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Emergency cerebrovascular

K Rygiel
Alzheimer's disease (AD) is a neurodegenerative disease, in which an accumulation of toxic amyloid beta in the brain precedes the emergence of clinical symptoms. AD spectrum consists of presymptomatic, early symptomatic, and symptomatic phase of dementia. At present, no pharmacotherapy exists to modify or reverse a course of AD, and only symptomatic treatments are available. Many elderly patients, diagnosed with multiple medical conditions (such as cardiovascular diseases, Type 2 diabetes mellitus, and cerebrovascular diseases) are at increased risk of the development of mild cognitive impairment (MCI), AD, and vascular dementia...
October 2016: Journal of Postgraduate Medicine
Sven Haller, Greg Zaharchuk, David L Thomas, Karl-Olof Lovblad, Frederik Barkhof, Xavier Golay
Arterial spin labeling (ASL) is a magnetic resonance (MR) imaging technique used to assess cerebral blood flow noninvasively by magnetically labeling inflowing blood. In this article, the main labeling techniques, notably pulsed and pseudocontinuous ASL, as well as emerging clinical applications will be reviewed. In dementia, the pattern of hypoperfusion on ASL images closely matches the established patterns of hypometabolism on fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) images due to the close coupling of perfusion and metabolism in the brain...
November 2016: Radiology
Levon Kocharyan, Lilit Baghdasaryan
OBJECTIVE: About 40% of adult population suffers from arterial hypertension and its complications are in the leading places among overall and cerebrovascular mortality. Despite the broad range of available medications and its combinations, less than half of the patients have adequately controlled blood pressure worldwide. And arterial hypertension has a great social and economic impact. Our goal was to create a program which will give an opportunity for long term control of arterial hypertension and closer follow up...
September 2016: Journal of Hypertension
Huimin Lin, Samuel T H Chew
An 85-year-old female with chronic kidney disease and newly acquired seizures on oral phenytoin received intravenous ertapenem 500 mg once daily for a urinary tract infection and bacteraemia involving extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. After three ertapenem doses, she developed seizures which self-aborted. Corrected phenytoin level was sub-therapeutic initially, but became therapeutic following a phenytoin dose increase. On Day 14 of ertapenem, the patient suffered another episode of seizure...
December 2015: Drug Saf Case Rep
Paul Owusu Donkor, Ying Chen, Liqin Ding, Feng Qiu
ETHNOPHARMACOLOGICAL RELEVANCE: Ligusticum species (Umbelliferae) have been widely used in traditional Chinese medicine, Korean folk medicine and Native American medicine for their medicinal and nutritional value. Decoctions of the rhizomes are used in treatment and prophylaxis of migraine, anaemia and cardiovascular conditions including stroke. AIM OF STUDY: This review is intended to fully compile the constituents of locally and traditionally used Ligusticum species, present their bioactivities and highlight potential leads for future drug design, and thus, provide a reference for further research and application of these species...
October 8, 2016: Journal of Ethnopharmacology
Janaka Weragoda, Manuj C Weerasinghe, Rohini Seneviratne, S M Wijeyaratne
BACKGROUND: Peripheral arterial disease (PAD) is an emerging problem in Sri Lanka, particularly with the ageing population. A considerable number of patients are detected at a late stage with severe limb ischemia or chronic non-healing leg ulceration. Public awareness about PAD is important in developing preventive strategies. METHODS: A cross sectional study was conducted to assess awareness of PAD among adults aged 40-74 years in a district in Sri Lanka. In total, 2912 adults were selected for the study using a multistage probability proportionate to size sampling technique...
October 12, 2016: BMC Public Health
Chun-Fang Chiu, Miaw-I Lin, I Lee, Shiow-Rong Jeang, Yan-Choiu Ku
BACKGROUND: Unplanned readmissions increase healthcare utilization rates and healthcare costs. The Taiwan Healthcare Indicator Series regards the rate of hospital readmission as an important indicator of inpatient-care quality. The elderly face a higher risk of unplanned readmission due to elderly-specific health and disease characteristics such as deteriorating body functions and the relatively high incidence of complications after the treatment of acute diseases. PURPOSE: To explore the factors that relate to the unplanned readmission of elderly within 90 days of discharge at a geriatric medical center...
