The purpose of this prospective study was to determine the quality of life and resocialization of post-stroke patients in the Osijek-Baranya County during six months. The study included 161 patients ...(82 men and 79 women) having sustained their first ever acute stroke and being treated at University Department of Neurology, Osijek University Hospital Center in Osijek. The Health Survey SF-36 questionnaire was used for self-evaluation of the patients' physical and mental health. Initial assessment was carried out in the acute phase of the disease and follow-up assessments were carried out 30, 90 and 180 days post-stroke in patient homes. The mean value of physical health measured by SF was 46.1 on initial measurement, 37.8 on second, 44.3 on third and 53.0 on fourth measurement. The mean value of mental health was 48.0 on initial measurement, 36.6 on second, 44.0 on third and 48.5 on fourth measurement. The median of total physical health and mental health on all measurements was higher in men than in women. Comparison of the quality of life areas and the items measured by SF-36 questionnaire according to sex and measurements showed statistically significant differences on all four measurements in women for all items except for social function (p = 0.669). In men, statistically significant differences between the measurements were only recorded for the item of physical activity (p = 0.013). Stroke significantly impairs the quality of life of affected people. The study showed that the poorest results were recorded 30 days of the onset of symptoms, while recovery was achieved in six months. Patients affected by stroke who stayed with their families considered their physical and mental health better than before stroke.
Aphasia in ischemic stroke patients is associated with increased mortality, decreased rates of functional recovery, and reduced work capability. The aim was to study the prevalence and ...characteristics of aphasia in ischemic stroke patients. This prospective, cohort study included 177 patients (94 male and 83 female) hospitalized for ischemic stroke at University Department of Neurology in Osijek in 2010. All patients were examined by a neurologist and speech therapist to specify the subtype of stroke and speech disturbance. The study showed 75 (42.4%) study patients to have aphasia (48.2% of females and 37.2% of males). The most frequent clinical type was expressive-receptive aphasia. Aphasic patients were statistically significantly older (75 vs. 70 years) and showed female predominance (53% vs. 42%). Patients with aphasia also had a threefold share of large vessel stroke (51% vs. 17%) and approximately twofold share of cardioembolic stroke (41% vs. 22%). The share of left hemisphere stroke was nearly twofold in aphasic (61%) compared to non-aphasic (31%) patients. The study showed a high prevalence of aphasia in patients with ischemic stroke, which increased with age, was more pronounced in females and most frequently found in patients suffering from large vessel stroke and cardioembolic stroke.
The aim of this study was to determine the distribution of risk factors according to age, gender, subtypes and recurrence of stroke in eastern Croatia. The study included 250 acute stroke patients ...admitted to University Department of Neurology, Osijek University Hospital Centre in 2011. Patients were grouped according to age, gender, subtypes and recurrence of stroke. The study showed significant differences in the distribution of cigarette smoking, diabetes, cardiomyopathy and hyperuricemia according to patient age. According to gender, male patients had a significantly higher prevalence of smoking and alcohol abuse, whereas in female patients the prevalence of arterial hypertension, atrial fibrillation and hyperuricemia was significantly higher. Regarding stroke subtypes, significant differences were noticed in the prevalence of arterial hypertension, atrial fibrillation, cardiomyopathy and cerebral blood vessel stenosis. Atrial fibrillation was significantly more common in first-ever than in recurrent stroke. Study results identified the groups of patients requiring special attention regarding particular risk factors in eastern Croatia and emphasized the need of developing regional strategies of screening, prevention and holistic care for stroke patients.
The purpose of this prospective study was to determine quality of life of patients after stroke in Osijek-Baranya County. The research included 161 patients (82 men and 79 women) who had their first ...acute stroke and were treated at Department of Neurology, Osijek University Hospital Center The Barthel Index (BI) was used to assess functional deficiency and SS-QOL (Stroke-Specific Quality of Life) questionnaire was used for self-evaluation of patients' physical and mental health. The first assessment was carried out in the acute phase of the disease, and control assessments 30, 90 and 180 days after the stroke. Mean Barthel Index score was higher at every successive measurement (55, 80, 95, 95). All BI items were statistically significant (Friedman, p < 0.001) apart from dressing and bowel control. BI score indicated greater dependence in women in all assessments except for those taken 90 days after onset of symptoms (chi2-test, p = 0.111). Mean values of SS-QOL for physical health were: 105.2, 98.3, 105.7, 117.5 and for mental health: 64.24, 57.9, 64.3, 68.1. Statistically significant difference was present in men, both for physical health (Friedman p = 0.009) and total SS-QOL (Friedman p = 0.014), while in women there was no statistically significant difference between the measurements (Friedman p = 0.719). The research showed that stroke has significant influence on basic and specific daily life activities and interferes with the quality of life of stroke patients. Women have lower level of independence. Patients who live with their families make better evaluation of their physical and mental health.
