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Assessment of atrial electromechanical delay and echocardiographic parameters in patients with multiple sclerosis 评估多发性硬化症患者的心房机电延迟和超声心动图参数
IF 0.2 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-01 DOI: 10.54029/2023yjr
Derya Özdoğru, F. Salkın, Elif Banu Söker, O. Uysal
Objective: Data on cardiovascular dysfunction is limited in the previous literature on patients with multiple sclerosis. In this study, we aimed to elucidate the cardiovascular parameters in multiple sclerosis patients by comparing the systolic-diastolic functions and atrial electro-mechanical delay compared to the control group. Method: A total of 37 patients with a diagnosis of relapsing-remitting multiple sclerosis and had Expanded Disability Status Scale (EDSS) scores between 0 – 3, and 20 individuals in the control group were included in the study. Seventeen of the MS patients (n=17) were taking immunomodulatory drugs and the other 20 did not receive any immunomodulatory agents. Patients with a diagnosis or clinical suspicion of cardiac dysfunction and using cardiotoxic medications were excluded. The measurement of systolic and diastolic function parameters was performed via M – Mode 2D transthoracic echocardiography, and Atrial electro-mechanical delay (AEMD) measurements were performed with tissue Doppler. Results: E’ MV lateral and MV E/A values were determined to be higher in MS patients, who did not use immunomodulatory drugs, compared to the control group (p<0.001, p=0.010 respectively). E/E’ MV lateral and MV AVmax values were determined to be significantly higher in the patient group using immunomodulators compared to the other two groups (p=0.009, p=0.012 respectively). PAs, PAI, left and right intraatrial EMG values were determined to be prolonged in MS patients using and not using drugs compared to the control group, but these values were not determined to be statistically significant. Conclusion: We found that left ventricular diastolic function was impaired in MS patients compared to the control group, and right-left intra- and interatrial AEMD were similar. Based on these results, we recommend echocardiographic assessment for early detection of left ventricular diastolic dysfunction in MS patients.
目的:以往文献中有关多发性硬化症患者心血管功能障碍的数据有限。在本研究中,我们旨在通过比较多发性硬化症患者与对照组的收缩-舒张功能和心房电子机械延迟,来阐明多发性硬化症患者的心血管参数。研究方法研究共纳入 37 名诊断为复发缓解型多发性硬化症且残疾状况扩展量表(EDSS)评分在 0 - 3 之间的患者,以及 20 名对照组患者。多发性硬化症患者中有 17 人(n=17)正在服用免疫调节药物,另外 20 人没有服用任何免疫调节药物。被诊断或临床怀疑有心功能不全以及正在使用心脏毒性药物的患者被排除在外。通过M-模式二维经胸超声心动图测量收缩和舒张功能参数,并通过组织多普勒测量心房电动力学延迟(AEMD)。结果与对照组相比,未使用免疫调节药物的多发性硬化症患者的 E' MV 侧值和 MV E/A 值均较高(分别为 p<0.001 和 p=0.010)。使用免疫调节剂的患者组的 E/E' MV lateral 值和 MV AVmax 值明显高于其他两组(分别为 p=0.009 和 p=0.012)。与对照组相比,使用和未使用药物的多发性硬化症患者的 PAs、PAI、左右心房内 EMG 值均被确定为延长,但这些值未被确定为具有统计学意义。结论我们发现,与对照组相比,多发性硬化症患者的左心室舒张功能受损,而左右心房内和心房间肌电图相似。基于这些结果,我们建议进行超声心动图评估,以便及早发现多发性硬化症患者的左心室舒张功能障碍。
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引用次数: 0
Cumulative seizure occurrence and the predictors of seizure in low- and high-grade gliomas 低级别和高级别胶质瘤的累积发作发生率和发作预测因素
IF 0.2 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-01 DOI: 10.54029/2023swz
Christine Audrey, Kheng Seang Lim, Chet-Ying Chan, Thinisha Sathis Kumar, Rui Jia Hou, Si-Lei Fong, Vairavan Narayanan, Wan Muhammad Afnan Wan Anuar, Chong-Tin Tan
