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14 results on '"Baron, J A"'

1. Oral bisphosphonates and risk of ischemic stroke: a case-control study.

Author

Christensen S, Mehnert F, Chapurlat RD, Baron JA, and Sørensen HT

Subjects
Administration, Oral, Aged, Aged, 80 and over, Atrial Fibrillation chemically induced, Atrial Fibrillation epidemiology, Bone Density Conservation Agents administration & dosage, Brain Ischemia chemically induced, Brain Ischemia epidemiology, Comorbidity, Denmark epidemiology, Diphosphonates administration & dosage, Drug Prescriptions statistics & numerical data, Drug Utilization statistics & numerical data, Epidemiologic Methods, Female, Humans, Middle Aged, Stroke epidemiology, Bone Density Conservation Agents adverse effects, Diphosphonates adverse effects, Stroke chemically induced
Abstract

Unlabelled: Bisphosphonates have been associated with an increased risk of atrial fibrillation and may thus be associated with an increased risk of ischemic stroke. This would have substantial clinical and public health implications. We found no evidence of an association between bisphosphonate use and risk of ischemic stroke., Introduction: Bisphosphonates have been associated with an increased risk of atrial fibrillation in some studies and may be associated with an increased risk of ischemic stroke. However, data regarding these possibilities are limited., Methods: We conducted a population-based case-control study of 6,257 female cases of ischemic stroke and 31,285 age- and gender-matched population controls. Data on bisphosphonate use, other medication use, comorbidity, and ischemic stroke were obtained from medical databases. Current bisphosphonate use was defined as at least one redeemed prescription within 90 days before diagnosis/index date. We estimated the odds ratio (OR) of ischemic stroke among users and nonusers of bisphosphonates using conditional logistic regression, controlling for potential confounding factors., Results: One hundred eighty-two (2.9%) cases and 901 (2.9%) controls were current users of bisphosphonates. Etidronate and alendronate were prescribed with similar frequency among cases and controls. The adjusted OR of ischemic stroke for bisphosphonate users compared with nonusers was 0.97 (95% confidence interval [CI], 0.82-1.15). New and continuing bisphosphonate users had adjusted ORs for ischemic stroke of 1.16 (95% CI, 0.69-1.96) and 0.97 (95% CI, 0.81-1.16), respectively. Excluding patients with known atrial fibrillation/flutter yielded an OR of 1.00 (95% CI, 0.85-1.19). The OR for ischemic stroke was 0.59 (95% CI, 0.32-1.09) among patients with a history of previous hospitalization for cardiovascular disease and 1.07 (95% CI, 0.88-1.18) among those without (P < 0.001). The OR for former users was 1.23 (95% CI, 1.01-1.49)., Conclusion: We found no evidence of an association of oral bisphosphonate use with the risk of ischemic stroke.

Published
2011
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2. Brain hypoxia mapping in acute stroke: Back-to-back T2′ MR versus 18F-fluoromisonidazole PET in rodents

Author

Jensen-Kondering, U, Manavaki, R, Ejaz, S, Sawiak, SJ, Carpenter, TA, Fryer, TD, Aigbirhio, FI, Williamson, DJ, Baron, J-C, Manavaki, Roido [0000-0002-4384-6626], Sawiak, Stephen [0000-0003-4210-9816], Carpenter, Adrian [0000-0002-2939-8222], Aigbirhio, Franklin [0000-0001-9453-5257], Baron, Jean-Claude [0000-0002-5264-2588], and Apollo - University of Cambridge Repository

Subjects
positron emission tomography, 18F-fluoro-misonidazole, brain imaging, stroke, cerebral ischemia, MRI
Abstract

