24 research outputs found
The symptoms of pathological fatigue, apathy, and depression in patients after stroke
Objective: to comparatively analyze the rate and correlation of the symptoms of pathological fatigue, apathy, and depression in patients in the termination phase of an acute stroke period.Patients and methods. The symptoms of asthenia (pathological fatigue), apathy, and depression were comparatively investigated in 105 patients at 3–4 weeks after stroke. The fatigue rating scale, apathy rating scale, and hospital anxiety and depression (HAD) scale were used to evaluate the symptoms of pathological fatigue, apathy, and depression. The level of anxiety was also estimated using the appropriate HAD subscale and the Epworth daytime sleepiness scale; the magnitude of cognitive impairments was judged from the Montreal cognitive assessment. The type, basin, and recurrence of stroke were registered. The severity of neurological deficit was evaluated using the U.S. National Institutes of Health Stroke Scale (NIHSS); limited functional capacities were estimated by the modified Rankin scale (mRS). The presence of prestroke fatigue was also determined.Results and discussion. The symptoms of asthenia were observed in 56% of the patients and associated with the severity of poststroke disability. The symptoms of apathy were detected in 10.5% of the patients; those of depression were present in 18% and determined by the magnitude of neurological deficit and the degree of poststroke disability and cognitive impairments. All the three phenomena were correlated with the magnitude of anxiety, daytime sleepiness, and between them. This suggests that they may complicate a reciprocal course in some cases. The symptoms of depression, asthenia, and apathy may also develop on their own, which is borne out by their different rates and correlations. Each of these phenomena requires an individual approach to diagnosis and treatment.Conclusion. The symptoms of pathological fatigue are most common and least specific in patients with mild poststroke neurological deficit. Apathy may be also associated with depression or develop on its own. Further investigation of mechanisms for the development of poststroke pathological fatigue and apathy is important for developing effective methods to correct these abnormalities
Non-invasive transcutaneuos dynamic electrical nerves stimulation in management of tension type headaches: design of a double blind randomized placebo controlled trial
In this paper we justify and describe design of our original prospective clinical trial of effectiveness of non-invasive transcutaneous dynamic electrical nerves stimulation (DENS) in management of patients with frequent episodic or chronic tension type headaches (TTH). As a DENS device we selected a small one - DiaDENS-PKM (made in Ekaterinburg, Russia, allowed for using in Russian Federation), as a placebo - a device made by the manufacturer, absolutely identical to the active one with no contacts in electrodes. We will analyze the effectiveness and safety of this technique in complex management of TTH in two groups of patients with different ages: youth and adolescents (group 1) and elderly (group 2). As a result of this study we plan to suggest guidelines for using this approach in target groups.В настоящей статье приводится обоснование и описывается дизайн оригинального проспективного клинического исследования эффективности неинвазивной чрескожной динамической электронейростимуляции (ДЭНС) в лечении пациентов с частыми эпизодическими или хроническими головными болями напряжения (ГБН). В качестве устройства ДЭНС выбран разрешенный к использованию в Российской Федерации компактный аппарат ДиаДЭНС-ПКМ (производство: г.Екатеринбург, Россия), в качестве плацебо - аппарат, созданный производителем, полностью идентичный исследуемому, с неподсоединенными электродами. Будет проведен анализ эффективности и безопасности данной методики в комплексной терапии ГБН в двух возрастных группах: молодежь до 25 лет и подростки (группа 1) и пожилые (группа 2). По результатам исследования планируется предложить рекомендации по использованию данной технологии в целевых группах
Diagnosis and management of low back pain: what is the evidence, what is reality
This article describes the diagnostic criteria for nonspecific pain in the lower back and analyzes approaches to the diagnosis of this condition in our university hospital.В данном материале описаны диагностические критерии неспецифических болей в нижней части спины и результаты анализа подходов к диагностике данного состояния в нашей университетской клинике
Острые церебральные сосудистые события после каротидной эндартерэктомии
Introduction. Acute cerebrovascular accident is recognized as the leading pathology in the structure of cerebrovascular diseases (CVD). Annually 6 million cases of CVD are registered in the world. Fatal outcomes from this pathology in Russia occur 1.5–2 times more often than in developed countries. According to the All-Russian Center for Preventive Medicine, 25% of males and 39% of females die from CVD. The incidence of CVD in Russia ranges from 460 to 560 cases per 100 thousand people. This pathology may be caused by carotid artery stenosis resulting from atherosclerotic vascular lesions and plaque formation which lead to embolism and stroke.Materials and methods. The study analyzed 341 medical histories of patients hospitalized at the Bashkir State Medical University Clinic (BSMU Clinic) in 2022, who underwent carotid endarterectomy (CEE) (288 of them had a history of chronic cerebrovascular accident) and 278 medical histories of patients with acute cerebrovascular accident, hospitalized at the Neurologic Clinic of the Avicenna Tajik State Medical University in 2022.Results and discussion. Perioperative complications that occurred during CEE at BSMU Clinic in 2022 included 12 cases of acute cerebrovascular accident of ischemic type (3.52%) and 2 cases of transient ischemic attack (0.6%), which is lower than the same rates in previously published observations at the same clinic.Conclusion. The number of complications resulting from the CEE does not exceed the global rates. Quantitative and qualitative indicators of carotid reconstructions demonstrate positive trends. Acute cerebrovascular accident requires clarifying the cause of its occurrence and taking measures to prevent ischemic strokes, including angiosurgical interventions.