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https://www.readbyqxmd.com/read/29156493/virtual-reality-for-stroke-rehabilitation
#1
REVIEW
Kate E Laver, Belinda Lange, Stacey George, Judith E Deutsch, Gustavo Saposnik, Maria Crotty
BACKGROUND: Virtual reality and interactive video gaming have emerged as recent treatment approaches in stroke rehabilitation with commercial gaming consoles in particular, being rapidly adopted in clinical settings. This is an update of a Cochrane Review published first in 2011 and then again in 2015. OBJECTIVES: Primary objective: to determine the efficacy of virtual reality compared with an alternative intervention or no intervention on upper limb function and activity...
November 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29156324/influence-of-post-stroke-spasticity-on-emg-force-coupling-and-force-steadiness-in-biceps-brachii
#2
Jennilee K Carlyle, George Mochizuki
BACKGROUND: Individuals with spasticity after stroke experience a decrease in force steadiness which can impact function. Alterations in the strength of EMG-force coupling may contribute to the reduction in force steadiness observed in spasticity. The aim was to determine the extent to which force steadiness and EMG-force coupling is affected by post-stroke spasticity. METHODS: This cross-sectional study involved individuals with upper limb spasticity after stroke...
November 13, 2017: Journal of Electromyography and Kinesiology
https://www.readbyqxmd.com/read/29156015/european-prospective-multicentre-study-of-hybrid-thoracoscopic-and-transcatheter-ablation-of-persistent-atrial-fibrillation-the-historic-af-trial
#3
Claudio Muneretto, Gianluigi Bisleri, Fabrizio Rosati, Ralf Krakor, Laura Giroletti, Lorenzo Di Bacco, Alberto Repossini, Massimo Moltrasio, Antonio Curnis, Claudio Tondo, Gianluca Polvani
OBJECTIVES: The HISTORIC-AF trial is a prospective, multicentre, single-arm study designed to evaluate the outcomes of a staged endoscopic and transcatheter ablation in patients with stand-alone, persistent or long-standing persistent atrial fibrillation (AF). METHODS: From 2012 to 2015, 100 consecutive patients were enrolled and underwent thoracoscopic left atrial epicardial isolation ('box lesion') followed by transcatheter ablation in case of AF recurrency. The safety end point was the composite outcome of freedom from major adverse events at 30-days, while efficacy end points were: (i) primary: freedom from AF and stable sinus rhythm following isolated thoracospic ablation >60% and (ii) secondary: freedom from AF and stable sinus rhythm >80% following hybrid ablation (as per HRS criteria)...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29155982/economic-and-survival-burden-of-dysphagia-among-inpatients-in-the-united-states
#4
D A Patel, S Krishnaswami, E Steger, E Conover, M F Vaezi, M R Ciucci, D O Francis
The inpatient burden of dysphagia has primarily been evaluated in patients with stroke. It is unclear whether dysphagia, irrespective of cause, is associated with worse clinical outcomes and higher costs compared to inpatients with similar demographic, hospital, and clinical characteristics without dysphagia. The aim of this study is to assess how a dysphagia diagnosis affects length of hospital stay (LOS), costs, discharge disposition, and in-hospital mortality among adult US inpatients. Annual and overall dysphagia prevalence, LOS, hospital charges, inpatient care costs, discharge disposition, and in-hospital mortality were measured using the AHRQ Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (2009-2013)...
November 16, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29155938/cerebral-autoregulation-in-cardiopulmonary-bypass-surgery-a-systematic-review
#5
Juliana R Caldas, Victoria J Haunton, Ronney B Panerai, Ludhmila A Hajjar, Thompson G Robinson
Cardiopulmonary bypass surgery is associated with a high incidence of neurological complications, including stroke, delirium and cognitive impairment. The development of strategies to reduce the incidence of such neurological events has been hampered by the lack of a clear understanding of their pathophysiology. Cerebral autoregulation (CA), which describes the ability of the brain to maintain a stable cerebral blood flow over a wide range of cerebral perfusion pressures despite changes in blood pressure, is known to be impaired in various neurological disorders...
November 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29155935/early-and-late-outcomes-of-open-repair-for-dissecting-aneurysms-of-the-descending-or-thoraco-abdominal-aorta
#6
Atsushi Omura, Kenji Minatoya, Jiro Matsuo, Yosuke Inoue, Yoshimasa Seike, Kyokun Uehara, Hiroaki Sasaki, Hitoshi Matsuda, Junjiro Kobayashi
OBJECTIVES: Although open repair is the standard surgical option for dissecting descending thoracic aneurysms (DTAs) and thoraco-abdominal aorta aneurysms (TAAAs), it remains a significant challenge with considerable perioperative morbidity and mortality. We retrospectively analysed early and late outcomes of open repair for these aortic aneurysms. METHODS: Early and late outcomes were investigated for 223 consecutive patients who underwent open repair for dissecting DTA or TAAA between January 2003 and December 2014 (mean age 55 ± 16 years)...
