Associations of eosinophil-to-monocyte ratio and C-reactive protein-to-high-density lipoprotein cholesterol ratio with early neurological deterioration after thrombolysis in acute ischemic stroke

'Associations' DO NOTHING FOR SURVIVOR RECOVERY! Are you that blitheringly stupid you don't know that survivors would like recovery rather than a completely fucking useless 'association'? 

Had you been thinking at all you would be solving the  5 causes of the neuronal cascade of death in the first week saving hundreds of million to billions of neurons! Thus, preventing early neurological deterioration. Or don't you have two functioning neurons to rub together for a spark of intelligence?

 Associations of eosinophil-to-monocyte ratio and C-reactive protein-to-high-density lipoprotein cholesterol ratio with early neurological deterioration after thrombolysis in acute ischemic stroke

Guohua HeGuilan XuYanqiao XiaoZhen WangYachun Yu^*

• Department of Neurology, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China

Background: Inflammation mechanisms play critical roles in acute ischemic stroke (AIS). However, the correlations of the eosinophil-to-monocyte ratio (EMR) and blood C-reactive protein to high-density lipoprotein cholesterol (CRP/HDL-C) ratio with post-thrombolysis early neurological deterioration (END) in patients with AIS remain uncertain.

Methods: Patients with AIS who received intravenous thrombolysis therapy from January 2020 to February 2025 were retrospectively recruited for this study. CRP level, blood lipid concentrations, and complete blood count measurements were recorded within 24 h of admission. Post-thrombolysis END was defined as an increase in the U.S National Institutes of Health Stroke Scale (NIHSS) score of ≥ 4 points compared to the initial NIHSS score taken within 24 h of initiating intravenous thrombolysis. Multivariate logistic regression modeling was performed to evaluate the correlations of EMR and the CRP/HDL-C ratio to post-thrombolysis END. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of both EMR and the CRP/HDL-C ratio in patients with post-thrombolysis END.

Results: Among 473 recruited patients, 103 (21.78%) were diagnosed with post-thrombolysis END. Patients with END had significantly higher systolic and diastolic blood pressures, white blood cell and monocyte counts, CRP levels, CRP/HDL-C ratios, and NIHSS scores on admission, while their eosinophil counts and EMRs were significantly lower. The multivariate logistic regression analysis indicated that EMR (odds ratio [OR], 0.03 [95% confidence interval (CI) 0.01–0.14]; p < 0.001) and CRP/HDL-C (odds ratio, 1.04[95%CI 1.01–1.08]; p = 0.025) were independently associated with END after adjusting for potential confounders. The areas under the receiver operating characteristic curve (AUC) for EMR and the CRP/HDL-C ratio were 0.757 (95% CI, 0.709–0.805) and 0.61 (95% CI, 0.545–0.675), respectively.

Conclusion: A lower EMR level and a higher CRP/HDL-C ratio in patients with AIS are independently associated with post-thrombolysis END. EMR and the CRP/HDL-C ratio may be potential biomarkers for post-thrombolysis END.

More at link.

Prognostic significance of the C-reactive protein–albumin–lymphocyte index and the pan-immune-inflammation value in ischemic and hemorrhagic stroke: a comparative analysis of subtypes

Prognostication and assessments do nothing for stroke survivor recovery. And I see NO protocol for reducing the risk of stroke based on these measurements; SO COMPLETELY FUCKING USELESS!

 Prognostic significance of the C-reactive protein–albumin–lymphocyte index and the pan-immune-inflammation value in ischemic and hemorrhagic stroke: a comparative analysis of subtypes

Canan Şahin^*†Yahya Şahin^†

• Department of Emergency Medicine, Ahi Evran University Faculty of Medicine, Kırşehir, Türkiye

Background: Cerebrovascular events are major causes of global mortality and disability. Inflammation, immune response, and nutritional status play crucial roles in stroke pathophysiology. The C-reactive protein–albumin–lymphocyte (CALLY) index and the pan-immune-inflammation value (PIV) are novel composite biomarkers reflecting these mechanisms. This study compared their prognostic performance between ischemic and hemorrhagic stroke.

