159 research outputs found
The link between weight shift asymmetry and gait disturbances in chronic hemiparetic stroke patients
No full textAndrzej Szopa,1 Małgorzata Domagalska-Szopa,2 Anetta Lasek-Bal,3 Amadeusz Żak3 1Department of Physiotherapy, 2Department of Medical Rehabilitation, School of Health Sciences in Katowice, 3Department of Neurology, Professor Leszek Giec Upper Silesian Medical Centre, Medical University of Silesia, Katowice, Poland Introduction: While the asymmetry of body posture and the asymmetrical nature of hemiparetic gait in poststroke (PS) patients are well documented, the role of weight shift asymmetry in gait disorders after stroke remains unclear. Objective: We examined the association of weight-bearing asymmetry (WBA) between paretic and nonparetic lower limbs during quiet standing with the degree of deviation of hemiplegic gait from normal gait evaluated by the Gillette Gait Index (GGI) incorporating 16 distinct clinically important kinematic and temporal parameters in chronic PS patients.Participants and methods: Twenty-two ambulatory patients with chronic stroke aged between 50 and 75 years were included in this study. Fourteen patients had hemiparesis on the nondominant side and 8 on the dominant side. The mean time PS was 2 years and 6 months. The reference group consisted of 22 students from the University of the Third Age presenting no neurological disorders. The examination consisted of posturographic weight-bearing (WB) distribution and 3-dimensional gait analyses.Results: A significant positive relationship between WBA and GGI was revealed. Moreover, we observed a significant negative association between WBA and paretic step length and walking speed. With regard to kinematic data, the range of motion of knee flexion and peak dorsiflexion in the swing phase of the paretic leg were significantly negatively associated with WBA.Conclusion: Although further research is needed to determine a causal link between postural control asymmetry and gait disturbance in hemiplegics, our findings support the inclusion of WB measurements between paretic and nonparetic body sides in early assessment after stroke. Keywords: stroke, weight-bearing, 3DGA, gait disturbances, Gillette Gait Index 
Elevated factor VIII level and stroke in patients without traditional risk factors associated with cardiovascular diseases
No full textAnetta Lasek-Bal, Przemyslaw Puz, Zofia KazibutowskaStroke Unit, Department of Neurology, Medical University of Silesia, Professor Leszek Giec Upper Silesian Medical Centre, Katowice, PolandIntroduction: Hemostasis is affected by interactions between physiological processes, including those connected with the coagulation system, whose essence is converting fibrinogen into fibrin. The role of factor VIII (FVIII) consists in activating factor X, which directly participates in the generation of thrombin, which is able to produce stable fibrin, which in turn forms blood clots. There are divergent opinions regarding the significance of high levels of FVIII in stroke pathogenesis.Aim: The aim of our study was to evaluate FVIII activity in individuals with cryptogenic stroke in order to determine a potential relationship between it and cerebral ischemia.Material and methods: Nine patients suffering with stroke were used in this study: six women and three men aged 49–63 years. In all of the patients, the presence of known and potential risk factors for stroke had been excluded during previous diagnostic procedures. These patients accounted for 1.2% of the 719 people who suffered a stroke and were hospitalized in 2011 at the Stroke Unit. FVIII activity was examined in each of the nine qualified subjects within 1–2 months of the occurrence of stroke (the first test) and repeated (the second test) in five patients with abnormal results obtained from the first examination.Results: Increased activity of FVIII was found in 5 out of 9 patients. In patients with abnormal results, elevated FVIII was found in follow-up examinations in the 8th–10th month following stroke. Hemodynamic abnormalities in carotid or cerebral artery (presence of thrombus) were found in 3 of the 5 patients with increased FVIII levels. In the first 24 hours following stroke the neurological state of patients with abnormal FVIII was worse than individuals with normal FVIII activity. The patients with abnormal FVIII levels were found to be more disabled in the examination of self-dependence on the 90th day after stroke.Conclusion: When searching for the causes of stroke, it is worth examining the coagulation system, including FVIII concentration, the abnormality of which may play a significant part in brain ischemia. More research is needed to determine the relationship between abnormal FVIII activity and stroke.Keywords: factor VIII, cryptogenic stroke, hemostasis, risk facto
Imaging methods for acute ischemic stroke
