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Monkeypox: A Viral Zoonotic Disease of Rising Global Concern

Infectious Diseases & Immunity 2024年第3期4卷 121-131页

作者： Sukumaran Ani Betsy Joseph Mary Thomas Vishnupriya K.Sweety Nandita Suresh Tumos Waltimo department of Dentistry Oral Health InstituteHamad Medical CorporationPost Box 3050DohaQatar College of dental Medicine Qatar UniversityPost Box 2713DohaQatar department of Periodontology Saveetha Dental College and HospitalsSaveetha Institute of Medical and Technical SciencesSaveetha UniversityChennai 600077India department of Oral and Maxillofacial Diseases Helsinki University and University HospitalHelsinki 00014Finland Pushpagiri Institute of Medical sciences and Research Centre MedicityPerumthuruthyTiruvallaKerala 689101India Clinic for Oral Health and Medicine University Center for Dental Medicine Basel UZBUniversity of Basel4058 BaselSwitzerland.

Monkeypox(mpox)is a rare viral zoonotic disease,endemic to Central and West Africa,caused by the monkeypox virus,an orthopoxvirus similar to the variola virus(smallpox).Although sporadic travel-associated cases have historically occurred outside Africa,in May 2022,mpox began spreading globally in multiple nonendemic countries across several *** 2024,there has been an increase in globally reported confirmed cases of mpox and deaths from mpox,making it a public health emergency of international *** reasons for the unusual global spread are under investigation but likely relate to increased travel and waning population immunity to *** now appears to be mainly through close,intimate contact,especially among men who have sex with *** is usually a self-limited *** limited approved antiviral treatments are available,such as tecovirimat,which the European Medicines Agency approved in January 2022 for the treatment of mpox,their widespread availability and effectiveness in the current outbreak remain to be *** health control measures include surveillance,case identification/isolation,contact tracing,and targeted vaccination of contacts at high risk of ***,challenges remain in curtailing the current unprecedented *** knowledge gaps include animal reservoir(s)responsible for initial spillover events,viral mutations that may enhance transmissibility,optimal diagnostics for noninvasive specimens,effective antiviral therapies,next-generation vaccines providing longer-term immunity,and building global capacity for outbreak *** review summarizes the current literature on mpox virology,epidemiology,pathogenesis,clinical manifestations,diagnostics,treatment,prevention,and public health control *** investigation and research are needed to better understand mpox’s evolving epidemiology,pathogenicity,transmissibility,and ecology to guide strategies for containin

关键词： Antiviral agents Disease outbreaks Epidemiology Mpox Smallpox vaccine Zoonoses

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Oral candidiasis and potential risk factors among disabled and nondisabled in Al-Baha region, Saudi Arabia

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World Journal of clinical Cases 2024年第27期12卷 6077-6086页

作者： Abdullah Ali H Alzahrani Nagesh Bhat Pankaj Kukreja Eltayeb Mohammed Alhassan Abdallah Ibrahim A Mudawi Faisal A Alzahrani Mohammad A Albanghali department of dental Health Faculty of Applied Medical SciencesAl-Baha UniversityAl Bahah 65731Saudi Arabia department of Preventive dental sciences School of DentistryAlBaha UniversityAl Bahah 65731Saudi Arabia department of Biomedical dental sciences School of DentistryAlBaha UniversityAl Bahah 65731Saudi Arabia department of Medical Services General Administration Public SecurityThe Saudi Ministry of InteriorRiyadh 11235Saudi Arabia department of Public Health Faculty of Applied Medical SciencesAl-Baha UniversityAl Bahah 65731Saudi Arabia

