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https://www.readbyqxmd.com/read/28725983/dabigatran-and-vitamin-k-antagonists-use-in-na%C3%A3-ve-patients-with-non-valvular-atrial-fibrillation-a-cross-sectional-study-of-primary-care-based-electronic-health-records
#1
Bogdan Vlacho, Maria Giner-Soriano, Edurne Zabaleta-Del-Olmo, Albert Roso-Llorach, Ana García-Sangenís, Rosa Morros-Pedrós
PURPOSE: The purpose of this study was to characterize the profile of patients with non-valvular atrial fibrillation who start an anticoagulant treatment after diagnosis with dabigatran and compare it with those who start with vitamin K antagonists (VKAs). METHODS: We analysed primary health care-based electronic health records data from 15,075 people with new diagnosis of atrial fibrillation who initiated treatment with dabigatran or VKA spanning 2011-2013. Logistic regression analysis for determination of factors associated with initiation of dabigatran was performed...
July 19, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28718878/deep-brain-and-cortical-stimulation-for-epilepsy
#2
REVIEW
Mathieu Sprengers, Kristl Vonck, Evelien Carrette, Anthony G Marson, Paul Boon
BACKGROUND: Despite optimal medical treatment, including epilepsy surgery, many epilepsy patients have uncontrolled seizures. Since the 1970s interest has grown in invasive intracranial neurostimulation as a treatment for these patients. Intracranial stimulation includes both deep brain stimulation (DBS) (stimulation through depth electrodes) and cortical stimulation (subdural electrodes). This is an updated version of a previous Cochrane review published in 2014. OBJECTIVES: To assess the efficacy, safety and tolerability of DBS and cortical stimulation for refractory epilepsy based on randomized controlled trials (RCTs)...
July 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28718234/paediatrics-brain-imaging-in-epilepsy-common-presenting-symptoms-and-spectrum-of-abnormalities-detected-on-mri
#3
Azmat Ali, Faiza Akram, Ghayyur Khan, Shaukat Hussain
BACKGROUND: Epilepsy, a common neurological disorder can present at any age and has a number of aetiologies with underlying brain disease being the most common aetiology. Brain imaging becomes important and mandatory in the work up for epilepsy in localization and lateralization of the seizure focus. METHODS: This cross-sectional study was conducted in the department of Radiology Ayub Medical Teaching Institution Abbottabad from 1st March 2015 to 31st March 2016...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28716276/adult-posthaemorrhagic-hydrocephalus-animal-models
#4
REVIEW
Cong Hua, Gang Zhao
Posthaemorrhagic hydrocephalus (PHH) is often associated with high morbidity and mortality and serves as an important clinical predictor of poor outcomes after intracranial haemorrhage (ICH). We are lack of effective medical intervention methods to improve functional outcomes in patients with PHH because little is still known about the mechanisms of PHH pathogenesis. Animal models play a key role in the study of PHH. Developed a suitable animal model that will help us to be better to find preventative strategies and improve the prognosis of patients with PHH...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28716153/a-nested-mechanistic-sub-study-into-the-effect-of-tranexamic-acid-versus-placebo-on-intracranial-haemorrhage-and-cerebral-ischaemia-in-isolated-traumatic-brain-injury-study-protocol-for-a-randomised-controlled-trial-crash-3-trial-intracranial-bleeding-mechanistic
#5
Abda Mahmood, Ian Roberts, Haleema Shakur
BACKGROUND: Tranexamic acid prevents blood clots from breaking down and reduces bleeding. However, it is uncertain whether tranexamic acid is effective in traumatic brain injury. The CRASH-3 trial is a randomised controlled trial that will examine the effect of tranexamic acid (versus placebo) on death and disability in 13,000 patients with traumatic brain injury. The CRASH-3 trial hypothesizes that tranexamic acid will reduce intracranial haemorrhage, which will reduce the risk of death...
