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Stroke clinical outcomes

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https://www.readbyqxmd.com/read/29792380/alirocumab-as-add-on-therapy-to-statins-current-evidence-and-clinical-potential
#1
Johann Auer, Robert Berent
Atherosclerotic cardiovascular diseases (ASCVDs) are associated with a substantial mortality, physical morbidity, and mental disability. Elevated plasma low-density lipoprotein cholesterol (LDL-C) levels play a major role in the pathophysiology of ASCVDs. Statins have been shown to reduce ASCVD risk and associated events and are recommended as first-line therapy for treatment of hypercholesterolemia by current international guidelines. The key issue is to attain guideline-recommended LDL-C levels (below 70 mg/dl) for patients at very high cardiovascular risk...
May 1, 2018: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29792314/severe-and-predominantly-active-atopic-eczema-in-adulthood-and-long-term-risk-of-cardiovascular-disease-population-based-cohort-study
#2
Richard J Silverwood, Harriet J Forbes, Katrina Abuabara, Anna Ascott, Morten Schmidt, Sigrún A J Schmidt, Liam Smeeth, Sinéad M Langan
OBJECTIVE: To investigate whether adults with atopic eczema are at an increased risk of cardiovascular disease and whether the risk varies by atopic eczema severity and condition activity over time. DESIGN: Population based matched cohort study. SETTING: UK electronic health records from the Clinical Practice Research Datalink, Hospital Episode Statistics, and data from the Office for National Statistics, 1998-2015. PARTICIPANTS: Adults with a diagnosis of atopic eczema, matched (on age, sex, general practice, and calendar time) to up to five patients without atopic eczema...
May 23, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29792090/procedural-and-clinical-outcomes-of-endovascular-recanalization-therapy-in-patients-with-cancer-related-stroke
#3
Seunguk Jung, Cheolkyu Jung, Jae Hyoung Kim, Byung Se Choi, Yun Jung Bae, Leonard Sunwoo, Ho Geol Woo, Jun Young Chang, Beom Joon Kim, Moon-Ku Han, Hee-Joon Bae
Objective Embolism due to coagulopathy might be the main pathomechanism underlying cancer-related stroke (CRS). CRS patients with a large artery occlusion could be candidates for endovascular recanalization therapy (ERT), although its procedural and clinical outcomes are not well known. This study aimed to investigate the procedural and clinical outcomes of ERT in CRS patients and the characteristics associated with outcomes compared with those of conventional stroke patients. Methods A registry of consecutive acute ischemic stroke patients who underwent ERT between January 2011 and October 2015 was retrospectively reviewed...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29792042/imaging-predictors-of-outcome-in-acute-spontaneous-subarachnoid-hemorrhage-a-review-of-the-literature
#4
Isabel Fragata, Patrícia Canhão
Spontaneous subarachnoid hemorrhage (SAH) accounts for about 5% of strokes, but has a very high morbidity and mortality. Many survivors are left with important cognitive impairment and are severely incapacitated. Prediction of complications such as vasospasm and delayed cerebral ischemia, and of clinical outcome after SAH, is challenging. Imaging studies are essential in the initial evaluation of SAH patients and are increasingly relevant in assessing for complications and prognosis. In this article, we reviewed the role of imaging studies in evaluating early brain injury and predicting complications as well as clinical and neuropsychological prognosis after acute SAH...
January 1, 2018: Acta Radiologica
https://www.readbyqxmd.com/read/29789877/-meta-analyses-on-measurement-precision-of-non-invasive-hemodynamic-monitoring-technologies-in-adults
#5
G Pestel, K Fukui, M Higashi, I Schmidtmann, C Werner
An ideal non-invasive monitoring system should provide accurate and reproducible measurements of clinically relevant variables that enables clinicians to guide therapy accordingly. The monitor should be rapid, easy to use, readily available at the bedside, operator-independent, cost-effective and should have a minimal risk and side effect profile for patients. An example is the introduction of pulse oximetry, which has become established for non-invasive monitoring of oxygenation worldwide. A corresponding non-invasive monitoring of hemodynamics and perfusion could optimize the anesthesiological treatment to the needs in individual cases...
