Original Article - The effects of hematocrit and age on transcranial Doppler measurements in patients with recent ischemic stroke

BACKGROUND: The effects of age and hematocrit on transcranial Doppler (TCD) velocities have not been evaluated in a large patient group with recent ischemic stroke. AIM: This study assessed the effects of age and hematocrit on TCD measurements in patients with recent ischemic stroke compared to patients with non-vascular diseases. SETTINGS AND DESIGN: University Hospital, retrospective study. MATERIALS AND METHODS: TCD records and data files of 862 consecutive patients (mean age, 57±16 years) with various neurological diagnoses were reviewed retrospectively. The peak systolic, end diastolic and mean flow velocities (FV), systolic/diastolic ratios and pulsatility indices (PI) in the middle cerebral arteries were averaged and the effect of age and hematocrit values on these TCD values was studied. Independent samples t test, Pearson′s coefficients of correlation, and linear regression test were used for statistical analysis. RESULTS: Among 862 patients, 413 were women (mean age, 53±17 years) and 449 were men (mean age, 60±13 years). Peak systolic and mean FV were higher and hematocrit concentration was lower in women compared to men (P<0.001). The relation of TCD velocities with age and hematocrit was more remarkable in the group of patients with non-vascular neurological disorders. PI values demonstrated a significant correlation to age (r=+0.47) (P<0.001), but did not change significantly with hematocrit level. CONCLUSIONS: It should be remembered that blood FV measured by TCD may be significantly affected by age and hematocrit level. However, there seems to be no significant association between TCD velocities and hematocrit in patients with a recent ischemic stroke

Clinical pharmacist’s contribution to treatment adherence and quality of life in patients with stroke

Primary objective: The optimal treatment adherence rate among patients with stroke is low. This study aims to determine the effect of clinical pharmacists’ intervention on treatment adherence and quality of life (QOL) in patients with first-ever stroke. Research design: This open, controlled, prospective and interventional study was conducted sequentially at two different university hospitals for 3 months. Patients in the intervention group (IG) were provided with clinical pharmacist-led education whereas the control group (CG) only received routine care. Methods and procedures: Treatment adherence and QOL were assessed on discharge day, and in months 1 and 3 after discharge. Morisky Green Levine Adherence Scale and Stroke Specific Quality of Life Scale were employed to evaluate treatment adherence and QOL, respectively. Main outcomes and results: Changes in treatment adherence score were higher between discharge day, 1st and 3rd months after discharge in IG than CG (p < 0.001). Regarding ‘energy’ and ‘work/productivity’ domains, patients’ scores in IG were higher than those from CG at months 1 and 3 after discharge (p < 0.05). Conclusion: Clinical pharmacist-led education improves treatment adherence in patients with first-ever stroke. The clinical pharmacist might be integrated into the multidisciplinary team to improve QOL and treatment adherence

Electrocardiographic and Troponin Changes in Acute Ischemic Stroke

Introduction: Cardiac enzyme elevation and electrocardiographic (ECG) changes are frequent in ischemic stroke patients. The aims of our study were to determine the relationship between TnI levels, ECG changes and acute ischemic stroke. We compared the relationship between TnI levels and ECG changes with ischemic stroke severity, cardiovascular complications, unfavorable outcome and mortality

Early Seizures in Patients with Acute Ischemic Stroke: Incidence, Predictive Factors, and Clinical Outcome

Objectives: Cerebrovascular disease is one of the major causes of epileptic seizures in the elderly. The aim of this study was to identify the incidence and predictive factors of early seizures after ischemic stroke (ESAIS) and the effect of early seizures on clinical outcome

İNME KLİNİK PRATİĞİNDE NOAK KULLANIMI:TÜRK BEYİN DAMAR HASTALIKLARI DERNEĞİ UZMAN GÖRÜŞÜ

Non-vitamin K oral antikoagülanların (NOAK) atrial fibrilasyonda inmenin önlenmesi amacıyla on yılı aşan bir süredirbaşarı ile kullanıldığı açıktır. Varfarine göre belirgin derecede az kanamaya yol açmaları ve inmeyi de eşit veya daha fazlaoranda önleyebilmeleri yanı sıra kolay kullanım özellikleri primer proflakside atrial fibrilasyona bağlı inmeyi azaltmakonusunda öne çıkmaktadır. Bunlar aynı zamanda genel inme prevalansının azalması anlamına gelmektedir. Yani AFnedenli inmenin engellenmesi toplum sağlığı için çağdaş bir gereklilik olarak algılanmalıdır. İnme klinik pratiğindekardiyoloji uzmanları ile birlikte bu bağlamda çaba sarf eden nöroloji uzmanları için Türk Beyin Damar HastalıklarıDerneği bu uzman görüşünü hazırladı. Görüşler NOAK grubu ilaçların kullanımında sıkça karşılaşılan sorunlar ve buproblemler için güncel çözüm önerilerini içermektedir.It is clear that nonvitamin K oral anticoagulants (NOACs) have been used successfully for more than ten years to preventstroke in atrial fibrillation. In addition to the fact that they cause significantly less bleeding compared to warfarin and canprevent stroke equally or more, their easy-to-use features stand out in reducing stroke due to atrial fibrillation in primaryprophylaxis. These also mean a decrease in the overall prevalence of stroke. For sure, prevention of AF-induced strokeshould be perceived as a contemporary requirement for public health. Turkish Society of Cerebrovascular Diseases hasprepared this expert opinion for neurologists who strive for this purpose together with cardiologists in the clinicalpractice of stroke. The article contains frequently encountered problems in the use of NOACs and current solutions forthese problems