Stroke Research and Treatment最新文献

{"title":"The Neurophysiological Impact of Subacute Stroke: Changes in Cortical Oscillations Evoked by Bimanual Finger Movement.","authors":"Ana Dionísio,&nbsp;Rita Gouveia,&nbsp;João Castelhano,&nbsp;Isabel Catarina Duarte,&nbsp;Gustavo C Santo,&nbsp;João Sargento-Freitas,&nbsp;Miguel Castelo-Branco","doi":"10.1155/2022/9772147","DOIUrl":"https://doi.org/10.1155/2022/9772147","url":null,"abstract":"<p><strong>Introduction: </strong>To design more effective interventions, such as neurostimulation, for stroke rehabilitation, there is a need to understand early physiological changes that take place that may be relevant for clinical monitoring. We aimed to study changes in neurophysiology following <i>recent</i> ischemic stroke, both at rest and with motor planning and execution.</p><p><strong>Materials and methods: </strong>We included 10 poststroke patients, between 7 and 10 days after stroke, and 20 age-matched controls to assess changes in cortical motor output via transcranial magnetic stimulation and in dynamics of oscillations, as recorded using electroencephalography (EEG).</p><p><strong>Results: </strong>We found significant differences in cortical oscillatory patterns comparing stroke patients with healthy participants, particularly in the beta rhythm during motor planning (<i>p</i> = 0.011) and execution (<i>p</i> = 0.004) of a complex movement with fingers from both hands simultaneously. <i>Discussion</i>. The stroke lesion induced a decrease in event-related desynchronization in patients, in comparison to controls, providing evidence for decreased disinhibition.</p><p><strong>Conclusions: </strong>After a stroke lesion, the dynamics of cortical oscillations is changed, with an increasing neural beta synchronization in the course of motor preparation and performance of complex bimanual finger tasks. The observed patterns may provide a potential functional measure that could be used to monitor and design interventional approaches in subacute stages.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":" ","pages":"9772147"},"PeriodicalIF":1.5,"publicationDate":"2022-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8831071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39915100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poststroke Erectile Dysfunction in Cameroon: Prevalence, Associated Factors, and Quality of Life.","authors":"Daniel Gams Massi,&nbsp;Gervais Ngoupayou Mountap,&nbsp;Hervé Edouard Moby,&nbsp;Frantz Guy Epoupa Ngalle,&nbsp;Sidick Mouliom,&nbsp;Jacques Doumbe,&nbsp;Njankouo Yacouba Mapoure","doi":"10.1155/2021/9988841","DOIUrl":"https://doi.org/10.1155/2021/9988841","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a severe disease due to its morbidity-mortality. It is the first cause of acquired disability including erectile dysfunction (ED). The purpose of this study was to determine the prevalence of ED in stroke patients at the Douala General Hospital, to identify associated factors and to evaluate their quality of life.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted over a period of seven months from November 2016 to May 2017 on two groups of patients in neurology, cardiology, and endocrinology units of the Douala General Hospital (Cameroon): stroke patients (stroke+) and nonstroke patients (stroke-). We collected sociodemographic and clinical data using a preestablished questionnaire. Erectile function was assessed using International Index of Erectile Function (IIEF-5). Associated and predictive factors were determined using univariate and multivariate analyses. Results were significant for a <i>p</i> value < 0.05.</p><p><strong>Results: </strong>A total of 269 patients were included, among them 87 stroke+ (32.34%) and 182 stroke- (67.66%) (controlled group). The mean age was 56.37 ± 12.89 years and 57.18 ± 10.24 years of stroke+ and stroke-, respectively (<i>p</i> = 0.608). Prevalence of poststroke ED was 64.4% (OR = 3.41, 95% CI: 1.99-5.82, <i>p</i> < 0.001). The average time of occurrence of the poststroke ED was 5 ± 5.85 months. Diabetes and dyslipidemia were the predictive factors of occurrence of poststroke ED. Depression was found both in stroke+ with ED and stroke+ without ED with no difference (<i>p</i> = 0.131).</p><p><strong>Conclusion: </strong>About two-thirds of stroke patients developed ED. Diabetes and dyslipidemia were predictive factors of ED in stroke patients.