scholarly journals Consequences of COVID-19 pandemic lockdown on emergency and stroke care in a German tertiary stroke center

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Robin Jansen ◽  
John-Ih Lee ◽  
Bernd Turowski ◽  
Marius Kaschner ◽  
Julian Caspers ◽  
...  
Keyword(s):  
Stroke Unit ◽  
Hot Spot ◽  
Stroke Care ◽  
Single Center ◽  
Stroke Patients ◽  
Number Of Patients ◽  
Single Center Study ◽  
The Mean ◽  
Stroke Center ◽  
Center Study

Abstract Background COVID-19 pandemic caused a decline in stroke care in several countries. The objective was to describe lockdown stroke care in a tertiary stroke center in Düsseldorf, Germany near Heinsberg, a German hot spot for COVID-19 in spring 2020. Methods In a retrospective, observational, single-center study, we compared all patients treated in our emergency department (ED), patients seen by a neurologist in the ED, ED patients suffering from ischemic and hemorrhagic strokes and transient ischemic attacks (TIAs) as well as stroke patients admitted to our stroke unit during lockdown in spring 2020 (16 March 2020–12 April 2020) to those cared for during the same period in 2019 and lockdown light in fall 2020 (2 November – 29 November 2020). Results In spring 2020 lockdown the mean number of patients admitted to our ED dropped by 37.4%, seen by a neurologist by 35.6%, ED stroke patients by 19.2% and number of patients admitted to our stroke unit by 10% compared to the same period in 2019. In fall lockdown light 2020 effects were comparable but less pronounced. Thrombolysis rate was stable during spring and fall lockdown, however, endovascular treatment (EVT) rate declined by 58% in spring lockdown and by 51% in fall lockdown compared to the period in 2019. Conclusions Our study indicates a profound reduction of overall ED patients, neurological ED patients and EVT during COVID-19 pandemic caused lockdowns. Planning for pandemic scenarios should include access to effective emergency therapies.

Independent predictors of mortality in subacute and chronic stroke patients: A single center study in Turkey

2017 ◽  
Vol 30 (5) ◽  
pp. 987-990 ◽  
Author(s):  
Gökhan Tuna Öztürk ◽  
Ender Erden ◽  
Süha Yalçın ◽  
Hüma Bölük ◽  
İlkay Karabay ◽  
...  
Keyword(s):  
Chronic Stroke ◽  
Single Center ◽  
Stroke Patients ◽  
Predictors Of Mortality ◽  
Single Center Study ◽  
Center Study

scholarly journals Stroke subtypes in southern Iran

2015 ◽  
Vol 4 (1) ◽  
pp. 47-49
Author(s):  
Rasool Safari ◽  
Afshin Borhanihaghighi ◽  
Seyed Taghi Heydari ◽  
Anahid Safari ◽  
Salvador Cruz-Flores
Keyword(s):  
Ischemic Stroke ◽  
Subarachnoid Hemorrhage ◽  
Intracerebral Hemorrhage ◽  
Single Center ◽  
Stroke Patients ◽  
Stroke Subtype ◽  
Younger Patients ◽  
Single Center Study ◽  
Length Of Hospitalization ◽  
Center Study

Objective: To investigate about frequency of different subtypes of stroke in south of IranMethods: This  is a retrospective, single-center study  conducted at Namazi Hospital, Shiraz, south of Iran. Age, sex, length of hospitalization and  mortality  of  stroke patients were recorded by reviewing hospital medical records.Results: 16 351 patients (53.6% male, 46.4%female) were recruited.  Ischemic stroke (10750 patients, 65.7%), intracerebral hemorrhage(3282 patients,20.1%) and subarachnoid hemorrhage(1057 patients,6.5%)  were the most common subtypes of stroke, respectively. In 1262 patients (7.7%) the stroke subtype could not been specified. Ischemic stroke and intracerebral hemorrhage were more common in men but subarachnoid hemorrhage was more common in women. Subarachnoid hemorrhage occurred significantly in younger patients. Mortality was significantly higher in intracerebral hemorrhage. Hospital stay was significantly longer in subarachnoid hemorrhage group.Conclusion: the distribution of the different  subtypes of stroke in Iran is similar to Caucasians.

