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51. New algorithm for treatment allocation reduced selection bias and loss of power in small trials

Author: Hofmeijer, J., Anema, P.C., and van der Tweel, I.
Published: 2008
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52. Postictal recovery of orientation in person, place and time relates to restoration of cortical activity after electroconvulsive therapy.

Author: Stuiver, S., Pottkämper, J., Verdijk, J., ten Doesschate, F., van Putten, M., Hofmeijer, J., and van Waarde, J.
Subjects: ELECTROCONVULSIVE therapy, MENTAL orientation, COGNITION, ELECTROENCEPHALOGRAPHY, BENZODIAZEPINES
Abstract: Introduction: Most patients show temporary impairments in clinical orientation (i.e., orientation in person, place, and time) after electroconvulsive therapy (ECT)-induced seizures. It is unclear whether postictal reorientation is related to electroencephalography (EEG) restoration. This tentative relationship may shed light on mechanistic aspects of reorientation after ECT. Objectives: To study whether postictal EEG restoration after an ECT-induced seizure is related to recovery of clinical orientation in the cognitive domains person, place and time. Methods: We performed a longitudinal study in ECT patients and collected continuous postictal EEGs. Postictal EEG restoration was estimated by the evolution of the normalized alpha/delta ratio (ADR). Recovery of orientation in the cognitive domains of person, place, and time was assessed using the Reorientation Time (ROT) questionnaire. In each cognitive domain, a linear mixed model was fitted to investigate the relationship between ROT and postictal EEG restoration. In these models, other (ECT-)parameters including seizure duration, use of benzodiazepines and electrode placement were included. Results: In total, 272 ictal and postictal EEG recordings of 32 patients were included. In all domains, longer ROT was associated with slower postictal EEG recovery. Longer seizure duration and use of benzodiazepines were related to longer ROT in all domains. Increased total charge of the ECT-stimulus was associated with increased ROT in place and age was positively associated with ROT in time. Image: Image 2: Conclusions: We show a relationship between restoration of the postictal EEG and clinical reorientation in person, place and time after ECT-induced seizures. This indicates that clinical reorientation probably depends on gradual cortical synaptic recovery. Increased seizure duration and the use of benzodiazepines were also related to increased ROT values. Longer seizures and use of benzodiazepines may induce longer postictal synaptic depression. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]
Published: 2024
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53. SURGICAL DECOMPRESSION FOR SPACE-OCCUPYING HEMISPHERIC INFARCTION: A SYSTEMATIC REVIEW AND INDIVIDUAL-PATIENT META-ANALYSIS

Author: Reinink, H., Juettler, E., Hacke, W., Hofmeijer, J., Vicaut, E., Vahedi, K., Greving, J., and Ege Üniversitesi
Subjects: [No Keyword]
Abstract: [No Abstract Available]
Published: 2020

54. Appreciation of the informed consent procedure in a randomised trial of decompressive surgery for space occupying hemispheric infarction

Author: Hofmeijer, J., Amelink, G.J., den Hertog, H.M., Algra, A., Kappelle, L.J., and van der Worp, H.B.
Subjects: Informed consent (Medical law) -- Standards, Informed consent (Medical law) -- Research, Clinical trials -- Ethical aspects, Brain -- Infarction, Brain -- Care and treatment, Brain -- Research, Brain -- Surgery, Health, Psychology and mental health
Published: 2007

55. Relevance of somatosensory evoked potential amplitude after cardiac arrest

Author: Glimmerveen, A.B., Keijzer, H.M., Ruijter, B.J., Tjepkema-Cloostermans, M.C., Putten, M.J.A.M van der, Hofmeijer, J., Glimmerveen, A.B., Keijzer, H.M., Ruijter, B.J., Tjepkema-Cloostermans, M.C., Putten, M.J.A.M van der, and Hofmeijer, J.
Abstract: Contains fulltext : 220543.pdf (publisher's version ) (Open Access), Objective: We present relations of SSEP amplitude with neurological outcome and of SSEP amplitude with EEG amplitude in comatose patients after cardiac arrest. Methods: This is a post hoc analysis of a prospective cohort study in comatose patients after cardiac arrest. Amplitude of SSEP recordings obtained within 48-72 h, and EEG patterns obtained at 12 and 24h after cardiac arrest were related to good (CPC 1-2) or poor (CPC 3-5) outcome at 6 months. In 39% of the study population multiple SSEP measurements were performed. Additionally, SSEP amplitude was related to mean EEG amplitude. Results: We included 138 patients (77% poor outcome). Absent SSEP responses, a N20 amplitude <0.4 μV within 48-72 h, and suppressed or synchronous EEG with suppressed background at 12 or 24 h after cardiac arrest were invariably associated with a poor outcome. Combined, these tests reached a sensitivity for prediction of poor outcome up to 58 at 100% specificity. N20 amplitude increased with a mean of 0.55 μV per day in patients with a poor outcome, and remained stable with a good outcome. There was no statistically significant correlation between SSEP and EEG amplitudes in 182 combined SSEP and EEG measurements (R (2) < 0.01). Conclusions: N20 amplitude <0.4 μV is invariably associated with poor outcome. There is no correlation between SSEP and EEG amplitude. Significance: SSEP amplitude analysis may contribute to outcome prediction after cardiac arrest.
Published: 2020

56. EEG reactivity testing for prediction of good outcome in patients after cardiac arrest

Author: Admiraal, M.M., Horn, J., Hofmeijer, J., Hoedemaekers, C.W.E., Kaam, C.R. van, Keijzer, H.M., Putten, Michel J.A.M. van, Schultz, M.J., Rootselaar, A.F. van, Admiraal, M.M., Horn, J., Hofmeijer, J., Hoedemaekers, C.W.E., Kaam, C.R. van, Keijzer, H.M., Putten, Michel J.A.M. van, Schultz, M.J., and Rootselaar, A.F. van
Abstract: Item does not contain fulltext, OBJECTIVE: To determine the additional value of EEG reactivity (EEG-R) testing to EEG background pattern for prediction of good outcome in adult patients after cardiac arrest (CA). METHODS: In this post hoc analysis of a prospective cohort study, EEG-R was tested twice a day, using a strict protocol. Good outcome was defined as a Cerebral Performance Category score of 1-2 within 6 months. The additional value of EEG-R per EEG background pattern was evaluated using the diagnostic odds ratio (DOR). Prognostic value (sensitivity and specificity) of EEG-R was investigated in relation to time after CA, sedative medication, different stimuli, and repeated testing. RESULTS: Between 12 and 24 hours after CA, data of 108 patients were available. Patients with a continuous (n = 64) or discontinuous (n = 19) normal voltage background pattern with reactivity were 3 and 8 times more likely to have a good outcome than without reactivity (continuous: DOR, 3.4; 95% confidence interval [CI], 0.97-12.0; p = 0.06; discontinuous: DOR, 8.0; 95% CI, 1.0-63.97; p = 0.0499). EEG-R was not observed in other background patterns within 24 hours after CA. In 119 patients with a normal voltage EEG background pattern, continuous or discontinuous, any time after CA, prognostic value was highest in sedated patients (sensitivity 81.3%, specificity 59.5%), irrespective of time after CA. EEG-R induced by handclapping and sternal rubbing, especially when combined, had highest prognostic value. Repeated EEG-R testing increased prognostic value. CONCLUSION: EEG-R has additional value for prediction of good outcome in patients with discontinuous normal voltage EEG background pattern and possibly with continuous normal voltage. The best stimuli were clapping and sternal rubbing.
Published: 2020

57. Anesthetic management during endovascular treatment of acute ischemic stroke in the MR CLEAN Registry

Author: Goldhoorn, R.B., Bernsen, M.L.E., Hofmeijer, J., Martens, J.M., Lingsma, H.F., Dippel, D.W., Lugt, A. van der, Buhre, W., Roos, Y., Majoie, C., Vos, J.A, Boiten, J., Emmer, B., Boogaarts, H.D., Dijk, E.J. van, Jenniskens, S.F.M., Geerlings, A.L., Straaten, T. van, Oostenbrugge, R.J. van, Zwam, W.H. van, Goldhoorn, R.B., Bernsen, M.L.E., Hofmeijer, J., Martens, J.M., Lingsma, H.F., Dippel, D.W., Lugt, A. van der, Buhre, W., Roos, Y., Majoie, C., Vos, J.A, Boiten, J., Emmer, B., Boogaarts, H.D., Dijk, E.J. van, Jenniskens, S.F.M., Geerlings, A.L., Straaten, T. van, Oostenbrugge, R.J. van, and Zwam, W.H. van
Abstract: Item does not contain fulltext, OBJECTIVE: To compare outcomes after endovascular treatment (EVT) for acute ischemic stroke with 3 different types of anesthetic management in clinical practice, as anesthetic management may influence functional outcome. METHODS: Data of patients with an anterior circulation occlusion, included in the Dutch nationwide, prospective Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) Registry between March 2014 and June 2016, were analyzed. Patients were divided into 3 groups defined by anesthetic technique performed during EVT: local anesthesia only (LA), general anesthesia (GA), or conscious sedation (CS). Primary outcome was the modified Rankin Scale score at 90 days. To compare functional outcome between groups, we estimated a common odds ratio (OR) with ordinal logistic regression, adjusted for age, sex, prestroke modified Rankin Scale score, baseline NIH Stroke Scale score, collaterals, and time from onset to arrival at intervention center. RESULTS: A total of 1,376 patients were included. Performed anesthetic technique was LA in 821 (60%), GA in 381 (28%), and CS in 174 (13%) patients. Compared to LA, both GA and CS were associated with worse functional outcome on the modified Rankin Scale score at 90 days (GA cORadj 0.75; 95% confidence interval [CI] 0.58-0.97; CS cORadj 0.45; 95% CI 0.33-0.62). CS was associated with worse functional outcome than GA (cORadj 0.60; 95% CI 0.42-0.87). CONCLUSIONS: LA is associated with better functional outcome than systemic sedation in patients undergoing EVT for acute ischemic stroke. Whereas LA had a clear advantage over CS, this was less prominent compared to GA. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for patients with acute ischemic stroke undergoing EVT, LA improves functional outcome compared to GA or CS.
Published: 2020

58. Path From Clinical Research to Implementation: Endovascular Treatment of Ischemic Stroke in the Netherlands

Author: Wiegers, E.J.A., Compagne, K.C.J., Janssen, P.M., Venema, E., Deckers, J.W., Schonewille, W.J., Vos, J. de, Nijeholt, G.J., Roozenbeek, B., Martens, J.M., Hofmeijer, J., Oostenbrugge, R.J. van, Zwam, W.H. van, Majoie, C., Lugt, A. van der, Lingsma, H.F., Dijk, E.J. van, Boogaarts, H.D., Jenniskens, S.F.M., Meijer, A., Roos, Y., Dippel, D.W., Wiegers, E.J.A., Compagne, K.C.J., Janssen, P.M., Venema, E., Deckers, J.W., Schonewille, W.J., Vos, J. de, Nijeholt, G.J., Roozenbeek, B., Martens, J.M., Hofmeijer, J., Oostenbrugge, R.J. van, Zwam, W.H. van, Majoie, C., Lugt, A. van der, Lingsma, H.F., Dijk, E.J. van, Boogaarts, H.D., Jenniskens, S.F.M., Meijer, A., Roos, Y., and Dippel, D.W.
Abstract: Contains fulltext : 220823.pdf (Publisher’s version ) (Closed access), Before 2015, endovascular treatment (EVT) for acute ischemic stroke was considered a promising treatment option. Based on limited evidence, it was performed in several dedicated stroke centers worldwide on selected patients. Since 2015, EVT for patients with intracranial large vessel occlusion has quickly been implemented as standard treatment in many countries worldwide, supported by the revised international guidelines based on solid evidence from multiple clinical trials. We describe the development in use of EVT in the Netherlands before, during, and after the pivotal EVT trials. We used data from all patients who were treated with EVT in the Netherlands from January 2002 until December 2018. We undertook a time-series analysis to examine trends in the use of EVT using Poisson regression analysis. Incidence rate ratios per year with 95% CIs were obtained to demonstrate the impact and implementation after the publication of the EVT trial results. We made regional observation plots, adjusted for stroke incidence, to assess the availability and use of the treatment in the country. In the buildup to the MR CLEAN (Multicenter Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands), a slow increase of EVT patients was observed, with 0.2% of all ischemic stroke patients receiving EVT. Before the trial results were formally announced, a statistically significant increase in EVT-treated patients per year was observed (incidence rate ratio, 1.72 [95% CI, 1.46-2.04]), and after the trial publication, an immediate steep increase was seen, followed by a more gradual increase (incidence rate ratio, 2.14 [95% CI, 1.77-2.59]). In 2018, the percentage of ischemic stroke patients receiving EVT increased to 5.8%. A well-developed infrastructure, a pragmatic approach toward the use of EVT in clinical practice, in combination with a strict adherence by the regulatory authorities to national evidence-based guidelines has led to successful implementation
Published: 2020

59. Delirium after cardiac arrest: Phenotype, prediction, and outcome

Author: Keijzer, H.M., Klop, M., Putten, M.J.A. van, Hofmeijer, J., Keijzer, H.M., Klop, M., Putten, M.J.A. van, and Hofmeijer, J.
Abstract: Contains fulltext : 220636.pdf (Publisher’s version ) (Open Access), AIM: To establish incidence, phenotype, long-term functional outcome, and early EEG predictors of delirium after cardiac arrest. METHODS: This is an ad hoc analysis of a prospective cohort study on outcome prediction of comatose patients after cardiac arrest. Patients with recovery of consciousness, who survived until hospital discharge, were subdivided in groups with and without delirium based on psychiatric consultation. Delirium phenotype and medical treatment were retrieved from patient files. All other data were prospectively collected. We used univariate analyses of baseline and early EEG characteristics for identification of possible delirium predictors. Association of delirium with neurological recovery at six months was analyzed with multinomial logistic regression analysis. RESULTS: Of 233 patients, 141 survived until hospital discharge, of whom 47 (33%) were diagnosed with delirium. There were no differences in baseline characteristics between patients with and without delirium. All delirious patients were treated with relatively high dosages of psychopharmaceuticals, mostly haloperidol and benzodiazepine agonists. Prevalent characteristics were disturbed cognition, perception and psychomotor functioning (98%). Half of the patients had language disorders or shouting. Delirium was associated with longer ICU and hospital admission, and more frequent discharge to rehabilitation centre or nursing home. There was a trend towards poorer neurological recovery. EEG measurements within 12 h after cardiac arrest could predict delirium with 91% specificity and 40% sensitivity. DISCUSSION: Delirium is common after cardiac arrest, and probably leads to longer hospitalization and poorer outcome. Optimal treatment is unclear. Early EEG holds potential to identify patients at risk.
Published: 2020

60. Path From Clinical Research to Implementation Endovascular Treatment of Ischemic Stroke in the Netherlands

Author: Wiegers, Eveline, Compagne, Kars, Janssen, Paula, Venema, Esmee, Deckers, Jaap, Schonewille, WJ, Vos, JA, Nijeholt, G, Roozenbeek, Bob, Martens, JM, Hofmeijer, J, van Oostenbrugge, RJ, Zwam, WH, Majoie, C, van der Lugt, Aad, Lingsma, Hester, Roos, Y, Dippel, Diederik, Wiegers, Eveline, Compagne, Kars, Janssen, Paula, Venema, Esmee, Deckers, Jaap, Schonewille, WJ, Vos, JA, Nijeholt, G, Roozenbeek, Bob, Martens, JM, Hofmeijer, J, van Oostenbrugge, RJ, Zwam, WH, Majoie, C, van der Lugt, Aad, Lingsma, Hester, Roos, Y, and Dippel, Diederik
Published: 2020

61. Anesthetic management during endovascular treatment of acute ischemic stroke in the MR CLEAN Registry

Author: Goldhoorn, RJB, Bernsen, MLE, Hofmeijer, J, Martens, JM, Lingsma, Hester, Dippel, Diederik, van der Lugt, Aad, Buhre, WF, Roos, YBWEM, Majoie, C B M, Vos, JA, Boiten, J, Emmer, Bart, van Oostenbrugge, RJ, Zwam, WH, Goldhoorn, RJB, Bernsen, MLE, Hofmeijer, J, Martens, JM, Lingsma, Hester, Dippel, Diederik, van der Lugt, Aad, Buhre, WF, Roos, YBWEM, Majoie, C B M, Vos, JA, Boiten, J, Emmer, Bart, van Oostenbrugge, RJ, and Zwam, WH
Published: 2020

62. Workflow Intervals of Endovascular Acute Stroke Therapy During On- Versus Off-Hours The MR CLEAN Registry

Author: Hinsenveld, W.H., Ridder, I.R. de, Oostenbrugge, R.J. van, Vos, J.A., Groot, A.E., Coutinho, J.M., Nijeholt, G.J.L.A., Boiten, J., Schonewille, W.J., Dippel, D.W.J., Lugt, A. van der, Majoie, C.B.L.M., Roos, Y.B.W.E.M., Zwam, W.H. van, Jansen, I.G.H., Mulder, M.J.H.L., Goldhoorn, R.J.B., Compagne, K.C.J., Kappelhof, M., Wermer, M.J.H., Walderveen, M.A.A. van, Staals, J., Hofmeijer, J., Martens, J.M., Roozenbeek, B., Emmer, B.J., Bruijn, S.F. de, Dijk, L.C. van, Worp, H.B. van der, R.H. lo, Dijk, E.J. van, Boogaarts, H.D., Kort, P.L.M. de, Peluso, J.J.P., Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Uyttenboogaart, M., Eshghi, O., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Yo, L.S.F., Hertog, H.M. den, Sturm, E.J.C., Sprengers, M.E.S., Jenniskens, S.F.M., Berg, R. van den, Yoo, A.J., Beenen, L.F.M., Postma, A.A., Roosendaal, S.D., Kallen, B.F.W. van der, Wijngaard, I.R. van den, Es, A.C.G.M. van, Bot, J., Doormaal, P.J. van, Flach, H.Z., Lingsma, H.F., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Aaldering, N., Zweedijk, B., Khalilzada, M., Venema, E., Chalos, V., Geuskens, R.R., Straaten, T. van, Ergezen, S., Harmsma, R.R.M., Muijres, D., Jong, A. de, Hinsenveld, W., Berkhemer, O.A., Boersc, A.M.M., Huguet, J., Groot, P.F.C., Mens, M.A., Kranendonk, K.R. van, Treurniet, K.M., Tolhuijsen, M.L., Alves, H., MR CLEAN Registry Investigators, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, MUMC+: MA Niet Med Staf Neurologie (9), Promovendi CD, MUMC+: MA Med Staf Spec Neurologie (9), MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA AIOS Neurologie (9), MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), MUMC+: DA BV AIOS Radiologie (9), Psychiatrie & Neuropsychologie, Radiology and nuclear medicine, VU University medical center, Pediatric surgery, ACS - Atherosclerosis & ischemic syndromes, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Graduate School, Neurology, ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, ACS - Microcirculation, ACS - Pulmonary hypertension & thrombosis, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, ARD - Amsterdam Reproduction and Development, Radiology & Nuclear Medicine, and Public Health
Subjects: Male, medicine.medical_specialty, Time Factors, workflow, medicine.medical_treatment, DOOR, endovascular procedures, DELAYS, Time-to-Treatment, All institutes and research themes of the Radboud University Medical Center, Modified Rankin Scale, medicine, Clinical endpoint, Humans, QUALITY, Registries, Lead (electronics), Stroke, Aged, Retrospective Studies, Aged, 80 and over, Advanced and Specialized Nursing, OUTCOMES, Groin, business.industry, delivery of health care, holidays, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Odds ratio, Middle Aged, THROMBECTOMY, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], medicine.disease, ADMISSION, stroke, Surgery, TIME, Observational Studies as Topic, medicine.anatomical_structure, ISCHEMIC-STROKE, Intravenous therapy, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, Complication, business
Abstract: Background and Purpose— Endovascular treatment (EVT) of patients with acute ischemic stroke because of large vessel occlusion involves complicated logistics, which may cause a delay in treatment initiation during off-hours. This might lead to a worse functional outcome. We compared workflow intervals between endovascular treatment–treated patients presenting during off- and on-hours. Methods— We retrospectively analyzed data from the MR CLEAN Registry, a prospective, multicenter, observational study in the Netherlands and included patients with an anterior circulation large vessel occlusion who presented between March 2014 and June 2016. Off-hours were defined as presentation on Monday to Friday between 17:00 and 08:00 hours, weekends (Friday 17:00 to Monday 8:00) and national holidays. Primary end point was first door to groin time. Secondary end points were functional outcome at 90 days (modified Rankin Scale) and workflow time intervals. We stratified for transfer status, adjusted for prognostic factors, and used linear and ordinal regression models. Results— We included 1488 patients of which 936 (62.9%) presented during off-hours. Median first door to groin time was 140 minutes (95% CI, 110–182) during off-hours and 121 minutes (95% CI, 85–157) during on-hours. Adjusted first door to groin time was 14.6 minutes (95% CI, 9.3–20.0) longer during off-hours. Door to needle times for intravenous therapy were slightly longer (3.5 minutes, 95% CI, 0.7–6.3) during off-hours. Groin puncture to reperfusion times did not differ between groups. For transferred patients, the delay within the intervention center was 5.0 minutes (95% CI, 0.5–9.6) longer. There was no significant difference in functional outcome between patients presenting during off- and on-hours (adjusted odds ratio, 0.92; 95% CI, 0.74–1.14). Reperfusion rates and complication rates were similar. Conclusions— Presentation during off-hours is associated with a slight delay in start of endovascular treatment in patients with acute ischemic stroke. This treatment delay did not translate into worse functional outcome or increased complication rates.
Published: 2019

63. Impact of single phase CT angiography collateral status on functional outcome over time: results from the MR CLEAN Registry

Author: Jansen, I.G.H., Mulder, M.J.H.L., Goldhoorn, R.J.B., Boers, A.M.M., Es, A.C.G.M. van, Yo, L.S.F., Hofmeijer, J., Martens, J.M., Walderveen, M.A.A. van, Kallen, B.F.W. van der, Jenniskens, S.F.M., Treurniet, K.M., Marqueriny, H.A., Sprengers, M.E.S., Schonewille, W.J., Bot, J.C.J., Nijeholt, G.J.L.A., Lingsma, H.F., Liebeskind, D.S., Boiten, J., Vos, J.A., Roos, Y.B.W.E.M., Oostenbrugge, R.J. van, Lugt, A. van der, Zwam, W.H. van, Dippel, D.W.J., Wijngaard, I.R. van den, Majoie, C.B.L.M., Coutinho, J.M., Wermern, M.J.H., Staals, J., Roozenbeek, B., Emmer, B.J., Bruijn, S.F. de, Dijk, L.C. van, Worp, H.B. van der, R.H. lo, Dijk, E.J. van, Boogaarts, H.D., Kort, P.L.M. de, Peluso, J.J.P., Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Uyttenboogaart, M., Eshghi, O., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Hertog, H.M. den, Sturm, E.J.C., Berg, R. van den, Yoo, A.J., Beenen, L.F.M., Roosendaal, S.D., Es, A. van, Emmer, B., Bot, J., Doormaal, P.J. van, Flach, H.Z., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Zweedijk, B., Khalilzada, M., Venema, E., Chalos, V., Compagne, K.J., Geuskens, R.R., Straaten, T. van, Ergezen, S., Harmsma, R.R.M., Muijres, D., Jong, A. de, Hinseveld, W., Berkhemer, O.A., Huguet, J., Groot, P.F.C., Mens, M.A., Kranendonk, K.R. van, Kappelhof, M., Tolhuijsen, M.L., Alves, H., MR CLEAN Registry Investigators, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Clinical Neurophysiology, Neurology, Radiology & Nuclear Medicine, Public Health, MUMC+: MA AIOS Neurologie (9), Klinische Neurowetenschappen, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, Promovendi CD, MUMC+: MA Neurologie (3), RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA Med Staf Spec Neurologie (9), Radiology and nuclear medicine, Amsterdam Neuroscience - Neurovascular Disorders, ACS - Atherosclerosis & ischemic syndromes, ANS - Neurovascular Disorders, ACS - Microcirculation, Graduate School, and Radiology and Nuclear Medicine
Subjects: Male, PREDICTOR, Computed Tomography Angiography, THERAPY, 030218 nuclear medicine & medical imaging, law.invention, Brain Ischemia, 0302 clinical medicine, Randomized controlled trial, Modified Rankin Scale, Time windows, law, ct angiography, REPERFUSION, Prospective Studies, Registries, Single phase, Stroke, intervention, Netherlands, Aged, 80 and over, medicine.diagnostic_test, Endovascular Procedures, General Medicine, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Treatment Outcome, Cardiology, Female, LEPTOMENINGEAL COLLATERALS, STROKE, Adult, medicine.medical_specialty, Adolescent, Time to treatment, Collateral Circulation, 03 medical and health sciences, Young Adult, Internal medicine, SCORE, medicine, MANAGEMENT, Humans, Endovascular treatment, Aged, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Recovery of Function, medicine.disease, n/a OA procedure, ENDOVASCULAR TREATMENT, Angiography, Surgery, Neurology (clinical), business, COMPUTED TOMOGRAPHIC ANGIOGRAPHY, 030217 neurology & neurosurgery
Abstract: BackgroundCollateral status modified the effect of endovascular treatment (EVT) for stroke in several randomized trials. We assessed the association between collaterals and functional outcome in EVT treated patients and investigated if this association is time dependent.MethodsWe included consecutive patients from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands (MR CLEAN) Registry (March 2014–June 2016) with an anterior circulation large vessel occlusion undergoing EVT. Functional outcome was measured on the modified Rankin Scale (mRS) at 90 days. We investigated the association between collaterals and mRS in the MR CLEAN Registry with ordinal logistic regression and if this association was time dependent with an interaction term. Additionally, we determined modification of EVT effect by collaterals compared with MR CLEAN controls, and also investigated if this was time dependent with multiplicative interaction terms.Results1412 patients were analyzed. Functional independence (mRS score of 0–2) was achieved in 13% of patients with grade 0 collaterals, in 27% with grade 1, in 46% with grade 2, and in 53% with grade 3. Collaterals were significantly associated with mRS (adjusted common OR 1.5 (95% CI 1.4 to 1.7)) and significantly modified EVT benefit (P=0.04). None of the effects were time dependent. Better collaterals corresponded to lower mortality (PConclusionIn routine clinical practice, better collateral status is associated with better functional outcome and greater treatment benefit in EVT treated acute ischemic stroke patients, independent of time to treatment. Within the 6 hour time window, a substantial proportion of patients with absent and poor collaterals can still achieve functional independence.
Published: 2019

64. Periprocedural Intravenous Heparin During Endovascular Treatment for Ischemic Stroke: Results From the MR CLEAN Registry

Author: Graaf, R.A. van de, Chalos, V., Es, A.C.G.M. van, Emmer, B.J., Nijeholt, G.J.L.A., Worp, H.B. van der, Schonewille, W.J., Lugt, A. van der, Dippel, D.W.J., Lingsma, H.F., Roozenbeek, B., Dippel, D., Majoie, C., Roos, Y., Oostenbrugge, R. van, Zwam, W. van, Boiten, J., Vos, J.A., Jansen, I., Mulder, M., Goldhoorn, R.J., Compagne, K., Kappelhof, M., Schonewille, W., Coutinho, J., Wermer, M., Walderveen, M. van, Staals, J., Hofmeijer, J., Martens, J.M., Nijeholt, G.L.A., Emmer, B., Bruijn, S. de, Dijk, L. van, R. lo, Dijk, E. van, Boogaarts, H., Kort, P. de, Peluso, J., Berg, J. van den, Hasselt, B. van, Aerden, L., Dallinga, R., Uyttenboogaart, M., Eshghi, O., Schreuder, T., Heijboer, R., Keizer, K., Yo, L., Hertog, H. den, Sturm, E., Sprengers, M., Jenniskens, S., Berg, R. van den, Yoo, A., Beenen, L., Postma, A., Roosendaal, S., Kallen, B. van der, Wijngaard, I. van den, Es, A. van, Martens, J., Bot, J., Doormaal, P.J. van, Worp, B. van der, Flach, Z., Lingsma, H., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Aaldering, N., Zweedijk, B., Khalilzada, M., Venema, E., Geuskens, R., Straaten, T. van, Ergezen, S., Harmsma, R., Muijres, D., Jong, A. de, Hinseveld, W., Berkhemer, O., Boers, A., Huguet, J., Groot, P., Mens, M., Kranendonk, K. van, Treurniet, K., Tolhuijsen, M., Alves, H., MR CLEAN Registry Investigators, Radiology and nuclear medicine, VU University medical center, Pediatric surgery, ACS - Atherosclerosis & ischemic syndromes, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Neurology, Radiology & Nuclear Medicine, Public Health, Radiology and Nuclear Medicine, ANS - Neurovascular Disorders, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA AIOS Neurologie (9), Promovendi CD, MUMC+: MA Med Staf Spec Neurologie (9), MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, and MUMC+: DA BV AIOS Radiologie (9)
Subjects: Male, Original Contributions, medicine.medical_treatment, heparin, GUIDELINES, Brain Ischemia, law.invention, Randomized controlled trial, Modified Rankin Scale, law, Recombinant Proteins/therapeutic use, 80 and over, REPERFUSION, PROUROKINASE, Heparin/administration & dosage, Stroke, Aged, 80 and over, Anticoagulants/administration & dosage, Cerebral infarction, Endovascular Procedures, Heparin, Thrombolysis, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], cerebral infarction, stroke, Recombinant Proteins, Treatment Outcome, thrombectomy, FOCAL CEREBRAL-ISCHEMIA, Anesthesia, Combination, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Drug Therapy, Combination, Female, Cardiology and Cardiovascular Medicine, Stroke/drug therapy, medicine.drug, Clinical Sciences, PROACT, All institutes and research themes of the Radboud University Medical Center, Fibrinolytic Agents, Drug Therapy, medicine, Humans, Urokinase-Type Plasminogen Activator/therapeutic use, Aged, Advanced and Specialized Nursing, business.industry, Fibrinolytic Agents/therapeutic use, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Anticoagulants, Brain Ischemia/drug therapy, Odds ratio, medicine.disease, Urokinase-Type Plasminogen Activator, Endovascular Procedures/methods, Ischemic stroke, Neurology (clinical), business
Abstract: Supplemental Digital Content is available in the text., Background and Purpose— Intravenous administration of heparin during endovascular treatment for ischemic stroke may improve outcomes. However, risks and benefits of this adjunctive therapy remain uncertain. We aimed to evaluate periprocedural intravenous heparin use in Dutch stroke intervention centers and to assess its efficacy and safety. Methods— Patients registered between March 2014 and June 2016 in the MR CLEAN Registry (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke), including all patients treated with endovascular treatment in the Netherlands, were analyzed. The primary outcome was functional outcome (modified Rankin Scale) at 90 days. Secondary outcomes were successful recanalization (extended Thrombolysis in Cerebral Infarction ≥2B), symptomatic intracranial hemorrhage, and mortality at 90 days. We used multilevel regression analysis to evaluate the association of periprocedural intravenous heparin on outcomes, adjusted for center effects and prognostic factors. To account for possible unobserved confounding by indication, we analyzed the effect of center preference to administer intravenous heparin, defined as percentage of patients treated with intravenous heparin in a center, on functional outcome. Results— One thousand four hundred eighty-eight patients from 16 centers were analyzed, of whom 398 (27%) received intravenous heparin (median dose 5000 international units). There was substantial between-center variability in the proportion of patients treated with intravenous heparin (range, 0%–94%). There was no significant difference in functional outcome between patients treated with intravenous heparin and those without (adjusted common odds ratio, 1.17; 95% CI, 0.87–1.56), successful recanalization (adjusted odds ratio, 1.24; 95% CI, 0.89–1.71), symptomatic intracranial hemorrhage (adjusted odds ratio, 1.13; 95% CI, 0.65–1.99), or mortality (adjusted odds ratio, 0.95; 95% CI, 0.66–1.38). Analysis at center level showed that functional outcomes were better in centers with higher percentages of heparin administration (adjusted common odds ratio, 1.07 per 10% more heparin, 95% CI, 1.01–1.13). Conclusions— Substantial between-center variability exists in periprocedural intravenous heparin use during endovascular treatment, but the treatment is safe. Centers using heparin more often had better outcomes. A randomized trial is needed to further study these effects.
Published: 2019

