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Stroke routing

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https://www.readbyqxmd.com/read/29149179/postmenopausal-hormone-therapy-and-risk-of-stroke-a-pooled-analysis-of-data-from-population-based-cohort-studies
#1
Germán D Carrasquilla, Paolo Frumento, Anita Berglund, Christer Borgfeldt, Matteo Bottai, Chiara Chiavenna, Mats Eliasson, Gunnar Engström, Göran Hallmans, Jan-Håkan Jansson, Patrik K Magnusson, Peter M Nilsson, Nancy L Pedersen, Alicja Wolk, Karin Leander
BACKGROUND: Recent research indicates a favourable influence of postmenopausal hormone therapy (HT) if initiated early, but not late, on subclinical atherosclerosis. However, the clinical relevance of timing of HT initiation for hard end points such as stroke remains to be determined. Further, no previous research has considered the timing of initiation of HT in relation to haemorrhagic stroke risk. The importance of the route of administration, type, active ingredient, and duration of HT for stroke risk is also unclear...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29132090/the-potential-use-of-transdermal-drug-delivery-for-the-prophylaxis-and-management-of-stroke-and-coronary-artery-disease
#2
REVIEW
Kevin Ita
In 2013, cardiovascular disease was responsible for 30.8% (800,937) of all 2,596,993 deaths, or approximately 1 of every 3 deaths while stroke caused about 1 of every 20 deaths in the United States [1]. To put it in context, about 795,000 people continue to have a new or recurrent stroke (ischemic or hemorrhagic) [1] in the USA. Mechanical vascular recanalization and thrombolysis with tissue plasminogen activator are the only clinically useful approaches available now for the management of ischemic stroke [2]...
June 4, 2017: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/29111008/management-of-blood-pressure-in-acute-stroke-comparison-of-current-prescribing-patterns-with-aha-asa-guidelines-in-a-sub-saharan-african-referral-hospital
#3
C Kuate-Tegueu, J J Dongmo-Tajeuna, J Doumbe, Y Mapoure-Njankouo, G Noubissi, V D P Djientcheu
BACKGROUND: High blood pressure (HBP) is common at acute phase of stroke. It may reflect untreated or uncontrolled hypertension before stroke, or it may relate to stress response. The present study was designed to compare current American Stroke Association (ASA) guidelines with actual prescribing patterns for management of HBP at the acute phase of stroke, in a tertiary care Hospital in Douala, Cameroon. METHODS: This cross-sectional study was conducted in the Cardiology and Neurology department of the Douala Laquintinie Hospital...
November 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29104777/studying-the-specific-activity-of-the-amide-form-of-hldf-6-peptide-using-the-transgenic-model-of-alzheimer-s-disease
#4
A P Bogachouk, Z I Storozheva, G B Telegin, A S Chernov, A T Proshin, V V Sherstnev, Yu A Zolotarev, V M Lipkin
The neuroprotective and nootropic activities of the amide form (AF) of the HLDF-6 peptide (TGENHR-NH2) were studied in transgenic mice of the B6C3-Tg(APPswe,PSEN1de9)85Dbo (Tg+) line (the animal model of familial Alzheimer's disease (AD)). The study was performed in 4 mouse groups: group 1 (study group): Tg+ mice intranasally injected with the peptide at a dose of 250 μg/kg; group 2 (active control): Tg+ mice intranasally injected with normal saline; group 3 (control 1): Tg- mice; and group 4 (control 2): C57Bl/6 mice...
July 2017: Acta Naturae
https://www.readbyqxmd.com/read/29070716/plumber-study-prevalence-of-large-vessel-occlusion-strokes-in-mecklenburg-county-emergency-response
#5
Adeline Dozois, Lorrie Hampton, Carlene W Kingston, Gwen Lambert, Thomas J Porcelli, Denise Sorenson, Megan Templin, Shellie VonCannon, Andrew W Asimos
BACKGROUND AND PURPOSE: The recently proposed American Heart Association/American Stroke Association EMS triage algorithm endorses routing patients with suspected large vessel occlusion (LVO) acute ischemic strokes directly to endovascular centers based on a stroke severity score. The predictive value of this algorithm for identifying LVO is dependent on the overall prevalence of LVO acute ischemic stroke in the EMS population screened for stroke, which has not been reported. METHODS: We performed a cross-sectional study of patients transported by our county's EMS agency who were dispatched as a possible stroke or had a primary impression of stroke by paramedics...
