Posterior circulation ischaemic stroke - A retrospective analysis from a General Hospital

Even though ischemic stroke represents a majority of strokes in general, only a smaller portion origi- nate from posterior circulation. Because of different origin and particular territory involvement, this represents a difficult clinical task. We compared relevant clinical data from literature with results of our patients affected by the posterior circulation stroke (PCS). We analyzed stroke patients admitted from 2018. to 2022. in General Hospital Pula, a touristic oriented county hospital in Croatia on the Adriatic Coast. In that five-year period we admitted 1795 patients with ischemic stroke. 246 or 13,6% of those originated from the posterior circulation, which is significantly less than data from similar reports. Majority of those patients were male, 64%. Comparing the outcome, we found that the PCS had significantly better outcome. Mortality rate was similar in both,14% for PCS versus 16% in the anterior circulation strokes (ACS). We analyzed the outcome by infarct region or etiology, as well as clinical particularities related to the territory of PCS involvement. We also selected patients having PCS as a result of dissection. According to our results the patients with PCS had better outcome in comparison to ACS. The most frequent site of stroke was cerebellar, followed by pontine stroke. The highest mortality was observed in patients with multiple posterior circulation strokes. Initial NIHSS score was lower in posterior circulation strokes then in anterior circulation strokes, with an important impact on reperfusion therapy rates. Therefore, it is crucial to perform comprehensive clinical evalua- tion of patients with posterior circulation ischemic strokes. Key words: Posterior circulation stroke, Anterior circulation stroke, National Institutes of Health Stroke Scale (NIHSS), Risk factors, Modified Rankin Score (mRS

Spontaneous High Frequency EMG Discharges in Dermatomyosytis

Dermatomyosytis, a rare inflammatory myopathy occurs with incidence of 1:17000, more often in females. Spontaneous electromyography (EMG) activity in the disease is well known, especially in the acute disease: 46-yrs old female, was examined and treated by dermatologist, because of skin inflammatory changes A neurological examination was then suggested, suspecting myositis. No family history of neuromuscular disorders, or any important disease is known. She had skin efflorescence’s for the last two years, a muscular weakness a last three weeks. In the physical examination a upper limb palsy (MRC 3), a and tie muscle palsy together with positive Gower’s sign. During the hospitalization a laboratory, electrophysiogical and hystopathological studies have been done. An inflammatory myopathy or polymyositis criteria (Bohan and Peter) was presented in case. Normal finding in muscle particle analysis could be negative if the preserved part of muscle was taken by biopsy.EMG HF discharges were similar to those often found in some rare inherited/genetic neuromuscular disease

Procjena nutritivnog rizika kod gastroenteroloških bolesnika u Kliničkom bolničkom centru Rijeka

Malnutrition is usually related to some diseases such as inflammatory bowel disease, chronic pancreatitis, chronic liver disease and malignant tumors. It is characterized by weight loss, protein deficiency, and deficit of specific nutrients. The aim was to estimate the prevalence of nutritional risk among 160 gastrointestinal patients by use of the Nutritional Risk Screening (NRS-2002) score at hospital admission and discharge. The patients stayed in the hospital between 5 and 15 days or longer. Results showed that 40% of patients at admission and 36.2% at discharge were malnourished. There were 53.1% of patients with recognized malnutrition at admission that received nutritional support, whereas at discharge 34.4% of patients at risk were not dietary supported. Malnourished patients were significantly older, had lower body mass index, longer hospital stay and higher rate of malignant diseases than properly nourished patients. Regular screening for malnutrition should be conveyed in hospitals as to provide appropriate dietary support for all patients at risk.Malnutricija se povezuje s nekim bolestima kao što su upalna bolest crijeva, kronični pankreatitis, kronična bolest jetre i zloćudni tumori. Kod malnutricije dolazi do gubitka težine, manjka proteina te nedostatka nekih specifičnih hranjivih tvari. Cilj ovoga rada bio je procijeniti učestalost nutritivnog rizika kod 160 gastroenteroloških bolesnika metodom procjene nutritivnog rizika (NRS-2002) pri prijmu i otpustu bolesnika. Bolesnici su boravili u bolnici između 5 i 15 dana ili duže. Rezultati su pokazali da je kod prijma u bolnicu 40%, a na otpustu 36,2% bolesnika bilo pothranjeno. Na prijmu je 53,1% pothranjenih bolesnika dobilo odgovarajuću nutritivnu potporu, dok 34,4% bolesnika nije dobilo takvu potporu pri otpustu iz bolnice. Pothranjeni bolesnici bili su značajno mlađi, imali su značajno niži indeks tjelesne mase, značajno su dulje boravili u bolnici te su češće bolovali od zloćudnih bolesti. Procjena nutritivnog rizika treba biti rutinska kako bi se osigurala odgovarajuća nutritivna potpora za sve bolesnike koji su u riziku od malnutricije