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https://www.readbyqxmd.com/read/28723732/role-of-anesthesia-in-endovascular-stroke-therapy
#1
Arthur Wang, Apolonia E Abramowicz
PURPOSE OF REVIEW: Recent randomized clinical trials have demonstrated strong efficacy of endovascular therapy (EVT) for acute ischemic stroke (AIS) from large vessel occlusions; in the USA alone, tens of thousands of patients annually may benefit. The impact of the type of anesthesia used during mechanical thrombectomy on patient outcomes remains controversial. This review discusses the current literature on the effects of anesthesia type on patient outcome following endovascular stroke therapy...
July 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28722662/antibiotic-prophylaxis-for-infections-in-patients-with-acute-stroke-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
Yan-Guo Xi, Xu Tian, Wei-Qing Chen, Sai Zhang, Shan Zhang, Wei-Dan Ren, Qi-Jun Pang, Guo-Tao Yang, Zhi-Ming Yang
OBJECTIVE: Infections are frequent after stroke and lead to increased mortality and neurological disability. Antibiotic prophylaxis has potential of decreasing the risk of infections and mortality and improving poor functional outcome. Several studies evaluated antibiotic prophylaxis for infections in acute stroke patients have generated conflicting results. The systematic review of randomized clinical trials (RCTs) aimed at comprehensively assessing the evidence of antibiotic prophylaxis for the treatment of acute stroke patients...
July 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/28721832/biomarkers-associated-with-bleeding-risk-in-the-setting-of-atrial-fibrillation
#3
Skevos Sideris, Stefanos Archontakis, George Latsios, George Lazaros, Konstantinos Toutouzas, Eleftherios Tsiamis, Manolis Vavuranakis, Charalampos Vlachopoulos, Konstantinos Gatzoulis, Konstantinos Tsioufis, Dimitris Tousoulis
Background Prevention of thromboembolic disease, mainly stroke, with oral anticoagulants remains a major therapeutic goal in patients with atrial fibrillation. Unfortunately, despite the high efficacy, anticoagulant therapy is associated with a significant risk of, frequently catastrophic, hemorrhagic complications. Among different clinical and laboratory parameters related to an increased risk of bleeding, several biological markers have been recognized and various risk scores for bleeding have been developed...
July 18, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28721691/occupational-therapy-for-adults-with-problems-in-activities-of-daily-living-after-stroke
#4
REVIEW
Lynn A Legg, Sharon R Lewis, Oliver J Schofield-Robinson, Avril Drummond, Peter Langhorne
BACKGROUND: A stroke occurs when the blood supply to part of the brain is cut off. Activities of daily living (ADL) are daily home-based activities that people carry out to maintain health and well-being. ADLs include the ability to: eat and drink unassisted, move, go to the toilet, carry out personal hygiene tasks, dress unassisted, and groom. Stroke causes impairment-related functional limitations that may result in difficulties participating in ADLs independent of supervision, direction, or physical assistance...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28721323/endovascular-management-of-stroke-patients-with-large-vessel-occlusion-and-minor-stroke-symptoms
#5
REVIEW
Saeed A Alqahtani, Andrew B Stemer, Michael F McCullough, Randy S Bell, Jeffrey Mai, Ai-Hsi Liu, Rocco A Armonda
Endovascular mechanical thrombectomy for stroke patients with large vessel occlusion (LVO) in the anterior circulation has become the standard of care based on several major randomized clinical trials. The successful result reported by these trials constitutes what may be the largest achievement in the history of neurological sciences. However, most of these mechanical thrombectomy trials (except for the multicenter randomized clinical trial of endovascular treatment for acute ischemic stroke in the Netherlands, i...
