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Universitat Autònoma de Barcelona

1. Vilar Bergua, Andrea. Utilidad de los biomarcadores en el diagnóstico de la enfermedad cerebrovascular silente.

Degree: Departament de Medicina, 2016, Universitat Autònoma de Barcelona

Nowadays cerebrovascular diseases have a major social impact; they are a commonly associated with increased rates of hospitalization, morbidity and mortality. Furthermore, it is expected that ageing will increases the incidence of cerebrovascular diseases and their associated healthcare costs. Cerebral infarcts occurring without stroke-like symptoms are known as silent or covert cerebral infarcts; they are five times more common than symptomatic stroke. Most of them are lacunar infarcts and they appear associated with other imaging markers of cerebral small vessel disease, as white matter hyperintensities, microbleeds or dilated perivascular spaces. Research on cerebral small vessel disease pre-clinical or pre-symptomatic stages may potentially improve the knowledge of the leading and involved disease pathways, and the development of prevention approaches aimed to reduce their incidence and associated complications (such as stroke and dementia). In this Thesis, we have performed a bibliographic literature review, and found that the number of studies regarding biomarker usefulness in the early detection of small vessel disease by identification of silent or subclinical cerebral lesions have increased for the last years. However, the use of biomarkers with diagnostic purposes to detect silent brain lesions has not been already established, so clinical their usefulness is still not justified. Previous studies limitations are heterogeneity regarding cerebral small vessel disease lesions definitions, the lack of replication in independent cohorts and the use of individual candidate biomarkers. Also longitudinal studies are needed to evaluate lesions progression and biomarkers associations. In this Thesis we also included biomarker study results, based on a hypertensive stroke and dementia-free population, 50-70 years old. This is a suitable population for the study of the onset of the disease, since hypertension is an established vascular risk factor. Magnetic resonance imaging-defined lesions where analyzed individually, and then combined in a previously described cerebral small vessel disease score being the latter a more physiologic condition. Statistic criteria were applied to evaluate the usefulness of the clinical models including the selected biomarkers, in the clinical practice. Small vessel disease biomarkers study can improve diagnosis of silent brain cerebrovascular lesions and also provide information regarding preclinical stage leading pathways. They can be useful as therapeutic and disease progression monitoring targets. Advisors/Committee Members: [email protected] (authoremail), true (authoremailshow), Delgado Martínez, Pilar (director), Fonollosa Pla, Vicent (tutor), true (authorsendemail).

Subjects/Keywords: Biomarcadors; Biomarcadores; Biomarkers; Malatia cerebrovascular silent; Enfermedad cerebrovascular silente; Silent cerebrovascular disease; Infart cerebral silent; Infarto cerebral silente; Silent brain infarct; Ciències de la Salut; 61

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Vilar Bergua, A. (2016). Utilidad de los biomarcadores en el diagnóstico de la enfermedad cerebrovascular silente. (Thesis). Universitat Autònoma de Barcelona. Retrieved from http://hdl.handle.net/10803/386549

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Vilar Bergua, Andrea. “Utilidad de los biomarcadores en el diagnóstico de la enfermedad cerebrovascular silente.” 2016. Thesis, Universitat Autònoma de Barcelona. Accessed December 16, 2019. http://hdl.handle.net/10803/386549.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Vilar Bergua, Andrea. “Utilidad de los biomarcadores en el diagnóstico de la enfermedad cerebrovascular silente.” 2016. Web. 16 Dec 2019.

Vancouver:

Vilar Bergua A. Utilidad de los biomarcadores en el diagnóstico de la enfermedad cerebrovascular silente. [Internet] [Thesis]. Universitat Autònoma de Barcelona; 2016. [cited 2019 Dec 16]. Available from: http://hdl.handle.net/10803/386549.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Vilar Bergua A. Utilidad de los biomarcadores en el diagnóstico de la enfermedad cerebrovascular silente. [Thesis]. Universitat Autònoma de Barcelona; 2016. Available from: http://hdl.handle.net/10803/386549

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

2. Kanavaki, Aikaterini. Μελέτη της αρτηριακής κυκλοφορίας του εγκεφάλου με χρήση διακρανιακού Doppler σε ασθενείς με ενδιάμεση μεσογειακή αναιμία. Αξιολόγηση αποτελεσμάτων ως δείκτη κινδύνου εγκεφαλικού επεισοδίου.