Objective: We aimed to determine the cumulative seizure occurrence, 1-year, and 5-years of preoperative seizures in gliomas, and an update on the predictors. Methods: This was a retrospective analysis of 239 patients with histopathologically confirmed gliomas in University Malaya Medical Centre, Malaysia, between 2008-2020. Kaplan-Meier curves were used to determine the cumulative incidence of seizures. Logistic regression was performed to determine the predictors of preoperative seizures. Results: A total of 80/239 patients (33.5%) had preoperative seizures. They were more commonly seen in those with younger age of presentation (40.0% in those <40 years old vs. 26.9% in ≥40 years old, p<0.05) and low-grade tumors (42.2% vs. 28.8% in high-grade tumors). Those with cortical involvement, especially the frontal lobe, or without focal deficit, headache, nausea, or vomiting were more likely to have seizures preoperatively. Logistic regression identified three significant predictors for preoperative seizure: absence of focal deficits at presentation (OR 6.090, 95% CI 3.110-11.925, p<0.001), cortical location (OR 3.834, 95% CI 1.363-10.786, p<0.05) and absence of headache at presentation (OR 2.487, 95% CI 1.139-5.431, p<0.05). The cumulative incidence of seizure was 29% at one year and 32% at 5-year for gliomas. Specifically, the seizure incidence was higher in low-grade gliomas (39% at 1-year) and certain tumor types such as ganglioglioma (50%), oligodendroglioma (48%), and astrocytoma (45%). Conclusion: The cumulative incidence of preoperative seizures in low-grade gliomas and certain tumor types is high. The predictors included cortical involvement and absence of focal neurological deficit or headache at presentation.
目的我们旨在确定胶质瘤患者术前发作的累积发生率、1年和5年发作率,以及预测因素的最新情况。方法:这是一项回顾性分析:这是一项回顾性分析,研究对象是 2008-2020 年间在马来西亚马来亚大学医疗中心接受组织病理学确诊的 239 名胶质瘤患者。采用Kaplan-Meier曲线确定癫痫发作的累积发生率。采用逻辑回归法确定术前癫痫发作的预测因素。结果:共有 80/239 例患者(33.5%)在术前出现癫痫发作。术前癫痫发作更常见于发病年龄较小(40 岁以下为 40.0%,≥40 岁为 26.9%,P<0.05)和低级别肿瘤(42.2%,高级别肿瘤为 28.8%)的患者。皮质(尤其是额叶)受累或无局灶性缺损、头痛、恶心或呕吐的患者术前更有可能出现癫痫发作。逻辑回归确定了术前癫痫发作的三个重要预测因素:发病时无局灶性障碍(OR 6.090,95% CI 3.110-11.925,P<0.001)、皮质位置(OR 3.834,95% CI 1.363-10.786,P<0.05)和发病时无头痛(OR 2.487,95% CI 1.139-5.431,P<0.05)。神经胶质瘤一年期和五年期的癫痫发作累积发生率分别为 29% 和 32%。具体而言,低级别胶质瘤(1年时39%)和某些肿瘤类型(如神经节胶质瘤(50%)、少突胶质瘤(48%)和星形细胞瘤(45%))的癫痫发作发生率较高。结论低级别胶质瘤和某些肿瘤类型术前癫痫发作的累积发生率很高。预测因素包括皮质受累和发病时无局灶性神经功能缺损或头痛。
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引用次数: 0
Intensive care unit admission prediction tool for ischemic stroke patients receiving intravenous thrombolysis: A retrospective cohort study 接受静脉溶栓治疗的缺血性脑卒中患者入住重症监护病房的预测工具:回顾性队列研究
IF 0.2 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-01 DOI: 10.54029/2023nyd
Chinarong Tiyadechachai, Veerapong Vattanavanit
Background: Some evidence suggests that given the limited healthcare resources, the majority of low- risk stroke patients may not require critical care monitoring. This study aimed to establish a predictive score for identifying post-intravenous thrombolysis (IVT) acute ischemic stroke patients who should be monitored in the intensive care unit (ICU). Methods: This was a retrospective cohort study of patients with acute ischemic stroke who underwent IVT at Songklanagarind Hospital, Thailand between January 2010 and December 2019. Baseline characteristics and clinical outcomes were recorded. Systolic blood pressure (SBP) was collected using the first recorded in the emergency department (ED) as well as the National Institutes of Health Stroke Scale (NIHSS). Results: Of the 171 patients with stroke, 73 (42.7%) needed ICU care. The median age was 67 years old. The median SBP and NIHSS were 160 mm Hg and 10, respectively. The predicting stroke ICU (PSU) score was developed, with the following points assigned: NIHSS score (1 point if > 9), SBP (1 point if > 170 mmHg), and infarct size greater than 1 lobe (2 points if present). The PSU score achieved an area under the ROC curve of 0.759 (95% confidence interval [CI] = 0.688–0.830). A PSU score ≥ 1 predicted the need for ICU care with a sensitivity of 91.78%. Conclusions: The PSU score, which is based on the NIHSS score, systolic blood pressure, and infarct size, predicts the need for ICU care after IVT in patients with stroke.
