Clinical characteristics of stroke patients with essential thrombocytosis according to Jak2 mutation

2015 ◽  
Vol 357 ◽  
pp. e406
Author(s):  
J. Rha ◽  
H. Park ◽  
C. Yoon ◽  
J. Kwon ◽  
S. Kim ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Stroke Patients ◽  
Essential Thrombocytosis ◽  
Jak2 Mutation

Abstract W P211: Clinical Characteristics of Pseudo Negative Cases in Prehospital Triage for Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Shuichi Tonomura
Keyword(s):  
Acute Stroke ◽  
Clinical Characteristics ◽  
Stroke Onset ◽  
The Other ◽  
Small Vessel ◽  
Stroke Patients ◽  
Vessel Occlusion ◽  
Stroke Subtypes ◽  
Prehospital Triage ◽  
Prehospital Diagnosis

Objective: The accuracy of prehospital diagnosis for stroke by emergency medical services (EMS) is improved using instruments for symptom recognition. On the other hand, prehospital misdiagnosis for stroke and subsequent delay in presentation to a hospital with stroke expertise play a critical role in the exclusion of potential therapeutic candidates. Our study aims to investigate the clinical characteristics of pseudo-negative cases in prehospital triage for stroke/TIA by EMS. Methods: From April 2013 to April 2014, consecutive 644 acute stroke patients were transferred by EMS to our hospital. We investigated prehospital diagnosis, Cincinnati prehospital stroke scale (CPSS) by EMS, neurological symptoms and complaints of patients themselves at stroke onset. We also examined activity of daily life (ADL) and cognitive impairments before stroke onset, and stroke subtypes in final diagnoses. Results: Among 644 acute stroke patients, 36 patients (22 men, mean 72.5±4.4 years old) were pseudo-negative cases in prehospital triage for stroke and had no abnormalities in CPSS by EMS. When EMS arrived at emergency site, 12 patients (33%) had loss of consciousness. Before stroke onset, 6 patients (17%) had impaired ADL (modified Rankin Scale >2), and 5 (14%) cognitive impairment. Among the stroke subtypes, the proportion of small vessel occlusion (22.4%, p=0.0025) and transient ischemic attack (TIA) (25%, p=0.0021) was significant higher in pseudo negative cases in prehospital triage; on the other hand, intracranial hemorrage (11%, p=0.0028) was lower. In complaint of patients themselves at stroke onset, weakness in one or two extremities was reported in 20 patients (56%), abnormal speech/language in 13 (36%), however all of them were not clarified by EMS. Conclusion: This study showed that small vessel occlusion and TIA tend to be misdiagnosed in a prehospital triage by EMS. The complaint of patients themselves at stroke onset is important to prehospital diagnoses by EMS.

Abstract 17352: Differences in Clinical Characteristics, Risk Factors, Rate of Recurrence and 1-year Outcome Between Acute Heart Failure Patients With Stroke or TIA and Those Without This Co-morbidity. Results From the Gulf aCute heArt failuRe rEgistry (gulf Care)

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Mohammed A Al Hashemi ◽  
Kadhim Sulaiman ◽  
Jassim Al-Suwaidi ◽  
Khalid F AlHabib ◽  
Husam AlFaleh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Heart Failure ◽  
Clinical Characteristics ◽  
De Novo ◽  
Stroke Patients ◽  
Lv Dysfunction ◽  
Co Morbidity ◽  
History Of ◽  
One Year ◽  
Ischemic Attack

