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Safety and efficacy of the Low-Profile Visualized Intraluminal Support stent in treating intracranial atherosclerotic stenosis 低剖面可视化管腔内支架治疗颅内动脉粥样硬化性狭窄的安全性和有效性
IF 3.9 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2023-10-01 DOI: 10.1016/j.nrl.2021.02.013
J.-W. Wang, X.-Y. Li, C.-H. Li, J.-F. Liu, H. Li, Y.-Y. Tian, B.-L. Gao

Purpose

The performance of the Low-Profile Visualized Intraluminal Support (LVIS) stent deployed following balloon angioplasty is unknown in treating intracranial atherosclerotic stenosis, and this study was to investigate the safety and efficacy of the LVIS stent in treating intracranial atherosclerotic stenosis in the middle cerebral artery M1 segment.

Methods

Thirty-five patients were enrolled with 35 atherosclerotic stenoses at the M1 segment. The stenosis was about 75% in 16 patients, 80% in 15, and 90% in the rest four. The LVIS stent was used to treat these patients.

Results

The success rate of stenting was 97.1%. The stenting procedure was failed in one patient because of intraprocedural dissection of the stenotic (75%) segment, resulting in a 30-day periprocedural complication rate of 2.9% (1/35). Before stenting, the stenosis rate ranged 75%–90% (mean 78.9% ± 4.7%), and after stenting, the diameter of the stented segment was significantly (P < 0.0001) increased to 1.5–3.4 mm (mean 2.1 ± 0.32 mm) ranging 68.2%–100% (mean 94.0% ± 5.8%) of the normal arterial diameter, with the residual stenosis ranging 0–31.8% (median 4.8%, IQR 2.4%–7.3%). Follow-up was performed at 6–20 months (mean 8.5) after stenting. One patient (2.9%) had occlusion of the stented M1 segment with no symptoms, and two patients (5.7%) had slight asymptomatic instent stenosis (40%) at the M1 segment, with the instent restenosis and occlusion rate of 8.6% (3/35).

Conclusion

The braided LVIS stent can be safely applied for treatment of intracranial atherosclerotic stenosis in the middle cerebral artery with good safety and efficacy immediately after stenting and at follow-up.

目的低剖面可视化管腔内支架(LVIS)治疗颅内动脉粥样硬化性狭窄的疗效尚不清楚,本研究旨在探讨LVIS支架治疗大脑中动脉M1段颅内动脉粥样硬化性病变的安全性和有效性。方法35例M1段动脉粥样硬化性狭窄患者。16例患者的狭窄率约为75%,15例为80%,其余4例为90%。LVIS支架用于治疗这些患者。结果支架置入成功率为97.1%,其中1例因术中剥离狭窄段(75%)而失败,30天围手术期并发症发生率为2.9%(1/35)。支架置入前,狭窄率为75%-90%(平均78.9%±4.7%),支架置入后,支架段的直径显著(P<;0.0001)增加到1.5–3.4 mm(平均2.1±0.32 mm),范围为正常动脉直径的68.2%-100%(平均94.0%±5.8%),残余狭窄范围为0–31.8%(中位数4.8%,IQR 2.4%–7.3%)。支架植入后6–20个月(平均8.5个月)进行随访。1名患者(2.9%)支架M1段闭塞,无症状,2名患者(5.7%)M1段轻度无症状狭窄(40%),支架再狭窄和闭塞率为8.6%(3/35)。结论编织型LVIS支架可安全应用于治疗大脑中动脉颅内动脉粥样硬化性狭窄,支架置入后即刻及随访安全有效。
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引用次数: 1
Réplica: Perfil clínico, tratamiento antibiótico y riesgo de ictus en pacientes con endocarditis infecciosa 感染性心内膜炎患者的临床概况、抗生素治疗和中风风险
IF 3.9 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2023-10-01 DOI: 10.1016/j.nrl.2022.09.008
J. Rodríguez-Montolio , D. Meseguer-González , M. Almeida-Zurita , S. Santos-Lasaosa
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引用次数: 0
Revisión sistemática de la aplicación de algoritmos de «machine learning» en la esclerosis múltiple “机器学习”算法在多发性硬化症中应用的系统评价
IF 3.9 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2023-10-01 DOI: 10.1016/j.nrl.2020.10.017
M. Vázquez-Marrufo , E. Sarrias-Arrabal , M. García-Torres , R. Martín-Clemente , G. Izquierdo

Introduction

The applications of artificial intelligence, and in particular automatic learning or “machine learning” (ML), constitute both a challenge and a great opportunity in numerous scientific, technical, and clinical disciplines. Specific applications in the study of multiple sclerosis (MS) have been no exception, and constitute an area of increasing interest in recent years.

