Acute Ischemic Stroke

2017 ◽  
Author(s):  
Harold P. Adams
Keyword(s):  
Public Health ◽  
Blood Flow ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Health Problem ◽  
Neurological Disease ◽  
Public Health Problem ◽  
Neurological Outcomes ◽  
Success Of Treatment ◽  
Early Restoration

Ischemic stroke is a leading public health problem and the most common acute neurological disease. Advances in the understanding of the pathophysiology of stroke, in particular the importance of early restoration of adequate perfusion, have resulted in improvements in the management of patients with acute ischemic stroke. The interval from onset of stroke until the administration of interventions to restore blood flow is a crucial factor in success of treatment. Still, patients with stroke now are being treated successfully with neurological outcomes improving. These advances are reducing the likelihood of death or disability from this potentially devastating neurological disease.

scholarly journals Cerebrolysin effects on neurological outcomes and cerebral blood flow in acute ischemic stroke

2014 ◽  
pp. 2299 ◽  
Author(s):  
Yousef Rezaei ◽  
Mohammad Reza Amiri-Nikpour ◽  
Surena Nazarbaghi ◽  
Babak Ahmadi-Salmasi ◽  
Tayebeh Mokari ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Neurological Outcomes

Kindesmisshandlung und deren Langzeitfolgen – Analyse einer repräsentativen deutschen Stichprobe

2019 ◽  
Vol 67 (2) ◽  
pp. 100-111 ◽  
Author(s):  
Andreas Witt ◽  
Rebecca Brown ◽  
Paul L. Plener ◽  
Elmar Brähler ◽  
Jörg M. Fegert ◽  
...  
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Public Health Problem ◽  
Nachhaltige Entwicklung

Zusammenfassung. Kindesmisshandlung stellt einen bedeutenden Risikofaktor für die Entwicklung dar. Einzelne Formen von Kindesmisshandlung treten häufig nicht isoliert auf, sondern das gemeinsame Auftreten verschiedener Formen von Kindesmisshandlung stellt eher die Regel als die Ausnahme dar. Neben den langfristigen und vielfältigen individuellen Folgen führt Kindesmisshandlung jährlich zu einer hohen gesamtgesellschaftlichen Belastung. Die WHO hat Kindesmisshandlung als großes Public Health Problem identifiziert und die Vereinten Nationen haben den Kampf gegen Kindesmisshandlung zum Ziel in ihrer Agenda für nachhaltige Entwicklung gemacht. In dem vorliegenden Beitrag werden die Häufigkeit sowie das gemeinsame Auftreten unterschiedlicher Formen von Kindesmisshandlung sowie deren Assoziation mit psychischen und somatischen Folgen auf Basis einer bevölkerungsrepräsentativen Stichprobe untersucht und dargestellt. Die Ergebnisse verdeutlichen den Zusammenhang zwischen der Kumulation verschiedener Formen von Misshandlung und negativen Folgen für die Betroffenen. So ist das Risiko für negative Konsequenzen beim Erleben von vier oder mehr Formen von Misshandlung um das bis zu 10-fache erhöht. Viel zu selten werden die kumulativen Effekte von mehreren Belastungen berücksichtigt. Gerade weil die Wirkweisen über die Misshandlung, die Gesundheit beeinflusst, zunehmend gut untersucht sind, muss dieses Wissen im Gesundheitswesen stärker bei der Konzeption von Präventions- und Interventionsmaßnahmen berücksichtigt werden.

PUBLIC HEALTH PROBLEM IN THE HISTORY OF RUSSIAN SOCIOLOGY

2017 ◽  
Vol 19 (3) ◽  
pp. 155-159
Author(s):  
I.E. Levchenko ◽  
◽  
A.Y. Kuznetsov ◽  
E.G. Korniltseva ◽  
◽  
...  
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Public Health Problem ◽  
History Of

Difusi dan Pola Spasial Sebaran Penyakit Demam Berdarah Dengue (DBD) Di Kota Bandar Lampung

2018 ◽  
Vol 1 (1) ◽  
pp. 87-95
Author(s):  
Nurul Qamila ◽  
Agel Vidian Krama
Keyword(s):  
Public Health ◽  
Spatial Analysis ◽  
Aedes Aegypti ◽  
Dengue Virus ◽  
Spatial Pattern ◽  
Dengue Hemorrhagic Fever ◽  
Health Problem ◽  
Public Health Problem ◽  
Hemorrhagic Fever ◽  
Descriptive Method

Dengue hemorrhagic fever (DHF) is a contagious disease caused by the dengue virus and is transmitted by the mosquito Aedes aegypti (Aa.aegypti). The population is still a public health problem that increases the number of sufferers and also widespread, with population and education. This study aims to reveal the spatial pattern and distribution of Dengue Hemorrhagic Fever (DHF) with the spatial pattern and the spread of Dengue Hemorrhagic Fever (DHF) can result in different locations of these allegations. From the map that can be used for the prevention of Dengue Hemorrhagic Fever (DBD) in Bandar Lampung City. This study aims to reveal the spatial pattern and distribution of Dengue Hemorrhagic Fever (DHF) with the descriptive method and spatial pattern of Dengue Hemorrhagic Fever (DHF) can result in different locations of these allegations. From the map that can be used for the prevention of Dengue Hemorrhagic Fever (DBD) in Bandar Lampung City. Keywords: DHF, Spatial Analysis

