Pub Date : 2024-07-25DOI: 10.22141/2224-0713.20.4.2024.1083
MD Anastasiya Bohdan, I. Bohdan, Z. Plakhtyr
Background. Up to 50–80 % of military service members suffer from postamputation pain. Residual limb pain significantly postpones prosthetic surgery, recovery, employability, negatively impacts rehabilitation and military duty performance. The purpose was to study residual limb pain types in military personnel after traumatic amputation and efficacy of methods for their treatment. Materials and methods. A randomized cross-sectional study was performed of 231 military service members with residual limb pain after combat traumatic amputation, who underwent surgical treatment in tertiary and quaternary level military medical center between 2022 and 2024 amid full-scale war. Results. Somatic residual limb pain was observed in 36.36 % of enrolled patients, which was mainly caused by heterotopic ossification (30.74 %). 41.13 % of amputees experienced neuropathic pain due to neuromas. Pain syndrome in 22.51 % of patients resulted from both somatic causes and neuromas. Prosthesis-associated pain as a type of somatic pain was observed in 17.32 % of individuals. This study found that the persistence or recurrence of neuropathic pain among patients from the group of lidocaine-alcohol injection for painful neuromas was significantly lower (Pα = 0.013) at 6-month follow-up compared to the simple neuroma resection group. During 3 months after regenerative peripheral nerve interface, which was performed for 25 terminal neuromas, no pain recurrence was observed. Conclusions. It is important to assume the presence of one or both pain types in a patient with residual limb pain: somatic and/or neuropathic. Simple neuroma resections lead to an undesirably high reoperation rate — 21.79 ± 4.86 % of persistent painful neuromas. Lidocaine-alcohol injections are sufficiently simple and effective (8.70 ± 3.26 % of reinjections) in the treatment of neuropathic pain caused by terminal neuromas. Regenerative peripheral nerve interface is promising in the treatment and prevention of symptomatic neuroma.
{"title":"Management of different types of postamputation residual limb pain amid full scale war","authors":"MD Anastasiya Bohdan, I. Bohdan, Z. Plakhtyr","doi":"10.22141/2224-0713.20.4.2024.1083","DOIUrl":"https://doi.org/10.22141/2224-0713.20.4.2024.1083","url":null,"abstract":"Background. Up to 50–80 % of military service members suffer from postamputation pain. Residual limb pain significantly postpones prosthetic surgery, recovery, employability, negatively impacts rehabilitation and military duty performance. The purpose was to study residual limb pain types in military personnel after traumatic amputation and efficacy of methods for their treatment. Materials and methods. A randomized cross-sectional study was performed of 231 military service members with residual limb pain after combat traumatic amputation, who underwent surgical treatment in tertiary and quaternary level military medical center between 2022 and 2024 amid full-scale war. Results. Somatic residual limb pain was observed in 36.36 % of enrolled patients, which was mainly caused by heterotopic ossification (30.74 %). 41.13 % of amputees experienced neuropathic pain due to neuromas. Pain syndrome in 22.51 % of patients resulted from both somatic causes and neuromas. Prosthesis-associated pain as a type of somatic pain was observed in 17.32 % of individuals. This study found that the persistence or recurrence of neuropathic pain among patients from the group of lidocaine-alcohol injection for painful neuromas was significantly lower (Pα = 0.013) at 6-month follow-up compared to the simple neuroma resection group. During 3 months after regenerative peripheral nerve interface, which was performed for 25 terminal neuromas, no pain recurrence was observed. Conclusions. It is important to assume the presence of one or both pain types in a patient with residual limb pain: somatic and/or neuropathic. Simple neuroma resections lead to an undesirably high reoperation rate — 21.79 ± 4.86 % of persistent painful neuromas. Lidocaine-alcohol injections are sufficiently simple and effective (8.70 ± 3.26 % of reinjections) in the treatment of neuropathic pain caused by terminal neuromas. Regenerative peripheral nerve interface is promising in the treatment and prevention of symptomatic neuroma.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"67 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141802372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.22141/2224-0713.20.4.2024.1084
H. Samoilova, O. Markovska, O. Tovazhnyanska, M. Myroshnychenko, V. Bibichenko, H.O. Sakal