May 22, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29789778/conscious-sedation-versus-general-anesthesia-for-patients-with-acute-ischemic-stroke-undergoing-endovascular-therapy-a-systematic-review-and-meta-analysis
#6
REVIEW
Ren Jing, Hui-Jun Dai, Fei Lin, Wan-Yun Ge, Ling-Hui Pan
The aim of this study is to compare the effect of conscious sedation (CS) with general anesthesia (GA) on clinical outcomes in patients with acute ischemic stroke (AIS) undergoing endovascular therapy (EVT). MEDLINE, EMBASE, and Cochrane Central Registers of Controlled Trials (from inception to July 2017) were searched for reports on CS and GA of AIS undergoing EVT. Two reviewers assessed the eligibility of the identified studies and extracted data. Data were analyzed using the fixed-effects model, and the sources of heterogeneity were explored by sensitive analysis...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29789393/long-term-outcomes-in-patients-aged-%C3%A2-70-years-with-intravenous-glyburide-from-the-phase-ii-games-rp-study-of-large-hemispheric-infarction-an-exploratory-analysis
#7
Kevin N Sheth, Nils H Petersen, Ken Cheung, Jordan J Elm, Holly E Hinson, Bradley J Molyneaux, Lauren A Beslow, Gordon K Sze, J Marc Simard, W Taylor Kimberly
BACKGROUND AND PURPOSE: We aimed to determine whether subjects aged ≤70 years who were treated with intravenous glyburide (RP-1127; BIIB093; glibenclamide) would have better long-term outcomes than those who received placebo. METHODS: GAMES-RP (Glyburide Advantage in Malignant Edema and Stroke-Remedy Pharmaceuticals) was a prospective, double-blind, randomized, placebo-controlled phase 2 clinical trial. Eighty-six participants, aged 18 to 80 years, who presented to 18 centers with large hemispheric infarction (baseline diffusion-weighted imaging volumes, 82-300 cm3 ) randomized within 10 hours of symptom onset were enrolled...
May 22, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29789215/clinical-outcomes-and-influencing-factors-of-in-stent-restenosis-after-stenting-for-symptomatic-stenosis-of-the-vertebral-v1-segment
#8
Wu-Qiang Che, Hui Dong, Xiong-Jing Jiang, Meng Peng, Yu-Bao Zou, Hong-Liang Xiong, Yue-Jin Yang, Run-Lin Gao
OBJECTIVE: The objective of this study was to evaluate 30-day and long-term clinical outcomes and influencing factors of in-stent restenosis (ISR) after stenting for symptomatic stenosis of the vertebral V1 segment. METHODS: The clinical and follow-up data of 301 consecutive patients (mean age, 64 ± 8 years; 252 men) with symptomatic V1 stenosis who underwent stenting at the Fuwai Hospital between January 2010 and June 2016 were collected retrospectively. The 30-day and long-term follow-up of stroke and death after stenting and the recurrence of symptoms, ISR, and repeated revascularization were assessed...
May 19, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29789214/emergent-carotid-endarterectomy-versus-stenting-in-acute-stroke-patients-with-tandem-occlusion
#9
Diana E Slawski, Mouhammad A Jumaa, Hisham Salahuddin, Julie Shawver, M Junaid Humayun, Todd Russell, Andrew Seiwert, David Paolini, Jihad Abbas, Munier Nazzal, Gretchen E Tietjen, Aixa Espinosa-Morales, Andrea Korsnack, Syed F Zaidi
OBJECTIVE: Acute stroke due to tandem cervical internal carotid artery (ICA) and intracranial large-vessel occlusion (ILVO) has a high rate of morbidity and mortality. The most appropriate treatment strategy for the extracranial culprit lesion remains unclear. In this study, we report our institutional outcomes with two approaches: emergent carotid endarterectomy (CEA) and carotid artery stenting (CAS). METHODS: Patients with tandem ICA-ILVO were identified in a prospective mechanical thrombectomy (MT) database between July 2012 and April 2016...
May 19, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29789153/adjunct-retrograde-cerebral-perfusion-provides-superior-outcomes-compared-with-hypothermic-circulatory-arrest-alone-a-meta-analysis
#10
David H Tian, Justin Weller, Shaheen Hasmat, Aung Oo, Paul Forrest, Hosen Kiat, Tristan D Yan
OBJECTIVE: Retrograde cerebral perfusion is becoming less frequently used as a method of neuroprotection during aortic surgery. The present meta-analysis aims to compare outcomes after arch surgery with hypothermic circulatory arrest versus hypothermic circulatory arrest + retrograde cerebral perfusion. METHODS: Electronic searches were performed using 7 databases from their inception to September 2016. Relevant comparative studies that included patient groups who underwent aortic arch surgery using hypothermic circulatory arrest with continuous retrograde cerebral perfusion or hypothermic circulatory arrest alone were identified, and data were extracted by 2 independent researchers...
