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Pesquisa : Transtornos and Cerebrovasculares [Palavras]
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[PMID]:29444392
[Au] Autor:Momeni M; Gaudin A
[Ti] Título:Intraoperative cerebral hypoperfusion and electroencephalogram suppression resulting in neurological complications after cardiac surgery : the need for an in depth investigation.
[So] Source:Acta Anaesthesiol Belg;67(2):73-79, 2016.
[Is] ISSN:0001-5164
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:Reports on the demographic profile of older populations estimate that, in 2050, 19 countries will have at least 10% of their population aged 80 years or more. Many high risk elderly patients undergo cardiac surgery. In addition, advanced age has been shown to be a strong predictor of adverse neurological outcome. Despite sig- nificant improvements achieved in the perioperative care of cardiac surgical patients, neurological complications remain a global health issue. Recent findings have pointed out that cerebral hypoperfusion and too deep levels of anesthesia are major sources of adverse neurological outcomes. Cerebral near-in-frared spectroscopy provides information about cerebral perfusion non-invasively, and is increasingly used. Depth of anesthesia is evaluated using monitors that are based on processed electroencephalogram. This non-systematic review focuses on the results of studies performed with each monitor separately, and the need for a combined evaluation of their utility and eventual impact on neurological outcomes. The use of a combined cerebral monitoring strategy based on the two aforementioned monitors is proposed in order to optimize cerebral outcomes.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardíacos/efeitos adversos
Transtornos Cerebrovasculares/etiologia
Eletroencefalografia
Monitorização Intraoperatória
Complicações Pós-Operatórias/etiologia
[Mh] Termos MeSH secundário: Disfunção Cognitiva/etiologia
Delírio/etiologia
Seres Humanos
Espectroscopia de Luz Próxima ao Infravermelho
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE


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[PMID]:29419394
[Au] Autor:Morley RL; Sharma A; Horsch AD; Hinchliffe RJ
[Ad] Endereço:North Bristol NHS Trust, Bristol, Bristol, UK.
[Ti] Título:Peripheral artery disease.
[So] Source:BMJ;360:j5842, 2018 02 01.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Aterosclerose/complicações
Transtornos Cerebrovasculares/complicações
Isquemia Miocárdica/complicações
Doença Arterial Periférica/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Aterosclerose/patologia
Transtornos Cerebrovasculares/epidemiologia
Complicações do Diabetes
Diagnóstico Diferencial
Inglaterra/epidemiologia
Seres Humanos
Meia-Idade
Isquemia Miocárdica/epidemiologia
Doença Arterial Periférica/complicações
Doença Arterial Periférica/epidemiologia
Doença Arterial Periférica/fisiopatologia
Guias de Prática Clínica como Assunto
Atenção Primária à Saúde/normas
Medição de Risco
Fatores de Risco
Fumar/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5842


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[PMID]:29386181
[Au] Autor:Adelborg K; Szépligeti SK; Holland-Bill L; Ehrenstein V; Horváth-Puhó E; Henderson VW; Sørensen HT
[Ad] Endereço:Department of Clinical Epidemiology, Aarhus University Hospital, Denmark kade@clin.au.dk.
[Ti] Título:Migraine and risk of cardiovascular diseases: Danish population based matched cohort study.
