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  1. Article: Does the Implementation of a National Health Insurance Program Result in Rationing Care for Ischemic Stroke Management? Analysis of the Indonesian National Health Insurance Program.

    Amalia, Lisda

    Risk management and healthcare policy

    2023  Volume 16, Page(s) 455–461

    Abstract: Background: There are 2.2 million stroke patients in Indonesia, and ischemic stroke represents 87% of all strokes. Ischemic stroke is one of the covered diseases (INA-CBGs) in the National Health Insurance (JKN). Based on the Indonesian Ministry of ... ...

    Abstract Background: There are 2.2 million stroke patients in Indonesia, and ischemic stroke represents 87% of all strokes. Ischemic stroke is one of the covered diseases (INA-CBGs) in the National Health Insurance (JKN). Based on the Indonesian Ministry of Health's data, stroke uses up 1% of the yearly budget. This study compares clinical outcomes and treatment patterns before and during the JKN era.
    Methods: A cross-sectional analytical study of ischemic stroke medical records treated at Hasan Sadikin Hospital in 2013 and 2015 as representatives of the before and during JKN era. Chi-Square is used for data processing relationship analysis.
    Results: 164 ischemic stroke patients were treated, 75 before implementing the JKN program and 89 after implementing the JKN program. There was a significant difference between treatment patterns (
    Conclusion: There is significant different between treatment pattern and clinical outcome of ischemic stroke patients before and after implementing The Indonesian National Health Insurance. This program has improved clinical outcomes concerning the purpose of the JKN program to provide social protection and welfare in terms of health.
    Language English
    Publishing date 2023-03-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 2495128-6
    ISSN 1179-1594
    ISSN 1179-1594
    DOI 10.2147/RMHP.S405986
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Characteristic of Acute Ischemic Stroke Patients Based on TOAST Classification During COVID-19 Pandemic Era: A Single Centre Study.

    Amalia, Lisda

    International journal of general medicine

    2023  Volume 16, Page(s) 581–588

    Abstract: Introduction: The categorization system used in the Trial Org 10172 classification in Acute Stroke Treatment (TOAST) provided more insight into the causal process. The aims of this study were to characterize individuals with acute ischemic stroke using ... ...

    Abstract Introduction: The categorization system used in the Trial Org 10172 classification in Acute Stroke Treatment (TOAST) provided more insight into the causal process. The aims of this study were to characterize individuals with acute ischemic stroke using the TOAST criteria and to determine risk variables for patients with acute ischemic stroke during the COVID-19 pandemic.
    Methods: A cross-sectional study was done on the medical records of acute ischemic stroke patients at Hasan Sadikin Hospital (RSHS) Bandung, Indonesia, who were hospitalized in the Neurology Department of Hasan Sadikin Hospital from January to December 2021. Eligible patients were divided into 2 groups, with and without COVID-19 infection.
    Results: There were 136 participants with acute ischemic stroke. Thirty-one percent of strokes were caused by atherosclerosis in the large arteries (LAA), followed by small-vessel occlusion (SVO) (25%), cardioembolism (CE) (22.1%), an undetermined cause (21.3%), and an other etiology (1.5%). CE risk factor was atrial fibrillation (p < 0.001), while hypertension, diabetes, and smoking were significant for LAA (p < 0.05). However, in patients with COVID-19 who had an acute ischemic stroke, most of the subtypes were stroke of undetermined etiology (76%), and hypercoagulation was the main risk factor (p < 0.001).
    Conclusion: Patients with and without COVID-19 show varied distributions of stroke subtypes according to the TOAST categorization. Hypercoagulation is a major risk factor for stroke of undetermined etiology in individuals with COVID-19 who suffer from acute ischemic stroke. Increased viral-mediated endothelial inflammation leading to aberrant coagulopathy may explain the correlation between COVID-19 and acute ischemic stroke.
    Language English
    Publishing date 2023-02-17
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2452220-X
    ISSN 1178-7074
    ISSN 1178-7074
    DOI 10.2147/IJGM.S394017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Factors Affecting the Delay of intravenous Thrombolysis in Hyperacute Ischemic Stroke Patients: A Single Centre Study.

