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https://www.readbyqxmd.com/read/28727727/a-comparative-study-of-patients-activities-and-interactions-in-a-stroke-unit-before-and-after-reconstruction-the-significance-of-the-built-environment
#1
Anna Anåker, Lena von Koch, Christina Sjöstrand, Julie Bernhardt, Marie Elf
Early mobilization and rehabilitation, multidisciplinary stroke expertise and comprehensive therapies are fundamental in a stroke unit. To achieve effective and safe stroke care, the physical environment in modern stroke units should facilitate the delivery of evidence-based care. Therefore, the purpose of this study was to explore patients' activities and interactions in a stroke unit before the reconstruction of the physical environment, while in a temporary location and after reconstruction. This case study examined a stroke unit as an integrated whole...
2017: PloS One
https://www.readbyqxmd.com/read/28727668/comprehensive-cardiac-rehabilitation-for-secondary-prevention-after-transient-ischemic-attack-or-mild-stroke-psychological-profile-and-outcomes
#2
Peter L Prior, Vladimir Hachinski, Richard Chan, Karen Unsworth, Sharon Mytka, Michael Harnadek, Christina OʼCallaghan, Neville Suskin
PURPOSE: Having previously reported that comprehensive cardiac rehabilitation (CCR) is effective for secondary prevention post-transient ischemic attack (TIA)/mild nondisabling stroke (MNDS), we present psychometric findings for the same sample that elucidate subacute TIA/MNDS psychological outcomes and test whether CCR would be independently associated with psychological improvements. METHODS: In this prospective cohort trial patients with ≥1 risk factor, recruited from a stroke prevention clinic within 12 months (mean = 11...
July 19, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28727355/-perfusion-imaging-of-acute-ischemic-stroke
#3
Carlo W Cereda, Patrik Michel, Karl-Olof Lovblad, Emmanuel Carrera
Multi-modal imaging in acute ischemic stroke includes structural imaging, perfusion imaging and angiographic assessment of brain arteries. Perfusion imaging discriminates brain tissue that is critically hypo-perfused but salvageable (ischemic penumbra) from irreversibly injured tissue (ischemic core). In acute reperfusion therapies (intravenous or endovascular), patients who have substantial penumbra and a small core (target mismatch pattern) are most likely to have a good clinical outcome. Patient selection based on multi-modal imaging is not proven mandatory for acute treatment in patients admitted within the established time-window...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28727192/current-evidence-for-endovascular-therapy-in-stroke-and-remaining-uncertainties-r1
#4
REVIEW
Ronan Motyer, Hamed Asadi, John Thornton, Patrick Nicholson, Hong Kuan Kok
Class 1 level A evidence now supports endovascular thrombectomy as best practice in the management of large vessel occlusion acute ischemic stroke. However, significant questions pertaining to initial imaging, radiological assessment, patient selection and therapeutic limits remain unanswered. A specific cohort of patients who benefit from endovascular thrombectomy has been established, although current uncertainties regarding selection of those not meeting top-tier evidence criteria may potentially deny certain patients the benefit of intervention...
July 20, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28726570/potential-biomarkers-for-predicting-hemorrhagic-transformation-of-ischemic-stroke
#5
Guanfeng Lu, Quanwei He, Yan Shen, Fei Cao
Reperfusion therapy contributes to better clinical outcomes in patients with acute ischemic stroke but carries a more significant risk of hemorrhagic transformation (HT) compared to supportive care. Once HT occurs, the outcome is usually poor and this causes a dilemma in the treatment of ischemic stroke. Consequently, early prediction of HT would be extremely helpful for guiding precise treatment of ischemic stroke. In this review, we focus on summarizing biomarkers of HT and elucidating possible mechanisms so as to identify potential biomarkers for predicting HT...
