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        Systolic blood pressure variability within 120 hours of admission predicts the functional outcomes at discharge of patients with acute ischemic stroke

        Pedro Tiago,Pereira Pedro,Costa Ana Sofia,Almeida Fábio,Loureiro Maria Luísa,Alfaiate Teresa,Gonçalves Abílio 대한신경집중치료학회 2022 대한신경집중치료학회지 Vol.15 No.1

        Background: Blood pressure variability (BPV) is a predictor of short- and long-term disability in patients with acute ischemic stroke (AIS). Its effect on more immediate functional outcomes has been seldom studied, and the results are inconsistent. We aimed to determine the role of BPV during the first 5 days of hospitalization in functional status at the time of discharge of patients with AIS.Methods: We enrolled 134 patients diagnosed with AIS and BPV using standard deviation and coefficient of variation (CV %). These were associated with the dichotomized modified Rankin Scale at discharge using logistic regression. Results: Patients with unfavorable outcomes were significantly older (P=0.014), had a lower body mass index (P=0.001), were less likely to present with dyslipidemia (P=0.001), had lower serum triglyceride levels (P=0.012), had a longer hospitalization period (P<0.001), and had a higher mean National Institutes of Health Stroke Scale score at admission (P<0.001). After adjusting for multiple confounders, the CV % of systolic blood pressure (SBP) in the first 120 hours after admission had a significant effect on functional disability at discharge. Conclusion: Variability in SBP in the first 5 days of hospitalization had a deleterious effect on the functional outcomes at discharge of patients with AIS. The role of diabolic blood pressure variability seems to be significant only in the first 24 hours of admission; however, further research is required.

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        Cardiovascular Magnetic Resonance Versus Histopathologic Study for Diagnosis of Benign and Malignant Cardiac Tumours: A Systematic Review and Meta-Analysis

        Sandra Nóbrega,Catarina Martins da Costa,Ana Filipa Amador,Sofia Justo,Elisabete Martins 한국심초음파학회 2023 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.31 No.4

        BACKGROUND: The gold standard for diagnosis of cardiac tumours is histopathological examination. Cardiovascular magnetic resonance (CMR) is a valuable non-invasive, radiation-free tool for identifying and characterizing cardiac tumours. Our aim is to understand CMR diagnosis of cardiac tumours by distinguishing benign vs. malignant tumours compared to the gold standard. METHODS: A systematic search was performed in the PubMed, Web of Science, and Scopus databases up to December 2022, and the results were reviewed by 2 independent investigators. Studies reporting CMR diagnosis were included in a meta-analysis, and pooled measures were obtained. The risk of bias was assessed using the Quality Assessment Tools from the National Institutes of Health. RESULTS: A total of 2,321 results was obtained; 10 studies were eligible, including one identified by citation search. Eight studies were included in the meta-analysis, which presented a pooled sensitivity of 93% and specificity of 94%, a diagnostic odds ratio of 185, and an area under the curve of 0.98 for CMR diagnosis of benign vs. malignant tumours. Additionally, 4 studies evaluated whether CMR diagnosis of cardiac tumours matched specific histopathological subtypes, with 73.6% achieving the correct diagnosis. CONCLUSIONS: To the best of our knowledge, this is the first published systematic review on CMR diagnosis of cardiac tumours. Compared to histopathological results, the ability to discriminate benign from malignant tumours was good but not outstanding. However, significant heterogeneity may have had an impact on our findings.

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