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1.
Neurosurg Rev ; 47(1): 258, 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38839660

RESUMEN

Administration of acetylsalicylic acid (ASA) at early stage after surgery for spontaneous intracerebral hemorrhage (SICH) may increase the risk of postoperative intracranial bleeding (PIB), because of potential inhibition of platelet function. This study aimed to investigate whether early ASA administration after surgery was related to increased risk of PIB. This retrospective study enrolled SICH patients receiving surgery from September 2019 to December 2022 in seven medical institution. Based on postoperative ASA administration, patients who continuously received ASA more than three days within seven days post-surgery were identified as ASA users, otherwise as non-ASA users. The primary outcome was symptomatic PIB events within seven days after surgery. Incidence of PIB was compared between ASA users and non-ASA users using survival analysis. This study included 744 appropriate patients from 794 SICH patients. PIB occurred in 42 patients. Survival analysis showed no statistical difference between ASA users and non-ASA users in incidence of PIB (P = 0.900). Multivariate Cox analysis demonstrated current smoker (hazard ratio [HR], 2.50, 95%CI, 1.33-4.71, P = 0.005), dyslipidemia (HR = 3.03; 95%CI, 1.31-6.99; P = 0.010) and pre-hemorrhagic antiplatelet therapy (HR = 3.05; 95% CI, 1.64-5.68; P < 0.001) were associated with PIB. Subgroup analysis manifested no significant difference in incidence of PIB between ASA users and non-ASA users after controlling the effect from factors of PIB (i.e., sex, age, current smoker, regular drinker, dyslipidemia, pre-hemorrhagic antiplatelet therapy and hematoma location). This study revealed that early ASA administration to SICH patients after surgery was not related to increased risk of PIB.


Asunto(s)
Aspirina , Hemorragia Cerebral , Inhibidores de Agregación Plaquetaria , Humanos , Masculino , Femenino , Aspirina/efectos adversos , Aspirina/administración & dosificación , Anciano , Persona de Mediana Edad , Estudios Retrospectivos , Inhibidores de Agregación Plaquetaria/efectos adversos , Inhibidores de Agregación Plaquetaria/administración & dosificación , Hemorragia Posoperatoria/epidemiología , Factores de Riesgo , Adulto , Hemorragias Intracraneales/epidemiología
2.
Environ Sci Pollut Res Int ; 31(1): 1576-1588, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38048003

RESUMEN

Extensive coral bleaching events can result in catastrophic degradation of coral reefs and reorganization of coral communities. In the present study, we analyzed the spatial differences in coral bleaching and possible reasons of large-scale coral bleaching, based on the results of a survey carried out in the northern South China Sea in 2020. In addition, we have continuously monitored the sea surface temperature (SST) of the northernmost Weizhou Island for more than six years. The living coral cover at Weizhou Island (W), Xuwen Nature Reserve (X), and Haihua Island (H) was relatively high at 24.6% ± 4.8%, 12.1% ± 3.8%, and 8.1% ± 2.6%, respectively, whereas their bleaching rates were 9.7% ± 2.6%, 9.7% ± 3.3%, and 6.9% ± 2.1%, respectively. Among them, the living coral cover of W was significantly different from those of X and H, whereas the bleaching rate was not significantly different among the three areas. In all three areas, the massive and encrusting corals predominate and exhibit relatively high bleaching rates, with Porites lutea and Bernardpora stutchburyi being the dominant species. In addition, the temperature monitoring results of Weizhou Island for six consecutive years showed that the critical SST of coral bleaching was 31.5 ℃. The monitoring results also showed that the average SST of Weizhou Island was 32.1 ℃, exceeding 32 ℃ in July 2020 for up to 533 h. The longest continuous time when the SST exceeded 32 ℃ was 97 h. These findings indicated that the coral bleaching event that occurred in the Beibu Gulf during 2020 was a large-scale and high-temperature transient event that presented a relatively homogeneous threat to the coral communities. We inferred that this sudden heat stress event was caused by the enclosed tidal current in the Beibu Gulf, which prevented the southern upwelling from reaching the north, as well as by the inability of the SST to decrease without rainfall caused by typhoon cyclones. Our findings suggested that abnormal heat waves can result in coral bleaching at high latitudes and even coral reef degradation. Furthermore, our study provides a new perspective for investigating the self-recovery and reorganization of coral communities following accumulated coral bleaching.