July 17, 2017: Trials
https://www.readbyqxmd.com/read/28712001/in-hospital-ischaemic-stroke-treated-with-intravenous-thrombolysis-or-mechanical-thrombectomy
#6
François Caparros, Marc Ferrigno, Amélie Decourcelle, Anais Hochart, Solène Moulin, Nelly Dequatre, Marie Bodenant, Hilde Hénon, Charlotte Cordonnier, Didier Leys
Patients with in-hospital strokes (IHS) may be eligible for recanalization therapies. The objective of this study is to compare outcomes in patients with IHS and community-onset strokes (COS) treated by recanalization therapy. We analysed data prospectively collected in consecutive patients treated by thrombolysis, thrombectomy, or both for cerebral ischemia at the Lille University Hospital. We compared four outcomes measures at 3 months in patients with IHS and COS: (1) modified Rankin scale (mRS) 0-1, (2) mRS 0-2, (3) death, and (4) symptomatic intracranial haemorrhage (ECASS 2 definition)...
July 15, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28705843/headache-tia-and-subarachnoid-haemorrhage-dissecting-an-unusual-cause-for-stroke-like-symptoms
#7
Elliot T Dawson, Desmond A Brown, Alejandro A Rabinstein
We present a case of supraclinoid internal carotid artery dissection. Eleven months prior, the patient developed isolated periorbital pain and was diagnosed with giant-cell arteritis with iritis. The patient experienced recurrent spells concerning for transient ischaemic attacks and was transferred to our institution for endovascular intervention after head CT revealed an embolic infarct with a 'dense middle cerebral artery sign.' Digital subtraction angiography was negative for occlusion, instead demonstrating luminal stenosis and poststenotic dilatation...
July 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28700711/non-vitamin-k-oral-anticoagulants-are-non-inferior-for-stroke-prevention-but-cause-fewer-major-bleedings-than-well-managed-warfarin-a-retrospective-register-study
#8
Vilhelm Sjögren, Björn Byström, Henrik Renlund, Peter J Svensson, Jonas Oldgren, Bo Norrving, Anders Själander
BACKGROUND: For patients with atrial fibrillation, non-vitamin K oral anticoagulants, or NOACs (dabigatran, rivaroxaban, edoxaban, and apixaban) have been proven non-inferior or superior to warfarin in preventing stroke and systemic embolism, and in risk of haemorrhage. In the pivotal NOAC studies, quality of warfarin treatment was poor with mean time in therapeutic range (TTR) 55-65%, compared with ≥70% in Swedish clinical practice. METHODS: We compared NOACs (as a group) to warfarin in non-valvular atrial fibrillation, studying all 12,694 patients starting NOAC treatment within the Swedish clinical register and dosing system Auricula, from July 1, 2011 to December 31, 2014, and matching them to 36,317 patients starting warfarin using propensity scoring...
2017: PloS One
https://www.readbyqxmd.com/read/28699675/intracranial-haemorrhage-in-children-and-adolescents-with-severe-haemophilia-a-or-b-the-impact-of-prophylactic-treatment
#9
Nadine G Andersson, Günter Auerswald, Chris Barnes, Manuel Carcao, Amy L Dunn, Karin Fijnvandraat, Marianne Hoffmann, Kaan Kavakli, Gili Kenet, Rainer Kobelt, Karin Kurnik, Ri Liesner, Anne Mäkipernaa, Marilyn J Manco-Johnson, Maria E Mancuso, Angelo C Molinari, Beatrice Nolan, Rosario Perez Garrido, Pia Petrini, Helen E Platokouki, Amy D Shapiro, Runhui Wu, Rolf Ljung
The discussion of prophylactic therapy in haemophilia is largely focused on joint outcomes. The impact of prophylactic therapy on intracranial haemorrhage (ICH) is less known. This study aimed to analyse ICH in children with haemophilia, with a focus on different prophylaxis regimens and sequelae of ICH. We conducted a multicentre retrospective and prospective study that included 33 haemophilia centres from 20 countries. Inclusion criteria were children and adolescents born between 1993 and 2014, with severe haemophilia A or B without inhibitors...
July 12, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28699168/intellectual-disability-in-children-aged-less-than-seven-years-born-moderately-and-late-preterm-compared-with-very-preterm-and-term-born-children-a-nationwide-birth-cohort-study
#10
M Hirvonen, R Ojala, P Korhonen, P Haataja, K Eriksson, K Rantanen, M Gissler, T Luukkaala, O Tammela
BACKGROUND: Prematurity has been shown to be associated with an increased risk of intellectual disability (ID). METHOD: The aim was to establish whether the prevalence of ID, defined as significant limitations in both intellectual (intelligence quotient below 70) and adaptive functioning among moderately preterm (MP; 32(+0) -33(+6)  weeks) and late preterm (LP; 34(+0) -36(+6)  weeks) infants, is increased compared with that in term infants (≥37(+0)  weeks)...