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"9988841"},"PeriodicalIF":1.5,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8664533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39582099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes after Intravenous Alteplase in Elderly Patients with Acute Ischaemic Stroke: A Retrospective Analysis of Patients Treated at a Tertiary Neurology Centre in England from 2013 to 2018.","authors":"Xuya Huang,&nbsp;Phillip Nash,&nbsp;Vafa Alakbarzade,&nbsp;Brian Clarke,&nbsp;Anthony C Pereira","doi":"10.1155/2021/3738017","DOIUrl":"https://doi.org/10.1155/2021/3738017","url":null,"abstract":"<p><p>Intravenous thrombolysis with alteplase within 4.5 hours from symptom onset is a well-established treatment of acute ischaemic stroke (AIS). The aim was to compare alteplase for AIS between patients aged >80 and ≤80 years in our registry data, from 2013 to 2018. Mechanical thrombectomy cases were excluded. We assessed clinical outcomes over the six-year period and between patients aged over 80 and ≤80 years, using measures including the discharge modified Rankin Scale (mRS), 24-hour National Institutes of Health Stroke Scale (NIHSS) improvement, and symptomatic intracerebral haemorrhage (sICH) rate. Of a total of 805 AIS patients who received intravenous alteplase, 278 (34.5%) were over 80 years old, and 527 (65%) were younger. 616 (76.5%) received thrombolysis ≤ 3 hours after symptom onset and 189 (23.5%) within 3-4.5 hours. Median baseline mRS and NIHSS of the elderly cohort were 1 (IQR 0-5) and 13 (IQR 2-37), respectively, compared to the younger cohort 0 (IQR 0-5) and 9 (IQR 0-29). The sICH rate was 7.2% in the elderly and 4.6% in those ≤80 years, <i>p</i> = 0.05. NIHSS improved within 24 hours in 34% of the elderly cohort compared to 35% in the younger cohort. At hospital discharge, the mortality rate was 9% in the elderly cohort compared to the 6% in the younger cohort, <i>p</i> = 0.154. 25% of patients aged >80 years had mRS ≤ 2 compared to 47% in the younger patients (<i>p</i> < 0.0001). In conclusion, thrombolysis in elderly patients results in clinical improvement comparable to younger patients.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"3738017"},"PeriodicalIF":1.5,"publicationDate":"2021-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8572621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39693491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Study of Cost-Effectiveness of Rivaroxaban versus Warfarin in Patients with Atrial Fibrillation Who Developed Ischemic Stroke.","authors":"Neda Jaberi,&nbsp;Zahra Kavosi,&nbsp;Etrat Hooshmandi,&nbsp;Nasrin Moradi,&nbsp;Khosro Keshavarz,&nbsp;Afshin Borhani-Haghighi","doi":"10.1155/2021/5534873","DOIUrl":"https://doi.org/10.1155/2021/5534873","url":null,"abstract":"<p><strong>Introduction: </strong>Rivaroxaban is a new anticoagulant providing benefits for the treatment of patients with atrial fibrillation (AF). This study is aimed at evaluating the cost-effectiveness of rivaroxaban compared to warfarin in patients with AF.</p><p><strong>Method: </strong>This economic evaluation study was conducted among 144 selected nonrandomly patients who were treated with rivaroxaban or warfarin and suffered from AF leading to stroke, in the stroke ward of Shiraz Nemazee Hospital in 2019. The final and clinical (intermediate) outcomes were QALYs and no bleeding and prevention of ischemic stroke, respectively. The study was performed from the social perspective, and a deterministic one-way sensitivity analysis was conducted to identify the effects of uncertainty. The analysis of the collected data was carried out using SPSS18 and TreeAge software.</p><p><strong>Results: </strong>Patients who received rivaroxaban had lower costs ($ 25275 vs. $ 26554) and higher QALYs (0.5 vs. 0.33) compared to those taking warfarin. Bleeding and stroke occurred in (9 vs. 40) and (1 vs. 3) patients in the rivaroxaban and warfarin groups, respectively, and there was a significant decrease in the incidence of bleeding in the rivaroxaban group (81.9% vs 44.4%). Thus, rivaroxaban in all the outcomes was cheaper and more effective than warfarin. The one-way sensitivity analysis confirmed the robustness of the results.</p><p><strong>Conclusions: </strong>Considering the incremental cost-effectiveness ratio, rivaroxaban is more cost-effective and can be a dominant alternative. Therefore, it is suggested to use rivaroxaban as the first priority in AF patients because rivaroxaban reduces costs and increases clinical outcomes compared with warfarin.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"5534873"},"PeriodicalIF":1.5,"publicationDate":"2021-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8440110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39426616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a Predictive Tool for Hospital Discharge Disposition of Patients Poststroke with 30-Day Readmission Validation.","authors":"Jin Cho, Krystal Place, Rebecca Salstrand, Monireh Rahmat, Misagh Mansouri, Nancy Fell, Mina Sartipi","doi":"10.1155/2021/5546766","DOIUrl":"10.1155/2021/5546766","url":null,"abstract":"<p><p>After short-term, acute-care hospitalization for stroke, patients may be discharged home or other facilities for continued medical or rehabilitative management. The site of postacute care affects overall mortality and functional outcomes. Determining discharge disposition is a complex decision by the healthcare team. Early prediction of discharge