Methods: This retrospective, single-center cohort included 357 patients diagnosed with ischemic or hemorrhagic stroke between January 2020 and December 2024. Demographic, clinical, and laboratory data were retrieved from electronic records. Indices including CALLY, PIV, HALP, SII, and MII were calculated from blood samples obtained within 24 h of admission. Group comparisons, multivariate logistic regression, and receiver operating characteristic (ROC) analyses identified independent predictors and diagnostic performance.

Results: Among 357 patients (mean age 67 ± 14 years; 56.6% ischemic, 43.4% hemorrhagic), the CALLY index was significantly higher in hemorrhagic cases (p < 0.001). Multivariate analysis identified CALLY (odds ratio = 1.255), PIV (odds ratio = 1.001), and HALP (odds ratio = 1.258) as independent predictors (all p < 0.001). CALLY showed the highest discriminative ability (area under the ROC curve = 0.756). In hemorrhagic stroke, lower CALLY values were associated with in-hospital mortality (AUC = 0.646, p = 0.002).

Conclusion: The CALLY index demonstrated superior prognostic value compared with other inflammatory markers and may serve as a simple, low-cost tool for early stroke risk assessment. Prospective, multicenter studies are warranted to validate these findings and to establish standardized cutoff values.

This Biomarker May Be More Predictive of Cardiovascular Disease Than Cholesterol

 I guess no one in the medical world reads anything from the WHO. They don't know that stroke has been called neurological disease by the WHO since 2006 not cardiovascular, once again proving our medical 'professionals' don't keep up to date in their field!

This Biomarker May Be More Predictive of Cardiovascular Disease Than Cholesterol

Doctors have long looked at certain risk factors including blood pressure, cholesterol, diabetes, smoking, and family history to predict a patient’s risk for cardiovascular disease. But increasingly, another lesser known biomarker, known as high-sensitivity C-reactive protein (hsCRP), seems to play an important role in whether a patient is at risk for a heart attack or stroke.

As a result, the American College of Cardiology recently published a report that found hsCRP strongly predicts recurrent cardiovascular events and elevated hsCRP in otherwise healthy individuals puts them into a higher-risk group, even if cholesterol levels are normal.

“High-sensitivity CRP has been shown to be an independent marker of risk in addition to and in some cases over and above all other risk factors that we typically talk about including smoking, diabetes, blood pressure, cholesterol, and weight,” said James D. Mills, MD, a cardiologist at RWJBarnabas Health in New Brunswick, New Jersey.

What is CRP?

CRP is produced by the liver when the body’s immune system is fighting infection or when chronic immune issues like rheumatoid arthritis, lupus, and heart disease cause levels to remain elevated.

Rohit Vuppuluri, MD

HsCRP is a more sensitive test that’s less likely to show inflammation caused by infection or an injury because it looks for smaller increases that are the result of low grade, long-term inflammation, more likely to be caused by cardiovascular and autoimmune disease.

“The plaque in your arteries is deemed a foreign s

Effects of Albumin, Uric Acid, Hemoglobin, and C-Reactive Protein Levels on Rehabilitation Outcomes in Stroke: A Retrospective Clinical Study

 Your competent? doctor has been working on Uric acid, albumin, C-reactive protein and hemoglobin a long time already, right? Oh no, you DON'T have a functioning stroke doctor, do you? And they still haven't been fired yet?

• Uric acid (11 posts to February 2014)

• albumin (5 posts to October 2011)

• C-reactive protein(18 posts to October 2012)
  • hemoglobin A1c (1 post to December 2017)
  • hemoglobin levels (3 posts to February 2024)
  • hemoglobin-albumin cluster (1 post to July 2018)
  • hemoglobin-to-red cell distribution width ratio (1 post to March 2025)
  • oxygenated hemoglobin concentration (1 post to June 2017)
  • glycated hemoglobin levels (1 post to April 2025)

 Effects of Albumin, Uric Acid, Hemoglobin, and C-Reactive Protein Levels on Rehabilitation Outcomes in Stroke: A Retrospective Clinical Study

y Selda Ciftci Inceoglu,1 Aylin Ayyildiz,2 Cansu Adikti,1 Banu Kuran1 1Department of Physical Medicine and Rehabilitation, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye 2Department of Physical Medicine and Rehabilitation, Basaksehir Cam & Sakura City Hospital, Istanbul, Türkiye 

 Objective: 

The aim was to explain the relationship between recovery in motor functions and ambulation skills after stroke and albumin, uric acid, C-reactive protein (CRP), and hemoglobin levels. 

