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Stroke Guideline

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https://www.readbyqxmd.com/read/29026741/salt-reduction-strategy-at-population-level
#1
Madhavi Bhargava
World is facing a huge burden of noncommunicable diseases such as hypertension, ischemic health diseases, and stroke. Moreover, the developing countries have had a relatively speedy rise of the problem, with noncommunicable diseases occurring at much lower age as compared to the developed world. The World Health Organization, therefore, recommends reduction in salt intake at population level to <5 g/day. Not all researchers and public health physicians agree to it, leading to conflicting information for a primary care physician...
January 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29022132/an-exploratory-study-of-the-electronic-medical-record-and-outpatient-vascular-neurology-consultations
#2
Larissa Georgeon, Philip B Gorelick, Tenko Raykov, Muhammad U Farooq, Jiangyong Min, Christopher Goshgarian, Bradley Haveman-Gould, Amy Groenhout, Molly McCarthy
We carried out a quality improvement project utilizing the electronic medical record (EMR) to determine (1) the quality of vascular neurologists' recommendations for recurrent stroke prevention and (2) primary care provider (PCP) acknowledgement of the vascular neurologists' recurrent stroke prevention recommendations and their frequency of meeting the recommended metrics for risk factor control and lifestyle modification. We conducted a retrospective EMR chart review on a convenience sample of ischemic stroke patients during two epochs...
October 11, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/29021359/increasing-prevalence-of-vascular-risk-factors-in-patients-with-stroke-a-call-to-action
#3
Fadar Oliver Otite, Nicholas Liaw, Priyank Khandelwal, Amer M Malik, Jose G Romano, Tatjana Rundek, Ralph L Sacco, Seemant Chaturvedi
OBJECTIVE: To evaluate trends in prevalence of cardiovascular risk factors (hypertension, diabetes, dyslipidemia, smoking, and drug abuse) and cardiovascular diseases (carotid stenosis, chronic renal failure [CRF], and coronary artery disease [CAD]) in acute ischemic stroke (AIS) in the United States. METHODS: We used the 2004-2014 National Inpatient Sample to compute weighted prevalence of each risk factor in hospitalized patients with AIS and used joinpoint regression to evaluate change in prevalence over time...
October 11, 2017: Neurology
https://www.readbyqxmd.com/read/29021333/is-risk-standardized-in-hospital-stroke-mortality-an-adequate-proxy-for-risk-standardized-30-day-stroke-mortality-data-findings-from-get-with-the-guidelines-stroke
#4
Mathew J Reeves, Gregg C Fonarow, Haolin Xu, Roland A Matsouaka, Ying Xian, Jeffrey Saver, Lee Schwamm, Eric E Smith
BACKGROUND: Hospital profiling is typically undertaken using risk-standardized 30-day mortality, but obtaining these data for hospitals can be difficult. We sought to determine whether risk-standardized in-hospital mortality could serve as an adequate proxy for risk-standardized 30-day mortality data for the purposes of identifying outlier hospitals. METHODS AND RESULTS: Acute ischemic stroke cases entered into GWTG (Get With The Guidelines)-Stroke between 2003 and 2013 were linked to fee-for-service Medicare files to obtain 30-day mortality...
October 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29020367/clinical-outcomes-of-state-of-the-art-percutaneous-coronary-revascularization-in-patients-with-de-novo-three-vessel-disease-1-year-results-of-the-syntax-ii-study
#5
Javier Escaned, Carlos Collet, Nicola Ryan, Giovanni Luigi De Maria, Simon Walsh, Manel Sabate, Justin Davies, Maciej Lesiak, Raul Moreno, Ignacio Cruz-Gonzalez, Stephan P Hoole, Nick Ej West, J J Piek, Azfar Zaman, Farzin Fath-Ordoubadi, Rodney H Stables, Clare Appleby, Nicolas van Mieghem, Robert Jm van Geuns, Neal Uren, Javier Zueco, Pawel Buszman, Andres Iñiguez, Javier Goicolea, David Hildick-Smith, Andrzej Ochala, Dariusz Dudek, Colm Hanratty, Rafael Cavalcante, Arie Pieter Kappetein, David P Taggart, Gerrit-Anne van Es, Marie-Angèle Morel, Ton de Vries, Yoshinobu Onuma, Vasim Farooq, Patrick W Serruys, Adrian P Banning
Aims: To investigate if recent technical and procedural developments in percutaneous coronary intervention (PCI) significantly influence outcomes in appropriately selected patients with three-vessel (3VD) coronary artery disease. Methods and results: The SYNTAX II study is a multicenter, all-comers, open-label, single arm study that investigated the impact of a contemporary PCI strategy on clinical outcomes in patients with 3VD in 22 centres from four European countries...
