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Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. La surveillance des maladies cardiovasculaires (MCV) au Québec et dans le reste du Canada est effectuée à l'aide de fichiers médico-administratifs, parmi lesquels on retrouve, au Québec, le fichier des services médicaux rémunérés à l'acte. La présence d'actes facturés sans diagnostic peut entraîner une sous-estimation du nombre de cas de MCV. L'objectif de cette étude est d'estimer la proportion de diagnostics de MCV et de cas de MCV possiblement manquants dans ces fichiers. Méthodologie. L'étude a été réalisée en utilisant une cohorte prospective comprenant 8 781 participants de la région de Québec. L'accès aux fichiers médico-administratifs a été obtenu pour l'ensemble des 28 années de suivi. Nous avons d'abord effectué des analyses de fréquence afin d'estimer la proportion de diagnostics de MCV manquants. Nous avons ensuite utilisé des algorithmes validés afin d'identifier les cas de MCV et d'estimer la proportion de cas de MCV possiblement manquants sur 28 ans. Résultats. Environ un cinquième (22,1 %) des diagnostics du fichier des services médicaux rémunérés à l'acte était manquant. La proportion de cas de MCV manquants a été estimée à 12,7 % pour la période 1991-2018, avec des variations selon la période (1991-1996: 15,5 %; 1997-2013: 10,7 %; 2014-2018: 16,3 %). Conclusion. Environ 1 cas de MCV sur 10 n'est pas identifié en raison des diagnostics manquants. Cette sous-estimation constitue une limite potentielle dont il faut tenir compte lors de l'utilisation des fichiers médico-administratifs québécois pour l'identification des cas de MCV dans un contexte de travaux de surveillance et d'études épidémiologiques. [ABSTRACT FROM AUTHOR]

Le cancer est associé à un état d'hypercoagulabilité et constitue un facteur de risque indépendant bien connu de maladie thromboembolique veineuse, alors que l'association entre le cancer et la maladie thromboembolique artérielle est moins bien établie. La maladie thromboembolique artérielle, principalement définie comme un infarctus du myocarde ou un accident vasculaire cérébral, est significativement plus fréquente chez les patients atteints de cancer, indépendamment des autres facteurs de risque maladie vasculaire. Elle est associée à un risque de mortalité trois fois plus élevé. Les patients atteints d'un cancer du cerveau, du poumon, du pancréas ou colorectal ont le risque relatif le plus élevé de développer une maladie thromboembolique artérielle. Les traitements antithrombotiques doivent être utilisés avec prudence en raison du risque accru d'hémorragie. Cancer is associated with a hypercoagulable state and is a well-known independent risk factor for venous thromboembolism, whereas the association between cancer and arterial thromboembolism is less well established. Arterial thromboembolism, primarily defined as myocardial infarction or stroke is significantly more frequent in patients with cancer, independently of vascular risk factors and associated with a three-fold increase in the risk of mortality. Patients with brain cancer, lung cancer, colorectal cancer and pancreatic cancer have the highest relative risk of developing arterial thromboembolism. Antithrombotic treatments should be used with caution due to the increased risk of haemorrhage, as specified in current practice guidelines. [ABSTRACT FROM AUTHOR]

Takayasu's arteritis is an uncommon vasculitis that poses diagnostic challenges due to its nonspecific clinical presentation, and which presents significant morbimortality burden, especially from ischemic complications. We present the case of a 30-year-old male patient who presented with acute right-sided hemiparesis and facial asymmetry, ultimately diagnosed with Takayasu's disease. Treatment with corticosteroids and methotrexate yielded significant clinical improvement. This case underscores the need of vigilance for uncommon vascular pathologies, especially in young patients with unusual risk factors, and report the case of a male patient suffering from Takayasu, which is unusual. It also highlights the important role of radiological imaging in diagnosis and guiding therapeutic interventions. Early recognition and treatment are crucial to reduce the disease-related morbidity and mortality. [ABSTRACT FROM AUTHOR]

Having brain CT (computed tomography) scan is limited by the financial means patients in Madagascar. Neurological examination becomes essential the management of stroke. Our goal was to establish the correlation between clinical criteria and brain CT scan result. Methods: we did a retrospective, descriptive and analytical study of patients admitted for stroke at the neurology department of the Joseph Raseta University Hospital in Befelatanana from October 2018 to September 2019. Results: Two hundred thirty seven cases were retained. The presence of higher functions problems’ is correlated with stroke of the superficial arteries and its absence with stroke of the perforating arteries. The Alternate syndrome predicted stroke of the brainstem and cerebellum. Conclusion: A well-conducted clinical examination helps manage stroke while waiting for a brain CT scan. The clinical criteria provide the topography of the artery affected during the stroke. [ABSTRACT FROM AUTHOR]

