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Rezaieyazdi Z, Sedighi S, Salari M, Fard MH, Azarpazhooh MR, Tabrizi PS, Afshari JT, Saghafi M. Investigation of the Association Between Carotid Artery Intima-Media Thickness (IMT) and Cardiac Risk Factors in Patients with Systemic Lupus Erythematosus. Curr Rheumatol Rev 2019; 16:125-133. [PMID: 31845633 DOI: 10.2174/1573397116666191217122030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND The relationship between SLE and traditional risk factors for cardiovascular events was evaluated. METHODS The data regarding sixty patients with SLE and 30 healthy controls (age and sex matched) were gathered using SLEDAI forms. Venous blood (10mL) from all the participants was examined for hs-CRP, homocysteine, VCAM1, CBC, anti-DNA antibody, C3, C4, low-density lipoprotein (LDL), cholesterol, FBS and triglyceride. The IMT of carotid arteries was determined bilaterally by ultrasound. Other measurements included insulin levels via Elisa (Linco/Millipore Corp) and the HOMA-IR index for insulin resistance. RESULTS The mean age (in years) in the test and control groups was 28.8±10.3 (18-52) and 33.8±9.13 (18-48), respectively. The average IMT in the test group was directly related to serum levels of VCAM1 (p<0.001), homocysteine (p<0.001), cholesterol (p<0.009), LDL (p<0.001), TG (p<0.001), and FPG (p=0.004). The association between other risk factors, insulin resistance, carotid IMT and SLEDAI, was nonexistent. Mean insulin and insulin resistance levels in all the participants were 0.43±2.06 µU/mL and 0.09±0.44, respectively. There was no significant difference between the test and control groups regarding serum insulin and insulin resistance levels (p=0.42 and p=0.9, respectively). None of the risk factors, such as hsCRP, VCAM1, or homocysteine, were shown to be related to insulin resistance (p=0.6, p=0.6, p=0.09, respectively). CONCLUSION Our findings did not show an increase in the prevalence of atherosclerosis in patients with SLE. There was no association between IMT and insulin resistance. However, the former was associated with FPG, total cholesterol, LDL, TG, homocystein and VCAM1.
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Affiliation(s)
- Zahra Rezaieyazdi
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sima Sedighi
- Bones, Joints and Connective tissue Research Centre (JBCRC), Golesatan University of Medical Sciences, Gorgan, Iran
| | - Masoumeh Salari
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammadreza H Fard
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud R Azarpazhooh
- Department of Neurology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Peyman S Tabrizi
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jalil T Afshari
- Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Saghafi
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Saber H, Palla M, Kazemlou S, Azarpazhooh MR, Seraji-Bozorgzad N, Behrouz R. Network meta-analysis of patent foramen ovale management strategies in cryptogenic stroke. Neurology 2018; 91:e1-e7. [DOI: 10.1212/wnl.0000000000005736] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 04/05/2018] [Indexed: 11/15/2022] Open
Abstract
ObjectiveTo compare the outcomes of patent foramen ovale (PFO) closure vs antiplatelet agent (APA) vs oral anticoagulation therapy (OAT) for secondary prevention of stroke in patients with cryptogenic stroke, using direct and indirect evidence from existing randomized data.MethodsRelevant randomized controlled trials were identified by a systematic review. The efficacy outcome was stroke recurrence, and safety outcomes were atrial fibrillation and bleeding complications at the end of follow-up. Bayesian network meta-analysis was performed to calculate risk estimates and the rank probabilities using APA therapy as the reference.ResultsIn a network meta-analysis of 6 randomized controlled trials consisting of 3,497 patients (1,732 PFO closure, 1,252 APA, 513 OAT), PFO closure and OAT were associated with lower rates of recurrent stroke (odds ratio [OR] 0.30, 95% credibility interval [CrI] 0.17–0.49 and OR 0.42, 95% CrI 0.22–0.78, respectively) with equal efficacy of OR 0.70 (95% CrI 0.37–1.49). PFO closure had the highest top rank probability of atrial fibrillation and OAT had the highest risk of bleeding complications.ConclusionsThese findings suggest that closure and OAT may be equally effective in recurrent stroke prevention in patients with PFO. There is an increased risk of atrial fibrillation and bleeding with closure and OAT therapy, respectively. A randomized trial is needed to identify patients who would benefit most from each strategy.
