scholarly journals Long-term complications after stent assist coiling dependent on clopidogrel response

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kenji Shoda ◽  
Yukiko Enomoto ◽  
Yusuke Egashira ◽  
Takamasa Kinoshita ◽  
Daisuke Mizutani ◽  
...  
Keyword(s):  
Acute Phase ◽  
Platelet Reactivity ◽  
Unruptured Aneurysms ◽  
Hemorrhagic Events ◽  
Before And After ◽  
Verifynow Assay ◽  
Previously Treated ◽  
The Relationship ◽  
Delayed Phase

Abstract Background Dual antiplatelet therapy (DAPT) is necessary for stent assisted coiling. However, long term use of DAPT has a potential risk of hemorrhagic events. We aimed to examine the relationship between clopidogrel reactivity and complications. Methods Patients who underwent stent assisted coiling for unruptured aneurysms or previously treated aneurysms and received periprocedural DAPT in our institution between August 2011 to March 2020 were included. Platelet reactivity for clopidogrel was measured by VerifyNow assay system, and we defined the cut off value of P2Y12 Reaction Units (PRU) at 208 and classified patients as hypo-responders (PRU≧208) or responders (PRU<208). The rates of hemorrhagic and thrombotic events within 30 days (acute phase) and 30 days after the procedure (delayed phase) were compared between the two groups. Furthermore, changes in hemoglobin levels were measured before and after the procedure and at chronic stages (1 to 6 months thereafter). Results From 61 patients included in this study, 36 patients were hypo-responders and 25 patients were responders. Hemorrhagic events occurred 8.0% only in responders in the acute phase (p = 0.16), and 2.78% in hypo-responders and 20.0% in responders in the delayed phase (p = 0.037). Changes in hemoglobin levels before and after the procedure were 1.22 g/dl in hypo-responders and 1.74 g/dl in responders (p = 0.032) while before the procedure and chronic stages they were 0.39 g/dl in hypo-responders and 1.39 g/dl in responders (p <  0.01). Thrombotic events were not significantly different between the two groups. Conclusion Long term use of DAPT after stent assisted coiling is related to hemorrhagic events in the delayed phase. Preventing for hemorrhagic events, the duration of DAPT should be carefully considered in clopidogrel responders.

scholarly journals Long-term Complications After Stent Assist Coiling Dependent on Clopidogrel Response

2021 ◽  
Author(s):  
Kenji Shoda ◽  
Yukiko Enomoto ◽  
Yusuke Egashira ◽  
Takamasa Kinoshita ◽  
Daisuke Mizutani ◽  
...  
Keyword(s):  
Acute Phase ◽  
Dual Antiplatelet Therapy ◽  
Platelet Reactivity ◽  
Unruptured Aneurysms ◽  
Hemorrhagic Events ◽  
Before And After ◽  
Verifynow Assay ◽  
The Relationship ◽  
Delayed Phase

Abstract BACKGROUND: Dual antiplatelet therapy (DAPT) is necessary for stent assisted coiling. However, long term use of DAPT has a potential risk of hemorrhagic events. We aimed to examine the relationship between clopidogrel reactivity and complications.METHODS: Patients who underwent stent assisted coiling for unruptured aneurysms and received periprocedural DAPT in our institution between August 2011 to March 2020 were included. Platelet reactivity for clopidogrel was measured by VerifyNow assay system, and we defined the cut off value of P2Y12 Reaction Units (PRU) at 208, and classified patients as hypo-responders (PRU≧208) or responders (PRU＜208). The rates of hemorrhagic and thrombotic events within 30 days (acute phase) and 30 days after the procedure (delayed phase) were compared between the two groups. Furthermore, changes in hemoglobin levels were measured before and after the procedure and at chronic stages (1 to 6 months thereafter).RESULTS: From 62 patients included in this study, 36 patients were hypo-responders and 26 patients were responders. Hemorrhagic events occurred 7.7% only in responders in the acute phase (p = 0.17), and 2.78% in hypo-responders and 23.1% in responders in the delayed phase (p = 0.02). Changes in hemoglobin levels before and after the procedure were 1.21 g/dl in hypo-responders and 1.92 g/dl in responders (p = 0.02) while before the procedure and chronic stages they were 0.39g/dl in hypo-responders and 1.41 g/dl in responders (p < 0.01). Thrombotic events were not significantly different between the two groups.CONCLUSION: Long term use of DAPT after stent assisted coiling is related to hemorrhagic events in the delayed phase. Preventing for hemorrhagic events, the duration of DAPT should be carefully considered in clopidogrel responders.

scholarly journals Trajectories of Bone Remodeling Markers and Bone Mineral Density during Treatment with Strontium Ranelate in Postmenopausal Women Previously Treated with Bisphosphonates