Percutaneous left atrial appendage closure (LAAC) is a procedure designed to exclude the left atrial appendage from the circulation using a sealed prosthesis. Its primary goal is to prevent ischemic events commonly associated with atrial fibrillation (AF). LAAC is typically performed on patients at high risk of bleeding, who cannot tolerate long-term anticoagulation. Following the implantation of the LAAC device, an antithrombotic treatment is recommended to prevent prosthesis thrombosis, a complication associated with an increased risk of ischemic events and the potential need to resume anticoagulant therapy. However, determining the optimal antithrombotic treatment after LAAC, one that strikes the right balance between ischemic protection and bleeding risk, remains uncertain. Over the course of a decade, a wide array of antithrombotic treatments has been employed in clinical practice, yielding a substantial amount of observational data. The objective of this review is to evaluate the available evidence for each antithrombotic regimen and provide insights to assist healthcare practitioners in making informed choices regarding antithrombotic therapy after LAAC. Several ongoing randomized studies are expected to significantly contribute to addressing this critical question. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The AVC is one of the most prevalent diseases in recent times, where physical and psychological symptoms appear on the patient, accompanied by painful shock to the patient and his family, and this study is to determine the extent of a family conflict in the person who has AVC? The researchers used the techniques of clinical examination from observation and interview, and applied the family recognition test F A T- Family Apperception Test-The study results from the existence of family conflict within the family of the case: "H" through the general reference to poor family employment and the disruption of relations between the spouses taking into account the family aspect of the situation, and the family system of the injured is affected by the individuality of the situation and the privacy of its relationship and place within the family style, Impact degree. The two groups recommend the need for psychological accompaniment of the AVC patient and his family so as to reduce the burden of psychological suffering on the one hand, and on the other avoid the various family conflicts within the patient's family. [ABSTRACT FROM AUTHOR]

Cerebrovascular accident is the most common disorder in the older adult population and can impair the swallowing function, resulting in neurogenic dysphagia with greater occurrence in its acute phase. This study aimed to check how the oropharyngeal dysphagia degree impacts the oral intake and nutritional status of older adults affected by cerebrovascular accident in the late stage after stroke. This is a retrospective cross-sectional study. According to the Dysphagia Outcome and Severity Scale (DOSS), three judges classified the oropharyngeal dysphagia after analyzing the instrumental evaluation of swallowing images captured through fiberoptic endoscopic evaluation of swallowing (FEES). The level of oral intake classification (FOIS) was performed by reviewing the usual patterns of food intake reported in the 24-hour food recall, and the nutritional status assessment was performed using data from the Mini Nutritional Assessment (MNA®) and anthropometric measurements: weight, height, body mass index (BMI), circumferences (arm), skin folds (triceps; biceps; subscapular; suprailiac). Researchers included 25 older adult subjects (14 male and 11 female) with an average age of 72 years old. A positive correlation was found between the oropharyngeal dysphagia degree and FOIS (p = 0.051), screening score (p = 0.011), and total score (p = 0.006) of the MNA® protocol, as well as between the classification of FOIS levels with the BMI (p = 0.029) and anthropometric measurements referring to muscle mass – AC (p = 0.021), AMC (p = 0.010) and AMA (p = 0.023). That leads to the conclusion that, although most research individuals had functional swallowing or mild dysphagia, their dysphagia influenced their level of oral intake and nutritional status. [ABSTRACT FROM AUTHOR]

Spatial neglect, a frequent consequence of stroke, is one of the invisible disabilities. Affected patients may, for example, ignore an object in their field of vision (visual neglect), fail to use the contralesional arm (motor neglect), or try to stand up on their own despite a severe motor deficit (anosognosia). These behaviors can be detrimental to the care relationship if they are not understood by professionals., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Les hémorragies intra cérébrales représentent environ 15 % des 115 000 accidents vasculaires cérébraux survenant chaque année en France. Bien que leur prise en charge dispose d'un arsenal thérapeutique plus réduit que pour l'infarctus cérébral, il existe des éléments importants permettant de réduire la morbi-mortalité à court terme, en limitant l'expansion de l'hématome et la survenue de complication précoces, et à long terme en diminuant le risque de récidive. Le but de cette mise au point est de répertorier les éléments clés permettant actuellement l'amélioration du pronostic des patients victimes d'hémorragies intra cérébrales. Intracerebral hemorrhage accounts for approximately 15% of the 115,000 strokes occurring each year in France. Although therapeutic strategies are more limited than for ischemic stroke, major points in the management of intracerebral hemorrhage can reduce short term morbidity and mortality by limiting the expansion of the hematoma and the occurrence of early complications, and long term patients' outcome by reducing the risk of recurrence. This article aims to update the key elements that contribute to improve of the prognosis of intracerebral hemorrhage patients. [ABSTRACT FROM AUTHOR]

