IUSS is a validated patient reported measure of urgency severity for collecting event specific information in the context of a clinical trial.

Background and Purpose-Statins reduce the risk of stroke recurrence, but the benefits of statins in improving outcome of acute stroke patients have not been well explored. Methods-We assessed potential effects of statins initiated before or within 4 weeks of stroke on 90-day outcome.Favorable outcomes were National Institutes of Health Stroke Scale (NIHSS) score Յ2 at 12 weeks and modified Rankin Scale (mRS) Յ2.

Background and Purpose-Basic fibroblast growth factor (bFGF) and citicoline (cytidine 5Ј-diphosphate choline, an endogenous compound that stabilizes membrane function) have demonstrated neuroprotective effects after focal cerebral ischemia. Both agents are candidates for future stroke therapy in humans. For evaluation of synergistic effects of bFGF and citicoline, a low-dose combination of both compounds was tested against each compound alone and placebo. Methods-Four groups of Sprague-Dawley rats (nϭ12 per group) underwent 90 minutes of focal cerebral ischemia with the use of the suture model of middle cerebral artery occlusion. Animals were randomly and blindly assigned to one of the following treatment groups: placebo, low-dose citicoline (250 mg/kg IP daily for 4 days), low-dose bFGF (10 g/kg per hour IV for 3 hours), and the combination of both (250 mg/kg citicoline and 10 g/kg per hour bFGF). Triphenyltetrazolium chloride staining was used after 4 days to determine postmortem infarction. Neurological scores were assessed on a daily basis. Results-The premature mortality rate was 41.7% in the placebo and citicoline groups, 33.3% in the bFGF group, and 25% (PϭNS) in the combination group. The mean neurological score on day 4 was 3.1Ϯ1.6 (placebo), 3.1Ϯ1.6 (citicoline), 2.9Ϯ1.5 (bFGF), and 2.4Ϯ1.4 (combination) (PϭNS Key Words: cerebral ischemia, focal Ⅲ citicoline Ⅲ growth factors Ⅲ rats N europrotective therapy is effective in animal stroke models but remains unproven in clinical stroke. Neuroprotective agents such as N-methyl-D-aspartate antagonists are well tolerated in animals but may cause major side effects in humans (eg, psychotic events). Reducing doses may reduce side effects but may also lower the neuroprotective capability of the agent. One way to reduce the dose of drugs and to maintain, or even increase, neuroprotective effects is to use a combination of agents that act on different steps in the ischemic cascade. Recently, combination studies for the treatment of experimental focal cerebral ischemia were reported with encouraging results for the combination of thrombolytic and neuroprotective therapy 1-3 and 2 different neuroprotective agents. 4 An intriguing idea for the treatment of acute stroke is the use of growth factors that have not only neuroprotective but also regenerative and proliferative capacities. A promising See Editorial Comment, page 431growth factor for the treatment of acute focal cerebral ischemia in stroke models is basic fibroblast growth factor (bFGF), a 18-kDa polypeptide that mediates the differentiation, survival, and regeneration of neuronal cells through specific receptors. 5 It has been shown in several in vivo experiments in different species that bFGF has neuroprotective and regenerative capabilities when administered after focal cerebral ischemia. 6 -13 Possible mechanisms of action for bFGF include a direct neuroprotective effect and an effect on cerebral blood flow (CBF) and cerebrovascular tone. 8,14,15 Citicoline (cytidine 5Ј-diphosphate choline), a naturally ...

No abstract