scholarly journals Physiological parameters deterioration in acute stage after stroke: Rehabilitation versus conventional care

2019 ◽  
Vol 10 (3) ◽  
pp. 79
Author(s):  
Reham AbdElhamed AbdElmawla Elsaid ◽  
Amina Mohamed AbdElfatah Sliman
Keyword(s):  
Acute Stroke ◽  
Acute Phase ◽  
Stroke Rehabilitation ◽  
Recovery Period ◽  
Acute Stage ◽  
Conventional Care ◽  
Physiological Parameters ◽  
Stroke Recovery ◽  
University Hospital ◽  
Control Group

Objective: Stroke is considered the main health problem and the second leading cause of death worldwide. Stroke resulting in varied and unpredictable complications if not managed correctly in the acute stage with intensive rehabilitation therapy which may affect stroke prognosis, and resulting functional decline. Therefore, the aim of the study was to explore the consequences of rehabilitation versus conventional care on physiological parameters during the acute stroke recovery period.Methods: The quasi-experimental research design was used in the neurology department at Mansoura University Hospital. A convenient sample of sixty-four adult patients of both sex with stroke, who corresponded to inclusion criteria was assigned into two equal groups, study group (rehabilitation group) and control group (conventional care).Results: The results indicates, acute phase rehabilitation limit physiological parameters deterioration during acute stroke recovery period comparing to conventional care only.Conclusions: Acute phase stroke rehabilitation has a significant positive impact on physiological parameters.

scholarly journals Change of acute stage reactants level in experimental intramedullary osteosynthesis

2014 ◽  
Vol 95 (3) ◽  
pp. 395-398
Author(s):  
I F Akhtyamov ◽  
F V Shakirova ◽  
L D Zubairova ◽  
E B Gatina ◽  
E I Aliev
Keyword(s):  
Acute Phase ◽  
Plasma Protein ◽  
Intervention Group ◽  
Acute Stage ◽  
Protein Fractions ◽  
Blood Protein ◽  
Control Group ◽  
Specific Response ◽  
Total Blood ◽  
Acute Phase Reactants

Aim. To assess the plasma protein fractions as organism’s reaction to osteosynthesis by medical devices made of medical steel and of medical steel coated by titanium and gafnium nitrides mixture. Methods. Diaphyseal tibial fracture was modeled on 30 rabbits with further assessment of animal organism reaction to osteosynthesis by pins made of medical steel and of medical steel coated by super-hard metal nitrides mixture. The change of blood plasma protein fractions and acute phase reactants was used as an indicator. Measurements were performed before the osteosynthesis and on the 5th and 180th day after the surgery. Results. Together with the stable level of total blood protein, dysproteinemia characteristic for acute phase of the inflammation was observed after the trauma and reparatory process induction. Two-waived reaction was registered. The first developed at the 5th day after the surgery and was characterized by the drop of blood albumin level together with α- and β2-globulin levels increase, the reaction was observed in the intervention group earlier compared to control group. The second wave developed at the 180th day and was characterized by β2- and γ-globulin levels increase. The registered changes corresponded with the phases of acute non-specific response, which includes the overproduction of «positive» and decreased production of «negative» acute phase reactants by liver, influenced by cytokines, as well as later adaptive immune response. Conclusion. Overall, the intensity of acute phase reactions was lower in the intervention group, indicating less damage associated with titanium and gafnium nitrides coated implants use.

The Effectiveness of Mirror Therapy to Upper Extremity Rehabilitation in Acute Stroke Patients

2021 ◽  
Author(s):  
Phassakorn Klinkwan ◽  
Chalunda Kongmaroeng ◽  
Sombat Muengtaweepongsa ◽  
Wiroj Limtrakarn
Keyword(s):  
Acute Stroke ◽  
Upper Extremity ◽  
Upper Limb ◽  
Conventional Therapy ◽  
Motor Recovery ◽  
Stroke Recovery ◽  
Home Exercise ◽  
Control Group ◽  
Mirror Therapy ◽  
Stroke Patients

