Cellular and Molecular Mechanisms Underlying Non-Pharmaceutical Ischemic Stroke Therapy in Aged Subjects

Abstract

The incidence of ischemic stroke in humans increases exponentially above 70 years both in men and women. Comorbidities like diabetes, arterial hypertension or co-morbidity factors such as hypercholesterolemia, obesity and body fat distribution as well as fat-rich diet and physical inactivity are common in elderly persons and are associated with higher risk of stroke, increased mortality and disability. Obesity could represent a state of chronic inflammation that can be prevented to some extent by non-pharmaceutical interventions such as calorie restriction and hypothermia. Indeed, recent results suggest that H2S-induced hypothermia in aged, overweight rats could have a higher probability of success in treating stroke as compared to other monotherapies, by reducing post-stroke brain inflammation. Likewise, it was recently reported that weight reduction prior to stroke, in aged, overweight rats induced by caloric restriction, led to an early re-gain of weight and a significant improvement in recovery of complex sensorimotor skills, cutaneous sensitivity, or spatial memory. Conclusion: animal models of stroke done in young animals ignore age-associated comorbidities and may explain, at least in part, the unsuccessful bench-to-bedside translation of neuroprotective strategies for ischemic stroke in aged subjects.

The Role of Colistin in Urinary Tract Infections in the Neurologic Patient

“…Of 16 Px with multidrug-resistant uropathogens to colistin, the treatment with colistin was indicated only for 12 Px (75%), in all cases it was established depending on the antibiotic results (6 strains were sensitive to colistin bacteriological healing was proven in all cases treated with colistin, a similar aspect to other studies [7,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Colistin resistance of multidrug-resistant bacteria is associated with the increase of mortality [4]; in the paper presented, Px evolution was favourable, which was possibly due to the preserved colistin sensitivity of uropathogens.…”

The Relationship between the Acute Confusing State and the Comorbidities of the Elderly Patient

“…Patients suffering from hyperactive delirium presented higher glucose levels than critical patients with non-hyperactive delirium. The activity of hypothalamic-pituitary-adrenal axis may be accelerated by this acute health condition leading, in consequence, to an increased release of cortisol and to a decreased insulin sensitivity, thus causing hyperglycemia [35][36][37][38][39][40][41][42][43][44][45][46][47]. In our study 15 patients presented diabetes mellitus, and 10 patients had hyperglycemia.…”

Filling the gaps on stroke research: Focus on inflammation and immunity

“…With the life expectancy increase of the population, ageing has become a principal risk factor for ischemic stroke, with incidence rates accelerating exponentially above 70 years ( Sandu et al, 2017 ). Interestingly, the neuroprotection has been related to anti-inflammation in young brain but related to proinflammation in the aged brain, with reduced microglial proliferation, attenuated macrophage cytokine production, and recruitment of macrophages in ischemic injury ( Kim and Cho, 2016 ).…”