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https://www.readbyqxmd.com/read/27921034/crowdsourcing-precision-cerebrovascular-health-imaging-and-cloud-seeding-a-million-brains-initiative%C3%A2
#1
David S Liebeskind
Crowdsourcing, an unorthodox approach in medicine, creates an unusual paradigm to study precision cerebrovascular health, eliminating the relative isolation and non-standardized nature of current imaging data infrastructure, while shifting emphasis to the astounding capacity of big data in the cloud. This perspective envisions the use of imaging data of the brain and vessels to orient and seed A Million Brains Initiative™ that may leapfrog incremental advances in stroke and rapidly provide useful data to the sizable population around the globe prone to the devastating effects of stroke and vascular substrates of dementia...
2016: Frontiers in Medicine
https://www.readbyqxmd.com/read/27919057/principles-of-precision-medicine-in-stroke
#2
REVIEW
Jason D Hinman, Natalia S Rost, Thomas W Leung, Joan Montaner, Keith W Muir, Scott Brown, Juan F Arenillas, Edward Feldmann, David S Liebeskind
The era of precision medicine has arrived and conveys tremendous potential, particularly for stroke neurology. The diagnosis of stroke, its underlying aetiology, theranostic strategies, recurrence risk and path to recovery are populated by a series of highly individualised questions. Moreover, the phenotypic complexity of a clinical diagnosis of stroke makes a simple genetic risk assessment only partially informative on an individual basis. The guiding principles of precision medicine in stroke underscore the need to identify, value, organise and analyse the multitude of variables obtained from each individual to generate a precise approach to optimise cerebrovascular health...
October 19, 2016: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27915126/stroke-risk-stratification-and-its-validation-using-ultrasonic-echolucent-carotid-wall-plaque-morphology-a-machine-learning-paradigm
#3
Tadashi Araki, Pankaj K Jain, Harman S Suri, Narendra D Londhe, Nobutaka Ikeda, Ayman El-Baz, Vimal K Shrivastava, Luca Saba, Andrew Nicolaides, Shoaib Shafique, John R Laird, Ajay Gupta, Jasjit S Suri
Stroke risk stratification based on grayscale morphology of the ultrasound carotid wall has recently been shown to have a promise in classification of high risk versus low risk plaque or symptomatic versus asymptomatic plaques. In previous studies, this stratification has been mainly based on analysis of the far wall of the carotid artery. Due to the multifocal nature of atherosclerotic disease, the plaque growth is not restricted to the far wall alone. This paper presents a new approach for stroke risk assessment by integrating assessment of both the near and far walls of the carotid artery using grayscale morphology of the plaque...
November 27, 2016: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/27909266/reliability-of-infarct-volumetry-its-relevance-and-the-improvement-by-a-software-assisted-approach
#4
Felix Friedländer, Ferdinand Bohmann, Max Brunkhorst, Ju-Hee Chae, Kavi Devraj, Yvette Köhler, Peter Kraft, Hannah Kuhn, Alexandra Lucaciu, Sebastian Luger, Waltraud Pfeilschifter, Rebecca Sadler, Arthur Liesz, Karolina Scholtyschik, Leonie Stolz, Rajkumar Vutukuri, Robert Brunkhorst
Despite the efficacy of neuroprotective approaches in animal models of stroke, their translation has so far failed from bench to bedside. One reason is presumed to be a low quality of preclinical study design, leading to bias and a low a priori power. In this study, we propose that the key read-out of experimental stroke studies, the volume of the ischemic damage as commonly measured by free-handed planimetry of TTC-stained brain sections, is subject to an unrecognized low inter-rater and test-retest reliability with strong implications for statistical power and bias...
