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Stroke routing

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https://www.readbyqxmd.com/read/28916666/regional-evaluation-of-the-severity-based-stroke-triage-algorithm-for-emergency-medical-services-using-discrete-event-simulation
#1
Brittany M Bogle, Andrew W Asimos, Wayne D Rosamond
BACKGROUND AND PURPOSE: The Severity-Based Stroke Triage Algorithm for Emergency Medical Services endorses routing patients with suspected large vessel occlusion acute ischemic strokes directly to endovascular stroke centers (ESCs). We sought to evaluate different specifications of this algorithm within a region. METHODS: We developed a discrete event simulation environment to model patients with suspected stroke transported according to algorithm specifications, which varied by stroke severity screen and permissible additional transport time for routing patients to ESCs...
September 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28904531/potential-therapeutic-mechanisms-and-tracking-of-transplanted-stem-cells-implications-for-stroke-treatment
#2
REVIEW
Yanhong Zhang, Honghong Yao
Stem cell therapy is a promising potential therapeutic strategy to treat cerebral ischemia in preclinical and clinical trials. Currently proposed treatments for stroke employing stem cells include the replacement of lost neurons and integration into the existing host circuitry, the release of growth factors to support and promote endogenous repair processes, and the secretion of extracellular vesicles containing proteins, noncoding RNA, or DNA to regulate gene expression in recipient cells and achieve immunomodulation...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28900664/-prehospital-care-for-stroke-patients
#3
REVIEW
C H Nolte, H J Audebert
The effectiveness of thrombolysis or mechanical recanalization for acute stroke is higher, the sooner these therapies are started. Therefore, acute stroke patients need to be evaluated by qualified staff for these therapies as soon as possible. Lay persons need to identify the typical symptoms of stroke as an emergency and act accordingly by calling the emergency medical system (EMS). The EMS team reassesses the symptoms and prompts cerebral imaging. Cerebral imaging is performed ideally in hospitals with a stroke unit where subsequent (stroke) treatments occur...
September 12, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28895285/complete-filter-based-cerebral-embolic-protection-with-transcatheter-aortic-valve-replacement
#4
Lennart Van Gils, Herbert Kroon, Joost Daemen, Claire Ren, Anne-Marie Maugenest, Marguerite Schipper, Peter P De Jaegere, Nicolas M Van Mieghem
OBJECTIVES: To evaluate the value of left vertebral artery filter protection in addition to the current filter-based embolic protection technology to achieve complete cerebral protection during TAVR. BACKGROUND: The occurrence of cerebrovascular events after transcatheter aortic valve replacement (TAVR) has fueled concern for its potential application in younger patients with longer life expectancy. Transcatheter cerebral embolic protection (TCEP) devices may limit periprocedural cerebrovascular events by preventing macro and micro-embolization to the brain...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28885866/caspase-inhibitors-a-review-of-recently-patented-compounds-2013-2015
#5
Hyemin Lee, Eun Ah Shin, Jae Hee Lee, Deoksoo Ahn, Chang Geun Kim, Ju-Ha Kim, Sung-Hoon Kim
Although many caspase inhibitors have been patented, caspase inhibitors have not entered the market due to their toxicity and poor pharmacokinetic profile. Areas covered: In this article, we review patents (2013-2015) for peptide and non-peptide caspase inhibitors and their compositions. Expert opinion: Noteworthy patents include a peptidic caspase-2 inhibitor for nasal administration and a peptidomimetic caspase-6 inhibitor that can be administered via several routes for the treatment of neurodegenerative diseases...
September 8, 2017: Expert Opinion on Therapeutic Patents
https://www.readbyqxmd.com/read/28884654/controlled-clinical-trials-of-cell-therapy-in-stroke-meta-analysis-at-six-months-after-treatment
#6
Olivier Detante, Anaïck Moisan, Marc Hommel, Assia Jaillard
Background Cell therapy is promising in experimental studies and has been assessed only in a few studies on humans. Aims To evaluate the effect of cell therapy in humans. Methods We included clinical trials with a control group that reported safety and efficacy six months following treatment. Quality was evaluated and clinical scales data were extracted. Quantitative analysis was based on the standardized means difference (SMD). Among 28 trials published from 1995 to 2016, nine studies (194 patients; 191 controls) were eligible...
October 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28835475/stroke-and-methamphetamine-use-in-young-adults-a-review
#7
REVIEW
Julia M Lappin, Shane Darke, Michael Farrell
BACKGROUND: Methamphetamine use and stroke are significant public health problems. Strokes among people aged below 45 years are much less common than in older age groups but have significant mortality and morbidity. Methamphetamine is a putative cause of strokes among younger people. METHODS: A review of methamphetamine-related strokes was conducted. Bibliographic databases were searched until February 2017 for articles related to methamphetamine and stroke. Both haemorrhagic and ischaemic strokes were considered...
