Sample records for stroke jacob suffered

  1. Oral carriage of yeasts and coliforms in stroke sufferers: a prospective longitudinal study. (United States)

    Zhu, H W; McMillan, A S; McGrath, C; Li, L S W; Samaranayake, L P


    To investigate prospectively the qualitative and quantitative changes in oral carriage of yeasts and coliforms in southern Chinese people suffering from stroke. In 56 elderly people suffering from stroke in a rehabilitation unit of a general medical hospital in Hong Kong, oral microbiological sampling using a combined imprint culture, oral rinse approach and clinical assessment was made during the acute stroke phase, on hospital discharge and 6 months later. The oral carriage of yeasts increased significantly during acute stroke (Pcoliform carriage did not. A reduction in oral carriage of yeasts was found on hospital discharge and 6 months later and in coliforms at the 6-month assessment (Pcoliform respectively. Stroke-related difficulty in tooth brushing and denture wearing were associated with higher oral yeast carriage (Pcoliforms in people suffering from stroke is noteworthy by care providers as K. pneumoniae may cause aspiration pneumonia.

  2. Vene Jacob / Elvis Kollom

    Index Scriptorium Estoniae

    Kollom, Elvis


    Vene Jacob'i stiilist. Prantsuse mööblimeister Georges Jacob (1739-1814) kutsuti XVIII sajandi lõpukümnendil sisustama Peterburi aristokraatlikke interjööre. Jacob'i stiilis vene mööblist ja selle kättesaadavusest Eestis. Vene jacob hakkas lõpuks muutuma äravahetamiseni sarnaseks vene ampiiriga. 4 värv. ill

  3. Safety of intravenous thrombolysis for acute ischaemic stroke including concomitant neoplastic disease sufferers - experience from Poland. (United States)

    Sobolewski, P; Brola, W; Szczuchniak, W; Fudala, M; Sobota, A


    Ischaemic stroke (IS), brain haemorrhage and cerebral venous thrombosis can occur as an early and late complication of cancer in the clinical course. Cancer patients are at increased risk for stroke from direct and indirect effects of their malignancy. The aim of our study was to evaluate the relationship between neoplastic disease and the long-term outcome, mortality and the presence of haemorrhagic complications in patients with acute IS treated with i.v. thrombolysis. We retrospectively evaluated the demographic and clinical data of 495 Caucasian patients with acute IS and 40 patients with IS and concomitant neoplastic disease who were consecutively treated from 2006 to 2013 in two experienced stroke centres. In analysed group, there were 7.8% of patients with cancer [50.0% male, mean age 72.3 ± 9.3; National Institutes of Health Stroke Scale - 13 (range 9.5-17)]. Cancer was diagnosed before i.v.-thrombolysis in 28 (70.0%) patients. After 3 months of follow up, 60% of patients were independent (mRS 0-2) compared with the group of patients without cancer - 55% (p = 0.54), 17.5% died (18.4%; p = 0.89), 12.4% suffered haemorrhagic transformation (HT) (17.6%; p = 0.41) and 2.5% experienced SICH (4.4%; p = 0.56, respectively). Other clinical complications were not found. A multivariate analysis showed no impact of neoplastic disease on unfavourable outcomes [modified Rankin scale 3-6)] after 3 months (p = 0.15). Intravenous thrombolysis performed in Caucasian stroke patients with past or current neoplastic diseases, but not in the course of chemo- and radiotherapy, can be a safe and effective method of treatment. In making decision on the thrombolytic treatment, the risk of bleeding complications and the life expectancy should be assessed. © 2015 John Wiley & Sons Ltd.

  4. Cognition and Comorbidity Behavior in Hospitalized Patients Suffering from Stroke. Seychelles 2010-2011

    Directory of Open Access Journals (Sweden)

    Armando Carlos Roca Socarras


    Full Text Available Background: cognitive impairment and high comorbidity are common health problems in patients with cerebrovascular disease. Objective: to describe the behavior of cognitive impairment and comorbidity in hospitalized patients suffering from stroke. Method: descriptive study of 77 patients with ischemic stroke admitted from April 2010 to December 2011, in Seychelles General Hospital. The behavior of this disease in relation to variables such as age, presence of chronic noncommunicable diseases, cognitive impairment, educational level, affected cerebral hemisphere and time of evolution was analyzed. Results: 68,9 % of patients presented cognitive impairment, their average age was 74,2 (± 9,19 years old compared to 62,4 (± 14,2 years old for those with no cognitive impairment. We found a higher frequency of chronic noncommunicable diseases in cognitively impaired patients with a Charlson comorbidity index of 2,11 (± 0,97. 18 patients with cognitive impairment and 23 patients with no cognitive impairment were diagnosed with depression. Conclusions: more than half of hospitalized patients experienced cognitive impairment and in most cases previous to cerebrovascular disease. Male patients predominated. There was an increase in age, severity of depression, as well as in the frequency of chronic noncommunicable diseases, and myocardial infarction of considerable size, in respect to patients with no cognitive impairment.

  5. Chandy, Dr Jacob

    Indian Academy of Sciences (India)

    Home; Fellowship. Fellow Profile. Elected: 1961 Section: Medicine. Chandy, Dr Jacob MBBS (Madras), FRCS (c) Council Service: 1962-70. Date of birth: 23 January 1910. Date of death: 23 June 2007. Specialization: Neurology, Neurosurgery and Medical Education Last known address: Paarra, Matteethra, Kottayam 686 ...

  6. Chandy, Dr Jacob

    Indian Academy of Sciences (India)

    Elected: 1961 Section: Medicine. Chandy, Dr Jacob MBBS (Madras), FRCS (c) Council Service: 1962-70. Date of birth: 23 January 1910. Date of death: 23 June 2007. Specialization: Neurology, Neurosurgery and Medical Education Last known address: Paarra, Matteethra, Kottayam 686 004. YouTube; Twitter; Facebook ...

  7. Gaining access to the life-world of women suffering from stroke - methodological issues in clinical phenomenological studies

    DEFF Research Database (Denmark)

    Kvigne, Kari; Gjengedal, Eva; Kirkevold, Marit


    a theoretical analysis supplemented by illustrations drawn from an ongoing study of women who have had suffered stroke. Findings. Openness is essential in the whole research process. It is a precondition for conversation with the informants. In interview-based investigations two forms of openness are at issue......, the researcher's theoretical insight, her ability to communicate, and not least the relationship between the informant and the researcher. A relationship of power, for example, might reinforce gender differences, differences in cultural background, education and social status. Conclusion. Openness on the part...

  8. Maurice Jacob 1933 - 2007

    CERN Multimedia


    CERN theorist Maurice Jacob passed away suddenly on May 2nd, following a heart attack. Throughout his research career, Maurice was a leader in the theory of high-energy hadron physics. In his early days, he made many key contributions, together with Giancarlo Wick, to the development of the helicity formalism that is being used increasingly in modern theoretical calculations. He was an expert on diffraction physics. Together with Sam Berman, he made the crucial observation that the appearance of point-like parton structures in deep-inelastic scattering implied the existence of high-transverse-momentum processes in proton-proton collisions, as subsequently observed at the CERN ISR. He was a pioneer of the studies of inclusive hadron-production processes, including scaling and its violations. Together with Ron Horgan, he made detailed predictions for the production of jets at the CERN proton-antiproton collider, which were subsequently discovered by the UA2 and UA1 experiments. Maurice worked closely with his...

  9. Bjerknes, Prof. Jacob Aall Bonneveie

    Indian Academy of Sciences (India)

    ... Mid Year Meetings · Discussion Meetings · Public Lectures · Lecture Workshops · Refresher Courses · Symposia · Live Streaming. Home; Fellowship. Fellow Profile. Elected: 1959 Honorary. Bjerknes, Prof. Jacob Aall Bonneveie. Date of birth: 2 November 1897. Date of death: 7 July 1975. YouTube; Twitter; Facebook; Blog ...

  10. Bjerknes, Prof. Jacob Aall Bonneveie

    Indian Academy of Sciences (India)

    Home; Fellowship. Fellow Profile. Elected: 1959 Honorary. Bjerknes, Prof. Jacob Aall Bonneveie. Date of birth: 2 November 1897. Date of death: 7 July 1975. YouTube; Twitter; Facebook; Blog. Academy News. IAS Logo. 29th Mid-year meeting. Posted on 19 January 2018. The 29th Mid-year meeting of the Academy will be ...

  11. A randomized trial of the effects of an aquatic exercise program on depression, anxiety levels, and functional capacity in of people who suffered an ischemic stroke. (United States)

    Aidar, Felipe J; Jacó de Oliveira, Ricardo; Gama de Matos, Dihogo; Chilibeck, Philip D; de Souza, Raphael F; Carneiro, André L; Machado Reis, Victor


    Aquatic exercise programs are used in rehabilitation and might help to reduce disability after stroke. This was a randomized intervention trial to assess the influence of an aquatic exercise program on people suffering from depression and anxiety after ischemic stroke. Participants were randomized to an experimental group (EG) composed of 19 individuals (51.8 ± 8.5 years; ten males and nine females), and a control group (CG) composed of 17 people (52.7 ± 6.7 years; nine males and eight females). The aquatic exercise program consisted of two sessions per week, each lasting between 45 and 60 minutes and divided into 5 to 10 minutes exercise sections during 12 weeks. The State-Trait Anxiety Inventory (STAI) was used to determine anxiety levels while the Beck Depression Inventory was used as a self-assessment of depression. EG improved measures of depression, anxiety trait and anxiety state between pre- and post-treatment, with no changes in CG. EG improved in all tests related to functional capacity compared to CG. The practice of aquatic exercises promotes improvements in the levels of depression and anxiety in people who suffered an ischemic stroke.

  12. RETRACTED: Early hyperbaric oxygen therapy may improve the long term neurological consequences of diabetic patients suffering from hemorrhagic stroke. (United States)

    Xu, Qian; Wei, Yi-Ting; Fan, Shuang-Bo; Wang, Liang; Zhou, Xiao-Ping


    This article has been retracted: please see Elsevier Policy on Article Withdrawal ( This article has been retracted at the request of Neuroscience Letters has learned that text throughout this paper duplicates, or nearly duplicates, text in an earlier paper by others (Rusyniak DE, Kirk MA, May JD, Kao LW, Brizendine EJ, Welch JL, Cordell WH, Alonso RJ; Hyperbaric Oxygen in Acute Ischemic Stroke Trial Pilot Study, Stroke. 2003 Feb;34(2):571-4). Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  13. Thicker carotid intima-media thickness and increased plasma VEGF levels suffered by post-acute thrombotic stroke patients

    Directory of Open Access Journals (Sweden)

    Yueniwati Y


    Full Text Available Yuyun Yueniwati,1 Ni Komang Darmiastini,1 Eko Arisetijono2 1Radiology Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia; 2Neurology Department, Faculty of Medicine, Brawijaya University, Malang, Indonesia Background and objectives: Atherosclerosis causes reduction of the oxygen supply to structures in the far arterial wall, provoking the release of factors that drive angiogenesis of vasa vasorum, including VEGF. Other studies have revealed the inflammatory response in atherosclerosis and the role of platelet factor 4 (PF4 as an anti-angiogenic chemokine through the inhibition of VEGF. This cross-sectional study aims at measuring the effect of atherosclerosis assessed through carotid intima-media thickness (CIMT against plasma VEGF levels in patients with post-acute thrombotic stroke. Materials and methods: CIMT was assessed sonographically using GE Logiq S6 with 13 MHz frequency linear probe. VEGF-A plasma levels were measured using enzyme-linked immunosorbent assay (ELISA method. Differences among variables were compared statistically. The data were analyzed using Pearson correlation. Results: A total of 25 patients with post-acute thrombotic stroke were identified in days 7 to 90. CIMT thickening was indicated in 88% of patients (1.202 ± 0.312 mm, while an increase in plasma VEGF was identified in all patients (178.28 ± 93.96 ng/mL. There was no significant correlation between CIMT and plasma VEGF levels in patients with post-acute thrombotic stroke (p=0.741. A significant correlation was recognized between CIMT and total cholesterol (p=0.029 and low-density lipoprotein (p=0.018. Conclusion: There were no significant correlations between CIMT and plasma VEGF levels in patients with post-acute thrombotic stroke. However, plasma VEGF increased in patients with thrombotic stroke. CIMT measurement is a promising noninvasive modality to assess the vascular condition of patients with stroke and diabetes, while plasma VEGF

  14. Jacob Kohler: Meestervakman en entrepreneur | Terblanche | South ...

    African Journals Online (AJOL)

    Jacob Kohler: Master-craftsman and entrepreneur: Jacob Kohler (1851-1925), born in Bavaria, ... He made a name for himself as a master-joiner. He excelled in innovative practices. ... Keywords: Port Elizabeth; German community; building trade; joinery; First World War; packaging industry. South Africa Journal of Cultural ...

  15. Johann Jacob Friedrich Wilhelm Parrot / Tõivo Sarmet

    Index Scriptorium Estoniae

    Sarmet, Tõivo


    Tartu Ülikooli rektorit Johann Jacob Friedrich Wilhelm Parrot loetakse Venemaa alpinismiajaloo alusepanijaks ja tema tähelepanuväärseimaks mägironimisalaseks teoks oli tõus Suur-Araratile 1829. aastal

  16. Gerrard Winstanley and Jacob Boehme

    Directory of Open Access Journals (Sweden)

    Hessayon, Ariel


    Full Text Available Given, firstly, justifiable claims made by the editors of the complete works of the Digger leader Gerrard Winstanley, that he was not just the ‘foremost radical of the English Revolution’ but also one of the ‘finest writers’ of a ‘glorious age of English non-fictional prose’, and secondly, the important suggestion that Winstanley was a forerunner of Quakerism, indeed that his writings shaped the formation of Quaker thought, Winstanley’s potential reading of the German Lutheran mystic Jacob Boehme deserves close attention. For more than a century scholars encompassing a range of backgrounds and ideological commitments have, with varying degrees of caution, drawn a number of rarely convincing and, unfortunately, usually ill-informed parallels between Boehme and Winstanley. As I will show, it seems certain that Winstanley did not consult any of Boehme’s works while writing his own. It also appears very probable that he never read Boehme. The disparities between them are far too great. Indeed, there is no analogue in the relevant texts by Boehme for a number of Winstanley’s doctrines and exhortations. Furthermore, Winstanley never quotes, paraphrases or alludes to Boehme. His prose style differs from the way in which Boehme’s translators rendered him into English. Nor does Winstanley adopt any of the neologisms introduced by these translators. Consequently I will suggest that since Winstanley most likely possessed only a handful of printed works or else a modest library, greater consideration needs to be given to how ideas were transmitted – not textually but orally, because it is probable that some of the seeds that germinated into Winstanley’s mature philosophy were sown in this manner.

  17. The prevalence of poor anticoagulant response to activated protein C (APC resistance) among patients suffering from stroke or venous thrombosis and among healthy subjects. (United States)

    Halbmayer, W M; Haushofer, A; Schön, R; Fischer, M


    A poor anticoagulant response to activated protein C (APC) in an activated partial thromboplastin time (aPTT) assay (APC resistance) was recently reported to be a cause of familial thrombophilia. The response to APC was measured in 30 patients suffering from juvenile or recurrent stroke, in 40 patients suffering from venous thromboembolism and in 50 healthy subjects. The prevalence of APC resistance was found to be significantly higher among patients with stroke (20%, P < 0.003) and venous thrombosis (17.5%, P < 0.02) compared with the prevalence of APC resistance among normal controls (2%). In one case of venous thrombosis, the proposita's family (A) could be investigated and in five out of nine investigated members (56%) a poor or borderline response to APC was detected. The family (B) of another APC-resistant patient revealed six subjects with poor coagulation response to APC out of eight family members studied (75%). Measuring protein S activity with an automated calcium-thromboplastin-based protein S activity assay, a significant correlation (P < 0.0001) between the results of this functional protein S assay and APC resistance (represented by the ratio (Rs value) of clotting time with and without addition of activated protein C) was observed. Nine out of 14 patients (64%) with poor APC response showed protein S activities below the normal range. Assessment of protein S activity with a second protein S clotting assay using factor Va as substrate confirmed only 47% of the decreased levels of the thromboplastin-based protein S clotting assay.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. JACOB: An Enterprise Framework for Computational Chemistry (United States)

    Waller, Mark P; Dresselhaus, Thomas; Yang, Jack


    Here, we present just a collection of beans (JACOB): an integrated batch-based framework designed for the rapid development of computational chemistry applications. The framework expedites developer productivity by handling the generic infrastructure tier, and can be easily extended by user-specific scientific code. Paradigms from enterprise software engineering were rigorously applied to create a scalable, testable, secure, and robust framework. A centralized web application is used to configure and control the operation of the framework. The application-programming interface provides a set of generic tools for processing large-scale noninteractive jobs (e.g., systematic studies), or for coordinating systems integration (e.g., complex workflows). The code for the JACOB framework is open sourced and is available at: © 2013 Wiley Periodicals, Inc. PMID:23553271

  19. Alexander von Humboldt and Coenraad Jacob Temminck

    NARCIS (Netherlands)

    Raat, A.J.P.


    INTRODUCTION In the archives of the Rijksmuseum van Natuurlijke Historie in Leiden there is a map with three letters written by Alexander von Humboldt (17691859) to the first director of the Museum, Coenraad Jacob Temminck (1778-1858). The map, the hard cover of John Gould's "Synopsis of the birds

  20. Corner Office Interview: Gates Foundation's Deborah Jacobs (United States)

    Miller, Rebecca


    U.S. libraries gave the world a top talent when Deborah Jacobs left her transformational role as City Librarian of Seattle in 2008 to head the Bill & Melinda Gates Foundation's Global Libraries program, the international sibling to the U.S. Libraries program. The initiative fosters national-scale projects with grantees in transitioning countries…

  1. GM2 gangliosidosis in British Jacob sheep. (United States)

    Wessels, M E; Holmes, J P; Jeffrey, M; Jackson, M; Mackintosh, A; Kolodny, E H; Zeng, B J; Wang, C B; Scholes, S F E


    GM2 gangliosidosis (Tay-Sachs disease) was diagnosed in 6- to 8-month-old pedigree Jacob lambs from two unrelated flocks presenting clinically with progressive neurological dysfunction of 10 day's to 8 week's duration. Clinical signs included hindlimb ataxia and weakness, recumbency and proprioceptive defects. Histopathological examination of the nervous system identified extensive neuronal cytoplasmic accumulation of material that stained with periodic acid--Schiff and Luxol fast blue. Electron microscopy identified membranous cytoplasmic bodies within the nervous system. Serum biochemistry detected a marked decrease in hexosaminidase A activity in the one lamb tested, when compared with the concentration in age matched controls and genetic analysis identified a mutation in the sheep hexa allele G444R consistent with Tay-Sachs disease in Jacob sheep in North America. The identification of Tay-Sachs disease in British Jacob sheep supports previous evidence that the mutation in North American Jacob sheep originated from imported UK stock. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  2. Writing with Light: Jacob Riis's Ambivalent Exposures (United States)

    Carter, Christopher


    The current interest in multimodal rhetoric was anticipated by Jacob Riis's social documentary texts and presentations during the late nineteenth and early twentieth centuries. In contrast with the socialist urban critiques presented by Friedrich Engels, Riis's work demonstrated profound ambivalence toward the city's poor. While calling for reform…

  3. 2663-IJBCS-Article-Afouda Jacob Yabi

    African Journals Online (AJOL)


    gestion de la fertilité des sols utilisées dans la commune de Ouaké au Nord-. Ouest du Bénin. Jacob Afouda YABI1*, François Xavier ..... exige un certain niveau de risque associé à la décision du choix des technologies. Aussi, les ... car, les producteurs ayant un accès facile aux crédits auront tendance à mieux adopter les.

  4. Irène Jacob visits CERN

    CERN Multimedia

    CERN Bulletin


    French actress Irène Jacob, the daughter of physicist Maurice Jacob, visited the ATLAS and CMS control rooms on Monday 17 May together with Italian theatre actor-director Pippo Delbono, in search of inspiration for a short film. The film will be screened at the “nuit des particules” event accompanying this year’s ICHEP.   Pippo Delbono et Irène Jacob discussing their project. “La nuit des particules” (night of the particles) is an event open to the general public that is being organised for the evening of Tuesday, 27 July, to accompany the 35th International Conference on High Energy Physics (ICHEP). ICHEP is a major highlight in every physicist’s calendar, and this year’s edition is being held in Paris from 22 to 28 July. The short film will be screened during the evening, which will include a lecture and a show at the legendary Parisian cinema Le Grand Rex, with a colossal seating capacity of 2 700 spe...

  5. Stroke (United States)

    ... adjust your treatment as needed. Rehabilitation After a stroke, you may need rehabilitation (rehab) to help you recover. Rehab may include working with speech, physical, and occupational therapists. Language, ... may have trouble communicating after a stroke. You may not be able to find the ...

  6. Tay-Sachs disease in Jacob sheep. (United States)

    Torres, Paola A; Zeng, Bai Jin; Porter, Brian F; Alroy, Joseph; Horak, Fred; Horak, Joan; Kolodny, Edwin H


    Autopsy studies of four Jacob sheep dying within their first 6-8 months of a progressive neurodegenerative disorder suggested the presence of a neuronal storage disease. Lysosomal enzyme studies of brain and liver from an affected animal revealed diminished activity of hexosaminidase A (Hex A) measured with an artificial substrate specific for this component of β-hexosaminidase. Absence of Hex A activity was confirmed by cellulose acetate electrophoresis. Brain lipid analyses demonstrated the presence of increased concentrations of G(M2)-ganglioside and asialo-G(M2)-ganglioside. The hexa cDNA of Jacob sheep was cloned and sequenced revealing an identical number of nucleotides and exons as in human HexA and 86% homology in nucleotide sequence. A missense mutation was found in the hexa cDNA of the affected sheep caused by a single nucleotide change at the end of exon 11 resulting in skipping of exon 11. Transfection of normal sheep hexa cDNA into COS1 cells and human Hex A-deficient cells led to expression of Hex S but no increase in Hex A indicating absence of cross-species dimerization of sheep Hex α-subunit with human Hex β-subunits. Using restriction site analysis, the heterozygote frequency of this mutation in Jacob sheep was determined in three geographically separate flocks to average 14%. This large naturally occurring animal model of Tay-Sachs disease is the first to offer promise as a means for trials of gene therapy applicable to human infants. Copyright © 2010 Elsevier Inc. All rights reserved.

  7. Jane Jacobs' ‘Cities First’ Model and Archaeological Reality


    Smith, Michael E.; Ur, Jason Alik; Feinman, Gary M.


    In The Economy of Cities, Jane Jacobs conjectured that the world's first cities preceded the origins of agriculture, a proposition that was most recently revived by Peter Taylor in the pages of this journal. Jacobs' idea was out of line with extant archaeological findings when first advanced decades ago, and it remains firmly contradicted by a much fuller corpus of data today. After a review of how and why Jacobs formulated her ‘cities first’ model, we review current archaeological knowledge ...

  8. Loving and Hating Jacob Zuma: Some Implications for Education (United States)

    Pattman, Rob


    Jacob Zuma is the former Deputy President of South Africa who was suspended from office pending a court case on corruption charges but whose name has dominated the South Africa media over the last few months in relation to his prosecution for rape of a much younger woman who was HIV positive. The Jacob Zuma trial has produced powerful feelings for…

  9. Jacob - an animated instruction agent for virtual reality

    NARCIS (Netherlands)

    Evers, M.J.; Nijholt, Antinus; Tan, T.; Shi, Y.; Gao, W.


    This paper gives an overview of the Jacob project. This project in-volves the construction of a 3D virtual environment where an animated human-like agent called Jacob gives instruction to the user. The project investigates virtual reality techniques and focuses on three issues: the software

  10. Jacob: An Educational Agent in a Virtual Environment

    NARCIS (Netherlands)

    van den Bosch, A.; Evers, M.J.; Nijholt, Antinus; Weigand, H.


    The Jacob Project involves the construction of a virtual environment where an animated human-like agent called Jacob gives instruction to the user. The project focuses on three issues: the software engineering aspects of building a virtual reality system, the integration of natural language

  11. Jacob: a web-based learning environment using virtual reality

    NARCIS (Netherlands)

    Evers, M.J.; Heemskerk, S.; Nijholt, Antinus


    This paper gives an overview of the Jacob project. This project involves the construction of a 3D virtual environment where an animated human-like agent called Jacob gives instruction to the user. The project investigates virtual reality techniques and focuses on three issues: the software

  12. Dr Jacob van der Land, marine biologist extraordinary

    NARCIS (Netherlands)

    Bruggen, van A.C.


    This contribution is an attempt to sketch the life and works of Dr Jacob van der Land, curator of worms and chief marine biologist of the National Museum of Natural History, on the occasion of his official retirement. Born in 1935, Jacob van der Land read biology at Leiden University (1958-1964),

  13. Jacob B. Winslow (1669-1760). (United States)

    Bellary, Sharath S; Walters, Andrew; Gielecki, Jerzy; Shoja, Mohammadali M; Tubbs, R Shane; Loukas, Marios


    Jacob Winslow was a Dutch born, French naturalized anatomist and physician whose contributions to medicine are abundant. His importance to medicine is undisputed. His personal life included a religious crisis that resulted in his estrangement from his family, but afforded him patrons in Paris to continue his work. Following this conversion, he changed his name to that of his catechist and was rechristened Jacques Benigne Wilson. His respect as an expert was well deserved, and he held several prominent positions during his career in Paris. His main work, Exposition anatomique de la structure du corps humain, was published in 1732 and is considered the first purely anatomical treatise. This review highlights his contributions to anatomy and medicine through the course of his career. © 2012 Wiley Periodicals, Inc.

  14. Maurice Jacob : "Fundamental physics looks forwards Space"; symposium in honour of Maurice Jacob on 27 March 1998

    CERN Document Server

    Laurent Guiraud


    On the occasion of the 65th birthday of Maurice Jacob, his friends are organizing, together with CERN, a symposium presenting some of the scinetific fields to which M Jacob has made decisive contributions during his career or in which he has a person

  15. Reassessing Jacob Strauss and the Mosaic Code

    Directory of Open Access Journals (Sweden)

    Joel McDurmon


    Full Text Available This article reviewed claims made by modern scholars Ford Lewis Battles, G.H. Williams, and Theodore Tappert concerning the views of Jacob Strauss (1480–1530, court preacher at Eisenach, particularly in regard to the imposition of Mosaic Law upon the civil realm. Most pointedly, Battles claims Strauss proposed to replace European civil law completely with the ‘entire Mosaic code’. This study examined Strauss’s relevant writings to determine his position on Mosaic Law and civil law and demonstrated that the claims of Battles, Williams, and Tappert were not supported by the primary source evidence. Selections from Strauss’ 51 theses on usury are translated into English for the first time. To a much lesser degree, this study addressed the issue in regard to the Weimar court preacher Wolfgang Stein, against whom the same claims were made. A paucity of evidence rendered those claims dubious in his case. In the end we were left only with unsubstantiated second-hand claims against these men.

  16. Toilet Grab-Bar Preference and Center of Pressure Deviation During Toilet Transfers in Healthy Seniors, Seniors With Hip Replacements, and Seniors Having Suffered a Stroke. (United States)

    Kennedy, Matthew Joel; Arcelus, Amaya; Guitard, Paulette; Goubran, R A; Sveistrup, Heidi


    Multiple toilet grab-bar configurations are required by people with a diverse spectrum of disability. The study purpose was to determine toilet grab-bar preference of healthy seniors, seniors with a hip replacement, and seniors post-stroke, and to determine the effect of each configuration on centre of pressure (COP) displacement during toilet transfers. 14 healthy seniors, 7 ambulatory seniors with a hip replacement, and 8 ambulatory seniors post-stroke participated in the study. Toilet transfers were performed with no bars (NB), commode (C), two vertical bars (2VB), one vertical bar (1VB), a horizontal bar (H), two swing-away bars (S) and a diagonal bar (D). COP was measured using pressure sensitive floor mats. Participants rated the safety, ease of use, helpfulness, comfort and preference for instalment. 2VB was most preferred and had the smallest COP deviation. Least preferred was H and NB. C caused largest COP displacement but had favourable ratings. The preference and safety of the 2VB should be considered in the design of accessible toilets and in accessibility construction guidelines. However these results need to be verified in non-ambulatory populations. C is frequently prescribed, but generates large COP deviation, suggesting it may present an increased risk of falls.

  17. Occipital condylar dysplasia in a Jacob lamb ( Ovis aries ) | Lee ...

    African Journals Online (AJOL)

    multihorned) phenotype. We describe a four-horned Jacob lamb that exhibited progressive congenital hindlimb ataxia and paresis, and was euthanased four weeks post-partum. Necropsy and CT-scan revealed deformity and asymmetry of the ...

  18. 860-IJBCS-Article-Prof Jacob A Kalawole

    African Journals Online (AJOL)

    DR GATSING The effect of Yoyo bitters on the pharmacokinetics of single oral dose paracetamol tablet in human volunteers. Bulus Vilret KUMDI, Jacob A. KOLAWOLE* and Emmanuel APEH. Department of Pharmaceutical Chemistry, ...

  19. Spontaneous ischaemic stroke in dogs

    DEFF Research Database (Denmark)

    Gredal, Hanne Birgit; Skerritt, G. C.; Gideon, P.


    Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms.......Translation of experimental stroke research into the clinical setting is often unsuccessful. Novel approaches are therefore desirable. As humans, pet dogs suffer from spontaneous ischaemic stroke and may hence offer new ways of studying genuine stroke injury mechanisms....

  20. Jacob Lawrence's "The Migration Series": Art as Narrative History (United States)

    Laney, James D.


    Because art is a reflection of cultural heritage, a natural affinity exists between art and social studies. In Jacob Lawrence's "The Migration Series," art serves as narrative history, with visual images telling the story of the Great Migration, a movement of African American people from the South to the North around World War I. Social studies…


    African Journals Online (AJOL)



    Feb 7, 2005 ... Osaji, Jacob Olasupo. Department of Religions,. University of Ilorin, Ilorin, .... as a citizen when political authorities put him in prison and flogged him without giving him proper trial (Acts 16:37-38, ... For example, the immigration and custom officers are meant to police our borders. They are supposed to ...

  2. Exploring resident-empowered meetingplaces in Dutch neighbourhoods : by Jane Jacobs Walking Action-research methodology

    NARCIS (Netherlands)

    Sanders, F.C.


    The ‘Jane Jacobs Walk’ organization as one of the Jane Jacobs (1916-2006) heritage initiative supported three Jane Jacobs Walks of certified Fred Sanders in the period 2011 - 2014 in Amsterdam neighbourhoods. These walks helped residents to explore resident-empowered meeting-places and activities in

  3. Confiabilidade do Perfil de Saúde de Nottingham após acidente vascular encefálico Reliability of the Nottingham Health Profile after suffering a stroke

    Directory of Open Access Journals (Sweden)

    Dinalva Lacerda Cabral


    Full Text Available O artigo tem o objetivo de avaliar a confiabilidade, a consistência interna e a concordância do instrumento de qualidade de vida (QV Perfil de Saúde de Nottingham (PSN em indivíduos após Acidente Vascular Encefálico (AVE. Estudo do tipo transversal realizado em comunidades da Cidade do Recife-PE. A amostra foi composta por 53 indivíduos na fase crônica do AVE. Após verificação do estado cognitivo foi aplicado o PSN. Utilizou-se estatística descritiva para caracterizar a amostra; a consistência interna foi medida através do alfa (α de Cronbach; a confiabilidade com o coeficiente de correlação intraclasse (CCI e a concordância pelo teste de plotagem Bland and Altman, com nível de significância de 5%. A percepção dos indivíduos sobre suas saúdes teve uma tendência positiva em 83,3% dos domínios do PSN (média > 50 pontos, exceto para o domínio "habilidades físicas" que variou entre 41,5 e 50 pontos. O instrumento obteve boa consistência interna, com α entre 0,81 e 0,87; excelente confiabilidade nos domínios "dor" e "habilidades físicas", ICC >0,90 (p This article seeks to evaluate the reliability, internal consistency and accuracy of the Nottingham Health Profile (NHP, namely a quality of life (QL instrument for individuals after suffering a stroke. This cross-sectional study was carried out in the communities of Recife in the State of Pernambuco. The sample was composed of 53 individuals at the chronic stroke phase. After checking the cognitive state, the NHP was applied. Descriptive statistics were employed for characterization of the sample; Cronbach's alpha (α coefficients were used for evaluation of internal consistency, and intra-class correlation coefficients (ICC were used for investigation of reliability, as well as consistency of the Bland and Altman plotting tests with 5% level of significance. Their perceptions of their own health were 83.3% positive for the majority of NHP criteria (average scores > 50

  4. Errant life, molecular biology, and biopower: Canguilhem, Jacob, and Foucault. (United States)

    Talcott, Samuel


    This paper considers the theoretical circumstances that urged Michel Foucault to analyse modern societies in terms of biopower. Georges Canguilhem's account of the relations between science and the living forms an essential starting point for Foucault's own later explorations, though the challenges posed by the molecular revolution in biology and François Jacob's history of it allowed Foucault to extend and transform Canguilhem's philosophy of error. Using archival research into his 1955-1956 course on "Science and Error," I show that, for Canguilhem, it is inauthentic to treat a living being as an error, even if living things are capable of making errors in the domain of knowledge. The emergent molecular biology in the 1960s posed a grave challenge, however, since it suggested that individuals could indeed be errors of genetic reproduction. The paper discusses how Canguilhem and Foucault each responded to this by examining, among other texts, their respective reviews of Jacob's The Logic of the Living. For Canguilhem this was an opportunity to reaffirm the creativity of life in the living individual, which is not a thing to be evaluated, but the source of values. For Foucault, drawing on Jacob's work, this was the opportunity to develop a transformed account of valuation by posing biopower as the DNA of society. Despite their disagreements, the paper examines these three authors as different iterations of a historical epistemology attuned to errancy, error, and experimentation.

  5. Jacob Bernouilli y el cálculo de probabilidades


    Gutiérrez, Santiago


    Hace trescientos años, en 1713, veía la luz un libro titulado Ars conjectandi (el arte de las conjeturas), considerado por un buen número de historiadores científicos como el origen del cálculo de probabilidades, en cuanto parte integrante de la ciencia matemática. Su autor, Jacob Bernoulli, había fallecido en 1705, dejando inconcluso su trabajo. no obstante mereció ser publicado, y así lo entendió y lo hizo su sobrino Nicolaus, matemático como su tío, hijo del pintor Nicolaus, hermano de Jac...

  6. Jacob Stael von Holstein ja palladionism eesti arhitektuuris / Ants Hein

    Index Scriptorium Estoniae

    Hein, Ants, 1952-


    Sõjaväeinsenerist ja arhitektist Jacob Stael von Holsteinist (1628, Pärnu-1679), tema kavandatud hoonetest ja rollist 17. sajandi II poole arhitektuuris. Fabian von Ferseni Toompeal Lossiplatsil asunud elamust (lammutati 1894) ja Maardu mõisahoonest, Hans von Ferseni Mäo mõisahoonest Järvamaal, Otto Wilhelm von Ferseni majast Toompeal, Axel von Roseni majast Tallinnas Pikk t. 28 (1670-74), Otto Reinhold von Taube majast Tartus (hävinud), J. S. von Holsteini enda hoonetest: majast Tallinnas Toompea 1, Anija mõisahoonest, elamust Riias jm. Bibliograafia lk. 452

  7. Jacob Hemet. Dentist to royalty and entrepreneur extraordinaire. (United States)

    Ring, Malvin E


    One of the most prominent dentists in late-18th century London was Jacob Hemet, member of a long family of dentists. He was appointed royal dentist to Queen Charlotte, wife of George the Third, and to George's favorite daughter, Amelia, and the Prince of Wales. He advertised widely, both in this country and in several European countries, including his native France. However, what makes him noteworthy is the fact that he was the very first person to patent a dentifrice and the first to use marketing techniques similar to those used by the foremost toothpaste manufacturers of today.

  8. "IS THIS FREEDOM?" A political theory of Harriet Jacobs's loopholes of emancipation


    Syedullah, Jasmine


    This dissertation theorizes Harriet Jacobs's politics of abolitionist emancipation as a loophole in modern theories of freedom. Jacobs's narrative, Incidents in the Life of a Slave Girl, is an immeasurably valuable critique of the sexual politics of the peculiar institution. Our return to Jacobs wonders what additional value might be gleamed from reading her contributions to the abolitionist tradition as a social critique of slavery animated by an immanent critique of the virtues of modern p...

  9. Remote Laboratory Java Server Based on JACOB Project

    Directory of Open Access Journals (Sweden)

    Pavol Bisták


    Full Text Available Remote laboratories play an important role in the educational process of engineers. This paper deals with the structure of remote laboratories. The principle of the proposed remote laboratory structure is based on the Java server application that communicates with Matlab through the COM technology for the data exchange under the Windows operating system. Java does not support COM directly so the results of the JACOB project are used and modified to cope with this problem. In laboratories for control engineering education a control algorithm usually runs on a PC with Matlab that really controls the real plant. This is the server side described in the paper in details. To demonstrate the possibilities of a remote control a Java client server application is also introduced. It covers communication and offers a user friendly interface for the control of a remote plant and visualization of measured data.

  10. Headache Sufferers' Diet (United States)

    ... Find A Provider Contact Membership Donate 13 Jan Headache Sufferers' Diet Posted at 21:35h in Headache ... No Comments Post A Comment Cancel Reply NATIONAL HEADACHE FOUNDATION Financials Annual Benefit HeadWise Magazine Subscribe to ...

  11. Spiritual pain and suffering. (United States)

    Brunjes, George B


    Spiritual pain/suffering is commonly experienced by persons with life-limiting illness and their families. Physical pain itself can be exacerbated by non-physical causes such as fear, anxiety, grief, unresolved guilt, depression and unmet spiritual meets. Likewise, the inability to manage physical pain well can be due to emotional and spiritual needs. This is why a holistic, interdisciplinary assessment of pain and suffering is required for each patient and family. The mind, body and spirit are understood in relationship to each other and, in those cases, in relationship to a deity or deities are important to understand. Cultural interpretations of pain and suffering may conflict with the goals of palliative care. Understanding the spiritual framework of the patient and family can help to assure that the physical and spiritual suffering of the patient can be eliminated to provide a peaceful death. Spiritual practices may help in the management of physical pain.

  12. Stroke Stories | NIH MedlinePlus the Magazine (United States)

    ... of this page please turn Javascript on. Feature: Stroke Rehabilitation Stroke Stories Past Issues / Spring 2013 Table of Contents ... these well-known personalities suffered one or more strokes. In each case, he or she has returned ...

  13. Stroke, social support and the partner

    NARCIS (Netherlands)

    Kruithof, WJ


    Stroke is one of the most common conditions with about 45,000 people suffering a first stroke in the Netherlands each year. Although survival after stroke has increased in recent decades, a substantial part of the survivors of stroke remain physically or cognitively impaired and in need of support

  14. World Stroke Organization Global Stroke Services Guidelines and Action Plan


    Lindsay, Patrice; Furie, Karen L.; Davis, Stephen M.; Donnan, Geoffrey A.; Norrving, Bo


    Every two seconds, someone across the globe suffers a symptomatic stroke. 'Silent' cerebrovascular disease insidiously contributes to worldwide disability by causing cognitive impairment in the elderly. The risk of cerebrovascular disease is disproportionately higher in low to middle income countries where there may be barriers to stroke care. The last two decades have seen a major transformation in the stroke field with the emergence of evidence-based approaches to stroke prevention,...

  15. Trauma, suffering and resilience

    DEFF Research Database (Denmark)

    de Casas Soberón, Elena; Berliner, Peter


    The article discusses the challenge of using a conceptual framework to understand traumatic stress and still be open to listening to the stories of suffering, of lamentation, grief, hope, and values of people being oppressed by organised violence. The complexity of responses to the losses caused ...

  16. Taani viib õpilaste testimise Internetti / Jacob Wandall ; intervjueerinud Raivo Juurak ; kommenteerinud Anti Teepere

    Index Scriptorium Estoniae

    Wandall, Jacob


    Ülevaade adaptiivtestidest ja nende rakendamise kavadest Taani põhikoolis. Vestlus Taani haridusministeeriumi koolivalitsuse peaspetsialist Jacob Wandalliga, kommenteerib REKK-i üldhariduse õppekavade ja eksamite osakonna peaspetsialist Anti Teepere

  17. Jacobs Engineering Group Inc. receives architectural and engineering design contract from Stanford Linear Accelerator Centre

    CERN Multimedia


    "Jacobs Engineering Group Inc. announced that a subsidiary company won a contract from Stanford Linear Accelerator Center (SLAC), to provide architectural and engineering design services for the Linac Coherent Light Source (LCLS) conventional facilities" (1/2 page)

  18. Does God Suffer?


    Sarot, M.


    The author argues that Thomas G. Weinandy in his book Does God Suffer? starts from the axiom of divine apathy, rather than that he argues for it. He criticizes the hermeneutic implicit in Weinandy's interpretation of 1 Samuel 15, and proposes an alternative approach. Moreover, he criticizes Weinandy's appeal to agreement among the church fathers (based on a non-representative selection) and his appeal to the doctrine of the Trinity (based on a most speculative, but insuffciently warranted int...

  19. Stroke Treatments (United States)

    ... Month Infographic Stroke Hero F.A.S.T. Quiz Stroke Treatment Stroke used to rank fourth in leading causes of ... type of treatment depends on the type of stroke. Ischemic stroke happens when a clot blocks a ...

  20. [Temporal meaning of suffering]. (United States)

    Porée, J


    If we had to find a few simple words to express what a suffering human being experiences, no matter what ills are causing the suffering and no matter what circumstances underlie the ills themselves, we could unmistakably say that it is the experience of not being able to go on like this. Suffering can be described, in this same sense, as an alteration in temporality. However, describing suffering as such only makes sense if we already have a conception of normal temporality. Yet for this, philosophical tradition offers not one but four competing conceptions. In the present article, we begin by briefly presenting these different conceptions. We then show how each one sheds light, by way of contrast, on a phenomenon whose meaning thus appears to be essentially negative. But does this phenomenon have a negative meaning only? Doesn't it correspond as much to a transformation as an alteration of temporality? This is what we will strive to establish in the third part of the article by relating suffering to hope, in a paradoxical sense of the term. Of the four conceptions of time likely to shed a contrasting light on the upheavals that suffering introduces into our life experience, the one described by Aristotle in Physics is historically the first. In particular, the notion of succession originates therein. But this conception does not account for what makes time the unit of a past, a present, and a future. In Book XI of Confessions, St. Augustine situated this unit not in nature but in the human mind. Hence, his definition of time as a distension of the soul and the necessary division into physical time and psychic time it entails. Husserl's Lessons on the phenomenology of the consciousness of internal time lend credit to this division, but they illuminate only the internal constitution of the "present", which is at the heart of the psychological conception of time. In Being and Time, Heidegger breaks away from this long-standing tradition; in his view, physical time

  1. Recovery of Dysphagia in Lateral Medullary Stroke


    Gupta, Hitesh; Banerjee, Alakananda


    Lateral medullary stroke is typically associated with increased likelihood of occurrence of dysphagia and exhibits the most severe and persistent form. Worldwide little research exists on dysphagia in brainstem stroke. An estimated 15% of all patients admitted to stroke rehabilitation units experience a brainstem stroke out of which about 47% suffer from dysphagia. In India, a study showed that 22.3% of posterior circulation stroke patients develop dysphagia. Dearth of literature on dysphagia...

  2. To See the Suffering. (United States)

    Charon, Rita


    The author notes the impressive growth in medical humanities programs, scholarly journals, textbooks, and national and international conferences as well as the convening of two recent national forums or boards addressing the potential of the humanities and the arts to improve medical practice. She also notes that the field of medical humanities seems to have shifted from addressing topics on the margins of medical education to equipping students with the foundational skills required for effective doctoring. This Invited Commentary proposes a number of personal, relational, and interpretive consequences to rigorous training in the humanities or the arts that might lead to improvement in the skills of doctoring. Where else but in hospitals with very ill patients and very young doctors who care for them are such skills needed the most? The author suggests that to see the suffering might be what the humanities in medicine are for, and that those who become capable of seeing the suffering around them in medical practice both experience the cost of countenancing the full burden of illness and death and, simultaneously, comprehend with clarity the worth of this thing, this life.

  3. Early Detection of Post-Stroke Depression

    NARCIS (Netherlands)

    de Man - van Ginkel, J.M.


    In the first two years after stroke approximately one-third of the patients suffer from depression, also referred to as post-stroke depression (PSD). Patients with PSD suffer from symptoms, such as a diminished interest or pleasure (anhedonia), depressed mood, sleep disturbances, loss of energy,

  4. Harriet Jacobs: forerunner of gender studies in slave narratives and african american women's literature


    Sedano Vivanco, Sonia


    [ES]Esta tesis pone de manifiesto como Harriet Jacobs decide poner por escrito sus tribulaciones en esclavitud, no se puede adherir por completo a las convenciones estilísticas y temáticas del género ya que la narrativa de esclavo había sido creada por hombres esclavos para narrar las experiencias en esclavitud de los hombres esclavos. Así, Jacobs transforma estas convenciones presentándolas desde un punto de vista womanista (feminista negra combativa). [EN]This thesis shows as Harriet Jac...

  5. Calidad de vida de cuidadores de adultos con accidente cerebrovascular Qualidade de vida de cuidadores de adultos com acidente cerebrovascular Quality of Life of Caretakers of Adults who Have Suffered a Stroke

    Directory of Open Access Journals (Sweden)



    ,6. Conclusões: a experiência de ser cuidador modifica de forma importante a qualidade de vida das pessoas; os cuidadores, como fonte importante de cuidado informal, requerem apoio dos sistemas de saúde e dos profissionais de enfermagem como parte do sistema.Objective: To describe the quality of life of family caretakers of adults with sequelae of cerebrovascular stroke accident in Cartagena, Colombia. Method: quantitative descriptive study conducted during the second half of 2008. Non-probabilistic convenience sample of 97 caregivers. The instrument proposed by Ferrell et al has been used. In order to assess each of the welfare indicators which make up for the quality of life, central trend measures and variation coefficient have been used. Results: the caretaker group registered a fitness average of 11.1 compared to the maximum score, which indicates the worst health status; psychological and social indicators of welfare had averages of 48.8 and 21.9, respectively, showing thus less impact. The best health status was found in spiritual welfare indicators, with an average of 22.6. Conclusions: The experience of working as a caretaker significantly modifies the quality of life of individuals. Caretakers, as an important source of informal care, require support from health systems and so do professionals in nursing as parts of said health systems.

  6. The Moral Economy of Suffering

    DEFF Research Database (Denmark)

    Danneskiold-Samsøe, Sofie


    . In contrast to approaches, which relate to the suffering of individual refugees, this study approaches suffering as a relational and social matter. Among other things this involves examining the quest of Iraqis for recognition of suffering as a social value that enters social exchange. When Iraqi refugges...

  7. Suffering from Alopecia Areata

    Directory of Open Access Journals (Sweden)

    mitra Safa


    Full Text Available Safa M1, Jebraili2, Momen-nasab M3 1. Assistant Professor, Department of Psychiatry, School of Medicine, Lorestan University of Medical Sciences 2. Assistant Professor, Department of Dermatology, Faculty of Medicine, Lorestan University of Medical Sciences 3. Instructor, Department of Nursing, Lorestan University of Medical Sciences Abstract Background: Some of the skin diseases cause severe stress in patients and relieving these stresses greatly helps to treat the underlying disease. Alopecia areata is one of the common causes of alopecia which is an autoimmune disease. Other factors like genetics and psychological factors have important roles in the beginning or exacerbation of the disease. This study aimed to determine the frequency of depression and anxiety disorders in patient suffering from alopecia areata. Materials and methods: In this descriptive study, 80 patients with alopecia areata who had referred to dermatologic clinic of Shohaday-e Ashayer hospital in Khorramabad from 1382 to 1383(Hj. were evaluated. After filling the questionnaires, the patients were referred to the Psychiatric Clinic and the cases were diagnosed by interviews using SCL-90 test and DSM-IV-IIIR scale. The analysis of data was done by the SPSS software. Results: 80 patients were selected as the subjects of the study. including 52 men (65% and 28 women (35%. 43 patients (53.8% were less than 25 years old and 54 (67.5% were unmarried. 56 patients (70% had a family history of alopecia areata and 45 (56.25% had no history of drug intake. In most of the patients (63.8% the site of the first lesion was the scalp. Out of 80 patients, 64 (80% had anxiety and 60 (75% had depression. 27 (33.3% had major depressive disorders. These findings were statistically significant. Major depressive disorders were more in women. No correlation was found between education, marital status, family history, and the history of drug intake, and the site of first lesion. Conclusion: The

  8. Bernard Schutz : "Fundamental physics looks forwards Space"; symposium in honour of Maurice Jacob on 27 March 1998

    CERN Multimedia

    Laurent Guiraud


    On the occasion of the 65th birthday of Maurice Jacob, his friends are organizing, together with CERN, a symposium presenting some of the scientific fields to which Maurice Jacob has made decisive contributions during his career or in which he has a

  9. Sudden unexpected death caused by stroke

    DEFF Research Database (Denmark)

    Ågesen, Frederik Nybye; Risgaard, Bjarke; Zachariasardóttir, Sára


    Background Stroke is the fifth leading cause of death in young individuals globally. Data on the burden of sudden death by stroke are sparse in the young. Aims The aim of this study was to report mortality rates, cause of death, stroke subtype, and symptoms in children and young adults who suffered...... contacted the healthcare system because of neurological symptoms, whereof one was suspected of having a stroke (6%). Conclusions Sudden death by stroke in children and young adults occurs primarily due to hemorrhagic stroke. We report a high frequency of neurological symptoms prior to sudden death by stroke....... Increased awareness among healthcare professionals towards stroke symptoms in children and young adults may lead to earlier detection of stroke, and thereby potentially lowering the incidence of sudden death by stroke....

  10. Lokalisatie van hersenfuncties, 125 jaar na het proefschrift van de eerste Nederlandse vrouwelijke arts, Aletta Jacobs

    NARCIS (Netherlands)

    de Jong, B M


    Aletta H. Jacobs was the first female physician in the Netherlands. In 1879, she defended her thesis which addressed the subject of localising brain functions. In it she described three neurological patients using systematic conventions highly resembling those in use today. Moreover, she discussed

  11. Eerst de waarheid, dan de vrede. Jacob Revius 1586-1658

    NARCIS (Netherlands)

    de Bruijn, H.A.


    This biography concentrates on the life, poetry and world view of the Dutch poet and theologian Jacob Revius (1586-1658). Revius was one of the most prominent Reformed opinion leaders in the seventeenth-century Dutch Republic, who lived through a period of revolutionary changes in science, religion

  12. Audru Püha Risti kirik / Jürgen Grablings, Jacob Greisson, Matthias Woywoden...[jt.

    Index Scriptorium Estoniae


    välisvaade, altar; kivikirik pühitseti 1680 (ehitusmeistrid Jürgen Grablings, Jacob Greisson, Matthias Woywoden), torn valmis pärast 1695. aastat; neogooti stiilis tornikiiver ja sisustus XIX sajandil; altarimaal "Kristus ristil" (Gustav Biermann, 1872)

  13. Jacob van Eyck en de anderen : Nederlands solorepertoire voor blokfluit in de Gouden Eeuw

    NARCIS (Netherlands)

    Wind, T.R.


    Jacob van Eyck (c1589/90-1657) was one of the most remarkable figures in Dutch musical life during the Golden Age. The blind nobleman was city carillonneur of Utrecht and gained international renown as the greatest bell expert of his time. In addition, he played the 'handfluyt', the instrument known

  14. A Marriage of Minds: James R. Jacobs & Shinjoung Yeo Univ. of California-San Diego (United States)

    Library Journal, 2005


    Their personalities and backgrounds are very different, but James R. Jacobs and Shinjoung Yeo are passionate about the same causes: librarianship, open government, and empowerment through information. They balance each other. Yeo is focused, realistic, critical, and an excellent researcher. Her superhero alter ego is Wet Blanket Woman, able to…

  15. Symposium at CERN in honour of Maurice Jacob on 27th March 1998

    CERN Multimedia

    Patrice Loïez


    The Jacobfest at CERN was prefaced by a talk by Maurice Jacob's longtime colleague Claude Cohen-Tannoudji of the College de France and Ecole Normale Superieure, who shared the 1997 Nobel Prize with Steven Chu of Stanford and William D. Phillips, of the US National Institute of Standards and Technology, for their development of methods to cool and trap atoms with laser light.

  16. Guest blog: Jacob Davidsen and Paul McIlvenny on Experiments with Big Video

    DEFF Research Database (Denmark)

    Davidsen, Jacob; Mcilvenny, Paul Bruce


    How good are your video records? One angle? Two? Wide-angle? Was the camera static or did you move to catch things – and miss other things? How good was the sound? All of us have occasionally been frustrated with what we find on the screen when we come to analyse it, but Jacob Davidsen and Paul Mc...

  17. Applications of the time-naught term in the Cooper and Jacob (1946) equation. (United States)

    Edwards, David A


    The ability to manipulate analytical expressions for aquifer drawdown can provide insights into groundwater flow processes and assist with assessing strengths and weaknesses of aquifer parameter estimation methods. In the Cooper and Jacob (1946) parameter estimation method, the antilog of the horizontal-axis intercept in a plot of drawdown vs. log(time) is referred to as time naught (t(0)), which is used for estimating storativity. This article briefly reviews traditional uses of the time-naught concept and then spends time introducing new insights and applications involving (1) time-naught/distance relationships, including ways to compensate for certain missing data; (2) use of time naught in a simple method providing a quick visual check of which data in a Cooper-Jacob plot are suitable for use in linear regression; (3) application of time naught, as determined for one well, in estimating the later minimum time for which data from a distant well can be used in the Cooper-Jacob method; (4) development of relationships between drawdown and time naught; (5) use of time naught in a simple algebraic equation to estimate drawdown at smaller times than feasible using the Cooper-Jacob method; and (6) employment of time naught and a vertical-axis intercept on a plot of drawdown vs. log(time) for evaluating storativity. This information may be useful to new hydrogeologists or others interested in further developing their analytical well hydraulics skills. © 2011, The Author(s). Ground Water © 2011, National Ground Water Association.

  18. The Paradox of Modern Suffering

    DEFF Research Database (Denmark)

    Dræby, Anders

    . According to Buddhism, existence is suffering, and each persons desire to reach a state of nothingness (Nirvana) causes them to return over and over through reincarnation, in order to work out their karma. In Christianity suffering is inseparable from man's earthly existence, and it must serve to overcome...

  19. Preventing stroke (United States)

    ... A.M. Editorial team. Related MedlinePlus Health Topics Hemorrhagic Stroke Ischemic Stroke Stroke Browse the Encyclopedia A.D. ... any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should ...

  20. Stroke Rehabilitation (United States)

    A stroke can cause lasting brain damage. People who survive a stroke need to relearn skills they lost because of ... them relearn those skills. The effects of a stroke depend on which area of the brain was ...

  1. El Debate del cálamo y la espada, de Jacob ben Eleazar de Toledo

    Directory of Open Access Journals (Sweden)

    Alba Cecilia, Amparo


    Full Text Available In this article we offer a Spanish translation with a commentary of the fourth chapter of Sefer ha-Mešalim, a collection of tales written by Jacob ben Eleazar of Toledo (13th century in the style of Maqāmāt; this chapter, known as the Debate between the Pen and the Sword, shows, in an allegorical way, the supremacy of the arts over the arms.En el presente artículo ofrecemos la traducción y el estudio del capítulo cuarto del Sefer ha-Mešalim, colección de cuentos al estilo de las macamas compuesta por Jacob ben Eleazar de Toledo (siglo XIII; este capítulo, conocido como el Debate del cálamo y la espada, expone en forma alegórica la supremacía de las letras sobre las armas.

