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1.
Dilek Necioglu Orken Gulay Kenangil Ender Uysal Lale Gundogdu Ethem Erginoz Hulki Forta 《Clinical neurology and neurosurgery》2010
Background
The association of cerebral microbleeds (CMBs) with intracerebral hemorrhage (ICH) is well known and its relationship with low serum cholesterol in ICH patients might be of interest.Methods
A total of 105 patients with ICH were evaluated. In all subjects cholesterol levels were measured after 12 h of fasting and gradient-echo magnetic resonance imaging (GE-MRI) was performed for detecting CMBs.Results
CMBs were more common among patients with hypertension and leukoaraiosis (p = 0.008 and p = 0.001). Patients with and without CMBs did not differ according to total cholesterol, LDL cholesterol, triglycerides and HDL cholesterol levels.Conclusion
In this study, 61% of Turkish ICH patients had CMBs, which was not associated with lipid profiles. Leukoaraiosis was independently associated with CMBs. 相似文献2.
Ezio Zanon Renzo Manara Marta Milan Barbara Brandolin Daniela Mapelli Rodica Mardari Sandra Rosini Piero Amodio 《Thrombosis research》2014
Background
Studies providing information about the cognitive profile of adult haemophiliacs are lacking.Aims
To assess the neuropsychological profile in a group of Haemophiliac patients; to detect asymptomatic cerebral microbleeds (CMBs) and any correlation between CMBs and cognitive dysfunctions; to verify how several contributing factors may determine cognitive dysfunctions and/or Magnetic Resonance Imaging (MRI) findings.Methods
Adult haemophiliacs without history of brain bleeding were prospectively enrolled on Padua Haemophilia Centre. Patients underwent: i) “Short Neuropsychological Test” assessing cognitive functions (Short Neuropsychological Examination) to obtain an overall cognitive performance (OCP) profile standardised on a cohort matched for age, sex, cultural profile; ii) MRI of the brain to evaluate areas of brain atrophy or haemorrhagic lesions. We collected information on anti-haemorrhagic treatment, cardiovascular risk profile, viral infections, birth trauma.Results
49 adults with haemophilia (31 severe-moderate, 18 mild) were enrolled. 73% of patients presented a reduction in OCP. According to OCP, no significant difference between severe and mild haemophilia was observed though scores tended to be worse in severe haemophilia (mean Z score 0.20 ± 0.10 vs s0.15 ± 0.11). Considering risk factors, OCP correlated significantly with coronary artery disease (p = 0.02). MRI findings in 44 patients, indicated CMBs were inversely related to OCP (R = − 0.32 p < 0.05). CMBs were associated with cardiovascular risk factors (p = 0.018).Conclusions
Adult haemophiliacs seem to present high prevalence of mild cognitive dysfunctions that doesn’t correlate with the severity of haemophilia probably for the few number of patients evaluated. OCP impairment seems to be related to the presence of CMBs and of risk factors for cardiovascular disease. 相似文献3.
Background
The aim of this retrospective study was to identify the factors which can predict the development of new onset post-operative Hydrocephalus following transsphenoidal surgery for pituitary adenomas.Methods
A total of 224 patients with the diagnosis of pituitary adenoma and without preoperative Hydrocephalus were identified from 1995 to 2012. Age, gender, tumor volumes, prior craniotomy and irradiation, outcome, hospital stay, CSF leak, infection and functional status of the tumor were included in the model for analysis.Results
A total of 13 patients (5.8%) developed new onset post-operative Hydrocephalus. Intraoperative and post-operative CSF leaks were noted in 19 (8.5%) and 17 (7.6%) patients respectively. CSF infection was seen in only 7 (3.1%) patients. Age of the patient (p = 0.010), length of hospital stay (p = 0.012), intraoperative CSF leak (p = 0.000), post-operative CSF leak (p = 0.000) and CSF infection (p = 0.000) had shown significant correlation with the de novo onset of postoperative HC. The independent predictors of post-operative HC were post-operative CSF leak [p = 0.002, OR 27.898, 95% CI 3.350–232.311] and intra-operative CSF leak [p = 0.050, OR 7.687, 95% CI 1.003–58.924].Conclusion
Age of the patient, intra-operative and post-operative CSF leak, CSF infection and duration of hospital stay were correlated with the development of HC. Post-operative and intra-operative CSF leaks were the independent predictors of new onset HC. 相似文献4.
