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Stroke , ischemic stroke , intracerebral

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https://www.readbyqxmd.com/read/28079139/blood-occludin-level-as-a-potential-biomarker-for-early-blood-brain-barrier-damage-following-ischemic-stroke
#1
Rong Pan, Kewei Yu, Theodore Weatherwax, Handong Zheng, Wenlan Liu, Ke Jian Liu
Concern about intracerebral hemorrhage (ICH) is the primary reason for withholding tPA therapy from patients with ischemic stroke. Early blood brain barrier (BBB) damage is the major risk factor for fatal post-thrombolysis ICH, but rapidly assessing BBB damage before tPA administration is highly challenging. We recently reported that ischemia induced rapid degradation of tight junction protein occludin in cerebromicrovessels. The present study investigates whether the cleaved occludin is released into the blood stream and how blood occludin levels correlate to the extent of BBB damage using a rat model of ischemic stroke...
January 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28060219/multicenter-study-of-adverse-events-after-intravenous-tissue-type-plasminogen-activator-treatment-of-acute-ischemic-stroke
#2
Hannah Fernandez-Gotico, Tiffany Lightfoot, Melissa Meighan
BACKGROUND AND PURPOSE: The approved treatment by the Food and Drug Administration for acute ischemic stroke is intravenous tissue-type plasminogen activator (IV tPA). After IV tPA administration, patients are monitored for adverse events using an American Heart Association/American Stroke Association guideline instituted in 1996. There is limited evidence describing the safest and most efficient method to monitor patients during the first 24 hours after tPA administration. Although the overall rates of adverse events have been reported, the time when patients may be at most risk for an event has not been studied...
February 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28059661/intravenous-infusion-of-mesenchymal-stem-cells-inhibits-intracranial-hemorrhage-after-recombinant-tissue-plasminogen-activator-therapy-for-transient-middle-cerebral-artery-occlusion-in-rats
#3
Masahito Nakazaki, Masanori Sasaki, Yuko Kataoka-Sasaki, Shinichi Oka, Takahiro Namioka, Ai Namioka, Rie Onodera, Junpei Suzuki, Yuichi Sasaki, Hiroshi Nagahama, Takeshi Mikami, Masahiko Wanibuchi, Jeffery D Kocsis, Osamu Honmou
OBJECTIVE Reperfusion therapy with intravenous recombinant tissue plasminogen activator (rtPA) is the standard of care for acute ischemic stroke. However, hemorrhagic complications can result. Intravenous infusion of mesenchymal stem cells (MSCs) reduces stroke volume and improves behavioral function in experimental stroke models. One suggested therapeutic mechanism is inhibition of vascular endothelial dysfunction. The objective of this study was to determine whether MSCs suppress hemorrhagic events after rtPA therapy in the acute phase of transient middle cerebral artery occlusion (tMCAO) in rats...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28059649/quantitative-analysis-of-the-effect-of-institutional-case-volume-on-complications-after-surgical-clipping-of-unruptured-aneurysms
#4
Lorenzo Rinaldo, Brandon A McCutcheon, Meghan E Murphy, Daniel L Shepherd, Patrick R Maloney, Panagiotis Kerezoudis, Mohamad Bydon, Giuseppe Lanzino
OBJECTIVE The mechanism by which greater institutional case volume translates into improved outcomes after surgical clipping of unruptured intracranial aneurysms (UIAs) is not well established. The authors thus aimed to assess the effect of case volume on the rate of various types of complications after clipping of UIAs. METHODS Using information on the outcomes of inpatient admissions for surgical clipping of UIAs collected within a national database, the relationship of institutional case volume to the incidence of different types of complications after clipping was investigated...
