Mico Foundation Toscano
STROKE
home and after an opportunity to regain the autonomy
ACTIVITIES 'OF DAILY
by: Katia
Santarossa (OSSS trainees)
Luis Sartori (OSSS trainees)
Operators Foundation M. TOSCANO
Castions Zoppola of June 1, 2007
Patients suffering from stroke or cerebral ischemia may have different injuries of varying length, can react with depression, easy to tears or euphoria unaware of their deficits, depending on the cerebral hemisphere affected.
Usually we are dealing with people with aphasia, difficulty articulating words, or even to understand the meaning of the same, then the communication becomes difficult and complex.
should speak slowly so clearly helping us with the non-verbal language (gestures, touch the person, ...)
Another problem is food: in fact, patients may be suffering from oropharyngeal dysphagia (difficulty swallowing) . In this case it is important to use food smoothies and thick (coat) and hydrated with gelled water (found in trade with different tastes) or with the use of thickening agents (particularly dense dust that makes the liquid).
E 'need to respect their time, no hurry, stimulate them to feed themselves, wherever possible. In performing daily hygiene should explain what we do to him, encourage them in the smallest movement can accomplish. NEVER EVER replace them, but to support and encourage. In
dressing should always start from the limb affected, while in viveversa spoliation, that is Inspired by the healthy.
E 'need to pay close attention to our movements, that should not be abrupt and remember not to pull the injured limb to prevent dislocations. If the person needs to be mobilized to avoid placing the patient's bed with all the weight of the hemiplegic with the help of pillows. If unable to walk must be borne by the injured party.
you surprised to know how many resources there are in people with stroke, adaptability, ... It 's true that you never stop to learn how the old saying goes.
summary:
STROKE - CEREBRAL ISCHEMIA INJURY
right brain
HEMIPLEGIA - left hemiparesis. Non-recognition of
affected side. Non-recognition of the disease
. Non-recognition of the space left
. emotional reaction of indifference or euphoria
INJURY left brain
HEMIPLEGIA - RIGHT
hemiparesis. Speech disorder - Aphasia:
can be articulated: the person may be working
understanding: the person has difficulty in collaborating
Dysphagia-difficulty 'TO EATING
. Chopped semi-solid foods and
. Liquid food
difficult to control. Loss of appetite (sometimes) or fear of choking
CORRECT SITTING POSITION
. Erect trunk - support the pelvis backward. Lean thighs for 2 / 3
. Proper rest your feet
. Verify that the venous and lymphatic return is not blocked
POSITION IN BED
. Promote sleep
. Prevent contractures and clones
. Upper limbs in
discharge.
mobilization. Beware of the hemiplegic side
STROKE
home and after an opportunity to regain the autonomy
CARDIOVASCULAR DISEASE
cerebrovascular disease
by: Dr.
Tonizzo
Castions Zoppola of June 1, 2007
DISEASES Cardiovascular and cerebrovascular diseases
Causes of death in the world 1990 projection estimated 2020
1. lower respiratory infections, ischemic heart disease
2. diarrheal diseases unipolar depression
3. perinatal conditions
4 motor vehicle accidents. unipolar depression cerebrovascular disease
5. ischemic heart disease COPD
6. cerebrovascular diseases, respiratory infections
7. Tuberculosis Tuberculosis
8. measles war
9. motor vehicle accidents diarrheal diseases
10. congenital HIV
(Murray JL et al, Lancet, 1997; 349:1436-1442,)
In Western countries, however, are already ...
- the leading cause of death
- the leading cause of disability 'in 2001
- There was a heart attack every 4 seconds
- There was a stroke every five seconds
ischemic heart disease in Italy -> 190-000 cases / year
ischemic heart disease in Friuli -> over 3,000 new cases per year
stroke in
ITALY In Italy 130,000 new cases per year of which 40,000 are seriously disabled
The cardiovascular and cerebrovascular diseases are the "plague" in Western countries
WHY '?
diseases are caused by many "risk factors" that ... slowly over time causes irreversible damage to vascular structures ...
ITALY In Italy 130,000 new cases per year of which 40,000 are seriously disabled
The cardiovascular and cerebrovascular diseases are the "plague" in Western countries
WHY '?
diseases are caused by many "risk factors" that ... slowly over time causes irreversible damage to vascular structures ...
FACTORS AFFECTING LONGEVITY '
SMOKE - Assets and liabilities (increased risk from 2 to 3 times)
- moderate or heavy smoking
- Cardiovascular risk declines after 2-4 years of abstention
- This prevents a stroke every 26 people who stop smoking
ALCOHOL Excessive consumption (more than 2 glasses of wine a day or use of hard liquor)
-
cause hypertension - increases the risk of stroke and myocardial infarction (up to 3 times)
ACTIVITIES 'NATURAL
A moderate physical activity and constant
-
reduces blood pressure - reduces body weight
- increases good cholesterol and reduces "bad"
- improves glycemic control in
diabetes - improves mood
-
reduces blood pressure - reduces body weight
- increases good cholesterol and reduces "bad"
- improves glycemic control in
diabetes - improves mood
WHAT TYPE OF EXERCISE?
