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[PMID]: 28494560 [Au] Autor: Chen WQ; Zhang GH; Lin HJ; Huang HC; Lin DS; Zheng JL; Zheng DZ [Ad] Endereço: Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou 515041, China. [Ti] Título: [Visual impact of sub-tenon s anesthesia during surgery for retinal detachment]. [So] Source: Zhonghua Yan Ke Za Zhi;53(5):332-337, 2017 May 11. [Is] ISSN: 0412-4081 [Cp] País de publicação: China [La] Idioma: chi [Ab] Resumo: To investigate the visual impact and influence factors of sub-Tenon s anesthesia in retinal detachment patients during pars plana vitrectomy (PPV) or combined phacoemulsification and PPV surgery. In this prospective case series study, 104 consecutive patients who underwent PPV or combined phacoemulsification and PPV under sub-Tenon s anesthesia between October 2012 and December 2013 were enrolled. Intraoperatively, the patients were asked whether they could see the light of the operating microscope or not at 5 minutes after sub-Tenon s anesthesia, and at the end of phacoemulsification, core vitreous removal, peripheral vitreous removal and the whole surgery, with their contralateral eyes being covered tightly and no photobleaching. The best corrected visual acuity and visual evoked potentials were examined and compared with each other preoperatively and at 1.5 months and 3 months postoperatively. Chi-square test was used to compare the detection rate of amaurosis between different modus operandi and whether covered contra-lateral eye. Student- test was used to compare the difference of age and preoperative BCVA between the patients with or without experienced amaurois. Lastly, BCVA between different times were tested by one-way analysis. Without covering the contralateral eyes, the incidence of no light perception in various surgical steps was 0%, while it was 72.1%(75/104), 93.8%(75/80), 96.2%(100/104), 96.2%(100/104) and 86.5%(90/104) at the five timepoints, respectively, when the contralateral eyes were covered tightly. The incidence was 51.9%(54/104), 85.0%(68/80), 85. 6%(89/104), 84.6%(69/104) and 66.3%(88/104), respectively, after photobleaching was excluded. Approximately 95.2%(99/104) of patients reported no light perception at least once, 54.5%(54/99) reported no light perception 5 minutes after sub-Tenon s anesthesia, and 30.3%(30/99) recovered light perception when the surgery was finished. All eyes recovered to at least light perception on the first postoperative day. The best corrected visual acuity and visual evoked potentials at 1.5 months and 3 months postoperatively were significantly better than those before surgery. The BCVA was 1.75±0.78 preoperative, 0.96±0.63 1.5 months after operation, and 0.92±0.57 3 months after operation. There was a significant statistical difference between preoperative BCVA and postoperative BCVA ( 50.61, 0.01) . In patients without waveform detection preoperatively, PVEP waveform could be found in 43.6% and 61.4% of the pactients at 1.5 months and 3 months after operation respectively. In those had certain waveform preoperatively, PVEP amplitudes rise significantly after surgery ( (1.5)=-2.69, (3)=-2.97, 0.05) . No light perception was detected in various surgical steps of vitrectomy under sub-Tenon s anesthesia in most patients. The blocking of optic nerve conduction may be caused by sub-Tenon s anesthesia. Photobleaching can also have some effect. The incidence of no light perception during the surgery was not correlated with preoperative visual acuity, age and gender. Moreover, the effect was transient and harmless to visual function. - . [Mh] Termos MeSH primário: Amaurose Fugaz/diagnóstico Anestesia Local/métodos Facoemulsificação Complicações Pós-Operatórias/diagnóstico Descolamento Retiniano/cirurgia Vitrectomia [Mh] Termos MeSH secundário: Idoso Amaurose Fugaz/epidemiologia Distribuição de Qui-Quadrado Terapia Combinada/métodos Potenciais Evocados Visuais Feminino Seres Humanos Incidência Masculino Meia-Idade Complicações Pós-Operatórias/epidemiologia Estudos Prospectivos Acuidade Visual [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170831 [Lr] Data última revisão: 170831 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170512 [St] Status: MEDLINE [do] DOI: 10.3760/cma.j.issn.0412-4081.2017.05.004