January 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28056515/race-ethnicity-as-a-predictor-for-location-of-death-in-patients-with-acute-neurovascular-events
#5
Say Salomon, Elizabeth Chuang, Deepa Bhupali, Daniel Labovitz
BACKGROUND: Site of death is an important quality indicator for patients with terminal illness. Racial and ethnic disparities exist in the quality of end-of-life care. This study explores the site of death of patients admitted for and dying of complications of acute neurovascular events in a hospital network in an urban, low-income, predominantly minority community. METHODS: This is a retrospective cohort study of patients admitted to 1 of 3 general hospitals that are part of an academic medical center in Bronx, New York, with the diagnosis of acute ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage who died during the index admission or were discharged with hospice services...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28052979/prevalence-incidence-and-mortality-of-stroke-in-china-results-from-a-nationwide-population-based-survey-of-480-687-adults
#6
Wenzhi Wang, Bin Jiang, Haixin Sun, Xiaojuan Ru, Dongling Sun, Linhong Wang, Limin Wang, Yong Jiang, Yichong Li, Yilong Wang, Zhenghong Chen, Shengping Wu, Yazhuo Zhang, David Wang, Yongjun Wang, Valery L Feigin
BACKGROUND: -China bears the biggest stroke burden in the world. However, little is known about the current prevalence, incidence, and mortality of stroke at the national level, and the trend in the last 30 years. METHODS: -In 2013 a nationally-representative door-to-door survey was conducted in 155 urban and rural centres in 31 provinces in China, totalling 480,687 adults aged ≥20 years. All stroke survivors were considered as prevalent stroke cases at the prevalent time (August 31, 2013)...
January 4, 2017: Circulation
https://www.readbyqxmd.com/read/28049735/adherence-to-a-healthy-nordic-diet-and-risk-of-stroke-a-danish-cohort-study
#7
Camilla Plambeck Hansen, Kim Overvad, Cecilie Kyrø, Anja Olsen, Anne Tjønneland, Søren Paaske Johnsen, Marianne Uhre Jakobsen, Christina Catherine Dahm
BACKGROUND AND PURPOSE: Specific dietary patterns, including the Mediterranean diet, have been associated with stroke prevention. Our aim was to investigate whether adherence to a healthy Nordic diet, including fish, apples and pears, cabbages, root vegetables, rye bread, and oatmeal, was associated with risk of stroke. METHODS: Incident cases of stroke among 55 338 men and women from the Danish Diet, Cancer and Health cohort were identified from the Danish National Patient Register and verified by review of records...
January 3, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28049189/functional-long-term-outcome-after-left-versus-right-sided-intracerebral-hemorrhage
#8
Vanessa D Beuscher, Joji B Kuramatsu, Stefan T Gerner, Julia Köhn, Hannes Lücking, Stephan P Kloska, Hagen B Huttner
BACKGROUND AND PURPOSE: Hemispheric location might influence outcome after intracerebral hemorrhage (ICH). INTERACT suggested higher short-term mortality in right hemispheric ICH, yet statistical imbalances were not addressed. This study aimed at determining the differences in long-term functional outcome in patients with right- vs. left-sided ICH with a priori-defined sub-analysis of lobar vs. deep bleedings. METHODS: Data from a prospective hospital registry were analyzed including patients with ICH admitted between January 2006 and August 2014...
January 4, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28041899/left-atrial-appendage-closure-in-patients-with-atrial-fibrillation-and-previous-intracerebral-hemorrhage
#9
Pauline Renou, Jean-Benoît Thambo, Xavier Iriart, Stéphanie Nicot, Nathanael Kabore, Zakaria Jalal, Stéphane Olindo, Sabrina Debruxelles, Mathilde Poli, François Rouanet, Igor Sibon
BACKGROUND: Percutaneous left atrial appendage closure (LAAC) may be considered in patients with atrial fibrillation and contraindication for long-term anticoagulation. This study aimed to assess the safety and efficacy of LAAC followed by single antiplatelet therapy in patients with atrial fibrillation and previous spontaneous intracerebral hemorrhage (ICH). METHODS: In this explorative, prospective, single-center study, consecutive patients who underwent LAAC because of previous spontaneous ICH over a period of 4 years were analyzed...
December 30, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28028726/predictors-of-in-hospital-mortality-and-dependence-at-discharge-in-patients-with-mca-stroke-with-intravenous-thrombolysis
#10
Renata Dal-Prá Ducci, Marcos Christiano Lange, Viviane de Hiroki Flumignan Zétola
Early risk stratification of mortality and dependence is important for guiding medical decision-making in stroke care. The study aim is to evaluate whether there are any differences between risk factors for in-hospital mortality and dependence at discharge in patients with first-episode ischemic stroke in the middle cerebral artery (MCA) receiving intravenous thrombolysis (IVT) treatment. The study comprised a single-center cohort of patients admitted consecutively for first-episode MCA ischemic stroke. A logistic regression analysis was performed to determine the variables associated with in-hospital mortality and dependence at discharge...
