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  • 1
    Online Resource
    Online Resource
    Impact of Prior Antiplatelet Therapy on Outcomes After Endovascular Therapy for Acute Stroke: Endovascular Treatment in Ischemic Stroke Registry Results
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Stroke Vol. 52, No. 12 ( 2021-12), p. 3864-3872
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 52, No. 12 ( 2021-12), p. 3864-3872
    Abstract: The influence of prior antiplatelet therapy (APT) uses on the outcomes of patients with acute ischemic stroke treated with endovascular therapy is unclear. We compared procedural and clinical outcomes of endovascular therapy in patients on APT or not before stroke onset. Methods: We analyzed 2 groups from the ongoing prospective multicenter Endovascular Treatment in Ischemic Stroke registry in France: patients on prior APT (APT+) and patients without prior APT (APT−) treated by endovascular therapy, with and without intravenous thrombolysis. Multilevel mixed-effects logistic models including center as random effect were used to compare angiographic (rates of reperfusion at the end of procedure, procedural complications) and clinical (favorable and excellent outcome, 90-day all-cause mortality, and hemorrhagic complications) outcomes according to APT subgroups. Comparisons were adjusted for prespecified confounders (age, admission National Institutes of Health Stroke Scale score, Alberta Stroke Program Early CT Score, intravenous thrombolysis, and time from onset to puncture), as well as for meaningful baseline between-group differences. Results: A total of 2939 patients were analyzed, of whom 877 (29.8%) were on prior APT. Patients with prior APT were older, had more frequent vascular risk factors, cardioembolic stroke mechanism, and prestroke disability. Rates of complete reperfusion (37.9% in the APT− group versus 42.7 % in the APT+ group; aOR, 1.09 [95% CI, 0.88–1.34]; P =0.41) and periprocedural complication (16.9% versus 13.3%; aOR, 0.90 [95% CI, 0.7–1.2]; P =0.66) did not differ between the two groups. Symptomatic intracerebral hemorrhage (aOR, 0.93 [95% CI, 0.63–1.37]; P =0.73), 3 months favorable clinical outcome (modified Rankin Scale score of 0–2; aOR, 0.98 [95% CI, 0.77–1.25]; P =0.89), and mortality (aOR, 0.95 [95% CI, 0.72–1.26]; P =0.76) at 90 days did not differ between the groups. Conclusions: Prior APT does not influence angiographic and functional outcomes following endovascular therapy and should not be taken into account for acute revascularization strategies.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.121.034670
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1467823-8
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  • 2
    Online Resource
    Online Resource
    Acute Stroke With Large Ischemic Core Treated by Thrombectomy : Predictors of Good Outcome and Mortality
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Stroke Vol. 50, No. 5 ( 2019-05), p. 1164-1171
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. 5 ( 2019-05), p. 1164-1171
    Abstract: Acute stroke patients with a large ischemic core may still benefit from mechanical thrombectomy (MT), but the predictors of clinical outcome are not well known after MT. We investigated the clinical and imaging factors associated with good outcome and mortality at 90 days in acute stroke patients with a large baseline ischemic core treated with MT. Methods— Data from the multicentric prospective ETIS (Endovascular Treatment in Ischemic Stroke) registry of consecutive acute ischemic stroke patients treated with MT from January 1, 2012, to August 31, 2016, were retrospectively analyzed. Baseline large ischemic core was defined as diffusion-weighted imaging (DWI)–Alberta Stroke Program Early CT Score of ≤5. The degree of disability was assessed by the modified Rankin Scale at 90 days. Outcomes included good outcome (modified Rankin Scale score of ≤2), and mortality (modified Rankin Scale score of 6). Results— Among 216 patients with DWI-Alberta Stroke Program Early CT Score of ≤5 (median DWI volume 77 mL, interquartile range 52–120 mL) treated with MT, good outcome was achieved in 55 (25.4%) patients and 75 (34.7%) died at 90 days. Hemorrhagic transformation was detected in 40 (18.5%) patients within 24 hours post-MT. Older age (adjusted odds ratio [OR] for every 10 years, 0.62; 95% CI, 0.48–0.80; P 〈 0.001) and increased DWI lesional volume (adjusted OR, 0.98; 95% CI, 0.97–0.99; P 〈 0.001) were associated with a lower chance of achieving a good outcome, while successful recanalization (modified Thrombolysis in Cerebral Infarction [mTICI] grades of ≤2b) predicted good outcome (adjusted OR, 4.56; 95% CI, 1.79–11.62; P =0.001). Successful recanalization (OR, 0.46; 95% CI, 0.22–0.97; P =0.042), increased DWI lesional volume (OR, 1.02; 95% CI, 1.01–1.03; P 〈 0.001), age (OR for every 10 years, 1.72; 95% CI, 1.31–2.26; P 〈 0.001), and diabetes mellitus (OR, 3.23; 95% CI, 1.34–7.8; P =0.009) were independent predictors of 90-day mortality. Conclusions— Successful recanalization and baseline DWI lesional volume are the strongest predictors of outcome in stroke patients with a large ischemic core.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.118.024295
