Hepatic and Renal Function Tests and Routine Hematological Markers in Patients with Cerebrovascular Accident and Transient Ischemic Attack

Background and Aim: Cerebrovascular accident (CVA), also known as stroke, is a vascular syndrome that is the second leading cause of death in the world after ischemic heart disease. Transient ischemic attacks (TIAs) is a warning sign for CVA so that 20% of patients with TIA experience a subsequent stroke within 90 days. Hence, identification of laboratory markers is crucial for the prognosis and diagnosis of patients with CVA and TIA. Changes in some laboratory markers occur in patients with CVA and TIA. Thus, the present study aimed to evaluate hepatic and renal function tests and routine hematological markers in patients with CVA and TIA. Methods: The present study was a cross - sectional analytical study. The study population was patients with CVA and TIA who were hospitalized in Abadan and Khorramshahr educational hospitals from March 21, 2019, to March 19, 2020. One hundred patients with CVA and one hundred patients with TIA were randomly selected and the necessary information (age, sex, liver enzymes, renal function tests, FBS, and routing hematologic markers including CBC, ESR, PT and PTT) of the patients was collected from HIS (Hospital Information System) of Abadan and Khorramshahr educational hospitals. Liver, kidney and hematologic diagnostic markers were evaluated by age and gender. Data analysis was performed using a t -test (to compare gender difference of laboratory markers in CVA and TIA groups) and one-way ANOVA (to compare laboratory markers among age groups of patients with CVA and TIA). Simple linear regression was used to examine the relationships between changes in FBS (mg / dl) and changes in laboratory diagnostic factors. Results: The results of this study showed that the highest frequency of patients with CVA (n= 130, 27.3%) and TIA (n= 49, 23.8%) was observed in the age group of 55-64 years. The results indicate that the mean level of some laboratory markers such as FBS (CVA: 174.32 ± 105.83; TIA: 150.32 ± 83.32), creatinine (CVA: 1.37 ± 1.32; 1.42 ± 1.09), LDH (CVA: 696.29 ± 344.90; TIA: 538.17 ± 230.76), and ESR (CVA: 52.41 ± 37.61; TIA: 14.00 ± 8.40) was higher than the normal range in both CVA and TIA. The mean of SGOT (34.10 ± 26.40 IU / L) and ALK (331.44 ± 370.78 IU / L) enzymes were higher than normal only in CVA patients and the mean of SGPT (33.08 ± 38.55 IU / L) was higher than normal only in TIA patients. It was also observed that in patients with CVA, with each unit increase in FBS, a significant increase occurs in K+ level (P < 0.001), WBC (P= 0.003), and RBC (P= 0.031) count, as well as a significant decrease in Na+ level (P= 0.008). Conclusion: The results of the present study showed an increase in the level of FBS, ESR and LDH both in CVA and TIA. While SGOT and ALK increased only in CVA patients, SGPT showed an increase only in TIA patients.   *First Corresponding Author: Esmat Radmanesh; Email: [email protected]; ORCID ID:                                        0000-0003-1369-6580 Second Corresponding Author: Sahar Golabi; Email: [email protected] Please cite this article as:  Monfared A, Fadavipour M, Golabi S, Kamyari N, Zahedi A, Hazbenejad A, Kanani K, Jelvay S, Tajvidi M, Radmanesh E. Hepatic and Renal Function Tests and Routine Hematological Markers in Patients with Cerebrovascular Accident and Transient Ischemic Attack. Arch Med Lab Sci. 2023;9:1-9 (e3). https://doi.org/10.22037/amls.v9.3925

Relationship Between General Health and Demographic Characteristics of Family Caregivers of Stroke Survivors

Objectives Caregiving of stroke survivors leads to several physiopsychlogical problems for family caregiver due to excessive demand by the stroke survivors. The aim of this study was to determine general health of the caregivers of stroke survivors and their relationship with demographic factors. Methods & Materials This was a cross-sectional study in which 60 caregivers of stroke survivors were selected by convenience sampling from Sina and Firouzgar Hospitals in Tehran province in Iran, in 2015. The data was collected by two questionnaires including demographic questionnaire and General Health Questionnaire (GHQ). The collected data were analyzed by descriptive and inferential statistics including mean and standard deviation using SPSS software (version 15). Results The mean GHQ score was 61.41±14.9; in female caregiver, it was 63.07±16.09, and in male caregiver, the score was 58.33±12.28. Significant correlation found between overall GHQ score and either of the factors such as occupational status, age category, or type of caring (P=0.01). Unemployment in caregiver, aging, and 24-hour caring of stroke survivors were related to a reduction in GHQ score. However, there was no significant association between GHQ of stroke caregivers and either of the factors such as sex (P=0.35), time of caring (0.24), marital status (P=0.71), or educational status. Conclusion This study showed that family caregivers of stroke survivors experience deterioration of general health at different dimensions. Therefore, it is recommended that planning for general health and social support for caregivers should be done through policy making in health and treatment

Trehalose: A promising new treatment for traumatic brain injury? A systematic review of animal evidence

Background: TBI is a major global health issue due to its high morbidity and mortality rates. Persistent neurodegeneration following secondary brain injuries is a significant concern. Trehalose, a naturally occurring disaccharide, has shown potential therapeutic effects in preclinical TBI models. This study systematically reviews the preclinical and clinical data on trehalose as a potential TBI treatment. Methods: We conducted a systematic review of trehalose’s role in TBI treatment following PRISMA guidelines. Our search spanned from the inception of PubMed, EMBASE, SCOPUS, and Web of Science until August 2023. Google Scholar was also manually searched. The quality of the studies was assessed using SYRCLE’s risk of bias tool for animal studies. Results: Out of sixty-six records reviewed, four animal studies were included. These studies indicated that trehalose enhanced motor and cognitive functions, reduced oxidative damage and inflammation, regulated metal dyshomeostasis, increased neurotrophic factors and synaptic proteins, and improved autophagy and mitochondrial function in mouse/rat TBI models. However, a significant risk of bias was noted. Conclusion: Trehalose demonstrates potential as a TBI treatment. However, more rigorous, and comprehensive research is needed to confirm its safety and efficacy in humans

Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study

Purpose: In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods: We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results: 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. Conclusions: HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes.</p

Epidemiology and outcomes of hospital-acquired bloodstream infections in intensive care unit patients: the EUROBACT-2 international cohort study

Purpose In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp. (20.3%), Escherichia coli (15.8%), and Pseudomonas spp. (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. Conclusions HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes