Gut Microbiotic Features Aiding the Diagnosis of Acute Ischemic Stroke

Increasing evidence suggests that features of the gut microbiota correlate with ischemic stroke. However, the specific characteristics of the gut microbiota in patients suffering different types of ischemic stroke, or recovering from such strokes, have rarely been studied, and potential microbiotic predictors of different types of stroke have seldom been analyzed. We subjected fecal specimens from patients with lacunar or non-lacunar acute ischemic infarctions, and those recovering from such strokes, to bacterial 16S rRNA sequencing and compared the results to those of healthy volunteers. We identified microbial markers of different types of ischemic stroke and verified that these were of diagnostic utility. Patients with two types of ischemic stroke, and those recovering from ischemic stroke, exhibited significant shifts in microbiotic diversities compared to healthy subjects. Cluster of Orthologous Groups of Proteins (COG) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses revealed reduced metabolic and transport-related pathway activities in ischemic stroke patients. We performed fivefold cross-validation using a Random Forest model to identify two optimal bacterial species (operational taxonomic units; OTUs) serving as markers of lacunar infarction; these were Lachnospiraceae (OTU_45) and Bacteroides (OTU_4), and the areas under the receiver operating characteristic curves (AUCs under the ROCs) were 0.881 and 0.872 respectively. In terms of non-lacunar acute ischemic infarction detection, the two optimal species were Bilophila (OTU_330) and Lachnospiraceae (OTU_338); the AUCs under the ROCs were 0.985 and 0.929 respectively. In post-ischemic stroke patients, the three optimal species were Pseudomonas (OTU_35), Sphingomonadaceae (OTU_303), and Akkermansia (OTU_9); the AUCs under the ROCs were 1, 0.897, and 0.846 respectively. Notably, the gut microbial markers were of considerable value for utility when diagnosing lacunar infarction, non-lacunar acute ischemic infarction, and post-ischemic stroke. This study is the first to characterize the gut microbiotic profiles of patients with lacunar or non-lacunar, acute ischemic strokes, and those recovering from stroke, and to identify microbiotic predictors of such strokes.

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Plasma D-Dimer Level in Different Types of Acute Ischaemic Stroke Patients: Experience at a Tertiary Hospital in Dhaka City

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v5i1.42162 ◽

2019 ◽

Vol 5 (1) ◽

pp. 13-17

Author(s):

Paritosh Kumar Sarkar ◽

Anwar Israil ◽

Mohammad Sayeed Hassan ◽

Abu Nayeem ◽

Md Azharul Hoque ◽

...

Keyword(s):

Internal Medicine ◽

Ischemic Stroke ◽

Ischaemic Stroke ◽

Clinical Diagnosis ◽

Acute Ischaemic Stroke ◽

Stroke Patients ◽

College Hospital ◽

Medical College ◽

Different Types ◽

D Dimer

Background: Plasma D-Dimer is a biomarker of thrombo-embolism. Objective: The purpose of the present study was to see the plasma D-dimer level in different types of acute ischaemic stroke patients. Methodology: This cross-sectional study was conducted in the Department of Neurology & Department of Internal Medicine at Dhaka Medical College Hospital, Dhaka, Bangladesh from July 2010 to June 2012 for a period of two (02) years. Patients with ischemic stroke with history within 7 days attending in the stroke clinic of Department of Neurology or admitted in the Department of Neurology and Internal Medicine through the outpatient and emergency Department of Dhaka Medical College Hospital (DMCH) were selected as study population for this study. Analysis of plasma D-Dimer was done in the Department of Hematology of DMCH.b Result: A total of 50 cases were recruited for this study. There were 24.0% lacunar infarcts, 40.0% atherothrombotic and 36.0% embolic infarcts in the study group. Highest level of plasma D-Dimer was observed in embolic (1700±964 ηg/ml) followed by atherothrombotic group (536±234 ηg/ml). The plasma D-Dimer was lowest (100±0 ηg/ml) in lacunar group. Concentration of Plasma D-Dimer showed significant correlation with clinical diagnosis in different subtypes of ischemic stroke (r=0.902; p=0.001) and also with risk factors, example, diabetes (r=0.319; p=0.012) and valvular heart disease (r=0.281; p=0.024), but no significant correlation with age, hypertension, hyperlipidaemia and smoking. Conclusion: In conclusion plasma D-Dimer is an important bio-marker in the clinical diagnosis and subtypes of ischemic stroke patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 13-17

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Сonstitucional features of ischemic stroke patients with concomitant cardiac pathology

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2010-4-148-151 ◽

2010 ◽

Vol 9 (4) ◽

pp. 148-151

Author(s):

N. V. Oleksyuk ◽

Yu. T. Kuryachenko

Keyword(s):

Ischemic Stroke ◽

Adverse Outcome ◽

Neurological Status ◽

Stroke Patients ◽

Cardiac Pathology ◽

Acute Period ◽

Positive Correlation ◽

Different Types

Identification of influence of cardiac pathology on the course of ischemic stroke in patients with different types of constitution, can play an important role in the tactics of treatment and prognosis. The assessment of neurological status in the acute period of stroke depending of the type of cardiac pathology and constitutional features, evaluation of hemostasis was performed. A positive correlation between the existed cardiac pathology with some anthropometric somatotype parameters and their influence on adverse outcome of stroke was revealed.

