Pub Date : 2023-07-19DOI: 10.30629/2658-7947-2023-28-3-28-35
L. B. Zavaliy, M. Sinkin, M. Kalantarova, A. Rakhmanina, G. R. Ramazanov, N. Shamalov, S. Petrikov
Treatment of patients with facial neuropathy (FN) is a big scientific problem. There is no single protocol and patient management tactics are different. We have conducted an analysis of clinical practice in the treatment of patients with FN.Material and methods. An anonymous online survey of neurologists positioning themselves as supporters of evidencebased medicine was conducted (n = 139, work experience – 5 [3; 10] years). It included 10 questions. The analysis of methods of treatment was carried out. We compared the experience of specialists, who prescribed a certain drug, and who did not prescribe it. Descriptive statistics are given in the form of: absolute (n) and relative values (%), medians (Me), lower [q1] and upper [q3] quartiles.Results. In the studied sample with FN, all doctors recommend glucocorticosteroids, of which almost 2/3 allow use only in the first 3 days of the disease. Antiviral drugs are prescribed by 91.4% (n = 127) of specialists, the main indication is the presence of herpetic infection in visual examination (n = 104; 74.8%), less often a positive test for herpes infection (n = 23; 16.5%) or prosoplegia (n = 16; 11.5%). Anticholinesterase agents are prescribed by 38.1% (n = 53) of neurologists, their work experience is greater – 7 [5; 13] versus 5 [2; 9.75], p = 0.035. More than half (n = 81; 58.3%) of doctors do not recommend medications for additional drug therapy. Botulinum therapy is considered in the clinical practice of treatment of FN by 59% (n = 82) of doctors, regardless of work experience (p = 0.697), however, we observed a large variability of opinions according to the indications for use. When deciding on referral for surgical treatment, the most important doctors considered the problem of poor awareness of the types of operations (n = 83; 59.7%), as well as the lack of clear indications for surgical treatment (n = 62; 44.6%).Conclusion. The study revealed a diversity of opinions even among specialists who position themselves as supporters of evidence-based medicine. There is a great need to develop Russian clinical guidelines for facial nerve neuropathy.
{"title":"Treatment of patients with facial neuropathy by practicing neurologists: online survey","authors":"L. B. Zavaliy, M. Sinkin, M. Kalantarova, A. Rakhmanina, G. R. Ramazanov, N. Shamalov, S. Petrikov","doi":"10.30629/2658-7947-2023-28-3-28-35","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-3-28-35","url":null,"abstract":"Treatment of patients with facial neuropathy (FN) is a big scientific problem. There is no single protocol and patient management tactics are different. We have conducted an analysis of clinical practice in the treatment of patients with FN.Material and methods. An anonymous online survey of neurologists positioning themselves as supporters of evidencebased medicine was conducted (n = 139, work experience – 5 [3; 10] years). It included 10 questions. The analysis of methods of treatment was carried out. We compared the experience of specialists, who prescribed a certain drug, and who did not prescribe it. Descriptive statistics are given in the form of: absolute (n) and relative values (%), medians (Me), lower [q1] and upper [q3] quartiles.Results. In the studied sample with FN, all doctors recommend glucocorticosteroids, of which almost 2/3 allow use only in the first 3 days of the disease. Antiviral drugs are prescribed by 91.4% (n = 127) of specialists, the main indication is the presence of herpetic infection in visual examination (n = 104; 74.8%), less often a positive test for herpes infection (n = 23; 