• Harvy Bailey posted an update 3 months, 1 week ago

    Genetic Stem Cells inhibitor polymorphisms of human β-defensins in patients with ischemic stroke. Acta Neurol Scand: 2012: 126: 109–115. © 2011 John Wiley & Sons A/S. Objectives and Methods –  Genetic predisposition of the inflammatory host response may affect the development of stroke. On the basis of the theory of infectious burden and risk of stroke, we considered it of interest to investigate the relevance of the single-nucleotide polymorphisms (SNPs) in the DEFB1 gene and the copy number variant (CNV) of the DEFB4 genes in ischemic stroke. Results –  There were no significant differences in the genotype frequencies of the three SNPs of the DEFB1 gene between the patients with stroke (n = 312) and the healthy blood donors (n = 221). However, a higher frequency of a lower (<4) copy number of the DEFB4 gene was observed in the patients with ischemic stroke as compared with the healthy controls (40% vs 24%, respectively). Additionally, low plasma concentrations of hBD-2 (187 ± 20 pg/ml) were characteristic of the patients with fewer than four copy numbers relative to those with more than four copy numbers (385 ± 35 pg/ml). Conclusions –  The low copy number of the DEFB4 gene, involving a weakened antimicrobial defense of the host, might be important in the pathogenesis of stroke. “”Etgen T, Freudenberger T, Schwahn M, Rieder G, Sander D. Multimodal strategy in the successful implementation of a stroke unit in a community hospital. Acta Neurol Scand: 2011: 123: 390–395. © 2010 John Wiley & Sons A/S. Objectives –  Thrombolysis in stroke remains underutilized in daily practice. We analyzed the impact of a multimodal strategy on the rate of thrombolysis and specific procedure times during the implementation of a community hospital stroke unit. Material and methods –  During a period of 2 years before and after implementation of a stroke unit, we prospectively recorded all patients with thrombolysis and specific procedure times. Calculated door-to-needle time (DNT), door-to-CT time (DCT) and CT-to-needle time (CNT) were analyzed. All structural changes before and after the implementation were analyzed. Results –  The number of patients with thrombolysis increased from 24 in 2005–2006 (4.8% of all admitted patients with ischemic stroke) to 95 in 2007–2008 (12.8%). DNT was significantly reduced from 62.2 ± 36.1 to 38.5 ± 22.2 min (P < 0.001). DCT remained unchanged at 10.3 ± 9.5 to 10.4 ± 13.9 min (P = 0.974), whereas CNT improved from 45.7 ± 23.1 to 28.3 ± 20.3 min (P = 0.001). Several structural changes concerning staff, logistics, procedures and laboratory were identified which contributed to decreasing DNT. Conclusions –  A multimodal strategy including several structural changes enables the successful implementation of a community hospital stroke unit offering rapid access to thrombolysis with a very short DNT. "”Smedal T, Johansen HH, Myhr K-M, Strand LI.