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Добірка наукової літератури з теми "Ischemia Etiology"

Автор: Grafiati

Опубліковано: 4 червня 2021

Оновлено: 29 січня 2023

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Статті в журналах з теми "Ischemia Etiology"

Natarajan, Balaji, Prashant Patel, and Ashis Mukherjee. "Acute Lower Limb Ischemia—Etiology, Pathology, and Management." International Journal of Angiology 29, no. 03 (June 27, 2020): 168–74. http://dx.doi.org/10.1055/s-0040-1713769.

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AbstractAcute limb ischemia (ALI) is a vascular emergency associated with a high risk for limb loss and death. Most cases result from in situ thrombosis in patients with preexisting peripheral arterial disease or those who have undergone vascular procedures including stenting and bypass grafts. The other common source is cardioembolic. The incidence has decreased in recent times due to better anticoagulation strategies. Patients with suspected ALI should be evaluated promptly by a vascular specialist and consideration should be given for transfer to a higher level of care if such expertise is not available locally. Initial assessment should focus on staging severity of ischemic injury and potential for limb salvage. Neurological deficits can occur early and are an important poor prognostic sign. Duplex ultrasound and computed tomography angiography help plan intervention in patients with a still-viable limb and prompt catheter-based angiography is mandated in patients with an immediately threatened limb. Further investigations need to be pursued to differentiate embolic from thrombotic cause for acute occlusion as this can change management. Options include intravascular interventions, surgical bypass, or a hybrid approach. In this article, the authors discuss the common etiologies, clinical evaluation, and management of patients presenting with acute limb ischemia.

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Calugaru, Dan. "Etiology, pathogenesis, and diagnosis of neovascular glaucoma." International Journal of Ophthalmology 15, no. 6 (June 18, 2022): 1005–10. http://dx.doi.org/10.18240/ijo.2022.06.20.

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Neovascular glaucoma is defined as iris and/or anterior chamber angle neovascularization associated with increased intraocular pressure. It is a secondary glaucoma that is most frequently caused by severe retinal ischemia. The most common diseases responsible for the development of neovascular glaucoma are diabetic retinopathy, ischemic central retinal vein occlusion, and ocular ischemic syndrome. Uncommon causes include ocular radiation, ocular tumors, uveitis and other miscellaneous conditions. Vascular endothelial growth factor is an important and likely predominant agent involved in the pathogenesis of intraocular neovascularization and neovascular glaucoma. The evolution of clinical and histopathological changes from predisposing conditions to the occurrence of rubeosis iridis and neovascular glaucoma is divided into four stages: prerubeosis, preglaucoma, open angle glaucoma, and angle-closure glaucoma.

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Charron, Paul, and Jeff Smith. "Mesenteric Venulitis in a 71-Year-Old Man after Acute Appendicitis." American Surgeon 71, no. 7 (July 2005): 574–77. http://dx.doi.org/10.1177/000313480507100707.

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Mesenteric inflammatory veno-occlusive disease (MIVOD) is a clinicopathological entity recently described for a case series of patients with intestinal ischemia of unknown etiology. MIVOD is characterized as a venulitis with lymphocytic, necrotizing, or mixed granulomatous morphology. The disease seems to be self-limiting with resolution of symptoms after surgical resection. We describe a 71-year-old man who developed focal intestinal ischemia in the postoperative period after laparoscopic appendectomy. At re-exploration, a 20-cm segment of grossly ischemic jejunum was identified and resected. The excised specimen demonstrated early ischemic mucosal injury and necrotizing mesenteric venulitis with thrombosis, consistent with verso-occlusive disease. The etiology of this rare vasculitis is currently unknown. We present our case report, which is followed by a review of the literature of MIVOD.

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Gherman, Robert B., Marc H. Incerpi, Deborah A. Wing, and T. Murphy Goodwin. "Ballantyne syndrome: Is placental ischemia the etiology?" Journal of Maternal-Fetal and Neonatal Medicine 7, no. 5 (January 1998): 227–29. http://dx.doi.org/10.3109/14767059809020448.

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Dobrilovic, Nick, Bryan J. Ellis, and Creighton B. Wright. "Vasculitis as an etiology for mesenteric ischemia." American Journal of Gastroenterology 95, no. 9 (September 2000): 2570. http://dx.doi.org/10.1111/j.1572-0241.2000.02907.x.

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Pineles, S. L., M. Y. Chang, E. L. Oltra, M. S. Pihlblad, J. P. Davila-Gonzalez, T. C. Sauer, and F. G. Velez. "Anterior segment ischemia: etiology, assessment, and management." Eye 32, no. 2 (November 17, 2017): 173–78. http://dx.doi.org/10.1038/eye.2017.248.

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Earnshaw, Jonothan J. "Demography and etiology of acute leg ischemia." Seminars in Vascular Surgery 14, no. 2 (June 2001): 86–92. http://dx.doi.org/10.1053/svas.2001.23158.

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Dyck, P. J., H. Yasuda, J. Karnes, A. Lais, P. OʼBrien, and E. J. Service. "ISCHEMIA IN THE ETIOLOGY OF DIABETIC POLYNEUROPATHY." Journal of Neuropathology and Experimental Neurology 44, no. 3 (May 1985): 346. http://dx.doi.org/10.1097/00005072-198505000-00127.

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Gherman, Robert B., Marc H. Incerpi, Deborah A. Wing, and T. Murphy Goodwin. "Ballantyne syndrome: Is placental ischemia the etiology?" Journal of Maternal-Fetal Medicine 7, no. 5 (September 1998): 227–29. http://dx.doi.org/10.1002/(sici)1520-6661(199809/10)7:5<227::aid-mfm3>3.0.co;2-i.

