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Ischemic stroke

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https://www.readbyqxmd.com/read/29667460/clinical-utility-of-remote-platelet-function-measurement-using-p-selectin-assessment-of-aspirin-clopidogrel-and-prasugrel-and-bleeding-disorders
#1
Philip M Bath, Jane May, Stan Heptinstall
Vascular diseases such as myocardial infarction and ischemic stroke are associated with increased platelet function whilst the risk of recurrence is reduced by antiplatelet agents such as aspirin, clopidogrel, and prasugrel. However, some patients exhibit high platelet reactivity, especially with clopidogrel. Existing platelet function tests may not be ideal in that they can be expensive, are often time consuming, and measurements must be made near to the patient and within a few hours of blood collection. Platelet activation leads to translocation of P-selectin from alpha-granules to the cell surface...
April 18, 2018: Platelets
https://www.readbyqxmd.com/read/29667266/application-of-the-dawn-clinical-imaging-mismatch-and-defuse-3-selection-criteria-benefit-seems-similar-but-restrictive-volume-cut-offs-might-omit-potential-responders
#2
Célina Ducroux, Naim Khoury, Augustin Lecler, Raphaël Blanc, Annaëlle Chetrit, Hocine Redjem, Gabriele Ciccio, Stanislas Smajda, Simon Escalard, Jean-Philippe Desilles, Mikaël Mazighi, Malek Ben Maacha, Michel Piotin, Robert Fahed
BACKGROUND: We aimed to conduct an external validation of the selection criteria of the diffusion-weighted-imaging or computerized-tomography-perfusion assessment with clinical mismatch in the triage of wake-up and late-presenting strokes undergoing Neurointervention with Trevo (DAWN) and the Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke (DEFUSE3) trials in a cohort of unknown onset stroke (UOS) patients treated with thrombectomy. METHODS: A validation cohort of UOS patients was selected from a prospectively collected thrombectomy database to match the inclusion criteria of DAWN and DEFUSE3...
April 18, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29666986/impaired-fasting-glucose-is-associated-with-unfavorable-outcome-in-ischemic-stroke-patients-treated-with-intravenous-alteplase
#3
E Osei, S Fonville, A A M Zandbergen, P J Koudstaal, D W J Dippel, H M den Hertog
OBJECTIVES: Hyperglycemia on admission and diabetes mellitus type II are associated with unfavorable outcome in stroke patients. We studied whether impaired fasting glucose (IFG) is associated with unfavorable outcome in ischemic stroke patients treated with intravenous alteplase as well and if IFG is a stronger prognostic factor than hyperglycemia on admission. METHODS: We studied 220 consecutive patients with ischemic stroke treated with intravenous alteplase...
April 17, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29666731/ischemic-stroke-in-an-hiv-positive-patient-an-initial-presentation-of-neurosyphilis
#4
Kalimullah Jan, Rebecca Hoe Hui Min, Tan Seow Yen, Shekhawat Ravindra Singh
Ischemic stroke occurring in patients with human immunodeficiency virus (HIV) needs to be approached with a vast differential diagnosis in mind. We report a case of middle-aged male patient with immune reconstituted HIV on therapy without known cardiovascular risk factors who had a right middle cerebral artery territory infarct. After a thorough evaluation, he received a final diagnosis of neurosyphilis-associated vasculitis leading to stroke. He recovered without any neurological deficits following treatment with intravenous benzylpenicillin...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29666704/practice-patterns-and-barriers-for-intravenous-thrombolysis-a-survey-of-neurologists-in-saudi-arabia
#5
Mohammed H Alanazy, Rima B Barakeh, Alanood Asiri, Maha F Edrees, Ahmad R Abuzinadah, Bandar N Aljafen, Taim Muayqil
Only a small fraction of patients with acute ischemic stroke receive intravenous thrombolysis (IVT). We sought to assess barriers and practice patterns in using IVT for acute ischemic stroke among neurologists in Saudi Arabia. An electronic survey was sent to all neurologists registered with the Saudi Commission for Health Specialties. A total of 148 (77.5%) neurologists responded. The most common reported barriers for IVT administration were delayed presentation to hospitals (82.4%) and unclear time of symptom onset (50...