Background: Chronic heart failure (CHF) is a known risk for stroke and morbidities and mortalities are known to be higher in CHF patients compared to stroke patients without CHF we here study the prevalence and the clinical significance in a group of patient with stroke or transient ischemic attack (TIA) who were admitted to hospital with acute heart failure (AHF) compared to those without stroke and are admitted with acute heart failure Methods: Data were derived from a prospective, multicenter, multinational study of 5005 patients hospitalized with AHF from February 2013 to November 2012. Data were analyzed according to the presence or absence of Stroke or bronchial TIA. Demographic, management, in-hospital and 1-year outcomes were compared Results: Stroke patients were likely to have a decompensation of chronic failure rather than De-Novo AHF when compared to those without Stroke/TIA (see table). Stroke patients were older; more likely to be female, have history of DM, HTN, dyslipidemia and CKD. Stroke patients were likely to have Atrial fibrillation, PVD, systolic LV dysfunction as well as CAD when compared to those without Stroke, they were also more likely receive NIV, IV inotropes and likely to have had cardiac PCI prior to this admission with AHF. Stroke patients had higher recurrence of stroke and one-year mortality rates. Conclusion: Patients who presented with AHF and history of stroke/TIA were having different clinical characteristics as well as comorbidities as compared to those without Stroke, with worse in-hospital and one-year outcome. The current study underlies the need to aggressively manage these high-risk patients.

Basic Clinical Syndromes and Definitions

2018 ◽  
pp. 1-21
Author(s):  
Aparna Pendurthi ◽  
Maxim Mokin
Keyword(s):  
Emergency Department ◽  
Acute Stroke ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Transient Ischemic Attacks ◽  
Stroke Patients ◽  
Duration Of Symptoms ◽  
Surgical Interventions ◽  
Clinical Syndromes

The goal for neurological evaluation in the Emergency Department is to appropriately route potential acute stroke patients toward medical or surgical interventions in the most expedient manner possible. This chapter focuses on familiarizing the reader with main stroke subtypes and clinical manifestations associated with specific syndromes. Acute neurologic episodes being evaluated in the emergent setting for stroke workup can be divided into broad categories based on duration of symptoms, clinical presentation, and findings from basic imaging. This chapter explores the most common of these stroke syndromes and discusses the classification and clinical characteristics of transient ischemic attacks and ischemic and hemorrhagic strokes.

White matter structure and clinical characteristics of stroke patients: A diffusion tensor MRI study

2016 ◽  
Vol 1635 ◽  
pp. 61-70 ◽  
Author(s):  
Ryo Ueda ◽  
Naoki Yamada ◽  
Wataru Kakuda ◽  
Masahiro Abo ◽  
Atsushi Senoo
Keyword(s):  
White Matter ◽  
Clinical Characteristics ◽  
Diffusion Tensor ◽  
Diffusion Tensor Mri ◽  
Stroke Patients ◽  
Mri Study

Hospitalized Hemorrhagic Stroke Patients with Renal Insufficiency: Clinical Characteristics, Care Patterns, and Outcomes

2014 ◽  
Vol 23 (9) ◽  
pp. 2265-2273 ◽  
Author(s):  
Bruce Ovbiagele ◽  
Lee H. Schwamm ◽  
Eric E. Smith ◽  
Maria V. Grau-Sepulveda ◽  
Jeffrey L. Saver ◽  
...  
Keyword(s):  
Renal Insufficiency ◽  
Clinical Characteristics ◽  
Hemorrhagic Stroke ◽  
Stroke Patients ◽  
Care Patterns

scholarly journals Thiol-disulphide homeostasis in essential thrombocythemia patients

2019 ◽  
Vol 38 (4) ◽  
pp. 475-480 ◽  
Author(s):  
Aysun Şentürk Yıkılmaz ◽  
Şule Mine Bakanay ◽  
Sema Akinci ◽  
Murat Alisik ◽  
Özcan Erel ◽  
...  
Keyword(s):  
Platelet Function ◽  
Control Group ◽  
Essential Thrombocytosis ◽  
Jak2 Mutation ◽  
Total Thiol ◽  
Study Results ◽  
The Status ◽  
Thrombotic Complications ◽  
And Gender ◽  
Oxidation Mechanisms

