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Stroke outcomes

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https://www.readbyqxmd.com/read/28550709/effect-of-renal-function-status-on-the-prognostic-value-of-heart-rate-in-acute-ischemic-stroke-patients
#1
Zhengbao Zhu, Chongke Zhong, Tian Xu, Aili Wang, Yanbo Peng, Tan Xu, Hao Peng, Chung-Shiuan Chen, Jinchao Wang, Zhong Ju, Qunwei Li, Deqin Geng, Yingxian Sun, Qingjuan Du, Yongqiu Li, Jing Chen, Yonghong Zhang, Jiang He
BACKGROUND AND AIMS: The association between heart rate and prognosis of ischemic stroke remains debatable, and whether renal function status influences the relationship between them is still not elucidated. METHODS: A total of 3923 ischemic stroke patients were included in this prospective multicenter study from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). The primary outcome was a combination of death and major disability (modified Rankin Scale score ≥3) at 3 months after stroke...
May 19, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28550481/antiplatelet-pretreatment-and-outcomes-in-intravenous-thrombolysis-for-stroke-a-systematic-review-and-meta-analysis
#2
Georgios Tsivgoulis, Aristeidis H Katsanos, Ramin Zand, Vijay K Sharma, Martin Köhrmann, Sotirios Giannopoulos, Efthymios Dardiotis, Anne W Alexandrov, Panayiotis D Mitsias, Peter D Schellinger, Andrei V Alexandrov
Since there are contradictory data regarding the association of antiplatelet pretreatment (AP) with safety and efficacy outcomes of intravenous thrombolysis (IVT) for acute ischemic stroke (AIS), we conducted a systematic review and meta-analysis of available randomized-controlled clinical trials (RCTs) to investigate the association of AP with outcomes of AIS patients treated with intravenous alteplase. The outcome events of interest included symptomatic intracranial hemorrhage (sICH), fatal ICH, complete recanalization (CR), 3-month favorable functional outcome (FFO, mRS score 0-1), 3-month functional independence (FI, mRS score 0-2), and mortality...
May 26, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28550195/dipeptidyl-peptidase-4-inhibition-stimulates-distal-tubular-natriuresis-and-increases-in-circulating-sdf-1%C3%AE-1-67-in-patients-with-type-2-diabetes
#3
Julie A Lovshin, Harindra Rajasekeran, Yulyia Lytvyn, Leif E Lovblom, Shajiha Khan, Robel Alemu, Amy Locke, Vesta Lai, Huaibing He, Lucinda Hittle, Weixun Wang, Daniel J Drucker, David Z I Cherney
OBJECTIVE: Antihyperglycemic agents, such as empagliflozin, stimulate proximal tubular natriuresis and improve cardiovascular and renal outcomes in patients with type 2 diabetes. Because dipeptidyl peptidase 4 (DPP-4) inhibitors are used in combination with sodium-glucose cotransporter 2 (SGLT-2) inhibitors, we examined whether and how sitagliptin modulates fractional sodium excretion and renal and systemic hemodynamic function. RESEARCH DESIGN AND METHODS: We studied 32 patients with type 2 diabetes in a prospective, double-blind, randomized, placebo-controlled trial...
May 26, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28550100/an-alternative-surgical-approach-reduces-variability-following-filament-induction-of-experimental-stroke-in-mice
#4
M Trotman-Lucas, M E Kelly, J Janus, R Fern, C L Gibson
Animal models are critical for understanding the pathology of stroke and investigating potential treatments. However, in vivo stroke models are associated, particularly in mice, with high variability in lesion volume. We investigated whether a surgical refinement where reperfusion is not reliant on the Circle of Willis reduced outcome variability. Mice underwent 60 minutes of transient middle cerebral artery occlusion avoiding ligation of the external carotid artery. During reperfusion the common carotid artery was either ligated (standard approach), or it was repaired to allow re-establishment of blood flow through the common carotid artery...
May 26, 2017: Disease Models & Mechanisms
https://www.readbyqxmd.com/read/28550098/contralesional-brain-computer-interface-control-of-a-powered-exoskeleton-for-motor-recovery-in-chronic-stroke-survivors
#5
David T Bundy, Lauren Souders, Kelly Baranyai, Laura Leonard, Gerwin Schalk, Robert Coker, Daniel W Moran, Thy Huskey, Eric C Leuthardt
BACKGROUND AND PURPOSE: There are few effective therapies to achieve functional recovery from motor-related disabilities affecting the upper limb after stroke. This feasibility study tested whether a powered exoskeleton driven by a brain-computer interface (BCI), using neural activity from the unaffected cortical hemisphere, could affect motor recovery in chronic hemiparetic stroke survivors. This novel system was designed and configured for a home-based setting to test the feasibility of BCI-driven neurorehabilitation in outpatient environments...
