scholarly journals The state of emergency care for patients with acute cerebrovascular accident

2001 ◽  
Vol XXXIII (1-2) ◽  
pp. 59-63
Author(s):  
M. F. Ismagilov
Keyword(s):  
Cerebrovascular Accident ◽  
Adult Population ◽  
Health Resources ◽  
Developed Countries ◽  
Cerebral Stroke ◽  
State Of Emergency ◽  
Acute Cerebrovascular Accident ◽  
The Social ◽  
Working Age ◽  
The Cost

At the turn of the second and third millennia, one of the main health problems was acute cerebrovascular accident - cerebral stroke (CS), which is the second leading cause of death in the industrially developed countries of the world and the main cause of disability in the adult population of the most working age. The social costs associated with the cost of treating stroke patients are a major source of depletion of scarce health resources in every country.

Population Policies in Turkey and Demographic Changes on a Social Map

2016 ◽  
Vol 6 (2) ◽  
pp. 240-266 ◽  
Author(s):  
Mustafa Murat Yucesahin ◽  
Tuğba Adalı ◽  
A Sinan Türkyılmaz
Keyword(s):  
Population Policy ◽  
Developed Countries ◽  
Ageing Population ◽  
Demographic Changes ◽  
Demographic Transitions ◽  
Population Policies ◽  
Demographic Indicators ◽  
The Social ◽  
Working Age ◽  
Low Levels

Compared to its past structure, Turkey is now a country with low levels of fertility and mortality. This junction that Turkey now has reached is associated with a number of risks, such as an ageing population, and a decreasing working-age population. The antinatalist policy era of Turkey was followed by a period of maintenance, yet the recent demographic changes formed the basis of a pronatalist population policy from the government’s view. This study discusses the link between demographic change and population policies in Turkey. It further aims to position Turkey spatially in relation to selected countries that are in various stages of their demographic transitions with different population policies, using a multidimensional scaling approach with data on 25 selected countries from the UN. The analysis is based on a 34-year period, 1975-2009, so as to better demonstrate Turkey’s international position on a social map, past and present. Our findings suggest that Turkey’s position on the social map shifted towards developed countries over time in terms of demographic indicators and population policies. 

SOME ASPECTS OF ACUTE CEREBROVASCULAR PATHOLOGY IN POSTPARTUM WOMEN

Vestnik ◽  
2021 ◽  
pp. 51-56
Author(s):  
Д.А. Митрохин ◽  
Ж.Б. Дюсембаева ◽  
М.М. Ибрагимов ◽  
А.А. Оспанов ◽  
А.Н. Сембинова ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Postpartum Period ◽  
Cerebrovascular Accident ◽  
Hemorrhagic Stroke ◽  
Speech Disorders ◽  
Cerebral Stroke ◽  
Postpartum Women ◽  
Bioelectrical Activity ◽  
Acute Cerebrovascular Accident ◽  
Epileptiform Discharges

