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Chen S.,Wenzhou University | Lu X.,First Peoples Hospital of Jiaxing | Zhang W.,Wenzhou University | Han Z.,Wenzhou University | And 8 more authors.
Journal of Stroke and Cerebrovascular Diseases

Background The effect of prior antiplatelet (AP) therapy on the risk of hemorrhagic transformation (HT), and on functional outcomes of acute ischemic stroke (AIS) after intravenous thrombolysis (IVT), is not known. We performed a retrospective analysis to determine whether history of AP therapy is associated with post-thrombolysis HT and poor prognosis in AIS patients. Methods Data pertaining to 145 patients with AIS, who underwent IVT between October 2008 and January 2015, were analyzed. The patients were divided into 2 groups based on whether or not they had received prior AP therapy. Neurological outcomes at 24 hours and 3 months after IVT therapy were assessed. Intergroup difference in cost of treatment was also evaluated. A multivariate logistic regression model was used to identify independent predictors of post-thrombolysis HT. Results Among 145 patients, 23 (15.8%) had received prior AP therapy. On multivariate analyses, older age (odds ratio [OR]: 1.084; confidence interval [CI], 1.028-1.144) and prior AP therapy (OR: 3.318; CI, 1.172-9.398) were found to be independent predictors of HT. Conclusion In this study, prior AP therapy was independently associated with post-thrombolysis HT in AIS. © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved. Source

Li H.,Municipal Hospital of Taizhou | Yu Y.,Municipal Hospital of Taizhou
BMC Geriatrics

Background: Recent observations suggest that migraine and cerebrovascular disease are comorbid conditions. However, the association of migraine with cerebrovascular disease in the population of elderly Chinese has not been established. This prospective case-control study aimed to investigate the prevalence and lesion characteristics of migraine in elderly Chinese patients with acute cerebral infarction (ACI). Methods. A total of 968 ACI patients aged 55-70 years and 1024 sex- and age-matched control subjects were recruited between January, 2003 and July, 2009. Migraine was determined based on the International Headache Society's Classification of Headache Disorders, together with past medical records and admission examination results, following an initial questionnaire screening at the first hospital visit. Prevalence rates of overall migraine, migraine with aura and migraine without aura in both ACI patients and control subjects, the stroke subtypes classified according to the Chinese Ischemic Stroke Subclassification (CISS) system and brain locations of the ischemic lesions in ACI patients were analyzed. Results: The overall prevalence rate of migraine was 17.15% (166/968) in patients with ACI but only 3.9% (40/1024) in control subjects (P < 0.01). In both subject groups, over 80% of migraine cases were migraine without aura. In the 166 ACI patients with comorbid migraine, large artery atherosclerosis was the most frequent subtype of ischemic lesion (65.06%), followed by cardiogenic stroke (23.50%), and all other lesion subtypes were each less than 10%. Ischemic infarctions were located predominantly in the anterior circulation in the brain in both ACI patients with and without migraine. Conclusions: The prevalence rate of migraine is significantly higher in ACI patients than non-ACI subjects in the population of elderly Chinese. Migraine without aura is the major form of migraine in both ACI patients and non-ACI subjects. In ACI patients, regardless of migraine, infarction lesions were predominantly located in the anterior cerebral circulation. © 2013 Li and Yu; licensee BioMed Central Ltd. Source

Li H.J.,Municipal Hospital of Taizhou | Yu Y.,Municipal Hospital of Taizhou | Chen Y.,Municipal Hospital of Taizhou | Liang H.Y.,Municipal Hospital of Taizhou
International Journal of Clinical and Experimental Medicine

Objective: Some studies have found that vascular risk factors were related to an increased risk of Parkinson’s disease. In order to investigate the comorbidities of the vascular risk factors with PD and their impact on PD progression, we launched a five-year follow-up study in 247 outpatients with probable PD. Methods: The incidence of vascular risk factors including hypertension, diabetes, hypercholesterolemia, hyperhomocysteinemia and carotid atherosclerotic plaque analyzed. The Hoen and Yahr score with and without vascular risk factors were compared at initial and at final evaluation. Results: Multiple regression analysis showed that age, hypertension and hyperhomocysteinemia were significant variables that are associated with the Hoen and Yahr scales. Younger patients with hypertension or hyperhomocysteinemia showed a greater increasing in the Hoen and Yahr score. There were no significant correlations among the Hoen and Yahr score with sex, initial of the Hoen and Yahr score, diabetes, hypercholesterolemia or carotid atherosclerotic plaque. Conclusion: The vascular risk factors are common comorbidities of PD. Younger, more educated patients are more likely to have quicker dyskinesia decline. In addition, hypertension and hyperhomocysteinemia may aggravate the progression of PD. The prevention and treatment of hypertension and hyperhomocysteinemia are important for PD patients. © 2015, E-Century Publishing Corporation. All rights reserved. Source

Wang L.,Municipal Hospital of Taizhou | Kang W.,Municipal Hospital of Taizhou | Zu M.,Municipal Hospital of Taizhou | Zhang Q.,Municipal Hospital of Taizhou | And 3 more authors.
Experimental and Therapeutic Medicine

The aim of this study was to evaluate the significance of using multi-row spiral computed tomography (CT) to scan for pulmonary artery thrombosis and lower limb deep vein thrombosis (LVT) in patients with suspected LVT. A total of 110 patients underwent a contrast-enhanced spiral CT inspection of the pulmonary artery and lower extremity veins. Three-dimensional digital image processing, including multi-planar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering (VR), was also conducted; two groups of experienced radiologists analyzed the CT images to evaluate the postprocessing techniques of these CT images. Seventy-five patients were diagnosed with LVT with or without pulmonary embolism (PE); out of these 75, 34 patients were diagnosed with PE and LVT together and 41 patients were diagnosed with LVT alone. A further 31 patients were diagnosed with iliac vein compression syndrome (IVCS), and no embolisms were detected in the remaining four patients. With regard to PE, MPR and MIP demonstrated an accuracy of 100%, while MPR also showed images of LVT with an accuracy of 100%. The follow-up results at 12 months were consistent with the CT scan results. The clinical use of 128-slice spiral CT combination scanning in the detection of PE and LVT has significant potential to improve upon the present methods of diagnosis. Source

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