23 research outputs found
Effects of an exercise-based rehabilitation program in patients with minor ischemic non-disabling stroke or transient ischemic attack
No full textBACKGROUND: Ischemic stroke and transient ischemic attack (TIA) present global health challenges. While physical activity is strongly recommended for secondary prevention of these clinical conditions, there’s a massive gap between guidelines and the real world. This study aimed to assess the effectiveness, safety, and feasibility of an exercise-based rehabilitation (EBR) program for patients with minor ischemic non-disabling stroke (MINDS) or TIA. METHODS: Consecutive patients from the Neurology Unit of Mirano – Venice, Italy, diagnosed with MINDS or TIA, underwent a structured EBR program. The program comprised 6 weeks of supervised training in a hospital gym and 12 months of territorial gym training. Safety, feasibility, and effectiveness were evaluated through adverse events, drop-out rates, and improvements in body composition, muscular strength, and cardiopulmonary fitness. RESULTS: The sample comprised 32 patients (mean age 66 years, 81,3% male). No adverse events were reported. During the in-hospital phase of the program, there were no dropouts, while 28% of patients ceased training during the territorial phase. After the in-hospital phase, there were significant improvements in body composition, muscular strength, and cardiopulmonary parameters. These benefits persisted at the 12-month territorial gym phase of the EBR program only for patients who continued training. CONCLUSIONS: The structured EBR program demonstrated safety, feasibility, and effectiveness in improving health parameters for MINDS or TIA patients. Such interventions promise to enhance secondary prevention and overall health outcomes in this patient group
Detection of fungal trunk pathogens from wood tissues and pruning wood debris of olive trees in Iran
No full text[EN] Between April 2015 and August 2017 a survey was conducted in olive orchards in different regions in Iran in order to collect and identify fungal trunk pathogens. Wood samples were collected from the trunk and branches of olive trees showing dieback and cankers, as well as pruning wood debris left in the orchards. Fungal isolation was performed from necrotic woody tissues, as well as fruiting bodies observed on bark of wood debris. Morphological identification of the fungal isolates was confirmed by DNA sequencing and comparisons of the internal transcribed spacer (ITS) nrDNA region and a partial sequence of translation elongation factor 1-alpha (tef-1 alpha) and beta-tubulin (tub2) genes. In this study, eight species of Botryosphaeriaceae namely Botryosphaeria (B.) dothidea, Diplodia (D.) gallae, D. intermedia, D. mutila, Dothiorella (Do.) sarmentorum, Neofusicoccum (Neof.) parvum, Neoscytalidium (Neos.) dimidiatum (as the most abundant species) and Neos. novaehollandiae were identified. Moreover, Pleurostoma (Pl.) richardsiae, Paecilomyces (P.) formosus, a Coniophora-like fungus and several isolates of Phoma, Chaetomium, Darksidea and Hypoxylon species were obtained. Pathogenicity trials on detached shoots of olive trees conducted under greenhouse conditions showed that P. formosus, Neos. dimidiatum, D. gallae, Neof. parvum, Dot. sarmentorum, Neos. novaehollandiae, Pl. richardsiae, B. dothidea, D. mutila, D. intermedia and Coniophora-like fungus were pathogenic on inoculated olive shoots. Paecilomyces formosus was the most virulent and caused the longest lesions. Based on literature reviews, this study represents the first report on the occurrence of D. mutila, Neof. parvum and Pl. richardsiae from diseased olive trees in Iran. Moreover, this is the first report of D. gallae from fruiting bodies on the bark of branches, and four species (namely D. intermedia, Neos. novaehollandiae, P. formosus and Coniophora-like fungus) from affected olive trees worldwide. Our results provide new insights into the etiology of olive fungal trunk diseases.Financial support by the Iranian Ministry of Science, Research and Technology (MSRT) for the first author during her 4 months stay in Spain as a part of her PhD project is greatly acknowledged.Sohrabi, M.;Mohammadi, H.;León Santana, Maela;Armengol Fortí, Josep (2025). Detection of fungal trunk pathogens from wood tissues and pruning wood debris of olive trees in Iran. Physiological and Molecular Plant Pathology. 138. https://doi.org/10.1016/j.pmpp.2025.102709S13
