The aim of the study was to identify cognitive disorders in patients with Parkinson's disease Material and methods. The study was conducted on the basis of the neurological department of the Regional Clinical Hospital (Odesa) during 2011-2021. 364 patients were diagnosed with Parkinson disease (PD) on the basis of diagnostic criteria of the British Brain Bank. Clinical and demographic data were studied: age, sex, severity according to the UPDRS scale, stage of the disease according to the Hoen-Yahr scale, the presence of cognitive impairment and their nature. MMSE (Mini-Mental State Examination;) and PD-CRS (Parkinson’s Disease-Cognitive Rating Scale) were used to study cognitive functions. Statistical processing was performed by analysis of variance, correlation and factor analysis using Statistica 13.0 software (TIBCO, USA). Results. At the onset of the disease, left lesions were noted in 126 of 364 patients, ie 34.6%, right - 127 (34.9%), the remaining 111 (30.5%) - bilateral lesions. The structure of the disease was dominated by mixed forms. Akinetic-rigid form was observed in 92 (25.3%) cases, trembling - in 27 (7.4%), mixed rigid-trembling in 157 (43.1%) cases, trembling-rigid in 92 (7.4%). Patients with stage 2 and 3 CP were most often registered in 28.6% and 28.0% of cases, respectively. 31 (8.5%) patients had more severe motor disorders (stages 3.5 and 4). Cognitive impairment was detected in a significant number of patients (238 or 45.2%), the mean score on the MMSE scale was 25.3 ± 0.3. Accordingly, on the PD-CRS scale, the average score was 91.2 ± 3.4 points. Subdemental changes were present in 82 (15.6%) patients. Accordingly, mild dementia was found in 15 (2.8%) patients, moderate dementia - in 18 (3.4%). Conclusions: The frequency of detection of cognitive impairment in patients with CP was 45.2% with a mean score on the MMSE scale of 25.3 ± 0.3, and on the PD-CRS scale - 91.2 ± 3.4 points Dementia changes were in 82 (15.6%) patients, mild dementia was found in 15 (2.8%) patients, moderate dementia - in 18 (3.4%) There is a direct correlation between the age and severity of intellectual disabilities (r = 0.50). Self-care disorders are determined by the severity of both motor and cognitive disorders by 72% (R = 0.851; R2 = 0.723; Adjusted R2 = 0.721; F (2.2) = 309; p <10-4; SE = 4.6 ). Key words: Parkinson's disease, cognitive impairment, quality of life
Aim: To assess the clinical effectiveness of a comprehensive rehabilitation program for patients with Parkinson’s disease Materials and Methods: The study was conducted in the regional center for movement disorders (Odesa, Ukraine). 90 patients with 1-2.5 Hoehn-Yahr stage were examined. Patients were randomly assigned to three groups (I (n=30) – standard drug therapy, II (n=30) – standard drug therapy +physical therapy, III (n=30) – standard drug therapy +physical therapy+ art therapy). The effectiveness of the therapy was assessed using the UPDRS questionnaires, Beck Depression Inventory (BDI), Montreal Cognitive Assessment (MoCA), and Pegboard Test. The follow-up period was 12 months. Results: Patients of the II and III groups noted an improvement in mood after physical exertion. They observed a decrease in daytime sleepiness, a decrease in tremors, and a decrease in the intensity of anxiety and fear. During the observation period, signs of disease progression were observed only in 4 (13.3%) patients of group II, in 2 (6.7%) patients of group III and in 12 (40.0%) ) patients of the control group (respectively, χ2 = 4.18 p = 0.04 and χ2 = 7.55 p = 0.006) Conclusions: 1. The use of complex rehabilitation allows to reduce the severity of motor and non-motor manifestations of Parkinson's disease. 2. The inclusion of art therapy in the complex rehabilitation program allows to halve the number of cases of disease progression. 3. The positive effect of the use of comprehensive rehabilitation is maintained throughout the observation period.
