The stability of cerebral inhibition was assessed across early childhood using a paired-click auditory sensory gating paradigm. The P50 ERP was measured during REM (or its infant analogue, active sleep) and NREM sleep in 14 children at approximately 3 months of age and again at approximately 4 years of age. Evoked response amplitudes, latencies, and the S2/S1 ratio of the amplitudes of the evoked responses were compared between the two visits. Significant reliability was found for the S2/S1 ratio (r = .73, p = .003) during REM but not non REM sleep (r = −.05, p = .88). A significant stimulus number by sleep stage interaction (F (1,12) = 17.1, p = .001) demonstrated that the response to the second stimulus decreased during REM but not NREM sleep. These findings suggest that this measure is stable during REM sleep across early childhood, is not affected by age, and is sleep-state dependent. P50 sensory gating is a biomarker which, if used properly, may provide a mechanism to further explore changes in the developing brain or may help with early screening for psychiatric illness vulnerability.
A patent foramen ovale (PFO) is a common finding in the general population and has been theorized to be a mechanism for ischemic stroke primarily due to a deep venous thrombus embolizing through the shunt into the arterial circulation. There has been much debate regarding the association between PFO and stroke, especially in the case of a cryptogenic stroke (i.e., stroke of unknown etiology) in a younger patient without other risk factors. Traditionally, when a PFO is detected, antithrombotic therapy to mitigate risk of a future ischemic event has been the mainstay of treatment. More recently, both surgical and transcatheter closure of a PFO have been widely utilized. However, there are only few randomized controlled trials assessing the efficacy of PFO closure for stroke prevention.
Introduction: There is a trend towards ischemic stroke (IS) occurring at younger ages. We sought to better characterize outcomes and mortality over 3 years by age at time of stroke within a large, biracial population. Methods: Incident IS were ascertained during the 2005 and 2010 study periods of our population based epidemiology study via ICD-9 codes 430-436. Research nurse coordinators performed medical record abstraction on all potential events, which were then adjudicated by study physicians as case/not a case. Abstractions included discharge or 30-day outcomes (if available) as measured by modified Rankin scale (mRS). Mortality for IS events out to 3 years was determined via all available information including the Social Security Death Index. We compared the outcomes and post-stroke mortality by 20-55 (young stroke) versus >55 years, and by decade. Descriptive statistics are reported as n (%), and mean (SD) or median (25 th and 75 th %ile) as appropriate. The primary analysis examined the effect of age, race and sex using regression, life table and proportional hazards models. Results: Results are shown in the table. IS in the young occurred more frequently among black cases. The median rNIHSS was 3 although the NIHSS distribution trended towards more severe IS in the older age group. Young strokes had lower baseline and 30-day mRS. The mortality rate was greater in the older ages, at each time point and overall. After adjusting for race, sex and stroke severity the hazard ratio for lower survival in the strokes >55 years old was 4.03 (95% CI 3.15, 5.17). Conclusion: IS patients < 55 years old are less likely to die after stroke. Young stroke occurs in demographically different populations than older strokes and this group would benefit from further study.
Introduction: Fever in intracerebral hemorrhage (ICH) patients can be due to infectious or noninfectious etiology, including central mechanisms. We sought to compare patients with ICH and infectious fever to those with noninfectious fever. Methods: Among 351 consecutive primary ICH patients admitted to our institution from April 2009 to March 2010, 136 (39%) developed fever. Fever was defined as temperature > 100.9°F during hospitalization. Cases were reviewed to determine if the patient had fever due to infectious versus noninfectious etiology. The diagnosis of infection was based on results of microbial cultures and National Healthcare Safety Network criteria. Other data collected included age, sex, maximum temperature (Tmax), medical history, ICH location, intraventricular hemorrhage (IVH), ICH volume as measured by standard ABC/2 bedside calculation, external ventricular drain (EVD) placement, surgical evacuation, length of stay (LOS), and inpatient mortality. Univariate analysis and multivariable logistic regression model were used to determine characteristics associated with infection status. Results: Among the 136 ICH patients with fever, 96 (71%) had noninfectious fever and 40 (29%) had infectious fever. In the univariate analysis, patients with infectious fever did not differ from patients with noninfectious fever with respect to age (61.3 vs 60.1 years, p 0.6), female sex (40% vs 48%, p 0.8), Tmax (102.2 vs 102.2°F, p 0.96), IVH (60% vs 71%, p 0.23), ICH volume (42 vs 40 cc, p 0.8), EVD placement (48% vs 51%, p 0.85), or surgical evacuation (30% vs 29%, p 1.0). Infectious fever was significantly associated with higher LOS (18.2 vs 11.1 days, p <0.001), and this remained significant in survivors (18.6 vs 14.2 days, p 0.01). Noninfectious fever was associated with significantly higher inpatient mortality (35% vs 8%, p 0.0006). In multivariate analysis, infectious fever significantly correlated with prolonged LOS in survivors when dichotomized using a median of 15 days (OR 5.37, p 0.003). Conclusions: Patients with ICH who develop fever associated with an infectious etiology have longer LOS but lower in-hospital mortality. Further studies are warranted to understand fever in ICH patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.