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Transient ischemic stroke

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https://www.readbyqxmd.com/read/28241354/effect-of-fibrinogen-concentrate-on-intraoperative-blood-loss-among-patients-with-intraoperative-bleeding-during-high-risk-cardiac-surgery-a-randomized-clinical-trial
#1
Süleyman Bilecen, Joris A H de Groot, Cor J Kalkman, Alexander J Spanjersberg, George J Brandon Bravo Bruinsma, Karel G M Moons, Arno P Nierich
Importance: Fibrinogen concentrate might partly restore coagulation defects and reduce intraoperative bleeding. Objective: To determine whether fibrinogen concentrate infusion dosed to achieve a plasma fibrinogen level of 2.5 g/L in high-risk cardiac surgery patients with intraoperative bleeding reduces intraoperative blood loss. Design, Setting, and Participants: A randomized, placebo-controlled, double-blind clinical trial conducted in Isala Zwolle, the Netherlands (February 2011-January 2015), involving patients undergoing elective, high-risk cardiac surgery (ie, combined coronary artery bypass graft [CABG] surgery and valve repair or replacement surgery, the replacement of multiple valves, aortic root reconstruction, or reconstruction of the ascending aorta or aortic arch) with intraoperative bleeding (blood volume between 60 and 250 mL suctioned from the thoracic cavity in a period of 5 minutes) were randomized to receive either fibrinogen concentrate or placebo...
February 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28241244/association-of-testosterone-replacement-with-cardiovascular-outcomes-among-men-with-androgen-deficiency
#2
T Craig Cheetham, JaeJin An, Steven J Jacobsen, Fang Niu, Stephen Sidney, Charles P Quesenberry, Stephen K VanDenEeden
Importance: Controversy exists regarding the safety of testosterone replacement therapy (TRT) following recent reports of an increased risk of adverse cardiovascular events. Objective: To investigate the association between TRT and cardiovascular outcomes in men with androgen deficiency. Design, Setting, and Participants: A retrospective cohort study was conducted within an integrated health care delivery system. Men at least 40 years old with evidence of androgen deficiency either by a coded diagnosis and/or a morning serum total testosterone level of less than 300 ng/dL were included...
February 21, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28241134/risk-of-ischemic-stroke-and-transient-ischemic-attack-is-increased-up-to-90-days-after-non-carotid-and-non-cardiac-surgery
#3
Armin J Grau, Martin Eicke, Christoph Burmeister, Roland Hardt, Eberhard Schmitt, Sieghard Dienlin
BACKGROUND: The risk of stroke after cardiac and carotid surgery is well established. In contrast, stroke risk in association with non-cardiac and non-carotid surgery and its time course are insufficiently known. We investigated the prevalence of recent and planned surgery among patients with stroke and transient ischemic attack (TIA), time dependency of stroke risk, stroke etiology, and interruption of antithrombotic medication in association with surgery. METHODS: Data on type and date of surgery and similar interventions within the last year or planned for the next 2 weeks were anonymously collected together with demographic data, vascular risk factors, stroke severity, handicap before stroke and stroke etiology within a state-wide, mandatory, hospital-based acute stroke care quality monitoring project (Rhineland-Palatinate, Germany) for 1 year (2010)...
February 28, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28238163/use-of-rivaroxaban-in-patients-with-stroke
#4
REVIEW
Danilo Toni, Antonio Carolei, Valeria Caso, Domenico Consoli, Massimo Del Sette, Domenico Inzitari, Maurizio Melis, Giuseppe Micieli, Leandro Provinciali, Stefano Ricci, Paola Santalucia, Vito Toso
Rivaroxaban, an inhibitor of Factor Xa, is a direct oral anti-coagulant that has been found to be non-inferior to warfarin in preventing cerebral ischemia in patients with non-valvular atrial fibrillation and in the subgroup of patients with a history of the previous stroke or transient ischemic attack. Vascular neurologists in daily clinical practice may encounter patients taking rivaroxaban or patients who may benefit from its use. In this paper, we review the current clinical indications, contraindications, and clinical management guidelines for rivaroxaban while providing a special focus on neurological aspects and expert opinions on rivaroxaban therapy management in various situations that a neurologist may encounter when treating patients with an ischemic stroke (including those requiring intravenous or intra-arterial reperfusion therapy) and patients with an intracerebral hemorrhage...
February 25, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28237318/strokes-are-possible-complications-of-cannabinoids-use
#5
REVIEW
Valérie Wolff, Emilie Jouanjus
It is critically important to identify all factors that may play a role in the recent increase of the incidence of stroke among the young population. Considering the worldwide use of cannabinoids (cannabis and synthetic cannabinoids), the recent legalization of their consumption in some countries, and their supposed involvement in cardiovascular events, we evaluated their role in the occurrence of neurovascular complications among the young. Ninety-eight patients were described in the literature as having a cannabinoids-related stroke (85 after cannabis use and 13 after synthetic cannabinoids)...
