Differentiation of MS lesions through analysis of microvascular distribution.

Conventional MRI is crucial for diagnosing multiple sclerosis (MS) but lacks precision, leading to the clinico-radiological paradox and misdiagnosis risk, especially when confronted with unspecific lesions not related to MS. Advancements in perfusion-weighted imaging (PWI) with an algorithm designed for diseases with anticipated contrast agent extravasation offer insight into microvascular impairment and flow heterogeneity. Our study aimed to assess these factors in MS patients and their association with clinically relevant white matter injury and disease course.

Beta-blocker side-effects in clinical practice: A nationwide approach.

Background: Concerns regarding side-effects of beta-blockers (BBs) are frequent but data regarding the incidence of side-effects are conflicting and real-world data are sparse. Hence, we aimed to investigate the absolute and relative risks of BB side-effects in clinical practice.

Methods: Using Danish nationwide registers, we included Danish hypertensive patients initiating anti-hypertensive treatment with a BB or calcium-channel blocker (CCB).

Effects of nocturnal periodic breathing on sympathetic nerve activity and ventilatory control at high altitude: a randomised, crossover study.

During acute exposure to the hypoxia of high altitude, activation of the peripheral chemoreflex increases sympathetic nerve activity (SNA) and pulmonary ventilation. If exposure extends over several days, SNA and ventilation further increase and we investigated whether nocturnal periodic breathing (nPB) - a form of sleep-disordered breathing that is common at high altitude - contributes to these further increases. In a randomised, placebo-controlled, crossover protocol, twelve healthy men completed two 3-day sojourns in hypobaric hypoxia equivalent to 4000 m altitude.

Minimally invasive surgical evacuation confers a mortality benefit in patients with moderate-sized putaminal hemorrhages.

Objective: Minimally invasive surgical (MIS) evacuation of basal ganglia hemorrhages has not demonstrated efficacy compared with medical management. Prior study from this group has suggested that MIS evacuation of moderate-sized putaminal intracranial hemorrhages (pICHs) using tubular retractors is associated with favorable functional outcomes. The authors hypothesized that postoperative functional outcomes were improved in patients with moderate-sized pICH compared with those of a matched cohort of medically managed patients.

Automated Computer Vision Methods for Image Segmentation, Stereotactic Localization, and Functional Outcome Prediction of Basal Ganglia Hemorrhages.

Background And Objectives: Basal ganglia intracranial hemorrhage (bgICH) morphology is associated with postoperative functional outcomes. We hypothesized that bgICH spatial representation modeling could be automated for functional outcome prediction after minimally invasive surgical (MIS) evacuation.

Methods: A training set of 678 computed tomography head and computed tomography angiography images from 63 patients were used to train key-point detection and instance segmentation convolutional neural network-based models for anatomic landmark identification and bgICH segmentation.

Fluoroquinolones and the risk of aortic aneurysm or aortic dissection: evidence from a nationwide nested case-control study paralleled with matched experimental models.

Aims: Fluoroquinolones (FQ) have been associated with aortic aneurysm and aortic dissection (AA/AD) resulting in an official warning. Recently, large-scale epidemiological studies failed to confirm this.

Methods And Results: The current study aimed to scrutinize the FQ-AA/AD association through a retrospective nested case-cohort analysis supplemented with animal experimentation.

Pediatric Onset Multiple Sclerosis (POMS): Exploring phenotypic characterization and pubertal influences in modulating the disease activity from the Danish MS Registry (DMSR).

Background: Pediatric-onset multiple sclerosis (POMS) constitutes ~5% of multiple sclerosis (MS) cases and presents distinct clinical and diagnostic challenges. Puberty, characterized by significant hormonal changes, may influence disease presentation, relapse rates, and long-term outcomes.

Objectives: To investigate the impact of pubertal stages on clinical characteristics, relapse activity and disability progression in POMS using data from the Danish MS Registry (DMSR).

The Bad Reputation of Digoxin in Atrial Fibrillation-Causality or Bias? Nationwide Nested Case-Control Study.

Aims: Studies have reported excess risk of mortality associated with digoxin in atrial fibrillation (AF).This study sought to investigate if these findings could be replicated and whether a potential association could be explained by bias.

Methods: Using Danish Nationwide registers, a nested-case control study from 2012 to 2022 was conducted in a cohort of patients with AF.

Carbonic anhydrase inhibitors prevent presymptomatic capillary flow disturbances in a model of cerebral amyloidosis.

Introduction: Disturbances in microvascular flow dynamics are hypothesized to precede the symptomatic phase of Alzheimer's disease (AD). However, evidence in presymptomatic AD remains elusive, underscoring the need for therapies targeting these early vascular changes.

Methods: We employed a multimodal approach, combining in vivo optical imaging, molecular techniques, and ex vivo magnetic resonance imaging, to investigate early capillary dysfunction in C57BL/6-Tg(Thy1-APPSwDutIowa)BWevn/Mmjax (Tg-SwDI) mice without memory impairment.