Background. Stroke is a heterogeneous syndrome, and identification of risk factors and treatment depends on the specific pathogenesis of the disease. Cardiovascular diseases are risk factors for the development of acute disorders of cerebral circulation. According to recent studies, one third of all ischemic strokes are cardioembolic. The main pathoetiology of a hemorrhagic stroke in the form of intracerebral hemorrhages is chronic hypertension and cerebral amyloid angiopathy. The occurrence of a hemorrhagic stroke against the background of atrial fibrillation in combination with hypertension is a rather rare phenomenon and poses a problem in the choice of treatment for such patients. The aim was to determine the optimal treatment for a complex case of a hemorrhagic stroke with atrial fibrillation in combination with hypertension. Materials and methods. We present the clinical case of an 84-year-old woman who developed a hemorrhagic stroke on the background of atrial fibrillation in combination with hypertension. The main issue the cardio-neurological team faced was the administration of oral anticoagulants. On the one hand, the patient had indications for their administration according to current clinical guidelines (CHA2DS2-VASc score of 6 points); on the other hand, the presence of a hemorrhagic stroke is a contraindication. Results. This case demonstrates the solution to the difficult issue of choosing treatment for a hemorrhagic stroke and prevention of secondary complications of atrial fibrillation in combination with hypertension. After medical cardioversion, using clinical recommendations for the treatment of a hemorrhagic stroke, as well as given the positive dynamics of the neurological status, the patient was prescribed apixaban at a dose of 2.5 mg twice a day under the control of a coagulogram from the 7th day of the disease onset. Conclusions. We believe it is necessary to perform a thorough neurological examination and assessment of cognitive functions in all patients with atrial fibrillation, as well as to consider neuroimaging prior to the prescription of anticoagulant therapy. We recommend considering the administration of oral anticoagulants to patients with a low risk of recurrence and a high risk of thromboembolic complications after intracerebral hemorrhage
{"title":"A case report of a hemorrhagic stroke with atrial fibrillation in combination with hypertension","authors":"H. Samoilova, O. Markovska, O. Tovazhnyanska, M. Myroshnychenko, V. Bibichenko, H.O. Sakal","doi":"10.22141/2224-0713.20.4.2024.1084","DOIUrl":"https://doi.org/10.22141/2224-0713.20.4.2024.1084","url":null,"abstract":"Background. Stroke is a heterogeneous syndrome, and identification of risk factors and treatment depends on the specific pathogenesis of the disease. Cardiovascular diseases are risk factors for the development of acute disorders of cerebral circulation. According to recent studies, one third of all ischemic strokes are cardioembolic. The main pathoetiology of a hemorrhagic stroke in the form of intracerebral hemorrhages is chronic hypertension and cerebral amyloid angiopathy. The occurrence of a hemorrhagic stroke against the background of atrial fibrillation in combination with hypertension is a rather rare phenomenon and poses a problem in the choice of treatment for such patients. The aim was to determine the optimal treatment for a complex case of a hemorrhagic stroke with atrial fibrillation in combination with hypertension. Materials and methods. We present the clinical case of an 84-year-old woman who developed a hemorrhagic stroke on the background of atrial fibrillation in combination with hypertension. The main issue the cardio-neurological team faced was the administration of oral anticoagulants. On the one hand, the patient had indications for their administration according to current clinical guidelines (CHA2DS2-VASc score of 6 points); on the other hand, the presence of a hemorrhagic stroke is a contraindication. Results. This case demonstrates the solution to the difficult issue of choosing treatment for a hemorrhagic stroke and prevention of secondary complications of atrial fibrillation in combination with hypertension. After medical cardioversion, using clinical recommendations for the treatment of a hemorrhagic stroke, as well as given the positive dynamics of the neurological status, the patient was prescribed apixaban at a dose of 2.5 mg twice a day under the control of a coagulogram from the 7th day of the disease onset. Conclusions. We believe it is necessary to perform a thorough neurological examination and assessment of cognitive functions in all patients with atrial fibrillation, as well as to consider neuroimaging prior to the prescription of anticoagulant therapy. We recommend considering the administration of oral anticoagulants to patients with a low risk of recurrence and a high risk of thromboembolic complications after intracerebral hemorrhage","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141802542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.22141/2224-0713.20.4.2024.1078
M.Yu. Pryima, T.O. Studeniak
The article reviews the problem of hippocampal sclerosis as the main cause of pharmacoresistant temporal lobe epilepsy. Clinical manifestations, diagnostic criteria, recommended methods of examination and treatment of hippocampal sclerosis are given. The effectiveness of surgical and medical treatments was analyzed. The relevance of this article is due to a general increase in the detection of this disease, primarily owing the improvement of neuroimaging methods. Given that this disease is relatively rare, and that surgical treatment is often delayed for many years, a review of this topic is useful for early diagnosis and improved treatment outcomes. Modern literary sources on hippocampal sclerosis were studied. The studied material is summarized and presented in the form of a literature review in this article. A search for literary sources was carried out in two main scientific databases: Scopus and PubMed. The review included original articles, research, and official guidelines from medical associations.
