scholarly journals The peculiarities of cognitive and emotional-volitional spheres of the patients with post-stroke neurological dysfunctions

2020 ◽  
pp. 9-15
Author(s):  
Dilara Gamzatovna Nazmetdinova ◽  
Viktoriya Borisovna Obukhovskaya
Keyword(s):  
Ischemic Stroke ◽  
Early Stage ◽  
Psychological Status ◽  
Long Term Memory ◽  
Depression And Anxiety ◽  
Post Stroke ◽  
Rehabilitation Period ◽  
The Subject

The subject of this research is the peculiarities of cognitive (memory, attention) and emotional-volitional (manifestations of anxiety and depression, motivation towards recovery) spheres of the patients with severe dysfunctions of cerebral circulation of ischemic type in the early and late rehabilitation period. The relevance of this topic is defined by commonness of the ischemic stroke, growing number of incapacitating consequences, and mortality rate in Russia. Ischemic stroke leads to the change of physical, social and psychological status of a patient, worsening of quality of life, and unfavorable prognosis for recovery. The scientific novelty consists in assessment of the dynamics of indicators in cognitive and emotional-volitional spheres of the post-stroke patients at various states of rehabilitation treatment. It is determined that the highest positive dynamics in cognitive and emotional-volitional spheres is observed at the early stage of rehabilitation. The resource and deficiency characteristics, which are most important for selecting the target of psychological interventions, are determined for each group of patients. In the cognitive sphere are noted veracious differences in the capacity of auditory-verbal short-term and long-term memory, memory for images, allocation and shifting of attention. In the emotional-volitional sphere – the indicators of depression and anxiety, motivation towards recovery. The presented data underlines the need for simultaneous provision of psychological rehabilitation and medication interventions for fullest readaptation of a patient to life at all stages of rehabilitation.  

scholarly journals Psychocorrective effect of application of combined medical rehabilitation methods in patients with ischemic stroke

2020 ◽  
Vol 19 (6) ◽  
pp. 380-383
Author(s):  
Anna A. Mikhailova ◽  
Natalya B. Korchazhkina ◽  
Elizaveta S. Koneva ◽  
Konstantin V. Kotenko
Keyword(s):  
Ischemic Stroke ◽  
Everyday Life ◽  
Well Being ◽  
Functional Independence ◽  
Medical Rehabilitation ◽  
Psychological Status ◽  
Control Group ◽  
Post Stroke ◽  
Combined Methods

Background. The annual death rate from stroke in Russia remains the highest in the world. Aims: To study the influence of combined methods of medical rehabilitation on the psychological status and functional independence of patients with post-stroke spasticity. Materials and methods. The article presents data on the effectiveness of the influence on the psychological status and functional independence of the combined methods of medical rehabilitation in 60 patients with ischemic stroke with movement disorders in the form of hemiparesis with increased muscle tone by the type of spasticity in the long-term period. The patients were divided into 2 groups comparable in terms of clinical and functional characteristics: the main group (n=30), who received combined methods of physiotherapy (thermotherapy, oxygen therapy, oxyhyperthermia, vibrotherapy, aromatherapy) from the Alpha LED Oxu Light Spa apparatus in addition to the standard rehabilitation complex , which includes exercise therapy, medical massage, kinesitherapy, and a control group (n=30), who received only a standard rehabilitation complex. To assess the initial psychological status and functional independence of the observed patients undergoing medical rehabilitation in the period from 3 to 6 months after the disease, the SAN method (well-being, activity, mood) and the FIM scale were used. Results. Before the start of rehabilitation in all patients included in the study. Тhere was a moderate degree of deterioration in well-being, a decrease in activity and mood, as well as a decrease in indicators of independence in everyday life. After the course of treatment (on day 14) and in the long-term period (after 8 months) the patients of the main group had a pronounced positive dynamics of the psycho-emotional status, which was manifested in an improvement in the indicators of well-being by 1.93 times (by 28%), activity by 1.95 times (by 29.6%) and mood by 2.01 times (by 29.8%) points. In the control group, after the standard course of treatment, there was less pronounced dynamics of psychometric indicators. When evaluating the results of functional independence on the FIM scale, there was a significant improvement in the indicators of independence in everyday life by 32%. Conclusion. The use of combined methods of medical rehabilitation in patients with post-stroke spasticity contributes to a significant increase in their quality of life and psychological status, which is confirmed by the FIM and SAN tests.