October 25, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29068166/meta-analysis-of-transfemoral-tavr-versus-surgical-aortic-valve-replacement
#6
Sameer Arora, Satyanarayana R Vaidya, Paula D Strassle, Jacob A Misenheimer, Jeremy A Rhodes, Cassandra J Ramm, Evan N Wheeler, Thomas G Caranasos, Matthew A Cavender, John P Vavalle
BACKGROUND: In the recently concluded PARTNER 2 trial, TF-TAVR cohort was shown to have lower risks of death or disabling strokes as compared to SAVR, whereas the outcomes with transthoracic TAVR were comparable with SAVR. METHODS: We searched PubMed, EMBASE, Web of Science, and Google Scholar for all comparison studies between TAVR and SAVR and mortality as an outcome, irrespective of surgical risk. Randomized controlled trials and propensity-score-matched cohort studies that used a transfemoral approach exclusively or stratified results by route of access and reported data for TF-TAVR patients were eligible for inclusion...
October 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29060113/monte-carlo-method-applied-to-the-evaluation-of-the-relationship-between-ejection-fraction-and-its-constituent-components
#7
Peter L M Kerkhof, B W Yoo, Jean Paul Merillon, Richard A Peace, Neal Handly
Ventricular function is routinely assessed by applying the clinically accepted metric ejection fraction (EF). The numerical value of EF depends on the interplay between end-systolic volume (ESV) and end-diastolic volume (EDV). The relative impact of the two constitutive components has received little attention. Pediatric cardiologists are interested in EF vs ESV when evaluating various congenital abnormalities. Following successful surgical intervention of Fallot tetralogy, many of these patients receive follow-up, not only during childhood, but also when being adults...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29051816/eptifibatide-is-associated-with-significant-cost-savings-and-similar-clinical-outcomes-to-abciximab-when-used-during-primary-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction-an-observational-cohort-study-of-3863-patients
#8
K S Rathod, S Antoniou, P Avari, N Ding, P Wright, C Knight, A K Jain, A Mathur, E J Smith, R Weerackody, A Wragg, D A Jones
INTRODUCTION: Glycoprotein IIb/IIIa inhibitors are recommended by guidelines in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. There are few studies directly comparing these agents. The aim of this study was to assess whether eptifibatide is a safe and cost-effective alternative to abciximab in the treatment of primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. METHODS: This was an observational cohort study of 3863 patients who received a GPIIb/IIIa inhibitor whilst undergoing primary percutaneous coronary intervention from 2007 to 2014...
January 2017: JRSM Cardiovascular Disease
https://www.readbyqxmd.com/read/29049855/intra-arterial-transplantation-of-human-bone-marrow-mesenchymal-stem-cells-hbmmscs-improves-behavioral-deficits-and-alters-gene-expression-in-rodent-stroke-model
#9
Vibhuti, Rehan Khan, Alpana Sharma, Suman Jain, Sujata Mohanty, Kameshwar Prasad
Stroke is a multi-factorial polygenic disease and is a major cause of death and adult disability. Administration of bone marrow stem cells protects ischemic rat brain by facilitating recovery of neurological functions. But the molecular mechanism of stem cells action and their effect on gene expression is not well explored. In this study, we have transplanted 1× 10(6) human bone marrow mesenchymal stem cells (hBMMSCs) in middle cerebral artery occluded (MCAo) adult male Wistar rats through intracarotid artery route at 24 hours after surgery...
October 19, 2017: Journal of Neurochemistry
https://www.readbyqxmd.com/read/29042407/can-favourable-psychosocial-working-conditions-in-midlife-moderate-the-risk-of-work-exit-for-chronically-ill-workers-a-20-year-follow-up-of-the-whitehall-ii-study
#10
Maria Fleischmann, Ewan Carr, Stephen A Stansfeld, Baowen Xue, Jenny Head
OBJECTIVES: To investigate if favourable psychosocial working conditions can reduce the risk of work exit and specifically for workers with chronic disease. METHODS: Men and women (32%) aged 35-55, working and having no chronic disease at baseline of the Whitehall II study of London-based civil servants were selected (n=9040). We observed participants' exit from work through retirement, health-related exit and unemployment, new diagnosis of chronic disease (ie, coronary heart disease, diabetes, stroke and cancer) and their psychosocial working conditions in midlife...
October 17, 2017: Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/29039146/estrogen-based-hormone-therapy-in-women-with-primary-ovarian-insufficiency-a-systematic-review
#11
Nydia Burgos, Dahima Cintron, Paula Latortue-Albino, Valentina Serrano, Rene Rodriguez Gutierrez, Stephanie Faubion, Gabriela Spencer-Bonilla, Patricia J Erwin, Mohammad Hassan Murad
PURPOSE: Sex hormones play a role in bone density, cardiovascular health, and wellbeing throughout reproductive lifespan. Women with primary ovarian insufficiency (POI) have lower estrogen levels requiring hormone therapy (HT) to manage symptoms and to protect against adverse long-term health outcomes. Yet, the effectiveness of HT in preventing adverse outcomes has not been systematically assessed. We summarize the evidence regarding effects of HT on bone and cardiovascular health in women with POI...
