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Stroke and predictive outcomes

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https://www.readbyqxmd.com/read/29777362/the-silver-effect-of-admission-glucose-level-on-excellent-outcome-in-thrombolysed-stroke-patients
#1
Charlotte Rosso, Flore Baronnet, Belen Diaz, Raphael Le Bouc, Giulia Frasca Polara, Eric Jr Moulton, Sandrine Deltour, Anne Leger, Sophie Crozier, Yves Samson
Higher admission glucose levels (AGL) are associated with less favorable outcome in thrombolysis. But, could AGL's impact on outcome vary by onset-to-treatment (OTT) time? Is hyperglycemia associated with a shorter therapeutic time window for excellent outcome for thrombolysed stroke patients? We assessed predictive values of AGL, baseline NIHSS, age, and OTT time quartiles on excellent outcome (3-month modified Rankin score of 0-1) in 773 patients treated by rt-Pa. We added the AGL × OTT time quartile interaction in the model and separately analyzed the predictive values of AGL, age, and NIHSS for each OTT time quartile if the interaction was significant...
May 18, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29777016/clinical-utility-of-electronic-alberta-stroke-program-early-computed-tomography-score-software-in-the-enchanted-trial-database
#2
Simon Nagel, Xia Wang, Cheryl Carcel, Thompson Robinson, Richard I Lindley, John Chalmers, Craig S Anderson
BACKGROUND AND PURPOSE: Clinical utility of electronic Alberta Stroke Program Early CT Score (e-ASPECTS), an automated system for quantifying signs of infarction, was evaluated in a large database of thrombolyzed patients with acute ischemic stroke. METHODS: All baseline noncontrast computed tomographic scans of patients with anterior circulation acute ischemic stroke who participated in the alteplase dose arm of the randomized controlled trial ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) were reviewed; poor quality and large (>6 mm) slice thickness were excluded...
May 18, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29776959/symptom-burden-of-atrial-fibrillation-and-its-relation-to-interventions-and-outcome-in-europe
#3
Renate B Schnabel, Ladislav Pecen, Nargiz Rzayeva, Markus Lucerna, Yanish Purmah, Francisco M Ojeda, Raffaele De Caterina, Paulus Kirchhof
BACKGROUND: Little is known about the association of atrial fibrillation symptom burden with quality of life and outcomes. METHODS AND RESULTS: In the Prevention of Thromboembolic Events-European Registry in Atrial Fibrillation (n=6196 patients with atrial fibrillation; mean±SD age, 71.8±10.4 years; 39.7% women), we assessed European Heart Rhythm Association score symptoms and calculated correlations with the standardized health status questionnaire (EQ-5D-5L)...
May 18, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29776431/validation-of-verbal-autopsy-methods-using-hospital-medical-records-a-case-study-in-vietnam
#4
Hong Thi Tran, Hoa Phuong Nguyen, Sue M Walker, Peter S Hill, Chalapati Rao
BACKGROUND: Information on causes of death (COD) is crucial for measuring the health outcomes of populations and progress towards the Sustainable Development Goals. In many countries such as Vietnam where the civil registration and vital statistics (CRVS) system is dysfunctional, information on vital events will continue to rely on verbal autopsy (VA) methods. This study assesses the validity of VA methods used in Vietnam, and provides recommendations on methods for implementing VA validation studies in Vietnam...
May 18, 2018: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/29773712/acute-kidney-injury-and-risk-of-heart-failure-and-atherosclerotic-events
#5
Alan S Go, Chi-Yuan Hsu, Jingrong Yang, Thida C Tan, Sijie Zheng, Juan D Ordonez, Kathleen D Liu
BACKGROUND AND OBJECTIVES: AKI in the hospital is common and is associated with excess mortality. We examined whether AKI is also independently associated with a higher risk of different cardiovascular events in the first year after discharge. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective analysis of a cohort between 2006 and 2013 with follow-up through 2014, within Kaiser Permanente Northern California. We identified all adults admitted to 21 hospitals who had one or more in-hospital serum creatinine test result and survived to discharge...