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[PMID]: 28386036 [Au] Autor: Golsari A; Bittersohl D; Cheng B; Griem P; Beck C; Hassenstein A; Nedelmann M; Magnus T; Fiehler J; Gerloff C; Thomalla G [Ad] Endereço: From the Department of Neurology (A.G., B.C., P.G., C.B., M.N., T.M., C.G., G.T.), Department of Neuroradiology (J.F.), and Department of Opthalmology (D.B., A.H.), University Medical Center Hamburg-Eppendorf, Germany; and Department of Neurology, Sana Regio Klinikum Pinneberg, Germany (M.N.). agols [Ti] Título: Silent Brain Infarctions and Leukoaraiosis in Patients With Retinal Ischemia: A Prospective Single-Center Observational Study. [So] Source: Stroke;48(5):1392-1396, 2017 May. [Is] ISSN: 1524-4628 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND AND PURPOSE: We aimed to determine the incidence of co-occurring cerebral ischemia, extent of cerebral small vessel disease, and vascular risk profile of patients with acute retinal ischemia. METHODS: RETIS (Frequency of Acute Silent Brain Infarction and Systematic Evaluation of Stroke Risk in Retinal Ischemia) was a single-center, prospective, observational study comprising ophthalmologic examination, brain magnetic resonance imaging, and extensive diagnostic work-up of vascular risk factors and stroke cause. Silent brain infarctions were identified on diffusion-weighted imaging, leukoaraiosis was quantified on fluid-attenuated inversion recovery sequences, and carotid artery stenosis was assessed by carotid ultrasound. RESULTS: Of 112 patients with retinal ischemia, 77 (68.8%) had retinal arterial occlusion, and 35 (31.3%) presented with amaurosis fugax. Silent brain infarctions were found in 17 (15.1%) patients. Internal carotid artery stenosis was present in 19 (17.0%) and severe leukoaraiosis in 29 (25.9%) patients. Atrial fibrillation was detected in 14 (12.5%) patients. Patients with silent brain infarctions had higher rates of internal carotid artery stenosis (35.3% versus 13.7%; =0.029) than those without, whereas leukoaraiosis and vascular risk factors were comparable between groups. Internal carotid artery stenosis was the only significant predictor of silent brain infarctions in multivariate analysis (odds ratio, 4.27; 95% confidence interval, 1.06-17.23). CONCLUSIONS: Silent cerebral ischemia is present in about 1 in 7 patients with retinal ischemia. The high rate of symptomatic internal carotid artery stenosis suggests that large artery atherosclerosis plays a major role in the pathogenesis of acute retinal ischemia. [Mh] Termos MeSH primário: Amaurose Fugaz/diagnóstico Estenose das Carótidas/diagnóstico por imagem Infarto Cerebral/diagnóstico por imagem Leucoaraiose/diagnóstico por imagem Oclusão da Artéria Retiniana/diagnóstico [Mh] Termos MeSH secundário: Idoso Amaurose Fugaz/epidemiologia Estenose das Carótidas/complicações Estenose das Carótidas/epidemiologia Infarto Cerebral/epidemiologia Comorbidade Imagem de Difusão por Ressonância Magnética Feminino Seres Humanos Incidência Leucoaraiose/epidemiologia Imagem por Ressonância Magnética Masculino Meia-Idade Oclusão da Artéria Retiniana/epidemiologia Oclusão da Artéria Retiniana/etiologia Ultrassonografia [Pt] Tipo de publicação: JOURNAL ARTICLE; OBSERVATIONAL STUDY [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 170630 [Lr] Data última revisão: 170630 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170408 [St] Status: MEDLINE [do] DOI: 10.1161/STROKEAHA.117.016467

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[PMID]: 28276953 [Au] Autor: Ji J; Dimitrijevic I; Sundquist J; Sundquist K; Zöller B [Ad] Endereço: a Centre for Primary Health Care Research , Lund University/Region Skåne , Malmö , Sweden. [Ti] Título: Risk of ocular manifestations in patients with giant cell arteritis: a nationwide study in Sweden. [So] Source: Scand J Rheumatol;46(6):484-489, 2017 Nov. [Is] ISSN: 1502-7732 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: OBJECTIVE: No large-scale nationwide study has determined the risk of ocular manifestations in patients with giant cell arteritis (GCA). The aim was to study the incidence and risk factors of ocular manifestations in patients with GCA in Sweden. METHOD: A national cohort was created by linking Swedish nationwide registers. GCA patients were identified from the Swedish Hospital Inpatient and Outpatient Registers between 2002 and 2010, and were followed until the development of ocular manifestations. