Association of intravenous thrombolysis and pre-interventional reperfusion: a post hoc analysis of the SWIFT DIRECT trial.

BACKGROUND A potential benefit of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT) is pre-interventional reperfusion. Currently, there are few data on the occurrence of pre-interventional reperfusion in patients randomized to IVT or no IVT before MT. METHODS SWIFT DIRECT (Solitaire With the Intention For Thrombectomy Plus Intravenous t-PA vs DIRECT Solitaire Stent-retriever Thrombectomy in Acute Anterior Circulation Stroke) was a randomized controlled trial including acute ischemic stroke IVT eligible patients being directly admitted to a comprehensive stroke center, with allocation to IVT with MT versus MT alone. The primary endpoint of this analysis was the occurrence of pre-interventional reperfusion, defined as a pre-interventional expanded Thrombolysis in Cerebral Infarction score of ≥2a. The effect of IVT and potential treatment effect heterogeneity were analyzed using logistic regression analyses. RESULTS Of 396 patients, pre-interventional reperfusion occurred in 20 (10.0%) patients randomized to IVT with MT, and in 7 (3.6%) patients randomized to MT alone. Receiving IVT favored the occurrence of pre-interventional reperfusion (adjusted OR 2.91, 95% CI 1.23 to 6.87). There was no IVT treatment effect heterogeneity on the occurrence of pre-interventional reperfusion with different strata of Randomization-to-Groin-Puncture time (p for interaction=0.33), although the effect tended to be stronger in patients with a Randomization-to-Groin-Puncture time >28 min (adjusted OR 4.65, 95% CI 1.16 to 18.68). There were no significant differences in rates of functional outcomes between patients with and without pre-interventional reperfusion. CONCLUSION Even for patients with proximal large vessel occlusions and direct access to MT, IVT resulted in an absolute increase of 6% in rates of pre-interventional reperfusion. The influence of time strata on the occurrence of pre-interventional reperfusion should be studied further in an individual patient data meta-analysis of comparable trials. TRIAL REGISTRATION NUMBER clinicaltrials.gov NCT03192332

Association of intravenous thrombolysis and pre-interventional reperfusion: a post hoc analysis of the SWIFT DIRECT trial

Stroke; Thrombectomy; ThrombolysisIctus; Trombectomia; TrombòlisiIctus; Trombectomía; TrombólisisBackground A potential benefit of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT) is pre-interventional reperfusion. Currently, there are few data on the occurrence of pre-interventional reperfusion in patients randomized to IVT or no IVT before MT. Methods SWIFT DIRECT (Solitaire With the Intention For Thrombectomy Plus Intravenous t-PA vs DIRECT Solitaire Stent-retriever Thrombectomy in Acute Anterior Circulation Stroke) was a randomized controlled trial including acute ischemic stroke IVT eligible patients being directly admitted to a comprehensive stroke center, with allocation to IVT with MT versus MT alone. The primary endpoint of this analysis was the occurrence of pre-interventional reperfusion, defined as a pre-interventional expanded Thrombolysis in Cerebral Infarction score of ≥2a. The effect of IVT and potential treatment effect heterogeneity were analyzed using logistic regression analyses. Results Of 396 patients, pre-interventional reperfusion occurred in 20 (10.0%) patients randomized to IVT with MT, and in 7 (3.6%) patients randomized to MT alone. Receiving IVT favored the occurrence of pre-interventional reperfusion (adjusted OR 2.91, 95% CI 1.23 to 6.87). There was no IVT treatment effect heterogeneity on the occurrence of pre-interventional reperfusion with different strata of Randomization-to-Groin-Puncture time (p for interaction=0.33), although the effect tended to be stronger in patients with a Randomization-to-Groin-Puncture time >28 min (adjusted OR 4.65, 95% CI 1.16 to 18.68). There were no significant differences in rates of functional outcomes between patients with and without pre-interventional reperfusion. Conclusion Even for patients with proximal large vessel occlusions and direct access to MT, IVT resulted in an absolute increase of 6% in rates of pre-interventional reperfusion. The influence of time strata on the occurrence of pre-interventional reperfusion should be studied further in an individual patient data meta-analysis of comparable trials. Trial registration number clinicaltrials.gov NCT03192332

A new study of the bacterial lipidome: HPTLC-MALDI-TOF imaging enlightening the presence of phosphatidylcholine in airborne Pseudomonas fluorescens MFAF76a

