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https://www.readbyqxmd.com/read/29352151/effects-of-genetic-variants-on-platelet-reactivity-and-one-year-clinical-outcomes-after-percutaneous-coronary-intervention-a-prospective-multicentre-registry-study
#1
Hyung Joon Joo, Sung Gyun Ahn, Jae Hyoung Park, Ji Young Park, Soon Jun Hong, Seok-Yeon Kim, WoongGil Choi, HyeonCheol Gwon, Young-Hyo Lim, Weon Kim, Woong Chol Kang, Yun-Hyeong Cho, Yong Hoon Kim, JungHan Yoon, WonYong Shin, Myeong-Ki Hong, Scot Garg, Yangsoo Jang, Do-Sun Lim
Clopidogrel is the mainstay for antiplatelet treatment after percutaneous coronary intervention (PCI). The relationship of platelet reactivity and genetic polymorphism with clinical outcomes with newer-generation drug-eluting stents is unclear. We analysed 4,587 patients for the most powerful single-nucleotide polymorphisms (CYP2C19, CYP2C9, ABCB1, PON1, and P2Y12) related to on-treatment platelet reactivity (OPR). The optimal cut-off value of high OPR for major adverse thrombotic events was 266. CYP2C19 was significantly associated with high OPR and the number of CYP2C19*R (*2 or *3) alleles was proportional to the increased risk of high OPR...
January 19, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29352059/increased-blood-pressure-variability-after-endovascular-thrombectomy-for-acute-stroke-is-associated-with-worse-clinical-outcome
#2
Alicia E Bennett, Michael J Wilder, J Scott McNally, Jana J Wold, Gregory J Stoddard, Jennifer J Majersik, Safdar Ansari, Adam de Havenon
BACKGROUND AND PURPOSE: Blood pressure variability has been found to contribute to worse outcomes after intravenous tissue plasminogen activator, but the association has not been established after intra-arterial therapies. METHODS: We retrospectively reviewed patients with an ischemic stroke treated with intra-arterial therapies from 2005 to 2015. Blood pressure variability was measured as standard deviation (SD), coefficient of variation (CV), and successive variation (SV)...
January 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29352054/increased-blood-brain-barrier-permeability-in-contralateral-hemisphere-predicts-worse-outcome-in-acute-ischemic-stroke-after-reperfusion-therapy
#3
Chang Liu, Shenqiang Yan, Ruiting Zhang, Zhicai Chen, Feina Shi, Ying Zhou, Meixia Zhang, Min Lou
AIMS: We sought to investigate the risk factors of blood-brain barrier (BBB) disruption, and its potential impact on 90-day clinical outcome in acute ischemic stroke (AIS) patients after reperfusion therapy. METHODS: Consecutive acute anterior circulation AIS patients imaged with computed tomographic perfusion (CTP) before reperfusion therapy were included. Tmax >6 s was used for the volumetric measurement of the hypoperfusion area. BBB permeability (BBBP) was calculated as the average relative permeability-surface area product (rPS) within the hypoperfusion region (rPShypo-i) and its contralateral mirror region (rPShypo-c) on CTP-derived PS color maps...
January 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29352007/outcomes-in-anticoagulated-patients-with-atrial-fibrillation-and-with-mitral-or-aortic-valve-disease
#4
Dragos Vinereanu, Alice Wang, Hillary Mulder, Renato D Lopes, Petr Jansky, Basil S Lewis, Bernard J Gersh, Alvaro Avezum, Michael Hanna, Claes Held, Lars Wallentin, Christopher B Granger, John H Alexander
OBJECTIVE: To assess stroke/systemic embolism, major bleeding and other outcomes, and treatment effect of apixaban versus warfarin, in patients with atrial fibrillation (AF) and different types of valvular heart disease (VHD), using data from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation trial. METHODS: There were 14 793 patients with known VHD status, categorised as having moderate or severe mitral regurgitation (MR) (n=3382), aortic regurgitation (AR) (n=842) or aortic stenosis (AS) (n=324); patients with moderate or severe mitral stenosis were excluded from the trial...
January 19, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29351787/scl20a2-mutation-presenting-with-acute-ischemic-stroke-a-case-report
#5
Xiaoyu Zhang, Gaoting Ma, Zhangning Zhao, Meijia Zhu
BACKGROUND: Primary familial brain calcification (PFBC) is a rare disorder characterized by distinctive bilateral brain calcification and variable clinical presentations. However, cerebrovascular attack was rarely reported in PFBC patients. We here reported a SLC20A2 mutation patient presenting with acute ischemic stroke. CASE PRESENTATION: A 56 years old man was transferred to our hospital because of 6 days of melena and 3 days of somnolence, agitation and mood changes...
