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https://www.readbyqxmd.com/read/28535201/regulatory-t-cells-ameliorate-tissue-plasminogen-activator-induced-brain-haemorrhage-after-stroke
#1
Leilei Mao, Peiying Li, Wen Zhu, Wei Cai, Zongjian Liu, Yanling Wang, Wenli Luo, Ruth A Stetler, Rehana K Leak, Weifeng Yu, Yanqin Gao, Jun Chen, Gang Chen, Xiaoming Hu
Delayed thrombolytic treatment with recombinant tissue plasminogen activator (tPA) may exacerbate blood-brain barrier breakdown after ischaemic stroke and lead to lethal haemorrhagic transformation. The immune system is a dynamic modulator of stroke response, and excessive immune cell accumulation in the cerebral vasculature is associated with compromised integrity of the blood-brain barrier. We previously reported that regulatory T cells, which function to suppress excessive immune responses, ameliorated blood-brain barrier damage after cerebral ischaemia...
May 22, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28528780/comparative-effectiveness-and-safety-of-apixaban-and-vitamin-k-antagonist-therapy-in-patients-with-nonvalvular-atrial-fibrillation-treated-in-routine-german-practice
#2
Craig I Coleman, W Frank Peacock, Matthias Antz
BACKGROUND: Scarce data comparing real-world outcomes between apixaban and vitamin K antagonist (VKA) users with nonvalvular atrial fibrillation (NVAF) are available. We sought to assess the effectiveness and safety of newly-initiated apixaban vs. VKA in German NVAF patients. MATERIALS AND METHODS: We performed a retrospective analysis in German outpatients using IMS Disease Analyzer data. Adults newly-initiated on apixaban or a VKA from January 2013 to March 2015 with a diagnosis of NVAF on the day of the first qualifying oral anticoagulant (OAC) prescription (index date) or any time during one year prior, and at least one year of follow-up were included...
May 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28524175/modulators-of-microglial-activation-and-polarization-after-intracerebral-haemorrhage
#3
REVIEW
Xi Lan, Xiaoning Han, Qian Li, Qing-Wu Yang, Jian Wang
Intracerebral haemorrhage (ICH) is the most lethal subtype of stroke but currently lacks effective treatment. Microglia are among the first non-neuronal cells on the scene during the innate immune response to ICH. Microglia respond to acute brain injury by becoming activated and developing classic M1-like (proinflammatory) or alternative M2-like (anti-inflammatory) phenotypes. This polarization implies as yet unrecognized actions of microglia in ICH pathology and recovery, perhaps involving microglial production of proinflammatory or anti-inflammatory cytokines and chemokines...
May 19, 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28522451/ada2-deficiency-dada2-as-an-unrecognised-cause-of-early-onset-polyarteritis-nodosa-and-stroke-a-multicentre-national-study
#4
Roberta Caorsi, Federica Penco, Alice Grossi, Antonella Insalaco, Alessia Omenetti, Maria Alessio, Giovanni Conti, Federico Marchetti, Paolo Picco, Alberto Tommasini, Silvana Martino, Clara Malattia, Romina Gallizi, Rosa Anna Podda, Annalisa Salis, Fernanda Falcini, Francesca Schena, Francesca Garbarino, Alessia Morreale, Manuela Pardeo, Claudia Ventrici, Chiara Passarelli, Qing Zhou, Mariasavina Severino, Carlo Gandolfo, Gianluca Damonte, Alberto Martini, Angelo Ravelli, Ivona Aksentijevich, Isabella Ceccherini, Marco Gattorno
OBJECTIVES: To analyse the prevalence of CECR1 mutations in patients diagnosed with early onset livedo reticularis and/or haemorrhagic/ischaemic strokes in the context of inflammation or polyarteritis nodosa (PAN). Forty-eight patients from 43 families were included in the study. METHODS: Direct sequencing of CECR1 was performed by Sanger analysis. Adenosine deaminase 2 (ADA2) enzymatic activity was analysed in monocyte isolated from patients and healthy controls incubated with adenosine and with or without an ADA1 inhibitor...
