Quality Of Later Life Research Articles

"Quality of life" analysis in the long-term follow-up after "Fontan" palliation for CHDs-a single-centre experience.

Complex CHDs are life threatening, and surgical treatment is needed for survival. Fontan palliation led to a significant increase in survival rates during the last decades. Consequently, quality of life became more essential. While a reduced quality of life compared to healthy children has been reported, detailed knowledge about individual quality of life and particular areas is lacking. Furthermore, the effect of different risk factors on quality of life is only rarely evaluated. Database of the department for pediatric cardiology, Heart Center Leipzig, was screened for children after total cavopulmonary connection palliation. n = 39 patients were included in the study, the outcome after total cavopulmonary connection was analysed in detail and quality of life data were collected and analysed using the standardised questionnaire "Pediatric quality of life inventory", version 4.0. We compared the total health score of our patients to the mean score of healthy children in the literature. The mean follow-up time was 6.4 ± 3.2 years, the overall survival was 100% after maximal follow-up time of 11.1 years. We could not find any age or gender dependence, nor an influence of age at total cavopulmonary connection on the later quality of life. Yet, patients with three-staged surgery exhibited a worse quality of life than patients with two-staged palliation. Late complications might influence quality of life, but patient number is too small, to find universal results. The total cavopulmonary connection palliation affects physical and psychological quality of life as well as cardiac health independently from age and gender. More patients and longer observation should be examined to confirm the results.

Stepfamily Variation in Parent-Child Relationship Quality in Later Life.

We use a family systems approach to examine how stepfamily structure is associated with both positive and negative parent-child relationships while considering mothers' and fathers' discrepant reports. Two in five older couples with children are in stepfamilies. Past research on later-life stepfamily dynamics has focused mainly on positive aspects of relationships and compared reports of mothers and fathers from different families. Using the U.S. Health and Retirement Study, we estimated multilevel models with data from married couples in which both spouses reported living children and answered all questions about positive and negative parent-child relationships (N = 2,150). Couples in stepfamilies reported less positive and more negative relationships with their children than did couples in non-stepfamilies. Mothers reported more positive relationships than fathers, but there was no gender difference in reports of negative relationships. The patterns of perceived parent-child relationships and divergent reports between mothers and fathers also varied by stepfamily structure. Structural complexity was not consistently related to positive or negative relationships. This study underscores the importance of considering mothers' and fathers' different points of view in the same family and examining both positive and negative parent-child interactions as negative relationships are not merely the reverse of positive relationships.

17th International Conference on Malignant Lymphoma, Palazzo dei Congressi, Lugano, Switzerland, 13 - 17 June, 2023.

Introduction: Hodgkin lymphoma (HL) in children, adolescents, and young adults (CAYA) is highly curable. Patient experiences during cancer treatment vary substantially and may influence later quality of life (QOL). We sought to: (1) describe patient-reported QOL during treatment for high-risk classical HL in CAYA with HLHR13, a brentuximab-incorporating chemotherapy regimen with response-adapted radiotherapy (r-aRT); (2) compare QOL among patients treated on HLHR13, high-risk HL patients treated with Stanford V chemotherapy and r-aRT (HOD99), and healthy CAYA. Methods: Eligible patients were ≤18 (HLHR13) or ≤21 years old (HOD99) upon diagnosis of Stage IIB, IIIB, or IV HL. For HLHR13 and HOD99, QOL was assessed with PedsQL 4.0 Generic Core Scales and PedsQL 3.0 Cancer Module. HLHR13 consisted of 2 “AEPA” cycles (brentuximab, etoposide, prednisone, and doxorubicin) and 4 “CAPDac” cycles (cyclophosphamide, brentuximab, prednisone, and dacarbazine) with r-aRT (25.5 vs. 0 Gy). HLHR13 chemotherapy lasted 20 weeks including 6 rest weeks. HOD99 consisted of 12 weeks of Stanford V (bleomycin, doxorubicin, mechlorethamine, prednisone, vinblastine, and vincristine) with r-aRT (25.5 vs. 15 Gy). Despite differing regimen durations, QOL assessments were compared at timepoints considered equivalent. HLHR13 incorporated 2-year off-therapy long-term follow up QOL assessments. Patient demographics and QOL scores were summarized by descriptive statistics. We used Wilcoxon rank-sum tests to compare PedsQL 3.0 scores in HLHR13 patients vs. HOD99 patients and pooled two sample t-tests to compare patient and healthy CAYA PedsQL 4.0 scores. Raw p-values were corrected for multiple comparisons. Results: At study entry, HLHR13 patients’ (n = 63) QOL was significantly worse than healthy CAYA and consistent with HOD99 patients’ (n = 78) QOL as measured by PedsQL 4.0 Generic Core Scales. HLHR13 patients’ QOL gradually improved. Compared to HOD99 patients, HLHR13 patients had better cancer-specific QOL scores (PedsQL 3.0 Cancer Module) during treatment, particularly for nausea, worry, cognitive problems and treatment anxiety. Two years off therapy, HLHR13 patients (n = 39) reported better QOL in social and emotional domains than did healthy CAYA. Conclusions: Among similar groups of CAYA with HL, HLHR13 treatment was associated with higher patient-reported cancer-specific QOL than was HOD99 despite longer treatment duration and more intensive administration schedule. PedsQL 3.0 Cancer Module distinguished cancer-specific experience differences between HLHR13 and HOD99. Mechlorethamine in HOD99 may have produced excess nausea. Two years after treatment, HLHR13-treated CAYA reported better social and emotional QOL than healthy peers. Observed excellent QOL could reflect positive psychosocial impacts of living beyond lymphoma or a biased group of CAYA continuing in survivorship care. Keywords: chemotherapy, late effects in lymphoma survivors, Hodgkin lymphoma The research was funded by: St. Jude Children's Research Hospital and Seagen Inc Conflicts of interests pertinent to the abstract: M. P. Link Research funding: Seagen, Inc J. E. Flerlage Research funding: Seagen, IncSS

