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Id: lil-494401
Autor: Buompadre, María Celeste; Arroyo, Hugo A.
Título: Accidente cerebrovascular isquemico: ¿desde dónde podemos actuar? / Ischemic stroke: wen to start prevention
Fonte: Med. infant;15(2):169-173, jun. 2008. ilus, tab.
Idioma: es.
Descritores: Acidente Vascular Cerebral/prevenção & controle
Isquemia Encefálica/etiologia
Isquemia Encefálica/prevenção & controle
Prevenção Primária
Prevenção Secundária
Prevenção Terciária
Limites: Feminino
Pré-Escolar
Tipo de Publ: Relatos de Casos
Responsável: AR94.1 - Centro de Información Pediatrica


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Id: lil-790601
Autor: Carvallo, P; Carvallo, E; Rivas, R; Carvallo, L; Sol, M. del.
Título: Oclusión de la arteria cerebral media en ataque cerebrovascular isquémico agudo / Middle cerebral artery occlusion in acute ischaemic cerebrovascular attack
Fonte: Int. j. med. surg. sci. (Print);3(1):747-751, 2016. ilus, tab.
Idioma: es.
Resumo: El ataque cerebrovascular isquémico (ACV) es una de las principales causas de morbimortalidad a nivel mundial y nacional. Se estudiaron 35 pacientes identificándose que las arterias que presentaron mayor frecuencia de oclusión en el ACV isquémico agudo fueron la arteria cerebral media y la arteria cerebral posterior. Consideramos necesario que los especialistas puedan localizaran atómicamente los ACV para la aplicación de terapias neuroprotectoras mejorando las opciones de tratamiento y previniendo obstrucciones secundarias.

Ischaemic stroke (CVA) is one of the leading causes of morbidity and mortality at a global and national level. We studied 35 patients, determined the arteries that presented a higher frequency of occlusion in acute ischemic stroke and identified the middle cerebral artery and the posterior cerebral artery. We consider it necessary that specialists can locate anatomically strokes in order to apply neuroprotective therapies to improve treatment options and preventing secondary obstructions.
Descritores: Infarto da Artéria Cerebral Média/epidemiologia
Infarto da Artéria Cerebral Posterior/epidemiologia
Isquemia Encefálica/complicações
-Acidente Vascular Cerebral/complicações
Doença Aguda
Imageamento por Ressonância Magnética
Infarto da Artéria Cerebral Média/patologia
Infarto da Artéria Cerebral Posterior/patologia
Índice de Gravidade de Doença
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso de 80 Anos ou mais
Responsável: CL1.1 - Biblioteca Central