February 23, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28237286/comparison-of-has-bled-and-has-bed-versus-chads2-and-cha2ds2vasc-stroke-and-bleeding-scores-in-patients-with-atrial-fibrillation
#6
Daniela Poli, Emilia Antonucci, Vittorio Pengo, Sophie Testa, Gualtiero Palareti
Anticoagulation is recommended in patients with atrial fibrillation (AF) for stroke prevention, and the bleeding risk associated suggests the need for a bleeding risk stratification. HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio (INR), elderly >65 years, drugs/alcohol concomitantly) score includes "labile INR" referred to quality of anticoagulation. However, in naïve patients, this item is not available. In addition, stroke and bleeding risk prediction scores shared several risk factors...
January 26, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28222857/liver-fibrosis-assessed-with-transient-elastography-is-an-independent-risk-factor-for-ischemic-stroke
#7
Seung Up Kim, Dongbeom Song, Ji Hoe Heo, Joonsang Yoo, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang Joon Kim, Kwang-Hyub Han, Young Dae Kim
BACKGROUND AND AIMS: The relationship between liver fibrosis and the occurrence of ischemic stroke is unknown. We investigated the correlation between liver fibrosis assessed with transient elastography (TE) and the risk of ischemic stroke. METHODS: Between April 2013 and August 2014, patients with acute ischemic stroke and subjects who underwent a health check-up were included in the study. Liver fibrotic burden was assessed with TE in all participants. The degree of liver fibrosis was compared between groups by using various multiple logistic regression models and propensity-score matched analyses...
February 12, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28218788/case-report-dysregulation-of-gene-expression-in-a-patient-with-depressive-disorder-after-transient-ischemic-attack-confirmed-by-a-neurophysiological-neuromarker
#8
M Trystuła, M Żychowska, M Wilk-Frańczuk, J D Kropotov, M Pąchalska
The aim of this study was to evaluate dysregulation of gene expression associated with the cellular stress response in a patient with a post-"warning stroke" depressive disorder confirmed by the presence of a neurophysiological neuromarker through the use of quantitative EEG and event-related potentials. The patient was tested for seven genes associated with the stress reaction: HSPA1A, HSPB1, IL6, IL10, CRP, and HSF-1 along with NF-κB, compared to gene expression in health controls. A 54-year-old patient with a past history of schizophrenia (at the age of 20), and of transient ischemic attack (at the age of 53) and depressive disorder confirmed by functional, cognitive, emotional, and affectional diagnostics underwent additional testing for expression of the genes associated with stress response...
February 16, 2017: Genetics and Molecular Research: GMR
https://www.readbyqxmd.com/read/28218217/efficacy-and-safety-of-the-watchman-left-atrial-appendage-system-for-stroke-prevention-in-chinese-patients-with-nonvalvular-atrial-fibrillation-a-single-center-prospective-observational-study
#9
Wei-Ping Huang, Yong-Hua Zhang, Lei He, Xi Su, Xin-Wei Yang, Zai-Xiong Guo
BACKGROUND: In patients with nonvalvular atrial fibrillation (NVAF), embolic stroke is thought to be associated with left atrial appendage (LAA) thrombi. The WATCHMAN LAA Occlusion Device has been shown to be noninferior to conventional oral anticoagulation with warfarin for stroke prevention in patients with NVAF. This study aimed to evaluate the procedural feasibility, safety and 12-month outcomes of the WATCHMAN LAA Occlusion Device in NVAF patients with high risk for stroke in China...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28215423/chads2-score-predicts-postoperative-atrial-fibrillation-in-patients-undergoing-elective-pulmonary-lobectomy
#10
Svetlana Kotova, Mansen Wang, Katie Lothrop, Gary Grunkemeier, Heather E Merry, John R Handy
BACKGROUND: Postoperative atrial fibrillation (PAF) affects 12% to 17% of patients undergoing lobectomy and is associated with increased morbidity. CHADS2 (congestive heart failure history, hypertension history, age ≥75 years, diabetes mellitus history, and stroke or transient ischemic attack symptoms previously) is used to predict stroke risk in patients with existing AF. It also has been shown also to predict new-onset PAF. Our objective was to determine whether CHADS2 can predict PAF in patients undergoing lobectomy...
