Sentinel headache as a warning symptom of ischemic stroke

Background: There are no previous controlled studies of sentinel headache in ischemic stroke. The purpose of the present study was to evaluate the presence of such headache, its characteristics and possible risk factors as compared to a simultaneous control group. Methods: Eligible patients (n = 550) had first-ever acute ischemic stroke with presence of new infarction on magnetic resonance imaging with diffusion-weighted imaging (n = 469) or on computed tomography (n = 81). As a control group we studied in parallel patients (n = 192) who were admitted to the emergency room without acute neurological deficits or serious neurological or somatic disorders. Consecutive patients with stroke and a simultaneous control group were extensively interviewed soon after admission using validated neurologist conducted semi-structured interview forms. Based on our previous study of sentinel headache in transient ischemic attacks we defined sentinel headache as a new type of headache or a previous kind of headache with altered characteristics (severe intensity, increased frequency, absence of effect of drugs) within seven days before stroke. Results: Among 550 patients with stroke 94 patients (17.1%) had headache during seven days before stroke and 12 (6.2%) controls (p < 0.001; OR 3.9; 95% CI 1.7-5.8). Totally 81 patients (14.7%) had sentinel headache within the last week before stroke and one control. Attacks of arrythmia during seven days before stroke were significantly associated with sentinel headache (p = 0.04, OR 2.3; 95% CI 1.1-4.8). Conclusions: A new type of headache and a previous kind of headache with altered characteristics during one week before stroke are significantly more prevalent than in controls. These headaches represent sentinel headaches. Sudden onset of such headaches should alarm about stroke. © 2020 The Author(s)

Regional specificity of the climatic evolution of soils in the southern part of Eastern Europe in the second half of the Holocene

The analysis of characteristic features of chernozems and chestnut soils of different ages that have been formed in the south of the East European Plain in the past 5000 years attests to the spatial and temporal heterogeneity of the rate and direction of pedogenetic processes, i.e., to the metachronous development of the soil cove

Vladimir Sakowicz (to his 70th birthday)

В июне 2012 года исполнилось 70 лет Владимиру Петровичу Саковичу - профессору кафедры нервных болезней и нейрохирургии Уральской Государственной медицинской академии, руководителю Уральского Межтерриториального нейрохирургического центра им. Проф. Д.Г. Шефер

Topological entropy and blocking cost for geodesics in riemannian manifolds

For a pair of points $x,y$ in a compact, riemannian manifold $M$ let $n_t(x,y)$ (resp. $s_t(x,y)$) be the number of geodesic segments with length $\leq t$ joining these points (resp. the minimal number of point obstacles needed to block them). We study relationships between the growth rates of $n_t(x,y)$ and $s_t(x,y)$ as $t\to\infty$. We derive lower bounds on $s_t(x,y)$ in terms of the topological entropy $h(M)$ and its fundamental group. This strengthens the results of Burns-Gutkin \cite{BG06} and Lafont-Schmidt \cite{LS}. For instance, by \cite{BG06,LS}, $h(M)>0$ implies that $s$ is unbounded; we show that $s$ grows exponentially, with the rate at least $h(M)/2$.Comment: 13 page

Analysis of the quality of diagnosis and treatment of primary headache in different social groups of the Ural Region

Objective: to analyze the quality of diagnosis and treatment of primary headache (HA) in different social groups of the Ural Region. Patients and methods. The study enrolled 3124 persons who were divided into three groups: 1) 1042 students; of them there were 719 women; mean age 20.6 years; range 17–40 years; 2) 1075 workers; of them there were 146 women; mean age 40.4 years; range 21–67 years; 3) 1007 blood donors; of them there were 484 women; mean age, 34.1 years; range 18–64 years. Semi-structured interviews involving the characteristics of HA and its prior diagnosis and treatment were conducted face-to-face in all those included in the study. HA was diagnosed using the International Classification of Headache Disorders, 3rd edition, beta version. Results and discussion. The following factors decreasing the quality of diagnosis and treatment of HA were identified in all the study groups: 1) low physician visit rates. Despite the high prevalence of all types of primary HA in 3 groups (67%), only 496 (23%) out of 2110 participants with HA visited their physician with this problem. Among the patients with HA, physicians were visited most often by 342 (35%) out of 968 students, least often by 60 (13%) out of 457 workers and by 94 (14%) out of 685 donors; 2) inadequate diagnosis of HA. Only 12 and 11.7% of the patients were correctly diagnosed with migraine and tension HA (THA), respectively; 3) the practically complete absence of preventive treatment for HA. The majority of patients used drugs to arrest HA attacks; preventive treatment for migraine was performed in 2 (0.4%) and not performed in any of the patients with THA. It is necessary to improve the diagnosis and treatment of primary HA and to elaborate new Russian clinical guidelines for patient management on the basis of international standards