Asunto(s)
Antozoos , Arrecifes de Coral , Animales , Temperatura , Clima , China
3.
Int J Surg ; 110(2): 788-798, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-37939108

RESUMEN

BACKGROUND: Surgical treatment demonstrated a reduction in mortality among patients suffering from severe spontaneous intracerebral hemorrhage (SSICH). However, which SSICH patients could benefit from surgical treatment was unclear. This study aimed to establish and validate a decision tree (DT) model to help determine which SSICH patients could benefit from surgical treatment. MATERIALS AND METHODS: SSICH patients from a prospective, multicenter cohort study were analyzed retrospectively. The primary outcome was the incidence of neurological poor outcome (modified Rankin scale as 4-6) on the 180th day posthemorrhage. Then, surgically-treated SSICH patients were set as the derivation cohort (from a referring hospital) and validation cohort (from multiple hospitals). A DT model to evaluate the risk of 180-day poor outcome was developed within the derivation cohort and validated within the validation cohort. The performance of clinicians in identifying patients with poor outcome before and after the help of the DT model was compared using the area under curve (AUC). RESULTS: One thousand two hundred sixty SSICH patients were included in this study (middle age as 56, and 984 male patients). Surgically-treated patients had a lower incidence of 180-day poor outcome compared to conservatively-treated patients (147/794 vs. 128/466, P <0.001). Based on 794 surgically-treated patients, multivariate logistic analysis revealed the ischemic cerebro-cardiovascular disease history, renal dysfunction, dual antiplatelet therapy, hematoma volume, and Glasgow coma score at admission as poor outcome factors. The DT model, incorporating these above factors, was highly predictive of 180-day poor outcome within the derivation cohort (AUC, 0.94) and validation cohort (AUC, 0.92). Within 794 surgically-treated patients, the DT improved junior clinicians' performance to identify patients at risk for poor outcomes (AUC from 0.81 to 0.89, P <0.001). CONCLUSIONS: This study provided a DT model for predicting the poor outcome of SSICH patients postsurgically, which may serve as a useful tool assisting clinicians in treatment decision-making for SSICH.


Asunto(s)
Hemorragia Cerebral , Humanos , Persona de Mediana Edad , Hemorragia Cerebral/cirugía , Estudios de Cohortes , Árboles de Decisión , Pronóstico , Estudios Prospectivos , Estudios Retrospectivos
4.
Stroke Vasc Neurol ; 2023 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-37586776

RESUMEN

BACKGROUND: Aspirin is widely used for preventing ischaemic events. About 20%-40% of patients have aspirin resistance (ASR), which prevents them from benefiting from aspirin medication. This study aimed to develop and validate a model based on single-nucleotide polymorphism (SNP) to distinguish ASR patients. METHODS: We included patients with spontaneous intracerebral haemorrhage and continuing antiplatelet therapy from a multicentre, prospective cohort study as the derivation cohort. Thromboelastography (inhibition of arachidonic acid channel<50%) was used to identify ASR. Genotyping was performed to identify the ASR-related SNP. Based on the result of the logistic analysis, the aspirin resistance in the Chinese population score (ASR-CN score) was established, and its accuracy was evaluated using the area under the curve (AUC). Patients receiving dual antiplatelet therapy for unruptured intracranial aneurysm embolism were prospectively included in the validation cohort. After embolism, 30-day ischaemic events, including ischaemic stroke, new or more frequent transient ischaemic attack, stent thrombosis and cerebrovascular death, were recorded. RESULTS: The derivation cohort included 212 patients (155 male patients and the median age as 59). 87 (41.0%) individuals were identified with ASR. The multivariate logistic analysis demonstrated six SNPs of GP1BA, TBXA2R, PTGS2 and NOS3 as risk factors related to ASR. The ASR-CN score integrating these SNPs performed well to discriminate ASR patients from non-ASR patients (AUC as 0.77). Based on the validation cohort of 372 patients receiving antiplatelet therapy after embolism (including 130 ASR patients), the ASR-CN score continued to distinguish ASR patients with good accuracy (AUC as 0.80). Patients with high a ASR-CN score were more likely to suffer from 30-day ischaemic events after embolism (OR, 1.28; 95% CI, 1.10 to 1.50; p=0.002). CONCLUSION: GP1BA, TBXA2R, PTGS2 and NOS3 were SNPs related to ASR. The ASR-CN score is an effective tool to discriminate ASR patients, which may guide antiplatelet therapy. CLINICAL TRIAL REGISTRATION: Surgical Treatments of Antiplatelet Intracerebral Hemorrhage cohort (unique identifier: ChiCTR1900024406, http://www.chictr.org.cn/edit.aspx?pid=40640&htm=4).