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 1467823-8
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  • 3
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    Online Resource
    Local Anesthesia Without Sedation During Thrombectomy for Anterior Circulation Stroke Is Associated With Worse Outcome
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Stroke Vol. 51, No. 10 ( 2020-10), p. 2951-2959
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. 10 ( 2020-10), p. 2951-2959
    Abstract: The best anesthetic management for mechanical thrombectomy of large vessel occlusion strokes is still uncertain and could impact the quality of reperfusion and clinical outcome. We aimed to compare the efficacy and safety outcomes between local anesthesia (LA) and conscious sedation in a large cohort of acute ischemic stroke patients with anterior circulation large vessel occlusion strokes treated with mechanical thrombectomy in current, everyday clinical practice. Methods: Patients undergoing mechanical thrombectomy for anterior large vessel occlusion strokes at 4 comprehensive stroke centers in France between January 1, 2018, and December 31, 2018, were pooled from the ongoing prospective multicenter observational Endovascular Treatment in Ischemic Stroke Registry in France. Intention-to-treat and per-protocol analyses were used. Results: Among the included 1034 patients, 762 were included in the conscious sedation group and 272 were included in the LA group. In the propensity score matched cohort, the rate of favorable outcome (90-day modified Rankin Scale score 0–2) was significantly lower in the LA group than in the conscious sedation group (40.0% versus 52.0%, matched relative risk=0.76 [95% CI, 0.60–0.97]), as well as the rate of successful reperfusion (modified Thrombolysis in Cerebral Infarction grade 2b–3; 76.6% versus 87.1%; matched relative risk=0.88 [95% CI, 0.79–0.98] ). There was no difference in procedure time between the 2 groups. In the inverse probability of treatment weighting-propensity score-adjusted cohort, similar significant differences were found for favorable outcomes and successful reperfusion. In inverse probability of treatment weighting-propensity score-adjusted cohort, a higher rate of 90-day mortality and a lower parenchymal hematoma were observed after LA. The sensitivity analysis restricted to our per-protocol sample provided similar results in the matched- and inverse probability of treatment weighting-propensity cohorts. Conclusions: In the Endovascular Treatment in Ischemic Stroke registry mainly included patients in early time window ( 〈 6 hours), LA was associated with lower odds of favorable outcome, successful reperfusion, and higher odds of mortality compared with conscious sedation for mechanical thrombectomy of large vessel occlusion.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.120.029194
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1467823-8
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  • 4
    Online Resource
    Online Resource
    Table_1.docx
    Frontiers Media SA ; 2023
    In:  Frontiers in Oncology Vol. 13 ( 2023-9-28)
    Details
    In: Frontiers in Oncology, Frontiers Media SA, Vol. 13 ( 2023-9-28)
    Abstract: Lung cancer is more common in posttransplant recipients than in the general population. The objective of this study was to examine the chimerism donor/recipient cell origin of graft cancer in recipients of lung transplant. Methods A retrospective chart review was conducted at Foch Hospital for all lung transplantations from 1989 to 2020. Short tandem repeat PCR (STR-PCR) analysis, the gold standard technique for chimerism quantification, was used to determine the donor/recipient cell origin of lung cancers in transplant patients. Results Fourteen (1.4%) of the 1,026 patients were found to have graft lung cancer after lung transplantation, and one developed two different lung tumors in the same lobe. Among the 15 lung tumors, 10 (67%) presented with adenocarcinoma, four (27%) with squamous cell carcinoma and one with small cell lung cancer. STR analysis showed that the origin of the cancer was the donor in 10 patients (71%), the recipient in three patients (21%), and was undetermined in one patient. Median time to diagnosis was 62 months. Conclusion The prevalence of lung cancer in lung transplant recipients is very low. However, the results of our study showed heterogeneity of genetic alterations, with 21% being of recipient origin. Our results highlight the importance of donor selection and medical supervision after lung transplantation.
