scholarly journals Effect of Statins on Patients with Acute Ischemic Stroke Infection based on Intelligent Data Acquisition of Computed Tomography Image information (Preprint)

2020 ◽  
Author(s):  
Weiye Yang ◽  
Jian Yang ◽  
Xin Xiong ◽  
Xu Weng ◽  
Wenjing Wu
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Test Group ◽  
Internal Capsule ◽  
Statin Treatment ◽  
Ct Images ◽  
Control Group ◽  
Stroke Patients ◽  
Tomography Image ◽  
Computed Tomography Image

BACKGROUND Background: Stroke is one of the main causes of chronic disability and death, and infection is the most common complication of stroke and the main influencing factor of 30d mortality. Studies have shown that statins can reduce the incidence and mortality of cardiovascular and cerebrovascular events, as well as the expression of inflammatory factors. However, the effect of statins on the prognosis of patients with acute ischemic stroke complicated with infection has not been determined. OBJECTIVE Objective: To reduce the infection rate in patients with acute ischemic stroke, effect of statins on patients with acute ischemic stroke infection based on intelligent data acquisition of computed tomography image information was investigated. METHODS Methods: In this study, 122 infected patients with acute ischemic stroke in our hospital from June 2016 to December 2018 were included as subjects, and they were divided into test group (statin treatment, n=69) and control group (non-statin treatment, n=53). On admissionon, the differences in baseline data, stroke classification, neurological impairment, and the number of affected cerebral lobes between the two groups were compared; the probability of pulmonary, urinary system, and co-infection in patients with different stroke types was compared; the modified Rankin score and pap scale were used to evaluate the prognosis of patients; filter back projection (FBP) and iDose4 algorithms were used to reconstruct CT images of stroke patients, and the differences in noise and Signal to Noise Ratio (SNR) of reconstructed images by different algorithms were compared; CT images were used to qualitatively and quantitatively analyze the imaging characteristics of stroke patients and the affected cerebral lobes. RESULTS Results: The proportion of TACI in the control group was significantly higher than that in the test group (P<0.01); the incidence of pulmonary infection in patients with total anterior circulation infarct (TACI) typing in the control group was significantly higher than that in the test group (P<0.01); the Rankin and Barthel index scores of the test group at 0 months (3.30±0.34 vs 4.19±0.42; 45.71±8.26 vs 29.65±5.58), 1 months (3.17±0.36 vs 4.39±0.47; 47.79±7.79 vs 31.97±6.02), and 2 months (3.16±0.32 vs 4.14±0.40; 59.33±9.87 vs 35.80±6.21) were significantly higher than those of the control group (P<0.05); the noise in the image reconstructed by iDose4 method was significantly lower than that by FBP method (P<0.01); there were statistically significant differences between the control group and the test group in the proportion of involvement in the right parietal lobe, left insula, left internal capsule, subcortex, and right brain stem (P<0.05), CONCLUSIONS Conclusions: iDose algorithm can more effectively reconstruct CT images of stroke patients, and statins can significantly improve the left internal capsule and subcutaneous involvement of stroke patients, so as to effectively improve the prognosis of patients with acute stroke. CLINICALTRIAL Trial Registration: CRD42017079863

Abstract TP224: Interleukin-37 Level is Elevated in Acute Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Saif Bushnaq ◽  
Atif Zafar ◽  
Kempuraj Duraisamy ◽  
Nudrat Tasneem ◽  
Mohammad M Khan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Inflammatory Responses ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Delayed Presentation ◽  
Stroke Patients ◽  
Post Stroke ◽  
Urine And Serum ◽  
Serum And Urine

Background: Interleukin-37 (IL-37) is a new member of IL-1 cytokine family with a defined role as a negative feedback inhibitor of pro-inflammatory responses. IL-37 has yet to be evaluated in non-immune neurological diseases like ischemic or hemorrhagic stroke. This study aimed to measure the urine and serum IL-37 levels in patients with acute ischemic stroke. Method: Twelve patients consented for the study. Two sets of serum and urine samples were obtained and analyzed; one upon admission to the hospital, and the second the next morning after overnight fasting. The trends in serum level of IL-37 in 5 stroke patients, while trends in urine level of 6 patients were available, measured by real-time polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). Prior studies with healthy volunteers as control group have consistently showed IL-37 plasma level around or less than 65 pg/ml with maximum normal levels on ELISA approximated at 130 pg/ml. Results: IL-37 level in urine in stroke patients ranged from 297 - 4467. IL-37 levels were in the range of 300s to 1000s in patients with ischemic stroke compared with reported healthy controls in literature where the level was always less than 90. Three of these 10 patients presented within 3 hours of stroke onset with IL-37 serum levels being 2655 pg/ml, 3517 pg/ml and 5235 pg/ml. In all others, it ranged much less than that, with the trend of delayed presentation giving less IL-37 levels, both in urine and serum. There were no clear differences found in patients with or without tPA, diabetes, hyperlipidemia and high blood pressure in our small study. Conclusion: The study shows a rather stable elevation of IL-37 levels post-ischemic stroke, which if compared to available data from other studies, is 3-10 times elevated after acute ischemic stroke with an uptrend in the first few days. IL-37 plays some role in mediating post-stroke inflammation with significant rise in serum and urine IL-37 levels suggesting a key role of this novel cytokine in post-stroke pathology. This is the first ever reported study measuring and trending IL-37 levels in human plasma after an acute ischemic stroke.

