scholarly journals Prediction of the Lethal Outcome of Acute Recurrent Cerebral Ischemic Hemispheric Stroke

Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 311
Author(s):  
Kozyolkin ◽  
Kuznietsov ◽  
Novikova
Keyword(s):  
Clinical Laboratory ◽  
Developed Countries ◽  
National Institutes Of Health ◽  
Lethal Outcome ◽  
Hemispheric Stroke ◽  
Multivariable Regression ◽  
Independent Risk Factors ◽  
Cerebral Ischemic ◽  
The Mathematical Model ◽  
The Brain

Background and objectives. Stroke-induced mortality is the third most common cause of death in developed countries. Intense interest has focused on the recurrent ischemic stroke, which rate makes up 30% during first 5 years after first-ever stroke. This work aims to develop criteria for the prediction of acute recurrent cerebral ischemic hemispheric stroke (RCIHS) outcome on the basis of comprehensive baseline clinical, laboratory, and neuroimaging examinations. Materials and Methods. One hundred thirty-six patients (71 males and 65 females, median age 74 (65; 78)) with acute RCIHS were enrolled in the study. All patients underwent a detailed clinical and neurological examination using National Institutes of Health Stroke Scale (NIHSS), computed tomography of the brain, hematological, and biochemical investigations. In order to detect the dependent and independent risk factors of the lethal outcome of the acute period of RCIHS, univariable and multivariable regression analysis were conducted. A receiver operating characteristic (ROC) analysis with the calculation of sensitivity and specificity was performed to determine the prediction variables. Results. Twenty-five patients died. The independent predictors of the lethal outcome of acute RCIHS were: Baseline NIHSS score (OR 95% CІ 1.33 (1.08–1.64), p = 0.0003), septum pellucidum displacement (OR 95% CI 1.53 (1.17–2.00), p = 0.0021), glucose serum level (OR 95% CI 1.28 (1.09–1.50), p = 0.0022), neutrophil-to-lymphocyte ratio (OR 95% CI 1.11 (1.00–1.21), p = 0.0303). The mathematical model, which included these variables was developed and it could determine the prognosis of lethal outcome of the acute RCIHS with an accuracy of 86.8% (AUC = 0.88 ± 0.04 (0.88–0.93), p < 0.0001).

Exploring the Role of Remote Ischemic Preconditioning In Long Term Cognitive Impairment after Global Ischemia-Reperfusion-Induced Vascular Dementia in Mice

2020 ◽  
Author(s):  
Amteshwar Singh Jaggi
Keyword(s):  
Cognitive Impairment ◽  
Cerebral Ischemia ◽  
Vascular Dementia ◽  
Ischemic Preconditioning ◽  
Ischemia Reperfusion ◽  
Remote Ischemic Preconditioning ◽  
Global Cerebral Ischemia ◽  
Cerebral Ischemic ◽  
The Brain

Aim: The aim of the present study is to explore the neuroprotective effects of remote ischemic preconditioning in long term cognitive impairment after global cerebral ischemia induced-vascular dementia in mice. Material and methods: The mice were subjected to global cerebral ischemia by occluding the bilateral common carotid arteries for 12 minutes followed by the 24 hours of the reperfusion. The remote ischemic preconditioning stimulus was delivered in the form of 4 cycles of ischemia/reperfusion for 5 minutes each. The cerebral ischemic injury induced-long term cognitive impairment-related learning and memory alterations was assessed using morris water maze, the motor performances of the animals were evaluated using rota-rod test and neurological severity score. The cerebral infract size of the brain were quantified using triphenyltetrazolium chloride staining. Results: Global cerebral ischemia causes long term memory impairment, decreases motor performances and increases the brain infract size in animals. The delivery of remote ischemic preconditioning stimulus significantly abolished the long-term cognitive impairment and ameliorates the motor performances as well as cerebral infract size in brain. Conclusion: The remote ischemic preconditioning mediates neuro protection against global cerebral ischemic injury induced long-term cognitive impairment.

