دورية أكاديمية
Children with sickle cell anemia with normal transcranial Doppler ultrasounds and without silent infarcts have a low incidence of new strokes.
| العنوان: | Children with sickle cell anemia with normal transcranial Doppler ultrasounds and without silent infarcts have a low incidence of new strokes. |
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| المؤلفون: | Jordan LC; Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, Tennessee., Roberts Williams DO; Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, Tennessee., Rodeghier MJ; Independent Statistician, Rodeghier Consultants, Chicago, Illinois., Covert Greene BV; Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, Tennessee., Ponisio MR; Department of Radiology, Washington University School of Medicine, St. Louis, Missouri., Casella JF; Department of Pediatrics, Division of Hematology, the Johns Hopkins University School of Medicine, Baltimore, Maryland., McKinstry RC; Departments of Radiology and Pediatrics, Washington University School of Medicine, St. Louis, Missouri., Noetzel MJ; Departments of Neurology and Pediatrics, Washington University School of Medicine, St Louis, Missouri., Kirkham FJ; Developmental Neurosciences, University College London Great Ormond Street Institute of Child Health, London, United Kingdom., Meier ER; Indiana Hemophilia & Thrombosis Center, Indianapolis, Indiana., Fuh B; Department of Pediatrics, Hematology/Oncology, Brody School of Medicine at East Carolina University, Greenville, North Carolina., McNaull M; Department of Pediatrics, Hematology/Oncology, University of Mississippi Medical Center, Jackson, Mississippi., Sarnaik S; Department of Pediatrics, Division of Hematology/Oncology, Wayne State University, Detroit, Michigan., Majumdar S; Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC., McCavit TL; Department of Pediatrics, Division of Hematology/Oncology, Cook Children's Hospital, Fort Worth, Texas., DeBaun MR; Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, Tennessee. |
| المصدر: | American journal of hematology [Am J Hematol] 2018 Jun; Vol. 93 (6), pp. 760-768. Date of Electronic Publication: 2018 Mar 30. |
| نوع المنشور: | Clinical Trial; Journal Article; Research Support, N.I.H., Extramural |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley-Blackwell Country of Publication: United States NLM ID: 7610369 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1096-8652 (Electronic) Linking ISSN: 03618609 NLM ISO Abbreviation: Am J Hematol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York Ny : Wiley-Blackwell Original Publication: New York, Liss. |
| مواضيع طبية MeSH: | Cerebral Infarction* , Ultrasonography, Doppler, Transcranial*, Anemia, Sickle Cell/*complications , Stroke/*etiology, Adolescent ; Child ; Child, Preschool ; Humans ; Incidence ; Ischemic Attack, Transient ; Prospective Studies ; Seizures |
| مستخلص: | In a prospective cohort study, we tested the hypothesis that children with sickle cell anemia (SCA) with normal transcranial Doppler ultrasound (TCD) velocities and without silent cerebral infarcts (SCIs) would have a lower incidence rate of new neurological events (strokes, seizures or transient ischemic attacks) compared to children with normal TCD measurements and SCIs, not receiving regular blood transfusions. Nonrandomized participants from the silent cerebral infarct transfusion (SIT) Trial who had screening magnetic resonance imaging (MRI) of the brain and normal TCD measurements were included. Follow-up ended at the time of first neurological event (stroke, seizure or transient ischemic attack), start of regular blood transfusion, or loss to follow-up, whichever came first. The primary endpoint was a new neurological event. Of 421 participants included, 68 had suspected SCIs. Mean follow-up was 3.6 years. Incidence rates of new neurological events in nontransfused participants with normal TCD values with SCIs and without SCIs were 1.71 and 0.47 neurological events per 100 patient-years, respectively, P = .065. The absence of SCI(s) at baseline was associated with a decreased risk of a new neurological event (hazard ratio 0.231, 95% CI 0.062-0.858; P = .029). Local pediatric neurologists examined 67 of 68 participants with suspected SCIs and identified 2 with overt strokes classified as SCIs by local hematologists; subsequently one had a seizure and the other an ischemic stroke. Children with SCA, without SCIs, and normal TCD measurements have a significantly lower rate of new neurological events when compared to those with SCIs and normal TCD measurements. Pediatric neurology assessment may assist risk stratification. (© 2018 Wiley Periodicals, Inc.) |
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| معلومات مُعتمدة: | U01 NS042804 United States NS NINDS NIH HHS; U54 HD083211 United States HD NICHD NIH HHS; UL1 TR000445 United States TR NCATS NIH HHS |
| تواريخ الأحداث: | Date Created: 20180310 Date Completed: 20190515 Latest Revision: 20190610 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC6038699 |
| DOI: | 10.1002/ajh.25085 |
| PMID: | 29520844 |
| قاعدة البيانات: | MEDLINE |
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