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[PMID]:29353037
[Au] Autor:Lu Z; Liu Y; Shi Y; Shi X; Wang X; Xu C; Zhao H; Dong Q
[Ad] Endereço:Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, PR China.
[Ti] Título:Curcumin protects cortical neurons against oxygen and glucose deprivation/reoxygenation injury through flotillin-1 and extracellular signal-regulated kinase1/2 pathway.
[So] Source:Biochem Biophys Res Commun;496(2):515-522, 2018 02 05.
[Is] ISSN:1090-2104
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In this study, we provided evidence that curcumin could be a promising therapeutic agent for ischemic stroke by activating neuroprotective signaling pathways. Post oxygen and glucose deprivation/reoxygenation (OGD/R), primary mouse cortical neurons treated with curcumin exhibited a significant decrease in cell death, LDH release and enzyme caspase-3 activity under OGD/R circumstances, which were abolished by flotillin-1 downregulation or extracellular signal-regulated kinase (ERK) inhibitor. Moreover, flotillin-1 knockdown led to suppression of curcumin-mediated ERK phosphorylation under OGD/R condition. Based on these findings, we concluded that curcumin could confer neuroprotection against OGD/R injury through a novel flotillin-1 and ERK1/2 pathway.
[Mh] Termos MeSH primário: Isquemia Encefálica/tratamento farmacológico
Curcumina/farmacologia
Sistema de Sinalização das MAP Quinases/efeitos dos fármacos
Proteínas de Membrana/metabolismo
Neurônios/efeitos dos fármacos
Fármacos Neuroprotetores/farmacologia
[Mh] Termos MeSH secundário: Animais
Isquemia Encefálica/metabolismo
Células Cultivadas
Córtex Cerebelar/citologia
Córtex Cerebelar/efeitos dos fármacos
Feminino
Glucose/metabolismo
Masculino
Camundongos Endogâmicos BALB C
Neurônios/metabolismo
Oxigênio/metabolismo
Traumatismo por Reperfusão/tratamento farmacológico
Traumatismo por Reperfusão/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Membrane Proteins); 0 (Neuroprotective Agents); 0 (flotillins); IT942ZTH98 (Curcumin); IY9XDZ35W2 (Glucose); S88TT14065 (Oxygen)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180122
[St] Status:MEDLINE


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[PMID]:29203753
[Au] Autor:Starostka-Tatar A; Labuz-Roszak B; Skrzypek M; Gasior M; Gierlotka M
[Ad] Endereço:Katedra I Klinika Neurologii W Zabrzu, Slaski Uniwersytet Medyczny W Katowicach, Zabrze, Polska.
[Ti] Título:[Definition and treatment of stroke over the centuries].
[So] Source:Wiad Lek;70(5):982-987, 2017.
[Is] ISSN:0043-5147
[Cp] País de publicação:Poland
[La] Idioma:pol
[Ab] Resumo:Stroke was already diagnosed in the ancient times. For hundreds of years the treatment of this disease has changed radically. According to the current WHO definition, stroke is a clinical syndrome caused by focal or generalized brain injury that lasts more than 24 hours or leads to death and has no other cause than vascular. Stroke constitutes a big social and economic problem, as it can lead to death or disability. In the highly developed countries stroke is the third most common cause of adult deaths, the second leading cause of dementia, and the most common cause of disability. The consequences of stroke also include epilepsy and depression. In the twentieth century, stroke was only treated symptomatically and rehabilitation was limited to passive exercises. The first breakthrough in ischemic stroke therapy was the introduction of aspirin (ASA), followed by intravenous thrombolysis using recombinant tissue plasminogen activator (rtPA), initially available in our country only in the drug programs, and since 2009 it has been reimbursed by the National Health Fund (NFZ). Gradually invasive stroke treatment has been developed. Mechanical thrombectomy is currently only performed in selected centers, giving hope for more effective stroke treatment. The purpose of this work was to show how stroke treatment has changed over the centuries.
