Stroke is the first cause of disability, the second cause of dementia and the third cause of mortality in industrialized countries. Due to its increasing incidence, there is a need to study the possibilities of early prevention and diagnosis. Our study was conducted on a group of 165 selected patients diagnosed with different forms of ischemic strokes, aged between 25 and 50 years. We explored them using contrast injected MRI technique, to show the usefulness of this radiologic method and to propose a protocol for the investigation of clinically diagnosed patients with stroke. Contrast injected MRI is demonstrated to be a gold technique in exploring early cases of ischemic stroke with different anomalies. Special agents combined with this technique allows assessment of the functionality of the blood-brain barrier, revealing the real ischemic penumbra.
Obstructive sleep apnea (OSA) is the most common type of sleep disordered breathing, with a signifi cant impact on health-related quality of life (HR-QoL). Continuous positive airway pressure (CPAP) is the gold-standard treatment for moderate-severe OSA, but is associated with poor patient compliance (due to fi nancial issues and frequent side eff ects). The purpose of this study is to evaluate HR-QoL among patients with moderate-severe OSA from NorthEastern Romania, at baseline and after 2 months of CPAP. 75 patients were initially included in our study but only 59 subjects returned for a second evaluation. HR-QoL was assessed using the European Quality of Life 5 Domain questionnaire (EQ-5D-5L). OSA has a signifi cant impact on quality of life in our group, with an average EQ-5D-5L index of 0.70±0.27 and an EQ-5D-5L Visual Analogue Scale (VAS) of 63.71±17.74%. Short-term CPAP use was associated with a statistically signifi cant improvement in Epworth Sleepiness Scale (Δ = 4.44, p <0.0000001), EQ-5D-5L index (Δ = 0.1, p=0.0008) and EQ-5D-5L VAS (Δ = 9.38%, p=0.00002). All patients with a high income (> 4000 lei/month) decided to continue using the device, while the decision not to continue CPAP was signifi cantly more frequent among patients with a low income (< 1000 lei /month-52.63% versus 21.21%, p=0.01). Our results suggest that income level signifi cantly infl uences CPAP compliance.
The concept of polyneuropathy comprises the etiological diversity of neurological syndromes characterized by the formation of bilateral and symmetrical lesions of limb peripheral nerves; symmetrical distal sensory-motor polyneuropathy is the most common form of diabetic neuropathy; it is the most frequent chronic complication of diabetes and more than half of the patients make this complication throughout their lives, both pathogenetic mechanisms and epidemiology, its diagnosis and treatment generate many controversy and challenges for both researchers and practitioners. The study batch consisted of 40 diabetic patients admitted to the Neurology Clinic of the Clinical Recovery Hospital and the Diabetes Clinic between January 2014 and December 2018 who were diagnosed according to clinical and electrophysiological criteria, the etiology of which was type II diabetes with a history of more than 5 years of development and who were examined the lower limb skin according to the local protocol. Thermography is already used as a diagnostic and monitoring tool for patients suffering from neuropathies, especially in the case of complex regional pain syndrome (sympathetic reflex dystrophy) and in our case of diabetic polyneuropathy. This non-invasive exploration has great potential for future research on its use in the diagnosis of other neurological diseases involving the peripheral nervous system. Medical imaging analysis provides a useful way to diagnose and monitor multiple physical illnesses; infrared imaging provides information about infrared energy from the surface of the skin. Emission of infrared radiation changes after nerve damage and vascular occlusions.
Objectives: To evaluate the severity of acute myocardial infarction (AMI) complicated with cardiogenic shock (CS), by comparison with inferior and right ventricular AMI, which is also considered a severe form of myocardial infarction. Methods: In an observational study, from 774 patients with STEMI hospitalized in our Cardiology Institute, over one year and a half, only 120 patients met the inclusion and exclusion criteria (60 patients with CS and 60 patients with right ventricular AMI). Data collected included age, sex, vital signs, oxygen saturation, respiratory rate, left ventricular ejection fraction, right ventricular dysfunction, complications during hospitalization and coronarography results. Results: Patients with CS had a more severe systolic dysfunction (median ejection fraction 22.72 ± 12.30% vs. 41.93 ± 10.50%, P < 0.0001). Single-vessel disease was the most common in both groups, left anterior descending artery being the culprit artery in most patients with cardiogenic shock, 25% of them having residual lesions with a severity >75%. Using a multivariate analysis, we observed that for patients with CS, delayed coronary angiography evaluation, as well as the presence of severe triple-vessel disease, were associated with a higher risk of death. In-hospital mortality (53.33% vs. 8.33%, P < 0.0001) and ventricular arrhythmia were significantly higher in patients with CS (48.3% vs. 11.3%, P < 0.0001). Conclusions: Our study suggests that patients with AMI and CS can be considered the most severe form of myocardial infarction and should, therefore, benefit of prompt and appropriate treatment, to improve the outcome.
Cerebrovascular disease is the second leading cause of death in developed countries after cardiovascular disease, with a prevalence of 794 percent of hundred thousand of people. Ischemic stroke (IS) remains an important public health issue of great importance in terms of its reality and the morbidity it implies, although the tendency is to reduce epidemiological indicators. In this paper we have updated informations on etiopathogenesis, epidemiology, pathological anatomy, clinical, laboratory and imaging investigations, differential diagnosis, evolution, complications, prophylaxis with antiplatelet treatment of patients with IS. IS remains an important public health issue of great importance in terms of its reality and the morbidity it implies, although the tendency is to reduce epidemiological indicators. Platelet function testing may potentially be useful in monitoring the biological effect of platelet antiaggregant medication. Aggregometry could provide personalized prognostic information and may thus become a useful tool in designing strategies for prevention and management of ischemic stroke.
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.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.