Happily Ever After or Not? Marital Quality among Culturally Diverse Older-Aged Canadian Parents

The quality of partnered relationships is integral to individual and family health and well-being over the life span. Significant shifts in ethno-cultural diversity, parental roles, and family life contribute to more complex partnership experiences in North American society. Drawing from a socio-cultural life course lens, we examine parental marital satisfaction/quality in later life in terms of ethnicity, socio-demographic variables (e.g., ethnic identity, gender, age, health status) and family context (e.g., presence of children at home, intergenerational relations, retirement status). Data are drawn from a sample of 454 married/partnered adults aged 50+ with a least one child aged 19–35 who reside in Metro Vancouver, British Columbia, from four cultural groups: British, Chinese, Persian/Iranian, and South Asian. Using Ordinary Linear Regression, we model predictors of three dependent variables: global marital satisfaction and two sub-scales, including positive and negative emotional/cognitive appraisals of relationship quality. Several ethnic group contrasts were supported, with Chinese reporting lower global marital satisfaction than the South Asians and Persian/Iranians reporting lower levels of positive marital appraisals than the South Asians. In addition, these associations were nuanced by interactions between ethnicity and gender, revealing distinct relationships with the dependent variables. Results also support associations for several covariates. In particular, greater income satisfaction and those reporting lower conflict with their children had higher marital quality; and males and those reporting better health only had positive associations with the global marital satisfaction scale. Implications for theorizing relationship quality in later life and recommendations for those who work with culturally diverse older adults (e.g., mental health care professionals, community service providers) are discussed.

Adolescence internalizing problems as a mediator between autism diagnosis in childhood and quality of life in emerging adults with and without autism: a 10-year longitudinal study

BackgroundIndividuals with autism tend to have a reduced quality of life across their lifespan. This reduced quality of life may be a result of autism traits, mental distress, and poor person/environment fit. In this longitudinal study, we looked at the role of adolescence internalizing and externalizing problems in mediating the relationship between having an autism diagnosis from childhood and perceived quality of life as emerging adults.MethodsA total of 66 participants in a group of emerging adults with autism (mean age 22.2 years), and without autism (mean age 20.9 years) were assessed in three assessment waves (T1 at 12 years, T2 at 14 years, and T3 at 22 years of age). Parents filled out the Child Behavior Checklist at T2 and participants filled out the Perceived Quality of Life Questionnaire at T3. Total and indirect effects were tested in serial mediation analysis.ResultsThe results showed that internalizing problems fully mediated the association between childhood autism diagnosis and the quality of life in emerging adulthood, while externalizing problems did not.ConclusionOur findings suggest that attention to adolescent internalizing problems is important to improve the later quality of life for emerging adults with autism.