July 20, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28726167/early-increased-bradykinin-1-receptor-contributes-to-hemorrhagic-transformation-after-ischemic-stroke-in-type-1-diabetic-rats
#6
Hongfei Sang, Zhongming Qiu, Jin Cai, Wenya Lan, Linjie Yu, Hao Zhang, Min Li, Yi Xie, Ruibing Guo, Ruidong Ye, Xinfeng Liu, Ling Liu, Renliang Zhang
Hemorrhagic transformation (HT) is a major complication of ischemic stroke and further deteriorates neurological outcomes. Bradykinin 1 receptor (B1R) has been proven to mediate vasculo-toxicity in various experimental models. However, its role in the development of HT after stroke remains unclear. We detected the B1R expression in brain tissues with or without HT in a rat model of cerebral ischemia/reperfusion (I/R) with type 1 diabetes, showing higher B1R expression in the hemorrhagic areas than the ischemic tissues...
July 19, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28725968/microglial-mediated-pdgf-cc-activation-increases-cerebrovascular-permeability-during-ischemic-stroke
#7
Enming Joseph Su, Chunzhang Cao, Linda Fredriksson, Ingrid Nilsson, Christina Stefanitsch, Tamara K Stevenson, Juanjuan Zhao, Margret Ragsdale, Yu-Yo Sun, Manuel Yepes, Chia-Yi Kuan, Ulf Eriksson, Dudley K Strickland, Daniel A Lawrence, Li Zhang
Treatment of acute ischemic stroke with the thrombolytic tissue plasminogen activator (tPA) can significantly improve neurological outcomes; however, thrombolytic therapy is associated with an increased risk of intra-cerebral hemorrhage (ICH). Previously, we demonstrated that during stroke tPA acting on the parenchymal side of the neurovascular unit (NVU) can increase blood-brain barrier (BBB) permeability and ICH through activation of latent platelet-derived growth factor-CC (PDGF-CC) and signaling by the PDGF receptor-α (PDGFRα)...
July 19, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28724590/long-term-antithrombotic-treatment-in-intracranial-hemorrhage-survivors-with-atrial-fibrillation
#8
Eleni Korompoki, Filippos T Filippidis, Peter B Nielsen, Angela Del Giudice, Gregory Y H Lip, Joji B Kuramatsu, Hagen B Huttner, Jiming Fang, Sam Schulman, Joan Martí-Fàbregas, Celine S Gathier, Anand Viswanathan, Alessandro Biffi, Daniela Poli, Christian Weimar, Uwe Malzahn, Peter Heuschmann, Roland Veltkamp
OBJECTIVE: To perform a systematic review and meta-analysis of studies reporting recurrent intracranial hemorrhage (ICH) and ischemic stroke (IS) in ICH survivors with atrial fibrillation (AF) during long-term follow-up. METHODS: A comprehensive literature search including MEDLINE, EMBASE, Cochrane library, clinical trials registry was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We considered studies capturing outcome events (ICH recurrence and IS) for ≥3 months and treatment exposure to vitamin K antagonists (VKAs), antiplatelet agents (APAs), or no antithrombotic medication (no-ATM)...
July 19, 2017: Neurology
https://www.readbyqxmd.com/read/28724339/influence-of-cerebrovascular-reactivity-on-outcome-of-the-patients-with-%C3%A2-50-symptomatic-unilateral-middle-cerebral-artery-stenosis
#9
Weiqing Zhang, Yanwei Yin, Yingqian Zhang, Fen Yang, Wenqian Shi, Dawei Chen, Chen Song, Huiping Shi, Xuanzhu Zhao, Jin Shi
Cerebrovascular reactivity (CVR) reflects the vasodilatory reserve of cerebral resistance vessels, which is an important marker for assessing cerebrovascular disease. The present study is to investigate whether CVR impairment increases adverse long-term outcome risk of patients with ≥ 50% symptomatic unilateral middle cerebral artery (MCA) stenosis (ischemic stroke (IS) or transient ischemic attack (TIA)). Digital subtraction angiography (DSA) was used to assess the degree of stenosis, and perfusion CT and 5% CO2 inhalation were adopted to evaluate CVR...
July 20, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28724170/circulating-insulin-like-growth-factor-1-and-insulin-like-growth-factor-binding-protein-3-predict-three-months-outcome-after-ischemic-stroke
#10
Moritz Armbrust, Hans Worthmann, Reinhard Dengler, Helmut Schumacher, Ralf Lichtinghagen, Christoph Cyrill Eschenfelder, Matthias Endres, Martin Ebinger
Reports on neuroprotective effects of Insulin-like growth factor-1 (IGF-1) and Insulin-like growth factor binding protein-3 (IGFBP-3) in ischemic brain tissue are inconsistent. The aim of this study was to determine if plasma levels of IGF-1 and IGFBP-3 in acute stroke patients are indicative of 3 months functional outcome. Plasma levels were measured via chemiluminescence immunoassay in heparin blood samples of patients included in the EARLY trial (NCT00562588). Plasma samples were drawn on admission and 8 days post-stroke...
