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Stroke and predictive outcomes

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https://www.readbyqxmd.com/read/27924049/early-trajectory-of-stroke-severity-predicts-long-term-functional-outcomes-in-ischemic-stroke-subjects-results-from-the-escape-trial-endovascular-treatment-for-small-core-and-anterior-circulation-proximal-occlusion-with-emphasis-on-minimizing-ct-to-recanalization
#1
Tolulope T Sajobi, Bijoy K Menon, Meng Wang, Oluwaseyi Lawal, Ashfaq Shuaib, David Williams, Alexandre Y Poppe, Tudor G Jovin, Leanne K Casaubon, Thomas Devlin, Dar Dowlatshahi, Chris Fanale, Mark W Lowerison, Andrew M Demchuk, Mayank Goyal, Michael D Hill
BACKGROUND AND PURPOSE: The trajectory of neurological improvement after stroke treatment is clinically likely to be an important prognostic signal. We compared the accuracy of early longitudinal National Institutes of Health Stroke Scale (NIHSS) measurement versus other early markers of stroke severity post treatment in predicting subjects' 90-day stroke outcome. METHODS: Data are from the Endovascular treatment for Small Core and Anterior circulation Proximal occlusion with ESCAPE trial (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times)...
December 6, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27909535/search-for-the-ideal-antithrombotic-drug-utopian-task-likely-is-implemented-already
#2
REVIEW
Petras Stirbys Md PhD
Atrial fibrillation is the most prevalent cardiac arrhythmia with a high risk of ischemic stroke. Thromboprophylaxis plays a key role in prevention of cardioembolic and non-cardioembolic events. Oral antithrombotic drugs are most often used to reduce hypercoagulable state. Patients may suffer from both under- and overtreatment compromising the outcomes. Medication peculiarities at large are well-known and widely debated. Non-adherence to antithrombotic drug regimen poses a significant risk of stroke. There is a pressing need for more detailed delineation of risk factors, namely by incorporation of the letter "N" (meaning "Non-adherence to drug therapy") into the well-known risk score alphanumeric display: CHA2DS2N-VASc...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27905390/-pr%C3%B0-gnosis-of-motor-function-recovery-in-ischemic-stroke-using-diffusion-tensor-mri
#3
M Yu Maksimova, T A Popova, R N Konovalov
AIM: To identify factors of motor recovery in ischemic stroke (IS) using diffusion tensor imaging (DTI). MATERIAL AND METHODS: Forty-seven patients with IS were studied within 1-2, 7-8, 14-15, 20-21 days after stroke. The fractional anisotropy (FA) values of the pyramidal tract were measured in the posterior limb of the internal capsule, cerebral peduncle and pons. Relative values of FA (rFA) ratio (rFA=FA affected side/FA unaffected side) were assessed as well...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/27904159/copeptin-as-a-biomarker-for-prediction-of-prognosis-of-acute-ischemic-stroke-and-transient-ischemic-attack-a-meta-analysis
#4
Qian Xu, Yunfan Tian, Hao Peng, Hongmei Li
This meta-analysis aimed to investigate the predictive effect of copeptin as a biomarker for the prognosis of acute ischemic stroke and transient ischemic attack. Electronic databases including PubMed, Medline, EMBASE, Web of Science and Cochrane Central were searched for studies assessing the association of copeptin level on admission with prognosis of acute ischemic stroke and transient ischemic attack. The Newcastle-Ottawa Quality assessment scale for cohort study was used to evaluate quality. A total of 1976 acute ischemic stroke patients from 6 studies were included, and 59% of patients were male...
December 1, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/27903562/validity-of-self-reported-myocardial-infarction-and-stroke-in-regions-with-sami-and-norwegian-populations-the-saminor-1-survey-and-the-cvdnor-project
#5
Bent-Martin Eliassen, Marita Melhus, Grethe S Tell, Kristin Benjaminsen Borch, Tonje Braaten, Ann Ragnhild Broderstad, Sidsel Graff-Iversen
OBJECTIVE: Updated knowledge on the validity of self-reported myocardial infarction (SMI) and self-reported stroke (SRS) is needed in Norway. Our objective was to compare questionnaire data and hospital discharge data from regions with Sami and Norwegian populations to assess the validity of these outcomes by ethnicity, sex, age and education. DESIGN: Validation study using cross-sectional questionnaire data and hospital discharge data from all Norwegian somatic hospitals...
