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Stroke clinical outcomes

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https://www.readbyqxmd.com/read/28340049/cardiac-troponin-i-as-a-predictor-of-mortality-in-patients-with-first-episode-acute-atrial-fibrillation
#1
Mohammad E Naffaa, Roni Nasser, Elias Manassa, Maha Younis, Zaher S Azzam, Doron Aronson
Background: Recent-onset atrial fibrillation (AF) is a frequent cause for presentation to the emergency department. Recent studies proposed that the addition of biomarker information might improve the prediction of clinical outcomes by enabling identification of patients at high risk. Aim: We aimed to examine the role of cardiac troponin I as a predictor of clinical outcome in patients with first episode acute atrial fibrillation. Design: : Patients, 18 years or older, presenting to our hospital with a primary diagnosis of first episode acute atrial fibrillation were included in this retrospective study...
March 11, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28339617/searching-for-the-smoker-s-paradox-in-acute-stroke-patients-treated-with-intravenous-thrombolysis
#2
Haitham M Hussein, Nicki Niemann, Emily D Parker, Adnan I Qureshi
Background: Inconsistent evidence supports better outcome in smokers after stroke. Our study examines this association in a large sample of ischemic stroke treated with intravenous thrombolysis. Method: Virtual International Stroke Trials Archive (VISTA) database, composed of individual patient data of multiple clinical trials, was queried. The primary outcome was functional independence at 3 months noted by modified Rankin Scale (mRS; a 7-point scale ranging from 0 [no deficit] to 6 [death]) score≤ 2...
January 28, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28339404/the-influence-of-task-related-training-combined-with-transcutaneous-electrical-nerve-stimulation-on-paretic-upper-limb-muscle-activation-in-patients-with-chronic-stroke
#3
Kyoungsim Jung, Jinhwa Jung, Taesung In, Taehoon Kim, Hwi-Young Cho
OBJECTIVES: This study investigated the efficacy of Task-Related Training (TRT) Combined with Transcutaneous Electrical Nerve Stimulation (TENS) on the improvement of upper limb muscle activation in chronic stroke survivors with mild or moderate paresis. METHODS: A single-blind, randomized clinical trial was conducted with 46stroke survivors with chronic paresis. They were randomly allocated two groups: the TRT+TENS group (n = 23) and the TRT+ placebo TENS (TRT+PLBO) group (n = 23)...
March 23, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28338937/association-of-blood-pressure-trajectory-with-mortality-incident-cardiovascular-disease-and-heart-failure-in-the-cardiovascular-health-study
#4
Christopher C Smitson, Rebecca Scherzer, Michael G Shlipak, Bruce M Psaty, Anne B Newman, Mark J Sarnak, Michelle C Odden, Carmen A Peralta
BACKGROUND: Common blood pressure (BP) trajectories are not well established in elderly persons, and their association with clinical outcomes is uncertain. METHODS: We used hierarchical cluster analysis to identify discrete BP trajectories among 4,067 participants in the Cardiovascular Health Study using repeated BP measures from years 0 to 7. We then evaluated associations of each BP trajectory cluster with all-cause mortality, incident cardiovascular disease (CVD, defined as stroke or myocardial infarction) (N = 2,837), and incident congestive heart failure (HF) (N = 3,633) using Cox proportional hazard models...
March 10, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28338788/hypertension-and-atrial-fibrillation-an-intimate-association-of-epidemiology-pathophysiology-and-outcomes
#5
Mikhail S Dzeshka, Farhan Shahid, Alena Shantsila, Gregory Y H Lip
Atrial fibrillation (AF) is the most prevalent sustained arrhythmia found in clinical practice. AF rarely exists as a single entity but rather as part of a diverse clinical spectrum of cardiovascular diseases, related to structural and electrical remodeling within the left atrium, leading to AF onset, perpetuation, and progression. Due to the high overall prevalence within the AF population arterial hypertension plays a significant role in the pathogenesis of AF and its complications. Fibroblast proliferation, apoptosis of cardiomyocytes, gap junction remodeling, accumulation of collagen both in atrial and ventricular myocardium all accompany ageing-related structural remodeling with impact on electrical activity...