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Behrouz R, Masjuán-Vallejo J, Vera R, Willey JZ, Zedet M, Moulin S, Cordonnier C, Klijn CJ, Kanselaar K, Dirks M, Silver B, Khan M, Azarpazhooh MR, Godoy DA, Roffe C, Paley L, Bray BD, Smith CJ, Di Napoli M. Outcomes of Nonagenarians with Acute Ischemic Stroke Treated with Intravenous Thrombolytics. J Stroke Cerebrovasc Dis 2018; 27:246-256. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.08.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/17/2017] [Accepted: 08/21/2017] [Indexed: 11/25/2022] Open
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Amiri A, Vafaeinezhad R, Azarpazhooh MR. Time is brain: An online controlling of traffic lights can save lives. Arch Emerg Med 2018; 35:71. [DOI: 10.1136/emermed-2017-206888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2017] [Indexed: 11/04/2022]
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Di Napoli M, Behrouz R, Topel CH, Misra V, Pomero F, Giraudo A, Pennati P, Masotti L, Schreuder FHBM, Staals J, Klijn CJM, Smith CJ, Parry-Jones AR, Slevin MA, Silver B, Willey JZ, Azarpazhooh MR, Vallejo JM, Nzwalo H, Popa-Wagner A, Godoy DA. Hypoalbuminemia, systemic inflammatory response syndrome, and functional outcome in intracerebral hemorrhage. J Crit Care 2017; 41:247-253. [PMID: 28599198 DOI: 10.1016/j.jcrc.2017.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 05/23/2017] [Accepted: 06/01/2017] [Indexed: 01/25/2023]
Abstract
PURPOSE Hypoalbuminemia and systemic inflammatory response syndrome (SIRS) are reported in critically-ill patients, but their relationship is unclear. We sought to determine the association of admission serum albumin and SIRS with outcomes in patients with intracerebral hemorrhage (ICH). METHODS We used a multicenter, multinational registry of ICH patients to select patients in whom SIRS parameters and serum albumin levels had been determined on admission. Hypoalbuminemia was defined as the lowest standardized quartile of albumin; SIRS according to standard criteria. Primary outcomes were modified Rankin Scale (mRS) at discharge and in-hospital mortality. Regression models were used to assess for the association of hypoalbuminemia and SIRS with discharge mRS and in-hospital mortality. RESULTS Of 761 ICH patients included in the registry 518 met inclusion criteria; 129 (25%) met SIRS criteria on admission. Hypoalbuminemia was more frequent in patients with SIRS (42% versus 19%; p<0.001). SIRS was associated with worse outcomes (OR: 4.68, 95%CI, 2.52-8.76) and in-hospital all-cause mortality (OR: 2.18, 95% CI, 1.60-2.97), while hypoalbuminemia was not associated with all-cause mortality. CONCLUSIONS In patients with ICH, hypoalbuminemia is strongly associated with SIRS. SIRS, but not hypoalbuminemia, predicts poor outcome at discharge. Recognizing and managing SIRS early may prevent death or disability in ICH patients.
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Affiliation(s)
- Mario Di Napoli
- Neurological Service, San Camillo de' Lellis General Hospital, Rieti, Italy; Neurological Section, Neuro-epidemiology Unit, SMDN, Centre for Cardiovascular Medicine and Cerebrovascular Disease Prevention, Sulmona, L'Aquila, Italy.
