scholarly journals Breath and plasma metabolomics to assess inflammation in acute stroke

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Waqar Ahmed ◽  
Iain R. White ◽  
Maxim Wilkinson ◽  
Craig F. Johnson ◽  
Nicholas Rattray ◽  
...  
Keyword(s):  
Time Course ◽  
Stroke Care ◽  
Multiple Time ◽  
Diagnostic Strategies ◽  
Post Stroke ◽  
Reactive Protein ◽  
Breath Sampling ◽  
Volatile Organic ◽  
Repeated Sampling ◽  
Injury And Repair

AbstractInflammation is strongly implicated in both injury and repair processes occurring after stroke. In this exploratory study we assessed the feasibility of repeated sampling of exhaled volatile organic compounds and performed an untargeted metabolomic analysis of plasma collected at multiple time periods after stroke. Metabolic profiles were compared with the time course of the inflammatory markers C-reactive protein (CRP) and interleukin-6 (IL-6). Serial breath sampling was well-tolerated by all patients and the measurement appears feasible in this group. We found that exhaled decanal tracks CRP and IL-6 levels post-stroke and correlates with several metabolic pathways associated with a post-stroke inflammatory response. This suggests that measurement of breath and blood metabolites could facilitate development of novel therapeutic and diagnostic strategies. Results are discussed in relation to the utility of breath analysis in stroke care, such as in monitoring recovery and complications including stroke associated infection.

scholarly journals Acute Stroke Care during the COVID-19 Pandemic: Reduction in the Number of Admissions of Elderly Patients and Increase in Prehospital Delays

2021 ◽  
pp. 1-7
Author(s):  
Gabriel Velilla-Alonso ◽  
Andrés García-Pastor ◽  
Ángela Rodríguez-López ◽  
Ana Gómez-Roldós ◽  
Antonio Sánchez-Soblechero ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Acute Stroke ◽  
Time Course ◽  
Intravenous Thrombolysis ◽  
Stroke Care ◽  
Acute Stroke Care ◽  
Group Data ◽  
Radiological Data ◽  
History Of ◽  
Prehospital Delays

Introduction: We analyzed whether the coronavirus disease 2019 (COVID-19) crisis affected acute stroke care in our center during the first 2 months of lockdown in Spain. Methods: This is a single-center, retrospective study. We collected demographic, clinical, and radiological data; time course; and treatment of patients meeting the stroke unit admission criteria from March 14 to May 14, 2020 (COVID-19 period group). Data were compared with the same period in 2019 (pre-COVID-19 period group). Results: 195 patients were analyzed; 83 in the COVID-19 period group, resulting in a 26% decline of acute strokes and transient ischemic attacks (TIAs) admitted to our center compared with the previous year (p = 0.038). Ten patients (12%) tested positive for PCR SARS-CoV-2. The proportion of patients aged 65 years and over was lower in the COVID-19 period group (53 vs. 68.8%, p = 0.025). During the pandemic period, analyzed patients were more frequently smokers (27.7 vs. 10.7%, p = 0.002) and had less frequently history of prior stroke (13.3 vs. 25%, p = 0.043) or atrial fibrillation (9.6 vs. 25%, p = 0.006). ASPECTS score was lower (9 [7–10] vs. 10 [8–10], p = 0.032), NIHSS score was slightly higher (5 [2–14] vs. 4 [2–8], p = 0.122), onset-to-door time was higher (304 [93–760] vs. 197 [91.25–645] min, p = 0.104), and a lower proportion arrived within 4.5 h from onset of symptoms (43.4 vs. 58%, p = 0.043) during the CO­VID-19 period. There were no differences between proportion of patients receiving recanalization treatment (intravenous thrombolysis and/or mechanical thrombectomy) and in-hospital delays. Conclusion: We observed a reduction in the number of acute strokes and TIAs admitted during the COVID-19 period. This drop affected especially elderly patients, and despite a delay in their arrival to the emergency department, the proportion of patients treated with recanalization therapies was preserved.

scholarly journals Assessing the usefulness of acute physiological responses following resistance exercise: sensitivity, magnitude of change, and time course of measures