July 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28724035/spontaneous-carotid-dissection
#11
Carolina Dutra Queiroz Flumignan, Ronald Luiz Gomes Flumignan, Luis Carlos Uta Nakano, Jorge Eduardo de Amorim
Carotid dissection is a rare occurrence but it is the main cause of stroke in individuals aged less than 45 years, and can be the etiology in up to 25% of strokes in young adults. We report a case with classic image of ying yang on vascular ultrasound, which was treated according to the best available medical evidence, yielding a favorable outcome.
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28723732/role-of-anesthesia-in-endovascular-stroke-therapy
#12
Arthur Wang, Apolonia E Abramowicz
PURPOSE OF REVIEW: Recent randomized clinical trials have demonstrated strong efficacy of endovascular therapy (EVT) for acute ischemic stroke (AIS) from large vessel occlusions; in the USA alone, tens of thousands of patients annually may benefit. The impact of the type of anesthesia used during mechanical thrombectomy on patient outcomes remains controversial. This review discusses the current literature on the effects of anesthesia type on patient outcome following endovascular stroke therapy...
July 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28723649/observation-of-elevated-fasting-blood-glucose-and-functional-outcome-after-ischemic-stroke-in-patients-with-and-without-diabetes
#13
Wen-Yu Xue, Yan-Cheng Xu, Yu-Wen Wu, Miao Yang
During May 2015 to October 2016, this prospective study enrolled a total of 438 patients with acute ischemic stroke(AIS), meanwhile, records regarding the severity of initial stroke and neurological outcomes at three months, as well as other examination were completed in patients on admission, as well as the measurement and evaluation of fasting blood glucose(FBG) levels. At admission, the median FBG levels in patients with a minor stroke (n=124), [P<0.001]) was significantly lower than that observed in patients with other degrees of stroke...
July 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28722662/antibiotic-prophylaxis-for-infections-in-patients-with-acute-stroke-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#14
Yan-Guo Xi, Xu Tian, Wei-Qing Chen, Sai Zhang, Shan Zhang, Wei-Dan Ren, Qi-Jun Pang, Guo-Tao Yang, Zhi-Ming Yang
OBJECTIVE: Infections are frequent after stroke and lead to increased mortality and neurological disability. Antibiotic prophylaxis has potential of decreasing the risk of infections and mortality and improving poor functional outcome. Several studies evaluated antibiotic prophylaxis for infections in acute stroke patients have generated conflicting results. The systematic review of randomized clinical trials (RCTs) aimed at comprehensively assessing the evidence of antibiotic prophylaxis for the treatment of acute stroke patients...
July 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/28722196/safety-of-orbital-atherectomy-in-patients-with-left-ventricular-systolic-dysfunction
#15
Evan Shlofmitz, Perwaiz Meraj, Rajiv Jauhar, Sanjum S Sethi, Richard A Shlofmitz, Michael S Lee
OBJECTIVES: We evaluated the angiographic and clinical outcomes in patients with severely calcified lesions and systolic dysfunction who underwent orbital atherectomy (OA). We hypothesized that OA would provide similar outcomes in patients with systolic dysfunction compared with patients with preserved systolic function. BACKGROUND: Systolic dysfunction is associated with an increased risk of adverse clinical events after percutaneous coronary intervention (PCI)...