背景:有证据表明,由于医疗资源有限,大多数低风险卒中患者可能不需要重症监护。本研究旨在建立一个预测评分,用于识别静脉溶栓(IVT)后急性缺血性卒中患者应在重症监护病房(ICU)接受监测。方法:这是一项回顾性队列研究:这是一项回顾性队列研究,研究对象是2010年1月至2019年12月期间在泰国宋卡那加林医院接受静脉溶栓治疗的急性缺血性脑卒中患者。研究记录了基线特征和临床结果。采用急诊科(ED)首次记录的收缩压(SBP)和美国国立卫生研究院卒中量表(NIHSS)进行收集。结果:在 171 名中风患者中,有 73 人(42.7%)需要重症监护室护理。中位年龄为 67 岁。中位 SBP 和 NIHSS 分别为 160 mm Hg 和 10。制定了卒中重症监护室(PSU)预测评分,并分配了以下分数:NIHSS评分(大于9分得1分)、SBP(大于170 mmHg得1分)、梗死面积大于1叶(大于1叶得2分)。PSU 评分的 ROC 曲线下面积为 0.759(95% 置信区间 [CI] = 0.688-0.830)。PSU评分≥1可预测是否需要重症监护室护理,灵敏度为91.78%。结论:PSU 评分基于 NIHSS 评分、收缩压和梗死面积,可预测脑卒中患者 IVT 后的 ICU 治疗需求。
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引用次数: 0
Pharmacogenomics knowledge within Neurology: A brief survey amongst physicians 神经内科药物基因组学知识:对医生的简要调查
IF 0.2 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-01 DOI: 10.54029/2023xfs
K. Narasimhalu, Joel Soo, Jia Yi Shen, Pei Shieen Wong
Pharmacogenomics has emerged as a tool to optimise treatment. Many neurologists encounter drugs with pharmacogenomic associations with unclear guidelines. We therefore aimed to determine the knowledge, attitudes, and barriers to implementing pharmacogenomics in clinical practice within a neurology unit. We developed and administered a survey on pharmacogenomics to physicians working in a neurology unit. Three drug-gene pairs clinically relevant to neurology were presented as case scenarios to assess physicians’ perceived competency, attitudes, and risks towards pharmacogenomics. Thirty-two (27.4%) physicians responded to the survey. Respondents were most confident about activities involving the HLA-B*15:02 test, followed by the CYP2C19 test, and lastly the CYP2C9 test. However, perceived competency in drug-drug-gene interactions was consistently low for all three tests. Referring to the product information leaflet ranked highest in usefulness, followed by local practice guidelines. In conclusion, local clinical guidelines and training on the clinical applications of pharmacogenomics are important to facilitate the implementation of pharmacogenomics.
