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Stroke therapy

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https://www.readbyqxmd.com/read/28926782/enterprise-stent-in-recanalizing-non-acute-atherosclerotic-intracranial-internal-carotid-artery-occlusion
#1
Xiaofei Wang, Zhigang Wang, Yong Ji, Xuan Ding, Yizheng Zang, Chengwei Wang
OBJECTIVE: To investigate the safety and effectiveness of recanalization in non-acute occlusion of intracranial internal carotid arteries using the flexible Enterprise self-expanding stent. PATIENTS AND METHODS: From June 2014 to June 2016, 12 consecutive patients with non-acute occlusion of intracranial internal carotid arteries received endovascular recanalization with Enterprise stenting. All patients received medication for anti-platelet aggregation therapy before and after the operation...
June 27, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28926405/elevated-ischemic-stroke-risk-among-women-living-with-hiv-infection
#2
Felicia C Chow, Susan Regan, Markella V Zanni, Sara E Looby, Cheryl D Bushnell, James B Meigs, Steven K Grinspoon, Steve K Feske, Virginia A Triant
OBJECTIVE: To determine if the greater risk of ischemic stroke observed in women living with HIV infection (WLWH) compared with HIV-uninfected women persists after accounting for both traditional and sex-specific stroke risk factors. METHODS: We performed an observational cohort study of WLWH (n = 1,214) and demographics-matched HIV-uninfected women (n = 12,041) seen between 1996 and 2011 at two tertiary care hospitals in Boston. We used Cox proportional hazards regression analyses to model time to ischemic stroke, adjusting first for demographics and traditional stroke risk factors and then for sex-specific stroke risk factors, including menopause and estrogen use...
September 18, 2017: AIDS
https://www.readbyqxmd.com/read/28925859/effects-of-evolocumab-on-cardiovascular-events
#3
Nasser Mikhail
BACKGROUND: Evolocumab is a potent lipid-lowering drug that decreases plasma levels of low-density lipoprotein cholesterol (LDL-C) by 50-60%. FOURIER is a landmark randomized, trial involving 27,564 patients with established cardiovascular disease already on statins and plasma LDL-C levels > 70 mg/dl. OBJECTIVE: the main objective of FOURIER was to examine the effects of evolocumab on cardiovascular events. RESULTS: After a mean follow-up of 2...
September 18, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28925645/vitamin-b12-deficiency-recognition-and-management
#4
Robert C Langan, Andrew J Goodbred
Vitamin B12 deficiency is a common cause of megaloblastic anemia, various neuropsychiatric symptoms, and other clinical manifestations. Screening average-risk adults for vitamin B12 deficiency is not recommended. Screening may be warranted in patients with one or more risk factors, such as gastric or small intestine resections, inflammatory bowel disease, use of metformin for more than four months, use of proton pump inhibitors or histamine H2 blockers for more than 12 months, vegans or strict vegetarians, and adults older than 75 years...
September 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28923530/transfer-of-stroke-patients-impairs-eligibility-for-endovascular-stroke-treatment
#5
Omid Nikoubashman, Franziska Pauli, Kolja Schürmann, Ahmed E Othman, Jan-Philipp Bach, Martin Wiesmann, Arno Reich
BACKGROUND: Many patients who are potentially eligible for endovascular stroke treatment (EST) receive intravenous rtPA in the closest stroke unit before being transferred to tertiary centres for EST. It has been shown that clinical outcome of transferred and EST-treated patients is comparable to that of patients with direct access to EST. We analysed clinical outcome of patients, who were transferred and eventually not treated due to clinical and/or radiological deterioration. METHODS: We retrospectively analysed our prospectively maintained stroke registry for patients who were transferred for stroke therapy...
September 15, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28923500/priorities-for-closing-the-evidence-practice-gaps-in-post-stroke-aphasia-rehabilitation-a-scoping-review
#6
REVIEW
Kirstine Shrubsole, Linda Worrall, Emma Power, Denise A O'Connor
OBJECTIVE: To identify implementation priorities for post-stroke aphasia management relevant to the Australian healthcare context. DATA SOURCES: Using systematized searches of databases (CINAHL, Medline), guideline and stroke websites, and other sources, evidence was identified and extracted for seven implementation criteria for 13 topic areas relevant to aphasia management. These seven priority-setting criteria were identified in the implementation literature; strength of the evidence; current evidence-practice gap; clinician preference; client preference; modifiability; measurability; and health impact...