[So] Source:BMJ;360:k96, 2018 01 31.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To examine the risks of myocardial infarction, stroke (ischaemic and haemorrhagic), peripheral artery disease, venous thromboembolism, atrial fibrillation or atrial flutter, and heart failure in patients with migraine and in a general population comparison cohort. DESIGN: Nationwide, population based cohort study. SETTING: All Danish hospitals and hospital outpatient clinics from 1995 to 2013. PARTICIPANTS: 51 032 patients with migraine and 510 320 people from the general population matched on age, sex, and calendar year. MAIN OUTCOME MEASURES: Comorbidity adjusted hazard ratios of cardiovascular outcomes based on Cox regression analysis. RESULTS: Higher absolute risks were observed among patients with incident migraine than in the general population across most outcomes and follow-up periods. After 19 years of follow-up, the cumulative incidences per 1000 people for the migraine cohort compared with the general population were 25 17 for myocardial infarction, 45 25 for ischaemic stroke, 11 6 for haemorrhagic stroke, 13 11 for peripheral artery disease, 27 18 for venous thromboembolism, 47 34 for atrial fibrillation or atrial flutter, and 19 18 for heart failure. Correspondingly, migraine was positively associated with myocardial infarction (adjusted hazard ratio 1.49, 95% confidence interval 1.36 to 1.64), ischaemic stroke (2.26, 2.11 to 2.41), and haemorrhagic stroke (1.94, 1.68 to 2.23), as well as venous thromboembolism (1.59, 1.45 to 1.74) and atrial fibrillation or atrial flutter (1.25, 1.16 to 1.36). No meaningful association was found with peripheral artery disease (adjusted hazard ratio 1.12, 0.96 to 1.30) or heart failure (1.04, 0.93 to 1.16). The associations, particularly for stroke outcomes, were stronger during the short term (0-1 years) after diagnosis than the long term (up to 19 years), in patients with aura than in those without aura, and in women than in men. In a subcohort of patients, the associations persisted after additional multivariable adjustment for body mass index and smoking. CONCLUSIONS: Migraine was associated with increased risks of myocardial infarction, ischaemic stroke, haemorrhagic stroke, venous thromboembolism, and atrial fibrillation or atrial flutter. Migraine may be an important risk factor for most cardiovascular diseases.
[Mh] Termos MeSH primário: Doenças Cardiovasculares/etiologia
Transtornos de Enxaqueca/complicações
Infarto do Miocárdio/etiologia
Acidente Vascular Cerebral/etiologia
[Mh] Termos MeSH secundário: Adulto
Fibrilação Atrial/epidemiologia
Fibrilação Atrial/etiologia
Índice de Massa Corporal
Doenças Cardiovasculares/epidemiologia
Estudos de Coortes
Comorbidade
Dinamarca/epidemiologia
Feminino
Insuficiência Cardíaca/epidemiologia
Insuficiência Cardíaca/etiologia
Seres Humanos
Incidência
Hemorragias Intracranianas/epidemiologia
Hemorragias Intracranianas/etiologia
Masculino
Meia-Idade
Transtornos de Enxaqueca/diagnóstico
Transtornos de Enxaqueca/epidemiologia
Infarto do Miocárdio/epidemiologia
Avaliação de Resultados (Cuidados de Saúde)
Doença Arterial Periférica/epidemiologia
Doença Arterial Periférica/etiologia
Estudos Prospectivos
Fatores de Risco
Fumar/epidemiologia
Acidente Vascular Cerebral/epidemiologia
Tromboembolia Venosa/epidemiologia
Tromboembolia Venosa/etiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180202
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.k96


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[PMID]:28468925
[Au] Autor:Wang YL; Lin GH; Huang YJ; Chen MH; Hsieh CL
[Ad] Endereço:From the Department of Rehabilitation, Chi Mei Medical Center, Tainan, Taiwan (Y.-L.W.); Center of General Education, Southern Taiwan University of Science and Technology, Tainan (Y.-L.W.); School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei (G.-H.L., Y.-J.H., C.-
[Ti] Título:Refining 3 Measures to Construct an Efficient Functional Assessment of Stroke.
