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https://www.readbyqxmd.com/read/29446070/a-hospital-based-retrospective-study-of-acute-postpartum-headache
#1
Angeliki Vgontzas, Matthew S Robbins
OBJECTIVE: To describe acute headache diagnoses in women presenting emergently in the postpartum period and to determine which factors may be associated with secondary vs primary headache. BACKGROUND: Hormonal, vascular, and procedural factors elevate the risk for both secondary and primary headache disorders in the postpartum period. Differentiating between these can be a diagnostic challenge, particularly among the most severe patients referred for urgent neurological consultation...
February 15, 2018: Headache
https://www.readbyqxmd.com/read/29439338/multi-parametric-classification-of-vascular-cognitive-impairment-and-dementia-the-impact-of-diverse-cerebrovascular-injury-biomarkers
#2
Brittany Lang, Mark S Kindy, F Andrew Kozel, Susan K Schultz, Saeid Taheri
Vascular cognitive impairment and dementia (VCID) is a diagnostic term applied to cognitively impaired individuals with heterogeneous cerebrovascular conditions affecting large and/or small vessels. Individual biomarkers have been identified as instrumental in relating VCID to specific underlying pathologies to better characterize this syndrome. Emerging research to refine panels of biomarkers will increase classification sensitivity and specificity. Refined VCID clustering based on the severity and pathology of vascular injury will permit the development of optimal prevention and treatment strategies...
2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29425190/acute-effects-of-ambient-pm2-5-on-all-cause-and-cause-specific-emergency-ambulance-dispatches-in-japan
#3
Vera Ling Hui Phung, Kayo Ueda, Shunji Kasaoka, Xerxes Seposo, Saira Tasmin, Shinichi Yonemochi, Arthit Phosri, Akiko Honda, Hirohisa Takano, Takehiro Michikawa, Hiroshi Nitta
Short-term health effects of ambient PM2.5 have been established with numerous studies, but evidence in Asian countries is limited. This study aimed to investigate the short-term effects of PM2.5 on acute health outcomes, particularly all-cause, cardiovascular, respiratory, cerebrovascular and neuropsychological outcomes. We utilized daily emergency ambulance dispatches (EAD) data from eight Japanese cities (2007-2011). Statistical analyses included two stages: (1) City-level generalized linear model with Poisson distribution; (2) Random-effects meta-analysis in pooling city-specific effect estimates...
February 9, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29414151/migrainous-aura-as-stroke-mimic-the-role-of-perfusion-computed-tomography
#4
Mariana Ridolfi, Antonio Granato, Paola Polverino, Giovanni Furlanis, Maja Ukmar, Irene Zorzenon, Paolo Manganotti
OBJECTIVES: The acute-onset of migrainuos aura (MA) can be erroneously diagnosed in Emergency Department (ED) as acute stroke (AS) and it can be classified as "stroke mimic" (SM). Perfusion computer tomography (PCT) may be useful to improve detection of infarcts. The aim of the study was to investigate the role in ED of PCT in improving diagnosis of migrainous aura. Data were compared with the well-defined perfusion patterns in patients with acute ischemic stroke. PATIENTS AND METHODS: A standardized Stroke Protocol was planned...
January 31, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29412119/sodium-glucose-cotransporter-2-inhibitors-and-ischemic-stroke
#5
Dimitrios Milonas, Konstantinos Tziomalos
BACKGROUND: Type 2 diabetes mellitus (T2DM) is associated with substantially increased risk for cardiovascular events, including ischemic stroke. In turn, ischemic stroke represents a leading cause of mortality and long-term disability worldwide. The newest class of glucose-lowering agents is sodium-glucose cotransporter 2 (SGLT-2) inhibitors, which act through inhibition of glucose reabsorption in the kidney, resulting in glucose excretion without stimulating insulin release. Accumulating data suggests that these agents improve multiple risk factors for ischemic stroke except their glucose-lowering effect...
February 6, 2018: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/29402689/patient-provider-and-environmental-factors-associated-with-adherence-to-cardiovascular-and-cerebrovascular-clinical-practice-guidelines-in-the-emergency-department
#6
Stacy A Trent, Michael A Johnson, Erica A Morse, Edward P Havranek, Jason S Haukoos
OBJECTIVES: Myocardial infarction and stroke are two of the leading causes of death in the U.S. Both diseases have clinical practice guidelines (CPGs) specific to the emergency department (ED) that improve patient outcomes. Our primary objectives were to estimate differences in ED adherence across CPGs for these diseases and identify patient, provider, and environmental factors associated with adherence. METHODS: Design: Retrospective study at 3 hospitals in Colorado using standard medical record review...
