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stroke anemia adult

David Roshal
This case report describes a 41-year-old previously healthy male who presented with stuttering transient ischemic symptoms and radiographic evidence of a left common carotid artery thrombus as well as acute and subacute ischemic infarcts in the left middle cerebral artery territory. An exhaustive stroke work-up did not provide a plausible etiology for his symptoms. His complete blood count and iron studies, however, revealed evidence of severe iron-deficiency anemia without reactive thrombocytosis. His stool guaiac test was positive...
2016: Case Reports in Neurological Medicine
J Strouse
Sickle cell disease (SCD) is an inherited hemoglobinopathy caused by a mutation in the sixth amino acid of the β-globin gene (HBB). It is the most common serious genetic diseases in childhood, affecting approximately 1 in 2500 births and 100 000 individuals in the USA, in addition to 300 000 new cases globally each year. Central nervous system injury is the most debilitating frequent complication of SCD and includes stroke, silent cerebral infarct (SCI), and cognitive impairment. Among children with sickle cell anemia (HbSS), 11% had a stroke by age 18 years before the implementation of transcranial Doppler screening...
2016: Handbook of Clinical Neurology
Joakim Alfredsson, Karen P Alexander
Older adults presenting with acute coronary syndromes (ACSs) often have multiple chronic conditions (MCCs). In addition to traditional cardiovascular (CV) risk factors (ie, hypertension, hyperlipidemia, and diabetes), common CV comorbidities include heart failure, stroke, and atrial fibrillation, whereas prevalent non-CV comorbidities include chronic kidney disease, anemia, depression, and chronic obstructive pulmonary disease. The presence of MCCs affects the presentation (eg, increased frequency of type 2 myocardial infarctions [MIs]), clinical course, and prognosis of ACS in older adults...
May 2016: Clinics in Geriatric Medicine
Alex Soroceanu, Douglas C Burton, Jonathan H Oren, Justin S Smith, Richard Hostin, Christopher I Shaffrey, Behrooz A Akbarnia, Christopher P Ames, Thomas J Errico, Shay Bess, Munish C Gupta, Vedat Deviren, Frank J Schwab, Virginie Lafage
STUDY DESIGN: Retrospective review of a prospective multi-center database evaluating surgical ASD patients. OBJECTIVE: This study aims to identify risk factors for medical complications in ASD patients undergoing surgery SUMMARY OF BACKGROUND DATA.: Adult Spinal Deformity (ASD) surgery is known for its high complication rate. This study examines baseline patient characteristics for predictors of medical complications in surgical ASD patients. METHODS: Intra and perioperative medical complications were included...
April 19, 2016: Spine
Ben Schöttker, W Rathmann, C Herder, B Thorand, T Wilsgaard, I Njølstad, G Siganos, E B Mathiesen, K U Saum, A Peasey, E Feskens, P Boffetta, A Trichopoulou, K Kuulasmaa, F Kee, H Brenner
BACKGROUND: To determine the shape of the associations of HbA1c with mortality and cardiovascular outcomes in non-diabetic individuals and explore potential explanations. METHODS: The associations of HbA1c with all-cause mortality, cardiovascular mortality and primary cardiovascular events (myocardial infarction or stroke) were assessed in non-diabetic subjects ≥50 years from six population-based cohort studies from Europe and the USA and meta-analyzed. Very low, low, intermediate and increased HbA1c were defined as <5...
2016: BMC Medicine
Samuel Ademola Adegoke, Maria Stella Figueiredo, Perla Vicari, Henrique Carrete, Marcos Hideki Idagawa, Ayrton Roberto Massaro, Gisele Sampaio Silva
BACKGROUND: The role of transcranial Doppler (TCD) ultrasonography in identifying children with sickle cell anemia (SCA) at risk for stroke is well known; however, the major studies that evaluated TCD velocities in children with SCA did not report posterior circulation evaluation data. The objective of our study was to describe the pattern of blood flow velocities in the posterior circulation of patients with SCA and to examine their relationship with findings on magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA)...
March 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Michael R DeBaun, Fenella J Kirkham
With advances in brain imaging and completion of randomized clinical trials (RCTs) for primary and secondary stroke prevention, the natural history of central nervous system (CNS) complications in sickle cell disease (SCD) is evolving. In order of current prevalence, the primary CNS complications include silent cerebral infarcts (39% by 18 years), headache (both acute and chronic: 36% in children with sickle cell anemia [SCA]), ischemic stroke (as low as 1% in children with SCA with effective screening and prophylaxis, but ∼11% in children with SCA without screening), and hemorrhagic stroke in children and adults with SCA (3% and 10%, respectively)...
