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https://www.readbyqxmd.com/read/29791706/use-of-a-noblestitch%C3%A2-el-device-for-pfo-closure
#1
Emanuela de Cillis, Tommaso Acquaviva, Pasquale D'Alessandro, Alessandro Santo Bortone
Cryptogenic stroke is the final diagnosis in almost 40% of ischemic acute cerebrovascular events. There is currently no definitive clinical evidence that percutaneous closure of patent foramen ovale (PFO) can prevent the recurrence of stroke or transient ischemic attack (TIA). Identification of the causes of neurologic ischemic syndromes is essential for any strategy intended to prevent the catastrophic consequences of cerebral infarction. Since the initial reports of an unexpectedly high prevalence of PFO in younger patients with cryptogenic stroke in 1988, there has been growing interest and experience in diagnosing and treating these patients, both medically and/or with percutaneous closure, in particular for the potential to eliminate paradoxical embolism via PFO, which is a likely mechanism for stroke in these patients...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29790365/non-vitamin-k-antagonist-oral-anticoagulants-in-atrial-fibrillation-patients-with-bioprosthetic-valves
#2
Jason G Andrade, Elena Meseguer, Romain Didier, Charles Dussault, Jeffrey I Weitz
The non-vitamin K antagonist oral anticoagulants (NOACs), which include dabigatran, apixaban, edoxaban and rivaroxaban, are preferred over vitamin K antagonists for stoke prevention in most patients with non-valvular atrial fibrillation. The NOACs are contraindicated in atrial fibrillation patients with rheumatic mitral stenosis or mechanical heart valves. There is evidence that bioprosthetic heart valves are less thrombogenic than mechanical heart valves, but it is unknown whether the risk of thromboembolism in atrial fibrillation patients with bioprosthetic valves differs from that in patients without such valves...
May 23, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29789335/prediction-of-thrombotic-and-bleeding-events-after-percutaneous-coronary-intervention-credo-kyoto-thrombotic-and-bleeding-risk-scores
#3
Masahiro Natsuaki, Takeshi Morimoto, Kyohei Yamaji, Hirotoshi Watanabe, Yusuke Yoshikawa, Hiroki Shiomi, Yoshihisa Nakagawa, Yutaka Furukawa, Kazushige Kadota, Kenji Ando, Takashi Akasaka, Keiichi Igarashi Hanaoka, Ken Kozuma, Kengo Tanabe, Yoshihiro Morino, Toshiya Muramatsu, Takeshi Kimura
BACKGROUND: Prediction of thrombotic and bleeding risk is important to optimize antithrombotic therapy after percutaneous coronary intervention. METHODS AND RESULTS: We developed the prediction rules for thrombotic and bleeding events separately in Japanese patients. Derivation and validation cohorts consisted of 4778 patients from CREDO-Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) registry cohort 2 and 4669 patients from RESET (Randomized Evaluation of Sirolimus-Eluting Versus Everolimus-Eluting Stent Trial) and NEXT (Nobori Biolimus-Eluting Versus Xience/Promus Everolimus-Eluting Stent Trial)...
May 22, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29788298/cardiac-diagnostic-work-up-of-ischaemic-stroke
#4
Hayang Yang, Martina Nassif, Paul Khairy, Joris R de Groot, Yvo B W E M Roos, Robbert J de Winter, Barbara J M Mulder, Berto J Bouma
Cardioembolic sources account for 20-30% of ischaemic strokes and are important to identify considering their prognostic and therapeutic implications. During the past years, new developments have been made in the cardiac diagnostic evaluation and management of patients with ischaemic stroke, especially regarding strokes of unknown aetiology. These recent advances have had a major impact on our understanding of embolic strokes, their diagnostic work-up, and clinical management. Herein, we propose a cardiac diagnostic work-up scheme for patients with ischaemic stroke from definite cardioembolic sources and embolic strokes of undetermined source...
May 21, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29786577/post-stroke-fatigue-and-its-dimensions-over-the-second-half-year-after-stroke
#5
Mykhaylo Y Delva, Iryna I Delva, Nataliya V Lytvynenko
OBJECTIVE: Introduction: Post-stroke fatigue (PSF) is a common and often debilitating sequel of both ischemic and hemorrhagic strokes. The aim: Assess the rates and intensities of PSF over the second half year after stroke. PATIENTS AND METHODS: Materials and methods: There were examined 128 patients at 6, 9 and 12 months after ischemic or hemorrhagic stroke onset. PSF was measured by fatigue assessment scale (FAS), multidimensional fatigue inventory-20 (MFI-20) and fatigue severity scale (FSS)...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29779884/smash-u-versus-h-atomic-a-head-to-head-comparison-for-the-etiologic-classification-of-intracerebral-hemorrhage
#6
Joan Martí-Fàbregas, Luis Prats-Sánchez, Daniel Guisado-Alonso, Alejandro Martínez-Domeño, Raquel Delgado-Mederos, Pol Camps-Renom
BACKGROUND: There is no agreement for the etiologic classification of patients with intracerebral hemorrhage (ICH). In a series of patients with ICH, we performed a randomized head-to-head comparison between the two recently proposed etiologic classification systems. METHODS: We evaluated patients registered in a prospective database of consecutive patients. A simplified H-ATOMIC classification defines 8 categories: hypertension, amyloid, tumor, oral anticoagulants, malformation, infrequent, cryptogenic, and combination...