Background Mapping the hypoxic brain in acute ischemic stroke has considerable potential for both diagnosis and treatment monitoring. PET using (18)F-fluoro-misonidazole (FMISO) is the reference method; however, it lacks clinical accessibility and involves radiation exposure. MR-based T2' mapping may identify tissue hypoxia and holds clinical potential. However, its validation against FMISO imaging is lacking. Here we implemented back-to-back FMISO-PET and T2' MR in rodents subjected to acute middle cerebral artery occlusion. For direct clinical relevance, regions of interest delineating reduced T2' signal areas were manually drawn. Methods Wistar rats were subjected to filament middle cerebral artery occlusion, immediately followed by intravenous FMISO injection. Multi-echo T2 and T2* sequences were acquired twice during FMISO brain uptake, interleaved with diffusion-weighted imaging. Perfusion-weighted MR was also acquired whenever feasible. Immediately following MR, PET data reflecting the history of FMISO brain uptake during MR acquisition were acquired. T2' maps were generated voxel-wise from T2 and T2*. Two raters independently drew T2' lesion regions of interest. FMISO uptake and perfusion data were obtained within T2' consensus regions of interest, and their overlap with the automatically generated FMISO lesion and apparent diffusion coefficient lesion regions of interest was computed. Results As predicted, consensus T2' lesion regions of interest exhibited high FMISO uptake as well as substantial overlap with the FMISO lesion and significant hypoperfusion, but only small overlap with the apparent diffusion coefficient lesion. Overlap of the T2' lesion regions of interest between the two raters was ∼50%. Conclusions This study provides formal validation of T2' to map non-core hypoxic tissue in acute stroke. T2' lesion delineation reproducibility was suboptimal, reflecting unclear lesion borders.

Published
2018
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3. Early neurological deterioration following thrombolysis for minor stroke with isolated internal carotid artery occlusion.

Author

Boulenoir, N., Turc, G., Henon, H., Laksiri, N., Mounier‐Véhier, F., Girard Buttaz, I., Duong, D.‐L., Papassin, J., Yger, M., Triquenot, A., Lyoubi, A., Ter Schiphorst, A., Denier, C., Baron, J.‐C., Seners, P., Ben Hassen, Wagih, Lapergue, Bertrand, Lamy, Chantal, Lucas, Ludovic, and Philippeau, Frédéric

Subjects
INTERNAL carotid artery, THROMBOLYTIC therapy, STROKE, CIRCLE of Willis, PATIENTS' attitudes, TRANSIENT ischemic attack
Abstract

Background and purpose: Better understanding the incidence, predictors and mechanisms of early neurological deterioration (END) following intravenous thrombolysis (IVT) for acute stroke with mild symptoms and isolated internal carotid artery occlusion (iICAo) may inform therapeutic decisions. Methods: From a multicenter retrospective database, we extracted all patients with both National Institutes of Health Stroke Scale (NIHSS) score <6 and iICAo (i.e. not involving the Willis circle) on admission imaging, intended for IVT alone. END was defined as ≥4 NIHSS points increase within 24 h. END and no‐END patients were compared for (i) pre‐treatment clinical and imaging variables and (ii) occurrence of intracranial occlusion, carotid recanalization and parenchymal hemorrhage on follow‐up imaging. Results: Seventy‐four patients were included, amongst whom 22 (30%) patients experienced END. Amongst pre‐treatment variables, suprabulbar carotid occlusion was the only admission predictor of END following stepwise variable selection (odds ratio = 4.0, 95% confidence interval: 1.3–12.2; P = 0.015). On follow‐up imaging, there was no instance of parenchymal hemorrhage, but an intracranial occlusion was now present in 76% vs. 0% of END and no‐END patients, respectively (P < 0.001), and there was a trend toward higher carotid recanalization rate in END patients (29% vs. 9%, P = 0.07). As compared to no‐END, END was strongly associated with a poor 3‐month outcome. Conclusions: Early neurological deterioration is a frequent and highly deleterious event after IVT for minor stroke with iICAo, and is of thromboembolic origin in three out of four patients. The strong association with iICAo site—largely a function of underlying stroke etiology—may point to a different response of the thrombus to IVT. These findings suggest END may be preventable in this setting. [ABSTRACT FROM AUTHOR]