May 18, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28513255/successful-mechanical-thrombectomy-in-a-comatose-patient-with-cerebral-venous-sinus-thrombosis-a-case-report
#5
Merel Jj Verhagen, Adriaan Cgm van Es, Geert J Lycklama À Nijeholt, Korné Jellema, Jonathan Coutinho, Ido R van den Wijngaard
Cerebral venous sinus thrombosis is a rare cause of stroke, which is routinely treated with systemic heparin. Unfavourable outcome is often seen in severe cases. Therefore alternative treatment methods should be explored in these patients. Due to the risk of haemorrhagic complications, treatment without administration of thrombolytics is of particular interest. This report presents a case of successful mechanical thrombectomy, without the use of thrombolytics, in a comatose patient with cerebral venous sinus thrombosis...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28502970/is-regular-screening-for-intracranial-aneurysm-necessary-in-patients-with-autosomal-dominant-polycystic-kidney-disease-a-systematic-review-and-meta-analysis
#6
Zien Zhou, Ying Xu, Candice Delcourt, Jiehui Shan, Qiang Li, Jianrong Xu, Maree L Hackett
BACKGROUND: The prevalence of intracranial aneurysm in patients with autosomal dominant polycystic kidney disease (ADPKD) is higher than that among the general population. We performed a systematic review and meta-analysis on the prevalence and natural history of intracranial aneurysm among patients with ADPKD. METHODS: Medline, Embase, Web of Science and Scopus, from inception to July 2016, were searched for studies reporting the occurrence of intracranial aneurysms among participants with ADPKD...
May 13, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28495396/cardiovascular-risk-prediction-in-chronic-kidney-disease-patients
#7
Santiago Cedeño Mora, Marian Goicoechea, Esther Torres, Úrsula Verdalles, Ana Pérez de José, Eduardo Verde, Soledad García de Vinuesa, José Luño
INTRODUCTION: Scores underestimate the prediction of cardiovascular risk (CVR) as they are not validated in patients with chronic kidney disease (CKD). Two of the most commonly used scores are the Framingham Risk Score (FRS-CVD) and the ASCVD (AHA/ACC 2013). The aim of this study is to evaluate the predictive ability of experiencing a cardiovascular event (CVE) via these 2scores in the CKD population. MATERIAL AND METHODS: Prospective, observational study of 400 prevalent patients with CKD (stages 4 and 5 according the KDOQI; not on dialysis)...
May 8, 2017: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/28485090/risk-of-stroke-in-prescription-and-other-amphetamine-type-stimulants-use-a-systematic-review
#8
REVIEW
Blanca Iciar Indave, Luis Sordo, María José Bravo, Ana Sarasa-Renedo, Sonia Fernández-Balbuena, Luis De la Fuente, Michela Sonego, Gregorio Barrio
INTRODUCTION AND AIMS: Amphetamine-type stimulants (ATS) are a putative cause of stroke with high abuse potential. We aim to systematically review the association between use of ATS and stroke. DESIGN AND METHODS: To assure a sensitive search strategy, a broad definition of ATS was used. Cochrane Plus, EMBASE, IBECS/Lilacs, ISI WOK, Medline and Scopus were searched through 2016. Three researchers independently reviewed studies (Meta-analysis of Observational Studies in Epidemiology and Preferred Reporting Items for Systematic Reviews and Meta-analyses)...
May 8, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/28471350/antiviral-therapy-reduces-risk-of-haemorrhagic-stroke-in-patients-with-hcv-infection-a-nationwide-cohort-study
#9
Ming-Shyan Lin, Chang-Min Chung, Wey-Yil Lin, Kuo-Liang Wei, Jui Wang, Ying-Ying Lee, Jing-Hong Hu, Tao-Hsin Tung, Yu-Sheng Lin
BACKGROUND: The tendency for haemorrhagic stroke in patients with chronic hepatitis C virus (HCV) infection has emerged recently but the finding may be confounded by comorbidities. Proving the causality between HCV infection and haemorrhagic stroke is mandatory. Our study was designed to investigate the incidence of intracranial haemorrhage in HCV-infected patients with and without treatment. METHODS: In the 11-year and population-based retrospective study, we acquired data from the Taiwan National Health Insurance Research Database...
May 4, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28463832/outcomes-of-endovascular-thrombectomy-with-and-without-thrombolysis-for-acute-large-artery-ischaemic-stroke-at-a-tertiary-stroke-centre
#10
Chee-Keong Wee, William McAuliffe, Constantine C Phatouros, Timothy J Phillips, David Blacker, Tejinder P Singh, Ellen Baker, Graeme J Hankey
BACKGROUND AND PURPOSE: Endovascular thrombectomy (EVT) improves the functional outcome when added to best medical therapy, including alteplase, in patients with acute ischaemic stroke secondary to large vessel occlusion (LVO) in the anterior circulation. However, the evidence for EVT in alteplase-ineligible patients is less compelling. It is also uncertain whether alteplase is necessary in patients with successful recanalization by EVT, as the treatment effect of EVT may be so powerful that bridging alteplase may not add to efficacy and may compromise safety by increasing bleeding risks...