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Abstract TP234: New Clinical Application of Measurement of Blood Viscosity With an Electromagnetically Spinning Sphere Viscometer in Acute Ischemic Stroke Patients

Stroke ◽

10.1161/str.47.suppl_1.tp234 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Takeo Abumiya ◽

Koji Furukawa ◽

Keiji Sakai ◽

Miki Hirano ◽

Toshiya Osanai ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Clinical Application ◽

Blood Viscosity ◽

Pathological Condition ◽

Hematological Parameters ◽

Vascular Diseases ◽

Lacunar Infarction ◽

Stroke Patients ◽

Clinical Value

Introduction: Blood viscosity (BV) is an important blood property for determining the hemodynamic status. High BV causes blood stagnation and subsequent thrombotic reactions leading to cerebral infarction. However, clinical application of the measurement of BV is out of fashion due to the stereotype that the measurement results are within expectations with less clinical value. Hypothesis: Since the importance of BV remains unchanged in the pathogenesis of vascular diseases, BV values should still contain important information. We hypothesize that BV values may differ among stroke subtypes based on pathological condition. Methods: A new type of viscometer was recently developed using an electromagnetically spinning sphere (EMS) method, which enable us to measure small amount of samples quickly and sequentially in non-contact disposable manner. We measured BV in 100 healthy outpatients and 67 acute ischemic stroke patients (atherothrombotic: 28, lacunar: 23, and cardioembolic: 16) with EMS viscometer. The relationships between BV and hematological parameters were analyzed. The measurements in the acute stroke patients were performed a total of 4 times (Day0, Day2, Day7, and Day14 from the admission). Results: BV values in the healthy outpatients correlated more strongly with the total count of red blood cells and platelets (R2=0.6957) than with the hematocrit (R2=0.6435) in an exponential approximation. Compared with BV values in the healthy outpatients (4.57±0.76 mPa·s), Day0 BV values in the lacunar patients (5.37±1.11 mPa·s) were significantly higher (p<0.01), but those in the atherothrombotic patients (4.82±0.98 mPa·s) and in the cardioembolic patients (4.66±0.93 mPa·s) were not significantly different. In comparison between the values at Day 0 and Day 14, the lacunar patients alone showed a significant decrease from Day0 to Day14, suggesting that the lacunar patients suffered from dehydration at the onset. Conclusion: BV values at Day0 of lacunar infarction were significantly increased, which indicated contribution of dehydration to the onset of lacunar infarction. These measurements were performed with only 0.3ml of blood quickly and sequentially; therefore, the clinical application of the EMS viscometer appears to be promising.

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Study on Plasma D-Dimer for Early Diagnosis of Ischemic Stroke

Journal of Dhaka Medical College ◽

10.3329/jdmc.v24i2.29622 ◽

2016 ◽

Vol 24 (2) ◽

pp. 117-125

Author(s):

Paritosh Kumar Sarkar ◽

Murshed Baqui ◽

Mohammad Shah Jahirul Hoque Chowdhury ◽

Konol Saha ◽

Md Abdullah Alamgir ◽

...

Keyword(s):

Ischemic Stroke ◽

Early Diagnosis ◽

Qualitative Analysis ◽

Acute Ischemic Stroke ◽

Latex Agglutination ◽

Stroke Patients ◽

Medical College ◽

Different Types ◽

Stroke Group ◽

D Dimer

Background: Plasma D-Dimer is a biomarker of thrombo-embolism and a sensitive indicator of subclinical coagulopathy. Its level begins to rise within the first 6 hours of onset of symptoms of acute ischemic stroke. The availability of a rapid diagnostic test like plasma D-Dimer in acute ischemic stroke would be a substantial adjunct to CT and MRI. The test for plasma D-Dimer is quick and easy to perform based on principle of latex agglutination. This study is taken to estimate Plasma D-Dimer level in ischemic stroke patients and to see its role in early diagnosis, and also to differentiate different types of acute ischemic stroke in Bangladeshi population.Methods: This case control study was conducted in Dhaka Medical College Hospital (DMCH) from July 2010 to June 2012. Plasma D-Dimer was estimated by latex agglutination method in DMCH laboratory. Fifty stroke patients (age, 58.36±14.8 years; sex-M/F: 34/16) and 50 age matched control (58.80±15.01 years; sex-M/F: 36/14) were enrolled. In ischemic stroke group all patients were presented from 4 hours to 3 days. CT scan of brain revealed both cortical and subcortical lesion (56%), subcortical lesion (34%) and cortical lesion (10%). The CT volume of the involved brain lesion was 19.95±4.92 cm3. The value of plasma D-Dimer were evaluated in both control and ischemic stroke patients, correlated with CT size of infract and different types of acute ischemic strokes.Results: Qualitative analysis of plasma D-Dimer reveals 76% positive and 24% negative in the ischemic stroke group. On the other hand, plasma D-Dimer value was only 6% positive and 94% negative in the control group. Qualitative analysis of plasma D-Dimer differs significantly (c2=50.64; p=0.001) between the two groups. The analysis also reveals 76% sensitivity and 94% specificity of the Plasma D-Dimer test. Quantitative measurement of plasma D-Dimer (p=0.001) was 804±120 hg/ml and 126±16 hg/ml in ischemic and control groups respectively. The plasma concentration of D-Dimer between the two groups was statistically highly significant (t=31.21; p=0.001). Mean plasma D-Dimer level was highest in embolic infarct (1700±964 hg/ml) followed by atherothrombotic (536±234 hg/ml) and lowest in lacunar (100±00 hg/ml) subtype.J Dhaka Medical College, Vol. 24, No.2, October, 2015, Page 117-125

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