August 26, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29019319/the-asymptomatic-carotid-surgery-trial-2-acst-2-an-ongoing-randomised-controlled-trial-comparing-carotid-endarterectomy-with-carotid-artery-stenting-to-prevent-stroke
#6
Richard Bulbulia, Alison Halliday
BACKGROUND: A successful open surgical operation to remove atheromatous carotid artery narrowing that has not yet caused a stroke (asymptomatic carotid stenosis) carries some procedural risk but, if completed successfully, halves patients' future annual stroke risk for at least 10 years. A newer, less invasive alternative is carotid stenting, which also carries some procedural risk, especially if the carotid lesion has recently given rise to a stroke (symptomatic carotid stenosis). For both surgery and stenting, improvements in technique (and in medication) have reduced risk...
October 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29018132/one-stop-management-of-acute-stroke-patients-minimizing-door-to-reperfusion-times
#7
Marios-Nikos Psychogios, Daniel Behme, Katharina Schregel, Ioannis Tsogkas, Ilko L Maier, Johanna Rosemarie Leyhe, Antonia Zapf, Julia Tran, Mathias Bähr, Jan Liman, Michael Knauth
BACKGROUND AND PURPOSE: Intrahospital time delays significantly affect the neurological outcome of stroke patients with large-vessel occlusion. This study was conducted to determine whether a one-stop management can reduce intrahospital times of patients with acute large-vessel occlusion. METHODS: In this observational study, we report the first 30 consecutive stroke patients imaged and treated in the same room. As part of our protocol, we transported patients with a National Institutes of Health Stroke Scale score of ≥10 directly to the angio suite, bypassing multidetector computed tomography (CT)...
October 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29018076/protocol-for-a-prospective-interventional-trial-to-develop-a-diagnostic-index-test-for-stroke-as-a-cause-of-vertigo-dizziness-and-imbalance-in-the-emergency-room-emvert-study
#8
Ken Möhwald, Stanislavs Bardins, Hans-Helge Müller, Klaus Jahn, Andreas Zwergal
INTRODUCTION: Identifying stroke as a cause of acute vertigo, dizziness and imbalance in the emergency room is still a clinical challenge. Many patients are admitted to stroke units, but only a minority will have strokes. This imposes a heavy financial burden on the healthcare system. The aim of this study is to develop a diagnostic index test to identify patients with a high risk of having a stroke as the cause of acute vertigo and imbalance. METHODS AND ANALYSIS: Patients with acute onset of vertigo, dizziness, postural imbalance or double vision within the last 24 hours lasting for at least 10 min are eligible to be included in the study...
October 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/29018068/epidemiology-of-venous-thromboembolism-in-africa-a-systematic-review-and-meta-analysis-protocol
#9
Celestin Danwang, Mazou N Temgoua, Valirie Ndip Agbor, Aurel T Tankeu, Jean Jacques Noubiap
INTRODUCTION: Venous thromboembolism (VTE) is among the three major causes of cardiovascular diseases worldwide after ischaemic heart disease and stroke. Knowledge on the global epidemiology of this condition is deficient in Africa. Accurate data are needed to evaluate the burden of VTE in Africa to design effective preventive and treatment strategies. This systematic review and meta-analysis aims to summarise epidemiological data on VTE in Africa and to evaluate the use of prophylaxis in African patients at risk of VTE...
October 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/29016766/temporal-pattern-episode-duration-based-classification-of-atrial-fibrillation-as-paroxysmal-vs-persistent-is-it-time-to-develop-a-more-integrated-prognostic-score-to-optimize-management
#10
Matthew Hammond-Haley, Rui Providência, Pier D Lambiase
Atrial fibrillation (AF) is a clinically heterogeneous arrhythmia that is currently classified according to the variety of temporal rhythm based manifestations observed clinically, including 'first detected episode', 'paroxysmal', 'persistent', or 'permanent' AF. Despite being widely adopted by the most recent consensus guidelines, the utility of this classification system to stratify patients into distinct and clinically useful groups that have different outcomes including mortality, morbidity, specific cardiovascular outcomes, and quality of life (QoL), remains questionable...
