Dyslipidemia and CVS by Mohit Soni and Chandan KumarOlgaGoryacheva4
My students Mohit Soni and Chandan Kumar had presented this topic in our 22nd Student Scientific Society Conference in the department of Propaedeutic of Internal Diseases No.2
Co-Chairs, Alok A. Khorana, MD, FACP, FASCO, and Robert D. McBane, II, MD, along with Dana Angelini, MD, prepared useful Practice Aids pertaining to VTE for this CME/MOC/NCPD/CPE activity titled “Reducing the Global Burden of Cancer-Associated VTE: Applying Guideline-Concordant, Evidence-Based Care and Shared Decision-Making Strategies to Improve Patient Outcomes.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD/CPE information, and to apply for credit, please visit us at https://bit.ly/3pxFR5t. CME/MOC/NCPD/CPE credit will be available until August 9, 2022.
Dyslipidemia and CVS by Mohit Soni and Chandan KumarOlgaGoryacheva4
My students Mohit Soni and Chandan Kumar had presented this topic in our 22nd Student Scientific Society Conference in the department of Propaedeutic of Internal Diseases No.2
Co-Chairs, Alok A. Khorana, MD, FACP, FASCO, and Robert D. McBane, II, MD, along with Dana Angelini, MD, prepared useful Practice Aids pertaining to VTE for this CME/MOC/NCPD/CPE activity titled “Reducing the Global Burden of Cancer-Associated VTE: Applying Guideline-Concordant, Evidence-Based Care and Shared Decision-Making Strategies to Improve Patient Outcomes.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/NCPD/CPE information, and to apply for credit, please visit us at https://bit.ly/3pxFR5t. CME/MOC/NCPD/CPE credit will be available until August 9, 2022.
cardiac bio markers are important diagnostic and prognostic tool in acute coronary syndrome. several new emerging bio markers are coming with more sensitivity and specificity.
Predictors of Ischaemia and Outcomes in Egyptian Patients with Diabetes Mellitus Referred for Perfusion Imaging. Samir Rafla*, Ahmed Abdel-Aaty, Mohamed Ahmed Sadaka, Aly Ahmed Abo Elhoda and Ahmed Mohamed Shams
Bio-Markers of Heart Failure (Dr.LIKHIT T)Likhit T
A brief on bio-markers of Heart failure...First of all, I thank the Authors of all the books from which I picked the points to make this presentation.. This presentation includes classification of bio-markers and explanation according their importance.. Thank you
Aim: of the study was to conduct a comparative analysis of inflammatory markers in patients with coronary heart disease of stable and unstable flow. Methods: 78 patients aged 36 to 75 years were enrolled in this study (mean age 58.2±12.6 years). Laboratory and instrumental data were obtained and assessed. IL-6, TNF-α in blood plasma was carried out by the method of enzyme immunoassay on a solid-phase analyzer «Humareader Single». Statistical processing of the obtained results was carried out using vibrational statistics methods recommended for biomedical research on the IBM PC AT Pentium IV. Results: In patients with unstable angina (UA), the frequency of elevated levels of CRP, TNF-α, and leukocytes was statistically significantly higher than in the group with stable ischemic heart disease (P<0.05). The mean levels of these markers were statistically significantly higher in patients with UA compared with patients with stable form of coronary heart disease (CHD, P<0.05): CRP (4.3 ± 2.4 and 2.9 ± 2.3 mg / L, p <0.05, respectively), TNF-α (10.5 ± 2.5 and 7.7 ± 3.4 pg / ml, p <0.05) and leukocytes (9.2 ± 2.5 6.9 ± 2.3x109 / l, p <0.05). The level of interleukin-6 in patients with UA was higher in comparison with patients with stable angina (SA, 3.4 ± 1.7 and 2.9 ± 0.5 pg/ml), but the difference was statistically not significant (p> 0.05 ). There were no significant differences in the level of fibrinogen and ESR between patients with UA and SA. Conclusion: It was noted that the signs of inflammation are detected both in patients with unstable forms and in patients with stable form of CHD, but the degree of inflammation in patients with UA (level of TNF-α, CRP and leukocytes) is higher than in patients with stable ischemic heart disease.