  3 / 593 LILACS  
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Texto completo SciELO Brasil
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Id: biblio-1278925
Autor: Zhang, Huiying; Zheng, Lei.
Título: Statistical analysis for efficacy of tirofiban combined with ozagrel in the treatment of progressive cerebral infarction patients out of thrombolytic therapy time window
Fonte: Clinics;76:e2728, 2021. tab, graf.
Idioma: en.
Resumo: OBJECTIVES: To investigate the safety and efficacy of combined tirofiban-ozagrel therapy for treating progressive stroke patients out of thrombolytic therapy time window. METHODS: This prospective, double-blind, randomized controlled study included 337 patients who had experienced an acute ischemic stroke between November 2017 and December 2018. All patients were randomized into three groups: 1) the tirofiban/ozagrel group (n=113), 2) the tirofiban group (n=110), and 3) the ozagrel group (n=114). The platelet aggregation (PAG), thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen (FIB) levels in the patients from these groups were evaluated before starting treatment and then, at 24h, 7 days, and 14 days after treatment. The National Institutes of Health Stroke Scale (NIHSS) scores were evaluated before treatment and then, 24h, 1 week, 2 weeks, and 4 weeks after treatment. The Barthel Index (BI) score was used to measure safety, and the modified Rankin scale (mRS) was used to evaluate disability following 3 months of treatment. The risk factors affecting clinical outcomes were analyzed using logistic multivariate regression. RESULTS: The mean NIHSS score for all the patients was 13.17±3.13 before treatment, and no significant difference between the basic clinical parameters of the three patient groups was found. Following treatment, both PAG and FIB were significantly reduced compared with the baseline (p<0.05). The levels of PAG and FIB in the tirofiban/ozagrel group were significantly lower than those in the tirofiban and ozagrel groups at 24h and 7 days after treatment (p<0.05). The NIHSS score decreased significantly in all treatment groups (p<0.05). The tirofiban/ozagrel NIHSS scores were significantly lower than that of the tirofiban and ozagrel groups at 24h, 1 week, and 2 weeks post initiation (p<0.05 for all). There were no significant differences in the BI and mRS scores or the intracranial hemorrhage rates; further, age, sex, Trial of ORG 10172 in acute stroke treatment (TOAST) type, baseline NIHSS and 24-h NIHSS scores, baseline thrombus-related factors, and treatment methods were shown to not be independent risk factors for clinical outcomes. CONCLUSION: The combination of tirofiban and ozagrel, as well as monotherapy with either tirofiban or ozagrel, transiently improves the neural function of patients and reduces platelet aggregation and fibrinogen formation in the first 4 weeks following a stroke event; additionally, none of these treatments increased the risk for hemorrhage in these progressive stroke patients over a 3-month period.
Descritores: Isquemia Encefálica/tratamento farmacológico
Acidente Vascular Cerebral/tratamento farmacológico
-Terapia Trombolítica
Infarto Cerebral/tratamento farmacológico
Método Duplo-Cego
Estudos Prospectivos
Resultado do Tratamento
Tirofibana/uso terapêutico
Metacrilatos
Limites: Humanos
Tipo de Publ: Ensaio Clínico Controlado Aleatório
Responsável: BR1.1 - BIREME


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Texto completo SciELO Chile
Texto completo
Id: biblio-961451
Autor: Reyes S, Pablo; Badilla O, Lautaro; Andreu, Daniel; Besa, Valentina; Rivera, Rodrigo; Sordo, Gabriel; Bustamante, Gonzalo; Pasten, Juan A; Vargas, Gabriel; Silva, Paula; Guerrero, Rodrigo; Feuerhake, Walter.
Título: Experiencia en el tratamiento endovascular del accidente cerebrovascular isquémico agudo en un centro chileno / Emergency endovascular management of ischemic stroke: experience in 104 patients
Fonte: Rev. méd. Chile;146(6):708-716, jun. 2018. tab, graf.
Idioma: es.
Resumo: Background: Recently, five randomized controlled trials confirmed the efficacy and safety of endovascular treatment with or without intravenous thrombolysis in acute ischemic stroke with large-vessel occlusion. Aim: To report patients with ischemic stroke treated with endovascular methods. Material and Methods: Retrospective analysis of 104 patients aged 61 ± 15 years (54% males) with ischemic stroke who received endovascular treatment at a single medical center between 2009 and 2017. Results: Sixty one percent were treated with intravenous thrombolysis plus endovascular procedures and 39% with endovascular procedures alone. The median door-to needle time was 61 minutes and door-to femoral puncture was 135 minutes. The median National Institute of Health Stroke Scale (NIHSS) scores on admission, 24 hours later and at discharge were 12,4 and 1 points, respectively. Middle cerebral artery was occluded in 60% of cases. Other frequent localizations where distal carotid artery in 17% and vertebro-basilar artery in 14%. Thrombolysis in cerebral infarction (TICI) scale flow score after the procedure was 3 or 2b in 58% of cases and significantly correlated with NIHSS scores at 24 hours and discharge. Fifty percent of patients had a mRankin score < = 1 and ten patients died (9.6%). Eight percent had a symptomatic intracerebral hemorrhage. Conclusions: The clinical improvement of these patients 24 hours after the procedure and at discharge demonstrate the effectiveness of endovascular treatment in ischemic stroke. The presence neurologists able to interpret multimodal images at the emergency room, the use of local guidelines, the availability of an experienced neuro-interventional team engaged with the workflow and the use of stent retrievers are strongly associated with good outcomes.
Descritores: Terapia Trombolítica/métodos
Isquemia Encefálica/terapia
Acidente Vascular Cerebral/terapia
Procedimentos Endovasculares/métodos
-Fatores de Tempo
Índice de Gravidade de Doença
Isquemia Encefálica/diagnóstico por imagem
Estudos Retrospectivos
Análise de Variância
Resultado do Tratamento
Estatísticas não Paramétricas
Acidente Vascular Cerebral/diagnóstico por imagem
Tempo para o Tratamento
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Idoso de 80 Anos ou mais
Adulto Jovem
Responsável: CL1.1 - Biblioteca Central