May 17, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29773577/determinants-and-outcomes-of-vasoplegia-following-left-ventricular-assist-device-implantation
#6
Kristen M Tecson, Brian Lima, Andy Y Lee, Fayez S Raza, Grace Ching, Cheng-Han Lee, Joost Felius, Ronald D Baxter, Sasha Still, Justin D G Collier, Shelley A Hall, Susan M Joseph
BACKGROUND: Vasoplegia is associated with adverse outcomes following cardiac surgery; however, its impact following left ventricular assist device implantation is largely unexplored. METHODS AND RESULTS: In 252 consecutive patients receiving a left ventricular assist device, vasoplegia was defined as the occurrence of normal cardiac function and index but with the need for intravenous vasopressors within 48 hours following surgery for >24 hours to maintain a mean arterial pressure >70 mm Hg...
May 17, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29770467/anticholinergic-load-negatively-correlates-with-recovery-of-cognitive-activities-of-daily-living-for-geriatric-patients-after-stroke-in-the-convalescent-stage
#7
E Kose, T Hirai, T Seki, S Hidaka, T Hamamoto
WHAT IS KNOWN AND OBJECTIVE: Anticholinergic drugs are associated with risks of falls, confusion and cognitive dysfunction. However, the effect of anticholinergic drug use on rehabilitation outcomes after a stroke is poorly documented. We therefore aimed to establish whether the anticholinergic load was associated with functional recovery among geriatric patients convalescing after stroke. METHOD: Consecutive geriatric stroke patients admitted and discharged from a convalescence rehabilitation ward between 2010 and 2016 were included in this retrospective cohort study...
May 16, 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29769800/the-therapeutic-potential-of-blocking-galectin-3-expression-in-acute-myocardial-infarction-and-mitigating-inflammation-of-infarct-region-a-clinical-outcome-based-translational-study
#8
Wassim Mosleh, Milind R Chaudhari, Swati Sonkawade, Supriya Mahajan, Charl Khalil, Kevin Frodey, Tanvi Shah, Suraj Dahal, Roshan Karki, Rujuta Katkar, W Matthijs Blankesteijn, Brian Page, Saraswati Pokharel, Minhyung Kim, Umesh C Sharma
Introduction: Increased galectin-3 is associated with ischemic cardiomyopathy, although its role in early remodeling post-myocardial infarction (MI) has not been fully elucidated. There are no data demonstrating that blocking galectin-3 expression would have an impact on the heart and that its relationship to remodeling is not simply an epiphenomenon. The direct association between galectin-3 and myocardial inflammation, dysfunction, and adverse cardiovascular outcomes post-MI was examined using clinical and translational studies...
2018: Biomarker Insights
https://www.readbyqxmd.com/read/29769590/low-factor-xiii-levels-after-intravenous-thrombolysis-predict-short-term-mortality-in-ischemic-stroke-patients
#9
Edina Gabriella Székely, Katalin Réka Czuriga-Kovács, Zsuzsanna Bereczky, Éva Katona, Zoltán András Mezei, Attila Nagy, Noémi Klára Tóth, Ervin Berényi, László Muszbek, László Csiba, Zsuzsa Bagoly
In this observational study we investigated whether levels of factor XIII (FXIII) and its major polymorphisms affect the outcome of thrombolysis by recombinant tissue plasminogen activator (rtPA) in acute ischemic stroke (AIS) patients. Study cohort included 132 consecutive AIS patients undergoing i.v. thrombolysis within 4.5 h of symptom onset. Blood samples taken on admission, immediately after and 24 h after therapy were analyzed for FXIII activity and antigen levels. FXIII-A p.Val34Leu, p.Tyr204Phe, FXIII-B p...
May 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29769241/multivessel-occlusion-in-patients-subjected-to-thrombectomy-prevalence-associated-factors-and-clinical-implications
#10
Johannes Kaesmacher, Pascal J Mosimann, Mattia Giarrusso, Marwan El-Koussy, Felix Zibold, Eike Piechowiak, Tomas Dobrocky, Raphael Meier, Simon Jung, Sebastian Bellwald, Marcel Arnold, Pasquale Mordasini, Urs Fischer, Jan Gralla
BACKGROUND AND PURPOSE: Patients with embolic large-vessel occlusion may present with additional coincidental acute occlusions within or distant from the involved territory, referred to as multivessel occlusion (MVO). Purpose of this study was to assess prevalence of MVO, associated factors, and clinical relevance in patients undergoing endovascular stroke treatment. METHODS: Image data of consecutive endovascular candidates (n=720) with direct access to angiography were extracted from a prospective registry...