February 18, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28338434/coexistence-of-obstructive-sleep-apnea-worsens-the-overall-outcome-of-intracranial-aneurysm-a-pioneer-study
#6
Shyamal C Bir, Anil Nanda, Hugo Cuellar, Hai Sun, Bharat Guthikonda, Cesar Liendo, Alireza Minagar, Oleg Y Chernyshev
OBJECTIVE Obstructive sleep apnea (OSA) is associated with the progression of abdominal and thoracic aortic aneurysms. However, the role of OSA in the overall outcome of intracranial aneurysms (IAs) has not yet been established. Authors of this report investigated the role of OSA in the overall outcome of IAs. METHODS Radiological and clinical data on patients (from 2010 through 2015) with confirmed IA were retrospectively reviewed. Significant differences between the OSA and non-OSA groups were determined using a chi-square test...
March 21, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28337386/long-term-clinical-outcomes-of-patients-with-rheumatoid-arthritis-and-concomitant-coronary-artery-disease
#7
Marco Spartera, Cosmo Godino, Elena Baldissera, Corrado Campochiaro, Ketty La Spina, Patrizia Aiello, Anna Salerno, Michela Cera, Valeria Magni, Richard J Jabbour, Lorenzo Dagna, Moreno Tresoldi, Alberto Cappelletti, Ottavio Alfieri, Antonio Colombo, Maria Grazia Sabbadini, Alberto Margonato
BACKGROUND: Rheumatoid arthritis (RA) is associated with high morbidity and mortality predominately due to increased cardiovascular risk. Few reports are available regarding the management of coronary artery disease (CAD) in RA patients and the long-term clinical outcomes after coronary revascularization. METHODS AND RESULTS: All consecutive patients with RA were identified by retrospective review at a rheumatology tertiary center in Milan, Italy between 2001 and 2013...
2017: American Journal of Cardiovascular Disease
https://www.readbyqxmd.com/read/28337356/cervical-stimulation-in-the-treatment-of-children-with-lymphedema-of-all-four-extremities-a-case-report-and-literature-review
#8
Livia Maria Pereira de Godoy, Paula Pereira de Godoy Capeletto, José Maria Pereira de Godoy, Maria de Fátima Guerreiro Godoy
Aim. The aim of this study is to report on the use of cervical stimulation as monotherapy to reduce swelling and normalize the size of limbs in two children with lymphedema of all four extremities. Case Presentation. One child also had hemifacial edema. In both cases, the mothers were trained to perform cervical stimulation under professional supervision. The cases of two girls, one of eight months and the other of six months, with primary congenital lymphedema are described. Outcome. After clinical diagnosis, the patients started treatment with cervical stimulation three times per week...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28337302/different-impairment-of-immune-and-inflammation-functions-in-short-and-long-term-after-ischemic-stroke
#9
Wen-Xing Li, Fei Qi, Jia-Qian Liu, Gong-Hua Li, Shao-Xing Dai, Tao Zhang, Fei Cheng, Dahai Liu, Song Guo Zheng
Ischemic stroke therapy and prognosis outcomes largely depend on the time periods after symptom onset. This study aims to explore the difference of global gene expression profiles and impairment of biological functions between short-term and long-term after stroke onset. We compared three short-term (3 h, 5 h and 24 h) and a long-term (6-month) gene expression levels by a multi-platform microarray data integration method. RankProd was used to calculate the differentially expressed genes between stroke patients and controls...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28336790/prioritizing-functional-capacity-as-a-principal-end-point-for-therapies-oriented-to-older-adults-with-cardiovascular-disease-a-scientific-statement-for-healthcare-professionals-from-the-american-heart-association
#10
REVIEW
Daniel E Forman, Ross Arena, Rebecca Boxer, Mary A Dolansky, Janice J Eng, Jerome L Fleg, Mark Haykowsky, Arshad Jahangir, Leonard A Kaminsky, Dalane W Kitzman, Eldrin F Lewis, Jonathan Myers, Gordon R Reeves, Win-Kuang Shen
Adults are living longer, and cardiovascular disease is endemic in the growing population of older adults who are surviving into old age. Functional capacity is a key metric in this population, both for the perspective it provides on aggregate health and as a vital goal of care. Whereas cardiorespiratory function has long been applied by cardiologists as a measure of function that depended primarily on cardiac physiology, multiple other factors also contribute, usually with increasing bearing as age advances...
