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NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS
Official Journal of the Bulgarian Society of Neurosonology and Cerebral Hemodynamics
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1.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, Vol. 1, 2005
,
,
,
Visualization of the basilar artery by transcranial colour-coded duplex sonography:comparison with postmortem
results
.
Schulte-Altedorneburg G, Droste D, Popa V, et al.
Visualization of the basilar artery by transcranial colour-coded duplex sonography:comparison with postmortem results.
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Results
:
Results:
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Objective was assess the clinical appearances, diagnostic procedures, therapeutic options and
results
in the cases having vein of Galen aneurysms.
The various clinical appearances of the vein of Galen aneurysms present considerable difficulties for diagnosis and treatment of the newborns having this vascular malformation.
Objective was assess the clinical appearances, diagnostic procedures, therapeutic options and results in the cases having vein of Galen aneurysms.
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Results
:
Results:
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vein of Galen aneurysm, childhood, surgical treatment,
results
vein of Galen aneurysm, childhood, surgical treatment, results
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
The tables and illustrations should be presented on a separate sheet of paper, numbered, with a short explanation. All measurements should be in international units, using a decimal point and with no use of Roman numerals.
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2.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 1, 2005, No. 2
,
,
,
In 1998, two large randomized controlled trials of endarterectomy versus medical treatment published their final
results
.
In 1954 the first endarterectomy has been performed in a patient with symptomatic carotid artery stenosis. Over the years it evolved and became a routine surgical treatment for carotid stenosis although no adequate clinical trials confirmed its benefits.
In 1998, two large randomized controlled trials of endarterectomy versus medical treatment published their final results.
Although their design was similar, differences in inclusion and exclusion criteria, methods of determining degree of stenosis and definitions of outcome events existed. The Veterans Affairs Trial was the third trial and was stopped when initial results of the two large trials were published in 1991.
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The Veterans Affairs Trial was the third trial and was stopped when initial
results
of the two large trials were published in 1991.
In 1954 the first endarterectomy has been performed in a patient with symptomatic carotid artery stenosis. Over the years it evolved and became a routine surgical treatment for carotid stenosis although no adequate clinical trials confirmed its benefits. In 1998, two large randomized controlled trials of endarterectomy versus medical treatment published their final results. Although their design was similar, differences in inclusion and exclusion criteria, methods of determining degree of stenosis and definitions of outcome events existed.
The Veterans Affairs Trial was the third trial and was stopped when initial results of the two large trials were published in 1991.
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Final
results
of both trials, European Carotid Surgery Trial (ECST) and North American
Final results of both trials, European Carotid Surgery Trial (ECST) and North American
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These
results
established CEA as the gold standard procedure for the prevention of a recurrent ischemic event in symptomatic patients with ipsilateral carotid stenosis greater then 70%.
50 percent.
These results established CEA as the gold standard procedure for the prevention of a recurrent ischemic event in symptomatic patients with ipsilateral carotid stenosis greater then 70%.
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First published
results
are expected in the second half of 2006.
The SPACE study plans to include 1200 patients by the end of 2005 which is a goal for an interim analysis.
First published results are expected in the second half of 2006.
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Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final
results
of the MRC European Carotid Surgery Trial (ECST).
European Carotid Surgery Trialist’s Collaborative Group.
Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST).
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The final
results
of the NASCET
North American Symptomatic Carotid Endarterectomy Trialist’s Collaborative Group.
The final results of the NASCET
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Controversial
results
between different studies and the future directions have been analyzed.
Despite a long history of the studies treating the problems of stroke, epileptic seizures and epilepsy associated with cerebrovadcular incidence arise many questions. This review summarizes the most important data concerning terminology, epidemiology, pathophysiology, risk factors, diagnosis and treatment of epileptic seizures and epilepsy after stroke.
Controversial results between different studies and the future directions have been analyzed.
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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surgical procedures,
results
surgical procedures, results
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To assess the causes, surgical procedures and postoperative
results
in the children having internal hydrocephalus, treated in our institution during the period of last five years.
To assess the causes, surgical procedures and postoperative results in the children having internal hydrocephalus, treated in our institution during the period of last five years.
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Results
:
Results:
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
The tables and illustrations should be presented on a separate sheet of paper, numbered, with a short explanation. All measurements should be in international units, using a decimal point and with no use of Roman numerals.
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3.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 2, 2006, No. 1
,
,
,
habilitation methods have gained plenty of interest and produced promising
results
in selected research patients with stroke.
habilitation methods have gained plenty of interest and produced promising results in selected research patients with stroke.
Here I wish to give one example of how a neuroimaging study of a new stroke rehabilitation method may give hard data on the effects of rehabilitation [1].
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This can be achieved through diligent research and rapid transfer of
results
to clinical practice.
minimize the deficits caused by such incidents as stroke.
This can be achieved through diligent research and rapid transfer of results to clinical practice.
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The
results
from a study of the polymorphism of the metalloproteinase gene (MMP-3) show structural and functional changes in the common carotid artery (CCA) in homozygous for the 6A allele which contribute to formation of carotid plaques.
4 алела на APOE. Връзката между генетичните вариации на ензима метилен тетрахидрофолат редуктаза с каротидната атеросклероза е противоречива. Проучвания върху полиморфизма на гена за параоксоназа 1 (PON 1) са показали по-висок индекс на плаките при LL хомозиготите, по-често срещан L алел при случаите със стенози, по-висока стойност на дебелината на ИМК при лица с генотип LL/QQ. Установена е връзка между полиморфизма на E 298 D (894 GT) polymorphism of the endothelial nitric-oxide synthase (eNOS) and the atherosclerotic plaques in different carotid vessel segments and with carotid IMT.
The results from a study of the polymorphism of the metalloproteinase gene (MMP-3) show structural and functional changes in the common carotid artery (CCA) in homozygous for the 6A allele which contribute to formation of carotid plaques.
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Paraoxonase PON1 polymorphism leu-Met54 is associated with carotid atherosclerosis:
results
of the Austrian Stroke Prevention Study.
Schmidt H, Schmidt R, Niederkorn K, Gradert A, Schumacher M, Watzinger N, Hartung HP, Kostner GM.
Paraoxonase PON1 polymorphism leu-Met54 is associated with carotid atherosclerosis: results of the Austrian Stroke Prevention Study.
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Results
:
Results:
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4.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 2, 2006, No. 2
,
,
,
Clinical aplication of Plavix in neurological practice –
results
from CAPRIE study
Clinical aplication of Plavix in neurological practice – results from CAPRIE study
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inhalation and acetazolamide test
results
, indicating
inhalation and acetazolamide test results, indicating
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Transcranial Low-Frequency Ultrasound-Mediated Thrombolysis in Brain Ischemia: Increased Risk of Hemorrhage With Combined Ultrasound and Tissue Plasminogen Activator:
Results
of a Phase II Clinical Trial.
Daffertshofer M, Gass A, Ringleb P, Sitzer M, Sliwka U, Els T, Sedlaczek O, Koroshetz WJ, Hennerici MG.
Transcranial Low-Frequency Ultrasound-Mediated Thrombolysis in Brain Ischemia: Increased Risk of Hemorrhage With Combined Ultrasound and Tissue Plasminogen Activator: Results of a Phase II Clinical Trial.
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Safety and Efficacy of Mechanical Embolectomy in Acute Ischemic Stroke:
Results
of the MERCI Trial.
Smith WS, Sung G, Starkman S, Saver JL, Kidwell CS, Gobin YP, Lutsep HL, Nesbit GM, Grobelny T, Rymer MM, Silverman IE, Higashida RT, Budzik RF, Marks MP for the MERCI Trial Investigators.
Safety and Efficacy of Mechanical Embolectomy in Acute Ischemic Stroke: Results of the MERCI Trial.
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Good final
results
of treatment, without any changes in sinus thrombosis is due to rapid compensation of venous blood flow by anastomoses, “intracranial decompression” by CSF and cerebral detritus leakage, surgical and therapeutical control of the brain edema, despite of lack of effect of anticoagulant therapy in one of the patients.
Good final results of treatment, without any changes in sinus thrombosis is due to rapid compensation of venous blood flow by anastomoses, “intracranial decompression” by CSF and cerebral detritus leakage, surgical and therapeutical control of the brain edema, despite of lack of effect of anticoagulant therapy in one of the patients.
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Results
:
Results:
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The
results
of our study on heart rate variability in patients with diabetic polyneuropathy show reduction of the fluctuations of heart rate, lowering of the low frequency power and shorter mean R–R intervals.
The results of our study on heart rate variability in patients with diabetic polyneuropathy show reduction of the fluctuations of heart rate, lowering of the low frequency power and shorter mean R–R intervals.
Abnormal cardiovascular responses with significant decrease of the R-Rmax-min response, the VR and the 30:15 ratio in the patients in comparison to the controls was established.
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The data obtained correlate with the
results
from the power spectral analysis of the autonomic balance and increase its sensitivity.
The data obtained correlate with the results from the power spectral analysis of the autonomic balance and increase its sensitivity.
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Results
:
Results:
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Clinical aplication of Plavix in neurological practice –
results
from CAPRIE study
Clinical aplication of Plavix in neurological practice – results from CAPRIE study
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Plavix in neurological practice –
results
from CAPRIE study
Plavix in neurological practice – results from CAPRIE study
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5.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 3, 2007, No. 1
,
,
,
Displacement to the arterial capillary
results
in ischemia, and to the venous capillary
part. The role of displacement of this 0-point in ischemia and hyperperfusion is shown.
Displacement to the arterial capillary results in ischemia, and to the venous capillary
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A relatively modest decrease of 10% in vessel diameter
results
in a 34% increase of flow resistance.
where K is a constant, which is always greater or equal to one, the later case representing the state of minimal loss flow, with a parabolic velocity profile. The use of this formula in hemodynamic is restricted because of some anatomical factors. However there is one very important fact: the flow resistance is inversely proportional to radius of the vessel in fourth power.
A relatively modest decrease of 10% in vessel diameter results in a 34% increase of flow resistance.
Halving the diameter increases the resistance by 16 times [2].
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and adenosine increase, consequent of brain activity,
results
in widening of blood vessel lumen, decrease of the resistance and increase of the blood circulation.
and adenosine increase, consequent of brain activity, results in widening of blood vessel lumen, decrease of the resistance and increase of the blood circulation.
This is a metabolic control (again in forth power!), without participation of neuronal meditation, as a parallel positive autoregulation mechanism of mill clack type. This is the normal way of work at the “nutrition unit” level.
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Here the neuronal control of the autonomous nervous system is superimposed as (1) a negative feedback (based on the pressure receptors of the carotid sinus), and
results
in suppression of the cardiac output and systemic (aortic) blood pressure, and (2) as a positive feedback to the
while maintaining the overall cerebral blood flow. The aforesaid local subsystems and the whole cerebral system are working as parts of the whole body circulation system, which driving forces are the cardiac output and systemic blood pressure. These directly influenced the pressure and blood flow at the beginning of the cerebral magistrals.
Here the neuronal control of the autonomous nervous system is superimposed as (1) a negative feedback (based on the pressure receptors of the carotid sinus), and results in suppression of the cardiac output and systemic (aortic) blood pressure, and (2) as a positive feedback to the
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A vasospasm before the place or in the territory of the ruptured aneurysm, or in the case of an intraarterial ulcerated plaque, could be considered as a defective mechanism, but
results
in decreased O
A vasospasm before the place or in the territory of the ruptured aneurysm, or in the case of an intraarterial ulcerated plaque, could be considered as a defective mechanism, but results in decreased O
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Intracranial pressure (ICP) when raised,
results
in a consequent rise of the blood pressure (the experiment of Dubois Raymond), which is a defensive reflex, ensuring the income of blood into the brain arterial system (if ICP≥ABP no circulation is possible).
Now, it is clear why lowering the blood pressure too mush, in cases with subarachnoid hemorrhage, is not the proper thing to do.
Intracranial pressure (ICP) when raised, results in a consequent rise of the blood pressure (the experiment of Dubois Raymond), which is a defensive reflex, ensuring the income of blood into the brain arterial system (if ICP≥ABP no circulation is possible).
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To determine the
results
of ACTH-drugs treatment in children with West syndrome.
To determine the results of ACTH-drugs treatment in children with West syndrome.
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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The
results
confirm the adverse effects оf age on some risk factors for CVD, associated with pathological changes in the cerebral circulation and carotid walls.
The results confirm the adverse effects оf age on some risk factors for CVD, associated with pathological changes in the cerebral circulation and carotid walls.
Among them the hemorheological and lipid factors and the carotid atheroscle
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Results
:
Results:
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
The tables and illustrations should be presented on a separate sheet of paper, numbered, with a short explanation. All measurements should be in international units, using a decimal point and with no use of Roman numerals.
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6.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 3, 2007, No. 2
,
,
,
The
results
of a multicenter study ESPRIT [8] confimed the
results
of ESPS2 about the superiority of ASA+DP over ASA alone.
ing the 2-year follow-up in ESPS2 2, NNT=33).
The results of a multicenter study ESPRIT [8] confimed the results of ESPS2 about the superiority of ASA+DP over ASA alone.
Clopidogrel may be a suitable alternative for those who can not tolerate aspirin or dipyridamole. In a Cochrane analysis [10], antiplatelet therapy during and after CEA reduced the outcome of stroke. When carotid endarterectomy is considered, antiplatelet therapy should always be started before surgery. ASA should be given before, during and following endarterectomy [11]. Clopidogrel should be terminated 5 days before surgery.
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Homocysteine and ischemic heart disease:
results
of a prospective study with implications regarding prevention.
Wald NJ, Watt HC, Law MR et al.
Homocysteine and ischemic heart disease: results of a prospective study with implications regarding prevention.
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
The tables and illustrations should be presented on a separate sheet of paper, numbered, with a short explanation. All measurements should be in international units, using a decimal point and with no use of Roman numerals
read the entire text >>
7.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 4, 2008, No. 1
,
,
,
All studies investigators performing TCD were not blinded to clinical, electroencephalographic or radiographic
results
.
Other didn’t meet the validation criteria for further analysis. Most TCD findings are based on the assessment of blood flow in the middle cerebral arteries, or diagnose of brain dead was made on clinical grounds alone, without apnea test. Some are comparing TCD with other diagnostic tests, although validity of reference tests can be compromised. Meta-analysis [9] of the two high-quality studies showed a sensitivity of 95% (95% CI 92-97%) and a specificity of 99% (95% CI 97-100%) to detect brain death. Metaanalysis of all ten studies showed a sensitivity of 89% and a specificity of 99%.
All studies investigators performing TCD were not blinded to clinical, electroencephalographic or radiographic results.
This meta-analysis showed that TCD is
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Large opening of the scull may result in false negative
results
.
Sensitivity and specificity for a positive pattern of oscillating flow and systolic spikes, indicating cerebral circulatory arrest were high in selected patient population. Few false-positive cases were reported in the literature, but only two instances [10, 17] were defined as false positive according to predefined criteria in this meta-analysis. In one patient [10] with TCD criteria of cerebral circulatory arrest, weak respiration was recorded after TCD examination. In the other report [17], a clinically brain-dead patient with cerebral circulatory arrest on TCD and angiography, EEG examination became isoelectric only several hours later. Both these patients became brain dead shortly after the false-positive TCD examination.
Large opening of the scull may result in false negative results.
After evaluating validity of TCD diagnosed brain death depending on the time lapse between clinical diagnosis and the performance of TCD, a specificity of 100% 24 hours after the clinical diagnosis was obtained [13].
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Results
:
Results:
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MRC European Carotid Surgery Trial: interim
results
for symptomatic patients with severe (70–99%) or with mild (0–29%) carotid stenosis.
European Carotid Surgery Trialists’ Collaborative Group.
MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70–99%) or with mild (0–29%) carotid stenosis.
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Comparison between the
results
from colour coded duplex scan (CCDS), B-flow imaging, computer tomography angiography (CTA) and digital subtraction angiography (DSA) was performed.
We present a 51 years old man with spontaneous left ICA dissection.
Comparison between the results from colour coded duplex scan (CCDS), B-flow imaging, computer tomography angiography (CTA) and digital subtraction angiography (DSA) was performed.
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Results
:
Results:
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Retrospectively the
results
from CTA were additionally analysed to prove the ICA dissection.
False negative result was obtained during routine CTA study – the carotid dissection was interpretated as a plaque. By comparison with CCDS B-flow imaging showed more precisely the intimal flap and the visualization of flow within the true and false lumens. The ultrasound data corresponded with the finding from DSA before stenting.
Retrospectively the results from CTA were additionally analysed to prove the ICA dissection.
A complete recanalization was observed after stenting using DSA, CCDS and B-flow.
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Results
:
Results:
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Results
:
Results:
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The study showed that most of the copies were not similar compared to the original drug product: their amount of impurities was higher, the content of clopidogrel lower, the dissolution profiles different and after 3 months under stress conditions in the original packaging, the
results
for the samples and the reference were significantly different in most of the cases
This article is a scientific information comparing 18 copies of PLAVIX tablets containing clopidogrel hydrogensulfate with the innovator drug product for uniformity of mass, impurity profile, content, dissolution properties and stability. In order to be able to separate the R-enantiomer of clopidogrel, an enantiospecific liquid chromatographic method was used to determine the impurities and to perform the assay.
The study showed that most of the copies were not similar compared to the original drug product: their amount of impurities was higher, the content of clopidogrel lower, the dissolution profiles different and after 3 months under stress conditions in the original packaging, the results for the samples and the reference were significantly different in most of the cases
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
The tables and illustrations should be presented on a separate sheet of paper, numbered, with a short explanation. All measurements should be in international units, using a decimal point and with no use of Roman numerals.
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8.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 4, 2008, No. 2
,
,
,
Results
:
Results:
read the entire text >>
Results
:
Results:
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Using TCCD false negative
results
were established in 7 patients, 1 had a false positive result.
Subarachnoid haemorrhage was found in 23 patients, 1 suffered from headache and 1 had ischemic cerebral stroke. DSA confirmed the existence of 27 cerebral aneurysms in 20 patients.
Using TCCD false negative results were established in 7 patients, 1 had a false positive result.
The diagnostic sensitivity of TCCDS compared to DSA was 74.1% and the disgnostic specifity – 83.3%
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Results
:
Results:
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MRC European Carotid Surgery Trial: interim
results
for symptomatic patients with severe (70–99%) or with mild (0–29%) carotid stenosis.
European Carotid Surgery Trialists’ Collaborative Group.
MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70–99%) or with mild (0–29%) carotid stenosis.
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Endarterectomy for moderate symptomatic carotid stenosis: interim
results
from the MRC European Carotid Surgery Trial.
European CarotidTrialists’Collaborative Group.
Endarterectomy for moderate symptomatic carotid stenosis: interim results from the MRC European Carotid Surgery Trial.
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Results
of a randomized controlled trial of carotid endarterectomy for asymptomatic carotid stenosis.
Mayberg MR, Wilson SE, Yatsu F, Weiss DG, Messina L, Hershey LA, Colling C, Eskridge J, Deykin D, Winn HR, for the Veterans Affairs Mayo Asymptomatic Carotid Endarterectomy Study Group.
Results of a randomized controlled trial of carotid endarterectomy for asymptomatic carotid stenosis.
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Long-term prognosis and effect of endarterectomy in patients with symptomatic severe carotid stenosis and contralateral carotid stenosis or occlusion:
results
from NASCET.
North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group.
Long-term prognosis and effect of endarterectomy in patients with symptomatic severe carotid stenosis and contralateral carotid stenosis or occlusion: results from NASCET.
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Results
:
Results:
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Blood pressure and risk of dementia:
results
from the Rotterdam study and the Gothenburg H-70 study,
Ruitenberg A, Skoog I, Ott A.
Blood pressure and risk of dementia: results from the Rotterdam study and the Gothenburg H-70 study,
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Results
:
Results:
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The proved advantages of ultrasound examinations are: harmlessness, protection of slow virus infections, possibility for repeated monitoring, comparable
results
, low prime cost of
results
, high advantages in comparing with the other neuroimaging methods.
Images of stretch of functional axis of muscles are hipoechogenic fibers. There is ultrasound effect – the effect of the comb. The assessment of blood vesicles of muscles are accomplishing by colour and power Doppler examination. The examination is made in time of contraction using a 7-10 MHz linear transducer. The ultrasound distinguishment of surrounding tissues (skin, bones and fat) is important.
The proved advantages of ultrasound examinations are: harmlessness, protection of slow virus infections, possibility for repeated monitoring, comparable results, low prime cost of results, high advantages in comparing with the other neuroimaging methods.
The usage of myosonology in neurology has high sense in inflamed and degerative diseases, tumors, traumas, biopsy and other diagnostic problems.
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The good early and late
results
are based on the combination of drug and surgical treatment.
Drug therapy includes antiplatelet therapy and reduction of the risk factors for atherosclerosis. It decreases the frequency of ischemic stroke and vascular dead. Surgical treatment (carotid endarterectomy) decreases also the frequency of ischemic stroke. It is successful when includes preand postoperative drug therapy. The article presents the complex treatment of 205 patients with carotid atherosclerosis.
The good early and late results are based on the combination of drug and surgical treatment.
Algorithm for therapeutic strategy in patients with carotid atherosclerosis is discussed.
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Perioperative statine and diuretic use influence the presentation of patients undergoing carotid endarterectomy:
Results
of a large single – institution case study.
Brooke B, M McGirt, G Woodworth.
Perioperative statine and diuretic use influence the presentation of patients undergoing carotid endarterectomy: Results of a large single – institution case study.
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Long-term prognosis and effect of endarterectomy in patients with symptomatic severe carotid stenosis and contralateral carotid stenosis or occlusion:
results
from NASCET.
* North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group.
Long-term prognosis and effect of endarterectomy in patients with symptomatic severe carotid stenosis and contralateral carotid stenosis or occlusion: results from NASCET.
J Neurosurg 83, 1995: 778–782.
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
The tables and illustrations should be presented on a separate sheet of paper, numbered, with a short explanation. All measurements should be in international units, using a decimal point and with no use of Roman numerals.
read the entire text >>
9.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 5, 2009, No. 1
,
,
,
The
results
obtained from a multicenter, openlabel, randomized cross-over study investigating the diagnostic potential of SonoVue using transcranial color-coded duplex sonography (TCCS) confirm this clinical observation [10].
The results obtained from a multicenter, openlabel, randomized cross-over study investigating the diagnostic potential of SonoVue using transcranial color-coded duplex sonography (TCCS) confirm this clinical observation [10].
In a group of forty patients, echo enhancement contributed to converting a non-diagnostic study into a diagnostic one in more than half of the indications (in 66%), and increased the confidence in diagnosis in 74 %. In a non-trial situation, this would have allowed the diagnosis to be reached more quickly. To make good treatment decisions, early, reliable information about the condition of the arteries of the Circle of Willis is necessary [11].
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Especially in those patients whose baseline scans are not of good quality, contrast enhancement is of great value to improve the diagnostic
results
(Fig. 1).
Especially in those patients whose baseline scans are not of good quality, contrast enhancement is of great value to improve the diagnostic results (Fig. 1).
For further diagnostic steps and for therapy in cases of an occlusion in a middle cerebral artery, it is important to know whether failure to visualize a cerebral vessel is due to methodological problems or to a pathological condition. The absence of a color-coded signal for the middle cerebral artery is indicative of an occlusion, if a good contrast-enhanced signal for the ipsilateral posterior cerebral artery can be displayed (Fig. 1b). In a posterior circulation,
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Results
of a phase-two study.
Bogdahn U, Becker G, Schlief R, Redding J, Hassel W. Contrast-enhanced transcranial color-coded real time sonography.
Results of a phase-two study.
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Preliminary
results
.
ttner T. Second harmonic imaging in acute middle cerebral artery infarction.
Preliminary results.
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Preliminary
results
.
P. Evaluation of cerebral perfusion deficit in stroke patients using new transcranial contrast imaging CPSTM technology.
Preliminary results.
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Harmonic imaging, principles and preliminary
results
.
Harmonic imaging, principles and preliminary results.
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The
results
were compaired with normal subjects without optic nerve pathology.
The study was performed in 3 patients with optic nerve and optic disc pathology (papilloedema) using duplex sonograph Loqic 7 (GE) with abilities for 3D/4D imaging of various structures.
The results were compaired with normal subjects without optic nerve pathology.
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Results
:
Results:
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Results
:
Results:
read the entire text >>
Blood pressure and risk of dementia:
results
from the Rotterdam study and the Gothenburg H-70 study.
Ruitenberg A, Skoog I, Ott A.
Blood pressure and risk of dementia: results from the Rotterdam study and the Gothenburg H-70 study.
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Schmidt R, Enzinger C, Ropele S, Schmidt H., Fazekas F., Progression of cerebral white matter lesions: 6-year
results
of the Austrian stroke prevention study.
Schmidt R, Enzinger C, Ropele S, Schmidt H., Fazekas F., Progression of cerebral white matter lesions: 6-year results of the Austrian stroke prevention study.
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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F. Progression of cerebral white matter lesions: 6-year
results
of the Austrian Stroke Prevention Study.
F. Progression of cerebral white matter lesions: 6-year results of the Austrian Stroke Prevention Study.
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Prof. Baykushev introduced as first in Bulgaria MEP by electrical stimulation and reported the
results
in Hamburg (1978), and later MEP by magnetic stimulation (1989).
Prof. Baykushev introduced as first in Bulgaria MEP by electrical stimulation and reported the results in Hamburg (1978), and later MEP by magnetic stimulation (1989).
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
The tables and illustrations should be presented on a separate sheet of paper, numbered, with a short explanation. All measurements should be in international units, using a decimal point and with no use of Roman numerals.
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10.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 5, 2009, No. 1
,
,
,
Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depression: preliminary
results
of a randomized trial.
Janicak PG, Dowd SM, Maris B et al.
Repetitive transcranial magnetic stimulation versus electroconvulsive therapy for major depression: preliminary results of a randomized trial.
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
The tables and illustrations should be presented on a separate sheet of paper, numbered, with a short explanation. All measurements should be in international units, using a decimal point and with no use of Roman numerals.
read the entire text >>
11.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 6, 2010, No. 1
,
,
,
Carotid stenting –
results
and prospects
Carotid stenting – results and prospects
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This reminds me the discussion after my first international presentation in the late seventies about our
results
comparing Doppler sonography and angiography.
In a recent “scientific statement of the American Heart Association” concerning imaging of acute ischemic stroke the use of “carotid ultrasound” for detecting surgical lesions was classified as a screening tool, which is not sufficient to be used as the sole methodology for the definite diagnosis. Summarising the relevant comparative studies this report concluded that using ultrasound alone “almost 1 of every 6 patients evaluated may undergo an unneeded or may not have a needed surgery” (R.E. Latchaw et.al: Stroke 2009; 40: 3646-3678).
This reminds me the discussion after my first international presentation in the late seventies about our results comparing Doppler sonography and angiography.
The comment was, in the end we need conventional angiography anyway”. Has nothing changed in more than 30 years? Was all the technical progress in ultrasonic imaging and understanding of hemodynamics useless? Is ultrasound still only a comparably inexpensive screening method or a decision making tool? Neurosonology is more than the question: Is it possible to select patients for surgery using ultrasound alone by separating out those with a =/>70% carotid stenosis.
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be sufficient to differentiate between clearly normal and pathologic
results
and to add other diagnostic modalities in case of any suspected pathology.
be sufficient to differentiate between clearly normal and pathologic results and to add other diagnostic modalities in case of any suspected pathology.
This has to be seen not only on a technical background but also on a clinical one. Crescendo TIA’s needs a faster and more definite assessment than a doubtful symptom a month ago. Any discussion about clinical decision making should be addressed in the frame of the 3 levels of training and competence as defined by the EFSUMB or a correspondent national definition.
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Nobody will take the trouble and expense to repeat these studies to prove that the
results
will be the same based on ultrasound.
The prophylactic effect of carotid surgery correlated with the degree of carotid stenosis as seen on X ray angiography. The pathogenetic substrate is a plaque characterized by its hemodynamic effect due to area reduction and/or a complicated structure and broken surface. The 2 dimensional X ray shadow does not elucidate this better than the ultrasound examination which includes morphological and hemodynamic criteria. The X ray angiography however is taken as gold standard because this was the method of choice at the time of the study design of NASCET and ECST.
Nobody will take the trouble and expense to repeat these studies to prove that the results will be the same based on ultrasound.