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated for ocular manifestations in patients with GCA compared to those without GCA. RESULTS: We identified 3737 males and 8311 females with GCA. A total of 1618 individuals had subsequent ocular manifestations, representing 13.4% of the GCA patients. The overall SIR of ocular manifestations was 6.96 (95% CI 6.63-7.31). The risk for disorders of the optic nerve or visual tract was particularly high (SIR = 51.68, 95% CI 46.12-57.73). Men with GCA had a higher risk than women, and GCA patients without polymyalgia rheumatica (PMR) symptoms had a higher risk than those with PMR symptoms. Living outside big cities was negatively associated with ocular manifestations in GCA patients, whereas hypertension and diabetes were associated with an increased risk of ocular manifestations. CONCLUSION: The overall risk of ocular manifestations was higher in GCA patients than in the general population, especially for men and for those without PMR symptoms. [Mh] Termos MeSH primário: Oftalmopatias/epidemiologia Arterite de Células Gigantes/epidemiologia Polimialgia Reumática/epidemiologia [Mh] Termos MeSH secundário: Idoso Amaurose Fugaz/epidemiologia Cegueira/epidemiologia Cidades Estudos de Coortes Diabetes Mellitus/epidemiologia Diplopia/epidemiologia Dor Ocular/epidemiologia Feminino Seres Humanos Hipertensão/epidemiologia Incidência Masculino Distribuição Espacial da População Oclusão da Artéria Retiniana/epidemiologia Oclusão da Veia Retiniana/epidemiologia Fatores de Risco Fatores Sexuais Suécia Baixa Visão/epidemiologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171107 [Lr] Data última revisão: 171107 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170310 [St] Status: MEDLINE [do] DOI: 10.1080/03009742.2016.1266030

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[PMID]: 28010865 [Au] Autor: McBride R; Porter J; Al-Khaffaf H [Ad] Endereço: Department of Vascular Surgery, Royal Blackburn Hospital, Blackburn, United Kingdom. [Ti] Título: The modified operative technique of partial eversion carotid endarterectomy. [So] Source: J Vasc Surg;65(1):263-266, 2017 Jan. [Is] ISSN: 1097-6809 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: We report a modified operative technique termed partial eversion carotid endarterectomy (PECE). During a 9-year period (2006-2015), 352 patients underwent PECE. Indications for surgery, intraoperative details, and outcomes were recorded. The initial 185 patients had carotid duplex ultrasound imaging at 6 weeks and then at 6, 12, and 24 months. Subsequent patients had carotid imaging at 4 to 6 weeks. Indications included stroke (76), transient ischemic attack (153), and amaurosis fugax (33); 58 patients were asymptomatic, and 32 patients had surgery before cardiac surgery. Median clamp time was 14 minutes (interquartile range, 11.5-17 minutes). Median total operation time was 41 minutes (interquartile range, 31-72 minutes). Outcomes included four transient ischemic attacks (1.2%), five strokes (1.4%), and two deaths at 30 days (0.5%). No significant cranial nerve injuries or carotid restenosis was detected during follow-up. PECE is technically straightforward, with outcomes comparable to those of current operative techniques. Its advantages included reduced operative and carotid clamping time. [Mh] Termos MeSH primário: Estenose das Carótidas/cirurgia Endarterectomia das Carótidas/métodos [Mh] Termos MeSH secundário: Idoso Amaurose Fugaz/etiologia Doenças Assintomáticas Estenose das Carótidas/complicações Estenose das Carótidas/diagnóstico por imagem Estenose das Carótidas/mortalidade Angiografia por Tomografia Computadorizada Endarterectomia das Carótidas/efeitos adversos Endarterectomia das Carótidas/mortalidade Feminino Seres Humanos Ataque Isquêmico Transitório/etiologia Masculino Meia-Idade Duração da Cirurgia Estudos Prospectivos Fatores de Risco Acidente Vascular Cerebral/etiologia Fatores de Tempo Resultado do Tratamento Ultrassonografia Doppler Dupla [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1705 [Cu] Atualização por classe: 170516 [Lr] Data última revisão: 170516 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161225 [St] Status: MEDLINE