September 15, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28923492/rationale-and-design-of-the-atrial-fibrillation-health-literacy-information-technology-trial-af-litt
#7
Emily N Guhl, Courtney L Schlusser, Lori E Henault, Timothy W Bickmore, Everlyne Kimani, Michael K Paasche-Orlow, Jared W Magnani
BACKGROUND: Atrial Fibrillation (AF) is a common cardiac arrhythmia that is challenging for patients and adversely impacts health-related quality of life (HRQoL). Long-term management of AF requires that patients adhere to complex therapies, understand difficult terminology, navigate subspecialty care, and have continued symptom monitoring with the goal of preventing adverse outcomes. Continued interventions to ameliorate the patient experience of AF are essential. DESIGN: The Atrial Fibrillation health Literacy Information Technology Trial (AF-LITT; NCT03093558) is an investigator-initiated, 2-arm randomized clinical trial (RCT)...
September 15, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28923278/can-adjunctive-therapies-augment-the-efficacy-of-endovascular-thrombolysis-a-potential-role-for-activated-protein-c
#8
REVIEW
Arun Paul Amar, Abhay P Sagare, Zhen Zhao, Yaoming Wang, Amy R Nelson, John H Griffin, Berislav V Zlokovic
In the management of acute ischemic stroke, vessel recanalization correlates with functional status, mortality, cost, and other outcome measures. Thrombolysis with intravenous tissue plasminogen activator has many limitations that restrict its applicability, but recent advances in the development of mechanical thrombectomy devices as well as improved systems of stroke care have resulted in greater likelihood of vessel revascularization. Nonetheless, there remains substantial discrepancy between rates of recanalization and rates of favorable outcome...
September 15, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28923277/animal-models-of-ischaemic-stroke-and-characterisation-of-the-ischaemic-penumbra
#9
REVIEW
Christopher McCabe, Mariana M Arroja, Emma Reid, I Mhairi Macrae
Over the past forty years, animal models of focal cerebral ischaemia have allowed us to identify the critical cerebral blood flow thresholds responsible for irreversible cell death, electrical failure, inhibition of protein synthesis, energy depletion and thereby the lifespan of the potentially salvageable penumbra. They have allowed us to understand the intricate biochemical and molecular mechanisms within the 'ischaemic cascade' that initiate cell death in the first minutes, hours and days following stroke...
September 16, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28923161/comparing-the-cognitive-process-of-circular-causality-in-two-patients-with-strokes-through-qualitative-analysis
#10
Seyed Alireza Derakhshanrad, Emily Piven, Bahareh Zeynalzadeh Ghoochani
Walter J. Freeman pioneered the neurodynamic model of brain activity when he described the brain dynamics for cognitive information transfer as the process of circular causality at intention, meaning, and perception (IMP) levels. This view contributed substantially to establishment of the Intention, Meaning, and Perception Model of Neuro-occupation in occupational therapy. As described by the model, IMP levels are three components of the brain dynamics system, with nonlinear connections that enable cognitive function to be processed in a circular causality fashion, known as Cognitive Process of Circular Causality (CPCC)...
