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International Journal of Stroke: Official Journal of the International Stroke Society

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https://www.readbyqxmd.com/read/29461155/cut-stroke-in-half-polypill-for-primary-prevention-in-stroke
#1
Michael Brainin, Valery Feigin, Sheila Martins, Karl Matz, Jayanta Roy, Peter Sandercock, Yvonne Teuschl, Jaakko Tuomilehto, Anita Wiseman
This review summarizes the potential for polypill therapies for stroke prevention. While a number of studies applying different approaches regarding polypill have been performed, none of them has had a focus on stroke as the main outcome. A combination pill containing drugs such as statins, diuretics, and other antihypertensives is currently available in various formats. Estimates focusing mostly on primary prevention show that using such a combination drug a reduction in the 5-year stroke incidence by 50% can be achieved - especially in low- and middle-income countries with a high prevalence of risk factors even among people at young ages...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29338604/clinical-significance-of-cerebral-microbleeds-on-mri-a-comprehensive-meta-analysis-of-risk-of-intracerebral-hemorrhage-ischemic-stroke-mortality-and-dementia-in-cohort-studies-v1
#2
Andreas Charidimou, Sara Shams, Jose R Romero, Jie Ding, Roland Veltkamp, Solveig Horstmann, Gudny Eiriksdottir, Mark A van Buchem, Vilmundur Gudnason, Jayandra J Himali, M Edip Gurol, Anand Viswanathan, Toshio Imaizumi, Meike W Vernooij, Sudha Seshadri, Steven M Greenberg, Oscar R Benavente, Lenore J Launer, Ashkan Shoamanesh
Background Cerebral microbleeds can confer a high risk of intracerebral hemorrhage, ischemic stroke, death and dementia, but estimated risks remain imprecise and often conflicting. We investigated the association between cerebral microbleeds presence and these outcomes in a large meta-analysis of all published cohorts including: ischemic stroke/TIA, memory clinic, "high risk" elderly populations, and healthy individuals in population-based studies. Methods Cohorts (with > 100 participants) that assessed cerebral microbleeds presence on MRI, with subsequent follow-up (≥3 months) were identified...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29319463/guidelines-for-treatment-of-susac-syndrome-an-update
#3
Robert M Rennebohm, Negar Asdaghi, Sunil Srivastava, Elie Gertner
Susac syndrome is an immune-mediated, pauci-inflammatory, ischemia-producing, occlusive microvascular endotheliopathy/basement membranopathy that affects the brain, retina, and inner ear. Treatment of Susac syndrome is particularly challenging. The organs involved can easily become irreversibly damaged, and the window of opportunity to protect them is often short. Optimal outcome requires rapid and complete disease suppression. Adding to the challenge is the absence of objective biomarkers of disease activity and the great variability in presentation, timing and extent of peak severity, duration of peak severity, and natural disease course...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29299960/closure-of-patent-foramen-ovale-in-cryptogenic-stroke-has-the-story-come-to-an-end
#4
Jean-Louis Mas, Gilles Chatellier
Contrasting with three randomized trials that failed to show any superiority of patent foramen ovale closure over antithrombotic therapy, two trials recently reported lower rates of stroke recurrence among patients assigned to patent foramen ovale closure than among those assigned to antiplatelet therapy. In addition, one of the initially negative trials concluded in favor of patent foramen ovale closure after an extended follow-up period. A better selection of patients, the use of reference treatment groups that included patients who received antiplatelet therapy alone (rather than antiplatelet drugs or oral anticoagulants, according to physician preference), and a longer follow-up of patients, may explain the divergent findings across studies...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29299959/how-to-do-high-quality-clinical-research-1-first-steps
#5
Peter Sandercock, William Whiteley
This is the first paper in a series of five on how to do good quality clinical research. It sets the scene for the four papers that follow. The aims of the series are to: promote reliable clinical research to inform clinical practice; help people new to research to get started (at any stage of their career); create teaching resources for experienced researchers; and help clinicians working in resource-poor settings to conduct research. We set out in this paper the skills clinicians need to run research projects that are relevant to their clinical practice...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29350610/research-edition
#6
Geoffrey A Donnan
No abstract text is available yet for this article.
February 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29299958/how-to-do-health-services-research-in-stroke-a-focus-on-performance-measurement-and-quality-improvement
#7
Dominique A Cadilhac, Rebecca Fisher, Julie Bernhardt
The objective of this "How to" research series article is to provide guidance on getting started in Health Services Research. The purpose of health services research is to contribute knowledge that can be used to help improve health systems and clinical services through influencing policy and practice. The methods used are broad, have varying levels of rigor, and may require different specialist skills. This paper sets out practical steps for undertaking health services research. Importantly, use of the highlighted techniques can identify solutions to address inadequate knowledge translation or promote greater access to evidence-based stroke care to optimize patient outcomes...
