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Stroke therapy

Y-X Wang, Y-Q Li, Y Chen, C-H Zhang, Z Dong, Z Wang, S-N Zhao, C-H Li, P-L Zhang
OBJECTIVE: Orolingual angioedema (OA) is a rare clinical complication with a potentially fatal risk that occurs after the intravenous application of alteplase (rt-PA) in patients with acute ischemic stroke. The purpose of this work is to investigate the related factors of OA in patients with acute ischemic stroke after the administration of intravenous thrombolytic therapy, to improve the predictive ability of OA during intravenous thrombolytic therapy, and to reduce the prevalence of complications...
March 2018: European Review for Medical and Pharmacological Sciences
David L Tirschwell, Mark Turner, David Thaler, James Choulerton, David Marks, John Carroll, Lee MacDonald, Richard W Smalling, Maria Koullick, Ning Yan Gu, Jeffrey L Saver
OBJECTIVE: Compared to medical therapy alone, percutaneous closure of patent foramen ovale (PFO) further reduces risk of recurrent ischemic strokes in carefully selected young to middle-aged patients with a recent cryptogenic ischemic stroke. The objective of this study was to evaluate the cost-effectiveness of this therapy in the context of the United Kingdom (UK) healthcare system. METHODS: A Markov cohort model consisting of 4 health states (Stable after index stroke, Post-Minor Recurrent Stroke, Post-Moderate Recurrent Stroke, and Death) was developed to simulate the economic outcomes of device-based PFO closure compared to medical therapy...
March 22, 2018: Journal of Medical Economics
Bea Essers, Sarah Meyer, Nele De Bruyn, Annick Van Gils, Leonardo Boccuni, Lisa Tedesco Triccas, André Peeters, Vincent Thijs, Hilde Feys, Geert Verheyden
PURPOSE: To investigate the relation between observed and perceived upper limb motor function in patients with chronic stroke. MATERIAL AND METHODS: We investigated 32 patients at six months after stroke with the Fugl-Meyer Assessment (observed function) and hand subscale of the Stroke Impact Scale (perceived function). Spearman correlation was calculated to relate observed and perceived function. Through cut-off scores, we divided our sample in low (Fugl-Meyer Assessment <31/66) and good observed function, and low (hand subscale of Stroke Impact Scale <61/100) and good perceived function...
March 22, 2018: Disability and Rehabilitation
Maria Shoaib, Jacqueline J Kraus, Muhammad T Khan
Herpes simplex virus encephalitis (HSVE) is a medical emergency associated with high mortality and morbidity. Definitive diagnosis is established by history, clinical examination, neuroimaging studies, supportive electroencephalogram (EEG) findings, and cerebrospinal fluid (CSF) analysis. We report a case of HSVE presenting as a stroke mimic in a 76-year-old female with a history of atrial fibrillation on warfarin. She was admitted to our medical intensive care unit with intermittent fever, lethargy, and new onset left-sided hemiparesis...
January 15, 2018: Curēus
Seong Heon Kim, Hye Young Kim, Su Young Kim
Hemolytic uremic syndrome (HUS) is often encountered in children with acute kidney injury. Besides the well-known shiga toxin-producing Escherichia coli -associated HUS, atypical HUS (aHUS) caused by genetic complement dysregulation has been studied recently. aHUS is a rare, chronic, and devastating disorder that progressively damages systemic organs, resulting in stroke, end-stage renal disease, and death. The traditional treatment for aHUS is mainly plasmapheresis or plasma infusion; however, many children with aHUS will progress to chronic kidney disease despite plasma therapy...
February 2018: Korean Journal of Pediatrics
Dong Yang, Min Lin, Shuiping Wang, Huaiming Wang, Yonggang Hao, Wenjie Zi, Penghua Lv, Dequan Zheng, Guodong Xiao, Gelin Xu, Yunyun Xiong, Xinfeng Liu
Objective The objective of this article is to compare the effectiveness of primary angioplasty and/or stenting with stent retriever thrombectomy in acute anterior large-vessel occlusion due to atherosclerotic disease. Methods Patients were retrospectively reviewed from the endovascular treatment for acute anterior circulation ischemic stroke registry. Patients with large-vessel occlusions due to atherosclerosis were selected. We evaluated modified Rankin Scale (mRS) score at 90 days, modified thrombolysis in cerebral infarction (mTICI) score immediately post-procedure, and symptomatic and asymptomatic intracranial hemorrhage within 72 hours...