December 1, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27882613/improvements-of-procedural-results-with-a-new-generation-self-expanding-transfemoral-aortic-valve-prosthesis-in-comparison-to-the-old-generation-device
#5
Bruna Gomes, Nicolas A Geis, Emmanuel Chorianopoulos, Benjamin Meder, Florian Leuschner, Hugo A Katus, Raffi Bekeredjian
OBJECTIVES: In this study, we compare procedural results of our first Evolut R (Medtronic, Minneapolis, MN, USA) implantations with the last CoreValve implantations. Main endpoints include paravalvular regurgitation, major vascular complications, stroke, and pacemaker implantation. BACKGROUND: The evolution of transcatheter aortic valve replacement (TAVR) was possible due to various technical improvements, leading to better periprocedural and long-term outcome. The newly designed Evolut R valve has the potential to further improve TAVR's performance...
November 24, 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27881558/the-american-heart-association-s-new-institute-for%C3%A2-precision-cardiovascular-medicine
#6
Steven R Houser
"One size does not fit all." These 6 simple words represent the fundamental concept driving an unprecedented initiative of the American Heart Association, the Institute for Precision Cardiovascular Medicine. In the field of heart disease and stroke research, we have seen enormous knowledge advances in recent decades, all of which have led to breakthroughs in our ability to treat and prevent these illnesses. We celebrate these advances because they are allowing us to save and improve more lives than ever before...
November 22, 2016: Circulation
https://www.readbyqxmd.com/read/27879970/mortality-hospital-days-and-expenditures-attributable-to-ambient-air-pollution-from-particulate-matter-in-israel
#7
Gary M Ginsberg, Ehud Kaliner, Itamar Grotto
BACKGROUND: Worldwide, ambient air pollution accounts for around 3.7 million deaths annually. Measuring the burden of disease is important not just for advocacy but also is a first step towards carrying out a full cost-utility analysis in order to prioritise technological interventions that are available to reduce air pollution (and subsequent morbidity and mortality) from industrial, power generating and vehicular sources. METHODS: We calculated the average national exposure to particulate matter particles less than 2...
2016: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/27863833/rapid-systematic-review-intra-arterial-thrombectomy-clot-retrieval-for-selected-patients-with-acute-ischemic-stroke
#8
William J Meurer, Bradley E Barth, Gary Gaddis, Gary M Vilke, Samuel H F Lam
BACKGROUND: Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality. However, precisely defining the optimal treatment for individual patients early after AIS onset remains elusive. There has recently been a surge in published studies documenting the effectiveness of mechanical intra-arterial thrombectomy for treatment of a subset of patients with AIS. This therapy has been proposed and studied for the small (<1.2%) subgroup of patients with ischemic strokes who have "large vessel" strokes or strokes that fail to improve after the administration of tissue plasminogen activator (t-PA)...
November 15, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27852229/access-timing-and-frequency-of-very-early-stroke-rehabilitation-insights-from-the-baden-wuerttemberg-stroke-registry
#9
Björn Reuter, Christoph Gumbinger, Tamara Sauer, Horst Wiethölter, Ingo Bruder, Curt Diehm, Peter A Ringleb, Werner Hacke, Michael G Hennerici, Rolf Kern
BACKGROUND: While the precise timing and intensity of very early rehabilitation (VER) after stroke onset is still under discussion, its beneficial effect on functional disability is generally accepted. The recently published randomized controlled AVERT trial indicated that patients with severe stroke might be more susceptible to harmful side effects of VER, which we hypothesized is contrary to current clinical practice. We analyzed the Baden-Wuerttemberg stroke registry to gain insight into the application of VER in acute ischemic stroke (IS) and intracerebral hemorrhage (ICH) in clinical practice...
November 16, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27824561/investigation-of-crossbeam-multi-receiver-configurations-for-accurate-3-d-vector-doppler-velocity-estimation
#10
Bushra Hussain, Billy Y S Yiu, Alfred C H Yu, James C Lacefield, Tamie L Poepping
An accurate estimation of low blood velocities whose Doppler shifts span the wall filter cutoff, 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 paper presents the comparative benefit of increasing the number of receiver beams above three for an improved estimation of low 3-D velocities. The 3-D crossbeam vector Doppler ultrasound configurations were studied in terms of the number of receiver beams, interbeam angle, and beam selection 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 2-D array for vascular imaging...