April 21, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29788103/post-ischaemic-administration-of-the-murine-canakinumab-surrogate-antibody-improves-outcome-in-experimental-stroke
#11
Luca Liberale, Candela Diaz-Cañestro, Nicole R Bonetti, Francesco Paneni, Alexander Akhmedov, Jürg H Beer, Fabrizio Montecucco, Thomas F Lüscher, Giovanni G Camici
Aims: The CANTOS trial underscored the efficacy of selective antibody-based interleukin (IL)-1β inhibition with Canakinumab in secondary prevention of cardiovascular events. Despite the success of the trial, incidence of stroke was not reduced likely due to the low number of events and the relatively young age of patients enrolled. Given the established role of IL-1β in stroke, we tested the efficacy of the murine Canakinumab-equivalent antibody in a mouse model of ischaemic stroke...
May 16, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29788044/clinical-and-haemodynamic-outcomes-of-balloon-expandable-transcatheter-mitral-valve-implantation-a-7-year-experience
#12
Marina Urena, Eric Brochet, Milena Lecomte, Caroline Kerneis, Jose Luis Carrasco, Walid Ghodbane, Jérémie Abtan, Soleiman Alkhoder, Richard Raffoul, Bernard Iung, Patrick Nataf, Alec Vahanian, Dominique Himbert
Aims: We analysed the early and long-term clinical and haemodynamic outcomes of balloon-expandable transcatheter mitral valve implantation (TMVI) in an experienced centre. Methods and results: All patients undergoing TMVI from July 2010 to July 2017 in our centre were prospectively included. Indication for TMVI relied on the judgement of the local heart team. Patients were followed at 1 month, 1 year, and yearly thereafter. A total of 91 patients underwent TMVI...
May 19, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29787871/spontaneous-intracerebral-hemorrhage-in-a-plateau-area-a-study-based-on-the-tibetan-population
#13
Ruiqi Chen, Anqi Xiao, Chao You, Lu Ma
OBJECTIVE: To reveal characteristics of spontaneous intracerebral hemorrhage (sICH) in a plateau area based on the Tibetan population. METHODS: Data of Tibetan and Han patients (control group) with sICH treated at our center from January 2013 to April 2017 were retrospectively reviewed. RESULTS: A total of 122 Tibetan and 927 Han patients were included. Compared with Han patients, Tibetan patients were older (54.7±11.2 VS 50.9±18.3 years, P=0...
May 19, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29787575/safety-of-intravenous-alteplase-within-4-5-hours-for-patients-awakening-with-stroke-symptoms
#14
Victor C Urrutia, Roland Faigle, Steven R Zeiler, Elisabeth B Marsh, Mona Bahouth, Mario Cerdan Trevino, Jennifer Dearborn, Richard Leigh, Susan Rice, Karen Lane, Mustapha Saheed, Peter Hill, Rafael H Llinas
BACKGROUND: Up to 25% of acute stroke patients first note symptoms upon awakening. We hypothesized that patients awaking with stroke symptoms may be safely treated with intravenous alteplase (IV tPA) using non-contrast head CT (NCHCT), if they meet all other standard criteria. METHODS: The SAfety of Intravenous thromboLytics in stroke ON awakening (SAIL ON) was a prospective, open-label, single treatment arm, pilot safety trial of standard dose IV tPA in patients who presented with stroke symptoms within 0-4...
2018: PloS One
https://www.readbyqxmd.com/read/29785667/cerebral-autoregulation-in-stroke
#15
REVIEW
Pedro Castro, Elsa Azevedo, Farzaneh Sorond
PURPOSE OF REVIEW: Cerebral autoregulation (CA) is a mechanism that maintains cerebral blood flow constant despite fluctuations in systemic arterial blood pressure. This review will focus on recent studies that measured CA non-invasively in acute cerebrovascular events, a feature unique to the transcranial Doppler ultrasound. We will summarize the rationale for CA assessment in acute cerebrovascular disorders and specifically evaluate the existing data on the value of CA measures in relation to clinical severity, guiding management decisions, and prognostication...