January 19, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29351610/orthotopic-branched-endovascular-aortic-arch-repair-in-patients-who-cannot-undergo-classical-surgery
#6
Martin Czerny, Bartosz Rylski, Julia Morlock, Holger Schröfel, Friedhelm Beyersdorf, Bertrand Saint Lebes, Olivier Meyrignac, Fatima Mokrane, Mario Lescan, Christian Schlensak, Constatijn Hazenberg, Trijntje Bloemert-Tuin, Sue Braithwaite, Joost van Herwaarden, Herve Rousseau
OBJECTIVES: Our goal was to assess the results after orthotopic branched endovascular aortic arch repair using a new double-branch endoprosthesis in patients with thoracic aortic disease affecting the aortic arch who cannot undergo classical surgery. METHODS: Within a 4-year period, 15 patients with thoracic aortic disease affecting the aortic arch were treated with the Bolton Relay plus double-branch endoprosthesis (Bolton Medical, Sunrise, FL, USA). We assessed clinical outcome, occurrence of endoleaks and the need for secondary interventions...
January 16, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29351145/recent-evidence-on-early-mobilization-in-critical-ill-patients
#7
Kristina Fuest, Stefan J Schaller
PURPOSE OF REVIEW: To examine the benefits of early mobilization and summarize the results of most recent clinical studies examining early mobilization in critically ill patients followed by a presentation of recent developments in the field. RECENT FINDINGS: Early mobilization of ICU patients, defined as mobilization within 72 h of ICU admission, is still uncommon. In medical and surgical critically ill patients, mobilization is well tolerated even in intubated patients...
January 17, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29350878/perfusion-ct-in-posterior-circulation-stroke-predictors-and-prognostic-implications-of-focal-hypoperfusion
#8
Lars-Peder Pallesen, Dimitris Lambrou, Ashraf Eskandari, Jessica Barlinn, Kristian Barlinn, Heinz Reichmann, Vincent Dunet, Philippe Maeder, Volker Puetz, Patrik Michel
BACKGROUND: We aimed to determine predictors of focal hypoperfusion on CT Perfusion (CTP) in patients with acute posterior circulation stroke and its association with long-term outcome. METHODS: We selected patients with posterior circulation stroke from the Acute STroke Registry and Analysis of Lausanne (ASTRAL) who underwent CTP within 24 hours of stroke onset as part of the stroke imaging protocol. Hypoperfusion was defined as an area of visually well demarcated mean-transit-time (MTT) prolongation corresponding to an arterial territory on standard reconstruction CTP imaging maps...
January 19, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29350803/thrombectomy-outcomes-for-acute-stroke-patients-with-anterior-circulation-tandem-lesions-a-clinical-registry-and-an-update-of-systematic-review-with-meta-analysis
#9
Udi Sadeh-Gonik, Noam Tau, Tal Friehmann, Serge Bracard, René Anxionnat, Anne-Laure Derelle, Romain Tonnelet, Liang Lia, Sébastien Richard, Xavier Armoiry, Benjamin Gory
BACKGROUND AND PURPOSE: Although mechanical thrombectomy (MT) appears to be superior in stroke patients with extracranial carotid disease (ECD) compared to thrombolysis alone, the impact of emergent carotid stenting during MT remains unclear. We assessed the MT outcomes in anterior stroke patients with ECD, especially when combined with carotid stenting. METHODS: We performed a retrospective analysis of our registry and conducted an update of a systematic review and meta-analysis of MT studies with or without stenting for anterior circulation stroke with ECD published between November 2010 and April 2017...
January 19, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29350569/practice-pearl-liraglutide-and-cardiovascular-and-renal-events-in-type-2-diabetes
#10
Robert Guthrie
Review of: Marso S, Daniels G, Brown-Frandsen K, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2016; 375: 311-322. Mann J, Orsted D, Brown-Frandsen K, et al. Liraglutide and Renal Outcomes in Type 2 Diabetes. N Engl J Med 2017; 377: 839-848. This comprehensive research project, LEADER, led to two reports, one focusing on the effect of liraglutide on cardiovascular events, and the second one reporting on the renal effects on the same study population. The study group included 9340 patients with type 2 diabetes...
