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https://www.readbyqxmd.com/read/27926618/does-sensory-transcutaneous-electrical-stimulation-prevent-pneumonia-in-the-acute-stage-of-stroke-a-preliminary-study
#1
Satoshi Hamada, Hirofumi Yamaguchi, Hiroyoshi Hara
Acute stroke patients with dysphagia are at risk of developing pulmonary infection, which increases the risk of death. Therefore, optimal management of dysphagia is essential; however, available evidence supporting the effectiveness of dysphagia treatments is limited. Surface electrical stimulation (e-stim) has been developed as a new treatment modality for dysphagia. In this study, we investigated the efficacy of surface sensory e-stim therapy in preventing pulmonary infection in 53 acute stroke patients with dysphagia...
December 6, 2016: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/27926465/freestyle-stentless-bioprosthesis-for-aortic-valve-therapy-17-year-clinical-results
#2
Juergen Ennker, Markus Meilwes, Joern Pons-Kuehnemann, Bernd Niemann, Philippe Grieshaber, Ina C Ennker, Andreas Boening
BACKGROUND: Aortic valve replacement with stentless bioprostheses has been shown to produce lower aortic gradients than stented bioprostheses, thus facilitating left ventricular mass regression and preventing heart failure. We sought to determine the long-term results of stentless biological aortic valve replacement over a 17-year follow-up. METHODS: Between 1996 and 2012, 2551 patients underwent isolated aortic valve replacement with a stentless prosthesis (Medtronic Freestyle) at a single center...
November 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27926449/the-role-of-dopamine-in-the-pathophysiology-and-treatment-of-apathy
#3
T T-J Chong, M Husain
Disorders of diminished motivation, such as apathy, are common and prevalent across a wide range of medical conditions, including Parkinson's disease, Alzheimer's dementia, stroke, depression, and schizophrenia. Such disorders have a significant impact on morbidity and quality of life, yet their management lacks consensus and remains unsatisfactory. Here, we review laboratory and clinical evidence for the use of dopaminergic therapies in the treatment of apathy. Dopamine is a key neurotransmitter that regulates motivated decision making in humans and other species...
2016: Progress in Brain Research
https://www.readbyqxmd.com/read/27926447/motivation-and-attention-following-hemispheric-stroke
#4
E Olgiati, C Russell, D Soto, P Malhotra
Spatial neglect (SN) is an extremely common disorder of attention; it is most frequently a consequence of stroke, especially to the right cerebral hemisphere. The current view of SN is that it is not a unitary deficit but a multicomponent syndrome. Crucially, it has been repeatedly shown that it has a considerable negative impact on rehabilitation outcome. Although a number of behavioral and pharmacological therapies have been developed, none of these appears to be applicable to all patients with SN or has proved unequivocally successful in clinical trials...
2016: Progress in Brain Research
https://www.readbyqxmd.com/read/27925310/prognostic-factors-in-patients-with-stemi-undergoing-primary-pci-in-the-clopidogrel-era-role-of-dual-antiplatelet-therapy-at-admission-and-the-smoking-paradox-on-long-term-outcome
#5
Giovanni Ciccarelli, Emanuele Barbato, Marco Golino, Giovanni Cimmino, Jozef Bartunek, Luigi Di Serafino, Domenico Di Girolamo, Bernard De Bruyne, William Wijns, Paolo Golino
BACKGROUND: Several clinical and laboratory variables have an impact on the prognosis of STEMI patients undergoing PPCI; however, little is known about the role of ongoing DAPT at the time of the event and the smoking status as prognostic factors affecting the outcome of these patients. METHODS AND RESULTS: Seven-hundred and thirteen consecutive STEMI patients undergoing PPCI, admitted to the S. Anna and S. Sebastiano Hospital (Caserta, Italy) and to the OLV Clinic (Aalst, Belgium), between March 2009 and December 2011, were retrospectively enrolled...
December 7, 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27924429/cyp2c19-lof-and-gof-guided-antiplatelet-therapy-in-patients-with-acute-coronary-syndrome-a-cost-effectiveness-analysis
#6
Minghuan Jiang, Joyce H S You
PURPOSE: This study aimed to examine the cost-effectiveness of CYP2C19 loss-of-function and gain-of-function allele guided (LOF/GOF-guided) antiplatelet therapy in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). METHODS: A life-long decision-analytic model was designed to simulate outcomes of three strategies: universal clopidogrel (75 mg daily), universal alternative P2Y12 inhibitor (prasugrel 10 mg daily or ticagrelor 90 mg twice daily), and LOF/GOF-guided therapy (LOF/GOF allele carriers receiving alternative P2Y12 inhibitor, wild-type patients receiving clopidogrel)...
