Anti-edema and antioxidant combination therapy for ischemic stroke via glyburide-loaded betulinic acid nanoparticles

The aim. To evaluate the effi cacy of swallowing recovery of patients with ischemic stroke carried out with the use of training rehabilitation method using special nutrient mixtures as part of combination therapy. Material and methods. The study included 65 patients (35 men and 30 women, aged 45 to 80 years) with dysphagia in the acute period of ischemic stroke. Thirty patients (control group) were treated with special binding compounds as part of a combination therapy. Thirty fi ve patients (comparison group) did not use the mixture. The dynamics of the recovery function of swallowing using the Penetration–Aspiration Scale (PAS) and the Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS), as well as the transition from tube to independent feeding were studied. Results. The training method of rehabilitation using special nutritional mixtures is eff ective assessed with PAS and FEDSS in patients with ischemic stroke and neurogenic dysphagia (p < 0.05). The most pronounced eff ect was achieved in the group of patients with pseudobulbar syndrome. In patients with bulbar syndrome no statistically signifi cant diff erences were observed in the dynamic assessment of the severity of dysphagia on the PAS and FEDSS scales. The application of the training method leads to a signifi cantly better transition from tube to independent feeding. Conclusion. The training method of rehabilitation using special nutritional mixtures is eff ective in patients with ischemic stroke and neurogenic dysphagia and leads to a signifi cantly better transition from tube to independent feeding.

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Abstract T P66: Safety and Effectiveness of Intravenous Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke Patients on Aspirin and Clopidogrel

Stroke ◽

10.1161/str.46.suppl_1.tp66 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Mushtaq H Qureshi ◽

Shayaan M Khan ◽

Nauman Jahangir ◽

Ahmed A Malik ◽

Melissa Freese ◽

...

Keyword(s):

Ischemic Stroke ◽

Combination Therapy ◽

Acute Ischemic Stroke ◽

Plasminogen Activator ◽

Tissue Plasminogen Activator ◽

Recombinant Tissue Plasminogen Activator ◽

Favorable Outcome ◽

Stroke Patients ◽

Neurological Improvement ◽

Tissue Plasminogen

Background: The number of acute ischemic stroke patients who are on both aspirin and clopidogrel treatment at time of acute ischemic event is increasing. There is limited data regarding the safety and efficacy of intravenous recombinant tissue plasminogen activator (rt-PA) treatment in such patients. Methods: We reviewed the medical records and imaging data of consecutive patients with acute ischemic stroke who received IV rt-PA within 4.5 hours of symptom onset. We stratified the patients based on active regular use of antiplatelet medications: monotherapy (aspirin or clopidogrel), combination therapy (aspirin and clopidogrel), and no therapy and compared the rates of symptomatic intracerebral hemorrhage (ICH), neurological improvement (≥4 points in National Institutes of Health Stroke Scale [NIHSS], and favorable outcome (modified Rankin scale [mRS] 0-1) at discharge between the three groups. Results: A total of 88 acute ischemic stroke patients (mean age±SD; 69.88 ±15) were treated with IV rt-PA within the study duration. Of the 88 patients 45 (50.6%), 37 (41.6%), and 52 (58.4) were on monotherapy, combination therapy, or no therapy at time of presentation. The proportion of patients who developed symptomatic ICHs were similar (p=0.8) in monotherapy, combination therapy, and no therapy groups (3.3%, 0.0%, and 4.1%, respectively). The rates of neurological improvement were greater in patients on monotherapy (20%) (p=0.03) followed by combination therapy (11.1%), and no therapy groups (2.0%). There was no significant reduction in the rate of favorable outcome at discharge among patients on combination treatment compared with no treatment (odds ratio 0.8 , 95% confidence interval 0.4-1.8 ) after adjusting for age and initial NIHSS score strata (<10, 10-19, and ≥20). Conclusions: Compared with patients on no antiplatelet treatment, acute ischemic stroke patients who are actively using aspirin and clopidogrel appear to have similar risks and benefits with IV rt-PA treatment.

