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Acute ischemic stroke

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https://www.readbyqxmd.com/read/28936740/therapeutic-effects-of-mesenchymal-stem-cell-derived-exosomes-in-cardiovascular-disease
#1
Etsu Suzuki, Daishi Fujita, Masao Takahashi, Shigeyoshi Oba, Hiroaki Nishimatsu
Mesenchymal stem cells (MSCs) are multipotent stem cells that reside in various organs. They have the capacity to differentiate into various cell types, including cardiomyocytes, vascular endothelial cells, and vascular smooth muscle cells. Among the various MSCs, bone marrow-derived MSCs (BMMSCs) have been widely used for treating acute myocardial infarction (AMI) and ischemic heart failure (IHF) in preclinical and clinical studies. Although the beneficial effects of BMMSCs in treating AMI and IHF were originally attributed to their capacity to differentiate into cardiac cell types, recent evidence suggests that the differentiation capacity of BMMSCs appears to be minimal and that BMMSCs exert cardioprotective effects by secreting paracrine factors...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28936196/anti-inflammatory-targets-for-the-treatment-of-reperfusion-injury-in-stroke
#2
REVIEW
Atsushi Mizuma, Midori A Yenari
While the mainstay of acute stroke treatment includes revascularization via recombinant tissue plasminogen activator or mechanical thrombectomy, only a minority of stroke patients are eligible for treatment, as delayed treatment can lead to worsened outcome. This worsened outcome at the experimental level has been attributed to an entity known as reperfusion injury (R/I). R/I is occurred when revascularization is delayed after critical brain and vascular injury has occurred, so that when oxygenated blood is restored, ischemic damage is increased, rather than decreased...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28935679/professional-medical-interpreters-influence-the-quality-of-acute-ischemic-stroke-care-for-patients-who-speak-languages-other-than-english
#3
Betty M Luan Erfe, Khawja A Siddiqui, Lee H Schwamm, Chris Kirwan, Anabela Nunes, Nicte I Mejia
BACKGROUND: The inability to communicate effectively in a common language can jeopardize clinicians' efforts to provide quality patient care. Professional medical interpreters (PMIs) can help provide linguistically appropriate health care, in particular for the >25 million Americans who identify speaking English less than very well. We aimed to evaluate the relationship between use of PMIs and quality of acute ischemic stroke care received by patients who preferred to have their medical care in languages other than English...
September 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28935626/wide-variability-in-prethrombectomy-workflow-practices-in-the-united-states-a-multicenter-survey
#4
A P Kansagra, G C Meyers, M S Kruzich, D T Cross, C J Moran
BACKGROUND AND PURPOSE: Clinical outcomes in patients with acute ischemic stroke caused by large vessel occlusion depend on the speed and quality of workflows leading to mechanical thrombectomy. In the absence of universally accepted best practices for workflow, developing stroke hospitals can benefit from improved awareness of real-world workflows in effect at experienced centers. To this end, we surveyed prethrombectomy workflow practices at stroke centers throughout the United States...
September 21, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28935502/outcomes-of-nonagenarians-with-acute-ischemic-stroke-treated-with-intravenous-thrombolytics
#5
Réza Behrouz, Jaime Masjuán-Vallejo, Rocío Vera, Joshua Z Willey, Mickael Zedet, Solène Moulin, Charlotte Cordonnier, Catharina J M Klijn, Karin Kanselaar, Maaike Dirks, Brian Silver, Muhib Khan, Mahmoud R Azarpazhooh, Daniel A Godoy, Christine Roffe, Lizz Paley, Benjamin D Bray, Craig J Smith, Mario Di Napoli
BACKGROUND: Nonagenarians are under-represented in thrombolytic trials for acute ischemic stroke (AIS). The effectiveness of intravenous thrombolytics in nonagenarians in terms of safety and outcome is not well established. MATERIALS AND METHODS: We used a multinational registry to identify patients aged 90 years or older with good baseline functional status who presented with AIS. Differences in outcomes-disability level at 90 days, frequency of symptomatic intracerebral hemorrhage (sICH), and mortality-between patients who did and did not receive thrombolytics were assessed using multivariable logistic regression, adjusted for prespecified prognostic factors...
September 18, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28935501/safety-and-time-course-of-drip-and-ship-in-treatment-of-acute-ischemic-stroke
#6
Hideyuki Ishihara, Fumiaki Oka, Takayuki Oku, Mizuya Shinoyama, Eiichi Suehiro, Kazutaka Sugimoto, Michiyasu Suzuki
BACKGROUND: The drip-and-ship approach allows intravenous tissue plasminogen activator therapy and adjuvant endovascular treatment in acute ischemic stroke, even in rural areas. Here, we examined the safety and time course of the drip-and-ship approach. METHODS: Fifty consecutive cases treated with the drip-and-ship approach (drip-and-ship group) in June 2009 to March 2016 were retrospectively examined. Changes in mean blood pressure, systemic complications, and neurological complications were compared according to method of transportation...
