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  • 1
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    Online Resource
    Optimal use of antithrombotic agents in ischemic stroke with atrial fibrillation and large artery atherosclerosis
    SAGE Publications ; 2023
    In:  International Journal of Stroke Vol. 18, No. 7 ( 2023-08), p. 812-820
    Details
    In: International Journal of Stroke, SAGE Publications, Vol. 18, No. 7 ( 2023-08), p. 812-820
    Abstract: Optimal antithrombotic regimens to prevent recurrent stroke in patients with ischemic stroke due to atrial fibrillation (AF) and atherosclerotic large-vessel stenosis remain unknown. Aims: This study aimed to evaluate the effect of multiple antithrombotic therapies on outcomes at 1 year after ischemic stroke due to two or more causes. Methods: We identified 862 patients with ischemic stroke due to AF and large artery atherosclerosis from the linked data. These patients were categorized into three groups according to antithrombotic therapies at discharge: (1) antiplatelets, (2) oral anticoagulants (OAC), and (3) antiplatelets plus OAC. The study outcomes were recurrent ischemic stroke, composite outcomes for cardiovascular events, and major bleeding after 1 year. Inverse probability of treatment weighting (IPTW) was used to balance the three groups using propensity scores. Results: Among 862 patients, 169 (19.6%) were treated with antiplatelets, 405 (47.0%) were treated with OAC, and 288 (33.4%) were treated with antiplatelets and OAC. After applying IPTW, only OAC had a significant beneficial effect on the 1-year composite outcome (hazard ratio (HR): 0.37, 95% confidence interval (CI): 0.23–0.60, p  〈  0.001) and death (HR: 0.35, 95% CI: (0.19–0.63), p  〈  0.001). The combination of antiplatelet agents and OAC group had an increased risk of major bleeding complications (HR: 5.27, 95% CI: (1.31–21.16), p = 0.019). However, there was no significant difference in 1-year recurrent stroke events among the three groups. Conclusion: This study demonstrated that OAC monotherapy was associated with lower risks of composite outcome and death in patients at 1 year after ischemic stroke due to AF and atherosclerotic stenosis. In addition, the combination of an antiplatelet and OAC had a high risk of major bleeding.
    Type of Medium: Online Resource
    ISSN: 1747-4930 , 1747-4949
    URL: Article
    DOI: 10.1177/17474930231158211
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2211666-7
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  • 2
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    Online Resource
    Dual antiplatelet Use for extended period taRgeted to AcuTe ischemic stroke with presumed atherosclerotic OrigiN (DURATION) trial: Rationale and design
    SAGE Publications ; 2023
    In:  International Journal of Stroke Vol. 18, No. 8 ( 2023-10), p. 1015-1020
    Details
    In: International Journal of Stroke, SAGE Publications, Vol. 18, No. 8 ( 2023-10), p. 1015-1020
    Abstract: The optimal duration of dual antiplatelet therapy (DAPT) with clopidogrel-aspirin for the large artery atherosclerotic (LAA) stroke subtype has been debated. Aims: To determine whether the 1-year risk of recurrent vascular events could be reduced by a longer duration of DAPT in patients with the LAA stroke subtype. Methods and study design: A total of 4806 participants will be recruited to detect a statistically significant relative risk reduction of 22% with 80% power and a two-sided alpha error of 0.05, including a 10% loss to follow-up. This is a registry-based, multicenter, prospective, randomized, open-label, blinded end point study designed to evaluate the efficacy and safety of a 12-month duration of DAPT compared with a 3-month duration of DAPT in the LAA stroke subtype. Patients will be randomized (1:1) to either DAPT for 12 months or DAPT for 3 months, followed by monotherapy (either aspirin or clopidogrel) for the remaining 9 months. Study outcomes: The primary efficacy outcome of the study is a composite of stroke (ischemic or hemorrhagic), myocardial infarction, and all-cause mortality for 1 year after the index stroke. The secondary efficacy outcomes are (1) stroke, (2) ischemic stroke or transient ischemic attack, (3) hemorrhagic stroke, and (4) all-cause mortality. The primary safety outcome is major bleeding. Discussion: This study will help stroke physicians determine the appropriate duration of dual therapy with clopidogrel-aspirin for patients with the LAA stroke subtype. Trial registration: URL: https://cris.nih.go.kr/cris . CRIS Registration Number: KCT0004407