Published
2021
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5. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials

Author

Baigent, Colin, Bhala, N., Emberson, J., Merhi, A., Abramson, S., Arber, N., Baron, J. A., Bombardier, C., Cannon, C., Farkouh, M. E., Fitzgerald, G. A., Goss, P., Halls, H., Hawk, E., Hawkey, C., Hennekens, C., Hochberg, M., Holland, L. E., Kearney, P. M., Laine, L., Lanas, A., Lance, P., Laupacis, A., Oates, J., Patrono, C., Schnitzer, T. J., Solomon, S., Tugwell, P., Wilson, K., Wittes, J., Adelowo, O., Aisen, P., Al Quorain, A., Altman, R., Bakris, G., Baumgartner, H., Bresee, C., Carducci, M., Chang, D. M., Chou, C. T., Clegg, D., Cudkowicz, M., Doody, L., Miedany, Y. E. l., Falandry, C., Farley, J., Ford, L., Garcia Losa, M., Gonzalez Ortiz, M., Haghighi, M., Hala, M., Iwama, T., Jajic, Z., Kerr, D., Kim, H. S., Kohne, C., Koo, B. K., Martin, B., Meinert, C., Muller, N., Myklebust, G., Neustadt, D., Omdal, R., Ozgocmen, S., Papas, A., Patrignani, P., Pelliccia, Francesco, Roy, V., Schlegelmilch, I., Umar, A., Wahlstrom, O., Wollheim, F., Yocum, S., Zhang, X. Y., Hall, E., Mcgettigan, P., Midgley, R., Moore, R. A., Philipson, R., Curtis, S., Reicin, A., Bond, J., Moore, A., Essex, M., Fabule, J., Morrison, B., Tive, L., Davies, K., and Yau, F.

Subjects
medicine.medical_specialty, Gastrointestinal Diseases, Perforation (oil well), coronary disease, Placebo, anti-inflammatory agents, non-steroidal, blood vessels, Diclofenac, vascular, Internal medicine, medicine, naproxen, Humans, Myocardial infarction, Vascular Diseases, medicine (all), Stroke, ibuprofen, anti-inflammatory, business.industry, Vascular disease, Anti-Inflammatory Agents, Non-Steroidal, General Medicine, Articles, Ibuprofen, medicine.disease, stroke, gastrointestinal, diclofenac, myocardial infarction, cyclooxygenase 2 inhibitors, Heart failure, Anesthesia, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, gastrointestinal tract, business, anti-inflammatory agents, non-steroidal, gastrointestinal diseases, humans, vascular diseases, medicine.drug
Abstract

BACKGROUND: The vascular and gastrointestinal effects of non-steroidal anti-inflammatory drugs (NSAIDs), including selective COX-2 inhibitors (coxibs) and traditional non-steroidal anti-inflammatory drugs (tNSAIDs), are not well characterised, particularly in patients at increased risk of vascular disease. We aimed to provide such information through meta-analyses of randomised trials. METHODS: We undertook meta-analyses of 280 trials of NSAIDs versus placebo (124,513 participants, 68,342 person-years) and 474 trials of one NSAID versus another NSAID (229,296 participants, 165,456 person-years). The main outcomes were major vascular events (non-fatal myocardial infarction, non-fatal stroke, or vascular death); major coronary events (non-fatal myocardial infarction or coronary death); stroke; mortality; heart failure; and upper gastrointestinal complications (perforation, obstruction, or bleed). FINDINGS: Major vascular events were increased by about a third by a coxib (rate ratio [RR] 1·37, 95% CI 1·14-1·66; p=0·0009) or diclofenac (1·41, 1·12-1·78; p=0·0036), chiefly due to an increase in major coronary events (coxibs 1·76, 1·31-2·37; p=0·0001; diclofenac 1·70, 1·19-2·41; p=0·0032). Ibuprofen also significantly increased major coronary events (2·22, 1·10-4·48; p=0·0253), but not major vascular events (1·44, 0·89-2·33). Compared with placebo, of 1000 patients allocated to a coxib or diclofenac for a year, three more had major vascular events, one of which was fatal. Naproxen did not significantly increase major vascular events (0·93, 0·69-1·27). Vascular death was increased significantly by coxibs (1·58, 99% CI 1·00-2·49; p=0·0103) and diclofenac (1·65, 0·95-2·85, p=0·0187), non-significantly by ibuprofen (1·90, 0·56-6·41; p=0·17), but not by naproxen (1·08, 0·48-2·47, p=0·80). The proportional effects on major vascular events were independent of baseline characteristics, including vascular risk. Heart failure risk was roughly doubled by all NSAIDs. All NSAID regimens increased upper gastrointestinal complications (coxibs 1·81, 1·17-2·81, p=0·0070; diclofenac 1·89, 1·16-3·09, p=0·0106; ibuprofen 3·97, 2·22-7·10, p