November 2016: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/27816341/stroke-prevention
#11
Clothilde Isabel, David Calvet, Jean-Louis Mas
Patients who have had a stroke are at high risk for recurrent stroke, myocardial infarction, and vascular death. Prevention of these events should be initiated promptly after stroke, because many recurrent events occur early, and should be tailored to the precise cause of stroke, which may require specific treatment. Lifestyle advice including abstinence from smoking, regular exercise, Mediterranean-style diet, and reduction of salt intake and alcohol consumption are recommended for all patients with stroke...
November 3, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27815681/coagulation-abnormalities-in-heart-failure-pathophysiology-and-therapeutic-implications
#12
REVIEW
Ju H Kim, Palak Shah, Udaya S Tantry, Paul A Gurbel
Heart failure (HF) represents a heterogeneous condition characterized by vulnerabilities in the blood, vasculature, and impaired flow dynamics that predispose to both arterial and venous thrombosis. Despite evidence-based advances in the medical and device management of chronic HF, it remains a leading cause of morbidity and mortality in the USA due to repeat hospitalizations and comorbid conditions such as atrial fibrillation (AF) and stroke. The presence of platelet activation and hypercoagulability in HF has been well documented...
November 4, 2016: Current Heart Failure Reports
https://www.readbyqxmd.com/read/27814312/impact-of-artifacts-on-vor-gain-measures-by-video-oculography-in-the-acute-vestibular-syndrome
#13
Georgios Mantokoudis, Ali S Saber Tehrani, Amy Wozniak, Karin Eibenberger, Jorge C Kattah, Cynthia I Guede, David S Zee, David E Newman-Toker
OBJECTIVE: The video head impulse test (HIT) measures vestibular function (vestibulo-ocular reflex [VOR] gain - ratio of eye to head movement), and, in principle, could be used to make a distinction between central and peripheral causes of vertigo. However, VOG recordings contain artifacts, so using unfiltered device data might bias the final diagnosis, limiting application in frontline healthcare settings such as the emergency department (ED). We sought to assess whether unfiltered data (containing artifacts) from a video-oculography (VOG) device have an impact on VOR gain measures in acute vestibular syndrome (AVS)...
November 3, 2016: Journal of Vestibular Research: Equilibrium & Orientation
https://www.readbyqxmd.com/read/27809599/associations-of-tnf%C3%AE-308g-a-and-tnf%C3%AE-238g-a-polymorphisms-with-ischemic-stroke-in-east-asians-and-non-east-asians-a-meta-analysis
#14
Di Song, Daobin Cheng
AIMS: Two well-characterized polymorphisms in the tumor necrosis factor (TNF) gene, TNFα-308G/A and TNFα-238G/A, are thought to play important roles in the etiology and pathogenesis of ischemic stroke. Due to ethnic diversity, studies of the associations between these polymorphisms and ischemic stroke are inconclusive. Thus, we conducted a meta-analysis to derive more precise estimates of these associations in East Asians and non-East Asians. MATERIALS AND METHODS: We searched relevant publications in the PubMed, Embase, and Medline databases...
November 3, 2016: Genetic Testing and Molecular Biomarkers
https://www.readbyqxmd.com/read/27807627/investigating-structure-and-function-in-the-healthy-human-brain-validity-of-acute-versus-chronic-lesion-symptom-mapping
#15
Hans-Otto Karnath, Johannes Rennig
Modern voxel-based lesion-symptom mapping (VLSM) analyses techniques provide powerful tools to examine the relationship between structure and function of the healthy human brain. However, there is still uncertainty on the type of and the appropriate time point of imaging and of behavioral testing for such analyses. Here we tested the validity of the three most common combinations of structural imaging data and behavioral scores used in VLSM analyses. Given the established knowledge about the neural substrate of the primary motor system in humans, we asked the mundane question of where the motor system is represented in the normal human brain, analyzing individual arm motor function of 60 unselected stroke patients...