In addition it will be no more possible ethically. Diameter reduction on X ray angiography is a surrogate parameter for the pathogenic plaque as are the ultrasound result with B-mode image, colour flow and velocity values. Both the angiographic and ultrasonic method yield surrogate parameters partially depending on different biologic variables and total agreement is not possible. Which of these methods represent better the true nature of a plaque has to be answered taking in account the complex background including the quality of the ultrasound result in the individual patient, experience of the examiner and the estimated degree of stenosis. Taking the example of a clear cut severe stenosis with established collateral flow through the anterior communicating artery or the ophthalmic artery, ultrasound and X-ray angiography will provide the same result concerning decision making.
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Unfortunately this is the criterion with a large scatter of
results
when compared with X ray angiography.
The internationally most frequently recommended single criterion for measuring the degree of stenosis is the “peak systolic velocity (PSV)”.
Unfortunately this is the criterion with a large scatter of results when compared with X ray angiography.
Angiography measure the diameter reduction but not the area reduction responsible for velocities. But most importantly the large scatter of results is due to hemodynamic influences. The ambiguity of this parameter used alone becomes immediately clear by looking on the “Spencer’s curve” with the same systolic velocity resulting from a moderate stenosis and a nearly occluded artery (Spencer, M.P., Reid, J.M.: Stroke 10 (1979) 326). In ad-
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But most importantly the large scatter of
results
is due to hemodynamic influences.
The internationally most frequently recommended single criterion for measuring the degree of stenosis is the “peak systolic velocity (PSV)”. Unfortunately this is the criterion with a large scatter of results when compared with X ray angiography. Angiography measure the diameter reduction but not the area reduction responsible for velocities.
But most importantly the large scatter of results is due to hemodynamic influences.
The ambiguity of this parameter used alone becomes immediately clear by looking on the “Spencer’s curve” with the same systolic velocity resulting from a moderate stenosis and a nearly occluded artery (Spencer, M.P., Reid, J.M.: Stroke 10 (1979) 326). In ad-
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to show the periprocedural and shortterm
results
of the interventional treatment of ischemic acute stroke in Tokuda Hospital – Sofia.
to show the periprocedural and shortterm results of the interventional treatment of ischemic acute stroke in Tokuda Hospital – Sofia.
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Results
:
Results:
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These
results
confirm the benefit of the interventional treatment in cases of acute ischemic stroke when performed by an experienced interventional team.
These results confirm the benefit of the interventional treatment in cases of acute ischemic stroke when performed by an experienced interventional team.
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We present the
results
of stenting of 51 occlusions and tight stenoses of carotid arteries for 2001 – 2009.
We present the results of stenting of 51 occlusions and tight stenoses of carotid arteries for 2001 – 2009.
They represent 21.9% of the total 232 carotid stenting procedures in this period 5 (9.8%) chronic carotid occlusions and 46 (90.2%) tight carotid stenoses.
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Results
:
Results:
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Randomised trial ofendarterectomy for recently symptomatic carotid stenosis: final
results
of the MRC European Carotid Surgery Trial (ECST).
European Carotid Surgery Trialists’Collaborative Group.
Randomised trial ofendarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST).
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Long-term
results
of elective stenting for severe carotid artery stenosis in Taiwan.
Kao HL, Lin LY, Lu CJ, Jeng JS, Yip PK, Lee YT.
Long-term results of elective stenting for severe carotid artery stenosis in Taiwan.
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The final
results
of the NASCET trial.
North American Symptomatic Carotid Endarterectomy Trialists’ Collaborative Group.
The final results of the NASCET trial.
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Despite the relationship between plasma Hcy and ischemic stroke, we should wait for the
results
of the ongoing trials to know if the reduction of Hcy levels with vitamin therapy is of clinical benefit.
Despite the relationship between plasma Hcy and ischemic stroke, we should wait for the results of the ongoing trials to know if the reduction of Hcy levels with vitamin therapy is of clinical benefit.
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concentration and the likelihood of nonfatal stroke:
results
from the Third National Health and Nutrition Examination Survey, 1988-1994.
concentration and the likelihood of nonfatal stroke: results from the Third National Health and Nutrition Examination Survey, 1988-1994.
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Even within 3-hour therapeutic window, earlier treatment leads to better
results
[30].
Several multicentral trials demonstrate the benefit from TL in AIS, more important of which are the NINDS, the ECASS I and II, and the ATLANTIS. The NINDS study demonstrated that TL with rt-PA used within three hours after stroke onset significantly improves outcome in patients with AIS [30, 64].
Even within 3-hour therapeutic window, earlier treatment leads to better results [30].
Odds ratios were 2.8 (95%
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TL for selected patients presenting with AIS between 3 and 4.5 hours was currently also included in the European labelling [modified January 2009], on the bases of ECASS-III study
results
[31].
The Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST) was a multicentre, multinational observational study which confirmed that rt-PA, compared to placebo, is as effective and safe in the routine clinical practice as it was reported by previous large randomised controlled trials [63, 65, 68].
TL for selected patients presenting with AIS between 3 and 4.5 hours was currently also included in the European labelling [modified January 2009], on the bases of ECASS-III study results [31].
Eligible patients with AIS for the ECASS-III were between 18 and 80 years of age. An absolute improvement of 7.2% for the rt-PA group, with an adjusted OR of favourable outcome (mRS 0-1) of 1.42, 1.02-1.98. Mortality rates did not differ significantly (7.7% versus 8.4%) between the groups. Cerebral hemorrhage was not observed with increased risk after rt-PA application (2.4% vs 0.2%) [31].
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Safe Implementation of Thrombolysis in Stroke International Stroke Thrombolysis Register (SITS-ISTR)
results
confirm findings of ECASS III that rt-PA remains safe when given between 3 and 4.5 h after symptom onset in AIS patients
The international SITS registry was developed with the aim to monitor the treatment outcomes in accordance with a request from the European Medicines Agency (EMEA), after intravenous rt-PA for treatment of AIS. It was a collaboration of more than 700 clinical centres in 35 countries. SITS register documents treatments for AIS in an interactive database over a secure internet portal [66, 67]. SITS database has currently over 33,000 patients.
Safe Implementation of Thrombolysis in Stroke International Stroke Thrombolysis Register (SITS-ISTR) results confirm findings of ECASS III that rt-PA remains safe when given between 3 and 4.5 h after symptom onset in AIS patients
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These
results
were independent on age, gender, stroke subtype, stroke severity [3, 11, 14, 32, 37, 42, 58, 60, 62, 63]. Rrandomised
As a special recommendation, the TL for routine clinical use needs to be administered in specialized stroke units (SUs) [3, 32]. Management in SUs improves the likelihood of discharge to home, and improves the longterm daily living activities as well as quality of life.
These results were independent on age, gender, stroke subtype, stroke severity [3, 11, 14, 32, 37, 42, 58, 60, 62, 63]. Rrandomised
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extending the treatment window for acute middle cerebral artery occlusion beyond 3 to 4,5 h although the
results
are currently negative [18];
extending the treatment window for acute middle cerebral artery occlusion beyond 3 to 4,5 h although the results are currently negative [18];
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Results
of using 0.6 mg/kg alteplase within 3 h of onset were compatible with data reported for a 0.9 mg/kg dose [52];
use of TL in less severe AIS or use of low dose t-PA plus better MRI evaluation of the patients.
Results of using 0.6 mg/kg alteplase within 3 h of onset were compatible with data reported for a 0.9 mg/kg dose [52];
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Acute neurological stroke care in Europe:
results
of the European Stroke Care Inventory 2000.
EFNS Task Force on Acute Neurological Stroke Care.
Acute neurological stroke care in Europe: results of the European Stroke Care Inventory 2000.
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The main components of stroke unit care:
results
of a European expert survey.
Leys D, Ringelstein EB, Kaste M, Hacke W. European Stroke Initiative Executive Committee.
The main components of stroke unit care: results of a European expert survey.
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Acute stroke care in the US:
results
from 4 pilot prototypes of the Paul Coverdell National Acute Stroke Registry.
Reeves MJ, Arora S, Broderick JP, Frankel M, Heinrich JP, Hickenbottom S, Karp H, LaBresh KA, Malarcher A, Mensah G, Moomaw CJ, Schwamm L, Weiss P. Paul Coverdell Prototype Registries Writing Group.
Acute stroke care in the US: results from 4 pilot prototypes of the Paul Coverdell National Acute Stroke Registry.
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Multivariable analysis of outcome predictors and adjustment of main outcome
results
to baseline data profile in randomized controlled trials; Safe Implementation of Thrombolysis in Stroke Monitoring Study (SITS-MOST).
Wahlgren N, Ahmed A, Eriksson N, Aichner F, Bluhmki E, Dávalos A, Erilä T, Ford GA, Grond M, Hacke W, Hennerici M, Kaste M, Köhrmann M, Larrue V, Lees KR, Machnig T, Roine RO, Toni D, Vanhooren G, for the SITSMOST investigators.
Multivariable analysis of outcome predictors and adjustment of main outcome results to baseline data profile in randomized controlled trials; Safe Implementation of Thrombolysis in Stroke Monitoring Study (SITS-MOST).
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Carotid stenting –
results
and prospects
Carotid stenting – results and prospects
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
The tables and illustrations should be presented on a separate sheet of paper, numbered, with a short explanation. All measurements should be in international units, using a decimal point and with no use of Roman numerals.
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12.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 6, 2010, No. 2
,
,
,
The
results
were compared with the myosonogram of a healthy man.
A 58-year-man from a Bulgarian family with autosomal dominant form of distal myopathy with voice and pharyngeal weakness, confirmed by geneticmolecular, electromyographic and histopathological examination was studied. Ultrasonic characteristics of the calf muscle was assessed using multi-modal color-duplex sonography.
The results were compared with the myosonogram of a healthy man.
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Results
:
Results:
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The
results
were compared to mysononograms of a 54-yearold healthy male control.
transducer for real time imaging. The changes of triceps surae muscle were investigated in a lying position according to a standard protocol. The transducer was positioned perpendicularly on the muscle in order to avoid possible artifacts. A qualitative and quantitative evaluation of the myosonograms were applied with measurements of the transverse diameter of the medial head of the calf muscle in longitudinal plane, the inclination of the muscle fibers towards the surface of the aponeurosis and their architectonics.
The results were compared to mysononograms of a 54-yearold healthy male control.
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Results
Results
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Subject of future studies is the clinical impact of myosonology as a screening method for early diagnosis, follow-up the evolution of muscle diseases and the
results
from different therapeutic approaches, as well as the ultrasound navigation during biopsies and invasive interventions.
Subject of future studies is the clinical impact of myosonology as a screening method for early diagnosis, follow-up the evolution of muscle diseases and the results from different therapeutic approaches, as well as the ultrasound navigation during biopsies and invasive interventions.
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Results
:
Results:
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Results
Results
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Results
:
Results:
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
The tables and illustrations should be presented on a separate sheet of paper, numbered, with a short explanation. All measurements should be in international units, using a decimal point and with no use of Roman numerals.
read the entire text >>
13.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 7, 2011, No. 1
,
,
,
Results
:
Results:
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Complete concurrence in the
results
of conducted color-coded duplex sonography and CTA of carotid artery was exposed.
Complete concurrence in the results of conducted color-coded duplex sonography and CTA of carotid artery was exposed.
Duplex ultrasound examination allows to view thrombus cyclical motion related to the cardiac cycles, which is of great advantage over other imaging methods of examination. Advantages and disadvantages of different modalities for treatment of this pathology are still discussed.
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Results
Results
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Results
:
Results:
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We will compare their
results
to the IMT of patients, having risk factors for CVD, but with no OSAS.
The aim of this study is to measure the IMT of patients with OSAS proven polysomnographically.
We will compare their results to the IMT of patients, having risk factors for CVD, but with no OSAS.
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All the
results
are analyzed manually.
) and a polysomnography with video-watching. The sleep phases are analyzed on the base of validated criteria.
All the results are analyzed manually.
The breathing is registered by nasal cannulas and combined respiratory inductive pletismography, which uses a composed signal and a thermistor. The basic evaluated characteristics are: apnea/ hypopnea index (AHI), calculated as the number of episodes of apnea and hypopnea per hour of sleep; index of desaturation defined as episodes of О2 desaturation >3% per hour sleep compared to a stable basic value. The grade of the sleep apnea is determined as: light – AHI 5-15 episodes of apnea and hypopnea per hour of sleep; moderate AHI 16-30 episodes of apnea and hypopnea per hour of sleep and heavyAHI more than 30 episodes of apnea and hypopnea per hour of sleep.
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Results
Results
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However, they often provide normal or non-specific
results
when pathological alterations are only at a functional level, which is the case of most neurodegenerative diseases, especially in the early stages [24].
CT and MRI, known as structural imaging methods, are invaluable when structural brain lesions exist.
However, they often provide normal or non-specific results when pathological alterations are only at a functional level, which is the case of most neurodegenerative diseases, especially in the early stages [24].
Such alterations can be detected by functional methods as PET and single photon emission tomography (SPECT) [2, 12]. These methods use either non-specific markers for metabolism/perfusion, or specific receptor and molecule markers. The latter are attractive for their specificity, but expensive, often hard to obtain, and not all are approved for clinical use. Because of the better resolution, PET tends to outperform perfusion SPECT in the workup of cognitive impairment and dementia [11].
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Patient preparation is of great importance for obtaining reliable
results
for FDG brain metabolism.
Patient preparation is of great importance for obtaining reliable results for FDG brain metabolism.
Attention should be paid to blood glucose level, especially in diabetic patients. Hyperglycemia leads to decreased accumulation of FDG in the brain due to competition with blood glucose, resulting in deteriorated image quality. Patients should be at rest, in a quiet and darkened room, avoiding all activities, e.g. reading or talking. It is advisable to discontinue psychotropic drugs temporarily on the day of assessment [5].
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Results
of the noninvasive diagnostic tests before TTT showed: ECG atrial flutter with atrioventricular block 3:1 and ventricular rate 75 beats/ min, RBBB, LAFB; 24-hour ECG monitoring: atrial flutter with a variable degree of atrio-ventricular block 2:1 to 4:1 and ventricular rate from 50 to
Results of the noninvasive diagnostic tests before TTT showed: ECG atrial flutter with atrioventricular block 3:1 and ventricular rate 75 beats/ min, RBBB, LAFB; 24-hour ECG monitoring: atrial flutter with a variable degree of atrio-ventricular block 2:1 to 4:1 and ventricular rate from 50 to
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These conditions provide
results
visualizing frontal and temporal speech areas, determining the dominant hemisphere [4, 27,
Neuro-oncological practice is not only a motivator out also a recipient of the attainments of language function assessment through FNM. fMRI is a renowned non-invasive technique for preoperative mapping of language areas. The possibility of precise localization of brain areas responsible for language functions is especially important when a precise identification of the neoplasm site is needed or when it affects strategic language areas and treatment should be extremely conservative. Two paradigms have been tested for estimation of speech lateralization and for visualization of cortical areas: naming a verb, appropriate to a given noun, and generation of words containing a given letter.
These conditions provide results visualizing frontal and temporal speech areas, determining the dominant hemisphere [4, 27,
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Results
of the fourth European Working Conditions Survey (EWCS)
In 2002 the Commission defined a new Community strategy for the period 2002–2006. The objective of this Strategy was to bring about a continuing improvement in well-being at work. Important objectives were a continuous reduction in accidents at work and illnesses. Furthermore, the adoption and application in recent decades of a large body of Community laws (Policy based on Article 137 of the EC Treaty) led to a considerable improvement of working conditions in the EU Member States and reduction in the incidence of work-related accidents and illness. In spite of the progress achieved, there are several reasons to continue the promotion of health and safety at work.
Results of the fourth European Working Conditions Survey (EWCS)
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paragraphs it was illustrated that analysis and publication of the LFS 2007 ad hoc module
results
takes place in an enduring and rich European tradition of analysis and publication of comparable and related datasets.
paragraphs it was illustrated that analysis and publication of the LFS 2007 ad hoc module results takes place in an enduring and rich European tradition of analysis and publication of comparable and related datasets.
The main goal of the study was: “To perform a sophisticated statistical analysis, including descriptive and multivariate analysis, of the HSW data provided by the LFS 2007 ad hoc module, in order to compare the occurrence of accidents at work, work-related diseases and harmful exposures according to various parameters describing the characteristics of the worker, workplace and employment situation.”
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The draft explanatory notes and the draft model questionnaire for the 2013 Labour Force Survey module on work related accidents and health problems are the
results
of the discussions within a dedicated Task Force composed of members from Bulgaria, Cyprus, the Czech Republic, France, Hungary, Ireland, Italy, the Netherlands, Sweden, the United Kingdom as well as EUROSTAT and DG EMPL.
The draft explanatory notes and the draft model questionnaire for the 2013 Labour Force Survey module on work related accidents and health problems are the results of the discussions within a dedicated Task Force composed of members from Bulgaria, Cyprus, the Czech Republic, France, Hungary, Ireland, Italy, the Netherlands, Sweden, the United Kingdom as well as EUROSTAT and DG EMPL.
The Task Force included both experts of LFS and experts of health and safety at work statistics.
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Health and safety at work,
Results
of the Labour Force Survey 2007 ad hoc module on accidents at work and workrelated health problems031.12873/01.03
Health and safety at work, Results of the Labour Force Survey 2007 ad hoc module on accidents at work and workrelated health problems031.12873/01.03
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The Consensus includes recommendations based on
results
of multicenter randomized clinical trials or meta-analysis (level of evidence A), single-center or non-randomized studies (level of evidence B) and expert advice or therapeutic standards (level of evidence C).
The consensus regulates noninvasive ultrasound diagnosis of carotid pathology and principles of behavior depending on its location, type, severity and functional characteristics. It serves as a practical guide for early diagnosis, adequate prevention, choosing the right therapeutic approach and long-term monitoring of threatened stroke risk population. Its application by different professionals contribute for high quality diagnostic, therapeutic and preventive health services in all units of outpatient and hospital care that are consistent with the level of competence of the hospital and the individual characteristics of the vascular pathology.
The Consensus includes recommendations based on results of multicenter randomized clinical trials or meta-analysis (level of evidence A), single-center or non-randomized studies (level of evidence B) and expert advice or therapeutic standards (level of evidence C).
Therapeutic and procedural recommendations are graded as required (class I), recommended (Class
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Long-term prognosis and effect of endarterectomy in patients with symptomatic severe carotid stenosis and contralateral carotid stenosis or occlusion:
results
from NASCET.
North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group.
Long-term prognosis and effect of endarterectomy in patients with symptomatic severe carotid stenosis and contralateral carotid stenosis or occlusion: results from NASCET.
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
The tables and illustrations should be presented on a separate sheet of paper, numbered, with a short explanation. All measurements should be in international units, using a decimal point and with no use of Roman numerals.
read the entire text >>
14.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 7, 2011, No. 2
,
,
,
The obtained
results
were compared with the myosonogram of a healthy ageand sex-matched control.
A 27-year-old female with genetically verified autosomal recessive hereditary inclusion body myopathy (Nonaka distal myopathy) was studied. Clinical examination, electromyography, echocardiography, molecular-genetic analysis and four-dimensional imaging of triceps surae muscles were performed.
The obtained results were compared with the myosonogram of a healthy ageand sex-matched control.
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Results
:
Results:
read the entire text >>
The
results
were compared to mysononograms of a 27-year-old healthy fe-
The cardiac function was assessed by echocardiography, the muscle activity and conduction velocities of the nerves – by EMG (electromyography) and nerve conduction studies and the structural changes in the hip muscles – by magnetic resonance imaging (MRI). The ultrasound characteristics of the skeletal muscles were evaluated by a multimodal colorcoded duplex sonograph (Logic 7, GE – Germany) with a special transducer for real time imaging. The changes of the triceps surae muscle were investigated in a lying position according to a standard protocol during rest and during muscle contraction (spontaneous and induced by electrostimulation). The transducer is positioned perpendicularly on the muscle in order to avoid artifacts. A qualitative and quantitative evaluation of the myosonograms with measurements of the transverse diameter of the lateral head of the muscle in longitudal projection, the inclination of the muscle fibers towards the surface of the aponeurosis and their architectonics were performed by 4D imaging during rest and plantar flexion (spontaneous and induced by electric stimulation).
The results were compared to mysononograms of a 27-year-old healthy fe-
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Results
Results
read the entire text >>
Results
:
Results:
read the entire text >>
Dynamics of neurological status, brain computed tomography (CT) findings, perimetry and
results
of neuropsychological testing were reported.
The patient was prospectively followed up on first and sixth month of the brain hemorrhage onset.
Dynamics of neurological status, brain computed tomography (CT) findings, perimetry and results of neuropsychological testing were reported.
A specialized neuropsychological battery based on Goodglass and Kaplan-Boston-1983 test for assessment of gnosis, praxis, language functions, memory and attention was used [4]. The test was adapted and validated for use in Bulgaria in 1995 by B. Alexandrova, M. Terzieva, I. Turnev and L. Mavlov.
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Results
Results
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Similar
results
are revealed by other authors [3, 5, 7, 10].
The presented case is interesting because of its complex combination and difficult differentiation of simultaneously occurring visual and visual-spatial disturbances. We observed the rare combination of hemineglect and hemianopsia, as well as Gerstmann syndrome due to brain hemorrhage in the left parietooccipital lobe.
Similar results are revealed by other authors [3, 5, 7, 10].
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Results
:
Results:
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The
results
were processed by a number of statistical methods.
The results were processed by a number of statistical methods.
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Results
Results
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Results
and discussion:
Results and discussion:
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These good practices in the field of health and safety at work will lead to improvement of the economic
results
of work [1, 7].
The bigger opportunities for finding and keeping jobs improve common health of the population as well. That is why it is very important to emphasis the contribution of the good occupational health to the public health in common. The workplace is the specific framework which plays important role in the development of the health prevention. This is particularly true for workers in the health system including those implementing highly specialized medical activities. The Strategy of EC and the performance of measures for the period 2002-2006 led to significant decrease of the number of work accidences.
These good practices in the field of health and safety at work will lead to improvement of the economic results of work [1, 7].
These health-economic aspects are related to the characteristics of: the labor force, working conditions, level and structure of the work accidents, occupational diseases and other work related health problems of the employee.
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Results
Results
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They are recommendations and a base for achievement of a better level of prevention with measurable
results
of: decrease in the risk of occupational diseases and work accidents and the related financial losses; improvement of the company’s image by increase of the competitive power and labour quality as an element of the
International Labor Organization (ILO) and the European Union create mechanisms, tools and conditions for implementation and unification of the steps and forms for efficient management of the health and safety at work [2, 7]. Different standards, methodologies and management systems are made, which allow the health and safety activities to be incorporated in the company policy of the firm. The different models, methods, standards, so called “Code of good practice” are not obligatory.
They are recommendations and a base for achievement of a better level of prevention with measurable results of: decrease in the risk of occupational diseases and work accidents and the related financial losses; improvement of the company’s image by increase of the competitive power and labour quality as an element of the
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The
results
show that fingolimod improves neuronal electrophysiological function, reduces motor impairment, decreases demyelination in CNS and restores the integrity of the blood–brain barrier [3].
Fingolimod can cross the blood–brain barrier into CNS where S1PRs are expressed, and is present in CNS following oral administration [11]. S1PR modulation by fingolimod is highly effective in numerous experimental autoimmune encephalomyelitis (EAE) models of MS in any stage of the disease [12].
The results show that fingolimod improves neuronal electrophysiological function, reduces motor impairment, decreases demyelination in CNS and restores the integrity of the blood–brain barrier [3].
In MS animal models fingolimod reduces demyelination and microglia activation in CNS in intact blood–brain barrier, indicating effects independent of lymphocyte infiltration [2]. Consistent with EAE models, S1PR modulation by fingolimod in patients with relapsing remitting MS has been shown to reduce disease progression, relapse activity and rate of brain atrophy compared to placebo or approved interferon β-1a therapy [9, 14].
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J. Oral Fingolimod (FTY720) Reduces the Rate of Relapses that Require Steroid Intervention or Hospitalization Compared with Intramuscular Interferon β-1a:
Results
from a Phase III study (TRANSFORMS) in Multiple Sclerosis Abstract P06.170 In: 62nd annual meeting of AAN; April 10-17, 2010, Toronto, Canada.
J. Oral Fingolimod (FTY720) Reduces the Rate of Relapses that Require Steroid Intervention or Hospitalization Compared with Intramuscular Interferon β-1a: Results from a Phase III study (TRANSFORMS) in Multiple Sclerosis Abstract P06.170 In: 62nd annual meeting of AAN; April 10-17, 2010, Toronto, Canada.
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
The tables and illustrations should be presented on a separate sheet of paper, numbered, with a short explanation. All measurements should be in international units, using a decimal point and with no use of Roman numerals.
read the entire text >>
15.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 8, 2012, No. 1
,
,
,
The sonographic findings were compared with the
results
from digital subtraction angiography (DSA).
resolution and 4 times faster than conventional B-mode [2]. A 4-dimensional ultrasound imaging was applied for assessment of echogenicity, consistency, shape and surface of the morphological changes of the arterial wall and lumen.
The sonographic findings were compared with the results from digital subtraction angiography (DSA).
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Results
Results
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Carotid patch angioplasty: immediate and long-term
results
.
Rosenthal D, Archie J.
Carotid patch angioplasty: immediate and long-term results.
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The
results
are compared to a healthy control and a patient with genetic distal myopathy.
We present a 48-year-old man with hereditary juvenile insulindependent diabetes mellitus complicated by late neuropathy. Clinical, electromyographic and myosonographic 4-dimensional studies of triceps surae muscles are performed.
The results are compared to a healthy control and a patient with genetic distal myopathy.
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Results
:
Results:
read the entire text >>
The
results
were compared with myosonograms of triceps surae in a healthy control and a patient with myopathy related to age and gender.
Ultrasound characteristics of the triceps surae muscle ware assessed by multi-color duplex sonography (Logic 7, GE Germany), equipped with a transducer for 4-dimensional imaging in real time. Changes in triceps surae were measured in supine position of the patient at rest and during muscle contraction (spontaneous and provoked by electric stimulation of n. tibialis) following a standard protocol [2]. The transducer was placed perpendicularly to the muscle to avoid ehogenic artifacts. Qualitative and quantitative evaluation of myosonograms was performed by measuring the transverse diameter of the muscle two heads (medial and lateral) in longitudinal projection, the inclination of the muscle fibers to the surface of the aponeurosis and their architectonics in 4-D imaging at rest and muscle contraction.
The results were compared with myosonograms of triceps surae in a healthy control and a patient with myopathy related to age and gender.
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Results
Results
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More significant and lasting
results
are achieved after repeated stimulation.
Clinical studies have shown statistically significant relief of bradykinesia and rigidity in high-frequency rTMS of primary motor cortex. These effects are short – only a few minutes after stimulation. The improvement in motor symptoms is explained by the release of endogenous dopamine in the ipsilateral striatum during stimulation [31].
More significant and lasting results are achieved after repeated stimulation.
A double-blind, placebo-controlled study using eight rTMS sessions over a period of 4 weeks found a significant therapeutic effect on motor symptoms with duration of 1 month after the stimulation [34]. Modern meta-analysis including 10 randomized controlled trials on 275 patients found positive effects of high frequency rTMS on motor symptoms in Parkinson's disease. It is concluded that high-frequency rTMS is a promising method of treatment of motor impairments in this disease [32]. There are substantial differences between the rTMS protocols, selection of patients, duration and stage of disease in different studies. It is necessary to specify the optimal simulation parameters, the effects of rTMS on different disease stages, gait, cognition and memory.
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The
results
from the application of low frequency rTMS in clinical conditions range from optimistic (reduction in seizure frequency by 36.2%) in uncontrolled studies to moderate and not very reliable in controlled randomized trials [2, 27].
Low frequency rTMS (≤ 1 Hz) decreases cortical excitability, while higher frequencies (> 5 Hz) increase it. In experimental conditions, low frequency rTMS (0.5 Hz) reduces the incidence of epileptic status and prolongs the latency of pentilentetrazol-induced seizures in rats.
The results from the application of low frequency rTMS in clinical conditions range from optimistic (reduction in seizure frequency by 36.2%) in uncontrolled studies to moderate and not very reliable in controlled randomized trials [2, 27].