Patterns and predictors of multiple sclerosis phenotype transition.

Currently, there are limited therapeutic options for patients with non-active secondary progressive multiple sclerosis. Therefore, real-world studies have investigated differences between patients with relapsing-remitting multiple sclerosis, non-active secondary progressive multiple sclerosis and active secondary progressive multiple sclerosis. Here, we explore patterns and predictors of transitioning between these phenotypes.

Direct Superficial Temporal Artery-Proximal Middle Bypass in Moyamoya Disease: Predicting Postoperative Symptomatic Contralateral Stroke Using Clinical Characteristics and Angiographic Collateralization Patterns.

Background: Moyamoya disease (MMD) is a rare cerebrovascular disorder marked by internal carotid artery narrowing, collateral neovascularization, and symptomatic cerebral ischemia. Select patients can benefit from direct bypass (superficial temporal artery [STA]-proximal middle [MCA] bypass) by restoring blood flow to hypoperfused territories. Symptomatic contralateral stroke (CS) following STA-MCA bypass is a devastating, poorly understood complication.

Computational modeling of basal ganglia hemorrhage morphology improves functional outcome prognostication after minimally invasive surgical evacuation.

Introduction: Anatomic factors that predict outcomes following basal ganglia intracranial hemorrhage (bgICH) evacuation are poorly understood. Given the compact neuroanatomic organization of the basal ganglia, we hypothesized that bgICH spatial representation could predict postoperative functional outcomes.

Methods: Patients undergoing minimally invasive surgical bgICH evacuation between 2013 and 2024 at one center were retrospectively reviewed.

Marked hemoglobin mass expansion and plasma volume contraction in Sherpas acclimatizing to 5,400 m altitude.

In lowlanders, high altitude (HA) acclimatization induces hemoconcentration by reducing plasma volume (PV) and increasing total hemoglobin mass (Hb). Conversely, Tibetan highlanders living at HA are reported to have a similar hemoglobin concentration ([Hb]) as lowlanders near sea level, and we investigated whether this reflects alterations in the PV or the Hb response to HA. Baseline assessment of PV and Hb was performed by carbon monoxide rebreathing at low altitudes (∼1,400 m) in Sherpas (an ethnic group of Tibetans living in Nepal) and native lowlanders.

The impact of medication-assisted treatment for opioid use disorder on congestive heart failure outcomes.

Congestive heart failure (CHF) and opioid use disorder (OUD) commonly coexist and are major contributors to high healthcare utilization in the United States. Medication assisted treatment (MAT; e.g.

Cerebral microvascular changes in healthy carriers of the APOE-ɛ4 Alzheimer's disease risk gene.

APOE-ɛ4 is a genetic risk factor for Alzheimer's disease (AD). AD is associated with reduced cerebral blood flow (CBF) and with microvascular changes that limit the transport of oxygen from blood into brain tissue: reduced microvascular cerebral blood volume and high relative transit time heterogeneity (RTH). Healthy APOE-ɛ4 carriers reveal brain regions with CBF compared with carriers of the common ɛ3 allele.

Disparities in the access to atrial fibrillation ablation in Denmark: who gets ablated, who neglected?

Aims: Atrial fibrillation (AF) is a common arrhythmia associated with reduced quality of life that can lead to serious complications such as stroke and heart failure. Ablation is a safe and effective treatment for AF but is not offered equally to all patients. The aim of this study is to identify demographic groups more or less likely to undergo AF ablation.

Carbonic anhydrase inhibitors prevent presymptomatic capillary flow disturbances in a model of cerebral amyloidosis.

Introduction: Disturbances in microvascular flow dynamics are hypothesized to precede the symptomatic phase of Alzheimer's disease (AD). However, evidence in presymptomatic AD remains elusive, underscoring the need for therapies targeting these early vascular changes.

Methods: We employed a multimodal approach, combining in vivo optical imaging, molecular techniques, and ex vivo MRI, to investigate early capillary dysfunction in Tg-SwDI mice without memory impairment.

Understanding the incidence of atrial fibrillation and stroke in hypertrophic cardiomyopathy patients: insights from Danish nationwide registries.

Aims: The treatment of atrial fibrillation (AF) in hypertrophic cardiomyopathy (HCM) can be challenging since AF aggravates symptoms and increases the risk of stroke. Which factors contribute to the development of AF and stroke in HCM remains unknown. The aim of this study was to determine the incidence of AF and stroke in HCM patients and identify the risk factors.

Effect of early cryoballoon ablation on atrial fibrillation recurrence-A Danish nationwide register study.

Introduction: Cryoballoon ablation is a safe and efficient rhythm control strategy in atrial fibrillation (AF) patients. The impact of time from diagnosis to ablation is unclear. The aim of this study was to examine the impact of timing of first-time cryoballoon ablation on AF recurrence in a nationwide cohort of AF patients.