    Amalia, Lisda

    International journal of general medicine

    2023  Volume 16, Page(s) 2157–2163

    Abstract: Introduction: Intravenous thrombolysis with r-tPA is the gold standard procedure in managing acute ischemic stroke recommended by the World Stroke Association, which is performed by injecting the drug r-tPA (Alteplase) intravenously. Generally, the ... ...

    Abstract Introduction: Intravenous thrombolysis with r-tPA is the gold standard procedure in managing acute ischemic stroke recommended by the World Stroke Association, which is performed by injecting the drug r-tPA (Alteplase) intravenously. Generally, the preparation time to achieve thrombolysis is divided into pre-hospital and in-hospital. If this time can be shortened, the efficacy of thrombolysis can be increased. This study aims to determine the factors that can affect the delay in thrombolysis.
    Methods: This is an analytic observational study with a retrospective cohort design in ischemic stroke confirmed by a neurologist at the neurology emergency unit of Hasan Sadikin Hospital (RSHS) from January 2021 to December 2021 and divided into two groups, delay and non-delay thrombolysis. A logistic regression test was performed to determine the independent predictor of delayed thrombolysis.
    Results: There were 141 patients with an ischemic stroke diagnosis confirmed by a neurologist at the neurological emergency unit at Hasan Sadikin Hospital (RSHS) from January 2021 to December 2021. A total of 118 (83.69%) patients were included in the "delay" category, while 23 (16.31%) patients were included in the "non-delay" category. Patients included in the "delay" category had an average age of 58.29+11.19 years with a male-to-female sex ratio of 57%, while patients included in the "non-delay" category had an average age of 55.57+15.55 years with a male-to-female sex ratio of 66%. The NIHSS admission score was a significant risk factor for delayed thrombolysis. Through multiple logistic regression, it was found that age, onset, female gender, NIHSS admission score, and NIHSS discharge score were independent predictors of delayed thrombolysis. However, all of them were not statistically significant.
    Conclusion: Gender, risk factors for dyslipidemia, and arrival onset are independent predictors of delayed thrombolysis. Prehospital factors contribute relatively more to the delay in thrombolytic action.
    Language English
    Publishing date 2023-05-31
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2452220-X
    ISSN 1178-7074
    ISSN 1178-7074
    DOI 10.2147/IJGM.S412262
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: D-Dimer Level Associated with Amount of Sinus involvement Using Digital Subtraction Angiography on Cerebral Venous Thrombosis Patients.

    Amalia, Lisda

    Journal of blood medicine

    2023  Volume 14, Page(s) 303–308

    Abstract: Background: Cerebral venous sinus thrombosis (CVST) is a form of the cerebrovascular disease characterized by varying degrees of obstruction of veins and cerebral sinuses caused by thrombus. Diagnosis is incredibly challenging due to the wide variety of ...

    Abstract Background: Cerebral venous sinus thrombosis (CVST) is a form of the cerebrovascular disease characterized by varying degrees of obstruction of veins and cerebral sinuses caused by thrombus. Diagnosis is incredibly challenging due to the wide variety of symptoms and the distinct radiological aspects of affected vessels. In patients with venous thrombosis, the presence of D-Dimer is used as an indicator of the presence of endogenous fibrinolysis. D-Dimer is a by-product of fibrin polymer fragmentation.
    Objective: To investigate the relationship between the level of D-Dimer and the number of sinuses in CVST by Digital Subtraction Angiography (DSA).
    Methods: Retrospective data from September 2021 to September 2022 were used in this analytical observational with a cross-sectional study design. Chi-Square is used for data processing relationship analysis.
    Results: Out of the 54 subjects with elevated levels of D-Dimer, 38 (70.4%) are females, whereas 16 (29.6%) are males. High levels of D-Dimer have been related to a greater risk of sinus thrombosis (p < 0.001). D-Dimer levels were similarly shown to rise in conjunction with the number of sinuses most severely damaged by thrombosis. The most common site for thrombosis to develop in this study were the left sigmoid and left transverse sinuses. Most risk factors were hormonal.
    Conclusion: There is a statistically significant relationship between an increase in the D-Dimer level and the greater number of sinuses involved as determined by DSA in individuals diagnosed with CVST.
    Language English
    Publishing date 2023-04-17
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2587464-0
    ISSN 1179-2736
    ISSN 1179-2736
    DOI 10.2147/JBM.S399661
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Correlation Between Hypercoagulable State and Severity Level of Ischemic Stroke With Covid-19 Infection.

