47 results on '"Vanhooren, G"'
Search Results
2. Stroke coach: a pilot study of a personal digital coaching program for patients after ischemic stroke
- Author
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Kamoen, Olivia, Maqueda, V., Yperzeele, L., Pottel, H., Cras, P., Vanhooren, G., and Vanacker, P.
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- 2020
- Full Text
- View/download PDF
3. An individualized coaching program for patients with acute ischemic stroke: Feasibility study
- Author
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Vanacker, P., Standaert, D., Libbrecht, N., Vansteenkiste, I., Bernard, D., Yperzeele, L., and Vanhooren, G.
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- 2017
- Full Text
- View/download PDF
4. Tuberothalamic infarction causing a central Horner syndrome with contralateral ataxia and paraphasia
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Gieraerts, Katrien, Casselman, L., Casselman, J. W., and Vanhooren, G.
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- 2015
- Full Text
- View/download PDF
5. Value of treatment by comprehensive stroke services for the reduction of critical gaps in acute stroke care in Europe
- Author
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Webb, AJS, Fonseca, AC, Berge, E, Randall, G, Fazekas, F, Norrving, B, Nivelle, E, Thijs, V, Vanhooren, G, and initiative, Stroke Working Group of the European Brain Council Value of Treatment
- Subjects
medicine.medical_specialty ,Cost effectiveness ,Total cost ,Cost-Benefit Analysis ,03 medical and health sciences ,0302 clinical medicine ,Atrial Fibrillation ,medicine ,media_common.cataloged_instance ,Humans ,030212 general & internal medicine ,European union ,Intensive care medicine ,Stroke ,health care economics and organizations ,Neurorehabilitation ,Cause of death ,media_common ,Cost database ,business.industry ,medicine.disease ,Markov Chains ,Europe ,Systematic review ,Neurology ,Neurology (clinical) ,Quality-Adjusted Life Years ,business ,030217 neurology & neurosurgery - Abstract
Stroke is the second leading cause of death and dependency in Europe and costs the European Union more than €30bn, yet significant gaps in the patient pathway remain and the cost-effectiveness of comprehensive stroke care to meet these needs is unknown. The European Brain Council Value of Treatment Initiative combined patient representatives, stroke experts, neurological societies and literature review to identify unmet needs in the patient pathway according to Rotterdam methodology. The cost-effectiveness of comprehensive stroke services was determined by a Markov model, using UK cost data as an exemplar and efficacy data for prevention of death and dependency from published systematic reviews and trials, expressing effectiveness as quality-adjusted life-years (QALYs). Model outcomes included total costs, total QALYs, incremental costs, incremental QALYs and the incremental cost-effectiveness ratio (ICER). Key unmet needs in the stroke patient pathway included inadequate treatment of atrial fibrillation (AF), access to neurorehabilitation and implementation of comprehensive stroke services. In the Markov model, full implementation of comprehensive stroke services was associated with a 9.8% absolute reduction in risk of death of dependency, at an intervention cost of £9566 versus £6640 for standard care, and long-term care costs of £35 169 per 5.1251 QALYS vs. £32 347.40 per 4.5853 QALYs, resulting in an ICER of £5227.89. Results were robust in one-way and probabilistic sensitivity analyses. Implementation of comprehensive stroke services is a cost-effective approach to meet unmet needs in the stroke patient pathway, to improve acute stroke care and support better treatment of AF and access to neurorehabilitation.
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- 2021
- Full Text
- View/download PDF
6. Global Impact of COVID-19 on Stroke Care and IV Thrombolysis
- Author
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Nogueira, R.G. Qureshi, M.M. Abdalkader, M. Martins, S.O. Yamagami, H. Qiu, Z. Mansour, O.Y. Sathya, A. Czlonkowska, A. Tsivgoulis, G. Aguiar de Sousa, D. Demeestere, J. Mikulik, R. Vanacker, P. Siegler, J.E. Kõrv, J. Biller, J. Liang, C.W. Sangha, N.S. Zha, A.M. Czap, A.L. Holmstedt, C.A. Turan, T.N. Ntaios, G. Malhotra, K. Tayal, A. Loochtan, A. Ranta, A. Mistry, E.A. Alexandrov, A.W. Huang, D.Y. Yaghi, S. Raz, E. Sheth, S.A. Mohammaden, M.H. Frankel, M. Bila Lamou, E.G. Aref, H.M. Elbassiouny, A. Hassan, F. Menecie, T. Mustafa, W. Shokri, H.M. Roushdy, T. Sarfo, F.S. Alabi, T.O. Arabambi, B. Nwazor, E.O. Sunmonu, T.A. Wahab, K. Yaria, J. Mohammed, H.H. Adebayo, P.B. Riahi, A.D. Sassi, S.B. Gwaunza, L. Ngwende, G.W. Sahakyan, D. Rahman, A. Ai, Z. Bai, F. Duan, Z. Hao, Y. Huang, W. Li, G. Li, W. Liu, G. Luo, J. Shang, X. Sui, Y. Tian, L. Wen, H. Wu, B. Yan, Y. Yuan, Z. Zhang, H. Zhang, J. Zhao, W. Zi, W. Leung, T.W. Chugh, C. Huded, V. Menon, B. Pandian, J.D. Sylaja, P.N. Usman, F.S. Farhoudi, M. Hokmabadi, E.S. Horev, A. Reznik, A. Sivan Hoffmann, R. Ohara, N. Sakai, N. Watanabe, D. Yamamoto, R. Doijiri, R. Tokuda, N. Yamada, T. Terasaki, T. Yazawa, Y. Uwatoko, T. Dembo, T. Shimizu, H. Sugiura, Y. Miyashita, F. Fukuda, H. Miyake, K. Shimbo, J. Sugimura, Y. Yagita, Y. Takenobu, Y. Matsumaru, Y. Yamada, S. Kono, R. Kanamaru, T. Yamazaki, H. Sakaguchi, M. Todo, K. Yamamoto, N. Sonoda, K. Yoshida, T. Hashimoto, H. Nakahara, I. Kondybayeva, A. Faizullina, K. Kamenova, S. Zhanuzakov, M. Baek, J.-H. Hwang, Y. Lee, J.S. Lee, S.B. Moon, J. Park, H. Seo, J.H. Seo, K.-D. Sohn, S.I. Young, C.J. Ahdab, R. Wan Zaidi, W.A. Aziz, Z.A. Basri, H.B. Chung, L.W. Ibrahim, A.B. Ibrahim, K.A. Looi, I. Tan, W.Y. Yahya, N.W. Groppa, S. Leahu, P. Al Hashmi, A.M. Imam, Y.Z. Akhtar, N. Pineda-Franks, M.C. Co, C.O. Kandyba, D. Alhazzani, A. Al-Jehani, H. Tham, C.H. Mamauag, M.J. Venketasubramanian, N. Chen, C.-H. Tang, S.-C. Churojana, A. Akil, E. Aykaç, Ö. Ozdemir, A.O. Giray, S. Hussain, S.I. John, S. Le Vu, H. Tran, A.D. Nguyen, H.H. Nhu Pham, T. Nguyen, T.H. Nguyen, T.Q. Gattringer, T. Enzinger, C. Killer-Oberpfalzer, M. Bellante, F. De Blauwe, S. Vanhooren, G. De Raedt, S. Dusart, A. Lemmens, R. Ligot, N. Pierre Rutgers, M. Yperzeele, L. Alexiev, F. Sakelarova, T. Bedeković, M.R. Budincevic, H. Cindric, I. Hucika, Z. Ozretic, D. Saric, M.S. Pfeifer, F. Karpowic, I. Cernik, D. Sramek, M. Skoda, M. Hlavacova, H. Klecka, L. Koutny, M. Vaclavik, D. Skoda, O. Fiksa, J. Hanelova, K. Nevsimalova, M. Rezek, R. Prochazka, P. Krejstova, G. Neumann, J. Vachova, M. Brzezanski, H. Hlinovsky, D. Tenora, D. Jura, R. Jurák, L. Novak, J. Novak, A. Topinka, Z. Fibrich, P. Sobolova, H. Volny, O. Krarup Christensen, H. Drenck, N. Klingenberg Iversen, H. Simonsen, C.Z. Truelsen, T.C. Wienecke, T. Vibo, R. Gross-Paju, K. Toomsoo, T. Antsov, K. Caparros, F. Cordonnier, C. Dan, M. Faucheux, J.-M. Mechtouff, L. Eker, O. Lesaine, E. Ondze, B. Peres, R. Pico, F. Piotin, M. Pop, R. Rouanet, F. Gubeladze, T. Khinikadze, M. Lobjanidze, N. Tsiskaridze, A. Nagel, S. Ringleb, P.A. Rosenkranz, M. Schmidt, H. Sedghi, A. Siepmann, T. Szabo, K. Thomalla, G. Palaiodimou, L. Sagris, D. Kargiotis, O. Klivenyi, P. Szapary, L. Tarkanyi, G. Adami, A. Bandini, F. Calabresi, P. Frisullo, G. Renieri, L. Sangalli, D. Pirson, A. Uyttenboogaart, M. van den Wijngaard, I. Kristoffersen, E.S. Brola, W. Fudala, M. Horoch-Lyszczarek, E. Karlinski, M. Kazmierski, R. Kram, P. Rogoziewicz, M. Kaczorowski, R. Luchowski, P. Sienkiewicz-Jarosz, H. Sobolewski, P. Fryze, W. Wisniewska, A. Wiszniewska, M. Ferreira, P. Ferreira, P. Fonseca, L. Marto, J.P. Pinho E Melo, T. Nunes, A.P. Rodrigues, M. Tedim Cruz, V. Falup-Pecurariu, C. Krastev, G. Mako, M. de Leciñana, M.A. Arenillas, J.F. Ayo-Martin, O. Cruz Culebras, A. Tejedor, E.D. Montaner, J. Pérez-Sánchez, S. Tola Arribas, M.A. Rodriguez Vasquez, A. Mayza, M. Bernava, G. Brehm, A. Machi, P. Fischer, U. Gralla, J. Michel, P.L. Psychogios, M.-N. Strambo, D. Banerjee, S. Krishnan, K. Kwan, J. Butt, A. Catanese, L. Demchuk, A.M. Field, T. Haynes, J. Hill, M.D. Khosravani, H. Mackey, A. Pikula, A. Saposnik, G. Scott, C.A. Shoamanesh, A. Shuaib, A. Yip, S. Barboza, M.A. Barrientos, J.D. Portillo Rivera, L.I. Gongora-Rivera, F. Novarro-Escudero, N. Blanco, A. Abraham, M. Alsbrook, D. Altschul, D. Alvarado-Ortiz, A.J. Bach, I. Badruddin, A. Barazangi, N. Brereton, C. Castonguay, A. Chaturvedi, S. Chaudry, S.A. Choe, H. Choi, J.H. Dharmadhikari, S. Desai, K. Devlin, T.G. Doss, V.T. Edgell, R. Etherton, M. Farooqui, M. Frei, D. Gandhi, D. Grigoryan, M. Gupta, R. Hassan, A.E. Helenius, J. Kaliaev, A. Kaushal, R. Khandelwal, P. Khawaja, A.M. Khoury, N.N. Kim, B.S. Kleindorfer, D.O. Koyfman, F. Lee, V.H. Leung, L.Y. Linares, G. Linfante, I. Lutsep, H.L. Macdougall, L. Male, S. Malik, A.M. Masoud, H. McDermott, M. Mehta, B.P. Min, J. Mittal, M. Morris, J.G. Multani, S.S. Nahab, F. Nalleballe, K. Nguyen, C.B. Novakovic-White, R. Ortega-Gutierrez, S. Rahangdale, R.H. Ramakrishnan, P. Romero, J.R. Rost, N. Rothstein, A. Ruland, S. Shah, R. Sharma, M. Silver, B. Simmons, M. Singh, A. Starosciak, A.K. Strasser, S.L. Szeder, V. Teleb, M. Tsai, J.P. Voetsch, B. Balaguera, O. Pujol Lereis, V.A. Luraschi, A. Almeida, M.S. Cardoso, F.B. Conforto, A. De Deus Silva, L. Varrone Giacomini, L. Oliveira Lima, F. Longo, A.L. Magalhães, P.S.C. Martins, R.T. Mont'alverne, F. Mora Cuervo, D.L. Costa Rebello, L. Valler, L. Zetola, V.F. Lavados, P.M. Navia, V. Olavarría, V.V. Almeida Toro, J.M. Amaya, P.F.R. Bayona, H. Corredor, A. Rivera Ordonez, C.E. Mantilla Barbosa, D.K. Lara, O. Patiño, M.R. Diaz Escobar, L.F. Dejesus Melgarejo Fariña, D.E. Cardozo Villamayor, A. Zelaya Zarza, A.J. Barrientos Iman, D.M. Rodriguez Kadota, L. Campbell, B. Hankey, G.J. Hair, C. Kleinig, T. Ma, A. Tomazini Martins, R. Sahathevan, R. Thijs, V. Salazar, D. Yuan-Hao Wu, T. Haussen, D.C. Liebeskind, D. Yavagal, D.R. Jovin, T.G. Zaidat, O.O. Nguyen, T.N. SVIN COVID-19 Global Stroke Registry SVIN COVID-19 Global Stroke Registry
- Abstract
OBJECTIVE: To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. METHODS: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. RESULTS: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] -11.7 to -11.3, p < 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI -13.8 to -12.7, p < 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI -13.7 to -10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2-9.8, p < 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. CONCLUSIONS: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months. © 2021 American Academy of Neurology.
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- 2021
7. Value of treatment by comprehensive stroke services for the reduction of critical gaps in acute stroke care in Europe.
- Author
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Webb, A. J. S., Fonseca, A. C., Berge, E., Randall, G., Fazekas, F., Norrving, B., Nivelle, E., Thijs, V., and Vanhooren, G.