• Cette étude a inclus 160 068 patients atteints d'arthrose et 160 068 patients sans arthrose. • L'incidence à 10 ans des AVC et des AIT était significativement plus élevée chez les patients arthrosiques que chez les patients sans arthrose. • L'arthrose a été associée positivement à l'AVC et à l'AIT. Cette étude avait pour objectif d'explorer la relation entre l'arthrose et l'incidence des accidents vasculaires cérébraux (AVC) et des accidents ischémiques transitoires (AIT) au Royaume-Uni. L'étude a inclus des patients ayant reçu un diagnostic initial d'arthrose dans l'un des 256 cabinets de médecine générale du Royaume-Uni entre 1997 et 2016 (date index). Des patients sans arthrose ont été appariés (1:1) aux patients avec arthrose selon des scores de propension fondés sur le sexe, l'âge, l'année index, le cabinet généraliste et les facteurs de risque vasculaire consignés dans les 12 mois précédant la date index (hypertension, obésité, diabète sucré, dyslipidémie et fibrillation atriale). Pour les patients sans arthrose, une date de consultation aléatoire entre 1997 et 2016 a été sélectionnée comme date index. La relation entre l'arthrose et l'incidence des AVC et AIT a été analysée au moyen de courbes de Kaplan-Meier et de régressions de Cox. Cette étude a inclus 160 068 patients atteints d'arthrose et 160 068 patients sans arthrose (61,6 % de femmes, âge moyen [écart-type] 64,2 [14,2] ans). L'incidence à 10 ans des AVC (4,5 % contre 3,0 %) et des AIT (3,3 % contre 2,0 %) était significativement plus élevée chez les patients avec arthrose. Les analyses de régression de Cox ont également fait apparaître une association positive entre arthrose et AVC (hazard ratio [HR] 1,45, intervalle de confiance [IC] à 95 % 1,39–1,51) et AIT (HR 1,55, IC 95 % 1,47–1,63). Ces observations suggèrent une possible association de l'arthrose avec une augmentation de l'incidence des AVC et des AIT. Des études longitudinales complémentaires sont nécessaires pour confirmer ou infirmer ces résultats. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Occupational Therapy is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Les dissections artérielles multiples associant les carotides et l'aorte sont des situations inhabituelles, peu rencontrées dans la littérature. Elles constituent une urgence cardiovasculaire, grevée d'un mauvais pronostic, avec un risque de mortalité élevé. Nous rapportons le cas d'un homme de 44 ans, éthylo-tabagique chronique et hypertendu, qui s'est présenté aux urgences pour une dyspnée aiguë et un accident vasculaire cérébral, dans un contexte non traumatique. Le bilan échographique a révélé une dissection de l'aorte abdominale étendue aux artères iliaques communes, de l'aorte ascendante et des artères carotides communes. Aucun signe de rupture aortique n'a été observé. Le patient ne pouvait pas être opéré et a reçu un traitement médical conservateur, sans anticoagulant ni antiagrégant plaquettaire. Hormis la survenue d'une cécité monoculaire gauche, l'évolution clinique a été favorable au bout de trois semaines d'hospitalisation. Multiple arterial dissections involving the carotids and the aorta are unusual situations, rarely reported in the literature. They constitute a cardiovascular emergency with poor prognosis and high risk of mortality. We report the case of a 44-year-old man, with a history of chronic alcoholism and smoking and hypertension, who presented to the emergency room with acute dyspnea and stroke, in a non-traumatic setting. The ultrasound workup found a dissection of the abdominal aorta extended to the common iliac arteries, the ascending aorta and the common carotid arteries. No signs of aortic rupture were observed. The patient could not be operated and received a conservative medical treatment without anticoagulant or antiplatelet agent. Apart from the occurrence of left monocular blindness, the clinical course was uneventful after three weeks of hospitalization. [ABSTRACT FROM AUTHOR]

