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S. Aslanyan C. J. Weir C. S. Johnston M. Krams A. P. Grieve K. R. Lees 《European journal of neurology》2007,14(1):1-6
We sought to simultaneously confirm that substantial recovery at day 1 and day 7 after acute ischaemic stroke onset is associated with subsequent neurological deterioration in patients of the Acute Stroke Therapy by Inhibition of Neutrophils randomized clinical trial. Substantial recovery was assessed by improvement in the National Institutes of Health Stroke Score (NIHSS). Neurological deterioration was defined as any stroke event or NIHSS worsening from recovery assessment to day 90. After adjusting for age, t-PA and day 1 NIHSS, there was a non-significant tendency of substantial (pre-specified as 75%) recovery at day 1 to be associated with later deterioration [odds ratio (OR) 2.47; 95% CI, 0.95–6.50]. The corresponding OR for substantial (pre-defined as 65%) recovery at day 7 was 1.84 (0.85–3.96). Other thresholds for recovery were significantly associated with later deterioration: >50%, 80%, 90% and 100% for day 1 and >50%, 60%, 70%, 90% and 100% for day 7. The effect of recovery at day 1 was more important than that of later recovery. This study confirms the association between recovery and subsequent neurological deterioration and is the first to indicate the greater importance of acute recovery at day 1 in comparison with later recovery. 相似文献
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A dosage study of the effect of the 21-aminosteroid U74006F on chronic cerebral vasospasm in a primate model 总被引:1,自引:0,他引:1
The efficacy of the 21-aminosteroid U74006F was investigated using different dosages in a restricted, randomized, placebo-controlled trial. Forty cynomolgous monkeys were divided into five groups of eight. There were two groups given treatment with placebos, one being saline and the other the vehicle in which U74006F was delivered. There were three U74006F treatment dosage groups: 0.3, 1.0, and 3.0 mg/kg. Each monkey underwent baseline cerebral angiography followed by right-sided craniectomy and subarachnoid placement of a clot around the middle cerebral artery (MCA). Treatment was administered intravenously every 8 hours for 6 days. Seven days after experimental subarachnoid hemorrhage, angiography was repeated, and the animals were killed. In both saline or vehicle placebo treatment groups, significant vasospasm (VSP) occurred on the clot side in the extradural internal carotid artery (C3), the intradural internal carotid artery, the precommunicating segment of the anterior cerebral artery (A1,) and the MCA (P less than 0.01). After U74006F treatment, significantly less VSP developed in the A1 on the clot side (0.3 mg/kg U74006F treatment group) and the MCA (all U74006F treatment groups, P less than 0.05). When the percentages of change from the baseline for the vessel diameters on the clot side were compared, VSP was attenuated in the A1 (P less than 0.05) and MCA (P less than 0.001) of all U74006F treatment groups as compared with the placebo treatment groups. Only 0.3 mg/kg of U74006F significantly prevented VSP in C3 (P less than 0.01). Although the 0.3 mg/kg dosage appeared to have the most favorable effect, no significant differences were observed among the three dosage groups. Electron microscopy of the MCA on the clot side in the animals treated with U74006F still showed luminal convolutions and morphological changes in the endothelial cells. These changes appeared less prominent in those MCAs with milder VSP. If these results in primates are applicable to humans, U74006F would be useful in reducing VSP after aneurysmal subarachnoid hemorrhage. 相似文献
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Anaesthesia for appendicectomy in childhood: a survey of practice in Northern Ireland. 总被引:1,自引:0,他引:1
P. S. Weir 《The Ulster medical journal》1997,66(1):34-37
A postal questionnaire was sent to all members of the Northern Ireland Society of Anaesthetists to determine current practice in anaesthesia for children with acute appendicitis. Respondents were asked to describe their usual practice in such cases. They were also asked about the occurrence of complications due to the use of suxamethonium, and for their views on the use of rocuronium in such cases. Few major differences in anaesthetic technique were demonstrated. 74% of consultants and 84% of trainees always perform a rapid sequence induction for appendicectomy. However 15% of consultants do not feel that this is necessary. Only 6% of consultants and 6% of trainees would normally use rocuronium, with the majority still preferring suxamethonium. Only 28% of consultants and 20% of trainees see rocuronium as a possible alternative to suxamethonium in these cases, although others expressed increasing concern over the use of suxamethonium in children. There was wide variation in the type of intra-operative and post-operative analgesia prescribed, with less than one third of consultants and trainees using combinations of opioids, local anaesthetics and non-steroidal anti-inflammatory drugs. 相似文献
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D. Ramsbottom J.M. Scott A. Molloy D. G. Weir P. N. Kirke J. L. Mills P. M. Gallagher A. S. Whitehead 《Clinical genetics》1997,51(1):39-42
Mildly elevated maternal plasma homocysteine (Hcy) levels (hyperhomocysteinemia) have recently been observed in some neural tube defect (NTD) pregnancies. Plasma levels of Hcy are governed by both genetic and nutritional factors and the aetiology of NTDs is also known to have both genetic and nutritional components. We therefore examined the frequency of relatively common mutations in the enzyme cystathionine β-synthase (CBS), which is one of the main enzymes that controls Hcy levels, in the NTD population. Neither the severely dysfunctional G307S CBS allele nor the recently reported 68 bp insertion/I278T CBS allele was observed at increased frequency in the cases relative to controls. We therefore conclude that loss of function CBS alleles do not account for a significant proportion of NTDs in Ireland. 相似文献
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Non-secretion of ABO blood group antigens as a host susceptibility factor in the spondyloarthropathies 总被引:1,自引:0,他引:1
R Shinebaum C C Blackwell P J Forster N P Hurst D M Weir G Nuki 《British medical journal (Clinical research ed.)》1987,294(6566):208-210
Gram negative bacteria precipitate reactive arthritis and may be concerned in the pathogenesis of ankylosing spondylitis and other spondyloarthropathies. Susceptibility to many infectious agents is associated with ABO blood group or secretor state, or both. The distribution of the ABO blood group or secretor state, or both, was therefore determined in 87 patients with ankylosing spondylitis and 32 with other forms of spondyloarthropathy. The prevalence of non-secretors was significantly increased in the total patient group (54/114; 47%) and in the subgroup with ankylosing spondylitis (41/84; 49%) compared with local controls (89/334; 27%) (p less than 0.001). Other subgroups of patients showed a similarly increased prevalence of non-secretion (33-47%). The distribution of ABO blood groups did not differ between patients and controls. The association between non-secretor state and ankylosing spondylitis strengthens the hypothesis that ankylosing spondylitis is a form of reactive arthritis. It also suggests several pathogenic mechanisms which may be relevant to the initial hostparasite interaction in ankylosing spondylitis. 相似文献
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