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https://www.readbyqxmd.com/read/29055286/in-defense-of-progesterone-a-review-of-the-literature
#1
Allan Lieberman, Luke Curtis
Context • The medical literature on the use of progesterone in postmenopausal women is often confusing and contradictory. Some physicians implicate natural progesterone in an increase in the risk of breast cancer. The chemical structure of natural progesterone (P4) is quite different from chemically altered, synthetic chemicals called progestins, which results in different actions at the cell level. Objective • The research team intended to review the literature to examine the benefits and safety of natural progesterone and determine whether it can cause an increase or decrease in breast cancer risk...
October 21, 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/29055224/primary-suction-thrombectomy-for-acute-ischemic-stroke-a-meta-analysis-of-the-current-literature
#2
Jin Pyeong Jeon, Sung-Eun Kim, Chul Ho Kim
OBJECTIVES: We conducted a meta-analysis to assess the angiographic and clinical outcomes for ischemic stroke patients treated with primary suction thrombectomy and to compare the procedural outcomes based on the treatment strategies (primary suction vs. stent retriever thrombectomy). PATIENTS AND METHODS: We conducted a systemic literature review through an online data base from January 2004 through December 2016. The primary outcomes were rate of successful recanalization on final angiogram and good outcome three months after stroke onset...
October 3, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29055181/pfa-100-measured-aspirin-resistance-is-the-predominant-risk-factor-for-hospitalized-cardiovascular-events-in-aspirin-treated-patients-a-5-year-cohort-study
#3
H Y Chen, P Chou
WHAT IS KNOWN AND OBJECTIVE: Aspirin therapy is the clinical gold standard for the prevention of cardiovascular events. However, cardiovascular events still develop in some patients undergoing aspirin therapy. Many laboratory methods exist for measuring aspirin resistance. Using the platelet Function Analyzer (PFA)-100 system, we aimed to determine the effect of aspirin resistance on hospitalized cardiovascular events (hCVE) in a 5-year follow-up cohort. We also sought to determine the impact of aspirin resistance on the relationship between common cardiovascular risk factors and cardiovascular hospitalization...
October 21, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29055168/long-term-safety-of-growth-hormone-a-combined-registry-analysis
#4
Kirstine Stochholm, Wieland Kiess
OBJECTIVES: Preliminary data from the French cohort of the Safety and Appropriateness of Growth hormone treatments in Europe (SAGhE) study raised concerns regarding the safety of recombinant human GH, suggesting that GH may increase mortality and incidence of stroke in patients treated during childhood for GH deficiency or short stature. We evaluated published safety data, focusing on mortality, neoplasms, cerebrovascular events and diabetes across a number of large-scale pharmaceutical company GH registries...
October 21, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/29055086/acute-mitogen-activated-protein-kinase-1-2-inhibition-improves-functional-recovery-and-vascular-changes-after-ischemic-stroke-in-rat-monitored-by-9-4-t-magnetic-resonance-imaging
#5
Maryam Mostajeran, Friedrich Wetterling, Frank W Blixt, Lars Edvinsson, Saema Ansar
AIM: The aim was to evaluate the beneficial effect of early mitogen activated protein kinase (MEK)1/2 inhibition administered at a clinical relevant time-point using the transient middle cerebral artery occlusion model and a dedicated rodent magnetic resonance imaging system (9.4T) to monitor cerebrovascular changes non-invasively for two weeks. METHOD: Transient middle cerebral artery occlusion was induced in male rats for two hours followed by reperfusion. The specific MEK1/2 inhibitor U0126 was administered i...
October 21, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/29054968/pivotal-neuroinflammatory-and-therapeutic-role-of-high-mobility-group-box-1-in-ischemic-stroke
#6
Seidu A Richard, Marian Sackey, Zhaoliang Su, Huaxi Xu
Stroke is a major cause of mortality and disability worldwide. Stroke is a frequent and severe neurovascular disorder. The main cause of stroke is atherosclerosis, and the most common risk factor for atherosclerosis is hypertension. Therefore, prevention and treatment of stroke are crucial issues in humans. High mobility group box 1 (HMGB1) is non-histone nuclear protein that is currently one of the crucial pro-inflammatory alarmin in ischemic stroke (IS). It is instantly released from necrotic cells in the ischemic core and activates an early inflammatory response...
October 20, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/29054946/management-challenges-of-late-presentation-dacron-patch-infection-after-carotid-endarterectomy
#7
Jie Hua Xu, Nishath Altaf, Patrik Tosenovsky, Bibombe Patrice Mwipatayi
An 83-year-old man presented 4 years after right carotid endarterectomy (CEA) with an infection of his prosthetic Dacron patch. Initial scans (CT angiogram and whole body labelled white cell scan) were clear with no infection or collection noted. Systemically, the patient presented well with no recorded fevers. With an occluded left internal carotid artery and severely stenosed vertebral arteries, surgery presented a high risk of major stroke due to the lack collateral supply and this was discussed extensively...
