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Jorge Enrique Machado-alba - One of the best experts on this subject based on the ideXlab platform.

  • Factores predictores de mortalidad por Accidente Cerebrovascular en el Hospital Universitario San Jorge de Pereira
    'Universidad del Norte', 2017
    Co-Authors: Cristhian David Morales-plaza, Claudio Aguirre-castañeda, Jorge Enrique Machado-alba
    Abstract:

    Resumen. Objetivo: Determinar los factores predictores de mortalidad por accidente cerebrovascular (ACV) en el Hospital Universitario San Jorge de Pereira, entre enero de 2008 y diciembre de 2011. Materiales y métodos. Estudio de corte transversal, realizado en los pacientes con diagnóstico de ACV. Se obtuvo la información de las historias clínicas  teniendo en cuenta las variables: edad, sexo, tipo de ACV (isquémico o hemorrágico), trastorno asociado, antecedentes personales relacionados con ACV, mortalidad. Se aplicaron modelos de regresión logística para determinar que variables se asociaron significativamente con la mortalidad. Resultados. 350 pacientes evaluados.  Edad promedio 69,2+/-11,6 años; del total 51,4% fueron mujeres. 57,4% presentaron un episodio súbito, 78,6% de los ACV fueron de tipo isquémico y el 21,4%  hemorrágico. Los trastornos en orden de aparición fueron: déficit motor (80,9%), déficit de lenguaje (43,4%), cefalea (35,7%), alteración de pares craneales (28,3%). Las comorbilidades encontradas fueron: hipertensión arterial (72,6%), dislipidemia (47,7%), diabetes mellitus (19,7%), tabaquismo (17,4%), enfermedad cardíaca isquémica (9,4%), ACV previo (6%) y fibrilación auricular (6%). El 16% de pacientes falleció por ACV; de estos, el 74,6% fueron hemorrágicos. Se encontró asociación estadísticamente significativa entre muerte por ACV e inicio súbito (OR:0,65 IC95%:0,021-0,200; p<0,001), hemorragia intraparenquimatosa (OR:91,3; IC95%:20,6-403,7; p<0,001) y edad entre 40 y 55 años (OR: 2,91; IC95%:2,07-5,18; p<0,001). Conclusiones. Dado que las variables asociadas con muerte no son modificables al ingreso del paciente al hospital, se deben reforzar las medidas de salud pública para prevenir la aparición de ictus. Abstract Objetive. Identify predictors of stroke mortality (ACV) at the University Hospital San Jorge de Pereira, between January 2008 and December 2011. Patients and methods. Cross sectional study, realized in patients with a diagnosis of stroke. Information was obtained from medical records taking into account patient age, sex, type of stroke (ischemic or hemorrhagic), associated Disorder, personal history associated with stroke mortality. We applied logistic regression models to determine which variables were significantly associated with mortality. Results. 350 patients evaluated. Mean age 69.2 years + / -11.6 years, 51.4% of the participants were women. 57.4% had a sudden episode, 78.6% of ischemic ACV and 21.4% was bleeding. Disorders in order of appearance were: Motor deficit (80.9%), language deficits (43.4%), headache (35.7%), Cranial Nerve Disorder (28.3%). Comorbidities were hypertension (72.6%), dyslipidemia (47.7%), diabetes mellitus (19.7%), smoking (17.4%), ischemic heart disease (9.4%), previous ACV (6%) and atrial fibrillation (6%). 16% of patients died from stroke, of these, 74.6% were bleeding. Statistically significant association was found between mortality from stroke and sudden onset (OR 0.65; 95%CI:0.021-0.200, p <0.001), intraparenchymal hemorrhage (OR:91.3; IC95%:20.6-403.7; p<0.001) and age between 40 and 55 years (OR:2.91; IC95%:2.07-5.18; p<0.001). Discussion. Since the variables associated with death are not modifiable at patient's admission to hospital, should reinforce the public health measures to prevent the occurrence of stroke. La correspondencia deberá dirigirse a: Nombre: Cristhian David Morales-Plaza Institución: Grupo de investigación en Farmacoepidemiología y Farmacovigilancia- Universidad Tecnológica de Pereira, Colombia Dirección: Calle 105 No. 14-140 Pereira Tel. 6+3137800, Fax 6+3137822. Correo electrónico: cdmorales@utp.edu.co El trabajo se realizó en el Hospital Universitario San Jorge. Dirección: Carrera 4 No 24-88 Pereira, Risaralda. Tel. (6) 335 63 33 Conteo de palabras: 2898 Los autores no manifiestan conflicto de interesesFinanciación: Universidad Tecnológica de Pereira. 

