Objectives. Although multiple mechanisms, including autonomic dysfunction, seem to link sleep-dis... more Objectives. Although multiple mechanisms, including autonomic dysfunction, seem to link sleep-disordered breathing (SDB) with dyslipidemia in animal studies, the data in clinical studies are limited. The aim of this study was to explore the association of lipoprotein levels with SDB measures in healthy habitual snorers. We supposed that autonomic dysfunction is the linking mechanism. Methods. We enrolled 110 previously healthy subjects with complaints of habitual snoring. To assess SDB, polysomnography was performed. Blood samples for the analysis of total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein cholesterol (LDL), and triglycerides (TG) were obtained in a fasting condition after the polysomnography. Baroreflex sensitivity (BRS) was used to assess the autonomic dysfunction. Results. In stepwise multiple linear regression analysis, minimal nocturnal blood oxygen saturation (beta=–0.240, p=0.020) and neck circumference (beta=0.224, p=0.03) were the onl...
Background/Aims: Dementia and psychiatric disorders are common in assisted living facilities (ALF... more Background/Aims: Dementia and psychiatric disorders are common in assisted living facilities (ALFs) and have suboptimal rates of recognition and treatment. Therefore, we aimed to obtain a direct estimate of the prevalence of cognitive impairment and especially dementia among residents of ALFs in western Slovakia and their rates of primary recognition and adequate treatment. Methods: We conducted two cross-sectional studies. Ten ALFs within the city of Bratislava were chosen for the study in 2004, and again in 2011. A total of 866 residents in ALFs were examined in 2004, and 821 residents in ALFs were examined in 2011. The rate and characterization of dementia, its primary recognition and adequate treatment were investigated in both cross-sectional studies. Results: In 2004, 57% of the participants had dementia. Only 7.2% of the participants with probable Alzheimer disease were treated with acetylcholinesterase inhibitors. In 2011, we observed a significant improvement in primary dia...
Ceska a Slovenska Neurologie a Neurochirurgie, Dec 1, 2013
Súhrn Ochorenie, ktoré dnes označujeme ako frontotemporálna lobárna degenerácia (FTLD), pre‐ šlo ... more Súhrn Ochorenie, ktoré dnes označujeme ako frontotemporálna lobárna degenerácia (FTLD), pre‐ šlo zložitým vývojom od svojho prvého opisu Arnoldom Pickom a neskôr Aloisom Alzhei‐ merom, cez prvé klinicko‐patologické kritériá predstavené Davidom Nearym a Davidom Man‐ nom, až po dnešné nomenklatúrne vnímanie ako komplexnej klinicko‐patologickej entity. V súčasnosti je frontotemporálna lobárna degenerácia vnímaná ako heterogénny syndróm spôsobený progresívnou degeneráciou frontálnych a temporálnych lalokov mozgu. Klinicky sa môže prejaviť ako tri syndrómy frontotemporálnej demencie (behaviorálny variant FTD, progresívna non‐fluentná afázia a sémantická demencia), ale aj ako tzv. overlap syndrómy zahrňujúce kortikobazálnu degeneráciu a progresívnu supranukleárnu obrnu. Jej výskyt je asi 10 % spomedzi všetkých demencií a 40 % spomedzi demencií so začiatkom medzi 45. a 65. rokom života. Klinická manifestácia jednotlivých subtypov sa líši, spoločným me‐ novateľom sú poruchy správania a postihnutie fatických, gnostických a exekutívnych funkcií. Mnestické a zrakovo‐ priestorové funkcie zostávajú síce relatívne dlho zachované, sú však prekryté rozpadom osobnosti, fatickými alebo gnostickými poruchami. V porovnaní s Alz‐ heimerovou chorobou má spravidla skorší vek nástupu, rýchlejší priebeh a devastujúcejšie postihnutie jednotlivých kognitívnych domén. Postihnutí sú spravidla rýchlejšie odkázaní na pomoc inej osoby alebo inštitúcie. V našom príspevku sa snažíme o súhrnný pohľad na túto výrazne heterogénnu klinicko‐patologickú entitu so zameraním sa na klinické, genetické a histopatologické špecifiká. Hlavnú pozornosť venujeme syndrómom frontotemporálnej demencie. Autoři deklarují, že v souvislosti s předmě‐ tem studie nemají žádné komerční zájmy. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. Redakční rada potvrzuje, že rukopis práce splnil ICMJE kritéria pro publikace zasílané do biomedicínských časopisů. The Editorial Board declares that the manu‐ script met the ICMJE “uniform requirements” for biomedical papers.
