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Wyświetlanie 1-4 z 4
Tytuł:
HEALTH-RELATED QUALITY OF LIFE IN A PATIENT FOLLOWING ANEURYSMOTOMY OF RARE MEGA-GIANT ANEURYSM OF THE COMMON CAROTID ARTERY
Autorzy:
Pąchalska, Maria
Trystuła, Mariusz
Powiązania:
https://bibliotekanauki.pl/articles/2137955.pdf
Data publikacji:
2020-10-16
Wydawca:
Fundacja Edukacji Medycznej, Promocji Zdrowia, Sztuki i Kultury Ars Medica
Tematy:
Carotid arteries
Aneurysm
Surgical procedures
Opis:
In the subject literature there are only a few articles devoted to the Health-Related Quality of Life (HRQoL) of patients with large ex- tracranial aneurysms of the carotid artery segment. There are no reports on the quality of life of patients with rare Mega-Giant Carotid Artery Aneurysms (MGCAA) manifesting themselves as chronically large and growing neck tumors. The aim of the research was an evaluation of the health related quality of life (HRQL) of a patient following aneurysmotomy of Mega-Giant Carotid Artery Aneurysms (MGCAA). An 82-year-old patient was referred to the Department of Vascular Surgery at the John Paul II Hospital in Krakow, due to the presence of a megagiant, painful tumor covering the entire left side of the neck. A physical examination and angio-CT confirmed the pres- ence of a pulsating tumor, which extended vertically from the level of the angle of the mandible to the clavicle, and horizontally from the trachea to the cervical spine. An aneurysmotomy and recon- struction of LICA with cerebral protection using a shunt catheter was performed. The patient was awakened from anesthesia and extubated shortly after the procedure, without any Central Nervous System neurological defects. The surgery was complicated by left recurrent laryngeal nerve paresis and aphonia without dyspnoea, which was only partially resolved around 3 months after the oper- ation itself. The postoperative period was uncomplicated. Health related Quality of Life (HRQoL) was studied using the 36-Item Short Form Health Survey (SF-36) to study both the clinical symp-toms and how these symptoms would be reduced in a year follow up after the aneurysmotomy. Despite the increasing availability of endovascular options and techniques, open surgical repair of ICA aneurysms, especially Mega- Giant Carotid Artery Aneurysms (MGCAA), using cerebral protection (shunts), remains a basic option, providing an opportunity to avoid major intraoperative and postoperative complications. The aneurysmotomy, despite laryngeal nerve paresis and aphonia without dyspnoea, improves the patient’s health-related quality of life.
Źródło:
Acta Neuropsychologica; 2020, 18(4); 411-423
1730-7503
2084-4298
Pojawia się w:
Acta Neuropsychologica
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
HEALTH RELATED QUALITY OF LIFE OF THE PATIENT WITH IMMUNOGLOBULIN G4-RELATED CRANIAL HYPERTROPHIC PACHYMENINGITIS (IGG-HP) CAUSING DISTURBANCES OF COGNITIVE CONTROL TREATED WITH NEUROFEEDBACK
Autorzy:
Morga, Rafał
Radwańska, Edyta
Trystuła, Mariusz
Pąchalska, Maria
Powiązania:
https://bibliotekanauki.pl/articles/2138049.pdf
Data publikacji:
2021-09-13
Wydawca:
Fundacja Edukacji Medycznej, Promocji Zdrowia, Sztuki i Kultury Ars Medica
Tematy:
qEEG
atDCS
seizures
cognitive control
quality of life
Opis:
Health related quality of life (HRQoL) is the most desired patient centered outcome of medical care (Leplége et al. 1997). In patients with long term illness, such as Hypertrophic Pachymeningitis (HP) still under diagnosis, therefore no possible to properly cure, it might be the only outcome achievable (Netuveli et al. 2005; Trystuła 2017). The problem becomes even more serious when occurs in young person: starting a family and caring for children becomes hard or even impossible, because of his/her physical and psychical conditions. Most clinicians are aware of the importance for quality of life of this functional limitation, but there are no articles describing this problem in the literature. We aimed to fill this gap in knowledge. 