Importantly, this high-affinity state alpha(2)AR upregulation can

Importantly, this high-affinity state alpha(2)AR upregulation can be normalized with antidepressant

treatments. Thus, depressive disorders appear to be associated with increased alpha(2)AR sensitivity and responsiveness, which may represent a physiological basis for the putative noradrenergic dysfunction in depressive disorders. In addition, we review changes in some key alpha(2)AR accessory proteins in depressive disorders and discuss their potential contribution to alpha(2)AR dysfunction. (C) 2012 Elsevier Ltd. All rights reserved.”
“Objective: This study documented with independent neurologic assessment the 30-day and 90-day outcomes in selected patients with severe internal carotid artery (ICA) stenosis who underwent carotid endarterectomy (CEA) in the acute phase of find more stroke-in-evolution (SIE).

Methods: From January 2003 to December 2010, data from patients who had surgery <= 2 weeks of an

SIE with high-grade carotid stenosis were extracted from two prospectively collected databases. Clinical assessment was by the vascular neurologist using the National Institute of Health Stroke Scale (NIHSS) and the modified Rankin Scale score. All patients had computed tomography or magnetic resonance brain imaging <= 3 hours of stroke onset. Those eligible received thrombolysis. Duplex ultrasound CRT0066101 cell line imaging was initially used for the diagnosis of severe (>= 60%) ICA stenosis, and further assessment was by magnetic resonance or computed tomography angiography, or both. Perioperative medical treatment and operative techniques were standardized. Stroke, death, https://www.selleck.cn/products/tpx-0005.html major cardiac events, and functional outcome were analyzed.

Results: Twenty-seven patients underwent carotid revascularization in the acute phase of SIE. Fluctuating or progressive neurologic deficit was the presenting pattern in 20 patients and occurred after

otherwise successful thrombolytic therapy in the remaining 7 (26%). Median NIHSS score at admission was 8. Median delay to surgery from the index event was 6 days. The mean degree of ICA stenosis was 87%. All patients received antiplatelet and statin therapy during the intervening period. Procedures were conventional CEA with patch angioplasty (polytetrafluoroethylene) in 26 patients (96.3%) and redo interposition bypass grafting in 1 patient. CEA was done under local anesthesia in 23 patients (85.2%), with selective shunting in 3 (13.0%), and under general anesthesia, with systematic shunting in 4. At discharge and at 1 and 3 months, no recurrent stroke or death, and one nonfatal myocardial infarction occurred in this series, with a 100% complete follow-up. At 3 months, all patients had a favorable functional outcome defined as a modified Rankin Scale score of <= 2.

Conclusions: This short series demonstrates that CEA in the acute phase of SIE with strict selection criteria and close blood pressure monitoring is safe, even after recent thrombolytic therapy, and is effective in functional outcome at 3 months.

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