Введение. Острое нарушение мозгового кровообращения является ведущей патологией в структуре цереброваскулярных заболеваний (ЦВЗ). Ежегодно в мире регистрируется 6 миллионов случаев возникновения ЦВЗ. Летальный исход от данной патологии в России возникает в 1,5–2 раза чаще, чем в развитых странах. Согласно данным Всероссийского центра профилактической медицины, от ЦВЗ умирает 25 % лиц мужского пола и 39 % лиц женского пола. Частота ЦВЗ в России составляет от 460 до 560 случаев на 100 тысяч человек. Данное состояние может быть обусловлено стенозом сонных артерий, возникшим вследствие атеросклеротического поражения сосудов и образования бляшек, приводящих к эмболии и развитию инсульта.Материалы и методы. Нами был произведен анализ 341 истории болезни пациентов, госпитализированных в Клинику Башкирского государственного медицинского университета (КБГМУ) в 2022 году, которым проведена каротидная эндартерэктомия (КЭЭ), из них у 288 пациентов в анамнезе было хроническое нарушение мозгового кровообращения, и 278 историй болезни пациентов с острым нарушением мозгового кровообращения, госпитализированных в неврологическую университетскую клинику Таджикского государственного медицинского университета имени Абуали ибни Сино в 2022 г.Результаты и обсуждение. В структуре периоперационных осложнений, возникших при проведении КЭЭ за 2022 год в КБГМУ, было зафиксировано 12 случаев острого нарушения мозгового кровообращения по ишемическому типу (3,52 %) и 2 случая транзиторной ишемической атаки (0,6 %), что является более низким показателем по сравнению с ранее опубликованными наблюдениями этой же клиники.Заключение. Количество осложнений, возникших в результате проведения КЭЭ, не превышает общемировые показатели. Наблюдается положительная динамика в отношении количественно-качественных показателей каротидных реконструкций. Острое нарушение мозгового кровообращения является состоянием, требующим уточнения причины его возникновения и проведения ранней профилактики развития инсультов по ишемическому типу, включая ангиохирургические вмешательства
Using stabilometric data for prognosis of falls in the elderly in-patients of neurology ward
This is our first analysis of clinical and paraclinical data from 176 elderly patients of a neurology ward (from 56 to 87 years of age). We included the results from the questionnaires and from computerized stabilometric tests. Using multifactor analysis we suggest the most significant factors for the risk of falls. A model for prognosis of the number of falls in the elderly patients with neurological conditions during 12 months is presented in this paper.Нами впервые проанализированы клинические и параклинические данные 176 пожилых пациентов неврологического стационара в возрасте от 56 до 87 лет с учетом результатов анкетирования и компьютерной стабилометрии. С помощью многофакторного анализа выделены наиболее значимые показатели стабиломерии для риска падений. В статье представлена модель, позволяющие прогнозировать число падений в течение 12 месяцев у пожилых пациентов с заболеваниями нервной системы
Possible neurological complications after carotid endarterectomy: causes and prevention methods
This is a joint research performed by neurologists and vascular surgeons. The aim of this study was to evaluate and compare our outcomes after carotid endarterectomy (CEA) at the vascular surgery department of the University Hospital in Ufa, Russia with the results in other hospitals in the world.Данная работа проведена совместно неврологами и сосудистыми хирургами. Цель настоящего исследования оценить и сравнить результаты каротидной эндартерэктомии (КЗАЗ) в сосудистом отделении клиники Башкирского государственного медицинского университета с мировыми показателям
Element redistribution along hydraulic and redox gradients of low-centered polygons, Lena Delta, northern Siberia
Wetland soils affected by permafrost are extensive in subarctic and arctic tundra. However, this fact does not imply these soils have been sufficiently investigated. In particular, studies of element translocation processes are scarce. This study was conducted (i) to determine the relationship between water and redox regimes in wetland soils in the Siberian tundra, and (ii) to investigate their influence on the distribution of redox sensitive and associate elements (Mn, Fe, P). Major geomorphic units were chosen (microhigh, polygon rim and slope; microlow, polygon center) from two low-centered polygons in the Lena Delta. Within polygons, redox potential, permafrost, and water level were measured during summer in 1999 and 2000 and (related) compared with element distribution. Manganese, Fe, and P accumulations were preferentially observed in aerobic microhighs. Anaerobic conditions in the microlows lead to a mobilization of Mn, Fe, and P. The elements migrate via water and are immobilized at the microhigh, which acts as an oxidative barrier. The element pattern, indicating an upward flux via water along redox gradients, is explained by higher evapotranspiration from soils and vegetation of the microhighs (Typic Aquiturbel) compared with soils and vegetation of the microlows (Typic Historthel). However, in further research this upward transport should be validated using labeled elements