  5 / 593 LILACS  
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Resende, Luiz Antonio de Lima
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Id: biblio-890770
Autor: Luvizutto, Gustavo José; Moliga, Augusta Fabiana; Rizzatti, Gabriela Rizzo Soares; Fogaroli, Marcelo Ortolani; Moura Neto, Eduardo de; Nunes, Hélio Rubens de Carvalho; Resende, Luiz Antônio de Lima; Bazan, Rodrigo.
Título: Unilateral spatial neglect in the acute phase of ischemic stroke can predict long-term disability and functional capacity
Fonte: Clinics;73:e131, 2018. tab, graf.
Idioma: en.
Projeto: FAPESP.
Resumo: OBJECTIVE: The aim of this study was to assess the relationship between the degree of unilateral spatial neglect during the acute phase of stroke and long-term functional independence. METHODS: This was a prospective study of right ischemic stroke patients in which the independent variable was the degree of spatial neglect and the outcome that was measured was functional independence. The potential confounding factors included sex, age, stroke severity, topography of the lesion, risk factors, glycemia and the treatment received. Unilateral spatial neglect was measured using the line cancellation test, the star cancellation test and the line bisection test within 48 hours of the onset of symptoms. Functional independence was measured using the modified Rankin and Barthel scales at 90 days after discharge. The relationship between unilateral spatial neglect and functional independence was analyzed using multiple logistic regression that was corrected for confounding factors. RESULTS: We studied 60 patients with a median age of 68 (34-89) years, 52% of whom were male and 74% of whom were Caucasian. The risk for moderate to severe disability increased with increasing star cancellation test scores (OR=1.14 [1.03-1.26], p=0.01) corrected for the stroke severity, which was a confounding factor that had a statistically positive association with disability (OR=1.63 [1.13-2.65], p=0.01). The best chance of functional independence decreased with increasing star cancellation test scores (OR=0.86 [0.78-0.96], p=0.006) corrected for the stroke severity, which was a confounding factor that had a statistically negative association with independence (OR=0.66 [0.48-0.92], p=0.017). CONCLUSION: The severity of unilateral spatial neglect in acute stroke worsens the degree of long-term disability and functional independence.
Descritores: Transtornos da Percepção/etiologia
Transtornos da Percepção/fisiopatologia
Isquemia Encefálica/complicações
Isquemia Encefálica/fisiopatologia
Acidente Vascular Cerebral/complicações
Avaliação da Deficiência
-Prognóstico
Índice de Gravidade de Doença
Modelos Logísticos
Estudos Prospectivos
Fatores de Risco
Acidente Vascular Cerebral/fisiopatologia
Testes Neuropsicológicos
Tipo de Publ: Research Support, Non-U.S. Gov't
Estudo Observacional
Responsável: BR1.1 - BIREME