 Materials and Methods: 

Patients who received inpatient rehabilitation in the physical medicine and rehabilitation (PM&R) clinic within the past 2 years were included in the study. Patients’ discharge report, albumin, CRP, uric acid, and hemoglobin levels were obtained from the blood tests taken during hospitalization through the hospital system. The relationship between Brunnstrom staging (BS) and functional ambulation category (FAC) assessments before treatment and on the 15th day of rehabilitation, and the initial albumin, CRP, uric acid, and hemoglobin levels was investigated. 

 Results: 

The files of 135 patients were accessed. Six patients were excluded because they did not meet the inclusion criteria, and 4 patients were excluded because their data were incomplete. The study was completed with 125 patients. Albumin levels were low in 22 (17.6%) patients, and hemoglobin levels were low in 75 (60%) patients. CRP levels were above normal in 53 (42.4%) patients. When uric acid levels were examined, 1 (0.8%) patient was below normal, and 15 (12%) patients were above normal. There was no significant relationship between BS and albumin, CRP, uric acid, and hemoglobin levels (p>0.05). There was a significant positive relationship between improvements in FAC and albumin and hemoglobin levels (p<0.05). 

 Conclusion: 

Post-stroke FAC recovery is associated with albumin and hemoglobin levels. 

 Keywords: 

Albumin, C-reactive protein, Hemoglobin, Stroke, Uric acid 

 Address for correspondence: Selda Ciftci Inceoglu, Department of Physical Medicine and Rehabilitation, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye E-mail: seldavd@gmail.com ORCID ID: 0000-0002-0387-3558 Submitted: 19.05.2025 Revised: 20.05.2025 Accepted: 14.07.2025 Available Online: 12.09.2025 European Archives of Medical Research – Available online at www.eurarchmedres.org OPEN ACCESS This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. ABSTRACT European Archives of Medical Research DOI: 10.14744/eamr.2025.20082 Eur Arch Med Res 2025;41(3):183–192 ORIGINAL ARTICLE INTRODUCTION Stroke is a cerebrovascular disease (CVD) that causes loss of brain function due to interruption of blood flow to the brain or bleeding.[1] It is a significant health problem worldwide. It is a significant cause of morbidity and mortality acquired in adulthood.[2] Most patients develop hemiplegia, affecting upper extremity functions and ambulation skills.[3] Stroke re habilitation is the primary treatment option recommended for functional limitations and disabilities that occur after a stroke.[4] Cite this article as: Ciftci Inceoglu S, Ayyildiz A, Adikti C, Kuran B. Effects of Albumin, Uric Acid, Hemoglobin, and C-Reactive Protein Levels on Rehabilitation Outcomes in Stroke: A Retrospective Clinical Study. Eur Arch Med Res 2025;41(3):183–192.

Major Study Links 15 Factors to Early Dementia Risk

 

 I bet you're not getting good stuff like this from your competent? doctor!

Major Study Links 15 Factors to Early Dementia Risk

Key Takeaways

• A recent study identified 15 lifestyle and health factors associated with young-onset dementia risk, including low socioeconomic status, social isolation, and hearing impairment.
• Moderate to heavy drinking was correlated with a reduced risk of young-onset dementia, while alcohol abuse led to an increased risk, according to the study.
• The research suggests that living healthier lives by addressing modifiable risk factors may help reduce the risk of developing dementia, particularly young-onset dementia.

See a mistake?

