A one-year longitudinal evaluation of cerebrospinal fluid and blood neurochemical markers in a patient with cryptococcal meningitis complicated by ischemic stroke.

Background and Purpose: Recurrent ischemic strokes increase the risk of disability and mortality. The role of conventional risk factors in recurrent strokes may change due to increased awareness of prevention strategies. The aim of this study was to explore the potential risk factors besides conventional ones which may help to affect the advances in future preventive concepts associated with one-year stroke recurrence (OSR). Methods: We analyzed 6,632 adult patients with ischemic stroke. Differences in clinical characteristics between patients with and without OSR were analyzed using multivariate logistic regression and classification and regression tree (CART) analyses. Results: Among the study population, 525 patients (7.9%) had OSR. Multivariate logistic regression analysis revealed that male sex (OR 1.243, 95% CI 1.025 – 1.506), age (OR 1.015, 95% CI 1.007 - 1.023), and a prior history of ischemic stroke (OR 1.331, 95% CI 1.096 – 1.615) were major factors associated with OSR. CART analysis further identified age and a prior history of ischemic stroke were important factors for OSR when classified the patients into three subgroups (with risks of OSR of 8.8%, 3.8%, and 12.5% for patients aged > 57.5 years, ≤ 57.5 years/with no prior history of ischemic stroke, and ≤ 57.5 years/with a prior history of ischemic stroke, respectively). Conclusions: Male sex, age, and a prior history of ischemic stroke could increase the risk of OSR by multivariate logistic regression analysis, and CART analysis further demonstrated that patients with a younger age (≤ 57.5 years) and a prior history of ischemic stroke had the highest risk of OSR.

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Cerebrospinal fluid microscopy as an index for predicting the prognosis of cryptococcal meningitis patients with and without HIV

Future Microbiology ◽

10.2217/fmb-2020-0086 ◽

2020 ◽

Vol 15 (17) ◽

pp. 1645-1652

Author(s):

Keming Zhang ◽

Hang Li ◽

Lei Zhang ◽

Wanqing Liao ◽

Liyan Ling ◽

...

Keyword(s):

Cerebrospinal Fluid ◽

Clinical Data ◽

Cryptococcal Meningitis ◽

Fungal Burden ◽

Hospital Patients ◽

Patient Prognosis ◽

Worse Prognosis ◽

Fluid Test

Aim: To evaluate the clinical data and quantitative cerebrospinal fluid for associations with the outcome of cryptococcal meningitis (CM) patients in the hospital. Patients & methods: We retrospectively analyzed a total of 139 CM patients comprising 108 without HIV and 31 with HIV admitted in a Jiang Xi hospital. Resμlts: We found that CM patients with the high fungal burden (≥10 yeasts/μl) (26.3%) had a worse prognosis than those with the low fungal burden (<10 yeasts/μl). (4.9%) (p = 0.0007 <0.05). Conclusion: In CM patients, a fungal burden of 10 yeasts/μl in the first cerebrospinal fluid test may be used as an indicator of patient prognosis, and we can personalize patients’ treatment based on the fungal burden to improve prognosis.

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Cerebrospinal Fluid Free Fatty Acid Levels Are Associated with Stroke Subtypes and Severity in Chinese Patients with Acute Ischemic Stroke

World Neurosurgery ◽

10.1016/j.wneu.2015.06.006 ◽

2015 ◽

Vol 84 (5) ◽

pp. 1299-1304 ◽

Cited By ~ 11

Author(s):

Guo-Ju Sun ◽

Su-Chun Ding ◽

Wen-Yuan Ling ◽

Fang Wang ◽

Xiao-Ping Yang

Keyword(s):

Cerebrospinal Fluid ◽

Ischemic Stroke ◽

Fatty Acid ◽

Free Fatty Acid ◽

Acute Ischemic Stroke ◽

Chinese Patients ◽

Stroke Subtypes

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Predictors of One-Year Disability and Death in Chinese Hospitalized Women after Ischemic Stroke

