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1.
Acta Neurochir Suppl ; 127: 175-178, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31407081

RESUMO

Five frontal systems circuits connect with the basal ganglia and other structures to control and regulate thinking and behavior. Subarachnoid hemorrhage and stroke following anterior circulation aneurysms typically disrupt these circuits, sometimes markedly affecting a patient's function. This article reviews the primary pathways and associated brain functions. The principles of cognitively and behaviorally rehabilitating these functions are also discussed by creating external structure and building on what the brain is still capable of doing.


Assuntos
Transtornos Cognitivos , Acidente Vascular Cerebral , Hemorragia Subaracnóidea , Gânglios da Base , Encéfalo , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/reabilitação , Humanos , Acidente Vascular Cerebral/complicações , Hemorragia Subaracnóidea/complicações , Hemorragia Subaracnóidea/reabilitação
3.
Radiol Clin North Am ; 57(6): 1109-1116, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31582038

RESUMO

Occlusion of a cervical or cerebral artery may cause acute ischemic stroke (AIS). Recent advances in AIS treatment by endovascular thrombectomy have led to more widespread use of advanced computed tomography (CT) imaging, including perfusion CT (PCT). This article reviews PCT for the evaluation of AIS patients.


Assuntos
Isquemia Encefálica/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Acidente Vascular Cerebral/diagnóstico por imagem , Encéfalo/irrigação sanguínea , Encéfalo/diagnóstico por imagem , Isquemia Encefálica/complicações , Angiografia Cerebral , Humanos , Acidente Vascular Cerebral/complicações
4.
Medicina (B Aires) ; 79 Suppl 3: 6-9, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31603835

RESUMO

The objective was to describe the frequency, mode of presentation and characteristics of epilepsy in children with congenital hemiparesis (CH). It is a etrospective, descriptive and multicenter study, based on the collection of data from the clinical records of patients from 0 to 19 years with CH secondary to perinatal infarction in different centers of the community of Catalonia. A total of 310 children were included (55% males and 45% females), from a total of 13 centers in Catalonia. Average age of onset of the crises was 2 ± 1 year. Epilepsy was present in 29.5% (n = 76), among which the most frequent vascular subtype was arterial presumed perinatal ischemic stroke (51.3%), followed by neonatal arterial ischemic stroke (18.4%), periventricular venous infarction (15.8%), neonatal hemorrhagic stroke (10.5%) and neonatal cerebral sinovenous thrombosis (3.9%). Semiology of the most frequent seizures was motor focal in 82%, followed by focal motor with secondary bilateralization in 23%, focal discognitive in 13.5%, generalized by 2% and spasms in 6.5%. The 67.3% were controlled with monotherapy and the drugs used were valproate, levetiracetam or carbamazepine. The antecedent of electrical status during sleep was identified in 3 patients, all associated with extensive lesions that included the thalamus. Of the total number of children with epilepsy, 35% began with neonatal seizu res in the first 3 days of life. The 30% of children with perinatal stroke and CH present a risk of epilepsy during childhood. Children with ischemic strock have the highest risk, so they will require a follow-up aimed at detecting prematurely the epilepsy and start a treatment.


Assuntos
Epilepsia/etiologia , Paresia/congênito , Paresia/etiologia , Acidente Vascular Cerebral/complicações , Adolescente , Anticonvulsivantes/uso terapêutico , Carbamazepina/uso terapêutico , Criança , Pré-Escolar , Epilepsia/tratamento farmacológico , Feminino , Humanos , Lactente , Recém-Nascido , Levetiracetam/uso terapêutico , Masculino , Estudos Retrospectivos , Fatores de Risco , Convulsões/etiologia , Espanha , Ácido Valproico/uso terapêutico , Adulto Jovem
6.
Zhongguo Zhong Yao Za Zhi ; 44(15): 3135-3142, 2019 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-31602864