destination can optimize poststroke care and improve outcomes. Previous attempts to predict discharge disposition outcome after stroke have limited clinical validations. In this study, readmission status was used as a measure of the clinical significance and effectiveness of a discharge disposition prediction. Low readmission rates indicate proper and thorough care with appropriate discharge disposition. We used Medicare beneficiary data taken from a subset of base claims in the years of 2014 and 2015 in our analyses. A predictive tool was created to determine discharge disposition based on risk scores derived from the coefficients of multivariable logistic regression related to an adjusted odds ratio. The top five risk scores were admission from a skilled nursing facility, acute heart attack, intracerebral hemorrhage, admission from \"other\" source, and an age of 75 or older. Validation of the predictive tool was accomplished using the readmission rates. A 75% probability for facility discharge corresponded with a risk score of greater than 9. The prediction was then compared to actual discharge disposition. Each cohort was further analyzed to determine how many readmissions occurred in each group. Of the actual home discharges, 95.7% were predicted to be there. However, only 47.8% of predictions for home discharge were actually discharged home. Predicted discharge to facility had 15.9% match to the actual facility discharge. The scenario of actual discharge home and predicted discharge to facility showed that 186 patients were readmitted. Following the algorithm in this scenario would have recommended continued medical management of these patients, potentially preventing these readmissions.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"5546766"},"PeriodicalIF":1.5,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8390171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39366978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Independence 6 and 18 Months after Ischemic Stroke Considering Differences in 12 Countries: A Secondary Analysis of the IST-3 Trial.","authors":"André Vieira,&nbsp;Patrícia Soares,&nbsp;Carla Nunes","doi":"10.1155/2021/5627868","DOIUrl":"https://doi.org/10.1155/2021/5627868","url":null,"abstract":"<p><strong>Objectives: </strong>This study is aimed at identifying the best clinical model to predict poststroke independence at 6 and 18 months, considering sociodemographic and clinical characteristics, and then identifying differences between countries.</p><p><strong>Methods: </strong>Data was retrieved from the International Stroke Trial 3 study. Nine clinical variables (age, gender, severity, rt-PA, living alone, atrial fibrillation, history of transient ischemic attack/stroke, and abilities to lift arms and walk) were measured immediately after the stroke and considered to predict independence at 6 and 18 months poststroke. Independence was measured using the Oxford Handicap Scale. The adequacy, predictive capacity, and discriminative capacity of the models were checked. Countries were added to the final models.</p><p><strong>Results: </strong>At 6 months poststroke, 35.8% (<i>n</i> = 1088) of participants were independent, and at 18 months, this proportion decreased to 29.9% (<i>n</i> = 747). Both 6 and 18 months poststroke predictive models obtained fair discriminatory capacities. Gender, living alone, and rt-PA only reached predictive significance at 18 months. Poststroke patients from Poland and Sweden showed greater chances to achieve independence at 6 months compared to the UK. Poland also achieved greater chances at 18 months. Italy had worse chances than the UK at both follow-ups. <i>Discussion</i>. Six and eight variables predicted poststroke independence at 6 and 18 months, respectively. Some variables only reached significance at 18 months, suggesting a late influence in stroke patients' rehabilitation. Differences found between countries in achieving independence may be related to healthcare system organization or cultural characteristics, a hypothesis that must be addressed in future studies. These results can allow the development of tailored interventions to improve the outcomes.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"5627868"},"PeriodicalIF":1.5,"publicationDate":"2021-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8349276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39306472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 Pandemic on Acute Ischemic Stroke Presentation, Treatment, and Outcomes.","authors":"Timothy G White,&nbsp;Gabriela Martinez,&nbsp;Jason Wang,&nbsp;Michele Gribko,&nbsp;Artem Boltyenkov,&nbsp;Rohan Arora,&nbsp;Jeffrey M Katz,&nbsp;Henry H Woo,&nbsp;Pina C Sanelli","doi":"10.1155/2021/8653396","DOIUrl":"https://doi.org/10.1155/2021/8653396","url":null,"abstract":"<p><strong>Introduction: </strong>The World Health Organization declared COVID-19 a global pandemic last year. While a clear impact of COVID-19 on the declining stroke volume has been reported, its overall impact on stroke presentation and clinical outcomes has not been established. The purpose of this study was to assess the impact of COVID-19 on acute ischemic stroke volume, presentation, treatment, and outcomes at comprehensive stroke centers.