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https://www.readbyqxmd.com/read/29227114/a-role-for-oral-health-personnel-in-stroke-prevention
#1
Jukka H Meurman
Possible links between stroke and periodontal disease are reviewed in this article. Topics covered include the signs and symptoms of stroke, dental and other infections associated with stroke, and the role of oral healthcare personnel in the prevention of stroke and treatment of stroke patients.
September 2017: Compendium of Continuing Education in Dentistry
https://www.readbyqxmd.com/read/29225577/if-channel-as-an-emerging-therapeutic-target-for-cardiovascular-diseases-a-review-of-current-evidence-and-controversies
#2
REVIEW
Hayelom G Mengesha, Tadesse B Tafesse, Mohammed H Bule
In 2015, non-communicable diseases accounted for 39.5 million (70%) of the total 56.4 million deaths that occurred globally, of which 17.7 million (45%) were due to cardiovascular diseases. An elevated heart rate is considered to be one of the independent predictors and markers of future cardiovascular diseases. A variety of experimental and epidemiological studies have found that atherosclerosis, heart failure, coronary artery disease, stroke, and arrhythmia are linked to elevated heart rate. Although there are established drugs to reduce the heart rate, these drugs have undesirable side effects...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29225324/effects-of-cilnidipine-an-l-n-type-calcium-channel-blocker-on-carotid-atherosclerosis-in-japanese-post-stroke-hypertensive-patients-results-from-the-ca-attend-study
#3
Tomohisa Nezu, Naohisa Hosomi, Shiro Aoki, Noriyuki Suzuki, Tsukasa Teshima, Hitoshi Sugii, Shinobu Nagahama, Yoshiki Kurose, Hirofumi Maruyama, Masayasu Matsumoto
AIMS: Although several antihypertensive agents reduced the carotid intima-media thickness (IMT), it remains unclear whether those agents affect the interadventitial diameter (IAD). We aimed to examine whether cilnidipine, an L/N-type calcium channel blocker, reduced the common carotid IMT or IAD in post-stroke hypertensive patients. METHODS: The common carotid IMT and IAD were measured at the start of cilnidipine treatment and 12 months from that. The changes in the mean max-IMT or IAD between baseline and the 12-month follow-up were evaluated and compared between the thick group (max-IMT ≥1...
December 9, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/29225254/observational-study-of-infective-endocarditis-at-a-community-based-hospital-dominance-of-elderly-patients-with-comorbidity
#4
Tomoo Nagai, Yoshiyuki Takase, Akira Hamabe, Hirotsugu Tabata
Objective The purpose of this study was to present the recent clinical profiles and the real-world management of infective endocarditis (IE). Methods All medical records of patients with IE were reviewed retrospectively for their clinical data, including clinical presentation, laboratory results, blood cultures, echocardiographic findings, treatments and complications. Using the clinical data collected, we calculated the EuroSCORE II, the European risk score for adult cardiac surgery, the Charlson Comorbidity Index as a surrogate of comordibity, and the Katz Index as a surrogate of frailty...
December 8, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29225139/astrocytes-and-ischemic-tolerance
#5
REVIEW
Yuri Hirayama, Schuichi Koizumi
A mild non-lethal ischemic episode can induce resistance to a subsequent severe ischemic injury in the brain. This phenomenon is termed ischemic tolerance or ischemic preconditioning, and is an endogenous mechanism that can provide robust neuroprotection. Because of its neuroprotective effects against cerebral ischemia or stroke, ischemic tolerance has been widely studied. However, almost all studies have been performed from the viewpoint of neurons. Accumulating evidence suggests that glial cells have various roles in regulation of brain function, including modulation of synaptic transmission, neuronal excitation, and neuronal structure...
December 7, 2017: Neuroscience Research
https://www.readbyqxmd.com/read/29224941/open-surgery-versus-endovascular-approach-in-treatment-of%C3%A2-extracranial-carotid-artery-aneurysms
#6
Leng Ni, Huiling Weng, Zuo Pu, Yuehong Zheng, Bao Liu, Wei Ye, Rong Zeng, Changwei Liu
OBJECTIVE: The objective of this study was to investigate and to compare the early and long-term results of open surgery with endovascular intervention in the treatment of extracranial carotid artery aneurysms (ECCAs). METHODS: A retrospective review of patients diagnosed with ECCAs who underwent open surgical or endovascular treatment from 1997 to 2017 was performed. Clinical characteristics, aneurysm profile, and treatment outcomes were recorded. Early results (<30 days) were evaluated in terms of mortality, perioperative stroke or transient ischemic attack, and cranial nerve injury...