January 19, 2018: Postgraduate Medicine
https://www.readbyqxmd.com/read/29350390/dual-antiplatelet-therapy-is-safe-and-efficient-after-left-atrial-appendage-closure
#11
Jakub Maksym, Tomasz Mazurek, Janusz Kochman, Marek Grygier, Agnieszka Kapłon-Cieślicka, Michał Marchel, Piotr Lodziński, Radosław Piątkowski, Radosław Wilimski, Paweł Czub, Anna Fojt, Natalia Karolczak, Piotr Hendzel, Grzegorz Opolski
BACKGROUND: Despite of PROTECT AF trial results many patients undergoing left atrial appendage closure (LAAC) have unconditional contraindications to warfarin. AIM: We sought to investigate whether double antiplatelet therapy (DAPT) is safe in patients after LAAC. METHODS: 44 (22 males, mean age 74±7.8) consecutive patients with non-valvular atrial fibrillation (NVAF) underwent LAAC procedure using Watchman device followed by DAPT (75 mg Aspirin and 75 mg Clopidogrel)...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350091/stent-assisted-coiling-of-cerebral-aneurysms-with-the-neuroform-atlas-stent
#12
Ferdi Cay, Ahmet Peker, Anıl Arat
Objectives The Neuroform Atlas stent (AS) is the smallest intracranial stent with an open-cell design. This study reports the first clinical experience with AS. Methods All intracranial aneurysms treated by stent-assisted coiling using a single AS in a single institution were retrospectively evaluated. Patient demographics, aneurysm characteristics, angles between the parent artery and stented branch, technical success, and clinical and angiographic follow-up were analyzed. Results Fifty-five consecutive aneurysms treated with AS-assisted coiling were included...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29349881/speech-and-language-therapists-perspectives-of-therapeutic-alliance-construction-and-maintenance-in-aphasia-rehabilitation-post-stroke
#13
Michelle Lawton, Karen Sage, Gillian Haddock, Paul Conroy, Laura Serrant
BACKGROUND: Therapeutic alliance refers to the interactional and relational processes operating during therapeutic interventions. It has been shown to be a strong determinant of treatment efficacy in psychotherapy, and evidence is emerging from a range of healthcare and medical disciplines to suggest that the construct of therapeutic alliance may in fact be a variable component of treatment outcome, engagement and satisfaction. Although this construct appears to be highly relevant to aphasia rehabilitation, no research to date has attempted to explore this phenomenon and thus consider its potential utility as a mechanism for change...
January 18, 2018: International Journal of Language & Communication Disorders
https://www.readbyqxmd.com/read/29349838/patent-foramen-ovale-repair-at-the-time-of-double-lung-transplantation-necessary-or-not
#14
Nicholas R Hess, Stephen A Esper, Marie Tuft, Matthew Morrell, Jonathan D'Cunha
INTRODUCTION: Patient foramen ovale (PFO) is a common and often incidental intraoperative finding during lung transplantation (LTx). We sought to characterize the potential outcomes related to the decision-making of whether the PFO was repaired or left unrepaired. METHODS: We retrospectively evaluated bilateral LTx recipients between 2005 and 2015 from our prospective database. Incidence of postoperative stoke, 90-day mortality, and overall survival was compared between the PFO-positive and PFO-negative groups, and secondly compared between repaired PFO (rPFO) and non-repaired PFO (nrPFO) groups...
January 19, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29349639/outcomes-in-syncope-research-a-systematic-review-and-critical-appraisal
#15
Monica Solbiati, Viviana Bozzano, Franca Barbic, Giovanni Casazza, Franca Dipaola, James V Quinn, Matthew J Reed, Robert S Sheldon, Win-Kuang Shen, Benjamin C Sun, Venkatesh Thiruganasambandamoorthy, Raffaello Furlan, Giorgio Costantino
Syncope is the common clinical manifestation of different diseases, and this makes it difficult to define what outcomes should be considered in prognostic studies. The aim of this study is to critically analyze the outcomes considered in syncope studies through systematic review and expert consensus. We performed a systematic review of the literature to identify prospective studies enrolling consecutive patients presenting to the Emergency Department with syncope, with data on the characteristics and incidence of short-term outcomes...
January 18, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29348677/the-proliferation-capacity-of-cultured-neural-stem-cells-promoted-by-csf-collected-from-sah-patients-correlates-to-clinical-outcome
#16
Yun-An Chen, Kuo-Chuan Wang, Der-Zen Liu, Tai-Horng Young, Li-Kai Tsai
Neurogenesis from endogenous neural stem cells (NSCs) might contribute to functional recovery after stroke based on animal studies; however, the relationship between neurogenesis and post-stroke outcome has rarely been demonstrated in humans. We prospectively collected cerebrospinal fluid (CSF) from 36 patients with subarachnoid hemorrhage (SAH). The CSF was added to the culture medium of the rat NSCs to test the effects on proliferation (proliferation index [PI], percentage of Ki-67 immunoreactive cells). We correlated the PI with functional outcome based on the modified Rankin Scale at 3 months post-SAH...