</p><p><strong>Methods: </strong>A retrospective review of patients with a discharge diagnosis of acute ischemic stroke from the Get With The Guidelines database was performed from January 1, 2019, to July 1, 2020. The following time periods were defined: Pre-COVID (January/February), Peak-COVID (March/April), and Post-COVID (May/June). Bivariate analyses were performed comparing the 2020 and 2019 time periods to determine differences in stroke volume, presentation, treatment, and outcomes.</p><p><strong>Results: </strong>Stroke volumes were significantly lower during the Peak-COVID period in 2020 compared to that in 2019, with an absolute decline of 49.5% (<i>P</i> < 0.001). Patients were more likely to present after 24 hours from last known well during the 2020 Peak-COVID period (<i>P</i> = 0.03). However, there was not a significant difference in the rate of treatment with either the tissue plasminogen activator (tPA) or mechanical thrombectomy during the Peak-COVID period. Interestingly, relative treatment rates increased during the 2020 Post-COVID period to 11.4% (<i>P</i> = 0.01).</p><p><strong>Conclusions: </strong>The overall ischemic stroke volume decreased during the pandemic, and patients had a tendency to present later, beyond eligible treatment windows. However, rates of treatment, patient demographics, and stroke outcomes did not significantly change when compared to the prior year.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"8653396"},"PeriodicalIF":1.5,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39265829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of Perfusion CT in the Prediction of Intracerebral Hemorrhage after Endovascular Treatment.","authors":"Friederike Austein,&nbsp;Antonia Carlotta Fischer,&nbsp;Jens Fiehler,&nbsp;Olav Jansen,&nbsp;Thomas Lindner,&nbsp;Susanne Gellißen","doi":"10.1155/2021/9933015","DOIUrl":"https://doi.org/10.1155/2021/9933015","url":null,"abstract":"<p><strong>Background: </strong>Intracerebral hemorrhage (ICH) is a serious complication of endovascular treatment (EVT) in stroke patients with large vessel occlusion (LVO) and associated with increased morbidity and mortality.</p><p><strong>Aims: </strong>Identification of radiological predictors is highly relevant. We investigated the predictive power of computed tomography perfusion (CTP) parameters concerning ICH in patients receiving EVT.</p><p><strong>Methods: </strong>392 patients with anterior circulation LVO with multimodal CT imaging who underwent EVT were analyzed. CTP parameters were visually evaluated for modified ASPECTS regions and compared between patients without ICH, those with hemorrhagic infarction (HI), and those with parenchymal hematoma (PH) according to the ECASS criteria at follow-up imaging and broken down by ASPECTS regions.</p><p><strong>Results: </strong>168 received intravenous thrombolysis (IV-rtPA), and 115 developed subsequent ICH (29.3%), of which 74 were classified as HI and 41 as PH. Patients with HI and PH had lower ASPECTS than patients without ICH and worse functional outcome after 90 days (<i>p</i> < 0.05). In 102 of the 115 patients with ICH, the deep middle cerebral artery (MCA) territory was affected with differences between patients without ICH, those with HI, and those with PH regarding cerebral blood volume (CBV) and blood-brain barrier permeability measured as flow extraction product (FED) relative to the contralateral hemisphere (<i>p</i> < 0.05). Patients with PH showed larger perfusion CT infarct core than patients without ICH (<i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>None of the examined CTP parameters was found to be a strong predictor of subsequent ICH. ASPECTS and initial CTP core volume were more reliable and may be useful and even so more practicable to assess the risk of subsequent ICH after EVT.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"9933015"},"PeriodicalIF":1.5,"publicationDate":"2021-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8321751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39265830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Pharyngeal Electrical Stimulation on Swallow Timings, Clearance and Safety in Post-Stroke Dysphagia: Analysis from the Swallowing Treatment Using Electrical Pharyngeal Stimulation (STEPS) Trial.","authors":"Lisa F Everton,&nbsp;Jacqueline K Benfield,&nbsp;Emilia Michou,&nbsp;Shaheen Hamdy,&nbsp;Philip M Bath","doi":"10.1155/2021/5520657","DOIUrl":"https://doi.org/10.1155/2021/5520657","url":null,"abstract":"<p><p>Swallowing impairment (dysphagia) post-stroke results in poorer outcomes. Pharyngeal electrical stimulation (PES) is a potential treatment for post-stroke dysphagia. In a post hoc analysis, we investigated PES using videofluoroscopy swallow studies (VFSS) from the STEPS trial incorporating multiple measures of safety (penetration aspiration scale-PAS), speed and duration (timing), and efficiency (clearance), as opposed to the original trial which only measured PAS scores. 