June 15, 2017: Curēus
https://www.readbyqxmd.com/read/28721171/response-to-an-unusual-outbreak-in-a-high-risk-situation
#6
Mahmood Muazu Dalhat, Olufunmilayo Ibitola Fawole, Patrick Mboya Nguku, Meeyoung Mattie Park, Casey Daniel Hall, Nasir Sani-Gwarzo
In 2010, a series of lead poisoning outbreaks linked to artisanal gold processing killed at least 400 young children in Zamfara State in northwestern Nigeria. There were several efforts to respond to the outbreaks as they occurred. Subsequent recurrence of lead poisoning outbreaks within Zamfara and beyond suggested that there were no efforts to mitigate the outbreaks as recommended for disaster management. This case study, to be completed within 3 hours, is suitable for senior level public health officials and those training for such positions...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28720644/effects-of-non-vitamin-k-antagonist-oral-anticoagulants-versus-warfarin-in-patients-with-atrial-fibrillation-and-valvular-heart-disease-a-systematic-review-and-meta-analysis
#7
REVIEW
Kuo-Li Pan, Daniel E Singer, Bruce Ovbiagele, Yi-Ling Wu, Mohamed A Ahmed, Meng Lee
BACKGROUND: The original non-vitamin K antagonist oral anticoagulant (NOAC) trials in nonvalvular atrial fibrillation (AF) enrolled patients with native valve pathologies. The object of this study was to quantify the benefit-risk profiles of NOACs versus warfarin in AF patients with native valvular heart disease (VHD). METHODS AND RESULTS: Trials were identified by exhaustive literature search. Trial data were combined using inverse variance weighting to produce a meta-analytic summary hazard ratio (HR) and 95% confidence interval (CI) of efficacy and safety of NOACs versus warfarin...
July 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28718666/atrial-cardiopathy-a-mechanism-of-cryptogenic-stroke
#8
Shadi Yaghi, Hooman Kamel, Mitchell S V Elkind
Cryptogenic stroke accounts for approximately 30% of all ischemic strokes. Recently, atrial cardiopathy diagnosed by the presence of one of its serum, imaging, or electrocardiogram biomarkers has been shown to be associated with ischemic stroke, particularly of embolic subtypes. Areas covered: This paper aims to summarize data on occult atrial fibrillation and stroke, provide an overview on mechanisms, such as inflammation and fibrosis, of stroke in atrial cardiopathy, critically review data on biomarkers of atrial cardiopathy and their association with stroke, and suggest therapeutic implications, including directions for future research...
July 18, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28717354/blood-pressure-and-penumbral-sustenance-in-stroke-from-large-vessel-occlusion
#9
REVIEW
Robert W Regenhardt, Alvin S Das, Christopher J Stapleton, Ronil V Chandra, James D Rabinov, Aman B Patel, Joshua A Hirsch, Thabele M Leslie-Mazwi
The global burden of stroke remains high, and of the various subtypes of stroke, large vessel occlusions (LVOs) account for the largest proportion of stroke-related death and disability. Several randomized controlled trials in 2015 changed the landscape of stroke care worldwide, with endovascular thrombectomy (ET) now the standard of care for all eligible patients. With the proven success of this therapy, there is a renewed focus on penumbral sustenance. In this review, we describe the ischemic penumbra, collateral circulation, autoregulation, and imaging assessment of the penumbra...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28716992/blood-pressure-trajectories-and-the-risk-of-intracerebral-hemorrhage-and-cerebral-infarction-a-prospective-study
#10
Weijuan Li, Cheng Jin, Anand Vaidya, Yuntao Wu, Kathryn Rexrode, Xiaoming Zheng, Mahmut E Gurol, Chaoran Ma, Shouling Wu, Xiang Gao
The association between long-term blood pressure (BP) patterns in community-dwelling adults and risk of intracerebral hemorrhage and cerebral infarction is not well characterized. This prospective study included 79 385 participants, free of stroke, myocardial infarction, and cancer in or before 2010 (baseline). Systolic BP trajectories were identified using latent mixture modeling with data from 2006, 2008, and 2010. Incident cases of intracerebral hemorrhage and cerebral infarction occurred during 2010 to 2014, confirmed by review of medical records, by 3 physicians...