RESUMO

This research is launched to look for the medication rules and characteristics of Tibetan medicine in the treatment of gZav-Grib( apoplexy sequelae). HIS records of gZav-Grib patients were selected from the Tibetan Hospital of Tibet Autonomous Region and Tibetan Hospital of the city of Naqu. SPSS Modeler,Gephi and other data mining and visualization software were used to study the actual law of drug use in the treatment of gZav-Grib in Tibetan medicine. Finally,479 cases of gZav-Grib patients in Tibetan medicine were included. Their average age is 63 and average hospital stay was 32 days. In total,82 Tibetan medicine prescriptions were used for treating gZav-Grib. The frequency in the front is Twenty-flavor Chenxiang Pills( 338 times),Ruyi Zhenbao Pills( 322 times),and Seventy-flavor Zhenzhu Pills( 315 times). According to the regularity of Tebitan medicine,they were applied in different time periods including the early morning,morning,noon,and evening,for example,in the early morning: Seventy-flavor Zhenzhu Pills,morning: Ruyi Zhenbao Pills,noon: Eighteen-flavor Dujuan Pills,evening: Twenty-flavor Chenxiang Pills. In the clinical joint,18 groups were found in the 10% support and 70% confidence. There are two prescriptions confidence more than 80% which nature focus on Gan,Ruan,Xi,Liang,Dun,Han,Wen. gZav-Grib of Tibetan medicine can be divided into two types: r Lung-Grib type and k Hrag-Grib type,in which the medicine of r Lung-Grib type takes Seventy-flavor Zhenzhu Pills as the core prescription,while the medicine of k Hrag-Grib type takes Ruyi Zhenbao Pills as the core prescription. It is found that the treatment of gZav-Grib by Tibetan medicine is mainly dominated by the treatment idea about " Therapeutic r Lung and blood,Consideration of venous diseases". Treatment functions is promoting the circulation of Qi,clearing blood heat and getting rid of bad blood,achieving the purpose of treating both principal secondary aspect of gZav-Grib. The research methods based on the HIS can't only optimize the Tibetan treating gZav-Grib sequela treatment plan and rule of medication,but also provide the scientific basis for Tibetan medicine treat gZav-Grib.


Assuntos
Medicina Tradicional Tibetana , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológico , Mineração de Dados , Humanos , Registros Médicos , Software , Tibet
7.
Codas ; 31(6): e20180160, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31618343

RESUMO

PURPOSE: To compare pharyngeal residues of different consistencies among groups of individuals with neurogenic oropharyngeal dysphagia. METHODS: In a cross-sectional study, a fiberoptic endoscopic evaluation was performed in 30 swallowing exams of individuals diagnosed with neurological disease and oropharyngeal dysphagia, regardless of the time or stage of the disease. The individuals were divided into three groups according to etiology: group I, 10 post-stroke, 8 male and 2 female, aged 51 to 80 years (average age: 67 years); group II, 10 individuals with amyotrophic lateral sclerosis, 5 male and 5 female, aged 39 to 78 years (average age: 57 years); group III, 10 examinations of individuals with Parkinson's disease, 5 male and 5 female aged 65-88 years (average age: 74 years). The Yale Pharyngeal Residue Severity Rating Scale was applied by two independent raters in a blind manner for the analysis of pharyngeal residues in valleculae and pyriform sinuses based on the first swallowing of 5 mL of pureed and thickened liquid. RESULTS: No statistically significant difference was observed among groups in the degree of pharyngeal residues of puree food or thickened liquid in the valleculae (p = 0.25/p = 0.18) or the pyriform sinuses (p = 1.41/0.49). CONCLUSION: The pharyngeal residue levels of pureed and thickened liquid were similar for the groups studied, with less severe levels being more frequent.