  2. Pragmática, sociedade (e a alma, uma entrevista com Jacob Mey

    Directory of Open Access Journals (Sweden)

    Daniel do Nascimento e Silva


    Full Text Available Jacob Mey, o linguista que fundou (em 1977, com Hartmut Haberland o Journal of Pragmatics e autor de inúmeros livros e artigos no campo da pragmática, visitou o Brasil em novembro/dezembro de 2012, por ocasião da homenagem ao trabalho do pragmaticista Kanavillil Rajagopalan, realizada na Unicamp, onde Rajagopalan desenvolveu trabalho exemplar. A visita de Mey ao Brasil foi uma convite à reflexão sobre o objeto da pragmática, suas vizinhanças, seus principais problemas e sua agenda. Esta entrevista, realizada no Rio de Janeiro, conta a trajetória de Jacob Mey e sua visada crítica sobre os principais temas e problemas da pragmática.

  3. Extensive cortical damage in a case of Creutzfeldt-Jacob disease: clinicoradiological correlations

    Energy Technology Data Exchange (ETDEWEB)

    Bergui, M.; Bradac, G.B. [Neuroradiology, Ospedale S. G. Battista, University of Torino, Via Cherasco 15, 10126, Torino (Italy); Rossi, G. [Neuropathology Department, Istituto Neurologico C. Besta, Milano (Italy); Orsi, L. [Neurology, Ospedale S. G. Battista, University of Torino, Via Cherasco 15, 10126, Torino (Italy)


    MRI demonstrated extensive cortical involvement in a patient with pathologically proven Creutzfeldt-Jacob disease. The whole brain was atrophic; some of the supratentorial cortex, putamen and caudate nucleus gave high signal on T2-weighted images; the changes were more extensive on diffusion-weighted images (DWI). Comparison of the history, and the sites of atrophy and signal change suggested that the latter predominates in regions with long-lasting damage and prevalent gliosis, while high signal on DWI indicate current neuronal loss. This case widens the range of MRI findings in patients with Creutzfeldt-Jacob disease, and suggests that some information about the progression of the disease can be extracted from single MRI study. (orig.)

  4. Extensive cortical damage in a case of Creutzfeldt-Jacob disease: clinicoradiological correlations. (United States)

    Bergui, M; Bradac, G B; Rossi, G; Orsi, L


    MRI demonstrated extensive cortical involvement in a patient with pathologically proven Creutzfeldt-Jacob disease. The whole brain was atrophic; some of the supratentorial cortex, putamen and caudate nucleus gave high signal on T2-weighted images; the changes were more extensive on diffusion-weighted images (DWI). Comparison of the history, and the sites of atrophy and signal change suggested that the latter predominates in regions with long-lasting damage and prevalent gliosis, while high signal on DWI indicate current neuronal loss. This case widens the range of MRI findings in patients with Creutzfeldt-Jacob disease, and suggests that some information about the progression of the disease can be extracted from single MRI study.

  5. 'Counterfeiting his maister' : Shared Folly in The History of Jacob and Esau

    NARCIS (Netherlands)

    Pelt, van N.T.


    La pièce calviniste Jacob and Esau se sert de la folie (« folly ») pour traiter de façon burlesque des moments doctrinalement incompatibles. Par ce biais la pièce soulève la question du rapport entre réalité et spectacle, c’est-à-dire si jouer quelque chose la rend réelle. D’un côté, l’approche du

  6. Suffering: toward a contextual praxis. (United States)

    Georges, Jane M


    Janice M. Morse's article in Advances in Nursing Science (24:1) revised and summarized the major findings of a research program exploring the behavioral-experiential nature of suffering. Using a feminist critical theory stance, this article addresses Morse's conceptualization of a praxis of suffering. First, it identifies the strengths and contributions of Morse's body of research to nursing science. Next, it undertakes a critique situated in feminist critical theory in which the limitations of Morse's work are explored using exemplars from the Western literary tradition. Finally, the article proposes a new conceptualization of an alternative contextual praxis of suffering in which nurses' responses to suffering are situated in an emancipatory paradigm of authentic presence.

  7. Paediatric stroke

    African Journals Online (AJOL)


    Apr 2, 2011 ... Ischemic Stroke Registry yielded an incidence of 3.3 cases per 100 000 children per year, of ... Neonatal stroke. The newborn period confers the highest risk period for childhood ischaemic stroke. Focal patterns of ischaemic brain injury to the perinatal brain are .... family history of young stroke/ thrombosis.

  8. Recovery of Dysphagia in Lateral Medullary Stroke

    Directory of Open Access Journals (Sweden)

    Hitesh Gupta


    Full Text Available Lateral medullary stroke is typically associated with increased likelihood of occurrence of dysphagia and exhibits the most severe and persistent form. Worldwide little research exists on dysphagia in brainstem stroke. An estimated 15% of all patients admitted to stroke rehabilitation units experience a brainstem stroke out of which about 47% suffer from dysphagia. In India, a study showed that 22.3% of posterior circulation stroke patients develop dysphagia. Dearth of literature on dysphagia and its outcome in brainstem stroke particularly lateral medullary stroke motivated the author to present an actual case study of a patient who had dysphagia following a lateral medullary infarct. This paper documents the severity and management approach of dysphagia in brainstem stroke, with traditional dysphagia therapy and VitalStim therapy. Despite being diagnosed with a severe form of dysphagia followed by late treatment intervention, the patient had complete recovery of the swallowing function.

  9. Spontaneous ischaemic stroke lesions in a dog brain: neuropathological characterisation and comparison to human ischaemic stroke

    DEFF Research Database (Denmark)

    Thomsen, Barbara Blicher; Gredal, Hanne; Wirenfeldt, Martin


    Background Dogs develop spontaneous ischaemic stroke with a clinical picture closely resembling human ischaemic stroke patients. Animal stroke models have been developed, but it has proved difficult to translate results obtained from such models into successful therapeutic strategies in human....../macrophages and astrocytes. Conclusions The neuropathological changes reported in the present study were similar to findings in human patients with ischaemic stroke. The dog with spontaneous ischaemic stroke is of interest as a complementary spontaneous animal model for further neuropathological studies....... stroke patients. In order to face this apparent translational gap within stroke research, dogs with ischaemic stroke constitute an opportunity to study the neuropathology of ischaemic stroke in an animal species. Case presentation A 7 years and 8 months old female neutered Rottweiler dog suffered...

  10. Teleneurology to improve stroke care in rural areas: The Telemedicine in Stroke in Swabia (TESS) Project. (United States)

    Wiborg, Andreas; Widder, Bernhard


    Assessing both stroke patients and their CT scans by using a conventional videoconference system offers an interesting opportunity to improve stroke care in rural areas. However, until now there have been no studies to suggest whether this method is feasible in routine stroke management. Seven rural hospitals in the southern part of Germany in Swabia were connected to the stroke unit of Günzburg with the use of a videoconference link (Telemedicine in Stroke in Swabia [TESS] Project). The local physicians are free to present every admitted stroke patient to the Günzburg stroke expert, who can assess the clinical status and CT images, thereafter giving therapeutic recommendations. All teleconsultations are rated concerning transmission quality and relevance of telemedicine for stroke management. A total of 153 stroke patients were examined by teleconsultation. Mean age was 67.5 years. Eighty-seven patients had suffered an ischemic stroke, 9 had an intracerebral hemorrhage, and 17 suffered a transient ischemic attack. Forty patients were revealed to have a diagnosis other than stroke. Duration of teleconsultation was 15 minutes on average. User satisfaction was good concerning imaging and audio quality, and patient satisfaction was very good or good in all cases. Relevant contributions could be made in >75% of the cases concerning diagnostic workup, CT assessment, and therapeutic recommendations. Teleconsultation using a videoconference system seems to be a feasible and promising method to improve stroke care in rural areas where management in a stroke unit is hindered by long transportation distances.

  11. Stroke Management: Nursing Roles


    Maryam Esmaeili


    Introduction: The subacute and long-term assessment and management of patients who have suffered a stroke includes physical therapy and testing to determine the precise etiology of the event so as to prevent recurrence. The acute management differs. Immediate goals include minimizing brain injury, treating medical complications, and moving toward uncovering the pathophysiologic basis of the patient's symptoms. Methods: This is a review paper that report up to date finding with review some...

  12. Dysphagia in Stroke: A New Solution


    Langdon, Claire; Blacker, David


    Dysphagia is extremely common following stroke, affecting 13%–94% of acute stroke sufferers. It is associated with respiratory complications, increased risk of aspiration pneumonia, nutritional compromise and dehydration, and detracts from quality of life. While many stroke survivors experience a rapid return to normal swallowing function, this does not always happen. Current dysphagia treatment in Australia focuses upon prevention of aspiration via diet and fluid modifications, compensato...

  13. Benefits of Suffering: Communicator Suffering. Benefiting, and Influence. (United States)


    period of greatest influence. Jesus , for example, had only a handful of followers until after his death. It was subsequent to the crucifixion that the...sacrifice and suffering of religious leaders such as Jesus , Moses or Joseph Smith is, of course, well known, and similar ex- periences among certain...political and/or ideological reasons which the communicator in the current study, and historical leaders such as Jesus , Mao, Hitler, etc., had for

  14. Creutzfeldt-Jacob-disease: The computerized tomogram in relation to clinical, electroencephalographic and neuropathological findings

    Energy Technology Data Exchange (ETDEWEB)

    Zieger, A.; Vonofakos, D.; Vitzthum, H.


    The computerized tomogram (CT) of a senile case of Creutzfeldt-Jacob disease with rapid progress, showed after an initially minor parietal dilatation of the gyri, a volume increase, predominantly on the right side, in the area of the cerebral convexity and a right-preponderant dilatation of the anterior horns. By neuropathologic examination indications for a passed cerebral oedema was found, covering the cortex atrophy, which previously had been detected by CT. Progression and local intensity of the atrophic signs in CT - in combination with clinical and electroencephalographic findings - suggest the existence of a Creutzfeldt-Jakob disease and permit its delineation against other atrophying processes.

  15. The origin of the logic of symbolic mathematics Edmund Husserl and Jacob Klein

    CERN Document Server

    Hopkins, Burt C


    Burt C. Hopkins presents the first in-depth study of the work of Edmund Husserl and Jacob Klein on the philosophical foundations of the logic of modern symbolic mathematics. Accounts of the philosophical origins of formalized concepts-especially mathematical concepts and the process of mathematical abstraction that generates them-have been paramount to the development of phenomenology. Both Husserl and Klein independently concluded that it is impossible to separate the historical origin of the thought that generates the basic concepts of mathematics from their philosophical meanings. Hopkins explores how Husserl and Klein arrived at their conclusion and its philosophical implications for the modern project of formalizing all knowledge.

  16. Chronotopes in Harriet Jacobs's Incidents in the Life of a Slave Girl


    Holmgren Troy, Maria


    This article employs Bakhtin’s concept of the chronotope to examine the interrelatedness of different places, temporalities, characterization, and values in Harriet Jacobs’s Incidents in the Life of a Slave Girl. Focusing on the complex interactions of four chronotopes—Dr. Flint’s house, the provincial town, the grandmother’s house, and the garret—the article yields a deeper understanding of how Jacobs critiques antebellum American society and, at the same time, constructs the grandmother’s h...

  17. Ischemic Stroke (United States)

    ... Workplace Giving Fundraise Planned Giving Corporate Giving Cause Marketing Join your team, your way! The Stroke Challenge ... Your Technology Guide High Blood Pressure and Stroke Importance of Physical Activity See More Multimedia Las minorías ...

  18. Stroke - slideshow (United States)

    ... this page: // Stroke - series—Part 1 To use the sharing features ... M. Editorial team. Related MedlinePlus Health Topics Ischemic Stroke A.D.A.M., Inc. is accredited by ...

  19. The disease impact, health care management and cost of stroke in the Netherlands

    NARCIS (Netherlands)

    Evers SMAA; Struijs JN; Ament AJHA; Genugten MML van; Jager JC; Bos GAM van den; Universiteit Maastricht; CZO


    Stroke is a major chronic disease with a high morbidity and mortality. In the Netherlands about 30,000 people a year suffer a stroke for the first time. One third of these stroke patients dies within the first year after stroke, and 41% of the survivors experience limitations in their daily

  20. Cryptogenic Stroke

    Directory of Open Access Journals (Sweden)

    Mohammad Saadatnia


    Full Text Available Cryptogenic stroke is defined as brain infarction that is not attributable to a source of definite embolism, large artery atherosclerosis, or small artery disease despite a thorough vascular, cardiac, and serologic evaluation. Despite many advances in our understanding of ischemic stroke, cryptogenic strokes remain a diagnostic and therapeutic challenge. The pathophysiology of cryptogenic stroke is likely various. Probable mechanisms include cardiac embolism secondary to occult paroxysmal atrial fibrillation, aortic atheromatous disease or other cardiac sources, paradoxical embolism from atrial septal abnormalities such as patent foramen ovale, hypercoagulable states, and preclinical or subclinical cerebrovascular disease.  Cryptogenic stroke is one-fourth among cerebral infarction, but most of them could be ascribed to embolic stroke. A significant proportion of cryptogenic strokes adhere to embolic infarct topography on brain imaging and improvement in our ability to detect paroxysmal atrial fibrillation in patients with cryptogenic stroke has strengthened the idea that these strokes are embolic in nature. a significant proportion of cryptogenic strokes adhere to embolic infarct topography on brain imaging.embolic stroke of undetermined sources(ESUS was planned for unifying embolic stroke of undetermined source.  The etiologies underlying ESUS included minor-risk potential cardioembolic sources, covert paroxysmal atrial fibrillation, cancer-associated coagulopathy and embolism, arteriogenic emboli, and paroxysmal embolism. Extensive evaluation including transesophageal echocardiography and cardiac monitoring for long time could identify the etiology of these patients. Therefore cryptogenic stroke is a diagnosis of exclusion. Compared with other stroke subtypes, cryptogenic stroke tends to have a better prognosis and lower long-term risk of recurrence.


    African Journals Online (AJOL)

    206 patients clinically diagnosed as stroke/cerebrovascular accidents(CVA) were investigated using computerized tomography. (CT) scan. 19 patients (9%) had normal scan, While 20(9.7%) patients had other lesions including atrophy and tumours. Of the l67(l8.l%) patients proven to have suffered a cerebro~vascular ...

  2. Motion sickness in migraine sufferers. (United States)

    Marcus, Dawn A; Furman, Joseph M; Balaban, Carey D


    Motion sickness commonly occurs after exposure to actual motion, such as car or amusement park rides, or virtual motion, such as panoramic movies. Motion sickness symptoms may be disabling, significantly limiting business, travel and leisure activities. Motion sickness occurs in approximately 50% of migraine sufferers. Understanding motion sickness in migraine patients may improve understanding of the physiology of both conditions. Recent literature suggests important relationships between the trigeminal system and vestibular nuclei that may have implications for both motion sickness and migraine. Studies demonstrating an important relationship between serotonin receptors and motion sickness susceptibility in both rodents and humans suggest possible new motion sickness prevention therapies.

  3. Home after stroke : A qualitative study of Dutch older stroke survivors making themselves at home again

    NARCIS (Netherlands)

    Meijering, Louise; Klaassens, Mirjam; Nanninga, Christa; Lettinga, Ant T.


    Older adults who have survived a stroke may suffer from physical effects such as paralysis, fatigue, and pain, as well as cognitive/emotional effects such as loss of cognitive function, aphasia, depression, and memory loss. After experiencing a stroke, most survivors work on their recovery in a

  4. Psychological functioning in headache sufferers. (United States)

    Andrasik, F; Blanchard, E B; Arena, J G; Teders, S J; Teevan, R C; Rodichok, L D


    The present study examined the psychological test responses of 99 headache sufferers and 30 matched nonheadache controls. Headache subjects were of four types: migraine (n = 26), muscle contraction (n = 39), combined migraine-muscle contract ion (n = 22), and cluster (n = 12). Measures consisted of the Minnesota Multiphasic Personality Inventory, a modified hostility scale derived from the MMPI, Back Depression Inventory, State-Trait Anxiety Inventory, Autonomic Perception Questionnaire, Rathus Assertiveness Schedule, Social Readjustment Rating Scale, Psychosomatic Symptom Checklist, Schalling-Sifneos Scale, Need for Achievement, and Hostile Press. Significant differences were found on five clinical scales of the MMPI--1, 2, 3, 6, and 7. Of the non-MMPI scales, only the Psychosomatic Symptom Checklist and Trait Anxiety Inventory were significant. Control subjects revealed no significant findings on any tests. The headache groups fell along a continuum, beginning with cluster subjects, who showed only minimal distress, continuing through migraine and combined migraine-muscle contraction, and ending with muscle contraction subjects, who revealed the greatest degree of psychological disturbance. However, none of the headache groups could be characterized by marked elevations on any of the psychological tests, which contrasts with past research findings. It is suggested that the present results may be more representative of the "typical" headache sufferer.

  5. Endovascular stroke treatment in a small-volume stroke center. (United States)

    Behzadi, Gry N; Fjetland, Lars; Advani, Rajiv; Kurz, Martin W; Kurz, Kathinka D


    Our purpose was to evaluate the safety and efficacy of endovascular treatment (EVT) of stroke caused by large vessel occlusions (LVO) performed by general interventional radiologists in cooperation with stroke neurologists and neuroradiologists at a center with a limited annual number of procedures. We aimed to compare our results with those previously reported from larger stroke centers. A total of 108 patients with acute stroke due to LVO treated with EVT were included. Outcome was measured using the modified Rankin scale (mRS) at 90 days. Efficacy was classified according to the modified thrombolysis in cerebral infarction (mTICI) scoring system. Safety was evaluated according to the incidence of procedural complications and symptomatic intracranial hemorrhage (sICH). Mean age of the patients was 67.5 years. The median National Institutes of Health Stroke Scale (NIHSS) on hospital admission was 17. Successful revascularization was achieved in 76%. 39.4% experienced a good clinical outcome (mRS<3). Intraprocedural complications were seen in 7.4%. 7.4% suffered a sICH. 21.3% died within 3 months after EVT. The use of general interventional radiologists in EVT of LVO may be a possible approach for improving EVT coverage where availability of specialized neurointerventionalists is challenging. EVT for LVO stroke performed by general interventional radiologists in close cooperation with diagnostic neuroradiologists and stroke neurologists can be safe and efficacious despite the low number of annual procedures.

  6. Aletta Jacobs and the Dutch Cap : Transfer of Knowledge and the Making of a Reputation in the Changing Networks of Birth Control Activists

    NARCIS (Netherlands)

    Bosch, Mineke


    A close review of Aletta Jacobs's actions in the international birth control movement reveals that they have been exaggerated in most historiographical representations. Thus the unsubstantiated claim that the pessary known as 'Dutch cap' was named that way due to Aletta Jacobs's interventions on

  7. Coping styles of headache sufferers. (United States)

    Siniatchkin, M; Riabus, M; Hasenbring, M


    Psychological factors are important in the chronification and aggravation of headaches. We studied 90 patients suffering from migraine, chronic daily headache (CDH) evolved from migraine, and episodic or chronic tension-type headache (TTH). Emotional, cognitive, and behavioral pain coping were assessed using the Kiel Pain Inventory (KPI), Beck's Depression Inventory, the State-Trait-Anxiety Inventory, and Quality of Life Questionnaire. In addition, the clinical course of headache was analyzed using a validated headache diary. The results were as follows. Firstly, the KPI is reliable internally for the assessment of pain-coping strategy employment among headache patients. Secondly, migraine sufferers were characterized by pronounced psychological abnormalities during the headache phase, demonstrating a less adaptive coping behavior. This was in contrast to the TTH patients, who showed more general distress manifesting in elevated anxiety and lower quality of life. The only factor which appeared to be essential for differentiating between migraine and TTH was the intensity of headache. Thirdly, chronic TTH and CDH evolved from migraine demonstrated more pronounced psychological disabilities and more severe clinical courses of headaches than episodic TTH or nontransformed migraine. The predictor variable for transformation of migraine was impairment of well-being/quality of life, and for transformation of TTH, the frequency of headaches and depression. Finally, analgesic misuse seems to be less important for chronification and transformation of headaches than the degree of psychological disability. This study draws attention to the role of psychological factors in the chronification of TTH and transformation of migraine and provides some recommendations for the behavioral treatment of chronic headaches.

  8. Jacob Lawrence’s Migration series: a pictorial memory of black America Les Migrations de Jacob Lawrence : souvenir pictural de l’Amérique noire

    Directory of Open Access Journals (Sweden)

    Eliane Elmaleh


    Full Text Available Jacob Lawrence, artiste afro-américain décédé en juin 2000, a étudié la condition humaine et plus spécifiquement la condition des Afro-américains durant plus de six décennies. Ses mises en scène visuelles, sous forme de séries de peintures aux thématiques variées vont d’événements historiques comme la Grande Migration des Noirs dans les années 1920-1930 à l’étude de personnages héroïques, symboles mythiques de la lutte pour l’émancipation et l’égalité. Cet article tente de mettre en lumière l’importance d’une période pour les Noirs américains qui, pour se libérer des lourdes conséquences de l’esclavage essayèrent de construire une nouvelle identité noire en affirmant l’existence d’une culture noire. Je tenterai de déterminer la façon dont Lawrence s’est positionné dans cette perspective et sa représentation de l’histoire afro-américaine au travers principalement de The Migration of the Negro, série de tableaux peints sous un mode narratif qui raconte la fuite de centaines de milliers de noirs américains du Sud rural vers le Nord urbain industrialisé après la Première Guerre mondiale. J’explorerai les multiples facettes de sa vision de la Grande Migration en tant qu’historien et artiste.

  9. Analysis of the bioclimatic strategies used by Frank Lloyd Wright in the Jacobs I house

    Directory of Open Access Journals (Sweden)

    M. Beltrán-Fernández


    Full Text Available Frank Lloyd Wright is considered one of the most influential architects of modern architecture due to the spatial and aesthetic qualities of his work. However, the importance of Wright’s construction and environmental solutions has been usually overlooked. In order to evaluate these qualities, the first house that Wright designed for the Jacobs family (Wisconsin, USA, 1937 has been analyzed. This well-known building has been much studied, and its architectural value much celebrated, but without analysing the advantages of the bioclimatic principles over interior environment. But how can the influence of this bioclimatic architecture be measured in terms of thermal comfort? Does the selected orientation improve interior comfort? And what about the natural ventilation or the deep overhangs? In order to assess this, a digital model for energy simulation has been built using Revit and Design Builder.

  10. Informing Physics: Jacob Bekenstein and the Informational Turn in Theoretical Physics (United States)

    Belfer, Israel


    In his PhD dissertation in the early 1970s, the Mexican-Israeli theoretical physicist Jacob Bekenstein developed the thermodynamics of black holes using a generalized version of the second law of thermodynamics. This work made it possible for physicists to describe and analyze black holes using information-theoretical concepts. It also helped to transform information theory into a fundamental and foundational concept in theoretical physics. The story of Bekenstein's work—which was initially opposed by many scientists, including Stephen Hawking—highlights the transformation within physics towards an information-oriented scientific mode of theorizing. This "informational turn" amounted to a mild-mannered revolution within physics, revolutionary without being rebellious.

  11. When is the next extending of Fick-Jacobs equation necessary? (United States)

    Kalinay, Pavol


    Applicability of the effective one-dimensional equations, such as Fick-Jacobs equation and its extensions, describing diffusion of particles in 2D or 3D channels with varying cross section A(x) along the longitudinal coordinate x, is studied. The leading nonstationary correction to Zwanzig-Reguera-Rubí equation [R. Zwanzig, J. Phys. Chem. 96, 3926 (1992), 10.1021/j100189a004; D. Reguera and J. M. Rubí, Phys. Rev. E 64, 061106 (2001), 10.1103/PhysRevE.64.061106] is derived and tested on the exactly solvable model, diffusion in a 2D linear cone. The effects of such correction are demonstrated and discussed on elementary nonstationary processes, a time dependent perturbation of the stationary flow and calculation of the mean first passage time.

  12. "Jacob and the Other": in the Light of the Cinema (Apollo.

    Directory of Open Access Journals (Sweden)

    Armando Escobar


    Full Text Available The relationship between Uruguayan writer Juan Carlos Onetti and the cinema is extensive and. When we analyze one of the many adaptations of his work, we have to consider that it is a relationship of double influence, since our author has also take from the cinema to develop one of the most extensive and essential works of Latin American literature. For this reason, it is increasingly common to find interpretations that propose a cinematic reading of Onetti's work. As part of a similar exercise, we propose to read the story "Jacob and the Other" (1961 in the light of his adaptation to the cinema made by Álvaro Brechner in Un mal día para pescar (2009. In doing so, Onetti's tale obtains new interpretations that can be reached by analyzing it with the eyes of the cinema.

  13. Cognitive performance after ischaemic stroke

    Directory of Open Access Journals (Sweden)

    Maria Gabriela R. Ferreira

    Full Text Available Cognitive impairment after stroke affects the patient recovery process. Therefore, the identification of factors associated with cognitive outcomes is important since it allows risk profiles of stroke survivors to be determined. OBJECTIVE: To assess cognitive outcome of stroke outpatients and investigate associations among clinical and demographic variables, vascular risk factors, depression symptoms and functional ability; and to describe the neuropsychological profile of these patients. METHODS: A cross-sectional design study was conducted. Subjects who suffered a first-ever ischaemic stroke 6 to 10 months prior to data collection underwent neuropsychological assessment and screening for depressive symptoms and functional ability. The outcome "cognitive performance" was analyzed considering two groups: "cognitive impairment" and "no cognitive impairment". RESULTS: There was a statistically significant association between cognitive impairment and female gender, age, stroke severity and functional ability. Regarding neuropsychological profile, the cognitive impairment group exhibited more generalized deficits in attention, visuospatial organization, verbal functions and verbal memory domains compared to the community control group. CONCLUSION: The occurrence of cognitive impairment among patients was high, especially in women, older participants, individuals with more severe stroke, and greater impairment in functional ability. Multiple cognitive domains are affected and this may hamper recovery and negatively impact independence and quality of life after stroke.

  14. Recovering after stroke (United States)

    Stroke rehabilitation; Cerebrovascular accident - rehabilitation; Recovery from stroke; Stroke - recovery; CVA - recovery ... LIVE AFTER A STROKE Most people will need stroke rehabilitation (rehab) to help them recover after they leave ...

  15. Colonial Dimensions of Dutch Women's Suffrage : Aletta Jacobs's travel letters from Africa and Asia, 1911-1912

    NARCIS (Netherlands)

    Bosch, Mineke


    In this article, Mineke Bosch analyzes from a postcolonial perspective the travel letters Aletta Jacobs wrote during the "world suffrage tour" she made with Carrie Chapman Catt from 1911 to 1912. Following the historical assessments of the imperialist dimension of British suffrage feminism at the

  16. Jacob Lorhard's ontology: A 17th century hypertext on the reality and temporality of the world of intelligibles

    NARCIS (Netherlands)

    Øhrstrøm, P.; Schärfe, H.; Uckelman, S.L.


    Jacob Lorhard published his ontology in 1606. In this work the term ontologia ‘ontology’ was used for the first time ever. In this paper, it is argued that Lorhard’s ontology provides a useful key to the understanding of the early 17th-century world view in Protestant Europe. Among other things,

  17. Cellular distribution of the NMDA-receptor activated synapto-nuclear messenger Jacob in the rat brain

    NARCIS (Netherlands)

    Mikhaylova, Marina; Karpova, A.; Bär, J.; Bethge, P.; Yuanxiang, P.; Chen, Yinan; Zuschratter, W.; Behnisch, T.; Kreutz, M.R.

    In previous work, we found that the protein messenger Jacob is involved in N-methyl-d-aspartate receptor (NMDAR) signaling to the nucleus and cAMP response element-binding protein (CREB) mediated gene expression in hippocampal primary neurons. Particularly, extrasynaptic NMDAR activation drives

  18. Jacob Lorhard’s Ontology: A 17th Century Hypertext on the Reality and Temporality of the World of Intelligibles

    DEFF Research Database (Denmark)

    Øhrstrøm, Peter; Schärfe, Henrik; Uckelman, Sara


    Jacob Lorhard published his ontology in 1606. In this work the term ontologia ‘ontology’ was used for the first time ever. In this paper, it is argued that Lorhard’s ontology provides a useful key to the understanding of the early 17th-century world view in Protestant Europe. Among other things, ...

  19. Stroke Rehabilitation (United States)

    ... unique for each person. Although a majority of functional abilities may be restored soon after a stroke, recovery is an ongoing process. Effects of a Stroke Weakness (hemiparesis) or paralysis (hemiplegia) on one side of the body that may affect the whole ...

  20. Pediatric Stroke (United States)

    ... of 3 and 10. In those with SCD, ischemic strokes most often occur in children under the age of 15 and adults over the age of 30, while hemorrhagic strokes most often occur in young adults between the ages of 20 and 30. ...

  1. Stroke and Cerebrovascular Diseases Registry (United States)


    Stroke; Acute Stroke; Acute Brain Injury; Ischemic Stroke; Hemorrhagic Stroke; Transient Ischemic Attack; Subarachnoid Hemorrhage; Cerebral Ischemia; Cerebral Infarction; Cerebral Stroke; Venous Sinus Thrombosis, Cranial

  2. Suffering in people with rheumatoid arthritis. (United States)

    Dildy, S P


    Knowledge of the nature, meaning, and impact of suffering from the perspective of people with rheumatoid arthritis is needed to determine what nursing interventions are most helpful in reducing suffering. Grounded theory was used to identify the nature of suffering in 14 people with rheumatoid arthritis. Suffering was found to be a process directed toward regaining normalcy and consisted of three phases: disintegration of self; the shattered self; and reconstruction of self. Experiencing suffering resulted in struggling, lose of dreams, restructuring a future orientation, and withdrawing. Finding meaning through positive life changes was an outcome of suffering. The informants' differentiation between pain and suffering also was examined. The provision of comfort measures along with a caring and empathetic attitude were identified as helpful nursing interventions in reducing suffering.

  3. Stroke Care 2: Stroke rehabilitation

    NARCIS (Netherlands)

    Langhorne, P.; Bernhardt, J.; Kwakkel, G.


    Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially

  4. Representation of victims’ suffering in violent conflicts: scope, obstacles and perspectives

    Directory of Open Access Journals (Sweden)

    Camila De Gamboa Tapias


    Full Text Available The main objective of this article is to analyze the types of moral feelings that victims’ testimonies should arouse among members of a political community that purports to be democratic, inclusive and respective of human rights. Hand in hand with Avishai Margalit, Tzvetan Todorov, Peter Strawson, Martha Nussbaum, Elizabeth Spelman and Manuel Reyes Mate, throughout the text we defend the thesis that the narrations and representations of the victims’ unfair suffering should be able to arouse indignation and informed compassion among citizens. To demonstrate the scope and meaning of this thesis, we will analyze two of the most serious problems faced by a policy that privileges the victims. The first is related to the distortions that may take place when the victims’ narrations are heard and that are largely associated with a kind of sacredness that is assigned to those who testify on the violence they have suffered. The second issue we will analyze is related to the manner in which the members of a political community represent said suffering. Specifically, we will discuss the different forms of trivialization that citizens may give the narrations that represent the damage. In the last part of the text, we shall analyze the exemplary testimony of Harriet Jacobs with the intention of showing how a testimony may generate informed indignation and compassion among the audience.

  5. Aspirin resistant patients with recent ischemic stroke. (United States)

    Castilla-Guerra, L; Navas-Alcántara, M S; Fernández-Moreno, M C


    Some patients with a recent ischemic stroke who are being treated with aspirin as an antiaggregant suffer a new ischemic stroke. These patients (15-25%) have been called unresponsive to aspirin or aspirin resistant. The aspirin-resistant patients have a four-time greater risk of suffering a stroke. Furthermore, these strokes are generally more severe, with increased infarct volume and greater risk of recurrence. There is currently no ideal laboratory test to detect the resistance to the antiaggregant effect of aspirin. The study of resistance to aspirin would only be indicated in selected cases. In these patients, one should first rule out any "pseudo-resistance" to aspirin (lack of compliance, concomitant treatments that interfere with the action of the aspirin). Copyright © 2013 Elsevier España, S.L. All rights reserved.

  6. Stroke while driving: Frequency and association with automobile accidents. (United States)

    Inamasu, Joji; Nakatsukasa, Masashi; Tomiyasu, Kazuhiro; Mayanagi, Keita; Nishimoto, Masaaki; Oshima, Takeo; Yoshii, Masami; Miyatake, Satoru; Imai, Akira


    Background Cardiovascular events while driving have occasionally been reported. In contrast, there have been few studies on stroke while driving. Aim The objectives of this study were to (1) report the frequency of stroke while driving and (2) evaluate its association with automobile accidents. Methods Clinical data prospectively acquired between January 2011 and December 2016 on 2145 stroke patients (1301 with ischemic stroke, 585 with intracerebral hemorrhage, and 259 with subarachnoid hemorrhage) were reviewed to identify patients who sustained a stroke while driving. The ratio of driving to performing other activities was evaluated for each stroke type. Furthermore, the drivers' response to stroke was reviewed to understand how automobile accidents occurred. Results Among the 2145 patients, 85 (63 ischemic stroke, 20 intracerebral hemorrhage, and 2 subarachnoid hemorrhage) sustained a stroke while driving. The ratio of driving to performing other activities was significantly higher in ischemic stroke (4.8%) than in intracerebral hemorrhage (3.4%) or subarachnoid hemorrhage (0.8%). A majority of drivers either continued driving or pulled over to the roadside after suffering a stroke. However, 14 (16%) patients were involved in automobile accidents. In most patients, an altered mental status due to severe stroke was the presumed cause of the accident. Conclusion Stroke occurred while driving in 4.0% of all strokes and accidents occurred in 16% of these instances.

  7. Pediatric stroke

    International Nuclear Information System (INIS)

    Hoermann, M.


    Stroke in childhood has gained increasingly more attention and is accepted as an important disease in childhood. The reasons for this severe event and the consequences for the rest of the life are totally different than for adults. This is also true for the diagnosis and therapy. This paper gives a comprehensive overview on the characteristics of pediatric stroke to assist radiologists in making a rapid and safe diagnosis in order to identify the underlying disease. (orig.) [de

  8. The wonderful apparatus of John Jacob Abel called the "artificial kidney". (United States)

    Eknoyan, Garabed


    Hemodialysis, which now provides life-saving therapy to millions of individuals, began as an exploratory attempt to sustain the lives of selected patients in the 1950s. That was a century after the formulation of the concept and determination of the laws governing dialysis. The first step in the translation of the laboratory principles of dialysis to living animals was the "vividiffusion" apparatus developed by John Jacob Abel (1859-1938), dubbed the "artificial kidney" in the August 11, 1913 issue of The Times of London reporting the demonstration of vividiffusion by Abel at University College. The detailed article in the January 18, 1914 of the New York Times, reproduced here, is based on the subsequent medical reports published by Abel et al. Tentative attempts of human dialysis in the decade that followed based on the vividiffusion apparatus of Abel and his materials (collodion, hirudin, and glass) met with failure and had to be abandoned. Practical dialysis became possible in the 1940s and thereafter after cellophane, heparin, and teflon became available. Abel worked in an age of great progress and experimental work in the basic sciences that laid the foundations of science-driven medicine. It was a "Heroic Age of Medicine," when medical discoveries and communicating them to the public were assuming increasing importance. This article provides the cultural, social, scientific, and medical background in which Abel worked, developed and reported his wonderful apparatus called the "artificial kidney."

  9. Authoritarianism, control and vigilance: Jacob Gorender on the aim of the repression (1940-1980

    Directory of Open Access Journals (Sweden)

    Lucileide Costa Cardoso


    Full Text Available The purpose of the article is to demonstrate through analysis of documents of repressive nature, the elements highlighted by the Military Justice to establish the trace of persecution of the intellectuals among other social sectors which dared to challenge the Dictatorship. The complete mapping, involving the combat strategies against the “communism”, including the knowledge of the political parties and their military staff, was accumulated by police and military sectors along the 20th century. We intended to follow, through these records, the political trajectory of the intellectual Jacob Gorender. As a journalist, he got involved in the discussion about the Brazilian participation in the World War II, joined the FEB in 1943. Before that, however, Gorender became a communist, recruited by Mario Alves in 1942. In the early 60’s, he acted as a militant and coordinator of PCB, when he decided to join PCBR, founded in 1968. The historian, in the beginning of the 1964 Strike, with his life already devastated by the Information and Security Community, experienced marginalization, imprisonment, torture and censorship of his writings among other abuses that also reached his closest friends, political companions and family members. The crossing of this amount of information with the memorial documents helps to understand the political repression tricks and the different Revolutionary projects in course.


    Directory of Open Access Journals (Sweden)

    José Altés Bustelo


    Full Text Available La primera edición de este libro apareció en 1961 en Nueva York. (Random House Inc. Edit.. Y la primera traducción en castellano, de Angel Abad, apareció en España sorprendentemente pronto, en enero de 1967, editada por Península. (Ediciones 62, Barcelona.El texto de Jane Jacobs se inicia con su ya famosa frase: "Este libro es un ataque contra las teorías más usuales sobre urbanización y reconstrucción de ciudades,..." advertencia insólita, aunque innecesaria si uno continua leyendo.Fruto de la experiencia directa, atenta, sensible, perspicaz, abierta a la observación y marcada por el amor y compromiso con su ciudad, Nueva York, y sus convecinos, y contrastada con minuciosos análisis en múltiples otras ciudades, J.J. nos desgrana una extensa cadena de reflexiones sobre la experiencia vivida de la realidad cotidiana en las distintas escalas de la ciudad: calle, barriada, distrito, sus límites y fronteras, parques y vacíos, comunicaciones, etc., y la constatación detallada del fracaso, siempre, en la acción de políticos, planificadores y arquitectos

  11. Las máscaras del poeta: Sobre la poesía de Porfirio Barba Jacob

    Directory of Open Access Journals (Sweden)

    Enrique Abel Foffani


    Full Text Available La crítica ha señalado repetidas veces el carácter postmodernista o epigonal de la poesía de Porfirio Barba Jacob, subsidiaria de un lenguaje y un imaginario anacrónicos. Nuestro artículo intenta leer en esta obra poética la singular construcción de la subjetividad desde la situación marginal en la que se inscribe Porfirio Barba Jacob: como homosexual, judío y un escritor situado fuera del territorio nacional. Esta peculiar posición desde la cual elabora una serie de seudónimos que complejizan las relaciones del Poeta con su propia obra, es analizada en el contexto de la poesía latinoamericana de las primeras décadas del siglo XX

  12. Las máscaras del poeta: Sobre la poesía de Porfirio Barba Jacob

    Directory of Open Access Journals (Sweden)

    Enrique Abel Foffani


    Full Text Available La crítica ha señalado repetidas veces el carácter postmodernista o epigonal de la poesía de Porfirio Barba Jacob, subsidiaria de un lenguaje y un imaginario anacrónicos. Nuestro artículo intenta leer en esta obra poética la singular construcción de la subjetividad desde la situación marginal en la que se inscribe Porfirio Barba Jacob: como homosexual, judío y un escritor situado fuera del territorio nacional. Esta peculiar posición desde la cual elabora una serie de seudónimos que complejizan las relaciones del Poeta con su propia obra, es analizada en el contexto de la poesía latinoamericana de las primeras décadas del siglo XX

  13. Risk factors for stress in children after parental stroke

    NARCIS (Netherlands)

    Sieh, D.S.; Meijer, A.M.; Visser-Meily, J.M.


    Objectives: To assess risk factors for stress in children 3 years after parental stroke. Participants: Questionnaires were filled in by 44 children aged 7-18 years, parents who suffered a stroke and healthy spouses from 29 families recruited in 9 participating rehabilitation centers across the

  14. Stopping Strokes (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts


    In the U.S., one person every 40 seconds suffers a stroke. This podcast discusses the importance of seeking immediate treatment for a stroke.  Created: 10/27/2016 by MMWR.   Date Released: 10/27/2016.

  15. Driving After a Stroke (United States)

    ... Stroke Professionals for Stroke Shop for Stroke Support for Stroke Association. ... a wheelchair accessible or modified van, truck or car can provide the assurance you need to feel ...

  16. Stroke Prevention (A Cup of Health with CDC)

    Centers for Disease Control (CDC) Podcasts


    Worldwide, strokes are the second leading cause of death among people over 60, and they are among the leading causes of disability. In the U.S., nearly 800,000 people suffer a stroke each year. In this podcast, Dr. Sallyann King discusses ways to prevent strokes.  Created: 10/29/2014 by MMWR.   Date Released: 10/29/2014.

  17. Ischemic stroke selectively inhibits REM sleep of rats


    Ahmed, Samreen; Meng, He; Liu, Tiecheng; Sutton, Blair; Opp, Mark R.; Borjigin, Jimo; Wang, Michael M.


    Sleep disorders are important risk factors for stroke; conversely, stroke patients suffer from sleep disturbances including disruptions of non-rapid eye movement (NREM) and rapid eye movement (REM) sleep and a decrease in total sleep. This study was performed to characterize the effect of stroke on sleep architecture of rats using continuous electroencephalography (EEG) and activity monitoring. Rats were implanted with transmitters which enabled continuous real time recording of EEG, electrom...

  18. Laboratory tests as short-term correlates of stroke


    Sughrue, Trevor; Swiernik, Michael A.; Huang, Yang; Brody, James P.


    Background The widespread adoption of electronic health records provides new opportunities to better predict which patients are likely to suffer a stroke. Using electronic health records, we assessed the correlation of different laboratory tests to future occurrences of a stroke. Methods We examined the electronic health records of 2.4 million people over a two year time span. These records contained 26,964 diagnoses of stroke. Using Cox regression analysis, we measured whether any one of 179...

  19. "Groβes zärtliches Brasilien": Das Brasilienbild in den Werken von Heinrich Eduard Jacob

    Directory of Open Access Journals (Sweden)

    Marlen Eckl


    Full Text Available Embora tendo viajado pelo Brasil em 1932 e depois escrito vários artigos sobre essa viagem assim como três livros de temática brasileira, Heinrich Eduard Jacob é quase desconhecido em Brasil. Por isso neste artigo são apresentados a trajetória do jornalista e escritor e as suas obras brasileiras Treibhaus Südamerika (1934, Saga e marcha triunfal do café (1934 e Estrangeiro. Einwandererschicksal in Brasilien (1951. Ademais Jacob será contextualizado atraves da conecção com os outros autores que, nos anos 30 e 40, escreveram sobre o país. Estes, na maioria, foram refugiados do nazismo como entre outros Stefan Zweig, Richard Katz, Wolfgang Hoffmann-Harnisch, Frank Arnau e Marte Brill. Quanto ao imaginário acerca do Brasil descrito por Jacob percebe-se que ele como tantos outros autores também viu no Brasil um "país de um futuro" (como o chamou e uma "democracia racial" pretensa existente no país. Apesar disso, não desistiu de desmascarar a cordialidade brasileira proverbial como sendo apenas disfarce e de indicar problemas existentes como a questão da política quanto ao café e as consequencias negativas do nacionalismo, fomentado pelo regime Vargas. Assim ele defendeu um ponto de vista que foi contrário àquele do seu amigo Stefan Zweig.

  20. Hollandi paviljon Hannoveri maailmanäitusel EXPO 2000 : Uus Loodus = Dutch Pavilion at EXPO 2000 in Hannover : New Nature / Winy Maas, Jacob van Rijs, Nathalie de Vries

    Index Scriptorium Estoniae

    Maas, Winy


    Hollandi paviljon - näide looduse ja tehnoloogia segunemisest. Projekteerija: MVRDV. Arhitektid Winy Maas, Jacob van Rijs, Nathalie de Vries; kaasa töötasid Stefan Witteman, Jaap van Dijk, Chrisoph Schindler, Kristina Adsersen, Rüdiger Kreiselmayer

  1. Nietzsche and the dilemma of suffering. (United States)

    Johnston, J S; Johnston, C


    In this paper, we attempt to view a long-held assumption in nursing as mistaken. That is, that patient suffering is something to be overcome. Utilizing Nietzsche's statements on Amor Fati, we carefully examine the cultural assumptions behind our denigration of suffering, look at specific nursing examples of this situation, and attempt the beginnings of a discourse on what it would take for nurses to overcome their own predetermined views of suffering in order to better help their patients "own" their own suffering.

  2. "[No] doctor but my master": Health reform and antislavery rhetoric in Harriet Jacobs's Incidents in the life of a slave girl. (United States)

    Berry, Sarah L


    This essay examines Harriet Jacobs's Incidents in the Life of a Slave Girl (1861) in light of new archival findings on the medical practices of Dr. James Norcom (Dr. Flint in the narrative). While critics have sharply defined the feminist politics of Jacobs's sexual victimization and resistance, they have overlooked her medical experience in slavery and her participation in reform after escape. I argue that Jacobs uses the rhetoric of a woman-led health reform movement underway during the 1850s to persuade her readers to end slavery. This essay reconstructs both contexts, revealing that Jacobs links enslaved women's physical and sexual vulnerability with her female readers' fears of male doctors' threats to modesty and of their standard bleed-and-purge treatments. Jacobs illustrates that slavery damages women's health as much as heroic medicine, and thus merits the political activism of her readers. Specifically, Jacobs dramatizes her conflicts with the rapacious physician-master at moments that are crucial to women's health: marriage, pregnancy, childbirth, and motherhood. Ultimately, this essay advances a new understanding of the role of health reform in social change: it galvanized other movements such as women's rights and abolition, particularly around issues of bodily autonomy for women and African Americans.

  3. Cutting edge SRU control : improved environmental compliance with Jacobs advanced burner control+ (ABC+)

    Energy Technology Data Exchange (ETDEWEB)

    Molenaar, G. [Jacobs Canada Inc., Calgary, AB (Canada); Henning, A.; Kobussen, S. [Jacobs Nederland BV, Hoogvliet (Netherlands)


    Oil sands bitumen contains approximately 4 to 5 per cent sulphur by weight and the bitumen is upgraded to produce lighter fractions. During coking the bitumen is heated and cracked into lighter molecules and a mixture of kerosene, naphtha and gas oil is recovered via fractionation. Then, the vapors leaving the fractionator are processed through hydrodesulphurization, followed by removal by amine based sweetening units. The acid gas from the ASUs is sent to the sulphur recovery units (SRUs) where most of the sulphur is recovered as elemental sulphur. The oil sands industry faces many challenges with respect to environmental impact, energy use and greenhouse gas emissions including the recovery of sulphur and minimizing hydrogen sulfide (H{sub 2}S) and sulphur dioxide (SO{sub 2}) emissions from the oil sands production facilities. In order to improve the SRU control response to acid gas feed variations, Jacobs Comprimo Sulphur Solutions implemented advanced burner control+ (ABC+) at Suncor's Simonette Gas Plant's SRU in northern Alberta. This control system used an acid gas feed analyzer and dynamic algorithms to control the combustion air to the reaction furnace. The analyzer measures H{sub 2}S, total hydrocarbons, carbon dioxide (CO{sub 2}) and water (H{sub 2}O) accurately and quickly, which is important for having effective and fast air-to-acid gas ratio control. The paper provided background information on the Suncor Simonette Gas Plant and discussed ABC+ versus conventional control. An overview of the simplified ABC and ABC+ systems was then illustrated and presented. The ABB multiwave process photometer was also explained. Last, a dynamic simulation of the potential benefits of ABC+ was discussed and the ABC+ benefits for oil sands were presented. It was concluded that ABC+ provides improved SRU performance, reduced SO{sub 2} emissions and violations, and reduced flaring. 1 tab., 3 figs.

  4. Medical expertise, existential suffering and ending life. (United States)

    Varelius, Jukka


    In this article, I assess the position that voluntary euthanasia (VE) and physician-assisted suicide (PAS) ought not to be accepted in the cases of persons who suffer existentially but who have no medical condition, because existential questions do not fall within the domain of physicians' professional expertise. I maintain that VE and PAS based on suffering arising from medical conditions involves existential issues relevantly similar to those confronted in connection with existential suffering. On that basis I conclude that if VE and PAS based on suffering arising from medical conditions is taken to fall within the domain of medical expertise, it is not consistent to use the view that physicians' professional expertise does not extend to existential questions as a reason for denying requests for VE and PAS from persons who suffer existentially but have no medical condition.

  5. Heat Stroke

    DEFF Research Database (Denmark)

    Mørch, Sofie Søndergaard; Andersen, Johnny Dohn Holmgren; Bestle, Morten Heiberg


    and mortality. This case report describes two Danish patients diagnosed with heat stroke syndrome during a heat wave in the summer of 2014. Both patients were morbidly obese and had several predisposing illnesses. However since heat stroke is a rare condition in areas with temperate climate, they were...... not diagnosed until several days after admittance; hence treatment with cooling was delayed. Both patients were admitted to the intensive care unit, where they were treated with an external cooling device and received treatment for complications. Both cases ended fatally. As global warming continues, more heat...

  6. Improved nutritional status in elderly patients 6 months after stroke

    DEFF Research Database (Denmark)

    Brynningsen, Peter Krogh; Husted, Steen; Damsgaard, Else Marie Skjøde


    , length of stay in hospital and infectious complications. SUBJECTS AND METHODS: 89 patients with ischemic stroke consecutively admitted to a geriatric stroke rehabilitation unit had their nutritional status evaluated in the hospital at 1 week and 5 weeks after stroke, and in their own home at 3 months...... variables was 31 (35 %) at 1 week and was reduced to 20 (22 %) at 6 months. CONCLUSION: 35 % of elderly patients with ischemic stroke admitted to a geriatric rehabilitation unit were malnourished 1 week after stroke. Particularly serum proteins and body fat were affected. Follow-up of nutritional variables......INTRODUCTION: Nutritional status among stroke patients has received limited attention despite the fact, that it may have an influence on clinical outcome. Previous studies have estimated that 15-20 % of patients suffer from malnutrition in the acute phase of stroke, but so far no studies have...

  7. Daily Variation in the Occurrence of Different Subtypes of Stroke

    Directory of Open Access Journals (Sweden)

    Luciana Ripamonti


    Full Text Available Three thousand two hundred and ninety-eight patients admitted to our Stroke Unit with hemorrhagic, large artery atherosclerosis, cardioembolic, small-vessel occlusion, and undetermined etiology-cryptogenic strokes were included in the study. The circadian variability in onset in each stroke subgroup and the associations with various risk factors were analyzed. In each subgroup, a significant minority of patients suffered from stroke during sleep. In the ischemic group, hypercholesterolemia, paroxysmal atrial fibrillation, and previous myocardial infarction facilitated the onset during waking. During waking, stroke onset was significantly higher in the morning compared to the afternoon both in the hemorrhagic and in the ischemic type. In hemorrhagic stroke, a previous stroke was associated with a lower early morning occurrence. In large artery atherosclerosis stroke, males were at higher risk of early morning occurrence (p<0.01. In small-vessel occlusion stroke, hypertension is significantly more present in the morning compared to the afternoon onset (p<0.005. Circadian patterns of stroke onset were observed both in hemorrhagic and in ischemic stroke, irrespective of the ischemic subgroup. In all groups, stroke was more likely to occur during waking than during sleep and, in the diurnal period, during morning than during afternoon. Moreover, sex and some clinical factors influence the diurnal pattern.

  8. War, suffering and modern German history. (United States)

    Hansen, Randall


    This introduction proceeds in five steps. First, it briefly considers the etymology of the term "suffering," as well as the way in which scholars from different disciplines have approached it conceptually and empirically. Second, drawing on the contributions to this issue, it raises general themes emerging from the study of the Thirty Years, Franco-Prussian and First World Wars, with particular attention to gender, the disabled, and Jewish-German veterans. Finally, it considers the most politically contested field of German suffering - the Second World War - and reflects on how that suffering can be narrated and understood without running into the intellectual dead ends of either self-pity or collective guilt.

  9. Syntax of the Self in Damon Galgut's In a Strange | Jacobs | English ...

    African Journals Online (AJOL)

    Toby Lichtig describes it as a narrative which “radiates alienation” (21); Philip Womack characterises Galgut as “a master of isolation and intensity;” while Eileen Battersby defines the theme of the novel as “loneliness and the search for love,” adding that Galgut “invariably describes psychological suffering and emotional ...

  10. Costs of stroke and stroke services: Determinants of patient costs and a comparison of costs of regular care and care organised in stroke services

    Directory of Open Access Journals (Sweden)

    Koopmanschap Marc A


    Full Text Available Abstract Background Stroke is a major cause of death and long-term disability in Western societies and constitutes a major claim on health care budgets. Organising stroke care in a stroke service has recently been demonstrated to result in better health effects for patients. This paper discusses patient costs after stroke and compares costs between regular and stroke service care. Methods Costs were calculated within the framework of the evaluation of three experiments with stroke services in the Netherlands. Cost calculations are base on medical consumption data and actual costs. Results 598 patients were consecutively admitted to hospital after stroke. The average total costs of care per patient for the 6 month follow-up are estimated at €16,000. Costs are dominated by institutional and accommodation costs. Patients who die after stroke incur less costs. For patients that survive the acute phase, the most important determinants of costs are disability status and having a partner – as they influence patients' stroke careers. These determinants also interact. The most efficient stroke service experiment was most successful in co-ordinating patient flow from hospital to (nursing home, through capacity planning and efficient discharge procedures. In this region the costs of stroke service care are the same as for regular stroke care. The other experiments suffered from waiting lists for nursing homes and home care, leading to "blocked beds" in hospitals and nursing homes and higher costs of care. Costs of co-ordination are estimated at about 3% of total costs of care. Conclusion This paper demonstrates that by organising care for stroke patients in a stroke service, better health effects can be achieved with the same budget. In addition, it provides insight in need, predisposing and enabling factors that determine costs of care after stroke.

  11. Surprised by joy: a journey through suffering. (United States)

    Afeef, Majeda; Alkhoulli, Laila


    Understanding suffering as possible meaning of cancer for patients and their families is a necessary part of cancer nursing care. Suffering occurs when the intactness or integrity of the individuals is threatened or disrupted (Cassel 1999); the authors believe that exploring cancer patients' suffering is vital to improve patient quality care. This article discusses suffering as a feature for oncology patients at tertiary hospital in Jordan. We are aiming through understanding the three following narratives of cancer patients who experience and witness the suffer during their disease journey to illustrate how the suffering reflect their behavior and day to day life. The first case is a young man of 24 years old who was diagnosed with nasopharyngeal carcinoma five years ago, treated then relapsed and receiving palliative care up to moment, the narrative focus on his suffering from corrupted relations with his wife due to infected face wound and loss of the financial support. The Second case is a 38 years old female who diagnosed with melanoma 15 years ago, she experience psychological suffering due to changes in her body image. She is taking care of motor handicapped husband in addition to her Kids. The Last case is a 54 years old female who had lung cancer. She is still fighting her disease. Consequently, she is suffering from the disease, cause to affect her job.We found out that their spirituality and beliefs system enables them to endure and fight their disease, alleviate suffering, enhance adaptation and redefine hope. The health care team who provide the care for these cases focus interdisciplinary team approach who affirm that the transcendental is there when disease and mute or expressive suffering are recognized together, they do the work of creating a full meaning for patients and families. Nurses play a crucial role in managing such cases .It is the core of nursing care to presence the mean of listening, touching, acknowledging, honoring patient's wishes

  12. Why do we suffer? Understanding, treatment and processing of suffering in terms of existential analysis

    Directory of Open Access Journals (Sweden)

    Alfried Längle


    Full Text Available The paper describes the existential analytical model within which the content of suffering is denoted and structured. The model shows that we suffer from when we suffer. Suffering is diverse in its «how» and «why.» The author highlights the features of various forms of suffering in accordance with their classification in the existential-analytical anthropology and reveals the essence of suffering. Within the framework of existential analysis there is an assumption that experience is perceived as fulfilling with suffering when the fundamental structures of existence are threatened or damaged, and the features of the contents of these structures are considered. Significant attention is paid to the ratio of human suffering and the loss of human sense of life, what is behind the feeling of senselessness of suffering. Suffering and pain fully or partly represent a threat to our very life and throw into question human lust for life. To avoid this, it is necessary to appeal to the vast opportunities of a person, and drawing strength from its sources to meet adequately the destructive factors and the abyss of existence. The paper considers the issue of activity which enables stepwise treatment of suffering. The model of stepwise coping with suffering is proposed. It helps to overcome the stagnation in the condition of suffering and returns to the world and life. Practical steps are suggested. These steps are applicable for all forms of suffering. They lay the basis for gaining inner peace. So we can target our efforts over the suffering and prevent the occurrence of mental illness (e.g., depression, hysteria, addiction, PTSD, etc..