Objective

We present a systematic review of the application of ML algorithms in MS.

Materials and methods

We used the PubMed search engine, which allows free access to the MEDLINE medical database, to identify studies including the keywords “machine learning” and “multiple sclerosis.” We excluded review articles, studies written in languages other than English or Spanish, and studies that were mainly technical and did not specifically apply to MS. The final selection included 76 articles, and 38 were rejected.

Conclusions

After the review process, we established 4 main applications of ML in MS: 1) classifying MS subtypes; 2) distinguishing patients with MS from healthy controls and individuals with other diseases; 3) predicting progression and response to therapeutic interventions; and 4) other applications. Results found to date have shown that ML algorithms may offer great support for health professionals both in clinical settings and in research into MS.

引言人工智能的应用,特别是自动学习或“机器学习”(ML),在许多科学、技术和临床学科中既是一个挑战,也是一个巨大的机遇。在多发性硬化症(MS)研究中的具体应用也不例外,近年来成为人们越来越感兴趣的领域。目的我们对ML算法在MS中的应用进行了系统综述。材料和方法我们使用PubMed搜索引擎来识别包括关键词“机器学习”和“多发性硬化症”在内的研究,以及主要是技术性的,不专门适用于MS的研究。最终选择包括76篇文章,38篇被拒绝。结论经过回顾,我们确定了ML在MS中的4个主要应用:1)MS亚型的分类;2) 将MS患者与健康对照组和患有其他疾病的个体区分开来;3) 预测治疗干预的进展和反应;以及4)其他应用。迄今为止发现的结果表明,ML算法可以在临床环境和MS研究中为卫生专业人员提供强大的支持。
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引用次数: 2
The MIGREX study: Prevalence and risk factors of sexual dysfunction among migraine patients MIGREX研究:偏头痛患者性功能障碍的患病率和危险因素
IF 3.9 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2023-10-01 DOI: 10.1016/j.nrl.2021.02.006
M. Torres-Ferrus , A.C. López-Veloso , V. Gonzalez-Quintanilla , N. González-García , J. Díaz de Teran , A. Gago-Veiga , J. Camiña , M. Ruiz , N. Mas-Sala , S. Bohórquez , V.J. Gallardo , P. Pozo-Rosich

Background

Migraine attacks have a high impact on daily activities. There is limited research on the burden of migraine on sexual functioning.

Objective

To determine the prevalence of sexual dysfunction in patients with migraine and its relationship with migraine features and comorbidities.

Method

This is a cross-sectional study. We included migraine patients between 18 and 60 years-old from 8 Headache Clinics in Spain. We recorded demographic data and migraine features. Patients fulfilled a survey including comorbidities, Arizona Sexual Experiences Scale, Hospital Anxiety and Depression Scale and a questionnaire about migraine impact on sexual activity. A K-nearest neighbor supervised learning algorithm was used to identify differences between migraine patients with and without sexual dysfunction.

Results

We included 306 patients (85.6% women, mean age 42.3 ±11.1 years). A 41.8% of participants had sexual dysfunction. Sexual dysfunction was associated with being female (OR [95% CI]: 2.42 [1.17–5.00]; p < 0.001), being older than 46.5 years (4.04 [2.48–6.59]; p < 0.001), having chronic migraine (2.31 [1.41–3.77]; p = 0.001), using preventive medication (2.45 [1.35–4.45]; p = 0.004), analgesic overusing (3.51 [2.03–6.07]; p < 0.001), menopause (4.18 [2.43–7.17]; p < 0.001) and anxiety (2.90 [1.80–4.67]; p < 0.001) and depression (6.14 [3.18–11.83]; p < 0.001). However, only female gender, age, menopause and depression were the statistically significant variables selected in the model to classify migraine patients with or without sexual dysfunction (Accuracy [95% CI]: 0.75 (0.62–0.85), Kappa: 0.48, p = 0.005).

Conclusions

Sexual dysfunction is frequent in migraine patients visited in a headache clinic. However, migraine characteristics or use of preventive medication are not directly associated with sexual dysfunction. Instead, risk factors for sexual dysfunction were female gender, higher age, menopause and depression.

