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Nguyen TQ, Tran MH, Phung HN, Nguyen KV, Tran HTM, Walter S, Hoang DCB, Pham BN, Truong ALT, Tran VT, Nguyen TN, Pham AL, Nguyen HT. Endovascular treatment for acute ischemic stroke beyond the 24-h time window: Selection by target mismatch profile. Int J Stroke 2024; 19:305-313. [PMID: 37807200 DOI: 10.1177/17474930231208817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
INTRODUCTION Endovascular treatment for acute ischemic stroke patients with large vessel occlusion (LVO) has been established as a promising clinical intervention within a late time window of 6-24 h after symptom onset. Patients with slow progression, however, may still benefit from endovascular treatment beyond the 24-h time window (very late window). AIM The aim of this study is to report insight into the potential clinical benefits of endovascular treatment for acute ischemic stroke beyond 24 h from symptom onset. METHODS A retrospective analysis was performed on consecutive patients undergoing endovascular treatment for acute anterior circulation LVO ischemic stroke beyond 24 h. Participants were recruited between July 2019 and November 2020. Patients were selected based on the DAWN/DEFUSE 3 criteria (Perfusion-RAPID, iSchemaView) and patients receiving treatment beyond 24 h were compared to a group of patients receiving endovascular treatment between 6 and 24 h after symptom onset. The primary outcome was the proportion of patients with functional independence at 90 days (modified Rankin Scale score of 0-2). The secondary outcomes were shift modified Rankin Scale (mRS) analysis and successful reperfusion was defined by thrombolysis in cerebral infarction (TICI) 2b-3 on the final procedure. Safety outcomes were symptomatic intracranial hemorrhage and death at the 90-day follow-up. Propensity score (PS)-matched analyses were employed to rectify the imbalanced baseline characteristics between the two groups. RESULTS A total of 166 patients were recruited with a median age of 63.0 (56.0-69.0) and 28.9% of all patients were females. Patients in the beyond 24-h group had a longer onset-to-groin time (median = 27.2 vs 14.3 h, p < 0.001) than those in the 6- to 24-h group. There were no statistically significant differences between the two groups in National Institutes of Health Stroke Scale (NIHSS) (median = 12.0 vs 15.0, p = 0.37), perfusion imaging characteristics (core: median = 11.0 vs 9.0 mL, p = 0.86; mismatch volume: median = 106.0 vs 96.0, p = 0.44; mismatch ratio = 6.46 vs 7.24, p = 0.91), and perfusion-to-groin time (median = 72.5 vs 76.0 min, p = 0.77). No significant differences were noted among patients between the two groups in the primary endpoint functional independence analysis (50.0% vs 46.6%, p = 0.77) and in the safety endpoint analysis: mortality (15.0% vs 11.0%, p = 0.71) or symptomatic hemorrhage (0% vs 3.42%, p > 0.999). In PS-matched analyses, there were no significant differences among patients between the two groups in functional independence (50.0% vs 54.8%, p = 0.74), mortality (16.7% vs 9.68%, p = 0.50), or symptomatic hemorrhage (0% vs 6.45%, p = 0.53). CONCLUSION Endovascular treatment can be performed safely and effectively in LVO patients beyond 24 h from symptom onset when selected by target mismatch profile. The clinical outcome of these patients was comparable to those treated in the 6- to 24-h window. Larger studies are needed to confirm these findings.
