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It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis

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Stroke & Vascular Neurology 2019年第5期4卷 28-35页

作者： Jason P Appleton Lisa J Woodhouse Andrew Belcher Daniel Bereczki Eivind Berge valeria caso Hui Meng Chang Hanne K Christensen Ronan Collins John Gommans Ann C Laska George Ntaios Serefnur Ozturk Gillian M Sare Szabolcs Szatmari Yongjun Wang Joanna M Wardlaw Nikola Sprigg Philip M Bath for the ENOS investigators Stroke Division of Clinical NeurosciencesUniversity of NottinghamNottinghamUK Stroke Nottingham University Hospitals NHS TrustNottinghamUK Department of Neurology Semmelweis UniversityBudapestHungary Department of Internal Medicine and Cardiology Oslo University HospitalOsloNorway Stroke Unit Santa Maria della Misericordia HospitalUniversity of PerugiaPerugiaItaly Department of Neurology Singapore General HospitalSingaporeSingapore Neurology Bispebjerg and Frederiksberg HospitalCopenhagenDenmark Tallaght Hospital Trinity College DublinDublinIreland Department of Medicine Hawke's Bay District Health BoardHastingsNew Zealand Department of Clinical Science Danderyd HospitalKarolinska InstituteStockholmSweden Department of Medicine University of ThessalyLarissaGreece Neurology Selcuk University Faculty of MedicineKonyaTurkey Neurology Nottingham University Hospitals NHS TrustNottinghamUK Department of Neurology Clinical County Emergency HospitalTargu MuresRomania Neurology Beijing Tiantan HospitalBeijingChina Centre for Clinical Brain Sciences EdinburghUK

Background There is concern that blood pressure(BP)lowering in acute stroke may compromise cerebral perfusion and worsen outcome in the presence of carotid *** assessed the effect of glyceryl trinitrate(GTN)in patients with carotid stenosis using data from the Efficacy of Nitric Oxide in Stroke(ENOS)*** ENOS randomised 4011 patients with acute stroke and raised systolic BP(140-220 mm Hg)to transdermal GTN or no GTN within 48 hours of *** on prestroke antihypertensives were also randomised to stop or continue their medication for 7 *** primary outcome was the modified Rankin Scale(mRS)at day *** carotid stenosis was split:<30%;30-<50%;50-<70%;≥70%.Data are ORs with 95%CIs adjusted for baseline prognostic *** 2023(60.5%)ischaemic stroke participants had carotid *** compared with<30%,≥70%ipsilateral stenosis was associated with an unfavourable shift in mRS(worse outcome)at 90 days(OR 1.88,95%CI 1.44 to 2.44,p<0.001).Those with≥70%stenosis who received GTN versus no GTN had a favourable shift in mRS(OR 0.56,95%CI 0.34 to 0.93,p=0.024).In those with 50-<70%stenosis,continuing versus stopping prestroke antihypertensives was associated with worse disability,mood,quality of life and cognition at 90 *** outcomes did not differ across bilateral stenosis *** Following ischaemic stroke,severe ipsilateral carotid stenosis is associated with worse functional outcome at 90 *** appears safe in ipsilateral or bilateral carotid stenosis,and might improve outcome in severe ipsilateral carotid stenosis.

关键词： stenosis carotid hypertensive

关于缺血性卒中后女性妊娠以及针对不育、避孕和绝经期进行激素治疗的共识文件

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国际脑血管病杂志 2017年第8期25卷 677-683页

作者： valeria caso Alberto Falomi Cheryl D. Bushnell Monica Acciarresi Jose Ronohi Nikola Sprigg Sandro Gerli 李勍景燕李红燕朱沂 From the Stroke Unit Department of Vascular and Cardiovascular Medicine Santa Maria della Miserieordia Hospital Department of Medicine Section of Internal Medicine and Endocrine and Metabolic Sciences Department of Surgical and Biomedical Sciences Section of Obstetrics and Gynecology University of Perugia Italy Department of Neurology Wake Forest Baptist Medical Center Winston-Salem NC Instituto Valenciano de Infertilidad Universidad de Valencia Spain Stroke Trials Unit Division of Clinical Nenrosciences School of Medicine University of Nottingham United Kingdom 新疆维吾尔自治区人民医院神经内科乌鲁木齐830001

