PAI-1 5G/5G genotype is an independent risk of intracranial hemorrhage in post-lysis stroke patients

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A szelektív monoaminoxidáz-B-gátlók helye a Parkinson-kór kezelési stratégiájában a marosvásárhelyi ideggyógyászati klinikák gyakorlatában = The role of selective monoamine oxidase B inhibitors in the therapeutic strategy of Parkinson’s disease in the neurology clinics of Tirgu Mures County Emergency Clinical Hospital

Absztrakt: Bevezetés: A Parkinson-kór kezelési stratégiájában a szelektív monoaminoxidáz-B-gátlóknak a betegség minden stádiumában jól meghatározott helyük van. Enyhe esetekben, főleg fiatal betegeknél, a szubsztitúciós terápia késleltetésének egyik hatékony eszközeként számolhatunk velük; előrehaladott Parkinson-kórban, a motoros komplikációk ellátásában, a levodopaterápia kiegészítői. Célkitűzés: Annak felmérése, hogy a marosvásárhelyi ideggyógyászati klinikákon alkalmazott terápiás stratégiákban mekkora szerep jut a szelektív monoaminoxidáz-B-gátlóknak. Módszer: Retrospektív tanulmányunkban 2003. január 1. és 2016. december 31. között a klinikákon vizsgált összes Parkinson-kóros beteg adatait elemeztük. A 2194 beteg zárójelentésében rögzített terápiás ajánlások alapján tanulmányoztuk a monoaminoxidáz-B-gátlók alkalmazásának sajátosságait. A Parkinson-kór megállapítása óta eltelt idő szerint öt éve, illetve több mint öt éve tartó betegségcsoportokat alkottunk. Eredmények: A vizsgált időszakban az öt éve vagy ennél rövidebb ideje diagnosztizált csoportban 1183 betegből 243 esetben szerepelt a kezelési stratégiában monoaminoxidáz-B-gátló: 12 esetben monoterápia, 52 esetben dopaminagonistával, illetve 61 esetben levodopával kombinálva. A többi 118 betegnél levodopa és dopaminagonista kombinációjához társítva kerültek alkalmazásra a monoaminoxidáz-B-gátlók. A több mint öt éve ismert 582 esetből 195-nél egészítették ki a terápiás stratégiát monoaminoxidáz-B-gátlóval (10 esetben szelegilin, 185 esetben rasagilin). Nem volt felhasználható adat a betegség kezdetét illetően 429 esetben (ezek közül öt esetben szelegilint, illetve 93 esetben rasagilint alkalmaztak). Következtetés: A vizsgált periódusban a monoaminoxidáz-B-gátlók alkalmazásának aránya hasonló az irodalomban talált adatokhoz. A betegséggel foglalkozó szakorvosoknak nagyobb bátorsággal kellene alkalmazniuk a rendelkezésre álló és az ajánlásokban szereplő készítményeket, jobban kihasználni a különböző gyógyszertársítások előnyeit, különösen, ha ez nem terheli anyagilag a beteget. Orv Hetil. 2017; 158(51): 2023–2028. | Abstract: Introduction: Selective monoamine oxidase B inhibitors have an accurate place in therapeutical strategy of Parkinsons’s disease. In the early stages of the disease, especially in younger patients with milder symptoms, the introduction of levodopa substitution could be efficacious in delaying; in advanced stages they are mainly used to treat motor complications, as an adjunct to levodopa. Aim: The evaluation of therapeutical strategies used in the neurology clinics of Tirgu Mures County Emergency Clinical Hospital in order to define the role of monoamine oxidase B inhibitors. Method: This retrospective study includes all records of patients with Parkinson’s disease hospitalized between 1 January 2003 and 31 December 2016. From the 2194 reports we used data focusing on the therapeutic recommendations. Regarding disease duration, we divided the patients in two groups: less than or equal to 5 years and more than 5 years. Results: From the 1183 patients in first group, 243 received monoamine oxidase inhibitors: 12 as monotherapy, 52 together with dopamine agonists, in 61 cases combined with levodopa. In 118 cases monoamine oxidase inhibitors were combined with levodopa and dopamine agonists. From 582 cases whith Parkinson’s disease for more than 5 years, 195 received monoamine oxidase B inhibitors (selegiline: 10 cases, rasagiline: 185 cases). In 429 cases we did not find accurate data regarding disease duration (selegiline: 5 cases, rasagiline: 93 cases). Conclusion: The use of monoamine oxidase B inhibitors was similar to those found in literature. The treating physicians should utilise more confidently the available therapeutical combinations. Orv Hetil. 2017; 158(51): 2023–2028

