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      Relación neutrófilo-linfocito como biomarcador de deterioro neurológico en ictus isquémico agudo: ensayo científico argumentativo Translated title: Neutrophil-lymphocyte ratio as a biomarker of neurological deterioration in acute ischemic stroke: argumentative scientific essay

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      Acta Médica Costarricense
      Colegio de Médicos y Cirujanos de Costa Rica
      hemograma, biomarcador, coma, ictus., hemogram, biomarker, coma, stroke.

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          Abstract

          Resumen El ictus isquémico es un problema de salud pública por su elevada morbimortalidad. Algunos pacientes presentan deterioro neurológico precoz pudiendo llegar al coma o la muerte antes de la primera semana de enfermedad a pesar de tener una tomografía cerebral inicial normal. Esto se debe al edema cerebral por la reacción inflamatoria que se produce dentro de la lesión isquémica. A pesar de que conocemos las citoquinas proinflamatorias que participan en esta reacción de neurotoxicidad, estudios de las últimas dos décadas no han demostrado su utilidad como biomarcadores inflamatorios por resultados contradictorios. Recientemente, se han publicado estudios prometedores sobre algunos índices leucocitarios del hemograma como biomarcadores inflamatorios de evolución en el ictus isquémico agudo. El objetivo de este ensayo científico es discutir la literatura científica más reciente sobre el uso de la relación neutrófilo-linfocito como biomarcador de deterioro neurológico en ictus isquémico agudo.

          Translated abstract

          Abstract Ischemic stroke is a public health problem due to its high morbidity and mortality. Some patients present early neurological deterioration, and may reach coma or death before the first week of illness, despite having a normal initial brain tomography. This is due to cerebral edema due to the inflammatory reaction that occurs within the ischemic lesion. Although we know the proinflammatory cytokines involved in this neurotoxic inflammatory reaction, studies over the last two decades have not demonstrated their usefulness as inflammatory biomarkers because of conflicting results. Recently, promising studies have been published on some leukocyte index of the hemogram as inflammatory biomarkers of evolution in acute ischemic stroke. This scientific essay aims to discuss the most recent scientific literature on the use of neutrophil-lymphocyte ratio as an biomarker for neurological deterioration in acute ischemic stroke.

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          Most cited references23

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          Immune responses to stroke: mechanisms, modulation, and therapeutic potential

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            Ischemic Stroke.

            This concise review of the epidemiology, pathophysiology, evaluation, acute management, and prevention of ischemic stroke targets internists, family practitioners, and emergency physicians who manage patient with stroke.
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              Neuroinflammatory Mechanisms in Ischemic Stroke: Focus on Cardioembolic Stroke, Background, and Therapeutic Approaches

              One of the most important causes of neurological morbidity and mortality in the world is ischemic stroke. It can be a result of multiple events such as embolism with a cardiac origin, occlusion of small vessels in the brain, and atherosclerosis affecting the cerebral circulation. Increasing evidence shows the intricate function played by the immune system in the pathophysiological variations that take place after cerebral ischemic injury. Following the ischemic cerebral harm, we can observe consequent neuroinflammation that causes additional damage provoking the death of the cells; on the other hand, it also plays a beneficial role in stimulating remedial action. Immune mediators are the origin of signals with a proinflammatory position that can boost the cells in the brain and promote the penetration of numerous inflammatory cytotypes (various subtypes of T cells, monocytes/macrophages, neutrophils, and different inflammatory cells) within the area affected by ischemia; this process is responsible for further ischemic damage of the brain. This inflammatory process seems to involve both the cerebral tissue and the whole organism in cardioembolic stroke, the stroke subtype that is associated with more severe brain damage and a consequent worse outcome (more disability, higher mortality). In this review, the authors want to present an overview of the present learning of the mechanisms of inflammation that takes place in the cerebral tissue and the role of the immune system involved in ischemic stroke, focusing on cardioembolic stroke and its potential treatment strategies.
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                Author and article information

                Journal
                amc
                Acta Médica Costarricense
                Acta méd. costarric
                Colegio de Médicos y Cirujanos de Costa Rica (San José, San José, Costa Rica )
                0001-6012
                0001-6002
                December 2023
                : 65
                : 4
                : 217-220
                Affiliations
                [1] Trujillo orgnameHospital Belén de Trujillo orgdiv1Universidad Nacional de Trujillo orgdiv2Facultad de Medicina Perú
                Author information
                https://orcid.org/0000-0001-9777-670X
                Article
                S0001-60022023000400217 S0001-6002(23)06500400217
                77f57406-4851-4cce-be87-e0fe838766b1

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 29 November 2022
                : 24 November 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 23, Pages: 4
                Product

                SciELO Costa Rica

                Categories
                Opinión

                stroke.,hemograma,biomarcador,coma,biomarker,hemogram,ictus.
                stroke., hemograma, biomarcador, coma, biomarker, hemogram, ictus.

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