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[PMID]: 27838111 [Au] Autor: Tsantilas P; Kühnl A; Kallmayer M; Pelisek J; Poppert H; Schmid S; Zimmermann A; Eckstein HH [Ad] Endereço: Department of Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. [Ti] Título: A short time interval between the neurologic index event and carotid endarterectomy is not a risk factor for carotid surgery. [So] Source: J Vasc Surg;65(1):12-20.e1, 2017 Jan. [Is] ISSN: 1097-6809 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: OBJECTIVE: Current guidelines recommend that carotid endarterectomy (CEA) be performed as early as possible after the neurologic index event in patients with 50% to 99% carotid artery stenosis. However, recent registry data showed that patients treated ≤48 hours had a significantly increased perioperative risk. Therefore, the aim of this single-center study was to determine the effect of the time interval between the neurologic index event and CEA on the periprocedural complication rate at our institution. METHODS: Prospectively collected data for 401 CEAs performed between 2004 and 2014 for symptomatic carotid stenosis were analyzed. Patients were divided into four groups according to the interval between the last neurologic event and surgery: group I, 0 to 2 days; group II, 3 to 7 days; group III, 8 to 14 days; and group IV, 15 to 180 days. The primary end point was the combined rate of in-hospital stroke or mortality. Data were analyzed by way of χ tests and multivariable regression analysis. RESULTS: The patients (68% men) had a median age of 70 years (interquartile range, 63-76 years). The index events included transient ischemic attack in 43.4%, amaurosis fugax in 25.4%, and an ipsilateral stroke in 31.2%. CEA was performed using the eversion technique in 61.1% of patients, and 50.1% were treated under locoregional anesthesia. The perioperative combined stroke and mortality rate was 2.5% (10 of 401), representing a perioperative mortality rate of 1.0% and stroke rate of 1.5%. Overall, myocardial infarction, cranial nerve injuries, and postoperative bleeding occurred in 0.7%, 2.2%, and 1.7%, respectively. We detected no significant differences for the combined stroke and mortality rate by time interval: 3% in group I, 3% in group II, 2% in group III, and 2% in group IV. Multivariable regression analysis showed no significant effect of the time interval on the primary end point. CONCLUSIONS: The combined mortality and stroke rate was 2.5% and did not differ significantly between the four different time interval groups. CEA was safe in our cohort, even when performed as soon as possible after the index event. [Mh] Termos MeSH primário: Amaurose Fugaz/etiologia Estenose das Carótidas/cirurgia Endarterectomia das Carótidas Ataque Isquêmico Transitório/etiologia Acidente Vascular Cerebral/etiologia Tempo para o Tratamento [Mh] Termos MeSH secundário: Idoso Amaurose Fugaz/diagnóstico Amaurose Fugaz/mortalidade Estenose das Carótidas/complicações Estenose das Carótidas/diagnóstico por imagem Estenose das Carótidas/mortalidade Distribuição de Qui-Quadrado Traumatismos dos Nervos Cranianos/etiologia Endarterectomia das Carótidas/efeitos adversos Endarterectomia das Carótidas/mortalidade Feminino Alemanha Mortalidade Hospitalar Seres Humanos Ataque Isquêmico Transitório/diagnóstico Ataque Isquêmico Transitório/mortalidade Masculino Meia-Idade Análise Multivariada Infarto do Miocárdio/etiologia Hemorragia Pós-Operatória/etiologia Estudos Retrospectivos Medição de Risco Fatores de Risco Acidente Vascular Cerebral/diagnóstico Acidente Vascular Cerebral/mortalidade Fatores de Tempo Resultado do Tratamento [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Em] Mês de entrada: 1705 [Cu] Atualização por classe: 170516 [Lr] Data última revisão: 170516 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161114 [St] Status: MEDLINE

