Background: Infection has been recognized as a significant predictor of outcome for ischemic stroke patients, although the mechanisms by which this association is operative have not been fully established, and their potential roles in a setting of close clinical monitoring, such as that of stroke units offering reperfusion therapies, have not been evaluated.
Methods: We reviewed the medical records of 139 consecutive tissue plasminogen activator-treated stroke patients admitted to our stroke unit to evaluate potential predictors of neurological outcome.
Results: 57 patients (41%) did not show neurological improvement by discharge, and 11.5% died during admission. Infections were related to lack of improvement (29.8 vs. 14.6%; p = 0.03) and PH-type hemorrhagic transformation (42.1 vs. 17.5%; p = 0.014); the latter was associated with a higher mortality rate (26.3 vs. 9.2%; p = 0.03).
Conclusions: Infection may be associated with poor functional outcome among tissue plasminogen activator-treated stroke patients.
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http://dx.doi.org/10.1159/000322903 | DOI Listing |
Exp Neurol
January 2025
Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan. Electronic address:
Ischemic stroke results in significant long-term disability and mortality worldwide. Although existing therapies, such as recombinant tissue plasminogen activator and mechanical thrombectomy, have shown promise, their application is limited by stringent conditions. Mesenchymal stem cell (MSC) transplantation, especially using SB623 cells (modified human bone marrow-derived MSCs), has emerged as a promising alternative, promoting neurogenesis and recovery.
View Article and Find Full Text PDFNeurology
February 2025
Department of Neurology, Washington University School of Medicine, St. Louis, MO.
Objectives: Intravenous tenecteplase (TNK) is increasingly used to treat adult patients with acute arterial ischemic stroke, but the risk profile of TNK in childhood stroke is unknown. This study aims to prospectively gather safety data regarding TNK administration in children.
Methods: Since December 2023, a monthly email survey was sent to participants recruited from the International Pediatric Stroke Study and Pediatric Neurocritical Care Research Group querying recent experience with TNK in childhood stroke.
Microbiol Spectr
January 2025
Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, USA.
Unlabelled: Group A (GAS) is a major human pathogen that causes several invasive diseases including necrotizing fasciitis. The host coagulation cascade initiates fibrin clots to sequester bacteria to prevent dissemination into deeper tissues. GAS, especially skin-tropic bacterial strains, utilize specific virulence factors, plasminogen binding M-protein (PAM) and streptokinase (SK), to manipulate hemostasis and activate plasminogen to cause fibrinolysis and fibrin clot escape.
View Article and Find Full Text PDFMacromol Biosci
January 2025
Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology (BIST), Carrer de Baldiri Reixac, 10, 12, Barcelona, 08028, Spain.
Blood-contacting medical devices, especially extracorporeal membrane oxygenators (ECMOs), are highly susceptible to surface-induced coagulation because of their extensive surface area. This can compromise device functionality and lead to life-threatening complications. High doses of anticoagulants, combined with anti-thrombogenic surface coatings, are typically employed to mitigate this risk, but such treatment can lead to hemorrhagic complications.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.
Objectives: To investigate the safety and efficacy outcomes of intravenous thrombolysis (IVT) in patients aged >80 years with acute ischaemic stroke (AIS) after IVT was approved in this patient population in several European and non-European countries during 2018-2019.
Design: This is an observational registry study using prospectively collected data from the Safe Implementation of Treatment in Stroke (SITS) registry. Comparisons will be performed between patients treated post-approval (July 2018 to December 2021) period with those treated pre-approval (June 2015 to June 2018) period using propensity score matching (PSM).
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