May 16, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29768352/effectiveness-of-trevo-stent-retriever-in-acute-ischemic-stroke-comparison-with-solitaire-stent
#11
Ho Jun Yi, Dong Hoon Lee, Sang Uk Kim
Recently, mechanical thrombectomy with stent retriever has achieved faster and higher rates of recanalization for intracranial major vessel occlusion. However, comparative studies of the most widely used Solitaire and Trevo stents have been rarely published.The authors retrospectively reviewed a total of 200 patients who performed mechanical thrombectomy at our center during 4 years and divided patients into 2 groups: mechanical thrombectomy with Solitaire stent (Group 1: Solitaire) and mechanical thrombectomy with Trevo stent (Group 2: Trevo)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29766355/early-functional-mri-activation-predicts-motor-outcome-after-ischemic-stroke-a-longitudinal-multimodal-study
#12
Juan Du, Fang Yang, Zhiqiang Zhang, Jingze Hu, Qiang Xu, Jianping Hu, Fanyong Zeng, Guangming Lu, Xinfeng Liu
An accurate prediction of long term outcome after stroke is urgently required to provide early individualized neurorehabilitation. This study aimed to examine the added value of early neuroimaging measures and identify the best approaches for predicting motor outcome after stroke. This prospective study involved 34 first-ever ischemic stroke patients (time since stroke: 1-14 days) with upper limb impairment. All patients underwent baseline multimodal assessments that included clinical (age, motor impairment), neurophysiological (motor-evoked potentials, MEP) and neuroimaging (diffusion tensor imaging and motor task-based fMRI) measures, and also underwent reassessment 3 months after stroke...
May 15, 2018: Brain Imaging and Behavior
https://www.readbyqxmd.com/read/29766275/implementing-cough-reflex-testing-in-a-clinical-pathway-for-acute-stroke-a-pragmatic-randomised-controlled-trial
#13
Makaela Field, Rachel Wenke, Arman Sabet, Melissa Lawrie, Elizabeth Cardell
Silent aspiration is common after stroke and can lead to subsequent pneumonia. While standard bedside dysphagia assessments are ineffective at predicting silent aspiration, cough reflex testing (CRT) has shown promise for identifying patients at risk of silent aspiration. We investigated the impact of CRT on patient and service outcomes when embedded into a clinical pathway. 488 acute stoke patients were randomly allocated to receive either CRT or standard care (i.e. bedside assessment). Primary outcomes included confirmed pneumonia within 3 months post stroke and length of acute inpatient stay...
May 15, 2018: Dysphagia
https://www.readbyqxmd.com/read/29765394/mechanical-thrombectomy-in-elderly-stroke-patients-with-mild-to-moderate-baseline-disability
#14
Diana E Slawski, Hisham Salahuddin, Julie Shawver, Cynthia L Kenmuir, Gretchen E Tietjen, Andrea Korsnack, Syed F Zaidi, Mouhammad A Jumaa
Background: The number of elderly patients suffering from ischemic stroke is rising. Randomized trials of mechanical thrombectomy (MT) generally exclude patients over the age of 80 years with baseline disability. The aim of this study was to understand the efficacy and safety of MT in elderly patients, many of whom may have baseline impairment. Methods: Between January 2015 and April 2017, 96 patients ≥80 years old who underwent MT for stroke were selected for a chart review...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29765301/the-additional-contribution-of-white-matter-hyperintensity-location-to-post-stroke-cognitive-impairment-insights-from-a-multiple-lesion-symptom-mapping-study
#15
Lei Zhao, Adrian Wong, Yishan Luo, Wenyan Liu, Winnie W C Chu, Jill M Abrigo, Ryan K L Lee, Vincent Mok, Lin Shi
White matter hyperintensities (WMH) are common in acute ischemic stroke patients. Although WMH volume has been reported to influence post-stroke cognition, it is still not clear whether WMH location, independent of acute ischemic lesion (AIL) volume and location, contributes to cognitive impairment after stroke. Here, we proposed a multiple-lesion symptom mapping model that considers both the presence of WMH and AIL to measure the additional contribution of WMH locations to post-stroke cognitive impairment...
