scholarly journals NITRIT OKSIDA DAN VOLUME EDEMA OTAK PADA STROK PERDARAHAN DALAM OTAK DENGAN POLIMORFISME G894T (Nitric Oxide and Cerebral Edema Volume in Intracerebral Hemorrhagic Stroke with G894T Polymorphism)

Author(s):  
Iskandar Zakaria ◽  
Arif Faisal ◽  
Sri Sutarni ◽  
Ahmad Hamim Sadewa ◽  
Imran Imran

Nitric Oxide (NO) is a vasodilator that regulates vascular smooth muscle tone. Low levels of NO can cause vasoconstriction andhemodynamic disturbances. In stroke the levels of NO are increased. Endothelial nitric oxide synthase gene polymorphism (eNOS) isbelieved to reduce levels of NO in blood. NO levels decreased in stroke patients with G894T polymorphisms of eNOS gene. Mortality rateof hemorrhagic stroke are increased in case with increased peri focal edema volume. The mechanism of the increased of peri focal edemavolume completely unknown yet, suspected genetics factor. This study was conducted to know the correlation between the NO and perifocal edema volume in stroke with eNOS gene G894T polymorphism by determination. The study was conducted by comparing the levelsof NO and edema volume of intra cerebral hemorrhagic stroke of 46 subjects from Neurology department of dr. Zainoel Abidin generalhospital in Banda Aceh from September 2014 through January 2015 with comparison to ischemic stroke patients the same amount.NO levels checked with Cayman Systems kit following the protocol Griess. G894T polymorphism was determined by PCR-RFLP method.The volume of edema was measured with semi-automatic CT volumetry. Chi Square test was used for comparison of two variables andSpearman correlation test to assess the relationship between the NO and perifocal edema volume. The result is significant, if p valuewas <0.05. The results of these study were levels of NO decreases if there were polymorphism (p=0.001). Peri focal edema volume wasincreased if there were G894T polymorphism (p=0.038). The correlation between low levels of NO and increase of edema volume wasobtained p=0.040 and R=0.304. The researchers concluded that in intra cerebral hemorrhagic stroke the level of NO were decreasedand peri focal edema volume increased if there was G894T polymorphism of eNOS gene. There was a less correlation between low levelsof NO and peri focal edema volume.

2006 ◽  
Vol 52 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Mohsen Kerkeni ◽  
Faouzi Addad ◽  
Maryline Chauffert ◽  
Anne Myara ◽  
Mohamed Ben Farhat ◽  
...  

Abstract Background: Hyperhomocysteinemia is an independent, graded risk factor for coronary artery disease (CAD). The G894T variant of endothelial nitric oxide synthase (eNOS) was postulated to be associated with hyperhomocysteinemia and could influence individual susceptibility to CAD. The aims of this study were to investigate (a) the relationship of the eNOS G894T polymorphism with the presence and the severity of CAD and (b) the possible relationship between hyperhomocysteinemia and the eNOS G894T variant for the risk of CAD severity in a Tunisian population. Methods: We used PCR with restriction fragment length polymorphism analysis to detect the G894T variant of the eNOS gene in 100 patients with CAD and 120 healthy controls. The severity of CAD was expressed by the number of affected vessels. Total plasma homocysteine concentrations were determined by direct chemiluminescence assay. Results: The frequencies of the eNOS GG, GT, and TT genotypes in the CAD group were significantly different from those in the control group (45%, 44%, and 11% vs 60%, 35.8% and 4.2%, respectively; P = 0.035). There was no association between the eNOS G894T genotype frequencies and the number of stenosed vessels (P = 0.149). In the CAD group, the coexistence of the 894 GT or TT genotypes and hyperhomocysteinemia led to an increased risk of CAD severity. Conclusion: The G894T polymorphism of the eNOS gene is associated with the presence of CAD, and in conjunction with hyperhomocysteinemia, increased the risk of CAD severity in a Tunisian population.


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Patty Noah ◽  
Melanie Henderson ◽  
Rebekah Heintz ◽  
Russell Cerejo ◽  
Christopher T Hackett ◽  
...  