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Affiliation(s)
- Trung Quoc Nguyen
- Department of Cerebrovascular Disease, 115 People's Hospital, Ho Chi Minh City, Vietnam
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Mai Hoang Tran
- School of Public Health, Griffith University, Gold Coast, QLD, Australia
| | - Hai Ngoc Phung
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Khang Vinh Nguyen
- Department of Neurology, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hang T Minh Tran
- Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Silke Walter
- Department of Neurology, Saarland University Hospital, Homburg, Germany
| | - Dinh C Bao Hoang
- Department of Neurology, Tam Anh Hospital, Ho Chi Minh City, Vietnam
| | - Binh Nguyen Pham
- Department of Cerebrovascular Disease, 115 People's Hospital, Ho Chi Minh City, Vietnam
| | - Anh Le Tuan Truong
- Department of Cerebrovascular Disease, 115 People's Hospital, Ho Chi Minh City, Vietnam
| | - Vu Thanh Tran
- Department of Neurointervention, 115 People's Hospital, Ho Chi Minh City, Vietnam
| | - Thanh N Nguyen
- Department of Neurology, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - An Le Pham
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Huy-Thang Nguyen
- Department of Cerebrovascular Disease, 115 People's Hospital, Ho Chi Minh City, Vietnam
- Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
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Pickel L, Iliuta IA, Scholey J, Pei Y, Sung HK. Dietary Interventions in Autosomal Dominant Polycystic Kidney Disease. Adv Nutr 2022; 13:652-666. [PMID: 34755831 PMCID: PMC8970828 DOI: 10.1093/advances/nmab131] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/12/2021] [Accepted: 11/02/2021] [Indexed: 12/22/2022] Open
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is characterized by the progressive growth of renal cysts, leading to the loss of functional nephrons. Recommendations for individuals with ADPKD to maintain a healthy diet and lifestyle are largely similar to those for the general population. However, recent evidence from preclinical models suggests that more tightly specified dietary regimens, including caloric restriction, intermittent fasting, and ketogenic diets, hold promise to slow disease progression, and the results of ongoing human clinical trials are eagerly awaited. These dietary interventions directly influence nutrient signaling and substrate availability in the cystic kidney, while also conferring systemic metabolic benefits. The present review focuses on the importance of local and systemic metabolism in ADPKD and summarizes current evidence for dietary interventions to slow disease progression and improve quality of life.
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Affiliation(s)
- Lauren Pickel
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ioan-Andrei Iliuta
- Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - James Scholey
- Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - York Pei
- Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Hoon-Ki Sung
- Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
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Fu H, Zhang K, Yang X, Li L, Cui L. Slow progression of amyotrophic lateral sclerosis in a Chinese patient carrying SOD1 p.S135T mutation. Amyotroph Lateral Scler Frontotemporal Degener 2021; 23:143-145. [PMID: 33860706 DOI: 10.1080/21678421.2021.1912771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease. Most patients die of respiratory failure within 3 years of onset. In this study, we reported a female Chinese ALS patient with SOD1 c.404G > C, p.S135T mutation. The missense mutation was identified as "Likely pathogenic" according to the ACMG/AMP 2015 guideline. The patient presented with weakness and atrophy of lower limbs with slow progression. We reviewed two other reports on patients with the same SOD1 p.S135T mutation. These patients had lower extremity onset, negative Babinski sign, slow disease progression, and prolonged survival. This report indicates that specific phenotype-genotype correlations of SOD1 p.S135T mutation in ALS.
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Affiliation(s)
- Hanhui Fu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China and
| | - Kang Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xunzhe Yang
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China and
| | - Libo Li
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China and
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China and
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Hokelekli FO, Whitwell JL, Machulda MM, Jones DT, Uitti RJ, Pham NTT, Giannini C, Baker M, Lowe VJ, Dickson DW, Josephs KA. Underlying pathology identified after 20 years of disease course in two cases of slowly progressive frontotemporal dementia syndromes. Neurocase 2021; 27:212-222. [PMID: 33904372 PMCID: PMC8189252 DOI: 10.1080/13554794.2021.1918723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
We report two cases from the frontotemporal lobar degeneration (FTLD) spectrum with remarkably slow progression. The first case demonstrated insidious-onset behavioral symptoms and personality changes resembling behavioral variant of frontotemporal dementia, followed a benign course over 26 years, his brain autopsy revealed the diffuse form of argyrophilic grain disease. The second case presented with slowly progressive cognitive and motor deficits, reminiscent of the corticobasal syndrome, deteriorated slowly over 22 years, his brain autopsy revealed FTLD-TDP with C9ORF72 pathology. These two cases confirm the notion of slowly progressive frontotemporal lobar degeneration caused by an underlying FTLD pathology, rather than a phenocopy.