While dementia is much more common in older adults, hundreds of thousands of people are diagnosed with young-onset dementia (YOD) each year, and an extensive study published in 2023 sheds some considerable light on why.

Most previous research in this area has looked at genetics passed down through generations, but here, the team was able to identify 15 different lifestyle and health factors that are associated with YOD risk.

"This is the largest and most robust study of its kind ever conducted," said epidemiologist David Llewellyn from the University of Exeter in the UK, when the results were published in December 2023.

"Excitingly, for the first time it reveals that we may be able to take action to reduce risk of this debilitating condition, through targeting a range of different factors."

The research team analyzed data collected on 356,052 people aged under 65 in the UK.

Flowchart of included participants. (Hendriks et al., JAMA Neurology, 2023)

Low socioeconomic status, social isolation, hearing impairment, stroke, diabetes, heart disease, and depression were all associated with a higher risk of YOD.

Vitamin D deficiency and high levels of the C-reactive protein (produced by the liver in response to inflammation) also meant a higher risk, as did having two of the ApoE4 ε4 gene variants (a genetic scenario already linked to Alzheimer's disease).

The researchers described the relationship between alcohol and YOD as "complex".

(Ketut Subiyanto/Pexels)

While alcohol abuse led to an increased risk, moderate to heavy drinking correlated with a reduced risk – possibly because people in this second group are usually healthier in general (bear in mind that those who abstain from alcohol often do so on medical grounds).

Higher levels of formal education and lower physical frailty (measured through higher handgrip strength) were also associated with a lower YOD risk. This all helps to fill in some of the knowledge gaps around YOD.

"We already knew from research on people who develop dementia at older age that there are a series of modifiable risk factors," said neuroepidemiologist Sebastian Köhler from Maastricht University in the Netherlands.

"In addition to physical factors, mental health also plays an important role, including avoiding chronic stress, loneliness, and depression."

More in Health

Experts sound alarm as new research identifies major threat to heart health: 'Less able to tolerate additional stressors'

The Cool Down

Dementia and Memory Loss Has Been Linked To One Common Habit. Are You Doing This?Memory 

While the results don't prove dementia is caused by these factors, they help build a more detailed picture. As always in this kind of research, knowing more about the causes can help develop better treatments and preventative measures.

Many of these factors are modifiable, which offers more hope for those working to find ways to beat dementia rather than just manage it.

Ultimately, dementia may be something we can reduce the risk of by living healthier lives.

We may be able to reduce the risk of dementia by living healthier lives. (shapecharge/Canva)

"Young-onset dementia has a very serious impact, because the people affected usually still have a job, children, and a busy life," said neuroscientist Stevie Hendriks, from Maastricht University.

"The cause is often assumed to be genetic, but for many people we don't actually know exactly what the cause is. This is why we also wanted to investigate other risk factors in this study."

The research has been published in JAMA Neurology.

A version of this article was first published in January 2024

High C-Reactive Protein Levels May Double Stroke Risk, Study Finds

 What is your competent? doctors EXACT PROTOCOL TO PREVENT THIS PROBLEM FROM ESCALATING TO A STROKE? Since your doctor doesn't have one, I guess you DON'T HAVE A FUNCTIONING STROKE DOCTOR, do you?

Send me hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and my response in my blog. Or are you afraid to engage with my stroke-addled mind? Your patients need an explanation of why you aren't working on survivor requirements of 100% recovery protocols. Have you created ANY rehab protocols(Not guidelines!) in the last 20 years? That answer will tell you the competence of your stroke medical 'professionals'!

C-reactive protein (18 posts to October 2012)

High C-Reactive Protein Levels May Double Stroke Risk, Study Finds

Association between C-reactive protein-albumin-lymphocyte index and stroke: an NHANES analysis (1999–2010)

So you found an association. WHAT THE FUCK NEEDS TO BE DONE TO PREVENT THE PROBLEMS? That is what good stroke research should be doing. This is useless for stroke recovery or prevention! I'd have the mentors and senior researchers fired for such crapola!

