Marcio Lehmann - Academia.edu (original) (raw)

Papers by Marcio Lehmann

Arq Bras Neurocir, Mar 1, 2010

Metabolic brain disease, Jan 11, 2015

The aim of this study was to evaluate the association between inflammatory and metabolic markers ... more The aim of this study was to evaluate the association between inflammatory and metabolic markers and short-time outcome with acute ischemic stroke subtypes. A total of 121 patients was classified according to TOAST criteria, such as large artery atherosclerosis (LAAS), lacunar infarct (LAC), cardioembolic infarct (CEI), other determined etiology (ODE), and undetermined etiology (UDE). The functional impairment was evaluated within the first eight hours of stroke and the outcome after three-month follow-up using the modified Rankin Scale. Blood samples were obtained up to 24 h of stroke. Compared with 96 controls, patients with LAAS, CEI, and LAC subtypes showed higher levels of white blood cells, high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL-6), metalloproteinase 9 (MMP-9), glucose, and iron (p < 0.05); and lower high-density lipoprotein cholesterol (HDL-C) (p < 0.0001); platelets, insulin, insulin resistance, and homocysteine were higher in LAC (p < 0.0001...

Metabolic Brain Disease, 2015

Oxidative stress has been implicated in the pathophysiology of cardiovascular disease and MetS an... more Oxidative stress has been implicated in the pathophysiology of cardiovascular disease and MetS and it may be one of molecular mechanisms involved in stroke. The aims of the present study were to verify differences in oxidative stress markers in acute ischemic stroke patients with and without MetS and to verify whether MetS influences disability and short time outcome of the patients. 148 patients with acute ischemic stroke were divided in two groups: with MetS (n = 92) and without MetS (n = 56). The modified Rankin Scale (mRS) was used for measuring the functional disability after 3-month follow-up. The study assessed the metabolic profile and oxidative stress markers. Stroke patients with MetS had higher levels of lipid hydroperoxides (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and advanced oxidation protein products (AOPP, p = 0.0302) than those without MetS. Hydroperoxides were directly and independently associated with MetS (OR: 1.000, 95 % IC = 1.000-1.000, p = 0.005). Linear regression demonstrated that AOPP levels (R(2) = 0.281, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and oxidative stress index (OSI, R(2) = 0.223, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) were directly associated with triglycerides levels and hydroperoxides levels was also directly associated with glucose levels (R(2) = 0.080, p = 0.013. The mRS and short-come outcome did not differ after 3 months in both groups. In conclusion, an increase in oxidative stress markers was shown in acute ischemic stroke patients with MetS and this elevation seems to be involved mainly with changes in lipid profile, but the presence of MetS did not influence short-time disability and survival of the acute ischemic stroke patients.

The risk of complication of cerebral angiography has always been the focus of attention. The aim ... more The risk of complication of cerebral angiography has always been the focus of attention. The aim of this study was to evaluate the outcome of cerebral angiography performed in the first 30 months of operational training in the endovascular neurosurgery service of a university hospital. Methods: A retrospective study evaluated 129 digital cerebral angiography examinations in 91 patients at a univeristy hospital from Southern Brazil. Results: The rate of complication was 2/129 (1.55%); of them, one (0.77%) presented a transient complication (hematoma puncture), and one (0.77%) a permanent complication with death of the patient because of an association between clotting in the middle cerebral artery and complications from the initial trauma.Conclusion: The rate of cerebral angiography complication obtained was low (1.75%) and underscores its reduced risk when performed in a neurological service even with professional in training. Objetivos: O risco de complicação de angiografia cerebral tem sido constantemente foco de atenção. O objetivo deste estudo foi avaliar o resultado de angiografia cerebral realizada nos primeiros 30 meses de treinamento operacional em um serviço de neurocirurgia endovascular em um hospital universitário. Métodos: Foi realizado um estudo retrospectivo para avaliação de 129 resultados de angiografia cerebral digital realizada em 91 pacientes em um hospital universitário da região sul do Brasil. Resultados: A taxa de complicação foi de 2 /129 (1,55%); destas, um (0,77%) paciente apresentou complicação transitória (hematoma no local da punção), e outro (0,77%) apresentou uma complicação permanente com óbito devido à associação entre coagulação na artéria média cerebral e complicações do trauma inicial. Conclusão: A taxa de complicação da angiografia cerebral observada neste estudo foi baixa (1,75%) e reafirma seu risco reduzido quando realizada em um serviço de neurocirurgia mesmo com profissionais médicos em treinamento.

