scholarly journals Changes in Pharyngeal Width Over Time as an Indicator of Dysphagia in Stroke Patients

2020 ◽  
Vol 44 (3) ◽  
pp. 203-209
Author(s):  
Seungki Baek ◽  
Il Hwan Jung ◽  
Ho Young Lee ◽  
Jimin Song ◽  
Eunsil Cha ◽  
...  
Keyword(s):  
X Rays ◽  
Lateral Neck ◽  
Spearman Correlation ◽  
Severity Scale ◽  
Stroke Patients ◽  
Average Value ◽  
Scale Scores ◽  
Vertebral Bodies ◽  
Serial Measurements ◽  
Over Time

Objective To verify the pharyngeal width at rest as a measurement that could be used to assess changes in the degree of dysphagia over time in stroke patients.Methods In a cohort of stroke patients, we performed serial measurements of the pharyngeal width at the midpoints of the second (C2) and third (C3) cervical vertebral bodies using lateral neck X-rays while the patients were at rest. The JOSCYL width, a parameter named after the first initial of each developers’ surname and defined as the average value of the upper and lower pharyngeal widths, was used to formulate the JOSCYL scale, which was calculated as the JOSCYL width × 100/neck circumference. All patients also underwent serial videofluoroscopic swallowing studies (VFSSs). The Spearman correlation analysis was used to detect correlations between the serial VFSS results, JOSCYL widths, and JOSCYL scale values.Results Over time, we observed significant positive and negative correlations of change in the JOSCYL width and scale with changes in the Penetration-Aspiration Scale and the Dysphagia Outcome and Severity Scale scores, respectively.Conclusion The JOSCYL width and JOSCYL scale clearly reflected changes in dysphagia in stroke patients over time. These parameters may provide an easier method for evaluating whether post-stroke dysphagia has been alleviated.

How Does Green Dot Bystander Training in High School and Beyond Impact Attitudes Toward Violence and Sexism in a Prospective Cohort?

2021 ◽  
pp. 088626052110063
Author(s):  
Ann L. Coker ◽  
Heather M. Bush ◽  
Zhengyan Huang ◽  
Candace J. Brancato ◽  
Emily R. Clear ◽  
...  
Keyword(s):  
High School ◽  
Prospective Cohort ◽  
Controlled Trial ◽  
Ambivalent Sexism ◽  
Cluster Rct ◽  
Attitudes Toward Violence ◽  
Scale Scores ◽  
Cluster Randomized ◽  
Over Time

Bystander interventions are recognized as “promising” programming to reduce sexual violence. Gaps in current evaluations include limited follow-up post-training (beyond 24 months) and knowledge of additional bystander training during follow-up. In this prospective cohort study, nested in a cluster randomized controlled trial (RCT), three cohorts of high school (HS) seniors were recruited (Fall 2013-2015) and followed through Spring 2018 ( n = 1,831). Training was based on their school cluster RCT assignment and receipt of additional Green Dot (GD) training after HS. Training was hypothesized to be associated with lower scores indicating less acceptance of violence or sexism. Sixty percent reported GD training after HS (68.7% of 986 in intervention and 50% of 845 in control conditions). No significant differences ( p < .05) were observed by GD training for four of the five violence acceptance or sexism attitudinal measures at recruitment or final surveys. For “ambivalent sexism” alone was there a significant reduction in scale scores over time in the intervention versus control condition. Additional GD training after the RCT significantly reduced neither violence acceptance nor sexism scores over time. GD training does not appear to have a consistent longer-term impact on reducing violence acceptance and sexism.

scholarly journals Percutaneous Discectomy—Continuous Irrigation and Drainage for Tuberculous Lumbar Spondylitis: A Report of Two Cases

2009 ◽  
Vol 2009 ◽  
pp. 1-4
Author(s):  
Sei Shibuya ◽  
Satoshi Komatsubara ◽  
Tetsuji Yamamoto ◽  
Nobuo Arima ◽  
Yoshiaki Kanda ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pathogenic Bacteria ◽  
Definitive Diagnosis ◽  
Continuous Irrigation ◽  
Percutaneous Discectomy ◽  
Caseous Necrosis ◽  
Postoperative Mri ◽  
Tuberculous Lesion ◽  
Vertebral Bodies ◽  
Over Time

