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https://www.readbyqxmd.com/read/29787575/safety-of-intravenous-alteplase-within-4-5-hours-for-patients-awakening-with-stroke-symptoms
#1
Victor C Urrutia, Roland Faigle, Steven R Zeiler, Elisabeth B Marsh, Mona Bahouth, Mario Cerdan Trevino, Jennifer Dearborn, Richard Leigh, Susan Rice, Karen Lane, Mustapha Saheed, Peter Hill, Rafael H Llinas
BACKGROUND: Up to 25% of acute stroke patients first note symptoms upon awakening. We hypothesized that patients awaking with stroke symptoms may be safely treated with intravenous alteplase (IV tPA) using non-contrast head CT (NCHCT), if they meet all other standard criteria. METHODS: The SAfety of Intravenous thromboLytics in stroke ON awakening (SAIL ON) was a prospective, open-label, single treatment arm, pilot safety trial of standard dose IV tPA in patients who presented with stroke symptoms within 0-4...
2018: PloS One
https://www.readbyqxmd.com/read/29771492/hyperpolarized-13c-mrs-reveals-the-rate-limiting-role-of-the-blood-brain-barrier-on-the-cerebral-uptake-and-metabolism-of-l-lactate-in-vivo
#2
Yuhei Takado, Tian Cheng, Jessica A M Bastiaansen, Hikari Yoshihara, Bernard Lanz, Mor Mishkovsky, Sylvain Lengacher, Arnaud Comment
The dynamics of L-lactate transport across the blood-brain barrier (BBB) and its cerebral metabolism are still subject to debate. We studied lactate uptake and intracellular metabolism in the mouse brain using hyperpolarized 13C magnetic resonance spectroscopy (MRS). Following the intravenous injection of hyperpolarized [1-13C]lactate, we observed that the distribution of 13C label between lactate and pyruvate, which has been shown to be representative of their pool size ratio, is different in NMRI and C57BL/6 mice, the latter exhibiting a higher cerebral lactate dehydrogenase A (Ldha) expression...
May 17, 2018: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/29764034/-application-of-low-profile-visualized-intraluminal-support-lvis-stents-in-assisting-coil-embolization-of-intracranial-aneurysms
#3
D C Xu, J Li, Z Q Jiang
Objective: To evaluate the safety and effectiveness of application of LVIS stent-assisted coiling endovascular procedures in cerebral aneurysms . Methods: The clinical data of 41 patients with intracranial aneurysms , which were performed in LVIS stent-assisted coiling endovascular therapies from June 2015 to October 2017 in The First Affiliated Hospital of Bengbu Medical College were analyzed retrospectively. 13 patients were unruptured and 28 patients were ruptured. Immediate angiography outcomes and follow-up angiography outcomes were assessed by DSA...
May 8, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29752869/allogeneic-umbilical-cord-blood-infusion-for-adults-with-ischemic-stroke-clinical-outcomes-from-a-phase-1-safety-study
#4
Daniel T Laskowitz, Ellen R Bennett, Rebecca J Durham, John J Volpi, Jonathan R Wiese, Michael Frankel, Elizabeth Shpall, Jeffry M Wilson, Jesse Troy, Joanne Kurtzberg
Stroke is a major cause of death and long-term disability, affecting one in six people worldwide. The only currently available approved pharmacological treatment for ischemic stroke is tissue plasminogen activator; however, relatively few patients are eligible for this therapy. We hypothesized that intravenous (IV) infusion of banked unrelated allogeneic umbilical cord blood (UCB) would improve functional outcomes in patients with ischemic stroke. To investigate this, we conducted a phase 1 open-label trial to assess the safety and feasibility of a single IV infusion of non-human leukocyte antigen (HLA) matched, ABO matched, unrelated allogeneic UCB into adult stroke patients...
May 12, 2018: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/29736141/isolation-and-sequence-analysis-of-pcs36-4cpa-a-small-plasmid-from-citrobacter-sp-36-4cpa
#5
Natalia V Zharikova, Timur R Iasakov, Boris K Bumazhkin, Ekaterina O Patutina, Evgeniia I Zhurenko, Vladislav V Korobov, Alina I Sagitova, Boris B Kuznetsov, Tatiana V Markusheva
A small plasmid designated pCS36-4CPA with a size of 5217 base pairs and G-C content of 50.74% was isolated from Citrobacter sp. 36-4CPA. The origin of replication ( ori ) of the plasmid was identified as a region of about 800 bp in length with an identity of 67.1% to the ColE1 plasmid at the nucleotide level. The replication region contained typical elements of ColE1-like plasmids: RNA I and RNA II with their corresponding -10 and -35 boxes, a single-strand initiation site ( ssi ), and a lagging-strand termination site ( terH )...
