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https://www.readbyqxmd.com/read/27898168/the-association-between-t-pa-administration-and-in-hospital-mortality-following-acute-ischemic-stroke-in-puerto-rican-patients
#1
Kevin Shah, Samuel Kohrman, Suehyb Alkhatib, Juan González, Fernando Santiago, Marcia Varella, Juan Zevallos
OBJECTIVE: Despite being the standard of care, thrombolytic therapy with tissue plasminogen activator (t-PA) is currently administered to only 5% of acute ischemic stroke (AIS) patients in the United States. Published scientific information regarding both the use of t-PA for AIS in Hispanic patients and its impact on short-term mortality is scarce. The objectives of this study are to investigate, among Puerto Rican patients hospitalized with AIS, the rate of t-PA administration, and the risk of in-hospital mortality in patients who received t-PA vs...
December 2016: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/27857839/fatal-outcome-in-a-hispanic-woman-with-moyamoya-syndrome-and-graves-disease
#2
Julian Choi, Perin Suthakar, Farbod Farmand
: We describe the case of a young Hispanic female who presented with thyrotoxicosis with seizures and ischemic stroke. She was diagnosed with a rare vasculopathy - moyamoya syndrome. After starting antithyroid therapy, her neurologic symptoms did not improve. Acute neurosurgical intervention had relieved her symptoms in the immediate post-operative period after re-anastomosis surgery. However, 2 post-operative days later, she was found to be in status epilepticus and in hyperthyroid state...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27834750/baseline-predictors-of-poor-outcome-in-patients-too-good-to-treat-with-intravenous-thrombolysis
#3
Syed F Ali, Khawja Siddiqui, Hakan Ay, Scott Silverman, Aneesh Singhal, Anand Viswanathan, Natalia Rost, Michael Lev, Lee H Schwamm
BACKGROUND AND PURPOSE: Several studies have reported poor outcomes in patients too good to treat with intravenous thrombolysis because of mild or rapidly improving symptoms. We sought to determine baseline clinical and imaging predictors of poor outcome in these patients. METHODS: Among 3950 consecutive stroke admissions (2009-2015) in our local Get With the Guidelines-Stroke database, 632 patients presented ≤4.5 hours and did not receive tissue-type plasminogen activator, with 380 of 632 (60...
November 10, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27829963/are-there-disparities-in-thrombolytic-treatment-and-mortality-in-acute-ischemic-stroke-in-the-hispanic-population-living-in-border-states-versus-nonborder-states
#4
Ameer E Hassan, David H Kassel, Malik M Adil, Wondwossen G Tekle, Adnan I Qureshi
BACKGROUND: Recent studies have found an underutilization of hospital in-patient care for coronary artery disease in Hispanics living in border states. OBJECTIVE: To identify acute treatment disparities in acute ischemic stroke Hispanic patients and determine the effect of such disparity on patient outcomes. METHODS: We identified Hispanic and non-Hispanic acute ischemic stroke patients from the Nationwide Inpatient Sample-2011 data files...
October 2016: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/27770075/emerging-temporal-trends-in-tissue-plasminogen-activator-use-results-from-the-basic-project
#5
Joseph S Domino, Jonggyu Baek, William J Meurer, Nelda Garcia, Lewis B Morgenstern, Morgan Campbell, Lynda D Lisabeth
OBJECTIVE: To explore temporal trends in tissue plasminogen activator (tPA) administration for acute ischemic stroke (AIS) in a biethnic community without an academic medical center and variation in trends by age, sex, ethnicity, and stroke severity. METHODS: Cases of AIS were identified from 7 hospitals in the Brain Attack Surveillance in Corpus Christi (BASIC) project, a population-based surveillance study between January 1, 2000, and June 30, 2012. tPA, demographics, and stroke severity as assessed by the NIH Stroke Scale (NIHSS) were ascertained from medical records...
