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Precision medicine stroke

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https://www.readbyqxmd.com/read/28597905/stroke-prevention-in-atrial-fibrillation-past-present-and-future-comparing-the-guidelines-and-practical-decision-making
#1
Gregory Lip, Gregory Y H Lip, Ben Freedman, Raffaele De Caterina, Tatjana S Potpara
Concepts and our approaches to stroke prevention in atrial fibrillation (AF) have changed markedly over the last decade. There has been an evolution over the approach to stroke and bleeding risk assessment, as well as new treatment options. An increasing awareness of AF has led to calls to improve the detection of and population screening for AF. Stroke and bleeding risk assessment continues to evolve, and the ongoing debate on balance between simplicity and practicality, against precision medicine will continue...
June 9, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28584214/study-on-language-rehabilitation-for-aphasia
#2
REVIEW
Zeng-Zhi Yu, Shu-Jun Jiang, Zi-Shan Jia, Hong-Yu Xiao, Mei-Qi Zhou
OBJECTIVE: The aim is to update our clinical recommendations for evidence-based language rehabilitation of people with aphasia, based on a systematic review of the literature from 1999 to 2015. DATA SOURCES: Articles referred to in this systematic review of the Medline and PubMed published in English language literatures were from 1998 to 2015. The terms used in the literature searches were aphasia and evidenced-based. STUDY SELECTION: The task force initially identified citations for 51 published articles...
June 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28557787/warfarin-personalized-dosage-re-compounding-for-a-more-suitable-therapy-and-better-compliance
#3
Tommaso Pellagatti, Marco Ternelli, Davide Frascio, Ruggero Bettini
Warfarin is still the most prescribed oral anticoagulant prescribed for the prophylaxis and treatment of thromboembolic events such as stroke, heart attack, embolism, and deep vein thrombosis. It is administered orally in the form of sodium salt as a tablet with a typical strength of 5 mg. The molecule has a narrow therapeutic index. As a consequence, the dosage must be individualized for each patient based on the patient response in terms of time of coagulation. Thus, warfarin represents an example of a drug whose dose needs to be tailored to individual requirements that are often changing and, therefore, constitute a paramount illustration of personalized medicine...
May 2017: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/28555527/mapping-the-collaterome-for-precision-cerebrovascular-health-theranostics-in-the-continuum-of-stroke-and-dementia
#4
David S Liebeskind
Precision cerebrovascular health or individualized long-term preservation of the brain and associated blood vessels, is predicated on understanding, diagnosing, and tailoring therapies for people at risk of ischemic injury associated with stroke and vascular dementia. The associated imaging patterns are sculpted by the protective effect of the collaterome, the innate compensatory ability of the brain and vasculature to offset hypoperfusion when antegrade or normal arterial inflow pathways are compromised. Theranostics or rational and synchronous use of diagnostic studies in tandem with specific therapies to optimally guide patient outcomes in ischemic brain disorders may capitalize on the pivotal role of the collaterome...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28548988/toward-precision-medicine-tailoring-interventional-strategies-based-on-noninvasive-brain-stimulation-for-motor-recovery-after-stroke
#5
Philipp J Koch, Friedhelm C Hummel
PURPOSE OF REVIEW: To support the recovery of disability and the reduced functional capacity influencing the independence of daily life after focal brain lesions like stroke, the application of noninvasive brain stimulation (NIBS) by repetitive transcranial magnetic stimulation or transcranial electric stimulation has been found useful in the last decades. Still, a positive influence on the recovery seems to be restricted to specific subgroups of patients. Therefore, a closer look on individual parameters influencing the recovery course and the effect of NIBS is needed...
May 25, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28345431/collaterals-2016-translating-the-collaterome-around-the-globe
#6
David S Liebeskind, Graham W Woolf, Ashfaq Shuaib
Collaterals 2016 (third International Symposium on Collaterals to the Brain) was a multidisciplinary scientific conference focused on collateral circulation in acute ischemic stroke. Decisive challenges include generalizability of optimal triage and selection paradigms based on collateral status for definitive treatment of acute ischemic stroke, rapid dissemination of expert methods, and the urgent need to leverage networking opportunities for stroke science related to the hemodynamics of collaterals. The collaterome, or individual capacity to offset ischemia in the brain, and determination of a favorable collateral profile have become pivotal factors in consideration of the precision medicine of stroke decision-making...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28337931/utilizing-nutritional-genomics-to-tailor-diets-for-the-prevention-of-cardiovascular-disease-a-guide-for-upcoming-studies-and-implementations
#7
REVIEW
Dolores Corella, Oscar Coltell, George Mattingley, José V Sorlí, Jose M Ordovas
Personalized diets based on an individual's genome to optimize the success of dietary intervention and reduce genetic cardiovascular disease (CVD) risk, is one of the challenges most frequently discussed in the scientific community. Areas covered: The authors gathered literature-based evidence on nutritional genomics and CVD phenotypes, our own results and research experience to provide a critical overview of the current situation of using nutritional genomics to tailor diets for CVD prevention and to propose guidelines for future studies and implementations...
May 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28236616/nuclear-factor-kb-and-inhibitor-of-kb-acupuncture-protection-against-acute-focal-cerebral-ischemia-in-rodents
#8
Wei Huang, Zhongyu Zhou, Bijiang Wan, Guang Chen, Jia Li
Context • Acute, focal, cerebral ischemic stroke is a leading cause of morbidity and mortality worldwide. Acupuncture is an emerging alternative therapy for treatment of acute brain ischemia. Nevertheless, the precise mechanism underlying the neuroprotective effects of acupuncture has not been elucidated. Nuclear factor κB (NF-κB) and nuclear factor of κ light polypeptide gene enhancer in B cell inhibitor alpha (IκB-α) are involved in cerebral inflammation. However, the involvement of NF-κB and IκB-α in the protective effects of acupuncture on ischemic tolerance remains unknown...