October 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29054914/flow-diversion-for-the-treatment-of-posterior-inferior-cerebellar-artery-aneurysms-a-novel-classification-and-strategies
#8
Visish M Srinivasan, Michael George Zaki Ghali, Oleg E Reznik, Jacob Cherian, Maxim Mokin, Travis M Dumont, John R Gaughen, Ramesh Grandhi, Ajit S Puri, Stephen R Chen, Jeremiah N Johnson, Peter Kan
BACKGROUND: The pipeline embolization device (PED) is frequently used in the treatment of anterior circulation aneurysms, especially around the carotid siphon, with generally excellent results. However, treatment of posterior inferior cerebellar artery (PICA) aneurysms with flow diversion (FD) has not been specifically described or discussed. While there are reports of treating PICA aneurysms using placement of FD stents in the vertebral artery, there are no reports of treating these lesions by placement of flow diverting stents in the PICA vessel itself...
October 20, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29054842/acute-biventricular-mechanical-circulatory-support-for-cardiogenic-shock
#9
Sudeep Kuchibhotla, Michele L Esposito, Catalina Breton, Robert Pedicini, Andrew Mullin, Ryan O'Kelly, Mark Anderson, Dennis L Morris, George Batsides, Danny Ramzy, Mark Grise, Duc Thinh Pham, Navin K Kapur
BACKGROUND: Biventricular failure is associated with high in-hospital mortality. Limited data regarding the efficacy of biventricular Impella axial flow catheters (BiPella) support for biventricular failure exist. The aim of this study was to explore the clinical utility of percutaneously delivered BiPella as a novel acute mechanical support strategy for patients with cardiogenic shock complicated by biventricular failure. METHODS AND RESULTS: We retrospectively analyzed data from 20 patients receiving BiPella for biventricular failure from 5 tertiary-care hospitals in the United States...
October 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29054778/validation-of-prognostic-models-to-predict-early-mortality-in-spontaneous-intracerebral-hemorrhage-a-cross-sectional-evaluation-of-a-singapore-stroke-database
#10
Julian Xinguang Han, Angela An Qi See, Nicolas Kon Kam King
OBJECTIVE: Numerous scores have been developed for prognostication of outcomes in intracerebral hemorrhage (ICH). Prediction models must be validated internally and externally before they are considered widely applicable. We aim to independently externally validate and compare three prediction models (ICH score, ICH grading scale (ICH-GS) and simplified ICH (sICH)) in our population, which has not been previously done. METHODS: We reviewed 1338 patients with spontaneous ICH consecutively admitted to the National Neuroscience Institute (NNI), Singapore, between January 2009 and November 2013...
October 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29054733/disrupted-ionic-homeostasis-in-ischemic-stroke-and-new-therapeutic-targets
#11
REVIEW
Hui-Jie Hu, Mingke Song
BACKGROUND: Stroke is a leading cause of long-term disability. All neuroprotectants targeting excitotoxicity have failed to become stroke medications. In order to explore and identify new therapeutic targets for stroke, we here reviewed present studies of ionic transporters and channels that are involved in ischemic brain damage. METHOD: We surveyed recent literature from animal experiments and clinical reports in the databases of PubMed and Elsevier ScienceDirect to analyze ionic mechanisms underlying ischemic cell damage and suggest promising ideas for stroke therapy...
October 17, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29054448/brain-ischemia-ct-and-mri-techniques-in-acute-ischemic-stroke
#12
REVIEW
Pedro Vilela, Howard A Rowley
Imaging plays a central role for intravenous and intra-arterial arterial ischemic stroke treatment patient selection. Computed tomography (CT) / CT angiography or magnetic resonance (MR) / MR angiography imaging are used to exclude stroke mimics and haemorrhage, to determine the cause and mechanism of stroke, to define the extension of brain infarct and to identify the arterial occlusion. Imaging may identify the patients that will be benefit more from revascularization therapies independently of the conventional therapeutic time window allowing individualized treatment decisions and improving individual patient outcome...
August 24, 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/29054427/common-brain-networks-for-distinct-deficits-in-visual-neglect-a-combined-structural-and-tractography-mri-approach
#13
Monica N Toba, Raffaella Migliaccio, Bénédicte Batrancourt, Clémence Bourlon, Christophe Duret, Pascale Pradat-Diehl, Bruno Dubois, Paolo Bartolomeo
Visual neglect is a heterogeneous, multi-component syndrome resulting from right hemisphere damage. Neglect patients do not pay attention to events occurring on their left side, and have a poor functional outcome. The intra-hemispheric location of lesions producing neglect is debated, because studies using different methods reported different locations in the grey matter and in the white matter of the right hemisphere. These reported locations show various patterns of overlapping with the fronto-parietal attention networks demonstrated by functional neuroimaging...