{"title":"Typical course of hippocampal sclerosis. Literature review","authors":"M.Yu. Pryima, T.O. Studeniak","doi":"10.22141/2224-0713.20.4.2024.1078","DOIUrl":"https://doi.org/10.22141/2224-0713.20.4.2024.1078","url":null,"abstract":"The article reviews the problem of hippocampal sclerosis as the main cause of pharmacoresistant temporal lobe epilepsy. Clinical manifestations, diagnostic criteria, recommended methods of examination and treatment of hippocampal sclerosis are given. The effectiveness of surgical and medical treatments was analyzed. The relevance of this article is due to a general increase in the detection of this disease, primarily owing the improvement of neuroimaging methods. Given that this disease is relatively rare, and that surgical treatment is often delayed for many years, a review of this topic is useful for early diagnosis and improved treatment outcomes. Modern literary sources on hippocampal sclerosis were studied. The studied material is summarized and presented in the form of a literature review in this article. A search for literary sources was carried out in two main scientific databases: Scopus and PubMed. The review included original articles, research, and official guidelines from medical associations.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"24 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141802834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.22141/2224-0713.20.4.2024.1082
O. Nekhlopochyn, A. N. Nikiforova, V. Verbov, T. A. Yovenko, I. Cheshuk
Background. Traumatic spinal cord injury is a significant medical and social issue. Despite numerous studies, substantial success in reducing neurological consequences in such patients has not yet been achieved, and several aspects remain understudied, particularly the response of the spinal cord to injury at different anatomical levels. The purpose is to analyze the influence of the anatomical level of injury, the patient’s gender, and the mechanism of injury on the pattern of functional disorders in the acute period of spinal cord trauma using the largest publicly available database of patients with traumatic spinal cord injuries. Materials and methods. A statistical analysis of data from the National Spinal Cord Injury Model Systems Database (version 2021 ARPublic) was conducted. It included 21,343 cases containing information on gender, age at the time of injury, circumstances of injury, the degree of neurological disorders at hospitalization, and the anatomical level of traumatic injury (with precision down to the spinal cord segment). Results. The data analysis revealed significant differences in the pattern of distribution of functional classes according to the American Spinal Injury Association scale depending on the anatomical level of spinal cord injury. For the cervical region, the distribution of frequencies for A, B, C, and D classes was as follows: 43.06 % (95% confidence interval (CI): 42.15–43.97 %), 14.99 % (95% CI: 14.35–15.66 %), 16.17 % (95% CI: 15.50–16.86 %) and 25.78 % (95% CI: 24.98–26.59 %), respectively, for the thoracic region — 70.97 % (95% CI: 69.94–71.97 %), 10.27 % (95% CI: 9.60–10.97 %), 9.92 % (95% CI: 9.26–10.61 %) and 8.85 % (95% CI: 8.23–9.51 %), for the lumbar region — 21.29 % (95% CI: 19.57–23.12 %), 15.87 % (95% CI: 14.35–17.52 %), 24.43 % (95% CI: 22.62–26.34 %) and 38.40 % (95% CI: 36.32–40.52 %). Conclusions. The pattern of distribution of functional classes of neurological impairments significantly depends on the anatomical level of spinal cord injury. Thoracic segment injuries are characterized by the most clinically severe symptoms, whereas lumbar segment injuries are the least severe. The patient’s gender does not have a statistically significant influence, while the circumstances of the injury correlate with the frequency of neurological impairments in cervical segments and do not affect this indicator in the lumbar region.
{"title":"Influence of the anatomical level of spinal cord injury on the severity of neurological impairments in spinal cord trauma","authors":"O. Nekhlopochyn, A. N. Nikiforova, V. Verbov, T. A. Yovenko, I. Cheshuk","doi":"10.22141/2224-0713.20.4.2024.1082","DOIUrl":"https://doi.org/10.22141/2224-0713.20.4.2024.1082","url":null,"abstract":"Background. Traumatic spinal cord injury is a significant medical and social issue. Despite numerous studies, substantial success in reducing neurological consequences in such patients has not yet been achieved, and several aspects remain understudied, particularly the response of the spinal cord to injury at different anatomical levels. The purpose is to analyze the influence of the anatomical level of injury, the patient’s gender, and the mechanism of injury on the pattern of functional disorders in the acute period of spinal cord trauma using the largest publicly available database of patients with traumatic spinal cord injuries. Materials and methods. A statistical analysis of data from the National Spinal Cord Injury Model Systems Database (version 2021 ARPublic) was conducted. It included 21,343 cases containing information on gender, age at the time of injury, circumstances of injury, the degree of neurological disorders at hospitalization, and the anatomical level of traumatic injury (with precision down to the spinal cord segment). Results. The data analysis revealed significant differences in the pattern of distribution of functional classes according to the American Spinal Injury Association scale depending on the anatomical level of spinal cord injury. For the cervical region, the distribution of frequencies for A, B, C, and D classes was as follows: 43.06 % (95% confidence