[How does it function? Stroke unit].
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Biomedical subjects
Publications and source records attributed to H Audebert.
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The practitioner plays a key role in the primary and secondary prevention of stroke. For the treatment of an acute stroke immediate transfer to a specialized stroke unit is mandatory, while secondary prevention is oriented to the etiology of stroke. The risk factors need to be controlled more stringently than is the case for primary prevention. To ensure the appropriate organization of subsequent care, knowledge of the impairment profile and the support needed by the patient is obligatory. Apart from aiding social integration and providing medical treatment, the general physician also has the task of supporting the patient and, where necessary, treating emotional disorders. The rigorous treatment of secondary complications, or the reinstitution of rehabilitation measures to minimize functional impairments are tasks that can only be performed by the general practitioner.
For patients who suffered a TIA or a stroke the risk of a second event is high. The recurrence rate, however, can be significantly reduced by a number of prophylactic strategies. Methods for secondary stroke prevention include a healthy lifestyle, intensive body exercise, a low cholesterol diet, and the cessation of smoking. High levels of blood pressure, cholesterol and blood glucose should be rigorously controlled. In particular, blood pressure levels should remain below 135/85 mmHg including a physiological day/night profile. All patients at high risk for cardiac embolism should receive oral anticoagulants. As the risk for embolic events increases with age (especially in patients with atrial fibrillation), a rigid "age-cutoff" for anticoagulation is not justified.
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From a legislative point of view, the allograft of bone marrow is considered as an organ transplant. It consists in "replacing a diseased or deficient marrow with a healthy marrow removed on a compatible living donor." This treatment has significant repercussions for the patient. Will he find, in his circle, the resources which will enable him to face the changes imposed by the marrow graft? The information can then be a way to meet the needs of the patient. Our study is based on questionnaires sent to 55 adults who underwent an allograft. Thanks to the results, we could highlight the most favourable moment for information, the person most capable of giving it, the precise content and the way best suited to the needs of the patient.