May 21, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29785613/neuroinfections-caused-by-fungi
#16
REVIEW
Katarzyna Góralska, Joanna Blaszkowska, Magdalena Dzikowiec
BACKGROUND: Fungal infections of the central nervous system (FIs-CNS) have become significantly more common over the past 2 decades. Invasion of the CNS largely depends on the immune status of the host and the virulence of the fungal strain. Infections with fungi cause a significant morbidity in immunocompromised hosts, and the involvement of the CNS may lead to fatal consequences. METHODS: One hundred and thirty-five articles on fungal neuroinfection in PubMed, Google Scholar, and Cochrane databases were selected for review using the following search words: "fungi and CNS mycoses", CNS fungal infections", "fungal brain infections", " fungal cerebritis", fungal meningitis", "diagnostics of fungal infections", and "treatment of CNS fungal infections"...
May 21, 2018: Infection
https://www.readbyqxmd.com/read/29785495/d-lactate-and-intestinal-fatty-acid-binding-protein-are-elevated-in-serum-in-patients-with-acute-ischemic-stroke
#17
Carlos R Camara-Lemarroy, Nicolás Escobedo-Zúñiga, Francisco J Guzmán-de la Garza, Jorge Castro-Garza, Javier Vargas-Villarreal, Fernando Góngora-Rivera
Experimental studies suggest that the intestinal barrier is affected in ischemic stroke. D-Lactate and intestinal fatty acid-binding protein (IFABP) are markers of intestinal mucosa integrity and barrier function. Our purpose was to evaluate the serum concentrations of these markers in patients with acute ischemic stroke (AIS). We included patients with AIS and used healthy subjects as controls. Clinical, demographic and outcome measures were recorded. Blood was drawn within 24 h of symptom onset. Serum concentrations of D-Lactate and IFABP were determined using commercially available colorimetric and ELISA kits, respectively...
May 21, 2018: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/29784563/limited-benefit-of-haemoglobin-glycation-index-as-risk-factor-for-cardiovascular-disease-in-type-2-diabetes-patients
#18
H B Østergaard, T Mandrup-Poulsen, G F N Berkelmans, Y van der Graaf, F L J Visseren, J Westerink
BACKGROUND: The haemoglobin glycation index (HGI) has been proposed as a marker of interindividual differences in haemoglobin glycosylation. Previous studies have shown a relationship between high HGI and risk of cardiovascular disease (CVD) in patients with diabetes. However, no studies have investigated the role of previous CVD in this association. METHODS: The study cohort comprised patients with type 2 diabetes mellitus (T2DM; n=1910) included in the Second Manifestations of Arterial Disease (SMART) study...
May 8, 2018: Diabetes & Metabolism
https://www.readbyqxmd.com/read/29782486/clinical-socioeconomic-and-behavioural-factors-at-age-50-years-and-risk-of-cardiometabolic-multimorbidity-and-mortality-a-cohort-study
#19
Archana Singh-Manoux, Aurore Fayosse, Séverine Sabia, Adam Tabak, Martin Shipley, Aline Dugravot, Mika Kivimäki
BACKGROUND: Multimorbidity is increasingly common and is associated with adverse health outcomes, highlighting the need to broaden the single-disease framework that dominates medical research. We examined the role of midlife clinical characteristics, socioeconomic position, and behavioural factors in the development of cardiometabolic multimorbidity (at least 2 of diabetes, coronary heart disease, and stroke), along with how these factors modify risk of mortality. METHODS AND FINDINGS: Data on 8,270 men and women were drawn from the Whitehall II cohort study, with mean follow-up of 23...
May 2018: PLoS Medicine
https://www.readbyqxmd.com/read/29782353/implementing-best-practice-into-the-emergency-department-triage-process
#20
Luke Burgess, Kathryn Kynoch, Sonia Hines
BACKGROUND: Triage is the process by which emergency departments (EDs) sort patients presenting for medical treatment. The Australasian Triage Scale, validated to measure urgency, answers the question 'This patient should wait for medical assessment and treatment no longer than…' Multiple patients may present within short time frames, and some will have conditions that have outcomes directly related to timeliness of treatment such as stroke, sepsis and myocardial infarction. The safety of patients within the ED is thus directly related to the triage system...
May 17, 2018: International Journal of Evidence-based Healthcare
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