In a controlled blind study on 24 patients with focal epilepsy (temporal and extratemporal) and a coil located on the epileptogenic focus, a statistically significant change in relapse frequency was not found. A better effect was observed in neocortical than in mesiotemporal focuses [50]. A randomized, controlled clinical trial with simulated rTMS found a statistically significant reduction in EEG epileptiform activity and improvement in some aspects of cognitive activity lasting about 2 months after stimulation. All patients had cortical defects on brain convexity [27]. The response of surface and neocortical temporal foci correlates with the modern capabilities of TMS – the intensity of the induced electric field decreases rapidly in depth.
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Despite expectations for a new modulation treatment of epilepsy with TMS, the
results
from its application are poor.
The response of surface and neocortical temporal foci correlates with the modern capabilities of TMS – the intensity of the induced electric field decreases rapidly in depth. The introduction of a new design of the stimulating coil, called H-coil would improve the stimulation of deep epileptogenic foci (distance of 5 cm from the scalp). It was found that rTMS is well tolerated by patients and side effects are mild (17.1%). The most frequent complication is headache. Repetitive TMS poses little risk of inducing seizures in strict compliance with approved work instructions [5].
Despite expectations for a new modulation treatment of epilepsy with TMS, the results from its application are poor.
Addressing some key methodological issues (the most appropriate area to promote, optimal simulation parameters), combined with modern technological innovations (H-coil, combining rTMS with EEG) would improve the applicability of the methodology in the future [27].
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Together with other neuroimaging techniques, it helps for a more detailed study of these processes and tracks the
results
of the therapy and rehabilitation.
In recent decades it has been shown that the adult human brain has some capacity for plastic reorganization and functional recovery after injury. TMS is one of modern methods for noninvasive somatotopic cortical localization of motor functions and study of the functional reorganization of affected motor areas.
Together with other neuroimaging techniques, it helps for a more detailed study of these processes and tracks the results of the therapy and rehabilitation.
The future of TMS is to modify and streamline
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With this kind of organization it could be anticipated to improve
results
in diagnostic and timely and adequate treatment of patients with syncope, determine prognosis regarding life-expectancy and frequency of recurrence with respect to different etiology, patient education on the aspects of nature of disease and how to prevent recurrences, establishing a close connection between patient and physician, long-term follow-up of these patients as well as research possibilities.
With this kind of organization it could be anticipated to improve results in diagnostic and timely and adequate treatment of patients with syncope, determine prognosis regarding life-expectancy and frequency of recurrence with respect to different etiology, patient education on the aspects of nature of disease and how to prevent recurrences, establishing a close connection between patient and physician, long-term follow-up of these patients as well as research possibilities.
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
The tables and illustrations should be presented on a separate sheet of paper, numbered, with a short explanation. All measurements should be in international units, using a decimal point and with no use of Roman numerals.
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16.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 2, 2012, No. 2
,
,
,
The
results
are compared to age and sex-matched healthy control.
We present a 54-year-old patient with chronic right-sided hemiparesis after ischemic stroke in the left middle cerebral artery. Clinical, electromyographic and myosonographic 4-dimensional studies of both triceps surae muscles are performed.
The results are compared to age and sex-matched healthy control.
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Results
:
Results:
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Results
Results
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Results
:
Results:
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Results
Results
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The CBC, immunological and coagulation status
results
were normal.
In admission the patient was conscious, with a latent right-sided hemiparesis. A few hours later tonic extensional attacks appeared, followed by coma, intubation and pulmonary ventilation.
The CBC, immunological and coagulation status results were normal.
Dyslipidemia and first-degre chronic renal failure were detected.
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The interpretation of
results
after completion of two landmark studies in patients after sudden cardiac arrest who were in coma (the first one in Europe and the second one – in Australia, both completed almost simultaneously with the
results
published in New England Journal of Medicine in 2002) showed the positive effect of mild TH on the short-term neurologic recovery and survival [3, 17].
The benefit of TH in patients after a cardiac arrest is neuroprotection since the brain is at risk of ischemia during the incident [3, 4, 5].
The interpretation of results after completion of two landmark studies in patients after sudden cardiac arrest who were in coma (the first one in Europe and the second one – in Australia, both completed almost simultaneously with the results published in New England Journal of Medicine in 2002) showed the positive effect of mild TH on the short-term neurologic recovery and survival [3, 17].
The patients were cooled 3-4 hours after the incident to the target temperature of 32–34°C and then rewarmed
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Better
results
are achieved when TH is initiated soon after the patient’s admission and before the start of revascularization [15, 18].
Animal studies show very promising data that the decrease of myocardial temperature by only several degrees significantly reduces the infarct size [15]. The benefit of hypothermia depends on the achieved target temperature and the time of initiation and duration of cooling.
Better results are achieved when TH is initiated soon after the patient’s admission and before the start of revascularization [15, 18].
The available results are still insufficient to support the inclusion of this method in the guidelines for management of patients after acute myocardial infarction.
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The available
results
are still insufficient to support the inclusion of this method in the guidelines for management of patients after acute myocardial infarction.
Animal studies show very promising data that the decrease of myocardial temperature by only several degrees significantly reduces the infarct size [15]. The benefit of hypothermia depends on the achieved target temperature and the time of initiation and duration of cooling. Better results are achieved when TH is initiated soon after the patient’s admission and before the start of revascularization [15, 18].
The available results are still insufficient to support the inclusion of this method in the guidelines for management of patients after acute myocardial infarction.
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The
results
from the studies in humans are quite controversial and inconsistent.
The aim of the treatment of brain and/or spinal cord injuries is the recovering of adequate perfusion; surgical evacuation of hematomas (if necessary) and oedema prophylaxis. Animal studies show the positive effect of hypothermia in central nervous system injuries. Basic science evidence also suggests that cooling affects many secondary biochemical cascades that are activated after acute injury. The potential benefit of this non-specific therapy is based on the observation that hypothermia reduces brain metabolism and energy consumption which might be feasible for improving the outcome of the injury [2, 19]. Comparing with the pharmacologic treatment which acts to a single neurochemical process, hypothermia interferes and inhibits multiple pathological processes simultaneously acting non-specifically.
The results from the studies in humans are quite controversial and inconsistent.
The results are difficult to interpret due to the limited number of patients, lack of controls, concomitant surgical procedures or concomitant use of drugs etc. [2, 6, 19]. So far, there are no sufficient data from controlled studies in humans about the benefits of hypothermia in treatment of brain injuries in term to improve outcome and reduce mortality.
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The
results
are difficult to interpret due to the limited number of patients, lack of controls, concomitant surgical procedures or concomitant use of drugs etc.
Animal studies show the positive effect of hypothermia in central nervous system injuries. Basic science evidence also suggests that cooling affects many secondary biochemical cascades that are activated after acute injury. The potential benefit of this non-specific therapy is based on the observation that hypothermia reduces brain metabolism and energy consumption which might be feasible for improving the outcome of the injury [2, 19]. Comparing with the pharmacologic treatment which acts to a single neurochemical process, hypothermia interferes and inhibits multiple pathological processes simultaneously acting non-specifically. The results from the studies in humans are quite controversial and inconsistent.
The results are difficult to interpret due to the limited number of patients, lack of controls, concomitant surgical procedures or concomitant use of drugs etc.
[2, 6, 19]. So far, there are no sufficient data from controlled studies in humans about the benefits of hypothermia in treatment of brain injuries in term to improve outcome and reduce mortality.
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As of the current moment, clinical data about hypothermia and its application in patients after an acute ischemic stroke showed good
results
[12, 14, 19, 25].
since the ancient time however its clinical application is limited – it is mainly applied for patients with cardiac arrest and of newborns with birth asphyxia for lowering the risk of brain damages [3, 8, 24].
As of the current moment, clinical data about hypothermia and its application in patients after an acute ischemic stroke showed good results [12, 14, 19, 25].
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When comparing the
results
, most of them report about mild and temporary improvement of patients after acute ischemic stroke although there is no significant change in the focal neurologic symptoms (standard scales for assessment of neurologic deficit were used after 7–30 days or
stroke [13, 23, 25]. A half of them are non-randomized and two are double blind. Body surface cooling or endovascular cooling methods are used as well as both methods are used at some of the trials. The specified temperature for hypothermia is 33°C and for normothermia – 36.5°C.
When comparing the results, most of them report about mild and temporary improvement of patients after acute ischemic stroke although there is no significant change in the focal neurologic symptoms (standard scales for assessment of neurologic deficit were used after 7–30 days or
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Its routine application in neurology practice would be based on the
results
from the present and future international multicenter clinical trials.
The reviewed data demonstrates that the therapeutic hypothermia is a promising method for neuroprotection and treatment of acute ischemic stroke which could be applied alone or in combination with other treatment methods.
Its routine application in neurology practice would be based on the results from the present and future international multicenter clinical trials.
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
The tables and illustrations should be presented on a separate sheet of paper, numbered, with a short explanation. All measurements should be in international units, using a decimal point.
read the entire text >>
17.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 9, 2013, No. 1
,
,
,
Many investigators tried to replicate Zamboni’s
results
with duplex sonography, MRI, and catheter angiography.
In 2006, Zamboni re-introduced the concept that chronic impaired venous outflow of the CNS is associated with multiple sclerosis (MS), coining the term of chronic cerebrospinal venous insufficiency (“CCSVI”). The diagnosis of “CCSVI” is based on sonographic criteria, which he found exclusively fulfilled in MS. The concept proposes that chronic venous outflow failure is associated with venous reflux and congestion and leads to iron deposition, thereby inducing neuroinflammation and degeneration. The revival of this concept has generated major interest in media and patient groups, mainly driven by the hope that endovascular treatment of “CCSVI” could alleviate MS.
Many investigators tried to replicate Zamboni’s results with duplex sonography, MRI, and catheter angiography.
The data obtained here do generally not support the “CCSVI” concept. Moreover, there are no methodologically adequate studies to prove or disprove beneficial effects of endovascular treatment in MS. This review gives a comprehensive overview of the methodological flaws of the ultrasound based “CCSVI” concept. In our view, there is currently no basis to diagnose or treat “CCSVI” in the care of MS patients.
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In 1947, Putnam, believing that thrombosis of the cerebral veins was a common finding in MS patients published preliminary
results
of treatment using dicoumarin in MS patients after experiments using induced sinus thrombosis in primates [50].
He coined the term “CCSVI” (chronic cerebrospinal venous insufficiency) in analogy to perivenous inflammation in chronic venous insufficiency of the legs. While Zamboni’s approach does not challenge the commonly accepted understanding of MS immunopathology [37], it does relegate it to the final stage in the disease cascade. According to the “CCSVI” concept, MS pathology starts with intracranial venous stasis based on a proximal obstruction of the main cervical and/or thoracic veins. This leads to perivenous diapedesis of erythrocytes in the white matter with subsequent release of iron, the actual catalyst of the widely known and accepted immune cascade [37]. The theory of venous outflow changes reaches back to the times of Charcot, who in 1868 provided an early histopathological description of perivenous inflammation in MS [16].
In 1947, Putnam, believing that thrombosis of the cerebral veins was a common finding in MS patients published preliminary results of treatment using dicoumarin in MS patients after experiments using induced sinus thrombosis in primates [50].
However, his findings have not been validated or revisited since this time. In 1986, Schelling posed the hypothesis that venous intracranial or intraspinal reflux plays a significant role in the development of MS [53]. Subsequently, Zamboni and colleagues published several studies which were meant to support the “CCSVI” hypothesis [67,69,70]. They applied catheter angiographies in order to demonstrate various extracranial venous outflow obstructions in the internal jugular veins (IJVs) or azygos veins (AVs) [66], and re-
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These astonishing
results
prompted other groups to attempt to confirm the findings using color-coded duplex sonography.
as reverted postural control, in which the IJV does not collapse as would be physiologically expected in upright position. The study in which these criteria were presented and applied examined 109 patients and 177 non-affected people. Zamboni found that each MS patient met at least two criteria, while none of the control group did. Thus, the sensitivity, specificity, the predictive and negative-predictive values were each 100%.
These astonishing results prompted other groups to attempt to confirm the findings using color-coded duplex sonography.
Some research groups also found a very high prevalence of at least two positive criteria for MS patients alone [2], while others described a relatively high proportion of healthy controls [14,63] and patients with other neurological diseases fulfilling the criteria [73]. In contrast, several other groups found that no or only few MS patients and healthy controls fulfilled the “CCSVI” criteria [6-8, 21, 36, 47, 57]. Despite these contradictory results, balloon angioplasty and stenting treatments of the venous system were performed based on these findings and are currently performed around the world [35].
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Despite these contradictory
results
, balloon angioplasty and stenting treatments of the venous system were performed based on these findings and are currently performed around the world [35].
Zamboni found that each MS patient met at least two criteria, while none of the control group did. Thus, the sensitivity, specificity, the predictive and negative-predictive values were each 100%. These astonishing results prompted other groups to attempt to confirm the findings using color-coded duplex sonography. Some research groups also found a very high prevalence of at least two positive criteria for MS patients alone [2], while others described a relatively high proportion of healthy controls [14,63] and patients with other neurological diseases fulfilling the criteria [73]. In contrast, several other groups found that no or only few MS patients and healthy controls fulfilled the “CCSVI” criteria [6-8, 21, 36, 47, 57].
Despite these contradictory results, balloon angioplasty and stenting treatments of the venous system were performed based on these findings and are currently performed around the world [35].
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The experience in ultrasonographic examination of cerebral-venous hemodynamics is limited, despite the fact that the technique is quite simple, and consequently well-researched and validated
results
describing normal and impaired venous drainage are lacking.
The experience in ultrasonographic examination of cerebral-venous hemodynamics is limited, despite the fact that the technique is quite simple, and consequently well-researched and validated results describing normal and impaired venous drainage are lacking.
Substantial data describing the normal venous blood flow using US have been published by our Berlin Charit
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Recently, Laupacis and co-workers presented the first meta-analysis of existing
results
on the “CCSVI” hypothesis, including all studies with MS patients and controls published so far [33].
Recently, Laupacis and co-workers presented the first meta-analysis of existing results on the “CCSVI” hypothesis, including all studies with MS patients and controls published so far [33].
The meta-analysis explicitly addressed the question of ultrasound examination quality and suggests that one possible reason for a low prevalence of “CCSVI” in some studies might be the insufficient experience of the investigators [33]. Interestingly their analysis shows a significant negative association between the postulated qualification/experience of certain research groups and the number of their published ultrasound studies in this field. US examination of veins responsible of the intracranial drainage requires the consideration of the particular features and specific characteristics of the cerebral and cervical venous system which is essential for correct differentiation between physiological variants/anomalies and pathological findings. For example, unlike to other parts of the body, the cerebral venous system is valveless allowing a reversal of blood flow direction [4, 45]. Furthermore, intracranial veins are not capacitance vessels like the veins of the extremities, as they only dilate to a limited degree.
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used these
results
to support their arguments, but substantially misrepresented these findings: “We assessed the lack of a Doppler detectable venous flow in the IJVs and/or VVs despite numerous deep inspirations.
Zamboni et al.
used these results to support their arguments, but substantially misrepresented these findings: “We assessed the lack of a Doppler detectable venous flow in the IJVs and/or VVs despite numerous deep inspirations.
In normal subjects this finding was never observed with the head in any position [Valdueza et al. 2000]…” It is crucial to clarify that a cessation of blood flow in one or both IJVs in supine or upright position cannot be considered to be clinically relevant.
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These
results
underline that the cerebral venous drainage is strongly dependent on the postural status, in which the IJVs usually assume the main role in supine position, whereas its significance decreased as the posture becomes more upright due to IJV collapse and blood flow in the VVs increases as partial compensation.
These results underline that the cerebral venous drainage is strongly dependent on the postural status, in which the IJVs usually assume the main role in supine position, whereas its significance decreased as the posture becomes more upright due to IJV collapse and blood flow in the VVs increases as partial compensation.
Thus, a lack of flow in the VV in supine posture in a noncollapsed vessel is not pathological. In contrast, a lack of a compensatory flow increase in the VVs in upright position seems to be unusual in our experience, and a lack of VV flow in standing position when the lumens are visible would be practically impossible.
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It seems very likely to us that groups unable to find a lack of flow in the VV fell victim to false-positive
results
.
discovery of a reference to our publication on the internet brought to our attention that Zamboni considers zero flow in a single vein, independently of posture, to be a pathological symptom [24]. It should also be pointed out that ultrasound examinations of the VVs often lead to an unintentional compression of the IJVs and thus to a compensatory increase in the VV flow. We observed a similar phenomenon in patients with a postoperative status after neck dissection with resection of an IJV [20].
It seems very likely to us that groups unable to find a lack of flow in the VV fell victim to false-positive results.
Even experienced investigators might find positive blood flow in the VVs due to accidental compression of the IJVs when the subject changes posture. But, again, we must emphasize that the absence of blood flow is not a pathological condition per se.
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With the “old” “CCSVI” criteria being refuted, the “new” criteria seem to call for new confirmatory studies to confirm or refuse the new
results
With the “old” “CCSVI” criteria being refuted, the “new” criteria seem to call for new confirmatory studies to confirm or refuse the new results
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Calling for controlled studies misses the point, because this suggests that the interventional therapies should be continued (possibly over many years) until definitive
results
are available.
The serious methodological limits and misinterpretations of other groups’ findings should be reason enough to halt the completely unsubstantiated CCSVI-based interventional therapy for MS patients.
Calling for controlled studies misses the point, because this suggests that the interventional therapies should be continued (possibly over many years) until definitive results are available.
The therapy, which costs thousands of dollars, places a significant financial burden on MS patients and poses a concrete risk. Only a complete halt to the therapy seems sensible.
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Results
of treatment of multiple sclerosis with dicoumarin.
Putnam TJ, Chiavacci LY, Hoff H, Weitzen HG.
Results of treatment of multiple sclerosis with dicoumarin.
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Results
:
Results:
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Our
results
showed that 57% of the patients had cognitive impairment at hospital discharge.
Our results showed that 57% of the patients had cognitive impairment at hospital discharge.
Age (p=0.0001), education (p=0.001), baseline systolic blood pressure (p=0.015), hyperglycemia (p=0.021) and serum hs-CRP level (p=0.050) on admission were the significant determinants of early cognitive deterioration. Of all the variables, serum hs-CRP level (OR 1, 12 (1,00–1,25), p=0,049), gender (OR 5,97 (1,05-34,00), p=0,044) and age (OR 1,30 (1,09–1,55), p=0,004) were identified as independent predictors of post-stroke recovery.
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Our study
results
confirm previous studies that enhanced serum hsCRP concentration in the acute period is correlated to cognitive impairment at discharge [29, 38].
Data has been published that increased hsCRP level is associated with the severity of neurological deficit and the clinical outcome of stroke [7, 24, 28]. We have also found higher serum hsCRP level in patients with more severe neurological and cognitive deficit at discharge.
Our study results confirm previous studies that enhanced serum hsCRP concentration in the acute period is correlated to cognitive impairment at discharge [29, 38].
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Our
results
confirm that the level of education influences significantly the cognitive state of patients at discharge [21, 31, 35].
Our results confirm that the level of education influences significantly the cognitive state of patients at discharge [21, 31, 35].
Patients with lower level of education probably have less functional cognitive reserve. Besides, the level of education determines lifestyle and risk behavior profiles of the patients.
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The
results
we obtained indicated a 6-fold higher probability for female patients to develop cognitive impairment in the acute phase of stroke.
The results we obtained indicated a 6-fold higher probability for female patients to develop cognitive impairment in the acute phase of stroke.
The published data about the effect of gender on post-stroke cognitive state are still controversial [4, 13, 21, 30]. Usually ischemic stroke in female patients occurs at older age, when the role of genetic factors associated with gender-related specific variations of blood pressure has disappeared [11]. The existence of sexual dimorphism in blood pressure regulation is confirmed by the results of many population-based studies [19]. With age arterial hypertension in females becomes constantly
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The existence of sexual dimorphism in blood pressure regulation is confirmed by the
results
of many population-based studies [19].
The results we obtained indicated a 6-fold higher probability for female patients to develop cognitive impairment in the acute phase of stroke. The published data about the effect of gender on post-stroke cognitive state are still controversial [4, 13, 21, 30]. Usually ischemic stroke in female patients occurs at older age, when the role of genetic factors associated with gender-related specific variations of blood pressure has disappeared [11].
The existence of sexual dimorphism in blood pressure regulation is confirmed by the results of many population-based studies [19].
With age arterial hypertension in females becomes constantly
read the entire text >>
According to our
results
baseline hyperglycemia was a significant determinant of cognitive impairment at discharge due to its positive correlation with systolic arterial hypertension (Rs=0.358; p=0.016).
Hyperglycemia is often found in acute stroke, even in cases without a history of diabetes mellitus [3]. It causes lactic acidosis, tissue acidosis and exerts direct neurotoxicity. Hyperglycemia worsens functional outcome of cerebral ischemia and influences negatively the cognitive state of patients in the acute phase of ischemic stroke [3] by impairing mainly the executive functions [18].
According to our results baseline hyperglycemia was a significant determinant of cognitive impairment at discharge due to its positive correlation with systolic arterial hypertension (Rs=0.358; p=0.016).
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Our study
results
confirm the role of increased hs-CRP as significant predictor of cognitive deficit after acute ischemic stroke in female patients with systolic arterial hypertension.
In conclusion, cognitive disorders after acute ischemic stroke are associated with complex interrelations between the acute cerebrovascular event, vascular risk factors and individual genetic characteristics of the patient.
Our study results confirm the role of increased hs-CRP as significant predictor of cognitive deficit after acute ischemic stroke in female patients with systolic arterial hypertension.
Future studies aiming at modification of risk factors and CRP are necessary to prevent or delay post-stroke cognitive decline.
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Results
of a longitudinal study.
Desmond DW, Moroney JT, Sano M, Stern Y. Incidence of dementia after ischemic stroke.
Results of a longitudinal study.
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The
results
were processed with a statistical analysis program SPSS (version 10).
The results were processed with a statistical analysis program SPSS (version 10).
An alternative and variance analysis was applied.
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Results
Results
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The abstract should be submitted by filling out the following categories: Objective, Material and Methods,
Results
, Discussion.
The abstract should be submitted by filling out the following categories: Objective, Material and Methods, Results, Discussion.
read the entire text >>
The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
The tables and illustrations should be presented on a separate sheet of paper, numbered, with a short explanation. All measurements should be in international units, using a decimal point.
read the entire text >>
18.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 9, 2013, No. 2
,
,
,
Counterproductive
Results
with the Use of an Emboli Protection Device in the Prevention of Microembolism Detected by Transcranial Doppler in Carotid Stent Placement.
Counterproductive Results with the Use of an Emboli Protection Device in the Prevention of Microembolism Detected by Transcranial Doppler in Carotid Stent Placement.
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Ultrasound Navigation in Neurosurgery – Fields of Application and Surgical
Results
.
Ultrasound Navigation in Neurosurgery – Fields of Application and Surgical Results.
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Thrombolytic Therapy –
Results
and Problems.
Thrombolytic Therapy – Results and Problems.
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In essence, our
results
indicate an absence of fibrinolysis at acoustic pressure levels up to 1.3 MPa per se but a pure haemolysis in the absence of rtPA.
In contrast to many authors who have used clot weight changes to characterize the effects of insonation, we have used a visual assessment with a camera allowing continuous monitoring over the treatment time. This allowed us to get more reproducible values and important information related to the rate of lysis, which can help in characterizing the effects of different pulsing sequences at various acoustic pressures. More specifically, we have studied the respective roles of fibrinolysis and haemolysis in the observed clot lysis.
In essence, our results indicate an absence of fibrinolysis at acoustic pressure levels up to 1.3 MPa per se but a pure haemolysis in the absence of rtPA.
Conversely, at this acoustic pressure level, the presence of 3 µg/ml rtPA led to a significant fibrinolysis when combined with US and microbubbles.
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These
results
will be further detailed with a translation in vivo to confirm the validity of the proposed approach of using moderate and acceptable US acoustic pressure levels in a clinical setting.
These results will be further detailed with a translation in vivo to confirm the validity of the proposed approach of using moderate and acceptable US acoustic pressure levels in a clinical setting.
Even though sonothrombolysis has been studied for more than 10 years, some key points remained unexplained, leading to a long delay in getting an approval for this treatment.
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Results
:
Results:
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Recently, there have been many research
results
in early judgment of PTV, and TCD studies are particularly prominent in this area.
Review of literature demonstrate that TCD is valid in predicting the patient's outcome of 6 months and correlates significantly with intracranial pressure when it is performed in the first 24 hours after event.
Recently, there have been many research results in early judgment of PTV, and TCD studies are particularly prominent in this area.
The prognosis is affected severely with regard to quality of life of patients, and earlier determination of the PTV becomes very important. TCD is non-invasive, fast, and reliable as an efficient ultrasound technology, especially in critically ill patients with PTV in an urgent examination. This means it that TCD has greater value and helps to improve the management of patients with TBI. Too often, the first sign is a neurologic deficit, which may be too late to reverse. However, use of TCD may predict PTV before clinical sequelae.
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Results
:
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:
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Intima-Medial-Thickness (IMT) will be measured every year during follow-up period and the
results
will be compared with the baseline data.
The primary hypothesis of this study is; cilostazol alone or with probucol will reduce the risk of cerebral hemorrhage without increase of cardiovascular events compared to aspirin in the ischemic stroke patients with symptomatic or asymptomatic old cerebral hemorrhage.
Intima-Medial-Thickness (IMT) will be measured every year during follow-up period and the results will be compared with the baseline data.
The change of IMT will be analyzed with the occurrence of cardiovascular events.
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Results
:
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:
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:
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The
results
were compared to the findings from other diagnostic methods.
Patients with carotid pathology, neuro-ophthalmic syndromes, neuropathy, myopathy, cervical tumors, calf muscle trauma and chronic spastic paralysis were studied by multimodal 2D/3D/4D sonography.
The results were compared to the findings from other diagnostic methods.
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Results
:
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:
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:
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:
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:
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The present
results
showed that detection of HITS is important to evaluate the risk and to select the treatment of intra-cardiac or aortic lesion determined by TEE.
LAA thrombus can be most dangerous source of embolism. Strands and PFE are thought to be the same origin. PFE is like a benign tumor collected many strands. Since PFE has more possibility of source of embolism than strands, HITS in patients with strands may indicate coagulability of blood. Embolic risk of patients with strands or aortic ulcerative lesion with HITS may decrease by anticoagulant.
The present results showed that detection of HITS is important to evaluate the risk and to select the treatment of intra-cardiac or aortic lesion determined by TEE.
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Results
:
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:
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COUNTERPRODUCTIVE
RESULTS
WITH THE USE OF AN EMBOLI PROTECTION DEVICE IN THE PREVENTION OF MICROEMBOLISMS DETECTED BY TRANSCRANIAL DOPPLER IN CAROTID STENT PLACEMENT
COUNTERPRODUCTIVE RESULTS WITH THE USE OF AN EMBOLI PROTECTION DEVICE IN THE PREVENTION OF MICROEMBOLISMS DETECTED BY TRANSCRANIAL DOPPLER IN CAROTID STENT PLACEMENT
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Results
:
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:
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The
results
manifest unsteady blood flow in the carotid bifurcation and dependence of the flow disturbances on the time and type of the stenoses.
The structures of the flow around the bifurcation from CCA to the internal (ICA) and external carotid artery (ECA) are obtained considering characteristic time points for one pulse wave period. The axial velocity distribution and wall shear stress (WSS) distribution and contours are presented.
The results manifest unsteady blood flow in the carotid bifurcation and dependence of the flow disturbances on the time and type of the stenoses.
The recirculation zone behind the stenosis is the area of low WSS. Comparison of the peak WSS for the four different cases shows that it reaches the maximum value of about 6.7Pa at the characteristic point of T=0,2s for the cases with two and three stenoses.
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Results
:
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:
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:
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Our
results
suggested that juxtaluminal 25% plaque echogenicity might have a more adequate ability over global plaque echogenicity in separating symptomatic and asymptomatic carotid plaques, only in the presence of significant stenosis.
Our results suggested that juxtaluminal 25% plaque echogenicity might have a more adequate ability over global plaque echogenicity in separating symptomatic and asymptomatic carotid plaques, only in the presence of significant stenosis.
This position might be solidified in natural history studies of asymptomatic individuals with carotid plaques, having as an end point the development of stroke.
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:
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:
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:
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:
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:
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Simultaneous spinal angiography and simulated anterior spinal artery flow in a cadaveric set-up confirmed the validity of the anatomic landmarks by demonstrating concordance with
results
obtained from volunteer research participants.