May 26, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28549958/a-novel-antegrade-approach-for-simultaneous-carotid-endarterectomy-and-angioplasty-of-proximal-lesions-in-patients-with-tandem-stenosis-of-supraaortic-arch-vessels
#6
Djordje Radak, Slobodan Tanaskovic, Dragan Sagic, Zelimir Antonic, Predrag Gajin, Srdjan Babic, Mihailo Neskovic, Predrag Matic, Vladimir Kovacevic, Dragoslav Nenezic, Nenad Ilijevski
INTRODUCTION: To date all published studies analyzing simultaneous treatment of carotid and proximal atherosclerotic lesions are describing retrograde approach and several technical variations. In the presented study, for the first time antegrade approach is described for simultaneous carotid endarterectomy (CEA) and associated brachiocephalic trunk (BCT) or common carotid artery (CCA) angioplasty in the hybrid operating room. METHODOLOGY: From January 2012 till January 2016 antegrade hybrid procedures were performed in 18 patients...
May 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28549755/cholesterol-and-stroke-roll-of-pcsk9-inhibitors
#7
L Castilla-Guerra, M C Fernández-Moreno, M A Rico-Corral
INTRODUCTION: Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays an important role in the modulation of plasma levels of low density lipoprotein cholesterol (LDLC). PCSK9 binds to the LDL receptor (LDLR), disrupts its endocytic recycling itinerary and directs it to lysosomal degradation. Activation of PCSK9 can thus decrease the expression of LDLR in the liver and inhibit LDL uptake, which leads to hypercholesterolaemia. DEVELOPMENT: Currently we now know that different polymorphisms of PCSK9 are associated with the occurrence of ischaemic stroke...
May 23, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28549705/association-of-grip-strength-with-risk-of-all-cause-mortality-cardiovascular-diseases-and-cancer-in-community-dwelling-populations-a-meta-analysis-of-prospective-cohort-studies
#8
Yili Wu, Weijing Wang, Tianwei Liu, Dongfeng Zhang
OBJECTIVES: Grip strength has been linked to risk of adverse health outcomes. This study aimed to quantitatively assess the associations between grip strength and risk of all-cause mortality, cardiovascular diseases, and cancer in community-dwelling populations. DESIGN: A meta-analysis of prospective cohort studies was conducted. SETTING: Embase, Medline, and PubMed were searched from inception to September 14, 2016. Study-specific most adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were combined with a random effects model...
June 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28549648/characterization-of-long-term-gait-deficits-in-mouse-dmcao-using-the-catwalk-system
#9
E Caballero-Garrido, J C Pena-Philippides, Z Galochkina, E Erhardt, T Roitbak
Evaluation of functional outcome is widely used across species to assess the recovery process following various pathological conditions, including spinal cord injury, musculo-skeletal injury, mithochondrial disease, neuropathic cancer, Huntington's disease, chronic pain, cortical lesion, and olivocerebellar degeneration among others. The Stroke Therapy Academic Industry Roundtable (STAIR) recommends multiple endpoints for behavioral studies in pre-clinical stroke research, to demonstrate their clinical relevance...
May 23, 2017: Behavioural Brain Research
https://www.readbyqxmd.com/read/28549277/reliability-of-lower-limb-transcranial-magnetic-stimulation-outcomes-in-the-ipsi-and-contralesional-hemispheres-of-adults-with-chronic-stroke
#10
Louis-David Beaulieu, Hugo Massé-Alarie, Edith Ribot-Ciscar, Cyril Schneider
OBJECTIVE: To investigate the ability of transcranial magnetic stimulation (TMS) outcomes in the chronic stroke population to (i) track individual plastic changes and (ii) detect differences between individuals. To this end, intrarater "test-retest" reliability (relative and absolute) was tested for the ipsilesional and contralesional hemispheres. METHODS: Thirteen participants with a unilateral stroke (≥6months ago) and sensorimotor impairments were enrolled...
