Perspectives in Medicine最新文献_第8页

Intra- and extracranial stenoses in TIA – Findings from the Aarhus TIA-study: A prospective population-based study TIA的颅内和颅外狭窄——来自Aarhus TIA研究的发现:一项基于人群的前瞻性研究

Perspectives in Medicine Pub Date : 2012-09-01 DOI: 10.1016/j.permed.2012.02.013

Paul von Weitzel-Mudersbach , Soeren Paaske Johnsen , Grethe Andersen

{"title":"Intra- and extracranial stenoses in TIA – Findings from the Aarhus TIA-study: A prospective population-based study","authors":"Paul von Weitzel-Mudersbach , Soeren Paaske Johnsen , Grethe Andersen","doi":"10.1016/j.permed.2012.02.013","DOIUrl":"10.1016/j.permed.2012.02.013","url":null,"abstract":"<div><h3>Background</h3><p>Atherosclerotic stenoses of the intracranial arteries (ICAS) is associated with high risk of stroke after TIA. The prevalence of intracranial stenoses is considered to be low in Caucasians, however population-based data are lacking and only a minority of patients with acute TIA or stroke is evaluated for ICAS.</p></div><div><h3>Methods</h3><p>We prospectively examined the prevalence of stenoses of the pre- and intracerebral vessels using transcranial colour coded sonography (TCCS) in a population based cohort of all TIA patients in the community of Aarhus, Denmark in the period 1.3.2007–29.2.2008.</p></div><div><h3>Results</h3><p>The TIA cohort included 203 patients fulfilling the diagnostic criteria for TIA. We examined 195 patients with extra- and intracranial TCCD.</p><p>Any stenoses and symptomatic ICAS was found in 12.3% and 8.2%, respectively. The stenoses were located in the intracranial internal carotid artery in 3.6% and 3.1%, anterior cerebral artery in 0.5% and 0%, middle cerebral artery in 4.6% and 2.6%, intracranial vertebral artery in 2.1% and 1.5%, and in the basilar artery in 1.5% and 1.5%, respectively. In comparison, we found any stenoses and symptomatic stenoses in the extracranial carotid artery in 14.4% and 10.8%, and the extracranial vertebral artery in 5.6% and 2.1% of the patients, respectively. Carotid occlusion was found in 3.6%, combined extra- and intracranial stenoses in 4.9%.</p></div><div><h3>Conclusion</h3><p>The prevalence of ICAS was in this population-based TIA cohort of Caucasians comparable with the prevalence of carotid stenoses. Systematic evaluation for intracranial stenoses should be considered in all patients with acute ischemic cerebrovascular disease.</p></div>","PeriodicalId":101010,"journal":{"name":"Perspectives in Medicine","volume":"1 1","pages":"Pages 207-210"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.permed.2012.02.013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73822170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Predictors of carotid artery in-stent restenosis 颈动脉支架内再狭窄的预测因素

Perspectives in Medicine Pub Date : 2012-09-01 DOI: 10.1016/j.permed.2012.02.051

Katrin Wasser , Sonja Gröschel , Janin Wohlfahrt , Klaus Gröschel

{"title":"Predictors of carotid artery in-stent restenosis","authors":"Katrin Wasser , Sonja Gröschel , Janin Wohlfahrt , Klaus Gröschel","doi":"10.1016/j.permed.2012.02.051","DOIUrl":"10.1016/j.permed.2012.02.051","url":null,"abstract":"<div><h3>Background</h3><p>Carotid angioplasty and stenting (CAS) is increasingly being used as a treatment alternative to endarterectomy (CEA), especially in patients aged <70 years with significant carotid artery stenosis. However, an in-stent restenosis (ISR) might endangering the long-term efficacy of CAS. The aim of this article was to review the current literature regarding incidence and clinical significance as well as predictors of in-stent restenosis.</p></div><div><h3>Methods</h3><p>We conducted a systematic review of the literature to identify all studies on the abovementioned factors.</p></div><div><h3>Results</h3><p>3 randomized-controlled trials comparing CAS and CEA and 13 single centre studies fulfilled our inclusion criteria. The occurrence of ISR after CAS ranged from 2.7 to 33% and was detected within the first year in most of the studies. The clinical impact as well as the therapeutic consequence of ISR remains unclear, but many baseline characteristics (age, prior CEA or radiation), procedural (insufficient stent deployment, stent dimensions, inflammatory marker) and follow-up factors (reduced HDL, diabetes mellitus) could be found to identify patients at special risk for ISR. A wide heterogeneity related to the definition and their corresponding ultrasound criteria for ISR was observed.</p></div><div><h3>Conclusions</h3><p>A close follow-up is suggested especially in those patients with predictors of an ISR. The wide range of ISR ultrasound definitions urges the need for an implementation of generally valid criteria in ISR diagnosis. Against the background of the unknown clinical significance of ISR and a lacking established treatment modality these findings should be taken into account when offering CAS as a treatment alternative to CEA.</p></div>","PeriodicalId":101010,"journal":{"name":"Perspectives in Medicine","volume":"1 1","pages":"Pages 122-128"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.permed.2012.02.051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80756482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 11

