Tratamiento de reperfusión en el ictus isquémico agudo por disección arterial cervicocerebral: descripción de los resultados de un estudio nacional multicéntrico / Reperfusion treatment in acute ischaemic stroke due to cervical and cerebral artery dissection: results of a Spanish national multicentre study

Introducción: El ictus isquémico (II) por disección arterial cervicocerebral (DAC) es una entidadinfrecuente y existen pocos datos sobre el uso de terapias de reperfusión como la fibrinólisis intravenosa y la trombectomía mecánica. Se analizó el uso de dichas terapias en pacientes conII por DAC y se comparó con aquellos pacientes reperfundidos con II por otras causas.Método: Estudio observacional retrospectivo multicéntrico de pacientes con II por DAC basadoen el Registro Nacional de Ictus de la Sociedad Espa˜nola de Neurología durante el periodo 2011-2019. Se realizaron análisis comparativos entre: a) pacientes con DAC tratados y no tratados conterapias de reperfusión y b) pacientes reperfundidos con II por DAC y pacientes reperfundidoscon II por otras causas. Se incluyeron variables epidemiológicas, del ictus y resultados al alta ya los 3 meses.Resultados: Un total de 21.037 pacientes con II fueron incluidos; 223 (1%) fueron por DAC y 68(30%) recibieron tratamiento de reperfusión. El uso de tratamientos de reperfusión fue menor enlos casos de DAC de arteria vertebral y mayor en los casos de oclusión carotídea. Los pacientescon II por DAC reperfundidos respecto a aquellos con II reperfundidos por otras causas fueronmás jóvenes, la trombectomía mecánica se utilizó más y la fibrinólisis intravenosa menos. Lascomplicaciones hemorrágicas, la mortalidad y la autonomía a los 3 meses fueron similares.Conclusiones: Las terapias de reperfusión se usan con frecuencia en los pacientes con II porDAC. Los resultados demuestran eficacia y seguridad y son equiparables a los pacientes tratadoscon terapias de reperfusión por II de otras causas.(AU)

Introduction: Ischaemic stroke (IS) due to cervical and cerebral artery dissection (CAD) is arare entity, and few data are available on the use of such reperfusion therapies as intravenousfibrinolysis and mechanical thrombectomy in these patients. We analysed the use of these treat-ments in patients with IS due to CAD and compared them against patients receiving reperfusiontreatment for IS of other aetiologies.Method: We conducted an observational, retrospective, multicentre study of patients with ISdue to CAD recorded in the National Stroke Registry of the Spanish Society of Neurology duringthe period 2011-2019. Comparative analyses were performed between: a) patients with CADtreated and not treated with reperfusion therapies and b) patients treated with reperfusion forIS due to CAD and patients treated with reperfusion for IS due to other causes. Epidemiologicaldata, stroke variables, and outcomes at discharge and at 3 months were included in the analysis.Results: The study included 21,037 patients with IS: 223 (1%) had IS due to CAD, of whom68 (30%) received reperfusion treatment. Reperfusion treatments were used less frequently incases of vertebral artery dissection and more frequently in patients with carotid artery occlu-sion. Compared to patients with IS due to other causes, patients with CAD were younger, morefrequently underwent mechanical thrombectomy, and less frequently received intravenous fibri-nolysis. Rates of haemorrhagic complications, mortality, and independence at 3 months weresimilar in both groups.Conclusions: Reperfusion therapy is frequently used in patients with IS due to CAD. The outco-mes of these patients demonstrate the efficacy and safety of reperfusion treatments, and arecomparable to the outcomes of patients with IS due to other aetiologies.(AU)

Reperfusion therapy in acute ischaemic stroke due to cervical and cerebral artery dissection: Results from a Spanish multicentre study.

INTRODUCTION: Ischaemic stroke (IS) due to cervical and cerebral artery dissection (CAD) is a rare entity, and few data are available on the use of such reperfusion therapies as intravenous fibrinolysis and mechanical thrombectomy in these patients. We analysed the use of these treatments in patients with IS due to CAD and compared them against patients receiving reperfusion treatment for IS of other aetiologies. METHODS: We conducted an observational, retrospective, multicentre study of patients with IS due to CAD recorded in the National Stroke Registry of the Spanish Society of Neurology during the period 2011-2019. Comparative analyses were performed between: a) patients with CAD treated and not treated with reperfusion therapies and b) patients treated with reperfusion for IS due to CAD and patients treated with reperfusion for IS due to other causes. Epidemiological data, stroke variables, and outcomes at discharge and at 3 months were included in the analysis. RESULTS: The study included 21,037 patients with IS: 223 (1%) had IS due to CAD, of whom 68 (30%) received reperfusion treatment. Reperfusion treatments were used less frequently in cases of vertebral artery dissection and more frequently in patients with carotid artery occlusion. Compared to patients with IS due to other causes, patients with CAD were younger, more frequently underwent mechanical thrombectomy, and less frequently received intravenous fibrinolysis. Rates of haemorrhagic complications, mortality, and independence at 3 months were similar in both groups. CONCLUSIONS: Reperfusion therapy is frequently used in patients with IS due to CAD. The outcomes of these patients demonstrate the efficacy and safety of reperfusion treatments, and are comparable to the outcomes of patients with IS due to other aetiologies.