May 9, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28549269/high-hair-cortisol-concentrations-predict-worse-cognitive-outcome-after-stroke-results-from-the-tabasco-prospective-cohort-study
#11
E Ben Assayag, O Tene, A D Korczyn, L Shopin, E Auriel, J Molad, H Hallevi, C Kirschbaum, N M Bornstein, S Shenhar-Tsarfaty, E Kliper, T Stalder
BACKGROUND AND PURPOSE: The role of stress-related endocrine dysregulation in the development of cognitive changes following a stroke needs further elucidation. We explored this issue in a longitudinal study on stroke survivors using hair cortisol concentrations (HCC), a measure of integrated long-term cortisol levels. METHODS: Participants were consecutive cognitively intact first-ever mild-moderate ischemic stroke/transient ischemic attack (TIA) survivors from the Tel Aviv Brain Acute Stroke Cohort (TABASCO) study...
May 18, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28549099/impact-of-resident-and-fellow-changeovers-on-patient-outcomes-a-nationwide-cross-sectional-study
#12
Jean-David Zeitoun, Jeanne Reboul-Marty, Jérémie H Lefèvre
Findings regarding the association of cohort changeovers with patient outcomes are mixed. We sought to examine the association of resident and fellow changeovers with a comprehensive set of indicators. We performed a cross-sectional comparative study including all French teaching and non-teaching hospitals. All-cause mortality and length of stay were assessed. Focused analysis for three medical conditions (myocardial infarction, intestinal hemorrhage, stroke) and three surgical procedures (colorectal, vascular and spine surgery) was performed regarding other quality and efficiency indicators (readmissions, intensive care unit admission, transfers)...
May 25, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28549087/thalamic-alterations-remote-to-infarct-appear-as-focal-iron-accumulation-and-impact-clinical-outcome
#13
Grégory Kuchcinski, Fanny Munsch, Renaud Lopes, Antoine Bigourdan, Jason Su, Sharmila Sagnier, Pauline Renou, Jean-Pierre Pruvo, Brian K Rutt, Vincent Dousset, Igor Sibon, Thomas Tourdias
Thalamic alterations have been observed in infarcts initially sparing the thalamus but interrupting thalamo-cortical or cortico-thalamic projections. We aimed at extending this knowledge by demonstrating with in vivo imaging sensitive to iron accumulation, one marker of neurodegeneration, that (i) secondary thalamic alterations are focally located in specific thalamic nuclei depending on the initial infarct location; and (ii) such secondary alterations can contribute independently to the long-term outcome. To tackle this issue, 172 patients with an infarct initially sparing the thalamus were prospectively evaluated clinically and with magnetic resonance imaging to quantify iron through R2* map at 24-72 h and at 1-year follow-up...
May 25, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28549027/a-minimally-invasive-stand-alone-cox-maze-procedure-is-as-effective-as-median-sternotomy-approach
#14
Matthew R Schill, Laurie A Sinn, Jason W Greenberg, Matthew C Henn, Timothy S Lancaster, Richard B Schuessler, Hersh S Maniar, Ralph J Damiano
OBJECTIVE: The Cox-Maze IV procedure has been shown to be an effective treatment for atrial fibrillation when performed concomitantly with other operations either via median sternotomy or right minithoracotomy. Few studies have compared these approaches in patients with lone atrial fibrillation. This study examined outcomes with sternotomy versus minithoracotomy in stand-alone Cox-Maze IV procedures at our institution. METHODS: Between 2002 and 2015, 195 patients underwent stand-alone biatrial Cox-Maze IV...