scholarly journals The research of the relationships between patent foramen ovale and ischemic stroke in elderly patients

2020 ◽  
Author(s):  
Xu Chao Sun ◽  
Wenjing Jiang ◽  
Yan Zhao ◽  
Lin Ma ◽  
Yan Lin ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Elderly Patients ◽  
Patent Foramen Ovale ◽  
Cryptogenic Stroke ◽  
Young Patients ◽  
Test Group ◽  
Control Group ◽  
Foramen Ovale ◽  
Stroke Patients ◽  
Shunt Volume

Abstract Background Research indicates that abnormal embolism caused by patent foramen ovale (PFO) may play an important role in cryptogenic stroke (CS). However, most researches has focused on young patients, and whether abnormal embolism caused by PFO also plays an important role in elderly CS is uncertain. The purpose of this study is to analyze the clinical characteristics of elderly patients with PFO, and to explore the correlation between elderly PFO and ischemic stroke.Methods 62 elderly patients diagnosed with ischemic stroke admitted to Qilu Hospital of Shandong University from April 2014 to April 2019 were selected as the Test Group. 62 non-stroke patients in our hospital's physical examination center and outpatient clinic were selected as the Control Group. Collect clinical data of patients for retrospective analysis.Results The incidence of PFO in the Test Group was significantly higher than that in the Control Group, the difference was statistically significant (p < 0.05). The proportion of large and medium shunt patients in the Test Group was significantly higher than that in the Control Group (p < 0.05). The proportion of patients with migraine in the PFO (+) group in the Test Group was significantly higher than the stroke patients in the PFO (-) group (p < 0.05).Conclusions The shunt volume of the PFO is related to ischemic stroke and may be a risk factor for ischemic stroke.

Abstract WP67: Ultra-early Institution of Statin Treatment is Associated With Improved Outcomes Among Acute Ischemic Stroke Patients Receiving Thrombolytic Treatment

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Adnan I Qureshi ◽  
Muhammad A Saleem
Keyword(s):  
Ischemic Stroke ◽  
Activities Of Daily Living ◽  
Endovascular Treatment ◽  
Acute Ischemic Stroke ◽  
Daily Living ◽  
Recombinant Tissue Plasminogen Activator ◽  
Statin Treatment ◽  
Functional Independence ◽  
Stroke Patients ◽  
Statin Use

Background: There is preliminary evidence that early statin use may improve the outcomes of acute ischemic stroke patients following endovascular treatment. Methods: We analyzed data from subjects treated with intravenous (IV) recombinant tissue plasminogen activator (rt-PA) alone or in combination with endovascular treatment the Interventional Management of Stroke III trial. We compared the rates of functional independence (defined by modified Rankin scale of 0-2) and minimal impairment of activities of daily living (Barthel index at 90 days 95-100)at 3 and 12 months among subjects with ultra-early institution of statin treatment (on Day 0) with those in whom statin treatment was not initiated and in those in whom statins were initiated between Day 1-discharge (delayed institution)after adjusting for age and baseline National Institutes of Health Stroke Scale score strata, history of hyperlipidemia; and statin use at baseline Results: Of the 656 subjects who were recruited in the trial, ultra-early institution of statin treatment and delayed institution occurred in 51 and 387 subjects, respectively. At 3 months post randomization, the adjusted rates of independent functional outcome (odds ratio [OR] 2.3; 95 % confidence interval [CI] 1.2-4.5; P = 0.015) and minimal impairment of activities of daily living (OR 2.2; 95 % CI 1.1-4.3; P = 0.022) were higher among subjects with ultra-early institution of statin treatment compared with those without any statin treatment. The adjusted rates of functional independence (OR 2.7; 95 % CI 1.4-5.2; P = 0.004) continued to higher among subjects with ultra-early institution of statin treatment at 12 months post randomization. The adjusted rates of functional independence and minimal impairment of activities of daily living were higher among subjects with ultra-early institution of statin treatment compared with those without any statin treatment in subjects randomized to endovascular treatment. Conclusions: Ultra-early institution of statin treatment in acute ischemic stroke patients treated with IV rt-PA with or without endovascular treatment was associated with improved outcome at both 3 and 12 months