- Subjects
STROKE ,STROKE units ,ATRIAL fibrillation ,NEUROREHABILITATION ,MARKOV processes ,STROKE patients - Abstract
Stroke is the second leading cause of death and dependency in Europe and costs the European Union more than €30bn, yet significant gaps in the patient pathway remain and the cost‐effectiveness of comprehensive stroke care to meet these needs is unknown. The European Brain Council Value of Treatment Initiative combined patient representatives, stroke experts, neurological societies and literature review to identify unmet needs in the patient pathway according to Rotterdam methodology. The cost‐effectiveness of comprehensive stroke services was determined by a Markov model, using UK cost data as an exemplar and efficacy data for prevention of death and dependency from published systematic reviews and trials, expressing effectiveness as quality‐adjusted life‐years (QALYs). Model outcomes included total costs, total QALYs, incremental costs, incremental QALYs and the incremental cost‐effectiveness ratio (ICER). Key unmet needs in the stroke patient pathway included inadequate treatment of atrial fibrillation (AF), access to neurorehabilitation and implementation of comprehensive stroke services. In the Markov model, full implementation of comprehensive stroke services was associated with a 9.8% absolute reduction in risk of death of dependency, at an intervention cost of £9566 versus £6640 for standard care, and long‐term care costs of £35 169 per 5.1251 QALYS vs. £32 347.40 per 4.5853 QALYs, resulting in an ICER of £5227.89. Results were robust in one‐way and probabilistic sensitivity analyses. Implementation of comprehensive stroke services is a cost‐effective approach to meet unmet needs in the stroke patient pathway, to improve acute stroke care and support better treatment of AF and access to neurorehabilitation. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
8. Status update and interim results from the asymptomatic carotid surgery trial-2 (ACST-2)
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Bulbulia, R, Gray, W, Naughten, A, den Hartog, A, Delmestri, A, Wallis, C, le Conte, S, Macdonald, S, Radak, D, Nessi, F, Torsello, G, Hendriks, J, Bjorses, K, Davidovic, L, Tusini, N, Gillgren, P, Casana, R, Tolva, V, Bausback, Y, Mehrzad, A, Gottsäter, A, Esisi, B, Cras, P, Hendriks, Jm, Lauwers, P, Hertoghs, M, Van Schil, P, De Jaegher, L, Peeters, P, Verbist, J, Dendooven, D, De Letter, J, Vanhooren, G, Astarci, P, Capron, I, Choghari, C, Hammer, F, Lacroix, V, Peeters, A, Verhelst, R, Bosiers, M, De Meester, K, Deloose, K, Van Buggenhout, E, Vinck, E, Geenens, M, Hemelsoet, D, Van Herzeele, I, Vermassen, F, De Koster, G, Desiron, Q, Maertens de Noordhout, A, Malmendier, D, Massoz, M, Saad, G, Cirelli, S, Dormal, P, Lerut, P, Thues, E, Coutts, S, Demchuk, A, Hill, M, Hudon, M, Klein, G, Mcclelland, M, Morrish, W, Samis, G, Sutherland, G, Watson, T, Wong, J, Liu, B, Liu, Cw, Barankova, L, Chlouba, V, Fiedler, J, Priban, V, Sterba, L, Kalabova, L, Kriz, Z, Krupa, P, Privara, M, Reif, M, Souckova, L, Staffa, R, Vlachovsky, R, Vojtisek, B, Hrbac, T, Kuliha, M, Prochazka, V, Roubec, M, Skoloudik, D, Abd Allah, F, Eldessoki, Mh, Kassem, Hh, Gharieb, Hs, Cardon, Jm, Le Gallou Wittenberg, A, Allaire, E, Becquemin, Jp, Cochennec, F, Desgranges, P, Hosseini, H, Kobeiter, H, Marzelle, J, Bergeron, P, Padovani, R, Trastour, Jc, Biermaier, B, Gissler, Hm, Klotzsch, C, Pfeiffer, T, Schneider, R, Soehl, L, Wennrih, M, Botsios, S, Branzan, D, Braunlich, S, Holzer, H, Lenzer, J, Reichenbecher, C, Piorkowski, C, Schuster, J, Scheinert, D, Schmidt, A, Ulrich, M, Werner, M, Coster, A, Engelhardt, A, Ratusinski, Cm, Berekoven, B, Frerker, K, Gordon, V, Bellenis, I, Polydorou, A, Polydorou, V, Tavernarakis, A, Ioannou, N, Terzoudi, M, Chatzinikou, E, Giannoukas, A, Hadjigeorgiou, G, Koutsias, S, Ralli, S, Rousas, N, Nemes, B, Jàrànyi, Z, Szabo, A, Varga, D, Barzo, P, Bodosi, M, Fako, E, Fulop, B, Kuncz, A, Nagy, E, Nemeth, T, Pazdernyik, S, Skoba, K, Voros, E, Haider, Sn, Harbison, J, Madhavan, P, Moore, D, Beyar, R, Hoffman, A, Karram, T, Kerner, A, Nikolsky, E, Nitecki, S, Amatucci, G, Vittorio, P, Frederico, Marinazzo, D, Regina, G, Giaquinta, A, Patti, F, Veroux, M, Veroux, P, Adobbati, L, Bertoni, G, Bianchi, P, Cireni, L, Martello, L, Arcuri, L, Casoni, F, Coppi, G, Moratto, R, Veronesi, J, Bajardi, G, Savettieri, G, Corbetta, R, Odero, A, Quaretti, P, Thyrion, Z, Cao, P, Caso, V, Derango, P, Farchioni, L, Parlani, G, Malferrari, G, Strozzi, F, Vecchiati, E, Biello, Antonella, Capoccia, Laura, Menna, Danilo, Rizzo, ANNA RITA, Sbarigia, Enrico, Speziale, Francesco, Toni, D, Giovanni, M, Meola, G, Nano, G, Occiuto, Mt, Stegher, S, Tealdi, D, Accrocca, F, Ambrogi, C, Barbazza, R, Marcucci, G, Cappelli, A, de Donato, G, Palasciano, G, Pieragalli, D, Setacci, C, Settaci, F, Labate, C, Ferrero, E, Ferri, M, Viazzo, A, Castelli, P, Delodovici, Ml, Ferrario, M, Piffaretti, G, Tomei, G, Furui, E, Inoue, T, Kondo, R, Matsumoto, Y, Shimizu, H, Aidashova, B, Kospanov, N, Lyssenko, R, Mussagaliev, D, De Borst GJ, Den Hartog AG, Lo, R, Moll, F, Toorop, R, Van Der Worp HB, Vonken, Ej, Bakke, S, Krohg Sorensen, K, Skjelland, M, Andziak, P, Drelichowski, S, Dratwicki, M, Gil, R, Iwanowski, W, Koncewicz, K, Nowicki, M, Pniewski, J, Rzezak, J, Seweryniak, P, Bialek, P, Biejat, Z, Czepel, W, Czlonkowska, A, Dowzenko, A, Jedzrejewska, J, Kobayashi, A, Leszezyuski, J, Malek, A, Polanski, J, Proczka, R, Skorski, M, Szostek, M, Aleksic, N, Babic, S, Kolar, J, Sagic, D, Tanaskovic, S, Colic, M, Jovanovic, D, Koncar, I, Bartko, D, Beno, P, Rusnak, F, Zelenak, K, Gasparini, M, Grad, A, Kompara, I, Milosevic, Z, Flis, V, Matela, J, Miksic, K, Milotic, F, Mrdja, B, Stirn, B, Tetickovic, E, Chamorro, A, Obach, V, Riambau, V, Roman, S, Blanco, E, Izquierdo, Ay, Guerra, M, Campbell, E, Lindgren, H, Nyberg, J, Plate, G, Parsson, H, Qvarfordt, P, Acosta, S, Brandt, K, Dias, N, Gottsater, A, Holst, J, Kristmundsson, T, Kuhme, T, Kolbel, T, Lindblad, B, Lindh, M, Malina, M, Ohrlander, T, Resch, T, Rönnle, V, Sonesson, B, Warvsten, M, Zdanowski, Z, Bengt, B, Delle, M, Formgren, J, Jarl, L, Kall, Tb, Konrad, P, Nyman, N, Skioldebrand, C, Steuer, J, Takolander, R, Ahlhelm, Fj, Bonati, L, Engelter, Ss, Eugster, T, Gensicke, H, Lyrer, P, Mariani, L, Stierli, P, Stippich, C, Wolff, T, Brown, E, Butler, N, Day, Dj, Hayes, P, Higgins, N, Jumilla, E, Martin, P, Mitchell, J, Varty, K, Birt, A, Davies, P, George, J, Graham, A, Jonker, L, Joseph, T, Kelsall, N, Potts, C, Wilson, T, Davey, P, Hayman, R, Tervitt, G, Abdul Hamiq, A, Bryce, J, Chetter, I, Ettles, D, Lakshminarayan, R, Mitchelsonm, K, Rhymes, C, Robinson, G, Scott, P, Vickers, A, Baht, H, Balogun, I, Burger, I, Cowie, L, Gunathilagan, G, Hargroves, D, Insall, R, Jones, S, Rudenko, H, Senaratne, J, Thomas, G, Thomson, A, Enevoldson, P, Nahser, H, O'Brian, I, Torella, F, Watling, D, White, R, Clifton, A, Eley, C, Khanom, N, O'Reilly, J, Pereira, A, Bicknell, C, Cheshire, N, Gibbs, R, Hamady, M, James, A, Jenkins, M, Lacey, A, Mireskandari, M, Sachs, T, Wolfe, J, Hardy, D, Justin, F, Phiri, L, Sekaran, L, Sethuraman, S, Tate, L, Akyea Mensah, J, Chrisopoulou, A, Smyth, Jv, Nichol, I, Parry, A, Young, G, Clarke, M, Davis, M, Dixit, A, Dyker, A, Ford, G, Jackson, R, Kappadath, S, Lambert, D, Lees, T, Louw, S, Parr, N, Stansby, G, Wales, L, Wealleans, V, Wilson, L, Wyatt, M, Dorman, P, Hughes, A, Jones, D, Mendelow, Ad, Rodgers, H, Macsweeney, S, Mcconachie, N, Southam, A, Sunman, W, Briley, D, Darby, C, Handa, A, Hands, L, Kuker, W, Michael, K, Perkins, J, Schulz, U, Smith, D, Teal, R, Donnelly, M, D'Souza, S, Asehosem Egun, A, Gregory, B, Kelly, C, Punekar, S, Raj, S, Seriki, D, Thomson, G, Beard, J, Cleveland, T, Humphreys, J, Jenkins, A, King, C, Lonsdale, R, Nair, R, Nawaz, S, Okhuoya, F, Turner, D, Venables, G, Brown, J, Durairajan, R, Guyler, P, Harman, P, Jakeways, M, Khuoge, C, Kundu, A, Loganathan, T, Sinha, D, Thompson, V, Tysoe, S, Barer, Brown, A, Crawford, S, Dunlop, P, Majmudar, Mitchell, D, O'Brien, O'Connell, Scott, Vetrivel, S, Ashleigh, R, Butterfield, S, Gamble, G, Ghosh, J, Mccollum, C, Welch, M, Welsh, S, Kazan, V, Nazzal, M, Ramsey Williams, V, Halliday, A, Davies, C, Peto, R, Gray, A, Mihaylova, B, Potter, J, Flather, M, Mansfield, A, Farrell, B, Rahimi, K, Simpson, D, Thomas, D, Gough, M, Rothwell, P, Giles, M, Leopold, P, Belli, A, Sandercock, P, Gray, R, Shearman, C, Molyneux, A, Hayter, E, Lay, M, Munday, A, Young, A, Delmestri, A., Halliday, A, Bulbulia, R, Gray, W, Naughten, A, den Hartog, A, Delmestri, A, Wallis, C, le Conte, S, Macdonald, S, Tolva, V, Cras, Patrick, Hendriks, Jeroen, Lauwers, Patrick, van Schil, Paul, ACST-2 Collaborative Group, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique, UCL - (SLuc) Service de radiologie, and UCL - (SLuc) Service de neurologie
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Male ,Time Factors ,Carotid artery stenosis ,Carotid artery stenting ,Carotid endarterectomy ,Randomized controlled trial ,Stroke ,medicine.medical_treatment ,Myocardial Infarction ,Severity of Illness Index ,law.invention ,law ,Risk Factors ,MED/22 - CHIRURGIA VASCOLARE ,Carotid Stenosis ,Endarterectomy ,Endarterectomy, Carotid ,Middle Aged ,Treatment Outcome ,Female ,Stents ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Aged ,Angioplasty ,Asymptomatic Diseases ,Cardiovascular Agents ,Humans ,Patient Selection ,Risk Assessment ,Asymptomatic ,medicine ,Carotid ,business.industry ,Vascular surgery ,medicine.disease ,Surgery ,Cardiovascular agent ,Human medicine ,business - Abstract
Objectives: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. Methods: Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both possible, but where there is substantial uncertainty as to which is most appropriate. Trial surgeons and interventionalists are expected to use their usual techniques and CE-approved devices. We report baseline characteristics and blinded combined interim results for 30-day mortality and major morbidity for 986 patients in the ongoing trial up to September 2012. Results: A total of 986 patients (687 men, 299 women), mean age 68.7 years (SD ± 8.1) were randomized equally to CEA or CAS. Most (96%) had ipsilateral stenosis of 70-99% (median 80%) with contralateral stenoses of 50-99% in 30% and contralateral occlusion in 8%. Patients were on appropriate medical treatment. For 691 patients undergoing intervention with at least 1-month follow-up and Rankin scoring at 6 months for any stroke, the overall serious cardiovascular event rate of periprocedural (within 30 days) disabling stroke, fatal myocardial infarction, and death at 30 days was 1.0%. Conclusions: Early ACST-2 results suggest contemporary carotid intervention for asymptomatic stenosis has a low risk of serious morbidity and mortality, on par with other recent trials. The trial continues to recruit, to monitor periprocedural events and all types of stroke, aiming to randomize up to 5,000 patients to determine any differential outcomes between interventions. Clinical trial: ISRCTN21144362. © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
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- 2016
9. Intravenous thrombolysis in stroke mimics: results from the SITS International Stroke Thrombolysis Register.
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Keselman, B., Cooray, C., Vanhooren, G., Bassi, P., Consoli, D., Nichelli, P., Peeters, A., Sanak, D., Zini, A., Wahlgren, N., Ahmed, N., and Mazya, M. V.