  13. Protecting Wild Animals from Unnecessary Suffering


    Spark, Gareth


    This article compares the protection from unnecessary suffering afforded to wild animals with that afforded to domesticated animals and animals under human control. It considers various species-specific bio-diversity- and conservation-based protection for wild animals, under legislation such as the Wildlife and Countryside Act 1981 and the Conservation of Habitats and Species Regulations 2010, as well as the general protection from intentionally inflicted unnecessary suffering afforded to wil...

  14. Development of the Adolescent Cancer Suffering Scale. (United States)

    Khadra, Christelle; Le May, Sylvie; Tremblay, Isabelle; Dupuis, France; Cara, Chantal; Mercier, Geneviève; Vachon, Marie-France; Lachance Fiola, Jacinthe


    While mortality due to pediatric cancer has decreased, suffering has increased due to complex and lengthy treatments. Cancer in adolescence has repercussions on personal and physical development. Although suffering can impede recovery, there is no validated scale in French or English to measure suffering in adolescents with cancer. To develop an objective scale to measure suffering in adolescents with cancer. A methodological design for instrument development was used. Following a MEDLINE search, semistructured interviews were conducted with adolescents 12 to 19 years of age who had undergone four to six weeks of cancer treatment, and with a multidisciplinary cohort of health care professionals. Adolescents with advanced terminal cancer or cognitive impairment were excluded. Enrollment proceeded from the hematology-oncology department⁄clinic in Montreal, Quebec, from December 2011 to March 2012. Content validity was assessed by five health care professionals and four adolescents with cancer. Interviews with 19 adolescents and 16 health care professionals identified six realms of suffering: physical, psychological, spiritual, social, cognitive and global. Through iterative feedback, the Adolescent Cancer Suffering Scale (ACSS) was developed, comprising 41 questions on a four-point Likert scale and one open-ended question. Content validity was 0.98, and inter-rater agreement among professionals was 88% for relevance and 86% for clarity. Adolescents considered the scale to be representative of their suffering. The ACSS is the first questionnaire to measure suffering in adolescents with cancer. In future research, the questionnaire should be validated extensively and interventions developed. Once validated, the ACSS will contribute to promote a holistic approach to health with appropriate intervention or referral.

  15. Collectivism and the meaning of suffering. (United States)

    Sullivan, Daniel; Landau, Mark J; Kay, Aaron C; Rothschild, Zachary K


    People need to understand why an instance of suffering occurred and what purpose it might have. One widespread account of suffering is a repressive suffering construal (RSC): interpreting suffering as occurring because people deviate from social norms and as having the purpose of reinforcing the social order. Based on the theorizing of Emile Durkheim and others, we propose that RSC is associated with social morality-the belief that society dictates morality-and is encouraged by collectivist (as opposed to individualist) sentiments. Study 1 showed that dispositional collectivism predicts both social morality and RSC. Studies 2-4 showed that priming collectivist (vs. individualist) self-construal increases RSC of various types of suffering and that this effect is mediated by increased social morality (Study 4). Study 5 examined behavioral intentions, demonstrating that parents primed with a collectivist self-construal interpreted children's suffering more repressively and showed greater support for corporal punishment of children. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

  16. Concepts Joy and Suffering in Russian Linguaculture

    Directory of Open Access Journals (Sweden)

    Svetlana V. Korostova


    Full Text Available In the Russian linguistic consciousness, the concepts of emotions joy and suffering are verbalized at the lexical and phraseological levels, forming the basis for metaphorical combinations. Concepts of emotions, suffering and joy are mutually reinforcing: in the presupposition of the idea of suffering, there is a knowledge that it is not infinite and is always replaced by joy. Russian naive-linguistic consciousness reflects the oldest ideas about the alternation of phenomena and events, desirable and undesirable for man. The concepts of suffering and joy are closely related to the universal category of time. As observations on linguistic projections of concepts show, suffering is realized as a longer process than joy. Emotives of different levels of language represent emotional states of joy and suffering in Russian linguistic culture. According to the National Corpus of the Russian language, lexical demonstrators of the concept of joy dominate. Cognitive interpretation of events in the mind of a person can be changed under the influence of the emotional regime carried out by the media.

  17. Stroke awareness in Denmark

    DEFF Research Database (Denmark)

    Truelsen, Thomas; Krarup, Lars-Henrik


    This is the first study to examine the awareness of major stroke symptoms and stroke risk factors among the general population in Denmark. Early recognition of stroke warning signs and means of reducing stroke occurrence could improve the treatment and prevention of stroke....

  18. Stroke rehabilitation. (United States)

    Langhorne, Peter; Bernhardt, Julie; Kwakkel, Gert


    Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially beneficial treatment options for motor recovery of the arm include constraint-induced movement therapy and robotics. Promising interventions that could be beneficial to improve aspects of gait include fitness training, high-intensity therapy, and repetitive-task training. Repetitive-task training might also improve transfer functions. Occupational therapy can improve activities of daily living; however, information about the clinical effect of various strategies of cognitive rehabilitation and strategies for aphasia and dysarthria is scarce. Several large trials of rehabilitation practice and of novel therapies (eg, stem-cell therapy, repetitive transcranial magnetic stimulation, virtual reality, robotic therapies, and drug augmentation) are underway to inform future practice. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Multiple Strokes

    Directory of Open Access Journals (Sweden)

    Obododimma Oha


    Full Text Available This poem playfully addresses the slippery nature of linguistic signification, employing humour and sarcasm in presenting a wide range of human experience. It ironical twists -- and "strokes" (read ambiguously as both a giving a punishment and erotic pleasuring -- move from the naming of location through international discourse of capital to the crumbling relationships between nation states. It reading of the signs of language is tied to the unease and fracture in cultural and political experience.

  20. [Etiologic mechanism and prevention of perioperative stroke]. (United States)

    Hayashi, Kentaro; Ujifuku, Kenta; Hiu, Takeshi; Kitagawa, Naoki; Suyama, Kazuhiko; Nagata, Izumi


    Despite advances in surgical techniques and improvements in perioperative care, the incidence of perioperative strokes has not decreased, reflecting the aging of the population and the increased number of patients with complication. We investigated the cases who were consulted due to perioperative stroke. From April, 2004 to March, 2007, a total of 102 patients were referred for neurological evaluation because of perioperative stroke. Types of planned or performed surgery, risk factors, types of stroke and timing of the events were analyzed. Sixty-seven cases were consulted preoperatively for history or risk factors of stroke. Forty-seven cases had ischemic risk factors and cerebral vascular recanalization was carried out in four patients who experienced severe cerebral hypoperfusion. The other patients with ischemic risk factors were treated to avoid dehydration or hypotension perioperatively. Nine cases with hemorrhagic risk factors, such as cerebral aneurysm, were treated to avoid significant hypertension during surgery. The types of planned surgery were cardiovascular surgery in 29 cases, abdominal surgery in 13, cervical surgery in 7, and thoracic surgery in 6. Except for one case, who suffered cerebral embolism due to cardiac surgery, those who were consulted preoperatively did not experience stroke. Neurological events had occurred in 35 patients and they were consulted postoperatively. The surgical procedures were cardiovascular surgery in 19 patients, thoracic surgery in 6, abdominal surgery in 6. The types of stroke were cerebral infarction in 20 cases, hypoxic brain in 8, and transient ischemic attack in 5. The cause of the cerebral infarction was considered as cerebral embolism in 19 cases. Those who were consulted preoperatively were treated to prevent intraoperative stroke and did not suffer neurological complication. Most stoke in patients undergoing surgery were not related to hypoperfusion but due to embolism.

  1. Preventing Stroke Deaths (United States)

    ... die within minutes. Strokes happen more in some populations and geographic areas. Stroke death declines have stalled in 3 out of every 4 states. Blacks have the highest stroke death rates among all ...

  2. Two Kinds of Stroke (United States)

    ... Issue Past Issues Special Section Two Kinds of Stroke Past Issues / Summer 2007 Table of Contents For ... are often a warning sign for future strokes. Stroke Can Affect Anyone Award-winning actress Julie Harris ...

  3. Healthy Living after Stroke (United States)

    ... Stories Stroke Heroes Among Us Healthy Living After Stroke Nutrition Good nutrition is one way to reduce ... the hospital. Thank goodness, she did. Subscribe to Stroke Connection Get quarterly digital issues plus our monthly ...

  4. Caring conversations - psychiatric patients' narratives about suffering. (United States)

    Fredriksson, Lennart; Lindström, Unni A


    The aim of this study was to increase and deepen the understanding of how psychiatric patients in conversations with nurses narrate their experience of suffering. Data were obtained in the years 2001-2002 by audio recording of 20 individual caring conversations between eight patients and three psychiatric nurses at a psychiatric outpatient unit in Sweden. Before the data were gathered the study was approved by a local research ethics committee. The methodology is inspired by the hermeneutics of Paul Ricoeur. The data is given a naïve reading which is followed by two structural analyses which explain the text. Finally, the structural analyses and the pre-understanding are confronted in a critical reflection. In the patients' narratives, suffering was at first concealed under a façade that helps the patient to cope with suffering and with shame. As they moved along to a turning point, something happened that made them able to risk everything, i.e. their very selves, but also gave them the possibility of regaining vital parts of themselves that where lost when the façade was constructed. As they took the suffering upon themselves, they grew to be fully visible as human beings and healing was possible as a re-establishment of the interpersonal bridge. This not only meant that the sufferer became open for relationships with others or an abstract other, but also that an opening in the relationship with themselves occurred. If psychiatric patients are allowed to narrate freely they develop different plot structures, which can either hide or reveal suffering. Patients who could establish an answer to the why-question of suffering could also interpret their suffering in a way that enabled growth and reconciliation. In order to do so, they had to abandon the shelter of the façade and confront suffering and shame. This turning point opened them up to life-sustaining relationships with themselves as well as with abstract and concrete others.

  5. [Strokes caused by infection in the tropics]. (United States)

    Carod-Artal, F J

    Almost three out of every four people in the world who suffer a fatal stroke live in developing countries. A number of different tropical diseases may appear in Europe in the coming years as a consequence of the demographic change that is being brought about by migratory flows. We review the main infectious causes of strokes in the tropics. There are estimated to be 500 million cases of malaria every year. Cerebral malaria can cause cerebral oedema, diffuse or focal compromise of the subcortical white matter and cortical, cerebellar and pontine infarctions. Chagas disease is an independent risk factor for stroke in South America. At least 20 million people have the chronic form of Chagas disease. The main prognostic factors for Chagas-related stroke are the presence of apical aneurysms, arrhythmia and heart failure. Vascular complications of neurocysticercosis include transient ischemic attacks, ischemic strokes due to angiitis and intracranial haemorrhages. The frequency of cerebral infarction associated with neurocysticercosis varies between 2% and 12%. Gnathostomiasis is a cause of subarachnoid haemorrhage in south-east Asia. Other less common causes of stroke are viral haemorrhagic fevers due to arenavirus and flavivirus. Several diseases that are endemic in the tropics can be responsible for up to 10% of the cases of strokes in adults.

  6. The King's College Hospital Acute Stroke Unit. (United States)

    Bath, P; Butterworth, R J; Soo, J; Kerr, J E


    The King's College Hospital (KCH) Acute Stroke Unit (ASU) was set up in January 1994 in order to provide acute management for patients admitted with stroke and to undertake biomedical research. Of 206 patients admitted to KCH with a stroke or suffering an in-hospital stroke, 141 (68%) patients were admitted to the ASU over its first 6 months of operation: 120 (85%) were from the Accident and Emergency Department and 21 (15%) from other wards. Management included resuscitation and medical stabilisation, investigation, prevention of stroke complications (including aspiration, venous thrombosis, and pressure sores), rehabilitation (physiotherapy, occupational therapy, speech and language therapy), nutrition (dietetics) and initiation of secondary prevention measures (aspirin or anticoagulation, blood pressure and lipid lowering, and carotid endarterectomy). All aspects of management are driven by agreed guidelines. Patients remain under the care of the admitting physician but specific stroke management and guidance is provided by two research doctors and the unit's nurses, therapists and dietician. The unit also facilitates research into stroke pathophysiology and acute therapeutic interventions. Our experience suggests that an ASU is relatively easy to set up and may contribute to improved care. Whether ASUs improve patient survival and functional outcome, and are cost-effective, requires further study.

  7. Understanding Life After Stroke


    Hjelmblink, Finn


    Stroke is an acute, neurological dysfunction of vascular origin with sudden occurrence and it influences physical, cognitive and psychological functions. Initial treatment aims at eliminating or reducing the brain damage. Soon, however, the influence of the stroke on the entire life of stroke survivors has to be considered. This thesis explores the meaning of life after stroke to 19 elderly stroke survivors during the first year post stroke. Survivors were interviewed twice and the interviews...

  8. Difficulty Swallowing After Stroke (Dysphagia) (United States)

    ... Simple Techniques Can Help Memory after a Stroke Self-Esteem after Stroke Cognitive Challenges After Stroke Depression Trumps ... spasticity), fatigue and more. Let's Talk About Stroke Fact Sheets Our stroke fact sheets cover treatments, recovery, ...

  9. Laboratory tests as short-term correlates of stroke. (United States)

    Sughrue, Trevor; Swiernik, Michael A; Huang, Yang; Brody, James P


    The widespread adoption of electronic health records provides new opportunities to better predict which patients are likely to suffer a stroke. Using electronic health records, we assessed the correlation of different laboratory tests to future occurrences of a stroke. We examined the electronic health records of 2.4 million people over a two year time span. These records contained 26,964 diagnoses of stroke. Using Cox regression analysis, we measured whether any one of 1796 different laboratory tests were effectively correlated with a future diagnosis of stroke. We identified 38 different laboratory tests that had significant short-term (two year) prognostic value for a future diagnosis of stroke. For each of the 38 laboratory tests we also compiled the Kaplan-Meier survival curve, and relative risk ratio that the test confers. Several dozen laboratory tests are effective short-term correlates of stroke.

  10. Systemic humiliation as daily social suffering

    DEFF Research Database (Denmark)

    Rothbart, Daniel; Poder, Poul


    . These instruments may appear innocuous, as when civil-society leaders render “reasonable” decisions, government officials establish “essential” directives, and bureaucrats implement “common sense” policies. But their effect is to promote the collective suffering of marginalized people. In this chapter, we examine...... and capacities of these people. Drawing upon recent developments in social identity theory, moral philosophy, sociological theory, and clinical psychology, we argue that systemic humiliation generates social pain that is experienced as annulment of one’s inherent value; it is an affront to suffering persons...

  11. To Love is to Suffer: Older Adults' Daily Emotional Contagion to Perceived Spousal Suffering. (United States)

    Monin, Joan K; Levy, Becca R; Kane, Heidi S


    For older adults coping with a spouse's chronic condition, greater marital satisfaction may not be entirely protective for psychological health. We examined marital satisfaction and gender as moderators of the association between perceived spousal suffering and daily emotional contagion. Based on empathy-altruism and interdependent self-construal theories, we hypothesized that high marital satisfaction and being female would heighten daily emotional contagion, or within-person associations between perceived spouse suffering and distress to spouse suffering. Forty-five older adults who had a spouse with a musculoskeletal condition completed daily interviews. Participants reported their marital satisfaction once in the laboratory and then daily perceptions of their spouse's physical suffering and their own distress to spouse suffering via phone at home for 7 days. Consistent with hypotheses, there were significant within-person effects such that highly satisfied wives experienced heightened emotional contagion on days when they perceived higher than average spouse suffering. Unexpectedly, men who were high in marital satisfaction experienced heightened daily distress irrespective of their perceptions of level of spousal suffering. Marital satisfaction can increase daily emotional contagion to spousal suffering among older couples dealing with chronic conditions. Wives' distress may be more dependent on perceiving high levels of partner suffering compared with husbands' distress.

  12. Prevention Of Stroke

    Directory of Open Access Journals (Sweden)

    Nagaraja D


    Full Text Available Stroke is an important cause for neurological morbidity and mortality. Prevention of ischemic stroke involves identification and prevention of risk factors and optimal use of pharmacotherapy. Risk factors have been classified as modifiable and non-modifiable; control of modifiable factors should prevent stroke occurrence. Stroke prevention has been described at three levels: primary, secondary and tertiary. Prolonged hypertension increases an individual′s risk for developing fatal or nonfatal stroke by three times and its control has been shown to prevent stroke. Diabetes mellitus is an important cause for microangiopathy and predisposes to stroke. Statin trials have shown significant reduction in stroke in those who were treated with statins. Stroke risk can be reduced by avoiding tobacco use, control of obesity and avoiding sedentary life style. Anti platelet medications are effective for secondary prevention of stroke. Educating society regarding modifiable risk factors and optimal use of pharmacotherapy form the cornerstone for the prevention of stroke.

  13. Atuação da enfermagem no autocuidado e reabilitação de pacientes que sofreram Acidente Vascular Encefálico Actuación de la enfermería en el autocuidado y rehabilitación de pacientes que sufreran Accidente Nursing activities in self-care and rehabilitation of patients who suffered Stroke

    Directory of Open Access Journals (Sweden)

    Juliana Cristina Lessmann


    Full Text Available Quando o cérebro sofre alterações vasculares podem ocorrer sérias sequelas motoras, sensoriais e na percepção. Nesta perspectiva o estudo objetiva relatar/ compartilhar assistência de Enfermagem ao indivíduo acometido pelo Acidente Vascular Encefálico enfatizando a reabilitação e o autocuidado baseado em Orem. Trata-se de relato de experiência de prática assistencial, realizada de maio a julho de 2006, com 15 indivíduos e seus familiares, em um centro de reabilitação da região sul do Brasil. O cuidado de Enfermagem integral ocorre com atividades de estimulação sensitiva, motora, controle postural, amplitude de movimentos e treino de marcha, sempre acompanhados por ações de educação em saúde. Estas habilidades conferem aos enfermeiros capacidades de atuação proporcionando a redução de danos e incapacidadesCuando o cerebro sufre alteraciones vasculares pueden ocurrir serias secuelas motoras, sensoriales y en la percepción. En esta perspectiva el estudio objetiva relatar/compartir asistencia de Enfermería al individuo afectado por accidente vascular cerebral enfatizando la rehabilitación y autocuidado basado en Orem. Se trata de relato de experiencia de práctica asistencial, realizada de mayo a julio de 2006, con 15 individuos y sus familiares, en un centro de rehabilitación de la región sur do Brasil. El cuidado de Enfermería integral ocurre con actividades de estimulación sensitiva, motora, control postural, amplitud de movimientos y entrenamiento de marcha, siempre acompañados por acciones de educación en salud. Estas habilidades confieren a los enfermeros capacidades de actuación, participando en la reducción de daños e incapacidadesThere can be serious damage to motor, sensatory, and perceptive capabilities when the brain suffers vascular alterations. With this in mind, the objective of this study is to report and share Nursing care to the individual who has suffered a cerebral vascular accident

  14. Measuring the Experience and Perception of Suffering (United States)

    Schulz, Richard; Monin, Joan K.; Czaja, Sara J.; Lingler, Jennifer H.; Beach, Scott R.; Martire, Lynn M.; Dodds, Angela; Hebert, Randy S.; Zdaniuk, Bozena; Cook, Thomas B.


    Purpose: Assess psychometric properties of scales developed to assess experience and perception of physical, psychological, and existential suffering in older individuals. Design and Methods: Scales were administered to 3 populations of older persons and/or their family caregivers: individuals with Alzheimer's disease (AD) and their family…

  15. Ischemic Stroke in Young Adults with Moyamoya Disease: Prognostic Factors for Stroke Recurrence and Functional Outcome after Revascularization. (United States)

    Zhao, Meng; Deng, Xiaofeng; Gao, Faliang; Zhang, Dong; Wang, Shuo; Zhang, Yan; Wang, Rong; Zhao, Jizong


    Stroke in young adults is uncommon and rarely described. Moyamoya disease is one of the leading causes of stroke in young adults. We aimed to study the prognostic factors for stroke recurrences and functional outcomes in young stroke patients with moyamoya disease after revascularization. We reviewed 696 consecutive patients with moyamoya disease admitted to our hospital from 2009-2015 and identified patients aged 18-45 years with first-ever stroke. Follow-up was conducted via face-to-face or structured telephone interviews. Outcome measures were recurrent stroke events and unfavorable functional outcomes (modified Rankin Scale >2). We included 121 young patients with moyamoya disease suffering from stroke (initial presentation age, 35.4 ± 7.5 years). All patients underwent revascularization after the acute phase of initial stroke events as the secondary prevention for recurrences. During follow-up (median, 40 months), 9 patients (7.4%) experienced recurrent strokes and 8 of them (6.6%) suffered unfavorable functional outcomes. In the multivariate analysis, diabetes was an independent predictor for stroke recurrences (hazard ratio 6.76; 95% confidence interval 1.30-35.11; P = 0.02) and was significantly associated with unfavorable functional outcomes (odds ratio 7.87; 95% confidence interval 1.42-38.74; P = 0.01). We identified diabetes as an independent risk factor for recurrent strokes and unfavorable functional outcomes after revascularization in young stroke patients with moyamoya disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Leukocytosis in acute stroke

    DEFF Research Database (Denmark)

    Kammersgaard, L P; Jørgensen, H S; Nakayama, H


    Leukocytosis is a common finding in the acute phase of stroke. A detrimental effect of leukocytosis on stroke outcome has been suggested, and trials aiming at reducing the leukocyte response in acute stroke are currently being conducted. However, the influence of leukocytosis on stroke outcome has...

  17. Stroke: First Aid (United States)

    First aid Stroke: First aid Stroke: First aid By Mayo Clinic Staff A stroke occurs when there's bleeding into your brain or when blood flow to your ... cells start dying. Seek immediate medical assistance. A stroke is a true emergency. The sooner treatment is ...

  18. Adapting the Home After a Stroke (United States)

    ... News About Neurology Image Library Search The Internet Stroke Center Patients & Families About Stroke Stroke Diagnosis Stroke ... after a Stroke Adapting the Home after a Stroke Caregiver Introduction What is Aphasia? Stroke Recovery Guides ...

  19. Diffusion-weighted magnetic resonance imaging - a new instrument in the diagnosis of Creutzfeldt-Jacob's disease

    International Nuclear Information System (INIS)

    Romi, Fredrik; Smivoll, Alf Inge; Moerk, Sverre; Tysnes, Ole-Bjoern


    Creutzfeldt-Jacob's disease (CID) is characterised by rapidly progressive dementia, ataxia, myoclonus and several other neurological deficits. It generally affects older adults and occurs in sporadic, genetic and iatrogenic forms. Death occurs usually within one year after onset of the disease. The diagnosis is based on clinical criteria, neuro physiological and radiological findings and confirmed by post mortal histopathology. During the last two years several cases of CID have been reported with diffusion-weighted magnetic resonance imaging (MR) abnormalities represented by increased signal intensity indicating reduced diffusion in basal ganglia and/or cortex cerebric. These abnormalities seem to be characteristic of CID. We report a case of CID in a 54 year old woman who developed vertigo, nystagmus, ataxia, myoclonus and dementia over a period of eight months. Diffusion-weighted magnetic resonance imaging showed increased signal intensity in corpus striatum and gyrus conguli. The diagnosis was post mortally confirmed with histopathology. (Author) 7 figs., 15 refs

  20. Serial MRI in early Creutzfeldt-Jacob disease with a point mutation of prion protein at codon 180

    International Nuclear Information System (INIS)

    Ishida, S.; Sugino, M.; Shinoda, K.; Ohsawa, N.; Koizumi, N.; Ohta, T.; Kitamoto, T.; Tateishi, J.


    We report a 66-year-old woman with histologically diagnosed Creutzfeld-Jacob disease (CJD), followed with MRI from an early clinical stage. MRI demonstrated expansion of the high cortical signal on T2-weighted images, which differs from previous MRI reports of CJD. This patient followed an atypical clinical course: 16 months had passed before she developed akinetic mutism, and periodic sharp waves had not been detected on EEG after 2 years in spite of her akinetic mutism. Brain biopsy showed primary spongiform changes in the grey matter, and a point mutation of the prion protein gene at codon 180 was discovered using polymerase chain reaction direct sequencing and Tth 111 I cutting. This is the first case with the point mutation of the codon 180 variant with an atypical clinical course and characteristic MRI findings. (orig.)

  1. Mental Suffering as a Struggle with Words

    DEFF Research Database (Denmark)

    Rosfort, René


    Human emotional life is structured and to a certain extent constituted by language, and yet making sense of and communicating how we feel is often a challenge. In this article, I will argue that a person’s struggle to make sense of and articulate her suffering plays a major role in the experience......, allows us to explore the significance of the phenomenological ambiguity of anxiety. Of particular importance in Kierkegaard’s theory is the dialectics of imagination and reality at work in anxiety, and in the concluding section, I will look at how this dialectics can help us understand how both...... the patient and the psychiatrist are challenged with the problem of finding a language for mental suffering....

  2. [Suffering and death from a philosopher's perspective]. (United States)

    Gembillo, G


    Death is a paradox. Without death we would not be. Heraclitus already knew that we exist because all that lives, ''lives of death and dies of life''. Without death the great chain of being would not exist. The Greeks called humans mortals, but Hegel taught us that to suffer means to undergo a gradual development. Pain is fight and competition, and every individual has his own threshold for pain.

  3. A problemática do cuidador familiar do portador de acidente vascular cerebral La problemática del cuidador familiar con el portador de accidente cerebral vascular The problematic aspects of the family caregiver of people who suffered strokes

    Directory of Open Access Journals (Sweden)

    Luciene Miranda de Andrade


    alta hospitalaria, 49 (29,9%. Estos resultados alertan sobre el papel del enfermero como educador, en la prevención de las enfermedades crónico degenerativas, y también la orientación dada a los cuidadores familiares sobre los cuidados a ser realizados después del alta hospitalaria.The purpose of this study was to identify the problematic aspects of the families of people who were hospitalized because of strokes, and discuss the difficulties of the family caregiver toward household care. The sample consisted of 154 families of patients admitted in a public hospital in Fortaleza, Ceará state, Brazil. The results showed that most caregivers are women, 104 (67.5%; 122 cases (79.2% showed family commitment and changes in the daily life of 115 accompanying partners (74.7%; 150 (97.4% were not instructed about the care, but 143 (92.9% felt safe to provide care. The predominant feeling was sadness, in 125 (81.2% of the subjects, and the main doubts were: eating habits, 64 (41.6%; administering medication, 49 (29.9%; and possible clinical complications after discharge, 49 (29.9%. These results are worth noting for the nurse's role as an educator, not only regarding the prevention of chronic-degenerative diseases, but also concerning delivering instructions to family caregivers about providing care after hospital discharge.

  4. Een liefdespaar onthuld: Jacob Adriaensz Backer's zogenoemde 'David en Bathseba' opnieuw geïdentificeerd als 'Isaäk en Rebekka'

    NARCIS (Netherlands)

    Kok, E.


    Jacob Backer signed and dated (1640) a history piece that until now was entitled David and Bathsheba and is located in Tokyo. The image however, lacks the traditional iconographical motifs from which we can recognize this old biblical story.In this article I propose that the painting is a portrait

  5. The Critical Pedagogical Potential of Using Jacob A. Riis' Works about the Immigrant Poor in "Gilded Age" New York (United States)

    Templer, Bill


    The article seeks to contribute to working-class and social justice pedagogy by developing concrete angles on teaching/exploring some of the (a) short fiction, (b) journalistic-photographic work and (c) sociography of poverty by the Danish-born US immigrant, muckraker ( and social reformer Jacob A. Riis (1849-1914,…

  6. Perlecan domain V therapy for stroke: a beacon of hope? (United States)

    Bix, Gregory J


    The sad reality is that in the year 2012, people are still dying or suffering from the extreme morbidity of ischemic stroke. This tragedy is only compounded by the graveyard full of once promising new therapies. While it is indeed true that the overall mortality from stroke has declined in the United States, perhaps due to increased awareness of stroke symptoms by both the lay public and physicians, it is clear that better therapies are needed. In this regard, progress has been tremendously slowed by the simple fact that experimental models of stroke and the animals that they typically employ, rats and mice, do not adequately represent human stroke. Furthermore, the neuroprotective therapeutic approach, in which potential treatments are administered with the hope of preventing the spread of dying neurons that accompanies a stroke, typically fail for a number of reasons such as there is simply more brain matter to protect in a human than there is in a rodent! For this reason, there has been somewhat of a shift in stroke research away from neuroprotection and toward a neurorepair approach. This too may be problematic in that agents that might foster brain repair could be acutely deleterious or neurotoxic and vice versa, making the timing of treatment administration after stroke critical. Therefore, in our efforts to discover a new stroke therapy, we decided to focus on identifying brain repair elements that were (1) endogenously and actively generated in response to stroke in both human and experimental animal brains, (2) present acutely and chronically after ischemic stroke, suggesting that they could have a role in acute neuroprotection and chronic neurorepair, and (3) able to be administered peripherally and reach the site of stroke brain injury. In this review, I will discuss the evidence that suggests that perlecan domain V may be just that substance, a potential beacon of hope for stroke patients.

  7. Experimental and analytical investigation on metal damage suffered from simulated lightning currents (United States)

    Yakun, LIU; Zhengcai, FU; Quanzhen, LIU; Baoquan, LIU; Anirban, GUHA


    The damage of two typical metal materials, Al alloy 3003 and steel alloy Q235B, subjected to four representative lightning current components are investigated by laboratory and analytical studies to provide fundamental data for lightning protection. The four lightning components simulating the natural lightning consist of the first return stroke, the continuing current of interval stroke, the long continuing current, and the subsequent stroke, with amplitudes 200 kA, 8 kA, 400 A, and 100 kA, respectively. The damage depth and area suffered from different lightning components are measured by the ultrasonic scanning system. And the temperature rise is measured by the thermal imaging camera. The results show that, for both Al 3003 and steel Q235B, the first return stroke component results in the largest damage area with damage depth 0.02 mm uttermost. The long continuing current component leads to the deepest damage depth of 3.3 mm for Al 3003 and much higher temperature rise than other components. The correlation analysis between damage results and lightning parameters indicates that the damage depth has a positive correlation with charge transfer. The damage area is mainly determined by the current amplitude and the temperature rise increases linearly with the charge transfer larger.

  8. Airplane stroke syndrome. (United States)

    Humaidan, Hani; Yassi, Nawaf; Weir, Louise; Davis, Stephen M; Meretoja, Atte


    Only 37 cases of stroke during or soon after long-haul flights have been published to our knowledge. In this retrospective observational study, we searched the Royal Melbourne Hospital prospective stroke database and all discharge summaries from 1 September 2003 to 30 September 2014 for flight-related strokes, defined as patients presenting with stroke within 14days of air travel. We hypothesised that a patent foramen ovale (PFO) is an important, but not the only mechanism, of flight-related stroke. We describe the patient, stroke, and flight characteristics. Over the study period, 131 million passengers arrived at Melbourne airport. Our centre admitted 5727 stroke patients, of whom 42 (0.73%) had flight-related strokes. Flight-related stroke patients were younger (median age 65 versus 73, p<0.001), had similar stroke severity, and received intravenous thrombolysis more often than non-flight-related stroke patients. Seven patients had flight-related intracerebral haemorrhage. The aetiology of the ischaemic strokes was cardioembolic in 14/35 (40%), including seven patients with confirmed PFO, one with atrial septal defect, four with atrial fibrillation, one with endocarditis, and one with aortic arch atheroma. Paradoxical embolism was confirmed in six patients. Stroke related to air travel is a rare occurrence, less than one in a million. Although 20% of patients had a PFO, distribution of stroke aetiologies was diverse and was not limited to PFO and paradoxical embolism. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. The image of a brain stroke in a computed tomograph

    International Nuclear Information System (INIS)

    Just, E.G.


    On the basis of 100 findings from patients who suffered brain strokes and by the use of 1500 ensured stroke images it was tested whether or not the stroke-predilection typologie outlined by Zuelch is based on a coincidental summation of individual cases. The radio-computed tomography with the possibility of evaluation of non-lethal cases proved itself as a suited method for confirmation or repudiation of this stroke theory. By means of the consistently achieved association of the frontal, respectively horizontal sectional image for the typology it could be proven and - with the exception of a few rather seldom types - also demonstrated that the basic and predilection types of brain stroke repeated themselves in their pattern. In individual cases a specification of lower types could also be undertaken. (orig./TRV) [de

  10. Risks for Heart Disease & Stroke (United States)

    ... Risks for Heart Disease & Stroke Risks for Heart Disease & Stroke About 1.5 million heart attacks and strokes ... the Centers for Disease Control and Prevention: Heart Disease Stroke High Blood Pressure Cholesterol Salt Video: Know Your ...

  11. Test Your Stroke Knowledge (United States)

    ... 9-1-1. Which of the following are risk factors for stroke? High blood pressure Heart disease Smoking High cholesterol Diabetes Show Answer All of these are risk factors for stroke. If you smoke - quit. If you have high ...

  12. Heart and Stroke Encyclopedia (United States)

    ... Thromboembolism Aortic Aneurysm More The Heart and Stroke Encyclopedia Click a letter below to get a brief ... of cardiovascular terms from our Heart and Stroke Encyclopedia and get links to in-depth information. A ...

  13. Stroke Connection Magazine (United States)

    ... Resources Submit A Story Edit Module Show Tags Stroke Rehabilitation Two-Part Series Making the Best Decisions at ... first part of a two-part series on stroke rehab, we offer guidance for the decision-making process ...

  14. Stroke (For Kids) (United States)

    ... your friend. Being around friends can help with healing. Preventing Strokes Some strokes can be prevented in ... Why Does Hair Turn Gray? What Are Wrinkles? Alzheimer Disease Your Brain & Nervous System Why Exercise Is ...

  15. Stroke Trials Registry (United States)

    ... News About Neurology Image Library Search The Internet Stroke Center Trials Registry Clinical Trials Interventions Conditions Sponsors ... a clinical trial near you Welcome to the Stroke Trials Registry Our registry of clinical trials in ...

  16. [Pain and suffering, in the footsteps of Paul Ricoeur]. (United States)

    Svandra, Philippe


    Understanding pain, enduring it, accepting it or detaching oneself from it: numerous philosophers have tackled this task. For suffering is existing. Suffering is part of life. Paul Ricoeur postulates a distinction between pain and suffering which relates pain to the body and suffering to reflexivity, language or the relationship with oneself. Suffering thereby becomes that through which I recognize myself and I recognize the Other.

  17. Progestins in HRT: sufferance or desire?

    DEFF Research Database (Denmark)

    Skouby, Sven O; Jespersen, Joergen


    's International Study of Long-duration (O)estrogen after Menopause the question can be raised: When dealing with optimal hormonal therapy after the menopause, is the progestin component accepted here on sufferance or is it desired? The answer is partly made up by the fact that the recent epidemiological data may...... the progestins result in a variety of tissue transforming changes as well as metabolic and hemostatic changes. Since no single test or algorithm presently serves as golden standard for all desired hormonal effects the least changes or no changes from the premenopausal physiology may often be advantageous. In our....... With special reference to cardiovascular disease this review therefore makes a plea for differentiating between the array of chemically and functionally distinct progestins used therapeutically after the menopause in combination therapy....

  18. [Bilateral acetabulum fracture after suffering sport trauma]. (United States)

    Trost, P; Kollersbeck, C; Pelitz, M; Walcher, T; Genelin, F


    This case study describes a 37-year-old male who suffered a bilateral transverse acetabulum fracture with a fracture of the posterior wall and a double-sided dorsal hip dislocation in combination with a left-sided femoral head fracture (Pipkin IV) while skiing in a "fun park". The accurate diagnosis and presurgical planning was made by means of a computed tomography (CT) scan and a subsequent 3D reconstruction. After a primarily executed shielded repositioning of the bilateral hip dislocationearly secondary and anatomical reconstruction of the double-sided acetabulum fracture was possible using the Kocher-Langenbeck approach. A consistent physiotherapy as well as rehabilitation finally led to a positive clinical result for the patient.

  19. Pity, modernity and the spectacle of suffering. (United States)

    Radley, Alan


    The concept of dignity is often invoked in relation to ideas about a "good" death and, indeed, a "good" life. In this article, I discuss the question of dignity in relation to the rights of the individual in the modern world. This world is one where the relationship of individuals to society is contested in the context of medicine, with all its technologies of treatment and uncertainties of prognosis. For patients who criticize or oppose medicine in order to recover their dignity, it is necessary to articulate or to portray their suffering. In this way, they are able to show not only that they live in spite of illness, but that they also live by virtue of it. From this perspective, dignity is shown to be part of a collective response to a medicalized world in which ideas about illness and health are also being transformed.

  20. [Genetics of ischemic stroke]. (United States)

    Gschwendtner, A; Dichgans, M


    Stroke is one of the most widespread causes of mortality und disability worldwide. Around 80 % of strokes are ischemic and different forms of intracranial bleeding account for the remaining cases. Monogenic stroke disorders are rare but the diagnosis may lead to specific therapeutic consequences for the affected patients who are predominantly young. In common sporadic stroke, genetic factors play a role in the form of susceptibility genes. Their discovery may give rise to new therapeutic options in the future.

  1. Hemorrhagic Stroke in Children


    Jordan M.D., Lori C.; Hillis M.D., Argye E.


    Hemorrhagic stroke accounts for approximately half of stroke in childhood. Unlike arterial ischemic stroke, there are no consensus guidelines to assist in the evaluation and treatment of these children. We review the literature on the evaluation, treatment, etiology and neurologic outcome of hemorrhagic stroke in children. Important differences between pediatric and adult hemorrhage are highlighted, as treatment guidelines for adults may not be applicable in all cases. Needed future research ...

  2. Dynamic Facial Prosthetics for Sufferers of Facial Paralysis

    Directory of Open Access Journals (Sweden)

    Fergal Coulter


    Full Text Available BackgroundThis paper discusses the various methods and the materialsfor the fabrication of active artificial facial muscles. Theprimary use for these will be the reanimation of paralysedor atrophied muscles in sufferers of non-recoverableunilateral facial paralysis.MethodThe prosthetic solution described in this paper is based onsensing muscle motion of the contralateral healthy musclesand replicating that motion across a patient’s paralysed sideof the face, via solid state and thin film actuators. Thedevelopment of this facial prosthetic device focused onrecreating a varying intensity smile, with emphasis ontiming, displacement and the appearance of the wrinklesand folds that commonly appear around the nose and eyesduring the expression.An animatronic face was constructed with actuations beingmade to a silicone representation musculature, usingmultiple shape-memory alloy cascades. Alongside theartificial muscle physical prototype, a facial expressionrecognition software system was constructed. This formsthe basis of an automated calibration and reconfigurationsystem for the artificial muscles following implantation, soas to suit the implantee’s unique physiognomy.ResultsAn animatronic model face with silicone musculature wasdesigned and built to evaluate the performance of ShapeMemory Alloy artificial muscles, their power controlcircuitry and software control systems. A dual facial motionsensing system was designed to allow real time control overmodel – a piezoresistive flex sensor to measure physicalmotion, and a computer vision system to evaluate real toartificial muscle performance.Analysis of various facial expressions in real subjects wasmade, which give useful data upon which to base thesystems parameter limits.ConclusionThe system performed well, and the various strengths andshortcomings of the materials and methods are reviewedand considered for the next research phase, when newpolymer based artificial muscles are constructed

  3. Dysphagia Post Subcortical and Supratentorial Stroke. (United States)

    Wan, Ping; Chen, Xuhui; Zhu, Lequn; Xu, Shuangjin; Huang, Li; Li, Xiangcui; Ye, Qing; Ding, Ruiying


    Studies have recognized that the damage in the subcortical and supratentorial regions may affect voluntary and involuntary aspects of the swallowing function. The current study attempted to explore the dysphagia characteristics in patients with subcortical and supratentorial stroke. Twelve post first or second subcortical and supratentorial stroke patients were included in the study. The location of the stroke was ascertained by computed tomography and magnetic resonance imaging. The characteristics of swallowing disorder were assessed by video fluoroscopic swallowing assessment/fiberoptic endoscopic evaluation of swallowing. The following main parameters were analyzed: oral transit time, pharyngeal delay time, presence of cricopharyngeal muscle achalasia (CMA), distance of laryngeal elevation, the amounts of vallecular residue and pyriform sinus residue (PSR), and the extent of pharyngeal contraction. Eighty-three percent of the 12 patients were found suffering from pharyngeal dysphagia, with 50% having 50%-100% PSRs, 50% having pharyngeal delay, and 41.6% cases demonstrating CMA. Simple regression analysis showed PSRs were most strongly associated with CMA. Pharyngeal delay in the study can be caused by infarcts of basal ganglia/thalamus, infarcts of sensory tract, infarcts of swallowing motor pathways in the centrum semiovale, or a combination of the three. Subcortical and supratentorial stroke may result in pharyngeal dysphagia such as PSR and pharyngeal delay. PSR was mainly caused by CMA. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  4. Ahead of his time: Jacob Lipman's 1930 estimate of atmospheric sulfur deposition for the conterminous United States (United States)

    Landa, Edward R.; Shanley, James B.


    A 1936 New Jersey Agricultural Experiment Station Bulletin provided an early quantitative assessment of atmospheric deposition of sulfur for the United States that has been compared in this study with more recent assessments. In the early 20th century, anthropogenic sulfur additions from the atmosphere to the soil by the combustion of fossil fuels were viewed as part of the requisite nutrient supply of crops. Jacob G. Lipman, the founding editor of Soil Science, and his team at Rutgers University, made an inventory of such additions to soils of the conterminous United States during the economic depression of the 1930s as part of a federally funded project looking at nutrient balances in soils. Lipman's team gathered data compiled by the US Bureau of Mines on coal and other fuel consumption by state and calculated the corresponding amounts of sulfur emitted. Their work pioneered a method of assessment that became the norm in the 1970s to 1980s—when acid rain emerged as a national issue. Lipman's estimate of atmospheric sulfur deposition in the 1930 is in reasonable agreement with recent historic reconstructions.

  5. Major stroke in a 19-year-old patient with a univentricular heart

    DEFF Research Database (Denmark)

    Riemann, Mads; Idorn, Lars; Wagner, Aase


    Patients with univentricular heart malformations are at increased risk of suffering from thromboembolic events. We present a case of a 19-year-old woman born with a univentricular heart who suffered a major stroke while being treated with only salicylic acid. At least 20% of patients...

  6. Practical wisdom: competencies required in alleviating suffering in palliative care. (United States)

    Ohlén, Joakim


    The aim of this article is to reflect upon the competencies required to alleviate suffering in palliative care. The knowledge to prudently and wisely act in a situation involving human relationships can be defined in terms of practical abilities and contextual skills. In the setting of the care of the very ill and dying, practical wisdom such as the carer's ability to meet the suffering person and to act with sensitivity and openness, becomes important. From this, learning to alleviate suffering emerges as receiving insight and wisdom from the suffering person's experience of suffering. This means that the testimony of suffering persons--what they have endured, given up and experienced--becomes as significant as theoretical and practical knowledge of suffering. The professional carer needs to learn how to be open to and interpret what the suffering person, living with suffering and death in the midst of life, can teach.

  7. Psychological vulnerability and problem gambling: an application of Durand Jacobs' general theory of addictions to electronic gaming machine playing in Australia. (United States)

    McCormick, Jessica; Delfabbro, Paul; Denson, Linley A


    The aim of this study was to conduct an empirical investigation of the validity of Jacobs' (in J Gambl Behav 2:15-31, 1986) general theory of addictions in relation to gambling problems associated with electronic gaming machines (EGM). Regular EGM gamblers (n = 190) completed a series of standardised measures relating to psychological and physiological vulnerability, substance use, dissociative experiences, early childhood trauma and abuse and problem gambling (the Problem Gambling Severity Index). Statistical analysis using structural equation modelling revealed clear relationships between childhood trauma and life stressors and psychological vulnerability, dissociative-like experiences and problem gambling. These findings confirm and extend a previous model validated by Gupta and Derevensky (in J Gambl Stud 14: 17-49, 1998) using an adolescent population. The significance of these findings are discussed for existing pathway models of problem gambling, for Jacobs' theory, and for clinicians engaged in assessment and intervention.

  8. Sex Disparities in Stroke

    DEFF Research Database (Denmark)

    Dehlendorff, Christian; Andersen, Klaus Kaae; Olsen, Tom Skyhøj


    between 2003 and 2012 (N=79 617), and the Danish Register of Causes of Death. Information was available on age, sex, marital status, stroke severity, stroke subtype, socioeconomic status, and cardiovascular risk profile. We studied only deaths due to the index stroke, with the assumption that death.......5%) or 1 month (6.9%), respectively. After the age of 60 years, women had more severe strokes than men. Up to ages in the mid-60s, no difference in the risk of death from stroke was seen between the 2 sexes. For people aged >65 years, however, the risk gradually became greater in men than in women...

  9. Neuropsychology and the relearning of motor skills following stroke

    NARCIS (Netherlands)

    Hochstenbach, J; Mulder, T

    Regaining independent mobility is one of the most important goals in physical therapy with patients suffering from the consequences of stroke. Both physical therapy and occupational therapy are learning processes in which the patient has to remaster old skills or has to learn novel skills. It is

  10. Top of the basilar artery embolic stroke and neonatal myoclonus

    NARCIS (Netherlands)

    Govaert, Paul; Dudink, Jeroen; Visser, Gerhard; Breukhoven, Petra; Vanhatalo, Sampsa; Lequin, Maarten

    Cerebellar stroke has been virtually unreported in the living newborn infant. A term newborn male weighing 3380g at birth suffered myoclonic seizures within 24 hours of birth by spontaneous vaginal delivery. Apgar scores were 3 and 4 at 1 and 5 minutes. Myoclonus persisted for 9 days, responding

  11. Cranial Computerized Tomography In The Evaluation Of Stroke ...

    African Journals Online (AJOL)

    206 patients clinically diagnosed as stroke / cerebrovascular accidents (CVA) were investigated using computerized tomography (CT) scan. 19 patients (9%) had normal scan. While 20(9.7%) had other lesions including atrophy and tumours. Of the 167 (18. %) patients proven to have suffered a cerebro- vascular accident ...

  12. Clinical Epidemiology Of Stroke

    Directory of Open Access Journals (Sweden)

    Nagaraja D


    Full Text Available Stroke is a huge public health problem because of its high morbidity and disability. The epidemiology of stroke is of relevance to construct practical paradigms to tackle this major health issue in the community. Recent data have shown that about 72-86% of strokes are ischemic, 9-18% are due to hemorrhage (intracerebral of subarachnoid and the rest are undefined. The risk factors for stroke are multiple and combined. At present, stroke is no more considered as unavoidable and untreatable. It is an emergency and specialized units and teams improve outcome and lower costs. Death related to stroke is declining in many countries and in both sexes. This decrease in multifactorial. The detection and more effective treatment of hypertension may play an important factor, as well as the improved medical care and improvement in diagnostic procedures. While stroke incidence appears stable and stroke mortality is slowly declining, the absolute magnitude of stroke is likely to grow over the next 30 years. as the population ages, the absolute number of stroke victims and demands on healthcare and other support systems is likely to increase substantially in the future. Keeping this in perspective, this chapter shall focus on the epidemiology of stroke in the world and in Indian, in particular.

  13. Registration of acute stroke

    DEFF Research Database (Denmark)

    Wildenschild, Cathrine; Mehnert, Frank; Thomsen, Reimar Wernich


    BACKGROUND: The validity of the registration of patients in stroke-specific registries has seldom been investigated, nor compared with administrative hospital discharge registries. The objective of this study was to examine the validity of the registration of patients in a stroke-specific registry...... (The Danish Stroke Registry [DSR]) and a hospital discharge registry (The Danish National Patient Registry [DNRP]). METHODS: Assuming that all patients with stroke were registered in either the DSR, DNRP or both, we first identified a sample of 75 patients registered with stroke in 2009; 25 patients...... in the DSR, 25 patients in the DNRP, and 25 patients registered in both data sources. Using the medical record as a gold standard, we then estimated the sensitivity and positive predictive value of a stroke diagnosis in the DSR and the DNRP. Secondly, we reviewed 160 medical records for all potential stroke...

  14. Sleep and Stroke

    Directory of Open Access Journals (Sweden)

    M V Padma Srivastav


    Full Text Available Circadian variations in conjunction with sleep-related heart rhythm changes and sleepdisordered breathing (SDB are contributing risk factors for stroke. Strong scientificevidence now exists indicating that SDB contributes to systemic hypertension, aprominent risk factor for stroke, and compelling circumstantial evidence is presentsuggesting that SDB raises the risk for development of stroke through other circulatorymechanisms as well. Preliminary evidence indicates that post-stroke patients have ahigher prevalence of SDB, which is likely to compromise their rehabilitation outcomes.Since SDB is modifiable with the application of CPAP and other treatment modalities,there is practical value in investigating patients at risk of stroke or post stroke forpresence of SDB. Successful application of CPAP or BiPAP therapy may improve theoutcome in both instances.Key words : Sleep, Stroke, SDB, CPAP

  15. Wake-up stroke-Amendable for thrombolysis-like stroke with known onset time? (United States)

    Kurz, M W; Advani, R; Behzadi, G N; Eldøen, G; Farbu, E; Kurz, K D


    Patients suffering an acute ischemic stroke can be treated with intravenous thrombolysis in the absence of contraindications. A known onset time is a prerequisite as treatment, according to guidelines, has to be started within 4.5 hours. In patients awakening with a stroke, the last time they were seen without a neurological deficit is assumed to be the time of onset. Thus, despite of lack of contraindications on initial brain imaging, these patients are largely excluded from therapy. This review discusses the underlying pathophysiological, clinical, and radiological evidence surrounding wake-up stroke and its consequences for making treatment decisions. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Acute ischemic stroke--from symptom recognition to thrombolysis. (United States)

    Kurz, M W; Kurz, K D; Farbu, E


    The understanding of stroke has changed in the recent years from rehabilitation to an emergency approach. We review existing data from symptom recognition to thrombolysis and identify challenges in the different phases of patient treatment. Implementation of treatment in dedicated stroke units with a multidisciplinary team exclusively treating stroke patients has led to significant reduction of stroke morbidity and mortality. Yet, first the introduction of treatment with intravenous rtPA (IVT) has led to the 'time is brain' concept where stroke is conceived as an emergency. As neuronal death in stroke is time dependent, all effort should be laid on immediate symptom recognition, rapid transport to the nearest hospital with a stroke treatment facility and diagnosis and treatment as soon as possible. The main cause of prehospital delay is that patients do not recognize that they suffered a stroke or out of other reasons do not call the Emergency Medical Services immediately. Educational stroke awareness campaigns may have an impact in increasing the number of patients eligible for rtPA treatment and can decrease the prehospital times if they are directed both to the public and to the medical divisions treating stroke. Stroke transport times can be shortened by the use of helicopter and a stroke mobile--an ambulance equipped with a CT scanner--may be helpful to decrease time from onset to treatment start in the future. Yet, IVT has several limitations such as a narrow time window and a weak effect in ischemic strokes caused by large vessel occlusions. In these cases, interventional procedures and the concept of bridging therapy, a combined approach of IVT and intraarterial thrombolysis or mechanical thrombectomy, might improve recanalization rates and patient outcome. As neuronal death in stroke patients occurs in a time-dependent fashion, all effort should be made to decrease time from symptom onset to treatment start with rtPA: major challenges are stroke

  17. Drug Abuse as an Emanating Risk for Stroke in Young Adults. (United States)

    Sulena; Sharma, Anjani Kumar


    Drug abuse is a substantial risk factor for stroke among patients under 45 years of age and ranks second among the most commonly identified potential risk factors. Drug abusers aged 15 to 44 years are 6.5 times more likely to have a stroke than non drug users. Stroke occurring in persons under 45 years of age accounts for only 4% of all strokes but causes an enormous toll in personal suffering, lost productivity, and health care costs. © Journal of the Association of Physicians of India 2011.

  18. Meta-Analysis of Perioperative Stroke and Mortality in Transcatheter Aortic Valve Implantation. (United States)

    Muralidharan, Aditya; Thiagarajan, Karthy; Van Ham, Raymond; Gleason, Thomas G; Mulukutla, Suresh; Schindler, John T; Jeevanantham, Vinodh; Thirumala, Parthasarathy D


    Transcatheter aortic valve implantation (TAVI) is a rapidly evolving safe method with decreasing incidence of perioperative stroke. There is a void in literature concerning the impact of stroke after TAVI in predicting 30-day stroke-related mortality. The primary aim of this meta-analysis was to determine whether perioperative stroke increases risk of stroke-related mortality after TAVI. Online databases, using relevant keywords, and additional related records were searched to retrieve articles involving TAVI and stroke after TAVI. Data were extracted from the finalized studies and analyzed to generate a summary odds ratio (OR) of stroke-related mortality after TAVI. The stroke rate and stroke-related mortality rate in the total patient population were 3.07% (893 of 29,043) and 12.27% (252 of 2,053), respectively. The all-cause mortality rate was 7.07% (2,053 of 29,043). Summary OR of stroke-related mortality after TAVI was estimated to be 6.45 (95% confidence interval 3.90 to 10.66, p York Heart Association class III/IV status, previous stroke, valve type, and implantation route. All failed to exhibit any significant associations with the OR. In conclusion, perioperative strokes after TAVI are associated with >6 times greater risk of 30-day stroke-related mortality. Transapical TAVI is not associated with increased stroke-related mortality in patients who suffer from perioperative stroke. Preventative measures need to be taken to alleviate the elevated rates of stroke after TAVI and subsequent direct mortality. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Stroke in Commercial Flights. (United States)

    Álvarez-Velasco, Rodrigo; Masjuan, Jaime; DeFelipe, Alicia; Corral, Iñigo; Estévez-Fraga, Carlos; Crespo, Leticia; Alonso-Cánovas, Araceli


    Stroke on board aircraft has been reported in retrospective case series, mainly focusing on economy class stroke syndrome. Data on the actual incidence, pathogenesis, and prognosis of stroke in commercial flights are lacking. A prospective registry was designed to include all consecutive patients referred from an international airport (40 million passengers a year) to our hospital with a diagnosis of ischemic stroke or transient ischemic attack and onset of symptoms during a flight or immediately after landing. Forty-four patients (32 ischemic strokes and 12 transient ischemic attacks) were included over a 76-month period (January 2008 to April 2014). The estimated incidence of stroke was 1 stroke in 35 000 flights. Pathogeneses of stroke or transient ischemic attack were atherothrombotic in 16 (36%), economy class stroke syndrome in 8 (18%), cardioembolic in 7 (16%), arterial dissection in 4 (9%), lacunar stroke in 4 (9%), and undetermined in 5 (12%) patients. Carotid stenosis >70% was found in 12 (27%) of the patients. Overall prognosis was good, and thrombolysis was applied in 44% of the cases. The most common reason for not treating patients who had experienced stroke onset midflight was the delay in reaching the hospital. Only 1 patient with symptom onset during the flight prompted a flight diversion. We found a low incidence of stroke in the setting of air travel. Economy class stroke syndrome and arterial dissection were well represented in our sample. However, the main pathogenesis was atherothrombosis with a high proportion of patients with high carotid stenosis. © 2016 American Heart Association, Inc.