背景偏头痛发作对日常活动有很大影响。关于偏头痛对性功能负担的研究有限。目的确定偏头痛患者性功能障碍的患病率及其与偏头痛特征和合并症的关系。方法这是一项横断面研究。我们纳入了来自西班牙8家头痛诊所的18至60岁的偏头痛患者。我们记录了人口统计数据和偏头痛特征。患者完成了一项调查,包括合并症、亚利桑那州性经验量表、医院焦虑和抑郁量表以及一份关于偏头痛对性活动影响的问卷。使用K近邻监督学习算法来识别有性功能障碍和没有性功能障碍的偏头痛患者之间的差异。结果306例患者(女性85.6%,平均年龄42.3±11.1岁)。41.8%的参与者有性功能障碍。性功能障碍与女性(OR[95%CI]:2.42[1.17–5.00];p<;0.001)、年龄超过46.5岁(4.04[2.48–6.59];p<;001)、患有慢性偏头痛(2.31[1.41–3.77];p=0.001)、使用预防性药物(2.45[1.35–4.45];p=0.004)、过度使用止痛药(3.51[2.03–6.07];p<;0.001)有关,更年期(4.18[2.43-7.17];p<;0.001)、焦虑(2.90[1.80-4.67];p&llt;0.001)和抑郁(6.14[3.18-11.83];p&lgt;0.001)。然而,在该模型中,只有女性性别、年龄、更年期和抑郁是对有或无性功能障碍的偏头痛患者进行分类的统计学显著变量(准确度[95%CI]:0.75(0.62-0.85),Kappa:0.48,p=0.005)。结论性功能障碍在头痛门诊就诊的偏头痛患者中很常见。然而,偏头痛的特征或预防性药物的使用与性功能障碍没有直接关系。相反,性功能障碍的危险因素是女性、年龄较大、更年期和抑郁症。
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引用次数: 1
Encefalopatía de Hashimoto posvacuna frente a coronavirus 2 del síndrome respiratorio agudo grave 严重急性呼吸综合征冠状病毒2疫苗后桥本脑病
IF 3.9 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2023-10-01 DOI: 10.1016/j.nrl.2022.09.006
M. Viscasillas Sancho, C. Moreno Loscertales, S. García Rubio, D. Sagarra Mur
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引用次数: 0
Impacto de las nuevas tecnologías en la neurología en España. Revisión del Comité Ad-Hoc de Nuevas Tecnologías de la Sociedad Española de Neurología 新技术对西班牙神经病学的影响。西班牙神经病学学会新技术特设委员会的审查
IF 3.9 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2023-10-01 DOI: 10.1016/j.nrl.2020.10.015
R. López-Blanco , A. Sorrentino Rodriguez , E. Cubo , Í. Gabilondo , D. Ezpeleta , M.A. Labrador-Espinosa , Á. Sánchez-Ferro , C. Tejero , M. Matarazzo , por el Comité Ad-Hoc de Nuevas Tecnologías de la SEN

Introduction

New technologies (NT) are increasingly widespread in biomedicine. Using the consensus definition of NT established by the New Technologies Ad-Hoc Committee of the Spanish Society of Neurology (SEN), we evaluated the impact of these technologies on Spanish neurology, based on communications presented at Annual Meetings of the SEN.

Material and methods

We defined the concept of NT in neurology as a novel technology or novel application of an existing technology, characterised by a certain degree of coherence persisting over time, with the potential to have an impact on the present and/or future of neurology. We conducted a descriptive study of scientific communications presented at the SEN's annual meetings from 2012 to 2018, analysing the type of NT, the field of neurology, and the geographical provenance of the studies.

Results

We identified 299 communications related with NT from a total of 8,139 (3.7%), including 120 posters and 179 oral communications, ranging from 1.6% of all communications in 2012 to 6.8% in 2018. The technologies most commonly addressed were advanced neuroimaging (24.7%), biosensors (17.1%), electrophysiology and neurostimulation (14.7%), and telemedicine (13.7%). The neurological fields where NT were most widely employed were movement disorders (18.4%), cerebrovascular diseases (15.7%), and dementia (13.4%). Madrid was the region presenting the highest number of communications related to NT (32.8%), followed by Catalonia (26.8%) and Andalusia (9.0%).

Conclusions

The number of communications addressing NT follows an upward trend. The number of NT used in neurology has increased in parallel with their availability. We found scientific communications in all neurological subspecialties, with a heterogeneous geographical distribution.