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Rink, Cameron, and Savita Khanna. "MicroRNA in ischemic stroke etiology and pathology." Physiological Genomics 43, no. 10 (May 2011): 521–28. http://dx.doi.org/10.1152/physiolgenomics.00158.2010.

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Small, noncoding, microRNAs (miRNAs) have emerged as key mediators of posttranscriptional gene silencing in both pathogenic and pathological aspects of ischemic stroke biology. In stroke etiology, miRNA have distinct expression patterns that modulate pathogenic processes including atherosclerosis (miR-21, miR-126), hyperlipidemia (miR-33, miR-125a-5p), hypertension (miR-155), and plaque rupture (miR-222, miR-210). Following focal cerebral ischemia, significant changes in the miRNA transcriptome, independent of an effect on expression of miRNA machinery, implicate miRNA in the pathological cascade of events that include blood brain barrier disruption (miR-15a) and caspase mediated cell death signaling (miR-497). Early activation of miR-200 family members improves neural cell survival via prolyl hydroxylase mRNA silencing and subsequent HIF-1α stabilization. Pro- (miR-125b) and anti-inflammatory (miR-26a, -34a, -145, and let-7b) miRNA may also be manipulated to positively influence stroke outcomes. Recent examples of successfully implemented miRNA-therapeutics direct the future of gene therapy and offer new therapeutic strategies by regulating large sets of genes in related pathways of the ischemic stroke cascade.

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Дисертації з теми "Ischemia Etiology"

Ehrensperger, Eric 1966. "Predictors of cerebral ischemic events in patients with asymptomatic carotid artery stenosis : systematic review." Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=111568.

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Background. Carotid stenosis is an important cause of stroke. Carotid endarterectomy is a means of reducing the burden of stroke but is of marginal benefit in individuals with asymptomatic carotid stenosis. The identification of factors associated with increased risk of cerebral ischemic events would help select individuals who may obtain a greater benefit.
Methods. A comprehensive search was performed to identify studies examining risk factors for cerebral ischemic events in patients with asymptomatic carotid stenosis. Inclusion criteria were defined a priori. Relevant studies were reviewed, assessed for quality, and data were extracted.
Results. Thirty-four studies met the inclusion criteria. There was a suggestion of increasing neurological events with increasing severity and progression of carotid stenosis. There was some evidence for an association with carotid plaque morphology. No consistent association was found with clinical factors, impaired cerebral vasoreactivity, or cerebral embolic signals.
Conclusions. The evidence is insufficient to reliably identify individuals with asymptomatic carotid stenosis who are at a higher risk of cerebral ischemic events.

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DUSSART, LAURENT. "Interet de l'etude de la vulnerabilite auriculaire dans les accidents vasculaeires cerebraux ischemiques sans etiologie apparente." Lille 2, 1992. http://www.theses.fr/1992LIL2M296.

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SKONIECZNY, MICHEL. "Apport respectif de l'echocardiographie transthoracique et transoesophagienne chez les patients ayant presente un accident ischemique cerebral inexplique par une etiologie carotidienne : a propos de 100 cas." Amiens, 1990. http://www.theses.fr/1990AMIEM058.

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Hailer, Yasmin D. "Legg-Calvé-Perthes Disease – Is it just the hip? : Epidemiological, Clinical and Psychosocial Studies with special focus on Etiology." Doctoral thesis, Uppsala universitet, Ortopedi, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-219158.

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The overall aim of the thesis was to add some pieces to the etiological puzzle of LCPD with special focus on vascular origin and hyperactivity. Furthermore we wanted to evaluate some consequences of LCPD in adulthood. Swedish registry data were used to identify a cohort of patients with the diagnosis of LCPD. This cohort was compared with a general population– based cohort without LCPD to assess the relative risk of cardiovascular diseases, blood or coagulation defects, injury, ADHD, depression and mortality. In a clinical study we assessed health-related quality of life (EQ-5D-3L), physical activity level (IPAQ) and screened for ADHD (ASRSv1.1) in 116 patients with a history of LCPD who were diagnosed or treated in Uppsala University Hospital between 1978 and 1995. The results confirmed our hypothesis: Patients with a history of LCPD had a 1.7-fold higher risk of cardiovascular diseases, and a 1.4-fold higher risk for blood or coagulation defects compared with gender- and age-matched individuals without LCPD. We found a 1.2-fold higher risk for injuries requiring hospital admission than in gender- and age-matched individuals without LCPD. The risk was more pronounced among females. Furthermore, we found a 1.5-fold higher risk for ADHD. Stratified analysis revealed a 2.1-fold higher risk for ADHD among females with LCPD than among females without LCPD. The risk for depression was 1.3-fold higher, and more pronounced among females with LCPD. Patients with LCPD had a slightly higher mortality risk with higher risk for death from suicide and cardiovascular causes. Patients with a history of LCPD reported a lower health-related quality of life and were more physically active than the Swedish population norm. 28% of 116 patients were likely to have ADHD or had already been diagnosed with ADHD. Both vascular and blood diseases could be present even in childhood and could, in combination with hyperactive behavior pattern and a high physical activity level, contribute to the etiology of LCPD. The lower health-related quality of life and higher risk for depression might reflect the mental burden of LCPD. Patients with LCPD have a higher mortality risk with higher risk for death from suicide and cardiovascular causes.

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Duncan, Henry J. (Henry John). "An isotope washout technique to study skin perfusion pressure and vascular resistance in diabetes, hypertension and peripheral vascular disease." 1986. http://web4.library.adelaide.edu.au/theses/09MD/09mdd911.pdf.

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Duncan, Henry J. (Henry John). "An isotope washout technique to study skin perfusion pressure and vascular resistance in diabetes, hypertension and peripheral vascular disease / by Henry J. Duncan." Thesis, 1986. http://hdl.handle.net/2440/38294.

