DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France

We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR = 2.05, 95%CI = 1.39–3.02, p < 0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR = 0.42, 95%CI = 0.18–0.99, p = 0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon

A European Perspective on the German System for Thrombectomy in Stroke Patients

Imaginal retraining is a noncomputerized variant of cognitive bias modification, an intervention aimed at reducing craving in substance use disorders and behavioral addictions. We conducted a dismantling study to elucidate which of its multiple components are effective and hence essential ingredients of the training and which are ineffective (and hence perhaps dispensable) in reducing craving. We randomized 187 smokers to one out of six conditions that instructed participants to perform a brief intervention. In four of these, participants were instructed to perform isolated components of the imaginal retraining protocol, and in the two other conditions participants either suppressed or simply observed (control condition) the image of a cigarette. Before and after the intervention, participants were asked to rate their level of craving and how pleasant they found three smoking-related images. We examined within-group changes by means of paired t-tests separately across conditions (trial registration: DRKS00021044). Mental distancing from cigarettes (without a corresponding actual physical movement; non-motor retraining) led to a significant decline in craving (paired t-test), which remained significant when compared to the control condition. The effects of other components of the retraining were less consistent. The present study shows that a single therapeutic 'dose' of distinct components involved in imaginal retraining can reduce craving for cigarettes. Future trials should investigate the effectiveness of components of imaginal retraining not yet tested (e.g., mood induction) and whether combinations and repetition of single components strengthen or dilute efficacy

Apport pronostique de l'IRM (1TESLA) de diffusion et de perfusion a la phase hyperaigue des accidents vasculaires cérebraux ischémiques

Objectif : Definir chez des patients victimes d'un AVD ischemique a un stade hyperaigu (<6 heures) des valeurs pronostiques grace aux sequences d'IRM de diffusion, de perfusion et d'angio MR. Materiels et methodes : Une etude prospective chez 12 patients porteurs d'un AVC ischemique a compris un bilan TDM et IRM (T2, flair, diffusion et perfusion, angioMR), dans les 6 premieres heures puis a J+4 et une IRM a 4 mois. Resultats : Nous avons etabli des correlations entre les volumes lesionnels definis par les differentes sequences d'IRM et les scores cliniques initiaux et finaux. Les sequences de diffusion et de perfusion a J0 sont tres bien correlees au volume infarci defini sur la sequence T2 de l'IRM a 4 mois, mais egalement au score clinique final. Les patients presentant une occlusion proximale sur l'angioMR, ont tous une evolution clinique plus defavorable. Conclusion : A un stade hyperaigu de l'AVC ischemique, les sequences de diffusion, de perfusion et d'angioMR paraissent predictives de la taille finale de l'infarctus et du devenir clinique a long terme. Les differents coefficients de diffusion et de perfusion etudies (ADC, TTP, VSC) devraient permettre d'etablir des donnees parametriques dans l'ischemie cerebrale et l'identification de plusieurs groupes relevant de therapeutiques differentes (techniques de desobstruction ou de repermeabilisation vasculaire et traitement neuroprotecteurs).ST ETIENNE-BU Médecine (422182102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Middle cerebral artery aneurysms: Feasibility, clinical and anatomical results of the endovascular treatment by WEB flow Disruption. Preliminary evaluation in a multicenter study

info:eu-repo/semantics/publishe

SAFE study (Safety and efficacy Analysis of FRED Embolic device in aneurysm treatment): 1-year clinical and anatomical results

International audienceFlow diversion is an innovative and increasingly used endovascular treatment for intracranial aneurysms. Its initial evaluation with the first devices available showed good efficacy of this treatment with variable safety results. The Flow Direction Endoluminal Device (FRED) has a specific design and was evaluated in a single-arm, multicenter, prospective, Good Clinical Practice study: SAFE (Safety and efficacy Analysis of FRED Embolic device in aneurysm treatment). This analysis reports clinical results at 1 year and anatomical results at 6 months and 1 year.METHODS:Patients with unruptured and recanalized aneurysms located in the anterior circulation treated with FRED and FRED Jr were prospectively included. A Clinical Event Committee and a Core Laboratory independently evaluated clinical outcome and anatomical results.RESULTS:Thirteen interventional neuroradiology centers included 103 patients/aneurysms. Aneurysm locations were supraclinoid internal carotid artery (ICA) in 71 (68.9%), cavernous ICA in 15 (14.6%), anterior cerebral or anterior communicating artery in 9 (8.7%), and middle cerebral artery in 8 (7.8%). Most aneurysms were small (<10 mm) in 71 patients (68.9%). Cumulative 1-year mortality and morbidity rates were 2/103 (1.9%) and 3/103 (2.9%), respectively, one death being related to cancer. At 1 year, anatomical results were: complete occlusion in 66/90 patients (73.3%), neck remnant in 7/90 patients (7.8%), and aneurysm remnant in 17/90 patients (18.9%).CONCLUSIONS:SAFE study analysis at 1 year confirms the excellent safety profile of the FRED device for aneurysm treatment, with low morbidity and mortality rates (2.9% and 1.9%, respectively) and demonstrates its efficacy (adequate occlusion in 73/90 (81.1%)).CLINICAL TRIAL REGISTRATION:Unique identifier: NCT02921698; Results