Background The neurotrophic drug Cerebrolysin accelerated recovery and prevented acute neuronal d... more Background The neurotrophic drug Cerebrolysin accelerated recovery and prevented acute neuronal damage in preclinical models of ischaemia. Previous clinical trials support therapeutic effects in stroke patients. The study investigated whether the combination with alteplase and Cerebrolysin is safe and can further reduce disability after acute ischaemic stroke. Methods This placebo-controlled, double-blind trial involved 119 patients with acute ischaemic hemispheric stroke, randomly assigned to a combined treatment with alteplase plus Cerebrolysin or placebo (administered 1 h after thrombolytic treatment) starting within three-hours after onset of symptoms. A daily i.v. infusion of 30 ml Cerebrolysin or placebo was given for 10 consecutive days. Primary outcome was the modified Rankin Scale at day 90. A sequential design with interim analyses was applied. Results The third interim analysis did not show a benefit in the modified Rankin Scale for Cerebrolysin on day 90 compared to plac...
OBJECTIVES Multiple sclerosis (MS) is a chronic inflammatory autoimmune and neurodegenerative dis... more OBJECTIVES Multiple sclerosis (MS) is a chronic inflammatory autoimmune and neurodegenerative disease of the central nervous system (CNS) typically affecting young adults. Although the pathogenesis of MS is not fully understood, there is evidence to suggest that inflammation-induced oxidative stress can play a role in demyelination and axonal damage. Oxidative stress also participates in the pathogenesis of endothelial dysfunction and atherogenesis. Data from large epidemiological studies showed a higher risk of vascular events in MS patients. The aim of our study was to analyse the presence of oxidative stress and its association with the parameters of subclinical atherosclerosis in the early stages of MS. MATERIAL AND METHODS We compared 13 newly diagnosed MS patients with a group of 13 healthy age- and BMI-matched controls. Blood samples were measured for total antioxidant activity using TEAC assay. Endothelial function, expressed as reperfusion hyperaemia index (RHI) and arteria...
Neurofilament light chain (NfL) is considered a major marker of neurodegeneration and disease act... more Neurofilament light chain (NfL) is considered a major marker of neurodegeneration and disease activity. Higher levels of NfL are associated with worse clinical outcomes and increased brain atrophy. In treated patients with Relapsing-Remitting Multiple Sclerosis (RRMS), we aimed to determine the level of NfL, an association between NfL and demographic, clinical and magnetic resonance imaging (MRI) characteristics as well as brain volume parameters. We wanted to confirm that level of NfL is clinically useful as biomarker of neurodegeneration and disease activity. 56 treated RRMS patients were enrolled. Plasmatic levels of NfL (pNfL) were measured by SIMOA® technique. Clinical severity of MS was expressed by Expanded Disability Status Scale (EDSS), and volumetric analysis of MRI data was performed using Icobrain software. The mean pNfL level was significantly higher in MS patients than in healthy controls (14.73 ± 6.38 versus 6.67 ± 3.9, p<0.001). In patients, we did not find associ...
To date, the clinical usefulness of measuring baroreflex sensitivity (BRS) to detect impairment o... more To date, the clinical usefulness of measuring baroreflex sensitivity (BRS) to detect impairment of the autonomic nervous system in patients with diabetes mellitus (DM) type I has not been evaluated sufficiently (Mlcáková et al. 2008). The aim of the current study was the determination and statistical comparison of the mean values of BRS in our DM type I patients cohort and in a control group of healthy volunteers as well as the determination of BRS value dependency on the duration of diabetes and the level of glycemic control in DM I patients. We also aimed to determine the inter-individual and intra-individual variability of BRS in our patients. We examined 100 patients with type I diabetes mellitus (37 women and 63 men, mean age 30 years, duration of the disease >or= 10 years) and 40 healthy, age- and sex-matched, subjects. Data from the patient cohort were subsequently analysed for duration of the diabetes and the level of glycemic control as assessed by glycated haemoglobin (...