Epidemiology of stroke KADOJIĆ, DRAGUTIN; DIKANOVIĆ, MARINKO; BITUNJAC, MILAN ...
Periodicum biologorum,
09/2012, Letnik:
114, Številka:
3
Journal Article
Odprti dostop
The epidemiology of stroke may be changing over time as a result of a
number of factors, including an aging population and advances in the prevention and treatment of stroke. Epidemiological ...indicators and research of stroke have great significance in estimating the impact of this disease on the population. Such research states the distribution of this illness and factors by which it is influenced, follows short-term and long-term consequences, as well as socio-economic burden of stroke for the whole community.
Data on stroke prevalence is important for creating the right strategies for health care in a specific area. Stroke-relatedmortality in any population is dependent upon three main factors: the incidence of stroke in the population, quality ofmedical care available, and the prevalence of cardiovascular diseases and comorbidities that can affect the likelihood of surviving stroke events. The quality of medical care available influences both the number of individuals suffering from stroke and the proportion of case-fatality among them.
Epidemiological data shows that stroke is one of the leading causes of
death and long-term disability in most industrialized populations, and the
same is true for Croatia. The existing systemof health care for stroke patients does not meet the needs and is not in accordance with latest trends in developed countries.Hence, there is a need for its reorganization and design of the national project for stroke prevention and treatment similar to those in European countries with favorable epidemiological data.
The aim of this study was to determine the specificity and sensitivity of transcranial sonography (TCS) and the Pocket Smell Test (PST) in differing Parkinson’s disease from essential tremor. The ...results were compared with the dopamin transporter scan (DaTSCAN) findings. Based on the DaTSCAN finding we formed a group of patients with essential tremor (51 patients) and a group with the Parkinson’s disease (59 patients). The control group consisted of 26 healthy one. To evaluate the olfactory dysfunction the PST was used, whereas by TCS the substantia nigra hyperechogenicity was marked. The sensitivity and specificity of each diagnostic method was statistically calculated. In confirming Parkinson’s disease the specificity of TCS was 88.2 % and the sensitivity 94.9 %. The specificity of PST was 80.4 % whereas the sensitivity was 74.6 %. TCS and PST should be performed to evaluate which patients need to be examined by DaTSCAN.
The intima-media thickness (IMT) of carotid arteries is a marker of subclinical atherosclerosis associated with risk factors for atherosclerosis and a predictor of vascular disease. The aim of the ...research was to determine the correlation of IMT and age, and above normal IMT values in healthy adults in Slavonia (eastern Croatia). The study included 275 subjects of both sexes, aged between 20 and 79, who had no clinical manifestations of vascular disease or presence of major risk factors for atherosclerosis (hypertension, hypercholesterolemia, diabetes mellitus, cigarette smoking). Ultrasonic measurement of IMT in the B-mode was performed on far walls of the carotid arteries on both sides at three locations (common and internal carotid artery, carotid bifurcation). At all three sites of measurement a high correlation between the IMT values and age was found in both sexes, including the maximum for IMT of carotid bifurcation (men r=0.92, women 0.91). Upper normal values (75th percentile) IMT of common carotid arteries were determined for the ten year age groups. It is the same for both men and women in age groups both 20-29 and 30-39 (0.41, 0.46 mm). On the other hand, in age groups 40-49, 50-59, 60-69 and 70-79 upper normal values for men are 0.57, 0.62, 0.77 and 0.96 mm, and for women 0.50, 0.57, 0.71 and 0.81 mm. Our study in healthy adults in Slavonia (eastern Croatia) established a clear con- nection between carotid IMT and age, which implies a need for taking the age as an essential factor into account when conducting researches that involve the IMT.
Continuous brain blood supply in healthy individuals is warranted by brain autoregulation, the borders of which are not completely strict and can be changed as a part of dynamic physiological ...control. In acute neurological diseases like hypertensive encephalopathy, brain infarction, intracerebral hemorrhage and subarachnoid hemorrhage, a great attention should be paid to cerebral perfusion pressure preservation (which represents a difference between mean arterial pressure and intracranial pressure) when blood pressure is regulated. To preserve neurological function it is necessary to know anatomic and pathophysiological qualities of brain circulation and to approach the treatment of hypertension. In case of ishemic stroke hypertension should be reduced gradually, through several days, having in mind the distance of ischemic penumbra. The ideal antihypertensive for the reduction of hypertension in acute neurological diseases should have the following characteristics precise value and time control of blood pressure, not to have a rebound-phemonenon, not to cause the effect of exceeding with initially severe hypotension, not to have impact on heart muscle and not to worsen intracranial pressure. In everyday clinical work with these patients one should act according to the instructions for management of patients with stroke prepared by the Croatian Society for Neurovascular Disorders of the Croatian Medical Association and the Croatian Society for the Prevention of Stroke.
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