16.5%) or prosoplegia (n = 16; 11.5%). Anticholinesterase agents are prescribed by 38.1% (n = 53) of neurologists, their work experience is greater – 7 [5; 13] versus 5 [2; 9.75], p = 0.035. More than half (n = 81; 58.3%) of doctors do not recommend medications for additional drug therapy. Botulinum therapy is considered in the clinical practice of treatment of FN by 59% (n = 82) of doctors, regardless of work experience (p = 0.697), however, we observed a large variability of opinions according to the indications for use. When deciding on referral for surgical treatment, the most important doctors considered the problem of poor awareness of the types of operations (n = 83; 59.7%), as well as the lack of clear indications for surgical treatment (n = 62; 44.6%).Conclusion. The study revealed a diversity of opinions even among specialists who position themselves as supporters of evidence-based medicine. There is a great need to develop Russian clinical guidelines for facial nerve neuropathy.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43894235","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 : 2023-07-19DOI: 10.30629/2658-7947-2023-28-3-14-21
D. A. Demin, A. Kulesh, S. Enginoev, V. V. Demetskaya, D. Kozmin, E. V. Demina, D. Stompel, P. Astanin
Abstract. Cerebral neurological complications (CNC) are the most common form of infective endocarditis (IE) extracardiac manifestations. They have important clinical implications, which justifies the need to study them.Purpose of the study: to evaluate symptomatic CNC (prevalence, predictors, effect on the prognosis) in patients with «left-sided» IE who have undergone cardiac surgery, according to the register of the Federal Center for Cardiovascular Surgery.Materials and methods. A retrospective review of data from the hospital information system was carried out in one of the Federal Centers for Cardiovascular Surgery of the Ministry of Health of the Russian Federation. In patients with significant/probable «left-sided» (mitral and/or aortic valves) acute/subacute IE at age of ≥ 18 years, the frequency of CNC and their subtypes was assessed, predictors and effect on the prognosis of the disease were determined. Differences between groups of patients depending on the status of the presence of CNC were assessed using the χ2 test, Fisher’s exact test and the Mann–Whitney test. Binary cross tables were further analyzed to calculate the odds ratio (OR). Integral predictive models were also built using the logistic regression algorithm. To assess the effect of CNC on patient survival, Kaplan–Meier analysis was used with the construction of survival curves.Results. For the analysis, 222 cases of IE in 216 patients were used. The incidence of CNC was 25.7% (19.4% – ischemic stroke, 5.4% – intracranial hemorrhage, 2.7% – meningitis, encephalitis and/or abscess). CNC predictors were embologenic vegetations: size > 10 mm (OR 6.3; 95% CI: 3.0–13.0), mobile (OR 8.5; 95% CI: 3.2–22.3) and multiple (OR 4.9; 95% CI: 2.1–11.4) vegetation; the level of white blood cells ≥ 10 × 109/L (OR 2.1, 1.1–3.8), as well as systemic embolism (OR 3.6; 95% CI: 1.6–7.9). The accuracy of the logistic regression model obtained using the above predictors was 83% (on the test set). No effect of CNC on the prognosis (in-hospital and long-term mortality, stroke in the long-term period) was found.Conclusion. Neurological complications have a high prevalence, occurring in one in four patients with «left-sided» IE. Ischemic stroke is the most common subtype of CNC, and vegetation characteristics are a determining factor of the embologenic potential of endocarditis. There was no effect on the prognosis (in-hospital and long-term mortality) in patients undergoing cardiac surgery.
