scholarly journals INJECTED CITICOLINE IMPROVES IMPAIRMENT AND DISABILITY DURING ACUTE PHASE TREATMENT IN ISCHEMIC STROKE PATIENTS

2016 ◽  
Vol 51 (4) ◽  
pp. 245
Author(s):  
Rino Wahyudi ◽  
Didik Hasmono ◽  
Ruhaya Fitrina ◽  
Khairil Armal
Keyword(s):  
Ischemic Stroke ◽  
Treatment Group ◽  
Acute Ischemic Stroke ◽  
Acute Phase ◽  
Barthel Index ◽  
Recombinant Tissue Plasminogen Activator ◽  
Rank Test ◽  
Control Group ◽  
Before And After ◽  
Acute Phase Treatment

Treatment strategy of ischemic stroke is to reduce the extent of the damage and rescue neurons from death in the early days of ischemic events. Recombinant Tissue-Plasminogen Activator (r-TPA) is the only recommended therapy, but their use is very limited. Citicoline is a neuroprotectant with a therapeutic effect on several stages of the ischemic cascade. However, its use is still being debated. The purpose of this study was to analyze the use of supplementation citicoline injection in patients with acute ischemic stroke in relations to differences in changes in the level of interference (impairment), rate limitation (disability) and the level of obstruction (handicap) between the group receiving supplementation of citicoline injection 2x500 mg iv and the group without supplementation during acute phase treatment. This study was a prospective cohort study using experimental design in patients with acute ischemic stroke who met the inclusion and exclusion criteria with or without supplementation citicoline between January - April 2015 in the National Stroke Hospital, Bukittinggi. Rate of interference was assessed with NIHSS, level of limitations with Barthel Index, and level of obstruction with modified Rankin Scale. Assessment was done 2 times, before and after the treatment. Statistical methods used in this study were Wilcoxon signed rank test, paired T-test and Mann-Whitney test. This study was conducted on 50 subjects divided into 2 groups, a control group without supplementation and group treated with injected citicoline of 2x500 mg iv. Demographic and baseline characteristics did not differ between groups. There were differences in level of interference changes. Mean decrease in control group was 0.96 ± 1.74 NIHSS, while that in treatment group was 2.84 ± 1.46 NIHSS (p <0.05). There were differences in changes in the level of limitations. Mean increase of Barthel Index in control group 9.60 ± 11.17 and in treatment group 20.40 ± 13.99 (p <0.05). However, changes in the level obstacle showed no difference. In conclusion, citicoline injection supplementation in patients with ischemic stroke during acute phase treatment showed improvement differences in changes in the level of distraction (impairment) and the rate limitations (disability), but showed no difference in changes in the level of obstruction (handycaps).

scholarly journals Functional Connection Changes among Cerebral Regions and between Hemispheres in the Acute Ischemic Stroke Patients Treated by Scalp Acupuncture: A Rs-fMRI Study

2020 ◽  
Author(s):  
Huacong Liu ◽  
Yijing Jiang ◽  
Ningning Wang ◽  
Lanpin Chen ◽  
Jingchun Gao ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Treatment Group ◽  
Middle Cerebral Artery ◽  
Acute Ischemic Stroke ◽  
Scalp Acupuncture ◽  
Middle Temporal Gyrus ◽  
Control Group ◽  
Middle Temporal ◽  
Functional Activities ◽  
Before And After

