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Search Results: 1 - 10 of 4416 matches for " Caplan Louis "
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Cardioembolic stroke: An update on etiology, diagnosis and management
Leary Megan,Caplan Louis
Annals of Indian Academy of Neurology , 2008,
Abstract: Stroke and ischemic heart diseases are among the most common causes of death and disability throughout the world. Even more worrisome is the suggestion that stroke rates may further increase in certain developing nations. The purpose of this article is to review the particular subtype of stroke known as cardioembolic stroke. A cardioembolic stroke occurs when the heart pumps unwanted materials into the brain circulation, resulting in the occlusion of a brain blood vessel and damage to the brain tissue. The etiology, clinical manifestations, diagnosis and management of cardioembolic stroke are reviewed.
Arteriosclerosis and the promise of GPIIb/IIIa inhibitors in stroke
SAPOSNIK, GUSTAVO;CAPLAN, LOUIS R;
Arquivos de Neuro-Psiquiatria , 2000, DOI: 10.1590/S0004-282X2000000100001
Abstract: ischemic mechanisms in patients with brain and heart attacks have been studied for more than 150 years. antiplatelets agents did show benefit in secondary prevention. aspirin is the most common antiaggregant in clinical use today. however, the benefit produced by the "best" antiplatelet regimen in stroke prevention is lower than 40%. the adherence of circulating platelets to the subendothelium is mediated by glycoprotein (gp) residing on the cell's surface. gpiib/iiia is the most important platelet membrane receptor that mediates the process of platelet aggregation, and thrombus formation. thus, new drugs that block the gpiib/iiia receptor have recently emerged. clinical trials using these agents have shown effectiveness in acute coronary syndromes. however, the absence of studies in cerebrovascular disease and the potential hemorrhagic complications questioned their use in stroke prevention. we review the clinical trials using the new gpiib/iiia agents in myocardial ischemia, and consider the potential implications for cerebrovascular disease.
Arteriosclerosis and the promise of GPIIb/IIIa inhibitors in stroke
SAPOSNIK GUSTAVO,CAPLAN LOUIS R
Arquivos de Neuro-Psiquiatria , 2000,
Abstract: Ischemic mechanisms in patients with brain and heart attacks have been studied for more than 150 years. Antiplatelets agents did show benefit in secondary prevention. Aspirin is the most common antiaggregant in clinical use today. However, the benefit produced by the "best" antiplatelet regimen in stroke prevention is lower than 40%. The adherence of circulating platelets to the subendothelium is mediated by glycoprotein (GP) residing on the cell's surface. GPIIb/IIIa is the most important platelet membrane receptor that mediates the process of platelet aggregation, and thrombus formation. Thus, new drugs that block the GPIIb/IIIa receptor have recently emerged. Clinical trials using these agents have shown effectiveness in acute coronary syndromes. However, the absence of studies in cerebrovascular disease and the potential hemorrhagic complications questioned their use in stroke prevention. We review the clinical trials using the new GPIIb/IIIa agents in myocardial ischemia, and consider the potential implications for cerebrovascular disease.
Effect of pre-stroke use of ACE inhibitors on ischemic stroke severity
Magdy Selim, Sean Savitz, Italo Linfante, Louis Caplan, Gottfried Schlaug
BMC Neurology , 2005, DOI: 10.1186/1471-2377-5-10
Abstract: We retrospectively studied 126 consecutive patients presenting within 24 hours of ischemic stroke onset, as confirmed by diffusion-weighted magnetic resonance imaging (DWI). We calculated the NIHSS score at presentation, as the primary measure of clinical stroke severity, and categorized stroke severity as mild (NIHSS [less than or equal to] 7), moderate (NIHSS 8–13) or severe (NIHSS [greater than or equal to] 14). We analyzed demographic data, risk-factor profile, blood pressure (BP) and medications on admissions, and determined stroke mechanism according to TOAST criteria. We also measured the volumes of admission diffusion- and perfusion-weighted (DWI /PWI) magnetic resonance imaging lesions, as a secondary measure of ischemic tissue volume. We compared these variables among patients on ACEI and those who were not.Thirty- three patients (26%) were on ACE-inhibitors. The overall median baseline NIHSS score was 5.5 (range 2–21) among ACEI-treated patients vs. 9 (range 1–36) in non-ACEI patients (p = 0.036). Patients on ACEI prior to their stroke had more mild and less severe strokes, and smaller DWI and PWI lesion volumes compared to non-ACEI treated patients. However, none of these differences were significant. Predictably, a higher percentage of patients on ACEI had a history of heart failure (p = 0.03). Age, time-to-imaging or neurological evaluation, risk-factor profile, concomitant therapy with lipid lowering, other antihypertensives or antithrombotic agents, or admission BP were comparable between the two groups.Our results suggest that ACE-inhibitors may reduce the clinical severity of stroke, as measured by NIHSS score. Further, larger-scale, prospective studies areneeded to validate our findings, and to elucidate the mechanism(s) of ACEImediated benefits in patients with ischemic stroke.Data from the heart outcomes prevention evaluation study (HOPE) suggest that angiotensin-converting enzyme inhibitors (ACEI) are effective in prevention of ischemic stroke,
Bioethics Grows Up
Arthur Caplan
PLOS Biology , 2012, DOI: 10.1371/journal.pbio.0060095
Abstract:
LONDON 2012: DISTRIBUTED IMAG(IN)INGS AND EXPLOITING PROTOCOL
Paul Caplan
PLATFORM : Journal of Media and Communication , 2010,
Abstract: he Olympic Games in London in 2012 is being built online as well as off through official and unofficial photographs which serve to position ‘2012’ within a discourse of legacy and participation. This paper looks at how network protocols can be addressed as what Bruno Latour would call ‘actants’, non-human actors that generate and discipline that visualisation within a particular network scopic regime (Jay, 1988). Following Galloway (2004), protocols such as JPEG/EXIF and XML can be seen as generating new scopic texts/practices around archive and openness which underpin 2012 ideologies of legacy and participation. The paper goes on to explore the potential of critical intervention in that regime using Benjamin’s model of writing history developed in The Arcades Project (1999).