    Type of Medium: Online Resource
    ISSN: 2234-943X
    URL: Article
    URL: Article
    DOI: 10.3389/fonc.2023.1225538
    DOI: 10.3389/fonc.2023.1225538.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2649216-7
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  • 5
    Online Resource
    Online Resource
    Évaluation de l’impact de l’utilisation d’une vidéo-laryngoscope MacGrath Mac™ sur la concentration d’analgésique lors de l’induction anesthésique réalisée par un système de « double boucle »
    Elsevier BV ; 2015
    In:  Anesthésie & Réanimation Vol. 1 ( 2015-09), p. A395-
    Details
    In: Anesthésie & Réanimation, Elsevier BV, Vol. 1 ( 2015-09), p. A395-
    Type of Medium: Online Resource
    ISSN: 2352-5800
    URL: Article
    DOI: 10.1016/j.anrea.2015.07.604
    Language: French
    Publisher: Elsevier BV
    Publication Date: 2015
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  • 6
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    Online Resource
    Hanging donor lungs give good short‐, mid‐ and long‐term results in lung transplantation
    Wiley ; 2020
    In:  Clinical Transplantation Vol. 34, No. 1 ( 2020-01)
    Details
    In: Clinical Transplantation, Wiley, Vol. 34, No. 1 ( 2020-01)
    Abstract: Hanging donors are considered as marginal donors and frequently unsuitable for lung transplantation. However, there is no evidence of higher lung transplantation (LTx) morbidity‐mortality with lungs providing by hanging donor. Methods Between January 2010 and July 2015, we performed a retrospective study at Foch hospital. We aimed to assess whether hanging donor grafts are suitable for lung transplantation. Results A total of 299 LTx were performed. Subjects were allocated to a hanging group (HG) (n = 20) and a control group (CG) (n = 279). Donor and recipient characteristics did not differ. Primary graft dysfunction (PGD) at 72 hours was comparable in both groups ( P  = .75). The median duration of postoperative mechanical ventilation (1 [range, 0‐84] vs 1 [range, 0‐410] day, P  = .35), the hospital length of stay (31 days [20‐84] vs 32 days [12‐435] , P  = .36) did not differ between the two groups. No statistically significant difference was found in 1‐year and 5‐year survival between the HG (83% and 78%) and the CG (86% and 75%), P  = .85. Conclusion We believe that hanging donors should be considered as conventional donors with particular caution in the final evaluation of the graft and in perioperative management.
    Type of Medium: Online Resource
    ISSN: 0902-0063 , 1399-0012
    URL: Issue
    URL: Article
    DOI: 10.1111/ctr.v34.1
    DOI: 10.1111/ctr.13758
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2739458-X
    detail.hit.zdb_id: 2004801-4
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  • 7
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    Online Resource
    Perineal Infiltration with Levobupivacaine or Placebo for Episiotomies or Second-Degree Tears: A Double-Blind Randomized Study
    Open Access Text Pvt, Ltd. ; 2017
    In:  Global Surgery Vol. 3, No. 4 ( 2017)
    Details
    In: Global Surgery, Open Access Text Pvt, Ltd., Vol. 3, No. 4 ( 2017)
    Type of Medium: Online Resource
    ISSN: 2396-7307
    URL: Journal
    URL: Article
    DOI: 10.15761/GOS
    DOI: 10.15761/GOS.1000168
    Language: Unknown
    Publisher: Open Access Text Pvt, Ltd.
    Publication Date: 2017
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  • 8
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    Online Resource
    A 10% blood pressure drop from baseline during mechanical thrombectomy for stroke is strongly associated with worse neurological outcomes
    BMJ ; 2020
    In:  Journal of NeuroInterventional Surgery Vol. 12, No. 4 ( 2020-04), p. 363-369
    Details
    In: Journal of NeuroInterventional Surgery, BMJ, Vol. 12, No. 4 ( 2020-04), p. 363-369
    Abstract: Mechanical thrombectomy (MT) for acute ischemic stroke can be performed under local anesthesia, with or without conscious sedation (CS), or under general anesthesia (GA). The hemodynamic consequence of anesthetic drugs may explain why GA may be associated with worse outcomes. We evaluated the association between hypotension duration during MT and the 90 day functional outcome under both anesthetic regimens. Methods Patients were included in this retrospective study if they had an ischemic stroke treated by MT under GA or CS. The main exposure variable was the time below 90% of the reference value of arterial pressure measured before MT. The primary outcome was poor functional outcome defined as a 90 day modified Rankin Score ≥3. Results 371 patients were included in the study. GA was performed in 42%. A linear association between the duration of arterial hypotension and outcome was observed. The odds ratio for poor functional outcome of 10 min under 90% of the baseline mean arterial pressure was 1.13 (95% CI 1.06 to 1.21) without adjustment and 1.11 (95% CI 1.02 to 1.21) after adjustment for confounding factors. The functional outcome was poorer for patients treated under GA compared with CS, but the association with the depth of hypotension remained similar under both conditions. Conclusion In this study, we observed a linear association between the duration of hypotension during MT and the functional outcome at 90 days. An aggressive and personalized strategy for the treatment of hypotension should be considered. Further trials should be conducted to address this question.