 Association between C-reactive protein-albumin-lymphocyte index and stroke: an NHANES analysis (1999–2010)

Yizhou Chen^1†, Meifang Liu^2,3†, Yi Zhang⁴, Xiaolin Yang¹, Mengqi Yue¹, Xu Chen¹, Haiqiang Wang¹, Zirong Wang¹, Haocheng Yu¹ and Jing Shi^1,2,3*

¹Yunnan University of Traditional Chinese Medicine, Kunming, Yunnan, China

²First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine, Kunming, Yunnan, China

³Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, Yunnan, China

⁴Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shangdong, China

Edited by
Guanghua Zhai, Nanjing Medical University, China

Reviewed by
Aditya Yashwant Sarode, Columbia University, United States
Gestter Willian Lattari Tessarin, University Center in the North of São Paulo (UNORTE), Brazil
Neel Patel, Staten Island University Hospital, United States

*Correspondence
Jing Shi, 2662831291@qq.com

^†These authors have contributed equally to this work

Received 07 January 2025
Accepted 20 March 2025
Published 02 April 2025

Citation
Chen Y, Liu M, Zhang Y, Yang X, Yue M, Chen X, Wang H, Wang Z, Yu H and Shi J (2025) Association between C-reactive protein-albumin-lymphocyte index and stroke: an NHANES analysis (1999–2010). Front. Neurol. 16:1548666. doi: 10.3389/fneur.2025.1548666

Objective: This cross-sectional study is based on the NHANES (1999–2010) database and aims to explore the potential relationship between the CALLY index and stroke in the U.S. population.

Methods: This cross-sectional study utilized data from NHANES (1999–2010), including 17,511 American participants after data cleaning. Laboratory markers related to the CALLY index were obtained through standardized biological sample collection and analysis procedures performed by trained professionals. Stroke status was determined based on self-reported questionnaires. Various statistical methods were employed to examine the association between the CALLY index and stroke, as well as its predictive efficacy for stroke risk, including multivariable logistic regression, subgroup analysis, RCS analysis, and ROC analysis.

Results: Among the 17,511 participants analyzed, our findings revealed a nonlinear L-shaped negative association between the CALLY index and stroke risk. In Model 3, a higher CALLY index was significantly associated with a lower stroke risk (OR: 0.99, 95% CI: 0.98–0.99, p = 0.045). Additionally, participants in the highest quartile (Q4) of the CALLY index had a 25% lower likelihood of stroke compared to those in the lowest quartile (Q1) (OR: 0.75, 95% CI: 0.58–0.97, p = 0.030). Furthermore, ROC analysis demonstrated that the CALLY index had superior predictive performance for stroke risk compared to the SIRI and SII indices.

Conclusion: A reduced CALLY index may be linked to a higher risk of stroke. Furthermore, the CALLY index demonstrates superior predictive performance compared to the SIRI and SII indices. The association between the CALLY index and stroke risk provides valuable insights for future stroke prevention and management strategies.

More at link.

Midlife Cognition Tied to Inflammation Years Earlier

 Well, what is your doctor doing to counteract this midlife cognition problem? NOTHING LIKE USUAL? I expect doctors to have EXACT answers to these questions if they are competent at all!

Midlife Cognition Tied to Inflammation Years Earlier

Consistently high CRP levels over 18 years raised the risk of poor cognitive function

by Judy George, Deputy Managing Editor, MedPage Today July 3, 2024

Key Takeaways

• Chronic inflammation in early adulthood was associated with midlife cognitive outcomes.
• Links emerged between inflammation trajectories and subsequent processing speed and executive function scores.
• There was no association between inflammation trajectories and memory, fluency, or global cognition impairment.

Inflammation in young adulthood was associated with midlife cognitive outcomes, data from the CARDIA study showed.

Compared with lower stable levels of C-reactive protein (CRP), consistently higher CRP levels over 18 years led to higher odds of poor processing speed scores in midlife (adjusted OR 1.67, 95% CI 1.23-2.26), as did moderately/increasing CRP levels (adjusted OR 2.04, 95% CI 1.40-2.96), reported Amber Bahorik, PhD, of the University of California San Francisco (UCSF), and co-authors.