Barış Ekici Nur Aydınlı Kubilay Aydın Mine Çalışkan Emine Eraslan Meral Özmen 《Clinical neurology and neurosurgery》2013
Objective
We aimed to analyze the development of epilepsy in a patient group with periventricular leukomalacia followed at a tertiary pediatric neurology center.Patients and methods
The study included 108 children aged between 2 and 8 years with radiologically proven periventricular leukomalacia who had been regularly observed at the Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Pediatric Neurology outpatient clinic between January 2006 and December 2011.Results
Neonatal seizures were reported in 22 patients (20.3%), 14 of whom developed epilepsy. A significant correlation was found between neonatal seizures and prematurity and newborn asphyxia (p = 0.013 and p = 0.010, respectively). Epilepsy developed in 35 patients (32.4%), history of neonatal seizures and more severe loss of white matter, periventricular hyperintensity and corpus callosum involvement were found to be correlated with epilepsy (p = 0.001, p = 0.004, p = 0.016, and p = 0.004, respectively). The most common seizure pattern observed was generalized tonic clonic seizures (n = 13) and complex partial seizures (n = 11). Those with focal EEG findings had a significantly better neurodevelopmental and cognitive level than those with multifocal/generalized EEG findings (p = 0.024). Seizures continued with varying frequency in 14 epileptic patients (40%) despite antiepileptic treatment.Conclusion
Almost a third of patients with periventricular leukomalacia develop epilepsy that can be intractable in substantial part. Neonatal seizures and severe MRI findings are important clues that can indicate the development of epilepsy in these patients. 相似文献5.
Soraya Stoquart-ElSankari Christine BottinMartine Roussel-Pieronne Olivier Godefroy 《Clinical neurology and neurosurgery》2010
Background
Action slowing is frequently observed in multiple sclerosis (MS) patients. Several factors may account for response slowing: motor, perceptual, cognitive deficits, global mental slowing. Our objective was to examine mechanisms accounting for action slowing in MS patients.Methods
Twenty MS patients, free of visual impairment and of upper limbs sensory–motor deficit underwent previously validated reaction time (RT) tests using visual stimuli. Three tasks were used: (1) motor tapping, (2) simple reaction time (SRT) in a simple and dual task condition, and (3) choice RT (CRT) with varying response probabilities. Results were compared to those of 20 healthy matched subjects.Results
MS patients had: (1) lower motor tapping frequency (p = 0.02); (2) SRT lengthening (p = 0.001) related to a lower proportion of fast responses (p = 0.001) indicating attentional deficit whereas perceptuomotor index was spared (p = 0.5), without higher sensitivity to dual task (p = 0.9); and (3) CRT lengthening (p = 0.001) with spared decision time (p = 0.7).Conclusions
This study showed that action slowing of MS patient is mainly related to (1) attentional deficit resulting in inability to maintain high level of rapid actions, and (2) subtle motor slowing even in patients without motor deficit on clinical examination, whereas (3) divided attention and decisional process are preserved. 相似文献6.
Young-Min Park Seung-Hwan Lee Sangrae Kim Sung-Man Bae 《Progress in neuro-psychopharmacology & biological psychiatry》2010
Background
Serotonergic dysfunction in schizophrenia, bipolar disorder, major depressive disorder, anxiety disorder, and healthy controls was evaluated by measuring the activity of the loudness dependence of the auditory evoked potential (LDAEP).Methods
The 357 subjects who were evaluated comprised 55 normal controls, 123 patients with major depressive disorder, 37 with bipolar disorder, 46 with schizophrenia, 37 with panic disorder (PD), 31 with generalized anxiety disorder (GAD), and 28 with post-traumatic stress disorder (PTSD).Results
LDAEP was significantly stronger in healthy controls than in patients with either bipolar disorder (p = 0.025) or schizophrenia (p = 0.008), and significantly stronger in patients with major depressive disorder than in those with bipolar disorder (p = 0.01) or schizophrenia (p = 0.03). LDAEP did not differ significantly between patients with major depressive disorder and healthy control subjects (p = 0.667), or between healthy control subjects and patients with anxiety disorder, including PD (p = 0.469), GAD (p = 0.664), and PTSD (p = 0.167).Conclusion
The findings of the present study reveal that patients with major psychiatric disorders exhibit different strengths of LDAEP according to their serotonin-related pathology. Studies controlled for psychotropic medication, menstruation cycle, and smoking are needed. 相似文献7.