药物基因组学已成为优化治疗的一种工具。许多神经科医生会遇到与药物基因组学相关的药物,但却没有明确的指导方针。因此,我们旨在确定神经内科临床实践中实施药物基因组学的知识、态度和障碍。我们制定并实施了一项关于药物基因组学的调查,调查对象是在神经内科工作的医生。我们将三种与神经病学临床相关的药物基因对作为案例情景,以评估医生对药物基因组学的认知能力、态度和风险。32名(27.4%)医生对调查做出了回应。受访者对涉及 HLA-B*15:02 检测的活动最有信心,其次是 CYP2C19 检测,最后是 CYP2C9 检测。然而,在药物与药物基因相互作用方面,受访者对所有三种检验的认知能力都很低。参考产品信息单页的有用性最高,其次是当地的实践指南。总之,当地的临床指南和药物基因组学临床应用培训对促进药物基因组学的实施非常重要。
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引用次数: 0
Depression as comorbidity in Sundanese epilepsy patients 巽他癫痫患者的抑郁症并发症
IF 0.2 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-01 DOI: 10.54029/2023xmy
Fedrick Tandiawan, Suryani Gunadharma, U. Gamayani, Anam Ong, Ahmad Rizal Ganiem, Sobaryati, Shelly Iskandar
Background: Depressive disorder is a common psychiatric comorbidity in patients with epilepsy (PWE). This health condition is prevalent among the Sundanese who have a calm and polite character, with a tendency to hide their feelings, which is associated with an increased risk of depression. Methods: This cross-sectional study aimed to determine the prevalence of major depressive disorder (MDD) and the associated factors among Sundanese PWE. The study was carried out in the neurology outpatient clinic at Hasan Sadikin General Hospital Bandung, consisting of the Sunda ethnic group as the majority of patients. Self-stigma degree was measured using the Indonesian version of Internalized Stigma of Epilepsy (ISEP) questionnaire, while depression symptom was screened through the Indonesian version of Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). Subsequently, patients who had depression symptoms were referred to a psychiatrist to confirm whether their conditions matched the criteria of MDD according to the Diagnostic and Statistical Manual of Mental Disorder-5. Results: The prevalence of depressive symptoms in Sundanese epilepsy patients was found to be 18.4%, and MDD was 6.8% among 103 patients included in this study. Many PWE with MDD were not married, had uncontrolled seizures, used polytherapy anti-seizure medication, and exhibited a higher degree of self-stigma. Conclusion: In this study, the prevalence of MDD was found to be 6.8% among a cohort of Sundanese PWE. A significant relationship was also observed between MDD and several factors, including single status, uncontrolled seizure, polytherapy, and a higher degree of self-stigma.
背景:抑郁障碍是癫痫患者(PWE)常见的精神并发症。这种健康状况在巽他人中很普遍,他们性格沉稳、彬彬有礼,倾向于隐藏自己的情感,这与抑郁风险的增加有关。研究方法这项横断面研究旨在确定重度抑郁障碍(MDD)在巽他菲律宾人中的患病率及其相关因素。研究在万隆哈桑-萨迪金综合医院(Hasan Sadikin General Hospital Bandung)的神经科门诊进行,巽他族是研究的主要对象。研究人员使用印尼语版癫痫内化成见(ISEP)问卷测量了患者的自我成见程度,并使用印尼语版癫痫神经系统疾病抑郁量表(NDDI-E)筛查了患者的抑郁症状。随后,有抑郁症状的患者被转诊至精神科医生处,以确认其病情是否符合《精神障碍诊断与统计手册-5》中关于多发性抑郁症的标准。研究结果研究发现,在 103 名巽他癫痫患者中,抑郁症状的发病率为 18.4%,而 MDD 的发病率为 6.8%。许多患有 MDD 的残疾人没有结婚,癫痫发作不受控制,使用多种抗癫痫药物,并表现出较高程度的自我耻辱感。结论在这项研究中,巽他残疾人群中 MDD 的患病率为 6.8%。此外,还观察到 MDD 与多种因素之间存在重要关系,其中包括单身、癫痫发作未得到控制、使用多种治疗方法以及较高程度的自我污名化。
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引用次数: 0
Factors that impact health-related quality of life in 168 myasthenia gravis in West China: Disease severity, social support, and coping style 影响中国西部 168 例重症肌无力患者健康相关生活质量的因素:疾病严重程度、社会支持和应对方式
IF 0.2 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-01 DOI: 10.54029/2023uyw
X. Miao, Hongxi Chen, Zi-yan Shi
Background: Myasthenia gravis (MG) is associated with reduced health-related quality of life (HRQOL). This study aimed to investigate factors that impact HRQOL in MG in a patient population in West China. Methods: A series of questionnaires were completed by 168 patients to assess the relationships between HRQOL and social support and coping style. We also evaluated the contributions of clinical characteristics to HRQOL. One-way analysis of variance (ANOVA), correlation and regression analysis were conducted to identify predictors that negatively impact HRQOL in MG. Results: There were significant differences in HRQOL scores among patients with different ratio of disease cost to income each month (F = 5.831, P = 0.001) and frequency of MG symptoms (F = 9.128, P < 0.001). Spearman’s correlation analysis showed that reduced HRQOL had low correlation with Myasthenia Gravis Composite score (r = 0.461, P < 0.001), confrontation (r = 0.312, P < 0.001) and acceptance- resignation coping style (r = 0.433, P < 0.001). Stepwise regression analysis further revealed that acceptance-resignation coping style (β = 0.380, P < 0.001) and MGC score (β = 0.322, P < 0.001) were the main predictors of HRQOL. Conclusions: Our study revealed the factors that impact HRQOL in MG patients and provided the first demonstration that acceptance-resignation is the main independent predictor of poor HRQOL in MG, other than disease severity.