July 11, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28994143/correlates-of-physical-activity-among-depressed-older-people-in-six-low-income-and-middle-income-countries-a-community-based-cross-sectional-study
#11
Davy Vancampfort, Brendon Stubbs, Nicola Veronese, James Mugisha, Nathalie Swinnen, Ai Koyanagi
OBJECTIVE: Despite the benefits of physical activity (PA) in older people with depression, many do not comply with the International PA guidelines. Thus, we investigated what factors influence PA participation among 915 community-dwelling older adults (aged ≥65 years) with depression in 6 low-income and middle-income countries (LMICs). METHODS: Cross-sectional data were analyzed from the World Health Organization's Study on Global Ageing and Adult Health. The sample was restricted to those with DSM-IV depression or receiving depression treatment in the last 12 months...
October 10, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28994036/comparison-of-4-different-strategies-of-dapt-after-pci-in-acs-real-world-population-from-a-northern-italy-registry
#12
Marta Rasia, Emilia Solinas, Massimiliano Marino, Paolo Guastaroba, Alberto Menozzi, Maria Alberta Cattabiani, Iacopo Tadonio, Rossana De Palma, Luigi Vignali
Aim of the study was to compare four different strategies of dual antiplatelet therapy (DAPT) in patients with acute coronary syndromes (ACS) treated with PCI. DAPT with Clopidogrel, Ticagrelor and Prasugrel has proved to be effective in patients with ACS treated with percutaneous coronary intervention (PCI) by reducing major adverse cardiovascular outcomes (MACE). However, the effect of the different strategies in a real-world population deserves further verification. A retrospective analysis of 2404 discharged ACS patients treated with PCI was performed, with a median follow-up of 1 year...
October 9, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28992764/use-of-guidelines-for-reducing-stroke-risk-in-patients-with-nonvalvular-atrial-fibrillation-a-review-from-a-latin-american-perspective
#13
Carlos Cantú-Brito, Gisele Sampaio Silva, Sebastián F Ameriso
Atrial fibrillation (AF) is a prominent risk factor for stroke and a leading cause of death and disability throughout Latin America. Contemporary evidence-based guidelines for the management of AF and stroke incorporate the use of practical and relatively simple scoring methods to estimate both stroke and bleeding risk, in order to assist in matching patients with appropriate interventions. This review examines consistencies and differences among guidelines for reducing stroke risk in patients with AF, assessing the role of user-friendly scoring methods to determine appropriate patients for anticoagulation and other treatment options...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28992319/atrial-fibrillation-in-kidney-transplant-recipients-is-there-a-place-for-the-novel-drugs
#14
Jolanta Malyszko, Paulina Lopatowska, Elzbieta Mlodawska, Dominika Musialowska, Jacek S Malyszko, Anna Tomaszuk-Kazberuk
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia of high clinical importance, occurring in 2% of the general population and in 19-24% in patients with chronic kidney disease. It is a well-known risk factor for cardiovascular morbidity and mortality. Kidney transplant recipients with a history of AF were associated with significantly higher rate of ischaemic strokes, graft failure and post-transplant mortality. AF occurs in over 7% of kidney transplant recipients in the first 3 years after transplantation and is associated with reduced graft and patient survival...