December 7, 2016: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/27924212/combined-administration-of-the-gpvi-fc-fusion-protein-revacept-with-low-dose-thrombolysis-in-the-treatment-of-stroke
#7
Andreas Reimann, Zhongmin Li, Silvia Goebel, Julia Fassbender, Hans-Peter Holthoff, Meinrad Gawaz, Götz Münch, Martin Ungerer
BACKGROUND: Thrombolytic therapy with recombinant tissue plasminogen activator (rtPA) remains the only approved medication for acute ischemic stroke, but incurs significant bleeding risks. Therefore, approaches to combine lower doses of thrombolytic therapy with other effective drugs aim at improving efficacy and reducing bleeding rates. We examined the safety and therapeutic effects of various dosings of rtPA, either alone or combined with glycoprotein VI-Fc fusion protein (GPVI-Fc, Revacept) on experimental stroke in mice...
January 2016: Heart International
https://www.readbyqxmd.com/read/27924073/diagnostic-performance-of-peroxiredoxin-1-to-determine-time-of-onset-of-acute-cerebral-infarction
#8
Sébastien Richard, Vanessa Lapierre, Nicolas Girerd, Mathieu Bonnerot, Pierre R Burkhard, Linnéa Lagerstedt, Serge Bracard, Marc Debouverie, Natacha Turck, Jean-Charles Sanchez
Accurately determining time-of-onset of cerebral infarction is important to clearly identify patients who could benefit from reperfusion therapies. We assessed the kinetics of peroxiredoxin 1 (PRDX1), a protein involved in oxidative stress during the acute phase of ischemia, and its ability to determine stroke onset in a population of patients with known onset of less than 24 hours and in a control group. Median PRDX1 levels were significantly higher in stroke patients compared to controls. PRDX1 levels were also higher from blood samples withdrawn before vs...
December 6, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27924055/lifestyle-interventions-to-prevent-cardiovascular-events-after-stroke-and-transient-ischemic-attack-systematic-review-and-meta-analysis
#9
Inger A Deijle, Sander M Van Schaik, Erwin E H Van Wegen, Henry C Weinstein, Gert Kwakkel, Renske M Van den Berg-Vos
BACKGROUND AND PURPOSE: Patients with a transient ischemic attack or ischemic stroke have an increased risk of subsequent cardiovascular events. The purpose of this systematic review and meta-analysis was to determine whether lifestyle interventions focusing on behaviorally modifiable risk factors with or without an exercise program are effective in terms of (1) preventing recurrent cardiovascular events, (2) reducing mortality, and (3) improving modifiable risk factors associated with cardiovascular disease in patients after a transient ischemic attack or ischemic stroke...
December 6, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27923755/safety-and-efficacy-of-surgical-and-endovascular-treatment-for-distal-anterior-cerebral-artery-aneurysms-a-systematic-review-and-meta-analysis
#10
Ondra Petr, Lucie Coufalová, Rafael Rehwald, Berharnd Glodny, Vladimír Beneš
BACKROUND: Aneurysms of the distal anterior cerebral artery (DACA) are rare, representing between 1% and 9% of all intracranial aneurysms. The best treatment strategy for these aneurysms continue to be debated. OBJECTIVE: We conducted a systematic review of the literature to evaluate the safety and efficacy of treatment strategies of DACA-aneurysms. METHODS: A systematic search of Medline, EMBASE, Scopus and Web of Science was done for studies published from 01/2000 to 08/2015...
December 3, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27923391/erratum-to-robot-assisted-and-conventional-therapies-produce-distinct-rehabilitative-trends-in-stroke-survivors
#11
Francisco J Valero-Cuevas, Verena Klamroth-Marganska, Carolee J Winstein, Robert Riener
No abstract text is available yet for this article.
December 6, 2016: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/27923376/immunomodulation-after-ischemic-stroke-potential-mechanisms-and-implications-for-therapy
#12
REVIEW
Cynthia Santos Samary, Paolo Pelosi, Pedro Leme Silva, Patricia Rieken Macedo Rocco
Brain injuries are often associated with intensive care admissions, and carry high morbidity and mortality rates. Ischemic stroke is one of the most frequent causes of injury to the central nervous system. It is now increasingly clear that human stroke causes multi-organ systemic disease. Brain inflammation may lead to opposing local and systemic effects. Suppression of systemic immunity by the nervous system could protect the brain from additional inflammatory damage; however, it may increase the susceptibility to infection...
December 7, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27922588/does-the-addition-of-ezetimibe-to-statins-reduce-cardiovascular-risk
#13
Francisca I Araya, Bruno Grassi
Statins are the mainstay of lipid-lowering therapy nowadays, since they reduce cardiovascular risk when used as primary or secondary prevention. However, only one third of the patients reach the goals established in several guidelines, and even if they do, they keep a risk higher than healthy controls. One of the new lipid-lowering agents is ezetimibe. Searching in Epistemonikos database, which is maintained by screening multiple databases, we identified nine systematic reviews comprising 67 trials overall...
December 5, 2016: Medwave
https://www.readbyqxmd.com/read/27920715/intra-arterial-mechanical-thrombectomy-an-effective-treatment-for-ischemic-stroke-caused-by-endocarditis
#14
Olafur Sveinsson, Lars Herrman, Staffan Holmin
Patients with stroke secondary to infectious endocarditis have a high in-hospital morbidity and mortality, with only one-third becoming functionally independent. Infective endocarditis is usually considered a relative contraindication to thrombolytic therapy. We describe 3 consecutive cases of acute middle cerebral artery occlusion due to infective endocarditis, who were all successfully treated with intra-arterial mechanical thrombectomy using the Solitaire device. From this limited experience, mechanical thrombectomy could be used as an effective acute treatment for ischemic stroke in patients with infective endocarditis...