February 18, 2016: Blood
Pranav S Garimella, Ronit Katz, Kushang V Patel, Stephen B Kritchevsky, Chirag R Parikh, Joachim H Ix, Linda F Fried, Anne B Newman, Michael G Shlipak, Tamara B Harris, Mark J Sarnak
BACKGROUND: Studies suggest that in patients with heart failure (HF), high serum erythropoietin is associated with risk of recurrent HF and mortality. Trials of erythropoietin-stimulating agents in persons with kidney disease have also suggested an increased incidence of adverse clinical events. No large studies of which we are aware have evaluated the association of endogenous erythropoietin levels with clinical outcomes in the community-living older adults. METHODS AND RESULTS: Erythropoietin concentration was measured in 2488 participants aged 70-79 years in the Health, Aging and Body Composition Study...
January 2016: Circulation. Heart Failure
Andreas Lammerich, Peter Balcke, Peter Bias, Simone Mangold, Martin Wiesholzer
PURPOSE: The European Medicines Agency recommends limiting the hemoglobin (Hb) concentration to 10 to 12 g/dL in adults with chronic kidney disease (CKD) receiving erythropoiesis-stimulating agents such as epoetin theta. This postauthorization study assessed the incidence and intensity of cardiovascular events, including ischemic stroke, in patients receiving epoetin theta for anemia associated with CKD. A secondary end point was adverse drug reactions, including pure red cell aplasia...
February 2016: Clinical Therapeutics
Alan D Moore, Peggy A Lynn, Alan H Feiveson
INTRODUCTION: Aerobic deconditioning may occur during International Space Station (ISS) flights. This paper documents findings from exercise testing conducted before, during, and after ISS expeditions. METHODS: There were 30 male and 7 female astronauts on ISS missions (48 to 219 d, mean 163 d) who performed cycle exercise protocols consisting of 5-min stages eliciting 25%, 50%, and 75% peak oxygen uptake (Vo(2peak)). Tests were conducted 30 to 90 d before missions, on flight day 15 and every 30 flight days thereafter, and on recovery (R) days +5 and +30...
December 2015: Aerospace Medicine and Human Performance
Joseph F McLaughlin, Samir K Ballas
BACKGROUND: Chronic blood transfusion is the standard of care in the management of overt stroke due to sickle cell anemia (SS) to prevent recurrence of stroke. The problem arises when children are transitioned to adult care where blood transfusion may be discontinued. The purpose of this study was to report the outcome of 22 patients with SS and overt stroke who were transitioned to our adult program between 1993 and 2009. STUDY DESIGN AND METHODS: Transitioned patients were kept on chronic blood transfusion they had as children...
May 2016: Transfusion
Natalie B Stollon, Christine W Paine, Matthew S Lucas, Lauren D Brumley, Erika S Poole, Tamara Peyton, Anne W Grant, Sophia Jan, Symme Trachtenberg, Miriam Zander, Christopher P Bonafide, Lisa A Schwartz
The transition from pediatric to adult health care is often challenging for adolescents and young adults with sickle cell disease (SCD). Our study aimed to identify (1) measures of success for the transition to adult health care; and (2) barriers and facilitators to this process. We interviewed 13 SCD experts and asked them about their experiences caring for adolescents and young adults with SCD. Our interview guide was developed based on Social-Ecological Model of Adolescent and Young Adult Readiness to Transition framework, and interviews were coded using the constant comparative method...
November 2015: Journal of Pediatric Hematology/oncology
M Ramirez-Lassepas, B K Patrick
Because information regarding cerebrospinal fluid (CSF) cellular response in acute ischemic stroke (AIS) is inconclusive, we conducted the following investigation. Cell counts were performed in CSF obtained within 24 h of onset of symptoms in 118 adult patients 86 years or younger with uncomplicated AIS, after hemorrhage and mass effect were ruled out by computed tomography. In 98, CSF examination was repeated on day 7. None of the patients had evidence for systemic infection, inflammatory disease, vasculitis, leukocytosis, anemia or coagulopathy...