February 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28208140/first-diagnosis-of-atrial-fibrillation-at-the-time-of-stroke
#11
Leila H Borowsky, Susan Regan, Yuchiao Chang, Alison Ayres, Steven M Greenberg, Daniel E Singer
BACKGROUND: Atrial fibrillation (AF) is a major cause of ischemic stroke. Individuals with undiagnosed AF lack the stroke protection afforded by oral anticoagulants. We obtained a contemporary estimate of the percentage of AF patients newly diagnosed at the time of stroke. METHODS: We identified patients admitted to the Massachusetts General Hospital (MGH) from January 1, 2010 to December 31, 2013 with acute ischemic stroke and either previously or newly diagnosed AF using hospital stroke registry data and stroke and AF ICD-9 code searches of hospital databases...
February 17, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28207342/cumulative-lifetime-marijuana-use-and-incident-cardiovascular-disease-in-middle-age-the-coronary-artery-risk-development-in-young-adults-cardia-study
#12
Jared P Reis, Reto Auer, Michael P Bancks, David C Goff, Cora E Lewis, Mark J Pletcher, Jamal S Rana, James M Shikany, Stephen Sidney
OBJECTIVES: To investigate the effects of marijuana in the development of incident cardiovascular and cerebrovascular outcomes. METHODS: Participants were 5113 adults aged 18 to 30 years at baseline (1985-1986) from the Coronary Artery Risk Development in Young Adults study, who were followed for more than 25 years. We estimated cumulative lifetime exposure to marijuana using repeated assessments collected at examinations every 2 to 5 years. The primary outcome was incident cardiovascular disease (CVD) through 2013...
February 16, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28205341/spatiotemporal-microstructural-white-matter-changes-in-diffusion-tensor-imaging-after-transient-focal-ischemic-stroke-in-rats
#13
Won-Beom Jung, Yong Hee Han, Julius Juhyun Chung, Sun Young Chae, Sung Hoon Lee, Geun Ho Im, JiHoon Cha, Jung Hee Lee
Structural reorganization in white matter (WM) after stroke is a potential contributor to substitute or to newly establish the functional field on the injured brain in nature. Diffusion tensor imaging (DTI) is an imaging modality that can be used to evaluate damage and recovery within the brain. This method of imaging allows for in vivo assessment of the restricted movements of water molecules in WM and provides a detailed look at structural connectivity in the brain. For longitudinal DTI studies after a stroke, the conventional region of interest method and voxel-based analysis are highly dependent on the user-hypothesis and parameter settings for implementation...
February 16, 2017: NMR in Biomedicine
https://www.readbyqxmd.com/read/28202057/improvement-of-memory-and-learning-by-intracerebroventricular-microinjection-of-t3-in-rat-model-of-ischemic-brain-stroke-mediated-by-upregulation-of-bdnf-and-gdnf-in-ca1-hippocampal-region
#14
Tahmineh Mokhtari, Mohammad Akbari, Fatemeh Malek, Iraj Ragerdi Kashani, Tayebeh Rastegar, Farshid Noorbakhsh, Mahmoud Ghazi-Khansari, Fatemeh Attari, Gholamreza Hassanzadeh
BACKGROUND: Ischemic stroke is a common leading cause of death and disability with lack of effective therapies. In this study, T3 was intra-ventricularly injected to evaluate gene expression and protein concentration of and brain-derived neurotrophic factor (BDNF) and Glial cell-derived neurotrophic factor (GDNF) in hippocampal CA1 region in rat model of brain ischemia/reperfusion (I/R). METHODS: In this study, transient middle cerebral artery occlusion (tMCAo) was used as model of ischemic brain stroke...
February 15, 2017: Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
https://www.readbyqxmd.com/read/28197090/automated-ischemic-lesion-segmentation-in-mri-mouse-brain-data-after-transient-middle-cerebral-artery-occlusion
#15
Inge A Mulder, Artem Khmelinskii, Oleh Dzyubachyk, Sebastiaan de Jong, Nathalie Rieff, Marieke J H Wermer, Mathias Hoehn, Boudewijn P F Lelieveldt, Arn M J M van den Maagdenberg
Magnetic resonance imaging (MRI) has become increasingly important in ischemic stroke experiments in mice, especially because it enables longitudinal studies. Still, quantitative analysis of MRI data remains challenging mainly because segmentation of mouse brain lesions in MRI data heavily relies on time-consuming manual tracing and thresholding techniques. Therefore, in the present study, a fully automated approach was developed to analyze longitudinal MRI data for quantification of ischemic lesion volume progression in the mouse brain...