65. Endovascular Treatment With or Without Prior Intravenous Alteplase for Acute Ischemic Stroke

Author: Chalos, V., LeCouffe, N.E., Uyttenboogaart, M., Lingsma, H.F., Mulder, M.J.H.L., Venema, E., Treurniet, K.M., Eshghi, O., Worp, H.B. van der, Lugt, A. van der, Roos, Y.B.W.E.M., Majoie, C.B.L.M., Dippel, D.W.J., Roozenbeek, B., Coutinho, J.M., Oostenbrugge, R.J. van, Zwam, W.H. van, Boiten, J., Vos, J.A., Jansen, I.G.H., Goldhoorn, R.J.B., Schonewille, W.J., Wermer, M.J.H., Walderveen, M.A.A. van, Staals, J., Hofmeijer, J., Martens, J.M., Nijeholt, G.J.L.A., Emmer, B.J., Bruijn, S.F. de, Dijk, L.C. van, R.H. lo, Dijk, E.J. van, Boogaarts, H.D., Kort, P.L.M. de, Peluso, J.J.P., Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Yo, L.S.F., Hertog, H.M. den, Sturm, E.J.C., Sprengers, M.E.S., Jenniskens, S.F.M., Berg, R. van den, Yoo, A.J., Beenen, L.F.M., Roosendaal, S.D., Kallen, B.F.W. van der, Wijngaard, I.R. van den, Es, A.C.G.M. van, Bot, J.C.J., Doormaal, P.J. van, Flach, H.Z., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Zweedijk, B., Khalilzada, M., Compagne, K.C.J., Geuskens, R.R., Straaten, T. van, Ergezen, S., Harmsma, R.R.M., Jong, A. de, Hinsenveld, W., Berkhemer, O.A., Boers, A.M.M., Groot, P.F.C., Mens, M.A., Kranendonk, K.R. van, Kappelhof, M., Tolhuijsen, M.L., Alves, H., MR CLEAN Registry Investigators, Neurology, Public Health, Radiology & Nuclear Medicine, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Radiology and nuclear medicine, ACS - Atherosclerosis & ischemic syndromes, Graduate School, ACS - Microcirculation, ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, MUMC+: MA Neurologie (3), Klinische Neurowetenschappen, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA Niet Med Staf Neurologie (9), Promovendi CD, MUMC+: MA Med Staf Spec Neurologie (9), and Clinical Neurophysiology
Subjects: Male, endovascular treatment, Time Factors, medicine.medical_treatment, RECANALIZATION, ANTERIOR CIRCULATION STROKE, THERAPY, law.invention, Brain Ischemia, Workflow, Disability Evaluation, Randomized controlled trial, Modified Rankin Scale, law, Risk Factors, REPERFUSION, Thrombolytic Therapy, Prospective Studies, Registries, Stroke, DIRECT MECHANICAL THROMBECTOMY, Netherlands, Original Research, Aged, 80 and over, OUTCOMES, Confounding, Endovascular Procedures, Atrial fibrillation, Thrombolysis, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Combined Modality Therapy, stroke, Treatment Outcome, thrombectomy, Tissue Plasminogen Activator, Cardiology, Female, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, thrombolysis, Cerebrovascular Procedures, All institutes and research themes of the Radboud University Medical Center, Fibrinolytic Agents, Internal medicine, large vessel occlusion, medicine, Humans, Aged, Ischemic Stroke, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Odds ratio, Recovery of Function, medicine.disease, Cerebrovascular Disease/Stroke, Observational study, business
Abstract: Background It is unclear whether intravenous thrombolysis ( IVT ) with alteplase before endovascular treatment ( EVT ) is beneficial for patients with acute ischemic stroke caused by a large vessel occlusion. We compared clinical and procedural outcomes, safety, and workflow between patients treated with both IVT and EVT and those treated with EVT alone in routine clinical practice. Methods and Results Using multivariable regression, we evaluated the association of IVT + EVT with 90‐day functional outcome (modified Rankin Scale), mortality, reperfusion, first‐pass effect, and symptomatic intracranial hemorrhage in the MR CLEAN (Multicenter Randomised Controlled Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands) Registry. Of 1485 patients, 1161 (78%) were treated with IVT + EVT , and 324 (22%) with EVT alone. Patients treated with IVT + EVT had atrial fibrillation less often (16% versus 44%) and had better pre‐stroke modified Rankin Scale scores (pre‐stroke modified Rankin Scale 0: 73% versus 52%) than those treated with EVT alone. Procedure time was shorter in the IVT + EVT group (median 62 versus 68 minutes). Nontransferred IVT + EVT patients had longer door‐to‐groin‐puncture times (median 105 versus 94 minutes). IVT + EVT was associated with better functional outcome (adjusted common odds ratio 1.47; 95% CI : 1.10–1.96) and lower mortality (adjusted odds ratio 0.58; 95% CI : 0.40–0.82). Successful reperfusion, first‐pass effect, and symptomatic intracranial hemorrhage did not differ between groups. Conclusions In this observational study, patients treated with IVT + EVT had better clinical outcomes than patients who received EVT alone. This finding may demonstrate a true benefit of IVT before EVT , but its interpretation is hampered by the possibility of residual confounding and selection bias. Randomized trials are required to properly assess the effect of IVT before EVT .
Published: 2019

66. Circle of Willis variations in migraine patients with ischemic stroke

Author: Hamming, A.M., Walderveen, M.A.A. van, Mulder, I.A., Schaaf, I.C. van der, Kappelle, L.J., Velthuis, B.K., Ferrari, M.D., Terwindt, G.M., Visser, M.C., Schonewille, W., Algra, A., Wermer, M.J.H., Majoie, C.B., Roos, Y.B., Duijm, L.E., Keizer, K., Lugt, A. van der, Dippel, D.W., Droogh-de Greeve, K.E., Bienfait, H.P., Nijeholt, G.J.L.A., Boiten, J., Duyndam, D., Kwa, V.I., Meijer, F.J., Dijk, E.J. van, Kesselring, F.O., Hofmeijer, J., Vos, J.A., Rooij, W.J. van, Kort, P.L. de, Pleiter, C.C., Bakker, S.L., Bot, J., Dankbaar, J.W., Mali, W.P., Seeters, T. van, Horsch, A.D., Niesten, J.M., Biessels, G.J., Luitse, M.J., Graaf, Y. van der, Dutch Acute Stroke Study, Amsterdam Neuroscience - Neurovascular Disorders, and Neurology
Subjects: Male, Computed Tomography Angiography, Brain Ischemia, Behavioral Neuroscience, 0302 clinical medicine, Risk Factors, Prevalence, Medicine, migraine, Prospective Studies, Non-U.S. Gov't, Circle of Willis/diagnostic imaging, circle of Willis, humans, Stroke, Original Research, Computed Tomography Angiography/methods, neuroimaging, Research Support, Non-U.S. Gov't, 05 social sciences, Brain, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Brain Ischemia/diagnosis, Female, Rare cancers Radboud Institute for Health Sciences [Radboudumc 9], Adult, medicine.medical_specialty, Migraine Disorders, Research Support, Brain/blood supply, 050105 experimental psychology, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, medicine.artery, Internal medicine, Journal Article, Anterior cerebral artery, Humans, 0501 psychology and cognitive sciences, Migraine Disorders/complications, Posterior communicating artery, Risk factor, Aged, Analysis of Variance, business.industry, computed tomography, Odds ratio, medicine.disease, Migraine, International Classification of Headache Disorders, strokes, business, 030217 neurology & neurosurgery, Stroke/complications, Circle of Willis
Abstract: Objectives: Migraine is a risk factor for stroke, which might be explained by a higher prevalence in anatomical variants in the circle of Willis (CoW). Here, we compared the presence of CoW variants in patients with stroke with and without migraine. Materials and Methods: Participants were recruited from the prospective Dutch acute Stroke Study. All participants underwent CT angiography on admission. Lifetime migraine history was assessed with a screening questionnaire and confirmed by an interview based on International Classification of Headache Disorders criteria. The CoW was assessed for incompleteness/hypoplasia (any segment 1/3), and for posterior communicating artery (Pcom) dominance (Pcom–P1 difference > 1/3). Odds ratios with adjustments for age and sex (aOR) were calculated with logistic regression. Results: We included 646 participants with stroke, of whom 52 had a history of migraine. Of these, 45 (87%) had an incomplete or hypoplastic CoW versus 506 (85%) of the 594 participants without migraine (aOR: 1.47; 95% CI: 0.63–3.44). There were no differences between participants with and without migraine in variations of the anterior or posterior CoW, anterior cerebral artery asymmetry (aOR: 0.86; 95% CI: 0.43–1.74), or Pcom dominance (aOR: 0.64; 95% CI: 0.32–1.30). There were no differences in CoW variations between migraine patients with or without aura. Conclusion: We found no significant difference in the completeness of the CoW in acute stroke patients with migraine compared to those without.
Published: 2019

67. Safety and Outcome of Endovascular Treatment for Minor Ischemic Stroke: Results From the Multicenter Clinical Registry of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands

Author: Goldhoorn, R.B., Mulder, M.J.H.L., Jansen, I.G.H., Zwam, W.H. van, Staals, J., Lugt, A. van der, Dippel, D.W.J., Lingsma, H.F., Vos, J.A., Boiten, J., Wijngaard, I.R. van den, Majoie, C.B.L.M., Roos, Y.B.W.E.M., Oostenbrugge, R.J. van, Goldhoorn, R.J.B., Schonewille, W.J., Coutinho, J.M., Wermer, M.J.H., Walderveen, M.A.A. van, Hofmeijer, J., Martens, J.M., Nijeholt, G.J.L.A., Roozenbeek, B., Emmer, B.J., Bruijn, S.F. de, Dijk, L.C. van, Worp, H.B. van der, R.H. lo, Dijk, E.J. van, Boogaarts, H.D., Kort, P.L.M. de, Peluso, J.J.P., Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Uyttenboogaart, M., Eshghi, O., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Yo, L.S.F., Hertog, H.M. den, Sturm, E.J.C., Sprengers, M.E.S., Jenniskens, S.F.M., Berg, R. van den, Yoo, A.J., Beenen, L.F.M., Roosendaal, S.D., Kallen, B.F.W. van der, Es, A. van, Emmer, B., Bot, J., Doormaal, P.J. van, Postma, A., Flach, H.Z., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Zweedijk, B., Khalilzada, M., Venema, E., Chalos, V., Compagne, K.J., Geuskens, R.R., Straaten, T. van, Ergezen, S., Harmsma, R.R.M., Muijres, D., Jong, A. de, Hinsenveld, W., Berkhemer, O.A., Boers, A.M.M., Huguet, J., Groot, P.F.C., Mens, M.A., Kranendonk, K.R. van, Treurniet, K.M., Kappelhof, M., Tolhuijsen, M.L., Alves, H., MR CLEAN Registry Investigators, Neurology, Radiology & Nuclear Medicine, Public Health, Klinische Neurowetenschappen, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, MUMC+: MA Niet Med Staf Neurologie (9), Promovendi CD, RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA Med Staf Spec Neurologie (9), MUMC+: MA Neurologie (3), MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: DA BV AIOS Radiologie (9), Amsterdam Neuroscience - Neurovascular Disorders, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, Radiology and Nuclear Medicine, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), and Radiology and nuclear medicine
Subjects: Male, endovascular treatment, Time Factors, Severity of Illness Index, THERAPY, ANGIOGRAPHY, law.invention, Brain Ischemia, Disability Evaluation, 0302 clinical medicine, Randomized controlled trial, Modified Rankin Scale, law, Risk Factors, Occlusion, Prospective Studies, Registries, Stroke, Netherlands, Ischemic stroke, medicine.diagnostic_test, LARGE VESSEL OCCLUSION, Rehabilitation, Endovascular Procedures, minor symptoms, Middle Aged, THROMBECTOMY, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Treatment Outcome, Cerebrovascular Circulation, Cardiology, ANTERIOR CIRCULATION, Female, TRIAL, SCALE SCORE, Cardiology and Cardiovascular Medicine, Intracranial Hemorrhages, medicine.medical_specialty, Clinical Decision-Making, 03 medical and health sciences, large vessel oclusion, All institutes and research themes of the Radboud University Medical Center, Internal medicine, medicine, Humans, Artery occlusion, cardiovascular diseases, Aged, business.industry, Patient Selection, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Recovery of Function, MILD, medicine.disease, Arterial occlusion, Angiography, Surgery, Observational study, Neurology (clinical), business, 030217 neurology & neurosurgery, INTRAARTERIAL TREATMENT
Abstract: Goal: Insufficient data is available about safety and efficacy of endovascular treatment (EVT) in patients with minor stroke symptoms because these patients were excluded from most randomized trials. We aimed to compare characteristics, functional outcome, and complications in patients with minor ischemic stroke National Institutes of Health Stroke Scale score ≤5 (NIHSS score ≤5) and moderate to severe ischemic stroke (NIHSS score ≥6) due to intracranial proximal artery occlusion of the anterior circulation who underwent EVT. Materials and Methods: We report patients with an anterior circulation occlusion who were included between March 2014 and June 2016 in the multicenter randomized clinical trial of EVT of acute ischemic stroke in the Netherlands Registry, a prospective, multicenter, observational study for stroke centers that perform EVT in the Netherlands. Minor ischemic stroke was defined as baseline NIHSS score of 5 or less. Primary outcome is the modified Rankin Scale (mRS) score at 90 days. Secondary outcomes include symptomatic intracranial hemorrhage (sICH) and mortality. Findings: Seventy-one (5.5%) patients had a NIHSS score of 5 or less. Functional independence (mRS 0-2 at 90 days) was reached in 75% of these patients, compared to 40% of patients with NIHSS score of 6 or more. sICH occurred in 4% of patients, of which 1% occurred peri-interventionally. Death occurred in 6% of patients. Conclusions: Patients with minor ischemic stroke with an intracranial proximal arterial occlusion of the anterior circulation who underwent EVT have a high chance of favorable outcome and appear to have low occurrence of treatment-related sICH. Therefore, our results encourage the use of EVT for minor ischemic stroke in the absence of effect estimates from controlled studies.
Published: 2019

68. Intracranial Cerebrospinal Fluid Volume as a Predictor of Malignant Middle Cerebral Artery Infarction

Author: Kauw, Frans, Bennink, Edwin, de Jong, Hugo W. A. M., Kappelle, L. Jaap, Horsch, Alexander D., Velthuis, Birgitta K., Dankbaar, Jan W., Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Droogh-de Greve, K. E., Bienfait, H. P., van Walderveen, M. A., Wermer, M. J., Nijeholt, Lycklama A. G. J., Boiten, J., Duyndam, D., Kwa, V., I, Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., Schonewille, W. J., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Visser, M. C., Velthuis, B. K., van der Schaaf, I. C., Dankbaar, J. W., Mali, W. P., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Kappelle, L. J., Luitse, M. J., van der Graaf, Y., Radiology & Nuclear Medicine, Neurology, Physics and medical technology, Radiology and nuclear medicine, VU University medical center, Dermatology, Surgery, Public and occupational health, Human genetics, Radiation Oncology, Amsterdam Neuroscience - Neurovascular Disorders, and ACS - Atherosclerosis & ischemic syndromes
Subjects: medicine.medical_specialty, Original Contributions, infarction, Clinical Sciences, Clinical Neurology, Infarction, Perfusion scanning, All institutes and research themes of the Radboud University Medical Center, Midline shift, Internal medicine, medicine.artery, Journal Article, Medicine, odds ratio, cardiovascular diseases, Advanced and Specialised Nursing, humans, Stroke, Advanced and Specialized Nursing, brain edema, middle cerebral artery, infarction, middle cerebral artery, Receiver operating characteristic, medicine.diagnostic_test, business.industry, Odds ratio, medicine.disease, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Angiography, Middle cerebral artery, Cardiology, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Neurology (clinical), prognosis, business, Cardiology and Cardiovascular Medicine, Rare cancers Radboud Institute for Health Sciences [Radboudumc 9]
Abstract: Supplemental Digital Content is available in the text., Background and Purpose— Predicting malignant middle cerebral artery (MCA) infarction can help to identify patients who may benefit from preventive decompressive surgery. We aimed to investigate the association between the ratio of intracranial cerebrospinal fluid (CSF) volume to intracranial volume (ICV) and malignant MCA infarction. Methods— Patients with an occlusion proximal to the M3 segment of the MCA were selected from the DUST (Dutch Acute Stroke Study). Admission imaging included noncontrast computed tomography (CT), CT perfusion, and CT angiography. Patient characteristics and CT findings were collected. The ratio of intracranial CSF volume to ICV (CSF/ICV) was quantified on admission thin-slice noncontrast CT. Malignant MCA infarction was defined as a midline shift of >5 mm on follow-up noncontrast CT, which was performed 3 days after the stroke or in case of clinical deterioration. To test the association between CSF/ICV and malignant MCA infarction, odds ratios and 95% CIs were calculated for 3 multivariable models by using binary logistic regression. Model performances were compared by using the likelihood ratio test. Results— Of the 286 included patients, 35 (12%) developed malignant MCA infarction. CSF/ICV was independently associated with malignant MCA infarction in 3 multivariable models: (1) with age and admission National Institutes of Health Stroke Scale (odds ratio, 3.3; 95% CI, 1.1–11.1), (2) with admission National Institutes of Health Stroke Scale and poor collateral score (odds ratio, 7.0; 95% CI, 2.6–21.3), and (3) with terminal internal carotid artery or proximal M1 occlusion and poor collateral score (odds ratio, 7.7; 95% CI, 2.8–23.9). The performance of model 1 (areas under the receiver operating characteristic curves, 0.795 versus 0.824; P=0.033), model 2 (areas under the receiver operating characteristic curves, 0.813 versus 0.850; P
Published: 2019

69. Acute endovascular treatment of patients with ischemic stroke from intracranial large vessel occlusion and extracranial carotid dissection

Author: Compagne, K.C.J., Goldhoorn, R.B., Uyttenboogaart, M., Oostenbrugge, R.J. van, Zwam, W.H. van, Doormaal, P.J. van, Dippel, D.W.J., Lugt, A. van der, Emmer, B.J., Es, A.C.G.M. van, Majoie, C.B.L.M., Roos, Y.B.W.E.M., Boiten, J., Vos, J.A., Jansen, I.G.H., Mulder, M.J.H.L., Kappelhof, M., Schonewille, W.J., Coutinho, J.M., Wermer, M.J.H., Walderveen, M.A.A. van, Staals, J., Hofmeijer, J., Martens, J.M., Nijeholt, G.J.L., Roozenbeek, B., Bruijn, S.F. de, Dijk, L.C. van, Worp, H.B. van der, R.H. lo, Dijk, E.J. van, Boogaarts, H.D., Kort, P.L.M. de, Peluso, J.J.P., Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Eshghi, O., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Yo, L.S.F., Hertog, H.M. den, Sturm, E.J.C., Sprengers, M.E.S., Jenniskens, S.F.M., Berg, R. van den, Yoo, A.J., Beenen, L.F.M., Postma, A.A., Roosendaal, S.D., Kallen, B.F.W. van der, Wijngaard, I.R. van den, Bot, J., Boiten, G.J., Flach, H.Z., Lingsma, H.F., Ghannouti, N. el, Sterrenberg, M., Puppels, C., Pellikaan, W., Sprengers, R., Elfrink, M., Meris, J. de, Vermeulen, T., Geerlings, A., Vemde, G. van, Simons, T., Rijswijk, C. van, Messchendorp, G., Bongenaar, H., Bodde, K., Kleijn, S., Lodico, J., Droste, H., Wollaert, M., Jeurrissen, D., Bos, E., Drabbe, Y., Aaldering, N., Zweedijk, B., Khalilzada, M., Venema, E., Chalos, V., Geuskens, R.R., Straaten, T. van, Ergezen, S., Harmsma, R.R.M., Muijres, D., Jong, A. de, Hinseveld, W., Berkhemer, O.A., Boers, A.M.M., Huguet, J., Groot, P.F.C., Mens, M.A., Kranendonk, K.R. van, Treurniet, K.M., Tolhuijsen, M.L., Alves, H., MR CLEAN Investigators, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Radiology and Nuclear Medicine, ANS - Neurovascular Disorders, Radiology and nuclear medicine, VU University medical center, Pediatric surgery, ACS - Atherosclerosis & ischemic syndromes, Klinische Neurowetenschappen, RS: Carim - B05 Cerebral small vessel disease, RS: CARIM - R3.03 - Cerebral small vessel disease, MUMC+: MA Niet Med Staf Neurologie (9), Promovendi CD, MUMC+: MA Neurologie (3), RS: Carim - B06 Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: CARIM - R3.11 - Imaging, MUMC+: MA Med Staf Spec Neurologie (9), MUMC+: DA BV AIOS Nucleaire Geneeskunde (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: DA BV AIOS Radiologie (9), Radiology & Nuclear Medicine, Neurology, and Public Health
Subjects: endovascular treatment, medicine.medical_specialty, carotid dissection, CAD, 030204 cardiovascular system & hematology, lcsh:RC346-429, Carotid artery dissection, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Occlusion, SCORE, medicine, ischemic stroke, MANAGEMENT, REPERFUSION, ACUTE ISCHEMIC-STROKE, cardiovascular diseases, Endovascular treatment, Contraindication, lcsh:Neurology. Diseases of the nervous system, Original Research, tandem lesion, business.industry, MECHANICAL THROMBECTOMY, ARTERY DISSECTION, medicine.disease, Neurology, thrombectomy, Carotid artery occlusion, Cardiology, Neurology (clinical), Carotid dissection, business, 030217 neurology & neurosurgery, Large vessel occlusion, INTRAARTERIAL TREATMENT
Abstract: Introduction: Carotid artery dissection (CAD) and atherosclerotic carotid artery occlusion (ACAO) are major causes of a tandem occlusion in patients with intracranial large vessel occlusion (LVO). Presence of tandem occlusions may hamper intracranial access and potentially increases the risk of procedural complications of endovascular treatment (EVT). Our aim was to assess neurological, functional and technical outcome and complications of EVT for intracranial LVO in patients with CAD in comparison to patients with ACAO and to patients without CAD or ACAO.Methods: We analyzed data of the MR CLEAN trial intervention arm and MR CLEAN Registry, acquired in 16 Dutch EVT-centers. Primary outcome was the change in stroke severity by comparing the National Institute of Health Stroke Scale (NIHSS) score at 24-48 h after treatment vs. baseline. Secondary outcomes included reperfusion rate and symptomatic intracranial hemorrhage (sICH). We compared outcomes and complications between patients with CAD vs. patients with ACAO and patients without CAD or ACAO.Results: In total, we identified 74 (4.7%) patients with CAD, 92 (5.9%) patients with ACAO and 1398 (89.4%) patients without CAD or ACAO. Neurological improvement at short-term after EVT in patients with CAD was significantly better compared to ACAO (raw mean -5 vs. mean -1 NIHSS point; p = 0.03) and did not differ compared to patients without CAD or ACAO (-4 NIHSS points; p = 0.62). Rates of successful reperfusion in patients with CAD (47%) was comparable to patients with ACAO (47%; p = 1.00), but was less often achieved compared to patients without CAD or ACAO (58%; p = 0.08). Occurrence of sICH did not differ significantly between CAD patients (5%) and ACAO (11%; p = 0.33) or without CAD/ACAO (6%; p = 1.00).Conclusion: EVT in patients with intracranial LVO due to CAD results in neurological improvement comparable to patients without tandem occlusions. Therefore, carotid artery dissection by itself should not be a contraindication for endovascular treatment in stroke patients with intracranial large vessel occlusion. Although more challenging endovascular procedures are to be suspected in both patients with CAD or ACAO, accurate distinction between CAD and ACAO might influence clinical decision making as better clinical outcome can be expected in patients with CAD.
Published: 2019

70. Reader response: Comparative safety and efficacy of combined IVT and MT with direct MT in large vessel occlusion

Author: LeCouffe, N.E., Treurniet, K.M., Majoie, C.B.L.M., Roos, Y.B.W.E.M., Coutinho, J.M., Emmer, B.J., Dippel, D.W.J., Es, A.C.G.M. van, Boiten, J., Nijeholt, G.J.L.A., Keizer, K., Yo, L.S.F., Zwam, W.H. van, Lugt, A. van der, Roozenbeek, B., Worp, H.B. van der, R.H. lo, Wijngaard, I.R. van den, Ridder, I. de, Costala, V., Lemmens, R., Hofmeijer, J., Martens, J.M., Schonewille, W.J., Vos, J.A., Uyttenboogaart, M., Bokkers, R.P.H., Peluso, J.J.P., Tuijl, J.H. van, Schreuder, F.H.B.M., Boogaarts, H.D., Dijk, L.C. van, Laat, K.F. de, Fransen, P.S.S., Hasselt, B.A.A.M. van, Brouwers, P.J., Sturm, E.J.C., Remmers, M.J.M., Jong, T.E.A.M. de, Rozeman, A.D., Elgersma, O.E.H., Wermer, M.J.H., Walderveen, M.A.A. van, MR CLEAN-NO IV Investigators, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Radiology and nuclear medicine, Amsterdam Neuroscience - Neurovascular Disorders, and ACS - Atherosclerosis & ischemic syndromes
Subjects: medicine.medical_specialty, medicine.medical_treatment, Clinical Neurology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Mechanical Thrombolysis, law, Internal medicine, Medicine, 030212 general & internal medicine, Science & Technology, business.industry, Confounding, Thrombolysis, Blood pressure, Hemostasis, Propensity score matching, Cardiology, Observational study, Neurosciences & Neurology, Neurology (clinical), business, Life Sciences & Biomedicine, 030217 neurology & neurosurgery
Abstract: In their article, Goyal et al.1 questioned the added benefit of IV thrombolysis (IVT) prior to mechanical thrombectomy (MT) in patients with ischemic stroke and a large vessel occlusion. As we await the results of ongoing randomized trials (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands [MR CLEAN–NO IV], [ISRCTN80619088][1]; Bridging Thrombolysis Versus Direct Mechanical Thrombectomy in Acute Ischemic Stroke [SWIFT DIRECT], [NCT03192332][2]; Direct Intra-arterial Thrombectomy in Order to Revascularize AIS Patients With Large Vessel Occlusion Efficiently in Chinese Tertiary Hospitals [DIRECT-MT], [NCT03469206][3]), we must rely on observational data with adequate adjustment for potential confounding variables to estimate the value of IVT in MT-eligible patients.2 Goyal et al.1 rightfully stated that no statistical method can completely adjust for allocation bias. However, current American Heart Association guidelines state that a blood pressure above 185/110 mm Hg and impaired hemostasis (direct oral anticoagulant use or international normalized ratio >1.7) are contraindications for IVT.3 These variables have also been associated with worse outcomes4 and, therefore, are true confounders. Much to our surprise, data on baseline blood pressure and hemostasis were not reported in by Goyal et al.,1 and it does not appear that these variables were used in the propensity score matching. We invite the authors to comment on why information on baseline blood pressure and hemostasis was not reported and how this may have affected their results. [1]: /external-ref?link_type=ISRCTN&access_num=ISRCTN80619088 [2]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03192332&atom=%2Fneurology%2F91%2F24%2F1115.atom [3]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03469206&atom=%2Fneurology%2F91%2F24%2F1115.atom
Published: 2018

71. Association between somatosensory evoked potentials and EEG in comatose patients after cardiac arrest

Author: Glimmerveen, Astrid B., Ruijter, Barry J., Keijzer, H.M., Tjepkema-Cloostermans, Marleen C., Putten, Michel J.A.M. van, Hofmeijer, J., Glimmerveen, Astrid B., Ruijter, Barry J., Keijzer, H.M., Tjepkema-Cloostermans, Marleen C., Putten, Michel J.A.M. van, and Hofmeijer, J.
Abstract: Item does not contain fulltext
Published: 2019

72. Early electroencephalography for outcome prediction of postanoxic coma: A prospective cohort study

Author: Ruijter, B.J., Tjepkema-Cloostermans, M.C., Tromp, S.C., Bergh, W.M. van den, Foudraine, N.A., Kornips, F.H.M., Drost, G., Scholten, E., Bosch, F.H., Beishuizen, A., Putten, M.J.A.M. van, Hofmeijer, J., Ruijter, B.J., Tjepkema-Cloostermans, M.C., Tromp, S.C., Bergh, W.M. van den, Foudraine, N.A., Kornips, F.H.M., Drost, G., Scholten, E., Bosch, F.H., Beishuizen, A., Putten, M.J.A.M. van, and Hofmeijer, J.
Abstract: Contains fulltext : 215606.pdf (publisher's version ) (Open Access), OBJECTIVE: To provide evidence that early electroencephalography (EEG) allows for reliable prediction of poor or good outcome after cardiac arrest. METHODS: In a 5-center prospective cohort study, we included consecutive, comatose survivors of cardiac arrest. Continuous EEG recordings were started as soon as possible and continued up to 5 days. Five-minute EEG epochs were assessed by 2 reviewers, independently, at 8 predefined time points from 6 hours to 5 days after cardiac arrest, blinded for patients' actual condition, treatment, and outcome. EEG patterns were categorized as generalized suppression (<10 muV), synchronous patterns with >/=50% suppression, continuous, or other. Outcome at 6 months was categorized as good (Cerebral Performance Category [CPC] = 1-2) or poor (CPC = 3-5). RESULTS: We included 850 patients, of whom 46% had a good outcome. Generalized suppression and synchronous patterns with >/=50% suppression predicted poor outcome without false positives at >/=6 hours after cardiac arrest. Their summed sensitivity was 0.47 (95% confidence interval [CI] = 0.42-0.51) at 12 hours and 0.30 (95% CI = 0.26-0.33) at 24 hours after cardiac arrest, with specificity of 1.00 (95% CI = 0.99-1.00) at both time points. At 36 hours or later, sensitivity for poor outcome was
Published: 2019