May 17, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29778365/cerebral-microbleeds-and-intracranial-haemorrhage-risk-in-patients-anticoagulated-for-atrial-fibrillation-after-acute-ischaemic-stroke-or-transient-ischaemic-attack-cromis-2-a-multicentre-observational-cohort-study
#7
Duncan Wilson, Gareth Ambler, Clare Shakeshaft, Martin M Brown, Andreas Charidimou, Rustam Al-Shahi Salman, Gregory Y H Lip, Hannah Cohen, Gargi Banerjee, Henry Houlden, Mark J White, Tarek A Yousry, Kirsty Harkness, Enrico Flossmann, Nigel Smyth, Louise J Shaw, Elizabeth Warburton, Keith W Muir, Hans Rolf Jäger, David J Werring
BACKGROUND: Cerebral microbleeds are a potential neuroimaging biomarker of cerebral small vessel diseases that are prone to intracranial bleeding. We aimed to determine whether presence of cerebral microbleeds can identify patients at high risk of symptomatic intracranial haemorrhage when anticoagulated for atrial fibrillation after recent ischaemic stroke or transient ischaemic attack. METHODS: Our observational, multicentre, prospective inception cohort study recruited adults aged 18 years or older from 79 hospitals in the UK and one in the Netherlands with atrial fibrillation and recent acute ischaemic stroke or transient ischaemic attack, treated with a vitamin K antagonist or direct oral anticoagulant, and followed up for 24 months using general practitioner and patient postal questionnaires, telephone interviews, hospital visits, and National Health Service digital data on hospital admissions or death...
June 2018: Lancet Neurology
https://www.readbyqxmd.com/read/29778315/the-risk-of-hemorrhagic-transformation-after-thrombolysis-for-acute-ischemic-stroke-in-chinese-versus-north-americans-a-comparative-study
#8
Xiaomeng Xu, Deren Wang, Fang Wang, Casey Norton, Xinfeng Liu, Magdy Selim
BACKGROUND: There is a widespread belief that Asians are more susceptible to hemorrhagic transformation (HT) after receiving recombinant tissue-type plasminogen activator (rt-PA) for acute ischemic stroke (AIS). However, this has not been examined in clinical practice. This study aims to compare the incidence of symptomatic hemorrhagic transformation (SHT) among thrombolysis-treated AIS patients in China and in the United States. METHODS: We compared 212 consecutive patients receiving thrombolysis within 4...
May 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29775421/probability-of-heat-intolerance-standardized-interpretation-of-heat-tolerance-testing-results-versus-specialist-judgment
#9
Haggai Schermann, Erin Craig, Einat Yanovich, Itay Ketko, Gary Kalmanovich, Ran Yanovich
CONTEXT:   The heat-tolerance test (HTT) is a screening tool for secondary prevention of exertional heat illness by the Israel Defense Forces. To discern participant tolerance, recruits are exposed to intermediate environmental and exercise stresses, and their physiological responses, core temperature, and heart rate are monitored. When their physiological measures rise at a higher rate or exceed the upper levels of absolute values compared with other participants, heat intolerance (HI) is diagnosed...
April 2018: Journal of Athletic Training
https://www.readbyqxmd.com/read/29773497/indications-for-red-cell-transfusions-in-pediatric-patients
#10
REVIEW
Jill M Cholette, Suzie A Noronha, Jerard Seghatchian, Neil Blumberg
Red cell transfusions are amongst the most common therapeutic procedures in seriously ill children, particularly in the inpatient setting. This is despite the fact that there is no evidence base for most clinical settings, with the exception of patients with hemoglobinopathies, particularly thalassemia and sickle cell anemia. Obviously exsanguinating hemorrhage and life threatening anemia are urgent indications for which no other therapeutic approach is currently available. Most transfusions are, however, given prophylactically to prevent the complications of hypoxia or hemodynamic stability, based upon expert opinion and a faith in the oxygen carrying capacity and beneficial hemodynamic properties of transfused red cells...
