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Chronic Stroke

Stylianos Panopoulos, Maria Tektonidou, Alexandros A Drosos, Stamatis-Nick Liossis, Theodoros Dimitroulas, Alexandros Garyfallos, Lazaros Sakkas, Dimitrios Boumpas, Paraskevi V Voulgari, Dimitrios Daoussis, Konstantinos Thomas, Georgios Georgiopoulos, Georgios Vosvotekas, Dimitrios Vassilopoulos, Petros P Sfikakis
BACKGROUND: Comorbidities are common in chronic systemic connective tissue diseases and are associated with adverse outcomes, increased morbidity and mortality. Although the prevalence of comorbidities has been well-studied in isolated diseases, comparative studies between different autoimmune diseases are limited. In this study, we compared the prevalence of common comorbidities between patients with systemic sclerosis (SSc) and patients with rheumatoid arthritis (RA). METHODS: Between 2016 and 2017, 408 consecutive patients with SSc, aged 59 ± 13 years (87% women), were matched 1:1 for age and gender with 408 patients with RA; mean disease duration was 10 ± 8 and 9 ± 8 years, respectively...
December 4, 2018: Arthritis Research & Therapy
Richard G Carson, Michelle L Rankin
There has been an explosion of interest in methods that may promote neural plasticity by indirectly stimulating tissue in damaged brains using transient magnetic fields or weak electrical currents. A major limitation of these approaches is that the induced variations in brain activity tend to be diffuse. Thus far it has proved extremely difficult to target pathways from the brain to specific muscles. This is a particular challenge for applications in rehabilitation. Stroke survivors often exhibit abnormal patterns of muscle activation, including diminished specificity and high levels of co-contraction...
2018: Frontiers in Psychology
Yunlong Huo, Huan Chen, Ghassan S Kassab
Background: The differential effects of rapid cardiac pacing on small and large vessels have not been well-established. The objective of this study was to investigate the effect of pacing-induced acute tachycardia on hemodynamics and arterial stiffness. Methods: The pressure and flow waves in ascending aorta and femoral artery of six domestic swine were recorded simultaneously at baseline and heart rates (HR) of 135 and 155 beats per minutes (bpm) and analyzed by the models of Windkessel and Womersley types...
2018: Frontiers in Physiology
Davy Vancampfort, Brendon Stubbs, Joseph Firth, Ai Koyanagi
PURPOSE: Handgrip strength provides a clinically validated marker of overall health and mortality risk. There are however, no multi-national population-based studies investigating the associations between handgrip strength, chronic physical conditions, and physical multimorbidity (i.e., ≥2 chronic conditions). We aimed to assess these associations among community-dwelling middle-aged and older adults using nationally representative data from six in low- and middle-income countries (LMICs)...
November 30, 2018: European Journal of Internal Medicine
Patricia Masterson-Algar, Sion Williams, Christopher R Burton, Calum A Arthur, Zoe Hoare, Val Morrison, Kate Radford, Diane Seddon, Salah Elghenzai
PURPOSE: Rebuilding one's life after stroke is a key priority persistently identified by patients yet professionally led interventions have little impact. This co-design study constructs and tests a novel peer-led coaching intervention to improve post-stroke leisure and general social participation. METHODS: This study followed the principles of co-design by actively engaging and harnessing the knowledge of stroke survivors in order to develop and test a peer-lead coaching intervention...
December 3, 2018: Disability and Rehabilitation
Lia Alves-Cabratosa, Marc Elosua-Bayes, Maria García-Gil, Marc Comas-Cufí, Ruth Martí-Lluch, Anna Ponjoan, Jordi Blanch, Dídac Parramon, Manuel Angel Gomez-Marcos, Rafel Ramos
OBJECTIVE: Assessment of asymptomatic organ damage in the management of hypertension includes low (<0.9) ankle brachial index (ABI) values. No recommendations are given for patients with high ABI (≥1.3), despite evidence of an association with increased risk. We aimed to study the association of high ABI with all-cause mortality and cardiovascular outcomes in a hypertensive population. METHODS: In anonymized clinical records from the Catalan Primary Care (SIDIAP) database, we designed a large cohort of hypertensive patients aged 35-85 years at the start date...
January 2019: Journal of Hypertension
Christopher S G Murray, Tamanna Nahar, Hayrapet Kalashyan, Harald Becher, Navin C Nanda
Following cardiac disease and cancer, stroke continues to be the third leading cause of death and disability due to chronic disease in the developed world. Appropriate screening tools are integral to early detection and prevention of major cardiovascular events. In a carotid artery, the presence of increased intima-media thickness, plaque, or stenosis is associated with increased risk of a transient ischemic attack or a stroke. Carotid artery ultrasound remains a long-standing and reliable tool in the current armamentarium of diagnostic modalities used to assess vascular morbidity at an early stage...
