Infection after Acute Ischemic Stroke: Risk Factors, Biomarkers, and Outcome

Background. The activation of inflammatory cascades triggered by ischemic stroke may play a key role in the development of infections. Methods. Patients admitted with ischemic stroke within 24 hours were prospectively enrolled. Biomarkers of infection were measured on days 1, 3, and 5. The patients were continuously monitored for predefined infections. Results. Patients with infection were older (OR 1.06 per year, 95% CI 1.01–1.11) and had a higher National Institute of Health Stroke Scale Score (NIHSS, OR 1.21, 95% CI 1.10–1.34), localization in the insula, and higher stroke volumes on diffusion-weighted imaging. The maximum temperature on days 1 and 3, leukocytes, interleukin-6, lipopolysaccharide-binding protein on days 1, 3, and 5, C-reactive protein on days 3 and 5, and procalcitonin on day 5 were higher and HLA-DR-expression on monocytes on days 1, 3, and 5 lower in patients with infection. Age and NIHSS predicted the development of infections. Infection was an independent predictor of poor functional outcome. Conclusions. Severe stroke and increasing age were shown to be early predictors for infections after stroke

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Background. The activation of inflammatory cascades triggered by ischemic stroke may play a key role in the development of infections. Methods. Patients admitted with ischemic stroke within 24 hours were prospectively enrolled. Biomarkers of infection were measured on days 1, 3, and 5. The patients were continuously monitored for predefined infections. Results. Patients with infection were older (OR 1.06 per year, 95% CI 1.01-1.11) and had a higher National Institute of Health Stroke Scale Score (NIHSS, OR 1.21, 95% CI 1.10-1.34), localization in the insula, and higher stroke volumes on diffusion-weighted imaging. The maximum temperature on days 1 and 3, leukocytes, interleukin-6, lipopolysaccharide-binding protein on days 1, 3, and 5, C-reactive protein on days 3 and 5, and procalcitonin on day 5 were higher and HLA-DR-expression on monocytes on days 1, 3, and 5 lower in patients with infection. Age and NIHSS predicted the development of infections. Infection was an independent predictor of poor functional outcome. Conclusions. Severe stroke and increasing age were shown to be early predictors for infections after stroke

a comparison between 2004 and 2005 for a specific search in the field of biotechnology

Aim of this work was the analysis of the changes occurring in hit lists of selected search engines at two different points of time.The same search query was applied to the search engine Google and to the science search engine Scirus in August 2004 and in April 2005. The first 40 hits of each search have been analysed on the basis of predefined qualitative and quantitative parameters. Further an analysis of overlapping between search hits at the above mentioned time points has been carried out for each search engine separately.The results of this study has shown on one hand the existence of positive trends in the result lists of both search engines (less dead links, a higher precision in results) and on the other hand the role played by search engines themselves in the dynamic of result lists. The method applied here has shown to be useful for describing and measuring trends and changes in the search results of search engines over a time span.Das Ziel dieser Arbeit war die Identifizierung und Quantifizierung der Veränderungen in den Suchergebnissen aus ausgewählten Suchmaschinen im Jahresabstand.Eine Recherche mit der gleichen Suchabfrage ist mit der allgemeinen Suchmaschine Google und mit der wissenschaftlichen Suchmaschine Scirus im August 2004 und April 2005 durchgeführt worden. Die ersten 40 Treffer sind nach vordefinierten qualitativen und quantitativen Parametern analysiert worden. Weiters ist die Überlappung der Suchergebnissen für die oben genannten Abfragezeitpunkte je nach Suchmaschine getrennt bewertet worden.Die aus dieser Studie resultierenden Ergebnisse zeigen einerseits die Existenz von positiven Tendenzen in den Ergebnislisten der untersuchten Suchmaschinen (Verbesserungen in der Relevanz der Treffer, eine Verringerung der Anzahl an nicht abrufbaren Links, sowie ein Zuwachs an erzielter Information) und andererseits die Rolle der Websuchinstrumente selbst hinsichtlich den Veränderungen von Suchergebnissen bei einer Recherche im Web

Mechanical Recanalization in Basilar Artery Occlusion: The ENDOSTROKE Study

ObjectiveA study was undertaken to evaluate clinical and procedural factors associated with outcome and recanalization in endovascular stroke treatment (EVT) of basilar artery (BA) occlusion. MethodsENDOSTROKE is an investigator-initiated multicenter registry for patients undergoing EVT. This analysis includes 148 consecutive patients with BA occlusion, with 59% having received intravenous thrombolysis prior to EVT. Recanalization (defined as Thrombolysis in Cerebral Infarction [TICI] score 2b-3) and collateral status (using the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology collateral grading system) were assessed by a blinded core laboratory. Good (moderate) outcome was defined as a modified Rankin Scale score of 0 to 2 (0-3) assessed after at least 3 months (median time to follow-up=120 days). ResultsThirty-four percent had good and 42% had moderate clinical outcome; mortality was 35%. TICI 2b-3 recanalization was achieved by 79%. Age, hypertension, National Institutes of Health Stroke Scale scores, collateral status, and the use of magnetic resonance imaging prior to EVT predicted clinical outcome, the latter 3 remaining independent predictors in multivariate analysis. Independent predictors of recanalization were better collateral status and the use of a stent retriever. However, recanalization did not significantly predict clinical outcome. InterpretationBeside initial stroke severity, the collateral status predicts clinical outcome and recanalization in BA occlusion. Our data suggest that the use of a stent retriever is associated with high recanalization rates, but recanalization on its own does not predict outcome. The role of other modifiable factors, including the choice of pretreatment imaging modality and time issues, warrants further investigation. Ann Neurol 2015;77:415-42