[Mh] Termos MeSH primário: Isquemia Encefálica/terapia
Reabilitação do Acidente Vascular Cerebral
Acidente Vascular Cerebral/terapia
[Mh] Termos MeSH secundário: Terapia Combinada
Fibrinolíticos/uso terapêutico
Seres Humanos
Trombectomia/métodos
Terapia Trombolítica/métodos
Ativador de Plasminogênio Tecidual/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Fibrinolytic Agents); EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


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[PMID]:29203746
[Au] Autor:Cwielag J; Woldanska-Okonska M
[Ad] Endereço:Sosnowiecki Szpital Miejski Sp. Z O.O. Oddzial Ortopedii I Traumatologii Narzadu Ruchu, Sosnowiec , Polska.
[Ti] Título:[Effectiveness of early physiotherapy treatment for ischaemic stroke patients suffering intercurrently from post-stroke depression and/or hemispatial neglect syndromes].
[So] Source:Wiad Lek;70(5):939-945, 2017.
[Is] ISSN:0043-5147
[Cp] País de publicação:Poland
[La] Idioma:pol
[Ab] Resumo:Wstep: Depresja poudarowa i zespol pomijania stronnego sa jednymi z szeregu zaburzen neurologicznych wystepujacych jako konsekwencje incydentu udarowego. Oba zaburzenia uwaza sie za czynniki negatywnie wplywajace na szybszy powrot pacjenta do zdrowia. Zadaniem wczesnej fizjoterapii po incydencie udarowym jest poprawa funkcji motorycznych oraz poprawa jakosci zycia pacjenta. Material i metody: W badaniu wzielo udzial 51 pacjentow zakwalifikowanych do wziecia udzialu w "Narodowym Programie Profilaktyki i Leczenia Chorob Ukladu Sercowo-Naczyniowego na lata 2006-2008 POLCARD". Wyniki badan pacjentow notowano w skali Barthel, NIH oraz Geriatrycznej Skali Oceny Depresji. Analiza statystyczna zostala wykonana w programie STATISTICA 6PL za pomoca testu Wilcoxona dla prob zaleznych. Wyniki: Analiza wynikow wykazala, ze osoby z zespolem zaniedbywania osiagnely wiekszy przyrost punktow w skali Barthel niz osoby bez zespolu pomijania stronnego (p≤0,05). Natomiast badanie osob z depresja poudarowa wykazaly wiekszy przyrost punktow w skali Barthel niz pacjenci, u ktorych depresja nie zostala stwierdzona. Wnioski: Skutecznosc wczesnej fizjoterapii zalezy od ciezkosci udaru, stopnia niepelnosprawnosci oraz czynnikow zaburzajacych, takich jak m.in. agnozja wzrokowo-przestrzenna lub depresja. Jednakze pacjenci ze wspolistniejacymi zespolami neurologicznymi poddani kompleksowej fizjoterapii we wczesnym okresie po udarze mozgu maja prawdopodobnie wieksza rezyliencje w zakresie motywacji, zdolnosci adaptacyjno-kompensacyjnych, czyli generalnie dotyczacych plastycznosci mozgu.
[Mh] Termos MeSH primário: Isquemia Encefálica/complicações
Isquemia Encefálica/reabilitação
Depressão/terapia
Transtornos da Percepção/terapia
Reabilitação do Acidente Vascular Cerebral/métodos
[Mh] Termos MeSH secundário: Animais
Depressão/etiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Modalidades de Fisioterapia
Síndrome
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


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[PMID]:29203738
[Au] Autor:Popruha AA; Bobyreva LE; Samarchenko LA; Mykhaylychenko TE
[Ad] Endereço:Higher State Educational Establishment Of Ukraine, "Ukrainian Medical Dental Academy", Poltava, Ukraine.
[Ti] Título:Mathematical model of diabetic encephalopathy.
[So] Source:Wiad Lek;70(5):906-909, 2017.