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Id: biblio-952813
Autor: Grilletti, Juliana Valente Francica; Scapini, Katia Bilhar; Bernardes, Nathalia; Spadari, Jaqueline; Bigongiari, Aline; Mazuchi, Flavia de Andrade e Souza; Caperuto, Erico Chagas; Sanches, Iris Callado; Rodrigues, Bruno; De Angelis, Kátia.
Título: Impaired baroreflex sensitivity and increased systolic blood pressure variability in chronic post-ischemic stroke
Fonte: Clinics;73:e253, 2018. tab, graf.
Idioma: en.
Resumo: OBJECTIVES: Acute post-stroke patients present cardiovascular autonomic dysfunction, which manifests as lower heart rate variability and impaired baroreflex sensitivity. However, few studies performed to date have evaluated cardiovascular autonomic function in chronic post-stroke patients. The aim of this study was to evaluate cardiovascular autonomic modulation in chronic post-ischemic stroke patients. METHODS: The seventeen enrolled subjects were divided into a stroke group (SG, n=10, 5±1 years after stroke) and a control group (CG, n=7). Non-invasive curves for blood pressure were continuously recorded (Finometer®) for 15 minutes while the subject was in a supine position. Heart rate variability and blood pressure variability were analyzed in the time and frequency domains. RESULTS: No differences were observed in systolic and diastolic pressure and heart rate between post-stroke patients and healthy individuals. The SG group had lower indexes for heart rate variability in the time domain (standard deviation of normal to normal R-R intervals, SDNN; variance of normal to normal R-R intervals, VarNN; and root mean square differences of successive R-R intervals, RMSSD) and a lower high-frequency band for heart rate variability than was observed in the CG. Systolic blood pressure variability and the low-frequency band for systolic pressure were higher in post-stroke patients, while the alpha index was lower in the SG than in the CG. CONCLUSION: After ischemic stroke, affected patients present chronically reduced heart rate variability, impaired cardiac vagal modulation, increased systolic blood pressure variability and higher sympathetic vascular modulation along with impaired baroreflex sensitivity, which can increase the risk of cardiovascular events, despite adequate blood pressure control.
Descritores: Sistema Nervoso Autônomo/fisiopatologia
Isquemia Encefálica/fisiopatologia
Barorreflexo/fisiologia
Frequência Cardíaca/fisiologia
Hipertensão/fisiopatologia
-Estudos de Casos e Controles
Doença Crônica
Eletrocardiografia
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME


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Id: biblio-1039559
Autor: Sun, Hongwei; Cai, Juan; Shen, Shiqi; Ren, Xiaohui.
Título: Hypothermia treatment ameliorated cyclin-dependent kinase 5-mediated inflammation in ischemic stroke and improved outcomes in ischemic stroke patients
Fonte: Clinics;74:e938, 2019. tab, graf.
Idioma: en.
Resumo: OBJECTIVES: The inflammatory response is a key mechanism of neuronal damage and loss during acute ischemic stroke. Hypothermia has shown promise as a treatment for ischemic stroke. In this study, we investigated the molecular signaling pathways in ischemic stroke after hypothermia treatment. METHODS: Cyclin-dependent kinase 5 (CDK5) was overexpressed or silenced in cultured cells. Nuclear transcription factor-κB (NF-κB) activity was assessed by measurement of the luciferase reporter gene. An ischemic stroke model was established in Sprague-Dawley (SD) rats using the suture-occluded method. Animals were assigned to three groups: sham operation control, ischemic stroke, and ischemic stroke + hypothermia treatment groups. Interleukin 1β (IL-1β) levels in the culture supernatant and blood samples were assessed by ELISA. Protein expression was measured by Western blotting. RESULTS: In HEK293 cells and primary cortical neuronal cultures exposed to hypothermia, CDK5 overexpression was associated with increased IL-1β, caspase 1, and NF-κB levels. In both a murine model of stroke and in patients, increased IL-1β levels were observed after stroke, and hypothermia treatment was associated with lower IL-1β levels. Furthermore, hypothermia-treated patients showed significant improvement in neurophysiological functional outcome. CONCLUSIONS: Overall, hypothermia offers clinical benefit, most likely through its effects on the inflammatory response.
Descritores: Isquemia Encefálica/terapia
NF-kappa B/sangue
Quinase 5 Dependente de Ciclina/sangue
Interleucina-1beta/sangue
Hipotermia Induzida/métodos
Inflamação/sangue
-Ensaio de Imunoadsorção Enzimática
Biomarcadores/sangue
Isquemia Encefálica/sangue
Western Blotting
Doença Aguda
Resultado do Tratamento
Ratos Sprague-Dawley
Modelos Animais de Doenças
Limites: Humanos
Animais
Ratos
Responsável: BR1.1 - BIREME