Activation of astroglial CB1R mediates cerebral ischemic tolerance induced by electroacupuncture

2021 ◽  
pp. 0271678X2199439
Author(s):  
Cen Yang ◽  
Jingjing Liu ◽  
Jingyi Wang ◽  
Anqi Yin ◽  
Zhenhua Jiang ◽  
...  
Keyword(s):  
Endocannabinoid System ◽  
Artery Occlusion ◽  
Ischemic Tolerance ◽  
Protective Mechanisms ◽  
Promising Therapeutic Approach ◽  
Subsequent Activation ◽  
Cerebral Ischemic ◽  
Cerebral Artery Occlusion ◽  
The Brain

There are no effective treatments for stroke. The activation of endogenous protective mechanisms is a promising therapeutic approach, which evokes the intrinsic ability of the brain to protect itself. Accumulated evidence strongly suggests that electroacupuncture (EA) pretreatment induces rapid tolerance to cerebral ischemia. With regard to mechanisms underlying ischemic tolerance induced by EA, many molecules and signaling pathways are involved, such as the endocannabinoid system, although the exact mechanisms have not been fully elucidated. In the current study, we employed mutant mice, neuropharmacology, microdialysis, and virus transfection techniques in a middle cerebral artery occlusion (MCAO) model to explore the cell-specific and brain region-specific mechanisms of EA-induced neuroprotection. EA pretreatment resulted in increased ambient endocannabinoid (eCB) levels and subsequent activation of ischemic penumbral astroglial cannabinoid type 1 receptors (CB1R) which led to moderate upregulation of extracellular glutamate that protected neurons from cerebral ischemic injury. These findings provide a novel cellular mechanism of EA and a potential therapeutic target for ischemic stroke.

Utility of CT perfusion scanning in patient selection for acute stroke intervention: experience at University at Buffalo Neurosurgery–Millard Fillmore Gates Circle Hospital

2011 ◽  
Vol 30 (6) ◽  
pp. E4 ◽  
Author(s):  
Peter T. Kan ◽  
Kenneth V. Snyder ◽  
Parham Yashar ◽  
Adnan H. Siddiqui ◽  
L. Nelson Hopkins ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Patient Selection ◽  
Ct Perfusion ◽  
Brain Parenchyma ◽  
National Institutes Of Health ◽  
Time Interval ◽  
Case Examples ◽  
Flow Parameters ◽  
Selection For ◽  
The Brain

Computed tomography perfusion scanning generates physiological flow parameters of the brain parenchyma, allowing differentiation of ischemic penumbra and core infarct. Perfusion maps, along with the National Institutes of Health Stroke Scale score, are used as the bases for endovascular stroke intervention at the authors' institute, regardless of the time interval from stroke onset. With case examples, the authors illustrate their perfusion-based imaging guidelines in patient selection for endovascular treatment in the setting of acute stroke.

scholarly journals Non-Coding RNA in Acute Ischemic Stroke: Mechanisms, Biomarkers and Therapeutic Targets

2018 ◽  
Vol 27 (12) ◽  
pp. 1763-1777 ◽  
Author(s):  
Sheng-Wen Wang ◽  
Zhong Liu ◽  
Zhong-Song Shi
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Neural Development ◽  
Therapeutic Targets ◽  
Circular Rnas ◽  
Non Coding Rna ◽  
Non Coding Rnas ◽  
Cerebral Ischemic ◽  
Functional Rnas ◽  
The Brain

