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https://www.readbyqxmd.com/read/29332471/fatal-exertional-heat-stroke-and-american-football-players-the-need-for-regional-heat-safety-guidelines
#1
Andrew J Grundstein, Yuri Hosokawa, Douglas J Casa
CONTEXT:   Weather-based activity modification in athletics is an important way to minimize heat illnesses. However, many commonly used heat-safety guidelines include a uniform set of heat-stress thresholds that do not account for geographic differences in acclimatization. OBJECTIVE:   To determine if heat-related fatalities among American football players occurred on days with unusually stressful weather conditions based on the local climate and to assess the need for regional heat-safety guidelines...
January 13, 2018: Journal of Athletic Training
https://www.readbyqxmd.com/read/29331206/mechanical-thrombectomy-determining-the-proportion-of-eligible-acute-ischemic-stroke-patients-in-the-cohort-of-single-academic-stroke-center
#2
Marcin Wiącek, Rafał Kaczorowski, Bartosz Sieczkowski, Natalia Kanas, Halina Bartosik-Psujek
BACKGROUND AND PURPOSE: Mechanical thrombectomy (MT) is now well-established treatment method for selected patients with acute ischemic stroke (AIS) and efforts are being made to incorporate it into the systems of stroke care. Our objective is to assess the number of AIS individuals eligible for MT in the cohort of single academic stroke center. METHODS: We retrospectively reviewed initial non-invasive vascular imaging data of AIS patients presenting within 5h of symptom onset for the presence of large vessel occlusion (LVO) over 2-year period (2015-2016)...
December 26, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/29330651/3d-computed-tomography-to-compare-the-dimensions-of-the-left-atrial-appendage-in-patients-with-normal-sinus-rhythm-and-those-with-paroxysmal-atrial-fibrillation
#3
Maiko Hozawa, Yoshihiro Morino, Yuki Matsumoto, Ryoichi Tanaka, Kyohei Nagata, Akiko Kumagai, Atsushi Tashiro, Akio Doi, Kunihiro Yoshioka
Although paroxysmal atrial fibrillation (PAF) is an important cause of cardioembolic stroke, in contrast to chronic AF patients, the anatomical features of the left atrial appendage (LAA) in PAF patients remain unknown. Here, we investigated differences in LAA structures in patients with PAF and those with normal sinus rhythms (NSR) using 3D-computed tomography (3D-CT), which allows us to visualize complicated LAA structures at high spatial resolution. Study subjects were 30 consecutive PAF and 30 NSR patients with complete enhanced cardiac 3D-CT images available...
January 12, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29330309/poverty-a-risk-factor-overlooked-a-cross-sectional-cohort-study-comparing-poverty-rate-and-cardiovascular-disease-outcomes-in-the-state-of-florida
#4
Bashar Al-Turk, Ciel Harris, Grant Nelson, Carmen Smotherman, Carlos Palacio, Jeff House
The purpose of this study is to examine the relationship between poverty rate and heart disease in our state. A cross-sectional data analysis was performed using figures provided by the Center for Disease Control's Interactive Atlas of Heart Disease and Stroke Tables. Spearman's correlations and simple regressions were used to determine if there was a relationship between poverty and cardiovascular hospitalization rate and cardiovascular death rate. There was a positive monotonic correlation between poverty rate and cardiovascular hospitalization rate (Rho=0...
January 12, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/29330071/onabotulinumtoxina-for-the-treatment-of-post-stroke-distal-lower-limb-spasticity-a-randomized-trial
#5
Theodore Wein, Alberto Esquenazi, Wolfgang H Jost, Anthony B Ward, Grace Pan, Rozalina Dimitrova
BACKGROUND: Post-stroke distal lower limb spasticity impairs mobility, limiting activities of daily living, requiring additional caregiver time. OBJECTIVE: To evaluate the efficacy, safety, and sustained benefit of onabotulinumtoxinA in adults with post-stroke lower limb spasticity (PSLLS). DESIGN: A multicenter, randomized, double-blind, phase 3, placebo-controlled trial. SETTING: 60 study centers across North America, Europe, Russia the United Kingdom, and South Korea...