New report of Biscogniauxia rosacearum as a pathogen on almond trees in Iran
No full text[EN] Biscogniauxia species are known as fungal trunk pathogens on various tree species in the world. During a survey of trunk diseases of fruit trees conducted in Iran, a branch dieback was observed on almond trees in Kerman province (in the Southeast of Iran). Evaluation of symptomatic branches revealed wood discoloration in cross-sections and the presence of fruiting bodies of an ascomycete fungus on their bark. A total of 31 fungal isolates were obtained, 13 isolates recovered from necrotic wood tissues and 18 isolates from fruiting bodies. These isolates were subjected to morphological analysis as well as sequencing analysis of the partial ITS-rDNA and beta tubulin gene sequences. These fungal isolates were identified as Biscogniauxia rosacearum. Results of the pathogenicity tests showed that this species is pathogenic on almond shoots. Based on our knowledge, this is the first report of this species on almond trees in Iran and in the world.The first author is financially supported by the Iranian Ministry of Science, Research and Technology (MSRT) just for her 4 months stay in Spain as a part of her PhD project. However, no funding was received from MSRT for this study by the authors.Sohrabi, M.; Mohammadi, H.; Armengol Fortí, J.; León Santana, M. (2022). New report of Biscogniauxia rosacearum as a pathogen on almond trees in Iran. Journal of Plant Diseases and Protection. 129:411-417. https://doi.org/10.1007/s41348-022-00582-yS411417129Bahmani Z, Abdollahzadeh J, Amini J, Evidente A (2021) Biscogniauxia rosacearum the charcoal canker agent as a pathogen associated with grapevine trunk diseases in Zagros region of Iran. 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Eur J Plant Pathol 157:327–351Spies CFJ, Mostert L, Carlucci A, Moyo P, van Jaarsveld WJ, Plessis IL, van Dyk M, Halleen F (2020) Dieback and decline pathogens of olive trees in South Africa. Persoonia 45:196–220Thompson JD, Higgins DG, Gibson TJ (1994) Clustral W: improving the sensitivity of progressive multiple sequence alignment through sequence weighting, position-specific gap penalties and weight matrix choice. Nucleic Acids Res 22:4673–4680Vaidya GD, Lohman J, Meier R (2011) Sequence Matrix: concatenation software for the fast assembly of multi-gene datasets with character set and codon information. Cladistics 27:171–180Whalley AJS, Phosri C, Ruchikachorn N, Sihanonth P, Sangvichien E, Suwannasai N, Thienhirun S, Whalley MA (2012) Interesting or rare Xylariaceae from Thailand. Rajabhat J Sci Human Soc Sci 13:9–19White TJ, Bruns T, Lee S, Taylor J (1990) Amplification and direct sequencing of fungal ribosomal RNA genes for phylogenetics. 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Stroke management during the coronavirus disease 2019 (COVID-19) pandemic: experience from three regions of the north east of Italy (Veneto, Friuli-Venezia-Giulia, Trentino-Alto-Adige)