May 10, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29773445/transcatheter-aortic-valve-insertion-in-patients-with-hostile-ascending-aorta-calcification
#11
Akio Nakasu, Kevin L Greason, Vuyisile T Nkomo, Mackram F Eleid, Alberto Pochettino, Katherine S King, Gurpreet S Sandhu, Eric E Williamson, David R Holmes
OBJECTIVE: Calcification of the ascending aorta complicates aortic valve replacement. Transcatheter aortic valve replacement is an alternative procedure in this situation, but it requires manipulation through the hostile area in the ascending aorta. We reviewed our transcatheter aortic valve insertion experience to better understand the surgical mortality risk of valve insertion in patients with extensive calcification of the ascending aorta. METHODS: We retrospectively reviewed the records of 665 consecutive patients who received transcatheter aortic valve insertion from November 2008 through December 2015...
April 7, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29769167/impact-of-sex-on-comparative-outcomes-of-bivalirudin-versus-unfractionated-heparin-in-patients-with-acute-coronary-syndromes-undergoing-invasive-management-a-pre-specified-analysis-of-the-matrix-trial
#12
Giuseppe Gargiulo, Bruno R da Costa, Enrico Frigoli, Cataldo Palmieri, Marco Stefano Nazzaro, Camillo Falcone, Armando Liso, Carlo Vigna, Fabio Abate, Marco Comeglio, Roberto Diletti, Gabriele Gabrielli, Emilio Di Lorenzo, Pietro Mazzarotto, Marco Zimarino, Claudio Moretti, Antonio Colombo, Carlo Penzo, Giampaolo Pasquetto, Salvatore Brugaletta, Fabio Ferrari, Gavino Casu, Vincenzo Guiducci, Antonio Dellavalle, Francesco Liistro, Ciro Mauro, Arnoud W J Van't Hof, Elmir Omerovic, Salvatore Curello, Jose Maria de la Torre Hernandez, Stefano De Servi, Flavia Belloni, Stephan Windecker, Marco Valgimigli
AIMS: To assess whether bivalirudin compared with unfractionated heparin (UFH) is associated with consistent outcomes in male and female patients with acute coronary syndrome (ACS) undergoing invasive management. METHODS AND RESULTS: In the MATRIX program,7213 patients were randomized to bivalirudin or UFH.Patients in bivalirudin group were subsequently assigned to receive or not to receive a post-PCI infusion.The 30-day coprimary outcomes were major adverse cardiovascular and cerebrovascular events (MACE),defined as death,myocardial infarction,or stroke,and net adverse clinical events (NACE),defined as MACE or major bleeding...
May 15, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29758953/electroacupunture-contributes-to-recovery-of-neurological-deficits-in-experimental-stroke-by-activating-astrocytes
#13
Haijun Zhao, Yan Lu, Yuan Wang, Xiaochun Han, Yanan Zhang, Bingbing Han, Tong Wang, Yan Li, Shijun Wang
BACKGROUND: Neurological deficits is one of the most prevalent clinical manifestation after stroke. The effects of astrocytes activated by electroacupunture (EA) after stroke on the neurological recovery in middle cerebral artery occlusion (MCAO) rats was not clear and definite. OBJECTIVE: Our previous study showed that treatment with EA for 7 days contributed to the activation of astrocytes in MCAO rats. The purposes of this study were to 1) confirm the effects of EA for 14 days on activation of astrocytes in MCAO rats, and 2) test the relationships between activation of astrocytes and neurological functional recovery induced by EA in MCAO rats...
May 6, 2018: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/29754671/rationale-and-design-for-the-vascular-outcomes-study-of-asa-along-with-rivaroxaban-in-endovascular-or-surgical-limb-revascularization-for-peripheral-artery-disease-voyager-pad
#14
Warren H Capell, Marc P Bonaca, Mark R Nehler, Edmond Chen, John M Kittelson, Sonia S Anand, Scott D Berkowitz, Eike Sebastian Debus, Fabrizio Fanelli, Lloyd Haskell, Manesh R Patel, Rupert Bauersachs, William R Hiatt
BACKGROUND: Patients with peripheral artery disease (PAD) undergoing a lower-extremity revascularization are at heightened risk for ischemic cardiac and limb events. Although intensification of antithrombotic therapy after revascularization has demonstrated benefit in coronary disease populations, this approach has not been well studied or shown consistent benefit in PAD. Recent trial evidence demonstrated that a treatment strategy of rivaroxaban added to background antiplatelet therapy reduced ischemic risk in patients following recent acute coronary syndromes, as well as in patients with stable atherosclerotic vascular disease...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29749914/endovascular-thrombectomy-can-be-beneficial-to-acute-ischemic-stroke-patients-with-large-infarcts
#15
Shaowei Jiang, Ya Peng, Chao-Hui Jing, Ai-Hua Fei, Hai-Rong Wang, Cheng-Jin Gao, Miao Chen, Yi Li, Shuming Pan
OBJECTIVE This study aimed to assess whether patients with acute ischemic stroke (AIS) and large infarct lesions benefit from reperfusion management. To determine the efficacy of different recanalization managements on AIS patients with Alberta Stroke Program Early CT Score (ASPECTS) < 6, the authors retrospectively analyzed hospitalized patients with AIS. METHODS Eighty-nine patients with AIS and ASPECTS < 6 were screened from 13,285 hospitalized patients treated by thrombolysis, thrombectomy, or conventional care in two stroke medical centers...