В данной статье, представлены результаты обследования 17 женщин, перенесших острое нарушение мозгового кровообращения в послеродовом периоде, с 2017 по 2021 годы, в возрасте от 19 до 39 лет. Показано, что у женщин в послеродовом периоде, перенесших острое нарушение мозгового кровообращения, выявлено преобладание ишемического инсульта над геморрагическим, что составило 64,7% и 35,3% соответственно. Неврологические признаки церебрального инсульта в послеродовом периоде характеризуются двигательными, речевыми расстройствами, нарушением чувствительности, а также часто психоэмоциональными проявлениями. Генерализованные тонико-клонические приступы чаще наблюдались у пациенток с геморрагическим инсультом (33,3%), в сравнении с ишемическим инсультом (9,1%). У женщин в послеродовом периоде, перенесших острое нарушение мозгового кровообращения, наиболее значимыми факторами риска являются: наличие хронических заболеваний, в том числе отягощенный акушерско-гинекологический анамнез, прием пероральных контрацептивов, а также курение. Биоэлектрическая активность головного мозга характеризовалась выраженной дельта и тета активностью, эпилептиформными разрядами в виде острых волн, спайков и комплексов «пик-волна», с преобладанием у пациенток с геморрагическим инсультом. Более значительное повышение индекса когерентности в дельта и тета диапазонах у пациентов, перенесших геморрагический инсульт, может указывать на более грубые межполушарные нарушения, в сравнении с ишемическим инсультом. Отмечено повышение интегрального индекса диапазона медленно-волновой активности и преобладание процентного отношения спектральных мощностей медленных волн (дельта, тета) к быстрым волнам (альфа, бета), особенно выраженное у больных с геморрагическим инсультом (р < 0,05), в сравнении с ишемическим инсультом. Наиболее тяжелое течение послеродового периода наблюдалось у пациенток с геморрагическим инсультом, именно в этом случае было 2 летальных исхода. This article presents the results of a survey of 17 women with acute cerebrovascular accident in the postpartum period, from 2017 to 2021, aged 19 to 39 years. It is shown that the period in women in the postpartum period, who underwent acute cerebrovascular accident, revealed the prevalence of ischemic stroke over hemorrhagic, which amounted to 64,7% and 35,3%, respectively. Neurological signs of cerebral stroke in the postpartum period are characterized by movement, speech disorders, impaired sensitivity, and often psychoemotional manifestations. Generalized tonic-clonic seizures were more often observed in patients with hemorrhagic stroke (33,3%) in comparison with ischemic stroke (9,1%). In postpartum women who have suffered acute cerebrovascular accident, the most significant risk factors are: the presence of chronic diseases, including a burdened obstetric and gynecological history, taking oral contraceptives, as well as smoking. The bioelectrical activity of the brain was characterized by pronounced delta and theta activity, epileptiform discharges in the form of sharp waves, spikes and peak-wave complexes, with a predominance in patients with hemorrhagic stroke. A more significant increase in the coherence index in the delta and theta ranges in patients after hemorrhagic stroke may indicate more severe interhemispheric disorders in comparison with ischemic stroke. An increase in the integral index of the range of slow-wave activity and a predominance of the percentage of the spectral powers of slow waves (delta, theta) to fast waves (alpha, beta), especially pronounced in patients with hemorrhagic stroke (p <0,05), in comparison with ischemic stroke. The most severe postpartum period was observed in patients with hemorrhagic stroke, in this case there were 2 deaths.

Development Policy

2020 ◽  
pp. 501-520
Author(s):  
Anne Mette Kjær
Keyword(s):  
Development Policy ◽  
Developed Countries ◽  
Development Aid ◽  
Least Developed Countries ◽  
Terror Attacks ◽  
International Environment ◽  
The Social ◽  
Common Interests ◽  
Political Spectrum ◽  
The Cost

This chapter analyses Danish development policy with an emphasis on changes since the 1990s. It focuses on how it changed from one of continuity and consensus around generous aid to help reduce poverty in the least developed countries to a more politicized era with aid cuts and a move away from the poverty focus. These changes can best be explained by an interplay of factors, most significantly the changed international environment after the 9/11 terror attacks, a shift in the composition of Parliament with reduced importance of the small pro-aid parties in the middle of the political spectrum, and a less coherent policy community of common interests. The centre-right government reframed development aid as coming at the cost of services at home and questioned the Social Democratic value of seeing aid as redistributing from rich to poor globally. A new consensus around a more modest aid budget, some of which is not spent in the poorest countries, may have emerged.

Considerazioni cliniche ed economiche nel trattamento del cancro della prostata: analisi costo-efficacia di bicalutamide vs flutamide in combinazione con LHRH

2003 ◽  
Vol 4 (3) ◽  
pp. 153-168
Author(s):  
Monia Marchetti ◽  
Giorgio Lorenzo Colombo
Keyword(s):  
Cost Effectiveness ◽  
National Health System ◽  
Drug Acquisition ◽  
Health Resources ◽  
Developed Countries ◽  
Cost Effectiveness Analysis ◽  
Terminal Phase ◽  
Effectiveness Analysis ◽  
Oncological Diseases ◽  
The Cost