Published
2013
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6. 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

Author

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.

Subjects
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.

Published
2009
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7. Does Perfusion Computed Tomography Facilitate Clinical Decision Making for Thrombolysis in Unselected Acute Patients with Suspected Ischaemic Stroke?

Author

Agarwal, S., Jones, P.S., Alawneh, J.A., Antoun, N.M., Barry, P.J., Carrera, E., Cotter, P.E., O'Brien, E.W., Salih, I., Scoffings, D.J., Baron, J.-C., and Warburton, E.A.

Subjects
TOMOGRAPHY, THROMBOLYTIC therapy, CORONARY disease, NEURORADIOLOGY, PERFUSION, DIAGNOSTIC imaging, PATIENTS
Abstract

Background: Despite use in clinical practice and major positive trials of thrombolysis, non-contrast computed tomography (NCCT) is not sensitive for identifying penumbral tissue in acute stroke. This study evaluated how physiological imaging using CT perfusion (CTP) could add to the diagnostic utility of an NCCT and inform clinical decisions regarding thrombolysis. Methods: Forty imaging datasets containing NCCT and CTP were retrospectively identified from a cohort of consecutive acute stroke patients. Two sets of observers (n = 6) and a neuroradiologist evaluated the images without knowledge of clinical symptoms. Inter-observer agreement was calculated using the κ statistic for identifying acute ischaemic change on NCCT: perfusion abnormalities (namely cerebral blood volume, cerebral blood flow and time to peak), and penumbral tissue on perfusion maps obtained by two image processing algorithms. Results: Inter-rater agreement was moderate (κ = 0.54) for early ischaemic change on NCCT. Perfusion maps improved this to substantial for cerebral blood volume (κ = 0.67) and to almost perfect for time to peak (κ = 0.87) and cerebral blood flow (κ = 0.87). The agreement for qualitative assessment of penumbral tissue was substantial to perfect for images obtained using the two different perfusion algorithms. Overall, there was a high rate of decision to thrombolyse based on NCCT (81.25%). CTP strengthened the decision to thrombolyse based on NCCT in 38.3% of cases. It negatively influenced the decision in 14.6% of cases, this being significantly more common in experienced observers (p = 0.02). Conclusions: We demonstrate that the qualitative evaluation of CTP produces near perfect inter-observer agreement, regardless of the post-processing method used. CTP is a reliable, accessible and practical imaging modality that improves confidence in reaching the appropriate diagnosis. It is particularly useful for less experienced clinicians, to arrive at a physiologically informed treatment decision. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2011
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8. Pathophysiology of ischaemic stroke: insights from imaging, and implications for therapy and drug discovery.

Author

Moustafa, R. R. and Baron, J.-C.

