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https://www.readbyqxmd.com/read/29778671/international-study-of-comparative-health-effectiveness-with-medical-and-invasive-approaches-ischemia-trial-rationale-and-design
#1
David J Maron, Judith S Hochman, Sean M O'Brien, Harmony R Reynolds, William E Boden, Gregg W Stone, Sripal Bangalore, John A Spertus, Daniel B Mark, Karen P Alexander, Leslee Shaw, Jeffrey S Berger, T Bruce Ferguson, David O Williams, Robert A Harrington, Yves Rosenberg
BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only included participants in whom coronary anatomy was known prior to randomization and did not include sufficient numbers of participants with significant ischemia. It remains unknown whether a routine invasive approach offers incremental value over a conservative approach with catheterization reserved for failure of medical therapy in patients with moderate or severe ischemia...
April 21, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29777579/acute-blood-pressure-levels-and-long-term-outcome-in-ischemic-stroke
#2
Johan-Emil Bager, Clara Hjalmarsson, Karin Manhem, Bjorn Andersson
OBJECTIVES: Elevated blood pressure (BP) is common in acute ischemic stroke, but its effect on outcome is not fully understood. We aimed to investigate the association of baseline BP and BP change within the first day after stroke with stroke severity, functional outcome, and mortality. METHODS: Patients admitted to hospital with acute ischemic stroke (IS) from 15 February 2005 through 31 May 2009 were consecutively included. Acute stroke severity and functional outcome at three and twelve months were investigated using multivariate regression analysis; the association between BP and all-cause mortality at one, three, and twelve was investigated by Cox proportional hazard regression and Kaplan-Meier survival curves...
May 18, 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29777308/theoretical-analysis-of-evaporative-cooling-of-classic-heat-stroke-patients
#3
Abdulaziz H Alzeer, E H Wissler
Heat stroke is a serious health concern globally, which is associated with high mortality. Newer treatments must be designed to improve outcomes. The aim of this study is to evaluate the effect of variations in ambient temperature and wind speed on the rate of cooling in a simulated heat stroke subject using the dynamic model of Wissler. We assume that a 60-year-old 70-kg female suffers classic heat stroke after walking fully exposed to the sun for 4 h while the ambient temperature is 40 °C, relative humidity is 20%, and wind speed is 2...
May 18, 2018: International Journal of Biometeorology
https://www.readbyqxmd.com/read/29776835/the-combination-of-mannitol-and-temozolomide-increases-the-effectiveness-of-stem-cell-treatment-in-a-chronic-stroke-model
#4
Chunggab Choi, Hye Min Kim, Jeeheun Shon, Jiae Park, Hyeong-Taek Kim, Suk Ho Kang, Seung-Hun Oh, Nam Keun Kim, Ok Joon Kim
BACKGROUND: The blood-brain barrier (BBB) presents a significant challenge to the therapeutic efficacy of stem cells in chronic stroke. Various methods have been developed to increase BBB permeability, but these are associated with adverse effects and are, therefore, not clinically applicable. We recently identified that combination drug treatment of mannitol and temozolomide improved BBB permeability in vitro. Here, we investigated whether this combination could increase the effectiveness of stem cell treatment in an animal model of chronic ischemic stroke...
May 15, 2018: Cytotherapy
https://www.readbyqxmd.com/read/29776451/myeloid-specific-tak1-deletion-results-in-reduced-brain-monocyte-infiltration-and-improved-outcomes-after-stroke
#5
Anjali Chauhan, Jacob Hudobenko, Abdullah Al Mamun, Edward C Koellhoffer, Anthony Patrizz, Rodney M Ritzel, Bhanu P Ganesh, Louise D McCullough
BACKGROUND: Activation of transforming growth factor-β-activated kinase 1 (TAK1) occurs after stroke and leads to an exacerbation of brain injury. TAK1 is involved in innate and adaptive immune responses, but it has divergent inflammatory effects that are dependent on the cell type in which it is activated. There is a robust infiltration of myeloid cells after stroke; however, the contribution of myeloid TAK1 to cerebral ischemia is currently unknown. We hypothesized that myeloid-specific deletion of TAK1 would protect against ischemic brain injury...