    Type of Medium: Online Resource
    ISSN: 1747-4930 , 1747-4949
    URL: Article
    DOI: 10.1177/17474930231168742
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2211666-7
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  • 3
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    Concurrent Chemoradiotherapy or Radiotherapy Alone for Locally Advanced Cervical Cancer in Elderly Women
    SAGE Publications ; 2010
    In:  Tumori Journal Vol. 96, No. 6 ( 2010-11), p. 959-965
    Details
    In: Tumori Journal, SAGE Publications, Vol. 96, No. 6 ( 2010-11), p. 959-965
    Abstract: To evaluate the efficacy and toxicity of concurrent chemoradiotherapy or radiotherapy alone in elderly patients with locally advanced cervical carcinoma (stage IB2-IVA). Methods and study design We retrospectively reviewed the medical records of 105 women aged ≥65 years who received radiotherapy (group I, n = 61) or concurrent chemoradiotherapy (group II, n = 44). Patients received a median dose of 76.4 Gy to point A, including 30-35 Gy of high-dose intracavity brachytherapy. The concurrent chemoradiotherapy group received platinum-based chemotherapy. Results The median follow-up was 65 months for surviving patients. There was no significant difference in compliance to radiotherapy between the two groups. Most acute toxicities were hematologic; acute hematologic and gastrointestinal toxicity were significantly more common in group II. Five-year overall survival and cancer-specific survival rates were, respectively, 53.5% and 66.6% in group I and 61.8% and 68.8% in group II. Performance status, comorbidity index, tumor size, and stage were independent prognostic factors for overall survival, whereas stage was the only prognostic factor for cancer-specific survival. Conclusions The analysis showed no benefit of concurrent chemoradiotherapy with respect to overall survival and cancer-specific survival in elderly women. A prospective study is needed to determine the role of concurrent chemoradiotherapy in this population. Free full text available at www.tumorionline.it
    Type of Medium: Online Resource
    ISSN: 0300-8916 , 2038-2529
    URL: Article
    DOI: 10.1177/548.6516
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2010
    detail.hit.zdb_id: 280962-X
    detail.hit.zdb_id: 2267832-3
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  • 4
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    Online Resource
    Numerical Simulation of PU Foaming Flow in a Refrigerator Cabinet
    SAGE Publications ; 2005
    In:  Journal of Cellular Plastics Vol. 41, No. 3 ( 2005-05), p. 251-266
    Details
    In: Journal of Cellular Plastics, SAGE Publications, Vol. 41, No. 3 ( 2005-05), p. 251-266
    Abstract: We have developed a numerical method for unsteady three-dimensional (3D) simulation of rigid polyurethane (PU) foaming flow in a refrigerator cabinet in this study. The governing equation for the compressible foaming flow is approximated with the Navier-Stokes equation, which means the foaming flow is assumed to be Newtonian. Numerical methods of simulation for unsteady compressible PU foaming flow with a free surface have been designed using a finite volume method (FVM) and the semi-implicit method for pressure-linked equations (SIMPLE) scheme as a pressure correction method. The formulation of numerical methods is developed on the basis of hexahedral meshes. Air in a refrigerator cabinet is neglected in the numerical method, and the free surface is traced with the volume of fluid (VOF) method. Viscosity and density of foam are assumed to be uniform in space and time-dependent, which are obtained with experimental methods. Results of numerical simulation for filling pattern and a finally filled position have been compared with the experimental results in a plate mold and a simple refrigerator cabinet. Simulation results of foaming fronts and finally filled position show good agreement with the experimental results. Numerical simulation of PU foaming flow is a useful tool to design a new refrigerator model and predict foam quality related to distance of foaming flow, air trapping, and location of finally filled position.
    Type of Medium: Online Resource
    ISSN: 0021-955X , 1530-7999
    URL: Article
    DOI: 10.1177/0021955X05053524
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2005
    detail.hit.zdb_id: 2098525-3
    SSG: 2
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