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Ischemic stroke

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https://www.readbyqxmd.com/read/29908420/ticagrelor-versus-clopidogrel-after-fibrinolytic-therapy-in-patients-with-st-elevation-myocardial-infarction-rationale-and-design-of-the-ticagrelor-in-patients-with-st-elevation-myocardial-infarction-treated-with-thrombolysis-treat-trial
#1
Otavio Berwanger, Jose C Nicolau, Antonio C Carvalho, Lixin Jiang, Shaun Goodman, Stephen J Nicholls, Alexander Parkhomenko, Oleg Averkov, Carlos Tajer, Germán Malaga, Jose F Kerr Saraiva, Francisco Fonseca, Helio P Guimaraes, Pedro G M de Barros E Silva, Lucas P Damiani, Denise M Paisani, Camila M R Lasagno, Carolina T Candido, Nanci Valeis, Diogo D F Moia, Leopoldo S Piegas, Christopher B Granger, Harvey White, Renato D Lopes
BACKGROUND: The safety and efficacy of ticagrelor in patients with ST-elevation myocardial infarction (STEMI) treated with fibrinolytic therapy remain uncertain. OBJECTIVES: The primary objective of the TicagRElor in pAtients with ST elevation myocardial infarction treated with Thrombolysis (TREAT) trial is to evaluate the short-term safety of ticagrelor when compared with clopidogrel in STEMI patients treated with fibrinolytic therapy. Key secondary objectives are to assess the safety and efficacy of ticagrelor compared with clopidogrel at 12-months...
March 3, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29908146/intravenous-xenogeneic-human-cardiosphere-derived-cell-extracellular-vesicles-exosomes-improves-behavioral-function-in-small-clot-embolized-rabbits
#2
Paul A Lapchak, Paul D Boitano, Geoffrey de Couto, Eduardo Marbán
Acute ischemic stroke is devastating to patients and their families because of few viable therapeutic options to promote recovery after reperfusion windows close. Recent breakthroughs in biotechnology have resulted in a reproducible patented process for the purification of extracellular vesicles (EVs) from human cardiosphere-derived cells (CDCs). Because CDC-EVs have many features potentially beneficial to treat acute ischemic stroke, CDC-EVs were evaluated in an established small-clot rabbit embolic stroke model, where clinically relevant end points were used to assess recovery in a more translational large animal model...
June 13, 2018: Experimental Neurology
https://www.readbyqxmd.com/read/29907656/temporal-trends-in-the-outcomes-of-dialysis-patients-admitted-with-acute-ischemic-stroke
#3
Fahad Alqahtani, Chalak O Berzingi, Sami Aljohani, Mohamed Al Hajji, Anas Diab, Muhammad Alvi, Khaled Boobes, Mohamad Alkhouli
BACKGROUND: There is a paucity of contemporary data on the characteristics and outcomes of acute ischemic stroke (AIS) in patients on maintenance dialysis. METHODS AND RESULTS: We used the nationwide inpatient sample to examine contemporary trends in the incidence, management patterns, and outcomes of AIS in dialysis patients. A total of 930 010 patients were admitted with AIS between 2003 and 2014, of whom 13 642 (1.5%) were on dialysis. Overall, the incidence of AIS among dialysis patients decreased significantly ( P trend <0...
June 15, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29907655/causes-and-predictors-of-readmission-in-patients-with-atrial-fibrillation-undergoing-catheter-ablation-a-national-population-based-cohort-study
#4
Shilpkumar Arora, Sopan Lahewala, Byomesh Tripathi, Varshil Mehta, Varun Kumar, Divya Chandramohan, Alejandro Lemor, Mihir Dave, Nileshkumar Patel, Nilay V Patel, Ghanshyam Palamaner Subash Shantha, Juan Viles-Gonzalez, Abhishek Deshmukh
BACKGROUND: Reducing readmission after catheter ablation (CA) in atrial fibrillation (AF) is important. METHODS AND RESULTS: We utilized National Readmission Data (NRD) 2010-2014. AF was identified by International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) diagnostic code 427.31 in the primary field, while first CA of AF was identified via ICD-9 -procedure code 37.34. Any admission within 30 or 90 days of index admission was considered a readmission...