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STROKE ,THROMBOLYTIC therapy ,CEREBROVASCULAR disease ,MAGNETIC resonance imaging ,NEUROLOGICAL disorders ,THERAPEUTICS ,STROKE patients - Abstract
Background and purpose: Patients with stroke mimics (SM), i.e. conditions with stroke‐like symptoms, may risk harm if treated with intravenous thrombolysis (IVT). Current guidelines state low risk of intracerebral hemorrhage based on studies comprising a total of <400 SM cases. We aimed to compare safety and outcomes following IVT between patients with acute ischaemic stroke and mimicking conditions. Methods: We included IVT‐treated ischaemic stroke patients in the SITS International Stroke Thrombolysis Register 2003–2017, examined with magnetic resonance imaging 22–36 h after treatment. Outcomes were parenchymal hematoma (PH) after treatment, symptomatic intracerebral hemorrhage (SICH) per Safe Implementation of Thrombolysis in Stroke Monitoring Study (SITS‐MOST), Second European Co‐operative Stroke Study (ECASS II) and National Institutes of Neurological Disorders and Stroke Study (NINDS) criteria, death and modified Rankin Scale score (mRS) at 3 months. Results: Of 10 436 patients, 429 mimics (4.1%) were identified. The most common types were functional (30.8%), migraine (17.5%) and seizure (14.2%). Patients with mimics had fewer cerebrovascular risk factors and lower median National Institutes of Health Stroke Scale score [7 (interquartile range, 5–10) vs. 8 (5–14), P < 0.001]. Among mimics versus stroke patients, PH was seen in 1.2% vs. 5.1% (P < 0.001), SICH NINDS in 0.5% vs. 3.9% (P < 0.001), SICH ECASS II in 0.2% vs. 2.1% (P = 0.007) and SICH SITS‐MOST in 0% vs. 0.5% (P = 0.28). Modified Rankin Scale score 0–1 at 3 months was present in 84.1% vs. 57.7% (P < 0.001) and death within 3 months in 2.6% vs. 5.4% (P = 0.028) of mimics and stroke patients, respectively. Conclusions: This large observational study indicated that PH and SICH following IVT in patients with SM are uncommon. [ABSTRACT FROM AUTHOR]
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- 2019
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10. Vorapaxar in the secondary prevention of atherothrombotic events
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A, Conway, B, Waites, J, Keays, P, Kopp, K, Hainzer, D, Podczeck Schweighofer, A, Priesnitz, T, Drexel, H, Hagspiel, V, Foeger, B, Hilbe, C, Trinka, E, Sinadinoska, D, Pilger, E, Brodmann, M, Stöllberger, C, Jungbauer, Lv, Koppensteiner, R, Hoke, M, Grisold, W, Berger, O, Gaul, Gb, Fazekas, N, Wandaller, C, Stockenhuber, F, Rek, A, Willeit, J, Zangerle, A, Kiechl, S, Sturm, W, Theurl, M, Gruber, F, Schacherl, S, Auer, J, Primus, C, Eber, B, Ammer, M, Hofer, Jf, Mayr, H, Moser, S, Hoellmueller, I, Van der Werf, F, Motte, S, Jorion, M, Schroë, H, Zwinnen, W, Vermassen, F, Geenens, M, De Wolf, L, Briké, C, De Deyn, P, Ongena, P, De Klippel, N, Meeuwissen, K, Desfontaines, P, Tincani, G, Vandermeeren, Y, de Fays, K, Pandolfo, M, Alaerts, N, Peeters, A, Findik, A, Tack, P, Degrande, E, Thijs, V, Marcelis, E, Van Landegem, W, Vanhagendoren, S, Vanhooren, G, Schotte, V, Celen, H, Bes, N, De Letter, J, Holvoet, G, Claerbout, B, Verhamme, P, Debaveye, B, Bourgeois, P, Debrabandere, K, Stalpaert, S, Dhondt, E, De Maeseneire, S, De Bleecker, J, de Koning, K, Vincent, M, Tahon, S, Monté, C, Maes, J, Vossaert, R, Vandenhoven, C, Roosen, J, Vissers, C, Sinnaeve, P, de Velder, L, Thoeng, J, Cauwenberghs, J, Deceuninck, F, Nicolau, J, Ardito, Wr, Queirantes, C, de Araujo Filho, Jd, Ribeiro, Jp, Guizzardi, Sp, Chaves, Ml, Titton, Nf, Pereira, Ah, Webber, I, da Silva DG, Jr, Uehara, Rm, Brasileiro, J, Maia, Ln, Souza, A, Bodanese, Lc, Homem, R, Friedrich, Ma, Macagnan, Ap, Dutra, Op, Brum, Ab, Rossi, Pr, Herek, L, Feitosa, G, Bernardes Ade, S, Braga, J, Rodrigues, D, Guimarães, A, Teixeira, Ab, Marin Neto, Ja, Tonani, M, Piegas, L, Amato, V, Leães, P, Osorio, Rl, Ganem, F, Vieira, Ap, Leao, P, Kanashiro, V, Franken, Ra, Martins, Ep, Gagliardi, Rj, Silva, L, Caffaro, Ra, Novaes, G, Carvalho, A, Laet, Vl, Miranda F., Jr, Crippa, Ba, Saraiva, Jf, Ormundo, Ct, Speciali, Jg, Guandolini, G, de Albuquerque, Dc, Silva, V, Abrantes, Ja, Pinheiro, L, Teixeira, M, Guanaes, Df, Resende, E, Andrade, Sf, Alves ÁR, Jr, Oliveira, Om, Tauil, Cb, Araujo, E, de Souza, J, de Freitas, Gr, Horokosky, Ap, Barbosa, Ec, Muniz, P, de Moraes JB, Jr, Cabral, M, Faria Neto, Jr, Belemer, A, Paiva, M, Brito, A, Hernandes, Me, Amorim, R, Pittella, Fj, Brito, Hh, Kouz, S, Roy, M, Gosselin, G, David, M, Huynh, T, Boudreault, C, Heath, J, Scott, L, Bhargava, R, Stafford, C, Klinke, Wp, Martin, L, Chan, Yk, Zaniol, D, Rebane, T, Abramovich, M, Vizel, S, Fox, B, Kornder, J, Breakwell, L, Constance, C, Gauthier, M, Cleveland, D, Valley, S, Dion, D, Morissette, A, Vertes, G, Ross, B, Pandey, A, Byrne, M, Abramson, B, Sodhi, N, Ervin, F, Thiessen, S, Halperin, F, Stedham, V, Pesant, Y, Sardin, V, Saw, J, Tarry, L, Pouliot, J, Marquette, S, Belisle, P, Gagne, D, Ducas, J, Munoz, A, Sussex, B, Newman, S, Madan, M, Hsu, E, Bata, I, Cossett, J, Glanz, A, Vilag, C, Paddock, V, Collings, E, Sabbah, E, Chausse, I, Fortin, C, Lepage, C, Chehayeb, R, Viau, C, Ma, P, Seib, M, Lamy, A, Rizzo, A, Rajakumar, Ar, Eikel, L, Nigro, F, Stoger, S, Welsh, R, Lindholm, L, Parker, Jd, Webber, S, Winkler, L, Hannah, G, Gupta, M, Kubiak, A, Mukherjee, A, Bozek, B, Nguyen, M, Dufort, L, Haichin, R, Toyota, V, Bujold, S, Syan, G, Chinnasane, S, Houde, G, Rousseau, S, Poirier, P, Lariviere, M, Dupuis, R, Ouimet, F, Audet, J, Darveau, C, Labonte, R, Rice, T, Nawaz, S, Cantor, W, Robbins, K, Boucher P., Jr, Roberge, J, Zadra, R, Mcpherson, C, Prieto, Jc, Noriega, V, Cereño, C, Mestas, M, Yovaniniz, P, Ferrada, W, Pincetti, C, Torres, G, Perez, L, Villan, C, Escobar, E, Martin, R, Padilla, I, Ramirez, M, Hormazabal, R, Pedemonte, O, Suazo, E, Hasbun, S, Mejias, M, Cardenas, F, Donoso, L, Godoy, I, Henriquez, P, Mariné, L, Vergara, T, Juri, C, Vergara, E, Muñoz, M, Solano, E, Toro, J, Cardenas, S, Mendoza, F, Martinez, S, Saaibi, Jf, Castillo, Km, Ruiz, Np, Castillo, T, Orozco, A, Muñoz, C, Martínez, J, Lopez, D, Ochoa, J, Andrade, J, Jaramillo, C, Garces, Gp, Botero, R, Cáceres, A, Jaramillo, M, Mejia, C, Schlesinger, A, Munevar, V, Rodriguez, J, Granados, Lm, Jaramillo, N, Aristizabal, C, Cano, N, Salazar, Jc, Urina, M, Manco, T, Valenzuela, C, Hernandez, Hj, Delgado, P, Vagner, B, Castaño, La, Ucros, P, Tellez, M, Delgado, Ja, Piedrahita, Ca, Crump, J, Fernandez, V, Quintero, Ca, Moreno, M, Hernandez Triana, E, Cuentas, I, Accini, Jl, Accini, M, Manzur, F, Rivera, E, Reynales, H, Huertas, D, Hovorka, J, Filipovsky, J, Hirmerova, J, Peska, S, Jura, R, Kanovsky, P, Herzig, R, Jansky, P, Fiala, R, Kalita, Z, Gatkova, A, Bauer, J, Fiksa, J, Sedlacek, J, Monhart, Z, Bren, J, Linhart, A, Skalicka, L, Vitovec, J, Hlinomaz, O, Parenica, J, Soucek, M, Rihacek, I, Branny, M, Sknouril, L, Klimsa, Z, Holub, M, Línkova, H, Rektor, I, Mikulik, R, Mayer O., Sr, Novakova, B, Bar, M, Brodova, P, Polasek, R, Sabl, P, Kos, P, Lorenc, Z, Macel, I, Graversen, Kh, Galatius, S, Soderberg, Lh, Sillesen, H, Madelung, S, Overgård, K, Stan, V, Rasmussen, Lh, Mortensen, B, Iversen, Hk, Back, C, Olesen, C, Christensen, H, Pedersen, A, Nielsen, T, Hasain, M, Tanggaard, L, Husted, S, Christensen, Ll, Haas, L, Mickley, H, Hosbond, S, Rosenlund, I, Jepsen, J, Kaspersen, Bb, Bronnum Schou, J, Hempel, H, Nyvad, O, Feldthaus, B, Jensen, B, Jensen, Mk, Andersen, G, Thomsen, Rb, Rokkedal, J, Joergensen, A, Bülow, M, Jeppesen, J, Lederballe, O, Scheibel, I, Sjol, A, Larsen, J, Graner, M, Svahn, T, Melin, J, Kaakkomäki, A, Airaksinen, J, Vasankari, T, Tatlisumak, T, Metso, M, Remes, A, Näppä, M, Jäkälä, P, Sivenius, J, Kalinen, M, Roine, Ro, Ketola, R, Bassand, J, Pales, D, Coisne, D, Berger, N, Galinier, M, Rosolin, N, Elbaz, M, Lacassagne, L, Montalescot, G, Vignolles, N, Gully, C, Lepage, I, Roynard, J, Hamon, M, Brucato, S, Macquin Mavier, I, Beitar, T, Berthezene, P, Medkour, T, Amarenco, P, Gueblaoui, N, Timsit, S, Riou, D, Mahagne, M, Suissa, L, Quere, I, Clouzot, S, Emmerich, J, Martinez, I, Moulin, T, Cole, M, Hosseini, H, Monod, V, Cottin, Y, Bichat, F, Galley, D, Beltra, C, Samson, Y, Pires, R, Bura Riviere, A, Pelvet, B, Giroud, M, Lecheneaut, C, Ohlmann, P, Ait m., bark Z, Farah, B, Petit, F, Caussin, C, Braun, C, Diehm, C, Mehrhof, F, Inkrot, S, Darius, H, Heinze, H, Radke, P, Kulikowsky, C, Ferrari, M, Utschig, S, Strasser, R, Haacke, K, Felix, Sb, Bruder, M, Nienaber, C, Pfaff, H, Sohn, H, Baylacher, M, Mudra, H, Setzer, P, Konstantinides, S, Hallmann, A, Kreuzer, J, Tsoy, I, Schneider, P, Appel, Kf, Habermeier, A, Zeiher, Am, Kretschmer, T, Mitrovic, V, Lehinant, S, Bohlscheid, V, Palme, B, Heuer, H, Espinola Klein, C, Savvidis, S, Kleinertz, K, Hänel, J, Schmidt, E, Schmidt, A, Ringleb, Pa, Ludwig, I, Dietzold, M, Schaffranka, A, Ranft, J, Cegla, C, Berrouschot, J, Stoll, A, Tanislav, C, Brandtner, Ma, Rosenkranz, M, Otto, D, Görtler, M, Barleben, M, Haberl, R, Miedl, S, Maschke, M, Schröder, K, Aral Becher, B, Herzog Hauff, S, Guenther, A, Herzau, C, Hoffmann, U, Roth Zetzsche, S, Grond, M, Becker, M, Hamann, G, Simon, K, Köhrmann, M, Glahn, J, Wuttig, H, Nabavi, Dg, Seraphin, D, Schellong, S, Frommhold, R, Dichgans, M, Doerr, A, Blessing, E, Buss, I, Butter, C, Bettin, D, Grosch, B, Blank, E, Wong, L, Liu, R, Lee, S, Kong, S, Yu, C, So, E, Jakal, Á, Masszi, G, Czuriga, I, Kapocsi, J, Soós, E, Csiba, L, Fekete, K, Valikovics, A, Dioszeghy, P, Muskóczki, E, Csányi, A, Matoltsy, A, Yuval, R, Bornstein, N, Elimelech, R, Chajek Shaul, T, Bursztyn, M, Hayek, T, Hazbon, K, Gavish, D, Anat, N, Wexler, D, Azar, P, Mosseri, M, Tsirulnikov, E, Rozenman, Y, Logvinenko, S, Tanne, D, Don, A, Gross, B, Feldman, Y, Klainman, E, Genin Dmitrishin, I, Eldar, M, Eizenberg, N, Atar, S, Lasri, E, Hammerman, H, Aharoni, G, Zimlichman, R, Zuker, S, Telman, G, Afanasiev, S, Katz, A, Biton, A, Goldhaber, A, Goldhaber, M, Elian, D, Linor, A, Meyuhas, S, Tsalihin, D, Kissos, D, Lampl, Y, Israelson, M, Gottlieb, S, Dotan, L, Elis, A, Karny, M, Hussein, O, Shestatski, K, Brenner, H, Segal, E, Baldini, U, Gavazzi, A, Poloni, M, Censori, B, Aiazzi, L, Maraglino, C, Marenzi, G, Specchia, G, Tritto, I, Golino, P, Cianflone, Domenico, Martignoni, A, Tamburino, C, Rubartelli, P, Ardissino, D, Tadonio, I, Stramba Badiale, M, Cernuschi, P, Nardulli, R, Sommariva, L, Giordano, A, Berni, A, Cavallini, C, Fiscella, A, Azzarelli, S, Esposito, G, Cassese, S, Danzi, G, Fattore, L, Barbieri, E, De Caterina, R, Odero, A, Puttini, M, Corrada, E, Monzini, N, Vadalà, A, Pistarini, C, Scrutinio, D, Ferratini, M, Marcheselli, S, Moretti, L, Partemi, L, Pupilella, T, Lazzari, A, Ledda, A, Geraci, G, Rasura, M, Beccia, M, Cassadonte, F, Vatrano, M, Bongiorni, D, Mos, L, Marcuzzi, G, Murena, E, Uguccioni, L, Ferretti, C, Piti ATerrosu, P, Perrone, Pf, Marconi, R, Grasso, L, Severi, S, Evola, R, Russo, N, Agnelli, G, Paci, C, Carugo, S, Silvestri, O, Testa, R, and Novo, S.
- Abstract
BACKGROUND:Thrombin potently activates platelets through the protease-activated receptor PAR-1. Vorapaxar is a novel antiplatelet agent that selectively inhibits the cellular actions of thrombin through antagonism of PAR-1.METHODS:We randomly assigned 26,449 patients who had a history of myocardial infarction, ischemic stroke, or peripheral arterial disease to receive vorapaxar (2.5 mg daily) or matching placebo and followed them for a median of 30 months. The primary efficacy end point was the composite of death from cardiovascular causes, myocardial infarction, or stroke. After 2 years, the data and safety monitoring board recommended discontinuation of the study treatment in patients with a history of stroke owing to the risk of intracranial hemorrhage.RESULTS:At 3 years, the primary end point had occurred in 1028 patients (9.3%) in the vorapaxar group and in 1176 patients (10.5%) in the placebo group (hazard ratio for the vorapaxar group, 0.87; 95% confidence interval [CI], 0.80 to 0.94; P
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- 2012
11. Aspects biologiques dans l'étude du bassin de l'Yser
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VANHOOREN G.
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Aquaculture. Fisheries. Angling ,SH1-691 - Abstract
L'examen hydrobiologique de l'Yser est axé principalement sur deux aspects : d'une part, celui de l'état trophique et d'autre part celui de la pollution de l'eau courante. En général, on se trouve en présence d'un écosystème en état de pollution organique, aussi bien exogène qu'autogène, cette pollution autogène étant provoquée par une eutrophisation fort avancée. Cet état, accentué par les caractéristiques ydrodynamiques du fleuve, s'explique par l'abondance des éléments nutritifs (composés azotés et phosphates). Les phénomènes biologiques qui en découlent donnent lieu à des situations d'anaérobiose en certains endroits et expliquent la détérioration du Bassin de l'Yser.
