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Stroke and predictive outcomes

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https://www.readbyqxmd.com/read/28942076/assessment-of-commonly-used-frailty-markers-for-high-and-extreme-risk-patients-undergoing-transcatheter-aortic-valve-replacement
#1
Jessica Forcillo, Jose F Condado, Yi-An Ko, Michael Yuan, Jose N Binongo, Nnaemeka M Ndubisi, John J Kelly, Vasilis Babaliaros, Robert A Guyton, Chandan Devireddy, Bradley G Leshnower, James P Stewart, Louis P Perrault, Paul Khairy, Vinod H Thourani
BACKGROUND: The effect of frailty on outcomes after transcatheter aortic valve replacement (TAVR) remains incompletely understood. The objective of this study was to evaluate the performance of four commonly used frailty markers as predictors of early and late outcomes among patients undergoing TAVR. METHODS: A review was performed of 361 high- and extreme-risk patients undergoing TAVR from 2011 to 2015. Four frailty variables were assessed: serum albumin (g/dL), 5-m walk (seconds), grip strength (kg), and Katz index of independence in activities of daily living...
September 21, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28939303/early-partial-recanalization-after-intravenous-thrombolysis-leads-to-prediction-of-favorable-outcome-in-cases-of-acute-ischemic-stroke-with-major-vessel-occlusion
#2
Jun Young Chang, Hyun Park, Se Young Jang, Seunguk Jung, Hee-Joon Bae, O-Ki Kwon, Moon-Ku Han
We investigated the association between early recanalization degree after intravenous thrombolysis (IVT), occurrence of hemorrhagic transformation, and functional outcome. We also evaluated whether recombinant tissue plasminogen activator (rTPA) dosing error could influence the outcome. Patients with ischemic stroke with major vessel occlusion (n=256) who underwent IVT were included. Recanalization status (no recanalization, partial recanalization, and complete recanalization) was confirmed by subsequent magnetic resonance or conventional angiography...
September 19, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28939050/relationship-between-stroke-events-during-pachinko-play-and-prognosis
#3
Hiroyuki Koizumi, Keika Hoshi, Daisuke Yamamoto, Yasushi Asari, Toshihiro Kumabe
BACKGROUND: This study investigated whether pachinko play influences the outcome of stroke events, and identified the significant variables affecting outcomes. METHODS: We reviewed the medical and imaging records of 2075 consecutive patients with stroke from January 2003 through June 2012. The remaining patients were divided into 2 groups, the pachinko players group (PP) and the non-pachinko players group (NPP). Background factors were recorded on admission. Multivariate logistic regression analysis was used to identify the factors significantly correlated with Glasgow Outcome Scale (GOS) score and risk of death at the time of discharge...
September 19, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28934189/cystatin-c-as-a-predictor-of-cardiovascular-outcomes-in-a-hypertensive-population
#4
R Garcia-Carretero, L Vigil-Medina, O Barquero-Perez, R Goya-Esteban, I Mora-Jimenez, C Soguero-Ruiz, J Ramos-Lopez
Calculating the estimated glomerular filtration rate (eGFR) using creatinine-based equations may underestimate cardiovascular risk. Cystatin C-based eGFR may be a stronger prognostic biomarker than creatinine-based eGFR when assessing cardiovascular outcomes and mortality. Our aim was to determine whether levels of serum cystatin C, as an estimator of GFR, had a higher predictive value than creatinine-based eGFR for incident cardiovascular disease among hypertensive patients. We retrospectively analyzed the records of 2016 hypertensive patients from the Hypertension Unit at Mostoles University Hospital between 2006 and 2016...
September 21, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28925479/relationship-between-lesion-patterns-of-single-small-infarct-and-early-neurological-deterioration-in-the-perforating-territory
#5
X-J Han
OBJECTIVE: To investigate the relationship between lesion patterns of single small infarct (SSI) in perforating territory of the vertebral-basilar artery and early neurological deterioration (end)/short-term functional outcome. PATIENTS AND METHODS: 126 patients with acute SSI in the perforating territory of the vertebral-basilar artery, admitted within 24 h after symptom onset, were recruited between August 2010 and May 2013. The patients were divided into proximal SSI and distal SSI according to the relationship between their lesion location and their parent artery...