Non-coding RNAs (ncRNAs) are a class of functional RNAs that regulate gene expression in a post-transcriptional manner. NcRNAs include microRNAs, long non-coding RNAs and circular RNAs. They are highly expressed in the brain and are involved in the regulation of physiological and pathophysiological processes, including cerebral ischemic injury, neurodegeneration, neural development, and plasticity. Stroke is one of the leading causes of death and physical disability worldwide. Acute ischemic stroke (AIS) occurs when brain blood flow stops, and that stoppage results in reduced oxygen and glucose supply to cells in the brain. In this article, we review the latest progress on ncRNAs in relation to their implications in AIS, as well as their potential as diagnostic and prognostic biomarkers. We also review ncRNAs acting as possible therapeutic targets in future precision medicine. Finally, we conclude with a brief discussion of current challenges and future directions for ncRNAs studies in AIS, which may facilitate the translation of ncRNAs research into clinical practice to improve clinical outcome of AIS.

scholarly journals Soft monetary policy in a sustainable economy as a rigid game

2021 ◽  
Vol 250 ◽  
pp. 06005
Author(s):  
Inna Čábelková
Keyword(s):  
Financial Markets ◽  
Developed Countries ◽  
Real Sector ◽  
The Real ◽  
Model Studies ◽  
Money Multiplier ◽  
The Past ◽  
Sustainable Economy ◽  
High Inflation ◽  
The Mathematical Model

Over the past decade, central banks in a majority of developed countries injected astonishing amounts of money into national and international economies in the hope of helping real sectors and with worries of high inflation. Neither of these came true. This paper describes the reasons for such unusual dynamics using a case of the sustainable economy. The three factors considered include the increased propensity to save, the decreased money multiplier, and substantial growth in the financial markets. The mathematical model studies the effect of the new money created on the real sector via the effect on real consumption depending on the share of the new money received by the less and more affluent part of the population. The results suggest, that the higher is the proportion of new money allocated to the poorer part of the society, the higher is the effect of overall money on the real sector if the propensity to consume in this part of the population is held constant.

Focal Ischemic Cerebral Injury in the Newborn: Diagnosis by Ultrasound and Correlation with Computed Tomographic Scan

PEDIATRICS ◽  
1983 ◽  
Vol 71 (5) ◽  
pp. 790-793
Author(s):  
Alan Hill ◽  
David J. Martin ◽  
Alan Daneman ◽  
Charles R. Fitz
Keyword(s):  
Term Infant ◽  
Cerebral Injury ◽  
Ultrasound Scanning ◽  
Older Children ◽  
Cerebral Lesions ◽  
Ischemic Brain ◽  
Computed Tomographic ◽  
Cerebral Ischemic ◽  
The Brain

Ischemic brain injury in the newborn is a common cause of subsequent neurologic deficits seen in older children. Clearly, determination of severity and location of such injury is important for management and prognosis. Although ultrasound scanning of the brain has been used extensively in the premature infant for diagnosis of hemorrhagic lesions, its use in the term infant for recognition of isehemic cerebral lesions has not been reported. Four cases are described in which focal echodense areas were identified on ultrasound scan of the brain. These echodense areas on ultrasound corresponded to the appearance on computed tomographic (CT) scan of areas of decreased density which are known to represent ischemic cerebral injury. In three of the four cases there were focal neurologic findings and/or focal abnormalities on EEG. In two cases, real-time ultrasound scanning demonstrated changes in arterial pulsations in cerebral vessels in the area of the lesions. Thus in both, there was diminution in pulsations within the echodense areas and in one case, an increase in pulsations was observed at the periphery of the echodense lesion. Our data demonstrate the value of ultrasound scanning for assessment of the extent and location of focal cerebral ischemic lesions in the newborn. Such assessment permite assessment of prognosis.

A Computational Simulation of the Cognitive Process of Children Knowledge Acquisition and Memory Development

2012 ◽  
pp. 111-127
Author(s):  
Jeff Bancroft ◽  
Yingxu Wang
Keyword(s):  
Knowledge Representation ◽  
Knowledge Acquisition ◽  
Computational Simulation ◽  
Simulation Tool ◽  
Memory Development ◽  
Cognitive Mechanisms ◽  
Children's Memory ◽  
Mechanisms Of Memory ◽  
The Mathematical Model ◽  
The Brain