5.
Int J Neurosci ; : 1-7, 2022 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-36503400

RESUMEN

BACKGROUND AND PURPOSE: Spontaneous intracranial hemorrhage (ICH) patients are still at risk of postoperative ischemic complications (PICs) after surgery. In addition, the proportion of patients receiving antiplatelet therapy (APT) in ICH patients increased significantly with age. This study aims to evaluate the impact of preoperative antiplatelet therapy on PICs in ICH patients. METHODS: This is a cohort study that retrospectively analyzed the data of ICH patients who underwent surgical treatment. PICs rate was compared between patients with preoperative ATP and those without preoperative ATP. Univariate and multivariate analyses were conducted to evaluate the impact of preoperative APT on PICs. In addition, Kaplan-Meier method was used for survival analysis and the impact of PICs on patients' postoperative outcomes was evaluated. RESULTS: A total of 216 patients were included in this study. There were 47 patients (21.76%) with preoperative APT; 169 patients (78.24%) without preoperative APT. The incidence of PICs in the APT group was significantly higher when compared with that in the nAPT group (36.17% vs. 20.71%, p = 0.028<0.05). Furthermore, significant differences were both observed in multivariate analysis (p = 0.035<0.05) and survival analysis (log rank χ2 = 5.415, p = 0.020<0.05). However, there was no significant difference between the outcomes of patients suffering from PICs and that of patients not suffering from PICs (p = 0.377 > 0.05). CONCLUSIONS: In conclusion, preoperative APT may be a risk factor for PICs in ICH patients undergoing surgical treatment significantly.

6.
Front Aging Neurosci ; 14: 1020224, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36506468

RESUMEN

Background: For severe spontaneous intracerebral hemorrhage (sSICH) patients with high risk of ischemic events, the incidence of postoperative major cardiovascular/cerebrovascular and peripheral vascular events (MACCPE) is notable. Although antiplatelet therapy is a potential way to benefit these patients, the severe hemorrhagic complications, e.g., intracranial re-hemorrhage, is a barrier for early starting antiplatelet therapy. Objectives: This randomized controlled trial aims to identify the benefit and safety of early starting antiplatelet therapy after operation for sSICH patients with high risk of ischemic events. Methods: This study is a multicenter, prospective, randomized, open-label, blinded-endpoint trial. We will enroll 250 sSICH patients with a high risk of ischemic events (including cerebral infarcts, transient ischemic attack, myocardial infarction, pulmonary embolism, and deep venous thrombosis). The participants will be randomized in a 1:1 manner to early-start group (start antiplatelet therapy at 3 days after operation) and normal-start group (start antiplatelet therapy at 30 days after operation). The early-start group will receive aspirin 100 mg daily. The control group will not receive antithrombotic therapy until 30 days after operation. The efficacy endpoint is the incidence of MACCPE, and the safety endpoint is the incidence of intracranial re-hemorrhage. Discussion: The Early-Start antiplatelet therapy after operation in patients with spontaneous intracerebral hemorrhage trial (E-start) is the first randomized trial about early start antiplatelet therapy for operated sSICH patients with a high risk of ischemic events. This study will provide a new strategy and evidence for postoperative management in the future. Clinical trial registration: ClinicalTrials.gov, identifier NCT04820972; Available at: https://clinicaltrials.gov/ct2/show/NCT04820972?term=NCT04820972&draw=2&rank=1.Chinese Clinical Trial Registry, identifier ChiCTR2100044560; Available at: http://www.chictr.org.cn/showproj.aspx?proj=123277.

