Shock,
Год журнала:
2023,
Номер
59(4), С. 583 - 590
Опубликована: Фев. 23, 2023
Background:
Sepsis-associated
encephalopathy
(SAE)
is
a
dysfunction
of
the
central
nervous
system
experienced
during
sepsis
with
variable
clinical
and
pathophysiologic
features.
We
sought
to
identify
distinct
SAE
phenotypes
in
relation
outcomes.
Methods:
The
Medical
Information
Mart
for
Intensive
Care
IV
(MIMIC-IV)
database
eICU
were
used
conduct
retrospective
cohort
study.
Adult
patients
included
was
defined
as
having
Glasgow
Coma
Scale
(GCS)
score
˂15
or
delirium.
following
our
as:
ischemic-hypoxic,
metabolic,
mixed
(ischemic-hypoxic
metabolic),
unclassified.
primary
outcome
in-hospital
mortality.
Results:
study
enrolled
4,120
patients,
2,239
from
MIMIC-IV
(including
1,489
SAE,
67%),
1,881
(1,291,
69%).
For
cohort,
2,780
total
(median
age,
67
years;
interquartile
range,
56-76.8;
1,589
(57%)
male;
median
GCS
12
[8-14];
Sequential
Organ
Failure
Assessment
6
[4-9]).
phenotype
distributions
between
cohorts
follows
(39%
vs.
35%
P
=
0.043;
38%
40%
0.239;
15%
mixed,
0.972;
unclassified,
0.471).
overall
mortality
unclassified
33.9%
(95%
confidence
interval,
0.3-0.37),
28.4%
(0.26-0.31),
41.5%
(0.37-0.46),
14.2%
(0.12-0.16),
respectively.
In
multivariable
logistic
analysis,
associated
highest
risk
after
adjusting
sex,
GCS,
modified
(adjusted
odds
ratio,
2.11;
95%
1.67-2.67;
<
0.001).
Conclusions:
Four
had
different
worst
Further
understanding
these
may
improve
trial
design
targeted
management.
CNS Neuroscience & Therapeutics,
Год журнала:
2024,
Номер
30(11)
Опубликована: Ноя. 1, 2024
ABSTRACT
Stroke,
a
major
neurological
disorder
and
leading
cause
of
disability
death,
often
inflicts
damage
upon
other
organs,
particularly
the
kidneys.
While
chronic
kidney
disease
(CKD)
has
long
been
established
as
significant
risk
factor
for
cerebrovascular
disease,
stroke
can
induce
renal
dysfunction,
manifesting
acute
injury
(AKI)
or
CKD.
Mounting
clinical
basic
research
evidence
supports
existence
bidirectional
brain‐kidney
crosstalk
following
stroke,
implicating
specific
mechanisms
pathways
in
stroke‐related
dysfunction.
This
review
analyzes
pertinent
experimental
studies,
elucidating
underlying
this
cerebro‐renal
interaction
stroke.
Additionally,
we
summarize
current
landscape
investigating
interplay
discuss
potential
challenges
future.
By
enhancing
our
understanding
scientific
underpinnings
crosstalk,
paves
way
improved
treatment
strategies
outcomes
patients.
Recognizing
intricate
between
brain
kidneys
after
holds
profound
implications.
Journal of Stroke and Cerebrovascular Diseases,
Год журнала:
2025,
Номер
unknown, С. 108285 - 108285
Опубликована: Март 1, 2025
ObjectivePatients
with
chronic
kidney
disease
(CKD)
exhibit
a
disproportionately
elevated
risk
of
stroke,
frequently
compounded
by
renal
impairment.
Therapeutic
strategies
for
stroke
based
on
Traditional
Chinese
Medicine's
'kidney–brain
axis'
theory
demonstrate
clinical
efficacy,
indicating
that
there
may
be
potential
association
between
and
which
needs
further
exploration
verification.MethodsIn
this
study,
databases
such
as
GEO,
NHANES,
GWAS
were
used
to
collect
data
related
CKD
stroke.
GEO
gene
enrichment
analysis
was
explore
possible
mediating
factors
NHANES
verify
the
results.
Mendelian
randomization
confirm
causal
relationship
effect
in
these
two
diseases.ResultsCross-gene
transcription
factor
revealed
lipid-related
pathways
have
Logistic
regression
changes
LDL-C,
HDL-C,
TC,
TG
can
affect
occurrence
determine
verified
effects
lipid
factors,
TG,
diseases.
Our
findings
highlight
relevance
bridging
By
integrating
predictive
biomarkers
multi-level
diagnostics,
study
paves
way
AI-driven
precision
medicine
prevention.
Specifically,
machine
learning
approaches
could
enhance
stratification
high-risk
cohorts,
enabling
tailored
interventions
lipid-lowering
therapies
personalized
monitoring
protocols.
These
align
emerging
paradigms
healthcare
benefits
population-specific
management.ConclusionThis
provides
new
insights
into
interactive
scientific
basis
process
syndrome
differentiation
treatment
under
guidance
"kidney–brain
correlation".
Moreover,
influence
metabolism
diseases
investigated,
deepened
researchers'
understanding
mechanism
ABSTRACT
Central
melanocortin
signaling
plays
a
critical
role
in
maintaining
energy
homeostasis
by
regulating
intake
and
expenditure,
with
impairment
of
this
system
closely
related
to
metabolic
diseases
such
as
obesity.
Among
receptor
subtypes,
4
(MC4R)
is
the
primary
mediator
these
effects
within
central
nervous
system.
Accumulating
evidence
suggests
that
MC4R
contributes
stress‐induced
disruptions
feeding
behavior
homeostasis.
However,
precise
neural
mechanisms
which
stress
alters
activity
remain
incompletely
understood.
In
study,
we
compared
brain‐wide
c‐Fos
expression
patterns
induced
two
distinct
paradigms:
lipopolysaccharide
(LPS)‐induced
inflammatory
restraint
male
mice,
further
examined
involvement
MC4R‐expressing
(MC4R
+
)
neurons
conditions.
We
found
both
stressors
elicited
activation
brain
areas
associated
responses
well
regulation.
Notably,
LPS‐induced
stress,
but
not
selectively
activated
amygdala
(CeA)
oval
nucleus
bed
stria
terminalis
(ovBNST).
These
results
highlight
recruitment
during
acute
offering
novel
insights
into
imbalance
depending
on
stressor
types.
Cardiology,
Год журнала:
2024,
Номер
149(4), С. 369 - 382
Опубликована: Янв. 1, 2024
In
recent
years,
the
mechanistic
interaction
between
brain
and
heart
has
been
explored
in
detail,
which
explains
effects
of
injuries
on
those
cardiac
dysfunction
brain.
Brain
are
predominant
cause
post-stroke
deaths,
is
second
leading
mortality
after
stroke
onset.