December 27, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28028143/abca1-apoe-hdl-pathway-mediates-gw3965-induced-neurorestoration-after-stroke
#11
Xu Cui, Michael Chopp, Zhenggang Zhang, Rongwen Li, Alex Zacharek, Julie Landschoot-Ward, Poornima Venkat, Jieli Chen
BACKGROUND AND PURPOSE: ATP-binding cassette transporter A1 (ABCA1) is a major reverse cholesterol transporter and plays critical role in the formation of brain high-density lipoprotein (HDL) cholesterol. Apolipoprotein E (ApoE) is the most abundant apolipoprotein and transports cholesterol into cells in brain. ABCA1 and ApoE are upregulated by liver-X receptors. Activation of liver-X receptors has neurorestorative benefit for stroke. The current study investigates whether ABCA1/ApoE/HDL pathway mediates GW3965, a synthetic dual liver-X receptor agonist, induced neurorestoration after stroke...
December 27, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28018982/prevalance-and-influence-of-chronic-obstructive-pulmonary-disease-on-stroke-outcomes-in-hospitalized-stroke-patients
#12
Alain Lekoubou, Bruce Ovbiagele
BACKGROUND: Chronic obstructive pulmonary disease (COPD) and stroke are important causes of death. COPD patients are at higher risk of cerebral hypoxia and aspiration. Yet, relatively little is known about the prevalence of COPD among stroke patients or its impact on outcomes after an index stroke. We assess the prevalence of COPD among hospitalized stroke patients in a nationally representative sample and examine the effect of COPD with mortality risk in the hospital after a stroke. METHODS: Using the National Inpatient Sample, a nationally representative dataset of US hospital admissions between January 2004 and December 2009 (n=48,087,002), we assessed Crude and age-adjusted COPD prevalence among stroke patients and in-hospital mortality rates by COPD status...
March 2017: ENeurologicalSci
https://www.readbyqxmd.com/read/28008091/lacunar-infarcts-and-intracerebral-hemorrhage-differences-a-nested-case-control-analysis-in-the-fhs-framingham-heart-study
#13
Vasileios-Arsenios Lioutas, Alexa Beiser, Jayandra Himali, Hugo Aparicio, Jose Rafael Romero, Charles DeCarli, Sudha Seshadri
BACKGROUND AND PURPOSE: Lacunar stroke (LS) and intracerebral hemorrhage (ICH) are 2 diverse manifestations of small vessel disease. What predisposes some patients to ischemic stroke and others to hemorrhage is not well understood. METHODS: We performed a nested case-control study within the FHS (Framingham Heart Study) comparing people with incident ICH and lacunar ischemic stroke, to age- and sex-matched controls for baseline prevalence and levels of cardiovascular risk factors...
December 22, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28007523/pinocembrin-protects-hemorrhagic-brain-primarily-by-inhibiting-toll-like-receptor-4-and-reducing-m1-phenotype-microglia
#14
Xi Lan, Xiaoning Han, Qian Li, Qiang Li, Yufeng Gao, Tian Cheng, Jieru Wan, Wei Zhu, Jian Wang
Neuroinflammation is a major contributor to intracerebral hemorrhage (ICH) progression, but no drug is currently available to reduce this response and protect against ICH-induced injury. Recently, the natural product pinocembrin has been shown to ameliorate neuroinflammation and is undergoing a phase II clinical trial for ischemic stroke treatment. In this study, we examined the efficacy of pinocembrin in an ICH model, and further examined its effect on microglial activation and polarization. In vivo, pinocembrin dose-dependently reduced lesion volume by ∼47...
December 20, 2016: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/28003010/endothelial-progenitor-cells-as-a-therapeutic-approach-for-intracerebral-hemorrhage
#15
Juan Pías-Peleteiro, Francisco Campos, María Pérez-Mato, Esteban López-Arias, Manuel Rodríguez-Yáñez, José Castillo, Tomás Sobrino
BACKGROUND: Intracerebral hemorrhage (ICH) is the most lethal subtype of stroke, a leading cause of death and disability in developed countries. Therapeutic options are notably limited. There is no specific pharmacological treatment, and early surgery has few indications that represent only a small clinically relevant survival advantage. It is therefore mandatory to investigate repairing processes after ICH in order to develop related therapeutic strategies. METHODS: The goal of this review is to discuss the current status of knowledge about the potential therapeutic role of endothelial progenitor cells (EPCs) in ICH, as well as the possible molecular mechanisms and future perspectives...
