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https://www.readbyqxmd.com/read/28210908/updates-in-outcomes-of-stereotactic-radiation-therapy-in-acromegaly
#1
REVIEW
Monica Livia Gheorghiu
Purpose Treatment of acromegaly has undergone important progress in the last 20 years mainly due to the development of new medical options and advances in surgical techniques. Pituitary surgery is usually first-line therapy, and medical treatment is indicated for persistent disease, while radiation (RT) is often used as third-line therapy. The benefits of RT (tumor volume control and decreased hormonal secretion) are hampered by the long latency of the effect and the high risk of adverse effects. Stereotactic RT methods have been developed with the aim to provide more precise targeting of the tumor with better control of the radiation dose received by the adjacent brain structures...
February 16, 2017: Pituitary
https://www.readbyqxmd.com/read/28207602/spreading-depolarization-monitoring-in-neurocritical-care-of-acute-brain-injury
#2
Jed A Hartings
PURPOSE OF REVIEW: Spreading depolarizations are unique in being discrete pathologic entities that are well characterized experimentally and also occur commonly in patients with substantial acute brain injury. Here, we review essential concepts in depolarization monitoring, highlighting its clinical significance, interpretation, and future potential. RECENT FINDINGS: Cortical lesion development in diverse animal models is mediated by tissue waves of mass spreading depolarization that cause the toxic loss of ion homeostasis and limit energy substrate supply through associated vasoconstriction...
February 14, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28202819/-melas-mitochondrial-encephalomyopathy-lactic-acidosis-and-stroke-like-episodes
#3
Hidetomo Murakami, Kenjiro Ono
Mitochondrial disease is caused by a deficiency in the energy supply to cells due to mitochondrial dysfunction. Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) is a mitochondrial disease that presents with stroke-like episodes such as acute onset of neurological deficits and characteristic imaging findings. Stroke-like episodes in MELAS have the following features: 1) neurological deficits due to localization of lesions in the brain, 2) episodes often accompany epilepsy, 3) lesions do not follow the vascular supply area, 4) lesions are more often seen in the posterior brain than in the anterior brain, 5) lesions spread to an adjacent area in the brain, and 6) neurological symptoms often disappear together with imaging findings, but later relapse...
February 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28178773/postural-control-of-individuals-with-chronic-stroke-compared-to-healthy-participants-tug-frt-and-center-of-pressure-movement
#4
Sigal Portnoy, Shlomit Reif, Tom Mendelboim, Debbie Rand
BACKGROUND: Balance impairments are common following stroke, and may lead to loss of independent functional mobility and falls. Previous studies strived to come up with precise measures of postural control, which will provide a better prognostic power for the health status and safety of the individual. To date, the degree of difference in postural control measures between individuals with chronic stroke and healthy participants is not reported. Also there are no reported correlations between these measures and the Timed-Up-and-Go (TUG) and the Functional Reach Test (FRT)...
February 8, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28153466/practical-identifiability-analysis-of-a-minimal-cardiovascular-system-model
#5
Antoine Pironet, Paul D Docherty, Pierre C Dauby, J Geoffrey Chase, Thomas Desaive
BACKGROUND AND OBJECTIVE: Parameters of mathematical models of the cardiovascular system can be used to monitor cardiovascular state, such as total stressed blood volume status, vessel elastance and resistance. To do so, the model parameters have to be estimated from data collected at the patient's bedside. This work considers a seven-parameter model of the cardiovascular system and investigates whether these parameters can be uniquely determined using indices derived from measurements of arterial and venous pressures, and stroke volume...
January 17, 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28152998/critical-appraisal-of-advance-directives-given-by-patients-with-fatal-acute-stroke-an-observational-cohort-study
#6
A Alonso, D Dörr, K Szabo
BACKGROUND: Advance directives (AD) imply the promise of determining future medical treatment in case of decisional incapacity. However, clinical practice increasingly indicates that standardized ADs often fail to support patients' autonomy. To date, little data are available about the quality and impact of ADs on end-of-life decisions for incapacitated acute stroke patients. METHODS: We analyzed the ADs of patients with fatal stroke, focusing on: (a) their availability and type, (b) stated circumstances to which the AD should apply, and (c) stated wishes regarding specific treatment options...