背景:重症肌无力(MG)与健康相关的生活质量(HRQOL)降低有关。本研究旨在调查影响中国西部肌无力患者 HRQOL 的因素。研究方法168名患者填写了一系列问卷,以评估HRQOL与社会支持和应对方式之间的关系。我们还评估了临床特征对 HRQOL 的贡献。通过单因素方差分析(ANOVA)、相关分析和回归分析来确定对 MG 患者 HRQOL 有负面影响的预测因素。结果显示不同疾病费用与每月收入之比(F = 5.831,P = 0.001)和 MG 症状频率(F = 9.128,P < 0.001)的患者在 HRQOL 评分上存在明显差异。斯皮尔曼相关分析表明,HRQOL 的降低与重症肌无力综合评分(r = 0.461,P < 0.001)、对抗(r = 0.312,P < 0.001)和接受-顺从应对方式(r = 0.433,P < 0.001)的相关性较低。逐步回归分析进一步显示,接受-辞职应对方式(β = 0.380,P < 0.001)和 MGC 评分(β = 0.322,P < 0.001)是预测 HRQOL 的主要因素。结论:我们的研究揭示了影响 HRQOL 的因素:我们的研究揭示了影响 MG 患者 HRQOL 的因素,并首次证明接受-辞职是除疾病严重程度外影响 MG 患者 HRQOL 差异的主要独立预测因素。
{"title":"Factors that impact health-related quality of life in 168 myasthenia gravis in West China: Disease severity, social support, and coping style","authors":"X. Miao, Hongxi Chen, Zi-yan Shi","doi":"10.54029/2023uyw","DOIUrl":"https://doi.org/10.54029/2023uyw","url":null,"abstract":"Background: Myasthenia gravis (MG) is associated with reduced health-related quality of life (HRQOL). This study aimed to investigate factors that impact HRQOL in MG in a patient population in West China. Methods: A series of questionnaires were completed by 168 patients to assess the relationships between HRQOL and social support and coping style. We also evaluated the contributions of clinical characteristics to HRQOL. One-way analysis of variance (ANOVA), correlation and regression analysis were conducted to identify predictors that negatively impact HRQOL in MG. Results: There were significant differences in HRQOL scores among patients with different ratio of disease cost to income each month (F = 5.831, P = 0.001) and frequency of MG symptoms (F = 9.128, P < 0.001). Spearman’s correlation analysis showed that reduced HRQOL had low correlation with Myasthenia Gravis Composite score (r = 0.461, P < 0.001), confrontation (r = 0.312, P < 0.001) and acceptance- resignation coping style (r = 0.433, P < 0.001). Stepwise regression analysis further revealed that acceptance-resignation coping style (β = 0.380, P < 0.001) and MGC score (β = 0.322, P < 0.001) were the main predictors of HRQOL. Conclusions: Our study revealed the factors that impact HRQOL in MG patients and provided the first demonstration that acceptance-resignation is the main independent predictor of poor HRQOL in MG, other than disease severity.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"284 ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139195263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mean platelet volume-to-lymphocyte ratio predicts poor functional outcome of acute ischemic stroke patients 平均血小板体积与淋巴细胞比值可预测急性缺血性脑卒中患者的不良功能预后
IF 0.2 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-01 DOI: 10.54029/2023thw
Anna Ying, Yiqing Jiang, Lingyan Chen
Background & Objective: The mean platelet volume-to-lymphocyte ratio (MPVLR) is a novel and easily available marker of poor short-term prognosis in myocardial infarction patients. The present study was to investigate the association between MPVLR and clinical outcome of patients with acute ischemic stroke. Methods: A total of 494 acute ischemic stroke patients were included in this study and received 3-months follow-up. Blood samples for MPVLR were obtained at admission and at 7 days after acute ischemic stroke. Poor functional outcome was defined as a modified Rankin Scale (mRS) score of 3-6 at 3 months after stroke. Results: Compared with good prognosis group, MPVLR level at admission and at 7 days in poor prognosis group was significantly higher, the difference between these two groups was statistically significant (P < 0.001). In multivariate logistic regression analysis, both MPVLR as a continuous (OR 1.13; 95%CI, 1.064-1.190, P=0.001) and categorical variable (OR 3.05; 95%CI, 1.85-5.05, P<0.001) were independently associated with poor outcome at 3 months. ROC analysis revealed the predictive value of MPVLR was better than that of platelet-to lymphocyte ratio (PLR). The nomogram was used for predicting 3-months unfavourable outcome after an acute ischemic stroke. Conclusions: MPVLR at admission and at 7 days after stroke were found to be independently associated with poor functional outcome. MPVLR may serve as an activity marker for poor prognosis in patients with acute ischemic stroke.
