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Stroke clinical outcomes

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https://www.readbyqxmd.com/read/28922886/intracranial-bypass-of-posterior-inferior-cerebellar-artery-aneurysms-indications-technical-aspects-and-clinical-outcomes
#1
David J Bonda, Mohamad Labib, Jeffrey M Katz, Rafael A Ortiz, David Chalif, Avi Setton, David J Langer, Amir R Dehdashti
BACKGROUND: For some posterior inferior cerebellar artery (PICA) aneurysms, there is no constructive endovascular or direct surgical clipping option. Intracranial bypass is an alternative to a deconstructive technique. OBJECTIVE: To evaluate the clinical features, surgical techniques, and outcome of PICA aneurysms treated with bypass and obliteration of the diseased segment. METHODS: Retrospective review of PICA aneurysms treated via intracranial bypass was performed...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28922885/patient-selection-and-clinical-efficacy-of-urgent-superficial-temporal-artery-middle-cerebral-artery-bypass-in-acute-ischemic-stroke-using-advanced-magnetic-resonance-imaging-techniques
#2
Hyun-Seok Park, Sang-Hyeon Kim, Hyun-Wook Nah, Jae-Hyung Choi, Dae-Hyun Kim, Myong-Jin Kang, Jae-Kwan Cha, Jae-Taeck Huh
BACKGROUND: Selected patients with acute ischemic stroke might benefit from superficial temporal artery-middle cerebral artery (STA-MCA) bypass, but the indications for urgent STA-MCA bypass are unknown. OBJECTIVE: To report our experiences of urgent STA-MCA bypass in patients requiring urgent reperfusion who were ineligible for other reperfusion therapies, using advanced magnetic resonance imaging (MRI) techniques. METHODS: The inclusion criteria for urgent STA-MCA bypass were as follows: acute infarct volume <70 mL with a ratio of perfusion/diffusion lesion volume ≥1...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28922311/motor-imagery-training-after-stroke-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#3
Zaqueline Fernandes Guerra, Alessandra L G Lucchetti, Giancarlo Lucchetti
BACKGROUND AND PURPOSE: A number of studies have suggested that imagery training (motor imagery [MI]) has value for improving motor function in persons with neurologic conditions. We performed a systematic review and meta-analysis to assess the available literature related to efficacy of MI in the recovery of individuals after stroke. METHODS: We searched the following databases: PubMed, Web of Knowledge, Scopus, Cochrane, and PEDro. Two reviewers independently selected clinical trials that investigated the effect of MI on outcomes commonly investigated in studies of stroke recovery...
October 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28920888/prediction-of-motor-recovery-after-stroke-advances-in-biomarkers
#4
REVIEW
Cathy M Stinear
Stroke remains a leading cause of adult disability, and the recovery of motor function after stroke is crucial for the patient to regain independence. However, making accurate predictions of a patient's motor recovery and outcome is difficult when based on clinical assessment alone. Clinical assessment of motor impairment within a few days of stroke can help to predict subsequent recovery, while neurophysiological and neuroimaging biomarkers of corticomotor structure and function can help to predict both motor recovery and motor outcome after stroke...
October 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28920522/constraint-and-multimodal-approaches-to-therapy-for-chronic-aphasia-a-systematic-review-and-meta-analysis
#5
John E Pierce, Maya Menahemi-Falkov, Robyn O'Halloran, Leanne Togher, Miranda L Rose
Aphasia is a significant cause of disability and reduced quality of life. Two speech pathology treatment approaches appear efficacious: multimodal and constraint-induced aphasia therapies. In constraint-induced therapies, non-verbal actions (e.g., gesture, drawing) are believed to interfere with treatment and patients are therefore constrained to speech. In contrast, multimodal therapies employ non-verbal modalities to cue word retrieval. Given the clinical and theoretical implications, a comparison of these two divergent treatments was pursued...
