Recently, many academic research groups focused their attention on changes in human brain networks related to several kinds of pathologies and diseases. Generally speaking, Network Medicine promises to identify the principles to understand, at the molecular level, the human life complex system. We applied the theoretical approach of the Network Medicine mainly to brain diseases, testing the potentiality of the method to produce an early and more in-depth diagnostic process. However, the range of our topics and application of the Network Medicine spans from common neurological and neuropsychological spectrum disorders to other physiological systems or district, only apparently out of the action range of the neurological one. In the areas of Neurology and Neuropsychology we are studying brain networks in Tourette Syndrome [TS] and Multiple Sclerosis [MS]. Moreover, we are studying brain networking related to genotype alteration responsible for different gustatory stimuli processing in the brain. Further, we recently started to study infective diseases and immunological system.
Acute ischemic stroke (AIS) is a common neurovascular emergency causing significant burden to society. Currently the main focus of AIS treatment is to restore blood flow to at risk brain tissue. For the last twenty years, intravenous tissue plasminogen activator (tPA) was the only proven therapy for patients with AIS. More recently, five randomized clinical trials established the efficacy of endovascular therapy with or without intravenous tPA in selected patient populations with AIS. Not all stroke patients benefit from intravenous tPA or endovascular treatment. Nonetheless, the concept of early recanalization of occluded arteries resulting in better clinical outcomes is well established. In this focused review, we will discuss how imaging modalities such as Non-Contrast CT, CT-Angiography, and CT-Perfusion can potentially help physicians determine which patients are likely to recanalize early with intravenous tPA and therefore benefit from this therapy.
Long standing, evidence based approved therapies for acute ischemic stroke include intravenous thrombolysis therapy (IVT) with alteplase (recombinant tissue plasminogen activator, rtPA) given within 4.5 h; aspirin therapy within 48 h; management in an acute stroke unit and hemicraniectomy in cases of malignant infarction. Multiple recent positive randomized controlled trials (RCTs) have now also established endovascular therapy with mechanical thrombectomy as the standard of care for acute ischemic stroke involving a large vessel occlusion in the anterior circulation. This article will review the history of endovascular treatments for acute ischemic stroke and will review the recent positive and negative randomized controlled trial evidence for its efficacy. Current guidelines and dilemmas regarding appropriate patient selection will be discussed.
A Karger 'Publishing Highlights 1890–2015' title This handbook takes the reader through the entire field of pediatric thrombosis and hemostasis. An introductory section concisely explains the complex pathophysiology of hemostasis and thrombosis. The chapters that follow include practical, evidence-based information on the diagnosis and management of inherited and acquired bleeding disorders and thrombotic events of the venous, arterial, cardiac and central nervous systems that affect children. Special features include practical clinical algorithms and appendices that cite normal laboratory reference ranges, as well as recommended dosages of blood products and major hemostatic agents. A stand-alone chapter is dedicated to developmental hemostasis and bleeding in the neonate. A chapter on antithrombotic therapy in children gives succinct information on the old and new anticoagulants, antiplatelet drugs and thrombolytic agents. Written and reviewed by international experts in the field, this handbook is intended for health care professionals involved in the assessment and care of children with inherited and acquired bleeding and clotting disorders, including general and specialist pediatricians (in particular intensivists, neonatologists, cardiologists/cardiac surgeons, rheumatologists and nephrologists), hematologists/oncologists (pediatric and adult), as well as medical trainees, nurses, nurse practitioners and pharmacists.