7.
Sci Total Environ ; 825: 154100, 2022 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-35218829

RESUMEN

Frequent marine heatwaves (MHWs), concurrent with climate warming, threaten global low-latitude, pristine coral reefs, leading to growing interest in identifying marginal coral reefs (relatively high-latitude and/or turbid reef environments) that can serve as thermal refugia from mass coral bleaching. However, the thermal refugia potential of marginal reefs remains controversial. We evaluated the thermal refugia potential of inshore reefs in the northern South China Sea (nSCS), a globally typical marginal reef system, by characterizing the long-term trend of MHW intensity and frequency and assessing thermal stress during a mass bleaching event in summer 2020. An unprecedented peak intensity of around 20 °C-weeks of cumulative heat stress, associated with a prolonged anomalous western Pacific subtropical high (WPSH) and weakened monsoon activity, induced record-breaking bleaching. The geographical variability of bleaching was strongly related to the extent of heat exposure and satellite-derived temperature anomalies. Under ongoing global warming, the frequency and intensity of MHWs over nSCS coral habitats show a markedly increasing trend, especially during the last decade. Intense MHWs and coral bleaching have already occurred throughout all El Niño-Southern Oscillation (ENSO) phases (e.g., 2010, 2015, and 2020). Climate change has pushed marginal coral reefs to or beyond the limits of their resilience, and frequent MHW events have amplified the increasing risk of thermal stress. There are no long-term thermal refugia for marginal reefs in the nSCS.


Asunto(s)
Antozoos , Refugio de Fauna , Animales , Arrecifes de Coral , El Niño Oscilación del Sur , Calentamiento Global , Temperatura
8.
Front Cardiovasc Med ; 9: 818789, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35155635

RESUMEN

BACKGROUND AND PURPOSE: Aneurysm wall enhancement (AWE) is correlated with the rupture and growth risk of unruptured intracranial aneurysms (UIAs). Pyroptosis is a proinflammation mode of lytic cell death, mediated by pyroptosis-related proteins, i.e., gasdermin D and interleukin 1 ß (IL-1ß). Integrating serum cytokines and histology, this study aimed to investigate the correlation between AWE and pyroptosis in UIAs. METHODS: UIA patients receiving microsurgical clipping were prospectively enrolled from January 2017 and June 2020. UIA samples were collected, as well as the corresponding blood samples. In this study, high-resolution magnetic resonance was employed to identify the AWE. The serum 46-cytokines examination and the histological analysis were conducted to determine pyroptosis, CD68 and MMP2. The IL-1 ra/beta ratio was determined by complying with the serum IL-1ß and IL-1.ra. A comparison was drawn in the differences between UIAs with and without AWE. Lastly, the correlation between inflammation in UIA samples and serums was investigated. RESULTS: This study included 34 UIA patients. The serum proinflammatory cytokines [IL-1ß (P < 0.001) and TNF-α (P < 0.001)] were up-regulated, and serum anti-inflammatory cytokine (IL-1.ra, P = 0.042) were down-regulated in patients with AWE UIAs. The patients with AWE UIAs achieved a higher IL-1.ra/beta ratio (P < 0.001). The multivariate logistic analysis demonstrated IL-1ß [odds ratio (OR), 1.15; 95% confidence interval (CI), 1.02-1.30; P = 0.028] and IL-1.ra (OR, 0.998; 95% CI, 0.997-1.000; P = 0.017) as the risk factors correlated with the AWE. IL-1.ra/beta ratio achieved the highest predictive accuracy [area under the curve (AUC), 0.96] for AWE, followed by IL-1.ra (AUC, 0.90), IL-1ß (AUC, 0.88) and TNF-α (AUC, 0.85). As compared with the UIAs without AWE, the AWE UIAs were manifested as a severer wall remodeling, with higher relative levels of pyroptosis-related proteins, CD68 and MMP2. The serum IL-1ß, IL-1.ra and IL-1.ra/beta ratio had a positive correlation with the relative levels of pyroptosis-related proteins, CD68 and MMP2 in UIA tissues. CONCLUSION: The serum IL-1ß and IL-1.ra were correlated with the AWE. More pyroptosis-related proteins were identified in UIAs with AWE. The serum IL-1ß and IL-1.ra were correlated with the pyroptosis-related proteins in aneurysm tissues.