March 23, 2017: Circulation
https://www.readbyqxmd.com/read/28336788/transcatheter-treatment-of-severe-tricuspid-regurgitation-with-the-edge-to-edge-mitraclip-technique
#11
Georg Nickenig, Marek Kowalski, Jörg Hausleiter, Daniel Braun, Joachim Schofer, Ermela Yzeiraj, Volker Rudolph, Kai Friedrichs, Francesco Maisano, Maurizio Taramasso, Neil P Fam, Giovanni Bianchi, Francesco Bedogni, Paolo Denti, Ottavio Alfieri, Azeem Latib, Antonio Colombo, Christoph Hammerstingl, Robert Schueler
Background -Current surgical and medical treatment options for severe tricuspid regurgitation (TR) are limited and additional interventional approaches are required. In the present observational study, the safety and feasibility of transcatheter repair of chronic severe TR with the MitraClip system were evaluated. In addition, the effects on clinical symptoms were assessed. Methods -Patients with heart failure symptoms and severe TR on optimal medical treatment were treated with the MitraClip system. Safety, defined as periprocedural adverse events such as death, myocardial infarction, stroke, or cardiac tamponade, and feasibility, defined as successful implantation of one or more MitraClip devices and reduction of TR by at least one grade, were evaluated before discharge and after 30 days...
March 23, 2017: Circulation
https://www.readbyqxmd.com/read/28336740/towards-personalised-intra-arterial-treatment-of-patients-with-acute-ischaemic-stroke-a-study-protocol-for-development-and-validation-of-a-clinical-decision-aid
#12
Maxim J H L Mulder, Esmee Venema, Bob Roozenbeek, Joseph P Broderick, Sharon D Yeatts, Pooja Khatri, Olvert A Berkhemer, Yvo B W E M Roos, Charles B L M Majoie, Robert J van Oostenbrugge, Wim H van Zwam, Aad van der Lugt, Ewout W Steyerberg, Diederik W J Dippel, Hester F Lingsma
INTRODUCTION: Overall, intra-arterial treatment (IAT) proved to be beneficial in patients with acute ischaemic stroke due to a proximal occlusion in the anterior circulation. However, heterogeneity in treatment benefit may be relevant for personalised clinical decision-making. Our aim is to improve selection of patients for IAT by predicting individual treatment benefit or harm. METHODS AND ANALYSIS: We will use data collected in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) trial to analyse the effect of baseline characteristics on outcome and treatment effect...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28336387/the-word-heart-federation-roadmap-for-nonvalvular-atrial-fibrillation
#13
Adrianna Murphy, Amitava Banerjee, Günter Breithardt, A John Camm, Patrick Commerford, Ben Freedman, J Antonio Gonzalez-Hermosillo, Jonathan L Halperin, Chu-Pak Lau, Pablo Perel, Denis Xavier, David Wood, Xavier Jouven, Carlos A Morillo
BACKGROUND: The World Heart Federation has undertaken an initiative to develop a series of Roadmaps to promote development of national policies and health systems approaches, and to identify potential roadblocks on the road to effective prevention, detection, and management of cardiovascular disease in low-and middle-income countries (LMICs) and develop strategies for overcoming these. This Roadmap focuses on atrial fibrillation (AF). AF is the most common, clinically significant arrhythmia and, among other clinical outcomes, is associated with increased risk of stroke...
March 20, 2017: Global Heart
https://www.readbyqxmd.com/read/28335701/the-effect-of-a-whole-body-vibration-therapy-on-the-sitting-balance-of-subacute-stroke-patients-a-randomized-controlled-trial
#14
Jong Hwa Lee, Sang Beom Kim, Kyeong Woo Lee, Sook Joung Lee, Hyuntae Park, Dong Won Kim
BACKGROUND: The use of a whole-body vibration (WBV) therapy has recently been applied and investigated as a rehabilitation method for subacute stroke patients. OBJECTIVE: To evaluate the effects of a WBV therapy on recovery of balance in subacute stroke patients who were unable to gain sitting balance. METHODS: The conventional rehabilitation group (CG) received conventional physical therapy, including sitting balance training by a physical therapist, for 30 min a one session, for twice a day for five days a week for two weeks...