Abstract Objective: Resting State Functional Magnetic Resonance Imaging (Rs-fMRI) was used to explore the changes on the functional connections between cerebral hemispheres and local functional activities in patients with acute ischemic stroke dysfunction treated by International Standard Scalp Acupuncture.Methods: 30 patients of acute ischemic stroke in the middle cerebral artery supply area of the dominant hemisphere were selected and randomly divided into treatment group and control group at a ratio of 1:1 according to the random number table method, with 15 patients in each group. Patients in the control group were treated with conventional western medicine, while patients in the treatment group combined the International Standard Scalp Acupuncture (MS5, MS6 and MS7). All the patients were evaluated for efficacy and received whole brain fMRI scan before and after the treatment. The observation indicators included (1) NHISS score and its sub-item scores related to dyskinesia before and after treatment. (2) the amplitude of low-frequency fluctuations (ALFF), regional homogeneity (ReHo), and voxel-mirror homotopy connection (VMHC) analyzed based on Matlab 2012a platform, SPM12, and REST1.8 before and after treatment.Results: 1. The difference of NHISS scores between the two groups was statistically significant before and after treatment (P<0.05), indicates that patients in the treatment group were improved better. 2. The changes in brain area activation between the two groups of patients were as follows: (1) The values of VMHC increased in brain regions dominated by bilateral BA6 and BA8; (2) The values of ALFF increased mainly in the left BA39 and the adjacent superior temporal gyrus and middle temporal gyrus . (3) The values of ReHo increased in the brain region of left middle temporal gyrus (including BA21) and its extending to BA37, and the left BA40 and angular gyrus and its extending to BA7. Conclusion: Scalp acupuncture can help the recovery of the patients with acute infarction of superior middle cerebral artery and its mechanism possibly related to the special changes in the regional functional activities of sensory integration, language processing and motor coordination, also the bilateral motor control of frontal lobe.Trial registration: Trial Registration Number: Chinese Clinical Trial Registry ChiCTR-IOR-15007672. Registration date: November 7, 2015.

scholarly journals Efficacy and safety of cinepazide maleate injection in patients with acute ischemic stroke: A multicenter, randomized, double-blind, placebo-controlled trial

2020 ◽  
Author(s):  
Jun Ni ◽  
Huisheng Chen ◽  
Guofang Chen ◽  
Yong Ji ◽  
Fei Yi ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
Barthel Index ◽  
Controlled Trial ◽  
Survival Rates ◽  
Control Group ◽  
Efficacy And Safety ◽  
Clinical Trial Registry ◽  
Double Blind

Abstract Background: Ischemic stroke is a leading cause of morbidity and mortality. Thrombolytic therapy improves disability and survival rates; however, to be effective, it must be given within 4.5 hours of onset. Moreover, thrombolytic therapy is frequently contraindicated. Therefore, alternative therapeutic options are required. In China, cinepazide maleate injection has been shown to improve the cerebral collateral circulation and further reduce disability in stroke patients; however, very few studies investigating this therapy have been conducted to date. Therefore, this study aimed to further confirm the efficacy and safety of cinepazide maleate injection in patients with acute ischemic stroke.Methods: Patients with acute ischemic stroke were administered an intravenous infusion of 320 mg cinepazide maleate or placebo once daily for 14 days. All patients were also administered basic therapy (citicoline sodium). The primary efficacy endpoint was the proportion of patients with a modified Rankin scale (mRS) ≤2 on day 90. Secondary efficacy endpoints included Barthel Index ≥95. Safety was evaluated by recording all adverse events (AEs), monitoring laboratory parameters and vital signs, and electrocardiogram.Results: In total, 937 patients with an acute ischemic stroke were included, with a mean (standard deviation, SD) National Institutes of Health Stroke Scale score of 8.8 (2.4) and a mean (SD) stroke onset of 30.9 (11.4) hours prior. Following treatment for 90 days, the proportion of patients with an mRS score ≤2 was significantly higher in the cinepazide maleate group than in the control group (60.9% vs. 50.1%; p=0.0004). Moreover, the proportion of patients with a Barthel Index of ≥95 on day 90 was also significantly higher in the cinepazide maleate group than in the control group (53.4% vs. 46.7%; p=0.0230). There were no statistically significant differences in safety parameters between the cinepazide maleate and control groups.Conclusions: The results of this study show that cinepazide maleate injection is superior to placebo in improving neurological function and activities of daily living, reducing disability, and promoting functional recovery in patients with acute ischemic stroke. Cinepazide maleate injection was safe and well tolerated with no unexpected AEs reported.Trial registration: Chinese Clinical Trial Registry CTR20160292 and ChiCTR1900023827. Retrospectively registered June 13, 2019.

