18 results match your criteria: "Inselspital University Hospital Bern and University of Bern[Affiliation]"

Intracerebral haemorrhage - mechanisms, diagnosis and prospects for treatment and prevention.

Nat Rev Neurol

December 2024

Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK.

Intracerebral haemorrhage (ICH) is a devastating condition associated with high mortality and substantial residual disability among survivors. Effective treatments for the acute stages of ICH are limited. However, promising findings from randomized trials of therapeutic strategies, including acute care bundles that target anticoagulation therapies, blood pressure control and other physiological parameters, and trials of minimally invasive neurosurgical procedures have led to renewed optimism that patient outcomes can be improved.

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Article Synopsis
  • The study aims to assess how common intracranial vessel occlusion is among patients with atrial fibrillation (AF) who have ischemic strokes, as well as its impact on their functional recovery after 90 days.
  • It analyzed data from over 10,000 patients who underwent CT or MR angiography between 2014 and 2022, finding that over half displayed vessel occlusion, particularly in the anterior circulation.
  • Results showed that those with vessel occlusion had a significantly higher rate of poor functional outcomes, indicating that this condition worsens recovery prospects regardless of anticoagulant use.
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Background: Levodopa-carbidopa intestinal gel (LCIG) is a continuously delivered Parkinson's disease therapy intended to stabilize plasma levodopa levels. Patients receiving LCIG require education and follow-up. Some LCIG support programs use video-assisted telenursing.

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Introduction: The risk of ischemic stroke and intracerebral hemorrhage (ICH) with intensive lipid control by statins among patients with atrial fibrillation (AF) who require direct oral anticoagulants (DOAC) is unclear. We aimed to determine the risks of ischemic stroke and ICH in AF patients treated with DOAC and statins.

Patients And Methods: In a population-based retrospective cohort study, we identified AF patients concurrently on DOAC and statins from 2015 to 2021 in Hong Kong.

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Atrial fibrillation is one of the most common cardiac arrhythmias and is a major cause of ischaemic stroke. Recent findings indicate the importance of atrial fibrillation burden (device-detected, subclinical, or paroxysmal and persistent or permanent) and whether atrial fibrillation was known before stroke onset or diagnosed after stroke for the risk of recurrence. Secondary prevention in patients with atrial fibrillation and stroke aims to reduce the risk of recurrent ischaemic stroke.

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Prothrombin Complex Concentrate vs Conservative Management in ICH Associated With Direct Oral Anticoagulants.

JAMA Netw Open

February 2024

Department of Medicine and Therapeutics, Faculty of Medicine, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR.

Importance: Intracerebral hemorrhage (ICH) associated with direct oral anticoagulant (DOAC) use carries extremely high morbidity and mortality. The clinical effectiveness of hemostatic therapy is unclear.

Objective: To compare the clinical and radiological outcomes of DOAC-associated ICH treated with prothrombin complex concentrate (PCC) vs conservative management.

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Article Synopsis
  • This study focused on how emergency departments manage hyperacute treatments for patients with non-traumatic intracerebral hemorrhage, revealing significant gaps in knowledge.
  • A total of 332 ICH patients were analyzed, showing varied modes of referral and treatment delays, with only 44% of those with high blood pressure achieving control during their stay.
  • The results indicate that patients referred through stroke codes had lower mortality rates, emphasizing the importance of prompt and appropriate care in improving outcomes.
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Background: Ischaemic stroke may occur despite antiplatelet therapy (APT). We aimed to investigate frequency, potential causes and outcomes in patients with ischaemic stroke despite APT.

Methods: In this cohort study, we enrolled patients with imaging-confirmed ischaemic stroke from the Swiss Stroke Registry (01/2014-07/2022).

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Objective: Sialendoscopy is a minimally invasive diagnostic and therapeutic technique used in the treatment of various salivary gland diseases. To date, there are very few suitable training models other than the pig's head, which has been used at the European Sialendoscopy Training Center for 22 years. The goal of this study was to describe an ovine model for sialendoscopy training and compare the ovine model's to the human anatomy.

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Association of Alternative Anticoagulation Strategies and Outcomes in Patients With Ischemic Stroke While Taking a Direct Oral Anticoagulant.

