Результаты применения кт-ангиографии брахиоцефальных артерий у пациентов с ОНМК по ишемическому типу и их связь с тяжестью неврологической симптоматики по шкале NIHSS
To determine the detection of large intracranial artery thrombosis by CT angiography (CTA) in patients with acute ischemic stroke, depending on the severity of neurological symptoms at the international NIHSS score.
Materials and methods. Study population are patients, hospitalized to the M.P. Konchalovsky City clinical hospital in Moscow during 2019 with ischemic stroke and underwent CTA scans of extra-and intracranial arteries: total 173 patients (94 women (54.3%), man 79 (45,7 %), average age – 70 years) with a diagnosis of acute ischemic stroke, who were in all cases, NIHSS scale was used to assess the severity of neurological symptoms.
Intravenous fibrinolytic therapy (FT) or intra-arterial mechanical thrombectomy (TE) was performed in all cases. The Spearman rank correlation was used to measure the correlation.
Results. In 63 of 173 patients (36%) NIHSS score was 6 points or less. Occlusions of large intracranial arteries were detected in 27.7% (n=46) of cases, of which only 61% (n=28) patients reached the stage of TE. FT was performed in 54% of cases (n=94). Of 46 cases with occlusion of large intracranial arteries only 2 patients (4%) had NIHSS score 6 or less. Of all patients, who underwent the CTA, only 2 (1.2%) had NIHSS score 6 or less. There was a significant positive correlation between NIHSS score and the detection of intracranial artery thrombosis. Spearman's rank correlation coefficient Rs is 0.55 (p<0.0001). For one patient brought to the TE stage, there were 6 CTA of extra-and intracranial arteries.
Conclusion. There is a strong relationship between NIHSS score and the detection of intracranial artery thrombosis by CTA. With the low values of the NIHSS score (less than 6), the probability of detection of thrombosis is extremely small. It is advisable to prescribe CTA for patients with NIHSS score of 7 or more only.
The Aphasia Bedside Check for Russian (ABC-Ru) is a screening test that allows the medical staff of a neurological ward to detect speech/language disorders in the first days post-stroke onset. To evaluate whether this test follows modern psychometric standards, we performed two studies. In Study 1, we reported the results of the standardization of the ABC-Ru in a clinical group of people with chronic speech/language disorders (N=80) and a cohort of neurologically healthy individuals (N=120). In Study 2, we validated the results in a group of people in the acute post-stroke period (N=20) with and without speech/language disorders. According to the results of the study, the ABC-Ru can be considered as a valid instrument and can potentially be used in neurological departments for the screening of speech and language disorders.
It is a common belief that the shift to digital imaging some 20 years ago helped medical image exchange and got rid of any potential image loss that was happening with printed image films. Unfortunately, this is not the case: despite the most recent advances in digital imaging, most hospitals still keep losing their imaging data, with these losses going completely unnoticed. As a result, not only does image loss affect the faith in digital imaging but it also affects patient diagnosis and daily quality of clinical work. This paper identifies the origins of invisible image losses, provides methods and procedures to detect image loss, and demonstrates modes of action that can be taken to stop the problem from happening.
Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival.
We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (U5MR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index.
Global U5MR decreased from 71·2 deaths per 1000 livebirths (95% uncertainty interval [UI] 68·3–74·0) in 2000 to 37·1 (33·2–41·7) in 2019 while global NMR correspondingly declined more slowly from 28·0 deaths per 1000 live births (26·8–29·5) in 2000 to 17·9 (16·3–19·8) in 2019. In 2019, 136 (67%) of 204 countries had a U5MR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030, 154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9·65 million (95% UI 9·05–10·30) in 2000 and 5·05 million (4·27–6·02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3·76 million [95% UI 3·53–4·02]) in 2000 to 48% (2·42 million; 2·06–2·86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0·80 (95% UI 0·71–0·86) deaths per 1000 livebirths and U5MR to 1·44 (95% UI 1·27–1·58) deaths per 1000 livebirths, and in 2019, there were as many as 1·87 million (95% UI 1·35–2·58; 37% [95% UI 32–43]) of 5·05 million more deaths of children younger than 5 years than the survival potential frontier.
Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve U5MR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress.
Background: In this review we survey medical treatments and research strategies, and we discuss why they have failed to cure degenerative disc diseases or even slow down the degenerative process.
Objective: We seek to stimulate discussion with respect to changing the medical paradigm associated with treatments and research applied to degenerative disc diseases.
Method Proposal: We summarize a Biological Transformation therapy for curing chronic inflammations and degenerative disc diseases, as was previously described in the book Biological Transformations controlled by the Mind Volume 1.