September 2016: Case Reports in Neurology
https://www.readbyqxmd.com/read/27920364/an-optimal-wilcoxon-mann-whitney-test-of-mortality-and-a-continuous-outcome
#15
Roland A Matsouaka, Aneesh B Singhal, Rebecca A Betensky
We consider a two-group randomized clinical trial, where mortality affects the assessment of a follow-up continuous outcome. Using the worst-rank composite endpoint, we develop a weighted Wilcoxon-Mann-Whitney test statistic to analyze the data. We determine the optimal weights for the Wilcoxon-Mann-Whitney test statistic that maximize its power. We derive a formula for its power and demonstrate its accuracy in simulations. Finally, we apply the method to data from an acute ischemic stroke clinical trial of normobaric oxygen therapy...
December 5, 2016: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/27919464/smart-syndrome-classic-transient-symptoms-leading-to-an-unusual-unfavorable-outcome
#16
F Bompaire, L Zinchenko, M Lahutte, K Mokhtari, D Psimaras, C Gaultier, A Monjour, J-Y Delattre, D Ricard
BACKGROUND: Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare complication of cerebral radiation therapy that usually presents>10 years after treatment as reversible paroxysmal episodes of neurological dysfunction associated with headaches. CASES: We report here on two cases of SMART syndrome in long-term survivors of high-grade glioma for whom neuropathological data were available. The course of the disease was unfavorable. Although the clinico-radiological picture of SMART syndrome clearly differs from classic cerebral radionecrosis, the gross neuropathological lesions observed in our two patients appeared to be similar to those described in focal radionecrosis...
December 2, 2016: Revue Neurologique
https://www.readbyqxmd.com/read/27919293/perioperative-statin-therapy-in-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#17
Alessandro Putzu, Bruno Capelli, Alessandro Belletti, Tiziano Cassina, Enrico Ferrari, Michele Gallo, Gabriele Casso, Giovanni Landoni
BACKGROUND: Several studies suggest beneficial effects of perioperative statin therapy on postoperative outcome after cardiac surgery. However, recent randomized controlled trials (RCTs) show potential detrimental effects. The objective of this systematic review is to examine the association between perioperative statin therapy and clinical outcomes in cardiac surgery patients. METHODS: Electronic databases were searched up to 1 November 2016 for RCTs of preoperative statin therapy versus placebo or no treatment in adult cardiac surgery...
December 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27917948/association-of-cortical-vein-filling-with-clot-location-and-clinical-outcomes-in-acute-ischaemic-stroke-patients
#18
Sonu Bhaskar, Andrew Bivard, Peter Stanwell, John R Attia, Mark Parsons, Michael Nilsson, Christopher Levi
Delay in cortical vein filling during the late-venous phase (delayed-LCVF) is characterized by opacification of cerebral veins despite contrast clearance from contralateral veins on dynamic computed tomography angiography (dCTA) in acute ischemic stroke (AIS) patients. The aim of the study was to investigate the associations of delayed-LCVF with clot location, reperfusion status at 24 hours, and 90-days functional outcome in AIS patients who received reperfusion therapy. A prospective cohort of AIS patients treated with intravenous thrombolysis was studied...
December 5, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27917945/improvement-in-stroke-induced-motor-dysfunction-by-music-supported-therapy-a-systematic-review-and-meta-analysis
#19
Yingshi Zhang, Jiayi Cai, Yaqiong Zhang, Tianshu Ren, Mingyi Zhao, Qingchun Zhao
To conduct a meta-analysis of clinical trials that examined the effect of music-supported therapy on stroke-induced motor dysfunction, comprehensive literature searches of PubMed, Embase and the Cochrane Library from their inception to April 2016 were performed. A total of 10 studies (13 analyses, 358 subjects) were included; all had acceptable quality according to PEDro scale score. The baseline differences between the two groups were confirmed to be comparable. Compared with the control group, the standardized mean difference of 9-Hole Peg Test was 0...
December 5, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27917716/antithrombotic-treatment-management-in-patients-with-intracerebral-hemorrhage-reversal-and-restart
#20
Dimitrios Giakoumettis, George A Alexiou, Dimitrios A Vrachatis, Kostas Themistoklis, Pantelis Stathis, Manolis Vavuranakis, Marios S Themistocleous
BACKGROUND: Intracerebral hemorrhage is the pathological accumulation of blood within the brain. It is a type of stroke more likely to be lethal or to severely disable the patient and results from a wide variety of causes. On the other hand antithrombotic therapy is used for the prevention or/and the therapy of thromboembolic episodes. Antithrombotic drugs are very effective in reducing risk or mortality rate after a thromboembolic event, yet they are associated with significant hemorrhages...
December 5, 2016: Current Pharmaceutical Design
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