scholarly journals The Effect of Stroke Subtypes on Baroreceptor Sensitivity, a Predict for Acute Stroke Outcome

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Wan-Chen Tsai ◽  
Hui-Chen Lin ◽  
Yun-Ru Lai ◽  
Che-Wei Hsu ◽  
Chih-Cheng Huang ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Baroreflex Sensitivity ◽  
Heart Rate Response ◽  
Control Group ◽  
Stepwise Logistic Regression ◽  
Deep Breathing ◽  
Baroreceptor Sensitivity ◽  
Brainstem Infarction ◽  
Potential Prognostic Factor ◽  
Insight Into

Background. Reduced baroreflex sensitivity (BRS) has been reported in patients with acute cardiovascular events. We tested the hypothesis that BRS varies in different subtypes of acute ischemic stroke (AIS) and that BRS is a predictor of clinical outcomes. Methods. We examined autonomic parameters in 34 patients with AIS, including the small deep hemisphere infarction, the large hemisphere infarction, and the brainstem infarction groups on Day 1, Day 7, and Day 30 after AIS. Autonomic parameters were also evaluated in 18 age- and sex-matched healthy volunteers as a control group. The clinical outcomes were analyzed using the modified Rankin scale at 30 days after stroke. Results. The BRS, Valsalva ratio, and heart rate response to deep breathing (HR-DB) were significantly lower in patients after AIS on admission than in controls (p<0.01). The frequency domain of HRV (LF/HF ratio) was significantly increased in patients after AIS compared to controls (p<0.05). BRS was significantly reduced in patients with large hemisphere infarction or brainstem infarction compared to patients with small deep hemisphere infarction on Day 1 after AIS (p<0.01). Stepwise logistic regression showed that the levels of BRS and NIHSS are prognostic factors of 1-month outcomes in patients with AIS. Conclusion. Beside NIHSS score on admission, BRS is a potential prognostic factor of 1-month outcomes in patients with AIS. Patients with large hemisphere infarction or brainstem infarction have more blunting BRS than do those with lacunar infarction, which provides some insight into which patients may be expected to have a poor outcome.

Altered cardiovascular haemodynamics and baroreceptor–heart rate reflex in adult sheep after prenatal exposure to dexamethasone

1999 ◽  
Vol 97 (1) ◽  
pp. 103-109 ◽  
Author(s):  
M. DODIC ◽  
A. PEERS ◽  
J. P. COGHLAN ◽  
C. N. MAY ◽  
E. LUMBERS ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Output ◽  
Baroreflex Sensitivity ◽  
Heart Rate Response ◽  
Metabolic Diseases ◽  
Epidemiological Studies ◽  
Control Group ◽  
Intrauterine Environment ◽  
Central Processing ◽  
Propranolol Treatment

Numerous epidemiological studies, together with mounting evidence from studies in animals, point to a correlation between an adverse intrauterine environment and the early onset of cardiovascular and metabolic diseases later in life. We were the first to show that sheep exposed to dexamethasone (0.28 mg⋅kg-1⋅day-1 for only 2 days) at the end of the first month of pregnancy (PTG1), but not those exposed at the end of the second month of pregnancy (PTG2), had a higher basal mean arterial pressure (MAP) 19 months after birth. In the present study we report the MAP, cardiovascular haemodynamics and baroreflex sensitivity in these animals at 40 months of age. MAP in the PTG1 group was significantly higher than in the control group (91±1 mmHg and 81±1 mmHg respectively; P< 0.001) and also when compared with the PTG2 group (82±1 mmHg; P< 0.001). There was a significant increase in cardiac output in the PTG1 group compared with the control group (108±2 and 96±4 ml⋅min-1⋅kg-1 respectively; P< 0.05). The increase in cardiac output in the PTG1 group was due to an increase in stroke volume (1.82±0.08 ml⋅kg-1⋅beat-1, compared with 1.46±0.06 ml⋅kg-1⋅beat-1 in the control group; P< 0.05), but not in heart rate. In the hypertensive group of animals (PTG1), there was a rightward shift of the baroreflex curve. In group PTG2 (the normotensive group of animals), a lower gain was found before and during propranolol treatment. The decrease in gain of the baroreflex was not associated with changes in heart rate range, suggesting an impairment in the central processing of the baroreceptor signals. Thus sheep fetuses exposed to dexamethasone for only 2 days at the end of the first month of gestation have high blood pressure (dependent upon the increase in cardiac output) and a reset of the baroreflex at 40 months of age. Animals that have received prenatal dexamethasone closer to mid-gestation, although normotensive with normal cardiac output, showed an altered baroreceptor-heart rate response.