October 2017: Nonlinear Dynamics, Psychology, and Life Sciences
https://www.readbyqxmd.com/read/28922885/patient-selection-and-clinical-efficacy-of-urgent-superficial-temporal-artery-middle-cerebral-artery-bypass-in-acute-ischemic-stroke-using-advanced-magnetic-resonance-imaging-techniques
#11
Hyun-Seok Park, Sang-Hyeon Kim, Hyun-Wook Nah, Jae-Hyung Choi, Dae-Hyun Kim, Myong-Jin Kang, Jae-Kwan Cha, Jae-Taeck Huh
BACKGROUND: Selected patients with acute ischemic stroke might benefit from superficial temporal artery-middle cerebral artery (STA-MCA) bypass, but the indications for urgent STA-MCA bypass are unknown. OBJECTIVE: To report our experiences of urgent STA-MCA bypass in patients requiring urgent reperfusion who were ineligible for other reperfusion therapies, using advanced magnetic resonance imaging (MRI) techniques. METHODS: The inclusion criteria for urgent STA-MCA bypass were as follows: acute infarct volume <70 mL with a ratio of perfusion/diffusion lesion volume ≥1...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28922451/low-medical-morbidity-and-mortality-after-acute-courses-of-electroconvulsive-therapy-in-a-population-based-sample
#12
D M Blumberger, D P Seitz, N Herrmann, J G Kirkham, R Ng, C Reimer, P Kurdyak, A Gruneir, M J Rapoport, Z J Daskalakis, B H Mulsant, S N Vigod
BACKGROUND: To determine event rates for specific medical events and mortality among individuals receiving electroconvulsive therapy (ECT). METHOD: Population-based cohort study using health administrative data of acute ECT treatments delivered in Ontario, Canada, from 2003 to 2011. We measured the following medical event rates, per 10 000 ECT treatments, up to 7 and 30 days post-treatment: stroke, seizure, acute myocardial infarction, arrhythmia, pneumonia, pulmonary embolus, deep vein thrombosis, gastrointestinal bleeding, falls, hip fracture, and mortality...
September 18, 2017: Acta Psychiatrica Scandinavica
https://www.readbyqxmd.com/read/28921447/structure-pharmacology-and-roles-in-physiology-of-the-p2y12-receptor
#13
Ivar von Kügelgen
P2Y receptors are G-protein-coupled receptors (GPCRs) for extracellular nucleotides. The platelet ADP-receptor which has been denominated P2Y12 receptor is an important target in pharmacotherapy. The receptor couples to Gαi2 mediating an inhibition of cyclic AMP accumulation and additional downstream events including the activation of phosphatidylinositol-3-kinase and Rap1b proteins. The nucleoside analogue ticagrelor and active metabolites of the thienopyridine compounds ticlopidine, clopidogrel and prasugrel block P2Y12 receptors and, thereby, inhibit ADP-induced platelet aggregation...
September 12, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28920522/constraint-and-multimodal-approaches-to-therapy-for-chronic-aphasia-a-systematic-review-and-meta-analysis
#14
John E Pierce, Maya Menahemi-Falkov, Robyn O'Halloran, Leanne Togher, Miranda L Rose
Aphasia is a significant cause of disability and reduced quality of life. Two speech pathology treatment approaches appear efficacious: multimodal and constraint-induced aphasia therapies. In constraint-induced therapies, non-verbal actions (e.g., gesture, drawing) are believed to interfere with treatment and patients are therefore constrained to speech. In contrast, multimodal therapies employ non-verbal modalities to cue word retrieval. Given the clinical and theoretical implications, a comparison of these two divergent treatments was pursued...
September 18, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28920085/baseline-prescription-and-one-year-persistence-of-secondary-prevention-drugs-after-an-index-stroke-in-central-ghana
#15
Fred Stephen Sarfo, Bruce Ovbiagele, John Akassi, Gloria Kyem
BACKGROUND AND PURPOSE: There is a paucity of data on persistence of secondary prevention medications among stroke survivors in resource-limited settings where stroke is on a rapid upward trajectory and its management severely challenged. To avert new cardiovascular events after stroke, preventive medications should be promptly instituted and used continuously. We report 1-year rates and determinants of persistent utilization of secondary prevention therapies after stroke in Ghana. METHODS: A retrospective observational study involving 418 stroke survivors enrolled into a Neurology clinic in a tertiary institution in central Ghana between January 2011 and December 2013...
