Intravascular volume status was assessed using the Delta Down (DD). We looked at the SPI response to FC according to DD, CePPF, and CeREMI. Results Following FC, SPI did PF-04929113 not change in 16, increased in 12,

and decreased in 3 patients. CeREMI poorly affected the SPI response to FC. In normovolaemic patients, the probability of an SPI change after FC was low under common CePPF (0.9 to 3.9 mu g/ml). A decrease in SPI was more probable with worsening hypovolaemia and lowering CePPF, while an increase in SPI was more probable with increasing CePPF. SPI changes were only attributable to modifications in pulse wave amplitude and not in heart rate. Conclusions During stable anaesthesia and surgery, SPI may change in response to FC. The effect of FC on SPI is influenced by volaemia and CePPF through pulse wave amplitude modifications. These situations may confound

the interpretation of SPI as a surrogate measure of the nociceptionanti-nociception balance.”
“Background and Purpose-Many randomized clinical trials have evaluated the benefit of long-term use of antiplatelet drugs in reducing the risk of new vascular events in patients with a recent AZD5582 transient ischemic attack or ischemic stroke. Evidence from these trials forms the basis for national and international guidelines for the management of nearly all such patients in clinical practice. However, abundant and strict enrollment criteria may limit the validity and the applicability of results of randomized clinical trials to clinical practice. We estimated the eligibility for participation in landmark trials of antiplatelet drugs of an unselected group of patients

with stroke or transient ischemic attack from a national stroke survey.\n\nMethods-Nine hundred seventy-two patients with transient ischemic attack or ischemic stroke were prospectively and consecutively enrolled Small molecule library purchase in the Netherlands Stroke Survey. We applied 7 large antiplatelet trials’ enrollment criteria.\n\nResults-In total, 886 patients were discharged alive and available for secondary prevention. Mean follow-up was 2.5 years. The annual rate of transient ischemic attack, stroke, or nonfatal myocardial infarction was 6.7%. The proportions of patients fulfilling the trial enrollment criteria ranged from 25% to 67%. Mortality was significantly higher in ineligible patients (27% to 41%) than in patients fulfilling enrollment criteria (16% to 20%). Rates of vascular events were not higher in trial-eligible patients than in ineligible patients.\n\nConclusions-Our data confirm that patients with ischemic attack and stroke enrolled in randomized clinical trials are only partially representative of patients in clinical practice.