BACKGROUND Oral candidiasis(OC)is an oral health disease that could influence patients’oral health quality of *** To estimate prevalence of OC among disabled and non-disabled individuals and its potential risk factors in the Al-Baha region,Saudi *** An observational cross-sectional study was carried out among 148 disabled and non-disabled *** technique of concentrated oral rinse employing the Sabouraud Dextrose Agar medium accompanied with 0.05%chloramphenicol was conducted to assess and isolate *** examination using the World Health Organization guidelines was conducted to examine participants’oral hea-lth status.A pre-designed questionnaire was also used to evaluate sociodemo-graphic,medical history,and oral hygiene habits of the studied *** Out of 148 participants(n=57,38%)had colonized *** of the studied population had visible Candida ***,Candida was found in the oral rinses without the subject presenting any lesions or issues caused by Candida(asymptomatic colonization).The most common prevalent OC among participants were Candida albicans,Candida glabrata,Candida dubliniensis,Candida krusei,Candida tropicalis,and Candida parapsilosis(n=35,61%;n=8,14%;n=6,10%;n=5,9%;n=2,4%;and n=1,2%)***,smoking,poor plaque,and gingival status were key potential risk factors that significantly associated with candida’s density and presence(P=0.001,P=0.001,P=0.01,and P=0.01)*** status had no statistically significant effect on presence and density of *** The prevalence of OC is almost third of the studied population;thus,may provoke a need to develop preventive strategies to reduce the OC rate and establish solid treatment plans.

关键词： Oral health Candida Oral candidiasis dental public health Disabled Disability Risk factors Epidemiology

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Bioinspired polysaccharide-based nanocomposite membranes with robust wet mechanical properties for guided bone regeneration

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National Science Review 2024年第3期11卷 215-226页

作者： Jian-Hong Xiao Zhen-Bang Zhang JiaHao Li Si-Ming Chen Huai-Ling Gao YinXiu Liao Lu Chen ZiShuo Wang YiFan Lu YuanZhen Hou HengAn Wu DuoHong Zou Shu-Hong Yu department of Chemistry New Cornerstone Science Laboratory Institute of Biomimetic Materials&Chemistry Anhui Engineering Laboratory of Biomimetic MaterialsDivision of Nanomaterials&Chemistry Hefei National Research Center for Physical Sciences at the Microscale University of Science and Technology of China department of dental Implant Center Stomatologic Hospital and College Key Laboratory of Oral Diseases Research of Anhui Province Anhui Medical University CAS Key Laboratory of Mechanical Behavior and Design of Materials Department of Modern Mechanics CAS Center for Excellence in Complex System Mechanics University of Science and Technology of China department of Oral Surgery College of Stomatology National Clinical Research Center for Oral DiseasesShanghai Key Laboratory of Stomatology Shanghai Research Institute of Stomatology Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Institute of Innovative Materials(I2M) Department of Chemistry Department of Materials Science and Engineering Southern University of Science and Technology

Polysaccharide-based membranes with excellent mechanical properties are highly desired. However, severe mechanical deterioration under wet conditions limits their biomedical applications. Here, inspired by the structural heterogeneity of strong yet hydrated biological materials, we propose a strategy based on heterogeneous crosslink-and-hydration（HCH） of a molecule/nano dual-scale network to fabricate polysaccharide-based nanocomposites with robust wet mechanical properties. The heterogeneity lies in that the crosslink-and-hydration occurs in the molecule-network while the stress-bearing nanofiber-network remains unaffected. As one demonstration, a membrane assembled by bacterial cellulose nanofiber-network and Ca2+-crosslinked and hydrated sodium alginate molecule-network is designed. Studies show that the crosslinked-and-hydrated molecule-network restricts water invasion and boosts stress transfer of the nanofiber-network by serving as interfibrous bridge. Overall, the molecule-network makes the membrane hydrated and flexible; the nanofiber-network as stress-bearing component provides strength and *** HCH dual-scale network featuring a cooperative effect stimulates the design of advanced biomaterials applied under wet conditions such as guided bone regeneration membranes.