[So] Source:Stroke;48(6):1630-1635, 2017 06.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: The Fugl-Meyer Assessment motor scale, Postural Assessment Scale for Stroke patients, and Barthel Index are widely used to assess patients' upper extremity and lower extremity motor function, balance, and basic activities of daily living after stroke, respectively. However, these 3 measures (72 items) require a great amount of time for assessment. Therefore, we aimed to develop an efficient test, the Functional Assessment of Stroke (FAS). METHODS: The FAS was constructed from 4 short-form tests of the Fugl-Meyer Assessment-upper extremity, Fugl-Meyer Assessment-lower extremity, Postural Assessment Scale for Stroke patients, and Barthel Index based on the results of Rasch analyses and the items' content. We examined the psychometric properties of the FAS, including Rasch reliability, concurrent validity, convergent validity, known-group validity, and responsiveness. RESULTS: The FAS contained 29 items (10, 6, 8, and 5 items for the 4 short-form tests, respectively). The FAS demonstrated high Rasch reliability (0.92-0.94), concurrent validity ( =0.90-0.97 with the original tests), convergent validity ( =0.62-0.94 with the 5-scale Fugl-Meyer Assessment), and known-group validity (significant difference in the FAS scores among 3 groups of disability levels; <0.001). In addition, the responsiveness of the FAS (standardized response mean=0.55-1.93) was similar or significantly superior to those of the original tests (standardized response mean=0.46-1.39). CONCLUSIONS: The FAS contains 29 items and has sufficient Rasch reliability, validities, and responsiveness. These findings support that the FAS is efficient for reliably and validly assessing upper extremity/lower extremity motor function, balance, and basic activities of daily living and for sensitively detecting change in those functions in patients with stroke.
[Mh] Termos MeSH primário: Atividades Cotidianas
Extremidade Inferior/fisiopatologia
Transtornos dos Movimentos/diagnóstico
Equilíbrio Postural/fisiologia
Índice de Gravidade de Doença
Acidente Vascular Cerebral/diagnóstico
Extremidade Superior/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Transtornos dos Movimentos/etiologia
Psicometria/métodos
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
Acidente Vascular Cerebral/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.116.015516


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[PMID]:28455324
[Au] Autor:Kulick ER; Wellenius GA; Kaufman JD; DeRosa JT; Kinney PL; Cheung YK; Wright CB; Sacco RL; Elkind MS
[Ad] Endereço:From the Department of Epidemiology, Mailman School of Public Health (E.R.K., M.S.E.), Department of Neurology, College of Physicians and Surgeons (E.R.K., J.T.D., M.S.E.), and Department of Biostatistics, Mailman School of Public Health (Y.K.C.), Columbia University, New York, NY; Department of Epi
[Ti] Título:Long-Term Exposure to Ambient Air Pollution and Subclinical Cerebrovascular Disease in NOMAS (the Northern Manhattan Study).
[So] Source:Stroke;48(7):1966-1968, 2017 07.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Long-term exposure to ambient air pollution is associated with higher risk of cardiovascular disease and stroke. We hypothesized that long-term exposure to air pollution would be associated with magnetic resonance imaging markers of subclinical cerebrovascular disease. METHODS: Participants were 1075 stroke-free individuals aged ≥50 years drawn from the magnetic resonance imaging subcohort of the Northern Manhattan Study who had lived at the same residence for at least 2 years before magnetic resonance imaging. Cross-sectional associations between ambient air pollution and subclinical cerebrovascular disease were analyzed. RESULTS: We found an association between distance to roadway, a proxy for residential exposure to traffic pollution, and white matter hyperintensity volume; however, after adjusting for risk factors, this relationship was no longer present. All other associations between pollutant measures and white matter hyperintensity volume were null. There was no clear association between exposure to air pollutants and subclinical brain infarcts or total cerebral brain volume. CONCLUSIONS: We found no evidence that long-term exposure to ambient air pollution is independently associated with subclinical cerebrovascular disease in an urban population-based cohort.
[Mh] Termos MeSH primário: Poluição do Ar/efeitos adversos
Transtornos Cerebrovasculares/induzido quimicamente
Transtornos Cerebrovasculares/diagnóstico por imagem
Exposição Ambiental/efeitos adversos
Substância Branca/diagnóstico por imagem
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos Transversais
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Cidade de Nova Iorque
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.016672


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[PMID]:28455315
[Au] Autor:Lundholm MD; Rooney M; Maas MB; Attarian H; Prabhakaran S
[Ad] Endereço:From the Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
[Ti] Título:Wake-Up Stroke Is Associated With Greater Nocturnal Mean Arterial Pressure Variability.
