Blood pressure in the initial phase of acute ischaemic stroke: evolution and its role as an independent prognosis factor at discharge and after 3 months of follow-up.

BACKGROUND: A prospective observational study was aimed at assessing the role of blood pressure (BP) during the first 24 h from stroke onset on the outcome of acute ischaemic stroke. METHODS: Subjects admitted within the first 3 h from stroke onset were included. Stroke severity was evaluated with the Canadian Stroke Scale (CSS). Functional recovery was defined as a modified Rankin Scale score < or =2. RESULTS: One hundred subjects were included. In a logistic regression model, the independent predictors of poor functional recovery at discharge were: age (OR = 1.12; 95% CI 1.04-1.21; p = 0.0033), non-lacunar stroke subtype (OR = 4.31; 95% CI 1.07-17.31; p = 0.0395), diabetes mellitus (OR = 8.38; 95% CI 1.67-41.95; p = 0.0097), a CSS score at admission < or =8 (OR = 28.64; 95% CI 5.59-146.68; p<0.0001), an average systolic BP during the first 6 h > or =180 mmHg (OR = 13.34; 95% CI 1.34-133.10; p = 0.0272) and a lower diastolic BP average from 6 to 24 h (OR for 5 mmHg increase: 0.57; CI 95% 0.36-0.88; p = 0.0115). Similar results were observed after 3 months of follow-up. CONCLUSION: In ischaemic stroke patients, systolic BP over 180 mmHg in the first 6 h and a decrease of diastolic BP during the 6-24 h from stroke onset were independent predictors of a poor functional recovery.

Interactions between the ganglioside GM1 and hexadecylphosphocholine (miltefosine) in monolayers at the air/water interface.

The ganglioside, GM1, was studied as Langmuir monolayers at the air/water interface with surface pressure-area measurements in addition to Brewster angle microscopy. A characteristic plateau transition, observed on aqueous subphases of pH 2 and 6, 20 degrees C, at the surface pressure of ca. 20 mN/m, was attributed to the reorientation of GM1 polar group upon film compression. This transition was found to disappear at alkaline subphases (pH 10) due to the hydration of fully ionized polar group, hindering its reorientation. The interactions between GM1 and hexadecylphosphocholine (miltefosine) were investigated in mixed monolayers and analyzed with the mean molecular areas, excess areas of mixing and the excess free energy of mixing versus film composition plots. The monolayers stability, quantified by the collapse pressure values, as well as the strength of interaction was found to diminish in the following order: pH 6>pH 2>pH 10. The strongest interaction occurs for mixed films of miltefosine molar fraction, XM=0.7-0.8, especially at low pressure region, and are explained as being due to the surface complex formation of 3:1 or 4:1 (miltefosine:ganglioside) stoichiometry (XM=0.75 or 0.8, respectively).