EXPRESS: Altering the rehabilitation environment to improve stroke survivor activity (AREISSA): a Phase II trial.

2021 ◽  
pp. 174749302110069
Author(s):  
Heidi Janssen ◽  
Louise Ada ◽  
Sandy Middleton ◽  
Michael Pollack ◽  
Michael Nilsson ◽  
...  
Keyword(s):  
Adverse Events ◽  
Clinical Outcomes ◽  
Environmental Enrichment ◽  
Brain Plasticity ◽  
Social Activity ◽  
Stroke Survivor ◽  
Group Differences ◽  
Control Group ◽  
Serious Adverse Events ◽  
Clinical Trial Registration

Background: Environmental enrichment involves organisation of the environment and provision of equipment to facilitate engagement in physical, cognitive and social activity. In animals with stroke, it promotes brain plasticity and recovery. Aims: To assess the feasibility and safety of a patient-driven model of environmental enrichment incorporating access to communal and individual environmental enrichment. Methods: A non-randomised cluster trial with blinded measurement involving people with stroke (n=193) in 4 rehabilitation units was carried out. Feasibility was operationalised as activity 10 days after admission to rehabilitation and availability of environmental enrichment. Safety was measured as falls and serious adverse events. Benefit was measured as clinical outcomes at 3 months, by an assessor blinded to group. Results: The experimental group (n=91) spent 7% (95% CI -14 to 0) less time inactive, 9% (95% CI 0 to 19) more time physically, and 6% (95% CI 2 to 10) more time socially active than the control group (n=102). Communal environmental enrichment was available 100% of the time, but individual environmental enrichment was rarely within reach (24%) or sight (39%). There were no between-group differences in serious adverse events or falls at discharge or 3 months nor in clinical outcomes at 3 months. Conclusions: This patient-driven model of environmental enrichment was feasible and safe. However, the very modest increase in activity by people with stroke, and the lack of benefit in clinical outcomes 3 months after stroke do not provide justification for an efficacy trial. Clinical Trial Registration: ANZCTR 12613000796785 Words: 245

scholarly journals Gut Microbiome and Metabolome Profiles Associated with High-Fat Diet in Mice

Metabolites ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 482
Author(s):  
Jae-Kwon Jo ◽  
Seung-Ho Seo ◽  
Seong-Eun Park ◽  
Hyun-Woo Kim ◽  
Eun-Ju Kim ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Relative Abundance ◽  
High Fat Diet ◽  
Amplicon Sequencing ◽  
Gas Chromatography Mass Spectrometry ◽  
Control Group ◽  
Rrna Gene ◽  
High Fat ◽  
Underlying Mechanisms ◽  
Insight Into

Obesity can be caused by microbes producing metabolites; it is thus important to determine the correlation between gut microbes and metabolites. This study aimed to identify gut microbiota-metabolomic signatures that change with a high-fat diet and understand the underlying mechanisms. To investigate the profiles of the gut microbiota and metabolites that changed after a 60% fat diet for 8 weeks, 16S rRNA gene amplicon sequencing and gas chromatography-mass spectrometry (GC-MS)-based metabolomic analyses were performed. Mice belonging to the HFD group showed a significant decrease in the relative abundance of Bacteroidetes but an increase in the relative abundance of Firmicutes compared to the control group. The relative abundance of Firmicutes, such as Lactococcus, Blautia, Lachnoclostridium, Oscillibacter, Ruminiclostridium, Harryflintia, Lactobacillus, Oscillospira, and Erysipelatoclostridium, was significantly higher in the HFD group than in the control group. The increased relative abundance of Firmicutes in the HFD group was positively correlated with fecal ribose, hypoxanthine, fructose, glycolic acid, ornithine, serum inositol, tyrosine, and glycine. Metabolic pathways affected by a high fat diet on serum were involved in aminoacyl-tRNA biosynthesis, glycine, serine and threonine metabolism, cysteine and methionine metabolism, glyoxylate and dicarboxylate metabolism, and phenylalanine, tyrosine, and trypto-phan biosynthesis. This study provides insight into the dysbiosis of gut microbiota and metabolites altered by HFD and may help to understand the mechanisms underlying obesity mediated by gut microbiota.

