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Stroke outcomes

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https://www.readbyqxmd.com/read/29775908/mirror-therapy-for-improving-lower-limb-motor-function-and-mobility-after-stroke-a-systematic-review-and-meta-analysis
#1
REVIEW
P Broderick, F Horgan, C Blake, M Ehrensberger, D Simpson, K Monaghan
BACKGROUND: Mirror therapy has been proposed as an effective intervention for lower limb rehabilitation post stroke. RESEARCH QUESTION: This systematic review with meta-analysis examined if lower limb mirror therapy improved the primary outcome measures of muscle tone and motor function and the secondary outcome measures balance characteristics, functional ambulation, walking velocity, passive range of motion (PROM) for ankle dorsiflexion and gait characteristics in patients with stroke compared to other interventions...
May 12, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29775605/outcomes-of-planned-2-stage-hybrid-aortic-repair-with-dacron-replaced-proximal-landing-zone
#2
David N Ranney, Babatunde A Yerokun, Ehsan Benrashid, Muath Bishawi, Adam Williams, Richard L McCann, G Chad Hughes
BACKGROUND: Results of hybrid arch repair (HAR) utilizing native zone 0 proximal landing zone (PLZ) have been unsatisfactory in many series, especially in the setting of ascending aortic dilation (>4.0 cm). This study reports early and late outcomes of planned 2-stage HAR with open 1st stage proximal aortic replacement (PAR) followed by 2nd stage thoracic endovascular aortic repair (TEVAR) with PLZ within the Dacron replaced zone 0. METHODS: N=34 patients underwent planned 2-stage HAR between 1/2006-8/2017...
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29774601/the-impact-of-mitral-stenosis-on-outcomes-of-aortic-valve-stenosis-patient-undergoing-surgical-aortic-valve-replacement-or-transcatheter-aortic-valve-replacement
#3
Yasser Al-Khadra, Fahed Darmoch, Motaz Baibars, Amir Kaki, Zaher Fanari, M Chadi Alraies
BACKGROUND: The concomitant presence of mitral stenosis (MS) in the setting of symptomatic aortic stenosis represent a clinical challenge. Little is known regarding the outcome of mitral stenosis (MS) patients undergoing transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). Therefore, we sought to study the outcome of MS patients undergoing aortic valve replacement (AVR). METHOD: Using weighted data from the National Inpatient Sample (NIS) database between 2011 and 2014, we identified patients who were diagnosed with MS...
May 17, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29774059/inflammation-in-stroke-the-role-of-cholinergic-purinergic-and-glutamatergic-signaling
#4
REVIEW
Abraham Martín, María Domercq, Carlos Matute
The inflammatory response is a major factor in stroke pathophysiology and contributes to secondary neuronal damage in both acute and chronic stages of the ischemic injury. Recent work in experimental cerebral ischemia has demonstrated the involvement of neurotransmitter signaling in the modulation of neuroinflammation. The present review discusses recent findings on the therapeutic potential and diagnostic perspectives of cholinergic, purinergic and glutamatergic receptors and transporters in experimental stroke...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29774055/immunotherapy-of-experimental-and-human-stroke-with-agents-approved-for-multiple-sclerosis-a-systematic-review
#5
REVIEW
Mirjam Dreikorn, Zeljko Milacic, Vladimir Pavlovic, Sven G Meuth, Christoph Kleinschnitz, Peter Kraft
Background: 'Thromboinflammation' describes a novel concept in stroke pathophysiology that has opened up the possibility of immunotherapeutic approaches which could become promising strategies for targeted stroke therapies in the future. Methods: We reviewed current evidence for agents approved for multiple sclerosis in preclinical and clinical stroke studies. A systematic review was performed in accordance with the PRISMA statement, searching MEDLINE, the Cochrane Central Register of Controlled Trials, and reference lists of articles published until 16 October 2017...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29774054/beta-adrenoceptor-blockade-ameliorates-impaired-glucose-tolerance-and-alterations-of-the-cerebral-ceramide-metabolism-in-an-experimental-model-of-ischemic-stroke
#6
Sebastian Luger, Annette Schwebler, Rajkumar Vutukuri, Nerea Ferreiros Bouzas, Sandra Labocha, Yannick Schreiber, Robert Brunkhorst, Helmuth Steinmetz, Josef Pfeilschifter, Waltraud Pfeilschifter