  20. Stroke And Substance Abuse

    Directory of Open Access Journals (Sweden)

    A Chitsaz


    Full Text Available Introduction: stroke in recreational substance users can be an indirect complication, like endocarditis and cardio embolism in parenteral drug users. With some drug like cocaine, stroke appear to be the result of a direct effect. In young subjects without other risk factors provide persuasive evidence for causality . OPIATES: Heroine is the most abused opiate drug, which is administered by injection, by snorting or by smoking. Stroke affects heroin users by diverse mechanisms,. Injectors are at risk of infections endocarditis, which carries risk for both ischemic and hemorrhagic stroke. Cerebral or subarachnoid hemorrhage usually occurs after rupture of a septic (mycotic aneurysm. Heroine users can are also at risk for hemorrhagic stroke secondary to liver failure with deranged clotting and to heroin nephropathy with uremia or malignant hypertension. In some heroin users the drug it self is directly causal due to vasculitis, hypersensitivity and immunologic changes. Embolization of foreign material to brain due to mixed of heroine with quinine can cause cerebral embolism. AMPHETAMINE AND other psychostimulants: In abuser of amphetamine hemorrhagic stroke can occur, oral, intravenous, nasal, and inhalational routes of administration have been reported. Most were chronic user, but in several patients, stroke followed a first exposure. Some of amphetamine induced intracranial hemorrhages are secondary to acute hypertension, some to cerebral vacuities, and some to a combination of two. Decongestants and diet pills: Phenylpropanolamine (PPA, an amphetamine – like drug, in decongestants and diet pills, induce acute hypertension, sever headache, psychiatric symptoms, seizures and hemorrhagic stroke. Ephedrine and pseudo ephedrine are present in decongestants and bronchodilators and induce headache, tachyarrhythmia, hypertensive emergency, and hemorrhagic and occlusive stroke. Ecstasy, 3,4 Methylenedioxymethamphetamin (MDMA with amphetamine like can

  1. Iconography and Politics in South Africa: the representation of Nelson Mandela, Thabo Mbeki and Jacob Zuma in cartoons of Zapiro

    Directory of Open Access Journals (Sweden)

    Renata de Paula dos Santos


    Full Text Available Mandela’s victory in the 1994 elections in South Africa is a reference point for South African history and represented the transition from apartheid to multiracial democracy. Since then Nelson Mandela (1994-1999, Thabo Mbeki (1999-2008 and Jacob Zuma (2009 - current, occupied the post of president of the country and led, each in its own way, the new direction of the country. During the nearly twenty years of multiracial democracy, one in particular cartoonist, Jonathan Shapiro, popularly known by the pseudonym Zapiro, portrayed the everyday life of this story. In this sense, the objective of this research is to analyze how Zapiro portrayed the political and social aspects, as well as the psychological characteristics of each of the three postapartheid presidents and which social representations are formed from their cartoon production. The choice of Zapiro explained by openly declared his opposition to apartheid and also for being the best known outside South African cartoonist. We elected to cartoon as an object of study because it is an iconographic object constituted by communicative humor, which adds to its constitution arguments transgression of the established order, enabling an analysis of South African history through a critical bias. As methods for the development of the work, we decided to gather historical research, the literature search and analysis of cartooon speech. Among the theoretical frameworks stand out Magnoli (1998, 2009, Jonge (1991 and Carlin (2009 in the South African question; reflections about social representations, we resort to Moscovici (2011 and Jodelet (1993, in the field the cartoon and humor, the references are Miani (2005; 2012, Romualdo (2000 and Eco (1989. With the completion of the analysis, we observed that Zapiro acts in different ways in the construction of the representation of each of the presidents in question and that the cartoonist presents Mandela as a competent leader marked by heroism and

  2. Sequential strokes in a hyperacute stroke unit. (United States)

    Ganesalingam, Jeban; Buddha, Sandeep; Carlton-Jones, Anoma L; Nicholas, Richard


    Vasculitis is a rare, but treatable condition that can present to hyperacute stroke units. Thrombolysis does not treat the underlying pathology, and a rapidly evolving clinical picture drives clinical decision often before all the investigation results are available.

  3. Improved nutritional status in elderly patients 6 months after stroke

    DEFF Research Database (Denmark)

    Brynningsen, P K; Damsgaard, Else Marie; Husted, Steen


    INTRODUCTION: Nutritional status among stroke patients has received limited attention despite the fact, that it may have an influence on clinical outcome. Previous studies have estimated that 15-20 % of patients suffer from malnutrition in the acute phase of stroke, but so far no studies have...... focused on the late rehabilitation phase after stroke in the patients own home, where the attention on nutrition may be reduced. AIMS: To determine the prevalence of malnutrition during 6 months of stroke rehabilitation, and to investigate the association between nutritional status, functional recovery...... and 6 months. Nutritional status was evaluated by body weight, body mass index (BMI), mid upper arm circumference (MAC), triceps skinfold thickness (TSF) and serum concentrations of albumin and transferrin. Malnutrition was defined if the patients had 2 or more abnormal nutritional variables. RESULTS...

  4. Blood Pressure Control: Stroke and Stroke Prevention

    Directory of Open Access Journals (Sweden)

    Hans-Christoph Diener


    Full Text Available Hypertension is the most important modifiable risk factor for primary and secondary stroke prevention.All antihypertensive drugs are effective in primary prevention: the risk reduction for stroke is 30—42%. However, not all classes of drugs have the same effects: there is some indication that angiotensin receptor blockers may be superior to other classes of antihypertensive drugs in stroke prevention.Seventy-five percent of patients who present to hospital with acute stroke have elevated blood pressure within the first 24—48 hours. Extremes of systolic blood pressure (SBP increase the risk of death or dependency. The aim of treatment should be to achieve and maintain the SBP in the range 140—160 mmHg. However, fast and drastic blood pressure lowering can have adverse consequences.The PROGRESS trial of secondary prevention with perindopril + indapamide versus placebo + placebo showed a decrease in numbers of stroke recurrences in patients given both active antihypertensive agents, more impressive for cerebral haemorrhage.There were also indications that active treatment might decrease the development of post-stroke dementia.

  5. Knowledge of Stroke Risk Factors among Stroke Survivors in Nigeria


    Grace Vincent-Onabajo; Taritei Moses


    Background. Knowledge of stroke risk factors is expected to reduce the incidence of stroke?whether first-ever or recurrent. This study examined knowledge of stroke risk factors and its determinants among stroke survivors. Methods. A cross-sectional survey of consenting stroke survivors at two physiotherapy facilities in Nigeria was carried out. Sociodemographic and clinical data were obtained and knowledge of stroke risk factors (defined as the ability to mention at least one correct risk fac...

  6. European Stroke Science Workshop (United States)

    Mattle, Heinrich P.; Brainin, Michael; Chamorro, Angel; Diener, Hans Christoph; Hacke, Werner; Leys, Didier; Norrving, Bo; Ward, Nick


    The European Stroke Organisation (ESO) held its first European Stroke Science Workshop in Garmisch-Partenkirchen, Germany (15-17 December 2011). Stroke experts based in Europe were invited to present and discuss their current research. The scope of the workshop was to review the most recent findings of selected topics in stroke, to exchange ideas, to stimulate new research and to enhance collaboration between European stroke research groups. Seven scientific sessions were held, each starting with a keynote lecture to review the state of the art of the given topic, followed by 4 or 5 short presentations by experts. They were asked to limit their presentations to 10 slides containing only recent information. The meeting was organized by the executive committee of the ESO (Heinrich Mattle, chairman, Michael Brainin, Angel Chamorro, Werner Hacke, Didier Leys) and supported by the European Stroke Conference (Michael Hennerici). In this article we summarize the main contents of this successful workshop. PMID:22836350

  7. Religious Perspectives on Human Suffering: Implications for Medicine and Bioethics. (United States)

    Fitzpatrick, Scott J; Kerridge, Ian H; Jordens, Christopher F C; Zoloth, Laurie; Tollefsen, Christopher; Tsomo, Karma Lekshe; Jensen, Michael P; Sachedina, Abdulaziz; Sarma, Deepak


    The prevention and relief of suffering has long been a core medical concern. But while this is a laudable goal, some question whether medicine can, or should, aim for a world without pain, sadness, anxiety, despair or uncertainty. To explore these issues, we invited experts from six of the world's major faith traditions to address the following question. Is there value in suffering? And is something lost in the prevention and/or relief of suffering? While each of the perspectives provided maintains that suffering should be alleviated and that medicine's proper role is to prevent and relieve suffering by ethical means, it is also apparent that questions regarding the meaning and value of suffering are beyond the realm of medicine. These perspectives suggest that medicine and bioethics have much to gain from respectful consideration of religious discourse surrounding suffering.

  8. Stroke patients who regain urinary continence in the first week after acute first-ever stroke have better prognosis than patients with persistent lower urinary tract dysfunction. (United States)

    Rotar, Melita; Blagus, Rok; Jeromel, Miran; Skrbec, Miha; Tršinar, Bojan; Vodušek, David B


    Urinary incontinence (UI) is a predictor of greater mortality and poor functional recovery; however published studies failed to evaluate lower urinary tract (LUT) function immediately after stroke. The aim of our study was to evaluate the course of LUT function in the first week after stroke, and its impact on prognosis. We included 100 consecutively admitted patients suffering first-ever stroke and evaluated them within 72 hours after stroke, after 7 days, 6 months, and 12 months. For LUT function assessment we used ultrasound measurement. The patients were divided into three groups: (i) patients who remained continent after stroke, (ii) patients who had LUT dysfunction in the acute phase but regained continence in the first week, and (iii) patients who did not regain normal LUT control in the first week. We assessed the influence of variables on death using the multiple logistic regression model. Immediately after stroke 58 patients had LUT dysfunction. The odds of dying in group with LUT dysfunction were significantly larger than odds in group without LUT dysfunction. Odds for death for patients who regained LUT function in 1 week after stroke were comparable to patients without LUT dysfunction. We confirmed that post-stroke UI is a predictor of greater mortality at 1 week, 6 months and 12 months after stroke. However, patients who regain normal bladder control in the first week have a comparable prognosis as the patients who do not have micturition disturbances following stroke. Copyright © 2011 Wiley-Liss, Inc.

  9. The Importance of Patient Involvement in Stroke Rehabilitation (United States)


    Objective To investigate the perceived needs for health services by persons with stroke within the first year after rehabilitation, and associations between perceived impact of stroke, involvement in decisions regarding care/treatment, and having health services needs met. Method Data was collected, through a mail survey, from patients with stroke who were admitted to a university hospital in 2012 and had received rehabilitation after discharge from the stroke unit. The rehabilitation lasted an average of 2 to 4.6 months. The Stroke Survivor Needs Survey Questionnaire was used to assess the participants' perceptions of involvement in decisions on care or treatment and needs for health services in 11 problem areas: mobility, falls, incontinence, pain, fatigue, emotion, concentration, memory, speaking, reading, and sight. The perceived impact of stroke in eight areas was assessed using the Stroke Impact Scale (SIS) 3.0. Eleven logistic regression models were created to explore associations between having health services needs met in each problem area respectively (dependent variable) and the independent variables. In all models the independent variables were: age, sex, SIS domain corresponding to the dependent variable, or stroke severity in cases when no corresponding SIS domain was identified, and involvement in decisions on care and treatment. Results The 63 participants who returned the questionnaires had a mean age of 72 years, 33 were male and 30 were female. Eighty percent had suffered a mild stroke. The number of participants who reported problems varied between 51 (80%, mobility) and 24 (38%, sight). Involvement in decisions on care and treatment was found to be associated with having health services needs met in six problem areas: falls, fatigue, emotion, memory, speaking, and reading. Conclusions The results highlight the importance of involving patients in making decisions on stroke rehabilitation, as it appears to be associated with meeting their health

  10. The influence of the level of physical activity and human development in the quality of life in survivors of stroke


    Aidar, Felipe J; de Oliveira, Ricardo J; Silva, Ant?nio J; de Matos, Dihogo G; Carneiro, Andr? L; Garrido, Nuno; Hickner, Robert C; Reis, Victor M


    Abstract Background The association between physical activity and quality of life in stroke survivors has not been analyzed within a framework related to the human development index. This study aimed to identify differences in physical activity level and in the quality of life of stroke survivors in two cities differing in economic aspects of the human development index. Methods Two groups of subjects who had suffered a stroke at least a year prior to testing and showed hemiplegia or hemipare...

  11. Huge Left Ventricular Thrombus and Apical Ballooning associated with Recurrent Massive Strokes in a Septic Shock Patient

    Directory of Open Access Journals (Sweden)

    Hyun-Jung Lee


    Full Text Available The most feared complication of left ventricular thrombus (LVT is the occurrence of systemic thromboembolic events, especially in the brain. Herein, we report a patient with severe sepsis who suffered recurrent devastating embolic stroke. Transthoracic echocardiography revealed apical ballooning of the left ventricle with a huge LVT, which had not been observed in chest computed tomography before the stroke. This case emphasizes the importance of serial cardiac evaluation in patients with stroke and severe medical illness.

  12. Acute stroke imaging research roadmap

    NARCIS (Netherlands)

    Wintermark, Max; Albers, Gregory W.; Alexandrov, Andrei V.; Alger, Jeffry R.; Bammer, Roland; Baron, Jean-Claude; Davis, Stephen; Demaerschalk, Bart M.; Derdeyn, Colin P.; Donnan, Geoffrey A.; Eastwood, James D.; Fiebach, Jochen B.; Fisher, Marc; Furie, Karen L.; Goldmakher, Gregory V.; Hacke, Werner; Kidwell, Chelsea S.; Kloska, Stephan P.; Koehrmann, Martin; Koroshetz, Walter; Lee, Ting-Yim; Lees, Kennedy R.; Lev, Michael H.; Liebeskind, David S.; Ostergaard, Leif; Powers, William J.; Provenzale, James; Schellinger, Peter; Silbergleit, Robert; Sorensen, Alma Gregory; Wardlaw, Joanna; Warach, Steven

    The recent "Advanced Neuroimaging for Acute Stroke Treatment" meeting on September 7 and 8, 2007 in Washington DC, brought together stroke neurologists, neuroradiologists, emergency physicians, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke

  13. Endothelial dysfunction, vascular disease and stroke: the ARTICO study. (United States)

    Roquer, J; Segura, T; Serena, J; Castillo, J


    Endothelial dysfunction is a fundamental step in the atherosclerotic disease process. Its presence is a risk factor for the development of clinical events, and may represent a marker of atherothrombotic burden. Also, endothelial dysfunction contributes to enhanced plaque vulnerability, may trigger plaque rupture, and favors thrombus formation. The assessment of endothelial vasomotion is a useful marker of atherosclerotic vascular disease. There are different methods to assess endothelial function: endothelium-dependent vasodilatation brachial flow-mediated dilation, cerebrovascular reactivity to L-arginine, and the determination of some biomarkers such as microalbuminuria, platelet function, and C-reactive protein. Endothelial dysfunction has been observed in stroke patients and has been related to stroke physiopathology, stroke subtypes, clinical severity and outcome. Resting ankle-brachial index (ABI) is also considered an indicator of generalized atherosclerosis, and a low ABI is associated with an increase in stroke incidence in the elderly. Despite all these data, there are no studies analyzing the predictive value of ABI for new cardiovascular events in patients after suffering an acute ischemic stroke. ARTICO is an ongoing prospective, observational, multicenter study being performed in 50 Spanish hospitals. The aim of the ARTICO study is to evaluate the prognostic value of a pathological ABI (ARTICO study will increase the knowledge of patient outcome after ischemic stroke and may help to improve our ability to detect patients at high risk of stroke recurrence or major cardiovascular events. (c) 2009 S. Karger AG, Basel.

  14. Oxidative stress and pathophysiology of ischemic stroke: novel therapeutic opportunities. (United States)

    Rodrigo, Ramón; Fernández-Gajardo, Rodrigo; Gutiérrez, Rodrigo; Matamala, José Manuel; Carrasco, Rodrigo; Miranda-Merchak, Andrés; Feuerhake, Walter


    Stroke is the second leading cause of death, after ischemic heart disease, and accounts for 9% of deaths worldwide. According to the World Health Organization [WHO], 15 million people suffer stroke worldwide each year. Of these, more than 6 million die and another 5 million are permanently disabled. Reactive oxygen species [ROS] have been implicated in brain injury after ischemic stroke. There is evidence that a rapid increase in the production of ROS immediately after acute ischemic stroke rapidly overwhelm antioxidant defences, causing further tissue damage. These ROS can damage cellular macromolecules leading to autophagy, apoptosis, and necrosis. Moreover, the rapid restoration of blood flow increases the level of tissue oxygenation and accountsfor a second burst of ROS generation, which leads to reperfusion injury. Current measures to protect the brain against severe stroke damage are insufficient. Thus, it is critical to investigate antioxidant strategies that lead to the diminution of oxidative injury. The antioxidant vitamins C and E, the polyphenol resveratrol, the xanthine oxidase [XO] inhibitor allopurinol, and other antioxidant strategies have been reviewed in the setting of strokes. This review focuses on the mechanisms involved in ROS generation, the role of oxidative stress in the pathogenesis of ischemic stroke, and the novel therapeutic strategies to be tested to reduce the cerebral damage related to both ischemia and reperfusion.

  15. Body Mass Index and Stroke

    DEFF Research Database (Denmark)

    Andersen, Klaus Kaae; Olsen, Tom Skyhøj


    Although obesity is associated with excess mortality and morbidity, mortality is lower in obese than in normal weight stroke patients (the obesity paradox). Studies now indicate that obesity is not associated with increased risk of recurrent stroke in the years after first stroke. We studied the ...... the association between body mass index (BMI) and stroke patient's risk of having a history of previous stroke (recurrent stroke)....

  16. A feminist perspective on Stroke Rehabilitation

    DEFF Research Database (Denmark)

    Kvigne, Kari; Kirkevold, M.


    and female sufferers may in part be explained by the fact that rehabilitation services are designed primarily to meet the needs of men. de Beauvoir's feminist theory maintains that one's body is fundamental in creating the person, which is a lifelong process. Traditionally, the female body has been exposed......The dominant view of women has changed radically during the last century. These changes have had an important impact on the way of life of women in general and, undoubtedly, on women as patients. So far, gender differences have received little attention when developing healthcare services. Stroke...... to alienation and oppression through life. This has led women to develop a life in immanence. This we feel can be of significance in connection with rehabilitation after a stroke, particularly for elderly women. In this article we will discuss how de Beauvoir's theory can throw new light on the experiences...

  17. Palis, Prof. Jacob

    Indian Academy of Sciences (India)

    Date of birth: 15 March 1940. Address: Instituto de Matematica Pura e, Aplicada - IMPA, Estrada Dona Castorina 110, Jardim Botanico, 22460-320 Rio de Janeiro, Brazil Contact: Office: (+55-21) 2529 5136. Residence: (+55-21) 2537 3272. Fax: (+55-21) 2529 5019. Email: YouTube; Twitter; Facebook; Blog ...

  18. T Jacob John, Vellore

    Indian Academy of Sciences (India)


    technology and reluctance to use science in public health are two glaring defects in. India's health management system. Defeating prophets of failure, India specifically targeted the poliovirus, applied every intervention necessary, refined the vaccine through research, and pulled off success. It was like surgically removing a ...

  19. T Jacob John, Vellore

    Indian Academy of Sciences (India)


    Was the economic investment of Rupees 1000 crores per annum worth it? Many had questioned the wisdom of targeting one among the so many neglected diseases and spending so much funds. Three elements justify our investment: humanitarian, human rights, economic. Polio paralysis, especially in the numbers India ...

  20. Unfulfilled rehabilitation needs and dissatisfaction with care 12 months after a stroke

    DEFF Research Database (Denmark)

    Tistad, Malin; Tham, Kerstin; von Koch, Lena


    a questionnaire. Stroke severity, domains of the Stroke Impact Scale (SIS), the Sense of Coherence scale (SOC) and socio demographic factors were used as independent variables in four logistic regression analyses. RESULTS: Unfulfilled needs for rehabilitation at 12 months were predicted by strength (SIS) (odds......BACKGROUND: People who have suffered a stroke commonly report unfulfilled need for rehabilitation. Using a model of patient satisfaction, we examined characteristics in individuals that at 3 months after stroke predicted, or at 12 months were associated with unmet need for rehabilitation...... or dissatisfaction with health care services at 12 months after stroke. METHODS: The participants (n = 175) received care at the stroke units at the Karolinska University Hospital, Sweden. The dependent variables "unfulfilled needs for rehabilitation" and "dissatisfaction with care" were collected using...

  1. Need for cognitive rehabilitation for children with sickle cell disease and strokes. (United States)

    King, Allison A; DeBaun, Michael R; White, Desiree A


    Stroke is a significant cause of morbidity among children with sickle cell disease (SCD). Approximately 30% of children with sickle cell anemia will have either an overt stroke or silent infarct (an injury to the brain that does not have any focal neurological findings or a history of focal neurological deficits). Despite the strong association between stroke and cognitive deficits and poor educational attainment, few interventions have been developed to address this vulnerable population of children. A cognitive rehabilitation program was piloted to improve the memory and educational achievement of children with sickle cell disease and stroke. While the intervention was feasible, additional research is needed to establish efficacy. Ongoing studies are designed to improve the cognitive impairment for children with SCD and stroke. The health and educational systems will need to work as partners to improve the cognitive and educational outcomes of these children after they suffer from stroke.

  2. Stroke syndromes in young people. (United States)

    Chambers, B R; Bladin, P F; McGrath, K; Goble, A J


    All contributory factors to the unusual occurrence of stroke in young people were evaluated in patients under age 40 admitted to the Stroke Unit of the Austin Hospital in Melbourne, Australia. Over the August 1977 to December 1980 period there were 700 admissions. Of these 14 patients were under the age of 40. There were 7 males and 7 females whose ages ranged from 17-38 years. Each patient was screened for factors which might contribute to premature vascular disease including hypertension, diabetes, smoking, obesity, and hyperlipidemia. In addition, the following tests were performed to exclude an arteritic process: full blood examination; ESR; protein electrophoresis; syphilis serology; and the presence of antinuclear factor. Each of the 14 patients suffered cerebral infarction. A summary of each case is presented in a table. In 9 patients, infarction occurred in the carotid territory of supply. Large cortical infarcts with or without subcortical involvement occurred in cases 1-8, of whom 5 had major vessel occlusion demonstrated angiographically and another had stenosing and ulcerative atheromatous disease at the extracranial carotid bifurcation. In a further 4 patients, infarction occurred within the vertebrobasilar territory and was either confined to the brain stem, the occiptal cortex, or involved both. Angiograms were performed in 2 of these patients and showed irregular narrowing of the vertebral artery which was interpreted as spasm and segmentally narrowing of the basilar artery. The final patient had several ischemic events which included right sided amaurosis fugax, and left frontal, right parieto-occipital and left occipital infarctions. Angiography was normal. All patients survived the stroke and were able to go home. There may be an interrelationship between the pathological findings of Irey et al. (1978) and the effect oral contraceptives (OCs) has on migraine. This is relevant to Case 13. Sustained exposure to OCs may produce the pathological

  3. Blunt Traumatic Extracranial Cerebrovascular Injury and Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Paul M. Foreman


    Full Text Available Background: Ischemic stroke occurs in a significant subset of patients with blunt traumatic cerebrovascular injury (TCVI. The patients are victims of motor vehicle crashes, assaults or other high-energy collisions, and suffer ischemic stroke due to injury to the extracranial carotid or vertebral arteries. Summary: An increasing number of patients with TCVI are being identified, largely because of the expanding use of computed tomography angiography for screening patients with blunt trauma. Patients with TCVI are particularly challenging to manage because they often suffer polytrauma, that is, numerous additional injuries including orthopedic, chest, abdominal, and head injuries. Presently, there is no consensus about optimal management. Key Messages: Most literature about TCVI and stroke has been published in trauma, general surgery, and neurosurgery journals; because of this, and because these patients are managed primarily by trauma surgeons, patients with stroke due to TCVI have been essentially hidden from view of neurologists. This review is intended to bring this clinical entity to the attention of clinicians and investigators with specific expertise in neurology and stroke.

  4. Immune interventions in stroke (United States)

    Fu, Ying; Liu, Qiang; Anrather, Josef


    Inflammatory and immune responses in the brain can shape the clinical presentation and outcome of stroke. Approaches for effective management of acute stroke are sparse and many measures for brain protection fail, but our ability to modulate the immune system and modify the disease progression of multiple sclerosis is increasing. As a result, immune interventions are currently being explored as therapeutic interventions in acute stroke. In this Review, we compare the immunological features of acute stroke with those of multiple sclerosis, identify unique immunological features of stroke, and consider the evidence for immune interventions. In acute stroke, microglia activation and cell death products trigger an inflammatory cascade that damages vessels and the parenchyma within minutes to hours of the ischaemia or haemorrhage. Immune interventions that restrict brain inflammation, vascular permeability and tissue oedema must be administered rapidly to reduce acute immune-mediated destruction and to avoid subsequent immunosuppression. Preliminary results suggest that the use of drugs that modify disease in multiple sclerosis might accomplish these goals in ischaemic and haemorrhagic stroke. Further elucidation of the immune mechanisms involved in stroke is likely to lead to successful immune interventions. PMID:26303850

  5. Relational Processing Following Stroke (United States)

    Andrews, Glenda; Halford, Graeme S.; Shum, David; Maujean, Annick; Chappell, Mark; Birney, Damian


    The research examined relational processing following stroke. Stroke patients (14 with frontal, 30 with non-frontal lesions) and 41 matched controls completed four relational processing tasks: sentence comprehension, Latin square matrix completion, modified Dimensional Change Card Sorting, and n-back. Each task included items at two or three…

  6. National Stroke Association (United States)

    ... Event Join a Stroke Challenge Team Comeback Trail Tell Your Story Community Presentations Faces of Stroke Volunteer With Us ... in a video presentation. Watch Video ... to feel the right side of her body. Kathryn’s friends performed the FAST exam and soon ...

  7. Diagnostic neuroimaging in stroke

    International Nuclear Information System (INIS)

    Jarenwattananon, A.; Khandji, A.; Brust, J.C.M.


    Since the development of cerebral angiography 60 years ago, there has been a proliferation of increasingly sophisticated, expensive, and, fortunately, safe imaging techniques for patients with cerebrovascular disease. In addition, occlusive and hemorrhagic stroke are now recognized as having a wide variety of possible causes. This chapter addresses the different imaging options available for particular kinds of stroke

  8. The Optimal Golf Stroke

    DEFF Research Database (Denmark)

    Buchinger, Mikael; Durigen, Susan; Dahl, Johan Rambech


    The paper presents a preliminary investigation into aspects of the game of golf. A series of models is proposed for the golf stroke, the momentum transfer between club and ball and the flight of the ball.Numerical and asymptotic solutions are presented reproducing many of the features observed...... in the golf stroke of a professional golfer....

  9. Marc Jacobs and Peter Scholliers (ed., Eating out in Europe: picnics, gourmet dining and snacks since the late eighteenth century

    Directory of Open Access Journals (Sweden)

    Jannike W. Hegnes


    Full Text Available Is there a connection between coarse bread eaten during harvesting in 1840, a cordial meal at a Berner Inn in 1870, the robust food of a factory’s canteen in 1900, a sophisticated dinner at a three-star restaurant in 1950, and a hamburger consumed outside a school gate in 1990 (p. 1? They are all examples of meals eaten outside the home, in Europe, during the last to centuries. In the book Eating Out in Europe the editors Marc Jacobs and Peter Scholliers want to give an overview and to demon...

  10. "A new lachrymal gland with an excretory duct in red and fallow deer" by Johann jacob Harder (1694): English translation and historical perspective. (United States)

    Hillenius, Willem J; Phillips, Darryl A; Rehorek, Susan J


    The Harderian gland is an enigmatic orbital gland that has been described for many tetrapods, although a consistent definition of this structure has remained elusive. In particular, an unambiguous distinction between the Harderian gland and the nictitans gland, which may both occur in the anterior aspect of the orbit of mammals, remains problematic. These glands were first distinguished in 1694 by Johann Jacob Harder, a Swiss physician and anatomist. To facilitate a renewed examination of the anatomical and developmental relationships of the anterior orbital glands, we review the historical context of Harder's discovery, and provide Harder's original Latin text as well as an English translation.

  11. Análisis de las estrategias bioclimáticas empleadas por Frank Lloyd Wright en la casa Jacobs I


    Beltrán-Fernández, M.; García-Muñoz, J.; Dufrasnes, E.


    Frank Lloyd Wright es considerado uno de los arquitectos más influyentes de la historia de la arquitectura moderna por la calidad espacial y estética de su obra. Sin embargo, la importancia de sus soluciones constructivas y medioambientales ha quedado en un segundo plano. Con el fin de destacar dichas cualidades se ha analizado la primera casa que diseñó para la familia Jacobs (Wisconsin, EE.UU., 1937), cuyo valor arquitectónico ha sido resaltado en varias ocasiones, sin que existan análisis ...

  12. Acute ischemic stroke update. (United States)

    Baldwin, Kathleen; Orr, Sean; Briand, Mary; Piazza, Carolyn; Veydt, Annita; McCoy, Stacey


    Stroke is the third most common cause of death in the United States and is the number one cause of long-term disability. Legislative mandates, largely the result of the American Heart Association, American Stroke Association, and Brain Attack Coalition working cooperatively, have resulted in nationwide standardization of care for patients who experience a stroke. Transport to a skilled facility that can provide optimal care, including immediate treatment to halt or reverse the damage caused by stroke, must occur swiftly. Admission to a certified stroke center is recommended for improving outcomes. Most strokes are ischemic in nature. Acute ischemic stroke is a heterogeneous group of vascular diseases, which makes targeted treatment challenging. To provide a thorough review of the literature since the 2007 acute ischemic stroke guidelines were developed, we performed a search of the MEDLINE database (January 1, 2004-July 1, 2009) for relevant English-language studies. Results (through July 1, 2009) from clinical trials included in the Internet Stroke Center registry were also accessed. Results from several pivotal studies have contributed to our knowledge of stroke. Additional data support the efficacy and safety of intravenous alteplase, the standard of care for acute ischemic stroke since 1995. Due to these study results, the American Stroke Association changed its recommendation to extend the time window for administration of intravenous alteplase from within 3 hours to 4.5 hours of symptom onset; this recommendation enables many more patients to receive the drug. Other findings included clinically useful biomarkers, the role of inflammation and infection, an expanded role for placement of intracranial stents, a reduced role for urgent carotid endarterectomy, alternative treatments for large-vessel disease, identification of nontraditional risk factors, including risk factors for women, and newly published pediatric stroke guidelines. In addition, new devices for

  13. The Danish Stroke Registry

    DEFF Research Database (Denmark)

    Johnsen, Søren Paaske; Ingeman, Annette; Hundborg, Heidi Holmager


    AIM OF DATABASE: The aim of the Danish Stroke Registry is to monitor and improve the quality of care among all patients with acute stroke and transient ischemic attack (TIA) treated at Danish hospitals. STUDY POPULATION: All patients with acute stroke (from 2003) or TIA (from 2013) treated...... at Danish hospitals. Reporting is mandatory by law for all hospital departments treating these patients. The registry included >130,000 events by the end of 2014, including 10,822 strokes and 4,227 TIAs registered in 2014. MAIN VARIABLES: The registry holds prospectively collected data on key processes...... of care, mainly covering the early phase after stroke, including data on time of delivery of the processes and the eligibility of the individual patients for each process. The data are used for assessing 18 process indicators reflecting recommendations in the national clinical guidelines for patients...

  14. Stroke mimic diagnoses presenting to a hyperacute stroke unit. (United States)

    Dawson, Ang; Cloud, Geoffrey C; Pereira, Anthony C; Moynihan, Barry J


    Stroke services have been centralised in several countries in recent years. Diagnosing acute stroke is challenging and a high proportion of patients admitted to stroke units are diagnosed as a non-stroke condition (stroke mimics). This study aims to describe the stroke mimic patient group, including their impact on stroke services. We analysed routine clinical data from 2,305 consecutive admissions to a stroke unit at St George's Hospital, London. Mimic groupings were derived from 335 individual codes into 17 groupings. From 2,305 admissions, 555 stroke mimic diagnoses were identified (24.2%) and 72% of stroke mimics had at least one stroke risk factor. Common mimic diagnoses were headache, seizure and syncope. Medically unexplained symptoms and decompensation of underlying conditions were also common. Median length of stay was 1 day; a diagnosis of dementia (p=0.028) or needing MRI (p=0.006) was associated with a longer stay. Despite emergency department assessment by specialist clinicians and computed tomography brain, one in four suspected stroke patients admitted to hospital had a non-stroke diagnosis. Stroke mimics represent a heterogeneous patient group with significant impacts on stroke services. Co-location of stroke and acute neurology services may offer advantages where service reorganisation is being considered. © Royal College of Physicians 2016. All rights reserved.

  15. Post-stroke depression among stroke survivors attending two ...

    African Journals Online (AJOL)

    Background: The burden of stroke worldwide is increasing rapidly. There is paucity of data on post-stroke depression (PSD) among stroke survivors in Uganda, despite the high prevalence of PSD reported elsewhere. Methods: In a cross-sectional study, we assessed adult participants with confirmed first stroke with a ...

  16. Perception of stroke among patients with stroke | Ajayi | Nigerian ...

    African Journals Online (AJOL)

    The perception of patients to stroke is variable. The aim of this study was to determine the perception of stroke among stroke patients. The study was carried out between January 2004 - December 2004 on all the patients presenting with features of stroke at the Federal Medical Center Ido, Nigeria. Data were collected by ...

  17. Cerebrorenal interaction and stroke. (United States)

    Toyoda, Kazunori


    Beyond the original meaning of chronic kidney disease (CKD) as high-risk state for future dialysis, CKD is now known as an established risk factor for cardiovascular diseases. Stroke is a major player of cardiovascular disease and has deep two-way relationships with CKD. CKD is an evident risk factor for stroke. Meta-analyses of cohort studies and trials indicate that proteinuria/albuminuria increases the risk of stroke by 71-92%, and reduced glomerular filtration rate increases the risk by 43%. In addition, CKD has a strong relationship with subclinical brain damage including white matter changes, microbleeds, cognitive impairment, and carotid atherosclerosis. CKD is prevalent in acute stroke patients; patients with estimated glomerular filtration rate stroke patients and 39% of total intracerebral hemorrhage patients in our institute. Acute and chronic management of stroke are influenced by CKD. Therapeutic effects of several antithrombotic and thrombolytic agents, including recently-developed novel oral anticoagulants, are affected by renal function. Moreover, reduced glomerular filtration rate is independently associated with increased 1- and 10-year mortalities in the end. Stroke also has deep relationships with end-stage kidney disease. Stroke occurs much more commonly in dialysis patients than general population or CKD patients without need for dialysis. The triggers of ischemic and hemorrhagic stroke in patients with end-stage kidney disease include special characteristics unique to dialysis, such as drastic hemodynamic change, dialysate and anticoagulants, and vascular calcification. As cohorts of dialysis patients become older, more hypertensive, and more diabetic than before, stroke become more prevalent and more serious events in dialysis clinics. Now, clinicians should have much interest in the association between CKD and cerebrovascular diseases, so-called the cerebro-renal interaction. Copyright © 2013 S. Karger AG, Basel.


    Directory of Open Access Journals (Sweden)

    Aji Kristianto Wijaya


    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Stroke is one of the most common cause of death worldwide and the third leading cause of death in the United States. Stroke composed 90,000 deaths of women and 60,000 men each year. In Indonesia, 8 of 1000 people suffered a stroke. Stroke is divided into two, non-hemorrhagic stroke and hemorrhagic stroke. Most of them (80% is non-hemorrhagic stroke. Non-hemorrhagic stroke can be caused by thrombi or emboli. Understanding the pathophysiology of non-hemorrhagic stroke caused by a thrombus is very important in regard with providing appropriate patient management. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  19. Stroke outcomes in Malawi, a country with high prevalence of HIV: a prospective follow-up study.

    Directory of Open Access Journals (Sweden)

    Terttu Heikinheimo

    Full Text Available BACKGROUND: Stroke contributes significantly to disability and mortality in developing countries yet little is known about the determinants of stroke outcomes in such countries. 12% of Malawian adults have HIV/AIDS. It is not known whether having HIV-infection alters the outcome of stroke. The aim of this study was to document the functional outcome and mortality at 1 year of first-ever acute stroke in Malawi. Also to find out if the baseline variables, including HIV-infection, affect the outcome of stroke. METHODS AND FINDINGS: 147 adult patients with first-ever acute stroke were prospectively followed up for 12 months. Conventional risk factors and HIV-infection were assessed at baseline. Stroke severity was evaluated with modified National Institute of Health Stroke Scale (mNIHSS and functional outcome with modified Rankin scale (mRS. Fifty (34% of patients were HIV-seropositive. 53.4% of patients had a poor outcome (severe disability or death, mRS 4-6 at 1 year. Poor outcome was related to stroke severity and female gender but not to presence of HIV-infection. HIV-seropositive patients were younger and had less often common risk factors for stroke. They suffer more often ischemic stroke than HIV-seronegative patients. CONCLUSIONS: Mild stroke and male gender were associated with favourable outcome. HIV-infection is common in stroke patients in Malawi but does not worsen the outcome of stroke. However, it may be a risk factor for ischemic stroke for young people, who do not have the common stroke risk factors. Our results are significant, because stroke outcome in HIV-seropositive patients has not been studied before in a setting such as ours, with very limited resources and a high prevalence of HIV.

  20. Anemia and stroke: Where do we stand? (United States)

    Kaiafa, G; Savopoulos, C; Kanellos, I; Mylonas, K S; Tsikalakis, G; Tegos, T; Kakaletsis, N; Hatzitolios, A I


    Anemia seems to have a clear relationship with cerebrovascular events (CVEs), as there is a direct connection between central nervous system, blood supply, and tissue oxygen delivery. Anemia is considered a hyperkinetic state which disturbs endothelial adhesion molecule genes that may lead to thrombus formation. Furthermore, blood flow augmentation and turbulence may result in the migration of this thrombus, thus producing artery-to-artery embolism. It is for this reason that anemia is characterized as "the fifth cardiovascular risk factor." Anemia is consistently present in patients with acute stroke, ranging from 15% to 29%, while the mortality rate was significantly higher in patients suffering from anemia at the time of admission. Different types of anemia (sickle cell disease, beta thalassemia, iron deficiency anemia [IDA]) have been associated with increased cardiovascular and CVE risk. The relation between hemoglobin level and stroke would require further investigation. Unfortunately, treatment of anemia in cardiovascular and cerebrovascular disease still lacks clear targets and specific therapy has not developed. However, packed red blood cell transfusion is generally reserved for therapy in patients with CVEs. What is more, treatment of IDA prevents thrombosis and the occurrence of stroke; although iron levels should be checked, chronic administration favors thrombosis. Regarding erythropoietin (EPO), as there is lack of studies in anemic stroke patients, it would be desirable to utilize both neuroprotective and hematopoietic properties of EPO in anemic stroke patients. This review aims to clarify the poorly investigated and defined issues concerning the relation of anemia and CVEs. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. A Community-Engaged Assessment of Barriers and Facilitators to Rapid Stroke Treatment (United States)

    Nemeth, Lynne S.; Jenkins, Carolyn; Jauch, Edward C.; Conway, Sharon; Pearlman, Adam; Spruill, Ida J.; Brown, Lynette J.; Linnen, Joyce; Linnen, Florene; Andrews, Jeannette O.


    Treatment for acute ischemic stroke must be initiated within hours of stroke symptom onset, and the sooner it is administered, the better. In South Carolina, 76% of the population can access expert stroke care, and rural hospitals may provide specialized treatment using telemedicine, but many stroke sufferers seek care too late to achieve full benefit. Using a community-engaged approach in a southern rural community, we explored barriers and facilitators to early stroke care and implications for improvement. The Community-Engaged Assessment to facilitate Stroke Elimination (CEASE) study was guided by a community advisory group to ensure community centeredness and local relevance. In a qualitative descriptive study, eight focus groups were conducted including 52 individuals: recent stroke survivors, family members, emergency medical personnel, hospital emergency department staff, primary care providers, and community leaders. From analysis of focus group transcripts came six themes: lack of trust in healthcare system and providers; weak relationships fueled by poor communication; low health literacy; financial limitations related to health care; community-based education; and faith as a message of hope. A hierarchy model for improving early community-based stroke care was developed through consensus dialogue by community representatives and the research team. This model can be used to inform a community-partnered, stake-holder-informed intervention to improve stroke care in a rural southern community with the goal of improving stroke education, care, and outcome. PMID:27545591

  2. Third European Stroke Science Workshop

    NARCIS (Netherlands)

    Dichgans, Martin; Planas, Anna M.; Biessels, Geert Jan|info:eu-repo/dai/nl/165576367; van der Worp, Bart|info:eu-repo/dai/nl/189855010; Sudlow, Cathie; Norrving, B.; Lees, Kennedy; Mattle, Heinrich P.


    Lake Eibsee, Garmisch-Partenkirchen, November 19 to 21, 2015: The European Stroke Organization convened >120 stroke experts from 27 countries to discuss latest results and hot topics in clinical, translational, and basic stroke research. Since its inception in 2011, the European Stroke Science

  3. Hearing Characteristics of Stroke Patients: Prevalence and Characteristics of Hearing Impairment and Auditory Processing Disorders in Stroke Patients. (United States)

    Koohi, Nehzat; Vickers, Deborah A; Lakshmanan, Rahul; Chandrashekar, Hoskote; Werring, David J; Warren, Jason D; Bamiou, Doris-Eva


    Stroke survivors may suffer from a range of hearing impairments that may restrict their participation in postacute rehabilitation programs. Hearing impairment may have a significant impact on listening, linguistic skills, and overall communication of the affected stroke patient. However, no studies sought to systematically characterize auditory function of stroke patients in detail, to establish the different types of hearing impairments in this cohort of patients. Such information would be clinically useful in understanding and addressing the hearing needs of stroke survivors. The present study aimed to characterize and classify the hearing impairments, using a detailed audiological assessment test battery, in order to determine the level of clinical need and inform appropriate rehabilitation for this patient population. A case-control study. Forty-two recruited stroke patients who were discharged from a stroke unit and 40 control participants matched for age. All participants underwent pure-tone audiometry and immittance measurements including acoustic reflex threshold, transient-evoked otoacoustic emissions, auditory-evoked brainstem response, and a central auditory processing assessment battery, performed in a single session. Hearing impairments were classified as peripheral hearing loss (cochlear and neural type), central auditory processing disorder (CAPD), and as a combination of CAPD and peripheral hearing loss. Overall mean hearing thresholds were not significantly different between the control and stroke groups. The most common type of hearing impairment in stroke patients was the combination type, "peripheral and CAPD," in the 61- to 80-yr-old subgroup (in 55%), and auditory processing deficits in 18- to 60-yr-olds (in 40%), which were both significantly higher than in controls. This is the first study to examine hearing function in detail in stroke patients. Given the importance of hearing for the efficiency of communication, it is essential to identify

  4. Dizziness in stroke

    Directory of Open Access Journals (Sweden)

    M. V. Zamergrad


    Full Text Available Differential diagnosis of new-onset acute vestibular vertigo is chiefly made between vestibular neuronitis and stroke. Dizziness in stroke is usually accompanied by other focal neurological symptoms of brainstem and cerebellar involvement. However, stroke may appear as isolated vestibular vertigo in some cases. An analysis of history data and the results of neurovestibular examination and brain magnetic resonance imaging allows stroke to be diagnosed in patients with acute isolated dizziness. The treatment of patients with stroke-induced dizziness involves a wide range of medications for the reduction of the degree of dizziness and unsteadiness and for the secondary prevention of stroke. Vestibular rehabilitation is an important component of treatment. The paper describes an observation of a patient with poorly controlled hypertension, who developed new-onset acute systemic dizziness. Vestibular neuronitis might be presumed to be a peripheral cause of vestibular disorders, by taking into account the absence of additional obvious neurological symptoms (such as pareses, defective sensation, diplopia, etc. and the nature of nystagmus. However, intention tremor in fingernose and heel-knee tests on the left side, a negative Halmagyi test, and results of Romberg’s test could suggest that stroke was a cause ofdizziness.

  5. A virtual sleepcoach for people suffering from insomnia

    NARCIS (Netherlands)

    Horsch, C.H.G.


    People suffering from insomnia have problems falling asleep or staying asleep. Insomnia impairs people’s daily life and their quality of life decreases. Approximately 10% of the population suffers from insomnia. The common treatment for insomnia is cognitive behavioural therapy for insomnia (CBT-I),

  6. 'You are not alone\\': the discursive construction of the 'suffering ...

    African Journals Online (AJOL)

    ... system (Martin & Rose, 2003) to analyse how the attitudinal language of the talk show constructs an identifiable victim whose narrative centres on overcoming suffering. The analysis reveals that expressions of Affect, Judgement and Appreciation are powerful mechanisms for legitimising the identity of the suffering victim.

  7. Singing in Individual Music Therapy with Persons suffering from Dementia

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner


    Persons suffering from dementia progressively loose language skills, cognitive skills, memory function, perception, etc. Still they seem to respond to music and to interact in the music therapy setting. As part of a Ph.D.-research I have worked with 6 persons suffering from middle to last stages ...

  8. ‘El Oeste en el Este’: hacia una historia de la Història de Jacob Xalabín

    Directory of Open Access Journals (Sweden)

    Lambros Kotsalás


    Full Text Available Resumen: Se trata de una anónima bajomedieval novela catalana de aventuras de trama por lo general oriental. En el subsuelo de dicha obra corre —como queda demonstrado a base de mi investigación del material fuente— la dramática historia de los últimos años de vida del llamado ‘condado’ de La Sola o Sálona catalano-bizantina en la región de Fócida o Fócide de Grecia central ante la invasión otomana (1394.   Palabras clave: Història de Jacob Xalabín, mentalidades catalanes y aragonesas bajomedievales, Romania y La Sálona   Abstract: An adventure romance of a mostly oriental setting written in Catalan by an anonymous author of the Late Middle Ages. As it is clear from my research carried out on the primary sources, under the surface of the literary work in question unfolds the drama of the very last years of the so-called ‘county’ of Catalan-Byzantine Sola, that is, Salona, in the central Greece region of Phocis before the ottoman invasion (1394 Keywords: Història de Jacob Xalabín, late medieval Catalan and Aragonese mentalities, Romania and Salona

  9. Pain and suffering as viewed by the Hindu religion. (United States)

    Whitman, Sarah M


    Religion and spiritual practices are among the resources used by patients to cope with chronic pain. The major concepts of Hinduism that are related to pain and suffering are presented. Ways that Hindu traditions deal with pain and suffering are reviewed, including the concept of acceptance, which has been studied in the pain medicine literature. By becoming more familiar with Hindu views of pain and suffering, pain medicine practitioners can offer potentially helpful concepts to all patients and support Hindus' spirituality as it relates to pain and suffering. Religion or spirituality is often important to patients. This article will inform the pain medicine practitioner how pain and suffering are viewed in Hinduism, the third largest religion in the world. It is hoped that these concepts will prove helpful when treating not only followers of Hinduism but all patients.

  10. 'The adventure': Charles-Ferdinand Ramuz's extraordinary stroke diary. (United States)

    Bogousslavsky, J


    The famous Swiss writer Charles-Ferdinand Ramuz suffered a stroke at 65 years, which he called 'the adventure' or 'the accident'. He developed language disturbances suggesting crossed aphasia in a right hander with left hemiparesis. This uncommon pattern allowed him to continue to write his diary and to report his disturbances, with a unique depth and precision, especially for cognitive-emotional changes. Language and motor dysfunction recovered within a few weeks, but Ramuz complained of persisting emotional flattening alternating with irritability, fatigue, depression, anxiety, and concentration difficulty, which gave him the feeling to have become another person and to be inhabited by a stranger, whom he compared with devils. Ramuz fought several months to resume his literary activity, having the impression to have lost inspiration and creativity. However, the novels he wrote less than 6 months after stroke show no stylistic changes and have been found to be of the same quality as his previous production. Ramuz even 'used' his stroke experience in his work, in particular in a novel depicting an old man who has a stroke and dies of it. Ramuz's diary, with his own daily description of stroke features and consequences during acute and recovery phases, is a unique document in a writer of his importance, and provides invaluable information on subjective emotional and cognitive experience of stroke. Copyright (c) 2010 S. Karger AG, Basel.

  11. Clinical neurogenetics: stroke. (United States)

    Rost, Natalia S


    Understanding the genetic architecture of cerebrovascular disease holds promise of novel stroke prevention strategies and therapeutics that are both safe and effective. Apart from a few single-gene disorders associated with cerebral ischemia or intracerebral hemorrhage, stroke is a complex genetic phenotype that requires careful ascertainment and robust association testing for discovery and validation analyses. The recently uncovered shared genetic contribution between clinically manifest stroke syndromes and closely related intermediate cerebrovascular phenotypes offers effective and efficient approaches to complex trait analysis. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Cost of stroke

    DEFF Research Database (Denmark)

    Jennum, Poul; Iversen, Helle K; Ibsen, Rikke


    . The attributable cost of direct net health care costs after the stroke (general practitioner services, hospital services, and medication) and indirect costs (loss of labor market income) were €10,720, €8,205 and €7,377 for patients, and €989, €1,544 and €1.645 for their partners, over and above that of controls......BACKGROUND: To estimate the direct and indirect costs of stroke in patients and their partners. DESCRIPTION: Direct and indirect costs were calculated using records from the Danish National Patient Registry from 93,047 ischemic, 26,012 hemorrhagic and 128,824 unspecified stroke patients...

  13. Determinan Penyakit Stroke

    Directory of Open Access Journals (Sweden)

    Woro Riyadina


    Full Text Available Penyakit stroke merupakan penyebab kematian dan kecacatan kronik yang paling tinggi pada kelompok umur diatas usia 45 tahun terbanyak di Indonesia. Tujuan penelitian ini untuk mengidentifikasi determinan utama yang berhubungan dengan penyakit stroke pada masyarakat di kelurahan Kebon Kalapa Bogor. Analisis lanjut terhadap 1.912 responden subset baseline data penelitian “Studi Kohort Faktor Risiko Penyakit Tidak Menular” Data dikumpulkan dengan metode wawancara pada penduduk tetap di kelurahan Kebon Kalapa, Kecamatan Bogor Tengah, Bogor tahun 2012. Diagnosis stroke berdasarkan anamnesis dan pemeriksaan dokter spesialis syaraf. Variabel independen meliputi karakteristik sosiodemografi, status kesehatan dan perilaku berisiko. Data dianalisis dengan uji regresi logistik ganda. Penyakit stroke ditemukan pada 49 (2,6% orang. Determinan utama stroke meliputi hipertensi (OR = 4,20; IK 95% = 2,20 – 8,03, penyakit jantung koroner (OR = 2,74; IK 95% = 1,51 – 4,99, diabetes melitus (OR = 2,89; IK 95% = 1,47 – 5,64, dan status ekonomi miskin (OR = 1,83 ; IK 95% = 1,03 – 3,33. Pencegahan penyakit stroke dilakukan dengan peningkatan edukasi (kampanye/penyuluhan melalui pengendalian faktor risiko utama yaitu hipertensi dan pencegahan terjadinya penyakit degeneratif lain yaitu penyakit jantung koroner dan diabetes melitus. Stroke disease is the leading cause of death and chronic disabi lity in most over the age of 45 years in Indonesia. The aim of study was to identify the major determinants of stroke disease in Kebon Kalapa community in Bogor. A deep analyze was conducted in 1.912 respondents based on the subset of baseline data “Risk Factors Cohort Study of Non Communicable Diseases.” Data was collected by interviews on Kebon Kalapa community, Bogor in 2012. Stroke diagnosis was determined by anamnesis and neu-rological examination with specialist. Independent variables were sociodemographic characteristics, health status and risk behavior

  14. The Migraine?Stroke Connection


    Lee, Mi Ji; Lee, Chungbin; Chung, Chin-Sang


    Migraine and stroke are common neurovascular disorders which share underlying physiological processes. Increased risks of ischemic stroke, hemorrhagic stroke, and subclinical ischemic lesions have been consistently found in migraineurs. Three possible associations are suggested. One is that underlying pathophysiology of migraine can lead to ischemic stroke. Second, common comorbidities between migraine and stroke can be present. Lastly, some syndromes can manifest with both migraine-like head...

  15. Suffering and distress at the end-of-life. (United States)

    Krikorian, Alicia; Limonero, Joaquín T; Maté, Jorge


    Suffering frequently occurs in the context of chronic and progressive medical illnesses and emerges with great intensity at end-of-life. A review of the literature on suffering and distress-related factors was conducted to illustrate the integrative nature of suffering in this context. We hope it will result in a comprehensive approach, centered in the patient-family unit, which will alleviate or eliminate unnecessary suffering and provide well-being, when possible. An extensive search of the literature on suffering and distress in end-of-life patients was conducted. While the present review is not a systematic one, an in-depth search using the terms 'Suffering', 'Distress', End-of-Life', 'Palliative Care', and 'Terminal illness' was conducted using search engines such as PubMed, PsycINFO, MEDLINE, EBSCO-Host, OVID, and SciELO. Taking into account the comprehensive and integrative nature of suffering, factors related to the physical, psychological, spiritual, and social human dimensions are described. As well, some treatment considerations in the palliative care context are briefly discussed. Suffering is individual, unique, and inherent to each person. Assessment processes require keeping in mind the complexity, multi-dimensionality, and subjectivity of symptoms and experiences. Optimal palliative care is based on continuous and multidimensional evaluation and treatment of symptoms and syndromes. It should take place in a clinical context where the psychological, spiritual, and socio-cultural needs of the patient-family unit are taken care of simultaneously. A deep knowledge of the nature of suffering and its associated factors is central to alleviate unnecessary suffering. Copyright © 2011 John Wiley & Sons, Ltd.