Loneliness, perceived isolation and sleep quality in later life. Longitudinal evidence from a population-based German study

ObjectivesTo date, there is restricted knowledge regarding the association between loneliness, perceived social isolation and sleep quality based on longitudinal studies. Our aim was therefore to clarify the association between loneliness, perceived social isolation and sleep quality stratified by sex using a longitudinal approach. MethodsLongitudinal data (wave 5 and wave 6) were used from a nationally representative sample of community-dwelling individuals ≥ 40 years in Germany. In our analytical sample, n equaled 8784 observations. The Bude and Lantermann tool was used to quantify perceived social isolation and the De Jong Gierveld tool was used to measure loneliness. Relying on key items of the Pittsburgh Sleep Quality Index, sleep quality was assessed. ResultsIncreases in loneliness were associated with worsening sleep quality (in men: in two outcomes; in women: in all three outcomes). Moreover, in men, increases in perceived social isolation was associated with decreases in overall sleep quality (β = 0.10, p < 0.01), but not with the other outcomes. In contrast, perceived social isolation was not associated with changes in any of the outcome measures in women. ConclusionsIncreases in loneliness were particularly associated with worsening sleep quality among women, whereas the overall sleep quality decreases when perceived social isolation increases in men. Efforts to reduce perceived social isolation (men) and loneliness (in men, but particularly in women) can contribute to sleep quality in individuals aged 40 years and over in Germany.

Exploring Older Adults' Adoption and Use of a Tablet Computer During COVID-19: Longitudinal Qualitative Study.

BackgroundAs mobile computing technology evolves, such as smartphones and tablet computers, it increasingly offers features that may be particularly beneficial to older adults. However, the digital divide exists, and many older adults have been shown to have difficulty using these devices. The COVID-19 pandemic has magnified how much older adults need but are excluded from having access to technologies to meet essential daily needs and overcome physical distancing restrictions.ObjectiveThis study sought to understand how older adults who had never used a tablet computer learn to use it, what they want to use it for, and what barriers they experience as they continue to use it during social isolation caused by the COVID-19 pandemic.MethodsWe conducted a series of semistructured interviews with eight people aged 65 years and older for 16 weeks, investigating older novice users’ adoption and use of a tablet computer during the nationwide lockdown due to COVID-19.ResultsParticipants were gradually yet successfully accustomed to using a tablet computer to serve various daily needs, including entertainment, social connectedness, and information-seeking. However, this success was not achieved through developing sufficient digital skills but rather by applying the methods they were already familiar with in its operation, such as taking and referring to instruction notes.ConclusionsOur findings imply that older adults without digital literacy can still benefit from a digital device for quality of later life if proper traditional methods they are already familiar with are offered in its use.

Місце кровоспинного джгута в сучасному алгоритмі тимчасової зупинки кровотечі на догоспітальному етапі

У статті проаналізовані показання і спірні моменти в алгоритмі тимчасової зупинки кровотечі на догоспітальному етапі за допомогою сучасних джгутів-турнікетів. У роботі надана коротка характеристика Combat Application Tourniquet, SWAT-Tourniquet як найбільш поширених джгутів. Табельний гумовий кровоспинний джгут має виражену шкідливу дію на тканини кінцівки і потребує вдосконалення або заміни. Профілактика турнікетного синдрому є важливим фактором у наданні екстреної медичної допомоги.

Effect of fasting hyperglycemia and insulin resistance on bone turnover markers in children aged 9-11years.

Impaired regulation of glucose metabolism in childhood adversely affects bone health. We assessed the effect of fasting hyperglycemia and insulin resistance on bone turnover markers in prepubertal children with normal glycemia (<100mg/dL) and fasting hyperglycemia (100-125mg/dL). Glucose, hemoglobin A1c, IGF-I (insulin-like growth factor I), iP1NP (N-terminal propeptide of type I procollagen), CTX-1 (C-terminal telopeptide of type I collagen) and insulin were measured. Bone turnover index (BTI) and HOMA-IR (homeostasis model assessment) were calculated. Bone resorption marker (CTX) levels were decreased by 26.5% in boys with hyperglycemia, though only 7% in girls. Hyperglycemia had no effect on the bone formation marker iP1NP. IGF-1, the best predictor of bone marker variance accounted for 25% of iP1NP and 5% of CTX variance. Girls presented significantly higher BTI indicating the predominance of bone formation over resorption. Insulin resistance significantly decreased CTX. In girls, HOMA-IR and IGF-1 predicted 15% of CTX variance. Fasting hyperglycemia and insulin resistance in children impact bone turnover suppressing bone resorption. Hyperglycemia decreased resorption, particularly in boys, while suppression of resorption by insulin resistance was more pronounced in girls. We suggest that the progression of disturbances accompanying prediabetes, may interfere with bone modelling and be deleterious to bone quality in later life.

