Publications (2)2.94 Total impact
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Article: Short-term prognostic value of serum neuron specific enolase and S100B in acute stroke patients.
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ABSTRACT: OBJECTIVE: To explore the value of blood markers for brain injury as outcome predictors in acute stroke. DESIGN AND METHODS: The study included 61 patients with acute stroke (44 ischemic and 17 hemorrhagic) and a high risk control group (79 individuals with no known history of neurological disease). Serum neuron specific enolase (NSE) and S100B were determined by immunoassay (CanAg Diagnostics, Sweden). Outcome at 60days was evaluated with clinical scales. RESULTS: Higher concentrations of NSE and S100B were measured in patients compared to high risk controls, but they were not related to stroke severity on admission. NSE was associated with functional neurological outcome at 60days and to the degree of recovery, whereas S100B exhibited a strong correlation with depression symptoms at 60days. CONCLUSIONS: The measurements of serum concentrations of NSE and S100B after acute stroke may be clinically relevant for predicting functional neurological outcome and post-stroke depression, respectively.Clinical biochemistry 07/2012; · 2.02 Impact Factor -
Article: Association between Blood Lipids and Types of Stroke
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ABSTRACT: INTRODUCTION The scientific community recognizes the association between blood lipids levels and risk of cardiovascular disease.[1] Strong association has been found between high levels of serum cho-lesterol – especially of low-density lipoprotein (LDL) cholesterol – and the development of atherosclerosis, while elevated levels of high-density lipoprotein (HDL) cholesterol seem to play a pro-tective role.[1] However, evidence linking blood lipids to cere-brovascular diseases has failed to put an end to a long-standing controversy: Is there a correlation between blood lipid levels and occurrence of stroke? In our opinion, a conclusive answer has not been found, since many studies to date have been hampered by conceptual and methodological limitations. These limitations can be summarized as follows: (1) stroke has been studied as a single entity, without distinguishing between cerebral infarction (CI) and cerebral hemorrhage (CH); (2) strokes of ischemic origin have been studied without separate consider-ation of each etiopathogenic subtype; (3) populations have been studied that were selected according to other criteria – such as those with high cardiovascular risk – not necessarily represen-tative of normal stroke behavior; and (4) blood lipid levels have been considered a nominal, rather than a continuous, variable using arbitrary lipid level classification categories. A good example of the above is the well-known Prospective Studies Collaboration, a meta-analysis of 450,000 persons in 45 prospective cohorts studied over an average of 16 years. These studies did not find an association between total cholesterol lev-els and stroke.[2] Cerebrovascular accidents (CVA) were not analyzed by type of stroke (ischemic or hemorrhagic), and in par-ticular, atherothrombotic CI was very poorly represented. Many of the cohorts were initially selected to study incidence of coronary heart disease (CHD) and thus consisted of middle-aged individu-als at risk of myocardial infarction. That is, the primary aim of the study was not to explore occurrence of stroke. Results change dramatically when ischemic and hemorrhagic strokes are assessed separately. For example, the Multiple Risk Factor Intervention Trial (MRFIT) demonstrated that mortality risk from non-hemorrhagic stroke increased proportionately with se-rum cholesterol levels in 351,000 men aged 35-57 years. Con-versely, negative association was found between hemorrhagic stroke and cholesterol levels below 200 mg/dl: the lower the blood cholesterol level the greater risk of hemorrhagic stroke.[3] This suggests a U-shaped correlation between blood cholester-ol levels and risk of stroke. Combining both types of stroke in a single study, as in the cohort examined for the Prospective Stud-ies Collaboration, masks correlation between blood cholesterol levels and risk of stroke.[2] The advent of HMCoA reductase inhibitors (statins), has contrib-uted new evidence supporting association of total cholesterol and LDL levels with risk of CI, with no modification of risk for hemor-rhagic stroke. A meta-analysis of nine clinical trials of statins[4] showed that these drugs reduced CI risk in patients with a history of CHD. Furthermore, the Stroke Prevention by Aggressive Re-duction in Cholesterol Levels (SPARCL) study found that statins use significantly reduced relapse risk in patients who had suffered CI or a transient ischemic attack (TIA).[5] A possible limitation of such trials' ability to demonstrate association between blood lip-ids and CI is that statins apparently have a favorable effect on ABSTRACT Introduction Many studies to date on the link between blood lipid lev-els and cerebrovascular disease have been hampered by conceptual and methodological limitations, especially failure to separate different types of stroke.MEDICC review 01/2008; 10. · 0.93 Impact Factor
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