Introduction: Dysphagia occurs in up to two thirds of stroke patients and can lead to serious complications such as aspiration pneumonia, which is also linked to increased morbidity and mortality. Evidence-based guidelines recommend a bedside dysphagia assessment before oral intake in stroke patients regardless of initial stroke severity. Several studies have described registered nurses’ competency in terms of knowledge and skills regarding dysphagia screening. We aimed to examine the rate of aspiration pneumonia compared to the rate of dysphagia screening. Methods: A retrospective analysis of prospectively collected data at a single tertiary stroke center was carried out between January 2017 and June 2020. Data comparison was completed utilizing ICD-10 diagnosis codes to identify aspiration pneumonia in ischemic and hemorrhagic stroke patients. The data was reviewed to compare the compliance of a completed dysphagia screen prior to any oral intake to rate of aspiration pneumonia. Chi square tests were used to assess proportion differences in completed dysphagia screen and proportion of aspiration pneumonia diagnosis in the ischemic and hemorrhagic stroke patients. Results: We identified 3320 patient that met inclusion criteria. 67% were ischemic strokes, 22% were intracerebral hemorrhages and 11% were subarachnoid hemorrhages. Compliance with dysphagia screening decreased from 94.2% (n=1555/1650) in 2017-2018 to 74.0% (n=1236/1670) in 2019-2020, OR=0.17 (95%CI 0.14 - 0.22), p < 0.0001. Aspiration pneumonias increased from 58 (3.5%) in 2017-2018 to 77 (4.6%) in 2019-2020, but this difference was not statistically significant, OR=0.75 (95%CI 0.53 - 1.07), p = 0.11. Conclusion: We noted that the decrease in compliance with completing a dysphagia screen in patients with acute stroke prior to any oral intake was associated with a higher trend of aspiration pneumonia.


2015 ◽  
Vol 22 (07) ◽  
pp. 887-895
Author(s):  
Santosh Kumar ◽  
Muhammad Aslam ◽  
Maria Maria ◽  
Saleem Saleem

Stroke is one of the leading factors of morbidity and mortality worldwide. Toreduce the incidences of stroke, it is essential to identify and modify the risk factors for stroke.Risk factors can be modifiable and non modifiable. The aim of study was to ascertain theoutcome of stroke patient admitted in all Medical Wards in Liaquat University Hospital HyderabadObjective: To see the mortality, morbidity, disability and co-infection in stroke patients. StudyDesign: Prospective study. Period: One year. Setting: Medical Wards of Liaquat UniversityHospital Hyderabad / Jamshoro. Material and Methods: 200 Patients were enrolled in ourstudy to see the excepted outcome like mortality, Disability, Bed Sores, UTI & Pneumonia andDehydration in Stroke patients. All the patients were Young Adults, greater than 12 years inage and old aged patients, with Ischemic & Hemorrhagic stroke. On categorical variable suchas sex, mortality, morbidity chi-square test was applied at 95% confidence interval and the P-value ≤0.05 was considered as statically significant while the mean ±SD will be calculated forquantitative variables. Results: Mean age of the patient in our study was 57.03 years with thestandard deviation of ±7.35 years. Gender distribution shows most of the patients in our studywere male, i.e. 75% while, only 25% of the patients were female. Ischemic Stroke was foundin 126(63%) patients while, hemorrhagic stroke was found in 74(37%) patients. Regardingoutcome, mortality was found in 5% patients, disability 2%, UTI 2%, pneumonia 15%, Coinfection4%, Bed Sores 21.5% and dehydration was present in 50.5% patients. Conclusion:The study concludes that maximum patients had Ischemic Stroke. Among these patientsdehydration was the most common entity followed by bed Sores, pneumonia, mortality, Coinfection,disability and UTI.


2018 ◽  
Vol 69 (9) ◽  
pp. 2351-2356 ◽  
Author(s):  
Angela Cozma ◽  
Adela Sitar Taut ◽  
Olga Orasan ◽  
Lucia Maria Procopciuc ◽  
Anca Daniela Farcas ◽  
...  

Metabolic syndrome (MS) is a clustering entity characterized by obesity, hypertension, hyperglycemia, dyslipidemia, and insulin resistance. Atherosclerotic lesions may be a complication of MS, arising from endothelial dysfunction and induced by decreased nitric oxide (NO) production. NO is synthesized by nitric oxide synthase (eNOS), encoded by the NOS3 gene, and displays anti-inflammatory, vasodilatory, and antiproliferative effects.We aimed to investigate the relationship between the G894T polymorphism of the eNOS gene and metabolic syndrome (including its components) and the association of this polymorphism with arterial function, assessed by determining pulse wave velocity and the augmentation index.The study included 100 consecutive patients, 55% with metabolic syndrome (based on IDF criteria -study group), 45% without MS (control group). Arterial stiffness was measured using TensioMedTMArteriograph. The presence of the homozygous (TT) or heterozygous (GT) state was associated, compared to subjects without the mutation (GG), with an increased prevalence of arterial hypertension, diabetes mellitus, with an increase of abdominal circumference, an increase of triglycerides, without significantly influencing the level of HDL. No significant differences were found between patients with G894T polymorphism compared to those without the mutation regarding the arterial stiffness. The eNOS gene polymorphism: 894G]T was significantly associated with the presence of MS; the polymorphism in homozygous and heterozygous state was associated with an increased risk of metabolic syndrome. G894T polymorphism did not significantly influence the values of the studied arterial parameters (pulse wave velocity, aortic and brachial augmentation index).