{"title":"Evaluation of cerebral neurological complications in patients with infective endocarditis: results of a single-center retrospective study","authors":"D. A. Demin, A. Kulesh, S. Enginoev, V. V. Demetskaya, D. Kozmin, E. V. Demina, D. Stompel, P. Astanin","doi":"10.30629/2658-7947-2023-28-3-14-21","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-3-14-21","url":null,"abstract":"Abstract. Cerebral neurological complications (CNC) are the most common form of infective endocarditis (IE) extracardiac manifestations. They have important clinical implications, which justifies the need to study them.Purpose of the study: to evaluate symptomatic CNC (prevalence, predictors, effect on the prognosis) in patients with «left-sided» IE who have undergone cardiac surgery, according to the register of the Federal Center for Cardiovascular Surgery.Materials and methods. A retrospective review of data from the hospital information system was carried out in one of the Federal Centers for Cardiovascular Surgery of the Ministry of Health of the Russian Federation. In patients with significant/probable «left-sided» (mitral and/or aortic valves) acute/subacute IE at age of ≥ 18 years, the frequency of CNC and their subtypes was assessed, predictors and effect on the prognosis of the disease were determined. Differences between groups of patients depending on the status of the presence of CNC were assessed using the χ2 test, Fisher’s exact test and the Mann–Whitney test. Binary cross tables were further analyzed to calculate the odds ratio (OR). Integral predictive models were also built using the logistic regression algorithm. To assess the effect of CNC on patient survival, Kaplan–Meier analysis was used with the construction of survival curves.Results. For the analysis, 222 cases of IE in 216 patients were used. The incidence of CNC was 25.7% (19.4% – ischemic stroke, 5.4% – intracranial hemorrhage, 2.7% – meningitis, encephalitis and/or abscess). CNC predictors were embologenic vegetations: size > 10 mm (OR 6.3; 95% CI: 3.0–13.0), mobile (OR 8.5; 95% CI: 3.2–22.3) and multiple (OR 4.9; 95% CI: 2.1–11.4) vegetation; the level of white blood cells ≥ 10 × 109/L (OR 2.1, 1.1–3.8), as well as systemic embolism (OR 3.6; 95% CI: 1.6–7.9). The accuracy of the logistic regression model obtained using the above predictors was 83% (on the test set). No effect of CNC on the prognosis (in-hospital and long-term mortality, stroke in the long-term period) was found.Conclusion. Neurological complications have a high prevalence, occurring in one in four patients with «left-sided» IE. Ischemic stroke is the most common subtype of CNC, and vegetation characteristics are a determining factor of the embologenic potential of endocarditis. There was no effect on the prognosis (in-hospital and long-term mortality) in patients undergoing cardiac surgery.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42295047","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 : 2023-07-19DOI: 10.30629/2658-7947-2023-28-3-69-74
M. Naprienko, G. R. Ramazanov, T. Novikova
Acute cerebrovascular accident is one of the main causes of disability in patients and has a significant impact on the functions of daily activity and the ability to self-care. With the improvement of methods of medical care and the increase in patient survival, active rehabilitation of patients is becoming increasingly important. Malnutrition and loss of muscle mass are among the most frequent complications associated with a decrease in rehabilitation potential and an increased risk of adverse outcomes, and therefore the issues of timely assessment and correction of nutritional deficiency are relevant for all specialists of the interdisciplinary team that takes part in the rehabilitation treatment at all stages of rehabilitation
{"title":"The effect of nutritional insufficiency on clinical outcomes of patients with acute ischemic stroke","authors":"M. Naprienko, G. R. Ramazanov, T. Novikova","doi":"10.30629/2658-7947-2023-28-3-69-74","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-3-69-74","url":null,"abstract":"Acute cerebrovascular accident is one of the main causes of disability in patients and has a significant impact on the functions of daily activity and the ability to self-care. With the improvement of methods of medical care and the increase in patient survival, active rehabilitation of patients is becoming increasingly important. Malnutrition and loss of muscle mass are among the most frequent complications associated with a decrease in rehabilitation potential and an increased risk of adverse outcomes, and therefore the issues of timely assessment and correction of nutritional deficiency are relevant for all specialists of the interdisciplinary team that takes part in the rehabilitation treatment at all stages of rehabilitation","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47426703","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 : 2023-07-19DOI: 10.30629/2658-7947-2023-28-3-5-13
A. P. Kopylova, V. Zakharov, N. V. Vakhnina
We conducted a systematic review of 23 original studies published from 2010 to 2022, which participated a total of 168 thousand people, including 48 thousand patients with chronic obstructive pulmonary disease (COPD) aged 45 to 93 years.Results. The prevalence of cognitive impairment (CI) in patients with COPD varies from 6 to 63%. COPD patients have a higher risk of developing mild CI (HR from 1.1 to 1.9; OR from 1.4 to 2.4) and dementia (HR from 1.3 to 1.9; OR = 1.2). The risk of cognitive dysfunction increases along with a decrease in the values of forced expiratory volume in one second as a percentage of its expected value (FEV1%) (OR = 1.34), arterial oxygen partial pressure (PaO2) (OR = 5.45), oxygen saturation (SaO2) and an increase in the level of arterial carbon dioxide partial pressure (PaCO2). There is a significant direct relationship between FEV1% and Mini-Mental State Examination (MMSE) (p < 0.0001) and an inverse relationship between COPD severity and MMSE (p < 0.0001). The MMSE score is correlated with FEV1% (r = 0.46, p < 0.01) and PaO2 (r = 0.43, p < 0.05).Conclusion. The available data confirm the association of COPD with an increased risk of occurrence and progression of CI. It is discussed that this is due to the unfavorable course of concomitant vascular and neurodegenerative diseases against the background of chronic hypoxia.