Rehabilitation is a crucial part of stroke recovery to help them regain use of their limb. The aim of this article was to compare the effectiveness of long-term training of mirror therapy with conventional rehabilitation therapy on neurological and recovery of upper limb in acute stroke patients. In this randomized and assessor-blinded control study, 20 acute stroke patients were analyzed in this study and allocated to a case (n = 10, 50.6 ± 17.90 years) and control group (n = 10, 55.9 ± 11.25 years). All the participants performed daily home exercise during 12 weeks. The patients in the control group were treated with conventional therapy (CT) and a group of cases were treated with mirror therapy (MT) alone program. The outcome measurements were assessed by a therapist blinded assessor using Fugl-Meyer Assessment (FMA) upper extremity score, Brunnstrom recovery stages (BRS), Modified Ashworth Scale (MAS) and Muscle Strength to evaluate upper limb motor function and motor recovery. Data were analyzed using Wilcoxon and Mann-Whitney U tests to compare within-groups and between-group differences. The results revealed that, after 12 weeks of treatment, patients of both groups presented statistically significant improvements in all the variables measured (p < 0.05). Compared with the control group, the patients of the MT group had greater improvement in the proximal movement portion of the FMA upper extremity mean score change (15.8 ± 3.2 versus 10.0 ± 2.7, p = 0.002) while there were no differences in other variables (p > 0.05). There were also no adverse events. It suggests that 12 weeks training of mirror therapy alone was likely to improve the motor recovery of the upper limb and activity of daily living in acute stroke patients than conventional therapy, if treated early.

scholarly journals Determinants of persistent post-COVID-19 symptoms: value of a novel COVID-19 symptom score

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Islam Galal ◽  
Aliae A. R. Mohamed Hussein ◽  
Mariam T. Amin ◽  
Mahmoud M. Saad ◽  
Hossam Eldeen E. Zayan ◽  
...  
Keyword(s):  
Symptom Score ◽  
Acute Phase ◽  
Acute Attack ◽  
Cross Sectional Study ◽  
Acute Stage ◽  
University Hospital ◽  
Cross Sectional ◽  
Before And After ◽  
The Mean ◽  
Main Determinants

Abstract Background Being a newly emerging disease, little is known about its long-lasting post-COVID-19 consequences. The aim of this work is to assess the frequency, patterns, and determinants of persistent post-COVID-19 symptoms and to evaluate the value of a proposed novel COVID-19 symptom score. Patients with confirmed COVID-19 in a hospital-based registry were included in a cross-sectional study (the hospitals including Assiut University Hospital, Assiut Chest Hospital, Aswan University Hospital, and Aswan Specialized Hospital). The patient demographics, comorbid disorders, the mean duration since the onset of the symptoms, history of hospital or ICU admittance, and the treatment taken during the acute state, as well as symptom score before and after convalescence, were recorded. Results The most frequent constitutional and neurological symptoms were myalgia (60.0%), arthralgia (57.2%), restriction of daily activities (57.0%), and sleeping troubles (50.9%), followed by anorexia (42.6%), chest pain (32.6%), gastritis (32.3%), cough (29.3%), and dyspnea (29.1%). The mean total score of acute stage symptoms was 31.0 ± 16.3 while post-COVID 19 symptom score was 13.1 ± 12.6 (P < 0.001). The main determinants of the persistent post-COVID-19 symptoms were the need for oxygen therapy (P < 0.001), pre-existing hypertension (P = 0.039), chronic pulmonary disorders (P = 0.012), and any chronic comorbidity (P = 0.004). There was a correlation between the symptom score during the acute attack and post-COVID-19 stage (P < 0.001, r = 0.67). The acute phase score had 83.5% sensitivity and 73.3% specificity for the cutoff point > 18 to predict occurrence of post-COVID-19 symptoms. Conclusions COVID-19 can present with a diverse spectrum of long-term post-COVID-19 symptoms. Increased acute phase symptom severity and COVID-19 symptom score > 18 together with the presence of any comorbid diseases increase the risk for persistent post-COVID-19 manifestations and severity.

Abstract TP95: Novel Biomarkers of Acute Ischemic Stroke Using MicroRNA Analysis

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jason King ◽  
Evgeny Sidorov ◽  
Jairam Vanamala ◽  
Cynthia Bejar ◽  
Vijay Indukuri ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Acute Phase ◽  
Chronic Phase ◽  
Rna Isolation ◽  
Acute Stage ◽  
Stroke Recovery ◽  
Stroke Severity ◽  
Mirna Regulation ◽  
Case Control Studies

