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Stroke prognosis

Pei-Li Wang, Lei Zhang, Shao-Li Wang, Qiao-Ning Yang, Zhu-Ye Gao, Jian-Peng Du, Da-Wu Zhang, Chang-Geng Fu, Feng Gu, Hao Xu, Li-Zhi Li, Cheng-Long Wang, Da-Zhuo Shi
OBJECTIVE: To evaluate the prognosis effect of Chinese herbal medicines (CHMs) for benefifiting qi and activating blood circulation adjunctive to conventional treatment in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). METHODS: A total of 702 patients with ACS who underwent PCI were enrolled and randomly assigned to receive conventional treatment plus CHMs for benefifiting qi and activating blood circulation (treatment group, 351 cases) or conventional treatment alone (control group, 351 cases) for 6 months...
October 24, 2016: Chinese Journal of Integrative Medicine
Dong-Hyun Choi, Seong-Ho Kang, Heesang Song
Platelets are essential for progression of atherosclerotic lesions, plaque destabilization, and thrombosis. They secrete and express many substances that are crucial mediators of coagulation, inflammation, and atherosclerosis. Mean platelet volume (MPV) is a precise measure of platelet size, and is routinely reported during complete blood count analysis. Emerging evidence supports the use of MPV as a biomarker predicting the risk of ischemic stroke in patients with atrial fibrillation, and as a guide for prescription of anticoagulation and rhythm-control therapy...
October 24, 2016: Korean Journal of Internal Medicine
L-Z Qin, W Li, Y Huang, F Lu, S-J Li, H-Q Yang, J-W Zhang
OBJECTIVE: This study aims to investigate the expression of pentraxin3 (PTX3) in elderly patients with acute cerebral infarction (ACI) and to analyze the relationship of PTX3 with the severity and prognosis of ACI. PATIENTS AND METHODS: Between June 2014 and August 2015, 96 elderly patients with first-onset of ACI admitted to our institution were enrolled in the present study. Also, 70 healthy elderly subjects were included as controls in this study. Levels of PTX3, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, homocysteine (Hcy), fibrinogen (FIB), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were determined in all patients both pre-therapeutically and 30 days post-therapeutically...
October 2016: European Review for Medical and Pharmacological Sciences
J Liu, H Yang, B Yu
OBJECTIVE: The objective of the present study was to determine the correlation between blood calcium level, hematoma volume and stroke severity in the prognosis of acute cerebral hemorrhage patients. PATIENTS AND METHODS: We selected 125 patients with acute cerebral hemorrhage admitted within 24 hours of symptom onset. Blood calcium levels were assessed by standard biochemical methods. Hematoma volume was measured by quantitative computed tomography. NIHSS (National Institutes of Health Stroke Scale) scores at one month, and the differences in survival rate and survival period at follow-up visits were assessed...
October 2016: European Review for Medical and Pharmacological Sciences
C Bickel, R B Schnabel, E Zengin, E Lubos, H Rupprecht, K Lackner, C Proust, D Tregouet, S Blankenberg, D Westermann, C Sinning
BACKGROUND AND AIMS: Whether single nucleotide polymorphisms (SNPs) of homocysteine metabolism enzymes influence the rate of cardiovascular (CV) events in coronary artery disease (CAD) patients remains controversial. METHODS AND RESULTS: In this analysis, 1126 subjects from the AtheroGene study with CAD and 332 control subjects without known CAD were included. The following SNPs were investigated: methylentetrahydrofolate reductase (MTHFR-C667T), methionin synthetase (MS-D919G), and cystathionin beta synthetase (CBS-I278T)...
September 17, 2016: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
Hugo Jesús Zetina-Tun, Guillermo Careaga-Reyna, José Galván-Díaz, Magdalena Sánchez-Uribe
BACKGROUND: Myocardial noncompaction of the left ventricle is a congenital cardiomyopathy characterised by left ventricular hypertrabeculation and prominent intertrabecular recesses. The incidence ranges from 0.15% to 2.2%. Clinical manifestations include heart failure, arrhythmias, and stroke. Prognosis is fatal in most cases. Heart transplantation is a therapeutic option for this cardiomyopathy, and few had been made worldwide. CLINICAL CASE: The case is presented of a 20 year-old male with noncompacted myocardium of the left ventricle, who had clinical signs of heart failure...