Résumé: Les maladies des petits artères cérébrales (MPAC) sont une cause fréquente d'accidents vasculaires cérébraux (AVC), qu'ils soient ischémiques ou hémorragiques. Une petite proportion des MPAC résulte de pathologies monogéniques. Bien qu'elles soient rares, l'identification de ces formes monogéniques est cruciale, permettant d'offrir une prise en charge adaptée à ces patients et à leurs apparentés. Dans cette revue, les principales situations devant conduire le clinicien à évoquer une forme monogénique de MPAC sont listées, et les principales caractéristiques des différentes MPAC connues à ce jour sont résumées. Cerebral small vessel diseases (cSVD) represent a common cause of stroke, either ischemic or hemorrhagic. Only a small proportion of cSVD results from monogenic conditions. Although they are involved in a minority of patient, the accurate identification by physicians of hereditary forms of cSVD is crucial for the medical care of these patients and their relatives. In this paper, the main situations that must lead physicians to suspect a hereditary cSVD are listed, and the key characteristics of the monogenic cSVD known to date are summarized. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Contexte : Les complications douloureuses de l'épaule chez les patients hémiplégiques sont très fréquentes et retardent la récupération fonctionnelle du membre supérieur. Une fois la douleur installée, le traitement curatif est très difficile et aucune thérapeutique spécifique n'a démontré une efficacité. Cette étude consistait à évaluer les facteurs de risque d'épaule douloureuse en post-accident vasculaire cérébral (AVC) pour améliorer leur prise en charge. Matériel et méthodes : Nous avons mené une étude observationnelle analytique, par remplissage d'une fiche préétablie, chez des patients victimes d'un premier accident vasculaire cérébral lors de la consultation de contrôle, dans le service de neurologie Befelatanana, Antananarivo, Madagascar, entre février et avril 2018. Résultats : Parmi les 131 patients retenus, 21 (68 %) ont eu des douleurs de l'épaule en post-AVC, dont 32 % étaient apparues à la deuxième semaine. La tendinite (29 %), la subluxation scapulo-humérale (19 %) et la spasticité (13 %) représentaient les principales causes. Cinq facteurs de risque ont été trouvés : score du National Institute of Health Stroke Score (NIHSS) entre 10 et 15 (p = 0,002 ; OR = 2,34), score du Modified Rankin Scale (MRS) ≥ 3 (p = 0,001 ; OR = 5,76), score du Medical Research Council (MRC) du membre supérieur déficitaire ≤ 2 (p = 0,04 ; OR = 3,12), atteinte de l'hémisphère mineur (p = 0,023 ; OR = 5,33) et l'absence de kinésithérapie (p = 0,032 ; OR = 2,10). Conclusion : La négligence de l'épaule hémiplégique et l'absence de prévention précoce contribuent largement à l'apparition de l'épaule douloureuse en post-AVC. Chez les patients à risque, la prévention précoce doit être systématique dès la première semaine de l'AVC. Background: The complications of the shoulder in hemiplegic patients are very frequent and delay the functional recovery of the upper limb. Once the pain is installed, the curative treatment is very difficult, and no specific therapy has demonstrated efficiency. This study was to evaluate the risk factors of the painful post-stroke shoulder to improve their care. Material and methods: We conducted an observational and analytical study, by filling a pre-established form, in patients who were victims of a stroke at the control consultation, in the Befelatanana Neurology Department, Antananarivo, Madagascar, between February and April 2018. Results: Among 131 patients retained 21 (68 %) had pain in their shoulder in post stroke, 32 % happened after the second week. Tendinitis (29 %), scapulo-humeral subluxation (19 %) and spasticity (13%) represented the main causes. Five risks factor of those pain were found: National Institute of Health Stroke Score (NIHSS) scale between 10 and 15 (P = 0.002, OR = 2,34), Modified Rankin Scale (MRS) at ≥ 3 (P = 0.001, OR = 5.76), Medical Research Council scale (MRC) of upper in deficit limb at ≤ 2 (P = 0.04, OR = 3.12), minor hemisphere lesion (P = 0.023, OR = 5.33) and the absence of physiotherapy (P = 0.032, OR = 2.10). Conclusion: The negligence of the hemiplegic shoulder and the absence of early prevention contributes significantly to the appearance of the painful shoulder in post-stroke. In hemiplegic patients at risk, early prevention of shoulder complications should be done firstly from the first week of stroke. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cet article tend à réfléchir sur les facteurs motivationnels liés à l’usage de jeux vidéos dans l’auto-rééducation des membres supérieurs des patients victimes d’un Accident Vasculaire Cérébral à domicile. L’enjeu est notamment de procurer aux utilisateurs un outil utile pour leur rééducation tout en maintenant leur motivation. A partir de la littérature, nous avons recensé divers facteurs se rapportant à la dimension de la motivation. Il ressort de ces lectures que la compréhension explicite des personnes est nécessaire pour augmenter l’intérêt des usagers pour des programmes vidéo ludiques. L’expérience utilisateur est au cœur des stratégies de développement des futurs dispositifs, et il est nécessaire que cette démarche se poursuive dans le domaine de la rééducation neurologique à domicile.