[So] Source:Stroke;48(6):1668-1670, 2017 06.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Wake-up strokes (WUS) account for ≈20% to 30% of ischemic strokes. Studies have shown that increased autonomic instability as measured by blood pressure variability (BPV) is greater in stroke patients than nonstroke patients, but no studies have compared BPV in WUS versus non-WUS patients. METHODS: From a single-center prospective registry, we identified consecutive ischemic stroke patients. BPV was calculated as the coefficient of variation of the mean arterial pressure during the first 24 hours after hospitalization. We assessed 24-hour BPV as a continuous measure and in quartiles in WUS versus non-WUS patients using univariable and multivariable statistics. RESULTS: Among 369 patients (64.9±16.5 years; 50.1% male; 64.7% white), 78 were WUS (21.1%). Clinical characteristics and medical history were not different between WUS and non-WUS patients except WUS patients were older (69.0 versus 63.8 years; =0.015) and more frequently had previous ischemic stroke (29.5% versus 17.2%; =0.012). Initial 24-hour BPV (11.77 versus 10.76; =0.098) was similar between groups. However, WUS patients had greater nocturnal BPV (10.50 versus 8.95; =0.030), whereas daytime BPV was similar between groups (10.96 versus 10.47, =0.459). In multivariate analysis, the highest quartile (≥11.48 mm Hg) of nocturnal BPV was independently associated with WUS (adjusted odds ratio, 1.95; confidence interval, 1.13-3.39; =0.017). CONCLUSIONS: In this single-center study, we observed that greater nocturnal BPV during the first 24 hours after hospitalization occurred in WUS than non-WUS patients. Nocturnal autonomic instability warrants further study as a potential mechanism of WUS.
[Mh] Termos MeSH primário: Pressão Arterial/fisiologia
Doenças do Sistema Nervoso Autônomo/fisiopatologia
Isquemia Encefálica/fisiopatologia
Sono/fisiologia
Acidente Vascular Cerebral/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Doenças do Sistema Nervoso Autônomo/complicações
Isquemia Encefálica/etiologia
Feminino
Hospitalização
Seres Humanos
Masculino
Meia-Idade
Sistema de Registros
Acidente Vascular Cerebral/etiologia
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.116.016202


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[PMID]:29480825
[Au] Autor:Jang SH; Jang WH
[Ad] Endereço:Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daemyungdong, Namku, Daegu.
[Ti] Título:The allocentric neglect due to injury of the inferior fronto-occipital fasciculus in a stroke patient: A case report.
[So] Source:Medicine (Baltimore);97(2):e9295, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: We report on a patient who developed allocentric neglect due to injury of the inferior fronto-occipital fasciculus (IFOF) following intracranial hemorrhage, diagnosed using diffusion tensor tractography (DTT). PATIENT CONCERNS: Her cognition seemed normal (A 17-year-old, right-handed female patient). However, in spite of a normal visual field, her perception was missing on the left side, and she had no awareness of her deficit. She was unable to perceive the left side in each of 2 objects, regardless of position of the 2 objects, and failed at detail exploration of the left side of 1 object. In addition, the line bisection test, the most representative neglect test, did not reveal any abnormality. DIAGNOSES: She was diagnosed with an intracerebral hemorrhage (right thalamus), intraventricular hemorrhage, and subarachnoid hemorrhage due to arteriovenous malformation in the right thalamus. INTERVENTIONS: Seven weeks after onset, she began rehabilitation. Consequently, the apple cancellation test to discriminate between allocentric and egocentric neglect was performed, with the result of severe allocentric neglect. OUTCOMES: The right superior longitudinal fasciculus and inferior longitudinal fasciculus were well-reconstructed without definite injury compared with those of the left side. However, the right IFOF was discontinued in the anterior portion around the frontal lobe. LESSONS: Allocentric neglect due to injury of IFOF was demonstrated in a stroke patient using DTT. It appears that DTT would be helpful in demonstrating the neglect type and pathway in patients with neglect.