No full textUdar mózgu stanowi jedną z wiodących przyczyn niepełnosprawności oraz śmierci na świecie. Pomimo spadku śmiertelności z powodu udaru mózgu, globalne obciążenie udarem wzrasta. Udar niedokrwienny charakteryzuje niejednorodny patomechanizm, począwszy od obrzęku cytotoksycznego (minuty od wystąpienia incydentu mózgowo-naczyniowego), obrzęku naczyniopochodnego (od 6 godzin), po procesy naprawcze (neuroangiogeneza, neurogeneza) w fazie podostrej i przewlekłej. Do podstawowych technik obrazowania udaru niedokrwiennego mózgu zaliczyć należy przede wszystkim tomografię komputerową (celem wyeliminowania ewentualnego krwawienia, innych przyczyn pogorszonego stanu neurologicznego), rezonans magnetyczny (techniki: dyfuzyjne, saturujące sygnał płynu mózgowo-rdzeniowego, podstawowe, podatności magnetycznej), angiografię (CT, MRI, DSA) oraz ultrasonografię. Techniki dyfuzyjne oraz perfuzyjne (CT, MRI, SPECT, PET) służą do oceny rozległości strefy półcienia. Techniki dyfuzyjne mają szczególne znaczenie w ocenie czasu wystąpienia incydentu mózgowo- naczyniowego. Uważa się, że DWI poprawia wykrywalność udarów niedokrwiennych mózgu aż do 95% w porównaniu ze standardowymi technikami obrazowania. Korelacja map ADC i obrazów DWI pozwala zidentyfikować obszary niedokrwienia. W obrazach DWI sygnał jest hiperintensywny w ciągu kilku minut od incydentu zawałowego, natomiast ADC wykazuje obniżone wartości w czasie od pierwszego do czwartego dnia, w piątej do dziesiątej dobie ma miejsce ich wzrost, po czym następuje wyrównanie względem tkanki zdrowej.Stroke is one of the leading causes of disability and death in the world. Despite the decline in stroke mortality, the global burden of stroke is increasing. Ischemic stroke is characterized by a heterogeneous pathomechanism, ranging from cytotoxic edema (minutes from the occurrence of a cerebrovascular accident), vasogenic edema (from 6 hours), to repair processes (neuroangiogenesis, neurogenesis) in the subacute and chronic phases. The basic techniques of ischemic stroke imaging include, first of all, computed tomography (to eliminate possible bleeding, other causes of deteriorated neurological condition), magnetic resonance (techniques: diffusion, saturating the cerebrospinal fluid signal, basic, magnetic susceptibility), angiography (CT, MRI, DSA) and ultrasound. Diffusion and perfusion techniques (CT, MRI, SPECT, PET) are used to assess the extent of the penumbra. Diffusion techniques are of particular importance in assessing the timing of a cerebrovascular accident. DWI is believed to improve the detection of ischemic strokes by up to 95% compared to standard imaging techniques. Correlation of ADC maps and DWI images identifies ischemic areas. In DWI images the signal is hyperintense within a few minutes of the infarction incident, while the ADC shows decreased values from the first to the fourth day, on the fifth to the tenth day their increase takes place, followed by compensation for healthy tissue
Safety and Efficacy of Fingolimod and Natalizumab in Multiple Sclerosis After the Failure of First-Line Therapy: Single Center Experience Based on the Treatment of Forty-Four Patients
No full textRepeated measurements of serum concentrations of TNF-alpha, interleukin-6 and interleukin-10 in the evaluation of internal carotid artery stenosis progression
No full textOcena stężenia wybranych cytokin zapalnych w surowicy krwi u pacjentów ze zwężeniem tętnicy szyjnej
Get PDFBackground: The inflammatory process plays an important role in the formation, growth and destabilization of atherosclerotic plaque narrowing the internal carotid artery. The aim of the study was to determine the concentrations of TNF-alpha, interleukin-6 and interleukin-10 in the serum of patients with internal carotid artery stenosis. Another aim was to compare the concentrations of these inflammatory markers in patients with symptomatic and asymptomatic internal carotid artery stenosis.
Material and methods: The study included 65 patients (F/M 20/45; aged 66.29 ± 7.77; 55–80) with symptomatic (39 individuals) or asymptomatic (26 individuals) atherosclerotic internal carotid artery stenosis above 50% on one or both sides. The control group consisted of 30 healthy volunteers (F/M 20/10; aged 61.03 ± 9.08; 50–78).
Results: The mean serum concentration of interleukin-6 was significantly higher both in the group of patients with symptomatic and asymptomatic ICA stenosis, as compared with the control group (p = 0.0002; p = 0.0208, respectively) There were no significant differences in serum concentration of THF-alpha and interleukin-10 between patients and control group.
Conclusions: Patients with atherosclerotic stenosis of the internal carotid artery have shown significantly elevated levels of interleukin-6 in the serum, which suggests that it is involved in the disease process. Cytokines and other inflammatory mediators in patients with carotid artery stenosis require further studies which would allow for a better understanding of the effect on the formation and activity of atherosclerotic lesions.Wstęp: W powstawaniu i aktywacji blaszek miażdżycowych zwężających tętnicę szyjną istotną rolę pełni proces zapalny. Celem badania było określenie stężenia TNF-alfa, interleukiny-6 i interleukiny-10 w surowicy krwi pacjentów ze zwężeniem tętnicy szyjnej wewnętrznej (ICA). Drugim celem badania było porównanie stężeń wymienionych markerów zapalnych u pacjentów z objawowym i nieobjawowym zwężeniem tętnicy szyjnej.
Materiał i metody: W badaniu uczestniczyło 65 pacjentów (K/M 20/45; w śr. wieku 66,29 ± 7,77 roku) z objawowym (39 osób) lub bezobjawowym (26 osób) miażdżycowym zwężeniem ICA (≥ 50% po jednej lub obu stronach). Grupę kontrolną tworzyło 30 zdrowych osób (K/M 20/10; w śr. wieku 61,03 ± 9,08 roku).