    Type of Medium: Online Resource
    ISSN: 1759-8478 , 1759-8486
    URL: Article
    DOI: 10.1136/neurintsurg-2019-015247
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2506028-4
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  • 9
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    Online Resource
    Influence of Sensory and Proprioceptive Impairment on the Development of Phantom Limb Syndrome during Regional Anesthesia
    Ovid Technologies (Wolters Kluwer Health) ; 2004
    In:  Anesthesiology Vol. 100, No. 4 ( 2004-04-01), p. 979-986
    Details
    In: Anesthesiology, Ovid Technologies (Wolters Kluwer Health), Vol. 100, No. 4 ( 2004-04-01), p. 979-986
    Abstract: The relation between impairment of sensorimotor function and occurrence of phantom limb syndrome (PLS) during regional anesthesia has not been described. This study assessed the temporal relation between PLS and the progression of sensorimotor impairment during placement of a brachial plexus nerve block. Methods Fifty-two patients had their arm randomly placed either alongside their body (group A) or in 90 degrees abduction (group B) immediately after brachial plexus nerve block placement. Responses to pin prick, cold, heat, touch, proprioception, and voluntary movement were assessed every 5 min for 60 min. Meanwhile, patients described their perceptions of the size, shape, and position of their anesthetized limb. Results Phantom limb syndrome occurred 19 +/- 9 min after nerve block placement. Proprioception was impaired and abolished after 22 +/- 9 and 43 +/- 17 min, respectively (P & lt; 0.05 vs. PLS onset). When PLS occurred, responses to pin prick, cold, heat, and proprioception were abolished in 96, 94, 87, and 4% of patients, respectively. Patients were more likely to feel their anesthetized limb in adduction and in abduction in groups A and B (P & lt; 0.05 vs. group A), respectively. After PLS had become motionless, two stereotyped positions were identified: arm adduction, elbow flexion, hand over the abdomen (68% of group A patients) and arm abduction, elbow flexion, hand held close to the homolateral ear (48% of group B patients). Conclusions This study provides a better understanding of the determinants of PLS by showing that the final position of PLS is related both to the abolition of proprioception and the initial position of the anesthetized limb.
    Type of Medium: Online Resource
    ISSN: 0003-3022
    URL: Article
    DOI: 10.1097/00000542-200404000-00032
    RVK:
    XA 22600
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2004
    detail.hit.zdb_id: 2016092-6
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  • 10
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    Comparative Cardiac Effects of Terlipressin, Vasopressin, and Norepinephrine on an Isolated Perfused Rabbit Heart
    Ovid Technologies (Wolters Kluwer Health) ; 2005
    In:  Anesthesiology Vol. 102, No. 1 ( 2005-01-01), p. 85-92
    Details
    In: Anesthesiology, Ovid Technologies (Wolters Kluwer Health), Vol. 102, No. 1 ( 2005-01-01), p. 85-92
    Abstract: Terlipressin, a synthetic analog of arginine-vasopressin (AVP), has been proposed as an effective vasopressive therapy in catecholamine-resistant vasodilatory shock. Although beneficial effects of terlipressin on systemic arterial pressure have been clearly demonstrated, its intrinsic effects on coronary circulation and myocardial performances remain unknown. Methods The authors compared the coronary and myocardial effects of terlipressin (1-100 nM, n = 10), AVP (10-1000 pM, n = 10), and norepinephrine (1-100 nM, n = 10) on an erythrocyte-perfused isolated rabbit heart. The cardiac effects of terlipressin were also assessed in erythrocyte-perfused hearts in which the myocardial oxygen delivery was maintained constant and buffer-perfused hearts. Finally, the cardiac effects of terlipressin and AVP were studied in hearts pretreated by [d(CH2)5Tyr(Me)]AVP (0.1 microM), a selective V1a receptor antagonist. Results Norepinephrine induced a biphasic coronary effect associated with a concentration-dependent increase in myocardial performances. AVP and terlipressin significantly decreased coronary blood flow and impaired myocardial performances from 30 pM and 30 nM, respectively (P & lt; 0.05). The cardiac side-effects of terlipressin were confirmed in buffer-perfused hearts but the maintenance of a constant myocardial oxygen delivery constant abolished its effects on myocardial performances. The cardiac effects induced by terlipressin and AVP were nearly completely abolished on hearts pretreated by [d(CH2)5Tyr(Me)]AVP. Conclusions On isolated rabbit heart, terlipressin induced a coronary vasopressor effect and in turn myocardial depression only at supratherapeutic concentrations ( & gt; or =30 nM). Its effects are mainly mediated via V1a receptors. However, these potential negative side effects on the heart were less pronounced than were those of AVP.
    Type of Medium: Online Resource
    ISSN: 0003-3022
    URL: Article
    DOI: 10.1097/00000542-200501000-00016
    RVK:
    XA 22600
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2005
    detail.hit.zdb_id: 2016092-6
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