An UXor among FUors: Extinction-related Brightness Variations of the Young Eruptive Star V582 Aur

V582 Aur is an FU Ori-type young eruptive star in outburst since similar to 1985. The eruption is currently in a relatively constant plateau phase, with photometric and spectroscopic variability superimposed. Here we will characterize the progenitor of the outbursting object, explore its environment, and analyze the temporal evolution of the eruption. We are particularly interested in the physical origin of the two deep photometric dips, one that occurred in 2012 and one that is ongoing since 2016. We collected archival photographic plates and carried out new optical, infrared, and millimeter-wave photometric and spectroscopic observations between 2010 and 2018, with a high sampling rate during the current minimum. Besides analyzing the color changes during fading, we compiled multiepoch spectral energy distributions and fitted them with a simple accretion disk model. Based on pre-outburst data and a millimeter continuum measurement, we suggest that the progenitor of the V582 Aur outburst is a low-mass T Tauri star with average properties. The mass of an unresolved circumstellar structure, probably a disk, is 0.04M(circle dot). The optical and near-infrared spectra demonstrate the presence of hydrogen and metallic lines, show the CO band head in absorption, and exhibit a variable Ha profile. The color variations strongly indicate that both the similar to 1 yr long brightness dip in 2012 and the current minimum since 2016 are caused by increased extinction along the line of sight. According to our accretion disk models, the reddening changed from A(V) = 4.5 to 12.5mag, while the accretion rate remained practically constant. Similarly to the models of the UXor phenomenon of intermediate- and low-mass young stars, orbiting disk structures could be responsible for the eclipses

Dipper-like variability of the Gaia alerted young star V555 Ori

V555 Ori is a T Tauri star, whose 1.5 mag brightening was published as a Gaia science alert in 2017. We carried out optical and near-infrared photometric, and optical spectroscopic observations to understand the light variations. The light curves show that V555 Ori was faint before 2017, entered a high state for about a year, and returned to the faint state by mid-2018. In addition to the long-term flux evolution, quasi-periodic brightness oscillations were also evident, with a period of about 5 days. At optical wavelengths both the long-term and short-term variations exhibited colourless changes, while in the near-infrared they were consistent with changing extinction. We explain the brightness variations as the consequence of changing extinction. The object has a low accretion rate whose variation in itself would not be enough to reproduce the optical flux changes. This behaviour makes V555 Ori similar to the pre-main sequence star AA Tau, where the light changes are interpreted as periodic eclipses of the star by a rotating inner disc warp. The brightness maximum of V555 Ori was a moderately obscured ($A_V$=2.3 mag) state, while the extinction in the low state was $A_V$=6.4 mag. We found that while the Gaia alert hinted at an accretion burst, V555 Ori is a standard dipper, similar to the prototype AA Tau. However, unlike in AA Tau, the periodic behaviour was also detectable in the faint phase, implying that the inner disc warp remained stable in both the high and low states of the system.Comment: Accepted to MNRA

Incidence and predictors of stroke and silent cerebral embolism following very high-power short-duration atrial fibrillation ablation.

AimsCerebral thrombo-embolism is a dreaded complication of pulmonary vein isolation (PVI) for atrial fibrillation; its surrogate, silent cerebral embolism (SCE) can be detected by diffusion-weighted brain magnetic resonance imaging (bMRI). Initial investigations have raised a concern that very high-power, short-duration (vHPSD; 90 W/4 s) temperature-controlled PVI with the QDOT Micro catheter may be associated with a higher incidence of SCE compared with low-power long-duration ablation. We aimed to assess the incidence of procedural complications of vHPSD PVI with an emphasis on cerebral safety.Methods and resultsWe enrolled 328 consecutive patients undergoing their PVI procedure using vHPSD. A subgroup of 61 consecutive patients underwent diffusion-weighted bMRI within 24 h of the procedure, and incidence and predictors of SCE were studied. The mean procedure time and left atrial dwell time for the overall cohort were 69.6 ± 24.1 and 46.5 ± 21.5 min, respectively. First-pass isolation was achieved in 82%. No stroke or transient ischaemic attack occurred. Silent cerebral embolism was identified in 5 of 61 patients (8.2%). Silent cerebral embolism following procedures was significantly associated with lower baseline generator impedance (105.8 vs. 112.6 Ω, P ConclusionVery high-power, short-duration PVI is a safe technique with an excellent acute success rate. Silent cerebral embolism incidence in our cohort was below the previously reported range, with no clinically overt cerebral complications. Lower baseline generator impedance and loss of contact during ablation may contribute to a higher risk of SCEs