November 2, 2016: Brain Structure & Function
https://www.readbyqxmd.com/read/27798137/spike-timing-dependent-plasticity-in-the-long-latency-stretch-reflex-following-paired-stimulation-from-a-wearable-electronic-device
#16
K M Riashad Foysal, Felipe de Carvalho, Stuart N Baker
: The long-latency stretch reflex (LLSR) in human elbow muscles probably depends on multiple pathways; one possible contributor is the reticulospinal tract. Here we attempted to induce plastic changes in the LLSR by pairing noninvasive stimuli that are known to activate reticulospinal pathways, at timings predicted to cause spike timing-dependent plasticity in the brainstem. In healthy human subjects, reflex responses in flexor muscles were recorded following extension perturbations at the elbow...
October 19, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/27784343/patterns-of-association-of-chronic-medical-conditions-and-major-depression
#17
S B Patten, J V A Williams, D H Lavorato, J L Wang, N Jetté, T T Sajobi, K M Fiest, A G M Bulloch
AIMS: Age and sex-related patterns of association between medical conditions and major depressive episodes (MDE) are important for understanding disease burden, anticipating clinical needs and for formulating etiological hypotheses. General population estimates are especially valuable because they are not distorted by help-seeking behaviours. However, even large population surveys often deliver inadequate precision to adequately describe such patterns. In this study, data from a set of national surveys were pooled to increase precision, supporting more precise characterisation of these associations...
October 27, 2016: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/27776204/mean-platelet-volume-a-potential-biomarker-of-the-risk-and-prognosis-of-heart-disease
#18
Dong-Hyun Choi, Seong-Ho Kang, Heesang Song
Platelets are essential for progression of atherosclerotic lesions, plaque destabilization, and thrombosis. They secrete and express many substances that are crucial mediators of coagulation, inflammation, and atherosclerosis. Mean platelet volume (MPV) is a precise measure of platelet size, and is routinely reported during complete blood count analysis. Emerging evidence supports the use of MPV as a biomarker predicting the risk of ischemic stroke in patients with atrial fibrillation, and as a guide for prescription of anticoagulation and rhythm-control therapy...
October 24, 2016: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/27757935/impact-of-salt-intake-on-the-pathogenesis-and-treatment-of-hypertension
#19
Petra Rust, Cem Ekmekcioglu
Excessive dietary salt (sodium chloride) intake is associated with an increased risk for hypertension, which in turn is especially a major risk factor for stroke and other cardiovascular pathologies, but also kidney diseases. Besides, high salt intake or preference for salty food is discussed to be positive associated with stomach cancer, and according to recent studies probably also obesity risk. On the other hand a reduction of dietary salt intake leads to a considerable reduction in blood pressure, especially in hypertensive patients but to a lesser extent also in normotensives as several meta-analyses of interventional studies have shown...
October 19, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27754044/os-14-01-an-estimated-optimal-hypertension-level-of-goals-on-drug-therapy-from-the-fever-trial
#20
Xuezhong Zhang, Yuqing Zhang, Lisheng Liu, Alberto Zanchetti
OBJECTIVE: There is some debate as to optimal BP goals with antihypertensive treatment derived mostly in post-hoc analysis of large trials. Because there was limited number of subjects and outcomes within the larger study which may cloud the analytical accuracy of the findings. We suggest a new method to estimate the J-curve. DESIGN AND METHOD: Felodipine Event Reduction (FEVER) study randomized 9711 Chinese hypertensive patients to more or less intense anti-hypertensive treatment with 159,844 BP measurements...
September 2016: Journal of Hypertension
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