interval (CI): 42.15–43.97 %), 14.99 % (95% CI: 14.35–15.66 %), 16.17 % (95% CI: 15.50–16.86 %) and 25.78 % (95% CI: 24.98–26.59 %), respectively, for the thoracic region — 70.97 % (95% CI: 69.94–71.97 %), 10.27 % (95% CI: 9.60–10.97 %), 9.92 % (95% CI: 9.26–10.61 %) and 8.85 % (95% CI: 8.23–9.51 %), for the lumbar region — 21.29 % (95% CI: 19.57–23.12 %), 15.87 % (95% CI: 14.35–17.52 %), 24.43 % (95% CI: 22.62–26.34 %) and 38.40 % (95% CI: 36.32–40.52 %). Conclusions. The pattern of distribution of functional classes of neurological impairments significantly depends on the anatomical level of spinal cord injury. Thoracic segment injuries are characterized by the most clinically severe symptoms, whereas lumbar segment injuries are the least severe. The patient’s gender does not have a statistically significant influence, while the circumstances of the injury correlate with the frequency of neurological impairments in cervical segments and do not affect this indicator in the lumbar region.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"46 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141802528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.22141/2224-0713.20.4.2024.1080
PhD Inna Chernenko, I. Voloshyn-Haponov, N. P. Voloshyna
The paper presents the results of the ultrasound diagnosis of 76 patients with neurological forms of hepatocerebral dystrophy, or Wilson’s disease (WD), who were examined and treated at the clinic of the Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Sciences of Ukraine. According to ultrasound diagnosis, all patients had pathological changes in the liver. In 58 % of patients, these changes corresponded to chronic hepatitis, in 42 % — to liver cirrhosis. 32 % of patients had evidence of portal hypertension. A Doppler test showed that background hepatic hemodynamics in patients with neurological forms of hepatocerebral dystrophy was within normal limits, but 82 % of patients had an impaired reciprocal autoregulation of liver microcirculation. It indicates a decrease in the compensatory and adaptive capabilities of the liver. This position is confirmed by the fact that 70 % of such patients have a decrease in the vasoactive function of the endothelium. In general, the indicator for the group was only 8.12 %, with a norm of 10 % or more. Despite the young average age of our patients (29.7 years), only 30 % of them had a normal vasoactive reaction. These were patients under the age of 25 with chronic hepatitis. The degree of endothelial dysfunction was significantly higher in patients with liver cirrhosis compared to those with chronic hepatitis. According to ultrasound elastography, most examined patients with WD (88 %) had increased stiffness of the liver parenchyma. On average, it was 10.62 kPa with a range from 4.74 to 20.69 kPa (norm 0.4–6.0 kPa). Thus, patients with neurological forms of WD who are observed by a neuropathologist should undergo an abdominal ultrasound before each course of treatment, but at least 1–2 times a year.
{"title":"Structural and functional changes in organs of the abdominal cavity in patients with Wilson’s disease","authors":"PhD Inna Chernenko, I. Voloshyn-Haponov, N. P. Voloshyna","doi":"10.22141/2224-0713.20.4.2024.1080","DOIUrl":"https://doi.org/10.22141/2224-0713.20.4.2024.1080","url":null,"abstract":"The paper presents the results of the ultrasound diagnosis of 76 patients with neurological forms of hepatocerebral dystrophy, or Wilson’s disease (WD), who were examined and treated at the clinic of the Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Sciences of Ukraine. According to ultrasound diagnosis, all patients had pathological changes in the liver. In 58 % of patients, these changes corresponded to chronic hepatitis, in 42 % — to liver cirrhosis. 32 % of patients had evidence of portal hypertension. A Doppler test showed that background hepatic hemodynamics in patients with neurological forms of hepatocerebral dystrophy was within normal limits, but 82 % of patients had an impaired reciprocal autoregulation of liver microcirculation. It indicates a decrease in the compensatory and adaptive capabilities of the liver. This position is confirmed by the fact that 70 % of such patients have a decrease in the vasoactive function of the endothelium. In general, the indicator for the group was only 8.12 %, with a norm of 10 % or more. Despite the young average age of our patients (29.7 years), only 30 % of them had a normal vasoactive reaction. These were patients under the age of 25 with chronic hepatitis. The degree of endothelial dysfunction was significantly higher in patients with liver cirrhosis compared to those with chronic hepatitis. According to ultrasound elastography, most examined patients with WD (88 %) had increased stiffness of the liver parenchyma. On average, it was 10.62 kPa with a range from 4.74 to 20.69 kPa (norm 0.4–6.0 kPa). Thus, patients with neurological forms of WD who are observed by a neuropathologist should undergo an abdominal ultrasound before each course of treatment, but at least 1–2 times a year.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141804405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.22141/2224-0713.20.4.2024.1081
M. Matiash, Yuriy Galanta