October 17, 2017: Neuropsychologia
https://www.readbyqxmd.com/read/29054193/polymorphisms-of-cytochrome-p450-are-potential-candidates-that-could-potentially-help-clinicians-on-the-treatment-of-cardiovascular-diseases-among-asian-populations
#14
López-Hernández Daniel
There are significant ethnic differences in the metabolism of some drugs that can be explained by cytochrome P450 polymorphisms and, in particular, the CYP2D6 isozyme. In addition, among patients who are not carriers of the CYP2C19 loss-of-function alleles, there is a reduced risk of stroke when clopidogrel is taken with aspirin compared to aspirin alone. These findings demonstrate that there is inter-ethnic variability in the metabolism of some drugs, which results in different responses to cardiovascular drugs in Asian versus non-Asian populations...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29054182/clinical-outcome-in-nonagenarians-undergoing-transcatheter-valve-replacement
#15
Oscar Mendiz, Carlos Fava, Fernando Cura, Carla Agatiello, Matias Sztejfman, Anibal Damonte, Hugo Londero, Alfonsina Candiello, Daniel Berrocal
BACKGROUND: Nonagenarians are mostly denied from different therapeutic strategies due to high preoperative risk. We present the results of nonagenarians with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). METHODS: Our retrospective analysis include baseline and procedural data along with clinical outcome. Clinical follow-up was performed in all patients after TAVR. RESULTS: Out of 689 patients, 33 nonagenarians with a mean age of 90...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29054044/metacognitive-deficits-in-categorization-tasks-in-a-population-with-impaired-inner-speech
#16
Peter Langland-Hassan, Christopher Gauker, Michael J Richardson, Aimee Dietz, Frank R Faries
This study examines the relation of language use to a person's ability to perform categorization tasks and to assess their own abilities in those categorization tasks. A silent rhyming task was used to confirm that a group of people with post-stroke aphasia (PWA) had corresponding covert language production (or "inner speech") impairments. The performance of the PWA was then compared to that of age- and education-matched healthy controls on three kinds of categorization tasks and on metacognitive self-assessments of their performance on those tasks...
October 17, 2017: Acta Psychologica
https://www.readbyqxmd.com/read/29054018/isolated-aphasia-in-the-emergency-department-the-likelihood-of-ischemia-is-low
#17
Gabriel Casella, Rafael H Llinas, Elisabeth B Marsh
OBJECTIVE: Aphasia is a common presentation of ischemic stroke, often diagnosed in the acute setting using tools such as the NIH Stroke Scale (NIHSS). Due to the vascular distribution of the middle cerebral artery, it is often accompanied by other symptoms such as weakness, sensory loss, or visual changes. Isolated aphasia due to ischemia is possible, but language problems mimicking aphasia syndromes can also be seen with other diagnoses such as metabolic abnormalities or dementia. In this study, we determine the incidence of aphasia-only strokes using the NIHSS, and factors associated with a higher likelihood of ischemia...
October 16, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29053913/morphological-changes-of-the-internal-carotid-artery-prevalence-and-characteristics-a-clinic-and-ultrasonographic-study-in-a-series-of-19-804-patients-over-25-years-old
#18
Hugo F G Martins, Alexandra Mayer, Paulo Batista, Fátima Soares, Vanessa Almeida, Ana Júlia Pedro, Victor Oliveira
BACKGROUND: Morphological changes of the internal carotid arteries (McICA) are frequently found during cervical ultrasound studies. However, McICA's etiology remains controversial. During this study, the prevalence and demographic characteristics of McICA such as kinking, coiling or looping, identified by Doppler ultrasound, were analysed and its relationship with vascular risk factors and stroke was assessed. METHODS: A retrospective study was performed by analysing 19,804 patients between Jan 2000 and Jun 2012 who were submitted to cervical ultrasonographic study...
October 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29053908/no-time-to-hesitate-in-acute-in-hospital-stroke
#19
EDITORIAL
Annette Fromm
The treatment options for acute ischemic stroke are rapidly improving, and there is high awareness for community-onset stroke, pre-hospital pathways and streamline in-hospital management. However, the management of in-hospital stroke is often less well established, and stringent procedures are frequently missing. Higher rates of in-hospital complications and in-hospital mortality were suggested among in-hospital stroke patients who had been treated with i.v. thrombolysis. This issue is addressed in a new propensity-matched analysis from the SITS-EAST registry...
October 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29053905/distinct-predictive-role-of-collateral-status-on-clinical-outcome-in-variant-stroke-subtypes-of-acute-large-arterial-occlusion
#20
Xuting Zhang, Meixia Zhang, Wenhong Ding, Shenqiang Yan, David S Liebeskind, Min Lou
BACKGROUND: Clinical trials have showed that robust collateral flow has a relationship with good clinical outcome, however, different stroke subtypes were lumped together. This study explored the relationship between baseline collaterals and the onset-to-imaging time (OIT), and the correlation between pre-treatment collateral status and clinical outcome among different subtypes. METHOD: We reviewed prospectively collected data from consecutive acute ischemic stroke (AIS) patients with acute middle cerebral artery occlusion who received reperfusion therapy...
October 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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