December 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29224649/efficacy-and-safety-of-potent-platelet-p2y12-receptor-inhibitors-in-elderly-versus-nonelderly-patients-with-acute-coronary-syndrome-a-systematic-review-and-meta-analysis
#7
Giuseppe Tarantini, Daisuke Ueshima, Gianpiero D'Amico, Giulia Masiero, Giuseppe Musumeci, Gregg W Stone, Sorin J Brener
BACKGROUND: The use of the potent oral P2Y12 inhibitors prasugrel and ticagrelor in patients with acute coronary syndromes (ACS) has a favorable net clinical effect compared with clopidogrel and is recommended as first-line therapy. However, the impact of these agents on ischemic and bleeding events in elderly ACS patients is not well defined. METHODS: We performed a systematic review of articles comparing potent P2Y12 inhibitors to clopidogrel in elderly and nonelderly patients (defined according to each study) with ACS in terms of efficacy (composite of cardiovascular death, myocardial infarction, or stroke) and safety (major bleeding) end points...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29224648/effect-of-high-dose-oral-multivitamins-and-minerals-in-participants-not-treated-with-statins-in-the-randomized-trial-to-assess-chelation-therapy-tact
#8
Omar M Issa, Rhonda Roberts, Daniel B Mark, Robin Boineau, Christine Goertz, Yves Rosenberg, Eldrin F Lewis, Erminia Guarneri, Jeanne Drisko, Allan Magaziner, Kerry L Lee, Gervasio A Lamas
IMPORTANCE: In a prespecified subgroup analysis of participants not on statin therapy at baseline in the TACT, a high-dose complex oral multivitamins and multimineral regimen was found to have a large unexpected benefit compared with placebo. The regimen tested was substantially different from any vitamin regimen tested in prior clinical trials. OBJECTIVE: To explore these results, we performed detailed additional analyses of participants not on statins at enrollment in TACT...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29224364/new-anticoagulants-for-venous-thromboembolism-and-atrial-fibrillation-what-the-future-holds
#9
Gerasimos Dimitropoulos, S M Zubair Rahim, Alexandra Sophie Moss, Gregory Y H Lip
Introduction The field of anticoagulation has seen impressive progress over the last decade. The introduction of the Non Vitamin K Oral Anticoagulants (NOACs) has revolutionized practice surrounding thromboprophylaxis, treatment of thromboembolic disease and stroke prevention in atrial fibrillation (AF). However, the search for the "holy grail" of anticoagulation, an agent that combines optimal efficacy with minimal bleeding diathesis, continues. Areas covered In this paper we aim to summarize the current evidence from pre-clinical studies and early phase clinical trials, presenting the pharmacodynamic and pharmacokinetic properties as well as the safety and efficacy profiles of the most important antithrombotic agents in development...
December 9, 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/29223954/effect-of-pcsk9-inhibitors-on-clinical-outcomes-in-patients-with-hypercholesterolemia-a-meta-analysis-of-35-randomized-controlled-trials
#10
REVIEW
Aris Karatasakis, Barbara A Danek, Judit Karacsonyi, Bavana V Rangan, Michele K Roesle, Thomas Knickelbine, Michael D Miedema, Houman Khalili, Zahid Ahmad, Shuaib Abdullah, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: We sought to examine the efficacy and safety of 2 PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors: alirocumab and evolocumab. METHODS AND RESULTS: We performed a systematic review and meta-analysis of randomized controlled trials comparing treatment with and without PCSK9 inhibitors; 35 randomized controlled trials comprising 45 539 patients (mean follow-up: 85.5 weeks) were included. Mean age was 61.0±2.8 years, and mean baseline low-density lipoprotein cholesterol was 106±22 mg/dL...
December 9, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29223708/comparison-of-neuroplastic-responses-to-cathodal-transcranial-direct-current-stimulation-and-continuous-theta-burst-stimulation-in-subacute-stroke
#11
Pierre Nicolo, Cécile Magnin, Elena Pedrazzini, Gijs Plomp, Anaïs Mottaz, Armin Schnider, Adrian G Guggisberg
OBJECTIVE: To investigate the effects of cathodal transcranial direct current stimulation (tDCS) and continuous theta burst stimulation (cTBS) on neural network connectivity and motor recovery in individuals with subacute stroke. DESIGN: Double-blinded, randomized, placebo-controlled study. SETTING: Stroke subjects recruited through a university hospital rehabilitation program. PARTICIPANTS: Stroke inpatients (N=41; mean age 65y, range 28-85; mean weeks poststroke 5, range 2-10) with resultant paresis in the upper extremity (mean Fugl-Meyer score 14, range 3-48)...
