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Stroke complication

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https://www.readbyqxmd.com/read/28644260/intravenous-alteplase-for-acute-stroke-and-pulmonary-embolism-in-a-patient-with-recent-abdominoplasty
#1
Michael E Christiansen, Gyanendra Kumar, Raman C Mahabir, Richard A Helmers, Bernard R Bendok, Cumara B O'Carroll
INTRODUCTION: Major surgery in the past 14 days is a relative contraindication to treatment of acute stroke with intravenous (IV) alteplase. The 2016 American Heart Association/American Stroke Association scientific statement discussing inclusion and exclusion criteria for alteplase in acute stroke allows for provider judgment citing a lack of evidence to support surgery as an absolute contraindication. CASE REPORT: A 59-year-old woman presented with acute left hemiparesis, dysarthria, and acute respiratory failure...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28644259/antiphospholipid-syndrome-with-a-distinctive-constellation-of-neurological-manifestations-blue-toes-red-valves-white-retinal-spots
#2
Brandon T Nokes, Oana M Dumitrascu, Fadi E Shamoun, Cumara B OʼCarroll
Antiphospholipid syndrome (APS) encompasses a hypercoagulable state with a markedly increased risk for cerebrovascular complications. In addition to the classic stroke features of APS, however, there are numerous recently described "non-criteria" neurological conditions such as headaches, seizures, and cognitive impairment. We present a case of APS with uncommon neurological manifestations.
July 2017: Neurologist
https://www.readbyqxmd.com/read/28643999/dexmedetomidine-and-general-anesthesia-a-narrative-literature-review-of-its-major-indications-for-use-in-adults-undergoing-non-cardiac-surgery
#3
Arthur Davy, Julien Fessler, Marc Fischler, Morgan le Guen
BACKGROUND: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. METHODS: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords "Dexmedetomidine, Dexdor, Precedex and Dexdomitor". The research ended in December 2016...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28643997/brain-monitoring-in-adult-and-pediatric-ecmo-patients-the-importance-of-early-and-late-assessments
#4
Roberto Lorusso, Fabio S Taccone, Mirko Belliato, Thijs Delnoij, Paolo Zanatta, Mirjana Cvetkovic, Mark Davidson, Jan Belohlavek, Nashwa Matta, Carl Davis, Hanneke Ijsselstijn, Thomas Mueller, Ralf Muellenbach, Dirk Donker, Piero David, Matteo DI Nardo, Dirk Vlasselaers, Dinis Dos Reis Miranda, Aparna Hoskote
Monitoring brain integrity and neuro-cognitive function is a new and important target for the management of a patient treated with extracorporeal membrane oxygenation (ECMO), in particular because of the increasing awareness of cerebral abnormalities that may potentially occur in this setting. Continuous regular monitoring, as well as repeated assessment for cerebral complications has become an essential element of the ECMO patient management. Besides well-known complications, like bleeding, ischemic stroke, seizures, and brain hypoperfusion, other less defined yet relevant injury and clinical manifestations are increasingly reported and impacting on ECMO patient prognosis at short term...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28643603/stroke-like-migraine-attacks-after-radiation-therapy-syndrome-case-report-and-review-of-the-literature
#5
Achint K Singh, Bundhit Tantiwongkosi, Anna-Marieta Moise, Wilson B Altmeyer
A 26-year-old female presented with vision loss accompanied by migraine-like headaches. A contrast-enhanced magnetic resonance imaging of the brain was performed which revealed findings suggestive of stroke-like migraine attacks after radiation therapy (SMART) syndrome. SMART syndrome is a delayed complication of brain radiation characterized by neurologic symptoms including migraine-like headaches, seizures, and hemispheric impairment. The purpose of this article is to make the readers aware of this rare complication of brain irradiation...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28643214/new-generation-devices-for-transfemoral-transcatheter-aortic-valve-replacement-are-superior-compared-with-last-generation-devices-with-respect-to-varc-2-outcome
#6
Julia Seeger, Birgid Gonska, Wolfgang Rottbauer, Jochen Wöhrle
New generation devices for transcatheter aortic valve replacement have been optimized to improve clinical outcome. We compared procedural, in-hospital, 30 days and 12 months outcome of the new generation repositionable Boston Lotus Valve and the balloon-expandable Edwards Sapien 3 valve with the last generation self-expandable Medtronic CoreValve and the balloon-expandable Edwards Sapien XT. Between 2010 and 2015 consecutive patients treated with the Medtronic CoreValve (N = 100), Edwards Sapien XT (N = 100), Edwards Sapien S3 (N = 100) and Boston Lotus device (N = 100) were enrolled...
June 22, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28642018/clinical-study-of-27-patients-with-medial-medullary-infarction
#7
Takayoshi Akimoto, Katsuhiko Ogawa, Akihiko Morita, Yutaka Suzuki, Satoshi Kamei
BACKGROUND: Medial medullary infarction (MMI) is a rare ischemic stroke. Frequency of each neurological finding in MMI was different in each study. METHODS: We retrospectively evaluated the medical records of patients with cerebral infarction who were admitted between March 1998 and October 2015. Patients in our study were diagnosed as having MMI by magnetic resonance image examination. RESULTS: Of 2727 patients with ischemic stroke, 27 patients (20 males and 7 females) had MMI...