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Pimentel, Bernardo Crespo. "Diagnostic workup and etiologic diagnosis of ischemic stroke in young adults : a retrospective two-center comparison." Master's thesis, 2017. http://hdl.handle.net/10451/30906.

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Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017
INTRODUCTION: Ischemic stroke in young adults is a disastrous event that causes death and disability. Cryptogenic stroke is much more common in young adults than in older patients. Strategies for diagnostic assessment vary widely: a comprehensive approach requires a fullevaluation of patients, a staged workup emphasizes local prevalence of potential causes and a selective approach is based on clinical hints. OBJECTIVES: This study aims to compare the etiology and workup strategy of ischemic stroke in young adults between stroke units of two tertiary hospitals in Europe. It investigates the influence of workup variations in etiological classification, ultimately aiming to identify the most effective diagnostic approach. METHODS: This retrospective study enrolled patients aged 18 to 55 years admitted for ischemic stroke or TIA to the stroke units of Santa Maria Hospital in Lisbon, Portugal, and Innsbruck State Hospital in Innsbruck, Austria, between 2014 and 2016. Etiology and diagnostic procedures were compared between centers using independent Student t-test and Pearson’s chi-squared test. RESULTS: A total of 156 patients from Innsbruck State Hospital and 110 patients from Santa Maria Hospital were enrolled. No differences in stroke etiology were found. CT scan was more performed in Lisbon, whereas in Innsbruck CT/MR angiography for extra- and intracranial vessel evaluation was preferred. Transcranial Doppler with and without contrast and TTE were more common in Lisbon, while TEE was more frequently performed in Innsbruck. Thrombophilia and autoimmune disorders were more often screened in Lisbon and ophthalmologic and dermatologic evaluation were more frequent in Innsbruck. CONCLUSION: The small variations found in the diagnostic workup between centers did not influence etiology diagnosis and may suggest that use of CT/MRI angiography is not advantageous over less costly tests for vessel imaging. Likewise, extensive laboratory testing doesn’t seem to influence diagnosis of other determined cause stroke, thereby emphasizing the importance of a selective diagnostic approach.
INTRODUÇÃO: O AVC isquémico nos adultos jovens é um evento catastrófico que pode causar morte e incapacidade duradoura. O principal desafio clínico é a identificação da sua etiologia. O AVC criptogénico é muito mais frequente no adulto jovem do que em doentes mais velhos, sendo a principal causa de AVC neste grupo etário o cardioembolismo e a disseção arterial. Em doentes com AVC considerado criptogénico, as causas mais frequentemente encontradas após investigação mais especializada incluem aterosclerose oculta, arteriopatias não ateroscleróticas como disseção e vasculite, e cardioembolism de várias fontes como FA (fibrilação auricular) paroxística, miocardiopatia dilatada e embolismo paradoxal. O sistema de classificação TOAST (Trial of Org 10172 for Acute Stroke Treatment) prevê a sistematização das etiologias do AVC em 5 categorias: doença dos grandes vasos, doença dos pequenos vasos, cardioembolisno, outra causa identificada e causa não identificada (AVC criptogénico). Um AVC isquémico criptogénico é definido como um enfarte cerebral sintomático para o qual não é identificada uma causa evidente ou provável ou mais do que uma causa provável é identificada após investigação. Dependendo dos recursos locais, as estratégias de investigação diagnóstica variam consideravelmente: uma abordagem extensiva requer uma avaliação completa e detalhada do doente; uma abordagem por etapas guia a investigação baseando-se na prevalência local de causas potenciais e uma abordagem seletiva baseia-se em suspeitas clínicas. Desconhece-se ainda como diferentes abordagens diagnósticas alteram a proporção de doentes classificados com uma causa identificável ou indeterminada de AVC. OBJETIVOS: Este estudo tem como objetivo comparar a etiologia e estratégias de diagnóstico do AVC em adultos jovens admitidos às unidades de AVC de dois hospitais terciários na Europa. Tomando em conta a investigação diagnóstica efetuada em ambos os centros, este estudo procura uma possível influência de variações na investigação diagnóstica na classificação etiológica dos doentes, com o objetivo principal de identificar a abordagem diagnóstica mais eficaz. MÉTODOS: Foi efetuado um estudo comparativo retrospetivo que incluiu doentes entre os 18 e os 55 anos admitidos nas Unidades de AVC do Hospital de Santa Maria, Lisboa, Portugal e o Hospital Estatal de Innsbruck em Innsbruck na Áustria, desde Janeiro de 2014 a Maio de 2016. Os dados clínicos foram colhidos de uma base de dados online e das notas de alta dos doentes. Foram recolhidos dados demográficos, fatores de risco para AVC no adulto jovem, procedimentos diagnósticos, etiologia do AVC e informação clínica e de tratamento. As variáveis foram comparadas entre os dois centros usando o teste independente de t-Student, o teste Qui-quadrado de Pearson e o teste de Mann-Whitney. Em cada grupo foram comparados subgrupos tomando em conta o diagnóstico etiológico, como por exemplo AVC criptogénico vs. AVC não criptogénico. RESULTADOS: Foi incluído um total de 156 doentes do Hospital Estatal de Innsbruck e 110 doentes do Hospital de Santa Maria. Não houve diferenças na prevalência de fatores de risco cardiovasculares à exceção da dislipidémia que foi significativamente mais frequente em Innsbruck (p <0.001). A gravidade do AVC à entrada avaliada pelo NIHSS (National Institutes of Health Stroke Scale) foi maior em Lisboa (p <0.001), tal como o grau de incapacidade à alta avaliado pela mRS (modified Rankin Scale) (p <0.001) e o tempo de internamento (p <0.05). Relativamente à etiologia dos AVCs, não foram encontradas diferenças significativas entre os dois centros, sendo que o AVC criptogénico representou 50% dos AVCs em Lisboa e 47% dos mesmos em Innsbruck. Os doentes portugueses foram mais frequentemente submetidos a TC-CE (tomografia computorizada crânio-encefálica) do que os doentes austríacos (p <0.001), sendo a proporção de doentes submetidos a RM-CE (ressonância magnética crânio-encefálica) semelhante. Na Áustria, a angio-RM e angio-TC para avaliação dos vasos intra e extracranianos foram significativamente mais comuns (p <0.001), tal como RM cervical com saturação de gordura para identificação de disseção arterial (p <0.001). O doppler transcraniano com e sem contraste foi mais frequente em Portugal (p <0.001) e a frequência de ecografia dos vasos do pescoço não demonstrou diferença significativa entre os centros. Quanto à avaliação cardíaca, a ETT (ecocardiografia trans-torácica) foi preferida em Lisboa (p <0.001) enquanto que a ETE (ecocardiografia trans-esofágica) foi mais comum em Innsbruck (p <0.05). No que toca a testes laboratoriais, a amostra portuguesa foi mais frequentemente testada para vasculites e doenças do tecido conjuntivo (p <0.001), sífilis (p <0.001), HIV (p <0.001) e trombofilia (p <0.05). A avaliação oftalmológica e dermatológica foi mais frequente em Innsbruck (p <0.001 e p <0.001, respetivamente). Ao comparar os subgrupos ‘AVC criptogénico’ vs ‘AVC não-criptogénico’, notou-se que os doentes com AVC criptogénico portugueses foram mais submetidos a TC-CE (p <0.001) e doppler transcraniano (p <0.001) com e sem contraste do que os doentes austríacos com AVC criptogénico. Por outro lado, angio-RM, angio-TC (p <0.001) e ETE (p <0.001) foram mais frequentemente efetuados em doentes austríacos criptogénico do que portugueses. DISCUSSÃO: Este é o primeiro estudo que caracteriza detalhadamente a investigação diagnóstica do AVC no adulto jovem e a compara entre Unidades de AVC de dois hospitais terciários em dois países europeus. As causas de AVC isquémico nesta faixa etária são várias e é necessária uma avaliação diagnóstica individualizada. Neste estudo, a maior gravidade do AVC na amostra portuguesa, bem como o maior tempo de internamento e a maior incapacidade à alta hospitalar podem dever-se a diferentes padrões de referenciação. As pequenas variações encontradas na investigação diagnóstica não influenciaram o diagnóstico etiológico do AVC. Os resultados sugerem que o uso de angio-TC e angio-RM para avaliação de doença dos grandes vasos intra e extracranianos não terá sido vantajoso sobre outros testes mais baratos como ecografia dos vasos do pescoço e o doppler transcraniano, como estudos anteriores indicaram. Da mesma forma, e também anteriormente evidenciado em estudos, o uso extensivo de ETE não mostrou ser superior ao uso rotineiro de doppler transcraniano no diagnóstico de AVC cardioembólico. A análise laboratorial extensiva e a avaliação dermatológica e oftalmológica não influenciaram a quantidade de AVCs de outra causa determinada, reforçando então o papel importante de uma abordagem seletiva e clínica dos exames de diagnóstico. Como limitações a este estudo podemos indicar entre outros o surgimento de eventuais fatores confundidores como diferenças na prevalência das causas de AVC entre Portugal e a Áustria e a constante incerteza de que um determinado exame estaria a ser efetuado com intuito de investigação etiológica e não interventivamente ou na investigação de uma eventual comorbilidade. A aplicação dos critérios de TOAST também apresenta limitações importantes e pode levar a uma sobrestimação do AVC criptogénico. Desta forma, são necessários testes prospetivos longitudinais com amostras de maiores dimensões e aplicação de mais modernos sistemas de classificação etiológica de AVC para caracterizar a melhor forma de investigação diagnóstica do AVC no adulto jovem, bem como as causas do mesmo nesta faixa etária.