scholarly journals Identification of Diagnostic and Prognostic microRNAs for Recurrent Vitreous Hemorrhage in Patients with Proliferative Diabetic Retinopathy

2019 ◽  
Vol 8 (12) ◽  
pp. 2217 ◽  
Author(s):  
Parviz Mammadzada ◽  
Juliette Bayle ◽  
Johann Gudmundsson ◽  
Anders Kvanta ◽  
Helder André
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Control Group ◽  
Ocular Tissues ◽  
Recurrent Hemorrhage ◽  
Pars Plana ◽  
And Control ◽  
Insight Into ◽  
Recurrent Vitreous Hemorrhage

MicroRNAs (miRNAs) can provide insight into the pathophysiological states of ocular tissues such as proliferative diabetic retinopathy (PDR). In this study, differences in miRNA expression in vitreous from PDR patients with and without incidence of recurrent vitreous hemorrhage (RVH) after the initial pars-plana vitrectomy (PPV) were analyzed, with the aim of identifying biomarkers for RVH. Fifty-four consented vitreous samples were analyzed from patients undergoing PPV for PDR, of which eighteen samples underwent a second surgery due to RVH. Ten of the sixty-six expressed miRNAs (miRNAs-19a, -20a, -22, -27a, -29a, -93, -126, -128, -130a, and -150) displayed divergences between the PDR vitreous groups and to the control. A significant increase in the miRNA-19a and -27a expression was determined in PDR patients undergoing PPV as compared to the controls. miRNA-20a and -93 were significantly upregulated in primary PPV vitreous samples of patients afflicted with RVH. Moreover, this observed upregulation was not significant between the non-RVH and control group, thus emphasizing the association with RVH incidence. miRNA-19a and -27a were detected as putative vitreous biomarkers for PDR, and elevated levels of miRNA-20a and -93 in vitreous with RVH suggest their biomarker potential for major PDR complications such as recurrent hemorrhage incidence.

scholarly journals Reoperations Following Lumbar Discectomy Are Associated With Worse Clinical Outcomes and Greater Socioeconomic Burden 3 Years After the Primary Procedure

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Claudius Thomé ◽  
Ali Araghi ◽  
Jason Inzana ◽  
Jonathan Stieber ◽  
Joshua M Ammerman
Keyword(s):  
Back Pain ◽  
Clinical Outcomes ◽  
Lumbar Discectomy ◽  
Control Treatment ◽  
Control Group ◽  
Closure Device ◽  
Number Of Patients ◽  
Patient Reported ◽  
Socioeconomic Burden ◽  
Index Level

