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1.
Cells ; 10(10)2021 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-34685493

RESUMO

Despite marked advances in surgical techniques and understanding of secondary brain injury mechanisms, the prognosis of intracerebral hemorrhage (ICH) remains devastating. Harnessing and promoting the regenerative potential of the central nervous system may improve the outcomes of patients with hemorrhagic stroke, but approaches are still in their infancy. In this review, we discuss the regenerative phenomena occurring in animal models and human ICH, provide results related to cellular and molecular mechanisms of the repair process including by microglia, and review potential methods to promote tissue regeneration in ICH. We aim to stimulate research involving tissue restoration after ICH.

2.
Neurosci Lett ; 764: 136297, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34666120

RESUMO

Intracerebral hemorrhage (ICH) is a severe neurological dysfunction and a medical emergency with a high mortality rate. Minocycline ameliorates deficits in rodent models of acute and chronic neurological diseases. However, the role of minocycline in ICH remains unclear. The extracellular matrix metalloproteinase inducer (EMMPRIN) is a key inflammatory mediator in some neurological diseases, triggering matrix metalloproteinases (MMPs) production. In this study, we aimed to use minocycline to inhibit EMMPRIN and thus the activity of MMPs. Male adult C57BL/6 mice were injected with collagenase type VII or saline into the right basal ganglia and euthanized at different time points. The minocycline was intraperitoneally injected once every 12 h for three days to block the expression of EMMPRIN from two hours after ICH. We found that breakdown of the BBB was most severe 3 days after ICH. The minocycline treatment significantly decreased EMMPRIN and MMP-9 expression, reduced zonula occludens-1 and occludin, and alleviated BBB disruption. Moreover, minocycline treatment displayed a lower brain water content, lesser neurological dysfunction, and smaller injury volume on day 3 than those of the vehicle-treated group. Minocycline also inhibited the activation of microglia/macrophages, infiltration of neutrophils, and production of inflammatory mediators, including tumor necrosis factor alpha and interleukin-1beta. The current study shows that minocycline exhibits protective roles in ICH by decreasing EMMPRIN and MMP-9 expression, alleviating BBB disruption, inhibiting neuroinflammation, areducing neuronal degeneration and death.

3.
Front Neurol ; 12: 727962, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34566872

RESUMO

Primary brainstem hemorrhage (PBSH) is the most fatal subtype of intracerebral hemorrhage and is invariably associated with poor prognosis. Several prognostic factors are involved, of which the two most predominant and consistent are the initial level of consciousness and hemorrhage size. Other predictors, such as age, hyperthermia, and hydrocephalus, are generally not dependable indicators for making prognoses. Scoring systems have now been developed that can predict mortality and functional outcomes in patients suffering from PBSH, which can thus guide treatment decision-making. A novel grading scale, entitled "the new primary pontine hemorrhage (PPH) score," represents the latest approach in scoring systems. In this system, patients with a score of 2-3 points appear to benefit from surgical management, although this claim requires further verification. The four main surgical options for the treatment of PBSH are craniotomy, stereotactic hematoma puncture and drainage, endoscopic hematoma removal, and external ventricular drainage. Nevertheless, the management of PBSH still primarily involves conservative treatment methods and surgery is generally not recommended, according to current practice. However, the ongoing clinical trial, entitled Safety and Efficacy of Surgical Treatment in Severe Primary Pontine Hemorrhage Evacuation (STIPE), should provide additional evidence to support the surgical treatment of PBSH. Therefore, we advocate the update of epidemiological data and re-evaluation of PBSH treatment in a contemporary context.