2018: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29763889/neutrophil-lymphocyte-ratio-predicts-functional-and-safety-outcomes-after-endovascular-treatment-for-acute-ischemic-stroke
#16
Zhenhui Duan, Huaiming Wang, Zhen Wang, Yonggang Hao, Wenjie Zi, Dong Yang, Zhiming Zhou, Wenhua Liu, Min Lin, Zhonghua Shi, Penghua Lv, Yue Wan, Gelin Xu, Yunyun Xiong, Wusheng Zhu, Xinfeng Liu
BACKGROUND AND OBJECTIVE: Endovascular treatment (EVT) is proven to be safe and effective for treating acute large vessel occlusion stroke (LVOS). The neutrophil-lymphocyte ratio (NLR) reflects systemic inflammation, which plays an important role in the process of treating ischemic stroke. This study aims to explore the relationship between NLR and the clinical outcomes of LVOS patients undergoing EVT. METHODS: Patients were selected from the EVT for acUte Anterior circuLation (ACTUAL) ischemic stroke registry...
May 15, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29760276/early-blood-brain-barrier-disruption-in-ischemic-stroke-initiates-multifocally-around-capillaries-venules
#17
Angelika Hoffmann, Tassilo Dege, Reiner Kunze, Anne-Sophie Ernst, Holger Lorenz, Laura-Inés Böhler, Thomas Korff, Hugo H Marti, Sabine Heiland, Martin Bendszus, Xavier Helluy, Mirko Pham
BACKGROUND AND PURPOSE: Detection and localization of the early phase of blood-brain barrier disruption (BBBD) in vivo during cerebral ischemia/reperfusion injury remain a major challenge but may be a relevant outcome parameter in stroke. METHODS: We studied early BBBD in mice after transient middle cerebral artery occlusion by multimodal, high-field (9.4T) in vivo magnetic resonance imaging, including the contrast agent gadofluorineM as an albumin-binding tracer...
May 14, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29759774/assessment-of-left-atrial-fibrosis-by-late-gadolinium-enhancement-magnetic-resonance-imaging-methodology-and-clinical-implications
#18
REVIEW
Johannes Siebermair, Eugene G Kholmovski, Nassir Marrouche
Recently, studies using late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) to identify structural changes of atrial tissue have contributed significantly to understanding the pathophysiology and progression of atrial fibrillation (AF). Moreover, imaging of atrial fibrosis using MRI has evolved to be a tool to improve clinical outcome of AF ablation procedures by allowing a patient-specific individualized management approach. LGE-MRI has been shown to predict AF ablation outcome based on pre-procedural imaging to define the extent of atrial fibrosis...
August 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29755897/improving-door-to-groin-puncture-time-for-mechanical-thrombectomy-via-iterative-quality-protocol-interventions
#19
Vincent J Cheung, Arvin R Wali, David R Santiago-Dieppa, Robert C Rennert, Michael G Brandel, Jeffrey A Steinberg, Brian R Hirshman, Kevin Porras, Peter Abraham, Julie Jurf, Emily Botts, Scott Olson, J Scott Pannell, Alexander A Khalessi
INTRODUCTION: Delays in door to groin puncture time (DGPT) for patients with ischemic stroke caused by acute large vessel occlusions (LVO) are associated with worse clinical outcomes. We present the results of a quality improvement protocol for endovascular stroke treatment at the University of California, San Diego (UCSD) that aimed to minimize DGPT. MATERIALS AND METHODS: Our stroke team implemented a series of quality improvement measures to decrease DGPT, with a target of 90 minutes or less...
March 10, 2018: Curēus
https://www.readbyqxmd.com/read/29752392/independent-prognostic-value-of-stroke-volume-index-in-patients-with-immunoglobulin-light-chain-amyloidosis
#20
(no author information available yet)
BACKGROUND: Heart involvement is the most important prognostic determinant in AL amyloidosis patients. Echocardiography is a cornerstone for the diagnosis and provides important prognostic information. METHODS AND RESULTS: We studied 754 patients with AL amyloidosis who underwent echocardiographic assessment at the Mayo Clinic, including a Doppler-derived measurement of stroke volume (SV) within 30 days of their diagnosis to explore the prognostic role of echocardiographic variables in the context of a well-established soluble cardiac biomarker staging system...
May 2018: Circulation. Cardiovascular Imaging
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