RESUMEN
BACKGROUND/AIMS: A number of risk factors for early worsening of neurological symptoms have been identified. We aimed to evaluate the influence of hemorheologic, biochemical, and metabolic factors on neurological deterioration during hospitalization following acute ischemic stroke and develop a model of neurological deterioration. METHODS: Worsening of stroke was defined as a deleterious increase in NIH Stroke Scale (NIHSS) score of ≥4 points during hospitalization. We performed multivariate logistic regression analysis and constructed a prediction model based on chart data of 2,398 patients admitted at five medical centers; 203 of the patients had worsening of stroke and 2,186 had not. RESULTS: The results of multivariate logistic regression analysis showed that hemoglobin (odds ratio: 0.529) and albumin (odds ratio: 0.024) were significantly associated with stroke deterioration, as were the modified Rankin Scale on emergency department admission (odds ratio: 4.956) and length of hospitalization (odds ratio: 1.201). After adjusting for age, gender and NIHSS on emergency department admission, only hemoglobin (odds ratio: 0.894, 95% confidence interval: 0.814-0.981, p = 0.018) was associated with worsening. CONCLUSION: Hemoglobin and albumin were found to be risk factors for persistent neurological deterioration during hospitalization following acute ischemic stroke, suggesting that blood viscosity may be related to neurological deterioration.
Asunto(s)
Isquemia Encefálica/diagnóstico , Progresión de la Enfermedad , Hospitalización , Accidente Cerebrovascular/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Recuperación de la Función , Estudios Retrospectivos , Factores de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND: Electrical stimulation of damaged peripheral nerve may aid regeneration. METHODS: A 10-mm gap was made in rat sciatic nerve by suturing the stumps into silicone rubber tubes. A control group received no stimulation. To determine whether 2 Hz of percutaneous electrical stimulation at 1 mA, 2 mA, or 4 mA augments regeneration between the proximal and distal nerve stumps. RESULTS: The groups receiving electrical treatment had larger mean values of axon number, endoneurial area, total nerve area, blood vessel number, and blood vessel area compared with the controls. In addition, the group receiving electrical stimulation, especially at 1 mA had significantly shorter latency, larger amplitude, larger area of the evoked muscle action potentials and faster conduction velocity compared with the controls. However, electrical stimulation at 4 mA provoked adverse responses to the function recovery of regenerated nerves in the kinematic gait analysis. CONCLUSION: Indeed, the electrical stimulation appears to have a detrimental effect on the regeneration process. It could promote the growth of regenerating nerves; however, excessive direct current could be repulsive to regrowing fibers. This reveals the importance for physical therapists using safe stimulus protocols for rehabilitation purposes.