The effects of full weight-bearing mobilization on clinical outcomes and subsidence in cemented and uncemented hemiarthroplasty in osteoporotic patients: A retrospective single-center study

2021 ◽  
pp. 1-8
Author(s):  
Betül Başar ◽  
Hakan Başar
Keyword(s):  
Clinical Outcomes ◽  
Weight Bearing ◽  
Femoral Stem ◽  
Harris Hip Score ◽  
Full Weight Bearing ◽  
Single Center ◽  
Single Center Study ◽  
Uncemented Hemiarthroplasty ◽  
The Mean ◽  
Center Study

BACKGROUND: Early full weight-bearing mobilization is controversial in osteoporotic patients who have undergone uncemented hemiarthroplasty (CH). OBJECTIVES: The aim of the study was to compare the results of early full weight-bearing mobilization in CH and uncemented hemiarthroplasty (UCH). The effect of subsidence on the results was also evaluated. METHODS: Fifty-nine patients who underwent CH and UCH were evaluated. The mean age was 79.8 years (10 females, 15 males) for CH and 75.5 years (10 females, 24 males) for UCH. All patients started immediate full weight-bearing mobilization and weight-bearing exercises. RESULTS: There was no difference between the groups according to the Harris Hip Score. Both groups were evaluated in subgroups according to whether there is varus in the femoral stem. There was no difference between subgroups according to the Harris Hip Score. The femoral subsidence was not determined in CH group. In the UCH group, the subsidence was 1.13 ± 1.03 mm in varus femoral stem subgroup and 0.81 ± 0.85 mm in without femoral stem varus subgroup. There was no difference in subsidence between femoral stem with varus and without varus. The subsidence did not affect the Harris Hip Score. CONCLUSION: Full weight-bearing mobilization could be safely preferred in UCH, as in CH. Femoral stem varus below 5 degrees does not affect the results and subsidence.

Abstract WP7: Does Administration of IV Contrast Impact Outcomes on Acute Ischemic Stroke Patients? A Propensity Score Matched Single Center Study

Stroke ◽  
2019 ◽  
Vol 50 (Suppl_1) ◽  
Author(s):  
Kavit Shah ◽  
Stephan A Mayer ◽  
Meredith G Van Harn ◽  
Mohammed Ismail ◽  
Lonni Schultz ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Propensity Score ◽  
Acute Ischemic Stroke ◽  
Single Center ◽  
Stroke Patients ◽  
Single Center Study ◽  
Center Study

scholarly journals Post-Transplant Erythrocytosis in Live Donor Kidney Transplant Recipients: A Retrospective Single Center Study

2020 ◽  
Vol 42 (3) ◽  
pp. 62-66
Author(s):  
Suresh Maharjan ◽  
Santosh Chhetri ◽  
Bikash Khatri ◽  
Nisha Sapkota ◽  
Mahesh R Sigdel
Keyword(s):  
Kidney Transplant ◽  
Transplant Recipients ◽  
Single Center ◽  
Kidney Transplant Recipients ◽  
Donor Kidney ◽  
Live Donor Kidney ◽  
Single Center Study ◽  
The Mean ◽  
Mean Time ◽  
Center Study

Introduction Post-transplant erythrocytosis (PTE) is defined as persistently elevated hemoglobin>17 g/dl and/or PCV>51% in kidney transplant recipients. The incidence of PTE varies from 5% to 17%, with occasional life‑threatening thromboembolic complications. We aimed to study the prevalence, risk factors and complications of PTE. MethodsWe conducted a retrospective single center study in 132 kidney transplant recipients who had undergone live donor kidney transplantation at Tribhuvan University Teaching Hospital, Nepal, between October 2017 and March 2019. Prior approval was obtained from Institutional Review Committee of Institute of Medicine. Patients with hemoglobin>17 g/dl were defined as PTE group, and others as non‑PTE group. The pattern of hemoglobin, serum creatinine, pre-transplant hemoglobin, native kidney disease, immunosuppression medications, rejection episodes, and new onset diabetes after transplantation were analyzed and compared between two groups. ResultsOut of the 132 kidney transplant recipients, PTE was diagnosed in 28 (21.2%) patients, out of which 27 patients (96.4%) were male and 1 (3.6%) were female with the mean time of onset at 7 months after transplantation. Patients with erythrocytosis had a relatively shorter duration of pre transplant dialysis (p=0.001). The mean pre transplant Hb and Hct in PTE group was 9.72g/dl and 30.35% whereas in non PTE group 10.02 g/dl and 31.31%. Thromboembolic and any other PTE related complications were not observed. Seventeen patients of PTE (60.7%) were treated with ACE Inhibitors and 11 (39.9%) patients did not require any treatment. ConclusionPost-transplant erythrocytosis was seen in nearly one fifth kidney transplant recipients at mean time of seven months post-transplantation; was more common in male with good graft function, and short duration of pre transplant dialysis. Response to ACE inhibitors was good.

scholarly journals Is Piecemeal Endoscopic Resection Acceptable for Early Colorectal Cancers in Certain Situations? A Single-Center French Study

2020 ◽  
Vol 29 (3) ◽  
pp. 353-360
Author(s):  
Jean-Philippe Ratone ◽  
Fabrice Caillol ◽  
Christophe Zemmour ◽  
Erwan Bories ◽  
Christian Pesenti ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Single Center ◽  
En Bloc ◽  
Number Of Patients ◽  
Single Center Study ◽  
Center Study