  8 / 593 LILACS  
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Id: biblio-1089602
Autor: Yan, Li; Zhou, Xiaodong; Yang, Xiaobin; Zheng, Yu; Liu, Chunying; Zheng, Lili; Fang, Ling; Luo, Wen; He, Guangbin; He, Jianguo; Zheng, Jianmin; Zhou, Yin.
Título: Establishment and evaluation of a monkey acute cerebral ischemia model
Fonte: Clinics;75:e1339, 2020. graf.
Idioma: en.
Projeto: National Key Research and Development Program of China.
Resumo: OBJECTIVES: Cerebral ischemia seriously threatens human health and is characterized by high rates of incidence, disability and death. Developing an ideal animal model of cerebral ischemia that reflects the human clinical features is critical for pathological studies and clinical research. The goal of this study is to establish a local cerebral ischemia model in rhesus macaque, thereby providing an optimal animal model to study cerebral ischemia. METHODS: Eight healthy rhesus monkeys were selected for this study. CT scans were performed before the operation to exclude cerebral vascular and intracranial lesions. Under guidance and monitoring with digital subtraction angiography (DSA), a microcatheter was inserted into the M1 segment of the middle cerebral artery (MCA) via the femoral artery. Then, autologous white thrombi were introduced to block blood flow. Immediately following embolization, multisequence MRI was used to monitor cerebrovascular and brain parenchymal conditions. Twenty-four hours after embolization, 2 monkeys were sacrificed and subjected to perfusion, fixation and pathological examination. RESULTS: The cerebral ischemia model was established in 7 rhesus monkeys; one animal died during intubation. DSA and magnetic resonance angiography (MRA) indicated the presence of an arterial occlusion. MRI showed acute local cerebral ischemia. HE staining revealed infarct lesions formed in the brain tissues, and thrombi were present in the cerebral artery. CONCLUSION: We established a rhesus macaque model of local cerebral ischemia by autologous thrombus placement. This model has important implications for basic and clinical research on cerebral ischemia. MRI and DSA can evaluate the models to ensure accuracy and effectiveness.
Descritores: Infarto Cerebral/diagnóstico por imagem
Isquemia Encefálica/diagnóstico por imagem
-Angiografia Digital
China
Macaca mulatta
Modelos Biológicos
Modelos Cardiovasculares
Limites: Humanos
Animais
Masculino
Responsável: BR1.1 - BIREME


  9 / 593 LILACS  
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Id: biblio-1133483
Autor: Muengtaweepongsa, Sombat; Srivilaithon, Winchana.
Título: Hypothermia treatment reduced cyclin-dependent kinase 5-mediated inflammation in ischemic stroke and improved outcomes in ischemic stroke patients
Fonte: Clinics;75:e1992, 2020.
Idioma: en.
Descritores: Isquemia Encefálica
Acidente Vascular Cerebral
Hipotermia
Hipotermia Induzida
-Quinase 5 Dependente de Ciclina
Inflamação
Limites: Humanos
Tipo de Publ: Comentário
Responsável: BR1.1 - BIREME


