The role of patent foramen ovale is a field of debate and current publications have increasing controversies about the patients' management in young undetermined stroke. Work up with echocardiography ...and transcranial Doppler (TCD) can aid the decision with better anatomical and functional characterization of right-to-left shunt (RLS). Medical and interventional strategy may benefit from this information.
a group of experts from the Latin American participants of the Neurosonology Research Group (NSRG) of World Federation of Neurology created a task force to review literature and describe the better methodology of contrast TCD (c-TCD). All signatories of the present consensus statement have published at least one study on TCD as an author or co-author in an indexed journal. Two meetings were held while the consensus statement was being drafted, during which controversial issues were discussed and voted on by the statement signatories. The statement paper was reviewed and approved by the Executive Committee of the NSRG of the World Federation of Neurology. The main objective of this consensus statement is to establish a standardization of the c-TCD technique and its interpretation, in order to improve the informative quality of the method, resulting in expanding the application of TCD in the clinical setting. These recommendations optimize the comparison of different diagnostic methods and encourage the use of c-TCD for RLS screening and complementary diagnosis in multicenter studies.
A 53-year-old right-handed man developed left hemiparesis (of grade 2 in the Medical Research Council Scale) and right head deviation due to ischemic stroke. When instructed to clap his hands, he ...brought his right hand to the midline and searched for the other hand. Fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) scans, the unilateral spatial neglect (USN) test, and the blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) study are presented in · The Eastchester clapping sign provides evidence of USN phenomena.- Frequently, patients with USN can ignore problems with the affected limb. This patient presented bilateral activation in the networks related to spatial attention (mainly parietal posterior lobes), and fMRI patterns indicated maladaptive plasticity.·
ABSTRACT Pasta products are generally formulated based on wheat flour, and the insertion of other vegetable raw materials, such as pequi fruit, can provide increased nutritional value, along with ...differentiated technological and sensory characteristics. Thus, the aim of this study was to produce pasta with different levels of substitution of wheat flour with pequi pulp flour, to determine its proximate composition and to evaluate its technological and sensory properties. Pastas were produced with 5%, 10% and 15% of wheat flour being substituted by pequi pulp flour, and there was also a control group. Technological analyses (cooking time, volume expansion, water absorption, cooking loss, color difference and chromaticity), chemical analyses (moisture, ash, lipids, proteins and total carbohydrates) and sensory tests (acceptance and intention consumption) were carried out. The main results showed that pequi flour promoted an expansion in volume and water absorption in the product; raw and cooked pasta had more intense colors; moisture, ash and lipid content was increased by using pequi flour; and the sensory test scores for the samples with pequi were high in relation to the control samples, with the formulations with the highest content of pequi flour being the best evaluated. It is concluded that the pastas with pequi flour are promising products for the food industry.
RESUMO Massas alimentícias são geralmente formuladas a base de farinha de trigo, sendo que a inserção de outras matérias-primas vegetais, como o fruto pequi, pode proporcionar incremento de valor nutricional, características tecnológicas e sensoriais diferenciadas. Dessa forma, o objetivo desse estudo foi produzir massas alimentícias com diferentes substituições da farinha de trigo por farinha da polpa de pequi, determinar a sua composição centesimal e avaliar as propriedades tecnológicas e sensoriais das massas elaboradas. As massas alimentícias foram produzidas com substituições de 5%, 10% e 15% da farinha de trigo pela farinha da polpa de pequi, além do grupo controle. Foram realizadas análises tecnológicas (tempo de cozimento, expansão de volume, absorção de água, perda de sólidos solúveis, diferença de cor e cromaticidade), análises químicas (umidade, cinzas, lipídios, proteínas e carboidratos totais) e testes sensoriais (aceitação e intenção de consumo). Os principais resultados mostrados foram que a farinha de pequi promoveu expansão no volume e na absorção de água no produto; massas cruas e coccionadas apresentaram cores mais intensas; incrementou-se os teores de umidade, cinzas e lipídios pelo uso da farinha de pequi; e as notas dos testes sensoriais das amostras com pequi foram elevadas em relação às amostras controle, sendo as formulações com maiores teores de substituição de farinha de pequi as melhores avaliadas. Conclui-se que, as massas alimentícias com farinha de pequi são produtos promissores para a indústria alimentícia.
