Abstract:
:Early infection after stroke is associated with a poor outcome. We aimed to determine whether delayed infections (up to 76 days post-stroke) are associated with poor outcome at 90 days. Data came from the international Efficacy of Nitric Oxide Stroke (ENOS, ISRCTN99414122) trial. Post hoc data on infections were obtained from serious adverse events reports between 1 and 76 days following stroke in this large cohort of patients. Regression models accounting for baseline covariates were used to analyse fatalities and functional outcomes (modified Rankin Scale (mRS), Barthel Index, Euro-Qol-5D) at 90 days, in patients with infection compared to those without infection. Of 4011 patients, 242 (6.0%) developed one or more serious infections. Infections were associated with an increased risk of death (p < 0.001) and an increased likelihood of dependency (measured by mRS) compared to those of all other patients (p < 0.001). This remained when only surviving patients were analysed, indicating that the worsening of functional outcome is not due to mortality (p < 0.001). In addition, the timing of the infection after stroke did not alter its detrimental association with fatality (p = 0.14) or functional outcome (p = 0.47). In conclusion, severe post-stroke infections, whether occurring early or late after stroke, are associated with an increased risk of death and poorer functional outcome, independent of differences in baseline characteristics or treatment. Not only are strategies needed for reducing the risk of infection immediately after stroke, but also during the first 3 months following a stroke. This study is registered: ISRCTN registry, number ISRCTN99414122, ClinicalTrials.gov Identifier, NCT00989716.
journal_name
Transl Stroke Resjournal_title
Translational stroke researchauthors
Learoyd AE,Woodhouse L,Shaw L,Sprigg N,Bereczki D,Berge E,Caso V,Christensen H,Collins R,Czlonkowska A,El Etribi A,Farr TD,Gommans J,Laska AC,Ntaios G,Ozturk S,Pocock SJ,Prasad K,Wardlaw JM,Fone KC,Bath PM,Truemdoi
10.1007/s12975-017-0553-3subject
Has Abstractpub_date
2017-12-01 00:00:00pages
541-548issue
6eissn
1868-4483issn
1868-601Xpii
10.1007/s12975-017-0553-3journal_volume
8pub_type
杂志文章,多中心研究,随机对照试验abstract::Silent information regulator 1 (SIRT1) is a NAD+-dependent histone deacetylase that represses gene expression and plays a role in longevity. SIRT1 responds to diverse stress conditions and regulates metabolism in nutrient deficiency conditions; therefore, it is involved in adaptive pathways to better fulfill tissue ne...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-013-0277-y
更新日期:2013-12-01 00:00:00
abstract::In the original publication of the article, there was a switched order of author names. ...
journal_title:Translational stroke research
pub_type: 杂志文章,已发布勘误
doi:10.1007/s12975-018-0618-y
更新日期:2018-12-01 00:00:00
abstract::Diabetes significantly increases the risk of stroke and post-stroke mortality. Recurrent hypoglycemia (RH) is common among diabetes patients owing to glucose-lowering therapies. Earlier, we showed that RH in a rat model of insulin-dependent diabetes exacerbates cerebral ischemic damage. Impaired mitochondrial function...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-018-0622-2
更新日期:2019-02-01 00:00:00
abstract::Although used extensively in stroke research, there is limited knowledge of how 2, 3, 5-triphenyltetrazolium chloride (TTC)-treated rat brain sections are altered and if they can be used for immunohistochemical quantification after staining with TTC. In the present study, we hypothesized that TTC treatment (TTC+) woul...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-017-0604-9
更新日期:2018-10-01 00:00:00
abstract::Aneurysmal subarachnoid hemorrhage comprises of an early phase after the bleeding and a late phase of delayed consequences of the bleeding. The development of delayed injury mechanisms, like the reduction of cerebral blood flow (CBF) due to cerebral vasospasm (CVS), seems mainly to depend on the amount and the duratio...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-015-0392-z
更新日期:2015-06-01 00:00:00
abstract::Increasing endogenous ciliary neurotrophic factor (CNTF) expression with a pharmacological agent might be beneficial after stroke as CNTF both promotes neurogenesis and, separately, is neuroprotective. P2X7 purinergic receptor inhibition is neuroprotective in rats and increases CNTF release in rat CMT1A Schwann cells....