    Amalia, Lisda

    Journal of blood medicine

    2023  Volume 14, Page(s) 537–542

    Abstract: Background: Hypercoagulable state in acute ischemic stroke patients with COVID-19, was found to occur in most cases, may affect the severity and clinical outcome of acute ischemic stroke with COVID-19. Ischemic stroke patients with COVID-19 infection ... ...

    Abstract Background: Hypercoagulable state in acute ischemic stroke patients with COVID-19, was found to occur in most cases, may affect the severity and clinical outcome of acute ischemic stroke with COVID-19. Ischemic stroke patients with COVID-19 infection have worsen prognosis in mortality regarding hypercoagulable state condition.
    Objective: The study aims to determine the relationship between the hypercoagulable state and the severity of acute ischemic stroke patients with COVID-19.
    Methods: This study is a retrospective analytic study using a cross-sectional method in acute ischemic stroke who meet the criteria must have focal clinical symptoms or global dysfunction lasting more than 24 hours, be caused by vascular factors, be confirmed positive for COVID-19, NIHSS (admission and discharge), and have an examination of D-dimer and/or fibrinogen. Chi-Square is used for data processing relationship analysis.
    Results: A total of 32 patients met the inclusion and exclusion criteria of this study. Elevated D-dimer and/or fibrinogen were found in 28 patients (87.5%), confirming a hypercoagulable state. In this study, the average value of D-dimer was 5.3 mg/mL, and fibrinogen was 479 mg/dL. Based on the admission NIHSS score, it was found that most of the patients had moderate strokes with an average NIHSS score of 12. The chi-square test results showed no relationship between the hypercoagulable state and the severity of acute ischemic stroke as measured by NIHSS admission (p=0.333), but it was closely related to NIHSS exit (p=0.02). The finding supports that 40.62% of acute ischemic stroke patients with COVID-19 confirmed to have a hypercoagulable state had a death discharge status.
    Conclusion: There is no significant relationship between hypercoagulable state and stroke severity on admission, but it closely related to NIHSS on discharge and high mortality in acute ischemic stroke patients with COVID-19.
    Language English
    Publishing date 2023-10-11
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2587464-0
    ISSN 1179-2736
    ISSN 1179-2736
    DOI 10.2147/JBM.S429357
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: The Role of Platelet-Selectin as a Marker of Thrombocyte Aggregation on Cerebral Sinus Venous Thrombosis.

    Amalia, Lisda

    Journal of blood medicine

    2022  Volume 13, Page(s) 267–274

    Abstract: Cerebral sinus venous thrombosis (CVST) is a disease caused by occlusion of intracranial venous structures, including the cerebral sinuses, cortical veins, and the proximal jugular vein. Delay in diagnosis and therapy can lead to complications such as ... ...

    Abstract Cerebral sinus venous thrombosis (CVST) is a disease caused by occlusion of intracranial venous structures, including the cerebral sinuses, cortical veins, and the proximal jugular vein. Delay in diagnosis and therapy can lead to complications such as bleeding infarction and even death. Thrombosis that causes CVST is the process of forming a blood clot in a blood vessel. Thrombosis occurs when the balance between thrombogenic factors and the protective mechanisms of thrombogenesis is disturbed. Platelet function abnormalities in CVST cases can be in the form of impaired adhesion function, impaired release or secretion reactions, and impaired aggregation function. Dysfunction and disruption of endothelial structure due to inflammation causes platelet adhesion so that platelets stick together with collagen in endothelial cells. Platelet-selectin is a type 1 transmembrane protein in platelet granules and megakaryocytes and plays a role in mediating interactions between leukocytes and ligands that help the adhesion process of leukocytes and platelets so that they can be used as predictors of thrombosis in patients with CVST.
    Language English
    Publishing date 2022-05-25
    Publishing country New Zealand
    Document type Journal Article ; Review
    ZDB-ID 2587464-0
    ISSN 1179-2736
    ISSN 1179-2736
    DOI 10.2147/JBM.S356028
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Serum erythropoietin in acute ischemic stroke: preliminary findings.

    Amalia, Lisda / Saputra, Gilang Nispu

    Scientific reports

    2024  Volume 14, Issue 1, Page(s) 2661

    Abstract: Ischemic stroke is the most common stroke, caused by occlusion of cerebral vessels and leading causes of disability. Erythropoietin (EPO) has non-hematopoietic effects as a neuroprotectant after ischemic event. This study aimed to learn the serum level ... ...

