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22. European Stroke Conference 892 Meta-analysis and reviews Cannabinoids and experimental stroke: a systematic review and meta-analysis T.J. England1, N. Abd Rashid2, W.H. Hind3, S.E. O’Sullivan4 University of Nottingham, Derby, UNITED KINGDOM1, University of Nottingham, Derby, UNITED KINGDOM2, University of Nottingham, Derby, UNITED KINGDOM3, University of Nottingham, Derby, UNITED KINGDOM4 Background Cannabinoids (CB) (including endo-, phyto- and synthetic -CBs) show promise as a neuroprotective treatment for stroke, with some agents already licensed, and well tolerated, in humans for other con-ditions. We aimed to systematically review and meta-analyse the use of CBs in experimental stroke. Methods Relevant studies were identified with searches of Medline, Embase and PubMed. Data was extract-ed on stroke lesion volume, neurological outcome and methodological quality. Data were analysed using Cochrane Review Manager using random effects models; results are expressed as standardised mean difference (SMD) with 95% confidence intervals CI. Results 94 studies from 22 publications assessed the effect of CBs on infarct volume in a total of 1022 male animals (512 rats, 496 mice, and 14 monkeys). CBs reduced infarct volume significantly in tran-sient (SMD -1.26, 95% CI -1.53, -0.99, p<0.00001) and permanent (SMD -2.22 -2.88, -1.56 p<0.00001) models of ischaemia and in all subclasses of CBs analysed: endocannabinoids (SMD -0.71 -1.22, -0.21), CB1/CB2 receptor ligands (SMD -1.76 -2.36, -1.17), CB2 ligands (SMD -1.64 -2.08, -1.21), cannabidiol (SMD -1.05 -1.50, -0.59), tetrahydrocannabinol (SMD -1.43 -2.01, -0.86) and HU-211 (SMD -3.73 -5.86, -1.60). Significant statistical heterogeneity was present (p<0.00001) and median study quality was 4 (range 2-6/8). Data on neurological outcome will also be presented. Conclusions CBs significantly reduce infarct volume in experimental stroke. Systematic review revealed that fur-ther studies in aged, larger and female animals models, with other co-morbidities (hypertension, dia-betes) are still required. 818 © 2013 S. Karger AG, Basel Scientific Programme 893 Meta-analysis and reviews The Challenge of Detecting Atrial fibrillation A literature based review on current studies M.S. Overgaard1, L.M. Christensen2, R. S. Rasmussen3, K. Overgaard4, H. Christensen5 University of Copenhagen, Faculty of Health and Medical Science, Copenhagen, DENMARK1, department of Neurology, University Hospital of Copenhagen, Bispebjerg Hospital, Copenhagen, DENMARK2, department of neurology, University hospital of Copenhagen, Herlev Hospital, Co-penhagen, DENMARK3, department of neurology, University hospital of Copenhagen, Herlev Hos-pital, Copenhagen, DENMARK4, department of neurology, University hospital of Copenhagen, Bis-pebjerg Hospital, Copenhagen, DENMARK5 Background: Atrial fibrillation (AF) increases the risk of stroke and early detection improves secondary preven-tion. The most prevalent test for AF is a single 12-lead ECG, but some conditions including parox-ysmal AF (PAF) can only be detected if PAF occurs during the 12-lead ECG test, which might not happen. The purpose of this review was to access the different detection methods available in the di-agnosis of PAF, their AF detection rate, advantages and disadvantages and to find the most efficient and cost-effective strategy. Methods: Literature study based on studies investigating AF detection techniques. Initial search on “atrial fibrillation detection” yielded over 900 publications. It was reduced to 189 articles by searching “atrial fibrillation detection monitoring” and furthermore reduced to 67 articles by searching “spe-cies: humans, article types: clinical trial, comparative study, meta-analysis, reviews, randomized controlled trial, systematic reviews, language: English”. 13 of the articles were of major interest in this report, supplemented with relevant articles quoted in the found articles. Results: Several AF screenings and detection methods were investigated such as nurse pulse assessment, bipolar ECG, finger probe, modified blood pressure monitor (MBPM), Holter, continuous cardiac telemetry, serial ECG, mobile cardiac outpatient telemetry, event loop recorders (ELR) and implant-able loop recorders (ILR). Both advantages and disadvantages were considered together with the PAF detection rate, sensitivity and specificity of each method. ELR and ILR were considered some of the best PAF detection methods (figure 1). Conclusion: Finger probes and MBPMs are cheap and effective screening methods for AF. ELR is one of the most cost-effective and best PAF detection methods, while ILR is one of the most accurate PAF de-tection devices. Regardless of the AF detection method; the longer monitoring, the higher PAF de-tection.


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