Cristhian David Morales-plaza - One of the best experts on this subject based on the ideXlab platform.

  • Factores predictores de mortalidad por Accidente Cerebrovascular en el Hospital Universitario San Jorge de Pereira
    'Universidad del Norte', 2017
    Co-Authors: Cristhian David Morales-plaza, Claudio Aguirre-castañeda, Jorge Enrique Machado-alba
    Abstract:

    Resumen. Objetivo: Determinar los factores predictores de mortalidad por accidente cerebrovascular (ACV) en el Hospital Universitario San Jorge de Pereira, entre enero de 2008 y diciembre de 2011. Materiales y métodos. Estudio de corte transversal, realizado en los pacientes con diagnóstico de ACV. Se obtuvo la información de las historias clínicas  teniendo en cuenta las variables: edad, sexo, tipo de ACV (isquémico o hemorrágico), trastorno asociado, antecedentes personales relacionados con ACV, mortalidad. Se aplicaron modelos de regresión logística para determinar que variables se asociaron significativamente con la mortalidad. Resultados. 350 pacientes evaluados.  Edad promedio 69,2+/-11,6 años; del total 51,4% fueron mujeres. 57,4% presentaron un episodio súbito, 78,6% de los ACV fueron de tipo isquémico y el 21,4%  hemorrágico. Los trastornos en orden de aparición fueron: déficit motor (80,9%), déficit de lenguaje (43,4%), cefalea (35,7%), alteración de pares craneales (28,3%). Las comorbilidades encontradas fueron: hipertensión arterial (72,6%), dislipidemia (47,7%), diabetes mellitus (19,7%), tabaquismo (17,4%), enfermedad cardíaca isquémica (9,4%), ACV previo (6%) y fibrilación auricular (6%). El 16% de pacientes falleció por ACV; de estos, el 74,6% fueron hemorrágicos. Se encontró asociación estadísticamente significativa entre muerte por ACV e inicio súbito (OR:0,65 IC95%:0,021-0,200; p<0,001), hemorragia intraparenquimatosa (OR:91,3; IC95%:20,6-403,7; p<0,001) y edad entre 40 y 55 años (OR: 2,91; IC95%:2,07-5,18; p<0,001). Conclusiones. Dado que las variables asociadas con muerte no son modificables al ingreso del paciente al hospital, se deben reforzar las medidas de salud pública para prevenir la aparición de ictus. Abstract Objetive. Identify predictors of stroke mortality (ACV) at the University Hospital San Jorge de Pereira, between January 2008 and December 2011. Patients and methods. Cross sectional study, realized in patients with a diagnosis of stroke. Information was obtained from medical records taking into account patient age, sex, type of stroke (ischemic or hemorrhagic), associated Disorder, personal history associated with stroke mortality. We applied logistic regression models to determine which variables were significantly associated with mortality. Results. 350 patients evaluated. Mean age 69.2 years + / -11.6 years, 51.4% of the participants were women. 57.4% had a sudden episode, 78.6% of ischemic ACV and 21.4% was bleeding. Disorders in order of appearance were: Motor deficit (80.9%), language deficits (43.4%), headache (35.7%), Cranial Nerve Disorder (28.3%). Comorbidities were hypertension (72.6%), dyslipidemia (47.7%), diabetes mellitus (19.7%), smoking (17.4%), ischemic heart disease (9.4%), previous ACV (6%) and atrial fibrillation (6%). 16% of patients died from stroke, of these, 74.6% were bleeding. Statistically significant association was found between mortality from stroke and sudden onset (OR 0.65; 95%CI:0.021-0.200, p <0.001), intraparenchymal hemorrhage (OR:91.3; IC95%:20.6-403.7; p<0.001) and age between 40 and 55 years (OR:2.91; IC95%:2.07-5.18; p<0.001). Discussion. Since the variables associated with death are not modifiable at patient's admission to hospital, should reinforce the public health measures to prevent the occurrence of stroke. La correspondencia deberá dirigirse a: Nombre: Cristhian David Morales-Plaza Institución: Grupo de investigación en Farmacoepidemiología y Farmacovigilancia- Universidad Tecnológica de Pereira, Colombia Dirección: Calle 105 No. 14-140 Pereira Tel. 6+3137800, Fax 6+3137822. Correo electrónico: cdmorales@utp.edu.co El trabajo se realizó en el Hospital Universitario San Jorge. Dirección: Carrera 4 No 24-88 Pereira, Risaralda. Tel. (6) 335 63 33 Conteo de palabras: 2898 Los autores no manifiestan conflicto de interesesFinanciación: Universidad Tecnológica de Pereira. 

