Prognostic Value of Investigating Neuron-Specific Enolase in Patients with Ischemic Stroke.

The aim of the study was to assess the prognostic value of the plasma neuron-specific enolase (NSE) level as a predictor of functional outcome and motor function recovery in the acute period of ischemic stroke (IS). Materials and Methods: Fifty patients with IS have been examined. On admission to the hospital and at 12-14 days after stroke onset, a clinical and neurological examination have been carried out with the supplementary quantitative assessment of neurological deficit severity according to the National Institutes of Health Stroke Scale (NIHSS), functional outcome according to the Modified Rankin Scale, and Rivermead Mobility Index. Enzyme immunoassay was used to determine NSE concentration in blood plasma in the acute period of the disease. Results: The NSE level in patients' blood plasma in the first 48 h after stroke onset positively correlates with the ischemic focus volume (r=0.49; p=0.003) and the severity of neurological symptoms (according to NIHSS) (r=0.33; p=0.02). NSE less than 2 ng/ml in the acute disease period is a predictor of good functional outcome 12-14 days after stroke onset (OR=12.4; р=0.006). The NSE level >2.6 ng/ml is associated with a high likelihood of lethal outcome.Neurological deficit below 15 according to NIHSS as well as the NSE level <2 ng/ml in the acute IS period are estimated as prognostic factors of significant recovery of motor function at 2 weeks after disease onset (OR=5.8; р=0.02). Conclusion: Determination of NSE in blood plasma makes it possible to predict functional outcome of the disease development and the recovery of motor function in patients with IS.

[Cerebral amyloid angiopathy, comorbid atrial fibrillation]. / Tserebral'naya amiloidnaya angiopatiya, komorbidnaya s fibrillyatsiei predserdii.

Cerebral amyloid angiopathy (CAA) is caused by the deposition of ß-amyloid in small vessels in the cerebral cortex and leptomeninges. Nowadays, CAA is recognized more often due to the development of neuroimaging technologies. The frequency of CAA increases in old age that explains its frequent association with cardiovascular diseases. Combination of CAA with atrial fibrillation (AF) causes particular difficulties in managing of the patients, since antithrombotic drugs prescribed to patients with AF mostly contraindicated in CAA because of increased risk of intracerebral hemorrhages. The article presents a case report of the patient with AF who was admitted to the stroke center with acute ischemic stroke. According to MRI, the focus of acute ischemia was small and localized in the cerebellum. This stroke was regarded as having an undetermined etiology according TOAST classification. Small-vessel occlusion subtype was not diagnosed because the TOAST criteria do not attribute an ischemic focus in the cerebellum to a lacunar stroke, while cardioembolic subtype was rejected due to a small (less than 1.5 cm in diameter) size of the focus. Probable CAA in the patient was diagnosed on the basis of the following MRI data: multiple cortical-subcortical micro-hemorrhages (T2*GRE); a single cortical focus with features of the hemorrhage at the stage of intracellular methemoglobin deposition (T1- weighted MR images); bilateral enlargement of perivascular spaces in semioval centers (FLAIR); a negative fronto-occipital gradient (T2-weighted MR images). A diagnosis of CAA was made in accordance with the 2010 Boston criteria and 2019 recommendations of the International CAA Association. The article discusses the hemorrhagic and non-hemorrhagic MRI features of CAA. Frequency of occurrence of cortical microinfarcts in CAA is discussed as well as their differences from small cardioembolic infarcts in AF. Algorithms for antithrombotic therapy for secondary prevention of ischemic stroke in patients with CAA and AF are considered.

[The prevalence of eating behavior disorders in patients with overweight and obesity].

The prevalence of food behavior abnormalities among people with overweight and obesity. The AIM OF INVESTIGATION: To estimate characteristics of food behaviour among people with overweight and obesity. MATERIALS AND METHODS: We examined 188 human of Chuvashia. Anthropometric data was estimated, bodyweight index and waist-hip index were calculated. Infringements of food behaviour were evaluated according to T.G. Voznesenskoj's recommendations. THE RESULTS AND CONCLUSION: Food behavior abnormalities appeared more often among people with overweight and obesity than among people with normal weight. The prevalence of food behavior abnormalities depended on the presence of abdominal obesity. The frequency of all types of food behavior abnormalities rose among individuals with overweight and obesity. The groups with overweight and obesity turned out comparable in prevalence and structure of food behavior abnormalities.

[Indices of mental working ability in school students learning some subjects by advanced educational programs].

The study enrolled 390 schoolchildren attending classes of general, humanitarian, and mathematical education profiles. Mental working ability, memory, and speed and level of cognitive processes were examined. Lower indices were revealed in pupils attending mathematical classes which may be a manifestation of greater fatigue characteristic of this group of pupils. The education in classes of humanitarian profile was associated with significantly higher volume of the operative memory. This finding suggests that the advanced learning of humanities promotes the development of memory. Higher speed of cognitive processes and accuracy of solution of mental tasks were shown to be characteristic of the pupils of mathematical classes.