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[PMID]: 27314958 [Au] Autor: Volkers EJ; Donders RC; Koudstaal PJ; van Gijn J; Algra A; Jaap Kappelle L [Ad] Endereço: University Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands. E.J.Volkers@umcutrecht.nl. [Ti] Título: Transient monocular blindness and the risk of vascular complications according to subtype: a prospective cohort study. [So] Source: J Neurol;263(9):1771-7, 2016 Sep. [Is] ISSN: 1432-1459 [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: Patients with transient monocular blindness (TMB) can present with many different symptoms, and diagnosis is usually based on the history alone. In this study, we assessed the risk of vascular complications according to different characteristics of TMB. We prospectively studied 341 consecutive patients with TMB. All patients were interviewed by a single investigator with a standardized questionnaire; reported symptoms were classified into predefined categories. We performed Cox regression analyses with adjustment for baseline vascular risk factors. During a mean follow-up of 4.0 years, the primary outcome event of vascular death, stroke, myocardial infarction, or retinal infarction occurred in 60 patients (annual incidence 4.4 %, 95 % confidence interval (CI) 3.4-5.7). An ipsilateral ischemic stroke occurred in 14 patients; an ipsilateral retinal infarct in six. Characteristics of TMB independently associated with subsequent vascular events were: involvement of only the peripheral part of the visual field (hazard ratio (HR) 6.5, 95 % CI 3.0-14.1), constricting onset of loss of vision (HR 3.5, 95 % CI 1.0-12.1), downward onset of loss of vision (HR 1.9, 95 % CI 1.0-3.5), upward resolution of loss of vision (HR 2.0, 95 % CI 1.0-4.0), and the occurrence of more than three attacks (HR 1.7, 95 % CI 1.0-2.9). We could not identify characteristics of TMB that predicted a low risk of vascular complications. In conclusion, careful recording the features of the attack in patients with TMB can provide important information about the risk of future vascular events. [Mh] Termos MeSH primário: Amaurose Fugaz/epidemiologia Doenças Vasculares/epidemiologia [Mh] Termos MeSH secundário: Amaurose Fugaz/complicações Amaurose Fugaz/diagnóstico Amaurose Fugaz/tratamento farmacológico Comorbidade Feminino Seguimentos Seres Humanos Estimativa de Kaplan-Meier Masculino Meia-Idade Prevalência Prognóstico Modelos de Riscos Proporcionais Estudos Prospectivos Risco Fatores de Risco Índice de Gravidade de Doença Doenças Vasculares/complicações Testes de Campo Visual [Pt] Tipo de publicação: JOURNAL ARTICLE; MULTICENTER STUDY [Em] Mês de entrada: 1704 [Cu] Atualização por classe: 170417 [Lr] Data última revisão: 170417 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160618 [St] Status: MEDLINE [do] DOI: 10.1007/s00415-016-8189-x

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[PMID]: 26962781 [Au] Autor: Han K; Chao AC; Chang FC; Hsu HY; Chung CP; Sheng WY; Chan L; Wu J; Hu HH [Ad] Endereço: From the Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, Jilin, China (KH, JW), Department of Neurology, College of Medicine, Kaohsiung Medical University and Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung (A-CC), Department of Radiology (F-CC), Department of Neurology Veterans General Hospital and National Yang-Ming University (C-PC, W-YS), Department of Neurology, Tungs' Taichung Metro Harbor Hospital and Department of Neurology, School of Medicine, Chung Shan Medical University, Taichung (H-YH), Department of Neurology, Taipei Medical University-Shaung Ho Hospital (LC), and Graduate Institute of Clinical Medicine and Department of Neurology, College of Medicine, Taipei Medical University and Hospital (H-HH), Taipei, Taiwan. [Ti] Título: Diagnosis of Transverse Sinus Hypoplasia in Magnetic Resonance Venography: New Insights Based on Magnetic Resonance Imaging in Combined Dataset of Venous Outflow Impairment Case-Control Studies: Post Hoc Case-Control Study. [So] Source: Medicine (Baltimore);95(10):e2862, 2016 Mar. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: In previous studies of transverse sinus (TS) hypoplasia, discrepancies between TS diameter measured by magnetic resonance venography (MRV) and contrast T1-weighted magnetic resonance (contrast T1) were observed. To investigate these discrepancies, and considering that TS hypoplasia is associated with neurological disorders, we performed a post hoc analysis of prospectively collected data from 3 case-control studies on transient global amnesia (TGA), transient monocular blindness (TMB), and panic disorders while retaining the original inclusion and exclusion criteria. Magnetic resonance (MR) imaging of 131 subjects was reviewed to evaluate TS diameter and the location and degree of venous flow stenosis and obstruction.MRV without contrast revealed that TS hypoplasia was observed in 69 subjects, whom we classified into 2 subgroups according to the concordance with contrast T1 observations: concordance indicated anatomically small TS (30 subjects), and discrepancy indicated that the MRV diagnosis is in fact flow-related and that TS is not anatomically small (39 subjects). The latter subgroup was associated with at least 1 site of venous compression/stenosis in the internal jugular vein (IJV) or the left brachiocephalic vein (BCV) (P < 0.001), which was significantly larger in patients than controls. Compensatory dilatation of contralateral TS diameter was only observed with MRV, not with contrast T1 imaging.The clinical implication of these results is that using MRV only, IJV/BCV compression/stenosis may be misdiagnosed as TS hypoplasia. And contralateral TS have no compensatory dilatation in its diameter in contrast T1 imaging, just compensatory increased flow volume. [Mh] Termos MeSH primário: Amaurose Fugaz/diagnóstico Amnésia Global Transitória/diagnóstico Angiografia por Ressonância Magnética/métodos Transtorno de Pânico/diagnóstico Flebografia/métodos Seios Transversos [Mh] Termos MeSH secundário: Adulto Idoso Amaurose Fugaz/fisiopatologia Amnésia Global Transitória/fisiopatologia Veias Braquiocefálicas/diagnóstico por imagem Veias Braquiocefálicas/patologia Estudos de Casos e Controles Circulação Cerebrovascular Diagnóstico Diferencial Feminino Seres Humanos Masculino Meia-Idade Transtorno de Pânico/fisiopatologia Estudos Retrospectivos Taiwan Seios Transversos/diagnóstico por imagem Seios Transversos/patologia Seios Transversos/fisiopatologia Grau de Desobstrução Vascular [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mês de entrada: 1612 [Cu] Atualização por classe: 170224 [Lr] Data última revisão: 170224 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 160311 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000002862

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[PMID]: 26901431 [Au] Autor: Lo Gullo A; Koster MJ; Crowson CS; Makol A; Ytterberg SR; Saitta A; Salvarani C; Matteson EL; Warrington KJ [Ad] Endereço: Department of Clinical and Experimental Medicine, University of Messina, Messina ME, Italy. [Ti] Título: Venous Thromboembolism and Cerebrovascular Events in Patients with Giant Cell Arteritis: A Population-Based Retrospective Cohort Study. [So] Source: PLoS One;11(2):e0149579, 2016. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: OBJECTIVE: To investigate the incidence of venous thromboembolism (VTE) and cerebrovascular events in a community-based incidence cohort of patients with giant cell arteritis (GCA) compared to the general population. METHODS: A population-based inception cohort of patients with incident GCA between January 1, 1950 and December 31, 2009 in Olmsted County, Minnesota and a cohort of non-GCA subjects from the same population were assembled and followed until December 31, 2013. Confirmed VTE and cerebrovascular events were identified through direct medical record review. RESULTS: The study population included 244 patients with GCA with a mean ± SD age at diagnosis of 76.2 ± 8.2 years (79% women) and an average length of follow-up of 10.2 ± 6.8 years. Compared to non-GCA subjects of similar age and sex, patients diagnosed with GCA had a higher incidence (%) of amaurosis fugax (cumulative incidence ± SE: 2.1 ± 0.9 versus 0, respectively; p = 0.014) but similar rates of stroke, transient ischemic attack (TIA), and VTE. Among patients with GCA, neither baseline characteristics nor laboratory parameters at diagnosis reliably predicted risk of VTE or cerebrovascular events. CONCLUSION: In this population-based study, the incidence of VTE, stroke and TIA was similar in patients with GCA compared to non-GCA subjects. [Mh] Termos MeSH primário: Arterite de Células Gigantes Acidente Vascular Cerebral Tromboembolia Venosa [Mh] Termos MeSH secundário: Fatores Etários Idoso Idoso de 80 Anos ou mais Amaurose Fugaz/epidemiologia Amaurose Fugaz/etiologia Feminino Seguimentos Arterite de Células Gigantes/complicações Arterite de Células Gigantes/epidemiologia Seres Humanos Incidência Masculino Estudos Retrospectivos Fatores Sexuais Acidente Vascular Cerebral/epidemiologia Acidente Vascular Cerebral/etiologia Tromboembolia Venosa/epidemiologia Tromboembolia Venosa/etiologia [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mês de entrada: 1607 [Cu] Atualização por classe: 161019 [Lr] Data última revisão: 161019 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160223 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0149579