November 30, 2016: BMJ Open
https://www.readbyqxmd.com/read/27899178/choice-of-a-hemodynamic-model-for-occlusive-thrombosis-in-arteries
#6
David N Ku, Lauren D C Casa, Susan M Hastings
Intravascular thrombosis can lead to heart attacks and strokes that together are the leading causes of death in the US (Kochanek, K.D., Murphy, S.L., Xu, J.Q., 2014). The ability to identify the offending biofluid mechanical conditions and predict the timescale of thrombotic occlusion in vessels and devices may improve patient outcomes. A computational model was developed to describe the growth of thrombus based on the local hemodynamic shear rate. The model predicts thrombus deposition based on initial geometric and fluid mechanical conditions, which are updated throughout the simulation to reflect the changing lumen dimensions...
November 12, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27896982/predictive-modeling-of-hospital-readmission-rates-using-electronic-medical-record-wide-machine-learning-a-case-study-using-mount-sinai-heart-failure-cohort
#7
Khader Shameer, Kipp W Johnson, Alexandre Yahi, Riccardo Miotto, L I Li, Doran Ricks, Jebakumar Jebakaran, Patricia Kovatch, Partho P Sengupta, Sengupta Gelijns, Alan Moskovitz, Bruce Darrow, David L David, Andrew Kasarskis, Nicholas P Tatonetti, Sean Pinney, Joel T Dudley
Reduction of preventable hospital readmissions that result from chronic or acute conditions like stroke, heart failure, myocardial infarction and pneumonia remains a significant challenge for improving the outcomes and decreasing the cost of healthcare delivery in the United States. Patient readmission rates are relatively high for conditions like heart failure (HF) despite the implementation of high-quality healthcare delivery operation guidelines created by regulatory authorities. Multiple predictive models are currently available to evaluate potential 30-day readmission rates of patients...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27895297/power-of-an-adaptive-trial-design-for-endovascular-stroke-studies-simulations-using-ims-interventional-management-of-stroke-iii-data
#8
Maarten G Lansberg, Ninad S Bhat, Sharon D Yeatts, Yuko Y Palesch, Joseph P Broderick, Gregory W Albers, Tze L Lai, Philip W Lavori
BACKGROUND AND PURPOSE: Adaptive trial designs that allow enrichment of the study population through subgroup selection can increase the chance of a positive trial when there is a differential treatment effect among patient subgroups. The goal of this study is to illustrate the potential benefit of adaptive subgroup selection in endovascular stroke studies. METHODS: We simulated the performance of a trial design with adaptive subgroup selection and compared it with that of a traditional design...
December 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27893797/risk-factors-for-multiple-organ-dysfunction-syndrome-in-severe-stroke-patients
#9
Wei Qin, Xiaoyu Zhang, Shuna Yang, Yue Li, Junliang Yuan, Lei Yang, Shujuan Li, Wenli Hu
BACKGROUND: Severe stroke patients have poor clinical outcome which may be associated with development of multiple organ dysfunction syndrome (MODS). Therefore, the aim of our study was to investigate independent risk factors for development of MODS in severe stroke patients. METHODS: Ninety seven severe stroke patients were prospective recruited from Jan 2011 to Jun 2015. The development of MODS was identified by Sequential Organ Failure Assessment (SOFA) score (score ≥ 3, at least two organs), which was assessed on day 1, 4, 7, 10 and 14 after admission...
2016: PloS One
https://www.readbyqxmd.com/read/27890440/three-month-outcomes-are-poor-in-stroke-patients-with-cancer-despite-acute-stroke-treatment
#10
Shawna Cutting, Meagan Wettengel, James J Conners, Bichun Ouyang, Katharina Busl
INTRODUCTION: Stroke risk is increased in cancer patients. Prognosis in these patients is poor, with higher in-hospital mortality and increased subsequent mortality. However, data on stroke in cancer patients are limited, specifically regarding acute stroke treatment and functional outcomes. We aim to determine the functional outcomes of cancer patients admitted with acute stroke. MATERIALS AND METHODS: We retrospectively reviewed patients carrying a diagnosis of cancer who were admitted with acute ischemic stroke between March 2013 and February 2016...
November 24, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27889089/susceptible-vessel-sign-identification-of-arterial-occlusion-and-clinical-implications-in-acute-ischaemic-stroke
#11
S Payabvash, J C Benson, S Taleb, J B Rykken, B Hoffman, A M McKinney, M C Oswood
AIM: To determine the accuracy of the susceptible vessel sign (SVS) in the detection of arterial occlusion and its clinical implication in acute ischaemic stroke. MATERIALS AND METHODS: Consecutive ischaemic stroke patients who underwent magnetic resonance imaging (MRI) with susceptibility-weighted imaging (SWI) within 24 hours of symptom onset or time last-seen-well were included. Two independent neuroradiologists reviewed the SWI for evidence of the SVS. Admission stroke severity was determined by the National Institute of Health Stroke Scale (NIHSS) scores, and poor clinical outcome was defined by a 3-months modified Rankin scale (mRS) score >2...
