A retrospective analysis of 254 acute stroke cases admitted to two university hospitals in Beirut: classification and associated factors

Abstract Background Cancers of unknown primary site (CUPs) are heterogeneous group of metastatic tumors for which a standardized diagnostic work-up could not recognize the site of origin at the time of diagnosis. Cancer registries around the world report the incidence of CUP in the range of 3%–5% of all malignancies, worldwide the overall age-standardized incidence per 100.000 people per year is 4–19 cases. CUP therefore ranks among the top 10 commonest malignancies. CUP occurs equally in both males and females, at average age 60 years old. Incidence of CUP in Egypt is 6.1%in males and 5.5% in females. Aim of the Work to retrospectively identify the prognostic factors that influence treatment outcome and survival of patients diagnosed with cancer of unknown primary treated patients at Clinical Oncology departments at Ain Shams University Hospitals (ASUH) and Helwan University Hospitals by retrospective analysis. Patients and Methods At the department of clinical oncology, Ain Shams University, 102 patients with cancer of unknown primary were identified in the period between January 2012 and December 2017, all patients data was collected and reviewed. The primary end point of this study is to identify different prognostic factors that influence treatment response and OS in 102 patients with CUP in the period from January 2012 to December 2017. Results Patients with PS 1, with no comorbidities showed better treatment response, also Patients younger than 65year, presented with PS1, with no comorbidity had longer survival. Conclusion CUP has a poor prognosis. Some prognostic factors that affect response to treatment and survival in these patients, which may be identified.

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Level of Adherence and Associated Factors Among HIV-Infected Patients on Antiretroviral Therapy in Northern Ethiopia: Retrospective Analysis

Patient Preference and Adherence ◽

10.2147/ppa.s268395 ◽

2020 ◽

Vol Volume 14 ◽

pp. 1585-1594

Author(s):

Abraham Aregay Desta ◽

Kibriti Mehari Kidane ◽

Ataklti Gebretsadik Woldegebriel ◽

Kiros Fenta Ajemu ◽

Asfawosen Aregay Berhe ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Retrospective Analysis ◽

Associated Factors ◽

Northern Ethiopia

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Measuring Patient Safety Climate in Acute Stroke Therapy

Frontiers in Neurology ◽

10.3389/fneur.2021.686649 ◽

2021 ◽

Vol 12 ◽

Author(s):

Ferdinand O. Bohmann ◽

Joachim Guenther ◽

Katharina Gruber ◽

Tanja Manser ◽

Helmuth Steinmetz ◽

...

Keyword(s):

Patient Safety ◽

Acute Stroke ◽

Safety Climate ◽

Stroke Care ◽

University Hospitals ◽

Acute Stroke Care ◽

Safety Attitudes ◽

Patient Safety Climate ◽

Stroke Team ◽

First Time

Background: Treatment of acute stroke is highly time-dependent and performed by a multiprofessional, interdisciplinary team. Interface problems are expectable and issues relevant to patient safety are omnipresent. The Safety Attitudes Questionnaire (SAQ) is a validated and widely used instrument to measure patient safety climate. The objective of this study was to evaluate the SAQ for the first time in the context of acute stroke care.Methods: A survey was carried out during the STREAM trial (NCT 032282) at seven university hospitals in Germany from October 2017 to October 2018. The anonymous survey included 33 questions (5-point Likert scale, 1 = disagree to 5 = agree) and addressed the entire multiprofessional stroke team. Statistical analyses were used to examine psychometric properties as well as descriptive findings.Results: 164 questionnaires were completed yielding a response rate of 66.4%. 67.7% of respondents were physicians and 25.0% were nurses. Confirmatory Factor Analysis revealed that the original 6-factor structure fits the data adequately. The SAQ for acute stroke care showed strong internal consistency (α = 0.88). Exploratory analysis revealed differences in scores on the SAQ dimensions when comparing physicians to nurses and when comparing physicians according to their duration of professional experience.Conclusion: The SAQ is a helpful and well-applicable tool to measure patient safety in acute stroke care. In comparison to other high-risk fields in medicine, patient safety climate in acute stroke care seems to be on a similar level with the potential for further improvements.Trial registration:www.ClinicalTrials.gov Identifier: NCT032282.

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Abstract TP238: Encephalopathy Only Stroke Codes (EoSC) Do Not Result in rt-PA Treatments

Stroke ◽

10.1161/str.51.suppl_1.tp238 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Patrick Chen ◽

Dawn Meyer ◽

Brett Meyer

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Acute Stroke ◽

Retrospective Analysis ◽

Thrombolytic Treatment ◽

Knowing That ◽

History Of ◽

Demographic Risk ◽

To Receive ◽

Demographic Risk Factor

Background: Isolated mental status changes as presenting sign (EoSC+), are not uncommon stroke code triggers. As stroke alerts, they still require the same intensive resources be applied. We previously showed that EoSC+ strokes (EoSC+CVA+) account for 8-9% of EoSC+ codes but only 0.1-0.2% of all codes. Whether these result in thrombolytic treatment (rt-PA), and the characteristics/ risk factor profiles of EoSC+CVA+ patients, have not been reported. Methods: Retrospective analysis of stroke codes from an IRB approved registry, from 2004 to 2018, was performed. EoSC+ definition used was consistent with prior publications (NIHSS>0 for Q1a, 1b, or 1c with remaining elements scored 0). Other definitions were also assessed. Characteristics and risk factors were compared for EoSC+, EoSC+CVA+, and rt-PA (EoSC+ CVA+TPA+) patients. Results: EoSC+ occurred in 59/2982 (1.98%) of all stroke codes. EoSC+CVA+ occurred in 8/59 (13.56%) of EoSC+ codes and 8/2982 (0.27%) of all stroke codes. 6/8 (75%) of EoSC+CVA+ scored NIHSS=1. Hispanic ethnicity (p=0.009), HTN (p=0.02), and history of stroke/TIA (p=0.002) were less common in EoSC+. No demographic/ risk factor differences were noted for [EoSC+CVA+ vs. EoSC+CVA-]. No cases of rt-PA eligibility/ treatment were noted. In EoSC+CVA+ analysis, imaging positive stroke/intracranial hemorrhage was noted on only 3 cases (3/2982=0.10% of all stroke codes) and none were posterior stroke. Conclusions: EoSC+ is not an uncommon reason to activate stroke codes, but rarely results in stroke/TIA (0.27%) or stroke (0.10%), and in our analysis never (0%) resulted in rt-PA. Sub-analysis did not show missed rt-PA or posterior strokes. This adds information for application of limited acute stroke code resources. Though stroke codes must still to be activated, understanding characteristics, and knowing that EoSC+CVA+ patients are unlikely to receive rt-PA, may help triage stroke resources. Further investigation is warranted.

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