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1.
J Stroke Cerebrovasc Dis ; 27(10): 2731-2737, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30056003

RESUMO

BACKGROUND: Several studies have shown that high level of plasma C-reactive protein (CRP) is associated with stroke outcomes and future vascular events, and a decrease in serum triiodothyronine (T3) was reported to be associated with stroke severity and poor prognosis. OBJECTIVE: The goal of this study is to evaluate CRP and T3 as independent predictors of poor functional and cognitive outcomes in patients with acute ischemic stroke at hospital discharge. METHODS: This study evaluated 120 patients who were admitted to the Clinical Hospital of Neurology and Psychiatry Brasov, between July 2016 and January 2017. The patients were evaluated for clinical stroke severity (National Institutes of Health Stroke Scale) and serum CRP and total T3 were evaluated on admission. Functional outcome and cognitive outcome were evaluated at discharge. RESULTS: The severity of NIHHS scores were associated with higher CRP levels (ß = .583, P = .000) and lower T3 concentration (ß = -.185, P = .043). Poor cognitive prognosis was associated with CRP levels (ß = .441, P = .000) but not with T3 concentrations (P = .142). Poor functional outcome was associated with higher CRP levels (ß = .457, P = .000), but not with T3 concentrations (P = .100). Using CRP and T3 as prognostic factors resulted in a probability of 53.5% to predict a poor functional outcome and of 80.42% to predict a poor cognitive outcome in stroke patients at discharge. CONCLUSIONS: The study showed that higher CRP and lower T3 levels were associated with stroke severity on admission. Functional outcome is likely secondary to stroke severity but functional outcome at discharge was associated with higher CRP levels and not with T3 concentration. Cognitive outcome was associated with higher CRP levels and not with T3 concentration.


Assuntos
Isquemia Encefálica/sangue , Proteína C-Reativa/análise , Acidente Vascular Cerebral/sangue , Tri-Iodotironina/sangue , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/fisiopatologia , Isquemia Encefálica/psicologia , Cognição , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Admissão do Paciente , Alta do Paciente , Valor Preditivo dos Testes , Recuperação de Função Fisiológica , Romênia , Índice de Gravidade de Doença , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Resultado do Tratamento
2.
Acta Dermatovenerol Croat ; 23(2): 108-13, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26228822

RESUMO

Patients with neoplasia who are severely immunocompromised have a higher risk of fungal infections. There are limited data in the literature regarding the frequency of dermatophyte infections and efficacy of antifungals in patients with malignancies. Objective was assessment of the incidence of dermatophyte infections and antifungal susceptibility, determination of dermatophyte species isolated from patients with neoplastic diseases. 138 patients diagnosed with various malignancies and 160 immunocompetent patients who were referred to the Department of Dermatology in Brasov, Romania, for suspicion of dermatophyte infections were included in the study. Nail clippings or skin scrapings were examined by direct microscopy and cultures in Sabouraud agar medium. Susceptibility tests for antifungals were conducted in vitro using a method of broth microdilution. Infections with dermatophytes were identified in 30.4% of patients with neoplastic diseases and in 29.37% in the control group. There was a significantly higher frequency of dermatophyte infections in patients with hematologic malignancies (52%) compared to those with solid cancers (25.66%) (P=0.01). The clinical aspects of dermatophyte infections in patients with neoplastic diseases were not different from those of patients without cancer; though in some cases the infections were more extensive. There were no statistically significant differences between mean values of minimum inhibitory concentration of antifungals compared with controls. Terbinafine had the highest antidermatophyte activity for all tested dermatophyte species isolated from patients with neoplastic diseases. There were no differences in frequency of dermatophyte infections and antifungal susceptibility to dermatophytes between patients with neoplastic diseases and immunocompetent patients.


Assuntos
Antifúngicos/uso terapêutico , Arthrodermataceae/efeitos dos fármacos , Dermatomicoses/epidemiologia , Neoplasias/microbiologia , Infecções Oportunistas/imunologia , Adulto , Idoso , Antifúngicos/farmacologia , Arthrodermataceae/isolamento & purificação , Estudos de Casos e Controles , Dermatomicoses/tratamento farmacológico , Dermatomicoses/microbiologia , Feminino , Seguimentos , Humanos , Hospedeiro Imunocomprometido/imunologia , Masculino , Testes de Sensibilidade Microbiana/estatística & dados numéricos , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Neoplasias/epidemiologia , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/epidemiologia , Prevalência , Valores de Referência , Medição de Risco
3.
Acta Dermatovenerol Croat ; 23(1): 28-35, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25969910

RESUMO

Many studies have suggested that cardiovascular risk factors seem to be more common in patients with psoriasis than in the general population. In this study we aimed to determine the prevalence of cardiovascular risk factors in patients with chronic plaque psoriasis depending on the severity of disease. We conducted a prospective study in Brasov County (Romania) including 142 patients with chronic plaque psoriasis and disease duration of at least six months and 167 controls without psoriasis. The severity of psoriasis was assessed using the psoriasis area and severity index (PASI) score. Along with a thorough medical history and physical examination, serum lipid profile and fasting plasma glucose tests were carried out. The 10-year Framingham risk score (FRS) for general cardiovascular disease, which includes age, gender, total cholesterol, HDL-cholesterol, systolic blood pressure, smoking status, and diabetes mellitus, was applied. The severity of chronic plaque psoriasis was mild in 32 patients (22.53%) and moderate to severe in 110 patients (77.47%). We found a significant higher prevalence of metabolic syndrome in the patient group compared to controls. Individual components of metabolic syndrome like waist circumference, elevated triglycerides, reduced HDL-C, impaired fasting plasma glucose, and arterial hypertension were also more prevalent in patients than in controls. Mean triglycerides, total cholesterol, LDL-cholesterol and HDL-cholesterol levels were significantly raised in patients with psoriasis when compared to controls. The 10-year FRS was significantly higher in patients with psoriasis than in controls (8.36±5.75 vs. 6.61±4.13; P<0.001). FRS was higher in men (P=0.012) and in patients older than 50 years (P=0.008). According to the severity of psoriasis, FRS increases significantly from mild to moderate-to-severe psoriasis (6.82±4.48 to 8.8±6.71; P=0.003). Psoriasis, and especially moderate to severe psoriasis, seems to represent a risk factor for cardiovascular disease. Patients with psoriasis should be risk-assessed for cardiovascular diseases, and comorbidities should be actively managed.


Assuntos
Doenças Cardiovasculares/etiologia , Psoríase/complicações , Adulto , Idoso , Estudos de Casos e Controles , Doença Crônica , Dislipidemias/epidemiologia , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Psoríase/sangue , Fatores de Risco , Romênia
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