November 23, 2016: Clinical Radiology
https://www.readbyqxmd.com/read/27884769/upregulation-of-cd74-and-its-potential-association-with-disease-severity-in-subjects-with-ischemic-stroke
#12
Liu Yang, Ying Kong, Honglei Ren, Minshu Li, Chang-Juan Wei, Elaine Shi, Wei-Na Jin, Junwei Hao, Arthur A Vandenbark, Halina Offner
Macrophage migration inhibitory factor (MIF) is a key cytokine/chemokine in the activation and recruitment of inflammatory T lymphocytes known to exacerbate experimental stroke severity. MIF effects are mediated through its primary cellular receptor, CD74, the MHC class II invariant chain present on all class II expressing cells, including monocytes, macrophages and dendritic cells (DC). We demonstrated previously that partial MHC class II/peptide constructs (pMHC) can effectively treat mice with experimental stroke, in part through their ability to competitively inhibit MIF/CD74 interactions and downstream signaling...
November 21, 2016: Neurochemistry International
https://www.readbyqxmd.com/read/27881958/motor-cortex-neurostimulation-technologies-for-chronic-post-stroke-pain-implications-of-tissue-damage-on-stimulation-currents
#13
Anthony T O'Brien, Rivadavio Amorim, R Jarrett Rushmore, Uri Eden, Linda Afifi, Laura Dipietro, Timothy Wagner, Antoni Valero-Cabré
Background: Central post stroke pain (CPSP) is a highly refractory syndrome that can occur after stroke. Primary motor cortex (M1) brain stimulation using epidural brain stimulation (EBS), transcranial magnetic stimulation (TMS), and transcranial direct current stimulation (tDCS) have been explored as potential therapies for CPSP. These techniques have demonstrated variable clinical efficacy. It is hypothesized that changes in the stimulating currents that are caused by stroke-induced changes in brain tissue conductivity limit the efficacy of these techniques...
2016: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/27881568/incident-type-2-myocardial-infarction-in-a-cohort-of-patients-undergoing-coronary-or-peripheral-arterial-angiography
#14
Hanna K Gaggin, Yuyin Liu, Asya Lyass, Roland R van Kimmenade, Shweta R Motiwala, Noreen Kelly, Aditi Mallick, Parul U Gandhi, Nasrien E Ibrahim, Mandy Simon, Anju Bhardwaj, Arianna Belcher, Jamie E Harisiades, Joseph M Massaro, Ralph B D'Agostino, James L Januzzi
BACKGROUND: -Despite growing recognition of Type 2 myocardial infarction (T2MI; related to supply-demand mismatch), little is known about its risk factors or its association with outcome. METHODS: -A single center cohort of patients undergoing coronary or peripheral angiography with or without intervention was prospectively enrolled and followed for incident type 1 and T2MI, as well as major adverse cardiovascular events (MACE, a composite of all-cause death, non-fatal MI, heart failure, stroke, transient ischemic attack, peripheral arterial complication and cardiac arrhythmia)...
November 21, 2016: Circulation
https://www.readbyqxmd.com/read/27881567/importance-of-assessing-cardiorespiratory-fitness-in-clinical-practice-a-case-for-fitness-as-a-clinical-vital-sign-a-scientific-statement-from-the-american-heart-association
#15
Robert Ross, Steven N Blair, Ross Arena, Timothy S Church, Jean-Pierre Després, Barry A Franklin, William L Haskell, Leonard A Kaminsky, Benjamin D Levine, Carl J Lavie, Jonathan Myers, Josef Niebauer, Robert Sallis, Susumu S Sawada, Xuemei Sui, Ulrik Wisløff
Mounting evidence has firmly established that low levels of cardiorespiratory fitness (CRF) are associated with a high risk of cardiovascular disease, all-cause mortality, and mortality rates attributable to various cancers. A growing body of epidemiological and clinical evidence demonstrates not only that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus, but that the addition of CRF to traditional risk factors significantly improves the reclassification of risk for adverse outcomes...