简介新技术在生物医学中越来越广泛。根据西班牙神经病学学会(SEN)新技术特设委员会对NT的一致定义,我们根据SEN年会上的交流,评估了这些技术对西班牙神经病学的影响。材料和方法我们将NT在神经病学中的概念定义为一种新技术或现有技术的新应用,其特征是随着时间的推移持续存在一定程度的连贯性,有可能对神经病学的现在和/或未来产生影响。我们对2012年至2018年SEN年会上发表的科学传播进行了描述性研究,分析了NT的类型、神经病学领域和研究的地理来源。结果我们从8139份(3.7%)与NT相关的通信中确定了299份,包括120份海报和179份口头通信,从2012年的1.6%到2018年的6.8%不等。最常见的技术是高级神经成像(24.7%)、生物传感器(17.1%)、电生理和神经刺激(14.7%)以及远程医疗(13.7%)。NT应用最广泛的神经领域是运动障碍(18.4%)、脑血管疾病(15.7%),马德里是与NT相关的通信数量最多的地区(32.8%),其次是加泰罗尼亚(26.8%)和安达卢西亚(9.0%)。神经科使用的NT数量随着其可用性的增加而增加。我们在所有神经亚专业中都发现了科学交流,具有异质的地理分布。
{"title":"Impacto de las nuevas tecnologías en la neurología en España. Revisión del Comité Ad-Hoc de Nuevas Tecnologías de la Sociedad Española de Neurología","authors":"R. López-Blanco ,&nbsp;A. Sorrentino Rodriguez ,&nbsp;E. Cubo ,&nbsp;Í. Gabilondo ,&nbsp;D. Ezpeleta ,&nbsp;M.A. Labrador-Espinosa ,&nbsp;Á. Sánchez-Ferro ,&nbsp;C. Tejero ,&nbsp;M. Matarazzo ,&nbsp;por el Comité Ad-Hoc de Nuevas Tecnologías de la SEN","doi":"10.1016/j.nrl.2020.10.015","DOIUrl":"https://doi.org/10.1016/j.nrl.2020.10.015","url":null,"abstract":"<div><h3>Introduction</h3><p>New technologies (NT) are increasingly widespread in biomedicine. Using the consensus definition of NT established by the New Technologies Ad-Hoc Committee of the Spanish Society of Neurology (SEN), we evaluated the impact of these technologies on Spanish neurology, based on communications presented at Annual Meetings of the SEN.</p></div><div><h3>Material and methods</h3><p>We defined the concept of NT in neurology as a novel technology or novel application of an existing technology, characterised by a certain degree of coherence persisting over time, with the potential to have an impact on the present and/or future of neurology. We conducted a descriptive study of scientific communications presented at the SEN's annual meetings from 2012 to 2018, analysing the type of NT, the field of neurology, and the geographical provenance of the studies.</p></div><div><h3>Results</h3><p>We identified 299 communications related with NT from a total of 8,139 (3.7%), including 120 posters and 179 oral communications, ranging from 1.6% of all communications in 2012 to 6.8% in 2018. The technologies most commonly addressed were advanced neuroimaging (24.7%), biosensors (17.1%), electrophysiology and neurostimulation (14.7%), and telemedicine (13.7%). The neurological fields where NT were most widely employed were movement disorders (18.4%), cerebrovascular diseases (15.7%), and dementia (13.4%). Madrid was the region presenting the highest number of communications related to NT (32.8%), followed by Catalonia (26.8%) and Andalusia (9.0%).</p></div><div><h3>Conclusions</h3><p>The number of communications addressing NT follows an upward trend. The number of NT used in neurology has increased in parallel with their availability. We found scientific communications in all neurological subspecialties, with a heterogeneous geographical distribution.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"38 8","pages":"Pages 591-598"},"PeriodicalIF":3.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nrl.2020.10.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50190508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gender may be related to the side of the motor syndrome and cognition in idiopathic Parkinson's disease 性别可能与特发性帕金森病的运动综合征和认知有关
IF 3.9 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2023-09-01 DOI: 10.1016/j.nrl.2021.01.009
A.R. Bentivoglio , M.R. Lo Monaco , R. Liperoti , D. Fusco , E. Di Stasio , A. Tondinelli , D. Marzullo , A. Maino , M.C. Cipriani , M.C. Silveri

Background

and Sex and cognitive profile may be related to the laterality of motor symptoms in idiopathic Parkinson's disease.

Introduction

Parkinson's disease (PD) is well recognised as an inherently asymmetric disease with unilateral onset of motor symptoms. The laterality of motor symptoms may be linked to sex, clinical and demographic variables, and neuropsychological disorders. However, the available data are inconsistent. This study aimed to explore the potential association between the laterality of motor symptoms and clinical and demographic variables and deficits in specific cognitive domains.