  16. Stem cell-paved biobridges facilitate stem transplant and host brain cell interactions for stroke therapy. (United States)

    Duncan, Kelsey; Gonzales-Portillo, Gabriel S; Acosta, Sandra A; Kaneko, Yuji; Borlongan, Cesar V; Tajiri, Naoki


    Distinguished by an infarct core encased within a penumbra, stroke remains a primary source of mortality within the United States. While our scientific knowledge regarding the pathology of stroke continues to improve, clinical treatment options for patients suffering from stroke are extremely limited. Tissue plasminogen activator (tPA) remains the sole FDA-approved drug proven to be helpful following stroke. However, due to the need to administer the drug within 4.5h of stroke onset its usefulness is constrained to less than 5% of all patients suffering from ischemic stroke. One experimental therapy for the treatment of stroke involves the utilization of stem cells. Stem cell transplantation has been linked to therapeutic benefit by means of cell replacement and release of growth factors; however the precise means by which this is accomplished has not yet been clearly delineated. Using a traumatic brain injury model, we recently demonstrated the ability of transplanted mesenchymal stromal cells (MSCs) to form a biobridge connecting the area of injury to the neurogenic niche within the brain. We hypothesize that MSCs may also have the capacity to create a similar biobridge following stroke; thereby forming a conduit between the neurogenic niche and the stroke core and peri-infarct area. We propose that this biobridge could assist and promote interaction of host brain cells with transplanted stem cells and offer more opportunities to enhance the effectiveness of stem cell therapy in stroke. This article is part of a Special Issue entitled SI: Cell Interactions In Stroke. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Legal Aspects In Stroke Management

    Directory of Open Access Journals (Sweden)

    Reza Hajmanouchehri


    Full Text Available Due to increasing the cases of complaint from therapeutic staff, referred to Legal Medicine decided to mention a few examples of these actions and by reviewing them, we want to do something even nothing to prevention. Three cases were given and discussed in this article. 1. Patient is a 68-year-old woman complaining of weakness of her left side and speech disturbance that started about 2 hours earlier, was admitted to hospital at 8 am. Patient with a diagnosis of ischemic stroke in progress is placed in antiplatelet therapy (Plavix 4 initial dose and one per day and an 80 mg aspirin per day and anti-Coagulation Heparin (initial dose of 6000 units and 1000 units per hour.Patient conflicts with loss of consciousness at 17:45. By doing CT, they have found a large hemorrhage in the right parietal Frontó with severe shift from midline, IVH, SAH. Currently, patient has movement disorders and several cerebral complications. 2. The patient took under angiography because of chest pain. Patient had an unpleasant feeling in organs at the time of angiography and the symptoms have been intensified in the afternoon of that day and conflicted with headache and blurred vision. The next day, he also afflicted with weakness of organs and at 8 am neurology consultation is requested, and according to a neurologist takes MRI. The patient was suffered from speech impairment and right hemiparesis. MRI indicates stroke. Two days later, intravenous heparin begins. The Patient discharged on 31/4/ … . 3. The patient hospitalized because of headache and weakness of right organs and with a presumptive diagnosis of stroke. Headache had progressive trend. There were not seen certain lesions on the initial CT. 5000 units of heparin with 1000 units of infusion in an hour starts with telephone orders at 8 am. The morning 1/8 /..., he afflicted with loss of consciousness, and transferred to the ICU. In morning experiment, patient’s platelet is reported low (47000.The patient

  18. [Impact of rural or urban areas on disability after a stroke]. (United States)

    Ortega-Barrio, M Ángeles; Herce-Martínez, M Begoña; Valiñas-Sieiro, Florita; Mariscal-Pérez, Natividad; López-Cunquero, M Ángeles; Cubo-Delgado, Esther


    To assess the residual disability in a sample of patients after suffering a first episode of a stroke and to compare the disability of those patients who live in rural areas with those living in urban areas. An observational, longitudinal study of a cohort of 89 patients from a Neurology Unit, affected by cerebrovascular accident. The following factors were assessed: sociodemographic and environmental factors, co-morbidity, functional status, disability, depression and anxiety, and quality of life. The different clinical and demographic variables were compared after admission to the unit, at hospital discharge, and 3 months afterwards. Regression analyses were also carried out in order to study the association between the clinical and sociodemographic factors, and post-stroke disability. Compared to their previous clinical state, after suffering a stroke patients showed a higher rate of co-morbidity (P<.0001), disability (P<.0001), depression (P=.002), and a poorer quality of life (P=.013). The difference between patients coming from rural and urban areas was not statistically significant in terms of disability, quality of life, anxiety, depression, or co-morbidity. The level of disability, depression and co-morbidity that patients showed after suffering a stroke was similar to the results obtained in other studies. As a novel feature, there were no differences between patients living in rural areas after suffering a stroke and those living in urban areas, as regards disability, depression, or co-morbidity. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  19. Stroke - risk factors (United States)

    ... Brain cells can die, causing lasting damage. Risk factors are things that increase your chance of getting ... disease or condition. This article discusses the risk factors for stroke and things you can do to ...

  20. Post-Stroke Rehabilitation (United States)

    ... negotiate the provision of reasonable accommodations in the workplace. When can a stroke patient begin rehabilitation? Rehabilitation ... at home gives people the advantage of practicing skills and developing compensatory strategies in the context of ...

  1. A Stroke of Language (United States)

    Blaisdell, Bob


    The author reflects on foreign-language learning by his EFL students as well as his own foreign-language learning. He concludes by musing on the possible and fantastical devastation on language-ability wrought by strokes.

  2. Epilepsy after stroke

    DEFF Research Database (Denmark)

    Olsen, T S; Høgenhaven, H; Thage, O


    Development of epilepsy was studied prospectively in a group of 77 consecutive stroke patients. Included were stroke patients less than 75 years old admitted within the first 3 days after the stroke. Excluded were patients with subarachnoid hemorrhage, vertebrobasilar stroke, and patients...... with other severe diseases. Cerebral angiography, CT, and EEG were performed in all patients. The patients were followed clinically for 2 to 4 years. Seven patients (9%) developed epilepsy. Of 23 patients with lesions involving the cortex, 6 (26%) developed epilepsy. Of 54 patients in whom the cortex...... was not involved, only 1 (2%) developed epilepsy. Patients with persisting paresis and cortical involvement seem to be at particularly high risk of developing epilepsy, as 50% of such patients (6 of 12) developed the disease....

  3. The "Know Stroke" Campaign (United States)

    ... Issue Past Issues Special Section The "Know Stroke" Campaign Past Issues / Summer 2007 Table of Contents For ... Javascript on. NINDS is conducting a public awareness campaign across the United States to educate people about ...

  4. Morphological risk factors of stroke during thoracic endovascular aortic repair. (United States)

    Kotelis, Drosos; Bischoff, Moritz S; Jobst, Bertram; von Tengg-Kobligk, Hendrik; Hinz, Ulf; Geisbüsch, Philipp; Böckler, Dittmar


    This study aims to identify independent factors correlating to an increased risk of perioperative stroke during thoracic endovascular aortic repair (TEVAR). A prospective maintained TEVAR database, medical records, and imaging studies of 300 patients (205 men; median age of all, 66 years, range 21-89), who underwent TEVAR between March 1997 and February 2011, were reviewed. Preoperative CT data sets were reviewed by two experienced radiologists with focus on the atheroma burden in the aortic arch (grade I, normal, to grade V, ulcerated or pedunculated atheroma). Aortic arch geometry (arch types I-III) was documented. Further parameters included in the univariate analysis were age, gender, urgency of repair, duration of procedure, adenosine-induced cardiac arrest or rapid pacing, proximal landing zone, left subclavian artery (LSA) coverage, and number of stent grafts. Multivariate logistic regression analysis was performed to assess the independent correlations of potential risk factors. Atherosclerotic aneurysm was the most common pathology (44%). One hundred and fifty-four of our patients (51%) were treated under urgent or emergent conditions. Seventeen percent of all patients had significant arch atheroma (grade IV or V), and 43% had a steep type III aortic arch. The perioperative stroke was 4% (12 patients; median age, 73 years, range 31-78). Two strokes were lethal (0.7%). All strokes were classified as embolic based on imaging characteristics. In eight patients, strokes were located in the left cerebral hemisphere (seven of them in the anterior and one in the posterior circulation). Four stroke patients (one in the left posterior circulation) underwent LSA coverage without revascularization. Three stroke patients had severe arch atheroma grade V. Five patients suffering stroke were recognized to have a type III aortic arch. Strokes were equally distributed between zones 0-2 vs. 3-4 (n = 6 each, 5 vs. 3.3%). The highest incidence was found in zone 1 (11

  5. Methylphenidate modulates cerebral post-stroke reorganization. (United States)

    Tardy, Jean; Pariente, Jérémie; Leger, Anne; Dechaumont-Palacin, Sophie; Gerdelat, Angélique; Guiraud, Vincent; Conchou, Fabrice; Albucher, Jean-François; Marque, Philippe; Franceries, Xavier; Cognard, Christophe; Rascol, Olivier; Chollet, François; Loubinoux, Isabelle


    We hypothesized that a single dose of methylphenidate (MP) would modulate cerebral motor activation and behavior in patients having suffered a subcortical stroke. Eight men with a single stroke on the corticospinal tract resulting in a pure motor hemiparesia were included in a randomized, cross-over, double-blind, placebo-controlled study. Patients were first evaluated 17 days after stroke onset by validated neurological scales, motor tests and fMRI (flexion/extension of the digits) after 20 mg MP or placebo. Seven days later, the patients underwent the same protocol and received the drug they had not taken at the first evaluation. Each patient was his own control. Placebo intake did not change performance. MP compared to placebo elicited a significant improvement in motor performance of the affected hand at the finger tapping test. MP induced: (1) a hyperactivation of the ipsilesional primary sensorimotor cortex including the motor hand and face areas and of the contralesional premotor cortex; (2) a hypoactivation of the ipsilesional anterior cingulum. Hyperactivation in the face motor area correlated positively with the improvement in performance. We demonstrated that the reorganized network may efficiently be targeted by the drug and that the effect of MP might partly rely on an improvement in attention/effort through cingulum modulation.

  6. The phenomenology of suffering in medicine and bioethics. (United States)

    Svenaeus, Fredrik


    This article develops a phenomenology of suffering with an emphasis on matters relevant to medical practice and bioethics. An attempt is made to explain how suffering can involve many different things-bodily pains, inability to carry out everyday actions, and failure to realize core life values-and yet be a distinct phenomenon. Proceeding from and expanding upon analyses found in the works of Eric Cassell and Elaine Scarry, suffering is found to be a potentially alienating mood overcoming the person and engaging her in a struggle to remain at home in the face of loss of meaning and purpose in life. Suffering involves painful experiences at different levels that are connected through the suffering-mood but are nevertheless distinguishable by being primarily about (1) my embodiment, (2) my engagements in the world together with others, and (3) my core life values. Suffering is in essence a feeling (a mood), but as such, it has implications for and involves the person's entire life: how she acts in the world, communicates with others, and understands and looks upon her priorities and goals in life. Suffering-moods are typically intense and painful in nature, but they may also display a rather subconscious quality in presenting things in the world and my life as a whole in an alienating way. In such situations, we are not focused directly upon the suffering-mood-as in the cases of pain and other bodily ailments-but rather, upon the things that the mood presents to us: not only our bodies, but also other things in the world that prevent us from having a good life and being the persons we want to be. Such suffering may in many cases be transformed or at least mitigated by a person's identifying and changing her core life values and in such a manner reinterpreting her life story to become an easier and more rewarding one to live under the present circumstances.

  7. Telestroke in stroke survivors. (United States)

    Joubert, Jacques; Joubert, Lynette B; de Bustos, Elizabeth Medeiros; Ware, Dallas; Jackson, David; Harrison, Terrence; Cadilhac, Dominique


    Stroke is a high-frequency disorder placing a significant burden on the health care systems, being the foremost cause of complex chronic disability in adults. Devising systems that can enhance the prevention of stroke recurrence is an important priority and challenge in both the developed and the developing world. The potential for recurrent stroke can be substantially reduced by effective management of vascular risk factors. Telestroke is a tool with potential application to improve risk management of stroke survivors. Lack of acknowledgment of existing practices as well as lack of awareness of potential financial barriers to diffusion of telestroke can lead to limited implementation. Telestroke offers service providers the opportunity to access large numbers of stroke survivors targeting secondary prevention. The ideal 'telestroke model' provides service support, education for the patient and caregiver, as well as integration of specialist and primary care services. Effective use of technological advances, with adequate recognition of the importance of human interaction in the long-term management of a largely elderly population of stroke survivors is challenging but possible. Telestroke should be systems- and not technology-driven. Barriers in the implementation of telestroke have been identified as insufficient planning of IT infrastructure, lack of long-term vision for sustainability, a lack of contextual perspective as well as poor communication across domains. Future telestroke models should provide effective action in an integrated model of care recognizing and involving all existing players and practices. (c) 2009 S. Karger AG, Basel.

  8. Autopsy approach to stroke. (United States)

    Love, Seth


    Stroke is a major cause of morbidity and mortality but the brain and other relevant tissues are often examined only cursorily when stroke patients come to autopsy. The pathological findings and clinical implications vary according to the type of stroke and its location and cause. Large ischaemic strokes are usually associated with atherosclerosis of extracranial or major intracranial arteries but can be caused by dissection. Most small cerebral infarcts are caused by arteriosclerosis or, in the elderly, cerebral amyloid angiopathy (CAA). However, vasculitides and coagulopathies can cause a range of different patterns of ischaemic (and, occasionally, haemorrhagic) stroke. Global brain ischaemia, caused by severe hypotension or raised intracranial pressure, produces damage that is accentuated in certain regions and neuronal populations and may be confused with hypoglycaemic injury. The main cause of subarachnoid haemorrhage is a ruptured berry aneurysm but CAA, arteriovenous malformations and infective aneurysms are occasionally responsible. These can also cause parenchymal brain haemorrhage, although this most often complicates hypertensive small vessel disease. Sometimes the haemorrhage arises from a neoplasm. Performing an adequate autopsy in stroke requires proper preparation, awareness of the likely pathological processes, familiarity with intracranial vascular anatomy, careful gross examination and dissection, and appropriate use of histology. © 2010 Blackwell Publishing Limited.

  9. Post-stroke dyskinesias

    Directory of Open Access Journals (Sweden)

    Nakawah MO


    Full Text Available Mohammad Obadah Nakawah, Eugene C Lai Stanely H. Appel Department of Neurology, Houston Methodist Neurological Institute, Houston, TX, USA Abstract: Strokes, whether ischemic or hemorrhagic, are among the most common causes of secondary movement disorders in elderly patients. Stroke-related (vascular movement disorders, however, are uncommon complications of this relatively common disease. The spectrum of post-stroke movement disorders is broad and includes both hypo- and hyperkinetic syndromes. Post-stroke dyskinesias are involuntary hyperkinetic movements arising from cerebrovascular insults and often present with mixed phenotypes of hyperkinesia which can sometimes be difficult to classify. Nevertheless, identification of the most relevant motor phenotype, whenever possible, allows for a more specific phenomenological categorization of the dyskinesia and thus helps guide its treatment. Fortunately, post-stroke dyskinesias are usually self-limiting and resolve within 6 to 12 months of onset, but a short-term pharmacotherapy might sometimes be required for symptom control. Functional neurosurgical interventions targeting the motor thalamus or globus pallidus interna might be considered for patients with severe, disabling, and persistent dyskinesias (arbitrarily defined as duration longer than 12 months. Keywords: vascular dyskinesia, stroke, movement disorders

  10. Nursing care for stroke patients

    DEFF Research Database (Denmark)

    Tulek, Zeliha; Poulsen, Ingrid; Gillis, Katrin


    AIMS AND OBJECTIVES: To conduct a survey of the clinical nursing practice in European countries in accordance with the European Stroke Strategies (ESS) 2006, and to examine to what extent the ESS have been implemented in stroke care nursing in Europe. BACKGROUND: Stroke is a leading cause of death...... comprising 61 questions based on the ESS and scientific evidence in nursing practice was distributed to representatives of the European Association of Neuroscience Nurses, who sent the questionnaire to nurses active in stroke care. The questionnaire covered the following areas of stroke care: Organization...... of stroke services, Management of acute stroke and prevention including basic care and nursing, and Secondary prevention. RESULTS: Ninety-two nurses in stroke care in 11 European countries participated in the survey. Within the first 48 hours after stroke onset, 95% monitor patients regularly, 94% start...

  11. Improving public education about stroke. (United States)

    Alberts, Mark J


    Stroke is a common and serious disease. Most studies have shown that basic public knowledge about what a stroke is, symptoms of a stroke, and the proper reaction to a stroke is quite deficient. The fact that a stroke affects cognitive, communicative, and motor functions may partially explain the poor reaction to acute stroke symptoms. Several educational studies, using diverse formats and messaging paradigms, have been shown to positively affect public knowledge of stroke symptoms. Such efforts have often used mass media public education campaigns with an emphasis on recognizing symptoms of an acute stroke. Some have been able to demonstrate an increase in the chance of patients (or by-standers) calling 911 and seeking emergency care. However, many programs were of brief duration, and their long-term benefits are uncertain. Continual educational efforts will be needed to improve stroke knowledge and increase the percentage of patients who seek emergency care. © 2012 New York Academy of Sciences.

  12. Monitoring Soil Erosion on a Burned Site in the Mojave-Great Basin Transition Zone: Final Report for the Jacob Fire Site

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Julianne [DRI; Etyemezian, Vic [DRI; Cablk, Mary E. [DRI; Shillito, Rose [DRI; Shafer, David [DOE Grand Junction, Colorado


    A historic return interval of 100 years for large fires in the U.S. southwestern deserts is being replaced by one where fires may reoccur as frequently as every 20 to 30 years. The shortened return interval, which translates to an increase in fires, has implications for management of Soil Corrective Action Units (CAUs) and Corrective Action Sites (CASs) for which the Department of Energy, National Nuclear Security Administration Nevada Field Office has responsibility. A series of studies was initiated at uncontaminated analog sites to better understand the possible impacts of erosion and transport by wind and water should contaminated soil sites burn. The first of these studies was undertaken at the Jacob Fire site approximately 12 kilometers (7.5 miles) north of Hiko, Nevada. A lightning-caused fire burned approximately 200 hectares during August 6-8, 2008. The site is representative of a transition between Mojave and Great Basin desert ecoregions on the Nevada National Security Site (NNSS), where the largest number of Soil CAUs/CASs are located. The area that burned at the Jacob Fire site was primarily a Coleogyne ramosissima (blackbrush) and Ephedra nevadensis (Mormon tea) community, also an abundant shrub assemblage in the similar transition zone on the NNSS. This report summarizes three years of measurements after the fire. Seven measurement campaigns at the Jacob Fire site were completed. Measurements were made on burned ridge (upland) and drainage sites, and on burned and unburned sites beneath and between vegetation. A Portable In-Situ Wind Erosion Lab (PI-SWERL) was used to estimate emissions of suspended particles at different wind speeds. Context for these measurements was provided through a meteorological tower that was installed at the Jacob Fire site to obtain local, relevant environmental parameters. Filter samples, collected from the exhaust of the PI-SWERL during measurements, were analyzed for chemical composition. Runoff and water erosion were

  13. Ischaemic stroke in patients treated with oral anticoagulants. (United States)

    Cano, L M; Cardona, P; Quesada, H; Lara, B; Rubio, F


    Cardioembolic stroke is associated with poorer outcomes. Prevention is based on oral anticoagulant (OAC) therapy. Haemorrhage is the main complication of OACs, which are sometimes ineffective. We retrospectively reviewed 1014 consecutive patients who suffered an ischaemic stroke between 2011 and 2013, analysing those who were receiving OAC treatment at stroke onset (107 patients in total) with special attention to aetiology, outcomes, and INR value in the acute phase. The mean age (SD) was 71.9 (10) years. Patients had been treated with OACs for 5.9 (5.5) years; 98.1% of them were being treated for heart disease. INR was strokes were cardioembolic and 1.9% were atherothrombotic. Anticoagulation therapy was discontinued in 48 patients (44.9%) due to haemorrhagic transformation (24 patients), extensive infarction (23), or endarterectomy (1). Therapy was resumed in 24 patients (50%) after a mean lapse of 36 days. This was not possible in the remaining patients because of death or severe sequelae. New OACs (NOACs) were prescribed to 9 patients (18.7% of all potential candidates). At 3 months, patients with INR>1.7 in the acute phase exhibited better outcomes than patients with INR≤1.7 (mRS 0-2 in 62% vs 30.8%; death in 10% vs 38.4%; P=.0004). Some patients taking OACs suffer ischaemic strokes that are usually cardioembolic, especially if INR is below the therapeutic range. OACs can be resumed without complications, and NOACs are still underused. Despite cases in which treatment is ineffective, outcomes are better when INR is above 1.7 at stroke onset. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Relearning the Basics: Rehabilitation after a Stroke (United States)

    ... of this page please turn Javascript on. Feature: Stroke Rehabilitation Relearning the Basics: Rehabilitation After a Stroke Past ... to help them recover successfully. What is post-stroke rehabilitation? Rehab helps stroke survivors relearn skills lost to ...

  15. Soy Allergy in Patients Suffering from Atopic Dermatitis (United States)

    Jarmila, Čelakovská; Květuše, Ettlerová; Karel, Ettler; Jaroslava, Vaněčková; Josef, Bukač


    Aim: The evaluation of soy allergy in patients over 14 years of age suffering from atopic dermatitis. The evaluation of the correlation to the occurence of peanut and pollen allergy. Materials and Methods: Altogether 175 persons suffering from atopic dermatitis were included in the study: Specific IgE, skin prick tests, atopy patch tests to soy, history and food allergy to peanut and pollen allergy were evaluated. Results: The early allergic reaction to soy was recorded in 2.8% patients. Sensitization to soy was found in another 27.2% patients with no clinical manifestation after soy ingestion. The correlation between the positive results of examinations to soy and between the occurence of peanut and pollen allergy was confirmed in statistics. Conclusion: Almost one third of patients suffering from atopic dermatitis are sensitized to soy without clinical symptoms. The early allergic reaction to soy occur in minority of patients suffering from atopic dermatitis. PMID:23919016

  16. (The Alliance Programme) for patients suffering from schizophrenia ...

    African Journals Online (AJOL)

    educational material (The Alliance Programme) for patients suffering from schizophrenia in the South African context. Method: A qualitative research approach was used. Fifteen Setswana speaking participants, with a diagnosis of schizophrenia ...

  17. Control of oncologic pain in relief of suffering. Our experience. (United States)

    González Barón, M; Lacasta Reverte, M A; Ordóñez Gallego, A; Belda-Iniesta, C


    Pain and suffering are not synonymous terms. The concept of suffering is wider than just physical pain. People can suffer for multiple causes, pain among them, but it is not the only reason since . If our main objective is the achievement of the well-being and the relief of pain, it will be necessary, according to Lazarus, Folkman, Chapman, Gravin, Bayés and Labrador, to reduce or eliminate the physical (cancer, pain and so on) and psychosocial harm (loneliness, culpability, etc.) perceived like a threat and to increase the perception of control about this situation. The main objectives of our work were: First: to evaluate the efficacy of a tool that allows the identification of the symptoms perceived by the patient as a threat in order to reduce or suppress them and empower their resources at the same time; and secondly to evaluate the incidence of pain in the suffering. Our tool includes the following groups of variables: subjective perception of the time course, emotional aspects, concerns and confrontation strategies, perception of adaptation and sense of life, perceived support and pain. This tool has been tested in 73 oncologic patients, 31 men and 42 women, mean aged 55, 41 (SD = 14, 54) visited at the Medical Oncology Service of La Paz Hospital. Mainly, people who refers great suffering are those with more pain (p < 0.05); while patients with less suffering and higher well-being are those that use strategies to face their situation (p < 0.05). Our tool reduces perceived threats and that reflects the need for a good control of pain and at the same time to empower the resources to relieve the suffering as much as possible. The referred tool seems to be effective in order to easy the intervention to relieve the suffering.

  18. A virtual sleepcoach for people suffering from insomnia


    Horsch, C.H.G.


    People suffering from insomnia have problems falling asleep or staying asleep. Insomnia impairs people’s daily life and their quality of life decreases. Approximately 10% of the population suffers from insomnia. The common treatment for insomnia is cognitive behavioural therapy for insomnia (CBT-I), mostly delivered by a therapist that people see once a week. A disadvantage of the current practice of insomnia treatment is the limited accessibility of insomnia treatment. Moreover, adherence to...

  19. Mini-Stroke vs. Regular Stroke: What's the Difference? (United States)

    ... How is a ministroke different from a regular stroke? Answers from Jerry W. Swanson, M.D. When ... brain, spinal cord or retina, which may cause stroke-like symptoms but does not damage brain cells ...

  20. Risk Factors and Stroke Characteristic in Patients with Postoperative Strokes. (United States)

    Dong, Yi; Cao, Wenjie; Cheng, Xin; Fang, Kun; Zhang, Xiaolong; Gu, Yuxiang; Leng, Bing; Dong, Qiang


    Intravenous thrombolysis and intra-arterial thrombectomy are now the standard therapies for patients with acute ischemic stroke. In-house strokes have often been overlooked even at stroke centers and there is no consensus on how they should be managed. Perioperative stroke happens rather frequently but treatment protocol is lacking, In China, the issue of in-house strokes has not been explored. The aim of this study is to explore the current management of in-house stroke and identify the common risk factors associated with perioperative strokes. Altogether, 51,841 patients were admitted to a tertiary hospital in Shanghai and the records of those who had a neurological consult for stroke were reviewed. Their demographics, clinical characteristics, in-hospital complications and operations, and management plans were prospectively studied. Routine laboratory test results and risk factors of these patients were analyzed by multiple logistic regression model. From January 1, 2015, to December 31, 2015, over 1800 patients had neurological consultations. Among these patients, 37 had an in-house stroke and 20 had more severe stroke during the postoperative period. Compared to in-house stroke patients without a procedure or operation, leukocytosis and elevated fasting glucose levels were more common in perioperative strokes. In multiple logistic regression model, perioperative strokes were more likely related to large vessel occlusion. Patients with perioperative strokes had different risk factors and severity from other in-house strokes. For these patients, obtaining a neurological consultation prior to surgery may be appropriate in order to evaluate the risk of perioperative stroke. Copyright © 2017. Published by Elsevier Inc.

  1. Stroke risk perception among participants of a stroke awareness campaign


    Kraywinkel, Klaus; Heidrich, Jan; Heuschmann, Peter U; Wagner, Markus; Berger, Klaus


    Abstract Background Subjective risk factor perception is an important component of the motivation to change unhealthy life styles. While prior studies assessed cardiovascular risk factor knowledge, little is known about determinants of the individual perception of stroke risk. Methods Survey by mailed questionnaire among 1483 participants of a prior public stroke campaign in Germany. Participants had been informed about their individual stroke risk based on the Framingham stroke risk score. S...

  2. Child-Mediated Stroke Communication: findings from Hip Hop Stroke. (United States)

    Williams, Olajide; DeSorbo, Alexandra; Noble, James; Gerin, William


    Low thrombolysis rates for acute ischemic stroke are linked to delays in seeking immediate treatment due to low public stroke awareness. We aimed to assess whether "Child-Mediated Stroke Communication" could improve stroke literacy of parents of children enrolled in a school-based stroke literacy program called Hip Hop Stroke. Parents of children aged 9 to 12 years from 2 public schools in Harlem, New York City, were recruited to participate in stroke literacy questionnaires before and after their child's participation in Hip Hop Stroke, a novel Child-Mediated Stroke Communication intervention delivered in school auditoriums. Parental recall of stroke information communicated through their child was assessed 1-week after the intervention. Fifth and sixth grade students (n=182) were enrolled into Hip Hop Stroke. One hundred two parents were approached in person to participate; 75 opted to participate and 71 completed both the pretest and post-test (74% response rate and 95% retention rate). Parental stroke literacy improved after the program; before the program, 3 parents of 75 (3.9%) were able to identify the 5 cardinal stroke symptoms, distracting symptom (chest pains), and had an urgent action plan (calling 911) compared with 21 of 71 parents (29.6%) postintervention (P<0.001). The FAST mnemonic was known by 2 (2.7%) of participants before the program versus 29 (41%) after program completion (P<0.001). Knowledge of stroke signs and symptoms remains low among residents of this high-risk population. The use of Child-Mediated Stroke Communication suggests that school children aged 9 to 12 years may be effective conduits of critical stroke knowledge to their parents.

  3. Jacob de Castro Sarmento e o conhecimento médico e científico do século XVIII


    Pinto, Hélio de Jesus Ferreira de Oliveira


    Henrique, ou Jacob, de Castro Sarmento (1691-1762), médico judeu, nascido em Bragança e exilado em Inglaterra a partir de 1721, devido às perseguições da Inquisição aos cristãos-novos, é considerado como o introdutor das ideias de Isaac Newton (1662-1727) em Portugal e um dos principais responsáveis pela disseminação da iatroquímica entre os médicos portugueses, contribuindo para o desenvolvimento da medicina e ciência portuguesas do século XVIII. Eleito para sócio da Royal Society em 1730, o...

  4. Jacob Jordaens en Een Nieu Liedeken van Callo. Een onverwacht dubbelzinnig gebruik van een zeventiende-eeuws Zuid-Nederlands zegelied

    Directory of Open Access Journals (Sweden)

    Michel Ceuterick


    Full Text Available Jordaens's aim in inscribing three differing compositions of the proverb As the old sang, so pipe the young with the title of a victory song from the Southern Netherlands, Een Nieu Liedeken van Callo (1638, can only be understood in conjunction with a rejoinder ballad from the North (1644, thus forming a terminus post quem for these paintings. The converse use of a song underscores the topsy-turvy world which Jordaens emulates in this proverb which is intent on facilitating a predestination interpretation. Erasmus and his contemporaries exploited exempla contraria to great success but the ability of the public to correctly interpret this dangerously confusing teaching method waned irrevocably during the seventeenth century. This protected Jacob Jordaens from persecution in his day but also impairs our ability to appreciate him as a sharp-witted artist with an edge, exploiting confessional equivocal themes on personal and/or commercial grounds.

  5. Child-Mediated Stroke Communication: Findings from Hip Hop Stroke (United States)

    Williams, Olajide; DeSorbo, Alexandra; Noble, James; Gerin, William


    Background and Purpose Low thrombolysis rates for acute ischemic stroke is linked to delays in seeking immediate treatment due to low public stroke awareness. We aimed to assess whether “Child-Mediated Stroke Communication” (CMSC) could improve stroke literacy parents of children enrolled in a school-based stroke literacy program called Hip Hop Stroke (HHS). Methods Parents of children aged 9 to 12 years from two public schools in Harlem, NYC, were recruited to participate in stroke literacy questionnaires before and after their child’s participation in HHS, a novel CMSC intervention delivered in school auditoriums. Parental recall of stroke information communicated through their child was assessed 1-week following the intervention. Results Fifth and Sixth grade students (n =182) were enrolled into HHS. 102 parents were approached in person to participate; 75 opted to participate and 71 completed both pretest and post-test (74% response rate and 95% retention rate). Parental stroke literacy improved after the program: before the program, 3 parents of 75 (3.9%) were able to identify the five cardinal stroke symptoms, distracting symptom (chest pains), and had an urgent action plan (calling 911), compared to 21 of 71 parents (29.6%) post-intervention (pstroke signs and symptoms remains low among residents of this high-risk population. The use of Child-Mediated Stroke Communication suggests that schoolchildren aged 9-12 may be effective conduits of critical stroke knowledge to their Parents. PMID:22033995

  6. From stroke unit care to stroke care unit

    NARCIS (Netherlands)

    De Keyser, J; Sulter, G.


    In some stroke units continuous monitoring of blood pressure, electrocardiogram, body temperature, and oxygen saturation has become an integral part of the management of acute stroke. In addition, regular measurements of blood glucose are performed. Stroke units equipped with such monitoring

  7. Diabetes, Heart Disease, and Stroke (United States)

    ... Disease, & Other Dental Problems Diabetes & Sexual & Urologic Problems Diabetes, Heart Disease, and Stroke Having diabetes means that ... help to stop. What is the link between diabetes, heart disease, and stroke? Over time, high blood ...

  8. The obesity paradox in stroke

    DEFF Research Database (Denmark)

    Andersen, Klaus Kaae; Olsen, Tom Skyhøj


    . Data include age, gender, civil status, stroke severity, computed tomography, and cardiovascular risk factors. Patients were followed up to 9·8 years (median 2·6 years). We used Cox regression models to compare risk of death and readmission for recurrent stroke in the four body mass index groups......BACKGROUND: Although associated with excess mortality and morbidity, obesity is associated with lower mortality after stroke. The association between obesity and risk of recurrent stroke is unclear. AIMS: The study aims to investigate the association in stroke patients between body mass index...... and risk of death and readmission for recurrent stroke. METHODS: An administrative Danish quality-control registry designed to collect a predefined dataset on all hospitalized stroke patients in Denmark 2000–2010 includes 45 615 acute first-ever stroke patients with information on body mass index in 29 326...

  9. Preventable Pediatric Stroke via Vaccination?

    Directory of Open Access Journals (Sweden)

    Craig A. Press


    Full Text Available Investigators from the Vascular Effects of Infection in Pediatric Stroke (VIPS group studied the risk of arterial ischemic stroke (AIS associated with minor infection and routine childhood vaccinations.



    Sujatha; Ramalingam; Vinodkumar; Vasumathi; Valarmathi; Anu


    BACKGROUND Ischemic strokes account for >80% of total stroke events. Biochemical modalities like serum uric acid, ESR, CRP, Serum Fibrinogen will be a low cost and useful way to predict functional outcome after ischemic stroke. The Barthel ADL index it is an ordinal scale helping us to measure performances in ADL-activities in daily living. The present study aims to study the Biochemical parameters Uric Acid, CRP, ESR and Fibrinogen in Ischemic Stroke patients and to assess fu...

  11. [Two simple questions to diagnose post-stroke depression]. (United States)

    Nolte, C H; Müller-Nordhorn, J; Jungehülsing, G J; Rossnagel, K; Reich, A; Roll, S; Laumeier, I; Beerfelde, D; Willich, S N; Villringer, A


    Many patients develop a depression after having suffered a stroke. Such a Post-Stroke Depression (PSD) impairs rehabilitation and quality of life. PSD is underdiagnosed in spite of available treatment. Several questionnaires have been created to diagnose a PSD. But questionnaires have been considered cumbersome and time-consuming. The aim of this study was to find out whether two simple, standardised questions will identify those stroke patients, who have developed a PSD. The two case-finding questions and the Beck Depression Inventory (BDI) were sent to patients of the Berlin Acute Stroke Study (BASS) four years after their stroke. Incomplete questionnaires were complemented via mail or telephone. Severity of depression was assessed by means of BDI. Out of 211 patients, 199 responded to the questionnaire (94 %). 193 questionnaires were complete (97 %). Forty-two patients affirmed both case-finding questions (22 %). Compared to patients, who did not affirm both questions, these patients had a higher BDI score (19 +/- 8 vs. 7 +/- 5; p two questions were 89 % and 90 %, respectively. The positive and negative predictive value were 60 % and 98 % respectively. The number of confirmed questions (0, 1, 2) correlated well with the BDI score (r (2) = 0.67, p Two standardized questions can identify patients with PSD for further diagnostic evaluation and therapy. Diagnosis of PSD might be facilitated by using them as screening instrument.

  12. Gamified In-Home Rehabilitation for Stroke Survivors: Analytical Review

    Directory of Open Access Journals (Sweden)

    Paul Tamayo-Serrano


    Full Text Available A stroke is a life-changing event that may end up as a disability, with repercussions on the patient’s quality of life. Stroke rehabilitation therapies are helpful to regain some of the patient’s lost functionality. However, in practice stroke patients may suffer from a gradual loss of motivation. Gamified systems are used to increase user motivation, hence, gamified elements have been implemented into stroke rehabilitation therapies in order to improve patients’ engagement and adherence. This review work focuses on selecting and analyzing developed and validated gamified stroke rehabilitation systems published between 2009 and 2017 to identify the most important features of these systems. After extensive research, 32 articles have met the selection criteria, resulting in a total of 28 unique works. The works were analyzed and a total of 20 features were identified. The features are explained, making emphasis on the works that implement them extensively. Finally, a classification of features based on objectives is proposed, which was used to identify the relationships between features and implementation gaps. It was found that there is a tendency to develop low-cost solutions as in-home therapy systems and provide a variety of games. This review allowed the definition of the opportunities for future research direction such as systems addressing the three rehabilitation areas; data analytics to make decisions; motivational content identification based on automatic engagement detection and emotion recognition; and alert systems for patient´s safety.

  13. SAR: Stroke Authorship Recognition

    KAUST Repository

    Shaheen, Sara


    Are simple strokes unique to the artist or designer who renders them? If so, can this idea be used to identify authorship or to classify artistic drawings? Also, could training methods be devised to develop particular styles? To answer these questions, we propose the Stroke Authorship Recognition (SAR) approach, a novel method that distinguishes the authorship of 2D digitized drawings. SAR converts a drawing into a histogram of stroke attributes that is discriminative of authorship. We provide extensive classification experiments on a large variety of data sets, which validate SAR\\'s ability to distinguish unique authorship of artists and designers. We also demonstrate the usefulness of SAR in several applications including the detection of fraudulent sketches, the training and monitoring of artists in learning a particular new style and the first quantitative way to measure the quality of automatic sketch synthesis tools. © 2015 The Eurographics Association and John Wiley & Sons Ltd.

  14. Personal accounts of stroke experiences

    NARCIS (Netherlands)

    Wachters-Kaufmann, CSM


    As there appeared to be a need for personal accounts of stroke experiences, a book called "Speaking about Stroke" was written for stroke patients and their caregivers. For the past two years, a questionnaire was sent to the people who had ordered the book, to gain an insight into the characteristics

  15. Questions and Answers about Stroke (United States)

    ... stroke. High blood pressure increases your risk of stroke four to six times. Heart disease, especially a condition ... leading cause of serious, long-term adult disability. Four million Americans are living with the effects of stroke. The length of time to recover from a ...

  16. Stroke and Episodic Memory Disorders (United States)

    Lim, Chun; Alexander, Michael P.


    Memory impairments are common after stroke, and the anatomical basis for impairments may be quite variable. To determine the range of stroke-related memory impairment, we identified all case reports and group studies through the Medline database and the Science Citation Index. There is no hypothesis about memory that is unique to stroke, but there…

  17. Canadian bishops' letter presents theology of healing, suffering. (United States)

    Daigeler, H W


    With board input from theologians, health personnel, patients, and others interested in health care, the Canadian Conference of Catholic Bishops released its pastoral letter on sickness and healing in September 1983. Acknowledging that suffering and healing are mysteries beyond complete understanding, the letter illuminates the connection between caring for one's own health, helping the sick, and following Christ. The letter's first major section reviews suffering and healing as presented in the Bible, and asserts that the act of healing should help to restore not only the body but also the sufferer's relationship with God and with the community. The letter's second section surveys the history of the healing tradition within the Church and notes that, because the great healers often suffered themselves, their example can help people to integrate suffering into their own quest for wholeness and spiritual growth. In the pastoral's third section the bishops suggest attitudes and practices for those who wish to be healers today. They apply theological teaching to five practical levels of pastoral concern: individual actions, parish communities, Catholic and other health care institutions, and the social, economic, and political community. Each level, the bishops stress, must play an important role in healing and salvation.

  18. Functional lymphatic alterations in patients suffering from lipedema. (United States)

    Bilancini, S; Lucchi, M; Tucci, S; Eleuteri, P


    Lipedema is a chronic vascular disease almost exclusively of female sex, characterized by the deposit of fat on the legs, with an "Egyptian column" shape, orthostatic edema, hypothermia of the skin, alteration of the plantar support, and negativity of Stemmer's sign. The etiology and pathogenesis of this disease are still the object of study, and therapy is very difficult. Various authors have described morphologic and functional alterations of prelymphatic structures and of lymphatic vessels. The big veins remain untouched in the phlebograms and an alteration of the skin elasticity is demonstrated. The present authors have studied by dynamic lymphoscintigraphy 12 women patients suffering from lipedema, and compared the results with those of 5 normal subjects and 5 patients suffering from idiopathic lymphedema who were sex and age matched with the patients suffering from lipedema. The patients suffering from lipedema showed an abnormal lymphoscintigraphic pattern with a slowing of the lymphatic flow that presented some analogies to the alterations found in the patients suffering from lymphedema. A frequent asymmetry was also noticed in the lymphoscintigraphic findings that is in contrast to the symmetry of the clinical profile.

  19. Hidden Suffering and the Effects of Adverse Childhood Experiences

    Directory of Open Access Journals (Sweden)

    William Fulford


    Full Text Available To understand suffering is to understand what it means to be human. Suffering focuses our attention on our vulnerability, which we would rather ignore or deny. As health care professionals (HCP we need to be able to listen, to attune and be empathic to the suffering patient. If we act as an “enlightened witness” we provide a safe place for a suffering patient to grieve their loss and be vulnerable. This is skilled and demanding work, it is also important to tend to our own needs through a practice of self-care and reflection to prevent burn-out and compassion fatigue. The topic of adverse childhood experiences (ACE, which are common in the general population, are addressed in the second part of this paper. Their effects are profound, and increase with the degree of maltreatment. The maltreatment and suffering of these children usually remains hidden into adulthood beneath years of shame and denial. One aspect of our job in health care is to help patients acknowledge, experience, and bear the reality of life with all its pleasures and heartache. In order to do this well, we need to keep in touch with our own humanity, but also continue to take care of ourselves.

  20. Stroke prevention: an update. (United States)

    Bousser, Marie-Germaine


    Stroke is a personal, familial, and social disaster. It is the third cause of death worldwide, the first cause of acquired disability, the second cause of dementia, and its cost is astronomic. The burden of stroke is likely to increase given the aging of the population and the growing incidence of many vascular risk factors. Prevention of stroke includes--as for all other diseases--a "mass approach" aiming at decreasing the risk at the society level and an individual approach, aiming at reducing the risk in a given subject. The mass approach is primarily based on the identification and treatment of vascular risk factors and, if possible, in the implementation of protective factors. These measures are the basis of primary prevention but most of them have now been shown to be also effective in secondary prevention. The individual approach combines a vascular risk factor modification and various treatments addressing the specific subtypes of stroke, such as antiplatelet drugs for the prevention of cerebral infarction in large and small artery diseases of the brain, carotid endarterectomy or stenting for tight carotid artery stenosis, and oral anticoagulants for the prevention of cardiac emboli. There is a growing awareness of the huge evidence-to-practice gap that exists in stroke prevention largely due to socio-economic factors. Recent approaches include low cost intervention packages to reduce blood pressure and cheap "polypills" combining in a single tablet aspirin and several drugs to lower blood pressure and cholesterol. Polypill intake should however not lead to abandon the healthy life-style measures which remain the mainstay of stroke prevention.

  1. Ischemic Stroke and Cancer: Stroke Severely Impacts Cancer Patients, While Cancer Increases the Number of Strokes


    Bang, Oh Young; Seok, Jin Myoung; Kim, Seon Gyeong; Hong, Ji Man; Kim, Hahn Young; Lee, Jun; Chung, Pil-Wook; Park, Kwang-Yeol; Kim, Gyeong-Moon; Chung, Chin-Sang; Lee, Kwang Ho


    Background Cancer and ischemic stroke are two of the most common causes of death among the elderly, and associations between them have been reported. However, the main pathomechanisms of stroke in cancer patients are not well known, and can only be established based on accurate knowledge of the characteristics of cancer-related strokes. We review herein recent studies concerning the clinical, laboratory, and radiological features of patients with cancer-related stroke. Main Contents This revi...

  2. Suffering in the mystical traditions of Buddhism and Christianity

    Directory of Open Access Journals (Sweden)

    Jakub Urbaniak


    Full Text Available This article seeks to explore the mystical approaches to suffering characteristic of both Buddhism and Christianity. Through the analysis of the meanings, the two traditions in question ascribe to suffering as a ‘component’ of mystical experience; it challenges the somewhat oversimplified understanding of the dichotomy ’sage-the-robot versus saint-the-sufferer’. Thus it contributes to the ongoing discussion on the theological–spiritual dimensions of the human predicament, as interpreted by various religious traditions. It also illustrates (though only implicitly in what sense – to use the Kantian distinction – the mystical experience offers boundaries (Schranken without imposing limits (Grenzen to interfaith encounter and dialogue. Man [sic] is ready and willing to shoulder any suffering, as soon and as long as he can see a meaning in it. (Frankl 1967:56

  3. Alcohol consumption and hangover patterns among migraine sufferers

    Directory of Open Access Journals (Sweden)

    Yair Zlotnik


    Full Text Available Aims: Alcohol hangover is a poorly understood cluster of symptoms occurring following a heavy consumption of alcohol. The term "delayed alcohol-induced headache" is often used synonymously. Our objective was to compare alcohol hangover symptoms in migraine sufferers and nonsufferers. Materials and Methods: In this cross-sectional study, university students were asked to fill structured questionnaires assessing headache history, alcoholic consumption, and hangover symptoms (using the Hangover Symptom Scale (HSS. Subjects were classified as suffering from migraine with or without aura and nonsufferers according the International Classification of Headache Disorders 2 nd Edition (ICHD-II. The 13 hangover symptoms were divided by the researches into migraine-like and other nonmigraine-like symptoms. Results: Hangover symptoms among 95 migraine sufferers and 597 nonsufferers were compared. Migraine sufferers consumed less alcohol compared with the nonsufferers (mean drinks/week 2.34 ± 4.11 vs. 2.92 ± 3.58, P = 0.038 and suffered from higher tendency to migraine-like symptoms after drinking (mean 2.91 ± 3.43 vs. 1.85 ± 2.35, P = 0.002 but not to other hangover symptoms (mean 5.39 ± 6.31 vs. 4.34 ± 4.56, P = 0.1. Conclusions: Migraine sufferers consume less alcohol, especially beer and liquors, and are more vulnerable to migraine-like hangover symptoms than nonsufferers. The finding that the tendency to develop migraine attacks affects the hangover symptomatology may suggest a similarity in pathophysiology, and possibly in treatment options.

  4. Family History in Young Patients With Stroke. (United States)

    Thijs, Vincent; Grittner, Ulrike; Dichgans, Martin; Enzinger, Christian; Fazekas, Franz; Giese, Anne-Katrin; Kessler, Christof; Kolodny, Edwin; Kropp, Peter; Martus, Peter; Norrving, Bo; Ringelstein, Erich Bernd; Rothwell, Peter M; Schmidt, Reinhold; Tanislav, Christian; Tatlisumak, Turgut; von Sarnowski, Bettina; Rolfs, Arndt


    Family history of stroke is an established risk factor for stroke. We evaluated whether family history of stroke predisposed to certain stroke subtypes and whether it differed by sex in young patients with stroke. We used data from the Stroke in Fabry Patients study, a large prospective, hospital-based, screening study for Fabry disease in young patients (aged stroke in whom cardiovascular risk factors and family history of stroke were obtained and detailed stroke subtyping was performed. A family history of stroke was present in 1578 of 4232 transient ischemic attack and ischemic stroke patients (37.3%). Female patients more often had a history of stroke in the maternal lineage (P=0.027) than in the paternal lineage. There was no association with stroke subtype according to Trial of Org 10172 in Acute Stroke Treatment nor with the presence of white matter disease on brain imaging. Patients with dissection less frequently reported a family history of stroke (30.4% versus 36.3%; P=0.018). Patients with a parental history of stroke more commonly had siblings with stroke (3.6% versus 2.6%; P=0.047). Although present in about a third of patients, a family history of stroke is not specifically related to stroke pathogenic subtypes in patients with young stroke. Young women with stroke more often report stroke in the maternal lineage. URL: Unique identifier: NCT00414583. © 2015 American Heart Association, Inc.

  5. The Future of Music Therapy with Persons Suffering from Schizophrenia

    DEFF Research Database (Denmark)

    Pedersen, Inge Nygaard


    This chapter presents important research concerning music therapy with persons suffering from schizophrenia. It further presents the most Applied theories and models concerning clinical practice individual and in Groups with this population. It offers ideas as to why music therapy Works...... with persons suffering from schizophrenia. These ideas are divided into 1) possible positions of the music therapist, 2) the function of the music. Finally a discussion on the questions:´ Should music therapy focus on symptoms, resources - or both?´, is unfodled....

  6. Experiences of well-being and suffering after hip fracture

    DEFF Research Database (Denmark)

    Rasmussen, Birgit; Uhrenfeldt, Lisbeth


    Background: Dependency and limited functional ability is common when older people fracture their hip. Experiences of well-being seem to be important during recovery and when living with a hip fracture as a balancing of suffering. Evidence exists that self-confidence is important during rehabilita...... whole. Conclusion: The meta-synthesis provided evidence that both the sufferings and the possibilities of older people need to be addressed during rehabilitation to support experiences of well-being, independency and confidence after a hip fracture. The study contributed with evidence...

  7. Higher Education Is Associated with a Lower Risk of Dementia after a Stroke or TIA. The Rotterdam Study. (United States)

    Mirza, Saira Saeed; Portegies, Marileen L P; Wolters, Frank J; Hofman, Albert; Koudstaal, Peter J; Tiemeier, Henning; Ikram, M Arfan


    Higher education is associated with a lower risk of dementia, possibly because of a higher tolerance to subclinical neurodegenerative pathology. Whether higher education also protects against dementia after clinical stroke or transient ischemic attack (TIA) remains unknown. Within the population-based Rotterdam Study, 12,561 participants free of stroke, TIA and dementia were followed for occurrence of stroke, TIA and dementia. Across the levels of education, associations of incident stroke or TIA with subsequent development of dementia and differences in cognitive decline following stroke or TIA were investigated. During 124,862 person-years, 1,463 persons suffered a stroke or TIA, 1,158 persons developed dementia, of whom 186 developed dementia after stroke or TIA. Risk of dementia after a stroke or TIA, compared to no stroke or TIA, was highest in the low education category (hazards ratio [HR] 1.46, 95% CI 1.18-1.81) followed by intermediate education category (HR 1.36, 95% CI 1.03-1.81). No significant association was observed in the high education category (HR 0.62, 95% CI 0.25-1.54). In gender stratified analyses, decrease in risk of dementia with increasing education was significant only in men. Higher education is associated with a lower risk of dementia after stroke or TIA, particularly in men, which might be explained by a higher cognitive reserve. © 2016 S. Karger AG, Basel.

  8. INTERACTION: training and monitoring of daily-life physical interaction with the environment after stroke

    NARCIS (Netherlands)

    Buurke, Jaap; Baten, Christian T.M.; Reenalda, J.; Reenalda, Jasper; Nikamp-Simons, Corien Diana Maria; Luft, A.R.; De Rossi, Danilo; Luinge, Hendrik J.; Paradiso, R.; Veltink, Petrus H.


    Persons who suffered a stroke are trained to improve adequate control over their movements with the objective to optimize their daily-life functional performance. Critical is how good they are able to interact physically with the dailylife environment, including handling objects, controlling body

  9. Depression in survivors of stroke : a community-based study at prevalence, risk factors and consequences

    NARCIS (Netherlands)

    Beekman, A T F; Penninx, B W J H; Deeg, DJH; Ormel, J; Braam, AW; van Tilburg, W


    Depression in survivors of stroke is both common and clinically relevant. It is associated with excess suffering, handicap, suicidal ideation and mortality and it hampers rehabilitation. Most of the data currently available are derived from clinical studies. The objective of the present study was to

  10. Epidemiology and Management of Atrial Fibrillation and Stroke : Review of Data from Four European Countries

    NARCIS (Netherlands)

    A.D. Ceornodolea (Andreea); R.A. Bal (Roland); J.L. Severens (Hans)


    textabstractIn Europe, 1–3% of the population suffers from atrial fibrillation (AF) and has increased stroke risk. By 2060 a doubling in number of cases and great burden in managing this medical condition are expected.This paper offers an overview of data on epidemiology and management of AF and

  11. 'Living a life in shades of grey': experiencing depressive symptoms in the acute phase after stroke. (United States)

    Kouwenhoven, Siren E; Kirkevold, Marit; Engedal, Knut; Kim, Hesook S


    The aim of the present study was to describe the lived experience of stroke survivors suffering from depressive symptoms in the acute phase; addressing the following questions: (a) what is the nature of depression as experienced by post-stroke patients in the acute phase? (b) what is it like to live with depression within the first weeks following stroke? Post-stroke depression occurs in at least one quarter of stroke survivors and is linked to poorer outcomes. This qualitative study is methodologically grounded in hermeneutic phenomenology, influenced by van Manen and Ricoeur. A descriptive, qualitative design was used applying in-depth interviews as the method of data collection with nine participants. The data collection took place in 2008. The material revealed two main themes that generate the feeling and description of 'living a life in shades of grey': (a) being trapped and (b) losing oneself. 'Shades of grey' could be understood as being confined in a new life-world and losing oneself as the person one knew. The participants confirmed suffering from depressive symptoms, but depression was not seen as meaningful on its own. They related their experiences of post-stroke depression in the acute phase to the losses they experienced. Nurses ought to take into account the depth of the life changes that stroke survivors may experience. There is a need for continued empirical research on how nurses may help and support stroke survivors dealing with depressive symptoms in the acute phase after stroke and how depressive symptoms develop over time. © 2011 Blackwell Publishing Ltd.

  12. Clinical Characteristics of Cerebrovascular Pathology with Patients Suffering from Ph-Negative Myeloproliferative Disease

    Directory of Open Access Journals (Sweden)

    Marine M. Tanashyan


    Full Text Available Background: Disturbances of microcirculation play a significant role in the development and progression of both acute and chronic cerebrovascular diseases (CVD and may be associated with different hemogram abnormalities. One of the reasons of the prothrombogenic state of the endothelium is the increase in the number of blood corpuscles leading to (non-Ph myeloproliferative disorders (MPD including essential thrombocythemia (ET, polycythemia vera (PV, and primary myelofibrosis (PM. Materials and Methods: The study included 167 patients: 102 patients with Ph-MPD and the control group comprising 65 patients with CVD. According to MPD subtype, the patients were divided into three groups: patients with ET (37%, n = 38, male/female 7/31, age 52 ± 7 years, those with PV (40%, n = 41, male/female 20/21, age 50 ± 6 years and those with PM (23%, n = 23, male/female 5/18, age 54 ± 4 years. Results: In 79% (n = 81 of cases in the study group (with Ph-MPD, patients had chronic CVD, with the most frequently identified symptoms being asthenia (92% and headache (72%. Headache in Ph-MPD patients was more frequently (86% associated with PM, while in patients with PV and ET it was equally distributed (70%. Neurological symptoms in 53% of cases were associated with focal changes of the brain on MRI localized in the subcortical area of the frontal and parietal lobes. Twenty-one (21% patients suffered an acute cerebrovascular accident, 8 of them had thrombotic occlusion of one of the internal carotid arteries leading to hemispheric infarcts. Endothelial function (as measured by flow-dependent dilation of the brachial artery was severely impaired in all study groups (median 5% with normal cut-off at 10%, the lowest degree of vasodilator activity being specific for patients with a history of stroke (p = 0.011. Conclusion: Patients suffering from MPD had asymptomatic focal changes in the brain in the absence of concomitant vascular disease (hypertension

  13. Ageism in stroke rehabilitation studies. (United States)

    Gaynor, Eva Joan; Geoghegan, Sheena Elizabeth; O'Neill, Desmond


    stroke is predominantly a disease of older people. While age bias has been demonstrated in studies of pharmacological therapeutic interventions in stroke, the extent of discrimination by age in stroke rehabilitation studies is unknown. The aim of this study was to systematically review the literature to assess the extent of ageism in stroke rehabilitation studies. all randomised control trials (RCT) on stroke rehabilitation entered in the Cochrane database which reported mean age were included. Patient gender and exclusion criteria were also recorded. of 241 RCT's identified, 182 were eligible for inclusion. The mean age of all patients was 64.3, almost a decade younger than those seen by stroke physicians in daily practice in global terms, and 11-12 years younger than encountered in hospital practice in the British Isles. Almost half (46%) of trials excluded patients with cognitive impairment, almost one-quarter (23%) patients with dysphasia and one-eighth (13%) excluded patients with multiple strokes. we have identified a clear difference in the mean age of those included in stroke rehabilitation studies compared with the international mean age of stroke. In addition, a quarter of trials excluded dysphasic patients which may indicate omission of more severe strokes. This means that the evidence base for stroke rehabilitation is deficient in terms of matching the characteristics of patients encountered in clinical practice, and a more representative sample of older people and those with significant disability must be included in future trials.

  14. Stroke? Localized, otogenic meningitis!

    DEFF Research Database (Denmark)

    Ingolfsdottir, Harpa Maria; Thomasen, Per Caye


    We report the case of a patient admitted with aphasia, treated for a stroke. Subsequently, it was revealed that the symptoms were caused by complicated otitis media with localized meningitis. This case draws attention to the possible intracranial spread of infection when neurological symptoms occur...

  15. Ischemic strokes and migraine

    International Nuclear Information System (INIS)

    Bousser, M.G.; Baron, J.C.; Chiras, J.