May 2018: Saudi Journal of Biological Sciences
https://www.readbyqxmd.com/read/29692476/randomized-trial-to-assess-safety-and-clinical-efficacy-of-intensive-blood-pressure-reduction-in-acute-spontaneous-intracerebral-haemorrhage
#6
Salil Gupta, A K Abbot, R Srinath, A K Tewari, Aditya Gupta, S P Gorthi, C S Narayanan, S I Totlani, Y S Sirohi, Ravi Anadure
Background: Haematoma expansion due to raised blood pressure in spontaneous intracerebral haemorrhage may determine outcome. The aim of this study was to determine safety and efficacy of lowering blood pressure in acute spontaneous intracerebral haemorrhage. Methods: This open label, multicentric trial randomized patients ≥18 years with spontaneous intracerebral haemorrhage with no secondary cause within 72 h of onset to tight BP control arm where treatment was initiated if mean arterial pressure (MAP) was ≥115 mm of Hg and conventional BP control arm where treatment was initiated if MAP was ≥130 mm of Hg...
April 2018: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/29689135/intravenous-thrombolysis-in-unwitnessed-stroke-onset-mr-witness-trial-results
#7
Lee H Schwamm, Ona Wu, Shlee S Song, Lawrence L Latour, Andria L Ford, Amie W Hsia, Alona Muzikansky, Rebecca A Betensky, Albert J Yoo, Michael H Lev, Gregoire Boulouis, Arne Lauer, Pedro Cougo, William A Copen, Gordon J Harris, Steven Warach
OBJECTIVE: Most acute ischemic stroke (AIS) patients with unwitnessed symptom onset are ineligible for intravenous thrombolysis due to timing alone. Lesion evolution on fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) correlates with stroke duration, and quantitative mismatch of diffusion-weighted MRI with FLAIR (qDFM) might indicate stroke duration within guideline-recommended thrombolysis. We tested whether intravenous thrombolysis ≤4.5 hours from the time of symptom discovery is safe in patients with qDFM in an open-label, phase 2a, prospective study (NCT01282242)...
April 24, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29688482/lumboperitoneal-shunts-for-the-treatment-of-idiopathic-normal-pressure-hydrocephalus-a-comparison-of-small-lumen-abdominal-catheters-to-gravitational-add-on-valves-in-a-single-center
#8
Madoka Nakajima, Masakazu Miyajima, Chihiro Akiba, Ikuko Ogino, Kaito Kawamura, Hidenori Sugano, Takeshi Hara, Yuichi Tange, Keiko Fusegi, Kostadin Karagiozov, Hajime Arai
BACKGROUND: Treating idiopathic normal pressure hydrocephalus (iNPH) with lumboperitoneal shunts (LPSs) may cause cerebrospinal fluid (CSF) overdrainage. OBJECTIVE: To investigate whether LPSs, including gravitational "add-on" and programmable pressure valves (PPVs/+GVs), reduce complications and improve outcomes. METHODS: We compared PPVs/+small lumen abdominal catheters (SLs) to PPVs/+GVs using different opening pressures for supine and standing positions...
April 23, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29676403/combined-endoscopic-transorbital-and-endonasal-repair-of-high-flow-orbital-apex-middle-fossa-cerebrospinal-fluid-leak-with-a-nasoseptal-flap
#9
Brandon Lucke-Wold, Gustavo Mendez, David Cua, Paul Akins, Haley Gillham, Jeremy Ciporen
Background and importance: High flow orbital apex or middle fossa cerebrospinal fluid (CSF) leaks can be life threatening and complex to repair. These leaks associated with large dural defects are most commonly repaired with an open temporalis muscle patch or free flaps, but these flaps do not always stop the leak. Clinical Presentation: A 65-year-old patient presented two years after orbital exenteration and radiation for squamous cell carcinoma. He developed multi-organism meningitis and pneumocephalus secondary to a large high-flow orbital apex/middle fossa CSF leak...
2018: Journal of neuroinflammation and neurodegenerative diseases
https://www.readbyqxmd.com/read/29673817/combined-outcomes-of-endovascular-or-surgical-treatment-of-unruptured-anterior-communicating-artery-aneurysms-is-a-more-aggressive-management-strategy-warranted
#10
Philip G R Schmalz, Alejandro Enriquez-Marulanda, Abdulrahman Alturki, Christopher J Stapleton, Ajith J Thomas, Christopher S Ogilvy
BACKGROUND: Updated natural history studies suggest anterior communicating artery aneurysms have a higher risk of rupture than formerly appreciated. As endovascular and open techniques advance, morbidity may fall to levels which suggest intervention even for small aneurysms. OBJECTIVE: Assess treatment risk for smaller, unruptured anterior communicating artery aneurysms. METHODS: A cross-sectional study of 149 patients with unruptured anterior communicating aneurysms treated over a six-year period was performed...