July 19, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28721691/occupational-therapy-for-adults-with-problems-in-activities-of-daily-living-after-stroke
#16
REVIEW
Lynn A Legg, Sharon R Lewis, Oliver J Schofield-Robinson, Avril Drummond, Peter Langhorne
BACKGROUND: A stroke occurs when the blood supply to part of the brain is cut off. Activities of daily living (ADL) are daily home-based activities that people carry out to maintain health and well-being. ADLs include the ability to: eat and drink unassisted, move, go to the toilet, carry out personal hygiene tasks, dress unassisted, and groom. Stroke causes impairment-related functional limitations that may result in difficulties participating in ADLs independent of supervision, direction, or physical assistance...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28721332/to-stent-or-not-to-stent-a-tale-of-two-occlusions
#17
Ali S Haider, Lyndon K Lee, Tijani Osumah, Saira Alli, Umair Khan, Steven Vayalumkal, Aida Kafai Golahmadi, Richa Thakur, Phu Nguyen, Kennith F Layton
Stenting and balloon angioplasty, along with mechanical thrombectomy, have gained notability as adjunctive treatment options to intravenous tissue plasminogen activator (IV-tPA) for tandem internal carotid artery (ICA) and middle cerebral artery (MCA) occlusions (TIM occlusions). Acute ischemic strokes (AISs) secondary to TIM occlusions are associated with poor patient outcomes primarily due to low recanalization rates following intravenous thrombolysis, consequently prompting the need for more invasive recanalization efforts...
June 17, 2017: Curēus
https://www.readbyqxmd.com/read/28721323/endovascular-management-of-stroke-patients-with-large-vessel-occlusion-and-minor-stroke-symptoms
#18
REVIEW
Saeed A Alqahtani, Andrew B Stemer, Michael F McCullough, Randy S Bell, Jeffrey Mai, Ai-Hsi Liu, Rocco A Armonda
Endovascular mechanical thrombectomy for stroke patients with large vessel occlusion (LVO) in the anterior circulation has become the standard of care based on several major randomized clinical trials. The successful result reported by these trials constitutes what may be the largest achievement in the history of neurological sciences. However, most of these mechanical thrombectomy trials (except for the multicenter randomized clinical trial of endovascular treatment for acute ischemic stroke in the Netherlands, i...
June 15, 2017: Curēus
https://www.readbyqxmd.com/read/28721154/obesity-and-inflammation-the-linking-mechanism-and-the-complications
#19
Mohammed S Ellulu, Ismail Patimah, Huzwah Khaza'ai, Asmah Rahmat, Yehia Abed
Obesity is the accumulation of abnormal or excessive fat that may interfere with the maintenance of an optimal state of health. The excess of macronutrients in the adipose tissues stimulates them to release inflammatory mediators such as tumor necrosis factor α and interleukin 6, and reduces production of adiponectin, predisposing to a pro-inflammatory state and oxidative stress. The increased level of interleukin 6 stimulates the liver to synthesize and secrete C-reactive protein. As a risk factor, inflammation is an imbedded mechanism of developed cardiovascular diseases including coagulation, atherosclerosis, metabolic syndrome, insulin resistance, and diabetes mellitus...
June 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28720659/microbleeds-cerebral-hemorrhage-and-functional-outcome-after-stroke-thrombolysis-individual-patient-data-meta-analysis
#20
Andreas Charidimou, Guillaume Turc, Catherine Oppenheim, Shenqiang Yan, Jan F Scheitz, Hebun Erdur, Pascal P Klinger-Gratz, Marwan El-Koussy, Wakoh Takahashi, Yusuke Moriya, Duncan Wilson, Chelsea S Kidwell, Jeffrey L Saver, Asma Sallem, Solene Moulin, Myriam Edjlali-Goujon, Vincent Thijs, Zoe Fox, Ashkan Shoamanesh, Gregory W Albers, Heinrich P Mattle, Oscar R Benavente, H Rolf Jäger, Gareth Ambler, Junya Aoki, Jean-Claude Baron, Kazumi Kimura, Wataru Kakuda, Shunya Takizawa, Simon Jung, Christian H Nolte, Min Lou, Charlotte Cordonnier, David J Werring
BACKGROUND AND PURPOSE: We assessed whether the presence, number, and distribution of cerebral microbleeds (CMBs) on pre-intravenous thrombolysis MRI scans of acute ischemic stroke patients are associated with an increased risk of intracerebral hemorrhage (ICH) or poor functional outcome. METHODS: We performed an individual patient data meta-analysis, including prospective and retrospective studies of acute ischemic stroke treated with intravenous tissue-type plasminogen activator...
July 18, 2017: Stroke; a Journal of Cerebral Circulation
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