Cerebrovascular Diseases最新文献

{"title":"Hair Follicle Mesenchymal Stem Cells Induce Neural Regeneration and Repair after Transient Ischemic Stroke.","authors":"Chen Yang, Lei Yu, Jia Wang, Xiaokun Wang, Yuhan Yang, Ni He, Shijing Zhang, Xu Gao, Hao Tang, Chendan Zou","doi":"10.1159/000543261","DOIUrl":"10.1159/000543261","url":null,"abstract":"<p><strong>Introduction: </strong>Considering the increasing recognition of the promising characteristic of hair follicle mesenchymal stem cells (HFMSCs) as multipotential cells with differentiation capability, in this study, we sought to investigate their hitherto unexplored therapeutic potentials in a rat model of transient ischemic stroke.</p><p><strong>Methods: </strong>Rat transient ischemic stroke model was established to verify the effect of HFMSC transplantation. Behavioral experiment and triphenyltetrazolium chloride staining were used to estimate neurological outcome after HFMSC therapy. Pathological experiments were performed to investigate the therapeutic roles of HFMSCs.</p><p><strong>Results: </strong>HFMSCs inhibited neural apoptosis and promoted neural proliferation. The number of neural cells around ischemic core increased after HFMSC transplantation. Besides, the transplanted HFMSCs expressed neuron-specific marker in the penumbra. Finally, HFMSCs diminished infarct area and improved neurological scores.</p><p><strong>Conclusion: </strong>HFMSCs can improve neurological outcome via anti-apoptosis and promoting neural stem cells proliferation, highlighting their therapeutic promise for ischemic stroke treatment.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-12"},"PeriodicalIF":2.2,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perfusion Image-Aided Treatment Decision for Acute Ischemic Stroke: Validation of a Clinical Decision Support System.","authors":"Xiang Li, Chao Wei, Yuefei Wu, Xiang Gao, Jie Sun, Tianqi Xu, Chushuang Chen, Qing Yang, Mark W Parsons, Yi Huang, Jianhong Yang, Longting Lin","doi":"10.1159/000543142","DOIUrl":"10.1159/000543142","url":null,"abstract":"<p><strong>Introduction: </strong>Our collaborative team has previously developed a prognostic model for acute ischemic stroke (AIS). This model, known as the clinical decision support system (CDSS), aims to provide personalized assistance to clinicians in making treatment decisions and improving patient prognosis. The objective of this study was to externally validate the model using Chinese AIS patients.</p><p><strong>Methods: </strong>All enrolled patients arrived at the hospital within 24 h after stroke onset. The primary outcome was the likelihood of a favorable functional outcome, which was defined as a modified Rankin Scale (mRS) <2 at 90 days. The model's predictive performance was evaluated by assessing its discriminative power (area under the curve [AUC]) and calibration power (Hosmer-Lemeshow goodness-of-fit test, Brier score).</p><p><strong>Results: </strong>In the validation cohort of 298 patients, the model demonstrated a moderate discriminatory ability to predict a favorable functional outcome (mRS 0-1), with an AUC of 0.805 (95% CI, 0.756-0.849). The calibration performance of the model was assessed using the Hosmer-Lemeshow chi-squared test, yielding a value of 9.211 and a p value of 0.325, and additionally, the Brier score for the prediction of a good outcome was 0.153, further supporting the model's good calibration performance.</p><p><strong>Conclusion: </strong>The study introduces the CDSS that integrates clinical baseline data and imaging indicators of brain perfusion status. This CDSS provides clinicians with an intuitive risk assessment of different treatment strategies for AIS patients. Moreover, the CDSS highlights substantial variations in treatment outcomes among patients, suggesting that it has the potential to significantly enhance personalized treatment approaches.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Right Bundle Branch Block with Ischemic Stroke Incidence: A UK Biobank Cohort Study.","authors":"Dougho Park, Sopheak Phoung, Phoeuk Borei, Myeonghwan Bang, Seungsoo Kim, Yousin Suh, Hyoung Seop Kim, Jong Hun Kim","doi":"10.1159/000543258","DOIUrl":"10.1159/000543258","url":null,"abstract":"<p><strong>Introduction: </strong>Right bundle branch block (RBBB) is often considered benign; however, its association with ischemic stroke (IS) remains unclear. We aimed to investigate the relationship between RBBB and the incidence of IS.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the UK Biobank database (2004-2021), which included 3,634 participants with new-onset RBBB and 3,643 matched controls. The primary outcome was the incidence of IS, while the secondary outcomes included atrial fibrillation (AF) and all-cause mortality. We applied a propensity score matching with variables such as age, sex, presence of hypertension, diabetes, dyslipidemia, and the Charlson Comorbidity Index. Subsequently, time-dependent Cox regression analyses were performed to assess the association between RBBB and the outcomes.