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Mario Lescan, Mateja Andic, Tobias Krüger, Vedran Ivosevic, Christian Schlensak
BACKGROUND:  Ascending aorta or hemi-arch repair are common in the acute phase of type A dissection. Postdissection aneurysms can develop with antegrade perfusion of the false lumen in the dissected aortic arch and require reoperation. METHODS:  From 2012 to 2018, we reoperated nine patients with postdissection aneurysms using a hybrid technique without cardiopulmonary bypass. The patients had a EuroSCORE II of 13% and a logistic EuroSCORE I of 45% and were not candidates for frozen elephant trunk surgery...
September 22, 2018: Thoracic and Cardiovascular Surgeon
Sang Hun Lee, Keun-Sik Hong, Ji Sung Lee, Yong-Jae Kim, Tae-Jin Song, Young Dae Kim, Man-Seok Park, Eung-Gyu Kim, Jae-Kwan Cha, Sang Min Sung, Byung-Woo Yoon, Oh Young Bang, Woo-Keun Seo, Yang-Ha Hwang, Seong Hwan Ahn, Dong-Wha Kang, Hyun Goo Kang, Kyung-Ho Yu, Sun U Kwon
OBJECTIVES: To investigate the predictors of hemorrhagic transformation (HT) in patients with mild atrial fibrillation-related stroke who were treated with early anticoagulation. We conducted a post-hoc subgroup analysis from Acute Cerebral Infarction Patients with Non-valvular Atrial Fibrillation (Triple AXEL) study. PATIENTS AND METHODS: The Triple AXEL study was a randomized, multicenter, open-label, blinded end-point evaluation, comparative phase 2 trial. To identify the relationship between the type of HT and risk factors...
September 9, 2018: Clinical Neurology and Neurosurgery
Cheng-Chun Wu, Liang-Chao Wang, Yu-Tin Su, Wei-Yen Wei, Kuen-Jer Tsai
Ischemic stroke is the leading cause of disability and death worldwide. An effective therapeutic approach is urgently needed. Stroke-induced angiogenesis and neurogenesis are essential mechanisms in the long-term repair. Extracellular matrix proteins are also involved in tissue self-repair. Recently, a PHSRN (Pro-His-Ser-Arg-Asn) peptide from the fibronectin synergistic motif that can promote wound healing in epithelia and induce endothelial proliferation and cancer cell migration was identified. The therapeutic potential of this peptide in stroke is unknown...
September 11, 2018: Biomaterials
Erin L Meier, Jeffrey P Johnson, Swathi Kiran
Traditional models of neural reorganization of language skills in patients with chronic stroke-induced aphasia (PWA) propose activation of reperfused or spared left hemisphere tissue results in the most favorable language outcomes. However, these models do not fully explain variable behavioral recovery patterns observed in chronic patients. Instead, investigation of connectivity patterns of critical network nodes may elucidate better-informed recovery models. In the present study, we combined fMRI and dynamic causal modeling (DCM) to examine effective connectivity of a simple three-node left hemisphere network during a semantic feature decision task in 25 PWA and 18 age-matched neurologically intact healthy controls...
August 27, 2018: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
Guanghui Zhang, Pin Meng, Zhenwei Guo, Na Liu, Niu Ji, Xiaomin Li, Shan Geng, Mingli He
BACKGROUND The optimal medical regimen for managing hypertension during acute phase of lacunar infarcts has not yet been clarified in real world setting. The aim of this study was to evaluate blood pressure lowering regimens on neurological progression and clinical outcomes during the acute phase of lacunar infarcts. MATERIAL AND METHODS For this study, 411 patients with first-episode lacunar infarcts and hypertension within 24 hours of symptom onset were included. All patients received antihypertension therapies, with different regimens, as well as routine medication during first 7 days after onset...
September 22, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Xiaowen Shi, Yasuyuki Ohta, Jingwei Shang, Ryuta Morihara, Yumiko Nakano, Yusuke Fukui, Xia Liu, Tian Feng, Yong Huang, Kota Sato, Mami Takemoto, Nozomi Hishikawa, Toru Yamashita, Eriko Suzuki, Keiji Hasumi, Koji Abe
Stachybotrys microspora triprenyl phenol (SMTP)-44D has both anti-oxidative and anti-inflammatory activities, but its efficacy has not been proved in relation to the pathological changes of neurovascular unit (NVU) and neurovascular trophic coupling (NVTC) in ischemic stroke. Here, the present study was designed to assess the efficacies of SMTP-44D, moreover, compared with the standard neuroprotective reagent edaravone in ischemic brains. ICR mice were subjected to transient middle cerebral artery occlusion (tMCAO) for 60 min, SMTP-44D (10 mg/kg) or edaravone (3 mg/kg) was intravenously administrated through subclavian vein just after the reperfusion, and these mice were examined at 1, 3, and 7 d after reperfusion...