2019 ◽  
Vol 44 (3) ◽  
pp. 309-319 ◽  
Author(s):  
Joshua S. Jackman ◽  
Phillip G. Bell ◽  
Simone Gill ◽  
Ken van Someren ◽  
Gareth W. Davison ◽  
...  
Keyword(s):  
Resistance Exercise ◽  
Time Course ◽  
Signal To Noise Ratio ◽  
Physiological Responses ◽  
High Sensitivity ◽  
Maximal Voluntary Isometric Contraction ◽  
Reactive Protein ◽  
Adaptation Processes ◽  
Exercise Stimulus ◽  
Metalloproteinase 9

A variety of strategies exist to modulate the acute physiological responses following resistance exercise aimed at enhancing recovery and/or adaptation processes. To assess the true impact of these strategies, it is important to know the ability of different measures to detect meaningful change. We investigated the sensitivity of measures used to quantify acute physiological responses to resistance exercise and constructed a physiological profile to characterise the magnitude of change and the time course of these responses. Eight males accustomed to regular resistance exercise performed experimental sessions during a “control week”, void of an exercise stimulus. The following week, termed the “exercise week”, participants repeated this sequence of experimental sessions, and they also performed a bout of lower-limb resistance exercise following the baseline assessments. Assessments were conducted at baseline and at 2, 6, 24, 48, 72, and 96 h after the intervention. On the basis of the signal-to-noise ratio, the most sensitive measures were maximal voluntary isometric contraction, 20-m sprint, countermovement jump peak force, rate of force development (100–200 ms), muscle soreness, Daily Analysis Of Life Demands For Athletes part B, limb girth, matrix metalloproteinase-9, interleukin-6, creatine kinase, and high-sensitivity C-reactive protein with ratios >1.5. Clear changes in these measures following resistance exercise were determined via magnitude-based inferences. These findings highlight measures that can detect real changes in acute physiological responses following resistance exercise in trained individuals. Researchers investigating strategies to manipulate acute physiological responses for recovery and/or adaptation can use these measures, as well as the recommended sampling points, to be confident that their interventions are making a worthwhile impact.

scholarly journals Conceptual and Practical Issues in the Pharmacological Treatment of Brain Injury

1993 ◽  
Vol 4 (3) ◽  
pp. 227-237 ◽  
Author(s):  
Donald G. Stein ◽  
Marylou M. Glasier ◽  
Stuart W. Hoffman
Keyword(s):  
Central Nervous System ◽  
Brain Injury ◽  
Time Course ◽  
Chemical Activity ◽  
Behavioral Testing ◽  
Naturally Occurring ◽  
New Information ◽  
Definition Of ◽  
Injury And Repair ◽  
The Brain

It is only within the last ten years that research on treatment for central nervous system (CNS) recovery after injury has become more focused on the complexities involved in promoting recovery from brain injury when the CNS is viewed as an integrated and dynamic system. There have been major advances in research in recovery over the last decade, including new information on the mechanics and genetics of metabolism and chemical activity, the definition of excitotoxic effects and the discovery that the brain itself secretes complex proteins, peptides and hormones which are capable of directly stimulating the repair of damaged neurons or blocking some of the degenerative processes caused by the injury cascade. Many of these agents, plus other nontoxic naturally occurring substances, are being tested as treatment for brain injury. Further work is needed to determine appropriate combinations of treatments and optimum times of administration with respect to the time course of the CNS disorder. In order to understand the mechanisms that mediate traumatic brain injury and repair, there must be a merging of findings from neurochemical studies with data from intensive behavioral testing.

scholarly journals Renal sensory and sympathetic nerves reinnervate the kidney in a similar time-dependent fashion after renal denervation in rats

2013 ◽  
Vol 304 (8) ◽  
pp. R675-R682 ◽  
Author(s):  
Jan Mulder ◽  
Tomas Hökfelt ◽  
Mark M. Knuepfer ◽  
Ulla C. Kopp
Keyword(s):  
Substance P ◽  
Optical Density ◽  
Renal Denervation ◽  
Time Course ◽  
Sympathetic Nerves ◽  
Sensory Nerves ◽  
Sensory Innervation ◽  
Multiple Time ◽  
Sensory Reinnervation ◽  
Renal Sympathetic

