Previous studies have shown the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) with stroke mortality and functional outcome after an acute ischemic stroke (AIS). Knowledge of its association with systemic and neurological in-hospital complications is scarce. Our objective is to analyze this. We performed an observational, retrospective study that included consecutive AIS patients during a 1-year period (2020). A multivariate analysis was performed to identify if NT-proBNP levels were independently associated with in-hospital complications. 308 patients were included, of whom 96 (31.1%) developed systemic and 62 (20.12%) neurological in-hospital complications. Patients with any complication (39.3%) showed higher NT-proBNP levels than those without (median (IQR): 864 (2556) vs. 142 (623) pg/dL, p < 0.001). The receiver operating characteristic curve (ROC) pointed to 326 pg/dL of NT-proBNP as the optimal cutoff level for developing in-hospital systemic complications (63.6% sensitivity and 64.7% specificity for any complication; 66.7% and 62.7% for systemic; and 62.9% and 57.7% for neurological complications). Multivariate analyses showed that NT-proBNP > 326 pg/dL was associated with systemic complications (OR 2.336, 95% CI: 1.259–4.335), adjusted for confounders. This did not reach statistical significance for neurological complications. NT-proBNP could be a predictor of in-hospital systemic complications in AIS patients. Further studies are needed.

Background: Dimethyl fumarate (DMF) and diroximel fumarate (DRF) are two treatments used for multiple sclerosis (MS) that have been shown to be effective in controlling MS patients. DRF was introduced in 2019 with the aim of decreasing the gastrointestinal side effects caused by DMF. Few real-life studies verify the data provided in the clinical trials. Methods: A retrospective descriptive study was conducted on MS patients at the Hospital Universitario Torrecárdenas under treatment with DRF and DMF. Demographic, clinical, and analytical variables were studied and compared between groups. Results: A total of 60 patients were recruited, 30 with each treatment, observing similar baseline characteristics. Fewer gastrointestinal (GI) effects were observed in the DRF group, while more infections were detected in the DMF group. We recorded lower levels in the DRF group, with four cases of moderate-severe lymphopenia in the DRF group vs. none in the DMF group. In addition, we observed a decrease in lymphocytes after the change from DMF to DRF in patients with a change. Conclusions: Our real-life analysis of patients treated with DMF or DRF supports several studies’ findings regarding decreased GI side effects with DRF vs. DMF without decreasing efficacy. However, our data show a greater reduction in lymphocytes in patients with DRF compared to DMF, so more studies are necessary.

Objectives: Cardiac point-of-care ultrasound (cPOCUS) enables rapid bedside cardiac assessment and may facilitate early identification of potential cardiac sources of embolism in patients with acute ischemic stroke (AIS). This study aimed to evaluate whether neurologist-performed cPOCUS is associated with reduced hospital length of stay (LOS) in patients admitted to a Stroke Unit (SU). Methods: We conducted a retrospective observational study including consecutive patients with AIS admitted between 2020 and 2021 who required cardiac ultrasound for etiological evaluation. Patients underwent cPOCUS and/or transthoracic echocardiography (TTE) and were classified into two groups: those evaluated with cPOCUS (with or without TTE) and those evaluated exclusively with TTE (control group). The availability of cPOCUS depended on predefined weekly schedules rather than individual clinical decision-making, partially mitigating selection bias. The primary outcome was LOS. Multivariable linear regression analysis was performed to adjust for potential confounders. Results: Among 808 patients with AIS, 332 underwent cardiac ultrasonography during hospitalization: 219 in the cPOCUS group and 113 in the control group. Overall, 60.4% were male, the mean age was 68.4 years (SD 13.3), and the median National Institutes of Health Stroke Scale score at admission was 5 (IQR 9), with no significant differences between groups. Median LOS was shorter in the cPOCUS group than in the control group [7 days (IQR 4) vs. 8 days (IQR 5); p = 0.015]. After adjustment for confounders, cPOCUS evaluation remained independently associated with shorter LOS (β −1.49, standard error 0.73, 95% CI −2.93 to −0.05; p = 0.04). Conclusions: Neurologist-performed cPOCUS is independently associated with reduced LOS in patients with AIS admitted to an SU. These findings suggest that cPOCUS may facilitate more efficient in-hospital workflows and support its potential integration into routine stroke care pathways.

