ABSTRACT
BACKGROUND AND PURPOSE: Ongoing evaluation of the results of thrombolytic therapy in patients with ischaemic stroke (IS) in regions with different health care organization is absolutely crucial for making this method of treatment safer and efficient. The aim of this study was to analyse the efficacy and safety of treatment with intravenous alteplase in patients with acute IS in a rural hospital. MATERIAL AND METHODS: Between 2006 and 2011, 1392 pa-tients with IS were treated (including 200 patients treated with alteplase; 14.37%). In patients treated with alteplase, we analysed the influence of several variables on the functional status after 3 months according to the modified Rankin Scale (mRS), case-fatality rate during 3 months after onset and symptomatic intracerebral haemorrhage (SICH). RESULTS: In the studied population, good outcome (mRS 0-2) at 3 months was related to younger age (p = 0.001), male sex (p = 0.02) and low scores (< 15 points) on the National Institutes of Health Stroke Scale (NIHSS) (p < 0.0001). Deaths within 3 months were related to older age (p = 0.027), female sex (p = 0.004), severity of stroke measured by NIHSS score (p < 0.0001) and presence of radiological signs of previous stroke in baseline computed tomography (CT)(p = 0.002). Patients with SICH had higher mean age (p = 0.014) and higher severity of neurological deficit measured on the NIHSS scale (p = 0.03). CONCLUSIONS: The indications for intravenous thrombolysis in patients with IS should be strictly analysed so that the treatment is effective and safe especially in older patients, patients with greater severity of neurological symptoms and patients with old post-stroke lesions in baseline CT.
Subject(s)
Fibrinolytic Agents/administration & dosage , Hospitals, Rural/statistics & numerical data , Stroke/drug therapy , Stroke/epidemiology , Thrombolytic Therapy/methods , Tissue Plasminogen Activator/administration & dosage , Adult , Age Factors , Aged , Aged, 80 and over , Atrial Fibrillation/epidemiology , Cerebral Hemorrhage/epidemiology , Comorbidity , Female , Humans , Infusions, Intravenous , Male , Middle Aged , Poland , Severity of Illness Index , Sex Factors , Stroke/diagnostic imaging , Survival Rate , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
The concentrations of Na+, K+, Li+ have been assayed in the epidermis samples from 58 cadavers and 20 healthy individuals. The samples have been taken from the heels, and assayed with 2 flame photometers (Corning 480), using standard solutions supplied by the manufacturer. A concentration of Na+ and K+ in men exceeded the levels of these ions in women by two-fold. A level of Li+ is the same in both sexes and amounts to 2.8 mEq/kg. The Na+:K+ ratio in the epidermis of women and men is about 4:1. In the samples collected from cadavers, the difference in Na+ and K+ levels has been lower but Li+ level has been higher, amounting to 4.3 mEq/kg.