81 randomised participants (PES (<i>N</i> = 43) versus sham (<i>N</i> = 38)) were analysed at baseline and 2 weeks. Participants swallowed up to 6 × 5 ml and 1 × 50 ml of thin liquid barium at 40% <i>w</i>/<i>v</i>, images at ≥25 fps. Based on PAS, the 5 ml mode bolus (most frequently occurring PAS from 6 × 5 ml) and the worst 50 ml bolus were chosen for further analysis. Eight timing measures were performed, including stage transition duration (STD) and pharyngeal transit time (PTT). Clearance measures comprised oral and pharyngeal residue and swallows to clear. Comparisons of change of scoring outcomes between PES and sham were done at 2 weeks. Wilcoxon Signed Ranks Test was also used to evaluate longitudinal changes from both groups' combined results at two weeks. Between-group analysis showed no statistically significant differences. Issues with suboptimal image quality and frame rate acquisition affected final numbers. At two weeks, both groups demonstrated a significant improvement in most safety scores (PAS) and STD, possibly due to spontaneous recovery or a combination of spontaneous recovery and swallowing treatment and usual care. A nonsignificant trend for improvement was seen in other timing measures, including PTT. This study, which conducted additional measurements of kinematic and residue analysis on the STEPS data did not detect \"missed\" improvements in swallowing function that the PAS is not designed to measure. However, more studies with greater numbers are required.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"5520657"},"PeriodicalIF":1.5,"publicationDate":"2021-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39073701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Sociodemographic Factors, Concomitant Disease States, and Measures Performed in the Emergency Department on Patient Disability in Ischemic Stroke: Retrospective Study from Lebanon.","authors":"Diana Malaeb,&nbsp;Souheil Hallit,&nbsp;Hiba Al Harfany,&nbsp;Sara Mansour,&nbsp;Frederic Faugeras,&nbsp;Pascale Salameh,&nbsp;Hassan Hosseini","doi":"10.1155/2021/5551558","DOIUrl":"https://doi.org/10.1155/2021/5551558","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a leading cause of death and disability in developed countries. The major factor affecting long-term survival other than age is the disability severity caused by stroke. The modified Rankin Scale (mRS) is a global functional endpoint measurement used in acute stroke to evaluate the degree of disability or dependence in daily life activities. The objective of this study was to assess the effects of sociodemographic factors, concomitant disease states, and some measures performed in the emergency department (ED) on patients' disability.</p><p><strong>Methods: </strong>We conducted a retrospective study on ischemic stroke patients admitted to Intensive Care Unit of three Lebanese university hospitals between June and December 2016. Patients were excluded if they had been discharged from ED without hospital admission or if mRS was not performed. The mRS was further subdivided into two categories considered as \"good prognosis\" (0-2 or 0-3) and \"poor prognosis\" (>2 or > 3).</p><p><strong>Results: </strong>204 patients were included in the study with mean age of 65.4 ± 11.9 years, hypertension was the most previous concomitant past medical disease (77.1%), and 27.1% of these patients had previous history of stroke. No significant differences were found in both mRS categories for all sociodemographic factors, and past medical history except that arrhythmia was significantly more common in the higher mRS categories > 2 and > 3. Based on multivariable analysis, there was a trend for previous intake of calcium channel blocker to be associated with lower mRS at admission (beta -0.586). However, intracranial arterial stenosis, ED blood glucose > 180 mg/dL, and performing brain imaging above 20 minutes after patient presentation to ED were significantly associated with higher mRS scores at discharge with an ORa and (confidence interval) of 2.986 (0.814, 10.962), 3.301 (1.072, 1.261), and 1.138 (1.071, 9.080), respectively.</p><p><strong>Conclusion: </strong>mRS is affected by previous disease states, prescribed medications, and acute measures performed in ED. It is also influenced by intracranial arterial stenosis etiology, which is associated with worse outcome.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2021 ","pages":"5551558"},"PeriodicalIF":1.5,"publicationDate":"2021-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8175140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39240225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}