73. Impact of single phase CT angiography collateral status on functional outcome over time: results from the MR CLEAN Registry

Author: Jansen, I.G., Mulder, M.J.H.L., Goldhoorn, R.B., Boers, A.M., Es, A.C. van, Yo, L.S., Hofmeijer, J., Martens, J.M., Walderveen, M.A. van, Kallen, B.F. van der, Jenniskens, S.F.M., Treurniet, K.M., Marquering, H.A., Sprengers, M.E., Schonewille, W.J., Bot, J.C., Dijk, E.J. van, Geerlings, A.L., Straaten, T. van, Boogaarts, H.D., Tolhuijsen, M.L., Alves, H., Jansen, I.G., Mulder, M.J.H.L., Goldhoorn, R.B., Boers, A.M., Es, A.C. van, Yo, L.S., Hofmeijer, J., Martens, J.M., Walderveen, M.A. van, Kallen, B.F. van der, Jenniskens, S.F.M., Treurniet, K.M., Marquering, H.A., Sprengers, M.E., Schonewille, W.J., Bot, J.C., Dijk, E.J. van, Geerlings, A.L., Straaten, T. van, Boogaarts, H.D., Tolhuijsen, M.L., and Alves, H.
Abstract: Item does not contain fulltext, BACKGROUND: Collateral status modified the effect of endovascular treatment (EVT) for stroke in several randomized trials. We assessed the association between collaterals and functional outcome in EVT treated patients and investigated if this association is time dependent. METHODS: We included consecutive patients from the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands (MR CLEAN) Registry (March 2014-June 2016) with an anterior circulation large vessel occlusion undergoing EVT. Functional outcome was measured on the modified Rankin Scale (mRS) at 90 days. We investigated the association between collaterals and mRS in the MR CLEAN Registry with ordinal logistic regression and if this association was time dependent with an interaction term. Additionally, we determined modification of EVT effect by collaterals compared with MR CLEAN controls, and also investigated if this was time dependent with multiplicative interaction terms. RESULTS: 1412 patients were analyzed. Functional independence (mRS score of 0-2) was achieved in 13% of patients with grade 0 collaterals, in 27% with grade 1, in 46% with grade 2, and in 53% with grade 3. Collaterals were significantly associated with mRS (adjusted common OR 1.5 (95% CI 1.4 to 1.7)) and significantly modified EVT benefit (P=0.04). None of the effects were time dependent. Better collaterals corresponded to lower mortality (P<0.001), but not to lower rates of symptomatic intracranial hemorrhage (P=0.14). CONCLUSION: In routine clinical practice, better collateral status is associated with better functional outcome and greater treatment benefit in EVT treated acute ischemic stroke patients, independent of time to treatment. Within the 6 hour time window, a substantial proportion of patients with absent and poor collaterals can still achieve functional independence.
Published: 2019

74. Electroencephalographic reactivity as predictor of neurological outcome in postanoxic coma: A multicenter prospective cohort study

Author: Admiraal, Marjolein M., Rootselaar, A.F. van, Hofmeijer, J., Hoedemaekers, C.W.E., Kaam, C.R. van, Keijzer, H.M., Schultz, Marcus J., Horn, Janneke, Admiraal, Marjolein M., Rootselaar, A.F. van, Hofmeijer, J., Hoedemaekers, C.W.E., Kaam, C.R. van, Keijzer, H.M., Schultz, Marcus J., and Horn, Janneke
Abstract: Contains fulltext : 204755.pdf (publisher's version ) (Open Access)
Published: 2019

75. Circle of Willis variations in migraine patients with ischemic stroke

Author: Hamming, Arend M., van Walderveen, Marianne A. A., Mulder, Inge A., van der Schaaf, Irene C., Kappelle, L. Jaap, Velthuis, Birgitta K., Ferrari, Michel D., Terwindt, Gisela M., Visser, Marieke C., Schonewille, Wouter, Algra, Ale, Wermer, Marieke J. H., Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Droogh-de Greeve, K. E., Bienfait, H. P., Lycklama a Nijeholt, G. J., Boiten, J., Duyndam, D., Kwa, V., I, Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Dankbaar, J. W., Mali, W. P., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Luitse, M. J., van der Graaf, Y., Hamming, Arend M., van Walderveen, Marianne A. A., Mulder, Inge A., van der Schaaf, Irene C., Kappelle, L. Jaap, Velthuis, Birgitta K., Ferrari, Michel D., Terwindt, Gisela M., Visser, Marieke C., Schonewille, Wouter, Algra, Ale, Wermer, Marieke J. H., Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Droogh-de Greeve, K. E., Bienfait, H. P., Lycklama a Nijeholt, G. J., Boiten, J., Duyndam, D., Kwa, V., I, Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Dankbaar, J. W., Mali, W. P., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Luitse, M. J., and van der Graaf, Y.
Published: 2019

76. Intracranial Cerebrospinal Fluid Volume as a Predictor of Malignant Middle Cerebral Artery Infarction

Author: Kauw, F., Bennink, E., de Jong, H., Kappelle, L.J. (Jaap), Horsch, AD, Velthuis, B.K. (Birgitta), Dankbaar, JW, Majoie, C.B. (Charles), Roos, YB, Duijm, LE, Keizer, K, Lugt, A. (Aad) van der, Dippel, D.W.J. (Diederik), de Greve, K.E., Bienfait, H.P. (Henri), van Walderveen, MA, Wermer, M.J., Nijeholt, G., Boiten, J., Duyndam, D., Kwa, V.I., Meijer, F.J., Dijk, E.J. (Ewoud) van, Kesselring, FO, Hofmeijer, J., Vos, J.A., Schonewille, WJ, Rooij, W.J. (W.) van, de Kort, PL, Pleiter, CC, Bakker, S.L., Bot, J.J. (Jan), Visser, M.C. (Marieke), Schaaf, I.C. (Irene) van der, Mali, W.P. (Willem), van Seeters, T, Niesten, JM, Biessels, GJ, Luitse, MJ, Graaf, Y. (Yolanda) van der, Kauw, F., Bennink, E., de Jong, H., Kappelle, L.J. (Jaap), Horsch, AD, Velthuis, B.K. (Birgitta), Dankbaar, JW, Majoie, C.B. (Charles), Roos, YB, Duijm, LE, Keizer, K, Lugt, A. (Aad) van der, Dippel, D.W.J. (Diederik), de Greve, K.E., Bienfait, H.P. (Henri), van Walderveen, MA, Wermer, M.J., Nijeholt, G., Boiten, J., Duyndam, D., Kwa, V.I., Meijer, F.J., Dijk, E.J. (Ewoud) van, Kesselring, FO, Hofmeijer, J., Vos, J.A., Schonewille, WJ, Rooij, W.J. (W.) van, de Kort, PL, Pleiter, CC, Bakker, S.L., Bot, J.J. (Jan), Visser, M.C. (Marieke), Schaaf, I.C. (Irene) van der, Mali, W.P. (Willem), van Seeters, T, Niesten, JM, Biessels, GJ, Luitse, MJ, and Graaf, Y. (Yolanda) van der
Abstract: Background and Purpose— Predicting malignant middle cerebral artery (MCA) infarction can help to identify patients who may benefit from preventive decompressive surgery. We aimed to investigate the association between the ratio of intracranial cerebrospinal fluid (CSF) volume to intracranial volume (ICV) and malignant MCA infarction. Methods— Patients with an occlusion proximal to the M3 segment of the MCA were selected from the DUST (Dutch Acute Stroke Study). Admission imaging included noncontrast computed tomography (CT), CT perfusion, and CT angiography. Patient characteristics and CT findings were collected. The ratio of intracranial CSF volume to ICV (CSF/ICV) was quantified on admission thin-slice noncontrast CT. Malignant MCA infarction was defined as a midline shift of >5 mm on follow-up noncontrast CT, which was performed 3 days after the stroke or in case of clinical deterioration. To test the association between CSF/ICV and malignant MCA infarction, odds ratios and 95% CIs were calculated for 3 multivariable models by using binary logistic regression. Model performances were compared by using the likelihood ratio test. Results— Of the 286 included patients, 35 (12%) developed malignant MCA infarction. CSF/ICV was independently associated with malignant MCA infarction in 3 multivariable models: (1) with age and admission National Institutes of Health Stroke Scale (odds ratio, 3.3; 95% CI, 1.1–11.1), (2) with admission National Institutes of Health Stroke Scale and poor collateral score (odds ratio, 7.0; 95% CI, 2.6–21.3), and (3) with terminal internal carotid artery or proximal M1 occlusion and poor collateral score (odds ratio, 7.7; 95% CI, 2.8–23.9). The performance of model 1 (areas under the receiver operating characteristic curves, 0.795 versus 0.824; P=0.033), model 2 (areas under the receiver operating characteristic curves, 0.813 versus 0.850; P<0.001), and model 3 (areas under the receiver operating characteristic curves, 0.811 versus 0.856; P<0
Published: 2019
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77. Multicentre Randomised trial of Acute Stroke treatment in the Ambulance with a nitroglycerin Patch (MR ASAP): study protocol for a randomised controlled trial

Author: van den Berg, S.A. (Sophie A.), Dippel, D.W.J. (Diederik), Hofmeijer, J., Fransen, P.S.S. (Puck), Caminada, K. (Klaartje), Siegers, A. (Arjen), Kruyt, N.D. (Nyika), Kerkhoff, H. (Henk), Leeuw, H.F. (Frank) de, Nederkoorn, P.J. (Paul), Worp, H.B. (Bart) van der, van den Berg, S.A. (Sophie A.), Dippel, D.W.J. (Diederik), Hofmeijer, J., Fransen, P.S.S. (Puck), Caminada, K. (Klaartje), Siegers, A. (Arjen), Kruyt, N.D. (Nyika), Kerkhoff, H. (Henk), Leeuw, H.F. (Frank) de, Nederkoorn, P.J. (Paul), and Worp, H.B. (Bart) van der
Abstract: BACKGROUND: Some studies have suggested that transdermal administration of glyceryl trinitrate (GTN; nitroglycerin) in the first few hours after symptom onset increases the chance of a favourable outcome after ischaemic stroke or intracerebral haemorrhage, possibly through an increase in intracranial collateral blood flow and a reduction in blood pressure. The Multicentre Randomised trial of Acute Stroke treatment in the Ambulance with a nitroglycerin Patch (MR ASAP) aims to assess the effect of transdermal GTN, started within 3 h after stroke onset in the prehospital setting, on functional outcome at 90 days in patients with acute ischaemic stroke or intracerebral haemorrhage. METHODS: MR ASAP is a phase III, multicentre, randomised, open-label clinical trial with a blinded outcome assessment. A total of 1400 adult patients with suspected stroke and a systolic blood pressure ≥ 140 mmHg will be randomised to transdermal GTN (5 mg/day), administered as a transdermal patch by paramedics in the prehospital setting within 3 h of stroke onset and continued for 24 h or to standard care. The primary outcome is the score on the modified Rankin Scale (mRS) at 90 days, analysed with ordinal logistic regression. Secondary outcomes include blood pressure and collateral circulation at hospital admission, neurological deficit measured with the National Institutes of Health Stroke Scale at 24 h, and mortality and poor outcome (mRS score 3 to 6) at 90 days. This trial will be conducted in the Netherlands and will use a deferred consent procedure. The trial is part of the Collaboration for New Treatments of Acute Stro
Published: 2019
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78. Outcome Prediction in Postanoxic Coma With Deep Learning

Author: Tjepkema-Cloostermans, M.C., Lourenco, C., Ruijter, B.J., Tromp, S.C., Drost, G., Kornips, F.H.M., Beishuizen, A., Bosch, F.H., Hofmeijer, J., Putten, M.J.A.M. van, Tjepkema-Cloostermans, M.C., Lourenco, C., Ruijter, B.J., Tromp, S.C., Drost, G., Kornips, F.H.M., Beishuizen, A., Bosch, F.H., Hofmeijer, J., and Putten, M.J.A.M. van
Abstract: Item does not contain fulltext, OBJECTIVES: Visual assessment of the electroencephalogram by experienced clinical neurophysiologists allows reliable outcome prediction of approximately half of all comatose patients after cardiac arrest. Deep neural networks hold promise to achieve similar or even better performance, being more objective and consistent. DESIGN: Prospective cohort study. SETTING: Medical ICU of five teaching hospitals in the Netherlands. PATIENTS: Eight-hundred ninety-five consecutive comatose patients after cardiac arrest. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Continuous electroencephalogram was recorded during the first 3 days after cardiac arrest. Functional outcome at 6 months was classified as good (Cerebral Performance Category 1-2) or poor (Cerebral Performance Category 3-5). We trained a convolutional neural network, with a VGG architecture (introduced by the Oxford Visual Geometry Group), to predict neurologic outcome at 12 and 24 hours after cardiac arrest using electroencephalogram epochs and outcome labels as inputs. Output of the network was the probability of good outcome. Data from two hospitals were used for training and internal validation (n = 661). Eighty percent of these data was used for training and cross-validation, the remaining 20% for independent internal validation. Data from the other three hospitals were used for external validation (n = 234). Prediction of poor outcome was most accurate at 12 hours, with a sensitivity in the external validation set of 58% (95% CI, 51-65%) at false positive rate of 0% (CI, 0-7%). Good outcome could be predicted at 12 hours with a sensitivity of 48% (CI, 45-51%) at a false positive rate of 5% (CI, 0-15%) in the external validation set. CONCLUSIONS: Deep learning of electroencephalogram signals outperforms any previously reported outcome predictor of coma after cardiac arrest, including visual electroencephalogram assessment by trained electroencephalogram experts. Our approach offers the potential for object
Published: 2019

79. Postmortem histopathology of electroencephalography and evoked potentials in postanoxic coma

Author: Putten, M.J.A.M. van, Jansen, C, Tjepkema-Cloostermans, M.C., Beernink, T.M.J., Koot, R., Bosch, F.H., Beishuizen, A., Hofmeijer, J., Putten, M.J.A.M. van, Jansen, C, Tjepkema-Cloostermans, M.C., Beernink, T.M.J., Koot, R., Bosch, F.H., Beishuizen, A., and Hofmeijer, J.
Abstract: Contains fulltext : 215687.pdf (publisher's version ) (Closed access), Early EEG patterns and SSEP responses are associated with neurological recovery of comatose patients with postanoxic encephalopathy after cardiac arrest. However, the nature and distribution of brain damage underlying the characteristic EEG and SSEP patterns are unknown. We relate EEG and SSEP findings with results from histological analyses of the brains of eleven non-survivors. With restoration towards continuous rhythms within 24h after cardiac arrest, no signs of structural neuronal damage were observed. Absent SSEP responses were always accompanied by thalamic damage. Pathological burst suppression patterns were associated with a variable degree of neuronal damage to cortex, cerebellum and hippocampus. In patients with additional thalamic involvement, burst-suppression with identical bursts was observed, a characteristic EEG pattern presumably reflecting residual activity from a relatively isolated and severely compromised cortex.
Published: 2019

80. Multicentre Randomised trial of Acute Stroke treatment in the Ambulance with a nitroglycerin Patch (MR ASAP): study protocol for a randomised controlled trial

Author: Berg, Sophie A. van den, Dippel, Diederik W.J., Hofmeijer, J., Fransen, Puck S.S., Caminada, Klaartje, Siegers, Arjen, Leeuw, F.E. de, Nederkoorn, Paul J., Worp, H.Bart van der, Berg, Sophie A. van den, Dippel, Diederik W.J., Hofmeijer, J., Fransen, Puck S.S., Caminada, Klaartje, Siegers, Arjen, Leeuw, F.E. de, Nederkoorn, Paul J., and Worp, H.Bart van der
Abstract: Contains fulltext : 205276.pdf (publisher's version ) (Open Access)
Published: 2019

81. Circle of Willis variations in migraine patients with ischemic stroke

Author: Circulatory Health, In Vivo NMR ISI, MS Radiologie, ZL Cerebrovasculaire Ziekten Medisch, Brain, Researchgr. Hart-brein as., JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Externen Hematologie, Affectieve & Psychotische Med., Cancer, Arts-Assistenten Onderwijs Radiologie, Arts-assistenten Radiologie, Onderzoek Beeld, ZL Algemene Neurologie Medisch, Opleiding Neurologie, Cardiovasculaire Epi Team 5, Hamming, Arend M., van Walderveen, Marianne A. A., Mulder, Inge A., van der Schaaf, Irene C., Kappelle, L. Jaap, Velthuis, Birgitta K., Ferrari, Michel D., Terwindt, Gisela M., Visser, Marieke C., Schonewille, Wouter, Algra, Ale, Wermer, Marieke J. H., Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Droogh-de Greeve, K. E., Bienfait, H. P., Lycklama a Nijeholt, G. J., Boiten, J., Duyndam, D., Kwa, V., I, Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Dankbaar, J. W., Mali, W. P., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Luitse, M. J., van der Graaf, Y., Circulatory Health, In Vivo NMR ISI, MS Radiologie, ZL Cerebrovasculaire Ziekten Medisch, Brain, Researchgr. Hart-brein as., JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Externen Hematologie, Affectieve & Psychotische Med., Cancer, Arts-Assistenten Onderwijs Radiologie, Arts-assistenten Radiologie, Onderzoek Beeld, ZL Algemene Neurologie Medisch, Opleiding Neurologie, Cardiovasculaire Epi Team 5, Hamming, Arend M., van Walderveen, Marianne A. A., Mulder, Inge A., van der Schaaf, Irene C., Kappelle, L. Jaap, Velthuis, Birgitta K., Ferrari, Michel D., Terwindt, Gisela M., Visser, Marieke C., Schonewille, Wouter, Algra, Ale, Wermer, Marieke J. H., Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Droogh-de Greeve, K. E., Bienfait, H. P., Lycklama a Nijeholt, G. J., Boiten, J., Duyndam, D., Kwa, V., I, Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Dankbaar, J. W., Mali, W. P., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Luitse, M. J., and van der Graaf, Y.
Published: 2019

82. Multicentre Randomised trial of Acute Stroke treatment in the Ambulance with a nitroglycerin Patch (MR ASAP): study protocol for a randomised controlled trial

Author: van den Berg, SA (Sophie), Dippel, Diederik, Hofmeijer, J, Fransen, PSS, Caminada, K, Siegers, A, Kruyt, ND, Kerkhoff, H, de Leeuw, FE, Nederkoorn, PJ, van der Worp, HB, van den Berg, SA (Sophie), Dippel, Diederik, Hofmeijer, J, Fransen, PSS, Caminada, K, Siegers, A, Kruyt, ND, Kerkhoff, H, de Leeuw, FE, Nederkoorn, PJ, and van der Worp, HB
Published: 2019

83. Intracranial Cerebrospinal Fluid Volume as a Predictor of Malignant Middle Cerebral Artery Infarction

Author: Kauw, F, Bennink, E, Jong, H, Kappelle, LJ, Horsch, AD, Velthuis, BK, Dankbaar, JW, Majoie, CB, Roos, YB, Duijm, LE, Keizer, K, van der Lugt, Aad, Dippel, Diederik, Greve, KE, Bienfait, HP, van Walderveen, MA, Wermer, MJ, Nijeholt, G, Boiten, J, Duyndam, D, Kwa, VI, Meijer, FJ, van Dijk, EJ, Kesselring, FO, Hofmeijer, J, Vos, JA, Schonewille, WJ, van Rooij, WJ, de Kort, PL, Pleiter, CC, Bakker, SL, Bot, J, Visser, MC, van der Schaaf, IC, Mali, WP, van Seeters, T, Niesten, JM, Biessels, GJ, Luitse, MJ, Graaf, Y, Kauw, F, Bennink, E, Jong, H, Kappelle, LJ, Horsch, AD, Velthuis, BK, Dankbaar, JW, Majoie, CB, Roos, YB, Duijm, LE, Keizer, K, van der Lugt, Aad, Dippel, Diederik, Greve, KE, Bienfait, HP, van Walderveen, MA, Wermer, MJ, Nijeholt, G, Boiten, J, Duyndam, D, Kwa, VI, Meijer, FJ, van Dijk, EJ, Kesselring, FO, Hofmeijer, J, Vos, JA, Schonewille, WJ, van Rooij, WJ, de Kort, PL, Pleiter, CC, Bakker, SL, Bot, J, Visser, MC, van der Schaaf, IC, Mali, WP, van Seeters, T, Niesten, JM, Biessels, GJ, Luitse, MJ, and Graaf, Y
Published: 2019

84. Delayed Decompressive Surgery Increases Apparent Diffusion Coefficient and Improves Peri-Infarct Perfusion in Rats With Space-Occupying Cerebral Infarction

Author: Hofmeijer, J., Schepers, J., Veldhuis, W.B., Nicolay, K., Kappelle, L.J., Bär, P.R., and van der Worp, H.B.
Published: 2004
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85. Collateral Circulation via the Ophthalmic Artery or Leptomeningeal Vessels Is Associated with Impaired Cerebral Vasoreactivity in Patients with Symptomatic Carotid Artery Occlusion

Author: Hofmeijer, J., Klijn, C. J. M., Kappelle, L. J., van Huffelen, A. C., and van Gijn, J.
Published: 2002

86. CT angiography and CT perfusion improve prediction of infarct volume in patients with anterior circulation stroke

Author: Seeters, T. van, Biessels, G.J., Kappelle, L.J., Schaaf, I.C. van der, Dankbaar, J.W., Horsch, A.D., Niesten, J.M., Luitse, M.J., Majoie, C.B., Vos, J.A., Schonewille, W.J., Walderveen, M.A. van, Wermer, M.J., Duijm, L.E.M., Keizer, K., Bot, J.C., Visser, M.C, Lugt, A. van der, Dippel, D.W., Kesselring, F.O., Hofmeijer, J., Lycklama a Nijeholt, G.J., Boiten, J., Rooij, W.J. van, Kort, P.L. de, Roos, Y.B., Meijer, F.J.A., Pleiter, C.C., Mali, W.P., Graaf, Y. van der, Velthuis, B.K., Dijk, E.J. van, Radiology and nuclear medicine, ICaR - Ischemia and repair, ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, ACS - Amsterdam Cardiovascular Sciences, Neurology, Clinical Neurophysiology, Faculty of Behavioural, Management and Social Sciences, Faculty of Science and Technology, and Radiology & Nuclear Medicine
Subjects: Male, Neurology, Computed Tomography Angiography, Perfusion scanning, 030204 cardiovascular system & hematology, 0302 clinical medicine, Prospective Studies, Non-U.S. Gov't, Stroke, Netherlands, Computed tomography angiography, Neuroradiology, Aged, 80 and over, Ischemic stroke, medicine.diagnostic_test, Research Support, Non-U.S. Gov't, Middle Aged, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Multicenter Study, CT angiography, Radiology Nuclear Medicine and imaging, Cerebrovascular Circulation, Predictive value of tests, cardiovascular system, Female, Neurosurgery, Radiology, Cardiology and Cardiovascular Medicine, Rare cancers Radboud Institute for Health Sciences [Radboudumc 9], Brain Infarction, medicine.medical_specialty, Clinical Neurology, Observational Study, Research Support, METIS-320852, IR-103002, 03 medical and health sciences, Predictive Value of Tests, medicine, Journal Article, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Diagnostic Neuroradiology, Aged, business.industry, medicine.disease, Logistic Models, Infarct volume, Angiography, CT perfusion, Neurology (clinical), business, Prediction, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract: Introduction We investigated whether baseline CT angiography (CTA) and CT perfusion (CTP) in acute ischemic stroke could improve prediction of infarct presence and infarct volume on follow-up imaging. Methods We analyzed 906 patients with suspected anterior circulation stroke from the prospective multicenter Dutch acute stroke study (DUST). All patients underwent baseline non-contrast CT, CTA, and CTP and follow-up non-contrast CT/MRI after 3 days. Multivariable regression models were developed including patient characteristics and non-contrast CT, and subsequently, CTA and CTP measures were added. The increase in area under the curve (AUC) and R2 was assessed to determine the additional value of CTA and CTP. Results At follow-up, 612 patients (67.5 %) had a detectable infarct on CT/MRI; median infarct volume was 14.8 mL (interquartile range (IQR) 2.8–69.6). Regarding infarct presence, the AUC of 0.82 (95 % confidence interval (CI) 0.79–0.85) for patient characteristics and non-contrast CT was improved with addition of CTA measures (AUC 0.85 (95 % CI 0.82–0.87); p
Published: 2016

87. Risk factors for atherosclerotic and medial arterial calcification of the intracranial internal carotid artery

Author: Vos, Annelotte, Kockelkoren, Remko, de Vis, Jill B., van der Schouw, Yvonne T., van der Schaaf, I. C., Velthuis, B. K., Mali, W. P., de Jong, Pim A., Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Droogh-de Greve, K. E., Bienfait, H. P., van Walderveen, M. A., Wermer, M. J.H., Lycklama à Nijeholt, G. J., Boiten, J., Duyndam, D., Kwa, V. I., Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., Schonewille, W. J., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Visser, M. C., Dankbaar, J. W., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Kappelle, L. J., Luitse, M. J., van der Graaf, Y., and the DUST study group
Subjects: Medial arterial calcification, Cardiovascular disease risk factors, Atherosclerosis, Intracranial carotid artery, Cardiology and Cardiovascular Medicine
Abstract: Background and aims: Calcifications of the intracranial internal carotid artery (iICA) are an important risk factor for stroke. The calcifications can occur both in the intimal and medial layer of the vascular wall. The aim of this study is to assess whether medial calcification in the iICA is differently related to risk factors for cardiovascular disease, compared to intimal calcification. Methods: Unenhanced thin slice computed tomography (CT) scans from 1132 patients from the Dutch acute stroke study cohort were assessed for dominant localization of calcification (medial or intimal) by one of three observers based on established methodology. Associations between known cardiovascular risk factors (age, gender, body mass index, pulse pressure, eGFR, smoking, hypertension, diabetes mellitus, hyperlipidemia, previous vascular disease, and family history) and the dominant localization of calcifications were assessed via logistic regression analysis. Results: In the 1132 patients (57% males, mean age 67.4 years [SD 13.8]), dominant intimal calcification was present in 30.9% and dominant medial calcification in 46.9%. In 10.5%, no calcification was seen. Age, pulse pressure and family history were risk factors for both types of calcification. Multivariably adjusted risk factors for dominant intimal calcification only were smoking (OR 2.09 [CI 1.27–3.44]) and hypertension (OR 2.09 [CI 1.29–3.40]) and for dominant medial calcification diabetes mellitus (OR 2.39 [CI 1.11–5.14]) and previous vascular disease (OR 2.20 [CI 1.30–3.75]). Conclusions: Risk factors are differently related to the dominant localizations of calcifications, a finding that supports the hypothesis that the intimal and medial calcification represents a distinct etiology.
Published: 2018

88. Endovascular treatment for acute ischaemic stroke in routine clinical practice: prospective, observational cohort study (MR CLEAN Registry)

Author: Jansen, I.G.H., Mulder, M.J.H.L., Goldhoorn, R.J.B., Emmer, B.J., Es, A.C.G.M. van, Roozenbeek, B., Schonewille, W.J., Berg, R. van den, Coutinho, J.M., Staals, J., Postma, A.A., Lycklama, G.J., Hofmeijer, J., Martens, J.M., Hertog, H.M. den, Sturm, F.J.C., Worp, H.B. van der, R.H. lo, Heijboer, R.J.J., Keizer, K., Uyttenboogaart, M., Eshghi, O., Wermer, M.J.H., Walderveen, M.A.A. van, Dijk, E.J. van, Boogaarts, H.D., Bruijn, S.F. de, Dijk, L.C. van, Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Kort, P.L.M. de, Peluso, J.P.P., Schreuder, T.H.C.M.L., Aerden, L.A.M., Dallinga, R.J., Sprengers, M.E.S., Yo, L.S.F., Jenniskens, S.F.M., Roosendaal, S.D., Kallen, B.F.W. van der, Wijngaard, I.R. van den, Bot, J.C.J., Doormaal, P.J. van, Flach, H.Z., Venema, E., Lingsma, H.F., Beenen, L.F.M., Yoo, A.J., Boiten, J., Vos, J.A., Roos, Y.B.W.E.M., Oostenbrugge, R.J. van, Lugt, A. van der, Zwam, W.H. van, Dippel, D.W.J., Majoie, C.B.L.M., R Clean Registry Investigators m, Amsterdam Neuroscience - Neurovascular Disorders, Radiology and nuclear medicine, Promovendi CD, Klinische Neurowetenschappen, MUMC+: MA Niet Med Staf Neurologie (9), RS: CARIM - R3.03 - Cerebral small vessel disease, MUMC+: MA Med Staf Spec Neurologie (9), Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), MUMC+: MA Neurologie (3), RS: CARIM - R3.11 - Imaging, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Neurology, Graduate School, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, and ANS - Neurovascular Disorders
Subjects: Male, medicine.medical_specialty, RANDOMIZED CONTROLLED-TRIALS, medicine.medical_treatment, 030204 cardiovascular system & hematology, CLOT BURDEN SCORE, Brain Ischemia, Time-to-Treatment, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Modified Rankin Scale, law, medicine, Humans, Registries, VALIDITY, METAANALYSIS, Aged, Netherlands, Thrombectomy, business.industry, Cerebral infarction, Research, MECHANICAL THROMBECTOMY, Endovascular Procedures, General Medicine, Thrombolysis, Odds ratio, Middle Aged, medicine.disease, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Confidence interval, Surgery, Stroke, Outcome and Process Assessment, Health Care, THROMBOLYTIC THERAPY, INFARCT, Female, Observational study, business, Intracranial Hemorrhages, 030217 neurology & neurosurgery, Cohort study
Abstract: Contains fulltext : 193545.pdf (Publisher’s version ) (Open Access) OBJECTIVE: To determine outcomes and safety of endovascular treatment for acute ischaemic stroke, due to proximal intracranial vessel occlusion in the anterior circulation, in routine clinical practice. DESIGN: Ongoing, prospective, observational cohort study. SETTING: 16 centres that perform endovascular treatment in the Netherlands. PARTICIPANTS: 1488 patients included in the Multicentre Randomised Controlled Trial of Endovascular Treatment for Acute Ischaemic Stroke in the Netherlands (MR CLEAN) Registry who had received endovascular treatment, including stent retriever thrombectomy, aspiration, and all alternative methods for acute ischaemic stroke within 6.5 hours from onset of symptoms between March 2014 and June 2016. MAIN OUTCOME MEASURES: The primary outcome was the modified Rankin Scale (mRS) score, ranging from 0 (no symptoms) to 6 (death) at 90 days after the onset of symptoms. Secondary outcomes were excellent functional outcome (mRS score 0-1), good functional outcome (mRS score 0-2), and favourable functional outcome (mRS score 0-3) at 90 days; score on the extended thrombolysis in cerebral infarction scale at the end of the intervention procedure; National Institutes of Health Stroke Scale score 24-48 hours after intervention; and complications that occurred during intervention, hospital admission, or three months' follow up period. Outcomes and safety variables in the MR CLEAN Registry were compared with the MR CLEAN trial intervention and control arms. RESULTS: A statistically significant shift was observed towards better functional outcome in patients in the MR CLEAN Registry compared with the MR CLEAN trial intervention arm (adjusted common odds ratio 1.30, 95% confidence interval 1.02 to 1.67) and the MR CLEAN trial control arm (1.85, 1.46 to 2.34). The reperfusion rate, with successful reperfusion defined as a score of 2B-3 on the extended thrombolysis in cerebral infarction score, was 58.7%, the same as for patients in the MR CLEAN trial. Duration from onset of stroke to start of endovascular treatment and from onset of stroke to successful reperfusion or last contrast bolus was one hour shorter for patients in the MR CLEAN Registry. Symptomatic intracranial haemorrhage occurred in 5.8% of patients in the MR CLEAN Registry compared with 7.7% in the MR CLEAN trial intervention arm and 6.4% in the MR CLEAN trial control arm. CONCLUSION: In routine clinical practice, endovascular treatment for patients with acute ischaemic stroke is at least as effective and safe as in the setting of a randomised controlled trial.
Published: 2018