scholarly journals AGE AND GENDER PREDILECTION OF PLASMA C-REACTIVE PROTEIN LEVELS ON MORTALITY IN FIRST EVER ACUTE ISCHEMIC STROKE

2021 ◽  
pp. 1-4
Author(s):  
Bharat L. Konin ◽  
Shiney Aggarwal ◽  
Swaraj S. Waddankeri
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Control Group ◽  
C Reactive Protein ◽  
Stroke Patients ◽  
Age And Gender ◽  
Protein Levels ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
And Gender

Background and Purpose: The measurement of markers of inflammation or thrombosis has been proposed as a method to improve the prediction of risk in patients with vascular disease. The role of C-reactive protein (CRP) as a novel plasma marker of atherothrombotic disease is currently under investigation. We related age and gender predilection of plasma CRP levels to first ever ischemic stroke and its role on mortality. Methods: Sixty patients with either hypertension or diabetes or both or none without thrombolysis with first ever acute ischemic stroke patients were examined. CT scan of brain was done after 24 hours of onset of symptoms to confirm the diagnosis. Plasma CRP level was determined after 12 - 72 hours range after the onset of symptoms in all CT confirmed ischemic stroke patients. This clinical study was done during June 2018 to January 2020. CRP was randomly measured in 60 age and sex matched individuals admitted in other wards of the hospital matched in all possible criteria expect the disease under study as a control group. Results: The CRP concentration in ischemic strokes is independent of infarction site, the value was more between 51-70 years of age group and almost equal in both gender. 54 of the 60 ischemic strokes studied had CRP value >6 mg/l and only 6 patients had <6 mg/l (p<0.001), chi square test value is ²=73.65 which is statistically significant. Only 7 of the 60 control group had CRP >6 mg/l. Conclusion: In this study mean C-Reactive protein levels were significantly higher in patients with ischemic stroke when compared to controls. C-reactive protein level increases as age advances. C-reactive protein is a better prognostic marker with no gender predilection and not a mortality predictor.

The effect of addition protein, phosphatidylcholine, phosphatidylserine, and inulin on GFAP levels of acute ischemic stroke patients at Dr. Kariadi Hospital, Semarang

2021 ◽  
Vol 9 (2) ◽  
pp. 184-197
Author(s):  
Diah Retno Wahyuningrum ◽  
Retnaningsih Retnaningsih ◽  
Martha Irene Kartasurya
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
G Protein ◽  
Intervention Group ◽  
Circulatory System ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Stroke Patients ◽  
Significant Difference ◽  
Enteral Formula

Background: The occurrence of ischemia causes a loss of energy to switch to anaerobic processes resulting in acidosis due to reduced Adenosina Triphosphate (ATP). This condition makes neuron cells apoptotic. Apoptotic of several biochemical substrates in the brain, such as Glial Fibrillary Acidic Protein (GFAP) exit into the circulatory system which is associated with dysbiosis through immunological pathways.Objectives: To determine the effect of giving enteral formula containing protein, phosphatidylcholine, phosphatidylserine, and inulin on GFAP levels in patients with acute ischemic stroke Dr. Kariadi Hospital.Materials and Methods: This study was done in a single-blind RCT. Eighteen ischemic stroke patients were randomly divided into intervention (9 subjects) and control groups (9 subjects). The intervention group received 69 g of the powdered enteral formula three times a day for seven days. The formula contained protein (15 g), phosphatidylcholine (128 mg),  phosphatidylserine (32 mg), and inulin (3 g). The subject who had diabetes mellitus received for 14 days at a dose of 34.5 g per day (7.5 g protein with additions 64mg phosphatidylcholine, 16mg phosphatidylserine, 1.5 g inulin). The control group received the standard enteral formula from the hospital, which contains (11.8 g protein without additions protein, phosphatidylcholine, phosphatidylserine, and inulin). GFAP levels by ELISA method (Enzyme-linked immunosorbent Assay) at pre and post-intervention.Results: There was a trend of decreasing GFAP levels before and after in the intervention group towards a better direction from 8.37±4.25 to 8.30±4.9 compared with the control group which experienced an increasing trend from 5.4±1.8 to 7.5±4. There was no significant difference in GFAP levels after intervention between groups (p = 0.7).Conclusions: The addition of protein, phosphatidylcholine, phosphatidylserine, and inulin had no significant effect on GFAP levels.