Red Blood Cell Indices in Relation to Post-stroke Psychiatric Disorders: A Longitudinal Study in a Follow-up Stroke Clinic

2020 ◽  
Vol 17 (3) ◽  
pp. 218-223
Author(s):  
Haichao Wang ◽  
Li Gong ◽  
Xiaomei Xia ◽  
Qiong Dong ◽  
Aiping Jin ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Ischemic Stroke ◽  
Blood Cell ◽  
Cox Regression ◽  
Depression And Anxiety ◽  
Cox Regression Analysis ◽  
Post Stroke ◽  
Rbc Indices ◽  
Post Stroke Depression

Background: Depression and anxiety after stroke are common conditions that are likely to be neglected. Abnormal red blood cell (RBC) indices may be associated with neuropsychiatric disorders. However, the association of RBC indices with post-stroke depression (PSD) and poststroke anxiety (PSA) has not been sufficiently investigated. Methods: We aimed to investigate the trajectory of post-stroke depression and anxiety in our follow- up stroke clinic at 1, 3, and 6 months, and the association of RBC indices with these. One hundred and sixty-two patients with a new diagnosis of ischemic stroke were followed up at 1, 3, and 6 months, and underwent Patient Health Questionnaire-9 (PHQ-9) and the general anxiety disorder 7-item (GAD-7) questionnaire for evaluation of depression and anxiety, respectively. First, we used Kaplan-Meier analysis to investigate the accumulated incidences of post-stroke depression and post-stroke anxiety. Next, to explore the association of RBC indices with psychiatric disorders after an ischemic stroke attack, we adjusted for demographic and vascular risk factors using multivariate Cox regression analysis. Results: Of the 162 patients with new-onset of ischemic stroke, we found the accumulated incidence rates of PSD (1.2%, 17.9%, and 35.8%) and PSA (1.2%, 13.6%, and 15.4%) at 1, 3, and 6 months, respectively. The incident PSD and PSA increased 3 months after a stroke attack. Multivariate Cox regression analysis indicated independent positive associations between PSD risk and higher mean corpuscular volume (MCV) (OR=1.42, 95% CI=1.16-1.76), older age (OR=2.63, 95% CI=1.16-5.93), and a negative relationship between male sex (OR=0.95, 95% CI=0.91-0.99) and PSA. Conclusion: The risks of PSD and PSA increased substantially 3 months beyond stroke onset. Of the RBC indices, higher MCV, showed an independent positive association with PSD.

scholarly journals Effects of long-term anti-seizure medication monotherapy on all-cause death in patients with post-stroke epilepsy: a nationwide population-based study in Taiwan

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chia-Yu Hsu ◽  
Chun-Yu Cheng ◽  
Jiann-Der Lee ◽  
Meng Lee ◽  
Bruce Ovbiagele
Keyword(s):  
Valproic Acid ◽  
Ischemic Stroke ◽  
Cox Regression ◽  
Population Based ◽  
Primary Diagnosis ◽  
Research Database ◽  
Post Stroke ◽  
Risk Of Death ◽  
Index Stroke

Abstract Objective We aim to compare the effect of long-term anti-seizure medication (ASM) monotherapy on the risk of death and new ischemic stroke in patients with post-stroke epilepsy (PSE). Patients and methods We identified all hospitalized patients (≥ 20 years) with a primary diagnosis of ischemic or hemorrhagic stroke from 2001 to 2012 using the National Health Insurance Research Database in Taiwan. The PSE cohort were defined as the stroke patients (1) who had no epilepsy and no ASMs use before the index stroke, and (2) who had epilepsy and ASMs use after 14 days from the stroke onset. The patients with PSE receiving ASM monotherapy were enrolled and were categorized into phenytoin, valproic acid, carbamazepine, and new ASM groups. We employed the Cox regression model to estimate the unadjusted and adjusted hazard ratios (HRs) with 95 % confidence intervals (CIs) of death and new ischemic stroke within 5 years across all groups, using the new ASM group as the reference. Results Of 6962 patients with PSE using ASM monotherapy, 3917 (56 %) were on phenytoin, 1623 (23 %) on valproic acid, 457 (7 %) on carbamazepine, and 965 (14 %) on new ASMs. After adjusting for confounders, compared with new ASM users, phenytoin users had a higher risk of death in 5 years (HR: 1.64; 95 % CI: 1.06–2.55). On the other hand, all ASM groups showed a similar risk of new ischemic stroke in 5 years. Conclusions Among patients with PSE on first-line monotherapy, compared to new ASMs, use of phenytoin was associated with a higher risk of death in 5 years.