Similar to stroke biomarkers a new era with diagnostic promise.pptx (20)
Adipokines as a potential biomarkers for vascular complications in type 2 dia...Moustafa Rezk
Adipose tissue has come into focus as an endocrine organAdipose tissue secretes a variety of bioactive peptides (adipokines).Adipokines may locally regulate fat mass by modulating adipocyte size/number or angiogenesis and inversely increased fat mass leads to dysregulation of adipocyte functions.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
stroke biomarkers a new era with diagnostic promise.pptx
1. Stroke Biomarkers: a new era with
diagnostic promise?
By
Prof. Moustafa Rizk
Prof. of Clinical Pathology
Faculty of Medicine, University of Alexandria
24/3/2022
5:20 AM 1
2. How to Spot a Stroke
B = Balance: Does the person have a sudden loss of balance or
coordination?
E = Eyes: Do they have sudden double vision, or loss of vision in one or
both eyes?
F = Face: Is one side of the face drooping? Ask the person to smile.
A = Arms: Can they keep their arms up, or does one arm drift down?
S = Speech: Do they suddenly have difficulty speaking or is their
speech slurred?
T = Time to act!.
5:20 AM 2
4. 5:20 AM 4
Adnan I, et al. Acute Ischemic Stroke and COVID-19.Stroke. 2021;52:905–912.
Acute Ischemic Stroke and COVID-19
A total of 8163 patients with confirmed COVID-19
among 27676 patients
103 (1.3%) patients developed acute ischemic stroke
among 8163 patients with COVID 19.
199 (1.0%) patients developed acute ischemic stroke
among 19513 patents in whom COVID-19 infection was
not diagnosed.
Acute ischemic stroke was infrequent in patients with
COVID-19 and usually occurs in the presence of other
cardiovascular risk factors.
5. Interventions in ischemic stroke
Thrombolysis with recombinant tissue
plasminogen activator (rt-PA)
Aspirin given within 48 h
Management of the patients within a dedicated
stroke unit
Hemicraniectomy
Recently endovascular clot retrieval
5:20 AM 5
7. What is a biomarker?
Biomarkers are objectively-measured biological signatures of normal
and pathologic processes that can serve a wide range of purposes
such as risk stratification, therapeutic assessment strategies,
clinical trial design and drug development.
A biomarker has good clinical acceptance if the biomarker is :
Accurate
Acceptable to the patient
Easy to interpret by clinicians
Has a high sensitivity and specificity for the outcome it is
expected
Understanding of the differences in pharmacological
responses
5:20 AM 7
8. Types of stroke biomarkers
1- Biomarkers of brain injury
Ex. S100β , MMP-9 , Neuron-specific enolase , GFAP,
Plasma microRNAs
2- Biomarkers of inflammation
Ex. Interleukin-6 , Procalcitonin level , Tumor necrosis
factor-a (TNF-a)
3- Biomarkers of oxidative damage
Ex. Thioredoxin, F2-isoprostanes , Uric acid
4- Lipids related Biomarkers
Ex. Apolipoprotein A-1
Fatty acid binding protein 4
5:20 AM 8
9. 5- Biomarkers of thrombus formation
Ex. D-dimers
Platelet reactivity
6- Biomarkers of cardiac function
N-terminal pro-Brain Natriuretic Peptide
High sensitivity troponin T
7- Biomarkers of stroke risk
Lipoprotein a ssociated phospholipase A2 (Lp-PLA2)
High levels of oxidized low-density lipoprotein
Asymmetric dimethylarginine (ADMA)
5:20 AM 9
10. S100β
The plasma S100β concentration in the ICH group was
significantly higher than in the IS group (p < 0.001).
So S100β could serve as a potential biomarker for
differentiating between ICH and IS
Plasma S100β concentration was significantly elevated
in patients with poor functional outcome vs. those
with favorable functional outcome (p < 0.001).
So predicting short-term functional outcome after ICH.
5:20 AM 10
Zhou S, Bao J, Wang Y, Pan S. S100β as a biomarker for differential diagnosis of
intracerebral hemorrhage and ischemic stroke. Neurol Res. 2016 Apr;38(4):327-32.