March 2017: ENeurologicalSci
https://www.readbyqxmd.com/read/28919312/the-combined-effects-of-adaptive-control-and-virtual-reality-on-robot-assisted-fine-hand-motion-rehabilitation-in-chronic-stroke-patients-a-case-study
#16
Xianwei Huang, Fazel Naghdy, Golshah Naghdy, Haiping Du, Catherine Todd
Robot-assisted therapy is regarded as an effective and reliable method for the delivery of highly repetitive training that is needed to trigger neuroplasticity following a stroke. However, the lack of fully adaptive assist-as-needed control of the robotic devices and an inadequate immersive virtual environment that can promote active participation during training are obstacles hindering the achievement of better training results with fewer training sessions required. This study thus focuses on these research gaps by combining these 2 key components into a rehabilitation system, with special attention on the rehabilitation of fine hand motion skills...
September 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28918255/microglia-mediated-baff-baffr-ligation-promotes-neuronal-survival-in-brain-ischemia-injury
#17
Kai Li, Wei Yu, Rangjuan Cao, Zhihua Zhu, Guoqing Zhao
The innate immune responses of brain to vascular occlusion are primarily orchestrated by activated microglia. However, the roles of microglia in inflammatory responses to brain ischemic injuries are controversial. Here, we report a new mechanism by which microglia confer protective effects on ischemic neuronal cells. We found that under ischemic condition, the B-cell activating factor (BAFF) was vastly upregulated in microglia and this upregulation could at least be attributed to JAK-STAT signaling pathway activated by IFN-γ and IL-10, which were spatio-temporally enriched in I/R injured brain as well...
September 13, 2017: Neuroscience
https://www.readbyqxmd.com/read/28918203/short-term-effects-of-preoperative-beta-blocker-use-for-isolated-coronary-artery-bypass-grafting-a-systematic-review-and-meta-analysis
#18
Liangshan Wang, Hong Wang, Xiaotong Hou
OBJECTIVE: The use of preoperative beta-blockers has been used as a quality standard for patients undergoing coronary artery bypass grafting (CABG). However, the benefits of beta-blockers use before CABG remain controversial. We performed a systematic review and meta-analysis to investigate the short-term effects of preoperative beta-blocker use for patients undergoing isolated CABG. METHODS: We searched PubMed, Embase, and the Cochrane Library for English articles published from inception to August 16, 2016...
August 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28918087/left-atrial-enlargement-and-anticoagulation-status-in-patients-with-acute-ischemic-stroke-and-atrial-fibrillation
#19
Katarina Dakay, Andrew D Chang, Morgan Hemendinger, Shawna Cutting, Ryan A McTaggart, Mahesh V Jayaraman, Antony Chu, Nikhil Panda, Christopher Song, Alexander Merkler, Gino Gialdini, Benjamin Kummer, Michael P Lerario, Hooman Kamel, Mitchell S V Elkind, Karen L Furie, Shadi Yaghi
BACKGROUND: Despite anticoagulation therapy, ischemic stroke risk in atrial fibrillation (AF) remains substantial. We hypothesize that left atrial enlargement (LAE) is more prevalent in AF patients admitted with ischemic stroke who are therapeutic, as opposed to nontherapeutic, on anticoagulation. METHODS: We included consecutive patients with AF admitted with ischemic stroke between April 1, 2015, and December 31, 2016. Patients were divided into two groups based on whether they were therapeutic (warfarin with an international normalized ratio ≥ 2...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28918085/positive-effects-of-extracorporeal-shock-wave-therapy-on-spasticity-in-poststroke-patients-a-meta-analysis
#20
REVIEW
Peipei Guo, Fuqiang Gao, Tingting Zhao, Wei Sun, Bailiang Wang, Zirong Li
BACKGROUND: Spasticity is a common and serious complication following a stroke, and many clinical research have been conducted to evaluate the effect of extracorporeal shock wave therapy (ESWT) on muscle spasticity in poststroke patients. This meta-analysis aimed to evaluate the therapeutic effect on decreasing spasticity caused by a stroke immediately and 4 weeks after the application of shock wave therapy. METHODS: We searched PubMed, Embase, Web of Science, and Cochrane Library databases for relevant studies through November 2016 using the following item: (Hypertonia OR Spasticity) and (Shock Wave or ESWT) and (Stroke)...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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