Copyright of Canadian Journal of Cardiovascular Nursing is the property of Canadian Council of Cardiovascular Nurses (CCCN) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Le diaphragme carotidien (DC) est une anomalie artérielle rare non athéroscléreuse touchant habituellement la portion proximale de la carotide interne et est apparentée à une forme focale de dysplasie fibromusculaire (DFM). Cette anomalie peut être découverte dans le cadre d'une exploration systématique des artères à distribution cérébrale ou d'un bilan étiologique d'un accident vasculaire cérébral ischémique (AVCi). Elle semble plus fréquemment rencontrée chez des patients plus jeunes et présentant moins de facteurs de risque vasculaire que ceux ayant habituellement un AVCi, suggérant ainsi son imputabilité. Le mécanisme physiopathologique suspecté de ces AVCi sur DC est une embolie d'origine artérielle via la formation d'un thrombus favorisé par la stase sanguine immédiatement en aval du DC. Si l'examen diagnostique de référence est l'artériographie conventionnelle, le diagnostic est généralement porté par des examens d'imagerie non invasifs, en particulier l'angioscanner des artères cervicales. Le risque de récidive d'AVCi chez les patients ayant un DC semble assez élevé. Ainsi, il est proposé de traiter cette anomalie de façon radicale par chirurgie ou stenting carotidien, en plus du traitement médical antithrombotique. En prévention primaire, un traitement antiplaquettaire est raisonnable. Carotid diaphragm (CD) is a rare nonatherosclerotic arterial anomaly usually affecting the proximal portion of the internal carotid artery and is related to a focal form of fibromuscular dysplasia (FMD). This anomaly can be detected in the context of routine exploration of cerebral arteries or in the etiological work-up of an ischemic stroke. It seems to be more frequently found in younger patients with fewer vascular risk factors than those who usually have a stroke, suggesting its imputability. The suspected pathophysiological mechanism of these CD-related strokes is an embolism of arterial origin via the formation of a thrombus favored by the blood stasis immediately downstream of the CD. Although the reference diagnostic examination is conventional arteriography, the diagnosis is generally made by non-invasive imaging examinations, in particular computed-tomography angiography of cervical arteries. The risk of stroke recurrence in this population seems to be significantly high. Thus, it is proposed to treat this anomaly by surgery or carotid stenting in addition to antithrombotic medical treatment. In primary prevention, antiplatelet therapy is reasonable. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: malignant arterial hypertension (MAH) is a nosologic disorder which has not been described in Nephrology. The purpose of this study was to describe the profile of patients with MAH in the Division of Nephrology and to identify prognostic factors. Methods: we conducted a retrospective, descriptive and analytical study from January 2013 to December 2018 in the Unit of Nephrology of the University Hospital Center in Treichville. The diagnosis of MAH was retained in patients with diastolic blood pressure (DBP) ≥ 130 mmHg, Keith Wegener grade III/IV hypertensive retinopathy, one or multiple visceral, cardiac and/or brain and/or renal diseases. Results: we collected data from 168 patients. The average age of patients was 41.10 ± 14.86 years, with male predominance (sex ratio 1.54). Cardiovascular risk factors were AH (79.20%), alcohol (32.10%), tobacco (19.60%), chronic kidney disease (15.30%) and diabetes (11.30%). They were admitted with dyspnea (39.29%), hypertensive crisis (26.16%), consciousness disorders (10.12%). Clinical examination showed anemia (82.10%), lower limb edema (63.10%), acute pulmonary edema (37.50%). Arterial hypertension resulted in renal failure (95,9%), left ventricular hypertrophy (92.81%), stroke (16,67%), and cardiac and renal involvement (85%). Renal failure was chronic in 78% of cases. The causes of MAH were essential AH (56,8%), chronic glomerulonephritis (29.8%), and diabetes (6%). Outcome was favorable in 66,7% of cases and overall mortality rate was 25.6%. In multivariate analysis uremia ≥ 2g/l [OR=5,07; 95%CI = 2,39-10.75; p = 0.0001], hperkalaemia [OR = 3.50; 95% CI = 1.70 - 7.19; p = 0.001], hyponatremia [OR = 2.90; 95% CI= 1.40 - 6.03; p = 0.004], haemoglobin level < 12g/dl [OR=5,91; 95% CI=1,34-26,00; p=0,019] and end-stage renal disease [OR = 6.06; 95% CI = 2.04 - 18.18; p = 0.001] were factors associated with the occurrence of death. Conclusion: MAH is a consequence of poorly treated or untreated AH. It mainly affects young adults with multivisceral complications. In our Hospital, these were dominated by end-stage chronic renal disease. Hence the importance of early diagnosis and adequate management in patients with AH. [ABSTRACT FROM AUTHOR]