November 22, 2016: Neurology
https://www.readbyqxmd.com/read/27744306/c-reactive-protein-is-associated-with-disability-independently-of-vascular-events-the-northern-manhattan-study
#6
Mandip S Dhamoon, Ying-Kuen Cheung, Yeseon P Moon, Clinton B Wright, Joshua Z Willey, Ralph Sacco, Mitchell Sv Elkind
BACKGROUND: high-sensitivity C-reactive protein (CRP) has been associated with cardiovascular events and mortality, but the association of CRP with functional status is not well defined. We hypothesised that serum levels of high-sensitivity CRP are associated with long-term trajectories of functional status independently of vascular risk factors and stroke and myocardial infarction (MI) occurring during follow-up. DESIGN: prospective, population-based. SETTING: northern Manhattan Study...
October 15, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27737957/untreated-hypertension-a-powerful-risk-factor-for-lobar-and-nonlobar-intracerebral-hemorrhage-in-whites-blacks-and-hispanics
#7
Kyle B Walsh, Daniel Woo, Padmini Sekar, Jennifer Osborne, Charles J Moomaw, Carl D Langefeld, Opeolu Adeoye
BACKGROUND: Hypertension is a significant risk factor for intracerebral hemorrhage (ICH). Although ethnic/racial disparities related to hypertension and ICH have been reported, these previous studies were limited by a lack of Hispanics and inadequate power to analyze by ICH location. In the current study, while overcoming these prior limitations, we investigated whether there was variation by ethnicity/race of treated and untreated hypertension as risk factors for ICH. METHODS: The ERICH study (Ethnic/Racial Variations of Intracerebral Hemorrhage) is a prospective, multicenter, case-control study of ICH among whites, blacks, and Hispanics...
November 8, 2016: Circulation
https://www.readbyqxmd.com/read/27737956/intracerebral-hemorrhage-racial-disparities-and-access-to-care
#8
Monika M Safford
Although it makes up only 15-20% of all strokes, intracerebral hemorrhage (ICH) is a particularly lethal form of this potentially disabling condition. A recent meta-analysis of 122 studies concluded that the 1-year survival following ICH was 46%, and the 5-year survival was only 29%.(1) Furthermore, quality of life for survivors is often very limited.(2) A thorough understanding of how to prevent these events is therefore a high priority.In this issue of Circulation, the study by Walsh and colleagues sheds light on several important findings that suggest where attention should be directed to prevent these types of strokes...
October 13, 2016: Circulation
https://www.readbyqxmd.com/read/27729362/association-of-impaired-glucose-regulation-and-insulin-resistance-with-cardiac-structure-and-function-results-from-echo-sol-echocardiographic-study-of-latinos
#9
Ryan T Demmer, Matthew A Allison, Jianwen Cai, Robert C Kaplan, Ankit A Desai, Barry E Hurwitz, Jill C Newman, Sanjiv J Shah, Katrina Swett, Gregory A Talavera, Ashley Thai, Marston E Youngblood, Carlos J Rodriguez
BACKGROUND: We examined the relationship between glucose homeostasis and comprehensive measures of cardiac structure and function among a representative sample of US Hispanics. METHODS AND RESULTS: ECHO-SOL (Echocardiographic Study of Latinos), an echocardiographic ancillary study of the HCHS/SOL (Hispanic Community Health Study/Study of Latinos), enrolled 1818 Hispanic/Latino men (43%) and women (57%) aged ≥45 years (mean=56). Glucose intolerance was defined as follows: (1) prediabetes: hemoglobin (HbA1c) ≥5...
October 2016: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27669431/the-role-of-chronic-psychosocial-stress-in-explaining-racial-differences-in-stress-reactivity-and-pain-sensitivity
#10
Jennifer L Gordon, Jacqueline Johnson, Samantha Nau, Beth Mechlin, Susan S Girdler
OBJECTIVE: To examine the role of psychosocial factors in mediating the relationship between African American (AA) race and both increased pain sensitivity and blunted stress reactivity. METHODS: Participants included 133 AA and non-Hispanic white (nHW) individuals (mean [SD] age, 37 [9]) matched for age, sex, and socioeconomic status. Participants underwent mental stress testing (Trier Social Stress Test) while cardiovascular, hemodynamic, and neuroendocrine reactivity were measured...