关键词： bioinspiration heterogeneous crosslink-and-hydration dual-scale network nanocomposite membrane wet mechanical properties guided bone regeneration

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Efficacy of graphene nanocomposites for air disinfection in dental clinics: A randomized controlled study

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World Journal of clinical Cases 2024年第28期12卷 6173-6179页

作者： Ya-Qiong Ju Xiang-Hua Yu Jing Wu Ying-Hui Hu Xiang-Yong Han Dan Fang department of Nursing Minhang District Dental ClinicShanghai 201107China department of Medical sciences Minhang District Dental ClinicShanghai 201107China department of Orthopedics Center for Spinal Minimally Invasive ResearchShanghai Jiao Tong UniversityShanghai 201107China

BACKGROUND Aerosols containing disease-causing microorganisms are produced during oral diagnosis and treatment can cause secondary *** To investigate the use of graphene material for air disinfection in dental clinics by leveraging its adsorption and antibacterial *** Patients who received ultrasonic cleaning at our hospital from April 2023 to April *** were randomly assigned to three groups(n=20 each):Graphene nanocomposite material suction group(Group A),ordinary filter suction group(Group B),and no air suction device group(Group C).The air quality and air colony count in the clinic rooms were assessed before,during,and after the ***,bacterial colony counts were obtained from the air outlets of the suction devices and the filter screens in Groups A and *** Before ultrasonic cleaning,no significant differences in air quality PM2.5 and colony counts were observed among the three ***,significant differences in air quality PM2.5 and colony counts were noted among the three groups during ultrasonic cleaning and after ultrasonic ***,the number of colonies on the exhaust port of the suction device and the surface of the filter were significantly lower in Group A than in Group B(P=0.000 and P=0.000,respectively).CONCLUSION Graphene nanocomposites can effectively sterilize the air in dental clinics by exerting their antimicrobial effects and may be used to reduce secondary pollution.

关键词： Graphene Nanocomposites Oral clinic Air disinfection Secondary contamination

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Perception of dental appearance and aesthetic analysis among patients,laypersons and dentists

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World Journal of clinical Cases 2024年第23期12卷 5354-5365页

作者： Alhanoof Aldegheishem Hadeel Mohammed Alfayadh Munirah AlDossary Shahad Asaad Elzahraa Eldwakhly Nour AL Huda AL Refaei Dana Alsenan Mai Soliman department of clinical dental sciences College of DentistryPrincess Nourah Bint Abdulrahman UniversityRiyadh 11671Saudi Arabia department of Oral Medicine and Pathology Ministry of HealthRiyadh 11176Saudi Arabia department of Prosthodontics Ministry of HealthRiyadh 11176Saudi Arabia department of Pediatric Ministry of HealthRiyadh 11176Saudi Arabia

BACKGROUND Current concepts of beauty are increasingly subjective,influenced by the viewpoints of *** aim of the study was to evaluate divergences in the perception of dental appearance and smile esthetics among patients,laypersons and dental *** study goals were to evaluate the influence of age,sex,education and dental specialty on the participants’judgment and to identify the values of different esthetic *** sample included 50 patients who responded to a dental appearance questionnaire(DAQ).Two frontal photographs were taken,one during a smile and one with retracted *** and dentists were asked to evaluate both photographs using a Linear Scale from(0-10),where 0 represent(absolutely unaesthetic)and 10 represent(absolutely aesthetic).One-way analysis of variance(ANOVA)and t-test analysis were measured for each *** patients in the sample expressed satisfaction with most aspects of their smiles and dental *** laypersons(including 488 participants),47 pictures“with lips”out of 50 had higher mean aesthetic scores compared to pictures“without lips”.Among the dentist sample,90 dentists’perception towards the esthetic smile and dental appearance for photos“with lips”and“without lips”were the same for 23 out of 50 *** of smile aesthetics differed between patients,laypersons and *** factors can contribute to shape the perception of smile *** To compare the perception of dental aesthetic among patients,laypersons,and professional dentists,to evaluate the impact of age,sex,educational background,and income on the judgments made by laypersons,to assess the variations in experience,specialty,age,and sex on professional dentists’judgment,and to evaluate the role of lips,skin shade and tooth shade in different participants’*** Patients sample included 50 patients who responded to *** frontal photographs were taken:one during a smile and one with retracted lip

关键词： Aesthetic perception Laypersons dental appearance Dentists Smile analysis dental aesthetic

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Extravasated contrast volumetric assessment on computed tomography angiography in gastrointestinal bleeding:A useful predictor of positive angiographic findings

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World Journal of Radiology 2024年第5期16卷 115-127页