2020 ◽  
Author(s):  
Maryam Jalili ◽  
Samira Asadollahi ◽  
Seyed Morteza Seifati ◽  
Hamid Reza Ashrafzadeh ◽  
Nasrin Ghasemi

Abstract Background: Repeated Pregnancy Loss (RPL) is defined as 2 or more consecutive spontaneous losses of pregnancy before 20 weeks. Some genetic polymorphisms such as endothelial nitric oxide synthase (eNOS) gene, which lead to the synthesis of nitric oxide, could be the reasons for RPL. This case-control study was investigated the frequency of -786 T>C variant in eNOS gene promoter in Iranian women with RPL. Methods : Blood samples were obtained from 100 unrelated women affected by recurrent pregnancy loss and 100 unaffected women as controls. Genomic DNA was extracted and -786 T>C polymorphism in eNOS gene promoter investigated by PCR-RFLP method in all of the samples. Statistical analysis in the group patients and controls were performed by chi-square test and P-values of <0.05 were considered significant.Results: Frequency of homozygous TT was 40% in cases and 46% in control group and frequency of CC was 6% in cases and 5% in the control group and frequency heterozygote TC was 54% in cases and 46% in control group. Genotype frequencies between the two groups showed no significant differences (P>0/05).Conclusion: The result of this study showed that this polymorphism is not more frequent in recurrent pregnancy loss in this population.


2013 ◽  
Vol 154 (44) ◽  
pp. 1743-1746
Author(s):  
Gergely Hofgárt ◽  
Rita Szepesi ◽  
Bertalan Vámosi ◽  
László Csiba

Introduction: During the past decades there has been a great progress in neuroimaging methods. Cranial computed tomography is part of the daily routine now and its use allows a fast diagnosis of parenchymal hemorrhage. However, before the availability of computed tomography the differentiation between ischemic and hemorrhagic stroke was based on patient history, physical examination, percutan angiography and cerebrospinal fluid sampling, and the clinical utility could be evaluated by autopsy of deceased patients. Aim: The authors explored the diagnostic performance of cerebrospinal fluid examination for the diagnosis of ischemic and hemorrhagic stroke. Method: Data of 200 deceased stroke patients were retrospectively evaluated. All patients had liquor sampling at admission and all of them had brain autopsy. Results: Bloody or yellowish cerebrospinal fluid at admission had a positive predictive value of 87.5% for hemorrhagic stroke confirmed by autopsy, while clear cerebrospinal fluid had positive predictive value of 90.7% for ischemic stroke. Patients who had clear liquor, but autopsy revealed hemorrhagic stroke had higher protein level in the cerebrospinal fluid, but the difference was not statistically significant (p = 0.09). Conclusions: The results confirm the importance of pathological evaluation of the brain in cases deceased from cerebral stroke. With this article the authors wanted to salute for those who contributed to the development of the Hungarian neuropathology. In this year we remember the 110th anniversary of the birth, and the 60th anniversary of the death of professor Kálmán Sántha. Professor László Molnár would be 90 years old in 2013. Orv. Hetil., 154 (44), 1743–1746.


2019 ◽  
Vol 7 (3) ◽  
pp. 232-237
Author(s):  
Hana Larasati ◽  
Theresia Titin Marlina

Background: stroke is a disorder of nervous system function that occurs suddenly and is caused by brain bleeding disorders that can affect the quality of life physical dimensions, social dimensions, psychological dimensions, environmental dimensions. Based on the result of Lumbu study (2015) the number of samples were 71 people collected data using the (WHOQOL-BREF). There were 56 people (78,9%) had the poor quality of life of post stroke. The mean of post-stroke quality of life domain was physical domain (45,27%), psychological domain (49,87%), social relations domain (48,15%) and environmental domain (50.01%). Objective: the purpose of the study was know the quality of life of the stroke patients in Outpatient Polyclinic of Private Hospital in Yogyakarta. Methods: used descriptive quantitative by using questionnaire test of purposive sampling system based on patients who have been affected of ischemic or hemorrhagic stroke before, number 30 respondents. Result: quality of life of stroke patient of medium physical dimension (67%), psychological dimension (71%), social dimension (67%), dimension good environment (63%). Conclusion: the quality of life of stroke patients of physical dimension, psychological dimension, and moderate social dimension, while the quality of life of stroke patients were good environmental dimension.   Keywords: Hemorrhagic stroke, ischemic stroke, quality of life


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