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Cerebral small vessel disease modifies outcomes after minimally invasive surgery for intracerebral haemorrhage

Stroke & Vascular neurology 2024年第4期9卷 446-456,I0147页

作者： Yunke Li Sung-Min Cho Radhika Avadhani Hassan Ali Yi Hao Santosh B Murthy Joshua n goldstein Fan Xia Xin Hu natalie L Ullman Issam Awad Daniel Hanley Wendy C Ziai The George Institute for Global Health BeijingChina Department of neurology Division of Neurocritical CareJohns Hopkins Medical InstitutionsBaltimoreMarylandUSA Department of neurology Division of Brain Injury OutcomesJohns Hopkins Medical Institutions CampusBaltimoreMarylandUSA Department of neurology Weill Cornell Medical CollegeNew YorkNew YorkUSA Department of Emergency Medicine Massachusetts General HospitalBostonMassachusettsUSA Department of neurosurgery West China Hospital of MedicineChengduSichuanChina Department of neurosurgery University of Chicago Pritzker School of MedicineChicagoIllinoisUSA

Background Minimally invasive surgery(MIS)for spontaneous supratentorial intracerebral haemorrhage(ICH)is controversial but may be beneficial if end-of-treatment(EOT)haematoma volume is reduced to≤15 *** explored whether MRI findings of cerebral small vessel disease(CSVD)modify the effect of MIS on long-term *** Prespecified blinded subgroup analysis of 288 subjects with qualified imaging sequences from the phase 3 Minimally Invasive Surgery Plus Alteplase for Intracerebral Haemorrhage Evacuation(MISTIE)*** tested for heterogeneity in the effects of MIS and MIS+EOT volume≤15 mL on the trial’s primary outcome of good versus poor function at 1 year by the presence of single CSVD features and CSVD scores using multivariable *** Of 499 patients enrolled in MISTIE III,288 patients had MRI,149(51.7%)randomised to MIS and 139(48.3%)to standard medical care(SMC).Median(IQR)ICH volume was 42(30–53)*** the full MRI cohort,there was no statistically significant heterogeneity in the effects of MIS versus SMC on 1-year outcomes by any specific CSVD feature or by CSVD scores(all P_(interaction)>0.05).In 94 MIS patients with EOT ICH volume≤15 mL,significant reduction in odds of poor outcome was found with cerebral amyloid angiopathy scorenteraction)=0.006),absence of lacunes(OR,0.37(0.18–0.80);P_(interaction)=0.02)and absence of severe white matter hyperintensities(WMHs)(OR,0.22(0.08–0.58);P_(interaction)=0.03).Conclusions Following successful haematoma reduction by MIS,we found significantly lower odds of poor functional outcome with lower total burden of CSVD in addition to absence of lacunes and severe *** features may have utility for prognostication and patient selection in clinical trials of MIS.

关键词： Surgery surgery absence

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Resource utilisation among patients transferred for intracerebral haemorrhage

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Stroke & Vascular neurology 2019年第4期4卷 223-226页

作者： Kori Sauser Zachrison Emily Aaronson Sadiqa Mahmood Jonathan Rosand Anand Viswanathan Lee H Schwamm Joshua n goldstein Department of Emergency Medicine Massachusetts General HospitalBostonMassachusettsUSA Department of Emergency Medicine Harvard Medical SchoolBostonMassachusettsUSA Health Catalyst CambridgeMassachusettsUSA Department of neurology Massachusetts General HospitalBostonMassachusettsUSA Department of neurology Harvard Medical SchoolBostonMassachusettsUSA

background Patients with intracerebral haemorrhage(ICH)are frequently transferred between hospitals for higher level of *** aimed to identify factors associated with resource utilisation among patients with ICH admitted to a single academic *** We used a prospectively collected registry of consecutive patients with primary ICH at an urban academic hospital between 1 January 2005 and 31 December *** primary outcome was use of either intensive care unit(ICU)admission or surgical *** regression examined factors associated with the outcome,controlling for age,sex,Glasgow coma score(GCS)and ICH *** Of the 2008 patients included,887(44.2%)received ICU stay or surgical *** patients were younger(71 vs 74 years,pn white(83.9% vs 89.3%,pne GCS(12 vs 14,pnd more frequently had intraventricular haemorrhage(58.6%vs 43.4%,pndependently associated with ICU stay or surgical intervention were age>65 years(OR 0.38,95% CI 0.21 to 0.69),GCSnd ICH score>0(OR 2.23,95% CI 1.70 to 2.91).Conclusion Among this cohort of primary patients with ICH,GCS of 15 and ICH score of 0 were associated with less frequent use of ICU or *** results should be validated in a larger sample but may be valuable for hospitals considering which patients with ICH could safely remain at the referring facility.