作者： Laura Maria Cacioppa Chiara Floridi Alessandra Bruno NicolòRossini Tommaso Valeri Alessandra Borgheresi Riccardo Inchingolo Francesco Cortese Giacomo Novelli Alessandro Felicioli Mario Torresi Pietro Boscarato Letizia Ottaviani Andrea Giovagnoni Division of Interventional Radiology Department of Radiological SciencesUniversity Politecnica Delle MarcheAncona 60126Italy department of clinical Special and Dental SciencesUniversity Politecnica Delle MarcheAncona 60126Italy Division of Radiology Department of Radiological SciencesUniversity Hospital"Azienda Ospedaliero Universitaria Delle Marche"Ancona 60126Italy Interventional Radiology Unit "F Miulli"Regional General HospitalAcquaviva delle Fonti 70021Italy department of Radiology IRCCS INRCAAncona 60126Italy

BACKGROUND Gastrointestinal bleeding(GIB)is a severe and potentially life-threatening condition,especially in cases of delayed *** tomography angiography(CTA)plays a pivotal role in the early identification of upper and lower GIB and in the prompt treatment of the *** To determine whether a volumetric estimation of the extravasated contrast at CTA in GIB may be a predictor of subsequent positive angiographic *** In this retrospective single-centre study,35 patients(22 men;median age 69 years;range 16-92 years)admitted to our institution for active GIB detected at CTA and further submitted to catheter angiography between January 2018 and February 2022 were ***-three(65.7%)patients underwent endoscopy before *** volumetry was evaluated in both arterial and venous phases via a semi-automated dedicated *** rate was obtained from volume change between the two phases and standardised for unit *** were divided into two groups,according to the angiographic signs and their concordance with *** Upper bleeding accounted for 42.9%and lower GIB for 57.1%.Mean haemoglobin value at the admission was 7.7 g/dL.A concordance between positive CTA and direct angiographic bleeding signs was found in 19(54.3%)*** no significant differences in terms of bleeding volume in the arterial phase(0.55 mL vs 0.33 mL,P=0.35),a statistically significant volume increase in the venous phase was identified in the group of patients with positive angiography(2.06 mL vs 0.9 mL,P=0.02).In the latter patient group,a significant increase in bleeding rate was also detected(2.18 mL/min vs 0.19 mL/min,P=0.02).CONCLUSION In GIB of any origin,extravasated contrast volumetric analysis at CTA could be a predictor of positive angiography and may help in avoiding further unnecessary procedures.

关键词： Gastrointestinal haemorrhage Computed tomography angiography Volumetric analysis Computer-assisted image interpretation Therapeutic embolization Transcatheter arterial embolization

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Associated Factors of dental Caries among Intellectually Disabled Persons in Specialized Centers of Ouagadougou

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Open Journal of Epidemiology 2024年第2期14卷 297-311页

作者： Jocelyne Valerie Gare Filwende Dan Kientega Ouedraogo Carole Nathaie Tenin Ouattara Seydou Kabore Wendpoulomde Aime Désire Nicolas Meda Training and Research Unit in Health sciences Department of Public Health Joseph Ki Zerbo University Ouagadougou Burkina Faso Training and Research Unit in Health sciences Department of Dental Surgery Joseph Ki Zerbo University Ouagadougou Burkina Faso

Introduction: Several studies have reported a high prevalence of dental caries among the people with intellectual disabilities. In order to identify the sociodemographic, clinical and behavioral factors associated with it, we conducted a study in specialized centers welcoming subjects with intellectual disabilities in Ouagadougou (Burkina Faso). Objectives: The objective of this study was to identify the factors associated with it among intellectually disabled in the specialized centers of Ouagadougou. Methods: The study was cross-sectional analytical. The survey took place between November 2020 and January 2021 among people with intellectual disabilities in reception centers receiving a grant from the Ministry of Women, National Solidarity, Family and Humanitarian Action. Data collection was done with a questionnaire adapted from the World Health Organization (WHO) and dental caries was recorded according to WHO criteria in decayed, missing or filled teeth generating a DMF index. Logistic regression was used to identify factors associated with the presence of dental caries. Results: A total of 193 participants were included in the study with an average age of 12.4 years ± 7.9. The overall prevalence of caries measured with the DMF index was 58.6% 95% CI [51.2 - 65.8]. It was significantly associated with female gender (OR = 4.2;95% CI [1.4 - 12.5], p = 0,01), the clinical form of mental illness (epilepsy OR = 3.8 95%;CI [1.2 - 12.7], p = 0,02, trisomy OR = 5.0;95% CI [1.1 - 22.9], p = 0,03, motor autonomy OR = 0.2 95%;CI [0.1 - 0.7], p = 0,01) and at use of toothpaste OR = 9.33;95% CI [1.05 - 82.7], p = 0,04. Conclusion: dental caries remains a very present pathology in most people living with an intellectual disability. Also, it is necessary to put in place prevention strategies to reduce its prevalence and improve access to oral care for these people.