Assuntos
Esclerose Amiotrófica Lateral/complicações , Transtornos de Deglutição/fisiopatologia , Doença de Parkinson/complicações , Acidente Vascular Cerebral/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Esclerose Amiotrófica Lateral/fisiopatologia , Estudos Transversais , Transtornos de Deglutição/diagnóstico por imagem , Transtornos de Deglutição/etiologia , Feminino , Humanos , Laringoscopia , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Índice de Gravidade de Doença , Acidente Vascular Cerebral/fisiopatologia , Gravação em Vídeo
8.
Medicine (Baltimore) ; 98(38): e17128, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567951

RESUMO

BACKGROUND: Post-stroke brain damage, which affects the central control of respiration, leads to various respiratory disorders. They can be caused by the weakening of the respiratory muscles and chest movements, which can indirectly contribute to an impairment of the ventilation function. The aim of the study is an objective assessment of the effect of a single-session intervention of respiratory stimulation through Proprioceptive Neuromuscular Facilitation (PNF) on chosen respiratory parameters and the following comparison of these changes with a group in which positioning was used (intra- and intergroup comparison). METHODS: This was a randomized interventional study evaluating the respiratory parameters depending on the applied respiratory stimulation in patients after ischemic stroke. The patients qualified to participate in the study were randomly assigned to 1 of 2 groups: PNF-treated group - in which respiratory stimulation through PNF was used, PNF untreated group - in which positioning was used. The research procedure consisted of several stages. First, an interview was conducted with each participant and basic data was collected. Then, spirometry was conducted, after which each patient underwent a single-session intervention according to their assigned group. Finally, the patients were given another spirometry examination. The main outcomes will be to compare the results of a spirometry test (FVC, FEV1, FEV1/ FVC%, PEF) before and after single-session intervention and between groups. RESULTS: Based on the inclusion and exclusion criteria for the study, 60 patients took part in the measurement. The values of FEV1/FVC% were higher in PNF-treated group than in PNF-untreated group, if the post-intervention measures (P = .04) are considered. The difference between the pre- and post-intervention results of the FEV1/FVC% values in PNF-untreated group was substantially lower than in PNF-treated group (P = .001). CONCLUSION: A single application of respiratory stimulation through PNF positively affect air flow in the respiratory tract. Application of PNF stimulation contributed to an increase in the FEV1/FVC% parameter. However, no positive changes were noted in the other parameters, which would provide proof of the beneficial effect of facilitation on the respiratory system function.


Assuntos
Isquemia Encefálica/complicações , Exercícios de Alongamento Muscular/métodos , Respiração , Músculos Respiratórios , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/complicações , Idoso , Isquemia Encefálica/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculos Respiratórios/fisiopatologia , Acidente Vascular Cerebral/terapia , Sobreviventes
9.
Medicine (Baltimore) ; 98(39): e17124, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574812

RESUMO

INTRODUCTION: Spasticity is the most common complication after stroke, which is the main obstacle in the recovery of motor function. Spasticity seriously affects the quality of life and brings a heavy burden to families and society. Acupuncture is an effective method for stroke. However, whether acupuncture is effective for poststroke spasticity is still unknown. The purpose of this systematic review (SR) is to evaluate the effectiveness and safety of acupuncture for poststroke spasticity. METHODS AND ANALYSIS: We will search the following databases from inception to July 2019: China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Wan Fang Data, the Chinese Science and Technology Periodical Database (VIP), PubMed, Embase, The Cochrane Library, and Web of Science. All relevant randomized controlled trials (RCTs) utilizing acupuncture for poststroke spasticity will be included. The primary outcome is the modified Ashworth scale. Secondary outcomes include composite spasticity scale, clinic spasticity index, electromyographic activity, Hoffmann reflex activity, or other spasticity-related outcomes. Study selection, data extraction, and quality assessment will be performed independently by 2 reviewers. Assessment of risk of bias and data synthesis will be conducted using Review Manager V5.3 software. ETHICS AND DISSEMINATION: The ethical approval is not required since SR is based on published studies. The results of this SR will be published in a peer-reviewed scientific journal according to the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) guidelines. PROSPERO REGISTRATION NUMBER: CRD42019129779.


