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Sökning: WFRF:(Yesilot Nilufer)

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1.
  • Ekker, Merel, et al. (författare)
  • Global Outcome Assessment Life-long after stroke in young adults initiative-the GOAL initiative: study protocol and rationale of a multicentre retrospective individual patient data meta-analysis.
  • 2019
  • Ingår i: BMJ open. - 2044-6055. ; 9:11
  • Tidskriftsartikel (refereegranskat)abstract
    • Worldwide, 2 million patients aged 18-50 years suffer a stroke each year, and this number is increasing. Knowledge about global distribution of risk factors and aetiologies, and information about prognosis and optimal secondary prevention in young stroke patients are limited. This limits evidence-based treatment and hampers the provision of appropriate information regarding the causes of stroke, risk factors and prognosis of young stroke patients.The Global Outcome Assessment Life-long after stroke in young adults (GOAL) initiative aims to perform a global individual patient data meta-analysis with existing data from young stroke cohorts worldwide. All patients aged 18-50 years with ischaemic stroke or intracerebral haemorrhage will be included. Outcomes will be the distribution of stroke aetiology and (vascular) risk factors, functional outcome after stroke, risk of recurrent vascular events and death and finally the use of secondary prevention. Subgroup analyses will be made based on age, gender, aetiology, ethnicity and climate of residence.Ethical approval for the GOAL study has already been obtained from the Medical Review Ethics Committee region Arnhem-Nijmegen. Additionally and when necessary, approval will also be obtained from national or local institutional review boards in the participating centres. When needed, a standardised data transfer agreement will be provided for participating centres. We plan dissemination of our results in peer-reviewed international scientific journals and through conference presentations. We expect that the results of this unique study will lead to better understanding of worldwide differences in risk factors, causes and outcome of young stroke patients.
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2.
  • Putaala, Jukka, et al. (författare)
  • Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Triggers, Causes, and Outcome (SECRETO): Rationale and design
  • 2017
  • Ingår i: European Stroke Journal. - : SAGE Publications. - 2396-9873. ; 2:2, s. 116-125
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Worldwide, about 1.3 million annual ischaemic strokes (IS) occur in adults aged <50 years. Of theseearly-onset strokes, up to 50% can be regarded as cryptogenic or associated with conditions with poorly documented causality like patent foramen ovale and coagulopathies. Key hypotheses/aims: (1) Investigate transient triggers and clinical/sub-clinical chronic risk factors associated with cryptogenic IS in the young; (2) use cardiac imaging methods exceeding state-of-the-art to reveal novel sources for embolism; (3) search for covert thrombosis and haemostasis abnormalities; (4) discover new disease pathways using next-generation sequencing and RNA gene expression studies; (5) determine patient prognosis by use of phenotypic and genetic data; and (6) adapt systems medicine approach to investigate complex risk-factor interactions. Design: Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO; NCT01934725) is a prospective multi-centre case–control study enrolling patients aged 18–49 years hospitalised due to first-ever imaging-proven IS of undetermined etiology. Patients are examined according to a standardised protocol and followed up for 10 years. Patients are 1:1 age- and sex-matched to stroke-free controls. Key study elements include centralised reading of echocardiography, electrocardiography, and neurovascular imaging, as well as blood samples for genetic, gene-expression, thrombosis and haemostasis and biomarker analysis. We aim to have 600 patient–control pairs enrolled by the end of 2018. Summary: SECRETO is aiming to establish novel mechanisms and prognosis of cryptogenic IS in the young and will provide new directions for therapy development for these patients. First results are anticipated in 2019.
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3.
  • Yesilot, Nilufer, et al. (författare)
  • Ethnic and Geographical Differences in Ischaemic Stroke Among Young Adults.
  • 2017
  • Ingår i: Current vascular pharmacology. - 1875-6212. ; 15:5, s. 416-429
  • Tidskriftsartikel (refereegranskat)abstract
    • Ischaemic stroke in young adults encompasses approximately 5 - 15% of all ischaemic strokes, depending on the selected upper age limit. The key features of the disease, including incidence, risk factors, underlying causes, mortality, outcomes, as well as long-term risks of recurrent events are different from those for elderly patients. There is also evidence indicating that these characteristics may differ ethnically and geographically. It is clinically important to recognize such differences not only for correct diagnosis and treatment, but also for introducing accurate preventive measures. Ethnic differences may stem from several factors, including genetic influence, and necessitate different approaches, such as personalized diagnostic work-up based on patient characteristics.In this review, we summarize and discuss the existing data on the geographic and ethnic differential characteristics of young adult ischaemic stroke.
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