October 16, 2017: Endocrine
https://www.readbyqxmd.com/read/29033504/procedural-characteristics-and-outcomes-of-transcatheter-aortic-valve-implantation-a-single-center-experience-of-the-first-100-inoperable-or-high-surgical-risk-patients-with-severe-aortic-stenosis
#12
Ying-Hwa Chen, Hsiao-Huang Chang, Po-Lin Chen, Zen-Chung Weng, I-Ming Chen, Hsin-Bang Leu, Chun-Yang Huang, Su-Man Lin, Mei-Han Wu
BACKGROUND: This is the first study of a Taiwanese population reporting transcatheter aortic valve implantation (TAVI) outcomes of the first 100 cases from a single center offering two different transcatheter heart valve technologies via six types of approaches. We herein report the 30-day and one-year outcomes in our first 100 TAVI patients at Taipei Veterans General Hospital. METHODS: From May 2010 to April 2016, 100 consecutive patients with severe aortic stenosis (AS) who were considered unsuitable or at high risk for surgical aortic valve replacement underwent TAVI...
July 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/29033030/how-to-use-stem-cells-for-repair-in-stroke-patients
#13
REVIEW
O Detante, C Rome, J Papassin
Regenerative cell therapy is a promising therapeutic strategy in neurology, most notably to improve stroke recovery. Although tolerability and feasibility have apparently been validated, many questions remain as to what is the best type of cells to use, the best route and the post-stroke delay for administration. Two main strategies have currently emerged: intravenous injection of mesenchymal stem cells with systemic trophic support; and intracerebral grafting of neural stem cells with brain repair effects at the lesion site...
November 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28984620/making-if-then-plans-counteracts-learned-non-use-in-stroke-patients-a-proof-of-principle-study
#14
Michael K Marquardt, Anna-Lisa Cohen, Peter M Gollwitzer, Sam J Gilbert, Christian Dettmers
BACKGROUND: After stroke, the learned non-use of a paretic arm is a major obstacle to the improvement of hand function. OBJECTIVE: We examined whether patients with a central paresis could profit from applying the self-regulation strategy of making if-then plans that specify situational triggers to using the paretic arm. METHOD: Seventeen stroke patients with a mild to moderate hand paresis were asked to perform a Simon task which is commonly used to study the enhanced executive control needed when there is a mismatch between stimulus (e...
2017: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/28982689/increase-in-endovascular-therapy-in-get-with-the-guidelines-stroke-after-the-publication-of-pivotal-trials
#15
Eric E Smith, Jeffrey L Saver, Margueritte Cox, Li Liang, Roland A Matsouaka, Ying Xian, Deepak L Bhatt, Gregg C Fonarow, Lee H Schwamm
Background -Beginning in December 2014, a series of pivotal trials showed that endovascular thrombectomy (EVT) was highly effective, prompting calls to reorganize stroke systems of care. However, there are few data on how these trials influenced the frequency of EVT in clinical practice. We used data from the Get With The Guidelines-Stroke program to determine how the frequency of EVT changed in U.S. practice. Methods -We analyzed prospectively collected data from a cohort of 2,437,975 ischemic stroke patients admitted to 2,222 participating hospitals between April 2003 and the third quarter (Q3) 2016...
October 5, 2017: Circulation
https://www.readbyqxmd.com/read/28977565/transcarotid-transcatheter-aortic-valve-implantation-multicentre-experience-in-france
#16
Thierry Folliguet, Nicolas Laurent, Maxime Bertram, Konstantinos Zannis, Mazen Elfarra, Fabrice Vanhuyse, Pablo Maureira, Thomas Modine
OBJECTIVES: Transcatheter aortic valve implantation is a well-recognized treatment option for high-risk patients with aortic stenosis. The femoral approach is possible in 80% of cases and remains the access of choice. When this approach is not feasible, other alternative routes have been proposed such as transapical, transaortic and subclavian. Transcarotid aortic valve implantation has been proposed as another direct vascular access. Its use is relatively new and still under evaluation...