1- Biomarkers of brain injury
11. MMP-9
• MMP-9 concentrations correlate positively to infarct size
and worse neurological outcome
• Serum MMP-9 concentrations ≥140 ng/ml were shown
to predict hemorrhagic transformation in rt-PA treated
ischemic stroke patients
• However, the rise of MMP-9 is not specific to ischemic
stroke, moreover its concentration is reported to peak at
24 h post stroke
5:20 AM 11
12. NSE
Significantly raised in stroke patients compared to controls
and to correlate with infarct size and stroke symptom
severity
Serum NSE levels assessed prospectively within 4.5 h of IS
symptom onset in rt-PA threated patients correlates with
NIHSS at 24 h , and lower serum NSE levels and NIHSS
scores were detected in patients with favorable
neurological outcomes
Overall, NSE has a similar discriminatory profile to S100B
(high specificity and low sensitivity)
5:20 AM 12
13. GFAP (glial fibrillary acidic protein)
• The best candidate to date for differentiating
hemorrhage and ischemic stroke
• Using GFAP cut-off of 2.9 ng/l provided a
specificity of 96.3% and a sensitivity of 84.2% for
distinguishing ICH and IS .
• A meta-analysis including nearly 1,300 patients
confirmed the potential of measuring GFAP in the
blood in the early phase of stroke (samples drawn
<3 h from symptoms onset), to discriminate IS,
ICH.
5:20 AM 13
14. • Following an AIS, high levels of miRNA-124 were
attributed to different cellular processes, such as
inflammation, edema, cell death, and neurogenesis.
• Increased levels of miRNA-142-3p were correlated with
vascular hemorrhage, whereas low levels caused
abnormal vascular remodeling.
• Elevated levels of miRNA-126 were established as a
biomarker for AIS
5:20 AM 14
Plasma microRNAs
15. • Using microarray analysis , the researchers found that among the
836 miRNAs present on the array chip, 157 miRNAs were
differentially regulated in the stroke subjects.
• Among those miRNAs, 138 miRNAs were highly expressed, and 19
were poorly expressed. Of the highly expressed miRNAs, 17 were
upregulated and of the poorly expressed miRNAs, 8 were down
regulated.
• The researchers found that analysis of miRNA profiling revealed
the following key events that occur during stroke recovery:
regulation of hypoxia, angiogenesis, and erythropoiesis/
hematopoiesis.
• They concluded that these miRNAs could be used to differentiate
large artery, small artery, and cardio embolic strokes from each
other.
5:20 AM 15
M. Vijayan, P.H. Reddy . Peripheral biomarkers of stroke: Focus on circulatory microRNAs .
Biochimica et Biophysica Acta 1862 (2016) 1984–1993
16. 5:20 AM 16
Differentially regulated miRNAs in ischemic stroke
patients with different conditions
M. Vijayan, P.H. Reddy . Peripheral biomarkers of stroke: Focus on circulatory microRNAs . Biochimica
et Biophysica Acta 1862 (2016) 1984–1993
17. 5:20 AM 17
Total RNA was separately extracted from MRI(-) acute stroke patients, MRI(+) acute
stroke patients, and control subjects. Then, significant changes in the miRNA
profiles were analyzed using pairwise comparisons between the groups. Only the
miRNAs showing 2-fold changes or greater between all two groups were selected.
Journal of Stroke and Cerebrovascular Diseases, Vol. 23, No. 10 (November-December), 2014: pp 2607-2613
Circulating MicroRNAs as Novel Potential Biomarkers for Early Diagnosis of Acute Stroke in Humans
18. 2- Biomarkers of inflammation
Interleukin-6
Released in the post-stroke setting and serves mediators
in the acute phase of AIS
Interleukin-6 (IL-6) expression was upregulated
following brain ischemia when measured in the first 24
h in the peripheral blood. .
IL-6 rise in peripheral blood had
a neuroprotecive effect and was
associated with better outcome,
but showed no value
as a diagnostic tool
5:20 AM 18
19. Procalcitonin level
• Significantly increased in ischemic stroke patients when
compared to a normal control group.