{"title":"Сognitive impairment in patients with chronic obstructive pulmonary disease","authors":"A. P. Kopylova, V. Zakharov, N. V. Vakhnina","doi":"10.30629/2658-7947-2023-28-3-5-13","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-3-5-13","url":null,"abstract":"We conducted a systematic review of 23 original studies published from 2010 to 2022, which participated a total of 168 thousand people, including 48 thousand patients with chronic obstructive pulmonary disease (COPD) aged 45 to 93 years.Results. The prevalence of cognitive impairment (CI) in patients with COPD varies from 6 to 63%. COPD patients have a higher risk of developing mild CI (HR from 1.1 to 1.9; OR from 1.4 to 2.4) and dementia (HR from 1.3 to 1.9; OR = 1.2). The risk of cognitive dysfunction increases along with a decrease in the values of forced expiratory volume in one second as a percentage of its expected value (FEV1%) (OR = 1.34), arterial oxygen partial pressure (PaO2) (OR = 5.45), oxygen saturation (SaO2) and an increase in the level of arterial carbon dioxide partial pressure (PaCO2). There is a significant direct relationship between FEV1% and Mini-Mental State Examination (MMSE) (p < 0.0001) and an inverse relationship between COPD severity and MMSE (p < 0.0001). The MMSE score is correlated with FEV1% (r = 0.46, p < 0.01) and PaO2 (r = 0.43, p < 0.05).Conclusion. The available data confirm the association of COPD with an increased risk of occurrence and progression of CI. It is discussed that this is due to the unfavorable course of concomitant vascular and neurodegenerative diseases against the background of chronic hypoxia.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46247327","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 : 2023-07-19DOI: 10.30629/2658-7947-2023-28-3-50-54
D. I. Abzalova, M. Sinkin, O. V. Kisyel, A. Grin
Degos disease is a rare disease that manifests itself as multifocal vasculopathy, the consequence of which is the defeat of many systems, including the nervous system. This disease is difficult to diagnose, today it does not have a standardized approach to treatment, and it is deadly.In the presented clinical case, the course of BD is described in a 66-year-old patient, whose debut of the disease was a lesion of the skin. The cause of hospitalization of the patient was the defeat of the central nervous system. During the additional examination, the patient was diagnosed with ischemic stroke in the basin of the left middle cerebral artery, posterior cerebral artery, right middle cerebral artery of another established etiology according to TOAST, aseptic leptomeningitis, pachymeningitis. The course of the disease was complicated by damage to the gastrointestinal tract, the cardiovascular system, as well as the addition of a coronavirus infection, which led to death.
