Predictors of atrial fibrillation in patients with ischemic stroke of undetermined etiology.

Aim    To identify a complex of predictors and to create a mathematical model for prognosis of atrial fibrillation (AF) in patients with ischemic stroke of undetermined etiology. Material and methods    The study included 981 patients with ischemic stroke. Effects of the following factors were evaluated: gender, a history of stroke, a history of thromboembolism, presence of diabetes mellitus, grade of arterial hypertension, functional class (FC) of chronic heart failure (CHF), age, data of blood biochemistry, and data of coagulogram. The prognostic model was constructed using the binary logistic regression. The value of area under the ROC curve for the proposed prognostic model was calculated.Results    The main predictors of AF in patients with ischemic stroke of undetermined etiology were CHF FC, a history of stroke, age, gender, values of cholesterol and prothrombin index, which were included into the final prognostic model. The sensitivity of the developed model was 83.5 % and the specificity was 85.5 %. The area under the ROC curve corresponding to the interrelation between the prognosis of AF and the regression function value was 0.921±0.012 with 95 % confidence interval: 0.898-0.944.Conclusion    According to the results of the study, the probability of AF in patients with ischemic stroke increased with CHF progression, recurrent stroke, older age, female gender, and reduced prothrombin index and cholesterol level.

[Clinical-epidemiological characteristics of multiple sclerosis and neuroopticomyelitis in the Central Asia]. / Kliniko-épidemiologicheskie kharakteristiki rasseiannogo skleroza i optikoneiromielita v Tsentral'noi Azii.

AIM: To study clinical-epidemiological characteristics of multiple sclerosis (MS) and neuroopticomyelitis spectrum diseases (NOMSD) in Semej town (Kazakhstan) taking into account ethnic identity. MATERIAL AND METHODS: Epidemiological indicators and clinical characteristics of MS and NOMSD in Semej (the Central Asia region) were studied. RESULTS AND DISCUSSION: General MS prevalence was 10.1 per 100 000 population, 16.8 in Caucasians, 4.9 in Asians (OR=2.64; 95% CI 1.31-5.36). General female to male (F/M) ratio was 1:2.5, 1:1.2 in Asians; 1:5 in Caucasians. Mean age of patients and EDSS index at the time of observation were equal in both ethnic groups. Ten cases of NOMSD were found, all of them were recorded in the Asian population (prevalence 4.9 per 100 000 population). F/M was 1:9. Mean age (p=0.02) and age at disease onset (p=0.01), as well as EDSS indexes at time of onset and observation (p<0.001 and p<0.001) were higher in NOMSD patients compared to MS. No NOMSD cases were identified in Caucasians, while in Asians the equal prevalence of MS and NOMSD was shown. This finding may be explained by the presence of both Asian and Caucasian haplogroups in the Kazakh population.

[Treatment of a neglect syndrome in movement rehabilitation of stroke patients]. / Osobennosti korrektsii sindroma neglekta pri osushchestvlenii dvigatel'noi reabilitatsii patsientov s polusharnym insul'tom.

AIM: To increase the efficiency and improvement of rehabilitation in patients with a neglect syndrome after stroke. MATERIAL AND METHODS: The results of treatment of 750 stroke patients, 396 women and 354 men, aged from 30 to 82 years, average age 63.4 years, were analyzed. An influence of cortexin on removal of the neglect syndrome, functional rehabilitation, increase in daily life activities and quality of life was studied. All patients were divided into two matched-controlled groups, receiving and not receiving cortexin. The functional rehabilitation was followed up using Barthel, Lindmark, Scandinavian and Merton and Sutton scales, MMSE and MoCA scales for assessment of cognitive functions, Sickness Impact Profile for quality of life. Moreover, the efficacy was evaluated by absence of signs of neglect syndrome. RESULTS: The combined rehabilitation with the use of cortexin helps to remove the neglect syndrome and improve the functional rehabilitation of stroke patients. CONCLUSION: Use of cortexin during rehabilitation in stroke patients with a neglect syndrome is justified and expedient for the increase of its efficiency that permits to recommend this drug for wide use in clinical practice.

[Theoretical and practical principles of neurorehabilitation in post-stroke patients]. / Teoreticheskie i prakticheskie printsipy neiroreabilitatsii patsientov, perenesshikh insul't.

This article is devoted to the basic principles of organization and carrying out the rehabilitation of patients with severe neurological diseases. Theoretical and practical aspects and prerequisites of effective rehabilitation are considered. An analysis of neurological dysfunctions due to focal brain's damages is important for the general organization of rehabilitation and for carrying out different methods of rehabilitation. Characteristics of multidisciplinary management of patients with severe neurological diseases are considered. Advantages and risks of early rehabilitation, and characteristics of passive verticalization are discussed.