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Domínguez-Mayoral A, Gutiérrez C, Sánchez-Gómez J, Pérez-Sánchez S, Fouz N, Guerrero-Zamora P, Ferrer M, Aguilar M, Galiani V, Albalá C, Moreno J, Gamero MA, García-Campos C, Banda S, Montaner J. Benefits in quality of life following an obstructive sleep apnea screening and treatment program in patients with acute ischemic stroke. Rev Neurol 2023; 76:117-125. [PMID: 36782347 PMCID: PMC10364073 DOI: 10.33588/rn.7604.2022359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Indexed: 02/15/2023]
Abstract
INTRODUCTION Obstructive sleep apnea (OSA) has been proposed as a factor that worsens stroke prognosis. Our aim was to determine if an OSA intervention could improve quality of life (QOL, first objective) and modified Rankin score (mRS, second objective). PATIENTS AND METHODS The intervention group of this quasi-experimental study included patients with acute ischemic stroke <72 hours who underwent polygraphy and Continuous Positive Airway Pressure (CPAP) and hygienic-dietary measures if required. The control group followed routine clinical practice. The Short Form 36 Health Survey (SF-36) and mRS were applied at the sixth month after stroke in both groups. RESULTS Fifty-five vs. sixty-two patients were included in the intervention and control group respectively. In the intervention group, 64.71% of patients accepted the proposed CPAP (16 cases with a good adherence). An improvement in SF-36 items was detected in the intervention group: physical functioning (p = 0.008), role physical (p = 0.002), bodily pain (p = 0.008), general health (p <0.001), vitality (p = 0.001) and role emotional (p = 0.015). In a per-protocol analysis, all these improvements were verified in the group of patients treated with good CPAP adherence (p < 0.05 in all the same SF-36 items). The percentage of patients with physical component summatory = 50 was higher in the intervention group (p = 0.003). There were no differences in the median of mRS (p = 0.262). CONCLUSIONS Although more evidence is needed, a significant improvement in QOL was suggested after our OSA intervention, particularly in patients with good CPAP adherence.
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Affiliation(s)
- A Domínguez-Mayoral
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
- Instituto de Biomedicina de Sevilla, Sevilla, España
| | - C Gutiérrez
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
| | - J Sánchez-Gómez
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
| | - S Pérez-Sánchez
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
- Instituto de Biomedicina de Sevilla, Sevilla, España
| | - N Fouz
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
| | | | - M Ferrer
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
| | - M Aguilar
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
| | - V Galiani
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
- Instituto de Biomedicina de Sevilla, Sevilla, España
| | - C Albalá
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
- Instituto de Biomedicina de Sevilla, Sevilla, España
| | - J Moreno
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
- Instituto de Biomedicina de Sevilla, Sevilla, España
| | - M A Gamero
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
- Instituto de Biomedicina de Sevilla, Sevilla, España
| | - C García-Campos
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
- Instituto de Biomedicina de Sevilla, Sevilla, España
| | - S Banda
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
- Instituto de Biomedicina de Sevilla, Sevilla, España
| | - J Montaner
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
- Instituto de Biomedicina de Sevilla, Sevilla, España
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Valenzuela-González A, Domínguez-Mayoral A, de Torres-Chacón MR, Castilla-Guerra L. [Hyperlipoproteinaemia(a) and stroke. A case report of a family with early-onset severe atherosclerotic disease]. Rev Neurol 2022; 74:35-36. [PMID: 34927703 DOI: 10.33588/rn.7401.2021188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | | | | | - L Castilla-Guerra
- Hospital Universitario Virgen Macarena, Sevilla, España.,Universidad de Sevilla, Sevilla, España
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Pérez-Sánchez S, Barragán-Prieto A, Sánchez-Miura JA, Domínguez-Mayoral A, de Torres-Chacón R, Gamero-García MA, Gálvez-San Román JL, Herrero-Lara J, Garrido-Castilla M, Cueto L, Navarro-Bustos C, Montaner J. [Delayed administration of thrombolytic therapy in minor stroke]. Rev Neurol 2021; 72:352-356. [PMID: 33978229 DOI: 10.33588/rn.7210.2020510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Minor strokes are considered to be those that present with few symptoms, although up to 40% of them entail long-term disability. The rate of thrombolysis in these patients is also lower than in other strokes. The aim of this study is to explore whether there are any differences in intravenous thrombolysis care times in minor strokes. PATIENTS AND METHODS We conducted a retrospective review of strokes treated with intravenous thrombolysis at our centre and a comparative analysis of the care times in minor strokes and in the other types. RESULTS Longer times were found in minor strokes in terms of door-to-CT scan and door-to-needle time. This was not the case, however, for the time from the onset of symptoms to arrival at the hospital. CONCLUSIONS The presence of few symptoms in minor strokes can make them difficult to recognise and could be a reason for delaying treatment. Training among staff caring for these patients is essential to improve this aspect.
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Affiliation(s)
- S Pérez-Sánchez
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
| | | | | | | | | | | | | | - J Herrero-Lara
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
| | | | - L Cueto
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
| | | | - J Montaner
- Hospital Universitario Virgen Macarena, 41003 Sevilla, España
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Eichau S, López Ruiz R, Castón Osorio J, Ramírez E, Domínguez-Mayoral A, Izquierdo G. Primary cytomegalovirus infection in a patient with relapsing-remitting multiple sclerosis under treatment with alemtuzumab. Neurología (English Edition) 2020. [DOI: 10.1016/j.nrleng.2018.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Eichau S, López Ruiz R, Castón Osorio JJ, Ramírez E, Domínguez-Mayoral A, Izquierdo G. Primary cytomegalovirus infection in a patient with relapsing-remitting multiple sclerosis under treatment with alemtuzumab. Neurologia 2018; 35:440-443. [PMID: 29907474 DOI: 10.1016/j.nrl.2018.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 01/28/2018] [Accepted: 03/01/2018] [Indexed: 11/15/2022] Open
Affiliation(s)
- S Eichau
- Servicio de Neurología, Unidad de Esclerosis Múltiple, Hospital Universitario Virgen Macarena, Sevilla, España
| | - R López Ruiz
- Servicio de Neurología, Unidad de Esclerosis Múltiple, Hospital Universitario Virgen Macarena, Sevilla, España.
| | - J J Castón Osorio
- Servicio de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Córdoba, España
| | - E Ramírez
- Servicio de Microbiología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - A Domínguez-Mayoral
- Servicio de Neurología, Unidad de Esclerosis Múltiple, Hospital Universitario Virgen Macarena, Sevilla, España
| | - G Izquierdo
- Servicio de Neurología, Unidad de Esclerosis Múltiple, Hospital Universitario Virgen Macarena, Sevilla, España
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Rojas-Marcos I, Rubí J, Blázquez A, Carbonell P, De Torres R, Domínguez-Mayoral A, Ávilla R, Martín-Casanueva M, Gutiérrez C, Márquez-Infante C, Rivas E, Paradas C, Domínguez-González C. Late onset riboflavin responsive lipid myopathy with multiple acyl-CoA dehydrogenase deficiency: Report of four patients. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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