scholarly journals The Effect of Occupatioal Therapy on Social Skill in Schizofrenia with Social Isolation

2014 ◽  
Vol 1 (2) ◽  
pp. 081-086
Author(s):  
Rendra Sukmana ◽  
Nawang Wulandari
Keyword(s):  
Social Skills ◽  
Treatment Group ◽  
Occupational Therapy ◽  
Social Isolation ◽  
Rank Test ◽  
Control Group ◽  
Before And After ◽  
Physical Disorders ◽  
Social Capability ◽  
And Control

Occupational therapy is a healing effort against someone who is experiencing mental and physical disorders by giving liveliness job. The purpose of the study to determine the effect of Occupational Therapy on social skills in schizophrenia with social isolation, using Quasy Control Group Pre-test Posttest Design. Sampel used in this experiments were 10 respondents that are divided into 2 groups: treatment and control. The treatment group was given occupational therapy 2 times a week for 3 weeks. Observations by 12 questions was conducted to determine the level of social skills of respondents. The results of this study showed no increase on the level of social skills before and after given granted Occupational Therapy. The level of social capability of 5 respondents in the treatment group before given an Occupational Therapy were 7 and while after given an occupational therapy were 10.2. This result have contrast to the control group which showed level of social capability were 7 . Statistic Analized using Wilcoxon Sign Rank Test showed significant is 0.0205 in the group between pre and post treatment, while the treatment and control group comparisons with Mann Whitney U test showed 0.029 ≤ 0.05. With these results Occupational Therapy can improve social skills clients with social isolation.

Abstract 65: Effects of Immediate Blood Pressure Reduction on Two-Year Mortality and Major Disability in Patients With Acute Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Jiang He ◽  
Yonghong Zhang ◽  
Tan Xu ◽  
Dali Wang ◽  
Chung-Shiuan Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Treatment Group ◽  
Acute Ischemic Stroke ◽  
Antihypertensive Treatment ◽  
Blood Pressure Reduction ◽  
Control Group ◽  
Antihypertensive Medications ◽  
Vascular Events

Although elevated blood pressure (BP) is very common in patients with acute ischemic stroke, the management of hypertension among them remains controversial. We tested the effect of immediate BP reduction on two-year mortality and major disability in acute ischemic stroke patients. The China Antihypertensive Trial in Acute Ischemic Stroke, a randomized, single-blind, blinded end-points trial, was conducted in 4,071 patients with ischemic stroke within 48 hours of onset and elevated systolic BP (SBP). Patients were randomly assigned to receive antihypertensive treatment (n=2,038) or to discontinue all antihypertensive medications (n=2,033) during hospitalization. Post-treatment follow-ups were conducted at 3, 12, and 24 months after hospital discharge. The primary outcome was a composite of death and major disability at the two-year follow-up visit. Mean SBP was reduced by 21.8 in the treatment group and 12.7 mm Hg in the control group within 24 hours after randomization (P<0.001). Mean SBP was 137.3 mm Hg in the treatment group and 146.5 in the control group at day 7 after randomization (P<0.001). At two-year follow-up, study outcomes were obtained in 1945 (95.4%) participants in the treatment group and 1925 (94.7%) in the control group. 78.8% of the patients in the treatment group and 72.6% in the control group reported the use of antihypertensive medications (p<0.001). SBP was 138.8 mmHg in the antihypertensive treatment group and 139.7 in the control group (p=0.02). Among patients in the antihypertensive treatment group, 24.5% (476/1945) died or had a major disability, compared with 22.1% (425/1925) in the control group (odds ratio 1.14 [95% CI 0.99 to 1.33], p=0.078). Hazard ratios for all-cause mortality (1.01 [0.81, 1.25], p=0.95), recurrent stroke (0.91 [0.73, 1.13], p=0.40), and vascular events (0.97 [0.79, 1.19], p=0.76) were not statistically significant comparing the antihypertensive treatment group to the control group. The effect of antihypertensive treatment did not differ by pre-defined subgroups. In conclusion, among patients with acute ischemic stroke, BP reduction with antihypertensive medications during hospitalization did not reduce or increase the composite outcome of death and major disability over two years.