Background: Sphingolipids are versatile signaling molecules derived from membrane lipids of eukaryotic cells. Ceramides regulate cellular processes such as proliferation, differentiation and apoptosis and are involved in cellular stress responses. Experimental evidence suggests a pivotal role of sphingolipids in the pathogenesis of cardiovascular diseases, including ischemic stroke. A neuroprotective effect has been shown for beta-adrenergic antagonists in rodent stroke models and supported by observational clinical data...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29774008/repeated-endovascular-treatment-of-early-recurrent-proximal-middle-cerebral-artery-occlusion-case-report-and-brief-review-of-the-literature
#7
Simon Fandler, Hannes Deutschmann, Franz Fazekas, Thomas Gattringer
Mechanical thrombectomy (MT) is the gold standard treatment for large vessel occlusion (LVO) stroke of the anterior circulation. Whether MT can also be effectively and safely performed in early recurrent LVO is largely unclear. We present the case of a middle-aged patient who was successfully treated by MT for right proximal middle cerebral artery (MCA) occlusion with excellent outcome. One day after discharge (9 days after the first MT), the patient was readmitted with wake-up stroke. MRI again revealed right proximal MCA occlusion with severe diffusion-perfusion mismatch...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29773949/effect-of-dual-antiplatelet-on-recurrent-stroke-in-minor-stroke-or-tia-depends-on-bodyweight
#8
Yan Ma, Ying Liu, Jie Xu, Yilong Wang, Yongjun Wang, Fenghe Du
Objective: To assess whether bodyweight influences the efficacy and safety of dual antiplatelet therapy (DAT) in male patients with minor stroke or transient ischemic attack patients. Materials and methods: All 3,420 male participants coming from the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events trial were divided into 3 groups based on bodyweight (<65 kg, 65-75 kg, and ≥75 kg). The stroke outcomes included stroke recurrence, combined vascular events, and bleeding events during 90 days of follow-up...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29773716/thrombectomy-6-24-hours-after-stroke-in-trial-ineligible-patients
#9
Shashvat M Desai, Marcelo Rocha, Bradley J Molyneaux, Matthew Starr, Cynthia L Kenmuir, Bradley A Gross, Brian Thomas Jankowitz, Tudor G Jovin, Ashutosh P Jadhav
BACKGROUND AND PURPOSE: The DAWN and DEFUSE-3 trials demonstrated the benefit of endovascular thrombectomy (ET) in late-presenting acute ischemic strokes due to anterior circulation large vessel occlusion (ACLVO). Strict criteria were employed for patient selection. We sought to evaluate the characteristics and outcomes of patients treated outside these trials. METHODS: A retrospective review of acute ischemic stroke admissions to a single comprehensive stroke center was performed during the DAWN trial enrollment period (November 2014 to February 2017) to identify all patients presenting in the 6-24 hour time window...
May 17, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29773715/embolus-retriever-with-interlinked-cages-versus-other-stent-retrievers-in-acute-ischemic-stroke-an-observational-comparative-study
#10
Philipp Gruber, Salome Zeller, Carlos Garcia-Esperon, Jatta Berberat, Javier Anon, Michael Diepers, Krassen Nedeltchev, Fabian Flottmann, Jens Fiehler, Luca Remonda, Timo Kahles
BACKGROUND AND PURPOSE: Given the promising performance of the new Embolus Retriever with Interlinked Cages (ERIC) in smaller case series, we sought to assess the efficacy and safety of mechanical thrombectomy (MT) with ERIC compared with other stent retrievers (SRs) in acute ischemic stroke due to large vessel occlusion (LVO). METHODS: We reviewed the databases of two comprehensive stroke centers in in Germany and Switzerland for MT due to LVO in the anterior circulation with either ERIC or another SR as a first device...
May 17, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29773712/acute-kidney-injury-and-risk-of-heart-failure-and-atherosclerotic-events
#11
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/29773579/use-rate-and-outcome-in-bilateral-internal-thoracic-artery-grafting-insights-from-a-systematic-review-and-meta-analysis
#12
REVIEW
Mario Gaudino, Faisal Bakaeen, Umberto Benedetto, Mohamed Rahouma, Antonino Di Franco, Derrick Y Tam, Mario Iannaccone, Thomas A Schwann, Robert Habib, Marc Ruel, John D Puskas, Joseph Sabik, Leonard N Girardi, David P Taggart, Stephen E Fremes
BACKGROUND: This meta-analysis was designed to assess whether center experience affects the short- and long-term results and the relative benefits of bilateral internal thoracic artery grafting (BITA) for coronary artery bypass grafting. METHODS AND RESULTS: MEDLINE and EMBASE were searched to identify all articles reporting the outcome of BITA in patients undergoing coronary artery bypass grafting. The BITA center experience was gauged according to the percentage use of BITA in the institutional overall coronary artery bypass grafting population (%BITA)...