Background and Aims: The use of endoscopic treatment for early colorectal cancer (ECC) is increasing. The European guidelines suggest performing piecemeal endoscopic resection (pmR) for benign lesions and en bloc resection for ECC, especially for patients with favorable lymph node involvement risk evaluations. However, en bloc resections for lesions larger than two centimeters require invasive endoscopic techniques. Our retrospective single-center study aimed to determine the clinical impact of performing pmR for ECC rather than traditional en bloc resection. Methods: A single-center study was performed between January 2012 and September 2017. All ECC patients were included. The main objective was to evaluate the number of patients who potentially underwent unnecessary surgery due to piecemeal resection. The secondary endpoints were as follows: disease-free survival (DFS), defined as the time from pmR to endoscopic failure (local recurrence not treatable by endoscopy), complication rate, number of patients who did not undergo surgery by default, and factors predictive of outcomes and complications. Results: One hundred and forty-six ECC endoscopically treated patients were included. In total, 85 patients were excluded (71 who underwent en bloc resection, 14 with pending follow-up). Data from 61 patients (33 women and 28 men) were analyzed. Two patients underwent potentially unnecessary surgery [3.28% (0.9%- 11.2%)]. The DFS rate was 87% (75%-93%) at 6 months and 85% [72%-92%] at 12 months. The median follow- up time was 16.5 months (12.4-20.9). Three patients (4.9%) had complications. One patient did not undergo surgery by default. A Paris classification of 0-2c (HR=9.3 (2.4-35.9), p<0.001) and Vienna classification of 5 [HR=16.3 (3.3-80.4), p<0.001] were factors associated with poor DFS. Conclusion: Performing pmR in place of en bloc resection for ECC had a limited impact on patients. If the pathology (especially deep margins) is analyzable, careful monitoring could be acceptable in ECC patients who undergo pmR.

scholarly journals The effect of montelukast in children with asthma predictive ındex negative episodic viral wheezing

2021 ◽  
Author(s):  
Ayşe Aydoğdu ◽  
Cihan Fidan
Keyword(s):  
Median Number ◽  
Potential Treatment ◽  
Single Center ◽  
Predictive Index ◽  
Pediatric Allergy ◽  
Allergy And Immunology ◽  
Single Center Study ◽  
Children With Asthma ◽  
The Mean ◽  
Center Study

Background: The effectiveness of montelukast for wheezing in young children is not clear. We aimed to evaluate whether the use of montelukast in the treatment of wheezing affects the number of attacks in children aged 1 to 6 years. Methods: This is a single center study. It was conducted between August 2019 – 2020. Children with aged 0-6 years old with a wheezing complaint who applied to the pediatric allergy and immunology outpatient clinic were included in the study. Modified asthma predictive index of the patients were evaluated. It was classified as episodic viral wheezing (EVW) or multiple trigger wheezing (MTW) based on the type of wheezing. Montelukast treatment was started and the number of attacks was checked. Results: The total of 141 children who applied with wheezing complaints were included in the study. The majority of the patients were boys (n=99). The mean age of the children was 4.2 ± 1.5 years. The median number of attacks before treatment was 2 (2-3). In 2.8% of the patients, eczema, in 12.8% of them, rhinitis and in 26.7% of them, elevated eosinophils were detected. IgE levels were 148.25 ± 279.20 IU/mL. According to the number of attacks before treatment, there was a significant decrease in the number of attacks in the control (p <0.001). Conclusion: In this study, montelukast has been shown to reduce the number of EVW attacks and we believe montelukast may be a potential treatment option for EVW in preschool children.

scholarly journals How Does 2016 WHO Criteria for Polycythemia Vera Contribute to Our Daily Practice? A Single-Center Study from Turkey

2020 ◽  
Author(s):  
Rafet Eren ◽  
Bahar Funda Sevinçoğlu ◽  
Esma Evrim Doğan ◽  
Demet Aydın ◽  
Nihan Nizam ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Polycythemia Vera ◽  
Daily Practice ◽  
Single Center ◽  
Who Criteria ◽  
Number Of Patients ◽  
Single Center Study ◽  
Serum Erythropoietin ◽  
Center Study ◽  
Who 2008