June 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28640117/incidence-of-constipation-in-stroke-patients-a-systematic-review-and-meta-analysis
#8
Jianxiang Li, Mengguo Yuan, Yunfang Liu, Yang Zhao, Jingqing Wang, Weifeng Guo
There is growing awareness of a link between the gut and cardiovascular disease. Constipation is common among individuals who have had a stroke, and it negatively affects social functioning and quality of life. However, no systematic study on the incidence of constipation in stroke patients has been reported.We selected studies included in Medline, Embase, Cochrane database, and Web of Science. Studies were included if they reported the incidence in stroke patients. Two authors selected the studies, extracted the data independently, and assessed these...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639262/interprofessional-collaboration-to-improve-professional-practice-and-healthcare-outcomes
#9
REVIEW
Scott Reeves, Ferruccio Pelone, Reema Harrison, Joanne Goldman, Merrick Zwarenstein
BACKGROUND: Poor interprofessional collaboration (IPC) can adversely affect the delivery of health services and patient care. Interventions that address IPC problems have the potential to improve professional practice and healthcare outcomes. OBJECTIVES: To assess the impact of practice-based interventions designed to improve interprofessional collaboration (IPC) amongst health and social care professionals, compared to usual care or to an alternative intervention, on at least one of the following primary outcomes: patient health outcomes, clinical process or efficiency outcomes or secondary outcomes (collaborative behaviour)...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28639039/a-novel-endoscopic-surgery-for-dysphagia-after-stroke
#10
Jian Wang, Wuyi Li, Yongjin Li, Xiaofeng Jin, Yanyan Niu, Xu Tian, Hong Huo
BACKGROUND: Dysphagia is a common complication in stroke patients, which severely affects quality of life. This study aimed to evaluate the effectiveness and safety of temperature-controlled plasma radiofrequency (coblation)-assisted endoscopic cricopharyngeal myotomy (CAECPM) for the treatment sustained (>6 months) dysphagia in stroke patients. METHODS: This retrospective case-control study included a total of 24 stroke patients with sustained dysphagia, who were either treated with transcervical cricopharyngeal myotomy (CPM) (n = 16) or CAECPM (n = 12)...
June 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28638249/circulatory-levels-of-c-x-c-motif-chemokine-ligands-1-9-and-10-are-elevated-in-patients-with-ischemic-stroke
#11
Masoud Amin, Alireza Vakilian, Mohammad Hossein Mahmoodi, Gholamhossein Hassanshahi, Soudeh Khanamani Falahati-Pour, Maryam Rafiei Dolatabadi, Ali Esmaeili Nadimi
OBJECTIVE: Inflammation plays a significant role in the development of ischemic stroke. CXC chemokines play pleiotropic roles in prolonged leukocyte locomotion, astrocyte migration/activation, and neural attachment/sprouting in response to focal stroke. In this study, we aimed to explore the changes in serum levels of three chemokines, C-X-C motif chemokine ligand 1 (CXCL1), C-X-C motif chemokine ligand 9 (CXCL9), and C-X-C motif chemokine ligand 10 (CXCL10), in ischemic stroke patients at the time of admission and before discharge from the hospital ward...
June 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28637886/cardiovascular-disease-and-type-2-diabetes-has-the-dawn-of-a-new-era-arrived
#12
Muhammad Abdul-Ghani, Ralph A DeFronzo, Stefano Del Prato, Robert Chilton, Rajvir Singh, Robert E J Ryder
Hyperglycemia is the major risk factor for microvascular complications in patients with type 2 diabetes (T2D). However, cardiovascular disease (CVD) is the principal cause of death, and lowering HbA1c has only a modest effect on reducing CVD risk and mortality. The recently published LEADER and SUSTAIN-6 trials demonstrate that, in T2D patients with high CVD risk, the glucagon-like peptide 1 receptor agonists liraglutide and semaglutide reduce the primary major adverse cardiac events (MACE) end point (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke) by 13% and 24%, respectively...
July 2017: Diabetes Care
https://www.readbyqxmd.com/read/28637732/outpatient-percutaneous-native-renal-biopsy-safety-profile-in-a-large-monocentric-cohort
#13
Dario Roccatello, Savino Sciascia, Daniela Rossi, Carla Naretto, Mario Bazzan, Laura Solfietti, Simone Baldovino, Elisa Menegatti
OBJECTIVES: We aim to evaluate the safety of performing percutaneous native kidney biopsy (PKB) as an outpatient procedure (implying an observation period of 6 hours) compared with the traditional inpatient policy. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: Group I, in whom PKB was performed in the outpatient department (2012-2016) and followed by 6 hours' observation period and then by regular outpatient visits and group II, in whom PKB was performed and followed by at least 1 day hospital admission...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28637340/an-analysis-of-the-use-of-multichannel-microelectrode-recording-during-deep-brain-stimulation-surgeries-at-a-single-center
#14
Steven Falowski, James Dierkes
BACKGROUND: Microelectrode recording (MER) can be used to map out the target nucleus and identify ideal lead placement. OBJECTIVE: To assess the use of multichannel MER to increase the efficiency of lead placement without compromising patient safety. METHODS: Analysis of a single center's technique for utilizing multichannel MER with 3 consistent anterior-to-posterior simultaneous passes that include an evaluation of the location of final lead placement, patient diagnosis, target nuclei, and additional work involved for refinement of targeting...
