scholarly journals GLYCATED HAEMOGLOBIN (HBA1C) AND ITS ASSOCIATION WITH ISCHAEMIC STROKE IN DIABETICS AND NON- DIABETICS.

2020 ◽  
pp. 4-6
Author(s):  
Mohan Raj ◽  
Manu Reddy. S ◽  
Kiruthika Kiruthika ◽  
Raghul Raju
Keyword(s):  
Glycated Haemoglobin ◽  
Mortality Rates ◽  
Severe Disabilities ◽  
Stroke Severity ◽  
Stroke Outcome ◽  
Functional Abilities ◽  
Phase 2 ◽  
Pattern Type ◽  
Timing Pattern ◽  
Ultimate Outcome

Stroke is a condition that results in high mortality rates and severe disabilities. Stroke is expected to be the second most important cause of mortality worldwide by 2020. Most stroke survivors can and do experience improvements in their functional abilities, but the amount, rate, timing, pattern, type, and ultimate outcome of the improvements differ across patients and situations.1 Stroke severity and patient age are the main predictors of stroke outcome in the acute phase 2. Additional important predictors include functional status prior to stroke, presence of comorbid medical conditions, etiologies and the vascular territories affected.3

scholarly journals GLYCATED HAEMOGLOBIN (HBA1C) AND ITS ASSOCIATION WITH ISCHAEMIC STROKE IN DIABETICS AND NON- DIABETICS.

2020 ◽  
pp. 39-41
Author(s):  
Mohan Raj ◽  
Manu Reddy. S ◽  
Kiruthika Kiruthika ◽  
Raghul Raju
Keyword(s):  
Glycated Haemoglobin ◽  
Mortality Rates ◽  
Severe Disabilities ◽  
Stroke Severity ◽  
Stroke Outcome ◽  
Functional Abilities ◽  
Phase 2 ◽  
Pattern Type ◽  
Timing Pattern ◽  
Ultimate Outcome

Stroke is a condition that results in high mortality rates and severe disabilities. Stroke is expected to be the second most important cause of mortality worldwide by 2020. Most stroke survivors can and do experience improvements in their functional abilities, but the amount, rate, timing, pattern, type, and ultimate outcome of the improvements differ across patients and situations.1 Stroke severity and patient age are the main predictors of stroke outcome in the acute phase 2. Additional important predictors include functional status prior to stroke, presence of comorbid medical conditions, etiologies and the vascular territories affected.3

scholarly journals Genetic variation at the IGF1 locus shows association with post-stroke outcome and to circulating IGF1

2013 ◽  
Vol 169 (6) ◽  
pp. 759-765 ◽  
Author(s):  
N David Åberg ◽  
Sandra Olsson ◽  
Daniel Åberg ◽  
Katarina Jood ◽  
Tara M Stanne ◽  
...  
Keyword(s):  
Genetic Variation ◽  
Ischemic Stroke ◽  
Stroke Severity ◽  
Stroke Outcome ◽  
Nucleotide Polymorphisms ◽  
Post Stroke ◽  
Index Stroke ◽  
Genetic Impact ◽  
Major Allele ◽  
Community Controls

ObjectiveIn humans, serum IGF1 (s-IGF1) is associated with outcome after ischemic stroke (IS). Therefore variation at the IGF1 locus could also associate with both IS and s-IGF1. We investigated whether genetic variation at the IGF1 locus is associated with i) s-IGF1, ii) IS occurrence, iii) IS severity, and iv) post-stroke outcome.Design/methodsPatients (n=844; 66% males, mean age 56 years) and community controls (n=668) were included from the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). Post-stroke outcome was evaluated with the modified Rankin Scale at 3 and 24 months after index stroke, and baseline stroke severity with the Scandinavian Stroke Scale. s-IGF1 was determined in patients and after random selection in 40 of the controls.ResultsEleven single nucleotide polymorphisms (SNPs) were selected in the IGF1 gene. In healthy controls the major allele of rs7136446 was associated with higher s-IGF1, whereas in patients no such association was found. No SNP was associated with IS, nor with stroke severity. After multivariate correction for presence of diabetes, smoking, and hypertension, the major allele of rs7136446 was associated with favorable functional outcome 24-months post-stroke (odds ratio 1.46; 95% CI 1.09–1.96).ConclusionVariation in rs7136446 of the IGF1 gene associates with post-stroke outcome in relatively young IS patients. Also, rs7136446 associates with s-IGF1 in controls but not in IS, which indicates that IS perturbs a normal genetic impact on s-IGF1 levels.