September 18, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28935027/sex-differences-in-the-impact-of-acute-stroke-treatment-in-a-population-based-study-a-sex-specific-propensity-score-approach
#7
Lynda D Lisabeth, Jonggyu Baek, Lewis B Morgenstern, Mathew J Reeves, Devin L Brown, Darin B Zahuranec, Melinda A Smith, Brisa N Sánchez
PURPOSE: We investigated whether sex modifies the association of acute stroke treatment on functional outcome using propensity score (PS) methods to minimize confounding and to explore the differential effects of confounders by sex. METHODS: We included tissue plasminogen activator (tPA) treated (n = 84) and nontreated ischemic stroke cases (n = 143) from a population-based stroke study (2008-2013). The PS model that estimated the probability of receiving tPA included interactions between sex and treatment predictors...
August 2017: Annals of Epidemiology
https://www.readbyqxmd.com/read/28934833/hemodynamic-analysis-of-radiation-induced-damage-in-common-carotid-arteries-by-using-color-doppler-ultrasonography
#8
Alireza Mohammadkarim, Manijhe Mokhtari-Dizaji, Ali Kazemian, Hazhir Saberi
Purpose: The aim of this study was to assess vascular changes and blood flow abnormalities in the common carotid arteries of patients with head and neck cancers after external radiotherapy, using color Doppler ultrasonography. Methods: We studied 24 patients treated with external radiotherapy for various head and neck cancers. In order to study the acute effects of irradiation on common carotid blood flow and arterial diameter changes, color Doppler ultrasonography parameters such as peak systolic velocity, end diastolic velocity, mean velocity, systolic-to-diastolic velocity (S/D) ratio, pulsatility index (PI), resistive index (RI), and instantaneous diameter changes were evaluated before and after external radiotherapy...
April 14, 2017: Ultrasonography
https://www.readbyqxmd.com/read/28934604/prognostic-value-of-lipoprotein-associated-phospholipase-a2-mass-for-all-cause-mortality-and-vascular-events-within-one-year-after-acute-ischemic-stroke
#9
Liyuan Han, Chongke Zhong, Xiaoqing Bu, Tan Xu, Aili Wang, Yanbo Peng, Tian Xu, Jinchao Wang, Hao Peng, Qunwei Li, Zhong Ju, Deqing Geng, Yonghong Zhang, Jiang He
BACKGROUND AND AIMS: We performed a prospective investigation of the longer-term prognostic value of lipoprotein-associated phospholipase A2 (Lp-PLA2) mass for all-cause mortality and vascular events within one year after acute ischemic stroke. METHODS: We examined the Lp-PLA2 mass among 3401 participants enrolled in the China Antihypertensive Trial in Acute Ischemic Stroke. The primary outcome was all-cause mortality. Cox proportional hazard ratios (HRs) and 95% confidence intervals (95% CIs) were constructed to assess the independent associations between the baseline Lp-PLA2 mass and the outcomes after adjustment for variables in models 1, 2, and 3 [further adjusted for low-density lipoprotein cholesterol (LDL-C)]...
September 14, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28934363/sex-related-differences-in-the-risk-factors-for-in-hospital-mortality-and-outcomes-of-ischemic-stroke-patients-in-rural-areas-of-taiwan
#10
Cheung-Ter Ong, Yi-Sin Wong, Sheng-Feng Sung, Chi-Shun Wu, Yung-Chu Hsu, Yu-Hsiang Su, Ling-Chien Hung
BACKGROUND AND PURPOSE: Sex-related differences in the clinical presentation and outcomes of stroke patients are issues that have attracted increased interest from the scientific community. The present study aimed to investigate sex-related differences in the risk factors for in-hospital mortality and outcome in ischemic stroke patients. METHODS: A total of 4278 acute ischemic stroke patients admitted to a stroke unit between January 1, 2007 and December 31, 2014 were included in the study...
2017: PloS One
https://www.readbyqxmd.com/read/28933065/cerebrovascular-disease-consequences-of-obesity-induced-endothelial-dysfunction
#11
Liliana Letra, Cristina Sena
Despite the well-known global impact of overweight and obesity in the incidence of cerebrovascular disease, many aspects of this association are still inconsistently defined. In this chapter we aim to present a critical review on the links between obesity and both ischemic and hemorrhagic stroke and discuss its influence on functional outcomes, survival, and current treatments to acute and chronic stroke. The role of cerebrovascular endothelial function and respective modulation is also described as well as its laboratory and clinical assessment...