Claudio Aguirre-castañeda - One of the best experts on this subject based on the ideXlab platform.

  • Factores predictores de mortalidad por Accidente Cerebrovascular en el Hospital Universitario San Jorge de Pereira
    'Universidad del Norte', 2017
    Co-Authors: Cristhian David Morales-plaza, Claudio Aguirre-castañeda, Jorge Enrique Machado-alba
    Abstract:

    Resumen. Objetivo: Determinar los factores predictores de mortalidad por accidente cerebrovascular (ACV) en el Hospital Universitario San Jorge de Pereira, entre enero de 2008 y diciembre de 2011. Materiales y métodos. Estudio de corte transversal, realizado en los pacientes con diagnóstico de ACV. Se obtuvo la información de las historias clínicas  teniendo en cuenta las variables: edad, sexo, tipo de ACV (isquémico o hemorrágico), trastorno asociado, antecedentes personales relacionados con ACV, mortalidad. Se aplicaron modelos de regresión logística para determinar que variables se asociaron significativamente con la mortalidad. Resultados. 350 pacientes evaluados.  Edad promedio 69,2+/-11,6 años; del total 51,4% fueron mujeres. 57,4% presentaron un episodio súbito, 78,6% de los ACV fueron de tipo isquémico y el 21,4%  hemorrágico. Los trastornos en orden de aparición fueron: déficit motor (80,9%), déficit de lenguaje (43,4%), cefalea (35,7%), alteración de pares craneales (28,3%). Las comorbilidades encontradas fueron: hipertensión arterial (72,6%), dislipidemia (47,7%), diabetes mellitus (19,7%), tabaquismo (17,4%), enfermedad cardíaca isquémica (9,4%), ACV previo (6%) y fibrilación auricular (6%). El 16% de pacientes falleció por ACV; de estos, el 74,6% fueron hemorrágicos. Se encontró asociación estadísticamente significativa entre muerte por ACV e inicio súbito (OR:0,65 IC95%:0,021-0,200; p<0,001), hemorragia intraparenquimatosa (OR:91,3; IC95%:20,6-403,7; p<0,001) y edad entre 40 y 55 años (OR: 2,91; IC95%:2,07-5,18; p<0,001). Conclusiones. Dado que las variables asociadas con muerte no son modificables al ingreso del paciente al hospital, se deben reforzar las medidas de salud pública para prevenir la aparición de ictus. Abstract Objetive. Identify predictors of stroke mortality (ACV) at the University Hospital San Jorge de Pereira, between January 2008 and December 2011. Patients and methods. Cross sectional study, realized in patients with a diagnosis of stroke. Information was obtained from medical records taking into account patient age, sex, type of stroke (ischemic or hemorrhagic), associated Disorder, personal history associated with stroke mortality. We applied logistic regression models to determine which variables were significantly associated with mortality. Results. 350 patients evaluated. Mean age 69.2 years + / -11.6 years, 51.4% of the participants were women. 57.4% had a sudden episode, 78.6% of ischemic ACV and 21.4% was bleeding. Disorders in order of appearance were: Motor deficit (80.9%), language deficits (43.4%), headache (35.7%), Cranial Nerve Disorder (28.3%). Comorbidities were hypertension (72.6%), dyslipidemia (47.7%), diabetes mellitus (19.7%), smoking (17.4%), ischemic heart disease (9.4%), previous ACV (6%) and atrial fibrillation (6%). 16% of patients died from stroke, of these, 74.6% were bleeding. Statistically significant association was found between mortality from stroke and sudden onset (OR 0.65; 95%CI:0.021-0.200, p <0.001), intraparenchymal hemorrhage (OR:91.3; IC95%:20.6-403.7; p<0.001) and age between 40 and 55 years (OR:2.91; IC95%:2.07-5.18; p<0.001). Discussion. Since the variables associated with death are not modifiable at patient's admission to hospital, should reinforce the public health measures to prevent the occurrence of stroke. La correspondencia deberá dirigirse a: Nombre: Cristhian David Morales-Plaza Institución: Grupo de investigación en Farmacoepidemiología y Farmacovigilancia- Universidad Tecnológica de Pereira, Colombia Dirección: Calle 105 No. 14-140 Pereira Tel. 6+3137800, Fax 6+3137822. Correo electrónico: cdmorales@utp.edu.co El trabajo se realizó en el Hospital Universitario San Jorge. Dirección: Carrera 4 No 24-88 Pereira, Risaralda. Tel. (6) 335 63 33 Conteo de palabras: 2898 Los autores no manifiestan conflicto de interesesFinanciación: Universidad Tecnológica de Pereira. 