June 15, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29907575/current-evidence-for-anesthesia-management-during-endovascular-stroke-therapy-updated-systematic-review-and-meta-analysis
#5
Nitin Goyal, Konark Malhotra, Muhammad F Ishfaq, Georgios Tsivgoulis, Christopher Nickele, Daniel Hoit, Adam S Arthur, Andrei V Alexandrov, Lucas Elijovich
INTRODUCTION: Debate continues about the optimal anesthetic management for patients undergoing endovascular treatment (ET) of acute ischemic stroke due to emergent large vessel occlusion. OBJECTIVE: To compare, using current evidence, the clinical outcomes and procedural characteristics among patients undergoing general anesthesia (GA) and local or monitored anesthesia (non-GA). METHODS: We performed a systematic review and meta-analysis of all available studies that involved the use of stent retrievers for ET (stentriever group)...
June 15, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29906552/interleukin-33-protects-ischemic-brain-injury-by-regulating-specific-microglial-activities
#6
Qianping Luo, Yong Fan, Lili Lin, Jingjing Wei, Zuanfang Li, Yongkun Li, Susumu Nakae, Wei Lin, Qi Chen
Interleukin-33 (IL-33), a novel member of the IL-1 family, expressed in many tissue and cell types, and is involved in inflammation and immune functions. Previous studies suggest that IL-33 may play a role in ischemic stroke. We tried to investigate the role of IL-33 in cerebral ischemia-reperfusion-induced injury and its underlying mechanism. Our data indicated that IL-33 deficiency exacerbated the neurological dysfunction caused by cerebral ischemia-reperfusion injury in mice and led to the formation of larger cerebral infarct volume as shown by 2,3,5-triphenyltetrazolium chloride (TTC) staining and magnetic resonance imaging...
June 12, 2018: Neuroscience
https://www.readbyqxmd.com/read/29906531/association-between-matrix-metalloproteinase-family-gene-polymorphisms-and-risk-of-ischemic-stroke-a-systematic-review-and-meta-analysis-of-29-studies
#7
REVIEW
Shubham Misra, Pumanshi Talwar, Amit Kumar, Pradeep Kumar, Ram Sagar, Deepti Vibha, Awadh K Pandit, Arti Gulati, Suman Kushwaha, Kameshwar Prasad
BACKGROUND: Ischemic stroke (IS) is a complex and devastating vascular disease that has become one of the leading causes of disability and mortality worldwide. Several studies have shown the association between matrix metalloproteinase (MMP) family gene polymorphisms and IS. However, the results have been indecisive. OBJECTIVE: To investigate the association between Matrix Metalloproteinase gene polymorphisms and risk of IS. METHODS: A literature search for eligible candidate gene studies published before, 28 June 2017, was conducted in the PubMed, EMBASE, Cochrane and Google Scholar databases...
June 12, 2018: Gene
https://www.readbyqxmd.com/read/29906509/photothrombotically-induced-unilateral-selective-hippocampal-ischemia-in-rat
#8
Sayed Masoud Hosseini, Hamid Gholami Pourbadie, Nima Naderi, Mohammad Sayyah, Mohammad Ismail Zibaii
INTRODUCTION: The vulnerability of hippocampal formation to ischemic insult has been documented in both humans and animal models. Ischemic injury induction through photothrombosis is an invasive and reproducible model of ischemic stroke which provides the ability to induce ischemia selectively in any desired area. In this study, we describe a method to induce selective unilateral hippocampal ischemia in rat through modified photothrombotic model. METHODS: Male wistar rats (n = 66) were subjected to stereotaxic surgery to insert a guide cannula just above the ascending part of hippocampal fissure...
June 12, 2018: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/29905566/-evaluation-of-neuroprotective-activity-of-complex-impact-of-magnesium-of-sulfate-lamotrygine-and-n-acetylcysteine-under-conditions-of-combined-normobaric-hypoxia-with-ligation-of-right-carotid-artery-in-rats
#9
M Samsonia, M Kandelaki, N Baratashvili
Cerebrovascular diseases of ischemic origin still remain the leading cause of death and disability of the population. In acute cerebral discirculation conditions, anaerobic glycolysis is activated, ATP formation rate decreases, the ion pumps work is disrupted and superoxide radicals are formed. Eventually, ionic asymmetry leads to the cytotoxic and vasogenic brain edema. Therefore, it is extremely important to induce simultaneous (complex) effect of medications on the key mechanisms of neuronal damage in process of survival of brain cells during acute ischemic stroke...
May 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29904963/experience-of-a-single-center-in-the-conservative-approach-of-20-consecutive-cases-of-asymptomatic-extracranial-carotid-artery-aneurysms
#10
V E C Pourier, J C Welleweerd, L J Kappelle, G J E Rinkel, Y M Ruigrok, H B van der Worp, T H Lo, M L Bots, F L Moll, Gert J de Borst
BACKGROUND: The clinical course and optimal treatment strategy for asymptomatic aneurysms of the extracranial carotid artery (ECAA) are unknown. We report our single-center experience with conservative management of patients with an asymptomatic ECAA. METHODS: A search in our hospital records from 1998 to 2013 revealed 20 patients (mean age 52 years, SD 12.5) with 23 ECAA, defined as a 150% or more fusiform dilation or any saccular dilatation compared to the healthy internal carotid artery...
