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https://www.readbyqxmd.com/read/28527058/headache-and-arterial-hypertension
#1
Cinzia Finocchi, Davide Sassos
Elevated blood pressure (BP) and headache have long been linked in the medical literature. Headache associated with arterial hypertension is a main concern in emergency department. It is believed that headache may be a symptom attributed to arterial hypertension only if the BP values are very high or rise quickly. Many studies support the hypothesis that migraine patients have an increased risk of developing hypertension, while hypertensive subjects do not seem to have an increased risk of migraine or other types of headache...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28522987/stroke-incidence-in-victoria-australia-emerging-improvements
#2
Benjamin B Clissold, Vijaya Sundararajan, Peter Cameron, John McNeil
BACKGROUND: Evidence of a decline in the incidence of stroke has emerged from population-based studies. These have included retrospective and prospective cohorts. However, in Australia and other countries, government bodies and stroke foundations predict a rise in the prevalence of stroke that is anticipated to increase the burden of stroke across the entire domain of care. This increase in prevalence must be viewed as different from the decline in incidence being observed, a measure of new stroke cases...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28515272/racial-disparities-in-neurologic-health-care-access-and-utilization-in-the-united-states
#3
Altaf Saadi, David U Himmelstein, Steffie Woolhandler, Nicte I Mejia
OBJECTIVE: To evaluate racial and ethnic differences in the utilization of neurologic care across a wide range of neurologic conditions in the United States. METHODS: We analyzed nationally representative data from the 2006-2013 Medical Expenditure Panel Survey (MEPS), including information on demographics, patient-reported health conditions, neurology visit rates, and costs. Using diagnostic codes, we identified persons with any self-identified neurologic disorder except back pain, as well as 5 subgroups (Parkinson disease, multiple sclerosis, headache, cerebrovascular disease, and epilepsy)...
May 17, 2017: Neurology
https://www.readbyqxmd.com/read/28504343/gas-diffusion-in-the-cns
#4
REVIEW
Beatriz Rodriguez-Grande, Jan-Pieter Konsman
Gases have been long known to have essential physiological functions in the CNS such as respiration or regulation of vascular tone. Since gases have been classically considered to freely diffuse, research in gas biology has so far focused on mechanisms of gas synthesis and gas reactivity, rather than gas diffusion and transport. However, the discovery of gas pores during the last two decades and the characterization of diverse diffusion patterns through different membranes has raised the possibility that modulation of gas diffusion is also a physiologically relevant parameter...
May 15, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28498345/effects-of-long-chain-omega-3-polyunsaturated-fatty-acids-on-endothelial-vasodilator-function-and-cognition-are-they-interrelated
#5
REVIEW
Julia C Kuszewski, Rachel H X Wong, Peter R C Howe
Long-chain omega-3 polyunsaturated fatty acids (LCn-3 PUFA) may improve brain functions by acting on endothelial cells in the cerebrovasculature to facilitate vasodilatation and perfusion. The aim of this review is to explore this hypothesis by analyzing the effect of LCn-3 PUFA supplementation on systemic vasodilator and cognitive function and finding evidence to link LCn-3 PUFA intake, vasodilator function and cognition. Forty randomized controlled trials examining the effect of LCn-3 PUFA supplementation in humans on either endothelial vasodilator function or cognition were identified and pooled effects measured with a weighted analysis...
May 12, 2017: Nutrients
https://www.readbyqxmd.com/read/28490616/integrated-care-in-atrial-fibrillation-a-systematic-review-and-meta-analysis
#6
Celine Gallagher, Adrian D Elliott, Christopher X Wong, Geetanjali Rangnekar, Melissa E Middeldorp, Rajiv Mahajan, Dennis H Lau, Prashanthan Sanders, Jeroen M L Hendriks
OBJECTIVE: Atrial fibrillation (AF) is an emerging global epidemic associated with significant morbidity and mortality. Whilst other chronic cardiovascular conditions have demonstrated enhanced patient outcomes from coordinated systems of care, the use of this approach in AF is a comparatively new concept. Recent evidence has suggested that the integrated care approach may be of benefit in the AF population, yet has not been widely implemented in routine clinical practice. We sought to undertake a systematic review and meta-analysis to evaluate the impact of integrated care approaches to care delivery in the AF population on outcomes including mortality, hospitalisations, emergency department visits, cerebrovascular events and patient-reported outcomes...
