Background: There is currently no instrument to stratify patients presenting with ischemic stroke

These results suggest that preadmission warfarin use associated with therapeutic level of anticoagulation can offer a benefit in limiting the extent of ischemic injury in an event of acute stroke.

IMPORTANCE Approximately half of recurrent strokes occur within days and weeks of an ischemic stroke. It is imperative to identify patients at imminent risk of recurrent stroke because recurrent events lead to prolonged hospitalization, worsened functional outcome, and increased mortality. OBJECTIVE To test the validity of a prognostic score that was exclusively developed to predict early risk of stroke recurrence in a multicenter setting. DESIGN, SETTING, AND PARTICIPANTS This hospital-based cohort study examined patients with and without magnetic resonance imaging-confirmed recurrent stroke within 90 days after an ischemic stroke. The study was performed at 3 teaching hospitals in the United States, Brazil, and South Korea and comprised adult patients admitted within 72 hours of symptom onset with a magnetic resonance imaging-confirmed diagnosis of acute ischemic stroke. Recruitment to the US cohort was performed from

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Objectives Platelet-to-lymphocyte ratio is a novel biomarker, recently shown to be correlated with atherosclerotic inflammation. This study investigated the role of platelet-to-lymphocyte ratio in patients with carotid artery stenosis and stroke. Methods Patients, who underwent carotid angiography with Multiple Detector Computed Tomography Angiography at our hospital, were retrospectively screened. Patients enrolled were divided into three groups based on the platelet-to-lymphocyte ratio. Patients with a platelet-to-lymphocyte ratio value between 55.0 and 106.71 were assigned to Group I, patients with a platelet-to-lymphocyte ratio value between 106.79 and 160.61 were assigned to Group II and patients with a platelet-to-lymphocyte ratio value between 162.96 and 619.61 were assigned to Group III. The carotid arterial stenosis calculated was classified as per the criteria of North American Symptomatic Carotid Endarterectomy Trial. Results One hundred fifty patients were included in our trial (mean age 61.9 ± 13.1 with 104 males). The rate of carotid arterial stenosis was detected to be higher in patients with a high platelet-to-lymphocyte ratio value (p = 0.010). Additionally, the platelet-to-lymphocyte ratio was positively correlated with the carotid arterial stenosis percentage (r = 0.250, p = 0.002). In the multi-variate regression analysis, platelet-to-lymphocyte ratio was detected to be an independent variable with respect to stroke (odd's ratio = 1.012, confidence interval = 1.001-1.024, p = 0.031). Conclusions Increased platelet-to-lymphocyte ratio could be a simple and practical marker of the clinical course in patients with carotid arterial stenosis.

Objective: Oral amino-acid-combination supplements have become a common intervention to maintain or potentially increase the lean body mass (LBM) in the elderly. Our aim was to determine the tolerance and efficacy of the 8-week beta-hydroxy beta-methylbutyrate/arginine/glutamine (HMB/Arg/Gln) supplementation on anthropometrics, LBM, muscle strength, and gait speed in elderly patients. Methods: In this longitudinal observational study, a total of 131 elderly patients were evaluated at two consecutive visits, including baseline (Week 0) and single follow-up (Week 8). The use of HMB/Arg/Gln was evaluated in terms of patient compliance, the efficacy on anthropometrics, LBM (kg, measured with bioelectrical impedance analysis-BIA), muscle strength (kg), gait speed, and safety. Results: The mean (standard deviation, SD) age was 74.7 (6.8) years (57.3% of participants were males). Of the patients were diagnosed with malnutrition (according to the Subjective Global Assessment test). The main indications for the HMB/Arg/Gln supplementation were sarcopenia (45.8%) and cancer cachexia (42.0%). Only two patients stopped supplementation because of taste problem (1.5%). Overall, 79.4% of patients were still on HMB/Arg/Gln at the follow-up. The mid-upper-arm circumference (MUAC, 25.3–27.0 cm, p=0.017), mid-upper-arm muscle circumference (MUAMC, 21.7–22.2 cm, p=0.006), hand grip strength (16.0–19.0 kg, p=0.0001), and gait speed (0.5–0.7 m/sec, p=0.008) were increased after the HMB/Arg/Gln supplementation. The adverse events were reported in 14 (10.7%) patients. No serious adverse events were reported in association with HMB/Arg/Gln. Conclusion: Our findings showed that 8 weeks of the HMB/Arg/Gln supplementation applied twice daily were well tolerated and safe in the elderly. The supplementation seems to improve the MUAC, MUAMC, muscle strength, and gait speed.

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