May 17, 2018: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29775963/brain-ischemic-preconditioning-protects-against-ischemic-injury-and-preserves-the-blood-brain-barrier-via-oxidative-signaling-and-nrf2-activation
#6
Tuo Yang, Yang Sun, Leilei Mao, Meijuan Zhang, Qianqian Li, Lili Zhang, Yejie Shi, Rehana K Leak, Jun Chen, Feng Zhang
Brain ischemic preconditioning (IPC) with mild ischemic episodes is well known to protect the brain against subsequent ischemic challenges. However, the underlying mechanisms are poorly understood. Here we demonstrate the critical role of the master redox transcription factor, nuclear factor (erythroid-derived 2)-like 2 (Nrf2), in IPC-mediated neuroprotection and blood-brain barrier (BBB) preservation. We report that IPC causes generation of endogenous lipid electrophiles, including 4-hydroxy-2-nonenal (4-HNE), which release Nrf2 from inhibition by Keap1 (via Keap1-C288) and inhibition by glycogen synthase kinase 3β (via GSK3β-C199)...
May 6, 2018: Redox Biology
https://www.readbyqxmd.com/read/29775202/the-development-of-an-in-vitro-assay-for-the-prospective-determination-of-aspirin-sensitivity
#7
Erica S Westphal, Caitlin Wisniewski, Michelle Rainka, Nicholas M Smith, Vernice Bates, Fran M Gengo
Aspirin remains the standard for stroke prophylaxis. However, as many as 20%-25% of patients may fail to show a full response to aspirin. Ideally, patients who are resistant to aspirin could be identified, then receive an increased dose of aspirin or be changed to an alternative therapy more efficiently. We have developed an in vitro assay that may make this possible. Healthy volunteers (n = 13) between 18 and 50 years of age were tested for both ex vivo and in vivo responses to aspirin. Dimethyl sulfoxide (DMSO) was selected as the solvent for aspirin in the assay...
May 18, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29775153/feasibility-safety-and-changes-in-systolic-blood-pressure-associated-with-endovascular-revascularization-of-symptomatic-and-chronically-occluded-cervical-internal-carotid-artery-using-a-newly-suggested-radiographic-classification-of-chronically-occluded-cervical
#8
David Hasan, Mario Zanaty, Robert M Starke, Elias Atallah, Nohra Chalouhi, Pascal Jabbour, Amit Singla, Waldo R Guerrero, Daichi Nakagawa, Edgar A Samaniego, Nnenna Mbabuike, Rabih G Tawk, Adnan H Siddiqui, Elad I Levy, Roberta L Novakovic, Jonathan White, Clemens M Schirmer, Thomas G Brott, Hussain Shallwani, L Nelson Hopkins
OBJECTIVE The overall risk of ischemic stroke from a chronically occluded internal carotid artery (COICA) is around 5%-7% per year despite receiving the best available medical therapy. Here, authors propose a radiographic classification of COICA that can be used as a guide to determine the technical success and safety of endovascular recanalization for symptomatic COICA and to assess the changes in systemic blood pressure following successful revascularization. METHODS The radiographic images of 100 consecutive subjects with COICA were analyzed...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29775142/aspirin-for-primary-prevention-of-stroke-in-traumatic-cerebrovascular-injury-association-with-increased-risk-of-transfusion
#9
Russell L Griffin, Stephanie R Falatko, Stella Aslibekyan, Virginia Strickland, Mark R Harrigan
OBJECTIVE Blunt traumatic extracranial carotid or vertebral artery injury (i.e., traumatic cerebrovascular injury [TCVI]) occurs in 1%-2% of all blunt trauma admissions, carries a 10% risk of thromboembolic ischemic stroke, and accounts for up to 9600 strokes annually in the US. Screening CT angiograms (CTAs) of patients with trauma has become ubiquitous in recent years, and patients with initially asymptomatic TCVI are commonly treated with antiplatelet agents to prevent stroke. Prophylaxis with antiplatelets is thought to be safer than anticoagulation, which carries a significant risk of hemorrhage in patients with trauma...
May 18, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29774601/the-impact-of-mitral-stenosis-on-outcomes-of-aortic-valve-stenosis-patient-undergoing-surgical-aortic-valve-replacement-or-transcatheter-aortic-valve-replacement
#10
Yasser Al-Khadra, Fahed Darmoch, Motaz Baibars, Amir Kaki, Zaher Fanari, M Chadi Alraies
BACKGROUND: The concomitant presence of mitral stenosis (MS) in the setting of symptomatic aortic stenosis represent a clinical challenge. Little is known regarding the outcome of mitral stenosis (MS) patients undergoing transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). Therefore, we sought to study the outcome of MS patients undergoing aortic valve replacement (AVR). METHOD: Using weighted data from the National Inpatient Sample (NIS) database between 2011 and 2014, we identified patients who were diagnosed with MS...