We detected flow in all segmental arteries at different levels of our field of insonation with mean depth (± standard deviation) of insonation at 3.9±0.7 cm identified by characteristic high resistance flow pattern. Anterior spinal artery was detected in 15 (62.5%) research participants at mean depth (± standard deviation) of 6.4 ± 1.2 cm identified by characteristic low resistance bidirectional flow. Age, gender, and body mass index were not correlated with either the detection rate or depth of insonation for anterior spinal artery.
Simultaneous spinal angiography and simulated anterior spinal artery flow in a cadaveric set-up confirmed the validity of the anatomic landmarks by demonstrating concordance with results obtained from volunteer research participants.
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:
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:
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:
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Based on these
results
, greater BAD may reflect subclinical atherosclerosis and BAD can be used as a useful parameter for differentiating ATBI from CE.
Based on these results, greater BAD may reflect subclinical atherosclerosis and BAD can be used as a useful parameter for differentiating ATBI from CE.
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:
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:
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:
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:
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Based on EST the patients were classified in three groups with positive, negative or questionable
results
.
Exercise stress-test (EST) and echocardiography were performed in 503 patients (mean age 54±17 years) with symptoms for CVD in two cardiological centers.
Based on EST the patients were classified in three groups with positive, negative or questionable results.
Color duplex sonography of both carotid arteries was performed in transverse and longitudinal planes and intima media thickness (IMT) of the common carotid (CCA) and internal carotid (ICA) arteries was measured. No modifiable (age and sex) and some modifiable (hypertension, diabetes, atrial fibrillation, dyslipidemia, carotid stenosis, obesity, hemorheological variables – leucocytes (Leuc) hemoglobin (Hb), hematocrit (Ht), FR for CVD were evaluated. The pts with positive EST were on PTCA undergone and pts with questionable EST the decision for PTCA was taken after severity of carotid pathology and clinical exam.
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Results
:
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:
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The association of the
results
of duplex was compared with ICP and systemic monitoring.
We coadministered intramuscular ketamine at dose of 15mg/ kgand xylazine at a dose of 2 mg/kg. The experimental hypertension was performed with an intracranial balloon. At each intervention we performed a neurological assessment of the pupils and Doppler exam (Ultrasound color duplex SonoSite-Micromax). Continuous intracranial pressure measurement by intraparenchymal and extradural catheters was also performed. The animals underwent to a baseline measurement, a pre-balloon insufflation, a post-balloon insufflation before and after saline solution infusion.
The association of the results of duplex was compared with ICP and systemic monitoring.
In complementary we measured
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:
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:
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:
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:
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:
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:
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The
results
of this study demonstrate that impaired
The results of this study demonstrate that impaired
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Results
:
Results:
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:
Results:
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:
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:
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:
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:
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We observed excellent early ultrasound
results
and clinical outcome in 2 patients, as well as mild to moderate in one.
Important determinants for success were time to IAT, stroke severity, and age.
We observed excellent early ultrasound results and clinical outcome in 2 patients, as well as mild to moderate in one.
No serious complications were noted despite non-consensus type of treatment. Future research and protocol improvement of IAT is needed to validate the best individual treatment approach.
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Results
:
Results:
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:
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In spite of
results
without significant statatistical difference (p=0,136), a trend to bether recovery was observed in the target group.
In spite of results without significant statatistical difference (p=0,136), a trend to bether recovery was observed in the target group.
TCD may have a role in the improvement of outcomes of patients submitted to thrombolytic approach.
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Results
:
Results:
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Results
:
Results:
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ULTRASOUND NAVIGATION IN NEUROSURGERY – FIELDS OF APPLICATION AND SURGICAL
RESULTS
ULTRASOUND NAVIGATION IN NEUROSURGERY – FIELDS OF APPLICATION AND SURGICAL RESULTS
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To analyze the
results
of the usage of intraoperative ultrasound combined with neuronavigation in different fields of neurosurgery.
For more than two decades the neuronavigation was successfully used in the neurosurgery. Some shortcomings of the method have evoked the need of an appropriate intraoperative imaging to compensate for the registration and shifting bias and the intraoperative ultrasound is found to be a good option.
To analyze the results of the usage of intraoperative ultrasound combined with neuronavigation in different fields of neurosurgery.
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Results
: Metastases (90 pts) and glial tumors (90 pts) prevailed among the oncologic cases, followed by meningiomas (24 pts).
Results: Metastases (90 pts) and glial tumors (90 pts) prevailed among the oncologic cases, followed by meningiomas (24 pts).
In 152 surgeries (69.4%) a total resection was achieved and in 6 cases (2.7%) with low-grade astrocytoma – a supratotal resection with perfect functional outcome. Among the vascular diseases, 6 out of 8 aneurysms were successfully clipped and one was “trapped”. All of the AVMs (2 pts) were totally excised. The complication rates were comparatively low with mostly
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complications, neurosurgery, surgical
results
, ultrasound navigation.
complications, neurosurgery, surgical results, ultrasound navigation.
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Results
:
Results:
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Results
:
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Results
:
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Results
:
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:
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The
results
were compared to EMG findings and myosonograms of healthy persons.
Different types of triceps surae (TS) muscle disturbances due to traumatic injury, genetic disorders, peripheral neuropathy, chronic spastic hemiparesis, venous pathology and combined hemiparesis after cervical and lumbar spinal surgery were evaluated by EMG and electroneurography. The findings were juxtaposed to corresponding images obtained by simultaneous multimodal 2D/3D/4D myosonography in rest, during maximal plantar flexion and electrical stimulation.
The results were compared to EMG findings and myosonograms of healthy persons.
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Results
:
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:
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:
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:
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THROMBOLYTIC THERAPY –
RESULTS
AND PROBLEMS
THROMBOLYTIC THERAPY – RESULTS AND PROBLEMS
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The aim of the present study is to describe the
results
and the problems in evaluation of the thrombolytic therapy for management of acute ischemic stroke in the Second clinic of Neurology with Intensive Neurology Care Unit .
The aim of the present study is to describe the results and the problems in evaluation of the thrombolytic therapy for management of acute ischemic stroke in the Second clinic of Neurology with Intensive Neurology Care Unit .
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Results
:
Results:
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Results
:
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Results
:
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Results
:
Results:
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In group A better
results
were shown in daily activities, motor ability and TUG, while group B improved more significantly the following parameters: fine movements, static balance and gait.
In the patients of both groups a significant improvement was observed.
In group A better results were shown in daily activities, motor ability and TUG, while group B improved more significantly the following parameters: fine movements, static balance and gait.
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Results
:
Results:
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Results
:
Results:
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
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19.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 10, 2014, No. 1
,
,
,
Results
:
Results:
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The
results
were compared with those obtained from brain
ln 2008 and 2009 experimental implantation of "Alloplant" was made in Russia with controversial subjective effect. Since then the patient has color hallucinations known as Charles Bonnet Syndrome. Parallel clinical and neuro-ophthalmological examinations for evaluation of his neurological and visual impairments were performed. The multimodal neuro-ophthalmo-sonography 2D/3D/4D was usеd for visualizing the structures: the vitreous bodies, the ophthalmic nerves and the ophthalmic papillae. The blood vessels of the eyes including the ophthalmic arteries and veins were evaluated by B-flow imaging.
The results were compared with those obtained from brain
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Results
Results
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Results
:
Results:
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The purpose of this study is to demonstrate the diagnostic abilities of multimodal 2D/ЗD/4D ultrasound imaging for malignant melanoma localized in the maxillofacial area in comparison to the СT, intraoperative and histologic
results
.
The purpose of this study is to demonstrate the diagnostic abilities of multimodal 2D/ЗD/4D ultrasound imaging for malignant melanoma localized in the maxillofacial area in comparison to the СT, intraoperative and histologic results.
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Results
Results
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Our
results
support the necessity of histological examination, which remains the gold standard for type differentiation of the pathological processes.
lymphangioma, hemangioma, cysts of the soft tissues etc.
Our results support the necessity of histological examination, which remains the gold standard for type differentiation of the pathological processes.
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Тo summarize and analyze our
results
of treating patients with acute ischemic stroke (AIS) with Actilyse® for the last five years.
Тo summarize and analyze our results of treating patients with acute ischemic stroke (AIS) with Actilyse® for the last five years.
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Results
:
Results:
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these
results
and with recommendation of ANA (American Heart Association), ASO (American Stroke Organization) and ESO (European Stroke Organization), in 2010 the time for applying the thrombolytic agent was extended from 3 to 4.5 hours.
these results and with recommendation of ANA (American Heart Association), ASO (American Stroke Organization) and ESO (European Stroke Organization), in 2010 the time for applying the thrombolytic agent was extended from 3 to 4.5 hours.
In Bulgaria the first thrombolysis with rt-PA was conducted in 2005 in Plovdiv [2, 23, 24].
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The aim of this study is to summarize and analyze our own five-year experience
results
of applying intravenous thrombolysis with Actilyse® for treatment of AIS.
The aim of this study is to summarize and analyze our own five-year experience results of applying intravenous thrombolysis with Actilyse® for treatment of AIS.
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Results
Results
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The average time from the beginning of symptoms to the hospitalization in the emergency room (ER), the beginning of treatment with Actilyse®, СT performance and the receiving of the laboratory
results
are shown on table 3.
The average time from the beginning of symptoms to the hospitalization in the emergency room (ER), the beginning of treatment with Actilyse®, СT performance and the receiving of the laboratory results are shown on table 3.
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Постъпване в СПО лабораторни резултати/ Door-to-labor
results
Постъпване в СПО лабораторни резултати/ Door-to-labor results
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Our
results
demonstrate that from all patients with AlS, hospitalized between 2009 and 2013 in Second Clinic of Neurology with lCU at the University Hospital "St.
Our results demonstrate that from all patients with AlS, hospitalized between 2009 and 2013 in Second Clinic of Neurology with lCU at the University Hospital "St.
Marina" Varna, thrombolysis with Actilyse® received only 3.1%. Patients suitable for treatment with Actilyse don't arrive in time in the hospital's ER. The trend for small increase of i.v. thrombolysis between
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Results
from CT Scan of the Brain by Hospitalization and 24 Hours after TL.
Results from CT Scan of the Brain by Hospitalization and 24 Hours after TL.
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Our
results
show, that in comparison to 2009 the mean time from the symptoms' onset to the arrival in ER and starting the thrombolysis have increased as result of prolonged therapeutic window to up to 4.5 hours.
Our results show, that in comparison to 2009 the mean time from the symptoms' onset to the arrival in ER and starting the thrombolysis have increased as result of prolonged therapeutic window to up to 4.5 hours.
Despite of prolonged time window the percentage of intracranial hemorrhages has not increased 6.6%. The same percentage is reported from the most world centers conducting thrombolysis. The same applies for mortality rate percentage after thrombolysis.
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Comparison between our
results
and the
results
from other centers is shown on table 6.
The mean time from the symptoms' onset to the treatment beginning is 151.4 min. The mean NIHSS in admission is 13.3 points and in discharge 5.9 points, which means that we have a decrease of 7.4 points.
Comparison between our results and the results from other centers is shown on table 6.
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In comparison to international studies, our investigation shows similar
results
for mean time from the symptoms' onset to the start of the thrombolysis, similar severity of stroke, estimated with NIHSS and lower mean age of thrombolysed patients, which can be the reason for the lower mortality rate in our contingent.
In comparison to international studies, our investigation shows similar results for mean time from the symptoms' onset to the start of the thrombolysis, similar severity of stroke, estimated with NIHSS and lower mean age of thrombolysed patients, which can be the reason for the lower mortality rate in our contingent.
The frequency of the intracranial hemorrhages is in the same range as in literature's data.
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Analysis of own
results
and
results
of some thrombolytic studies.
Analysis of own results and results of some thrombolytic studies.
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Thrombolysis for acute ischemic stroke:
results
of the Canadian Alteplase for Stroke Effectiveness Study (CASES).
Hill M, Вuchan A.
Thrombolysis for acute ischemic stroke: results of the Canadian Alteplase for Stroke Effectiveness Study (CASES).
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Multivariable analysis of outcome predictors and adjustment of main outcome
results
to baseline data profle in randomized controlled trials: Safe lmplementation of Thrombolysis in Stroke-Monitoring Study (SlTS-MOST).
hrmann M, Larrue W, Lees K, Machnig T, Roine R, Toni D, Vanhooren G.
Multivariable analysis of outcome predictors and adjustment of main outcome results to baseline data profle in randomized controlled trials: Safe lmplementation of Thrombolysis in Stroke-Monitoring Study (SlTS-MOST).
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Results
:
Results:
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Results
Results
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The laboratory blood
results
were normal except for dyslipidemia.
ln admission the patient was conscious, with an acute left-sided hemiplegia.
The laboratory blood results were normal except for dyslipidemia.
ln absence of contraindications and after signing an informed consent from the patient's relatives, intravenous thrombolysis was performed. ln the next 24 hours after the thrombolysis there was no change in the focal neurological deficit. Emergency MRl and magnetic resonance angiography (MRA) were performed because of worsening signs of increased intracranial pressure, showing persisting ischemia in the MСA territory, severe cerebral edema and signs of haemorrhagic infarction (fig. 1). Оn the third day after the symptoms onset and following a neurosurgical consultation, the patient underwent decompressive craniectomy. ln the next few days the patient's condition improved with full regression of edema but persisting severe left central hemiparesis to hand monoplegia (Rankin score 5).
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results
and is life-saving in some patients.
results and is life-saving in some patients.
The outcome of the decompressive craniectomy depends on procedure complications: insufficient decompression, infection, hemorrhage and development of contralateral cerebrospinal fluid collection [12, 14]. Advanced age, more severe motor deficit, longer duration of intensive therapy and prolonged mechanical ventilation are associated with a worse prognosis and quality of life of these patients [2, 3, 16, 18].
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The condition is irreversible if CPR is not administered and
results
in biological death.
vices etc.). The most typical clinical manifestation of SCD is: sudden loss of consciousness, missing perceptible pulse in auscultation, no pulsations of large arteries and no breathing.
The condition is irreversible if CPR is not administered and results in biological death.
Since SCD is a sudden condition the cardiac diseases in terminal stage of heart failure and traumatic events are excluded.
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The efforts for achieving better therapeutic
results
have been focused in two directions:
The cardiac arrest is a global, socially significant medical condition associated with high mortality rate and severe disability. lt is characterized with a high variety of etiological factors and pathogenesis which define the possibility for recovering after CPR.
The efforts for achieving better therapeutic results have been focused in two directions:
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grouping of
results
by absolute value and by percent.
grouping of results by absolute value and by percent.
The largest observational study is published in 1977, 1063 patients have been observed for 10 years analyzing the survival after CА in a Multiprofile Hospital excluding Coronary and lntensive Care Units. The reported results after CPR were, as follows: died after unsuccessful CPR (65%); died later in hospital (23%) and discharged alive (7%)[25, 28]. ln an observational study published in 2001, 557 patients are analyzed for a 5-year period in Cardiology Hospital and the
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The reported
results
after CPR were, as follows: died after unsuccessful CPR (65%); died later in hospital (23%) and discharged alive (7%)[25, 28].
grouping of results by absolute value and by percent. The largest observational study is published in 1977, 1063 patients have been observed for 10 years analyzing the survival after CА in a Multiprofile Hospital excluding Coronary and lntensive Care Units.
The reported results after CPR were, as follows: died after unsuccessful CPR (65%); died later in hospital (23%) and discharged alive (7%)[25, 28].
ln an observational study published in 2001, 557 patients are analyzed for a 5-year period in Cardiology Hospital and the
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The rest of the parameters could not be analyzed due to the following reasons: the analyzed data are from СPR which is performed in different circumstances; the included patients have different characteristics; statistically significant differences are observed in
results
from similar parameters as well as the existence of heterogeneous, incomparable parameters.
after СPR.
The rest of the parameters could not be analyzed due to the following reasons: the analyzed data are from СPR which is performed in different circumstances; the included patients have different characteristics; statistically significant differences are observed in results from similar parameters as well as the existence of heterogeneous, incomparable parameters.
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of АНА and the International Liaison Committee on Resuscitation (ILCOR) refer to the cases with initially registered rhythm of VF, some studies even demonstrate worse
results
for another types of rhythm [1].
of АНА and the International Liaison Committee on Resuscitation (ILCOR) refer to the cases with initially registered rhythm of VF, some studies even demonstrate worse results for another types of rhythm [1].
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The reliability of PAR index as a predictor of CPR failure has not been sufficiently clinically proven and some controversial
results
have been reported [23, 24, 27].
hospital and outhospital patients thus it has not been implemented in the clinical practice [16, 19]. Pre Arrest Morbidity (РАМ) index was developed in 1989 including the following parameters which are associated with higher in-hospital mortality rate: pneumonia, hypotension, renal insufficiency, cancer and sedentary lifestyle; it has a negative relation with survival until discharge. During the hospitalization and 0 score of the index, the survival rate is up to 50.6% and the patients die with a score above 8 [3, 11]. Prognostics After Resuscitation (PAR index) is developed in 1992 by modification of PAM index based on a metaanalysis of 14 studies (2643 patients) assessing the in-hospital survival after CPR. The modified index is a better predictor of ineffective CPR [8, 23].
The reliability of PAR index as a predictor of CPR failure has not been sufficiently clinically proven and some controversial results have been reported [23, 24, 27].
No index or scale is available in order to be used in the practice in countries where a decision for "do" or "do not" resuscitate is defined by the locally acting regulation which requires searching for more reliable predictors of CPR outcome.
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Prognostic Factors of the
Results
of Cardiopulmonary Resuscitation in a Cardiology Hospital.
Timerman А, Sauaia N, Piegas L, Ramos R, Gun C, Santos E, Bianco А, Sousa J.
Prognostic Factors of the Results of Cardiopulmonary Resuscitation in a Cardiology Hospital.
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Scientific reviews and original research
results
in the field of experimental and clinical Receptology were presented.
On April 13, 2013 in the Medical Faculty of Sofia University "St. Kliment Ohridski" a scientific meeting of medical students on: "Cell Receptors Research Methods, Immunobiological Characteristics and Medical Importance", dedicated to Prof. Rita Levi-Montalcini (Nobel Prize in Medicine) was held.
Scientific reviews and original research results in the field of experimental and clinical Receptology were presented.
The event was organized by the Committee for Medical Education of the Medical Students Association in Bulgaria (MSAB) Sofia University, jointly with lecturers from the Department "Biology, Medical Genetics and Microbiology" at the Medical Faculty of Sofia University "St. Kliment Ohridski".
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
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20.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 10, 2014, No. 2
,
,
,
Contribution of atrial fibrillation to incidence and outcome of ischemic stroke:
results
from a populationbased study.
Marini C, De Santis F, Sacco S, Russo T, Olivieri L, Totaro R, Carolei Al.
Contribution of atrial fibrillation to incidence and outcome of ischemic stroke: results from a populationbased study.
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The changes in the cortex organization include an increase in the number and density of dendrites, synapses and neurotrophic factors synthesis which
results
in two ways: unmasking of existing neuronal circuits and establishing of new neuronal circuits.
The brain damage caused by a stroke may result in the loss of cerebral function. However, the brain can use neuroplasticity to adjust itself functionally, by reorganizing the cortical maps, which contributes to the stroke recovery.
The changes in the cortex organization include an increase in the number and density of dendrites, synapses and neurotrophic factors synthesis which results in two ways: unmasking of existing neuronal circuits and establishing of new neuronal circuits.
Term neuroplasticity comes from Greek word "plastos" which means pliable; it means that neurochemical, synaptic, receptor and functional reorganization in brain results in new functional possibilities. After damage of the motor cortex, changes of activation in other motor areas are observed. These changes occur in homologue areas of the nonaffected hemisphere which can substitute for the lost functions or in the intact cortex adjacent to the damage. Due to these cortical reorganizations, which begin from one to two days after the stroke, and can be extended for months, the patients can recover, at least in part, their lost abilities. The recovery of functions of the limbs which is promoted by plasticity is more difficult to occur, due to a
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Term neuroplasticity comes from Greek word "plastos" which means pliable; it means that neurochemical, synaptic, receptor and functional reorganization in brain
results
in new functional possibilities.
The brain damage caused by a stroke may result in the loss of cerebral function. However, the brain can use neuroplasticity to adjust itself functionally, by reorganizing the cortical maps, which contributes to the stroke recovery. The changes in the cortex organization include an increase in the number and density of dendrites, synapses and neurotrophic factors synthesis which results in two ways: unmasking of existing neuronal circuits and establishing of new neuronal circuits.
Term neuroplasticity comes from Greek word "plastos" which means pliable; it means that neurochemical, synaptic, receptor and functional reorganization in brain results in new functional possibilities.
After damage of the motor cortex, changes of activation in other motor areas are observed. These changes occur in homologue areas of the nonaffected hemisphere which can substitute for the lost functions or in the intact cortex adjacent to the damage. Due to these cortical reorganizations, which begin from one to two days after the stroke, and can be extended for months, the patients can recover, at least in part, their lost abilities. The recovery of functions of the limbs which is promoted by plasticity is more difficult to occur, due to a
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This is reflected by the
results
of classical intelligence tests
Our understanding of neuropsychological changes in normal aging has evolved considerably in recent past [6, 10] . Most studies agree that age is accompanied by an overall decline in cognitive functions as measured by IQ tests. A more detailed analysis shows that, in general, verbal functions (corresponding to so-called crystallized intelligence are relatively preserved in aging subjects, while non-verbal functions ("fluid intelligence") tend to show a decline.
This is reflected by the results of classical intelligence tests
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Similar
results
were obtained by Grober et al.
Collie [7] et al reported verbal episodic memory performance in an MCI group that was as impaired as that seen in mild AD. However, the same MCI group's performance on measures assessing other cognitive domains (naming, executive functions, etc.) was equivalent to that of healthy older controls. Other studies of MCI report cognitive deficits similar to those described by Petersen and colleagues. Grundman [13] in line with the concept of amnestic MCI, we would like to stress on the benefits of the Buschke’s FCSR test [12] usage, in spite of the studies that examined memory functioning in MCI using free recall measures [1, 2]. Our recent findings [22] show that MCI patients recalled significantly fewer words on immediate and delayed free recall than did matched control participants and show, in addition, lesser efficacy of cued recall.
Similar results were obtained by Grober et al.
[12] who investigated learning and retention in participants who later developed AD. Considered together, our findings with those of Grober et al. [12] indicate that detection of MCI and very early AD may be best accomplished by using robust learning tests that control cognitive processing.
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Thus, although an episodic memory deficit is generally considered to be the first sign of AD, these longitudinal
results
support a multiple pattern of deterioration prior to AD.
and some, indeed report executive functions to be equally predictive for the latter development of AD.
Thus, although an episodic memory deficit is generally considered to be the first sign of AD, these longitudinal results support a multiple pattern of deterioration prior to AD.
Similarly, recent studies show, that when the clinical syndrome of MCI evolves on a neurodegenerative basis, the multiple-domain type of MCI has a less favorable prognosis than the amnestic type and may represent a more advanced prodromal stage of dementia [3].
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The
results
show a noticeable impairment on free recall, some deficit on cued recall, and quasi-normal recognition memory in VaD patients relative to controls.
Recently, we found that VaD patients showed fewer impairment on episodic memory measures than AD patients.
The results show a noticeable impairment on free recall, some deficit on cued recall, and quasi-normal recognition memory in VaD patients relative to controls.
This deficit should be considered a retrieval defect of memory, patients being helped by semantic cues. In contrast, AD patients show lesser efficacy of cued recall (as assessed by the proportion of maximum possible recall obtained by total recall) and impaired recognition as compared with VaD. Our findings indicate that use of a cued recall and recognition procedures significantly enhance the ability to discriminate between VaD and AD. In addition, patients with VaD have a significantly greater number of perseverative errors during tasks that assess "frontal" lobe functions, while AD patients exhibit more perseverations on tests of semantic knowledge.
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prevent blood from entering the skull during diastole
results
in brain death [3].
prevent blood from entering the skull during diastole results in brain death [3].
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Both AD and VaD changes are present in smaller vessels, where occlusion secondary to stenosis/thrombosis or spasm (which occurs as a reaction to an elevation in mean arterial pressure)
results
in elevated total peripheral resistance.
Both AD and VaD changes are present in smaller vessels, where occlusion secondary to stenosis/thrombosis or spasm (which occurs as a reaction to an elevation in mean arterial pressure) results in elevated total peripheral resistance.
These dementias may thus represent end-organ failure secondary to the effects of vascular disease [25]. Several years ago a study by Rundek et al. described the changes of CVMR in patients with VaD, and to a lesser extent in those with AD [26]. A reduction in CVMR was associated with cognitive decline at 12 months follow-up, as reported by Silvestrini [16]. These results suggest that vascular factors are important in the pathogenesis of cognitive impairment in some patients with AD.
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These
results
suggest that vascular factors are important in the pathogenesis of cognitive impairment in some patients with AD.
Both AD and VaD changes are present in smaller vessels, where occlusion secondary to stenosis/thrombosis or spasm (which occurs as a reaction to an elevation in mean arterial pressure) results in elevated total peripheral resistance. These dementias may thus represent end-organ failure secondary to the effects of vascular disease [25]. Several years ago a study by Rundek et al. described the changes of CVMR in patients with VaD, and to a lesser extent in those with AD [26]. A reduction in CVMR was associated with cognitive decline at 12 months follow-up, as reported by Silvestrini [16].
These results suggest that vascular factors are important in the pathogenesis of cognitive impairment in some patients with AD.
AD is characterized by various pathological processes, such as cerebral angiopathy, atherosclerosis, capillary endothelial and basement membrane changes, and thus the cerebral blood flow may be impaired. Changes of CVR in the absence of neck vessels stenosis may reflect increased arteriolar wall stiffness attributable to intrinsic anatomical changes.
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have shown similar
results
.
Roher et al.
have shown similar results.
PI of the arteries in AD patients is generally greater than that of similarly aged patients without dementia. They suggest that with the increased artery wall rigidity imposed by atherosclerotic changes, mean flow velocities were generally lower in patients with AD [27].
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Results
of large emboli are stroke and transient ischaemic attack, but repeated small asymptomatic emboli over a long period of time may cause progressive cerebral damage.
Transcranial Doppler also has a place in detecting asymptomatic spontaneous cerebral emboli (ASCE) which are common findings in patients with VaD and AD [28]. One of the most common sources of ASCE is carotid artery disease. Embolic signals are often detected by TCD of the middle cerebral arteries when monitored for a number of hours in most patients with symptomatic and severe stenosis [29].
Results of large emboli are stroke and transient ischaemic attack, but repeated small asymptomatic emboli over a long period of time may cause progressive cerebral damage.
During open heart surgery or carotid surgery microemboli entering the cerebral circulation might cause memory loss and cognitive impairment. [30, 31] Valvular heart disease, atrial fibrillation and paradoxal embolisation of venous emboli into the arterial circulation may also result in ASCE [32, 33].
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Thus the individual rehabilitation therapy design had to respect the neuropsychological test
results
.
It is mandatory to check all stroke patients for basic cognitive function before rehabilitation. Memory or attentional deficits limit all rehabilitation processes.
Thus the individual rehabilitation therapy design had to respect the neuropsychological test results.
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Similar
results
were obtained e.g.
In addition, an increase in the MEP amplitudes is accompanied by an improvement of clinical and functional scores. However, many of the earlier intervention studies concentrated on hand motor cortex. Only few randomized controlled intervention trials have established that intensive practice with the affected hand and arm for 3 to 6 hours/day for 2 weeks can result in increased number of active TMS sites compared to less intensive treatment or no treatment [6]. The enlarged motor representation in the lesioned hemisphere was shown to remain for up to 4 months in the follow-up period. In our previous clinical trial, the MEP amplitudes in the lesioned hemisphere increased after 2 weeks of intensive hand and arm exercise therapy [7].
Similar results were obtained e.g.
by Koski et al. [8], who reported that MTs decreased after more training, whereas MEP amplitude and map size
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Our
results
of gait rehabilitation and TA MEPs confirm their conclusion that TMS is useful in both moderately affected and in more impaired patients as a physiological assay of treatment-induced plasticity and functional gains.
increased after less extensive treatment.
Our results of gait rehabilitation and TA MEPs confirm their conclusion that TMS is useful in both moderately affected and in more impaired patients as a physiological assay of treatment-induced plasticity and functional gains.
There is evidence that neural reorganization can be enhanced by gait-oriented rehabilitation. These results support previous clinical studies of MEPs of the lower limb in predicting motor recovery and ambulation and correlations between MEPs and gait recovery after stroke [9].
