Title
Prognostički značaj biohemijskih, radioloških i kliničkih parametara za razvoj perifokalnog moždanog edema i ishod kod pacijenata sa intracerebralnom hemoragijom
Creator
Rendevski, Vladimir K. 1979-
Copyright date
2018
Object Links
Select license
Autorstvo 3.0 Srbija (CC BY 3.0)
License description
Dozvoljavate umnožavanje, distribuciju i javno saopštavanje dela, i prerade, ako se navede ime autora na način odredjen od strane autora ili davaoca licence, čak i u komercijalne svrhe. Ovo je najslobodnija od svih licenci. Osnovni opis Licence: http://creativecommons.org/licenses/by/3.0/rs/deed.sr_LATN Sadržaj ugovora u celini: http://creativecommons.org/licenses/by/3.0/rs/legalcode.sr-Latn
Language
Serbian
Cobiss-ID
Theses Type
Doktorska disertacija
description
Datum odbrane: 18.12.2018.
Other responsibilities
mentor
Stojanov, Dragan
član komisije
Kocić, Gordana
član komisije
Radovanović, Zoran
član komisije
Lukić, Snežana
član komisije
Nikolov, Vesna
Academic Expertise
Medicinske nauke
University
Univerzitet u Nišu
Faculty
Medicinski fakultet
Group
Katedra za neurologiju
Alternative title
Prognostic value of the biochemical, radiological and clinical parameters for development of the brain perifocal edema and the outcome in patients with intracerebral hemorrhage
Publisher
[V. К. Rendevski]
Format
XIII, 112 listova
description
Beleška o autoru: list 112;
Bibliografija: listovi 94-106.
description
Neurosurgery
Abstract (en)
Background: In the present study, we have assessed the prognostic role of the biochemical (plasma glutamate and TNF-α), radiological and clinical variables for the development of the brain perifocal edema and the outcome in patients with intracerebral hemorrhage (ICH). Methods: This longitudinal study includes fifty patients with ICH and fifty healthy controls. Their peripheral blood plasma glutamate and TNF-α levels were detected by high-sensitivity ELISA. The initial hematoma volume, the volume of the hematoma and perifocal edema after five days and, the volume of the residual cavity 3 months after ICH were carefully evaluated by using computer tomography (CT); the Canadian Stroke Scale (CSS) was used for estimation of the symptom severity at admission and for estimation of the 3-month functional status and outcome after ICH. Results: We have revealed highly significant differences in blood plasma glutamate and TNF-α levels between patients and healthy controls, with good separation of their values. The two biochemical variables correlated with the admission symptom severity, the initial volume of ICH at admission, the volume of ICH five days after ICH and the volume of the perifocal edema. Both peripheral glutamate and TNF-α levels at admission were estimated as significant predictors for the volume of perifocal edema five days after ICH, but it was shown that they independently contribute (without any effect of interaction) to the volume of the edema, regardless the localization of the ICH. A priori, the anatomic localization of ICH was estimated as the only significant predictor for poor neurological outcome 3 months after ICH; patients with deep ICH had 96 times higher odds for poor outcome. Nevertheless, after the anatomic localization of ICH was omitted from the model, TNF-α was also confirmed as significant predictor for poor outcome. Conclusions: Our results support the idea for the significance of glutamate and TNF-α as peripheral markers for excitotoxicity and inflammation in ICH patients. Moreover, we believe that the developed multiple regression models for prediction of the volume of the perifocal edema and the clinical outcome could help in the dilemma between conservative treatment and surgical intervention in the clinical practice.
Authors Key words
intracerebralna hemoragija, glutamat, TNF-α, perifokalni edem, klinički ishod
Authors Key words
intracerebral hemorrhage, glutamate, TNF-α, perifocal edema, clinical outcome
Classification
616.831-005.1-005.98-036(043.3)
Subject
B640
Type
Tekst
Abstract (en)
Background: In the present study, we have assessed the prognostic role of the biochemical (plasma glutamate and TNF-α), radiological and clinical variables for the development of the brain perifocal edema and the outcome in patients with intracerebral hemorrhage (ICH). Methods: This longitudinal study includes fifty patients with ICH and fifty healthy controls. Their peripheral blood plasma glutamate and TNF-α levels were detected by high-sensitivity ELISA. The initial hematoma volume, the volume of the hematoma and perifocal edema after five days and, the volume of the residual cavity 3 months after ICH were carefully evaluated by using computer tomography (CT); the Canadian Stroke Scale (CSS) was used for estimation of the symptom severity at admission and for estimation of the 3-month functional status and outcome after ICH. Results: We have revealed highly significant differences in blood plasma glutamate and TNF-α levels between patients and healthy controls, with good separation of their values. The two biochemical variables correlated with the admission symptom severity, the initial volume of ICH at admission, the volume of ICH five days after ICH and the volume of the perifocal edema. Both peripheral glutamate and TNF-α levels at admission were estimated as significant predictors for the volume of perifocal edema five days after ICH, but it was shown that they independently contribute (without any effect of interaction) to the volume of the edema, regardless the localization of the ICH. A priori, the anatomic localization of ICH was estimated as the only significant predictor for poor neurological outcome 3 months after ICH; patients with deep ICH had 96 times higher odds for poor outcome. Nevertheless, after the anatomic localization of ICH was omitted from the model, TNF-α was also confirmed as significant predictor for poor outcome. Conclusions: Our results support the idea for the significance of glutamate and TNF-α as peripheral markers for excitotoxicity and inflammation in ICH patients. Moreover, we believe that the developed multiple regression models for prediction of the volume of the perifocal edema and the clinical outcome could help in the dilemma between conservative treatment and surgical intervention in the clinical practice.
“Data exchange” service offers individual users metadata transfer in several different formats. Citation formats are offered for transfers in texts as for the transfer into internet pages. Citation formats include permanent links that guarantee access to cited sources. For use are commonly structured metadata schemes : Dublin Core xml and ETUB-MS xml, local adaptation of international ETD-MS scheme intended for use in academic documents.