Percutaneous curettage and continuous irrigation were performed for definitive diagnosis and treatment of tuberculous (TB) lumbar spondylitis. Under local anaesthesia, affected lumbar discs were curetted using a procedure of percutaneous nucleotomy, and in-tube and the out-tube were placed for continuous irrigation. The period of continuous irrigation was 12–16 days.Mycobacterium tuberculosiswas demonstrated in case 1 by culture and PCR, whereas histology showed tuberculous lesion with caseous necrosis in both cases. Postoperative MRI showed markedly reduced abscesses after 3 months in both cases. The signal intensity in vertebral bodies was improved. In Case 2, CT observations showed remodeling over time in the vertebral body cavities. This method is advantageous in that although minimally invasive, it achieves identification of pathogenic bacteria and treatment simultaneously. This surgical procedure is expected to prove effective for both TB and pyogenic spondylitis.

scholarly journals Impact of baseline Diabetic Retinopathy Severity Scale scores on visual outcomes in the VIVID-DME and VISTA-DME studies

2017 ◽  
Vol 102 (7) ◽  
pp. 954-958 ◽  
Author(s):  
Giovanni Staurenghi ◽  
Nicolas Feltgen ◽  
Jennifer J Arnold ◽  
Todd A Katz ◽  
Carola Metzig ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Group Versus ◽  
Diabetic Macular Oedema ◽  
Severity Scale ◽  
Treatment Benefit ◽  
Treatment Groups ◽  
Link Type ◽  
Intravitreal Aflibercept ◽  
Scale Scores ◽  
Consistent Treatment

Background/aimsTo evaluate intravitreal aflibercept versus laser in subgroups of patients with baseline Diabetic Retinopathy Severity Scale (DRSS) scores ≤43, 47, and ≥53 in VIVID-DME and VISTA-DME.MethodsPatients with diabetic macular oedema were randomised to receive intravitreal aflibercept 2 mg every 4 weeks (2q4), intravitreal aflibercept 2 mg every 8 weeks after five initial monthly doses (2q8), or macular laser photocoagulation at baseline with sham injections at every visit. These post hoc analyses evaluate outcomes based on baseline DRSS scores in patients in the integrated dataset. The 2q4 and 2q8 treatment groups were also pooled.Results748 patients had a baseline DRSS score based on fundus photographs (≤43, n=301; 47, n=153; ≥53, n=294). At week 100, the least squares mean difference between treatment groups (effect of intravitreal aflibercept above that of laser, adjusting for baseline best-corrected visual acuity) was 8.9 (95% CI 5.99 to 11.81), 9.7 (95% CI 5.54 to 13.91), and 11.0 (95% CI 7.96 to 14.1) letters in those with baseline DRSS scores ≤43, 47, and ≥53, respectively. The proportions of patients with ≥2 step DRSS score improvement were greater in the intravitreal aflibercept group versus laser, respectively, for those with baseline DRSS scores of ≤43 (13% vs 5.9%), 47 (25.8% vs 4.5%), and ≥53 (64.5% vs 28.4%).ConclusionsRegardless of baseline DRSS score, functional outcomes were superior in intravitreal aflibercept-treated patients, demonstrating consistent treatment benefit across various baseline levels of retinopathy.Trial registration numbersNCT01331681 and NCT01363440, Post-results.

scholarly journals Lipid Profile in New and Recurrent Ischemic Stroke Patients at Haji General Hospital of North Sumatra Indonesia

2019 ◽  
Vol 3 (3) ◽  
pp. 146
Author(s):  
Meizly Andina ◽  
Lisa Nabila Pratiwi ◽  
Fadhilah Ramadhan Aribowo
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Lipid Profile ◽  
General Hospital ◽  
Recurrent Stroke ◽  
Secondary Data ◽  
Ischemic Stroke Patient ◽  
Stroke Patients ◽  
Average Value ◽  
North Sumatra

