Mood Disorder Following Cerebrovascular Accident

1989 ◽  
Vol 154 (2) ◽  
pp. 195-200 ◽  
Author(s):  
M. R. Eastwood ◽  
S. L. Rifat ◽  
H. Nobbs ◽  
J. Ruderman
Keyword(s):  
Risk Factors ◽  
Psychiatric Disorder ◽  
Depressed Mood ◽  
Cerebrovascular Accident ◽  
Patient Population ◽  
Stroke Rehabilitation ◽  
Brain Lesion ◽  
Hemispheric Differences ◽  
Rehabilitation Unit ◽  
History Of

Depression appears to be common after stroke, and therefore may have a bearing upon rehabilitation. To examine whether the depression is due to a specific brain lesion, or is reactive to the consequent disability, this study looked at the frequency and associations of depressed mood in a stroke rehabilitation unit in-patient population, unselected for site of lesion. Depression affected 50% of the patients; history of previous psychiatric disorder and cerebrovascular accident appeared to be important risk factors. There were hemispheric differences in the relationships between measures, with both the site-of-lesion and reactive viewpoints being upheld.

Maternity Blues

1989 ◽  
Vol 155 (3) ◽  
pp. 367-373 ◽  
Author(s):  
Helen Kennerley ◽  
Dennis Gath ◽  
Susan Iles
Keyword(s):  
Psychiatric Disorder ◽  
Social Adjustment ◽  
Depressed Mood ◽  
Previous History ◽  
History Of ◽  
Case Status ◽  
Obstetric Factors ◽  
In Pregnancy

One hundred and six women were assessed psychiatrically in the 14–16th and 36–38th weeks of pregnancy and the 12th week after childbirth. They also completed a maternity blues questionnaire daily in the ten days after delivery. Blues scores were significantly associated with: neuroticism; anxiety and depressed mood during pregnancy; fear of labour; poor social adjustment; and retrospective severity of pre-menstrual tension. Blues scores were not associated with obstetric factors, with previous history of psychiatric disorder, or with case status on the PSE in pregnancy or 12 weeks after delivery.

scholarly journals The moderating role of underlying predictors of survival in patients with brain stroke: a statistical modeling

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Nasrin Someeh ◽  
Seyed Morteza Shamshirgaran ◽  
Farshid Farzipoor ◽  
Mohammad Asghari-Jafarabadi
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Oral Contraceptive ◽  
Cerebrovascular Accident ◽  
Oral Contraceptive Pill ◽  
Related Factors ◽  
Contraceptive Pill ◽  
History Of ◽  
Brain Stroke ◽  
Age Category

Abstract Determining subclinical Brain stroke (BS) risk factors may allow for early and more operative BS prevention measures to find the main risk factors and moderating effects of survival in patients with BS. In this prospective study, a total of 332 patients were recruited from 2004 up to 2018. Cox's proportional hazard regressions were used to analyze the predictors of survival and the moderating effect by introducing the interaction effects. The survival probability 1-, 5- and 10-year death rates were 0.254, 0.053, and 0. 023, respectively. The most important risk factors for predicting BS were age category, sex, history of blood pressure, history of diabetes, history of hyperlipoproteinemia, oral contraceptive pill, hemorrhagic cerebrovascular accident. Interestingly, the age category and education level, smoking and using oral contraceptive pill moderates the relationship between the history of cerebrovascular accident, history of heart disease, and history of blood pressure with the hazard of BS, respectively. Instead of considerable advances in the treatment of the patient with BS, effective BS prevention remains the best means for dropping the BS load regarding the related factors found in this study.

scholarly journals Prekallikrein Deficiency Presenting as Recurrent Cerebrovascular Accident: Case Report and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Esteban Uribe Bojanini ◽  
Arturo Loaiza-Bonilla ◽  
Agustin Pimentel
Keyword(s):  
Risk Factors ◽  
Cerebrovascular Accident ◽  
Clinical Manifestations ◽  
Activated Partial Thromboplastin Time ◽  
Review Of The Literature ◽  
Cerebrovascular Accidents ◽  
History Of ◽  
Thrombotic Complications ◽  
Mri Changes ◽  
Accident Case

We report the case of a woman with history of hypertension and hyperlipidemia presenting with recurrent episodes consistent clinically with cerebrovascular accidents (CVA), and MRI changes suggestive of ischemia versus vasculitis as their cause. No anatomical neurological, rheumatic, cardioembolic, or arteriosclerotic etiologies could be determined by extensive workup. Incidentally, the patient was found to have prolonged activated Partial Thromboplastin Time (aPTT) and a normal Prothrombin Time (PT); further testing revealed a prekallikrein deficiency. Since no other cause for the CVAs was established, and other prothrombotic states were ruled out, it is proposed that they are clinical manifestations derived from the prekallikrein deficiency, which in a patient with known cardiovascular risk factors could lead to thrombotic complications such as stroke.