89. P38-T Relevance of SSEP amplitude after cardiac arrest

Author: Glimmerveen, Astrid, primary, Keijzer, H.M., additional, Ruijter, B.J., additional, Tjepkema-Cloostermans, M.C., additional, van Putten, M.J.A.M., additional, and Hofmeijer, J., additional
Published: 2019
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90. Towards improved outcome after cardiac arrest: New studies coming up

Author: Horn, J., Hofmeijer, J., Kuiper, M., Spoelstra-de Man, A., Intensive care medicine, ACS - Atherosclerosis & ischemic syndromes, Amsterdam Reproduction & Development (AR&D), ACS - Diabetes & metabolism, and Clinical Neurophysiology
Subjects: Randomized controlled trial, Brain injury, Cardiac arrest, Neuroprotection
Abstract: Patients admitted to an intensive care unit after cardiac arrest often suffer from severe brain injury. This injury worsens further after restoration of circulation due to the cascade of reactions in the brain. Neuroprotective therapies aim to diminish this secondary brain injury, thereby targeting at a better outcome. Several new large international studies will start soon, next to two smaller national phase II studies. In this paper we describe the new studies and invite Dutch intensive care units to join.
Published: 2017

91. A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke

Author: Berkhemer, O.A., Fransen, P.S.S., Beumer, D., Berg, L.A. van den, Lingsma, H.F., Yoo, A.J., Schonewille, W.J., Vos, J.A., Nederkoorn, P.J., Wermer, M.J.H., Walderveen, M.A.A. van, Staals, J., Hofmeijer, J., Oostayen, J.A. van, Nijeholt, G.J.L.A., Boiten, J., Brouwer, P.A., Emmer, B.J., Bruijn, S.F. de, Dijk, L.C. van, Kappelle, L.J., R.H. lo, Dijk, E.J. van, Vries, J. de, Kort, P.L.M. de, Rooij, W.J.J. van, Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Visser, M.C., Bot, J.C.J., Vroomen, P.C., Eshghi, O., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Tielbeek, A.V., Hertog, H.M. den, Gerrits, D.G., Berg-Vos, R.M. van den, Karas, G.B., Steyerberg, E.W., Flach, H.Z., Marquering, H.A., Sprengers, M.E.S., Jenniskens, S.F.M., Beenen, L.F.M., Berg, R. van den, Koudstaal, P.J., Zwam, W.H. van, Roos, Y.B.W.E.M., Lugt, A. van der, Oostenbrugge, R.J. van, Majoie, C.B.L.M., Dippel, D.W.J., MR CLEAN Investigators, Clinical Neurophysiology, Faculty of Science and Technology, ACS - Amsterdam Cardiovascular Sciences, ANS - Amsterdam Neuroscience, Radiology and Nuclear Medicine, Graduate School, Neurology, Biomedical Engineering and Physics, Other Research, Other departments, Radiology and nuclear medicine, NCA - neurodegeneration, Public Health, Radiology & Nuclear Medicine, RS: CARIM - R3 - Vascular biology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, MUMC+: MA AIOS Neurologie (9), Interne Geneeskunde, Klinische Neurowetenschappen, MUMC+: MA Med Staf Spec Neurologie (9), MUMC+: MA Arts Assistenten Obstetrie Gynaecologie (9), Huisartsgeneeskunde, NUTRIM, and MUMC+: DA BV Medisch Specialisten Radiologie (9)
Subjects: medicine.medical_specialty, Solitaire Cryptographic Algorithm, Randomization, RECANALIZATION, THERAPY, law.invention, Randomized controlled trial, Modified Rankin Scale, law, SCORE, medicine, OCCLUSIONS, IR-98132, Intracerebral hemorrhage, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], General Medicine, Odds ratio, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], medicine.disease, Confidence interval, Surgery, Clinical trial, Anesthesia, ENDOVASCULAR TREATMENT, METIS-313119, CEREBRAL INFARCT, business
Abstract: Contains fulltext : 153000.pdf (Publisher’s version ) (Open Access) BACKGROUND: In patients with acute ischemic stroke caused by a proximal intracranial arterial occlusion, intraarterial treatment is highly effective for emergency revascularization. However, proof of a beneficial effect on functional outcome is lacking. METHODS: We randomly assigned eligible patients to either intraarterial treatment plus usual care or usual care alone. Eligible patients had a proximal arterial occlusion in the anterior cerebral circulation that was confirmed on vessel imaging and that could be treated intraarterially within 6 hours after symptom onset. The primary outcome was the modified Rankin scale score at 90 days; this categorical scale measures functional outcome, with scores ranging from 0 (no symptoms) to 6 (death). The treatment effect was estimated with ordinal logistic regression as a common odds ratio, adjusted for prespecified prognostic factors. The adjusted common odds ratio measured the likelihood that intraarterial treatment would lead to lower modified Rankin scores, as compared with usual care alone (shift analysis). RESULTS: We enrolled 500 patients at 16 medical centers in The Netherlands (233 assigned to intraarterial treatment and 267 to usual care alone). The mean age was 65 years (range, 23 to 96), and 445 patients (89.0%) were treated with intravenous alteplase before randomization. Retrievable stents were used in 190 of the 233 patients (81.5%) assigned to intraarterial treatment. The adjusted common odds ratio was 1.67 (95% confidence interval [CI], 1.21 to 2.30). There was an absolute difference of 13.5 percentage points (95% CI, 5.9 to 21.2) in the rate of functional independence (modified Rankin score, 0 to 2) in favor of the intervention (32.6% vs. 19.1%). There were no significant differences in mortality or the occurrence of symptomatic intracerebral hemorrhage. CONCLUSIONS: In patients with acute ischemic stroke caused by a proximal intracranial occlusion of the anterior circulation, intraarterial treatment administered within 6 hours after stroke onset was effective and safe. (Funded by the Dutch Heart Foundation and others; MR CLEAN Netherlands Trial Registry number, NTR1804, and Current Controlled Trials number, ISRCTN10888758.).
Published: 2015