2018: Neurology Research International
https://www.readbyqxmd.com/read/29666603/long-term-factors-associated-with-falls-and-fractures-poststroke
#6
Emma J Foster, Raphae S Barlas, Joao H Bettencourt-Silva, Allan B Clark, Anthony K Metcalf, Kristian M Bowles, John F Potter, Phyo K Myint
Background: Risk factors for poststroke falls and fractures remain poorly understood. This study aimed to evaluate which factors increased risk of these events after stroke. Methods: Data from 7,267 hospitalized stroke patients were acquired from the Norfolk and Norwich University Hospital Stroke Register from 2003-2015. The impacts of multiple patient level and stroke characteristics and comorbidities on post-discharge falls and fractures were assessed. Univariate and multivariable models were constructed, adjusting for multiple confounders, using binary logistic regression for short-term analysis (up to 1-year post-discharge) and Cox-proportional hazard models for longer term analysis (1-3, 3-5, and 0-10 years follow-up)...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29666180/thrombectomy-for-acute-ischemic-stroke-in-the-elderly-a-real-world-experience
#7
Ali Alawieh, Arindam Chatterjee, Wuwei Feng, Guilherme Porto, Jan Vargas, Ryan Kellogg, Aquilla S Turk, Raymond D Turner, M Imran Chaudry, Alejandro M Spiotta
INTRODUCTION: Completed randomized trials on endovascular thrombectomy (ET) did not independently assess the efficacy of ET in the elderly (≥80 years old) who were often excluded or under-represented in trials. There were also inconsistent criteria for patient selection in this population across the different trials. This work evaluates outcomes after ET for acute ischemic stroke (AIS) in the elderly at a high volume stroke center. METHODS: We reviewed all cases of AIS that underwent a direct aspiration first pass technique (ADAPT) thrombectomy for large vessel occlusions between March 2013 and October 2017 while comparing outcomes in the elderly with younger counterparts...
April 17, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29666071/b-type-natriuretic-peptide-assessment-in-patients-undergoing-revascularization-for-left-main-coronary-artery-disease-analysis-from-the-excel-trial
#8
Björn Redfors, Shmuel Chen, Aaron Crowley, Ori Ben-Yehuda, Bernard J Gersh, Nicholas J Lembo, W Morris Brown, Adrian P Banning, David P Taggart, Patrick W Serruys, Arie Pieter Kappetein, Joseph F Sabik, Gregg W Stone
Background -Elevated B-type natriuretic peptide (BNP) is reflective of impaired cardiac function and is associated with worse prognosis among patients with coronary artery disease (CAD). We sought to assess the association between baseline BNP, adverse outcomes, and the relative efficacy of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in patients with left main (LM) CAD. Methods -The EXCEL trial randomized patients with LMCAD and low or intermediate SYNTAX scores to PCI with everolimus-eluting stents versus CABG...
April 17, 2018: Circulation
https://www.readbyqxmd.com/read/29665789/idiopathic-basal-ganglia-calcification-associated-with-cerebral-micro-infarcts-a-case-report
#9
Takuma Nishimoto, Fumiaki Oka, Hideyuki Ishihara, Mizuya Shinoyama, Michiyasu Suzuki
BACKGROUND: Idiopathic basal ganglia calcification (IBGC) is a rare neurodegenerative disorder characterized by symmetric intracranial calcium deposition. We report a patient with IBGC associated with cerebral infarction due to impairment of cerebrovascular reactivity based on single-photon emission computed tomography (SPECT) with acetazolamide challenge. CASE PRESENTATION: A 66-year-old male presented with right conjugate deviation, right hemiparesis and total aphasia due to a convulsive seizure...
April 17, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29665290/timely-visualization-of-the-collaterals-formed-during-acute-ischemic-stroke-with-fe-3-o-4-nanoparticle-based-mr-imaging-probe
#10
Ting Wang, Yi Hou, Bo Bu, Wenxin Wang, Tiancong Ma, Chunyan Liu, Lan Lin, Lin Ma, Xin Lou, Mingyuan Gao
Ischemic stroke is one of the major leading causes for long-term disability and mortality. Collateral vessels provide an alternative pathway to protect the brain against ischemic injury after arterial occlusion. Aiming at visualizing the collaterals occurring during acute ischemic stroke, an integrin αv β3 -specific Fe3 O4 -Arg-Gly-Asp (RGD) nanoprobe is prepared for magnetic resonance imaging (MRI) of the collaterals. Rat models are constructed by occluding the middle cerebral artery for imaging studies of cerebral ischemia and ischemia-reperfusion on 7...