February 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29214907/the-attend-trial-an-alternative-explanation-with-implications-for-future-recovery-and-rehabilitation-clinical-trials
#8
Carolee Winstein
Over the past decade, ATTEND is one of only a handful of moderate to large-scale nonpharmacologic stroke recovery trials with a focus on rehabilitation. While unique in some respects, its test of superiority for the experimental intervention returned negative/neutral results, with no differences in outcome between the experimental intervention and an appropriate control group - a result not uncommon to the majority of moderate to large stroke rehabilitation intervention trials (i.e. six out of eight conducted in the past decade)...
February 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29231796/navigating-2018-a-year-in-stroke
#9
Geoffrey A Donnan
No abstract text is available yet for this article.
January 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28920538/fibrinolytic-for-treatment-of-intraventricular-hemorrhage-a-meta-analysis-and-systematic-review
#10
Alexandra Delaney Baker, Krissia Margarita Rivera Perla, Zhiyuan Yu, Rachel Dlugash, Radhika Avadhani, William Andrew Mould, Wendy Ziai, Richard E Thompson, Dimitre Staykov, Daniel F Hanley
Background Intraventricular hemorrhage is a significant cause of mortality and morbidity worldwide. Treating intraventricular hemorrhage with intraventricular fibrinolytic therapy via a catheter is becoming an increasingly utilized intervention. Aims This meta-analysis aimed to investigate the role of intraventricular fibrinolytic treatment in hypertensive intraventricular hemorrhage patients and evaluate the effect sizes for survival as well as level of function at differing time points. Summary of review PubMed, CNKI, VIP, and Wanfang were searched using the terms "IVH" and "IVH and ICH" for human studies with adult patients published between January 1950 and July 2016...
January 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29090662/cryptogenic-stroke
#11
Geoffrey A Donnan
No abstract text is available yet for this article.
December 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29090661/patent-foramen-ovale-closure-with-gore-helex-or-cardioform-septal-occluder-vs-antiplatelet-therapy-for-reduction-of-recurrent-stroke-or-new-brain-infarct-in-patients-with-prior-cryptogenic-stroke-design-of-the-randomized-gore-reduce-clinical-study
#12
Scott E Kasner, Lars Thomassen, Lars Søndergaard, John F Rhodes, Coby C Larsen, Joth Jacobson
Rationale The utility of patent foramen ovale (PFO) closure for secondary prevention in patients with prior cryptogenic stroke is uncertain despite multiple randomized trials completed to date. Aims The Gore REDUCE Clinical Study (REDUCE) aims to establish superiority of patent foramen ovale closure in conjunction with antiplatelet therapy over antiplatelet therapy alone in reducing the risk of recurrent clinical ischemic stroke or new silent brain infarct in patients who have had a cryptogenic stroke. Methods and design This controlled, open-label trial randomized 664 subjects with cryptogenic stroke at 63 multinational sites in a 2:1 ratio to either antiplatelet therapy plus patent foramen ovale closure (with GORE® HELEX® Septal Occluder or GORE® CARDIOFORM Septal Occluder) or antiplatelet therapy alone...
December 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28436307/choice-of-anesthesia-for-endovascular-treatment-of-acute-ischemic-stroke-protocol-for-a-randomized-controlled-canvas-trial
#13
Yuming Peng, Yan Li, Minyu Jian, Xiaoyuan Liu, Jian Sun, Bo Jia, Jia Dong, Min Zeng, Nan Lin, Li Zhang, Adrian W Gelb, Matthew Tv Chan, Ruquan Han
Background Observational studies indicate that the type of anesthesia, local or general, may be associated with the post-procedural neurological function in patients with acute ischemic stroke undergoing endovascular treatment. However, these results need further confirmation, and the causal relationship has not yet been established. Methods This is a randomized controlled equivalence trial. Permuted block randomization stratified by culprit vessels will be used. Six hundred and forty patients with acute ischemic stroke undergoing endovascular recanalization will be randomized one to one to receive either general anesthesia or local anesthesia...
December 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28436306/cardiac-magnetic-resonance-imaging-has-limited-additional-yield-in-cryptogenic-stroke-evaluation-after-transesophageal-echocardiography
#14
Ava L Liberman, Rizwan E Kalani, Jessie Aw-Zoretic, Matthew Sondag, Vistasp J Daruwalla, Sumeet S Mitter, Richard Bernstein, Jeremy D Collins, Shyam Prabhakaran
Background The use of cardiac magnetic resonance imaging is increasing, but its role in the diagnostic work-up following ischemic stroke has received limited study. We aimed to explore the added yield of cardiac magnetic resonance imaging to identify cardio-aortic sources not detected by transesophageal echocardiography among patients with cryptogenic stroke. Methods A retrospective single-center cohort study was performed from 01 January 2009 to 01 March 2013. Consecutive patients who had both a stroke protocol cardiac magnetic resonance imaging and a transesophageal echocardiography preformed during a single hospitalization were included...