May 17, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29774429/the-utility-of-superb-microvascular-imaging-for-the-detection-of-deep-vein-thrombosis
#11
Yuta Hagiwara, Rie Sasaki, Takahiro Shimizu, Kaima Soga, Chihiro Hatada, Motoki Miyauchi, Takanori Okamura, Masaru Sakurai, Hisanao Akiyama, Yasuhiro Hasegawa
Superb microvascular imaging (SMI) reduces motion artifacts significantly and allows visualization of low-velocity blood flow in vessels; thus, thrombi are clearly demonstrated compared to conventional B-mode and color Doppler imaging. Ultrasonographic images of the lower extremities of a 69-year-old woman with acute ischemic stroke complicated with deep vein thrombosis (DVT) are presented. Because SMI allows visualization of low-velocity blood flow, echo contrast between the thrombus and the surrounding flow makes it possible to clearly visualize the thrombus...
May 17, 2018: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/29774174/outpatient-interventions-that-may-enhance-the-care-of-a-patient-with-co-existing-moyamoya-and-down-syndromes
#12
Anita Lwanga, Waldo Herrera, Katya Cruz Madrid, Antony Irungu
Moyamoya vasculopathy is a condition of chronic, progressive occlusion of the distal internal carotid arteries and the Circle of Willis. The resultant ischemia produces compensatory angiogenesis and the growth of a network of collateral blood vessels, which on angiography resemble a "puff of smoke" or "moyamoya" in Japanese. The objective of this case report is to describe the clinical course of a patient with Down and moyamoya syndromes and to enlighten clinicians about strategies that can be taken to enhance the care of similar patients...
March 16, 2018: Curēus
https://www.readbyqxmd.com/read/29773577/determinants-and-outcomes-of-vasoplegia-following-left-ventricular-assist-device-implantation
#13
Kristen M Tecson, Brian Lima, Andy Y Lee, Fayez S Raza, Grace Ching, Cheng-Han Lee, Joost Felius, Ronald D Baxter, Sasha Still, Justin D G Collier, Shelley A Hall, Susan M Joseph
BACKGROUND: Vasoplegia is associated with adverse outcomes following cardiac surgery; however, its impact following left ventricular assist device implantation is largely unexplored. METHODS AND RESULTS: In 252 consecutive patients receiving a left ventricular assist device, vasoplegia was defined as the occurrence of normal cardiac function and index but with the need for intravenous vasopressors within 48 hours following surgery for >24 hours to maintain a mean arterial pressure >70 mm Hg...
May 17, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29773175/blood-lead-and-cadmium-in-age-related-macular-degeneration-in-a-turkish-urban-population
#14
Elif Damar Güngör, Fatma Yülek, Utku Serkant, Yasin Toklu, Asım Hocaoğlu, Şaban Şimsek
PURPOSE: To evaluate the blood lead (Pb) and cadmium (Cd) levels in age related macular degeneration (AMD) in a turkish urban population. METHODS: Blood Pb and Cd levels of 31 AMD patients and 24 age and gender matched controls with no sign of AMD were measured using dual atomic absorption spectrophotometer system (AAS). History of hypertension, diabetes mellitus, cigarette smoking, myocardial infarction and stroke were obtained from all subjects. Degree of AMD was grade 4 according to the Age-Related Eye Disease Study grading system...
July 2018: Journal of Trace Elements in Medicine and Biology
https://www.readbyqxmd.com/read/29773120/age-specific-association-between-blood-pressure-and-vascular-and-non-vascular-chronic-diseases-in-0%C3%A2-5-million-adults-in-china-a-prospective-cohort-study
#15
Ben Lacey, Sarah Lewington, Robert Clarke, Xiang Ling Kong, Yiping Chen, Yu Guo, Ling Yang, Derrick Bennett, Fiona Bragg, Zheng Bian, Shaojie Wang, Hua Zhang, Junshi Chen, Robin G Walters, Rory Collins, Richard Peto, Liming Li, Zhengming Chen
BACKGROUND: The age-specific association between blood pressure and vascular disease has been studied mostly in high-income countries, and before the widespread use of brain imaging for diagnosis of the main stroke types (ischaemic stroke and intracerebral haemorrhage). We aimed to investigate this relationship among adults in China. METHODS: 512 891 adults (59% women) aged 30-79 years were recruited into a prospective study from ten areas of China between June 25, 2004, and July 15, 2008...