Assuntos
Terapia por Acupuntura/métodos , Espasticidade Muscular/terapia , Acidente Vascular Cerebral/complicações , Humanos , Metanálise como Assunto , Espasticidade Muscular/etiologia , Projetos de Pesquisa , Revisão Sistemática como Assunto , Resultado do Tratamento
10.
Medicine (Baltimore) ; 98(39): e17261, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574840

RESUMO

BACKGROUND: This study aims to systematically explore the effectiveness of neuromuscular electrical stimulation (NMES) combined with rehabilitation training (RT) for the treatment of post-stroke limb spasticity (PSLS). METHODS: We will search Cochrane Library, MEDILINE, EMBASE, CINAHL, AMED, PsycINFO, WOS, Scopus, OpenGrey, and 4 Chinese databases from inception to the present without language restrictions. We will only consider randomized controlled trial on assessing the effectiveness and safety of NMES combined with RT for the treatment of PSLS. All included randomized controlled trials will be assessed using Cochrane risk of bias tool. Two researchers will independently perform study selection, risk of bias assessment, and data extraction, respectively. Any disagreements will be solved by a third researcher through discussion. RESULTS: Primary outcome is limb spasticity status. Secondary outcomes comprise of limb function, quality of life, and adverse events. CONCLUSION: This study will summarize the latest evidence of NMES combined with RT for the treatment of patients with PSLS. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019138900.


Assuntos
Terapia por Estimulação Elétrica/métodos , Espasticidade Muscular/terapia , Acidente Vascular Cerebral/complicações , Humanos , Extremidade Inferior/fisiopatologia , Espasticidade Muscular/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Acidente Vascular Cerebral/fisiopatologia , Revisão Sistemática como Assunto , Resultado do Tratamento , Extremidade Superior/fisiopatologia
11.
Medicine (Baltimore) ; 98(39): e17317, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574862

RESUMO

INTRODUCTION: Stroke is the principal cause of impairment in the motor function and gait of adults. One of the resources used in rehabilitation to optimize gait is a prescription of ankle-foot orthosis (AFO), and the most prescribed AFOs are Fixed AFO and Articulated AFO; however, it is not known which of these options is more effective for these individuals. The aim of this study is to evaluate the impact of different types of ankle-foot orthosis functional mobility and dynamic balance in stroke patients. METHODS: Prospective randomized controlled clinical trial with 2 parallel groups will be conducted, and the aim is to recruit 50 patients with stroke diagnosis within 1 year, who indicated that they use both types of orthotics, who had a previous Rankin score less than or equal to 3, and who obtained AFO orthosis through the Hospital Clinics at the Botucatu Medical School (HCBMS) São Paulo, Brazil. After a specific evaluation by a physiotherapist, the patient will receive 1 of the AFO types via randomization. After 30 days, the patient will be reevaluated. The primary outcomes will be balance and mobility, which will be evaluated by the Time Up Go Test (TUG) and Tinetti's Scale of Mobility and Balance (TSMB). The secondary outcomes will be quality of life and the levels of anxiety and depression, which will be evaluated with the European (5D) Quality of Life Scale (Euroqol) and Hospital Anxiety and Depression Scale (HADS). Group allocation will be not concealed because the blinding of participants and of therapists that provide intervention is not possible, and all analyses will be based on an intention-to-treat principle. This study was approved by the Human Research Ethics Committee of the São Paulo State University UNESP, number 2.367.953. The results will be published in relevant journal. DISCUSSION: The results of this study will contribute to clinical practice by identifying the type of AFO orthosis that is more suitable for this condition, helping to standardize prescription of these orthoses by professionals, and guiding future research studies on this subject, which is still incompletely defined in the literature. TRIAL REGISTRATION: RBR-6SF2VV (March 5, 2018).


