Spolne razlike u raspodjeli rizičnih čimbenika, težini i ishodu ishemijskog moždanog udara

The aim of the study was to identify differences in baseline characteristics and outcomes of men and women with acute ischemic stroke. Ischemic stroke was confirmed by CT scan or autopsy in patients admitted to the 2nd Department of Neurology, Institute of Psychiatry and Neurology in Warsaw, Poland from 1995 to 2007. Male and female patients were compared for risk factors, state of activity prior to stroke, stroke type according to Oxfordshire Community Stroke Project classification, diagnostic test findings, and early 30-day outcome. Data on 1379 women and 1155 men admitted with ischemic stroke were analyzed. The mean age of female and male patients was 74.3 and 68.8 years, respectively. Women were more often disabled prior to stroke, hypertensive, diagnosed with atrial fibrillation or heart failure, and had impaired consciousness at admission, whereas men were more likely to smoke, abuse alcohol and have a history of myocardial infarction or transient ischemic attack. A higher percentage of female stroke patients suffered from total anterior circulation syndrome than males (21.2% and 14.0%, respectively). Internal carotid artery stenosis over 70% was reported in 10.8% of women and 19.1% of men. The 30-day mortality and poor outcome rates were significantly higher in women than men (17.2% vs. 13.1% and 59.9% vs. 46.2%). After adjusting for casemix in multivariate analysis, female sex was independently associated with a higher risk of an early poor outcome. In conclusion, the risk factor distribution, clinical characteristics, diagnostic test findings, and early outcomes were different between female and male ischemic stroke patients. Female sex was associated with poorer prognosis, indicating that more intensive acute and long-term global care may be needed to improve the outcome among female stroke patients.Cilj studije bio je utvrditi razlike u osnovnim značajkama i ishodu između muškaraca i žena s akutnim ishemijskim moždanim udarom. Ishemijski moždani udar potvrđen je kompjutorskom tomografijom ili pri autopsiji u bolesnika primljenih na Drugi neurološki odjel Zavoda za psihijatriju i neurologiju u Varšavi, Poljska, od 1995. do 2007. godine. Bolesnici i bolesnice uspoređeni su u odnosu na rizične čimbenike, stanje aktivnosti prije moždanog udara, vrst moždanog udara prema klasifikaciji Oxfordshire Community Stroke projekta, nalaze dijagnostičkih pretraga i rani 30-dnevni ishod. Analizirali su se podatci za 1379 žena i 1155 muškaraca s ishemijskim moždanim udarom. Srednja dob bolesnica bila je 74,3 godine, a bolesnika 68,8 godina. Žene su češće imale invalidnost prije moždanog udara, kao i hipertenziju, atrijsku fibrilaciju ili srčano zatajenje, te poremećaj svijesti kod prijma, dok je kod muškaraca češće zabilježena navika pušenja, zlouporaba alkohola te povijest infarkta miokarda ili prolaznog ishemijskog napadaja. Bolesnice su u većem postotku patile od sindroma ukupne prednje cirkulacije nego muškarci (21,2% prema 14,0%). Stenoza unutarnje karotidne arterije veća od 70% zabilježena je u 10,8% žena i 19,1% muškaraca. Smrtnost unutar 30 dana i stope lošeg ishoda bile su značajno više u žena negoli u muškaraca (17,2% prema 13,1%, odnosno 59,9% prema 46,2%). Nakon prilagodbe za casemix u multivarijatnoj analizi ženski spol bio je neovisno udružen s većim rizikom za rani loš ishod. U zaključku, raspodjela rizičnih čimbenika, te kliničke značajke, nalazi dijagnostičkih pretraga i rani ishodi razlikovali su se između muških i ženskih bolesnika s ishemijskim moždanim udarom. Ženski spol bio je udružen s lošijom prognozom, ukazujući na potrebu intenzivnije akutne i dugoročne opće skrbi kako bi se poboljšao ishod bolesti među bolesnicama s ishemijskim moždanim udarom