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Abstract T P76: Cerebral Lactate and Monocarboxylate Transporters Are Reduced by Ethanol and Normobaric Oxygen Therapy after Severe Transient and Permanent Ischemic Stroke

Stroke ◽

10.1161/str.46.suppl_1.tp76 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

David Brogan ◽

Christopher Sy ◽

Changya Peng ◽

Rhadika Rastogi ◽

Sunpreet Singh ◽

...

Keyword(s):

Ischemic Stroke ◽

Lactic Acidosis ◽

Combination Therapy ◽

Artery Occlusion ◽

Monocarboxylate Transporters ◽

Ros Generation ◽

Sprague Dawley ◽

Transient Ischemia ◽

Normobaric Oxygen ◽

Lactate Levels

Objectives: Recent studies conducted by this lab have shown the neuroprotective benefits of ethanol (EtOH) and normobaric oxygenation (NBO), which is partially due to amelioration of aberrant glucose metabolism and a reduction in reactive oxygen species (ROS). In the current study, we sought to identify whether the neuroprotective benefits of EtOH, with or without NBO, attenuates lactic acidosis by reducing expression of monocarboxylate transporters (MCTs), resulting in ROS reduction after transient and permanent ischemic stroke. Methods: Sprague-Dawley rats (n=64) were subjected to right middle cerebral artery occlusion (MCAO) for 2 h or 4 h (transient ischemia), or 28h (permanent ischemia) followed by 3h, 24h, or no reperfusion. Rats in each group were randomly assigned to receive either an injection of saline (sham treatment), an intraperitoneal injection of EtOH (1.5g/kg), two doses of EtOH (1.5g/kg at onset of reperfusion followed by 1.0 g/kg 2 h after 1 st dose), or EtOH + 95% NBO for 6 h (permanent ischemia). Lactate and ROS levels were detected at 3h and 24h following reperfusion. Gene and protein expressions of MCT-1, MCT-2, and MCT-4 were assessed by RT-PCR and Western Blotting, respectively. Results: A dose dependent neuroprotection of EtOH administration was found in transient ischemia. Single dose in 2 h MCAO and double dose in 4 h MCAO significantly attenuated lactate levels and ROS generation, MCT-1, MCT-2, and MCT-4 mRNA and protein expression after severe transient ischemia. However, EtOH treatment alone, even with 2 doses, was insufficient for permanent stroke, while combination therapy (EtOH + 95% NBO) resulted in a more potent decrease of all levels and expressions. Conclusions: Our study suggests that acute EtOH administration can attenuate lactic acidosis-induced oxidative stress following a transient ischemic stroke. This EtOH-induced attenuation of brain injury was enhanced by NBO in permanent ischemic stroke. Both EtOH and NBO are widely available, inexpensive, easy to administer, and have few side effects. Ultimately, this combination therapy could be an effective approach to future stroke treatments.

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Abstract TP132: The Combination Therapy of Intravenous Mannitol and Hypoxic Preconditioned Stem Cells for Ischemic Stroke

Stroke ◽

10.1161/str.50.suppl_1.tp132 ◽

2019 ◽

Vol 50 (Suppl_1) ◽

Author(s):

Dong-Hyuk Park ◽

Ho-Young Kang

Keyword(s):

Stem Cells ◽

Ischemic Stroke ◽

Combination Therapy

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Combination therapy with liposomal neuroprotectants and tissue plasminogen activator for treatment of ischemic stroke

The FASEB Journal ◽

10.1096/fj.201601209r ◽

2017 ◽

Vol 31 (5) ◽

pp. 1879-1890 ◽

Cited By ~ 24

Author(s):

Tatsuya Fukuta ◽

Tomohiro Asai ◽

Yosuke Yanagida ◽

Mio Namba ◽

Hiroyuki Koide ◽

...

Keyword(s):

Ischemic Stroke ◽

Combination Therapy ◽

Plasminogen Activator ◽

Tissue Plasminogen Activator ◽

Tissue Plasminogen

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Combination therapy with beraprost sodium and aspirin for acute ischemic stroke: a single-center retrospective study

Journal of International Medical Research ◽

10.1177/0300060519850401 ◽

2019 ◽

Vol 47 (7) ◽

pp. 3014-3024 ◽

Cited By ~ 1

Author(s):

De Cai ◽

Xiao-Pu Chen ◽

Dun-Can Wei ◽

Qian Zhang ◽

Si-Qia Chen ◽

...