May 10, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28490287/cheiro-oral-syndrome
#7
Mamoun Saeed, Abdelrahman Abbker, Paul Brenan, Tarig Mohammed Abkur
We describe a 64-year-old man who presented to the emergency department with a two-day history of left perioral and hand numbness. Examination revealed impaired sensation of the left corner of the mouth and ipsilateral fingers. Neuroimaging showed an acute right thalamic lacunar infarct consistent with the diagnosis of cheiro-oral syndrome. In this report, we discuss the importance of recognising this syndrome and instituting appropriate management to prevent further cerebrovascular events.
January 1, 2017: Scottish Medical Journal
https://www.readbyqxmd.com/read/28482887/economic-burden-of-comorbidities-in-psoriasis-patients-in-the-united-states-results-from-a-retrospective-u-s-database
#8
Steven R Feldman, Haijun Tian, Isabelle Gilloteau, Patrick Mollon, Meng Shu
BACKGROUND: Psoriasis is a multifactorial, inflammatory, skin disease associated with various comorbidities. The cost of those comorbidities is not well characterized. The present study assesses the incremental burden of comorbidities on healthcare resource utilization, direct costs and indirect costs associated with short-term disabilities among patients with psoriasis in the United States. METHODS: A retrospective, U.S. cohort analysis was conducted using a large claims database...
May 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28477280/biomarkers-of-acute-stroke-etiology-base-study-methodology
#9
Edward C Jauch, Andrew D Barreto, Joseph P Broderick, Doug M Char, Brett L Cucchiara, Thomas G Devlin, Alison J Haddock, William J Hicks, Brian C Hiestand, Glen C Jickling, Jeff June, David S Liebeskind, Ted J Lowenkopf, Joseph B Miller, John O'Neill, Tim L Schoonover, Frank R Sharp, W Frank Peacock
Acute ischemic stroke affects over 800,000 US adults annually, with hundreds of thousands more experiencing a transient ischemic attack. Emergent evaluation, prompt acute treatment, and identification of stroke or TIA (transient ischemic attack) etiology for specific secondary prevention are critical for decreasing further morbidity and mortality of cerebrovascular disease. The Biomarkers of Acute Stroke Etiology (BASE) study is a multicenter observational study to identify serum markers defining the etiology of acute ischemic stroke...
May 5, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28473274/alterations-in-optic-nerve-sheath-diameter-according-to-cerebrovascular-disease-sub-groups
#10
Emre Gökcen, İbrahim Caltekin, Atakan Savrun, Hilal Korkmaz, Şeyda Tuba Savrun, Gökhan Yıldırım
BACKGROUND: ONSD (optic nerve sheath diameter) is a method used for indirect measurement of the increased intracranial pressure. In previous studies, the relation between the increased intracranial pressure and ONSD was analyzed in the patients suffering from cerebrovascular diseases (CVD). In our study, the patients suffering from ischemic CVD were categorized into 4 subgroups according to Oxfordshire Community Stroke Project classification (OCSP); the relationship between each group and ONSD, and the influence on each eye were analyzed...