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Книги з теми "Ischemia Etiology"

Vukovic, Dmitry. Myocardial ischemia: Causes, symptoms and treatment. New York: Nova Biomedical Books, 2010.

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1938-, Rosen Michael R., and Palti Yoram, eds. Lethal arrhythmias resulting from myocardial ischemia and infarction: [proceedings of the Second Rappaport Symposium]. Boston: Kluwer Academic Publishers, 1989.

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Coronary circulation in nonsmokers and smokers. New York: Nova Science Publishers, 2008.

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Zoppo, Gregory J. Del. Innate inflammation and stroke. Edited by New York Academy of Sciences. Boston, Mass: Published by Blackwell Pub. on behalf of the New York Academy of Sciences, 2010.

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1946-, Feuerstein Giora Z., ed. Inflammation and stroke. Basel: Birkhäuser, 2001.

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International, Symposium on Mechanisms of Secondary Brain Damage (7th 2003? Mules Italy). Mechanisms of secondary brain damage from trauma and ischemia: Recent advances of our understanding : [proceedings of 7th International Symposium on Mechanisms of Secondary Brain Damage, Mauls, Italy]. Wien: Springer, 2004.

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A, Baethmann, ed. Mechanisms of secondary brain damage from trauma and ischemia: Recent advances of our understanding : [proceedings of 7th International Symposium on Mechanisms of Secondary Brain Damage, Mauls, Italy]. Wien: Springer, 2004.

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Kirkham, Lindsay Jack. The epidemiologic characteristics of a century of end stage atherosclerotic deaths: Ischemic heart disease and cerebral thrombosis : a surprise, a disappointment, and new etiologic concept. Washington, DC: Morris Publishing, 1999.

