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7 záznamů v Medvik Filtry

Článek

Intravenous thrombolysis for patients with in-hospital stroke onset: propensity-matched analysis from the Safe Implementation of Treatments in Stroke-East registry

Tsivgoulis, G
Autor Tsivgoulis, G Second Department of Neurology, 'Attikon' Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. International Clinical Research Center and Neurology Department, St Anne's Hospital, Brno, Czech Republic
Katsanos, A H
Autor Katsanos, A H Second Department of Neurology, 'Attikon' Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece. Department of Neurology, University of Ioannina, Ioannina, Greece
Kadlecová, P
Autor Kadlecová, P International Clinical Research Center and Neurology Department, St Anne's Hospital, Brno, Czech Republic
Czlonkowska, A
Autor Czlonkowska, A Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw. Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw
Kobayashi, A
Autor Kobayashi, A Second Department of Neurology, Institute of Psychiatry and Neurology, Warsaw. Department of Neuroradiology, Interventional Stroke and Cerebrovascular Disease Treatment Centre, Institute of Psychiatry and Neurology, Warsaw, Poland
Brozman, M
Autor Brozman, M Department of Neurology, Faculty Hospital Nitra, Constantine University Nitra, Nitra, Slovakia
Švigelj, V
Autor Švigelj, V Department of Vascular Neurology and Neurological Intensive Care, University Medical Centre Ljubljana, Ljubljana, Slovenia
Csiba, L
Autor Csiba, L Department of Neurology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
Fekete, K
Autor Fekete, K Department of Neurology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
Kõrv, J
Autor Kõrv, J Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia

European journal of neurology. 2017 ; 24 (12) : 1493-1498. [pub] 20171005

Eur J Neurol
ISSN 1468-1331
Medvik
Zdroj

BACKGROUND AND PURPOSE: Recent cross-sectional study data suggest that intravenous thrombolysis (IVT) in patients with in-hospital stroke (IHS) onset is associated with unfavorable functional outcomes at hospital discharge and in-hospital mortality compared to patients with out-of-hospital stroke (OHS) onset treated with IVT. We sought to compare outcomes between IVT-treated patients with IHS and OHS by analysing propensity-score-matched data from the Safe Implementation of Treatments in Stroke-East registry. METHODS: We compared the following outcomes for all propensity-score-matched patients: (i) symptomatic intracranial hemorrhage defined with the safe implementation of thrombolysis in stroke-monitoring study criteria, (ii) favorable functional outcome defined as a modified Rankin Scale (mRS) score of 0-1 at 3 months, (iii) functional independence defined as an mRS score of 0-2 at 3 months and (iv) 3-month mortality. RESULTS: Out of a total of 19 077 IVT-treated patients with acute ischaemic stroke, 196 patients with IHS were matched to 5124 patients with OHS, with no differences in all baseline characteristics (P > 0.1). Patients with IHS had longer door-to-needle [90 (interquartile range, IQR, 60-140) vs. 65 (IQR, 47-95) min, P < 0.001] and door-to-imaging [40 (IQR, 20-90) vs. 24 (IQR, 15-35) min, P < 0.001] times compared with patients with OHS. No differences were detected in the rates of symptomatic intracranial hemorrhage (1.6% vs. 1.9%, P = 0.756), favorable functional outcome (46.4% vs. 42.3%, P = 0.257), functional independence (60.7% vs. 60.0%, P = 0.447) and mortality (14.3% vs. 15.1%, P = 0.764). The distribution of 3-month mRS scores was similar in the two groups (P = 0.273). CONCLUSIONS: Our findings underline the safety and efficacy of IVT for IHS. They also underscore the potential of reducing in-hospital delays for timely tissue plasminogen activator delivery in patients with IHS.

MeSH
čas zasáhnout při rozvinutí nemoci MeSH
cévní mozková příhoda farmakoterapie MeSH
fibrinolytika terapeutické užití MeSH
intravenózní infuze MeSH
ischemie mozku farmakoterapie MeSH
lidé středního věku MeSH
lidé MeSH
nemocnice MeSH
průřezové studie MeSH
registrace MeSH
senioři nad 80 let MeSH
senioři MeSH
tendenční skóre MeSH
tkáňový aktivátor plazminogenu terapeutické užití MeSH
trombolytická terapie metody MeSH
výsledek terapie MeSH
Check Tag
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
senioři nad 80 let MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
práce podpořená grantem MeSH

Článek

Hereditary angio-oedema with C1 inhibitor deficiency: Characteristics and diagnostic delay of Czech patients from one centre

Allergologia et immunopathologia. 2016 ; 44 (3) : 241-5. [pub] 20160113

Allergol Immunopathol
ISSN 1578-1267
Medvik
Zdroj

BACKGROUND: Hereditary angio-oedema (HAE) is manifested by repeated episodes of localised subcutaneous or sub-mucosal oedema. Symptoms are extremely variable in frequency, localisation, and severity. Atypical or mild clinical symptoms of the disease may lead to erroneous diagnosis, causing diagnostic delay. The goal of this study was to assess how diagnostic delay has changed over 33 years at a single referral centre. METHODS: We analysed diagnostic delay and first symptoms of HAE in patients who were diagnosed at an immunology department between 1980 and 2013. Patient's records were analysed. RESULTS: The median diagnostic delay in 77 HAE type 1 and 2 patients was seven (range, 0-42) years. The difference observed in diagnostic delay between probands (18 [0-42] years) and others (1 [0-37] year) was significant (p<0.001). Our data show a significant negative correlation between the length of diagnostic delay and the year of diagnosis in our group of patients (p=0.024). The median age of first symptoms among all HAE patients (N=64) was 17 (1-40) years. The first symptoms of HAE in 64 patients were analysed. Twenty-six patients had abdominal, seventeen peripheral, five facial, two urogenital, and three had laryngeal oedema as the first manifestation of the disease. The last death that was attributed to HAE was in 1977. CONCLUSIONS: Our observations demonstrate improved awareness of HAE among physicians, as documented by the significant decrease in diagnostic delay. It is believed that earlier treatment will improve patient quality of life and life expectancy.