Keyword(s):

Ischemic Stroke ◽

Retrospective Study ◽

Combination Therapy ◽

Adverse Events ◽

Acute Ischemic Stroke ◽

Blood Coagulation ◽

Control Group ◽

Single Center ◽

Beraprost Sodium ◽

Significant Difference

Objectives To evaluate the effectiveness and safety of the combination of beraprost sodium (BPS) and aspirin in patients with acute ischemic stroke (AIS). Methods There were 384 patients with AIS enrolled in this single-center, retrospective study. The BPS group comprised patients who received combination therapy with BPS and aspirin, and the control group comprised those who received only aspirin. Primary measurements were glomerular filtration rate (GFR), cystatin-c (Cys-C), National Institute of Health Stroke Scale (NIHSS) score, modified activities of daily living index (MBI), modified Rankin scale (mRS), and blood coagulation indexes. Recurrence and adverse events were recorded. Results There were no significant differences in patient characteristics at baseline between the two groups. GFR and Cys-C levels increased in the BPS group compared with the control group. After treatment, the NIHSS and mRS score were significantly lower in the BPS group compared with the control group, whereas the MBI scores were significantly higher in the BPS group compared with the control group. There was no significant difference in blood coagulation between the two groups. There were no serious adverse events in either group. Conclusions Combination therapy with BPS and aspirin may be a safe and effective treatment for AIS.

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Longitudinal multiparametric MRI study of hydrogen-enriched water with minocycline combination therapy in experimental ischemic stroke in rats

Brain Research ◽

10.1016/j.brainres.2020.147122 ◽

2020 ◽

Vol 1748 ◽

pp. 147122

Author(s):

Zhao Jiang ◽

Tharun T. Alamuri ◽

Eric R. Muir ◽

Dennis W. Choi ◽

Tim Q. Duong

Keyword(s):

Ischemic Stroke ◽

Combination Therapy ◽

Multiparametric Mri ◽

Mri Study

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EVALUATING EFFICIENCY OF TREATMENT MOTOR REHABILITATION AFTER ISCHEMIC STROKE WITH A COMBINATION OF&NBSP; “HUYET PHU TRUC U” DECOCTION AND&NBSP; ELECTRONIC ACUPUNCTURE

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.6.21 ◽

2018 ◽

Vol 8 (6) ◽

pp. 157-163

Author(s):

Thanh Le Ngoc ◽

Tan Nguyen Thi ◽

Loc Huynh Nguyen

Keyword(s):

Ischemic Stroke ◽

Longitudinal Study ◽

Muscle Strength ◽

Combination Therapy ◽

Barthel Index ◽

Urgent Problem ◽

Motor Rehabilitation ◽

Neurological Sequelae ◽

Acupuncture Research

Introduction: Stroke is still an urgent problem because of an increase in morbidity, mortality and many neurological sequelae. In Vietnam, studies using traditional medicine combined with acupuncture in the treatment of motor rehabilitation after stroke are still less compared to acupuncture studies. This study evaluates the efficacy of “Huyet phu truc u” decoction and electronic acupuncture combination therapy in motor rehabilitation in patients with hemiplegia after ischemic stroke. Subjects and methods: 40 patients with hemiplegia after ischemic stroke, eligible for study, were treated with “Huyet phu truc u” decoction combined electronic acupuncture. Research Methods: Longitudinal study with pre- and post-treatment follow-up. Result: Barthel points at the end of the study increased 1.73 times, Barthel points are ranked from the average or higher 97.5%, good + fairly 55%. Muscle strength from the 2/5 or higher 100%, from the 3/5 or higher 70%. Conclusions: The method treated with “Huyet phu truc u” decoction and electronic acupuncture combination has effected for treatment motor rehabilitation in patients with hemiplegia after ischemic stroke. Key words: “Huyet phu truc u” decoction, “Huyet phu truc u” decoction and electronic acupuncture, The Barthel index

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