October 20, 2016: Cirugia y Cirujanos
Cristina Rodríguez, Tomás Sobrino, Jesús Agulla, Verónica Bobo-Jiménez, María E Ramos-Araque, Juan J Duarte, José C Gómez-Sánchez, Juan P Bolaños, José Castillo, Ángeles Almeida
Intracerebral hemorrhage (ICH) is a devastating subtype of stroke that lacks effective therapy and reliable prognosis. Neovascularization following ICH is an essential compensatory response that mediates brain repair and modulates the clinical outcome of stroke patients. However, the mechanism that dictates this process is unknown. Bone marrow-derived endothelial progenitor cells (EPCs) promote endothelial repair and contribute to ischemia-induced neovascularization. The human Tp53 gene harbors a common single-nucleotide polymorphism (SNP) at codon 72, which yields an arginine-to-proline amino-acidic substitution (Arg72Pro) that modulates the apoptotic activity of the p53 protein...
October 21, 2016: Cell Death and Differentiation
Rachael E C Schutz, Heather L Coats, Ruth A Engelberg, J Randall Curtis, Claire J Creutzfeldt
BACKGROUND: Patients with severe acute brain injury (SABI) raise important palliative care considerations associated with sudden devastating injury and uncertain prognosis. OBJECTIVE: The goal of this study was to explore how family members, nurses, and physicians experience the palliative and supportive care needs of patients with SABI receiving care in the neuroscience intensive care unit (neuro-ICU). DESIGN: Semistructured interviews were audiotaped, transcribed, and analyzed using thematic analysis...
October 20, 2016: Journal of Palliative Medicine
K Mugundhan, Rajesh Shankar Iyer
Strokes involving posterior inferior cerebellar arteries (PICA) are rare and usually unilateral. They can involve either the lateral division or the medial division of PICA. Sudden simultaneous cerebellar infarctions in the medial PICA territories are extremely rare. We report one such patient who presented with acute bilateral cerebellar infarctions in the medial PICA territories. She was a diabetic and had features of diffuse atherosclerotic vertebrobasilar disease. We discuss the anatomical peculiarities of PICA and its blood supply along with the clinical features differentiating the medial and lateral PICA infarctions...
August 2016: Journal of the Association of Physicians of India
Huakun Liu, Jianfeng Chu, Lei Zhang, Chaolai Liu, Zhongrui Yan, Shengnian Zhou
BACKGROUND: With carotid artery stenosis, infarcts can occur in the cortical or internal watershed areas, or both. The timing of carotid artery stenting (CAS) after a cerebral watershed infarction (CWI) is not yet codified. In this retrospective study, we analyzed the safety and clinical effect of early CAS for CWI patients due to carotid artery stenosis. METHODS: Between March 2011 and April 2014, 120 CWI patients with ipsilateral carotid artery stenosis were recruited...
October 20, 2016: European Neurology
Luca Liberale, Fabrizio Montecucco, Ilaria Casetta, Silva Saraceni, Alessandro Trentini, Marina Padroni, Franco Dallegri, François Mach, Enrico Fainardi, Federico Carbone
BACKGROUND: Soluble mediators have been investigated to predict the prognosis of acute ischemic stroke (AIS). Among them, proprotein convertase subtilisin/kexin type 9 (PCSK9) might have both clinical and pathophysiological relevance. MATERIALS AND METHODS: All available serum samples from a cohort of patients with first AIS (n=72) were tested for PCSK9 and included in this sub-study analysis. The primary endpoint investigated the predictive value of early PCSK9 level variations (ΔPCSK9) from AIS onset to day 7 or from day 1 to day 7, towards a 90-day outcome by modified Rankin Scale (mRS)...
October 19, 2016: European Journal of Clinical Investigation
Babak Bakhshayesh-Eghbali, Seyed-Ali Roudbary, Seddigheh Basir Jafari, Seyedeh-Parand Nabizadeh, Naghmeh Naderi-Asrami, Reza Sohrabnejad
BACKGROUND: Stroke is one of the leading causes of mortality and long-term morbidity. The aim of the present study was to determine the ability of baseline serum C-reactive protein (CRP) and white blood cell count (WBC) values in predicting the outcome of acute ischemic stroke (AIS). METHODS: This study consisted of patients with first AIS referred to Poursina Hospital, Rasht, Iran. Severity of stroke was determined according to the National Institute of Health (NIH) Stroke Scale at the time of admission...
2016: Caspian Journal of Internal Medicine
Junichiro Hashimoto
Arterial structure and function change progressively with advancing age. Owing to long-lasting repetitive stretch with intermittent cardiac contraction, elastic fibers in the tunica media of large arteries gradually degenerate and are replaced by collagenous fibers. Such medial degeneration causes elastic arteries to stiffen and dilate. However, the speed of the vascular aging varies considerably among individuals; a discrepancy often exists between the chronological age of an individual and the biological age of his or her arteries...