December 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28361615/unclear-onset-intracerebral-hemorrhage-clinical-characteristics-hematoma-features-and-outcomes
#15
Yasuteru Inoue, Fumio Miyashita, Masatoshi Koga, Kazuo Minematsu, Kazunori Toyoda
Background and purpose Although unclear-onset ischemic stroke, including wake-up ischemic stroke, is drawing attention as a potential target for reperfusion therapy, acute unclear-onset intracerebral hemorrhage has been understudied. Clinical characteristics, hematoma features, and outcomes of patients who developed intracerebral hemorrhage during sleep or those with intracerebral hemorrhage who were unconscious when witnessed were determined. Methods Consecutive intracerebral hemorrhage patients admitted within 24 hours after onset or last-known normal time were classified into clear-onset intracerebral hemorrhage and unclear-onset intracerebral hemorrhage groups...
December 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28358291/feasibility-and-utility-of-an-integrated-medical-imaging-and-informatics-smartphone-system-for-management-of-acute-stroke
#16
Kristina Shkirkova, Eftitan Y Akam, Josephine Huang, Sunil A Sheth, May Nour, Conrad W Liang, Michael McManus, Van Trinh, Gary Duckwiler, Jason Tarpley, Fernando Vinuela, Jeffrey L Saver
Background Rapid dissemination and coordination of clinical and imaging data among multidisciplinary team members are essential for optimal acute stroke care. Aim To characterize the feasibility and utility of the Synapse Emergency Room mobile (Synapse ERm) informatics system. Methods We implemented the Synapse ERm system for integration of clinical data, computerized tomography, magnetic resonance, and catheter angiographic imaging, and real-time stroke team communications, in consecutive acute neurovascular patients at a Comprehensive Stroke Center...
December 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28355960/preventive-effects-of-multiple-domain-interventions-on-lifestyle-and-risk-factor-changes-in-stroke-survivors-evidence-from-a-two-year-randomized-trial
#17
Yvonne Teuschl, Karl Matz, Bernadette Firlinger, Alexandra Dachenhausen, Jaakko Tuomilehto, Michael Brainin
Background and aim Behavioral and lifestyle interventions in stroke patients need to be intense enough to result in sustainable treatment differences among groups of a randomized trial. Therefore, we report the effects of multidomain interventions on lifestyle and laboratory parameters after 12 and 24 months from a trial that examined whether intensive risk factor management can prevent cognitive decline in ischemic stroke patients. Methods This prospective randomized, open-label, blinded endpoint trial recruited patients within three months after acute stroke in five Austrian neurological clinics during June 2010 and November 2012...
December 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27881833/apixaban-for-treatment-of-embolic-stroke-of-undetermined-source-atticus-randomized-trial-rationale-and-study-design
#18
Tobias Geisler, Sven Poli, Christoph Meisner, Juergen Schreieck, Christine S Zuern, Thomas Nägele, Johannes Brachmann, Werner Jung, Georg Gahn, Elisabeth Schmid, Hansjörg Bäezner, Timea Keller, Gabor C Petzold, Jan-Wilko Schrickel, Jan Liman, Rolf Wachter, Frauke Schön, Martin Schabet, Alfred Lindner, Albert C Ludolph, Hubert Kimmig, Sebastian Jander, Uwe Schlegel, Meinrad Gawaz, Ulf Ziemann
Rationale Optimal secondary prevention of embolic stroke of undetermined source is not established. The current standard in these patients is acetylsalicylic acid, despite high prevalence of yet undetected paroxysmal atrial fibrillation. Aim The ATTICUS randomized trial is designed to determine whether the factor Xa inhibitor apixaban administered within 7 days after embolic stroke of undetermined source, is superior to acetylsalicylic acid for prevention of new ischemic lesions documented by brain magnetic resonance imaging within 12 months after index stroke...
December 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27811310/time-patterns-in-multiple-acute-cerebral-infarcts
#19
Vojtech Novotny, Andrej N Khanevski, Lars Thomassen, Ulrike Waje-Andreassen, Halvor Naess
Background Multiple acute cerebral infarcts in different arterial territories may be caused by several emboli concurrently or successively. Aim and/or hypothesis We hypothesized that the time from stroke onset to magnetic resonance imaging may shed light on underlying mechanisms of multiple acute cerebral infarcts. Methods This is a prospective observational cohort study involving 2697 ischemic stroke patients conducted at Haukeland University Hospital between February 2006 and October 2013. Only patients with diffusion-weighted imaging lesions in more than one arterial territory (left or right anterior circulation or posterior circulation) were included...
December 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27765898/cerebral-perfusion-difference-between-hemispheres-with-symptomatic-and-asymptomatic-intracranial-arterial-stenosis
#20
Linfang Lan, Xinyi Leng, Jill Abrigo, Vincent Ip, Yannie Oy Soo, Thomas Leung, Xiangyan Chen, Ka Sing Wong
No abstract text is available yet for this article.
December 2017: International Journal of Stroke: Official Journal of the International Stroke Society
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