Christian Veauthier Gunnar Gaede Helena Radbruch Sandra Gottschalk Klaus-Dieter Wernecke Friedemann Paul 《Clinical neurology and neurosurgery》2013
Objective
In a previous polysomnographic cross-sectional study we found a significant relationship between sleep disorders and multiple sclerosis (MS) related fatigue. The purpose of this open follow-up observation was to compare the impact of treatment of sleep disorders on MS related fatigue measured with the Modified Fatigue Impact Scale (MFIS).Methods
Non-randomized follow-up observation: treated versus untreated patients, subgroups according to compliance with sleep medical treatment recommendations (univariate, multivariate analysis, multiple logistic regression). 66 MS patients were followed after polysomnography, 49 patients with relevant sleep disorders and 17 without.Results
Mean MFIS scores decreased from 41.2 to 26.2 (p = 0.025) in patients with good compliance (GC; n = 18), from 42.4 to 32.1 (p = 0.12) in patients with moderate compliance (MC; n = 12), and from 41.6 to 35.5 (p = 0.17) in non-compliant patients (NC; n = 17). Mean MFIS values increased in patients without sleep disorders from 22.9 to 25.4 (NSD; n = 12, p = 0.56). In multiple logistic regression, treatment of sleep disorders predicted decrease of MFIS-values (GC versus NSD odds ratio 13.4; p = 0.015; 95% confidence interval (CI) 1.7–107.2, MC versus NSD odds ratio 13.8; p = 0.028; 95% CI 1.3–143.3).Conclusions
Sleep medical treatment may improve MS related fatigue when patients adhere to treatment recommendations. 相似文献8.
Munife Neyal Fatih Yimenicioglu Ali Aydeniz Abdullah Taskin Sadullah Saglam Mustafa Cekmen Abdurrahman Neyal Savas Gursoy Ozcan Erel Ayse Balat 《Clinical neurology and neurosurgery》2013
Objectives
Tension-type headache (TTH) and fibromyalgia syndrome (FM) are worldwide seen chronic pain syndromes of unknown etiology. Despite the growing body of data on pathophysiology and generation mechanisms of pain; our knowledge on pain mechanisms in both FM and TTH is yet to be limited.Patients and methods
We investigated the plasma nitrite levels, total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) in 35 TTH, 33 FM patients and 31 healthy controls.Results
The mean plasma nitrite levels and TAS levels were significantly low and OSI was found to be significantly high in TTH and FM groups compared to the control group (p = 0.001, p = 0.001, p = 0.001 and p = 0.001, respectively). The mean serum TOS levels were also significantly higher in FM group according to the control group (p = 0.034), but there was not a significant difference between TTH and control groups (p = 0.066).Conclusion
These results indicated that; FM and TTH patients revealed higher oxidative stress index and lower total nitrite levels than healthy controls. We conclude that oxidative stress may have a role in the pathophysiological mechanisms of TTH and FM, although, whether it is the cause or the consequence, is not clear. 相似文献9.