No full textBackground: Efficiency of care chain response and hospital reactivity were and are challenged for stroke acute care management during the pandemic period of coronavirus disease 2019 (COVID-19) in North-Eastern Italy (Veneto, Friuli-Venezia-Giulia, Trentino-Alto-Adige), counting 7,193,880 inhabitants (ISTAT), with consequences in acute treatment for patients with ischemic stroke. Methods: We conducted a retrospective data collection of patients admitted to stroke units eventually treated with thrombolysis and thrombectomy, ranging from January to May 2020 from the beginning to the end of the main first pandemic period of COVID-19 in Italy. The primary endpoint was the number of patients arriving to these stroke units, and secondary endpoints were the number of thrombolysis and/or thrombectomy. Chi-square analysis was used on all patients; furthermore, patients were divided into two cohorts (pre-lockdown and lockdown periods) and the Kruskal-Wallis test was used to test differences on admission and reperfusive therapies. Results: In total, 2536 patients were included in 22 centers. There was a significant decrease of admissions in April compared to January. Furthermore, we observed a significant decrease of thrombectomy during the lockdown period, while thrombolysis rate was unaffected in the same interval across all centers. Conclusions: Our study confirmed a decrease in admission rate of stroke patients in a large area of northern Italy during the lockdown period, especially during the first dramatic phase. Overall, there was no decrease in thrombolysis rate, confirming an effect of emergency care system for stroke patients. Instead, the significant decrease in thrombectomy rate during lockdown addresses some considerations of local and regional stroke networks during COVID-19 pandemic evolution
Acute revascularization treatments for ischemic stroke in the Stroke Units of Triveneto, northeast Italy: time to treatment and functional outcomes
No full text: It is not known whether the current territorial organization for acute revascularization treatments in ischemic stroke patients guarantees similar time to treatment and functional outcomes among different levels of institutional stroke care. We aimed to assess the impact of time to treatment on functional outcomes in ischemic stroke patients who received intravenous thrombolysis (IVT) alone, bridging (IVT plus thrombectomy), or primary thrombectomy in level 1 and level 2 Stroke Units (SUs) in Triveneto, a geographical macroarea in Northeast of Italy. We conducted an analysis of data prospectively collected from 512 consecutive ischemic stroke patients who received IVT and/or mechanical thrombectomy in 25 SUs from September 17th to December 9th 2018. The favorable outcome measures were mRS score 0-1 and 0-2 at 3 months. The unfavorable outcome measures were mRS score 3-5 and death at 3 months. We estimated separately the possible association of each variable for time to treatment (onset-to-door, door-to-needle, onset-to-needle, door-to-groin puncture, needle-to-groin puncture, and onset-to-groin puncture) with 3-month outcome measures by calculating the odds ratios (ORs) with two-sided 95% confidence intervals (CI) after adjustment for pre-defined variables and variables with a probability value ≤ 0.10 in the univariate analysis for each outcome measure. Distribution of acute revascularization treatments was different between level 1 and level 2 SUs (p < 0.001). Among 182 patients admitted to level 1 SUs (n = 16), treatments were IVT alone in 164 (90.1%), bridging in 12 (6.6%), and primary thrombectomy in 6 (3.3%) patients. Among 330 patients admitted to level 2 SUs (n = 9), treatments were IVT alone in 219 (66.4%), bridging in 74 (22.4%), and primary thrombectomy in 37 (11.2%) patients. Rates of excellent outcome (51.4% vs 45.9%), favorable outcome (60.1% vs 58.7%), unfavorable outcome (33.3% vs 33.8%), and death (9.8% vs 11.3%) at 3 months were similar between level 1 and 2 SUs. No significant association was found between time to IVT alone (onset-to-door, door-to-needle, and onset-to-needle) and functional outcomes. After adjustment, door-to-needle time ≤ 60 min (OR 4.005, 95% CI 1.232-13.016), shorter door-to-groin time (OR 0.991, 95% CI 0.983-0.999), shorter needle-to-groin time (OR 0.986, 95% CI 0.975-0.997), and shorter onset-to-groin time (OR 0.994, 95% CI 0.988-1.000) were associated with mRS 0-1. Shorter door-to-groin time (OR 0.991, 95% CI 0.984-0.998), door-to-groin time ≤ 90 min (OR 12.146, 95% CI 2.193-67.280), shorter needle-to-groin