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Psychiatric symptoms may be related to a silent cerebral infarct, a phenomenon that has been described previously in literature. Acute psychosis or other neuropsychiatric symptoms including depression may present in stroke patients and patients with lesions either within the prefrontal or occipital cortices, or in subcortical areas such as the basal ganglia, thalamus, mid-brain, and brainstem. Psychosis in clinical stroke or in silent cerebral infarction is uncommon and not well documented in the literature. Neurological deficits are the most common presentation in stroke, and nearly a third of patients that suffer a stroke may experience psychological disorders such as depression and anxiety, related to physical disability. The present case report describes an elderly female patient who presented with hallucinations and depressive symptoms, and was discovered to have a recent right frontal brain infarction, without other significant neurological deficits.
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Smoking is a well-known risk factor of cancer, chronic disease, and cerebrovascular disease. Hospital admission is a good time to quit smoking but patients have little opportunity to take part in an intensive smoking cessation intervention. The purpose of this study was to identify the factors of successful smoking cessation among stroke patients who undergo an intensive cessation intervention during the hospitalization period.
Thirty-nine male smokers who were admitted with stroke were enrolled in the study. They participated in a smoking cessation intervention during hospitalization. Smoking status was followed up by telephone 3 months later. Nicotine dependence, sociodemographic factors, and other clinical characteristics were assessed.
After 3 months post-intervention, the number of patients who stopped smoking was 27 (69.2%). In addition, there was no significant difference in nicotine dependence, sociodemographic factors, and clinical characteristics. Only the stages of readiness for smoking cessation were a significant predictor (odds ratio, 18.86; 95% confidence interval, 1.59–223.22).
This study shows that a patient's willingness to quit is the most significant predictor of stopping smoking after Inpatient cessation Intervention for stroke Patients.
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Coffee is one of the most widely consumed beverages in the world, and contains caffeine and phenolic compounds. Many studies on the association between coffee consumption and risk of stroke have been reported, however, more research is needed to further explore many studies' inconsistent results. Therefore, we conducted a meta-analysis to verify the relationship between coffee consumption and stroke.
We searched MEDLINE (PubMed), EMBASE, and the Cochrane Library, using the keywords "coffee" or "caffeine" for the exposure factors, and "transient ischemic attack" or "stroke" or "acute cerebral infarction" or "cardiovascular events" for the outcome factors. We included prospective cohort and case-control studies published between 2001 and July 2011 in this review. The search was limited to English language.
Among 27 articles identified for this review, only 9 studies met the inclusion criteria, all of which were cohort studies. When using all cohort studies, the pooled relative risk (RR) of stroke for the highest vs. lowest category of coffee consumption was 0.83 (95% confidence interval [CI], 0.76 to 0.91). When subgroup analysis was performed, for Europeans, increased coffee drinking showed a preventive effect on stroke occurrence with RR 0.82 (95% CI, 0.74 to 0.92); RR for women 0.81 (95% CI, 0.70 to 0.93); for ischemic stroke 0.80 (95% CI, 0.71 to 0.90); and for those drinking 4 cups or more per day 0.83 (95% CI, 0.75 to 0.91).
We found that coffee consumption of 4 cups or more per day showed a preventive effect on stroke in this meta-analysis.
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