4.
Aging (Albany NY) ; 13(18): 21810-21811, 2021 09 28.
Artigo em Inglês | MEDLINE | ID: mdl-34586082
5.
Neurol Res ; : 1-8, 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34112057

RESUMO

Objectives: This article aimed to analyze the relationship between obesity and the efficacy of acute ischaemic stroke patients treated with IVT.Background: Stroke causes morbidity and mortality in large numbers of individuals annually. Intravenous thrombolysis (IVT)with recombinant tissue plasminogen activator (r-tPA) is currently the only approved by the FDA for treatment of acute ischaemic stroke. Researchers have focused on studying the mechanisms associated with ischaemic stroke. Obesity is an established vascular risk factor with increasing prevalence and a huge impact on public health worldwide. It is an independent predictor for ischaemic stroke with a 4% risk increase for each unit augmentation in body mass index (BMI). Therefore, obese patients will constitute an increasing subgroup of candidates for IVT. However, its impact on prognosis in acute ischaemic stroke patients with intravenous thrombolysis did not reach a consensus conclusion.Methods: Systematic literature search of PUBMED databases published before August 2020, was performed to identify studies addressing the role of obesity in acute ischaemic stroke patients treated with IVT. Studies included randomized clinical trials, observational studies, guideline statements, and review articles.Conclusions: Obesity may be related to long-term prognosis of large group of AIS patients treated with IVT. It depends on the scale of clinical study samples, follow-up time, and evaluation criteria.

6.
Neurol Res ; 43(10): 854-864, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34107863

RESUMO

Objectives: Intracerebral hemorrhage (ICH) is a devastating type of strokes that carries high mortality rates, but effective therapeutic options are still lacking. Here, the adult rat model of ICH was used to investigate the efficacy of a combinational therapy of deferoxamine (DFX) and minocycline.Methods: The ICH was induced by stereotaxic infusion of collagenase into striatum of adult rats. After the induction of ICH, rats were treated with intraperitoneal injection of deferoxamine (50 mg/kg), minocycline (45 mg/kg), or both agents, at 2 hours after ICH and then every 12 hours for up to 3 days. The vehicle group were treated with phosphate-buffered saline (PBS) only. Rats were killed at 1, 2, and 3 day(s) for examination of iron deposition, neuronal death, neurological deficits, the area of brain damage, activation of microglia/macrophages.Results: Our data revealed that the systemic administration of DFX and/or minocycline decreased iron accumulation. And immunofluorescence staining results indicated that drug-treated group significantly decreased the neuronal degeneration, the number of activated microglia/macrophages and the amount of cell death after ICH. In addition, neurological deficits caused by ICH were improved in the presence of DFX and/or minocycline compare with vehicle group. Furthermore, the combination treatment showed better effects in neuroprotection and anti-inflammation when compared to the monotherapy groups.Conclusions: The combination therapy significantly reduces the number of neuronal deaths, suppresses of the activation of microglia/macrophages, decreases iron accumulation in the area around the hematoma, lessening the brain damage area, and improving neurological deficits in ICH.

7.
Front Bioeng Biotechnol ; 9: 616555, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34026739

RESUMO

Bone serves to maintain the shape of the human body due to its hard and solid nature. A loss or weakening of bone tissues, such as in case of traumatic injury, diseases (e.g., osteosarcoma), or old age, adversely affects the individuals quality of life. Although bone has the innate ability to remodel and regenerate in case of small damage or a crack, a loss of a large volume of bone in case of a traumatic injury requires the restoration of bone function by adopting different biophysical approaches and chemotherapies as well as a surgical reconstruction. Compared to the biophysical and chemotherapeutic approaches, which may cause complications and bear side effects, the surgical reconstruction involves the implantation of external materials such as ceramics, metals, and different other materials as bone substitutes. Compared to the synthetic substitutes, the use of biomaterials could be an ideal choice for bone regeneration owing to their renewability, non-toxicity, and non-immunogenicity. Among the different types of biomaterials, nanocellulose-based materials are receiving tremendous attention in the medical field during recent years, which are used for scaffolding as well as regeneration. Nanocellulose not only serves as the matrix for the deposition of bioceramics, metallic nanoparticles, polymers, and different other materials to develop bone substitutes but also serves as the drug carrier for treating osteosarcomas. This review describes the natural sources and production of nanocellulose and discusses its important properties to justify its suitability in developing scaffolds for bone and cartilage regeneration and serve as the matrix for reinforcement of different materials and as a drug carrier for treating osteosarcomas. It discusses the potential health risks, immunogenicity, and biodegradation of nanocellulose in the human body.

