Neurosciences最新文献

Objectives: To determine the relationship between hemoglobin A1c (HbA1c) and different types of stroke, and how different comorbidities and risk factors are related to the occurrence of stroke in a Saudi Arabian tertiary care hospital.

Methods: This retrospective study was conducted at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. The study included patients who experienced either hemorrhagic stroke (HS), ischemic stroke (IS), or transient ischemic attack (TIA) between 2015 and 2020.

Results: In total, 976 patients were included, of whom 670 were males (68.6%). The incidence of HS was significantly higher in males compared to females (14.2% vs. 6.9%), whereas the incidence of IS was higher in females (76.8% vs. 74.6%) (p=0.001). Ischemic stroke was significantly higher in the 65 years or older age group, whereas HS was comparatively higher among those aged <65 years. The means HbA1c levels in all three types of stroke were abnormally high. However, HbA1c levels were significantly higher in IS than in the other 2 stroke types (p=0.017). The HbA1c levels showed statistically significant differences between the different types of stroke, where the estimated marginal means were higher in patients with IS with a small effect size. Heart disease was also more prevalent in the IS group. Stroke-related mortality was reported in 16 patients and was significantly higher in the IS group than in the HS group.

Conclusion: The HbA1c levels were elevated in all types of stroke, significantly in IS. Controlling patients' HbA1c and other modifiable risk factors could significantly reduce the risk of stroke.

Objectives: To explore the barriers preventing pioglitazone use in stroke survivors and primary and secondary stroke care services.

Methods: A qualitative grounded theory approached design was used to assess post-stroke diabetes treatments and to assess clinical applicability of pioglitazone as a preventive treatment to minimize its side effects (SEs) associated. Three focus groups were established with 48 participants from Scotland and Wales health board centers during January 2019 to July 2022.

Results: A qualitative grounded theory approached design was used to assess post-stroke diabetes treatments and to assess clinical applicability of pioglitazone as a preventive treatment to minimize its SEs associated. Three focus groups were established with 48 participants from Scotland and Wales health board centers during January 2019 to July 2022.

Conclusion: These strategies might allow greater treatment adherence by stroke survivors and increased confidence of the health care professionals in their practice. The findings suggest that further research will be needed to facilitate wider usage of pioglitazone in treating people with stroke and health education is necessitate when using diabetes drugs post-stroke.

Objectives: To assess the effects of decompressive craniectomy combined with edaravone on the postoperative neurological functions and hemodynamics of patients with severe traumatic brain injury (STBI).

Methods: The subjects included totally 186 STBI patients admitted during January 2018 and January 2021. The random number table method was adopted to set an operation group (n=82) and a combined medication group (n=104) for the subjects. The changes of the clinical indicators were observed.

Results: Compared with the operation group, the combined medication group had higher Neurobehavioral Cognitive Status Examination score, Barthel index score, total response rate and heart rate (p<0.05). Besides, by contrast to those of the operation group, the mean arterial pressure, myocardial zymogram indicators, postoperative neurological function indicators and total incidence rate of complications of the combined medication group were reduced (p<0.05). In comparison with the operation group, the combined medication group exhibited raised ipsilateral contralateral blood velocities (p<0.05). Furthermore, the combined medication group had a better postoperative 1-year prognosis than the operation group (p<0.05).

Conclusion: Edaravone in combination with decompressive craniectomy benefits the postoperative improvement of neurological functions of STBI patients, effectively stabilizes the hemodynamics, induces few complications and improves the prognosis.

Objectives: To establish antibiogram data for patients with spinal cord injury (SCI) that would help differentiate the organisms commonly present depending on the voiding method and antibiotic sensitivity for empirical treatment.

Methods: A total of 499 urine culture results were obtained from 151 SCI patients with symptomatic urinary tract infection (UTI) with significant bacteriuria and pyuria with more than 10 white blood cells per high power field. The voiding method was categorized as follows: self-intermittent catheterization (SIC), suprapubic catheter (SPC), Foley catheter, condom catheter, or voiding freely.

Results: The demographic data were as follows: male, n=124 (82.2%); female, n=27 (17.8%); mean age, 39; paraplegic n=105 (69.5%); and tetraplegic, n=45 (29.8%). The SIC was the most common voiding method (n=64, 42.3%), followed by Foley catheter (n=39, 25.8%). Escherichia coli was the most common organism overall (29%) and more frequent in patients using SIC as the voiding method. Proteus mirabilis was present more frequently in patients using SPC (33%), and Klebsiella pneumoniae in voiding freely cultures (30%). Antibiotic sensitivity was as follows Gentamicin (44.1%), Nitrofurantoin (39.1%), Augmentin (33.5%), and Ciprofloxacin (31.5%).

Conclusion: Increased preference of the local population to foley catheter as a voiding method which needs to be investigated more. The type of voiding methods in patients with SCI results in different common causative organisms of UTI. Ciprofloxacin resistance profile increased overall except in patients voiding with SPC. Nitrofurantoin is the most overall sensitive oral antibiotic in our sample followed by Augmentin then Cefuroxime.

Objectives: To assess outcomes and complications of patients with cerebral venous thrombosis (CVT).

Methods: This multicenter retrospective study was conducted at 2 health care centers in Saudi Arabia and Oman. Adult patients diagnosed with CVT in radiological imaging between 2006 and 2020 were included. Data were collected from medical records and analyzed using the software IBM® SPSS version 22. Neurological disability occurring after CVT was graded according to the modified Rankin scale (mRS).

Results: The study included 103 patients, of which the majority (68%) were female. The mean age was 39.12±12.96 years. Two-thirds of patients received low-molecular-weight heparin (LMWH) in acute treatment, while 76% of discharged patients used warfarin. The majority of patients had no or mild neurological disability during follow-up, and 6 patients had an mRS score ≥3, implying significant neurological disability. There were 55 patients (52.3%) who had complications from CVT, including seizures in 17 (16.5%) patients and one mortality. Follow-up imaging of 55 patients showed complete thrombus resolution in 20 patients (36%).

Conclusion: Anticoagulation is the mainstay treatment for CVT patients. Approximately half of patients experience complications. Prospective studies are needed to assess the long-term neurological outcomes in such patients.