Background: Despite recent advances in treatment, early diagnosis and prognosis of acute ischemic stroke (AIS) suffers from significant limitations. Growing number of mostly case-control studies have determined that noncoding, micro-ribonucleic acid (miRNAs) play a role in the pathophysiologic processes related to cerebral ischemia and post-stroke recovery. This pilot project is a longitudinal study, which investigates difference in miRNA regulation in acute vs. chronic stage of ischemic stroke. Hypothesis: Expression of some miRNAs is significantly altered in acute stage of ischemic stroke. Methods: Blood and urine specimens collected during the acute phase (<72 hours) of ischemic stroke and at follow-up phases (within 3 months) were used to quantify the expression of five selected miRNAs (miRNA 21-5p; miRNA 124-5p, miRNA 126, miRNA 223, and miRNA 298) using 20 sample pairs (N=40) available with urine and blood specimens. Total RNA from frozen blood samples were isolated using the mir VANA RNA isolation kit (Ambion, USA). We extracted exosomal RNA from urine samples using exosome kit (Qiagen, USA). We ran miRNA expression assays using TaqMan probes (Applied Biosciences, USA) on 384-well microplates using QuantStudio 6 available in our lab. Each assay was run in duplicates using endogenous (U6) and blank controls. Results: The miRNA21-5p was significantly down-regulated (p<0.0001) at the acute phase in both blood and urine; inversely, miRNA124 was significantly upregulated (p<0.0001) at the acute phase vs. the chronic phase. The increased expression of miRNA 124-5p in both urine and serum strongly correlated with a lower stroke scale (NIHSS score (<8)), and its expression was significantly diminished with the increase in stroke severity (NIHSS >10). Expression of exosomal miRNA126 extracted from urine, was significantly upregulated (p<0.0001) during the acute phase, but remained unchanged at the acute and chronic phase (p=0.857) in serum. Conclusion: Our study showed the dysregulation of important miRNAs in acute stage of stroke. The upregulation of miRNA 124-5p in strokes with lower NIHSS may serve as early prognostic biomarker. Once replicated in larger scale studies, it will provide novel insights on understanding stroke pathophysiology.

Effect and Safety of Naomaili Granules (脑脉利颗粒) for the Treatment of Acute Ischemic Stroke: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial

2020 ◽  
Author(s):  
Xiaogang Li ◽  
Dongjing Song ◽  
Peiyang Zhou ◽  
Huagang Wang ◽  
Chengfang Zhou ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Western Medicine ◽  
Treatment Plan ◽  
Integrated Treatment ◽  
Acute Stage ◽  
Control Group ◽  
Significant Difference ◽  
Experimental Group

Abstract Background: It is of vital importance for the treatment and prognosis of Acute Stroke to find effective Chinese medicine that can be combined with western medicine in the acute stage. The purpose of this study is to investigate the effect and safety of Naomaili Granules (脑脉利颗粒, NML) for the treatment of acute stroke, hoping to provide a new idea and drug choice for the integrated treatment of Chinese and Western medicine in the acute stage of ischemic stroke, and at the same time to improve the treatment plan in the acute stage of ischemic stroke from the perspective of TCM syndromes. Methods: A total of 187 patients with acute ischemic stroke were randomly divided into the NML group (93 cases) and the placebo group (94 NML mimics), 1 bag (10g/bag), thrice daily for 20 days. Basic medications during the trial: Aspirin enteric-coated tablets, 1 tablet (0.1g/tablet), once a day. After treatment, the modified Rankin scale, the incidence of cardiovascular events and TCM Syndrome effect were the main efficacy indicators. Meanwhile, adverse events (AEs) were evaluated during the whole clinical trial. Results: In the FAS 90 days after the onset, the experimental group was 70.00%, and the control group was 45.24%. There was a statistically significant difference between the two groups. The incidence of acute cardio-cerebrovascular events was 1 case (1.08%) in the experimental group and 0 in the control group after 20 days of FAS treatment. Conclusion: The combined application of NML in the acute stage of ischemic stroke can effectively improve the prognosis of patients, and improve the independent survival ability of patients, and its safety is reliable, providing a new way of thinking and medication choice for the treatment of acute ischemic stroke with integrated traditional Chinese and western medicine.Trial registration: ChiCTR, ChiCTR2000033619. Registered 7 June 2020 - Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=54619

Problems of post-hospital rehabilitation of patients suffering from post-stroke depression

2020 ◽  
pp. 31-37
Author(s):  
M. A. Privalova ◽  
L. A. Karasaeva ◽  
G. A. Alekseev ◽  
A. A. Okhotnikova
Keyword(s):  
Cerebrovascular Accident ◽  
Recovery Period ◽  
Main Group ◽  
Stroke Recovery ◽  
Control Group ◽  
Antidepressant Medications ◽  
Post Stroke ◽  
Acute Cerebrovascular Accident ◽  
Post Stroke Depression ◽  
Hospital Rehabilitation