关键词： patients admitted Glasgow

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Improving detection of cerebral small vessel disease aetiology in patients with isolated lobar intracerebral haemorrhage

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Stroke & Vascular neurology 2023年第1期8卷 26-33页

作者： Alvin S Das Elif Gokcal Robert W Regenhardt Mitchell J Horn Kristin Schwab nader Daoud Anand Viswanathan W Taylor Kimberly Joshua n goldstein Alessandro Biffi natalia Rost Jonathan Rosand Lee H Schwamm Steven M Greenberg M Edip Gurol Department of neurology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA Department of neurology Massachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA Department of neurosurgery Massachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA Department of Emergency Medicine Massachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA

Background and purpose We evaluate whether non-haemorrhagic imaging markers(nHIM)(white matter hyperintensity patterns,lacunes and enlarged perivascular spaces(EPVS))can discriminate cerebral amyloid angiopathy(CAA)from hypertensive cerebral small vessel disease(HTn-cSVD)among patients with isolated lobar intracerebral haemorrhage(isolated-LICH).Methods In patients with isolated-LICH,four cSVD aetiologic groups were created by incorporating the presence/distribution of nHIM:HTn-cSVD pattern,CAA pattern,mixed nHIM and no *** pattern consisted of patients with any combination of severe centrum semiovale EPVS,lobar lacunes or multiple subcortical spots ***-cSVD pattern consisted of any HTn-cSVD markers:severe basal ganglia PVS,deep lacunes or peribasal ganglia white matter hyperintensity *** nHIM consisted of at least one imaging marker from either *** hypothesis was that patients with HTn-cSVD pattern/mixed nHIM would have a higher frequency of left ventricular hypertrophy(LVH),which is associated with *** In 261 patients with isolated-LICH,CAA pattern was diagnosed in 93 patients,HTn-cSVD pattern in 53 patients,mixed nHIM in 19 patients and no nHIM in 96 *** frequency of LVH was similar among those with HTn-cSVD pattern and mixed nHIM(50%vs 39%,p=0.418)but was more frequent in HTn-cSVD pattern compared with CAA pattern(50%vs 20%,pn a regression model,HTn-cSVD pattern(OR:7.38;95%CI 2.84 to 19.20)and mixed nHIM(OR:4.45;95%CI 1.25 to 15.90)were found to be independently associated with *** Among patients with isolated-LICH,nHIM may help differentiate HTn-cSVD from CAA,using LVH as a marker for HTn-cSVD.

关键词： patients cerebral hypertensive

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采用新型无创、无袖带、无线设备进行24 h动态血压监测

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中华高血压杂志(中英文) 2022年第7期 700-700页

作者： nachman D Gilan A goldstein n Constantini K Littman R Eisenkraft A Grossman E Gepner Y 袁源郑武洪

当前高血压诊断和治疗采用袖带式设备进行动态血压监测(ambulatory blood pressure monitoring, ABPM)。技术限制、低依从性和复杂操作限制了其使用。本研究旨在验证与标准袖带式ABPM设备相比，新型基于光学体积描记术的可穿戴设备(腕...

当前高血压诊断和治疗采用袖带式设备进行动态血压监测(ambulatory blood pressure monitoring, ABPM)。技术限制、低依从性和复杂操作限制了其使用。本研究旨在验证与标准袖带式ABPM设备相比，新型基于光学体积描记术的可穿戴设备(腕式监测仪)的准确性。方法：对年龄18～65岁的志愿者同时使用两种设备测定24 h ABPM,并记录他们的日常活动及两种设备的舒适性和活动干扰程度。

关键词：

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长期减重干预与血压的关系:一项18个月的随机对照试验

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中华高血压杂志 2021年第3期29卷 267-267页

作者：袁源(摘译) 郑武洪(审校) Gepner Y goldstein n Shelef I Schwarzfuchs D Zelicha H Meir AY Tsaban G Grossman E 不详

肥胖与血压升高相关。肥胖合并高血压的患者,减重可降低血压,但减重对血压的长期作用尚不清楚。本研究是随机对照试验,纳入腹型肥胖或血清三酰甘油升高和低高密度脂蛋白的受试者278例为研究对象,年龄(47.9±9.3)岁,男性占89%,高血压患者... 详细信息