May 2, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28455666/revisiting-progressive-stroke-incidence-predictors-pathophysiology-and-management-of-unexplained-early-neurological-deterioration-following-acute-ischemic-stroke
#11
Pierre Seners, Jean-Claude Baron
Early neurological deterioration (END) following acute ischemic stroke is a serious clinical event strongly associated with poor outcome. Regarding specifically END occurring within 24 h following stroke onset, apart from straightforward causes such as symptomatic intracranial haemorrhage and malignant edema, the cause of END remains unclear in more than a half of cases. In the latter situation, patients are often referred to as 'progressive stroke', a default clinical category that does not imply underlying mechanisms, precluding informed management...
April 28, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28439778/dabigatran-etexilate-appropriate-use-in-patients-with-chronic-kidney-disease-and-in-the-elderly-patients
#12
REVIEW
Mauro Molteni, Mario Bo, Giovanni Di Minno, Giuseppe Di Pasquale, Simonetta Genovesi, Danilo Toni, Paolo Verdecchia
Dabigatran etexilate (DE) is a direct thrombin inhibitor, which has been approved for the treatment of non-valvular atrial fibrillation (AF), and for the prevention and treatment of venous thromboembolism (VTE). Despite large randomized clinical trials and independent observational studies providing robust data concerning DE safety and efficacy, some physicians still perceive mild-to-moderate renal impairment and old age as a relative contraindication to its use. In this article, we review the available scientific evidence supporting the use of DE in these clinical situations...
April 24, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28435084/optimization-of-behavioural-tests-for-the-prediction-of-outcomes-in-mouse-models-of-focal-middle-cerebral-artery-occlusion
#13
Zhuoyu Wen, Xiaomeng Xu, Lili Xu, Lian Yang, Xiaohui Xu, Juehu A Zhu, Li Wu, Yongjun Jiang, Xinfeng Liu
Intraluminal middle cerebral artery occlusion (MCAO) is the most widely used model of stroke. We aimed to predict the outcome of MCAO using a combination of fine behavioural tests for the prediction of unsuccessful surgery in mice leading to no infarction, haemorrhage and unexpected death. MCAO was performed on adult mice under the guidance of laser-Doppler flowmetry (LDF) to warrant a decrease in regional cerebral blood flow (rCBF) in the MCA territory. Four outcomes of MCAO were defined according to histological analysis: infarction, no infarction, haemorrhage and unexpected death (death within 24 h post-surgery)...
April 20, 2017: Brain Research
https://www.readbyqxmd.com/read/28420931/paediatrics-primary-myelofibrosis-and-acute-stroke-a-rare-presentation
#14
Wajida Mazher, Ather Hasan Rizvi, Arsalan Majeed Adam, Muhammad Saad Ali Mallick, Ansab Godil
Idiopathic Myelofibrosis is a rare myeloproliferative disorder. In children, it becomes even rarer. Herein, we report a case of idiopathic myelofibrosis of a 6-year old male patient who presented with complaints of pallor, petechiae and bleeding from gums. Bone marrow aspirate showed afragmented haemodiluted smears with erythroid and myeloid precursors scattered throughout. Trephine biopsy showed increased background fibrotic activity along with clusters of histiocytes. A diagnosis of paediatric primary myelofibrosis was made on biopsy...
April 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28408613/air-pollution-and-the-incidence-of-ischaemic-and-haemorrhagic-stroke-in-the-south-london-stroke-register-a-case-cross-over-analysis
#15
B K Butland, R W Atkinson, S Crichton, B Barratt, S Beevers, A Spiridou, U Hoang, F J Kelly, C D Wolfe
BACKGROUND: Few European studies investigating associations between short-term exposure to air pollution and incident stroke have considered stroke subtypes. Using information from the South London Stroke Register for 2005-2012, we investigated associations between daily concentrations of gaseous and particulate air pollutants and incident stroke subtypes in an ethnically diverse area of London, UK. METHODS: Modelled daily pollutant concentrations based on a combination of measurements and dispersion modelling were linked at postcode level to incident stroke events stratified by haemorrhagic and ischaemic subtypes...