[Is] ISSN:0043-5147
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Diabetes mellitus (DM) is one of the leading risk factors for cerebrovascular disorders. The risk of stroke is 3-4 times higher in this population. In 10% of cases of vascular accidents in diabetic patients leads to fatal. The mortality rate for ischemic stroke is undergoing 50-60% and 70-95% of hemorrhagic form. It is known that diabetes increases the course of acute disorders of cerebral circulation. At the same time, there are data that about 415 million of the inhabitants of the planet suffer from diabetes, in 95% of cases they have type 2 diabetes, which is the second risk factor for the development of ischemic stroke after an arterial hypertension. This determines the relevance of studying the factors that affect the development of the ischemic process in patients with diabetes The aim of this research is to optimize the methods for diagnosis of diabetic encephalopathy based on a study of indicators of cerebrovascular hemodynamics, functional state of the brain, metabolic disorders and morphological characteristics of the brain tissue. MATERIALS AND METHODS: It was carried out a comprehensive survey of 537 patients with diabetes, including type 1 diabetes is set to 342 (63.7%) type 2 diabetes - in 195 (36.3%) patients. In 108 (20.1%) patients with diabetes, the clinical syndrome DE not identified in 429 (79.9%) - found DE I, II and stage III disease. CONCLUSIONS: Construction of mathematical model allows to objectify the diagnosis where with the help of clinical and metabolic parameters without expensive equipment. At the same time, the availability of informative indicators identified will allow the doctor to diagnose DE the early stages or to predict its development and to discover at the preclinical stage.
[Mh] Termos MeSH primário: Isquemia Encefálica/etiologia
Diabetes Mellitus Tipo 1/complicações
Diabetes Mellitus Tipo 2/complicações
Modelos Teóricos
[Mh] Termos MeSH secundário: Seres Humanos
Hipertensão/complicações
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


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[PMID]:29489691
[Au] Autor:Murayama K; Suzuki S; Matsukiyo R; Takenaka A; Hayakawa M; Tsutsumi T; Fujii K; Katada K; Toyama H
[Ad] Endereço:Department of Radiology, Fujita Health University.
[Ti] Título:Preliminary study of time maximum intensity projection computed tomography imaging for the detection of early ischemic change in patient with acute ischemic stroke.
[So] Source:Medicine (Baltimore);97(9):e9906, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Noncontrast computed tomography (NCCT) has been used for the detection of early ischemic change (EIC); however, correct interpretation of NCCT findings requires much clinical experience. This study aimed to assess the accuracy of time maximum intensity projection computed tomography technique (tMIP), which reflects the maximum value for the time phase direction from the dynamic volume data for each projected plane, for detection of EIC, against that of NCCT.Retrospective review of NCCT, cerebral blood volume in CT perfusion (CTP-CBV), and tMIP of 186 lesions from 280 regions evaluated by Alberta Stroke Program Early CT Score (ASPECTS) in 14 patients with acute middle cerebral artery stroke who had undergone whole-brain CTP using 320-row area detector CT was performed. Four radiologists reviewed EIC on NCCT, CTP-CBV, and tMIP in each ASPECTS region at onset using the continuous certainty factor method. Receiver operating characteristic analysis was performed to compare the relative performance for detection of EIC. The correlations were evaluated.tMIP-color showed the best discriminative value for detection of EIC. There were significant differences in the area under the curve for NCCT and tMIP-color, CTP-CBV (P < .05). Scatter plots of ASPECTS showed a positive significant correlation between NCCT, tMIP-gray, tMIP-color, and the follow-up study (NCCT, r = 0.32, P = .0166; tMIP-gray, r = 0.44, P = .0007; tMIP-color, r = 0.34, P = .0104).Because tMIP provides a high contrast parenchymal image with anatomical and vascular information in 1 sequential scan, it showed greater accuracy for detection of EIC and predicted the final infarct extent more accurately than NCCT based on ASPECTS.