29 year old patient, a car mechanic, married, with 4-year-old son, with the long his- tory of the illnes, and especially persistent, diffuse, non-specific headaches, frequent seizures and cognitive deterioration which have been particularly troublesome recently. He was finalny diagnosed with Hypertrophic Pachymeningitis (HP) associated with Immunoglobulin G4-related (IgG4) with the use of specific diagnostic criteria for HP associated with IgG4-RD (IgG4-HP), which rely on histopathologic analysis (Lindstrom et al. 2010; Lu et al 2014). Computed tomography (CT) of the head showed massive calcifications visible along the cerebellar tentorium on the right side, along the cerebral falx, as well as on dura mater on the cranial vault of both cerebral hemispheres. The patient was diagnosed with common variable immunodeficiency (D 83), thrombocytopenia, chronic EBV hepatitis and epilepsy. IgG4-HP was confirmed by CT, MRI and biopsy (IGg4-RHP antibody was detected). The treatment with steroids, and immunosuppressive therapy (RTX) was introduced (as it was suggested by Levraut et al. (2019). It should be stressed that he had a significantly reduced health-related quality of life (HRQoL), mainly because of long-lasting illness, diverse symptoms, often hospitalization, complex differential diagnosis, and especially biopsy which requires neurosurgical intervention, which affect his physical and mental well-being, especially cognitive control, and not possibility to take care of his family. To help the patient we introduce HBI methodology (Kropotov 2016), that is an evaluation of working brain in milliseconds. Quantitative electroencephalography (qEEG), event-related potentials (ERPs) and low-resolution sLORETA tomography were performed. We did not found any paroxysm of 3 Hz rhythm in Eyes Closed (EO) and in Eyes Open (EO) conditions, however the ERPs deviations from the reference indicate deficit of cognitive control (decrease of P3 NOGO wave in comparison to 100 persons from the normative data base from the Human Brain Index in Chur, Switzerland). Therefore, the patient was offered Transcranial Direct Current Stimulation (atDCS) combined with goal-oriented psychotherapy program. It was found that after 40 days of therapy, cognitive control returned, which was translated into a better quality of life related to the patient's health, measure in the 36-Item Short Form Survey (SF-36). The patient returned to his previous job as a head of car mechanic service. Final diagnosis of IgG4-HP and subsequently, proper farmacotherapy, and introduction of HBI methodology allowing for the selection of an adequate method of neurotherapy, for our patient the transcranial direct current stimulation (atDCS) combined with goal- oriented psychotherapy, was helpful in the improvement of his quality of life.
Źródło:
Acta Neuropsychologica; 2021, 19(3); 373-388
1730-7503
2084-4298
Pojawia się w:
Acta Neuropsychologica
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Quality of life of a patient with persistent complications after SARS-CoV-2 infection requiring urgent surgical intervention – endarterectomy with emergency angioplasty of an inflamed, bleeding Right Internal Carotid Artery (RICA) using the Trans-Carotid Artery Revascularization (TCAR)
Autorzy:
Hydzik, Adam
Opławski, Maxymilian
Trystuła, Mariusz
Pąchalska, Maria
Powiązania:
https://bibliotekanauki.pl/articles/29519210.pdf
Data publikacji:
2023-07-17
Wydawca:
Fundacja Edukacji Medycznej, Promocji Zdrowia, Sztuki i Kultury Ars Medica
Tematy:
long COVID
depression
diabetes
TIA
CAS
CEA
SF-36
emergency
TCAR
HRQOL
Opis:
SUMMARY The purpose of this study was to determine the quality of life of a patient with persistent complications of SARS-CoV-2 infection requiring urgens surgical intervention – endarterectomy with emergency angioplasty of an inflamed, bleeding Right Internal Carotid Artery (RICA) by direct access via Right Common Carotid Artery (RCCA), known as Transcarotid Artery Revascularization (TCAR). A patient in her 60s was infected with the SARS-CoV-2 virus and contracted COVID-19 in March 2022, as confirmed by RT PCR antigen test. The infection was followed by short- and long-term complications, many of which can be linked to COVID. These include significant weakness persisting for months after the illness, rapid weight loss of 25 kg, sleep disturbances, chronic fatigue, severe dizziness, onset of diabetes, decrease dimmunity with increased periodontal inflammation (including formation of a periapical abscess of a molar tooth) and secondary suppuration of the submandibular lymphnodes, one of which lying jacent to the right internal carotidartery (RICA). This accumulation of symptoms led the patient to seek medical and neuropsychological help. Test ingusing the Beck Depression Inventory (BDI) confirmed depression, with vegetative disorders being the most predominant. Eight months after undergoing