December 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29397139/management-of-antiplatelet-therapy-in-patients-with-coronary-stents-undergoing-noncardiac-surgery-association-with-adverse-events
#7
A Rodriguez, N Guilera, A Mases, P Sierra, J C Oliva, C Colilles
BACKGROUND: Perioperative discontinuation of antiplatelet therapy (APT) in patients with coronary stents has been associated with major adverse cardiac events. Our aim was to analyse the perioperative management of APT in such patients and its relationship to the incidence of major adverse cardiac and cerebrovascular events (MACCE) and major bleeding events (MBE) in noncardiac surgery. METHODS: We completed a prospective multicentre observational study of patients with coronary stents undergoing noncardiac surgery in 11 hospitals in Spain...
January 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29394733/-surgical-treatment-for-extremely-elderly-patients-over-90-years-of-age-with-stage-iv-colorectal-cancer-a-report-of-four-cases
#8
Tetsunori Yoshimura, Eisuke Yamamoto, Sakiko Yabe, Taiki Masuda, Hitoshi Sugimoto, Haruya Koshiishi
We report 4 cases ofStage IV colorectal cancer patients over 90 years ofage who received surgical treatment. All of 4 cases were right-sided advanced colon cancer(1 case had also recto-sigmoid advanced cancer)and were received emergency operation. Two cases received resection ofprimary tumors and anastomosis, the other 2 cases received only ileostomy or colostomy. Three cases were able to be discharged from hospital successfully, but unfortunately, we lost one case because of cerebrovascular complication after surgery...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29385837/verification-of-a-proteomic-biomarker-panel-to-diagnose-minor-stroke-and-transient-ischaemic-attack-phase-1-of-spectra-a-large-scale-translational-study
#9
Andrew M Penn, Maximilian B Bibok, Viera K Saly, Shelagh B Coutts, Mary L Lesperance, Robert F Balshaw, Kristine Votova, Nicole S Croteau, Anurag Trivedi, Angela M Jackson, Janka Hegedus, Evgenia Klourfeld, Amy Y X Yu, Charlotte Zerna, Christoph H Borchers
OBJECTIVE: To derive a plasma biomarker protein panel from a list of 141 candidate proteins which can differentiate transient ischaemic attack (TIA)/minor stroke from non-cerebrovascular ('mimic') conditions in emergency department (ED) settings. DESIGN: Prospective clinical study (#NCT03050099) with up to three timed blood draws no more than 36 hours following symptom onset. Plasma samples analysed by multiple reaction monitoring-mass spectrometry (MRM-MS). PARTICIPANTS: 545 participants suspected of TIA enrolled in the EDs of two urban medical centres...
February 1, 2018: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/29380947/photodynamic-opening-of-the-blood-brain-barrier-and-pathways-of-brain-clearing
#10
Oxana Semyachkina-Glushkovskaya, Vladimir Chehonin, Ekaterina Borisova, Ivan Fedosov, Anton Namykin, Arkady Abdurashitov, Alexander Shirokov, Boris Khlebtsov, Yelena Lyubun, Nikita Navolokin, Mariya Ulanova, Natalia Shushunova, Alexander Khorovodov, Ilana Agranovich, Anastasia Bodrova, Madina Sagatova, Ali Esmat Shareef, Elena Saranceva, Tatyana Iskra, Mariya Dvoryatkina, Ekaterina Zhinchenko, Olga Sindeeva, Valery Tuchin, Jurgen Kurths
A new application of the photodynamic treatment (PDT) is presented for the opening of blood-brain barrier (BBB) and the brain clearing activation that is associated with it, including the use of gold nanoparticles as emerging photosensitizer carriers in PDT. The obtained results clearly demonstrate two pathways for the brain clearing: 1) using PDT-opening of BBB and intravenous injection of FITC-dextran we showed a clearance of this tracer via the meningeal lymphatic system in the subdural space; 2) using optical coherence tomography and intra-parenchymal injection of gold nanorods we observed their clearance through the exit gate of cerebral spinal fluid from the brain into the deep cervical lymph node, where the gold nanorods were accumulated...