The aim of the work was to study the epidemiology of Alzheimer’s disease in the Odesa region. Materials and methods. The study was carried out on the basis of the Regional Mental Health Center (Odesa) in 2016–2021. The data of the primary referral of patients with a verified diagnosis of Alzheimer’s disease were analyzed. Statistical processing of the obtained data was performed by frequency analysis methods using standard MS Excel packages (Microsoft Inc., USA). The population of the Odesa region was determined according to the State Statistics Service of Ukraine. Results. According to the retrospective analysis over the past 5 years, there was a constant increase in the number of identified patients with Alzheimer’s disease, from 4.9 cases per 100,000 population in 2016 to 6.0 cases in 2020 with a slight predominance of women in the structure of cases. Brain MRI was performed only in 29 (4.6 %) patients, EEG in 41 (6.5 %) patients. There were no cases of familial Alzheimer’s disease or early-onset Alzheimer’s disease. In 2020, Alzheimer’s and dementia deaths reached 14,196 or 2.54 % of total mortality in Ukraine. Conclusions. The prevalence of Alzheimer’s disease was 6.0 cases per 100,000 in the population of the Odesa region at the end of 2021, which was an order of magnitude less than the global average. The mean score on the MMSE scale was 18.6 ± 0.5. The analysis on subscales has shown the prevalence of memory, spatial orientation and verbal disorders. The Ukrainian population is characterized by the small number of patients of the older age group (3.3 %) and the predominance of female patients (59.4 %).
Авторами проведен анализ данных отечественной и иностранной литературы по изучаемой проблеме. Обобщены взгляды на проблему этиопатогенеза, классификацию, клинико-диагностический алгоритм оптикомиелита Девика.Проведена дифференциация оптикомиелита и рассеянного склероза, острого демиелинизирующего энцефаломиелита, поперечного некротизирующего миелита и др. Представлены общие схемы лечения описываемого синдрома.В качестве иллюстрации использовано собственное клиническое наблюдение, подтвержденное результатами нейровизуализации. Обоснована практическая направленность изложенного научного сообщения.
Метою дослідження була оцінка поширеності хронічного болю у хворих на хворобу Паркінсона (ХП) в Одеській області. Матеріал і методи. Дослідження виконано на базі Обласної клінічної лікарні (м. Одеса). Проведений ретроспективний аналіз реєстру хворих (n=527) на ХП, створеного фахівцями обласного центру екстрапірамідної патології. Додатково проведене проспективне обстеження 50 хворих у віці 50–60 років з верифікованим діагнозом ХП. Оцінювали моторні та немоторні прояви захворювання, особливості його перебігу, приділяючи особливу увагу проявам больового синдрому в залежності від застосованої терапії. Результати. Сумарна оцінка за шкалами KPPQ склала, в середньому, (26,9±2,0) балів. При цьому найвища інтенсивність больового синдрому спостерігалася при болях, асоційованих з флуктуаціями – (20,5±6,1) балів та при нічних болях – (13,5±2,0) балів. При орофасціальному болю його інтенсивність складала (8,4±3,3) балів, а при корінцевому болю – (7,5±2,7) балів. При набряках та ознаках запалення інтенсивність болю відповідала (9,9±2,4) балів. При оцінці впливу лікування на вираження больового синдрому при проспективному спостереженні встановлено, що інтенсивність болю за ВАШ зменшується через 3 місяці на 30–35 %. Висновки. У 121 (23,0 %) пацієнта наявний больовий синдром різного ступеня вираженості. Найчастіше зустрічалися нічний біль (21,5 %) та м’язово-скелетний біль, як ізольовані (23,1 %) так і в різних комбінаціях. Біль з флуктуаціями різної локалізації виявлено у 27 (5,1 % від загальної численності осіб у реєстрі (n=527)). Нічний біль зустрічався у 94 (17,8 %) випадків, орофасціальний – у 29 (5,5 %). Біль, пов’язаний із набряками та ознаками запалення, був у 58 (11,0 %), корінцевий біль – у 37 (7,0 %). При застосуванні комбінованої протипаркінсонічної терапії інтенсивність болю за ВАШ зменшується через 3 місяці на 30–35 %.
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