August 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28922885/patient-selection-and-clinical-efficacy-of-urgent-superficial-temporal-artery-middle-cerebral-artery-bypass-in-acute-ischemic-stroke-using-advanced-magnetic-resonance-imaging-techniques
#6
Hyun-Seok Park, Sang-Hyeon Kim, Hyun-Wook Nah, Jae-Hyung Choi, Dae-Hyun Kim, Myong-Jin Kang, Jae-Kwan Cha, Jae-Taeck Huh
BACKGROUND: Selected patients with acute ischemic stroke might benefit from superficial temporal artery-middle cerebral artery (STA-MCA) bypass, but the indications for urgent STA-MCA bypass are unknown. OBJECTIVE: To report our experiences of urgent STA-MCA bypass in patients requiring urgent reperfusion who were ineligible for other reperfusion therapies, using advanced magnetic resonance imaging (MRI) techniques. METHODS: The inclusion criteria for urgent STA-MCA bypass were as follows: acute infarct volume <70 mL with a ratio of perfusion/diffusion lesion volume ≥1...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28920888/prediction-of-motor-recovery-after-stroke-advances-in-biomarkers
#7
REVIEW
Cathy M Stinear
Stroke remains a leading cause of adult disability, and the recovery of motor function after stroke is crucial for the patient to regain independence. However, making accurate predictions of a patient's motor recovery and outcome is difficult when based on clinical assessment alone. Clinical assessment of motor impairment within a few days of stroke can help to predict subsequent recovery, while neurophysiological and neuroimaging biomarkers of corticomotor structure and function can help to predict both motor recovery and motor outcome after stroke...
October 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28916666/regional-evaluation-of-the-severity-based-stroke-triage-algorithm-for-emergency-medical-services-using-discrete-event-simulation
#8
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/28911268/apathy-not-depressive-symptoms-as-a-predictor-of-semantic-and-phonemic-fluency-task-performance-in-stroke-and-transient-ischemic-attack
#9
Keera N Fishman, Andrea R Ashbaugh, Krista L Lanctôt, Megan L Cayley, Nathan Herrmann, Brian J Murray, Michelle Sicard, Karen Lien, Demetrios J Sahlas, Richard H Swartz
OBJECTIVES: This study examined the relationship between apathy and cognition in patients with cerebrovascular disease. Apathy may result from damage to frontal subcortical circuits causing dysexecutive syndromes, but apathy is also related to depression. We assessed the ability of apathy to predict phonemic fluency and semantic fluency performance after controlling for depressive symptoms in 282 individuals with stroke and/or transient ischemic attack. METHOD: Participants (N = 282) completed the Phonemic Fluency Test, Semantic Fluency Test, Center for Epidemiologic Studies Depression Scale, and Apathy Evaluation Scale...
September 15, 2017: Journal of Clinical and Experimental Neuropsychology
https://www.readbyqxmd.com/read/28905995/leptomeningeal-collateral-status-predicts-outcome-after-middle-cerebral-artery-occlusion
#10
C F Madelung, C Ovesen, C Trampedach, A Christensen, I Havsteen, C K Hansen, H Christensen
OBJECTIVES: Perfusion through leptomeningeal collateral vessels is a likely pivotal factor in the outcome of stroke patients. We aimed to investigate the effect of collateral status on outcome in a cohort of unselected, consecutive stroke patients with middle cerebral artery occlusion undergoing reperfusion therapy. MATERIALS AND METHODS: This retrospectively planned analysis was passed on prospectively collected data from 187 consecutive patients with middle cerebral artery occlusion admitted within 4...
