Malnutrition impact on stroke outcome: an analysis of a patient cohort 3 months after recanalization treatment

Background: Malnutrition is thought to affect 30% to 70% of hospitalized patients. Little is known about consequences of undernutrition during the acute phase of stroke. We would like to assess the impact of pre-infarction malnutrition on stroke patients treated with thrombolysis and/ or thrombectomy. Material and methods: We performed a retrospective observational study on a cohort of stroke patients who benefited from thrombolysis and/ or thrombectomy during 2015 in Saint Joseph Hospital’s Stroke Unit. The main objective of our research was to observe the clinical course of undernourished patients compared to the non-undernourished ones, using the NIHSS score at the stroke unit discharged and the 3 months modified Rankin score. Undernutrition was defined by a body mass index of (BMI) ≤ 21. Results: A total of 81 patients with thrombolysis and/or thrombectomy treatment were included. The median BMI in < 70-year-old patients was 24.5 and 25 in > 70-year-old patients. Initial severity measured by baseline NIHSS score was comparable among the undernourished and non-undernourished patients. Undernourished patients over 70 had a more severe neurological state at discharge (NIHSS 8.5 versus 3.9, NS) and were more disabled 3 months after discharge (Rankin 3.1 versus 2, NS). Conclusions: Undernutrition prior to stroke seems to have an impact on the functional prognosis of cerebral infarction, especially in patients > 70 years of age. Lack of significant results may be explained by the limited statistical means. A complementary study with a larger cohort is planned in order to assess this hypothesis

Fusion rules for admissible representations of affine algebras: the case of A2(1)A_2^{(1)}

We derive the fusion rules for a basic series of admissible representations of $\hat{sl}(3)$ at fractional level $3/p-3$. The formulae admit an interpretation in terms of the affine Weyl group introduced by Kac and Wakimoto. It replaces the ordinary affine Weyl group in the analogous formula for the fusion rules multiplicities of integrable representations. Elements of the representation theory of a hidden finite dimensional graded algebra behind the admissible representations are briefly discussed.Comment: containing two TEX files: main file using input files harvmac.tex, amssym.def, amssym.tex, 19p.; file with figures using XY-pic package, 6p. Correction in the definition of general shifted weight diagra

Лечение инсульта. Обзор литературы и клинический случай.

Treatment of cerebral heart attack. Literature review and clinical case.Accidentul ischemic cerebral (AIC) sau infarctul cerebral (IC) reprezintă 80% din numărul total de accidente vasculare cerebrale (AVC), ocluzia unei/sau mai multor artere cerebrale fiind confirmată prin examene imagistice non invazive (IRM sau TC cerebrală cu sau fără injectare a substanței de contrast). Ultimele 3-4 decenii au fost revoluționare pentru tratamentul AIC, fiind puse &icirc;n aplicare: aspirina, anticoagulantele orale antivitamina K (AVK), anticoagulantele orale cu acțiune directă (AOD), tromboliza intravenoasă (TI), trombectomia (T) și hemicraniotomia decompresivă. Terapia de recanalizare prin tratament fibrinolitic intravenos și trombectomie au obiectivul de ameliorare clinică a pacientului prin reperfuzia zonei de penumbră ischemică. AIC este o urgență vitală, iar un tratament administrat rapid, adecvat și eficient semnifică nu doar viața, ci și recuperarea autonomiei pacientului - &bdquo;time is brain&rdquo;.Лечение инсульта. Обзор литературы и клинический случай

The Prethalamus Is Established during Gastrulation and Influences Diencephalic Regionalization

The vertebrate neural plate contains distinct domains of gene expression, prefiguring the future brain areas. In this study, we draw an extended expression map of the rostral neural plate that reveals discrete domains inside the presumptive posterior forebrain. We show, by fate mapping, that these well-defined cell populations will develop into specific diencephalic regions. To address whether these early subterritories are already committed to restricted identities, we began to analyse the consequences of ablation and transplantation of these specific cell populations. We found that precursors of the prethalamus are already specified and irreplaceable at late gastrula stage, because ablation of these cells results in loss of prethalamic markers. Moreover, when transplanted into the ectopic environment of the presumptive hindbrain, these cells still pursue their prethalamic differentiation program. Finally, transplantation of these precursors, in the rostral-most neural epithelium, induces changes in cell identity in the surrounding host forebrain. This cell–non-autonomous property led us to propose that these committed prethalamic precursors may play an instructive role in the regionalization of the developing diencephalon

Performance of Pyridylthiourea-Polyethylenimine Polyplex for siRNA-Mediated Liver Cancer Therapy in Cell Monolayer, Spheroid, and Tumor Xenograft Models

