ABSTRACT
Objective:To investigate the clinical characteristics and outcome of patients with voltage-gated potassium channel complex (VGKCc) antibody associated clinical syndromes complicated with myasthenia gravis (MG) with thymoma.Methods:The clinical history, examinations and follow-up prognosis of 2 cases of VGKCc antibodies associated clinical syndromes with MG complicated with thymoma in Qilu Hospital (Qingdao), Cheeloo College of Medicine,Shandong University in September 2020 and December 2020 were reviewed. Related literatures were summarized at the same time.Results:Case 1, a 64-year-old female clinically presented with cognitive impairment, psychosis, and epilepsy seizures, whose serum autoimmune antibody testing showed positive leucine-rich glioma-inhibited 1 (LGI1) antibody, was diagnosed as anti-LGI1 encephalitis,and had history of MG with thymoma. Her symptoms were improved by immunotherapy. Case 2, a 67-year-old male, was diagnosed as MG, and developed cognitive impairment, myokymia and autonomic dysfunction later. His serum autoimmune antibody testing showed positive contactin associated protein-like 2 antibody. Therefore, Morvan syndrome complicated with MG with thymoma was definitely diagnosed. After admission, the patient was improved with immunotherapy and thymoma resection.Conclusions:Patients with VGKCc antibody-associated clinical syndromes complicated with MG have the clinical characteristics of the two diseases simultaneously, and there is also crossover. Immunotherapy and treatment for thymoma are generally effective.
ABSTRACT
Objective To investigate the effect of health literacy on stroke education in patients with ischemic cerebrovascular disease and their family members.Methods Health literacy questionnaire was used to conduct the health literacy questionnaire survey for patients with ischemic cerebrovascular disease and their family members.The respondents received stroke education randomly through neurologists' explanation or self-reading.The corresponding questionnaire was used to evaluate the mastering of the content of stroke education for the respondents.Results The complete data of 42 patients with ischemic cerebrovascular disease (34 ischemic stroke and 8 transient ischemic attack) and 57 family members of the patients with ischemic cerebrovascular disease were collected and enrolled in the analysis.The good health literacy score group (＜ 10) and the poor health literacy score group (≥ 10) were 61 and 38 subjects respectively.The proportions of younger age (x2 =16.410,P ＜0.001) and high school or above (68.85％ vs.23.68％ ;x2 =19.25,P ＜ 0.001) of the former were higher than those of the latter,and the proportion of patients (32.79％vs.57.89％;x2 =6.043,P=0.014) was significantly lower than that of the latter,but there was no significant difference in the proportion of the males between the two groups (55.74％ vs.44.74％ ;x2 =1.134,P =0.287).Multivariate logistic regression analysis showed that health literacy was independently associated with the age of respondents (≤40 years:odds ratio [OR] 7.753,95％ confidence interval [CI]1.208-49.740; P=0.031) and the level of education (high school and above:OR,3.993,95％ CI 1.305-12.218; P=0.015),and it was not correlated with gender and role.Those with good stroke education score (≥7)and poor stroke education score (＜7) were 57 and 42,respectively.The proportions of younger age (x2 =17.095,P ＜0.001),high school and above (70.00％ vs.23.08％ ;x2 =20.836,P ＜ 0.001),and good health literacy score (88.33％ vs.20.51％;x2 =45.968,P＜0.001) were significantly higher than those of the latter,while there were no significant differences in the proportions of gender,role,and stroke education.Multivariatelogistic regression analysis showed that only the good health literacy was independently associated with the stroke education score (OR 20.147,95％ CI6.089-66.655; P＜0.001).Conclusions Health literacy can significantly affected the effect of the stroke education in patients with ischemic cerebrovascular disease and their family members.In the development of individualized stroke education program,it should be considered.