IN-HOSPITAL STROKE RECURRENCE OF ACUTE ISCEMIC STROKE

BACKROUND: Stroke survivors are athigh risk of recurrent stroke, communitybasedstudies show that this risk is about30%. Recurrent strokes tend to be moredeadly than the first stroke and lead tofurther neurological impairment. In thissudy, in-hospital stroke recurrence ina university hospital stroke unit settingwere investigated.PATIENTS AND METHODS: Strokeregistry data of 2128 patients hospitalizedat the Istanbul Faculty of Medicine,Department of Neurology, Edip AktinStroke Unit between 1994-2007 wereevaluated. Recurent stroke was definedas a new neurological deficit not causedby neurological complications such asedema, mass effect or hemorrhagic transformationor progression of the indexevent. Clinical, laboratory and neuroimagingfindings of 67 recurrent ischemicstroke patients were compared with ischemicstroke patients (n = 1658) withoutany recurrence. Statistical methods usedwere; chi-squared test for parametricvariables, t-test for continuous variablesand univariate and multivariate analysisusing SPSS version 15.0.RESULTS: In- hospital stroke reccurencerate was 3.9% (n = 83/2128) inall stroke patients and %4 in ischemicstroke (IS) patients. There were no statisticallysignificant differences betweenIS patients with and without recurrencein terms of demographic features, andmost traditional risk factors. Only peripheralvascular disease frequency wassignificantly higher in the recurrent stroke group (p = 0.05, 95% CI = 0.98 to5.524). Posterior circulation syndrome(POCS) and was significantly more frequentlyencountered in the recurrentstroke group (p = 0.012).The most importantfactor in determining the recurrenceof IS was large artery atherosclerosis(LAS) (p <0.001, 95% CI = 0.062 to0.44).CONCLUSION: In a stroke unit whereacute stroke treatments were mostly unavailable,a higher in-hospital stroke recurrencerate associated with LAS in ISpatients may be indicative of the importanceof early theraputic intervention

Does Lower Urinary Tract Status Affect Renal Transplantation Outcomes in Children?

Background. Lower urinary tract dysfunction (LUTD), an important cause of end stage renal disease (ESRD) in children, can adversely affect renal graft survival. We compared renal transplant patients with LUTD as primary renal disease to those without LUTD

Surgical Management Of Renovascular Hypertension In Children And Young Adults: A 13-Year Experience

OBJECTIVES: In this study, we aimed to evaluate the early and mid-term outcomes of surgery for renovascular hypertension (RVH) at our institution, within the last 13years. METHODS: We retrospectively reviewed 19 patients who underwent surgery for RVH, between 2005 and 2017. The age at operation, clinical characteristics, cause of arterial stenosis, diagnostic workup, surgical management and outcomes during the follow-up were analysed. The continuous variables were expressed as meanstandard deviation. RESULTS: Twelve female and 7 male patients underwent surgery for RVH. Their mean age was 17.07 +/- 11.9years (range 4-42years). Nine patients had renal arterial stenosis, and 10 patients had midaortic syndrome (MAS). Aortorenal bypass with the saphenous vein was performed in 6 patients with renal arterial stenosis and 1 patient with MAS. An isolated thoracic aorta-abdominal aortic bypass was performed in 1 patient with MAS, and thoracic aorta-abdominal aortic bypass combined with unilateral aortarenal bypass was performed in 9 patients with MAS. The other surgical procedures performed were 2 autotransplantations and 2 unilateral nephrectomies. Among the patients with MAS, 4 underwent reoperation. The mean follow-up duration was 45.58 +/- 32.7months. Hypertension was cured in 3 patients and improved in 14 patients. The postoperative follow-up creatinine levels were similar to preoperative creatinine levels. All bypasses were patent on mid-term follow-up. One patient who underwent aortorenal bypass died 14months postoperatively. CONCLUSIONS: Surgical management is a suitable option for patients with RVH, who were unresponsive to medical and/or endovascular management. Surgical methods are safe and effective in children and young adults with RVH.WoSScopu