[Artificial ventilation in patients with stroke: main results of the Russian multicenter observational clinical trial RETAS].

Objective: To analyze the relationship between the characteristics of respiratory support (RS) for patients with stroke and clinical factors with the number and structure of complications, deaths, and length of stay in the intensive care unit (ICU) and duration of artificial pulmonary ventilation (ALV).

Material And Methods: The Russian multicenter observational clinical study «Respiratory Therapy for Acute Stroke» (RETAS) that enrolled 1289 patients with stroke requiring RS was conducted under the auspices of the All-Russian public organization «Federation of Anesthesiologists and Resuscitators». Indications for ALV, the use of hyperventilation, the maximum level of positive end-expiratory pressure, starting modes of mechanical ventilation, timing of tracheostomy, the incidence of protein-energy malnutrition (PEM) and infectious complications were analyzed.

[Russian multicenter observational clinical study «Register of respiratory therapy for patients with stroke (RETAS)»: a comparative analysis of the outcomes of stroke].

Objective: To analyze the treatment of patients with severe stroke requiring respiratory support, and identify predictors of death.

Material And Methods: A multicenter observational clinical study «REspiratory Therapy for Acute Stroke» (RETAS) was conducted under the aegis of the «Federation of Anaesthesiologists and Reanimatologists» (FAR). The study involved 14 clinical centers and included 1289 stroke patients with respiratory support.

[Influence of chemosensional disorders on taste preferences in cancer patients who are receiving oral nutrition supplements].

Chemosensory disorders (CSD) such as disorders of taste and smell are one of the causes of malnutrition in cancer patients. of the research was to evaluate the influence of CSD on taste preferences in cancer patients receiving oral nutritional supplements (ONS). .

[Cytoflavin as a modulator of rehabilitation treatment of patients with ischemic stroke complicated by post-intensive care syndrome].

Objective: To assess an effect of cytoflavin on the results of rehabilitation treatment and the increase in exercise tolerance in patients with stroke complicated by post-intensive care syndrome (PICS).

Material And Methods: The data of 53 patients who underwent neurorehabilitation in the ICU after ischemic stroke were analyzed. Depending on the treatment regimen, the patients were divided into two groups.

[Changes in lipid and carbohydrate metabolism in patients with severe sepsis of different etiology].

Unlabelled: Different origin (heterogeneity) of sepsis is a key stone in many discussions regarding options for the course and outcome, despite the general rules of development of the pathogenic mechanisms.

Purpose Of The Study: To compare data of systemic inflammation (CRP, PCT, IL-8, IL-6, IL-4, TNF-alpha) and markers of endothelial dysfunction (NO, lactate, D-dimers), also lipid (cholesterol, triglycerides, HDL, LDL, VLDL) and carbohydrate metabolism between the two groups of patients with severe intra-abdominal infection (n = 109) and severe sepsis of other etiologies (n = 53).

Results: We found out a significant difference between the groups in serum levels of the CRP, IL-4 and cholesterol at all stages of the study.

[Are we controlling the sedation in ICU? A multicenter study results].

The aim of this study is to evaluate the issues of sedation and analgesia in all-purpose ICUs in Russia. To obtain that, a single-day observational survey was performed in 55 ICUs of Ural and Siberia regions. This work enabled to describe the targets, instruments of control and patterns of sedative and analgetics and sedatives prescription, as well as to make conclusions about issues in this area and possibilities of creation and necessity of analgesia and sedation standards.

Granulocyte-colony-stimulating Factor for Acute Ischemic Stroke: A Randomized Controlled Trial (STEMTHER).

Granulocyte-colony-stimulating factor (G-CSF) functions both as a neuroprotectant and a stimulator of autologous bone marrow stem cell release. Therefore, administration of G-CSF should improve the outcome of stroke. Here, we examine the safety of using G-CSF to treat acute ischemic stroke using a randomized controlled trial involving 20 adult patients presenting with ischemia in the carotid region within 48 h of onset.

[Effect of an original enteral feeding protocol on clinical outcome indicators in patients with acute cerebral damage of vascular and traumatic genesis].

The prospective randomized controlled study enrolled 58 patients diagnosed as having brain injury and hemorrhagic stroke. Enteral feeding was started within the first 24 hours after admission to an intensive care unit (ICU); a control group (n = 28) was given an isocalorie formula while a study group (n = 28) received a combination of a hypercalorie formula and a fiber-containing formula. In the study group, the intestine was stimulated with erythromycin within the first 3 days.

[Correction of intracranial hypertension syndrome using hyperosmolar solutions in patients with severe brain damage (multicenter randomized clinical study)].

The paper presents the results of a muticenter study of the effect of 3 hyperosmolar solutions (15% mannitol solution, 10% sodium chloride solution, and the combined solution HyperHAES containing 7.2% sodium chloride and hydroxyethyl starch 200/0.5) on the value of intracranial pressure (ICP) (invasive ICP monitoring) and systemic hemodynamic parameters (PiCCOplus) in 94 clinical cases of intracranial hypertension (ICP more than 20 mm Hg) in 25 patients with acute cerebral pathology (severe brain injury, aneurysmatic subarachnoid hemorrhage).

[Evaluation of the effectiveness and safety of synthetic colloid solutions in the treatment of severe abdominal sepsis: a randomized comparative study].

Infusion therapy, surgical debridement of an infection focus, and antimicrobial therapy are basic treatments for severe sepsis. At the same time there are no uniform guidelines on how to choose fluids for infusion therapy. The results of individual studies serve as the basis for refusing the use of synthetic colloid agents in the therapy of severe sepsis.

[Changes in lipid metabolic parameters in patients with severe sepsis].