[Mh] Termos MeSH primário: Isquemia Encefálica/diagnóstico por imagem
Infarto da Artéria Cerebral Média/diagnóstico por imagem
Acidente Vascular Cerebral/diagnóstico por imagem
Tomografia Computadorizada por Raios X/estatística & dados numéricos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Área Sob a Curva
Encéfalo/irrigação sanguínea
Circulação Cerebrovascular
Feminino
Seguimentos
Seres Humanos
Masculino
Curva ROC
Estudos Retrospectivos
Fatores de Tempo
Tomografia Computadorizada por Raios X/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009906


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[PMID]:28747463
[Au] Autor:Man S; Schold JD; Uchino K
[Ad] Endereço:From the Clinical Neuroscience Institute, Miami Valley Hospital, Wright State University Boonshoft School of Medicine Dayton, OH (S.M.); Department of Quantitative Health Sciences, Cleveland Clinic, OH (J.D.S.); and Cerebrovascular Center, Neurological Institute, Cleveland Clinic, OH (K.U.).
[Ti] Título:Impact of Stroke Center Certification on Mortality After Ischemic Stroke: The Medicare Cohort From 2009 to 2013.
[So] Source:Stroke;48(9):2527-2533, 2017 09.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: An increasing number of hospitals have been certified as primary stroke centers (PSCs). It remains unknown whether the action toward PSC certification has improved the outcome of stroke care. This study aimed to understand whether PSC certification reduced stroke mortality. METHODS: We examined Medicare fee-for-service beneficiaries aged ≥65 years who were hospitalized between 2009 and 2013 for ischemic stroke. Hospitals were classified into 3 groups: new PSCs, the hospitals that received initial PSC certification between 2009 and 2013 (n=634); existing PSCs, the PSCs certified before 2009 (n=785); and non-SCs, the hospitals that have never been certified as PSCs (n=2640). Multivariate logistic regression and Cox proportional hazards model was used to compare the mortality among the 3 groups. RESULTS: Existing PSCs were significantly larger than new PSCs as reflected by total number of beds and annual stroke admission ( <0.0001). Compared with existing PSCs, new PSCs had lower in-hospital (odds ratio, 0.862; 95% confidence interval [CI], 0.817-0.910) and 30-day mortality (hazard ratio [HR], 0.981; 95% CI, 0.968-0.993), after adjusting for patient demographics and comorbidities. Compared with non-SCs, new PSCs had lower adjusted in-hospital (odds ratio, 0.894; 95% CI, 0.848-0.943), 30-day (HR, 0.904; 95% CI, 0.892-0.917), and 1-year mortality (HR, 0.907; 95% CI, 0.898-0.915). Existing PSCs had lower adjusted 30-day (HR, 0.922; 95% CI, 0.911-0.933) and 1-year mortality (HR, 0.900; 95% CI, 0.892-0.907) than non-SCs. CONCLUSIONS: Obtaining stroke certification may reduce stroke mortality and overcome the disadvantage of being smaller hospitals. Further study of other outcome measures will be useful to improve stroke system of care.
[Mh] Termos MeSH primário: Isquemia Encefálica/mortalidade
Certificação/estatística & dados numéricos
Hospitais/estatística & dados numéricos
Acidente Vascular Cerebral/mortalidade
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Planos de Pagamento por Serviço Prestado
Feminino
Seres Humanos
Joint Commission on Accreditation of Healthcare Organizations
Modelos Logísticos
Masculino
Medicare
Análise Multivariada
Prognóstico
Modelos de Riscos Proporcionais
Qualidade da Assistência à Saúde
Estudos Retrospectivos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.116.016473


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[PMID]:28468926
[Au] Autor:Lubitz SA; Parsons OE; Anderson CD; Benjamin EJ; Malik R; Weng LC; Dichgans M; Sudlow CL; Rothwell PM; Rosand J; Ellinor PT; Markus HS; Traylor M; WTCCC2, International Stroke Genetics Consortium, and AFGen Consortia
[Ad] Endereço:From the Stroke Research Center (C.D.A., J.R.), Center for Human Genetic Research (C.D.A., J.R.), and Cardiovascular Research Center (S.A.L., L.-C.W., P.T.E.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics, The Broad Insitute of Harvard and MIT, Cambridge, MA (S.