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These
results
support previous clinical studies of MEPs of the lower limb in predicting motor recovery and ambulation and correlations between MEPs and gait recovery after stroke [9].
increased after less extensive treatment. Our results of gait rehabilitation and TA MEPs confirm their conclusion that TMS is useful in both moderately affected and in more impaired patients as a physiological assay of treatment-induced plasticity and functional gains. There is evidence that neural reorganization can be enhanced by gait-oriented rehabilitation.
These results support previous clinical studies of MEPs of the lower limb in predicting motor recovery and ambulation and correlations between MEPs and gait recovery after stroke [9].
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We obtained corresponding
results
in early acute stage of stroke.
In a treadmill training study of Forrester et al. [10], 3/11 patients walked on a treadmill 3 times per a week for 6 months. The MEP amplitudes increased in all 3 trained patients in the lesioned hemisphere, whereas MEPs decreased in 6/8 of their untrained counterparts.
We obtained corresponding results in early acute stage of stroke.
Only 3 weeks of intensive gait-oriented walking training resulted in increased MEP amplitudes in the affected leg. Four weeks of gait training at subacute stage has been shown to decrease the MT for TA in the lesioned hemisphere [11] and the map size for TA increased in both hemispheres, whereas the corresponding value for abductor hallucis increased only in the lesioned
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Results
:
Results:
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Preliminary
results
demonstrate that ES mediated by ILC resulted in a statistically significant improvement in range of movement in all four joint angles studied (shoulder flexion; elbow, wrist and index finger extension) over 17 intervention sessions.
Preliminary results demonstrate that ES mediated by ILC resulted in a statistically significant improvement in range of movement in all four joint angles studied (shoulder flexion; elbow, wrist and index finger extension) over 17 intervention sessions.
Additionally, participants required signficantly less extrinsic support for each task. The tasks and system is described and initial intervention data are reported.
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Results
Results
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These
results
indicate reduced motor impairment.
These results indicate reduced motor impairment.
This will be further quantified with the clinical assessments post-intervention. Data collection is on-going.
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The
results
of this feasibility study are relevant to all studies in which non-contact movement measurement is required.
The results of this feasibility study are relevant to all studies in which non-contact movement measurement is required.
This type of system will become increasingly important in the drive to deliver cost-effective improvements in stroke rehabilitation and to fulfil national clinical guidelines which include recommendations for patients to have every opportunity to practise within their capacity.
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The
results
from this sample indicate reduced motor impairment following the intervention.
The results from this sample indicate reduced motor impairment following the intervention.
The different improvements visible in Figure 2 relate to the movement requirements necessary for performing the different tasks. The ipsilateral and contralateral tasks challenged the elbow extension, but not the shoulder flexion. Participants were able to control their shoulder flexion and elbow extension so this may have reduced the degrees of freedom allowing the participants to forcus (focus) on their wrist extension. The far reach task challenged all joints, but was the only task to require index finger extension to complete the task; repetitive practice resulted in the most significant improvement in index finger extension. The highlight switch task challenged participants repeatedly in terms of their shoulder flexion, and this is where the changes in movement occurred.
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Now we have demonstrated the feasibility of using this technology we will seek to verify these
results
with a larger sample of participants in a randomised controlled trial or cross-over study design in which the effects of no ES (unweighting from the arm support alone) or ES that is not precisely controlled by ILC are
Limitations of the study were a small sample size, no control group or follow-up (due to time constraints). Participant had also taken part in previous ILC studies, so it is possible that the improvements seen were not representative of participants who have not had the opportunity of using ES mediated by ILC.
Now we have demonstrated the feasibility of using this technology we will seek to verify these results with a larger sample of participants in a randomised controlled trial or cross-over study design in which the effects of no ES (unweighting from the arm support alone) or ES that is not precisely controlled by ILC are
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Better
results
are considered in combination of ground gait training with treadmill or high-technology approaches (body weight support treadmill training, robotic devices, ect) [14, 26].
There is no systematic review addressed to the efficacy of gait training methods in stroke rehabilitation. For acute stage of stroke there is a consensus that ground gait training helps for recovery of patients who cannot walk independently [5], but the opinion of gait training in chronic patients with permanent mobility deficits is contraversal – from negative to small, time-limited benefits mainly for walking speed [38].
Better results are considered in combination of ground gait training with treadmill or high-technology approaches (body weight support treadmill training, robotic devices, ect) [14, 26].
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Fasoli SE, Krebs HI, Stein J, Frontera WR, Hughes R, Hogan N: Robotic therapy for chronic motor impairments after stroke: follow-up
results
.
Fasoli SE, Krebs HI, Stein J, Frontera WR, Hughes R, Hogan N: Robotic therapy for chronic motor impairments after stroke: follow-up results.
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[16] reported stimulating
results
: there were more recanalizations (Fig.
[16] reported stimulating results: there were more recanalizations (Fig.
1), better clinical outcome (Fig. 2), with no effect on mortality (Fig. 3). An increase of asymptomatic and symptomatic hemorrhages was mainly due to the concomitant use of microbubbles (Fig. 4) [16, 17, 18, 19, 20], further enhancing clot lysis and blood brain barrier (BBB) disruption. Nevertheless, other studies reported no effect of US on BBB and did not show any increase of apoptosis and markers of tissue damage outside the infarcted area [21].
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Waiting for the
results
of these two trial, ST represent a therapy still not-authorized for routine clinical use.
Waiting for the results of these two trial, ST represent a therapy still not-authorized for routine clinical use.
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Sonothrombolysis with transcranial color-coded sonography and recombinant tissue-type plasminogen activator in acute middle cerebral artery main stem occlusion:
results
from a randomized study.
ndler G, Seidel G.
Sonothrombolysis with transcranial color-coded sonography and recombinant tissue-type plasminogen activator in acute middle cerebral artery main stem occlusion: results from a randomized study.
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We published
results
in larger group of “54 consecutive, clinically stable patients with WD who were classified as predominantly neurologic or hepatic form of the disease and were adequately assessable by TCS from both sides.
We published results in larger group of “54 consecutive, clinically stable patients with WD who were classified as predominantly neurologic or hepatic form of the disease and were adequately assessable by TCS from both sides.
TCS showed significantly higher prevalence of SN and LN hyperechogenicity in WD patients in comparison with healthy controls. Moderate to marked SN hyperechogenicity was found in 31.5% of our WD patients (42% and of those with predominantly neurologic form and 7% with hepatic form of WD). SN hyperechogenicity was also found in 8% of healthy controls in our study. Disease severity correlated with the hyperechogenicity of SN and with the width of the third ventricle that was significantly higher in patients with neurologic form of WD” [18].
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Results
of both TCS studies in WD patients, confirmed the ability of the method for early detection of trace metals in the basal ganglia (probably copper and possibly iron and manganese).
Results of both TCS studies in WD patients, confirmed the ability of the method for early detection of trace metals in the basal ganglia (probably copper and possibly iron and manganese).
Similar findings were observed in some other neurodegenerative diseases with trace metals accumulation. Our group conducted MRI parallel to TCS in 5 unrelated patients with pantothenate kinase-associated neurodegeneration (PKAN), caused by PANK2 mutations [19]. “All patients in our study had an eye of the tiger sign on MRI. Hypointense lesions on the T2-weighted MRI images were restricted to the globus pallidus (GP) and SN. TCS also revealed bilateral hyperechogenic areas restricted to the LN and SN, with normal values of the third ventricle diameter.
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It is important to take care about the color gain during insonation, while if it is inappropriate could give false positive or negative
results
.
For correct diagnosis, the appropriate examination technique and the experience of the sonographer are very important. There is a need for high quality color duplex ultrasound equipment, with standardized adjustments and a high frequency (> 8MHz) linear transducer [26]. False positive and negative halos may be seen in ultrasound examination.
It is important to take care about the color gain during insonation, while if it is inappropriate could give false positive or negative results.
Ultrasound is not able to differentiate between TA and other vasculitis that can involve the temporal arteries.
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These investigations are more expensive, they are associated with radiation and often reveal variable
results
.
(PET), single photon emission comuterized tomography (SPECT).
These investigations are more expensive, they are associated with radiation and often reveal variable results.
During the last years different magnetic-resonance imaging (MRI) techniques for examination of the cerebral VMR: blood oxygen level dependent MRI (BOLD MRI) with estimation of the cerebral oxygenation, arterial spin labeling MRI (ASL – MRI) with estimation of the arterial blood flow [19] and quantitative MRI angiography [3] have been used. BOLD MPI gives possibility for cerebral VMR mapping and for evaluation of its regional heterogeneity. Comparative studies have shown good correlations between the results of the MRI and TCD tests when examining the cerebral VMR in one and the same patient. When comparing the parallel investigation of the VMR with PET and TCD however, coincidence of the results in only half of the patients with symptomatic occlusions of the internal carotid arteries was found [24].
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Comparative studies have shown good correlations between the
results
of the MRI and TCD tests when examining the cerebral VMR in one and the same patient.
(PET), single photon emission comuterized tomography (SPECT). These investigations are more expensive, they are associated with radiation and often reveal variable results. During the last years different magnetic-resonance imaging (MRI) techniques for examination of the cerebral VMR: blood oxygen level dependent MRI (BOLD MRI) with estimation of the cerebral oxygenation, arterial spin labeling MRI (ASL – MRI) with estimation of the arterial blood flow [19] and quantitative MRI angiography [3] have been used. BOLD MPI gives possibility for cerebral VMR mapping and for evaluation of its regional heterogeneity.
Comparative studies have shown good correlations between the results of the MRI and TCD tests when examining the cerebral VMR in one and the same patient.
When comparing the parallel investigation of the VMR with PET and TCD however, coincidence of the results in only half of the patients with symptomatic occlusions of the internal carotid arteries was found [24].
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When comparing the parallel investigation of the VMR with PET and TCD however, coincidence of the
results
in only half of the patients with symptomatic occlusions of the internal carotid arteries was found [24].
(PET), single photon emission comuterized tomography (SPECT). These investigations are more expensive, they are associated with radiation and often reveal variable results. During the last years different magnetic-resonance imaging (MRI) techniques for examination of the cerebral VMR: blood oxygen level dependent MRI (BOLD MRI) with estimation of the cerebral oxygenation, arterial spin labeling MRI (ASL – MRI) with estimation of the arterial blood flow [19] and quantitative MRI angiography [3] have been used. BOLD MPI gives possibility for cerebral VMR mapping and for evaluation of its regional heterogeneity. Comparative studies have shown good correlations between the results of the MRI and TCD tests when examining the cerebral VMR in one and the same patient.
When comparing the parallel investigation of the VMR with PET and TCD however, coincidence of the results in only half of the patients with symptomatic occlusions of the internal carotid arteries was found [24].
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The impairment of the hemodynamic reserve capacity is frequently observed in patients with multiple asymptomatic subcortical infarctions, the
results
suggesting vasculopathy of the small vessels and hypoperfusion pathogenetic mechanism of their origin.
Meta-analyses of prospective studies in a great number of patients with asymptomatic or symptomatic high-grade carotid stenosis or occlusion and decreased VMR have shown significantly increased risk of stroke or transient ischemic attacks [12, 17, 21]. The impaired VMR is associated with risk of mortality, cardiovascular or noncardiovascular, regardless of the presence or absence of stroke. In these cases the VMR is discussed to reflect the existence of systemic vascular damage [25]. A prospective study with evaluation of the VMR on admission and after 6 months in patients with acute stroke and symptomatic intracranial or extracranial stenosis shows better VMR values from the ipsilateral hemisphere in the patients with extracranial than with intractranial stenosis. The VMR measures from admission correlated positively with the Barthel index on the 6th month [29].
The impairment of the hemodynamic reserve capacity is frequently observed in patients with multiple asymptomatic subcortical infarctions, the results suggesting vasculopathy of the small vessels and hypoperfusion pathogenetic mechanism of their origin.
When investigating patients with cerebral infarctions and symptomatic carotid stenoses Jolnic W. et al. [15] established that the TCD examined VMR has not identified the subgroup with high risk of stroke recurrence. Our studies with estimation of the VMR in the MCA in patients with unilateral cerebral infarctions showed its bilateral decrease [30]. In cases with cerebral infarctions ipsilateral to high-grade stenosis or thrombosis of the internal carotid
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21.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 11, 2015, No. 1
,
,
,
In Bulgaria the procedure is applied in the first 3 – 4.5 hours after the ischemic stroke onset in persons from 18 to 75 years of age (for Europe up to 80 years) in accordance with the
results
of European studies [8].
Worldwide and in our country the main reason for the low rate of thrombolytic therapy is the late patient hospitalization – outside the time window in which thrombolysis could be applied.
In Bulgaria the procedure is applied in the first 3 – 4.5 hours after the ischemic stroke onset in persons from 18 to 75 years of age (for Europe up to 80 years) in accordance with the results of European studies [8].
This period could be increased to 6 hours, using intra-arterial thrombolysis and/or endovascular recanalization (mechanical extraction of the thrombus or stenting). There are a number of contraindications, making these procedures inapplicable in a relatively large number of patients who reached promptly the health facility. In the absence of contraindications for early revascularization, implementation of endovascular intervention within 2 weeks of AIS is possible [7]. In recent years the percent of carotid endarterectomies remains very low – about 0.1% per year. The frequency of carot-
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Results
:
Results:
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The
results
were statistically processed with variance and correlation analysis.
The results were statistically processed with variance and correlation analysis.
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Results
Results
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SITS was formed as a reaction to the NINDS (National Institute of Neurological Disorders and Stroke) and ECASS (European Cooperative Acute Stroke Study) study
results
.
SITS was formed as a reaction to the NINDS (National Institute of Neurological Disorders and Stroke) and ECASS (European Cooperative Acute Stroke Study) study results.
Swedish Local ECASS investigators decided to form a national committee for implementation of thrombolysis in stroke. The group was called SITS (“Svenska Implementerings kommitt
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The meeting ended with two
results
: a randomized controlled trial of rt-PA for patients who would be treated between 3 and 4 hours after the stroke onset (ECASS III), and a safety monitoring study of all patients treated after an approval, based on the SITS registry (SITS-MOST).
gren and prof Kennedy Lees from Glasgow were invited to the discussions as advisers to the manufacturer, Boehringer-Ingelheim.
The meeting ended with two results: a randomized controlled trial of rt-PA for patients who would be treated between 3 and 4 hours after the stroke onset (ECASS III), and a safety monitoring study of all patients treated after an approval, based on the SITS registry (SITS-MOST).
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SITS Investigators Within-day and weekly variations of thrombolysis in acute Ischemic stroke:
results
from Safe Implementation of Treatments in Stroke-International stroke thrombolysis register.
Lorenzano S, Ahmed N, Tatlisumak T, Gomis M, Davalos A, Mikulik R, Sevcik P, Ollikainen J, Wahlgren N, Toni D.
SITS Investigators Within-day and weekly variations of thrombolysis in acute Ischemic stroke: results from Safe Implementation of Treatments in Stroke-International stroke thrombolysis register.
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Remote or extraischemic intracerebral hemorrhage-an uncommon complication of stroke thrombolysis:
results
from the Safe Implementation of Treatments in Stroke-International stroke thrombolysis register.
Mazya MV, Ahmed N, Ford GA, Hobohm C, Mikulik R, Nunes AP, Wahlgren N.
Remote or extraischemic intracerebral hemorrhage-an uncommon complication of stroke thrombolysis: results from the Safe Implementation of Treatments in Stroke-International stroke thrombolysis register.
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Multivariable analysis of outcome predictors and adjustment of main outcome
results
to baseline data profile in randomized controlled trials; Safe Implementation of Thrombolysis in Stroke Monitoring Study (SITS-MOST).
hrmann M, Larrue V, Lees KR, Machnig T, Roine RO, Toni D, Vanhooren G. For the SITS-MOST investigators.
Multivariable analysis of outcome predictors and adjustment of main outcome results to baseline data profile in randomized controlled trials; Safe Implementation of Thrombolysis in Stroke Monitoring Study (SITS-MOST).
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
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22.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 11, 2015, No. 2
,
,
,
Results
:
Results:
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Then c-TEE was performed in these patients because of the positive
results
of the “bubble test”.
A mixture of 9 ml of saline and 1 ml of air was used as a contrast agent, which is shaken several times in order to create microbubbles as ultrasound contrast. If there is R-L cardiac shunt, the contrast agent reaches the cerebral arterial circulation and contrast microbubbles are detected in ultrasound range of the tested blood vessel in the form of MES with the use of 2 MHz ultrasound probes of TCD appliance of the brand Rimed Digi-Lite (Rimed Ltd., Israel). The test is considered positive even if one MES is detected. First the test was performed without, and then with the Valsalva maneuver to increase the sensitivity of shunt detection. The size of the shunt was determined based on the number of detected microbubbles (shunt grade I-V).
Then c-TEE was performed in these patients because of the positive results of the “bubble test”.
The test is carried out by injecting contrast agent (agitated saline) into the cubital vein and then it is monitored using transesophageal ultrasound probe whether there is transition of the contrast from the right to the left heart chambers. The Valsalva maneuver was performed during c-TEE examination, because in this manner the pressure in the right atrium is increased, thereby increasing the possibility to detect small or latent PFO or shunts. Presence of isolated PFO, ASD, ASA, and PFO with ASA was observed. The test is considered positive if at least one MES in the left atrium is detected during 3 cardiac cycles, from the moment of appearance of intravenously injected contrast into the right atrium. C-TEE test was performed in all patients by a trained cardiologist, upon written consent of the patient, using the ultrasound device Toshiba APLI 300 CV (Toshiba, Japan) and transesophageal ultrasound probe.
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The research
results
are presented in tables.
The research results are presented in tables.
Descriptive statistical parameters of observed characteristics, mean values, standard deviation, and minimum and maximum of all values are presented.
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Prospective studies that have been done on a larger sample of patients showed no major fluctuations between the sensitivity of these two complementary contrast test, although the
results
of these studies are in favor of somewhat greater sensitivity of c-TCD (c-TCD – 69% vs.
Our study shows that the degree of correlation between the two methods for detecting R-L shunt, c-TCD and c-TEE is very low, and exists only in 6.9% of the cases. According to our research, cTCD has much greater sensitivity (R-L shunt was detected by c-TCD in all 58 selected patients, whereas the shunt was detected by c-TEE in 4 patients). However, high percentage (72.4%) of other interatrial septal abnormalities as possible R-L shunt sites were detected by c-TEE examination. In contrast to our findings, some studies have shown a significant correlation between cTCD and c-TEE in the detection of R-L cardiac shunts (63.6%), and also significantly higher sensitivity of c-TCD compared with c-TEE (93.8% cTCD vs. 53.1% c-TEE) [2].
Prospective studies that have been done on a larger sample of patients showed no major fluctuations between the sensitivity of these two complementary contrast test, although the results of these studies are in favor of somewhat greater sensitivity of c-TCD (c-TCD – 69% vs.
c-TEE – 58%) [6].
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This finding implies the possibility of a shunt at the site of these anatomical defects of the interatrial septum, which was not detected by using c-TEE, namely it is possible that there are “false negative”
results
for R-L shunt.
This result of our study could be attributed to the fact that the research was conducted on a small sample of highly selected patients and should not be generalized to the general population or larger series of patients, but also the sensitivity of c-TEE must not be underestimated, because a significant number of patients with a variety of interatrial septal defects (over 72% of patients) have been registered by this method.
This finding implies the possibility of a shunt at the site of these anatomical defects of the interatrial septum, which was not detected by using c-TEE, namely it is possible that there are “false negative” results for R-L shunt.
The reasons for “false negative” results could be the invasiveness
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The reasons for “false negative”
results
could be the invasiveness
This result of our study could be attributed to the fact that the research was conducted on a small sample of highly selected patients and should not be generalized to the general population or larger series of patients, but also the sensitivity of c-TEE must not be underestimated, because a significant number of patients with a variety of interatrial septal defects (over 72% of patients) have been registered by this method. This finding implies the possibility of a shunt at the site of these anatomical defects of the interatrial septum, which was not detected by using c-TEE, namely it is possible that there are “false negative” results for R-L shunt.
The reasons for “false negative” results could be the invasiveness
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The possibility of “false positive”
results
of the “bubble test” should not be ignored because of potential artifacts due to patient movement or speech, but we believe that the possibility of such findings is small, considering the fact that a special TCD software application was used for MES detection, which differentiates MES from artifacts with high certainty based on clearly defined criteria.
of c-TEE method, which often prevents adequate performance of VM due to sedation of patients or appropriate application of the contrast agent. In addition, only 1 MES in the MCA spectrum is sufficient for R-L shunt detection using c-TCD, which suggests the possibility of a very small shunt not visible by c-TEE, thus making the result “false-negative”. Furthermore, it should be noted as a limitation of our study, that the test was conducted on a sample of patients with already positive “bubble test”, and afterwards a correlation with c-TEE was performed. Therefore, care should be taken with the estimate of “bubble test” or c-TCD sensitivity.
The possibility of “false positive” results of the “bubble test” should not be ignored because of potential artifacts due to patient movement or speech, but we believe that the possibility of such findings is small, considering the fact that a special TCD software application was used for MES detection, which differentiates MES from artifacts with high certainty based on clearly defined criteria.
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Our research has shown that there is no statistically significant correlation between vascular risk factors and “bubble test”
results
in patients with ischemic stroke/TIA.
Our research has shown that there is no statistically significant correlation between vascular risk factors and “bubble test” results in patients with ischemic stroke/TIA.
This may be due to the mainly younger population (mean age of the tested group 36 years), and to the fact that atherosclerotic changes in them were not pronounced enough to have a significant,
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With regard to this fact, the
results
could be explained by the fact that pronounced thickening of IMC in the carotid arteries attributes to a more pronounced and diffuse atherosclerotic process that leads to certain hemodynamic changes in cerebral circulation, even in the absence of high-grade carotid stenosis (most of our subjects had a diameter stenosis of the carotid artery up to 50%).
A positive correlation between IMC thickness and time of MES appearance in the cerebral arteries was also observed. Some studies have shown that in patients with cryptogenic ischemic stroke, IMC thickness positively correlates with the degree of systemic atherosclerosis development, and IMC thickness > 0.78mm is considered indicative of the search for cardiovascular sources of embolus as causes of ischemic stroke [9].
With regard to this fact, the results could be explained by the fact that pronounced thickening of IMC in the carotid arteries attributes to a more pronounced and diffuse atherosclerotic process that leads to certain hemodynamic changes in cerebral circulation, even in the absence of high-grade carotid stenosis (most of our subjects had a diameter stenosis of the carotid artery up to 50%).
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Results
:
Results:
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Similar
results
in exposed to vibration have been established by other researchers [4].
Similar results in exposed to vibration have been established by other researchers [4].
Basal vagal activity according to the R-R variability is reduced in vibration disease [1, 5]. Studies suggest a prevalence of sympathetic tone in HAVS. Decreased parasympathetic activity was found in HAVS patients, which is a negative correlation with the duration of the vibration exposure [9, 10]. A number of authors found significant differences between the indices of heart rate variability during deep breathing and the duration of vibration exposure. Segmental vibration has an independent negative relation with indicators of heart variability and effects on autonomic functions [17].
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PS5 NIRDIABO-Grant for the Prevention of Diabetes and Obesity in Bulgaria: Recent
Results
.
PS5 NIRDIABO-Grant for the Prevention of Diabetes and Obesity in Bulgaria: Recent Results.
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The initial
results
were based on case reports, case series and in the last several years on registries mainly concerning stent retrievers.
Mechanical thrombectomy (TE) devices have been used for treatment of acute ischemic stroke caused by brain vessel occlusion for more than ten years.
The initial results were based on case reports, case series and in the last several years on registries mainly concerning stent retrievers.
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In the light of the very positive
results
of registry based studies using stent retrievers, RCT's using these devices and focusing on proximal vesssel occlusions were planned and launched.
In the light of the very positive results of registry based studies using stent retrievers, RCT's using these devices and focusing on proximal vesssel occlusions were planned and launched.
In October 2014 the MR CLEAN Study from the Netherlands was presented and showed a significant benefit of TE starting within 6 hours after the stroke onset using the Solitaire device over IVT alone.
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These
results
refer to the anterior circulation.
These results refer to the anterior circulation.
In Basilar Artery Occlusion TE is feasible and reduces mortality to around 35%, as shown in recent registry data. However prospective data for the posterior circulation are not yet available.
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Long-term
results
of the ABSORB study showed that on the fifth year of follow-up of 30 patients with implanted Absorb BVS, no stent thrombosis, need for revascularization as a result of in-stent restenosis and death due to cardiovascular event were reported.
The bio-absorbable stents are considered the third revolution in stent technology (after the development of the first bare metal stents and the first drug eluting stents).
Long-term results of the ABSORB study showed that on the fifth year of follow-up of 30 patients with implanted Absorb BVS, no stent thrombosis, need for revascularization as a result of in-stent restenosis and death due to cardiovascular event were reported.
Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a new opportunity for better lipid control in patients intolerable to statins or with poor control with the maximum tolerated statin dose. The three major trials for evolucomab (PCSK9 inhibitor) show a mean of 57% lowering
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Results
:
Results:
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Results
:
Results:
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According to our
results
VCI in SVD patients is associated with older age, functional status, presence of white matter lesions (WML) and severity of confluent WML.
There are data indicating that 20% of elder persons have "silent” lesions whereas 25% of all symptomatic ischemic infarctions belong to SVD. Symptomatic subcortical ischemic SVD are the most frequent and the most homogenic cause of VCI.
According to our results VCI in SVD patients is associated with older age, functional status, presence of white matter lesions (WML) and severity of confluent WML.
Independent VCI predictors are the functional status and severity of WML.
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One of the most important
results
is that the treatment of obesity and prevention of DM2 realizes preventive cardiology.
Belgrade Prevention Programme (Serbia) is one of the most efficient with 64% reduction of DM2 incidence.
One of the most important results is that the treatment of obesity and prevention of DM2 realizes preventive cardiology.
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These
results
have been confirmed by many European Prevention Plans: DE-PLAN, IMAGE, and others, some still ongoing: for example the ePREDICE project.
These results have been confirmed by many European Prevention Plans: DE-PLAN, IMAGE, and others, some still ongoing: for example the ePREDICE project.
The prevention team from Belgrade is leaded by Acad. Prof. Predrag Djordjevic. Glucose control management and targets in older diabetic patients requires levels of Hba1c up to 7.0–7.5%. In order to achieve this goal the first-line therapy is Metformin. If the patient is intolerant to Metformin, Sulfonylureas are the next step.
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Results
:
Results:
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Results
:
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Adequate assistance and best
results
can be achieved with a specialized team prepared for treating strokes, including a clinical center with availability of diagnostic imaging, laboratory, resuscitation and neurosonology specialists.
The implemented on time and directed neurosonology examination may have a key role in the diagnosis and monitoring of treatment outcomes of patients with stroke.
Adequate assistance and best results can be achieved with a specialized team prepared for treating strokes, including a clinical center with availability of diagnostic imaging, laboratory, resuscitation and neurosonology specialists.
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Results
:
Results:
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Results
:
Results:
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We compared these
results
with data from the international registry of patients with stroke SITS.
We studied 166 patients with acute ischemic stroke with thrombolytic therapy and 1532 patients with acute ischemic stroke without TL therapy. The prospective study involved a five-year period.
We compared these results with data from the international registry of patients with stroke SITS.
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Results
:
Results:
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The comparative
results
give us reason to propose the creation of a national registry of patients with acute ischemic stroke.
There is no precise information about the causes that leed to significant increase in deaths over the same three-month period.
The comparative results give us reason to propose the creation of a national registry of patients with acute ischemic stroke.
The data from the registry would serve also for planning and directing the efforts for training the
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Results
:
Results:
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:
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:
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Patients with CIHD showed poor
results
on MMSE, short-term memory, delayed recall, BVRT, Isaacs verbal fluency test and HDS (p
Patients with CIHD showed poor results on MMSE, short-term memory, delayed recall, BVRT, Isaacs verbal fluency test and HDS (p
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Results
:
Results:
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The numerical
results
of the blood flow in the CCA bifurcation give a detailed picture of the axial and radial velocity distribution and presented as velocity and vorticity magnitudes.
The numerical results of the blood flow in the CCA bifurcation give a detailed picture of the axial and radial velocity distribution and presented as velocity and vorticity magnitudes.
The structures of the flow around the bifurcation from the CCA to the internal and external carotid arteries are obtained considering characteristic time points for one pulse wave period. The axial velocity distribution and wall shear stress distribution and contours are presented.