A multifactorial model for the etiology of neuropsychiatric disorders: the role of advanced paternal age.

Mental or neuropsychiatric disorders are widespread within our societies affecting one in every four people in the world. Very often the onset of a mental disorder (MD) occurs in early childhood and substantially reduces the quality of later life. Although the global burden of MDs is rising, mental health care is still suboptimal, partly due to insufficient understanding of the processes of disease development. New insights are needed to respond to this worldwide health problem. Next to the growing burden of MDs, there is a tendency to postpone pregnancy for various economic and practical reasons. In this review, we describe the current knowledge on the potential effect from advanced paternal age (APA) on development of autism spectrum disorder, schizophrenia, attention-deficit/hyperactivity disorder, bipolar disorder, obsessive-compulsive disorder, and Tourette syndrome. Although literature did not clearly define an age cut-off for APA, we here present a comprehensive multifactorial model for the development of MDs, including the role of aging, de novo mutations, epigenetic mechanisms, psychosocial environment, and selection into late fatherhood. Our model is part of the Paternal Origins of Health and Disease paradigm and may serve as a foundation for future epidemiological research designs. This blueprint will increase the understanding of the etiology of MDs and can be used as a practical guide for clinicians favoring early detection and developing a tailored treatment plan. Ultimately, this will help health policy practitioners to prevent the development of MDs and to inform health-care workers and the community about disease determinants. Better knowledge of the proportion of all risk factors, their interactions, and their role in the development of MDs will lead to an optimization of mental health care and management. IMPACT: We design a model of causation for MDs, integrating male aging, (epi)genetics, and environmental influences. It adds new insights into the current knowledge about associations between APA and MDs. In clinical practice, this comprehensive model may be helpful in early diagnosis and in treatment adopting a personal approach. It may help in identifying the proximate cause on an individual level or in a specific subpopulation. Besides the opportunity to measure the attributed proportions of risk factors, this model may be used as a blueprint to design prevention strategies for public health purposes.

Generating meaningfulness through lifelong and life-wide leisure engagement with music

The authors in this article each bring a particular insight to the overarching question of how pedagogical and facilitation approaches can deepen and strengthen a lifelong value attached to music learning and engagement in leisure music activities. It is argued that when learner voice is privileged and social connections are embedded in pedagogical approaches early on, for example in formal school music or extracurricular youth learning contexts, this will likely underpin lifelong habits of engagement in valued, meaningful leisure activity. A lifelong learning mindset, oriented around serious leisure, can in turn promote the quality of later life, when a potential sense of loss related to personal work and family identity can be profound.

Septic Shock Complicated with Limb Ischemic Necrosis: Three Case Reports and their Review of Literature

Purpose: Limb ischemic necrosis is a very rare but severe condition that generally leads to amputation in septic shock. Our aim is to review the risk factors for development of limb ischemic necrosis in ICU patients requiring vasopressor support and draw the attention of doctors. Methods: A retrospective review of clinical information and photographs in 3 septic shock patients, including APACHII scores, dose of norepinephrine, time of ischemic necrosis and final outcome from July 2001 to June 2020 at a single intensive care unit. Results: All of the three patients had high APACHE II score, obvious coagulation dysfunction and severe hypotension on admission; In order to maintain the target blood pressure, the dose of norepinephrine range from 0.36 to 7.27 μg/kg/min; Case 2 and 3 had a higher average dose and length of NE treatment when comparing to case 1. Finally, case 1 survived but undergone amputation, case 2 and case 3 died. Conclusion: Septic shock with limb ischemic necrosis is a very serious complication and may indicate a poor prognosis. As an ICU doctor, we should pay attention to the complication in our clinical practice which can greatly affect patient’s quality of later life.

The Role and Impact of Radio Listening Practices in Older Adults' Everyday Lives.