January 1, 2018: Interventional Neuroradiology
Valentina A Babenko, Denis N Silachev, Vasily A Popkov, Ljubava D Zorova, Irina B Pevzner, Egor Y Plotnikov, Gennady T Sukhikh, Dmitry B Zorov
A recently discovered key role of reactive oxygen species (ROS) in mitochondrial traffic has opened a wide alley for studying the interactions between cells, including stem cells. Since its discovery in 2006, intercellular mitochondria transport has been intensively studied in different cellular models as a basis for cell therapy, since the potential of replacing malfunctioning organelles appears to be very promising. In this study, we explored the transfer of mitochondria from multipotent mesenchymal stem cells (MMSC) to neural cells and analyzed its efficacy under normal conditions and upon induction of mitochondrial damage...
March 19, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
Caiyun Jia, Ci Wei, Ming Hu, Jing Xu, Kun Niu, Chao Zhang, Peiyuan Lv, Ling Li, Yanhong Dong
OBJECTIVE: To investigate the clinical significance of antiplatelet aggregation therapy for patients diagnosed with acute cerebral infarction (ACI) complicated with the cerebral microbleeds (CMBs). METHODS: Thirty patients with ACI and 36 patients with intracerebral hemorrhage (ICH) were included in this research. Two groups, studied by susceptibility-weighted imaging (SWI), were compared in terms of the number, location, and severity of CMBs. Then, 30 cases of ACI patients were divided into CMBs sub-group and non-CMBs sub-group...
March 15, 2018: Journal of X-ray Science and Technology
Michael P Kilgard, Robert L Rennaker, Jen Alexander, Jesse Dawson
BACKGROUND: Recent studies indicate that vagus nerve stimulation (VNS) paired with rehabilitation can enhance neural plasticity in the primary sensory and motor cortices, improve forelimb function after stroke in animal models and improve motor function in patients with arm weakness after stroke. OBJECTIVE: To gain "first-in-man" experience of VNS paired with tactile training in a patient with severe sensory impairment after stroke. METHODS: During the long-term follow-up phase of a clinical trial of VNS paired with motor rehabilitation, a 71-year-old man who had made good motor recovery had ongoing severe sensory loss in his left hand and arm...
2018: NeuroRehabilitation
Ji-Ho Park, Yong-Il Shin, Joshua Sung H You, Min Su Park
BACKGROUND: Robotic-assisted gait training (RAGT) has been proposed as a novel, promising intervention paradigm to improve gait function in subacute or chronic stroke neurorehabilitation. However, the benefits of RAGT combined with conventional physical therapy for gait recovery in patients with subacute and chronic hemiparetic stroke remain unclear. OBJECTIVES: The aim of the present study was to compare the effect of RAGT combine with conventional physical therapy on hip joint kinetics, kinematics, and clinical function characteristics between subacute and chronic hemiparetic stroke...
2018: NeuroRehabilitation
Shalender Bhasin, Juan P Brito, Glenn R Cunningham, Frances J Hayes, Howard N Hodis, Alvin M Matsumoto, Peter J Snyder, Ronald S Swerdloff, Frederick C Wu, Maria A Yialamas
Objective: To update the "Testosterone Therapy in Men With Androgen Deficiency Syndromes" guideline published in 2010. Participants: The participants include an Endocrine Society-appointed task force of 10 medical content experts and a clinical practice guideline methodologist. Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence...
March 17, 2018: Journal of Clinical Endocrinology and Metabolism
Jan Steffel, Peter Verhamme, Tatjana S Potpara, Pierre Albaladejo, Matthias Antz, Lien Desteghe, Karl Georg Haeusler, Jonas Oldgren, Holger Reinecke, Vanessa Roldan-Schilling, Nigel Rowell, Peter Sinnaeve, Ronan Collins, A John Camm, Hein Heidbüchel
The current manuscript is the Executive Summary of the second update to the original Practical Guide, published in 2013. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain...
March 19, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Jan Steffel, Peter Verhamme, Tatjana S Potpara, Pierre Albaladejo, Matthias Antz, Lien Desteghe, Karl Georg Haeusler, Jonas Oldgren, Holger Reinecke, Vanessa Roldan-Schilling, Nigel Rowell, Peter Sinnaeve, Ronan Collins, A John Camm, Hein Heidbüchel
The current manuscript is the second update of the original Practical Guide, published in 2013 [Heidbuchel et al. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013;15:625-651; Heidbuchel et al. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace 2015;17:1467-1507]. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF) and have emerged as the preferred choice, particularly in patients newly started on anticoagulation...