92. Intracerebral hemorrhage in ICU: is it worth treating?

Author: Sivakumar, S, Taccone, F, Desai, K, Lazaridis, C, Skarzynski, M, Sekhon, M, Henderson, W, Griesdale, D, Chapple, L, Deane, A, Williams, L, Strickland, R, Lange, K, Heyland, D, Chapman, M, Rowland, M, Garry, P, Westbrook, J, Corkill, R, Antoniades, C, Pattinson, K, Fatania, G, Strong, A, Myers, R, Jermaine, C, Robertson, C, Rusin, C, Hofmeijer, J, Sondag, L, Tjepkema Cloostermans, M, Beishuizen, A, Bosch, F, van Putten, M, Carteron, L, Patet, C, Solari, D, Oddo, M, Ali, M, Dias, C, Almeida, R, Vaz Ferreira, A, Silva, J, Monteiro, E, Cerejo, A, Rocha, A, Elsayed, A, Abougabal, A, Beshey, B, Alzahaby, K, Pozzebon, S, Ortiz, A, Cristallini, S, Lheureux, O, Brasseur, A, Vincent, J, Creteur, J, Hravnak, M, Yousef, K, Chang, Y, Crago, E, Friedlander, R, Abdelmonem, S, Tahon, S, Helmy, T, Meligy, H, Puig, F, Dunn Siegrist, I, Pugin, J, Gupta, S, Govil, D, Srinivasan, S, Patel, S, N, J, Gupta, A, Tomar, D, Shafi, M, Harne, R, Arora, D, Talwar, N, Mazumdar, S, Papakrivou, E, Makris, D, Manoulakas, E, Tsolaki, B, Karadodas, B, Zakynthinos, E, Garcia, I, Martin, A, Encinares, V, Ibañez, M, Montero, J, Labrador, G, Cangueiro, T, Poulose, V, Koh, J, Kam, J, Yeter, H, Kara, A, Aktepe, O, Topeli, A, Tsolakoglou, I, Intas, G, Stergiannis, P, Kolaros, A, Chalari, E, Athanasiadou, E, Martika, A, Fildisis, G, Faivre, V, Mengelle, C, Favier, B, Payen, D, Poppe, A, Winkler, M, Mudersbach, E, Schreiber, J, Wruck, M, Schwedhelm, E, Kluge, S, Zöllner, C, Tavladaki, T, Spanaki, A, Dimitriou, H, Kondili, E, Choulaki, C, Meleti, E, Kafetzopoulos, D, Georgopoulos, D, Briassoulis, G, la Torre, A, de la Torre Prados, M, Tsvetanova Spasova, T, Nuevo Ortega, P, Rueda Molina, C, Fernández Porcel, A, Camara Sola, E, Salido Díaz, L, García Alcántara, A, Meleti, D, Suberviola, B, Riera, J, Rellan, L, Sanchez, M, Robles, J, Lopez, E, Vicente, R, Miñambres, E, Santibañez, M, Le Guen, M, Moore, J, Mason, N, Windpassinger, M, Plattner, O, Mascha, E, Sessler, D, Research, O, Melia, U, Fontanet, J, van den Berg, J, Struys, M, Vereecke, H, Jensen, E, Rood, P, van de Schoor, F, van Tertholen, K, Pickkers, P, van den Boogaard, M, Beardow, Z, Redhead, H, Paramasivam, K, Numan, T, Kamper, A, Peelen, L, Zeman, P, Slooter, A, van Ewijk, C, Jacobs, G, Girbes, A, Myatra, S, Harish, M, Prabu, N, Siddiqui, S, Kulkarni, A, Divatia, J, Murbach, L, Leite, M, Osaku, E, Costa, C, Pelenz, M, Neitzke, N, Moraes, M, Jaskowiak, J, Silva, M, Zaponi, R, Abentroth, L, Ogasawara, S, Jorge, A, Duarte, P, Hernández Sánchez, N, Sánchez Hurtado, L, García Guillen, F, Ñamendys Silva, S, Maghsoudi, B, Emami, M, Khosravi, M, Zand, F, Tabatabaie, H, Masjedi, M, Sabetiyan, G, Mokri, A, Troubleyn, J, Diltoer, M, Jacobs, R, Nguyen, D, De Waele, E, De Regt, J, Honoré, P, Van Gorp, V, Spapen, H, Contreras, R, Toapanta, N, Moreno, G, Sabater, J, Torrado, H, Gonzalez, M, Marin, M, Farigola, E, Gonzalez, A, Fernandez, J, Vera, A, Gisbert, X, Juliá, C, Uya, J, Corral, L, Elias Jones, I, Gemmell, L, Mackay, A, Randall, D, Adwaney, A, Blunden, M, Prowle, J, Kirwan, C, Thomas, N, Owen, H, Darwin, L, Conway, D, Atkinson, D, Sharman, M, Barbanti, C, Amour, J, Gaudard, P, Rozec, B, Mauriat, P, M'Rini, M, Leger, P, Cambonie, G, Liet, J, Girard, C, Laroche, S, Damas, P, Assaf, Z, Loron, G, Lecourt, L, Pouard, P, Kim, S, Na, S, Kim, J, Oh, S, Jung, C, Yoo, S, Min, S, Chung, E, Lee, H, Lee, N, Lee, K, Suh, K, Ryu, H, Marshall, D, Goodson, R, Salciccioli, J, Shalhoub, J, Potter, E, Kirk Bayley, J, Karanjia, N, Forni, L, Creagh Brown, B, Bossy, M, Nyman, M, Tailor, A, D'Antini, D, Spadaro, S, Valentino, F, Sollitto, F, Cinnella, G, Mirabella, L, Calvo, F, Bejarano, N, Padilla, D, Baladron, V, Villajero, P, Villazala, R, Redondo, J, Yuste, A, Liu, J, Shen, F, Teboul, J, Anguel, N, Beurton, A, Bezaz, N, Richard, C, Monnet, X, Fossali, T, Colombo, R, Ottolina, D, Rossetti, M, Mazzucco, C, Marchi, A, Porta, A, Catena, E, Tollisen, K, Andersen, G, Heyerdahl, F, Jacobsen, D, de Waard, M, van IJzendoorn, M, Buter, H, Kingma, W, Navis, G, Boerma, E, Rulisek, J, Balik, M, Zacharov, S, Kim, H, Jeon, S, Namgung, H, Lee, E, Cho, Y, Lee, Y, Huang, A, Cioccari, L, Luethi, N, Mårtensson, J, Bellomo, R, Forsberg, M, Edman, G, Höjer, J, Forsberg, S, Freile, M, Hidalgo, F, Molina, J, Lecumberri, R, Rosselló, A, Travieso, P, Leon, G, Sanchez, J, Frias, L, Rosello, D, Verdejo, J, Serrano, J, Winterwerp, D, van Galen, T, Vazin, A, Karimzade, I, Zand, A, Ozen, E, Ekemen, S, Akcan, A, Sen, E, Yelken, B, Kureshi, N, Fenerty, L, Thibault Halman, G, Erdogan, M, Walling, S, Green, R, Clarke, D, Briassoulis, P, Kalimeris, K, Ntzouvani, A, Nomikos, T, Papaparaskeva, K, Politi, E, Kostopanagiotou, G, Crewdson, K, Rehn, M, Weaver, A, Brohi, K, Lockey, D, Wright, S, Thomas, K, Baker, C, Mansfield, L, Stafford, V, Wade, C, Watson, G, Bryant, A, Chadwick, T, Shen, J, Wilkinson, J, Furneval, J, Henderson, A, Hugill, K, Howard, P, Roy, A, Bonner, S, Baudouin, S, Ramírez, C, Escalada, S, Viera, M, Santana, M, Balcázar, L, Monroy, N, Campelo, F, Vázquez, C, Santana, P, Santana, S, Quintard, H, Bouzat, P, Wollersheim, T, Malleike, J, Haas, K, Carbon, N, Schneider, J, Birchmeier, C, Fielitz, J, Spuler, S, Weber Carstens, S, Enseñat, L, Pérez Madrigal, A, Saludes, P, Proença, L, Gruartmoner, G, Espinal, C, Mesquida, J, Huber, W, Eckmann, M, Elkmann, F, Gruber, A, Lahmer, T, Mayr, U, Herner, A, Schellnegger, R, Schmid, R, Ayoub, W, Samy, W, Esmat, A, Battah, A, Mukhtar, S, Mongkolpun, W, Cortés, D, Cordeiro, C, Funcke, S, Groesdonk, H, Saugel, B, Wagenpfeil, G, Wagenpfeil, S, Reuter, D, Fernandez, M, Fernandez, R, Magret, M, González Castro, A, Bouza, M, García, C, Balerdi, B, Mas, A, Arauzo, V, Añón, J, Ruiz, F, Ferreres, J, Tomás, R, Alabert, M, Tizón, A, Altaba, S, Llamas, N, Goligher, E, Fan, E, Herridge, M, Vorona, S, Sklar, M, Dres, M, Rittayamai, N, Lanys, A, Urrea, C, Tomlinson, G, Reid, W, Rubenfeld, G, Kavanagh, B, Brochard, L, Ferguson, N, Neto, A, de Abreu, M, Pelosi, P, Schultz, M, Guérin, C, Papazian, L, Reignier, J, Ayzac, L, Loundou, A, Forel, J, Rolland Debord, C, Bureau, C, Poitou, T, Clavel, M, Perbet, S, Terzi, N, Kouatchet, A, Similowski, T, Demoule, A, Hunfeld, N, Trogrlic, Z, Ladage, S, Osse, R, Koch, B, Rietdijk, W, Devlin, J, van der Jagt, M, Picetti, E, Ceccarelli, P, Mensi, F, Malchiodi, L, Risolo, S, Rossi, I, Antonini, M, Servadei, F, Caspani, M, Roquilly, A, Lasocki, S, Seguin, P, Geeraerts, T, Perrigault, P, Dahyot Fizelier, C, Paugam Burtz, C, Cook, F, Cinotti, R, Dit Latte, D, Mahe, P, Fortuit, C, Feuillet, F, Asehnoune, K, Marzorati, C, Spina, S, Scaravilli, V, Vargiolu, A, Riva, M, Barbadillo, S, de Molina, F, Álvarez Lerma, F, Rodríguez, A, Zakharkina, T, Martin Loeches, I, Matamoros, S, Povoa, P, Torres, A, Kastelijn, J, Hofstra, J, de Jong, M, Sterk, P, Artigas, A, Bos, L, Moreau, A, Salluh, J, Rodriguez, A, Nseir, S, de Jong, E, van Oers, J, Nijsten, M, de Lange, D, Bonvicini, D, Labate, D, Benacchio, L, Olivieri, A, Pizzirani, E, Lopez Delgado, J, Gonzalez Romero, M, Fuentes Mila, V, Berbel Franco, D, Romera Peregrina, I, Martinez Pascual, A, Perez Sanchez, J, Abellan Lencina, R, Ávila Espinoza, R, Moreno Gonzalez, G, Sbraga, F, Griffiths, S, Grocott, M, Doyle, J, Wilkerson, P, Soon, Y, Huddart, S, Dickinson, M, Riga, A, Zuleika, A, Miyamoto, K, Kawazoe, Y, Morimoto, T, Yamamoto, T, Fuke, A, Hashimoto, A, Koami, H, Beppu, S, Katayama, Y, Ito, M, Ohta, Y, Yamamura, H, Rygård, S, Holst, L, Wetterslev, J, Johansson, P, Perner, A, Soliman, I, van Dijk, D, van Delden, J, Cremer, O, Mcwilliams, D, Snelson, C, Neves, A, Loudet, C, Busico, M, Vazquez, D, Villalba, D, Veronesi, M, Lischinsky, A, López, F, Mori, L, Plotnikow, G, Díaz, A, Giannasi, S, Hernandez, R, Krzisnik, L, Cecotti, C, Viola, L, Lopez, R, Sottile, J, Benavent, G, Estenssoro, E, Chen, C, Lai, C, Cheng, K, Chou, W, Chan, K, Roeker, L, Horkan, C, Gibbons, F, Christopher, K, Weijs, P, Mogensen, K, Rawn, J, Robinson, M, Tang, Z, Qiu, C, Ouyang, B, Cai, C, Guan, X, Regueira, T, Cea, L, Carlos, S, Elisa, B, Puebla, C, Vargas, A, Poulsen, M, Thomsen, L, Kjærgaard, S, Rees, S, Karbing, D, Frank, S, Müller, M, Skrypnikov, V, Pickerodt, P, Falk, R, Mahlau, A, Lee, A, Inglis, R, Morgan, R, Barker, G, Kamata, K, Abe, T, Saitoh, D, Tokuda, Y, Butler, M, Hwa, H, Gil, L, Vaquero, R, Rodriguez Ruiz, E, Lago, A, Allut, J, Gestal, A, Thomas Rüddel, D, Schwarzkopf, D, Fleischmann, C, Reinhart, K, Suwanpasu, S, Sattayasomboon, Y, Filho, N, Oliveira, J, Ballalai, C, De Lucia, C, Araponga, G, Veiga, L, Silva, C, Garrido, M, Ramos, B, Ricaldi, E, Gomes, S, Wright, C, Docking, R, Doherty, P, Black, E, Stenhouse, P, Plummer, M, Finnis, M, Phillips, L, Kar, P, Bihari, S, Biradar, V, Moodie, S, Horowitz, M, Shaw, J, Yatabe, T, Inoue, S, Sakaguchi, M, Egi, M, Abdelhamid, Y, Hokka, M, Mizobuchi, S, Giersch, E, Summers, M, Hatzinikolas, S, Heller, S, Jones, K, Schweizer, R, Jacquet Lagreze, M, Portran, P, Junot, S, Allaouchiche, B, Fellahi, J, Guerci, P, Ergin, B, Kapucu, A, Ince, C, Crisman, M, Shinotsuka, C, Fagnoul, D, Orbegozo, D, Preiser, J, Thooft, A, Brimioulle, S, Iwasaka, H, Tahara, S, Nagamine, M, Ichigatani, A, Cabrera, A, Zepeda, E, Granillo, J, Sánchez, J, Montoya, A, Montenegro, A, Blanco, G, Robles, C, Drolz, A, Horvatits, T, Roedl, K, Rutter, K, Funk, G, Schneeweiss, B, Fuhrmann, V, Sabetian, G, Pooresmaeel, F, Ghaffaripour, S, Farbod, A, Tabei, H, Taheri, L, Anandanadesan, R, Metaxa, V, Teixeira, C, Pereira, S, Hernández Marrero, P, Carvalho, A, Beckmann, M, Hartog, C, Raadts, A, Robertsen, A, Førde, R, Skaga, N, Helseth, E, Honeybul, S, Ho, K, Lopez, P, Ortega, P, Sola, E, Spasova, T, Kopecky, O, Rusinova, K, Waldauf, P, Cepeplikova, Z, Domínguez, J, Almudevar, P, Carmona, S, Muñoz, J, Castañeda, D, Abellán, A, Villamizar, P, Ramos, J, Pérez, L, Lucendo, A, Ejarque, M, Estella, A, Camps, V, Martín, M, Masnou, N, Barbosa, S, Varela, A, Palma, I, Cristina, L, Nunes, E, Pereira, I, Campello, G, Granja, C, Pande, R, Pandey, M, Varghese, S, Chanu, M, Van Dam, M, Ter Braak, E, Gracia, M, Viciana, R, Recuerda, M, Fontaiña, L, Tharmalingam, B, Kovari, F, Rose, L, Mcginlay, M, Amin, R, Burns, K, Connolly, B, Hart, N, Jouvet, P, Katz, S, Leasa, D, Mawdsley, C, Mcauley, D, Blackwood, B, Denham, S, Worrall, R, Arshad, M, Isherwood, P, Khadjibaev, A, Sabirov, D, Rosstalnaya, A, Parpibaev, F, Sharipova, V, Guzman, C, Cha, Y, Lee, S, Tyagi, N, Rajput, R, Taneja, S, Singh, V, Sharma, S, Mittal, S, Rao, B, Ayachi, J, Fraj, N, Romdhani, S, Khedher, A, Meddeb, K, Sma, N, Azouzi, A, Bouneb, R, Chouchene, I, El Ghardallou, M, Boussarsar, M, Jennings, R, Walter, E, Ribeiro, J, Moniz, I, Marçal, R, Santos, A, Candeias, C, E. Silva, Z, Gomez, S, Nieto, O, Gonzalez, J, Cuellar, A, Mildh, H, Pettilä, V, Korhonen, A, Karlsson, S, Ala Kokko, T, Reinikainen, M, Vaara, S, Zaleska Kociecka, M, Grabowski, M, Dąbrowski, M, Wozniak, S, Piotrowska, K, Banaszewski, M, Imiela, J, Stepinska, J, Pérez, A, Ordoñez, P, Giribet, A, Cuervo, M, Cuervo, R, Esteban, M, Fraile, L, Mittelbrum, C, Albaiceta, G, Koeze, J, Keus, F, Dieperink, W, van der Horst, I, van Meurs, M, Zijlstra, J, Roberts, S, Caballero, C, Isgro, G, Hall, D, Beitland, S, Trøseid, A, Brusletto, B, Waldum Grevbo, B, Berg, J, Sunde, K, Huertas, D, Manzano, F, Quintana, M, Osuna, A, Santiago Ruiz, F, Rodríguez Mejías, C, Wangensteen, R, Jamaati, H, Hashemian, S, Abbasi, G, Khaloo, V, Tabei, S, Kafilzadeh, A, Bakhodaei, H, Diaz, J, Silva, R, Garcia, D, Luis, E, Gomez, M, Soriano, R, Gonzalez, P, Ibrahim, I, Rafik, M, Al Ansary, A, Algendi, M, Ali, A, Benten, D, Kluwe, J, Siedler, S, Adedugbe, I, Bird, G, Kennedy, R, Yugi, G, Haroon, B, Witter, T, Khaliq, W, Singer, M, Havaldar, A, Krishna, B, Sriram, S, Espinoza, E, Pozo, M, Edul, V, Furche, M, Motta, M, Vazquez, A, Birri, P, Dubin, A, Dogliotti, A, Ramos, A, Lovesio, C, Delile, E, Nevière, R, Thiébaut, P, Maupoint, J, Mulder, P, Coquerel, D, Renet, S, do Rego, J, Rieusset, J, Richard, V, Tamion, F, Andreis, D, Smit, B, Smulders, Y, van Straaten, H, Eringa, E, Man, A, Alegría, L, Soto, D, Luengo, C, Gomez, J, Jarufe, N, Bruhn, A, Castro, R, Kattan, E, Tapia, P, Rebolledo, R, Achurra, P, Ospina Tascón, G, Bakker, J, Hernández, G, Bertini, P, Guarracino, F, Baldassarri, R, Pinsky, M, Vera, M, Dreyse, J, Carpio, D, Henriquez, C, Gajardo, D, Bravo, S, Lee, M, Park, S, So, S, Kačar, M, Kačar, S, Uddin, I, Belhaj, A, Aydın, M, Avsec, D, Kapuağası, A, Kaymak, Ç, Kovach, L, Şencan, I, Meço, B, Özçelik, M, Ünal, N, Jenni Moser, B, Jeitziner, M, Galassi, M, Sales, F, de Moraes, K, Batista, C, Júnior, J, Marcari, T, Lobato, R, Castro, C, de Souza, L, Rodrigues, F, Correa, N, Pelegrini, A, Eid, R, Timenetsky, K, Cazati, D, Lobato, M, Diniz, P, Rocha, L, Cavalheiro, A, Lucinio, N, Santos, E, Norrenberg, M, Gleize, A, Simón, I, Valhonrat, I, Almudévar, P, Dávila, F, Rubio, J, Reina, Á, López, N, Pérez, M, Apolo, D, Villén, L, García, I, Izurieta, J, Guerrero, J, Calvert, S, Quint, M, Adeniji, K, Young, R, Shevill, D, Robertson, E, Garside, P, Isotti, P, De Vecchi, M, Perduca, A, Negro, A, Villa, G, Manara, D, Cabrini, L, Zangrillo, A, Frencken, J, van Baal, L, Donker, D, Horn, J, van der Poll, T, van Klei, W, Bonten, M, Menard, C, Kumar, A, Rimmer, E, Doucette, S, Turgeon, A, Houston, B, Houston, D, Zarychanski, R, Pinto, B, Carrara, M, Ferrario, M, Bendjelid, K, Nunes, J, Diaz, P, Silva, G, Escórcio, S, Chaves, S, Jardim, M, Fernandes, N, Câmara, M, Duarte, R, Pereira, C, Vieira, J, Nóbrega, J, de Oca Sandoval, M, Sánchez Rodríguez, A, Joya Galeana, J, Correa Morales, A, Camarena Alejo, G, Aguirre Sánchez, J, Franco Granillo, J, Soliman, M, Al Azab, A, El Hossainy, R, Nagy, H, Nirmalan, M, Crippa, I, Cavicchi, F, Chaari, A, Hakim, K, Hassanein, H, Etman, M, El Bahr, M, Bousselmi, K, Khalil, E, Kauts, V, Casey, W, Imahase, H, Sakamoto, Y, Yamada, K, Miike, T, Nagashima, F, Iwamura, T, Boscolo, A, Lucchetta, V, Piasentini, E, Bertini, D, Manesso, L, Spiezia, L, Simioni, P, Ori, C, Souza, R, Martins, A, Liberatore, A, Kang, Y, Nakamae, M, Koh, I, Hanslin, K, Wilske, F, Skorup, P, Sjölin, J, Lipcsey, M, Long, W, Zhen, C, Vakalos, A, Avramidis, V, Wu, S, Shyu, L, Li, C, Yu, C, Chen, H, Wang, C, Lin, K, Aray, Z, Gómez, C, Tejero, A, Monge, D, Losada, V, Tarancón, C, Cortés, S, Gutiérrez, A, Álvarez, T, Rouze, A, Jaffal, K, Six, S, Stolz, K, Cattoen, V, Arnal, J, Saoli, M, Novotni, D, Garnero, A, Becher, T, Buchholz, V, Schädler, D, Frerichs, I, Weiler, N, Eronia, N, Mauri, T, Gatti, S, Maffezzini, E, Bronco, A, Alban, L, Sasso, T, Marenghi, C, Grasselli, G, Pesenti, A, Bellani, G, Al Fares, A, Del Sorbo, L, Anwar, S, Facchin, F, Azad, S, Zamel, R, Cypel, M, Keshavjee, S, Durlinger, E, Spoelstra de Man, A, de Grooth, H, Straaten, H, Alfaro, M, Parrilla, F, Meli, A, Pellegrini, M, Rodriguez, N, Goyeneche, J, Morán, I, Aguirre, H, Mancebo, J, Heines, S, Strauch, U, Bergmans, D, Blankman, P, Shono, A, Hasan, D, Gommers, D, Chung, W, Jung, Y, Park, J, Sheen, S, Park, K, Worral, R, Larraza, S, Dey, N, Brohus, J, Winding, R, Volta, C, Ampatzidou, F, Vlachou, A, Kehagioglou, G, Karaiskos, T, Madesis, A, Mauromanolis, C, Michail, N, Drossos, G, Saraj, N, Rijkenberg, S, Feijen, H, Endeman, H, Donnelly, A, Morgan, E, Garrard, H, Buckley, H, Russell, L, Haase, N, Goh, C, Mouyis, K, Woodward, C, Halliday, J, Encina, G, Ros, J, Lagunes, L, Tabernero, J, Rello, J, Morente Constantin, E, Rivera Ginés, B, Colmenero Ruiz, M, Sanz, J, Simon, I, Valbuena, B, Pais, M, Ramalingam, S, Díaz, C, Fox, L, Santafe, M, Barba, P, García, M, Leal, S, Veganzones, J, Martínez, N, Moors, I, Mokart, D, Pène, F, Lambert, J, Mayaux, J, Vincent, F, Nyunga, M, Bruneel, F, Laisne, L, Rabbat, A, Lebert, C, Perez, P, Chaize, M, Renault, A, Meert, A, Hamidfar, R, Jourdain, M, Darmon, M, Schlemmer, B, Chevret, S, Lemiale, V, Azoulay, E, Benoit, D, Martins Branco, D, Sousa, M, Marum, S, Bouw, M, Galstyan, G, Makarova, P, Parovichnikova, E, Kuzmina, L, Troitskaya, V, Drize, N, Gemdzhian, E, Savchenko, V, Chao, H, Kılıc, E, Demiriz, B, Uygur, M, Sürücü, M, Cınar, K, Yıldırım, A, Kiss, K, Köves, B, Csernus, V, Molnár, Z, Ntantana, A, Matamis, D, Savvidou, S, Giannakou, M, Gouva, M, Nakos, G, Koulouras, V, Gaffney, S, Judge, C, Drew, T, Misran, H, Munshi, R, Mcgovern, L, Coyle, M, Dunne, L, Deasy, E, Lavin, P, Fahy, A, Darcy, D, Donnelly, M, Ismail, N, Hall, T, Wykes, K, Jack, J, Ngu, W, Morgan, P, Ruiz Ramos, J, Ramirez, P, Gordon, M, Villarreal, E, Frasquet, J, Poveda Andrés, J, Castellanos, A, Ijssennagger, C, Ten Hoorn, S, van Wijk, A, van den Broek, J, Tuinman, P, Elmenshawy, A, Hammond, B, Gibbon, G, Belcham, T, Burton, K, Taniguchi, L, Ramos, F, Momma, A, Martins Filho, A, Bartocci, J, Lopes, M, Sad, M, Rodrigues, C, Pires, E, Barreto, J, Duarte, S, Taba, S, Miglioranza, D, Gund, D, Lordani, C, Capuzzo, M, Corte, F, Terranova, S, Scaramuzzo, G, Fogagnolo, A, Bertacchini, S, Bellonzi, A, Ragazzi, R, Cruz, C, Nunes, A, Pereira, F, Aragão, I, Cardoso, A, Santos, C, Malheiro, M, Castro, H, Cardoso, T, Paratz, J, Kenardy, J, Comans, T, Coyer, F, Thomas, P, Boots, R, Pereira, N, Vilas Boas, A, Gomes, E, Torres, J, Carvalho, D, Molinos, E, Vales, C, Araújo, R, Karnatovskaia, L, Philbrick, K, Ognjen, G, Clark, M, Montero, R, Varas, J, Sánchez Elvira, L, Delgado, C, Díaz, P, Ruiz, B, Guerrero, A, Galache, J, Jiménez, R, Rebollo, S, Alejandro, O, Fernández, A, Moreno, S, Herrera, L, Ojados, A, Galindo, M, Murcia, J, Contreras, M, Sánchez Argente, S, Bonilla, Y, Rodríguez, M, Allegue, J, Cakin, Ö, Parlak, H, Kirca, H, Mutlu, F, Aydınlı, B, Cengiz, M, Ramazanoglu, A, Jung, E, Domenech, J, Montalvo, A, Chornet, T, Martinez, P, Ribas, M, Costa, R, Ortega, A, Forbes, C, Prescott, H, Lal, A, Khan, F, Dela Pena, E, Dizon, J, Wong, C, Garach, M, Romero, O, Puerta, R, Diaz, F, Bailon, A, Pinel, A, Maldonado, L, Kalaiselvan, M, Kumar, R, Renuka, M, De Rosa, S, Ferrari, F, Checcacci, S, Rigobello, A, Joannidis, M, Politi, F, Pellizzari, A, Bonato, R, Fernandez Carmona, A, Macias Guarasa, I, Gutierrez Rodriguez, R, Martinez Lopez, P, Diaz Castellanos, M, Arias Diaz, M, Aguilar Alonso, E, Nikandish, R, Artemenko, V, Budnyuk, A, Bassi, G, Senussi, T, Idone, F, Xiol, E, Travierso, C, Chiurazzi, C, Motos, A, Amaro, R, Hua, Y, Fernández Barat, L, Ranzani, O, Bobi, Q, Rigol, M, Youn, A, Hwang, J, Ossorio, M, Figueira, H, Oliveira, R, Mota, A, Kamp, O, Cruciger, O, Aach, M, Kaczmarek, C, Waydhas, C, Schildhauer, T, Hamsen, U, Camprubí Rimblas, M, Chimenti, L, Guillamat Prats, R, Lebouvier, T, Bringué, J, Tijero, J, Gómez, M, Blanch, L, Tagliabue, G, Ji, M, Jagers, J, Easton, P, Hong, J, Shin, M, Park, M, Pomprapa, A, Hofferberth, M, Russ, M, Braun, W, Walter, M, Francis, R, Lachmann, B, Leonhardt, S, Landaverde López, A, Canedo Castillo, N, Esquivel Chávez, A, Arvizu Tachiquín, P, Baltazar Torres, J, Cardoso, V, Krystopchuk, A, Castro, S, Melão, L, Firmino, S, Marreiros, A, Almaziad, S, Kubbara, A, Barnett, W, Nakity, R, Alamoudi, W, Altook, R, Tarazi, T, Fida, M, Safi, F, Assaly, R, Santini, A, Milesi, M, Maraffi, T, Pugni, P, Cavenago, M, Gattinoni, L, Protti, A, Perchiazzi, G, Borges, J, Bayat, S, Porra, L, Broche, L, Hedenstierna, G, Larsson, A, Roneus, A, Segelsjö, M, Vestito, M, Gremo, E, Nyberg, A, Castegren, M, Pikwer, A, Yoshida, T, Engelberts, D, Otulakowski, G, Katira, B, Post, M, Amato, M, Koch, N, Hoellthaler, J, Mair, S, Phillip, V, Beitz, A, Baladrón, V, Villarejo, P, Steenstra, R, Banierink, H, Hof, J, Hoekstra, M, Sterz, F, Horvatits, K, Herkner, H, Kott, M, Zitta, K, Brandt, B, Schildhauer, C, Elke, G, Hummitzsch, L, Albrecht, M, González, L, Alonso, D, Sánchez, R, Lucas, J, Ferlitsch, A, Fauler, G, Trauner, M, Pischke, S, Fischer, L, Thaiss, F, Koch, M, Bangert, K, Lohse, A, Nashan, B, Sterneck, M, Faenza, S, Siniscalchi, A, Pierucci, E, Mancini, E, Ricci, D, Gemelli, C, Cuoghi, A, Magnani, S, Atti, M, Sotos, F, Cánovas, J, López, A, Burruezo, A, Torres, D, Herrera Gutierrez, M, Barrueco Francioni, J, Arias Verdú, D, Lozano Saez, R, Quesada Garcia, G, Seller Pérez, G, Figueiredo, A, Anzola, Y, Pereira, R, Bento, L, Lai, M, Deiana, M, Seller Perez, G, Vardas, K, Ilia, S, Sertedaki, A, Charmadari, E, Stratakis, C, Briassouli, E, Goukos, D, Psarra, K, Botoula, E, Tsagarakis, S, Mageira, E, Routsi, C, Nanas, S, Campello, E, Radu, C, Su, H, Lam, Y, Willis, K, Pullar, V, Hubner, R, Tsang, J, de Guadiana Romualdo, L, Rebollo Acebes, S, Esteban Torrella, P, Jiménez Sánchez, R, Jiménez Santos, E, Ortín Freire, A, Hernando Holgado, A, Albaladejo Otón, M, Coelho, L, Rabello, L, Póvoa, P, Varis, E, Poukkanen, M, Jacob, S, Takala, J, Wilkman, E, Lundberg, O, Bergenzaun, L, Rydén, J, Rosenqvist, M, Melander, O, Chew, M, Kishihara, Y, Yasuda, H, Jimenez, R, Torrella, P, Fernandez, A, Sanchez, S, Ortin, A, Prats, R, Aguilera, E, Marti, D, Fernandez, L, Ferrer, M, Lanziotti, V, Pulcheri, L, Ribeiro, M, Barbosa, A, E. Silva, J, Soares, M, Marqués, M, Moreno, A, Pizarraya, A, Smani, Y, Connell, M, Zhang, L, Parker, R, Banerjee, I, Clermont, G, Norberg, E, Oras, J, Cuisinier, A, Maufrais, C, Payen, J, Nottin, S, Walther, G, Arib, S, Bilotta, F, Badenes, R, Rubulotta, F, Mirek, S, Monfort, B, Stazi, E, Roig, A, Magnoni, S, Marando, M, Pifferi, S, Conte, V, Ortolano, F, Carbonara, M, Bertani, G, Scola, E, Cadioli, M, Triulzi, F, Colombo, A, Stocchetti, N, Rotzel, H, Lázaro, A, Prada, D, Guimillo, M, Piqueras, C, Guia, J, Simon, M, Arizmendi, A, Carratalá, A, El Maraghi, S, Yehia, A, Bakry, M, Shoman, A, Backes, F, Bianchin, M, Vieira, S, de Souza, A, Backes, A, Klein, C, Arunkumar, A, Lozano, A, Gallaher, C, Cattlin, S, Gordon, S, Picard, J, Fontana, V, Bond, O, Nobile, L, Mrozek, S, Delamarre, L, Capilla, F, Al Saati, T, Fourcade, O, Dominguez Berrot, A, Gonzalez Vaquero, M, Vallejo Pascual, M, Gupta, D, Ivory, B, Chopra, M, Mccarthy, J, Felderhof, C, Macneil, C, Maggiorini, M, Duska, F, Fumis, R, Junior, J, Amarante, G, Skorko, A, Sanders, S, Aron, J, Kroll, R, Redfearn, C, Krishnan, P, Khalil, J, Kongpolprom, N, Gulia, V, Lourenço, E, Duro, C, Baptista, G, Alves, A, Arminda, B, Rodrigues, M, Hayward, J, Baldwin, F, Gray, R, Katinakis, P, Stijf, M, Ten Kleij, M, Jansen Frederiks, M, Broek, R, de Bruijne, M, Spronk, P, Sinha, K, Luney, M, Palmer, K, Keating, L, Abu Habsa, M, Bahl, R, Baskaralingam, N, Ahmad, A, Kanapeckaite, L, Bhatti, P, Glace, S, Jeyabraba, S, Lewis, H, Kostopoulos, A, Raja, M, West, A, Ely, A, Turkoglu, L, Zolfaghari, P, Baptista, J, Marques, M, Martins, P, Pimentel, J, Su, Y, Villacres, S, Stone, M, Parsikia, A, Medar, S, O'Dea, K, Porter, J, Tirlapur, N, Jonathan, J, Singh, S, Takata, M, Mcwhirter, E, Lyon, R, Hariz, M, Azmi, E, Alkhan, J, Movsisyan, V, Petrikov, S, Marutyan, Z, Aliev, I, Evdokimov, A, Antonucci, E, Merz, T, Hartmann, C, Calzia, E, Radermacher, P, Nußbaum, B, Huber Lang, M, Gröger, M, Svoren Jabalera, E, Davenport, E, Humburg, P, Knight, J, Hinds, C, Jun, I, Kim, W, Besch, G, Perrotti, A, Puyraveau, M, Baltres, M, Samain, E, Chocron, S, Pili Floury, S, Plata Menchaca, E, Sabater Riera, J, Estruch, M, Boza, E, Toscana Fernández, J, Bruguera Pellicer, E, Ordoñez Llanos, J, Pérez Fernández, X, Cavaleiro, P, Tralhão, A, Arrigo, M, Lopes, J, Lebrun, M, Cholley, B, Perezvela, J, Marinmateos, H, Rivera, J, Llorente, M, De Marcos, B, Fernandez, F, Laborda, C, Zamora, D, Delgado, J, Imperiali, C, Dastis, M, Górka, J, Górka, K, Iwaniec, T, Frołow, M, Polok, K, Fronczek, J, Kózka, M, Musiał, J, Szczeklik, W, Sileli, M, Moursia, C, Maleoglou, H, Leleki, K, Uz, Z, Ince, Y, Papatella, R, Bulent, E, De Mol, B, Vicka, V, Gineityte, D, Ringaitiene, D, Norkiene, I, Sipylaite, J, Möller, C, Thomas Rueddel, D, Vlasakov, V, Rochwerg, B, Theurer, P, Al Sibai, J, Camblor, P, Fernandez, P, Gala, J, Guisasola, J, Tamura, T, Miyajima, I, Yamashita, K, Yokoyama, M, Dalampini, E, Nastou, M, Baddour, A, Ignatiadis, A, Asteri, T, Hathorn, K, Purtle, S, Viana, M, Tonietto, T, Gross, L, Costa, V, Tavares, A, Lisboa, B, Moraes, R, Viana, L, Azevedo, M, Ceniccola, G, Pequeno, R, Holanda, T, Mendonça, V, Araújo, W, Carvalho, L, Segaran, E, Vickers, L, Brinchmann, K, Wignall, I, De Brito Ashurst, I, Del Olmo, R, Vaquerizo, C, Carreño, R, Gálvez, V, Kaminsky, G, Nieto, B, Fuentes, M, De la Torre, M, Torres, E, Alonso, A, Velayos, C, Saldaña, T, Escribá, A, Grip, J, Kölegård, R, Sundblad, P, Rooyackers, O, Naser, B, Jaziri, F, Jazia, A, Barghouth, M, Hentati, O, Skouri, W, El Euch, M, Mahfoudhi, M, Turki, S, Abdelghni, K, Abdallah, B, Maha, B, Lorente, M, Włudarczyk, A, Hałek, A, Bargouth, M, Bennasr, M, Abdelghani, K, Abdallah, T, Geenen, I, Parienti, J, Shum, H, King, H, Yan, W, Londoño, J, Cardenas, C, Pedrosa, M, Gubianas, C, Bertolin, C, Batllori, N, Sirvent, J, Mukhopadhyay, A, Chan, H, Kowitlawakul, Y, Remani, D, Leong, C, Henry, C, Puthucheary, Z, Mendsaikhan, N, Begzjav, T, Lundeg, G, Dünser, M, Welsh, S, Guerra, E, Zerpa, M, Zechner, F, Berdaguer, F, Risso Vazquez, A, Masevicius, F, Greaney, D, Magee, A, Fitzpatrick, G, Lugo Cob, R, Tejeda Huezo, B, Cano Oviedo, A, Aydogan, M, Togal, T, Taha, A, Chai, H, Kam, C, Razali, S, Sivasamy, V, Kuan, L, Morales, M, Pires, T, Azevedo, L., GIUSSANI, CARLO GIORGIO, SGANZERLA, ERIK PIETRO, CITERIO, GIUSEPPE, Sivakumar, S, Taccone, F, Desai, K, Lazaridis, C, Skarzynski, M, Sekhon, M, Henderson, W, Griesdale, D, Chapple, L, Deane, A, Williams, L, Strickland, R, Lange, K, Heyland, D, Chapman, M, Rowland, M, Garry, P, Westbrook, J, Corkill, R, Antoniades, C, Pattinson, K, Fatania, G, Strong, A, Myers, R, Jermaine, C, Robertson, C, Rusin, C, Hofmeijer, J, Sondag, L, Tjepkema Cloostermans, M, Beishuizen, A, Bosch, F, van Putten, M, Carteron, L, Patet, C, Solari, D, Oddo, M, Ali, M, Dias, C, Almeida, R, Vaz Ferreira, A, Silva, J, Monteiro, E, Cerejo, A, Rocha, A, Elsayed, A, Abougabal, A, Beshey, B, Alzahaby, K, Pozzebon, S, Ortiz, A, Cristallini, S, Lheureux, O, Brasseur, A, Vincent, J, Creteur, J, Hravnak, M, Yousef, K, Chang, Y, Crago, E, Friedlander, R, Abdelmonem, S, Tahon, S, Helmy, T, Meligy, H, Puig, F, Dunn Siegrist, I, Pugin, J, Gupta, S, Govil, D, Srinivasan, S, Patel, S, N, J, Gupta, A, Tomar, D, Shafi, M, Harne, R, Arora, D, Talwar, N, Mazumdar, S, Papakrivou, E, Makris, D, Manoulakas, E, Tsolaki, B, Karadodas, B, Zakynthinos, E, Garcia, I, Martin, A, Encinares, V, Ibañez, M, Montero, J, Labrador, G, Cangueiro, T, Poulose, V, Koh, J, Kam, J, Yeter, H, Kara, A, Aktepe, O, Topeli, A, Tsolakoglou, I, Intas, G, Stergiannis, P, Kolaros, A, Chalari, E, Athanasiadou, E, Martika, A, Fildisis, G, Faivre, V, Mengelle, C, Favier, B, Payen, D, Poppe, A, Winkler, M, Mudersbach, E, Schreiber, J, Wruck, M, Schwedhelm, E, Kluge, S, Zöllner, C, Tavladaki, T, Spanaki, A, Dimitriou, H, Kondili, E, Choulaki, C, Meleti, E, Kafetzopoulos, D, Georgopoulos, D, Briassoulis, G, la Torre, A, de la Torre Prados, M, Tsvetanova Spasova, T, Nuevo Ortega, P, Rueda Molina, C, Fernández Porcel, A, Camara Sola, E, Salido Díaz, L, García Alcántara, A, Meleti, D, Suberviola, B, Riera, J, Rellan, L, Sanchez, M, Robles, J, Lopez, E, Vicente, R, Miñambres, E, Santibañez, M, Le Guen, M, Moore, J, Mason, N, Windpassinger, M, Plattner, O, Mascha, E, Sessler, D, Research, O, Melia, U, Fontanet, J, van den Berg, J, Struys, M, Vereecke, H, Jensen, E, Rood, P, van de Schoor, F, van Tertholen, K, Pickkers, P, van den Boogaard, M, Beardow, Z, Redhead, H, Paramasivam, K, Numan, T, Kamper, A, Peelen, L, Zeman, P, Slooter, A, van Ewijk, C, Jacobs, G, Girbes, A, Myatra, S, Harish, M, Prabu, N, Siddiqui, S, Kulkarni, A, Divatia, J, Murbach, L, Leite, M, Osaku, E, Costa, C, Pelenz, M, Neitzke, N, Moraes, M, Jaskowiak, J, Silva, M, Zaponi, R, Abentroth, L, Ogasawara, S, Jorge, A, Duarte, P, Hernández Sánchez, N, Sánchez Hurtado, L, García Guillen, F, Ñamendys Silva, S, Maghsoudi, B, Emami, M, Khosravi, M, Zand, F, Tabatabaie, H, Masjedi, M, Sabetiyan, G, Mokri, A, Troubleyn, J, Diltoer, M, Jacobs, R, Nguyen, D, De Waele, E, De Regt, J, Honoré, P, Van Gorp, V, Spapen, H, Contreras, R, Toapanta, N, Moreno, G, Sabater, J, Torrado, H, Gonzalez, M, Marin, M, Farigola, E, Gonzalez, A, Fernandez, J, Vera, A, Gisbert, X, Juliá, C, Uya, J, Corral, L, Elias Jones, I, Gemmell, L, Mackay, A, Randall, D, Adwaney, A, Blunden, M, Prowle, J, Kirwan, C, Thomas, N, Owen, H, Darwin, L, Conway, D, Atkinson, D, Sharman, M, Barbanti, C, Amour, J, Gaudard, P, Rozec, B, Mauriat, P, M'Rini, M, Leger, P, Cambonie, G, Liet, J, Girard, C, Laroche, S, Damas, P, Assaf, Z, Loron, G, Lecourt, L, Pouard, P, Kim, S, Na, S, Kim, J, Oh, S, Jung, C, Yoo, S, Min, S, Chung, E, Lee, H, Lee, N, Lee, K, Suh, K, Ryu, H, Marshall, D, Goodson, R, Salciccioli, J, Shalhoub, J, Potter, E, Kirk Bayley, J, Karanjia, N, Forni, L, Creagh Brown, B, Bossy, M, Nyman, M, Tailor, A, D'Antini, D, Spadaro, S, Valentino, F, Sollitto, F, Cinnella, G, Mirabella, L, Calvo, F, Bejarano, N, Padilla, D, Baladron, V, Villajero, P, Villazala, R, Redondo, J, Yuste, A, Liu, J, Shen, F, Teboul, J, Anguel, N, Beurton, A, Bezaz, N, Richard, C, Monnet, X, Fossali, T, Colombo, R, Ottolina, D, Rossetti, M, Mazzucco, C, Marchi, A, Porta, A, Catena, E, Tollisen, K, Andersen, G, Heyerdahl, F, Jacobsen, D, de Waard, M, van IJzendoorn, M, Buter, H, Kingma, W, Navis, G, Boerma, E, Rulisek, J, Balik, M, Zacharov, S, Kim, H, Jeon, S, Namgung, H, Lee, E, Cho, Y, Lee, Y, Huang, A, Cioccari, L, Luethi, N, Mårtensson, J, Bellomo, R, Forsberg, M, Edman, G, Höjer, J, Forsberg, S, Freile, M, Hidalgo, F, Molina, J, Lecumberri, R, Rosselló, A, Travieso, P, Leon, G, Sanchez, J, Frias, L, Rosello, D, Verdejo, J, Serrano, J, Winterwerp, D, van Galen, T, Vazin, A, Karimzade, I, Zand, A, Ozen, E, Ekemen, S, Akcan, A, Sen, E, Yelken, B, Kureshi, N, Fenerty, L, Thibault Halman, G, Erdogan, M, Walling, S, Green, R, Clarke, D, Briassoulis, P, Kalimeris, K, Ntzouvani, A, Nomikos, T, Papaparaskeva, K, Politi, E, Kostopanagiotou, G, Crewdson, K, Rehn, M, Weaver, A, Brohi, K, Lockey, D, Wright, S, Thomas, K, Baker, C, Mansfield, L, Stafford, V, Wade, C, Watson, G, Bryant, A, Chadwick, T, Shen, J, Wilkinson, J, Furneval, J, Henderson, A, Hugill, K, Howard, P, Roy, A, Bonner, S, Baudouin, S, Ramírez, C, Escalada, S, Viera, M, Santana, M, Balcázar, L, Monroy, N, Campelo, F, Vázquez, C, Santana, P, Santana, S, Quintard, H, Bouzat, P, Wollersheim, T, Malleike, J, Haas, K, Carbon, N, Schneider, J, Birchmeier, C, Fielitz, J, Spuler, S, Weber Carstens, S, Enseñat, L, Pérez Madrigal, A, Saludes, P, Proença, L, Gruartmoner, G, Espinal, C, Mesquida, J, Huber, W, Eckmann, M, Elkmann, F, Gruber, A, Lahmer, T, Mayr, U, Herner, A, Schellnegger, R, Schmid, R, Ayoub, W, Samy, W, Esmat, A, Battah, A, Mukhtar, S, Mongkolpun, W, Cortés, D, Cordeiro, C, Funcke, S, Groesdonk, H, Saugel, B, Wagenpfeil, G, Wagenpfeil, S, Reuter, D, Fernandez, M, Fernandez, R, Magret, M, González Castro, A, Bouza, M, García, C, Balerdi, B, Mas, A, Arauzo, V, Añón, J, Ruiz, F, Ferreres, J, Tomás, R, Alabert, M, Tizón, A, Altaba, S, Llamas, N, Goligher, E, Fan, E, Herridge, M, Vorona, S, Sklar, M, Dres, M, Rittayamai, N, Lanys, A, Urrea, C, Tomlinson, G, Reid, W, Rubenfeld, G, Kavanagh, B, Brochard, L, Ferguson, N, Neto, A, de Abreu, M, Pelosi, P, Schultz, M, Guérin, C, Papazian, L, Reignier, J, Ayzac, L, Loundou, A, Forel, J, Rolland Debord, C, Bureau, C, Poitou, T, Clavel, M, Perbet, S, Terzi, N, Kouatchet, A, Similowski, T, Demoule, A, Hunfeld, N, Trogrlic, Z, Ladage, S, Osse, R, Koch, B, Rietdijk, W, Devlin, J, van der Jagt, M, Picetti, E, Ceccarelli, P, Mensi, F, Malchiodi, L, Risolo, S, Rossi, I, Antonini, M, Servadei, F, Caspani, M, Roquilly, A, Lasocki, S, Seguin, P, Geeraerts, T, Perrigault, P, Dahyot Fizelier, C, Paugam Burtz, C, Cook, F, Cinotti, R, Dit Latte, D, Mahe, P, Fortuit, C, Feuillet, F, Asehnoune, K, Marzorati, C, Spina, S, Scaravilli, V, Vargiolu, A, Riva, M, Giussani, C, Sganzerla, E, Citerio, G, Barbadillo, S, de Molina, F, Álvarez Lerma, F, Rodríguez, A, Zakharkina, T, Martin Loeches, I, Matamoros, S, Povoa, P, Torres, A, Kastelijn, J, Hofstra, J, de Jong, M, Sterk, P, Artigas, A, Bos, L, Moreau, A, Salluh, J, Rodriguez, A, Nseir, S, de Jong, E, van Oers, J, Nijsten, M, de Lange, D, Bonvicini, D, Labate, D, Benacchio, L, Olivieri, A, Pizzirani, E, Lopez Delgado, J, Gonzalez Romero, M, Fuentes Mila, V, Berbel Franco, D, Romera Peregrina, I, Martinez Pascual, A, Perez Sanchez, J, Abellan Lencina, R, Ávila Espinoza, R, Moreno Gonzalez, G, Sbraga, F, Griffiths, S, Grocott, M, Doyle, J, Wilkerson, P, Soon, Y, Huddart, S, Dickinson, M, Riga, A, Zuleika, A, Miyamoto, K, Kawazoe, Y, Morimoto, T, Yamamoto, T, Fuke, A, Hashimoto, A, Koami, H, Beppu, S, Katayama, Y, Ito, M, Ohta, Y, Yamamura, H, Rygård, S, Holst, L, Wetterslev, J, Johansson, P, Perner, A, Soliman, I, van Dijk, D, van Delden, J, Cremer, O, Mcwilliams, D, Snelson, C, Neves, A, Loudet, C, Busico, M, Vazquez, D, Villalba, D, Veronesi, M, Lischinsky, A, López, F, Mori, L, Plotnikow, G, Díaz, A, Giannasi, S, Hernandez, R, Krzisnik, L, Cecotti, C, Viola, L, Lopez, R, Sottile, J, Benavent, G, Estenssoro, E, Chen, C, Lai, C, Cheng, K, Chou, W, Chan, K, Roeker, L, Horkan, C, Gibbons, F, Christopher, K, Weijs, P, Mogensen, K, Rawn, J, Robinson, M, Tang, Z, Qiu, C, Ouyang, B, Cai, C, Guan, X, Regueira, T, Cea, L, Carlos, S, Elisa, B, Puebla, C, Vargas, A, Poulsen, M, Thomsen, L, Kjærgaard, S, Rees, S, Karbing, D, Frank, S, Müller, M, Skrypnikov, V, Pickerodt, P, Falk, R, Mahlau, A, Lee, A, Inglis, R, Morgan, R, Barker, G, Kamata, K, Abe, T, Saitoh, D, Tokuda, Y, Butler, M, Hwa, H, Gil, L, Vaquero, R, Rodriguez Ruiz, E, Lago, A, Allut, J, Gestal, A, Thomas Rüddel, D, Schwarzkopf, D, Fleischmann, C, Reinhart, K, Suwanpasu, S, Sattayasomboon, Y, Filho, N, Oliveira, J, Ballalai, C, De Lucia, C, Araponga, G, Veiga, L, Silva, C, Garrido, M, Ramos, B, Ricaldi, E, Gomes, S, Wright, C, Docking, R, Doherty, P, Black, E, Stenhouse, P, Plummer, M, Finnis, M, Phillips, L, Kar, P, Bihari, S, Biradar, V, Moodie, S, Horowitz, M, Shaw, J, Yatabe, T, Inoue, S, Sakaguchi, M, Egi, M, Abdelhamid, Y, Hokka, M, Mizobuchi, S, Giersch, E, Summers, M, Hatzinikolas, S, Heller, S, Jones, K, Schweizer, R, Jacquet Lagreze, M, Portran, P, Junot, S, Allaouchiche, B, Fellahi, J, Guerci, P, Ergin, B, Kapucu, A, Ince, C, Crisman, M, Shinotsuka, C, Fagnoul, D, Orbegozo, D, Preiser, J, Thooft, A, Brimioulle, S, Iwasaka, H, Tahara, S, Nagamine, M, Ichigatani, A, Cabrera, A, Zepeda, E, Granillo, J, Sánchez, J, Montoya, A, Montenegro, A, Blanco, G, Robles, C, Drolz, A, Horvatits, T, Roedl, K, Rutter, K, Funk, G, Schneeweiss, B, Fuhrmann, V, Sabetian, G, Pooresmaeel, F, Ghaffaripour, S, Farbod, A, Tabei, H, Taheri, L, Anandanadesan, R, Metaxa, V, Teixeira, C, Pereira, S, Hernández Marrero, P, Carvalho, A, Beckmann, M, Hartog, C, Raadts, A, Robertsen, A, Førde, R, Skaga, N, Helseth, E, Honeybul, S, Ho, K, Lopez, P, Ortega, P, Sola, E, Spasova, T, Kopecky, O, Rusinova, K, Waldauf, P, Cepeplikova, Z, Domínguez, J, Almudevar, P, Carmona, S, Muñoz, J, Castañeda, D, Abellán, A, Villamizar, P, Ramos, J, Pérez, L, Lucendo, A, Ejarque, M, Estella, A, Camps, V, Martín, M, Masnou, N, Barbosa, S, Varela, A, Palma, I, Cristina, L, Nunes, E, Pereira, I, Campello, G, Granja, C, Pande, R, Pandey, M, Varghese, S, Chanu, M, Van Dam, M, Ter Braak, E, Gracia, M, Viciana, R, Recuerda, M, Fontaiña, L, Tharmalingam, B, Kovari, F, Rose, L, Mcginlay, M, Amin, R, Burns, K, Connolly, B, Hart, N, Jouvet, P, Katz, S, Leasa, D, Mawdsley, C, Mcauley, D, Blackwood, B, Denham, S, Worrall, R, Arshad, M, Isherwood, P, Khadjibaev, A, Sabirov, D, Rosstalnaya, A, Parpibaev, F, Sharipova, V, Guzman, C, Cha, Y, Lee, S, Tyagi, N, Rajput, R, Taneja, S, Singh, V, Sharma, S, Mittal, S, Rao, B, Ayachi, J, Fraj, N, Romdhani, S, Khedher, A, Meddeb, K, Sma, N, Azouzi, A, Bouneb, R, Chouchene, I, El Ghardallou, M, Boussarsar, M, Jennings, R, Walter, E, Ribeiro, J, Moniz, I, Marçal, R, Santos, A, Candeias, C, E. Silva, Z, Gomez, S, Nieto, O, Gonzalez, J, Cuellar, A, Mildh, H, Pettilä, V, Korhonen, A, Karlsson, S, Ala Kokko, T, Reinikainen, M, Vaara, S, Zaleska Kociecka, M, Grabowski, M, Dąbrowski, M, Wozniak, S, Piotrowska, K, Banaszewski, M, Imiela, J, Stepinska, J, Pérez, A, Ordoñez, P, Giribet, A, Cuervo, M, Cuervo, R, Esteban, M, Fraile, L, Mittelbrum, C, Albaiceta, G, Koeze, J, Keus, F, Dieperink, W, van der Horst, I, van Meurs, M, Zijlstra, J, Roberts, S, Caballero, C, Isgro, G, Hall, D, Beitland, S, Trøseid, A, Brusletto, B, Waldum Grevbo, B, Berg, J, Sunde, K, Huertas, D, Manzano, F, Quintana, M, Osuna, A, Santiago Ruiz, F, Rodríguez Mejías, C, Wangensteen, R, Jamaati, H, Hashemian, S, Abbasi, G, Khaloo, V, Tabei, S, Kafilzadeh, A, Bakhodaei, H, Diaz, J, Silva, R, Garcia, D, Luis, E, Gomez, M, Soriano, R, Gonzalez, P, Ibrahim, I, Rafik, M, Al Ansary, A, Algendi, M, Ali, A, Benten, D, Kluwe, J, Siedler, S, Adedugbe, I, Bird, G, Kennedy, R, Yugi, G, Haroon, B, Witter, T, Khaliq, W, Singer, M, Havaldar, A, Krishna, B, Sriram, S, Espinoza, E, Pozo, M, Edul, V, Furche, M, Motta, M, Vazquez, A, Birri, P, Dubin, A, Dogliotti, A, Ramos, A, Lovesio, C, Delile, E, Nevière, R, Thiébaut, P, Maupoint, J, Mulder, P, Coquerel, D, Renet, S, do Rego, J, Rieusset, J, Richard, V, Tamion, F, Andreis, D, Smit, B, Smulders, Y, van Straaten, H, Eringa, E, Man, A, Alegría, L, Soto, D, Luengo, C, Gomez, J, Jarufe, N, Bruhn, A, Castro, R, Kattan, E, Tapia, P, Rebolledo, R, Achurra, P, Ospina Tascón, G, Bakker, J, Hernández, G, Bertini, P, Guarracino, F, Baldassarri, R, Pinsky, M, Vera, M, Dreyse, J, Carpio, D, Henriquez, C, Gajardo, D, Bravo, S, Lee, M, Park, S, So, S, Kačar, M, Kačar, S, Uddin, I, Belhaj, A, Aydın, M, Avsec, D, Kapuağası, A, Kaymak, Ç, Kovach, L, Şencan, I, Meço, B, Özçelik, M, Ünal, N, Jenni Moser, B, Jeitziner, M, Galassi, M, Sales, F, de Moraes, K, Batista, C, Júnior, J, Marcari, T, Lobato, R, Castro, C, de Souza, L, Rodrigues, F, Correa, N, Pelegrini, A, Eid, R, Timenetsky, K, Cazati, D, Lobato, M, Diniz, P, Rocha, L, Cavalheiro, A, Lucinio, N, Santos, E, Norrenberg, M, Gleize, A, Simón, I, Valhonrat, I, Almudévar, P, Dávila, F, Rubio, J, Reina, Á, López, N, Pérez, M, Apolo, D, Villén, L, García, I, Izurieta, J, Guerrero, J, Calvert, S, Quint, M, Adeniji, K, Young, R, Shevill, D, Robertson, E, Garside, P, Isotti, P, De Vecchi, M, Perduca, A, Negro, A, Villa, G, Manara, D, Cabrini, L, Zangrillo, A, Frencken, J, van Baal, L, Donker, D, Horn, J, van der Poll, T, van Klei, W, Bonten, M, Menard, C, Kumar, A, Rimmer, E, Doucette, S, Turgeon, A, Houston, B, Houston, D, Zarychanski, R, Pinto, B, Carrara, M, Ferrario, M, Bendjelid, K, Nunes, J, Diaz, P, Silva, G, Escórcio, S, Chaves, S, Jardim, M, Fernandes, N, Câmara, M, Duarte, R, Pereira, C, Vieira, J, Nóbrega, J, de Oca Sandoval, M, Sánchez Rodríguez, A, Joya Galeana, J, Correa Morales, A, Camarena Alejo, G, Aguirre Sánchez, J, Franco Granillo, J, Soliman, M, Al Azab, A, El Hossainy, R, Nagy, H, Nirmalan, M, Crippa, I, Cavicchi, F, Chaari, A, Hakim, K, Hassanein, H, Etman, M, El Bahr, M, Bousselmi, K, Khalil, E, Kauts, V, Casey, W, Imahase, H, Sakamoto, Y, Yamada, K, Miike, T, Nagashima, F, Iwamura, T, Boscolo, A, Lucchetta, V, Piasentini, E, Bertini, D, Manesso, L, Spiezia, L, Simioni, P, Ori, C, Souza, R, Martins, A, Liberatore, A, Kang, Y, Nakamae, M, Koh, I, Hanslin, K, Wilske, F, Skorup, P, Sjölin, J, Lipcsey, M, Long, W, Zhen, C, Vakalos, A, Avramidis, V, Wu, S, Shyu, L, Li, C, Yu, C, Chen, H, Wang, C, Lin, K, Aray, Z, Gómez, C, Tejero, A, Monge, D, Losada, V, Tarancón, C, Cortés, S, Gutiérrez, A, Álvarez, T, Rouze, A, Jaffal, K, Six, S, Stolz, K, Cattoen, V, Arnal, J, Saoli, M, Novotni, D, Garnero, A, Becher, T, Buchholz, V, Schädler, D, Frerichs, I, Weiler, N, Eronia, N, Mauri, T, Gatti, S, Maffezzini, E, Bronco, A, Alban, L, Sasso, T, Marenghi, C, Grasselli, G, Pesenti, A, Bellani, G, Al Fares, A, Del Sorbo, L, Anwar, S, Facchin, F, Azad, S, Zamel, R, Cypel, M, Keshavjee, S, Durlinger, E, Spoelstra de Man, A, de Grooth, H, Straaten, H, Alfaro, M, Parrilla, F, Meli, A, Pellegrini, M, Rodriguez, N, Goyeneche, J, Morán, I, Aguirre, H, Mancebo, J, Heines, S, Strauch, U, Bergmans, D, Blankman, P, Shono, A, Hasan, D, Gommers, D, Chung, W, Jung, Y, Park, J, Sheen, S, Park, K, Worral, R, Larraza, S, Dey, N, Brohus, J, Winding, R, Volta, C, Ampatzidou, F, Vlachou, A, Kehagioglou, G, Karaiskos, T, Madesis, A, Mauromanolis, C, Michail, N, Drossos, G, Saraj, N, Rijkenberg, S, Feijen, H, Endeman, H, Donnelly, A, Morgan, E, Garrard, H, Buckley, H, Russell, L, Haase, N, Goh, C, Mouyis, K, Woodward, C, Halliday, J, Encina, G, Ros, J, Lagunes, L, Tabernero, J, Rello, J, Morente Constantin, E, Rivera Ginés, B, Colmenero Ruiz, M, Sanz, J, Simon, I, Valbuena, B, Pais, M, Ramalingam, S, Díaz, C, Fox, L, Santafe, M, Barba, P, García, M, Leal, S, Veganzones, J, Martínez, N, Moors, I, Mokart, D, Pène, F, Lambert, J, Mayaux, J, Vincent, F, Nyunga, M, Bruneel, F, Laisne, L, Rabbat, A, Lebert, C, Perez, P, Chaize, M, Renault, A, Meert, A, Hamidfar, R, Jourdain, M, Darmon, M, Schlemmer, B, Chevret, S, Lemiale, V, Azoulay, E, Benoit, D, Martins Branco, D, Sousa, M, Marum, S, Bouw, M, Galstyan, G, Makarova, P, Parovichnikova, E, Kuzmina, L, Troitskaya, V, Drize, N, Gemdzhian, E, Savchenko, V, Chao, H, Kılıc, E, Demiriz, B, Uygur, M, Sürücü, M, Cınar, K, Yıldırım, A, Kiss, K, Köves, B, Csernus, V, Molnár, Z, Ntantana, A, Matamis, D, Savvidou, S, Giannakou, M, Gouva, M, Nakos, G, Koulouras, V, Gaffney, S, Judge, C, Drew, T, Misran, H, Munshi, R, Mcgovern, L, Coyle, M, Dunne, L, Deasy, E, Lavin, P, Fahy, A, Darcy, D, Donnelly, M, Ismail, N, Hall, T, Wykes, K, Jack, J, Ngu, W, Morgan, P, Ruiz Ramos, J, Ramirez, P, Gordon, M, Villarreal, E, Frasquet, J, Poveda Andrés, J, Castellanos, A, Ijssennagger, C, Ten Hoorn, S, van Wijk, A, van den Broek, J, Tuinman, P, Elmenshawy, A, Hammond, B, Gibbon, G, Belcham, T, Burton, K, Taniguchi, L, Ramos, F, Momma, A, Martins Filho, A, Bartocci, J, Lopes, M, Sad, M, Rodrigues, C, Pires, E, Barreto, J, Duarte, S, Taba, S, Miglioranza, D, Gund, D, Lordani, C, Capuzzo, M, Corte, F, Terranova, S, Scaramuzzo, G, Fogagnolo, A, Bertacchini, S, Bellonzi, A, Ragazzi, R, Cruz, C, Nunes, A, Pereira, F, Aragão, I, Cardoso, A, Santos, C, Malheiro, M, Castro, H, Cardoso, T, Paratz, J, Kenardy, J, Comans, T, Coyer, F, Thomas, P, Boots, R, Pereira, N, Vilas Boas, A, Gomes, E, Torres, J, Carvalho, D, Molinos, E, Vales, C, Araújo, R, Karnatovskaia, L, Philbrick, K, Ognjen, G, Clark, M, Montero, R, Varas, J, Sánchez Elvira, L, Delgado, C, Díaz, P, Ruiz, B, Guerrero, A, Galache, J, Jiménez, R, Rebollo, S, Alejandro, O, Fernández, A, Moreno, S, Herrera, L, Ojados, A, Galindo, M, Murcia, J, Contreras, M, Sánchez Argente, S, Bonilla, Y, Rodríguez, M, Allegue, J, Cakin, Ö, Parlak, H, Kirca, H, Mutlu, F, Aydınlı, B, Cengiz, M, Ramazanoglu, A, Jung, E, Domenech, J, Montalvo, A, Chornet, T, Martinez, P, Ribas, M, Costa, R, Ortega, A, Forbes, C, Prescott, H, Lal, A, Khan, F, Dela Pena, E, Dizon, J, Wong, C, Garach, M, Romero, O, Puerta, R, Diaz, F, Bailon, A, Pinel, A, Maldonado, L, Kalaiselvan, M, Kumar, R, Renuka, M, De Rosa, S, Ferrari, F, Checcacci, S, Rigobello, A, Joannidis, M, Politi, F, Pellizzari, A, Bonato, R, Fernandez Carmona, A, Macias Guarasa, I, Gutierrez Rodriguez, R, Martinez Lopez, P, Diaz Castellanos, M, Arias Diaz, M, Aguilar Alonso, E, Nikandish, R, Artemenko, V, Budnyuk, A, Bassi, G, Senussi, T, Idone, F, Xiol, E, Travierso, C, Chiurazzi, C, Motos, A, Amaro, R, Hua, Y, Fernández Barat, L, Ranzani, O, Bobi, Q, Rigol, M, Youn, A, Hwang, J, Ossorio, M, Figueira, H, Oliveira, R, Mota, A, Kamp, O, Cruciger, O, Aach, M, Kaczmarek, C, Waydhas, C, Schildhauer, T, Hamsen, U, Camprubí Rimblas, M, Chimenti, L, Guillamat Prats, R, Lebouvier, T, Bringué, J, Tijero, J, Gómez, M, Blanch, L, Tagliabue, G, Ji, M, Jagers, J, Easton, P, Hong, J, Shin, M, Park, M, Pomprapa, A, Hofferberth, M, Russ, M, Braun, W, Walter, M, Francis, R, Lachmann, B, Leonhardt, S, Landaverde López, A, Canedo Castillo, N, Esquivel Chávez, A, Arvizu Tachiquín, P, Baltazar Torres, J, Cardoso, V, Krystopchuk, A, Castro, S, Melão, L, Firmino, S, Marreiros, A, Almaziad, S, Kubbara, A, Barnett, W, Nakity, R, Alamoudi, W, Altook, R, Tarazi, T, Fida, M, Safi, F, Assaly, R, Santini, A, Milesi, M, Maraffi, T, Pugni, P, Cavenago, M, Gattinoni, L, Protti, A, Perchiazzi, G, Borges, J, Bayat, S, Porra, L, Broche, L, Hedenstierna, G, Larsson, A, Roneus, A, Segelsjö, M, Vestito, M, Gremo, E, Nyberg, A, Castegren, M, Pikwer, A, Yoshida, T, Engelberts, D, Otulakowski, G, Katira, B, Post, M, Amato, M, Koch, N, Hoellthaler, J, Mair, S, Phillip, V, Beitz, A, Baladrón, V, Villarejo, P, Steenstra, R, Banierink, H, Hof, J, Hoekstra, M, Sterz, F, Horvatits, K, Herkner, H, Kott, M, Zitta, K, Brandt, B, Schildhauer, C, Elke, G, Hummitzsch, L, Albrecht, M, González, L, Alonso, D, Sánchez, R, Lucas, J, Ferlitsch, A, Fauler, G, Trauner, M, Pischke, S, Fischer, L, Thaiss, F, Koch, M, Bangert, K, Lohse, A, Nashan, B, Sterneck, M, Faenza, S, Siniscalchi, A, Pierucci, E, Mancini, E, Ricci, D, Gemelli, C, Cuoghi, A, Magnani, S, Atti, M, Sotos, F, Cánovas, J, López, A, Burruezo, A, Torres, D, Herrera Gutierrez, M, Barrueco Francioni, J, Arias Verdú, D, Lozano Saez, R, Quesada Garcia, G, Seller Pérez, G, Figueiredo, A, Anzola, Y, Pereira, R, Bento, L, Lai, M, Deiana, M, Seller Perez, G, Vardas, K, Ilia, S, Sertedaki, A, Charmadari, E, Stratakis, C, Briassouli, E, Goukos, D, Psarra, K, Botoula, E, Tsagarakis, S, Mageira, E, Routsi, C, Nanas, S, Campello, E, Radu, C, Su, H, Lam, Y, Willis, K, Pullar, V, Hubner, R, Tsang, J, de Guadiana Romualdo, L, Rebollo Acebes, S, Esteban Torrella, P, Jiménez Sánchez, R, Jiménez Santos, E, Ortín Freire, A, Hernando Holgado, A, Albaladejo Otón, M, Coelho, L, Rabello, L, Póvoa, P, Varis, E, Poukkanen, M, Jacob, S, Takala, J, Wilkman, E, Lundberg, O, Bergenzaun, L, Rydén, J, Rosenqvist, M, Melander, O, Chew, M, Kishihara, Y, Yasuda, H, Jimenez, R, Torrella, P, Fernandez, A, Sanchez, S, Ortin, A, Prats, R, Aguilera, E, Marti, D, Fernandez, L, Ferrer, M, Lanziotti, V, Pulcheri, L, Ribeiro, M, Barbosa, A, E. Silva, J, Soares, M, Marqués, M, Moreno, A, Pizarraya, A, Smani, Y, Connell, M, Zhang, L, Parker, R, Banerjee, I, Clermont, G, Norberg, E, Oras, J, Cuisinier, A, Maufrais, C, Payen, J, Nottin, S, Walther, G, Arib, S, Bilotta, F, Badenes, R, Rubulotta, F, Mirek, S, Monfort, B, Stazi, E, Roig, A, Magnoni, S, Marando, M, Pifferi, S, Conte, V, Ortolano, F, Carbonara, M, Bertani, G, Scola, E, Cadioli, M, Triulzi, F, Colombo, A, Stocchetti, N, Rotzel, H, Lázaro, A, Prada, D, Guimillo, M, Piqueras, C, Guia, J, Simon, M, Arizmendi, A, Carratalá, A, El Maraghi, S, Yehia, A, Bakry, M, Shoman, A, Backes, F, Bianchin, M, Vieira, S, de Souza, A, Backes, A, Klein, C, Arunkumar, A, Lozano, A, Gallaher, C, Cattlin, S, Gordon, S, Picard, J, Fontana, V, Bond, O, Nobile, L, Mrozek, S, Delamarre, L, Capilla, F, Al Saati, T, Fourcade, O, Dominguez Berrot, A, Gonzalez Vaquero, M, Vallejo Pascual, M, Gupta, D, Ivory, B, Chopra, M, Mccarthy, J, Felderhof, C, Macneil, C, Maggiorini, M, Duska, F, Fumis, R, Junior, J, Amarante, G, Skorko, A, Sanders, S, Aron, J, Kroll, R, Redfearn, C, Krishnan, P, Khalil, J, Kongpolprom, N, Gulia, V, Lourenço, E, Duro, C, Baptista, G, Alves, A, Arminda, B, Rodrigues, M, Hayward, J, Baldwin, F, Gray, R, Katinakis, P, Stijf, M, Ten Kleij, M, Jansen Frederiks, M, Broek, R, de Bruijne, M, Spronk, P, Sinha, K, Luney, M, Palmer, K, Keating, L, Abu Habsa, M, Bahl, R, Baskaralingam, N, Ahmad, A, Kanapeckaite, L, Bhatti, P, Glace, S, Jeyabraba, S, Lewis, H, Kostopoulos, A, Raja, M, West, A, Ely, A, Turkoglu, L, Zolfaghari, P, Baptista, J, Marques, M, Martins, P, Pimentel, J, Su, Y, Villacres, S, Stone, M, Parsikia, A, Medar, S, O'Dea, K, Porter, J, Tirlapur, N, Jonathan, J, Singh, S, Takata, M, Mcwhirter, E, Lyon, R, Hariz, M, Azmi, E, Alkhan, J, Movsisyan, V, Petrikov, S, Marutyan, Z, Aliev, I, Evdokimov, A, Antonucci, E, Merz, T, Hartmann, C, Calzia, E, Radermacher, P, Nußbaum, B, Huber Lang, M, Gröger, M, Svoren Jabalera, E, Davenport, E, Humburg, P, Knight, J, Hinds, C, Jun, I, Kim, W, Besch, G, Perrotti, A, Puyraveau, M, Baltres, M, Samain, E, Chocron, S, Pili Floury, S, Plata Menchaca, E, Sabater Riera, J, Estruch, M, Boza, E, Toscana Fernández, J, Bruguera Pellicer, E, Ordoñez Llanos, J, Pérez Fernández, X, Cavaleiro, P, Tralhão, A, Arrigo, M, Lopes, J, Lebrun, M, Cholley, B, Perezvela, J, Marinmateos, H, Rivera, J, Llorente, M, De Marcos, B, Fernandez, F, Laborda, C, Zamora, D, Delgado, J, Imperiali, C, Dastis, M, Górka, J, Górka, K, Iwaniec, T, Frołow, M, Polok, K, Fronczek, J, Kózka, M, Musiał, J, Szczeklik, W, Sileli, M, Moursia, C, Maleoglou, H, Leleki, K, Uz, Z, Ince, Y, Papatella, R, Bulent, E, De Mol, B, Vicka, V, Gineityte, D, Ringaitiene, D, Norkiene, I, Sipylaite, J, Möller, C, Thomas Rueddel, D, Vlasakov, V, Rochwerg, B, Theurer, P, Al Sibai, J, Camblor, P, Fernandez, P, Gala, J, Guisasola, J, Tamura, T, Miyajima, I, Yamashita, K, Yokoyama, M, Dalampini, E, Nastou, M, Baddour, A, Ignatiadis, A, Asteri, T, Hathorn, K, Purtle, S, Viana, M, Tonietto, T, Gross, L, Costa, V, Tavares, A, Lisboa, B, Moraes, R, Viana, L, Azevedo, M, Ceniccola, G, Pequeno, R, Holanda, T, Mendonça, V, Araújo, W, Carvalho, L, Segaran, E, Vickers, L, Brinchmann, K, Wignall, I, De Brito Ashurst, I, Del Olmo, R, Vaquerizo, C, Carreño, R, Gálvez, V, Kaminsky, G, Nieto, B, Fuentes, M, De la Torre, M, Torres, E, Alonso, A, Velayos, C, Saldaña, T, Escribá, A, Grip, J, Kölegård, R, Sundblad, P, Rooyackers, O, Naser, B, Jaziri, F, Jazia, A, Barghouth, M, Hentati, O, Skouri, W, El Euch, M, Mahfoudhi, M, Turki, S, Abdelghni, K, Abdallah, B, Maha, B, Lorente, M, Włudarczyk, A, Hałek, A, Bargouth, M, Bennasr, M, Abdelghani, K, Abdallah, T, Geenen, I, Parienti, J, Shum, H, King, H, Yan, W, Londoño, J, Cardenas, C, Pedrosa, M, Gubianas, C, Bertolin, C, Batllori, N, Sirvent, J, Mukhopadhyay, A, Chan, H, Kowitlawakul, Y, Remani, D, Leong, C, Henry, C, Puthucheary, Z, Mendsaikhan, N, Begzjav, T, Lundeg, G, Dünser, M, Welsh, S, Guerra, E, Zerpa, M, Zechner, F, Berdaguer, F, Risso Vazquez, A, Masevicius, F, Greaney, D, Magee, A, Fitzpatrick, G, Lugo Cob, R, Tejeda Huezo, B, Cano Oviedo, A, Aydogan, M, Togal, T, Taha, A, Chai, H, Kam, C, Razali, S, Sivasamy, V, Kuan, L, Morales, M, Pires, T, and Azevedo, L
Subjects: intracerebral haemorrhage in intensive care
Published: 2016