Bioethics Grows Up
Arthur Caplan
PLOS Biology , 2008, DOI: 10.1371/journal.pbio.0060095
Abstract:
GRAF1 forms a complex with MICAL-L1 and EHD1 to cooperate in tubular recycling endosome vesiculation
Steve Caplan
Frontiers in Cell and Developmental Biology , 2014, DOI: 10.3389/fcell.2014.00022
Abstract: The biogenesis of tubular recycling endosomes (TREs) and their subsequent vesiculation after cargo-sorting has occurred, is essential for receptor and lipid recycling to the plasma membrane. Although recent studies have implicated the C-terminal Eps15 Homology Domain (EHD) protein, EHD1, as a key regulator of TRE vesiculation, additional proteins involved in this process have been largely uncharacterized. In the present study, we identify the GTPase Regulator Associated with Focal adhesion kinase-1 (GRAF1) protein in a complex with EHD1 and the TRE hub protein, Molecules Interacting with CasL-Like1 (MICAL-L1). Over-expression of GRAF1 caused vesiculation of MICAL-L1-containing TRE, whereas GRAF1-depletion led to impaired TRE vesiculation and delayed receptor recycling. Moreover, co-addition of purified EHD1 and GRAF1 in a semi-permeabilized cell vesiculation assay produced synergistic TRE vesiculation. Overall, based on our data, we suggest that in addition to its roles in clathrin-independent endocytosis, GRAF1 synergizes with EHD1 to support TRE vesiculation.
Delay in Breast Cancer: Implications for Stage at Diagnosis and Survival
Lee Caplan
Frontiers in Public Health , 2014, DOI: 10.3389/fpubh.2014.00087
Abstract: Breast cancer continues to be a disease with tremendous public health significance. Primary prevention of breast cancer is still not available, so efforts to promote early detection continue to be the major focus in fighting breast cancer. Since early detection is associated with decreased mortality, one would think that it is important to minimize delays in detection and diagnosis. There are two major types of delay. Patient delay is delay in seeking medical attention after self-discovering a potential breast cancer symptom. System delay is delay within the health care system in getting appointments, scheduling diagnostic tests, receiving a definitive diagnosis, and initiating therapy. Earlier studies of the consequences of delay on prognosis tended to show that increased delay is associated with more advanced stage cancers at diagnosis, thus resulting in poorer chances for survival. More recent studies have had mixed results, with some studies showing increased survival with longer delays. One hypothesis is that diagnostic difficulties could perhaps account for this survival paradox. A rapidly growing lump may suggest cancer to both doctors and patients, while a slow growing lump or other symptoms could be less obvious to them. If this is the case, then the shorter delays would be seen with the more aggressive tumors for which the prognosis is worse leading to reduced survival. It seems logical that a tumor that is more advanced at diagnosis would lead to shorter survival but the several counter-intuitive studies in this review show that it is dangerous to make assumptions.
Psychopathology in Pediatric Epilepsy: Role of Antiepileptic Drugs
Rochelle Caplan
Frontiers in Neurology , 2012, DOI: 10.3389/fneur.2012.00163
Abstract: Children with epilepsy are usually treated with antiepileptic drugs (AEDS). Some AEDs adversely affect behavior in susceptible children. Since psychiatric comorbidity is prevalent in pediatric epilepsy, this paper attempts to disentangle these AED side effects from the psychopathology associated with this illness. It first outlines the clinical and methodological problems involved in determining if AEDs contribute to the behavior and emotional problems of children with epilepsy. It then presents research evidence for and against the role AEDs play in the psychopathology of children with epilepsy, and outlines how future studies might investigate this problem. A brief description of how to clinically separate out AED effects from the complex illness-related and psychosocial factors that contribute to the behavior difficulties of children with epilepsy concludes the paper.
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