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Stroke Guideline

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https://www.readbyqxmd.com/read/29453020/2018-consensus-of-the-taiwan-society-of-cardiology-and-the-diabetes-association-of-republic-of-china-taiwan-on-the-pharmacological-management-of-patients-with-type-2-diabetes-and-cardiovascular-diseases
#1
Chern-En Chiang, Shih-Yi Lin, Tsung-Hsien Lin, Tzung-Dau Wang, Hung-I Yeh, Jung-Fu Chen, Chia-Ti Tsai, Yi-Jen Hung, Yi-Heng Li, Ping-Yen Liu, Kuan-Cheng Chang, Kang-Ling Wang, Ting-Hsing Chao, Kou-Gi Shyu, Wei-Shiung Yang, Kwo-Chang Ueng, Pao-Hsien Chu, Wei-Hsian Yin, Yen-Wen Wu, Hao-Min Cheng, Shyi-Jang Shin, Chien-Ning Huang, Lee-Ming Chuang, Shing-Jong Lin, San-Jou Yeh, Wayne Huey-Herng Sheu, Jiunn-Lee Lin
The global incidence and prevalence of type 2 diabetes have been escalating in recent decades. Patients with type 2 diabetes have an increased risk of atherosclerotic cardiovascular disease (ASCVD). About two-thirds of death in type 2 diabetes are due to ASCVD, including 40% from coronary heart disease (CHD), 15% from heart failure (HF), and 10% from stroke. The association between hyperglycemia and elevated CV risk has been demonstrated in multiple cohort studies. However, clinical trials of intensive glucose reduction did not significantly reduce macrovascular outcomes...
February 13, 2018: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29450734/two-hour-post-challenge-glucose-is-a-better-predictor-of-adverse-outcome-after-myocardial-infarction-than-fasting-or-admission-glucose-in-patients-without-diabetes
#2
Sudipta Chattopadhyay, Anish George, Joseph John, Thozukat Sathyapalan
AIMS: We evaluate prevalence of new abnormal glucose tolerance (AGT) in post-MI survivors without known diabetes (DM) if guidelines are followed and compare the ability of admission (APG), fasting (FPG) and 2-h post-load plasma glucose (2h-PG) to predict prognosis. METHODS: A total of 674 patients were followed up for 4 years for incidence of major adverse cardiovascular events (MACE) of cardiovascular death, non-fatal re-infarction or non-haemorrhagic stroke. Ability of models including APG, FPG and 2h-PG to predict MACE was compared...
February 15, 2018: Acta Diabetologica
https://www.readbyqxmd.com/read/29440581/implications-of-new-high-blood-pressure-guidelines-for-stroke-primary-and-secondary-prevention
#3
EDITORIAL
Daniel T Lackland
No abstract text is available yet for this article.
February 12, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29438515/diabetes-and-long-term-outcomes-of-ischaemic-stroke-findings-from-get-with-the-guidelines-stroke
#4
Justin B Echouffo-Tcheugui, Haolin Xu, Roland A Matsouaka, Ying Xian, Lee H Schwamm, Eric E Smith, Deepak L Bhatt, Adrian F Hernandez, Paul A Heidenreich, Gregg C Fonarow
Aims: There is a paucity of data on the influence of diabetes on long-term outcomes after ischaemic stroke (IS). We assessed whether outcomes after IS differ between patients with and without diabetes. Methods and results: Patients aged ≥65 years (n = 409 060) in Get With The Guidelines-Stroke (nationwide registry of stroke patients from 1690 sites in the USA) were followed for 3 years post-discharge. The outcomes of interest were mortality, cardiovascular and non-cardiovascular hospitalizations, heart failure (HF), and recurrence of IS/transient ischaemic attack (TIA)...