July 17, 2017: Hypertension
https://www.readbyqxmd.com/read/28716983/systematic-review-of-the-cost-and-cost-effectiveness-of-rapid-endovascular-therapy-for-acute-ischemic-stroke
#11
Laura K Sevick, Sarah Ghali, Michael D Hill, Vishva Danthurebandara, Diane L Lorenzetti, Tom Noseworthy, Eldon Spackman, Fiona Clement
BACKGROUND AND PURPOSE: Rapid endovascular therapy (EVT) is an emerging treatment option for acute ischemic stroke. Several economic evaluations have been published examining the cost-effectiveness of EVT, and many international bodies are currently making adoption decisions. The objective of this study was to establish the cost-effectiveness of EVT for ischemic stroke patients and to synthesize all the publicly available economic literature. METHODS: A systematic review of the published literature was conducted to identify economic evaluations and cost analyses of EVT for acute ischemic stroke patients...
July 17, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28716982/real-world-setting-comparison-of-nonvitamin-k-antagonist-oral-anticoagulants-versus-vitamin-k-antagonists-for-stroke-prevention-in-atrial-fibrillation-a-systematic-review-and-meta-analysis
#12
George Ntaios, Vasileios Papavasileiou, Konstantinos Makaritsis, Konstantinos Vemmos, Patrik Michel, Gregory Y H Lip
BACKGROUND AND PURPOSE: Evidence from the real-world setting complements evidence coming from randomized controlled trials. We aimed to summarize all available evidence from high-quality real-world observational studies about efficacy and safety of nonvitamin-K oral anticoagulants compared with vitamin-K antagonists in patients with atrial fibrillation. METHODS: We searched PubMed and Web of Science until January 7, 2017 for observational nationwide or health insurance databases reporting matched or adjusted results comparing nonvitamin-K oral anticoagulants versus vitamin-K antagonists in patients with atrial fibrillation...
July 17, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28716585/ascertainment-of-alaska-native-stroke-incidence-2005-2009-lessons-for-assessing-the-global-burden-of-stroke
#13
Bernadette Boden-Albala, James Allen, Eric T Roberts, Lisa Bulkow, Brian Trimble
BACKGROUND: Stroke is a critical public health issue in the United States and globally. System models to optimally capture stroke incidence in rural and culturally diverse communities are needed. The epidemiological transition to a western lifestyle has been associated with an increased burden of vascular risk factors among Alaska Native (AN) people. The burden of stroke in AN communities remains understudied. METHODS: The Alaska Native Stroke Registry (ANSR) was designed to screen and capture all stroke cases between 2005 and 2009 through its integration into the existing single-payer Alaska Tribal Health System infrastructure...
July 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28716152/development-of-a-theory-informed-implementation-intervention-to-improve-the-triage-treatment-and-transfer-of-stroke-patients-in-emergency-departments-using-the-theoretical-domains-framework-tdf-the-t-3-trial
#14
Louise E Craig, Natalie Taylor, Rohan Grimley, Dominique A Cadilhac, Elizabeth McInnes, Rosemary Phillips, Simeon Dale, Denise O'Connor, Chris Levi, Mark Fitzgerald, Julie Considine, Jeremy M Grimshaw, Richard Gerraty, N Wah Cheung, Jeanette Ward, Sandy Middleton
BACKGROUND: Theoretical frameworks and models based on behaviour change theories are increasingly used in the development of implementation interventions. Development of an implementation intervention is often based on the available evidence base and practical issues, i.e. feasibility and acceptability. The aim of this study was to describe the development of an implementation intervention for the T(3) Trial (Triage, Treatment and Transfer of patients with stroke in emergency departments (EDs)) using theory to recommend behaviour change techniques (BCTs) and drawing on the research evidence base and practical issues of feasibility and acceptability...