scholarly journals The Early Outcomes of Nurse Case Management in Patients with Acute Ischemic Stroke Treated with Intravenous Recombinant Tissue Plasminogen Activator: A Prospective Randomized Controlled Trial

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Urai Kummarg ◽  
Siriorn Sindhu ◽  
Sombat Muengtaweepongsa
Keyword(s):  
Ischemic Stroke ◽  
Case Management ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Fast Track ◽  
Recombinant Tissue Plasminogen Activator ◽  
Control Group ◽  
Nurse Case Management ◽  
Tissue Plasminogen

Background. Intravenous recombinant tissue plasminogen activator (i.v. rt-PA) is the milestone treatment for patients with acute ischemic stroke. Stroke Fast Track (SFT) facilitates time reduction, guarantees safety, and promotes good clinical outcomes in i.v. rt-PA treatment. Nursing case management is a healthcare service providing clinical benefits in many specific diseases. The knowledge about the efficacy of a nurse case management for Stroke Fast Track is limited. We aim to study the effect of nurse case management on clinical outcomes in patients with acute ischemic stroke involving intravenous recombinant tissue plasminogen activator (i.v. rt-PA) treatment. Methods. Seventy-six patients with acute ischemic stroke who received i.v. rt-PA treatment under Stroke Fast Track protocol of Thammasat University Hospital were randomized into two groups. One group was assigned to get standard care (control) while another group was assigned to get standard care under a nurse case management. The National Institute of Health Stroke Scale (NIHSS) at 24 hours after treatment between the control and the experimental groups was evaluated. Results. Time from triage to treatment in the experimental group was significantly faster than in the control group (mean = 39.02 and 59.37 minutes, respectively; p=.001). The NIHSS at 24 hours after treatment in the nurse case management group was significantly improved as compared to the control group (p=.001). No symptomatic intracranial hemorrhage (sICH) was detected at 24 hours after onset in both groups. Conclusion. The nurse case management should provide some benefits in the acute stroke system. Although the early benefit is demonstrated in our study, further studies are needed to ensure the long-term benefit and confirm its profit in patients with acute ischemic stroke.

Escitalopram improves neural functional prognosis and endothelial dysfunction in patients with acute cerebral infarction

2020 ◽  
Vol 38 (5) ◽  
pp. 385-393
Author(s):  
Jin-Xia Cao ◽  
Li Liu ◽  
Yun-Tao Sun ◽  
Qing-Hong Zeng ◽  
Zhen-Dong Yang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Treatment Group ◽  
Endothelial Dysfunction ◽  
Acute Ischemic Stroke ◽  
Rating Scale ◽  
Mmse Score ◽  
Neurological Deficits ◽  
Control Group ◽  
Relative Safety ◽  
The Mean

Background: Escitalopram is one of the most commonly used SSRIs at present, which has the characteristics of quick onset, less interactions with other drugs, and relative safety. Objective: This study aims to investigate the effects of escitalopram on neural functional prognoses and endothelial dysfunction after acute ischemic stroke. Methods: One hundred eligible patients afflicted with acute ischemic stroke were randomized into two groups: control and treatment groups. Patients in the treatment group received escitalopram in addition to the basic therapies in the control group over a period of 90 days. Neurological deficits were quantified using the National Institutes of Health Stroke Scale (NIHSS) score and Barthel index (BI) score, cognitive impairment was determined using the Mini-Mental State Examination (MMSE) score, depressive symptoms were measured using the 17-item Hamilton Depression Rating Scale (HAMD). Furthermore, post-stroke depression (PSD) was defined based on the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), with a HAMD score ≥17. Flow-mediated vascular dilatation (FMD) of the brachial artery was use as a surrogate indicator for endothelial dysfunction assessment with ultrasound. Results: The mean NIHSS and HAMD scores on day 90 after treatment were significantly lower in the treatment group than in the control group (2.17±0.36 vs. 4.24±0.85; 5.81±1.35 vs. 10.43±4.91; P < 0.01), while the mean BI score and FMD were significantly higher in the treatment group (93.08±6.23 vs. 79.64±7.56, P < 0.01; 8.71±2.35 vs. 5.83±1.21, P < 0.05) than in the control group. The improvement in MMSE score was not significantly different between the two groups. Conclusions: Treatment with escitalopram early after ischemic stroke can improve neural functional prognoses and endothelial dysfunction. Escitalopram had less side effects, which is worthy of clinical prophylactic application.

