Mean platelet volume in acute phase of ischemic stroke, as predictor of mortality and functional outcome after 1 year.

BACKGROUND: Mean platelet volume (MPV) could be a predictor of prognosis after ischemic stroke. Our aim is to investigate the association of MPV with a greater mortality and morbidity (defined as readmissions) after 1 year of follow-up in patients with acute stroke, and with a poor functional outcome in these patients. METHODS: Patients with ischemic stroke (N = 379) were recruited and assessed for an average of 46.27 weeks. MPV was measured at admission. The sample was divided in thirds according with the tertiles of distribution of MPV. Univariate and multivariate analysis were performed. RESULTS: The median (interquartile range) of MPV by third was 10 (0.7), 11(0.4), and 12 (0.8) fentoliters. Patients within highest third had a significant higher risk of either death or readmission (odds ratio 1.3; 95% confidence interval 1.00-1.7; P < .048) compared with patients within the lowest third. Functional outcome, defined as a modified Rankin Scale score of 3 to 6, was significantly higher (P < .0004) by greater third of MPV. CONCLUSIONS: MPV may be an easily available predictor for the prognosis in patients with acute ischemic stroke.

Lowering C-reactive protein with statins after an ischemic stroke avoids mortality and readmissions. A prospective cohort study.

AIMS: A hypothetical benefit of statins after an ischemic stroke could be provided by their pleiotropic effects. Our aim is to test if statins are able to avoid mortality and readmissions of patients with ischemic stroke, by lowering their levels of not only LDL-cholesterol but also CRP. METHODS: A prospective cohort study was performed. Pre-stroke and post-stroke medications were recorded. Cholesterol and hsCRP levels were measured at admission and 90 days post-stroke. Rankin score and fatality or readmissions were assessed at 90 days and 1 year. We have used robust statistical methods. RESULTS: Of 359 stroke patients, statins were prescribed before stroke onset in 30.6% (110/359) and were begun during hospitalization in an additional 32.3% (116/359). In logistic regression analysis adjusted, statins therapy was independently associated with improved total mortality (OR 0.30; 95% CI 0.11-0.86; P < 0.02), improved cardiovascular mortality (OR 0.29; 95% CI 0.08-0.98; P < 0.04), and improved total mortality and readmission rates (OR 0.35; 95% CI 0.18-0.7; P < 0.003). In the final model, lowering the levels of hsCRP by 0.4mg/dL, a 30% of mortality or readmissions would be avoided. CONCLUSIONS: Therapy with statins, either previous or early initiation, after an ischemic stroke, could improve the survival and readmission rates by lowering both cholesterol and hsCRP levels.

[Keratosis linearis with ichthyosis congenita and sclerosing keratoderma (KLICK syndrome)]. / Queratosis linear con ictiosis congénita y queratodermia esclerosante (síndrome KLICK).

We describe the case of a 32-year-old male patient who had presented from birth with generalized ichthyosiform dermatosis, palmoplantar keratoderma with constrictive bands around the fingers and keratotic plaques in a linear arrangement, located in the large skin folds. The dermatopathological examination showed orthokeratotic hyperkeratosis and epidermal hyperplasia with hypergranulosis. No other members of the patient's family were affected. With these clinical and histological findings, the diagnosis was keratosis linearis with ichthyosis congenita and sclerosing keratoderma (KLICK syndrome). The patient rejected treatment with oral retinoids and was treated with emollients and 30 % urea creams, with little clinical response.