October 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29155848/an-electronic-health-record-based-model-predicts-statin-adherence-ldl-cholesterol-and-cardiovascular-disease-in-the-united-states-military-health-system
#7
Joseph E Lucas, Taylor C Bazemore, Celan Alo, Patrick B Monahan, Deepak Voora
HMG-CoA reductase inhibitors (or "statins") are important and commonly used medications to lower cholesterol and prevent cardiovascular disease. Nearly half of patients stop taking statin medications one year after they are prescribed leading to higher cholesterol, increased cardiovascular risk, and costs due to excess hospitalizations. Identifying which patients are at highest risk for not adhering to long-term statin therapy is an important step towards individualizing interventions to improve adherence. Electronic health records (EHR) are an increasingly common source of data that are challenging to analyze but have potential for generating more accurate predictions of disease risk...
2017: PloS One
https://www.readbyqxmd.com/read/29155470/safety-and-effectiveness-of-endovascular-embolization-or-stent-graft-reconstruction-for-treatment-of-acute-carotid-blowout-syndrome-in-patients-with-head-and-neck-cancer-case-series-and-systematic-review-of-observational-studies
#8
Daniel J Y Wong, Christopher Donaldson, Leon T Lai, Andrew Coleman, Charles Giddings, Lee-Anne Slater, Ronil V Chandra
BACKGROUND: Indications for treatment and outcomes after endovascular management of carotid blowout syndrome for patients with head and neck cancer are not well defined. We investigated the safety and effectiveness of endovascular embolization and stent-graft reconstruction. METHODS: A literature review was performed for studies published between 2001 and 2015 with relevance to treatment outcomes. Our institutional database was examined to identify patients treated with endovascular techniques...
November 20, 2017: Head & Neck
https://www.readbyqxmd.com/read/29155435/periventricular-white-matter-hyperintensities-and-functional-decline
#9
Mandip S Dhamoon, Ying-Kuen Cheung, Ahmet Bagci, Noam Alperin, Ralph L Sacco, Mitchell S V Elkind, Clinton B Wright
BACKGROUND/OBJECTIVES: We previously showed that global brain white matter hyperintensity volume (WMHV) was associated with accelerated long-term functional decline. The objective of the current study was to determine whether WMHV in particular brain regions is more predictive of functional decline. DESIGN: Prospective population-based study. SETTING: Northern Manhattan magnetic resonance imaging (MRI) study. PARTICIPANTS: Individuals free of stroke at baseline (N = 1,195; mean age 71 ± 9; n = 460 (39%) male)...
November 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29155387/the-impact-of-chronic-kidney-disease-on-outcomes-following-percutaneous-coronary-interventions-versus-coronary-artery-bypass-grafting-in-patients-with-complex-coronary-artery-disease-5-year-follow-up-of-the-syntax-trial
#10
Milan Milojevic, Stuart J Head, Michael J Mack, Friedrich W Mohr, Marie-Claude Morice, Keith D Dawkins, David R Holmes, Patrick W Serruys, A Pieter Kappetein
AIMS: To investigate short-term and 5-year follow-up results from patients randomized to coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) with paclitaxel-eluting stents in the SYNTAX trial, focusing on patients with chronic kidney disease (CKD). METHODS AND RESULTS: Baseline glomerular filtration rate estimates (eGFR) were available in 1638 patients (PCI=852 and CABG=786). The Kidney Disease Improving Global Outcomes threshold was used to define staging of CKD...
November 21, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29154813/one-year-outcomes-of-prasugrel-versus-ticagrelor-in-acute-myocardial-infarction-treated-with-primary-angioplasty-the-prague-18-study
#11
Zuzana Motovska, Ota Hlinomaz, Petr Kala, Milan Hromadka, Jiri Knot, Ivo Varvarovsky, Jaroslav Dusek, Jiri Jarkovsky, Roman Miklik, Richard Rokyta, Frantisek Tousek, Petra Kramarikova, Michal Svoboda, Bohumil Majtan, Stanislav Simek, Marian Branny, Jan Mrozek, Pavel Cervinka, Jiri Ostransky, Petr Widimsky
BACKGROUND: Early outcomes of patients in the PRAGUE-18 study did not find any significant differences between two potent P2Y12 inhibitors. OBJECTIVE: The one-year follow-up of the PRAGUE-18 study focused on (1) a comparison of efficacy and safety between prasugrel and ticagrelor, and (2) on the risk of major ischemic events related to an economically motivated post-discharge switch to clopidogrel. METHODS: A total of 1,230 patients with acute myocardial infarction (MI) treated with primary PCI were randomized to prasugrel or ticagrelor with an intended treatment duration of 12 months...