Background: We evaluated the frequency of subnormal erythropoietin levels, JAK2V617F positivity and polycythemia vera (PV) in patients who did not meet WHO 2008 criterion for hemoglobin levels but were suggested to be investigated for PV in 2016 revision. Materials and Methods: We assessed the data of 92 patients, who were further evaluated with JAK2V617F mutation and serum erythropoietin (EPO) levels and bone marrow biopsy, if necessary. We also compared this patient group with 20 patients whose Hgb>18.5 g/dL for men and >16.5 g/dL for women. Results: Nine patients (45%) in the higher hemoglobin group were JAK2V617F positive, while 4 patients (4.3%) in the lower hemoglobin group were JAK2V617F positive (p<0.001). The number of patients with serum EPO levels <4.3 mIU/mL was significantly higher in the higher hemoglobin group (n=13, 65%) than the lower hemoglobin group (n=7, 7.6%) (p<0.001). Finally, the number of patients who received a diagnosis of PV was significantly higher in the higher hemoglobin group (n=13, 65%) than the lower hemoglobin group (n=9, 9.8%) (p<0.001). Conclusion: We found a substantial increase in patients who were candidates for testing for PV with the introduction of WHO 2016 criteria; these patients were diagnosed with PV with a rate (9.8%) that cannot be underestimated.  

scholarly journals Measuring rFIX-Fc with 17 Different Combinations Coagulometers — Reagents: A Single Center Study

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5016-5016
Author(s):  
Thomas Sinegre ◽  
Adeline Trayaud ◽  
Maryse Tardieu ◽  
Laurie Talon ◽  
Aurélie Vaissade ◽  
...  
Keyword(s):  
Single Center ◽  
Bleeding Events ◽  
Target Concentration ◽  
Low Concentrations ◽  
Single Room ◽  
Single Center Study ◽  
Activity Measurements ◽  
Target Values ◽  
The Mean ◽  
Center Study

Abstract rFIX-Fc is an extended half-life (EHL) recombinant FIX concentrate approved for the prophylaxis and treatment of bleeding events in haemophilia B. A high laboratory and reagent-specific variability is described for rFIX-Fc activity measurements, overall in lower FIX concentrations. The aim of this single-center study was to evaluate the intra-laboratory variability of 17 different combinations coagulometers/reagents including both one stage clotting (OSC) and chromogenic assays with a focus on lower concentrations. Human FIX deficient plasma (FIX<1%, George King Bio-Medical) was spiked with rFIX-Fc at 150%, 100%, 80%, 20%, 5%, 2% and 1% based on label potency. We evaluated the spikes recovery with 3 coagulometers (STAR MAX (Stago), ACL TOP700 (Werfen) and Cs2100 (Siemens)) using for each instrument captive silica based aPTT reagents (PTT automate (Stago) and Pathromtin (Siemens)) and non-silica based (CK Prest (Stago), Synthafax (Werfen) and Actin FS (Siemens)). Two reagents (STA-Cephascreen (Stago) and Synthafax (Werfen)) were evaluated on all coagulometers because they potentially behave one the same way for EHL FIX products. The 2 available chromogenic assays (ROS FIXa (Rossix) and Biophen FIX:C were evaluated on all coagulometer. All experiments were performed by the same staff, in a single room, in triplicates with 3 dilutions. For a given combination, all the concentrations were evaluated on the same calibration curve. The spike recovery were calculated as the (mean of 3 experiments / targeted FIX value) x 100. The range values of 70% - 130% were considered as acceptable for spike recoveries'. The summary of all spikes recoveries' are presented in table 1. We confirmed that kaolin based OSC assays underestimate rFIX-Fc including for low concentrations. Acceptable recoveries were found for PTT automate on Stago coagulometer from 150% to 5% and an underestimation was found for low concentrations (2% and 1 %). Pathromtin and Actin FS performed on Cs2100 display acceptable recoveries on all the range of target values. Synthasil performed on ACL TOP700 have acceptable recoveries from 150% to 20% and an overestimation was found for low concentrations (5% to 1%). STA-Cephascreen performed on the 3 coagulometers has acceptable recoveries, except for low concentrations (5% to 1%) on ACL TOP coagulometer, leading to an overestimation of rFIX-FC measurements. Synthafax performed on the 3 coagulometers has acceptable recoveries with ACL TOP700 coagulometer for all the range of concentrations. This reagent adapted on STAR MAX coagulometer shows an overall overestimation of rFIX-Fc measurements (except for the 150% target concentration) and when adapted on a Cs2100 coagulometer, it displays acceptable recoveries except for low concentrations (5% to 1%) that are overestimated. The two chromogenic assays have acceptable recoveries for rFIX-Fc on all coagulometers from 150% to 50% concentrations. ROS FIXa underestimated rFIX-Fc recovery for the lower concentrations (1% and 2%) on STAR MAX and ACL TOP700 coagulometers. Biophen FIX:C underestimated rFIX-Fc recoveries for concentrations below 50% with all coagulometers. This study provides the pattern of several combinations coagulometers - reagents for rFIX-Fc measurements and confirms a high variability for several reagents for low concentrations. Table. Table. Disclosures Lebreton: Sobi: Consultancy, Research Funding.

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