October 2016: Hu Li za Zhi the Journal of Nursing
Alexandra Rohracher, Doris P Reiter, Francesco Brigo, Gudrun Kalss, Aljoscha Thomschewski, Helmut Novak, Alexander Zerbs, Judith Dobesberger, Aynur Akhundova, Julia Höfler, Giorgi Kuchukhidze, Markus Leitinger, Eugen Trinka
PURPOSE: Status epilepticus (SE) is one of the most common neurological emergencies with a high incidence in the elderly. Major determinants of prognosis are patients' age, duration of SE and underlying etiology. We aimed identifying differences in clinical presentation of SE, etiologies and outcome between patients (pts.) sixty years or older (≥60) and younger than sixty (<60) years (yrs). METHODS: We retrospectively analyzed 120 patients (48 women) with SE admitted to the Neurological Intensive Care Unit (NICU), Department of Neurology, Paracelsus Medical University Salzburg, Austria between 1/2011 and 01/2013...
August 22, 2016: Epilepsy Research
Nurver Ulger Toprak, Gulcin Balkose, Deniz Durak, Ender Dulundu, Tolga Demirbaş, Cumhur Yegen, Guner Soyletir
Extra-intestinal infections due to Clostridium difficile have been reported rarely. Herein we report a case of pyogenic liver abscess from toxigenic C. difficile in an 80-year-old non-hospitalized woman with diabetes mellitus, cerebrovascular and cardiovascular diseases. The patient was admitted to the emergency department with fever and abdominal pain. There was no history of diarrhea or use of antibiotics. Laboratory parameters revealed signs of inflammation and elevated AST and ALT levels. Abdominal ultrasound and computer tomography showed multiple focal lesions in the bilateral liver lobes and hydropic gallbladder with stones...
September 28, 2016: Anaerobe
Avais Jabbar, Ayush Khurana, Ashfaq Mohammed, Rajiv Das, Azfar Zaman, Richard Edwards
Transcatheter aortic valve replacement (TAVR) is conventionally performed under general anesthesia (GA) allowing intraoperative transoesophageal echocardiogram imaging. We present our experience in patients having the procedure under local anesthesia (LA), who were subsequently transferred to a low dependency unit postprocedure, to assess safety and length of hospital stay. We retrospectively assessed all the transfemoral TAVR procedures conducted at our center from January 03, 2011. Of 216 patients, 145 had the procedure under GA and 71 under LA...
August 30, 2016: American Journal of Cardiology
Philippe Charbonneau, Paule Lessard Bonaventure, Laura M Drudi, Nathalie Beaudoin, Jean-François Blair, Stéphane Elkouri
OBJECTIVE: The aim of this study was to assess time delays between first cerebrovascular symptoms and carotid endarterectomy (CEA) at a single center and to systematically evaluate causes of these delays. METHODS: Consecutive adult patients who underwent CEAs between January 2010 and September 2011 at a single university-affiliated center (Centre Hospitalier de l'Université Montréal-Hôtel-Dieu Hospital, Montreal) were identified from a clinical database and operative records...
September 20, 2016: Journal of Vascular Surgery
Maurizio Forte, Valeria Conti, Antonio Damato, Mariateresa Ambrosio, Annibale A Puca, Sebastiano Sciarretta, Giacomo Frati, Carmine Vecchione, Albino Carrizzo
Within the family of endogenous gasotransmitters, nitric oxide (NO) is the smallest gaseous intercellular messenger involved in the modulation of several processes, such as blood flow and platelet aggregation control, essential to maintain vascular homeostasis. NO is produced by nitric oxide synthases (NOS) and its effects are mediated by cGMP-dependent or cGMP-independent mechanisms. Growing evidence suggests a crosstalk between the NO signaling and the occurrence of oxidative stress in the onset and progression of vascular diseases, such as hypertension, heart failure, ischemia, and stroke...
2016: Oxidative Medicine and Cellular Longevity
Levon Kocharyan, Lilit Baghdasaryan
OBJECTIVE: About 40% of adult population suffers from arterial hypertension and its complications are in the leading places among overall and cerebrovascular mortality. Despite the broad range of available medications and its combinations, less than half of the patients have adequately controlled blood pressure worldwide. And arterial hypertension has a great social and economic impact. Our goal was to create a program which will give an opportunity for long term control of arterial hypertension and closer follow up...