背景与目的:血小板体积与淋巴细胞平均比值(MPVLR)是心肌梗死患者短期预后不良的一种新颖且易于获得的标志物。本研究旨在探讨 MPVLR 与急性缺血性脑卒中患者临床预后之间的关系。研究方法本研究共纳入 494 名急性缺血性脑卒中患者,对其进行为期 3 个月的随访。入院时和急性缺血性脑卒中后 7 天抽取血液样本检测 MPVLR。脑卒中后 3 个月时,改良 Rankin 量表(mRS)评分为 3-6 分,即为功能预后不良。结果与预后良好组相比,预后不良组入院时和 7 天时的 MPVLR 水平明显更高,两组间差异有统计学意义(P < 0.001)。在多变量逻辑回归分析中,MPVLR 作为连续变量(OR 1.13;95%CI,1.064-1.190,P=0.001)和分类变量(OR 3.05;95%CI,1.85-5.05,P<0.001)均与 3 个月时的不良预后独立相关。ROC分析显示,MPVLR的预测价值优于血小板与淋巴细胞比值(PLR)。该提名图可用于预测急性缺血性卒中后 3 个月的不良预后。结论发现入院时和卒中后 7 天的 MPVLR 与不良功能预后独立相关。MPVLR 可作为急性缺血性脑卒中患者预后不良的活动标志物。
{"title":"Mean platelet volume-to-lymphocyte ratio predicts poor functional outcome of acute ischemic stroke patients","authors":"Anna Ying, Yiqing Jiang, Lingyan Chen","doi":"10.54029/2023thw","DOIUrl":"https://doi.org/10.54029/2023thw","url":null,"abstract":"Background & Objective: The mean platelet volume-to-lymphocyte ratio (MPVLR) is a novel and easily available marker of poor short-term prognosis in myocardial infarction patients. The present study was to investigate the association between MPVLR and clinical outcome of patients with acute ischemic stroke. Methods: A total of 494 acute ischemic stroke patients were included in this study and received 3-months follow-up. Blood samples for MPVLR were obtained at admission and at 7 days after acute ischemic stroke. Poor functional outcome was defined as a modified Rankin Scale (mRS) score of 3-6 at 3 months after stroke. Results: Compared with good prognosis group, MPVLR level at admission and at 7 days in poor prognosis group was significantly higher, the difference between these two groups was statistically significant (P < 0.001). In multivariate logistic regression analysis, both MPVLR as a continuous (OR 1.13; 95%CI, 1.064-1.190, P=0.001) and categorical variable (OR 3.05; 95%CI, 1.85-5.05, P<0.001) were independently associated with poor outcome at 3 months. ROC analysis revealed the predictive value of MPVLR was better than that of platelet-to lymphocyte ratio (PLR). The nomogram was used for predicting 3-months unfavourable outcome after an acute ischemic stroke. Conclusions: MPVLR at admission and at 7 days after stroke were found to be independently associated with poor functional outcome. MPVLR may serve as an activity marker for poor prognosis in patients with acute ischemic stroke.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"39 7","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139191166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between language function and body composition characteristics in patients with subacute left hemispheric stroke 亚急性左半球脑卒中患者的语言功能与身体成分特征之间的关系
IF 0.2 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-01 DOI: 10.54029/2023upt
Soo Jeong Han, J. Suh
Background & Objectives: Stroke-related sarcopenia and language disorder are main sequelae of stroke. The aim of this study is to evaluate the association between language function and body composition characteristics in patients with subacute left hemiplegic stroke. Methods: Body mass index, skeletal muscle index (SMI), and body fat percentage using bioimpedance analysis, hand grip strength, and Medical Research Council (MRC) sum score were evaluated. Language function was evaluated using the Western Aphasia Battery (WAB). A partial correlation analysis was used to assess the relationship between body composition and language function. Results: A total of 54 patients with subacute left hemispheric stroke were enrolled in the study. The aphasia quotient (AQ) of WAB was significantly correlated with SMI, body fat percentage, MRC-sum score, MRC-sum score of unaffected side and hand grip strength. In the multiple regression analysis after adjusting for age and sex, the AQ of WAB was significantly correlated with SMI. Conclusions: Skeletal muscle index showed highest correlation with language function in patients with left hemispheric stroke.