Prostate carcinoma (PC) is the most common malign neoplasm found in men over 65 years of age. In Italy, the incidence of this cancer is around 60/100,000/year, corresponding to about 11,000 new cases each year. Patients with PC consume health resources for a cost that is 10-24% higher than that of similar populations without PC. It is estimated that in Italy, each year, there are 19,000 hospitalizations for prostate cancer in patients over 65, a figure that represents 4% of the total hospitalizations for oncological diseases. We conducted a marginal cost/effectiveness analysis of bicalutamide vs. flutamide, both administered in combination with LHRH, in patients with advanced (metastatic) PC, on the basis of a randomized trial comparing 4 strategies of total androgenic blockade (TAB). The analysis was conducted in the perspective of the SSN (National health system). The comparison revealed that drug acquisition costs are not the only determinants of the economical differences between the two therapeutical strategies. Furthermore, we demonstrated that prolonged survival of the patients does not increase the consumption of health resources, since the chronological shift of the terminal phase reduces the value of the resources dedicated to it. When conducing the cost/effectiveness analysis, the survival advantage associated to bicalutamide has been adjusted to balance the low quality of life of PC patients. The pharmacoeconomical benefit of bicalutamide resulted of 12,150 Euro/QALY, while the cost per year of life saved resulted inferior, ranging from 8.327 to 11.440 Euro. This cost/QALY value is nevertheless lower than that associated to several therapeutical strategies that are commonly accepted in developed countries (domiciliar hemodialysis, heart transplantation, breast cancer screening, etc.). Considering that 12.150 Euro/QALY is the highest estimate of the relative cost/effectiveness of bicalutamide, it appears that the combination bicalutamide + LHRH represents an economically acceptable alternative to flutamide + LHRH in advanced PC patients.

The older worker

2019 ◽  
pp. 135-161
Author(s):  
Steven Nimmo
Keyword(s):  
Occupational Health ◽  
Health Professionals ◽  
Older Workers ◽  
Working Life ◽  
Population Demographics ◽  
The Social ◽  
Working Age ◽  
The Cost ◽  
Developed World ◽  
Substantial Change

Throughout the developed world, birth rates are falling and people are living longer, so populations are getting older. This is causing a substantial change in population demographics and an increase in the ratio of people traditionally regarded as ‘retirement age’ to those regarded as ‘working age’. People are also living longer in retirement, further increasing the cost to society of supporting them. To maintain funding for pensions and other social benefits, the pattern of working life and the social and political structures that underpin it have to change to match the changing needs of society. In particular, people in the developed world must expect to work for longer, a change that has implications both for employees and employers. Occupational health professionals have an important role to play so that older workers can be ‘healthy, happy, and here’ in the workplace for longer.

CLINICAL CASE OF ACUTE CEREBROVASCULAR ACCIDENT IN A CHILD WITH HEREDITARY THROMBOPHILIA

2020 ◽  
Vol 99 (1) ◽  
pp. 232-236
Author(s):  
P.V. Shumilov ◽  
◽  
A.Ya. Ilyina ◽  
A.L. Mishchenko ◽  
A.S. Barinova ◽  
...  
Keyword(s):  
Cerebrovascular Accident ◽  
Clinical Case ◽  
Acute Cerebrovascular Accident ◽  
Hereditary Thrombophilia

Some Comments on the Highest Attainable Standard of Health

2020 ◽  
Vol 26 (2) ◽  
pp. 134-140
Author(s):  
Gabriela Belova ◽  
Stanislav Pavlov
Keyword(s):  
Health Resources ◽  
Right To Health ◽  
International Standards ◽  
Special Rapporteur ◽  
Health It ◽  
Significant Development ◽  
Cultural Rights ◽  
Optional Protocol ◽  
The Social ◽  
The Right

AbstractThe last decades present a significant development of the economic, social and cultural rights and specifically, the right to health. Until 2000, the right to health has not been interpreted officially. By providing international standards, General Comment No.14 on the right to the Highest Attainable Standard of Health has led to wider agreement that the right to health includes the social determinants of health such as access to various conditions, services, goods or facilities that are crucial for its implementation. The Reports of the Special Rapporteur on the right to health within the UN human rights system have contributed to the process of gaining the greater clarity about the right to health. It is obvious that achieving the highest attainable level of health depends on the principle of progressive implementation and the availability of the necessary health resources. The possibility individual complaints to be considered by the Committee on Economic Social and Cultural Rights was introduced with the Optional Protocol to the International Covenant on Economic, Social and Cultural Rights, entered into force in 2013.