Efferent renal sympathetic nerves reinnervate the kidney after renal denervation in animals and humans. Therefore, the long-term reduction in arterial pressure following renal denervation in drug-resistant hypertensive patients has been attributed to lack of afferent renal sensory reinnervation. However, afferent sensory reinnervation of any organ, including the kidney, is an understudied question. Therefore, we analyzed the time course of sympathetic and sensory reinnervation at multiple time points (1, 4, and 5 days and 1, 2, 3, 4, 6, 9, and 12 wk) after renal denervation in normal Sprague-Dawley rats. Sympathetic and sensory innervation in the innervated and contralateral denervated kidney was determined as optical density (ImageJ) of the sympathetic and sensory nerves identified by immunohistochemistry using antibodies against markers for sympathetic nerves [neuropeptide Y (NPY) and tyrosine hydroxylase (TH)] and sensory nerves [substance P and calcitonin gene-related peptide (CGRP)]. In denervated kidneys, the optical density of NPY-immunoreactive (ir) fibers in the renal cortex and substance P-ir fibers in the pelvic wall was 6, 39, and 100% and 8, 47, and 100%, respectively, of that in the contralateral innervated kidney at 4 days, 4 wk, and 12 wk after denervation. Linear regression analysis of the optical density of the ratio of the denervated/innervated kidney versus time yielded similar intercept and slope values for NPY-ir, TH-ir, substance P-ir, and CGRP-ir fibers (all R2 > 0.76). In conclusion, in normotensive rats, reinnervation of the renal sensory nerves occurs over the same time course as reinnervation of the renal sympathetic nerves, both being complete at 9 to 12 wk following renal denervation.

scholarly journals Determination of the cut-off point of the Functional Independence Measure as a predictor of adverse events in patients with acute stroke

2018 ◽  
Vol 46 (10) ◽  
pp. 4235-4245 ◽  
Author(s):  
Noriko Kurokawa ◽  
Chiho Kai ◽  
Yoko Hokotachi ◽  
Mari Hasegawa ◽  
Teruyoshi Amagai
Keyword(s):  
Adverse Events ◽  
Acute Stroke ◽  
Energy Intake ◽  
Characteristic Curve ◽  
Functional Independence Measure ◽  
Stroke Care ◽  
Functional Independence ◽  
High Energy ◽  
Reactive Protein ◽  
Energy Group

Objective This study was performed to determine the cut-off point of the Functional Independence Measure (FIM) to discriminate patients with acute stroke who develop adverse events during their stay in a stroke care unit (SCU). Methods All consecutive patients with stroke admitted to a single institute from January to March 2015 were enrolled. They were divided into two groups according to their average daily energy intake in the SCU: ≥66% or <66% of the target (high- and low-energy group, respectively). A receiver operating characteristic curve was used to determine the cut-off point of the FIM to predict adverse events in patients with acute stroke. Results The length of stay in the SCU was significantly longer and the serum C-reactive protein level (CRP) was significantly higher in the low- than high-energy group (7 vs. 4 days and 2.15 vs. 0.20 mg/dL, respectively). The total FIM score cut-off value was 63 points. Conclusions An energy intake of <66% of the target was associated with a significantly longer stay in the SCU and a higher CRP level. A total FIM score cut-off value of 63 points is useful to discriminate patients with adverse events among those with acute stroke.

scholarly journals A comparison of two-dimensional and three-dimensional techniques for determining the kinematic patterns for hindlimb obstacle clearance during sheep locomotion.