November 21, 2016: Circulation
https://www.readbyqxmd.com/read/27881558/the-american-heart-association-s-new-institute-for%C3%A2-precision-cardiovascular-medicine
#16
Steven R Houser
"One size does not fit all." These 6 simple words represent the fundamental concept driving an unprecedented initiative of the American Heart Association, the Institute for Precision Cardiovascular Medicine. In the field of heart disease and stroke research, we have seen enormous knowledge advances in recent decades, all of which have led to breakthroughs in our ability to treat and prevent these illnesses. We celebrate these advances because they are allowing us to save and improve more lives than ever before...
November 22, 2016: Circulation
https://www.readbyqxmd.com/read/27880852/clinical-characteristics-and-outcomes-of-patients-with-high-ankle-brachial-index-from-the-impact-abi-study
#17
Hitoshi Nishimura, Takashi Miura, Masatoshi Minamisawa, Yasushi Ueki, Naoyuki Abe, Naoto Hashizume, Tomoaki Mochidome, Mikiko Harada, Kunihiko Shimizu, Wataru Shoin, Koji Yoshie, Yasutaka Oguchi, Soichiro Ebisawa, Hirohiko Motoki, Atsushi Izawa, Jun Koyama, Uichi Ikeda, Koichiro Kuwahara
BACKGROUND: Reduced ankle-brachial index (ABI) is a predictor of cardiovascular events. However, the significance of high ABI remains poorly understood. This study aimed to assess the characteristics and outcomes of patients with high ABI. METHODS: The IMPACT-ABI study was a retrospective cohort study that enrolled and examined ABI in 3,131 patients hospitalized for cardiovascular disease between January 2005 and December 2012. From this cohort, 2,419 patients were identified and stratified into two groups: high ABI (> 1...
2016: PloS One
https://www.readbyqxmd.com/read/27880819/risk-assessment-of-patients-undergoing-transfemoral-aortic-valve-implantation-upon-admission-for-post-interventional-intensive-care-and-surveillance-implications-on-short-and-midterm-outcomes
#18
Fadi Al-Rashid, Philipp Kahlert, Friederike Selge, Heike Hildebrandt, Polycarpos-Christos Patsalis, Matthias Totzeck, Petra Mummel, Tienush Rassaf, Rolf Alexander Jánosi
BACKGROUND: Several studies have found that standard risk scores inaccurately reflect risk in TAVI cohorts. The assessment of mortality risk upon post-interventional ICU admission is important to optimizing clinical management. This study sought to determine outcomes and factors affecting mortality in patients admitted to the intensive care unit (ICU) after transcatheter aortic valve implantation (TAVI), and to analyze and compare the predictive values of SAPS II and EuroSCORE. METHODS AND FINDINGS: 214 consecutive patients treated with transfemoral TAVI (2006-2012) admitted to the ICU in an academic tertiary-care university hospital, were included in this retrospective data analysis...
2016: PloS One
https://www.readbyqxmd.com/read/27879446/quantification-of-serial-cerebral-blood-flow-in-acute-stroke-using-arterial-spin-labeling
#19
George W J Harston, Thomas W Okell, Fintan Sheerin, Ursula Schulz, Phil Mathieson, Ian Reckless, Kunal Shah, Gary A Ford, Michael A Chappell, Peter Jezzard, James Kennedy
BACKGROUND AND PURPOSE: Perfusion-weighted imaging is used to select patients with acute ischemic stroke for intervention, but knowledge of cerebral perfusion can also inform the understanding of ischemic injury. Arterial spin labeling allows repeated measurement of absolute cerebral blood flow (CBF) without the need for exogenous contrast. The aim of this study was to explore the relationship between dynamic CBF and tissue outcome in the month after stroke onset. METHODS: Patients with nonlacunar ischemic stroke underwent ≤5 repeated magnetic resonance imaging scans at presentation, 2 hours, 1 day, 1 week, and 1 month...
November 22, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27878925/left-ventricular-deformation-at-rest-predicts-exercise-induced-elevation-in-pulmonary-artery-wedge-pressure-in-patients-with-unexplained-dyspnoea
#20
Tor Biering-Sørensen, Mário Santos, Jose Rivero, Shane D McCullough, Erin West, Alexander R Opotowsky, Aaron B Waxman, David M Systrom, Amil M Shah
AIMS: Impaired left ventricular (LV) deformation despite preserved LV ejection fraction (LVEF) is common and predicts outcomes in heart failure with preserved LVEF. We hypothesized that impaired LV deformation at rest is a marker of impaired cardiac systolic and diastolic reserve, and aimed to determine whether resting longitudinal (LS) and circumferential strain (CS) are associated with invasively measured haemodynamic response to exercise in patients with dyspnoea and a normal LVEF...
November 22, 2016: European Journal of Heart Failure
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