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Results
:
Results:
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Results
:
Results:
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To perform an ultrasound assessment of the third ventricle’s diameter in patients with brain atrophy and to compare the
results
with the brain CT measurements.
To perform an ultrasound assessment of the third ventricle’s diameter in patients with brain atrophy and to compare the results with the brain CT measurements.
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The
results
were processed by correlation and variation analysis.
The values of the third ventricle’s diameter were measured in axial plane at the level of the thalami by transcranial sonography in 14 patients at medium age of 73.50±9,67, suffering from vascular or degenerative dementia, whose CT showed brain atrophy. Parallel ultrasound and computed tomographic measurements of the third ventricle’s diameter were performed.
The results were processed by correlation and variation analysis.
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Results
:
Results:
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The
results
were compared with healthy controls at the same age.
tial tremor, confirmed by SPECT (DaTscan). The severity of Parkinson’s disease was evaluated by the scales of Hoehn and Yahr and Unified Parkinson’s Disease Rating Scale (UPDRS), and the cognitive capacity – by Mini Mental State Examination Scale.
The results were compared with healthy controls at the same age.
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Results
:
Results:
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These data correlated with the
results
from DaTscan Imaging.
In contrast to controls and the patient with essential tremor an asymmetric and enlarched hyperechogenic substantia nigra was found in all three patients with Parkinson's disease.
These data correlated with the results from DaTscan Imaging.
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Surgical
results
were assessed in respect to the extent of resection, postoperative complications and local recurrence of the disease.
For a period of 7 years 116 surgeries on cerebral metastases were performed under intraoperative ultrasound guidance. A powerful ultrasound scanner integrated with neuronavigation system (Sonowand Invite, Sonowand) was used to locate metastatic lesions and to confirm their total removal. Tumor size and location, number of metastases and preoperative status of patients, measured according to the Karnofsky performance scale (KPS) were analyzed.
Surgical results were assessed in respect to the extent of resection, postoperative complications and local recurrence of the disease.
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The
results
were compared to EMG findings and myosonograms of healthy persons.
Different types of triceps surae (TS) muscle disturbances due to traumatic injury, genetic disorders, peripheral neuropathy, chronic spastic hemiparesis, venous pathology and combined hemiparesis after cervical and lumbar spinal surgery were evaluated by EMG and electroneurography. The findings were juxtaposed to corresponding images obtained by simultaneous multimodal 2D/3D/4D myosonography in rest, during maximal plantar flexion and electrical stimulation.
The results were compared to EMG findings and myosonograms of healthy persons.
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Results
:
Results:
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Results
:
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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The
results
were compared to a brain MRI of a clinically healthy person of the same age.
Parallel clinical, neuropsychological and neuroimaging studies (MRI and MRI tractography) were conducted in a 23-years old patient with proved DCC.
The results were compared to a brain MRI of a clinically healthy person of the same age.
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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The
results
of the FSS score correlated with the decrease of the systolic blood pressure after the head-up tilt.
At rest decrease of the spectral parameters: total power, low frequency (LF) and high frequency (HF) power and slight increase of the LF/HF ration (1.8±1,6 vs. 1.6±1.3) in comparison to controls was established. The deep breathing test caused increase of the frequency components, especially of LF, which predominated in the patients group.
The results of the FSS score correlated with the decrease of the systolic blood pressure after the head-up tilt.
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Results
:
Results:
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Results
:
Results:
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Hydrokinesitherapy shows better
results
and is a method of choice, according to its potential for use in sanatoriums and spa hotels.
Kinesitherapy is an essential part of the complex therapeutic approach in patients with chronic lumbar discal disease.
Hydrokinesitherapy shows better results and is a method of choice, according to its potential for use in sanatoriums and spa hotels.
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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Our experimental
results
on rats with obesity demonstrated that topiramate influenced blood levels of insulin and leptin and may affect the appetite.
Obesity is spreading globally and the management of obesity Topiramate is well known antiepileptic drug. It modulates voltage-activated sodium channels and calcium channels as well as mediates GABA receptor-mediated inhibitory currents and antagonizes alpha-amino 3-hydroxyl-4 isoxazole-propionic acid kainite receptors. There are data indicated that topiramate increase body weight in obese people.
Our experimental results on rats with obesity demonstrated that topiramate influenced blood levels of insulin and leptin and may affect the appetite.
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Results
:
Results:
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The
results
demonstrated the effects of topiramate on free radicals of rats with experimental obesity.
The results demonstrated the effects of topiramate on free radicals of rats with experimental obesity.
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NIRDIABO-GRANT FOR THE PREVENTION OF DIABETES AND OBESITY IN BULGARIA: RECENT
RESULTS
NIRDIABO-GRANT FOR THE PREVENTION OF DIABETES AND OBESITY IN BULGARIA: RECENT RESULTS
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
read the entire text >>
23.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 12, 2016, No. 1
,
,
,
Poor
results
in these patients are reason to search other treatment methods [5, 9].
– in 30%. Other major problems are the narrow therapeutic window and the re-occlusion.
Poor results in these patients are reason to search other treatment methods [5, 9].
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The positive effect in the MR CLEAN trial was time dependent, with the best
results
obtained
The positive effect in the MR CLEAN trial was time dependent, with the best results obtained
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Similar
results
were obtained in ESCAPE and SWIFT PRIME trials (in the latter with upper age limit of 80 years) showing bene
48%) and favorable outcomes (68% vs. 15%) as well as lower mortality (18% vs. 41%) compared to intraarterial thrombolysis [8, 9]. In MR CLEAN trial 16% of the patients were 80 years old or older. There was a positive treatment effect in this subgroup [1].
Similar results were obtained in ESCAPE and SWIFT PRIME trials (in the latter with upper age limit of 80 years) showing bene
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Results
:
Results:
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The
results
of the neuroimaging studies of the patient’s brain are compared with those of a clinically healthy male of the same age.
For the aim of the study, the patient underwent clinical, neurological and neuropsychological studies, EEG, visual and auditory evoked potential tests. The brain parenchyma is evaluated with magnetic resonance tomography (MRT) and tractography.
The results of the neuroimaging studies of the patient’s brain are compared with those of a clinically healthy male of the same age.
In order to find additional anomalies an echocardiography, pharyngoscopy, audiometry and neuroophtalmic studies were made.
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Results
Results
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Results
:
Results:
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Results
Results
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Results
:
Results:
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Paradoxically, in one NEJM audit and also in one questionnaire obtained in the USA similar
results
were obtained [11].
The Asymptomatic Carotid Surgery Trial (ACST) showed that the 10-year stroke risk in patients who underwent CEA was 10.8% compared with 16.9% in those treated with medical therapy [10].
Paradoxically, in one NEJM audit and also in one questionnaire obtained in the USA similar results were obtained [11].
According to these trials, about 49% of respondents recommended BMT, compared with 31% for CEA and 20% for CAS. In addition, Abbott proposed medical management as the best option for patients with ACAS due to the high costs of surgical intervention and associated complications [12]. Also there are patients in whom medical therapy
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CJ. Severity of asymptomatic carotid stenosis and risk of ipsilateral hemispheric ischaemic events:
results
from the ACSRS study.
CJ. Severity of asymptomatic carotid stenosis and risk of ipsilateral hemispheric ischaemic events: results from the ACSRS study.
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Management of carotid stenosisd – polling
results
.
Klein A, Solomon CG, Hamel MB.
Management of carotid stenosisd – polling results.
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Medical (nonsurgical) intervention alone is now best for prevention of stroke associated with asymptomatic severe carotid stenosis:
results
of a systematic review and analysis.
Abbott AL.
Medical (nonsurgical) intervention alone is now best for prevention of stroke associated with asymptomatic severe carotid stenosis: results of a systematic review and analysis.
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A. Natural history of carotid artery stenosis contralateral to endarterectomy:
results
from two randomized prospective trials.
A. Natural history of carotid artery stenosis contralateral to endarterectomy: results from two randomized prospective trials.
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“If the
results
are good this method can be applied to many patients in clinical practice” Assoc. Prof.
lifespan of patients with acute myocardial infarction. The study includes 200 patients from 18 to 80 years from hospitals in the United States, Spain, Belgium, Serbia and other countries. From the Bulgarian side the hospitals “City Clinic”, “Tokuda” and “Aleksandrovska” are involved in the ambitious project. The study is in its final third phase and will be completed in 2017.
“If the results are good this method can be applied to many patients in clinical practice” Assoc. Prof.
Ivo Petrov, Head of the Cardiology Department in “City Clinic” explained.
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
read the entire text >>
24.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 12, 2016, No. 2
,
,
,
The first
results
of thermal ablation of tractus pallidothalamicus (pallidotractotomy) with HIFU were published by Magara et al.
The first results of thermal ablation of tractus pallidothalamicus (pallidotractotomy) with HIFU were published by Magara et al.
in 2014 [33]. The research was conducted with 13 Parkinson's disease patients (9 with tremulo-akinetic form,
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The
results
of a year-long tracing show reduction of pain with an average of 57% and 41% in Visual Analog Score [24].
It is used in treatment of chronic refractory pain (radicular and plexus pain, phantom pain, post-herpetic or post-traumatic pain, pain in syringomyelia, paraplegia, thalamic infarction, etc.).
The results of a year-long tracing show reduction of pain with an average of 57% and 41% in Visual Analog Score [24].
Applying HIFU in trigeminal neuralgia is limited to experimental research, which is inadequate so far [44].
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Transcranial low-frequency ultrasound-mediated thrombolysis in brain ischemia: Increased risk of hemorrhage with combined ultrasound and tissue plasminogen activator
Results
of a phase II clinical trial.
Daffertshofer M, Gass A, Ringleb P, Sitzer M, Sliwka U, Els T, Sedlaczek O, Koroshetz WJ, Hennerici MG.
Transcranial low-frequency ultrasound-mediated thrombolysis in brain ischemia: Increased risk of hemorrhage with combined ultrasound and tissue plasminogen activator Results of a phase II clinical trial.
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Non-invasive transcranial ultrasound therapy based on a 3D CT scan: protocol validation and in vitro
results
.
Marquet F, Pernot M, Aubry J-F, Montaldo G, Marsac L, Tanter M, Fink M.
Non-invasive transcranial ultrasound therapy based on a 3D CT scan: protocol validation and in vitro results.
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Results
:
Results:
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Our
results
showed that from the examined 68 men and 87 women, 88 were with a dominant left VA (56% of men and 58% of women), 11 (7%) showed no dominance.
Our results showed that from the examined 68 men and 87 women, 88 were with a dominant left VA (56% of men and 58% of women), 11 (7%) showed no dominance.
Men had both VAs wider, and a larger diameter of the “wider" VA. There were no differences in MBFVs between men and women.
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Results
Results
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Results
were similar for the other side: 36% of men and 37% of women had a narrower left vertebral artery.
Among men and women the right vertebral artery was noticed to be narrower than the left one in most cases (table 1). The term “narrower" refers to a smaller vertebral artery lumen when both sides are compared. Fifty-seven percent of subjects had a narrower right vertebral artery as opposed to 36% with a narrower left one. Vertebral arteries of equal width were found in 10% of subjects. A similar percentage of men and women were found to have a narrower right vertebral artery: 56% of men and 58% of women.
Results were similar for the other side: 36% of men and 37% of women had a narrower left vertebral artery.
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Our
results
confirmed some earlier findings.
Our results confirmed some earlier findings.
Back in 1999 Seidel [25] showed that mean blood flow velocities are lower in right vertebral arteries and that lumen diameters of right vertebral arteries are smaller than the left ones. Our results showed different findings in regard to mean blood flow velocities, which didn't differ greatly between the right and left vertebral artery, but confirmed the dominance of the left vertebral artery. Our investigation supported some results of earlier studies done by Karayenbuehel and Yasargila in 1957. They found that vertebral arteries had different diameters in 74% of the population, and 42% of the population had a dominant left vertebral artery. Our study showed different diameters of the right and left vertebral artery in 92% of men and 95% of women.
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Our
results
showed different findings in regard to mean blood flow velocities, which didn't differ greatly between the right and left vertebral artery, but confirmed the dominance of the left vertebral artery.
Our results confirmed some earlier findings. Back in 1999 Seidel [25] showed that mean blood flow velocities are lower in right vertebral arteries and that lumen diameters of right vertebral arteries are smaller than the left ones.
Our results showed different findings in regard to mean blood flow velocities, which didn't differ greatly between the right and left vertebral artery, but confirmed the dominance of the left vertebral artery.
Our investigation supported some results of earlier studies done by Karayenbuehel and Yasargila in 1957. They found that vertebral arteries had different diameters in 74% of the population, and 42% of the population had a dominant left vertebral artery. Our study showed different diameters of the right and left vertebral artery in 92% of men and 95% of women. Touboul et al.
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Our investigation supported some
results
of earlier studies done by Karayenbuehel and Yasargila in 1957.
Our results confirmed some earlier findings. Back in 1999 Seidel [25] showed that mean blood flow velocities are lower in right vertebral arteries and that lumen diameters of right vertebral arteries are smaller than the left ones. Our results showed different findings in regard to mean blood flow velocities, which didn't differ greatly between the right and left vertebral artery, but confirmed the dominance of the left vertebral artery.
Our investigation supported some results of earlier studies done by Karayenbuehel and Yasargila in 1957.
They found that vertebral arteries had different diameters in 74% of the population, and 42% of the population had a dominant left vertebral artery. Our study showed different diameters of the right and left vertebral artery in 92% of men and 95% of women. Touboul et al.
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Results
:
Results:
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Results
Results
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Symptomatic Ostial Vertebral Artery Stenosis: Treatment with Drug-eluting Stents– Clinical and Angiographic
Results
at 1-year Follow-up.
Chun Ho Yu S, Wai Hong Leung T.
Symptomatic Ostial Vertebral Artery Stenosis: Treatment with Drug-eluting Stents– Clinical and Angiographic Results at 1-year Follow-up.
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Symptomatic Ostial Vertebral Artery Stenosis: Treatment with Drug-eluting Stents—Clinical and Angiographic
Results
at 1-year Follow-up.
Chun Ho Yu S, Wai Hong Leung, Suk Yee Lam J, Wai Man Lam W, Ka Sing Wong L.
Symptomatic Ostial Vertebral Artery Stenosis: Treatment with Drug-eluting Stents—Clinical and Angiographic Results at 1-year Follow-up.
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P3 Transcranial Brain Sonography Findings in Parkinson’s Disease: First
Results
from Tuzla, Bosnia and Herzegovina.
P3 Transcranial Brain Sonography Findings in Parkinson’s Disease: First Results from Tuzla, Bosnia and Herzegovina.
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Optimum reduction in DTN time delays is not achievable by any single intervention but rather
results
from continuous analysis of data and improvement of the stroke process as a whole.
Optimum reduction in DTN time delays is not achievable by any single intervention but rather results from continuous analysis of data and improvement of the stroke process as a whole.
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Management is directed to secondary stroke prevention and such urgent approach
results
in the reduction of event rates from 10% to 3–4%.
Management is directed to secondary stroke prevention and such urgent approach results in the reduction of event rates from 10% to 3–4%.
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The STICH II study
results
confirm that early surgery does not increase the rate of death or disability at 6 months and might have a small but clinically relevant survival advantage for patients with spontaneous superficial ICH without intra-
For most patients with ICH, the usefulness of surgery is uncertain. Specific exceptions to this recommendation include patients with 1) cerebellar hemorrhage who are deteriorating neurologically or who have brainstem compression and/or hydrocephalus from ventricular obstruction and 2) patients presenting with lobar clots >30 mL and within 1 cm of the surface.
The STICH II study results confirm that early surgery does not increase the rate of death or disability at 6 months and might have a small but clinically relevant survival advantage for patients with spontaneous superficial ICH without intra-
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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TRANSCRANIAL BRAIN SONOGRAPHY FINDINGS IN PARKINSON'S DISEASE: FIRST
RESULTS
FROM TUZLA, BOSNIA AND HERZEGOVINA
TRANSCRANIAL BRAIN SONOGRAPHY FINDINGS IN PARKINSON'S DISEASE: FIRST RESULTS FROM TUZLA, BOSNIA AND HERZEGOVINA
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
read the entire text >>
25.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 13, 2017, No. 1
,
,
,
Results
:
Results:
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Results
:
Results:
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The
results
of several studies have demonstrated that adequate collateral circulation may prevent the development of hemodynamic failure.
The results of several studies have demonstrated that adequate collateral circulation may prevent the development of hemodynamic failure.
In contrast, findings from different studies showed that the presence of leptomeningeal collateral flow was associated with an increased risk of future ischemic stroke [1, 4–6]. The actual contribution of the individual collateral pathways is difficult to assess and quantify. Assessment of cerebral hemodynamics can be performed with different techniques. The non-invasive evaluation of the collateral circulation status became possible only after introduction into clinical practice of several neuro-angioimaging tools, as Computed Tomography angiography (CTA), Magnetic-resonance angiography ((MRA), Color Doppler sonography (CDUS), Transcranial Color Doppler (TCCD) modalities. All above-mentioned modalities give valuable information about the presence and efficiency of collateral supply in patients with ICA occlusive changes.
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Results
Results
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The
results
of our study are in overall agreement with previously published
results
.
The reason of the deep white matter diffuse and focal changes may be hypoperfusion of corticomedullar arteries and transformation of their supply area in the “deep border-zone” [3, 10, 12]. In fact, there is evidence that cerebral hemodynamic status can predict the outcome of ICA occlusion. Anterior and posterior communicating arteries are considered the primary collateral pathways; the ophthalmic artery and blood flow via leptomeningeal vessels are considered the secondary pathways. Our study shows that the most important compensatory path in patients with unilateral ICA occlusion is collateral flow from contralateral ICA via AComA. CDUS shows that the mean BFV in the contralateral ICA is increased almost by 55%.
The results of our study are in overall agreement with previously published results.
On the other hand, our data show that the mean net flow volume in the VAs is increased by almost 18% when compared with the control ones, confirming that the vertebrobasilar circulation is also important in collateral supply in cases of ICA occlusion. Our data suggest that the anterior circle is a preferential mode of collateral supply in patients with ICA unilateral occlusion. Patients with collateral flow via the anterior communicating artery have less impaired hemodynamic parameters than those with collateral flow via the PComA (85% infarction in group without AComA vs. 12% infarction in patients with patent AComA). Secondary collateral pathways include the external carotid artery via the ophthalmic artery.
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The
results
of this study suggest that careful use of phenylephrineinduced hypertension is not associated with an increase in morbidity or mortality in AIS and that a subset of patients, particularly those with multiple stenoses of cerebral arteries, may improve neurologically upon elevation of the blood pressure [11].
That is why Wise et al. suggest that it is probably better to discontinue vasopressor therapy in patients who do not have any clinical improvement after several hours of treatment [9]. Nowadays, induced hypertension has been abandoned as a treatment for ischemic stroke due to the perceived risk of hemorrhage and edema, but interestingly similar therapy has become the gold standard for management of cerebral vasospasm after subarachnoid hemorrhage (triple H therapy) [10]. Rordorf and colleagues have conducted a retrospective study on 63 patients admitted to the neurological intensive care unit with a diagnosis of ischemic stroke. Thirty-three were not given a pressor agent, while 30 were treated with phenylephrine in an attempt to improve cerebral perfusion.
The results of this study suggest that careful use of phenylephrineinduced hypertension is not associated with an increase in morbidity or mortality in AIS and that a subset of patients, particularly those with multiple stenoses of cerebral arteries, may improve neurologically upon elevation of the blood pressure [11].
A few years later the same author and his colleagues conducted a pilot study of druginduced hypertension for the treatment of acute stroke. They concluded that induced hypertension in acute stroke is feasible and probably safe, and can improve the neurological examination in some patients [12]. Data about the safety of induced arterial hypertension therapy also came from the retrospective study by Marzan et al. These authors concluded that induced arterial hypertension is feasible and safe in patients with acute stroke [13]. In a randomized double-blind, placebo-controlled trial with 16 hypertensive patients, Lisk et al.
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published the
results
of a prospective, double-blind; placebo-controlled, randomized, multicentre phase II study with 500 recruited patients.
In 2003, Schrader et al.
published the results of a prospective, double-blind; placebo-controlled, randomized, multicentre phase II study with 500 recruited patients.
This study, called ACCESS (Acute Candesartan Cilexetil Therapy in Stroke Survivors), was designed to assess the safety of modest blood pressure reduction by candesartan cilexetil in the early treatment of stroke. Although this safety trial was stopped prematurely when
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These neutral
results
might be because COSSACS was underpowered owing to early termination of the trial, and support the continuation of ongoing research trials [18].
after acute mild stroke were not associated with an increase in adverse events.
These neutral results might be because COSSACS was underpowered owing to early termination of the trial, and support the continuation of ongoing research trials [18].
Anderson and other INTERACT2 investigators randomly assigned 2839 patients who had had a spontaneous intracerebral hemorrhage within the previous 6 h and elevated systolic blood pressure to receive intensive treatment to lower their blood pressure (with a target systolic level of
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The
results
of an international multicentre prospective randomized single-blind blinded-endpoint parallel-group partial-factorial controlled trial of transdermal glyceryl trinitrate (a nitric oxide donor, given for 7 days) versus no glyceryl trinitrate and of continuing versus stopping (temporarily for 7 days) pre-stroke
remains unclear.
The results of an international multicentre prospective randomized single-blind blinded-endpoint parallel-group partial-factorial controlled trial of transdermal glyceryl trinitrate (a nitric oxide donor, given for 7 days) versus no glyceryl trinitrate and of continuing versus stopping (temporarily for 7 days) pre-stroke
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The data from the trial will improve the precision of estimating the
results
(efficacy and safety) from completed trials of blood pressure management in acute stroke and provide the first large-scale randomized evidence on transdermal glyceryl trinitrate and on continuing (versus stopping) pre-stroke antihypertensive medications in AIS [21].
antihypertensive drugs if relevant, in patients with AIS and high systolic blood pressure (140−220 mmHg), are about to be issued by Bath and his collaborators in the ENOS (Efficacy of Nitric Oxide in Stroke) study.
The data from the trial will improve the precision of estimating the results (efficacy and safety) from completed trials of blood pressure management in acute stroke and provide the first large-scale randomized evidence on transdermal glyceryl trinitrate and on continuing (versus stopping) pre-stroke antihypertensive medications in AIS [21].
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Although the
results
of this trial were neutral, the design was such that key questions remain unanswered.
Only one large randomized efficacy trial of hyperglycemia treatment in acute stroke has been reported so far. In the Glucose Insulin Stroke Trial – UK (GIST-UK), 933 patients with AIS within 24 h of symptom onset, not previously treated with insulin, were randomized to unblinded intravenous treatment with insulin, potassium and glucose versus placebo − saline. Protocol treatment continued for 24 h.
Although the results of this trial were neutral, the design was such that key questions remain unanswered.
First, the trial was stopped early; 2355 subjects were originally planned and it was thus underpowered to detect a possible treatment effect. Second, the mean glucose level in the insulin-treated group was only 10 mg/dL lower than in the saline control group, and the control group was only with mild hyperglycemia (≈122 mg/dL between hours 8 and 24). This was probably because of the inclusion of predominantly non-diabetic patients (84%). Third, the median time to initiation of protocol treatment was 13 h. Although the optimal time to correct hyperglycemia during AIS has not been established, earlier treatment may have been therapeutic [32].
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Similar
results
came from Dippel et al.
Guided by the above-mentioned facts, Kasner et al. conducted a randomized, controlled clinical trial at two university hospitals. They found that early administration of acetaminophen (3900 mg/day) to afebrile patients with acute stroke may result in a small reduction in core body temperature. Acetaminophen may also modestly promote hypothermia (below 36.5 °C) or prevent hyperthermia (over 37.5 °C) [42].
Similar results came from Dippel et al.
who treated 75 acute stroke patients with a daily dose of 6000 mg acetaminophen. This treatment may result in a small, but potentially beneficial, decrease in body temperature shortly after ischemic stroke, even in normothermic and subfebrile patients [43]. Although many experts are guided by consensus
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− the lower the better − we should wait for the
results
of many randomized clinical trials that are being conducted at the present time, for example the EuroHYP-1: European multicentre, randomized, phase III clinical trial of therapeutic hypothermia [44].
− the lower the better − we should wait for the results of many randomized clinical trials that are being conducted at the present time, for example the EuroHYP-1: European multicentre, randomized, phase III clinical trial of therapeutic hypothermia [44].
At the present time, insufficient evidence exists to recommend hypothermia for treatment of patients with acute stroke, but
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one may consider lowering body temperature as soon as it reaches 37.0 °C, but soon we shall have the
results
of large randomized controlled trials, and new guidelines will be issued.
one may consider lowering body temperature as soon as it reaches 37.0 °C, but soon we shall have the results of large randomized controlled trials, and new guidelines will be issued.
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The protocol is based on the
results
from main randomized trials in the field of endovascular treatment of acute ischemic stroke, their advantages and disadvantages (angiographical, endovascular and clinical) to minimize the patient‘s risk.
The protocol is based on the results from main randomized trials in the field of endovascular treatment of acute ischemic stroke, their advantages and disadvantages (angiographical, endovascular and clinical) to minimize the patient‘s risk.
Referred are the mandatory criteria for training and certification of endovascular specialists, indications and contraindications for the procedure, the types of methods and overall organization of the stroke units and stroke centers for interventional procedures.
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
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26.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 13, 2017, No. 2
,
,
,
Results
provide strong support for the recommendations to consume more than
cant protective effect on both ischaemic and haemorrhagic stroke. Increased fruit and vegetable intake in the range commonly consumed is associated with a reduced risk of stroke.
Results provide strong support for the recommendations to consume more than
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Results
demonstrated 2391 incident cases of CHD (1597-nonfatal and 794-fatal), 1763 incident cases of stroke (959 ischemic, 329 hemorrhagic and 475 unclassified).
Mediterranean diet.
Results demonstrated 2391 incident cases of CHD (1597-nonfatal and 794-fatal), 1763 incident cases of stroke (959 ischemic, 329 hemorrhagic and 475 unclassified).
Of all strokes, 1480 cases were nonfatal and 283 cases were fatal. There were 1077 cardiovascular disease deaths (fatal CHD and strokes combined) [15]. Long-chain
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The
results
were consistent across green and black tea.
≥ 3 cups of tea (green or black) per day was calculated. Regardless of their country of origin, individuals consuming ≥ 3 cups of tea per day had a 21% lower risk of stroke than those consuming less then 1 cup per day (absolute risk reduction, 0.79; CI 0.73-0.85).
The results were consistent across green and black tea.
The types of catechins differ between green and black tea; their total amounts are comparable because both black and green tea are derived from the same source, the catechins produced within the Camelia sinensis plant, and both have demonstrated effects on vascular function. Catechin ingestion blocked the increase in serum nitric oxide concentration in rats after reperfusion and tea had a demonstrated effect on endothelial function. Theanine is readily bioavailable from both green and black tea; crosses the blood–brain barrier and has effects on brain function; contains glutamate molecule and it might reduce glutamate-related endothelial damage. Regular tea consumption, instead of preventing evident stroke, may instead reduce the post ischemic damage to a level that results in subclinical ischemia or hidden strokes. This would result in diagnosing stroke only in individuals with more extensive post ischemic damage or a greater stroke volume.
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Regular tea consumption, instead of preventing evident stroke, may instead reduce the post ischemic damage to a level that
results
in subclinical ischemia or hidden strokes.
Regardless of their country of origin, individuals consuming ≥ 3 cups of tea per day had a 21% lower risk of stroke than those consuming less then 1 cup per day (absolute risk reduction, 0.79; CI 0.73-0.85). The results were consistent across green and black tea. The types of catechins differ between green and black tea; their total amounts are comparable because both black and green tea are derived from the same source, the catechins produced within the Camelia sinensis plant, and both have demonstrated effects on vascular function. Catechin ingestion blocked the increase in serum nitric oxide concentration in rats after reperfusion and tea had a demonstrated effect on endothelial function. Theanine is readily bioavailable from both green and black tea; crosses the blood–brain barrier and has effects on brain function; contains glutamate molecule and it might reduce glutamate-related endothelial damage.
Regular tea consumption, instead of preventing evident stroke, may instead reduce the post ischemic damage to a level that results in subclinical ischemia or hidden strokes.
This would result in diagnosing stroke only in individuals with more extensive post ischemic damage or a greater stroke volume.