Subjects
*CEREBROVASCULAR disease, *PATHOLOGICAL physiology, *DRUG development, *INFARCTION, *PHARMACOLOGY
Abstract

Preventing death and limiting handicap from ischaemic stroke are major goals that can be achieved only if the pathophysiology of infarct expansion is properly understood. Primate studies showed that following occlusion of the middle cerebral artery (MCA)––the most frequent and prototypical stroke, local tissue fate depends on the severity of hypoperfusion and duration of occlusion, with a fraction of the MCA territory being initially in a ‘penumbral’ state. Physiological quantitative PET imaging has translated this knowledge in man and revealed the presence of considerable pathophysiological heterogeneity from patient to patient, largely unpredictable from elapsed time since onset or clinical deficit. While these observations underpinned key trials of thrombolysis, they also indicate that only patients who are likely to benefit should be exposed to its risks. Accordingly, imaging-based diagnosis is rapidly becoming an essential component of stroke assessment, replacing the clock by individually customized management. Diffusion- and perfusion-weighted MR (DWI-PWI) and CT-based perfusion imaging are increasingly being used to implement this, and are undergoing formal validation against PET. Beyond thrombolysis per se, knowledge of the individual pathophysiology also guides management of variables like blood pressure, blood glucose and oxygen saturation, which can otherwise precipitate the penumbra into the core, and the oligaemic tissue into the penumbra. We propose that future therapeutic trials use physiological imaging to select the patient category that best matches the drug's presumed mode of action, rather than lumping together patients with entirely different pathophysiological patterns in so-called ‘large trials’, which have all failed so far.British Journal of Pharmacology (2008) 153, S44–S54; doi:10.1038/sj.bjp.0707530; published online 26 November 2007 [ABSTRACT FROM AUTHOR]

Published
2008
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9. PHYSICIAN ASSESSMENT OF STROKE RISK IN HYPERTENSIVE PATIENTS IN THE MIDDLE EAST AND AFRICA: RESULTS OF THE ACTION SURVEY.

Author

Badr, Kamal F., Merad Boudia, Khereddine M., Alami, Mohamed, Khoja, Waleed A., Beihani, Ali B., Nawar, Moustafa, Ragy, Hany, Ishaq, Mohammad, Muscat Baron, J. M., Hammoudeh, Ayman J., De Mar Youssef, Suzan S., Nakhle, Reine M., and Chalfoun, Amale G.

Subjects
HEALTH surveys, CEREBROVASCULAR disease risk factors, PATIENTS, HYPERTENSION, COHORT analysis
Abstract

The article discusses the results of the Action Survey, which was designed to provide preliminary data on stroke risk in hypertensive patients in the Middle East and Africa and assess blood pressure control. A ten-year absolute stroke risk was calculated using a scoring system based on the Framingham Heart Study observations, and comparisons made with an age-matched cohort study.

Published
2007

10. How Healthy Is the Acutely Reperfused Ischemic Penumbra?

Author

Baron, J.-C.

Subjects
*REPERFUSION, *BRAIN disease treatment, *CEREBROVASCULAR disease, *MYOCARDIAL reperfusion, *THERAPEUTICS, *INFLAMMATION, *NEUROPLASTICITY
Abstract

Because it is the main determinant of clinical recovery, early reperfusion of the ischemic penumbra has become the mainstay of acute stroke therapy. Although early permanent recanalization can be associated with spectacular and complete recovery, some patients in fact exhibit delayed or incomplete recovery, even despite small infarcts on late structural imaging. This might result from tissue inflammation and selective neuronal death/damage, two probably inter-related cellular events well described in the animal literature, precluding full functional restoration in the salvaged penumbra. However, impact of these processes on recovery may be complex because of the interplay with ongoing plasticity and the possible promoting effect of inflammation on the latter. Preliminary results from imaging studies of inflammation and selective neuronal loss after middle cerebral artery territory stroke, using radioligands of the central benzodiazepine receptor and the activated microglia, respectively, reviewed here, suggest these phenomena also exist in man, although their relationship with acute-stage hypoperfusion and their impact on clinical recovery, if any, remain poorly understood. Furthermore, their inter-relationships in the salvaged penumbra have not been addressed. Better understanding of these potentially harmful processes might help to maximize benefits from thrombolysis, and could also have implications for patients who enjoy spontaneous recanalization. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2005
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11. Ischemic strokes and migraine.