The aim of this 4-year observational study is to analyze the outcomes of stroke patients treated with direct mechanical thrombectomy (dMT) compared to bridging therapy (BT) (intravenous thrombolysis [IVT] + BT) based on 3-month outcomes, in real clinical practice in the "Stroke Belt" of Southern Europe. In total, 300 patients were included (41.3% dMT and 58.6% BT). The frequency of direct referral to the stroke center was similar in the dMT and BT group, whereas the time from onset to groin was longer in the BT group (median 210 [IQR 160–303] vs. 399 [IQR 225–675], p = 0.001). Successful recanalization (TICI 2b-3) and hemorrhagic transformation were similar in both groups. The BT group more frequently showed excellent outcomes at 3 months (32.4% vs. 15.4%, p = 0.004). Multivariate analysis showed that BT was independently associated with excellent outcomes (OR 2.7. 95% CI,1.2–5.9, p = 0.02) and lower mortality (OR 0.36. 95% CI 0.16–0.82, p = 015). Conclusions: Compared with dMT, BT was associated with excellent functional outcomes and lower 3-month mortality in this real-world clinical practice study conducted in a region belonging to the “Stroke Belt” of Southern Europe. Given the disparity of results on the benefit of BT in the current evidence, it is of vital importance to analyze the convenience of its use in each health area.

Dimethyl fumarate (DMF) and diroximel fumarate (DRF) are two treatments used in multiple sclerosis (MS), that have been shown to be effective in controlling MS patients. DRF was intro-duced in 2019, with the aim of decreasing the gastrointestinal side effects caused by DMF. Few real-life studies verify the data provided in the clinical trials. Methods: A retrospective descriptive study was conducted in MS patients at the Hospital Universitario Torrecárdenas under treatment with DRF and DMF. Demographic, clinical, and analytical variables were studied and compared between groups. Results: 60 patients were recruited, 30 with each treatment, observing similar baseline characteristics. Fewer gastrointestinal (GI) effects were observed in the DRF group, while more infections were detected in the DMF group. We recorded lower levels in the DRF group, with 4 moderate-severe lymphopenia in the DRF group vs. none in the DMF group. In addition, we observed a decrease in lymphocytes after the change from DMF to DRF in patients with a change. Conclusions: Our real-life analysis of patients treated with DMF or DRF supports studies’ findings of decreased GI side effects with DRF vs. DMF, without decreasing efficacy. However, our data show greater reduction in lymphocytes in patients with DRF compared to DMF, so more studies are necessary.

Objectives Cardiac point-of-care ultrasound (cPOCUS) enables rapid bedside cardiac assessment and may facilitate early identification of potential cardiac sources of embolism in patients with acute ischemic stroke (AIS). This study evaluated whether neurologist-performed cPOCUS is associated with a reduced hospital length of stay (LOS) in patients admitted to a Stroke Unit (SU). Methods We conducted a retrospective observational study including consecutive patients with AIS admitted between 2020 and 2021 who required cardiac ultrasound for etiological evaluation. Patients underwent cPOCUS and/or transthoracic echocardiography (TTE) and were classified into two groups: those evaluated with cPOCUS (with or without TTE) and those evaluated exclusively with TTE (control group). The availability of cPOCUS depended on predefined weekly schedules rather than individual clinical decision-making, partially mitigating selection bias. The primary outcome was LOS. Multivariable linear regression analyses were performed to adjust for potential confounders. Results Among 808 patients with AIS, 332 underwent cardiac ultrasonography during hospitalization: 219 in the cPOCUS group and 113 in the control group. Overall, 60.4% were male, the mean age was 68.4 years (SD 13.3), and the median National Institutes of Health Stroke Scale score at admission was 5 (IQR 9), with no significant differences between groups. Median LOS was shorter in the cPOCUS group than in the control group [7 days (IQR 4) vs. 8 days (IQR 5); p = 0.015]. After adjustment for confounders, cPOCUS evaluation remained independently associated with a shorter LOS (β −1.49, standard error 0.73). Conclusions Neurologist-performed cPOCUS is independently associated with reduced LOS in patients with AIS admitted to an SU. These findings suggest that cPOCUS may facilitate more efficient in-hospital workflows and support its potential integration into routine stroke care pathways.