February 9, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29436443/diagnosis-and-management-of-cerebral-venous-thrombosis
#5
Roya Behrouzi, Martin Punter
Cerebral venous thrombosis (CVT) is rare and accounts for 0.5% of all strokes. Its clinical presentation is variable and diagnosis requires a high index of clinical suspicion in conjunction with neuroradiological diagnostic support. Treatment options are limited and are mostly based on consensus. Therefore, familiarity with international guidelines is important. Outcome is often good and most patients make a full recovery, although a small proportion suffers death or disability. Here, we describe the clinical features, risk factors, acute imaging features, management and complications of CVT...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29436194/comparison-of-rhythm-and-rate-control-strategies-for-stroke-occurrence-in-a-prospective-cohort-of-atrial-fibrillation-patients
#6
Yu Jeong Choi, Ki Woon Kang, Tae Hoon Kim, Myung Jin Cha, Jung Myung Lee, Junbeom Park, Jin Kyu Park, Jaemin Shim, Jae Sun Uhm, Jun Kim, Hyung Wook Park, Eue Keun Choi, Jin Bae Kim, Changsoo Kim, Young Soo Lee, Boyoung Joung
PURPOSE: Comparisons of rhythm and rate control strategies for stroke prevention in patients with atrial fibrillation (AF) are still inconclusive. We compared differences in clinical outcomes between the rhythm and rate control strategies. MATERIALS AND METHODS: The COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF) registry prospectively enrolled 6000 patients who were treated for AF using real-world guideline adherence at multiple referral centers...
March 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29432241/evaluation-and-acute-management-of-ischemic-stroke-in-infants-and-children
#7
Catherine Amlie-Lefond
PURPOSE OF REVIEW: This article provides an overview of stroke in neonates, infants, and children. RECENT FINDINGS: Arterial ischemic stroke and cerebral venous sinus thrombosis are increasingly recognized in childhood as important causes of lifelong morbidity and mortality. Diagnosis of arterial ischemic stroke is frequently delayed, as acute neurologic deficits can be challenging to detect in the young child, and stroke is often not considered in the differential diagnosis...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29428538/carotid-access-for-endovascular-repair-of-aortic-pathology-a-systematic-review
#8
Thomas W Stonier, Kirtan Patel, Vamsee Bhrugubanda, Andrew Mtl Choong
BACKGROUND: Endovascular repair is now preferred to open access for the management of aortic diseases. This is typically performed via the femoral artery, however not all patients are eligible for this. This systematic review summaries the current evidence for utilising the carotid artery as an alternative access route. METHODS: A systematic review was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines using four electronic databases...
February 8, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29426361/nursing-home-care-educational-intervention-for-family-caregivers-of-older-adults-post-stroke-share-study-protocol-for-a-randomised-trial
#9
Carolina Baltar Day, Carla Cristiane Becker Kottwitz Bierhals, Naiana Oliveira Dos Santos, Duane Mocellin, Mariane Lurdes Predebon, Fernanda Laís Fengler Dal Pizzol, Lisiane Manganelli Girardi Paskulin
BACKGROUND: Family caregivers of aged stroke survivors face challenging difficulties such as the lack of support and the knowledge and skills to practice home care. These aspects negatively influence the caregivers' burden and quality of life, the use of health services, and hospital readmissions of the stroke survivor. The aim of this research is to describe an educational intervention focused on family caregivers of stroke survivors for the development of home care in the south of Brazil...
February 9, 2018: Trials
https://www.readbyqxmd.com/read/29424734/what-we-have-learned-from-the-european-heart-rhythm-association-consensus-document-on-device-detected-subclinical-atrial-tachyarrhythmias
#10
Emin Evren Özcan, Bülent Görenek
Although various cardiac monitoring methods were developed to detect subclinical arrhythmias, guidelines do not address in detail the management of subclinical atrial fibrillation and tachyarrhythmias. The European Heart Rhythm Association recently published a consensus document that addresses the clinical importance, implications, and management of device-detected subclinical atrial tachyarrhythmias. This paper comprehensively reviews the diagnostic tools to detect subclinical atrial arrhythmias and discusses the pathophysiologic link between devicedetected subclinical atrial fibrillation and stroke...