-Those activities that improve the function of the joints and encourage the development of muscle mass such as aerobics
- Those who favor the resistance to physical stress such as cycling, walking or dancing at a fast pace
What intensity 'of physical exertion?
Considering that the objective was a good preformance cardiovascular and respiratory ...
- It is recommended to maintain a heart rate between 50 and 75% of the theoretical maximum (the theoretical maximum heart rate is calculated as follows: 220 - years)
- Start gradually
-Those activities that improve the function of the joints and encourage the development of muscle mass such as aerobics
- Those who favor the resistance to physical stress such as cycling, walking or dancing at a fast pace
What intensity 'of physical exertion?
Considering that the objective was a good preformance cardiovascular and respiratory ...
- It is recommended to maintain a heart rate between 50 and 75% of the theoretical maximum (the theoretical maximum heart rate is calculated as follows: 220 - years)
- Start gradually
FOR HOW LONG? - For at least 40-50 minutes at least three times a week
CAN 'ESTIMATE THAT ...
maintaining a constant physical activity 150 minutes per week, combined with a weight loss of 5-7%
reduces mortality 'CARDIOVASCULAR OF 14% IN THREE YEARS.
DIET - Obesity
- table salt
-
Mediterranean Diet Obesity and overweight are increasingly common not only in adults but unfortunately, even in children in Campania
recent study showed that 50% of children aged school was overweight
Overweight and obesity '
urbanization and mechanization of many tasks is accompanied by important changes is that the supply sedentary.
features of this new eating habits are the "snacking" (nibble) and the use of foods with high energy density
FOODS HIGH DENSITY 'ENERGY
They have the characteristic of being more attractive because they are high in fat, starches and sugars, but are poor in water and waste.
- Damage less immediate feeling of satiety
- "dormant" appetite for a short time
MEDITERRANEAN DIET
Few appreciate that the prolongation of life achieved with the most expensive cocktail of pharmacological or surgical procedures with the most innovative and expensive it is nothing compared to avoiding becoming "patients."
cardio and cerebrovascular diseases in the preventive intervention is more feasible in the crop of the Mediterranean diet concept supported by the best scientific evidence
diet consumed in the South in the '70s in Italian with a predominance of cereals, fruits and vegetables. The added fats are vegetable (65% of added fat is olive oil).
proteins are mainly vegetable origin. Vegetable fibers are indigestible share important. Key elements are wheat, tomato, olive oil, nuts, oily fish, wine (drunk in small quantities).
WHY '?
tomatoes, olives and grapes are exposed to pro-oxidant environments (sun and heat) and therefore develop defense mechanisms with very potent antioxidant that, in the diet have been shown to reduce the atherogenicity of the "cholesterol". Oleic acid appears to have a protective effect on arteries. The seed oils are particularly rich in Vitamin E.
ANTIOXIDANTS IN MEDITERRANEAN DIET
• carotenoids • vitamin C • vitamin E •
flavonoids
• lycopene • coffee, tea, chocolate
leafy vegetables, fruits, legumes, soy, nuts are rich in Ac. Folic acid.
Folic acid and B vitamins lower blood levels of homocysteine \u200b\u200b
blood concentrations of homocysteine \u200b\u200band risk of stroke in adult men in England
maintaining a constant physical activity 150 minutes per week, combined with a weight loss of 5-7%
reduces mortality 'CARDIOVASCULAR OF 14% IN THREE YEARS.
DIET - Obesity
- table salt
-
Mediterranean Diet Obesity and overweight are increasingly common not only in adults but unfortunately, even in children in Campania
recent study showed that 50% of children aged school was overweight
Overweight and obesity '
urbanization and mechanization of many tasks is accompanied by important changes is that the supply sedentary.
features of this new eating habits are the "snacking" (nibble) and the use of foods with high energy density
FOODS HIGH DENSITY 'ENERGY
They have the characteristic of being more attractive because they are high in fat, starches and sugars, but are poor in water and waste.
- Damage less immediate feeling of satiety
- "dormant" appetite for a short time
MEDITERRANEAN DIET
Few appreciate that the prolongation of life achieved with the most expensive cocktail of pharmacological or surgical procedures with the most innovative and expensive it is nothing compared to avoiding becoming "patients."
cardio and cerebrovascular diseases in the preventive intervention is more feasible in the crop of the Mediterranean diet concept supported by the best scientific evidence
diet consumed in the South in the '70s in Italian with a predominance of cereals, fruits and vegetables. The added fats are vegetable (65% of added fat is olive oil).
proteins are mainly vegetable origin. Vegetable fibers are indigestible share important. Key elements are wheat, tomato, olive oil, nuts, oily fish, wine (drunk in small quantities).
WHY '?
tomatoes, olives and grapes are exposed to pro-oxidant environments (sun and heat) and therefore develop defense mechanisms with very potent antioxidant that, in the diet have been shown to reduce the atherogenicity of the "cholesterol". Oleic acid appears to have a protective effect on arteries. The seed oils are particularly rich in Vitamin E.
