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https://www.readbyqxmd.com/read/28437813/presenting-symptoms-of-pituitary-apoplexy
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28384077/american-telemedicine-association-telestroke-guidelines
#8
Bart M Demaerschalk, Jill Berg, Brian W Chong, Hartmut Gross, Karin Nystrom, Opeolu Adeoye, Lee Schwamm, Lawrence Wechsler, Sallie Whitchurch
The following telestroke guidelines were developed to assist practitioners in providing assessment, diagnosis, management, and/or remote consultative support to patients exhibiting symptoms and signs consistent with an acute stroke syndrome, using telemedicine communication technologies. Although telestroke practices may include the more broad utilization of telemedicine across the entire continuum of stroke care, with some even consulting on all neurologic emergencies, this document focuses on the acute phase of stroke, including both pre- and in-hospital encounters for cerebrovascular neurological emergencies...
April 6, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28368084/neurovascular-ultrasound-in-emergency-settings-diagnostic-and-therapeutic-aspects
#9
REVIEW
T Santos, M Veloso, P Barros
INTRODUCTION: Neurovascular ultrasound is a non-invasive, portable and fast imaging method that, when performed by an experienced neurosonologist, offers reliable and reproducible information on the morphological and hemodynamic status of cervical and intracranial vessels. AIM: To review the available evidence regarding the use of this tool in the approach to acute stroke. DEVELOPMENT: Neurovascular ultrasound can be used in one of two ways: diagnostic and therapeutic...
April 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28365629/mimics-and-chameleons-in-stroke
#10
Sujo Anathhanam, Ahamad Hassan
Ischaemic stroke is a treatable medical emergency. In an era of time-dependent reperfusion techniques, it is crucial that an accurate and prompt diagnosis is made. Approximately 30% of patients admitted to hyperacute stroke units are subsequently found not to have a final diagnosis of acute stroke although some of these patients do have incidental or previously symptomatic cerebrovascular disease. These patients do not benefit from thrombolysis and may require the input of other specialists or treatments. Meanwhile, a proportion of patients with acute stroke have unusual presentations and are sometimes initially admitted to general medical admissions units prior to accessing stroke unit care...
April 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28358291/feasibility-and-utility-of-an-integrated-medical-imaging-and-informatics-smartphone-system-for-management-of-acute-stroke
#11
Kristina Shkirkova, Eftitan Y Akam, Josephine Huang, Sunil A Sheth, May Nour, Conrad W Liang, Michael McManus, Van Trinh, Gary Duckwiler, Jason Tarpley, Fernando Vinuela, Jeffrey L Saver
Background Rapid dissemination and coordination of clinical and imaging data among multidisciplinary team members are essential for optimal acute stroke care. Aim To characterize the feasibility and utility of the Synapse Emergency Room mobile (Synapse ERm) informatics system. Methods We implemented the Synapse ERm system for integration of clinical data, computerized tomography, magnetic resonance, and catheter angiographic imaging, and real-time stroke team communications, in consecutive acute neurovascular patients at a Comprehensive Stroke Center...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28356464/ed-misdiagnosis-of-cerebrovascular-events-in-the-era-of-modern-neuroimaging-a-meta-analysis
#12
REVIEW
Alexander Andrea Tarnutzer, Seung-Han Lee, Karen A Robinson, Zheyu Wang, Jonathan A Edlow, David E Newman-Toker
OBJECTIVE: With the emergency department (ED) being a high-risk site for diagnostic errors, we sought to estimate ED diagnostic accuracy for identifying acute cerebrovascular events. METHODS: MEDLINE and Embase were searched for studies (1995-2016) reporting ED diagnostic accuracy for ischemic stroke, TIA, or subarachnoid hemorrhage (SAH). Two independent reviewers determined inclusion. We identified 1,693 unique citations, examined 214 full articles, and analyzed 23 studies...
April 11, 2017: Neurology
https://www.readbyqxmd.com/read/28343274/predictive-score-of-haematological-toxicity-in-patients-treated-with-linezolid
#13
J González-Del Castillo, F J Candel, R Manzano-Lorenzo, L Arias, E J García-Lamberechts, F J Martín-Sánchez
OBJECTIVE: The aims of our study were to determine the factors associated with developing haematological toxicity (HT) in patients taking linezolid (LZD), to develop a predictive model of HT in these patients, and to evaluate factors associated with 30-day mortality. METHODS: This was an observational retrospective cohort study of patients treated for at least 5 days with LDZ in 2015. Demographic, clinical and analytical data were collected. Development of HT was defined as a 25% platelet count decrease between the basal count and the 1-week lab test...
March 25, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28341442/risk-factors-for-postoperative-delirium-after-colorectal-operation
#14
Frederik J van der Sluis, Pieter L Buisman, Mark Meerdink, Wouter B Aan de Stegge, Boudewijn van Etten, Geertruida H de Bock, Barbara L van Leeuwen, Robert A Pol
BACKGROUND: A clear understanding of risk factors for postoperative delirium helps in the selection of individuals who might benefit from targeted perioperative intervention. The aim of this study was to identify risk factors for postoperative delirium after colorectal operation for malignancy. METHODS: All consecutive patients who underwent elective or emergency operation because of malignancy of the colon, sigmoid, or rectum between 2009 and 2012 were included in this study...