93. Detecting Cortical Spreading Depolarization with Full Band Scalp Electroencephalography: An Illusion?

Author: Hofmeijer, J., Kaam, C.R. van, Werff, B. van de, Vermeer, S.E., Tjepkema-Cloostermans, M.C., Putten, M.J.A.M. van, Hofmeijer, J., Kaam, C.R. van, Werff, B. van de, Vermeer, S.E., Tjepkema-Cloostermans, M.C., and Putten, M.J.A.M. van
Abstract: Contains fulltext : 196371.pdf (publisher's version ) (Open Access), Introduction: There is strong evidence suggesting detrimental effects of cortical spreading depolarization (CSD) in patients with acute ischemic stroke and severe traumatic brain injury. Previous studies implicated scalp electroencephalography (EEG) features to be correlates of CSD based on retrospective analysis of EEG epochs after having detected "CSD" in time aligned electrocorticography. We studied the feasibility of CSD detection in a prospective cohort study with continuous EEG in 18 patients with acute ischemic stroke and 18 with acute severe traumatic brain injury. Methods: Full band EEG with 21 silver/silver chloride electrodes was started within 48 h since symptom onset. Five additional electrodes were used above the infarct. We visually analyzed all raw EEG data in epochs of 1 h. Inspection was directed at detection of the typical combination of CSD characteristics, i.e., (i) a large slow potential change (SPC) accompanied by a simultaneous amplitude depression of >1Hz activity, (ii) focal presentation, and (iii) spread reflected as appearance on neighboring electrodes with a delay. Results: In 3,035 one-hour EEG epochs, infraslow activity (ISA) was present in half to three quarters of the registration time. Typically, activity was intermittent with amplitudes of 40-220 microV, approximately half was oscillatory. There was no specific spatial distribution. Relevant changes of ISA were always visible in multiple electrodes, and not focal, as expected in CSD. ISA appearing as "SPC" was mostly associated with an amplitude increase of faster activities, and never with suppression. In all patients, depressions of spontaneous brain activity occurred. However, these were not accompanied by simultaneous SPC, occurred simultaneously on all channels, and were not focal, let alone spread, as expected in CSD. Conclusion: With full band scalp EEG in patients with cortical ischemic stroke or traumatic brain injury, we observed various ISA, probably modulating cortical
Published: 2018

94. Risk factors for atherosclerotic and medial arterial calcification of the intracranial internal carotid artery

Author: AvL-U, Circulatory Health, Onderzoek Beeld, Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Radiologie, Researchgr. Hart-brein as., Brain, Cancer, Researchgr. Systems Radiology, Infection & Immunity, Public Health Practice, Externen Hematologie, Affectieve & Psychotische Med., Pathologie Pathologen staf, Arts-Assistenten Onderwijs Radiologie, ZL Algemene Neurologie Medisch, ZL Cerebrovasculaire Ziekten Medisch, Opleiding Neurologie, Vos, Annelotte, Kockelkoren, Remko, de Vis, Jill B., van der Schouw, Yvonne T., van der Schaaf, I. C., Velthuis, B. K., Mali, W. P., de Jong, Pim A., Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Droogh-de Greve, K. E., Bienfait, H. P., van Walderveen, M. A., Wermer, M. J.H., Lycklama à Nijeholt, G. J., Boiten, J., Duyndam, D., Kwa, V. I., Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., Schonewille, W. J., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Visser, M. C., Dankbaar, J. W., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Kappelle, L. J., Luitse, M. J., van der Graaf, Y., the DUST study group, AvL-U, Circulatory Health, Onderzoek Beeld, Cardiovasculaire Epidemiologie, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, MS Radiologie, Researchgr. Hart-brein as., Brain, Cancer, Researchgr. Systems Radiology, Infection & Immunity, Public Health Practice, Externen Hematologie, Affectieve & Psychotische Med., Pathologie Pathologen staf, Arts-Assistenten Onderwijs Radiologie, ZL Algemene Neurologie Medisch, ZL Cerebrovasculaire Ziekten Medisch, Opleiding Neurologie, Vos, Annelotte, Kockelkoren, Remko, de Vis, Jill B., van der Schouw, Yvonne T., van der Schaaf, I. C., Velthuis, B. K., Mali, W. P., de Jong, Pim A., Majoie, C. B., Roos, Y. B., Duijm, L. E., Keizer, K., van der Lugt, A., Dippel, D. W., Droogh-de Greve, K. E., Bienfait, H. P., van Walderveen, M. A., Wermer, M. J.H., Lycklama à Nijeholt, G. J., Boiten, J., Duyndam, D., Kwa, V. I., Meijer, F. J., van Dijk, E. J., Kesselring, F. O., Hofmeijer, J., Vos, J. A., Schonewille, W. J., van Rooij, W. J., de Kort, P. L., Pleiter, C. C., Bakker, S. L., Bot, J., Visser, M. C., Dankbaar, J. W., van Seeters, T., Horsch, A. D., Niesten, J. M., Biessels, G. J., Kappelle, L. J., Luitse, M. J., van der Graaf, Y., and the DUST study group
Published: 2018

95. Predicting the presence of macrovascular causes in non-traumatic intracerebral haemorrhage: the DIAGRAM prediction score

Author: Hilkens, Nina A., van Asch, Charlotte J. J., Werring, David J., Wilson, Duncan, Rinkel, Gabriël J. E., Algra, Ale, Velthuis, Birgitta K., de Kort, G. rard A. P., Witkamp, Theo D., van Nieuwenhuizen, Koen M., de Leeuw, Frank-Erik, Schonewille, Wouter J., de Kort, Paul L. M., Dippel, Diederik W. J., Raaymakers, Theodora W. M., Hofmeijer, Jeannette, Wermer, Marieke J. H., Kerkhoff, Henk, Jellema, Korné, Bronner, Irene M., Remmers, Michel J. M., Bienfait, Henri Paul, Witjes, Ron J. G. M., Jäger, H. Rolf, Greving, Jacoba P., Klijn, Catharina J. M., Boogaarts, H. B., van Dijk, E. J., Schonewille, W. J., Pellikaan, W. M. J., Puppels-de Waard, C., de Kort, P. L. M., Peluso, J. P., van Tuijl, J. H., Hofmeijer, J., Joosten, F. B. M., Dippel, D. W., Khajeh, L., Raaijmakers, T. W. M., Wermer, M. J., van Walderveen, M. A., Kerkhoff, H., Zock, E., Jellema, K., Lycklama, G. J., Bronner, I. M., Remmers, M. J. M., Witjes, R. J. G. M., Bienfait, H. P., Droogh-Greve, K. E., Donders, R. C. J. M., Kwa, V. I. H., Schreuder, T. H., Franke, C. L., Straver, J. S., Jansen, C., Bakker, S. L. M., Pleiter, C. C., Visser, M. C., van Asch, C. J. J., Velthuis, B. K., Rinkel, G. J. E., van Nieuwenhuizen, K. M., Klijn, C. J. M., Neurology, and Amsterdam Neuroscience - Neurovascular Disorders
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Computed Tomography Angiography, Clinical Neurology, Logistic regression, Magnetic resonance angiography, 03 medical and health sciences, Young Adult, 0302 clinical medicine, All institutes and research themes of the Radboud University Medical Center, Predictive Value of Tests, Risk Factors, Internal medicine, Non traumatic, medicine, Humans, 030212 general & internal medicine, cardiovascular diseases, Prospective Studies, Aged, Cerebral Hemorrhage, Netherlands, Central Nervous System Vascular Malformations, Prediction score, medicine.diagnostic_test, business.industry, Arteriovenous malformation, Digital subtraction angiography, Middle Aged, medicine.disease, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], nervous system diseases, Cerebral Angiography, Psychiatry and Mental health, Logistic Models, Cohort, Angiography, Cardiology, Surgery, Female, Neurology (clinical), business, 030217 neurology & neurosurgery, Magnetic Resonance Angiography
Abstract: ObjectiveA substantial part of non-traumatic intracerebral haemorrhages (ICH) arises from a macrovascular cause, but there is little guidance on selection of patients for additional diagnostic work-up. We aimed to develop and externally validate a model for predicting the probability of a macrovascular cause in patients with non-traumatic ICH.MethodsThe DIagnostic AngioGRAphy to find vascular Malformations (DIAGRAM) study (n=298; 69 macrovascular cause; 23%) is a prospective, multicentre study assessing yield and accuracy of CT angiography (CTA), MRI/ magnetic resonance angiography (MRA) and intra-arterial catheter angiography in diagnosing macrovascular causes in patients with non-traumatic ICH. We considered prespecified patient and ICH characteristics in multivariable logistic regression analyses as predictors for a macrovascular cause. We combined independent predictors in a model, which we validated in an external cohort of 173 patients with ICH (78 macrovascular cause, 45%).ResultsIndependent predictors were younger age, lobar or posterior fossa (vs deep) location of ICH, and absence of small vessel disease (SVD). A model that combined these predictors showed good performance in the development data (c-statistic 0.83; 95% CI 0.78 to 0.88) and moderate performance in external validation (c-statistic 0.66; 95% CI 0.58 to 0.74). When CTA results were added, the c-statistic was excellent (0.91; 95% CI 0.88 to 0.94) and good after external validation (0.88; 95% CI 0.83 to 0.94). Predicted probabilities varied from 1% in patients aged 51–70 years with deep ICH and SVD, to more than 50% in patients aged 18–50 years with lobar or posterior fossa ICH without SVD.ConclusionThe DIAGRAM scores help to predict the probability of a macrovascular cause in patients with non-traumatic ICH based on age, ICH location, SVD and CTA.
Published: 2017