Multiple sclerosis (MS) is a chronic inflammatory autoimmune and neurodegenerative disease of the... more Multiple sclerosis (MS) is a chronic inflammatory autoimmune and neurodegenerative disease of the central nervous system (CNS) typically affecting young adults. Although the pathogenesis of MS is not fully understood, there is evidence to suggest that inflammation-induced oxidative stress can play a role in demyelination and axonal damage. Oxidative stress also participates in the pathogenesis of endothelial dysfunction and atherogenesis. Data from large epidemiological studies showed a higher risk of vascular events in MS patients. The aim of our study was to analyse the presence of oxidative stress and its association with the parameters of subclinical atherosclerosis in the early stages of MS. We compared 13 newly diagnosed MS patients with a group of 13 healthy age- and BMI-matched controls. Blood samples were measured for total antioxidant activity using TEAC assay. Endothelial function, expressed as reperfusion hyperaemia index (RHI) and arterial stiffness, expressed as augmen...
Journal of the International Society of Antioxidants in Nutrition & Health, 2016
In the pathogenesis of acute ischaemic stroke (AIS), oxidative stress plays a critical role. In t... more In the pathogenesis of acute ischaemic stroke (AIS), oxidative stress plays a critical role. In this study we have focused on determining the range of oxidative stress biomarkers and their dynamic changes as well as the protein expression of SOD and catalase in stroke patients at different time points after the AIS. 82 patients with AIS were involved in our study and were tested: within 24h from the onset of the attack; at 7-day and 3-month follow-ups. 81 healthy, age and gender matched volunteers were used as controls. Stroke patients had significantly higher concentrations of plasma lipid peroxides when compared with controls. Activities of superoxide dismutase (SOD) and catalase were elevated and activity of paraoxonase (PON1) reduced compared with controls. Activity of GPx was without any change. Patients at the 7-day follow-up had increased activities of SOD and catalase but reduced activity of PON1. Patients at the 3-month follow-up had significantly elevated plasma antioxi...
BACKGROUND Neurofilament light chain (NfL) is considered a major marker of neurodegeneration and ... more BACKGROUND Neurofilament light chain (NfL) is considered a major marker of neurodegeneration and disease activity. Higher levels of NfL are associated with worse clinical outcomes and increased brain atrophy. In treated patients with Relapsing-Remitting Multiple Sclerosis (RRMS), we aimed to determine the level of NfL, an association between NfL and demographic, clinical and magnetic resonance imaging (MRI) characteristics as well as brain volume parameters. We wanted to confirm that level of NfL is clinically useful as biomarker of neurodegeneration and disease activity. METHODS 56 treated RRMS patients were enrolled. Plasmatic levels of NfL (pNfL) were measured by SIMOA® technique. Clinical severity of MS was expressed by Expanded Disability Status Scale (EDSS), and volumetric analysis of MRI data was performed using Icobrain software. RESULTS The mean pNfL level was significantly higher in MS patients than in healthy controls (14.73 ± 6.38 versus 6.67 ± 3.9, p<0.001). In patie...
BACKGROUND AND PURPOSE Autonomic nervous system (ANS) seems to play an important role in the post... more BACKGROUND AND PURPOSE Autonomic nervous system (ANS) seems to play an important role in the post-stroke immunosuppression syndrome with increased susceptibility to infections. The aim of this study was to investigate if ANS activity measured at admission is associated with post-stroke infections. METHODS We prospectively analyzed patients with acute ischemic stroke. ANS was measured using the cross-correlational baroreflex sensitivity (BRS) at admission. The occurrence and cause of in-hospital infections was assessed based on the clinical and laboratory examination. Demographic and clinical variables including initial stroke severity, dysphagia, procedures as nasogastric tubes, central venous and urinary catheters and mechanical ventilation were included in the analysis. RESULTS We included 161 patients with ischemic stroke, of those 49 (30.4%) developed a nosocomial infection during the first 7 days of hospital stay. Patients with infections had significantly lower BRS (median 3 vs 5 ms/mmHg, p < .001) higher initial NIHSS (median 15 vs 5, p < .001), had more often non-lacunar etiology and underwent more invasive procedures. In the multivariable regression model decreased BRS (adjusted OR 1.21, 95% CI 1.03-1.41, p = .02), admission NIHSS (adjusted OR 1.10, 95% CI 1.02-1.19, p = .02) and invasive procedures (adjusted OR 1.46, 95% CI 1.03-2.06, p = .03) were independently associated with infection after ischemic stroke. CONCLUSIONS Decreased BRS was independently associated with infections after ischemic stroke. Autonomic shift may play an important role in increased susceptibility to infections after stroke. The possible diagnostic and therapeutic relevance of this finding deserves further research.