May 17, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29773577/determinants-and-outcomes-of-vasoplegia-following-left-ventricular-assist-device-implantation
#13
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/29773569/mobile-stroke-unit-reduces-time-to-image-acquisition-and-reporting
#14
E M Nyberg, J R Cox, R G Kowalski, D V Duarte, B Schimpf, W J Jones
Timely administration of thrombolytic therapy is critical to maximizing the likelihood of favorable outcomes in patients with acute ischemic stroke. Although emergency medical service activation overall improves the timeliness of acute stroke treatment, the time from emergency medical service dispatch to hospital arrival unavoidably decreases the timeliness of thrombolytic administration. Our mobile stroke unit, a new-generation ambulance with on-board CT scanning capability, reduces key imaging time metrics and facilitates in-the-field delivery of IV thrombolytic therapy...
May 17, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29770736/carotid-artery-stenosis-screening-where-are-we-now
#15
Rebecca Mortimer, Subramanian Nachiappan, David C Howlett
Stroke poses a significant burden on healthcare and is the second largest cause of death globally. Both medical and surgical interventions to reduce the risk of stroke in asymptomatic patients have been shown to be effective but identifying the target at risk population is more problematic. Screening for carotid artery stenosis offers one pathway for this, as there is some correlation between risk of stroke and extent of stenosis. Identification of patients who are at risk of cardiovascular disease as well as stroke, allows initiation of effective medical treatment of modifiable risk factors to address this risk...
May 17, 2018: British Journal of Radiology
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
#16
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/29770439/increase-of-frontal-neuronal-activity-in-chronic-neglect-after-training-in-virtual-reality
#17
U Ekman, H Fordell, J Eriksson, N Lenfeldt, A Wåhlin, A Eklund, J Malm
OBJECTIVES: A third of patients with stroke acquire spatial neglect associated with poor rehabilitation outcome. New effective rehabilitation interventions are needed. Scanning training combined with multisensory stimulation to enhance the rehabilitation effect is suggested. In accordance, we have designed a virtual-reality based scanning training that combines visual, audio and sensori-motor stimulation called RehAtt® . Effects were shown in behavioural tests and activity of daily living...
May 16, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29770431/outcome-in-lacunar-stroke-a-cohort-study
#18
V Mantero, C Scaccabarozzi, E Botto, G Giussani, A Aliprandi, A Lunghi, E Ciusani, G Brenna, A Salmaggi
OBJECTIVES: We evaluated a prospective cohort of 150 patients under observation in our centre for lacunar strokes. The purpose of this study was to evaluate the outcome at time of discharge and 6 months after lacunar stroke, as well as the correlation with cardiovascular risk factors and selected biochemical parameters already evaluated on admission. Focus was to identify possible prognostic factors, which might be targeted through appropriate intervention concentrating on reduction in the incidence and impact of early clinical deterioration...
May 16, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29770231/cardiovascular-outcomes-of-pcsk9-inhibitors-with-special-emphasis-on-its-effect-beyond-ldl-cholesterol-lowering
#19
REVIEW
Dhrubajyoti Bandyopadhyay, Kumar Ashish, Adrija Hajra, Arshna Qureshi, Raktim K Ghosh
PCSK9 inhibitors, monoclonal antibodies, are novel antihypercholesterolemic drugs. FDA first approved them in July 2015. PCSK9 protein (692-amino acids) was discovered in 2003. It plays a major role in LDL receptor degradation and is a prominent modulator in low-density lipoprotein cholesterol (LDL-C) metabolism. PCSK9 inhibitors are monoclonal antibodies that target PCSK9 protein in liver and inhibiting this protein leads to drastically lowering harmful LDL-C level in the bloodstream. Despite widespread use of the statin, not all the high-risk patients were able to achieve targeted level of LDL-C...
2018: Journal of Lipids
https://www.readbyqxmd.com/read/29770166/free-radical-damage-in-ischemia-reperfusion-injury-an-obstacle-in-acute-ischemic-stroke-after-revascularization-therapy
#20
REVIEW
Ming-Shuo Sun, Hang Jin, Xin Sun, Shuo Huang, Fu-Liang Zhang, Zhen-Ni Guo, Yi Yang
Acute ischemic stroke is a common cause of morbidity and mortality worldwide. Thrombolysis with recombinant tissue plasminogen activator and endovascular thrombectomy are the main revascularization therapies for acute ischemic stroke. However, ischemia-reperfusion injury after revascularization therapy can result in worsening outcomes. Among all possible pathological mechanisms of ischemia-reperfusion injury, free radical damage (mainly oxidative/nitrosative stress injury) has been found to play a key role in the process...
2018: Oxidative Medicine and Cellular Longevity
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