AJNR. American journal of neuroradiology, 2005

We report the unusual case of pulsatile tinnitus caused by muscular branches of the occipital art... more We report the unusual case of pulsatile tinnitus caused by muscular branches of the occipital artery, which developed to supply the distal vertebral artery after subclavian artery occlusion. Anatomical findings and options of endovascular treatment are discussed. To our knowledge, subclavian artery occlusion causing an objective tinnitus has not been reported.

Metabolic Brain Disease, 2014

Polymorphisms in genes coding for pro-inflammatory molecules represent important factors for the ... more Polymorphisms in genes coding for pro-inflammatory molecules represent important factors for the pathogenesis and outcome of stroke. The aim of this study was to evaluate the relationship between the tumor necrosis factor beta (TNF-β) NcoI (rs909253) polymorphism with inflammatory and metabolic markers in acute ischemic stroke. Ninetythree patients and 134 controls were included. The TNF-β polymorphism was determined using PCR-RFLP with NcoI restriction enzyme. Stroke subtypes and neurological deficit score were evaluated. White blood cell counts, erythrocyte sedimentation rate (ESR), plasma levels of IL-6 and TNF-α, serum high sensitivity C-reactive Protein (hsCRP), serum lipid profile, plasma levels of glucose and insulin, and homeostatic model assessment of insulin resistance (HOMA-IR) were determined. Stroke patients presented higher white blood cell counts, hsCRP, ESR, glucose, insulin, and HOMA-IR, and lower HDL cholesterol than controls (p<0.01). There was no difference in genotypic and allelic frequency of TNF-β NcoI polymorphism among patients and controls (p>0.05). However, stroke patients carrying the TNFB2/B2 genotype presented higher levels of TNF-α, white blood cell counts, total cholesterol, LDL cholesterol, glucose, insulin, and HOMA-IR than those with other genotypes (p<0.05). White blood cells, IL-6, hsCRP, and ESR were positively correlated with the neurological deficit of the patients (p<0.05). Taken together, TNF-β NcoI polymorphism, by itself, was not associated with increased susceptibility for stroke development. However, the homozygous genotype for the allele TNFB2 was associated with higher expression of classical inflammatory and metabolic markers of development and outcome of stroke than other genotypes. The identification of variant alleles might allow both better prediction of susceptibility for stroke as well the identification of novel stroke mechanisms that could be target to new therapeutic approaches. Stroke patients carrying the TNFB2 variant allele could have a beneficial effect with the anti-inflammatory therapies in the early inflammatory phase of stroke.

Arq Bras Neurocir, Mar 1, 2010

Metabolic brain disease, Jan 11, 2015

The aim of this study was to evaluate the association between inflammatory and metabolic markers ... more The aim of this study was to evaluate the association between inflammatory and metabolic markers and short-time outcome with acute ischemic stroke subtypes. A total of 121 patients was classified according to TOAST criteria, such as large artery atherosclerosis (LAAS), lacunar infarct (LAC), cardioembolic infarct (CEI), other determined etiology (ODE), and undetermined etiology (UDE). The functional impairment was evaluated within the first eight hours of stroke and the outcome after three-month follow-up using the modified Rankin Scale. Blood samples were obtained up to 24 h of stroke. Compared with 96 controls, patients with LAAS, CEI, and LAC subtypes showed higher levels of white blood cells, high-sensitivity C-reactive protein (hsCRP), interleukin 6 (IL-6), metalloproteinase 9 (MMP-9), glucose, and iron (p < 0.05); and lower high-density lipoprotein cholesterol (HDL-C) (p < 0.0001); platelets, insulin, insulin resistance, and homocysteine were higher in LAC (p < 0.0001...

Metabolic Brain Disease, 2015

Oxidative stress has been implicated in the pathophysiology of cardiovascular disease and MetS an... more Oxidative stress has been implicated in the pathophysiology of cardiovascular disease and MetS and it may be one of molecular mechanisms involved in stroke. The aims of the present study were to verify differences in oxidative stress markers in acute ischemic stroke patients with and without MetS and to verify whether MetS influences disability and short time outcome of the patients. 148 patients with acute ischemic stroke were divided in two groups: with MetS (n = 92) and without MetS (n = 56). The modified Rankin Scale (mRS) was used for measuring the functional disability after 3-month follow-up. The study assessed the metabolic profile and oxidative stress markers. Stroke patients with MetS had higher levels of lipid hydroperoxides (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and advanced oxidation protein products (AOPP, p = 0.0302) than those without MetS. Hydroperoxides were directly and independently associated with MetS (OR: 1.000, 95 % IC = 1.000-1.000, p = 0.005). Linear regression demonstrated that AOPP levels (R(2) = 0.281, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) and oxidative stress index (OSI, R(2) = 0.223, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0001) were directly associated with triglycerides levels and hydroperoxides levels was also directly associated with glucose levels (R(2) = 0.080, p = 0.013. The mRS and short-come outcome did not differ after 3 months in both groups. In conclusion, an increase in oxidative stress markers was shown in acute ischemic stroke patients with MetS and this elevation seems to be involved mainly with changes in lipid profile, but the presence of MetS did not influence short-time disability and survival of the acute ischemic stroke patients.