The relationship between serum and liquor IL-1β, IL-6, TNFa, IL-10 levels and clinical, cognitive and functional characteristics in acute ischemic stroke

2016 ◽  
Vol 94 (9) ◽  
pp. 657-662 ◽  
Author(s):  
Aleksey A. Kulesh ◽  
E. M. Kuklina ◽  
V. V. Shestakov
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Processing Speed ◽  
Cerebrovascular Diseases ◽  
Control Group ◽  
Cerebral Stroke ◽  
Main Process ◽  
Stroke Patients ◽  
Functional Characteristics ◽  
Visual Spatial

Introduction. Inflammation is probably the main process that links cardiovascular risk factors with damage to blood vessels and neurons. Elucidation of mechanisms of this relationship is an important issue. Materials and methods. 70 acute stroke patients were studied to assess their neuropsychological (MMSE, MoCA, FAB, Clock Drawing Test, Shulte Tables and Verbal Fluency) and functional status (mRS, RivermeadMobility Index). The serum and liquor IL-1β, IL-6, TNFa and IL-10 levels were analyzed. Control group included subjects without cerebrovascular diseases. Results. Stroke patients had higher IL-10 serum concentration than controls. No difference was found for other cytokines. There was correlation between serum and liquor cytokines levels. We found positive correlation between IL-1β, IL-6 and IL-10 levels. High IL-1β concentration was associated with vascular riskfactors, cardioembolic stroke, enhanced severity of cerebral stroke, low processing speed, impaired executive and visual-spatial functions and higher grade of mRS on discharge. The same pattern was revealed for IL-6 and IL-10. IL-6 level was related to mRS without relation to NIHSS on admission. High TNFa concentration was linked with vascular riskfactors, low MMSE score and processing speed. Discussion. Despite the antagonistic effects of IL-1β, IL-6 and IL-10 on inflammation, associations of these cytokines with anamnestic, clinical, neuropsychological and functional characteristics were similar in acute ischemic stroke. Probably, this fact indicates that during the acute ischemic brain damage process the immune response develops at the same time in pro- and anti-inflammatory directions. Its magnitude correlates with the damage severity and is associated with the effects of vascular riskfactors before stroke.

Persistent hyperfibrinogenemia in acute ischemic stroke / transient ischemic attack (TIA)

2008 ◽  
Vol 99 (01) ◽  
pp. 169-173 ◽  
Author(s):  
Einor Ben Assayag ◽  
Irena Bova ◽  
Ludmila Shopin ◽  
Michael Cohen ◽  
Shlomo Berliner ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Time Course ◽  
Venous Blood ◽  
Control Group ◽  
Fibrinogen Concentration ◽  
Stroke Patients ◽  
Ischemic Attack ◽  
A Minor ◽  
Acute Event

SummaryIncreased fibrinogen concentration is a well known phenomenon following acute ischemic stroke. However, the natural course of this hyperfibrinogenemia is uncertain. We aimed to clarify whether it is of a transient or more persistent nature in patients who harbor an underlying morbid biology of atherothrombo-inflammation. Venous blood for fibrinogen measurements was obtained from the control group participants and from stroke patients within 24 hours of admission, as well as 12 months following the acute event. In order to perform a time course analysis, we divided our cohort into tiles of time from symptoms' onset and compared the fibrinogen concentrations usingANOVA. Elevated fibrinogen concentrations were found in stroke patients on admission compared with matched controls (p<0.001).Analysis of variance in the different tertiles of time from symptoms' onset identified that fibrinogen concentrations were already relatively high during the initial phase of the event and did not differ significantly between the tiles (p=0.268). Moreover, when we calculated the absolute differences between the patients' fibrinogen concentrations and that of the matched controls there was clearly a minor increment during the time course from symptoms' onset in the stroke patients group. In conclusion, persistent hyperfibrinogenemia is present in patients with acute ischemic cerebral events and it might be present during the earlier stages of the disease as presently shown. Prompt and longterm, rather than short term, interventions to reduce the concentrations of this protein might therefore be of relevance.

scholarly journals Serum magnesium levels in patients of ischemic stroke and its correlation with neurological disability