September 18, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28919704/secondary-prevention-of-major-cerebrovascular-events-with-seven-different-statins-a-multi-treatment-meta-analysis
#6
Ping Zhong, Danhong Wu, Xiaofei Ye, Ying Wu, Tuming Li, Shuwen Tong, Xueyuan Liu
BACKGROUND: Statins have been recommended for the use in atherosclerotic cardiovascular diseases, but different statins have distinct pharmacological characteristics. This multi-treatment meta-analysis aimed to evaluate the efficacy of seven statins in the secondary prevention of major cerebrovascular events (CVEs). METHODS AND ANALYSES: The PubMed, Embase, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials were searched to identify studies published between January 1, 2011, and June 30, 2016...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28919313/periprocedural-outcomes-of-carotid-artery-stenting-in-elderly-patients
#7
Masataka Nanto, Yudai Goto, Hiroyuki Yamamoto, Seisuke Tanigawa, Michiko Takado, Takahiro Ogawa, Yoshikazu Nakahara
BACKGROUND: Carotid artery stenting has emerged as an alternative to carotid endarterectomy especially in patients with high risk of carotid endarterectomy. Older age (≥80 years old) was recognized as one of the high risk factors of carotid endarterectomy. However, the association between older age and increased risk of adverse events for carotid artery stenting has been reported. The purpose of this study was to evaluate the association between age and periprocedural outcomes after carotid artery stenting...
September 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28918085/positive-effects-of-extracorporeal-shock-wave-therapy-on-spasticity-in-poststroke-patients-a-meta-analysis
#8
REVIEW
Peipei Guo, Fuqiang Gao, Tingting Zhao, Wei Sun, Bailiang Wang, Zirong Li
BACKGROUND: Spasticity is a common and serious complication following a stroke, and many clinical research have been conducted to evaluate the effect of extracorporeal shock wave therapy (ESWT) on muscle spasticity in poststroke patients. This meta-analysis aimed to evaluate the therapeutic effect on decreasing spasticity caused by a stroke immediately and 4 weeks after the application of shock wave therapy. METHODS: We searched PubMed, Embase, Web of Science, and Cochrane Library databases for relevant studies through November 2016 using the following item: (Hypertonia OR Spasticity) and (Shock Wave or ESWT) and (Stroke)...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28917545/effects-of-acarbose-on-cardiovascular-and-diabetes-outcomes-in-patients-with-coronary-heart-disease-and-impaired-glucose-tolerance-ace-a-randomised-double-blind-placebo-controlled-trial
#9
Rury R Holman, Ruth L Coleman, Juliana C N Chan, Jean-Louis Chiasson, Huimei Feng, Junbo Ge, Hertzel C Gerstein, Richard Gray, Yong Huo, Zhihui Lang, John J McMurray, Lars Rydén, Stefan Schröder, Yihong Sun, Michael J Theodorakis, Michal Tendera, Lynne Tucker, Jaakko Tuomilehto, Yidong Wei, Wenying Yang, Duolao Wang, Dayi Hu, Changyu Pan
BACKGROUND: The effect of the α-glucosidase inhibitor acarbose on cardiovascular outcomes in patients with coronary heart disease and impaired glucose tolerance is unknown. We aimed to assess whether acarbose could reduce the frequency of cardiovascular events in Chinese patients with established coronary heart disease and impaired glucose tolerance, and whether the incidence of type 2 diabetes could be reduced. METHODS: The Acarbose Cardiovascular Evaluation (ACE) trial was a randomised, double-blind, placebo-controlled, phase 4 trial, with patients recruited from 176 hospital outpatient clinics in China...