March 23, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28335690/promoting-physical-activity-after-stroke-via-self-management-a-feasibility-study
#15
Elisabeth Preston, Catherine M Dean, Louise Ada, Rosalyn Stanton, Sandy Brauer, Suzanne Kuys, Gordon Waddington
BACKGROUND: Many people with mild disability after stroke are physically inactive despite the risk of recurrent stroke. A self-management program may be one strategy to increase physical activity in stroke survivors. OBJECTIVES: To investigate the feasibility of a self-management program, and determine whether self-management can increase daily physical activity levels and self-efficacy for exercise, decrease cardiovascular risk, and improve walking ability, participation, and quality of life in people with mild disability after stroke...
March 23, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28335394/motor-function-evaluation-of-hemiplegic-upper-extremities-using-data-fusion-from-wearable-inertial-and-surface-emg-sensors
#16
Yanran Li, Xu Zhang, Yanan Gong, Ying Cheng, Xiaoping Gao, Xiang Chen
Quantitative evaluation of motor function is of great demand for monitoring clinical outcome of applied interventions and further guiding the establishment of therapeutic protocol. This study proposes a novel framework for evaluating upper limb motor function based on data fusion from inertial measurement units (IMUs) and surface electromyography (EMG) sensors. With wearable sensors worn on the tested upper limbs, subjects were asked to perform eleven straightforward, specifically designed canonical upper-limb functional tasks...
March 13, 2017: Sensors
https://www.readbyqxmd.com/read/28333820/committee-opinion-no-692-emergent-therapy-for-acute-onset-severe-hypertension-during-pregnancy-and-the-postpartum-period
#17
(no author information available yet)
Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset, severe systolic hypertension; severe diastolic hypertension; or both require urgent antihypertensive therapy. Introducing standardized, evidence-based clinical guidelines for the management of patients with preeclampsia and eclampsia has been demonstrated to reduce the incidence of adverse maternal outcomes...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333812/committee-opinion-no-692-summary-emergent-therapy-for-acute-onset-severe-hypertension-during-pregnancy-and-the-postpartum-period
#18
(no author information available yet)
Acute-onset, severe systolic hypertension; severe diastolic hypertension; or both can occur during the prenatal, intrapartum, or postpartum periods. Pregnant women or women in the postpartum period with acute-onset, severe systolic hypertension; severe diastolic hypertension; or both require urgent antihypertensive therapy. Introducing standardized, evidence-based clinical guidelines for the management of patients with preeclampsia and eclampsia has been demonstrated to reduce the incidence of adverse maternal outcomes...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28331926/cessation-of-oral-anticoagulation-is-an-important-risk-factor-for-stroke-and-mortality-in-atrial-fibrillation-patients
#19
José Miguel Rivera-Caravaca, Vanessa Roldán, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Gregory Y H Lip, Francisco Marín
Oral anticoagulation (OAC) is highly effective preventing stroke and mortality in AF, but withdrawal is common in the elderly, when high bleeding risk and when are difficulties achieving an optimal time in therapeutic range (TTR). We analysed the rate of OAC cessation, predisposing factors to cessation and the relation to clinical outcomes in a large 'real world' cohort of AF patients over a long follow-up period. Consecutive non-valvular AF outpatients clinically stables for six months were recruited. Rates of cardiovascular events, major bleeding and mortality were recorded and related to OAC cessation...
March 23, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28331857/thrombosis-neuroinflammation-and-poststroke-infection-the-multifaceted-role-of-neutrophils-in-stroke
#20
REVIEW
Johanna Ruhnau, Juliane Schulze, Alexander Dressel, Antje Vogelgesang
Immune cells can significantly predict and affect the clinical outcome of stroke. In particular, the neutrophil-to-lymphocyte ratio was shown to predict hemorrhagic transformation and the clinical outcome of stroke; however, the immunological mechanisms underlying these effects are poorly understood. Neutrophils are the first cells to invade injured tissue following focal brain ischemia. In these conditions, their proinflammatory properties enhance tissue damage and may promote ischemic incidences by inducing thrombus formation...
2017: Journal of Immunology Research
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