February 2, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28135841/annals-express-ten-year-standardization-of-lipids-and-high-sensitivity-c-reactive-protein-in-a-randomized-controlled-trial-to-assess-effects-of-statins-on-secondary-stroke-prevention-japan-statin-treatment-against-recurrent-stroke-j-stars
#7
Masakazu Nakamura, Tatsuyuki Fukukawa, Kazuo Kitagawa, Yoji Nagai, Naohisa Hosomi, Masayasu Matsumoto, Kazuo Minematsu, Shinichiro Uchiyama, Yoshihiro Miyamoto
BACKGROUND: The Japan Statin Treatment Against Recurrent Stroke (J-STARS) is a clinical trial that administered pravastatin for secondary stroke prevention. Lipid levels are a well- established risk factor for cerebrovascular diseases. Elevated high-sensitivity C-reactive protein (hs-CRP) indicates a high risk of inflammatory reactions. In clinical trials, internationally approved standardization is essential for obtaining study results that are comparable with those from overseas. Therefore, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and hs-CRP were standardized throughout a 10-year study period...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28134854/topologically-optimized-nano-positioning-stage-integrating-with-a-capacitive-comb-sensor
#8
Tao Chen, Yaqiong Wang, Huicong Liu, Zhan Yang, Pengbo Wang, Lining Sun
Nano-positioning technology has been widely used in many fields, such as microelectronics, optical engineering, and micro manufacturing. This paper presents a one-dimensional (1D) nano-positioning system, adopting a piezoelectric ceramic (PZT) actuator and a multi-objective topological optimal structure. The combination of a nano-positioning stage and a feedback capacitive comb sensor has been achieved. In order to obtain better performance, a wedge-shaped structure is used to apply the precise pre-tension for the piezoelectric ceramics...
January 28, 2017: Sensors
https://www.readbyqxmd.com/read/28134824/a-new-adaptable-optical-high-resolution-3-axis-sensor
#9
Niels Buchhold, Christian Baumgartner
This article presents a new optical, multi-functional, high-resolution 3-axis sensor which serves to navigate and can, for example, replace standard joysticks in medical devices such as electric wheelchairs, surgical robots or medical diagnosis devices. A light source, e.g., a laser diode, is affixed to a movable axis and projects a random geometric shape on an image sensor (CMOS or CCD). The downstream microcontroller's software identifies the geometric shape's center, distortion and size, and then calculates x, y, and z coordinates, which can be processed in attached devices...
January 27, 2017: Sensors
https://www.readbyqxmd.com/read/28132879/microrna-137-protects-neurons-against-ischemia-reperfusion-injury-through-regulation-of-the-notch-signaling-pathway
#10
Fangkun Shi, Zhiling Dong, Hualian Li, Xiaoman Liu, Hongmei Liu, Ruifang Dong
MicroRNAs (miRNAs) have emerged as novel regulators in various pathological processes including ischemic stroke. However, the precise role of miRNAs in ischemic stroke remains largely unknown. In this study, we investigated the role of miR-137 in the regulation of neuronal ischemia/reperfusion injury with oxygen-glucose deprivation and reoxygenation (OGD/R), a model of global brain ischemia. The results showed that miR-137 was significantly downregulated in neurons subjected to OGD/R treatment: OGD/R-induced cell injury was markedly inhibited by miR-137 overexpression and exacerbated by miR-137 suppression...