Objectives. Although multiple mechanisms, including autonomic dysfunction, seem to link sleep-dis... more Objectives. Although multiple mechanisms, including autonomic dysfunction, seem to link sleep-disordered breathing (SDB) with dyslipidemia in animal studies, the data in clinical studies are limited. The aim of this study was to explore the association of lipoprotein levels with SDB measures in healthy habitual snorers. We supposed that autonomic dysfunction is the linking mechanism. Methods. We enrolled 110 previously healthy subjects with complaints of habitual snoring. To assess SDB, polysomnography was performed. Blood samples for the analysis of total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein cholesterol (LDL), and triglycerides (TG) were obtained in a fasting condition after the polysomnography. Baroreflex sensitivity (BRS) was used to assess the autonomic dysfunction. Results. In stepwise multiple linear regression analysis, minimal nocturnal blood oxygen saturation (beta=–0.240, p=0.020) and neck circumference (beta=0.224, p=0.03) were the onl...
Background/Aims: Dementia and psychiatric disorders are common in assisted living facilities (ALF... more Background/Aims: Dementia and psychiatric disorders are common in assisted living facilities (ALFs) and have suboptimal rates of recognition and treatment. Therefore, we aimed to obtain a direct estimate of the prevalence of cognitive impairment and especially dementia among residents of ALFs in western Slovakia and their rates of primary recognition and adequate treatment. Methods: We conducted two cross-sectional studies. Ten ALFs within the city of Bratislava were chosen for the study in 2004, and again in 2011. A total of 866 residents in ALFs were examined in 2004, and 821 residents in ALFs were examined in 2011. The rate and characterization of dementia, its primary recognition and adequate treatment were investigated in both cross-sectional studies. Results: In 2004, 57% of the participants had dementia. Only 7.2% of the participants with probable Alzheimer disease were treated with acetylcholinesterase inhibitors. In 2011, we observed a significant improvement in primary dia...
Ceska a Slovenska Neurologie a Neurochirurgie, Dec 1, 2013
Súhrn Ochorenie, ktoré dnes označujeme ako frontotemporálna lobárna degenerácia (FTLD), pre‐ šlo ... more Súhrn Ochorenie, ktoré dnes označujeme ako frontotemporálna lobárna degenerácia (FTLD), pre‐ šlo zložitým vývojom od svojho prvého opisu Arnoldom Pickom a neskôr Aloisom Alzhei‐ merom, cez prvé klinicko‐patologické kritériá predstavené Davidom Nearym a Davidom Man‐ nom, až po dnešné nomenklatúrne vnímanie ako komplexnej klinicko‐patologickej entity. V súčasnosti je frontotemporálna lobárna degenerácia vnímaná ako heterogénny syndróm spôsobený progresívnou degeneráciou frontálnych a temporálnych lalokov mozgu. Klinicky sa môže prejaviť ako tri syndrómy frontotemporálnej demencie (behaviorálny variant FTD, progresívna non‐fluentná afázia a sémantická demencia), ale aj ako tzv. overlap syndrómy zahrňujúce kortikobazálnu degeneráciu a progresívnu supranukleárnu obrnu. Jej výskyt je asi 10 % spomedzi všetkých demencií a 40 % spomedzi demencií so začiatkom medzi 45. a 65. rokom života. Klinická manifestácia jednotlivých subtypov sa líši, spoločným me‐ novateľom sú poruchy správania a postihnutie fatických, gnostických a exekutívnych funkcií. Mnestické a zrakovo‐ priestorové funkcie zostávajú síce relatívne dlho zachované, sú však prekryté rozpadom osobnosti, fatickými alebo gnostickými poruchami. V porovnaní s Alz‐ heimerovou chorobou má spravidla skorší vek nástupu, rýchlejší priebeh a devastujúcejšie postihnutie jednotlivých kognitívnych domén. Postihnutí sú spravidla rýchlejšie odkázaní na pomoc inej osoby alebo inštitúcie. V našom príspevku sa snažíme o súhrnný pohľad na túto výrazne heterogénnu klinicko‐patologickú entitu so zameraním sa na klinické, genetické a histopatologické špecifiká. Hlavnú pozornosť venujeme syndrómom frontotemporálnej demencie. Autoři deklarují, že v souvislosti s předmě‐ tem studie nemají žádné komerční zájmy. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. Redakční rada potvrzuje, že rukopis práce splnil ICMJE kritéria pro publikace zasílané do biomedicínských časopisů. The Editorial Board declares that the manu‐ script met the ICMJE “uniform requirements” for biomedical papers.