Kate Monagle Sophie Jones Ingrid King Robert Weintraub Paul Monagle Fiona Newall 《Thrombosis research》2014
Objectives
Cardiomyopathy is a common cause of heart failure in children. Thrombosis is a potential significant secondary complication. Thus warfarin is recommended by the American College of Chest Physicians for the treatment of children with cardiomyopathy despite the lack of published evidence to support its use.Methods
A retrospective clinical audit to estimate the rates of major bleeding and incidence of thromboembolism associated with oral anticoagulant therapy (warfarin) for primary thromboprophylaxis in a cohort of children with cardiomyopathy. Relevant outcomes including thrombosis and major haemorrhage were defined a priori according to internationally accepted definitions.Results
36 children (35.9 warfarin years) were examined, with 25% taking warfarin for greater than 1 year. Primary reasons for discontinuation of warfarin therapy were cardiac transplantation (n = 7), transition to VAD (n = 1), improved cardiac function (n = 17), transfer of care (n = 3), change to aspirin (n = 2). The mean age at starting warfarin was 5.4 years (range 0.2-15.2). The most common Target Therapeutic Range (TTR) for warfarin therapy was 2.0 – 3.0. TTR achievement was normally distributed and occurred in a mean 48.5% of all INR tests. There were zero warfarin related adverse events, including thrombosis or haemorrhage.Conclusion
The low rate of TTR achievement is consistent with previously reported TTR achievement rates for infants. In addition the low rate of TTR achievement was likely influenced by the clinical profile of this complicated condition in children. Nonetheless, this data shows that the clinical outcomes for this cohort are acceptable and warfarin therapy can be safe in children with cardiomyopathy. 相似文献10.
Najiba Fekih-Mrissa Sarra Klai Jamel Zaouali Nasreddine Gritli Ridha Mrissa 《Clinical neurology and neurosurgery》2013
Background and objective
Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction. MG has been shown to be associated with many human leukocyte antigens (HLA) in different populations. The aim of this study was to investigate the probable association between HLA-DR/DQ alleles and MG in Tunisian patients.Patients and methods
HLA DR/DQ genotyping was performed using polymerase chain reaction sequence-specific primers (PCR-SSP) with 48 MG patients and 100 healthy individuals serving as the control group.Results
Myasthenia gravis in Tunisian patients was found to be associated with the following alleles (pc denotes Bonferroni corrected probability values): HLA-DRB1*03 (pc < 10−3), DRB1*04 (pc = 0.005), DQB1*02 (pc = 0.002) and, DQB1*03 (pc = 0.007).Conclusion
Our data demonstrated a new HLA-MG predisposition with DRB1*04. The DRB1*03, DRB1*04, DQB1*02, and DQB1*03 alleles also could be predisposing genetic factors for MG in the Tunisian population. 相似文献11.
Nohra Chalouhi George Ghobrial Stavropoula Tjoumakaris Aaron S. Dumont L. Fernando Gonzalez Samantha Witte Justin Davanzo Robert M. Starke Ciro Randazzo Adam E. Flanders David Hasan Rohan Chitale Robert Rosenwasser Pascal Jabbour 《Clinical neurology and neurosurgery》2013
Objective
Perfusion studies are increasingly used to triage acute stroke patients for endovascular recanalization therapies. We compare the safety and efficacy of CT perfusion (CTP)-guided to time-guided mechanical recanalization in acute ischemic stroke (AIS) patients.Methods
A review was conducted on 132 patients, 94 undergoing CTP-guided and 38 undergoing time-guided (maximum 8 h from symptom onset) mechanical recanalization at our institution.Results
The rate of partial-to-complete recanalization did not differ between the CTP and the non-CTP group (78.7% vs. 81.6%, respectively, p = 0.71). ICH occurred respectively in 18.1% in the CTP group versus 31.6% in the non-CTP group (p = 0.06). The overall in-hospital mortality rate was significantly lower in the CTP group (15.9% vs. 36.8%, p = 0.04). In multivariable analysis, CTP-guided patient selection was an independent negative predictor of in-hospital mortality (OR = 3.2; p = 0.01). CTP-guided patient selection, however, was not a predictor of favorable outcome (Modified Rankin Scale 0–2 or 0–3).Conclusions
CTP-based patient selection was associated with lower ICH and mortality rates. Favorable outcomes, however, did not differ between the 2 groups. These results may suggest a possible benefit in terms of in-hospital mortality with CTP-guided triage of AIS patients for endovascular treatment. 相似文献12.