[Ti] Título:Atrial Fibrillation Genetic Risk and Ischemic Stroke Mechanisms.
[So] Source:Stroke;48(6):1451-1456, 2017 06.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Atrial fibrillation (AF) is a leading cause of cardioembolic stroke, but the relationship between AF and noncardioembolic stroke subtypes are unclear. Because AF may be unrecognized, and because AF has a substantial genetic basis, we assessed for predisposition to AF across ischemic stroke subtypes. METHODS: We examined associations between AF genetic risk and Trial of Org 10172 in Acute Stroke Treatment stroke subtypes in 2374 ambulatory individuals with ischemic stroke and 5175 without from the Wellcome Trust Case-Control Consortium 2 using logistic regression. We calculated AF genetic risk scores using single-nucleotide polymorphisms associated with AF in a previous independent analysis across a range of preselected significance thresholds. RESULTS: There were 460 (19.4%) individuals with cardioembolic stroke, 498 (21.0%) with large vessel, 474 (20.0%) with small vessel, and 814 (32.3%) individuals with strokes of undetermined cause. Most AF genetic risk scores were associated with stroke, with the strongest association ( =6×10 ) attributed to scores of 944 single-nucleotide polymorphisms (each associated with AF at <1×10 in a previous analysis). Associations between AF genetic risk and stroke were enriched in the cardioembolic stroke subset (strongest =1.2×10 , 944 single-nucleotide polymorphism score). In contrast, AF genetic risk was not significantly associated with noncardioembolic stroke subtypes. CONCLUSIONS: Comprehensive AF genetic risk scores were specific for cardioembolic stroke. Incomplete workups and subtype misclassification may have limited the power to detect associations with strokes of undetermined pathogenesis. Future studies are warranted to determine whether AF genetic risk is a useful biomarker to enhance clinical discrimination of stroke pathogeneses.
[Mh] Termos MeSH primário: Fibrilação Atrial/genética
Isquemia Encefálica/genética
Embolia/genética
Estudos de Associação Genética
Predisposição Genética para Doença
Acidente Vascular Cerebral/genética
[Mh] Termos MeSH secundário: Estudos de Casos e Controles
Genótipo
Seres Humanos
Polimorfismo de Nucleotídeo Único
Fatores de Risco
Acidente Vascular Cerebral/etiologia
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[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.116.016198


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[PMID]:28465460
[Au] Autor:Menjot de Champfleur N; Saver JL; Goyal M; Jahan R; Diener HC; Bonafe A; Levy EI; Pereira VM; Cognard C; Yavagal DR; Albers GW
[Ad] Endereço:From the Stanford Stroke Center, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, CA (G.W.A.); Department of Radiology (M.G.) and Department of Clinical Neurosciences (M.G.), University of Calgary, Alberta, Canada; Division of Interventional Neuroradiology (
[Ti] Título:Efficacy of Stent-Retriever Thrombectomy in Magnetic Resonance Imaging Versus Computed Tomographic Perfusion-Selected Patients in SWIFT PRIME Trial (Solitaire FR With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke).
