93 research outputs found
Mild Cognitive Impairment as a single sign of brain hemiatrophy in patient with Localized Scleroderma and Parry–Romberg Syndrome
Neurologic involvement is well recognized in Systemic Scleroderma and increasingly reported in Localized Scleroderma. MRI brain abnormalities are often associated with symptoms such as seizures or headaches. In some cases they may be clinically silent. We describe a 23 years old female with head, trunk and limbs scleroderma who developed Parry–Romberg Syndrome. Brain MRI showed ipsilateral temporal lobe atrophy without any prominent neurologic symptoms. Neuropsychological examination revealed Mild Cognitive Impairment. During the 7 years of follow up we have noticed progression of face atrophy but no progression of brain atrophy. Cognitive functions have been stable. This case highlight that major MRI brain abnormalities in LS may occur with only subtle clinical manifestation such as Mild Cognitive Impairment
Mild Cognitive Impairment as a single sign of brain hemiatrophy in patient with Localized Scleroderma and Parry : Romberg Syndrome
Neurologic involvement is well recognized in Systemic Scleroderma and increasingly
reported in Localized Scleroderma. MRI brain abnormalities are often associated with
symptoms such as seizures or headaches. In some cases they may be clinically silent.
We describe a 23 years old female with head, trunk and limbs scleroderma who developed
Parry-Romberg Syndrome. Brain MRI showed ipsilateral temporal lobe atrophy without any
prominent neurologic symptoms. Neuropsychological examination revealed Mild Cognitive
Impairment. During the 7 years of follow up we have noticed progression of face atrophy but
no progression of brain atrophy. Cognitive functions have been stable. This case highlight
that major MRI brain abnormalities in LS may occur with only subtle clinical manifestation
such as Mild Cognitive Impairment
What determines spontaneous physical activity in patients with parkinsons disease?
Physical activity (PA) is a factor that may have an influence on the symptoms of Parkinson’s disease (PD). The aim of this study was to identify the potential determinants of spontaneous PA in a PD patient group. A total of 134 PD patients aged 65.2 ± 9.2 years with a Hoehn–Yahr scale score ≤4 and a Mini Mental State Examination (MMSE) score ≥24 were examined. For the study’s purposes, the authors analyzed age, sex, education, history of PD, dopaminergic treatment, the severity of PD symptoms using Unified Parkinson’s Disease Rating Scale (UPDRS), and Hoehn–Yahr scale. Additionally, all participants were evaluated through a set of scales for specific neuropsychiatric symptoms including depression, anxiety, apathy, fatigue, and sleep disorders. A linear regression analysis was used with backward elimination. In the total explanatory model, for 12% of the variability in activity (R2 = 0.125; F(16.133) = 2.185; p < 0.01), the significant predictor was starting therapy with the dopamine agonist (DA) (β= 0.420; t= 4.068; p = 0.000), which was associated with a longer duration of moderate PA. In the total explanatory model, for more than 13% of the variance in time spent sitting (R2 = 0.135; F(16.130) = 2.267; p < 0.01), the significant predictors were secondary education and the results of the UPDRS. The patients with secondary and vocational education, those starting treatment with DA and those with a less severe degree of Parkinson’s symptoms (UPDRS), spent less time sitting in a day. It is possible to identify determinants of spontaneous PA. It may elucidate consequences in terms of influence on modifiable conditions of PA and the proper approach to patients with unmodifiable PA factors
The sustained increase of plasma fibrinogen during ischemic stroke predicts worse outcome independently of baseline fibrinogen level
Hyperfibrinogenemia at the beginning of ischemic stroke is associated with poor outcome.
We hypothesized that the sustained increase of plasma fibrinogen during stroke predicts outcome independently
of baseline fibrinogen concentration. We included 266 patients with first-ever ischemic stroke
in whom plasma fibrinogen level was measured on days 1, 7, and 14. The sustained fibrinogen's
increase was defined as the persistent elevation of fibrinogen's concentration on days 7 and 14 by at least
20 % compared to the level on day 1. The functional outcome on day 30 was assessed using modified
Rankin Scale (mRS). Favorable outcome was defined as mRS 0-1. The sustained increase of fibrinogen
was found in 17 % of patients. On multivariate logistic regression analysis adjusted for age, NIHSS
score, baseline fibrinogen >2.66 mmol/L, presence of infection, and hyperglycemia, the sustained fibrinogen's
level was associated with reduced chance of favorable outcome (OR: 0.17, 95 % CI: 0.06-0.48, P<0.01)
Early depression independently of other neuropsychiatric conditions, influences disability and mortality after stroke (research study-part of PROPOLIS study)
Post-stroke depression (PSD) is the most frequent neuropsychiatric consequence of stroke. The nature of the relationship between PSD and mortality still remains unknown. One hypothesis is that PSD could be more frequent in those patients who are more vulnerable to physical disability, a mediator variable for higher level of physical damage related to higher risk of mortality. Therefore, the authors’ objective was to explore the assumption that PSD increases disability after stroke, and secondly, that mortality is higher among patients with PSD regardless of stroke severity and other neuropsychiatric conditions. We included 524 consecutive patients with acute stroke or transient ischemic attack, who were screened for depression between 7–10 days after stroke onset. Physical impairment and death were the outcomes measures at evaluation check points three and 12 months post-stroke. PSD independently increased the level of disability three (OR = 1.94, 95% CI 1.31–2.87, p = 0.001), and 12 months post-stroke (OR = 1.61, 95% CI 1.14–2.48, p = 0.009). PSD was also an independent risk factor for death three (OR = 5.68, 95% CI 1.58–20.37, p = 0.008) and 12 months after stroke (OR = 4.53, 95% CI 2.06–9.94, p = 0.001). Our study shows the negative impact of early PSD on the level of disability and survival rates during first year after stroke and supports the assumption that depression may act as an independent mediator for disability leading to death in patients who are more vulnerable for brain injury
Improvement of survival in Polish stroke patients is related to reduced stroke severity and better control of risk factors : the Krakow Stroke Database
Introduction: In the last decade, the stroke mortality rate in Poland significantly decreased. We hypothesised that stroke severity, the major determinant of outcome, is lowered in Polish stroke patients.
Material and methods: We compared the stroke severity in two cohorts of
first-ever ischaemic stroke patients admitted within 24 h after stroke onset
to the Department of Neurology, Jagiellonian University, Krakow in the years
1994-2000 and 2008-2012. To assess stroke severity we used the National
Institute of Health Stroke Scale (NIHSS). We defined mild stroke as an NIHSS
score ≤ 4.
Results: We included 816 patients hospitalised in the years 1994-2000 and
569 patients hospitalised in the years 2008-2012. NIHSS score on admission was higher in the former (mean: 12.0 ±7.0 vs. 8.0 ±6.0, p < 0.01), and
the frequency of mild stroke was higher in the latter (12.7% vs. 41.8%, p <
0.01). Although the frequency of hypertension (67.3% vs. 81.2%, p < 0.01),
diabetes mellitus (20.8% vs. 26.4%, p = 0.02) and atrial fibrillation (20.7%
vs. 26.2%, p = 0.02) was higher in patients hospitalised in the years 2008-
2012, the systolic and diastolic blood pressure values and the frequency
of fasting hyperglycaemia were lower in this cohort. This cohort also less
frequently suffered from hypercholesterolaemia (25.4% vs. 16.3%, p < 0.01).
Conclusions: Reduced stroke severity is associated with better recognition
and control of risk factors and explains the improvement of survival in Polish
stroke patients
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