Summary Background This study aimed to show the status of thioldisulphide homeostasis in essential thrombocytosis patients, which is known to play a role in platelet function. Methods The study included 27 ET patients and a control group of 36 healthy subjects. Serum total (–SH + –S–S–) and native (–SH) thiol levels were measured in all subjects using an automatic method. Results Age and gender distribution were similar in both groups. Compared with the control group, in the ET group, there were increased native thiol and total thiol levels (p = 0.001, p = 0.046). There was no correlation between thiol, total thiol and disulphide ratios with Jak2 mutation, hemorrhage and thrombosis. A positive correlation was determined between thrombosis and thiol disulphide homeostasis (p = 0.058). The study results showed that thiol-disulphide homeostasis shifted to the proliferative side in ET, in which ineffective erythropoiesis was predominant. It is also known that platelets are more active in ET cases and thiol disulphide balance is important in platelet function. Conclusions This result suggests that thrombotic complications may be reduced if the formation is achieved of mechanisms (oxidation mechanisms) that will trigger the increase of disulphide groups. However, more extensive research is needed on this subject.

scholarly journals Incidence and Clinical Characteristics of Ischemic Stroke Patients with Underlying Cancer

2019 ◽  
Vol 12 (2) ◽  
Author(s):  
Soon Woo Kwon ◽  
Won Jun Meng ◽  
Hae in Lee ◽  
Doo Young Kim ◽  
Sung-Bom Pyun
Keyword(s):  
Ischemic Stroke ◽  
Clinical Characteristics ◽  
Stroke Patients

scholarly journals 01 Development and validation of a pragmatic prehospital tool to identify stroke MIMIC patients

2019 ◽  
Vol 36 (1) ◽  
pp. e1.1-e1
Author(s):  
Graham McClelland ◽  
Darren Flynn ◽  
Helen Rodgers ◽  
Chris Price
Keyword(s):  
Clinical Characteristics ◽  
List Type ◽  
Stroke Patients ◽  
Stroke Mimics ◽  
Primary Hospital ◽  
Stroke Services ◽  
Suspected Stroke ◽  
Stroke Mimic ◽  
High Level ◽  
Development And Validation

BackgroundStroke mimics (SM) are non-stroke conditions producing similar symptoms to stroke. Prehospital stroke identification tools prioritise sensitivity over specificity, therefore >25% of prehospital suspected stroke patients are SM. Failure to identify SM Results in inefficient use of ambulances and specialist stroke services. We developed a pragmatic tool for paramedics, using information often available in the prehospital setting, to identify SM amongst suspected stroke patients.MethodsThe initial tool was developed using a systematic literature review to identify SM characteristics, a survey of UK paramedics to explore the acceptability of SM identification and regression analysis of clinical variables documented in ambulance records of suspected stroke patients linked to their primary hospital diagnoses (n=1,650, 40% SM).The initial tool was refined using two focus groups with paramedics (n=3) and hospital clinicians (n=9) and analysis of an expanded prehospital dataset (n=3,797, 41% SM) to produce the final STEAM tool.ResultsSTEAM scores six variables:1 point for Systolic blood pressure <90 mmHg1 point for Temperature >38.5°C with heart rate >90 bpm1 point for seizures or 2 points for seizures with diagnosed Epilepsy1 point for Age <40 years or 2 points for age <30 years1 point for headache with diagnosed Migraine1 point for FAST–veA score of ≥2 on STEAM predicted SM diagnosis in the expanded derivation dataset with 5.5% sensitivity, 99.6% specificity and positive predictive value (PPV) of 91.4%. STEAM was validated using an external dataset (n=1,848, 33% SM) of prehospital suspected stroke patients where STEAM was 5.5% sensitive, 99.4% specific with a PPV of 82.5%.ConclusionsSTEAM uses common clinical characteristics to identify a small number of SM patients with a high level of certainty. The benefits of reducing SM admissions to specialist stroke services should be weighed against delayed admission for the small number of stroke patients identified as a SM.

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