2020 ◽  
Author(s):  
Camila Cardoso Diogo ◽  
Bárbara Fonseca ◽  
Francisca S.M. Almeida ◽  
Luís Maltez da Costa ◽  
José Eduardo Pereira ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Peripheral Nerve Injury ◽  
Time Course ◽  
Objective Assessment ◽  
Three Dimensional ◽  
Two Dimensional ◽  
Ovine Model ◽  
Obstacle Clearance ◽  
Injury And Repair

Abstract Background: Analysis of locomotion is often used as a measure for impairment and recovery following experimental peripheral nerve injury. Compared to rodents, sheep offer several attractive features as an experimental model for studying peripheral nerve regeneration. There are no studies on locomotion outcomes after peripheral nerve injury and repair in the sheep model. In the present study, we performed and compared two-dimensional (2D) and, for the first time, three-dimensional (3D) hindlimb kinematics during obstacle avoidance in the ovine model. This study aimed to obtain kinematic data to serve as a template for an objective assessment of the ankle joint motion in future studies of common peroneal nerve (CP) injury and repair in the ovine model. Results: The strategy used by the sheep to bring the hindlimb over a moderately high obstacle, set to 10% of its hindlimb length, was the pronounced knee, ankle and metatarsophalangeal flexion when approaching and clearing the obstacle. Despite the overall time course kinematic patterns about the hip, knee, ankle, and metatarsophalangeal were identical, we found significant differences between values of the 2D and 3D joint angular motion. Conclusions: Our results show that the most apparent changes that occurred during the gait cycle were for the ankle and metatarsophalangeal joints, whereas the hip and knee joints were much less affected. Data and techniques described here are likely to be useful for an objective assessment of altered gait after CP injury and repair in an ovine model.

scholarly journals C-reactive protein in intracerebral hemorrhage: Time course, tissue localization, and prognosis

Neurology ◽  
2012 ◽  
Vol 79 (7) ◽  
pp. 690-699 ◽  
Author(s):  
M. Di Napoli ◽  
D. A. Godoy ◽  
V. Campi ◽  
L. Masotti ◽  
C. J. Smith ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Time Course ◽  
C Reactive Protein ◽  
Tissue Localization ◽  
Reactive Protein

Abstract 2874: Functional Polymorphisms in Toll-like Receptor 4 Predict Worse Outcome in Acute Ischemic Stroke Patients

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Jonathan R Weinstein ◽  
Juliane Schulze ◽  
Richard V Lee ◽  
Dannielle Zierath ◽  
Patricia Tanzi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Immune Cell ◽  
Stroke Severity ◽  
Multiple Time ◽  
Toll Like Receptor ◽  
C Reactive Protein ◽  
Toll Like Receptor 4 ◽  
Reactive Protein ◽  
Functional Polymorphisms

Background: Toll-like receptor-4 (TLR4) plays a central role in the pathophysiology of acute ischemic stroke (AIS). Specific single nucleotide polymorphisms (SNPs) in TLR4 including 1063 A/G [Asp299Gly] and 1363 C/T [Thr399Ile] alter immune cell responsiveness to lipopolysaccharide (LPS) and are associated with increased rates of infection. The effect of these TLR4 SNPs on outcome following AIS is unknown. Methods: Patients were prospectively enrolled after onset of AIS. Clinical and demographic data were collected and neurological outcomes assessed at 3 months. Blood was drawn at multiple time points to quantify leukocyte subsets and assess plasma levels of C-reactive protein and a panel of cytokines. Genotyping for the TLR4 SNPs was also performed on blood samples. Uni- and multivariate analyses were performed to assess associations between TLR4 SNP haplotype and (i) each laboratory parameter noted above, (ii) infection risk and (iii) stroke outcome. Results: Of the 42 patients included; 6 (14%) were heterozygous for either one or both TLR4 SNPs. Baseline characteristics were similar in patients with or without a TLR4 SNP. In analyses adjusted for both initial stroke severity and age, the presence of a TLR4 SNP was associated with increases in blood leukocytes, plasma C-reactive protein and the cytokine interleukin-1 receptor antagonist (IL-1ra). The presence of either TLR4 SNP was also associated with a trend toward increased rates of infection (adjusted odds ratio and 95% confidence interval of 8.20 and 0.826-81.5, respectively) and a decreased likelihood of favorable outcome as defined by a modified Rankin Scale score of two or less at three months from stroke onset (0.014, 0.00-0.759). Conclusions: In AIS patients, functionally significant genetic variations in TLR4 influence both rates of stroke-associated infection and neurological outcome. These data suggest a direct connection between TLR4 function and stroke pathophysiology.

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