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I. Derraz M. Pou J. Labreuche L Legrand S. Soize M. Tisserand C. Rosso M. Piotin G. Boulouis C. Oppenheim O. Naggara S. Bracard F. Clarenon B. Lapergue R. Bourcier 《AJNR. American journal of neuroradiology》2021,42(1):42
BACKGROUND AND PURPOSE:Collateral status and thrombus length have been independently associated with functional outcome in patients with acute ischemic stroke. It has been suggested that thrombus length would influence functional outcome via interaction with the collateral circulation. We investigated the individual and combined effects of thrombus length assessed by the clot burden score and collateral status assessed by a FLAIR vascular hyperintensity–ASPECTS rating system on functional outcome (mRS).MATERIALS AND METHODS:Patients with anterior circulation acute ischemic stroke due to large-vessel occlusion from the ASTER and THRACE trials treated with endovascular thrombectomy were pooled. The clot burden score and FLAIR vascular hyperintensity score were determined on MR imaging obtained before endovascular thrombectomy. Favorable outcome was defined as an mRS score of 0–2 at 90 days. Association of the clot burden score and the FLAIR vascular hyperintensity score with favorable outcome (individual effect and interaction) was examined using logistic regression models.RESULTS:Of the 326 patients treated by endovascular thrombectomy with both the clot burden score and FLAIR vascular hyperintensity assessment, favorable outcome was observed in 165 (51%). The rate of favorable outcome increased with clot burden score (smaller clots) and FLAIR vascular hyperintensity (better collaterals) values. The association between clot burden score and functional outcome was significantly modified by the FLAIR vascular hyperintensity score, and this association was stronger in patients with good collaterals, with an adjusted OR = 6.15 (95% CI, 1.03–36.81).CONCLUSIONS:The association between the clot burden score and functional outcome varied for different collateral scores. The FLAIR vascular hyperintensity score might be a valuable prognostic factor, especially when contrast-based vascular imaging is not available.Therapeutic reperfusion with endovascular thrombectomy (EVT) is consistently associated with a better long-term functional outcome in anterior circulation acute ischemic stroke (AIS).1 Early reperfusion is the mainstay of therapy because it strongly predicts functional outcome.2 Many factors impact clinical outcomes, including the extent of clot and collateral supply.3–7The clot burden score (CBS) assessed by the T2* MR imaging sequence (T2*-CBS), which was adapted from the CTA-CBS,8 has been used to assess the extent of the clot9 and has been independently associated with functional outcome in patients undergoing EVT.10Good collaterals have been related to better clinical outcome through 2 distinct mechanisms. First, collaterals are thought to contribute to prolonged penumbra sustenance.11,12 Second, good retrograde collateral filling beyond the occlusion could promote successful reperfusion by providing more access to thrombolytics at the distal end of the clot and robust collaterals dissolving clot fragments in the distal vasculature.13,14 The Highly Effective Reperfusion evaluated in Multiple Endovascular Stroke Trials (HERMES) collaboration analysis suggested a benefit with EVT across all strata of collateral circulation status;15 however, patients with poor collaterals are less likely to benefit from EVT than those with better collaterals.Most interesting, FLAIR vascular hyperintensity (FVH) on baseline MR imaging could indicate the formation of a leptomeningeal collateral circulation and serve as a prognostic marker for patients with AIS.16-18 Both collaterals and the CBS were separately associated with functional outcome in patients undergoing EVT,10,16 but their combined effect regarding clinical outcome is still poorly understood and has been assessed and quantified only with CTA or contrast-enhanced MRA in patients with AIS.14,15 Furthermore, the lack of adjustment for possible confounders because of the small number of patients with very low collateral scores might also have influenced results in these studies.The purpose of this study was to determine whether there is an association between the CBS and FVH score and whether the association between the CBS and functional outcome is modified by the FVH score for patients who were treated by EVT for large-vessel occlusion within the framework of the Contact Aspiration versus Stent Retriever for Successful Revascularization (ASTER) and the THRombectomie des Artères CErebrales (THRACE) randomized trials.19,20 相似文献
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Calwing Liao BSc Faezeh Sarayloo MSc Daniel Rochefort MSc Gabrielle Houle BSc Fulya Akçimen MSc Qin He PhD Alexandre D. Laporte MSc Dan Spiegelman MSc Werner Poewe MD Daniela Berg MD Stefanie Müller PhD Franziska Hopfner MD PhD Günther Deuschl MD PhD Gregor Kuhlenbäeumer MD PhD Alex Rajput MD Patrick A. Dion PhD Guy A. Rouleau MD PhD 《Movement disorders》2020,35(7):1153-1162
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Faezeh Tatari Vahid Farnia Khodamorad Momeni Omran Davarinejad Bahareh Soltani 《Journal of substance use》2021,26(1):7-12
ABSTRACT Background: Addiction has been reported as a major personal, social and political challenge in people of different strata and education levels in all countries. The present study was conducted to predict addiction potential based on sensation-seeking, psychological hardiness and assertiveness in students. Methods: The present correlational study was conducted in 2018 on a statistical population comprising all the students of the School of Medicine in Kermanshah University of Medical Sciences, Kermanshah, Iran. Convenience sampling was used to select 200 subjects. The data collection tools included the sensation-seeking scale, the psychological hardiness questionnaire, the assertion inventory and the addiction potential scale. The data collected were analyzed in SPSS using the statistical methods of the Pearson correlation coefficient and regression analysis. Results: Analyzing the findings showed the total scores of addiction potential and active addiction potential are positively associated with the total score of sensation-seeking and negatively and significantly correlated with that of psychological hardiness. Conclusions: Given the role of sensation-seeking, psychological hardiness and assertiveness in addiction potential, university authorities are recommended to hold workshops and seminars to enhance the awareness of students of the personality traits conducive to addiction. 相似文献
6.