    Lasting neurological deficits, though most infrequent, do occur in migrainous subjects and are well documented by clinical angiographic computed tomographic (CT scan) and even pathological studies. However the mechanism of cerebral ischemia in migraine remains widely unknown and the precise role of migraine in the pathogenesis of ischemic strokes is still debated. (orig./MG)

  16. Stroke while jogging.


    Kelly, W. F.; Roussak, J.


    Jogging is a form of physical exercise that has stimulated the imagination of the public as shown by recent appearance of its own journal (Jogging Magazine, Editor J. Bryant). We wish to report the unusual complication of an acute stroke sustained during jogging.

  17. Stroke while jogging. (United States)

    Kelly, W. F.; Roussak, J.


    Jogging is a form of physical exercise that has stimulated the imagination of the public as shown by recent appearance of its own journal (Jogging Magazine, Editor J. Bryant). We wish to report the unusual complication of an acute stroke sustained during jogging. Images p229-a Fig. 1 PMID:7448490

  18. Sex differences in stroke.

    NARCIS (Netherlands)

    Haast, R.A.M.; Gustafson, D.R.; Kiliaan, A.J.


    Sex differences in stroke are observed across epidemiologic studies, pathophysiology, treatments, and outcomes. These sex differences have profound implications for effective prevention and treatment and are the focus of this review. Epidemiologic studies reveal a clear age-by-sex interaction in

  19. Family History and Stroke Risk in China: Evidence from a Large Cohort Study. (United States)

    Tian, Tian; Jin, Guangfu; Yu, Canqing; Lv, Jun; Guo, Yu; Bian, Zheng; Yang, Ling; Chen, Yiping; Shen, Hongbing; Chen, Zhengming; Hu, Zhibin; Li, Liming


    Large cohort studies on relationship between family history of stroke (FHS) and stroke risk are lacking in Asians. We aimed to systematically evaluate the association of FHS with stroke risk in a cohort study of 0.5 million Chinese adults. Information about FHS was self-reported. The median follow-up time was 7.16 years and the end-point of follow-up was incident stroke, which was entered directly into the China Kadoorie Biobank system. Multivariate analyses were performed with Cox proportional hazards model, and interaction analyses were carried using likelihood-ratio tests. Compared with participants without FHS, the hazard ratio (HR) (95% confidence interval, CI) of stroke for participants with FHS was 1.50 (1.46-1.55). The HRs increased with the number of first degree relatives with stroke (HRs=1.41, 1.98 and 2.47 for 1, 2 and ≥3 relatives, respectively, P trend history and parental history, respectively. Similar associations with offspring stroke risk were observed between paternal history (HR=1.48, 95% CI: 1.43-1.54) and maternal history (HR=1.49, 95% CI: 1.43-1.55). Moreover, significant interactions were detected between FHS and health-risk behaviors (tobacco smoking and alcohol drinking). FHS is an independent risk factor for stroke in Chinese. The more first degree relatives are affected by stroke, the higher are individuals' risk of suffering from stroke. The management of the health-risk behaviors for reducing stroke should be highlighted, especially for the individuals with FHS.

  20. [The Determinants of Dysphagia in Patients With Stroke During Hospitalized Rehabilitation]. (United States)

    Szu, Li-Yun; Hsieh, Suh-Ing; Tseng, Su-Mei; Huang, Tzu-Hsin


    Stroke was the third leading cause of death in Taiwan in 2014. A study found that 53.61% of stroke patients suffered from dysphagia disorder during the rehabilitation phase, which may result in lung aspiration and death. The determinants of dysphagia among nationally hospitalized-rehabilitation stroke patients have not been explored comprehensively. To explore the incidence of dysphagia among hospitalized-rehabilitation stroke patients and the related determinants of dysphagia. This descriptive and correlational research design employed a convenience sample of 130 hospitalized stroke patients from rehabilitation wards at a northern regional hospital in Taiwan. A questionnaire and functional assessment were used to collect data. Instruments used included personal and clinical characteristics data questionnaire, the National Institute of Health Stroke Scale (NIHSS), Barthel Index, Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Standardization Swallowing Assessment (SSA), and Acute Stroke Dysphagia Screening (ASDS). Data analyses contained descriptive statistics and logistic regression. The incidence of stroke dysphagia was 63.8% (SSA) and 64.6% (ASDS), respectively. Age, marital status, stroke site, stroke severity (NIHSS), and cognitive status (MMSE) were identified as significant determinants of dysphagia in bivariate logistic regression, whereas stroke severity and cognitive status were identified as significant independent determinants of dysphagia in multivariate logistic regression. Two-thirds of the participant sample were affected by dysphagia, for which NIHSS and cognitive status were identified as significant determinants. Thus, nurses may conduct early screening for high risk populations based on patients' clinical characteristics in order to reduce aspiration pneumonia problems and to improve the quality of clinical care for dysphagia patients.

  1. Acute Ischemic Stroke in a Patient with a Native Valvular Strand

    Directory of Open Access Journals (Sweden)

    Hak Young Rhee


    Full Text Available Valvular strands are known to be a potential source of cardioembolism but the natural history of native valvular strands has not yet been fully outlined. We report a case of ischemic stroke in a patient with a native valvular strand of the aortic valve and the patient’s clinical course. A previously healthy 21-year-old man suffered acute cerebral infarction in the right posterior cerebral artery territory. On echocardiography, there was a strand-like, oscillating mass on the left coronary cusp of the aortic valve. The patient received 100 mg aspirin daily and the valvular strand was not found on subsequent transthoracic echocardiography performed 10 days after the first examination. Serial echocardiographic examinations have been performed since the stroke and failed to find any abnormality. The patient did not suffer a recurrent stroke over a 3-year follow-up period.

  2. The impact of early stroke on identity: A discourse analytic study. (United States)

    Guise, Jennifer; McKinlay, Andy; Widdicombe, Sue


    This article examines the ways in which sufferers talk about early stroke and the effects this chronic condition has on identity. Traditional research into chronic illness has largely used medical, psychiatric or cognitive models. We adopt a social constructionist perspective and use a discourse analytic methodology to study data collected via focus group interaction. Analysis of the data collected shows that participants displayed sensitivity about having acquired a potentially 'damaged' sense of self by mitigating negative features of their experiences. Participants also attended to the issue of whether their accounts were persuasive or believable. Some carers were present in these discussions. As a consequence, participants who had suffered a stroke displayed sensitivity to the way that carers might respond to mitigation of the negative aspects of stroke.

  3. A comparative study of medication use after stroke in four countries. (United States)

    Desmaele, Sara; Putman, Koen; De Wit, Liesbet; Dejaeger, Eddy; Gantenbein, Andreas R; Schupp, Wilfried; Steurbaut, Stephane; Dupont, Alain G; De Paepe, Kristien


    The use of medication plays an important role in secondary stroke prevention and treatment of post-stroke comorbidities. The Collaborative Evaluation of Rehabilitation in Stroke across Europe (CERISE) was set up to investigate the inpatient stroke rehabilitation process in four centres, each in a different European country: Belgium, Germany, United Kingdom and Switzerland. Patients' medication use 5 years post-stroke was compared between countries. Focus was put on cerebrovascular secondary prevention, including (a) adequate antithrombotic treatment, (b) treatment of cardiovascular comorbidities and diabetes, and (c) the use of lipid-lowering drugs; as well as on the treatment of stroke-related disorders such as depression, anxiety and pain. Medication data were available for 247 patients. Data about depression and anxiety were available for 233. There were no significant differences between the four centres in antithrombotic treatment and in the treatment of cardiovascular comorbidities and diabetes. However, significantly more patients from the UK were treated with lipid-lowering drugs compared to Belgian patients. Significant differences were also observed between the centres in the prevalence and treatment of depression. More Belgian patients suffered from depression compared to German patients and significantly more Belgian patients took antidepressants than patients in Germany. This was in contrast to the prevalence and treatment of anxiety and pain, for which no significant differences between the centres were seen. Related to pain treatment, it was observed that almost 40% of all patients suffering from pain, used no specific medication. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Thrombolysis in Postoperative Stroke. (United States)

    Voelkel, Nicolas; Hubert, Nikolai Dominik; Backhaus, Roland; Haberl, Roman Ludwig; Hubert, Gordian Jan


    Intravenous thrombolysis (IVT) is beneficial in reducing disability in selected patients with acute ischemic stroke. There are numerous contraindications to IVT. One is recent surgery. The aim of this study was to analyze the safety of IVT in patients with postoperative stroke. Data of consecutive IVT patients from the Telemedical Project for Integrative Stroke Care thrombolysis registry (February 2003 to October 2014; n=4848) were retrospectively searched for keywords indicating preceding surgery. Patients were included if surgery was performed within the last 90 days before stroke. The primary outcome was defined as surgical site hemorrhage. Subgroups with major/minor surgery and recent/nonrecent surgery (within 10 days before IVT) were analyzed separately. One hundred thirty-four patients underwent surgical intervention before IVT. Surgery had been performed recently (days 1-10) in 49 (37%) and nonrecently (days 11-90) in 85 patients (63%). In 86 patients (64%), surgery was classified as major, and in 48 (36%) as minor. Nine patients (7%) developed surgical site hemorrhage after IVT, of whom 4 (3%) were serious, but none was fatal. One fatal bleeding occurred remotely from surgical area. Rate of surgical site hemorrhage was significantly higher in recent than in nonrecent surgery (14.3% versus 2.4%, respectively, odds ratio adjusted 10.73; 95% confidence interval, 1.88-61.27). Difference between patients with major and minor surgeries was less distinct (8.1% and 4.2%, respectively; odds ratio adjusted 4.03; 95% confidence interval, 0.65-25.04). Overall in-hospital mortality was 8.2%. Intracranial hemorrhage occurred in 9.7% and was asymptomatic in all cases. IVT may be administered safely in postoperative patients as off-label use after appropriate risk-benefit assessment. However, bleeding risk in surgical area should be taken into account particularly in patients who have undergone surgery shortly before stroke onset. © 2017 American Heart Association, Inc.

  5. Imaging of Hemorrhagic Stroke. (United States)

    Hakimi, Ryan; Garg, Ankur


    Hemorrhagic stroke comprises approximately 15% to 20% of all strokes. This article provides readers with an understanding of the indications and significance of various neuroimaging techniques available for patients presenting with hemorrhagic strokes of distinct causes. The most common initial neuroimaging study is a noncontrast head CT, which allows for the identification of hemorrhage. Once an intracranial hemorrhage has been identified, the pattern of blood and the patient's medical history, neurologic examination, and laboratory studies lead the practitioner to pursue further neuroimaging studies to guide the medical, surgical, and interventional management. Given that hemorrhagic stroke constitutes a heterogeneous collection of diagnoses, the subsequent neuroimaging pathway necessary to better evaluate and care for these patients is variable based on the etiology.With an increasing incidence and prevalence of atrial fibrillation associated with the aging population and the introduction of three new direct factor Xa inhibitors and one direct thrombin inhibitor to complement vitamin K antagonists, oral anticoagulant use continues to increase. Patients on oral anticoagulants have a sevenfold to tenfold increased risk for intracerebral hemorrhage (ICH). Furthermore, patients who have an ICH associated with oral anticoagulant use have a higher mortality rate than those with primary ICH. Despite the reduced incidence of hypertension-related ICH over the past decade, it is expected that the incidence of ICH will continue to increase. Neuroimaging studies are integral to the identification of hemorrhagic stroke, determination of the underlying etiology, prevention of hematoma expansion, treatment of acute complications, and treatment of the underlying etiology, if indicated. Neuroimaging is essential for prognostication and thus directly impacts patient care.

  6. Rehabilitating the Stroke Collection

    Directory of Open Access Journals (Sweden)

    Mary Grimmond


    Full Text Available Objective The aim of this project was to complete an analysis of monograph and audiovisual items held in the Central Coast Health Service (CCHS Libraries and containing information relevant to the treatment of acute stroke. Acute stroke is treated by multidisciplinary teams of clinicians based at two hospitals within the CCHS. The adequacy of the library collection was measured by subject coverage and age. Methods The methodology used consisted of three main steps: a literature review; design, administration, and analysis of a questionnaire to members of the CCHS Acute Stroke Team; and an analysis of the libraries’ collections. The research project utilised project management methodology and an evidence based librarianship framework. Results The questionnaire revealed that electronic resources were by far the most frequently used by participants, followed in order by print journals, books, interlibrary loan articles, and audiovisual items. Collection analysis demonstrated that the monograph and audiovisual collections were adequate in both scope and currency to support the information needs of Acute Stroke Team members, with the exception of resources to support patient education. Conclusion The researchers developed recommendations for future collection development in the area of acute stroke resources. Conducting this project within the evidence based librarianship framework helped to develop library staff members’ confidence in their ability to make future collection development decisions, informed by the target group’s information needs and preferences. The collection analysis methodology was designed to be replicated, and new specialist groups within the client base of the library will be targeted to repeat the collection analysis process.

  7. Socio-economic Determinants of Domestic Violence Suffered by ...

    African Journals Online (AJOL)

    The study identified the socio-economic determinants of domestic violence suffered by rural women crop farmers in Orlu agricultural zone of Imo State, Nigeria. Multi-stage sampling procedure was used to select 80 rural women crop farmers for the study. Data were collected using structured interview schedule and ...

  8. 153 Socio-economic Determinants of Domestic Violence Suffered by ...

    African Journals Online (AJOL)


    effects of domestic violence. Key Words: Socio-economic determinants of women voilence, women, domestic violence. .... communities of the nation, this study identified the socio-economic determinants of domestic violence suffered by .... study area fall under emotional/psychological violence. This agrees with the findings.

  9. Suffering from Loneliness Indicates Significant Mortality Risk of Older People

    Directory of Open Access Journals (Sweden)

    Reijo S. Tilvis


    Full Text Available Background. The harmful associates of suffering from loneliness are still in dispute. Objective. To examine the association of feelings of loneliness with all-cause mortality in a general aged population. Methods. A postal questionnaire was sent to randomly selected community-dwelling of elderly people (>74 years from the Finnish National Population Register. The questionnaire included demographic characteristics, living conditions, functioning, health, and need for help. Suffering from loneliness was assessed with one question and participants were categorized as lonely or not lonely. Total mortality was retrieved from the National Population Information System. Results. Of 3687 respondents, 39% suffered from loneliness. Lonely people were more likely to be deceased during the 57-month follow-up (31% than subjects not feeling lonely (23%, <.001. Excess mortality (HR=1.38, 95% CI=1.21-1.57 of lonely people increased over time. After controlling for age and gender, the mortality risk of the lonely individuals was 1.33 (95% CI=1.17-1.51 and after further controlling for subjective health 1.17 (CI=1.02-1.33. The excess mortality was consistent in all major subgroups. Conclusion. Suffering from loneliness is common and indicates significant mortality risk in old age.

  10. Sociable Weavers Increase Cooperative Nest Construction after Suffering Aggression.

    Directory of Open Access Journals (Sweden)

    Gavin M Leighton

    Full Text Available The major transitions in evolution rely on the formation of stable groups that are composed of previously independent units, and the stability of these groups requires both cooperation and reduced conflict. Conflict over group resources may be common, as suggested by work in both cichlids and humans that has investigated how societies resolve conflict regarding investment in group resources, i.e. public goods. We investigated whether sociable weavers (Philetairus socius use aggressive behaviors to modulate the cooperative behavior of group mates. We find that the individuals that build the communal thatch of the nest, i.e. the individuals most at risk of exploitation, are the most aggressive individuals. We show that individuals that invest in interior chamber maintenance, possibly a more selfish behavior, suffer relatively more aggression. After suffering aggression individuals significantly increase cooperative construction of the communal nest thatch. We show that cooperative individuals target aggression towards selfish individuals, and the individuals suffering aggression perform cooperative behaviors subsequent to suffering aggression. In addition to other evolutionary mechanisms, these results suggest that aggression, possibly via the pay-to-stay mechanism, is possibly being used to maintain a public good.

  11. The Joy of Suffering: Nietzsche, theodicy and women's | Brown ...

    African Journals Online (AJOL)

    explore how, through a process of creative deception, this suffering comes to be experienced as pleasure. That is, the women reconstruct their bodies using two dominant stories to which they have access: Christianity and glamorous. Brazilian soap operas. South African Journal of Philosophy Vol. 26 (1) 2007: pp. 31-43 ...

  12. "Unnecessary suffering": the cornerstone of animal protection legislation considered. (United States)

    Radford, M


    Causing "unnecessary suffering" has been widely adopted in legislation to define criminal liability in respect of the treatment of animals. This article examines the way in which the term has been interpreted and applied by the courts, and considers its effectiveness in affording animals protection from abuse.

  13. Leprosy Sufferers' Perception Of Social Stigma As A Determinant Of ...

    African Journals Online (AJOL)

    This study aimed at relating leprosy sufferers perception of social stigma to their lifestyles. Eighty leprosy affected persons comprising males and females drawn from Delta State Government Tuberculosis and Leprosy Referral Center participated in this study. A focus group discussion schedule containing information about ...

  14. Evaluation of plasma lipids and lipoproteins in nigerians suffering ...

    African Journals Online (AJOL)

    There are conflicting reports on the role of plasma lipids in depressive illness. Very little is known about the lipid and lipoprotein status in Nigerian adults suffering from depression. One hundred subjects consisting of sixty (60) depressed patients with mean age (40.3±12.3 yrs) and forty (40) apparently healthy controls ...

  15. Nurses stigmatization of sufferers of sexually transmitted diseases ...

    African Journals Online (AJOL)

    This study's objective is to assess nurses' stigmatization of sufferers of sexual transmitted diseases and its implications on treatment options. The study's method was the survey research through structured questionnaire and interview technique for selected sample of students and nurses. The multistage random sampling ...

  16. Frida Kahlo: Visual Articulations of Suffering and Loss. (United States)

    Nixon, Lois LaCivita


    Illustrates the value of interdisciplinary approaches to patient care by exploring visual articulations of suffering as rendered by one artist. Makes general observations about the nature of humanities courses offered to medical students and depicts a visual portrayal of an illness story representing personal perspectives about patient suffering…

  17. Might Avatar-Mediated Interactions Rehabilitate People Suffering from Aphasia?

    DEFF Research Database (Denmark)

    Konnerup, Ulla


    Many people suffering from communication disabilities after a brain injury have difficulties coming to terms with their new self as disabled persons. Being unable to deal with these problems verbally exacerbates the condition. As a result they often isolate socially and develop low self-esteem...

  18. Perception of Suffering and Compassion Experience: Brain Gender Disparities (United States)

    Mercadillo, Roberto E.; Diaz, Jose Luis; Pasaye, Erick H.; Barrios, Fernando A.


    Compassion is considered a moral emotion related to the perception of suffering in others, and resulting in a motivation to alleviate the afflicted party. We compared brain correlates of compassion-evoking images in women and men. BOLD functional images of 24 healthy volunteers (twelve women and twelve men; age=27 [plus or minus] 2.5 y.o.) were…

  19. Intensive meditation training influences emotional responses to suffering. (United States)

    Rosenberg, Erika L; Zanesco, Anthony P; King, Brandon G; Aichele, Stephen R; Jacobs, Tonya L; Bridwell, David A; MacLean, Katherine A; Shaver, Phillip R; Ferrer, Emilio; Sahdra, Baljinder K; Lavy, Shiri; Wallace, B Alan; Saron, Clifford D


    Meditation practices purportedly help people develop focused and sustained attention, cultivate feelings of compassionate concern for self and others, and strengthen motivation to help others who are in need. We examined the impact of 3 months of intensive meditative training on emotional responses to scenes of human suffering. Sixty participants were assigned randomly to either a 3-month intensive meditation retreat or a wait-list control group. Training consisted of daily practice in techniques designed to improve attention and enhance compassionate regard for others. Participants viewed film scenes depicting human suffering at pre- and posttraining laboratory assessments, during which both facial and subjective measures of emotion were collected. At post-assessment, training group participants were more likely than controls to show facial displays of sadness. Trainees also showed fewer facial displays of rejection emotions (anger, contempt, disgust). The groups did not differ on the likelihood or frequency of showing these emotions prior to training. Self-reported sympathy--but not sadness or distress--predicted sad behavior and inversely predicted displays of rejection emotions in trainees only. These results suggest that intensive meditation training encourages emotional responses to suffering characterized by enhanced sympathetic concern for, and reduced aversion to, the suffering of others. (c) 2015 APA, all rights reserved).

  20. Stroke treatment outcomes in hospitals with and without Stroke Units. (United States)

    Masjuan, J; Gállego Culleré, J; Ignacio García, E; Mira Solves, J J; Ollero Ortiz, A; Vidal de Francisco, D; López-Mesonero, L; Bestué, M; Albertí, O; Acebrón, F; Navarro Soler, I M


    Organisational capacity in terms of resources and care circuits to shorten response times in new stroke cases is key to obtaining positive outcomes. This study compares therapeutic approaches and treatment outcomes between traditional care centres (with stroke teams and no stroke unit) and centres with stroke units. We conducted a prospective, quasi-experimental study (without randomisation of the units analysed) to draw comparisons between 2 centres with stroke units and 4 centres providing traditional care through the neurology department, analysing a selection of agreed indicators for monitoring quality of stroke care. A total of 225 patients participated in the study. In addition, self-administered questionnaires were used to collect patients' evaluations of the service and healthcare received. Centres with stroke units showed shorter response times after symptom onset, both in the time taken to arrive at the centre and in the time elapsed from patient's arrival at the hospital to diagnostic imaging. Hospitals with stroke units had greater capacity to respond through the application of intravenous thrombolysis than centres delivering traditional neurological care. Centres with stroke units showed a better fit to the reference standards for stroke response time, as calculated in the Quick study, than centres providing traditional care through the neurology department. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Secular trends in ischemic stroke subtypes and stroke risk factors. (United States)

    Bogiatzi, Chrysi; Hackam, Daniel G; McLeod, A Ian; Spence, J David


    Early diagnosis and treatment of a stroke improves patient outcomes, and knowledge of the cause of the initial event is crucial to identification of the appropriate therapy to maximally reduce risk of recurrence. Assumptions based on historical frequency of ischemic subtypes may need revision if stroke subtypes are changing as a result of recent changes in therapy, such as increased use of statins. We analyzed secular trends in stroke risk factors and ischemic stroke subtypes among patients with transient ischemic attack or minor or moderate stroke referred to an urgent transient ischemic attack clinic from 2002 to 2012. There was a significant decline in low-density lipoprotein cholesterol and blood pressure, associated with a significant decline in large artery stroke and small vessel stroke. The proportion of cardioembolic stroke increased from 26% in 2002 to 56% in 2012 (Prisk factors was observed, with a significant decline in stroke/transient ischemic attack caused by large artery atherosclerosis and small vessel disease. As a result, cardioembolic stroke/transient ischemic attack has increased significantly. Our findings suggest that more intensive investigation for cardiac sources of embolism and greater use of anticoagulation may be warranted. © 2014 American Heart Association, Inc.

  2. Outcome Determinants of Stroke in a Brazilian Primary Stroke Center

    Directory of Open Access Journals (Sweden)

    Gustavo W. Kuster


    Full Text Available Background. Stroke mortality in Brazil is one of the highest among Western countries. Nonetheless, stroke outcome determinants are still poorly known in this country. In this study we evaluate outcome determinants of stroke in a primary stroke center in São Paulo, Brazil. Methods. We evaluated demographic, clinical, and outcome data of patients with ischemic stroke (IS, transient ischemic attack (TIA, and intracerebral hemorrhage (ICH admitted at “Hospital Paulistano,” São Paulo, Brazil. In-hospital mortality and functional outcome determinants were assessed. Univariate and binary logistic regression analysis were performed. Results. Three hundred forty-one patients were included in the study, 52.2% being male with 66.8±15.7 years. The stroke type distribution was IS: 59.2%, TIA: 29.6%, and ICH: 11.1%. ICH was associated with greater severity and poorer functional outcome. The determinants of poorer functional outcome were higher NIHSS, lower Glasgow score, and lower oxygen saturation level. The most important mortality determinant was the presence of visual symptoms. Conclusions. The stroke mortality and stroke outcome determinants found in the present study do not remarkably differ from studies carried out in developed countries. Stroke prognosis studies are crucial to better understand the high burden of stroke in Brazil.

  3. The moral aesthetics of simulated suffering in standardized patient performances. (United States)

    Taylor, Janelle S


    Standardized patient (SP) performances are staged clinical encounters between health-professional students and people who specialize in role-playing the part of patients. Such performances have in recent years become increasingly central to the teaching and assessment of clinical skills in U.S. medical schools. SP performances are valued for being both "real" (in that they involve interaction with a real person, unlike written examinations) and "not real" (in that the SP does not actually suffer from the condition portrayed, unlike an actual patient). This article considers how people involved in creating SP performances reconcile a moral commitment to avoid suffering (to keep it "not real"), with an aesthetic commitment to realistically portray it (to keep it "real"). The term "moral aesthetic" is proposed, to indicate a sensibility that combines ideas about what is morally right with ideas about what is aesthetically compelling. Drawing on ethnographic research among SPs and SP program staff and medical faculty who work closely with them, this article argues that their work of creating "realism" in simulated clinical encounters encompasses multiple different (and sometimes conflicting) understandings and practices of realism, informed by three different moral aesthetics: (1) a moral aesthetic of induction, in which an accurate portrayal with a well-documented provenance serves to introduce experientially distant forms of suffering; (2) a moral aesthetic of inoculation, in which the authenticity and emotional impact of a performance are meant to inoculate students against the impact of future encounters with suffering; (3) a moral aesthetic of presence, generating forms of voice and care that are born out of the embodied presence of suffering individuals in a clinical space. All are premised on the assumption that risk and suffering can be banished from SP performances. This article suggests, however, that SP performances necessarily raise the same difficult

  4. Can S100B Predict Cerebral Vasospasms in Patients Suffering from Subarachnoid Hemorrhage? (United States)

    Amiri, Moshgan; Astrand, Ramona; Romner, Bertil


    Background: Protein S100B has proven to be a useful biomarker for cerebral damages. Increased levels of serum and cerebrospinal fluid (CSF) S100B have been shown in patients suffering subarachnoid hemorrhage (SAH), severe head injury and stroke. In patients with SAH, the course of S100B levels has been correlated with neurological deficits and outcome. Cerebral vasospasm is a major contributor to morbidity and mortality. The primary aim of this study was to investigate the potential of S100B protein as a predictor of cerebral vasospasm in patients with severe SAH. Materials and Methods: Patients with SAH, Fisher grade 3 and 4, were included in the study. Five samples of CSF and serum S100B were collected from each patient. The first sample (baseline sample) was drawn within the first 3 days following ictus and the following four samples, once a day on days 5–8, with day of ictus defined as day 1. Clinical suspicion of cerebral vasospasm confirmed by computed tomography angiography was used to diagnose cerebral vasospasm. Results: A total of 18 patients were included. Five patients (28%) developed cerebral vasospasm, two (11%) developed ventriculitis. There were no significant differences between S100B for those with and without vasospasm. Serum S100B levels in patients with vasospasm were slightly lower within the first 5 days following ictus, compared to patients without vasospasm. Two out of five patients had elevated and increasing serum S100B prior to vasospasm. Only one showed a peak level of S100B 1 day before vasospasm could be diagnosed. Due to the low number of patients in the study, statistical significance could not be reached. Conclusion: Neither serum nor CSF S100B can be used as predictor of cerebral vasospasm in patients suffering from SAH. PMID:23761779

  5. Can S100B predict cerebral vasospasms in patients suffering from subarachnoid hemorrhage?

    Directory of Open Access Journals (Sweden)

    Moshgan eAmiri


    Full Text Available Background: Protein S100B has proven to be a useful biomarker for cerebral damages. Increased levels of serum and CSF S100B have been shown in patients suffering subarachnoid hemorrhage, severe head injury and stroke. In patients with subarachnoid hemorrhage, the course of S100B levels has been correlated with neurological deficits and outcome. Cerebral vasospasm is a major contributor to morbidity and mortality. The primary aim of this study was to investigate the potential of S100B protein as a predictor of cerebral vasospasm in patients with severe subarachnoid hemorrhage.Methods: Patients with SAH, Fisher grade 3 and 4, were included in the study. Five samples of CSF and serum S100B were collected from each patient. The first sample (baseline sample was drawn within the first three days following ictus and the following four samples, once a day on days 5 to 8, with day of ictus defined as day 1. Clinical suspicion of cerebral vasospasm confirmed by computed tomography angiography was used to diagnose cerebral vasospasm.Results: A total of 18 patients were included. Five patients (28 % developed cerebral vasospasm, two (11 % developed ventriculitis. There were no significant differences between S100B for those with and without vasospasm. Serum S100B levels in patients with vasospasm were slightly lower within the first 5 days following ictus, compared to patients without vasospasm. Two out of 5 patients had elevated and increasing serum S100B prior to vasospasm. Only one showed a peak level of S100B one day before vasospasm could be diagnosed. Due to the low number of patients in the study, statistical significance could not be reached. Conclusion: Neither serum nor CSF S100B can be used as predictor of cerebral vasospasm in patients suffering from subarachnoid hemorrhage.

  6. Understanding Stroke - Know Stroke • Know the Signs • Act in Time (United States)

    ... Home Current Issue Past Issues Special Section Understanding Stroke Know Stroke • Know the Signs • Act in Time Past Issues / ... Julie Harris, and motivational speaker David Layton. Preventing Stroke "Until I had my stroke, I didn't ...

  7. Treatment of holistic suffering in cancer: A systematic literature review. (United States)

    Best, Megan; Aldridge, Lynley; Butow, Phyllis; Olver, Ian; Price, Melanie A; Webster, Fleur


    Holistic suffering is a debilitating problem for cancer patients. Although many treatments have been suggested for its alleviation, they have not been compared for effectiveness. This literature review seeks to identify what interventions are effective in treatment of holistic suffering of cancer patients. A systematic review was conducted to identify and evaluate studies of interventions for holistic suffering in adult cancer patients. Search terms were generated iteratively from the literature. MEDLINE, EMBASE, the Cochrane Library and PsycINFO databases were searched for the years 1992-2015. Included studies were peer-reviewed, English language reports of either a controlled trial or a randomised controlled trial focusing on therapies aimed at relieving suffering in adult cancer patients. Articles were excluded if focused predominantly on spiritual or existential issues or concerns not leading to suffering. Studies were graded for quality using the QualSyst quantitative checklist. Levels of evidence were ascertained by completing the National Health and Medical Research Council criteria. Results are reported according to AMSTAR guidelines. The studies represented seven intervention types. Meaning-centred, hope-centred and stress-reduction interventions were found to be effective. Results of both psycho-educational and spiritual interventions in improving spiritual well-being were mixed. Supportive-expressive interventions - with the exception of forgiveness therapy - were not efficacious. There was little or no evidence for the efficacy of creative and healing arts and other assessed interventions such as animal therapy and haptotherapy. This systematic review found that spiritual well-being, meaning, hope and benefit finding can be positively impacted by a variety of treatment modalities. © The Author(s) 2015.

  8. [Violence and mental suffering among men in primary health care]. (United States)

    Albuquerque, Fernando Pessoa de; Barros, Claudia Renata dos Santos; Schraiber, Lilia Blima


    To analyze the association between male mental health problems and violence experienced. Cross sectional study with 477 males aged between 18 and 60, users of two primary healthcare centers in Sao Paulo, SP, Southeastern Brazil. The selection for the sample was based on a sequentiality criterion, according to the order of arrival of the users. Sociodemographic and health characteristics and reports of having experienced violence at any time and/or having witnessed violence in childhood were collected. Information was also collected on the use of mental health services and/or psychological complaints/diagnoses during consultation at medical clinics by reading medical records, to categorize the dependent variable "mental suffering". The variables were described as absolute and relative frequencies. The association was tested using a confirmatory Poisson model with robust variance adjusted for age, marital status, education, violence witnessed in childhood and psychoactive substance use. The prevalence of mental suffering was 29.4%. Mental suffering was associated with experiencing repeated physical and/or sexual violence (RP 1.75, 95%CI 1.13;2.72). The association with a single episode of violence lost significance after the inclusion of psychoactive substance use in the model. Analysis of the fraction attributable to repetitive physical and/or sexual violence for the mental suffering of the men, verified it as 30.4%. The relationship between violence and mental suffering, already highlighted in studies with women, is also relevant to men's health, drawing attention to the similar need of identification, in the health services, of situations of violence experienced by the male population. For men, this relationship was shown to be influenced by the presence of psychoactive substance use; a situation which must be dealt with, more and in a better way, by the health care service.

  9. Ethics and images of suffering bodies in humanitarian medicine. (United States)

    Calain, Philippe


    Media representations of suffering bodies from medical humanitarian organisations raise ethical questions, which deserve critical attention for at least three reasons. Firstly, there is a normative vacuum at the intersection of medical ethics, humanitarian ethics and the ethics of photojournalism. Secondly, the perpetuation of stereotypes of illness, famine or disasters, and their political derivations are a source of moral criticism, to which humanitarian medicine is not immune. Thirdly, accidental encounters between members of the health professions and members of the press in the humanitarian arena can result in misunderstandings and moral tension. From an ethics perspective the problem can be specified and better understood through two successive stages of reasoning. Firstly, by applying criteria of medical ethics to the concrete example of an advertising poster from a medical humanitarian organisation, I observe that media representations of suffering bodies would generally not meet ethical standards commonly applied in medical practice. Secondly, I try to identify what overriding humanitarian imperatives could outweigh such reservations. The possibility of action and the expression of moral outrage are two relevant humanitarian values which can further be spelt out through a semantic analysis of 'témoignage' (testimony). While the exact balance between the opposing sets of considerations (medical ethics and humanitarian perspectives) is difficult to appraise, awareness of all values at stake is an important initial standpoint for ethical deliberations of media representations of suffering bodies. Future pragmatic approaches to the issue should include: exploring ethical values endorsed by photojournalism, questioning current social norms about the display of suffering, collecting empirical data from past or potential victims of disasters in diverse cultural settings, and developing new canons with more creative or less problematic representations of

  10. Challenging comparison of stroke scales

    Directory of Open Access Journals (Sweden)

    Kavian Ghandehari


    Full Text Available Stroke scales can be classified as clinicometric scales and functional impairment, handicap scales. All studies describing stroke scales were reviewed by internet searching engines with the final search performed on January 1, 2013. The following string of keywords was entered into search engines; stroke, scale, score and disability. Despite advantages of modified National Institute of Health Stroke Scale and Scandinavian stroke scale comparing to the NIHSS, including their simplification and less inter-rater variability; most of the stroke neurologists around the world continue using the NIHSS. The modified Rankin scale (mRS and Barthel index (BI are widely used functional impairment and disability scales. Distinction between grades of mRS is poorly defined. The Asian stroke disability scale is a simplified functional impairment, handicap scale which is as valid as mRS and BI. At the present time, the NIHSS, mRS and BI are routine stroke scales because physicians have used to work with these scales for more than two decades, although it could not be an acceptable reason. On the other side, results of previous stroke trials, which are the basis of stroke management guidelines are driven using these scales.

  11. Post-stroke urinary incontinence. (United States)

    Mehdi, Z; Birns, J; Bhalla, A


    To provide a comprehensive review of the current evidence on post-stroke urinary incontinence. An electronic database search was performed to identify relevant studies and review articles related to Urinary Incontinence (UI) in the stroke population between the years 1966 and 2012. Urinary incontinence following stroke is a common problem affecting more than one-third of acute stroke patients and persisting in up to a quarter at 1 year. It is well established that this condition is a strong marker of stroke severity and is associated with poorer functional outcomes and increased institutionalisation and mortality rates compared with those who remain continent. Despite evidence linking better outcomes to those patients who regain continence, the results of national audits have demonstrated that the management of UI following stroke is suboptimal, with less than two-thirds of stroke units having a documented plan to promote continence. Current evidence supports a thorough assessment to categorise the type and severity of post-stroke urinary incontinence. An individually tailored, structured management strategy to promote continence should be employed. This has been associated with better stroke outcomes and should be the aim of all stroke health professionals. © 2013 John Wiley & Sons Ltd.

  12. The recurrent aphthous stomatitis' healing duration differences in female students between the sufferer and non sufferer of chicken pox

    Directory of Open Access Journals (Sweden)

    Isidora Karsini Soewondo


    Full Text Available Chicken pox (CP is a generalized primary infection that occurs the first time an individual contacts the virus. The etiology of CP is a VZV virus, and the replication of virus allowing recovery in two to three weeks. During the process, the VZV may progress along sensory nerves to the sensory ganglia, where it can reside in a latent, undetectable form; and can be reactivated at any time. Recurrent aphthous stomatitis (RAS is a recurrent ulcer in the mouth, painful, disturbing the mouth's function and esthetic when occurs in the lips. One of the etiology of RAS is the reactivation of the latent virus in the mouth. The aim of this study was to know the contribution of the latent virus in the ganglia, intervered with the differences of the healing duration of RAS in female students, between the CP sufferer and non CP sufferer. By cross-sectionally, clinical examination, after filling the questioner that included informed consent, 307 students of The St. Yusup Senior High School, Karangpilang Surabaya, were examined. In the 3rd class, there were only 6 female students that suffered RAS had CP history, while 11, student did not. Levene's test for equality of variances was done, and p: 0.698, while 2-tail sign: 0.512. According to this statistical analysis, there was no significant difference between the two groups examined. It was suggested that the female students of RAS' sufferer should maintain their balanced food intake, so the ulcer of RAS would heal quickly.

  13. Guidelines for acute ischemic stroke treatment: part II: stroke treatment

    Directory of Open Access Journals (Sweden)

    Sheila Cristina Ouriques Martins


    Full Text Available The second part of these Guidelines covers the topics of antiplatelet, anticoagulant, and statin therapy in acute ischemic stroke, reperfusion therapy, and classification of Stroke Centers. Information on the classes and levels of evidence used in this guideline is provided in Part I. A translated version of the Guidelines is available from the Brazilian Stroke Society website (

  14. For whom the desert bell tolls: heat stroke or stroke

    Directory of Open Access Journals (Sweden)

    Mustafa Bolatkale


    Full Text Available Heat stroke is the most complicated and dangerous amongst heat injuries that can lead to irreversible injury and even death with itself or with creating predisposibility to different diseases. The following case report depicts a patient who presented primarily with impairment of consciousness after walking 45 km in the summer heat to cross the Syria-Turkey border and later syncope. This case report aims to highlight the possibility of higher co-incidence with heat stroke and stroke.

  15. British Association of Stroke Physicians: benchmarking survey of stroke services. (United States)

    Rodgers, Helen; Dennis, Martin; Cohen, David; Rudd, Anthony


    the National Service Framework for Older People requires every general hospital which cares for stroke patients to introduce a specialist stroke service by 2004. to describe the organisation and staffing of specialist hospital-based stroke services in the UK. a national postal survey of consultant members of the British Association of Stroke Physicians (BASP) seeking details of the provision of neurovascular clinics, acute stroke units (ASUs), stroke rehabilitation units (SRUs), and the organisation and staffing of these services. the response rate was 91/126 (72%). Fifty-four neurovascular clinics, 40 ASUs and 68 SRUs were identified. Neurovascular clinics used a number of strategies to maintain rapid access and 30 (56%) were run by a single consultant. Only 50% ASUs usually admitted patients within 24 h of stroke. As the number of beds available on ASUs and SRUs did not reflect the total number of stroke in-patients, 21 (53%) ASUs and 45 (79%) SRUs had admission criteria. Training opportunities were limited: 37% ASUs and 82% SRUs had no specialist registrar. The therapy sessions (1 session=half a day) available per bed per week on a SRU were: physiotherapy 0.8; occupational therapy 0.6; speech and language therapy 0.25. significant development is needed to achieve the NSF target for hospital-based stroke services as few Trusts currently have all components in place and even when available not all stroke patients have access to specialist care. Stroke specialists will be required to run these services but training opportunities are currently limited. Stroke unit therapy staffing levels were lower than was available in randomised controlled trials.

  16. On-line 'automatic pilot' training for hand and arm motor rehabilitation after stroke. (United States)

    Zeng, Jinhua; Sun, Yaoru; Jiang, Li


    As stroke being one of the most leading causes of death worldwide, even stroke survivors have to suffer from dysfunctions of limb controls and inabilities of speech or vision. Cognitive neuroscientists have found various forms of automatic behaviours in healthy people, which generally cover motor components of upper limbs and are essential for coordination and mobility relevant activities. Meanwhile, the robot-assisted therapy and functional electrical stimulation have become prominent rehabilitation techniques for patients' rehabilitation after stroke. With the integration of robot-aided therapeutic systems and the functional electrical stimulation, the on-line 'automatic pilot' training of the visual inspired stimulation for upper limbs can offer a feasible treatment for patients after stroke to recover motor performance. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. First-ever Ischemic Stroke after a Flight in a Patient with Prior Poliomyelitis

    Directory of Open Access Journals (Sweden)

    Cheng-Chiang Chang


    Full Text Available Survivors of poliomyelitis sometimes travel by air with mobility assistance. However, prolonged seating during long-haul flights may also possibly produce stroke events on polio-inflicted patients. A 48-year-old polio-inflicted male suffered a stroke after an extended flight. A two-dimensional echocardiography was normal without detected patent foramen ovale or dyskinetic segment. The venodynamic variables were all within normal limits. MR Imaging studies revealed acute cerebral infarction in the distribution of the right middle cerebral artery and posterior watershed area. Hematological examination revealed positive anti-cardiolipin IgG antibody which might contribute to the risk of thrombosis as an underlying condition in addition to immobilization. This is the first presentation of ischemic stroke after a flight in a patient with prior poliomyelitis. In addition to decompression sickness, economy class stroke syndrome and postpoliomyelitis syndrome, the physician should also take other coagulation disorders into consideration during the investigation.

  18. Body, coping and self-identity. A qualitative 5-year follow-up study of stroke

    DEFF Research Database (Denmark)

    Pallesen, Hanne


    Objective: The purpose of this article is to identify, from a long-term perspective, stroke survivors' self-identity, their views of any associated disabilities and how they manage their lives after stroke. Methods: The interviews and analyses were conducted using a phenomenological qualitative...... they still had to deal with the consequences of stroke. They had suffered further illnesses and additions to side effects of the stroke. In dealing with their disabilities and changes to self-identity and life patterns, they seemed to be in a continuous process of change that never truly stabilised...... to life can lead to continued learning about abilities and limitations, to the development of new skills and to the fashioning of a new self-identity....

  19. Hemichorea after ischemic stroke

    Directory of Open Access Journals (Sweden)

    Sadullah Saglam


    Full Text Available The deterioration of the balance between direct and indirect ways in the basal ganglia causes chorea. The lesions of contralateral basal ganglia, thalamus or the connection of them all together are responsible for this. Chorea can be observed during the course of metabolic and vascular diseases, neurodegenerative or hereditary diseases. Hyperkinetic movement disorders after acute ischemic stroke are reported as rare; however, hemichorea is the most frequent developing disorder of hyperkinetic movement as a result of cerebrovascular disease. In this case report, we presented two case who applied us with choreiform movements in his left half of the body after acute thalamic stroke. [Cukurova Med J 2016; 41(0.100: 29-32

  20. [Smoking and stroke]. (United States)

    Hashimoto, Yoichiro


    Cigarette smoking is a risk factor for the brain infarction (lacunar and atherothrombotic brain infarction) and subarachnoid hemorrhage. Not only active smoking but also passive smoking and smokeless tobacco products pose a risk. The risk after smoking cessation for 5-10 years is equal to that faced by a non-smoker. Many patients continue smoking even after an attack of stroke; therefore, support measures to enforce nonsmoking are required in this high-risk population. We offer nonsmoking support using the 5A approach, and assess the nonsmoking stage (precontemplation, contemplation, preparation, action, and maintenance). We also administer medical therapy for smoking cessation when the patients find it difficult to quit smoking on their own accord. Nicotine dependency needs a follow-up like that required for other risk factors in the primary and secondary prevention of the stroke because smoking is a chronic disease that tends to recur.

  1. Engendering social suffering: a Chinese diasporic community in northern Thailand. (United States)

    Huang, Shu-Min


    This paper examines how reproducing Chineseness has become a source of social suffering through the case study of a group of Yunnan Chinese who escaped Chinese communist rules in the Mainland in 1949 or shortly after and settled in northern Thailand in the 1960s. As self-proclaimed carriers of traditional Chinese culture, they worked arduously to replicate whatever they considered 'authentic' Chinese through a narrow interpretation of the Confucian moral tenets in daily life. The (re)establishment of a patriarchal social order in Thailand - a society with a relatively high level of gender-equality, has inflicted tremendous pain and suffering among women and youth in this reified society. Ethnographic fieldwork, upon which this paper was based, was conducted in Maehong Village, Chiang Mai Province, between 2002 and 2007.

  2. [Work context, job satisfaction and suffering in primary health care]. (United States)

    Maissiat, Greisse da Silveira; Lautert, Liana; Pai, Daiane Dal; Tavares, Juliana Petri


    To evaluate the work context, job satisfaction and suffering from the perspective of workers in primary health care. This cross-sectional study was conducted with 242 employees of a municipality of Rio Grande do Sul, Brazil, from May to July 2012. The adopted instruments were the Work Context Assessment Scale (EACT) and the Job Satisfaction and Suffering Indicators Scale (EIPST). Research also included descriptive and inferential statistical analysis. Organization (91.3%) and work conditions (64%) received the worst scores in terms of context. The indicators of job satisfaction were related to professional achievement (55.8%), freedom of expression (62.4%) and recognition (59.9%). However, 64.5% presented professional exhaustion, which had an inverse association with age and years in the institution (psatisfaction.

  3. Compassion training alters altruism and neural responses to suffering. (United States)

    Weng, Helen Y; Fox, Andrew S; Shackman, Alexander J; Stodola, Diane E; Caldwell, Jessica Z K; Olson, Matthew C; Rogers, Gregory M; Davidson, Richard J


    Compassion is a key motivator of altruistic behavior, but little is known about individuals' capacity to cultivate compassion through training. We examined whether compassion may be systematically trained by testing whether (a) short-term compassion training increases altruistic behavior and (b) individual differences in altruism are associated with training-induced changes in neural responses to suffering. In healthy adults, we found that compassion training increased altruistic redistribution of funds to a victim encountered outside of the training context. Furthermore, increased altruistic behavior after compassion training was associated with altered activation in brain regions implicated in social cognition and emotion regulation, including the inferior parietal cortex and dorsolateral prefrontal cortex (DLPFC), and in DLPFC connectivity with the nucleus accumbens. These results suggest that compassion can be cultivated with training and that greater altruistic behavior may emerge from increased engagement of neural systems implicated in understanding the suffering of other people, executive and emotional control, and reward processing.

  4. Work context, job satisfaction and suffering in primary health care

    Directory of Open Access Journals (Sweden)

    Greisse da Silveira Maissiat

    Full Text Available OBJECTIVE: To evaluate the work context, job satisfaction and suffering from the perspective of workers in primary health care. METHOD: This cross-sectional study was conducted with 242 employees of a municipality of Rio Grande do Sul, Brazil, from May to July 2012. The adopted instruments were the Work Context Assessment Scale (EACT and the Job Satisfaction and Suffering Indicators Scale (EIPST. Research also included descriptive and inferential statistical analysis. RESULTS: Organization (91.3% and work conditions (64% received the worst scores in terms of context. The indicators of job satisfaction were related to professional achievement (55.8%, freedom of expression (62.4% and recognition (59.9%. However, 64.5% presented professional exhaustion, which had an inverse association with age and years in the institution (p<0.05. CONCLUSION: The workers evaluated their work context as inappropriate and complained of exhaustion, although they claimed their work affords some satisfaction.

  5. Detrusor Hyperreflexia in Stroke


    AYBEK, Zafer


    In this study detrusor hyperreflexia was investigated by urodynamic study during the acute phase of stroke in patients who became incontinent after a cerebrovascular accident. Urodynamic studies reveal physiopathological findings of incontinence while the acute period of cerebrovascular accident do not cover neurogenic bladder features. In our study it was observed that most of the patients (60%) had normal bladder functions and detrusor hyperreflexia was a rare rindings. This res...

  6. Swedish ambulance nurses' experiences of nursing patients suffering cardiac arrest. (United States)

    Larsson, Ricard; Engström, Åsa


    Effective pre-hospital treatment of a person suffering cardiac arrest is a challenging task for the ambulance nurses. The aim of this study was to describe ambulance nurses' experiences of nursing patients suffering cardiac arrest. Qualitative personal interviews were conducted during 2011 in Sweden with seven ambulance nurses with experience of nursing patients suffering cardiac arrests. The interview texts were analyzed using qualitative thematic content analysis, which resulted in the formulation of one theme with six categories. Mutual preparation, regular training and education were important factors in the nursing of patients suffering cardiac arrest. Ambulance nurses are placed in ethically demanding situations regarding if and for how long they should continue cardio-pulmonary resuscitation (CPR) to accord with pre-hospital cardiac guidelines and patients' wishes. When a cardiac arrest patient is nursed their relatives also need the attention of ambulance nurses. Reflection is one way for ambulance nurses to learn from, and talk about, their experiences. This study provides knowledge of ambulance nurses' experiences in the care of people with cardiac arrest. Better feedback about the care given by the ambulance nurses, and about the diagnosis and nursing care the patients received after they were admitted to the hospital are suggested as improvements that would allow ambulance nurses to learn more from their experience. Further development and research concerning the technical equipment might improve the situation for both the ambulance nurses and the patients. Ambulance nurses need regularly training and education to be prepared for saving people's lives and also to be able to make the right decisions. © 2013 Wiley Publishing Asia Pty Ltd.

  7. Did Fyodor Mikhailovich Dostoevsky suffer from mesial temporal lobe epilepsy? (United States)

    Baumann, Christian R; Novikov, Vladimir P I; Regard, Marianne; Siegel, Adrian M


    Many scientific authors--among them famous names such as Henri Gastaut or Sigmund Freud--dealt with the question from what kind of epilepsy Fyodor Mikhailovitch Dostoevsky (1821-1881) might had suffered. Because of the tight interplay between Dostoevsky's literary work and his own disease we throw light on the author's epilepsy against the background of his epileptic fictional characters. Moreover, we attempt to classify Dostoevsky's epilepsy on the basis of his bibliography, language, and literary work.

  8. Suffering transaction: a process of reflecting and understanding


    Wong, Shyh-Heng


    This study examines the transaction of the lived experience of ‘suffering’ in the process of psychotherapy. ‘Suffering’ is conceptualised as having its weight and value transacted between a psychotherapist and his or her client. As a psychotherapist from a family with a disabled member, my fieldwork in a hospital with the parents of disabled children was conducted in Taiwan. The development of our therapeutic relationship was discovered as the process of ‘suffering transaction’...

  9. Drug Abuse In Women suffering from Eating Disorder


    Krankusová, Barbora


    This thesis concerns addictive substance abuse in women suffering from eating disorders. In the theoretical part it defines the term eating disorder itself and furthermore briefly works with the cause of these disorders, patients' personality and commonly associating complicating diagnoses. Afterwards it defines the term addiction and illustrates some of the possible influences on development. Then it characterises commonly abused substances and their relation with eating disorders. The empir...

  10. Early rehabilitation after stroke. (United States)

    Bernhardt, Julie; Godecke, Erin; Johnson, Liam; Langhorne, Peter


    Early rehabilitation is recommended in many guidelines, with limited evidence to guide practice. Brain neurobiology suggests that early training, at the right dose, will aid recovery. In this review, we highlight recent trials of early mobilization, aphasia, dysphagia and upper limb treatment in which intervention is commenced within 7 days of stroke and discuss future research directions. Trials in this early time window are few. Although the seminal AVERT trial suggests that a cautious approach is necessary immediately (stroke, early mobility training and mobilization appear well tolerated, with few reasons to delay initiating some rehabilitation within the first week. The results of large clinical trials of early aphasia therapy are on the horizon, and examples of targeted upper limb treatments with better patient selection are emerging. Early rehabilitation trials are complex, particularly those that intervene across acute and rehabilitation care settings, but these trials are important if we are to optimize recovery potential in the critical window for repair. Concerted efforts to standardize 'early' recruitment, appropriately stratify participants and implement longer term follow-up is needed. Trial standards are improving. New recommendations from a recent Stroke Recovery and Rehabilitation Roundtable will help drive new research.

  11. Frédéric Chopin and his suffering. (United States)

    Kongsgaard, Ulf E


    In 2010 we celebrated the bicentennial of Chopin's birth. He left more than 230 fantastic compositions, often described as romantic, emotional and poetic. Chopin composed almost exclusively for piano solo and has been called the pianists' composer. From his teens he suffered from respiratory tract infections, gradually accompanied by haemoptysis, pronounced breathing problems, diarrhoea and loss of weight. He experienced part of his adult life as a period of great suffering. He was 39 years old when he died. The assumed cause of death was tuberculosis, but other possible differential diagnoses have been suggested in recent years. In order to examine the different diagnostic alternatives, a non-systematic search of the literature was carried out in PubMed, Embase, Current Contents, Google and relevant reference books. The official cause of death was tuberculosis, but the autopsy report has never been found. Both cystic fibrosis and alpha-1-antitrypsin deficiency are possible differential diagnoses that can explain his symptoms. In spite of a disabling disease, Chopin was musically creative right to the end of his life. His suffering must have influenced his musical expression, which is characterised by intimacy and sentimentality. It is unlikely that we will ever find the true cause of death.

  12. Hospitalized patients experienced suffering in life with incurable cancer. (United States)

    Rydahl-Hansen, Susan


    The concept 'suffering' has been central within nursing since Florence Nightingale. But few researchers have made empirical studies about the lived phenomenon. Several researchers within nursing agree that more research concerning individual groups of patients has to be initiated. Within research about patients with incurable cancer focus has been on death, the terminal period and patients experience of being dying. This qualitative study was initiated to describe the characteristics of a group of Danish hospitalized patients' experienced suffering in life with incurable cancer. Twenty-five semi-structured interviews were arranged with 12 patients ones a week within a period of 4 weeks. In week 2 and 4, the interviews were supplemented by questions developed on the basis of the potential signs of suffering which appeared during the participant observations that took place the day before each interview. C. S. Peirce's semiotic and phenomenological grounded theory of signs was used in order to identify the potential signs. A phenomenological methodology developed by A. Giorgi was used to develop and describe the general structure of the phenomenon. The phenomenon is described as: 'The experience of living in an increasingly unpredictable existents at the mercy of the body, the consciousness, the illness, the death, the treatment, the professionals, one's articulateness, the past, the present and the future, influenced by increasing powerlessness, loneliness and isolation, and the experience of existing in an persistent, and with time, unconquerable struggle to maintain and regain control'.

  13. Mental suffering and the DSM-5: a critical review. (United States)

    Vanheule, Stijn; Devisch, Ignaas


    The definition of mental disorder included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), indicates that mental disorders are usually associated with significant distress. However, the handbook is vague with respect to whether distress is crucial to the diagnosis of mental disorders, and a conceptual framework on the precise nature of distress is lacking. As a result, it remains vague how the term 'distress' is to be taken into account in actual diagnostic situations: the DSM-5 provides no operational framework for diagnosing distress. The authors argue that the work of Georges Canguilhem, who focuses on the topic of abnormality and pathology, and Paul Ricoeur's philosophical reflections on the theme of mental suffering may provide a structure for conceptualizing and evaluating distress. Ricoeur's phenomenological model of mental suffering is discussed. Here, mental suffering can be thought of in terms of the relationship between self and other, and also in terms of the continuum made up by, what he terms, languishing and acting. Ricoeur suggests that distress is not a quantity that can be measured, but a characteristic that should be studied qualitatively in interpersonal and narrative contexts. Consequently, diagnosticians should describe and document how individuals experience subjective distress. On a practical level, this means that clinicians' ideas about patients' distress should be embedded in case formulations. A detailed evaluation of an individual's pathos-experience should be made before conclusions are drawn with regard to diagnosis. © 2014 John Wiley & Sons, Ltd.