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Kirkham, Lindsay Jack. The epidemiologic characteristics of a century of end stage atherosclerotic deaths: Ischemic heart disease and cerebral thrombosis : a surprise, a disappointment, a new etiologic concept. Kearney, NE: Morris Publishing, 1999.

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D, Silver Malcolm, ed. Sudden death in ischemic heart disease: An alternative view on the significance of morphologic findings. New York: Springer-Verlag, 1995.

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Частини книг з теми "Ischemia Etiology"

Jauch, Edward C., W. Frank Peacock, Judy Morgan, Jeff June, and James Ireland. "RNA Gene Expression to Identify the Etiology of Acute Ischemic Stroke: The Biomarkers of Acute Stroke Etiology (BASE) Study." In Neuromethods, 157–69. New York, NY: Springer New York, 2019. http://dx.doi.org/10.1007/978-1-4939-9682-7_9.

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Silva, JA. "Etiology, natural history and pathophysiology of mesenteric ischemia." In Textbook of Peripheral Vascular Interventions, Second Edition, 553–56. CRC Press, 2008. http://dx.doi.org/10.3109/9781439801970-69.

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"Etiology, natural history, and pathophysiology of mesenteric ischemia." In Textbook of Peripheral Vascular Interventions, 573–76. CRC Press, 2008. http://dx.doi.org/10.3109/9781439801970-70.

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Macnab, Andrew. "Pathogenesis and Prevention of Fetal and Neonatal Brain Injury." In Advancement and New Understanding in Brain Injury [Working Title]. IntechOpen, 2020. http://dx.doi.org/10.5772/intechopen.93840.

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Recent advances in the clinical management of at-risk pregnancy and care of the newborn have reduced morbidity and mortality among sick neonates, and improved our knowledge of factors that influence the risks of brain injury. In parallel, the refinement of imaging techniques has added to the ability of clinicians to define the etiology, timing and location of pathologic changes with diagnostic and prognostic relevance to the developing fetus and newborn infant. Abnormalities of brain growth, or injury to the developing brain can occur during pregnancy; during labor and delivery, hypoxia, acidosis and ischemia pose major risks to the fetus. Defined practices for the management of pregnancy and delivery, and evidence-based strategies for care in the newborn period are influencing outcome. However, newborn infants, especially those born prematurely, remain at risk from situations that can cause or worsen brain injury. The literature reviewed here explains the mechanisms and timing of injury, and the importance of hypoxia, ischemia, hypotension and infection; describes current diagnostic strategies, neuroimaging technologies and care entities available; and outlines approaches that can be used to prevent or mitigate brain injury. Some show particular promise, and all are relevant to lowering the incidence and severity of brain damage.

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Miller, Stephen. "Tachycardia." In Acute Care Casebook, edited by Julie Mayglothling Winkle, 197–200. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190865412.003.0040.

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The case illustrates the approach to the evaluation and management of monomorphic ventricular tachycardia. Clinical management of this potential life-threatening arrhythmia begins with the early recognition of rhythm morphology and duration, as well as patient stability. Timely interventions with electrical cardioversion, antiarrhythmic pharmacology, and evaluation of potential etiologies such as acute ischemia, hypoxia, and electrolyte abnormalities, are vital to the care of the patient. The management key points including recognizing a change in cardiac rhythm with wide complex tachycardia, use of a cardiac monitor and appropriately placed defibrillator pads, identification of a sustained ventricular tachycardia and the need for electrical cardioversion, dosing with antiarrhymthmic medication and proper evaluation of the etiology of the ventricular tachycardia, and following with a cardiology consult and transfer to intensive care unit.

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Seki, Mitsuru. "Cardiovascular Health in Kawasaki Disease." In Cardiovascular Diseases [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.108679.

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Kawasaki disease (KD) is a self-limiting vasculitis of unknown etiology primarily affecting young children. The most important aspect in the treatment of KD is the prevention of coronary artery lesions (CALs) because myocardial ischemia or infarction due to coronary artery stenosis or occlusion may be lethal. In addition, patients with a history of KD have systemic vasculitis, which indicates vascular endothelial damage. Therefore, patients with CAL are at a high risk of atherosclerosis. While some reports have shown an increase in vascular stiffness, others have not, and the presence of atherosclerotic lesions in patients with KD is controversial. Appropriate acute-phase treatment to prevent CAL and systemic vasculitis and subsequent regular follow-ups are important. This chapter deals with the cardiovascular health of patients with a history of KD.

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Hattendorf, Brandy. "Stress Testing in Children." In Ellestad's Stress Testing, edited by Gregory S. Thomas, L. Samuel Wann, and Myrvin H. Ellestad, 517–32. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190225483.003.0027.

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The chapter Stress Testing in Children reviews the opportunity to evaluate children with congenital and acquired cardiovascular disease. Clinical pediatric exercise testing differs from adult testing in both disease etiology as well as the characteristics of cardiovascular response. Unlike exercise testing in adults, the indications for testing in pediatrics generally are not to evaluate for ischemia. Commonly, pediatric exercise testing is used to evaluate specific signs and symptoms induced or aggravated by exercise, including identification of exercise induced arrhythmias, whereas metabolic testing can provide further patient information regarding cardiac output, maximal oxygen consumption, and lung capacity. Exercise testing can also assess the efficacy of medical or surgical treatments for individual congenital heart disease patients. Functional capacity can be used to determine patient safety for recreational, athletic, and vocational activities. Exercise modification and restrictions are necessary for some patients based on the data provided by exercise testing.

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"Ischemic Stroke Etiology and Secondary Prevention." In Acute Stroke Care, 119–52. Cambridge University Press, 2019. http://dx.doi.org/10.1017/9781108759823.008.

