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Stroke and predictive outcomes

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https://www.readbyqxmd.com/read/28087825/incidence-and-predictors-of-epilepsy-after-pediatric-arterial-ischemic-stroke
#1
Lori L Billinghurst, Lauren A Beslow, Nicholas S Abend, Michael Uohara, Laura Jastrzab, Daniel J Licht, Rebecca N Ichord
OBJECTIVE: To determine the cumulative incidence and clinical predictors of remote symptomatic seizures and epilepsy after pediatric arterial ischemic stroke (AIS). METHODS: We performed a retrospective analysis of 218 participants with neonatal AIS (NAIS), presumed perinatal AIS (PPAIS), and childhood AIS (CAIS) from a single-center prospective consecutive cohort enrolled from 2006 to 2014. Medical records were reviewed for timing, semiology, and treatment of acute symptomatic seizures, remote symptomatic seizures (RSS), and epilepsy...
January 13, 2017: Neurology
https://www.readbyqxmd.com/read/28087807/field-validation-of-the-los-angeles-motor-scale-as-a-tool-for-paramedic-assessment-of-stroke-severity
#2
Joon-Tae Kim, Pil-Wook Chung, Sidney Starkman, Nerses Sanossian, Samuel J Stratton, Marc Eckstein, Frank D Pratt, Robin Conwit, David S Liebeskind, Latisha Sharma, Lucas Restrepo, May-Kim Tenser, Miguel Valdes-Sueiras, Jeffrey Gornbein, Scott Hamilton, Jeffrey L Saver
BACKGROUND AND PURPOSE: The Los Angeles Motor Scale (LAMS) is a 3-item, 0- to 10-point motor stroke-deficit scale developed for prehospital use. We assessed the convergent, divergent, and predictive validity of the LAMS when performed by paramedics in the field at multiple sites in a large and diverse geographic region. METHODS: We analyzed early assessment and outcome data prospectively gathered in the FAST-MAG trial (Field Administration of Stroke Therapy-Magnesium phase 3) among patients with acute cerebrovascular disease (cerebral ischemia and intracranial hemorrhage) within 2 hours of onset, transported by 315 ambulances to 60 receiving hospitals...
January 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28087112/the-impact-of-temperature-in-aortic-arch-surgery-patients-receiving-antegrade-cerebral-perfusion-for-30%C3%A2-minutes-how-relevant-is-it-really
#3
Ourania Preventza, Joseph S Coselli, Shahab Akvan, Sarang A Kashyap, Andrea Garcia, Katherine H Simpson, Matt D Price, Jessica Mayor, Kim I de la Cruz, Lorraine D Cornwell, Shuab Omer, Faisal G Bakaeen, Ricky J L Haywood-Watson, Athina Rammou
OBJECTIVE: We examined the early outcomes and the long-term survival associated with different degrees of hypothermia in patients who received antegrade cerebral perfusion (ACP) for >30 minutes. METHODS: During a 10-year period, 544 consecutive patients underwent proximal and total aortic arch surgery and received ACP for >30 minutes and 1 of 3 levels of hypothermia: deep (14.1°C-20°C; n = 116 [21.3%]), low-moderate (20.1°C-23.9°C; n = 262 [48.2%]), and high-moderate (24°C-28°C; n = 166 [30...
December 19, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28087105/left-ventricular-assist-device-outcomes-based-on-flow-configuration-and-pre-operative-left-ventricular-dimension-an-interagency-registry-for-mechanically-assisted-circulatory-support-analysis
#4
Palak Shah, Sarah Birk, Simon Maltais, John Stulak, Angelo Elmi, Francis D Pagani, Jennifer A Cowger
BACKGROUND: Axial configuration (AC) and centrifugal configuration (CC) left ventricular assist devices (LVAD) have different flow characteristics, and whether the interaction between device flow configuration and the pre-operative left ventricular internal diastolic diameter (LVIDD) mediates adverse events after LVAD implantation is unknown. METHODS: We queried 9,424 continuous-flow LVAD recipients who received LVADs from April 2008 to June of 2015 in the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS)...
December 16, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28075218/the-relationship-between-stroke-survivors-perceived-identity-and-mood-self-esteem-and-quality-of-life
#5
Irina Lapadatu, Reg Morris
OBJECTIVES: To examine change in identity after stroke and to elucidate its relationship with mood and quality of life. To test Higgins' theory of the impact of identity (self-discrepancy) on anxiety and depression. To examine the role of self-esteem in mediating the relationship between identity and outcomes. METHOD: Sixty-five community-living first-time stroke survivors, mean age 61.58 and time since stroke 5.60 years, were recruited from stroke charities. A cross-sectional study used the Head Injury Semantic Differential Scale, the Hospital Anxiety and Depression Scale, the Rosenberg Self-Esteem Scale, the Stroke-Specific Quality of Life Questionnaire (adapted) and the Barthel Index...
