scholarly journals Effect of early sleep apnoea treatment with adaptive servo-ventilation in acute stroke patients on cerebral lesion evolution and neurological outcomes: study protocol for a multicentre, randomized controlled, rater-blinded, clinical trial (eSATIS: early Sleep Apnoea Treatment in Stroke)

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Simone B. Duss ◽  
Anne-Kathrin Brill ◽  
Sébastien Baillieul ◽  
Thomas Horvath ◽  
Frédéric Zubler ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Acute Stroke ◽  
Acute Ischaemic Stroke ◽  
Sleep Apnoea ◽  
Resonance Imaging ◽  
Stroke Patients ◽  
Adaptive Servo Ventilation ◽  
Randomized Controlled ◽  
The Impact

Abstract Background Sleep-disordered breathing (SDB) is highly prevalent in acute ischaemic stroke and is associated with worse functional outcome and increased risk of recurrence. Recent meta-analyses suggest the possibility of beneficial effects of nocturnal ventilatory treatments (continuous positive airway pressure (CPAP) or adaptive servo-ventilation (ASV)) in stroke patients with SDB. The evidence for a favourable effect of early SDB treatment in acute stroke patients remains, however, uncertain. Methods eSATIS is an open-label, multicentre (6 centres in 4 countries), interventional, randomized controlled trial in patients with acute ischaemic stroke and significant SDB. Primary outcome of the study is the impact of immediate SDB treatment with non-invasive ASV on infarct progression measured with magnetic resonance imaging in the first 3 months after stroke. Secondary outcomes are the effects of immediate SDB treatment vs non-treatment on clinical outcome (independence in daily functioning, new cardio-/cerebrovascular events including death, cognition) and physiological parameters (blood pressure, endothelial functioning/arterial stiffness). After respiratory polygraphy in the first night after stroke, patients are classified as having significant SDB (apnoea-hypopnoea index (AHI) > 20/h) or no SDB (AHI < 5/h). Patients with significant SDB are randomized to treatment (ASV+ group) or no treatment (ASV− group) from the second night after stroke. In all patients, clinical, physiological and magnetic resonance imaging studies are performed between day 1 (visit 1) and days 4–7 (visit 4) and repeated at day 90 ± 7 (visit 6) after stroke. Discussion The trial will give information on the feasibility and efficacy of ASV treatment in patients with acute stroke and SDB and allows assessing the impact of SDB on stroke outcome. Diagnosing and treating SDB during the acute phase of stroke is not yet current medical practice. Evidence in favour of ASV treatment from a randomized multicentre trial may lead to a change in stroke care and to improved outcomes. Trial registration ClinicalTrials.gov NCT02554487, retrospectively registered on 16 September 2015 (actual study start date, 13 August 2015), and www.kofam.ch (SNCTP000001521).

scholarly journals Impact of the COVID-19 pandemic on neuroimaging scan volumes at a teaching hospital

2021 ◽  
pp. 197140092098866
Author(s):  
Daniel Thomas Ginat ◽  
James Kenniff
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
The United States ◽  
Radiology Department ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Academic Medical Centre ◽  
Academic Medical ◽  
The Impact

Background The COVID-19 pandemic led to a widespread socioeconomic shutdown, including medical facilities in many parts of the world. The purpose of this study was to assess the impact on neuroimaging utilisation at an academic medical centre in the United States caused by this shutdown. Methods Exam volumes from 1 February 2020 to 11 August 2020 were calculated based on patient location, including outpatient, inpatient and emergency, as well as modality type, including computed tomography and magnetic resonance imaging. 13 March 2020 was designated as the beginning of the shutdown period for the radiology department and 1 May 2020 was designated as the reopening date. The scan volumes during the pre-shutdown, shutdown and post-shutdown periods were compared using t-tests. Results Overall, neuroimaging scan volumes declined significantly by 41% during the shutdown period and returned to 98% of the pre-shutdown period levels after the shutdown, with an estimated 3231 missed scans. Outpatient scan volumes were more greatly affected than inpatient scan volumes, while emergency scan volumes declined the least during the shutdown. In addition, the magnetic resonance imaging scan volumes declined to a greater degree than the computed tomography scan volumes during the shutdown. Conclusion The shutdown from the COVID-19 pandemic had a substantial but transient impact on neuroimaging utilisation overall, with variable magnitude depending on patient location and modality type.

scholarly journals Neuroimaging at Term Equivalent Age: Is There Value for the Preterm Infant? A Narrative Summary

Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 227
Author(s):  
Rudaina Banihani ◽  
Judy Seesahai ◽  
Elizabeth Asztalos ◽  
Paige Terrien Church
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Preterm Infant ◽  
Resonance Imaging ◽  
Long Term Outcomes ◽  
Equivalent Age ◽  
Current State ◽  
Patterns Of Injury ◽  
The Impact

Advances in neuroimaging of the preterm infant have enhanced the ability to detect brain injury. This added information has been a blessing and a curse. Neuroimaging, particularly with magnetic resonance imaging, has provided greater insight into the patterns of injury and specific vulnerabilities. It has also provided a better understanding of the microscopic and functional impacts of subtle and significant injuries. While the ability to detect injury is important and irresistible, the evidence for how these injuries link to specific long-term outcomes is less clear. In addition, the impact on parents can be profound. This narrative summary will review the history and current state of brain imaging, focusing on magnetic resonance imaging in the preterm population and the current state of the evidence for how these patterns relate to long-term outcomes.

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