2014 ◽  
Vol 7 ◽  
pp. CMED.S15086 ◽  
Author(s):  
Helisane Lima ◽  
Juliana Maia ◽  
Francisco Bandeira
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Strontium Ranelate ◽  
Mineral Density ◽  
Bone Remodeling Markers ◽  
Before And After ◽  
Previously Treated

Objective To evaluate the responses of C-terminal telopeptide (CTX) and serum osteocalcin after the first 4 months of treatment with strontium ranelate (SR) and demonstrate their association with long-term bone density changes. Subjects and Methods A sample of 13 postmenopausal women with osteoporosis was analyzed (mean age 65 ± 7.7 years), who were treated with SR for an average of 2.56 ± 0.86 years. All patients had undergone previous treatment with bisphosphonates for an average period of 4.88 ± 2.27 years. Serum CTX and osteocalcin levels were determined before and after four months of treatment with SR. Bone mineral density in the lumbar spine and femoral neck were obtained before and after treatment with SR. Results We observed an average increase of 53.7% in the CTX levels, and 30.7% in the osteocalcin levels. The increase in bone markers was associated with a mean 4.8% increase in lumbar spine bone mineral density (BMD) from 0.820 to 0.860 g/cm2 ( T-score from –2.67 to –1.92; P= 0.001), after 2.5 years of treatment with SR. Conclusion These data suggest an anabolic effect of SR on postmenopausal women who were previously treated with long-term bisphosphonates.

scholarly journals Coach Mid-Season Replacement and Team Performance in Professional Soccer

2011 ◽  
Vol 28 (1) ◽  
pp. 115-122 ◽  
Author(s):  
Carlos Lago-Peñas
Keyword(s):  
Team Performance ◽  
Positive Impact ◽  
Short Term ◽  
Shock Effect ◽  
Professional Soccer ◽  
Before And After ◽  
Using Data ◽  
The Relationship ◽  
The Empirical Analysis

Coach Mid-Season Replacement and Team Performance in Professional SoccerThe coaching carousel or turnover is an extreme but frequently occurring phenomenon in soccer. Among the reasons for firing a coach, the most common is the existence of a shock-effect: a new coach would be able to motivate the players better and therefore to improve results. Using data from the Spanish Soccer League during the seasons from 1997-1998 to 2006-2007, this paper investigates the relationship between team performance and coach change over time. The empirical analysis shows that the shock effect of a turnover has a positive impact on team performance in the short term. Results reveal no impact of coach turnover in the long term. The favourable short-term impact on team performance of a coach turnover is followed by continued gradual worsening of results. The turnover effect is non-existent when the comparison between the new coach and the old coach is done over 10, 15 or 20 matches before and after termination.

scholarly journals The Evolutionary Characteristics of Reservoir Microstructure under Long-Term Waterflooding Development and Its Fractal Description

Geofluids ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Fengjiao Wang ◽  
Xu Wang ◽  
Yikun Liu ◽  
Qingjun Deng ◽  
Jianjun Xu ◽  
...  
Keyword(s):  
Pore Structure ◽  
Physical Simulation ◽  
Structural Parameters ◽  
Fractal Theory ◽  
Evolution Model ◽  
Structure Evolution ◽  
Before And After ◽  
Water Cut ◽  
The Relationship

Generally, long-term waterflooding development often leads to the change of reservoir pore and clay mineral composition, which results in the change of permeability and wettability. In order to explore the relationship between core micropore structure and water cut, based on physical simulation experiments and fractal theory, we proposed a fractal evolutionary model to describe the evolution characteristics of microstructure of long-term water driving reservoirs. In this paper, core pore structure by SEM was first conducted to analyze the change of core pore structure before and after waterflooding under the conditions of magnification of 200 times, 800 times, and 2000 times, respectively. Then, conventional and constant rate mercury injection tests were combined to perform the comparative analysis of core structural parameters before and after waterflooding. Finally, a micropore-throat structure evolution model of core was established. Research shows that the connectivity of larger pores becomes better after long-term water driving, the degree of heterogeneity weakens, and the micro heterogeneity of small pores becomes stronger and stronger. The throat characteristics change in a complex manner, the radius tends to increase, and the sorting becomes better, while the connectivity of small throat changes complex. In general, the heterogeneity of throat increases with the time of water injection in reservoirs with low porosity and permeability. On the basis of fractal theory and variation characteristics of rock pore structure in water driving reservoirs, we have established a micropore-throat structure evolution model of core pore-throat characteristics. This fractal evolution model quantitatively characterized the complexity and evolution law of pore structure and clarified the relationship between fractal dimension of core pore structure and water cut under different stages of water driving.