April 17, 2018: Small
https://www.readbyqxmd.com/read/29664664/c-reactive-protein-levels-and-clinical-outcomes-in-stroke-patients-a-prospective-cohort-study
#11
Shahir Mazaheri, Elahe Reisi, Jalal Poorolajal, Masoud Ghiasian
BACKGROUND: The C-reactive protein (CRP) level, as an early prognostic factor of functional outcome after stroke, may be of clinical importance. The aim of this study was to determine the prognostic value of CRP on functional outcome and death in stroke patients. METHODS: This prospective study was conducted from 2015 to 2016 in Hamadan province, Iran. Patients with both ischemic and hemorrhagic stroke who were admitted in the first 12 hours were enrolled. The clinical characteristics of the patients were recorded at time of admission as well as on the fourth and the 90th day after stroke...
January 1, 2018: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/29664350/computed-tomographic-angiography-in-stroke-and-high-risk-transient-ischemic-attack-do-not-leave-the-emergency-department-without-it
#12
Brett R Graham, Bijoy K Menon, Shelagh B Coutts, Mayank Goyal, Andrew M Demchuk
Stroke is a major cause of morbidity and mortality worldwide, and effective treatment requires rapid diagnosis and recognition of relevant vascular lesions. In this review we will discuss the usefulness and versatility of computed tomography angiography in the setting of stroke, be it ischemic or hemorrhagic, minor or disabling. Furthermore, we also highlight how we use computed tomography angiography in decision making in transient ischemic attacks, acute disabling ischemic stroke, and hemorrhagic stroke.
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29664057/remote-ischemic-postconditioning-for-ischemic-stroke-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#13
Jing-Jing Zhao, Hui Xiao, Wen-Bo Zhao, Xiao-Pei Zhang, Yu Xiang, Zeng-Jie Ye, Miao-Miao Mo, Xue-Ting Peng, Lin Wei
Background: Remote ischemic postconditioning (RIPostC) appears to protect distant organs from ischemia-reperfusion injury (IRI). However, cerebral protection results have remained inconclusive. In the present study, a meta-analysis was performed to compare stroke patients with and without RIPostC. Methods: CNKI, WanFang, VIP, CBM, PubMed, and Cochrane Library databases were searched up to July 2016. Data were analyzed using both fixed-effects and random-effects models by Review Manager...
April 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29663986/-interpretation-of-2018-guidelines-for-the-early-management-of-patients-with-acute-ischemic-stroke
#14
Gang Wang, Bangjiang Fang, Xuezhong Yu, Zhijun Li
In 2018, the American Heart Association/American Stroke Association (AHA/ASA) has developed the latest 2018 guidelines for the early management of patients with acute ischemic stroke (AIS), based on the latest evidences. The 2018 guidelines including recommendations on pre-hospital and in-hospital management treatment, has revised and add new recommendations from 2013 guideline. The major changes in 2018 guideline involve applications of brain imaging in early stage, intravenous thrombolysis and mechanical thrombectomy, et al...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29663930/diffusion-tensor-imaging-evaluation-of-axonal-white-matter-remodeling-in-a-mouse-model-of-diabetic-stroke-treated-with-novel-p38-mapk-inhibitor-vcp979
#15
Yu Cai, Chunqiang Lu, Tingting Xu, Yuanyuan Ma, Shudan Min, Peter Scammells, Binghui Wang, Shenghong Ju
Type 2 diabetes mellitus (T2DM) is associated with severe axonal/white matter (WM) injury and poor functional outcomes following ischemic stroke. T2DM induces activation of p38 mitogen-activated protein kinases (MAPKs), which may be linked to the axonal/WM damage. In the present study, adult male C57BL/6J mice with streptozotocin (STZ)-induced T2DM mice were subjected to photothrombotic ischemic stroke and treatment with p38 MAPK inhibitors. The novel p38 MAPK inhibitor, VCP979, significantly promoted axonal/WM remodeling, neural progenitor cell migration, and improved functional recovery in T2DM mice...