</p><p><strong>Results: </strong>The cumulative incidence of IS was higher in the RBBB group. RBBB was independently associated with an increased risk of IS (adjusted hazard ratio [aHR], 3.57; 95% confidence interval [CI], 2.12-6.03; p < 0.001), as well as AF (aHR, 4.58; 95% CI, 3.86-5.43; p < 0.001) and all-cause mortality (aHR, 2.66; 95% CI, 2.35-3.02; p < 0.001).</p><p><strong>Conclusion: </strong>RBBB was associated with an increased risk of IS, independent of age, sex, and other comorbidities. These findings emphasize the need for careful monitoring and management of patients with RBBB to mitigate the risk of IS and other adverse outcomes. Further research is needed to elucidate the underlying mechanisms and better inform clinical management strategies for patients with RBBB.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-6"},"PeriodicalIF":2.2,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional Outcome Prediction in Japanese Patients with Nonsurgical Intracerebral Hemorrhage: The FSR ICH Score.","authors":"Takuya Kiyohara, Ryu Matsuo, Fumi Irie, Kuniyuki Nakamura, Jun Hata, Yoshinobu Wakisaka, Takanari Kitazono, Masahiro Kamouchi, Tetsuro Ago","doi":"10.1159/000543362","DOIUrl":"10.1159/000543362","url":null,"abstract":"<p><strong>Introduction: </strong>There has been limited research on predicting the functional prognosis of patients with nonsurgical intracerebral hemorrhage (ICH) from the acute stage. The aim of this study was to develop a risk prediction model for the natural course in patients with nonsurgical ICH and to evaluate its performance using a multicenter hospital-based prospective study of stroke patients in Japan.</p><p><strong>Methods: </strong>We consecutively registered a total of 1,017 patients with acute ICH (mean age, 68 years) who underwent conservative treatment and followed them up for 3 months. The study outcome was a poor functional outcome (modified Rankin Scale score, 4-6) at 3 months after ICH onset. To develop the risk prediction model for natural course in patients with nonsurgical ICH, we included the following clinical common factors assessed on admission in daily clinical practice for ICH: age, sex, medical history (hypertension, diabetes mellitus, dyslipidemia, pre-stroke dementia, previous stroke, coronary artery disease, smoking status, alcohol drinking status, oral anticoagulation, and antiplatelet medication), admission status (time from onset to admission, systolic blood pressure, diastolic blood pressure, pulse pressure, plasma glucose levels, severity of the stroke), and neuroradiologic data (ICH location, intraventricular hemorrhage, and hematoma volume). The risk prediction model for poor functional outcome was developed using logistic regression analysis. In addition, the risk prediction model was translated into a point-based simple risk score (FSR ICH score) using the approach in the Framingham Heart Study.</p><p><strong>Results: </strong>At 3 months after the ICH onset, 323 (31.8%) patients developed a poor functional outcome. Age, diabetes mellitus, pre-stroke dementia, NIHSS score on admission, intraventricular hemorrhage, and hematoma volume were included in the risk prediction model. This model demonstrated excellent discrimination (C statistic = 0.884 [95% confidence interval, 0.863-0.905]; optimism-corrected C statistic based on 200 bootstrap samples = 0.877) and calibration (Hosmer-Lemeshow goodness-of-fit test: p = 0.72). The FSR ICH score, a point-based simple risk score, also showed excellent discrimination, with a C statistic of 0.882 (95% CI: 0.861-0.903).</p><p><strong>Conclusions: </strong>We developed a new risk prediction model for 3-month poor functional outcome in patients with nonsurgical ICH using a multicenter hospital-based prospective study in Japan. The current risk prediction model has the potential to be a useful tool for estimating the natural course in patients with nonsurgical ICH, aiding in making treatment decisions, including surgical options, early formulation of rehabilitation plans, and efficient utilization of medical resources.