January 30, 2018: Journal of Biophotonics
https://www.readbyqxmd.com/read/29378972/impact-of-the-use-of-intravascular-imaging-on-patients-who-underwent-orbital-atherectomy
#11
Michael S Lee, Evan Shlofmitz, Jeremy Kong, Gentian Lluri, Pratyaksh K Srivastava, Richard Shlofmitz
OBJECTIVES: We assessed the impact of intravascular ultrasound (IVUS)/optical coherence tomography (OCT) on outcomes of patients who underwent orbital atherectomy. BACKGROUND: Intravascular imaging provides enhanced lesion morphology assessment and optimization of percutaneous coronary intervention (PCI) outcomes. Severe coronary artery calcification increases the complexity of PCI and is associated with worse clinical outcomes. Orbital atherectomy modifies calcified plaque, facilitating stent delivery and optimizing stent expansion...
February 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29373168/risk-factors-of-urinary-tract-infection-caused-by-extended-spectrum-%C3%AE-lactamase-producing-escherichia-coli-in-emergency-department
#12
Hyeonseok Lee, Seung Baik Han, Ji Hye Kim, Soo Kang, Areum Durey
OBJECTIVES: The incidence of urinary tract infection (UTI) due to extended-spectrum β-lactamase (ESBL)-producing Escherichia coli has increased over recent years. Initial empirical therapy is often ineffective for these resistant isolates resulting in prolonged hospitalization and increased mortality. This study was conducted to determine the risk factors of UTI caused by ESBL E. coli in the emergency department (ED). METHODS: This is a retrospective case-control study at a university hospital in Korea with UTI patients who visited ED between June 2015 and December 2016...
January 16, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29368175/differential-proteomics-for-distinguishing-ischemic-stroke-from-controls-a-pilot-study-of-the-spectra-project
#13
A M Penn, V Saly, A Trivedi, M L Lesperance, K Votova, A M Jackson, N S Croteau, R F Balshaw, M B Bibok, D S Smith, K K Lam, J Morrison, L Lu, S B Coutts, C H Borchers
A diagnostic blood test for stroke is desirable but will likely require multiple proteins rather than a single "troponin." Validating large protein panels requires large patient numbers. Mass spectrometry (MS) is a cost-effective tool for this task. We compared differences in the abundance of 147 protein markers to distinguish 20 acute cerebrovascular syndrome (ACVS) patients who presented to the Emergency Department of one urban hospital within < 24 h from onset) and from 20 control patients who were enrolled via an outpatient neurology clinic...
January 24, 2018: Translational Stroke Research
https://www.readbyqxmd.com/read/29344329/major-adverse-cardiovascular-event-reduction-with-glp-1-and-sglt2-agents-evidence-and-clinical-potential
#14
REVIEW
Michael E Røder
Treatment of patients with type 2 diabetes is directed against treating symptoms of hyperglycemia, minimizing the risk of hypoglycemia, and the risk of microvascular and macrovascular complications. The majority of patients with type 2 diabetes die from cardiovascular or cerebrovascular disease. Future therapies should therefore focus on reducing cardiovascular morbidity in this high-risk population. Glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose co-transporter 2 inhibitors (SGLT2-i) are two drug classes with proven antihyperglycemic effect in type 2 diabetes...
January 2018: Therapeutic Advances in Chronic Disease
https://www.readbyqxmd.com/read/29332570/proprotein-convertase-subtilisin-kexin-type-9-inhibition-in-cardiovascular-prevention
#15
Ali Ali, Pierluigi Costanzo, Angela Hoye
Elevated levels of Low Density Lipoprotein cholesterol (LDL-C) are directly associated with increased risk for atherosclerotic cardiovascular and cerebrovascular events. Statins have been used to control serum LDL-C and this has translated into reduction in cardiovascular and cerebrovascular events. However, despite high dose statin therapy, LDL-C control may remain inadequate in some patients, particularly those with familial hypercholesterolemia. A new therapeutic approach has emerged in recent years with proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors...