April 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29629229/ambiguity-in-the-dural-tail-sign-on-mri
#11
Ramesh S Doddamani, Rajesh K Meena, Dattaraj Sawarkar
Background: Meningiomas give rise to the dural tail sign (DTS) on contrast-enhanced magnetic resonance imaging (CEMRI). The presence of DTS does not always qualify for a meningioma, as it is seen in only 60-72% of cases. This sign has been described in various other lesions like lymphomas, metastasis, hemangiopericytomas, schwannomas and very rarely glioblastoma multiforme (GBM). The characteristics of dural-based GBMs are discussed here, as only eleven such cases are reported in the literature till date...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29626176/preventive-antibiotics-in-stroke-study-pass-a-cost-effectiveness-study
#12
Willeke F Westendorp, Elles Zock, Jan-Dirk Vermeij, Henk Kerkhoff, Paul J Nederkoorn, Marcel G W Dijkgraaf, Diederik van de Beek
OBJECTIVE: To evaluate the cost-effectiveness of preventive ceftriaxone vs standard stroke unit care without preventive antimicrobial therapy in acute stroke patients. METHODS: In this multicenter, randomized, open-label trial with masked endpoint assessment, 2,550 patients with acute stroke were included between 2010 and 2014. Economic evaluation was performed from a societal perspective with a time horizon of 3 months. Volumes and costs of direct, indirect, medical, and nonmedical care were assessed...
May 1, 2018: Neurology
https://www.readbyqxmd.com/read/29595449/routine-low-dose-continuous-or-nocturnal-oxygen-for-people-with-acute-stroke-three-arm-stroke-oxygen-supplementation-rct
#13
Christine Roffe, Tracy Nevatte, Jon Bishop, Julius Sim, Cristina Penaloza, Susan Jowett, Natalie Ives, Richard Gray, Phillip Ferdinand, Girish Muddegowda
BACKGROUND: Stroke is a major cause of death and disability worldwide. Hypoxia is common after stroke and is associated with worse outcomes. Oxygen supplementation could prevent hypoxia and secondary brain damage. OBJECTIVES: (1) To assess whether or not routine low-dose oxygen supplementation in patients with acute stroke improves outcome compared with no oxygen; and (2) to assess whether or not oxygen given at night only, when oxygen saturation is most likely to be low, is more effective than continuous supplementation...
March 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29577674/a-phase-4-study-of-nilotinib-in-korean-patients-with-philadelphia-chromosome-positive-chronic-myeloid-leukemia-in-chronic-phase-enestkorea
#14
Junghoon Shin, Youngil Koh, Seo Hyun Yoon, Joo-Youn Cho, Dae-Young Kim, Kyoo-Hyung Lee, Hyeong-Joon Kim, Jae-Sook Ahn, Yeo-Kyeoung Kim, Jinny Park, Sang-Kyun Sohn, Joon Ho Moon, Yoo Jin Lee, Seonghae Yoon, Jeong-Ok Lee, June-Won Cheong, Kyoung Ha Kim, Sung-Hyun Kim, Hoon-Gu Kim, Hawk Kim, Seung-Hyun Nam, Young Rok Do, Sang-Gon Park, Seong Kyu Park, Sung Hwa Bae, Hun Ho Song, Dong-Yeop Shin, Doyeun Oh, Min Kyoung Kim, Chul Won Jung, Seonyang Park, Inho Kim
Although nilotinib has improved efficacy compared to imatinib, suboptimal response and intolerable adverse events (AEs) limit its effectiveness in many patients with chronic myeloid leukemia in chronic phase (CML-CP). We investigated the 2-year efficacy and safety of nilotinib and their relationships with plasma nilotinib concentrations (PNCs). In this open-label, multi-institutional phase 4 study, 110 Philadelphia chromosome-positive CML-CP patients were treated with nilotinib at a starting dose of 300 mg twice daily...
March 25, 2018: Cancer Medicine
https://www.readbyqxmd.com/read/29571842/comparative-effects-of-low-dose-versus-standard-dose-alteplase-in-ischemic-patients-with-prior-stroke-and-or-diabetes-mellitus-the-enchanted-trial
#15
Guofang Chen, Xia Wang, Thompson G Robinson, Miriam Pikkemaat, Richard I Lindley, Shengkui Zhou, Lei Ping, Weiwei Liu, Leijing Liu, John Chalmers, Craig S Anderson
BACKGROUND AND PURPOSE: History of prior stroke (PS) and diabetes mellitus (DM) are considered relative contraindications to the use of intravenous alteplase in patients with acute ischemic stroke (AIS). We aimed to assess whether a history of PS and DM modified the comparative effects of low- versus standard-dose alteplase in patients who participated in the alteplase-dose arm of the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED). METHODS: Data from an international, multi-center, prospective, randomized, open-label, blinded-endpoint trial were used to assess the benefits and risks of low (0...