Virtual Navigator study: Subset of preliminary data about cerebral venous circulation 虚拟导航研究:脑静脉循环的初步数据子集

Perspectives in Medicine Pub Date : 2012-09-01 DOI: 10.1016/j.permed.2012.02.008

Marialuisa Zedde , Giovanni Malferrari , Gianni De Berti , Massimo Maggi , Luca Lodigiani

{"title":"Virtual Navigator study: Subset of preliminary data about cerebral venous circulation","authors":"Marialuisa Zedde , Giovanni Malferrari , Gianni De Berti , Massimo Maggi , Luca Lodigiani","doi":"10.1016/j.permed.2012.02.008","DOIUrl":"10.1016/j.permed.2012.02.008","url":null,"abstract":"<div><h3>Introduction</h3><p>Neuroradiological techniques are known for their high spatial resolution in imaging of intracranial structures, in comparison with neurosonological techniques (TCCS), known for their high temporal resolution. An ideal study of intracranial circulation should combine the high temporal resolution of ultrasound with the high spatial resolution of Magnetic Resonance (MR) Imaging. This imaging fusion system is actually used for the ultrasound liver examination and it is known as Virtual Navigator. Therefore we implemented this system for the examination of the intracranial venous hemodynamics.</p></div><div><h3>Patients and methods</h3><p>Fifteen consecutive subjects (7 men and 8 women, mean age 51.5±8.64 years) were chosen among patients who underwent standard TCCS examinations at our lab and had age >18 years, a suitable temporal acoustic window and a recently performed intracranial MR venography. The axial scanning approach was used from the temporal window and the standard TCCS examination was compared with the Virtual Navigator examination, for the insonation rate of the basal vein of Rosenthal (BVR), Galen vein (GV), Straight sinus (SRS) and Transverse sinus (TS).</p></div><div><h3>Results and discussion</h3><p>The insonation rates of the venous structures are only slightly improved for BVR (from 90% to 96.67%) but are substantially increased for SRS and TS (for this last one from 63.33% to 86.67%) with a statistically significant difference (<em>p</em>  <!-->0.05).</p></div><div><h3>Conclusions</h3><p>The Virtual Navigator protocol can help to insonate the intracranial venous system.</p></div>","PeriodicalId":101010,"journal":{"name":"Perspectives in Medicine","volume":"1 1","pages":"Pages 385-389"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.permed.2012.02.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74436731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Act on Stroke – Optimization of clinical processes and workflow for stroke diagnosis and treatment 对中风的行动-中风诊断和治疗的临床过程和工作流程的优化

Perspectives in Medicine Pub Date : 2012-09-01 DOI: 10.1016/j.permed.2012.03.007

Bernd M. Hofmann , Udo Zikeli , E. Bernd Ringelstein

引用次数: 3

An overview of musculoskeletal ultrasound – A thirteen years experience in Pakistan 肌肉骨骼超声的概述-巴基斯坦十三年的经验