ANTIOXIDANTS IN MEDITERRANEAN DIET
• carotenoids • vitamin C • vitamin E •
flavonoids
• lycopene • coffee, tea, chocolate
leafy vegetables, fruits, legumes, soy, nuts are rich in Ac. Folic acid.
Folic acid and B vitamins lower blood levels of homocysteine \u200b\u200b
blood concentrations of homocysteine \u200b\u200band risk of stroke in adult men in England
Perry IJ et al, Lancet 1995
Most of the calories in this diet comes from carbohydrates that have different absorption if introduced as simple sugars, bread or pasta.
CLICEMICO
INDEX - E 'index' global 'absorption of carbohydrates.
- Technically, it is "the area under the curve" of blood glucose following administration of a dose of a food that contains a default amount of carbohydrates.
- More than a carbohydrate is "digested", the more its glycemic index is high.
after meal blood glucose curve after white bread and spaghetti
CLICEMICO
INDEX - E 'index' global 'absorption of carbohydrates.
- Technically, it is "the area under the curve" of blood glucose following administration of a dose of a food that contains a default amount of carbohydrates.
- More than a carbohydrate is "digested", the more its glycemic index is high.
after meal blood glucose curve after white bread and spaghetti
HIGH OR LOW GLYCEMIC INDEX (GI): WHAT? HIGH
IG
• Blood sugar rises more and more quickly
• The insulin response is more marked
• The body uses glucose for energy and "save" the fat, even the conversion of glucose into fat tends to increase
• After 2-4 hours the blood sugar falls, and come back hungry
• Over time you create an "overload" work for the pancreas
LOW GI
• Blood sugar rises more slowly and less
• The insulin response is less marked
• The use of fats and sugars for energy is more balanced
• Blood sugar remains stable for a long time and the sense of hunger is reduced
fatty acids
General
Saturated: solid at room temp. (RT) stable, or animal origin generally tropical. Monounsaturated
: thick at room temperature, stable enough, of plant origin (olive oil, hazelnuts, almonds) and animal. Polyunsaturated
: fluids at room temperature., Unstable, of vegetable origin (seed oils) or navy.
Trans: solid at room temperature, stable, with a predominantly technological.
oleic and linoleic acid content (% on total fatty acids) in Some Meats in '64 and nel''84
'
IG
• Blood sugar rises more and more quickly
• The insulin response is more marked
• The body uses glucose for energy and "save" the fat, even the conversion of glucose into fat tends to increase
• After 2-4 hours the blood sugar falls, and come back hungry
• Over time you create an "overload" work for the pancreas
LOW GI
• Blood sugar rises more slowly and less
• The insulin response is less marked
• The use of fats and sugars for energy is more balanced
• Blood sugar remains stable for a long time and the sense of hunger is reduced
fatty acids
General
Saturated: solid at room temp. (RT) stable, or animal origin generally tropical. Monounsaturated
: thick at room temperature, stable enough, of plant origin (olive oil, hazelnuts, almonds) and animal. Polyunsaturated
: fluids at room temperature., Unstable, of vegetable origin (seed oils) or navy.
Trans: solid at room temperature, stable, with a predominantly technological.
oleic and linoleic acid content (% on total fatty acids) in Some Meats in '64 and nel''84
'
The polyunsaturated w3 are found only in fish that are produced by algae but not in terrestrial plants.
They are important because it is protective for cardio cerebral vascular diseases.
They are important because it is protective for cardio cerebral vascular diseases.
protective effects of n-3 fatty acids
• They have an effective ability to control the rate of triglycerides in the blood
• They play antiplatelet action similar to that possessed by 'Aspirin
• They have a significant anti-inflammatory activity
• They possess antiarrhythmic properties of type (to prevent irregular heart rhythm) whose clinical relevance has been demonstrated in controlled clinical trials
indigestible dietary fibers play an important role both for balance glyco-metabolic control (slow down the absorption of sugars ) and for the lipid lowering blood concentrations of "bad" cholesterol
AND WINE? ...
red wine drunk in small quantities and only during the meal
• They have an effective ability to control the rate of triglycerides in the blood
• They play antiplatelet action similar to that possessed by 'Aspirin
• They have a significant anti-inflammatory activity
• They possess antiarrhythmic properties of type (to prevent irregular heart rhythm) whose clinical relevance has been demonstrated in controlled clinical trials
indigestible dietary fibers play an important role both for balance glyco-metabolic control (slow down the absorption of sugars ) and for the lipid lowering blood concentrations of "bad" cholesterol
AND WINE? ...
red wine drunk in small quantities and only during the meal Red wine is rich in antioxidants like resveratrol and flavonoids, is rich in polyphenols, which increase the synthesis of oxide nitric acid, the small amount of alcohol increases a little 'triglycerides but also increases the "good cholesterol": with 2 drinks per day, there was a 12% increase in HDL cholesterol ...
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