EXPRESS: Impact of Stroke Center Certification on rt-PA Thrombolysis after Acute Ischemic Stroke in South China from 2015 to 2020

2021 ◽  
pp. 174749302110314
Author(s):  
Yicong Chen ◽  
Jiaoxing Li ◽  
Chao Dang ◽  
Shuangquan Tan ◽  
Fubing Ouyang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
South China ◽  
Intravenous Thrombolysis ◽  
Recombinant Tissue Plasminogen Activator ◽  
Number Of Patients ◽  
Tissue Plasminogen ◽  
Before And After ◽  
Stroke Center ◽  
The City

Background and purpose: In China, stroke center certification was launched in 2015, but little is known about its impact on intravenous thrombolysis. This study aimed to evaluate the effects of stroke center certification on the use of intravenous thrombolysis during a five-year period in South China. Methods: We retrospectively collected data regarding the use of recombinant tissue plasminogen activator (rt-PA) in 21 cities of Guangdong from 2015 to 2020. The annual thrombolysis rate was defined as the number of patients who underwent intravenous rt-PA therapy divided by the number of those who had acute ischemic stroke (AIS) within the same year. The density of stroke centers was calculated as the number of stroke centers divided by the corresponding residents. Spearman’s correlation analysis was used to determine the correlations between the annual thrombolysis rates and the number/density of stroke centers. Paired t-test was used to compare differences in growth in annual thrombolysis rates before and after having stroke center. Results: From 2015 to 2020, the annual rt-PA thrombolysis rates of Guangdong increased from 1.4% to 7.2%, which was accompanied by an increase in the number of stroke centers from 0 to 82 and density of stroke centers from 0.00 to 0.71 per million population. The average annual rt-PA use in stroke centers were higher than that in non-stroke centers from 2016 to 2020 (all P < 0.05). There was a positive correlation of annual thrombolysis rates with the number of stroke centers (r = 1.00, P = 0.0028) and with the density of stroke centers in the 21 cities from 2018 to 2020 (all P < 0.05). The growth in annual thrombolysis rates significantly accelerated at the city-level after having stroke centers (1.55 %/y vs. 0.77 %/y, P < 0.001). Conclusions: Stroke center certification may partially drive the increased use of rt-PA thrombolysis. Stroke center certification should be continually promoted to facilitate access to intravenous thrombolysis for patients with AIS.

scholarly journals PROFIL PASIEN STROKE ISKEMIK AKUT DENGAN TERAPI RECOMBINANT TISSUE PLASMINOGEN ACTIVATOR DI RSUP DR. KARIADI SEMARANG

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Retnaningsih Retnaningsih ◽  
Theodorus Kevin Hendartono
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Barthel Index ◽  
Recombinant Tissue Plasminogen Activator ◽  
Stroke Patients ◽  
Tissue Plasminogen ◽  
The Mean ◽  
Age Range