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Texto completo
Id: biblio-1040257
Autor: Lima, Helbert do Nascimento; Saibel, Tais; Colato, Gisele; Cabral, Norberto Luiz.
Título: The impact of acute kidney injury on fatality of ischemic stroke from a hospital-based population in Joinville, Brazil / O impacto da insuficiência renal aguda na letalidade do acidente vascular cerebral isquêmico de uma população de base hospitalar em Joinville, Brasil
Fonte: J. bras. nefrol;41(3):323-329, July-Sept. 2019. tab, graf.
Idioma: en.
Resumo: Abstract Introduction: The occurrence of acute kidney injury (AKI) after ischemic stroke has been associated to a worse prognosis. There is a lack of Brazilian studies evaluating this issue. This study aimed to describe the impact of AKI after a first-ever ischemic stroke in relation to fatality rate in 30 days. Methods: This was a retrospective hospital-based cohort. We included patients who had their first ischemic stroke between January to December 2015. AKI was defined by an increase of serum creatinine in relation to baseline value at admission ≥ 0.3 mg/dL or a rise in serum creatinine level by 1.5 times the baseline value at any point in the first week after admission. We performed a univariate and multivariate analysis to evaluate the presence of AKI with fatality in 30 days. Results: The final study population (n=214) had mean age of 66.46 ± 13.73 years, 48.1% were men, the mean NIHSS was 6.33 ± 6.27 and 20 (9.3%) presented AKI. Patients with AKI were older, had a higher score on the NIHSS, and had higher creatinine values on hospital discharge. The 30-day mortality was higher in the AKI subgroup compared to non-AKI (35% vs. 6.2%, p < 0.001). AKI was an independent predictor of fatality after an ischemic stroke but limited by severity of stroke (NIHSS). Conclusion: The presence of AKI is an important complication after ischemic stroke. Despite its impact on 30-day fatality, the predictive strength of AKI was limited by the severity of stroke.

Resumo Introdução: A ocorrência de insuficiência renal aguda (IRA) após acidente vascular cerebral isquêmico (AVCI) está associada a pior prognóstico. Há uma deficiência de estudos brasileiros a respeito dessa questão. O presente estudo teve como objetivo descrever o impacto da IRA após o primeiro episódio de AVCI em relação à taxa de letalidade em 30 dias. Métodos: A presente coorte retrospectiva de base hospitalar incluiu pacientes que sofreram seu primeiro AVCI entre janeiro e dezembro de 2015. IRA foi definida por elevações da creatinina sérica em relação ao valor basal na internação ≥ 0.3 mg/dL ou aumento da creatinina sérica equivalente a 1,5 vez o valor basal em qualquer instante durante a primeira semana após a internação. Foi realizada análise univariada e multivariada para avaliar a presença de IRA com letalidade em 30 dias. Resultados: A população final do estudo (n = 214) apresentou média de idade de 66,46 ± 13,73 anos; 48,1% eram homens; a média de pontuação no NIHSS foi 6,33 ± 6,27; e 20 (9,3%) apresentaram IRA. Pacientes com IRA tinham idade mais avançada, pontuação maior na NIHSS e valores mais elevados de creatinina no momento da alta hospitalar. A mortalidade em 30 dias foi maior no subgrupo com IRA em comparação ao grupo sem IRA (35% vs. 6,2%, p < 0,001). IRA foi preditor independente de mortalidade após AVCI, porém limitado pela gravidade do acidente vascular cerebral (NIHSS). Conclusão: A presença de IRA é uma complicação importante após AVCI. Apesar de seu impacto na letalidade de 30 dias, a força preditiva da IRA foi limitada pela gravidade do AVC.
Descritores: Isquemia Encefálica/complicações
Isquemia Encefálica/mortalidade
Mortalidade Hospitalar
Acidente Vascular Cerebral/complicações
Injúria Renal Aguda/etiologia
Injúria Renal Aguda/epidemiologia
-Prognóstico
Índice de Gravidade de Doença
Brasil/epidemiologia
Prevalência
Estudos Retrospectivos
Fatores de Risco
Creatinina/sangue
Acidente Vascular Cerebral/mortalidade
Estimativa de Kaplan-Meier
Hospitalização
Limites: Humanos
Masculino
Feminino
Pessoa de Meia-Idade
Idoso
Idoso de 80 Anos ou mais
Responsável: BR1.1 - BIREME



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