The risk of complication of cerebral angiography has always been the focus of attention. The aim ... more The risk of complication of cerebral angiography has always been the focus of attention. The aim of this study was to evaluate the outcome of cerebral angiography performed in the first 30 months of operational training in the endovascular neurosurgery service of a university hospital. Methods: A retrospective study evaluated 129 digital cerebral angiography examinations in 91 patients at a univeristy hospital from Southern Brazil. Results: The rate of complication was 2/129 (1.55%); of them, one (0.77%) presented a transient complication (hematoma puncture), and one (0.77%) a permanent complication with death of the patient because of an association between clotting in the middle cerebral artery and complications from the initial trauma.Conclusion: The rate of cerebral angiography complication obtained was low (1.75%) and underscores its reduced risk when performed in a neurological service even with professional in training. Objetivos: O risco de complicação de angiografia cerebral tem sido constantemente foco de atenção. O objetivo deste estudo foi avaliar o resultado de angiografia cerebral realizada nos primeiros 30 meses de treinamento operacional em um serviço de neurocirurgia endovascular em um hospital universitário. Métodos: Foi realizado um estudo retrospectivo para avaliação de 129 resultados de angiografia cerebral digital realizada em 91 pacientes em um hospital universitário da região sul do Brasil. Resultados: A taxa de complicação foi de 2 /129 (1,55%); destas, um (0,77%) paciente apresentou complicação transitória (hematoma no local da punção), e outro (0,77%) apresentou uma complicação permanente com óbito devido à associação entre coagulação na artéria média cerebral e complicações do trauma inicial. Conclusão: A taxa de complicação da angiografia cerebral observada neste estudo foi baixa (1,75%) e reafirma seu risco reduzido quando realizada em um serviço de neurocirurgia mesmo com profissionais médicos em treinamento.

AJNR. American journal of neuroradiology, 2005

We report the unusual case of pulsatile tinnitus caused by muscular branches of the occipital art... more We report the unusual case of pulsatile tinnitus caused by muscular branches of the occipital artery, which developed to supply the distal vertebral artery after subclavian artery occlusion. Anatomical findings and options of endovascular treatment are discussed. To our knowledge, subclavian artery occlusion causing an objective tinnitus has not been reported.

Metabolic Brain Disease, 2014

Polymorphisms in genes coding for pro-inflammatory molecules represent important factors for the ... more Polymorphisms in genes coding for pro-inflammatory molecules represent important factors for the pathogenesis and outcome of stroke. The aim of this study was to evaluate the relationship between the tumor necrosis factor beta (TNF-β) NcoI (rs909253) polymorphism with inflammatory and metabolic markers in acute ischemic stroke. Ninetythree patients and 134 controls were included. The TNF-β polymorphism was determined using PCR-RFLP with NcoI restriction enzyme. Stroke subtypes and neurological deficit score were evaluated. White blood cell counts, erythrocyte sedimentation rate (ESR), plasma levels of IL-6 and TNF-α, serum high sensitivity C-reactive Protein (hsCRP), serum lipid profile, plasma levels of glucose and insulin, and homeostatic model assessment of insulin resistance (HOMA-IR) were determined. Stroke patients presented higher white blood cell counts, hsCRP, ESR, glucose, insulin, and HOMA-IR, and lower HDL cholesterol than controls (p<0.01). There was no difference in genotypic and allelic frequency of TNF-β NcoI polymorphism among patients and controls (p>0.05). However, stroke patients carrying the TNFB2/B2 genotype presented higher levels of TNF-α, white blood cell counts, total cholesterol, LDL cholesterol, glucose, insulin, and HOMA-IR than those with other genotypes (p<0.05). White blood cells, IL-6, hsCRP, and ESR were positively correlated with the neurological deficit of the patients (p<0.05). Taken together, TNF-β NcoI polymorphism, by itself, was not associated with increased susceptibility for stroke development. However, the homozygous genotype for the allele TNFB2 was associated with higher expression of classical inflammatory and metabolic markers of development and outcome of stroke than other genotypes. The identification of variant alleles might allow both better prediction of susceptibility for stroke as well the identification of novel stroke mechanisms that could be target to new therapeutic approaches. Stroke patients carrying the TNFB2 variant allele could have a beneficial effect with the anti-inflammatory therapies in the early inflammatory phase of stroke.