March 1, 2018: Journal of Biomedical Nanotechnology
https://www.readbyqxmd.com/read/29663853/collateral-pial-circulation-relates-to-the-degree-of-brain-edema-on-ct-24-hours-after-ischemic-stroke
#16
Orlando Galego, Joana Jesus-Ribeiro, Mariana Baptista, João Sargento-Freitas, Ana Inês Martins, Fernando Silva, Gustavo Cordeiro Santos, Luís Cunha, César Nunes, Egídio Machado
Background Cerebral edema is frequent in patients with acute ischemic stroke (AIS) who undergo reperfusion therapy and is associated with high mortality. The impact of collateral pial circulation (CPC) status on the development of edema has not yet been determined. Methods We studied consecutive patients with AIS and documented M1-middle cerebral artery (MCA) and/or distal internal carotid artery (ICA) occlusion who underwent reperfusion treatment. Edema was graded on the 24-hour non-contrast computed tomography (NCCT) scan...
January 1, 2018: Neuroradiology Journal
https://www.readbyqxmd.com/read/29663576/neuroprotection-by-post-stroke-administration-of-an-oral-formulation-of-angiotensin-1-7-in-ischemic-stroke
#17
Douglas M Bennion, Chad H Jones, Lauren L Donnangelo, Justin T Graham, Jacob D Isenberg, Alex N Dang, Vermali Rodriguez, Ruben D M Sinisterra, Frederico B Sousa, Robson A S Santos, Colin Sumners
NEW FINDINGS: What is the central question of this study? Angiotensin-(1-7) decreases cerebral infarct volume and improves neurological function when delivered centrally prior to and during ischemic stroke. Here, we assessed the neuroprotective effects of angiotensin-(1-7) when delivered orally post-stroke. What is the main finding and its importance? We show that oral delivery of angiotensin-(1-7) attenuates cerebral damage induced by middle cerebral artery occlusion in rats, without affecting blood pressure or cerebral blood flow...
April 16, 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29663514/combined-carotid-endarterectomy-and-transcatheter-aortic-valve-replacement-technique-and-outcomes
#18
Robert J Moraca, Anil A Shah, Stephen H Bailey, Daniel Benckart, David Lasorda, Ramzi Khalil, Bart Chess, Walter McGregor, Michael S Halbreiner
BACKGROUND: Stroke and transient ischemic attack after transcatheter aortic valve replacement results in significantly higher morbidity and mortality. Severe carotid artery disease may be a contributing factor to this increased risk. We report our technique and outcomes of combined carotid endarterectomy (CEA) with transcatheter aortic valve replacement (TAVR). METHODS: From March 2013 to November 2017 a total of 753 TAVRs were performed at our institution for symptomatic severe aortic stenosis...
April 16, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29663377/ubiad1-protects-against-oxygen-glucose-deprivation-reperfusion-induced-multiple-subcellular-organelles-injury-through-pi3k-akt-pathway-in-n2a-cells
#19
Yan Huang, Zhiping Hu
Cerebral ischemia/reperfusion-induced injury plays a significant role in the development of multi-subcellular organelles injury after ischemic stroke. UBIAD1 was discovered originally as a potential tumor suppressor protein. Recently, analysis of UBIAD1 has indicated it is a prenyltransferase enzyme for both non-mitochondrial CoQ10 and vitamin K2 production. Further, UBIAD1 has been localized to multiple subcellular organelles. Particularly, UBIAD1 plays an important role in the regulation of oxidative stress, apoptosis and cell proliferation, cholesterol and lipid metabolism, which was closely associated with the cerebral ischemic/reperfusion mechanism...
April 16, 2018: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/29663313/microbleeds-in-ischemic-vs-hemorrhagic-strokes-on-novel-oral-anticoagulants
#20
J C Purrucker, M Wolf, K Haas, T Siedler, T Rizos, S Khan, P U Heuschmann, R Veltkamp
OBJECTIVES: To identify differences in clinical characteristics and severity of cerebral small vessel disease (CSVD) including cerebral microbleeds (CMBs), between patients suffering ischemic stroke (IS) or intracerebral hemorrhage (ICH) while taking novel (non-vitamin K antagonists) oral anticoagulants (NOACs). METHODS: Multicenter, prospective, observational cohort study performed at 38 centers between 2012 and 2015. We compared demographics, comorbidity, and functional status (before and after stroke) between NOAC-IS and NOAC-ICH patients...
April 16, 2018: Acta Neurologica Scandinavica
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