Degree: 2017, National and Kapodistrian University of Athens; Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ)

Cerebrovascular accidents, either overt strokes or silent infarcts, consist a well-known complication in patients with hemoglobinopathies, especially with sickle cell disease. During the last years, transcranial Doppler(TCD) has become an essential methos in screening patients with sickle cell disease (SCD) at risk for stroke and has contributed in diminishing strokes in this group of patients.Patients with thalassemia intermedia (TI) are also at risk for brain ischemia, essentially for silent infarcts.The purpose of this study was to evaluate the role of TCD in the assessment of TI patients at risk for brain ischemia.We included in our study 44 patients followed in the Thalassemia Unit of the 1st Department of Pediatrics of the University of Athens, 35 with TI and 9 with SCD.All of these patients had benefitted of a TCD examination with the use of a non-imaging TCD machine. The Time-averaged mean of the maximum velocity- TAMMV, peak velocity, pulsatility and resistive index were measured in the anterior, middle, posterior cerebral arteries and basilar artery. TAMMV values were compared to normal values referred in literature. Nine patients underwent brain MRI/MRA.We have also measured serum levels of NSE and S100 proteins, that are considered as biomarkers of glial cell and neuronal loss in order to find a possible relation between these proteins and TCD, which is considered as an index of brain ischemia.Twenty-nine out of 35 patients presented TAMMV values higher than normal in ≥1 of examined vessels. None of them, however, had TAMMV or peak velocity values higher than the established risk criteria for SCD patients. One patient had findings consistent with silent infarct on MRI without, however, signs of vasculopathy on MRA. This patient presented higher values of TAMMV and peak velocities compared to other TI patients.When we compared splenectomised to non-splenectomised TI patients, we found no statistical significant difference in TAMMV and peak velocities, PI and RI, despite the statistical significant difference in platelet count levels. Consequently, despite the increased risk of hypercoagulability and of thromboembolic/ischemic events in splenectomised patients there was no influence in TCD parameters.Considering NSE and S100 levels, there was a high correlation between the serum levels of S100 and TAMVV/ peak velocity of the left MCA. There was also a high correlation between NSE values and RI/PI of the left MCA. This finding shows the presence of correlation between biomarkers of neuronal/glial loss and markers of cerebral blood flow.There was also a high correlation between levels of NSE and LDH, that is between a hemolysis index and a neuronal loss biomarker, showing a possible etiologic relation between neuronal loss, hemolysis and alterations in NO levels in TI patients.In conclusion, our results are in favour of the hypothesis that TCD is helpful in assessing the risk of brain ischemia in TI patients, it cannot however discriminate high from low risk patients as in SCD. Our results also imply that…

Subjects/Keywords: Διακρανιακό  Doppler; Ενδιάμεση μεσογειακή αναιμία; Ισχαιμικό αγγειακό εγκεφαλικό επεισόδιο; Σιωπηρό έμφρακτο; Πρόληψη; Μέση ταχύτητα; Transcranial Doppler; Thalassemia intermedia; Cerebrovascular accident (C.V.A); Stroke; Silent infarct; Screening; S100-B protein; Neuron specific enolase; Time averaged maximum mean velocity

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Kanavaki, A. (2017). Μελέτη της αρτηριακής κυκλοφορίας του εγκεφάλου με χρήση διακρανιακού Doppler σε ασθενείς με ενδιάμεση μεσογειακή αναιμία. Αξιολόγηση αποτελεσμάτων ως δείκτη κινδύνου εγκεφαλικού επεισοδίου. (Thesis). National and Kapodistrian University of Athens; Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ). Retrieved from http://hdl.handle.net/10442/hedi/40790

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Kanavaki, Aikaterini. “Μελέτη της αρτηριακής κυκλοφορίας του εγκεφάλου με χρήση διακρανιακού Doppler σε ασθενείς με ενδιάμεση μεσογειακή αναιμία. Αξιολόγηση αποτελεσμάτων ως δείκτη κινδύνου εγκεφαλικού επεισοδίου.” 2017. Thesis, National and Kapodistrian University of Athens; Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ). Accessed December 16, 2019. http://hdl.handle.net/10442/hedi/40790.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Kanavaki, Aikaterini. “Μελέτη της αρτηριακής κυκλοφορίας του εγκεφάλου με χρήση διακρανιακού Doppler σε ασθενείς με ενδιάμεση μεσογειακή αναιμία. Αξιολόγηση αποτελεσμάτων ως δείκτη κινδύνου εγκεφαλικού επεισοδίου.” 2017. Web. 16 Dec 2019.

Vancouver:

Kanavaki A. Μελέτη της αρτηριακής κυκλοφορίας του εγκεφάλου με χρήση διακρανιακού Doppler σε ασθενείς με ενδιάμεση μεσογειακή αναιμία. Αξιολόγηση αποτελεσμάτων ως δείκτη κινδύνου εγκεφαλικού επεισοδίου. [Internet] [Thesis]. National and Kapodistrian University of Athens; Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ); 2017. [cited 2019 Dec 16]. Available from: http://hdl.handle.net/10442/hedi/40790.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Kanavaki A. Μελέτη της αρτηριακής κυκλοφορίας του εγκεφάλου με χρήση διακρανιακού Doppler σε ασθενείς με ενδιάμεση μεσογειακή αναιμία. Αξιολόγηση αποτελεσμάτων ως δείκτη κινδύνου εγκεφαλικού επεισοδίου. [Thesis]. National and Kapodistrian University of Athens; Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ); 2017. Available from: http://hdl.handle.net/10442/hedi/40790

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

.