January 11, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28075037/gauging-the-response-to-cardiac-resynchronization-therapy-the-important-interplay-between-predictor-variables-and-definition-of-a-favorable-outcome
#6
Milan Petrovic, Marija Petrovic, Goran Milasinovic, Bosiljka Vujisic Tesic, Danijela Trifunovic, Olga Petrovic, Ivana Nedeljkovic, Ivana Petrovic, Marko Banovic, Marija Boricic-Kostic, Jelena Petrovic, Ross Arena, Dejana Popovic
AIMS: Selection of patients who are viable candidates for cardiac resynchronization therapy (CRT), prediction of the response to CRT as well as an optimal definition of a favorable response, all require further exploration. The purpose of this study was to evaluate the interplay between the prediction of the response to CRT and the definition of a favorable outcome. METHODS: Seventy patients who received CRT were included. All patients met current guideline criteria for CRT...
January 11, 2017: Echocardiography
https://www.readbyqxmd.com/read/28074801/delirium-after-cardiac-surgery-a-pilot-study-from-a-single-tertiary-referral-center
#7
Ashok K Kumar, Aveek Jayant, V K Arya, Rohan Magoon, Ridhima Sharma
BACKGROUND: Advances in cardiac surgery has shifted paradigm of management to perioperative psychological illnesses. Delirium is a state of altered consciousness with easy distraction of thoughts. The pathophysiology of this complication is not clear, but identification of risk factors is important for positive postoperative outcomes. The goal of the present study was to prospectively identify the incidence, motoric subtypes, and risk factors associated with development of delirium in cardiac surgical patients admitted to postoperative cardiac intensive care, using a validated delirium monitoring instrument...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28073769/aldosterone-does-not-predict-cardiovascular-events-following-acute-coronary-syndrome-in-patients-initially-without-heart-failure
#8
Reynaria Pitts, Elise Gunzburger, Christie M Ballantyne, Philip J Barter, David Kallend, Lawrence A Leiter, Eran Leitersdorf, Stephen J Nicholls, Prediman K Shah, Jean-Claude Tardif, Anders G Olsson, John J V McMurray, John Kittelson, Gregory G Schwartz
BACKGROUND: Aldosterone may have adverse effects in the myocardium and vasculature. Treatment with an aldosterone antagonist reduces cardiovascular risk in patients with acute myocardial infarction complicated by heart failure (HF) and left ventricular systolic dysfunction. However, most patients with acute coronary syndrome do not have advanced HF. Among such patients, it is unknown whether aldosterone predicts cardiovascular risk. METHODS AND RESULTS: To address this question, we examined data from the dal-OUTCOMES trial that compared the cholesteryl ester transfer protein inhibitor dalcetrapib with placebo, beginning 4 to 12 weeks after an index acute coronary syndrome...
January 10, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28073753/migraine-and-risk-of-perioperative-ischemic-stroke-and-hospital-readmission-hospital-based-registry-study
#9
Fanny P Timm, Timothy T Houle, Stephanie D Grabitz, Anne-Louise Lihn, Janne B Stokholm, Katharina Eikermann-Haerter, Ala Nozari, Tobias Kurth, Matthias Eikermann
OBJECTIVE:  To evaluate whether patients with migraine are at increased risk of perioperative ischemic stroke and whether this may lead to an increased hospital readmission rate. DESIGN:  Prospective hospital registry study. SETTING:  Massachusetts General Hospital and two satellite campuses between January 2007 and August 2014. PARTICIPANTS:  124 558 surgical patients (mean age 52.6 years; 54.5% women). MAIN OUTCOME MEASURES:  The primary outcome was perioperative ischemic stroke occurring within 30 days after surgery in patients with and without migraine and migraine aura...