    Abstract Ischemic stroke is the most common stroke, caused by occlusion of cerebral vessels and leading causes of disability. Erythropoietin (EPO) has non-hematopoietic effects as a neuroprotectant after ischemic event. This study aimed to learn the serum level of EPO in acute ischemic stroke. This cross-sectional study of ischemic stroke patients with onset < 24 h and consecutive sampling was used to collect the data from medical records review, physical examinations, head CT, 24-h EPO, 24-h and seventh-day NIHSS. A total of 47 patients consisting of 59.6% women, with a median age of 53 years old (21-70). The median 24 h EPO level was 808.6 pg/mL (134.2-2988.9). The relationship between 24 h-EPO and 24-h NIHSS were not significant (r = 0.101; p = 0.250), nor to 7th day NIHSS (r =  - 0.0174; p = 0.121) and to delta NIHSS (r = 0.186; p = 0.106). The relationship of blood collection time (hour) and EPO was significant (r =  - 0.260; p = 0.039). There was a statistically significant difference between serum EPO levels in ischemic stroke patients with lacunar stroke compared to non-lacunar stroke (288.5 vs. 855.4 ng/mL; p = 0.021). There was a relationship between the time of collection of blood and the level of EPO and also there was difference EPO level in lacunar stroke subtype compared with non-lacunar. The relationship between EPO and NIHSS lost significance after analysis. There is a need for a future study comparing each stroke risk factor and the same blood collection time.
    MeSH term(s) Female ; Humans ; Male ; Middle Aged ; Brain Ischemia ; Cross-Sectional Studies ; Erythropoietin ; Ischemic Stroke ; Stroke ; Stroke, Lacunar
    Chemical Substances Erythropoietin (11096-26-7) ; EPO protein, human
    Language English
    Publishing date 2024-02-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-024-53180-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Hypercoagulable State Induced Spinal Cord Stroke After Coronavirus Disease 19 Infection.

    Amalia, Lisda

    Journal of blood medicine

    2021  Volume 12, Page(s) 1057–1060

    Abstract: Background: Spinal cord stroke after coronavirus disease 19 (COVID-19) infection is rare, and limited cases have been reported. Spinal cord ischemia after COVID-19 infection is related to increased coagulopathy with thromboembolic consequences. Patients ...

    Abstract Background: Spinal cord stroke after coronavirus disease 19 (COVID-19) infection is rare, and limited cases have been reported. Spinal cord ischemia after COVID-19 infection is related to increased coagulopathy with thromboembolic consequences. Patients with COVID-19 may have a hypercoagulable state and an increased rate of thromboembolic events, such as occlusion in the spinal artery.
    Case presentation: We report a male case with confirmed COVID-19 infection, aged 60 years, with flaccid paraplegia, hyporeflexia, loss of sensation below the 12th thoracic level, loss of autonomic function, bilateral positive Babinski sign 14 days after the onset of flu-like symptoms, and elevated serum D-dimer and fibrinogen levels. There was stenosis of the spinal artery at the 12th thoracic level in magnetic resonance imaging and magnetic resonance angiography. He showed improvement in motor strength of the lower limb (walking with assistance), numbness and pain, and urine and fecal retention after receiving a subcutaneous anticoagulant.
    Conclusion: COVID-19 can damage endothelial cells and activate thrombotic pathways, which can lead to clinical thromboembolic complications, such as occlusion in the spinal artery, resulting in spinal cord stroke.
    Language English
    Publishing date 2021-12-14
    Publishing country New Zealand
    Document type Case Reports
    ZDB-ID 2587464-0
    ISSN 1179-2736
    ISSN 1179-2736
    DOI 10.2147/JBM.S329449
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Glial Fibrillary Acidic Protein (GFAP): Neuroinflammation Biomarker in Acute Ischemic Stroke.

    Amalia, Lisda

    Journal of inflammation research

    2021  Volume 14, Page(s) 7501–7506

    Abstract: Introduction: Blockage of the cerebral arteries due to thrombosis and embolism resulting in decreased blood flow to the brain, reduced oxygen supply to the brain, resulting in neuronal damage and causes astrocyte cells to secrete glial fibrillary acidic ...

