1.The study of risk factors of stroke in young adults in Southern Sichuan
Zongqin LI ; Xiu CHEN ; Benbing RONG ; Qianni LI ; Xingli XIAO ; Yidie LI
Chinese Journal of Nervous and Mental Diseases 2014;(10):616-619
Objective To investigate the etiology and risk factors of stroke in young adults from Southern Sichuan, China to provide a basis for prevention and treatment of stroke. Methods The data of 398 young patients with first-ever stroke (aged 18 to 44) admitted to department of Neurology, the Affiliated Hospital of Luzhou Medical College from 2009 to 2013 was retrospectively analyzed. Four hundred twenty-five cases of stroke (aged greater than or equal to 45) were re?cruited by stratified random sampling to analyze its causes and risk factors in the same period. Results ① Young stroke accounted for 6.09% of all hospitalized stroke patients in which 78.39% of young stroke was ischemic, 64.57%was male and 58.04% aged from 40 to 44. ② According to TOAST etiology classification group, the percentage of large-artery atherosclerosis, small-vessel, cardioembolism, other determined and undetermined reasons were 56.09%, 17.95%, 9.93%, 10.90% and 5.13% in young stroke, respectively. Compared with the elderly group, other determined and undetermined reasons were higher, and the small-vessel was lower in young stroke (P<0.05). Hypertensive cerebral hemorrhage accounted for 50%of Hemorrhage in young group, and the type of Hemorrhage between two groups was no statistically significant.(P>0.05).③ Risk factors analysis revealed that the constituent ratio of smoking (34.92%), hyper?lipidemia (31.41%), alcohol (20.10%), obesity (13.07%), rheumatic heart disease (6.03%) in youth group were higher whereas hypertension(66.12%), diabetes(20.47%)and coronary heart disease(10.82%)were lower in young stroke com?pared with the elderly group (P<0.05). Conclusion ①Large-artery atherosclerosis is the most common etiology of youth ischemic stroke. ② Hypertensive cerebral hemorrhage is the most frequent type in Hemorrhagic stroke. ③ Hyperten?sion, smoking and hyperlipidemia are the most common risk factors to stroke.
2.Pharmaceutical Care for Tacrolimus-associated Posterior Reversible Encephalopathy Syndrome in A Pediatric Patient with Nephrotic Syndrome
Leli TANG ; Yidie HUANG ; Xunjie ZHANG ; Lin ZHU ; Zhiping LI
Herald of Medicine 2024;43(2):292-298
Objective To present a pharmaceutical care case of a pediatric patient with nephrotic syndrome developing tacrolimus-inducedposterior reversible encephalopathy syndrome(PRES)during tacrolimus treatment,and to accumulate experience for the treatment and pharmaceutical services of related diseases.Methods Clinical pharmacists conduct an analysis and evaluation of the correlation of drug-induced PRES caused by tacrolimus in a pediatric patient.Simultaneously,regarding the latest evidence-based information,they propose optimized drug therapy recommendations and provide personalized pharmaceutical services.Results After treatment with antispasmodics,blood pressure control,intracranial pressure reduction,and tapering of tacrolimus,the clinical symptoms of the child improved.Follow-up cranial MRI demonstrated partial absorption of abnormal signals in the brain,and the lesions were significantly smaller than before.Conclusion For tacrolimus-related PRES,clinical pharmacists can enhance the long-term safety and effectiveness of patient medication through aspects such as choosing antihypertensive drugs,adjusting treatment plans based on drug concentration monitoring,and implementing targeted pharmaceutical monitoring and educatio.