February 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29424469/effect-of-intensive-blood-pressure-control-in-patients-with-type-2-diabetes-mellitus-over-9-years-of-follow-up-a-subgroup-analysis-of-high-risk-accordion-trial-participants
#11
Leo F Buckley, Dave L Dixon, George F Wohlford, Dayanjan S Wijesinghe, William L Baker, Benjamin W Van Tassell
Although guidelines recommend strict blood pressure (BP) control in patients with type 2 diabetes mellitus (T2DM) and elevated cardiovascular risk, the long-term effects of this approach are unknown. We investigated the effect of intensive BP control on clinical outcomes in patients with T2DM over 9 years of follow-up. We included ACCORD BP participants in the standard glucose control arm who had established cardiovascular disease, chronic kidney disease, age ≥75 years or 10-year coronary heart risk ≥15%...
February 9, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29424346/emergency-thrombectomy-for-acute-ischaemic-stroke-current-evidence-international-guidelines-and-local-clinical-practice
#12
A Co Tsang, R Wl Yeung, M My Tse, R Lee, W M Lui
Acute ischaemic stroke due to large vessel occlusion leads to grave neurological morbidity and mortality. Conventional intravenous thrombolysis is ineffective in achieving timely reperfusion in this group of patients. The publication of five positive randomised controlled trials of emergency thrombectomy for acute ischaemic stroke in 2015 provided strong evidence to support endovascular reperfusion therapy and represented a paradigm shift in acute stroke management. In this article, we review the current evidence and international guidelines, and report on the findings of a survey study of the clinical practice and opinions of local neurologists, neurosurgeons, and interventional radiologists in emergency thrombectomy...
February 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29422277/revascularization-of-radiation-induced-carotid-artery-stenosis-with-carotid-endarterectomy-vs-carotid-artery-stenting-a-systematic-review-and-meta-analysis
#13
REVIEW
Stefanos Giannopoulos, Pavlos Texakalidis, Anil Kumar Jonnalagadda, Theofilos Karasavvidis, Spyridon Giannopoulos, Damianos G Kokkinidis
OBJECTIVE: The incidence of carotid artery stenosis after head and neck radiation is anticipated to rise due to the increasing survival of patients with head and neck malignancies. It remains unclear whether carotid artery stenting (CAS) or endarterectomy (CEA) is the best treatment strategy for radiation-induced carotid artery stenosis. MATERIALS & METHODS: This study was performed according to the PRISMA and MOOSE guidelines. Eligible studies were identified through a comprehensive search of PubMed, Scopus and Cochrane Central until July 20, 2017...
January 31, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29421687/baseline-blood-pressure-the-2017-acc-aha-high-blood-pressure-guidelines-and-long-term-cardiovascular-risk-in-sprint
#14
Muthiah Vaduganathan, Manan Pareek, Arman Qamar, Ambarish Pandey, Michael H Olsen, Deepak L Bhatt
BACKGROUND: The 2017 ACC/AHA guidelines include lower thresholds to define hypertension than previous guidelines. Little is known about the impact of these guideline changes in patients with or at high risk for cardiovascular disease. METHODS: In this exploratory analysis using baseline blood pressure assessments in SPRINT (Systolic Blood Pressure Intervention Trial), we evaluated the prevalence and associated cardiovascular prognosis of patients newly reclassified with hypertension based on the 2017 ACC/AHA (SBP≥130mmHg or DBP≥80mmHg) compared with the JNC 7 guidelines (SBP≥140mmHg or DBP≥90mmHg)...
February 5, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29421016/rationale-and-design-of-the-dear-old-trial-randomized-evaluation-of-routinely-deferred-versus-early-invasive-strategy-in-elderly-patients-of-75-years-or-older-with-non-st-elevation-myocardial-infarction
#15
Wen-Xiu Leng, Jingang Yang, Wei Li, Yang Wang, Yue-Jin Yang
BACKGROUND: Comparing with conservative strategy, early invasive approach has been shown to be beneficial for initially stabilized patients with non-ST-elevation myocardial infarction (NSTEMI). However, concerns of increased risk of bleeding and other complications associated with early revascularization in patients aged ≥75 years persist. A routinely deferred invasive strategy aiming to facilitate revascularization after stabilizing the culprit lesion predominates across China. AIM: The aim was to compare efficacy and safety of deferred invasive strategy versus guideline-recommended early invasive strategy in initially stabilized Chinese patients aged ≥75 years with NSTEMI...