April 13, 2017: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/28400384/stroke-in-systemic-lupus-erythematosus-a-swedish-population-based-cohort-study
#16
Elizabeth V Arkema, Elisabet Svenungsson, Mia Von Euler, Christopher Sjöwall, Julia F Simard
OBJECTIVE: To study the occurrence of ischaemic and haemorrhagic stroke in systemic lupus erythematosus (SLE) compared with the general population by age, sex and time since SLE diagnosis METHODS: Adults with incident SLE were identified from the Swedish National Patient Register (NPR, n=3390) and general population comparators from the Total Population Register were matched on age, sex and county (n=16730). Individuals were followed prospectively until first of death, December 2013, emigration or incident stroke (identified from the NPR, Cause of Death Register and the Stroke Register)...
April 11, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28384147/trends-in-new-zealand-stroke-thrombolysis-treatment-rates
#17
Qiliang Liu, Annemarei Anna Ranta, Ginny Abernethy, P Alan Barber
AIMS: To describe trends in treatment delays and short-term outcome over the first 18 months of the New Zealand stroke thrombolysis register. METHODS: The National Stroke Network introduced a central register of all ischaemic stroke patients treated with intravenous alteplase on January 1, 2015. The aim was to increase thrombolysis treatment rates and drive improvements in safety. RESULTS: From January 1, 2015 to June 30, 2016, alteplase was given to 623 patients [344 men, mean (range) age 70 (22-98) years] out of a total of 8,857 ischaemic and unspecified stroke patients, giving a thrombolysis rate of 7...
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28381307/reasons-for-non-recruitment-of-eligible-patients-to-a-randomised-controlled-trial-of-secondary-prevention-after-intracerebral-haemorrhage-observational-study
#18
Amy E Maxwell, Mary Joan MacLeod, Anu Joyson, Sharon Johnson, Hawraman Ramadan, Ruth Bellfield, Anthony Byrne, Caroline McGhee, Anthony Rudd, Fiona Price, Evangelos Vasileiadis, Melinda Holden, Jonathan Hewitt, Michael Carpenter, Ann Needle, Stacey Valentine, Farzana Patel, Frances Harrington, Paul Mudd, Hedley Emsley, Bindu Gregary, Ingrid Kane, Keith Muir, Divya Tiwari, Peter Owusu-Agyei, Natalie Temple, Lakshmanan Sekaran, Suzanne Ragab, Timothy England, Amanda Hedstrom, Phil Jones, Sarah Jones, Mandy Doherty, Mark O McCarron, David L Cohen, Sharon Tysoe, Rustam Al-Shahi Salman
BACKGROUND: Recruitment to randomised prevention trials is challenging, not least for intracerebral haemorrhage (ICH) associated with antithrombotic drug use. We investigated reasons for not recruiting apparently eligible patients at hospital sites that keep screening logs in the ongoing REstart or STop Antithrombotics Randomised Trial (RESTART), which seeks to determine whether to start antiplatelet drugs after ICH. METHOD: By the end of May 2015, 158 participants had been recruited at 108 active sites in RESTART...
April 5, 2017: Trials
https://www.readbyqxmd.com/read/28374884/low-molecular-weight-heparins-or-heparinoids-versus-standard-unfractionated-heparin-for-acute-ischaemic-stroke
#19
REVIEW
Peter Ag Sandercock, Tze Shin Leong
BACKGROUND: Low-molecular-weight heparins (LMWHs) and heparinoids are anticoagulants that may have more powerful antithrombotic effects than standard unfractionated heparin (UFH) but a lower risk of bleeding complications. This is an update of the original Cochrane Review of these agents, first published in 2001 and last updated in 2008. OBJECTIVES: To determine whether antithrombotic therapy with LMWHs or heparinoids is associated with a reduction in the proportion of people who are dead or dependent for activities in daily living compared with UFH...
April 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28372902/prognostic-value-of-peripheral-leukocyte-counts-and-plasma-glucose-in-intracerebral-haemorrhage
#20
S Kayhanian, C K Weerasuriya, U Rai, A M H Young
INTRODUCTION: The value of routine blood markers as prognostic indicators is increasingly established in acute ischaemic stroke. The relationship is less well defined in haemorrhagic stroke. In this study, we examined routine admission blood markers and applied a logistic regression model to predict outcome in haemorrhagic stroke. METHOD: A retrospective study was performed between September 2009-2011 in a general admission stroke unit in the UK. 1400 patients were admitted with stroke during this period, of which 117 were haemorrhagic...
March 31, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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