January 9, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29329535/measurement-of-the-potential-geographic-accessibility-from-call-to-definitive-care-for-patient-with-acute-stroke
#6
J Freyssenge, F Renard, A M Schott, L Derex, N Nighoghossian, K Tazarourte, C El Khoury
BACKGROUND: The World Health Organization refers to stroke, the second most frequent cause of death in the world, in terms of pandemic. Present treatments are only effective within precise time windows. Only 10% of thrombolysis patients are eligible. Late assessment of the patient resulting from admission and lack of knowledge of the symptoms is the main explanation of lack of eligibility. METHODS: The aim is the measurement of the time of access to treatment facilities for stroke victims, using ambulances (firemen ambulances or EMS ambulances) and private car...
January 12, 2018: International Journal of Health Geographics
https://www.readbyqxmd.com/read/29327997/mechanical-thrombectomy-in-basilar-artery-occlusion-influence-of-reperfusion-on-clinical-outcome-and-impact-of-the-first-line-strategy-adapt-vs-stent-retriever
#7
Benjamin Gory, Mikael Mazighi, Raphael Blanc, Julien Labreuche, Michel Piotin, Francis Turjman, Bertrand Lapergue
OBJECTIVE Several randomized trials have been focused on patients with anterior circulation stroke, whereas few data on posterior circulation stroke are available. Thus, new mechanical thrombectomy (MT) strategies, including a direct-aspiration first-pass technique (ADAPT), remain to be evaluated in basilar artery occlusion (BAO) patients. The authors here assessed the influence of reperfusion on outcome in BAO patients and examined whether ADAPT improves the reperfusion rate compared with stent retriever devices...
January 12, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29327485/right-left-propensity-of-cardiogenic-cerebral-embolism-in-standard-versus-bovine-aortic-arch-variant
#8
Menachem Gold, Mojdeh Khamesi, Mangaiyarkkarasi Sivakumar, Vijaya Natarajan, Hooman Motahari, Nicholas Caputo
INTRODUCTION: Left-hemispheric ischemic strokes are more frequent overall and often have a worse outcome than their right-hemispheric counterparts. We hypothesized that the right-left propensity of CE cerebral infarcts differs between patients with standard and bovine arch variants. METHODS: We retrospectively identified all patients with acute stroke of the anterior circulation admitted to our primary stroke center between January 2011 and June 2017 who had moderate- to high-risk cardio-embolic sources according to the SSS-TOAST classification...
January 12, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29327286/abcd3-i-score-and-the-risk-of-early-or-3-month-stroke-recurrence-in-tissue-and-time-based-definitions-of-tia-and-minor-stroke
#9
Lukas Mayer, Julia Ferrari, Stefan Krebs, Christian Boehme, Thomas Toell, Benjamin Matosevic, Alexander Tinchon, Michael Brainin, Thomas Gattringer, Peter Sommer, Peter Thun, Johann Willeit, Wilfried Lang, Stefan Kiechl, Michael Knoflach
Changing definition of TIA from time to a tissue basis questions the validity of the well-established ABCD3-I risk score for recurrent ischemic cerebrovascular events. We analyzed patients with ischemic stroke with mild neurological symptoms arriving < 24 h after symptom onset in a phase where it is unclear, if the event turns out to be a TIA or minor stroke, in the prospective multi-center Austrian Stroke Unit Registry. Patients were retrospectively categorized according to a time-based (symptom duration below/above 24 h) and tissue-based (without/with corresponding brain lesion on CT or MRI) definition of TIA or minor stroke...
January 11, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29325799/elevated-circulating-homocysteine-and-high-sensitivity-c-reactive-protein-jointly-predicts-post-stroke-depression-among-chinese-patients-with-acute-ischemic-stroke
#10
Jieyun Yin, Chongke Zhong, Zhengbao Zhu, Xiaoqing Bu, Tan Xu, Libing Guo, Xuemei Wang, Jintao Zhang, Yong Cui, Dong Li, Jianhui Zhang, Zhong Ju, Chung-Shiuan Chen, Jing Chen, Yonghong Zhang, Jiang He
BACKGROUND: Homocysteine (HCY) and high sensitivity C reactive protein (hs-CRP) were suggested to be involved in post-stroke depression (PSD), which is a frequent mood disorder after stroke. However, the combined effect of HCY and hs-CRP on PSD remains unclear. METHODS: A total of 598 acute ischemic stroke patients from 7 of 26 centers participating in the China Antihypertensive Trial in Acute Ischemic Stroke with HCY or hs-CRP measurements were included in this analysis...