March 2017: Surgery
https://www.readbyqxmd.com/read/28334869/emerging-concepts-in-sporadic-cerebral-amyloid-angiopathy
#15
Andreas Charidimou, Gregoire Boulouis, M Edip Gurol, Cenk Ayata, Brian J Bacskai, Matthew P Frosch, Anand Viswanathan, Steven M Greenberg
Sporadic cerebral amyloid angiopathy is a common, well-defined small vessel disease and a largely untreatable cause of intracerebral haemorrhage and contributor to age-related cognitive decline. The term 'cerebral amyloid angiopathy' now encompasses not only a specific cerebrovascular pathological finding, but also different clinical syndromes (both acute and progressive), brain parenchymal lesions seen on neuroimaging and a set of diagnostic criteria-the Boston criteria, which have resulted in increasingly detected disease during life...
March 13, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28331228/traumatic-brain-injury-results-in-acute-rarefication-of-the-vascular-network
#16
Andre Obenaus, Michelle Ng, Amanda M Orantes, Eli Kinney-Lang, Faisal Rashid, Mary Hamer, Richard A DeFazio, Jiping Tang, John H Zhang, William J Pearce
The role of the cerebrovascular network and its acute response to TBI is poorly defined and emerging evidence suggests that cerebrovascular reactivity is altered. We explored how cortical vessels are physically altered following TBI using a newly developed technique, vessel painting. We tested our hypothesis that a focal moderate TBI results in global decrements to structural aspects of the vasculature. Rats (naïve, sham-operated, TBI) underwent a moderate controlled cortical impact. Animals underwent vessel painting perfusion to label the entire cortex at 1 day post TBI followed by whole brain axial and coronal images using a wide-field fluorescence microscope...
March 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28329325/comparison-of-radial-and-bilateral-internal-thoracic-artery-grafting-in-patients-with-peripheral-vascular-disease%C3%A2
#17
Dmitry Pevni, Yanai Ben-Gal, Rephael Mohr, Nadav Teich, Zvi Raviv, Amir Kramer, Yosef Paz, Benjamin Medalion, Nahum Nesher
OBJECTIVES: The composite T-graft with radial artery (RA) attached end-to-side to the left internal thoracic artery (ITA) provides arterial myocardial revascularization without the increased risk of deep sternal wound infection associated with harvesting 2 ITAs. However, many surgeons are reluctant to use RA in patients with peripheral vascular disease (PVD) due to concerns regarding the quality of the conduit in this subset of patients. The purpose of this study is to compare early- and long-term outcomes of arterial grafting with bilateral ITAs (BITA) to that of single ITA and RA in patients with PVD...
March 2, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329254/periodic-limb-movements-and-white-matter-hyperintensities-in-first-ever-minor-stroke-or-high-risk-transient-ischemic-attack
#18
Mark I Boulos, Brian J Murray, Ryan T Muir, Fuqiang Gao, Gregory M Szilagyi, Menal Huroy, Alexander Kiss, Arthur S Walters, Sandra E Black, Andrew S Lim, Richard H Swartz
Study Objectives: Emerging evidence suggests that periodic limb movements (PLMs) may contribute to the development of cerebrovascular disease. White matter hyperintensities (WMHs), a widely accepted biomarker for cerebral small vessel disease, are associated with incident stroke and death. We evaluated the association between increased PLM indices and WMH burden in patients presenting with stroke or transient ischemic attack (TIA), while controlling for vascular risk factors and stroke severity...
March 1, 2017: Sleep
https://www.readbyqxmd.com/read/28328569/mid-term-follow-up-of-minimally-invasive-multivessel-coronary-artery-bypass-grafting-is-the-early-learning-phase-detrimental
#19
Maria Lorena Rodriguez, Harry R Lapierre, Benjamin Sohmer, David Glineur, Marc Ruel
OBJECTIVE: Minimally invasive coronary artery bypass grafting (MICS CABG) through a small left thoracotomy is a novel technique for surgical coronary revascularization, which is increasingly being adopted around the world. This study aimed to describe the characteristics and mid-term outcomes of a series of MICS CABG to identify areas for improvement. METHODS: A prospective longitudinal study was performed on the 306 MICS CABG patients operated on by a single surgeon from 2005 to 2015...
March 22, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28327964/imaging-approaches-to-stroke-and-neurovascular-disease
#20
Seena Dehkharghani, Jalal Andre
Imaging is paramount to the diagnosis and management of ischemic stroke, offering a battery of structural and functional probes of cerebrovascular physiology. The technical underpinnings of stroke imaging continue to evolve, bringing the neuroscience community increasingly closer to high-resolution, tissue-level biomarkers of brain perfusion, metabolism, and viability. The rapid expansion of neuroimaging in this domain has met with controversies, and in many respects, a lack of generalizable conclusions regarding optimized use in cerebrovascular disease...
January 28, 2017: Neurosurgery
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