February 27, 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28207602/spreading-depolarization-monitoring-in-neurocritical-care-of-acute-brain-injury
#9
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...
April 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28102150/ultra-rare-genetic-variation-in-common-epilepsies-a-case-control-sequencing-study
#10
(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/28076681/computational-modeling-of-neurotransmitter-release-evoked-by-electrical-stimulation-nonlinear-approaches-to-predicting-stimulation-evoked-dopamine-release
#11
James K Trevathan, Ali Yousefi, Hyung Ook Park, John J Bartoletta, Kip A Ludwig, Kendall H Lee, J Luis Lujan
Neurochemical changes evoked by electrical stimulation of the nervous system have been linked to both therapeutic and undesired effects of neuromodulation therapies used to treat obsessive-compulsive disorder, depression, epilepsy, Parkinson's disease, stroke, hypertension, tinnitus, and many other indications. In fact, interest in better understanding the role of neurochemical signaling in neuromodulation therapies has been a focus of recent government- and industry-sponsored programs whose ultimate goal is to usher in an era of personalized medicine by creating neuromodulation therapies that respond to real-time changes in patient status...
February 15, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/27921034/crowdsourcing-precision-cerebrovascular-health-imaging-and-cloud-seeding-a-million-brains-initiative%C3%A2
#12
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
#13
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...
January 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27881558/the-american-heart-association-s-new-institute-for-precision-cardiovascular-medicine
#14
Steven R Houser
No abstract text is available yet for this article.
December 13, 2016: Circulation
https://www.readbyqxmd.com/read/27753828/sy-03-1-genetic-basis-of-blood-pressure-and-hypertension
#15
Anna Dominiczak
Human primary or essential hypertension is a complex, polygenic trait with some 50% contribution from genes and environment. Richard Lifton and colleagues provided elegant dissection of several rare Mendelian forms of hypertension, exemplified by the glucocorticoid remediable aldosteronism and Liddle's syndrome. These discoveries illustrate that a single gene mutation can explain the entire pathogenesis of severe, early onset hypertension as well as dictating the best treatment.The dissection of the much more common polygenic hypertension has proven much more difficult...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27726639/genetics-of-sickle-cell-associated-cardiovascular-disease-an-expert-review-with-lessons-learned-in-africa
#16
Amy Geard, Gift D Pule, David Chelo, Valentina Josiane Ngo Bitoungui, Ambroise Wonkam
Sickle cell disease (SCD) vastly impacts the African continent and is associated with cardiovascular diseases. Stroke, kidney disease, and pulmonary hypertension are considered as proxies of severity in SCD with several genomic loci implicated in their heritability. The present expert review examined the current data on epidemiology and genetic risk factors of stroke, pulmonary hypertension, and kidney disease associated with SCD, as indexed in PubMed(®) and Google Scholar(®). Studies collectively show that stroke and kidney disease each affect ∼10% of SCD patients, with pulmonary hypertension displaying a higher prevalence of 30% among adults with SCD...
October 2016: Omics: a Journal of Integrative Biology
https://www.readbyqxmd.com/read/27719649/precision-medicine-and-a-patient-orientated-approach-is-this-the-future-for-tracking-cardiovascular-disorders
#17
Etheresia Pretorius
The latest statistics from the 2016 heart disease and stroke statistics update shows that cardiovascular disease is the leading global cause of death, currently accounting for more than 17.3 million deaths per year. Type II diabetes is also on the rise with out-of-control numbers. To address these pandemics, we need to treat patients using an individualized patient care approach, but simultaneously gather data to support the precision medicine initiative. Last year the NIH announced the precision medicine initiative to generate novel knowledge regarding diseases, with a near-term focus on cancers, followed by a longer-term aim, applicable to a whole range of health applications and diseases...
2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27642881/sy-03-1-genetic-basis-of-blood-pressure-and-hypertension
#18
Anna Dominiczak
Human primary or essential hypertension is a complex, polygenic trait with some 50% contribution from genes and environment. Richard Lifton and colleagues provided elegant dissection of several rare Mendelian forms of hypertension, exemplified by the glucocorticoid remediable aldosteronism and Liddle's syndrome. These discoveries illustrate that a single gene mutation can explain the entire pathogenesis of severe, early onset hypertension as well as dictating the best treatment.The dissection of the much more common polygenic hypertension has proven much more difficult...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27591800/editorial-commentary-beyond-the-guidelines-to-expertise-in-precision-stroke-medicine
#19
EDITORIAL
David S Liebeskind
No abstract text is available yet for this article.
January 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27570664/exploring-gaps-of-family-history-documentation-in-ehr-for-precision-medicine-a-case-study-of-familial-hypercholesterolemia-ascertainment
#20
Saeed Mehrabi, Yanshan Wang, Donna Ihrke, Hongfang Liu
In the era of precision medicine, accurately identifying familial conditions is crucial for providing target treatment. However, it is challenging to identify familial conditions without detailed family history information. In this work, we studied the documentation of family history of premature cardiovascular disease and hypercholesterolemia. The information on patients' family history of stroke within the Patient-provided information (PPI) forms was compared with the information gathered by clinicians in clinical notes...
2016: AMIA Summits on Translational Science Proceedings
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