January 8, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29325365/-efficacy-comparison-of-3-strategies-for-real-world-stable-coronary-artery-disease-patients-with-three-vessel-disease
#11
R Liu, L Jiang, L J Xu, J Tian, X Y Zhao, Y Zhang, J J Xu, Y Song, H H Wang, Z Gao, L Song, J Q Yuan
Objective: To compare the effectiveness of percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) or medical therapy (MT) alone for real-world stable coronary artery disease (SCAD) patients with three-vessel disease (TVD) in mainland China. Methods: A total of 8 943 consecutive cases with TVD hospitalized in our center from April 2004 to February 2011 were screened for this study. In this cohort, 3 435 cases diagnosed as SCAD were analyzed. PCI, CABG, MT alone were performed in 1 313 (38...
December 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29322885/analysis-of-a-15-years-experience-in-including-shoulder-muscles-when-treating-upper-limb-spasticity-post-stroke-with-botulinum-toxin-type-a
#12
Maria Pais de Carvalho, Daniela Pinto, Melissa Gorayeb, Jorge Jacinto
Background Botulinum toxin type-A (BoNTA) is a recognized treatment for upper limb spasticity (ULS) after stroke, but there aren't many studies analyzing its effect in shoulder muscles. Objective To evaluate the efficacy of BoNTA injections for ULS, when shoulder muscles are included. Methods A cross-sectional study. Data from clinical forms of outpatients, treated at a Rehabilitation Center (2001-2016). Analyzes: goals of treatment; demographic characteristics/goal; treatment success, using Goal Attainment Scaling...
January 11, 2018: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/29322232/mechanical-thrombectomy-using-the-new-solitaire%C3%A2-platinum-stent-retriever-reperfusion-results-complication-rates-and-early-neurological-outcome
#13
Johannes Pfaff, Stefan Rohde, Tobias Engelhorn, Arnd Doerfler, Martin Bendszus, Markus Alfred Möhlenbruch
BACKGROUND AND PURPOSE: The application of radiopaque markers to the Solitaire™ stent-retriever for better visibility during mechanical thrombectomy (MT) has the potential to alter the well-known characteristics of the device; however, it is uncertain whether this adjustment influences efficacy or safety of the enhanced stent-retriever. METHODS: Retrospective analysis of stroke databases of three comprehensive stroke centers. Our investigation was focused on technical and angiographic parameters, including procedure times, reperfusion results (thrombolysis in cerebral infarction, TICI), periprocedural complications and favorable early neurological recovery at discharge (modified Rankin scale ≤2 or National Institutes of Health Stroke Scale, NIHSS = 0 or ∆NIHSS ≥ 10), from consecutive patients with acute anterior circulation ischemic stroke treated with a Solitaire™ Platinum stent-retriever between October 2016 and March 2017...
January 10, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29321339/detection-of-anterior-circulation-large-artery-occlusion-in-ischemic-stroke-using-noninvasive-cerebral-oximetry
#14
Alexander C Flint, Shiv G Bhandari, Sean P Cullen, Adhikari V Reddy, Daniel P Hsu, Vivek A Rao, Minal Patel, Jasmeen Pombra, Nancy J Edwards, Sheila L Chan
BACKGROUND AND PURPOSE: Large artery occlusion (LAO) in ischemic stroke requires recognition and triage to an endovascular stroke treatment center. Noninvasive LAO detection is needed to improve triage. METHODS: Prospective study to test whether noninvasive cerebral oximetry can detect anterior circulation LAO in acute stroke. Interhemispheric ΔBrSO2 in LAO was compared with controls. RESULTS: In LAO stroke, mean interhemispheric ΔBrSO2 was -8...
January 10, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29321134/efficacy-of-a-chronic-care-based-intervention-on-secondary-stroke-prevention-among-vulnerable-stroke-survivors-a-randomized-controlled-trial
#15
Eric M Cheng, William E Cunningham, Amytis Towfighi, Nerses Sanossian, Robert J Bryg, Thomas L Anderson, Frances Barry, Susan M Douglas, Lillie Hudson, Monica Ayala-Rivera, Jeffrey J Guterman, Sandra Gross-Schulman, Sylvia Beanes, Andrea S Jones, Honghu Liu, Barbara G Vickrey
BACKGROUND: Disparities of care among stroke survivors are well documented. Effective interventions to improve recurrent stroke preventative care in vulnerable populations are lacking. METHODS AND RESULTS: In a randomized controlled trial, we tested the efficacy of components of a chronic care model-based intervention versus usual care among 404 subjects having an ischemic stroke or transient ischemic attack within 90 days of enrollment and receiving care within the Los Angeles public healthcare system...