9.
J Neurosurg ; : 1-10, 2022 Jan 21.
Artículo en Inglés | MEDLINE | ID: mdl-35061990

RESUMEN

OBJECTIVE: The probable stability of the lesion is critical in guiding treatment decisions in unruptured intracranial aneurysms (IAs). The authors aimed to develop multidimensional predictive models for the stability of unruptured IAs. METHODS: Patients with unruptured IAs in the anterior circulation were prospectively enrolled and regularly followed up. Clinical data were collected, IA morphological features were assessed, and adjacent hemodynamic features were quantified with patient-specific computational fluid dynamics modeling. Based on multivariate logistic regression analyses, nomograms incorporating these factors were developed in a primary cohort (patients enrolled between January 2017 and February 2018) to predict aneurysm rupture or growth within 2 years. The predictive accuracies of the nomograms were compared with the population, hypertension, age, size, earlier rupture, and site (PHASES) and earlier subarachnoid hemorrhage, location, age, population, size, and shape (ELAPSS) scores and validated in the validation cohort (patients enrolled between March and October 2018). RESULTS: Among 231 patients with 272 unruptured IAs in the primary cohort, hypertension, aneurysm location, irregular shape, size ratio, normalized wall shear stress average, and relative resident time were independently related to the 2-year stability of unruptured IAs. The nomogram including clinical, morphological, and hemodynamic features (C+M+H nomogram) had the highest predictive accuracy (c-statistic 0.94), followed by the nomogram including clinical and morphological features (C+M nomogram; c-statistic 0.89), PHASES score (c-statistic 0.68), and ELAPSS score (c-statistic 0.58). Similarly, the C+M+H nomogram had the highest predictive accuracy (c-statistic 0.94) in the validation cohort (85 patients with 97 unruptured IAs). CONCLUSIONS: Hemodynamics have predictive values for 2-year stability of unruptured IAs treated conservatively. Multidimensional nomograms have significantly higher predictive accuracies than conventional risk prediction scores.

10.
Neurosurg Rev ; 45(2): 1491-1499, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34643829

RESUMEN

Hematoma growth (HG) affects the prognosis of patients with spontaneous intracranial hematoma (ICH), but there is still a lack of evidence about the effects of aspirin (acetylsalicylic acid, ASA) on HG in patients with severe ICH. This study retrospectively analyzed patients with severe ICH who met the inclusion and exclusion criteria in Beijing Tiantan Hospital, Capital Medical University, between January 1, 2015, and July 31, 2019. Severe ICH patients were divided into ASA group and nASA groups according to ASA usage, and the incidence of HG between the groups was compared. Univariate analysis was performed by the Mann-Whitney U test, chi-square test, or Fisher exact test. Multivariate logistic regression analysis was used to analyze the impact of ASA on HG and to screen for risk factors of HG. In total, 221 patients with severe ICH were consecutively enrolled in this study. There were 72 (32.6%) patients in the ASA group and 149 patients in the nASA group. Although the incidence of HG in the nASA group was higher than that in the ASA group (34.9% VS 22.2%, p = 0.056), ASA did not significantly affect the occurrence of HG (p = 0.285) after adjusting for initial hematoma volume, high blood pressure at admission, coronary heart disease, and GCS at admission. In addition, we found that high blood pressure at admission was a risk factor for HG. Prior ASA does not increase the incidence of HG in severe ICH patients, and high blood pressure at admission is a risk factor for HG.