 PROFILE OF ACUTE ISCHEMIC STROKE PATIENTS WITH RECOMBINANT TISSUE PLASMINOGEN ACTIVATOR THERAPY IN DR. KARIADI HOSPITAL SEMARANGABSTRACTIntroduction: The use of recombinant tissue plasminogen activator (rtPA) is recommended within 4.5 hours from onset, with door to needle (DTN) time <60 minutes, so that it will decrease morbidity and mortality rates.Aims: To evaluate the evaluate the profile of acute ischemic stroke patients with rtPA therapy in Dr. Kariadi Hospital Semarang.Methods: This was a descriptive study by looking at medical records of patients with acute ischemic stroke with onset less than 4.5 hours performed rtPA therapy in Dr. Kariadi Hospital Semarang during Januari 2017 until May 2018.Results: There were 36 patients, 19 (52.8%) male, 17 (47.2%) female. Age range from 36 to 74 years with stroke onset 15-180 minutes. There were lacuner ischemia in 29 patients (80.6%) and teritorial ischemia in 7 patients (19.4%). The mean DTN time 67.22 ± 12.29 with DTN time for rtPA >60 minutes was performed in 23 (63.9%) patients and <60 minutes in 13 (36.1%) patients. The mean NIHSS on admission 8.67±3.51; The mean NIHSS within first 24 hours 6.94±3.25; The mean NIHSS on discharge 5.64±5.50. The mean Barthel Index on admission 57.97±19.27, and The mean Barthel Index on discharge 73.33±26.25.Discussion: There was an improvement of NIHSS and Barthel Index in acute ischemic stroke patients with rtPA therapy. The mean DTN time still >60 minutes, so that service system improvements are needed in order to improve clinical outcomes of acute ischemic stroke patients with rtPA therapy (DTN time <60 minutes).Keywords: Barthel Index, NIHSS, recombinant tissue plasminogen activator (rtPA), ischemic stroke, door to needle (DTN)ABSTRAKPendahuluan: Pemberian recombinant tissue plasminogen activator (rtPA) direkomendasikan dalam waktu sampai 4,5 jam dengan waktu door to needle (DTN) <60 menit agar dapat menurunkan tingkat morbiditas dan mortalitas pada stroke iskemik akut.Tujuan: Untuk mengetahui profil pasien stroke iskemik akut dengan terapi rtPA di RSUP Dr. Kariadi Semarang.Metode: Penelitian deskriptif dengan melihat rekam medis pasien-pasien stroke iskemik akut periode Januari 2017 hingga Mei 2018 dengan onset kurang dari 4,5 jam yang mendapatkan terapi rtPA di RSUP Dr. Kariadi Semarang.Hasil: Dari 36 subjek, didapatkan proporsi laki-laki lebih banyak dari pada perempuan (52,8% vs 47,2%) dan rerata usia 58±8,63 tahun. Rerata waktu awitan adalah 92,5±42,79 menit dengan tipe iskemik lakuner (80,6%) dan rerata waktu DTN 67,22±12,29 menit.  Rerata NIHSS 24 jam pertama adalah 6,94±3,25 yang menurun menjadi 5,64±5,50 saat keluar RS. Rerata Indeks Barthel subjek saat masuk RS adalah 57,91±19,27 yang meningkat saat keluar menjadi 73,33±26,25.Diskusi: Terdapat perbaikan nilai NIHSS dan Indeks Barthel pada subjek stroke iskemik akut yang mendapatkan terapi rtPA. Rerata waktu DTN adalah >60 menit, menunjukkan perlunya perbaikan sistem pelayanan untuk meningkatkan luaran klinis pasien stroke iskemik akut dengan DTN <60 menit.Kata kunci: Door to needle, Indeks Barthel, NIHSS, recombinant tissue plasminogen activator, stroke iskemik  

scholarly journals Evaluation of the efficacy of recombinant tissue plasminogen activators in improving clinical status of acute ischemic stroke: A randomized clinical trial in Iran

2018 ◽  
Vol 5 (9) ◽  
pp. 2697-2702
Author(s):  
Mojtaba Khazaei ◽  
Zaher Khazaei ◽  
Elham Goodarzi ◽  
Ali Ghadimi
Keyword(s):  
Clinical Trial ◽  
Ischemic Stroke ◽  
Treatment Group ◽  
Acute Ischemic Stroke ◽  
Clinical Status ◽  
Plasminogen Activators ◽  
Control Group ◽  
Tissue Plasminogen ◽  
The Mean ◽  
The Difference