Migraine before rupture of intracranial aneurysms

BACKGROUND: Rupture of a saccular intracranial aneurysm (SIA) causes thunderclap headache but it remains unclear whether headache in general and migraine in particular are more prevalent in patients with unruptured SIA. METHODS: In a prospective case–control study 199 consecutive patients with SIA (103 females and 96 males, mean age: 43.2 years) received a semistructured face to face interview focusing on past headaches. All were admitted to hospital mostly because of rupture (177) or for unruptured aneurysm (22). In parallel we interviewed 194 blood donors (86 females, 108 males, mean age: 38.4 years). Diagnoses were made according to the International Headache Society criteria. Aneurysms were diagnosed by conventional cerebral angiography. RESULTS: During the year before rupture, 124 (62.3%) had one or more types of headache. These headaches included: migraine without aura (MO): 78 (39.2%), migraine with aura (MA): 2 (1%), probable migraine (PM): 4 (2%), tension-type headache (TTH): 39 (19.6%), cluster headache (CH): 2 (1%), posttraumatic headaches (PH): 2 (1%). 1-year prevalence of headaches in controls was 32.5% (63 patients out of 194), they included: TTH: 45 (23.1%), MO: 17(8.8%), PH: 1(0.5%). Only the prevalence of MO was significantly higher in patients with SIA (OR 6.7, 95% CI 3.8-11.9, p < 0.0001). CONCLUSIONS: Unruptured SIA cause a marked increase in the prevalence of migraine without aura but not in the prevalence of other types of headache

Cryptic Diversity in Paramecium multimicronucleatum Revealed with a Polyphasic Approach

Paramecium (Ciliophora) systematics is well studied, and about twenty morphological species have been described. The morphological species may include several genetic species. How-ever, molecular phylogenetic analyses revealed that the species diversity within Paramecium could be even higher and has raised a problem of cryptic species whose statuses remain uncertain. In the present study, we provide the morphological and molecular characterization of two novel Paramecium species. While Paramecium lynni n. sp., although morphologically similar to P. multimicronucleatum, is phylogenetically well separated from all other Paramecium species, Paramecium fokini n. sp. appears to be a cryptic sister species to P. multimicronucleatum. The latter two species can be distinguished only by molecular methods. The number and structure of micronuclei, traditionally utilized to discriminate species in Paramecium, vary not only between but also within each of the three studied species and, thus, cannot be considered a reliable feature for species identification. The geographic distribution of the P. multimicronucleatum and P. fokini n. sp. strains do not show defined patterns, still leaving space for a role of the geographic factor in initial speciation in Paramecium. Future findings of new Paramecium species can be predicted from the molecular data, while morphological characteristics appear to be unstable and overlapping at least in some species

ВАРИАНТЫ КОГНИТИВНОГО ДЕФИЦИТА В ЗАВИСИМОСТИ ОТ КЛИНИЧЕСКИХ ХАРАКТЕРИСТИК ЗАБОЛЕВАНИЯ У ПАЦИЕНТОВ С ПАРАНОИДНОЙ ШИЗОФРЕНИЕЙ

Pecific aspects of cognitive impairments in patients with paranoid schizophrenia depending on the clinical characteristics of the disease have been studied. One hundred and thirty patients were examined. A clinico-psychological, experimental psychological and statistical methods were used. Three main types of cognitive deficiency with paranoid schizophrenia, associated with the onset, disease duration, and severity of psychiatric symptomology : 1) long-term course of the disease accompanied by the average level of clinical symptomology associated with abnormal attention and visuospatial functions; 2) late onset of the disease and unexpressed clinical symptomology combined with memory impairments; 3) acute onset and early age combined with the absence of cognitive impairments.Была изучена специфика когнитивных нарушений у пациентов с параноидной шизофренией в зависимости от клинических характеристик заболевания. Были обследованы 130 пациентов. Использовались клинико-психологический, экспериментально-психологический и статистический методы. Выявлены три основных варианта когнитивного дефицита при параноидной шизофрении, которые были связаны с началом, длительностью заболевания и остротой психопатологической симптоматики: 1) длительное течение заболевания, сопровождающееся средним уровнем клинической симптоматики, сочетающееся с нарушением внимания и зрительно-пространственных функций; 2) позднее начало заболевания и невыраженная клиническая симптоматика, сочетающаяся с нарушениями памяти; 3) острое начало заболевания и ранний возраст, сочетающиеся с отсутствием когнитивных нарушений