96. Temporal profile of body temperature in acute ischemic stroke: Relation to infarct size and outcome

Author: Geurts, Marjolein, Scheijmans, Féline E.V., van Seeters, Tom, Biessels, Geert Jan, Kappelle, L. Jaap, Velthuis, Birgitta K., van der Worp, H. Bart, Majoie, C.B., Roos, Y.B., Duijm, L.E., Keizer, K., van der Lugt, A., Dippel, D.W., Greve, Droogh de, Bienfait, H.P., van Walderveen, Marianne A. A., Wermer, M.J., Lycklama à Nijeholt, G. J., Boiten, J., Duyndam, D.A., Kwa, V.I.H., Meijer, Frederick J. A., van Dijk, E. J., Kesselring, F.O., Hofmeijer, J., Vos, J. A., Schonewille, Wouter J., van Rooij, W.J.J., de Kort, P.L., Pleiter, C. Constantijn, Bakker, S. L., Bot, J., Visser, M. C., van der Schaaf, Irene C., Dankbaar, J.W., Mali, W.P., van Seeters, T., Horsch, Alexander D., Niesten, Joris M., Biessels, G.J., Luitse, M.J., van der Graaf, Y., Radiology and Nuclear Medicine, ANS - Neurovascular Disorders, ACS - Microcirculation, Neurology, ACS - Atherosclerosis & ischemic syndromes, Public and occupational health, Molecular cell biology and Immunology, Radiology and nuclear medicine, and Pathology
Subjects: Male, medicine.medical_specialty, Time Factors, Neurology, Clinical Neurology, Hypothermia, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Hypothermia, Induced, Modified Rankin Scale, Journal Article, medicine, Humans, Body temperature, cardiovascular diseases, Stroke, Aged, medicine.diagnostic_test, business.industry, Cerebral infarction, Magnetic resonance imaging, Recovery of Function, General Medicine, Prognosis, medicine.disease, Magnetic Resonance Imaging, Confidence interval, Relative risk, Anesthesia, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, Research Article
Abstract: Background: High body temperatures after ischemic stroke have been associated with larger infarct size, but the temporal profile of this relation is unknown. We assess the relation between temporal profile of body temperature and infarct size and functional outcome in patients with acute ischemic stroke. Methods: In 419 patients with acute ischemic stroke we assessed the relation between body temperature on admission and during the first 3 days with both infarct size and functional outcome. Infarct size was measured in milliliters on CT or MRI after 3 days. Poor functional outcome was defined as a modified Rankin Scale score ≥3 at 3 months. Results: Body temperature on admission was not associated with infarct size or poor outcome in adjusted analyses. By contrast, each additional 1.0 °C in body temperature on day 1 was associated with 0.31 ml larger infarct size (95% confidence interval (CI) 0.04-0.59), on day 2 with 1.13 ml larger infarct size(95% CI, 0.83-1.43), and on day 3 with 0.80 ml larger infarct size (95% CI, 0.48-1.12), in adjusted linear regression analyses. Higher peak body temperatures on days two and three were also associated with poor outcome (adjusted relative risks per additional 1.0 °C in body temperature, 1.52 (95% CI, 1.17-1.99) and 1.47 (95% CI, 1.22-1.77), respectively). Conclusions: Higher peak body temperatures during the first days after ischemic stroke, rather than on admission, are associated with larger infarct size and poor functional outcome. This suggests that prevention of high temperatures may improve outcome if continued for at least 3 days.
Published: 2016

97. Risk factors for atherosclerotic and medial arterial calcification of the intracranial internal carotid artery

Author: Vos, Annelotte, primary, Kockelkoren, Remko, additional, de Vis, Jill B., additional, van der Schouw, Yvonne T., additional, van der Schaaf, Irene C., additional, Velthuis, Birgitta K., additional, Mali, Willem P.T.M., additional, de Jong, Pim A., additional, Majoie, C.B., additional, Roos, Y.B., additional, Duijm, L.E., additional, Keizer, K., additional, van der Lugt, A., additional, Dippel, D.W., additional, Droogh-de Greve, K.E., additional, Bienfait, H.P., additional, van Walderveen, M.A., additional, Wermer, M.J.H., additional, Lycklama à Nijeholt, G.J., additional, Boiten, J., additional, Duyndam, D., additional, Kwa, V.I., additional, Meijer, F.J., additional, van Dijk, E.J., additional, Kesselring, F.O., additional, Hofmeijer, J., additional, Vos, J.A., additional, Schonewille, W.J., additional, van Rooij, W.J., additional, de Kort, P.L., additional, Pleiter, C.C., additional, Bakker, S.L., additional, Bot, J., additional, Visser, M.C., additional, Velthuis, B.K., additional, van der Schaaf, I.C., additional, Dankbaar, J.W., additional, Mali, W.P., additional, van Seeters, T., additional, Horsch, A.D., additional, Niesten, J.M., additional, Biessels, G.J., additional, Kappelle, L.J., additional, Luitse, M.J., additional, and van der Graaf, Y., additional
Published: 2018
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98. Low cerebral blood flow after cardiac arrest is not associated with anaerobic cerebral metabolism

Author: Hoedemaekers, C.W.E., Ainslie, P.N., Hinssen, S., Aries, M.J., Bisschops, L.L., Hofmeijer, J., Hoeven, J.G. van der, Hoedemaekers, C.W.E., Ainslie, P.N., Hinssen, S., Aries, M.J., Bisschops, L.L., Hofmeijer, J., and Hoeven, J.G. van der
Abstract: Item does not contain fulltext, AIM OF THE STUDY: Estimation of cerebral anaerobic metabolism in survivors and non-survivors after cardiac arrest. METHODS: We performed an observational study in twenty comatose patients after cardiac arrest and 19 healthy control subjects. We measured mean flow velocity in the middle cerebral artery (MFVMCA) by transcranial Doppler. Arterial and jugular blood samples were used for calculation of the jugular venous-to-arterial CO2/arterial to-jugular venous O2 content difference ratio. RESULTS: After cardiac arrest, MFVMCA increased from 26.0[18.6-40.4]cm/sec on admission to 63.9[48.3-73.1]cm/sec after 72h (p<0.0001), with no significant differences between survivors and non-survivors (p=0.4853). The MFVMCA in controls was 59.1[52.8-69.0]cm/sec. The oxygen extraction fraction (O2EF) was 38.9[24.4-47.7]% on admission and decreased significantly to 17.3[12.1-26.2]% at 72h (p<0.0001). The decrease in O2EF was more pronounced in non-survivors (p=0.0173). O2EF in the control group was 35.4[32.4-38.7]%. The jugular bulb-arterial CO2 to arterial-jugular bulb O2 content difference ratio was >1 at all time points after cardiac arrest and did not change during admission, with no differences between survivors and non-survivors. Values in cardiac arrest patients were similar to those in normal subjects. CONCLUSIONS: In this study, low CBF after cardiac arrest is not associated with anaerobic metabolism. Hypoperfusion appears to be the consequence of a decrease of neuronal functioning and metabolic needs. Alternatively, hypoperfusion may decrease cerebral metabolism. Subsequently, metabolism increases in survivors, consistent with resumption of neuronal activity, whereas in non-survivors lasting low metabolism reflects irreversible neuronal damage.
Published: 2017