scholarly journals Identifying unmet needs in long-term stroke care using in-depth assessment and the Post-Stroke Checklist – The Managing Aftercare for Stroke (MAS-I) study

2018 ◽  
Vol 3 (3) ◽  
pp. 237-245 ◽  
Author(s):  
Benjamin Hotter ◽  
Inken Padberg ◽  
Andrea Liebenau ◽  
Petra Knispel ◽  
Sabine Heel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Caregiver Burden ◽  
Unmet Needs ◽  
Community Dwelling ◽  
Social Needs ◽  
Interquartile Range ◽  
Stroke Patients ◽  
Post Stroke

Introduction Detailed data on the long-term consequences and treatment of stroke are scarce. We aimed to assess the needs and disease burden of community-dwelling stroke patients and their carers and to compare their treatment to evidence-based guidelines by a stroke neurologist. Methods We invited long-term stroke patients from two previous acute clinical studies ( n = 516) in Berlin, Germany to participate in an observational, cross-sectional study. Participants underwent a comprehensive interview and examination using the Post-Stroke Checklist and validated standard measures of: self-reported needs, quality of life, overall outcome, spasticity, pain, aphasia, cognition, depression, secondary prevention, social needs and caregiver burden. Results Fifty-seven participants (median initial National Institutes of Health Stroke Scale score 10 interquartile range 4–12.75) consented to assessment (median 41 months (interquartile range 36–50) after stroke. Modified Rankin Scale was 2 (median; interquartile range 1–3), EuroQoL index value was 0.81 (median; interquartile range 0.70–1.00). The frequencies for disabilities in the major domains were: spasticity 35%; cognition 61%; depression 20%; medication non-compliance 14%. Spasticity ( p = 0.008) and social needs ( p < 0.001) had the strongest impact on quality of life. The corresponding items in the Post-Stroke Checklist were predictive for low mood ( p < 0.001), impaired cognition ( p = 0.015), social needs ( p = 0.005) and caregiver burden ( p = 0.031). In the comprehensive interview, we identified the following needs: medical review (30%), optimization of pharmacotherapy (18%), outpatient therapy (47%) and social work input (33%). Conclusion These results suggest significant unmet needs and gaps in health and social care in long-term stroke patients. Further research to develop a comprehensive model for managing stroke aftercare is warranted. Clinical Trial Registration: clinicaltrials.gov NCT02320994.

Doubly modifiable synapses: a model of short and long term auto-associative memory

1989 ◽  
Vol 238 (1291) ◽  
pp. 137-154 ◽  
Keyword(s):  
Long Term Memory ◽  
Short Term ◽  
High Quality ◽  
Stage Process ◽  
Short And Long Term ◽  
Associative Recall ◽  
Term Performance ◽  
Long Term Experience

Synapses that can be strengthened in temporary and persistent manners by two separate mechanisms are shown to have powerful advantages in neural networks that perform auto-associative recall and recognition. A multiplicative relation between the two weights allows the same set of connections to be used in a closely interactive way for short-term and long-term memory. Algorithms and simulations are described for the storage, consolidation and recall of patterns that have been presented only once to a network. With double modifiability, the short-term performance is dramatically improved, becoming almost independent of the amount of long-term experience. The high quality of short-term recall allows consolidation to take place, with benefits from the selection and optimization of long term engram s to take account of relations between stored patterns. Long-term capacity is greater than short-term capacity, with little or no deficit compared with that, obtained with singly modifiable synapses. Long-term recall requires special, simply implemented, procedures for increasing the temporary weights of the synapses being used to initiate recall. A consolidation algorithm is described for improving long-term recall when there is overlap between patterns. Confusional errors are reduced by strengthening the associations between non-overlapping elements in the patterns, in a two-stage process that has several of the characteristics of sleep.