8.
Saudi J Biol Sci ; 28(5): 3137-3151, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33642896

RESUMO

Coronavirus disease (COVID-19) is an infection of the respiratory system caused by single standard RNA viruses named as Severe Acute Respiratory Syndrome 2 (SARS-CoV-2). The disease appeared as a serious problem and the leading cause of death in human beings throughout the world. The main source of different phytochemicals are plants, which helps in the development of new drugs against various ailments. Islam is comprehensive religion and a complete code of life for Muslims. The teaching of Islam, according to the Holy Quran and Hadith are universal for the benefit of humanity. Islam believes that every ailment is from God and who made the disease definitely made its medication. There is a complete guideline with regard to taking measures against infectious diseases such as quarantine and seeking medicinal treatment. The research objective is to gather the knowledge of medicinal plants described in the Holy Quran or utilized by the Prophet (SAW) for the treatment of different ailments or advised to use them to boost immunity and strengthen the body. Scientists across the globe have found these plants beneficial for many diseases and have antiviral potential. In present study, the six plant species including Olea europaea, Nigella sativa, Allium Sativum, Allium cepa, Zingiber officinale and Cassia senna were selected which contain phytochemicals like Calcium Elenolate, Thymoquinone, S-Allylcysteine, Dipropyl Disulfide, Sesquiterpene, Monoterpene, Pelargonidin 3-Galactoside ion and Kaempferol. The phytochemicals monoterpene (from Zingiber officinale) shows best interaction with target proteins RdRP, 3CLPro, ACE2. Calcium Elonate (from olive) bonds with 3CLPro, ACE2 and Kemoferol and Pelargomidine (from Senna Makki) bonds with RdRP, ACE2. The ligands show a unique set of intersections i.e. hydrogen bonding, and alkyl interaction. These medicinal plants can be utilized immediately for the treatment of COVID-19 as their safety is already established. This treatment can enhance recovery when combined with other treatments. Furthermore, the screening of bioactive compounds or phytochemicals found in these plants can be utilized to design new therapeutic drug to treat COVID-19 pandemic.

9.
J Mater Chem B ; 9(8): 1965-1979, 2021 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-33595050

RESUMO

Hollow iron oxide nanoparticles (NPs) are an attractive class of hollow nanostructures that have received significant attention in the biomedical field due to their low toxicity, good biocompatibility, and intrinsic magnetic nature. We review the recent advances in the preparation, surface functionalization, and biomedical applications of hollow iron oxide NPs. Hollow iron oxide NPs are generally synthesized by the following five strategies, including the Kirkendall effect, galvanic replacement, chemical etching, nano template-mediated, and hydrothermal/solvothermal routes. We also summarize the general strategies for iron oxide NP surface functionalization. Moreover, various promising biomedical applications of hollow iron oxide NPs, including magnetic resonance imaging, drug delivery, and cancer therapy, are highlighted in detail. Finally, perspectives of hollow iron oxide NPs are provided.


Assuntos
Materiais Biocompatíveis/química , Compostos Férricos/química , Nanopartículas , Animais , Materiais Biocompatíveis/farmacologia , Compostos Férricos/farmacologia , Humanos
10.
Carcinogenesis ; 42(6): 864-873, 2021 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-33608694

RESUMO

Biological rhythms regulate physiological activities. Shiftwork disrupts normal circadian rhythms and may increase the risk of cancer through unknown mechanisms. To mimic environmental light/dark changes encountered by shift workers, a protocol called 'chronic jet lag (CJL)' induced by repeatedly shifting light-dark cycles has been used. Here, we subjected mice to CJL by advancing light-dark cycle by 6 h every 2 days, and conducted RNA sequencing to analyze the expression profile and molecular signature in the brain areas of prefrontal cortex and nucleus accumbens. We also performed positron emission tomography (PET) imaging to monitor changes related to glucose metabolism in brain. Our results reveal systematic reprogramming of gene expression associated with cancer-related pathways and metabolic pathways in prefrontal cortex and nucleus accumbens. PET imaging indicates that glucose uptake level was significantly reduced in whole brain as well as the individual brain regions. Moreover, qPCR analysis describes that the expression levels of cancer-related genes were altered in prefrontal cortex and nucleus accumbens. Overall, these results suggest a molecular and metabolic link with CJL-mediated cancer risk, and generate hypotheses on how CJL increases the susceptibility to cancer.


Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias Encefálicas/patologia , Regulação Neoplásica da Expressão Gênica , Síndrome do Jet Lag/complicações , Núcleo Accumbens/patologia , Fotoperíodo , Córtex Pré-Frontal/patologia , Animais , Biomarcadores Tumorais/genética , Neoplasias Encefálicas/etiologia , Neoplasias Encefálicas/metabolismo , Doença Crônica , Modelos Animais de Doenças , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Núcleo Accumbens/metabolismo , Córtex Pré-Frontal/metabolismo , RNA-Seq
11.
Hum Vaccin Immunother ; 17(4): 1113-1121, 2021 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-33064630

RESUMO

A novel coronavirus (2019-nCov) emerged in China, at the end of December 2019 which posed an International Public Health Emergency, and later declared as a global pandemic by the World Health Organization (WHO). The International Committee on Taxonomy of Viruses (ICTV) named it SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2), while the disease was named COVID-19 (Coronavirus Disease- 2019). Many questions related to the exact mode of transmission, animal origins, and antiviral therapeutics are not clear yet. Nevertheless, it is required to urgently launch a new protocol to evaluate the side effects of unapproved vaccines and antiviral therapeutics to accelerate the clinical application of new drugs. In this review, we highlight the most salient characteristics and recent findings of COVID-19 disease, molecular virology, interspecies mechanisms, and health consequences related to this disease.


Assuntos
Antivirais/farmacologia , Vacinas contra COVID-19/imunologia , COVID-19/patologia , COVID-19/transmissão , Inibidores de Protease de Coronavírus/farmacologia , Monofosfato de Adenosina/análogos & derivados , Monofosfato de Adenosina/farmacologia , Alanina/análogos & derivados , Alanina/farmacologia , Animais , Antivirais/efeitos adversos , COVID-19/tratamento farmacológico , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Quirópteros/virologia , Humanos , Lopinavir/farmacologia , Ritonavir/farmacologia , SARS-CoV-2/efeitos dos fármacos , Ligação Viral , Internalização do Vírus
12.
Talanta ; 223(Pt 1): 121704, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33303154

RESUMO

The rapid outbreak of coronavirus disease 2019 (COVID-19) around the world is a tragic and shocking event that demonstrates the unpreparedness of humans to develop quick diagnostic platforms for novel infectious diseases. In fact, statistical reports of diagnostic tools show that their accuracy, specificity and sensitivity in the detection of COVID hampered by some challenges that can be eliminated by using nanoparticles (NPs). In this study, we aimed to present an overview on the most important ways to diagnose different kinds of viruses followed by the introduction of nanobiosensors. Afterward, some methods of COVID-19 detection such as imaging, laboratory and kit-based diagnostic tests are surveyed. Furthermore, nucleic acids/protein- and immunoglobulin (Ig)-based nanobiosensors for the COVID-19 detection infection are reviewed. Finally, current challenges and future perspective for the development of diagnostic or monitoring technologies in the control of COVID-19 are discussed to persuade the scientists in advancing their technologies beyond imagination. In conclusion, it can be deduced that as rapid COVID-19 detection infection can play a vital role in disease control and treatment, this review may be of great help for controlling the COVID-19 outbreak by providing some necessary information for the development of portable, accurate, selectable and simple nanobiosensors.


