Opportunities of ultrasound diagnostics of lung injury in SARS-CoV-2 infection (COVID-19): a clinical case

2020 ◽  
Vol 98 (11) ◽  
pp. 51-56
Author(s):  
G. V. Neklyudova ◽  
А. V. Chernyak ◽  
N. А. Tsareva ◽  
S. N. Аvdeev
Keyword(s):  
Lung Injury ◽  
Clinical Case ◽  
Ultrasound Examination ◽  
Recovery Period ◽  
Early Recovery ◽  
Acute Period ◽  
Ultrasound Diagnostics ◽  
Early Recovery Period

The article describes a clinical case demonstrating the results of the lungs ultrasound examination in the COVID-19 patient during the acute period of the disease and early recovery period.

scholarly journals Comparative Characterization of Candidate Molecular Markers in Ischemic and Hemorrhagic Stroke

2021 ◽  
Vol 17 (5) ◽  
pp. 23-34
Author(s):  
A. M. Golubev ◽  
A. V. Grechko ◽  
V. E. Zakharchenko ◽  
M. M. Kanarsky ◽  
M. V. Petrova ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Molecular Markers ◽  
Neurotrophic Factor ◽  
Hemorrhagic Stroke ◽  
Recovery Period ◽  
Control Group ◽  
Early Recovery ◽  
Acute Period ◽  
S 100 ◽  
Early Recovery Period

According to epidemiological studies, the leading cause of morbidity, disability and mortality are cerebrovascular diseases, in particular ischemic and hemorrhagic strokes. In recent years considerable attention has been given to the study of molecular markers of ischemic and hemorrhagic strokes. These studies are relevant because brain-specific protein biomarkers of neurons and glial cells can provide valuable and timely diagnostic information necessary for clinical decision-making.The aim of the study was to reveal the differences in the serum level of molecular markers in acute, subacute and early recovery periods of ischemic and hemorrhagic strokes.Material and methods. The study included 59 patients. Twenty patients were diagnosed with hemorrhagic stroke and 39 had ischemic stroke. The control group included 20 volunteers. Serum levels of molecular CNS markers were determined in acute, subacute, and early recovery stages of stroke. The serum levels of CNS molecular markers of patients with ischemic and hemorrhagic stroke was measured quantitatively by enzyme immunoassay. Statistical analysis was performed by nonparametric Mann-Whitney method.Results. The level of brain-derived neurotrophic factor (BDNF) in the control volunteers was 574.5 [455.5; 615] pg/ml. Significant differences were found for acute and subacute periods of hemorrhagic stroke: it was 674 [560; 749] pg/ml (P=0.003) and 664 [616; 762] pg/ml (P=0.0001).The level of neuron-specific enolase was significantly increased in all periods of the study: it was 4.15 [3.53; 4.8] ng/ml in the control group, 5.4 [4.4; 6.4] ng/ml in acute period of ischemic stroke (P<0.001), 5.4 [4.4; 6.4] ng/ml in early recovery period of ischemic stroke (P=0.001), 5.1 [4.6; 6.4] ng/ml in acute period of hemorrhagic stroke (P=0.014), 664 [616; 762] ng/ml in subacute period of hemorrhagic stroke (P=0.003).In the control group, the serum S-100 protein level was 4.5 [3.8; 5.4] ng/ml. In the acute and early recovery periods of ischemic stroke, S-100 protein level has significantly fallen down to 4.1 [3.4; 4.6] ng/ml (P<0.031) and 3.9 [3.4; 6] ng/ml (P=0.014), respectively. Glial-cell derived neurotrophic factor level was 1.98 [1.64; 2.1] ng/ml in the controls and increased up to 2.4 [2.2; 5] ng/ml (P=0.002) in the acute period and 2.4 [2.3; 2.6] ng/ml (P<0.001) in the subacute period of hemorrhagic stroke.The vascular endothelial growth factor receptor-1 (VEGFR-1) was significantly lower in the subacute period of hemorrhagic stroke: 485 [211; 945] pg/ml in the subacute period vs 903.5 [626; 1115] pg/ml in the controls (P=0.001).Conclusion. We found differences in the serum level of molecular markers in patients with ischemic and hemorrhagic strokes. In the acute period, early recovery period of ischemic stroke, and subacute period of hemorrhagic stroke, there was an increase in the serum level of neuron-specific enolase. The level of brain-derived neurotrophic factor increased significantly in the acute and subacute periods of hemorrhagic stroke. In the acute and early recovery periods of ischemic stroke, the level of S-100 protein decreased. The level of glial cell-derived neurotrophic factor increased in the acute and subacute periods of hemorrhagic stroke. In the subacute period of hemorrhagic stroke, the level of endothelial growth factor receptor-1 significantly decreased. Moreover, there was significant difference between values of this parameter in the subacute period of hemorrhagic stroke and in the early recovery period of ischemic stroke.