The vital importance of systemic inflammatory reactions in developing a critical condition of any etiology is generally accepted at the present developmental stage of reanimatology and intensive care. The metabolic component remains a less studied part of a complex of the universal pathophysiological changes that characterize a critical condition. Lipid metabolic changes in sepsis are less investigated.

[Dynamic metabolic monitoring as a basis of nutritional support in acute cerebral insufficiency of vascular genesis].

Within the framework of a prospective controlled study, the metabolic status was evaluated in 148 patients with stroke, by using the dynamic metabolic monitoring technique comprising the calculation of real daily calorie consumption, the assessment of the degree of hypermetabolism, protein hypercatabolism, nutritional disorders, and needs for nutrients, and the daily evaluation of nutritional support. As a result, the authors provide evidence that dynamic metabolic monitoring rapidly and adequately reflect changes in the degree of hypercatabolism and hypermetabolism in patients with lesions of the central nervous system and the structures responsible for regulation of metabolism and nutritional support in accordance with monitoring data makes it possible to enhance the efficiency of intensive care and to reduce the frequency of neurotrophic complications.

[Nutritional support in critical conditions as intensive care technology].

The patients of intensive care units represent a group in which nutritional support methods, such as enteral and parenteral feeding, are most frequently used to correct protein and energy metabolisms. The purpose of this paper is to analyze the most significant clinical problems ensuing in nutritional support in an intensive care unit, such as the high incidence of hospital exhaustion, difficulties in metabolic monitoring and in the determination of patients' needs for nutrients, in the choice for media for intravenous and enteral feeding, in the prevention of possible complications of nutritional support; organizational aspects.

[Effect of various colloidal solutions on pulmonary oxygenizing function in patients with acute lung lesion].

The effects of 6% hydroxyethyl starch and 10% albumin solution on the parameters of central hemodynamics and pulmonary extravascular water were studied in acute lung lesion. The patients were divided into 2 groups that did not significantly differ by the baseline severity of a condition (APACHE II and Murray scales). Groups 1 and 2 patients were transfused 6% hydroxyethyl starch and 10% albumin solution, respectively.

[Approaches to nutrition of patients with severe thermal trauma].

Basic principles of feeding of the patients (adult and children) with a serious thermal trauma, which cause considerable disturbances of a homeostasis of organism: hypermetabolic inverse of a metabolism, decrease of immune resistance, losses of water and electrolytes masses. Early use of quality and valuable nutrition for such patients (under observation was 56 patient--adult and children of different age) is a method of treatment reliably improving outcome of an intensive therapy reducing number of complications of a burn disease and contributing to the prompt convalescence of the patients.

[Characteristics of amino acid metabolism in patients with severe sepsis and septic shock].

The development of the multiorgan dysfunction syndrome, directly determining the severity of the septic process, is characterized by not only inverse ratio of the energy and plastic material, but by metabolic changes which are still unclear and cannot yet be explained. Our purpose was to detect some features of amino acid metabolism in patients with grave sepsis and septic shock. The concentrations of plasma free amino acids were measured on days 1, 3, and 5 in 37 patients with grave sepsis and septic shock.

Induction of microsomal antigen and comparison with histologic localization of HLA-DR in Graves' thyroid tissue.

We have characterized thyroid microsomal antigen (M-Ag) prepared from Graves' and normal thyroid tissues using 100,000 x g thyroid membrane fractions in enzyme-linked immunosorbent assays with pooled polyclonal human sera containing high titers of antibody to M-Ag. A ten-fold parallel increase in dose inhibition potencies occurred with M-Ag preparations from Graves' as compared to normal thyroid tissue. The M-Ag preparations were further evaluated by SDS-polyacrylamide gel electrophoresis and proteins visualized by Western blot using high titer microsomal antibody (M-Ab) sera (n = 2) devoid of thyroglobulin antibody activity.

Thymocyte maturity in male and female hypogonadal mice and the effect of preoptic area brain grafts.

Hypogonadal mice with a genetic deficiency of gonadotropin-releasing hormone (GnRH) have low levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH) and gonadal steroids. In this study we found differences from normal mice in many aspects of thymic development. Thymus weights and cellularity were higher in hypogonadal than in normal male mice but lower in hypogonadal than in normal females.

Pediatric acquired immunodeficiency syndrome-related complex: clinical and immunologic features.

The long term clinical outcome for infants and children with the pediatric acquired immunodeficiency syndrome-related complex is unknown. This report describes our experience with 14 patients with acquired immunodeficiency syndrome-related complex who have been followed for 11 to 71 months since the onset of their symptoms. The most frequent clinical features at presentation were persistent generalized lymphadenopathy (14 of 14), hepatosplenomegaly (11 of 14) and a history of recurrent otitis media (7 of 14).

A glycoprotein inhibitor of in vitro granulopoiesis associated with AIDS.

Patients infected with the human immunodeficiency virus (HIV) often present with neutropenia. To elucidate the mechanism(s) of this HIV-related neutropenia, we assessed the proliferative capacity of the granulocyte-macrophage progenitor cell (CFU-GM) from the bone marrow (BM) of 78 patients within the AIDS spectrum manifesting symptoms or signs related to HIV infection. Of these, 70 had a significant deficit in the growth of this committed progenitor when compared with normal controls (P less than .

Opportunistic infections in acquired immune deficiency syndrome result from synergistic defects of both the natural and adaptive components of cellular immunity.

We evaluated the cellular immunity of 408 clinically stratified subjects at risk for acquired immune deficiency syndrome (AIDS), to define the role of interferon-alpha production deficits in the pathogenesis of opportunistic infections (OI). We followed 115 prospectively for up to 45 mo. Onset of OI was associated with, and predicted by, deficiency both of interferon-alpha generation in vitro, and of circulating Leu-3a+ cells.