67 Identifying Risk Factors that Increase Analgesic Requirements at Discharge Among Patients with Burn Injuries

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S47-S48
Author(s):  
Celine Yeung ◽  
Alex Kiss ◽  
Sarah Rehou ◽  
Shahriar Shahrohki
Keyword(s):  
Risk Factors ◽  
Neuropathic Pain ◽  
Patient Population ◽  
Substance Misuse ◽  
Burn Injuries ◽  
Surgical Debridement ◽  
Care Providers ◽  
Burn Care ◽  
History Of ◽  
Higher Doses

Abstract Introduction Opioids and neuropathic pain agents (NPAs) like gabapentin and pregabalin are commonly prescribed in large doses to achieve adequate pain control among patients with burn injuries. This patient population is therefore at greater risk of becoming dependent and misusing analgesics following their injuries. Factors that increase the risk of chronic use of opioids or NPAs among this patient population has not yet been characterized. The purpose of this study was to identify factors that increase the amount of analgesics required by patients with acute burn injuries at the time of discharge. Methods Patient charts from July 1, 2015 - 2018 were reviewed retrospectively to determine opioid and neuropathic pain agent (NPAs) requirements 24 hours before discharge (n = 199). Regression models were performed to determine whether the following risk factors increased analgesic requirements at discharge: surgical intervention; age; gender; TBSA; history of psychiatric disorder; and history of substance misuse. Results Patients with a history of substance misuse or who were managed surgically required higher doses of opioids at discharge compared to those without a history of misuse or those who were managed conservatively (p = 0.01 and 0.02, respectively). Similarly, patients who had undergone surgery required more NPAs compared to those who did not have surgical debridement of their injuries (p < 0.001). For every percent increase in TBSA, patients required 14 mg more NPAs (p = 0.01). In contrast, older patients and those with a longer hospital stay required fewer amounts of NPAs before they were discharged from hospital. For every increase in years of age, patients required on average 7 mg less NPAs (p = 0.006), and for each additional day in a patient’s length of stay, patients required 6 mg less NPAs (p = 0.009). Conclusions Predictors of high analgesic requirements at discharge include patients with a history of substance misuse, those who underwent surgical debridement of their burn injuries, and patients with higher TBSA. Characterizing patient risk factors that increase analgesic requirements may help burn care providers tailor how much narcotics and NPAs to prescribe each patient at discharge.

Predictors of restenosis after carotid artery stenting in 241 cases

2015 ◽  
Vol 8 (7) ◽  
pp. 677-679 ◽  
Author(s):  
Badih Daou ◽  
Nohra Chalouhi ◽  
Robert M Starke ◽  
Richard Dalyai ◽  
Adam Polifka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Multivariate Analysis ◽  
Carotid Artery ◽  
Cerebrovascular Accident ◽  
Carotid Artery Stenting ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression ◽  
History Of

BackgroundVariable rates of restenosis after carotid artery stenting (CAS) have been reported, and few predictors have been suggested. Because CAS is being performed with increasing frequency, more data are needed to evaluate the rate and predictors of restenosis and possibly identify new risk factors for restenosis after CAS. The aim of this study was to analyze the rate and predictors of restenosis after CAS.Methods241 patients with carotid artery stenosis treated with stenting were analyzed retrospectively to identify patients who had restenosis after stenting. Univariate analysis and multivariate logistic regression were conducted to determine the predictors of restenosis.ResultsMean patient age was 67.5 years. 8.3% of patients who underwent CAS had carotid restenosis of ≥50% during follow-up. 3.7% of patients required retreatment. Mean duration from CAS to retreatment was 11 months. In multivariate analysis, the predictors of restenosis included history of cardiovascular disease (OR=8.88, p<0.001) and having a cerebrovascular accident (CVA) prior to stenting (OR=1.87, p=0.034). A higher percentage of preoperative carotid stenosis was associated with higher odds of restenosis in univariate analysis (p=0.04, OR stenosis ≥80%=5.7).ConclusionsOur results suggest that the rate of carotid restenosis after stenting is low. Patients with cardiovascular disease, patients who had a CVA prior to stenting, and patients with higher percentages of preoperative stenosis had higher odds of restenosis. Higher rates of restenosis should be kept in mind when opting for CAS in these patients.

scholarly journals Quantifying the Contribution of Risk Factors for Ischemic Stroke in Patients with a History of TIA

ISRN Stroke ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-7
Author(s):  
Duncan C. Ramsey ◽  
Mark G. Burnett ◽  
Matthew C. Cowperthwaite
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Patient Population ◽  
Stroke Risk ◽  
Significant Risk ◽  
Individual Risk ◽  
Readmission Rates ◽  
Cardiovascular Comorbidities ◽  
History Of ◽  
Ischemic Attack

Background. Patients with a history of transient ischemic attack (TIA) are known to be at higher risk for a stroke. We sought to investigate predictors of individual risk for an ischemic stroke within 30 days of a TIA. Methods and Results. A retrospective analysis of 57,585 TIA admissions was collected from 155 United States hospitals. Data describing each admission included demographic and clinical data, and information about the admitting hospital. Cerebrovascular disease was the primary readmission reason (19% of readmissions) in the TIA patient population. The prevalence of 30-day ischemic stroke readmissions was 11 per 1,000 TIA admissions; however, 53% of stroke readmissions occurred within one week. Hierarchal regression models suggested that peripheral vascular disease and hypertensive chronic kidney disease were significant individual stroke risk factors, whereas history of myocardial infarction, essential hypertension, and diabetes mellitus was not associated with significant stroke risk. Certified stroke centers were not associated with significantly lower stroke readmission rates. Conclusions. The results suggest that cardiovascular comorbidities confer the most significant risk for an ischemic stroke within 30 days of a TIA. Interestingly, certified stroke centers do not appear to be associated with significantly lower stroke-readmission rates, highlighting the challenges managing this patient population.