Assuntos
Técnicas Biossensoriais , COVID-19/diagnóstico , Nanotecnologia , Humanos , Kit de Reagentes para Diagnóstico , Sensibilidade e Especificidade
13.
Brain Behav ; 11(2): e01901, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33314732

RESUMO

BACKGROUND: Anxiety and stress like mental illnesses are the common outcomes of viral epidemics and pandemics. Novel coronavirus disease 2019 (COVID-19) outbreak caused by the severe acute respiratory syndrome coronavirus virus 2 (SARS-CoV-2) was first reported in Wuhan, China, and then spread all over the world in a short time. OBJECTIVES: To highlight and discuss the impact of COVID-19 pandemic on mental or psychological health. METHOD: Literature search and collection of the information were performed using PubMed, the reports from the World health organization, and the Center for disease control and prevention. RESULTS: COVID-19 infection has already been declared as a global pandemic, which in association with infodemic has increased the risk of psychiatric/psychological disorders. A large population of the world is prone to develop anxiety, depressive disorders, and other mental abnormalities. Therefore, timely psychological interventions and preventive strategies are required. Moreover, the infection has been reported to be linked with cerebrovascular conditions; therefore, patients with underlying cerebrovascular diseases should be given attention. CONCLUSION: COVID-19-mediated mental health complications and cerebrovascular conditions may cause a huge burden on healthcare communities in the future. Therefore, timely intervention and the development or application of preventive strategies are required to decrease the risk of neurological consequences.


Assuntos
Infecções por Coronavirus , Transtornos Mentais , COVID-19 , Surtos de Doenças , Humanos , Transtornos Mentais/epidemiologia , Saúde Mental , SARS-CoV-2
14.
Stroke Vasc Neurol ; 5(4): 388-395, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33376200

RESUMO

Spontaneous intracerebral haemorrhage (ICH) is a devastating type of stroke with high mortality and morbidity and for which no effective treatments are available to date. Much experimental and clinical research have been performed to explore its mechanisms regard the subsequent inflammatory cascade and to seek the potential therapeutic strategies. The aim of this review is to discuss insights from clinical settings that have led to the development of numerous animal models of ICH. Some of the current and future challenges for clinicians to understand ICH are also surveyed.


Assuntos
Hemorragia Cerebral , AVC Hemorrágico , Animais , Hemorragia Cerebral/etiologia , Hemorragia Cerebral/patologia , Hemorragia Cerebral/fisiopatologia , Hemorragia Cerebral/terapia , Modelos Animais de Doenças , Progressão da Doença , AVC Hemorrágico/etiologia , AVC Hemorrágico/patologia , AVC Hemorrágico/fisiopatologia , AVC Hemorrágico/terapia , Humanos , Prognóstico
15.
Lancet Neurol ; 19(12): 1023-1032, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33212054

RESUMO

Intracerebral haemorrhage is inadequately controlled by current treatments, requiring new solutions to improve the prognosis. Following the primary injury, a proinflammatory cascade in the perihaematomal region, composed of activated resident microglia and astrocytes and infiltrated leucocytes, propagates neural cell death. The protracted nature of neuroinflammation in intracerebral haemorrhage provides a window of opportunity for therapies to subdue the undesired consequences. In animal models and early clinical trials in intracerebral haemorrhage, several drugs have reduced detrimental neuroinflammation without substantial compromise of the beneficial reparative aspects of an inflammatory response. Potential strategies include controlling excessive harmful neuroinflammation with minocycline, sphingosine-1-phosphate receptor modulators, and statins after a brain haemorrhage. The quick initiation of these drugs, particularly in high systemic doses, could be key to counteracting the evolving secondary injury in people with intracerebral haemorrhage and provides a promising way in which the poor prognosis of intracerebral haemorrhage might one day be counteracted.