time (OR 0.983, 95% CI 0.972-0.995), and shorter onset-to-groin time (OR 0.993, 95% CI 0.987-0.999) were associated with mRS 0-2. Longer door-to-groin time (OR 1.007, 95% CI 1.001-1.014) and longer needle-to-groin time (OR 1.019, 95% CI 1.005-1.034) were associated with mRS 3-5, while door-to-groin time ≤ 90 min (OR 0.229, 95% CI 0.065-0.808) was inversely associated with mRS 3-5. Longer onset-to-needle time (OR 1.025, 95% CI 1.002-1.048) was associated with death. Times to treatment influenced the 3-month outcomes in patients treated with thrombectomy (bridging or primary). A revision of the current territorial organization for acute stroke treatments in Triveneto is needed to reduce transfer time and to increase the proportion of patients transferred from a level 1 SU to a level 2 SU to perform thrombectomy
Current territorial organization for access to revascularization therapies for acute ischemic stroke in the Veneto region (Italy) from 2017 to 2021
No full textIntroductionTo evaluate the access to treatments with intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT) in acute ischemic stroke patients admitted to stroke units (SUs) of Veneto region (Italy) according to current "hub-and-spoke" model from 2017 to 2021.Patients and methodsWe retrospectively analyzed data on treatments with IVT and/or MT for stroke patients admitted to the 23 SUs (6 Hubs and 17 Spokes) of the 6 macro-areas including 9 local sanitary units (LSUs) and 2 hospitals.ResultsWe reported 6093 treatments with IVT alone, 1114 with IVT plus MT, and 921 with MT alone. Number of stroke unit (SU) beds/100,000 inhabitants ranges from 2.3 to 2.8, and no difference was found among different macro-areas. Number of treatments/100,000 inhabitants/year ranges from 19 to 34 for IVT alone, from 2 to 7 for IVT plus MT, and from 2 to 5 for MT alone. Number of IVT alone/SU bed/year ranges from 9 to 21 in the Hub and from 6 to 12 in the Spokes. Rate of IVT plus MT in patients directly arrived in the same LSU's Hub ranges from 50 to 81%, likewise the one of MT alone ranges from 49 to 84%.ConclusionsTreatment target rates of IVT and MT set by Action Plan for Stroke in Europe 2018-2030 has been globally exceeded in the Veneto region. However, the target rate of MT and access revascularization treatments is heterogeneous among different macro-areas. Further efforts should be made to homogenize the current territorial organization
Fungal pathogens associated with branch and trunk cankers of nut crops in Iran
No full text[EN] Branch and trunk canker diseases have become prevalent on nut crops in Iran. During 2015 to 2018, extensive field surveys were conducted on 58 almond, 43 pistachio and 80 walnut orchards in Iran to study fungal pathogens associated with symptomatic trees. One hundred and fifty-six representative fungal isolates were selected and identified based on morphological characteristics and by phylogenetic comparison of DNA sequence data. Fungal species found were Collophorina hispanica, Pleurostoma richardsiae, nine species of Phaeoacremonium (namely P. angustius, P. cinereum, P. italicum, P. fraxinopennsylvanicum, P. minimum, P. parasiticum, P. scolyti, P. tuscanum and P. viticola), 11 species of Botryosphaeriaceae (namely Botryosphaeria dothidea, Diplodia gallae, D. mutila, D. seriata, Dothiorella plurivora, Do. sarmentorum, Do. viticola, Lasiodiplodia citricola, L. mahajangana, L. theobromae and Neofusicoccum parvum), four species of Diatrypaceae (namely Cryptosphaeria pullmanensis, Diatrype whitmanensis, Eutypella citricola and E. vitis) and two non-identified Eutypella spp. (Eutypella sp. 1 and Eutypella sp. 2). Some of these species represent new reports in Iran and/or are reported for the first time in their respective hosts. Pathogenicity tests demonstrated that most of these fungi were pathogenic to inoculated almond, pistachio and walnut shoots. Therefore, more importance should be given to fungal trunk pathogens in Iran, and specific management strategies should be included within the nut crops IPM management programs, with the aim of improving their sustainability.Financial support by the Iranian Ministry of Science, Research and Technology (MSRT) for the first author during her 4 months stay in Spain as a part of her PhD project is greatly acknowledged.Sohrabi, M.; Mohammadi, H.; León Santana, M.; Armengol Fortí, J.; Banihashemi, Z. (2020). Fungal pathogens associated with branch and trunk cankers of nut crops in Iran. European Journal of Plant Pathology. 