December 2018: Echocardiography
Hao Ma, Weiping Wang, Shaofeng Xu, Ling Wang, Xiaoliang Wang
Potassium 2-(1-hydroxypentyl)-benzoate (PHPB) is a novel drug candidate for acute ischemic stroke. PHPB has been also shown to be beneficial for some neurodegenerative diseases. In this study, we demonstrated that PHPB improved depressive-like behaviors induced by chronic unpredictable mild stress (CUMS) in rats. Male SD rats were subjected to the stress for five weeks. PHPB (30 and 100 mg/kg) or fluoxetine (FLX 10 mg/kg, as positive control) was administered orally from the third week in CUMS procedure...
October 2018: Acta Pharmaceutica Sinica. B
James A Reiffel
That clinically-documented atrial fibrillation (AF) in association with a variety of elevated clinical/laboratory risk markers is associated with an increased risk of stroke is well known -- regardless of whether the AF is paroxysmal, persistent, or permanent. Moreover, data is accumulating to suggest that the absolute rate of stroke should be expectedly higher with a greater burden of AF and greater degree of comorbid contributors. Relatedly, stroke prevention with chronic oral anticoagulation (OAC) is recommended for AF patients with appropriate risk markers by all major medical, cardiologic, and surgical guideline-writing organizations...
August 2018: Journal of Atrial Fibrillation
Robert B Hamanaka, Gökhan M Mutlu
Air pollution is a complex mixture of gaseous and particulate components, each of which has detrimental effects on human health. While the composition of air pollution varies greatly depending on the source, studies from across the world have consistently shown that air pollution is an important modifiable risk factor for significantly increased morbidity and mortality. Moreover, clinical studies have generally shown a greater impact of particulate matter (PM) air pollution on health than the gaseous components...
2018: Frontiers in Endocrinology
Anna Tomaszuk-Kazberuk, Dimitrios Nikas, Paulina Lopatowska, Elzbieta Młodawska, Jolanta Malyszko, Hanna Bachorzewska-Gajewska, Slawomir Dobrzycki, Bożena Sobkowicz, Ioannis Goudevenos
BACKGROUND/AIMS: Several studies have implicated atrial fibrillation (AF) as a contributing factor in chronic kidney disease (CKD) and cardiovascular events. The prevalence of coronary artery disease (CAD) in patients with AF varies substantially from 17% to 46.5%. There are only few studies concerning renal function in population with AF undergoing coronary angiography. The aim of the present study was to assess which type of AF is dominant in CKD population scheduled for coronary angiography and if it can influence patients' outcome, the association between renal impairment and the type of coronary procedures in AF patients and the influence of renal function on in-hospital mortality...
November 30, 2018: Kidney & Blood Pressure Research
Nikola Sladojevic, Svetlana M Stamatovic, Allison M Johnson, Jennifer Choi, Anna Hu, Sophie Dithmer, Ingolf E Blasig, Richard F Keep, Anuska V Andjelkovic
Recent evidence suggests that blood brain barrier (BBB) recovery and reestablishment of BBB impermeability after stroke is incomplete. This could influence stroke recovery, increase the risk of repeat stroke and be a solid substrate for developing vascular dementia. While accumulating evidence has defined morphological alterations and underlying mechanisms of tight junction (TJ) changes during BBB breakdown in acute stroke, very little is known about the type of alterations and mechanisms in BBB "leakage" found sub-acutely or chronically...
November 30, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
T Blanco, R Casas, A Marco, I Martínez
OBJECTIVE: To contribute the design, development, and assessment of a new concept: Micro ad hoc Health Social Networks (uHSN), to create a social-based solution for supporting patients with chronic disease. DESIGN: After in-depth fieldwork and intensive co-design over a 4-year project following Community-Based Participatory Research (CBPR), this paper contributes a new paradigm of uHSN, defining two interaction areas (the "backstage", the sphere invisible to the final user, where processes that build services take place; and the "onstage", the visible part that includes the patients and relatives), and describes a new transversal concept, i...
November 29, 2018: Journal of Biomedical Informatics
Sandeep K Subramanian, Shreya S Prasanna
BACKGROUND: Efforts to augment post-stroke upper limb (UL) motor improvement include the use of newer interventions such as noninvasive brain stimulation (NIBS) and task practice in virtual reality environments (VEs). Despite increasing interest in using a combination of these 2 interventions, the effectiveness of this combination to enhance UL motor improvement outcomes has not been examined. OBJECTIVE: To evaluate the effectiveness of a combination of NIBS and task practice in a VE to augment post-stroke UL motor improvement...