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-013-0265-2
更新日期:2013-10-01 00:00:00
abstract::We reported previously that both a cannabinoid receptor 2 (CB2R) agonist and a cannabinoid receptor 1 (CB1R) antagonist were protective in the treatment of transient middle cerebral artery occlusion/reperfusion injury (MCAO/R) and that they acted in a synergistic manner when administered in combination. The goal of th...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-012-0197-2
更新日期:2012-09-01 00:00:00
abstract::Pulmonary complications associated with persistent respiratory muscle weakness, paralysis, and spasticity are among the most important problems faced by patients with spinal cord injury when lack of muscle strength and disorganization of reciprocal respiratory muscle control lead to breathing insufficiency. This revie...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-011-0114-0
更新日期:2011-12-01 00:00:00
abstract::Cerebrovascular disease is a leading cause of death-from-disease and of disability worldwide, affecting some 15 million people. The incidence of stroke or "brain attack" is unlikely to recede for a decade at minimum by most predictions, despite large public health initiatives in stroke prevention. It has been well est...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-012-0238-x
更新日期:2013-08-01 00:00:00
abstract::Global ischemia following cardiac arrest is characterized by high mortality and significant neurological deficits in long-term survivors. Its mechanisms of neuronal cell death have only partially been elucidated. 12/15-lipoxygenase (12/15-LOX) is a major contributor to delayed neuronal cell death and vascular injury i...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-016-0509-z
更新日期:2017-04-01 00:00:00
abstract::In a porcine ischemic stroke model, we sought to compare the acute predicted infarct core volume (PIV) defined by CT perfusion (CTP)-hemodynamic parameters and MR-diffusion-weighted imaging (MR-DWI)/apparent diffusion coefficient (ADC), with the true infarct core volume (TIV) as defined by histology. Ten Duroc-cross p...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-015-0394-x
更新日期:2015-06-01 00:00:00
abstract::Despite being a conveniently portable technology for stroke assessment, Transcranial Doppler ultrasound (TCD) remains widely underutilized due to complex training requirements necessary to reliably obtain and interpret cerebral blood flow velocity (CBFV) waveforms. The validation of objective TCD metrics for large ves...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-018-0667-2
更新日期:2019-10-01 00:00:00
abstract::Traumatic brain injury (TBI) affects all age groups in a population and is an injury generating scientific interest not only as an acute event, but also as a complex brain disease with several underlying neurobehavioral and neuropathological characteristics. We review early and long-term alterations after juvenile and...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-011-0126-9
更新日期:2011-12-01 00:00:00
abstract::Impaired cerebral autoregulation and neurovascular coupling (NVC) contribute to delayed cerebral ischemia after subarachnoid hemorrhage (SAH). Retinal vessel analysis (RVA) allows non-invasive assessment of vessel dimension and NVC hereby demonstrating a predictive value in the context of various neurovascular disease...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-017-0585-8
更新日期:2018-06-01 00:00:00
abstract::Low translational yield for stroke may reflect the focus of discovery science on rodents rather than humans. Just how little is known about human neuronal ischaemic responses is confirmed by systematic review and meta-analysis revealing that data for the most commonly used SH-SY5Y human cells comprises only 84 papers....