July 11, 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/28698750/the-relationship-between-risk-factors-of-head-trauma-with-ct-scan-findings-in-children-with-minor-head-trauma-admitted-to-hospital
#11
Babak Masoumi, Farhad Heydari, Hamidreza Hatamabadi, Reza Azizkhani, Zahra Yoosefian, Majid Zamani
BACKGROUND: In emergency medicine for determining the intracranial injury (ICI) in children with head trauma, usually brain CT scan is performed. Since brain CT scan, especially in children, has some disadvantages, it is better to find a procedure which could help to choose only the children with real head trauma injury for brain CT scan. AIMS: The aim of this study is to find such procedure. This study was descriptive, analytic and non-interventional. METHODS: We reviewed the archived files of children with head trauma injuries referred to the emergency department of Imam Hossein Hospital within two years...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28692106/haemostasis-biomarkers-and-risk-of-intracerebral-haemorrhage-in-the-reasons-for-geographic-and-racial-differences-in-stroke-study
#12
Neil Zakai, Nels C Olson, Suzanne E Judd, Dawn O Kleindorfer, Brett M Kissela, George Howard, Mary Cushman
Pathologic alterations in haemostasis cause bleeding disorders, but it is unknown if variation within the normal range relates to intracerebral haemorrhage (ICH) risk. It was our objective to assess the prospective associations of haemostasis biomarkers with ICH risk. The REasons for Geographic and Racial Differences in Stroke study (REGARDS) recruited 30,239 U. S. individuals aged ≥45 years. ICH was ascertained through biannual telephone contact and review of deaths followed by medical record evaluation...
July 6, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28683728/post-operative-re-bleeding-in-patients-with-hypertensive-ich-is-closely-associated-with-the-ct-blend-sign
#13
Guofeng Wu, Zhengkui Shen, Likun Wang, Shujie Sun, Jinbiao Luo, Yuanhong Mao
BACKGROUNDS: Intracranial post-operative re-haemorrhage is an important complication in patients with hypertensive intracerebral haemorrhage (ICH). The purpose of the present study was to determine the value of the computed tomography (CT) blend sign in predicting post-operative re-haemorrhage in patients with ICH. METHODS: A total of 126 patients with ICH were included in the present study. All the patients underwent standard stereotactic minimally invasive surgery(MIS) to remove the ICH within 24 h following admission...
July 6, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28679888/cfd-modelling-of-local-hemodynamics-in-intracranial-aneurysms-harboring-arterial-branches
#14
Vladimir Krylov, Elena Grigoryeva, Daria Dolotova, Evgenia Blagosklonova, Andrey Gavrilov
The main cause of non-traumatic subarachnoid haemorrhage is an intracranial aneurysm's rupture. The choice of treatment approach is exceptionally difficult in cases of aneurysms with additional branches on the aneurysm's dome or neck. The impact of the arterial branches on local hemodynamics is still unclear and controversial question. At the same time, up-to-date methods of image processing and mathematical modeling provide a way to investigate the hemodynamic environment of aneurysms. The paper discusses hemodynamic aspects of aneurysms harboring arterial branch through the use of patient-specific 3D models and computational fluid dynamics (CFD) methods...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28671322/factors-related-to-retinal-haemorrhage-in-infants-born-at-high-risk
#15
Qinglan Pu, Ping Li, Huiqin Jiang, Hong Wang, Qiaoyun Zhou, Jia Liu, Wenhua Zhong, Huafei Huang
PURPOSE: This study aims to determine risk factors for retinal haemorrhage (RH) in high-risk infants. METHODS: A total of 3123 cases with high-risk pregnancy and/or neonatal asphyxia 72 hr after delivery were enrolled into this study. Fundus examinations were performed on newborns utilizing a wide-angle imaging system (RetCam III). Retinal haemorrhage (RH) was classified into three grades. Maternal, obstetric and neonatal parameters from high-risk infants with RH were compared with parameters from infants without RH...