December 21, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28003003/endothelial-progenitor-cells-as-a-therapeutic-approach-for-intracerebral-hemorrhage
#16
Juan Pías-Peleteiro, Francisco Campos, María Pérez-Mato, Esteban López-Arias, Manuel Rodríguez-Yáñez, José Castillo, Tomás Sobrino
BACKGROUND: Intracerebral hemorrhage (ICH) is the most lethal subtype of stroke, a leading cause of death and disability in developed countries. Therapeutic options are notably limited. There is no specific pharmacological treatment, and early surgery has few indications that represent only a small clinically relevant survival advantage. It is therefore mandatory to investigate repairing processes after ICH in order to develop related therapeutic strategies. METHODS: The goal of this review is to discuss the current status of knowledge about the potential therapeutic role of endothelial progenitor cells (EPCs) in ICH, as well as the possible molecular mechanisms and future perspectives...
December 21, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28000130/early-mobilization-in-the-neuro-icu-how-far-can-we-go
#17
Brian F Olkowski, Syed Omar Shah
Immobility that is frequently encountered in the intensive care unit (ICU) can lead to patient complications. Early mobilization of patients in the ICU has been shown to reduce the complications associated with critical illness; however, early mobilization in the neurological intensive care unit (NICU) presents a unique challenge for the multidisciplinary team. The early mobilization of patients with acute neurologic injuries such as acute ischemic stroke, aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, and neurotrauma varies because of differing disease processes and management...
December 20, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/28000127/intensive-care-unit-admission-for-patients-in-the-interact2-ich-blood-pressure-treatment-trial-characteristics-predictors-and-outcomes
#18
Katja E Wartenberg, Xia Wang, Paula Muñoz-Venturelli, Alejandro A Rabinstein, Pablo M Lavados, Craig S Anderson, Thompson Robinson
BACKGROUND: Wide variation exists in criteria for accessing intensive care unit (ICU) facilities for managing patients with critical illnesses such as acute intracerebral hemorrhage (ICH). We aimed to determine the predictors of admission, length of stay, and outcome for ICU among participants of the main Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). METHODS: INTERACT2 was an international, open, blinded endpoint, randomized controlled trial of 2839 ICH patients (<6 h) and elevated systolic blood pressure (SBP) allocated to receive intensive (target SBP <140 mmHg within 1 h) or guideline-recommended (target SBP <180 mmHg) BP-lowering treatment...
December 20, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27999507/the-penumbra-5max-ace-catheter-is-safe-efficient-and-cost-saving-as-a-primary-mechanical-thrombectomy-device-for-large-vessel-occlusions-in-acute-ischemic-stroke
#19
Gabriel A Vidal, James M Milburn
BACKGROUND: Reperfusion of large vessel occlusions in acute stroke can improve patient outcomes. The purposes of this study were to assess the safety and efficacy of the Penumbra 5MAX ACE catheter for revascularization of large vessels and to compare its cost to the cost of stent retrievers. METHODS: In this retrospective, single-center case review study, data were captured on consecutive patients treated with the Penumbra 5MAX ACE as first-line therapy during an 11-month period...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27998323/short-and-long-term-reduction-of-door-to-needle-time-in-thrombolysis-for-acute-stroke
#20
Bing Yu Chen, Aimen Moussaddy, Mark R Keezer, Yan Deschaintre, Alexandre Y Poppe
BACKGROUND: More timely administration of tissue plasminogen activator (alteplase) for patients with acute ischemic stroke yields greater clinical benefits. We implemented door-to-needle (DTN) time reduction strategies at our center and evaluated their short- and long-term effects on in-hospital treatment delays and clinical outcomes. METHODS: Strategies, including stroke team prenotification, direct computed tomography transfer, not routinely waiting for laboratory results and alteplase delivery on the computed tomography table, were implemented in June 2013...
December 21, 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
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