肥胖与血压升高相关。肥胖合并高血压的患者,减重可降低血压,但减重对血压的长期作用尚不清楚。本研究是随机对照试验,纳入腹型肥胖或血清三酰甘油升高和低高密度脂蛋白的受试者278例为研究对象,年龄(47.9±9.3)岁,男性占89%,高血压患者占56%,进行18个月的减重干预,观察受试者在基线,6和18个月测体质量和血压,旨在评估长期减重干预对正常血压者和高血压患者血压的影响。

关键词：正常血压腹型肥胖高密度脂蛋白合并高血压随机对照试验受试者降低血压高血压患者

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novel transparent MgGa_(2)O_(4) and ni^(2+)-doped MgGa_(2)O_(4) ceramics

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Journal of Advanced Ceramics 2022年第3期11卷 470-481页

作者： Guangran ZHAnG Adrian goldstein Yiquan WU Kazuo Inamori School of Engineering New York State College of CeramicsAlfred UniversityAlfredNew York 14802USA Israel Ceramic and Silicate Institute HaifaIsrael

In this study we fabricated, for the first time, magnesium gallate (MgGa_(2)O_(4), a partially inverted spinel) transparent ceramics, both undoped and doped with 1 at% ni. The specimens were derived from in-house prepared powder, with a crystallite size of ∼10 nm (by wet chemistry) and densified by pulsed electric current sintering (PECS;peak temperature 950 ℃ for 90 min). Densification levels of 99.84% and 99.52% of theoretical density were attained for doped and undoped materials, respectively. Doping with ni was seen to marginally improve the densification level. Quite transparent specimens were produced: the best showing transmission of ∼89% of the theoretical level (thickness t = 0.85 mm). The absorption spectra revealed that the dopant was accumulated as ni^(2+) in the octahedral sites of the lattice, as occurs in single-crystal specimens. After excitation at 980 nm, the doped disks exhibited a wide fluorescence band centered at 1264 nm.

关键词： magnesium gallate(MgGa_(2)O_(4)) spinel transparent ceramics pulsed electric current sintering(PECS)

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自发性脑出血管理指南美国心脏协会／美国卒中协会针对医疗专业人员的指南

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国际脑血管病杂志 2015年第10期23卷 721-739页

作者： J. Claude Hemphill Ⅲ Steven M. Greenberg Craig S. Anderson Kyra Beckelr Bernard R. Bendok Mary Cushman Gordon L. Fung Joshua n. goldstein R. LochMacdonald Pamela H Mitchell, Phillip A Scott,Magdy H Selim, Daniel Woo 高圆圆徐欣不详南京大学医学院附属鼓楼医院神经内科 210008

目的本指南旨在为自发性脑出血的诊断和治疗提供最新的全面推荐意见。方法利用PubMed进行规范化文献检索，检索时间至2013年8月底。撰写委员会成员通过远程电信会议讨论指南内容及推荐意见，采用美国心脏协会／美国卒中协会的疗效确定... 详细信息

目的本指南旨在为自发性脑出血的诊断和治疗提供最新的全面推荐意见。方法利用PubMed进行规范化文献检索，检索时间至2013年8月底。撰写委员会成员通过远程电信会议讨论指南内容及推荐意见，采用美国心脏协会／美国卒中协会的疗效确定性水平和证据分级方案对推荐意见进行分级。由6位同行评议专家以及卒中委员会科学声明监督委员会和卒中委员会领导委员会成员对指南草案进行发表前审阅。结果本文为急性脑出血患者的医疗诊治提供了循证指南，重点包括诊断、凝血功能障碍和血压管理、继发性脑损伤防治、颅内压控制、外科治疗的作用、转归预测、康复、二级预防以及将来需要考虑的问题。本指南已纳入最新的3期临床试验结果。结论脑出血是一种需要进行早期积极救治的危重疾病。本指南为脑出血患者的目标导向治疗提供了一个框架。

关键词：美国心脏协会科学声明血压凝血功能障碍诊断脑出血脑室出血外科手术治疗

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到美国急诊室就诊的头痛患者:人口统计学资料、病理诊断的建立和发生率

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世界核心医学期刊文摘(神经病学分册) 2006年第11期 43-43页

作者： goldstein J.n Camargo Jr. C.A Pelletier A.J Edlow J.A 周永 Department of Emergency Medicine Beth Israel Deaconess Medical Center 1 Deaconess Road Boston MA 02215 United States Dr.