Consistently higher CRP was also linked with poor executive function scores in midlife (adjusted OR 1.36, 95% CI 1.00-1.88), the researchers reported in Neurology.

Higher levels of inflammation are associated with obesity, physical inactivity, chronic illness, stress, and smoking. Inflammation levels tend to vary over the life course, and this variation over time may help predict cognitive aging, the researchers suggested.

"There is likely a direct and indirect effect of inflammation on cognition," co-author Kristine Yaffe, MD, also of UCSF, said in a statement. "Fortunately, there are ways to reduce inflammation -- such as by increasing physical activity and quitting smoking -- that might be promising paths for prevention."

Late-life inflammation has been tied to dementia risk and cognitive decline, Yaffe noted. In a recent U.K. Biobank analysis, high levels of CRP emerged as one of several risk factors for young-onset dementia.

The CARDIA research "underscores the importance of considering earlier time points when exploring the determinants of cognitive decline and the relevance of monitoring inflammation in this context," noted Eleanor Conole, PhD, of the University of Oxford in England, in an accompanying editoria.

"Approaches that consider multiple immune markers in deeply phenotyped populations are strongly encouraged, and advances in our ability to measure immune function at low cost and at scale may aid in clarifying these relationships," she added.

But whether CRP is the best marker to assess baseline inflammation in a population study like this isn't clear, Conole pointed out. "CRP is an acute phase protein produced in the liver and, true to its name, is acute, phasic, and reactive," she wrote.

Clinically, changes in CRP levels are indicators of deterioration or recovery; rising levels can signal a flare-up and decreasing levels can indicate effective treatment. "However, this phasic nature of CRP poses problems for capturing baseline inflammation in population studies, a limitation acknowledged by the authors," Conole observed.

Bahorik and colleagues followed 2,364 adults in the ongoing CARDIA study, a longitudinal cohort study that started in 1985 to evaluate determinants of cardiovascular disease and their risk factors. About half the participants were female; a little under half were Black, and the rest were white. Participants with elevated levels of inflammation (CRP of 10 mg/L or more) were excluded from the study.

CRP was measured at four time points over 18 years when people were from ages 24 to 58 years. Inflammation trajectories that reflected overall patterns showed that 39% of participants had consistently higher CRP, 16% had moderate/increasing CRP, and 45% had lower stable CRP.

Five years after the last CRP measurement, the researchers administered a battery of six cognitive tests to assess verbal memory, processing speed, executive function, verbal and category fluency, and global cognition. Participants were ages 47 to 63 when they were tested. Poor cognitive performance was defined as a decline of one or more standard deviations less than the mean on each domain.

Patterns of consistently higher and moderate/increasing inflammation were associated with slower processing speed and worse executive function after controlling for demographics, lifestyle risk factors, and APOE4. "Participants with a pattern of consistently higher inflammation were most likely to have higher odds of poor cognitive function," Bahorik and colleagues noted. "There was no association of inflammation trajectory and impairment in memory, fluency, or global cognition."

Limitations of the research included possible selection bias due to loss of follow-up and the study's reliance on CRP as the only inflammatory marker, they acknowledged.

• Judy George covers neurology and neuroscience news for MedPage Today, writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more. Follow

Disclosures

The CARDIA study is supported by the NIH.

Yaffe reported relationships with Eli Lilly, Alpha Cognition, Alector, the Dominantly Inherited Alzheimer Network Trials Unit, the Beeson Scientific Advisory Board, and the Global Council on Brain Health. Bahorik and other authors reported no disclosures.

Conole reported no relevant disclosures.

Primary Source

Neurology

Source Reference: Bahorik AL, et al "Association of changes in C-reactive protein level trajectories through early adulthood with cognitive function at midlife: the CARDIA study" Neurology 2024; DOI: 10.1212/WNL.0000000000209526.

Secondary Source

Neurology

Source Reference: Conole ELS "Chronic inflammation and brain health: the case for early monitoring" Neurology 2024; DOI: 10.1212/WNL.0000000000209613.