Alejandro Ballesteros Ann Summerfelt Xiaoming Du Pan Jiang Joshua Chiappelli Malle Tagamets Patricio O’Donnell Peter Kochunov L. Elliot Hong 《Clinical neurophysiology》2013,124(11):2209-2215
Objective
Diverse electrophysiological abnormalities have been associated with schizophrenia, but the underlying causes remain elusive. We tested whether the altered oxidative stress in schizophrenia contributes to the electrophysiological abnormalities.Methods
We used an auditory oddball task to measure mismatch negativity (MMN) and gamma band response on 29 schizophrenia patients and 25 normal controls. Oxidative stress was assessed by monomeric glutathione (GSH, reduced form) and glutathione disulfide (GSSG, oxidized form).Results
Patients had reduced MMN (p = 0.015) and reduced power of gamma band responses at 21–40 Hz and 41–85 Hz (all p < 0.001). GSH was significantly lower (p < 0.001) while %GSSG was higher (p = 0.023) in patients compared with controls. MMN was correlated with GSH in controls; while 21–40 Hz responses were correlated with GSH in patients. Lower GSH and higher GSSG levels were associated with low community functioning (p = 0.018). Multivariate mediation modeling showed that gamma band at 21–40 Hz was a significant mediator for GSH effect on community functions.Conclusions
High beta/low gamma range (21–40 Hz) responses may be an intermediate biomarker indexing oxidative stress and its effect on clinical functions.Significance
Electrophysiological abnormalities and associated clinical functional changes may in part be associated with heightened oxidative stress in schizophrenia. 相似文献13.
Introduction
A better understanding of patients’ knowledge, satisfaction and concerns can identify deficits and help develop targeted patient education. This study aimed to examine patients’ knowledge, satisfaction and concerns regarding warfarin therapy and assess their association with warfarin adherence and international normalized ratio (INR) control.Materials and methods
A cross-sectional survey was conducted in a convenience sample of patients taking warfarin in an anticoagulation clinic. The questionnaire consisted of questions on patients’ knowledge, satisfaction and concerns regarding warfarin treatment. Patients’ warfarin refill records and time within the therapeutic INR range were retrieved from hospital databases.Results
One hundred and eighty-three patients participated in the survey. Patients had inadequate knowledge of warfarin-diet and warfarin-drug interactions. Over 40% of the respondents were not satisfied with the waiting time to see a pharmacist. The most common concerns of taking warfarin were worries about warfarin-drug interactions (36.1%), forgetting to take warfarin (26.2%) and worries about side effects (25.7%). Higher satisfaction was associated with better knowledge (r = 0.24, p = 0.001) and fewer concerns (rs = − 0.23, p = 0.002). Better knowledge and higher satisfaction were associated with higher warfarin adherence (rs = 0.21 and 0.16; p = 0.01 and 0.046, respectively). Better knowledge, higher satisfaction, fewer concerns, and better warfarin adherence were associated with good INR control (p = 0.003, 0.02, 0.03 and 0.003, respectively).Conclusions
This study highlighted patients’ concerns and deficits in knowledge regarding warfarin treatment, and also demonstrated their association with warfarin adherence and INR control. 相似文献14.
Yutaro Suzuki Kazushi Sawamura Shin Ono Naoki Fukui Takuro Sugai Junzo Watanabe Nobuto Tsuneyama Yoshimasa Inoue Toshiyuki Someya 《Progress in neuro-psychopharmacology & biological psychiatry》2010
Background
Perospirone was developed in Japan and is used for the treatment of schizophrenia and related illnesses. The authors investigated the relationship between the dosage of perospirone and the plasma levels of perospirone and its active metabolite, ID15036, and also evaluated the impact of the plasma concentrations of perospirone and ID15036 on the plasma prolactin level to examine whether perospirone or ID15036 affected the dopamine D2 blockade, in psychiatric patients treated with perospirone.Methods
The subjects consisted of 21 adults treated with perospirone (4–60 mg/day). The plasma perospirone and ID15036 levels were measured in 21 patients and serum prolactin levels were investigated in 10 male patients with schizophrenia.Results
The plasma ID15036 level was higher than the plasma perospirone, and a positive correlation was observed between the dosage of perospirone and the ID15036 levels (p = 0.032). The 10 male patients showed a positive correlation between the plasma perospirone levels and plasma prolactin levels (r = 0.688, p = 0.028) and between the plasma ID15036 levels and prolactin levels (r = 0.775, p = 0.009).Conclusion
The plasma levels of ID15036 may have a greater impact on the dopamine D2 blockade than perospirone in patients treated with perospirone. 相似文献15.