January 10, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29316169/elevated-blood-pressure-during-emergency-departments-visit-is-associated-with-increased-rate-of-hospitalization-for-heart-failure-a-retrospective-cohort-study
#16
Irit Ayalon-Dangur, Yaron Rudman, Tzippy Shochat, Shachaf Shiber, Alon Grossman
There is a limited literature discussing the long-term outcome of patients admitted to the emergency department with elevated blood pressure. The aim of the present study was to evaluate outcomes of patients with hypertension who attended an emergency department. All patients with hypertension who attended an emergency department without target organ damage were evaluated. A composite end point at 18 months, which included all-cause mortality, acute coronary syndrome, cerebrovascular accident, or hospitalization for heart failure, were compared between patients with hypertension and those with normotension...
January 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29315984/default-mode-network-modifications-in-fabry-disease-a-resting-state-fmri-study-with-structural-correlations
#17
Sirio Cocozza, Giuseppe Pontillo, Mario Quarantelli, Francesco Saccà, Eleonora Riccio, Teresa Costabile, Gaia Olivo, Vincenzo Brescia Morra, Antonio Pisani, Arturo Brunetti, Enrico Tedeschi
Aim of the study was to evaluate the presence of Default Mode Network (DMN) modifications in Fabry Disease (FD), and their possible correlations with structural alterations and neuropsychological scores. Thirty-two FD patients with a genetically confirmed diagnosis of classical FD (12 males, mean age 43.3 ± 12.2) were enrolled, along with 35 healthy controls (HC) of comparable age and sex (14 males, mean age 42.1 ± 14.5). Resting-State fMRI data were analyzed using a seed-based approach, with six different seeds sampling the main hubs of the DMN...
January 9, 2018: Human Brain Mapping
https://www.readbyqxmd.com/read/29314105/ambulatory-diagnostic-ecg-monitoring-for-syncope-and-collapse-an-assessment-of-clinical-practice-in-the-united-states
#18
David G Benditt, Wayne O Adkisson, Richard Sutton, Robin K Mears, Scott Sakaguchi
INTRODUCTION: Diagnostic ambulatory ECG (AECG) monitoring is widely used for evaluating syncope and collapse, and practice guidelines provide recommendations regarding optimal AECG device selection. However, whether physicians utilize AECGs in accordance with the pertinent guidelines is unclear. This study assessed utilization of AECG monitoring systems for syncope and collapse diagnosis by physicians in the United States. METHODS AND RESULTS: A quantitative survey was undertaken of physicians comprising multiple specialties (Emergency Room, n = 35; Primary care, n = 35; Hospitalists, n = 30; Neurologists, n = 30; non-implanting, n = 34 and implanting-Cardiologists, n = 35)...
January 4, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29310988/an-updated-diagnostic-approach-to-subtype-definition-of-vascular-parkinsonism-recommendations-from-an-expert-working-group
#19
REVIEW
Ivan Rektor, Nicolaas I Bohnen, Amos D Korczyn, Viktoria Gryb, Hrishikesh Kumar, Milica G Kramberger, Frank-Erik de Leeuw, Zvezdan Pirtošek, Irena Rektorová, Ilana Schlesinger, Jaroslaw Slawek, Peter Valkovič, Branislav Veselý
This expert working group report proposes an updated approach to subtype definition of vascular parkinsonism (VaP) based on a review of the existing literature. The persistent lack of consensus on clear terminology and inconsistent conceptual definition of VaP formed the impetus for the current expert recommendation report. The updated diagnostic approach intends to provide a comprehensive tool for clinical practice. The preamble for this initiative is that VaP can be diagnosed in individual patients with possible prognostic and therapeutic consequences and therefore should be recognized as a clinical entity...
December 29, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/29285684/socioeconomic-disparities-and-metabolic-risk-in-veterans-with-serious-mental-illness
#20
Stanley N Caroff, Shirley H Leong, Daisy Ng-Mak, E Cabrina Campbell, Rosalind M Berkowitz, Krithika Rajagopalan, Chien-Chia Chuang, Antony Loebel
Socioeconomic disparities were assessed in predicting metabolic risk among veterans with serious mental illness. Veterans with schizophrenia, schizoaffective, or bipolar disorders were identified in VISN 4 facilities from 10/1/2010 to 9/30/2012. Differences between patients with and without metabolic syndrome were compared using t-tests, Chi square tests and multivariate logistic regressions. Among 10,132 veterans with mental illness, 48.8% had metabolic syndrome. Multivariate logistic regression analysis confirmed that patients with metabolic syndrome were significantly more likely to be older, male, African-American, married, and receiving disability pensions but less likely to be homeless...
December 28, 2017: Community Mental Health Journal
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