January 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29348020/autosomal-recessive-hypercholesterolemia-long-term-cardiovascular-outcomes
#17
Laura D'Erasmo, Ilenia Minicocci, Antonio Nicolucci, Paolo Pintus, Janine E Roeters Van Lennep, Luis Masana, Pedro Mata, Rosa Maria Sánchez-Hernández, Pablo Prieto-Matos, Josè T Real, Juan F Ascaso, Eduardo Esteve Lafuente, Miguel Pocovi, Francisco J Fuentes, Sandro Muntoni, Stefano Bertolini, Cesare Sirtori, Laura Calabresi, Chiara Pavanello, Maurizio Averna, Angelo Baldassare Cefalu, Davide Noto, Adolfo Arturo Pacifico, Giovanni Mario Pes, Mariko Harada-Shiba, Enzo Manzato, Sabina Zambon, Alberto Zambon, Anja Vogt, Marco Scardapane, Barbara Sjouke, Renato Fellin, Marcello Arca
BACKGROUND: Autosomal recessive hypercholesterolemia (ARH) is a rare lipid disorder characterized by premature atherosclerotic cardiovascular disease (ASCVD). There are sparse data for clinical management and cardiovascular outcomes in ARH. OBJECTIVES: Evaluation of changes in lipid management, achievement of low-density lipoprotein cholesterol (LDL-C) goals and cardiovascular outcomes in ARH. METHODS: Published ARH cases were identified by electronic search...
January 23, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29348010/early-outcomes-with-the-evolut-pro-repositionable-self-expanding-transcatheter-aortic-valve-with-pericardial-wrap
#18
John K Forrest, Abeel A Mangi, Jeffrey J Popma, Kamal Khabbaz, Michael J Reardon, Neal S Kleiman, Steven J Yakubov, Daniel Watson, Susheel Kodali, Isaac George, Peter Tadros, George L Zorn, John Brown, Robert Kipperman, Sara Saul, Hongyan Qiao, Jae K Oh, Mathew R Williams
OBJECTIVES: This study sought to evaluate the Medtronic Evolut PRO Transcatheter Aortic Valve System in patients with severe symptomatic aortic stenosis. BACKGROUND: A next-generation self-expanding transcatheter aortic valve was designed with an external pericardial wrap with the intent to reduce paravalvular leak while maintaining the benefits of a low-profile, self-expanding, and repositionable supra-annular valve. METHODS: The Medtronic Evolut PRO Clinical Study included 60 patients undergoing transcatheter aortic valve replacement with the Evolut PRO valve at 8 investigational sites in the United States...
January 22, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29346126/complete-revascularization-for-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-coronary-artery-disease-a-meta-analysis-of-randomized-trials
#19
Gani Bajraktari, Haki Jashari, Pranvera Ibrahimi, Fernando Alfonso, Fisnik Jashari, Gjin Ndrepepa, Shpend Elezi, Michael Y Henein
INTRODUCTION: Despite the recent findings in randomized clinical trials (RCTs) with limited sample sizes and the updates in clinical guidelines, the current available data for the complete revascularization (CR) in hemodynamically stable patients with ST-segment elevation myocardial infarction (STEMI) at the time of primary percutaneous coronary intervention (PCI) are still contradictory. AIM: The aim of this meta-analysis of the existing RCTs was to assess the efficacy of the CR versus revascularization of infarct-related artery (IRA) only during primary PCI in patients with STEMI and multivessel disease (MVD)...
January 17, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29345529/effects-of-telestroke-on-thrombolysis-times-and-outcomes-a-meta-analysis
#20
Alireza Baratloo, Leila Rahimpour, Abdelrahman Ibrahim Abushouk, Saeed Safari, Chung Wing Lee, Ali Abdalvand
OBJECTIVE: Telestroke systems are tools, used to provide an advanced stroke care in regions without sufficient neurologic services. We performed this meta-analysis to assess the effects of telemedicine on treatment times and clinical outcomes of acute stroke care. METHODS: A literature search of PubMed, SCOPUS, and Cochrane CENTRAL was conducted for original studies investigating telemedicine applications in acute stroke care. Dichotomous data on treatment outcomes were pooled as odds ratios (ORs), while continuous data on thrombolysis times were pooled as mean differences (MDs) with 95% confidence interval (CI), using RevMan software (version 5...
January 18, 2018: Prehospital Emergency Care
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