June 14, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29904828/estrogen-migraine-and-vascular-risk
#11
Gianni Allais, Giulia Chiarle, Silvia Sinigaglia, Gisella Airola, Paola Schiapparelli, Chiara Benedetto
Migraine has a predilection for female sex and the course of symptoms is influenced by life stage (presence of menstrual cycle, pregnancy, puerperium, menopause) and use of hormone therapy, such as hormonal contraception and hormone replacement therapy. Hormonal changes figure among common migraine triggers, especially sudden estrogen drop. Moreover, estrogens can modulate neuronal excitability, through serotonin, norepinephrine, dopamine, and endorphin regulation, and they interact with the vascular endothelium of the brain...
June 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29904443/critical-event-intervals-in-determining-candidacy-for-intravenous-thrombolysis-in-acute-stroke
#12
John S Garrett, Steven Sonnamaker, Yahya Daoud, Hao Wang, Dion Graybeal
Background: The aim of the study was to determine the optimal set point for the critical event benchmarks described in stroke guidelines and validate the ability of these goals to predict successful administration of intravenous thrombolysis within 60 min of hospital arrival. Methods: This was a retrospective cohort analysis of patients with acute ischemic stroke who received intravenous thrombolysis following presentation to the emergency department. The national benchmarks for time intervals associated with the completion of critical events required to determine candidacy for thrombolysis were evaluated for the ability to predict successful administration of thrombolysis within 60 min of hospital arrival...
July 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29904091/naloxone-attenuates-ischemic-brain-injury-in-rats-through-suppressing-the-nik-ikk%C3%AE-nf-%C3%AE%C2%BAb-and-neuronal-apoptotic-pathways
#13
Xuan Wang, Zu-Jun Sun, Jun-Lu Wu, Wen-Qiang Quan, Wei-Dong Xiao, Helen Chew, Cui-Min Jiang, Dong Li
Although naloxone has been documented to exert neuroprotection in animal model of cerebral ischemia, the mechanism is not well understood. In this present study we investigated whether naloxone affected the mitochondrial apoptotic pathway in ischemic brain injury of rats. SD rats were subjected to a permanent middle cerebral artery occlusion surgery, and received naloxone (0.5, 1, 2 mg/kg, i.v.) immediately after ischemia. Neurological deficits were evaluated 24 h after ischemia using the McGraw Stroke Index, and then the rats were killed, and the brains were collected for further analyses...
June 14, 2018: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/29903733/t-cells-prevent-hemorrhagic-transformation-in-ischemic-stroke-by-p-selectin-binding
#14
Angélica Salas-Perdomo, Francesc Miró-Mur, Xabier Urra, Carles Justicia, Mattia Gallizioli, Yashu Zhao, Vanessa H Brait, Carlos Laredo, Raúl Tudela, Andrés Hidalgo, Ángel Chamorro, Anna M Planas
OBJECTIVE: Hemorrhagic transformation is a serious complication of ischemic stroke after recanalization therapies. This study aims to identify mechanisms underlying hemorrhagic transformation after cerebral ischemia/reperfusion. APPROACH AND RESULTS: We used wild-type mice and Selplg-/- and Fut7-/- mice defective in P-selectin binding and lymphopenic Rag2-/- mice. We induced 30-minute or 45-minute ischemia by intraluminal occlusion of the middle cerebral artery and assessed hemorrhagic transformation at 48 hours with a hemorrhage grading score, histological means, brain hemoglobin content, or magnetic resonance imaging...
June 14, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29903352/stroke-prevention-in-nonvalvular-atrial-fibrillation-a-stakeholder-perspective
#15
REVIEW
Mohamad Alkhouli, Peter A Noseworthy, Charanjit S Rihal, David R Holmes
Ischemic stroke in patients with atrial fibrillation is associated with substantial morbidity and mortality. The growing epidemic of atrial fibrillation worldwide has raised concerns about the dire need for effective stroke prevention systems in these patients. Fortunately, the last decade has witnessed a plethora of data on novel stroke prevention methods in patients with nonvalvular atrial fibrillation. However, optimal selection and effective implementation of these preventative strategies require an integrative approach that takes into account not only the available clinical data but also the perspective of each of the stakeholders involved (patient, physician, and society)...
