[Prognostic methods of postoperative cognitive dysfunction in patients with ischemic heart disease after coronary bypass surgery under extracorporeal circulation]. / Prognozirovanie posleoperatsionnoi kognitivnoi disfunktsii u bol'nykh ishemicheskoi bolezn'iu serdtsa, perenesshikh operatsiiu koronarnogo shuntirovaniia v usloviiakh iskusstvennogo krovoobrashcheniia.

AIM: To work out the techniques of forecasting the development of postoperative cognitive dysfunction in early and late periods after coronary bypass surgery using fully connected multilayer neural networks. MATERIAL AND METHODS: Based on the study of 264 patients with stroke, 9 neural network models for prognosis of cognitive dysfunction after coronary bypass surgery and 7 models for prognosis of cognitive dysfunction 12 months after surgery were built. Fully connected multilayer neural networks of direct propagation were used for working-out the prognostic techniques. RESULTS AND CONCLUSION: The high prognostic significance of neural networks in relation to cognitive disorders in early and late periods after coronary bypass surgery under extracorporeal circulation was demonstrated. Possibilities of creating neural networks make their application in cardiac surgery clinics available and promising.

[Correction of postoperative cognitive dysfunction in cardiosurgery using computer-based stimulation programs]. / Korrektsiya posleoperatsionnoi kognitivnoi disfunktsii v kardiokhirurgii s ispol'zovaniem komp'yuternykh stimuliruyushchikh programm.

AIM: To evaluate the efficacy of computer-based stimulation programs in the correction of postoperative cognitive dysfunction in patients with ischemic heart disease in remote period after coronary artery bypass surgery. MATERIAL AND METHODS: The study involved 74 patients. All patients underwent a drug therapy and the rehabilitation course using computer-based stimulation programs (1 time per day for 20 minutes during10 days). Coronary artery bypass surgery was performed for all patients. Patients were examined before operation, after 6 and 12 months. RESULTS: The significant improvement of higher cortical functions assessed with the FAB scale, the Schulte test, associated thinking test, ten-word retrieval test at the first attempt, the Clock drawing test) was revealed in the group using computer-based stimulation programs in comparison with the control group. CONCLUSION: It is found that rehabilitation course using computer-based stimulation programs in patients with ischemic heart disease after coronary artery bypass surgery is the effective method of cognitive function correction.

[The influence of depression on the course of coronary heart disease and quality of life].

We undertook the analysis of cardiovascular risk factors and psycho-social factors in 230 patients with coronary heart disease (CHD) based at a city polyclinic. Ninety (31.1%) patients suffered depression (19-28 CES-D scores). Patients with and without depression were significantly different in terms of clinical and functional manifestations of stable angina of effort, cardiovascular risk factors, gender; and psycho-social factors. CHD with depression was associated with a higher FC of angina of effort, risk of adverse outcome (Duke index), frequency of concomitant pathology, psycho-social stress, loss of working capacity and a lower income levels. These patients treated with selective antidepressants (serotonin reuptake inhibitors) for 6 months experienced a marked decrease in the degree of depression and manifestation of its symptoms, improvedpsycho- social protection and quality of life compared with untreated patients. These data illustrate pathogenetic and behavioural mechanisms underlying the relationship between CHD and depression.

Correction of post-stroke cognitive impairments using computer programs.

Neurorehabilitation of poststroke cognitive impairments is an important medical problem. The purpose of the present study was to estimate the efficacy of new methods of restoration of impaired cognitive functions using computer correction programs. 43 poststroke patients aged 57-69, (male - 23, female - 20) were randomized into two groups. First group patients have been treated with the standard methods and supplementary neuropsychological computer training for 14days, 25-35min of duration per day. Control group received standard treatment according to Federal and local medical recommendations. Initial and achieved levels of cognitive functioning were estimated with the use of Mini Mental State Examination, Frontal Assessment Battery, the Clock Drawing Test, the Montreal Cognitive Assessment, Schulte's test, Hospital Anxiety and Depression Scale. We found that including the computer correction programs into the complex protocol of rehabilitation of post-stroke patients confirmed their efficacy in both clinical aspects and the Patient Global Impression Scale. Although the results are encouraging, further studies are required with larger samples and longer follow-up to identify characteristics of those patients who are most likely to benefit from computer training of cognitive functions.

[Prognostic significance of platelet metabolism in patients with cerebrovascular complications of hypertension in combination with coronary heart disease].

The study of hemostasis and NAD(P)-dependent platelet dehydrogenases activity was made in 90 patients with cerebrovascular complications (development of ischemic stroke) of hypertension and coronary heart disease. On the basis of NADP-dependent platelet dehydrogenases activity we suggested a mode of prognostication a development of repeated cerebrovascular complications of thrombotic nature (the acute stroke, transitory ischemic attack, acute myocardial infarction, cardiovascular death). The proposed prognostic factor has heightened sensibility and specificity.