Reperfusion treatment in acute ischaemic stroke due to cervical and cerebral artery dissection: results of a Spanish national multicentre study. / Tratamiento de reperfusión en el ictus isquémico agudo por disección arterial cervicocerebral: descripción de los resultados de un estudio nacional multicéntrico.

INTRODUCTION: Ischaemic stroke (IS) due to cervical and cerebral artery dissection (CAD) is a rare entity, and few data are available on the use of such reperfusion therapies as intravenous fibrinolysis and mechanical thrombectomy in these patients. We analysed the use of these treatments in patients with IS due to CAD and compared them against patients receiving reperfusion treatment for IS of other aetiologies. METHOD: We conducted an observational, retrospective, multicentre study of patients with IS due to CAD recorded in the National Stroke Registry of the Spanish Society of Neurology during the period 2011-2019. Comparative analyses were performed between: a) patients with CAD treated and not treated with reperfusion therapies and b) patients treated with reperfusion for IS due to CAD and patients treated with reperfusion for IS due to other causes. Epidemiological data, stroke variables, and outcomes at discharge and at 3 months were included in the analysis. RESULTS: The study included 21,037 patients with IS: 223 (1%) had IS due to CAD, of whom 68 (30%) received reperfusion treatment. Reperfusion treatments were used less frequently in cases of vertebral artery dissection and more frequently in patients with carotid artery occlusion. Compared to patients with IS due to other causes, patients with CAD were younger, more frequently underwent mechanical thrombectomy, and less frequently received intravenous fibrinolysis. Rates of haemorrhagic complications, mortality, and independence at 3 months were similar in both groups. CONCLUSIONS: Reperfusion therapy is frequently used in patients with IS due to CAD. The outcomes of these patients demonstrate the efficacy and safety of reperfusion treatments, and are comparable to the outcomes of patients with IS due to other aetiologies.

High prevalence of non-alcoholic fatty liver disease among hidradenitis suppurativa patients independent of classic metabolic risk factors.

BACKGROUND: Some chronic inflammatory skin diseases, such as psoriasis, have been associated with an increased prevalence of non-alcoholic fatty liver disease (NAFLD). Nevertheless, this prevalence in hidradenitis suppurativa (HS) has not been assessed to date. OBJECTIVES: To determine the prevalence of NAFLD in patients with HS and the risk factors associated with this disorder. METHODS: This case-control study enrolled 70 HS patients and 150 age- and gender-matched controls who were evaluated by hepatic ultrasonography (US) and transient elastography (TE) after excluding other secondary causes of chronic liver disease. The diagnosis of NAFLD was established if US and/or TE were altered. RESULTS: The prevalence of NAFLD was significantly increased in patients with HS compared to controls (72.9% vs. 24.7%: P < 0.001). In the multivariable regression model adjusted for age, sex and classic metabolic risk factors for NAFLD, HS was significantly and independently associated with the presence of NAFLD [OR 7.75 confidence interval (CI) 2.54-23.64; P < 0.001]. CONCLUSIONS: Our results show a high prevalence of NAFLD in HS patients independent of classic metabolic risk factors. Therefore, we suggest HS patients to be evaluated for NAFLD and managed accordingly.

Intraepithelial lymphocytes subsets in different forms of celiac disease.

AIM: The enumeration of intraepithelial lymphocytes subsets (total, γδ, and CD3(-) IELs) by flow cytometry (FCM), named as IEL lymphogram, constitutes a useful tool for celiac disease (CD) diagnosis. The aim of this study was to quantify IELs by FCM and their diagnostic value to differentiate active, silent and potential CD. METHODS: Prospective study of 60 active and 20 silent CD patients, and 161 controls in which duodenal biopsy and IEL quantification by FCM was performed. RESULTS: Active and silent CD patients had significant higher levels of both total and γδ IELs than absent CD patients (P < 0.0001 and P < 0.0001, P = 0.012 and P < 0.011; respectively). Active and silent CD patients had significant lower levels of CD3(-) IELs than absent CD patients (P < 0.047 and P < 0.009, respectively). Moreover, they were lower in silent than in active CD patients (P = 0.002). Changes of IELs subsets were more marked in children than adults active CD. The optimal IEL lymphogram cut off values for active CD diagnosis were: ≥10, ≥15 and ≤9 %, and with better performance characteristics for silent CD: ≥ 11, ≥10 and ≤5 %. CONCLUSION: The evaluation of IELs subsets by FCM is useful to confirm diagnosis of active and silent CD.

Galectin-1 in stable liver transplant recipients.

INTRODUCTION: The achievement of a state of tolerance and minimization of the immunosuppressive load form part of the "Holy Grail" in solid organ transplantation. Galectin-1 recently has been described to be involved in the maintenance of a tolerant environment, but there is no evidence of its role in human liver transplantation. The aim of our study was to measure the serum levels of galectin-1 in stable liver transplant recipients. METHODS: Serum levels of galectin-1 were determined in 30 stable liver transplant recipients who had been free of rejection episodes for at least 8 years. Fifteen patients with an acute rejection episode and 34 healthy subjects were used as the control group. RESULTS: The concentrations of galectin-1 were significantly higher in stable liver transplant recipients compared with healthy subjects and with the acute rejection group. CONCLUSIONS: These preliminary results indicate that galectin-1 is upregulated in stable liver transplant recipients. Thus, our results extend the recent findings that galectin-1 may play an immune-suppressive role in liver transplantation. It remains to be established whether it might help to induce tolerance in liver transplantation.