April 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29538036/crossed-cerebellar-tracer-uptake-on-acute-stage-123i-iomazenil-spect-imaging-predicts-3-month-functional-outcome-in-patients-with-nonfatal-hypertensive-putaminal-or-thalamic-hemorrhage
#16
Daigo Kojima, Nobukazu Komoribayashi, Shinichi Omama, Kohki Oikawa, Shunrou Fujiwara, Masakazu Kobayashi, Yoshitaka Kubo, Kazunori Terasaki, Kuniaki Ogasawara
PURPOSE: Whereas SPECT images obtained 180 minutes after administration of I-iomazenil (IMZ) (late images) are proportional to the distribution of central benzodiazepine receptor-binding potential, SPECT images obtained within 30 minutes after I-IMZ administration (early images) correlate with regional brain perfusion. The aim of the present study was to determine whether crossed cerebellar tracer uptake on acute-stage I-IMZ SPECT imaging predicts 3-month functional outcome in patients with nonfatal hypertensive putaminal or thalamic hemorrhage...
June 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29511588/management-of-the-patients-with-persistent-m%C3%A3-llerian-duct-syndrome-is-the-ultimate-goal-testicular-descent
#17
Serpil Sancar, Esra Özçakır, Mete Kaya
Objective: Persistent Müllerian duct syndrome (PMDS) is a rare congenital disease characterized by the presence of rudimentary Müllerian structures within an intra-abdominal or hernial sac in a virilized male, often presenting as undescended testes. In this study, we aim to present a series of the PMDS patients who were managed by orchiopexy without removal of Müllerian remnants (MR). Material and methods: Between May 2010 and June 2017, we treated six cases diagnosed as PMDS in our department...
March 2018: Turkish Journal of Urology
https://www.readbyqxmd.com/read/29497826/comparison-of-propofol-and-desflurane-for-postanaesthetic-morbidity-in-patients-undergoing-surgery-for-aneurysmal-sah-a-randomized-clinical-trial
#18
Avanish Bhardwaj, Hemant Bhagat, Vinod Kumar Grover, Nidhi Bidyut Panda, Kiran Jangra, Seelora Sahu, Navneet Singla
PURPOSE: Surgery for aneurysmal clipping after subarachnoid haemorrhage (SAH) poses a unique anaesthetic challenge. However, data on the influence of anaesthetic agents in these patients are lacking. The study aims to evaluate the superiority of propofol over desflurane for postanaesthetic morbidity in patients undergoing surgery following aneurysmal SAH. METHODS: Seventy World Federation of Neurosurgeons Grade I and II patients were randomized into propofol (n = 35) and desflurane groups (n = 35)...
April 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29459612/review-of-uterine-sling-after-five-years-of-operation-in-a-40-years-lady
#19
R A Khanam, A Rubaiat, A S Azam
Uterine sling is a operation, done with own rectus sleeve to correct the uterine descend. If necessary correction of cystocele and/or rectocele and or perineal tear done on the same sitting. After 5 years of such operation abdomen of Mrs. X was opened due to ovarian cyst in Nirapad Hospital, Shantinagar, Dhaka, Bangladesh on August 2016. Uterus was found in normal position and size. Rectus sleeves were found attached with the uterus where it was anchored. Omentum was attached over the rectus sleeves and sealed the weak points at both lateral ends of the rectus sleeves through which the sleeves were taken to the abdominal cavity...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29407539/a-pilot-study-of-minocycline-for-the-treatment-of-bipolar-depression-effects-on-cortical-glutathione-and-oxidative-stress-in-vivo
#20
James W Murrough, Kathryn M Huryk, Xiangling Mao, Brian Iacoviello, Katherine Collins, Andrew A Nierenberg, Guoxin Kang, Dikoma C Shungu, Dan V Iosifescu
BACKGROUND: The antibiotic minocycline appears to promote neuroprotection through antioxidant and other mechanisms that may be relevant to the pathophysiology of bipolar disorder. The present study assessed the efficacy of minocycline in bipolar depression and examined the association between minocycline treatment and brain glutathione (GSH), an essential regulator of oxidative stress. METHOD: Twenty patients with bipolar disorder experiencing acute depressive symptoms enrolled in an 8-week, open-label trial of adjuvant minocycline...
April 1, 2018: Journal of Affective Disorders
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