September 14, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28904231/interactions-between-the-corticospinal-tract-and-premotor-motor-pathways-for-residual-motor-output-after-stroke
#11
Robert Schulz, Eunhee Park, Jungsoo Lee, Won Hyuk Chang, Ahee Lee, Yun-Hee Kim, Friedhelm C Hummel
BACKGROUND AND PURPOSE: Brain imaging has continuously enhanced our understanding how different brain networks contribute to motor recovery after stroke. However, the present models are still incomplete and do not fit for every patient. The interaction between the degree of damage of the corticospinal tract (CST) and of corticocortical motor connections, that is, the influence of the microstructural state of one connection on the importance of another has been largely neglected. METHODS: Applying diffusion-weighted imaging and probabilistic tractography, we investigated cross-network interactions between the integrity of ipsilesional CST and ipsilesional corticocortical motor pathways for variance in residual motor outcome in 53 patients with subacute stroke...
September 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28902807/external-validation-of-pooled-cohort-risk-equations-to-predict-1-year-clinical-outcome-in-ischemic-stroke-patients
#12
Haiyan Li, Runhua Zhang, Gaifen Liu, Liping Liu, Yilong Wang, Yongjun Wang
BACKGROUND The present study aimed to validate the pooled cohort risk (PCR) equations in a Chinese ischemic stroke population and to explore its prognostic value in predicting stroke recurrence, coronary heart disease, and vascular death. MATERIAL AND METHODS Patients were selected from the China National Stroke Registry. The C statistic was used to examine the clinical prediction of the scores. To analyze the relevant risk factors, univariate and multivariate logistic regressions were performed. RESULTS Out of a total of 22 216 patients, 8287 patients (including 7652 acute ischemic stroke [AIS] and 635 transient ischemic attack [TIA] patients) were selected and enrolled in the study...
September 13, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28901219/primary-prevention-of-stroke-and-cardiovascular-disease-in-the-community-prevents-methodology-of-a-health-wellness-coaching-intervention-to-reduce-stroke-and-cardiovascular-disease-risk-a-randomized-clinical-trial
#13
Susan Mahon, Rita Krishnamurthi, Alain Vandal, Emma Witt, Suzanne Barker-Collo, Priya Parmar, Alice Theadom, Alan Barber, Bruce Arroll, Elaine Rush, Hinemoa Elder, Jesse Dyer, Valery Feigin
Rationale Stroke is a major cause of death and disability worldwide, yet 80% of strokes can be prevented through modifications of risk factors and lifestyle and by medication. While management strategies for primary stroke prevention in high cardiovascular disease risk individuals are well established, they are underutilized and existing practice of primary stroke prevention are inadequate. Behavioral interventions are emerging as highly promising strategies to improve cardiovascular disease risk factor management...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28899932/utility-of-perfusion-imaging-in-acute-stroke-treatment-a-systematic-review-and-meta-analysis
#14
REVIEW
Won Hyung A Ryu, Michael B Avery, Navjit Dharampal, Isabel E Allen, Steven W Hetts
BACKGROUND: Variability in imaging protocols and techniques has resulted in a lack of consensus regarding the incorporation of perfusion imaging into stroke triage and treatment. The objective of our study was to evaluate the available scientific evidence regarding the utility of perfusion imaging in determining treatment eligibility in patients with acute stroke and in predicting their clinical outcome. METHODS: We performed a systematic review of the literature using PubMed, Web of Science, and Cochrane Library focusing on themes of medical imaging, stroke, treatment, and outcome (CRD42016037817)...
October 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28895808/shared-decision-making-after-severe-stroke-how-can-we-improve-patient-and-family-involvement-in-treatment-decisions
#15
Akila Visvanathan, Martin Dennis, Gillian Mead, William N Whiteley, Julia Lawton, Fergus Neil Doubal
People who are well may regard survival with disability as being worse than death. However, this is often not the case when those surviving with disability (e.g. stroke survivors) are asked the same question. Many routine treatments provided after an acute stroke (e.g. feeding via a tube) increase survival, but with disability. Therefore, clinicians need to support patients and families in making informed decisions about the use of these treatments, in a process termed shared decision making. This is challenging after acute stroke: there is prognostic uncertainty, patients are often too unwell to participate in decision making, and proxies may not know the patients' expressed wishes (i...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28893573/measurement-of-nutritional-status-using-body-mass-index-waist-to-hip-ratio-and-waist-circumference-to-predict-treatment-outcome-in-females-and-males-with-acute-first-ever-ischemic-stroke
#16
Jan Paweł Bembenek, Michał Karlinski, Maciej Niewada, Iwona Kurkowska-Jastrzębska, Anna Członkowska
BACKGROUND: We aimed to investigate whether increased waist-to-hip ratio (WHR), waist circumference (WC), or improper body mass index (BMI) may differently predict short-term outcomes in females and males with first-ever acute ischemic stroke. METHODS: This was a retrospective study of consecutive patients (1109 females and 939 males) admitted for first-ever ischemic stroke between 2003 and 2015. Data were collected in a detailed hospital stroke registry. BMI of 18...
