8 results on '"J. Kejda-Scharler"'
Search Results
2. Simple variables predict miserable outcome after intravenous thrombolysis
- Author
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P. Ginsbach, Turgut Tatlisumak, Christopher Tränka, David J. Seiffge, Henrik Gensicke, P. A. Lyrer, Leo H. Bonati, Nils Peters, J. Kejda-Scharler, A. Karagiannis, K. Kotisaari, Stefan T. Engelter, Mika Leppä, and Daniel Strbian
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,information science ,Severity of Illness Index ,Brain Ischemia ,Fibrinolytic Agents ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,Thrombolytic Therapy ,Treatment Failure ,Endovascular treatment ,Aged ,Aged, 80 and over ,Receiver operating characteristic ,business.industry ,Modified rankin score ,Glasgow Coma Scale ,Thrombolysis ,Middle Aged ,Prognosis ,Triage ,Confidence interval ,Surgery ,Stroke ,Neurology ,Tissue Plasminogen Activator ,Cohort ,Female ,Neurology (clinical) ,business - Abstract
To test the predictability of miserable outcome amongst ischaemic stroke patients receiving intravenous thrombolysis (IVT) based on a simple variables model (SVM) and to compare the model's predictive performance with that of an existing score which includes imaging and laboratory parameters (DRAGON).; The SVM consists of the parameters age, independence before stroke, normal Glasgow coma verbal score, able to lift arms and able to walk. In a derivation cohort (n = 1346) and a validation cohort (n = 638) of consecutive IVT-treated stroke patients, the probability estimated by SVM and the observed occurrence of miserable 3-month outcome (modified Rankin score 5-6) were compared. The performances of SVM and the DRAGON score were compared. The area under the receiver operating curve (AUC) (95% confidence interval, CI) and the bootstrapping approach were used to compare the predictive performance.; The AUCs to predict miserable outcome in the derivation cohort were 0.807 (95% CI 0.774-0.838) using the SVM and 0.822 (0.790-0.850) using the DRAGON score (P = 0.3). For the validation cohort, AUCs were 0.786 (0.742-0.829) for the SVM and 0.809 (0.774-0.845) for the DRAGON score (P = 0.23). Only one patient with an SVM probability of
- Published
- 2013
- Full Text
- View/download PDF
3. Diagnosis and treatment of arteriovenous malformations
- Author
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J. Kejda-Scharler, J. Pile-Spellman, and Jay P. Mohr
- Subjects
Intracranial Arteriovenous Malformations ,medicine.medical_specialty ,Neurology ,Imaging data ,law.invention ,Randomized controlled trial ,law ,Intervention (counseling) ,Epidemiology ,medicine ,Humans ,Intensive care medicine ,Cerebral Hemorrhage ,medicine.diagnostic_test ,business.industry ,General Neuroscience ,Brain ,Arteriovenous malformation ,medicine.disease ,Surgery ,Cerebral Angiography ,Neurology (clinical) ,Headaches ,medicine.symptom ,business ,Cerebral angiography - Abstract
Brain arteriovenous malformations (bAVMs) are among the least common of causes of brain hemorrhage, seizures, or headaches. Embedded in the brain, their widely varying size, arterial feeders draining venous pattern and nidus complexity make them among the most challenging of disorders for attempted eradication. The low prevalence has created a literature long dominated by anecdote, only recently and slowly being clarified by epidemiological, pathophysiological, and imaging data. A first-ever randomized clinical trial seeks to determine if invasive intervention to eradicate the lesion--and its attendant risks of complications--offers a better prognosis than awaiting a hemorrhage before undertaking such efforts.
- Published
- 2013
4. Carotid artery disease and interventional therapy
- Author
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J. Kejda-Scharler, Wesley S. Moore, and Jay P. Mohr
- Subjects
Interventional therapy ,Carotid Artery Diseases ,medicine.medical_specialty ,medicine.medical_treatment ,Carotid endarterectomy ,Asymptomatic ,Carotid angioplasty ,Carotid artery disease ,medicine ,Humans ,Clinical Trials as Topic ,Endarterectomy, Carotid ,medicine.diagnostic_test ,business.industry ,Angioplasty ,Disease Management ,Interventional radiology ,medicine.disease ,Clinical trial ,Treatment Outcome ,Neurology ,Stents ,Neurology (clinical) ,Radiology ,medicine.symptom ,business - Abstract
PURPOSE OF REVIEW Major results of recent clinical trials for carotid artery disease are changing the understanding of management. RECENT FINDINGS A major trial comparing carotid endarterectomy with carotid angioplasty and stenting for symptomatic or asymptomatic patients suggests comparable results by overall outcomes analyses, and different results by subset analyses. These results modify the findings of prior trials. SUMMARY Based on age there appear to be differences in outcomes that may influence decision for management for such patients.