November 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Shoroq M Altawalbeh, Osama Y Alshogran, Kenneth J Smith
BACKGROUND: Warfarin use for stroke prevention in atrial fibrillation (AF) patients with chronic kidney disease is debated. Apixaban was shown to be safer than warfarin, with superior reduction in the risk of stroke, systemic embolism, mortality, and major bleeding irrespective of kidney function. OBJECTIVES: To evaluate the cost-utility of apixaban compared with warfarin in AF patients at different levels of kidney function. METHODS: A Markov model was used to estimate the cost effectiveness of apixaban compared with warfarin in AF patients at three levels of kidney function: estimated glomerular filtration rate (eGFR) of more than 80 ml/min, 50 to 80 ml/min, and 50 ml/min or less...
December 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Iqbal Sayeed, Nefize Turan, Donald G Stein, Bushra Wali
Because vitamin D hormone deficiency (VDHdef ) can worsen severity and outcome for ischemic stroke, we examined the role of VDH in maintaining blood-brain-barrier (BBB integrity) in a rat model of stroke. In most types of stroke, the BBB is markedly compromised, potentially leading to a cascade of injury processes and functional deficits, so we examined a number of biomarkers associated with BBB disruption to determine whether VDH deficiency would further compromise the BBB following a stroke. Male Wistar rats were randomly assigned to one of two diet cohorts, VDH-sufficient (VDHsuf ) and VDHdef ...
November 28, 2018: Experimental Neurology
Vasanthan Rajagopalan, Manikandan Natarajan, Johnson Alex, John M Solomon
OBJECTIVE: To explore the personal and environmental contextual factors that influence use of affected arm for function among stroke survivors. METHODS: We conducted a qualitative phenomenological study using an interpretivist paradigm among 23 stroke survivors in their late sub-acute and chronic stages and their relatives living in the rural regions of India using maximum variation sampling. Semi-structured interviews were conducted to identify personal and environmental contextual factors relevant to arm use...
November 22, 2018: Brazilian Journal of Physical Therapy
Sherifa A Hamed
Uremic syndrome of chronic kidney disease (CKD) is a term used to describe clinical, metabolic and hormonal abnormalities associated with progressive kidney failure. It is a rapidly growing public health problem worldwide. Nervous system complications occur in every patient with uremic syndrome of CKD. Areas covered: This review summarized central and peripheral nervous system complications of uremic syndrome of CKD and their pathogenic mechanisms. They include cognitive deterioration, encephalopathy, seizures, asterixis, myoclonus, restless leg syndrome, central pontine myelinosis, stroke, extrapyramidal movement disorders, neuropathies and myopathy...
December 2, 2018: Expert Review of Clinical Pharmacology
Alessio Facciolà, Giuseppa Visalli, Sebastiano La Maestra, Manuela Ceccarelli, Francesco D'Aleo, Giuseppe Nunnari, Giovanni Francesco Pellicanò, Angela Di Pietro
Due to their morphological and physicochemical properties, carbon nanotubes (CNTs) enhance the structural properties of several materials and are produced in great volumes. The production and the manufacturing of CNTs-incorporated products can lead to the potential environmental release of CNTs. For these reasons, CNTs can represent a serious concern for human health. Humans are exposed to nanoparticles through inhalation, ingestion and skin uptake. After their entrance, the particles can reach the Central Nervous System (CNS) through three different pathways: the systemic, olfactory and trigeminal pathways...
November 22, 2018: Environmental Toxicology and Pharmacology
Josu de la Fuente, Nathalie Dhedin, Tatsuki Koyama, Francoise Bernaudin, Mathieu Kuentz, Leena Karnik, Gérard Socié, Kathryn A Culos, Robert A Brodsky, Michael R DeBaun, Adetola A Kassim
Curative therapy for individuals with severe sickle cell disease (SCD) who lack an HLA-identical sibling donor has been frustratingly elusive. With the goal of improving engraftment while minimizing transplant related morbidity, a multi-institution learning collaborative was developed in 2013, in the context of a phase II clinical trial of a non-myeloablative, related HLA-haploidentical bone marrow transplant (haplo-BMT), with post-transplant cyclophosphamide. All eligible participants had HbSS, 89% (16/18) had an identifiable donor...
November 27, 2018: Biology of Blood and Marrow Transplantation
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