September 22, 2018: Journal of Neuroscience Research
Devin W McBride, Eric C K Gren, Wayne Kelln, William K Hayes, John H Zhang
Hemorrhagic transformation after ischemic stroke is an independent predictor for poor outcome and is characterized by blood vessel rupture leading to brain edema. To date, no therapies for preventing hemorrhagic transformation exist. Disintegrins from the venom of Crotalus atrox have targets within the coagulation cascade, including receptors on platelets. We hypothesized that disintegrins from C. atrox venom can attenuate hemorrhagic transformation by preventing activation of matrix metalloproteinase after middle cerebral artery occlusion (MCAO) in hyperglycemic rats...
September 22, 2018: Journal of Neuroscience Research
Sung-Chun Tang, Kai-Chien Yang, Chih-Hao Chen, Shieh-Yueh Yang, Ming-Jang Chiu, Chau-Chung Wu, Jiann-Shing Jeng
Increases in plasma of β-amyloids (Aβ) and tau proteins have been noted in patients with Alzheimer's dementia (AD). Our study investigated the associations of plasma Aβ and tau proteins with dementia in stroke patients. This cross-sectional study recruited 24 controls (mean age: 67.4 ± 7.5 years, 33.3% male), 27 stroke patients without dementia (mean age: 70.7 ± 6.9 years, 60.7% male), 34 stroke patients with dementia (mean age: 78.3 ± 5.3 years, 45.5% male, Clinical Dementia Ranking (CDR): 1...
September 21, 2018: Neuromolecular Medicine
Mehdi Najafzadeh, Sebastian Schneeweiss, Niteesh K Choudhry, Jerry Avorn, Joshua J Gagne
OBJECTIVES: Preference weights derived from general population samples are often used for therapeutic decision making. In contrast, patients with cardiovascular disease may have different preferences concerning the benefits and risks of anticoagulant therapy. Using a discrete choice experiment, we compared preferences for anticoagulant treatment outcomes between the general population and patients with cardiovascular disease. METHODS: A sample of the general US population and a sample of patients with cardiovascular disease were selected from online panels...
September 21, 2018: Patient
Valeria De Giuli, Francesca Graziano, Andrea Zini, Marialuisa Zedde, Rosalba Patella, Corrado Lodigiani, Simona Marcheselli, Maria Luisa DeLodovici, Maurizio Paciaroni, Ilaria Casetta, Elisa Giorli, Alessandro Adami, Massimiliano Braga, Carmela Casella, Alessia Giossi, Giorgio Silvestrelli, Lucia Tancredi, Enrico Maria Lotti, Loris Poli, Filomena Caria, Valeria Piras, Laura Cucurachi, Massimo Gamba, Mario Grassi, Alessandro Padovani, Alessandro Pezzini
OBJECTIVE: Whether migraine modifies after spontaneous cervical artery dissection (sCeAD) more than after other stroke etiologic subtypes has never been adequately investigated. METHODS: In the setting of the Italian Project on Stroke in Young Adults (IPSYS), we compared the course of migraine before and after acute brain infarct in a group of migraine patients with sCeAD and a group of migraine patients whose ischemia was due to a cause other than CeAD (non-CeAD IS), matched by sex, age (± 3 years), and migraine subtype...
September 21, 2018: Neurological Sciences
Richard W Frieden
No abstract text is available yet for this article.
September 18, 2018: Annals of Internal Medicine
Zhiwei Mou, Zhuoming Chen, Jing Yang, Li Xu
This study investigated the acoustic features of vowel production in Mandarin-speaking patients with post-stroke dysarthria (PSD). The subjects included 31 native Mandarin-speaking patients with PSD (age: 25-83 years old) and 38 neurologically normal adults in a similar age range (age: 21-76 years old). Each subject was recorded producing a list of Mandarin monosyllables that included six monophthong vowels (i.e., /a, i, u, ɤ, y, o/) embedded in the /CV/ context. The patients' speech samples were evaluated by two native Mandarin speakers...
September 21, 2018: Scientific Reports
Michael S Woody, Michael J Greenberg, Bipasha Barua, Donald A Winkelmann, Yale E Goldman, E Michael Ostap
Omecamtiv mecarbil (OM) is a positive cardiac inotrope in phase-3 clinical trials for treatment of heart failure. Although initially described as a direct myosin activator, subsequent studies are at odds with this description and do not explain OM-mediated increases in cardiac performance. Here we show, via single-molecule, biophysical experiments on cardiac myosin, that OM suppresses myosin's working stroke and prolongs actomyosin attachment 5-fold, which explains inhibitory actions of the drug observed in vitro...