{"title":"Neurological manifestations of Degos disease","authors":"D. I. Abzalova, M. Sinkin, O. V. Kisyel, A. Grin","doi":"10.30629/2658-7947-2023-28-3-50-54","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-3-50-54","url":null,"abstract":"Degos disease is a rare disease that manifests itself as multifocal vasculopathy, the consequence of which is the defeat of many systems, including the nervous system. This disease is difficult to diagnose, today it does not have a standardized approach to treatment, and it is deadly.In the presented clinical case, the course of BD is described in a 66-year-old patient, whose debut of the disease was a lesion of the skin. The cause of hospitalization of the patient was the defeat of the central nervous system. During the additional examination, the patient was diagnosed with ischemic stroke in the basin of the left middle cerebral artery, posterior cerebral artery, right middle cerebral artery of another established etiology according to TOAST, aseptic leptomeningitis, pachymeningitis. The course of the disease was complicated by damage to the gastrointestinal tract, the cardiovascular system, as well as the addition of a coronavirus infection, which led to death.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46812936","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 : 2023-07-19DOI: 10.30629/2658-7947-2023-28-3-44-49
L. Novikova, A. Akopian, K. M. Sharapova, R. F. Latypova, N. Faizullina
Myotubular (centronuclear) myopathy is a rare hereditary disease with primary muscle damage and clinical manifestations of congenital myopathy. The article describes a clinical case of myotubular myopathy in a boy who was observed by us from the age of 2 months to 2 years 5 months. The disease was manifested by muscle weakness, hypotension, respiratory failure, peripheral tetraparesis, bulbar disorders, the need for artificial lung ventilation and probe nutrition.
{"title":"Myotubular X-linked myopathy","authors":"L. Novikova, A. Akopian, K. M. Sharapova, R. F. Latypova, N. Faizullina","doi":"10.30629/2658-7947-2023-28-3-44-49","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-3-44-49","url":null,"abstract":"Myotubular (centronuclear) myopathy is a rare hereditary disease with primary muscle damage and clinical manifestations of congenital myopathy. The article describes a clinical case of myotubular myopathy in a boy who was observed by us from the age of 2 months to 2 years 5 months. The disease was manifested by muscle weakness, hypotension, respiratory failure, peripheral tetraparesis, bulbar disorders, the need for artificial lung ventilation and probe nutrition.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46970728","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 : 2023-05-18DOI: 10.30629/2658-7947-2023-28-2-46-52
R. I. Isaev, E. Mkhitaryan, I. Strazhesko, N. Vorobyeva, V. S. Ostapenko, O. Tkacheva
Oldest old are the fastest growing age group in most countries of the world, including the Russian Federation. Disability and institutionalization in oldest old is associated with an increased risk of cognitive impairment. The relationship between cognitive status and other geriatric syndromes has not been studied sufficiently in institutionalized oldest old.Objective. To assess the relationship between cognitive status and geriatric syndromes in persons ≥ 90 years, who live in long term care facilities (LTCF).Material and methods. The study involved patients aged ≥ 90 years, who were examined in the LTCF of Moscow. All patients underwent a neuropsychological examination, which included Mini-mental State Examination (MMSE), Frontal Assessment Battery (FAB), 5-word test, clock-drawing test and verbal fluency. A comprehensive geriatric assessment was carried out for all the subjects. To diagnose the frailty, we used the Short Physical Performance Battery (SPPB). The Bartel index was used to assess performance of activities of daily living. Instrumental activities of daily living were assessed using the Lawton scale. Nutritional status was assessed based on the Mini-Nutritional Assessment. The pain intensity syndrome was assessed by visual analogue scale. To detect dinopenia we used dynamometry with manual dynamometer. Statistical data analysis was performed using the statistical program SPSS 23.0 (SPSS Inc., USA). Fischer’s two-sided accurate test was used for two groups comparison. The relationships between the variables were evaluated using binary logistic regression with calculation of the odds ratio (OR) and 95% confidence interval (CI).Results. Dementia was diagnosed in 69% of patients. According to multivariate analysis, sensory defi ciency (OR 4.23; CI 95% 1.96–9.09; p < 0.001), malnutrition (OR 2.68; CI 95% 1.10–6.52; p = 0.030), fecal incontinence (OR 4.37; CI 95% 2.14–8.90; p < 0.001), frailty (OR 4.23; CI 95%; 1.96–9.09; p < 0.001) are associated with the presence of dementia; an increase in age for every 1 year correlates with an increase in the chances of having dementia by 15%. Urinary incontinence and chronic pain syndrome were noted in more than half of oldest old, constipation syndrome and falls syndrome were detected in more than a third of the subjects, and more than 2/3 of oldest old had dinopenia.Conclusion. The majority of institutionalized oldest old suffer from dementia, while an increase in the chances of having it is associated with frailty, sensory deficiency, malnutrition and an increase in the age of oldest old.