    Abstract Introduction: Blockage of the cerebral arteries due to thrombosis and embolism resulting in decreased blood flow to the brain, reduced oxygen supply to the brain, resulting in neuronal damage and causes astrocyte cells to secrete glial fibrillary acidic protein (GFAP). The objective of this study was to determine the correlation between GFAP levels serum and clinical outcome in patients with acute ischemic stroke.
    Methods: This was observational with a cross-sectional design on acute ischemic stroke patients confirmed by CT scans and divided into large vessel occlusion and small-vessel occlusion. Clinical outcome was measured using the National Institutional Health Stroke Scale (NIHSS) tool. Statistical analysis uses Spearman's rank correlation test and Mann Whitney's test, significant if p < 0.05.
    Results: After collecting 33 research subjects, we found 16 people with large vessel occlusion and 17 people with small vessel occlusion. Serum GFAP levels were 0.2-1.9 ng/mL, 9.1% with a mild neurological deficit, 45.45% were moderate neurological deficits, and 45.45% were severe neurological deficits. There was a significant positive correlation (r = 0.522; p = 0.002) between serum GFAP levels and the degree of neurological deficit in ischemic stroke patients. There was a statistically significant difference between serum GFAP levels in ischemic stroke patients with CT scan results of large artery occlusion compared to small artery occlusion (0.7 vs 0.4ng/mL; p = 0.001).
    Conclusion: There was a positive correlation between GFAP level serum and NIHSS score on acute ischemic stroke. The higher the value of GFAP serum level, the higher the value for NIHSS and correlated with stroke severity and the extent of brain damage in ischemic stroke patients.
    Language English
    Publishing date 2021-12-30
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 2494878-0
    ISSN 1178-7031
    ISSN 1178-7031
    DOI 10.2147/JIR.S342097
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Difference between Nutrition Status in First and Recurrent Ischemic Stroke Patients

    Lisda Amalia / Shafa Ayu Khairunnisa

    Global Medical & Health Communication, Vol 11, Iss

    a Retrospective Cross-Sectional Study

    2023  Volume 3

    Abstract: Malnutrition in stroke patients can be caused by neurological deficits such as decreased consciousness, dysphagia, cranial nerve paresis, and hemiparesis/hemiplegia. The condition of malnutrition seriously impacts healing and can exacerbate the ... ...

    Abstract Malnutrition in stroke patients can be caused by neurological deficits such as decreased consciousness, dysphagia, cranial nerve paresis, and hemiparesis/hemiplegia. The condition of malnutrition seriously impacts healing and can exacerbate the underlying disease, in this case, stroke, so malnutrition in stroke patients extends the length of stay and increases morbidity and mortality. This study compares nutritional status between first and recurrent ischemic stroke patients based on body mass index (BMI) and subjective global assessment (SGA). This study is a comparative analysis of the medical records of ischemic stroke patients in Dr. Hasan Sadikin General Hospital Bandung from January 2018 until December 2020. The chi-square and Fisher's exact tests were used for statistical analysis. The significance criteria are the p-value if p≤0.05 means statistically significant. A total of 236 subjects in both groups of first and recurrent ischemic stroke patients consisting of 130 men and 106 women with an average age of 56.64 and 61.75 years, and the majority had risk factors for hypertension. The first ischemic stroke group has a good nutrition status compared with the recurrent stroke group (p<0.05). Thirteen patients (11.02%) of first ischemic stroke and 11 patients of recurrent ischemic stroke (9.32%) were underweight, 67 patients (56.78%) of first ischemic stroke and 74 patients of recurrent ischemic stroke (62.71%) had average weight, 31 patients (26.27%) first ischemic stroke and 33 patients (27.97%) recurrent ischemic stroke were overweight, five patients (4.24%) first ischemic stroke and seven patients (5.93%) recurrent ischemic stroke were obese (p<0.05). In conclusion, there was a significant difference in the nutritional status of first and repeated ischemic stroke patients. The nutritional status of recurrent ischemic stroke patients is worse than that of first ischemic stroke patients.
    Keywords bmi ; first ischemic stroke ; nutritional status ; recurrent ischemic stroke ; sga ; Medicine ; R ; Medicine (General) ; R5-920
    Subject code 616
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher Universitas Islam Bandung
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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