Introduction: Stroke refers to any sudden neurological disorder that occurs due to the cessation of blood flow through the arterial supply system of the brain. The etiology obstructions are atherosclerosis. There was an imbalance of lipid profiles in patients with ischemic stroke There was an imbalance of lipid profiles in patients with ischemic stroke. The objective of this research is to determine differences between lipid profile in new ischemic stroke patients with recurrent stroke at Haji General Hospital of North Sumatra Indonesia in 2015-2016.Methods: This is a cross-sectional study using total sampling method with a total of 64samples. Secondary data obtained from General hospital Haji Medan. Secondary data collected were data on lipid profile in patients with acute stroke and recurrent stroke by collecting medical records.Results: The result from the acute stroke patients found HDL levels of 33.97 mg/dl, recurrent stroke patients found HDL levels of 35.25 mg/dl. LDL levels in acute stroke patients were 109.56 mg/dl and recurrent stroke patients were 123.16 mg/dl. In new ischemic stroke patient, the average value of triglyceride levels was 143 mg/dl and the average value of total cholesterol was 205.8 mg/ dl. In recurrent ischemic stroke patient, the average value of triglyceride levels was 165.2 mg/dl and the mean total cholesterol level was 180.8 mg/dl.Discussion: There are no differences of lipid profile in new and recurrent ischemic stroke patients at Haji General Hospital of North Sumatra Indonesia in 2015-2016 (p>0.05)International Journal of Human and Health Sciences Vol. 03 No. 03 July’19. Page: 146-149

scholarly journals Comparison of Tryglicerides Levels and Total Cholesterol in Ischemic Stroke and Haemorrhagic Stroke Patients

2020 ◽  
Vol 1 (2) ◽  
pp. 49
Author(s):  
Hijriyah Putri Tarmizi Hasibuan ◽  
Isra Thristy
Keyword(s):  
Ischemic Stroke ◽  
Total Cholesterol ◽  
Large Scale ◽  
Hemorrhagic Stroke ◽  
Total Cholesterol Level ◽  
Haemorrhagic Stroke ◽  
Total Sample ◽  
Stroke Patients ◽  
Average Value ◽  
Significant Difference

Background: Stroke is the second largest cause of death in the world. Stroke is classified based on its etiology as ischemic stroke and hemorrhagic stroke. Most large-scale studies on the risk of total cholesterol and triglyceride levels in stroke are not distinguished between ischemic and hemorrhagic strokes. Purposes: The purpose of this study was to determine the comparison of triglyceride and total cholesterol levels in ischemic stroke patients with hemorrhagic stroke. Method: Descriptive analytic study using medical records of patients at Medan Haji General Hospital in 2018-2019. The number of ischemic stroke patients is 28 patients and hemorrhagic stroke 28 patients with a total sample of 56 patients. Results: In ischemic stroke patients, the average value of triglyceride levels was 144.75 mg/dL and the average value of total cholesterol was 250.93 mg/dL. In hemorrhagic stroke patients, the average value of triglyceride levels is 126.93 mg/dL and the average total cholesterol level is 174.25 mg/dL. Conclusion: From this study we found a significant difference in total cholesterol between ischemic and hemorrhagic strokes. No significant difference was found in triglycerides between ischemic and hemorrhagic strokes.

scholarly journals LACK OF EMPHASIS ON PSYCHOLOGICAL REHABILITATION FOR STROKE PATIENTS

2012 ◽  
Vol 1 (1) ◽  
pp. 2
Author(s):  
Samina Masood Haider
Keyword(s):  
Emotional Difficulties ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Post Stroke ◽  
Post Stroke Depression ◽  
The Many ◽  
Over Time

It has been observed that most of the patients are not aware of the dilapidating affects of post stroke depression on their recovery, survival and a return to normal activities of life. The lack of emphasis on psychological rehabilitation for stroke patients is a source of concern for me and I would like to bring to your attention about the facts regarding the implications of proper psychological rehabilitation is not undertaken. Stroke survivors report a range of emotional difficulties, most common being fear, anxiety, frustration, anger, sadness and a sense of grief for their physical and mental losses. Usually these feelings may fade over time however, some patients may struggle with adjusting to the many changes following stroke. When this happens these feelings can develop into depression. It is estimated that approximately one-third of stroke1 survivors develop post-stroke depression (PSD)

scholarly journals Radiolucent lines are decreased at 3 years following total knee arthroplasty using trabecular metal tibial components

2018 ◽  
Vol 46 (5) ◽  
pp. 1919-1927 ◽  
Author(s):  
Hirotaka Mutsuzaki ◽  
Arata Watanabe ◽  
Tomonori Kinugasa ◽  
Kotaro Ikeda
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
X Rays ◽  
Trabecular Metal ◽  
Change Over Time ◽  
Radiolucent Lines ◽  
Total Knee ◽  
Over Time