The problem of the study is that due to the COVID-19 pandemic caused by SARS-CoV-2, many people experience post-infectious long-term symptoms, namely post-COVID syndrome. This disease is characterized by persistent debilitating fatigue, neurocognitive difficulties, muscle pain and weakness, as well as depression, and generalized anxiety disorder (GAD) that lasts for more than 3 to 12 weeks after SARS-CoV-2 infection. Among these symptoms, neurocognitive and psychiatric consequences, including attention and memory impairment, symptoms of anxiety and depression, have become the main focus of attention of modern healthcare professionals due to their significant impact on public health. In this regard, assessment tools play a crucial role in the early screening of cognitive changes caused by the prolonged course of COVID-19. This includes general cognitive assessment tools such as the Montreal Cognitive Assessment (MoCA) and more specific ones, namely the Patient Health Questionnaire (PHQ-9) for screening, diagnosing and monitoring depression symptoms and the GAD-7 for assessing anxiety and screening for generalized anxiety disorder. The aim of the study was to determine the impact of post-COVID syndrome on the cognitive and emotional sphere of people, as well as to develop recommendations for overcoming its consequences. The study sample consisted of 70 patients who had contracted COVID-19. They were divided into three groups, according to the COVID-19 classification by the severity, namely: group 1 — mild; group 2 — moderate and group 3 — severe. The results of the patient examinations showed that according to the MoCA, all respondents had a low level of cognitive impairment. This indicates the need for psychological support and clinical care. The score on the PHQ-9 demonstrated that in 15 (21 %) patients with mild COVID-19 and in 30 (43 %) with moderate course, mild depression prevailed. However, according to this questionnaire, patients with severe COVID-19 are characterized by moderate depression. The results showed that the more severe the disease, the higher the level of depression in patients. The GAD-7 scale showed that 15 (21 %) patients with mild COVID-19 and 30 (43 %) patients with moderate course were characterized by a moderate level of generalized anxiety disorder. Instead, the results of the study using the same questionnaire showed that 25 (36 %) patients with severe COVID-19 had an average level of generalized anxiety disorder. The results obtained according to the GAD-7 scale show that the more severe the degree of COVID-19, the higher the level of generalized anxiety disorder in patients. Special recommendations have been proposed to overcome cognitive and emotional disturbances associated with post-COVID syndrome.
{"title":"The medical and psychological components of post-COVID syndrome: disorders of the cognitive and emotional sphere of a person","authors":"M. Matiash, Yuriy Galanta","doi":"10.22141/2224-0713.20.4.2024.1081","DOIUrl":"https://doi.org/10.22141/2224-0713.20.4.2024.1081","url":null,"abstract":"The problem of the study is that due to the COVID-19 pandemic caused by SARS-CoV-2, many people experience post-infectious long-term symptoms, namely post-COVID syndrome. This disease is characterized by persistent debilitating fatigue, neurocognitive difficulties, muscle pain and weakness, as well as depression, and generalized anxiety disorder (GAD) that lasts for more than 3 to 12 weeks after SARS-CoV-2 infection. Among these symptoms, neurocognitive and psychiatric consequences, including attention and memory impairment, symptoms of anxiety and depression, have become the main focus of attention of modern healthcare professionals due to their significant impact on public health. In this regard, assessment tools play a crucial role in the early screening of cognitive changes caused by the prolonged course of COVID-19. This includes general cognitive assessment tools such as the Montreal Cognitive Assessment (MoCA) and more specific ones, namely the Patient Health Questionnaire (PHQ-9) for screening, diagnosing and monitoring depression symptoms and the GAD-7 for assessing anxiety and screening for generalized anxiety disorder. The aim of the study was to determine the impact of post-COVID syndrome on the cognitive and emotional sphere of people, as well as to develop recommendations for overcoming its consequences. The study sample consisted of 70 patients who had contracted COVID-19. They were divided into three groups, according to the COVID-19 classification by the severity, namely: group 1 — mild; group 2 — moderate and group 3 — severe. The results of the patient examinations showed that according to the MoCA, all respondents had a low level of cognitive impairment. This indicates the need for psychological support and clinical care. The score on the PHQ-9 demonstrated that in 15 (21 %) patients with mild COVID-19 and in 30 (43 %) with moderate course, mild depression prevailed. However, according to this questionnaire, patients with severe COVID-19 are characterized by moderate depression. The results showed that the more severe the disease, the higher the level of depression in patients. The GAD-7 scale showed that 15 (21 %) patients with mild COVID-19 and 30 (43 %) patients with moderate course were characterized by a moderate level of generalized anxiety disorder. Instead, the results of the study using the same questionnaire showed that 25 (36 %) patients with severe COVID-19 had an average level of generalized anxiety disorder. The results obtained according to the GAD-7 scale show that the more severe the degree of COVID-19, the higher the level of generalized anxiety disorder in patients. Special recommendations have been proposed to overcome cognitive and emotional disturbances associated with post-COVID syndrome.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"40 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141803884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-06DOI: 10.22141/2224-0713.20.2.2024.1059