September 23, 2016: Psychosomatic Medicine
https://www.readbyqxmd.com/read/27664805/trends-in-transient-ischemic-attack-hospitalizations-in-the-united-states
#11
Lucas Ramirez, May A Kim-Tenser, Nerses Sanossian, Steven Cen, Ge Wen, Shuhan He, William J Mack, Amytis Towfighi
BACKGROUND: Transient ischemic attack (TIA) is a major predictor of subsequent stroke. No study has assessed nation-wide trends in hospitalization for TIA in the United States. METHODS AND RESULTS: Temporal trends in hospitalization for TIA (International Classification of Diseases, Ninth Revision code 435.0-435.9) from 2000 to 2010 were assessed among adults aged ≥25 years using the Nationwide Inpatient Sample. Age-, sex-, and race/ethnic-specific TIA hospitalization rates were calculated using the weighted number of hospitalizations as the numerator and the US population as the denominator...
2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27638784/cerebral-microbleeds-vascular-risk-factors-and-magnetic-resonance-imaging-markers-the-northern-manhattan-study
#12
Michelle R Caunca, Victor Del Brutto, Hannah Gardener, Nirav Shah, Nelly Dequatre-Ponchelle, Ying Kuen Cheung, Mitchell S V Elkind, Truman R Brown, Charlotte Cordonnier, Ralph L Sacco, Clinton B Wright
BACKGROUND: Cerebral microbleeds (CMBs) represent intracerebral hemorrhages due to amyloid angiopathy or exposure to modifiable risk factors. Few community-based stroke-free studies including blacks and Hispanics have been done. METHODS AND RESULTS: The Northern Manhattan Study (NOMAS) is a stroke-free, racially and ethnically diverse cohort study. Brain MRI was performed in 1290 participants, 925 of whom had available T2* gradient-recall echo data. We used multivariable logistic regression to examine the association of sociodemographics, vascular risk factors, apolipoprotein E (APOE) genotype, and brain MRI markers with CMB presence and location...
September 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27634805/dsm-5-insomnia-and-short-sleep-comorbidity-landscape-and-racial-disparities
#13
David A Kalmbach, Vivek Pillai, J Todd Arnedt, Christopher L Drake
STUDY OBJECTIVES: We estimated rates of cardiometabolic disease, pain conditions, and psychiatric illness associated with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) insomnia disorder (current and in remission) and habitual short sleep (fewer than 6 h), and examined the roles of insomnia and short sleep in racial disparities in disease burden between black and non-Hispanic white Americans. METHODS: This epidemiological survey study was cross-sectional...
September 9, 2016: Sleep
https://www.readbyqxmd.com/read/27629092/why-are-acute-ischemic-stroke-patients-not-receiving-iv-tpa-results-from-a-national-registry
#14
Steven R Messé, Pooja Khatri, Mathew J Reeves, Eric E Smith, Jeffrey L Saver, Deepak L Bhatt, Maria V Grau-Sepulveda, Margueritte Cox, Eric D Peterson, Gregg C Fonarow, Lee H Schwamm
OBJECTIVE: To determine patient and hospital characteristics associated with not providing IV tissue plasminogen activator (tPA) to eligible patients with acute ischemic stroke (AIS) in clinical practice. METHODS: We performed a retrospective cohort study of patients with AIS arriving within 2 hours of onset to hospitals participating in Get With The Guidelines-Stroke without documented contraindications to IV tPA from April 2003 through December 2011, comparing those who received tPA to those who did not...
October 11, 2016: Neurology
https://www.readbyqxmd.com/read/27606797/childhood-trauma-and-adult-risk-factors-and-disease-in-hispanics-latinos-in-the-us-results-from-the-hispanic-community-health-study-study-of-latinos-hchs-sol-sociocultural-ancillary-study
#15
Maria M Llabre, Neil Scneiderman, Linda C Gallo, William Arguelles, Martha L Daviglus, Franklyn Gonzalez, Carmen R Isasi, Krista M Perreira, Frank J Penedo
OBJECTIVES: Adverse childhood experiences (ACEs) are implicated in diseases of adulthood. We report the prevalence of ACEs in Hispanics/Latinos in the US and their association with major risk factors and diseases in adulthood. METHODS: Data from the Sociocultural Ancillary Study of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were used. The Sociocultural Ancillary Study of the Hispanic Community Health Study/Study of Latinos is an epidemiological study conducted in four urban communities in the US: Bronx, Chicago, Miami, and San Diego...