Asunto(s)
Aspirina , Hipertensión , Aspirina/efectos adversos , Hemorragia Cerebral/etiología , Hematoma/complicaciones , Humanos , Hipertensión/complicaciones , Estudios Retrospectivos
11.
Neurosurg Rev ; 45(2): 1571-1578, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34714418

RESUMEN

The 30-day mortality rate of spontaneous cerebral hemorrhage (ICH) is approximately 30-50%. Surgery may improve the prognosis of patients with severe ICH. However, ICH survivors after surgery still face the risks of postoperative intracranial rebleeding (PIB), and clinical tools that accurately predict the risk of PIB occurrence are not available. Therefore, a retrospective study was performed. The population was divided into two groups according to the occurrence of PIB. Univariate and multivariate logistic regression analyses were performed to screen risk factors for PIB. Next, an early PIB risk nomogram prediction model was constructed. In addition, the impact of PIB on the prognosis of ICH was evaluated. In total, 150 ICH patients were continuously enrolled in this study; 21 patients suffered from PIB, and the overall incidence of PIB was 14.0% (21/150). Coronary heart disease history, a lower GCS score, and subarachnoid hemorrhage absence were screened as risk factors for early PIB. The early PIB risk nomogram showed good calibration and discrimination with a concordance index of 0.807 (95% confidence interval (CI), 0.715-0.899), which was confirmed to be 0.788 through bootstrapping validation. In addition, a significant difference in discharged GOS scores (P = 0.043) was observed between the PIB group and the n-PIB group. These results showed that a history of coronary heart disease, a lower GCS score, and absence of subarachnoid hemorrhage were risk factors for early PIB. In addition, the early PIB risk nomogram prediction model exhibits good discrimination and calibration. The occurrence of PIB could reduce the prognosis of ICH patients.


Asunto(s)
Hematoma , Nomogramas , Hemorragia Cerebral/complicaciones , Hemorragia Cerebral/cirugía , Hematoma/cirugía , Humanos , Pronóstico , Estudios Retrospectivos
12.
Front Aging Neurosci ; 13: 681998, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34276341

RESUMEN

BACKGROUND AND PURPOSE: The effect of antiplatelet therapy (APT) on early postoperative rehemorrhage and outcomes of patients with spontaneous intracerebral hemorrhage (ICH) is still unclear. This study is to evaluate the effect of preoperative APT on early postoperative rehemorrhage and outcomes in ICH patients. METHODS: This was a multicenter cohort study. ICH patients undergoing surgery were divided into APT group and no antiplatelet therapy (nAPT) group according to whether patients received APT or not. Chi-square test, t-test, and Mann-Whitney U test were used to compare the differences in variables, postoperative rehematoma, and outcomes between groups. Multivariate logistics regression analysis was used to correct for confounding variables, which were different in group comparison. RESULTS: One hundred fifty ICH patients undergoing surgical treatment were consecutively included in this study. Thirty five (23.33%) people were included in the APT group, while 115 (76.67%) people were included in the nAPT group. The incidence of early postoperative rehemorrhage in the APT group was significantly higher than that in the nAPT group (25.7% VS 10.4%, p = 0.047 < 0.05). After adjustment for age, ischemic stroke history, and ventricular hematoma, preoperative APT had no significant effect on early postoperative rehemorrhage (p = 0.067). There was no statistical difference between the two groups in early poorer outcomes (p = 0.222) at 14 days after surgery. After adjustment for age, ischemic stroke history, and ventricular hematoma, preoperative APT also had no significant effect on early poorer modified Rankin Scale (mRS) (p = 0.072). CONCLUSION: In conclusion, preoperative APT appears to be safe and have no significant effect on early postoperative rehematoma and outcomes in ICH patients.

13.
Neurosurg Rev ; 44(6): 3557-3566, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33877464

RESUMEN

Spontaneous intracranial hematoma (ICH) is the second leading cause of stroke and has a high risk of postoperative ischemic events (PIEs). But, the evidence on PIEs in ICH patients still lacks. Therefore, a retrospective study was carried out to screen the risk factors for PIEs and construct a visual predictive model. This was a retrospective study whose population were divided into two groups based on the occurrence of PIEs. Univariate logistic regression analysis was used to determine factors associated with PIEs. Multifactorial logistic regression analysis was used to screen risk factors and construct the early PIEs risk nomogram. In addition, impact of PIEs on patient prognosis and surgery related costs was assessed. Out of 122 ICH patients, 24 (19.7%) were diagnosed with PIEs. Coronary heart disease history, ischemic stroke history, regular shaped hematoma and platelet number were identified as risk factors for early PIEs. Early PIEs risk nomogram showed good calibration and discrimination of the data with concordance index of 0.846 (95% confidence interval, 0.747-0.945) which was confirmed to be 0.827 through bootstrapping validation. In addition, there was statistical difference in discharged Glasgow Coma Scale score (P = 0.046) and surgery related costs (p = 0.031) between PIEs group and nPIEs group. These results showed the early PIEs risk nomogram was accurate for prediction risks of PIEs and the occurrence of PIEs affects prognosis of patients, and increases surgery related costs.