September 12, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28917544/effects-on-the-incidence-of-cardiovascular-events-of-the-addition-of-pioglitazone-versus-sulfonylureas-in-patients-with-type-2-diabetes-inadequately-controlled-with-metformin-tosca-it-a-randomised-multicentre-trial
#10
Olga Vaccaro, Maria Masulli, Antonio Nicolucci, Enzo Bonora, Stefano Del Prato, Aldo P Maggioni, Angela A Rivellese, Sebastiano Squatrito, Carlo B Giorda, Giorgio Sesti, Paolo Mocarelli, Giuseppe Lucisano, Michele Sacco, Stefano Signorini, Fabrizio Cappellini, Gabriele Perriello, Anna Carla Babini, Annunziata Lapolla, Giovanna Gregori, Carla Giordano, Laura Corsi, Raffaella Buzzetti, Gennaro Clemente, Graziano Di Cianni, Rossella Iannarelli, Renzo Cordera, Olga La Macchia, Chiara Zamboni, Cristiana Scaranna, Massimo Boemi, Ciro Iovine, Davide Lauro, Sergio Leotta, Elisabetta Dall'Aglio, Emanuela Cannarsa, Laura Tonutti, Giuseppe Pugliese, Antonio C Bossi, Roberto Anichini, Francesco Dotta, Antonino Di Benedetto, Giuseppe Citro, Daniela Antenucci, Lucia Ricci, Francesco Giorgino, Costanza Santini, Agostino Gnasso, Salvatore De Cosmo, Donatella Zavaroni, Monica Vedovato, Agostino Consoli, Maria Calabrese, Paolo di Bartolo, Paolo Fornengo, Gabriele Riccardi
BACKGROUND: The best treatment option for patients with type 2 diabetes in whom treatment with metformin alone fails to achieve adequate glycaemic control is debated. We aimed to compare the long-term effects of pioglitazone versus sulfonylureas, given in addition to metformin, on cardiovascular events in patients with type 2 diabetes. METHODS: TOSCA.IT was a multicentre, randomised, pragmatic clinical trial, in which patients aged 50-75 years with type 2 diabetes inadequately controlled with metformin monotherapy (2-3 g per day) were recruited from 57 diabetes clinics in Italy...
September 12, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28916664/safety-of-simultaneous-coronary-artery-bypass-grafting-and-carotid-endarterectomy-versus-isolated-coronary-artery-bypass-grafting-a-randomized-clinical-trial
#11
Christian Weimar, Konstantinos Bilbilis, Jan Rekowski, Torulv Holst, Friedhelm Beyersdorf, Martin Breuer, Manfred Dahm, Anno Diegeler, Arne Kowalski, Sven Martens, Friedrich W Mohr, Jiri Ondrášek, Beate Reiter, Peter Roth, Ralf Seipelt, Markus Siggelkow, Gustav Steinhoff, Anton Moritz, Mathias Wilhelmi, Gerhard Wimmer-Greinecker, Hans-Christoph Diener, Heinz Jakob, Claudia Ose, Andre Scherag, Stephan C Knipp
BACKGROUND AND PURPOSE: The optimal operative strategy in patients with severe carotid artery disease undergoing coronary artery bypass grafting (CABG) is unknown. We sought to investigate the safety and efficacy of synchronous combined carotid endarterectomy and CABG as compared with isolated CABG. METHODS: Patients with asymptomatic high-grade carotid artery stenosis ≥80% according to ECST (European Carotid Surgery Trial) ultrasound criteria (corresponding to ≥70% NASCET [North American Symptomatic Carotid Endarterectomy Trial]) who required CABG surgery were randomly assigned to synchronous carotid endarterectomy+CABG or isolated CABG...
September 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28916640/clinical-profile-and-consequences-of-atrial-fibrillation-in-hypertrophic-cardiomyopathy
#12
Ethan J Rowin, Anais Hausvater, Mark S Link, Patrick Abt, William Gionfriddo, Wendy Wang, Hassan Rastegar, N A Mark Estes, Martin S Maron, Barry J Maron
Background -Atrial fibrillation (AF), the most common sustained arrhythmia in hypertrophic cardiomyopathy (HCM), is capable of producing symptoms that impact quality of life and is associated with risk for embolic stroke. However, the influence of AF on clinical course and outcome in HCM remains incompletely resolved. Methods -Records were accessed of 1558 consecutive patients followed at the Tufts Medical Center Hypertrophic Cardiomyopathy Institute for 4.8 ± 3.4 years, from 2004 to 2014. Results -Of the 1558 HCM patients, 304 (20%) had episodes of AF, of which 226 (74%) were confined to symptomatic paroxysmal AF (PAF; average 5 ± 5; range 1 to > 20), while 78 (26%) developed permanent AF, preceded by 7 ± 6 PAF episodes...