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-8"},"PeriodicalIF":2.2,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Music-Supported Therapy for Depression and Cognitive Disorders in People Living with Stroke and Its Impact on Quality of Life: A Systematic Evaluation and Meta-Analysis.","authors":"Zhen Wang, Yingxia Xue, Guiying Sun, Jiajia Yun, Yalei Li, Qi Chen, Ruiwen Wang, Jiahui Wang, Chao Ren","doi":"10.1159/000543361","DOIUrl":"https://doi.org/10.1159/000543361","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke not only leads to physical dysfunction in people living with stroke, but also causes emotional and cognitive abnormalities, which significantly affect survival and quality of life. Prior research has shown that music-supported therapy (MST) has the ability to improve depression and cognitive performance through stimulation of the central nervous system. Nevertheless, there is a dearth of rigorous systematic assessments of the effectiveness of MST in improving depression and cognitive impairments in people living with stroke, as well as the impact of these benefits on their overall quality of life. This systematic review and meta-analysis aimed to assess the impact of MST on emotional and cognitive impairments in people living with stroke, as well as its influence on their quality of life.</p><p><strong>Methods: </strong>The PRISMA 2020 guidelines were followed to search for articles on MST treating depression and cognitive issues in people living with stroke in the PubMed, Embase, Web of Science, Wanfang, CNKI, CSTJ, and SinoMed databases, with a cut-off date of July 11, 2024. Two researchers utilized the revised Cochrane RoB-I risk of bias technique to evaluate the quality of all relevant literature obtained. They subsequently extracted and meta-analyzed the data using Review Manager 5.4.1 software.</p><p><strong>Results: </strong>Seventy-two studies involving a total of 5,543 people living with stroke were included, and the meta-analysis revealed that MST had a significant effect on depression and cognitive deficits in people living with stroke (SMDHAMD = 1.49, 95% CI: 1.21-1.76, p < 0.001, MDMMSE = 2.53, CI: 1.60-3.45, p < 0.001, MDMoCA = 3.59, CI: 2.57-4.62, p < 0.001), which took effect from 2 weeks of treatment and was accompanied by an increase in serum 5-HT level (SMD5-HT = 2.22, CI: 1.47-2.96, p < 0.001) and improvements in depression and cognitive function, daily living abilities (SMDADL = 1.72, CI: 1.32-2.11, p < 0.001), limb motor function (SMDFMA = 1.25, CI: 0.47-2.02, p < 0.001), and neurological function (SMDNIHSS = -1.77, CI: -2.50 to -1.04, p < 0.001).</p><p><strong>Conclusion: </strong>MST effectively improves depression and cognitive function of people living with a stroke and enhances their ability to perform daily activities and limb motor function. Importantly, improvements in depression and cognitive function occur earlier than those in daily life ability and neurological function. Additionally, the level of serum 5-HT may serve as a potential indicator for assessing the effectiveness of MST.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-26"},"PeriodicalIF":2.2,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral Artery Overexpression of the NMUR1 Gene Is Associated with Moyamoya Disease: A Weighted Gene Co-Expression Network Analysis.","authors":"Samuel D Pettersson, Shunsuke Koga, Shan Ali, Alejandro Enriquez-Marulanda, Philipp Taussky, Christopher S Ogilvy","doi":"10.1159/000538035","DOIUrl":"10.1159/000538035","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to elucidate mechanisms underlying moyamoya disease (MMD) pathogenesis and to identify potential novel biomarkers. We utilized gene co-expression networks to identify hub genes associated with the disease.</p><p><strong>Methods: </strong>Twenty-one middle cerebral artery (MCA) samples from MMD patients and 11 MCA control samples were obtained from the Gene Expression Omnibus (GEO) dataset, GSE189993. To discover functional pathways and potential biomarkers, weighted gene co-expression network analysis (WGCNA) was employed. The hub genes identified were re-assessed through differential gene expression analysis (DGEA) via DESeq2 for further reliability verification. Additional 4 samples from the superficial temporal arteries (STAs) from MMD patients were obtained from GSE141025, and a subgroup analysis stratified by arterial type (MCA vs. STA) DGEA was performed to assess if the hub genes associated with MMD are expressed significantly greater on the affected arteries compared to healthy ones in MMD.</p><p><strong>Results: </strong>WGCNA revealed a predominant module encompassing 139 hub genes, predominantly associated with the neuroactive ligand-receptor interaction (NLRI) pathway. Of those, 17 genes were validated as significantly differentially expressed. Neuromedin U receptor 1 (NMUR1) and thyrotropin-releasing hormone were 2 out of the 17 hub genes involved in the NLRI pathway (log fold change [logFC]: 1.150, p = 0.00028; logFC: 1.146, p = 0.00115, respectively). MMD-only subgroup analysis stratified by location showed that NMUR1 is significantly overexpressed in the MCA compared to the STA (logFC: 1.962; p = 0.00053) which further suggests its possible localized involvement in the progressive stenosis seen in the cerebral arteries in MMD.