| | - Réza Behrouz
- Department of Neurology, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA
| | - Christopher H Topel
- Department of Neurology, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA
| | - Vivek Misra
- Houston Methodist Hospital, Houston, TX, USA
| | - Fulvio Pomero
- Department of Internal Medicine, Ospedale Santa Croce e Carle, Cuneo, Italy
| | - Alessia Giraudo
- Department of Internal Medicine, Ospedale Santa Croce e Carle, Cuneo, Italy
| | - Paolo Pennati
- Department of Internal Medicine, Ospedale Santa Croce e Carle, Cuneo, Italy; Emergency-Urgency Department, Ospedale Livorno, Livorno, Italy
| | - Luca Masotti
- Department of Internal Medicine, Ospedale Santa Maria Nuova, Florence, Italy
| | - Floris H B M Schreuder
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Julie Staals
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Catharina J M Klijn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Craig J Smith
- Stroke and Vascular Centre, Institute of Cardiovascular Sciences, University of Manchester, UK; Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford, UK
| | - Adrian R Parry-Jones
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Mark A Slevin
- School of Healthcare Science, Manchester Metropolitan University, Manchester, UK
| | - Brian Silver
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Joshua Z Willey
- Department of Neurology, Columbia University College of Physicians & Surgeons, New York, NY, USA
| | - Mahmoud R Azarpazhooh
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | | | - Hipólito Nzwalo
- Stroke Unit, Centro Hospitalar do Algarve, University do Algarve, Algarve, Portugal
| | - Aurel Popa-Wagner
- University of Medicine and Pharmacy Craiova, Romania; Department of Psychiatry, Universitätsmedizin Rostock, Rostock, Germany
| | - Daniel A Godoy
- Neurocritical Care Unit, Sanatorio Pasteur, Catamarca, Argentina; Unidad de Terapia Intensiva, Hospital Interzonal de Agudos "San Juan Bautista", Catamarca, Argentina
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Mirhafez SR, Ebrahimi M, Saberi Karimian M, Avan A, Tayefi M, Heidari-Bakavoli A, Parizadeh MR, Moohebati M, Azarpazhooh MR, Esmaily H, Nematy M, Safarian M, Ferns GA, Ghayour-Mobarhan M. Serum high-sensitivity C-reactive protein as a biomarker in patients with metabolic syndrome: evidence-based study with 7284 subjects. Eur J Clin Nutr 2016; 70:1298-1304. [PMID: 27460263 DOI: 10.1038/ejcn.2016.111] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 05/07/2016] [Accepted: 05/23/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND/OBJECTIVES Metabolic syndrome (MetS) is characterized by abdominal obesity, dyslipidemia, hypertension and glucose intolerance, and is associated with an increased risk of developing cardiovascular disease (CVD), diabetes mellitus and related diseases. Circulating levels of inflammatory markers such as C-reactive-protein (CRP) have reported to be associated with CVD. Against this background, the prevalence of MetS is increasing globally, and thus predictive biomarkers are required for identification of MetS patients at an increased risk. Here we explored the value of CRP as a biomarker in 7284 subjects and also investigated which features of MetS have the greatest association with the hs-CRP level. SUBJECTS/METHODS The subjects were recruited from the Mashhad stroke and heart atherosclerotic disorder study. Anthropometric factors and biochemical parameters (for example, high-sensitivity CRP (hs-CRP), high-density lipoprotein/low-density lipoprotein, triglycerides (TGs) and fasting blood glucose (FBG)) were determined. Univariate and multivariate analyses were conducted to evaluate the association of hs-CRP and MetS. RESULTS Our results illustrated that the concentration of serum hs-CRP increased progressively with the number of MetS components, and subjects who fulfilled the criteria of MetS for waist circumference, TGs, blood pressure and FBG were found to have hs-CRP of 0.53, 0.38, 0.34 and 0.71 mg/l, respectively, higher than matched-subjects. Importantly, FBG had the greatest association with hs-CRP concentration. CONCLUSIONS Our data demonstrate the significant association between MetS components with hs-CRP, indicating that this association was cumulative by increasing the number of the defining features of MetS, supporting further studies to explore the value of emerging marker as a novel method for detecting individuals at high risk of developing MetS.
