Where are we in terms of poststroke functional outcomes and risk factors.

BACKGROUND: Stroke is acute vascular deterioration of cerebral functions and 2nd leading cause of death. As population gets older, as well as the increasing prevalence of stroke and disability from chronic disease, the demand for rehabilitation care will continue to rise. There is need for evidence based rehabilitation approaches and rehabilitation outcomes should be proved by objective questionnairres to qualify the process. OBJECTIVE: To present the functional outcomes of stroke rehabilitation process among functional impairment measure evaluation. Determine the contributing factors on functional gain. MATERIAL-METHODS: Retrospectively assessment of data of 142 posttroke patients performed. In addition to demographical and clinical properties, functional outcomes with functional impairment measurement (FIM) and motor evaluation by Brunnstrom Motricitiy Index were recorded. Risk factors for stroke were questionned also. RESULTS: The mean of ages was 64.30 ± 11.9 years, male/female ratios were 47.2%/ 52.8%. The functional gain was 20.4% in M-FIM, 14.7% in C-FIM. Better outcomes gained by the patients who stayed longer than 15 days (ANOVA, p: 0.000) and who had hemorrhagic etiology (MannWhitney U, p: 0.048), meanwhile there was no significant difference in gender and plegic side groups on both Motor-FIM and Cognitive-FIM gains (p > 0.05, MannWhitney U). Regression models exhibited highest impact on the M-FIM gain were the admission M-FIM scores and DM (adjusted Rsquare: 0.173, p: 0.000). Admission C-FIM scores had positive correlation with discharge C-FIM scores (r: 0.917, p: 0.000). Although older age was the negative determinant of C-FIM gain (r: -0.202, p: 0.016). We obtained the risk factor distribution 71.8% for HT, 29.6% for CAD, 25.6% for smoking, 16.2% for TIA and 33.1% for DM. All had negative impact on functional outcomes but DM had significantly (regression analysis p < 0.05). CONCLUSION: Improvement by rehabilitation programme determined by FIM scores. Data provided about the poststroke patients and present risk factors. Still there exists similar ratios of risk factors as studies before eventhough prevention recommendations.

Two rare involvement sites: synovial chondromatosis.

Synovial chondromatosis (SC) is a rarely encountered benign disease of unknown etiology characterized by multiple joint mouse, as well as metaplastic cartilage points in the joint, bursa and tendon sheaths. Although single joint involvement is frequently encountered, multiple joint involvements may also occur. In this study, two patients with SC in the right shoulder joint and in both ankles were presented, reviewed according to literature.

The relation of serum vascular endothelial growth factor level with disease duration and activity in patients with rheumatoid arthritis.

Vascular endothelial growth factor (VEGF) is known to be involved in the pathogenesis of rheumatoid arthritis (RA). In order to elucidate the association between VEGF levels and RA disease activity, VEGF concentrations were measured in RA patients at different phases and severity levels. Thirty-eight healthy subjects and 40 patients with RA were prospectively included in the study. Subjects were further categorized into four subgroups (high, moderate, low, or remission) using the disease activity score-28 (DAS28) scoring system. VEGF levels were significantly higher in patients than controls (p < 0.001). VEGF levels differed significantly in controls, early and late-phase RA patients (p = 0.002). A significant difference was found between controls and patients with high RA disease activity scores (p < 0.0001). VEGF levels were not correlated with age (r = -0.016; p = 0.921) or sex (r = 0.209; p = 0.921). VEGF values were correlated with erythrocyte sedimentation rate (r = 0.445; p = 0.004), but was not correlated with serum rheumatoid factor levels (r = -0.130; p = 0.424) in the patient group. In conclusion, higher VEGF levels are associated with late phase and high disease activity in RA, independent of age and sex.