RESUMO
OBJECTIVE: To evaluate pre-stroke bone mineral density (BMD) of the patients with first stroke events. We previously reported that pre-stroke BMD of first stroke patients with severe immobility were relatively lower than those of normal population. In current study, we evaluated pre-stroke BMD of patients in first stroke patients regardless of severity or type of stroke. METHOD: The 121 patients with first stroke events were included. To reflect pre-stroke BMD, patients who had bone densitometry scans within the first thirty days from onset were chosen. The BMDs of the lumbar spine and both femurs (total hip and femoral neck) were examined. RESULTS: Among the 121 stroke patients, 56.2% were osteoporotic and 28.1% were osteopenic. In the female patients, 78.1% were osteoporotic and 20.5% were osteopenic. In the male patients, 22.9% were osteoporotic and 39.6% were osteopenic. CONCLUSION: Patients with first stroke events showed a high prevalence of pre-stroke low BMD. In the acute stages of stroke, bone loss progression is rapid. Therefore, such a high prevalence of pre-stroke low BMD can bring on a greater risk of fractures and additional functional loss. Early screening and active intervention of osteoporosis including patient education from the acute stages of stroke is crucial.
Assuntos
Feminino , Humanos , Masculino , Densidade Óssea , Doenças Ósseas Metabólicas , Densitometria , Fêmur , Quadril , Programas de Rastreamento , Osteoporose , Educação de Pacientes como Assunto , Prevalência , Coluna Vertebral , Acidente Vascular CerebralRESUMO
Superior mesenteric artery syndrome (SMAS) is a rare cause of proximal duodenal obstruction resulting from compression of the duodenum by the SMA against the aorta. Risk factors associated with SMAS are prolonged supine position, weight loss and decreased abdominal wall muscle tone; all of which are frequently accompanied with traumatic brain injury (TBI). The following case report describes a patient who developed SMAS in the setting of TBI. This report presents a 16 year old male with TBI who had postprandial epigastric pain, vomiting and weight loss. Computed tomography and upper gastrointestinal series demonstrated the existence of SMAS. The patient was managed conservatively with total parenteral nutrition to obtain a positive nitrogen balance. Physician should consider SMAS in the differential diagnosis of patients presenting with abdominal pain and vomiting.
Assuntos
Humanos , Masculino , Dor Abdominal , Parede Abdominal , Aorta , Encéfalo , Lesões Encefálicas , Diagnóstico Diferencial , Obstrução Duodenal , Duodeno , Artéria Mesentérica Superior , Músculos , Nitrogênio , Nutrição Parenteral Total , Fatores de Risco , Síndrome da Artéria Mesentérica Superior , Decúbito Dorsal , Vômito , Redução de PesoRESUMO
A subset of aged individuals with Down syndrome (DS) exhibits eating, drinking, and swallowing (EDS) difficulties, which have the potential to lead to life-threatening conditions such as malnutrition. We report a case of 37-year-old woman with DS, who developed Wernicke's encephalopathy related to malnutrition that was caused by EDS problems. The patient presented with a history of EDS problems for 2 years without treatment and had developed mental-status changes, unsteadiness of stance and gait with associated MRI findings, corresponding to Wernicke's encephalopathy. The patient was treated with nutritional support including thiamine replacement and dysphagia rehabilitation therapy. Our case highlights the importance of early and proper management of malnutrition associated with EDS problems in adult DS. The suspicion of Wernicke's encephalopathy must be considered when adult DS manifests as prolonged malnutrition, altered mentality and decreased mobility.