January 26, 2017: Experimental Cell Research
https://www.readbyqxmd.com/read/28129320/totally-endoscopic-robotic-left-atrial-appendage-closure-demonstrates-high-success-rate
#11
Alison F Ward, Robert M Applebaum, Nana Toyoda, Ans Fakiha, Peter J Neuburger, Jennie Ngai, Robert G Nampiaparampil, David W Yaffee, Didier F Loulmet, Eugene A Grossi
OBJECTIVE: In patients with atrial fibrillation, 90% of embolic strokes originate from the left atrial appendage (LAA). Successful exclusion of the LAA is associated with a lower stroke rate in patients with atrial fibrillation. Surgical oversewing of the LAA is often incomplete when evaluated with transesophageal echocardiogram (TEE). External closure techniques of suturing and stapling have also demonstrated high failure rates with persistent flow and large stumps. We hypothesized that the precise visualization of a robotic LAA closure (RLAAC) would result in superior closure rates...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28117813/setting-up-a-stroke-team-algorithm-and-conducting-simulation-based-training-in-the-emergency-department-a-practical-guide
#12
Damla Tahtali, Ferdinand Bohmann, Peter Rostek, Marlies Wagner, Helmuth Steinmetz, Waltraud Pfeilschifter
Time is of the essence when caring for an acute stroke patient. The ultimate goal is to restore blood flow to the ischemic brain. This can be achieved by either thrombolysis with recombinant tissue-plasminogen activator (rt-PA), the standard therapy for stroke patients who present within the first hours of symptom onset without contraindications, or by an endovascular approach, if a proximal brain vessel occlusion is detected. As the efficacy of both therapies declines over time, every minute saved along the way will improve the patient's outcome...
January 15, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28116327/constitutional-de-novo-and-postzygotic-mutations-in-isolated-cases-of-cerebral-cavernous-malformations
#13
Matthias Rath, Stefanie Spiegler, Neetika Nath, Konrad Schwefel, Nataliya Di Donato, Johannes Gerber, G Christoph Korenke, Yorck Hellenbroich, Ute Hehr, Stephanie Gross, Ulrich Sure, Barbara Zoll, Eberhard Gilberg, Lars Kaderali, Ute Felbor
BACKGROUND: Cerebral cavernous malformations (CCM) are vascular lesions of the central nervous system that can be found in sporadic or autosomal dominantly inherited forms and manifest with headaches, seizures, and hemorrhagic stroke. The precise proportion of de novo mutations in the CCM1,CCM2, and CCM3 genes remains unknown. METHODS: We here present a series of six trios with de novo mutations that have been analyzed by amplicon deep sequencing to differentiate between constitutional and postzygotic mutations...
January 2017: Molecular Genetics & Genomic Medicine
https://www.readbyqxmd.com/read/28113622/investigation-of-crossbeam-multi-receiver-configurations-for-accurate-3d-vector-doppler-velocity-estimation
#14
Bushra Hussain, Billy Yiu, Alfred C H Yu, James C Lacefield, Tamie L Poepping
Accurate estimation of low blood velocities whose Doppler shifts span the wall filter cut-off, such as near the wall in recirculation or disturbed flow regions, is important for accurate mapping of velocities to achieve improved estimations of wall shear stress and turbulence, which are known risk factors for atherosclerosis and stroke. This study presents the comparative benefit of increasing the number of receiver beams above three for improved estimation of low 3D velocities. The 3D-crossbeam vector Doppler ultrasound configurations were studied in terms of the number of receiver beams, inter-beam angle, and beamselection method (criterion for discriminating between tissue and blood Doppler signals) for a range of velocity orientations, which may prove useful in the design of a future 2D array for vascular imaging...
August 24, 2016: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/28113331/alignment-free-self-calibrating-elbow-angles-measurement-using-inertial-sensors
#15
Philipp Muller, Marc-Andre Begin, Thomas Schauer, Thomas Seel
Due to their relative ease of handling and low cost, inertial measurement unit (IMU)-based joint angle measurements are used for a widespread range of applications. These include sports performance, gait analysis and rehabilitation (e.g. Parkinson's disease monitoring or post-stroke assessment). However, a major downside of current algorithms, recomposing human kinematics from IMU data, is that they require calibration motions and/or the careful alignment of the IMUs with respect to the body segments. In this article, we propose a new method, which is alignment-free and self-calibrating using arbitrary movements of the user and an initial zero reference arm pose...