December 6, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29223441/edoxaban-for-the-management-of-elderly-japanese-patients-with-atrial-fibrillation-ineligible-for-standard-oral-anticoagulant-therapies-rationale-and-design-of-the-eldercare-af-study
#12
Ken Okumura, Gregory Y H Lip, Masaharu Akao, Kimihiko Tanizawa, Masayuki Fukuzawa, Kenji Abe, Masahiro Akishita, Takeshi Yamashita
Edoxaban-a non-vitamin K antagonist oral anticoagulant (NOAC)- 60-mg and 30-mg once-daily dose regimens are noninferior versus well-managed warfarin for the prevention of stroke or systemic embolic events (SEE) with less major bleeding in patients with nonvalvular atrial fibrillation (NVAF). There are no published data from phase 3 clinical trials specifically evaluating the use of NOACs in elderly NVAF patients, especially those considered ineligible for available oral anticoagulants. The Edoxaban Low-Dose for EldeR CARE AF patients (ELDERCARE-AF) study is a phase 3, randomized, double-blind, placebo-controlled, parallel-group, multicenter study that will compare the safety and efficacy of once-daily edoxaban 15 mg versus placebo in Japanese patients with NVAF ≥80 years of age who are considered ineligible for standard oral anticoagulant therapy...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29223435/atrial-fibrillation-decision-support-tool-population-perspective
#13
Mark H Eckman, Alexandru Costea, Mehran Attari, Jitender Munjal, Ruth E Wise, Carol Knochelmann, Matthew L Flaherty, Pete Baker, Robert Ireton, Brett M Harnett, Anthony C Leonard, Dylan Steen, Adam Rose, John Kues
BACKGROUND: Appropriate thromboprophylaxis for patients with atrial fibrillation or atrial flutter (AF) remains a national challenge. The recent availability of direct oral anticoagulants (DOACs) with comparable efficacy and improved safety compared with warfarin alters the balance between risk factors for stroke and benefit of anticoagulation. Our objective was to examine the impact of DOACs as an alternative to warfarin on the net benefit of oral anticoagulant therapy (OAT) in a real-world population of AF patients...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29223433/contemporary-rates-and-correlates-of-statin-use-and-adherence-in-nondiabetic-adults-with-cardiovascular-risk-factors-the-kp-champ-study
#14
Alan S Go, Dongjie Fan, Sue Hee Sung, Alda I Inveiss, Victoria Romo-LeTourneau, Usha G Mallya, Susan Boklage, Joan C Lo
BACKGROUND: Statin therapy is highly efficacious in the prevention of fatal and nonfatal atherosclerotic events in persons at increased cardiovascular risk. However, its long-term effectiveness in practice depends on a high level of medication adherence by patients. METHODS: We identified nondiabetic adults with cardiovascular risk factors between 2008 and 2010 within a large integrated health care delivery system in Northern California. Through 2013, we examined the use and adherence of newly initiated statin therapy based on data from dispensed prescriptions from outpatient pharmacy databases...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29223431/international-trends-in-clinical-characteristics-and-oral-anticoagulation-treatment-for-patients-with-atrial-fibrillation-results-from-the-garfield-af-orbit-af-i-and-orbit-af-ii-registries
#15
Benjamin A Steinberg, Haiyan Gao, Peter Shrader, Karen Pieper, Laine Thomas, A John Camm, Michael D Ezekowitz, Gregg C Fonarow, Bernard J Gersh, Samuel Goldhaber, Sylvia Haas, Werner Hacke, Peter R Kowey, Jack Ansell, Kenneth W Mahaffey, Gerald Naccarelli, James A Reiffel, Alexander Turpie, Freek Verheugt, Jonathan P Piccini, Ajay Kakkar, Eric D Peterson, Keith A A Fox
Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world. We aimed to provide comprehensive data on international patterns of AF stroke prevention treatment. METHODS: Demographics, comorbidities, and stroke risk of the patients in the GARFIELD-AF (n=51,270), ORBIT-AF I (n=10,132), and ORBIT-AF II (n=11,602) registries were compared (overall N=73,004 from 35 countries). Stroke prevention therapies were assessed among patients with new-onset AF (≤6 weeks). RESULTS: Patients from GARFIELD-AF were less likely to be white (63% vs 89% for ORBIT-AF I and 86% for ORBIT-AF II) or have coronary artery disease (19% vs 36% and 27%), but had similar stroke risk (85% CHA2DS2-VASc ≥2 vs 91% and 85%) and lower bleeding risk (11% with HAS-BLED ≥3 vs 24% and 15%)...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29222799/middle-cerebral-artery-occlusion-by-an-intraluminal-suture-method