January 10, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28073429/relation-of-the-myocardial-contraction-fraction-as-calculated-from-m-mode-echocardiography-with-incident-heart-failure-atherosclerotic-cardiovascular-disease-and-mortality-results-from-the-cardiovascular-health-study
#10
Mathew S Maurer, William J H Koh, Traci M Bartz, Sirish Vullaganti, Eddy Barasch, Julius M Gardin, John S Gottdiener, Bruce M Psaty, Jorge R Kizer
We evaluated the association between 2-dimensional (2D) echocardiography (echo)-determined myocardial contraction fraction (MCF) and adverse cardiovascular outcomes including incident heart failure (HF), atherosclerotic cardiovascular disease (ASCVD), and mortality. The MCF, the ratio of left ventricular (LV) stroke volume (SV) to myocardial volume (MV), is a volumetric measure of myocardial shortening that can distinguish pathologic from physiological hypertrophy. Using 2D echo-guided M-mode data from the Cardiovascular Health Study, we calculated MCF in subjects with LV ejection fraction (EF) ≥55% and used Cox models to evaluate its association with incident HF, ASCVD, and all-cause mortality after adjusting for clinical and echo parameters...
December 18, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28067203/long-term-prognostic-impact-of-left-atrial-volumes-and-emptying-fraction-in-a-community-based-cohort
#11
Pär Hedberg, Jonas Selmeryd, Jerzy Leppert, Egil Henriksen
OBJECTIVE: We hypothesised that left atrial emptying fraction (LAEF) would predict long-term cardiovascular outcome in the general population and better so than left atrial (LA) volumes. METHODS: A community-based sample (n=740) in sinus rhythm prospectively underwent clinical evaluation, echocardiography and blood analyses including N-terminal pro B-type natriuretic peptide (NTproBNP). The LA maximum (LAVmax) and minimum volumes (LAVmin) were indexed to body surface area (LAVImax and LAVImin, respectively)...
November 9, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28066971/the-association-between-diffusion-mri-defined-infarct-volume-and-nihss-score-in-patients-with-minor-acute-stroke
#12
Shadi Yaghi, Charlotte Herber, Amelia K Boehme, Howard Andrews, Joshua Z Willey, Sara K Rostanski, Matthew Siket, Mahesh V Jayaraman, Ryan A McTaggart, Karen L Furie, Randolph S Marshall, Ronald M Lazar, Bernadette Boden-Albala
BACKGROUND: Prior studies have shown a correlation between the National Institutes of Health Stroke Scale (NIHSS) and stroke volume on diffusion weighted imaging (DWI); data are more limited in patients with minor stroke. We sought to determine the association between DWI lesion(s) volume and the (1) total NIHSS score and (2) NIHSS component scores in patients with minor stroke. METHODS: We included all patients with minor stroke (NIHSS 0-5) enrolled in the Stroke Warning Information and Faster Treatment study...
January 9, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28064150/a-novel-risk-prediction-score-in-atrial-fibrillation-for-a-net-clinical-outcome-from-the-engage-af-timi-48-randomized-clinical-trial
#13
Christina L Fanola, Robert P Giugliano, Christian T Ruff, Marco Trevisan, Francesco Nordio, Michele F Mercuri, Elliott M Antman, Eugene Braunwald
AIMS: The choice between initiating a non-vitamin K antagonist oral anticoagulant (NOAC) and a vitamin K antagonist (VKA) in patients with atrial fibrillation (AF) may be challenging. To assist in this decision, we developed a risk score to identify patients for whom a therapeutic benefit of NOACs over VKA is predicted. METHODS AND RESULTS: ENGAGE AF-TIMI 48 was a randomized clinical trial of edoxaban vs. warfarin in 21 105 patients with AF. Cox proportional hazard models identified factors associated with a serious net clinical outcome (NCO) of disabling stroke, life-threatening bleeding, and all-cause mortality in VKA naïve patients from the warfarin arm...
January 6, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28063771/matrix-metalloproteinase-9-and-recovery-of-acute-ischemic-stroke
#14
Maged M Abdelnaseer, Nervana M Elfauomy, Eman H Esmail, Manal M Kamal, Enji H Elsawy
BACKGROUND: Stroke outcome can be predicted by clinical features, biochemical parameters, and some risk factors. Matrix metalloproteinase-9 (MMP-9) is involved in various stages of stroke pathology. MMP-9 inhibitors are potential stroke therapeutic agents. Little is known about the relation between MMP-9-after the acute stage-and clinical recovery. OBJECTIVE: The study aimed to investigate the serum level of MMP-9 at stroke onset as predictor of stroke outcome and the relation between the level of MMP-9 after 30 days and stroke recovery...