journal_title:Translational stroke research
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s12975-018-0620-4
更新日期:2018-12-01 00:00:00
abstract::Inflammation is a critical process behind cerebral aneurysm formation and rupture. Tumor necrosis factor alpha (TNF-α) is a key immune modulator that has been implicated in cerebral aneurysm pathophysiology. This may occur through TNF-α-mediated endothelial injury, smooth muscle cell phenotypic modulation, recruitment...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-013-0287-9
更新日期:2014-04-01 00:00:00
abstract::The most deadly form of stroke, intracerebral hemorrhage (ICH) continues to puzzle researchers and produce substantial decrements in the quality of patients' lives. Intensive basic research has devised many agents with putative benefit in mitigating the devastating effects of ICH, but these therapies have been largely...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-012-0207-4
更新日期:2012-12-01 00:00:00
abstract::Ischemic stroke contributes to the majority of brain injuries and remains to be a leading cause of death and long-term disability. Despite the devastating pathology and high incidence of disease, there remain only few treatment options (TPA and endovascular procedures), which may be hampered by time-dependent administ...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-013-0319-5
更新日期:2014-02-01 00:00:00
abstract::Voltage-gated potassium (Kv) channels are widely expressed in the central and peripheral nervous system and are crucial mediators of neuronal excitability. Importantly, these channels also actively participate in cellular and molecular signaling pathways that regulate the life and death of neurons. Injury-mediated inc...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-013-0297-7
更新日期:2014-02-01 00:00:00
abstract::Infection is a leading cause of death in patients with stroke; however, the impact of cerebral infarct size or location on infectious outcome is unclear. To examine the effect of infarct size on post-stroke infection, we utilised the intraluminal middle-cerebral artery occlusion (MCAO) mouse model of ischemic stroke a...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-019-00738-3
更新日期:2020-06-01 00:00:00
abstract::Despite ischemic stroke being the fifth leading cause of death in the USA, there are few therapeutic options available. We recently showed that the neuroprotective compound P7C3-A20 reduced brain atrophy, increased neurogenesis, and improved functional recovery when treatment was initiated immediately post-reperfusion...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-017-0565-z
更新日期:2018-04-01 00:00:00
abstract::Preconditioning is a paradigm in which sublethal stress-prior to a more injurious insult-induces protection against injury. In the central nervous system (CNS), preconditioning against ischemic stroke is induced by short durations of ischemia, brief seizures, exposure to anesthetics, and other stresses. Increasing evi...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-017-0547-1
更新日期:2017-12-01 00:00:00
abstract::Approximately, 16 million strokes occur worldwide each year, causing 6 million deaths and considerable disability, implying an enormous social, individual health, and economic burden. Due to this high incidence, strategies to promote stroke recovery are urgently needed. Research into new therapeutic approaches for str...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-018-0654-7
更新日期:2019-06-01 00:00:00
abstract::Positron emission tomography (PET) is widely used in clinical and animal studies, along with the development of diverse tracers. The biochemical characteristics of PET tracers may help uncover the pathophysiological consequences of cardiac arrest (CA) and ischemic stroke, which include cerebral ischemia and reperfusio...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-019-00765-0
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:To elucidate the role of magnesium sulfate in patients with subarachnoid hemorrhagic (SAH) brain injury METHOD:Studies for the meta-analysis were identified from PubMed (1966 to 2009), Embase (1980 to 2009), and two Chinese journals (1989 to 2009). Paper selection was based on randomized controlled trials co...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-010-0022-8
更新日期:2010-06-01 00:00:00
abstract::Increasingly, experimental research in subarachnoid hemorrhage (SAH) has investigated early brain injury and the microcirculation. A number of pathophysiological changes occur in the cerebral microvessels after SAH including altered vasoreactivity, vasoconstriction, inflammation, blood-brain barrier impairment, increa...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-014-0323-4
更新日期:2014-04-01 00:00:00
abstract::Anticoagulation increases the risk of intracerebral hemorrhage (ICH) in patients with cerebral amyloid angiopathy (CAA), so the management of stroke-risk in patients with both atrial fibrillation (AF) and CAA is controversial. Advances in left atrial appendage closure (LAAC) techniques provide a stroke-risk-reduction ...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-020-00838-5
更新日期:2020-08-07 00:00:00
abstract::Pathophysiological findings of early brain injury in humans have not permitted conclusive determinations. We explored the essence of this phenomenon by taking intraoperative cortical specimens of Hunt-Kosnik grades IV~V (poor-grade) subarachnoid hemorrhages (SAH). From 2013 to 2017, we treated 39 consecutive poor-grad...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-020-00875-0
更新日期:2020-11-27 00:00:00
abstract::An argument for preclinical stroke research to make more use of the permanent middle cerebral artery occlusion (MCAO) model, rather than transient MCAO, is presented. Despite STAIR recommending permanent MCAO as the primary model, preclinical stroke research has not been listened. In 2012, Hossmann reported that 64% o...
journal_title:Translational stroke research
pub_type: 杂志文章
doi:10.1007/s12975-017-0554-2
更新日期:2017-07-17 00:00:00
abstract::Management of intracranial aneurysms remains controversial. For unruptured aneurysms, many factors should be taken into account before deciding the type of treatment and whether to treat or not. Ruptured aneurysms on the other hand are almost always treated. Still, the question remains what are the indicators that one...
journal_title:Translational stroke research
pub_type: 杂志文章,评审
doi:10.1007/s12975-013-0311-0
更新日期:2014-04-01 00:00:00