已有报道妊娠与缺血性卒中风险增高相关，妊娠期间发生卒中是导致孕产妇死亡的主要原因之一。Kuklina等对1994年至1995年与2006年至2007年的住院数据进行的比较显示，孕妇在产前发生任何类型卒中的风险增高47％（从0．15次／1000次分娩... 详细信息

已有报道妊娠与缺血性卒中风险增高相关，妊娠期间发生卒中是导致孕产妇死亡的主要原因之一。Kuklina等对1994年至1995年与2006年至2007年的住院数据进行的比较显示，孕妇在产前发生任何类型卒中的风险增高47％（从0．15次／1000次分娩～0．22次／1000次分娩），在产后发生任何卒中的风险增高83％（从0．12次／1000次分娩～0．22次／1000次分娩）。

关键词：缺血性卒中妊娠期间卒中后激素治疗绝经期不育女性文件

急性缺血性卒中的机械取栓治疗：ESO、ESMINT、ESNR和EAN共同支持的2014／2015 ESO-卡罗林斯卡卒中更新会议共识声明

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国际脑血管病杂志 2016年第1期24卷 1-12页

作者： Nils Wahlgren Tiago Moreira Patrik Michel Thorsten Steiner Olav Jansen Christophe Cognard Heinrich P Mattle Wim van Zwam Staffan Holmin Turgut Tatlisumak Jesper Petersson valeria caso Werner Hacke Mikael Mazighi Marcel Arnold Urs Fischer Istvan Szikora Laurent Pierot Jens Fiehler Jan Gralla Franz Fazekas Kennedy R Lees 高洁徐格林不详南京军区南京总医院神经内科 210002

这份卒中后机械取栓治疗共识声明的原始版本于2014年11月16—18日在斯德哥尔摩召开的欧洲卒中组织（European Stroke Organisation, ESO）-卡罗林斯卡卒中更新会议期间得到批准。根据会议安排，在2015年利用新的临床试验数据对该声明进... 详细信息

这份卒中后机械取栓治疗共识声明的原始版本于2014年11月16—18日在斯德哥尔摩召开的欧洲卒中组织（European Stroke Organisation, ESO）-卡罗林斯卡卒中更新会议期间得到批准。根据会议安排，在2015年利用新的临床试验数据对该声明进行了更新。2015年2月，在瑞士伯尔尼召开的ESO冬季培训会期间组织了面对面会议对共识声明进行修订，然后通过电子邮件交换意见，最终版本得到各学会的认可。推荐意见与原始版本一致，证据等级更新到2015年2月20日为止，在2015年5月15日获得确认。ESO-卡罗林斯卡卒中更新会议的目的在于总结卒中治疗研究的最新进展并探讨如何将这些最新研究结果应用于临床实践。共识会议选择了一些议题进行讨论，与会者草拟一份共识声明并进行讨论。该声明接受了ESO指南委员会的指导。这份共识声明包括对急性卒中后机械取栓治疗的推荐意见，得到欧洲卒中组织ESO、欧洲神经微创治疗学会（European Society of Minimally Invasive Neurological Therapy, ESMINT）、欧洲神经放射学学会（European Society of Neuroradiology, ESNR）和欧洲神经病学学会（European Academy of Neurology, EAN）的支持。

关键词：推荐共识声明急性卒中治疗机械取栓血管内

This pain drives me crazy:Psychiatric symptoms in women with interstitial cystitis/bladder pain syndrome

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World Journal of Psychiatry 2024年第6期14卷 954-984页

