RESUMO
BACKGROUND AND PURPOSE: Intracranial arterial stenosis (ICAS)-related stroke occurs due to three primary mechanisms with distinct infarct patterns: (1) borderzone infarcts (BZI) due to impaired distal perfusion, (2) territorial infarcts due to distal plaque/thrombus embolization, and (3) plaque progression occluding perforators. The objective of the systematic review is to determine whether BZI secondary to ICAS is associated with a higher risk of recurrent stroke or neurological deterioration. METHODS: As part of this registered systematic review (CRD42021265230), a comprehensive search was performed to identify relevant papers and conference abstracts (with ≥20 patients) reporting initial infarct patterns and recurrence rates in patients with symptomatic ICAS. Subgroup analyses were performed for studies including any BZI versus isolated BZI and those excluding posterior circulation stroke. The study outcome included neurological deterioration or recurrent stroke during follow-up. For all outcome events, corresponding risk ratios (RRs) and 95% confidence intervals (95% CI) were calculated. RESULTS: A literature search yielded 4,478 records with 32 selected during the title/abstract triage for full text; 11 met inclusion criteria and 8 studies were included in the analysis (n=1,219 patients; 341 with BZI). The meta-analysis demonstrated that the RR of outcome in the BZI group compared to the no BZI group was 2.10 (95% CI 1.52-2.90). Limiting the analysis to studies including any BZI, the RR was 2.10 (95% CI 1.38-3.18). For isolated BZI, RR was 2.59 (95% CI 1.24-5.41). RR was 2.96 (95% CI 1.71-5.12) for studies only including anterior circulation stroke patients. CONCLUSION: This systematic review and meta-analysis suggests that the presence of BZI secondary to ICAS may be an imaging biomarker that predicts neurological deterioration and/or stroke recurrence.
RESUMO
The impact of pH on the physicochemical properties of 10% menhaden oil-in-water (O/W) emulsions containing 2% whey protein isolate (WPI) and 0.1% xanthan (XG)-locust bean gum (LBG) mixtures was investigated. The O/W emulsions containing 0.1% XG-LBG mixtures were compared to emulsions with 0.1% XG and 0.1% LBG. The results indicated that stability is dependent on pH and biopolymer type. At both pH 3 and 5, emulsions containing either XG or XG-LBG mixtures had large particle sizes, viscosity, droplet aggregation, and creaming index, resulting in poor physical stability which can be related to the adsorbed protein-polysaccharide interactions. At pH7, the XG-LBG emulsions showed the greatest resistance to phase separation and resulted in stable emulsions. Lipid oxidation measurements also indicated that XG-LBG mixtures can be used to form stable emulsions at pH 3 and pH 7. These results have significant implications for the development of novel structures containing lipid phases susceptible to lipid oxidation.
