Cilostazol is Effective to Prevent Stroke-Associated Pneumonia in Patients Receiving Tube Feeding

AbstractStroke-associated pneumonia (SAP) is a frequent complication in acute ischemic stroke (IS) patients, especially those receiving tube feeding (TF). In this retrospective study, we investigated whether or not cilostazol, a pluripotent phosphodiesterase III-specific inhibitor with anti-platelet and vasculogenic effects, can prevent SAP in these patients and reduce their duration of stay in intensive care unit/hospitalization. We recruited 158 IS patients receiving TF. Patients ’ characteristics (including age, gender, past history), National Institute of Health Stroke Scale and serum albumin level on admission, concomitant medications associated with SAP prevention (including cilostazol), and stroke characteristics (bilateral subcortical white matter lesion, brainstem i nvolvement, large infarction, and asymptomatic hemorrhagic infarction) were compared between the SAP(−) and SAP(+) groups. Cilostazol was more frequently used in the SAP(−) group (20.8% vs. 6.1%,p 
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research

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Conclusions—Although the analysis was limited by small and heterogeneous study populations, limiting determination of microbiological causality, this review suggests aerobic Gram-negative bacilli and Gram-positive cocci are frequently associated with pneumonia complicating stroke. This supports the need for appropriately designed studies to determine microbial cause and a consensus-based approach in antibiotic usage and further targeted antibiotic treatment trials for enhanced antibiotic stewardship.
Source: Stroke - Category: Neurology Authors: Tags: Complications, Meta Analysis, Cerebrovascular Disease/Stroke, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research
Authors: Rajborirug K, Tumviriyakul H, Suwanno J Abstract Background: Several trials have verified the benefits of stroke unit (SU) in acute stroke care worldwide. Objective: Compare clinical outcomes and costs of care in acute ischemic stroke patients who were ineligible for thrombolytic treatment (recombinant tissue plasminogen activator-rt PA) in a primary stroke center. Material and Method: A prospective study was conducted in acute ischemic stroke patients, aged 15 years old and above, presenting within 72 hours of onset. At discharge, neurological and medical complications, mortality rate, National In...
Source: Journal of the Medical Association of Thailand = Chotmaihet thangphaet - Category: General Medicine Tags: J Med Assoc Thai Source Type: research
Authors: Beghi G, De Tanti A, Serafini P, Bertolino C, Celentano A, Taormina G Abstract Nosocomial or hospital acquired pneumonia (HAP) is an illness contracted during a hospital stay, generally with onset 48 hours or more after admission to hospital, or within 14 days of discharge from hospital. HAP is divided into subgroups: Ventilator-associated pneumonia (VAP), accounting for 86% of hospital acquired pneumonia, and stroke-associated pneumonia (SAP). The incidence of SAP in neurological intensive care units (NICUs) is 4.1-56.6%, in medical intensive care units (MICUs) it is 17-50%, in stroke units it is 3.9-44% ...
Source: Monaldi Archives for Chest Disease - Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research
This article reviews the concept of brain injury –induced immune modulation, and summarizes available data and knowledge on nosocomial meningitis and ventriculitis, and systemic infectious complications in patients with traumatic brain injury, ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and status epilepticus.
Source: Neurosurgery Clinics of North America - Category: Neurosurgery Authors: Source Type: research
Conclusion: This study confirms the efficacy and safety of tenecteplase for stroke thrombolysis in our clinical setting. Tenecteplase appears to be a suitable option for stroke thrombolysis in resource-limited settings, considering its cost-effectiveness, and ease of administration.
Source: Annals of African Medicine - Category: African Health Authors: Source Type: research
This article reviews the concept of brain injury –induced immune modulation, and summarizes available data and knowledge on nosocomial meningitis and ventriculitis, and systemic infectious complications in patients with traumatic brain injury, ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and status epilepticus.
Source: Neurosurgery Clinics of North America - Category: Neurosurgery Authors: Source Type: research
Abstract BackgroundIn‐hospital complications after stroke represent barriers of optimal recovery and are even potentially life‐threatening. Anemia is common in stroke patients and is related to poor outcome after stroke. Less is known, however, of the association of anemia with complications. We aimed to investigate the impact of anemia on a series of in‐hospital complications after ischemic stroke. MethodsConsecutive patients with ischemic stroke within 7 days were included. Anemia on admission and its severity were defined according to World Health Organization criteria. Eight prespecified complications, such as pn...
Source: European Journal of Neurology - Category: Neurology Authors: Tags: Original Article Source Type: research
CONCLUSIONS: Preventive antibiotics had no effect on functional outcome or mortality, but significantly reduced the risk of 'overall' infections. This reduction was driven mainly by prevention of urinary tract infection; no effect for pneumonia was found. PMID: 29355906 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
In this study, the authors compare key outcomes after early versus late tracheostomy and develop a useful pre-operative decision-making tool to predict post-operative tracheostomy dependence.MethodsWe performed a retrospective analysis of prospectively collected registry data. We developed a propensity-weighted decision tree analysis to predict tracheostomy requirement using factors present prior to surgical decompression. In addition, outcomes include probability functions for intensive care unit length of stay, hospital length of stay, and mortality, based on data for early ( ≤ 10 days) versus late (> &...
Source: Journal of Intensive Care - Category: Intensive Care Source Type: research
Abstract BackgroundThe aim of this study was to investigate how the use of analgesics, sleeping drugs, and sedatives relates to prognosis and complications in stroke patients in the acute care phase (≤48 hr) after a stroke. Materials and MethodsPatients with ischemic stroke, hemorrhagic stroke, and transient ischemic attack were included. The study is based on gathering of data on medication from 921 patient records belonging to patients included in the Bergen NORSTROKE registry, 12.2009‐02.2012. In this database risk factors, stroke severity, etiology, and blood analyses were prospectively registered. We have re...
Source: Brain and Behavior - Category: Neurology Authors: Tags: ORIGINAL RESEARCH Source Type: research
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