Preoperative Risk Factors for Nasal Carriage of Staphylococcus aureus

2004 ◽  
Vol 25 (6) ◽  
pp. 481-484 ◽  
Author(s):  
Loreen A. Herwaldt ◽  
Joseph J. Cullen ◽  
Pamela French ◽  
Jianfang Hu ◽  
Michael A. Pfaller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Cerebrovascular Accident ◽  
Antimicrobial Agents ◽  
Nasal Carriage ◽  
Male Gender ◽  
Stepwise Logistic Regression ◽  
Stepwise Logistic Regression Analysis ◽  
Surgical Specialty ◽  
History Of

AbstractBackground:Staphylococcus aureus nasal carriage is a risk factor for surgical-site infections (SSIs) caused by S. aureus, and eradication of carriage reduces postoperative nosocomial infections caused by it. No study has compared large groups of preoperative carriers and non-carriers to identify factors that are linked to S. aureus nasal carriage.Methods:While conducting a clinical trial evaluating whether mupirocin prevented S. aureus SSIs, we prospectively collected data on 70 patient characteristics that might be associated with S. aureus carriage. We performed stepwise logistic regression analysis.Results:Of the 4,030 patients, 891 (22%) carried S. aureus. Independent risk factors for S. aureus nasal carriage were obesity (odds ratio [OR], 1.29; 95% confidence interval [CI95], 1.11-1.50), male gender (OR, 1.29; CI95,1.11-1.51), and a history of a cerebrovascular accident (OR, 1.53; CI95, 1.03-2.25) for all patients. Factors associated with nasal carriage varied somewhat by surgical specialty. In all groups, preoperative use of antimicrobial agents was independently associated with a lower risk of carrying S. aureus in the nares. Previously identified risk factors were not significantly associated with S. aureus nasal carriage in this large group of surgical patients.Conclusion:Male gender, obesity, and a history of a cerebrovascular accident were identified as risk factors for S. aureus nasal carriage. It remains to be seen whether preoperative weight loss would reduce the rate of nasal carriage. In addition, the value of screening this patient population for S. aureus nasal carriage merits further investigation.

Protective Factors and Suicidality in Members of Arab Kindred

Crisis ◽  
2012 ◽  
Vol 33 (2) ◽  
pp. 80-86 ◽  
Author(s):  
Sami Hamdan ◽  
Nadine Melhem ◽  
Israel Orbach ◽  
Ilana Farbstein ◽  
Mohammad El-Haib ◽  
...  
Keyword(s):  
Risk Factors ◽  
Protective Factors ◽  
Suicidal Behavior ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Suicidal Risk ◽  
Arab Population ◽  
Psychiatric Interview ◽  
History Of

Background: Relatively little is known about the role of protective factors in an Arab population in the presence of suicidal risk factors. Aims: To examine the role of protective factors in a subsample of in large Arab Kindred participants in the presence of suicidal risk factors. Methods: We assessed protective and risk factors in a sample of 64 participants (16 suicidal and 48 nonsuicidal) between 15 and 55 years of age, using a comprehensive structured psychiatric interview, the Composite International Diagnostic Interview (CIDI), self-reported depression, anxiety, hopelessness, impulsivity, hostility, and suicidal behavior in first-degree and second-relatives. We also used the Religiosity Questionnaire and suicide attitude (SUIATT) and multidimensional perceived support scale. Results: Suicidal as opposed to nonsuicidal participants were more likely to have a lifetime history of major depressive disorder (MDD) (68.8% vs. 22.9% χ2 = 11.17, p = .001), an anxiety disorder (87.5% vs. 22.9, χ2 = 21.02, p < .001), or posttraumatic stress disorder (PTSD) (25% vs. 0.0%, Fisher’s, p = .003). Individuals who are otherwise at high risk for suicidality have a much lower risk when they experience higher perceived social support (3.31 ± 1.36 vs. 4.96 ± 1.40, t = 4.10, df = 62, p < .001), and they have the view that suicide is somehow unacceptable (1.83 ± .10 vs. 1.89 ± .07, t = 2.76, df = 60, p = .008). Conclusions: Taken together with other studies, these data suggest that the augmentation of protective factors could play a very important role in the prevention of incidental and recurrent suicidal behavior in Arab populations, where suicidal behavior in increasing rapidly.

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