Background: A number of studies have been conducted in Nigeria on the prevalence of cryptococcal infections mostly on HIV-infected patients using culture, India ink and/or latex agglutination tests. These tests are either laborious, time-consuming and expensive or have low sensitivity, thus limiting their use. Cryptococcal antigen lateral flow assays (LFA) were introduced in the last decade as rapid user-friendly tests for diagnosis. In this study, we sought to determine the diagnostic accuracy of an LFA kit for the detection of cryptococcal antigen in the serum of HIV-negative patients with or without cerebrovascular accident (CVA) or stroke in University College Hospital, Ibadan, Nigeria. Methodology: The diagnostic accuracy of Dynamiker CrAg LFA was tested against BiosynexR CryptoPS on serum samples of 100 HIV-negative patients with and without stroke. Samples were tested and results interpreted in accordance with the manufacturer's instructions. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and positive and negative likelihood ratios of the Dynamiker CrAg LFA were calculated by comparing with the BiosynexR CryptoPS as 'gold standard'. Results: Overall, a total of 98 valid patient sample results were analysed; 17 samples (17.3%) were positive with Dynamiker CrAg LFA cryptococcal antigen and 16 samples (16.3%) were positive with BiosynexR CryptoPS. The sensitivity, specificity, PPV and NPV of Dynamiker CrAg LFA compared to the BiosynexR CryptoPS were 100%, 98.8%, 94.1% and 100% respectively, while the positive and negative likelihood ratios were 82 and 0 respectively. Conclusion: In comparison to the BiosynexR CryptoPS, the Dynamiker CrAg LFA is a highly sensitive and specific test for the detection of cryptococcal antigen in serum. The test kit should be considered as a screening device for cryptococcal infection both in outreach and clinical settings, especially in antiretroviral therapy (ART) centres. [ABSTRACT FROM AUTHOR]

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Cerebrospinal patients are victims of acquired brain lesions of multiple etiologies: head trauma, stroke, brain tumors, arteriovenous malformations, progressive degenerative diseases. Their care requires a combination of neurological, neuropsychological, psychiatric and psychopathological knowledge. Psychological follow-up of patients with cerebral palsy is one of the dimensions of their care., (Copyright © 2024. Publié par Elsevier Masson SAS.)

INTRODUCTION: l´accident vasculaire cérébral (AVC) constitue un problème majeur de santé publique, tant par le nombre de personnes atteintes, que par ses conséquences médicales, sociales et économiques. L´objectif était de dégager les facteurs de mauvais pronostic vital à la phase aiguë de l´AVC artériel. METHODES: il s´agit d´une étude prospective durant quatre mois portant sur les patients présentant une symptomatologie évocatrice d´AVC aux deux CHU de Sfax, Tunisie. Le suivi a été de un mois. RESULTATS: nous avons colligé 200 patients. Après un mois de suivi, la mortalité était de 19,9%. Les facteurs de mauvais pronostic vital étaient: le sexe masculin, la consommation de tabac, l´antécédent d´AVC, le score de Glasgow bas, le NIHSS élevé, les céphalées, les crises épileptiques symptomatiques aiguës, le signe de Babinski, la mydriase, l´aphasie, la déviation conjuguée de la tête et des yeux, les chiffres élevés de pression artérielle systolique (PAS), pression artérielle diastolique (PAD) et pression artérielle pulmonaire (PAP), l´hyperthermie, l´hyperglycémie, l´hyperleucocytose, l´augmentation des CRP, créatinine, urée et la troponine Tc, la nature hémorragique de l´AVC, l´œdème péri lésionnel, l´effet de masse, l´engagement, la topographie sylvienne totale de l´ischémie, la présence de signes précoces d´ischémie, l´hémorragie méningée, l´inondation ventriculaire, l´hydrocéphalie, le recours à une assistance respiratoire, au traitement anti-œdémateux et antihypertenseur, la transformation hémorragique, l´épilepsie vasculaire, les complications infectieuses, métaboliques et de décubitus. CONCLUSION: l´identification des facteurs prédictifs du devenir vital permet d´optimiser les procédures thérapeutiques et mieux organiser les filières de prise en charge. Une étude comparative sera envisagée afin de mesurer l´impact des mesures correctives.