关键词： dental Caries Mental Disability Intellectual Disability Associated Factors Ouagadougou

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A multi-platform analysis of human gingival crevicular fluid reveals ferroptosis as a relevant regulated cell death mechanism during the clinical progression of periodontitis

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International Journal of Oral Science 2024年第2期16卷 265-279页

作者： Alfredo Torres M.Angélica Michea Ákos Végvári Marion Arce Valentina Pérez Marcela Alcota Alicia Morales Rolando Vernal Mauricio Budini Roman A.Zubarev Fermín E.González Laboratory of Experimental Immunology&Cancer Faculty of DentistryUniversity of ChileSantiagoChile department of Conservative Dentistry Faculty of DentistryUniversity of ChileSantiagoChile Division of Chemistry I Department of Medical Biochemistry and BiophysicsKarolinska InstitutetStockholmSweden Periodontal Biology Laboratory Faculty of DentistryUniversidad de ChileSantiagoChile Laboratory of Cellular and Molecular Pathology Institute for Research in Dental SciencesFaculty of DentistryUniversity of ChileSantiagoChile

Ferroptosis is implicated in the pathogenesis of numerous chronic-inflammatory diseases,yet its association with progressive periodontitis remains *** investigate the involvement and significance of ferroptosis in periodontitis progression,we assessed sixteen periodontitis-diagnosed *** progression was clinically monitored over twelve weeks via weekly clinical evaluations and gingival crevicular fluid(GCF)collection was performed for further *** metrics,proteomic data,in silico methods,and bioinformatics tools were combined to identify protein profiles linked to periodontitis progression and to explore their potential connection with *** western blot analyses validated key ***,a single-cell RNA sequencing(scRNA-seq)dataset(GSE164241)for gingival tissues was analyzed to elucidate cellular dynamics during periodontitis *** progression was identified as occurring at a faster rate than traditionally *** samples from progressing and non-progressing periodontal sites showed quantitative and qualitatively distinct proteomic *** addition,specific biological processes and molecular functions during progressive periodontitis were revealed and a set of hub proteins,including SNCA,CA1,HBB,SLC4A1,and ANK1 was strongly associated with the clinical progression status of ***,we found specific proteins-drivers or suppressors-associated with ferroptosis(SNCA,FTH1,HSPB1,CD44,and GCLC),revealing the co-occurrence of this specific type of regulated cell death during the clinical progression of ***,the integration of quantitative proteomic data with scRNA-seq analysis suggested the susceptibility of fibroblasts to *** analyses reveal proteins and processes linked to ferroptosis for the first time in periodontal patients,which offer new insights into the molecular mechanisms of progressive periodontal *** findings may le

关键词： finding progression faster

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Expert consensus on pediatric orthodontic therapies of malocclusions in children

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International Journal of Oral Science 2024年第2期16卷 186-196页