August 23, 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28771575/zl006-a-small-molecule-inhibitor-of-psd-95-nnos-interaction-does-not-induce-antidepressant-like-effects-in-two-genetically-predisposed-rat-models-of-depression-and-control-animals
#8
Sandra Tillmann, Vitor Silva Pereira, Nico Liebenberg, Anne Karina Christensen, Gregers Wegener
N-methyl-D-aspartate receptor (NMDA-R) antagonists and nitric oxide inhibitors have shown promising efficacy in depression but commonly induce adverse events. To circumvent these, a more indirect disruption of the nitric oxide synthase/postsynaptic density protein 95 kDa complex at the NMDA-R has been proposed. This disruption can be achieved using small molecule inhibitors such as ZL006, which has attracted attention as ischemic stroke therapy in rodents and has been proposed as a potential novel treatment for depression...
2017: PloS One
https://www.readbyqxmd.com/read/28770403/route-of-feeding-as-a-proxy-for-dysphagia-after-stroke-and-the-effect-of-transdermal-glyceryl-trinitrate-data-from-the-efficacy-of-nitric-oxide-in-stroke-randomised-controlled-trial
#9
Lisa J Woodhouse, Polly Scutt, Shaheen Hamdy, David G Smithard, David L Cohen, Christine Roffe, Daniel Bereczki, Eivind Berge, Christopher F Bladin, Valeria Caso, Hanne K Christensen, Rónán Collins, Anna Czlonkowska, Asita de Silva, Anwar Etribi, Ann-Charlotte Laska, George Ntaios, Serefnur Ozturk, Stephen J Phillips, Kameshwar Prasad, Szabolcs Szatmari, Nikola Sprigg, Philip M Bath
Post-stroke dysphagia is common, associated with poor outcome and often requires non-oral feeding/fluids. The relationship between route of feeding and outcome, as well as treatment with glyceryl trinitrate (GTN), was studied prospectively. The Efficacy of Nitric Oxide in Stroke (ENOS) trial assessed transdermal GTN (5 mg versus none for 7 days) in 4011 patients with acute stroke and high blood pressure. Feeding route (oral = normal or soft diet; non-oral = nasogastric tube, percutaneous endoscopic gastrostomy tube, parenteral fluids, no fluids) was assessed at baseline and day 7...
August 2, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28762187/the-choroid-plexus-is-a-key-cerebral-invasion-route-for-t-cells-after-stroke
#10
Gemma Llovera, Corinne Benakis, Gaby Enzmann, Ruiyao Cai, Thomas Arzberger, Alireza Ghasemigharagoz, Xiang Mao, Rainer Malik, Ivana Lazarevic, Sabine Liebscher, Ali Ertürk, Lilja Meissner, Denis Vivien, Christof Haffner, Nikolaus Plesnila, Joan Montaner, Britta Engelhardt, Arthur Liesz
Neuroinflammation contributes substantially to stroke pathophysiology. Cerebral invasion of peripheral leukocytes-particularly T cells-has been shown to be a key event promoting inflammatory tissue damage after stroke. While previous research has focused on the vascular invasion of T cells into the ischemic brain, the choroid plexus (ChP) as an alternative cerebral T-cell invasion route after stroke has not been investigated. We here report specific accumulation of T cells in the peri-infarct cortex and detection of T cells as the predominant population in the ipsilateral ChP in mice as well as in human post-stroke autopsy samples...
July 31, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28754163/choroid-plexus-cerebrospinal-fluid-route-for-monocyte-derived-macrophages-after-stroke
#11
Ruimin Ge, Daniel Tornero, Masao Hirota, Emanuela Monni, Cecilia Laterza, Olle Lindvall, Zaal Kokaia
BACKGROUND: Choroid plexus (CP) supports the entry of monocyte-derived macrophages (MDMs) to the central nervous system in animal models of traumatic brain injury, spinal cord injury, and Alzheimer's disease. Whether the CP is involved in the recruitment of MDMs to the injured brain after ischemic stroke is unknown. METHODS: Adult male C57BL/6 mice were subjected to focal cortical ischemia by permanent occlusion of the distal branch of the right middle cerebral artery...
July 28, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28738421/cardiovascular-disease-among-transgender-adults-receiving-hormone-therapy-a-narrative-review
#12
REVIEW
Carl G Streed, Omar Harfouch, Francoise Marvel, Roger S Blumenthal, Seth S Martin, Monica Mukherjee
Recent reports estimate that 0.6% of adults in the United States, or approximately 1.4 million persons, identify as transgender. Despite gains in rights and media attention, the reality is that transgender persons experience health disparities, and a dearth of research and evidence-based guidelines remains regarding their specific health needs. The lack of research to characterize cardiovascular disease (CVD) and CVD risk factors in transgender populations receiving cross-sex hormone therapy (CSHT) limits appropriate primary and specialty care...