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Affiliation(s)
- S R Mirhafez
- Department of Basic Medical Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - M Ebrahimi
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Saberi Karimian
- Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - A Avan
- Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Tayefi
- Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - A Heidari-Bakavoli
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M R Parizadeh
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M R Azarpazhooh
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - H Esmaily
- Department of Biostatistics and Epidemiology, Health Sciences Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Nematy
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Safarian
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - G A Ferns
- Division of Medical Education; Brighton & Sussex Medical School, Falmer, Brighton, UK
| | - M Ghayour-Mobarhan
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Modern Sciences and Technologies, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Saber H, Silver B, Santillan A, Azarpazhooh MR, Misra V, Behrouz R. Role of emergent chest radiography in evaluation of hyperacute stroke. Neurology 2016; 87:782-5. [DOI: 10.1212/wnl.0000000000002964] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 05/11/2016] [Indexed: 11/15/2022] Open
Abstract
Objective:To use data from a large multicenter trial to assess the role and significance of chest radiograph (CXR) in the initial evaluation of acute stroke.Methods:Predefined clinical characteristics of patients who had recorded data on CXR examination during the initial evaluation were collected. We compared features of patients who had a CXR done before IV thrombolytics with those who did not. Rates of adverse cardiopulmonary events, intubation, and in-hospital mortality were also compared. Logistic regression analysis was performed to evaluate for the association of CXR performance with door-to-needle time ≥60 minutes.Results:In a cohort of 615 patients, 243 had CXR done before IV thrombolytics. Patients with CXR before treatment had significantly higher admission neurologic deficit, initial respiratory rates, and door-to-needle time than those with CXR after treatment. The rates of cardiopulmonary adverse events in the first 24 hours of admission, endotracheal intubation in the first 7 hours, and in-hospital mortality were not different between the 2 groups. Patients with CXR done before treatment had longer mean door-to-needle times than those without pretreatment radiography (75.8 vs 58.3 minutes, p = 0.0001). Performance of CXR was independently associated with door-to-needle time ≥60 minutes (odds ratio 2.78, 95% confidence interval 1.97–3.92; p = 0.00001).Conclusions:Performance of CXR prior to IV thrombolytics prolongs door-to-needle time in acute ischemic stroke patients. CXR before treatment should be reserved for situations wherein acute cardiopulmonary conditions would otherwise preclude the administration of IV thrombolytics or substantially influence management.
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Behrouz R, Azarpazhooh MR, Godoy DA, Hoffmann MW, Masotti L, Parry-Jones AR, Popa-Wagner A, Schreuder FHBM, Slevin MA, Smith CJ, Di Napoli M. The Multi-National Survey on Epidemiology, Morbidity, and Outcomes in Intracerebral Haemorrhage (MNEMONICH). Int J Stroke 2015; 10:E86. [DOI: 10.1111/ijs.12629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Réza Behrouz
- Stroke Program, Department of Neurology, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA
| | - Mahmoud R. Azarpazhooh
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Daniel A. Godoy
- The Neurointensive Care Unit, Sanatorio Pasteur and the Intensive Care Unit, Hospital Interzonal de Agudos ‘San Juan Bautista’, Catamarca, Argentina
| | - Michael W. Hoffmann
- Stroke Program, Orlando Veterans Affairs Medical Center and the University of Central Florida College of Medicine, Orlando, FL, USA
| | - Luca Masotti
- Department of Internal Medicine, Santa Maria Nuova Hospital, Florence, Italy
| | - Adrian R. Parry-Jones
- Greater Manchester Comprehensive Stroke Centre, Department of Medical Neurosciences, Salford Royal Foundation Trust, Salford, UK
| | - Aurel Popa-Wagner
- Department of Psychiatry, Rostock University Medical School, Rostock, Germany
- University of Medicine and Pharmacy, Craiova, Romania
| | | | - Mark A. Slevin
- Healthcare Science Research Centre, School of Healthcare Science, Manchester Metropolitan University, Manchester, UK
| | - Craig J. Smith
- Greater Manchester Comprehensive Stroke Centre, Department of Medical Neurosciences, Salford Royal Foundation Trust, Salford, UK
| | - Mario Di Napoli
- Neurological Section, SMDN, Centre for Cardiovascular Medicine and Cerebrovascular Disease Prevention, Sulmona, L'Aquila, Italy
- Neurological Service, San Camillo de’ Lellis General Hospital, Rieti, Italy
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Behrouz R, Godoy DA, Azarpazhooh MR, Di Napoli M. Altered mental status in the neurocritical care unit. J Crit Care 2015; 30:1272-7. [PMID: 26315655 DOI: 10.1016/j.jcrc.2015.07.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 07/21/2015] [Accepted: 07/22/2015] [Indexed: 11/24/2022]
Abstract
Altered mental status is a common pathological entity in critically ill patients and particularly in those with preexisting cerebral injury. In the neurological critical care unit, the prevalence of altered mental status is especially high because of the inherent nervous system disease of these patients. Altered mental status can be crudely divided into encephalopathy and delirium. Although often used interchangeably, the 2 pathological entities have subtle differences in etiology and presentation. This is a review of delirium and encephalopathy in the neurological critical care unit.
