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Clinical-therapeutic and recuperatory features in a patient with pluripatology: ischemic stroke, ischemic heart disease (sechelar myocardial infarction), chronic kidney disease and monstrous gout

Introduction: gout is a chronic inflammatory arthropathy produced by depositing crystals of monosodium uric acid (in joints and tissues) following an anomaly (genetics or acquired) in the purine metabolism (1,2). The manifestations of the disease are: hyperuricemia, recurrent episodes of acute arthritis, the presence of tophi, chronic kidney disease, urinary lithiasis(2). Stroke represents„ the rapid development of localized or global clinical signs of cerebral dysfunction with symptoms exceeding 24 hours, leading to death, without any other cause, except for vascular origin”. (3)
Materials and Methods: with the permission of the THEBA Ethics Commission ( no.17464/14.06.2019), we will present the clinical case of a 57-year-old patient admitted to the TEHBA Neuromuscular Recovery Clinic presenting a right hemiplegia and mixed aphasia after an ischemic stroke in the territory of the left middle cerebral artery, on the background of complex polypathology (monstrous gout arthropathy, chronic smoking, arterial hypertension, myocardial infarction with coronary artery stenosis, chronic kidney disease).
Results: the patient did in our clinic a neuro-muscular recovery treatment, adapted to his needs,which consisted of kinetotherapy and speech therapy and received appropriate medical treatment. The clinical evolution of the patient was slowly favorable, with improvement in language disorders and motor control of paralyzed limbs.
Conclusions: the case of this patient has several particularities. This is a patient with a vicious life style, with a severe arthropathy, with severe cardio-vascular sufferers, hospitalized for recovering neuro-muscular deficits after an ischemic stroke. Despite limited prognosis, the patient has improved ADL and the quality of life after recovery treatment.
 Key words: stroke, hemiplegia, poly-pathologic, ischemic,