Assuntos
Tornozelo/fisiopatologia , Órtoses do Pé/normas , Transtornos Neurológicos da Marcha , Qualidade de Vida , Reabilitação do Acidente Vascular Cerebral , Adulto , Articulação do Tornozelo/fisiopatologia , Fenômenos Biomecânicos , Desenho de Equipamento , Feminino , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/terapia , Humanos , Masculino , Equilíbrio Postural , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações , Reabilitação do Acidente Vascular Cerebral/instrumentação , Reabilitação do Acidente Vascular Cerebral/métodos , Reabilitação do Acidente Vascular Cerebral/psicologia
12.
Rev Lat Am Enfermagem ; 27: e3197, 2019 Oct 14.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31618390

RESUMO

OBJECTIVE: to analyze the in-hospital complications of prolonged hospital stay in patients with ischemic stroke or transient ischemic attack, admitted to the stroke unit of a tertiary hospital. METHOD: this is an evaluative correlational study. All first-ever ischemic stroke or transient ischemic attack patients admitted were retrospectively analyzed. During hospital stay, the predictors of long-term hospitalization considered were: 1) clinical complications (pneumonia, urinary tract infection, pressure damage and deep vein thrombosis), and 2) neurological complications (malignant ischemic stroke and symptomatic hemorrhagic transformation). RESULTS: 353 patients were discharged in the study period. Mean age was 64.1±13.7 years old and 186 (52.6%) were men. The mean time of hospital stay was 13.7±14.3 days. Pneumonia (25.3±28.8 days, p<0.001), urinary tract infection (32.9±45.2 days, p<0.001) and malignant stroke (29.1±21.4 days, p<0.001) increased significantly the length of hospital stay compared to patients without any complications (11.2±7.1 days). CONCLUSION: this study showed that three complications delayed hospital discharge in patients admitted in a stroke unit, two preventable ones: pneumonia and urinary tract infection. More intense measures to avoid them should be included in the performance indicators to reduce the length of hospital stay in stroke units.


Assuntos
Hospitalização/estatística & dados numéricos , Ataque Isquêmico Transitório/prevenção & controle , Tempo de Internação/estatística & dados numéricos , Acidente Vascular Cerebral/prevenção & controle , Fatores Etários , Idoso , Correlação de Dados , Complicações do Diabetes/complicações , Feminino , Humanos , Hipertensão/complicações , Ataque Isquêmico Transitório/complicações , Masculino , Pessoa de Meia-Idade , Alta do Paciente/estatística & dados numéricos , Pneumonia/complicações , Estudos Retrospectivos , Fatores de Risco , Acidente Vascular Cerebral/complicações , Reabilitação do Acidente Vascular Cerebral/estatística & dados numéricos , Centros de Atenção Terciária/estatística & dados numéricos , Infecções Urinárias/complicações
13.
Adv Exp Med Biol ; 1161: 125-131, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31562627

RESUMO

Ischemic strokes are caused by one or more blood clots that typically obstruct one of the major arteries in the brain, but frequently also result in leakage of the blood-brain barrier and subsequent hemorrhage. While it has long been known that the enzyme 12/15-lipoxygenase (12/15-LOX) is up-regulated following ischemic strokes and contributes to neuronal cell death, recent research has shown an additional major role for 12/15-LOX in causing this hemorrhagic transformation. These findings have important implications for the use of 12/15-LOX inhibitors in the treatment of stroke.


Assuntos
Araquidonato 15-Lipoxigenase , Isquemia Encefálica , Hemorragia , Acidente Vascular Cerebral , Barreira Hematoencefálica/patologia , Encéfalo/patologia , Isquemia Encefálica/complicações , Isquemia Encefálica/fisiopatologia , Hemorragia/etiologia , Hemorragia/fisiopatologia , Humanos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/fisiopatologia
14.
J Biol Regul Homeost Agents ; 33(3 Suppl. 1): 135-144, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31538460

RESUMO

The aim of this review is to determine if there is a relationship between periodontal disease and stroke. The included case-control and cohort studies mediate the incidence of stroke and periodontal disease by analyzing different parameters. A literature review was carried out in PubMed, Scopus and Embase databases using the key word "stroke" AND "periodontal disease". An amount of 932 articles came out from our research on these three databases. These articles were selected according to PRISMA criteria. The following inclusion criteria were established: studies conducted in humans, articles published in English and published in the last ten years. Exclusion criteria were: experimental studies on animals, articles published more than 10 years ago, non-English language articles, articles of non-indexed journals, and articles not directly related to the association between stroke and periodontitis. These criteria reduced the number of articles from 932 to 399. At the end, articles that appeared to be repeated in different databases have been eliminated: 254 articles remained. All these articles titles were reviewed by the authors, who decided whether or not to include them in the review. We selected an amount of 43 articles. These studies were reviewed by reading the titles and abstracts, and by finally selecting the ones with the same topic of this review. When titles or abstracts were not clear, the complete article was read. At the end 7 articles were selected. In addition, 2 systematic reviews and 1 article, cited in the discussion, and regarding the protocol used in patients suffering from cardiovascular diseases and periodontitis, were selected. The quality of these articles was evaluated through the JADAD system. In conclusion, patients with stroke have a higher prevalence of periodontitis.