Wei-Chieh Weng Wen-Yi Huang Feng-Chieh Su Yu-Yi Chien Chia-Lun Wu Tsong-Hai Lee Tsung-I Peng 《Clinical neurology and neurosurgery》2013
Objectives
We aimed to investigate the effect of hypercholesterolemia on recovery after acute ischemic stroke.Methods
Data of 3048 patients admitted for acute ischemic stroke from January to December 2009 were collected from the Stroke Registry in the Chang Gung Healthcare System. Baseline characteristics of patients with and without hypercholesterolemia were compared. The association of hypercholesterolemia with neurological severity and recovery was analyzed using multivariate logistic regression. The patients were then divided on the basis of age for subgroup analysis.Results
The number of patients with and without a history of hypercholesterolemia was 474 (15.6%) and 2574 (84.4%), respectively. Univariate analysis showed that patients with hypercholesterolemia had a lower National Institutes of Health Stroke Scale (NIHSS) score on admission (p = 0.004). However, during hospitalization, these patients displayed less improvement in their NIHSS score (p = 0.002). These results remained significant in multivariate logistic regression analysis (p < 0.001 and p = 0.002, respectively). Subgroup analysis showed a similar association for hypercholesterolemia in both younger (age < 70) and older (age ≥ 70) age groups.Conclusions
Acute ischemic stroke in patients with hypercholesterolemia was correlated with reduced severity on admission and less favorable recovery during hospitalization, regardless of age. 相似文献16.
Purpose
To evaluate the efficacy of cyberknife (CK) and neurosurgery (NS) in patients newly diagnosed as solitary brain metastasis (SBM) from non-small cell lung cancer (NSCLC).Methods and materials
We retrospectively analyzed 76 patients between 1990 and 2012 from our institution, including 38 patients performing CK and the other half performing NS. The observation end point was overall survival time (OS), local control of treated metastasis (LC) and intracranial control (IC). Kaplan–Meier OS curves were compared with the log-rank test. Cox regression analysis was used to determine prognosticators for OS, LC and IC.Results
The baseline characteristic between the two groups was not significantly different. The 1-year OS rates were 53.5% and 30.5% in the CK group and NS group, respectively, (p = 0.121). The 1-year LC rates were 50.8% and 31.3%, respectively, (p = 0.078). The 1-year IC rates were 50.8% and 27.7%, respectively, (p = 0.066). In multivariate analysis, improved OS was significantly associated with younger age (p = 0.016), better ECOG performance status (p = 0.000) and graded prognostic assessment (GPA, 3.5–4.0, p = 0.006). The LC was also associated with better ECOG performance status (p = 0.000). The IC was associated with both better ECOG performance status (p = 0.000) and GPA (3.5–4.0, p = 0.005).Conclusions
There was no statistical difference between CK and NS for SBM from NSCLC in OS, LC and IC. However, CK is less invasive and may be more acceptable for patients. The result needs randomized trials to confirm and further study. 相似文献17.
Fumiyasu Ishii Noriyuki Matsukawa Mitsuya Horiba Takehiko Yamanaka Manabu Hattori Ikuo Wada Kosei Ojika 《Clinical neurology and neurosurgery》2010
Background
: Stroke patients experience postural instability that can impede functional improvements in their gait. However, the precise functions of the dominant and non-dominant hemispheres in controlling static standing posture and weight-bearing remain unclear.Objective
: To investigate differences in balancing ability between right-handed patients with right and left hemispheric lesions.Methods
: Weight shifting was quantitatively evaluated to determine the ability of patients to control their balance in a static posture and during conscious weight shifting onto the paretic or non-paretic leg. Participants were enrolled from a consecutive series of stroke patients attending a rehabilitation program (n = 49; 31 male, 18 female; mean age 69.3 ± 9.4 years). Age-matched normal controls were recruited as volunteers (n = 12; 4 male, 8 female; mean age 67.9 ± 4.9 years).Results
: Patients with cortical lesions in the right hemisphere were able to shift less weight onto the non-paretic leg than patients with cortical lesions in the left hemisphere (p < 0.05). There were no correlations between the existence of unilateral spatial neglect and the percentage of weight shifted onto the non-paretic leg, static standing posture (r = 0.27, p = 0.40) or dynamic standing posture (r = −0.37, p = 0.24). In contrast, there was a significant correlation between the percentage of weight consciously shifted onto the non-paretic leg and the existence of anosognosia (r = 0.74, p = 0.006), but not between static standing posture and anosognosia (r = −0.15, p = 0.63).Conclusion
: Patients with right cortical hemispheric lesions were able to shift less body weight onto their non-paretic leg. These patients should be encouraged to practice shifting their weight towards their non-paretic leg to improve their balance. 相似文献18.