Previous research has indicated older adults value listening to music as a leisure activity. Yet, recent research into listening practices broadly has often focused on younger adults and the use of newer, digital listening technologies. Nonetheless, the radio, which is familiar to older people who grew up with it at the forefront of family life, is important to consider with regard to listening practices and the potential associated well-being benefits. This research investigated older adults’ everyday radio listening practices, in order to begin to understand how the radio fits into their daily lives and how it might influence their sense of well-being. Twenty-five Australian residents (aged 66–87; 56% female, 44% male) participated in semi-structured, one-to-one interviews. The results of a qualitative thematic analysis revealed themes concerning listening preferences, listening routines, access, and motivations/outcomes. While personal preferences (concerning content, stations, and presenters) were diverse, individuals clearly communicated these as well as their established listening routines and habits. Listener motivations varied: some people focused on the enjoyment that listening to the radio creates while some noted benefits to their well-being, such as relaxation, modifying their mood, and feelings of comfort and community. Radio listening practices can be defined in terms of differing engagement styles, as characterized using continua ranging from passive to active, or focused, listening as well as generalized or specific listening. Based on participants’ experiences, a proposed engagement space model links how people engage with the radio to the possible outcomes mentioned. Importantly, benefits to well-being can result from varied engagement styles. The findings presented provide an in-depth understanding of how the radio fits into older adults’ everyday life, with implications for considering how the radio might be used as a widely accessed, low-cost tool for maintaining and enhancing quality of later life.

Creativity, music, and quality of later life: A systematic review

The aim of this systematic review was to interrogate the existing literature that articulates indirect or direct links between quality of life (QoL) and creativity in later life musical learning and participation. Search terms were related to the concept (creativity), the context (music), the population (aging), and the outcome (QoL). Twenty-three articles were retained. The link between creativity and QoL focused primarily on the role of creativity in life enrichment and subjective well-being. Creativity in participatory music-making was found to be underpinned by social engagement, collaboration, and inclusivity. Opportunities for creative expression through participatory music-making offered a range of benefits relating to QoL that included positive emotions, engagement, relationships, a sense of meaning, and accomplishment. Our systematic review highlights limitations with regard to theoretical explanations for the characteristics of a creative musical process or product within later life contexts, the specific contributions of these creative processes and products in relation to quality of later life, and the specific ways in which creative musical expression can be facilitated within diverse and multicultural later life contexts so as to maximize the potential QoL benefits for our aging population.

Epigenomic profile and biological age

Man ages at a constant chronological rate while their biological aging rate is extremely variable. Interventions to improve, or to slow the rate of biological aging are the subject of several research. The broad spectrum of molecules and its intricate role from the biological point of view and its relation with environmental factors are being investigated. Recently, researchers have been putting its efforts to understand the epigenetic mechanisms and how it can interfere with alterations in gene expression that leads to predisposition and, or pathological outcome. Some of these investigations have shed light about how one can determine the biological age from a simple blood sample, just by detecting the epigenetic alterations on only three CpGs sites with a reasonable certainty. Also, the enzymes inhibitors that can interfere with methylation and demethylation were effective to reverse the epigenetic mechanisms. Other studies have shown how the environmental changes since from early life can affect these alterations on the epigenome. Taking all together, some biomolecular markers are already available to determine the genetic background of an individual and this information can be used to guide the lifestyle in order to prevent some future diseases development and/or improve the quality of later life.

Is ‘minimally adequate treatment’ really adequate? investigating the effect of mental health treatment on quality of life for children with mental health problems.

BackgroundMinimally adequate treatment (MAT) is intended to represent treatment minimally sufficient for common mental health problems. For children, MAT has been defined over a twelve-month period as either eight or more mental health visits, or four to seven visits plus relevant medication. MAT is used to identify those missing out on adequate care, but it is unknown whether MAT improves children's outcomes. MethodsThis paper examines whether MAT is associated with improved outcomes for children. It uses survey data from the nationally representative Longitudinal Study of Australian children on 596 children with mental health problems based on the Strengths and Difficulties Questionnaire at ages 8–15 years, linked to health service administrative data from 2012 to 2016. Statistical analysis examines the association of MAT with later quality of life (Pediatric Quality of Life Inventory), using a lagged dependent variable model to account for time-varying unobserved confounding. ResultsCompared to children with lower levels of treatment, those who received MAT between baseline and follow up had no statistically significant improvement in either quality of life or mental health symptoms. LimitationsThe observational data provide insight into real-world practice but require statistical methods to account for selection into treatment. ConclusionsWhile clinical trials show mental health treatments can be efficacious, this study shows no evidence that children receiving MAT in routine practice have better outcomes. These findings demonstrate the need for better understanding of the nature and impact of children's mental health care as it is delivered and received in routine practice.