The article covers the issues of organization of rehabilitation at the post-hospital stage for patients who have suffered an acute cerebrovascular accident. According to statistics, almost half of patients who have suffered an acute cerebrovascular accident have a risk of a repeated stroke in the next five years of life against the background of manifestations of post-stroke depression. It is established that in these cases, one of the causes of repeated cerebrovascular accidents is the failure of patients to take prescribed antidepressant medications. The article analyzes two groups of patients who were observed in dynamics up to 6–12 months after the rehabilitation treatment in the Department of Neurology of the hospital. The main group included the patients with diagnosed post-stroke depression. The control group included patients without signs of clinically apparent depression. As a result of a retrospective study, it was found that 85,7 % of patients in the main group who had a repeated stroke did not adhere to the regime for taking antidepressant medications. Among the patients who continue to take antidepressants, there have not been repeated cases of cerebral circulatory disorders. Therefore, timely detection and correction of post-stroke depression in the early stroke recovery period and maintaining the principle of continuity at the post-hospital stage of rehabilitation contributes not only to the recovery of neurological deficit, but also reduces the risk of developing repeated disorders of cerebral circulation.

Self-esteem in an acute stroke rehabilitation sample: a control group comparison

2008 ◽  
Vol 22 (2) ◽  
pp. 179-187 ◽  
Author(s):  
Chad D. Vickery ◽  
Arash Sepehri ◽  
Clea C. Evans
Keyword(s):  
Acute Stroke ◽  
Stroke Rehabilitation ◽  
Self Esteem ◽  
Control Group ◽  
Group Comparison

MYCOPLASMA AND CHLAMYDIA AS ETHIOLOGICAL FACTORS OF BRONCHIAL ASTHMA IN TERMS OF ETHNOGENESIS

2013 ◽  
Vol 68 (7) ◽  
pp. 57-60
Author(s):  
O. A. Sharavii ◽  
S. V. Smirnova
Keyword(s):  
Immune Response ◽  
Chlamydia Trachomatis ◽  
Blood Serum ◽  
Bronchial Asthma ◽  
Mycoplasma Hominis ◽  
Acute Stage ◽  
Control Group ◽  
Clinical Markers ◽  
Chlamydophila Psittaci ◽  
Asthma Patients

 Aim. The study of the prevalence and clinical peculiarities of Mycoplasmosis and Chlamydiosis in patients with different pathogenic forms of bronchial asthma (BA) taking into account ethnicity of a patient. Subjects and Methods. The research covered 239 subjects – both the Europeoids and the Mongoloids in the city of Krasnoyarsk and the town of Kyzyl, all of them being BA patients of different stages, including acute stage and practically healthy. We had determined antigens Mycoplasma pneumoniae, Mycoplasma hominis, Chlamydophila pneumoniae, Chlamydophila psittaci and Chlamydia trachomatis in smears of mucosa of pharynx and antibodies to these antigens in peripheral blood serum. Results.  We found high frequency of Mycoplasmosis and Chlamydiosis in the inhabitants of Eastern Siberia, BA patients with different pathogenic forms as compared to control group. We had determined ethnic peculiarities of specific immune response: IgM to М. pneumoniae was revealed in the Europoids more frequently than in the Mongoloids, but IgM to С. pneumoniae and to C. trachomatis, C. trachomatis antigens had been revealed more often in the Mongoloids than in the Europoids. We accepted as clinical equivalents of Mycoplasmosis and Chlamydiosis diagnostics the following signs: temperature around 37C (subfebrile temperature), non-intensive but stable coughing with scanty mucous and muco-purulent sputum, dyspnea of mixed character. Conclusions. Mycoplasma and Chlamydia are meaningful etiologic factors of bronchial asthma. We have found the peculiarities of immune response depending on ethnicity of a patient (ethnic belonging). Clinical markers of Mycoplasmosis and Chlamydiosis should be taken into account in bronchial asthma in order to provide diagnostics timely as well as eradication of infection agents. Because of insufficient knowledge of problem of bronchial asthma related to contamination with Мycoplasma and Chlamydia we put the goal to study the frequency of Mycoplasmosis and Chlamydiosis occurrence in bronchial asthma patients and determine the characteristics clinical course of diseases. We defined antigens Мycoplasma pneumoniae, Мycoplasma hominis, Chlamydophila pneumoniaе, Chlamydophila psittaci, Chlamydia trachomatis in smears of oropharynx mucosa and antibodies to them in blood serum. 