June 19, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29901608/efficacy-and-safety-of-cyp2c19-genotype-in-stroke-or-transient-ischemic-attack-patients-treated-with-clopidogrel-monotherapy-or-clopidogrel-plus-aspirin-protocol-for-a-systemic-review-and-meta-analysis
#16
Jia-Chen Yao, Min Cui, Mang-Mang Pan, Zhi-Chun Gu, Wen-Yan Li
BACKGROUND: The relationship of CYP2C19 genotype and clinical efficacy in stroke or transient ischemic attack (TIA) patients treated with clopidogrel monotherapy or clopidogrel plus aspirin remains unknown. We thus aim to conduct a meta-analysis to appraise evidence on the association of CYP2C19 genotype and clinical efficacy for stroke or TIA. METHODS: An electronic search will be performed for clinical trials that reported the interested efficacy data (stroke, myocardial infarction, or vascular death) and safety data (any bleeding) in clopigogrel-treated patients with stroke or TIA...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29901484/the-efficacy-of-a-comprehensive-reminder-system-to-improve-health-behaviors-and-blood-pressure-control-in-hypertensive-ischemic-stroke-patients-a-randomized-controlled-trial
#17
Li-Hong Wan, Xiao-Pei Zhang, Li-Ming You, Heng-Fang Ruan, Shao-Xian Chen
BACKGROUND AND OBJECTIVE: The health behaviors of hypertensive stroke patients in China are not satisfactory. In this study, we tested the effect of a Health Belief Model Comprehensive Reminder System on health behaviors and blood pressure control in hypertensive ischemic stroke patients after occurrence and hospital discharge. METHODS: A randomized, parallel-group, assessor-blinded experimental design yielded participation of 174 hospitalized hypertensive ischemic stroke patients...
June 12, 2018: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29901447/long-term-effectiveness-and-safety-of-transcatheter-closure-of-patent-foramen-ovale-compared-with-antithrombotic-therapy-a-meta-analysis-of-6-randomised-clinical-trials-and-3560-patients-with-reconstructed-time-to-event-data
#18
Daniele Giacoppo, Nicola Caronna, Antonio H Frangieh, Jonathan Michel, Giuseppe Andò, Giuseppe Tarantini, Albert M Kasel, Davide Capodanno, Robert A Byrne
AIMS: Although three recent trials showed a significant stroke risk reduction after tPFOc, the impact on pooled evidence deserves attention and individual statistical power is limited. We aimed to pool available randomised clinical trials (RCT) to assess whether tPFOc is more effective and safe than antithrombotic therapy alone (ATA). METHODS AND RESULTS: Major electronic databases and tangential sources were searched and 6 trials (3560 patients) identified. At a median follow-up of 3...
June 12, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29900524/association-of-abcg-2-polymorphisms-with-ischemic-stroke-in-a-chinese-population
#19
Tonghanyu Liu, Feng Jiang, Xin Liu, Hongye Zhang, Lefeng Wang, Wenzhi Liu, Xingyu Wang
ATP-binding cassette, superfamily G, member 2 (ABCG2 ) has been shown to play an important role in the development of ischemic stroke in European and African American populations. The aim of the present study is to test the hypothesis that there are associations between ABCG2 polymorphisms and ischemic stroke risk in a Chinese population. We conducted a case-control study including 967 participants with ischemic stroke and 939 stroke-free controls. The rs2231137C > T and rs2231142G > T were genotyped using a TaqMan real-time polymerase chain reaction assay...
June 13, 2018: Annals of Human Genetics
https://www.readbyqxmd.com/read/29900414/development-and-validation-of-the-dutch-stroke-score-for-predicting-disability-and-functional-outcome-after-ischemic-stroke-a-tool-to-support-efficient-discharge-planning
#20
Inger R de Ridder, Simone A Dijkland, Maaike Scheele, Heleen M den Hertog, Maaike Dirks, Willeke F Westendorp, Paul J Nederkoorn, Diederik van de Beek, Gerard M Ribbers, Ewout W Steyerberg, Hester F Lingsma, Diederik Wj Dippel
Introduction: We aimed to develop and validate a prognostic score for disability at discharge and functional outcome at three months in patients with acute ischemic stroke based on clinical information available on admission. Patients and methods: The Dutch Stroke Score (DSS) was developed in 1227 patients with ischemic stroke included in the Paracetamol (Acetaminophen) In Stroke study. Predictors for Barthel Index (BI) at discharge ('DSS-discharge') and modified Rankin Scale (mRS) at three months ('DSS-3 months') were identified in multivariable ordinal regression...
June 2018: European stroke journal
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