December 2023
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7 Reads
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1 Citation
Clinical Neurology and Neurosurgery
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December 2023
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7 Reads
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1 Citation
Clinical Neurology and Neurosurgery
March 2023
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25 Reads
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3 Citations
Aging Clinical and Experimental Research
Background Frailty is a state of cumulative degeneration of bodily functions that is consistently associated with poor outcomes in older people following illness. Combined stroke intervention and frailty may yield additive and synergistic effects adults with stroke. Objective To evaluate the safety and efficacy of endovascular therapy (EVT) in frail patients. Methods We conducted a systematic review of the relationship between debilitation and acute ischemic stroke (AIS) after EVT. Until August 2022, researchers have searched three databases (Pubmed, EMBASE and Cochrane). Random-effects meta-analysis, combined ratio (OR) and 95% confidence interval (95%CI) were used to assess efficacy values. The I² statistic was used to assess heterogeneity. Comprehensive meta-analysis software was used for meta-analysis. Results We ultimately included eight studies including 3662 non-overlapping participants. Four studies used the Clinical Frailty Scale (CFS), two studies used the Hospital Frailty Risk Score (HFRS), a study used frailty index and a study used the comprehensive geriatric assessment (CGA). Frailty prevalence: 35%; 95% CI, 0.27–0.43; low quality evidence, downgraded due to heterogeneity, bias. Random effects showed that poor functional outcome (5 studies, OR 1.956, 95% CI 1.256–3.048) and mortality (9 studies, OR 2.320, 95% CI 1.680–3.205) was significantly associated with frailty. In adjusted analyses, poor functional outcome (4 studies, ORadj 1.189, 95% CI 1.043–1.357), and mortality (3 studies, ORadj 1.036, 95% CI 1.008–1.065) were significantly associated with frailty. Conclusion Pre-stroke frailty is an important predictor of poor prognosis assessed by EVT and can be added to the classical predictors of stroke outcome. Routine assessment of pre-stroke frailty can help patients to make decisions about the efficacy of their choice of EVT.
August 2022
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40 Reads
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2 Citations
Neurological Sciences
Background Previous meta-analysis had concluded that desferrioxamine mesylate (DFO) could effectively treat intracerebral hematoma (ICH) in animal models. We hope to confirm that DFO could treat ICH patients effectively through the systemic review and meta-analysis of clinical researches. Method Data extraction included hematoma volume (HV), reduction of National Institute of Health Stroke Scale (NIHSS) scores, and relative perihematomal edema (RPHE). The standard mean difference (SMD) and 95% confidence interval (95% CI ) were calculated by fixed effects model. I-square ( I ² ) statistic was used to test the heterogeneity. All p values were two-side with a significant level at 0.05. Results Five randomized controlled trials were included in the meta-analysis, which included 239 patients. At 7 days after onset, there was significant difference of RPHE development (− 1.87 (− 2.22, − 1.51) ( I ² = 0, p = 0.639)) and significant difference of HV absorption (− 0.71 (− 1.06, 0.36) ( I ² = 17.5%, p = 0.271)) between DFO and control groups. There was significant difference of reduction of NHISS scores (0.25 (0.05, 0.46) ( I ² = 0, p = 0.992)) between DFO and control groups at 30 days after onset. Conclusion DFO reduced HV and perihematomal edema in ICH patients at 7 days after onset and improve neurological function at 30 days after onset efficiently and safely. DFO might be a new route of improving treatment of ICH.
May 2021
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60 Reads
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10 Citations
Environmental Science and Pollution Research
Ambient fine particulate matter of 2.5 μm or less in diameter (PM2.5) of environment contamination is deemed as a risk factor of cerebrovascular diseases. Yet there is still no explicit evidence strongly supporting that PM2.5 with per unit increment can increase the risk of hemorrhagic stroke (HS). Literatures were searched from PubMed, Cochrane, and Embase. After the systemic review of relevant studies, random effects model was used to perform meta-analysis and to evaluate the association between PM2.5 and risk of HS. Seven cohort studies were finally included, involving more than 6 million people and 37,667 endpoint events (incidence or mortality of HS). Total scores of quality assessment were 50. Pooled hazard ratio (HR) for crude HRs was 1.13 (95%CI: 1.09–1.17) (CI for confidence interval). Pooled HR of subgroup analysis for current smoking with exposure to growing PM2.5 was 1.14 (95%CI: 0.92–2.15) and for never and former smoking was 1.04 (95%CI: 0.74–1.46). Ambient PM2.5 level is significantly associated with the risk of HS, which might be a potential risk factor of HS. Smoking does not further increase the risk of HS under exposure of PM2.5.
May 2020
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28 Reads
Purpose: To summarize the experience of diagnosis and treatment of echinococcosis in nervous system in Qinghai-Tibet Plateau. Methods: Patients with echinococcosis of nervous system treated in Qinghai Provincial People's Hospital from January 2010 to September 2018 were selected. All patients were examined by enzyme linked immunosorbent assay and imaging examination. During the hospital, all patients received surgery. After operation, patients exanimated regularly and followed up for one year. Results: A total of 13 patients were included in this study. The average age was 38.8±13.7 and seven cases (54%) were male. Among these patients, six cases had cystic echinococcosis and seven cases with alveolar echinococcosis, meanwhile, eight patients had cerebral echinococcosis and five patients with spinal echinococcosis. The enzyme linked immunosorbent assay indicated positive results in 8 cases and one patient was misdiagnosed as vertebral metastases by imaging examination before operation. One patient recurred after operation but refused treatment. After follow-up for one year, the mRS (Modified Rankin Scale) of cerebral echinococcosis improved from 3.3±0.5 to 2.1±0.4, four cases of spinal echinococcosis improved in ASIA (American Spinal Injury Association). Conclusion: Current evidence indicated that early surgical treatment and oral albendazole might improve the outcome of patients with nervous system echinococcosis in short time.
... In a meta-analysis, DFO treatment was demonstrated to reduce edema and improve neurological function in randomized controlled clinical trials in patients with intracerebral hemorrhage. Additionally, DFO infusions were shown to be safe, feasible and well-tolerated [100]. However, at a high dose, DFO infusions have been associated with increased pulmonary toxicity and acute respiratory distress syndrome [77]. ...
August 2022
Neurological Sciences
... Ambient air pollution is a major environmental concern for the health of the population in both urban and rural areas worldwide (Zhao et al. 2021). Fine particulate matter with a diameter of less than 2.5 micrometres (PM2.5) has emerged as a significant and widespread air pollutant, and it represents a new environmental risk factor for accelerated brain ageing (Underwood 2017), as well as being linked to an increased risk of multiple chronic diseases (Tainio et al. 2021) including Alzheimer's disease (AD) (Younan et al. 2020). ...
May 2021
Environmental Science and Pollution Research