CONSTITUTIONAL AND LEGAL IDEA OF THE “SOCIAL STATE” IN THE HISTORY OF LEGAL AND POLITICAL THOUGHT

2020 ◽  
Author(s):  
Roman Fedorov
Keyword(s):  
Political Thought ◽  
Historical Development ◽  
Significant Contribution ◽  
Developed Countries ◽  
State Structure ◽  
Thomas More ◽  
Social State ◽  
Classical Liberal ◽  
The Social ◽  
History Of

The article is devoted to the problem of the social state as one of the fundamental constitutional principles of the state structure of modern developed countries. The course of historical development of philosophical and legal thought on this problem is considered. The idea of a close connection between the concept of the social state and the ideas of utopian socialism of Thomas More and Henri Saint-Simon is put forward. Liberals also made a significant contribution to the development of the idea of the social state, they argued that the ratio of equality and freedom is a key problem for the classical liberal doctrine. It is concluded that the emergence of the theory of the social state for objective reasons was inevitable, since it is due to the historical development of society.

Progressive Early Rehabilitation Program Applied to Patients with Acute Cerebrovascular Accident

2020 ◽  
Vol 25 (3) ◽  
pp. 17-25 ◽  
Author(s):  
G. R. Ramazanov ◽  
L. B. Zavaliy ◽  
L. L. Semenov ◽  
S. A. Abudeev ◽  
A. O. Ptitsyn ◽  
...  
Keyword(s):  
Cerebrovascular Accident ◽  
Lung Ventilation ◽  
Rehabilitation Program ◽  
Artificial Lung ◽  
Early Rehabilitation ◽  
Gravity Gradient ◽  
Acute Cerebrovascular Accident ◽  
Artificial Lung Ventilation ◽  
Bed Days ◽  
Severity Of The Disease

Abstract. Early rehabilitation (ER) of patients with acute cerebrovascular accident (ACA) is one of the priority tasks of the vascular centers; the issue of increasing the volume of rehabilitation measures in the resuscitation and intensive care units (ICU) is relevant. Objective. To evaluate the safety and effectiveness of the progressive ER program in patients with ACA. Material and research methods. The study included 129 patients with ACA in ICU. Each patient of the main group (MGr, n = 61) underwent progressive ER: at least 4–5 vertical adjustments per day, passive mode Kinesiotherapy 49 ± 9.3 minutes, a double load of physiotherapy exercises, preventive physiotherapy; the total time of classes reached 240 minutes per day. In the comparison group (СGr, n = 68), standard ER was performed no more than 120 minutes per day. The groups are comparable by sex, age, severity of the disease and comorbidity. The severity of ACA, the gravity gradient, patient mobility, functional status, degree of dependence, and the presence of complications were evaluated. Results. During a month of work with the MGr, 102 ICU bed-days, 94 days of the artificial lung ventilation use, p < 0.05 were saved. Mortality in MGr decreased -— 8 patients (13.1%) versus 14 (20.6%) in CGr (p < 0.05). In patients within CGr, pulmonary thromboembolism developed in 8.8%, in MGr – in 3.3%. The severity of the apoplectic attack decreased ( by 28% in MGr, and by 20% in CGr ), mobility increased. Comparing the modalities of post resuscitationsyndrome in MGr, it was noted that the score decreased by 2 times from 6 [5; 6] to 3 [2.3; 3.3], but it has not changed in the CGr. Patients in the MGr were 2-–3 days earlier adapted to the vertical adjustment. Conclusions. The progressive ER program in ICU is safe, effective, realisable, and allows reducing the number of bed-days in ICU, the number of days of the artificial lung ventilation use, complications, and mortality in comparison with standard medical care.

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