Abstract INTRODUCTION Lumbar discectomy patients with large annular defects are at significantly greater risk for symptom recurrence and revision. Previous studies suggest that outcomes following revision surgery are less positive than outcomes from primary discectomy. This analysis aimed to assess the clinical and socioeconomic outcomes associated with postdiscectomy reoperations and the utility of a bone-anchored annular closure device (ACD) for avoiding reoperations. METHODS This study was a retrospective analysis of a prospective randomized controlled trial (RCT). Lumbar discectomy patients with large (>6 mm) annular defects were treated with discectomy alone (Control; n = 278) or discectomy with an ACD (n = 272). Patient-reported outcomes included visual analog scale (VAS) for ipsilateral leg or back pain and Oswestry Disability Index (ODI). At 3 yr, clinical outcomes were available for 75% of the patients. Comparisons of outcomes were made between reoperated (n = 64) and nonreoperated (n = 351) patients, regardless of ACD or Control treatment, at 3 yr following the primary surgery. RESULTS Reoperated patients had significantly worse scores for ODI (24 ± 19 vs 11 ± 13; P < .0001), VAS leg pain (28 ± 30 vs 12 ± 19; P < .0001), and VAS back pain (36 ± 31 vs 17 ± 21; P < .0001). Significantly more nonreoperated patients were working at 3 yr (97% vs 84%; P < .001). Based on Kaplan-Meier analysis, the proportion of subjects experiencing at least 1 index-level reoperation in 3 yr was 11% in the ACD group and 19% in the Control group (P = .007). CONCLUSION Index-level reoperations following lumbar discectomy are associated with worse outcomes and greater socioeconomic burden in patients with large annular defects (>6 mm). These findings are consistent with reports from large registry analyses, including the Spine Patient Outcomes Research Trial (SPORT) and the Swedish National Spine Registry (Swespine). The ACD reduced the number of patients experiencing index-level reoperation by 43%.

scholarly journals Association of Hypertriglycerideamia with Ischaemic Stroke

2016 ◽  
Vol 32 (1) ◽  
pp. 34-38
Author(s):  
Biplob Kumar Das ◽  
Kanak Jyoti Mondal
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Ischaemic Stroke ◽  
Significant Risk ◽  
Serum Triglyceride ◽  
Control Group ◽  
Case Group ◽  
Stepwise Logistic Regression ◽  
Serum Triglyceride Level ◽  
Analysis Model

Stroke is one of the foremost causes of morbidity, mortality and is a socioeconomic challenge. This is particularly true for developing countries like Bangladesh, where health support system including the rehabilitation system is not within the reach of common people. Hypertriglycerademia has an effective influence in the pathogenesis of Ischaemic Stroke (IS). So, the focus of this study was to evaluate and assess the association of serum triglyceride level in patients of IS. This case control study was carried out in the Department of Neurology in collaboration with Department of Biochemistry, BSMMU, Dhaka from July 2011 to June 2013. In this study, 60 diagnosed cases of ischaemic stroke patients and 60 age and sex matched healthy controls were enrolled. Risk factors of Ischemic Stroke (IS) patients were assessed ( adjusted Odds Ratio) in comparison with healthy adults. In this study, being married [OR. 1.95, 95% CI (0.40-9.42), p=0.409] , smoker [OR.1.65, 95% CI (0.57 - 4.82),p= 0.357], DM [OR. 1.48, 95% CI (0.36-6.06), p=0.582 ], IHD [OR. 1.51, 95% CI (0.29 – 7.89), p=0.624] , HTN [OR. 3.66, 95% CI (1.11–12.12), p=0.033] , overweight [OR.2.31, 95% CI (0.77 – 6.91), 0.135] and obesity [OR. 16.19, 95% CI (1.31–200.6), p=0.030] , increased level of serum TC [OR.8.24, 95% CI (2.07 – 32.83), p=0.003], TG [OR. 9.40, 95% CI (1.17 -75.86), p=0.035], LDL [OR. 0.45, 95% CI (0.10–2.05), p=0.308],and decreased level of HDL [OR. 3.37, 95% CI (1.03 - 12.25), p=0.045] were found as risk factors in developing IS. Independent t-test was done to find out the statistically significant differences of continuous variables like serum lipid profile between case and control group. The mean (SD) value of TG which is focus of this study, was found 237.67 (61.74) in case group, and 169.97 (26.95) in control group which was highly statistically significant (p < 0.0001). All of the significant variables were entered into stepwise logistic regression analysis model. From the logistic regression model, it can be finally concluded that hypertension, obesity, increased level of TC, increased level of TG and decreased level of HDL were statistically significant risk factors for development of IS. Bangladesh Journal of Neuroscience 2016; Vol. 32 (1): 34-38

scholarly journals Evaluación de disfunción autonómica en pacientes con insuficiencia renal crónica en programa de hemodiálisis.