September 21, 2018: Nature Communications
Avilash Cramer, Jake Hecla, Dufan Wu, Xiaochun Lai, Tim Boers, Kai Yang, Tim Moulton, Steven Kenyon, Zaven Arzoumanian, Wolfgang Krull, Keith Gendreau, Rajiv Gupta
Computed tomography (CT) is used to diagnose many emergent medical conditions, including stroke and traumatic brain injuries. Unfortunately, the size, weight, and expense of CT systems make them largely inaccessible for patients outside of major hospitals. We have designed a module containing multiple miniature x-ray sources that could allow for CT systems to be significantly lighter, smaller, and cheaper, and to operate without any moving parts. We have developed a novel photocathode-based x-ray source, created by depositing a thin film of magnesium on an electron multiplier...
September 21, 2018: Scientific Reports
Vladimir Makaloski, Tilo Kölbel, Fiona Rohlffs, Christian A Behrendt, Yuk Law, Eike S Debus, Nikolaos Tsilimparis
AIM: To compare early outcome after complex endovascular aortic repair in octogenarians (age ≥ 80 years) versus non-octogenarians (age < 80 years) treated with fenestrated or branched stent grafts. METHODS: Single centre retrospective analysis from a prospectively collected database of all patients undergoing repair with fenestrated or branched stent grafts for para/suprarenal aortic aneurysm, type Ia endoleak after previous endovascular aortic repair, and thoraco-abdominal aortic aneurysm between January 2015 and December 2017...
September 18, 2018: European Journal of Vascular and Endovascular Surgery
Jose Antonio Merchán-Baeza, Manuel González-Sánchez, Antonio Ignacio Cuesta-Vargas
GOAL: The main objective was to use the inertial sensor integrated into a smartphone to collect quantitative data on lower limb functioning during execution of the timed up and go test and sit to stand test by people in the acute stage of stroke. The secondary objective was to analyze whether smartphones provide reliable quantitative data on performance of these functional tests. MATERIAL AND METHODS: Cross-sectional analytical study involving 8 elderly people (M age = 67...
September 18, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Justin Fried, Arthur R Garan, Sophia Shames, Amirali Masoumi, Melana Yuzefpolskaya, Koji Takeda, Hiroo Takayama, Nir Uriel, Yoshifumi Naka, Paolo C Colombo, Veli K Topkara
BACKGROUND: Aortic root thrombosis (ART) is a recently recognized complication of continuous-flow left ventricular assist device (CF-LVAD) therapy. However, little is known about the prevalence or clinical significance of this complication. The aim of our study was to systematically evaluate the incidence and significance of ART on CF-LVAD support. METHODS: We retrospectively reviewed all patients who underwent HeartMate II or HeartWare HVAD CF-LVAD implantation from April 2004 through June 2016 at the Columbia University Medical Center...
July 25, 2018: Journal of Heart and Lung Transplantation
Jiaqing Wang, Xia Chen, Baoshi Yuan, Weicong Wang, Chunmin Xu, Weiwei Zhao, Pengpeng Zhao, Yilong Wang, Xingquan Zhao, Yongjun Wang
PURPOSE: Edaravone is a free-radical scavenger. Edaravone 30mg IV has been approved for use in the treatment of acute ischemic stroke in Japan and China, and for amyotrophic lateral sclerosis in Japan and the United States. Considering the inconvenience of IV infusion in clinical practice, an oral tablet formulation of edaravone was developed but failed in 2011 due to poor bioavailability. More recently, a sublingual (SL) tablet formulation of edaravone 30mg was developed by a Good Manufacturing Practices-compliant manufacturer in China...
September 18, 2018: Clinical Therapeutics
Quanhe Yang, Julia L Durmer, Anne G Wheaton, Sandra L Jackson, Zefeng Zhang
OBJECTIVES: Insufficient sleep negatively impacts the cardiovascular system. No study has examined the association between sleep duration and heart age (person's predicted vascular age based on cardiovascular disease [CVD] risk profile). This study examines association between sleep duration and excess heart age (EHA; difference between heart age and chronological age) among US adults. DESIGN AND PARTICIPANTS: Cross-sectional 2007-2014 National Health and Nutrition Examination Survey data for respondents aged 30-74 years without CVD or stroke (n = 12,775)...
October 2018: Sleep Health
Symielle A Gaston, W Braxton Jackson, David R Williams, Chandra L Jackson
OBJECTIVES: To investigate Black-White disparities in suboptimal sleep and cardiometabolic health by government-assisted rental housing status. DESIGN: National Health Interview Survey (NHIS) pooled cross-sectional data (2004-2016). SETTING: United States. PARTICIPANTS: Black and White adult participants (n = 80,880). MEASUREMENTS: Poisson regression with robust variance was used to estimate prevalence ratios (PRs) and 95% confidence intervals for self-reported unrecommended (<6 hours), short (≤6-<7 hours), and long (>9 hours) sleep duration (each separately vs recommended (≤7-9 hours)) and sleep difficulties (eg, trouble falling/staying asleep ≥3 days/week) (yes vs no) among Blacks compared to Whites within rental housing categories (government-assisted vs unassisted), separately, for men and women...
October 2018: Sleep Health
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