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Results
previously showed that omega-3 supplementation did not influence the IMT, thus the dietary intervention and no dietary intervention groups were pooled. The
A 3-year intervention study [8] showed that vitamin C consumption was associated with less progression in carotid IMT in elderly men. In the study, IMT of the carotid artery and diet in elderly men were assessed. Men were randomly assigned to 1 of 4 groups: dietary intervention, omega-3 supplementation, both or neither.
Results previously showed that omega-3 supplementation did not influence the IMT, thus the dietary intervention and no dietary intervention groups were pooled. The
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The initial
results
were based on case reports and case series and in the last several years on registries, mainly concerning stent retrievers.
Mechanical thrombectomy devices have been used for treatment of acute ischemic stroke caused by brain vessel occlusion for more than ten years.
The initial results were based on case reports and case series and in the last several years on registries, mainly concerning stent retrievers.
The present article presents the findings from recent international trials.
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The initial
results
were based on case reports and case series and in the last several years on registries, mainly concerning stent retrievers.
Mechanical thrombectomy (TE) devices have been used for treatment of acute ischemic stroke caused by brain vessel occlusion for more than ten years.
The initial results were based on case reports and case series and in the last several years on registries, mainly concerning stent retrievers.
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In the light of very positive
results
of registry based studies using stent retrievers, RCT’s using these devices and focusing on proximal vesssel occlusions were planned and launched.
In the light of very positive results of registry based studies using stent retrievers, RCT’s using these devices and focusing on proximal vesssel occlusions were planned and launched.
In October 2014 the MR CLEAN Study from the Netherlands was presented and showed a significant benefit of TE starting within 6 hours after onset of stroke using the Soltaire device over IVT alone [2].
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These
results
refer to the anterior circulation.
These results refer to the anterior circulation.
In Basilar Artery Occlusion TE is feasable and reduces mortality to around 35%, as shown in
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The Austrian Stroke Network Thrombectomy
results
were published recently [5].
The Austrian Stroke Network Thrombectomy results were published recently [5].
The TE results in Styria (Neurointervention Center Graz, catchment area 1.5 million inhabitants) are comparable to the nationwide data (Table 1).
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The TE
results
in Styria (Neurointervention Center Graz, catchment area 1.5 million inhabitants) are comparable to the nationwide data (Table 1).
The Austrian Stroke Network Thrombectomy results were published recently [5].
The TE results in Styria (Neurointervention Center Graz, catchment area 1.5 million inhabitants) are comparable to the nationwide data (Table 1).
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Results
of Mechanical Thrombectomy in Styria 2011–2014
Results of Mechanical Thrombectomy in Styria 2011–2014
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The possibility for comparing the
results
of the treatments would lead to optimization of the process at the individual centers with the aim of decreasing mortality and improving the functional outcome in AIS patients.
The possibility for comparing the results of the treatments would lead to optimization of the process at the individual centers with the aim of decreasing mortality and improving the functional outcome in AIS patients.
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Since there is no a national registry of AIS patients, and for the aim of analyzing the
results
from our research data related to treatment optimization, we have to compare the generalized analysis of the data at the clinic to the database of the remaining centers included in the SITS international registry and the RES-Q
Since there is no a national registry of AIS patients, and for the aim of analyzing the results from our research data related to treatment optimization, we have to compare the generalized analysis of the data at the clinic to the database of the remaining centers included in the SITS international registry and the RES-Q
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Table 2 shows the comparative
results
of the outcome after thrombolytic treatment during hospital stay or on the seventh day after the beginning of the treatment.
Table 2 shows the comparative results of the outcome after thrombolytic treatment during hospital stay or on the seventh day after the beginning of the treatment.
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Results
of the outcome of treating patients with TL during hospitalization
Results of the outcome of treating patients with TL during hospitalization
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Figure 8 shows the comparative
results
of our research.
Figure 8 shows the comparative results of our research.
Both in patients with or without TL treatment, on the third month after the stroke onset no significant changes in mortality rate or in disability level assessed by mRS, are observed. The results of the research allow us to presume that mortality resulting from stroke during
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The
results
of the research allow us to presume that mortality resulting from stroke during
Figure 8 shows the comparative results of our research. Both in patients with or without TL treatment, on the third month after the stroke onset no significant changes in mortality rate or in disability level assessed by mRS, are observed.
The results of the research allow us to presume that mortality resulting from stroke during
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, the complete and profound analysis of the
results
of the research on the AIS treatment shows that intravenous thrombolysis decreases significantly the early mortality and
, the complete and profound analysis of the results of the research on the AIS treatment shows that intravenous thrombolysis decreases significantly the early mortality and
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Our inclusion of our clinic in the international SITS and RES-Q registries has given us the opportunity to carry out comparative analysis of our
results
to those of the other centers in the registries.
Our inclusion of our clinic in the international SITS and RES-Q registries has given us the opportunity to carry out comparative analysis of our results to those of the other centers in the registries.
International research has revealed that a number of objective factors limit the implementation of TL in AIS [16], among them the short therapeutic time window and numerous additional contraindications play a key role [11]. A research by Eissa et al. [17] of 2165 patients shows that because of certain contraindications, 13% of the candidates for TL have been excluded from the therapy, and according to Barber et al.
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Results
of numerous studies showed that listening to music can improve cognition, motor skills and moods, enhancing recovery after brain injury.
Due to mechanism of neuroplasticity, brain is capable of making new connections, activating new pathways and unmasking secondary roads. Music is a strong stimulus for neuroplasticity, thus having possibility to enhance recovery after stroke. fMRI studies have shown reorganization of motor and auditory cortex in professional musicians and other studies showed the changes in neurotransmitter and hormone serum levels in correlation to music.
Results of numerous studies showed that listening to music can improve cognition, motor skills and moods, enhancing recovery after brain injury.
In the field of visual art, brain lesion can lead to the visuospatial neglect, loss of details and significant impairment of artistic work while the lesions affecting the left hemisphere reveal new artistic dimensions, disinhibit the right hemisphere, work is more spontaneous and emotional with the gain of artistic quality. All kinds of arts (music, painting, dancing...) stimulate the brain. They should be part of the treatment processes. Work of many artists is an excellent example for the interweaving the neurology and arts.
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Zeki conducted a study the
results
of which have revealed that a beauty experience is indeed in the beholder, though not in the eye, but in the brain [11].
Where it comes from is crucial for some product to become a piece of art: the creativity arising from artist’s brain is necessary. But it is also interesting to establish why a great number of people find a particular piece of art, music, dance or a poem beautiful. The saying “The beauty is in the eye of the beholder” is known from ancient times. Recently, T. Ishizu and S.
Zeki conducted a study the results of which have revealed that a beauty experience is indeed in the beholder, though not in the eye, but in the brain [11].
As well as for the art experience, Zeki
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Based on experience and on
results
of numerous studies, it is easier to understand that music is biologically and not just aesthetically, a part of human life [4, 1].
Using modern technology in science, as was already pointed out, allows an almost direct insight into the changes that music makes in human brain. Music stimulates specific regions of the brain and affects processes responsible for memory, motor control, timing and language. fMRI studies have shown reorganization of motor and auditory cortex in professional musicians. There are other studies that analyze the changes in neurotransmitter and hormone serum levels in correlation to music.
Based on experience and on results of numerous studies, it is easier to understand that music is biologically and not just aesthetically, a part of human life [4, 1].
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Music has a superior effect on brain plasticity, active music training in children for a longer period of time revealed significantly better
results
on general measures of intelligence, in reading fluency and in performance in the geometry skills compared to
results
of children that didn’t receive training [10, 18].
There is growing evidence that artistic training improves attention and cognition. These insights arise from numerous studies with both children and adults participating and are based beyond simplified understanding that improvement can be expected just from periodical exposure to arts [23]. The key point is again activity-dependent neuroplasticity; the focused training in any of the arts, music, dance or drama activates attention networks that are a crucial part in learning and memory process. The attention networks are easier to activate with the type of arts that person is really interested in.
Music has a superior effect on brain plasticity, active music training in children for a longer period of time revealed significantly better results on general measures of intelligence, in reading fluency and in performance in the geometry skills compared to results of children that didn’t receive training [10, 18].
Practicing some skill increases efficiency of attention networks what besides pure cognitive improvement can enhance the executive attention skills (emotion control, empathy, impulse control…), necessary for a successful learning process.
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program was recently published [18] and showed optimistic
results
considering safety issues.
program was recently published [18] and showed optimistic results considering safety issues.
There was also a trend towards improvement of clinical outcome. The phase III MISTIE trial started in December 2014 and has already recruited a very large proportion of the planned sample size of 500 patients. The results of this trial are eagerly expected and will probably be made available in 2018.
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The
results
of this trial are eagerly expected and will probably be made available in 2018.
program was recently published [18] and showed optimistic results considering safety issues. There was also a trend towards improvement of clinical outcome. The phase III MISTIE trial started in December 2014 and has already recruited a very large proportion of the planned sample size of 500 patients.
The results of this trial are eagerly expected and will probably be made available in 2018.
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Intraventricular hemorrhage and hydrocephalus after spontaneous intracerebral hemorrhage:
results
from the STICH trial.
Bhattathiri PS, Gregson B, Prasad KS & Mendelow AD.
Intraventricular hemorrhage and hydrocephalus after spontaneous intracerebral hemorrhage: results from the STICH trial.
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MISTIE II Trial: 365-day
Results
Demonstrate Improved Outcomes and Cost Benefit International Stroke Conference, Honolulu, Hawaii, USA, 2013.
Hanley DF.
MISTIE II Trial: 365-day Results Demonstrate Improved Outcomes and Cost Benefit International Stroke Conference, Honolulu, Hawaii, USA, 2013.
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Thrombolytic removal of intraventricular haemorrhage in treatment of severe stroke:
results
of the randomised, multicentre, multiregion, placebo-controlled CLEAR III trial.
Hanley DF, Lane K, McBee N, Ziai W, Tuhrim S, Lees KR, Dawson J, Gandhi D, Ullman N, Mould WA, Mayo SW, Mendelow AD, Gregson B, Butcher K, Vespa P, Wright DW, Kase CS, Carhuapoma JR, Keyl PM, Diener-West M, Muschelli J, Betz JF, Thompson CB, Sugar EA, Yenokyan G, Janis S, John S, Harnof S, Lopez GA, Aldrich EF, Harrigan MR, Ansari S, Jallo J, Caron JL, LeDoux D, Adeoye O, Zuccarello M, Adams HP Jr, Rosenblum M, Thompson RE, Awad IA.
Thrombolytic removal of intraventricular haemorrhage in treatment of severe stroke: results of the randomised, multicentre, multiregion, placebo-controlled CLEAR III trial.
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Early endoscope-assisted hematoma evacuation in patients with supratentorial intracerebral hemorrhage: case selection, surgical technique, and long-term
results
.
Kuo LT, Chen CM, Li CH, Tsai JC, Chiu HC, Liu LC, Tu YK, Huang AP.
Early endoscope-assisted hematoma evacuation in patients with supratentorial intracerebral hemorrhage: case selection, surgical technique, and long-term results.
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conservative treatment for spontaneous intracerebral hemorrhage:
results
from a randomized clinical trial in China.
Wang WZ, Jiang B, Liu HM, Li D, Lu CZ, Zhao YD, Sander JW. Minimally invasive craniopuncture therapy vs.
conservative treatment for spontaneous intracerebral hemorrhage: results from a randomized clinical trial in China.
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Mannitol and Outcome in Intracerebral Hemorrhage: Propensity Score and Multivariable Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial 2
Results
.
Wang X, Arima H, Yang J, Zhang S, Wu G, Woodward M, Munoz-Venturelli P, Lavados PM, Stapf C, Robinson T, Heeley E, Delcourt C, Lindley RI, Parsons M, Chalmers J, Anderson, CS.
Mannitol and Outcome in Intracerebral Hemorrhage: Propensity Score and Multivariable Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial 2 Results.
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The
results
of longitudinal studies suggest that TCS of SN may serve as a screening tool for detecting subjects at risk of developing PD [2, 3].
Transcranial B-mode sonography (TCS) of the brain parenchyma is a non-invasive neuroimaging method that allows high-resolution imaging of deep brain structures in patients with degenerative brain diseases [8]. Beside transtemporal axial and coronal imaging planes also transfrontal sagittal planes can be applied for special diagnostic purposes [9]. Hyperechogenicity of substantia nigra (SN), found in about 90% of patients with idiopathic Parkinson's disease (PD), is already present in presymptomatic disease stages.
The results of longitudinal studies suggest that TCS of SN may serve as a screening tool for detecting subjects at risk of developing PD [2, 3].
Studies of our and other groups show that the combination of TCS with simple olfaction and motor tests already at very early disease stages discriminates PD from other Parkinsonian disorders. In turn, normal SN echogenicity in combination with lenticular nucleus hyperechogenicity indicates an atypical Parkinsonian syndrome rather than PD with a specificity of more than 95% [2, 10]. SN hyperechogenicity has also been reported in spinocerebellar atrophy type 2 with Parkinsonism and the parkinsonism-dominant variant of X-linked dystonia-parkinsonism [6, 11]. TCS detects characteristic basal ganglia changes
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In 42.0% of cases US findings were normal or confirmed clinical-neurophysiological
results
.
Also in that study [8] US strongly modified the diagnostic and therapeutic path (in 58.0% of cases) providing information regarding therapeutic approach, diagnosis and follow-up (contributive group).
In 42.0% of cases US findings were normal or confirmed clinical-neurophysiological results.
So in these cases US did not modify the diagnostic path or therapeutic decision (non contributive group).
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The
results
of literature and of our studies [3, 4, 7–12] show that US could complement neurophysiological assessment in a consistent amount of patients with nerve impairment.
The results of literature and of our studies [3, 4, 7–12] show that US could complement neurophysiological assessment in a consistent amount of patients with nerve impairment.
The combined use of US and electrophysiology gives information that is impossible to obtain if we use neurophysiology or US separately [7,8,9]. In the light of the available data, US evaluation is absolutely recommended [2].
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The
results
should be compared to mysononograms of ageand sexmatched healthy controls as no international reference values are available up to day.
Muscles are better evaluated in a lying position by using probes for 2D or 3D/4D real time imaging located at the anatomical place for each particular muscle. The longitudinal and transverse diameters, the angle of inclination of the muscle fibers towards the surface of the aponeurosis and, if possible, the 3D/4D muscle architectonics can be evaluated in rest, during passive, active or ES muscle movements.
The results should be compared to mysononograms of ageand sexmatched healthy controls as no international reference values are available up to day.
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artifacts could compromise the
results
.
artifacts could compromise the results.
Therefore, the M-mode ultrasound monitoring can be used mostly as a screening method for differentiating of various hand tremors based on their frequency (fig. 6).
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The
results
of several studies suggest that US-guidance can improve efficacy and reduce adverse effects of BoNT therapy when compared to conventional placement [1–5].
Botulinum neurotoxin (BoNT) therapy is used in neurology to treat muscle hyperactivity disorders including dystonia, spasticity, cerebral palsy, hemifacial spasms and re-innervation synkinesias. For an optimal effect exact BoNT placement in the target muscle is important. Ultrasonography (US) allows non-invasive, realtime imaging of muscles and their surrounding structures. US can therefore visualise and guide the entire procedure of BoNT application [6, 7].
The results of several studies suggest that US-guidance can improve efficacy and reduce adverse effects of BoNT therapy when compared to conventional placement [1–5].
In task-related dystonia such as writer’s cramp and musician dystonia the importance of exact targeting by US is especially high because (i) only the functionally relevant muscle should be weakened and (ii) only small quantities of BoNT can be injected since otherwise functionally relevant paresis can occur [2]. Compared to EMG-guidance US-guidance allows a more precise placement of BoNT in the target muscle, especially in small muscles. In the neck region US-guidance is recommendable in patients with cervical dystonia when the anterior or middle scalene, longissimus capitis and the obliquus capitis inferior are target muscles [6, 7,
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If US-guided BoNT injection is adequately performed the
results
are a stable therapeutic response and often the need of lower BoNT doses compared to the visual approach of BT injection.
8]. The exact knowledge of the muscular anatomy including its display on ultrasound and training of eye-hand coordination are prerequisites for the US-guided approach.
If US-guided BoNT injection is adequately performed the results are a stable therapeutic response and often the need of lower BoNT doses compared to the visual approach of BT injection.
An interesting novel approach for selected patients is ultrasound-MRI real-time fusion imaging to target BoNT injection into very deep muscles [7].
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5) Chronic anxiety or stress
results
in the alteration of gonadal, adrenal, and neuroactive steroid levels in skin and oral mucosa.
5) Chronic anxiety or stress results in the alteration of gonadal, adrenal, and neuroactive steroid levels in skin and oral mucosa.
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The depression subscale presented very different score ranges, with 13% indicated as having depression, and 68% having scores that corresponded to a non-depressive state; 19% had
results
of borderline significance [25].
In the study of Lamey and Lamb (25) the majority of the 75 patients studied were female, which agrees with previous studies relating to burning mouth syndrome. Analysis of the Hospital Anxiety and Depression (HAD) scale completed by the patients in this study showed that 39% had clinically significant anxiety, 23% had anxiety scores of borderline significance and 38% were not anxious.
The depression subscale presented very different score ranges, with 13% indicated as having depression, and 68% having scores that corresponded to a non-depressive state; 19% had results of borderline significance [25].
From the results of this study it could be concluded that more than one third of the BMS patients, the majority of whom were female, had anxiety. This suggested that their somatic symptoms of burning mouth were at least partly the psychological result of restlessness, tension, and an inherent inability to relax [25]. Only one in seven patients in this cohort had depression, suggesting that depression does not seem to play an important role in the etiology of burning mouth syndrome as previous publications suggested [25].
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From the
results
of this study it could be concluded that more than one third of the BMS patients, the majority of whom were female, had anxiety.
In the study of Lamey and Lamb (25) the majority of the 75 patients studied were female, which agrees with previous studies relating to burning mouth syndrome. Analysis of the Hospital Anxiety and Depression (HAD) scale completed by the patients in this study showed that 39% had clinically significant anxiety, 23% had anxiety scores of borderline significance and 38% were not anxious. The depression subscale presented very different score ranges, with 13% indicated as having depression, and 68% having scores that corresponded to a non-depressive state; 19% had results of borderline significance [25].
From the results of this study it could be concluded that more than one third of the BMS patients, the majority of whom were female, had anxiety.
This suggested that their somatic symptoms of burning mouth were at least partly the psychological result of restlessness, tension, and an inherent inability to relax [25]. Only one in seven patients in this cohort had depression, suggesting that depression does not seem to play an important role in the etiology of burning mouth syndrome as previous publications suggested [25].
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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:
Results:
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The score of subjective complains is lower with decreasing the pain, and the
results
in the test of squats per minute are significantly improved due to the improved strength of the lower extremities.
Measuring the muscle volume in centimeters and the muscle weakness by MMT show improvement of muscle volume and strength, due to the systematic kinesitherapy and strength exercises for upper and lower extremities.
The score of subjective complains is lower with decreasing the pain, and the results in the test of squats per minute are significantly improved due to the improved strength of the lower extremities.
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Results
:
Results:
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
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severe ischemic stroke:
Results
from the SITS-ISTR Registry.
severe ischemic stroke: Results from the SITS-ISTR Registry.
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Time trends in patient characteristics treated on acute stroke-units:
results
from the Austrian Stroke Unit Registry 2003-2011.
Teuschl Y, Brainin M, Matz K, Dachenhausen A, Ferrari J, Seyfang L, Lang W.
Time trends in patient characteristics treated on acute stroke-units: results from the Austrian Stroke Unit Registry 2003-2011.
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27.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 14, 2018, No. 1
,
,
,
Similar
results
were also reported using MEG [31].
In electrophysiological methods (EEG, MEG) the indicator giving information about the mirror function of the neurons, is the so-called μ (mu) rhythm. The μ-wave reflects the electrical activity of the motor cortex at rest. It represents a synchronized activity of multiple pyramidal neurons with a frequency ranging from 8 to 13 Hz. Normally these waves are suppressed by body movements, phenomenon called “event-related desynchronization”. Already in 1950, Gastaut discovered that such desynchronization also occurred during observation and/or imagining a motor act, which later became associated with the presence of a network of mirror neurons.
Similar results were also reported using MEG [31].
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These
results
are not the same for all children with autism, so the theory of the "broken mirror" remains controversial [17].
These results are not the same for all children with autism, so the theory of the "broken mirror" remains controversial [17].
It is assumed that the applied methods are difficult to interpret and that the indicators used do not reflect fully and exclusively the activity of the mirror neurons. One of the possible reasons for this is the high heterogeneity of the study groups with autism in terms of age, gender, degree of functional and morphological impairment, and social experience prior to treatment.
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The
results
of clinical
has become an integral part of the standard post-operative care for surgical patients [2, 8].
The results of clinical
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For achieving optimal
results
, the resources of cardiac rehabilitation, neurorehabilitation, and postoperative rehabilitation are combined.
This rehabilitation requires a multidisciplinary approach, and precise assessment of the patient’s functional status. The basic principles of Physical Medicine and Rehabilitation in these patients includes individual approach, gradual increase of the load, and complexity.
For achieving optimal results, the resources of cardiac rehabilitation, neurorehabilitation, and postoperative rehabilitation are combined.
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Results
Results
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Results
:
Results:
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Results
Results
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This finding is in line with previous published
results
for multiple artery dissection accounting from 13% to 28% of overall CCAD cases [2, 11, 1, 16].
Although the number of patients with cervical artery dissection was small, it showed that one third of them had multiple artery dissection.
This finding is in line with previous published results for multiple artery dissection accounting from 13% to 28% of overall CCAD cases [2, 11, 1, 16].
Our results showed that hypertension was the most common risk factor for cervical artery dissection, involving more than half of patients. However, in CADISP study, hypertension was not so frequently found as in ours [8], but it significantly varied between countries (supplemental material). We found hypercholesterolemia to be the most common risk factor for dissection in all groups, contrary to CADISP study showing inverse association of CCAD with hypercholesterolemia [8]. Other vascular risk factors like diabetes mellitus, smoking and obesity were not frequently found, similar to other studies [8]. Other risk factors recorded in population studies [8] like migraine, previous infection, remote neck surgery, low BMI, MTHFRC6775 genotype, were recorded
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Our
results
showed that hypertension was the most common risk factor for cervical artery dissection, involving more than half of patients.
Although the number of patients with cervical artery dissection was small, it showed that one third of them had multiple artery dissection. This finding is in line with previous published results for multiple artery dissection accounting from 13% to 28% of overall CCAD cases [2, 11, 1, 16].
Our results showed that hypertension was the most common risk factor for cervical artery dissection, involving more than half of patients.
However, in CADISP study, hypertension was not so frequently found as in ours [8], but it significantly varied between countries (supplemental material). We found hypercholesterolemia to be the most common risk factor for dissection in all groups, contrary to CADISP study showing inverse association of CCAD with hypercholesterolemia [8]. Other vascular risk factors like diabetes mellitus, smoking and obesity were not frequently found, similar to other studies [8]. Other risk factors recorded in population studies [8] like migraine, previous infection, remote neck surgery, low BMI, MTHFRC6775 genotype, were recorded
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Although the number of patients was small, the
results
showed similar to CADISP study findings.
Although the number of patients was small, the results showed similar to CADISP study findings.
There are differences between patients with single and multiple artery involvement, and differences between patients with carotid and vertebral artery dissection. We found a high proportion of thyroid abnormalities and migraine in patients with bilateral CCAD. Thyroid abnormalities were not observed in CADISP or in other studies.
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Results
:
Results:
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The
results
of the measuring of the maximum and minimum diameter were an average of two maximal systolic and two minimal diastolic lumen diameters.
media area of close and far arterial wall was performed in maximum systolic expansion of the artery and minimal lumen width during the relaxation of the artery at the end of diastole [1]. It was performed 4 or 5 times on each artery, with the maximum magnification, along with the examination of previously recorded and stored images over 3 to 5 cardiac cycles [17].
The results of the measuring of the maximum and minimum diameter were an average of two maximal systolic and two minimal diastolic lumen diameters.
Shortly before and during the measurement of the carotid arteries diameter, the blood pressure was also measured on the upper arm side that corresponded to the test of the current carotid artery. The measurement was carried out by automatic electronic sphygmomanometer (Omron M6 Comfort, Kyoto, Japan), which was validated according to the international protocol of the European Society of Hypertension [2, 4]. The conversion factor of the measured blood pressure from mmHg to kPa is 0.13.
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Intraobserver variability was observed in Wilcoxon test, used for paired data in 11 subjects to examine the difference in
results
of the first and the second ultrasound, performed within three months.
Intraobserver variability was observed in Wilcoxon test, used for paired data in 11 subjects to examine the difference in results of the first and the second ultrasound, performed within three months.
Statistically significant data was not found (p>0.05) in any of the observed ultrasound parameters (cIMT, diameter, ∆D). Furthermore, statistically significant difference was not found in the number of subjects with carotid atherosclerotic plaque.
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Expedience of the numerical variable in subclinical atherosclerosis risk assessment is discussed because of its sensitivity and specificity, but also because of receiver-operating characteristics (ROC) curve
results
analysis.
T-test, i.e. ANOVA test was used to verify the difference in the expected numerical values of arterial walls, depending on their groups. Where it was necessary, Kruskal–Wallis test, Mann– Whitney U test for independent samples, or Wilcoxon's signed rank test for paired samples were used.
Expedience of the numerical variable in subclinical atherosclerosis risk assessment is discussed because of its sensitivity and specificity, but also because of receiver-operating characteristics (ROC) curve results analysis.
Significance level was set at 0.05 in all of the tests. Statistical analysis was carried out in the data analysis program R (https://cran.r-project. org/, software package ROCR and pROC) and Statistica (StatSoft, version 11, http//www.statsoft. com/company/).
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Results
Results
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stiffness index and aging, as well as negative correlation of DC and aging support the previous
results
.
stiffness index and aging, as well as negative correlation of DC and aging support the previous results.
We used ultrasound markers of the carotid wall stiffness and elasticity – DC, CC and
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Similar
results
for some of the ultrasound markers have been published before [5, 15, 18, 23].
– in detecting statistically significant differences in subclinical atherosclerotic alteration in women with diabetes and hypertension with respect to women without CVRF.
Similar results for some of the ultrasound markers have been published before [5, 15, 18, 23].
Van Sloten’s research led to conclusion that YEM is valid indicator of difference in carotid stiffness of people with and without cardiovascular incident [29]. In our research YEM did not indicate significant differences in carotid stiffness of observed groups of women. Contrary to the effect of other CVRF, Sharett et al. reported on conclusive correlation of smoking and lower stiffness of carotid artery (based on YEM) and higher elasticity of carotid artery (based on DC) [26]. Our DC results of vascular healthy women indicate higher elasticity and
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Our DC
results
of vascular healthy women indicate higher elasticity and
Similar results for some of the ultrasound markers have been published before [5, 15, 18, 23]. Van Sloten’s research led to conclusion that YEM is valid indicator of difference in carotid stiffness of people with and without cardiovascular incident [29]. In our research YEM did not indicate significant differences in carotid stiffness of observed groups of women. Contrary to the effect of other CVRF, Sharett et al. reported on conclusive correlation of smoking and lower stiffness of carotid artery (based on YEM) and higher elasticity of carotid artery (based on DC) [26].
Our DC results of vascular healthy women indicate higher elasticity and
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results
indicate lower arterial stiffness in women smokers in comparison with the control group, but these data are not statistically significant (p>0.05).
results indicate lower arterial stiffness in women smokers in comparison with the control group, but these data are not statistically significant (p>0.05).
It could be argued that women need a longer period of exposure to cigarette smoke for the formation of functional vascular changes that can be detected by ultrasound than in the case of diabetes or hypertension. The high dispersion between the minimum and maximum DC results in women-smokers (Fig. 1) could indicate a possible influence of other CVRF associated with smoking, but that was not the focus of this research. In the scientific literature, we have not found comparison of different ultrasound tests of functional properties of the arterial wall in the prediction of subclinical atherosclerosis. Our results (ROC analysis) indicate that DC and
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The high dispersion between the minimum and maximum DC
results
in women-smokers (Fig.
results indicate lower arterial stiffness in women smokers in comparison with the control group, but these data are not statistically significant (p>0.05). It could be argued that women need a longer period of exposure to cigarette smoke for the formation of functional vascular changes that can be detected by ultrasound than in the case of diabetes or hypertension.
The high dispersion between the minimum and maximum DC results in women-smokers (Fig.