{"title":"Associations between cognitive status and geriatric syndromes in institutionalized oldest old","authors":"R. I. Isaev, E. Mkhitaryan, I. Strazhesko, N. Vorobyeva, V. S. Ostapenko, O. Tkacheva","doi":"10.30629/2658-7947-2023-28-2-46-52","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-2-46-52","url":null,"abstract":"Oldest old are the fastest growing age group in most countries of the world, including the Russian Federation. Disability and institutionalization in oldest old is associated with an increased risk of cognitive impairment. The relationship between cognitive status and other geriatric syndromes has not been studied sufficiently in institutionalized oldest old.Objective. To assess the relationship between cognitive status and geriatric syndromes in persons ≥ 90 years, who live in long term care facilities (LTCF).Material and methods. The study involved patients aged ≥ 90 years, who were examined in the LTCF of Moscow. All patients underwent a neuropsychological examination, which included Mini-mental State Examination (MMSE), Frontal Assessment Battery (FAB), 5-word test, clock-drawing test and verbal fluency. A comprehensive geriatric assessment was carried out for all the subjects. To diagnose the frailty, we used the Short Physical Performance Battery (SPPB). The Bartel index was used to assess performance of activities of daily living. Instrumental activities of daily living were assessed using the Lawton scale. Nutritional status was assessed based on the Mini-Nutritional Assessment. The pain intensity syndrome was assessed by visual analogue scale. To detect dinopenia we used dynamometry with manual dynamometer. Statistical data analysis was performed using the statistical program SPSS 23.0 (SPSS Inc., USA). Fischer’s two-sided accurate test was used for two groups comparison. The relationships between the variables were evaluated using binary logistic regression with calculation of the odds ratio (OR) and 95% confidence interval (CI).Results. Dementia was diagnosed in 69% of patients. According to multivariate analysis, sensory defi ciency (OR 4.23; CI 95% 1.96–9.09; p < 0.001), malnutrition (OR 2.68; CI 95% 1.10–6.52; p = 0.030), fecal incontinence (OR 4.37; CI 95% 2.14–8.90; p < 0.001), frailty (OR 4.23; CI 95%; 1.96–9.09; p < 0.001) are associated with the presence of dementia; an increase in age for every 1 year correlates with an increase in the chances of having dementia by 15%. Urinary incontinence and chronic pain syndrome were noted in more than half of oldest old, constipation syndrome and falls syndrome were detected in more than a third of the subjects, and more than 2/3 of oldest old had dinopenia.Conclusion. The majority of institutionalized oldest old suffer from dementia, while an increase in the chances of having it is associated with frailty, sensory deficiency, malnutrition and an increase in the age of oldest old.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48944433","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 : 2023-05-18DOI: 10.30629/2658-7947-2023-28-2-59-65
A. A. Shatokhin, L. A. Vyshlova, S. Karpov, A. V. Kuzyuberdin
Lower back pain is an urgent global problem. Often it is combined with metabolic disorders, which leads to mutual aggravation of both pathological conditions. The aim of the study was a comparative assessment of the complex therapy of patients with exacerbation of chronic vertebrogenic dorsalgia using various methods.Materials and methods. We examined 60 patients with concomitant metabolic disorders in the form of obesity.Results. The effectiveness of the use of non-drug methods, namely therapeutic exercises with elements of yoga practice and reflexology in the complex therapy of patients with chronic pain in the lower back in combination with metabolic disorders, has been proven.Conclusion. The use of these methods allows to achieve a positive effect, which manifests itself in reducing the intensity of the pain syndrome and improving the functionality of patients, as well as correction of concomitant metabolic disorders.