</p><p><strong>Conclusion: </strong>This is the first study to have performed WGCNA on samples directly affected by MMD. NMUR1 expression is well known to induce localized arterial smooth muscle constriction and, recently, type 2 inflammation which can predispose to arterial stenosis potentially advancing the symptoms and progression of MMD. Further validation and functional studies are necessary to understand the precise role of NMUR1 upregulation in MMD and its potential implications.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"1-10"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"9th World Intracranial Hemorrhage Conference (WICH) 2025, Wesley Conference Centre, Sydney, Australia, March 28-29, 2025: Abstracts.","authors":"","doi":"10.1159/000545895","DOIUrl":"10.1159/000545895","url":null,"abstract":"<p><p>Abstracts are uploaded as attachment.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":"54 Suppl 1","pages":"1-80"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late Lesion Growth following Endovascular Therapy: Is 24 h Too Early to Assess Acute Infarct Size Including the Effects of Secondary Injury?","authors":"Marie Luby, Amie W Hsia, Carolyn A Lomahan, Victoria Uche, Rachel Davis, Yongwoo Kim, Sana Somani, Shannon Burton, Rainier Cabatbat, Veronica Craft, Jill B De Vis, Malik M Adil, Mariam M Afzal, Leila C Thomas, William Gandler, Evan S McCreedy, John K Lynch, Lawrence L Latour","doi":"10.1159/000536470","DOIUrl":"10.1159/000536470","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Stroke lesion volume on MRI or CT provides objective evidence of tissue injury as a consequence of ischemic stroke. Measurement of \"final\" lesion volume at 24-h following endovascular therapy (post-EVT) has been used in multiple studies as a surrogate for clinical outcome. However, despite successful recanalization, a significant proportion of patients do not experience favorable clinical outcome. The goals of this study were to quantify lesion growth during the first week after treatment, identify early predictors, and explore the association with clinical outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a prospective study of stroke patients at two centers who met the following criteria: (i) anterior large vessel occlusion acute ischemic stroke, (ii) attempted EVT, and (iii) had 3T MRI post-EVT at 24-h and 5-day. We defined \"early\" and \"late\" lesion growth as ≥10 mL lesion growth between baseline and 24-h diffusion-weighted imaging (DWI) and between 24-h DWI and 5-day fluid attenuated inversion recovery imaging, respectively. Complete reperfusion was defined as &gt;90% reduction of the volume of tissue with perfusion delay (Tmax&gt;6 s) between pre-EVT and 24-h post-EVT. Favorable clinical outcome was defined as modified Rankin scale (mRS) of 0-2 at 30 or 90 days.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;One hundred twelve patients met study criteria with median age 67 years, 56% female, median admit NIHSS 19, 54% received IV or IA thrombolysis, 66% with M1 occlusion, and median baseline DWI volume 21.2 mL. Successful recanalization was achieved in 87%, and 68% had complete reperfusion, with an overall favorable clinical outcome rate of 53%. Nearly two-thirds (65%) of the patients did not have late lesion growth with a median volume change of -0.3 mL between 24-h and 5-day and an associated high rate of favorable clinical outcome (64%). However, ∼1/3 of patients (35%) did have significant late lesion growth despite successful recanalization (87%: 46% mTICI 2b/41% mTICI 3). Late lesion growth patients had a 27.4 mL change in late lesion volume and 30.1 mL change in early lesion volume. These patients had an increased hemorrhagic transformation (HT) rate of 68% with only 1 in 3 patients having favorable clinical outcome. Late lesion growth was independently associated with incomplete reperfusion, HT, and unfavorable outcome.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Approximately 1 out of 3 patients had late lesion growth following EVT, with a favorable clinical outcome occurring in only 1 out of 3 of these patients. Most patients with no early lesion growth had no late lesion growth. Identification of patients with late lesion growth could be critical to guide clinical management and inform prognosis post-EVT. Additionally, it can serve as an imaging biomarker for the development of adjunctive therapies to mitigate reperfusion injury.