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Affiliation(s)
| | | | - Mary M Machulda
- Departments of Psychiatry and Psychology, Mayo Clinic Rochester, Minnesota, USA
| | - David T Jones
- Departments of Neurology, Mayo Clinic Rochester, Minnesota, USA
| | - Ryan J Uitti
- Departments of Neurology, Mayo Clinic Rochester, Minnesota, USA
| | | | | | - Matthew Baker
- Departments of Neuroscience, Mayo Clinic Rochester, Florida, US
| | - Val J Lowe
- Departments of Neurology, Mayo Clinic Rochester, Minnesota, USA
| | | | - Keith A Josephs
- Departments of Neurology, Mayo Clinic Rochester, Minnesota, USA
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Perera G, Mueller C, Stewart R. Factors associated with slow progression of cognitive impairment following first dementia diagnosis. Int J Geriatr Psychiatry 2021; 36:271-285. [PMID: 32881117 DOI: 10.1002/gps.5420] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 08/31/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To investigate the extent to which slow progression of dementia after diagnosis might be predicted from routine longitudinal healthcare data, in order to clarify characteristics of people who experience this outcome. METHODS A retrospective observational study was conducted using data from the South London and Maudsley NHS Foundation Trust Biomedical Research Centre Case Register. This study included all patients receiving a first dementia diagnosis between 2006 and 2017, restricted to those with a baseline Mini-Mental State Examination (MMSE) score within 6 months of initial diagnosis of dementia and at least one MMSE score after 3 years post-diagnosis. Slow progression was defined as a change in MMSE score of -1, 0 or an increase at the follow-up point. This group was compared to the remainder with an MMSE decline of -2 or more. RESULTS Overall, 682 patients with slow progression were compared to 1045 with faster progression. In the confounder-adjusted multivariate logistic regression model, slow progression was more likely in younger patients (age 65-74 years; odds ratio: 1.18; 95% confidence intervals: 1.04-1.37), males (1.24; 1.01-1.53), those with moderate or severe dementia according to MMSE, patients with mixed-type dementia (2.06; 1.11-3.82) compared to Alzheimer's disease and less likely in those receiving acetylcholinesterase inhibitor (AChEI) treatment (0.57; 0.46-0.71). CONCLUSION Slow dementia progression after diagnosis was common in patients with mixed Alzheimer's and vascular dementia, younger age, males and non-receipt of AChEIs, possibly suggesting non-Alzheimer pathologies and clarifying such predictors is important, as there is currently very limited information on which to base prognosis estimates in post-diagnosis counselling.
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Affiliation(s)
- Gayan Perera
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christoph Mueller
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Robert Stewart
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Li X, Liu M, Zhang H, Liu H, Chen J. Clinical study of apatinib combined with EGFR-TKI in the treatment of chronic progression after EGFR-TKI treatment in non-small cell lung cancer (ChiCTR1800019185). Thorac Cancer 2020; 11:819-826. [PMID: 31918452 PMCID: PMC7049491 DOI: 10.1111/1759-7714.13303] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/16/2019] [Accepted: 12/22/2019] [Indexed: 11/29/2022] Open
Abstract
This clinical trial (ChiCTR1800019185) is designed to be an open‐label, prospective, single‐center, single arm exploratory research study. The study will recruit non‐small cell lung cancer patients (NSCLC) with slow progression after first‐line treatment with EGFR‐TKI drugs. Slow progression will be confirmed by the presence of serum carcinoembryonic antigen or imaging evaluation. The primary aim is to assess progression‐free survival after EGFR‐TKIs treatment combined with apatinib 250 mg once daily. The secondary objectives are to evaluate objective efficacy, disease control rates, quality of life, overall survival, and safety. From September 2018 to September 2020, under specific entry and discharge standards, we plan to enroll 38 eligible patients until the end of the study. We hope that our study will help to explore a new way of combining the small molecular inhibitors of antiangiogenesis with EGFR‐TKIs to overcome acquired drug resistance.
