17 research outputs found
Leki przeciwp艂ytkowe w profilaktyce i leczeniu udaru niedokrwiennego m贸zgu
Udar m贸zgu jest drug膮 przyczyn膮 艣mierci i pierwsz膮 przyczyn膮 niepe艂nosprawno艣ci w艣r贸d os贸b doros艂ych
na 艣wiecie. Roczna 艣wiatowa zapadalno艣膰 na udar m贸zgu wynosi 15 milion贸w przypadk贸w. Obecnie nie
ma lek贸w, kt贸re przywraca艂yby funkcj臋 uszkodzonej tkance. Opieka nad pacjentem w ostrej fazie udaru polega
na pr贸bie przywr贸cenia dro偶no艣ci zamkni臋tego naczynia, zapobieganiu wczesnym i odleg艂ym powik艂aniom
udaru oraz jak najwcze艣niejszej rehabilitacji. Dotychczas udowodniono skuteczno艣膰 3 metod
w zmniejszaniu niepe艂nosprawno艣ci i 艣miertelno艣ci z powodu udaru m贸zgu — leczenia na oddziale udarowym,
leczenia trombolitycznego oraz leczenia kwasem acetylosalicylowym. Niniejszy artyku艂 zawiera przegl膮d
bada艅 i aktualnych wytycznych dotycz膮cych stosowania lek贸w przeciwp艂ytkowych w prewencji pierwotnej
i wt贸rnej oraz w leczeniu ostrej fazy udaru niedokrwiennego m贸zg
Ostra reakcja hipertensyjna w udarze niedokrwiennym m贸zgu
Podwy偶szone ci艣nienie t臋tnicze (≥ 140/90 mm Hg) dotyczy 75% chorych z udarem niedokrwiennym
m贸zgu, przy czym u oko艂o po艂owy z nich stwierdza si臋 nadci艣nienie w wywiadzie. Samo
stwierdzenie podwy偶szonego ci艣nienia t臋tniczego podczas udaru m贸zgu nie uprawnia do rozpoznania
nadci艣nienia t臋tniczego, poniewa偶 w okresie ostrym choroby wyst臋puje spontaniczne
obni偶enie ci艣nienia t臋tniczego, mimo braku specyficznego leczenia, dlatego dla omawianego
zjawiska w艂a艣ciwsze wydaje si臋 poj臋cie „ostrej reakcji hipertensyjnej”.
Wp艂yw ostrej reakcji hipertensyjnej na rokowanie po udarze nie jest jasny. Istniej膮 przes艂anki
przemawiaj膮ce zar贸wno za obni偶aniem ci艣nienia t臋tniczego, jak i za pozostawianiem go bez leczenia
w ostrej fazie udaru m贸zgu.
Wiadomo jednak, 偶e obni偶one ci艣nienie t臋tnicze w udarze mo偶e si臋 wi膮za膰 ze zwi臋kszon膮 艣miertelno艣ci膮.
Randomizowane badania nie dostarczy艂y przekonuj膮cych dowod贸w umo偶liwiaj膮cych
wdro偶enie jednoznacznej strategii post臋powania z nadci艣nieniem t臋tniczym w udarze niedokrwiennym
m贸zgu. Konieczne s膮 dalsze badania, w kt贸rych zostan膮 ocenione korzy艣ci oraz
zagro偶enia zwi膮zane z terapi膮 ostrej reakcji hipertensyjnej u chorych z udarem niedokrwiennym
m贸zgu
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Nova DAQ, System Architecture, Data Combiner and Timing System
NOvA (E929) is a long baseline experiment that will search for neutrino oscillations. There will be one detector near the beam source at Fermilab, and one detector in northern Minnesota. The DAQ system for the far detector collects over-threshold hits from over 450,000 channels of scintillator readouts, sorts the time-stamped data packets and archives selected time periods of data for transmission and processing. While a simple point-to-point protocol is used for the first level of data collection, Ethernet was chosen as the fabric for the rest of the DAQ. The packet time-stamp and overall system synchronization is based on two common-view GPS trained clock oscillators, one at each site. The present design cost-effectively satisfies the experiment's moderate speed and data volume requirements
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Results from a data acquisition system prototype project using a switch-based event builder
A prototype of a high bandwidth parallel event builder has been designed and tested. The architecture is based on a simple switching network and is adaptable to a wide variety of data acquisition systems. An eight channel system with a peak throughput of 160 Megabytes per second has been implemented. It is modularly expandable to 64 channels (over one Gigabyte per second). The prototype uses a number of relatively recent commercial technologies, including very high speed fiber-optic data links, high integration crossbar switches and embedded RISC processors. It is based on an open architecture which permits the installation of new technologies with little redesign effort. 5 refs., 6 figs
Mu2e Technical Design Report
The Mu2e experiment at Fermilab will search for charged lepton flavor
violation via the coherent conversion process mu- N --> e- N with a sensitivity
approximately four orders of magnitude better than the current world's best
limits for this process. The experiment's sensitivity offers discovery
potential over a wide array of new physics models and probes mass scales well
beyond the reach of the LHC. We describe herein the preliminary design of the
proposed Mu2e experiment. This document was created in partial fulfillment of
the requirements necessary to obtain DOE CD-2 approval.Comment: compressed file, 888 pages, 621 figures, 126 tables; full resolution
available at http://mu2e.fnal.gov; corrected typo in background summary,
Table 3.