August 4, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28956577/high-strain-actuation-liquid-crystal-elastomers-via-modulation-of-mesophase-structure
#17
Mohand O Saed, Ross H Volpe, Nicholas A Traugutt, Rayshan Visvanathan, Noel A Clark, Christopher M Yakacki
Control of the mesophase in liquid crystalline elastomers (LCEs) is a critical aspect in harnessing their unique stimuli-responsive properties. Few studies have compared nematic and smectic main-chain LCEs in a direct way. Traditionally, it is believed that the mesogen core and synthetic route determines the phase behavior. In this study, we hypothesized that tuning the LC phases in main-chain LCE systems can be achieved by varying the spacer length while maintaining the same mesogen (RM257). By increasing the length of dithiol alkyl spacers containing two to eleven carbons along the spacer backbone (C2 to C11), we can modulate the mesophase from nematic to smectic, tailor the nematic to isotropic transition temperature between 90 and 140 °C, and increase the average work capacity from 128 to 262 kJ m(-3)...
October 25, 2017: Soft Matter
https://www.readbyqxmd.com/read/28955508/mobile-real-time-tracking-of-acute-stroke-patients-and-instant-secure-inter-team-communication-the-join-app
#18
Stephan A Munich, Lee A Tan, Danilo M Nogueira, Kiffon M Keigher, Michael Chen, R Webster Crowley, James J Conners, Demetrius K Lopes
PURPOSE: The primary correlate to survival and preservation of neurologic function in patients suffering from an acute ischemic stroke is time from symptom onset to initiation of therapy and reperfusion. Communication and coordination among members of the stroke team are essential to maximizing efficiency and subsequently early reperfusion. In this work, we aim to describe our preliminary experience using the Join mobile application as a means to improve interdisciplinary team communication and efficiency...
September 2017: Neurointervention
https://www.readbyqxmd.com/read/28943516/interhospital-transfer-prior-to-thrombectomy-is-associated-with-delayed-treatment-and-worse-outcome-in-the-stratis-registry
#19
Michael T Froehler, Jeffrey L Saver, Osama O Zaidat, Reza Jahan, Mohammad Ali Aziz-Sultan, Richard P Klucznick, Diogo C Haussen, Frank R Hellinger, Dileep R Yavagal, Tom L Yao, David S Liebeskind, Ashutosh P Jadhav, Rishi Gupta, Ameer E Hassan, Coleman O Martin, Hormozd Bozorgchami, Ritesh Kaushal, Raul G Nogueira, Ravi H Gandhi, Eric C Peterson, Shervin R Dashti, Curtis A Given, Brijesh P Mehta, Vivek Deshmukh, Sidney Starkman, Italo Linfante, Scott H McPherson, Peter Kvamme, Thomas J Grobelny, Muhammad S Hussain, Ike Thacker, Nirav Vora, Peng Roc Chen, Stephen J Monteith, Robert D Ecker, Clemens M Schirmer, Eric Sauvageau, Alex Abou-Chebl, Colin P Derdeyn, Lucian Maidan, Aamir Badruddin, Adnan H Siddiqui, Travis M Dumont, Abdulnasser Alhajeri, M Asif Taqi, Khaled Asi, Jeffrey S Carpenter, Alan Boulos, Gaurav Jindal, Ajit S Puri, Rohan Chitale, Eric M Deshaies, David H Robinson, David F Kallmes, Blaise W Baxter, Mouhammad A Jumaa, Peter Sunenshine, Aniel Q Majjhoo, Joey D English, Shuichi Suzuki, Richard D Fessler, Josser E Delgado Almandoz, Jerry C Martin, Nils H Mueller-Kronast
Background -Endovascular treatment with mechanical thrombectomy (MT) is beneficial for acute stroke patients suffering a large vessel occlusion, though treatment efficacy is highly time-dependent. We hypothesized that interhospital transfer to endovascular-capable centers would result in treatment delays and worse clinical outcomes compared to direct presentation. Methods -STRATIS was a prospective, multicenter, observational, single-arm study of real-world MT for acute stroke due to anterior-circulation large vessel occlusion performed at 55 sites over 2 years, including 1000 patients with severe stroke and treated within 8 hours...
September 24, 2017: Circulation
https://www.readbyqxmd.com/read/28925323/recanalization-reperfusion-and-recirculation-in-stroke
#20
John H Zhang, Andre Obenaus, David S Liebeskind, Jiping Tang, Richard Hartman, William J Pearce
Recirculation, from arterial inflow routes through venous outflow pathways, was conceptualized in stroke research 50 years ago. As new technologies were developed, blocked arteries could be reopened, capillaries could be reperfused, and the use of recanalization and reperfusion grew to dominate therapeutic strategies. These approaches overwhelmingly focused on restoration of arterial and capillary inflow, but not on veins even though venous disorders may initiate or exacerbate brain injury. In this commentary, we advance the term "recirculation" after "recanalization" and "reperfusion" as a primary concept of stroke pathophysiology that targets the restoration of both the arterial and venous cerebral circulations...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
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