November 9, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29154131/impact-of-age-sex-therapeutic-intent-race-and-severity-of-advanced-heart-failure-on-short-term-principal-outcomes-in-the-momentum-3-trial
#12
Daniel J Goldstein, Mandeep R Mehra, Yoshifumi Naka, Christopher Salerno, Nir Uriel, David Dean, Akinobu Itoh, Francis D Pagani, Eric R Skipper, Geetha Bhat, Nirav Raval, Brian A Bruckner, Jerry D Estep, Rebecca Cogswell, Carmelo Milano, Lahn Fendelander, John B O'Connell, Joseph Cleveland
BACKGROUND: Primary outcomes analysis of the Multicenter Study of MagLev Technology in Patients Undergoing MCS Therapy With HeartMate 3 (MOMENTUM 3) trial short-term cohort demonstrated a higher survival rate free of debilitating stroke and reoperation to replace/remove the device (primary end-point) in patients receiving the HeartMate 3 (HM3) compared with the HeartMate (HMII). In this study we sought to evaluate the individual and interactive effects of pre-specified patient subgroups (age, sex, race, therapeutic intent [bridge to transplant/bridge to candidacy/destination therapy] and severity of illness) on primary end-point outcomes in MOMENTUM 3 patients implanted with HM3 and HMII devices...
November 3, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29153847/effect-of-incentive-payments-on-chronic-disease-management-and-health-services-use-in-british-columbia-canada-interrupted-time-series-analysis
#13
M Ruth Lavergne, Michael R Law, Sandra Peterson, Scott Garrison, Jeremiah Hurley, Lucy Cheng, Kimberlyn McGrail
We studied the effects of incentive payments to primary care physicians for the care of patients with diabetes, hypertension, and Chronic Obstructive Pulmonary Disease (COPD) in British Columbia, Canada. We used linked administrative health data to examine monthly primary care visits, continuity of care, laboratory testing, pharmaceutical dispensing, hospitalizations, and total h ealth care spending. We examined periods two years before and two years after each incentive was introduced, and used segmented regression to assess whether there were changes in level or trend of outcome measures across all eligible patients following incentive introduction, relative to pre-intervention periods...
November 10, 2017: Health Policy
https://www.readbyqxmd.com/read/29153772/effectiveness-and-safety-of-transcatheter-aortic-valve-implantation-for-aortic-stenosis-in-patients-with-porcelain-aorta
#14
Fernando Ramirez-Del Val, Sameer A Hirji, Maroun Yammine, Julius I Ejiofor, Siobhan McGurk, Anthony Norman, Prem Shekar, Sary Aranki, Deepak L Bhatt, Pinak Shah, Lawrence H Cohn, Tsuyoshi Kaneko
Surgical aortic valve replacement (SAVR) in patients with porcelain aorta is considered a high-risk procedure. Hence, transcatheter aortic valve implantation (TAVI) is emerging as the intervention of choice. However, there is a paucity of data directly comparing TAVI with SAVR in patients with porcelain aorta. We compared outcomes of TAVI versus SAVR in high-risk patients with porcelain between March 2012 and June 2015. The TAVI group included 54 patients, whereas 130 SAVR patients with porcelain aorta were identified (operated on between 2004 and 2015)...
October 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29153643/prevalence-and-predictive-factors-of-urinary-tract-infection-among-patients-with-stroke-a-meta-analysis
#15
Tianyuan Yan, Chenxia Liu, Yingxia Li, Wei Xiao, Yating Li, Shuhui Wang
BACKGROUND: Urinary tract infection (UTI) is thought to be a common complication of stroke and is regarded as a potential risk factor for poor stroke outcomes. However, there is a controversy among predictive factors of stroke-associated UTIs. We aim to estimate the prevalence and predisposing factors of UTIs among patients with stroke. METHODS: PubMed, EMBASE, and Elsevier Science Direct were searched by 2 independent researchers. Sixteen studies with a total of 13,513 patients were included to evaluate the prevalence and predictive factors of stroke-associated UTIs published from the earliest records to March 10, 2017...
