Clopidogrel is increasingly being used for the secondary prevention of ischemic stroke according to the updated guidelines on acute stroke management. Failure to achieve a drug response is referred to as clopidogrel resistance. Similarly, a higher activation of platelets during clopidogrel therapy—high on-treatment platelet reactivity—is equivalent to a reduced effectiveness of a therapy. Clopidogrel resistance is considered to be a common and multifactorial phenomenon that significantly limits the efficacy of antiplatelet agents. The aim of the current study is to review the latest literature data to identify the prevalance and predictors of clopidogrel high on-treatment platelet reactivity among stroke subjects and to establish the potential impact on clinical outcomes and prognosis. Clinical databases were searched by two independent researchers to select relevant papers on the topic, including all types of articles. Several important predictors contributing to clopidogrel resistance were identified, including genetic polymorphisms, the concomitant use of other drugs, or vascular risk factors, in particular nonsmoking and diabetes. Clopidogrel high on-treatment platelet reactivity has a negative impact on the clinical course of stroke, worsens the early- and long-term prognoses, and increases the risk of recurrent vascular events. Platelet function testing should be considered in selected stroke individuals, especially those predisposed to clopidogrel resistance, for whom an improvement in the efficacy of antiplatelet therapy is essential. This particular group may become the greatest beneficiaries of the modification of existing therapy based on platelet function monitoring.

Aim: This study investigated the status of job burnout, work‐related depression and job satisfaction among neurological and neurosurgical nurses in Poland.Design: A cross‐sectional and multicentre study.Methods: The sample consisted of 206 neurological and neurosurgical nurses, all of whom completed a self‐report questionnaire designed by the authors.Results: The results revealed a work‐related burnout incidence of 32%, colleague‐related burnout incidence of 44.2% and patient‐related burnout incidence of 22.8%. Nurses working in neurological departments were statistically over three times more likely to struggle with colleague‐related burnout than nurses working in neurosurgical departments were. Further, work‐related burnout was higher in people aged above 54 years than those in the youngest age category. Nonetheless, 71.8% of the nurses expressed satisfaction with their work. In sum, our results indicated that job burnout is common among registered nurses and that personal (age) and workplace (type of ward, distance to work, experience and shift work) factors contributed to symptoms of burnout.

The ongoing COVID-19 pandemic is believed to have caused a sharp increase in the incidence of elder abuse (EA), including as a result of isolation, social distance combined with increased interpersonal stressors. Thus, the aim of this study is to determine the impact of the COVID-19 pandemic on the elder abuse rates and the characteristics of risk factors. A total of 347 patients hospitalized in the Department of Neurology and Department of Geriatrics at University Hospital No. 1 in Bydgoszcz were selected as subjects for the analysis. The tools used in the study are: Authors-Designed Questionnaire, the Vulnerability to Abuse Screening Scale, the Geriatric Depression Scale and the Activities of Daily Living Scale. Descriptive statistics, chi-squared tests, Spearman’s rank correlation test, and logistic regression analyses were used. In the studied population, nearly 45% of the elderly were victims of violence. This represents an increase of more than 6 percent compared to the pre-pandemic. The most common type of EA was psychological abuse (72.3%). In the final models, the risk factors include, among others, low income (OR = 3.60, 95% CI = 1.93–6.72), chronic diseases (OR = 2.06, 95% CI = 1.28–3.31), poor relationship with the family (OR = 3.26, 95% CI = 1.96–5.43), and moderate and severe depression (OR = 18.29, 95% CI = 10.24–32.69; OR = 18.49, 95% CI = 3.91–87.30, respectively). Moreover, moderate functional impairment 5.52 times more often and severe functional impairment 21.07 times more likely to predispose to EA. People who suffered from COVID-19 are 1.59 times more likely to be victims of EA (95% CI = 1.03–2.46). In this study, we saw significant increases in EA rates during the COVID-19 pandemic.

The impact of COVID-19 lockdown on prehospital stroke care is largely unknown. We aimed to compare stroke care patterns before and during a state-wide lockdown. Thus, we analysed prospective data of stroke alerts referred to our stroke centre between 1 December 2019 and 16 June 2020, and compared them between two periods—15 weeks before and 13 weeks during the state-wide lockdown declared in Lithuania on 16 March 2020. Among 719 referrals for suspected stroke, there was a decrease in stroke alerts (rate ratio 0.61, 95% CI (0.52–0.71)), stroke admissions (0.63, 95% CI (0.52–0.76)), and decrease in prehospital stroke triage quality (positive predictive value 72.1% vs. 79.9%, p = 0.042) during the lockdown. The onset-to-door time was longer (153.0 vs. 120.5 min, p = 0.049) and seizures and intracranial tumours were more common among stroke mimics (16.9% vs. 6.7%, p = 0.012 and 9.6% vs. 3.0%, p = 0.037, respectively). We conclude that there was a decline in prehospital stroke triage quality during the lockdown despite low COVID-19 incidence in the country. Moreover, we observed an increase in hospital arrival delays and severe conditions presenting as stroke mimics. Our findings suggest that improved strategies are required to maintain optimal neurological care during public health emergencies.

Aphasia leads to disability, which, in turn, limits and can result in a complete breakdown of roles and social bonds. Thus, the aim of this study was to assess the impact of aphasia disorders on the quality of life of patients after an ischemic stroke. A prospective study among 116 patients with an ischemic stroke (the study group: 68 participants, 38.25% female, included patients with aphasia after a stroke; the control group: 48 patients, 37.5% female, without aphasia) was conducted at the Neurological Department of the Provincial Specialist Hospital in Włocławek. The patients were assessed twice: the first assessment was conducted during hospitalization using the Aphasia Dynamics Assessment Scale and the Aphasia Test Method of Jadwiga Szumska, and the second assessment of the quality of life after six months was conducted using the WHOQOL-BREF questionnaire. The patients from the control group rated their overall quality of life more highly than the patients from the study group. Statistically significant differences were observed in the physical domain, the psychological domain, and the environmental domain. The analysis of sociodemographic factors indicated a negative impact on the quality of life of the following variables: female gender, 55–64 years of age, vocational education, and place of residence—rural area. The degree and type of aphasia influenced the overall quality of life. Studies with larger samples are necessary.