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Guntel, Murat. "Transient Ischemic Attack." In Futuristic Design and Intelligent Computational Techniques in Neuroscience and Neuroengineering, 157–69. IGI Global, 2022. http://dx.doi.org/10.4018/978-1-7998-7433-1.ch010.

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The transient ischemic attack is a neurological emergency which is a clinical view of focal cerebral, retinal, or spinal dysfunction that lasts less than an hour, without any detectable acute infarction in neurological imaging methods. TIA is a serious warning for ischemic stroke, and this risk is particularly high in the first 48 hours. Following TIAs, approximately 10-15% of patients undergo stroke in 90 days and about half of these patients suffer a stroke in the first two days. Neuroimaging and laboratory studies should be performed quickly to reveal the etiology and to reduce the risk of stroke that may develop in patients present with TIA. Therapeutic and preventive interventions should be started as soon as possible. With early diagnosis and treatment, the risk of a 90-day stroke in these patients can be reduced by 80%. In addition to antiplatelet and anticoagulant treatments, aggressive control of blood pressure, regulation of blood sugar, statin, dietary recommendations, exercise, and managing the other underlying specific conditions should be started quickly.

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Shekhar, Shashank, Shreyas Gangadhara, and Rebecca Sugg. "Medical Management of Hemorrhagic Stroke." In Acute Stroke Management in the First 24 Hours, 221–38. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190856519.003.0013.

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Since the management of hemorrhagic stroke differs from that of ischemic stroke, prompt, accurate, and early diagnosis is vital in the management of patients who present with acute onset of focal neurologic symptoms and/or with altered mental status. Diagnostic imaging in the form of computed tomography scan or magnetic resonance imaging and a vessel study is required to ascertain the bleeding characteristic, location, and etiology. A multidisciplinary approach is required in the management of hemorrhagic stroke. Early diagnosis and treatment of the hemorrhagic stroke impacts the long-term outcome of such patients. This chapter reviews the common clinical presentations, diagnostic imaging modalities and prehospital and emergency department medical management of the most common types of hemorrhagic stroke.

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Тези доповідей конференцій з теми "Ischemia Etiology"

Linder-Ganz, Eran, and Amit Gefen. "The Effects of Pressure and Shear on Capillary Closure in the Microstructure of Skeletal Muscles: Computational Studies." In ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-176516.

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Deep tissue injury (DTI) is a serious and potentially deadly type of pressure ulcers, which initiate in deep muscle tissue under bony prominences of immobilized patients, and progress outwards towards the skin with no clear visual indications of the injury at the surface of the body. It had been suggested that DTI appear in muscle tissue first, due to the dense capillary vasculature in skeletal muscles which is susceptible to obstruction and occlusion by mechanical forces [1–3]. Though mechanical forces may cause capillaries to collapse and thus induce ischemic conditions in adjacent muscle cells [2], some investigators stipulated that ischemia alone cannot explain the etiology of DTI, and so, other mechanisms, particularly excessive cellular deformations must be involved [1]. We hypothesize that physiological levels of stresses and strains in muscle tissue under bony prominences — even when muscles are highly loaded as during sitting — do not cause complete closure of muscle capillaries, and therefore, do not cause an acute ischemia in muscles. If this is indeed the case, then ischemia cannot be the only factor contributing to DTI onset. In order to test our hypothesis, we developed a finite element (FE) model of the microstructure of skeletal muscle, at the level of muscle fascicles, and employed the model to determine the stress and strain levels required for causing partial and complete closure of capillaries.

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Norman, Richard E., Ian A. Sigal, Sophie M. K. Rausch, Inka Tertinegg, Armin Eilaghi, Sharon Portnoy, John G. Sled, John G. Flanagan, and C. Ross Ethier. "Mechanics of Individual-Specific Corneoscleral Shell Models." In ASME 2008 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2008. http://dx.doi.org/10.1115/sbc2008-192576.

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Glaucoma is a group of diseases involving a progressive optic neuropathy of unknown etiology. It is one of the leading causes of blindness worldwide. It has been postulated that glaucomatous optic neuropathy may result from mechanical stresses on the optic nerve fibers passing through the lamina cribrosa (LC), from ischemia in the LC region, or from a combination of these two.

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Reis, Ana Luísa Lopes Espínola da Costa, Leonardo Henrique Gandolfi de Souza, and Vitor Roberto Pugliesi Marques. "Ischemic stroke with agraphestesia signal focus." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.470.

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Introduction: The ischemic stroke is one of the main causes of death and disability in Brazil. Among the main risk factors are age, atrial fibrillation (AF), diabetes, dyslipidemia and physical inactivity. The main etiology of stroke is cardioembolic, resulting in obstruction of the cerebral arteries by a thrombus of cardiac origin. The artery most affected in ischemic strokes is the middle cerebral artery. The stroke has main characteristics, with emphasis on the sudden onset of symptoms, involvement of a focal area, ischemia caused by obstruction of a vessel and neurological deficits depending on the affected area. Graphesthesia is defined as a cutaneous sensory ability to recognize letters or numbers traced on the skin. The loss of this sensory ability is known as agraphesthesia. Case Report: M.A.F.O. female, 78a, arrived at the UPA complaining of mental confusion. Patient denies previous stroke. Personal history of systemic arterial hypertension. Upon physical examination, the patient was conscious, self and disoriented and inattentive. He was able to repeat and evoke words, without measurable motor déficits. Left upper limb with agraphestesia. Computed tomography was requested, which showed an extensive hypodense area in the right parietoccipital region, which leads to the erasure of the furrows between the adjacent gyres, which may correspond to a recent ischemic event. Magnetic resonance imaging, diffusion-restricted area with correspondence on the ADC map, located in the right temporoparietal region inferring an acute ischemic event. An electrocardiogram was also requested, which showed an irregular rhythm, characteristic of atrial fibrillation, resulting in a diagnostic hypothesis of cardioembolic ischemic stroke. Discussion: The involvement of post-central ischemic gyrus lesions may correspond to paresthesia, anesthesia, hypoesthesia; the involvement of secondary and terciary areas of sensitivity in the upper parietal lobe, especially in the active movements of the hand and in the modalities of integrated sensitivity, their lesions may be clinically affected by: apraxias, dysgraphias, hemineglect, agraphestesia, stereoagnosia and spacial disorientation.