157(2):327-351. https://doi.org/10.1007/s10658-020-01996-wS3273511572Abdollahzadeh, J., Javadi, A., Mohmammadi Goltapeh, E., Zare, R., & Phillips, A. J. L. (2010). Phylogeny and morphology of four new species of Lasiodiplodia from Iran. Persoonia, 25, 1–10.Abdollahzadeh, J., Zare, R., & Phillips, A. J. L. (2013). 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Identification and pathogenicity of Macrophomina species collected from weeds in melon fields in Northeastern Brazil
No full text"This is the peer reviewed version of the following article: Negreiros, AMP, Sales Júnior, R, León, M, et al. Identification and pathogenicity of Macrophomina species collected from weeds in melon fields in Northeastern Brazil. J Phytopathol. 2019; 167: 326 337. , which has been published in final form at https://doi.org/10.1111/jph.12801. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving."[EN] In this work, a collection of 94 Macrophomina isolates obtained from roots of two weed species, Trianthema portulacastrum and Boerhavia diffusa, collected during surveys conducted during 2015 and 2016 in melon production fields in Northeastern Brazil, were characterized by using molecular techniques. Phylogenetic analysis of the EF1-alpha gene allowed the identification of 32 isolates as M. phaseolina and 62 isolates as M. pseudophaseolina. Results of a pathogenicity test performed on melon seedlings of the cv. "Gladial" revealed that all M. phaseolina isolates inoculated were able to cause disease to melon seedlings, but only some M. pseudophaseolina isolates were able to infect them. This study represents the first report of M. pseudophaseolina in both T. portulacastrum and B. diffusa weeds, which are prevalent in the main Brazilian melon producing and exporting regions. Information about the biology and epidemiology of M. pseudophaseolina is scarce because of its recent description; thus, further research is needed for a better understanding of this fungus as a potentially emerging pathogen of melon and other crops.Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior-Brazil (CAPES); Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Negreiros, AMP.; Sales Junior, R.; León Santana, M.; de Assis Melo N.J.; Michereff, S.; de Queiroz Ambrósio M.M.; De Sousa Medeiros, H.... (2019). 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Real-world comparison of dual versus single antiplatelet treatment in patients with non-cardioembolic mild-to-moderate ischemic stroke: a propensity matched analysis
No full textBackground:
Short-term dual antiplatelet treatment (DAPT) is superior to single antiplatelet treatment (SAPT) for secondary prevention in non-cardioembolic minor ischemic stroke and high-risk transient ischemic attack (TIA). As the real-world use of DAPT is broader than in trials, it is important to clarify its benefit/risk profile in a diverse population.
Methods:
Post hoc analysis of prospectively collected data from the READAPT cohort and three prospective stroke registries including patients with mild-to-moderate (National Institute of Health Stroke Scale (NIHSS) score 0–10) ischemic stroke receiving early DAPT or SAPT. The primary effectiveness outcome was 90-day return to pre-stroke neurological functioning using modified Rankin Scale (mRS) score. Secondary effectiveness outcomes were 90-day mRS shift, new ischemic stroke/TIA, vascular and all-cause death, 24 h early neurological improvement or deterioration. The safety outcome was 90-day intracranial hemorrhage.