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- 1976
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12. Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial
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Ederle, J., Dobson, J., Featherstone, R. L., Bonati, L. H., Worp, H. B., Borst, G. J., Lo, T. H., Gaines, P., Dorman, P. J., Macdonald, S., Lyrer, P. A., Hendriks, J. M., Mccollum, C., Nederkoorn, P. J., Brown, M. M., Algra, A., Bamford, J., Beard, J., Bland, M., Bradbury, A. W., Clifton, A., Hacke, W., Halliday, A., Malik, I., Mas, J. L., Mcguire, A. J., Sidhu, P., Venables, G., Bradbury, A., Collins, R., Molynewc, A., Naylor, R., Warlow, C., Ferro, J. M., Thomas, D., Coward, L., Featherstone, R. F., Tindall, H., Mccabe, D. J. H., Wallis, A., Brooks, M., Chambers, B., Chan, A., Chu, P., Clark, D., Dewey, H., Donnan, G., Fell, G., Hoare, M., Molan, M., Roberts, A., Roberts, N., Beiles, B., Bladin, C., Clifford, C., Grigg, M., New, G., Bell, R., Bower, S., Chong, W., Holt, M., Saunder, A., Than, P. G., Gett, S., Leggett, D., Mcgahan, T., Quinn, J., Ray, M., Wong, A., Woodruff, P., Foreman, R., Schultz, D., Scroop, R., Stanley, B., Allard, B., Atkinson, N., Cambell, W., Davies, S., Field, P., Milne, P., Mitchell, P., Tress, B., Yan, B., Beasley, A., Dunbabin, D., Stary, D., Walker, S., Cras, P., D Archambeau, O., Hendriks, J. M. H., Schil, P., Bosiers, M., Deloose, K., Buggenhout, E., Letter, J., Devos, V., Ghekiere, J., Vanhooren, G., Astarci, P., Hammer, F., Lacroix, V., Peters, A., Verhelst, R., Dejaegher, L., Peeters, A., Verbist, J., Blair, J. F., Caron, J. L., Daneault, M., Giroux, M. F., Guilbert, F., Lanthier, S., Lebrun, L. H., Oliva, V., Raymond, J., Roy, D., Soulez, G., Weill, A., Hill, M., Hu, W., Hudion, M., Morrish, W., Sutherland, G., Wong, J., Alback, A., Harno, H., Ijas, P., Kaste, M., Lepantalo, M., Mustanoja, S., Paananen, T., Porras, M., Puutala, J., Railo, M., Sairanen, T., Soinne, L., Vehmas, A., Vikatmaa, P., Goertler, M., Halloul, Z., Skalej, M., Brennan, P., Kelly, C., Leahy, A., Moroney, J., Thornton, J., Koelemay, M. J. W., Reekers, J. A. A., Roos, Y. B. W. E. M., Koudstaal, P. J., Pattynama, P. M. T., Lugt, A., Dijk, L. C., Sambeek, L. R. H. M., Urk, H., Verhargen, H. J. M., Bruininckx, C. M. A., Bruijn, S. F., Keunen, R., Knippenberg, B., Mosch, A., Treurniet, F., Dijk, L., Overhagen, H., Wever, J., Beer, F. C., Den Berg, J. S. P., Hasselt, B. A. A. M., Zeilstra, D. J., Boiten, J., Otterloo, J. C. A. D., Vries, A. C., Nieholt, G. J. L. A., Kallen, B. F. W., Blankensteijn, J. D., Leeuw, F. E., Kool, L. J. S., Vliet, J. A., Kort, G. A. P., Kapelle, L. J., Mali, W. P. T. M., Moll, F., Verhagen, H., Barber, P. A., Bourchier, R., Hill, A., Holden, A., Stewart, J., Bakke, S. J., Krohg-Sorensen, K., Skjelland, M., Tennoe, B., Bialek, P., Biejat, Z., Czepiel, W., Czlonkowska, A., Dowzenko, A., Jedrzejewska, J., Kobayashi, A., Lelek, M., Polanski, J., Kirbis, J., Milosevic, Z., Zvan, B., Vasco, J., Blasco, J., Chamorro, A., Macho, J., Obach, V., Riambau, V., San Roman, L., Branera, J., Canovas, D., Estela, J., Gaibar, A. G., Perendreu, J., Bjorses, K., Gottsater, A., Ivancev, K., Maetzsch, T., Sonesson, B., Berg, B., Delle, M., Formgren, J., Gillgren, P., Kall, T. B., Konrad, P., Nyman, N., Takolander, R., Andersson, T., Malmstedt, A., Soderman, M., Wahlgren, C., Wahlgren, N., Binaghi, S., Hirt, L., Michel, P., Ruchat, P., Engelter, S. T., Fluri, F., Guerke, L., Jacob, A. L., Kirsch, E., Radue, E. W., Stierli, P., Wasner, M., Wetznel, S., Bonvin, C., Kalangos, A., Lovblad, K., Murith, N., Ruefenacht, D., Sztajzel, R., Higgins, N., Kirkpatrick, P. J., Martin, P., Adam, D., Bell, J., Crowe, P., Gannon, M., Henderson, M. J., Sandler, D., Shinton, R. A., Scriven, J. M., Wilmink, T., D Souza, S., Egun, A., Guta, R., Punekar, S., Seriki, D. M., Thomson, G., Brennan, A., Enevoldson, T. P., Gilling-Smith, G., Gould, D. A., Harris, P. L., Mcwilliams, R. G., Nasser, H. C., White, R., Prakash, K. G., Serracino-Inglott, F., Subramanian, G., Smyth, J. V., Walker, M. G., Clarke, M., Davis, M., Dixit, S. A., Dolman, P., Dyker, A., Ford, G., Golkar, A., Jackson, R., Jayakrishnan, V., Lambert, D., Lees, T., Louw, S., Mendelow, A. D., Rodgers, H., Rose, J., Stansby, G., Wyatt, M., Baker, T., Baldwin, N., Jones, L., Mitchell, D., Munro, E., Thornton, M., Baker, D., Davis, N., Hamilton, G., Mccabe, D., Platts, A., Tibballs, J., Cleveland, T., Dodd, D., Lonsdale, R., Nair, R., Nassef, A., Nawaz, S., Belli, A., Cloud, G., Markus, H., Mcfarland, R., Morgan, R., Pereira, A., Thompson, A., Chataway, J., Cheshire, N., Gibbs, R., Hammady, M., Jenkins, M., Wolfe, J., Adiseshiah, M., Bishop, C., Brew, S., Brookes, J., Jager, R., Kitchen, N., Ashleigh, R., Butterfield, S., Gamble, G. E., Nasim, A., O Neill, P., Edwards, R. D., Lees, K. R., Mackay, A. J., Moss, J., Rogers, P., Developmental Genetics, International Carotid Stenting Study, ACS - Amsterdam Cardiovascular Sciences, Neurology, Surgery, Radiology and Nuclear Medicine, and ANS - Amsterdam Neuroscience
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Male ,medicine.medical_specialty ,SURGERY ,medicine.medical_treatment ,Carotid endarterectomy ,030204 cardiovascular system & hematology ,Neuroinformatics [DCN 3] ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Angioplasty ,medicine ,Humans ,Carotid Stenosis ,cardiovascular diseases ,ANGIOPLASTY ,Stroke ,Endarterectomy ,Aged ,Endarterectomy, Carotid ,Intention-to-treat analysis ,Cardiovascular diseases [NCEBP 14] ,business.industry ,Stent ,General Medicine ,Interim analysis ,medicine.disease ,3. Good health ,Surgery ,Female ,Stents ,Human medicine ,Carotid stenting ,business ,030217 neurology & neurosurgery ,Angioplasty, Balloon - Abstract
Contains fulltext : 88112.pdf (Publisher’s version ) (Closed access) BACKGROUND: Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. METHODS: The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded adjudication of outcomes. Patients with recently symptomatic carotid artery stenosis were randomly assigned in a 1:1 ratio to receive carotid artery stenting or carotid endarterectomy. Randomisation was by telephone call or fax to a central computerised service and was stratified by centre with minimisation for sex, age, contralateral occlusion, and side of the randomised artery. Patients and investigators were not masked to treatment assignment. Patients were followed up by independent clinicians not directly involved in delivering the randomised treatment. The primary outcome measure of the trial is the 3-year rate of fatal or disabling stroke in any territory, which has not been analysed yet. The main outcome measure for the interim safety analysis was the 120-day rate of stroke, death, or procedural myocardial infarction. Analysis was by intention to treat (ITT). This study is registered, number ISRCTN25337470. FINDINGS: The trial enrolled 1713 patients (stenting group, n=855; endarterectomy group, n=858). Two patients in the stenting group and one in the endarterectomy group withdrew immediately after randomisation, and were not included in the ITT analysis. Between randomisation and 120 days, there were 34 (Kaplan-Meier estimate 4.0%) events of disabling stroke or death in the stenting group compared with 27 (3.2%) events in the endarterectomy group (hazard ratio [HR] 1.28, 95% CI 0.77-2.11). The incidence of stroke, death, or procedural myocardial infarction was 8.5% in the stenting group compared with 5.2% in the endarterectomy group (72 vs 44 events; HR 1.69, 1.16-2.45, p=0.006). Risks of any stroke (65 vs 35 events; HR 1.92, 1.27-2.89) and all-cause death (19 vs seven events; HR 2.76, 1.16-6.56) were higher in the stenting group than in the endarterectomy group. Three procedural myocardial infarctions were recorded in the stenting group, all of which were fatal, compared with four, all non-fatal, in the endarterectomy group. There was one event of cranial nerve palsy in the stenting group compared with 45 in the endarterectomy group. There were also fewer haematomas of any severity in the stenting group than in the endarterectomy group (31 vs 50 events; p=0.0197). INTERPRETATION: Completion of long-term follow-up is needed to establish the efficacy of carotid artery stenting compared with endarterectomy. In the meantime, carotid endarterectomy should remain the treatment of choice for patients suitable for surgery. FUNDING: Medical Research Council, the Stroke Association, Sanofi-Synthelabo, European Union.
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- 2010
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13. Rationale and design of a randomized, double-blind, parallel-group study of terutroban 30 mg/day versus aspirin 100 mg/day in stroke patients: the prevention of cerebrovascular and cardiovascular events of ischemic origin with terutroban in patients with a history of ischemic stroke or transient ischemic attack (PERFORM) study
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Bousser, M, Amarenco, P, Chamorro, A, Fisher, M, Ford, I, Fox, K, Hennerici, M, Mattle, H, Rothwell, P, Julian, D, Fieschi, G, Fieschi, C, Boysen, G, Pocock, S, Conard, J, Orgogozo, J, Inzitari, D, Erkinjuntti, T, Pasquier, F, O'Brien, J, Mas, J, Gueret, P, Lenzi, G, Leys, D, Lopez Sendon, J, Norrving, B, Ferro, J, Thygesen, K, Cowpply, B, P, Ameriso, S, Donnan, D, Lang, W, Thijs, V, Fernandes, J, Stamenova, P, Teal, P, Lavados, P, Lu, C, Poljakovic, Z, Kalita, Z, Kaste, M, Moulin, T, Vemmos, K, Diener, H, Wong, L, Nagy, Z, Chopra, J, Mccormack, P, Gensini, G, Budrys, V, Droste, D, Tan, K, Benomar, A, Cantu Brito, C, Barber, A, Koudstaal, P, Thomassen, L, Czlonkowska, A, Cunha, L, Bajenaru, O, Yakhno, N, Chen, C, Lisy, L, Zvan, B, Bryer, A, Kim, J, Vivancos, J, Wahlgren, N, Liu, S, Poungvarin, N, Hentati, F, Bahar, S, Mischenko, T, Lees, K, Abdel Masih, M, Barboza, A, Cirio, J, Crespo, E, Escaray, G, Esnaola, M, Rojas Estol, C, Ferrari, J, Fraiman, H, Garrote, M, Gatto, E, Giannaula, R, Gori, H, Herrera, G, Ioli, P, Losano, J, Povedano Reich, E, Rey, R, Rotta Escalante, R, Saredo, G, Zurru, M, Anderson, C, Bladin, C, Crimmins, D, Davis, S, Donnan, G, Dunbabin, D, Frayne, J, Gates, P, Hankey, G, Helme, R, Herkes, G, Karrasch, J, Kimber, T, Jannes, J, Landau, P, Levi, C, Lueck, C, Markus, R, Phan, T, Schwartz, R, Schultz, D, Blacker, D, Read, S, Williams, M, Aichner, F, Auff, E, Bancher, C, Binder, H, Brainin, M, Brucke, T, Eggers, C, Fertl, E, Ladurner, G, Lalouschek, W, Mamoli, B, Mitrovic, N, Noisternig, G, Schmidt, R, Vosko, M, Willeit, J, Zaruba, E, Boon, P, Bourgeois, P, Caekebeke, J, Cals, N, Cras, P, Desfontaines, P, De Deyn, P, Dieudonne, L, De Klippel, N, Laloux, P, Maertens de Noordhout, A, Merlevede, K, Michotte, A, Pandolfo, M, Peeters, A, Peeters, D, Tack, P, Van Buggenhout, E, Van Landegem, W, Vanhooren, G, Vermylen, P, Annes, M, Brondani, R, De Carvalho, J, Cendes, F, Fabio, S, Ferraz, A, De Freitas, G, Gagliardi, R, Gomes Neto, A, Haussen, S, Kowacs, P, Martins, S, Minelli, C, Moro, C, Noujaim, J, Rocha, M, Da Silva, M, Silveira, J, Yamamoto, F, Zetola, V, Baldaranov, D, Deleva, N, Haralanov, L, Milanov, I, Mintchev, D, Petrova, N, Shotekov, P, Stamenov, B, Zahariev, Z, Arts, R, Bayer, N, Beaudry, M, Berger, L, Bozek, C, Collier, T, Cote, R, Desai, H, Durocher, A, Hachinski, V, Hill, M, Hoppe, B, Howse, D, Mackey, A, Maharaj, M, Minuk, J, Moddel, G, Novak, D, Penn, A, Rabinovitch, H, Selchen, D, Shuaib, A, Silva, J, Silver, F, Spence, D, Stotts, G, Tamayo, A, Teitelbaum, J, Veloso, F, Voll, C, Winder, T, Barrientos Uribe, N, Galdames Poblete, D, Garcia Figueroa, P, Gasic Yaconi, K, Jaramillo Munoz, A, Lavados Germain, P, Lavados Montes, M, Nancupil