Long-term quality of life outcomes of women treated for early-stage endometrial cancer

2020 ◽  
pp. ijgc-2020-002145
Author(s):  
Saira Sanjida ◽  
Andreas Obermair ◽  
Val Gebski ◽  
Nigel Armfield ◽  
Monika Janda
Keyword(s):  
Quality Of Life ◽  
Endometrial Cancer ◽  
Early Stage ◽  
Age Groups ◽  
Laparoscopic Hysterectomy ◽  
Well Being ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy

ObjectiveTo compare long-term quality of life in women treated for early-stage endometrial cancer with population norms, and to compare quality of life outcomes of patients who had total laparoscopic or total abdominal hysterectomy.MethodsOnce the last enrolled patient had completed 4.5 years of follow-up after surgery, participants in the Laparoscopic Approach to Cancer of the Endometrium (LACE) clinical trial were asked to complete a self-administered questionnaire. Two instruments—EuroQol 5 Dimension 3-level (EQ-5D-3L) and the Functional Assessment of Cancer Treatment-General Population (FACT-GP)—were used to determine quality of life. The mean computed EQ-5D-3L index scores for LACE participants at different age categories were compared with Australian normative scores; and the FACT-GP scores were compared between patients treated with surgical treatments.ResultsOf 760 women originally enrolled in the LACE trial, 259 (50.2%) of 516 women consented to provide long-term follow-up data at a median of 9 years (range 6—12) after surgery. On the EQ-5D-3L, long-term endometrial cancer survivors reported higher prevalence of anxiety/depression than normative levels across all age groups (55–64 years, 30% vs 14.9%; 65–74 years, 30.1% vs 15.8%; ≥75 years, 25.9% vs 10.7%). For women ≥75 years of age, the prevalence of impairment in mobility (57.6% vs 43.3%) and usual activities (58.8% vs 37.9%) was also higher than for population norms. For the FACT-GP, the physical (effect size: −0.28, p<0.028) and functional (effect size: −0.30, p<0.015) well-being sub-scale favored the total laparoscopic hysterectomy compared with total abdominal hysterectomy recipients.ConclusionCompared with population-based norms, long-term endometrial cancer survivors reported higher prevalence of anxiety/depression across all age groups, and deficits in mobility and usual activities for women aged ≥75 years. Physical and functional well-being were better among women who were treated with total laparoscopic hysterectomy than among those receiving total abdominal hysterectomy.

scholarly journals Poverty Alleviation Through the Program Slums in the City of Kendari, Indonesia

2019 ◽  
Vol 9 (2) ◽  
pp. 35
Author(s):  
Joko Tri Brata ◽  
La Ode Bariun ◽  
Asri Djauhar ◽  
Andi Gusti Tantu
Keyword(s):  
Quality Improvement ◽  
Focus Group ◽  
Poverty Alleviation ◽  
Poverty Reduction ◽  
Group Discussion ◽  
Governance Model ◽  
The Subject ◽  
The City

The long-term goal of the concept of poverty reduction is to give the same level of welfare for the Indonesian people, and in this research is the development of innovative Models of Poverty Reduction, with the subject on (1) How the application design model of the institutional prevention of poverty through interface Program Quality Improvement of Slums and (2) how the efforts in governance of slum through simulation integration with poverty alleviation. The method used is the description by sharpening the Focus Group Discussion (FGD) about the handling of the slums in the city of Kendari and intervention efforts Increase the quality of housing and slums, so that the governance model can be used in other areas in Southeast Sulawesi.

scholarly journals POST-STROKE PSYCHIATRIC DISORDERS: AN OVERVIEW ON ITS SCREENING AND MANAGEMENT

2019 ◽  
Vol 12 (1) ◽  
pp. 11
Author(s):  
Keerthana Chandrasekar ◽  
Nakka Gautam Sai ◽  
Princy Sabu John ◽  
Sruthi Ninan ◽  
Raja D ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Bipolar Disorders ◽  
Depression And Anxiety ◽  
Stroke Patients ◽  
Post Stroke ◽  
The Third ◽  
Insufficient Amount ◽  
Psychiatric Complications ◽  
The Brain

Stroke is the third leading cause of death. Stroke occurs when an insufficient amount of blood is supplied to the brain due to a thrombus or an emboli leading to permanent tissue damage. Lesions in the brain can lead to psychiatric complications. The prevalence of psychiatric complications after stroke is very common. Psychiatric complications such as depression, anxiety, apathy, pseudobulbar effects (laughing and crying), mania, psychosis, and bipolar disorders are seen after stroke. In this review, various psychiatric disorders are reported among post-stroke survivors in which depression and anxiety are common. Consequently, apathy, pseudobulbar effects, catastrophic reactions, psychosis, bipolar disorder, and mania are also observed after stroke. Therefore, early detection and management of psychiatric disorders prevent further complications and improve the quality of life in post-stroke patients.

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