Assuntos
Doenças Cardiovasculares/complicações , Periodontite/complicações , Acidente Vascular Cerebral/complicações , Humanos , Fatores de Risco
15.
Zhen Ci Yan Jiu ; 44(8): 605-9, 2019 Aug 25.
Artigo em Chinês | MEDLINE | ID: mdl-31475496

RESUMO

OBJECTIVE: To observe the clinical therapeutic effect of "Tiaoshen Zhitong" (mental regulating and pain relieving) needling and its influence on serological indicators in the treatment of post-stroke shoulder pain, so as to provide new therapeutic thoughts and approach for post-stroke shoulder pain. METHODS: A total of 80 inpatients with post-stroke shoulder pain were randomly divided into a control group (routine needling, 39 cases) and an observation group ("Tiaoshen Zhitong" needling, 41 cases) according to the random number table. Patients of the two groups accepted basic medication treatment including anticoagulants, hypotensive drugs, hypoglycermic drugs, lipid-lowering drugs, etc. In addition, patients of the control group were also treated by routine acupuncture stimulation (uniform reinforcing-reducing stimulation) of Jianyu (LI15), Jianqian (EX-UE12), Jianhou (Extra), Jianliao (TE14), Waiguan (TE5) and Hegu (LI4) on the affected side, and those of the observation group also treated by "Tiaoshen Zhitong" needling of Ear-Shenmen (MA-TF1), bilateral Neiguan (PC6, lifting-thrusting-reducing method), Shuigou (GV26, lifting-thrusting-reducing method), and Jianyu (LI15), Jianliao(TE14), Jianzhen (SI9) and Yanglingquan (GB34, the latter 4 points were stimulated with uniform reinforcing-reducing method) on the affected side. The treatment was given once every day, 6 days a week for 4 weeks. The pain severity was assessed by using visual analogue scale (VAS), the upper limb function evaluated by using Fugl-Meyer assessment (FMA) scale, the shoulder-joint function evaluated by using Constant-Murley score (CMS) questionnaire, and the daily living ability assessed by using Barthel index (BI) scale. The enzyme linked immunosorbent assay (ELISA) was used to determine the contents of serum beta-endorphin (ß-EP), enkephalin (ENK) and dynorphin (Dyn). The clinical therapeutic effect was evaluated by using Nimodipine scale method. RESULTS: Of the 39 and 41 cases in the control and observation groups, 7(17.95%) and 12(29.27%) were basically cured, 12(30.77%) and 13(31.71%) experienced marked improvement, 8(20.51%) and 11(26.83%) were effective, 12(30.77%) and 5 (12.19%) failed, with the total effective rate being 69.23% and 87.80%, respectively. The effective rate of the observation group was significantly higher than that of the control group (P<0.05). After the treatment, the VAS score was obviously reduced (P<0.01), and the scores of FMA scale, CMS questionnaire and BI scale, and contents of serum ß-EP, ENK and Dyn were all increased obviously in the two groups compared with their own pre-treatment (P<0.01). The therapeutic effect of "Tiaoshen Zhitong" needling was significantly superior to that of the routine needling in lowering VAS, and in raising scores of FMA scale, CMS questionnaire and BI scale and in up-regulating serum ß-EP, ENK and Dyn levels (P<0.01). CONCLUSION: "Tiaoshen Zhitong" needling is effective in reducing post-stroke shoulder pain and improving the motor function of the upper limb and shoulder-joint as well as the quality of daily life in stroke patients with shoulder pain. Its analgesic effect is probably related to the increase of the levels of serum ß-EP, ENK and Dyn.