April 30, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28467535/association-of-the-modified-frailty-index-with-30-day-surgical-readmission
#11
Tyler S Wahl, Laura A Graham, Mary T Hawn, Joshua Richman, Robert H Hollis, Caroline E Jones, Laurel A Copeland, Edith A Burns, Kamal M Itani, Melanie S Morris
Importance: Frail patients are known to have poor perioperative outcomes. There is a paucity of literature investigating how the Modified Frailty Index (mFI), a validated measure of frailty, is associated with unplanned readmission among military veterans following surgery. Objective: To understand the association between frailty and 30-day postoperative unplanned readmission. Design, Setting, and Participants: A retrospective cohort study was conducted among adult patients who underwent surgery and were discharged alive from Veterans Affairs hospitals for orthopedic, general, and vascular conditions between October 1, 2007, and September 30, 2014, with a postoperative length of stay between 2 and 30 days...
May 3, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28447144/-standardized-collection-of-presenting-complaints-in-the-emergency-room-integration-of-coded-presenting-complaints-into-the-electronic-medical-record-system-of-an-emergency-department-and-their-value-for-health-care-research
#12
F Greiner, D Brammen, M Kulla, F Walcher, B Erdmann
BACKGROUND: The point of entry of a patient in emergency care is a symptom or a complaint. To evaluate subsequent processes in an emergency department until a diagnosis is made, this information has to be taken into account. OBJECTIVES: We report the introduction of coded presenting complaints into the electronic medical record system of an emergency department and describe the patients based on these data. METHODS: The CEDIS presenting complaint list was integrated into the emergency department information system of an emergency department (38,000 patients/year)...
April 26, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28446702/alteration-of-cerebrovascular-haemodynamic-patterns-due-to-atrial-fibrillation-an-in-silico-investigation
#13
S Scarsoglio, A Saglietto, M Anselmino, F Gaita, L Ridolfi
There has recently been growing evidence that atrial fibrillation (AF), the most common cardiac arrhythmia, is independently associated with the risk of dementia. This represents a very recent frontier with high social impact for the number of individuals involved and for the expected increase in AF incidence in the next 40 years. Although a number of potential haemodynamic processes, such as microembolisms, altered cerebral blood flow, hypoperfusion and microbleeds, arise as connecting links between the two pathologies, the causal mechanisms are far from clear...
April 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28437813/presenting-symptoms-of-pituitary-apoplexy
#14
Efstratios-Stylianos Pyrgelis, Ioannis Mavridis, Maria Meliou
The classical term "pituitary apoplexy" (PA) describes a clinical syndrome usually characterized by abrupt onset of headache accompanied by neurologic and/or endocrinologic deterioration due to sudden expansion of a mass within the sella turcica as a result of hemorrhage or infarction within a pituitary tumor and adjacent pituitary gland. PA is a medical emergency and a difficult diagnosis to establish. Thus this article reviews the presenting symptoms of PA patients to help clinicians recognize or at least suspect this critical condition early on...
April 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28433337/increased-resource-utilization-and-overall-morbidity-are-associated-with-general-versus-regional-anesthesia-for-carotid-endarterectomy-in-data-collected-by-the-michigan-surgical-quality-collaborative
#15
Ahmad S Hussain, Andrew Mullard, William F Oppat, Kevin D Nolan
OBJECTIVE: Advocates for performing carotid endarterectomy (CEA) under regional anesthesia (RA) cite reduction in hemodynamic instability and the ability for neurologic monitoring, but many still prefer general anesthesia (GA) as benefits of RA have not been clearly demonstrated, reliable RA may not be available in all centers, and a certain amount of movement by the patient during the procedure may not be uniformly tolerated. We evaluated the association of anesthesia type and perioperative morbidity and mortality as well as resource utilization in patients undergoing CEA using the Michigan Surgical Quality Collaborative (MSQC) database...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28431593/high-on-treatment-platelet-reactivity-to-aspirin-and-clopidogrel-in-ischemic-stroke-a-systematic-review-and-meta-analysis