Neurology

July 2023

From the Department of Medicine and Therapeutics (Y.M.B.I., H.K., L.L., A.Y., G.L.-H.W., T.C.-F.Y., X.L., Howard Chan, Helen Chan, V.M., Y.O.Y.S., T.W.L.), Faculty of Medicine, The Prince of Wales Hospital, Chinese University of Hong Kong; Department of Medicine (K.K.L.), Queen Mary Hospital, University of Hong Kong; Li Ka Shing Institute of Health Sciences (H.K.), Faculty of Medicine; Medical Data Analytic Centre (G.L.-H.W., T.C.-F.Y.), The Chinese University of Hong Kong; and Department of Neurology (D.S.), Inselspital University Hospital Bern and University of Bern, Switzerland.

Background And Objectives: Ischemic stroke despite a direct oral anticoagulant (DOAC) is increasingly common and portends a high risk of subsequent ischemic stroke. The efficacy and safety of antithrombotic regimens after the condition are unclear. We aimed to compare the outcomes of patients with ischemic stroke despite DOACs with and without an alternative antithrombotic regimen and determine the risk factors of recurrent ischemic stroke while on anticoagulation.

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Genetic stratification of motor and QoL outcomes in Parkinson's disease in the EARLYSTIM study.

Parkinsonism Relat Disord

October 2022

Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg; Transversal Translational Medicine, Luxembourg Institute of Health, Strassen, Luxembourg; Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg.

Article Synopsis
  • The study explores whether genetic variables can predict outcomes of subthalamic deep brain stimulation (STN-DBS) in patients with Parkinson's disease (PD).
  • Researchers aimed to replicate an earlier finding that a specific genetic variant (SNCA rs356220) was linked to better STN-DBS responses and looked at additional genetic factors from recent genome-wide association studies (GWAS).
  • Although the SNCA rs356220 variant didn't predict motor outcomes, it was associated with improved quality of life; other genetic markers showed predictive value for DBS outcomes, but polygenic risk scores were not useful in this context.
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Traditional simulation techniques such as wave optics methods and Monte Carlo (MC) particle transport cannot model both interference and inelastic scattering phenomena within one framework. Based on the rules of quantum mechanics to calculate probabilities, we propose a new semi-classical MC algorithm for efficient and simultaneous modeling of scattering and interference processes. The similarities to MC particle transport allow the implementation as a flexible c++ object oriented extension of EGSnrc-a well-established MC toolkit.

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Purpose Of Review: Direct oral anticoagulants (DOAC) are the mainstay of anticoagulant therapy for stroke prevention in patients with nonvalvular atrial fibrillation. Persistent uncertainties remain in different areas, and this review discusses current dilemmas based on selected studies.

Recent Findings: Optimal timing of DOAC initiation after a recent ischaemic stroke in patients with atrial fibrillation is currently unknown and subject of ongoing randomized controlled trials.

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Paclitaxel is a powerful chemotherapeutic drug, used for the treatment of many cancer types, including esophageal adenocarcinomas (EAC). Autophagy is a lysosome-dependent degradation process maintaining cellular homeostasis. Defective autophagy has been implicated in cancer biology and therapy resistance.

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Over the last couple of years the implementation of Monte Carlo (MC) methods of grating based imaging techniques is of increasing interest. Several different approaches were taken to include coherent effects into MC in order to simulate the radiation transport of the image forming procedure. These include full MC using FLUKA [1], which however are only considering monochromatic sources.

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Esophageal adenocarcinomas (EAC) are aggressive tumors with considerable rates of chemoresistance. Autophagy is a lysosome-dependent degradation process, characterized by the formation of vesicles called autophagosomes, and has been implicated in cancer. Protein light chain 3 B (LC3B) and p62 are associated with autophagosomal membranes and degraded.

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In diacetylmorphine prescription programs for heavily dependent addicts, diacetylmorphine is usually administered intravenously, but this may not be possible due to venosclerosis or when heroin abuse had occurred via non-intravenous routes. Since up to 25% of patients administer diacetylmorphine orally, we characterised morphine absorption after single oral doses of immediate and extended release diacetylmorphine in 8 opioid addicts. Plasma concentrations were determined by liquid chromatography-mass spectrometry.

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