September 15, 2017: Circulation
https://www.readbyqxmd.com/read/28916604/coronary-perforation-complicating-percutaneous-coronary-intervention-in-patients-with-a-history-of-coronary-artery-bypass-surgery-an-analysis-of-309-perforation-cases-from-the-british-cardiovascular-intervention-society-database
#13
Tim Kinnaird, Richard Anderson, Nick Ossei-Gerning, James Cockburn, Alex Sirker, Peter Ludman, Mark de Belder, Thomas W Johnson, Samuel Copt, Azfar Zaman, Mamas A Mamas
BACKGROUND: The evidence base for coronary perforation (CP) occurring during percutaneous coronary intervention in patients with a history of coronary artery bypass surgery (PCI-CABG) is limited and the long-term effects unclear. Using a national PCI database, the incidence, predictors, and outcomes of CP during PCI-CABG were defined. METHODS AND RESULTS: Data were analyzed on all PCI-CABG procedures performed in England and Wales between 2005 and 2013. Multivariate logistic regressions and propensity scores were used to identify predictors of CP and its association with outcomes...
September 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28915826/acupuncture-lowering-blood-pressure-for-secondary-prevention-of-stroke-a-study-protocol-for-a-multicenter-randomized-controlled-trial
#14
Yu-Zheng Du, Xin-Xin Gao, Cheng-Ting Wang, Hai-Zhen Zheng, Yun Lei, Meng-Han Wu, Xue-Min Shi, Hai-Peng Ban, Wen-Long Gu, Xiang-Gang Meng, Mao-Ti Wei, Chun-Xiao Hu
BACKGROUND: Stroke is the prime cause of morbidity and mortality in the general population, and hypertension will increase the recurrence and mortality of stroke. We report a protocol of a pragmatic randomized controlled trial (RCT) using blood pressure (BP)-lowering acupuncture add-on treatment to treat patients with hypertension and stroke. METHODS: This is a large-scale, multicenter, subject-, assessor- and analyst-blinded, pragmatic RCT. A total of 480 patients with hypertension and ischemic stroke will be randomly assigned to two groups: an experimental group and a control group...
September 15, 2017: Trials
https://www.readbyqxmd.com/read/28915508/preoperative-intraaortic-balloon-pump-improves-early-outcomes-following-high-risk-coronary-artery-bypass-graft-surgery-a-meta-analysis-of-randomized-trials-and-prospective-study-design
#15
Penelope P Rampersad, Jacob A Udell, Rami Zawi, Maral Ouzounian, Christopher B Overgaard, Vinoda Sharma, Vivek Rao, Michael E Farkouh, Vladimír Džavík
BACKGROUND: Despite widespread use, evidence to support preemptive intraaortic balloon pump (IABP) insertion for patients undergoing high-risk coronary artery bypass graft (CABG) surgery remains sparse, and in need of a well-defined clinical trial. To inform the design of a prospective trial, we sought to review outcomes in randomized controlled trials (RCTs) of anticipatory IABP use vs control in patients undergoing high-risk CABG through meta-analysis. The primary endpoint was all-cause mortality within 30 days of surgery...