- Published
- 2011
5. Simple variables predict miserable outcome after intravenous thrombolysis.
- Author
-
Seiffge DJ, Karagiannis A, Strbian D, Gensicke H, Peters N, Bonati LH, Kotisaari K, Leppä M, Kejda-Scharler J, Tränka C, Ginsbach P, Tatlisumak T, Lyrer PA, and Engelter ST
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Prognosis, Severity of Illness Index, Treatment Failure, Brain Ischemia drug therapy, Fibrinolytic Agents therapeutic use, Stroke drug therapy, Thrombolytic Therapy, Tissue Plasminogen Activator therapeutic use
- Abstract
Background and Purpose: To test the predictability of miserable outcome amongst ischaemic stroke patients receiving intravenous thrombolysis (IVT) based on a simple variables model (SVM) and to compare the model's predictive performance with that of an existing score which includes imaging and laboratory parameters (DRAGON)., Methods: The SVM consists of the parameters age, independence before stroke, normal Glasgow coma verbal score, able to lift arms and able to walk. In a derivation cohort (n = 1346) and a validation cohort (n = 638) of consecutive IVT-treated stroke patients, the probability estimated by SVM and the observed occurrence of miserable 3-month outcome (modified Rankin score 5-6) were compared. The performances of SVM and the DRAGON score were compared. The area under the receiver operating curve (AUC) (95% confidence interval, CI) and the bootstrapping approach were used to compare the predictive performance., Results: The AUCs to predict miserable outcome in the derivation cohort were 0.807 (95% CI 0.774-0.838) using the SVM and 0.822 (0.790-0.850) using the DRAGON score (P = 0.3). For the validation cohort, AUCs were 0.786 (0.742-0.829) for the SVM and 0.809 (0.774-0.845) for the DRAGON score (P = 0.23). Only one patient with an SVM probability of >70% for miserable outcome in either cohort had a good outcome whilst 83% had a miserable outcome. An online SVM calculator to estimate the probability of miserable outcome for individual patients is available under http://www.unispital-basel.ch/SVM-Tool., Conclusion: The SVM was similar in accuracy to the DRAGON score for predicting miserable outcome after IVT. As these simple variables are available already at the pre-hospital stage, the SVM may facilitate and accelerate pre-hospital triage of patients at high risk for miserable outcome after IVT towards endovascular treatment., (© 2013 The Author(s) European Journal of Neurology © 2013 EFNS.)
- Published
- 2014
- Full Text
- View/download PDF
6. Diagnosis and treatment of arteriovenous malformations.
- Author
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Mohr JP, Kejda-Scharler J, and Pile-Spellman J
- Subjects
- Cerebral Angiography, Cerebral Hemorrhage diagnosis, Cerebral Hemorrhage therapy, Humans, Brain diagnostic imaging, Intracranial Arteriovenous Malformations diagnosis, Intracranial Arteriovenous Malformations therapy
- Abstract
Brain arteriovenous malformations (bAVMs) are among the least common of causes of brain hemorrhage, seizures, or headaches. Embedded in the brain, their widely varying size, arterial feeders draining venous pattern and nidus complexity make them among the most challenging of disorders for attempted eradication. The low prevalence has created a literature long dominated by anecdote, only recently and slowly being clarified by epidemiological, pathophysiological, and imaging data. A first-ever randomized clinical trial seeks to determine if invasive intervention to eradicate the lesion--and its attendant risks of complications--offers a better prognosis than awaiting a hemorrhage before undertaking such efforts.
- Published
- 2013
- Full Text
- View/download PDF
7. Carotid artery disease and interventional therapy.
- Author
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Mohr JP, Moore WS, and Kejda-Scharler J
- Subjects
- Angioplasty methods, Clinical Trials as Topic, Disease Management, Endarterectomy, Carotid methods, Humans, Stents, Treatment Outcome, Carotid Artery Diseases therapy
- Abstract
Purpose of Review: Major results of recent clinical trials for carotid artery disease are changing the understanding of management., Recent Findings: A major trial comparing carotid endarterectomy with carotid angioplasty and stenting for symptomatic or asymptomatic patients suggests comparable results by overall outcomes analyses, and different results by subset analyses. These results modify the findings of prior trials., Summary: Based on age there appear to be differences in outcomes that may influence decision for management for such patients.
- Published
- 2012
- Full Text
- View/download PDF
8. A strong start: plasma glial fibrillary acidic protein and stroke differential diagnosis.
- Author
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Mohr JP and Kejda-Scharler J
- Subjects
- Female, Humans, Male, Brain Ischemia diagnosis, Cerebral Hemorrhage diagnosis, Glial Fibrillary Acidic Protein blood, Stroke diagnosis
- Published
- 2012
- Full Text
- View/download PDF
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