Revascularization and functional outcomes after mechanical thrombectomy for acute ischemic stroke in elderly patients

2020 ◽  
Vol 132 (4) ◽  
pp. 1182-1187 ◽  
Author(s):  
Carrie E. Andrews ◽  
Nikolaos Mouchtouris ◽  
Evan M. Fitchett ◽  
Fadi Al Saiegh ◽  
Michael J. Lang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Elderly Patients ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Multivariate Logistic Regression Analysis ◽  
Standard Of Care ◽  
Stroke Severity ◽  
Vessel Occlusion ◽  
Younger Patients ◽  
Success Of Treatment

OBJECTIVEMechanical thrombectomy (MT) is now the standard of care for acute ischemic stroke (AIS) secondary to large-vessel occlusion, but there remains a question of whether elderly patients benefit from this procedure to the same degree as the younger populations enrolled in the seminal trials on MT. The authors compared outcomes after MT of patients 80–89 and ≥ 90 years old with AIS to those of younger patients.METHODSThe authors retrospectively analyzed records of patients undergoing MT at their institution to examine stroke severity, comorbid conditions, medical management, recanalization results, and clinical outcomes. Univariate and multivariate logistic regression analysis were used to compare patients < 80 years, 80–89 years, and ≥ 90 years old.RESULTSAll groups had similar rates of comorbid disease and tissue plasminogen activator (tPA) administration, and stroke severity did not differ significantly between groups. Elderly patients had equivalent recanalization outcomes, with similar rates of readmission, 30-day mortality, and hospital-associated complications. These patients were more likely to have poor clinical outcome on discharge, as defined by a modified Rankin Scale (mRS) score of 3–6, but this difference was not significant when controlled for stroke severity, tPA administration, and recanalization results.CONCLUSIONSOctogenarians, nonagenarians, and centenarians with AIS have similar rates of mortality, hospital readmission, and hospital-associated complications as younger patients after MT. Elderly patients also have the capacity to achieve good functional outcome after MT, but this potential is moderated by stroke severity and success of treatment.

Mechanical thrombectomy in pediatric stroke: systematic review, individual patient data meta-analysis, and case series

2019 ◽  
Vol 24 (5) ◽  
pp. 558-571 ◽  
Author(s):  
Kartik Bhatia ◽  
Hans Kortman ◽  
Christopher Blair ◽  
Geoffrey Parker ◽  
David Brunacci ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Neurological Outcomes

OBJECTIVEThe role of mechanical thrombectomy in pediatric acute ischemic stroke is uncertain, despite extensive evidence of benefit in adults. The existing literature consists of several recent small single-arm cohort studies, as well as multiple prior small case series and case reports. Published reports of pediatric cases have increased markedly since 2015, after the publication of the positive trials in adults. The recent AHA/ASA Scientific Statement on this issue was informed predominantly by pre-2015 case reports and identified several knowledge gaps, including how young a child may undergo thrombectomy. A repeat systematic review and meta-analysis is warranted to help guide therapeutic decisions and address gaps in knowledge.METHODSUsing PRISMA-IPD guidelines, the authors performed a systematic review of the literature from 1999 to April 2019 and individual patient data meta-analysis, with 2 independent reviewers. An additional series of 3 cases in adolescent males from one of the authors’ centers was also included. The primary outcomes were the rate of good long-term (mRS score 0–2 at final follow-up) and short-term (reduction in NIHSS score by ≥ 8 points or NIHSS score 0–1 at up to 24 hours post-thrombectomy) neurological outcomes following mechanical thrombectomy for acute ischemic stroke in patients < 18 years of age. The secondary outcome was the rate of successful angiographic recanalization (mTICI score 2b/3).RESULTSThe authors’ review yielded 113 cases of mechanical thrombectomy in 110 pediatric patients. Although complete follow-up data are not available for all patients, 87 of 96 (90.6%) had good long-term neurological outcomes (mRS score 0–2), 55 of 79 (69.6%) had good short-term neurological outcomes, and 86 of 98 (87.8%) had successful angiographic recanalization (mTICI score 2b/3). Death occurred in 2 patients and symptomatic intracranial hemorrhage in 1 patient. Sixteen published thrombectomy cases were identified in children < 5 years of age.CONCLUSIONSMechanical thrombectomy may be considered for acute ischemic stroke due to large vessel occlusion (ICA terminus, M1, basilar artery) in patients aged 1–18 years (Level C evidence; Class IIb recommendation). The existing evidence base is likely affected by selection and publication bias. A prospective multinational registry is recommended as the next investigative step.

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