Pulmonary embolism is a major cause of mortality in stroke patients and up to 50% of premature deaths in hospitalized patients. The non-specific clinical picture causes diagnostic errors and severely limits the initiation of treatment in atimely manner.The aim of the study was to analyze missed cases of pulmonary embolism in stroke patients treated within the institutional cohort by analyzing the results of morpho pathological examinations. Materials and methods: Retrospective study. Pulmonary thromboembolism was studied as a major cause of death in patients with stroke, hospitalized in the Diomid Gherman Institute of Neurology and Neurosurgery during 2017-2020. 13 patients with a morpho pathologically confirmed diagnosis were included in the study. Results: The study included 5 men (38.5%) and 8 women (61.5%) with an average age of 65±5.2 years. In all patients the diagnosis of stroke was confirmed by CT: ischemic stroke was established in 6 patients (46.8%), hemorrhagic stroke in 4 patients (30.1%), of which 1 patient underwent surgery (7.7%), stroke with hemorrhagic transformation in 3 patients (23.1%). For 11 patients (84.6%) the stroke was primary, and for 2 patients (15.4%) it was repeated. The risk factors were hypertension - 12 patients (92.3%), in 8 patients (61.5%) obesity, diabetes mellitus -5 patients (38.5%), atrial fibrillation in 5 patients (38.5%), 1 patient (7.7%) with thrombosis in other areas. The morpho pathological diagnosis established that pulmonary embolism was the cause of death in all cases, but only 2 (15.4%) patients presented specific symptoms. Conclusion. Stroke patients are at increased risk of pulmonary embolism due to bed rest, limb paralysis and predisposing risk factors, but only a small number of patients are diagnosed in a timely manner, therefore it is important for the clinician to be aware of the severity of the problem and establishing strict prophylaxis and treatment protocols.
The circadian rhythm is an endogenous process that has a periodicity of approximately 24 hours and stimulates the anticipation of repeated and regular events that occur daily, enabling the regulation of most major physiological systems in humans and animals. Thus, studies have shown that disruption of circadian rhythm and sleep is a frequent cause of a series of pathologies for the general population, including pregnant women and their fetus. The purpose of this article is to review the literature on the relationship between circadian rhythm and sleep disorders in pregnant women and the influence on the development of the fetus, as well as the future developing adult. Pregnancy is a critical period in which the systems of organs of a new human body are developing, and any disturbance in the environment in which the fetus grows can lead to developmental disorders that alter the metabolic and physiological functions of the fetus. Thus, maintaining an undisturbed circadian rhythm, including during pregnancy, protects the health of both the mother and the child, reducing the susceptibility to the development of certain postnatal diseases later in life.
Migraine is a disorder of multisensory integration of somatosensory, visual, auditory, olfactory stimuli, which subsequently can lead to various combinations of symptoms: headache, photophobia, phonophobia, nausea/vomiting, osmophobia.The purpose of the study: To isolate the characteristics of pain phenomenon (frequency, duration, and severity of migraine symptoms) in relation to associated symptoms in migraine patients. Materials and Methods: 94 patients with frequent episodic and chronic migraine were included in a cross-sectional study. Research methods used: clinical, descriptive, statistical. Migraine patient questionnaires were used as a research instrument. Primary data were entered into Excel programs and processed in MedCalc. Results and discussion: A statistically significant positive correlation between phonophobia and throbbing headache was observed in the conducted study. Statistically significant positive correlations were found between the duration of a migraine attack (in hours) and some migraine-related symptoms, such as: anxiety, shortness of breath. Conclusions: Thus, intensity rather than duration of headache may be the trigger for most, but not all, of the associated symptoms. This study demonstrated the clinical significance of the pain phenomenon and symptoms associated with migraine. In order to isolate the specificity of migraine attacks and elucidate their features, the study of autonomic symptoms accompanying the pain phenomenon is a particularly important part of establishing a correct diagnosis.
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