Week 10- Resp and CVD Flashcards
smoking down stream affects
smoking–>alevoli disrupiton/damage–>increase in local lung inflamm–>involvement in other systems as smoking becomes chronic–>impacts gut microbiota directly or because of increase in systmeic inflamm
the systmeic inflamm can cause increase in imm cells in the gut or a difference of mcirobiota composure also more bacteria/harmful bacteria in other tissues
HIV downstream affects
HIV–>pulmonary hypertension–>local and systemic inflamm–>affects the heart
strokw downstream affects
stroke can cuase significant increase in inflamm and exasterbate damage in brain but also lead to increase in immune cells ending up in places like the lung(thought to becontribtuing to lung infection) and gut.
we also see chnages in gut microbiota where its been found in the urinary tract(many stroke patients get UTIs)
how many of the surviving stroke patients get a recurring storke? and if they do what are the implications
10%
icnreased chnage of severe stoke and increased chnace of death
Why do we treat with aspirin?
to prevent recurring storke particularly as these patients tend to have clotting complications and other risk factors (atrial fibrillation and hypertension-main risk fatcro)
infarct damage is caused by …
Immediate necrosis or and delayed apoptosis
Which type of stroke has the best survival probability over 15 yr period?
subarachnoid
Which types of stroke have the worst survival probability over 15 years?
intracerebral hemorrhage and cerebral ischemia have worst outcomes, with quite low probability of survival after 15 yrs(20%)
what is the most likely cause of death after the first nonfatal stroke?
recurring stroke
TIA is an indicator of…
a more severe stoke potentially occurring afterwards
How many stroke patients in an acute time end up with pneumonia?
6%
Why is pneumonia risk increased post stroke?
after stroke–> rapid increase in imm cell infiltration into brain–>?3-4 days post stroke, brain shuts down imm system to creased inflitration and the dmaage associated.–> patientsa re now immunosuppressed leading to increased risk of infection
The spleen reduces in size post stroke because…
an huge influx of imm cells infiltrating the brain and because of increased apoptosis
Why was it first thought that storke patients got pneumonia?
because the patients are in the hopsital
After inducing ischeamic attack in a mouse CFU were found as early as …. in the lungs
12hrs
Were CFU foudn int he lungs of blood first and what does this mean?
in the lungs first, propsed that potentilaly it invades the lungs and then leeches into blood but still ubknown
histological changes in the mouse lungs after MCAO
chnage in lung strutcure, increased imm cell infiltration(inflamm), increased in neutrphil infiltration, evidence of E.coli pneumonia
When anaylysing the bacteria found in the lungs of MCAO mice they foudn…
the genus types were very simialr to gut microbiota, showing that it may be getting out of the gut anf being found in other tissues
How did we confirm that this bacteria was leeching to other tissues post stroke?
germ free mice used and stroke induced to see if there was this similar infiltration and inflammation after the stroke. normal mice had signoifcant amount of bacteria in the lungs but there was not in the germ free mcie
mechanism that is driving increased bacteira in the lungs?
stroke–> increase in symp output–>(gut and spleen are very symp acitvated)–> more bacteria infiltration
By using increasing propanolol(a b2 antag) to decrease symp activation post stroke what was found…
wiht increasing doses we see decrease in CFU in both lung and blood.
also found that there was a decrease in mortality when propanolol was administered
antibacterial treatment was found to…
increase functional mobility, decrease mortality, decrease infarct damage
Preventative antibiotics for stroke
foudn that infections were siginicantly reduced but pneumonia reduction was not significant
all clinical trials have found the same thing.