2020 ◽  
Vol 8 (4) ◽  
pp. 1241
Author(s):  
Vishali Kotwal ◽  
Rajesh Maini
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Glutamate Release ◽  
Serum Magnesium ◽  
Normal Subjects ◽  
Control Group ◽  
P Value ◽  
Stroke Patients ◽  
Neurological Disability ◽  
Neuroprotective Effects

Background: Stroke is a leading cause of death and disability worldwide acute ischaemic stroke accounts for 87% of strokes and mostly affects persons at the peak of their lives. Magnesium is known to have neuroprotective effects in ischemic stroke through a variety of mechanisms including decrease in glutamate release and inhibition of NMDA receptors and vasodilation. Previous studies on serum magnesium levels in stroke patients have shown variable results with many of them finding lower levels than in normal subjects. This study was undertaken to compare serum magnesium levels in patients of acute ischemic stroke with those of controls and also find a correlation if any between serum magnesium levels and neurological disability.Methods: This was a prospective non-interventional case-control study in which 50 patients of acute ischemic stroke in the age group of 20 to 80 years admitted in the department of Medicine Government Medical College Jammu from October 2019 to January 2020 were taken. Their serum magnesium levels were analysed within first 24 hours of admission and neurological disability was measured using modified Rankin Score. Serum magnesium levels were also estimated in 35 healthy controls for comparison.Results: Serum magnesium was lower in the study group (mean of 1.85±0.36) as compared to the control group (mean of 2.4±0.21) which was statistically significant (p value =0.001). Modified Rankin Score was 4 to 5 in 27 patients and 2 to 3 in 23 patients and it was negatively correlated with serum magnesium levels (r =-0.67).Conclusions: Ischemic stroke patients had lower serum magnesium levels as compared to healthy subjects in our study and also lower levels were seen in those with higher neurological disability.

scholarly journals Sertraline for Functional Recovery After Acute Ischemic Stroke: A Prospective Observational Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Isabella Stuckart ◽  
Timo Siepmann ◽  
Christian Hartmann ◽  
Lars-Peder Pallesen ◽  
Annahita Sedghi ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Ischemic Stroke ◽  
Observational Study ◽  
Acute Ischemic Stroke ◽  
Functional Recovery ◽  
Prospective Observational Study ◽  
Functional Independence ◽  
Motor Deficit ◽  
Control Group ◽  
Stroke Patients

Background: Neuroprotective and neurorestorative effects have been postulated for selective serotonin-reuptake inhibitors (SSRI). We hypothesized that sertraline, which is characterized by less severe adverse effects and more stable pharmacokinetics than classic SSRI, is associated with improved functional recovery in acute ischemic stroke patients with motor deficits.Methods: Prospective observational study of consecutive acute ischemic stroke patients who received sertraline for clinically suspected post-stroke depression (PSD) or at high risk for PSD. Eligibility comprised acute motor deficit caused by ischemic stroke (≥2 points on NIHSS motor items) and functional independence pre-stroke (mRS ≤1). Decision to initiate treatment with SSRI during hospital stay was at the discretion of the treating stroke physician. Patients not receiving sertraline served as control group. Favorable functional recovery defined as mRS ≤2 was prospectively assessed at 3 months. Multivariable logistic regression analysis was used to explore the effects of sertraline on 3-months functional recovery. Secondary outcomes were frequency of any and incident PSD (defined by BDI ≥10) at 3 months.Results: During the study period (03/2017–12/2018), 114 patients were assigned to sertraline (n = 72, 62.6%) or control group (n = 42, 37.4%). At study entry, patients in sertraline group were more severely neurologically affected than patients in the control group (NIHSS: 8 [IQR, 5–11] vs. 5 [IQR, 4–7]; p = 0.002). Also, motor NIHSS scores were more pronounced in sertraline than in control group (4 [IQR 2–7] vs. 2 [IQR 2–4], p = 0.001). After adjusting for age and baseline NIHSS, multivariable regression analysis revealed a significant association between sertraline intake and favorable functional outcome at 3 months (OR 3.10, 95% CI 1.02–9.41; p = 0.045). There was no difference between both groups regarding the frequency of any depression at 3 months (26/53 [49.1%] vs. 14/28 [50.0%] patients, p = 0.643, BDI ≥10). However, fewer incident depressions were observed in sertraline group patients compared to patients in control group (0/53 [0%] vs. 5/28 [17.9%] patients, p = 0.004).Conclusions: In this non-randomized comparison, early treatment with sertraline tended to favor functional recovery in patients with acute ischemic stroke. While exploratory in nature, this hypothesis needs further investigation in a clinical trial.

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