Poznavanje činjenica o moždanom udaru među bolesnicima bez moždanog udara

The aim of the study was to evaluate the knowledge among patients at non-neurologic wards about the risk factors for stroke, warning signs, and initial actions that must be taken when a stroke occurs. Data were collected from 75 inpatients suffering from a range of diseases, mean age 49.57±14.87 years. Study subjects were asked to fill in a standardized questionnaire containing 46 questions subdivided into two sections. The answers concerning warning symptoms, risk factors, causes of stroke, and initial action were quasi-quantified according to an arbitrary scoring system. Of 75 patients, only 5.3% were not aware of any medical risk factor, and 12% were not aware of any warning signals. On the other hand, only 2.6% and 10.66% of subjects listed correctly all risk factors and warning signs, respectively. Anyhow, many patients gave wrong answers. Most respondents (89.54%) would choose a desirable action if stroke was suspected. The scores for knowledge about stroke were better among higher educated respondents and among women. The factors such as belonging to a high-risk group for stroke, age, and other characteristics did not influence the score. Family, friends, and mass media provided major sources of the patients’ knowledge. It is concluded that, despite the fact that the respondents knew a lot about stroke, the nature of stroke and the problems involved often caused confusion or misunderstanding. Further public education is needed to increase the awareness of the warning signals and risk factors, especially among patients who are at an increased risk of stroke.Cilj ispitivanja bio je procijeniti poznavanje činjenica o moždanom udaru, znakovima upozorenja i hitnim mjerama koje treba poduzeti u slučaju moždanog udara, među bolesnicima ne-neuroloških odjela. Prikupljeni su podaci za 75 bolnički liječenih osoba zbog različitih bolesti, srednje dobi 49,57±14,87 godina. Ispitanici su bili zamoljeni da ispune standardizirani upitnik koji je sadržavao 46 pitanja podijeljenih u dvije skupine. Odgovori su se odnosili na simptome upozorenja, rizične čimbenike, uzroke moždanog udara i prve mjere koje valja poduzeti u slučaju moždanog udara, a bili su polukvantificirani prema proizvoljnom bodovnom sustavu. Od 75 bolesnika, samo ih 5,3% nije bilo upoznato ni s kojim medicinskim rizičnim čimbenikom, dok ih 12% nije poznavalo bilo koji znak upozorenja. S druge strane, samo je 2,6% odnosno 10,66% ispitanika ispravno navelo sve rizične čimbenike i znakove upozorenja, dok su mnogi ispitanici naveli krive odgovore. Većina ispitanika(89,54%) odabrala bi prave mjere u slučaju sumnje na moždani udar. Osobe višeg obrazovanja i žene polučile su bolji bodovni rezultat glede znanja o moždanom udaru. Čimbenici kao što su pripadanje visoko rizičnoj skupini za moždani udar, starosna dob i druga obilježja nisu imala utjecaj na bodovni rezultat. Obitelj, prijatelji i sredstva javnog priopćavanja bili su glavni izvori znanja za ispitanike. Zaključujemo kako, usprkos činjenici da su ispitanici znali dosta o moždanom udaru, narav moždanog udara i s njim povezani problemi često izazivaju zbunjenost ili krivo tumačenje. Potrebna je daljnja izobrazba javnosti kako bi se poboljšalo raspoznavanje znakova upozorenja i rizičnih čimbenika, poglavito među bolesnicima s povećanim rizikom za moždani udar

Rat epididymal epithelial cells and 17beta-estradiol synthesis under hCG stimulation in vitro.