Albert C Ludolph - One of the best experts on this subject based on the ideXlab platform.

  • differential diagnosis of peripheral facial Nerve palsy a retrospective clinical mri and csf based study
    Journal of Neurology, 2019
    Co-Authors: Julia Zimmermann, Sarah Jesse, Jan Kassubek, Elmar H Pinkhardt, Albert C Ludolph
    Abstract:

    Facial Nerve palsy is the most common Cranial Nerve Disorder. There is no consensus on a single diagnostic tool deemed as the ‘gold standard’ for distinguishing between idiopathic (Bell’s palsy) and symptomatic causes. The diagnosis is one of exclusion and most often made on physical examination. In the present study, we describe the etiological background of peripheral facial palsy in N = 509 patients and evaluate the relevance of cerebrospinal fluid (CSF) analysis and magnetic resonance imaging (MRI) in differential diagnosis. We carried out a retrospective data analysis of 509 patients with the clinical diagnosis of peripheral facial palsy admitted to our emergency unit between January 2006 and January 2017. All patients were seen clinically; their CSF was analyzed and MRI was performed. Of N = 526 patients with isolated facial palsy, 17 patients were excluded because they did not consent to CSF analysis. Of the remaining N = 509 patients, 383 patients (75.2%) were diagnosed with idiopathic facial palsy. In the remaining 126 patients (24.8%), the following etiologies for facial palsy could be found: Ramsay-Hunt-Syndrome (N = 34), Lyme Neuroborreliosis (N = 32), other viral/bacterial central nervous system (CNS) infections (N = 8), neoplasias (N = 18), autoimmune disease (N = 12), otogenous processes (N = 6), or other etiologies (N = 16). Analysis of the CSF showed 85% sensitivity for Ramsay-Hunt-Syndrome and 100% for Lyme Neuroborreliosis and other viral/bacterial CNS infections. CSF analysis proved a reliable diagnostic tool for identifying these subgroups. MRI with contrast compounds, as performed in 409 patients, was the most important tool in diagnosing neoplasias (88% sensitivity) and otogenous processes (83% sensitivity). MRI with contrast-enhancing compounds did not reveal additional information concerning inflammatory facial Nerve lesions when performed the same day as hospital admission. Although peripheral facial palsy was predominantly idiopathic (75.3%) in our cohort, the disease was caused in approximately 25% of the patients by factors which require specific treatment. In the present study, CSF analysis proved to be the leading method for the diagnosis of Ramsay-Hunt-Syndrome, Lyme Neuroborreliosis, and other CNS infections. These subgroups made up approximately 15% of our cohort. To detect these subgroups reliably, routine use of CSF analysis in peripheral facial palsy may be advisable, whereas MRI proved to be useful for exclusion of otogenic and neoplastic processes with a sensitivity of 83% and 88%. We found that the use of MRI with contrast-enhancing compounds does not provide additional diagnostic information on the day of hospital admission. Hence, the potential benefits of routine use of MRI in patients with facial Nerve palsy should be weighed against health care cost factors.