Bello, C, Prina Pacheco, L, Vargas Canas, A, Venegas, F, Chen, P, H, Cheng, Y, Cui, L, Di, Q, Dong, Q, Fan, D, Feng, H, Huang, Y, Li, J, Li, W, Li, Z, Lin, H, Liu, M, Miao, L, Ren, H, Wang, Y, Wu, J, Zhang, W, Zhao, G, Zhao, H, Zhou, H, Antoncic, I, Demarin, V, Lusic, I, Pavlicek, I, Soldo Butkovic, S, Bar, M, Bauer, J, Kalina, M, Kanovsky, P, Jura, R, Neumann, J, Rektor, I, Skoda, O, Vaclavik, D, Eerola, A, Hillbom, M, Kinnunen, E, Koivisto, K, Numminen, H, Rissanen, A, Roine, R, Sivenius, J, Alamowitch, S, Autret, A, Avendano, S, Bataillard, M, Berthier, E, Besson, G, Bille Turc, F, Boulliat, J, Boulesteix, J, Brosset, C, Cesaro, P, Albucher, J, Clavelou, P, Colamarino, R, Crassard, I, de Broucker, T, de Bray, J, Desbordes, P, Diot, E, Ducrocq, X, Ellie, E, Faucheux, J, Giroud, M, Godefroy, O, Guillon, B, Huttin, H, Just, A, Lamy, C, Lejeune, P, Lucas, C, Macian Montoro, F, Mackowiak, A, Maillet Vioud, M, Pico, F, Milandre, L, Milhaud, D, Malbec, M, Neau, J, Pinel, J, Robin, C, Rodier, G, Rosolacci, T, Rouanet, F, Rouhart, F, Sablot, D, Servan, J, Smadja, D, Trouillas, P, Valance, J, Viader, F, Viallet, F, Wolff, V, Zagnoli, F, Zuber, M, Angerer, M, Becker, U, Berlit, P, Berrouschot, J, Biniek, R, Bitsch, A, Brodhun, R, Dichgans, M, Druschky, K, Dux, R, Faiss, J, Ferbert, A, Gahn, G, Grotemeyer, K, Goertler, M, Grau, A, Griewing, B, Grond, M, Haan, J, Haberl, R, Hamann, G, Hamer, H, Harms, L, Heide, W, Henningsen, H, Hetzel, A, Hoffmann, F, Huber, R, Isenmann, S, Jander, S, Joerg, J, Kaps, M, Kastrup, A, Kessler, C, Koehler, W, Koelmel, H, Lichy, C, Luckner, K, Malessa, R, Mallmann, A, Meyding Lamade, U, Molitor, H, Mueller Jensen, A, Muellges, W, Noth, J, Nueckel, M, Ochs, G, Poppert, H, Roether, J, Rosenkranz, M, Sander, D, Schaebitz, W, Schlachetzki, F, Schlegel, U, Schmid, E, Schneider, D, Schwarz, M, Seidel, G, Sieble, M, Sliwka, U, Stingele, R, Stoegbauer, F, Szabo, K, Topper, R, Treib, J, Weissenborn, K, Widder, B, Witte, O, Karageorgiou, K, Mitsikostas, D, Papadimitriou, A, Papathanasopoulos, P, Chan, H, Ng, P, Tsoi, T, Bartos, L, Csanyi, A, Csiba, L, Csornai, M, Dioszeghy, P, Fazekas, A, Harcos, P, Horvath, S, Kaposzta, Z, Kerenyi, L, Kincses, J, Koves, A, Nikl, J, Panczel, G, Pongracz, E, Sebestyen, K, Semjen, J, Szabo, M, Szegedi, N, Valikovics, A, Varszegi, R, Vecsei, L, Borah, N, Ichaporia, N, Kaul, S, Meenakshi Sundaram, S, Mehndiratta, M, Misra, U, Murthy, J, Nayak, D, Poncha, F, Shah, A, Singh, G, Srinivasa, R, Venkateswarlu, K, Wadia, R, Collins, R, Harbison, J, Hickey, P, Kelly, P, Murphy, S, Adami, A, Agnelli, G, Agostoni, E, Anzola, G, Arnaboldi, M, Bassi, P, Billo, G, Bottacchi, E, Bovi, P, Cappa, S, Cappelletti, C, Carolei, A, Cavallini, A, Chiodo Grandi, F, Comi, G, Consoli, D, Corsi, F, Costanzo, E, De Falco, F, Devetag, F, Di Lazzaro, V, Di Piero, V, Diomedi, M, Fattorello Salimbeni, C, Federico, F, Feleppa, M, Ferrarese, C, Gandolfo, C, Giaccaglini, E, Giaquinto, S, Giobbe, D, Giometto, B, Greco, G, Guidetti, D, Guidotti, M, Iudice, A, Lembo, G, Marengo, C, Marini, P, Melis, M, Micieli, G, Musolino, R, Mutani, R, Neri, G, Parati, E, Pastore, L, Porazzi, D, Prati, P, Procaccianti, G, Rasura, M, Rossini, P, Santilli, I, Semplicini, A, Silvestrini, M, Tanganelli, P, Tedeschi, G, Tezzon, F, Tola, M, Villani, A, Zanferrari, C, Zarcone, D, Bickuviene, I, Gumbrevicius, G, Obelieniene, D, Skaringa, A, Virketiene, I, Tharakan, J, Aleman Pedroza, J, Escamilla Garza, J, Fernandez Vera, J, Leal Cantu, R, Leon Flores, L, Lopez Ruiz, M, Reyes Gutierrez, G, Reyes Morales, S, Rivera Castano, L, Rodrigues Leyva, I, Ruiz Sandoval, J, Vega Boada, F, Belahsen, F, Kissani, N, Mosseddaq, R, Slassi, I, Yahyaoui, M, Boiten, J, Bornebroek, M, De Kort, P, De Leeuw, H, Donders, R, Franke, C, Hertzberger, L, Jansen, B, Kappelle, L, Keizer, K, Kuster, J, Limburg, M, Mulleners, W, Pop, P, Van Den Berg, J, Van Gemert, H, Verbiest, H, Weinstein, H, Clark, M, Fink, J, Gommans, J, Jayathissa, S, Kilfoyle, D, Kumar, A, Hurtig, U, Indredavik, B, Kloster, R, Salvesen, R, Drozdowski, W, Fryze, W, Klimek, A, Kochanowski, J, Kozubski, W, Ksiazkiewicz, B, Kwiecinski, H, Kuczynska Zardzewialy, A, Motta, E, Nowacki, P, Nyka, W, Opala, G, Pierzchala, K, Pniewski, J, Podemski, R, Selmaj, K, Stelmasiak, Z, Stepien, A, Strzelecka Gorzynska, M, Szczudlik, A, Wajgt, A, Wiszniewska, M, Wlodek, A, Canhao, P, Correia, C, Grilo Goncalves, J, Machado Candido, J, Salgado, A, Bulboaca, A, Campeanu, A, Lazar, T, Marginean, I, Minea, D, Pascu, I, Pereanu, M, Perju Dumbrava, L, Popescu, C, Simu, M, Stefanache, F, Toldisan, I, Tuta, S, Zaharia, C, Alifirova, V, Arkhipov, S, Balunov, O, Balyazin, V, Belkin, A, Belova, A, Boiko, A, Bogdanov, E, Butko, D, Chukhlovina, M, Doronin, B, Ermilova, E, Evzelman, M, Fedin, A, Fedorova, N, Golikov, K, Golovkin, V, Gusev, E, Gustov, A, Jakupov, E, Kamchatnov, P, Khabirov, F, Kirienko, A, Klimov, I, Klocheva, E, Kotov, S, Kuznetsov, A, Laskov, V, Levin, Y, Mashkova, N, Nazarov, A, Novikova, L, Odinak, M, Parfenov, V, Pilipenko, P, Pokrovsky, A, Poverennova, I, Rodoman, G, Roshkovskaya, L, Shirokov, E, Shmyriov, V, Sholomov, I, Skoromets, A, Skvortsova, V, Spirin, N, Stakhovskaya, L, Sharov, M, Sherman, M, Shutov, A, Strachunskaya, E, Stulin, I, Suslina, Z, Volosevitch, A, Vorobiev, P, Vorobyeva, O, Voronkova, L, Voskresenskaya, O, Zhuliov, N, Chan, B, Chang, H, Ramani, N, Brozman, M, Dvorak, M, Dzugan, J, Garay, R, Gdovinova, Z, Gurcik, L, Krastev, G, Kukumberg, P, Kurca, E, Meluch, S, Nyeky, M, Turcani, P, Vyletelka, J, Klanjscek, G, Zujovic, E, Zupan, M, Bester, F, Carr, J, Coetzee, C, Frost, A, Gardiner, J, Giampaolo, D, Kesler, S, Lurie, D, Retief, C, Roos, J, Bae, H, Cha, J, Cho, K, Heo, J, Kim, E, Lee, B, Lee, K, Lee, J, Rha, J, Yoon, B, Alvarez Sabin, J, Arboix Damunt, A, De Arce Borda, A, Asensi Alvarez JM, Bermejo Pareja, F, Botia Paniagua, E, Casado, I, Naranjo, I, Castillo Sanchez, J, Chamorro Sanchez, A, Davalos Errando, A, Diaz Marin, C, Diez Tejedor, E, Egido Herrero JA, Fernandez Bolanos, R, Fernandez Fernandez, O, Figuerola Roig, A, Geffner Sclarsky, D, Gil Nunez, A, Gomez Sanchez JC, Gomez Escalonilla Escobar CI, Gonzalez Masegosa, A, Gonzalez Menacho, J, Gracia Fleta, F, Izquierdo Ayuso, G, Jimenez Hernandez, D, Jimenez Martinez, C, Lago Martin, A, Lainez Andres JM, Larracoechea Jausoro, J, Lopez Fernandez JC, Maestre Moreno, J, Marti Vilalta JL, Martin Gonzalez, R, Masjuan Vallejo, J, Medina Rodriguez, A, Molto Jorda JM, Moreno Carre tero MJ, Moris de le Tassa, G, Morlan Gracia, L, Mostacero Miguez, E, Osuna Pulido, T, Pareja Martinez, A, Pinedo Brochado, A, Pons Amate JM, Rodriguez Alvarez JR, Roquer Gonzalez, J, Sanahuja Montesinos, J, Sanchez Sanchez MC, Segura Martin, T, Serena Leal, J, Tejada Garcia, J, Trejo Gabriel JM, Vivancos Mora, J, Andersson, B, Bysell, S, Cederin, B, Laska, A, Lindgren, A, Petersson, T, Wallen, T, Baumgartner, R, Beer, H, Hirt, L, Hungerbuehler, H, Lyrer, P, Michel, P, Mueller, F, Tettenborn, B, Chang, K, Jeng, J, Lien, L, Lin, R, Liu, C, Po, H, Wu, S, Chankrachang, S, Laptikultham, S, Nidhinandana, S, Pongpakdee, S, Benammou, S, Frih Ayed, M, Gouider, R, Mhiri, C, M'Rabet, A, Mrissa, R, Balkan, S, Can, U, Dalkara, T, Kirbas, D, Kumral, E, Ozdemir, G, Ozeren, A, Ozmenoglu, M, Ozturk, S, Lebedynets, V, Maly, V, Moskovko, S, Orzheshkovskyy, V, Smolanka, V, Yavors'Ka, V, Zozulya, I, Bamford, J, Barber, M, Barer, D, Baron, J, Bath, P, Broughton, D, Brown, M, Chataway, J, Curless, R, Darawil, K, Datta, P, Dennis, M, Durairaj, R, Egbuji, J, Ellis, S, Ford, G, Freeman, A, Fulcher, R, Gray, C, Harrington, F, Hudson, C, Iveson, E, James, M, Jenkinson, D, Kalra, L, Kelly, D, Krishnamoorthy, S, Langhorne, P, Magorrian, M, Macleod, M, Macwalter, R, Markus, H, Muhiddin, K, Muir, K, Murphy, P, Power, M, Price, C, Rashed, K, Robinson, T, Rudd, A, Sanmuganathan, P, Sharma, J, Shaw, L, Shetty, H, Smithard, D, Tyrrell, P, Vahidassr, M, Venables, G, Watt, M, White, R, Bousser, M, Amarenco, P, Chamorro, A, Fisher, M, Ford, I, Fox, K, Hennerici, M, Mattle, H, Rothwell, P, Ferrarese, C, PERFORM study, I, PERFORM STUDY, Investigator, Tedeschi, Gioacchino, Cras, Patrick, De Deyn, Peter Paul, and et al.
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perform study ,Male ,Thromboxane ,International Cooperation ,Receptors, Thromboxane ,antiplatelet therapy ,terutroban ,Cardiovascular Disease ,Receptors ,80 and over ,Stroke ,Aged, 80 and over ,Aspirin ,Ischemic Attack ,Transient ,Ischemic Attack, Transient ,Double-Blind Method ,Endpoint Determination ,Dose-Response Relationship, Drug ,Humans ,Aged ,Propionates ,Naphthalenes ,Treatment Outcome ,Platelet Aggregation Inhibitors ,Cardiovascular Diseases ,Middle Aged ,Female ,Propionic Acids ,Neurology ,Terutroban ,Anesthesia ,tp receptor antagonist ,stroke ,secondary prevention ,aspirin ,Cardiology ,Platelet aggregation inhibitor ,Settore MED/26 - Neurologia ,stroke prevention ,Drug ,Cardiology and Cardiovascular Medicine ,medicine.drug ,Human ,medicine.medical_specialty ,Dose-Response Relationship ,Internal medicine ,medicine ,Dementia ,In patient ,business.industry ,Platelet Aggregation Inhibitor ,schemic ,medicine.disease ,DementiaI ,transient ischemic attack ,Ischemic stroke ,Human medicine ,Neurology (clinical) ,business ,Propionic Acid ,Naphthalene - Abstract
Background: Ischemic stroke is the leading cause of mortality worldwide and a major contributor to neurological disability and dementia. Terutroban is a specific TP receptor antagonist with antithrombotic, antivasoconstrictive, and antiatherosclerotic properties, which may be of interest for the secondary prevention of ischemic stroke. This article describes the rationale and design of the Prevention of cerebrovascular and cardiovascular Events of ischemic origin with teRutroban in patients with a history oF ischemic strOke or tRansient ischeMic Attack (PERFORM) Study, which aims to demonstrate the superiority of the efficacy of terutroban versus aspirin in secondary prevention of cerebrovascular and cardiovascular events. Methods and Results: The PERFORM Study is a multicenter, randomized, double-blind, parallel-group study being carried out in 802 centers in 46 countries. The study population includes patients aged ≥55 years, having suffered an ischemic stroke (≤3 months) or a transient ischemic attack (≤8 days). Participants are randomly allocated to terutroban (30 mg/day) or aspirin (100 mg/day). The primary efficacy endpoint is a composite of ischemic stroke (fatal or nonfatal), myocardial infarction (fatal or nonfatal), or other vascular death (excluding hemorrhagic death of any origin). Safety is being evaluated by assessing hemorrhagic events. Follow-up is expected to last for 2–4 years. Assuming a relative risk reduction of 13%, the expected number of primary events is 2,340. To obtain statistical power of 90%, this requires inclusion of at least 18,000 patients in this event-driven trial. The first patient was randomized in February 2006. Conclusions: The PERFORM Study will explore the benefits and safety of terutroban in secondary cardiovascular prevention after a cerebral ischemic event.
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- 2009
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14. Safe Implementation of Thrombolysis in Stroke-MOnitoring STudy (SITS-MOST): multivariable analysis of outcome predictors and adjustment of main outcome results to baseline data profile in randomized controlled trials
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Wahlgren, N, Ahmed, N, Eriksson, N, Aichner, F, Bluhmki, E, Dávalos, A, Erilä, T, Ford, Ga, Grond, M, Hacke, W, Hennerici, Mg, Kaste, M, Köhrmann, M, Machnig, T, Larrue, V, Lees, Kr, Roine, Ro, Toni, Danilo, and Vanhooren, G.