January 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29317364/early-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-infarction-in-asian-patients-a-single-centre-study
#16
Prakash Paliwal, Farasat Kazmi, Hock Luen Teoh, Leonard Ll Yeo, Raymond Cs Seet, Tseng Tsai Yeo, Lwin Sein, Ning Chou, Thomas Tch, Bernard Pl Chan, Vijay K Sharma
INTRODUCTION: Early Decompression craniectomy(within 48-hours of stroke-onset) in acute and malignant middle cerebral artery(MCA) ischemic stroke(IS) reduces mortality and increases the proportion of patients with favourable functional outcome. Various cultural and social issues anong Asians lead to some differences in clinical practice specially when surgical interventions are involved. Accordingly decompressive craniectomy in Asian stroke patients is often delayed. MATERIALS & METHODS: Data for all acute IS patients hospitalized to our center were entered into a prospectively maintained registry...
January 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29316204/outcomes-of-intermediate-risk-patients-treated-with-transcatheter-and-surgical-aortic-valve-replacement-in-the-veterans-affairs-healthcare-system-a-single-center-20-year-experience
#17
Santiago Garcia, Rosemary Kelly, Mackenzie Mbai, Sergey Gurevich, Brett Oestreich, Demetris Yannopoulos, Selcuk Adabag
BACKGROUND: Transfemoral transcatheter aortic valve replacement (TAVR) was superior to surgical aortic valve replacement (SAVR) in the placement of aortic transcatheter valves (PARTNER) 2A trial (P2). The generalizability of the trial results to the broader population of patients with intermediate surgical risk remains unknown. OBJECTIVE: To compare the outcomes of SAVR and TAVR among patients with intermediate surgical risk treated in the VA Healthcare System. METHODS: We retrospectively analyzed the clinical characteristics and outcomes on all SAVR (1987-2014) and TAVR procedures (2015-2017) performed at the Minneapolis VA Healthcare System...
January 9, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29314257/contemporary-management-and-outcomes-of-acute-type-a-aortic-dissection-an-analysis-of-the-sts-adult-cardiac-surgery-database
#18
Teng C Lee, Zachary Kon, Faisal H Cheema, Maria V Grau-Sepulveda, Brian Englum, Sunghee Kim, Paramita S Chaudhuri, Vinod H Thourani, Gorav Ailawadi, G Chad Hughes, Matthew L Williams, J Matthew Brennan, Lars Svensson, James S Gammie
PURPOSE: Management of acute type A aortic dissection (AAAD) is challenging and operative strategies are varied. We used the STS Adult Cardiac Surgery Database (STS ACSD) to describe contemporary surgical strategies and outcomes for AAAD. METHODS: Between July 2011 and September 2012, 2982 patients with AAAD underwent operations at 640 centers in North America. RESULTS: In this cohort, median age was 60 years old, 66% were male, and 80% had hypertension...
January 4, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29314242/co-morbidities-only-account-for-a-small-proportion-of-excess-mortality-after-fracture-a-record-linkage-study-of-individual-fracture-types
#19
Weiwen Chen, Judy M Simpson, Lyn M March, Fiona M Blyth, Dana Bliuc, Thach Tran, Tuan V Nguyen, John A Eisman, Jacqueline R Center
BACKGROUND: Non-hip non-vertebral fractures (NHNV) constitute the majority of osteoporotic fractures but few studies have examined the association between these fractures, co-morbidity and mortality. OBJECTIVE: To examine the relationship between individual non-hip non-vertebral fractures, co-morbidities and mortality. METHODS: Prospective population-based cohort of 267,043 subjects (45 and Up Study, Australia) had baseline questionnaires linked to hospital administrative and all-cause mortality data from 2006 - 2013...
January 4, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29313505/effectiveness-safety-and-cost-of-partial-exchange-transfusions-in-patients-with-sickle-cell-anemia-at-a-sickle-cell-disease-center-in-sub-saharan-africa
#20
P Boma Muteb, J F J Kaluila Mamba, P Muhau Pfutila, V Bilo, J D Panda Mulefu, D A Diallo
The partial exchange transfusions necessary for management of some sickle-cell complications raise the issue of effectiveness in the context of limited resources and inadequate blood safety. This study evaluated the effectiveness, safety, and cost of partial exchange transfusions in 39 patients with sickle-cell anemia in Lubumbashi, looking at the patients' age and gender and the tolerability and direct cost of the transfusions. Excel and SPSS 18 were used for data entry and analysis. Chi2 and Fisher exact tests were used for comparisons...
November 1, 2017: Médecine et Santé Tropicales
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