Perspectives in Medicine Pub Date : 2012-09-01 DOI: 10.1016/j.permed.2012.02.056

Syed Amir Gilani

{"title":"An overview of musculoskeletal ultrasound – A thirteen years experience in Pakistan","authors":"Syed Amir Gilani","doi":"10.1016/j.permed.2012.02.056","DOIUrl":"10.1016/j.permed.2012.02.056","url":null,"abstract":"<div><h3>Objective</h3><p>(1) To provide an overview on 13 years experience on patients with musculoskeletal disorders in Pakistan. (2) To assess accuracy of ultrasound in musculoskeletal disorders. (3) To determine percentage of different regional pathologies referred for musculoskeletal ultrasound.</p></div><div><h3>Material and methods</h3><p>We scanned 25,437 patients coming from all over Pakistan including 18,715 males and 6722 females from 1 month to 85 years of age.</p><p>We used two ultrasound equipments with a multi-frequency (6–14MHz) linear probe to perform studies in patients with possible musculoskeletal system problems.</p></div><div><h3>Results</h3><p>All patients with different joint or specific problems of musculoskeletal system were scanned, the total number of patients of any specific disorder was calculated and the accuracy of ultrasound was compared with MRI in a given percentage of patients.</p></div><div><h3>Discussion</h3><p>In all musculoskeletal disorders ultrasound was found to be accurate in about 84.8%. It was 83.5% accurate in the cases which went for MRI, its accuracy with other lab tests was 81.2% and that with surgery was 93.3%.</p></div><div><h3>Conclusion</h3><p>Musculoskeletal ultrasound is a very useful tool in almost all disorders of musculoskeletal system and shall be a necessary tool of a physicians, specially a family physician, orthopedic surgeon, physiotherapist and rheumatologist.</p></div>","PeriodicalId":101010,"journal":{"name":"Perspectives in Medicine","volume":"1 1","pages":"Pages 427-430"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.permed.2012.02.056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88820037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Arterial wall dynamics 动脉壁动力学

Perspectives in Medicine Pub Date : 2012-09-01 DOI: 10.1016/j.permed.2012.02.049

Galina Baltgaile

{"title":"Arterial wall dynamics","authors":"Galina Baltgaile","doi":"10.1016/j.permed.2012.02.049","DOIUrl":"10.1016/j.permed.2012.02.049","url":null,"abstract":"<div><p>An early change in arterial wall dynamics introduced as a novel risk factor for cardiovascular events in various populations is discussed in this review.</p><p>Distensibility of an artery segment as reflection of the mechanical stress affecting the arterial wall during the cardiac cycle has been intensively studied recent years through the technological development of high-resolution ultrasound systems.</p><p>A decrease of arterial distensibility (i.e. increase of arterial wall stiffness) seems to be a common pathological mechanism for many factors associated with cerebrovascular and cardiovascular diseases. It is difficult to define the role of each factor affecting the arterial wall motions dependent mainly on the left ventricle, intra arterial pressure and blood volume, endothelium function, smooth muscle tone and neural control mechanism. The calculations of arterial compliance, elastic modulus, augmentation pressure, stiffness and intima–media thickness may help to identify the role of each mechanism if they are based on high-tech measurements of arterial wall.</p><p>The role of nervous regulation of blood vessel's tone in this process is not clear. Our studies show the strong correlation between autonomic imbalance and increase of carotid arterial distensibility in young patients. Various possible relationships between changes in the dynamic artery wall properties and neural regulation are discussed.</p></div>","PeriodicalId":101010,"journal":{"name":"Perspectives in Medicine","volume":"1 1","pages":"Pages 146-151"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.permed.2012.02.049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90481260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 34

Ultrasound fusion imaging 超声融合成像

Perspectives in Medicine Pub Date : 2012-09-01 DOI: 10.1016/j.permed.2012.05.004

Jeffrey Stoll

引用次数: 8

Reversible cerebral vasoconstriction syndrome after preeclampsia 子痫前期后可逆性脑血管收缩综合征

Perspectives in Medicine Pub Date : 2012-09-01 DOI: 10.1016/j.permed.2012.02.033

Robert Müller, Oliver Meier, Roman L. Haberl

引用次数: 1

Microbubble signal properties from PFO tests using transcranial Doppler ultrasound 经颅多普勒超声检测PFO微泡信号特性

Perspectives in Medicine Pub Date : 2012-09-01 DOI: 10.1016/j.permed.2012.01.003

Caroline Banahan , Rizwan Patel , Vikram Jeyagopal , Amit Mistri , James P. Hague , David H. Evans , Emma M.L. Chung