O.V. Tkachenko, O. Demydas, O. Kononets, L.Yu. Lichman
Background. The purpose was to study the effect of Helicobacter pylori (H.pylori) in duodenal ulcer on the neuropsychological and psychometric scores. Materials and methods. We conducted a comprehensive clinical, neurological, neuropsychological, and psychometric examination of 60 patients with duodenal ulcer aged 25–60 (the mean of 39.80 ± 1.29) years. All of them were divided into two groups considering whether H.pylori infection was detected (group 1) or not (group 2). The control group included 30 apparently healthy individuals with no somatic abnormalities. To study psychometric and neuropsychological characteristics, the patients were comprehensively tested, in particular using the Beck Depression Inventory for evaluating the severity of depression, the State-Trait Anxiety Inventory for assessing separate dimensions of state and trait anxiety, the Well-being, Activity, Mood (WAM) questionnaire, the Mini-Mental Health Examination for screening cognitive function, the Schulte tables for evaluating the refocusing speeds and performance distribution. Results. The level of depression in H.pylori-positive duodenal ulcer was significantly higher than with H.pylori-negative duodenal ulcer (p < 0.05). The patients from the group 1 had higher scores of state and trait anxiety and the lower ones of the functional state. The concentration of attention detected by means of the Schulte tables was lower in these patients. A direct correlation was found between the degree of depressive disorders and the number of complaints associated with psycho-emotional disorders in the patients with duodenal ulcer (r = 0.61). We found an inverse correlation (p < 0.05) between the anxiety level and the WAM indices, on the one hand, and between depressive disorders and the WAM indices, on the other hand, in the patients with duodenal ulcer. Depression and anxiety were comorbid in 73.3 % of cases in the group 1 and in 30 % of cases in the group 2. Conclusions. The complaints associated with psycho-emotional disorders occurred in the patients with both H.pylori-positive and H.pylori-negative duodenal ulcer; however, they were more frequent in the group 1. The clinical presentations of depression were observed in both groups, but the depression level was significantly higher in the patients with H.pylori-positive duodenal ulcer (p < 0.05). An increase in anxiety was also found in both groups; however, the rates of state and trait anxiety were higher in the group 1. At duodenal ulcer exacerbation, no matter if H.pylori infection was present or not, the patients had unsatisfactory well-being, low activity, and poor mood. The decreased indices of the functional state self-assessment were detected in the group with H.pylori-positive duodenal ulcer. Using the Schulte tables, we found that a decrease in attention concentration was more evident in the group 1 that in the patients with H.pylori-negative duodenal ulcer. Thus, having conducted the neuropsychological and psychometric
{"title":"Neuropsychological and psychometric parameters in the patients with duodenal ulcer depending on Helicobacter pylori presence","authors":"O.V. Tkachenko, O. Demydas, O. Kononets, L.Yu. Lichman","doi":"10.22141/2224-0713.20.2.2024.1059","DOIUrl":"https://doi.org/10.22141/2224-0713.20.2.2024.1059","url":null,"abstract":"Background. The purpose was to study the effect of Helicobacter pylori (H.pylori) in duodenal ulcer on the neuropsychological and psychometric scores. Materials and methods. We conducted a comprehensive clinical, neurological, neuropsychological, and psychometric examination of 60 patients with duodenal ulcer aged 25–60 (the mean of 39.80 ± 1.29) years. All of them were divided into two groups considering whether H.pylori infection was detected (group 1) or not (group 2). The control group included 30 apparently healthy individuals with no somatic abnormalities. To study psychometric and neuropsychological characteristics, the patients were comprehensively tested, in particular using the Beck Depression Inventory for evaluating the severity of depression, the State-Trait Anxiety Inventory for assessing separate dimensions of state and trait anxiety, the Well-being, Activity, Mood (WAM) questionnaire, the Mini-Mental Health Examination for screening cognitive function, the Schulte tables for evaluating the refocusing speeds and performance distribution. Results. The level of depression in H.pylori-positive duodenal ulcer was significantly higher than with H.pylori-negative duodenal ulcer (p < 0.05). The patients from the group 1 had higher scores of state and trait anxiety and the lower ones of the functional state. The concentration of attention detected by means of the Schulte tables was lower in these patients. A direct correlation was found between the degree of depressive disorders and the number of complaints associated with psycho-emotional disorders in the patients with duodenal ulcer (r = 0.61). We found an inverse correlation (p < 0.05) between the anxiety level and the WAM indices, on the one hand, and between depressive disorders and the WAM indices, on the other hand, in the patients with duodenal ulcer. Depression and anxiety were comorbid in 73.3 % of cases in the group 1 and in 30 % of cases in the group 2. Conclusions. The complaints associated with psycho-emotional disorders occurred in the patients with both H.pylori-positive and H.pylori-negative duodenal ulcer; however, they were more frequent in the group 1. The clinical presentations of depression were observed in both groups, but the depression level was significantly higher in the patients with H.pylori-positive duodenal