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Gonçalves, Victoria Veiga Ribeiro, Isabela Fonseca Risso, Pedro Vinícius Brito Alves, Guilherme Diogo Silva, Jorge Fernando de Miranda Pereira, Coralia Gabrielle Vieira Silveira, Paula Baleeiro Rodrigues Silva, et al. "Neurosyphilis causing stroke in young adult: a case report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.127.

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Introduction: Up to 10% of strokes affect people under 45 years old. Syphilis is most common in adults. Fourteen percent of neurosyphilis cases have stroke its first manifestation. Objectives: To discuss neurosyphilis as an overlooked etiology for stroke. Design and setting: The case occurred in a public secondary care hospital located in São Paulo - Brazil. Methods: We present a case report of a 28-year-old woman brought to the emergency department due to acute ataxia. Previous history shows stroke at the age of 20 years old. Brain MRI showed ischemia in both cerebellar hemispheres, pons and midbrain. Arterial angiography showed segmental basilar artery stenosis. Serum laboratory tests showed Venereal Disease Research Laboratory (VDRL) of 1:128. Cerebrospinal fluid (CSF) analysis showed 117 cells (predominantly lymphomononuclear), protein 81 mg/ dl, normal glucose and VDRL of 1:8, confirming neurosyphilis. Treatment with intravenous penicillin led to partial improvement in ataxia before discharge. Discusion: A high percentage (up to 80%) of diagnostical errors is expected when stroke is caused by neurosyphilis. Misdiagnosis may compromise secondary prevention. It is possible that the first stroke was also caused by neurosyphilis in our patient. The involvement of the vertebrobasilar territory occurs in 25% of patients with meningovascular neurosyphilis. Basilar stenosis is typical for neurosyphilis. Conclusion: Stroke in young adults should include VDRL to screen for neurosyphilis. If positive, it should indicate a CSF exam.

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Marques, Marina Trombin, Leonardo de Sousa Bernardes, Rafael Zini Moreira da Silva, Matheus Gonçalves Maia, Edson Junior Gonçalves Bechara, Eduardo dos Santos Sousa, Juliana Rodrigues Dias Primo, Vivian Dias Baptista Gagliardi, and Rubens José Gagliardi. "Trousseau Syndrome in a patient on Direct Oral Anticoagulant use: A Case Report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.508.

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Background: The Three Territory Sign (TTS) is a radiologic marker of ischemic stroke associated with malignant neoplastic diseases (Trousseau Syndrome) and corresponds to a rare stroke etiology. Case Report: Female, 62-year-old patient, with comorbidities of smoking, hypertension and diabetes, presented with a sudden faciobrachial-predominant left hemiparesis settled in the day before the admission. Diagnosed with a metastatic rectal adenocarcinoma seven months before, she underwent a rectosigmoidectomy three months ago and developed deep vein thrombosis, starting anticoagulant therapy with rivaroxaban 20mg daily. A Magnetic Resonance Imaging (MRI) revealed several lesions with restricted diffusion in multiple vascular territories, bilaterally, corresponding to ischemic stroke. Etiologic investigation did not detect signs of cardioembolism, nor significant vessel stenosis or unstable atherosclerotic plaques. In admission, she had a D-dimer level of 11,43μg (0- 0,5μg/mL). Conclusion: The evidence of TTS is about six times more frequent in stroke related to malignancies compared to cardioembolic etiology. The D-dimer is a marker of malignancies in cryptogenic stroke, elevated in 75% of cases. The most common associated neoplasms are pulmonary (40%) and gastrointestinal (33,3%). In the MRI, the lesions can be isolated or gathered, generally small and peripheral. There is no evidence regarding the ideal preventive therapy. It is necessary to reinforce the importance of investigating malignancies in patients presenting with cryptogenic stroke and TTS, a syndrome that is still poorly recognized.

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Torquato, Ana Claudia Crispiniano Siqueira, Silvana Sobreira Santos, and Rodrigo Pinto Pedrosa. "Association between obstructive sleep apnea and ischemic stroke etiology." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.147.

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Introduction: Stroke is a potentially disabling event, therefore determining its etiology is the key in the development of management strategies to reduce the risk of a new event and costs. Obstructive sleep apnea (OSA) is common in stroke and is an independent risk factor. The objective of this study was to determine the association between the etiology of ischemic stroke and the presence of OSA. Methods: Observational, descriptive, patients with ischemic stroke or acute transient ischemic attack (TIA) in the Hospital Memorial São José and Hospital Esperança Recife-PE for one year, the etiology of stroke was categorized by TOAST classification and portable polysomnography for diagnosis of OSA. Results: 100 patients analyzed, 81 ischemic strokes and 19 TIA. The prevalence OSA (AHI≥15) was 51%. The mean age of the sample was 67.9±14.6 years, with older OSA patients (70.0±14.2 vs 65.6±14.7, p=0.128). There was a higher occurrence of females, DM, dyslipidemia and previous ictus in patients with OSA (p=0.052 /0.008 /0.055 /0.018, respectively). BMI was 27.22±4.3kg/m² in patients without OSA and 28.05±3.8kg/m² among patients with OSA. There was no association between the etiological subtype of ictus and the presence of OSA (p=0.698). Conclusions: Our study included an elderly population with a higher frequency of dyslipidemia, DM and previous ictus in patients with OSA, but it was not possible to establish a relationship between the etiology of the stroke and the presence of OSA.