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- 2008
15. Multivariable analysis of outcome predictors and adjustment of main outcome results to baseline data profile in randomized controlled trials: Safe Implementation of Thrombolysis in Stroke-MOnitoring STudy (SITS-MOST).
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Wahlgren N, Ahmed N, Eriksson N, Aichner F, Bluhmki E, Dávalos A, Erilä T, Ford GA, Grond M, Hacke W, Hennerici MG, Kaste M, Köhrmann M, Larrue V, Lees KR, Machnig T, Roine RO, Toni D, Vanhooren G, and Safe Implementation of Thrombolysis in Stroke-MOnitoring STudy Investigators
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- 2008
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16. Benign paroxysmal positional vertigo of the horizontal canal.
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De la Meilleure, G, Dehaene, I, Depondt, M, Damman, W, Crevits, L, and Vanhooren, G
- Abstract
Objectives: To review the clinical features, electronystagmography findings, the possible mechanism, and a possible therapeutic approach to benign paroxysmal positional vertigo (BPPV).Methods: Sixty-three cases of BPPV of the horizontal canal type have been reviewed. It is characterised by horizontal nystagmus and an intense vertigo, provoked by rotation of the head in a supine patient. The horizontal nystagmus beats towards the ground on both sides, becomes more pronounced when lying on the pathological side, and then the nystagmus often changes direction.Results: Forty-eight patients underwent electronystagmography. On the pathological side, the first phase nystagmus had a mean latency of three seconds and a mean duration of 31.6 seconds. Nystagmus inversion occurred in 36 patients after a nystagmus free interval. The mean second phase nystagmus duration lasted 33.4 seconds. On the healthy side, the nystagmus had a mean latency of 3.4 seconds and a mean duration of 39.5 seconds. Fatigue was seen in six patients. Simultaneous involvement of the posterior canal was present in 16 patients. A liberatory manoeuvre was successful in six patients.Conclusions: The liberatory manoeuvre should be tried in patients with horizontal canal vertigo. It should not be performed in patients with severe cervical arthrosis, vertebrobasilar insufficiency, or when the patient has neck pain during the manoeuvre. [ABSTRACT FROM AUTHOR]- Published
- 1996
17. Nuclear oculomotor nerve paralysis.
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Dehaene, I., Marchau, M., and Vanhooren, G.
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- 1987
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18. Cerebral venous thrombosis and the G20210A mutation of factor II.
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Simons, P J, Vanhooren, G, Longstreth, W T Jr, and Colven, R M
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- 2000
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19. L'analyse hydrobiologique des cours d'eau au benelux
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Madeleine Molitor, A.M. and Vanhooren, G.
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- 1984
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20. Thrombolysis with alteplase for acute ischaemic stroke in the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST): an observational study.
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Wahlgren N, Ahmed N, Dávalos A, Ford GA, Grond M, Hacke W, Hennerici MG, Kaste M, Kuelkens S, Larrue V, Lees KR, Roine RO, Soinne L, Toni D, Vanhooren G, and SITS-MOST investigators
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- 2007
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21. Temperature threshold in amyotrophic lateral sclerosis (ALS) : Scientific meeting of the Flemish Society of Neuro-Psychiatry, held in Kortrijk, 15th April 1989
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Vanhooren, G., Michielsens, B., and van Hees, J.
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- 1989
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22. Unilateral asterixis in a patient with an infarction in the ventroposterolateral thalamus
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Vanhooren, G., Van Zandijcke, M., and Dehaene, I.
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- 1988
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23. Scientific Meeting of the Flemish Society of Neurology-Psychiatry held in Aalst, May 9th 1987
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Lenders, M.B., de Wit, P., Castelein, P., Schuddinck, L., Vanhooren, G., Dehaene, I., van Zandijcke, M., Marchau, M., De Bleecker, J., de Reuck, J., Vingerhoets, G., Thiery, E., van Calenbergh, F., Dom, R., Goffin, J., Plets, C., van den Bergh, R., de Koninck, J., Ceusters, W., van Ooteghem, Ph., Vakaet, A., Claeys, G., Verschraegen, J., van Orshoven, M., van Orshoven, F., Gouban, P., Carton, H., Taelman, H., Druyts-Voets, E., De Smyter, J., Picssesn, F., Meyer, B., van den Bergh, V., Hoogenraad, T.U., Triau, E., Malfroid, M., Baro, F., Mercelis, R., de Jonghe, P., Gheuens, J., and Martin, J.J.
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- 1987
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24. Smartphone-based atrial fibrillation screening in the general population: feasibility and impact on medical treatment.
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Gruwez H, Verbrugge FH, Proesmans T, Evens S, Vanacker P, Rutgers MP, Vanhooren G, Bertrand P, Pison L, Haemers P, Vandervoort P, and Nuyens D
- Abstract
Aims: The aim of this study is to determine the feasibility, detection rate, and therapeutic implications of large-scale smartphone-based screening for atrial fibrillation (AF)., Methods and Results: Subjects from the general population in Belgium were recruited through a media campaign to perform AF screening during 8 consecutive days with a smartphone application. The application analyses photoplethysmography traces with artificial intelligence and offline validation of suspected signals to detect AF. The impact of AF screening on medical therapy was measured through questionnaires. Atrial fibrillation was detected in the screened population ( n = 60.629) in 791 subjects (1.3%). From this group, 55% responded to the questionnaire. Clinical AF [AF confirmed on a surface electrocardiogram (ECG)] was newly diagnosed in 60 individuals and triggered the initiation of anti-thrombotic therapy in 45%, adjustment of rate or rhythm controlling strategies in 62%, and risk factor management in 17%. In subjects diagnosed with known AF before screening, a positive screening result led to these therapy adjustments in 9%, 39%, and 11%, respectively. In all subjects with clinical AF and an indication for oral anti-coagulation (OAC), OAC uptake increased from 56% to 74% with AF screening. Subjects with clinical AF were older with more co-morbidities compared with subclinical AF (no surface ECG confirmation of AF) ( P < 0.001). In subjects with subclinical AF ( n = 202), therapy adjustments were performed in only 7%., Conclusion: Smartphone-based AF screening is feasible at large scale. Screening increased OAC uptake and impacted therapy of both new and previously diagnosed clinical AF but failed to impact risk factor management in subjects with subclinical AF., Competing Interests: Conflict of interest: H.G. is supported as pre-doctoral strategic basic research fellow by the Fund for Scientific Research Flanders (FWO 1S83221N). F.H.V. is supported by the Special Research Fund (BOF) of Hasselt University (BOF19PD04). T.P and S.E. reported serving as employees for Qompium NV, the company that holds the exclusive rights to FibriCheck©. P.VDV. holds personal stock in Qompium NV (Belgium) and participates an unpaid role in the advisory board of Qompium. P.V. receives fees form Daiichi-Sankyo, Boehringer Ingelheim, and Pfizer. M.R. receives fees from Novartis and Bayer. No other conflicts of interest were reported., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)
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- 2023
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25. Thrombectomy is a cost-saving procedure up to 24 h after onset.
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Nivelle E, Dewilde S, Peeters A, Vanhooren G, and Thijs V
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- Humans, Quality-Adjusted Life Years, Randomized Controlled Trials as Topic, Treatment Outcome, Brain Ischemia surgery, Cost-Benefit Analysis statistics & numerical data, Ischemic Stroke surgery, Thrombectomy economics
- Abstract
Introduction and Aim: The treatment of ischemic stroke due to large-vessel occlusion has been revolutionized by mechanical thrombectomy (MT), as multiple trials have consistently shown improved functional outcomes compared to standard medical management both in the early and late time windows after symptom onset. However, MT is an interventional procedure that is more costly than best supportive care (BSC)., Methods: We set out to study the cost-utility and budget impact of MT + BSC versus BSC alone for large-vessel occlusion using a combined decision tree and Markov model. The analysis was conducted from a Belgian payer perspective over a lifetime horizon, and health states were defined by the modified Rankin Scale (mRS). The treatment effect of MT + BSC combined clinical outcomes from all published early and late treatment window studies showing improved mRS after 90 days. Resource use and utilities were informed by an observational Belgian study of 569 stroke patients. Long-term mRS transitions were sourced from the Oxford Vascular study., Results: MT + BSC generated 1.31 additional quality-adjusted life years and resulted in cost savings of €10,216 per patient over lifetime. Deterministic sensitivity analyses demonstrated dominance of MT over a wide range of parameter inputs. In a Belgian setting, adding MT to BSC within an early time window for 1575 eligible stroke patients every year produced cost savings between €6.3 million (year 1) and €14.6 million (year 5), or a total cost saving of €56.2 million over 5 years., Conclusion: Mechanical thrombectomy is a highly cost-effective treatment for ischemic stroke patients, providing quality-adjusted survival at lower health care cost, both when given in an early time window, as well as in a late time window., (© 2021. Belgian Neurological Society.)
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- 2022
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26. The impact of COVID-19 on acute stroke care in Belgium.
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Raymaekers V, Demeestere J, Bellante F, De Blauwe S, De Raedt S, Dusart A, Jodaitis L, Lemmens R, Loos C, Noémie L, Rutgers MP, Vandervorst F, Vanhooren G, Yperzeele L, Nogueira RG, Nguyen TN, and Vanacker P
- Subjects
- Belgium, Humans, SARS-CoV-2, COVID-19, Stroke epidemiology
- Abstract
A worldwide decline in stroke hospitalizations during the COVID-19 pandemic has been reported. Information on stroke care during the pandemic in Belgium is lacking. This study aims to analyze the impact of COVID-19 on acute stroke care in eight Belgian stroke centers. This Belgian study is part of an international observational and retrospective study in 70 countries and 457 stroke centers. We compared volumes of COVID-19 and stroke hospitalizations, intravenous thrombolysis and endovascular treatment rates, acute treatment time intervals and functional outcome at 90 days during the first wave of the pandemic to two control intervals (March-May 2019 and December-February 2020). From March 2020 to May 2020, 860 stroke patients were hospitalized. In the same time period, 2850 COVID-19 patients were admitted, of which 37 (1.3%) were diagnosed with a stroke. Compared to the months prior to the pandemic and the same time epoch one year earlier, stroke hospitalizations were reduced (relative difference 15.9% [p = 0.03] and 14.5% [p = 0.05], respectively). Despite a reduction in absolute volumes, there was no difference in the monthly proportion of thrombolysis or endovascular treatment provided to the overall stroke hospitalizations. Acute treatment time metrics did not change between COVID-19 pandemic and control time epochs. We found no difference in 90-day functional outcomes nor in mortality after stroke between patients admitted during the pandemic versus control periods. We found a decline in the volume of stroke hospitalizations during the first wave of the COVID-19 pandemic in Belgium. Stroke care quality parameters remained unchanged., (© 2021. Belgian Neurological Society.)
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- 2021
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27. Multicenter, retrospective analysis of endovascular treatment for acute ischemic stroke in nonagenarians.
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Janssen H, Nannoni S, Francois O, Dewaele T, De Blauwe S, Vanhooren G, Ghekiere J, Kager J, Peeters A, Goffette P, Hammer F, Duprez T, Demeestere J, Lemmens R, Cornelissen S, Heye S, Yperzeele L, Baar I, Voormolen M, Van der Zijden T, Mondelaers A, Andersson T, Pottel H, Odier C, Karkri F, Michel P, and Vanacker P
- Subjects
- Age Factors, Aged, 80 and over, Belgium, Brain Ischemia diagnosis, Brain Ischemia mortality, Brain Ischemia physiopathology, Canada, Databases, Factual, Female, Humans, Male, Recovery of Function, Retrospective Studies, Risk Assessment, Risk Factors, Stroke diagnosis, Stroke mortality, Stroke physiopathology, Switzerland, Time Factors, Treatment Outcome, Brain Ischemia therapy, Endovascular Procedures adverse effects, Endovascular Procedures mortality, Stroke therapy
- Abstract
Background: With the increasing age of acute stroke patients being admitted to hospitals, more data are needed on indications, complications and outcome of endovascular treatment (EVT) in the very elderly., Methods: Retrospective observational study with data collection from Belgian, Swiss, Canadian comprehensive stroke centers and Swedish EVT National database. All patients with acute ischemic stroke were eligible if aged older than or ≥90 years and treated with EVT ± pretreatment with intravenous thrombolysis (IVT). Safety assessment comprised presence of periprocedural complications, hemorrhagic transformation or other adverse events (<7days). Efficacy and outcome measures were successful recanalization (modified Treatment In Cerebral Infarction (mTICI) score ≥2b), favorable clinical outcome (modified Rankin Score (mRS) 0-2) and 3-months mortality., Results: Inclusion of 112 nonagenarians (mean age 93.3 ± 2.5 years; 76.8% women; pre-mRS ≤2 in 69.4%). Pretreatment with IVT was performed in 54.7%. In 74.6% successful recanalization (mTICI ≥2b) was achieved. Favorable outcome (mRS ≤2) was seen in 16.4% and 3-months mortality was 62.3%. Multivariate logistic regression analysis showed younger age (odds ratio [OR] 2.99; 1.29-6.95; P = .011) and lower prestroke mRS (OR 13.46; 2.32-78.30; P = .004) as significant predictors for good clinical outcome at 90 days., Conclusions: Our observational study on EVT in nonagenarians demonstrates the need for careful patient selection. A substantial proportion of nonagenarians shows an unfavorable clinical outcome and high mortality, despite acceptable recanalization rates. A high prestroke disability (mRS) and advancing age predict an unfavorable outcome. Treatment decisions should be made on case-by-case evaluation, keeping in mind limited chances of favorable outcome and high risk of mortality., Competing Interests: Disclosures No conflicts of interests to declare: HJ, NS, FO, DT, DBS, VG, GJ, KJ, PA, GP, HF, DT, DJ, LR, CSA, HS, YL, BI, VM, VDZT, MA, PH, OC, KF, VPA. VG is a consultant for Medtronic and Bayer and has received speaker fees from Bayer, Pfizer, AMGEN and travel fees from BI. AT is a consultant for Ablynx, Amnis Therapeutics, Anaconda, Cerenovus-Neuravi, Medtronic and Rapid Medical.MP has received within the last 2 years through his institution research grants from the Swiss Heart Foundation and BMS; speaker fees from Boehringer-Ingelheim, Medtronic, and Amgen; consulting fees from Medtronic and Amgen, and honoraria from scientific advisory boards from Boehringer-Ingelheim, Pfizer and BMS. All this support is used for stroke education and research., (Copyright © 2020 Elsevier Inc. All rights reserved.)
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- 2020
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28. The relationship between Home-time, quality of life and costs after ischemic stroke: the impact of the need for mobility aids, home and car modifications on Home-time.