2013 ◽  
Vol 9 (3) ◽  
pp. 98
Author(s):  
Rafael CONTRERAS RIOS ◽  
Abdías HURTADO ARESTEGUI
Keyword(s):  
Heart Rate ◽  
Autonomic Dysfunction ◽  
Associated Factors ◽  
Case Control Study ◽  
Hemodialysis Patients ◽  
Case Control ◽  
Control Group ◽  
Deep Breathing ◽  
Program Material ◽  
Control Study

Objective: To determine the frequency of autonomic dysfunction and associated factors in patients with chronic renal failure in hemodialysis program. Material and methods: A case-control study we evaluated 30 patients in hemodialysis program and equal number of healthy volunters, using the heart rate variability test during deep breathing. Results: In hemodialysis group, twenty two patients (80%) had autonomic dysfunction, 67% were asimptomatics. In control group only two patients had autonomic dysfunction (6.7%). In both groups, we found positive correlation than age with autonomic dysfunction stage. Conclusion: Autonomic dysfunction is a frequent complication in hemodialysis patients; it’s frequently asymptomatic and it has age relationship.

scholarly journals Effect of deep breathing exercises and incentive spirometry on respiratory distress scoring in second degree inhalational burn patients.

2019 ◽  
Vol 2 (1) ◽  
pp. 13-16
Author(s):  
Summiya Siddique Malik ◽  
Sadaf Saeed ◽  
Sumaira Kanwal
Keyword(s):  
Respiratory Distress ◽  
Vital Signs ◽  
Blood Gases ◽  
Sampling Technique ◽  
Control Group ◽  
Deep Breathing ◽  
Breathing Exercises ◽  
Arterial Blood ◽  
Experimental Group ◽  
Second Degree

Objective: Study was conducted for 6 months in PIMS Hospital Islamabad. Data was collected on self-structured Questionnaire, Respiratory distress scoring, Objective tools of Arterial blood gases and vital signs with signed consent. Methodology: The subjects were randomly allocated in experimental and control groups. Baseline data was collected and re-collected on Day 0 and Day 7 respectively and assessed using non-probability convenient sampling technique. Both groups were given standard medical and nursing care. Results: The experimental group was given single treatment regimen i.e. Deep breathing exercises (with 5-10 repetitions of each DBE being possible onto patient for 15-30 minutes twice daily). The control group was given 10-15 cycles of ISM with prior steam inhalation and nebulization with salbutamol for a period of 15-20 minutes for 35-45 minutes twice daily for a period of 07 days. Conclusion: The experimental group results show that deep breathing exercises are significantly effective in improving post burn complications like pneumonia in patients suffering from second degree inhalation burns.

scholarly journals Zingerone Ameliorates Hepatotoxicity

2020 ◽  
Vol 11 (1) ◽  
pp. 280-284 ◽  
Author(s):  
Julietpoornamathy J ◽  
Parameswari C.S.
Keyword(s):  
The Body ◽  
Control Group ◽  
Medical Sciences ◽  
Toxic Compounds ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Insight Into ◽  
Group 1

In medical sciences, toxicity is an area wherein extensive studies have been carried to improve the diseases as well as to prevent. So, there is a high requirement for novel and improved alternative therapeutic strategies to manage diseases. The liver is the largest gland in the body, which executes several important mechanisms; it stores minerals and vitamins and releases them in periods of need. The main aim of this study was to give a closer insight into potent non- toxic compounds that is capable of modifying the responses. Animals were divided into five equal groups viz control (Group 1), administered with food and water ad libitum, (Group 2) administered with olive oil, (Group 3) administered with zingerone, (Group 4) administered with concanavalin A, (Group 5) administered with cyclosporine A followed by zingerone. Our results revealed significant changes in liver marker enzymes and liver histology of zingerone treated rats when compared to control rats.  A corollary, zingerone has no toxic effect on hepatocytes and was found to be safe at a dose of 10mg/kg b wt and also ameliorates hepatotoxicity.

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