Cardiovascular disease is the leading cause of death worldwide. Conceptually, endothelial dysfunction, inflammatory conditions and oxidative stress are at the forefront of the onset and development of most cardiovascular diseases, particularly coronary artery disease and heart failure. Serum albumin has many physiological properties, including in particular antioxidant, anti-inflammatory, anticoagulant and anti-platelet aggregation activity. It also plays an essential role in the exchange of fluids across the capillary membrane. Hypoalbuminemia is a powerful prognostic marker in the general population as well as in many disease states. In the more specific context of cardiovascular disease, low serum albumin is independently associated with the development of various deleterious conditions such as coronary artery disease, heart failure, atrial fibrillation, stroke and venous thromboembolism. Low serum albumin has also emerged as a potent prognostic parameter in patients with cardiovascular disease regardless of usual prognostic markers. Remarkably, its potent prognostic value persists after adjusting for causative confounders such as malnutrition and inflammation. This prognostic value probably refers primarily to the syndrome of malnutrition-inflammation and the severity of comorbidities. Nevertheless, several recent meta-analyses strongly support the hypothesis that hypoalbuminemia may act as an unrecognized, potentially modifiable risk factor contributing to the emergence and progression of cardiovascular disease, primarily by exacerbating oxidative stress, inflammation and platelet aggregation, and by favouring peripheral congestion and pulmonary edema. Currently, it is unknown whether prevention and correction of low serum albumin offers a benefit to patients with or at risk for cardiovascular disease, and further studies are critically needed in this setting. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Occupational Therapy is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the care of neurological patients with a lesion of the first motor neuron, for example after stroke or multiple sclerosis, spasticity is a common problem with considerable impairment of quality of life. The treatment is based in the first place on therapeutic and nursing interventions. In addition, a systemic antispastic medication or, depending on the distribution of the spasticity, local injections with botulinum neurotoxin can be applied. If this is insufficient, surgical procedures may be considered. [ABSTRACT FROM AUTHOR]

Les maladies des petits vaisseaux cérébraux sont des affections extrêmement fréquentes touchant tous les âges. Si les formes les plus fréquentes liées à l'âge et à l'hypertension artérielle ou à l'angiopathie amyloïde cérébrale sont essentiellement des pathologies des sujets de plus de 50 ans, il existe des formes plus rares qui touchent les sujets jeunes, parfois même les enfants. Certaines formes familiales ou inflammatoires peuvent être particulièrement trompeuses avec des présentations parfois très difficiles à relier à une origine microvasculaire. Les maladies des petits vaisseaux cérébraux posent donc des problèmes thérapeutiques quotidiens et des problèmes diagnostiques plus rares mais parfois extrêmement complexes. L'objet de cette revue est donc de rappeler les principales présentations inaugurales et les spectres clinico-radiologiques des affections qui y sont associées. Cerebral small vessel diseases are frequent and can be seen through all ages. Although the most frequent forms related to age and hypertension or to cerebral amyloid angiopathy are mainly observed in subjects over 50 years of age, rarer forms may affect young people, sometimes even children. Some familial or inflammatory forms can be particularly misleading with some presentations very difficult to relate to a microvascular origin. Cerebral small vessel diseases thus raise both daily therapeutic issues and much rarer diagnostic questions, sometimes extremely complex. Our aim was to review the main clinical initial presentations and the clinico-radiological spectrum of associated underlying conditions. [ABSTRACT FROM AUTHOR]