1) could indicate a possible influence of other CVRF associated with smoking, but that was not the focus of this research. In the scientific literature, we have not found comparison of different ultrasound tests of functional properties of the arterial wall in the prediction of subclinical atherosclerosis. Our results (ROC analysis) indicate that DC and
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Our
results
(ROC analysis) indicate that DC and
results indicate lower arterial stiffness in women smokers in comparison with the control group, but these data are not statistically significant (p>0.05). It could be argued that women need a longer period of exposure to cigarette smoke for the formation of functional vascular changes that can be detected by ultrasound than in the case of diabetes or hypertension. The high dispersion between the minimum and maximum DC results in women-smokers (Fig. 1) could indicate a possible influence of other CVRF associated with smoking, but that was not the focus of this research. In the scientific literature, we have not found comparison of different ultrasound tests of functional properties of the arterial wall in the prediction of subclinical atherosclerosis.
Our results (ROC analysis) indicate that DC and
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reports on the good reproducibility of the measurement
results
in B and M-mode, according to Prado et al.
reports on the good reproducibility of the measurement results in B and M-mode, according to Prado et al.
and Cuadrado–Godia et al., could be arguments for the admissibility of our way of ultrasound measuring in this study [8, 22].
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Sex-specific associations of cardiovascular risk factors with carotid-stiffness –
results
from the SAPALDIA cohort study.
Caviezel S, Dratva J, Schaffner E, Schindler C, Zempt Stutz E, de Groot E.
Sex-specific associations of cardiovascular risk factors with carotid-stiffness – results from the SAPALDIA cohort study.
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TCS also showed promising
results
in several other neurodenerative diseases characterized with movement disorders.
TCS also showed promising results in several other neurodenerative diseases characterized with movement disorders.
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Our group published
results
in a larger group of patients, 54 consecutive, clinically stable patients with WD who were classified as predominantly neurologic or hepatic form of the disease and were adequately assessable by TCS from both sides.
Our group published results in a larger group of patients, 54 consecutive, clinically stable patients with WD who were classified as predominantly neurologic or hepatic form of the disease and were adequately assessable by TCS from both sides.
TCS revealed significantly higher
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The updated
results
from the mechanical thrombectomy as a relatively new treatment approach in acute stroke, and the workup of cryptogenic stroke were discussed by prof.
The updated results from the mechanical thrombectomy as a relatively new treatment approach in acute stroke, and the workup of cryptogenic stroke were discussed by prof.
Kurt Niederkorn (Austria). Assoc. Prof. Dimitre Staykov (Austria/Bulgaria) made a comprehensive review on the recent concept for the quality of stroke units and the importance of unified stroke register. During the interactive workshop he presented the international practical approach to the treatment of intracerebral hemorrhage. Prof. Silva Andonova (Bulgaria) paid attention on the prospective follow-up of thrombolytic versus standard therapy in acute ischemic stroke.
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
read the entire text >>
28.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 14, 2018, No. 2
,
,
,
Results
:
Results:
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These
results
suggest that PFO might not be involved in the stroke mechanism of our young patients.
(12) of PFOpatients, in line with other reports [28]. PFO was more often detected in patients with an ESUS pattern (40.6% vs. 13.5%, p=0.02). However, PFO was not associated with a higher MES incidence and rate; in addition MES count was not correlated with shunt magnitude, concomitant atrial septal aneurysm and type of secondary prevention treatment (medical therapy or endovascular closure).
These results suggest that PFO might not be involved in the stroke mechanism of our young patients.
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Despite our study limitations, we think that these
results
encourage the inclusion of TCD
Nonetheless, as we have already mentioned, MES detected far from neurological symptom onset and irrespective of treatment are associated with a higher risk of stroke recurrence [11]. Furthermore, in our study the timing of TCD monitoring did not show any correlation with MES incidence and number; 3. The monitoring duration of 60 minutes may be too short for cryptogenic stroke patients. However, most of the studies were carried out within this time frame, which is the shortest duration with still high sensitivity [24, 36] and represents a good compromise between monitoring needs and patient cooperation. At this time there are no data, which document that longer monitoring allows a greater accuracy in this setting.
Despite our study limitations, we think that these results encourage the inclusion of TCD
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All
results
were interpreted at 95% confidential level.
We examined 109 post-stroke survivors and 112 corresponding by sex, age and level of education control subjects via Mini Mental State Examination (MMSE). Patients were examined twice: during the first three days (stage 1) and at the 90th day (stage 2) after the incident. All patients underwent clinical examination, laboratory and computer tomography studies. No one was suitable for thrombolysis.
All results were interpreted at 95% confidential level.
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Results
:
Results:
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There is a statistically significant difference between patients’ and controls’
results
.
There is a statistically significant difference between patients’ and controls’ results.
There was no difference between MMSE results at the first and second study stages, except for the patients examined at the first day after the IS (p=0.0001), who showed significant improvement with 1.66 points. Most of the poststroke survivors at the first study stage had mild cognitive impairment (36%), followed by those with moderate (33%) and borderline (29%). Patients with mild cognitive decline prevailed again at the second stage (44%), with moderate impairment were 28%, and with borderline -18% of the cases.
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There was no difference between MMSE
results
at the first and second study stages, except for the patients examined at the first day after the IS (p=0.0001), who showed significant improvement with 1.66 points.
There is a statistically significant difference between patients’ and controls’ results.
There was no difference between MMSE results at the first and second study stages, except for the patients examined at the first day after the IS (p=0.0001), who showed significant improvement with 1.66 points.
Most of the poststroke survivors at the first study stage had mild cognitive impairment (36%), followed by those with moderate (33%) and borderline (29%). Patients with mild cognitive decline prevailed again at the second stage (44%), with moderate impairment were 28%, and with borderline -18% of the cases.
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The
results
were considered at 95% confidential level.
Medical history, full neurological and somatic examination, laboratory data, brain computer tomography and electrocardiography were performed in all patients. MMSE was applied in all patients. The same scale was used at the 90th day after the incident.
The results were considered at 95% confidential level.
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Results
Results
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Early MMSE test
results
(at day 2 and 3) could be considered a good predictor for cognitive functioning of post-stroke survivors during the first three months after the incident.
The data for the overall cognitive performance time-dynamics are given at table 2. Significant difference of cognitive profile between patients and controls was found (р=0.0001). There was no significant MMSE difference between the first and second study stage, except for the patients examined at the 1st day, who showed significant improvement with 1.66 points.
Early MMSE test results (at day 2 and 3) could be considered a good predictor for cognitive functioning of post-stroke survivors during the first three months after the incident.
The difference on MMSE results between the first two groups and patients examined at the 3rd day was due to the severe clinical picture of the last group, leading to examination delay. Most of our patients had mild cognitive decline (36%), followed by those with moderate one (33%), and borderline cognitive impairment was found in 29%. Patients with mild cognitive impairment (44%) prevailed over those with moderate (28%) and borderline (18%) cognitive impairment at the second study stage.
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The difference on MMSE
results
between the first two groups and patients examined at the 3rd day was due to the severe clinical picture of the last group, leading to examination delay.
The data for the overall cognitive performance time-dynamics are given at table 2. Significant difference of cognitive profile between patients and controls was found (р=0.0001). There was no significant MMSE difference between the first and second study stage, except for the patients examined at the 1st day, who showed significant improvement with 1.66 points. Early MMSE test results (at day 2 and 3) could be considered a good predictor for cognitive functioning of post-stroke survivors during the first three months after the incident.
The difference on MMSE results between the first two groups and patients examined at the 3rd day was due to the severe clinical picture of the last group, leading to examination delay.
Most of our patients had mild cognitive decline (36%), followed by those with moderate one (33%), and borderline cognitive impairment was found in 29%. Patients with mild cognitive impairment (44%) prevailed over those with moderate (28%) and borderline (18%) cognitive impairment at the second study stage.
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The lower MMSE
results
of patients, examined at the 3
day after IS. This result is slightly higher than ours from the first 3 days. Our data are similar to those of other authors [10, 31, 32, 42, 46]. Two previous studies have reported significantly lower frequencies [9, 45], but they were performed on younger patients with mild strokes.
The lower MMSE results of patients, examined at the 3
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We formed a specific risk patient group with low MMSE
results
at the first days after stroke onset, for early cognitive rehabilitation and evaluation of medical outcome risk.
day are due to the severe clinical picture and not to initial symptom worsening. Some cognitive improvement is found only for patients examined at the first stroke day. The MMSE test performed at day 2 and 3 after IS is a good predictor for cognitive dysfunction at the first 3 months after the incident. Low MMSE is a risk factor for low quality of life and poor functional recovery [24, 38, 40] and independent factor for clinical worsening, death and late dementia [1].
We formed a specific risk patient group with low MMSE results at the first days after stroke onset, for early cognitive rehabilitation and evaluation of medical outcome risk.
Patients with low MMSE results and
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Patients with low MMSE
results
and
day are due to the severe clinical picture and not to initial symptom worsening. Some cognitive improvement is found only for patients examined at the first stroke day. The MMSE test performed at day 2 and 3 after IS is a good predictor for cognitive dysfunction at the first 3 months after the incident. Low MMSE is a risk factor for low quality of life and poor functional recovery [24, 38, 40] and independent factor for clinical worsening, death and late dementia [1]. We formed a specific risk patient group with low MMSE results at the first days after stroke onset, for early cognitive rehabilitation and evaluation of medical outcome risk.
Patients with low MMSE results and
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MMSE 2 from day 1, 2 and 3 – MMSE
results
from the second study stage of 1, 2, 3 groups.
1 – first study stage; 2 – second study stage. С – controls. Day 1 – MMSE measured at the first day – group 1. Ден 2 – MMSE measured at the second day – group 2. Day 3 – at the third day – group 3.
MMSE 2 from day 1, 2 and 3 – MMSE results from the second study stage of 1, 2, 3 groups.
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produce false negative
results
as to the detection of a dissection, especially in a case of dissection with normal lumen, such in our case [15].
produce false negative results as to the detection of a dissection, especially in a case of dissection with normal lumen, such in our case [15].
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Dilation of resistance vessels
results
in decreased cerebrovascular resistance, therefore the pulsatility
and acetazolamide cause dilation of the cerebral microvessels.
Dilation of resistance vessels results in decreased cerebrovascular resistance, therefore the pulsatility
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)
results
in increase of diameter of these vessels, leading to increase in cerebral blood flow and flow velocity (Fig. 2).
) results in increase of diameter of these vessels, leading to increase in cerebral blood flow and flow velocity (Fig. 2).
However, the circle of Willis is often not complete, therefore the communicating arteries cannot compensate the effect of the carotid stenosis in this case. If the collateral circulation does not function properly, severe carotid stenosis results in decrease in perfusion pressure. In response to
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If the collateral circulation does not function properly, severe carotid stenosis
results
in decrease in perfusion pressure.
) results in increase of diameter of these vessels, leading to increase in cerebral blood flow and flow velocity (Fig. 2). However, the circle of Willis is often not complete, therefore the communicating arteries cannot compensate the effect of the carotid stenosis in this case.
If the collateral circulation does not function properly, severe carotid stenosis results in decrease in perfusion pressure.
In response to
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In case of poor cerebral collateral circulation, ICA stenosis
results
in decrease in perfusion pressure.
In case of poor cerebral collateral circulation, ICA stenosis results in decrease in perfusion pressure.
According to autoregulation, decreased perfusion pressure leads to compensatory vasodilation of the resistance vessels, therefore vasodilative agents do not cause significant further vasodilation. Lack of significant vasodilation after administration of vasodilative stimuli explains the only mild or the absence of flow velocity increase. Quite contrary, good collateral circulation prevents the decrease of perfusion pressure in ICA stenosis, therefore the diameter of microvessels do not change. Application of a vasodilative agent causes vasodilation of resistance vessels and consequently increases the cerebral blood flow and flow velocity. Different effect of vasodiative stimuli on flow velocity changes allows us to differentiate asymptomatic ICA stenosis with poor or good collateral circulation.
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results
in a gradual increase in mean flow velocity that is continued for several seconds after the end of breath holding.
results in a gradual increase in mean flow velocity that is continued for several seconds after the end of breath holding.
Its cause is the decrease of intrathoracic pressure immediately after expiration. The cerebrovascular reserve capacity (CRC) was expressed as percent increase of flow velocity, as well as percent increase of flow velocity normalised to the duration of
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and compensated perfusion pressure, vasodilative stimulus
results
in dilation of arterioles and due to the decreased vascular resistance the pulsatility index decreases and cerebral blood flow and flow velocity increase in the middle cerebral artery (Fig. 3).
and compensated perfusion pressure, vasodilative stimulus results in dilation of arterioles and due to the decreased vascular resistance the pulsatility index decreases and cerebral blood flow and flow velocity increase in the middle cerebral artery (Fig. 3).
However, if the arterioles have already been dilated compensatory before the vasoreactivity test, suggesting poor cerebral collateral circulation, vasodilative stimulus can cause only mild or no further arteriolar dilation, therefore no appropriate increase of flow velocity is observed, indicating exhausted cerebrovascular reserve capacity. Vasodilative agents used during the examination can be acetazolamide, or CO
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Medical (nonsurgical) intervention alone is now best for prevention of stroke associated with asymptomatic severe carotid stenosis:
results
of a systematic review and analysis.
Abbott AL.
Medical (nonsurgical) intervention alone is now best for prevention of stroke associated with asymptomatic severe carotid stenosis: results of a systematic review and analysis.
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Results
of a randomized controlled trial of carotid endarterectomy for asymptomatic carotid stenosis.
Mayo Asymptomatic Carotid Endarterectomy Study Group.
Results of a randomized controlled trial of carotid endarterectomy for asymptomatic carotid stenosis.
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The recommendations in the guidelines on the management of acute ischemic stroke are based on
results
of a number of clinical trials
The recommendations in the guidelines on the management of acute ischemic stroke are based on results of a number of clinical trials
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Results
:
Results:
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The outcome treatment
results
are followed up for a period from three months to five years for some patients.
The clinical presentation and neurological topical diagnosis are analyzed in the context of the relevant differential diagnosis, use of advanced neuroimaging methods and role of emergency neurosonographic evaluation. The importance of the time-window organization in the acute neurological settings, criteria for choosing one or another neuro-interventional approach or thrombolytic therapy are stressed.
The outcome treatment results are followed up for a period from three months to five years for some patients.
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Results
of numerous studies showed that listening to music can improve cognition, motor skills and moods, enhancing recovery after brain injury.
The optimal time for brain repair appears to be at later stage of stroke rather than the earlier stage. It is expected that these new insights will advance our understanding of stroke recovery and assist in developing the next generation of restorative approaches with enhancing and harnessing neuroplasticity by multiple actions: enhancing the mirror neuron system for chronic stroke recovery, using different pharmaceutical interventions for activating growth factors and neurotrophins in rewiring neurovascular network. Due to a mechanism of neuroplasticity, the brain is capable of making new connections, activating new pathways and unmasking secondary roads. Music is a strong stimulus for neuroplasticity, thus having a possibility to enhance recovery after stroke. fMRI studies have shown reorganization of a motor and auditory cortex in professional musicians and other studies showed the changes in neurotransmitter and hormone serum levels in correlation to music.
Results of numerous studies showed that listening to music can improve cognition, motor skills and moods, enhancing recovery after brain injury.
In the field of visual art, the brain lesion can lead to the visuospatial neglect, loss of details and significant impairment of artistic work, while activation of neuroplasticity restores the skill and function again. All kinds of arts (music, painting, dancing...) stimulate the brain. They should be the part of treatment processes.
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Future perspectives are discussed looking on
results
of actual gait analysis including a new developed clinical score system (Rehab X score).
Physical therapeutic interventions are focused on high repetitive task training and supporting robotic systems are more and more involved. The rehabilitation had to include physical, pharmaceutical and orthotic applications over a long period (up to years afer stroke onset) to optimize the recovery. But it is not clear, which combination, dosage and time period are most effective. Gait analysis mаy help to understand better the kinetic problems in stroke patients. In this presentation the state of the art in stroke rehabilitation will be presented.
Future perspectives are discussed looking on results of actual gait analysis including a new developed clinical score system (Rehab X score).
The impact on interlimb
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A number of neurorehabilitation treatment strategies have been aimed to stimulate mechanisms of sensory cortical plasticity with
results
showing improvements in sensorimotor deficits following treatments.
Impaired somatic sensation is known to be a significant predictor for poor rehabilitation outcome in cerebrovascular stroke patients.
A number of neurorehabilitation treatment strategies have been aimed to stimulate mechanisms of sensory cortical plasticity with results showing improvements in sensorimotor deficits following treatments.
In attempts to understand cortical sensory plasticity in humans my research group has investigated automatic sensory processing of non-nociceptive and
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Results
:
Results:
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The advantages of carotid IMT trials are: a/ measure the effect of a new drug onto the IMT; b/ the
results
(needs much shorter time than a morbidity-mortality trial) may be decisive to start or refute a long-lasting and expensive morbidity trial on drugs aimed on atherosclerosis.
Age, hypertension, hyperlipidemia, smoking, alcohol influence the intima-media thickness (IMT), which should be less than 1 mm in healthy persons. It was proven with prospective trials, that the IMT could be decreased by appropriate treatment. The positive effect of statins, antihypertensive drugs have been proven. Some statins and antihypertensive drugs resulted in significant decrease of IMT thickness after one or 2 years therapy while others did not have beneficial effect. Besides, the majority of trials detected significant positive correlation between the reversal of IMT and the risk of vascular events.
The advantages of carotid IMT trials are: a/ measure the effect of a new drug onto the IMT; b/ the results (needs much shorter time than a morbidity-mortality trial) may be decisive to start or refute a long-lasting and expensive morbidity trial on drugs aimed on atherosclerosis.
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Results
:
Results:
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Although no statistically significant differences in the sway path between UPV and CVP patient groups were present, we found a tendency for scoring better
results
in patients with UPV: best difference for left-right sway with eyes closed (22.5 cm).
Although no statistically significant differences in the sway path between UPV and CVP patient groups were present, we found a tendency for scoring better results in patients with UPV: best difference for left-right sway with eyes closed (22.5 cm).
In fact, there was also a tendency for scoring worse results in patients with CVP: worst difference for antero-posterior sway with eyes closed (2.76 cm).
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In fact, there was also a tendency for scoring worse
results
in patients with CVP: worst difference for antero-posterior sway with eyes closed (2.76 cm).
Although no statistically significant differences in the sway path between UPV and CVP patient groups were present, we found a tendency for scoring better results in patients with UPV: best difference for left-right sway with eyes closed (22.5 cm).
In fact, there was also a tendency for scoring worse results in patients with CVP: worst difference for antero-posterior sway with eyes closed (2.76 cm).
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Results
:
Results:
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Results
:
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:
Results:
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In the end of the course, the
results
of ОDI increased in both groups.
In the end of the course, the results of ОDI increased in both groups.
The exercise-included group showed statistically more significant improvement in function (p
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Results
:
Results:
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Results
:
Results:
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:
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Positive
results
was achieved after an intensive, three-month treatment.
Positive results was achieved after an intensive, three-month treatment.
The control MRI showed a complete change of the herniated disc.
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When discussing hernia, one should not think of a single treatment solution, such as surgery; it is necessary to apply conservative therapy as in this patient with excellent
results
.
When discussing hernia, one should not think of a single treatment solution, such as surgery; it is necessary to apply conservative therapy as in this patient with excellent results.
During the threemonth treatment, positive results were achieved, in the direction of reduced pain, motivation and overcoming muscular instability. Factors that can have a positive effect on the results include a gradual progression of the load, consistency, and high motivation of the patient.
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During the threemonth treatment, positive
results
were achieved, in the direction of reduced pain, motivation and overcoming muscular instability.
When discussing hernia, one should not think of a single treatment solution, such as surgery; it is necessary to apply conservative therapy as in this patient with excellent results.
During the threemonth treatment, positive results were achieved, in the direction of reduced pain, motivation and overcoming muscular instability.
Factors that can have a positive effect on the results include a gradual progression of the load, consistency, and high motivation of the patient.
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Factors that can have a positive effect on the
results
include a gradual progression of the load, consistency, and high motivation of the patient.
When discussing hernia, one should not think of a single treatment solution, such as surgery; it is necessary to apply conservative therapy as in this patient with excellent results. During the threemonth treatment, positive results were achieved, in the direction of reduced pain, motivation and overcoming muscular instability.
Factors that can have a positive effect on the results include a gradual progression of the load, consistency, and high motivation of the patient.
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Results
:
Results:
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Results
:
Results:
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Results
:
Results:
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Factors that can have a positive impact on the
results
include gradual progression of interventions, consistency, patient high motivation, transmission and training.
The patient got better for the three-week neurorehabilitation period. He improved his functional mobility and walking during treatment.
Factors that can have a positive impact on the results include gradual progression of interventions, consistency, patient high motivation, transmission and training.
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Results
:
Results:
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Physiotherapy improves postural control in patients with stroke, but questions remain about the physiotherapy program and the systems used, which program gives the best
results
and what is the effectiveness depending on the time after the stroke.
Physiotherapy improves postural control in patients with stroke, but questions remain about the physiotherapy program and the systems used, which program gives the best results and what is the effectiveness depending on the time after the stroke.
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Results
:
Results:
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Results
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Results:
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:
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Respiratory exercises give positive
results
in improving respiratory function and strengthening the external muscles of the body.
Taking Levodopa/Carbidopa therapy confirms significant improvement in motor performance after six weeks. Continuous performance of the exercises shows significant improvement in flexibility, reduced rigidly increased muscle tone and improved mobility of the spinal column and limbs.
Respiratory exercises give positive results in improving respiratory function and strengthening the external muscles of the body.
The applied targeted exercises play a role in reducing tremor and improving physiological synkinesias. Slowly executed coordination and balance exercises affect the positioning and control of spinal muscles and improve walking.
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Combined neurorehabilitation is individual for every patient and shows positive
results
in maintaining a better functional state.
Combined neurorehabilitation is individual for every patient and shows positive results in maintaining a better functional state.
Daily exercises in combination with a properly dosed medication therapy reduce comorbidity and disability and improve the patient's mobility and functional status.
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Results
:
Results:
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Results:
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Results
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Results:
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Results
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Results:
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Results
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Results:
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Both men were directed for additional imaging and the
results
from CT and MRI phlebography correlated with ultrasound findings.
nal compression of left brachiocephalic vein, as well as vena cava superior syndrom.
Both men were directed for additional imaging and the results from CT and MRI phlebography correlated with ultrasound findings.
Two different tumor formations, the first one in supraclavicular area and the second one in the anterior and superior mediastinum, affect to varying degrees the cervical and upper limbs veins and vena cava superior.
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
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29.
NEUROSONOLOGY AND CEREBRAL HEMODYNAMICS, vol. 15, 2019, No. 1
,
,
,
Results
:
Results:
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The
results
of the imaging ultrasound were compared with head CT and MRI data.
(color duplex scanning, B-Flow and 2D/3D/4D imaging) of extracranial brain arteries, optic nerves and papillae was performed. The optic nerve diameters were measured and the optic nerve/sheath index was determined. The blood flow in the central retinal artery was shown using B-flow and its velocities were recorded (Fig. 2) [1, 16, 17, 18].
The results of the imaging ultrasound were compared with head CT and MRI data.
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Results
Results
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Results
:
Results:
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Results
Results
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At the right no differences with the previous imaging
results
are seen.
The patient is referred to Rheumatology Clinic for therapy, where immunological tests confirm Takayasu decease. After a three-month treatment (immunosuppressive therapy and corticosteroids) and normalization of immunological markers, a follow-up CTA shows a complete thrombosis of the aneurysm of the left common carotid artery and a collateral filling of the internal carotid artery at the left via the ipsilateral external carotid artery. The internal carotid artery on the left is poorly filled along its entire length up to the circle of Willis (Fig. 5).
At the right no differences with the previous imaging results are seen.
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The
results
from the blood samples, biochemical analysis and coagulation status were normal.
On admission the patient was in severe general condition, conscious, but contactless due to aphasia. Physical examination showed tachydyspnea, rhythmic tachycardia with arterial pressure of 116/60 mm Hg and heart rate of 100 bpm. Neurological examination revealed conjugated head and gaze deviation to the left, right central hemiparesis up to arm plegia, and sensory-motor aphasia.
The results from the blood samples, biochemical analysis and coagulation status were normal.
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Carbohydrate disorders are defined depending on the test
results
(Table 1).
Oral glucose tolerance test (OGTT) with 75 g of glucose should be performed for differentiation between normal state and DM.
Carbohydrate disorders are defined depending on the test results (Table 1).
Impaired fasting glucose (IFG) is diagnosed when the blood sugar is between
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Oral glucose tolerance test
results
, using 75 g of glucose define the degree of carbohydrate impairment
Oral glucose tolerance test results, using 75 g of glucose define the degree of carbohydrate impairment
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The
results
however do not succeed in motivating the patients for life style changes.
There are a lot of questionnaires for risk assessment based on anthropometric parameters and self-assessment or on anthropometric and laboratory parameters [24, 25]. The advantage of this approach is the capability for investigation of great population groups.
The results however do not succeed in motivating the patients for life style changes.
Some of them are based on symptom assessment, which is not useful for preclinic diagnosis.
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For comparable values laboratories adjust their
results
to those, used in the Diabetes Control and Complication Trail (DCCT).
In 2010 the American Diabetes Association recommended the use of HbA1c for diagnosis of DM when values are above 6.5% (twice assessed) [20]. Values between 5.7-6.4% are known as defining a higher risk for diabetes; for values between 6.06.4% prevention is needed. The cost of the study is relatively high and cannot be held everywhere. Hemoglobin variants interfere with the glycosylated hemoglobin assays. Increased levels of HbF (beta-thalassemia) may cause false increase in HbA1c concentrations, whereas increase in HbS levels (sickle-cell disease) may produce falsely low values.
For comparable values laboratories adjust their results to those, used in the Diabetes Control and Complication Trail (DCCT).
The price is high and the test couldn’t be widely used.
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A great advantage is that the
results
are ready for use immediately after the assessment and could be used for motivating the patients for life-style changes.
A new and different approach for screening of carbohydrate disorders and their complications is the EZSCAN methodology. It is based on assessment of sweat gland function with reverse iontophoresis and chronoampermetry, and skin conductance measurement [8, 9, 10]. It estimates the metabolic and cardiovascular risk and gives the opportunity for studying the insulin resistance treatment. This method is noninvasive and is used for investigation of healthy patients with high risk for DM.
A great advantage is that the results are ready for use immediately after the assessment and could be used for motivating the patients for life-style changes.
This method shows high sensitivity and specificity [19]. The results are presented graphically and are easy to assess. They are received in color scales depending on perspiration dysfunction (Fig. 1):
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The
results
are presented graphically and are easy to assess.
It is based on assessment of sweat gland function with reverse iontophoresis and chronoampermetry, and skin conductance measurement [8, 9, 10]. It estimates the metabolic and cardiovascular risk and gives the opportunity for studying the insulin resistance treatment. This method is noninvasive and is used for investigation of healthy patients with high risk for DM. A great advantage is that the results are ready for use immediately after the assessment and could be used for motivating the patients for life-style changes. This method shows high sensitivity and specificity [19].
The results are presented graphically and are easy to assess.
They are received in color scales depending on perspiration dysfunction (Fig. 1):
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carbohydrate disorders [1] when the other
results
are still normal.
carbohydrate disorders [1] when the other results are still normal.
Some authors use the glucose challenge test with glucose measuring at the first hour after 50 g of glucose intake for screening. For this test no fasting is needed [7] and it is more flexible for assessment of large, not prepared groups. The blood glucose levels during OGTT and their maximal deviations correlate with the IMT of carotid arteries (assessed with ultrasound methods) more than fasting blood sugar [28]. OGTT has eightfold higher diagnostic value for carbohydrate impairments than using fasting plasma glucose alone [20]. Oral glucose tolerance test needs to be performed in special conditions (after an 8-10 hour fasting period, with appropriate diet the last tree days with not consuming less than 150 g of carbohydrates).
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L. Fasting versus postload plasma glucose concentration and the risk for future type 2 diabetes:
results
from the Botnia Study.
L. Fasting versus postload plasma glucose concentration and the risk for future type 2 diabetes: results from the Botnia Study.
Diabetes Care 32, 2009: 281-286.
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The original papers and short scientific reports include introduction, objective, material and methods,
results
, discussion.
The original papers and short scientific reports include introduction, objective, material and methods, results, discussion.
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