November 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29153636/early-intervention-for-lactate-dehydrogenase-elevation-improves-clinical-outcomes-in-patients-with-the-heartmate-ii-left-ventricular-assist-device-insights-from-the-prevent-study
#16
Thenappan Thenappan, John M Stulak, Richa Agarwal, Simon Maltais, Palak Shah, Peter Eckman, Sitaramesh Emani, Jason N Katz, Igor Gregoric, Mary E Keebler, Nir Uriel, Eric Adler, Joyce Chuang, David J Farrar, Kartik S Sundareswaran, Ranjit John
BACKGROUND: Hemolysis, assessed by elevated serum lactate dehydrogenase (LDH), is strongly associated with HeartMate II pump thrombosis (PT). However, it is unknown whether early intervention for elevated LDH circumvents the risk of serious PT requiring pump exchange. We sought to evaluate the relationship between elevated LDH and clinical outcomes, the effectiveness of early medical intervention, and risk factors for elevated LDH. METHODS: We studied 268 patients in the prospective, multicenter PREVENT study who had 2 or more LDH measurements at ≥30 days post-implant...
October 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29153576/coronary-artery-calcium-and-long-term%C3%A2-risk-of-death-myocardial%C3%A2-infarction-and-stroke-the-walter-reed-cohort-study
#17
Joshua D Mitchell, Robert Paisley, Patrick Moon, Eric Novak, Todd C Villines
OBJECTIVES: This study aimed to assess the long-term risk of death and atherosclerotic cardiovascular disease (ASCVD) outcomes, including stroke, in a real-world cohort that underwent coronary artery calcium (CAC) scoring. BACKGROUND: Large-scale, long-term studies assessing the independent relationship of CAC for prediction of ASCVD events, to include stroke, in young, low-risk patients are uncommon outside of the clinical trial setting. METHODS: A total of 23,637 consecutive subjects without ASCVD who underwent CAC scoring from 1997 to 2009 were studied...
November 10, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29153441/complex-endovascular-repair-of-postdissection-arch-and-thoracoabdominal-aneurysms
#18
Rafaëlle Spear, Adrien Hertault, Katrien Van Calster, Nicla Settembre, Matthieu Delloye, Richard Azzaoui, Jonathan Sobocinski, Dominique Fabre, Mark Tyrrell, Stéphan Haulon
OBJECTIVE: We report our experience of the treatment of postdissection arch aneurysms and thoracoabdominal aortic aneurysms (TAAAs) by endovascular repair using fenestrated and branched endografts. METHODS: This study includes all patients presenting with chronic postdissection aneurysms >55 mm in diameter deemed unfit for open surgery and treated by complex endografting between October 2011 and April 2017. Where appropriate, staged management strategies including left subclavian artery revascularization, thoracic endografting, dissection flap fenestration, and tear enlargement were performed before the complex endovascular repair...
November 15, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29153396/the-prognostic-value-of-serum-uric-acid-in-the-acute-phase-of-ischemic-stroke-in-black-africans
#19
Yacouba Njankouo Mapoure, Chia Mark Ayeah, Hamadou Ba, Romuald Hentchoya, Henry Namme Luma
BACKGROUND: The association between hyperuricemia and stroke outcome still remains controversial worldwide. This study aims to determine the prevalence of hyperuricemia and its association with the outcome of patients with acute ischemic stroke in a tertiary care hospital. METHODS: This was a hospital-based prospective cohort study that included patients with ischemic stroke with baseline uric acid levels and 3-month post-stroke follow-up data. Associations between hyperuricemia and stroke outcomes were analyzed using multiple logistic regression, Kaplan-Meier, and Cox proportional hazards regression analysis...
November 15, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29153286/combined-transaortic-and-transapical-approach-to-septal-myectomy-in-patients-with-complex-hypertrophic-cardiomyopathy
#20
Dustin Hang, Hartzell V Schaff, Steve R Ommen, Joseph A Dearani, Rick A Nishimura
OBJECTIVES: Residual midventricular obstruction after transaortic myectomy may lead to recurrent symptoms and reoperation in patients with hypertrophic cardiomyopathy and long-segment septal hypertrophy. A combined transaortic and transapical approach to septal myectomy during initial operation allows for the complete relief of subaortic and midventricular gradients and may reduce the risk of poor late functional results. METHODS: We analyzed the early outcomes of 86 patients aged 18 years or more who underwent combined transaortic and transapical septal myectomy for left ventricular outflow tract obstruction due to systolic anterior motion and midventricular obstruction or cavitary obliteration due to apical hypertrophic cardiomyopathy...
October 27, 2017: Journal of Thoracic and Cardiovascular Surgery
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