ulcer (p < 0.05). An increase in anxiety was also found in both groups; however, the rates of state and trait anxiety were higher in the group 1. At duodenal ulcer exacerbation, no matter if H.pylori infection was present or not, the patients had unsatisfactory well-being, low activity, and poor mood. The decreased indices of the functional state self-assessment were detected in the group with H.pylori-positive duodenal ulcer. Using the Schulte tables, we found that a decrease in attention concentration was more evident in the group 1 that in the patients with H.pylori-negative duodenal ulcer. Thus, having conducted the neuropsychological and psychometric ","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"85 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141010896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-06DOI: 10.22141/2224-0713.20.2.2024.1060
PhD Tetiana Halenova, T. Halenova, N. G. Raksha, T. B. Vovk, V. Karbovskyy, S. Sholomon, V. Melnyk, O. M. Savchuk
Background. The purpose of this study was to investigate plasma levels of fibrinogen and products of its degradation in patients with multiple sclerosis (MS) with and without a history of coronavirus disease 2019 (COVID-19). Materials and methods. We examined 97 patients with MS. Based on the presence of COVID-19, all cases were divided into two groups. MS group included 56 patients who did not suffer from COVID-19 previously. MS + COVID group consisted of 41 cases who had a laboratory-verified diagnosis of COVID-19. The group of healthy controls included 30 healthy volunteers. Spectrophotometric techniques were used to measure the concentrations of fibrinogen, D-dimer, and soluble fibrin monomer complexes (SFMCs). Size-exclusion chromatography was applied to analyze the composition of SFMC fractions. Results. We found that concentrations of fibrinogen, D-dimer, and SFMCs were remarkably increased in plasma of all MS patients compared with healthy controls. The levels of D-dimer, and SFMCs did not differ between two MS groups, while plasma fibrinogen concentration was significantly increased in MS + COVID patients compared to MS group. Moreover, the development of MS was accompanied by the changes in both quantity and quality of SFMC composition compared to that of healthy controls. Our results demonstrated accumulation of high-molecular-weight SFMCs in plasma of MS patients. Conclusions. The findings indicated that MS patients had changed hemostasis characteristics; however, more research is required to determine the connection between particular hemostatic factors, namely fibrinogen, D-dimer, and SFMCs, and the pathophysiology of MS.
{"title":"Characteristics of fibrin/fibrinogen degradation products in multiple sclerosis following SARS-CoV-2 infection","authors":"PhD Tetiana Halenova, T. Halenova, N. G. Raksha, T. B. Vovk, V. Karbovskyy, S. Sholomon, V. Melnyk, O. M. Savchuk","doi":"10.22141/2224-0713.20.2.2024.1060","DOIUrl":"https://doi.org/10.22141/2224-0713.20.2.2024.1060","url":null,"abstract":"Background. The purpose of this study was to investigate plasma levels of fibrinogen and products of its degradation in patients with multiple sclerosis (MS) with and without a history of coronavirus disease 2019 (COVID-19). Materials and methods. We examined 97 patients with MS. Based on the presence of COVID-19, all cases were divided into two groups. MS group included 56 patients who did not suffer from COVID-19 previously. MS + COVID group consisted of 41 cases who had a laboratory-verified diagnosis of COVID-19. The group of healthy controls included 30 healthy volunteers. Spectrophotometric techniques were used to measure the concentrations of fibrinogen, D-dimer, and soluble fibrin monomer complexes (SFMCs). Size-exclusion chromatography was applied to analyze the composition of SFMC fractions. Results. We found that concentrations of fibrinogen, D-dimer, and SFMCs were remarkably increased in plasma of all MS patients compared with healthy controls. The levels of D-dimer, and SFMCs did not differ between two MS groups, while plasma fibrinogen concentration was significantly increased in MS + COVID patients compared to MS group. Moreover, the development of MS was accompanied by the changes in both quantity and quality of SFMC composition compared to that of healthy controls. Our results demonstrated accumulation of high-molecular-weight SFMCs in plasma of MS patients. Conclusions. The findings indicated that MS patients had changed hemostasis characteristics; however, more research is required to determine the connection between particular hemostatic factors, namely fibrinogen, D-dimer, and SFMCs, and the pathophysiology of MS.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"23 5‐6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141006624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-06DOI: 10.22141/2224-0713.20.2.2024.1053
D.R. Stelmashchuk, O. Kopchak
The article reviews the problem of paraneoplastic neurological syndromes with a focus on paraneoplastic subacute neuropathy. It outlines clinical manifestations, diagnostic criteria of the 2021 PNS-Care Score, recommended methods of patients’ examination and treatment for paraneoplastic sensory neuropathies. The relevance of this article is driven by the overall increase in cancers in the population and, consequently, the rise in the frequency of paraneoplastic syndromes. Given that paraneoplastic syndromes can arise at any stage of oncological disease, both in diagnosed cancer and in preclinical stages preceding the detection of primary cancer, a review of this topic is beneficial for early diagnosis and improvement of treatment outcomes.