Effects of Leisure Participation on Life Satisfaction in Older Korean Adults: A Panel Analysis.

South Koreans’ life expectancy has dramatically increased over the last four decades. However, the life satisfaction index of older Korean adults has been in the bottom third globally. The large majority of older Koreans spend most of the day watching television at home. However, concrete evidence regarding the effects of leisure involvement on older adults’ quality of later life is scant. Only a few existing studies have examined the link via cross-sectional survey data. Thus, the purpose of this study was to investigate whether meaningful leisure participation outside the home in older age plays an essential role in improving life satisfaction. To achieve the research aim, nationally representative panel data from the Korea Employment Information Service were used for the data analysis. The results indicated that social and productive leisure participation in religious activity, social gatherings, and volunteering was significantly related to quality of life in older adults. Moreover, frequent participation in travel and cultural activities outside the home were positively related to life satisfaction. These findings suggest that participation in meaningful leisure activities is a critical factor contributing to subjective well-being and good mental health in older Korean adults and should be encouraged.

중년부부의 성역할 태도 유사성이 남편과 아내의 부부관계 만족도와 부부갈등 수준에 미치는 영향

This study aimed to examine the effect of similarity in gender role attitudes on husbands" and wives" marital satisfaction and conflict among middle-aged couples. For the analyses, the Third National Survey of Korean Families was utilized and the sample was 1,053 couples aged 40 to 60. The dependent variables were husbands’ and wives’ perceived marital satisfaction and conflict, and the independent variable was similarity in gender role attitudes between husband and wife. Covariates were age, education level, employment status, marriage duration, and number of children. Latent Profile Analysis was applied to identify the patterns of gender role attitudes. Using the results, similarity in gender role attitudes was generated by dummy- coding the coincidence of the gender role attitude pattern between husband and wife. Then, Seemingly Unrelated Regression was applied to analyze the effect of similarity in gender role attitudes on husbands’ and wives’ marital satisfaction and conflict. The results indicated that husbands who had similar gender role attitudes to their wives reported lower levels of marital conflict. However, the effect of similarity in gender role attitudes on marital satisfaction was not significant for husbands. On the other hand, wives who had similar gender role attitudes to their husbands reported both higher levels of marital satisfaction and lower levels of marital conflict. This study may provide insights to discussions about ways to better promote and understand marital quality in later life. Moreover, its findings may be useful in the field of marriage and family therapy to develop educational programs seeking to improve marital quality in later life.

Revisiting Intergenerational Contact and Relationship Quality in Later Life: Parental Characteristics Matter.

Contact and relationship quality between adult children and aging parents are two widely used indicators of intergenerational solidarity and are often assumed to be positively correlated. However, the association between the two may depend on characteristics of the parent involved. Using Family Exchanges Study Wave 1, this study assessed whether parental difficulties-measured as functional limitations and life problems-and gender moderated the associations between middle-aged adults' contact and relationship quality with their parents. We found that more frequent email or phone contact was associated with worse relationship quality for fathers who had functional limitations. For life problems, however, more contact was not related to relationship quality for fathers with life problems. The associations did not differ by mother's difficulties. These results suggest that frequent contact between middle-aged adult children and aging parents does not uniformly reflect better relationship quality but rather depends on parents' characteristics.

Ischemic stroke and antithrombotic therapy: key aspects

The paper considers the key areas of antithrombotic therapy for ischemic stroke (IS). Antiplatelet therapy is shown to be a multistage and multidisciplinary strategy of treatment for patients with IS, which begins with the appearance of the first symptoms of the disease and continues throughout life. Each stage, including fibrinolytic therapy, early use of antithrombotic and anticoagulant drugs, and personalized antithrombotic prevention of recurrent cerebral disorders, is important in itself and serves a common goal. As a result, all efforts should be aimed at reducing mortality rates in the acute phase of stroke and the functional dependence of a patient and at preventing venous thromboses, recurrent stroke, and all cardiovascular events to increase life expectancy and to improve quality of life. Fibrinolytic therapy increases the patient’s chances of a full neurologic recovery and improves the quality of later life. Antithrombotic drugs reduce the risk of cardiovascular death, early recurrences of stroke, and recurrent noncardioembolic stroke. Parenteral anticoagulants in acute stroke decrease the risk of venous thrombosis/thromboembolism, oral anticoagulants reduce that of recurrent cardioembolic stroke.