September 2016: Journal of Hypertension
Yu Hasegawa, Shokei Kim-Mitsuyama
OBJECTIVE: Although hypertensive patients show significant elevation of blood pressure (BP) in acute phase after cerebral infarction, it is still unknown how it should be managed to carry the best prognosis. To address this issue, we investigated the effect of acute control of elevated BP by bilateral renal denervation (RD) against ischemic stroke in SHRSP rats with 90 minutes transient middle cerebral arterial occlusion (MCAO). DESIGN AND METHOD: Seventy-five male SHRSP rats of 15 weeks of age were assigned to sham-operated (control, n = 15) and MCAO + sham (sham, n = 30), and MCAO + RD (RD, n = 30)...
September 2016: Journal of Hypertension
Enrico Agabiti Rosei
Current Hypertension Guidelines emphasize the importance of assessing the presence of preclinical organ damage. In fact, an extensive evaluation of organ damage may increase the number of patients classified at high CV risk and therefore strongly influence the clinical management of patients. Hypertensive heart disease remains to date the form of organ damage for which there is the greatest amount of evidence of a strong independent prognostic significance. In the presence of a chronic pressure overload, a parallel addition of sarcomers takes place with an increase in myocyte width, which in turn increases left ventricular wall thickness; myocyte hypertrophy is also associated with apoptosis, collagen deposition and ventricular fibrosis with an impairment of coronary hemodynamics as well, thus profoundly influencing functional properties of the left (and right) ventricle...
September 2016: Journal of Hypertension
Yoshihiro Kokubo
Hypertension is one of the strongest risk factor for cardiovascular disease. Recently, accumulating evidence also indicates that hypertension has been linked with non-cardiovascular diseases including dementia, cancer, oral health diseases and so on. In general, elderly individuals tend to have multiple diseases as getting older. Preventing of hypertension is also benefit for other diseases.In the Hisayama Study, hypertension increased the risk of vascular dementia, but were not associated with an increased risk of Alzheimer disease, and that subjects with hypertension in midlife and normotension and hypertension in late-life increased risks of incident vascular dementia...
September 2016: Journal of Hypertension
Yong-Jin Kim
Aortic stenosis (AS) is a common valve disease, affecting nearly 5% of elderly individuals. Because most common etiology of AS is degenerative valve disease, hypertension (HT) is not rare in patients with AS. It was reported that more than 30% of patients with AS had systemic hypertension. Therefore, management of hypertension is an important issue for these patients. There are several effects of combined AS and HT. First, HT increases hemodynamic load of left ventricle and peak systolic left ventricular wall stress...
September 2016: Journal of Hypertension
Kazuomi Kario
The essential benefit of the management of hypertension is derived from the blood pressure (BP) lowering per se, indicating the importance of BP throughout 24 hours. Recent guidelines stressed the importance of home BP for the diagnosis and management of hypertension. It is well-known that cardiovascular events occur more frequently in the morning BP levels have been shown to increase during the period from night to early morning. Clinical research using ambulatory BP monitoring (ABPM) or home BP monitoring has clarified that morning BP and BP surge are more closely related to the cardiovascular risk than office BP (Kario et al...
September 2016: Journal of Hypertension
Kazuomi Kario
Out-of-office blood pressure (BP) measured by home BP monitoring (HBPM) or ambulatory BP monitoring (ABPM) was demonstrated to be superior to office BP for the prediction of cardiovascular events. The ABPM is superior to HBPM for detecting the all the BP-related risks throughout 24-hr, and the self-measured HBPM underestimates the risk of daytime stress hypertension and nocturnal hypertension. However, ABPM cannot always be provided in clinical practice, and home BP monitoring can be superior to ABPM as part of a home BP-guided antihypertension strategy in clinical practice...
September 2016: Journal of Hypertension
Tuomas O Kiviniemi, Arto Pietilä, Jarmo M Gunn, Jenni M Aittokallio, Markku S Mähönen, Veikko V Salomaa, Teemu J Niiranen
AIMS: The aim of the study was to investigate the 20-year trends in rates, patient selection and prognosis of coronary revascularisations in Finland. METHODS AND RESULTS: We identified patients from nationwide registers who had undergone first-ever percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) between 1994 and 2013. We examined changes in procedure rates, patient characteristics and estimated hazard ratios (HR) and 95% confidence intervals for cardiovascular events during this period...
October 20, 2016: EuroIntervention
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