Characteristics of acute ischemic stroke in patients with Nephrotic syndrome

The incidence of ischemic stroke (IS) is higher in nephrotic syndrome (NS) patients compared to general population. However, there is limited information on the specific characteristics to stroke patients with NS. In this study, we aimed to examine the clinical manifestations of acute IS in a large group of NS patients, comparing to those without NS. We conducted a retrospective cohort study to compare the clinical presentations of acute IS in patients with and without NS. This study was a multi-institutional study and used data from Chang Gung Research Database of Taiwan from 1 January 2001, to 31 December 2017. A total of 233 IS patients with NS and 1358 IS patients without NS were enrolled. The median age of participants was 68 (range: 59–79) years. The risk of dependent functional status (modified Rankin Scale score≧3) after IS was higher in NS patients compared to those without NS (Odd ratio (OR) 4.02, 95% confidence interval (CI) 2.39 to 6.76, p p p = 037). The risks of mortality or stroke recurrence within 30 days were similar between the two groups for all stroke subtypes. In conclusion, NS was associated with a higher risk of functional dependence following IS. Intensive treatment and rehabilitation should be considered for IS patients with NS.</p

The time curves from two patients with right ICA stenosis.

<p>The BOLD responses between different ROIs, from the same breath holding task, were consistent in patient A (A), but with large varieties in patient B (B).</p

The scatter plot of CBF index of lesion side versus correlation (r²) of the ipsilateral and contralateral MCA time courses from the 17 patients.

<p>Red dots represent patients with r²<0.18 (t-value<2.1, p>0.05). Four of these five patients have greater CBF index than the patients with r²>0.18 (t-value≥2.1, p<0.05) by one standard deviation (CBF index>1.17).</p

Colored map of the region-of-interest template (selected sections from basal ganglia to centrum semiovale, left to right, in transverse view).

<p>Blue and red represent the ACA and MCA territories, respectively. Occipital white matter, which is shown in green, is used as a reference region.</p

Impact of Coexisting Coronary Artery Disease on the Occurrence of Cerebral Ischemic Lesions after Carotid Stenting

<div><p>Background</p><p>Coronary artery disease (CAD) may coexist with extracranial carotid artery stenosis (ECAS), but the influence of CAD on procedure-related complications after carotid artery stenting (CAS) has not been well investigated. The study aimed to determine the impact of CAD on the occurrence of peri-CAS cerebral ischemic lesions on diffusion-weighted imaging (DWI) scanning.</p><p>Methods</p><p>Coronary angiography was performed within six months before CAS. DWI scanning was repetitively done within 1 week before and after CAS. Clinical outcome measures were stroke, angina, myocardial infarction and death within 30 days.</p><p>Results</p><p>Among 126 patients (69.5±9.0 years) recruited for unilateral protected CAS, 33 (26%) patients had peri-CAS DWI-positive lesions. CAD was noted in 79% (26 in 33) and 48% (45 in 93) of patients with and without peri-CAS DWI-positive lesions (OR, 4.0; 95% CI, 1.6–10.0; <i>P</i> = .0018), and the number of concomitant CAD on coronary angiography was positively correlated with the risk for peri-CAS DWI-positive lesions (<i>P</i> = .0032). In patients with no CAD (n = 55), asymptomatic CAD (n = 41) and symptomatic CAD (n = 30), the occurrence rates of peri-CAS DWI-positive lesions were 13%, 41% and 30% (<i>P</i> = .0048), and the peri-CAS stroke rates were 2%, 7% and 0% (<i>P</i> = .2120).</p><p>Conclusions</p><p>The severity of morphological CAD and the presence of either symptomatic or asymptomatic CAD are associated with the occurrence of peri-CAS cerebral ischemic lesions.</p></div

Clinical and imaging characteristics of patients with no CAD, asymptomatic CAD and symptomatic CAD.

<p>*Comparison with ANOVA test.</p>†<p>Comparison with chi-square test or Fisher's exact test.</p>‡<p>p<0.05 versus patients with no CAD by Bonferroni post hoc analysis.</p>§<p>Comparison between patients with asymptomatic and symptomatic CAD.</p>∥<p>p<0.01 after adjustment for age, gender, LVEF, creatinine level, symptomatic carotid stenosis, hypertension, dyslipidemia and anti-platelet medication history.</p><p>CAS, carotid artery stenting; DWI, diffusion-weighted imaging; CAD, coronary artery disease.</p

Additional file 1: of Visualization of ischemic stroke-related changes on 18F-THK-5351 positron emission tomography

Table S1. The standardized uptake value ratios (SUVRs) of 18F-THK-5351 PET and diffusion tensor imaging parameters in the bilateral cerebral hemispheres. (DOCX 45 kb