作者： Marianna Mazza Stella Margoni Giuseppe Mandracchia Guglielmo Donofrio Alessia Fischetti Georgios D Kotzalidis Giuseppe Marano Alessio Simonetti Delfina Janiri Lorenzo Moccia Ilaria Marcelli Greta Sfratta Domenico De Berardis Ottavia Ferrara Evelina Bernardi Antonio Restaino Francesco Maria Lisci Antonio Maria D'Onofrio Caterina Brisi Flavia Grisoni Claudia Calderoni Michele Ciliberto Andrea Brugnami Sara Rossi Maria Chiara Spera valeria De Masi Ester Maria Marzo Francesca Abate Gianluca Boggio Maria Benedetta Anesini Cecilia Falsini Anna Quintano Alberto Torresi Miriam Militenda Giovanni Bartolucci Marco Biscosi Sara Ruggiero Luca Lo Giudice Giulia Mastroeni Elisabetta Benini Luca Di Benedetto Romina caso Francesco Pesaresi Francesco Traccis Luca Onori Luca Chisari Leonardo Monacelli Mariateresa Acanfora Eleonora Gaetani Monia Marturano Sara Barbonetti Elettra Specogna Francesca Bardi Emanuela De Chiara Gianmarco Stella Andrea Zanzarri Flavio Tavoletta Arianna Crupi Giulia Battisti Laura Monti Giovanni Camardese Daniela Chieffo Antonio Gasbarrini Giovanni Scambia Gabriele Sani Department of Neurosciences Fondazione Policlinico Universitario A Gemelli IRCCSUniversita Cattolica del Sacro CuoreRome 00168Italy Department of Psychiatry UniversitàCattolica del Sacro CuoreRome 00168Italy Department of Neurosciences Section of PsychiatryFondazione Policlinico Universitario Agostino Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy Mental Health NHSASL 4 TeramoTeramo 64100Italy Medical and Surgical Sciences UniversitàCattolica del Sacro CuoreRome 00168Italy Division of Gynecologic Oncology UniversitàCattolica del Sacro CuoreRome 00168Italy UOS Psicologia Clinica Governo ClinicoFondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy CEMAD Digestive Disease Center Fondazione Policlinico Universitario A.Gemelli-IRCCSRome 00168Italy Department of Woman and Child Health Catholic UniversityRome 00168Italy UOC Psichiatria Clinica e d’Urgenza Dipartimento di Scienze Dell’InvecchiamentoNeurologicheOrtopediche e Della Testa-colloFondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy

BACKGROUND Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic *** the term cystitis suggests an inflammatory or infectious origin,no definite cause has been *** occurs in both sexes,but women are twice as much *** To systematically review evidence of psychiatric/psychological changes in persons with IC/*** Hypothesizing that particular psychological characteristics could underpin IC/BPS,we investigated in three databases the presence of psychiatric symptoms and/or disorders and/or psychological characteristics in patients with IC/BPS using the following strategy:("interstitial cystitis"OR"bladder pain syndrome")AND("mood disorder"OR depressive OR antidepressant OR depression OR depressed OR hyperthymic OR mania OR manic OR rapid cyclasterisk OR dysthymiasterisk OR dysphoriasterisk).RESULTS On September 27,2023,the PubMed search produced 223 articles,CINAHL 62,and the combined PsycLIT/PsycARTICLES/PsycINFO/Psychology and Behavioral Sciences Collection search *** on *** produced 14 studies,of which none had available *** were peer-reviewed articles reporting psychiatric/psychological symptoms in patients with IC/BPS,i.e.63 articles spanning from 2000 to October *** studies identified depression and anxiety problems in the IC/BPS population,along with sleep problems and the tendency to *** Psychotherapies targeting catastrophizing and life stress emotional awareness and expression reduced perceived pain in women with IC/*** concepts should be considered when implementing treatments aimed at reducing IC/BPS-related pain.

关键词： Interstitial cystitis/bladder pain syndrome Psychiatric symptoms Psychological symptoms Catastrophizing Anxiety Depression