Background The neurotrophic drug Cerebrolysin accelerated recovery and prevented acute neuronal d... more Background The neurotrophic drug Cerebrolysin accelerated recovery and prevented acute neuronal damage in preclinical models of ischaemia. Previous clinical trials support therapeutic effects in stroke patients. The study investigated whether the combination with alteplase and Cerebrolysin is safe and can further reduce disability after acute ischaemic stroke. Methods This placebo-controlled, double-blind trial involved 119 patients with acute ischaemic hemispheric stroke, randomly assigned to a combined treatment with alteplase plus Cerebrolysin or placebo (administered 1 h after thrombolytic treatment) starting within three-hours after onset of symptoms. A daily i.v. infusion of 30 ml Cerebrolysin or placebo was given for 10 consecutive days. Primary outcome was the modified Rankin Scale at day 90. A sequential design with interim analyses was applied. Results The third interim analysis did not show a benefit in the modified Rankin Scale for Cerebrolysin on day 90 compared to plac...
OBJECTIVES Multiple sclerosis (MS) is a chronic inflammatory autoimmune and neurodegenerative dis... more OBJECTIVES Multiple sclerosis (MS) is a chronic inflammatory autoimmune and neurodegenerative disease of the central nervous system (CNS) typically affecting young adults. Although the pathogenesis of MS is not fully understood, there is evidence to suggest that inflammation-induced oxidative stress can play a role in demyelination and axonal damage. Oxidative stress also participates in the pathogenesis of endothelial dysfunction and atherogenesis. Data from large epidemiological studies showed a higher risk of vascular events in MS patients. The aim of our study was to analyse the presence of oxidative stress and its association with the parameters of subclinical atherosclerosis in the early stages of MS. MATERIAL AND METHODS We compared 13 newly diagnosed MS patients with a group of 13 healthy age- and BMI-matched controls. Blood samples were measured for total antioxidant activity using TEAC assay. Endothelial function, expressed as reperfusion hyperaemia index (RHI) and arteria...
Neurofilament light chain (NfL) is considered a major marker of neurodegeneration and disease act... more Neurofilament light chain (NfL) is considered a major marker of neurodegeneration and disease activity. Higher levels of NfL are associated with worse clinical outcomes and increased brain atrophy. In treated patients with Relapsing-Remitting Multiple Sclerosis (RRMS), we aimed to determine the level of NfL, an association between NfL and demographic, clinical and magnetic resonance imaging (MRI) characteristics as well as brain volume parameters. We wanted to confirm that level of NfL is clinically useful as biomarker of neurodegeneration and disease activity. 56 treated RRMS patients were enrolled. Plasmatic levels of NfL (pNfL) were measured by SIMOA® technique. Clinical severity of MS was expressed by Expanded Disability Status Scale (EDSS), and volumetric analysis of MRI data was performed using Icobrain software. The mean pNfL level was significantly higher in MS patients than in healthy controls (14.73 ± 6.38 versus 6.67 ± 3.9, p<0.001). In patients, we did not find associ...
To date, the clinical usefulness of measuring baroreflex sensitivity (BRS) to detect impairment o... more To date, the clinical usefulness of measuring baroreflex sensitivity (BRS) to detect impairment of the autonomic nervous system in patients with diabetes mellitus (DM) type I has not been evaluated sufficiently (Mlcáková et al. 2008). The aim of the current study was the determination and statistical comparison of the mean values of BRS in our DM type I patients cohort and in a control group of healthy volunteers as well as the determination of BRS value dependency on the duration of diabetes and the level of glycemic control in DM I patients. We also aimed to determine the inter-individual and intra-individual variability of BRS in our patients. We examined 100 patients with type I diabetes mellitus (37 women and 63 men, mean age 30 years, duration of the disease >or= 10 years) and 40 healthy, age- and sex-matched, subjects. Data from the patient cohort were subsequently analysed for duration of the diabetes and the level of glycemic control as assessed by glycated haemoglobin (...
