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Malnutrition is relatively common in stroke survivors and it also affects weight loss and muscle strength. Various nutritional assessment tools have been used to monitor changes in nutritional status. Among such tools, the Controlling Nutritional Status (CONUT) score is a convenient and cost-effective index calculated from serum albumin level, total peripheral lymphocyte count, and total cholesterol level. This study investigated the prognostic role of malnutrition, as assessed by the CONUT scoring system. We hypothesized that malnutrition negatively affects outcomes as expressed by Functional Independence Measure (FIM) motor or Berg Balance Scale (BBS) change in stroke patients. This was a retrospective cohort study involving 117 individuals including first-time subacute stroke inpatients from March 2017 to February 2020. All participants were evaluated with BBS and FIM. We used multiple linear regression analysis with backward stepwise selection to examine the association between CONUT and changes during rehabilitation. After adjusting for independent predictors, we found the CONUT score to be associated with FIM motor (B = -1.848 ± 5.811, P

Balance impairment could occur due to weakness of the core muscles in stroke patients.To investigate the association between functional ability, including trunk balance and core muscle thickness using ultrasonography in subacute hemiplegic stroke patients.The muscle thickness of the anterior and posterior trunk muscles was measured using ultrasonography. For the evaluation of trunk balance, trunk impairment scale and Berg balance scale (BBS) were used. The functional ambulatory scale (FAS), timed up-and-go test, 10 m gait velocity, functional reach (FR), and functional independence measure were also assessed for functional ability.Overall, 41 patients with subacute hemiplegic stroke were included. Partial correlation analysis showed that posterior trunk muscle thickness was significantly correlated with BBS, FAS, and FR. As for the paralytic side, the posterior trunk muscle thickness of both paretic and nonparetic sides presented a significant relationship with BBS, FAS, and FR. The quadratus lumborum (QL) thickness of both sides showed a significant relationship with BBS, FAS, and FR.The thickness of the posterior trunk muscles, especially the QL, on both the paretic and nonparetic sides, was significantly related with the functional ability after stroke. The exercise program of core posterior trunk muscles closely related with functional ability would be helpful to improve trunk balance and ambulatory function in subacute stroke patients.

Prestroke cardiopulmonary fitness (CPF) levels can affect post-stroke respiratory function and functional status, including gait and activities of daily living (ADL). To investigate the prestroke CPF level measured by the Jurca prediction index as a predictor of functional outcomes after stroke and to evaluate the association between estimated prestroke CPF and respiratory function after stroke. This was a prospective observational study involving 71 inpatients with first-time subacute stroke between June 2017 and July 2019. The prestroke VO2max was assessed using the Jurca prediction index, which was calculated from age, sex, resting heart rate, body mass index, and physical activity level. Linear regression analysis was performed to determine the relationship between the Jurca prediction index, functional outcomes, pulmonary functions, and cough strength variables. The estimated prestroke VO2max was significantly associated with the post-stroke Berg Balance Scale (��=1.199, PP=0.006), and Functional Independence Measure score (��=1.102, P=0.004) at admission, and these relationships remained significant at the follow-up evaluation after 1 month of conventional rehabilitation (PP=0.037) was significantly associated with the estimated prestroke VO2max. Prestroke CPF likely affects the stability of core muscles that are related to PCF and the functional status, including balance function and ADL after stroke. Regular exercise to increase the CPF level should be encouraged in patients with risk factors for stroke, not only for primary prevention but also for functional improvement after stroke.

Toxic epidermal necrolysis (TEN) is a drug-related fatal disease. Extensive necrosis of the epidermis can lead to serious complications. This report describes two cases of TEN, associated with deflazacort (DFZ), in two boys, aged 4 years and 14 years, with nephrotic syndrome (NS). The 14-year-old male teenager received DFZ following NS relapse. After 17 days, pruritic papules appeared on the lower extremities. Another case involved a 4-year-old boy receiving DFZ and enalapril. After a 41-day DFZ treatment period, erythematous papules appeared on the palms and soles. Within 3 days, both boys developed widespread skin lesions (>50%) and were admitted to the intensive care unit for resuscitative and supportive treatment. The patients showed improvement after intravenous immunoglobulin-G therapy. Owing to the rapid, fatal course of TEN, clinicians need to be aware of the adverse effects of this drug when treating cases of NS.