Embedding Choice in the Context of Daily Routines: An Experimental Case Study

1995 ◽  
Vol 20 (3) ◽  
pp. 185-195 ◽  
Author(s):  
Linda M. Bambara ◽  
Freya Koger ◽  
Theresa Katzer ◽  
Teresa A. Davenport
Keyword(s):  
Functional Analysis ◽  
Problem Behaviors ◽  
Task Analysis ◽  
Phase 1 ◽  
Severe Disabilities ◽  
Choice Task ◽  
Phase 2 ◽  
Daily Routines ◽  
Household Activities

In this study, we evaluated the effect of individualized, embedded choice opportunities in daily routines on the task initiations and protests by one man with severe disabilities. An initial functional analysis conducted during Phase 1 revealed that low rates of participation and high rates of protests in household activities were related to prompts that offered no control. Subsequently in Phase 2, we modified prompts within three different routines to provide greater control through choice. Within the context of an A-B-A-B design, the effects of a “traditional” no-choice versus choice task analysis were evaluated in each routine across three staff. The results demonstrated that when routines included opportunities for choice, task initiations were high, whereas protests, including severe aggression, were virtually eliminated. These results are discussed in relation to their implications for participant control, individualizing choice opportunities, embedding choice in daily routines, and the prevention of problem behaviors.

scholarly journals Clinical Significance of Serum Zinc Levels in Cerebral Ischemia

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Archit Bhatt ◽  
Muhammad U. Farooq ◽  
Sailaja Enduri ◽  
Clement Pillainayagam ◽  
Bharath Naravetla ◽  
...  
Keyword(s):  
Functional Status ◽  
Serum Zinc ◽  
Stroke Severity ◽  
Stroke Outcome ◽  
Cellular Functions ◽  
Zinc Concentrations ◽  
Poor Functional Status ◽  
Zinc Levels ◽  
Serum Zinc Levels ◽  
Low Serum

Background. Zinc mediates several vital physiological, enzymatic and cellular functions. The association between serum zinc and stroke outcome has not been previously evaluated.Methods. This single center retrospective study was conducted on consecutive stroke () and TIA () patients. We sought to determine whether serum zinc concentrations in patients with acute ischemic strokes were associated with stroke severity and poor functional status at discharge, respectively.Results. Overall, out of the 224 patients analyzed (mean age 67 years), 35.7% patients had low zinc levels (65 mcg/dL). Patients with stroke () were more likely to have low zinc levels (, CI , ) compared to patients with TIA (). For patients with stroke (), multivariate analysis showed that low serum zinc levels (OR 2.82, CI , ) and strokes with admission severe strokes () (OR 2.68, CI , ) were independently associated with poor functional status () at discharge from the hospital.Conclusion. Low serum zinc concentrations are associated with more severe strokes on admission and poor functional status at discharge.

Biological age is better than chronological as predictor of 3-month outcome in ischemic stroke

Neurology ◽  
2017 ◽  
Vol 89 (8) ◽  
pp. 830-836 ◽  
Author(s):  
Carolina Soriano-Tárraga ◽  
Marina Mola-Caminal ◽  
Eva Giralt-Steinhauer ◽  
Angel Ois ◽  
Ana Rodríguez-Campello ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Ischemic Stroke ◽  
Biological Age ◽  
Bivariate Analysis ◽  
Stroke Severity ◽  
Stroke Outcome ◽  
Explanatory Variables ◽  
Age Related ◽  
Better Than ◽  
Independent Cohort

Objective:To analyze the effect of age-related DNA methylation changes in multiple cytosine-phosphate-guanine (CpG) sites (biological age [b-age]) on patient outcomes at 3 months after an ischemic stroke.Methods:We included 511 patients with first-ever acute ischemic stroke assessed at Hospital del Mar (Barcelona, Spain) as the discovery cohort. Demographic and clinical data, including chronological age (c-age), vascular risk factors, initial stroke severity, recanalization treatment, and previous and 3-month modified Rankin Scale (p-mRS and 3-mRS, respectively) were registered. B-age was estimated with an algorithm, based on DNA methylation in 71 CpGs. Bivariate analysis determined variables associated with 3-mRS for inclusion in ordinal multivariate analysis.Results:After ordinal regressions for 3-month ischemic stroke outcome (3-mRS), b-age was associated with outcome (odds ratio 1.04 [95% confidence interval 1.01–1.07]), nullifying c-age. Stepwise regression kept b-age, basal NIH Stroke Scale, sex, p-mRS, and recanalization treatment as better explanatory variables, instead of c-age. These results were successfully replicated in an independent cohort.Conclusions:B-age, estimated by DNA methylation, is an independent predictor of ischemic stroke outcome regardless of chronological years.