Preliminary Studies: A single-patient case study is presented that documents complete recovery from an advanced lumbar bilateral discopathy and long-term hypertrophic chronic rhinitis by application of the method proposed.
Conclusion: Biological transformations controlled by the mind can be applied by men and women in order to improve their quality of life and cure degenerative disc diseases and chronic inflammations illnesses.
Proceedings of the conference "Molecular basis of epidemiology, diagnosis, prevention and treatment of current infections" 4-6 December 2018
The study of clinical terminology has always occupied a significant place in the discipline "Latin language and outlines of medical terminology." Undoubtedly, surgical terminology is one of the most voluminous terminology in the clinical block. Moreover, there are a lot of terms used in it in other departments of the clinical direction, so-called "common" terms.
Objective: Glioblastoma is a highly aggressive and invasive brain and Central Nervous System (CNS) tumor. Current treatment options do not prolong overall survival significantly because the disease is highly prone to relapse. Therefore, research to find new therapies is of paramount importance. It has been discovered that glioblastomas contain a population of cells with stem-like properties and that these cells are may be responsible for tumor recurrence.
Methods: A review of relevant papers and clinical trials in the field was conducted. A PubMed search with related keywords was used to gather the data. For example, “glioblastoma stem cells AND WNT signaling” is an example used to find information on clinical trials using the database ClinicalTrials.gov.
Results: Cancer stem cell research has several fundamental issues and uncertainties that should be taken into consideration. Theoretically, a number of treatment options that target glioblastoma stem cells are available for patients. However, only a few of them have obtained promising results in clinical trials. Several strategies are still under investigation.
Conclusion: The majority of treatments to target cancer stem cells have failed during clinical trials. Taking into account a number of biases in the field and the number of unsuccessful investigations, the application of the cancer stem cells concept is questionable in clinical settings, at least with respect to glioblastoma.
The series “Advances in Intelligent Systems and Computing” contains publications on theory, applications, and design methods of Intelligent Systems and Intelligent Computing. Virtually all disciplines such as engineering, natural sciences, computer and information science, ICT, economics, business, e-commerce, environment, healthcare, life science are covered. The list of topics spans all the areas of modern intelligent systems and computing such as: computational intelligence, soft computing including neural networks, fuzzy systems, evolutionary computing and the fusion of these paradigms, social intelligence, ambient intelligence, computational neuroscience, artificial life, virtual worlds and society, cognitive science and systems, Perception and Vision, DNA and immune based systems, self-organizing and adaptive systems, e-Learning and teaching, human-centered and human-centric computing, recommender systems, intelligent control, robotics and mechatronics including human-machine teaming, knowledge-based paradigms, learning paradigms, machine ethics, intelligent data analysis, knowledge management, intelligent agents, intelligent decision making and support, intelligent network security, trust management, interactive entertainment, Web intelligence and multimedia.
The publications within “Advances in Intelligent Systems and Computing” are primarily proceedings of important conferences, symposia and congresses. They cover significant recent developments in the field, both of a foundational and applicable character. An important characteristic feature of the series is the short publication time and world-wide distribution. This permits a rapid and broad dissemination of research results.
This book contains a selection of papers accepted for the presentation and discussion at the 2018 International Conference on Digital Science (DSIC’18). This Conference had the support of the Institute of Certified Specialists, Russia, AISTI (Iberian Association for Information Systems and Technologies), and Springer. It will take place at Convention Centre, Budva, Montenegro, October 19–21, 2018. DSIC’18 is an international forum for researchers and practitioners to present and discuss the most recent innovations, trends, results, experiences, and concerns in the several perspectives of Digital Science. The main idea of this Conference is that the world of science is unified and united allowing all scientists/practitioners to be able to think, analyze, and generalize their thoughts. DSIC aims efficiently to disseminate original research results in natural, social, art, and humanities sciences. An important characteristic feature of the Conference should be the short publication time and worldwide distribution. This Conference enables fast dissemination, so conference participants can publish their papers in print and electronic format, which is then made available worldwide and accessible by numerous researchers. The Scientific Committee of DSIC’18 was composed of a multidisciplinary group of 26 experts. One hundred and seven invited reviewers who are intimately concerned with Digital Science have had the responsibility for evaluating, in a “double-blind review” process, the papers received for each of the main themes proposed for the Conference: Digital Art and Humanities; Digital Economics; Digital Education; Digital Engineering; Digital Environmental Sciences; Digital Finance, Business and Banking; Digital Media; Digital Medicine, Pharma and Public Health; Digital Public Administration; Digital Technology and Applied Sciences.
DSIC’18 received 88 contributions from 16 countries around the world. The papers accepted for the presentation and discussion at the Conference are published by Springer (this book) and will be submitted for indexing by ISI, SCOPUS, among others.