September 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28914187/improving-quality-and-outcomes-of-stroke-care-in-hospitals-protocol-and-statistical-analysis-plan-for-the-stroke123-implementation-study
#16
Dominique A Cadilhac, Nadine E Andrew, Monique F Kilkenny, Kelvin Hill, Brenda Grabsch, Natasha A Lannin, Amanda G Thrift, Craig S Anderson, Geoffrey A Donnan, Sandy Middleton, Rohan Grimley
Rationale The effectiveness of clinician-focused interventions to improve stroke care is uncertain. Aims To determine whether an organizational intervention can improve the quality of stroke care over usual care. Sample size estimates To detect an absolute 10% difference in overall performance (composite outcome), a minimum of 21 hospitals and 843 patients per group was determined. Methods and design Before and after controlled design in hospitals in Queensland, Australia. Intervention Externally facilitated program (StrokeLink) using outreach workshops incorporating clinical performance feedback, patient outcomes (survival, quality of life at 90-180 days), local barrier assessments to best practice care, action planning, and ongoing support...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28913755/management-and-clinical-outcome-of-stable-coronary-artery-disease-in-austria-results-from-5%C3%A2-years-of-the-clarify-registry
#17
Irene M Lang, Roza Badr-Eslam, Nicola Greenlaw, Robin Young, Philippe Gabriel Steg
BACKGROUND: The population of patients with established coronary artery disease (CAD) is growing because of an improvement in outcomes and survival from acute disease episodes. Nevertheless, these patients remain at high risk of cardiovascular events. Thus, CAD management is important in prevention of disease progression. The objective of this analysis was to describe disease management and clinical outcome of Austrian outpatients with stable CAD over 5 years by using data from the international CLARIFY registry...
September 14, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28912707/methodological-choices-in-muscle-synergy-analysis-impact-differentiation-of-physiological-characteristics-following-stroke
#18
Caitlin L Banks, Mihir M Pai, Theresa E McGuirk, Benjamin J Fregly, Carolynn Patten
Muscle synergy analysis (MSA) is a mathematical technique that reduces the dimensionality of electromyographic (EMG) data. Used increasingly in biomechanics research, MSA requires methodological choices at each stage of the analysis. Differences in methodological steps affect the overall outcome, making it difficult to compare results across studies. We applied MSA to EMG data collected from individuals post-stroke identified as either responders (RES) or non-responders (nRES) on the basis of a critical post-treatment increase in walking speed...
2017: Frontiers in Computational Neuroscience
https://www.readbyqxmd.com/read/28912642/nox-inhibitors-a-promising-avenue-for-ischemic-stroke
#19
REVIEW
Jong Youl Kim, Joohyun Park, Jong Eun Lee, Midori A Yenari
NADPH-oxidase (NOX) mediated superoxide originally found on leukocytes, but now recognized in several types of cells in the brain. It has been shown to play an important role in the progression of stroke and related cerebrovascular disease. NOX is a multisubunit complex consisting of 2 membrane-associated and 4 cytosolic subunits. NOX activation occurs when cytosolic subunits translocate to the membrane, leading to transport electrons to oxygen, thus producing superoxide. Superoxide produced by NOX is thought to function in long-term potentiation and intercellular signaling, but excessive production is damaging and has been implicated to play an important role in the progression of ischemic brain...
August 2017: Experimental Neurobiology
https://www.readbyqxmd.com/read/28912210/sex-differences-in-clinical-characteristics-psychosocial-factors-and-outcomes-among-patients-with-stable-coronary-heart-disease-insights-from-the-stability-stabilization-of-atherosclerotic-plaque-by-initiation-of-darapladib-therapy-trial
#20
Patricia Oliveira Guimarães, Christopher B Granger, Amanda Stebbins, Karen Chiswell, Claes Held, Judith S Hochman, Susan Krug-Gourley, Eva Lonn, Renato D Lopes, Ralph A H Stewart, Dragos Vinereanu, Lars Wallentin, Harvey D White, Emil Hagström, Nicolas Danchin
BACKGROUND: Greater understanding of differences between men and women with coronary heart disease is needed. METHODS AND RESULTS: In this post hoc analysis of the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) trial, we described psychosocial factors, treatments, and outcomes of men versus women with stable coronary heart disease and explored the association of sex with psychosocial characteristics and cardiovascular risk...
September 14, 2017: Journal of the American Heart Association
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