July 3, 2017: Acta Ophthalmologica
https://www.readbyqxmd.com/read/28659171/comparison-of-endoscopic-evacuation-stereotactic-aspiration-and-craniotomy-for-the-treatment-of-supratentorial-hypertensive-intracerebral-haemorrhage-study-protocol-for-a-randomised-controlled-trial
#16
Xinghua Xu, Yi Zheng, Xiaolei Chen, Fangye Li, Huaping Zhang, Xin Ge
BACKGROUND: Hypertensive intracerebral haemorrhage (HICH) is the most common form of haemorrhagic stroke with the highest morbidity and mortality of all stroke types. The choice of surgical or conservative treatment for patients with HICH remains controversial. In recent years, minimally invasive surgeries, such as endoscopic evacuation and stereotactic aspiration, have been attempted for haematoma removal and offer promise. However, research evidence on the benefits of endoscopic evacuation or stereotactic aspiration is still insufficient...
June 28, 2017: Trials
https://www.readbyqxmd.com/read/28656193/a-preliminary-review-of-warfarin-toxicity-in-a-tertiary-hospital-in-cape-town-south-africa
#17
Annemarie Jacobs, Fatima Bassa, Eric H Decloedt
AIM: Warfarin is a widely used anticoagulant for the prevention and treatment of thromboembolism. We conducted a retrospective review to determine the causes and management of warfarin toxicity of patients admitted to Tygerberg hospital between June 2014 and June 2015. RESULTS: We identified and evaluated 126 patients who met the inclusion criteria. The cause of warfarin toxicity was identified and addressed in only 14.3% (18/126) of patients. Where the cause was identified, 56% (10/18) was due to dosing errors and 17% (3/18) drug-drug interaction (DDI)...
May 21, 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/28652053/mr-imaging-in-hyperacute-ischemic-stroke
#18
Carla Vert, Carmen Parra Fariñas, Àlex Rovira
Brain and vascular imaging are required components of the emergency assessment of patients with suspected stroke. Either CT or MRI may be used as the initial imaging test. MRI is more sensitive to the presence of acute and chronic ischemic lesions, and chronic microbleeds, but CT remains the most practical and used initial brain imaging test. Although, a non-enhanced CT or T2* MRI sequence showing no haemorrhage is sufficient for deciding intravenous treatment eligibility within the first 4.5h after stroke onset, a non-invasive intracranial vascular study is strongly recommended during the initial imaging evaluation of the acute stroke patient, particularly if mechanical thrombectomy is contemplated...
June 19, 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28647723/a-retrospective-cohort-study-of-high-impact-users-among-patients-with-cerebrovascular-conditions
#19
Ahsan Rao, Alice Jones, Alex Bottle, Ara Darzi, Paul Aylin
OBJECTIVE: To apply group-based trajectory modelling (GBTM) to the hospital administrative data to evaluate, model and visualise trends and changes in the frequency of long-term hospital care use of the subgroups of patients with cerebrovascular conditions. DESIGN: A retrospective cohort study of patients with cerebrovascular conditions. SETTINGS: Secondary care of all patients with cerebrovascular conditions admitted to English National Hospital Service hospitals...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28645776/selective-inhibition-of-flt3-by-gilteritinib-in-relapsed-or-refractory-acute-myeloid-leukaemia-a-multicentre-first-in-human-open-label-phase-1-2-study
#20
Alexander E Perl, Jessica K Altman, Jorge Cortes, Catherine Smith, Mark Litzow, Maria R Baer, David Claxton, Harry P Erba, Stan Gill, Stuart Goldberg, Joseph G Jurcic, Richard A Larson, Chaofeng Liu, Ellen Ritchie, Gary Schiller, Alexander I Spira, Stephen A Strickland, Raoul Tibes, Celalettin Ustun, Eunice S Wang, Robert Stuart, Christoph Röllig, Andreas Neubauer, Giovanni Martinelli, Erkut Bahceci, Mark Levis
BACKGROUND: Internal tandem duplication mutations in FLT3 are common in acute myeloid leukaemia and are associated with rapid relapse and short overall survival. The clinical benefit of FLT3 inhibitors in patients with acute myeloid leukaemia has been limited by rapid generation of resistance mutations, particularly in codon Asp835 (D835). We aimed to assess the highly selective oral FLT3 inhibitor gilteritinib in patients with relapsed or refractory acute myeloid leukaemia. METHODS: In this phase 1-2 trial, we enrolled patients aged 18 years or older with acute myeloid leukaemia who either were refractory to induction therapy or had relapsed after achieving remission with previous treatment...
June 20, 2017: Lancet Oncology
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