{"title":"Subacute paraneoplastic neuropathy as a form of “classic” paraneoplastic syndrome (literature review)","authors":"D.R. Stelmashchuk, O. Kopchak","doi":"10.22141/2224-0713.20.2.2024.1053","DOIUrl":"https://doi.org/10.22141/2224-0713.20.2.2024.1053","url":null,"abstract":"The article reviews the problem of paraneoplastic neurological syndromes with a focus on paraneoplastic subacute neuropathy. It outlines clinical manifestations, diagnostic criteria of the 2021 PNS-Care Score, recommended methods of patients’ examination and treatment for paraneoplastic sensory neuropathies. The relevance of this article is driven by the overall increase in cancers in the population and, consequently, the rise in the frequency of paraneoplastic syndromes. Given that paraneoplastic syndromes can arise at any stage of oncological disease, both in diagnosed cancer and in preclinical stages preceding the detection of primary cancer, a review of this topic is beneficial for early diagnosis and improvement of treatment outcomes.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"357 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141006803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-06DOI: 10.22141/2224-0713.20.2.2024.1058
М. Trishchynska, O.P. Onopriyenko
The article highlights the global problems of stroke. Most of them are associated with three groups of risk factors for stroke: well-known pathogenetic, psychogenic, and ecological factors of environmental pollution. The authors draw attention to this on the eve of 38th anniversary of the man-made Chernobyl disaster (April 26, 1986) comparing data on the stroke in Japan after the Fukushima nuclear accident (March 11–12, 2011) due to the earthquake, which led to the reactor core melting at three power units. Issues of improving the provision of specialized medical care to patients with stroke, risk factors for stroke are considered to minimize the consequences, optimize treatment, prevention of risk factors, especially in areas where the population is exposed to incorporated radiation damage through food, water, milk, fish, meat, berries, mushrooms, as well as the issues of improving the specialized stroke care, creation of stroke centers in regions of Ukraine. Studies conducted show that there are many causes of strokes, and they are not yet fully understood. The features of the clinical course of strokes in the Chernobyl liquidators are their development in the middle (40–49 years) and advanced age, long vascular history characterized by vascular dystonia transformation into dyscirculatory (postradiation) encephalopathy during the onset, the predominance of ischemic stroke over hemorrhagic one, lesions mainly of the carotid system, the relative benignity of clinical course, progressive nature of mental disorders, concomitant somatic pathology, the presence of stable pathomorphological substrate from both vascular endothelial dysfunction and cerebral liquor system. The obtained information complements the data on the pathogenesis, clinical picture, diagnosis of cerebral strokes in Chernobyl liquidators and is of practical interest. Raised issues of optimizing the provision of specialized care in stroke units, centers and further rehabilitation, their sufficient supply, both in terms of staffing and equipment, are becoming a cornerstone in overcoming the stroke epidemic. Based on the above, there is still a need to continue substantial research in this area, promptly develop and implement a scientific concept on the prevention, early detection of major modifiable risk factors for stroke together with family medicine doctors, specialist physicians, proper stroke treatment, which will undoubtedly improve quality of life of patients and their relatives.
{"title":"Epidemiology of stroke in the Left bank area of Kyiv region on the eve of the 38th anniversary of the man-made Chernobyl disaster: implementing international experience into practice (modern view of the problem and own research)","authors":"М. Trishchynska, O.P. Onopriyenko","doi":"10.22141/2224-0713.20.2.2024.1058","DOIUrl":"https://doi.org/10.22141/2224-0713.20.2.2024.1058","url":null,"abstract":"The article highlights the global problems of stroke. Most of them are associated with three groups of risk factors for stroke: well-known pathogenetic, psychogenic, and ecological factors of environmental pollution. The authors draw attention to this on the eve of 38th anniversary of the man-made Chernobyl disaster (April 26, 1986) comparing data on the stroke in Japan after the Fukushima nuclear accident (March 11–12, 2011) due to the earthquake, which led to the reactor core melting at three power units. Issues of improving the provision of specialized medical care to patients with stroke, risk factors for stroke are considered to minimize the consequences, optimize treatment, prevention of risk factors, especially in areas where the population is exposed to incorporated radiation damage through food, water, milk, fish, meat, berries, mushrooms, as well as the issues of improving the specialized stroke care, creation of stroke centers in regions of Ukraine. Studies conducted show that there are many causes of strokes, and they are not yet fully understood. The features of the clinical course of strokes in the Chernobyl liquidators are their development in the middle (40–49 years) and advanced age, long vascular history characterized by vascular dystonia transformation into dyscirculatory (postradiation) encephalopathy during the onset, the predominance of ischemic stroke over hemorrhagic one, lesions mainly of the carotid system, the relative benignity of clinical course, progressive nature of mental disorders, concomitant somatic pathology, the presence of stable pathomorphological substrate from both vascular endothelial dysfunction and cerebral liquor system. The obtained information complements the data on the pathogenesis, clinical picture, diagnosis of cerebral strokes in Chernobyl liquidators and is of practical interest. Raised issues of optimizing the provision of specialized care in stroke units, centers and further rehabilitation, their sufficient supply, both in terms of staffing and equipment, are becoming a cornerstone in overcoming the stroke epidemic. Based on the above, there is still a need to continue substantial research in this area, promptly develop and implement a scientific concept on the prevention, early detection of major modifiable risk factors for stroke together with family medicine doctors, specialist physicians, proper stroke treatment, which will undoubtedly improve quality of life of patients and their relatives.","PeriodicalId":14476,"journal":{"name":"INTERNATIONAL NEUROLOGICAL JOURNAL","volume":"12 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141008787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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