Epithelial cells of human and animal epididymis display features of steroidogenic cells. Rat epididymal epithelial cells in vitro produce androgens which are converted to 17beta-estradiol, and released into the medium. The regulation of the epididymal steroidogenesis is not fully understood but it could be expected that it remains under LH influence. In previous study we observed that the morphology of rat epididymal epithelial cells in vitro was affected by hCG and the increase of amount of lipid droplets, glycogen and PAS-positive substances was observed. The present studies show the organelles which take part in synthesis of steroids in rat epididymal epithelial cells in vitro and the effect of hCG on E2 synthesis. The cells were cultured in the medium with/without DHT and without DHT in supplementation with hCG. After hCG stimulation the amount of an active mitochondria were increased when compared to the amount of mitochondria in the epididymal epithelial cells cultured without DHT. Ultrastructure of the cells was similar to the cells cultured with DHT, while the cytoplasm of the cells cultured without DHT was disorganized. The synthesis of 17beta-estradiol was stimulated by hCG, that exerted its effect through LH/hCG receptors, localized in the epididymal epithelial cells

Deletions in chromosome 6p22.3-p24.3, including ATXN1, are associated with developmental delay and autism spectrum disorders

Interstitial deletions of the short arm of chromosome 6 are rare and have been associated with developmental delay, hypotonia, congenital anomalies, and dysmorphic features. We used array comparative genomic hybridization in a South Carolina Autism Project (SCAP) cohort of 97 subjects with autism spectrum disorders (ASDs) and identified an ~ 5.4 Mb deletion on chromosome 6p22.3-p23 in a 15-year-old patient with intellectual disability and ASDs. Subsequent database queries revealed five additional individuals with overlapping submicroscopic deletions and presenting with developmental and speech delay, seizures, behavioral abnormalities, heart defects, and dysmorphic features. The deletion found in the SCAP patient harbors ATXN1, DTNBP1, JARID2, and NHLRC1 that we propose may be responsible for ASDs and developmental delay

Rat epididymal epithelial cells and 17beta-estradiol synthesis under hCG stimulation in vitro.

Epithelial cells of human and animal epididymis display features of steroidogenic cells. Rat epididymal epithelial cells in vitro produce androgens which are converted to 17beta-estradiol, and released into the medium. The regulation of the epididymal steroidogenesis is not fully understood but it could be expected that it remains under LH influence. In previous study we observed that the morphology of rat epididymal epithelial cells in vitro was affected by hCG and the increase of amount of lipid droplets, glycogen and PAS-positive substances was observed. The present studies show the organelles which take part in synthesis of steroids in rat epididymal epithelial cells in vitro and the effect of hCG on E2 synthesis. The cells were cultured in the medium with/without DHT and without DHT in supplementation with hCG. After hCG stimulation the amount of an active mitochondria were increased when compared to the amount of mitochondria in the epididymal epithelial cells cultured without DHT. Ultrastructure of the cells was similar to the cells cultured with DHT, while the cytoplasm of the cells cultured without DHT was disorganized. The synthesis of 17beta-estradiol was stimulated by hCG, that exerted its effect through LH/hCG receptors, localized in the epididymal epithelial cells

Deletions in chromosome 6p22.3-p24.3, including <it>ATXN1</it>, are associated with developmental delay and autism spectrum disorders

Abstract Interstitial deletions of the short arm of chromosome 6 are rare and have been associated with developmental delay, hypotonia, congenital anomalies, and dysmorphic features. We used array comparative genomic hybridization in a South Carolina Autism Project (SCAP) cohort of 97 subjects with autism spectrum disorders (ASDs) and identified an ~ 5.4 Mb deletion on chromosome 6p22.3-p23 in a 15-year-old patient with intellectual disability and ASDs. Subsequent database queries revealed five additional individuals with overlapping submicroscopic deletions and presenting with developmental and speech delay, seizures, behavioral abnormalities, heart defects, and dysmorphic features. The deletion found in the SCAP patient harbors ATXN1, DTNBP1, JARID2, and NHLRC1 that we propose may be responsible for ASDs and developmental delay.</p

Global Impact of COVID-19 on Stroke Care and IV Thrombolysis

Objective To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. Methods. We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. Results. There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] −11.7 to −11.3, p \u3c 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI −13.8 to −12.7, p \u3c 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI −13.7 to −10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2–9.8, p \u3c 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. Conclusions. The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months