Assuntos
Anti-Infecciosos/farmacologia , Hemorragia Cerebral/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Imunoterapia , Inflamação/tratamento farmacológico , Minociclina/farmacologia , Moduladores do Receptor de Esfingosina 1 Fosfato/farmacologia , Animais , Hemorragia Cerebral/complicações , Hemorragia Cerebral/imunologia , Humanos , Inflamação/etiologia , Inflamação/imunologia , Pesquisa Médica Translacional
17.
J Infect Public Health ; 13(12): 1840-1844, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32741731

RESUMO

Coronavirus disease-2019 (COVID-19) pandemic started from Wuhan, China has infected more than 6.7 million individuals and killed more than 390,000 individuals globally. Due to the higher transmissibility and infectiousness, asymptomatic infection, and lack of effective treatment options and vaccine, fatalities and morbidities are increasing day by day globally. Despite physical health consequences, COVID-19 pandemic has created stress and anxiety, as result there is an increased risk of mental illnesses both in the infected and normal individuals. To eradicate these risks, it is necessary to determine the COVID-19 zoonotic source of transmission to humans and clinical manifestations in infected individuals. Although, identification or development of the highly effective therapeutic agents is necessary, however, development of protective strategies against the COVID-19 by enhancing immune responses will be an asset in the current scenarios of the COVID-19 pandemic. In this paper, we discuss the transmission, health consequences, and potential management (therapeutic and preventive) options for COVID-19 disease.


Assuntos
COVID-19/prevenção & controle , Transtornos Mentais , SARS-CoV-2 , COVID-19/etiologia , COVID-19/psicologia , Humanos
19.
Front Med (Lausanne) ; 7: 310, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32582747

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is rapidly spreading across the world to cause thousands of mortalities each day. Poor responses from the authorities to the spread of infection, lack of effective measures for prevention, unavailability of promising treatment options, and sufficient diagnostic options have created an alarming for the world. The transmission routes from human to human of SARS-CoV-2 can be the direct transmission, droplet inhalation transmission, contact transmission, transmission through saliva, and transmission via fecal-oral routes. Due to the asymptomatic spread of SARS-CoV-2's, developing control and prevention measures is challenging. Implementing proper strategies addressing the infection control and clinical supplies, understanding the mechanism associated with pathogenesis, advancing in preventive measures and effective treatment and diagnostic options are necessary to control the ongoing pandemic. In this article, we briefly discuss the features, entry mechanism, infectiousness, and health consequences related to the COVID-19 outbreak.

20.
Arch Gerontol Geriatr ; 89: 104104, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32460124

RESUMO

BACKGROUND: In the present study, we assessed the relationship between serum alkaline phosphatase (ALP) levels and cognitive function changes in acute ischaemic stroke patients. METHODS: We retrospectively collected the demographic data and clinical information from the medical records of patients after the onset of ischaemic stroke. We used the Chinese version of the Mini-Mental State Examination to assess cognitive function. Mixed linear and logistic regression models adjusted for several factors were used to explore the relationship between ALP and cognitive impairment. RESULTS: A total of 1019 patients were included in the analysis, including 523 poststroke patients with cognitive impairment (PSCI) and 496 patients with non-PSCI. The incidence of poststroke cognitive impairment was 51.3 %. The serum ALP level in the PSCI group was significantly higher than that in the non-PSCI group (86.5 ± 18.9 U/L vs 68.6 ± 15.5 U/L, P < 0.001). The mixed linear model fully adjusted for all variables indicated that the ALP level was positively associated with cognitive impairment (based on the Mini-mental State Examination score) decline, with changes from -0.54 to -0.16 per unit increase in ALP. The logistic regression revealed that the odds of cognitive impairment increased by 42 % when the ALP concentration increased by one U/L (odds ratio (OR) = 1.42, 95 %CI: 1.17-3.09, P = 0.012). The spline regression model further confirmed the dose-response relationships between ALP levels and three-month cognitive impairment (P for nonlinear trend = 0.012). CONCLUSION: The present study revealed that relatively high serum ALP levels at baseline might be an independent risk factor for cognitive impairment in patients with acute ischaemic stroke.


Assuntos
Fosfatase Alcalina , Isquemia Encefálica , Disfunção Cognitiva , Acidente Vascular Cerebral , Fosfatase Alcalina/sangue , Isquemia Encefálica/complicações , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/etiologia , Humanos , Estudos Retrospectivos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/epidemiologia
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