Active Participation of Care Partners in a Physical Activity Intervention alongside People with Stroke: A Feasibility Study

2021 ◽  
pp. e20200035
Author(s):  
Reed Handlery ◽  
Elizabeth Regan ◽  
Allison Foster Lewis ◽  
Chelsea Larsen ◽  
Kaci Handlery ◽  
...  
Keyword(s):  
Physical Activity ◽  
Social Support ◽  
Physical Activity Intervention ◽  
Care Partners ◽  
Before And After ◽  
Physical Activity Adherence ◽  
Ongoing Support ◽  
The Relationship

Purpose: This study investigated the feasibility of a physical activity intervention for people with stroke and their care partners and the role social support plays in physical activity adherence. Method: The study used a single-group, pretest–posttest design with follow-up. Participants were adults with chronic stroke and their care partners. The intervention consisted of 8 weeks of structured, group-based physical activity classes, followed by 19 weeks of self-directed physical activity. Recruitment, adherence, safety, and retention were assessed. Familial social support was assessed before and after the 8-week structured portion and again 19 weeks later. Results: A total of 21 participants (15 people with stroke, 6 care partners), mean (SD) age 67.6 (11.6) years, were recruited; 19 (90.5%) completed the 19-week assessment. No adverse events were experienced during the programme. Attendance during the 8-week portion was better than during the 19-week portion (mean difference 0.95; p < 0.001; 95% CI: 0.71, 1.19 visits/wk). No relationship was found between social support and physical activity adherence ( p > 0.05). Conclusions: Involvement of care partners in a physical activity intervention is feasible and safe. Both people with stroke and their care partners may require ongoing support to participate in long-term physical activity. The relationship between social support and physical activity adherence requires further study.

Activity-mediated changes in feed-forward inhibition in the dentate commissural pathway: relationship to EPSP/spike dissociation in the converging perforant path

1993 ◽  
Vol 69 (1) ◽  
pp. 165-173 ◽  
Author(s):  
R. A. Tomasulo ◽  
J. J. Ramirez
Keyword(s):  
Perforant Path ◽  
Excitatory Postsynaptic Potential ◽  
Feed Forward ◽  
Pulse Trains ◽  
Before And After ◽  
Commissural Pathway ◽  
High Stimulus ◽  
The Relationship ◽  
Feed Forward Inhibition

1. We tested the hypothesis that long-term synaptic potentiation (LTP)-associated excitatory postsynaptic potential (EPSP)/spike dissociation in the dentate gyrus (DG) is determined, in part, by changes in the feed-forward inhibition evoked by perforant path (PP) stimulation. The dentate commissural pathway (CP) and the PP activate a common pool of interneurons. Therefore a change in synaptic efficacy in the inhibitory circuit due to activation of one pathway could lead to changes in inhibitory efficacy in the other. The relationship between changes in feed-forward inhibition in the CP and EPSP/spike (E-S) functions in the PP should provide information about the site(s) of synaptic modification. 2. In urethan-anesthetized rats, we measured the inhibition of evoked PP population spikes by the CP at interstimulus intervals of 6 and 12 ms. This measure of commissural inhibition and conventional E-S functions for the PP input to the DG were obtained before and after 1) PP tetany (400 Hz, 8-pulse trains) at low, medium, and high stimulus intensities, and 2) CP tetany (200 Hz, 7-pulse trains). 3. Low-intensity PP conditioning (just above population spike threshold) led to a decrease in CP inhibition and large left shifts of the E-S function. High- and medium-intensity PP conditioning yielded increases in commissural inhibition and smaller leftward E-S shifts. 4. Commissural conditioning led to increases in commissural inhibition and inconsistent changes in the E-S functions.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Predicting the cumulative medical load of COVID-19 outbreaks after the peak in daily fatalities

2020 ◽  
Author(s):  
Claudius Gros ◽  
Roser Valenti ◽  
Lukas Schneider ◽  
Benedikt Gutsche ◽  
Dimitrije Markovic
Keyword(s):  
Sir Model ◽  
Cumulative Number ◽  
Hospitalised Patients ◽  
Before And After ◽  
The Status ◽  
Containment Measures ◽  
Short And Long Term ◽  
The Relationship ◽  
Fixed Period

The distinct ways the COVID-19 pandemics has been unfolding in different countries and regions suggest that local societal and governmental structures play an essential role both for the baseline infection rate and the short-term and long-term reaction to the outbreak. Here we investigate how societies as a whole, and governments, in particular, modulate the dynamics of a novel epidemic using a generalisation of the SIR model, the controlled SIR model. We posit that containment measures correspond to feedback between the status of the outbreak (the daily or the cumulative number of cases and fatalities) and the reproduction factor. We present the exact phase space solution of the controlled SIR model and use it to quantify containment policies for a large number of countries in terms of short- and long-term control parameters. Furthermore, we identified for numerous countries a relationship between the number of fatalities within a fixed period before and after the peak in daily fatalities. As the number of fatalities corresponds to the number of hospitalised patients, the relationship can be used to predict the cumulative medical load, once the effectiveness of outbreak suppression policies is established with sufficient certainty.