Headache is a common complaint in the emergency department (ED). In order to examine headache work-ups and diagnoses across the USA, we queried a representative sample of adult ED visits (the national Hospital Ambulatory Medical Care Survey)for the years 1992-2001. Headache accounted for 2.1 million ED visits per year (2.2%of visits). Of the 14%of patients who underwent neuroimaging, 5.5%received a pathological diagnosis. Of the 2%of patients who underwent lumbar puncture, 11%received a pathological diagnosis. On multivariable analysis, a decreased rate of imaging was noted for patients without private insurance [odds ratio (OR) 0.61, confidence interval (CI) 0.44, 0.86] and for those presenting off-hours (OR 0.55, CI 0.39, 0.77). Patients over 50 were more likely to receive a pathological diagnosis (OR 3.3, CI 1.2, 9.3). In conclusion, clinicians should ensure that appropriate work-ups are performed regardless of presentation time or insurance status, and be vigilant in the evaluation of older patients.

关键词：头痛患者病理诊断急诊室美国美利坚合众国北美洲

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地壳形成年龄的应用和误用

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地质地球化学 1989年第1期17卷 47-49页

作者： n.T.Arndt S.L.goldstein 李学明中国科学技术大学

钐-钕(Sm-nd)同位素研究可用来评价地壳生长的历史,有时可给出反映壳幔分异时间的“地壳形成”年龄。然而,如果一个样品是不同时期来源于地幔的物质的混合物,那么Sm-nd同位素分馏系列可能只提供该样品中的物质存留于大陆壳内的平均时间... 详细信息

钐-钕(Sm-nd)同位素研究可用来评价地壳生长的历史,有时可给出反映壳幔分异时间的“地壳形成”年龄。然而,如果一个样品是不同时期来源于地幔的物质的混合物,那么Sm-nd同位素分馏系列可能只提供该样品中的物质存留于大陆壳内的平均时间估计值。在这些情况下,Sm-nd同位素不给出地壳形成年龄的直接信息。这些年龄只有在得到了其他地质和地质年代信息的支持后才可解释为壳幔分离的时间。错误的解释会导致对地壳发育得出错误的结论。

关键词：地壳年龄 Md模式年龄

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Transdiagnostic considerations of mental health for the post-COVID era:Lessons from the first surge of the pandemic

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World Journal of Clinical Cases 2023年第4期11卷 809-820页

作者： Sari goldstein Ferber Gal Shoval Rodolfo Rossi Viviana Trezza Giorgio Di Lorenzo Gil Zalsman Aron Weller J John Mann Aron Weller Department of PsychologyBar Ilan UniversityRamat Gan 5290002Israel Department of neuroscience Princeton UniversityPrinceton NJ 08544United States Geha Mental Health Center Petah TiqvaIsrael and Sackler Faculty of MedicineTel Aviv UniversityTel Aviv 77096Israel Department of Systems Medicine University of Rome Tor VergataRome 00133Italy Department of Science Rome Tre UniversityRome 00154Italy Department of Psychiatry Rome University Tor VergataRome 00179Italy IRCCS-Fondazione Santa Lucia Rome 00179Italy Division of Molecular Imaging and neuropathology Department of PsychiatryColumbia UniversityNY10032United States

BACKGROUnD The Coronavirus disease 19(COVID-19)-related psychiatric burden partly results from prolonged social stress *** have examined the psychiatric impact of COVID-19 on Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM 5)and International Classification of Diseases 11th Revision(ICD-11)categories,implicating multiple diagnoses,complicating clinical *** To verify whether COVID-19-related psychopathology spans multiple DSM-5 and ICD-11 diagnoses,but not in a random ***,empirical analysis of the multiple associated symptoms will better describe COVID-19-related *** We conducted a bi-national study during the first surge of the pandemic:an Italian sample(n=21217,studied March-April 2020);and three representative longitudinal samples from Israel(n=1276,1189,and 1432 respectively,studied May-July 2020).Data in Italy were collected by a national internet-based survey with an initially approached sample of about one million persons and in Israel by the Israeli Central Bureau of Statistics using probability-based national representative *** analysis focused on the frequency and patterns of reported multiple mental health *** Combinations with all symptoms were more prevalent than combinations with fewer symptoms,with no majorities-minorities differences in both countries,demonstrating the generalizability of the transdiagnostic pattern of mental health issues in both nations.A history of previous mental disorder(Italian study)and an increase in symptom prevalence over time(Israel study)were associated with an increased number of ***:Based on finding correlated symptom diversity spanning conventional diagnostic categories,we suggest that the pattern of mental health issues associated with the COVID-19 pandemic is *** The findings have implications for improving prevention and treatment of COVID-19 related psychopathology and

关键词： Post-COVID-19 Diagnosis Stress Mental disorders Transdiagnosis Reactive psychiatric disorders

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