Medical application of siRNAs relies on methods for delivering nucleic acids into the cytosol. Synthetic carriers, which assemble with nucleic acids into delivery systems, show promises for cancer therapy but efficiency remains to be improved. In here, the effectiveness of pyridylthiourea‐polyethylenimine (πPEI), a siRNA carrier that favors both polyplex disassembly and endosome rupture upon sensing the acidic endosomal environment, in 3 experimental models of hepatocellular cancer is tested. The πPEI‐assisted delivery of a siRNA targeting the polo‐like kinase 1 into Huh‐7 monolayer produces a 90% cell death via a demonstrated RNA interference mechanism. Incubation of polyplex with Huh‐7 spheroids leads to siRNA delivery into the superficial first cell layer and a 60% reduction in spheroid growth compared to untreated controls. Administration of polyplexes into mice bearing subcutaneous implanted Huh‐7Luc tumors results in a reduced tumor progression, similar to the one observed in the spheroid model. Altogether, these results support the in vivo use of synthetic and dedicated polymers for increasing siRNA‐mediated gene knockdown, and their clinical promise in cancer therapeutics

Patent Foramen Ovale Closure or Anticoagulation vs. Antiplatelets after Stroke

BACKGROUND Trials of patent foramen ovale (PFO) closure to prevent recurrent stroke have been inconclusive. We investigated whether patients with cryptogenic stroke and echocardiographic features representing risk of stroke would benefit from PFO closure or anticoagulation, as compared with antiplatelet therapy. METHODS In a multicenter, randomized, open-label trial, we assigned, in a 1:1:1 ratio, patients 16 to 60 years of age who had had a recent stroke attributed to PFO, with an associated atrial septal aneurysm or large interatrial shunt, to transcatheter PFO closure plus long-term antiplatelet therapy (PFO closure group), antiplatelet therapy alone (antiplatelet-only group), or oral anticoagulation (anticoagulation group) (randomization group 1). Patients with contraindications to anticoagulants or to PFO closure were randomly assigned to the alternative noncontraindicated treatment or to antiplatelet therapy (randomization groups 2 and 3). The primary outcome was occurrence of stroke. The comparison of PFO closure plus antiplatelet therapy with antiplatelet therapy alone was performed with combined data from randomization groups 1 and 2, and the comparison of oral anticoagulation with antiplatelet therapy alone was performed with combined data from randomization groups 1 and 3. RESULTS A total of 663 patients underwent randomization and were followed for a mean (+/- SD) of 5.3 +/- 2.0 years. In the analysis of randomization groups 1 and 2, no stroke occurred among the 238 patients in the PFO closure group, whereas stroke occurred in 14 of the 235 patients in the antiplatelet-only group (hazard ratio, 0.03; 95% confidence interval, 0 to 0.26; P&lt;0.001). Procedural complications from PFO closure occurred in 14 patients (5.9%). The rate of atrial fibrillation was higher in the PFO closure group than in the antiplatelet-only group (4.6% vs. 0.9%, P = 0.02). The number of serious adverse events did not differ significantly between the treatment groups (P = 0.56). In the analysis of randomization groups 1 and 3, stroke occurred in 3 of 187 patients assigned to oral anticoagulants and in 7 of 174 patients assigned to antiplatelet therapy alone. CONCLUSIONS Among patients who had had a recent cryptogenic stroke attributed to PFO with an associated atrial septal aneurysm or large interatrial shunt, the rate of stroke recurrence was lower among those assigned to PFO closure combined with antiplatelet therapy than among those assigned to antiplatelet therapy alone. PFO closure was associated with an increased risk of atrial fibrillation

Trapping in irradiated p-on-n silicon sensors at fluences anticipated at the HL-LHC outer tracker

The degradation of signal in silicon sensors is studied under conditions expected at the CERN High-Luminosity LHC. 200 $\mu$m thick n-type silicon sensors are irradiated with protons of different energies to fluences of up to $3 \cdot 10^{15}$ neq/cm$^2$. Pulsed red laser light with a wavelength of 672 nm is used to generate electron-hole pairs in the sensors. The induced signals are used to determine the charge collection efficiencies separately for electrons and holes drifting through the sensor. The effective trapping rates are extracted by comparing the results to simulation. The electric field is simulated using Synopsys device simulation assuming two effective defects. The generation and drift of charge carriers are simulated in an independent simulation based on PixelAV. The effective trapping rates are determined from the measured charge collection efficiencies and the simulated and measured time-resolved current pulses are compared. The effective trapping rates determined for both electrons and holes are about 50% smaller than those obtained using standard extrapolations of studies at low fluences and suggests an improved tracker performance over initial expectations

The Role of Short Term Psychological and Somatic Anxiety in the Prediction of Long Term Anxiety of Early Hospital Discharged Patients with Complete Functional Recovery after a Mild Stroke

Few previous investigations have focused on post-stroke anxiety (PSA) predictors in mild stroke patients. The aim of the study was to determine whether anxiety-related psychological symptoms and psychomotor agitation predict PSA. We compared 10 anxious and 10 non-anxious patients at 6 months post-stroke (T2) to their psychological anxiety and psychomotor agitation levels 3 months earlier (T1). Anxious patients had more psychological anxiety symptoms than non-anxious patients. Overall T2 anxiety was strongly correlated with T1 psychological anxiety. Thus, psychological symptoms are a better predictor of PSA than somatic symptoms of anxiety. Those results could improve PSA diagnosis and prognosis by directing clinicians to pay particular attention to psychological anxiety after a stroke, even in early discharged patients with complete functional recovery.</p