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Dewilde S, Annemans L, Peeters A, Hemelsoet D, Vandermeeren Y, Desfontaines P, Brouns R, Vanhooren G, Cras P, Michielsens B, Redondo P, and Thijs V
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- Aged, Comorbidity, Disability Evaluation, Female, Health Care Costs statistics & numerical data, Humans, Male, Middle Aged, Retrospective Studies, Severity of Illness Index, Transportation of Patients methods, Persons with Disabilities psychology, Persons with Disabilities rehabilitation, Home Nursing methods, Home Nursing organization & administration, Home Nursing statistics & numerical data, Ischemic Stroke complications, Ischemic Stroke diagnosis, Quality of Life, Stroke Rehabilitation economics, Stroke Rehabilitation methods, Stroke Rehabilitation psychology, Stroke Rehabilitation statistics & numerical data
- Abstract
Purpose: Home-time (the number of days spent at home during the first 3 months after stroke) shows a strong association with the modified Rankin scale (mRS). We studied whether Home-time was also a determinant of quality-of-life and medical care costs after ischemic stroke, and assessed factors delaying discharge home. Materials and methods: Five hundred and sixty nine patients participated in a retrospective study when returning for an in-person visit after an ischemic stroke. Home-time, mRS, EQ-5D-3L, inpatient and outpatient resource utilization, use of mobility aids, changes to home and car, comorbidities were recorded. Results: Each additional Home-time day was significantly associated with an increase in utility of 0.0056 ( p < 0.0001) and an in- and outpatient cost saving of $99 ( p = 0.0158). Requiring extra material support significantly decreased Home-time by 76 days (including: requiring home changes: -68 days, car alterations: -49 days, needing a wheelchair: -80 days or walker: -71 days, needing bed or bath rails: -79 days). This univariable effect was confirmed in multivariable analysis when comparing with patients having the same disability level without requiring material support. Conclusions: Home-time is a stroke outcome associated with disease severity, healthcare costs and patient wellbeing. Streamlining the discharge process for those requiring extra material support may lead to cost savings and higher quality-of-life.Implications for rehabilitationDelays in discharge from the acute hospital or rehabilitation facility are incurred when patients need extra material support in order to return home.Staff from the discharging facility should assist families by giving timely information on the availability and the cost of wheel chairs and walkers; and explaining and planning the need of a stair lift, bed and bath rails as well as car modifications.Planning the discharge process with the families will lead to a more rapid return home and will result in reduced overall health care costs and higher quality of life for the patients.
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- 2020
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29. Therapeutic hypothermia for acute ischaemic stroke. Results of a European multicentre, randomised, phase III clinical trial.
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van der Worp HB, Macleod MR, Bath PM, Bathula R, Christensen H, Colam B, Cordonnier C, Demotes-Mainard J, Durand-Zaleski I, Gluud C, Jakobsen JC, Kallmünzer B, Kollmar R, Krieger DW, Lees KR, Michalski D, Molina C, Montaner J, Roine RO, Petersson J, Perry R, Sprigg N, Staykov D, Szabo I, Vanhooren G, Wardlaw JM, Winkel P, and Schwab S
- Abstract
Introduction: We assessed whether modest systemic cooling started within 6 hours of symptom onset improves functional outcome at three months in awake patients with acute ischaemic stroke., Patients and Methods: In this European randomised open-label clinical trial with blinded outcome assessment, adult patients with acute ischaemic stroke were randomised to cooling to a target body temperature of 34.0-35.0°C, started within 6 h after stroke onset and maintained for 12 or 24 h , versus standard treatment. The primary outcome was the score on the modified Rankin Scale at 91 days, as analysed with ordinal logistic regression., Results: The trial was stopped after inclusion of 98 of the originally intended 1500 patients because of slow recruitment and cessation of funding. Forty-nine patients were randomised to hypothermia versus 49 to standard treatment. Four patients were lost to follow-up. Of patients randomised to hypothermia, 15 (31%) achieved the predefined cooling targets. The primary outcome did not differ between the groups (odds ratio for good outcome, 1.01; 95% confidence interval, 0.48-2.13; p = 0.97). The number of patients with one or more serious adverse events did not differ between groups (relative risk, 1.22; 95% confidence interval, 0.65-1.94; p = 0.52)., Discussion: In this trial, cooling to a target of 34.0-35.0°C and maintaining this for 12 or 24 h was not feasible in the majority of patients. The final sample was underpowered to detect clinically relevant differences in outcomes., Conclusion: Before new trials are launched, the feasibility of cooling needs to be improved., (© European Stroke Organisation 2019.)
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- 2019
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30. Recommendations on telestroke in Europe.
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Hubert GJ, Santo G, Vanhooren G, Zvan B, Tur Campos S, Alasheev A, Abilleira S, and Corea F
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Lack of stroke specialists determines that many European rural areas remain underserved. Use of telemedicine in stroke care has shown to be safe, increase use of evidence-based therapy and enable coverage of large areas of low population density. The aim of this article is to summarise the following recommendations of the Telestroke Committee of the European Stroke Organisation on the setup of telestroke networks in Europe: Hospitals participating in telestroke networks should be chosen according to criteria that include population density, transportation distance, geographic specifics and in-hospital infrastructure and professional resources. Three hospital categories are identified to be part of a hub-and-spoke network: (1) the Telemedicine Stroke Centre (an European Stroke Organisation stroke centre or equivalent with specific infrastructure and setup for network and telemedicine support), (2) the telemedicine-assisted stroke Unit (equivalent to an European Stroke Organisation stroke unit but without 24 h onsite stroke expertise) and (3) the telemedicine-assisted stroke ready hospital (only covering hyperacute treatment in the emergency department and transferring all patients for further treatment).
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- 2019
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31. The combined impact of dependency on caregivers, disability, and coping strategy on quality of life after ischemic stroke.
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Dewilde S, Annemans L, Lloyd A, Peeters A, Hemelsoet D, Vandermeeren Y, Desfontaines P, Brouns R, Vanhooren G, Cras P, Michielsens B, Redondo P, and Thijs V
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- Adaptation, Psychological, Aged, Brain Ischemia psychology, Comorbidity, Female, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Stroke therapy, Surveys and Questionnaires, Caregivers psychology, Persons with Disabilities psychology, Quality of Life psychology, Stroke psychology
- Abstract
Background: To estimate the additional impact of coping and of being dependent on caregivers, over and above the large effects of disability on utility after ischemic stroke., Methods: A total of 539 patients were recruited into an observational, retrospective study when returning for a check-up between 3 and 36 months after an ischemic stroke. Patients' modified Rankin Scale (mRS), dependency on caregivers, the Brandtstädter and Renner Coping questionnaire (with summary scores: Tenacity of Goal Pursuit (TGP) and Flexible Goal Adjustment (FGA) coping styles), EQ-5D-3 L and co-morbidities were evaluated., Results: In multivariable regression, greater disability (mRS) resulted in large utility losses, between 0.06 for mRS 1 to 0.65 for mRS 5 (p < 0.0001). Dependency on caregivers caused an additional dis-utility of 0.104 (p = 0.0006) which varied by mRS (0.044, 0.060, 0.083, 0.115, 0.150 and 0.173 for mRS 0-5). The effect of coping on utility varied by coping style, by the disability level of the patient and by his or her dependency on caregivers. FGA coping was associated with additional increases in utility (p < 0.0001) over and above the effect of disability and dependency, whereas TGA had no significant impact. FGA coping was associated with larger utility changes among more disabled patients (0.018 to 0.105 additional utility, for mRS 0 to mRS 5 respectively). Dependent patients had more to gain from FGA coping than patients who function independently of caregivers: utility gains were between 0.049 and 0.072 for moderate to high levels of FGA coping. In contrast, the same positive evolution in FGA coping resulted in 0.039 and 0.057 utility gain among independent patients. Finally, we found that important stroke risk factors and co-morbidities, such as diabetes and atrial fibrillation, were not predictors of EQ-5D utility in a multivariable setting., Conclusions: This study suggests that treatment strategies targeting flexible coping styles and decreasing dependency on caregivers may lead to significant gains in quality of life above and beyond treatment strategies that solely target disability.
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- 2019
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32. Modified Rankin scale as a determinant of direct medical costs after stroke.
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Dewilde S, Annemans L, Peeters A, Hemelsoet D, Vandermeeren Y, Desfontaines P, Brouns R, Vanhooren G, Cras P, Michielsens B, Redondo P, and Thijs V
- Subjects
- Aged, Atrial Fibrillation complications, Brain Ischemia complications, Persons with Disabilities, Female, Health Care Costs, Hospitalization, Humans, Male, Middle Aged, Stroke economics, Survivors, Atrial Fibrillation therapy, Brain Ischemia therapy, Stroke therapy
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Background Resource use in the acute and subacute phases after stroke depends on the degree of disability. Aims To determine if direct costs after stroke also vary by level of disability as measured using the modified Rankin scale at the chronic stage after stroke. Methods In a multicentre study, we collected acute and chronic in- and outpatient resource use in survivors of ischemic stroke stratified by levels of disability according to the modified Rankin Scale. Statistical inference on costs at each level of the modified Rankin Scale was estimated using a general linear model for the first three months, the first year, and any subsequent year after ischemic stroke. Results A total of 569 survivors of ischemic stroke with a mean age of 71.7 years were enrolled (41% female) from 10 academic and nonacademic centers. Costs varied substantially over time and with each modified Rankin Scale level. The total average costs in the first year were estimated $33,147 per patient, ranging from $9,114 for modified Rankin Scale 0 to $83,236 for modified Rankin Scale 5. In the second year, medical costs were on average $14,039, varying from $2,921 to $39,723 for patients with modified Rankin Scale 0-5. The level of disability based on the modified Rankin Scale was a major determinant of resource use, irrespective of age, gender, atrial fibrillation, and vascular risk factors. Conclusion Long-term resource use after stroke is high and is mainly driven by degree of disability as measured by the modified Rankin scale.
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- 2017
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33. Importance of proper patient selection and endpoint selection in evaluation of new therapies in acute stroke: further analysis of the SENTIS trial.
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Shuaib A, Schwab S, Rutledge JN, Starkman S, Liebeskind DS, Bernardini GL, Boulos A, Abou-Chebl A, Huang DY, Vanhooren G, Cruz-Flores S, Klucznik RP, and Saver JL
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- Cohort Studies, Follow-Up Studies, Humans, Prospective Studies, Retrospective Studies, Stroke epidemiology, Treatment Outcome, Endpoint Determination, Patient Selection, Stroke diagnosis, Stroke therapy
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Background: The magnitude of treatment effect in acute stroke depends on several factors, including time from symptom onset (TFSO) to treatment and severity of the initial insult., Objective: To report further evaluation of NeuroFlo therapy, focusing on the effect of time and stroke severity., Methods: SENTIS was a prospective randomized trial (N=515) comparing standard medical therapy with/without NeuroFlo therapy. For this analysis, we evaluated outcomes in groups of patients based on TFSO and stroke severity: patients randomized <6 h, 6-10 h, and >10 h with mild (NIHSS<8), moderate (8-14), and severe (>14) symptoms at randomization. 90-Day mRS (modified Rankin Scale) scores and stroke-related death rates were compared between treatment groups., Results: For patients randomized <6 h TFSO (n=128), the OR for mRS 0-2 was 3.11 (CI 1.30 to 7.46, p=0.011) for treated versus non-treated patients. In patients with disease of moderate severity (NIHSS 8-14, n=214), NeuroFlo-treated patients were more likely to have a good outcome (mRS 0-2; OR=1.84, CI 1.02 to 3.33, p=0.043). The stroke-related death rate was better in the treated group with TFSO >10 h and NIHSS >14 (n=42) (OR=7.10, CI 1.13 to 44.55, p=0.036)., Conclusions: The results of our analysis support the importance of careful selection of outcome measures and the impact that rapid treatment and initial stroke severity have on outcome.
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- 2013
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34. Stroke prevention in atrial fibrillation: current status and emerging therapies.
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Van Mieghem W, Mairesse G, Missault L, Vanhooren G, Verhamme P, and Dupont A
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- Atrial Fibrillation diagnosis, Humans, Practice Guidelines as Topic, Randomized Controlled Trials as Topic, Risk Assessment, Risk Factors, Stroke etiology, Treatment Outcome, Antifibrinolytic Agents therapeutic use, Atrial Fibrillation complications, Atrial Fibrillation drug therapy, Stroke prevention & control, Vitamin K antagonists & inhibitors
- Abstract
Stroke is the most common cardiovascular disorder after heart disease, with a high mortality and often poor quality of life in survivors. Atrial fibrillation (AF), the most commonly occurring sustained cardiac arrhythmia increases the risk of stroke by five. However, stroke risk is not homogeneous and varies with associated morbidities and risk factors. Risk assessment scores have been developed and according to the calculated level of risk, guidelines recommend treatment with antithrombotic agents, preferably vitamin K antagonists (VKA). Despite these recommendations many patients with AF do not receive adequate thromboprophylaxis. The presence of AF is often not recognized and VKA are underused due to doctor- or patient-related factors and intrinsic disadvantages of these drugs. An awareness campaign for the diagnosis of AF is warranted, highlighting the risk of stroke. Novel anticoagulants that largely overcome many of the limitations of vitamin K antagonists are becoming available.
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- 2012
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35. Progressive multifocal leukoencephalopathy in liver transplant recipients: a case report and review of the literature.
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Verhelst X, Vanhooren G, Vanopdenbosch L, Casselman J, Laleman W, Pirenne J, Nevens F, and Orlent H
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- Aged, Fatal Outcome, Female, Humans, Immunocompromised Host, JC Virus, Immunosuppressive Agents adverse effects, Leukoencephalopathy, Progressive Multifocal etiology, Liver Transplantation adverse effects
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Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system caused by the reactivation of the JC polyomavirus in immunocompromised patients. We report a case of PML in a liver transplant recipient and review the other published cases. The clinical course of PML is characterised by a rapid progressive neurological decline coinciding with the presence of white matter lesions on magnetic resonance images. There is no direct antiviral therapy available against the JC polyomavirus. Restoration of the immune response achieved by tapering or terminating the immunosuppressive regimen is the mainstay of treatment at present in transplanted patients. The prognosis remains, however, extremely poor regardless of treatment., (© 2010 The Authors. Transplant International © 2010 European Society for Organ Transplantation.)
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- 2011
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36. The Belgian experience with intravenous thrombolysis for acute ischemic stroke.
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Vanacker P, Thijs V, Peeters A, Bruneel B, Laloux P, Druwé P, De Deyn P, Ahmed N, Wahlgren N, and Vanhooren G
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- Adolescent, Adult, Aged, Aged, 80 and over, Atrial Fibrillation chemically induced, Belgium epidemiology, Cerebral Hemorrhage chemically induced, Child, Female, Humans, Hyperlipidemias chemically induced, Injections, Intravenous methods, Male, Middle Aged, Odds Ratio, Registries, Retrospective Studies, Risk Assessment, Sex Factors, Stroke epidemiology, Time Factors, Young Adult, Fibrinolytic Agents therapeutic use, Stroke drug therapy, Tissue Plasminogen Activator therapeutic use
- Abstract
Purpose: We report the Belgian results of the Safe Implementation of Thrombolysis in Stroke - International Stroke Thrombolysis Register (SITS-ISTR). This prospective observational register evaluates the safety and efficacy of intravenous thrombolysis with rtPA (recombinant tissue Plasminogen Activator) for ischemic stroke in routine clinical practice., Methods: We compared the baseline characteristics, treatment delay, rate of symptomatic intracerebral hemorrhage and functional outcome at 90 days after treatment between patients enrolled in centres in Belgium and the non-Belgian SITS-registry population. We performed a multivariate analysis to adjust for differences in demographic and baseline characteristics., Results: 743 patients were enrolled in 42 centers in Belgium between December 2002 and December 2007. These patients were older, had more severe stroke were more frequently female and more frequently had hyperlipidemia and atrial fibrillation. The median stroke onset-to-treatment delay was 140 min vs. 145 min. More patients died and were disabled 3 months after the stroke. A slight, non-significant, increase of symptomatic intracerebral hemorrhage (SICH) as per SITS protocol was observed (2.4 vs. 1.6%, p = 0.15). After adjustment for differences in baseline characteristics, functional independence (mRS < or = 2) at 3 months (OR 0.95, 95% CI 0.86-1.05, p = 0.31) was not different from non-Belgian patients, nor was the rate of SICH. However mortality at 3 months in Belgian patients was slightly higher (OR 1.15, 95% CI 1.02-1.29, p = 0.02)., Conclusion: Intravenous thrombolysis for ischemic stroke is safe and effective in the routine clinical use in Belgium. The higher mortality we observed is not related to a higher rate of SICH.