Clozapine in the treatment of patients with autsim spectrum disorder and severe disruptive behaviours

2011 ◽  
Vol 26 (S2) ◽  
pp. 1228-1228
Author(s):  
L. Béhérec ◽  
S. Lambrey ◽  
G. Quilici ◽  
A. Rosier ◽  
B. Falissard ◽  
...  
Keyword(s):  
Antipsychotic Drugs ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Marginal Model ◽  
Double Blind ◽  
Before And After ◽  
Disruptive Behaviours ◽  
Extrapyramidal Effects ◽  
The Relationship

Autism spectrum disorder (ASD) is a serious childhood-onset disorder that affects all areas of development and is associated with disruptive symptoms including aggression and self injury. In ASD, risperidone and aripiprazole are the only second generation antipsychotic drugs (SGA) that have shown to decrease disruptive behaviours in controlled double-blind studies. However, some patients are not improved by these drugs. Clozapine, a SGA known to be effective to treat aggressiveness in schizophrenia, has received little attention in ASD. We conducted a retrospective analysis of the changes in disruptive for all patients with ASD who were treated with clozapine from 2002 to 2010. Disruptive behaviours were monitored during the 4 to 6 months before and after the initiation of clozapine, and long term tolerance (10 months to 7 years) was also assessed. The relationship between disruptive behaviours and periods of treatment was studied with a generalized linear marginal model. Clozapine resulted in a significant 2 fold decrease in the number of the days with aggression, a decrease of the number of psychotropic drugs and the dose of the antipsychotic drugs. The long term tolerance (white blood cell count, extrapyramidal effects) was good with the exception for a significant weight gain (of 22.3% +/- 18,2%), the occurence of metabolic syndrome in one patient and tachycardia in another patient.These results suggest that clozapine should be considered for the management of disruptive behaviours in patients with ASD not improved by first line antipsychotic drugs.

Relationships between temperament and growth in a feedlot and commercial carcass traits of Bos indicus crossbreds

1997 ◽  
Vol 37 (4) ◽  
pp. 407 ◽  
Author(s):  
H. M. Burrow ◽  
R. D. Dillon
Keyword(s):  
Bos Indicus ◽  
Negative Relationship ◽  
Flight Speed ◽  
Short Term ◽  
Before And After ◽  
Speed Score ◽  
Fat Thickness ◽  
Dressing Percentage ◽  
The Relationship

Summary. Two cohorts of Bos indicus crossbreds were studied to determine the relationships between temperament and growth in a feedlot and commercial carcass characteristics. Prior to entry to the feedlot, one cohort received intensive, short-term training at weaning but minimal handling before and after weaning, while the second cohort received similar training at weaning and also experienced a 4-month period of relatively intense handling immediately before entering the feedlot. Both cohorts entered the feedlot at similar ages. Temperament was recorded as the animal’s flight speed, which is the time taken for the animal to cover 1.7 m after leaving a weighing crush, with fast times indicating animals that have poor temperaments. Average flight speed scores of animals in the 2 cohorts differed substantially, with 51 and 12% of animals in cohorts 1 and 2 respectively having fast flight speed scores. Conversely, 23 and 69% of animals in cohorts 1 and 2 respectively had slow flight speed scores and could therefore be regarded as docile. In the first cohort, animals with slow flight speeds gained weight more rapidly (P<0.05) to achieve heavier slaughter and carcass weights (P<0.05) than animals with fast flight speeds. The relationship between flight speed and growth in the feedlot in the second cohort was not significant, although animals with the fastest flight speeds in that cohort had the lowest liveweight gains. Docile animals in both cohorts had comparable liveweight gains in the feedlot. These results suggest that animals with slow flight speed scores (good temperaments) may grow faster in a feedlot than animals with faster flight speed scores (poorer temperaments), regardless of whether the favourable scores result from intensive, long-term handling or because the animals are naturally docile. There was no relationship in either experiment between flight speed and fat thickness or carcass bruising, when bruising was scored simply as presence or absence of bruising. A negative relationship was evident between flight speed score and dressing percentage in the second cohort (P<0.05). The relationship between flight speed and dressing percentage was not significant in the first cohort. It is suggested that feedlot operators could select potential feedlot animals on the basis of temperament before entry to the feedlot to improve performance in the feedlot.

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