Material and methods

We retrospectively recruited 97 participants with idiopathic PD without dementia; 60 presented motor symptoms on the left side and 37 on the right side. Both groups were comparable in terms of age, age at disease onset, disease duration, and severity of the neurological deficits according to the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr scale.

Results

Participants with left-side motor symptoms scored lower on the Schwab and England Activities of Daily Living scale. Our sample included more men than women (67% vs. 33%). Both sexes were not equally represented in the 2 groups: there were significantly more men than women in the group of patients with left-side motor symptoms (77% vs. 23%), whereas the percentages of men and women in the group of patients with right-side motor symptoms were similar (51% vs. 49%). Both groups performed similarly in all neuropsychological tasks, but women, independently of laterality, performed better than men in the naming task.

Conclusion

We found a clear prevalence of men in the group of patients with left-side motor symptoms; this group also scored lower on the Schwab and England Scale. Female sex was predictive of better performance in the naming task. Sex should always be considered in disorders that cause asymmetric involvement of the brain, such as PD.

背景和性别及认知特征可能与特发性帕金森病运动症状的偏侧性有关。引言帕金森病(PD)是一种固有的不对称疾病,具有单侧发作的运动症状。运动症状的偏侧性可能与性别、临床和人口统计学变量以及神经心理障碍有关。然而,现有数据不一致。本研究旨在探索运动症状的偏侧性与临床和人口统计学变量以及特定认知领域的缺陷之间的潜在联系。材料和方法我们回顾性地招募了97名无痴呆的特发性帕金森病患者;60例左侧出现运动症状,37例右侧出现运动症状。根据统一帕金森病评定量表和Hoehn和Yahr量表,两组在年龄、发病年龄、疾病持续时间和神经系统缺陷严重程度方面具有可比性。结果有左侧运动症状的参与者在施瓦布和英格兰日常生活活动量表中得分较低。我们的样本中男性多于女性(67%对33%)。在这两组中,两性的比例并不平等:在左侧运动症状患者组中,男性明显多于女性(77%对23%),而在右侧运动症状患者中,男性和女性的比例相似(51%对49%)。两组在所有神经心理学任务中表现相似,但女性在命名任务中表现优于男性,与偏侧性无关。结论我们发现男性患者中明显存在左侧运动症状;这一组在施瓦布和英格兰量表上的得分也较低。女性在命名任务中表现较好。在导致大脑不对称参与的疾病中,如帕金森病,应始终考虑性行为。
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引用次数: 3
La SEN y el modelo español de recertificación impulsado por FACME y sus sociedades científico-médicas federadas SEN和FACME及其联合科学-医学协会推动的西班牙再认证模式
IF 3.9 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2023-09-01 DOI: 10.1016/j.nrl.2022.08.003
M. Mendibe Bilbao , D. Ezpeleta Echávarri , J.M. Láinez Andrés
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引用次数: 0
Encefalitis anti-NMDA-R post-COVID-19: descripción de un caso y propuesta de su mecanismo fisiopatológico 新型冠状病毒后抗NMDA-R脑炎1例并提出其病理生理机制
IF 3.9 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2023-09-01 DOI: 10.1016/j.nrl.2022.08.002
A. Sanchez-Larsen, L. Rojas-Bartolomé, M. Fernández-Valiente, D. Sopelana
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引用次数: 1
Alice in Wonderland syndrome heralding posterior reversible encephalopathy syndrome in a patient with undiagnosed multiple myeloma Alice-in-Wonderland综合征预示一例未确诊的多发性骨髓瘤患者的后部可逆性脑病综合征
IF 3.9 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2023-09-01 DOI: 10.1016/j.nrl.2022.09.001
Ritwik Ghosh , Moisés León-Ruiz , Dipayan Roy , Kunal Bole , Julián Benito-León
{"title":"Alice in Wonderland syndrome heralding posterior reversible encephalopathy syndrome in a patient with undiagnosed multiple myeloma","authors":"Ritwik Ghosh ,&nbsp;Moisés León-Ruiz ,&nbsp;Dipayan Roy ,&nbsp;Kunal Bole ,&nbsp;Julián Benito-León","doi":"10.1016/j.nrl.2022.09.001","DOIUrl":"https://doi.org/10.1016/j.nrl.2022.09.001","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"38 7","pages":"Pages 516-519"},"PeriodicalIF":3.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50180343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Neurologia
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