June 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29773119/adiposity-and-risk-of-ischaemic-and-haemorrhagic-stroke-in-0%C3%A2-5-million-chinese-men-and-women-a-prospective-cohort-study
#16
Zhengming Chen, Andri Iona, Sarah Parish, Yiping Chen, Yu Guo, Fiona Bragg, Ling Yang, Zheng Bian, Michael V Holmes, Sarah Lewington, Ben Lacey, Ruqin Gao, Fang Liu, Zengzhi Zhang, Junshi Chen, Robin G Walters, Rory Collins, Robert Clarke, Richard Peto, Liming Li
BACKGROUND: China has high stroke rates despite the population being relatively lean. Uncertainty persists about the relevance of adiposity to risk of stroke types. We aimed to assess the associations of adiposity with incidence of stroke types and effect mediation by blood pressure in Chinese men and women. METHODS: The China Kadoorie Biobank enrolled 512 891 adults aged 30-79 years from ten areas (five urban and five rural) during 2004-08. During a median 9 years (IQR 8-10) of follow-up, 32 448 strokes (about 90% confirmed by neuroimaging) were recorded among 489 301 participants without previous cardiovascular disease...
June 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29772467/yawning-and-cortisol-levels-in-multiple-sclerosis-potential-new-diagnostic-tool
#17
Simon B N Thompson, Alister Coleman, Nicola Williams
Yawning is a significant behavioural response and, together with cortisol, is potentially a new diagnostic marker of neurological diseases. Evidence of an association between yawning and cortisol was found which supports the Thompson Cortisol Hypothesis and thermoregulation hypotheses, indication that brain cooling occurs when yawning. 117 volunteers aged 18-69 years were randomly allocated to experimentally controlled conditions to provoke yawning. Thirty-three had been diagnosed with multiple sclerosis. Saliva cortisol samples were collected before and after yawning or after stimuli presentation in the absence of yawning...
May 2, 2018: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29772078/evaluating-blood-clot-progression-using-magnetic-particle-spectroscopy
#18
Hafsa Khurshid, Yipeng Shi, Brent L Berwin, John B Weaver
PURPOSE: To evaluate the thrombus maturity non-invasively providing the promise of much earlier and more accurate diagnosis of diseases ranging from stroke to myocardial infarction to deep vein thrombosis. METHODS: Magnetic spectroscopy of nanoparticle Brownian rotation (MSB), a form of magnetic particle spectroscopy sensitive to Brownian rotation of magnetic nanoparticles, was used for the detection and characterization of blood clots. The nanoparticles' relaxation time was quantified by scaling the MSB spectra in frequency to match the spectra from nanoparticles in a reference state...
May 17, 2018: Medical Physics
https://www.readbyqxmd.com/read/29771897/is-general-practice-identification-of-prior-cardiovascular-disease-at-the-time-of-cvd-risk-assessment-accurate-and-does-it-matter
#19
Sue Wells, Katrina Poppe, Vanessa Selak, Andrew Kerr, Romana Pylypchuk, Billy Wu, Wing Cheuk Chan, Corina Grey, Suneela Mehta, Dudley Gr Gentles, Rod Jackson
AIMS: To determine the accuracy of general practice recording of prior cardiovascular disease (CVD) at the time of CVD risk assessment and whether recording impacts on CVD management. METHODS: Prior CVD status entered at the time of a first CVD risk assessment from 2002-2015 was compared to prior ischaemic CVD hospitalisations from national datasets using anonymous linkage with an encrypted National Health Index identifier. Clinical factors associated with inaccurate recording of prior events were identified using multivariable logistic regression...
May 18, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29770166/free-radical-damage-in-ischemia-reperfusion-injury-an-obstacle-in-acute-ischemic-stroke-after-revascularization-therapy
#20
REVIEW
Ming-Shuo Sun, Hang Jin, Xin Sun, Shuo Huang, Fu-Liang Zhang, Zhen-Ni Guo, Yi Yang
Acute ischemic stroke is a common cause of morbidity and mortality worldwide. Thrombolysis with recombinant tissue plasminogen activator and endovascular thrombectomy are the main revascularization therapies for acute ischemic stroke. However, ischemia-reperfusion injury after revascularization therapy can result in worsening outcomes. Among all possible pathological mechanisms of ischemia-reperfusion injury, free radical damage (mainly oxidative/nitrosative stress injury) has been found to play a key role in the process...
2018: Oxidative Medicine and Cellular Longevity
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