作者： Chenchen Zhou Peipei Duan Hong He Jinlin Song Min Hu Yuehua Liu Yan Liu Jie Guo Fang Jin Yang Cao Lingyong Jiang Qingsong Ye Min Zhu Beizhan Jiang Wenhua Ruan Xiao Yuan Huang Li Rui Zou Yulou Tian Li Gao Rui Shu Jianwei Chen Renkai Liu Shujuan Zou Xiaobing Li State Key Laboratory of Oral Diseases&National Center for Stomatology&National clinical Research Center for Oral Diseases&department of Pediatric Dentistry West China Hospital of StomatologySichuan UniversityChengduChina State Key Laboratory of Oral Diseases&National Center for Stomatology&National clinical Research Center for Oral Diseases&department of Orthodontics West China Hospital of StomatologySichuan UniversityChengduChina State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration&Key Laboratory of Oral Biomedicine Ministry of Education&Hubei Key Laboratory of Stomatology&department of Orthodontics&Center for Dentofacial Development and Sleep Medicine School and Hospital of StomatologyWuhan UniversityWuhanChina Chongqing Key Laboratory of Oral Diseases and Biomedical sciences&Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education Stomatological Hospital of Chongqing Medical UniversityChongqing Medical University&College of StomatologyChongqing Medical UniversityChongqingChina department of Orthodontics Hospital of StomatologyJilin UniversityChangchunChina department of Orthodontic&Oral Biomedical Engineering Laboratory Shanghai Stomatological HospitalFudan UniversityShanghaiChina department of Orthodontics Central LaboratoryPeking University School and Hospital for Stomatology&National Center for Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Research Center of Oral Biomaterials and Digital Medical Devices&Beijing Key Laboratory of Digital Stomatology&Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health&NMPA Key Laboratory for Dental Materials&National Engineering Research Center of Oral Biomaterials and Digital Medical DevicesBeijingChina department of Orthodontics School and Hospital of StomatologyCollege of MedicineShandong University&Shandong Key Laboratory of Oral Tissue Regeneration&Shandong Engineering Laboratory for Dental Materials and Oral Tissue

Malocclusion,identified by the World Health Organization(WHO)as one of three major oral diseases,profoundly impacts the dental-maxillofacial functions,facial esthetics,and long-term development of~260 million children in *** its physical manifestations,malocclusion also significantly influences the psycho-social well-being of these *** intervention in malocclusion can foster an environment conducive to dental-maxillofacial development and substantially decrease the incidence of malocclusion or reduce the severity and complexity of malocclusion in the permanent dentition,by mitigating the negative impact of abnormal environmental influences on the *** orthodontic treatment encompasses accurate identification and treatment of dental and maxillofacial morphological and functional abnormalities during various stages of dental-maxillofacial development,ranging from fetal stages to the early permanent dentition *** an economic and societal standpoint,the urgency for effective early orthodontic treatments for malocclusions in childhood cannot be overstated,underlining its profound practical and social *** consensus paper discusses the characteristics and the detrimental effects of malocclusion in children,emphasizing critical need for early *** elaborates on corresponding core principles and fundamental approaches in early orthodontics,proposing comprehensive guidance for preventive and interceptive orthodontic treatment,serving as a reference for clinicians engaged in early orthodontic treatment.

关键词： permanent stated children

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Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIGHT- 2 randomised sham- controlled ambulance trial

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Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： Jason Philip Appleton Lisa J Woodhouse Craig S Anderson Sandeep Ankolekar Lesley Cala Mark Dixon Timothy J England Kailash Krishnan Grant Mair Keith W Muir John Potter Christopher I Price Marc Randall Thompson G Robinson Christine Roffe Else C Sandset Jeffrey L Saver Angela Shone Aloysius Niroshan Siriwardena Joanna M Wardlaw Nikola Sprigg Philip M Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of Medicine The George Institute for Global HealthSydneyNew South WalesAustralia The George Institute China at Peking University Health Science Center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and Medical sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East Midlands Ambulance Service NHS Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK Centre for clinical Brain sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob Champion Research and Education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK department of Cardiovascular sciences and NIHR Leicester Biomedical Research Centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway department of Neurology and Comprehensive Stroke Center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and Graduate Services University of NottinghamNottinghamUK Community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RIGHT-2).Methods RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRS)at day *** outcomes included death;a global analysis(Wei-Lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),Glasgow Coma Scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%CI 0.85 to 1.54),death or global analysis(MWD 0.00,95%CI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** In patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** IS ALREADY KNOWN ON THIS TOPIC⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those w

关键词： Glasgow nitrate random

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