Infective endocarditis represents a classical contra-indication to thrombolysis for acute ischemic stroke due to a potential increased risk of intracranial hemorrhage. However, some case reports have suggested safety and potential efficacy of intravenous or intra-arterial thrombolysis in stroke related to infective endocarditis. We present a case of ischemic stroke related to infective endocarditis who was treated with intravenous tissue plasminogen activator within the first 3 h of symptoms onset and subsequently developed symptomatic multifocal intracerebral hemorrhages, and summarize currently available data on this issue.
Introduction: Cognitive disorders frequency arising after a cardio-cerebral vascular disease (stroke) is currently on the rise due to the ageing population and the increase in the number of survivors after stroke occurrence. Objective: Determining post-stroke cognitive decline and identifying associated factors. Method: It consists in a cross-sectional, prospective, descriptive and analytical study which was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. The study involved 100 patients who have known stroke for at least the past 6 months and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. The cognitive decline (CD) was estimated by using a modified and adapted MMSE to suit our cultural era. Results: All patients were aged 58.9 years ± 13.6 years. Sex-ratio was 1.4. Cognitive decline frequency was 20%. Post-stroke cognitive decline frequency per sex was 11.6% and 8.4% respectively for females and males. Ischemia stroke patients had a higher cognitive decline (22.5%). 58.3% had severe CD. Moreover the CD frequency increased with time, from 16.7% in a year to 50% in 3 years. Total MMSE varied from 6 to 23 with 21 as median. From the unvaried analysis, the presence of sphincter disorders (1.26 [0.35 -4.59], p = 0.004), consciousness disorders (15.67 [1.46 -168], p = 0.04), and convulsion disorders (3.77 [1.01 -14.00], p = 0.003) was associated with cognitive decline. From multi-varied analysis, the sole presence of convulsive attacks (11.5 [1.79 -73.58], p = 0.01) was individually associated with post-stroke cognitive decline. Conclusion: This study reveals the importance of CD after stroke. The occurrence of convulsions at stroke acute stage is a prognostic factor of CD medium or long-term occurrence. The overall coverage improvement depends on the integration of these data in stroke reach-out programs. D. D. Gnonlonfoun et al.
Background: From 2014 to 2015, West Africa has faced an unprecedented Ebola outbreak and the most affected three countries were Guinea, Liberia and Sierra Leone. The purpose of this paper was to analyze Ebola cases in these three Countries and compare the epidemic trends in each country. Methods: This study was comparative and covered the period from August 2014 to November 24 th 2015. It is based on statistics provided by each country to the World Health Organization (WHO); which are available on the WHO"s website under the title of "situation reports in response to the Ebola outbreak". The paper analysed the trend of probable, confirmed and death cases in each country, and presented various strategies used. Results: The results shown that combine number of probable and confirmed cases of Ebola virus disease (EVD) was higher in Sierra Leone (8,991 cases) compare to Liberia (5,036 cases) and Guinea (3,804 cases). However, the total number of death was higher in Liberia with 4,808 deaths followed by Sierra Leone with 3,955 deaths, then the Republic of Guinea with 2,536 deaths. Conclusions: We can retain that the West African Ebola outbreak started in Guinea and stayed there longer, but Sierra Leone had the higher number of confirmed Ebola cases, while Liberia had the highest number of deaths. This epidemic highlighted the weaknesses of different health care systems and the lack of epidemiologic surveillance in these countries. The need to implement a sustainable epidemiologic surveillance system has been underlined.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.