  14. Knowledge of stroke risk factors among primary care patients with previous stroke or TIA: a questionnaire study

    Directory of Open Access Journals (Sweden)

    Strender Lars-Erik


    , hyperlipidemia and smoking as risk factors was good, and patients who suffered from atrial fibrillation or carotid stenosis seemed to be well informed about these conditions as risk factors. However, the knowledge level was low regarding diabetes as a risk factor and regarding the use of anticoagulants and platelet aggregation inhibitors for stroke/TIA prevention. Better teaching strategies for stroke/TIA patients should be developed, with special attention focused on diabetic patients.

  15. Blood glucose in acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj


    Blood glucose is often elevated in acute stroke, and higher admission glucose levels are associated with larger lesions, greater mortality and poorer functional outcome. In patients treated with thrombolysis, hyperglycemia is associated with an increased risk of hemorrhagic transformation...... to the risk of inducing potentially harmful hypoglycemia has been raised. Still, basic and observational research is overwhelmingly in support of a causal relationship between blood glucose and stroke outcome and further research on glucose-lowering therapy in acute stroke is highly warranted....

  16. Acute Stroke Imaging Research Roadmap


    Wintermark, Max; Albers, Gregory W.; Alexandrov, Andrei V.; Alger, Jeffry R.; Bammer, Roland; Baron, Jean-Claude; Davis, Stephen; Demaerschalk, Bart M.; Derdeyn, Colin P.; Donnan, Geoffrey A.; Eastwood, James D.; Fiebach, Jochen B.; Fisher, Marc; Furie, Karen L.; Goldmakher, Gregory V.


    The recent “Advanced Neuroimaging for Acute Stroke Treatment” meeting on September 7 and 8, 2007 in Washington DC, brought together stroke neurologists, neuroradiologists, emergency physicians, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute of Biomedical Imaging and Bioengineering (NIBIB), industry representatives, and members of the US Food and Drug Administration (FDA) to discuss the role of advanced n...

  17. Problematising risk in stroke rehabilitation. (United States)

    Egan, Mary Y; Kessler, Dorothy; Ceci, Christine; Laliberté-Rudman, Debbie; McGrath, Colleen; Sikora, Lindsey; Gardner, Paula


    Following stroke, re-engagement in personally valued activities requires some experience of risk. Risk, therefore, must be seen as having positive as well as negative aspects in rehabilitation. Our aim was to identify the dominant understanding of risk in stroke rehabilitation and the assumptions underpinning these understandings, determine how these understandings affect research and practise, and if necessary, propose alternate ways to conceptualise risk in research and practise. Alvesson and Sandberg's method of problematisation was used. We began with a historical overview of stroke rehabilitation, and proceeded through five steps undertaken in an iterative fashion: literature search and selection; data extraction; syntheses across texts; identification of assumptions informing the literature and; generation of alternatives. Discussion of risk in stroke rehabilitation is largely implicit. However, two prominent conceptualisations of risk underpin both knowledge development and clinical practise: the risk to the individual stroke survivor of remaining dependent in activities of daily living and the risk that the health care system will be overwhelmed by the costs of providing stroke rehabilitation. Conceptualisation of risk in stroke rehabilitation, while implicit, drives both research and practise in ways that reinforce a focus on impairment and a generic, decontextualised approach to rehabilitation. Implications for rehabilitation Much of stroke rehabilitation practise and research seems to centre implicitly on two risks: risk to the patient of remaining dependent in ADL and risk to the health care system of bankruptcy due to the provision of stroke rehabilitation. The implicit focus on ADL dependence limits the ability of clinicians and researchers to address other goals supportive of a good life following stroke. The implicit focus on financial risk to the health care system may limit access to rehabilitation for people who have experienced either milder or

  18. Demethylation of Circulating Estrogen Receptor Alpha Gene in Cerebral Ischemic Stroke.

    Directory of Open Access Journals (Sweden)

    Hsiu-Fen Lin

    Full Text Available Estrogen is involved in neuron plasticity and can promote neuronal survival in stroke. Its actions are mostly exerted via estrogen receptor alpha (ERα. Previous animal studies have shown that ERα is upregulated by DNA demethylation following ischemic injury. This study investigated the methylation levels in the ERα promoter in the peripheral blood of ischemic stroke patients.The study included 201 ischemic stroke patients, and 217 age- and sex-comparable healthy controls. The quantitative methylation level in the 14 CpG sites of the ERα promoter was measured by pyrosequencing in each participant. Multivariate regression model was used to adjust for stroke traditional risk factors. Stroke subtypes and sex-specific analysis were also conducted.The results demonstrated that the stroke cases had a lower ERα methylation level than controls in all 14 CpG sites, and site 13 and site 14 had significant adjusted p-values of 0.035 and 0.026, respectively. Stroke subtypes analysis showed that large-artery atherosclerosis and cardio-embolic subtypes had significantly lower methylation levels than the healthy controls at CpG site 5, site 9, site 12, site 13 and site 14 with adjusted p = 0.039, 0.009, 0.025, 0.046 and 0.027 respectively. However, the methylation level for the patients with small vessel subtype was not significant. We combined the methylation data from the above five sites for further sex-specific analysis. The results showed that the significant association only existed in women (adjusted p = 0.011, but not in men (adjusted p = 0.300.Female stroke cases have lower ERα methylation levels than those in the controls, especially in large-artery and cardio-embolic stroke subtypes. The study implies that women suffering from ischemic stroke of specific subtype may undergo different protective mechanisms to reduce the brain injury.

  19. Characteristics of Inpatient Care and Rehabilitation for Acute First-Ever Stroke Patients (United States)

    Chang, Won Hyuk; Shin, Yong-Il; Lee, Sam-Gyu; Oh, Gyung-Jae; Lim, Young Shil


    Purpose The purpose of this study was to analyze the status of inpatient care for acute first-ever stroke at three general hospitals in Korea to provide basic data and useful information on the development of comprehensive and systematic rehabilitation care for stroke patients. Materials and Methods This study conducted a retrospective complete enumeration survey of all acute first-ever stroke patients admitted to three distinct general hospitals for 2 years by reviewing medical records. Both ischemic and hemorrhagic strokes were included. Survey items included demographic data, risk factors, stroke type, state of rehabilitation treatment, discharge destination, and functional status at discharge. Results A total of 2159 patients were reviewed. The mean age was 61.5±14.4 years and the ratio of males to females was 1.23:1. Proportion of ischemic stroke comprised 54.9% and hemorrhagic stroke 45.1%. Early hospital mortality rate was 8.1%. Among these patients, 27.9% received rehabilitation consultation and 22.9% underwent inpatient rehabilitation treatment. The mean period from admission to rehabilitation consultation was 14.5 days. Only 12.9% of patients were transferred to a rehabilitation department and the mean period from onset to transfer was 23.4 days. Improvements in functional status were observed in the patients who had received inpatient rehabilitation treatment after acute stroke management. Conclusion Our analysis revealed that a relatively small portion of patients who suffered from an acute first-ever stroke received rehabilitation consultation and inpatient rehabilitation treatment. Thus, applying standardized clinical practice guidelines for post-acute rehabilitation care is needed to provide more effective and efficient rehabilitation services to patients with stroke. PMID:25510773

  20. Guide to Choosing Stroke Rehabilitation Services (United States)

    National Stroke Association’s Guide to Choosing Stroke Rehabilitation Services Rehabilitation, often referred to as rehab, is an important part of stroke recovery. Through rehab, you:  Re-learn basic skills such ...

  1. What You Need to Know about Stroke (United States)

    ... the brain. The other kind of stroke, called hemorrhagic stroke, is caused by a blood vessel that breaks ... are very common among African Americans. The best treatment for stroke is prevention. You can reduce your ...

  2. Epidermoid Causing Ischemic Stroke in the Brainstem

    Directory of Open Access Journals (Sweden)

    Raghvendra Ramdasi


    Full Text Available Intracranial tumors may rarely cause stroke. We report an epidermoid cyst causing stroke in a pediatric patient. We have also reviewed the literature and pathogenesis of stroke caused by intracranial tumors.

  3. What Are the Warning Signs of Stroke? (United States)

    ... Cardiovascular Conditions What Are the Warning Signs of Stroke? Brain tissue affected by blockage Stroke is the fifth leading cause of death in ... over 55 years old have more chance of stroke, and the risk gets greater as you get ...

  4. Rehabilitation of cortical blindness secondary to stroke. (United States)

    Gaber, Tarek A-Z K


    Cortical blindness is a rare complication of posterior circulation stroke. However, its complex presentation with sensory, physical, cognitive and behavioural impairments makes it one of the most challenging. Appropriate approach from a rehabilitation standpoint was never reported. Our study aims to discuss the rehabilitation methods and outcomes of a cohort of patients with cortical blindness. The notes of all patients with cortical blindness referred to a local NHS rehabilitation service in the last 6~years were examined. Patients' demographics, presenting symptoms, scan findings, rehabilitation programmes and outcomes were documented. Seven patients presented to our service, six of them were males. The mean age was 63. Patients 1, 2 and 3 had total blindness with severe cognitive and behavioural impairments, wandering and akathisia. All of them failed to respond to any rehabilitation effort and the focus was on damage limitation. Pharmacological interventions had a modest impact on behaviour and sleep pattern. The 3 patients were discharged to a nursing facility. Patients 4, 5, 6 and 7 had partial blindness with variable severity. All of them suffered from significant memory impairment. However, none suffered from any behavioural, physical or other cognitive impairment. Rehabilitation efforts on 3 patients were carried out collaboratively between brain injury occupational therapists and sensory disability officers. All patients experienced significant improvement in handicap and they all maintained community placements. This small cohort of patients suggests that the rehabilitation philosophy and outcomes of these 2 distinct groups of either total or partial cortical blindness differ significantly.

  5. Burden of stroke in Cambodia. (United States)

    Loo, Keat Wei; Gan, Siew Hua


    In Cambodia, stroke is not ranked among the top 10 leading causes of death, but infectious disease are among the top three leading causes of death. This finding could be attributed to a lack of awareness among Cambodians of the signs and symptoms of stroke or to poor reporting, incomplete data, lack of neurologists and neurosurgeons, or low accessibility to the hospitals. The only study of stroke in Cambodia is the Prevalence of Non-Communicable Disease Risk Factors in Cambodia survey, which identified several stroke-related risk factors in the population. Tobacco chewing or smoking is the main risk factor for stroke in Cambodia. Traditional therapies, such as oyt pleung (moxibustion) and jup (cupping), are widely practiced for stroke rehabilitation. In Cambodia, there are few neurologists and few important equipment, such as magnetic resonance imaging machines and computed tomography scanners. The Cambodian government should cooperate with the World Health Organization and the United Nations Children's Fund to attract foreign expertise and technologies to treat stroke patients. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

  6. Infections and Ischemic Stroke Outcome


    Grabska, Katarzyna; Gromadzka, Grażyna; Członkowska, Anna


    Background. Infections increase the risk of ischemic stroke (IS) and may worsen IS prognosis. Adverse effects of in-hospital infections on stroke outcome were also reported. We aimed to study the prevalence of pre- and poststroke infections and their impact on IS outcome. Methods. We analysed clinical data of 2066 IS patients to assess the effect of pre-stroke and post-stroke infections on IS severity, as well as short-term (up to 30 days) and long-term (90 days) outcome. The independent i...

  7. Stroke scale score and early prediction of outcome after stroke

    International Nuclear Information System (INIS)

    Ahmed, R.; Zuberi, F.Z.; Afsar, S.


    Objective: To evaluate the baseline National Institute of Health Stroke Scale (NIHSS) score as a predictor of functional outcome after ischemic stroke. Subjects and Methods: The study included 50 patients who presented to Civil Hospital, Karachi, during the study period with acute stroke and were evaluated with CT scan of brain. Only those patients were enrolled in the study that had acute ischemic stroke. The enrolled subjects were then evaluated for the neurological impairment using National Institute of Health Stroke Scale (NIHSS). The subjects were followed-up and their functional outcome was assessed using Barthel index (BI) on the 7th day of their admission. Results: Of the fifty patients enrolled in the study, 31 (62%) were males and 19 (38%) were females, with age ranging from 45 years to 95 years and a mean age of 59.9 years. Neurological impairment at presentation was assessed by NIHSS. The score ranged between 2 and 28. The functional outcome was evaluated on the 7th day using Barthel index (BI), which ranged from 0 to 80. NIHSS score was found to be a good predictor of functional outcome in patients with ischemic stroke (p<0.001). Other factors like gender, hypertension and heart disease did not affect the functional recovery in such patients. Various factors were found to be significant for early prediction of stroke recovery. The NIHSS score was the strongest predictor of outcome after ischemic stroke. Age at the time of the event was also found to be an important predictor for stroke recovery. Conclusion: The NIHSS score is a good predictor of patient's recovery after stroke. Assessing the patient's neurological impairment at first presentation of ischemic stroke can guide the physician regarding the prognosis and management plan. (author)

  8. Identification of stroke mimics among clinically diagnosed acute strokes. (United States)

    Tuntiyatorn, Lojana; Saksornchai, Pichaya; Tunlayadechanont, Supoch


    Stroke is a clinically syndrome of a sudden onset of neurological deficit in a vascular cause. Stroke mimics is the non-vascular disorders with stroke-like clinical symptoms. It is important to distinguish true stroke from mimics since treatment plan may differ To determine the incidence of the stroke mimics and identify their etiologies. All non-contrast head CT of the patients with clinically diagnosed stroke who immediately received imaging upon arrival at the emergency department of the university hospital were retrospectively reviewed in 12-month period between January 1 and December 31, 2008. Medical records, laboratory results, MRI, and 6-month clinical follow-up records were reviewed for final diagnosis. Seven hundred four patients were included in this study, including 363 (51.5%) men and 341 (48.5%) women with range in age from 24 to 108 years. Amongst those, 417 (59.2%) were ischemic stroke, 80 (11.40%) were hemorrhagic stroke, 186 (26.4%) were stroke-mimics, and 21 (3%) were inconclusive. The etiologies among stroke-mimics were metabolic/intoxication (35, 18.8%), sepsis (28, 15.0%), seizure (21, 11.3%), syncope (20, 10.8%), subdural hemorrhage (14, 7.5%), vertigo (11, 6.0%), brain tumor (10, 5.30%), central nervous system infection (5, 2.7%), others (26, 14.0%), and unspecified (16, 8.6%). Incidence rates and etiologies of the stroke mimics were similar to the western reports. However the frequency of each mimic was not.

  9. Improving the comfort of nurses caring for stroke patients at the end of life. (United States)

    Zwicker, Jocelyn; Martineau, Isabelle; Walsh, Sarah; Lavoie, Jenny; Weger, Evelyn; Scott, John


    End-of-life care of stroke patients is an important aspect of stroke care. It has been previously reported that nurses express discomfort caring for patients at the end of life or caring for patients who have suffered severe strokes. Nurses at our centre expressed similar discomfort. To improve the comfort of nurses caring for patients at the end of life after stroke. Nurses were asked to rate their comfort with treating patients at the end of life using the Stroke End-of-Life Care Comfort Scale before and after attending an education session. The education sessions included the presentation of a checklist for suggested orders for end-of-life care. The project was conducted with the neurosciences nurses at a tertiary care hospital. 54 out of a possible 122 nurses attended an education session. There was a significant improvement in the Stroke End-of-Life Care Comfort Scale score (p=0.00004) 3-4 weeks after the education session compared to the score before the session. The combination of focused education sessions and an order checklist can significantly improve the comfort of nurses caring for patients at the end-of-life after stroke.

  10. Themes of Slavery, Christianity & Descriptions of Paradox in the Practice of Christianity in Two Slave Narratives - Harriet Jacobs Incidents in the Life of a Slave Girl & Harriet Wilson OUR NIG Sketches from the Life of a Free Black


    Ganaah, Miriam Adwoa


    The thesis describes the role of Christianity in the lives of slaves and slave owners in the American South, pointing out the inconsistencies in the ways slave owners manage the tension between their Christian faith and their way of life as slave holders. The case studies are Harriet Jacobs, "Incidents in the Life of a Slave Girl" and Harriet Wilson's "OUR NIG Sketches from the Life of a Free Black".

  11. Stroke in Saudi children

    International Nuclear Information System (INIS)

    Salih, Mustafa A.; Al-Jarallah, Ahmed A.; Kentab, Anal Y.; Al-Nasser, Mohammad N.; Bahakim, Hassan M.; Kurban, Khadija M.; Zahraa, Jihad N.; Nasir, Ali A.; Abdel-Gader, Abdel-Galil M.; Alorainy, Ibrahim A.; Hassan, Hamdy H.; Kabiraj, Mohammad M.; Khoja, Waleed A.


    To describe the epidemiology and clinical features of stroke in a prospective and retrospective cohort of Saudi children and ascertain the causes, pathogenesis, and risk factors. The Retrospective Study Group (RSG) included children with stroke who were evaluated at the Division of Pediatric Neurology, or admitted to King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia during the period July 1992 to February 2001. The Prospective Study Group (PSG) included those seen between February 2001 and March 2003. During the combined study periods of 10 years and 7 months, 117 children (61 males and 56 females, aged one month-12 years) were evaluated; the majority (89%) of these were Saudis. The calculated annual hospital frequency rate of stroke was 27.1/100,000 of the pediatric (1month-12 years) population The mean age at onset of the initial stroke in the 104 Saudi children was 27.1 months (SD=39.3 months) median and median was 6 months. Ischemic strokes accounted for the majority of cases (76%). Large-vessel infarcts (LVI, 51.9%) were more common than small-vessel lacunar lesions (SVLL, 19.2%). Five patients (4.8%) had combined LVI and SVLL. Intracranial hemorrhage was less common (18.2%), whereas sinovenous thrombosis was diagnosed in 6 (5.8%) patients. A major risk factor was identified in 94 of 104 (89.4%) Saudi children. Significantly more hematologic disorders and coagulopathies were identified in the PSG compared to the RSG (p=0.001), reflecting a better yield following introduction of more comprehensive hematologic and cogulation laboratory tests during the prospective study period. Hematologic disorders were the most common risk factor (46.2%); presumed perinatal ischemic cerebral injury was risk factor in 23 children (22.1) and infectious and inflammatory disorders of the circulatory system in 18 (17.3%). Congenital and genetic cerebrovascular anomalies were the underlying cause in 7 patients (6.7%) and

  12. Propranolol for Paroxysmal Sympathetic Hyperactivity with Lateralizing Hyperhidrosis after Stroke

    Directory of Open Access Journals (Sweden)

    Jason W. Siefferman


    Full Text Available Brain injury can lead to impaired cortical inhibition of the hypothalamus, resulting in increased sympathetic nervous system activation. Symptoms of paroxysmal sympathetic hyperactivity may include hyperthermia, tachycardia, tachypnea, vasodilation, and hyperhidrosis. We report the case of a 41-year-old man who suffered from a left middle cerebral artery stroke and subsequently developed central fever, contralateral temperature change, and hyperhidrosis. His symptoms abated with low-dose propranolol and then returned upon discontinuation. Restarting propranolol again stopped his symptoms. This represents the first report of propranolol being used for unilateral dysautonomia after stroke. Propranolol is a lipophilic nonselective beta-blocker which easily crosses the blood-brain barrier and may be used to treat paroxysmal sympathetic hyperactivity.

  13. Ischemic Stroke: MedlinePlus Health Topic (United States)

    ... Clots) (American Stroke Association) Let's Talk about Ischemic Stroke (American Heart Association) Also in Spanish Prevention and Risk Factors Carotid Endarterectomy (National Heart, Lung, and Blood Institute) ...

  14. Stroke subtypes and factors associated with ischemic stroke in ...

    African Journals Online (AJOL)

    Stroke subtypes assessed four OCSP (Oxfordshire Communi-. African Health Sciences Vol 15 Issue 1, March 2015. 68. 69 ty Stroke Project Classification) subtypes classification. 13 was used with lacunar circulation infarct (LACI) and total anterior (TACI), partial anterior (PACI), posterior. (POCI) circulation infarcts as non ...

  15. 'This stroke was sent…': Stroke-related illness concepts and ...

    African Journals Online (AJOL)

    Though there is evidence that stroke incidence is increasing even in low and middle income countries, there is no study of stroke-related illness concepts and HSB in Nigerians. Data from 960 educated Nigerians were analysed. Eight hundred and fifty four respondents (431 aged 20-40 years and 423 aged 41 years or ...

  16. Thromboxane biosynthesis in stroke and post-stroke dementia

    NARCIS (Netherlands)

    F. van Kooten (Fop)


    textabstractWith 25 to 30 thousand new patients per year and an incidence of 170/100.000, stroke is a major health problem in the Netherlands, as it is in other western countries. It accounts for almost I 0% of the annual death in the Netherlands. Approximately 80% of stroke is of ischemic

  17. Thromboxane biosynthesis in stroke and post-stroke dementia

    NARCIS (Netherlands)

    F. van Kooten (Fop)


    textabstractWith 25 to 30 thousand new patients per year and an incidence of 170/100.000, stroke is a major health problem in the Netherlands, as it is in other western countries. It accounts for almost I 0% of the annual death in the Netherlands. Approximately 80% of stroke is of ischemic origin,

  18. Improving Stroke Management through Specialized Stroke Units in ...

    African Journals Online (AJOL)

    ... rehabilitation of the stroke patient. The establishment of stroke units has been found to improve the survival of patients and significantly reduce disability by rendering holistic care. Early intervention to rapidly restore and maintain blood supply to the ischemic area in the brain, minimize brain damage and hence impairment ...

  19. Caregiver experiences and perceptions of stroke

    Directory of Open Access Journals (Sweden)

    Mary Thomas


    Full Text Available With the increasing prevalence of people in developing countries who suffer strokes, the long-term care of people who have had a stroke and who are living with disabilities has substantial consequences for caregivers and their respective families. As the caregiver plays a pivotal role in the rehabilitation of the people who have had a stroke, the objectives of this study constitute an investigation into the complexities of caregiving, including both perceptions and experiences of the healthcare system. Semi-structured interviews were utilised to elicit post-stroke experiences of six caregivers. The challenge the South African context adds to these experiences was probed. The data were analysed qualitatively by thematic and content analysis. Prominent themes associated with caregiving included: role changes and relationship disruptions within the family, occupational and social implications, fatigue, anxiety, depression, loneliness, frustration as well as financial problems. Caregiver experiences were exacerbated by the inadequate support structures available. The results are interpreted within a biopsychosocial approach, concluding with the concerns raised by caregivers on the support they require from the healthcare system in order to provide home-based care. Opsomming Met die toenemende voorkoms van beroerte in ontwikkelende lande bring die langdurige versorging van pasiënte met gestremdheid beduidende gevolge vir sorggewers en hulle onderskeie gesinne mee. Aangesien die sorggewer ‘n sleutelrol in die rehabilitasie van die beroertepasiënt speel, behels die doelstellings van hierdie studie ‘n ondersoek na die verwikkeldhede van versorging, wat sowel persepsies as ondervinding van die gesondheidsorgstelsel insluit. Semi- gestruktureerde onderhoude is aangewend om die na-beroerte ondervindings van ses sorggewers te peil. Die uitdaging wat die Suid- Afrikaanse konteks tot hierdie ondervindings meebring is ondersoek. Die data is kwalitatief

  20. Diagnosis in stroke - an uptake

    International Nuclear Information System (INIS)

    Aichner, F.T.


    In practical day-to-day terms, most patients have one of the common causes of stroke: ischemic stroke caused by the complications of atherothrombosis, intracranial small vessel disease, embolism from the heart, primary intracerebral hemorrhage caused by hypertension, or subarachnoid hemorrhage as a result of a ruptured saccular aneurysm. There are three issues to be considered in assessing the reliability of the clinical diagnosis of stroke: the diagnosis of stroke itself: is it a stroke or not; whether the stroke is caused by an infarct or a hemorrhage and particular in ischemic stroke the site and size of the lesion (anterior vs. posterior circulation, lacunar vs. cortical, etc.). No clinical scoring method can differentiate with absolute reliability ischemic stroke from primary intracerebral hemorrhage. To do this brain computed tomography or magnetic resonance imaging is required. For vascular diagnosis ultrasound and magnetic resonance angiography are ideal and complementary non-invasive techniques. Both have no risks and are reasonably sensitive. Catheterangiography is only reserved for patients with subarachnoid hemorrhage with a view to surgical or endovascular treatment or in exceptional cases to establish a more firm prognosis. The diagnosis of ischemic stroke caused by embolism from the heart can only be considered at all if there is an identifiable cardioembolic source which is the case in about 30 % of ischemic stroke, a higher proportion in recent studies using transoesophageal echocardiography. It is not clear that transoesophageal echocardiography provides much more information for clinical decision-making than transthoracic echocardiography, although it certainly provides more anatomical information in selected patients. This article summarizes the diagnostic armamentarium which is used for the diagnosis of stroke and gives an overview of clinically reliable and relevant measures. Refs. 23 (author)

  1. Statins and clinical outcome of acute ischemic stroke: a systematic review

    Directory of Open Access Journals (Sweden)

    Lakhan Shaheen E


    Full Text Available Abstract Background Statin therapy is considered an effective measure for the prevention of ischemic stroke. Several recent studies have indicated that treatment with statins, prior to the onset of acute ischemic stroke, may also substantially reduce the severity of stroke and the degree of patient disability. The purpose of the present review is to systematically evaluate the effectiveness of statin pretreatment on functional outcome of acute ischemic stroke and to assess potential adverse events associated with statin use. Methods Relevant articles on the role of statins in acute ischemic stroke were identified via MEDLINE/PubMed, EMBASE, CENTRAL, and by manual searches of the references of identified papers. Clinical studies (most were prospective cohort studies assessing statin therapy for acute ischemic stroke were selected for the review. Only two randomized controlled clinical trials met the criteria to be included in the analysis. Clinical outcome was assessed based on the degree of disability determined with the modified Rankin Scale (mRS and Barthel index (BI. The National Institutes of Health Stroke Scale (NIHSS was used to measure stroke severity. Recurrence of stroke in patients who had suffered from a previous stroke was analyzed with and without statin therapy. Incidence and severity of adverse reactions was reviewed. Because there were too many differences in study outcome measures, a quantitative analysis of data was deemed inappropriate. A qualitative summary of the data was consequently completed. Results Thirteen reports were systematically reviewed to evaluate the efficacy and safety of statins in the pretreatment of acute ischemic stroke. Pretreatment with statins was found to reduce the recurrence of stroke and to result in more favorable outcomes for patients. The beneficial effects of prior statin therapy in acute ischemic stroke were shown to be especially profound in whites, diabetics, elderly patients with

  2. Impact of air quality guidelines on COPD sufferers. (United States)

    Liu, Youcheng; Yan, Shuang; Poh, Karen; Liu, Suyang; Iyioriobhe, Emanehi; Sterling, David A


    COPD is one of the leading causes of morbidity and mortality in both high- and low-income countries and a major public health burden worldwide. While cigarette smoking remains the main cause of COPD, outdoor and indoor air pollution are important risk factors to its etiology. Although studies over the last 30 years helped reduce the values, it is not very clear if the current air quality guidelines are adequately protective for COPD sufferers. This systematic review was to summarize the up-to-date literature on the impact of air pollution on the COPD sufferers. PubMed and Google Scholar were utilized to search for articles related to our study's focus. Search terms included "COPD exacerbation", "air pollution", "air quality guidelines", "air quality standards", "COPD morbidity and mortality", "chronic bronchitis", and "air pollution control" separately and in combination. We focused on articles from 1990 to 2015. We also used articles prior to 1990 if they contained relevant information. We focused on articles written in English or with an English abstract. We also used the articles in the reference lists of the identified articles. Both short-term and long-term exposures to outdoor air pollution around the world are associated with the mortality and morbidity of COPD sufferers even at levels below the current air quality guidelines. Biomass cooking in low-income countries was clearly associated with COPD morbidity in adult nonsmoking females. There is a need to continue to improve the air quality guidelines. A range of intervention measures could be selected at different levels based on countries' socioeconomic conditions to reduce the air pollution exposure and COPD burden.

  3. Anxiety and depression in patients suffering from chronic low backache

    International Nuclear Information System (INIS)

    Bhatti, A.R.; Saleem, B.; Ahsin, S.; Farooqi, A.Z.; Farooqi, A.Z.


    To determine the frequency of anxiety and depression in patients with chronic low backache and to document other co-morbidities among these patients presenting at rheumatology clinic of a tertiary care hospital in Islamabad. Study Design: Cross sectional study. Place and Duration of Study: Study was conducted at Pakistan Institute of Medical Sciences from July 2012 to April 2013. Methodology: A total of 170 chronic low backache patients were administered urdu translated Zung Self-Rating Depression Scale and Zung Self-Rating Anxiety Scales. Scoring was done on Likert-type scale of 1-4 (based on these replies: a little of the time, some of the time, good part of the time, most of the time) with overall assessment by cumulative score ranging from 20 to 80, where 20-44 was normal range, 45-59 mildly depressed/anxious, 60-69 moderately depressed / anxious and 70 and above severely depressed / anxious. Results: Out of 170 patients, 157 patients above 18 years of age with male to female ratio 2:3 completed the study. Among study sample 72.2% had mild depression, 21.6% had mild anxiety, 32% had mixed mild anxiety and depression, 0.8% had severe depression, 1.6% had severe anxiety while 2.4% suffered from severe mixed symptoms. Overall, 125 (79.6%) patients were suffering from mild to severe form of depression and anxiety both alone or mixed. Obesity was present in 34 (21.66%) of patients with chronic backache and out of these 29 (85.3%) had psychological co-morbidity. Conclusion: Two thirds of the chronic backache patients reporting at rheumatology clinic of a tertiary care hospital were suffering from mild to severe degree of depression and anxiety. This worrying situation calls for thorough systematic evaluation of all chronic backache patient arriving at rheumatology clinic for mood disorders and psychological ailment. (author)

  4. Impact of air quality guidelines on COPD sufferers (United States)

    Liu, Youcheng; Yan, Shuang; Poh, Karen; Liu, Suyang; Iyioriobhe, Emanehi; Sterling, David A


    Background COPD is one of the leading causes of morbidity and mortality in both high- and low-income countries and a major public health burden worldwide. While cigarette smoking remains the main cause of COPD, outdoor and indoor air pollution are important risk factors to its etiology. Although studies over the last 30 years helped reduce the values, it is not very clear if the current air quality guidelines are adequately protective for COPD sufferers. Objective This systematic review was to summarize the up-to-date literature on the impact of air pollution on the COPD sufferers. Methods PubMed and Google Scholar were utilized to search for articles related to our study’s focus. Search terms included “COPD exacerbation”, “air pollution”, “air quality guidelines”, “air quality standards”, “COPD morbidity and mortality”, “chronic bronchitis”, and “air pollution control” separately and in combination. We focused on articles from 1990 to 2015. We also used articles prior to 1990 if they contained relevant information. We focused on articles written in English or with an English abstract. We also used the articles in the reference lists of the identified articles. Results Both short-term and long-term exposures to outdoor air pollution around the world are associated with the mortality and morbidity of COPD sufferers even at levels below the current air quality guidelines. Biomass cooking in low-income countries was clearly associated with COPD morbidity in adult nonsmoking females. Conclusion There is a need to continue to improve the air quality guidelines. A range of intervention measures could be selected at different levels based on countries’ socioeconomic conditions to reduce the air pollution exposure and COPD burden. PMID:27143874

  5. Pericardial Tamponade in an Adult Suffering from Acute Mumps Infection

    Directory of Open Access Journals (Sweden)

    Sascha Kahlfuss


    Full Text Available Here, we report a case of a 51-year-old man with acute pericardial tamponade requiring emergency pericardiocentesis after he suffered from sore throat, headache, malaise, and sweats for two weeks. Serological analyses revealed increased mumps IgM and IgG indicating an acute mumps infection whereas other bacterial and viral infections were excluded. In addition, MRI revealed atypical swelling of the left submandibular gland. Whereas mumps has become a rare entity in children due to comprehensive vaccination regimens in western civilizations, our case highlights mumps as an important differential diagnosis also in adults, where the virus can induce life-threatening complications such as pericardial tamponade.

  6. [Cultural structures that determine suffering among various populations]. (United States)

    Pagés Larraya, F


    The cross-cultural consideration of our Psychiatric Epidemiology Program outlined the profile of the madman and his discourse as both mirror and enigma of his cultural community. This enigma occurs as a result of the suffering, the violence and the slyness inherent to creativity, in the sense that his own accomplishments are inexorably questionable because of the ubiquitous presence of the tragic and das Unheimliche. The madman "malgré soi" becomes a perfect interpreter of the cultural crisis and is a real key to his deepest structural interpretation. Therefore, we uphold a "tragic erasmism" and from then on discuss the hermeneutics of Nietzsche, Freud and Heidegger.

  7. [Difficulties at work and work motivation of ulcerative colitis suffers]. (United States)

    Nasu, Ayami; Yamada, Kazuko; Morioka, Ikuharu


    Because ulcerative colitis (UC) repeats remission and relapse, it is necessary to keep the condition at the relapse time in mind when considering support to provide UC suffers with at the workplace. The aim of this survey was to clarify the difficulties at work and work motivation that UC suffers feel at present and experience at the worsening time, and the factors for maintaining work motivation. We carried out an anonymous questionnaire survey of patients with present or past work experience. The difficulties at work (17 items) and work motivation (4 items) in the past week and at the time when the symptoms were most intensive during work were investigated using a newly designed questionnaire. We regarded the time in the past week as the present, and the time when the symptoms were most intensive during work as the worsening time. There were 70 respondents (response rate 32.0%). Their mean age was 43.8 years, and their mean age at onset was 33.8 years. All subjects, except 2 subjects after surgery, took medicine. Fifty-three (75.7%) of the subjects were in remission at the present, and most of them (91.4%) managed their physical condition well. Difficulties at work that many subjects worried about at the present were relevant to work conditions, such as "Others at workplace do not understand having an intractable and relapsing disease" (41.4%) or "Feel delayed or lack of chance of promotion or career advancement due to the disease" (38.6%). At the worsening time, the management of physical condition went wrong, and the frequency of hospital visits was increased, but few subjects consulted with superiors or colleagues at workplace. Difficulties at work that many subjects underwent at the worsening time were relevant to symptoms, such as "Feel physically tired" (80.0%) or "Decline foods or alcoholic beverages offered at business parties" (72.9%). Those who maintained work motivation even at the worsening time received no work-related consideration and had an

  8. Correlates of perceptions of elder’s suffering from depression

    Directory of Open Access Journals (Sweden)

    Michael N. Kane


    Full Text Available The study investigated social work students’ perceptions of elders as depressed and suffering (N= 156. Four predictor variables were identified from a standard regression analysis that account for 32% of the model’s adjusted variance: (a perceptions of elders as vulnerable, (b perceptions about elders as oppressed. Overall, respondents perceived elders as being depressed, vulnerable, members of an oppressed group, abusive of substances, and only moderately resilient in response to mental health services. Implications are discussed for social work education.

  9. Impact of culture on the expression of pain and suffering. (United States)

    Wein, Simon


    A primary human challenge is how to alleviate suffering and loss. One way is through culture. The core characteristics of culture are symbols, sharing and groups. These three factors enable society to help the individual cope with loss. In the modern age traditional culture is disintegrating and is being replaced. Often it is outstanding individuals who provide the impetus and tools with which to change the culture and to adapt to new challenges. One lesson to be drawn from the discussion is the idea of using our culture more pro-actively to routinely contemplate loss, ageing and death.

  10. Therapeutic hypothermia for acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Weber, Uno Jakob; Kammersgaard, Lars Peter


    Experimental evidence and clinical experience show that hypothermia protects the brain from damage during ischaemia. There is a growing hope that the prevention of fever in stroke will improve outcome and that hypothermia may be a therapeutic option for the treatment of stroke. Body temperature i...

  11. One Stroke at a Time (United States)

    Hollibaugh, Molly


    At first glance, a Zentangle creation can seem intricate and complicated. But, when you learn how it is done, you realize how simple it is. Zentangles are patterns, or "tangles," that have been reduced to a simple sequence of elemental strokes. When you learn to focus on each stroke you find yourself capable of things that you may have once…

  12. Acute Stroke Imaging Research Roadmap (United States)

    Wintermark, Max; Albers, Gregory W.; Alexandrov, Andrei V.; Alger, Jeffry R.; Bammer, Roland; Baron, Jean-Claude; Davis, Stephen; Demaerschalk, Bart M.; Derdeyn, Colin P.; Donnan, Geoffrey A.; Eastwood, James D.; Fiebach, Jochen B.; Fisher, Marc; Furie, Karen L.; Goldmakher, Gregory V.; Hacke, Werner; Kidwell, Chelsea S.; Kloska, Stephan P.; Köhrmann, Martin; Koroshetz, Walter; Lee, Ting-Yim; Lees, Kennedy R.; Lev, Michael H.; Liebeskind, David S.; Ostergaard, Leif; Powers, William J.; Provenzale, James; Schellinger, Peter; Silbergleit, Robert; Sorensen, Alma Gregory; Wardlaw, Joanna; Wu, Ona; Warach, Steven


    The recent “Advanced Neuroimaging for Acute Stroke Treatment” meeting on September 7 and 8, 2007 in Washington DC, brought together stroke neurologists, neuroradiologists, emergency physicians, neuroimaging research scientists, members of the National Institute of Neurological Disorders and Stroke (NINDS), the National Institute of Biomedical Imaging and Bioengineering (NIBIB), industry representatives, and members of the US Food and Drug Administration (FDA) to discuss the role of advanced neuroimaging in acute stroke treatment. The goals of the meeting were to assess state-of-the-art practice in terms of acute stroke imaging research and to propose specific recommendations regarding: (1) the standardization of perfusion and penumbral imaging techniques, (2) the validation of the accuracy and clinical utility of imaging markers of the ischemic penumbra, (3) the validation of imaging biomarkers relevant to clinical outcomes, and (4) the creation of a central repository to achieve these goals. The present article summarizes these recommendations and examines practical steps to achieve them. PMID:18477656

  13. Auditory Hallucinations in Acute Stroke

    Directory of Open Access Journals (Sweden)

    Yair Lampl


    Full Text Available Auditory hallucinations are uncommon phenomena which can be directly caused by acute stroke, mostly described after lesions of the brain stem, very rarely reported after cortical strokes. The purpose of this study is to determine the frequency of this phenomenon. In a cross sectional study, 641 stroke patients were followed in the period between 1996–2000. Each patient underwent comprehensive investigation and follow-up. Four patients were found to have post cortical stroke auditory hallucinations. All of them occurred after an ischemic lesion of the right temporal lobe. After no more than four months, all patients were symptom-free and without therapy. The fact the auditory hallucinations may be of cortical origin must be taken into consideration in the treatment of stroke patients. The phenomenon may be completely reversible after a couple of months.

  14. The imaging of ischaemic stroke

    International Nuclear Information System (INIS)

    Hoggard, Nigel; Wilkinson, Iain D.; Griffiths, Paul D.


    Stroke is a clinical syndrome of a rapidly developing focal neurological deficit that may be classified for practical purposes into ischaemic and haemorrhagic. The role of imaging is to exclude mimics of ischaemic stroke or intracranial haemorrhage and confirm the presence of an ischaemic stroke. Computed tomography (CT) remains the investigation of choice to exclude acute intracranial haemorrhage but diffusion weighted magnetic resonance (MR) has proved to be a sensitive method of detecting early ischaemic infarction. Perfusion weighted MR allows further assessment at the same examination that could help guide the clinician in the risk/benefit analysis of treatment with thrombolytics or neuroprotective agents under evaluation. This can also be achieved with CT. This review article discusses the imaging of ischaemic stroke, relating the pathophysiology of stroke to it. It deals separately in more detail with these newer MR techniques. Hoggard, N. et al. (2001)

  15. Narrating Trauma and Suffering: Towards Understanding Intersubjectively Constituted Memory

    Directory of Open Access Journals (Sweden)

    Jan K. Coetzee


    Full Text Available Remembering is a complex and notoriously fallible process. This is partly because memory is not an exclusively individual act. Not only what we remember, but the way we remember is influenced by social circumstances and co-constructed worldviews, as well as by our personal needs and perspectives. In the context of the research interview, the researcher-participant relationship also mediates how experience is re-membered and narrated. All these factors need to be taken into account when, as social researchers, we attempt to unpack the meanings and motives that underlie what research participants say. This paper aims to show how interviewees who have endured traumatic experiences for prolonged periods of time remember, reflect on and articulate their suffering. To illustrate how personal memories of lived, real experiences intertwine with socially and contextually embedded values and relationships we draw on the narratives of former political prisoners in South Africa and in erstwhile Czechoslovakia. We also present narratives of South African street children, and women living with HIV/AIDS. When interpreting the in-depth data that show how participants remember their experience of suffering, we find that the very nature of memory poses a hermeneutical challenge. URN: urn:nbn:de:0114-fqs0902144

  16. Personalized symptoms forecasting for pollen-induced allergic rhinitis sufferers (United States)

    Voukantsis, D.; Berger, U.; Tzima, F.; Karatzas, K.; Jaeger, S.; Bergmann, K. C.


    Hay fever is a pollen-induced allergic reaction that strongly affects the overall quality of life of many individuals. The disorder may vary in severity and symptoms depending on patient-specific factors such as genetic disposition, individual threshold of pollen concentration levels, medication, former immunotherapy, and others. Thus, information services that improve the quality of life of hay fever sufferers must address the needs of each individual separately. In this paper, we demonstrate the development of information services that offer personalized pollen-induced symptoms forecasts. The backbone of these services consists of data of allergic symptoms reported by the users of the Personal Hay Fever Diary system and pollen concentration levels (European Aeroallergen Network) in several sampling sites. Data were analyzed using computational intelligence methods, resulting in highly customizable forecasting models that offer personalized warnings to users of the Patient Hay Fever Diary system. The overall system performance for the pilot area (Vienna and Lower Austria) reached a correlation coefficient of r = 0.71 ± 0.17 (average ± standard deviation) in a sample of 219 users with major contribution to the Pollen Hay Fever Diary system and an overall performance of r = 0.66 ± 0.18 in a second sample of 393 users, with minor contribution to the system. These findings provide an example of combining data from different sources using advanced data engineering in order to develop innovative e-health services with the capacity to provide more direct and personalized information to allergic rhinitis sufferers.

  17. Cyberhugs: creating a voice for chronic pain sufferers through technology. (United States)

    Becker, Karin L


    Chronic pain is a pervasive and expensive public health problem affecting roughly one-third of the American population. The inability of language to accurately convey pain expressions combined with the social stigmas associated with discussing pain persuade many sufferers to remain silent about their pain. Gender politics and fear of professional repercussions further encourage silence. This article explores the need for a safe and secure place for chronic pain sufferers to talk of their pain experiences. The extent to which digital communication technology can fulfill this need is examined. This descriptive study examines the use of one online chronic pain management workshop for its ability to create an engaged community of choice. Workshop admittance was based on participants having a qualifying chronic pain condition. A thematic discourse analysis is conducted of all entries chronic pain participants posted. In addition to goal setting, participants discuss the ways in which pain affects them on a daily basis. Two themes emerge: validation and encouragement. This study suggests that chronic pain users need a discursive space to legitimate their chronic pain identity. It confirms that online websites and virtual audiences facilitate disclosure and allow for authentic communication. The benefits of computer-mediated discussion as well as its limitations are examined.

  18. Perception of suffering and compassion experience: brain gender disparities. (United States)

    Mercadillo, Roberto E; Díaz, José Luis; Pasaye, Erick H; Barrios, Fernando A


    Compassion is considered a moral emotion related to the perception of suffering in others, and resulting in a motivation to alleviate the afflicted party. We compared brain correlates of compassion-evoking images in women and men. BOLD functional images of 24 healthy volunteers (twelve women and twelve men; age=27±2.5 y.o.) were acquired in a 3T magnetic resonance scanner while subjects viewed pictures of human suffering previously verified to elicit compassion and indicated their compassionate experience by finger movements. Functional analysis revealed that while women manifested activation in areas involved in basic emotional, empathic, and moral processes, such as basal regions and cingulate and frontal cortices, activation in men was restricted mainly to the occipital cortex and parahippocampal gyrus. These findings suggest that compassion and its moral elements constitute gender-relative subjective phenomena emerging from differently evolved neural mechanisms and socially learned features possibly related to nurturing skills. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Mechanisms of illegal aggressive behavior of women suffering from schizophrenia

    Directory of Open Access Journals (Sweden)

    Z I Kekelidze


    Full Text Available Aim. To establish comparative clinical and psychopathological and social factors leading to realization of intrafamilial and extrafamilial aggressive actions of females suffering from schizophrenia when comparing the mechanisms of illegal actions. Methods. The article presents the results of the study of 91 female patients diagnosed with schizophrenia according to the International Classification of Diseases, 10th revision, (F20.0 of continuous and episodic with progressive deficit type of course, who committed aggressive socially dangerous acts and are admitted for involuntary treatment to Kazan psychiatric hospital of specialized type with intensive supervision. Two groups were identified: group 1 included 57 patients committed aggressive criminal acts in the family, and group 2 included 34 patients committed criminal acts against persons outside the family. A comparison was performed between two basic scientific concepts regarding the reasons and conditions of illegal acts committed by mentally ill persons. Statistical significance of the differences between the compared data was determined (using Fisher's angular transformation criterion and Mann-Whitney test. Results. Comparative study of the analysis concepts of illegal behavior in females suffering from schizophrenia demonstrated that the results turned out to be more detailed when using the concept of psychopathological mechanisms. So, in the productive psychotic mechanism imperative hallucinations and automatisms were noted predominantly in women from group 1 - in 59.5% (p1


    Directory of Open Access Journals (Sweden)

    F. Mushtaq, S. A. Khan, A. Aslam, K. Saeed1, G. Saleem and H. Mushtaq


    Full Text Available This project was aimed to evaluate immunostimulatory effects of three therapeutic substances in broilers suffering from infectious bursal disease (IBD. For this purpose, 150 chicks were divided into five equal groups i.e. A, B, C, D and E having 30 birds each. Group A, B, C and D were challenged with infectious bursal disease virus. There were three immunostimulatory treatments i.e. levamisole (group A, vitamin E (group B, and bursinex (group C. Groups D and E were untreated control. Bursa body weight index, histopathology of bursa of Fabricius, plasma cell counting in Harderian gland and estimation of antibody response against infectious bursal disease virus was recorded. Vitamin E played a major role in improving the condition of birds suffering from infectious bursal disease, as it showed increased bursa body weight index (BBIx, less histopathological lesions in bursa of Fabricius, increased number of plasma cells in Harderian gland and high antibody response in infectious bursal disease infected broilers as compared to levamisole and bursinex. Levamisole played a minor role in improving condition of birds, while bursinex did not seem to be much effective against infectious bursal disease virus in this study.

  1. Leonardo Da Vinci and stroke - vegetarian diet as a possible cause. (United States)

    Oztürk, Serefnur; Altieri, Marta; Troisi, Pina


    Leonardo da Vinci (April 15, 1452 to May 2, 1519) was an Italian Renaissance architect, musician, anatomist, inventor, engineer, sculptor, geometer, and painter. It has been gleaned from the many available historical documents that da Vinci was a vegetarian who respected and loved animals, and that he suffered from right hemiparesis in the last 5 years of his life. A vegetarian diet has both positive and negative influences on the cerebrovascular system. In this report, a possible relation between a vegetarian diet and stroke is discussed from various perspectives as related to Leonardo da Vinci's stroke. Copyright (c) 2010 S. Karger AG, Basel.

  2. Rehabilitative Games for Stroke Patients

    Directory of Open Access Journals (Sweden)

    A. Pyae


    Full Text Available Stroke is one of the major problems in medical and healthcare that can cause severe disability and death of patients especially for older population. Rehabilitation plays an important role in stroke therapy. However, most of the rehabilitative exercises are monotonous and tiring for the patients. For a particular time, they can easily get bored in doing these exercises. The role of patient’s motivation in rehabilitation is vital. Motivation and rehabilitative outcomes are strongly related. Digital games promise to help stroke patients to feel motivated and more engaged in rehabilitative training through motivational gameplay. Most of the commercial games available in the market are not well-designed for stroke patients and their motivational needs in rehabilitation. This study aims at understanding the motivational requirements of stroke patients in doing rehabilitative exercises and living in a post-stroke life. Based on the findings from the literature review, we report factors that can influence the stroke patients’ level of motivation such as social functioning, patient-therapist relationship, goal-setting, and music. These findings are insightful and useful for ideating and designing interactive motivation-driven games for stroke patients. The motivational factors of stroke patients in rehabilitation may help the game designers to design motivation-driven game contexts, contents, and gameplay. Moreover, these findings may also help healthcare professionals who concern stroke patient’s motivation in rehabilitative context. In this paper, we reported our Virtual Nursing Home (VNH concept and the games that we are currently developing and re-designing. Based on this literature review, we will present and test out the ideas how we can integrate these motivational factors in our future game design, development, and enhancement.

  3. Basics of acute stroke treatment

    International Nuclear Information System (INIS)

    Haass, A.


    Acute stroke presents an emergency that requires immediate referral to a specialized hospital, preferably with a stroke unit. Disability and mortality are reduced by 30% in patients treated in stroke units compared to those treated on regular wards, even if a specialized team is present on the ward. Systolic blood pressure may remain high at 200-220 mmHg in the acute phase and should not be lowered too quickly. Further guidelines for basic care include: optimal O 2 delivery, blood sugar levels below 100-150 mg%, and lowering body temperature below 37.5 C using physical means or drugs. Increased intracranial pressure should be treated by raising the upper body of the patient, administration of glycerol, mannitol, and/or sorbitol, artificial respiration, and special monitoring of Tris buffer. Decompressive craniectomy may be considered in cases of ''malignant'' media stroke and expansive cerebellar infarction. Fibrinolysis is the most effective stroke treatment and is twice as effective in the treatment of stroke than myocardial infarction. Fibrinolysis may be initiated within 3 h of a stroke in the anterior circulation. If a penumbra is detectable by ''PWI-DWI mismatch MRI,'' specialized hospitals may perform fibrinolysis up to 6 h after symptom onset. In cases of stroke in the basilar artery, fibrinolysis may be performed even later after symptom onset. Intra-arterial fibrinolysis is performed in these cases using rt-PA or urokinase. Follow-up treatment of stroke patients should not only address post-stroke depression and neuropsychological deficits, but also include patient education about risk factors such as high blood pressure, diabetes mellitus, and cardiac arrhythmias. (orig.) [de

  4. Serum hsCRP: A Novel Marker for Prediction of Cerebrovascular Accidents (Stroke). (United States)

    Patgiri, Dibyaratna; Pathak, Mauchumi Saikia; Sharma, Pradeep; Kutum, Tridip; Mattack, Nirmali


    Strokes are caused by disruption of the blood supply to the brain. This may result from either blockage or rupture of a blood vessel. Yearly 15 million people worldwide suffer a stroke. India ranks second worldwide in terms of deaths from stroke. The incidence of stroke increases with age affecting the economically productive middle aged population. Hypertension and male sex are other risk factors for stroke. C-Reactive Protein (CRP) is an acute phase protein whose concentration rises in blood following inflammation. Formerly, assays for CRP detected its rise only after significant inflammation. However, recently developed high sensitivity assays (hsCRP) enable the measurement of CRP in individuals who are apparently healthy. Several studies indicate that hsCRP is elevated in individuals who are at risk of developing Coronary Artery Disease or Cerebrovascular events, the elevation may be found years before the first detection of vascular problems. In the absence of other biochemical markers, the present study aimed to evaluate the predictive and diagnostic role of hsCRP in stroke. The study consisted of 50 patients of acute stroke admitted in Gauhati Medical College and Hospital. The control population consisted of two groups - 50 age and sex matched controls with hypertension (Hypertensive control group) and 50 age and sex matched controls with no obvious disease constituted the Normal control group. hsCRP levels were measured in all the groups and compared statistically. hsCRP is an acute phase reactant whose concentration rises in stroke as well as in those at risk. The rise may be identified even before the appearance of risk factors. Hence, hsCRP may be useful as a predictive and diagnostic marker in stroke.

  5. mStroke: "Mobile Stroke"-Improving Acute Stroke Care with Smartphone Technology. (United States)

    Andrew, Benjamin Y; Stack, Colleen M; Yang, Julian P; Dodds, Jodi A


    This study aimed to evaluate the effect of method and time of system activation on clinical metrics in cases utilizing the Stop Stroke (Pulsara, Inc.) mobile acute stroke care coordination application. A retrospective cohort analysis of stroke codes at 12 medical centers using Stop Stroke from March 2013 to May 2016 was performed. Comparison of metrics (door-to-needle time [DTN] and door-to-CT time [DTC], and rate of DTN ≤ 60 minutes [goal DTN]) was performed between subgroups based on method (emergency medical service [EMS] versus emergency department [ED]) and time of activation. Effects were adjusted for confounders (age, sex, National Institutes of Health Stroke Scale [NIHSS] score) using multiple linear and logistic regression. The final dataset included 2589 cases. Cases activated by EMS were more severe (median NIHSS score 8 versus 4, P smartphone technology provides unique insight into acute stroke codes. Activation of mobile electronic stroke coordination in the field appears to promote a more expedited and successful care process. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  6. Cor triatriatum and stroke. (United States)

    Diestro, Jose Danilo Bengzon; Regaldo, Joseph Justin Hipolito; Gonzales, Eddieson Masangcay; Dorotan, Maria Kristina Casanova; Espiritu, Adrian Isidro; Pascual, Jose Leonard Rivera


    Cor triatriatum sinistrum (CTS) is a congenital anomaly where the left atrium is divided into two compartments by a fibromuscular membrane. This report aims to add to the literature on a rare cardiac condition that can cause neurological morbidity. We report a case of a 19-year-old female with an infarct in the right middle cerebral artery (MCA) territory initially maintained on aspirin. Eighteen months later, she had recurrence of weakness, for which repeat transthoracic echocardiography (TTE) and re-evaluation of the first TTE demonstrated a hyperechoic membrane spanning the width of the left atrium, clinching the diagnosis of CTS. Despite anticoagulation with apixaban, she was admitted for a third stroke where she succumbed to hospital-acquired pneumonia. Among cases of CTS associated with stroke, anticoagulation and surgery were the main modes of treatment. This case has the longest follow-up and the first to demonstrate failure of antiplatelet therapy and anticoagulation. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Wen Dan Decoction for hemorrhagic stroke and ischemic stroke. (United States)

    Xu, Jia-Hua; Huang, Yan-Mei; Ling, Wei; Li, Yang; Wang, Min; Chen, Xiang-Yan; Sui, Yi; Zhao, Hai-Lu


    The use of traditional Chinese medicine (TCM) in stroke is increasing worldwide. Here we report the existing clinical evidence of the Pinellia Ternata containing formula Wen Dan Decoction (WDD) for the treatment of ischemic stroke and hemorrhagic stroke. PubMed, CNKI, Wan Fang database, Cochrane Library and online Clinical Trial Registry were searched up to 26 February 2013 for randomized, controlled clinical trials (RCTs) using WDD as intervention versus Western conventional medicine as control to treat stroke. Clinical outcomes were improvement of the Neurological Functional Deficit Scores (NFDS) and overall therapeutic efficacy rates including rate of cure. Meta-regression analysis using Hedges'g was performed for RCTs with significant heterogeneity. A total of 22 RCTs of ischemic stroke and 4 RCTs of hemorrhagic stroke, involving 2214 patients (1167 used WDD), met our inclusion criteria. Meta-analysis of the 13 RCTs reporting NFDS improvement favored WDD over the control (mean difference=-3.40, 95% confidence intervals [CI]=[-4.64, -2.15]). Rate of overall therapeutic efficacy (odds ratio [OR]=3.39, 95%CI=[1.81, 6.37]) for hemorrhagic stroke were significantly higher in WDD treated patients than the control subjects. In the 1898 patients with ischemic stroke, WDD medication also achieved higher rates of cure (OR=2.22, 95%CI=[1.66, 2.97]) and overall therapeutic efficacy (OR=3.31, 95%CI=[2.54, 4.31]) than the conventional treatment. WDD displays benefits on improvement of neurological function and overall therapeutic efficacy in post-stroke patients. TCM such as WDD may serve as a therapeutic tool of dual actions to explore the common mechanisms underlying cerebral hemorrhage and ischemia. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Pre-stroke use of beta-blockers does not affect ischaemic stroke severity and outcome

    NARCIS (Netherlands)

    De Raedt, S.; Haentjens, P.; De Smedt, A.; Brouns, R.; Uyttenboogaart, Maarten; Luijckx, G. J.; De Keyser, J.