P. Sobolewski G. Kozera R. Kaźmierski S. Michalak W. Szczuchniak M. Śledzińska-Dźwigał W.M. Nyka 《Clinical neurology and neurosurgery》2013
Objective
Renal dysfunction (RD) increases risk for ischaemic stroke (IS). The impact of RD on the effects of iv-thrombolysis in the Caucasian population has not been fully determined.Aims
To evaluate the associations between RD and the outcome of iv-thrombolysis in Caucasian patients with IS.Methods
The observational, multicentre study included 404 patients with IS who were treated with iv-thrombolysis. RD was defined as estimated glomerular filtration rate ≤60 ml/min/1.73 m2. Outcome was assessed with modified Rankin Score at 3 months after the stroke onset.Results
Medians baseline NIHSS score did not differ between groups of patients with and without RD (12.0 vs. 11.0 pts, p = 0.33). Unfavourable outcome was found in 52.1% of patients with and in 41.2% of patients without RD (p = 0.05), mortality was higher in patients with RD (29.9% vs. 14.3%, p < 0.001), and the presence of haemorrhagic transformation (HT) did not differ between the groups (17.1% vs. 17.1% respectively, p = 0.996). A multivariate analysis showed no impact of RD on the unfavourable outcome (OR 0.98; 95%CI 0.88–1.10), mortality (OR 0.92; 95%CI 0.81–1.05) or presence of HT (OR 1.03; 95%CI 0.90–1.18).Conclusions
We found no impact of RD on the safety and efficacy of iv-thrombolysis in Caucasian patients with IS. 相似文献19.
Hongwei Wang Bo HuangChangqing Li Zhengfeng Zhang Jian WangWenjie Zheng Yue Zhou 《Clinical neurology and neurosurgery》2013
Purpose
To evaluate the differences of learning curve for PELD depending on the surgeon’ s training level of minimally invasive spine surgery.Methods
We retrospectively reviewed the medical records of 120 patients (surgeon A with his first 60 patients, surgeon B with his first 60 patients) with sciatica and single-level L4/5 disk herniation who underwent PELD by the two surgeons with different training level of minimally invasive spine surgery (Group A: surgeon with little professional training of PELD; Group B: surgeon with 2 years of demonstration teaching of PELD).Results
Significant differences were observed in the operation time (p = 0.000), postoperative hospital stay (p = 0.026) and reoperation rate (p = 0.050) between the two groups. In the operation time, significant differences were observed between the 1–20 patients group and 41–60 patients group in Group B (p = 0.041), but there were no significant differences among the 1–20 patients group, 21–40 patients group and 41–60 patients group in Group A. In the postoperative hospital stay, the significant differences were observed in the 1–20 patients group between Group A and Group B (p = 0.011). Significant differences were observed between preoperative and postoperative VAS back score, VAS leg score and JOA score. Higher improvement in the VAS leg score was observed in Group B than Group A (p = 0.031). In the rate of reoperation, the significant difference was observed between the 1–20 patients group and 41–60 patients group in Group A (p = 0.028) but there were no significant differences among the 1–20 patients group, 21–40 patients group and 41–60 patients group in Group B.Conclusions
The surgeons’ training level of minimally invasive spine surgery was an important factor for the success of PELD, especially the demonstration teaching of PELD for the new minimally invasive spine surgeons. 相似文献20.
Amy Ronaldson Lydia Poole Tara Kidd Elizabeth Leigh Marjan Jahangiri Andrew Steptoe 《Journal of psychosomatic research》2014