• Patients with procalcitonin level above 1.20 ng/ml were
at a higher risk for AIS in comparison to healthy
individuals
Tumor necrosis factor-a (TNF-a)
• Tumor necrosis factor-a reaches a high concentration in
the first 6 h after AIS, but its similar behavior in other
inflammatory and infectious processes limits its capacity
to be used as a valuable diagnostic tool.
5:20 AM 19
20. 3-Biomarkers of oxidative damage
Thioredoxin
A redox-regulating protein with antioxidant activity that
can be a potential indicator of oxidative stress in strokes
Oxidative stress index (OSI)
The ratio of total oxidant status (TOS ) level to total
antioxidant status (TAS) level.
Serum thioredoxin level was higher in patients with AIS
when compared to healthy patients (15.03 ng/ml vs.
8.95 ng/ml)
Strong correlation between increased thioredoxin serum
levels and risk of AIS
5:20 AM 20
21. F2-isoprostanes (A family of prostaglandin isomers)
Rise in F2-isoprostanes occurred as early as three hours
after ischemic stroke onset and remained elevated for
several days.
Uric acid (an antioxidant role of urate) Uric acid levels were
inversely associated with the extent of neurological deficits
on admission and the final infarct volume on CT/MRI scans
5:20 AM 21
22. 4- Lipids related Biomarkers
• Apolipoprotein A-1
5:20 AM 22
Journal of Stroke and Cerebrovascular Diseases, Vol. 25, No. 6 (June), 2016: pp 1360–1365
23. 5:20 AM 23
Median Apo A-I levels were lower in ischemic stroke cases versus controls (140 versus 175
mg/dL, difference of 35 mg/dL, 95% CI −54 to −16) and in ischemic stroke versus ICH
cases (140 versus 180 mg/dL, difference of 40 mg/dL, 95% CI −57 to −23)
Journal of Stroke and Cerebrovascular Diseases, Vol. 25, No. 6 (June), 2016: pp 1360–1365
Apolipoprotein A-I and Paraoxonase-1 Are Potential Blood Biomarkers for
Ischemic Stroke Diagnosis
24. 5:20 AM 24
Median paraoxonase-1 was lower in ischemic stroke cases than in both ICH cases and
matched controls
Journal of Stroke and Cerebrovascular Diseases, Vol. 25, No. 6 (June), 2016: pp 1360–1365
Apolipoprotein A-I and Paraoxonase-1 Are Potential Blood Biomarkers for
Ischemic Stroke Diagnosis
25. • A panel of nine apo-lipoproteins was tested as a
tool to distinguish IS and ICH patients within the
first week after symptom onset using a mass
spectrometry assay.
• Apo C-I and Apo C-III reported to provide the
best classification power as individual markers
but combining Apo C-III and Apo A-I provided
the best discrimination overall .
5:20 AM 25
26. Fatty acid binding protein 4
Previous studies have suggested that FABP4 was associated
with the following known cardiocerebrovascular diseases risk
factors: insulin resistance and obesity, hypertension,
atherosclerosis and diabetes.
5:20 AM 26
27. 5:20 AM 27
Circulating FABP4 levels are associated with stroke risk and clinical severity and
may represent an important pathophysiological mediator of atherosclerosis, which
may point to a new target of treatment options.
Although further studies are now needed to replicate these findings, data suggest
that FABP4 level shows potential as a novel biomarker for stroke risk and stroke
severity.
Journal of Neuroimmunology 311 (2017) 29–34
Fatty acid binding protein 4
Fatty acid binding protein 4 is associated with stroke risk and severity in patients with acute ischemic stroke
28. 5:20 AM 28
Journal of Stroke and Cerebrovascular Diseases, Vol. 23, No. 5 (May-June), 2014: pp 910-918
Do we need a panel of biomarkers ?
29. 5:20 AM 29
Dagonnier M, Donnan GA, Davis SM, Dewey HM and Howells DW (2021) Acute Stroke Biomarkers: Are We There Yet?
Front. Neurol. 12:619721. doi: 10.3389/fneur.2021.619721
Main clinical uses and their linked potential biomarkers.
30. 5:20 AM 30
Dagonnier M, Donnan GA, Davis SM, Dewey HM and Howells DW (2021) Acute Stroke Biomarkers: Are We There Yet?