September 2016: Journal of Hypertension
Mostafa Almasi, Nader Hodjati Firoozabadi, Faeze Ghasemi, Mojtaba Chardoli
Background. The ABCD2 score is now identified as a useful clinical prediction rule to determine the risk for stroke in the days following brain ischemic attacks. Aim. The present study aimed to introduce a new scoring system named "ABCD2F" and compare its value with the previous ABCD2 system to predict recurrent ischemic stroke within 90 days of the initial cerebrovascular accident (CVA). Methods. 138 consecutive patients with the final diagnosis of ischemic CVA or TIAs who referred to emergency ward of Rasoul-e-Akram general hospital in Tehran from September 2012 to December 2013 were eligible...
2016: Neurology Research International
Jan-Karl Burkhardt, Giuseppe Esposito, Jorn Fierstra, Oliver Bozinov, Luca Regli
AIM: Managing ruptured giant internal carotid artery (ICA) aneurysms in an emergency situation is very challenging. By reporting two cases, we discuss the role of the Excimer Laser-assisted Non-occlusive Anastomosis (ELANA) technique as an armamentarium for cerebrovascular surgeons dealing with giant ICA aneurysms presenting with subarachnoid hemorrhage (SAH). MATERIALS AND METHODS: The management of two consecutive patients treated with ELANA bypass during a 6-month period (June- December 2013) for ruptured giant ICA aneurysms in an emergency setting is presented...
2016: Acta Neurochirurgica. Supplement
Mounia Guerram, Lu-Yong Zhang, Zhen-Zhou Jiang
Neurodegenerative and cerebrovascular diseases are frequent in elderly populations and comprise primarily of dementia (mainly Alzheimer's disease) Parkinson's disease and stroke. These neurological disorders (NDs) occur as a result of neurodegenerative processes and represent one of the most frequent causes of death and disability worldwide with a significant clinical and socio-economic impact. Although NDs have been characterized for many years, the exact molecular mechanisms that govern these pathologies or why they target specific individuals and specific neuronal populations remain unclear...
September 9, 2016: Neurochemistry International
Anusha Mishra
Astrocytes are the most common glial cells in the brain with fine processes and endfeet that intimately contact both neuronal synapses and the cerebral vasculature. They play an important role in mediating neurovascular coupling (NVC) via several astrocytic Ca(2+) -dependent signalling pathways such as K(+) release through BK channels, and the production and release of arachidonic acid metabolites. They are also involved in maintaining the resting tone of the cerebral vessels by releasing ATP and COX-1 derivatives...
September 13, 2016: Journal of Physiology
T N Gibson, S E Shirley, E W Williams, A Rhudd, S French, R Hibbert
Objectives: To determine the cause of death diagnoses and the discrepancy rate between clinical and autopsy diagnoses in the Emergency Department (ED) of the University Hospital of the West Indies (UHWI). Methods: Clinical and post-mortem records were reviewed for all patients dying in the ED of the UHWI within 24 hours of admission, during the period January 2007 - December 2010. Patient demographic data, clinical cause of death and cause of death established at autopsy were documented for each case...
November 6, 2015: West Indian Medical Journal
Mark T Mackay, Adriana Yock-Corrales, Leonid Churilov, Paul Monagle, Geoffrey A Donnan, Franz E Babl
BACKGROUND AND PURPOSE: Clinical identification of stroke in the pediatric emergency department is critical for improving access to hyperacute therapies. We identified key clinical features associated with childhood stroke or transient ischemic attack compared with mimics. METHODS: Two hundred and eighty consecutive children presenting to the emergency department with mimics, prospectively recruited over 18 months from 2009 to 2010, were compared with 102 children with stroke or transient ischemic attack, prospectively/retrospectively recruited from 2003 to 2010...
October 2016: Stroke; a Journal of Cerebral Circulation
Erica Simon, Brit Long, Alex Koyfman
BACKGROUND: Sickle cell disease (SCD) affects approximately 100,000 individuals in the United States. Due to alterations in the structural conformation of hemoglobin molecules under deoxygenated conditions, patients with SCD are predisposed to numerous sequelae, many of which require acute intervention. OBJECTIVE: Our aim was to provide emergency physicians with an evidence-based update regarding the diagnosis and management of SCD complications. DISCUSSION: SCD patients experience significant morbidity and mortality secondary to cerebrovascular accident, acute chest syndrome, acute vaso-occlusive pain crises, SCD-related multi-organ failure, cholecystitis, acute intrahepatic cholestasis, acute sickle hepatic crisis, acute hepatic sequestration, priapism, and renal disease...
October 2016: Journal of Emergency Medicine
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