scholarly journals Genetic Predisposition to Mosaic Chromosomal Loss Is Associated With Functional Outcome After Ischemic Stroke

2021 ◽  
Vol 7 (6) ◽  
pp. e634
Author(s):  
Malin Johansson ◽  
Annie Pedersen ◽  
John W. Cole ◽  
Cecilia Lagging ◽  
Arne Lindgren ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Functional Outcome ◽  
Genome Wide Association Study ◽  
Genetic Alterations ◽  
European Ancestry ◽  
Stroke Severity ◽  
Polygenic Risk Score ◽  
Stroke Outcome ◽  
Data Set ◽  
Logistic Regression Models

Background and ObjectivesTo test the hypothesis that a predisposition to acquired genetic alterations is associated with ischemic stroke outcome by investigating the association between a polygenic risk score (PRS) for mosaic loss of chromosome Y (mLOY) and outcome in a large international data set.MethodsWe used data from the genome-wide association study performed within the Genetics of Ischemic Stroke Functional Outcome network, which included 6,165 patients (3,497 men and 2,668 women) with acute ischemic stroke of mainly European ancestry. We assessed a weighted PRS for mLOY and examined possible associations with the modified Rankin Scale (mRS) score 3 months poststroke in logistic regression models. We investigated the whole study sample as well as men and women separately.ResultsIncreasing PRS for mLOY was associated with poor functional outcome (mRS score >2) with an odds ratio (OR) of 1.11 (95% confidence interval [CI] 1.03–1.19) per 1 SD increase in the PRS after adjustment for age, sex, ancestry, stroke severity (NIH Stroke Scale), smoking, and diabetes mellitus. In sex-stratified analyses, we found a statistically significant association in women (adjusted OR 1.20, 95% CI 1.08–1.33). In men, the association was in the same direction (adjusted OR 1.04, 95% CI 0.95–1.14), and we observed no significant genotype-sex interaction.DiscussionIn this exploratory study, we found associations between genetic variants predisposing to mLOY and stroke outcome. The significant association in women suggests underlying mechanisms related to genomic instability that operate in both sexes. These findings need replication and mechanistic exploration.

scholarly journals Neurobiochemical Markers of Brain Damage in Cerebrospinal Fluid of Acute Ischemic Stroke Patients

2010 ◽  
Vol 56 (3) ◽  
pp. 451-458 ◽  
Author(s):  
Raf Brouns ◽  
Bart De Vil ◽  
Patrick Cras ◽  
Didier De Surgeloose ◽  
Peter Mariën ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Calcium Binding ◽  
Infarct Volume ◽  
Neuron Specific Enolase ◽  
Stroke Severity ◽  
Stroke Outcome ◽  
Stroke Patients ◽  
Nihss Score

Abstract Background: Ischemic injury to the central nervous system causes cellular activation and disintegration, leading to release of cell-type–specific proteins into the cerebrospinal fluid (CSF). We investigated CSF concentrations of myelin basic protein (MBP), glial fibrillary astrocytic protein (GFAP), the calcium-binding protein S100B, and neuron-specific enolase (NSE) in acute ischemic stroke patients and their relation to initial stroke severity, stroke location, and long-term stroke outcome. Methods: CSF concentrations of MBP, GFAP, S100B, and NSE were assessed in 89 stroke patients on admission (mean 8.7 h after stroke onset) and in 35 controls. We evaluated the relation between CSF concentrations and (a) stroke severity (NIH Stroke Scale [NIHSS] score on admission, infarct volume), (b) stroke location, and (c) stroke outcome (modified Rankin Scale [mRS] score at month 3). Results: MBP concentration was significantly higher in subcortical than in cortical infarcts (median MBP, 1.18 vs 0.66 μg/L, P < 0.001). GFAP and S100B concentrations correlated with the NIHSS score on admission (GFAP, R = 0.35, P = 0.001; S100B, R = 0.29, P = 0.006), infarct volume (GFAP, R = 0.34, P = 0.001; S100B, R = 0.28, P = 0.008), and mRS score at month 3 (R = 0.42, P < 0.001 and R = 0.28, P = 0.007). Concentrations of NSE did not correlate with stroke characteristics. Conclusions: MBP, GFAP, S100B, and NSE display relevant differences in cellular and subcellular origins, which are reflected in their relation to stroke characteristics. MBP is a marker for infarct location. GFAP and S100B correlate with stroke severity and outcome.

scholarly journals Paradoxical role of hepatocyte growth factor in ischemic stroke: stroke risk/stroke recovery