背景与目的:中风相关的肌肉疏松症和语言障碍是中风的主要后遗症。本研究旨在评估亚急性左侧偏瘫中风患者的语言功能与身体成分特征之间的关联。研究方法采用生物阻抗分析法评估体重指数、骨骼肌指数(SMI)和体脂百分比、手部握力和医学研究委员会(MRC)总分。语言功能使用西方失语测试法(WAB)进行评估。采用偏相关分析评估身体成分与语言功能之间的关系。结果共有 54 名亚急性左半球脑卒中患者参加了研究。WAB的失语商数(AQ)与SMI、体脂率、MRC-sum评分、非受影响侧MRC-sum评分和手握力显著相关。在调整年龄和性别后进行的多元回归分析中,WAB 的 AQ 与 SMI 显著相关。结论左侧大脑半球卒中患者的骨骼肌指数与语言功能的相关性最高。
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引用次数: 0
The level of physical activity among ambulant stroke survivors at one year: a cross sectional study in a tertiary center in Malaysia 中风幸存者一年后的体育锻炼水平:马来西亚一家三级中心的横断面研究
IF 0.2 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-01 DOI: 10.54029/2023exj
Mitchel Brian Jilimin, Mazlina Mazlan
Background & Objective: Despite the importance of physical activity, there is lack of evidence measuring the level of activity performed by the stroke survivors. This study aims to determine the level of physical activity amongst ambulant stroke patients in a tertiary centre in Malaysia and to investigate the factors that may impact their physical activity. Methods: A cross-sectional study was conducted on ambulant stroke participants at one year post stroke. International Physical Activity Questionnaire (IPAQ) was used to measure the level of physical activity, and 6 Minute Walk Test (6MWT) was recorded to assess the participants functional walking distance and endurance. The participants were categorised into low, moderate, or high physical activity levels. Age-matched healthy controls were recruited form community. Factors including presence of depression were tested in relation to physical activity. P-value of <0.05 was considered statically significant in all statistical analyses. Results: There were 45 stroke patients and 30 controls recruited in this study. Participants in the stroke group has significantly lower level of physical activity compared to the control group, especially in the high physical activity level (p<0.001); 55.6% reported having moderate, 31.1% low and 13.3% high physical activity level respectively. No significant factors were found to be associated with the physical activity. Only depression was found to have a weak negative correlation with level of physical activity (p=0.003). Conclusion: Stroke survivors have lower level of physical activity at one year post stroke despite having mild physical impairments. Rehabilitation strategies to promote physical activities should be implemented early to take advantage on the benefits of cardiovascular fitness as secondary prevention of stroke.