Supplementary Material for: Aortic stiffness is independently associated with intracranial carotid artery calcification in patients with ischemic stroke
Background and aims
Intracranial carotid artery calcification (ICAC), as a strong contributor to the occurrence of ischemic stroke, might be present in the medial or intimal arterial layer. Traditional cardiovascular risk factors (CVRFs) are associated with ICAC; however, its association with new markers of vascular function are less understood. The paper aims to evaluate the relationship between carotid-femoral pulse wave velocity (CF-PWV) and ICAC subtypes.
Methods
We enrolled 65 patients with ischemic stroke. CF-PWV, systolic, diastolic, mean blood pressure, and pulse pressure (SBP, DBP, MBP, PP) were measured within 6卤2 days after stroke onset, CT was performed within 24 hours. ICAC on the stroke site was classified by two methods: volume- and score-based. Tertiles of ICAC volume were determined, and low-grade ICAC (T1) was regarded as a reference. According to the score-based method, (dominant) medial and (dominant) intimal ICAC subtypes were determined. Data were analysed with multivariate logistic regression.
Results
Medial and intimal ICAC subtypes were found in 34 (52%) and 24 (37%) patients, respectively. In 11% of patients no ICAC calcifications were found. CF-PWV was higher in patients with high-grade ICAC (OR=1.56, 95%CI=1.03-2.35, p=0.035). CF-PWV was higher in patients with the medial ICAC subtype (OR=1.60, 95%CI=1.00-2.55, p=0.049) after adjustment for traditional CVRFs.
Conclusions
Our study demonstrates that among patients with ischemic stroke, aortic stiffness is independently associated with ICAC, and that medial ICAC, compared with intimal ICAC, is accompanied by more advanced aortic stiffness
Supplementary Material for: Aortic stiffness is independently associated with intracranial carotid artery calcification in patients with ischemic stroke
Background and aims
Intracranial carotid artery calcification (ICAC), as a strong contributor to the occurrence of ischemic stroke, might be present in the medial or intimal arterial layer. Traditional cardiovascular risk factors (CVRFs) are associated with ICAC; however, its association with new markers of vascular function are less understood. The paper aims to evaluate the relationship between carotid-femoral pulse wave velocity (CF-PWV) and ICAC subtypes.
Methods
We enrolled 65 patients with ischemic stroke. CF-PWV, systolic, diastolic, mean blood pressure, and pulse pressure (SBP, DBP, MBP, PP) were measured within 6卤2 days after stroke onset, CT was performed within 24 hours. ICAC on the stroke site was classified by two methods: volume- and score-based. Tertiles of ICAC volume were determined, and low-grade ICAC (T1) was regarded as a reference. According to the score-based method, (dominant) medial and (dominant) intimal ICAC subtypes were determined. Data were analysed with multivariate logistic regression.
Results
Medial and intimal ICAC subtypes were found in 34 (52%) and 24 (37%) patients, respectively. In 11% of patients no ICAC calcifications were found. CF-PWV was higher in patients with high-grade ICAC (OR=1.56, 95%CI=1.03-2.35, p=0.035). CF-PWV was higher in patients with the medial ICAC subtype (OR=1.60, 95%CI=1.00-2.55, p=0.049) after adjustment for traditional CVRFs.
Conclusions
Our study demonstrates that among patients with ischemic stroke, aortic stiffness is independently associated with ICAC, and that medial ICAC, compared with intimal ICAC, is accompanied by more advanced aortic stiffness
Blood pressure in acute ischemic stroke: Challenges in trial interpretation and clinical management: Position of the ESH Working Group on Hypertension and the Brain
Altered blood pressure (BP) is a common phenomenon in acute ischemic stroke (AIS), with high BP being the most frequent scenario. The pathophysiology of BP changes in AIS is complex and only partially understood. The available evidence indicates that extremely high BP during AIS is associated with a poor outcome. Importantly, the observed relationship between BP and stroke outcome may or may not be causally related. Higher baseline BPs in focal cerebral ischemia may indicate preexisting hypertension, but may also be an effect of both nonspecific and stroke-related factors. Although antihypertensive therapy effectively reduces BP in AIS, studies on early BP lowering in AIS produce conflicting results in terms of functional outcome and mortality. Systematic reviews on BP management in AIS did not result in clinically applicable conclusions in general. However, the investigation on the effect of BP and its alterations in AIS are hampered by various important methodological issues. This position statement was prepared by a group of experts from the European Society of Hypertension and invited neurologists to discuss the main reasons for the discrepancies in the current evidence on the prognosis and treatment of altered BP in AIS which should be taken into account in future studies. Copyright 漏 2018 Wolters Kluwer Health, Inc. All rights reserved