A STUDY ON THE VARIATION IN CA 72-4 LEVELS OF THE GASTRIC CANCER’S PATIENTS BEFORE AND AFTER SURGERY TREATMENT

2011 ◽  
pp. 81-87
Author(s):  
Thi Thu Huong Hoang ◽  
Minh Vuong Nguyen
Keyword(s):  
Gastric Cancer ◽  
Study Groups ◽  
University Hospital ◽  
Control Group ◽  
Central Hospital ◽  
Before And After

Objectives: Studying on the variation in CA 72-4 levels of the gastric cancer’s patients before and after 10 days and 30 days surgery treatment. Materials and methods: The studying group included 42 gastric cancer’s patients who were examinated and treated in cancerology service of Hue University Hospital and gastroenterology service of Hue Central Hospital. The control group included 30 healthy normal examinated at Hue University Hospital. The study groups were clinical, endoscopic anatopathologic examination diagnosed with gastric cancer and quantitative levels of CA 72-4 in three times points: before surgerying, after surgerying 10 days and 30 days postoperatively. Rerults: The concentration of CA 72-4 in gastric cancer’s patients was 10.06 ± 16.49 U/ml. Clearly higher than the control group 1.2 ± 0.4 U/ml(p <0.01). The rate increased levels of CA 72-4 in gastric cancer’s patients before surgerying was 27.5% and the control group was 0%. After 10 days of surgery, CA 72-4 level was 5.56 ± 8.55 U/ml; 82.5% of patients have reduced levels of CA 72-4 and 17.5% no changes; there are 0% increased cases. After 30 days of surgery, CA 72-4 level was 3.79 ± 6,52 U/ml. CA 72-4 level 10 days after surgering have decreased significantly compared to before surgery (p < 0.05) and 30 days after surgery have decreased significantly compared to after 10 days (p < 0.05). 30 days postoperatively, 90% patients had reduced levels of CA 72-4, 10% no changes, no patient had increased levels of CA 72-4 and no patient be relapsed after 30 days of treatment. Conclusions: CA 72-4 concentrations before surgerying increased 27.5%, after surgery 10 days and 30 days reduced step by step, no case have increased CA 72-4 levels, no case relapsed after 30 days.

Prevalence of Thyroid Diseases in an Occupationally Radiation Exposed Group: A Cross-Sectional Study in a University Hospital of Southern Italy

2019 ◽  
Vol 19 (6) ◽  
pp. 803-808 ◽  
Author(s):  
Luigi Vimercati ◽  
Luigi De Maria ◽  
Francesca Mansi ◽  
Antonio Caputi ◽  
Giovanni M. Ferri ◽  
...  
Keyword(s):  
Ionizing Radiation ◽  
Healthcare Workers ◽  
Southern Italy ◽  
Cross Sectional Study ◽  
Thyroid Diseases ◽  
University Hospital ◽  
Control Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Exposed Workers

Background: Thyroid diseases occur more frequently in people exposed to ionizing radiation, but the relationship between occupational exposure to ionizing radiation and thyroid pathologies still remains unclear. Objective: To evaluate the prevalence of thyroid diseases in healthcare workers exposed to low-level ionizing radiation compared with a control group working at the University Hospital of Bari, Southern Italy, and living in the same geographical area, characterized by mild iodine deficiency. Methods: We ran a cross-sectional study to investigate whether healthcare workers exposed to ionizing radiation had a higher prevalence of thyroid diseases. Four hundred and forty-four exposed healthcare workers (241 more exposed, or “A Category”, and 203 less exposed, or “B Category”) and 614 nonexposed healthcare workers were enrolled during a routine examination at the Occupational Health Unit. They were asked to fill in an anamnestic questionnaire and undergo a physical examination, serum determination of fT3, fT4 and TSH, anti-TPO ab and anti-TG ab and ultrasound neck scan. Thyroid nodules were submitted to fine needle aspiration biopsy when indicated. Results: The prevalence of thyroid diseases was statistically higher in the exposed workers compared to controls (40% vs 29%, adPR 1.65; IC95% 1.34-2.07). In particular, the thyroid nodularity prevalence in the exposed group was approximately twice as high as that in the controls (29% vs 13%; adPR 2.83; IC95% 2.12-3.8). No statistically significant association was found between exposure to ionizing radiation and other thyroid diseases. Conclusion: In our study, mild ionizing radiation-exposed healthcare workers had a statistically higher prevalence of thyroid diseases than the control group. The results are likely due to a closer and more meticulous health surveillance programme carried out in the ionising radiation-exposed workers, allowing them to identify thyroid alterations earlier than non-exposed health staff.

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