August 15, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28684296/a-systematic-investigation-of-navigation-impairment-in-chronic-stroke-patients-evidence-for-three-distinct-types
#13
Michiel H G Claessen, Johanna M A Visser-Meily, Tobias Meilinger, Albert Postma, Nicolien K de Rooij, Ineke J M van der Ham
OBJECTIVE: In a recent systematic review, Claessen and van der Ham (2017) have analyzed the types of navigation impairment in the single-case study literature. Three dissociable types related to landmarks, locations, and paths were identified. This recent model as well as previous models of navigation impairment have never been verified in a systematic manner. The aim of the current study was thus to investigate the prevalence of landmark-based, location-based, and path-based navigation impairment in a large sample of stroke patients...
July 3, 2017: Neuropsychologia
https://www.readbyqxmd.com/read/28683542/feasibility-and-applicability-of-static-vascular-outline-roadmapping-during-tavi
#14
Navid Madershahian, Carolyn Weber, Payman Majd, Tanja Rudolph, Elmar Kuhn, Maximilian Scherner, Yeong-Hoon Choi, Kaveh Eghbalzadeh, Volker Rudolph, Cherif Sahyoun, Thorsten Wahlers
BACKGROUND: We investigated the application and feasibility of a novel software tool designed for the visualization of the aortic root during transcatheter aortic valve implantation (TAVI). The final positioning of the device prior deployment remains the most critical phase during TAVI. METHODS: Philips "Vascular Outlining" prototype application was used during balloon expandable Edwards Lifesciences SapienXT valve deployment. It processes any angiographic sequences, extracting the static outline of vessels and projecting the two- dimensional vessel margins as a roadmap on live fluoroscopy...
July 5, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28683504/initial-experience-with-the-transapical-access-for-tevar
#15
Andreas H Mahnken, Marc Irqsusi, Walter Hundt, Rainer G Moosdorf
Background The endovascular approach has become a mainstay in the treatment of aortic aneurysms. While the transfemoral approach is most commonly used, it is often inaccessible due to a vascular pathology, such as occlusion, tortuosity or heavy calcifications. The transapical access provides an alternative approach. The goal of this study is to report the feasibility of the transapical approach for total endovascular repair of thoracic aortic aneurysms (TEVAR). Methods Three patients with thoracic aortic aneurysms with inaccessible femoral arteries underwent TEVAR via the transapical approach...
August 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28674431/9-cis-retinoic-acid-induces-neurorepair-in-stroke-brain
#16
Seong-Jin Yu, Mikko Airavaara, Kuo-Jen Wu, Brandon K Harvey, H S Liu, Yihong Yang, Alex Zacharek, Jieli Chen, Yun Wang
The purpose of this study was to examine the neurorestorative effect of delayed 9 cis retinoic acid (9cRA) treatment for stroke. Adult male rats received a 90-min right distal middle cerebral artery occlusion (dMCAo). Animals were separated into two groups with similar infarction sizes, based on magnetic resonance imaging on day 2 after dMCAo. 9cRA or vehicle was given via an intranasal route daily starting from day 3. Stroke rats receiving 9cRA post-treatment showed an increase in brain 9cRA levels and greater recovery in motor function...
July 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28650892/the-2017-hormone-therapy-position-statement-of-the-north-american-menopause-society
#17
(no author information available yet)
The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence...
June 22, 2017: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/28650869/the-2017-hormone-therapy-position-statement-of-the-north-american-menopause-society
#18
(no author information available yet)
The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence...
July 2017: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/28626058/risk-of-stroke-with-various-types-of-menopausal-hormone-therapies-a-national-cohort-study
#19
Ellen Løkkegaard, Lars Hougaard Nielsen, Niels Keiding
BACKGROUND AND PURPOSE: Double-blind randomized studies on the effects of oral postmenopausal hormone therapies were stopped mainly because of increased risk of stroke. We aimed to assess the risk of all strokes and various subtypes associated with hormone therapy and explore the influence of regimens and routes of administration. METHODS: A national historical cohort of women aged 51 to 70 years from 1995 to 2010 was established by linking 5 Danish registries. The National Registry of Medicinal Product Statistics provided information on hormone therapy exposure and the National Patient or Cause of Death Registries supplied data regarding stroke diagnoses (ischemic/hemorrhagic/subarachnoid hemorrhage)...
August 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28548223/cannabis-smoking-and-cardiovascular-health-it-s-complicated
#20
REVIEW
M R Piano
Many states have legalized cannabis use for treatment of certain medical conditions or have legalized cannabis for recreational use. Consequently, cannabis use prevalence has escalated, giving rise to concerns about potential health effects. Cannabis smoking remains the most prevalent route of administration and is associated with inhalation of chemical toxicants. The aim of this article is to summarize the effects of cannabis smoking on the vasculature and occurrence of cardiovascular (CV) events such as myocardial infarction (MI) and stroke...
August 2017: Clinical Pharmacology and Therapeutics
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