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Ibraheim Al-Ahmar ◽  
Noha Mohamed ◽  
Hosna Elshony
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Carotid Atherosclerosis ◽  
Stroke Recovery ◽  
Stroke Severity ◽  
Stroke Outcome ◽  
Stroke Patients ◽  
Atherosclerosis Risk ◽  
Atherosclerosis Risk Factors ◽  
Hepatocyte Growth

Abstract Background Hepatocyte growth factor (HGF) has an obvious pathological role in atherosclerosis and plaque instability leading to an acute ischemic stroke; however, its beneficial role in stroke recovery is still restricted to experimental studies. The aim of the current study was to investigate the association between HGF and carotid atherosclerosis and evaluate its value as a prognostic marker of ischemic stroke and its role in stroke recovery. Results This case–control study was done on 100 patients with first time anterior circulation ischemic stroke, subjected to clinical and laboratory evaluation of atherosclerosis risk factors. Brain imaging, cardiac work-up and ultrasonographic assessment of carotid atherosclerosis (using intimal medial thickness and plaque score) were all done. Clinical evaluation of initial stroke severity, using National Institutes of Health Stroke Scale (NIHSS), and stroke outcome after 3 m, using Modified Rankin Scale (MRS), was performed. Measurement of HGF serum concentration was done to all stroke patients within 24 h of stroke onset and compared to results of 100 matched healthy subjects aged more than 50 years. HGF was significantly higher in stroke patients than healthy controls and in atherothrombotic than cardioembolic stroke group and its level was significantly correlated with atherosclerosis risk factors, degree of carotid atherosclerosis and better stroke outcome; however, it was not significantly correlated with initial stroke severity. Conclusion HGF is strongly associated with carotid atherosclerosis and other atherosclerosis risk factors and subsequent atherothrombotic stroke. Also, it can be used as a good prognostic marker in atherothrombotic stroke suggesting its role in stroke recovery but more studies are needed to explore this beneficial role as well as its therapeutic potentials in ischemic stroke patients.

scholarly journals Assessment of Stroke Outcome Based on Initial Stroke Severity Measured on Different Stroke Severity Scales

1970 ◽  
Vol 11 (2) ◽  
pp. 137-142
Author(s):  
Abdul Quddus ◽  
Matiur Rahman ◽  
Faisal Ahmed ◽  
Badrul Alam Mondol ◽  
Md Mahmudur Rahman Siddiqui
Keyword(s):  
Barthel Index ◽  
Cerebral Hemorrhage ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Cerebral Infarct ◽  
Stroke Severity ◽  
Stroke Outcome ◽  
Group I ◽  
Sf 36 ◽  
The Difference

Background: Stroke is the second most common cause of death globally and the major cause of disability. Thougha number of studies have been conducted on stroke outcome and recovery of walking function, the list and effectsof predictive factors are still a major challenge to stroke rehabilitation.Materials and methods: This was a randomized prospective study to evaluate whether initial stroke severityinfluences the stroke outcome. The patients were categorized after CT scan into two groups (group I- infarction typeand group II haemorrhagic type). Initial stroke severity was evaluated in Scandinavian Stroke Scale (SSS). Functionalstatus was evaluated after admission in Functional Independence Measure (FIM), Barthel Index (BI) and ShortForm- 36 (SF- 36).To see the outcome in relation to time patients were evaluated with FIM, BI and SF- 36 four weeksafter discharge.Results: Analysis of Scandinavian Stroke Scale indicated that the overall score was higher among the patients withcerebral infarct (mean score 29.25) compared to patients with cerebral hemorrhage (mean score 20.08) and themean difference was statistically significant (p<0.001). Analysis of Barthel Index indicated that the percentage ofimprovement was significantly high among the patients with cerebral hemorrhage compared to cerebral infarct interms of transfers from bed to chair or vice versa (p<0.001). However, improvement was also high among thepatients with cerebral hemorrhage as well as cerebral infarct, but the difference was not statistically significant(p>0.05)Conclusion: This study indicates that initial motor, sensory and cognitive impairment can be good predictor inamount and time period of recovery of mobility function and other aspect in acute stroke patients, as data shows thatmilder the initial impairment faster and more is the recovery.Keywords: Stroke; cerebrovascular accident; outcome assessmentDOI: 10.3329/jom.v11i2.5460J MEDICINE 2010; 11 : 137-142

Initial stroke severity and stroke outcome – the inseparable link

2017 ◽  
Vol 65 (6) ◽  
pp. 1260
Author(s):  
PN Sylaja ◽  
SN Sruthi
Keyword(s):  
Stroke Severity ◽  
Stroke Outcome
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