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Introduction: Stroke is the second leading underlying cause of death globally and the leading cause of disability in adults. Stroke diagnosis should be performed quickly and efficiently to eliminate other potential causes of neurological deficits and to assess the time since the onset of clinical symptoms. Computed tomography (CT) and magnetic resonance imaging (MRI) are essential methods of detecting and evaluating stroke type and treatmentoptions. Diffusion and perfusion MR imaging is recommended for early stroke diagnosis, as well as for the selection of patients for recanalization therapy, and is considered effective in assessing treatment outcomes. The objectives of this study were to demonstrate the diagnostic value of diffusion and perfusion imaging in the diagnosis of acute ischemic stroke, analyze the role of magnetic resonance imaging in the selection of patients with acute stroke for recanalization therapy, and assess the effect of acute stroke complicity.Material and methods: The research is designed as a systematic review of the primary scientific research literature, which was published in English in relevant scientific databases (PubMed, Google Scholar, Medline) from 2014 to 2021.Results: 14 scientific research papers were singled out and the general characteristics of the study were analyzed (country, authors, year of publication, title of the study, type of study, study objectives, research methods, results and conclusion). A quality assessment of the included studies with cohort design and randomized controlled studies was performed, and most belong to the category of high-quality studies with a smaller number of medium-quality studies. The overall percentage of detected AIS cases in isolated studies using the DWI and/or PWI sequence was 90.8%. At the same time, the outcome of recanalization therapy was assessed using MRI studies (the number of patients who developed adverse events with functional data outcome 30 or 90 days after the procedure was observed). Comparison of MRI and CT imaging protocols provided data on the total percentage of detected acute stroke cases using CT imaging protocols (68.9%) and MRI imaging protocols (88.5%), which is why MRI is considered a superior method.Conclusion: Although CT is a suitable method for visualizing bleeding and also for early differentiation of hemorrhagic from ischemic stroke, if MRI imaging is available, it is recommended to use DWI, PWI, MRA sequences for a more accurate diagnosis of stroke in the acute phase.

The paper deals with the basic pathogenic mechanisms of thrombosis development both arterial and venous in patients with COVID-19. These patients developed critical complications in cases of vascular risk factors that significantly enhances the risk of occurrence of such vascular events as acute ischemic stroke. The thrombophilia mechanism in a patient with COVID-19 disease turns on the direct activation of coagulation, so antiplatelet drugs cannot prevent the development of thrombosis while the vascular risk factors and prominent inflammatory reaction cause vascular events. The optimization of antiplatelet therapy in patients with COVID-19 disease with vascular risk factors is relevant. Triflusal is an antiplatelet drug with the best characteristics for the treatment of these patients., В статье освещены основные патогенетические механизмы развития тромбозов, как артериальных, так и венозных, у пациентов с COVID-19. Осложнения, которые развиваются у таких пациентов, имеют крайне важное значение в случаях наличия сосудистых факторов риска, что значимо повышает риски развития таких сосудистых событий, как острый ишемический инсульт. Механизм тромбофилии у больного COVID-19 включает прямую активацию факторов свертывания крови, поэтому антитромбоцитарные препараты не в состоянии предотвратить развитие тромбозов, тогда как сосудистые факторы риска и выраженная воспалительная реакция вызывают развитие сосудистых событий. Актуальной является оптимизация антитромботической терапии у пациентов с COVID-19 с сосудистыми факторами риска. Трифлузал — антитромбоцитарный препарат, имеющий наилучшие характеристики для таких пациентов., У статті висвітлені основні патогенетичні механізми розвитку тромбозів, як артеріальних, так і венозних, у пацієнтів з COVID-19. Ускладнення, що розвиваються у таких пациентів, мають вкрай важливе значення у випадку наявності судинних факторів ризику, що значуще підвищує ризик розвитку таких судинних подій, як гострий ішемічний інсульт. Механізм тромбофілії у хворих на COVID-19 включає пряму активацію факторів згортання крові, тому антитромбоцитарні препарати не в змозі запобігти розвитку тромбозів, тоді як судинні фактори ризику та виражена запальна реакція викликають розвиток судинних подій. Актуальною є оптимізація антитромботичної терапії у пацієнтів з COVID-19 із судинними факторами ризику. Трифлузал — антитромбоцитарний препарат, що має найкращі характеристики для таких пацієнтів.