- Published
- 2010
37. Are ACE-inhibitors or ARB's still needed for cardiovascular prevention in high risk patients? Insights from profess and transcend.
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Van Mieghem W, Billiouw JM, Brohet C, Dupont AG, Gazagnes MD, Heller F, Krzesinski JM, Missault L, Persu A, Piérard L, Rottiers R, Vanhooren G, Vervaet P, and Herman AG
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- Aged, Cardiovascular Diseases complications, Cardiovascular Diseases mortality, Female, Follow-Up Studies, Humans, Male, Middle Aged, Survival Analysis, Telmisartan, Treatment Outcome, Angiotensin II Type 1 Receptor Blockers therapeutic use, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Benzimidazoles therapeutic use, Benzoates therapeutic use, Cardiovascular Diseases prevention & control, Perindopril therapeutic use, Ramipril therapeutic use
- Abstract
The HOPE and EUROPA clinical studies have shown that treatment with the angiotensin-converting enzyme (ACE) inhibitors, ramipril and perindopril, may reduce the occurrence of major cardiovascular events in patients with proven atherosclerotic disease. The recently published results of the PRoFESS and TRANSCEND trials completed the much needed information concerning the use of an angiotensin receptor blocker for patients at high risk of cardiovascular events. PROFESS compared a therapy of telmisartan 80 mg daily with placebo in patients with a recent ischemic stroke. The difference in the primary outcome of first recurrent stroke was not statistically significant between telmisartan and placebo. The secondary outcome of major cardiovascular events showed a relative risk reduction (RRR) of 7% in favour of telmisartan. This tended to be significant (p = 0.06) despite a rather short follow-up period of only 28 months. In TRANSCEND 5926 patients at high risk for cardiovascular events were randomized to a treatment with telmisartan 80 mg daily or placebo for a mean duration of follow-up of 56 months. The primary composite outcome of cardiovascular death, myocardial infarction, stroke or hospitalization for heart failure showed a non-significant 8% RRR in favour of the telmisartan treated patients. The main secondary outcome of cardiovascular death and myocardial infarction or stroke as used in the HOPE trial showed a non-significant RRR of 13% in favour of telmisartan treated patients (p = 0.068 adjusted for multiplicity of comparisons). In comparing the Kaplan-Meier curves for the endpoint of major cardiovascular events used in HOPE, EUROPA, TRANSCEND and PRoFESS, the trends are similar. Results of most of the recently published trials have been neutral.This could partly be explained by major improvements in the optimal background therapy of the patients included. Nevertheless, the results of PRoFESS and TRANSCEND do not contradict the results from previous studies with theACE inhibitors ramipril and perindopril and the ARB telmisartan.
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- 2010
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38. Organisation of inhospital acute stroke care and minimum criteria for stroke care units. Recommendations of the Belgian Stroke Council.
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Thijs V, Peeters A, Dewindt A, Hemelsoet D, De Klippel N, Laloux P, Redondo P, Cras P, De Deyn PP, Desfontaines P, Brouns R, De Raedt S, Van Landegem W, Vandermeeren Y, and Vanhooren G
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- Belgium, Emergency Medical Services standards, Hospital Units standards, Humans, Patient Care Team standards, Emergency Medical Services organization & administration, Hospital Units organization & administration, Patient Care Team organization & administration, Stroke therapy
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There is ample evidence from randomized trials that for patients with stroke, stroke unit care is superior to care in general medical or neurological wards. This evidence, which has been adopted by international guidelines has to be implemented into daily stroke care. This consensus document prepared by the Belgian Stroke Council provides a set of minimum criteria to meet international standards for stroke care. It is intended to provide help in the creation of stroke units in centers who do not currently have one and to provide a benchmark for centres already having organised stroke care.
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- 2009
39. Lessons from ONTARGET.
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Berlaimont V, Billiouw JM, Brohet C, Dupont AG, Gazagnes MD, Heller F, Krzesinski JM, Missault L, Persu A, Piérard L, Rottiers R, Vanhooren G, Van Mieghem W, Vervaet P, and Herman AG
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- Cardiovascular Diseases metabolism, Drug Therapy, Combination, Humans, Renin-Angiotensin System physiology, Risk Factors, Telmisartan, Treatment Outcome, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Benzimidazoles therapeutic use, Benzoates therapeutic use, Cardiovascular Diseases prevention & control, Clinical Trials as Topic methods, Ramipril therapeutic use
- Abstract
The recently published results of the ONTARGET trial shed a new light on the cardiovascular protection of patients at high risk of a cardiovascular event. Despite a number of trials looking at the efficacy of Angiotensin Converting Enzyme inhibitors (ACEis) or Angiotensin Receptor Blockers (ARBs) in the prevention of cardiovascular events in patients with specific high risk profiles, the question of the equivalence of ACEis and ARBs remained unanswered. The ONTARGET trial has shown that telmisartan 80 mg administered for a median duration of 4.5 years to patients at high risk of developing a major cardiovascular event, is equally effective to ramipril 10 mg. In addition, telmisartan was slightly better tolerated. The comparator ramipril has been chosen as it is currently the gold standard ACEi since the results of the HOPE study, in terms of the composite outcome of cardiovascular death, myocardial infarction and stroke. Moreover, ONTARGET is the first trial to test the hypothesis of superiority of adding an ARB (telmisartan 80 mg) to an ACEi (ramipril 10 mg) over the ACEi ramipril monotherapy in cardiovascular protection of the same broad range of high-risk patients. Surprisingly, despite a more pronounced blood pressure lowering, the combination of the two agents did not lead to an additional decrease in the number of events, but had significantly more side-effects compared to ramipril monotherapy. ONTARGET is a landmark study, performed according to the highest statistical and clinical standards, providing compelling evidence and clear answers to two important clinical questions.
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- 2008
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40. VITATOPS, the VITAmins TO prevent stroke trial: rationale and design of a randomised trial of B-vitamin therapy in patients with recent transient ischaemic attack or stroke (NCT00097669) (ISRCTN74743444).
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Hankey GJ, Algra A, Chen C, Wong MC, Cheung R, Wong L, Divjak I, Ferro J, de Freitas G, Gommans J, Groppa S, Hill M, Spence D, Lees K, Lisheng L, Navarro J, Ranawaka U, Ricci S, Schmidt R, Slivka A, Tan K, Tsiskaridze A, Uddin W, Vanhooren G, Xavier D, Armitage J, Hobbs M, Le M, Sudlow C, Wheatley K, Yi Q, Bulder M, Eikelboom JW, Hankey GJ, Ho WK, Jamrozik K, Klijn K, Koedam E, Langton P, Nijboer E, Tuch P, Pizzi J, Tang M, Antenucci M, Chew Y, Chinnery D, Cockayne C, Loh K, McMullin L, Smith F, Schmidt R, Chen C, Wong MC, de Freitas G, Hankey GJ, Loh K, and Song S
- Subjects
- Humans, Secondary Prevention, Ischemic Attack, Transient prevention & control, Research Design, Stroke prevention & control, Vitamin B Complex therapeutic use
- Abstract
Background: Epidemiological studies suggest that raised plasma concentrations of total homocysteine (tHcy) may be a common, causal and treatable risk factor for atherothromboembolic ischaemic stroke, dementia and depression. Although tHcy can be lowered effectively with small doses of folic acid, vitamin B(12) and vitamin B(6), it is not known whether lowering tHcy, by means of B vitamin therapy, can prevent stroke and other major atherothromboembolic vascular events., Aim: To determine whether the addition of B-vitamin supplements (folic acid 2 mg, B(6) 25 mg, B(12) 500 microg) to best medical and surgical management will reduce the combined incidence of stroke, myocardial infarction (MI) and vascular death in patients with recent stroke or transient ischaemic attack (TIA) of the brain or eye., Design: A prospective, international, multicentre, randomised, double blind, placebo-controlled clinical trial., Setting: One hundred and four medical centres in 20 countries on five continents., Subjects: Eight thousand (6600 recruited as of 5 January, 2006) patients with recent (<7 months) stroke (ischaemic or haemorrhagic) or TIA (brain or eye)., Randomisation: Randomisation and data collection are performed by means of a central telephone service or secure internet site., Intervention: One tablet daily of either placebo or B vitamins (folic acid 2 mg, B(6) 25 mg, B(12) 500 mug)., Primary Outcome: The composite of stroke, MI or death from any vascular cause, whichever occurs first. Outcome and serious adverse events are adjudicated blinded to treatment allocation., Secondary Outcomes: TIA, unstable angina, revascularisation procedures, dementia, depression. STATISTICAL POWER: With 8000 patients followed up for a median of 2 years and an annual incidence of the primary outcome of 8% among patients assigned placebo, the study will have at least 80% power to detect a relative reduction of 15% in the incidence of the primary outcome among patients assigned B vitamins (to 6.8%/year), applying a two-tailed level of significance of 5%., Conclusion: VITATOPS aims to recruit and follow-up 8000 patients between 1998 and 2008, and provide a reliable estimate of the safety and effectiveness of folic acid, vitamin B(12), and vitamin B(6) supplementation in reducing recurrent serious vascular events among a wide range of patients with TIA and stroke throughout the world.
- Published
- 2007
- Full Text
- View/download PDF
41. Collaborative study for the establishment of a European Phamacopoeia Biological reference preparation for Bordetella pertussis mouse antiserum for serological potency testing of acellular pertussis vaccines.
- Author
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Poirier B, Bornstein N, Andre M, Marmonier D, Pares M, Vanhooren G, Rautmann G, Behr-Gross ME, Dobbelaer R, and Fuchs F
- Subjects
- Animals, Cooperative Behavior, Mice, Bordetella pertussis immunology, Immune Sera immunology, Pertussis Vaccine immunology, Pharmacopoeias as Topic, Reference Standards
- Abstract
A collaborative study was organised by the European Directorate For the Quality of Medicines (EDQM) to assess the suitability of a candidate mouse antiserum as a European Pharmacopoeia Biological reference preparation (BRP) for acellular pertussis vaccine potency testing. The candidate antiserum was obtained by immunising mice with a five-component acellular pertussis vaccine: pertussis toxin (PT), filamentous haemagglutinin (FHA), pertactin (PRN) and Fimbrial 2/Fimbrial 3 (Fim 2&3). The study has been divided into two separate phases. Phase I was a pre-qualification study including three laboratories. This phase was aimed at pre-qualifying the candidate BRP (cBRP) and at documenting the impact of differences in the antibody detection methodology enzyme linked immunosorbent assay (ELISA) procedures on results of pertussis antisera calibration versus the currently used standard US standard pertussis antiserum (mouse) Lot 1 (SPAM-1) (United States Food and Drug Administration (USFDA) reference serum) and the cBRP. As no significant difference between the antibody titres determined by using the different ELISA methodologies was found, a large-scale study enrolling 13 laboratories (Phase II) was carried out, each participant performing its in-house methodology. Its aim was to calibrate the cBRP (in terms of the SPAM-1 reference) and to demonstrate its equivalence or superiority to internal references. The study showed that there was no difference in positive sera titres expressed relative to their corresponding internal reference (homologous situation) or the proposed standard (heterologous situation) reference. The cBRP can, therefore, reliably act as replacement for the in-house reference preparations. Further analysis of the outcome of this study enabled to assign to the cBRP a potency of 39, 138, 34 and 56 ELISA unit per millilitre, respectively, to its anti-PT, anti-FHA, anti-PRN and anti-Fim 2&3 antibody contents. The cBRP has been adopted by the European Pharmacopoeia Commission at its June 2000 session as Bordetella pertussis mouse anti-serum Ph Eur. BRP batch 1.
- Published
- 2003
- Full Text
- View/download PDF
42. Proposal of guidelines for stroke units.
- Author
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Desfontaines P, Vanhooren G, Peeters A, and Laloux P
- Subjects
- Humans, Emergency Service, Hospital organization & administration, Emergency Service, Hospital standards, Stroke therapy
- Published
- 2002
43. Crossed innervation of the superior rectus.
- Author
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Vanhooren GT
- Subjects
- Humans, Dominance, Cerebral physiology, Oculomotor Muscles innervation, Oculomotor Nerve pathology, Oculomotor Nerve Diseases pathology
- Published
- 1992
- Full Text
- View/download PDF
44. Apraxia of eyelid opening secondary to right frontal infarction.
- Author
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Algoed L, Janssens J, and Vanhooren G
- Subjects
- Aged, Cerebral Infarction diagnostic imaging, Female, Humans, Tomography, X-Ray Computed, Apraxias etiology, Cerebral Infarction complications, Eyelid Diseases etiology, Frontal Lobe blood supply
- Abstract
Apraxia of eyelid opening is the incapacity of voluntarily eyelid opening in the absence of motor dysfunction or blepharospasm. It has mostly been described in extrapyramidal diseases and only very rarely in cortical lesions. We report a right-handed patient with a right frontal infarction exhibiting eyelid opening apraxia.
- Published
- 1992
45. Polyneuropathy in lithium intoxication.
- Author
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Vanhooren G, Dehaene I, Van Zandycke M, Piessens F, Vandenbergh V, Van Hees J, Lammens M, and Carton H
- Subjects
- Adult, Electromyography, Female, Humans, Lithium adverse effects, Lithium Carbonate, Male, Middle Aged, Neural Conduction physiology, Peripheral Nervous System Diseases physiopathology, Lithium poisoning, Peripheral Nervous System Diseases chemically induced
- Abstract
Two patients developed acute sensorimotor polyneuropathy after intoxication with lithium carbonate. Nerve conduction studies, electromyography, and sural nerve biopsy proved it to be an axonal neuropathy. Recovery of muscle strength, reflexes, and sensory function started weeks after discontinuation of lithium therapy. One patient fully recovered within a year. In the literature we found nine other cases of lithium polyneuropathy.
- Published
- 1990
- Full Text
- View/download PDF
46. Evaluating community health services.
- Author
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Vanhooren G
- Subjects
- Aftercare, Alberta, Community Health Services economics, Home Care Services, Humans, Patient Discharge, Community Health Services organization & administration, Hospitals, Patient Care Planning
- Published
- 1978
47. Hospital reimbursement - back to the drawing board.
- Author
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Vanhooren G
- Subjects
- Canada, Community Participation economics, Fees, Medical, Financial Management, Humans, Insurance, Hospitalization economics, Reimbursement Mechanisms
- Published
- 1981
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