Multiple sclerosis (MS) is a chronic inflammatory autoimmune and neurodegenerative disease of the... more Multiple sclerosis (MS) is a chronic inflammatory autoimmune and neurodegenerative disease of the central nervous system (CNS) typically affecting young adults. Although the pathogenesis of MS is not fully understood, there is evidence to suggest that inflammation-induced oxidative stress can play a role in demyelination and axonal damage. Oxidative stress also participates in the pathogenesis of endothelial dysfunction and atherogenesis. Data from large epidemiological studies showed a higher risk of vascular events in MS patients. The aim of our study was to analyse the presence of oxidative stress and its association with the parameters of subclinical atherosclerosis in the early stages of MS. We compared 13 newly diagnosed MS patients with a group of 13 healthy age- and BMI-matched controls. Blood samples were measured for total antioxidant activity using TEAC assay. Endothelial function, expressed as reperfusion hyperaemia index (RHI) and arterial stiffness, expressed as augmen...
Journal of the International Society of Antioxidants in Nutrition & Health, 2016
In the pathogenesis of acute ischaemic stroke (AIS), oxidative stress plays a critical role. In t... more In the pathogenesis of acute ischaemic stroke (AIS), oxidative stress plays a critical role. In this study we have focused on determining the range of oxidative stress biomarkers and their dynamic changes as well as the protein expression of SOD and catalase in stroke patients at different time points after the AIS. 82 patients with AIS were involved in our study and were tested: within 24h from the onset of the attack; at 7-day and 3-month follow-ups. 81 healthy, age and gender matched volunteers were used as controls. Stroke patients had significantly higher concentrations of plasma lipid peroxides when compared with controls. Activities of superoxide dismutase (SOD) and catalase were elevated and activity of paraoxonase (PON1) reduced compared with controls. Activity of GPx was without any change. Patients at the 7-day follow-up had increased activities of SOD and catalase but reduced activity of PON1. Patients at the 3-month follow-up had significantly elevated plasma antioxi...
BACKGROUND Neurofilament light chain (NfL) is considered a major marker of neurodegeneration and ... more BACKGROUND Neurofilament light chain (NfL) is considered a major marker of neurodegeneration and disease activity. Higher levels of NfL are associated with worse clinical outcomes and increased brain atrophy. In treated patients with Relapsing-Remitting Multiple Sclerosis (RRMS), we aimed to determine the level of NfL, an association between NfL and demographic, clinical and magnetic resonance imaging (MRI) characteristics as well as brain volume parameters. We wanted to confirm that level of NfL is clinically useful as biomarker of neurodegeneration and disease activity. METHODS 56 treated RRMS patients were enrolled. Plasmatic levels of NfL (pNfL) were measured by SIMOA® technique. Clinical severity of MS was expressed by Expanded Disability Status Scale (EDSS), and volumetric analysis of MRI data was performed using Icobrain software. RESULTS The mean pNfL level was significantly higher in MS patients than in healthy controls (14.73 ± 6.38 versus 6.67 ± 3.9, p<0.001). In patie...
BACKGROUND AND PURPOSE Autonomic nervous system (ANS) seems to play an important role in the post... more BACKGROUND AND PURPOSE Autonomic nervous system (ANS) seems to play an important role in the post-stroke immunosuppression syndrome with increased susceptibility to infections. The aim of this study was to investigate if ANS activity measured at admission is associated with post-stroke infections. METHODS We prospectively analyzed patients with acute ischemic stroke. ANS was measured using the cross-correlational baroreflex sensitivity (BRS) at admission. The occurrence and cause of in-hospital infections was assessed based on the clinical and laboratory examination. Demographic and clinical variables including initial stroke severity, dysphagia, procedures as nasogastric tubes, central venous and urinary catheters and mechanical ventilation were included in the analysis. RESULTS We included 161 patients with ischemic stroke, of those 49 (30.4%) developed a nosocomial infection during the first 7 days of hospital stay. Patients with infections had significantly lower BRS (median 3 vs 5 ms/mmHg, p < .001) higher initial NIHSS (median 15 vs 5, p < .001), had more often non-lacunar etiology and underwent more invasive procedures. In the multivariable regression model decreased BRS (adjusted OR 1.21, 95% CI 1.03-1.41, p = .02), admission NIHSS (adjusted OR 1.10, 95% CI 1.02-1.19, p = .02) and invasive procedures (adjusted OR 1.46, 95% CI 1.03-2.06, p = .03) were independently associated with infection after ischemic stroke. CONCLUSIONS Decreased BRS was independently associated with infections after ischemic stroke. Autonomic shift may play an important role in increased susceptibility to infections after stroke. The possible diagnostic and therapeutic relevance of this finding deserves further research.
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