Assuntos
Terapia por Acupuntura , Dor de Ombro/terapia , Acidente Vascular Cerebral , Humanos , Ombro , Dor de Ombro/etiologia , Acidente Vascular Cerebral/complicações , Resultado do Tratamento
17.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 48(3): 254-259, 2019 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-31496156

RESUMO

OBJECTIVE: To investigate the association of atrial fibrillation (AF) with hemorrhagic transformation (HT) in patients with ischemic stroke treated by intravenous thrombolysis. METHODS: Clinical data of 3272 patients treated by intravenous thrombolysis from 71 hospitals in Zhejiang Province during June 2017 and December 2018 were retrospectively reviewed. Intracranial HT was defined as intracranial hemorrhage suggested by imaging examination 24 hours after intravenous thrombolysis. Patients were dichotomized into HT group (n=533) and non-HT group (n=2739). The association of AF and HT was analyzed by univariate analysis and binary logistic regression. RESULTS: Compared with the non-HT group, the HT group were older, had longer onset to needle time (ONT), higher baseline National Institute of Health Stroke Scale (NIHSS) score, higher baseline glucose level, and higher AF rate (P<0.05 or P<0.01). Binary logistic regression analysis revealed that AF was independently associated with HT (OR=2.527, 95%CI:2.030-3.146, P<0.01). CONCLUSIONS: AF is independently associated with the occurrence of HT in ischemic stroke patients treated with intravenous thrombolysis.


Assuntos
Fibrilação Atrial , Isquemia Encefálica , Acidente Vascular Cerebral , Antifibrinolíticos/efeitos adversos , Antifibrinolíticos/farmacologia , Fibrilação Atrial/complicações , Isquemia Encefálica/complicações , Isquemia Encefálica/tratamento farmacológico , Humanos , Estudos Retrospectivos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/tratamento farmacológico , Terapia Trombolítica/efeitos adversos , Resultado do Tratamento
18.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 48(3): 275-281, 2019 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-31496159

RESUMO

OBJECTIVE: To investigate the clinical features and implication of restless legs syndrome (RLS) in ischemic stroke patients. METHODS: A total of 199 ischemic stroke patients were enrolled and assessed by polysomnography (PSG). RLS was identified according to criteria of International Restless Legs Syndrome Study Group. Epworth Sleepiness Scale (ESS), Mini-mental State Examination (MMSE) and Patient Health Questionnaire (PHQ-9) were used to evaluate the sleep quality, cognitive function and post-stroke depression, respectively. The National Institute of Health Stroke Scale (NIHSS) was used to evaluate the neurological function 3 months after stroke onset. Gender-and age-matched non-ischemic stroke patients with RLS (primary PLS) were selected as controls. RESULTS: Twenty-two cases of RLS were identified among 199 ischemic stroke patients (11.1%). Generalized linear model and logistic regression showed that low serum ferritin level (ß=-133.3 mg/L, 95%CI:-200.4--0.1, P<0.01), subcortical infarction (OR=4.05, 95%CI:1.15-14.18, P<0.05) and female (OR=2.54, 95%CI:1.04-6.23, P<0.05) were identified as the risk factors of RLS in ischemic stroke patients. Compared with ischemic stroke patients without RLS, ESS increased by 4.37 (95%CI:2.33-6.41, P<0.01), PHQ-9 increased by 2.17 (95%CI:0.39--3.94, P<0.05), and reduced NIHSS from the baseline deceased by 0.97 (95%CI:-1.79--0.15, P<0.05) in ischemic stroke patients with RLS. In addition, the incidence of moderate-severe depression increased (OR=4.27, 95%CI:1.40-13.10, P<0.05) in ischemic stroke patients with RLS. The index of periodic leg movements of sleep (PLMS) with arousal in ischemic stroke patients with RLS was significantly higher than that in patients with primary RLS (ß=12.85, 95%CI:2.04-23.67, P<0.05). CONCLUSIONS: RLS is common in ischemic stroke patients and has adverse influences on patients.