Results:
We matched 1008 patients treated with DAPT and 1008 treated with SAPT. Compared to SAPT, patients treated with DAPT showed higher likelihood of 90-day primary effectiveness outcome (87.5% vs. 84.4%, risk difference 3.1% (95% confidence interval (CI): 0.1%–6.1%); p = 0.047, risk ratio 1.03 (95% CI: 1.01–1.07); p = 0.043) and higher rate of 24-h early neurological improvement (25.3% vs. 15.4%, risk difference 9.9% (95% CI: 6.4%–13.4%); p < 0.001, risk ratio 1.65 (95% CI: 1.37–1.97); p < 0.001). No differences were observed for other study outcomes. Subgroup analysis confirmed benefit of DAPT over SAPT for primary effectiveness outcome in patients with moderate stroke, those treated with intravenous thrombolysis, and those who received antiplatelet loading dose.
Conclusion:
Our findings suggest that DAPT use might be safe and more effective than SAPT even in the real world and in patients who do not strictly fulfill the criteria of landmark large clinical trials
Admission systolic blood pressure and short-term outcomes after dual antiplatelet therapy in patients with minor ischemic stroke or transient ischemic attack
No full textBackground: Elevated baseline systolic blood pressure (SBP) was associated with poor outcomes following dual antiplatelet therapy (DAPT) in patients with non-cardioembolic minor ischemic stroke (MIS) or high-risk transient ischemic attack (TIA) in clinical trials.
Objectives: We aimed to assess the impact of admission SBP on the short-term outcomes after DAPT in patients with non-cardioembolic MIS or high-risk TIA.
Methods: We performed an inverse probability weighted (IPW) analysis from a prospective multicentric real-world study (READAPT) including patients with non-cardioembolic MIS (National Institute of Health Stroke Scale of 0–5) or high-risk TIA (ABCD2 ⩾4) who initiated DAPT within 48 h of symptom onset. The primary effectiveness outcome was the 90-day risk of new ischemic stroke or other vascular events. The secondary effectiveness outcomes were the 90-day modified Rankin Scale score ordinal shift, vascular and all-cause mortality, 24-h early neurological improvement or deterioration. The safety outcomes included the 90-day risk of moderate-to-severe and any bleedings, symptomatic intracranial hemorrhage, and 24-h hemorrhagic transformation. We used Cox proportional hazards regression with restricted cubic splines to model the continuous relationship between SBP and the hazard ratio (HR) of new vascular events. We selected SBP = 124 mm Hg as cut-off point for the IPW weighting. Outcomes were compared using Cox and generalized logistic regression analyses, adjusted for residual confounders.
Results: From 2278 patients in the READAPT cohort, we included 1291 MIS or high-risk TIAs (mean age 70.6 ± 11.4 years; 65.8% males). After IPW, patients with admission SBP ⩾124 mm Hg versus <124 mm Hg had a significantly higher risk of 90-day ischemic stroke or other vascular events (adjusted HR: 2.14 (95% CI 1.07%–4.98%); p = 0.033) and of 24-h early neurological deterioration (adjusted risk difference: 1.91% (95% CI 0.60%–3.41%); p = 0.006). The overall risk of safety outcomes was low, although patients with SBP ⩾124 mm Hg on admission showed higher rates of 90-day moderate-to-severe and any bleeding events (adjusted risk difference: 1.24% (95% CI 0.38%–2.14%); p = 0.004 and 6.18% (95% CI 4.19%–8.16%); p < 0.001; respectively), as well as of 24-h hemorrhagic transformation (adjusted risk difference: 1.57% (95% CI 0.60%–2.55%); p = 0.001). Subgroup analysis showed a significant interaction between admission SBP, sex, and time to DAPT start in predicting 90-day new vascular events (p for interaction <0.001 and 0.007, respectively).
Conclusion: In patients with non-cardioembolic MIS or high-risk TIA, higher levels of admission SBP may be associated with an increased risk of new vascular events, early neurological deterioration, and bleeding after DAPT use. Future studies should further investigate if optimizing blood pressure management may further improve prognosis