[Mh] Termos MeSH primário: Encéfalo/diagnóstico por imagem
Hemorragia Cerebral/complicações
Malformações Arteriovenosas Intracranianas/complicações
Transtornos da Percepção/etiologia
Acidente Vascular Cerebral/complicações
Hemorragia Subaracnóidea/complicações
[Mh] Termos MeSH secundário: Adolescente
Encéfalo/fisiopatologia
Hemorragia Cerebral/diagnóstico por imagem
Hemorragia Cerebral/fisiopatologia
Imagem de Tensor de Difusão
Feminino
Seres Humanos
Malformações Arteriovenosas Intracranianas/diagnóstico por imagem
Malformações Arteriovenosas Intracranianas/fisiopatologia
Vias Neurais/lesões
Vias Neurais/fisiopatologia
Transtornos da Percepção/diagnóstico por imagem
Transtornos da Percepção/fisiopatologia
Transtornos da Percepção/reabilitação
Acidente Vascular Cerebral/diagnóstico por imagem
Acidente Vascular Cerebral/fisiopatologia
Hemorragia Subaracnóidea/diagnóstico por imagem
Hemorragia Subaracnóidea/fisiopatologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009295


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[PMID]:29390393
[Au] Autor:Li X; Wu L; Guo F; Liang X; Fu H; Li N
[Ad] Endereço:Acupuncture and Moxibustion Four Ward, Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine.
[Ti] Título:Quick needle insertion at pharyngeal acupoints for poststroke dysphagia: A case report.
[So] Source:Medicine (Baltimore);96(50):e9299, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Dysphagia following stroke is a major complaint among patients, and effective treatment of post-stroke dysphagia can be difficult. We present a case report describing a new treatment for dysphagia, namely, quick needle insertion at pharyngeal acupoints. PATIENT CONCERNS: A 70-year-old man developed pharyngeal dysphagia after a stroke. Three months after the patient experienced a sudden stroke leading to liquid dysphagia, acupuncture, one of the most important therapies in Traditional Chinese Medicine, was used to treat the patient. DIAGNOSES: A diagnosis of cerebral infarction and bulbar paralysis was made. INTERVENTIONS: Quick needle insertion was performed at five pharyngeal acupoints, once a day, 6 times a week for 6 weeks. OUTCOMES: The patient subsequently showed significant improvement in the pharyngeal phase of swallowing. His performance in the drinking water test reduced to level 1 from level 4. The functional oral intake scale score changed from level 2 to level 7. In the video fluoroscopic swallowing study, no spillage occurred, but aspiration was present. The residue of the contrast agent was reduced. LESSONS: Quick needle insertion at pharyngeal acupoints can be an efficient way to treat post-stroke dysphagia.
[Mh] Termos MeSH primário: Pontos de Acupuntura
Terapia por Acupuntura/métodos
Transtornos de Deglutição/etiologia
Transtornos de Deglutição/terapia
Faringe
Acidente Vascular Cerebral/complicações
[Mh] Termos MeSH secundário: Idoso
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009299


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[PMID]:27774897
[Au] Autor:Li J; Gao Y; Ren X; Li Y; Wu L; Yang X; Wang J; Shang H; Xiong X; Xing Y
[Ad] Endereço:Department of Cardiology, Guang`anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.
[Ti] Título:The Role of Biologically Active Ingredients from Chinese Herbal Medicines in the Regulation of Autophagy in Treating Cardiovascular Diseases and Other Chronic Diseases.
[So] Source:Curr Pharm Des;23(7):1060-1069, 2017.