May 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28549013/effect-of-preoperative-diabetes-management-on-glycemic-control-and-clinical-outcomes-after-elective-surgery
#15
Rajesh Garg, Brooke Schuman, Angela Bader, Shelley Hurwitz, Alexander Turchin, Patricia Underwood, Cheyenne Metzger, Raquel Rein, Meghan Lortie
OBJECTIVE: The aim of this study was to evaluate whether preoperative diabetes management can improve glycemic control and clinical outcomes after elective surgery. BACKGROUND: There is lack of data on the importance of diabetes treatment before elective surgery. Diabetes is often ignored before surgery and aggressively treated afterwards. METHODS: Patients with diabetes were identified and treated proactively before their scheduled surgeries...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28548595/effect-of-treatment-modality-on-in-hospital-outcome-in-patients-with-subarachnoid-hemorrhage-a-nationwide-study-in-japan-j-aspect-study
#16
Ryota Kurogi, Akiko Kada, Kunihiro Nishimura, Satoru Kamitani, Ataru Nishimura, Tetsuro Sayama, Jyoji Nakagawara, Kazunori Toyoda, Kuniaki Ogasawara, Junichi Ono, Yoshiaki Shiokawa, Toru Aruga, Shigeru Miyachi, Izumi Nagata, Shinya Matsuda, Shinichi Yoshimura, Kazuo Okuchi, Akifumi Suzuki, Fumiaki Nakamura, Daisuke Onozuka, Akihito Hagihara, Koji Iihara
OBJECTIVE Although heterogeneity in patient outcomes following subarachnoid hemorrhage (SAH) has been observed across different centers, the relative merits of clipping and coiling for SAH remain unknown. The authors sought to compare the patient outcomes between these therapeutic modalities using a large nationwide discharge database encompassing hospitals with different comprehensive stroke center (CSC) capabilities. METHODS They analyzed data from 5214 patients with SAH (clipping 3624, coiling 1590) who had been urgently hospitalized at 393 institutions in Japan in the period from April 2012 to March 2013...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28548476/is-cold-blood-cardioplegia-absolutely-superior-to-cold-crystalloid-cardioplegia-in-aortic-valve-surgery
#17
Daniel A Lerman, Matilde Otero-Losada, Kiddy Ume, Pablo A Salgado, Sai Prasad, Kelvin Lim, Bruno Péault, Nasri Alotti
BACKGROUND: Experimental evidence suggests that blood cardioplegia (BCP) may be superior to cold crystalloid cardioplegia (CCP) for myocardial protection. However, robust clinical data are lacking. We compared post-operative outcome of patients undergoing aortic valve replacement (AVR) using cold anterograde-retrograde intermittent BCP versus anterograde (CCP). METHODS: Adult consecutive isolated AVR performed between April 2006 and February 2011 at the Royal Infirmary Hospital of Edinburgh were retrospectively analyzed...
May 26, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28548204/endovascular-treatment-for-ruptured-abdominal-aortic-aneurysm
#18
REVIEW
Stephen Badger, Rachel Forster, Paul H Blair, Peter Ellis, Frank Kee, Denis W Harkin
BACKGROUND: An abdominal aortic aneurysm (AAA) (pathological enlargement of the aorta) is a condition that can occur as a person ages. It is most commonly seen in men older than 65 years of age. Progressive aneurysm enlargement can lead to rupture and massive internal bleeding, which is fatal unless timely repair can be achieved. Despite improvements in perioperative care, mortality remains high (approximately 50%) after conventional open surgical repair. Endovascular aneurysm repair (EVAR), a minimally invasive technique, has been shown to reduce early morbidity and mortality as compared to conventional open surgery for planned AAA repair...
May 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28547922/videofluoroscopic-assessment-of-the-pathophysiology-of-chronic-poststroke-oropharyngeal-dysphagia
#19
N Vilardell, L Rofes, V Arreola, A Martin, D Muriana, E Palomeras, O Ortega, P Clavé
BACKGROUND AND PURPOSE: Oropharyngeal dysphagia (OD) is a major complaint following stroke, associated with poor clinical outcome and high mortality rates. We aimed at characterizing the kinematics of swallow response associated with unsafe swallowing in chronic poststroke patients with OD. PATIENTS AND METHODS: Consecutive poststroke patients with a positive volume-viscosity swallow test for OD 3 months following stroke were studied by videofluoroscopy (VFS). Demographical and clinical factors and kinematics of swallow response were compared between those poststroke patients with safe swallow (penetration-aspiration scale, PAS≤2) and those with unsafe swallow (PAS≥3)...
May 25, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28546328/microrna-15a-16-1-antagomir-ameliorates-ischemic-brain-injury-in-experimental-stroke
#20
Xinxin Yang, Xuelian Tang, Ping Sun, Yejie Shi, Kai Liu, Sulaiman H Hassan, R Anne Stetler, Jun Chen, Ke-Jie Yin
BACKGROUND AND PURPOSE: Dysregulation of the miR-15a/16-1 cluster in plasma has been reported in patients with stroke as a potential biomarker for diagnostic and prognostic use. However, the essential role and therapeutic potential of the miR-15a/16-1 cluster in ischemic stroke are poorly understood. This study is aimed at investigating the regulatory role of the miR-15a/16-1 cluster in ischemic brain injury and insight mechanisms. METHODS: Adult male miR-15a/16-1 knockout and wild-type mice, or adult male C57 BL/6J mice injected via tail vein with the miR-15a/16-1-specific inhibitor (antagomir, 30 pmol/g), were subjected to 1 hour of middle cerebral artery occlusion and 72 hours of reperfusion...
May 25, 2017: Stroke; a Journal of Cerebral Circulation
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