International audienceLipids are major functional components of bacterial cells that play fundamental roles in bacterial metabolism and the barrier function between cells and the environment. In an effort to investigate the bacterial lipidome, we adopted a protocol using MALDI-TOF MS imaging coupled to HPTLC to screen a large number of phospholipid classes in a short span of time.With this method, phospholipids of airborne Pseudomonas fluorescens MFAF76a were visualized and identified in sample extracts (measurement accuracy below 0.1 Da, phospholipid identification by means of four characteristic fragment peaks). Via this technique, the P. fluorescens lipidome was shown to comprise three major lipid classes: phosphatidylethanolamine, phosphatidylglycerol and phosphatidylcholine.The protocol described herein is simple, rapid and effective for screening of bacterial phospholipid classes. The remarkable presence of a eukaryotic phospholipid, phosphatidylcholine, was observed in P. fluorescens MFAF76a. This lipid is known to play a role in bacteria–host interactions and had not been known to be found in P. fluorescens cells

Chemical and Mössbauer Spectroscopy Characterization associated to Oxidative Potential of particulate matter from Brake Wear Emissions

International audienceThe road transport is recognized to be an important contributor to the air pollution. Brake wear may contribute up 55% in mass of PM10 of total emission of non-exhaust particles. The presence of high content of heavy metal and their oxides (Kukutschova et al 2011) in brake dusts combined to a nanosized fraction predict of their cytotoxic effects and oxidative stresses (Gasser et al 2009). We report chemical characterization of brake wear using TEM/STEM-EDX single particle analysis, to identify chemical element size and morphology of particles, known to be key determinant in tissue interaction or cellular uptake (Buzea et al 2007). Particles were generated from a home-made bench test designed specifically to reproduce real-world driving conditions. Source of many health adverse effects, oxidative stress was assessed by measuring the oxidative intrinsic potential of particles using acellular depletion DTT, Ascorbic Acid and GSH assays. Findings show a significant ultrafine fraction <100nm. Embedding in a carbonaceous matrix, Fe, Cu are the both major metal elements present in more than 94% of ultrafine fraction. Additionnal elements Mg, S, Ca, Cr, Zn, Ti, Al and Ba are clustered within particles, reflecting a probable remodeling of primary chemical components. An original approach by Spectroscopy Mossbauer defineIron-particles-content phases as mainly Fe0 (69%), and in lower proportion as Fe2+ (14%) and Fe3+ (17%). Compared to Diesel particles, brake wear exhibit high elevated oxidative potential starting with 14μg/ml of particles. Results provided pertinent information which can be used to study health effects via in vivo rodent exposur

Chemical and Mössbauer Spectroscopy Characterization associated to Oxidative Potential of particulate matter from Brake Wear Emissions

International audienceThe road transport is recognized to be an important contributor to the air pollution. Brake wear may contribute up 55% in mass of PM10 of total emission of non-exhaust particles. The presence of high content of heavy metal and their oxides (Kukutschova et al 2011) in brake dusts combined to a nanosized fraction predict of their cytotoxic effects and oxidative stresses (Gasser et al 2009). We report chemical characterization of brake wear using TEM/STEM-EDX single particle analysis, to identify chemical element size and morphology of particles, known to be key determinant in tissue interaction or cellular uptake (Buzea et al 2007). Particles were generated from a home-made bench test designed specifically to reproduce real-world driving conditions. Source of many health adverse effects, oxidative stress was assessed by measuring the oxidative intrinsic potential of particles using acellular depletion DTT, Ascorbic Acid and GSH assays. Findings show a significant ultrafine fraction <100nm. Embedding in a carbonaceous matrix, Fe, Cu are the both major metal elements present in more than 94% of ultrafine fraction. Additionnal elements Mg, S, Ca, Cr, Zn, Ti, Al and Ba are clustered within particles, reflecting a probable remodeling of primary chemical components. An original approach by Spectroscopy Mossbauer defineIron-particles-content phases as mainly Fe0 (69%), and in lower proportion as Fe2+ (14%) and Fe3+ (17%). Compared to Diesel particles, brake wear exhibit high elevated oxidative potential starting with 14μg/ml of particles. Results provided pertinent information which can be used to study health effects via in vivo rodent exposur

Management of acute central retinal artery occlusion: Intravenous thrombolysis is feasible and safe

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0461 : Comparison of cardiovascular responses to nitrogen dioxide and diesel exhausts. An experimental study with controlled exposures to air pollutants

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