March 17, 2018: European Heart Journal
Yi Dong, Kun Fang, Xin Wang, Shengdi Chen, Xueyuan Liu, Yuwu Zhao, Yangtai Guan, Dingfang Cai, Gang Li, Jianmin Liu, Jianren Liu, Jianhua Zhuang, Panshi Wang, Xin Chen, Haipeng Shen, David Z Wang, Ying Xian, Wuwei Feng, Bruce Cv Campbell, Mark Parsons, Qiang Dong
Background Several stroke outcome and quality control projects have demonstrated the success in stroke care quality improvement through structured process. However, Chinese health-care systems are challenged with its overwhelming numbers of patients, limited resources, and large regional disparities. Aim To improve quality of stroke care to address regional disparities through process improvement. Method and design The Shanghai Stroke Service System (4S) is established as a regional network for stroke care quality improvement in the Shanghai metropolitan area...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
A R Godunova, A A Rakhimova, O I Leontyeva, I G Talipova, R M Yakhin, Sh G Musin
AIM: To study an effect of submaximal doses of mexidol on the dynamics of biochemical markers of inflammation and damage to brain tissue in the acute period of ischemic stroke. MATERIAL AND METHODS: A total of 60 patients admitted in the first 6h after disease onset with a verified ischemic stroke (7-9 points on the ASPECT scale) were enrolled in the study. Thirty patients in the study group received submaximal doses of mexidol: 750 mg infusion dropwise in 250 ml of 0...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
I E Sazonov, T D Klementenko, A A Kudinov, M A Avramenko, S N Yarmonov
AIM: To evaluate the efficacy of cytoflavin in the dose of 10 ml/day in the complex therapy in acute period of hemorrhagic stroke. MATERIAL AND METHODS: Sixty patients were examined in the acute period of hemorrhagic stroke (HS). The NIHSS, the Rivermead Mobility Index, the Rankin scale and the Barthel Index of Activities of Daily Living were used. Patients were divided into 2 groups: the main group included 30 patients who received cytoflavin in addition to basic therapy...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Selene Pozzebon, Aaron Blandino Ortiz, Federico Franchi, Stefano Cristallini, Mirko Belliato, Olivier Lheureux, Alexandre Brasseur, Jean-Louis Vincent, Sabino Scolletta, Jacques Creteur, Fabio Silvio Taccone
BACKGROUND: Acute cerebral complications (ACC) of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) are associated with poor long-term neurologic outcome. We described the role of rSO2 monitoring in detecting ACC and desaturations and their relationship with poor outcome when employing VA-ECMO. METHODS: Retrospective analysis of patients monitored by cerebral frontal near-infrared spectroscopy (NIRS) (CAS Medical Systems Inc., Branford, CT, USA) during VA-ECMO (November 2008-December 2015)...
March 20, 2018: Neurocritical Care
Woo-Jin Lee, Keun-Hwa Jung, Young Jin Ryu, Jeong-Min Kim, Soon-Tae Lee, Kon Chu, Manho Kim, Sang Kun Lee, Chul-Ho Sohn, Jae-Kyu Roh
Objective: We aimed to evaluate the impact of underlying mechanism of basilar artery (BA) occlusion on the outcomes after endovascular therapy (EVT) for reperfusion and the outcome factors associated with each mechanism, and to identify radiologic parameters enabling to distinguish the underlying mechanism. Methods: From a registry database, 194 consecutive patients with acute BA occlusion who underwent EVT were analyzed. Stroke mechanism, classified into in situ atherosclerotic thrombosis (ISAT) and embolism, clot sign location profiles in pre-angiography magnetic resonance image (MRI), parameters of angiography and EVT, and reperfusion were assessed...
March 2018: Annals of Clinical and Translational Neurology
Byung Hyun Baek, Hyung Seok Kim, Woong Yoon, Yun Young Lee, Jang Mi Baek, Eun Hee Kim, Seul Kee Kim
Objective: In this study we investigate the association between the expression of inflammatory mediators measured in clots retrieved by mechanical thrombectomy, stroke etiology, and the susceptibility vessel sign (SVS) on gradient-echo (GRE) MR imaging in acute ischemic stroke patients. Methods: We performed molecular analysis of intracranial clots retrieved by mechanical thrombectomy from 82 patients with acute stroke. Seventy-two of these patients underwent GRE imaging before endovascular therapy...
March 2018: Annals of Clinical and Translational Neurology
Seung Yeol Lee, Hyun Seok, Sang-Hyun Kim, Mingeun Park, Jihoon Kim
Objective: To investigate the immediate therapeutic effects of mental singing while walking intervention on gait disturbances in hemiplegic stroke patients. Methods: Eligible, post-stroke, hemiplegic patients were prospectively enrolled in this study. The inclusion criteria were a diagnosis of hemiplegia due to stroke, and ability to walk more than 10 m with or without gait aids. Each patient underwent structured music therapy sessions comprising 7 consecutive tasks, and were trained to sing in their mind (mental singing) while walking...
February 2018: Annals of Rehabilitation Medicine
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