COVID-19, the patient suffered a Transient Ischemic Attack (TIA). The accumulation of diseases (diabetes mellitus, stage III hypertension and TIA) had a dramatic impact on the patient's health, including life-threatening conditions.A vascular surgeon consulted the patient advised immediate surgical treatment: carotid endarterectomy. The urgency of the situation was exacerbated by bleeding during the operation from the operated, secondarily inflamed wall of the RICA (lying adjacent to the suppurated submandibular node). This prompted an emergency decision for an endovascular procedure: the implantation of a stent covered with water-proof material (peripheral stent graft). This was made by a direct access via puncture of the common carotid artery (RCCA) below the endarterectomy level (TCAR). The SF-36 questionnaire was chosen to measure health-related quality of life (HRQOL).The SF-36 results are presented in such a way that higher scores correspond to fewer complaints, indicating better health and higher quality of life. Before revascularization, the patient's HRQOL was found to be lower, which was related to the negative impact of long COVID, while after the procedure, the quality of life gradually improved in subsequent surveys. A significant difference was found in physical function, with a mean score of 66.0 (p<0.001) compared to a score of 94.9 (±9.4) for 100 age-matched health subjects. A similar result was found in the physical role (p < 0.001). The patient's overall quality of life score was 331.0 compared to a score of 578.0 (±111.9) for age-matched normal healthy people. Better quality of life in patients with long COVID is an important therapeutic goal that can be achieved through comprehensive, multispecialty treatment for both physical and psychological conditions.
Źródło:
Acta Neuropsychologica; 2023, 21(3); 259-278
1730-7503
2084-4298
Pojawia się w:
Acta Neuropsychologica
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
FUNCTIONAL NEUROMARKERS OF POST-TRAUMATIC STRESS DISORDER (PTSD) IN A MAJOR ISCHEMIC STROKE SURVIVOR AFTER CAROTID ENDARTERECTOMY (CEA) REVASCULARIZATION
Autorzy:
Trystuła, Mariusz
Góral-Półrola, Jolanta
Kropotov, Juri D
Pąchalska, Maria
Powiązania:
https://bibliotekanauki.pl/articles/2137757.pdf
Data publikacji:
2018-12-20
Wydawca:
Fundacja Edukacji Medycznej, Promocji Zdrowia, Sztuki i Kultury Ars Medica
Tematy:
Event-Related Potentials (ERPs)
cued GO/NOGO task
information processing
functional neuromarkers
Opis:
The aim of this study was to test the hypothesis of developing Post-Traumatic Stress Disorder (PTSD) in a major right-hemisphere ischemic brain stroke survivor half a year after CEA revascularization, with the use of Event Related Potentials (ERPs). He was in a serious condition and had limited consciousness. Therefore, the doctor informed the patient's wife about the possibility of sudden death. The patient heard this information and remembered it, which was one of the main causes of the development of PTSD. On the basis of previous research amplitudes of P3 ERP, components elicited in the cued GO/NOGO tasks have been chosen as the candidate for PTSD neuromarkers . A 44-year-old patient had a major ischemic brain stroke while sizeable atherosclerotic plaque causing critical stenosis of the internal carotid artery in Angio-CT was dioscovered. The patient was urgently operated on using CEA. After the operation he had the opportunity to see the removed plaque which had been the cause of his stroke. Despite the positive postoperative recovery, half a year later, the patient began to complain of flashbacks, anxiety, trouble in falling and staying asleep, difficulty in concentration, a loss of interest. For the diagnosis of PTSD we used Checklist Specific for a stressor (PCL-S). Additionally we used Checklist according to the Diagnostic Statistical Manual-5 (DSM-5) classification, and the patient met the PTSD criteria. The cognitive profile of the patient was measured with the use of the Wechsler Memory Test – III (WMS-III). Subsequently, the patient participated in the cued GO/NOGO task (Kropotov, 2009) with a recording 19-channel EEG. The P3 GO and NOGO waves in this task were found to be significantly smaller at p
Źródło:
Acta Neuropsychologica; 2018, 16(4); 417-429
1730-7503
2084-4298
Pojawia się w:
Acta Neuropsychologica
Dostawca treści:
Biblioteka Nauki
Artykuł
    Wyświetlanie 1-4 z 4

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