Background In some acute care trials, immediate informed consent is not possible, but deferred consent is often considered problematic. We investigated the opinions of patients, proxies, and physicians about deferred consent in an acute stroke trial to gain insight into its acceptability and effects. Methods Paper-based surveys were sent to patients who were randomly assigned in the Ultra-early Tranexamic Acid After Subarachnoid Hemorrhage (ULTRA) trial between 2015 and 2018 in two tertiary referral centers and to physicians of centers who agreed or declined to participate. The primary outcome measure was the proportion of respondents who agreed with deferral of consent in the ULTRA trial. Secondary outcomes included respondents’ preferred consent procedure for the ULTRA trial, the effect of deferred consent on trust in physicians and scientific research, and the willingness to participate in future research. Results Eighty-nine of 135 (66%) patients or proxies and 20 of 30 (67%) physicians completed the survey. Of these, 82 of 89 (92%) patients or proxies and 14 of 20 (70%) physicians agreed with deferral of consent in the ULTRA trial. When asked for their preferred consent procedure for the ULTRA trial, 31 of 89 (35%) patients or proxies indicated deferred consent, 15 of 89 (17%) preferred immediate informed consent, and 32 of 89 (36%) had no preference. None of the patients’ or proxies’ trust in physicians or scientific research had decreased because of the deferred consent procedure. Willingness to participate in future studies remained the same or increased in 84 of 89 (94%) patients or proxies. Conclusions A large majority of the surveyed patients and proxies and a somewhat smaller majority of the surveyed physicians agreed with deferred consent in the ULTRA trial. Deferred consent may enable acute care trials in an acceptable manner without decreasing trust in medicine. Future research should investigate factors facilitating the responsible use of deferred consent, such as in-depth interviews, to study the minority of participants who agreed with deferred consent but still preferred immediate informed consent.

Durch das stetig steigende Durschnittalter ist in den nächsten Jahren mit einem An-stieg der Schlaganfallerkrankungshäufigkeit zu rechnen. Die Mehrheit der ischämischen oder hämorrhagischen Schlaganfälle zeigen in der akuten Erkrankungsphase Schluckstörungen auf. Dysphagie ist ein signifikanter Risikofaktor für eine Aspirationspneumonie. Die Bachelorarbeit stellt die Dysphagie - Screeninginstrumente die in der Literatur beschrieben werden dar und untersucht den Einfluss der Mundpflege auf die Aspirationspneumonie. Die Literaturrecherche wurde in den Datenbanken „CINAHL“, „SpringerLink“, „PubMed“ und in der Internetdatenbank „Google Scholar“ durchgeführt. Es wurden insgesamt 12 Studien gefunden, die in der Arbeit dargestellt wurden. Die selektierten Studien wurden in tabellarischer Form ausführlich dargestellt. Die Ergebnisse der Literaturrecherche zeigten mehrere unterschiedliche Screeningin-strumente auf. GUSS (Gugging Swallowing Screen) ist eines der am häufigsten beschriebenen Instrumente. Die frühzeitige Dysphagieerhebung wird in mehreren Ergebnissen stark hervorgehoben. Eine intensivierte Mundhygiene und eine standardisierte Vorgehensweise ist mit einer Verringerung der Pneumonieprävalenz verbunden. Due to the steadily increasing average age, an increase in the frequency of strokes is to be expected in the coming years. The majority of ischemic or hemorrhagic strokes show dysphagia in the acute phase of the disease. Dysphagia is a significant risk factor for aspiration pneumonia. The bachelor thesis presents the dysphagia - screening tools described in the literature and investigates the influence of oral care on aspiration pneumonia. The literature search was conducted in the databases "CINAHL", "SpringerLink", "PubMed" and in the internet database "Google Scholar". A total of 12 studies were found and presented in the paper. The selected studies were presented in detail in tabular form. The results of the literature search revealed several different screening instruments. GUSS (Gugging Swallowing Screen) is one of the most frequently described instruments. Early dysphagia detection is strongly emphasized in several results. Intensified oral hygiene and a standardized approach is associated with a reduction in pneumonia prevalence.