Особливості і динаміка когнітивних порушень у хворих на первинний і вторинний мозковий ішемічний півкульовий інсульт
Bibliographic record
Abstract
Acute cerebrovascular disease is a global medical and social problem of the modern angioneurology, occupying leading positions in the structure of morbidity and mortality among adult population of the world. Ischemic stroke – is one of the most common pathology. Today this disease took out the world pandemic. More than 16 million new cases of cerebral infarction recorded in the world each year and it “kills” about 7 million of people.About 111,953 cases of cerebral stroke were registered in 2013 in Ukraine. Cognitive impairment, t hat significantly disrupt daily activities and life of the patient, is one of the most significant post-stroke complications that have social, medical and biological significance.Aim. The purpose of this investigation was to study features and dynamics of cognitive impairments in patients with primary and recurrent cerebral hemispheric ischemic stroke (CHIS ) in the acute stage of the disease.Materials and methods. To achieve the aim, and the decision of tasks in the clinic of nervous diseases Zaporozhye State Medical University (supervisor - Doctor of Medicine, Professor Kozelkin A.) based on the department of acute cerebrovascular disease were performed comparative, prospective cohort study, which included comprehensive clinical and paraclinical examinations of 41 patients (26 men and 15 women) aged 45 to 85 years (mean age 66,4 ± 1,4 years) with acute left-hemispheric (2 patients) and right - hemispheric (39 patients) CHIS . First up was a group of 28 patients (19 men and 9 women, mean age 65,6 ± 1,6 years), who suffered from primary CHIS. The second group consisted of 13 patients (7 men and 6 women, mean age 68,1 ± 2,5 years) with recurrent CHIS. The groups were matched by age, sex, localization of the lesion and the initial level of neurological deficit.All patients underwent physical examination, neurological examination. Dynamic clinical neurological examination assessing the severity of stroke was conducted using a NIHS scale. Neuropsychological examination included verification of the existence and structure of the cognitive impairments using scales Montreal Cognitive Assessment (MoCA), Mini-Menthal State Examination (MMSE), Frontal Assessment Battery (FAB) on the 1st -3rd and 10 - 13th day of the acute period of the disease. Outcome of the acute period of the disease was assessed by the modified Rankin scale .All patients underwent a CT scan (Siemens Somatom Spirit, Germany) of the brain and laboratory investigations. The obtained data were processed using the program Statistica 6.0 (StatSoft., USA ) and software package Microsoft Excel.It was detected that patients with recurrent ischemic supratentorial stroke are characterized with lower summary score by Mini-Menthal State Examination, Montreal Cognitive Assessment and Frontal Assessment Battery scales than those with first stroke episode. It was revealed that moderate cognitive disturbances are prevailed in the structure of cognitive disorders in primary stroke, while in recurrent brain ischemia mild and moderate dementia is dominated. Transitory type of perception-gnostic field violations in primary ischemic supratentorial stroke was established. The leading cognitive domains which are associated with expressed cognitive disfunction in patients with recurrent brain ischemia were detected.Conclusions. The patients with recurrent CHIS were characterized by more severe cognitive impairment in the acute period of the disease, so a primary CHIS we can considered as a main risk factor for the progression of cognitive disorders in a specified group of patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.014 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".