Front. Neurol. 12:619721. doi: 10.3389/fneur.2021.619721
31. 5:20 AM 31
Dagonnier M, Donnan GA, Davis SM, Dewey HM and Howells DW (2021) Acute Stroke Biomarkers: Are We There Yet?
Front. Neurol. 12:619721. doi: 10.3389/fneur.2021.619721
32. Conclusions
Improving in patient outcomes in acute stroke
requires a rapid and accurate diagnosis of stroke and
its subtypes.
A biomarker that could differentiate between
hemorrhagic and ischemic stroke or risk of
subsequent bleeding would, in theory, permit
widespread initiation of thrombolysis in the
ambulance and save valuable time and brain tissue.
The ultimate aim of the stroke biomarker research is
the development of a point of care device. A quick
and reliable bedside biomarker assessment would
revolutionize the acute stroke management.
5:20 AM 32
A total of 103 (1.3%) patients developed acute ischemic stroke among 8163 patients with COVID-19. Among all patients with COVID-19, the proportion of patients with hypertension, diabetes, hyperlipidemia, atrial fibrillation, and congestive heart failure was significantly higher among those with acute ischemic stroke. Acute ischemic stroke was associated with discharge to destination other than home or death (relative risk, 2.1 [95% CI, 1.6–2.4]; P
The National Institutes of Health Stroke Scale, or NIH Stroke Scale (NIHSS) is a tool used by healthcare providers to objectively quantify the impairment caused by a stroke. The NIHSS is composed of 11 items, each of which scores a specific ability between a 0 and 4. For each item, a score of 0 typically indicates normal function in that specific ability, while a higher score is indicative of some level of impairment.[1] The individual scores from each item are summed in order to calculate a patient's total NIHSS score. The maximum possible score is 42, with the minimum score being a 0
MiRNAs are important regulators of several biological processes, such as cell growth, apoptosis, cell proliferation, embryonic development, and tissue differentiation. According to the miRbase-21 database released in June 2014, 1881 precursor and 2588 mature miRNAs have been identified. Furthermore, miRNAs can act as sensitive biomarkers of secondary brain damage
After an ischemic brain injury, the tight junctions between endothelial cells of the BBB become leaky, which allow circulatory
immune cells to permeate and infiltrate the surrounding brain parenchyma. These immune cells secrete pro-inflammatory
cytokines (such as IL-6 and TLRs) to overcome the injurious damage. following stroke. In the clinical setting, IL-6 has been measured following the onset of acute ischemic stroke, consistently showing an increase in IL-6 levels.
It was seen that oxidant-antioxidant balance was impaired in favor of oxidants in ACI and AIH. In addition, impairment in oxidant-antioxidant balance was found in the early stages of ACI. Therefore,these biomarkers can be used especially in the early diagnosis of thrombolytic therapy candidates in ACI.
In vivo, uric acid is a potent water-soluble antioxidant that targets free radicals caused by oxidative damage, including
hydroxyl radicals and superoxide. Patients with malignant middle cerebral artery infarction and symptomatic intracranial hemorrhage have significantly lower uric acid levels.
Paraoxonase-1, matrix metalloproteinase (MMP)- 3, MMP-9, apolipoprotein (Apo) A-I, Apo C-I, and Apo C-III.
Apolipoprotein (Apo) is the protein component of lipoproteins,including HDL. Apo A-I is the primary lipoprotein associated with HDL in plasma. Lower Apo
A-I levels were predictive of higher stroke risk in a large cohort study with over 175,000 patients, as well as ischemic stroke risk
Paraoxonase-1 is a class A calcium-dependent, HDLassociated esterase. Its activities include the hydrolysis of toxic oxon metabolites and protection against vascular disease by metabolizing oxidized lipids. A strong association between the paraoxonase-1 Gln192Arg singlenucleotide polymorphism and stroke risk has been previously reported, and paraoxonase-1 activity has been shown to be decreased in ischemic stroke patients compared to controls. araoxonase-1 cotransports with HDL (and therefore Apo A-I) and is thought to account for at least some of the antioxidant properties of HDL