Use of ICF in Rehabilitation: a Clinical Case

2021 ◽  
pp. 145-155
Author(s):  
N.V. Kozlova ◽  
◽  
T.E. Levitskaya ◽  
E.A. Tsekhmejstruk ◽  
I.V. Atamanova ◽  
...  
Keyword(s):  
Environmental Factors ◽  
Multidisciplinary Team ◽  
Clinical Case ◽  
Recovery Period ◽  
Medical Rehabilitation ◽  
Psychological Status ◽  
Clinical Psychologist ◽  
Early Recovery ◽  
Second Stage ◽  
Early Recovery Period

The article describes a clinical case of a patient with an acute cerebrovascular accident (CVA) at the second stage of medical rehabilitation, conducted by a psychologist as part of a multidisciplinary team. It presents the main concepts and content of the International Classi-fication of Functioning, Disability and Health (ICF). Attention is drawn to a unified language of its application, available to all members of such a multidisciplinary team implementing the process of rehabilitation. The importance of psychological evaluation within the ICF catego-ries for effective interaction between this team’s specialists has been shown. A specific fea-ture of this case was a possibility of using categories belonging to almost all the ICF sections. The purpose of this work is to introduce psychologists to a clinical psychologist’s com-petencies and possibilities of applying the ICF in the rehabilitation of patients with an acute CVA at the second stage of medical rehabilitation. Materials and methods. The article focuses on a clinical case of a female patient with an acute CVA during the early recovery period at the second stage of medical rehabilitation with a description of the dynamics of her psychological status, using the ICF categories. Results. The article provides a list of psychological domains presented in the following ICF sections: "Body Functions", "Activity and Participation", and "Environmental Factors", which can be used by a clinical psychologist within rehabilitation activities. The rehabilitation diagnosis for this patient with an acute CVA in her early recovery period was provided by means of the ICF categories based on her individual characteristics and impairments, and the dynamics of recovery has been revealed. The ICF domains are presented with an indication of the content aspect and the degree of impairment. Discussion of results. The clinical case demonstrates the importance of taking into ac-count personal and environmental factors when describing one’s rehabilitation diagnosis and organizing the rehabilitation process. Applying the ICF categories makes the patient's features and problems clear to all the multidisciplinary team members. The main difficulties of working with the ICF are related to the selection of domains due to the discrepancy between the conceptual apparatus of foreign and domestic psychology. The importance of understanding the semantic component of the domain has been shown. Limitations of screening tests have been noted, and the need to conduct a qualitative analysis of mental disorders within the framework of a personality-oriented approach has been updated. Conclusions. Applying the ICF allows one to maintain a productive interaction with all the members of the multidisciplinary team, describe the patient’s current problems and visually assess the dynamics of recovery. At the same time, its use in the practice of a clinical psychologist requires a specialist to have a deep understanding of the content of the ICF psychological domains and skills to select them for each specific case.

Patterns of development of insomnia in patients with early recovery period of stroke

2019 ◽  
Vol 17 (7) ◽  
pp. 95-99
Author(s):  
O. V. Kurushina ◽  
◽  
E. A. Kurakova ◽  
Keyword(s):  
Recovery Period ◽  
Early Recovery ◽  
Early Recovery Period

Neurorehabilitation in the Early Recovery Period of Ischemic Stroke. Pharmacology Support

2021 ◽  
Vol 63 (1) ◽  
pp. 22-25
Author(s):  
Denys N. Khramtsov ◽  
Olexandr N. Stoyanov ◽  
Tetiana N. Muratova ◽  
Olexandr R. Pulyk
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Recovery Period ◽  
Rehabilitation Medicine ◽  
Neuroprotective Agents ◽  
Early Recovery ◽  
National Medical ◽  
Cholinergic Agents ◽  
Early Recovery Period ◽  
Medical University

Aim: The aim of the study was to evaluate the clinical outcome in the use of neuroprotective agents in the acute period of ischemic stroke. Material and Methods: The study was performed on the basis of the stroke of the Center for Reconstructive and Rehabilitation Medicine (University Clinic) of the Odessa National Medical University. A retrospective analysis of clinical outcomes of 115 patients with acute stroke was conducted. Results: An average NIHSS score at discharge was 4.1±0.1 points when treated with no refinery, then it reached 3.6±0.1 points when using peptidergic drugs, and 3.4±0.1 when using D-fdf. 3.1±0.1 points. When using D-FDF, the MMSE score was 3.5±0.1 points, whereas when using cholinergic agents, this index did not exceed 26.9±1.5 points, and when using peptidergic agents - 26.8±1.4 points. Conclusion: The use of neuroprotective agents positively affects the effectiveness of neuro-rehabilitation in patients with acute stroke. The best results in three months after the hospitalization were obtained for peptidergic agents and D-fructose-1,6-diphosphate.