{"title":"Microbubble signal properties from PFO tests using transcranial Doppler ultrasound","authors":"Caroline Banahan , Rizwan Patel , Vikram Jeyagopal , Amit Mistri , James P. Hague , David H. Evans , Emma M.L. Chung","doi":"10.1016/j.permed.2012.01.003","DOIUrl":"10.1016/j.permed.2012.01.003","url":null,"abstract":"<div><h3>Background</h3><p>A limitation of transcranial Doppler (TCD) ultrasound is the inability to distinguish tiny benign bubbles from potentially hazardous particulate emboli based on analysis of the intensity of backscattered ultrasound. This study examines the Doppler characteristics of small microbubbles detected during screening of patients for a patent foramen ovale (PFO). The aim of this study was to identify unique microbubble properties that could differentiate between solid and gaseous emboli.</p></div><div><h3>Methods</h3><p>Bilateral TCD monitoring of the middle cerebral arteries (MCA) was performed for 34 patients during PFO screening using agitated saline. Patients were injected up to three times and asked to perform a valsalva manoeuvre. The raw audio data was recorded onto an external laptop for subsequent analysis.</p></div><div><h3>Results</h3><p>Eleven patients tested positive for a PFO, yielding 331 embolic signals with intensities <35dB. The median peak measured-embolus-blood-ratio (MEBR) was 25.7dB and the median duration was 33.0ms. The majority of signals lasted between 12 and 92ms, which are much longer than previously reported for particulate thrombus where the majority of signal durations are between 6 and 41ms. Pearson correlation tests revealed a weak positive correlation between estimated microbubble velocity and signal duration (0.26, <em>p</em>  <!-->0.0001).</p></div><div><h3>Conclusions</h3><p>Doppler signal properties were analysed for over 300 microbubbles recorded in vivo. Microbubble signal duration was found to be higher than measured for solid emboli. Further work to develop a clinically useful model based on microembolus properties to differentiate solid and gaseous is ongoing.</p></div>","PeriodicalId":101010,"journal":{"name":"Perspectives in Medicine","volume":"1 1","pages":"Pages 232-235"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.permed.2012.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81287778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The long-term effects of hypobaric and hyperbaric conditions on brain hemodynamic: A transcranial Doppler ultrasonography of blood flow velocity of middle cerebral and basilar arteries in pilots and divers 低压和高压条件对脑血流动力学的长期影响:飞行员和潜水员大脑中动脉和基底动脉血流速度的经颅多普勒超声检查

Perspectives in Medicine Pub Date : 2012-09-01 DOI: 10.1016/j.permed.2012.01.002

Seyed-Mohammad Fereshtehnejad , Masoud Mehrpour , Seyed Mohammad Hossein Mahmoodi , Poorang Bassir , Banafsheh Dormanesh , Mohammad Reza Motamed

{"title":"The long-term effects of hypobaric and hyperbaric conditions on brain hemodynamic: A transcranial Doppler ultrasonography of blood flow velocity of middle cerebral and basilar arteries in pilots and divers","authors":"Seyed-Mohammad Fereshtehnejad , Masoud Mehrpour , Seyed Mohammad Hossein Mahmoodi , Poorang Bassir , Banafsheh Dormanesh , Mohammad Reza Motamed","doi":"10.1016/j.permed.2012.01.002","DOIUrl":"10.1016/j.permed.2012.01.002","url":null,"abstract":"<div><h3>Background</h3><p>Nowadays, more attention is paid to the potential risk factors of cerebrovascular events including some environmental conditions. We aimed to compare the long-term effects of hypobaric condition of pilots versus hyperbaric condition of divers as two possible occupational risk factors on blood flow velocity of middle cerebral and basilar arteries.</p></div><div><h3>Methods</h3><p>This cross-sectional study was performed in Firoozgar Hospital, Tehran, Iran between March 2009 and June 2010. A final number of 15 pilots and 16 divers were referred to the Neurology Laboratory of Firoozgar Hospital. Afterward, Transcranial Doppler ultrasonography was performed to evaluate blood flow velocity of middle cerebral (MCA) and basilar arteries.</p></div><div><h3>Results</h3><p>Comparison of the TCD findings between these two groups showed that resistance index was significantly higher in divers [0.57 (SD=0.03) vs. 0.52 (SD=0.06), <em>P</em>  =−0.58, <em>P</em>  <!-->0.027) of right MCA even after eliminating the confounding effect of age.</p></div><div><h3>Conclusion</h3><p>In our report, some considerable associations were found especially with regard to the long-term effects of hyperbaric condition of divers on blood flow velocity of middle cerebral and basilar arteries using Transcranial Doppler ultrasonography. Chronic exposure to the hyperbaric condition of diving seems to have some probable effects on brain hemodynamics in the long-term which are in favor of decreasing blood flow and increasing of RI and PI.</p></div>","PeriodicalId":101010,"journal":{"name":"Perspectives in Medicine","volume":"1 1","pages":"Pages 316-320"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.permed.2012.01.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84848070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4