Rehabilitation outcomes of stroke patients treated with multi-modal endovascular reperfusion therapy.

AIM: The aim of this study was to investigate the influence of multi-modal endovascular reperfusion therapy (MMRT) on functional outcomes following rehabilitation. METHODS: Data from 14 MMRT-treated patients were analyzed and compared to MMRT-ineligible, age and stroke severity-matched patients treated at the same Neurological and Rehabilitation departments. Neurological evaluation was assessed with the NIH stroke scale (NIHSS). Activity of daily living was measured using the FIMTM instrument. Functional outcome was measured using the modified Rankin scale (mRS). RESULTS: The baseline characteristics of both groups were similar. NIHSS scores were lower in the MMRT group and they had slightly better functional and rehabilitation scores on admission to rehabilitation. At the end of rehabilitation, more MMRT-treated patients reached functional independence (mRS≤2; 50% vs. 7% respectively P=0.03). FIM scores were also higher in the MMRT group (mean score 93.3 vs. 87.7, respectively) but the difference did not reach significance. The delta in FIM and NIHSS scores obtained during rehabilitation did not significantly differ between the groups. MMRT remained a significant modifier of good outcome after regression analysis (OR 21.5 95% CI 1.1-410). CONCLUSION: MMRT-treated patients have better chances of attaining independence after rehabilitation therapy. However, the additional improvements gained while in active rehabilitation were independent of reperfusion status.

Evaluation of T-lymphocyte subtypes in the diagnosis of celiac disease.

The objectives of this study were to verify comparatively clinical age reported antecedents and the morphological aspect of the intestinal mucosa in patients sensitive to gluten, hospitalised at IOMC ("Alfred Russescu" Hospital) in the last 7 years. Celiac disease is an inflammation most frequently affecting the proximal small intestine, depending on the presence of gluten in the diet, whose pathogenesis seems to be immunological in nature. 107 cases were divided in three groups following clinical manifestations types at hospitalisation time: typical digestive, untypical digestive and extra digestive manifestations. Intestinal biopsies, made with Crosby probe, in children aged between 1.3 and 8 years (one single case was diagnosed as late as at the age of 15), regardless of gender. Then we analysed morphologically (HE usual and PAS histochemical staining) and immunohistochemically (lymphocytes B, T with possible subtypes). The lesions were counted at the first biopsy according to the Marsh score. The immunohistochemical tests have indicated the prevalence of T lymphocytes (UCHL1, CD3, CD4, CD8, gamma-delta) both in the luminal epithelium with various degrees of aggression in lamina propria and also spread in stroma. B-lymphocytes (L26) are distributed prevalently nodular in stroma. In conclusion, it is CD4 T cells that are present in particular in the control of the gluten immune response in patients with Marsh I and Marsh III lesions.