The cognitive mechanisms of knowledge representation, memory establishment, and learning are fundamental issues in understanding the brain. A basic approach to studying these mental processes is to observe and simulate how knowledge is memorized by little children. This paper presents a simulation tool for knowledge acquisition and memory development for young children of two to five years old. The cognitive mechanisms of memory, the mathematical model of concepts and knowledge, and the fundamental elements of internal knowledge representation are explored. The cognitive processes of children’s memory and knowledge development are described based on concept algebra and the object-attribute-relation (OAR) model. The design of the simulation tool for children’s knowledge acquisition and memory development is presented with the graphical representor of memory and the dynamic concept network of knowledge. Applications of the simulation tool are described by case studies on children’s knowledge acquisition about family members, relatives, and transportation. This work is a part of the development of cognitive computers that mimic human knowledge processing and autonomous learning.

Epidemiology and aetiopathogenesis

2020 ◽  
pp. 9-24
Author(s):  
Timothy J. England
Keyword(s):  
Small Vessel Disease ◽  
The Elderly ◽  
Developed Countries ◽  
Amyloid Angiopathy ◽  
Ageing Population ◽  
Vessel Disease ◽  
The Brain ◽  
Spontaneous Intracerebral Haemorrhage ◽  
Pathological Subtypes ◽  
Large Vessel Disease

Stroke is a common disabling condition associated with a high mortality, especially in the elderly. Subsequent social and monetary costs are high and despite a decreasing incidence of stroke in developed countries in recent years, prevalence has not declined due to an ageing population. Chapter 2 deals with ‘Epidemiology and aetiopathogenesis’ and examines the definitions of stroke and its pathological subtypes; epidemiology on a worldwide basis; age-specific data; mortality rates; cerebral blood flow and its relationship with ischaemic thresholds; and macroscopic and microscopic changes in the brain with increasing age and their relationship with ischaemic and haemorrhagic strokes. Changes related to large vessel disease, cardioembolism, small vessel disease, inflammatory arteriopathies, spontaneous intracerebral haemorrhage and cerebral amyloid angiopathy, are also described.

Tuberculosis in native Israeli Arabs and Jews: trends and treatment outcomes, 1999–2011

2015 ◽  
Vol 143 (15) ◽  
pp. 3203-3210 ◽  
Author(s):  
H. BISHARA ◽  
D. GOLDBLATT ◽  
E. RORMAN ◽  
Z. MOR
Keyword(s):  
Treatment Outcomes ◽  
Clinical Laboratory ◽  
Treatment Success ◽  
Developed Countries ◽  
National Average ◽  
Success Rates ◽  
Pulmonary Tb ◽  
Tb Treatment ◽  
Lower Treatment ◽  
Israeli Arabs

SUMMARYThe incidence of tuberculosis (TB) in native ethnic minorities remains high in developed countries. Arabs, the major ethnic minority in Israel, comprise 21% of its population. This retrospective study compared TB incidence, demographic, clinical, laboratory, genotyping characteristics and treatment outcomes in all Israeli-born citizens diagnosed with TB between 1999 and 2011 by ethnicity, i.e. Israeli-born Arabs (IA) and Jews (IJ). A total of 831 Israeli-born TB patients were reported. Of those, there were 530 (64%) IJ and 301 (36%) IA, with an average annual TB rate of 1·1 and 1·6 cases/100 000 population, respectively, lower than the national average (7·0 cases/100 000 population). TB rates in IA and IJ declined and converged to 1 case/100 000 residents. IA TB patients were more likely to be older, have more pulmonary TB and have lower treatment success rates than IJ. Older age and HIV co-infection, but not ethnicity, were predictive of non-success in TB treatment. Ten mixed IA–IJ clades were detected by spoligotyping and three mixed IA–IJ clusters were identified by MIRU-VNTR typing. Only one IA–IJ couple recalled mutual contact. In conclusion, TB rate in IA was higher than in IJ, but declined and converged in both to 1 case/100 000. Treatment success was high in both groups, and was unrelated to ethnicity.

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