背景与目的:尽管体育锻炼非常重要,但目前还缺乏衡量中风幸存者体育锻炼水平的证据。本研究旨在确定马来西亚一家三级医疗中心内行动不便的中风患者的体力活动水平,并调查可能影响其体力活动的因素。研究方法对中风后一年的卧床中风患者进行横断面研究。国际体力活动调查表(IPAQ)用于测量参与者的体力活动水平,6 分钟步行测试(6MWT)用于评估参与者的功能性步行距离和耐力。参与者被分为低、中、高体力活动水平。在社区中招募了年龄相匹配的健康对照组。测试了抑郁等因素与体力活动的关系。在所有统计分析中,P 值小于 0.05 被认为具有统计学意义。结果本研究共招募了 45 名中风患者和 30 名对照组患者。与对照组相比,脑卒中组参与者的体力活动水平明显较低,尤其是在高体力活动水平方面(P<0.001);55.6%的参与者报告其体力活动水平为中度,31.1%为低度,13.3%为高度。没有发现与体力活动相关的重要因素。只有抑郁症与体力活动水平有微弱的负相关(p=0.003)。结论卒中幸存者在卒中后一年的体力活动水平较低,尽管他们有轻微的肢体障碍。应尽早实施促进体力活动的康复策略,以利用心血管健康的益处作为中风的二级预防。
{"title":"The level of physical activity among ambulant stroke survivors at one year: a cross sectional study in a tertiary center in Malaysia","authors":"Mitchel Brian Jilimin, Mazlina Mazlan","doi":"10.54029/2023exj","DOIUrl":"https://doi.org/10.54029/2023exj","url":null,"abstract":"Background & Objective: Despite the importance of physical activity, there is lack of evidence measuring the level of activity performed by the stroke survivors. This study aims to determine the level of physical activity amongst ambulant stroke patients in a tertiary centre in Malaysia and to investigate the factors that may impact their physical activity. Methods: A cross-sectional study was conducted on ambulant stroke participants at one year post stroke. International Physical Activity Questionnaire (IPAQ) was used to measure the level of physical activity, and 6 Minute Walk Test (6MWT) was recorded to assess the participants functional walking distance and endurance. The participants were categorised into low, moderate, or high physical activity levels. Age-matched healthy controls were recruited form community. Factors including presence of depression were tested in relation to physical activity. P-value of <0.05 was considered statically significant in all statistical analyses. Results: There were 45 stroke patients and 30 controls recruited in this study. Participants in the stroke group has significantly lower level of physical activity compared to the control group, especially in the high physical activity level (p<0.001); 55.6% reported having moderate, 31.1% low and 13.3% high physical activity level respectively. No significant factors were found to be associated with the physical activity. Only depression was found to have a weak negative correlation with level of physical activity (p=0.003). Conclusion: Stroke survivors have lower level of physical activity at one year post stroke despite having mild physical impairments. Rehabilitation strategies to promote physical activities should be implemented early to take advantage on the benefits of cardiovascular fitness as secondary prevention of stroke.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"26 3","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139192401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of headache in children with psychiatric symptoms 对有精神症状的儿童头痛进行评估
IF 0.2 4区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2023-12-01 DOI: 10.54029/2023mwn
Arzu Yavuz, Burcu Ersöz Alan, Tuna Çek Esen
Background: This study aims to evaluate the relationship between headaches and psychiatric symptoms in a psychiatric clinic. Methods: We compared 102 children aged 8-16 years (31 girls, 30.4%) who presented to the child and adolescent psychiatry clinic (study group) with 100 children aged 8-16 years, (52 girls, 52%) who did not (control group). Headache was evaluated with the Headache-Attributed Restriction, Disability, Social Handicap, and Impaired Participation (HARDSHIP) Questionnaire. Psychiatric symptoms (depression, anxiety, sleep, attention, hyperactivity) were evaluated via standardized scales. Results: The study group had more headaches in the preceding year as well as the day before. Depression, anxiety and sleep problems were positively correlated with headache frequency in the preceding week in the study group, and in the study group, children with migraine had more depression, anxiety, and emotional problems. While the total quality of life (QoL) scores were not significantly different between groups, migraine decreased the QoL in both the study and control groups. Conclusion: This study indicates that headache type and burden should be evaluated in psychiatric clinics as depression and anxiety are associated with headache, especially migraine.
研究背景本研究旨在评估精神病诊所中头痛与精神症状之间的关系。研究方法我们将 102 名 8-16 岁到儿童和青少年精神病诊所就诊的儿童(研究组)(31 名女孩,占 30.4%)与 100 名 8-16 岁未就诊的儿童(对照组)(52 名女孩,占 52%)进行了比较。头痛通过头痛导致的限制、残疾、社会障碍和参与障碍(HARDSHIP)问卷进行评估。精神症状(抑郁、焦虑、睡眠、注意力、多动)通过标准化量表进行评估。研究结果研究组在前一年和前一天有更多头痛。在研究组中,抑郁、焦虑和睡眠问题与前一周的头痛频率呈正相关,而在研究组中,偏头痛儿童的抑郁、焦虑和情绪问题更多。虽然研究组和对照组的生活质量(QoL)总分没有显著差异,但偏头痛会降低研究组和对照组的生活质量。结论本研究表明,由于抑郁和焦虑与头痛尤其是偏头痛有关,因此应在精神科诊所对头痛类型和负担进行评估。
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Neurology Asia
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