Author

Bousser, M., Baron, J., and Chiras, J.

Abstract

The coincidence of migraine and ischemic strokes is rare but unequivocal. Some of the cases described are recalled and the possible mechanisms discussed. [ABSTRACT FROM AUTHOR]

Published
1985
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12. Combined PET-FDG and USPIO-enhanced MR Imaging in Patients with Symptomatic Moderate Carotid Artery Stenosis.

Author

Tang, T.Y., Moustafa, R.R., Howarth, S.P., Walsh, S.R., Boyle, J.R., Li, Z.Y., Baron, J.-C., Gillard, J.H., and Warburton, E.A.

Subjects
MAGNETIC resonance imaging, ARTERIAL stenosis, DUPLEX ultrasonography, MEDICAL imaging systems
Abstract

Abstract: Introduction: PET-FDG and USPIO-enhanced MRI are increasingly being used in depicting carotid atheroma inflammation – a risk factor for the high risk plaque. Their combined use has not been previously reported. Report: Two patients presenting with stroke and identified with 50% carotid stenosis on duplex ultrasonography, underwent PET FDG and USPIO-enhanced MR imaging. Results were concordant and complementary suggesting that both techniques reflect similar metabolic processes. Discussion: The selection of patients for carotid revascularisation has largely been based on the severity of luminal stenosis alone. The two imaging modalities, which identify inflammatory activity, may be potential surrogate risk markers in the selection of patients eligible for carotid surgery, if plaque inflammation can be correlated with risk of developing clinical symptoms. [Copyright &y& Elsevier]

Published
2008
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13. Lacunar stroke attributable to radiation-induced intracranial arteriopathy.

Author

Salih, I. S. M., Higgins, N. J. N., Warburton, E. A., and Baron, J.-C.

Subjects
CEREBROVASCULAR disease, ARTICULATION disorders, MEDULLOBLASTOMA, RADIOTHERAPY, CEREBRAL infarction, STENOSIS, ARTERIAL occlusions
Abstract

We report the rare presentation of lacunar stroke syndrome secondary to single perforator mouth occlusion from radiation-induced middle cerebral artery (MCA) stem arteriopathy. A 30-year-old female had acute-onset right-sided ataxic hemiparesis and dysarthria. As a child, she had a medulloblastoma of the posterior fossa and had surgery followed by cranial radiotherapy. She had no significant vascular risk factors. Acute CT showed extensive bilateral basal ganglia and left thalamic calcification; DWI showed a left internal capsule lacunar infarct; and MRA and CTA showed a 50% stenosis of the proximal left MCA. [ABSTRACT FROM AUTHOR]

Published
2007
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14. Mapping anterograde and retrograde degeneration after stroke.

Author

Baron, J.-C.

Subjects
*CEREBROVASCULAR disease, *NEURODEGENERATION, *PYRAMIDAL tract, *EFFERENT pathways, *ANISOTROPY, *CEREBRAL peduncle, *BIOLOGICAL assay, *BRAIN, *BRAIN mapping, *PROGNOSIS, *STROKE, *DISEASE complications
Abstract

This article focuses on tools to quantify secondary degeneration after stroke and monitor effects of intervention. Researchers monitored in two patients the time course of Wallerian degeneration (WD) of the pyramidal tract following striatocapsular stroke. Diffusion tensor imaging was obtained on three occasions from the subacute into the chronic stage. They found a progressive decrease of the fractional anisotropy (FA) with an increase in mean diffusivity (MD) in the pyramidal tract at the level of the cerebral peduncle, reflecting the changes expected in WD-a progressive disintegration of fibre structure. They found significant increases in MD from 1 month onward, without parallel changes in FA, presumably reflecting a progressive loss of neurons and glial cells.

Published
2005
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