Objective To analyse location and frequency, and change over time, of radiolucent lines (RLLs) around trabecular metal tibial components in total knee arthroplasty (TKA). Methods Osteoarthritic knees in patients who had undergone TKA were retrospectively evaluated via analysis of RLLs on anteroposterior and lateral X-rays obtained at 2 and 6 months, and 1, 2 and 3 years following TKA. Results In 125 osteoarthritic knees from 90 patients (mean age, 75.0 ± 6.2; 21 male/69 female), frequency of RLLs around trabecular metal tibial components was generally highest at 2 and 6 months, and 1 year following TKA, then gradually decreased over the 3-year follow-up. Frequency of RLLs around trabecular metal tibial components was greater at the tip of the two pegs, particularly the medial peg, and around the pegs, versus other zones. No postoperative revisions were performed for loosening. Conclusions Over 3 years following TKA, RLLs were most frequently observed up to 1 year, then gradually decreased. RLLs were significantly more frequent in the medial peg zone and zones close to the medial peg than in other zones.

Abstract 3319: Prediction Of Lesion Expansion In Stroke Patients Using Acute MRI

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Ona Wu ◽  
Elissa C McIntosh ◽  
Raquel C Bezerra ◽  
Izzuddin Diwan ◽  
Priya Garg ◽  
...  
Keyword(s):  
Time Windows ◽  
Reperfusion Therapy ◽  
Treated Group ◽  
Residue Function ◽  
Stroke Patients ◽  
Significant Difference ◽  
Scale Scores ◽  
Apparent Diffusion ◽  
Lesion Growth ◽  
Regional Analyses

Background: We investigated whether MRI-based algorithms combining acute DWI & PWI can be used to identify patients likely to experience lesion expansion. Methods: We analyzed MRI from 181 unilateral stroke patients who underwent DWI & PWI ≤ 12h from last seen well and had follow-up imaging (F/u) ≥4 days with lesions ≥ 1 cm 3 . Apparent diffusion coefficient, T2, DWI, CBF, CBV, MTT and Tmax (time of peak of deconvolved residue function) maps were co-registered, normalized and used as covariates in a model that produced infarction risk maps. Coefficients were calculated from 111 non-lysed patients and applied to 70 patients who received mechanical or drug lysis. Area under generated receiver operating characteristic curves (AUC) were calculated. Regional analyses were performed comparing mean risk values in Core (acute DWI), Growth (F/u - Core), Reverse (Core - F/u) and Normal (ipsilesional hemisphere - F/u) regions. Predicted lesion volumes (PLV) using a 50% risk threshold and post-hoc artifact removal for classifying infarcted tissue were correlated with the measured lesion volumes (MLV) on F/u. Values are median [IQR] or mean±SD. Results: The thrombolysis-treated group differed significantly from the non-lysis group in admission NIH Stroke Scale scores (12 [9-16] vs 6 [3-13]; P<0.001), time-to-MRI (4.8±1.9 h vs 5.9±2.8 h; P=0.005), acute DWI lesion volumes (21 [7-56] vs 11 [3-36] cm 3 ; P=0.02) and F/u lesion volumes (39 [12-72] vs 17 [6-56] cm 3 ; P=0.02). No significant difference was found between age (67±15 vs 65±17 years old), male sex (59% vs 67%) and time to F/u (15 [6-47] vs 10 [6-46] days). Significant differences in predicted risk between the 4 regions were found for both lysed (Core: 0.72±0.15; Growth: 0.41±0.13; Reverse: 0.64±0.16; Normal: 0.25±0.06; P<0.0001) and non-lysed groups (Core: 0.72±0. 15; Growth:0.42±0.12; Reverse: 0.64±0.15; Normal: 0.22±0.05; P<0.0001). AUCs of the prediction for the non-lysed group were higher than for the lysed group (0.86±0.09 vs 0.81±0.11; P<0.001). Correlations between PLV and MLV were significant for both lysed (R=0.57, P<0.001) and non-lysed groups (R=0.85, P<0.001). Mismatch between PLV and Core volumes (i.e. predicted lesion growth) was significantly correlated with actual lesion growth for the non-lysed group (R=0.49, P<0.001) but not for the lysed group (R=0.04, P=0.72). Conclusion: Mismatch in PLV and core can be used to identify patients most likely to experience lesion expansion if not given reperfusion therapy. The performance of the models was reduced in thrombolysed patients, which we propose is due to salvage of tissue that would have otherwise infarcted. MRI-based algorithms may identify patients who are not candidates for thrombolysis, yet have tissue to salvage. This may be useful as imaging selection criteria for future investigational trials of reperfusion therapy in extended time windows or for patients with unclear onsets.