Background Sickle cell anemia (SCA) is the leading cause of childhood stroke. We aimed to evaluate whether altered cerebral flow velocities, as measured by transcranial Doppler (TCD), are associated ...with vaso-occlusive complications in addition to stroke in pediatric SCA patients. Methods We evaluated 37 children aged between 2 and 16 years with SCA who underwent screening for TCD between January 2012 and October 2018. Genotypic profiles and demographic data were collected, TCD examinations were performed during follow-up, and the presence of sickling crises was compared. Survival analyses were performed using simple frailty models, in which each predictor variable was analyzed separately in relation to the occurrence of a sickling crisis. Results The variables related to sickle cell crises in the univariate analysis were peak systolic velocity (PSV) in the middle cerebral artery (MCA), hazard ratio (HR) 1.01 (1.00--1.02) p = 0.04; end-diastolic velocity (EDV) in the MCA, HR 1.02 (1.01--1.04) p = 0.01; time average mean maximum velocity (TAMMV) in the basilar artery (BA), HR 1.02 (1.00--1.04) p = 0.04; hemoglobin, HR 0.49 (0.38--0.65) p < 0.001; hematocrit, HR 0.78 (0.71--0.85) p < 0.001; leukocyte counts, HR 1.1 (1.05--1.15) p < 0.001; platelets counts, HR 0.997 (0.994--0.999) p = 0.02; and reticulocyte numbers, HR 1.14 (1.06--1.23) p < 0.001. Conclusions Our results indicate PSV and EDV in the MCA and TAMMV in the BA as markers of risk for the occurrence of sickling crises in SCA. Keywords: Stroke, Sickle cell anemia, Transcranial Doppler
Abstract
Background:
Patent foramen ovale (PFO) has been considered a potential mechanism of embolic stroke of undetermined origin.
Objective:
The aim of the present study was to identify the ...features of the right-to-left shunt (RLS) in patients with undetermined embolic ischemic stroke and compare them with those of patients with non-cardioembolic ischemic stroke.
Methods:
A retrospective study was conducted with 168 patients with stroke and RLS separated into the following two groups: the undetermined embolic stroke group (UES group) and non-cardioembolic stroke group (NCES group). All patients were assessed by transcranial Doppler to evaluate the presence and quantification of microembolic signals (MES) at rest and under Valsalva maneuver.
Results:
Of all patients evaluated in the current study, 96 were included in the UES group and 72 in the NCES group. In the UES group, 65 patients had RLS with ≥10 MES (67.7%), which was higher than that observed in the NCES group (51.4%, p=0.038). According to the moment of the cardiac cycle, 75 patients (78.1%) in the UES group had a positive test at rest compared to 42 (58.3%) in the NCES group (p=0.007).
Conclusions:
The current study demonstrated that almost 70% of patients with undetermined embolic stroke and PFO presented a large RLS and more than 75% had RLS at rest. These findings suggest that the size of the shunt should be taken into account when evaluating whether PFO could be a possible mechanism underlying cryptogenic stroke.
Evaluation of the use of pequi pulp flour in breaded meat Braga-Souto, Renata Nolasco; Santos, Thalita Cordeiro; Barbosa, Rafaela Pereira de Assis ...
Semina. Ciências agrárias : revista cultural e científica da Universidade Estadual de Londrina,
01/2020
Journal Article
Recenzirano
Odprti dostop
Processed meat foods may be associated with poor eating habits, but the aggregation of vegetable ingredients, such as pequi (Caryocar brasiliense), makes the formulations of these products healthier ...and more nutritious. Thus this study aimed to characterize the chemical composition of breaded chicken prepared with pequi pulp flour in breading, as well as to evaluate the technological and sensorial properties of the breaded chicken. The pequis pulp from the region of Montes Claros - MG was dehydrated to obtain flour used in predust, with substitutions of 0%, 25%, 50% and 100% of the breadcrumbs flour. Meat products were chemically evaluated for moisture, lipids, proteins, carbohydrates, and ashes, technologically with measures of specific volume, yield, color difference, chromaticity, and tone of the breaded chicken, and sensorially by the evaluation of the intention of consumption and acceptance. As a result, pequi flour added lipid and protein content, improved yield, allowed higher specific volumes, and more intense color tones to the breaded. In addition, these presented good sensorial results and without significant differences among the studied formulations. It was concluded that the use of pequi flour in the production of breaded chicken can provide nutritional and technological enrichment to these products, without adversely affecting their sensorial characteristics.