Asunto(s)
Hemorragia Cerebral , Nomogramas , Hematoma/epidemiología , Hematoma/etiología , Humanos , Pronóstico , Estudios Retrospectivos
14.
Neurol Sci ; 42(12): 5007-5019, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33725231

RESUMEN

OBJECTIVES: The stability of intracranial aneurysms (IAs) may involve in multidimensional factors. Backpropagation (BP) neural network could be adopted to support clinical work. This preliminary study aimed to delve into the feasibility of BP neural network in assessing the risk of IA rupture/growth and to prove the advantage of multidimensional model over single/double-dimensional model. METHODS: Thirty-six IA patients were recruited from a prospective registration study (ChiCTR1900024547). All patients were followed up until aneurysm ruptured/grew or 36 months after being diagnosed with the IAs. The multidimensional data regarding clinical, morphological, and hemodynamic characteristics were acquired. Hemodynamic analyses were conducted with patient-specific models. Based on these characteristics, seven models were built with BP neural network (the ratio of training set to validation set as 8:1). The area under curves (AUC) was calculated for subsequent comparison. RESULTS: Forty-five characteristics were determined from 36 patients with 37 IAs. In the models based on the single dimension of IA characteristics, only morphological characteristics exhibited high performance in assessing 3-year IA stability (AUC = 0.703, P = 0.035). Among the models integrating two dimensions of IA characteristics, clinical-morphological (AUC = 0.731, P = 0.016), clinical-hemodynamic (AUC = 0.702, P = 0.036), and morphological-hemodynamic (AUC = 0.785, P = 0.003) models were capable of assessing the risk of 3-year IA rupture/growth. Moreover, the models including all three dimensions exhibited the maximum predicting significance (AUC = 0.811, P = 0.001). CONCLUSION: The present preliminary study reported that BP neural network might support assessing the 3-year stability of IAs. Models based on multidimensional characteristics could improve the assessment accuracy for IA rupture/growth.


Asunto(s)
Aneurisma Roto , Aneurisma Intracraneal , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Redes Neurales de la Computación , Estudios Prospectivos , Estudios Retrospectivos
15.
CNS Neurosci Ther ; 27(6): 687-693, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33739605

RESUMEN

BACKGROUND: Pain empathy enables a person to experience and understand other's pain state by observing others in pain condition. Such prosocial ability is deficient in many psychopathological disorders. Somatosensory alpha suppression is considered as neural correlates of pain empathy and is hypothesized as a target for enhancement of pain empathy. Researches demonstrated that alpha suppression could be enhanced by transcranial alternating current stimulation (tACS) at alpha frequency non-invasively. AIMS: We applied alpha tACS over the primary somatosensory cortex of healthy subjects to investigate whether alpha tACS is able to enhance the pain empathy performance. RESULTS: The results showed that there was no difference of pain empathy performance between alpha tACS and sham tACS either when tACS was applied during the task or before task. While in the alpha tACS group, the pain empathy performance was positively correlated with empathic concern of male subjects, the sub-component of personal trait empathy. CONCLUSIONS: Alpha tACS cannot alter the empathy performance overall, but the modulation effect of alpha tACS on pain empathy is dependent on the gender and trait empathy of subjects.


Asunto(s)
Ritmo alfa , Empatía/fisiología , Potenciales Evocados Somatosensoriales/fisiología , Dolor/psicología , Estimulación Transcraneal de Corriente Directa , Adolescente , Adulto , Electroencefalografía , Femenino , Humanos , Masculino , Pruebas Neuropsicológicas , Caracteres Sexuales , Corteza Somatosensorial/fisiología , Adulto Joven
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