September 7, 2016: Psychosomatic Medicine
https://www.readbyqxmd.com/read/27597905/cerebrovascular-accident-due-to-thyroid-storm-should-we-anticoagulate
#16
Alex Gonzalez-Bossolo, Alexis Gonzalez-Rivera, Santiago Coste-Sibilia
Thyroid storm is a life-threatening condition that occurs secondary to an uncontrolled hyperthyroid state. Atrial fibrillation is a cardiovascular complication occurring in up to 15% of patients experiencing thyroid storm, and if left untreated this condition could have up to a 25% mortality rate. Thyroid storm with stroke is a rare presentation. This case report details a left middle cerebral artery (MCA) stroke with global aphasia and thyroid storm in a 53-year-old Hispanic male patient. Although uncommon, this combination has been reported in multiple case series...
2016: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/27590800/self-reported-health-and-functional-characteristics-of-mexican-and-mexican-american-adults-aged-80-and-over
#17
Brian Downer, Nai-Wei Chen, Rebeca Wong, Kyriakos S Markides
OBJECTIVE: To examine the health and functional characteristics of Mexican and Mexican American adults aged ≥80. METHOD: Data came from Wave I (2001) and Wave III (2012) of the Mexican Health and Aging Study (MHAS), and Wave IV (2000-2001) and Wave VII (2010-2011) of the Hispanic Established Populations for Epidemiologic Studies of the Elderly (HEPESE). RESULTS: In 2000-2001, diabetes, arthritis, hypertension, and stroke were higher in the HEPESE than in the MHAS...
October 2016: Journal of Aging and Health
https://www.readbyqxmd.com/read/27575936/lipoprotein-a-level-apolipoprotein-a-size-and-risk-of-unexplained-ischemic-stroke-in-young-and-middle-aged-adults
#18
Azadeh Beheshtian, Sanyog G Shitole, Alan Z Segal, Dana Leifer, Russell P Tracy, Daniel J Rader, Richard B Devereux, Jorge R Kizer
BACKGROUND AND AIMS: Circulating lipoprotein (a) [Lp(a)] level relates inversely to apolipoprotein (a) [apo(a)] size. Both smaller apo(a) isoforms and higher Lp(a) levels have been linked to coronary heart disease and stroke, but their independent contributions are less well defined. We examined the role of Lp(a) in younger adults with cryptogenic stroke. METHODS: Lp(a) and apo(a) isoforms were evaluated in a prospectively designed case-control study of patients with unexplained ischemic stroke and stroke-free controls, ages 18 to 64...
October 2016: Atherosclerosis
https://www.readbyqxmd.com/read/27554701/endovascular-management-of-concomitant-thoracic-and-abdominal-aortic-ruptures-resulting-from-brucellosis-aortitis
#19
Samuel L Chen, Isabella J Kuo, Roy M Fujitani, Nii-Kabu Kabutey
INTRODUCTION: Acute aortic symptomatology is an unusual manifestation of Brucella melitensis infection. We present a rare case of acute multifocal thoracic and abdominal aortic ruptures arising from Brucellosis aortitis managed exclusively with endovascular surgery. METHODS: A 71 year-old Hispanic male with a history of atrial fibrillation and prior stroke on chronic anticoagulation, presented with shortness of breath and malaise. In addition, he had been treated approximately one year previously in Mexico for Brucella melitensis bacteremia after eating fresh unpasteurized cheese...
August 20, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27501282/fibroblast-growth-factor-23-and-cause-specific-mortality-in-the-general-population-the-northern-manhattan-study
#20
Nao Souma, Tamara Isakova, David Lipiszko, Ralph L Sacco, Mitchell S V Elkind, Janet T DeRosa, Shonni J Silverberg, Armando J Mendez, Chuanhui Dong, Clinton B Wright, Myles Wolf
CONTEXT: An elevated fibroblast growth factor (FGF) 23 is an independent risk factor for cardiovascular disease and mortality in patients with kidney disease. The relationship between FGF23 and cause-specific mortality in the general population is unknown. OBJECTIVE: To investigate the association of elevated FGF23 with the risk of cause-specific mortality in a racially and ethnically diverse urban general population. DESIGN, SETTING, PARTICIPANTS: The Northern Manhattan Study is a population-based prospective cohort study...
October 2016: Journal of Clinical Endocrinology and Metabolism
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