RESUMO
INTRODUCTION: Poststroke hyperglycaemia is an independent risk factor for poorer outcomes in patients treated with mechanical thrombectomy (MT) and is associated with a lower probability of functional recovery and higher mortality at 3 months. This study aims to evaluate the association between glucose levels during cerebral reperfusion with MT and functional recovery at 3 months, measured by subcutaneous continuous glucose monitoring (CGM) devices. METHODS: This prospective observational study aims to recruit 100 patients with ischaemic stroke and large anterior circulation vessel occlusion, in whom MT is indicated. CGM will be performed using a Freestyle Libre ProIQ device (FSL-CGM, Abbott Diabetes Care, Alameda, California, USA), which will be implanted on admission to the emergency department, to monitor glucose levels before, during and after reperfusion. The study's primary endpoint will be the functional status at 3 months, as measured by the dichotomised modified Rankin Scale (0-2 indicating good recovery and 3-6 indicating dependency or death). We will analyse expression profiles of microRNA (miRNA) at the time of reperfusion and 24 hours later, as potential biomarkers of ischaemic-reperfusion injury. The most promising miRNAs include miR-100, miR-29b, miR-339, miR-15a and miR-424. All patients will undergo treatment according to current international recommendations and local protocols for the treatment of stroke, including intravenous thrombolysis if indicated. ETHICS AND DISSEMINATION: This study (protocol V.1.1, dated 29 October 2021, code 6017) has been approved by the Clinical Research Ethics Committee of La Paz University Hospital (Madrid, Spain) and has been registered in ClinicalTrials.gov (NCT05871502). Study results will be disseminated through peer-reviewed publications in Open Access format and at conference presentations. TRIAL REGISTRATION NUMBER: NCT05871502.
Assuntos
Glicemia , AVC Isquêmico , Traumatismo por Reperfusão , Trombectomia , Humanos , Estudos Prospectivos , AVC Isquêmico/terapia , AVC Isquêmico/cirurgia , Trombectomia/métodos , Traumatismo por Reperfusão/terapia , Glicemia/metabolismo , Glicemia/análise , Hiperglicemia/complicações , Estudos Observacionais como Assunto , Masculino , MicroRNAs , Recuperação de Função Fisiológica , FemininoRESUMO
No disponible
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Humanos , Masculino , Adulto , Doenças do Nervo Vestibulococlear/diagnóstico , Doenças Vestibulares/diagnóstico , Dissecação da Artéria Vertebral/diagnóstico , Diagnóstico DiferencialRESUMO
No disponible
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Humanos , Masculino , Adulto , Doenças do Nervo Vestibulococlear/diagnóstico , Doenças Vestibulares/diagnóstico , Dissecação da Artéria Vertebral/diagnóstico , Diagnóstico DiferencialRESUMO
La alta incidencia de las fracturas por fragilidad y especialmente de las fracturas vertebrales (FV) en mujeres con osteoporosis posmenopáusica obliga a abordar este tema una y otra vez. En este manuscrito se actualizan los datos epidemiológicos que indican la magnitud del problema y se revisan alternativas de tratamiento farmacológico, tanto para disminuir el dolor producido por la FV como para prevenir la presentación de nuevas fracturas osteoporóticas de cualquier tipo, indicando los agentes antirresortivos y osteoformadores disponibles actualmente. En los casos de FV por compresión, en las que el tratamiento farmacológico habitual no produce mejoría del dolor y siempre que no existan contraindicaciones, puede ser muy apropiado realizar vertebroplastia o cifoplastia (AU)
The high incidence of fractures by fragility and, especially of the vertebral fractures in osteoporotic postmenopausal women, forces us to approach this subject once more. In this manuscript epidemiological data that indicates the magnitude of the problem will be updated. Treatment alternatives to decrease back pain produced by vertebral fracture are will be reviewed, and the prevention of the occurrence of new osteoporotic fractures of any type, through the administration of suitable antiresorptive and bone-forming pharmacological agents to increase bone mineral density will also be addressed. In some patients with painful vertebral compression fractures it is possible obtain an analgesic effect by percutaneous vertebroplasty or by kiphoplasty using polymethylmetacrilate cement or calcium- phosphate cement, injected into vertebral bodies (AU)
Assuntos
Humanos , Osteoporose Pós-Menopausa/complicações , Fraturas da Coluna Vertebral/cirurgia , Cifose/cirurgia , Vertebroplastia , Fraturas da Coluna Vertebral/prevenção & controle , Conservadores da Densidade Óssea/uso terapêuticoRESUMO
Los tumores del estroma gastrointestinal son neoplasias infrecuentes, de difícil caracterización radiológica gastrointestinal, cuyo pronóstico, generalmente pobre, va a depender de la precocidad de su detección. Describimos los rasgos diagnósticos por imagen en dos casos (adultos) de leiomiosarcomas de localización duodenal, no ampular. Evaluados con tránsito baritado gastrointestinal, ultrasonidos y tomografía computadorizada. Analizamos los distintos hallazgos en relación con los hasta ahora mencionados en la literatura e informamos la historia clínica y los hallazgos por imagen en dos pacientes