99. ESICM LIVES 2016: part two

Author: Sivakumar, S., Taccone, F. S., Desai, K. A., Lazaridis, C., Skarzynski, M., Sekhon, M., Henderson, W., Griesdale, D., Chapple, L., Deane, A., Williams, L., Strickland, R., Lange, K., Heyland, D., Chapman, M., Rowland, M. J., Garry, P., Westbrook, J., Corkill, R., Antoniades, C. A., Pattinson, K. T., Fatania, G., Strong, A. J., Myers, R. B., Jermaine, C. M., Robertson, C. S., Rusin, C. G., Hofmeijer, J., Sondag, L., Tjepkema-Cloostermans, M. C., Beishuizen, A., Bosch, F. H., van Putten, M. J. A. M., Carteron, L., Patet, C., Solari, D., Oddo, M., Ali, M. A., Dias, C., Almeida, R., Vaz-Ferreira, A., Silva, J., Monteiro, E., Cerejo, A., Rocha, A. P., Elsayed, A. A., Abougabal, A. M., Beshey, B. N., Alzahaby, K. M., Pozzebon, S., Ortiz, A. Blandino, Cristallini, S., Lheureux, O., Brasseur, A., Vincent, J. L., Creteur, J., Hravnak, M., Yousef, K., Chang, Y., Crago, E., Friedlander, R. M., Abdelmonem, S. A., Tahon, S. A., Helmy, T. A., Meligy, H. S., Puig, F., Dunn-Siegrist, I., Pugin, J., Gupta, S., Govil, D., Srinivasan, S., Patel, S. J., N, J. K., Gupta, A., Tomar, D. S., Shafi, M., Harne, R., Arora, D. P., Talwar, N., Mazumdar, S., Papakrivou, E. E., Makris, D., Manoulakas, E., Tsolaki, B., Karadodas, B., Zakynthinos, E., Garcia, I. Palacios, Martin, A. Diaz, Encinares, V. Sanchez, Ibañez, M. Pachón, Montero, J. Garnacho, Labrador, G., Cangueiro, T. Cebrero, Poulose, V., Koh, J., Kam, J. W., Yeter, H., Kara, A., Aktepe, O., Topeli, A., Tsolakoglou, I., Intas, G., Stergiannis, P., Kolaros, A. A., Chalari, E., Athanasiadou, E., Martika, A., Fildisis, G., Faivre, V., Mengelle, C., Favier, B., Payen, D., Poppe, A., Winkler, M. S., Mudersbach, E., Schreiber, J., Wruck, M. L., Schwedhelm, E., Kluge, S., Zöllner, C., Tavladaki, T., Spanaki, A. M., Dimitriou, H., Kondili, E., Choulaki, C., Meleti, E., Kafetzopoulos, D., Georgopoulos, D., Briassoulis, G., la Torre, A. García-de, de la Torre-Prados, M. V., Tsvetanova-Spasova, T., Nuevo-Ortega, P., Rueda-Molina, C., Fernández-Porcel, A., Camara-Sola, E., Salido-Díaz, L., García-Alcántara, A., Meleti, D. E., Suberviola, B., Riera, J., Rellan, L., Sanchez, M., Robles, J. C., Lopez, E., Vicente, R., Miñambres, E., Santibañez, M., Le Guen, M., Moore, J., Mason, N., Windpassinger, M., Plattner, O., Mascha, E., Sessler, D. I., Research, Outcomes, Melia, U., Fontanet, J., van den Berg, J. P., Struys, M. M. R. F., Vereecke, H. E. M., Jensen, E. W., Rood, P. J. T., van de Schoor, F., van Tertholen, K., Pickkers, P., van den Boogaard, M., Beardow, Z. J., Redhead, H., Paramasivam, K., Numan, T., Kamper, A. M., Rood, P., Peelen, L. M., Zeman, P. M., Slooter, A. J., van Ewijk, C. E., Jacobs, G. E., Girbes, A. R. J., Myatra, S. N., Harish, M. M., Prabu, N. R., Siddiqui, S., Kulkarni, A. P., Divatia, J. V., Murbach, L. D., Leite, M. A., Osaku, E. F., Costa, C. R. L. M., Pelenz, M., Neitzke, N. M., Moraes, M. M., Jaskowiak, J. L., Silva, M. M. M., Zaponi, R. S., Abentroth, L. R. L., Ogasawara, S. M., Jorge, A. C., Duarte, P. A. D., Hernández-Sánchez, N., Sánchez-Hurtado, L. A., García-Guillen, F. J., Ñamendys-Silva, S. A., Maghsoudi, B., Emami, M., Khosravi, M. B., Zand, F., Tabatabaie, H. R., Masjedi, M., Sabetiyan, G., Mokri, A., Troubleyn, J., Diltoer, M., Jacobs, R., Nguyen, D. N., De Waele, E., De Regt, J., Honoré, P. M., Van Gorp, V., Spapen, H. D., Contreras, R. S., Toapanta, N. D., Moreno, G., Sabater, J., Torrado, H., Gonzalez, M., Marin, M., Farigola, E., Gonzalez, A., Fernandez, J., Vera, A., Gisbert, X., Juliá, C., Uya, J., Corral, L., Elias-Jones, I., Gemmell, L., MacKay, A., Randall, D., Adwaney, A., Blunden, M., Prowle, J. R., Kirwan, C. J., Thomas, N., Martin, A., Owen, H., Darwin, L., Conway, D., Atkinson, D., Sharman, M., Barbanti, C., Amour, J., Gaudard, P., Rozec, B., Mauriat, P., M’rini, M., Leger, P. L., Cambonie, G., Liet, J. M., Girard, C., Laroche, S., Damas, P., Assaf, Z., Loron, G., Lecourt, L., Pouard, P., Prowle, J.R., Kim, S. H., Na, S., Kim, J., Oh, S. Y., Jung, C. W., Yoo, S. H., Min, S. H., Chung, E. J., Lee, H., Lee, N. J., Lee, K. W., Suh, K. S., Ryu, H. G., Marshall, D. C., Goodson, R. J., Salciccioli, J. D., Shalhoub, J., Potter, E. K., Kirk-Bayley, J., Karanjia, N. D., Forni, L. G., Creagh-Brown, B. C., Bossy, M., Nyman, M., Tailor, A., Creagh-Brown, B., D’Antini, D., Spadaro, S., Valentino, F., Sollitto, F., Cinnella, G., Mirabella, L., Calvo, F. J. Redondo, Bejarano, N., Padilla, D., Baladron, V., Villajero, P., Villazala, R., Redondo, J., Yuste, A. S., Liu, J., Shen, F., Teboul, J. L., Anguel, N., Beurton, A., Bezaz, N., Richard, C., Monnet, X., Fossali, T., Colombo, R., Ottolina, D., Rossetti, M., Mazzucco, C., Marchi, A., Porta, A., Catena, E., Tollisen, K. H., Andersen, G. Ø., Heyerdahl, F., Jacobsen, D., de Waard, M. C., van IJzendoorn, M. C. O., Buter, H., Kingma, W. P., Navis, G. J., Boerma, E. C., Rulisek, J., Balik, M., Zacharov, S., Kim, H. S., Jeon, S. J., Namgung, H., Lee, E., Cho, Y. J., Lee, Y. J., Huang, A., Cioccari, L., Luethi, N., Mårtensson, J., Bellomo, R., Forsberg, M., Edman, G., Höjer, J., Forsberg, S., Freile, M. T. Chiquito, Hidalgo, F. N., Molina, J. A. Martinez, Lecumberri, R., Rosselló, A. Figuerola, Travieso, P. Medrano, Leon, G. Tuero, Sanchez, J. Gonzalez, Frias, L. Sahuquillo, Rosello, D. Balsells, Verdejo, J. A. Garcia, Serrano, J. A. Noria, Winterwerp, D., van Galen, T., Vazin, A., Karimzade, I., Zand, A., Ozen, E., Ekemen, S., Akcan, A., Sen, E., Yelken, B. Buyukkidan, Kureshi, N., Fenerty, L., Thibault-Halman, G., Erdogan, M., Walling, S., Green, R. S., Clarke, D. B., Briassoulis, P., Kalimeris, K., Ntzouvani, A., Nomikos, T., Papaparaskeva, K., Politi, E., Kostopanagiotou, G., Crewdson, K., Rehn, M., Weaver, A., Brohi, K., Lockey, D., Wright, S., Thomas, K., Baker, C., Mansfield, L., Stafford, V., Wade, C., Watson, G., Bryant, A., Chadwick, T., Shen, J., Wilkinson, J., Furneval, J., Henderson, A., Hugill, K., Howard, P., Roy, A., Bonner, S., Baudouin, S., Ramírez, C. Sánchez, Escalada, S. Hípola, Viera, M. A. Hernández, Santana, M. Cabrera, Balcázar, L. Caipe, Monroy, N. Sangil, Campelo, F. Artiles, Vázquez, C. F. Lübbe, Santana, P. Saavedra, Santana, S. Ruiz, Quintard, H., Bouzat, P., Wollersheim, T., Malleike, J., Haas, K., Carbon, N., Schneider, J., Birchmeier, C., Fielitz, J., Spuler, S., Weber-Carstens, S., Enseñat, L., Pérez-Madrigal, A., Saludes, P., Proença, L., Gruartmoner, G., Espinal, C., Mesquida, J., Huber, W., Eckmann, M., Elkmann, F., Gruber, A., Lahmer, T., Mayr, U., Herner, A., Schellnegger, R., Schmid, R. M., Ayoub, W., Samy, W., Esmat, A., Battah, A., Mukhtar, S., Mongkolpun, W., Cortés, D. Orbegozo, Cordeiro, C. P. R., Funcke, S., Groesdonk, H., Saugel, B., Wagenpfeil, G., Wagenpfeil, S., Reuter, D. A., Fernandez, M. M., Fernandez, R., Magret, M., González-Castro, A., Bouza, M. T., Ibañez, M., García, C., Balerdi, B., Mas, A., Arauzo, V., Añón, J. M., Ruiz, F., Ferreres, J., Tomás, R., Alabert, M., Tizón, A. I., Altaba, S., Llamas, N., Goligher, E C., Fan, E., Herridge, M., Vorona, S., Sklar, M., Dres, M., Rittayamai, N., Lanys, A., Urrea, C., Tomlinson, G., Reid, W. D., Rubenfeld, G. D., Kavanagh, B. P., Brochard, L. J., Ferguson, N. D., Neto, A. Serpa, de Abreu, M. Gama, Pelosi, P., Schultz, M. J., Guérin, C., Papazian, L., Reignier, J., Ayzac, L., Loundou, A., Forel, J. M., Rolland-Debord, C., Bureau, C., Poitou, T., Clavel, M., Perbet, S., Terzi, N., Kouatchet, A., Similowski, T., Demoule, A., Hunfeld, N., Trogrlic, Z., Ladage, S., Osse, R. J., Koch, B., Rietdijk, W., Devlin, J., van der Jagt, M., Picetti, E., Ceccarelli, P., Mensi, F., Malchiodi, L., Risolo, S., Rossi, I., Antonini, M. V., Servadei, F., Caspani, M. L., Roquilly, A., Lasocki, S., Seguin, P., Geeraerts, T., Perrigault, P. F., Dahyot-Fizelier, C., Paugam-Burtz, C., Cook, F., Cinotti, R., dit Latte, D. Demeure, Mahe, P. J., Fortuit, C., Feuillet, F., Asehnoune, K., Marzorati, C., Spina, S., Scaravilli, V., Vargiolu, A., Riva, M., Giussani, C., Sganzerla, E., Citerio, G., Barbadillo, S., de Molina, F. J. González, Álvarez-Lerma, F., Rodríguez, A., Zakharkina, T., Martin-Loeches, I., Matamoros, S., Povoa, P., Torres, A., Kastelijn, J., Hofstra, J. J., de Jong, M., Schultz, M., Sterk, P., Artigas, A., Bos, L. J., Moreau, A. S., Salluh, J., Rodriguez, A., Nseir, S., de Jong, E., van Oers, J. A., Nijsten, M. W. N., de Lange, D. W., Bonvicini, D., Labate, D., Benacchio, L., Olivieri, A., Pizzirani, E., Lopez-Delgado, J. C., Gonzalez-Romero, M., Fuentes-Mila, V., Berbel-Franco, D., Romera-Peregrina, I., Martinez-Pascual, A., Perez-Sanchez, J., Abellan-Lencina, R., Ávila-Espinoza, R. E., Moreno-Gonzalez, G., Sbraga, F., Griffiths, S., Grocott, M. P. W., Doyle, J., Wilkerson, P., Soon, Y., Huddart, S., Dickinson, M., Riga, A., Zuleika, A., Miyamoto, K., Kawazoe, Y., Morimoto, T., Yamamoto, T., Fuke, A., Hashimoto, A., Koami, H., Beppu, S., Katayama, Y., Ito, M., Ohta, Y., Yamamura, H., Rygård, S. L., Holst, L B., Wetterslev, J., Johansson, P. I., Perner, A., Soliman, I. W., van Dijk, D., van Delden, J. J. M., Cremer, O. L., Slooter, A. J. C., McWilliams, D., Snelson, C., Neves, A. Das, Loudet, C. I., Busico, M., Vazquez, D., Villalba, D., Veronesi, M., Lischinsky, A., López, F. J. L., Mori, L. Benito, Plotnikow, G., Díaz, A., Giannasi, S., Hernandez, R., Krzisnik, L., Cecotti, C., Viola, L., Lopez, R., Sottile, J. P., Benavent, G., Estenssoro, E., Chen, C. M., Lai, C. C., Cheng, K. C., Chou, W., Chan, K. S., Roeker, L. E., Horkan, C. M., Gibbons, F. K., Christopher, K. B., Weijs, P. J. M., Mogensen, K. M., Rawn, J. D., Robinson, M. K., Tang, Z., Qiu, C., Ouyang, B., Cai, C., Guan, X., Regueira, T., Cea, L., Carlos, S. Juan, Elisa, B., Puebla, C., Vargas, A., Poulsen, M. K., Thomsen, L. P., Kjærgaard, S., Rees, S. E., Karbing, D. S., Frank, S., Müller, M. C., Carbon, N. M., Skrypnikov, V., Pickerodt, P. A., Falk, R., Mahlau, A., Lee, A., Inglis, R., Morgan, R., Barker, G., Kamata, K., Abe, T., Saitoh, D., Tokuda, Y., Butler, M. B., Hwa, H. Tae, Gil, L. Jae, Vaquero, R. Hernández, Rodriguez-Ruiz, E., Lago, A. Lopez, Allut, J. L. Garcia, Gestal, A. Estany, Gonzalez, M. A. Garcia, Thomas-Rüddel, D. O., Schwarzkopf, D., Fleischmann, C., Reinhart, K., Suwanpasu, S., Sattayasomboon, Y., Filho, N. M. Filgueiras, Oliveira, J. C. A., Ballalai, C. S., De Lucia, C. V., Araponga, G. P., Veiga, L. N., Silva, C. S., Garrido, M. E., Ramos, B. B., Ricaldi, E. F., Gomes, S. S., Wright, C., Docking, R. I., Doherty, P., Black, E., Stenhouse, P., Plummer, M. P., Finnis, M. E., Phillips, L. K., Kar, P., Bihari, S., Biradar, V., Moodie, S., Horowitz, M., Shaw, J. E., Deane, A. M., Yatabe, T., Inoue, S., Sakaguchi, M., Egi, M., Abdelhamid, Y. Ali, Hokka, M., Mizobuchi, S., Plummer, M., Giersch, E., Summers, M., Hatzinikolas, S., Heller, S., Jones, K., Schweizer, R., Jacquet-Lagreze, M., Portran, P., Junot, S., Allaouchiche, B., Fellahi, J. L., Guerci, P., Ergin, B., Kapucu, A., Ince, C., Crisman, M., Shinotsuka, C. Righy, Fagnoul, D., Orbegozo, D., Preiser, J. C., Thooft, A., Brimioulle, S., Iwasaka, H., Tahara, S., Nagamine, M., Ichigatani, A., Cabrera, A. Rugerio, Zepeda, E. Monares, Granillo, J. Franco, Sánchez, J. S. Aguirre, Montoya, A. A. Tanaka, Montenegro, A. Pedraza, Blanco, G. A. Gálvez, Robles, C. M. Coronado, Drolz, A., Horvatits, T., Roedl, K., Rutter, K., Funk, G. C., Schneeweiss, B., Fuhrmann, V., Sabetian, G., Pooresmaeel, F., Ghaffaripour, S., Farbod, A., Tabei, H., Taheri, L., Anandanadesan, R., Metaxa, V., Teixeira, C., Pereira, S. M., Hernández-Marrero, P., Carvalho, A. S., Beckmann, M., Hartog, C. S., Raadts, A., Robertsen, A., Førde, R., Skaga, N. O., Helseth, E., Honeybul, S., Ho, K., Lopez, P. Martinez, Gonzalez, M. Nieto, Ortega, P. Nuevo, Sola, E. Camara, Spasova, T., Kopecky, O., Rusinova, K., Waldauf, P., Cepeplikova, Z., Domínguez, J. Palamidessi, Almudevar, P. Matia, Carmona, S. Alcántara, Muñoz, J. J. Rubio, Castañeda, D. Palacios, Abellán, A. Naharro, Villamizar, P. Rodríguez, Ramos, J. Veganzones, Pérez, L. Pérez, Lucendo, A. Pérez, Ejarque, M. Camós, Estella, A., Camps, V. Lopez, Martín, M. C., Masnou, N., Barbosa, S., Varela, A., Palma, I., Cristina, L., Nunes, E., Pereira, I., Campello, G., Granja, C., Pande, R., Pandey, M., Varghese, S., Chanu, M., Van Dam, M. J., Ter Braak, E. W. M. T., Gracia, M., Viciana, R., Recuerda, M., Fontaiña, L. Perez, Tharmalingam, B., Kovari, F., Rose, L., Mcginlay, M., Amin, R., Burns, K., Connolly, B., Hart, N., Jouvet, P., Katz, S., Leasa, D., Mawdsley, C., Mcauley, D., Blackwood, B., Denham, S., Worrall, R., Arshad, M., Isherwood, P., Khadjibaev, A., Sabirov, D., Rosstalnaya, A., Parpibaev, F., Sharipova, V., Blanco, G. A. Galvez, Guzman, C. I. Olvera, Cha, Y. S., Lee, S. J., Tyagi, N., Rajput, R. K., Taneja, S., Singh, V. K., Sharma, S. C., Mittal, S., Rao, B. K., Ayachi, J., Fraj, N., Romdhani, S., Khedher, A., Meddeb, K., Sma, N., Azouzi, A., Bouneb, R., Chouchene, I., El Ghardallou, M., Boussarsar, M., Jennings, R., Walter, E., Ribeiro, J. M., Moniz, I., Marçal, R., Santos, A. C., Candeias, C., e Silva, Z. Costa, Gomez, S. E. Zamora, Nieto, O. R. Perez, Gonzalez, J. A. Castanon, Cuellar, A. I. Vasquez, Mildh, H., Pettilä, V., Korhonen, A. M., Karlsson, S., Ala-Kokko, T., Reinikainen, M., Vaara, S. T., Zaleska-Kociecka, M., Grabowski, M., Dąbrowski, M., Wozniak, S., Piotrowska, K., Banaszewski, M., Imiela, J., Stepinska, J., Pérez, A. González, Ordoñez, P. Florez, Giribet, A., Cuervo, M. A. Alonso, Cuervo, R. Alonso, Esteban, M. A. Rodriguez, Fraile, L. Iglesias, Mittelbrum, C. Ponte, Albaiceta, G. Muñiz, Koeze, J., Keus, F., Dieperink, W., van der Horst, I. C. C., van Meurs, M., Zijlstra, J. G., Roberts, S., Caballero, C. Hernandez, Isgro, G., Hall, D., Beitland, S., Trøseid, A.-M. S., Brusletto, B. S., Waldum-Grevbo, B. E., Berg, J. P., Sunde, K., Huertas, D. García, Manzano, F., Quintana, M. M. Jiménez, Osuna, A., Santiago-Ruiz, F., Rodríguez-Mejías, C., Wangensteen, R., Jamaati, H. R., Hashemian, S. M. R., Abbasi, G., Khaloo, V., Tabei, S. H.a., Kafilzadeh, A., Bakhodaei, H. Haddad, Diaz, J. A., Silva, R., Garcia, D. J., Luis, E., Gomez, M. N., Soriano, R., Gonzalez, P. L., Ibrahim, I. A., Rafik, M. M., Al-Ansary, A. M., Algendi, M. A., Ali, A. A., Benten, D., Kluwe, J., Siedler, S., Adedugbe, I., Bird, G. T., Kennedy, R. M., Sharma, S., Yugi, G., Haroon, B. A., Witter, T., Khaliq, W., Singer, M., Havaldar, A. A., Krishna, B., Sriram, S., Espinoza, E. D. Valenzuela, Pozo, M. O., Edul, V. S. Kanoore, Furche, M., Motta, M. F., Vazquez, A. Risso, Birri, P. N. Rubatto, Dubin, A., Dogliotti, A., Ramos, A., Lovesio, C., Delile, E., Nevière, R., Thiébaut, P.-A., Maupoint, J., Mulder, P., Coquerel, D., Renet, S., do Rego, J. C., Rieusset, J., Richard, V., Tamion, F., Andreis, D. T., Smit, B., Smulders, Y. M., van Straaten, H. M. Oudemans, Eringa, E. C., Man, A. M. E. Spoelstra-de, Alegría, L., Soto, D., Luengo, C., Gomez, J., Jarufe, N., Bruhn, A., Castro, R., Kattan, E., Tapia, P., Rebolledo, R., Achurra, P., Ospina-Tascón, G., Bakker, J., Hernández, G., Bertini, P., Guarracino, F., Baldassarri, R., Pinsky, M. R., Vera, M., Dreyse, J., Carpio, D., Henriquez, C., Gajardo, D., Bravo, S., Kim, S., Lee, M., Park, S. Y., So, S., Kačar, M. B., Kačar, S. M., Uddin, I., Belhaj, A. M., Aydın, M. A., Avsec, D., Kapuağası, A., Kaymak, Ç., Kovach, L., Şencan, İ., Meço, B., Özçelik, M., Ünal, N., Jenni-Moser, B., Jeitziner, M.-M., Galassi, M. S., Sales, F. L., de Moraes, K. C. L., Batista, C. L., Júnior, J. A. de Souza, Marcari, T. B., Lobato, R., Castro, C. S. A. A., de Souza, L. M., Rodrigues, F. F. P., Correa, N. G., Pelegrini, A. M., Eid, R. A. C., Timenetsky, K. T., Cazati, D., Lobato, M., Diniz, P. S., Rocha, L. L., Cavalheiro, A. M., Lucinio, N. M., Santos, E. R., Norrenberg, M., Gleize, A., Simón, I. Fernández, Valhonrat, I. Lipperheide, Almudévar, P. Matía, Dávila, F., Rubio, J. J., Ramos, A. J., Reina, Á. J. Roldán, López, N. Palomo, Pérez, M. Adriaensens, Apolo, D. X. Cuenca, Villén, L. Martín, López, F. M. Porras, García, I. Palacios, Izurieta, J. R. Naranjo, Guerrero, J. J. Egea, Calvert, S., Quint, M., Adeniji, K., Young, R., Shevill, D. D., Robertson, E., Garside, P., Isotti, P., De Vecchi, M. M., Perduca, A. E., Negro, A., Villa, G., Manara, D. F., Cabrini, L., Zangrillo, A., Frencken, J. F., van Baal, L., Donker, D. W., Horn, J., van der Poll, T., van Klei, W. A., Bonten, M. J. M., Menard, C. E., Kumar, A., Rimmer, E., Doucette, S., Turgeon, A. F., Houston, B. L., Houston, D. S., Zarychanski, R., Pinto, B. Bollen, Carrara, M., Ferrario, M., Bendjelid, K., Nunes, J., Diaz, P., Silva, G., Escórcio, S., Chaves, S., Jardim, M., Fernandes, N., Câmara, M., Duarte, R., Pereira, C. A., Vieira, J., Nóbrega, J. J., de Oca-Sandoval, M. A. Montes, Sánchez-Rodríguez, A., Joya-Galeana, J. G., Correa-Morales, A., Camarena-Alejo, G., Aguirre-Sánchez, J., Franco-Granillo, J., Soliman, M., Al Azab, A., El Hossainy, R., Nagy, H., Nirmalan, M., Crippa, I. A., Cavicchi, F. Zama, Chaari, A., Hakim, K. Abdel, Hassanein, H., Etman, M., El Bahr, M., Bousselmi, K., Khalil, E. S., Kauts, V., Casey, W. F., Imahase, H., Sakamoto, Y., Yamada, K. C., Miike, T., Nagashima, F., Iwamura, T., Boscolo, A., Lucchetta, V., Piasentini, E., Bertini, D., Manesso, L., Spiezia, L., Simioni, P., Ori, C., Souza, R. B., Martins, A. M., Liberatore, A. M. A., Kang, Y. R., Nakamae, M. N., Vieira, J. C. F., Koh, I. H. J., Hanslin, K., Wilske, F., Skorup, P., Sjölin, J., Lipcsey, M., Long, W. Jin, Zhen, C. Er, Vakalos, A., Avramidis, V., Wu, S. H., Shyu, L. J., Li, C. H., Yu, C. H., Chen, H. C., Wang, C. H., Lin, K. H., Aray, Z. E., Gómez, C. F., Tejero, A. P., Monge, D. D., Losada, V. M., Tarancón, C. M., Cortés, S. D., Gutiérrez, A. M., Álvarez, T. P., Rouze, A., Jaffal, K., Six, S., Stolz, K., Cattoen, V., Arnal, J. M., Saoli, M., Novotni, D., Garnero, A., Becher, T., Buchholz, V., Schädler, D., Frerichs, I., Weiler, N., Eronia, N., Mauri, T., Gatti, S., Maffezzini, E., Bronco, A., Alban, L., Sasso, T., Marenghi, C., Grasselli, G., Pesenti, A., Bellani, G., Al-Fares, A., Del Sorbo, L., Anwar, S., Facchin, F., Azad, S., Zamel, R., Ferguson, N., Cypel, M., Keshavjee, S., Durlinger, E., Spoelstra-de Man, A., de Grooth, H. J., Girbes, A., Straaten, H. Oudemans-van, Smulders, Y., Alfaro, M. A., Parrilla, F., Meli, A., Pellegrini, M., Rodriguez, N., Goyeneche, J. M., Morán, I., Aguirre, H., Mancebo, J., Heines, S. J. H., Strauch, U., Bergmans, D. C. J. J., Blankman, P., Shono, A., Hasan, D., Gommers, D., Chung, W. Y., Lee, K. S., Jung, Y. J., Park, J. H., Sheen, S. S., Park, K. J., Worral, R., Larraza, S., Dey, N., Brohus, J. B., Winding, R. W., Volta, C. A., Ampatzidou, F., Vlachou, A., Kehagioglou, G., Karaiskos, T., Madesis, A., Mauromanolis, C., Michail, N., Drossos, G., Saraj, N., Rijkenberg, S., Feijen, H. M., Endeman, H., Donnelly, A. A. J., Morgan, E., Garrard, H., Buckley, H., Russell, L., Haase, N., Goh, C., Mouyis, K., Woodward, C. L. N., Halliday, J., Encina, G. B., Ros, J., Lagunes, L., Tabernero, J., Bosch, F., Rello, J., Morente-Constantin, E., Rivera-Ginés, B., Colmenero-Ruiz, M., Sanz, J. García, Simon, I. Fernandez, Valbuena, B. Lobo, Carmona, S. Alcantara, Pais, M., Ramalingam, S., Díaz, C., Fox, L., Santafe, M., Barba, P., García, M., Leal, S., Pérez, M., Pérez, M. L. Pérez, Veganzones, J., Simón, I. Fernandez, Martínez, N., Moors, I., Mokart, D., Pène, F., Lambert, J., Mayaux, J., Vincent, F., Nyunga, M., Bruneel, F., Laisne, L., Rabbat, A., Lebert, C., Perez, P., Chaize, M., Renault, A., Meert, A. P., Hamidfar, R., Jourdain, M., Darmon, M., Schlemmer, B., Chevret, S., Lemiale, V., Azoulay, E., Benoit, D., Martins-Branco, D., Sousa, M., Marum, S., Bouw, M. J., Galstyan, G., Makarova, P., Parovichnikova, E., Kuzmina, L., Troitskaya, V., Drize, N., Gemdzhian, E., Savchenko, V., Chao, H. C., Kılıc, E., Demiriz, B., Uygur, M. L., Sürücü, M., Cınar, K., Yıldırım, A. E., Kiss, K., Köves, B., Csernus, V., Molnár, Z., Ntantana, A., Matamis, D., Savvidou, S., Giannakou, M., Gouva, M., Nakos, G., Koulouras, V., Gaffney, S., Docking, R., Judge, C., Drew, T., Misran, H., Munshi, R., McGovern, L., Coyle, M., Dunne, L., Deasy, E., Lavin, P., Fahy, A., Darcy, D. M., Donnelly, M., Ismail, N. H., Hall, T., Wykes, K., Jack, J., Ngu, W. C., Morgan, P., Ruiz-Ramos, J., Ramirez, P., Gordon, M., Villarreal, E., Frasquet, J., Poveda-Andrés, J. L., Castellanos, A., Ijssennagger, C. E., ten Hoorn, S., van Wijk, A., van den Broek, J. M., Tuinman, P. R., Elmenshawy, A. M., Hammond, B. D., Gibbon, G., Belcham, T., Burton, K., Taniguchi, L. U., Ramos, F. J. S., Momma, A. K., Martins-Filho, A. P. R., Bartocci, J. J., Lopes, M. F. D., Sad, M. H., Rodrigues, C. M., Pires, E. M. C., Vieira, J. M., Barreto, J., Duarte, S. T., Taba, S., Miglioranza, D., Gund, D. P., Lordani, C. F., Capuzzo, M., Corte, F. Dalla, Terranova, S., Scaramuzzo, G., Fogagnolo, A., Bertacchini, S., Bellonzi, A., Ragazzi, R., Cruz, C., Nunes, A., Pereira, F. Seabra, Aragão, I., Cardoso, A. F., Santos, C., Malheiro, M. J., Castro, H., Cardoso, T., Paratz, J., Kenardy, J., Comans, T., Coyer, F., Thomas, P., Boots, R., Pereira, N., Vilas-Boas, A., Gomes, E., Torres, J., Carvalho, D., Molinos, E., Vales, C., Araújo, R., Karnatovskaia, L., Philbrick, K., Ognjen, G., Clark, M., Montero, R. Molina, Varas, J. Luján, Sánchez-Elvira, L. Alcázar, Delgado, C. Pintado, Díaz, P. Villa, Ruiz, B. Llorente, Guerrero, A. Pardo, Galache, J. A. Cambronero, Jiménez, R., Rebollo, S., Alejandro, O., Fernández, A., Moreno, S., Herrera, L., Ojados, A., Galindo, M., Murcia, J., Contreras, M., Sánchez-Argente, S., Bonilla, Y., Rodríguez, M. D., Allegue, J. M., Cakin, Ö., Parlak, H., Kirca, H., Mutlu, F., Aydınlı, B., Cengiz, M., Ramazanoglu, A., Jung, E.-J., Oh, S.-Y., Domenech, J. Cebrián, Montalvo, A. Pinos, Chornet, T. Ciges, Martinez, P. Concha, Ribas, M. Piñol, Costa, R. Gimeno, Ortega, A. Castellanos, Forbes, C., Prescott, H., Lal, A., Khan, F. A., Dela Pena, E. G., Dizon, J. S., Perez, P. P. P., Wong, C. M. J., Garach, M. Muñoz, Romero, O. Moreno, Puerta, R. Ramirez, Diaz, F. Acosta, Bailon, A. M. Perez, Pinel, A. Carranza, Maldonado, L. Peñas, Kalaiselvan, M. S., kumar, R. L. Siva, Renuka, M. K., Kumar, A. S. Arun, De Rosa, S., Ferrari, F., Checcacci, S. Carboni, Rigobello, A., Joannidis, M., Politi, F., Pellizzari, A., Bonato, R., Fernandez-Carmona, A., Macias-Guarasa, I., Gutierrez-Rodriguez, R., Martinez-Lopez, P., Diaz-Castellanos, M. A., Arias-Diaz, M., Aguilar-Alonso, E., Nikandish, R. N., Artemenko, V., Budnyuk, A., Bassi, G. Li, Senussi, T., Idone, F., Xiol, E. Aguilera, Travierso, C., Chiurazzi, C., Motos, A., Amaro, R., Hua, Y., Fernández-Barat, L., Ranzani, O. T., Bobi, Q., Rigol, M., Youn, A., Hwang, J. Gyung, Ossorio, M. E. Yuste, Figueira, H., Oliveira, R., Mota, A., Kamp, O., Cruciger, O., Aach, M., Kaczmarek, C., Waydhas, C., Schildhauer, T. A., Hamsen, U., Camprubí-Rimblas, M., Chimenti, L., Guillamat-Prats, R., Lebouvier, T., Bringué, J., Tijero, J., Gómez, M. N., Blanch, L., Tagliabue, G., Ji, M., Jagers, J. V. Suneby, Easton, P. A., Martins, A. M. C. R. P. F., Hong, J. Y., Shin, M. H., Park, M. S., Pomprapa, A., Hofferberth, M. B. T., Russ, M., Braun, W., Walter, M., Francis, R., Lachmann, B., Leonhardt, S., Landaverde-López, A., Canedo-Castillo, N. A., Esquivel-Chávez, A., Arvizu-Tachiquín, P. C., Baltazar-Torres, J. A., Cardoso, V., Krystopchuk, A., Castro, S., Melão, L., Firmino, S., Marreiros, A., Almaziad, S., Kubbara, A., Barnett, W., Nakity, R., Alamoudi, W., Altook, R., Tarazi, T., Fida, M., Safi, F., Assaly, R., Santini, A., Milesi, M., Maraffi, T., Pugni, P., Cavenago, M., Gattinoni, L., Protti, A., Perchiazzi, G., Borges, J. B., Bayat, S., Porra, L., Broche, L., Hedenstierna, G., Larsson, A., Roneus, A., Segelsjö, M., Vestito, M. C., Gremo, E., Nyberg, A., Castegren, M., Pikwer, A., Yoshida, T., Engelberts, D., Otulakowski, G., Katira, B., Post, M., Brochard, L., Amato, M. B. P., Koch, N., Hoellthaler, J., Mair, S., Phillip, V., Beitz, A., Baladrón, V., Villarejo, P., Steenstra, R. J., Banierink, H., Hof, J., van der Horst, I. C., Nijsten, M. W., Hoekstra, M., Sterz, F., Horvatits, K., Herkner, H., Kott, M., Zitta, K., Brandt, B., Schildhauer, C., Elke, G., Hummitzsch, L., Albrecht, M., González, L. Rey, Alonso, D. Cabestrero, Sánchez, R. de Pablo, Lucas, J. Higuera, Ferlitsch, A., Fauler, G., Trauner, M., Pischke, S., Fischer, L., Thaiss, F., Koch, M., Bangert, K., Lohse, A. W., Nashan, B., Sterneck, M., Faenza, S., Siniscalchi, A., Pierucci, E., Mancini, E., Ricci, D., Gemelli, C., Cuoghi, A., Magnani, S., Atti, M., Sotos, F., Cánovas, J., López, A., Burruezo, A., Torres, D., Herrera-Gutierrez, M. E., Barrueco-Francioni, J., Arias-Verdú, D., Lozano-Saez, R., Quesada-Garcia, G., Seller-Pérez, G., Figueiredo, A., Anzola, Y., Pereira, R., Bento, L., Lai, M., Deiana, M., Seller-Perez, G., Vardas, K., Ilia, S., Sertedaki, A., Charmadari, E., Stratakis, C. A., Briassouli, E., Goukos, D., Psarra, K., Botoula, E., Tsagarakis, S., Mageira, E., Routsi, C., Nanas, S., Campello, E., Radu, C. M., Su, H., Lam, Y. M., Willis, K., Pullar, V., Hubner, R. P., Tsang, J. L., de Guadiana-Romualdo, L. García, Rebollo-Acebes, S., Esteban-Torrella, P., Jiménez-Sánchez, R., Jiménez-Santos, E., Ortín-Freire, A., Hernando-Holgado, A., Albaladejo-Otón, M. D., Coelho, L., Rabello, L., Póvoa, P., Varis, E., Poukkanen, M., Jacob, S., Takala, J., Wilkman, E., Lundberg, O. H. M., Bergenzaun, L., Rydén, J., Rosenqvist, M., Melander, O., Chew, M. S., Kishihara, Y., Yasuda, H., Jimenez, R., Torrella, P. Esteban, Fernandez, A., Sanchez, S., Ortin, A., Prats, R. Guillamat, Aguilera, E., Marti, D., Fernandez, L., Ferrer, M., Lanziotti, V. S., Pulcheri, L., Ribeiro, M. O., Barbosa, A. P., e Silva, J. R. Lapa, Soares, M., Salluh, J. I. F., Marqués, M. Gil, Moreno, A. Puppo, Pizarraya, A. Gutierrez, Diaz, J. Pachón, Smani, Y., Connell, M. Mc, Zhang, L. A., Parker, R. S., Banerjee, I., Clermont, G., Norberg, E., Oras, J., Cuisinier, A., Maufrais, C., Payen, J. F., Nottin, S., Walther, G., Arib, S., Bilotta, F., Badenes, R., Rubulotta, F., Mirek, S., Monfort, B., Stazi, E., Roig, A. Lozano, Magnoni, S., Marando, M., Pifferi, S., Conte, V., Ortolano, F., Carbonara, M., Bertani, G., Scola, E., Cadioli, M., Triulzi, F., Colombo, A., Stocchetti, N., Rotzel, H. B., Lázaro, A. Serrano, Prada, D. Aguillón, Guimillo, M. Rodriguez, Piqueras, C. Sanchís, Guia, J. Romero, Simon, M. García, Arizmendi, A. Mesejo, Carratalá, A., El Maraghi, S., Yehia, A., Bakry, M., Shoman, A., Backes, F. N., Bianchin, M. M., Vieira, S. R. R., de Souza, A., Backes, A. N., Klein, C., Arunkumar, A. S., Lozano, A., Gallaher, C., Cattlin, S., Gordon, S., Picard, J., Fontana, V., Bond, O., Nobile, L., Mrozek, S., Delamarre, L., Capilla, F., Al-Saati, T., Fourcade, O., Dominguez-Berrot, A. M., Gonzalez-Vaquero, M., Vallejo-Pascual, M. E., Gupta, D., Ivory, B. D., Chopra, M., McCarthy, J., Felderhof, C. L., MacNeil, C., Maggiorini, M., Duska, F., Fumis, R. R. L., Junior, J. M. Vieira, Amarante, G., Skorko, A., Sanders, S., Aron, J., Kroll, R. J., Redfearn, C., Krishnan, P., Khalil, J. E., Kongpolprom, N., Gulia, V., Lourenço, E., Duro, C., Baptista, G., Alves, A., Arminda, B., Rodrigues, M., Hayward, J., Baldwin, F., Gray, R., Katinakis, P. A., Stijf, M., Ten Kleij, M., Jansen-Frederiks, M., Broek, R., de Bruijne, M., Spronk, P. E., Sinha, K., Luney, M., Palmer, K., Keating, L., Abu-Habsa, M., Bahl, R., Baskaralingam, N., Ahmad, A., Kanapeckaite, L., Bhatti, P., Glace, S., Jeyabraba, S., Lewis, H. F., Kostopoulos, A., Raja, M., West, A., Ely, A., Turkoglu, L. M., Zolfaghari, P., Baptista, J. P., Marques, M. P., Martins, P., Pimentel, J., Su, Y. C., Villacres, S., Stone, M. E., Parsikia, A., Medar, S., O’Dea, K. P., Porter, J., Tirlapur, N., Jonathan, J. M., Singh, S., Takata, M., McWhirter, E., Lyon, R., Hariz, M. L., Azmi, E., Alkhan, J., Movsisyan, V., Petrikov, S., Marutyan, Z., Aliev, I., Evdokimov, A., Antonucci, E., Merz, T., Hartmann, C., Calzia, E., Radermacher, P., Nußbaum, B., Huber-Lang, M., Gröger, M., Svoren-Jabalera, E., Davenport, E. E., Humburg, P., Knight, J., Hinds, C. J., Jun, I. J., Kim, W. J., Lee, E. H., Besch, G., Perrotti, A., Puyraveau, M., Baltres, M., Samain, E., Chocron, S., Pili-Floury, S., Plata-Menchaca, E. P., Sabater-Riera, J., Estruch, M., Boza, E., Toscana-Fernández, J., Bruguera-Pellicer, E., Ordoñez-Llanos, J., Pérez-Fernández, X. L., Cavaleiro, P., Tralhão, A., Arrigo, M., Lopes, J.-P., Lebrun, M., Cholley, B., PerezVela, J. L., MarinMateos, H., Rivera, J. J. Jimenez, Llorente, M. A. Alcala, De Marcos, B. Gonzalez, Fernandez, F. J. Gonzalez, Laborda, C. Garcia, Zamora, D. Fernandez, Delgado, J. C. Lopez, Imperiali, C., Dastis, M., Górka, J., Górka, K., Iwaniec, T., Frołow, M., Polok, K., Fronczek, J., Kózka, M., Musiał, J., Szczeklik, W., Sileli, M., Moursia, C., Maleoglou, H., Leleki, K., Uz, Z., Ince, Y., Papatella, R., Bulent, E., De Mol, B., Vicka, V., Gineityte, D., Ringaitiene, D., Norkiene, I., Sipylaite, J., Möller, C., Thomas-Rueddel, D. O., Vlasakov, V., Rochwerg, B., Theurer, P., Al Sibai, J. Zanabili, Camblor, P. Martinez, Fernandez, P. Alvarez, Gala, J. M. García, Guisasola, J. Silba, Tamura, T., Miyajima, I., Yamashita, K., Yokoyama, M., Dalampini, E., Nastou, M., Baddour, A., Ignatiadis, A., Asteri, T., Hathorn, K. E., Purtle, S. W., Viana, M. V., Tonietto, T. A., Gross, L. A., Costa, V. L., Tavares, A. L. J., Lisboa, B. O., Moraes, R. B., Vieira, S. R., Viana, L. V., Azevedo, M. J., Ceniccola, G. D., Pequeno, R. S. F., Holanda, T. P., Mendonça, V. S., Araújo, W. M. C., Carvalho, L. S. F., Segaran, E., Vickers, L., Brinchmann, K., Wignall, I., De Brito-Ashurst, I., del Olmo, R., Esteban, M. J., Vaquerizo, C., Carreño, R., Gálvez, V., Kaminsky, G., Nieto, B., Fuentes, M., De la Torre, M. A., Torres, E., Alonso, A., Velayos, C., Saldaña, T., Escribá, A., GRIP, J., Kölegård, R., Sundblad, P., Rooyackers, O., Naser, Ben, Jaziri, F., Jazia, A. Ben, Barghouth, M., Hentati, O., Skouri, W., El Euch, M., Mahfoudhi, M., Turki, S., Abdelghni, K. Ben, Abdallah, Ben, Maha, B. N. M., Lorente, M., Włudarczyk, A., Hałek, A., Bargouth, M., Bennasr, M., Abdelghani, K. Ben, Abdallah, T. Ben, Geenen, I. L., Parienti, J. J., Straaten, H. M. Oudemans-van, Shum, H. P., King, H. S., Chan, K. C., Yan, W. W., Londoño, J. Gonzalez, Cardenas, C. Lorencio, Pedrosa, M. Morales, Gubianas, C. Murcia, Bertolin, C. Fuster, Batllori, N. Vila, Sirvent, J. M., Mukhopadhyay, A., Chan, H. Y., Kowitlawakul, Y., Remani, D., Leong, C. S. F., Henry, C. J., Puthucheary, Z. A., Mendsaikhan, N., Begzjav, T., Lundeg, G., Dünser, M., Welsh, S. P., Guerra, E., Zerpa, M. C. l., Zechner, F., Berdaguer, F., Risso-Vazquez, A., Masevicius, F. D., Greaney, D., Magee, A., Fitzpatrick, G., Lugo-Cob, R. G., Tejeda-Huezo, B. C., Cano-Oviedo, A. A., Aydogan, M. S., Togal, T., Taha, A., Chai, H. Z., Kam, C., Razali, S. S. Yang, Sivasamy, V., Kuan, L. Y., Morales, M. A. Lopez, Pires, T., and Azevedo, L. C. P.
Subjects: Meeting Abstracts
Abstract: Introduction In addition to systemic hemodynamics, the management\ud of neurocritically ill patients is often informed by neuromonitoring. In\ud the absence of high-level evidence clinicians are often guided by personal\ud and local expertise. Little is known about practices as they pertain\ud to the use of such monitoring in patients with acute brain injury (ABI).\ud Objectives To investigate practices in bedside monitoring for ABI patients.\ud Particularly interested in differences among “neurointensivists”\ud (NIs; defined here as intensivists whose clinical practice is comprised\ud > 1/3 by neurocritical care) and other intensivists (OIs). Also, to\ud explore patterns specific to traumatic brain injury (TBI) and subarachnoid\ud hemorrhage (SAH), as well as preferences and availability of\ud particular technologies/devices.\ud Methods Electronic survey of 22 items including two case-based scenarios;\ud endorsed by SCCM (9,000 recipients) and ESICM (on-line\ud newsletter) in 2013. A sample size of 370 was calculated based on a\ud population of 10,000 physician members, a 5 % margin error, and\ud 95 % confidence interval. We summarized results using descriptive\ud statistics (proportions with 95 % confidence intervals). A chi-square\ud test was used to compare proportions of responses between NIs and\ud OIs with a significance p < 0.05.\ud Results There were 655 responders (66 % completion rate); 422(65 %)\ud were classified as OIs and 226(35 %) as NIs. More NIs follow\ud hemodynamic protocols for neurocritically-ill patients (56 % vs. 43 %, p\ud 0.001), in TBI (44.5 % vs. 33.3 %, p 0.007), and in SAH (38.1 % vs. 21.3 %,\ud p < 000.1). For delayed cerebral ischemia (DCI), more NIs target cardiac\ud index (CI) (35 % vs. 21 %, p 0.0001), and fluid responsiveness (62 % vs.\ud 53 %, p 0.03), use more bedside ultrasound (BUS) (42 % vs. 29 %, p\ud 0.005) and arterial waveform analysis (40 % vs. 29 %, p 0.02). For DCI\ud neuromonitoring, NIs use more angiography (57 % vs. 43 %, p 0.004),\ud TCD (46 % vs. 38 %, p 0.0001), and CTP (32 % vs.16 %, p 0.0001). For\ud CPP optimization in TBI, NIs use more arterial waveform analysis (45 %\ud vs. 35 %, p 0.019), and BUS (37 % vs. 27.7 %, p 0.023), while more OIs\ud monitor mixed venous oxygen saturation (54.1 % vs. 45 %, p 0.045). For\ud TBI neuromonitoring, NIs use more PbtO2 (28 % vs. 10 %, p 0.0001). In\ud the case scenario of raised ICP/low PbtO2, most employ analgosedation\ud (47 %) and osmotherapy (38 %). Fewer make use of preserved pressure\ud reactivity, particularly OIs (vasopressor use 23 % vs. 34 %, p 0.014).\ud Conclusions There is large heterogeneity in the use of monitoring protocols,\ud variables, and technologies/devices. “Neurointensivists” not only\ud employ more neuromonitoring but also more hemodynamic monitoring\ud in patients with acute brain injury. ICP/CPP remain the most commonly\ud followed neuro-variables in TBI patients, with low use of other\ud brain-physiology parameters, sugg
Published: 2016

100. Time to Reperfusion and Treatment Effect for Acute Ischemic Stroke A Randomized Clinical Trial

Author: Fransen, P.S.S., Berkhemer, O.A., Lingsma, H.F., Beumer, D., Berg, L.A. van den, Yoo, A.J., Schonewille, W.J., Vos, J.A., Nederkoorn, P.J., Wermer, M.J.H., Walderveen, M.A.A. van, Staals, J., Hofmeijer, J., Oostayen, J.A. van, Nijeholt, G.J.L.A., Boiten, J., Brouwer, P.A., Emmer, B.J., Bruijn, S.F. de, Dijk, L.C. van, Kappelle, L.J., R.H. lo, Dijk, E.J. van, Vries, J. de, Kort, P.L.M. de, Berg, J.S.P. van den, Hasselt, B.A.A.M. van, Aerden, L.A.M., Dallinga, R.J., Visser, M.C., Bot, J.C.J., Vroomen, P.C., Eshghi, O., Schreuder, T.H.C.M.L., Heijboer, R.J.J., Keizer, K., Tielbeek, A.V., Hertog, H.M. den, Gerrits, D.G., Berg-Vos, R.M. van den, Karas, G.B., Steyerberg, E.W., Flach, H.Z., Marquering, H.A., Sprengers, M.E.S., Jenniskens, S.F.M., Beenen, L.F.M., Berg, R. van den, Koudstaal, P.J., Zwam, W.H. van, Roos, Y.B.W.E.M., Oostenbrugge, R.J. van, Majoie, C.B.L.M., Lugt, A. van der, Dippel, D.W.J., Multictr Randomized Clin Trial End, Other departments, Radiology and Nuclear Medicine, ACS - Amsterdam Cardiovascular Sciences, ANS - Neurovascular Disorders, Graduate School, Neurology, Biomedical Engineering and Physics, Other Research, MUMC+: MA AIOS Neurologie (9), RS: CARIM - R3.03 - Cerebral small vessel disease, Klinische Neurowetenschappen, MUMC+: MA Med Staf Spec Neurologie (9), RS: CARIM - R3.11 - Imaging, Beeldvorming, MUMC+: DA BV Medisch Specialisten Radiologie (9), RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Clinical Neurophysiology, Faculty of Science and Technology, Radiology and nuclear medicine, Amsterdam Neuroscience - Neurovascular Disorders, Radiology & Nuclear Medicine, and Public Health
Subjects: Male, Time Factors, ANGIOGRAPHIC REPERFUSION, 030204 cardiovascular system & hematology, THERAPY, law.invention, Brain Ischemia, 0302 clinical medicine, Randomized controlled trial, Modified Rankin Scale, law, Interquartile range, Non-U.S. Gov't, 610 Medicine & health, Stroke, OUTCOMES, Research Support, Non-U.S. Gov't, Endovascular Procedures, Atrial fibrillation, Middle Aged, THROMBECTOMY, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], Multicenter Study, Treatment Outcome, Anesthesia, Tissue Plasminogen Activator, Randomized Controlled Trial, Female, IMAGING SELECTION, INTERVENTION, medicine.medical_specialty, Research Support, METIS-320854, 03 medical and health sciences, Reperfusion therapy, Fibrinolytic Agents, SDG 3 - Good Health and Well-being, medicine, Journal Article, Humans, Aged, Intention-to-treat analysis, COMPLEXITY, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], medicine.disease, Surgery, INTRAVENOUS T-PA, IR-103531, ENDOVASCULAR TREATMENT, Reperfusion, Neurology (clinical), business, 030217 neurology & neurosurgery, Fibrinolytic agent
Abstract: Item does not contain fulltext IMPORTANCE: Intra-arterial treatment (IAT) for acute ischemic stroke caused by intracranial arterial occlusion leads to improved functional outcome in patients treated within 6 hours after onset. The influence of treatment delay on treatment effect is not yet known. OBJECTIVE: To evaluate the influence of time from stroke onset to the start of treatment and from stroke onset to reperfusion on the effect of IAT. DESIGN, SETTING, AND PARTICIPANTS: The Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) was a multicenter, randomized clinical open-label trial of IAT vs no IAT in 500 patients. The time to the start of treatment was defined as the time from onset of symptoms to groin puncture (TOG). The time from onset of treatment to reperfusion (TOR) was defined as the time to reopening the vessel occlusion or the end of the procedure in cases for which reperfusion was not achieved. Data were collected from December 3, 2010, to June 3, 2014, and analyzed (intention to treat) from July 1, 2014, to September 19, 2015. MAIN OUTCOMES AND MEASURES: Main outcome was the modified Rankin Scale (mRS) score for functional outcome (range, 0 [no symptoms] to 6 [death]). Multiple ordinal logistic regression analysis estimated the effect of treatment and tested for the interaction of time to randomization, TOG, and TOR with treatment. The effect of treatment as a risk difference on reaching independence (mRS score, 0-2) was computed as a function of TOG and TOR. Calculations were adjusted for age, National Institutes of Health Stroke Scale score, previous stroke, atrial fibrillation, diabetes mellitus, and intracranial arterial terminus occlusion. RESULTS: Among 500 patients (58% male; median age, 67 years), the median TOG was 260 (interquartile range [IQR], 210-311) minutes; median TOR, 340 (IQR, 274-395) minutes. An interaction between TOR and treatment (P = .04) existed, but not between TOG and treatment (P = .26). The adjusted risk difference (95% CI) was 25.9% (8.3%-44.4%) when reperfusion was reached at 3 hours, 18.8% (6.6%-32.6%) at 4 hours, and 6.7% (0.4%-14.5%) at 6 hours. CONCLUSION AND RELEVANCE: For every hour of reperfusion delay, the initially large benefit of IAT decreases; the absolute risk difference for a good outcome is reduced by 6% per hour of delay. Patients with acute ischemic stroke require immediate diagnostic workup and IAT in case of intracranial arterial vessel occlusion. TRIAL REGISTRATION: trialregister.nl Identifier: NTR1804.
Published: 2016

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