{"title":"Features of rehabilitation of patients with chronic vertebrogen dorsalgia in combination with metabolic disorders","authors":"A. A. Shatokhin, L. A. Vyshlova, S. Karpov, A. V. Kuzyuberdin","doi":"10.30629/2658-7947-2023-28-2-59-65","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-2-59-65","url":null,"abstract":"Lower back pain is an urgent global problem. Often it is combined with metabolic disorders, which leads to mutual aggravation of both pathological conditions. The aim of the study was a comparative assessment of the complex therapy of patients with exacerbation of chronic vertebrogenic dorsalgia using various methods.Materials and methods. We examined 60 patients with concomitant metabolic disorders in the form of obesity.Results. The effectiveness of the use of non-drug methods, namely therapeutic exercises with elements of yoga practice and reflexology in the complex therapy of patients with chronic pain in the lower back in combination with metabolic disorders, has been proven.Conclusion. The use of these methods allows to achieve a positive effect, which manifests itself in reducing the intensity of the pain syndrome and improving the functionality of patients, as well as correction of concomitant metabolic disorders.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43568710","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 : 2023-05-18DOI: 10.30629/2658-7947-2023-28-2-53-58
M. Novikova, V. Zakharov
Emotional-affective disorders often accompany vascular cognitive impairment. Currently, there is insufficient data on the impact of non-drug treatment of cognitive impairment on the emotional sphere.The aim of the study was to evaluate the effect of non-drug methods (meal planning, exercise, cognitive training) on anxiety and depression in patients with mild cognitive impairment of vascular etiology.Material and methods. The study included 60 patients aged 45 to 88 years (mean age 63.9 ± 9.7, 26 males and 34 females) with mild cognitive impairment of vascular etiology. 30 patients (study group, 18 women, 12 men, mean age 63.7 ± 8.8 years, Montreal Cognitive Assessment (MoCA) score 22.5 ± 2.4) received a set of non-drug methods for 1 month, including cognitive training, detailed recommendations on physical activity and meal planning. Patients in the control group (n = 30, 16 women, 14 men, mean age — 64.2 ± 10.7 years, MoCA score — 21.7 ± 2.4 points) were once informed by the attending physician about the expediency of a physically and cognitively active lifestyle and the basic principles diets, however, systematic training with them was not carried out. Anxiety and depression were assessed at the stage of inclusion in the study, after 1 month, after 6 months, and one year after the start of observation using the Beck Depression Scale, the Spielberger–Khanin Anxiety Scale.Results. 1 month after the start of the study, along with a significant (p < 0.05) improvement in cognitive functions according MoCA, a significant decrease in the severity of anxiety was noted in the study group (p < 0.05). In patients with mild and moderate depression (n = 13), a significant (p < 0.05) regression in the severity of depression was recorded after a month of using non-drug methods. However, in the process of long-term follow-up (1 year), the differences with the initial visit for these indicators lost statistical significance. In the control group, a month after the start of the study, there were no significant differences in the MoCA test (p > 0.05), while the indicators of anxiety and depression worsened throughout the entire observation period. The study group significantly (p < 0.05) outperformed the control group in the MoCA test immediately after treatment and after 6 months. Differences of anxiety level were significant only immediately after treatment.Conclusion. A complex of non-drug methods is effective in the treatment of vascular MCI and reduces anxiety in patients. In patients with mild and moderate depression decrease of depression symptoms was observed also. However the effect of the monthly course was not stable.