#16
Aidonio Fiolaki, Aristeidis H Katsanos, Athanassios P Kyritsis, Styliani Papadaki, Maria Kosmidou, Iraklis C Moschonas, Alexandros D Tselepis, Sotirios Giannopoulos
Emerging studies highlight high on-treatment of platelet reactivity (HTPR) as a major hindrance to the secondary prevention of cardiovascular ischemic events. The aim of this systematic review and meta-analysis is to assess the prevalence of HTPR in patients with ischemic stroke (IS) or transient ischemic attack (TIA) and reveal a possible relation with a higher risk of cerebrovascular event recurrence. Studies were selected if they reported absolute numbers or percentages of HTPR with ASA or clopidogrel in IS/TIA patients at any time point after the cerebrovascular event onset and assessed with any type of platelet function tests...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28416195/pitavastatin-versus-pravastatin-in-adults-with-hiv-1-infection-and-dyslipidaemia-intrepid-12-week-and-52-week-results-of-a-phase-4-multicentre-randomised-double-blind-superiority-trial
#17
Judith A Aberg, Craig A Sponseller, Douglas J Ward, Vladimir A Kryzhanovski, Stuart E Campbell, Melanie A Thompson
BACKGROUND: People living with HIV-1 infection are at greater risk for cardiovascular disease than seronegative adults. Treatment of dyslipidaemia with statins has been challenging in people with HIV because of an increased potential for drug interactions due to competing cytochrome P450 metabolism between statins and commonly used antiretroviral agents. Neither pitavastatin nor pravastatin depend on cytochrome P450 for primary metabolism. We aimed to assess the safety and efficacy of pitavastatin versus pravastatin in adults with HIV and dyslipidaemia...
April 13, 2017: Lancet HIV
https://www.readbyqxmd.com/read/28410995/transcatheter-versus-surgical-aortic-valve-replacement-in-patients-with-non-high-surgical-risk-severe-aortic-stenosis-a-systematic-review
#18
REVIEW
Tariq H Enezate, Arun Kumar, Mazen Abu Fadel, Mitul Patel, Ashraf Al Dadah, Jad Omran
OBJECTIVE: Transcatether aortic valve replacement (TAVR) has emerged as an acceptable alternative to surgical aortic valve replacement (SAVR) in patients with high-risk surgical profile. In this analysis, we compare both approaches in non-high surgical risk severe aortic stenosis. METHODS: Only studies comparing SAVR and TAVR and enrolling patients with low-intermediate risk were included from January 2000 through May 2016. Primary endpoints were assessed at 1 and 12months including: mortality, cerebrovascular accident (CVA) and myocardial infarction (MI)...
February 20, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28400034/association-of-syntax-score-with-short-term-outcomes-among-acute-st-elevation-myocardial-infarction-patients-undergoing-primary-pci
#19
Sarita Choudhary
OBJECTIVE: Syntax score (SX) has emerged as a reproducible angiographic tool to quantify the extent of coronary artery disease based on location and complexity of each lesion. It has been shown to predict long-term clinical outcomes in patients with left main or multi-vessel disease and recently also in ST-segment elevation myocardial infarction undergoing primary PCI. The aim of this study was to evaluate whether the syntax score is associated with short-term cardiovascular outcomes in patients treated with primary percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI)...
April 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28387710/in-vivo-bioimpedance-spectroscopy-characterization-of-healthy-hemorrhagic-and-ischemic-rabbit-brain-within-10-hz-1-mhz
#20
Lin Yang, Wenbo Liu, Rongqing Chen, Ge Zhang, Weichen Li, Feng Fu, Xiuzhen Dong
Acute stroke is a serious cerebrovascular disease and has been the second leading cause of death worldwide. Conventional diagnostic modalities for stroke, such as CT and MRI, may not be available in emergency settings. Hence, it is imperative to develop a portable tool to diagnose stroke in a timely manner. Since there are differences in impedance spectra between normal, hemorrhagic and ischemic brain tissues, multi-frequency electrical impedance tomography (MFEIT) shows great promise in detecting stroke. Measuring the impedance spectra of healthy, hemorrhagic and ischemic brain in vivo is crucial to the success of MFEIT...
April 7, 2017: Sensors
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