Cerebrovascular Diseases ◽

10.1159/000267852 ◽

2010 ◽

Vol 29 (3) ◽

pp. 255-262 ◽

Cited By ~ 43

Author(s):

Fan-Yi Kong ◽

Wen-Dan Tao ◽

Zi-Long Hao ◽

Ming Liu

Keyword(s):

Ischemic Stroke ◽

One Year

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Incidence and mortality of ischemic stroke subtypes in Joinville, Brazil: a population-based study

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20150081 ◽

2015 ◽

Vol 73 (8) ◽

pp. 648-654 ◽

Cited By ~ 8

Author(s):

Marcos C. Lange ◽

Norberto L. Cabral ◽

Carla H. C. Moro ◽

Alexandre L. Longo ◽

Anderson R. Gonçalves ◽

...

Keyword(s):

Ischemic Stroke ◽

Population Based ◽

Large Artery ◽

Vessel Occlusion ◽

Population Based Study ◽

Incidence And Mortality ◽

One Year ◽

Undetermined Etiology ◽

And Control ◽

Adjusted Incidence

Aims To measure the incidence and mortality rates of ischemic stroke (IS) subtypes in Joinville, Brazil. Methods All first-ever IS patients that occurred in Joinville from January 2005 to December 2006 were identified. The IS subtypes were classified by the TOAST criteria, and the patients were followed-up for one year after IS onset. Results The age-adjusted incidence per 100,000 inhabitants was 26 (17-39) for large-artery atherosclerosis (LAA), 17 (11-27) for cardioembolic (CE), 29 (20-41) for small vessel occlusion (SVO), 2 (0.6-7) for stroke of other determined etiology (OTH) and 30 (20-43) for stroke of undetermined etiology (UND). The 1-year mortality rate per 100,000 inhabitants was 5 (2-11) for LAA, 6 (3-13) for CE, 1 (0.1-6) for SVO, 0.2 (0-0.9) for OTH and 9 (4-17) for UND. Conclusion In the population of Joinville, the incidences of IS subtypes were similar to those found in other populations. These findings highlight the importance of better detection and control of atherosclerotic risk factors.

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Venous and CSF pressure in cerebral infarction with a hemorrhagic component

Kazan medical journal ◽

10.17816/kazmj62190 ◽

1985 ◽

Vol 66 (6) ◽

pp. 419-421

Author(s):

A. A. Ashman

Keyword(s):

Cerebrospinal Fluid ◽

Ischemic Stroke ◽

Cerebral Infarction ◽

Fluid Pressure ◽

Cerebrospinal Fluid Pressure ◽

Csf Pressure

Literature data on the value of cerebrospinal fluid pressure in certain forms of ischemic stroke are few and contradictory.

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Abstract TP202: Association of Rs7961894 with Mean Platelet Volume in Patients with Acute Ischemic Stroke

Stroke ◽

10.1161/str.48.suppl_1.tp202 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Malgorzata Miller ◽