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Abreu, Fernanda Ferreira de, Vinícius Bessa Mendez, Ivã Taiuan Fialho Silva, Alice Monteiro Soares Cajaíba, and Pedro Antonio Pereira de Jesus. "Hemorrhagic transformation predictors in ischemic stroke patients from a Stroke Unit." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.659.

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Background: Hemorrhagic transformation (HT) is an aggravating factor to patients with ischemic stroke. For patients’ best care, it’s essential to know its predictors. Objective: To describe HT in patients with ischemic stroke. Design and setting: Prospective cohort with ischemic stroke patients from a Stroke Unit, admitted between 2017 to 2019. Methods: All patients performed a brain computer tomography (CT) scan on arrival and 24-hours later. Patients with or without HT were compared for predictors. Results: 363 patients were included, with a mean age of 63,14 (±13,92), 53,1% were male and 9,9% (n= 38) had HT. Thrombolysis didn’t increase the risk of HT [(55,3% vs 42,5%); p= 0,132]. Patients with atrial fibrillation [(31,6% vs 12,6%); p= 0,002], and cardioembolic etiology according with TOAST classification [(57,6% vs 21,7%); p< 0,001] had higher risk of HT. Patients with HT had lower ASPECTS scores on their initial CT [8 (6-9) vs 9 (8-10); p< 0,001] and higher NIHSS scores [12 (9-15) vs 8 (5-12); p< 0,001]. Cardioembolic strokes [OR= 4,67; (IC95% 2,01-10,84)] and higher NIHSS [OR= 1,11; (IC95% 1,01-1,22)] were independently associated with HT after multivariate adjustments, considering ASPECTS and thrombolysis. Conclusion: Cardioembolic etiology and higher NIHSS score were independently associated with HT. It’s essential to know HT predictors due to worse outcomes associated with its occurrence.

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Silva, Bruno Custódio, Vivianne Amanda do Nascimento, Maria Isabelle Nakano Vieira, Guilherme Rocha Spiller, and Celso David Lago. "Medium cerebral artery thrombosis – radiological fing: hyperdense MCA sign – case report." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.244.

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Introduction: Vascular diseases are the leading cause of death in the world. Although major advances in neuroimaging and stroke treatment have contributed to a decrease in mortality, strokes occupy second place in the list. Case report: A 75-year-old man is admitted to emergency with an altered neurological examination: right hemiplegia, Broca’s aphasia and dysphagia. Conscience was preserved. Computed tomography (CT) was performed, which showed the radiological finding of hyperdense MCA sign, confirming the diagnosis of ischemic stroke with involvement of the left middle cerebral artery branch. The treatment, in this case, was outside the criteria for thrombolytics. Discussion: Irrigation of the brain is done by Willis polygon. One of the essential branches is the medium cerebral artery (MCA), the most important termination of the internal carotid arteries, responsible for blood supply of the dorsolateral hemifacial of both cerebral hemispheres, irrigating the frontal, parietal and temporal lobes. The imaging exam in suspected cases of stroke focuses on confirming its diagnosis and etiology, location of the lesion, extent of ischemic evolution, therapeutic treatment and prognosis. CT is the main modality of neuroimaging for stroke and an important radiological finding is the hyperdense artery sign, which is more common in MCA and demonstrates an evolving or impending infarction and is secondary to a plunger housed in this vessel. Therefore, it is an important early tomographic sign of ischemic stroke found on non-contrast blood CT. Conclusion: Ischemic stroke is the most common etiology among strokes. The diagnosis must be based mainly on anamnesis and image exam, such as a CT scan. The CT performed helps to guide treatment, prognosis and clinical evolution. Finally, the recognition of the hyperdense MCA sign, found in the first 6 hours, is also extremely helpful for stroke classification.

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Xu, Xiaowei, Lu Qin, Zixiao Li, and Jiao Li. "Developing an Interpretable Etiology Classification Model for Ischemic Stroke Based on Chinese Clinical Practice Guideline." In 2021 IEEE 9th International Conference on Healthcare Informatics (ICHI). IEEE, 2021. http://dx.doi.org/10.1109/ichi52183.2021.00098.

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Altynbaeva, E. N., V. I. Ruzov, M. N. Goryachaya, and N. A. Slobodnjuk. "Functional activity of platelets in aged patients with chronic heart failure with hyperbaric oxygenation." In VIII Vserossijskaja konferencija s mezhdunarodnym uchastiem «Mediko-fiziologicheskie problemy jekologii cheloveka». Publishing center of Ulyanovsk State University, 2021. http://dx.doi.org/10.34014/mpphe.2021-6-8.

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105 patients with chronic heart failure (CHF) with ischemic etiology of functional class were examined, among them 70 men (67%) and 35 women (33%), average age 78,67±13,80 years. A five-day course of hyperbaric oxygen treatment in the BLKS-303MK pressure chamber (Russia) in the 1.2 ATA with a 30-45 minutes session was accompanied by a study of the func-tional activity of platelets. It was found that after hyperbaric oxygenation treatment ADP-induced aggregation significantly decreased in women, spontaneous aggregation in men. How-ever, the nature of the response of platelet functional activity to hyperbaric oxygenation is af-fected by the initial state of the platelet hemostasis. Key words: platelets, hyperbaric oxygenation, platelet aggregation, heart failure, hemo-stasis.

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