Relationship between nitrate headache and outcome in patients with acute stroke: results from the efficacy of nitric oxide in stroke (ENOS) trial

IntroductionNitrate-induced headache is common and may signify responsive cerebral vasculature. We assessed the relationship between nitrate-headache and outcome in patients with acute stroke.Materials and MethodsPatients were those randomised to glyceryl trinitrate (GTN) versus no GTN in the Efficacy of Nitric Oxide in Stroke trial. Development of headache by end of treatment (day 7), and functional outcome (modified Rankin Scale, mRS, primary outcome) at day 90, were assessed. Analyses are adjusted for baseline prognostic factors and give odds ratio (OR) and mean difference (MD) with 95% confidence intervals (95% CI).ResultsIn 4011 patients, headache was more common in GTN than control (360, 18.0% vs. 170, 8.5%; 2

Effects of Sildenafil on Cerebrovascular Reactivity in Patients with Becker Muscular Dystrophy

Patients suffering from Becker muscular dystrophy (BMD) have dysfunctional dystrophin proteins and are deficient in neuronal nitric oxide synthase (nNOS) in muscles. This causes functional ischemia and contributes to muscle wasting. Similar functional ischemia may be present in brains of patients with BMD, who often have mild cognitive impairment, and nNOS may be important for the regulation of the microvascular circulation in the brain. We hypothesized that treatment with sildenafil, a phosphodiesterase type 5 inhibitor that potentiates nitric oxide responses, would augment both the blood oxygen level-dependent (BOLD) response and cerebral blood flow (CBF) in patients with BMD. Seventeen patients (mean ± SD age 38.5 ± 10.8 years) with BMD were included in this randomized, double-blind, placebo-controlled, crossover trial. Twelve patients completed the entire study. Effects of sildenafil were assessed by 3 T magnetic resonance (MR) scanning, evoked potentials, somatosensory task-induced BOLD functional MR imaging, regional and global perfusion, and angiography before and after 4 weeks of sildenafil, 20 mg (Revatio in gelatine capsules, oral, 3 times daily), or placebo treatment. Sildenafil increased the event-related sensory and visual BOLD response compared with placebo (p < 0.01). However, sildenafil did not alter CBF, measured by MR phase contrast mapping, or the arterial diameter of the middle cerebral artery, measured by MR angiography. We conclude that nNOS may play a role in event-related neurovascular responses. Further studies in patients with BMD may help clarify the roles of dystrophin and nNOS in neurovascular coupling in general, and in patients with BMD in particular. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13311-016-0467-x) contains supplementary material, which is available to authorized users

Research Performance Management in a CRIS Environment: Does Research Evaluation Affect Publishing Activity?

Presented at the CRIS2012 Conference in Prague.-- 10 pages.-- Full conference programme available at: http://www.cris2012.org/findByFilter.do?categoryId=1158In this article we describe the results from a study of researchers’ publishing activity at one Danish university before and after the implementation of a national research evaluation system (RES). More specifically, we investigate the extent to which researchers at Aalborg University publish in prestigious journals in a period of ten years.Different yardsticks were used to measure the prestige of publications; an internal yardstick and several external yardsticks. The internal yardstick has been developed as part of the Bibliometric Research Indicator, namely the Authority List of Journals. The external yardsticks are the share of publications in Web of Science and Scopus and their measures of prestige, namely the Journal Impact Factor (JIF) and the Source Normalised Impact per Paper (SNIP).The results regarding the publishing activity as measured by the national Danish RES show that the share of publications without level decreases, the share of publications in ‘normal’ (level 1) journals increases and the share of publications in ‘prestigious’ (level 2) journals is status quo. The results regarding the publishing activity measured in relation to external yardsticks show that Aalborg University has had a relative larger increase than Denmark and Norway in the amount of Scopus publications. Aalborg University has also had a larger increase than Denmark in the amount of WOS publications. The results also show that Aalborg University has published in slightly more prestigious journals if measured by JIF and SNIP. However, we do not have evidence supporting the assumption underlying the implementation of the Bibliometric Research Indicator, namely an increase in publications in prestigious journals

Relationship between nitrate headache and outcome in patients with acute stroke: results from the efficacy of nitric oxide in stroke (ENOS) trial

Introduction Nitrate-induced headache is common and may signify responsive cerebral vasculature. We assessed the relationship between nitrate headache and outcome in patients with acute stroke. Materials and methods Patients were those randomised to glyceryl trinitrate (GTN) versus no GTN in the efficacy of nitric oxide in stroke trial. Development of headache by end of treatment (day 7), and functional outcome (modified Rankin Scale, primary outcome) at day 90, were assessed. Analyses are adjusted for baseline prognostic factors and give OR and mean difference (MD) with 95% CI. Results In 4011 patients, headache was more common in GTN than control (360, 18.0% vs 170, 8.5%; p Discussion and conclusion Development of a nitrate headache by day 7 after stroke may be associated with improved activities of daily living and cognitive impairment at day 90, which was not seen with non-nitrate headache.</p