Assuntos
Isquemia Encefálica , Síndrome das Pernas Inquietas , Acidente Vascular Cerebral , Isquemia Encefálica/complicações , Isquemia Encefálica/patologia , Depressão/complicações , Feminino , Humanos , Masculino , Polissonografia , Síndrome das Pernas Inquietas/complicações , Síndrome das Pernas Inquietas/patologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/patologia
19.
Braz J Med Biol Res ; 52(9): e8533, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31483000

RESUMO

This study aimed to evaluate the effect of a newly designed intensive caregiver education program (ICEP) on reducing cognitive impairment, anxiety, and depression in acute ischemic stroke (AIS) patients. One hundred and ninety-six AIS patients were divided into ICEP group and Control group in a 1:1 ratio using blocked randomization method. In the ICEP group, the caregivers received ICEP, while in the Control group caregivers received usual education and guidance. All patients received conventional rehabilitation treatment. Cognitive impairment (assessed by Mini Mental State Examination (MMSE) score and Montreal Cognitive Assessment (MoCA) score), anxiety (assessed by Hospital Anxiety and Depression Scale (HADS)-A score and Self-rating Anxiety Scale (SAS) score), and depression (assessed by HADS-D score and Self-rating Depression Scale (SDS) score) were assessed at baseline (M0), 3 months (M3), 6 months (M6), and 12 months (M12). Cognitive impairment score at M12 and cognitive impairment score change (M12-M0) were increased, while cognitive impairment rate at M12 was reduced in the ICEP group compared with the Control group. Anxiety score change (M12-M0), anxiety score at M12, and anxiety rate at M12 were decreased in the ICEP group compared with the Control group. Depression score change (M12-M0), depression score at M12, and depression rate at M12 were lower in the ICEP group compared with the Control group. Further subgroup analysis based on baseline features also provided similar results. In conclusion, ICEP effectively reduced cognitive impairment, anxiety, and depression in AIS patients.


Assuntos
Transtornos de Ansiedade/prevenção & controle , Ansiedade/prevenção & controle , Cuidadores , Disfunção Cognitiva/prevenção & controle , Transtorno Depressivo/prevenção & controle , Educação em Saúde/métodos , Acidente Vascular Cerebral/enfermagem , Adulto , Ansiedade/etiologia , Transtornos de Ansiedade/etiologia , Estudos de Casos e Controles , Disfunção Cognitiva/etiologia , Transtorno Depressivo/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/psicologia , Reabilitação do Acidente Vascular Cerebral
20.
Medicine (Baltimore) ; 98(37): e17116, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517848

RESUMO

BACKGROUND: Buyang Huanwu Tang (BHT) is a well-known herbal complex used for stroke treatment and has been used mainly during post-stroke rehabilitation in East Asia. In this review, we aim to evaluate the efficacy and safety of BHT as a treatment for post-stroke fatigue (PSF). METHODS: Eight databases will be searched for relevant studies from inception to the present date. We will include randomized controlled trials (RCTs), which assess the effect and safety of BHT for the treatment of PSF. The methodological qualities, including the risk of bias (RoB), will be evaluated using the Cochrane RoB assessment tool. After screening the studies, a meta-analysis of the RCTs will be done. RESULTS: This study will provide high-quality synthesis of current evidence of BHT for PSF. CONCLUSION: The conclusion of our systematic review will provide evidence to judge whether BHT is an effective intervention for patients with PSF. ETHICS AND DISSEMINATION: Ethical approval is not required, as this study is based on the review of published research. This review will be published in a peer-reviewed journal and disseminated both electronically and in print. TRIAL REGISTRATION NUMBER: PROSPERO CRD42019130178.


Assuntos
Medicamentos de Ervas Chinesas/normas , Fadiga/tratamento farmacológico , Acidente Vascular Cerebral/complicações , Medicamentos de Ervas Chinesas/uso terapêutico , Fadiga/etiologia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos
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