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Abstract NS8: Predictors Of Complete Oral Feeding Resumption After Stroke Based On The Modified Volume-viscosity Swallow Test In A Rehabilitation Hospital

Stroke

Stroke, Volume 54, Issue Suppl_1, Page ANS8-ANS8, February 1, 2023. Objective:Although the importance of early tube feeding after stroke has been established, many risks and problems such as negative impacts on swallow function, respiratory infections and feeling uncomfortable, also warrant attention. The trajectory of swallowing function recovery may be related to each patient’s characteristics. There is still no systematic predictors for clinical decision-making regarding oral feeding resumption. The aim is to explore predictors of complete oral feeding resumption after feeding tube with stroke based on the modified V-VST.Methods:A total of 86 stroke patients with tube feeding were enrolled after admission in rehabilitation hospital from 2020 to 2021. The swallowing function was screened with modified V-VST. If a patient complete every viscosity more than 5ml, feeding tube will be removed. Oral feeding was begun using mechanical soft diet and thickener to ensure every meal safe. 55 patients(63.95%) resumed complete oral intake, while 31 patients(36.05%) presented a more permanent way of tube feeding. We compared the baseline and clinical characteristics between the groups. To analyze oral feeding resumption probability, the Kaplan-Meier method was used.Results:The days of onset to rehabilitation hospital admission was significantly shorter in the complete oral resumption group(20.89±11.27 vs 37.16±27.37; P21days) tolerated tube feeding longer.(P

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Febbraio 2023

Abstract TMP45: Nanobiotechnology-based, Ultra-rapid Test For Brain Injuries To Accelerate Differential Diagnosis Of Stroke From Mimics

Stroke

Stroke, Volume 54, Issue Suppl_1, Page ATMP45-ATMP45, February 1, 2023. Introduction:Stroke is the 5th leading cause of death, and a leading cause of long-term disability in the US. Thus, there is a need for a rapid biomarker-based screen that enables an objective and timely diagnosis and better patient outcome; however, the lack of such a technology delays diagnosis and treatment, increases misdiagnosis, and leads to the overuse of thrombolysis in patients with stroke mimics.Methods:Here we present pilot data of a nanobiotechnology based test platform, in which enzyme-functionalized nanoparticles (TET, Tethered Enzyme Technology) are used for ultra-rapid biomarker detection. As proof of concept, we used TET to quantify the enzymatic activity of a widely studied brain injury biomarker, neuron-specific enolase (NSE), in a trial performed at a regional stroke center.Results:Plasma from 36 suspected stroke and 17 asymptomatic subjects (Total N=53) was tested to determine levels of the novel biomarker NSE catalytic activity (NSE-A) versus the conventional NSE protein (NSE-P). Based on clinical diagnoses, our data demonstrate a significant increase in the levels of NSE-A in subjects suffering from injury to neurons (BI, Brain Injury) compared to those with negative diagnoses (Neg, stroke mimics). Moreover, we show that NSE-A provides a considerable diagnostic advantage over the NIH Stroke Scale or NSE-P (Figure 1A-C) in both clinical utility and speed. In diagnosis of stroke mimics (including TIAs and Neg) versus BI, NSE-A showed significantly better performance than NIHSS or NSE-P, as shown by ROC and AUC analyses (Figure 1D).Conclusions:TET-based detection of NSE-A can rapidly differentiate patients suffering a neuronal injury, including stroke, from those presenting with stroke mimics. Upon further development of a point-of-care test for NSE-A and other biomarkers, TET could be an asset to ongoing efforts to streamline stroke patient care, reduce door to needle time, and decrease overall brain injury and long-term disability.

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Febbraio 2023
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