scholarly journals Practical Care Support During the Early Recovery Period After Acute Coronary Syndrome

2016 ◽  
Vol 37 (7) ◽  
pp. 881-903 ◽  
Author(s):  
Alexandra M. Hajduk ◽  
Jacquelyn E. Hyde ◽  
Molly E. Waring ◽  
Darleen M. Lessard ◽  
David D. McManus ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Recovery Period ◽  
Patient Characteristics ◽  
Informational Support ◽  
Post Discharge ◽  
Early Recovery ◽  
Coronary Syndrome ◽  
Practical Support ◽  
Impaired Health ◽  
Early Recovery Period

Objective: To describe the prevalence and predictors of receipt of practical support among acute coronary syndrome (ACS) survivors during the early post-discharge period. Method: 406 ACS patients were interviewed about receipt of practical (instrumental and informational) support during the week after discharge. Demographic, clinical, functional, and psychosocial predictors of instrumental and informational practical support were examined. Results: 81% of participants reported receiving practical support during the early post-discharge period: 75% reported receipt of instrumental support and 51% reported receipt of informational support. Men were less likely to report receiving certain types of practical support, whereas married participants and those with higher education, impaired health literacy, impaired activities of daily living, and in-hospital complications were more likely to report receiving certain types of practical support. Conclusion: Receipt of practical support is very common among ACS survivors during the early post-discharge period, and type of support received differs according to patient characteristics.

Septic Arthritis of the Small Joints of the Hand

2006 ◽  
Vol 31 (6) ◽  
pp. 665-672 ◽  
Author(s):  
M. SINHA ◽  
S. JAIN ◽  
D. A. WOODS
Keyword(s):  
Recovery Period ◽  
Postal Questionnaire ◽  
Significant Loss ◽  
Early Recovery ◽  
Joint Pathology ◽  
Significant Disability ◽  
Early Recovery Period ◽  
And Function ◽  
Loss Of Motion

Twenty-five patients with sepsis of 26 hand joints were treated by urgent debridement, antibiotics and early hand therapy. We reviewed 15 patients (16 joints) in a clinic and three patients by postal questionnaire after a mean follow-up of 54 (range 10–94) months. Of the 26 involved joints, 14 had restricted motion at discharge. Stiffness increased with increase in delay between onset and treatment. At final review, one joint with painful degenerative changes had been fused. Seven patients had regained full movements. The remaining six had some stiffness but, nevertheless, had undergone significant improvement in the ranges of movement. There were two cases with radiological joint degeneration in this group of six patients. Three patients had mild, intermittent pain. No patient had significant disability. While there is significant loss of motion after this joint pathology in the early recovery period, overall motion and function appears to improve over the longer term.

scholarly journals Changes in PHQ-9 depression scores in acute stroke patients shortly after returning home

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259806
Author(s):  
Brent Strong ◽  
Michele C. Fritz ◽  
Liming Dong ◽  
Lynda D. Lisabeth ◽  
Mathew J. Reeves
Keyword(s):  
Depressive Symptoms ◽  
Acute Stroke ◽  
Recovery Period ◽  
Stroke Severity ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Early Recovery ◽  
Post Stroke ◽  
Early Recovery Period ◽  
Over Time

Introduction Post-stroke depression is a disabling condition that occurs in approximately one-third of stroke survivors. There is limited information on changes in depressive symptoms shortly after stroke survivors return home. To identify factors associated with changes in post-stroke depressive symptoms during the early recovery period, we conducted a secondary analysis of patients enrolled in a clinical trial conducted during the transition period shortly after patients returned home (MISTT). Methods The Michigan Stroke Transitions Trial (MISTT) tested the efficacy of social worker case management and access to online information to improve patient-reported outcomes following an acute stroke. Patient Health Questionnaire-9 (PHQ-9) scores were collected via telephone interviews conducted at 7 and 90 days post-discharge; higher scores indicate more depressive symptoms. Generalized estimating equations were used to identify independent predictors of baseline PHQ-9 score at 7 days and of changes over time to 90 days. Results Of 265 patients, 193 and 185 completed the PHQ-9 survey at 7 and 90 days, respectively. The mean PHQ-9 score was 5.9 at 7 days and 5.1 at 90 days. Older age, being unmarried, and having moderate stroke severity (versus mild) were significantly associated with lower 7-day PHQ-9 scores (indicating fewer depressive symptoms). However, at 90 days, both unmarried patients and those with moderate or high stroke severity had significant increases in depressive symptoms over time. Conclusions In stroke patients who recently returned home, both marital status and stroke severity were associated with depressive symptom scores; however, the relationships were complex. Being unmarried and having higher stroke severity was associated with fewer depressive symptoms at baseline, but both factors were associated with worsening depressive symptoms over time. Identifying risk factors for changes in depressive symptoms may help guide effective management strategies during the early recovery period.

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