June 14, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28636749/annual-direct-medical-costs-associated-with-diabetes-related-complications-in-the-event-year-and-in-subsequent-years-in-hong-kong
#15
F Jiao, C K H Wong, S C W Tang, C S C Fung, K C B Tan, S McGhee, R Gangwani, C L K Lam
AIM: To develop models to estimate the direct medical costs associated with diabetes-related complicationsin the event year and in subsequent years. METHODS: The public direct medical costs associated with 13 diabetes-related complications were estimated among a cohort of 128 353 people with diabetes over 5 years. Private direct medical costs were estimated from a cross-sectional survey among 1825 people with diabetes. We used panel data regression with fixed effects to investigate the impact of each complication on direct medical costs in the event year and subsequent years, adjusting for age and co-existing complications...
June 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28635876/-salivation-after-stroke
#16
Z A Zalyalova
Salivation after stroke (sialorrhea, hypersalivation, ptyalism) can be caused by the overproduction or a lack of utilization of saliva. Patients after stroke often have sialorrhea as a result of dysphagia. Neurogenic dysphagia in acute period after stroke occurs in 25-65% of patients. The mortality rate among people with post-stroke dysphagia and tube feeding ranges from 20 to 24%. Patients who suffering from profuse salivation have difficulties with articulation and swallowing, bad breath, irritation and maceration of perioral area, contamination of clothing and bed linen...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28635328/dietary-implications-for-patients-receiving-long-term-oral-anticoagulation-therapy-for-treatment-and-prevention-of-thromboembolic-disease
#17
Emmanouela Kampouraki, Farhad Kamali
The effectiveness of oral anticoagulation therapy with warfarin (a vitamin K antagonist) in the treatment of thromboembolic disease, including stroke prophylaxis in patients with atrial fibrillation is well recognised. However, warfarin has a narrow therapeutic window and an unpredictable anticoagulation response, which make it difficult to achieve and maintain optimal anticoagulation. Various dietary factors, including sudden changes in eating patterns, can significantly alter anticoagulation control, thereby potentially exposing patients to the risk of bleeding or thromboembolic complications...
June 21, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28633397/impact-of-a-refined-advanced-design-for-left-atrial-appendage-exclusion
#18
Gengo Sunagawa, Jamshid H Karimov, May Breitbach, Nicholas A Robinson, Kiyotaka Fukamachi
OBJECTIVES: Exclusion of the left atrial appendage has been proposed to reduce the risk of stroke in patients with atrial fibrillation. The aim of this study was to evaluate the feasibility and efficacy of the AtriClip PRO·V device (AOD2), now in development, for left atrial appendage exclusion in a canine model. METHODS: The newest AtriClip design comprises a dual-spring mechanism that allows the clip to open into a 'V' shape while still providing equivalent force along the length of the beam...
June 13, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28632121/anti-inflammatory-treatment-and-risk-for-depression-after-first-time-stroke-in-a-cohort-of-147-487-danish-patients
#19
Ida Kim Wium-Andersen, Marie Kim Wium-Andersen, Martin Balslev Jørgensen, Merete Osler
BACKGROUND: Depression is a common complication after stroke, and inflammation may be a pathophysiological mechanism. This study examines whether anti-inflammatory treatment with acetylsalicylic acid (ASA), nonsteroid anti-inflammatory drugs (NSAID) or statins influence the risk of depression after stroke. METHODS: A register-based cohort including all patients admitted to hospital with a first-time stroke from Jan. 1, 2001, through Dec. 31, 2011, and a nonstroke population with a similar age and sex distribution was followed for depression until Dec...
June 20, 2017: Journal of Psychiatry & Neuroscience: JPN
https://www.readbyqxmd.com/read/28631316/recannulation-of-the-axillary-artery-in-aortic-and-complex-cardiac-surgery
#20
Philippa Jane Temple Bowers, Manu Narain Mathur
OBJECTIVES: Axillary artery cannulation has been used as an alternative site for cardiopulmonary bypass during surgery for aortic dissections and aneurysmal disease of the ascending aorta and arch. This study reports our experience with reusing the axillary artery for cardiopulmonary bypass during complex aortic and cardiac surgical procedures. METHODS: This was a retrospective review of a single surgeon's experience of recannulating the axillary artery for redo operations in complex aortic surgery...
June 19, 2017: Journal of Cardiac Surgery
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