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Cette article vise à analyser les comorbidités de l'accident vasculaire cérébral (AVC) ischémique aigu et celles influençant sa létalité hospitalière. Nous avons étudié les patients âgés de 25 ans et plus, résidant en Wallonie et admis dans un hôpital belge pour un AVC durant les années 2013 et 2014. Les données médico-administratives analysées sont issues du résumé hospitalier minimum qui enregistre toutes les hospitalisations de la Wallonie. Pour la mise en évidence des profils de comorbidités, une analyse factorielle des correspondances a été effectuée. Une régression logistique a été employée pour analyser les comorbidités influençant la létalité hospitalière. Les facteurs de risque d'AVC varient en fonction de l'âge. Les problèmes cardiaques sont davantage présents chez les personnes âgées de 85 ans et plus. L'hypertension artérielle, l'hypercholestérolémie et le diabète sont plus marqués entre 65 et 84 ans. La surcharge pondérale est plus présente entre 55 et 74 ans. Les personnes ayant une dépendance à l'alcool ou au tabac ont souvent 65 ans et moins. L'âge, les maladies ischémiques et l'arythmie cardiaque sont les facteurs de risque augmentant la létalité. Il y a cependant une diminution de la létalité en présence d'hypertension artérielle, d'hypercholestérolémie, de surcharge pondérale et de dépendance au tabac ou à l'alcool. Cette étude démontre que les bases de données médico-administratives et les méthodes statistiques factorielles sont parfaitement adaptées pour confirmer les facteurs de risque liés à l'AVC ischémiques. Ce type d'étude permettra de cibler avec plus de précision les actions de prévention secondaire et tertiaire de l'AVC. The aim of the study consists of analyzing the comorbidities of acute ischemic stroke and those influencing its hospital lethality. We considered patients from Wallonia aged 25 years or more and admitted to a Belgian hospital for an acute ischemic stroke in 2013 and 2014. The analyzed medico-administrative data are taken from the Minimum Hospital Summary. A factorial correspondence analysis (FCA) was used to demonstrate the comorbidities profiles. A logistic regression was used to analyse the comorbidities influencing hospital lethality by ischemic stroke. The stroke risk factors vary according to the age. Cardiac problems are more common in older people aged 85 years or more. High blood pressure, hypercholesterolemia and diabetes are more present between 65- and 84-year-olds. Overweight is more present between 55 and 74-year-olds. People who are addicted to alcohol or tobacco are often 65 years or younger. The logistic regression showed that age and heart problems are the risk factors that increase lethality. However there is a lethality diminution in the presence of high blood pressure, hypercholesterolemia, overweight and addiction to alcohol or tobacco. This study demonstrates that medico-administrative databases and factorial statistical methods are perfectly adapted to confirm the ischemic stroke risk factors. This type of study will allow to target with more precision the secondary and tertiary prevention actions of stroke. [ABSTRACT FROM AUTHOR]

Background.: Neuro-occupation was coined to conflate three distinctly different concepts: the brain, context, and occupation. Discussing neuro-occupation has been more of an academic exercise rather than cogently researched for everyday practice, perhaps due to the seemingly incongruity among the concepts. Purpose.: This article traces the self-organization approach, an assumption of complex systems, to understand how the concepts can be conflated. Method.: Deductive category application, a qualitative descriptive method for tracing theoretical assumptions, was drawn from the lived experiences of 11 Iranian participants with cerebrovascular accidents. Matrix construction aided collection of data for analysis. Findings.: The self-organization approach, underpinning neuro-occupation, was shown to be traceable, explaining how occupational participation may be influenced by the brain circular causality and perturbations provided by the context. Implications.: By understanding the dynamics of self-organization, occupational therapists can identify and create salient features that may motivate and enable clients to enhance occupational participation. [ABSTRACT FROM AUTHOR]

Introduction: cerebrovascular accident (stroke) constitutes a major public health problem due to the number of people affected and to its medical social and economic consequences. This study aims to identify poor vital prognostic factors for survival in patients with acute arterial stroke. Methods: we conducted a prospective study of patients with symptoms suggestive of stroke at the two University Hospitals of Sfax, Tunisia over a period of 4 months. Patients were followed-up for a period of 1 month. Results: we collected data from 200 patients. After one month of follow-up, mortality was 19.9%. Poor prognostic factors were: male sex, consumption of tobacco, a history of stroke, low Glasgow score, high NIHSS, headaches, acute symptomatic epileptic seizures, Babinski's sign, mydriasis, aphasia, combined deviation of the head and the eyes, high PAS, PAD and PAM, hyperthermia, hyperglycaemia, leukocytosis, high concentration of CRP, creatinine, urea and troponin T, haemorrhagic stroke, perilesional oedema, a mass effect, commitment, total middle cerebral artery topography of ischemia, early signs of ischemia, meningeal hemorrhage, ventricular flood, hydrocephalus, the recourse to respiratory support, to anti-edematous treatment and to antihypertensive therapy, hemorrhagic transformation, vascular epilepsy, infectious, metabolic complications, complications of bed sores. Conclusion: the identification of the predictive factors for survival allows for optimisation of therapeutic procedures and better implementation of patient' management. A comparative study will be considered to measure the impact of the corrective measures. [ABSTRACT FROM AUTHOR]