    Background and purpose: It is unclear whether pre-stroke beta-blockers use may influence stroke outcome. This study evaluates the independent effect of pre-stroke use of beta-blockers on ischaemic stroke severity and 3 months functional outcome. Methods: Pre-stroke use of beta-blockers was

  9. What about self-management post-stroke? Challenges for stroke survivors, spouses and professionals

    NARCIS (Netherlands)

    Satink, A.J.H.


    Self-management post-stroke is challenging for many persons after a stroke. In this thesis is explored how stroke survivors, spouses and professionals perceived self-management post-stroke and how the process of self-management post-stroke evolved over time. The following studies are conducted: a

  10. Gait training assisted by multi-channel functional electrical stimulation early after stroke: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    van Bloemendaal, Maijke; Bus, Sicco A.; de Boer, Charlotte E.; Nollet, Frans; Geurts, Alexander C. H.; Beelen, Anita


    Many stroke survivors suffer from paresis of lower limb muscles, resulting in compensatory gait patterns characterised by asymmetries in spatial and temporal parameters and reduced walking capacity. Functional electrical stimulation has been used to improve walking capacity, but evidence is mostly

  11. [Apotemnophilia as a contemporary frame for psychological suffering]. (United States)

    Baubet, T; Gal, B; Dendoncker-Viry, S; Masquelet, A C; Gatt, M-T; Moro, M R


    The word was created in 1977. It was first used to describe an extreme paraphilia concerning both the search for amputees as sexual partners, and the fantasies and wishes to be amputated linked to a sexual arousal. More recently, the number of self-demand amputations appears to have raised. Some amputations of healthy legs have even been performed in hospital settings, raising important ethical issues. A new category of trouble has been described: the Body Integrity Identity Disorder (BIID). Criterias for its diagnosis have been developed and submitted to DSM V task force. According to clinicians who support the existence of BIID, this disorder is not a paraphilia, don't overlap with other psychiatric disorders and could be in some ways compared to transexualism. The patient's health would therefore require the amputation of healthy limbs in order to themselves and to help them to become bodied> according to their . Still according to those clinicians, psychiatric symptoms would be either a consequence of the shame resulting from this condition, or a consequence of the doctor's refusal to perform these amputations. An ever growing litterature on the web support this opinion, but the scientific litterature is still very scarce. In this paper, we analyse available scientific datas. This review does not support the existence of BIID as a discrete nor a specific condition. In a second part of this paper, we describe the case of a young woman who started asking for above-the-knee leg amputation after a minor knee trauma, while complaining for pain and leg rigidity. Her medical state worsened, probably because of repeated self-inflicted lesions and food restriction, leading to a severe undernutrition and life-threatening hypokaliemia. After some time, her medical state required amputation. This surgery did not resolve her psychological suffering. She never talked about amputation as a way to achieve herself. She did not meet the criterias for BIID. We consider her

  12. Basic Land Drills for Swimming Stroke Acquisition (United States)

    Zhang, Peng


    Teaching swimming strokes can be a challenging task in physical education. The purpose of the article is to introduce 12 on land drills that can be utilized to facilitate the learning of swimming strokes, including elementary back stroke, sidestroke, front crawl, back stroke, breaststroke, and butterfly. Each drill consists of four components…

  13. Early infection and prognosis after acute stroke

    DEFF Research Database (Denmark)

    Kammersgaard, L P; Jørgensen, H S; Reith, J


    Infection is a frequent complication in the early course of acute stroke and may adversely affect stroke outcome. In the present study, we investigate early infection developing in patients within 3 days of admission to the hospital and its independent relation to recovery and stroke outcome....... In addition, we identify predictors for early infections, infection subtypes, and their relation to initial stroke severity....

  14. Stroke rehabilitation: recent advances and future therapies.

    LENUS (Irish Health Repository)

    Brewer, L


    Despite advances in the acute management of stroke, a large proportion of stroke patients are left with significant impairments. Over the coming decades the prevalence of stroke-related disability is expected to increase worldwide and this will impact greatly on families, healthcare systems and economies. Effective neuro-rehabilitation is a key factor in reducing disability after stroke. In this review, we discuss the effects of stroke, principles of stroke rehabilitative care and predictors of recovery. We also discuss novel therapies in stroke rehabilitation, including non-invasive brain stimulation, robotics and pharmacological augmentation. Many trials are currently underway, which, in time, may impact on future rehabilitative practice.

  15. Resources for hyperhidrosis sufferers, patients, and health care providers. (United States)

    Pieretti, Lisa J


    The excessive sweating of hyperhidrosis creates profound psychosocial, professional, and financial burdens on the individual sufferer; it contributes to impaired self-worth and self-efficacy, decreased satisfaction in all relationships, avoidance of specific careers, and increased expenditures on everything from clothing to medical treatment. Despite morbidity equal to other well-known dermatologic conditions, hyperhidrosis has historically been underacknowledged and undertreated because of the lack of accessible, scientifically accurate information and dispersal of that information within patient and medical communities. Thankfully, the development of the Internet and the work of the not-for-profit International Hyperhidrosis Society (IHHS) have increased awareness of hyperhidrosis. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Bearded ladies: females suffer fitness consequences when bearing male traits. (United States)

    Swierk, Lindsey; Langkilde, Tracy


    A central assumption in evolutionary biology is that females of sexually dimorphic species suffer costs when bearing male secondary sexual traits, such as ornamentation. Nevertheless, it is common in nature to observe females bearing rudimentary versions of male ornaments (e.g. 'bearded ladies'), as ornaments can be under similar genetic control in both sexes. Here, we provide evidence that masculinized females incur both social and reproductive costs in nature. Male fence lizards (Sceloporus undulatus) discriminated against ornamented females during mate choice. Ornamented females had lower reproductive output, and produced eggs that were laid and hatched later than those of non-ornamented females. These findings support established theories of the evolution of sexual dimorphism and intralocus sexual conflict, and raise questions regarding the persistence of masculinizing ornamentation in females.

  17. The suffering witness: a missiological reading of Lamentations

    Directory of Open Access Journals (Sweden)

    Bob Wielenga


    Full Text Available This article explores the possibilities of a missiological reading of the book of Lamentations. Based upon a historical understanding of Lamentations, Christological conclusions are drawn from it with a view on formulating some missiologically relevant guidelines for missionary praxis. This article contends that Lamentations was composed to be used pastorally in an unprecedented crisis in Jerusalem in 586 BCE. In a situation of utter powerlessness and otherlessness the lamenting population was shown a way to rebuild their shattered universe by, paradoxically, reaching out to their God who was not there for them anymore. The suffering witness of Lamentations 3 is used as a Christological model, which is applied to missionary praxis. In the fields of worship and liturgy, aid and assistance and prophetic analysis the church has to continue the witnessing ministry of her Lord, empowered by his Spirit.

  18. Nursing in family environment: caring for person in mental suffering

    Directory of Open Access Journals (Sweden)

    Lucas Amaral Martins


    Full Text Available The study aims to describe the experience of nursing care to person in mental suffering (PMS in the family context. Developed by nursing academic during home attendance, in the 2008.2 semester. The results showed that: is undeniable the family function of the PMS care, becoming the main partner of the heath teams, the care in the perspective of psychosocial rehabilitation influences the attitudes, patterns of response and participation in treatment, resulting in the empowerment of PMS and family. It’s concluded that home attendance contributes to the process of psychosocial rehabilitation of the PMS and assessment of mental health services, subsidizing the formulation of public policies for the sector, especially, in regard to care in perspective of the whole human life.

  19. Doll therapy for dementia sufferers: A systematic review. (United States)

    Ng, Qin Xiang; Ho, Collin Yih Xian; Koh, Shawn Shao Hong; Tan, Wei Chuan; Chan, Hwei Wuen


    Dementia affects more than 47.5 million people worldwide, and the number is expected to continue to increase as the population ages. Doll therapy is an emerging nonpharmacologic management strategy for patients with advanced dementia, especially in patients with challenging behaviours. A total of 12 published studies (mainly cohort and observational studies) were identified and discussed in this systematic review. In most instances, cognitive, behavioural and emotional symptoms were alleviated and overall wellbeing was improved with doll therapy, and dementia sufferers were found to be able to better relate with their external environment. Despite the relative paucity of empirical data and ethical concerns, we are of the opinion that doll therapy is effective for dementia care, is well-aligned with the ethos of person-centred care and should be applied in the management of dementia patients. Future research should include more robust randomized controlled trials. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. [Nutritional management of patients suffering of chronic renal failure]. (United States)

    Rondanelli, M; Opizzi, A; Bonisio, A; Lingua, S; Cena, H; Giacosa, A; Roggi, C


    Nutritional support constitutes a fundamental approach to favour the management of chronic renal failure and to postpone the need of kidney dialysis. The specific goals of the nutrition intervention are: control of protein intake, control of phosphate and of calcium intake, control of potassium intake, control of energy intake, control of lipid intake with clear identification of the polyunsaturated vs monounsaturated vs saturated fatty acid rate, control of vitamin intake, prevention of malnutrition and intervention with oral supplements or artificial nutrition (even if for short time) if malnutrition occurs. The proper management of the nutritional problems of patients with chronic renal failure slows the disease progression, prevents or controls symptoms associated with uremia and postpones the beginning of substitutive treatment that is of hemodialysis or of peritoneal dialysis, thus allowing a better quality of life either in the short or long term for patients suffering of chronic renal failure.

  1. Cornual pregnancy in a patient suffering from sickle cell anemia

    Directory of Open Access Journals (Sweden)

    Onilda Labrada Silva


    Full Text Available Nowadays, ectopic pregnancy is a pathological entity of great incidence, which is increased, among other things, by each time earlier sexual relations. Cornual pregnancy is as a result of the implantation of the blastocyte within the segment of the fallopian tube that goes into the uterus wall or between the tubal ostium and the proximal portion of the isthmus. This is a case of a cornual pregnancy in which the use of ultrasonography played an essential role for its diagnosis, since it is about a patient suffering from sickle cell anemia, where it was not possible to clinically eliminate the possibility of an occlusive vessel crisis as the cause of abdominal pain. Subtotal hysterectomy of the right tube was performed. The patient’s evolution is satisfactory.

  2. Kumbhakarna : Did he suffer from the disorder of the hypothalamus?

    Directory of Open Access Journals (Sweden)

    Om J Lakhani


    Full Text Available Kumbhakarna was brother of the evil Raavana in the mythological tale of Ramayana. According the legend, Kumbhakarna had an insatiable appetite and thirst and used to sleep for great lengths of time. He also had an uncontrollable temper, which was feared by many. It is our assessment that Kumbhakarna possibly suffered from hypothalamic obesity. Hypothalamic obesity can be defined as significant polyphagia and weight gain that occurs because of structural or function involvement of the ventromedial nucleus of the hypothalamus bilaterally. The characteristic features are obesity associated with polyphagia. Somnolence is present in 40% of cases. Sham rage is a characteristic behavioral abnormality seen in these patients. All these symptoms are described in the mythological text while describing Kumbhakarna. The episodic nature of Kumbhakarna′s symptoms can also be explained by another hypothalamic syndrome called Klein-Levine syndrome. This syndrome is characterized by with periodic episodes of somnolence, hyperphagia and hypersexuality along with other behavioral and cognitive difficulties.

  3. [Plan for stroke healthcare delivery]. (United States)

    Alvarez Sabín, J; Alonso de Leciñana, M; Gállego, J; Gil-Peralta, A; Casado, I; Castillo, J; Díez Tejedor, E; Gil, A; Jiménez, C; Lago, A; Martínez-Vila, E; Ortega, A; Rebollo, M; Rubio, F


    All stroke patients should receive the same degree of specialized healthcare attention according to the stage of their disease, independently of where they live, their age, gender or ethnicity. To create an organized healthcare system able to offer the needed care for each patient, optimizing the use of the existing resource. A committee of 14 neurologists specialized in neurovascular diseases representing different regions of Spain evaluated the available scientific evidence according to the published literature. During the acute phase, all stroke patients must be evaluated in hospitals that offer access to specialized physicians (neurologists) and the indicated diagnostic and therapeutic procedures. Hospitals that deliver care to acute stroke patients must be prepared to attend these patients and need to arrange a predefined transferring circuit coordinated with the extrahospitalary emergency service. Since resources are limited, they should be structured into different care levels according to the target population. Thus, three types of hospitals will be defined for stroke care: reference stroke hospital, hospital with stroke unit, hospital with stroke team.

  4. Perceived Walking Speed, Measured Tandem Walk, Incident Stroke, and Mortality in Older Latino Adults: A Prospective Cohort Study. (United States)

    Zeki Al Hazzouri, Adina; Mayeda, Elizabeth Rose; Elfassy, Tali; Lee, Anne; Odden, Michelle C; Thekkethala, Divya; Wright, Clinton B; Glymour, Maria M; Haan, Mary N


    Walking speed is associated with functional status and all-cause mortality. Yet the relationship between walking speed and stroke, also a leading cause of disability, remains poorly understood, especially in older Latino adults who suffer from a significant burden of stroke. A total of 1,486 stroke-free participants from the Sacramento Area Latino Study on Aging, aged 60 and older at baseline in 1998-1999, were followed annually through 2010. Participants reported their usual walking speed outdoors which was classified into slow, medium, or fast. We also assessed timed tandem walk ability (unable or eight or more errors vs less than eight errors). We ascertained three incident stroke endpoints: total stroke, nonfatal stroke, and fatal stroke. Using Cox proportional hazards models, we estimated hazard ratios (HRs) for stroke at different walking speed and timed tandem walk categories. Over an average of 6 years of follow-up (SD = 2.8), the incidence rate of total strokes was 23.2/1,000 person-years for slow walkers compared to 15.6/1,000 person-years for medium walkers, and 7.6/1,000 person-years for fast walkers. In Cox models adjusted for sociodemographics, cardiovascular risk, cognition and functional status, and self-rated health, the hazard of total stroke was 31% lower for medium walkers (HR: 0.69, 95% confidence interval [CI]: 0.47, 1.02) and 56% lower for fast walkers (HR: 0.44, 95% CI: 0.24, 0.82) compared with slow walkers. We found similar associations with timed tandem walk ability (fully adjusted HR: 0.66, 95% CI: 0.45, 0.98). Our findings suggest perceived walking speed captures more than self-rated health alone and is a strong risk factor for stroke risk in Latino older adults.


    Petriček, G; Cerovečki, V; Adžić, Z Ožvačić


    Although survey results indicate clear connection between the physician-patient communication and health outcomes, mechanisms of their action are still insufficiently clear. The aim was to investigate the specificity of communication with patients suffering from gastrointestinal diseases and the impact of good communication on measurable outcomes. We performed PubMed (Medline) search using the following key words: communication, health outcomes, and gastrointestinal diseases. Seven pathways through which communication can lead to better health include increased access to care, greater patient knowledge and shared understanding, higher quality medical decisions, enhanced therapeutic alliances, increased social support, patient agency and empowerment, and better management of emotions. Although these pathways were explored with respect to cancer care, they are certainly applicable to other health conditions as well, including the care of patients suffering from gastrointestinal diseases. Although proposing a number of pathways through which communication can lead to improved health, it should be emphasized that the relative importance of a particular pathway will depend on the outcome of interest, the health condition, where the patient is in the illness trajectory, and the patient’s life circumstances. Besides, research increasingly points to the importance of placebo effect, and it is recommended that health professionals encourage placebo effect by applying precisely targeted communication skills, as the unquestionable and successful part of many treatments. It is important that the clinician knows the possible positive and negative effects of communication on health outcomes, and in daily work consciously maximizes therapeutic effects of communication, reaching its proximal (understanding, satisfaction, clinician-patient agreement, trust, feeling known, rapport, motivation) and intermediate outcomes (access to care, quality medical decision, commitment to

  6. Acupuncture for acute stroke. (United States)

    Xu, Mangmang; Li, Dan; Zhang, Shihong


    Sensory stimulation via acupuncture has been reported to alter activities of numerous neural systems by activating multiple efferent pathways. Acupuncture, one of the main physical therapies in Traditional Chinese Medicine, has been widely used to treat patients with stroke for over hundreds of years. This is the first update of the Cochrane Review originally published in 2005. To assess whether acupuncture could reduce the proportion of people with death or dependency, while improving quality of life, after acute ischemic or hemorrhagic stroke. We searched the Cochrane Stroke Group trials register (last searched on February 2, 2017), the Cochrane Central Register of Controlled Trials Ovid (CENTRAL Ovid; 2017, Issue 2) in the Cochrane Library, MEDLINE Ovid (1946 to February 2017), Embase Ovid (1974 to February 2017), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) EBSCO (1982 to February 2017), the Allied and Complementary Medicine Database (AMED; 1985 to February 2017), China Academic Journal Network Publishing Database (1998 to February 2017), and the VIP database (VIP Chinese Science Journal Evaluation Reports; 1989 to February 2017). We also identified relevant trials in the Chinese Clinical Trial Registry (last searched on Feburuary 20, 2017), the World Health Organization (WHO) International Clinical Trials Registry Platform (last searched on April 30, 2017), and (last searched on April 30, 2017). In addition, we handsearched the reference lists of systematic reviews and relevant clinical trials. We sought randomized clinical trials (RCTs) of acupuncture started within 30 days from stroke onset compared with placebo or sham acupuncture or open control (no placebo) in people with acute ischemic or hemorrhagic stroke, or both. Needling into the skin was required for acupuncture. Comparisons were made versus (1) all controls (open control or sham acupuncture), and (2) sham acupuncture controls. Two review authors applied

  7. Editorial for the Third Pangu Stroke Conference. (United States)

    Chen, Gang; Chen, Jun; Ji, Xunming; Xi, Guohua; Zhang, John


    The Pangu Stroke Conference has been held annually in China since 2012 and is based on the successful templates of the Princeton Stroke Conference in the United States and the Marburg Conference on Cerebral Ischemia in Germany. All participants in the Pangu Stroke Conference are expert stroke clinicians or stroke basic science researchers of Chinese origin. This conference promotes collaboration between clinicians and basic science researchers and between stroke researchers in mainland China and other parts of the world. The Pangu Stroke Conference fosters translational stroke research, discussions of stroke research milestones, and proposals for future directions. Some of the keynote presentations in the third Pangu Stroke Conference are included in this special issue. Copyright © 2015. Published by Elsevier Inc.

  8. [The importance of neuronal networks for motor rehabilitation after a stroke]. (United States)

    Hummel, F C


    Every year in Europe 1.5 million patients suffer a new stroke. Despite the further developments in acute therapy with nationwide stroke units, thrombolysis, thrombectomy and post-acute neurorehabilitation, only a small proportion of patients recover to a satisfactory degree allowing them to return to their normal social and professional life. This makes stroke the main cause of long-term disability with a corresponding impact on patient lives, socioeconomics and the healthcare system. Thus, the concepts of neurorehabilitation have to be extended to enhance the effects of rehabilitative treatment strategies. To achieve this, an understanding of the prediction of the course of recovery, the mechanisms underlying functional recovery and factors influencing recovery have to be enhanced for the development towards patient-tailored precision medicine approaches. A central point towards this is the understanding of stroke as a disease, which not only influences the damaged area but also the associated network. This is crucial for the understanding of the stroke-induced deficits, for prediction of recovery and options for interventional treatment strategies, which can target different areas in this network (e.g. primary motor cortex and secondary motor regions) based on individual factors of the patient. The present article discusses the importance of network alterations for motor neurorehabilitation after a stroke and which novel options, concepts and consequences could arise from this for neurorehabilitation.

  9. Factor V Leiden does not have a role in cryptogenic ischemic stroke among Iranian young adults. (United States)

    Kheradmand, Ehsan; Pourhossein, Meraj; Amini, Gilda; Saadatnia, Mohammad


    Different risk factors have been suggested for ischemic stroke in young adults. In a group of these patients despite of extensive diagnostic work-up, the primary cause remains unknown. Coagulation tendency is accounted as a possible cause in these patients. Previous studies on factor V Leiden (FVL) as the main cause of inherited thrombophilia for clarifying the role of FVL in stroke have resulted in controversial findings. The current study investigates the role of this factor in ischemic stroke among Iranians. This case-control study was performed between September 2007 and December 2008 in Isfahan, Iran. The case group comprised of 22 patients of which 15 were males and 7 were females with age range of ≤50 years, diagnosed as ischemic stroke without classic risk factors and the control group consisted of 54 healthy young adults. After filling consent form, venous blood samples were obtained and sent to the laboratory for genetic examination. No FVL mutation was found in the case group. There was one carrier of the mutation as heterozygous in the control group (relative frequency = 1.85%). Based on our study, FVL might not be considered as an independent risk factor for ischemic stroke in Iranian individuals who are not suffering from other risk factors of ischemic stroke.

  10. Dysphagia in Acute Stroke: Incidence, Burden and Impact on Clinical Outcome (United States)

    Broeg-Morvay, Anne; Meisterernst, Julia; Schlager, Markus; Mono, Marie-Luise; El-Koussy, Marwan; Kägi, Georg; Jung, Simon; Sarikaya, Hakan


    Background Reported frequency of post-stroke dysphagia in the literature is highly variable. In view of progress in stroke management, we aimed to assess the current burden of dysphagia in acute ischemic stroke. Methods We studied 570 consecutive patients treated in a tertiary stroke center. Dysphagia was evaluated by using the Gugging Swallowing Screen (GUSS). We investigated the relationship of dysphagia with pneumonia, length of hospital stay and discharge destination and compared rates of favourable clinical outcome and mortality at 3 months between dysphagic patients and those without dysphagia. Results Dysphagia was diagnosed in 118 of 570 (20.7%) patients and persisted in 60 (50.9%) at hospital discharge. Thirty-six (30.5%) patients needed nasogastric tube because of severe dysphagia. Stroke severity rather than infarct location was associated with dysphagia. Dysphagic patients suffered more frequently from pneumonia (23.1% vs. 1.1%, pdysphagia. At 3 months, dysphagic patients less often had a favourable outcome (35.7% vs. 69.7%; pdysphagia to be an independent predictor of discharge destination and institutionalization at 3 months, while severe dysphagia requiring tube placement was strongly associated with mortality. Conclusion Dysphagia still affects a substantial portion of stroke patients and may have a large impact on clinical outcome, mortality and institutionalization. PMID:26863627

  11. Plasma cytokines in acute stroke

    DEFF Research Database (Denmark)

    Christensen, Hanne Krarup; Boysen, Gudrun; Christensen, Erik


    GOALS: The aim of this study was to test the relations between plasma cytokines and the clinical characteristics, course, and risk factors in acute stroke. PATIENTS AND METHODS: The analysis was based on 179 patients with acute stroke included within 24 hours of stroke onset. On inclusion and 3...... months later plasma levels of interleukin 1 beta (IL-1beta), tumor necrosis factor alpha (TNF-alpha), interleukin-1 receptor antagonist (IL-1RA), interleukin 6 (IL-6), interleukin 10 (IL-10), soluble tumor necrosis factor receptor 1 (sTNF-R1), and soluble tumor necrosis factor receptor 2 (sTNF-R2) were...

  12. Specific antismoking advice after stroke

    DEFF Research Database (Denmark)

    Hornnes, Nete; Larsen, Klaus; Brink-Kjær, Tove


    INTRODUCTION: Many stroke survivors would benefit from modification of their lifestyle in order to reduce their risk of recurrent stroke. We investigated if tailored smoking cessation advice would yield a higher smoking cessation rate and a higher rate with sustained abstinence in ex......-smokers in the intervention group than among controls. MATERIAL AND METHODS: Patients admitted with an acute stroke or a transient ischaemic attack were included in a randomised controlled trial focusing on control of lifestyle risk factors and hypertension. Here, we report the intervention focused on smoking cessation. We...

  13. Strokes in young adults: epidemiology and prevention

    Directory of Open Access Journals (Sweden)

    Smajlović D


    Full Text Available Dževdet Smajlović Department of Neurology, University Clinical Centre Tuzla, School of Medicine, University of Tuzla, Bosnia and Herzegovina Abstract: Strokes in young adults are reported as being uncommon, comprising 10%–15% of all stroke patients. However, compared with stroke in older adults, stroke in the young has a disproportionately large economic impact by leaving victims disabled before their most productive years. Recent publications report an increased incidence of stroke in young adults. This is important given the fact that younger stroke patients have a clearly increased risk of death compared with the general population. The prevalence of standard modifiable vascular risk factors in young stroke patients is different from that in older patients. Modifiable risk factors for stroke, such as dyslipidemia, smoking, and hypertension, are highly prevalent in the young stroke population, with no significant difference in geographic, climatic, nutritional, lifestyle, or genetic diversity. The list of potential stroke etiologies among young adults is extensive. Strokes of undetermined and of other determined etiology are the most common types among young patients according to TOAST (Trial of Org 10172 in Acute Stroke Treatment criteria. Prevention is the primary treatment strategy aimed at reducing morbidity and mortality related to stroke. Therefore, primary prevention is very important with regard to stroke in young adults, and aggressive treatment of risk factors for stroke, such as hypertension, smoking, and dyslipidemia, is essential. The best form of secondary stroke prevention is directed toward stroke etiology as well as treatment of additional risk factors. However, there is a lack of specific recommendations and guidelines for stroke management in young adults. In conclusion, strokes in young adults are a major public health problem and further research, with standardized methodology, is needed in order to give us more

  14. The PRE-hospital Stroke Treatment Organization. (United States)

    Audebert, Heinrich; Fassbender, Klaus; Hussain, M Shazam; Ebinger, Martin; Turc, Guillaume; Uchino, Ken; Davis, Stephen; Alexandrov, Anne; Grotta, James


    Background The PRE-hospital Stroke Treatment Organization was formed in 2016 as an international consortium of medical practitioners involved in pre-hospital treatment of patients with acute stroke. Aims PRE-hospital Stroke Treatment Organization's mission is to improve stroke outcomes by supporting research and advocacy for pre-hospital stroke treatment in Mobile Stroke Units. PRE-hospital Stroke Treatment Organization will provide a platform to enhance collaborative research across the spectrum of acute stroke management in the pre-hospital setting. PRE-hospital Stroke Treatment Organization will also facilitate the appropriate proliferation and distribution of Mobile Stroke Units by providing a forum for professional communication, resource for public education, and stimulus for government, industry, and philanthropic support. Summary of review In this "white paper", we describe the evidence supporting pre-hospital stroke treatment, progress to date, practical issues such as application in various environments and staffing, planned research initiatives, and organizational structure. Conclusions PRE-hospital Stroke Treatment Organization is not-for-profit, with membership open to anyone involved (or hoping to become involved) in pre-hospital stroke care. PRE-hospital Stroke Treatment Organization has a Steering Committee comprised of members from Europe, U.S., Canada, Australia, and other regions having a Mobile Stroke Unit in operation. PRE-hospital Stroke Treatment Organization convenes satellite meetings for membership at the International Stroke Conference and European Stroke Congress each year to address the PRE-hospital Stroke Treatment Organization mission. The first research collaborations agreed upon are to: (1) develop a list of common data elements to be collected by all Mobile Stroke Unit programs and entered into a common research database, and (2) develop a protocol for investigating the natural history of hyper-acute Intracerebral Hemorrhage.

  15. Sex-specific responses to stroke


    Turtzo, L Christine; McCullough, Louise D


    Stroke is a sexually dimorphic disease, with differences between males and females observed both clinically and in the laboratory. While males have a higher incidence of stroke throughout much of the lifespan, aged females have a higher burden of stroke. Sex differences in stroke result from a combination of factors, including elements intrinsic to the sex chromosomes as well as the effects of sex hormone exposure throughout the lifespan. Research investigating the sexual dimorphism of stroke...

  16. Stroke subtypes and factors associated with ischemic stroke in ...

    African Journals Online (AJOL)

    . Better understanding and controlling factors associated will improve the prevention of the disease. This study reviews records of patients with ischemic stroke in Central Africa. Material and methods: Patients of Bantu ethnicity with clinical ...

  17. Self-rated health, symptoms of depression and general symptoms at 3 and 12 months after a first-ever stroke: a municipality-based study in Sweden

    Directory of Open Access Journals (Sweden)

    Hassler Ejda


    Full Text Available Abstract Background Self-rated health is an important indicator of quality of life as well as a good predictor of future health. The purpose of the study was to follow up the self-rated health and the prevalence of symptoms of depression and general symptoms in a population of first-ever stroke patients 3 and 12 months after stroke. Methods All patients surviving their first-ever stroke and residing in Nacka municipality in Stockholm County Council were included using a multiple overlapping search strategy during an 18-month period (n = 187. Our study group comprised the 145 patients who survived the first 3 months after stroke. Three and 12 months after their stroke, the patients were assessed regarding self-rated health and general symptoms using parts of the Göteborg Quality of Life Instrument (GQLI, and regarding symptoms of depression using the Montgomery Asberg Depression Scale (MADRS-S. Results Self-rated health was rated as very good or rather good by 62% at 3 months after stroke and by 78% at 12 months after stroke. More than half of the patients suffered from symptoms of depression, with no significant improvement at 12 months. The most common general symptoms at 3 months after stroke were fatigue, sadness, pain in the legs, dizziness and irritability. Fatigue and sadness were still common at 12 months. Twelve months after stroke the prevalences of crying easily, irritability, impaired concentration, nausea and loss of weight were significantly lower. Conclusion The majority of patients rated their health as rather good or very good at 3 and 12 months after stroke. However, the majority suffered from fatigue and from symptoms of depression after both 3 and 12 months. In continued care of stroke survivors, it is important to consider the fact that many patients who rate their health as good may nevertheless have symptoms of depression, and some of them may benefit from anti-depressive treatment.

  18. Combination of Transcranial Direct Current Stimulation and Neuromuscular Electrical Stimulation Improves Gait Ability in a Patient in Chronic Stage of Stroke


    Satow, Takeshi; Kawase, Tomotaka; Kitamura, Atsushi; Kajitani, Yuki; Yamaguchi, Takuya; Tanabe, Nobuhiko; Otoi, Reiko; Komuro, Taro; Kobayashi, Akira; Nagata, Hirokazu; Mima, Tatsuya


    Background: Walking ability is important in stroke patients to maintain daily life. Nevertheless, its improvement is limited with conventional physical therapy in chronic stage. We report the case of a chronic stroke patient showing a remarkable improvement in gait function after a new neurorehabilitation protocol using transcranial direct current stimulation (tDCS) and neuromuscular electrical stimulation (NMES). Case Presentation: A 62-year-old male with left putaminal hemorrhage suffered f...

  19. [Post-stroke apathy]. (United States)

    López-Dóriga Bonnardeaux, Pedro; Andrino Díaz, Nuria


    Apathy is a motivational disturbance that can be defined as a quantitative reduction of goal-directed behaviour. Patients present with loss of motivation, concern, interest, and emotional response, resulting in a loss of initiative, decreased interaction with their environment, and a reduced interest in social life. Apathy not only appears to be common in stroke patients, but it has also been related to a wide range of negative consequences for the patients and their caregivers, including poor functional recovery, loss of social independence, and caregiver distress. Clear definition and consensus diagnostic criteria for apathy are needed to accomplish an accurate assessment and an individualised treatment plan. Although there have been reports of successful behavioural therapy treatment of apathetic states, there is a paucity of controlled clinical trials on the efficacy of apathetic behaviours using pharmacotherapy. Copyright © 2015 SEGG. Published by Elsevier Espana. All rights reserved.

  20. 153 - 158_Jacob_Antibacterial

    African Journals Online (AJOL)


    A purple colour appearing at the interface indicates the presence of reducing sugar in the extract (Trease and Evans,. 2002). Test for alkaloids. Each extract (1 g) .... certain skin ailments. Terpenes help to counter stress and anxiety, improve mood, promote alertness and memory retention. For example, limonene, a major.

  1. Jacob et al (21).cdr

    African Journals Online (AJOL)

    Timothy Ademakinwa

    1Department of Chemistry, Federal University of Technology, Minna, Nigeria. 2Department of Chemistry, University of Abuja, PMB 117, Abuja, Nigeria ... pesticides, use of polluted water for irrigation, waste disposal, industrial and mining activities. (Ashish et al., 2013). Massive and regular chemical analysis of farmland soil ...

  2. Stroke etiology and collaterals: atheroembolic strokes have greater collateral recruitment than cardioembolic strokes. (United States)

    Rebello, L C; Bouslama, M; Haussen, D C; Grossberg, J A; Dehkharghani, S; Anderson, A; Belagaje, S R; Bianchi, N A; Grigoryan, M; Frankel, M R; Nogueira, R G


    Chronic hypoperfusion from athero-stenotic lesions is thought to lead to better collateral recruitment compared to cardioembolic strokes. It was sought to compare collateral flow in stroke patients with atrial fibrillation (AF) versus stroke patients with cervical atherosclerotic steno-occlusive disease (CASOD). This was a retrospective review of a prospectively collected endovascular database. Patients with (i) anterior circulation large vessel occlusion stroke, (ii) pre-treatment computed tomography angiography (CTA) and (iii) intracranial embolism from AF or CASOD were included. CTA collateral patterns were evaluated and categorized into two groups: absent/poor collaterals (CTA collateral score 0-1) versus moderate/good collaterals (CTA collateral score 2-4). CT perfusion was also utilized for baseline core volume and evaluation of infarct growth. A total of 122 patients fitted the inclusion criteria, of whom 88 (72%) had AF and 34 (27%) CASOD. Patients with AF were older (P Collateral scores were lower in the AF group (P = 0.01) with patients having poor collaterals in 28% of cases versus 9% in the CASOD group (P = 0.03). Mortality rates (20% vs. 0%; P = 0.02) were higher in the AF patients whilst rates of any parenchymal hemorrhage (6% vs. 26%; P collaterals (odds ratio 4.70; 95% confidence interval 1.17-18.79; P = 0.03). Atheroembolic strokes seem to be associated with better collateral flow compared to cardioembolic strokes. This may in part explain the worse outcomes of AF-related stroke. © 2017 EAN.

  3. Epidemiology of nonfatal stroke and transient ischemic attack in Al-Kharga District, New Valley, Egypt

    Directory of Open Access Journals (Sweden)

    Farghaly WM


    Full Text Available Wafaa MA Farghaly,1 Hamdy N El-Tallawy,1 Ghaydaa A Shehata,1 Tarek A Rageh,1 Nabil M Abdel-Hakeem,2 Mohamed A Abd Elhamed,1 Bastawy MA Al-Fawal,3 Reda Badry1 1Department of Neurology, Faculty of Medicine, Assiut University, Assiut, 2Department of Neurology, Faculty of Medicine, Al-Azhar University, Assiut Branch, Assiut, 3Aswan Health Insurance Hospital, Ministry of Health, Aswan, Egypt Background: Stroke is a medical emergency. Nonfatal stroke may cause permanent neurologic damage, complications, and disability. The aim of this study was to determine the epidemiology of nonfatal stroke in Al-Kharga District, New Valley, Egypt. Methods: The total population (62,583 was screened via a door-to-door study by three neurology specialists and 15 female social workers for demographic data collection. All subjects with probable stroke were subjected to a full clinical examination, neuroimaging (computed tomography and/or magnetic resonance imaging of the brain, and laboratory investigations including blood sugar, lipid profile, serum uric acid, a complete blood count, blood urea, and serum creatinine. Stroke severity and outcome were assessed using the Scandinavian Stroke Scale and Barthel Index. Carotid Doppler, echocardiography, and thyroid function tests were done in selected cases. Results: During the study period (June 1, 2005 to May 31, 2008, 351 subjects were diagnosed as having suffered a cerebrovascular stroke at some point during their lives, yielding a total lifetime prevalence of 5.6 per 1,000 population. Of these, 156 subjects were identified as having suffered a stroke during the year from January 1 to December 31, 2007, with an incidence rate of 2.5 per 1,000. Both prevalence and incidence rates were higher in urban (5.8 per 1,000 and 2.6 per 1,000, respectively than rural communities (5.2 per 1,000 and 2.3 per 1,000, and were higher in males (6.1 per 1,000 and 2.7 per 1,000, respectively than in females (5.1 per 1,000 and 2.3 per 1

  4. Stroke Laterality Bias in the Management of Acute Ischemic Stroke. (United States)

    McCluskey, Gavin; Wade, Carrie; McKee, Jacqueline; McCarron, Peter; McVerry, Ferghal; McCarron, Mark O


    Little is known of the impact of stroke laterality on the management process and outcome of patients with acute ischemic stroke (AIS). Consecutive patients admitted to a general hospital over 1 year with supratentorial AIS were eligible for inclusion in the study. Baseline characteristics and risk factors, delays in hospital admission, imaging, intrahospital transfer to an acute stoke unit, stroke severity and classification, length of hospital admission, as well as 10-year mortality were measured and compared among right and left hemisphere AIS patients. There were 141 patients (77 men, 64 women; median age 73 [interquartile range 63-79] years), There were 71 patients with left hemisphere AIS and 70 with right hemisphere AIS. Delays to hospital admission from stroke onset to neuroimaging were similar among right and left hemisphere AIS patients. Delay in transfer to an acute stroke unit (ASU) following hospital admission was on average 14 hours more for right hemisphere compared to left hemisphere AIS patients (P = .01). Laterality was not associated with any difference in 10-year survival. Patients with mild and nondominant AIS merit particular attention to minimize their intrahospital transfer time to an ASU. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  5. Suffering and euthanasia: a qualitative study of dying cancer patients' perspectives. (United States)

    Karlsson, Marit; Milberg, Anna; Strang, Peter


    Although intolerable suffering is a core concept used to justify euthanasia, little is known about dying cancer patients' own interpretations and conclusions of suffering in relation to euthanasia. Sixty-six patients with cancer in a palliative phase were selected through maximum-variation sampling, and in-depth interviews were conducted on suffering and euthanasia. The interviews were analyzed using qualitative content analysis with no predetermined categories. The analysis demonstrated patients' different perspectives on suffering in connection to their attitude to euthanasia. Those advocating euthanasia, though not for themselves at the time of the study, did so due to (1) perceptions of suffering as meaningless, (2) anticipatory fears of losses and multi-dimensional suffering, or (3) doubts over the possibility of receiving help to alleviate suffering. Those opposing euthanasia did so due to (1) perceptions of life, despite suffering, as being meaningful, (2) trust in bodily or psychological adaptation to reduce suffering, a phenomenon personally experienced by informants, and (3) by placing trust in the provision of help and support by healthcare services to reduce future suffering. Dying cancer patients draw varying conclusions from suffering: suffering can, but does not necessarily, lead to advocations of euthanasia. Patients experiencing meaning and trust, and who find strategies to handle suffering, oppose euthanasia. In contrast, patients with anticipatory fears of multi-dimensional meaningless suffering and with lack of belief in the continuing availability of help, advocate euthanasia. This indicates a need for healthcare staff to address issues of trust, meaning, and anticipatory fears.

  6. Characteristics and risk factors of cerebrovascular accidents after percutaneous coronary interventions in patients with history of stroke. (United States)

    Zhang, Hua; Feng, Li-qun; Bi, Qi; Wang, Yu-ping


    Percutaneous coronary intervention (PCI) is a well-established method for managing coronary diseases. However, the increasing use of PCI has led to an increased incidence of acute cerebrovascular accidents (CVA) related to PCI. In this study, we investigated the characteristics and risk factors of CVA after PCI in patients with known stroke history. Between January 1, 2005 and March 1, 2009, 621 patients with a history of stroke underwent a total of 665 PCI procedures and were included in this retrospective study. Demographic and clinical characteristics, previous medications, procedures, neurologic deficits, location of lesion and in-hospital clinical outcomes of patients who developed a CVA after the cardiac catheterization laboratory visit and before discharge were reviewed. Acute CVA was diagnosed in 53 (8.5%) patients during the operation or the perioperative period. Seventeen patients suffered from transient ischemic attack, thirty-four patients suffered from cerebral infarction and two patients suffered from cerebral hemorrhage. The risk factors for CVA after PCI in stroke patients were: admission with an acute coronary syndrome, use of an intra-aortic balloon pump, urgent or emergency procedures, diabetes mellitus, and poor left ventricular systolic function, arterial fibrillation, previous myocardial infarction, dyslipidemia, tobacco use, and no/irregular use of anti-platelet medications. The incidence of CVA during and after PCI in patients with history of stroke is much higher than that in patients without history of stroke. Patients with atrial fibrillation, previous myocardial infarction, diabetes mellitus, dyslipidemia, tobacco use, and no or irregular use of anti-platelet medications were at higher risk for recurrent stroke. This study showed a strong association between acute coronary syndromes and in-hospital stroke after PCI.



    Liu, Shimin; Zhen, Gehua; Meloni, Bruno P.; Campbell, Kym; Winn, H Richard


    Translational stroke research is a challenging task that needs long term team work of the stroke research community. Highly reproducible stroke models with excellent outcome consistence are essential for obtaining useful data from preclinical stroke trials as well as for improving inter-lab comparability. However, our review of literature shows that the infarct variation coefficient of commonly performed stroke models ranges from 5% to 200%. An overall improvement of the commonly used stroke ...

  8. Spinal Epidural Hematoma as a Complication of Intravenous Thrombolysis in an Acute Ischemic Stroke Patient

    Directory of Open Access Journals (Sweden)

    Ron Liebkind


    Full Text Available An 80-year-old white male suffered a stroke, fell to the floor, and suffered acute right hemiparesis and facial palsy. After an intravenous alteplase infusion 2.5 h later, the patient first complained of numbness in his right arm, then neck pain, followed by left leg numbness and slowly progressing paraparesis. MRI of the spine demonstrated an acute spinal dorsal epidural hematoma extending from the C6 to the T6 level; 12 h later, he underwent hematoma evacuation and laminectomy. Three months after surgery, the patient was paraplegic with moderate sensory loss below mamillary level. Acute ischemic stroke is often associated with a sudden fall, which, after thrombolysis, may result in unusual hemorrhagic complications.

  9. Magnetic Resonance Imaging of Stroke

    NARCIS (Netherlands)

    Bouts, Mark. J. R. J.; Wu, O.; Dijkhuizen, R. M.


    Magnetic resonance imaging (MRI) provides a powerful (neuro)imaging modality for the diagnosis and outcome prediction after (acute) stroke. Since MRI allows noninvasive, longitudinal, and three-dimensional assessment of vessel occlusion (with magnetic resonance angiography (MRA)), tissue injury

  10. Genetic View To Stroke Occurrence

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    Sadegh Yoosefee


    Full Text Available Stroke is the third leading cause of death. The role of genetics in the etiology and development of this disease is undeniable. As a result of inadequate previous research, more and more studies in the field of genetics are necessary to identify pathways involved in the pathogenesis of stroke, which in turn, may lead to new therapeutic approaches. However, due to the multifactorial nature of stroke and the few studies conducted in this field, genetic diversity is able to predict only a small fraction of the risk of disease. On the other hand, studies have shown genetically different architecture for different types of stroke, and finally pharmacogenomics as an important part of personalized medicine approach, is influenced by genetic studies, all of which confirm the need of addressing the topic by researchers.

  11. Heart Disease and Stroke Statistics (United States)

    ... mortality statistics found in the Heart Disease & Stroke Statistics Update . Because mortality is considered "hard" data, it's possible to do time-trend analysis and compute percent changes over time. What are ...

  12. Blood glucose in acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj


    Blood glucose is often elevated in acute stroke, and higher admission glucose levels are associated with larger lesions, greater mortality and poorer functional outcome. In patients treated with thrombolysis, hyperglycemia is associated with an increased risk of hemorrhagic transformation...... of infarcts. For a number of years, tight glycemic control has been regarded as beneficial in critically illness, but recent research has been unable to support this notion. The only completed randomized study on glucose-lowering therapy in stroke has failed to demonstrate effect, and concerns relating...... to the risk of inducing potentially harmful hypoglycemia has been raised. Still, basic and observational research is overwhelmingly in support of a causal relationship between blood glucose and stroke outcome and further research on glucose-lowering therapy in acute stroke is highly warranted....

  13. Analysis of suffering at work in Family Health Support Centers. (United States)

    Nascimento, Débora Dupas Gonçalves do; Oliveira, Maria Amélia de Campos


    Analyzing the work process in the Family Health Support Center. An exploratory, descriptive case study using a qualitative approach. Focus groups were conducted with 20 workers of a Family Health Support Center, and the empirical material was subjected to content analysis technique and analyzed in light of Work Psychodynamics. The category of suffering is presented herein as arising from the dialectical contradiction between actual work and prescribed work, from resistance to the Family Health Support Center's proposal and a lack of understanding of their role; due to an immediatist and curative culture of the users and the Family Health Strategy; of the profile, overload and identification with work. The dialectical contradiction between expectations from Family Health Strategy teams and the work in the Family Health Support Center compromises its execution and creates suffering for workers. Analisar o processo de trabalho no Núcleo de Apoio à Saúde da Família. Estudo de caso exploratório, descritivo e de abordagem qualitativa. Grupos focais foram realizados com 20 trabalhadores do Núcleo de Apoio à Saúde da Família, o material empírico foi submetido à técnica de análise de conteúdo e analisado à luz da Psicodinâmica do Trabalho. Apresenta-se aqui a categoria sofrimento que neste estudo decorre da contradição dialética entre o trabalho real e o trabalho prescrito, da resistência à proposta do Núcleo de Apoio à Saúde da Família e da falta de compreensão de seu papel; da cultura imediatista e curativa do usuário e da Estratégia Saúde da Família; do perfil, sobrecarga e identificação com o trabalho. A contradição dialética entre expectativas das equipes da Estratégia Saúde da Família e o trabalho no Núcleo de Apoio à Saúde da Família compromete sua efetivação e gera sofrimento aos trabalhadores.

  14. Sacrifice: an ethical dimension of caring that makes suffering meaningful. (United States)

    Helin, Kaija; Lindström, Unni A


    transformation to achieve atonement and healing. Atonement then implies finding meaningfulness in one's suffering. The concept of sacrifice, understood in a novel way, opens up a deeper dimension in the understanding of suffering and makes caring in 'the patient's world' possible.

  15. [Animal-assisted therapy for people suffering from severe dementia]. (United States)

    Tribet, J; Boucharlat, M; Myslinski, M


    The elderly represent the fastest growing population group in France. The care management of people suffering from dementia has become an important problem. Demented patients manifest behavioral problems, depression, apathy, impairment in social activities and language skill disorders. The literature contains few studies investigating animal-assisted therapy for demented patients. However, there is a clear need for psychological assistance for this population. In the management of such behavioural problems associated with dementia, we propose to develop a dog-assisted therapy. Three qualitative case studies are analysed to specify the perceptions of the therapist regarding animal-assisted therapy. This study is a qualitative pilot study. Subjects were two female and one male patients admitted in a nursing home. They were diagnosed with severe dementia. Their mean age was 94 years. All of them agreed to attend the dog therapy activities and informed consent from their family was requested. We met these patients 15 times over nine months. The meetings always took place in the same place for 30 min, once a week. The evaluation was based on the clinical observations of the psychologist. This study revealed many psychological benefits for patients with dementia. The animal-assisted therapy had a calming effect on the patients. It could well be helpful as a communication link during therapy sessions. The dog, because of its unconditional acceptance, increases the self-esteem of the patient and contributes to a more secure environment. The patients, who rarely interacted socially, increased their interactions with the dog. In spite of the lack of normal verbal use of language, nonverbal communication continues including touching and posture. Furthermore, patients verbalized that the dog was affectionate and they could identify themselves with it. This prospective study leads up to the conclusion that pet therapy could prove to be efficient. We conducted animal

  16. Presentation of pain in patients suffering from systemic sclerosis

    Directory of Open Access Journals (Sweden)

    Janković Katarina


    Full Text Available Introduction: Systemic sclerosis (SSc is a chronic autoimmune disease with very heterogeneous clinical manifestations. There are not many studies which directly research the pain experienced by patients with SSc. Aim: Evaluation of pain in patients with verified systemic sclerosis; making comparison in the two subsets of SSc (diffuse and limited and in the anti-centromere antibodies (ACA and anti-topoisomerase-I antibodies (ATA detected in patients. Material and methods: The study group included 42 patients with SSc. The research was conducted at the Institute of Rheumatology in Belgrade. Each patient was asked to complete the questionnaire, which included the questions about frequency, location and intensity of the pain. Two statistical methodologies were used in the data analysis: descriptive and analytical statistics. Results: Most of the patients (93% confirmed they had some kind of pain . Arthralgia was the most common pain symptom (78,6%, 29 (69% suffered from pain during Raynaud phenomenon, the back pain was found in 20 (47,6%, a headache in 13 (31%, the chest pain in 10 (23,8%, odynophagia in 9 (21,4% and in 8 (19% patients painful digital ulcers. The pain from digital ulcers was rated as the most intensive with the average value of 8,5/10. The patients with diffuse subset of SSc had a higher average intensity score of arthralgia (7,6, compared to those with limited SSc (5,5. The statistically significant difference in the frequency and intensity of the pain in the patients with anti-topoisomerase-I antibodies and the patients with anti-centromere antibodies was not found. Conclusion: Most of the patients suffer from some kind of pain. The most common pain was arthralgia, and the most intensive one was from digital ulcers, although it was the rarest. The pain frequency and intensity were not significantly different in patients with anti-topoisomerase-I and anti-centromere antibodies. There was a statisticaly significant difference in the

  17. Renal impairment in stroke patients: A comparison between the haemorrhagic and ischemic variants [version 1; referees: 2 approved, 1 not approved

    Directory of Open Access Journals (Sweden)

    Pratyush Shrestha


    Full Text Available Background: Renal impairment is regularly seen in hospitalized stroke patients, affecting the outcome of patients, as well as causing difficulties in their management. A prospective cohort study was conducted to assess the trend of renal function in hospitalized ischemic and haemorrhagic stroke patients. The incidence of renal impairment in these subgroups, the contributing factors and the need for renal replacement in renal impaired patients was evaluated. Methods: Alternate day renal function testing was performed in hospitalized stroke patients. Estimated glomerular filtration rate (e-GFR was calculated and the trend of renal function in the two stroke subgroups (haemorrhagic and ischemic was assessed, with renal impairment defined as e-GFR < 60mL/ minute per 1.73m2. Results: Among 52 patients, 25 had haemorrhagic stroke (mean age 59.81 ± 14.67 and 27 had ischemic stroke (mean age 56.12 ± 13.08. The mean e-GFR (mL/minute per 1.732m2 at admission in the haemorrhagic stroke subgroup was 64.79 ± 25.85 compared to 86.04 ± 26.09 in the ischemic stroke subgroup (p=0.005. Sixteen out of 25 (64% patients in the haemorrhagic stroke subgroup and 9 out of 27 (33.3% patients in the ischemic subgroup developed renal impairment (p=0.27. The location of the bleed (p=0.8, volume of hematoma (p=0.966 and surgical intervention (p=0.4 did not predispose the patients to renal impairment. One out of 16 patients with haemorrhagic stroke (who eventually died, and 2 out of 9 patients with ischemic stroke required renal replacement. Conclusion: Renal impairment is commonly seen in stroke patients, more so in patients who suffered haemorrhagic strokes.  The impairment, however, is transient and rarely requires renal replacement therapy.

  18. Impact of early applied upper limb stimulation: The EXPLICIT-stroke programme design

    Directory of Open Access Journals (Sweden)

    Lindeman Eline


    Full Text Available Abstract Background Main claims of the literature are that functional recovery of the paretic upper limb is mainly defined within the first month post stroke and that rehabilitation services should preferably be applied intensively and in a task-oriented way within this particular time window. EXplaining PLastICITy after stroke (acronym EXPLICIT-stroke aims to explore the underlying mechanisms of post stroke upper limb recovery. Two randomized single blinded trials form the core of the programme, investigating the effects of early modified Constraint-Induced Movement Therapy (modified CIMT and EMG-triggered Neuro-Muscular Stimulation (EMG-NMS in patients with respectively a favourable or poor probability for recovery of dexterity. Methods/design 180 participants suffering from an acute, first-ever ischemic stroke will be recruited. Functional prognosis at the end of the first week post stroke is used to stratify patient into a poor prognosis group for upper limb recovery (N = 120, A2 project and a group with a favourable prognosis (N = 60, A1 project. Both groups will be randomized to an experimental arm receiving respectively modified CIMT (favourable prognosis or EMG-NMS (poor prognosis for 3 weeks or to a control arm receiving usual care. Primary outcome variable will be the Action Research Arm Test (ARAT, assessed at 1,2,3,4,5, 8, 12 and 26 weeks post stroke. To study the impact of modified CIMT or EMG-NMS on stroke recovery mechanisms i.e. neuroplasticity, compensatory movements and upper limb neuromechanics, 60 patients randomly selected from projects A1 and A2 will undergo TMS, kinematical and haptic robotic measurements within a repeated measurement design. Additionally, 30 patients from the A1 project will undergo fMRI at baseline, 5 and 26 weeks post stroke. Conclusion EXPLICIT stroke is a 5 year translational research programme which main aim is to investigate the effects of early applied intensive intervention for regaining dexterity

  19. Clinical and imaging features associated with an increased risk of early and late stroke in patients with symptomatic carotid disease

    DEFF Research Database (Denmark)

    Naylor, A R; Sillesen, H; Schroeder, T V


    intracranial disease; (v) a failure to recruit intracranial collaterals; (vi) low GSM; (vii) MR diagnosis of intra-plaque haemorrhage; (vii) spontaneous embolisation on TCD; and (viii) increased FDG uptake in the carotid plaque on PET. Clinical/imaging parameters associated with a lower risk of stroke include......OBJECTIVE: The aim of this review was to identify clinical and/or imaging parameters that are associated with an increased (decreased) risk of early/late stroke in patients with symptomatic carotid disease. IN THE FIRST 14 DAYS: Natural history studies suggest that 8-15% of patients with 50......-99% stenoses will suffer a stroke within 72 hours of their index symptom. Currently, there are insufficient validated data to identify highest-risk patients for emergency carotid endarterectomy (CEA), but an increased risk of stroke appears to be predicted by (i) an ABCD(2) score of 4-7; (ii) the presence...

  20. Protein consumptions in stroke patients

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    Zahra Maghsoudi


    Full Text Available Background : Stroke is one of the most common causes of disabilities and death all over the world. The mortality rate of stroke is predicted to be doubled by 2030 in the Middle East countries. Nutrition is an effective strategy in prevention and management of stroke. This study assessed the relationship between various protein types and stroke risk. Materials and Methods: This hospital-based case-control study was performed in a University hospital. The data regarding consumption of usual food intake of 69 cases (46 men and 23 women and 60 controls (30 men and 30 women was collected with a food frequency questionnaire (FFQ. The mean consumption of red and white meat and vegetable and processed proteins consumption were compared between two groups. Results: The percent of total of daily protein intake were lower in patients with stroke in both sexes (25.92% vs 30.55% in men and 30.7% vs 31.14% in women. Conclusion: Lower protein consumption may be observed in patients with stroke patients in both sex.