September 7, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28992159/compliance-with-accreditation-and-recommended-hospital-care-a-danish-nationwide-population-based-study
#15
Anne Mette Falstie-Jensen, Søren Bie Bogh, Erik Hollnagel, Søren Paaske Johnsen
Objective: To examine the association between compliance with accreditation and recommended hospital care. Design: A Danish nationwide population-based follow-up study based on data from six national, clinical quality registries between November 2009 and December 2012. Setting: Public, non-psychiatric Danish hospitals. Participants: Patients with acute stroke, chronic obstructive pulmonary disease, diabetes, heart failure, hip fracture and bleeding/perforated ulcers...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28989804/the-chinese-stroke-association-scientific-statement-intravenous-thrombolysis-in-acute-ischaemic-stroke
#16
REVIEW
Qiang Dong, Yi Dong, Liping Liu, Anding Xu, Yusheng Zhang, Huaguang Zheng, Yongjun Wang
The most effective medical treatment for acute ischaemic stroke (AIS) is to offer intravenous thrombolysis during the ultra-early period of time after the onset. Even based on the Consensus of Chinese Experts on Intravenous Thrombolysis for AIS in 2012 and 2014 Chinese Guidelines on the Diagnosis and Treatment of AIS, the rate of thrombolysis for AIS in China remained around 2.4%, and the rate of intravenous tissue plasminogen activator usage was only about 1.6% in real world. The indication of thrombolysis for AIS has been expanded, and contraindications have been reduced with recently published studies...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28988732/rupture-of-an-occult-intracranial-mycotic-aneurysm-after-intravenous-thrombolysis-with-recombinant-tissue-plasminogen-activator-for-acute-ischemic-stroke
#17
Jared Glenn, Margaret Strecker-McGraw, Ian McGraw, Karim Jabbar, Nathan A James, C Keith Stone
BACKGROUND: The treatment of acute ischemic stroke with recombinant tissue plasminogen activator (rtPA) has become the mainstay of treatment, but its use carries a risk of subsequent intracranial hemorrhage (ICH). Guidelines have been developed to aid in the selection of the appropriate candidates to treat with rtPA to reduce this risk. We present a case of a stroke patient who was an appropriate candidate and was treated with rtPA who experienced a fatal subarachnoid hemorrhage due to a ruptured mycotic aneurysm (MA)...
October 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28985849/treating-a-20-mm-hg-gradient-alleviates-myocardial-hypertrophy-in-experimental-aortic-coarctation
#18
David C Wendell, Ingeborg Friehs, Margaret M Samyn, Leanne M Harmann, John F LaDisa
BACKGROUND: Children with coarctation of the aorta (CoA) can have a hyperdynamic and remodeled left ventricle (LV) from increased afterload. Literature from an experimental model suggests the putative 20 mm Hg blood pressure gradient (BPG) treatment guideline frequently implemented in CoA studies may permit irreversible vascular changes. LV remodeling from pressure overload has been studied, but data are limited following correction and using a clinically representative BPG. MATERIALS AND METHODS: Rabbits underwent CoA at 10 weeks to induce a 20 mm Hg BPG using permanent or dissolvable suture thereby replicating untreated and corrected CoA, respectively...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28985560/ferroptosis-a-regulated-cell-death-nexus-linking-metabolism-redox-biology-and-disease
#19
REVIEW
Brent R Stockwell, José Pedro Friedmann Angeli, Hülya Bayir, Ashley I Bush, Marcus Conrad, Scott J Dixon, Simone Fulda, Sergio Gascón, Stavroula K Hatzios, Valerian E Kagan, Kay Noel, Xuejun Jiang, Andreas Linkermann, Maureen E Murphy, Michael Overholtzer, Atsushi Oyagi, Gabriela C Pagnussat, Jason Park, Qitao Ran, Craig S Rosenfeld, Konstantin Salnikow, Daolin Tang, Frank M Torti, Suzy V Torti, Shinya Toyokuni, K A Woerpel, Donna D Zhang
Ferroptosis is a form of regulated cell death characterized by the iron-dependent accumulation of lipid hydroperoxides to lethal levels. Emerging evidence suggests that ferroptosis represents an ancient vulnerability caused by the incorporation of polyunsaturated fatty acids into cellular membranes, and cells have developed complex systems that exploit and defend against this vulnerability in different contexts. The sensitivity to ferroptosis is tightly linked to numerous biological processes, including amino acid, iron, and polyunsaturated fatty acid metabolism, and the biosynthesis of glutathione, phospholipids, NADPH, and coenzyme Q10...
October 5, 2017: Cell
https://www.readbyqxmd.com/read/28985276/mortality-and-macrovascular-risk-in-elderly-with-hypertension-and-diabetes-effect-of-intensive-drug-therapy
#20
Arseniy P Yashkin, Julia Kravchenko, Anatoliy I Yashin, Frank Sloan
Background: This study identifies the effect of intensive drug therapy in individuals age 65+ with diabetes (T2D) and hypertension on all-cause death, congestive heart failure (CHF) and hospitalization for myocardial infarction (MI) and stroke/transient ischemic attack (stroke/TIA). Methods: Individuals from the Medicare 5% dataset with hypertension and T2D undergoing intensive drug therapy for these conditions were propensity score matched to a non-intensive-drug-therapy group...
August 14, 2017: American Journal of Hypertension
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