July 17, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28716008/does-infection-with-human-immunodeficiency-virus-have-any-impact-on-the-cardiovascular-outcomes-following-percutaneous-coronary-intervention-a-systematic-review-and-meta-analysis
#15
Pravesh Kumar Bundhun, Manish Pursun, Wei-Qiang Huang
BACKGROUND: A direct link between human immunodeficiency virus (HIV)-infected patients and the risk of cardiovascular diseases (CVD) has been shown in recent scientific research. However, this issue is controversial since other previous reports showed no apparent impact of HIV or its anti-retroviral drugs on the cardiovascular system. We aimed to systematically compare the postinterventional adverse cardiovascular outcomes which were observed in patients with and without HIV infection during a mean follow up period ranging from 1 year to 3 years...
July 17, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28715991/trimethylamine-n-oxide-the-microbiome-and-heart-and-kidney-disease
#16
Steven H Zeisel, Manya Warrier
Trimethylamine N-oxide (TMAO) is a biologically active molecule and is a putative promoter of chronic diseases including atherosclerosis in humans. Host intestinal bacteria produce its precursor trimethylamine (TMA) from carnitine, choline, or choline-containing compounds. Most of the TMA produced is passively absorbed into portal circulation, and hepatic flavin-dependent monooxygenases (FMOs) efficiently oxidize TMA to TMAO. Both observational and experimental studies suggest a strong positive correlation between increased plasma TMAO concentrations and adverse cardiovascular events, such as myocardial infarction, stroke, and death...
July 17, 2017: Annual Review of Nutrition
https://www.readbyqxmd.com/read/28715924/moyamoya-disease-in-children-results-from-the-international-pediatric-stroke-study
#17
Sarah Lee, Michael J Rivkin, Adam Kirton, Gabrielle deVeber, Jorina Elbers
This study aimed to describe children with moyamoya disease from an international multicenter stroke database, and explore risk factors for stroke recurrence. We reviewed data of children >28-days old with moyamoya disease enrolled in the International Pediatric Stroke Study from January 2003 to March 2013. A total of 174 children from 32 sites and 14 countries had moyamoya disease; median age 7.4 years, 49% male. Of these, 90% presented with ischemic stroke, 7.5% with transient ischemic attack, and 2.5% with hemorrhagic stroke...
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28714410/management-of-blood-pressure-and-heart-rate-in-patients-with-acute-stroke
#18
Carlo Maida, Antonino Tuttolomondo, Domenico Di Raimondo, Antonio Pinto
BACKGROUND: Stroke represent one of the most devastating of all neurological diseases, affecting about 15 million people per year and is an important cause of morbidity and mortality worldwide and currently the leading cause of adult disability in developed countries. Blood pressure and heart rate may undergo several modifications in patients with both ischemic and hemorrhagic stroke in fact raised blood pressure levels may lead to cerebral edema, hematoma expansion or hemorrhagic transformation and in contrast low blood pressure can lead to increased cerebral infarction or perihematomal ischemia...
July 14, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28714342/a-multicentre-study-of-how-goal-setting-is-practised-during-inpatient-stroke-rehabilitation
#19
Sarah Plant, Sarah F Tyson
OBJECTIVE: To describe goal-setting during inpatient stroke rehabilitation. DESIGN: There were two stages: an electronic questionnaire for multidisciplinary teams and an analysis of goal-setting documentation for rehabilitation patients. SETTING: Five inpatient stroke units. PARTICIPANTS: Staff involved in goal-setting and patients undergoing stroke rehabilitation. RESULTS: A total of 13 therapists and 49 patients were recruited, and 351 documented goals were examined...
July 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28713549/where-are-aphasia-theory-and-management-headed
#20
REVIEW
Donna C Tippett, Argye E Hillis
The sequelae of post-stroke aphasia are considerable, necessitating an understanding of the functional neuroanatomy of language, cognitive processes underlying various language tasks, and the mechanisms of recovery after stroke. This knowledge is vital in providing optimal care of individuals with aphasia and counseling to their families and caregivers. The standard of care in the rehabilitation of aphasia dictates that treatment be evidence-based and person-centered. Promising techniques, such as cortical stimulation as an adjunct to behavioral therapy, are just beginning to be explored...
2017: F1000Research
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