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Affiliation(s)
- Xin Li
- Department of Lung Cancer Surgery, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Minghui Liu
- Department of Lung Cancer Surgery, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Hongbing Zhang
- Department of Lung Cancer Surgery, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Hongyu Liu
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Jun Chen
- Department of Lung Cancer Surgery, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
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Saito N, Yamasaki M, Daido W, Ishiyama S, Deguchi N, Taniwaki M. A bronchial fibroepithelial polyp with abnormal findings on auto-fluorescence imaging. Respirol Case Rep 2017; 5:e00244. [PMID: 28603622 PMCID: PMC5465754 DOI: 10.1002/rcr2.244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 04/04/2017] [Accepted: 05/04/2017] [Indexed: 01/31/2023] Open
Abstract
Bronchial fibroepithelial polyps represent a rare type of tumour that displays endobronchial growth. The findings of these lesions on auto‐fluorescence imaging (AFI) bronchoscopy have not been reported, despite the usefulness of AFI in detecting early lung cancer. We report the case of a patient with a bronchial fibroepithelial polyp that displayed positivity (magenta colour) on AFI. The patient was a 65‐year‐old man, in whom an endobronchial polypoid lesion of 10 mm diameter had been detected in the right basal bronchus by chest computed tomography (CT). On bronchoscopic examination, we found a whitish, smooth polypoid lesion. The lesion appeared magenta on AFI. On CT, however, the lesion had been almost stable for 4 years and 4 months. Bronchial fibroepithelial polyps may show AFI positivity, even when the lesion displays benign behaviour. The diagnosis of the lesion should not be confused by AFI positivity, and unnecessary surgical intervention should be avoided.
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Affiliation(s)
- Naomi Saito
- Department of Respiratory DiseaseHiroshima Red Cross Hospital & Atomic Bomb Survivors HospitalHiroshimaJapan
| | - Masahiro Yamasaki
- Department of Respiratory DiseaseHiroshima Red Cross Hospital & Atomic Bomb Survivors HospitalHiroshimaJapan
| | - Wakako Daido
- Department of Respiratory DiseaseHiroshima Red Cross Hospital & Atomic Bomb Survivors HospitalHiroshimaJapan
| | - Sayaka Ishiyama
- Department of Respiratory DiseaseHiroshima Red Cross Hospital & Atomic Bomb Survivors HospitalHiroshimaJapan
| | - Naoko Deguchi
- Department of Respiratory DiseaseHiroshima Red Cross Hospital & Atomic Bomb Survivors HospitalHiroshimaJapan
| | - Masaya Taniwaki
- Department of Respiratory DiseaseHiroshima Red Cross Hospital & Atomic Bomb Survivors HospitalHiroshimaJapan
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Taieb G, Polge A, Juntas-Morales R, Pageot N, Lumbroso S, Mouzat K, Camu W. Slowly progressive motor neuron disease with multi-system involvement related to p.E121G SOD1 mutation. Amyotroph Lateral Scler Frontotemporal Degener 2016; 18:296-297. [PMID: 27892702 DOI: 10.1080/21678421.2016.1255756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We report the third case of amyotrophic lateral sclerosis related to p.E121G Superoxide dismutase-1 (SOD1) mutation. Besides a sporadic presentation and a slow progressive course, as described in the 2 previously cases, our patient presented with prominent sensory and cerebellar signs. This case report strengthens that p.E121G should be considered as a causal mutation. Slowly upper and lower motor neuron degeneration, even with non-motor clinical features, should prompt a sequencing of SOD1.
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Affiliation(s)
- Guillaume Taieb
- a Department of Neurology , CHU Montpellier, Hopital Guy de Chauliac , 80 avenue Augustin Fliche , 34295 Montpellier Cedex 5 , France and
| | - Anne Polge
- b Department of Biochemistry and Molecular Biology , CHU Nîmes, Hôpital Caremeau , Place du Pr Debré , 30029 Nîmes Cedex 4 , France
| | - Raul Juntas-Morales
- a Department of Neurology , CHU Montpellier, Hopital Guy de Chauliac , 80 avenue Augustin Fliche , 34295 Montpellier Cedex 5 , France and
| | - Nicolas Pageot
- a Department of Neurology , CHU Montpellier, Hopital Guy de Chauliac , 80 avenue Augustin Fliche , 34295 Montpellier Cedex 5 , France and
| | - Serge Lumbroso
- b Department of Biochemistry and Molecular Biology , CHU Nîmes, Hôpital Caremeau , Place du Pr Debré , 30029 Nîmes Cedex 4 , France
| | - Kevin Mouzat
- b Department of Biochemistry and Molecular Biology , CHU Nîmes, Hôpital Caremeau , Place du Pr Debré , 30029 Nîmes Cedex 4 , France
| | - William Camu
- a Department of Neurology , CHU Montpellier, Hopital Guy de Chauliac , 80 avenue Augustin Fliche , 34295 Montpellier Cedex 5 , France and
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