[Is] ISSN:1873-4286
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Autophagy, a highly conserved starvation response mechanism with both defensive and protective effects in eukaryotic cells, is a lysosome-mediated degradation process for non-essential or damaged cellular constituents. It plays an important role in the cell survival, differentiation and development to maintain homeostasis. Autophagy is involved in cardiovascular diseases, cerebrovascular diseases, and neurodegenerative diseases, as well as tumours. Thus, modulating autophagy may provide potential therapeutic strategies. Recently, many active components of Chinese herbal medicines (CHM) have been found to modulate autophagy in myocardial cells, cerebral vascular cells, endothelial cells and tumour cells. This paper reviews the advances in studies on the active components of CHM that modulating autophagy in treating cardiovascular diseases and other chronic diseases over the past five years.
[Mh] Termos MeSH primário: Autofagia/efeitos dos fármacos
Doenças Cardiovasculares/tratamento farmacológico
Transtornos Cerebrovasculares/tratamento farmacológico
Medicamentos de Ervas Chinesas/farmacologia
Neoplasias/tratamento farmacológico
Doenças Neurodegenerativas/tratamento farmacológico
[Mh] Termos MeSH secundário: Doenças Cardiovasculares/patologia
Transtornos Cerebrovasculares/patologia
Doença Crônica/tratamento farmacológico
Medicamentos de Ervas Chinesas/química
Medicamentos de Ervas Chinesas/isolamento & purificação
Seres Humanos
Neoplasias/patologia
Doenças Neurodegenerativas/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Drugs, Chinese Herbal)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.2174/1381612822666161021161850


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[PMID]:28454636
[Au] Autor:Udesh R; Mehta A; Gleason T; Thirumala PD
[Ad] Endereço:Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
[Ti] Título:Carotid artery disease and perioperative stroke risk after surgical aortic valve replacement: A nationwide inpatient sample analysis.
[So] Source:J Clin Neurosci;42:91-96, 2017 Aug.
[Is] ISSN:1532-2653
[Cp] País de publicação:Scotland
[La] Idioma:eng
[Ab] Resumo:To study the role of carotid stenosis (CS) and cerebrovascular disease as independent risk factors for perioperative stroke following surgical aortic valve replacement (SAVR). The National Inpatient Sample (NIS) database was used for our study. All patients who underwent SAVR from 1999 to 2011 were identified using ICD-9 codes. Univariate and multivariate analysis of baseline characteristics, Elixhauser comorbidities and other covariates were examined to identify independent predictors of perioperative strokes following SAVR. Data on 50,979 patients who underwent SAVR from 1999 to 2011 was obtained. The mean age of the study cohort was 60.5. The study patients were predominantly Caucasian (79.3%) and males (60.01%). The incidence of perioperative stroke was 2.48%. CS (OR 1.8, 95%CI 1.1-2.8, p=0.009) and cerebral arterial occlusion (OR 3.4, 95% CI 1.3-8.9) significantly increased perioperative stroke risk following SAVR. Infective endocarditis (OR 4.6, 95%CI 3.8-5.6, p=0.00) and neurological disorders (OR 4.8, 95% CI 4-5.8, p=0.00) appeared to be the strongest risk factors for strokes. Other risk factors found to be significant predictors of perioperative strokes (p<0.05) were - age, higher VWR scores, CS, cerebral arterial occlusion, infective endocarditis, DM, HTN, renal failure, neurological disorders, coagulopathy and hypothyroidsm. In conclusion, perioperative stroke risk has remained more or less constant despite advancements in surgical techniques with risk having gone up in patients <65years of age. CS and cerebral arterial occlusion significantly increase stroke risk following SAVR. Improved patient selection with pre-operative risk stratification and institution of preventive strategies are necessary to improve operative outcomes following SAVR.
[Mh] Termos MeSH primário: Estenose da Valva Aórtica/epidemiologia
Valva Aórtica/cirurgia
Estenose das Carótidas/epidemiologia
Transtornos Cerebrovasculares/epidemiologia
Complicações Intraoperatórias/epidemiologia
Acidente Vascular Cerebral/epidemiologia
[Mh] Termos MeSH secundário: Idoso
Comorbidade
Feminino
Próteses Valvulares Cardíacas
Seres Humanos
Incidência
Pacientes Internados
Masculino
Meia-Idade
Fatores de Risco
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE



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