September 8, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28893489/review-of-aspirin-and-clopidogrel-resistance-in-peripheral-arterial-disease
#17
REVIEW
Mina Guirgis, Peter Thompson, Shirley Jansen
OBJECTIVE: Aspirin resistance (AR) and clopidogrel resistance (CR) are terms used to describe a reduction in the medication's efficacy in inhibiting platelet aggregation despite regular dosing. This review gives context to the clinical role and implications of antiplatelet resistance in peripheral arterial disease (PAD). METHODS: A review of English-language literature on AR and CR in PAD involving human subjects using PubMed and MEDLINE databases was performed in April 2017...
September 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28890062/national-utilization-and-outcomes-of-redo-lower-extremity-bypass-vs-endovascular-intervention-after-previous-failed-bypass-redo-lower-extremity-bypass-superior-to-endovascular-intervention
#18
J Hunter Mehaffey, Alexander Shannon, Robert B Hawkins, Anna Fashandi, Margret C Tracci, Irving L Kron, Gilbert R Upchurch, William P Robinson
BACKGROUND: Redo Lower extremity bypass (LEB) and infrainguinal endovascular intervention (IEI) are options to treat critical limb ischemia after a failed prior lower extremity bypass but the utilization and outcomes of each are poorly described. The purpose of this study was to compare 30-day Major Adverse Limb Events (MALE) and Major Adverse Cardiovascular Events (MACE) after LEB and IEI in patients with a failed prior ipsilateral LEB and determine risk factors for each composite outcome...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28887396/influence-of-penumbral-reperfusion-on-clinical-outcome-depends-on-baseline-ischemic-core-volume
#19
Chushuang Chen, Mark W Parsons, Matthew Clapham, Christopher Oldmeadow, Christopher R Levi, Longting Lin, Xin Cheng, Min Lou, Timothy J Kleinig, Kenneth S Butcher, Qiang Dong, Andrew Bivard
BACKGROUND AND PURPOSE: In alteplase-treated patients with acute ischemic stroke, we investigated the relationship between penumbral reperfusion at 24 hours and clinical outcomes, with and without adjustment for baseline ischemic core volume. METHODS: Data were collected from consecutive acute ischemic stroke patients with baseline and follow-up perfusion imaging presenting to hospital within 4.5 hours of symptom onset at 7 hospitals. Logistic regression models were used for predicting the effect of the reperfused penumbral volume on the dichotomized modified Rankin Scale (mRS) at 90 days and improvement of National Institutes of Health Stroke Scale at 24 hours, both adjusted for baseline ischemic core volume...
September 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28882488/association-between-serum-periostin-concentrations-and-outcome-after-acute-spontaneous-intracerebral-hemorrhage
#20
Wen-Jian Ji, Xiao-Min Chou, Gang-Qun Wu, Yang-Fang Shen, Xiao-Gang Yang, Zhi-Feng Wang, Luo-Xin Lan, Xu-Gang Shi
BACKGROUND: Higher serum periostin concentrations are associated with mortality after head trauma. We further determined the relationship between periostin concentrations, severity, and clinical outcome in patients with intracerebral hemorrhage (ICH). METHODS: We prospectively included 128 controls and 128 consecutive patients with acute ICH within the first 24h after onset. At admission, we measured serum periostin concentrations. RESULTS: Serum periostin concentrations were significantly higher in the patients than in the controls...
September 4, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
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