[So] Source:Stroke;48(6):1560-1566, 2017 06.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: The majority of patients enrolled in SWIFT PRIME trial (Solitaire FR With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke) had computed tomographic perfusion (CTP) imaging before randomization; 34 patients were randomized after magnetic resonance imaging (MRI). METHODS: Patients with middle cerebral artery and distal carotid occlusions were randomized to treatment with tPA (tissue-type plasminogen activator) alone or tPA+stentriever thrombectomy. The primary outcome was the distribution of the modified Rankin Scale score at 90 days. Patients with the target mismatch profile for enrollment were identified on MRI and CTP. RESULTS: MRI selection was performed in 34 patients; CTP in 139 patients. Baseline National Institutes of Health Stroke Scale score was 17 in both groups. Target mismatch profile was present in 95% (MRI) versus 83% (CTP). A higher percentage of the MRI group was transferred from an outside hospital ( =0.02), and therefore, the time from stroke onset to randomization was longer in the MRI group ( =0.003). Time from emergency room arrival to randomization did not differ in CTP versus MRI-selected patients. Baseline ischemic core volumes were similar in both groups. Reperfusion rates (>90%/TICI [Thrombolysis in Cerebral Infarction] score 3) did not differ in the stentriever-treated patients in the MRI versus CTP groups. The primary efficacy analysis (90-day mRS score) demonstrated a statistically significant benefit in both subgroups (MRI, =0.02; CTP, =0.01). Infarct growth was reduced in the stentriever-treated group in both MRI and CTP groups. CONCLUSIONS: Time to randomization was significantly longer in MRI-selected patients; however, site arrival to randomization times were not prolonged, and the benefits of endovascular therapy were similar. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01657461.
[Mh] Termos MeSH primário: Isquemia Encefálica/diagnóstico por imagem
Isquemia Encefálica/terapia
Circulação Cerebrovascular
Imagem de Difusão por Ressonância Magnética/métodos
Fibrinolíticos/uso terapêutico
Avaliação de Processos e Resultados (Cuidados de Saúde)
Stents
Acidente Vascular Cerebral/diagnóstico por imagem
Acidente Vascular Cerebral/terapia
Trombectomia/métodos
Ativador de Plasminogênio Tecidual/uso terapêutico
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Isquemia Encefálica/etiologia
Doenças das Artérias Carótidas/complicações
Terapia Combinada
Feminino
Seres Humanos
Infarto da Artéria Cerebral Média/complicações
Masculino
Meia-Idade
Método Simples-Cego
Acidente Vascular Cerebral/etiologia
Fatores de Tempo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Fibrinolytic Agents); EC 3.4.21.68 (Tissue Plasminogen Activator)
[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:170504
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.016669


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[PMID]:28455321
[Au] Autor:Derdeyn CP; Fiorella D; Lynn MJ; Turan TN; Cotsonis GA; Lane BF; Montgomery J; Janis LS; Chimowitz MI; SAMMPRIS Investigators
[Ad] Endereço:From the Departments of Radiology, Neurology, and Neurosurgery, University of Iowa Hospitals and Clinics (C.P.D.); Department of Neurosurgery, State University of New York, Stony Brook (D.F.); Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta,
[Ti] Título:Nonprocedural Symptomatic Infarction and In-Stent Restenosis After Intracranial Angioplasty and Stenting in the SAMMPRIS Trial (Stenting and Aggressive Medical Management for the Prevention of Recurrent Stroke in Intracranial Stenosis).
[So] Source:Stroke;48(6):1501-1506, 2017 06.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: The purpose of this study was to investigate the frequency of symptomatic in-stent restenosis (ISR) and its contribution to nonprocedural symptomatic infarction in the SAMMPRIS trial (Stenting and Aggressive Medical Management for the Prevention of Recurrent Stroke in Intracranial Stenosis). METHODS: Patients without a periprocedural primary end point were followed up to determine the occurrence of any of the following events: ischemic stroke, cerebral infarct with temporary signs, or transient ischemic attack in the territory of the stented artery. Vascular imaging performed after these events was reviewed for ISR. Annual rates for symptomatic ISR were calculated using Kaplan-Meier estimates. RESULTS: Of 183 patients in the stenting group without a periprocedural primary end point, 27 (14.8%) had a symptomatic infarction (stroke or cerebral infarct with temporary signs) and 16 (8.7%) had transient ischemic attack alone in the territory during a median follow-up of 35.0 months. Of the 27 patients with infarctions, 17 (9.3%) had an ischemic stroke and 10 (5.5%) had a cerebral infarct with temporary signs alone. Adequate vascular imaging to evaluate ISR was available in 24 patients with infarctions (showing ISR in 16 [66.7%]) and in 10 patients with transient ischemic attack alone (showing ISR in 8 [80%]). The 1-, 2-, and 3-year rates (with 95% confidence limits) for symptomatic ISR in the SAMMPRIS stent cohort were 9.6% (6.1%-14.9%), 11.3% (7.5%-17.0%), and 14.0% (9.6%-20.2%), respectively. CONCLUSIONS: Symptomatic ISR occurred in at least 1 of 7 patients in SAMMPRIS by 3 years of follow-up and was likely responsible for the majority of nonprocedural cerebral infarctions. CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov. Unique identifier: NCT00576693.