Julia Zimmermann - One of the best experts on this subject based on the ideXlab platform.

  • differential diagnosis of peripheral facial Nerve palsy a retrospective clinical mri and csf based study
    Journal of Neurology, 2019
    Co-Authors: Julia Zimmermann, Sarah Jesse, Jan Kassubek, Elmar H Pinkhardt, Albert C Ludolph
    Abstract:

    Facial Nerve palsy is the most common Cranial Nerve Disorder. There is no consensus on a single diagnostic tool deemed as the ‘gold standard’ for distinguishing between idiopathic (Bell’s palsy) and symptomatic causes. The diagnosis is one of exclusion and most often made on physical examination. In the present study, we describe the etiological background of peripheral facial palsy in N = 509 patients and evaluate the relevance of cerebrospinal fluid (CSF) analysis and magnetic resonance imaging (MRI) in differential diagnosis. We carried out a retrospective data analysis of 509 patients with the clinical diagnosis of peripheral facial palsy admitted to our emergency unit between January 2006 and January 2017. All patients were seen clinically; their CSF was analyzed and MRI was performed. Of N = 526 patients with isolated facial palsy, 17 patients were excluded because they did not consent to CSF analysis. Of the remaining N = 509 patients, 383 patients (75.2%) were diagnosed with idiopathic facial palsy. In the remaining 126 patients (24.8%), the following etiologies for facial palsy could be found: Ramsay-Hunt-Syndrome (N = 34), Lyme Neuroborreliosis (N = 32), other viral/bacterial central nervous system (CNS) infections (N = 8), neoplasias (N = 18), autoimmune disease (N = 12), otogenous processes (N = 6), or other etiologies (N = 16). Analysis of the CSF showed 85% sensitivity for Ramsay-Hunt-Syndrome and 100% for Lyme Neuroborreliosis and other viral/bacterial CNS infections. CSF analysis proved a reliable diagnostic tool for identifying these subgroups. MRI with contrast compounds, as performed in 409 patients, was the most important tool in diagnosing neoplasias (88% sensitivity) and otogenous processes (83% sensitivity). MRI with contrast-enhancing compounds did not reveal additional information concerning inflammatory facial Nerve lesions when performed the same day as hospital admission. Although peripheral facial palsy was predominantly idiopathic (75.3%) in our cohort, the disease was caused in approximately 25% of the patients by factors which require specific treatment. In the present study, CSF analysis proved to be the leading method for the diagnosis of Ramsay-Hunt-Syndrome, Lyme Neuroborreliosis, and other CNS infections. These subgroups made up approximately 15% of our cohort. To detect these subgroups reliably, routine use of CSF analysis in peripheral facial palsy may be advisable, whereas MRI proved to be useful for exclusion of otogenic and neoplastic processes with a sensitivity of 83% and 88%. We found that the use of MRI with contrast-enhancing compounds does not provide additional diagnostic information on the day of hospital admission. Hence, the potential benefits of routine use of MRI in patients with facial Nerve palsy should be weighed against health care cost factors.