Wyniki: U chorych ze zwężeniem ICA (zarówno objawowym, jak i nieobjawowym) średnie stężenie interleukiny-6 w surowicy było znamiennie wyższe w porównaniu ze średnim stężeniem interleukiny-6 w surowicy osób z grupy kontrolnej (odpowiednio: p = 0,0002, p = 0,0208). Nie obserwowano znamiennych statystycznie różnic w średnim stężeniu TNF-alfa oraz interleukiny-10 między grupą pacjentów a grupą kontrolną oraz między pacjentami z objawowym zwężeniem tętnicy a pacjentami z nieobjawowym zwężeniem tętnicy.
Wnioski: U chorych z miażdżycowym zwężeniem ICA stwierdza się znamienne podwyższenie stężenia interleukiny-6 w surowicy, co sugeruje jej udział w tym procesie chorobowym. Cytokiny i inne mediatory zapalne u pacjentów ze zwężeniem ICA wymagają dalszych badań w celu lepszego rozumienia mechanizmu ich wpływu na kształtowanie i aktywność zmian miażdżycowych
The Influence of Selected Meteorological Factors on the Prevalence and Course of Stroke
No full textBackground: The objective of this study was to evaluate the impact of weather factors on stroke parameters. Methods: This retrospective study analyzed the records of stroke patients concerning the influence of meteorological conditions and moon phases on stroke parameters. Results: The study group consisted of 402 patients aged between 20 and 102; women constituted 49.8% of the subjects. Ischaemic stroke was diagnosed in 90.5% of patients and hemorrhagic stroke was diagnosed in 9.5% of patients. The highest number of hospitalizations due to stroke was observed in January (48 events); the lowest number was observed in July (23 events). There was no statistically significant correlation between the meteorological parameters on the day of onset and the preceding day of stroke and the neurological status (NIHSS) of patients. Mean air temperature on the day of stroke and the day preceding stroke was significantly lower in the group of patients discharged with a very good functional status (≤2 points in modified Rankin scale (mRS)) compared to the patients with a bad functional status (>2 points in mRS); respectively: 7.98 ± 8.01 vs. 9.63 ± 7.78; p = 0.041 and 8.13 ± 7.72 vs. 9.70 ± 7.50; p = 0.048). Humidity above 75% on the day of stroke was found to be a factor for excellent functional state (RR 1.61; p = 0.016). The total anterior circulation infarcts (in comparison with stroke in the other localization) were more frequent (70%) during a third quarter moon (p = 0.011). The following parameters had a significant influence on the number of stroke cases in relation to autumn having the lowest number of onsets: mean temperature (OR 1.019 95% CI 1.014–1.024, p p p p p Conclusion: Air humidity and air temperature on the day of stroke onset as well as air temperature on the day preceding stroke are important for the functional status of patients in the acute disease period. A combination of the following meteorological parameters: lowered mean temperature and low sunshine, high humidity and high wind speed all increase the risk of stroke during the winter period. High humidity combined with high precipitation, low wind speed and low sunshine in the autumn period are associated with the lowest stroke incidence risk. A possible relationship between phases of the moon and the incidence requires further investigation
Use of Stabilometric Platform and Visual Feedback in Physiotherapy of Patients after the Brain Injury
Get PDFAuthor: Anetta Prokopenková Tutor: MUDr. Markéta Janatová Abstract: This bachelor's thesis is focused on use of visual feedback with stabilometric platform for therapy of patients after the brain injury. Theoretical part of this thesis includes basic facts about the brain injury, shows therapeutic methods with use of modern methods as visual feedback is. In practical part are processed two protocols, described the therapy and evaluated use of standardized tests Timed Up and Go test and Berg Balance Scale together with the reference exercise on the stabilometric platform. There were two women patients chosen for this therapy, both former KRL 1. LF UK clients. At the end of this work, we evaluate and comment this type of therapy which was practically examined. Key words: stabilometric platform, Nintendo Wii Balance Board, postural stability, visual feedback, virtual realit
Deux tableaux inédits de Claude Vignon
No full textTwo unpublished paintings by Claude Vignon.
The author recently had the opportunity to discover two unsigned canvasses which, owing to their facture and subject, might be ascribed to Claude Vignon : an Adoration of the Magi in the parish church of Saint-Martin in Rouez (Sarthe), and a Saint Paul in the convent of the Visitation in La Flèche (at present a hospital). The first painting is very close to an Adoration of the Magi kept in the church of Fère en Tardenois (Aisne), signed and dated 1643. The identification of the Saint Paul is more difficult. Strongly influenced by Caravaggio’s style, its facture looks close to the saints painted by Vignon during his Roman period (before 1643).Palonka-Lavenant Anetta. Deux tableaux inédits de Claude Vignon. In: Histoire de l'art, N°42-43, 1998. Architecture et décor. pp. 127-129
Response to the letter concerning the article “Rivaroxaban in secondary cardiogenic stroke prevention: two-year single-centre experience based on follow-up of 209 patients”
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