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Affiliation(s)
- Réza Behrouz
- Department of Neurology, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA.
| | - Daniel A Godoy
- The Neurointensive Care Unit, Sanatorio Pasteur; and the Intensive Care Unit, Hospital Interzonal de Agudos ''San Juan Bautista," Catamarca, Argentina
| | - Mahmoud R Azarpazhooh
- Department of Clinical Neurological Sciences, Schulich School of Medicine, Western University, London, ON, Canada
| | - Mario Di Napoli
- Neurological Service, San Camillo de' Lellis General Hospital, Rieti, Italy; Neurological Section, SMDN Centre for Cardiovascular Medicine and Cerebrovascular Disease Prevention, Sulmona, L'Aquila, Italy
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Kazemi-Bajestani SM, Azarpazhooh MR, Ebrahimi M, Vedadian P, Esmaeili H, Parizadeh SMR, Heidari-Bakavoli AR, Moohebati M, Safarian M, Mokhber N, Nematy M, Mazidi M, Ferns GA, Ghayour-Mobarhan M. Serum high sensitivity CRP concentrations predict the presence of carotid artery plaque in individuals without a history of cardiovascular events. Nutr Metab Cardiovasc Dis 2015; 25:434-435. [PMID: 25698154 DOI: 10.1016/j.numecd.2014.12.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 12/22/2014] [Accepted: 12/29/2014] [Indexed: 11/23/2022]
Affiliation(s)
- S M Kazemi-Bajestani
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - M R Azarpazhooh
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - M Ebrahimi
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - P Vedadian
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - H Esmaeili
- Department of Statistics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - S M R Parizadeh
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - A R Heidari-Bakavoli
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - M Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - M Safarian
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - N Mokhber
- Psychiatry and Behavioral Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Nematy
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - M Mazidi
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - G A Ferns
- Division of Medical Education, Brighton and Sussex Medical School, University of Brighton, Rm 342, Mayfield House, BN1 9PH, UK
| | - M Ghayour-Mobarhan
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran; Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Azarpazhooh MR, Chambers BR. Clinical application of transcranial Doppler monitoring for embolic signals. J Clin Neurosci 2006; 13:799-810. [PMID: 16908159 DOI: 10.1016/j.jocn.2005.12.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2005] [Accepted: 12/20/2005] [Indexed: 12/12/2022]
Abstract
A major advantage of transcranial ultrasound is its suitability for continuous monitoring. Microembolic signals (MES) are brief, high-intensity transients that occur when particulate microemboli or gaseous microbubbles pass through the ultrasound beam. These MES have been detected in several clinical scenarios, but rarely in age-matched controls. The detection of MES provides important pathophysiological information in a variety of disorders, but their clinical importance and possible therapeutic implications are still under debate. The present article summarizes the significance of MES in different clinical settings and outlines some of the problems to be resolved so that transcranial ultrasound can be applied in clinical practice.
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Affiliation(s)
- M R Azarpazhooh
- National Stroke Research Institute, University of Melbourne, Austin Health, Heidelberg Heights, Victoria, Australia
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