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Stroke lesion volume on MRI or CT provides objective evidence o","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"129-137"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Care, Secondary Prevention, and Outcomes after Ischaemic and Haemorrhagic Stroke in Men and Women: A Data-Linkage Study.","authors":"Kadie-Ann Sterling, Mary Joan MacLeod, Mark Barber, Melanie Turner","doi":"10.1159/000540371","DOIUrl":"10.1159/000540371","url":null,"abstract":"<p><strong>Introduction: </strong>There is evidence that sex differences exist in stroke presentation, risk factors, severity, treatment, and outcomes. To further understand this, we explored how sex differences influence acute stroke management, secondary prevention prescribing, and mortality outcomes in a well-characterised cohort of first-ever stroke patients in Scotland.</p><p><strong>Methods: </strong>This is a retrospective, population-based, data-linkage study of stroke admissions to acute care hospitals in Scotland between January 1, 2011, and December 31, 2018. Data sources included the Scottish Stroke Care Audit (SSCA), the Prescribing Information System (PIS), the Scottish Morbidity Record 01 (SMR01), and the National Records of Scotland (NRS) death records. Multivariable logistic regression was used to explore the association between patient sex, acute stroke care, and secondary prevention prescribing, while Cox proportional hazards models were used to explore the association between patient sex and all-cause mortality up to 1 year after index event.</p><p><strong>Results: </strong>This study included 5,901 patients with a first-ever intracerebral haemorrhage (ICH) and 47,087 patients with a first-ever acute ischaemic stroke (AIS). After an ICH, women had significantly lower odds of receiving all components of the stroke care bundle (adjusted odds ratio [aOR], 0.78; 95% confidence interval [CI], 0.69-0.87) and were less likely to be prescribed antihypertensives within 90 days after discharge to the usual place of residence (aOR, 0.78; 95% CI, 0.63-0.97). There was no sex difference in stroke care bundle achievement for those admitted with AIS; however, women had significantly lower odds of receiving antihypertensives, lipid-lowering drugs, or oral anticoagulants after discharge. The risk of all-cause mortality was lower in women at 1 year after both ICH (adjusted hazard ratio [aHR], 0.90; 95% CI, 0.83-0.98) and AIS (aHR, 0.91; 95% CI, 0.87-0.95) after adjusting for potential confounders.</p><p><strong>Conclusion: </strong>The sex differences in stroke treatment and outcomes may be partly explained by the older age of women at the time of stroke, which influences stroke presentation, severity, and prognosis. However, following adjustment, women had a reduced risk of all-cause mortality after both ICH and AIS.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"371-378"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Miller Fisher's Rules and Digital Health: The Best of Both Worlds.","authors":"Joao Brainer Andrade, George Nunes Mendes, Gisele Sampaio Silva","doi":"10.1159/000539323","DOIUrl":"10.1159/000539323","url":null,"abstract":"<p><strong>Background: </strong>Professor Fisher's legacy, defined by meticulous observation, curiosity, and profound knowledge, has established a foundational cornerstone in medical practice. However, the advent of automated algorithms and artificial intelligence (AI) in medicine raises questions about the applicability of Fisher's principles in this era. Our objective was to propose adaptations to these enduring rules, addressing the challenges and leveraging the opportunities presented by digital health.</p><p><strong>Summary: </strong>The adapted rules we propose advocate for the harmonious integration of traditional bedside manners with contemporary technological advancements. The judicious use of advanced devices for patient examination, recording, and sharing, while upholding patient confidentiality, is pivotal in modern practice and academic research. Additionally, the strategic employment of AI tools at the bedside, to aid in diagnosis and hypothesis generation, underscores their role as valued complements to clinical reasoning. These adapted rules emphasize the importance of continual learning from experience, literature, and colleagues, and stress the necessity for a critical approach toward AI-derived information, which further consolidates clinical skills. These aspects underscore the perpetual relevance of Professor Fisher's rules, advocating not for their replacement but for their evolution. Thus, a balanced methodology that adeptly utilizes the strengths of AI and digital tools, while steadfastly maintaining the core humanistic values, arises as essential in the modern practice of medicine.</p><p><strong>Key messages: </strong>A commitment between traditional medical wisdom and modern technological capabilities may enhance medical practice and patient care. This represents the future of medicine - a resolute commitment to progress and technology, while preserving the essence of medical humanities.</p>","PeriodicalId":9683,"journal":{"name":"Cerebrovascular Diseases","volume":" ","pages":"228-235"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}