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[PMID]: 26312923 [Au] Autor: Al-Khaled M; Scheef B [Ad] Endereço: a Department of Neurology , University of Lübeck , Lübeck , Germany. [Ti] Título: Symptomatic carotid stenosis and stroke risk in patients with transient ischemic attack according to the tissue-based definition. [So] Source: Int J Neurosci;126(10):888-92, 2016 Oct. [Is] ISSN: 1563-5279 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND AND PURPOSE: Symptomatic carotid stenosis (sCS), a common cause of transient ischemic attack (TIA), is correlated with higher stroke risk. We investigated the frequency and associated factors of sCS in patients with TIA and the association between sCS and stroke risk following TIA. METHODS: Over a three-year period (2011-2013), 861 consecutive patients with TIA, who were admitted to the Department of Neurology at the University of Lübeck, Germany, were included in a monocenter study and prospectively evaluated. Diagnosis of TIA was in accordance with the tissue-based definition (transient neurological symptoms without evidence of infarction by brain imaging). RESULTS: Of 827 patients (mean age, 70 ± 13.2 years; 49.7% women), 64 patients (7.7%; 95% confidence interval [CI], 5.9%-9.7%) exhibited sCS and 3 patients (0.3%) showed an occlusion of the corresponding internal carotid artery. Logistic regression revealed that sCS was associated with male sex (odds ratio [OR], 2.7; 95% CI, 1.2-3.6; p = 0.012), amaurosis fugax (OR, 8.1; 95% CI, 3.4-19-4; p < 0.001), unilateral weakness (OR, 3.4; 95% CI, 1.9-6.1; p < 0.001), symptom duration less than 1 h (OR, 2.0; 95% CI, 1.1-3.4; p = 0.019) and previous stroke (OR, 2.7; 95% CI, 1.5-4.7; p = 0.001). During hospitalization (mean, 6.6 days), five patients (0.6%; 95% CI, 0.1%-1.2%) suffered from stroke. The stroke risk was higher in patients with sCS than in those without sCS (6.3% vs. 0.1%; p < 0.001), whereas the recurrent TIA risk (2.6%) did not differ between the groups (4.7% vs. 2.5%; p = 0.29). CONCLUSION: SCS appears to be associated with a higher risk of stroke in patients with TIA defined according to the tissue-based definition. [Mh] Termos MeSH primário: Amaurose Fugaz/epidemiologia Estenose das Carótidas/epidemiologia Ataque Isquêmico Transitório/epidemiologia Acidente Vascular Cerebral/epidemiologia [Mh] Termos MeSH secundário: Idoso Idoso de 80 Anos ou mais Amaurose Fugaz/etiologia Estenose das Carótidas/complicações Estenose das Carótidas/terapia Feminino Alemanha/epidemiologia Seres Humanos Masculino Meia-Idade Risco Fatores Sexuais Acidente Vascular Cerebral/etiologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 170314 [Lr] Data última revisão: 170314 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 150828 [St] Status: MEDLINE [do] DOI: 10.3109/00207454.2015.1077834

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MEDLINE

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[PMID]: 26627820 [Au] Autor: Tripathy K; Ramesh P; Sharma YR [Ad] Endereço: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India koushiktripathy@gmail.com. [Ti] Título: Headache and amaurosis fugax in an obese woman. [So] Source: BMJ;351:h6365, 2015 Dec 01. [Is] ISSN: 1756-1833 [Cp] País de publicação: England [La] Idioma: eng [Mh] Termos MeSH primário: Amaurose Fugaz/diagnóstico Cefaleia/diagnóstico Obesidade/complicações [Mh] Termos MeSH secundário: Adulto Feminino Seres Humanos Hipertensão Intracraniana/diagnóstico Papiledema/diagnóstico [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1602 [Cu] Atualização por classe: 151202 [Lr] Data última revisão: 151202 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 151203 [St] Status: MEDLINE [do] DOI: 10.1136/bmj.h6365

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