[Mh] Termos MeSH primário: Angioplastia com Balão/estatística & dados numéricos
Isquemia Encefálica/epidemiologia
Constrição Patológica/epidemiologia
Doenças Arteriais Intracranianas/epidemiologia
Doenças Arteriais Intracranianas/terapia
Complicações Pós-Operatórias/epidemiologia
Stents/estatística & dados numéricos
Acidente Vascular Cerebral/epidemiologia
[Mh] Termos MeSH secundário: Assistência ao Convalescente
Idoso
Angioplastia com Balão/efeitos adversos
Isquemia Encefálica/diagnóstico
Angiografia Cerebral
Infarto Cerebral/diagnóstico por imagem
Infarto Cerebral/epidemiologia
Constrição Patológica/diagnóstico por imagem
Feminino
Seres Humanos
Doenças Arteriais Intracranianas/diagnóstico por imagem
Ataque Isquêmico Transitório/diagnóstico por imagem
Ataque Isquêmico Transitório/epidemiologia
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Complicações Pós-Operatórias/diagnóstico por imagem
Recidiva
Risco
Stents/efeitos adversos
Acidente Vascular Cerebral/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[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
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.116.014537


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[PMID]:28455322
[Au] Autor:Neuberger U; Möhlenbruch MA; Herweh C; Ulfert C; Bendszus M; Pfaff J
[Ad] Endereço:From the Department of Neuroradiology, Heidelberg University Hospital, Germany.
[Ti] Título:Classification of Bleeding Events: Comparison of ECASS III (European Cooperative Acute Stroke Study) and the New Heidelberg Bleeding Classification.
[So] Source:Stroke;48(7):1983-1985, 2017 07.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: Intracranial hemorrhage (ICH) after acute ischemic stroke treatments represents a feared complication with possible prognostic implications. In recent years, ICHs were commonly classified according to the ECASS (European Cooperative Acute Stroke Study). To improve the clinical applicability and relevance, the new Heidelberg Bleeding Classification (HBC) has been proposed in 2015. Here, we compared the ECASS and HBC classification with regard to observed events and prognostic relevance. METHODS: A retrospective analysis of a prospectively compiled database of patients with acute ischemic stroke in the anterior circulation who received mechanical thrombectomy between February 2011 and March 2016 was performed. Presence of ICH after mechanical thrombectomy was evaluated on postinterventional computed tomographic imaging. ICHs were specified according to both ECASS III and HBC classification and analyzed with regard to their symptoms and outcome. RESULTS: ICHs were observed in 156 of 768 patients (20.3%). Using ECASS III classification, 101 ICHs could be unambiguously assigned, of which 28 (27.7%; 3.6% of all treated patients) were symptomatic ICHs. Using HBC, 55 additional ICHs could be categorized. Of these total 156 ICHs, 29 (18.6%; 3.8% of all treated patients) were classified as symptomatic according to HBC. CONCLUSIONS: Classification of ICH by ECASS III and HBC criteria show distinct differences. These differences warrant special attention during interpretation and comparison of scientific publications.
[Mh] Termos MeSH primário: Isquemia Encefálica/terapia
Hemorragias Intracranianas/classificação
Hemorragias Intracranianas/diagnóstico por imagem
Trombólise Mecânica/métodos
Complicações Pós-Operatórias/diagnóstico por imagem
Acidente Vascular Cerebral/terapia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Isquemia Encefálica/diagnóstico por imagem
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Acidente Vascular Cerebral/diagnóstico por imagem
[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:170430
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.016735



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