The aim of this study was to relate the presence of a temporal acoustic window (TAW) to the variables sex, age and race. This observational study was conducted in patients under etiologic ...investigation after stroke, sickle-cell anemia and hospitalization in an intensive therapy neurologic unit. TAW presence was confirmed by bilateral assessment by two neurologists via transcranial Doppler (TCD). Multiple logistic regression was performed to explain the presence of the window as a function of sex, age and race. In 20% of the 262 patients evaluated, a TAW was not present. The incidence of TAW presence was greater in men (odds ratio OR = 5.4, 95% confidence interval CI = 2.5-11.7, p < 0.01); lower with increased age (OR = 0.9, 95% CI = 0.92-0.97, p < 0.01); and lower among those of African and Asian descent (OR = 0.32, 95% CI = 0.14-0.70, p = 0.005). On the basis of the results, more men than women had TAWs, and the decrease in TAWs was associated with increased age and African or Asian descent.
Malignant cerebral artery strokes have a poor prognosis, with nearly 80% of mortality in some series despite intensive care. After a large randomized trial, decompressive hemicraniectomy has been ...performed more often in stroke patients. Here, we describe patients in a tertiary teaching hospital in Brazil, emphasizing the impact of age on outcomes.
A retrospective cohort of patients, with malignant strokes which received a decompressive hemicraniectomy, from paper and electronic medical records, from January 2010 to December 2013 was divided into two groups according to age.
The final analysis included 60 patients. The overall mortality was higher among patients older than 60 yrs (67% vs. 41%; p = 0.039), whose group also had a worse outcome (76% with mRS 5 or 6) at 90 days (OR 3.91 CI95% 1.30-11.74), whereas only 24% had mRS of 0-4 (p = 0.015). All patients who presented with sepsis died (p = 0.003). The incidence of pulmonary infection was very high in the elderly group (76%) with significant intergroup differences (p = 0.027, OR 8.32 CI95% 0.70-98.48).
Older patients present more commonly with infections, more disabilities and a higher mortality, highlighting very poor results in elderly population. These results should be proved with a South American trial, and if confirmed, it can impact on future decisions regarding decompressive craniectomy for acute ischemic stroke in our region.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Introduction
The presence of microembolic signals (MES) during the acute phase of stroke is poorly understood, and its role and clinical application in relation to risk stratification and prognosis ...in patients remain uncertain. We assessed the prevalence of spontaneous MES in acute stroke and their relationship with risk stratification, stroke recurrence, morbidity, and mortality.
Patients and methods
This was a prospective cohort study conducted in the Stroke Unit. The MES presence was evaluated by transcranial Doppler (TCD) in patients with ischemic stroke within 48 h. The outcomes (risk stratification, morbidity, mortality, and recurrence of a stroke) were followed up for 6 months. The relationship between risk stratification and MES was obtained by odds ratios and that between MES and stroke recurrence, morbidity, and mortality using multiple logistic regression; considering statistical significance at
P
< 0.05.
Results
Of the 111 patients studied, 70 were men (63.1%) and 90 were white (81.1%), with a median age of 68 years. The MES frequency was 7%. There was a significant relationship between MES and symptomatic carotid disease (OR = 22.7; 95% CI 4.1–125.7;
P
< 0.001), a shorter time to monitoring (OR = 12.4; 95% CI 1.4–105.4;
P
= 0.02), and stroke recurrence (OR = 16.83; 95% CI 2.01–141;
P
= .009).
Discussion
It was observed that the stroke recurrence adjusted for prior stroke was higher and earlier among patients with MES detection. In conclusion, MES demonstrated a significant correlation with symptomatic carotid disease and a shorter DELAY until monitoring, and could be a predictor for the early recurrence of stroke in the long term.
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