persona de Mediana EdadRESUMEN
We examined an association of the C-148T beta-fibrinogen gene polymorphism with fibrinogen level and platelet aggregation in patients with ischemic stroke and in people with vascular risk factors but no ischemic stroke. Among stroke patients, carriers of an -148T allele had significantly higher plasma fibrinogen level and platelet aggregation to norepinephrin compared to the C/C homozygotes. No significant differences in frequencies of a C-148 allele between stroke patients and controls were observed.