1992: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Steven K Feske, Marcia Goldberg, David M Dudzinski, Ramon Gilberto Gonzalez, Alexandra E Kovach
Presentation of Case. Dr. Blair Wylie (Obstetrics and Gynecology): A 38-year-old pregnant woman (gravida 2, para 0) was admitted to this hospital at 33 weeks 3 days of gestation because of headache and visual symptoms. The patient had been in her usual health until 2 weeks before admission, when..
September 17, 2015: New England Journal of Medicine
Christopher Babua, Robert Kalyesubula, Emmy Okello, Barbara Kakande, Erias Sebatta, Michael Mungoma, Charles Mondo
BACKGROUND: Chronic kidney disease is a risk factor for development of cardiovascular diseases. Cardiovascular diseases are the primary cause of morbidity and mortality in patients with chronic kidney disease. There is limited data on cardiovascular diseases among chronic kidney disease patients in resource limited settings including Uganda. We determined the prevalence and patterns of cardiac diseases among patients with chronic kidney disease attending the nephrology outpatient clinic in Mulago National Referral Hospital in Uganda...
2015: BMC Nephrology
Sreejesh Sreedharanunni, Man Updesh Singh Sachdeva, Parveen Bose, Neelam Varma, Deepak Bansal, Amita Trehan
BACKGROUND: The literature on paroxysmal nocturnal hemoglobinuria (PNH) in aplastic anemia (AA) is largely focused on adults with few studies in children. Moreover, large studies are conspicuously absent from developing countries. Knowledge of the prevalence and utility of their detection is required before widespread use of PNH screening in pediatric AA in resource-limited settings. METHODS: We performed a retrospective audit over a period of 9 years to study the prevalence of PNH clones by flow cytometry (FCM) in children ≤12 years of age presenting with AA, and analyzed their response to immunosuppressant therapy...
January 2016: Pediatric Blood & Cancer
David Calvet, Françoise Bernaudin, Antoine Gueguen, Hassan Hosseini, Anoosha Habibi, Frédéric Galactéros, Pablo Bartolucci
BACKGROUND AND PURPOSE: There is little evidence about characteristics of ischemic stroke (IS) occurring in adults with sickle-cell disease (SCD). The objective of this study was to assess characteristics of first-ever IS in adults with SCD and to assess whether they differ from those occurring in child patients with SCD. METHODS: Adult and child individuals with SCD who had a first-ever IS were identified from cohorts of patients followed up in an adult and a child sickle cell referral center...
August 2015: Stroke; a Journal of Cerebral Circulation
Adnan I Qureshi, Ahmed A Malik, Malik M Adil, M Fareed K Suri
OBJECTIVE: Oral contraceptives increase the risk of ischemic stroke among women. However, the effect is not studied in the stroke prone sickle cell disease (SCD) population. We want to determine the rate of incident stroke among women with SCD enrolled in a large cohort with longitudinal follow-up. STUDY DESIGN: A total of 1257 women aged ≥15 and <45years, enrolled in Phase 1 of Cooperative Study of SCD, underwent a baseline examination for assessment of demographics, prior medical history, laboratory assessments, and clinical data...
August 2015: Thrombosis Research
Regina A Abel, Esther Cho, Kelley R Chadwick-Mansker, Natalia D'Souza, Ashley J Housten, Allison A King
OBJECTIVE: This article describes how adolescents with sickle cell disease (SCD) perceive their ability to perform everyday tasks required for transition to adult health care and independent living. METHOD: The Adolescent Autonomy Checklist (AAC) was adapted to include skills associated with managing SCD (AAC-SCD) and was administered to adolescents during clinic visits. Participants indicated "can do already" or "needs practice" for 100 activities in 12 categories...
March 2015: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
Daisuke Yoshioka, Koichi Toda, Shuhei Okazaki, Taichi Sakaguchi, Shigeru Miyagawa, Yasushi Yoshikawa, Yoshiki Sawa
BACKGROUND: Infective endocarditis is often associated with cerebral complications, the most serious of which is intraoperative hemorrhagic stroke owing to anticoagulation for cardiopulmonary bypass. However, its prevalence and risk factors are unknown. We evaluated the prevalence and risk factors of intraoperative hemorrhagic stroke in patients with infective endocarditis. METHODS: In 246 patients who underwent valve surgery for active endocarditis between 2005 and 2012, 127 patients had both preoperative and postoperative intracranial neuroimaging...
July 2015: Annals of Thoracic Surgery
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