Background: Acute ischemic stroke is caused by blockage of a cerebral artery and is also known as cerebrovascular accident (CVA). Recombinant tissue plasminogen activator (rt-PA) therapy is effective in reducing early and long-term neurologic disabilities if it is started quickly. Therefore, the aim of this study was to determine the efficacy of treatment with recombinant tissue plasminogen activators in improving the clinical status of acute ischemic stroke. Methods: The current study was performed as a clinical trial of two groups- treatment and control (n=20 per group). The treatment group consisted of patients who received rt-PA, while the control group consisted of patients who did not receive rt-PA. For each group, evaluation of neurological disabilities following ischemic stroke was based off the National Institutes of Health Stroke Scale (NIHSS), for early assessment of disability on the third day of treatment), and off the modified Rankin Scale (MRS) at 90 days after stroke. The drug effect criterion was used to reduce the neurological disability or the difference in NIHSS on day 3 after treatment. Also, the duration of onset of symptoms until the arrival of the patients to the emergency room (ER), as well as the risk factors, complications and number of deaths in both groups, were recorded. Data obtained were analyzed by SPSS software. Results: The results of the study showed that the mean of ER arrival time, NIHSS before treatment, and NIHSS on day 3 of treatment in the control group was higher than that of the treatment group; the difference was statistically significant (P<0.05). The results also indicated that the probability of improvement of neurological disabilities in the experimental group was greater than that of the control group (relative risk (RR) =1.25). Additionally, the odds ratio (OR) for receiving rt-PA in the NIHSS positive treatment group compared to the control group was equal to 1/5 (OR=1.5). The results showed that 30% of the patients in the treatment group were treated with a complication. The mean of MRS was higher in the control group at 90 days after the stroke, compared with the treatment group. Conclusion: Treatment with rt-PA reduces the neurological disability in patients with ischemic stroke, since the mean of MRS is lower in the treatment group, compared with the control group, after 90 days of treatment.

scholarly journals New Candidates for Biomarkers and Drug Targets of Ischemic Stroke—A First Dynamic LC-MS Human Serum Proteomic Study

2022 ◽  
Vol 11 (2) ◽  
pp. 339
Author(s):  
Aleksandra Turek-Jakubowska ◽  
Janusz Dębski ◽  
Maciej Jakubowski ◽  
Ewa Szahidewicz-Krupska ◽  
Jakub Gawryś ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Heat Shock ◽  
Acute Ischemic Stroke ◽  
Human Serum ◽  
Acute Phase ◽  
Drug Targets ◽  
Control Group ◽  
Proteomic Study ◽  
Novel Drug ◽  
Novel Drug Targets

(1) Background: The aim of this dynamic-LC/MS-human-serum-proteomic-study was to identify potential proteins-candidates for biomarkers of acute ischemic stroke, their changes during acute phase of stroke and to define potential novel drug-targets. (2) Methods: A total of 32 patients (29–80 years) with acute ischemic stroke were enrolled to the study. The control group constituted 29 demographically-matched volunteers. Subjects with stroke presented clinical symptoms lasting no longer than 24 h, confirmed by neurological-examination and/or new cerebral ischemia visualized in the CT scans (computed tomography). The analysis of plasma proteome was performed using LC-MS (liquid chromatography–mass spectrometry). (3) Results: Ten proteins with significantly different serum concentrations between groups volunteers were: complement-factor-B, apolipoprotein-A-I, fibronectin, alpha-2-HS-glycoprotein, alpha-1B-glycoprotein, heat-shock-cognate-71kDa protein/heat-shock-related-70kDa-protein-2, thymidine phosphorylase-2, cytoplasmic-tryptophan-tRNA-ligase, ficolin-2, beta-Ala-His-dipeptidase. (4) Conclusions: This is the first dynamic LC-MS study performed on a clinical model which differentiates serum proteome of patients in acute phase of ischemic stroke in time series and compares to control group. Listed proteins should be considered as risk factors, markers of ischemic stroke or potential therapeutic targets. Further clinical validation might define their exact role in differential diagnostics, monitoring the course of the ischemic stroke or specifying them as novel drug targets.

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