January 4, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28062805/intravenous-thrombolysis-before-endovascular-therapy-for-large-vessel-strokes-can-lead-to-significantly-higher-hospital-costs-without-improving-outcomes
#15
Ansaar T Rai, SoHyun Boo, Chelsea Buseman, Amelia K Adcock, Abdul R Tarabishy, Maurice M Miller, Thomas D Roberts, Jennifer R Domico, Jeffrey S Carpenter
BACKGROUND: Limited efficacy of IV recombinant tissue plasminogen activator (rt-PA) for large vessel occlusions (LVO) raises doubts about its utility prior to endovascular therapy. PURPOSE: To compare outcomes and hospital costs for anterior circulation LVOs (middle cerebral artery, internal carotid artery terminus (ICA-T)) treated with either primary endovascular therapy alone (EV-Only) or bridging therapy (IV+EV)). METHODS: A single-center retrospective analysis was performed...
January 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28062625/high-sensitivity-troponin-i-in-stable-patients-with-atherosclerotic-disease-in-the-tra-2%C3%A2-p-timi-50-trial
#16
Alon Eisen, Marc P Bonaca, Petr Jarolim, Benjamin M Scirica, Harvey D White, Michal Tendera, Mikael Dellborg, Jose C Nicolau, Joao Morais, Keith A A Fox, Erin A Bohula, Sabina A Murphy, Eugene Braunwald, David A Morrow
BACKGROUND: Cardiac troponin I, measured with a high-sensitivity assay (hs-TnI), is well-established for risk prediction in acute coronary syndromes. However, its prognostic role in stable atherosclerotic disease, particularly for future myocardial infarction (MI), is less well defined. METHODS: We measured hs-TnI (Abbott ARCHITECT) in 15833 patients with prior MI, ischemic stroke, or peripheral arterial disease from the placebo-controlled Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events (TRA 2°P)-Thrombolysis in Myocardial Infarction (TIMI) 50 trial of the platelet inhibitor vorapaxar, excluding patients with recent MI (<30 days)...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28059848/hemodynamic-monitoring-in-thoracic-surgical-patients
#17
Jacob Raphael, Lindsay A Regali, Robert H Thiele
PURPOSE OF REVIEW: This article reviews the technology and clinical data describing hemodynamic monitoring devices available to anesthesiologists and intensivists caring for patients undergoing thoracic surgical procedures, so that they may better utilize available technology to improve outcomes in this high-risk surgical population. RECENT FINDINGS: Noninvasive stroke volume monitors are based on several different technology platforms, all of which have distinct performance characteristics...
January 3, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28056847/impact-of-diabetes-and-hypertension-on-cardiovascular-outcomes-in-patients-with-coronary-artery-disease-receiving-percutaneous-coronary-intervention
#18
Mao-Jen Lin, Chun-Yu Chen, Hau-De Lin, Han-Ping Wu
BACKGROUND: Percutaneous coronary intervention (PCI) is a necessary procedure commonly performed for patients with coronary artery disease (CAD). However, the impact of diabetes and hypertension on long-term outcomes of patients after receiving PCI has not yet been determined. METHODS: The data of 1234 patients who received PCI were collected prospectively, and patients were divided into four groups, including patients with and without DM and those with either DM or hypertension alone...
January 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28056802/is-non-hdl-cholesterol-a-better-predictor-of-long-term-outcome-in-patients-after-acute-myocardial-infarction-compared-to-ldl-cholesterol-a-retrospective-study
#19
Wanwarang Wongcharoen, Satjatham Sutthiwutthichai, Siriluck Gunaparn, Arintaya Phrommintikul
BACKGROUND: It has recently been shown that non-high density lipoprotein cholesterol (non-HDL-C) may be a better predictor of cardiovascular risk than low density lipoprotein cholesterol (LDL-C). Based on known ethic differences in lipid parameters and cardiovascular risk prediction, we sought to study the predictability of attaining non-HDL-C target and long-term major adverse cardiovascular event (MACE) in Thai patients after acute myocardial infarction (AMI) compared to attaining LDL-C target...
January 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28056795/bleeding-outcomes-associated-with-rivaroxaban-and-dabigatran-in-patients-treated-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#20
Pravesh Kumar Bundhun, Mohammad Zafooruddin Sani Soogund, Abhishek Rishikesh Teeluck, Manish Pursun, Akash Bhurtu, Wei-Qiang Huang
BACKGROUND: Warfarin is commonly used as a secondary prevention of stroke in patients with atrial fibrillation (AF). However, limitations have been observed even with the use of this medication. Recently, several newer direct oral anticoagulants (DOACs) have been approved for use by the food and drug administrations. Unfortunately, these newer drugs have seldom been compared directly with each other. Therefore, this study aimed to compare the bleeding events associated with rivaroxaban and dabigatran in patients treated for non-valvular AF...
January 6, 2017: BMC Cardiovascular Disorders
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