Abstract TP12: The Trend of Successful First Pass in M2 Segment Stroke Thrombectomy- Insights From the STAR Collaboration

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Eyad Almallouhi ◽  
Sami Al kasab ◽  
Ali Alawieh ◽  
Reda M Chalhoub ◽  
Marios Psychogios ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Independent Predictor ◽  
Star Collaboration ◽  
Stroke Patients ◽  
First Pass ◽  
Thrombectomy Device ◽  
Intravenous Alteplase ◽  
Multicenter Registry ◽  
Over Time ◽  
Iv Tpa

Introduction: Stroke thrombectomy devices and the experience of neurointerventionists have improved significantly over the last few years making targeting distal occlusions such as of the M2 segment of the middle cerebral artery more feasible. We aimed to study the trend in the successful first pass (SFP) of M2 occlusions over time using the data from a contemporary multicenter registry. Methods: We reviewed the data from the Stroke Thrombectomy and Aneurysm Registry (STAR), which included data from 11 thrombectomy-capable stroke centers to identify stroke patients who underwent mechanical thrombectomy of M2 segment occlusion. SFP was defined by achieving modified Thrombolysis in Cerebral Infarction (mTICI) score≥2b with a single thrombectomy device pass. We analyzed the linear trendline of the rate of SFP over time. Then, we used a logistic regression model to assess predictors of SFP of M2 segment occlusion. Results: We included 401 patients who underwent stroke thrombectomy of M2 occlusion; median age was 71 (IQR 60-80), 212 (52.9%) were females, 174 (43.4%) were white, National Institute of Health stroke scale (NIHSS) was 14 (IQR 8-19), Alberta Stroke Program Early CT (ASPECT) score on presentation was 9 (IQR 7-10) and onset wot groin time was 287 (IQR 181-454). SFP was achieved in 118 (29.4%) patients (linear trendline over time is in Figure 1). Presenting after 2014 was an independent predictor of SFP (OR 1.9, 95% CI 1.1-3.2, P=0.019) after controlling for age, sex, NIHSS on presentation, intravenous alteplase (IV-tPA), and onset to groin time. Conclusion: SFP rate of M2 segment occlusion has increased after 2014 likely secondary the improvement in stroke thrombectomy devices and neurointerventionists experience.

Abstract TP75: Safety and Outcome of Thrombolysis in Acute Stroke with Prolonged Onset-to-Treatment Times and Low National Institute of Health Stroke Scale Scores. Report on Experience in China, First 1000 Patients of 3300 Treated

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Pei-Lan Zhang ◽  
Jin-Huan Wang ◽  
Yu-Xin Wang ◽  
Yan Chen ◽  
Chen-Hao Zhang ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Treatment Time ◽  
Significant Risk ◽  
Stroke Patients ◽  
Data Set ◽  
Scale Scores ◽  
Before And After ◽  
Metropolitan Hospital ◽  
Mri Scans ◽  
Efficacy Of Treatment

Introduction: Stroke in China is the leading cause of death. We report on a collaboration between a large metropolitan hospital in China, Tianjin Huanhu Hospital, and Inova Fairfax and Inova Alexandria Stroke Programs presenting data on the first 1000 (of more than 3300 treated since 2012) patients treated with IV-rtPA. The safety and efficacy of treatment with rtPA between 4.5-6 hours after onset is unclear. Similarly there is little data on outcome of patients treated with rtPA with normal or low NIHSS. Methods: Patients were treated with thrombolysis between late 2012 and fall of 2014. Patients had MRI scans at 24 hours. Patients had NIHSS scores before and after treatment, and modified Rankin Scores (mRS) at 90 days after treatment. Results: See Chart. Conclusions: 1) IV-rtPA can be given safely between 4.5-6 hours without significant risk of sICH and worsening outcomes. 2) Higher NIHSS before thrombolysis was correlated with poorer outcomes. 3) There was no significant correlation between onset to treatment time up to 6 hours and outcome. 4) Outcome was excellent (mRS 0-1) in 72% treated 0-3 hours, 74% 3-4.5 hours and remarkably 85% 4.5-6 hours. The data set includes many patients who were asymptomatic or nearly so prior to treatment. This will need to be more fully evaluated in the remainder (2300) of this cohort of more than 3300 treated patients. Comment: This cohort represents one of the largest series of acute stroke patients treated with IV-rtPA > 4.5 hours after onset. It also reveals outcome of treatment in patients with low NIHSS treated at various intervals after last know well.

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