#16
Rosalia Crupi, Rosanna Di Paola, Emanuela Esposito, Salvatore Cuzzocrea
Stroke represents the most common fatal neurological disease especially in highly developed countries. Even today, treatment options are very limited. The development of new therapeutic approaches replies, to a great extent, on experimental rodent models of focal cerebral ischemia. Since ~80% of ischemic strokes occur in the area of middle cerebral artery (MCA), a number of these stroke models are based on this artery. The intraluminal monofilament model of MCA occlusion involves the insertion of a surgical filament inside the external carotid artery and its extension into the internal carotid artery until the tip occludes the source of the MCA-thus arresting blood flow with resultant infarction in the MCA area...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29222530/seizure-rates-in-enzalutamide-treated-men-with-metastatic-castration-resistant-prostate-cancer-and-risk-of-seizure-the-upward-study
#17
Susan Slovin, William Clark, Joan Carles, Andrew Krivoshik, Jung Wook Park, Fong Wang, Daniel George
Importance: The androgen receptor inhibitor enzalutamide prolongs survival in men with metastatic castration-resistant prostate cancer (mCRPC). In controlled clinical studies, 0.5% (10 of 2051) of patients experienced seizure, but patients with a history of or risk factors for seizure were excluded. Men with mCRPC and seizure risk factors have an estimated seizure rate of 2.8 per 100 patient-years without enzalutamide exposure. Objective: To assess seizure incidence in patients with seizure risk factors who were receiving enzalutamide for mCRPC...
December 7, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29222393/protect-proximal-balloon-occlusion-together-with-direct-thrombus-aspiration-during-stent-retriever-thrombectomy-evaluation-of-a-double-embolic-protection-approach-in-endovascular-stroke-treatment
#18
Christian Maegerlein, Sebastian Moench, Tobias Boeckh-Behrens, Manuel Lehm, Dennis M Hedderich, Maria Teresa Berndt, Silke Wunderlich, Claus Zimmer, Johannes Kaesmacher, Benjamin Friedrich
PURPOSE: Stent retriever-based mechanical thrombectomy (MT) for emergent large vessel occlusions (ELVO) is often complicated by thrombus fragmentation causing distal embolization and embolization to new vascular territories. Well-established embolic protection approaches include proximal flow arrest and distal aspiration techniques during stent retriever maneuvers. Aiming at the reduction of thrombus fragmentation during MT we evaluated a technical approach combining proximal balloon occlusion together with direct thrombus aspiration during MT: the PROTECT technique...
December 8, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29222290/chronic-organ-failure-in-adult-sickle-cell-disease
#19
REVIEW
Elliott Vichinsky
Sickle cell disease is now a chronic adult illness characterized by progressive multiorgan failure, particularly involving the brain and kidney. The etiology is multifactorial; it includes hemolysis and nitric oxide deficiency. As patients age, most experience neurologic insult. Twenty-five percent of older adults have had a clinical stroke and at least half of the population have had a silent infarct, cortical atrophy, and neurocognitive impairment. Periodic screening with neuroimaging and neurocognitive testing is recommended...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222229/visual-aids-for-patient-family-and-physician-decision-making-about-endovascular-thrombectomy-for-acute-ischemic-stroke
#20
Ivie Tokunboh, Marta Vales Montero, Matheus Fellipe Zopelaro Almeida, Latisha Sharma, Sidney Starkman, Viktor Szeder, Reza Jahan, David Liebeskind, Nestor Gonzalez, Andrew Demchuk, Michael T Froehler, Mayank Goyal, Maarten G Lansberg, Helmi Lutsep, Lee Schwamm, Jeffrey L Saver
BACKGROUND AND PURPOSE: Rapid decision making optimizes outcomes from endovascular thrombectomy for acute cerebral ischemia. Visual displays facilitate swift review of potential outcomes and can accelerate decision processes. METHODS: From patient-level, pooled randomized trial data, 100 person-icon arrays (Kuiper-Marshall personographs) were generated showing beneficial and adverse effects of endovascular thrombectomy for patients with acute cerebral ischemia and large vessel occlusion using (1) automated (algorithmic) and (2) expert-guided joint outcome table specification...
December 8, 2017: Stroke; a Journal of Cerebral Circulation
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