December 14, 2016: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28111353/gc-ms-based-metabolomics-identifies-an-amino-acid-signature-of-acute-ischemic-stroke
#16
Dian Wang, Jing Kong, Jiayan Wu, Xingxing Wang, Minchao Lai
Ischemic stroke is a serious public health problem worldwide. Here, we characterized the metabolite features of acute ischemic stroke (AIS) using a gas chromatography-mass spectrometry-based metabolomics. Forty AIS patients and 29 sex and age-matched controls were recruited. The serum metabolic profiles were significantly different between the two groups. Compared to the controls, the patients had elevated levels of lactate, carbonate and glutamate (P<0.01), and lowered levels of alanine, citrate, glycine, isoleucine, leucine, serine, tyrosine, methionine, tryptophan, erythronic acid, urea, purine, hypoxanthine, and proline in the serum (P<0...
January 19, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28105697/association-of-hematocrit-with-blood-pressure-and-hypertension
#17
Marzieh Emamian, Seyed Mahdi Hasanian, Maryam Tayefi, Moniba Bijari, Faeze Movahedian Far, Mojtaba Shafiee, Amir Avan, Alireza Heidari-Bakavoli, Mohsen Moohebati, Mahmoud Ebrahimi, Sousan Darroudi, Parvin Zamani, Mahmoud Reza Azarpazhooh, Mohsen Nematy, Mohammad Safarian, Gordon A Ferns, Habibollah Esmaeili, Mohammad Reza Parizadeh, Majid Ghayour-Mobarhan
BACKGROUND: Hypertension (HTN) is a risk factor for stroke, renal failure, and cardiovascular disease. The association between biochemical and hematological parameters with high blood pressure may provide a more precise approach to risk prediction conferred by HTN in these patients. OBJECTIVE: The aim of current study was to explore whether biochemical and hematological parameters are associated with HTN in a cohort study with a 7-year follow-up. MATERIALS AND METHODS: A total of 9808 individuals were enrolled and recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study, and biochemical and hematological factors were measured in all subjects...
January 20, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28102150/ultra-rare-genetic-variation-in-common-epilepsies-a-case-control-sequencing-study
#18
(no author information available yet)
BACKGROUND: Despite progress in understanding the genetics of rare epilepsies, the more common epilepsies have proven less amenable to traditional gene-discovery analyses. We aimed to assess the contribution of ultra-rare genetic variation to common epilepsies. METHODS: We did a case-control sequencing study with exome sequence data from unrelated individuals clinically evaluated for one of the two most common epilepsy syndromes: familial genetic generalised epilepsy, or familial or sporadic non-acquired focal epilepsy...
February 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28089455/comparison-of-transcatheter-aortic-valve-implantation-with-the-newest-generation-sapien-3-vs-direct-flow-medical-valve-in-a-single-center-cohort
#19
Eberhard Schulz, Alexander Jabs, Alexander Tamm, Patrick Herz, Andreas Schulz, Tommaso Gori, Stephan von Bardeleben, Walter Kasper-König, Ulrich Hink, Christian-Friedrich Vahl, Thomas Münzel
BACKGROUND: The latest generation transcatheter heart valves including Edwards Sapien 3 (ES3) and Direct Flow Medical (DFM) were designed to allow precise implantation at the intended position and to minimize prosthesis dysfunction as well as procedural complications. Our aim was to compare short-term functional and clinical outcomes of these 2 transcatheter aortic valve systems. METHODS: Of 174 patients undergoing transfemoral transcatheter aortic valve implantation (TAVI) at our institution between August 2013 and June 2015, 113 were treated with ES3 and 61 with DFM...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28088628/methods-needed-to-measure-predictive-accuracy-a-study-of-diabetic-patients
#20
Hafiz M R Khan, Sarah Mende, Aamrin Rafiq, Kemesha Gabbidon, P Hemachandra Reddy
Diabetes is one of the leading causes of morbidity and mortality and it can result in several complications such as kidney failure, heart failure, stroke, and blindness making it a major medical and public health concern in the United States. Statistical methods are important to detect risk factors and identify the best sampling plan to determine predictive bounds for diabetic patients' data. The main objective of this paper is to identify the best fit bootstrapping sampling method and to draw the predictive bound considering diabetes patient data...
January 11, 2017: Biochimica et Biophysica Acta
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