Nahid Dehghan-Nayeri Zohreh Khakbazan Faezeh Ghafoori 《Disability and health journal》2018,11(2):274-280
Background
Multiple sclerosis (MS) is a debilitating and life-long disease that affects the sexual life of people. However, in Iran little attention has been paid to the sexual life of women with MS.Objective
The aim of this study was to understand the sexual life and experiences of Iranian women with multiple sclerosis.Methods
A qualitative study was designed, and face-to-face semi-structured interviews were conducted with twenty-five women with MS. The interviews were tape-recorded and transcribed verbatim. Data were analyzed using a content analysis approach and through MAXQDA.10 software.Results
The main themes identified during the analysis were: (1) limited sexual activity, (2) sex life behind the mask, and (3) lack of sexual support during the rehabilitation process. In fact, the participants in this study expressed that their sexual activity was negatively affected by MS. They were trying to hide their sexual problems, and present themselves to their husbands differently from what they are, which can be considered as sex life behind the mask. Furthermore, Iranian women with MS received little sexual support from the rehabilitation team.Conclusions
Hiding sexual problems from husbands is thought to be a common practice and behavior among Iranian women with MS. Understanding this insight and its consequences can assist the rehabilitation team in helping and solving sexual problems of women with MS. Moreover, sexual awareness and education should be extended, especially among the husbands of women with MS. 相似文献7.
Seyed Mostafa Monzavi Aida Alirezaei Zhaleh Shariati-Sarabi Jalil Tavakol Afshari Mahmoud Mahmoudi Banafsheh Dormanesh Faezeh Jahandoost Ali Reza Khoshdel Ali Etemad Rezaie 《Inflammopharmacology》2018,26(5):1175-1182
Background
Hydroxychloroquine (HCQ) is a widely prescribed medication to patients with systemic lupus erythematosus (SLE), with potential anti-inflammatory effects. This study was performed to investigate the efficacy of HCQ therapy by serial assessment of disease activity and serum levels of proinflammatory cytokines in SLE patients.Methods
In this prospective cohort study, 41 newly diagnosed SLE patients receiving 400 mg HCQ per day were included. Patients requiring statins and immunosuppressive drugs except prednisolone at doses lower than 10 mg/day were excluded. Outcome measures were assessed before commencement of HCQ therapy (baseline visit) as well as in two follow-up visits (1 and 2 months after beginning the HCQ therapy). Serum samples of 41 age-matched healthy donors were used as controls.Results
Median levels of IL-1β (p?<?0.001), IL-6 (p?=?0.001), and TNF-α (p?<?0.001) were significantly higher, whereas, median CH50 level was significantly lower (p?<?0.001) in SLE patients compared with controls. Two-month treatment with HCQ resulted in significant decrease in SLEDAI-2K (p?<?0.001), anti-dsDNA (p?<?0.001), IL-1β (p?=?0.003), IL-6 (p?<?0.001) and TNF-α (p?<?0.001) and a significant increase in CH50 levels (p?=?0.012). The reductions in SLEDAI-2K and serum levels of IL-1β and TNF-α were significantly greater in the first month compared with the reductions in the second month.Conclusion
HCQ therapy is effective on clinical improvement of SLE patients through interfering with inflammatory signaling pathways, reducing anti-DNA autoantibodies and normalizing the complement activity.8.
Thomas Pagliardini Lucas Castagna Samia Harbi Matteo Della Porta Jerome Rey Sabine Fürst Stefania Bramanti Colombe Saillard Faezeh Legrand Valerio Maisano Catherine Faucher Angela Granata Marie-Anne Hospital Wang Lining Pierre-Jean Weiller Boris Calmels Aude Charbonnier Claude Lemarie Raynier Devillier 《Biology of blood and marrow transplantation》2019,25(9):1803-1809
Haploidentical stem cell transplantation (haplo-SCT) with post-transplant cyclophosphamide (PT-Cy) is an alternative treatment for acute myeloid leukemia (AML) patients who lack HLA-matched donors. Relapse after haplo-SCT remains a major concern, especially after nonmyeloablative conditioning regimens. Promising results were reported for TBF-based conditioning regimens (thiotepa, busulfan, and fludarabine) in patients transplanted from different categories of donors and for various disease types but not specifically in PT-Cy haplo-SCT for AML. Here we evaluate the outcome of 100 AML patients who received haplo-SCT with PT-Cy after TBF conditioning regimens (reduced-intensity conditioning, n = 77; myeloablative conditioning, n = 23) in 2 transplant programs. Cumulative incidences of grades III to IV acute and moderate or severe chronic graft-versus-host disease (GVHD) were 7% and 14%, respectively. NRM at 2 years was 28%, significantly influenced by disease status at haplo-SCT (first complete response [CR1] versus advanced AML: 16% versus 38%, P = .016) but not by conditioning intensity or age. The cumulative incidences of relapse at 2 years were 17% and 24% in CR1 and advanced AML, respectively (not significant). Progression-free survival, overall survival, and GVHD and relapse-free survival at 2 years were 67%, 71%, and 49% in CR1 patients, respectively, whereas comparative values in patients with advanced disease were 37%, 41%, and 32%. Our study suggests that TBF conditioning for PT-Cy haplo-SCT is safe and effective for AML patients in CR1. In patients with more advanced disease, the relatively low incidence of relapse seems counterbalanced by a high nonrelapse mortality, underlining the need for alternative strategies to decrease relapse risk, without increasing the intensity of conditioning regimen. 相似文献
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