2017: Frontiers in Neuroinformatics
https://www.readbyqxmd.com/read/28196817/comparison-of-carotid-plaque-score-and-coronary-artery-calcium-score-for-predicting-cardiovascular-disease-events-the-multi-ethnic-study-of-atherosclerosis
#16
Adam D Gepner, Rebekah Young, Joseph A Delaney, Matthew J Budoff, Joseph F Polak, Michael J Blaha, Wendy S Post, Erin D Michos, Joel Kaufman, James H Stein
BACKGROUND: Coronary artery calcium (CAC) predicts coronary heart disease (CHD) events better than carotid wall plaque presence; however, differences in the utility of CAC burden and carotid plaque burden across the spectrum of cardiovascular disease (CVD) events is unknown. METHODS AND RESULTS: CVD, CHD and stroke/transient ischemic attack (TIA) events were evaluated prospectively in a multiethnic cohort without CVD at baseline. Carotid plaque score was determined by the number of ultrasound-detected plaques in the common, bifurcation, and internal carotid artery segments...
February 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28192195/puerarin-provides-a-neuroprotection-against-transient-cerebral-ischemia-by-attenuating-autophagy-at-the-ischemic-penumbra-in-neurons-but-not-in-astrocytes
#17
He Hongyun, Guo Tao, Zhang Pengyue, Yang Liqiang, Deng Yihao
Puerarin is an isoflavone derived from the Chinese medical herb of Radix puerariae (kudzu root), and has been widely used in the treatment for ischemic stroke in China. However, its underlying pharmacological mechanisms are still not understood. This study was to investigate the efficacy of puerarin on autophagy in the ischemic penumbra after cerebral stroke. A model of cerebral stroke in Sprague-Dawley rats was prepared by middle cerebral artery occlusion (MCAO); rats were then randomly divided into 5 groups: MCAO+Pue group (rats were treated with puerarin), MCAO+Pue+Tat-Beclin-1 group (rats were administrated with both puerarin and autophagy inducer Tat-Beclin-1), MCAO+Tat-Beclin-1 group (rats were treated with Tat-Beclin-1), MCAO+saline group (rats were administrated with the same volume of physiological saline), and sham surgery group...
February 10, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28191863/ulinastatin-downregulates-tlr4-and-nf-kb-expression-and-protects-mouse-brains-against-ischemia-reperfusion-injury
#18
Xiaofang Li, Likai Su, Xiangjian Zhang, Cong Zhang, Lina Wang, Yaoru Li, Ye Zhang, Tingting He, Xingyuan Zhu, Lili Cui
BACKGROUND: Inflammatory damage plays an important role in ischemic stroke and provides potential targets for therapy. Ulinastatin (UTI), a drug used to treat shock and acute pancreatitis in clinic, has attracted attention for its protective effects through immunomodulatory and anti-inflammatory properties. However, the effect of UTI in the acute phase of cerebral ischemia/reperfusion (I/R) is not clear. This study is to investigate the potential neuroprotective effect of UTI and explore its underlying mechanisms...
February 13, 2017: Neurological Research
https://www.readbyqxmd.com/read/28190714/carotid-endarterectomy-should-not-be-based-on-consensus-statement-duplex-velocity-criteria
#19
Jesse A Columbo, Bjoern D Suckow, Claire L Griffin, Jack L Cronenwett, Philip P Goodney, Timothy G Lukovits, Robert M Zwolak, Mark F Fillinger
OBJECTIVE: Randomized trials support carotid endarterectomy (CEA) in asymptomatic patients with ≥60% internal carotid artery (ICA) stenosis. The widely referenced Society for Radiologists in Ultrasound Consensus Statement on carotid duplex ultrasound (CDUS) imaging indicates that an ICA peak systolic velocity (PSV) ≥230 cm/s corresponds to a ≥70% ICA stenosis, leading to the potential conclusion that asymptomatic patients with an ICA PSV ≥230 cm/s would benefit from CEA. Our goal was to determine the natural history stroke risk of asymptomatic patients who might have undergone CEA based on consensus statement PSV of ≥230 cm/s but instead were treated medically based on more conservative CDUS imaging criteria...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28190603/neuroprotective-effects-of-a-novel-antioxidant-mixture-twendee-x-in-mouse-stroke-model
#20
Momoko Kusaki, Yasuyuki Ohta, Haruhiko Inufusa, Toru Yamashita, Ryuta Morihara, Yumiko Nakano, Xia Liu, Jingwei Shang, Feng Tian, Yusuke Fukui, Kota Sato, Mami Takemoto, Nozomi Hishikawa, Koji Abe
BACKGROUND: Oxidative stress and inflammation are important aggravating factors in acute ischemic stroke. METHODS: In the present study, the neuroprotective effects of a novel antioxidant mixture Twendee X containing multiple antioxidative ingredients, such as coenzyme Q10, ascorbic acid, and cystine, were evaluated. After the pretreatment of a vehicle or Twendee X (20 mg/kg/d) for 14 days, mice were subjected to transient middle cerebral artery occlusion for 60 minutes and further treated with vehicle or Twendee X for 1 or 5 days...
February 9, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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