February 2018: American Heart Journal
https://www.readbyqxmd.com/read/29420546/microbubbles-combined-with-ultrasound-therapy-in-ischemic-stroke-a-systematic-review-of-in-vivo-preclinical-studies
#16
Laurent Auboire, Charles A Sennoga, Jean-Marc Hyvelin, Fréderic Ossant, Jean-Michel Escoffre, François Tranquart, Ayache Bouakaz
BACKGROUND: Microbubbles (MBs) combined with ultrasound sonothrombolysis (STL) appears to be an alternative therapeutic strategy for acute ischemic stroke (IS), but clinical results remain controversial. OBJECTIVE: The aim of this systematic review is to identify the parameters tested; to assess evidence on the safety and efficacy on preclinical data on STL; and to assess the validity and publication bias. METHODS: Pubmed® and Web of ScienceTM databases were systematically searched from January 1995 to April 2017 in French and English...
2018: PloS One
https://www.readbyqxmd.com/read/29419560/implications-of-the-new-national-guidelines-for-hypertension
#17
Wilbert S Aronow, William H Frishman
Automated validated devices should be used for measuring blood pressure (BP). A systolic BP between 120 and 129 mm Hg with a diastolic BP < 80 mm Hg should be treated by lifestyle measures. Lifestyle measures plus BP lowering drugs should be used for secondary prevention of recurrent cardiovascular disease (CVD) events in persons with clinical CVD (coronary heart disease, congestive heart failure, and stroke) and an average systolic BP of ≥130 mm Hg or an average diastolic BP ≥ 80 mm Hg. Lifestyle measures plus BP lowering drugs should be used for primary prevention of CVD in persons with an estimated 10-year risk of atherosclerotic CVD ≥ 10% and an average systolic BP ≥130 mm Hg or an average diastolic BP ≥ 80 mm Hg...
March 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29417379/a-snapshot-of-type-two-diabetes-mellitus-management-in-general-practice-prior-to-the-introduction-of-diabetes-cycle-of-care
#18
Jennifer V Gettings, Raymond O'Connor, Jane O'Doherty, Ailish Hannigan, Walter Cullen, Louise Hickey, Andrew O'Regan
BACKGROUND: Diabetes is associated with complications, including coronary heart disease, stroke, kidney failure, blindness and amputation, and ultimately is a major cause of disability and death worldwide. Adherence to best practice guidelines is limited in unstructured diabetes management in primary care settings. AIMS: This study aims to establish what data was being collected in general practice prior to the introduction of the Cycle of Care, which is a proactive model of diabetes management introduced in Ireland...
February 7, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29417147/direct-oral-anticoagulants-in-addition-to-antiplatelet-therapy-for-secondary-prevention-after-acute-coronary-syndromes-a-systematic-review-and-meta-analysis
#19
Mauro Chiarito, Davide Cao, Francesco Cannata, Cosmo Godino, Corrado Lodigiani, Giuseppe Ferrante, Renato D Lopes, John H Alexander, Bernhard Reimers, Gianluigi Condorelli, Giulio G Stefanini
Importance: Patients with acute coronary syndrome (ACS) remain at high risk for experiencing recurrent ischemic events. Direct oral anticoagulants (DOAC) have been proposed for secondary prevention after ACS. Objective: To evaluate the safety and efficacy of DOAC in addition to antiplatelet therapy (APT) after ACS, focusing on treatment effects stratified by baseline clinical presentation (non-ST-segment elevation ACS [NSTE-ACS] vs ST-segment elevation myocardial infarction [STEMI])...
February 7, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29413725/current-practices-and-safety-of-medication-use-during-rapid-sequence-intubation
#20
Christine M Groth, Nicole M Acquisto, Tina Khadem
PURPOSE: Characterize medication practices during and immediately after rapid sequence intubation (RSI) by provider/location and evaluate adverse drug events. MATERIALS AND METHODS: This was a multicenter, observational, cross-sectional study of adult and pediatric intensive care unit and emergency department patients over a 24-h period surrounding first intubation. RESULTS: A total of 404 patients from 34 geographically diverse institutions were included (mean age 58 ± 22 years, males 59%, pediatric 8%)...
January 30, 2018: Journal of Critical Care
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