Nils Henninger ◽

Renato Umeton ◽

Agnieszka Slowik

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Mean Platelet Volume ◽

Myocardial Infarct ◽

Mortality Data ◽

Platelet Volume ◽

Laboratory Findings ◽

Stroke Subtypes ◽

Increased Risk ◽

One Year

Introduction: Mean platelet volume (MPV) is a marker of platelet function and elevated MPV was found to be an independent risk factor for death after myocardial infarct in patients with coronary artery disease. Higher MPV was associated with increased risk of ischemic stroke, yet there is insufficient data regarding the role of MPV as a marker of outcome in patients with ischemic stroke. The variability of platelet indices in humans is largely determined by genetic factors and rs7961894 located within intron 3 of WDR66 gene showed the strongest association with MPV in all genome wide association (GWA) studies in the European population. Aim: To determine the association of rs7961894 with MPV in patients with acute ischemic stroke and to assess whether rs7961894 and MPV could be markers of one year mortality in different stroke subtypes. Material and methods: For 426 adults with first-ever ischemic stroke MPV was measured within 72h of stroke onset and single nucleotide polymorphism genotyping of rs7961894 was performed accordingly (RT-PCR, Applied Biosystems). Epidemiologic and clinical characteristics (including TOAST classification), laboratory findings as well as one year mortality data were collected for each participant. Results: Allele T and genotypes CT and TT of the rs7961894 polymorphism were associated with the highest (>11.5fL) MPV quartile (Chi 2 test, p<0.01). MPV was significantly higher in patients with genotype TT as compared to CT and CC genotype (12.0±0.24fL vs. 11.10±0.15fL and 10.77±0.05fL, respectively, ANOVA, p <0.005 with Tukey HSD post-hoc test, Figure 1). Conclusions: Allele T of rs7961894 polymorphism is associated with increased MPV in the recessive and dominant model and patients with genotype TT have significantly higher MPV as compared to the rest of the population study. Further analysis is currently being conducted to determine the association of MPV and rs7961894 polymorphism with one year mortality and stroke subtypes.

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Abstract P670: Obesity and Mortality After the First Ischemic Stroke: Is Obesity Paradox Real?

Stroke ◽

10.1161/str.52.suppl_1.p670 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Durgesh Chaudhary ◽

Ayesha Khan ◽

Mudit Gupta ◽

Yirui Hu ◽

Jiang Li ◽

...

Keyword(s):

Ischemic Stroke ◽

Proportional Hazards Model ◽

Obesity Paradox ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Obese Patients ◽

Stroke Patients ◽

Stroke Event ◽

One Year ◽

First Time

Introduction: Obesity is an established risk factor for ischemic stroke but the association of increased body mass index (BMI) with survival after ischemic stroke remains controversial. Many studies have shown that increased BMI has a “protective” effect on survival after stroke while other studies have debunked the obesity paradox. This study aimed at examining the relationship between BMI and all-cause mortality at one year in first-time ischemic stroke patients using data extracted from different resources including electronic health records. Methods: We analyzed consecutive ischemic stroke patients captured in the Geisinger NeuroScience Ischemic Stroke (GNSIS) database. Survival in first-time ischemic stroke patients was analyzed using Kaplan-Meier estimator, stratified by different BMI categories. The predictors of mortality at one-year were assessed using a multivariate Cox proportional hazards model. Results: Among 6,703 first-time adult ischemic stroke patients, mean age was 70.2 ±13.5 years and 52% were men. Of these patients, 24% patients were non-overweight (BMI < 25), 34% were overweight (BMI 25-29.9) and 41% were obese (BMI ≥ 30). One-year survival probability was significantly higher in overweight patients (87%, 95% CI: [85.6 - 88.4], p<0.001) and obese patients (89.5%, 95% CI: [88.4 - 90.7], p<0.001) compared to non-overweight patients (78.1%, 95% CI: [76.0 - 80.1]). In multivariate analysis, one-year mortality was significantly lower in overweight and obese patients (overweight patients- HR = 0.61 [95% CI, 0.52 - 0.72]; obese patients- HR = 0.56 [95% CI, 0.48 - 0.67]). Other significant predictors of one-year mortality were age at the ischemic stroke event (HR = 1.04 [95% CI, 1.03 - 1.04]), history of neoplasm (HR = 1.59 [95% CI, 1.38 - 1.85]), atrial fibrillation or flutter (HR = 1.26 [95% CI, 1.09 - 1.46]), heart failure (HR = 1.68 [95% CI, 1.42 - 1.98]), diabetes mellitus (HR = 1.27 [95% CI, 1.1 - 1.47]), rheumatic disease (HR = 1.37 [95% CI, 1.05 - 1.78]) and myocardial infarction ((HR = 1.23 [95% CI, 1.02 - 1.48]). Conclusion: Our results support the obesity paradox in ischemic stroke patients as shown by a significantly decreased hazard ratio for one-year mortality among overweight and obese patients in comparison to non-overweight patients.

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