May 11, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29749592/-a-systematic-review-of-the-characteristics-and-prognosis-of-subjects-who-suffer-an-embolic-stroke-of-undetermined-source
#16
J Molina-Seguin, A B Vena, L Colas-Campas, I Benalbdelhak, F Purroy
INTRODUCTION: The concept of embolic stroke of undetermined source (ESUS) has recently appeared to better characterise patients with cryptogenic stroke. PATIENTS AND METHODS: A systematic review of studies published since 2014 was performed to evaluate the epidemiology, clinical features and prognosis of patients with ESUS and their proportion among patients with cryptogenic stroke. RESULTS: Ten studies were identified with a total of 14,810 patients...
May 16, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29747915/prognostic-and-practical-validation-of-current-definitions-of-myocardial-infarction-associated-with-percutaneous-coronary-intervention
#17
Pierluigi Tricoci, L Kristin Newby, Robert M Clare, Sergio Leonardi, C Michael Gibson, Robert P Giugliano, Paul W Armstrong, Frans Van de Werf, Gilles Montalescot, David J Moliterno, Claes Held, Philip E Aylward, Lars Wallentin, Robert A Harrington, Eugene Braunwald, Kenneth W Mahaffey, Harvey D White
OBJECTIVES: In 13,038 patients with non-ST-segment elevation acute coronary syndrome undergoing index percutaneous coronary intervention (PCI) in the EARLY ACS (Early Glycoprotein IIb/IIIa Inhibition in Non-ST-Segment Elevation Acute Coronary Syndrome) and TRACER (Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome) trials, the relationship between PCI-related myocardial infarction (MI) and 1-year mortality was assessed. BACKGROUND: The definition of PCI-related MI is controversial...
May 14, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29746546/transcatheter-aortic-valve-implantation-for-aortic-stenosis-in-high-surgical-risk-patients-a-systematic-review-and-meta-analysis
#18
Zulian Liu, Elaine Kidney, Danai Bem, George Bramley, Susan Bayliss, Mark A de Belder, Carole Cummins, Rui Duarte
BACKGROUND: Symptomatic aortic stenosis has a poor prognosis. Many patients are considered inoperable or at high surgical risk for surgical aortic valve replacement (SAVR), reflecting their age, comorbidities and frailty. The clinical effectiveness and safety of TAVI have not been reviewed systematically for these high levels of surgical risk. This systematic review compares mortality and other important clinical outcomes up to 5 years post treatment following TAVI or other treatment in these risk groups...
2018: PloS One
https://www.readbyqxmd.com/read/29744563/diagnostic-workup-etiologies-and-management-of-acute-right-ventricle-failure-a-state-of-the-art-paper
#19
REVIEW
Antoine Vieillard-Baron, R Naeije, F Haddad, H J Bogaard, T M Bull, N Fletcher, T Lahm, S Magder, S Orde, G Schmidt, M R Pinsky
INTRODUCTION: This is a state-of-the-art article of the diagnostic process, etiologies and management of acute right ventricular (RV) failure in critically ill patients. It is based on a large review of previously published articles in the field, as well as the expertise of the authors. RESULTS: The authors propose the ten key points and directions for future research in the field. RV failure (RVF) is frequent in the ICU, magnified by the frequent need for positive pressure ventilation...
May 9, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29740507/major-risks-and-complications-of-cervical-epidural-steroid-injections-an-updated-review
#20
REVIEW
Nancy E Epstein
Background: Too many patients, with or without significant cervical disease, unnecessarily undergo cervical epidural steroid injections (CESIs). These include interlaminar (ICESI) and transforaminal ESI (TF-CESI) injections that are not Food and Drug Administration (FDA) approved, have no documented long-term efficacy, and carry severe risks and complications. Methods: Here we reviewed recent reports of morbidity and mortality attributed to the various types of CESIS...
2018: Surgical Neurology International
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