{"title":"The influence of nondrug methods on cognitive and emotional-affective disorders in patients with mild vascular cognitive impairment","authors":"M. Novikova, V. Zakharov","doi":"10.30629/2658-7947-2023-28-2-53-58","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-2-53-58","url":null,"abstract":"Emotional-affective disorders often accompany vascular cognitive impairment. Currently, there is insufficient data on the impact of non-drug treatment of cognitive impairment on the emotional sphere.The aim of the study was to evaluate the effect of non-drug methods (meal planning, exercise, cognitive training) on anxiety and depression in patients with mild cognitive impairment of vascular etiology.Material and methods. The study included 60 patients aged 45 to 88 years (mean age 63.9 ± 9.7, 26 males and 34 females) with mild cognitive impairment of vascular etiology. 30 patients (study group, 18 women, 12 men, mean age 63.7 ± 8.8 years, Montreal Cognitive Assessment (MoCA) score 22.5 ± 2.4) received a set of non-drug methods for 1 month, including cognitive training, detailed recommendations on physical activity and meal planning. Patients in the control group (n = 30, 16 women, 14 men, mean age — 64.2 ± 10.7 years, MoCA score — 21.7 ± 2.4 points) were once informed by the attending physician about the expediency of a physically and cognitively active lifestyle and the basic principles diets, however, systematic training with them was not carried out. Anxiety and depression were assessed at the stage of inclusion in the study, after 1 month, after 6 months, and one year after the start of observation using the Beck Depression Scale, the Spielberger–Khanin Anxiety Scale.Results. 1 month after the start of the study, along with a significant (p < 0.05) improvement in cognitive functions according MoCA, a significant decrease in the severity of anxiety was noted in the study group (p < 0.05). In patients with mild and moderate depression (n = 13), a significant (p < 0.05) regression in the severity of depression was recorded after a month of using non-drug methods. However, in the process of long-term follow-up (1 year), the differences with the initial visit for these indicators lost statistical significance. In the control group, a month after the start of the study, there were no significant differences in the MoCA test (p > 0.05), while the indicators of anxiety and depression worsened throughout the entire observation period. The study group significantly (p < 0.05) outperformed the control group in the MoCA test immediately after treatment and after 6 months. Differences of anxiety level were significant only immediately after treatment.Conclusion. A complex of non-drug methods is effective in the treatment of vascular MCI and reduces anxiety in patients. In patients with mild and moderate depression decrease of depression symptoms was observed also. However the effect of the monthly course was not stable.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48352546","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 : 2023-05-18DOI: 10.30629/2658-7947-2023-28-2-66-72
M. Topuzova, A. Kipkeeva, E. Panina, T. Pavlova, K. D. Popov, D. Fedorov, A. Smirnova, T. Alekseeva
Progressive supranuclear palsy is a sporadic neurodegenerative disease manifested by oculomotor disorders, akinetic- rigid syndrome, early development of postural instability, gradual development of frontal dementia, and pseudobulbar syndrome. Diagnosis of PNP is determined by the specifi c topical distribution of the degenerative lesion in the brain. This article describes a clinical case of a 67-year-old patient with PNP, a feature of which is the complexity of diff erential diagnosis, given the presence of a variety of comorbidities.
{"title":"Difficulties in diagnosing progressive supranuclear palsy","authors":"M. Topuzova, A. Kipkeeva, E. Panina, T. Pavlova, K. D. Popov, D. Fedorov, A. Smirnova, T. Alekseeva","doi":"10.30629/2658-7947-2023-28-2-66-72","DOIUrl":"https://doi.org/10.30629/2658-7947-2023-28-2-66-72","url":null,"abstract":"Progressive supranuclear palsy is a sporadic neurodegenerative disease manifested by oculomotor disorders, akinetic- rigid syndrome, early development of postural instability, gradual development of frontal dementia, and pseudobulbar syndrome. Diagnosis of PNP is determined by the specifi c topical distribution of the degenerative lesion in the brain. This article describes a clinical case of a 67-year-old patient with PNP, a feature of which is the complexity of diff erential diagnosis, given the presence of a variety of comorbidities.","PeriodicalId":36724,"journal":{"name":"Russian Neurological Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47111380","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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