2017: Advances in Neurobiology
https://www.readbyqxmd.com/read/28932290/moderate-to-high-intensity-statins-for-secondary-prevention-in-patients-with-type-2-diabetes-mellitus-on-dialysis-after-acute-myocardial-infarction
#12
Yan-Rong Li, Sung-Sheng Tsai, Yu-Sheng Lin, Chang-Min Chung, Szu-Tah Chen, Jui-Hung Sun, Miaw-Jene Liou, Tien-Hsing Chen
BACKGROUND: Evidences support the benefits of moderate- to high-intensity statins for patients with acute myocardial infarction (AMI) except for those with type 2 diabetes mellitus (T2DM) on dialysis after AMI. This study was aimed to investigate the safety and efficacy of secondary prevention of cardiovascular diseases using moderate- to high-intensity statins in T2DM patients on dialysis after AMI. METHODS: A simulated prospective cohort study was conducted between January 1st, 2001 and December 31st, 2013 utilizing data from the Taiwan National Health Insurance Research Database...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28931621/minimal-clinically-important-difference-for-safe-and-simple-novel-acute-ischemic-stroke-therapies
#13
Jessica S Cranston, Brett D Kaplan, Jeffrey L Saver
BACKGROUND AND PURPOSE: Determining the minimal clinically important difference (MCID) is essential for evaluating novel therapies. For acute ischemic stroke, expert surveys have yielded MCIDs that are substantially higher than the MCIDs observed in actual expert behavior in guideline writing and clinical practice, potentially because of anchoring bias. METHODS: We administered a structured, internet-based survey to a cross-section of academic stroke neurologists in the United States...
September 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28931617/normobaric-hyperoxia-reduces-blood-occludin-fragments-in-rats-and-patients-with-acute-ischemic-stroke
#14
Shuhai Shi, Zhifeng Qi, Qingfeng Ma, Rong Pan, Graham S Timmins, Yongmei Zhao, Wenjuan Shi, Yunzhou Zhang, Xunming Ji, Ke Jian Liu
BACKGROUND AND PURPOSE: Damage of the blood-brain barrier (BBB) increases the incidence of neurovascular complications, especially for cerebral hemorrhage after tPA (tissue-type plasminogen activator) therapy. Currently, there is no effective method to evaluate the extent of BBB damage to guide tPA use. Herein, we investigated whether blood levels of tight junction proteins could serve as biomarker of BBB damages in acute ischemic stroke (AIS) in both rats and patients. We examined whether this biomarker could reflect the extent of BBB permeability during cerebral ischemia/reperfusion and the effects of normobaric hyperoxia (NBO) on BBB damage...
September 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28931568/a-cross-talk-between-neuronal-urokinase-type-plasminogen-activator-upa-and-astrocytic-upa-receptor-upar-promotes-astrocytic-activation-and-synaptic-recovery-in-the-ischemic-brain
#15
Ariel Diaz, Paola Merino, Luis Guillermo Manrique, Juan Pablo Ospina, Lihong Cheng, Fang Wu, Valerie Jeanneret, Manuel Yepes
Urokinase-type plasminogen activator (uPA) is a serine proteinase that upon binding to its receptor (uPAR) catalyzes the conversion of plasminogen into plasmin on the cell surface. Our previous studies indicate that uPA and uPAR expression increase in the ischemic brain during the recovery phase from an acute ischemic injury, and that uPA binding to uPAR promotes neurological recovery following an acute ischemic stroke. Here we used male mice genetically deficient on either uPA (uPA(-/-)), or uPAR (uPAR(-/-)), or with a 4 amino acids substitution into the growth factor domain of uPA that abrogates its binding to uPAR (Plat(GFDhu/GFDhu)) to investigate the mechanism whereby uPA promotes neurorepair in the ischemic brain...
September 20, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28931362/dual-antiplatelet-therapy-is-associated-with-coagulopathy-detectable-by-thrombelastography-in-acute-stroke
#16
Mark M McDonald, Tareq S Almaghrabi, Daniel M Saenz, Chunyan Cai, Mohammad H Rahbar, H Alex Choi, Kiwon Lee, James C Grotta, Tiffany R Chang
BACKGROUND: Thrombelastography (TEG) provides a global, dynamic measure of coagulation. We examined the effect of antiplatelet (AP) medications on coagulation in patients with acute stroke as measured by TEG. METHODS: We reviewed prospectively collected data on patients presenting with acute ischemic stroke (AIS) and spontaneous intracerebral hemorrhage (ICH) between 2009 and 2014. Patient demographics and baseline TEG values were compared among 4 different drug use groups: aspirin only, clopidogrel only, both aspirin and clopidogrel, and no AP...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28930049/experience-with-the-syncardia-total-artificial-heart-in-a-canadian-centre
#17
Anthony Nguyen, Michel Pellerin, Louis P Perrault, Michel White, Anique Ducharme, Normand Racine, Michel Carrier
BACKGROUND: The SynCardia total artificial heart (TAH) provides complete circulatory support by replacing both native ventricles. Accepted indications include bridge to transplantation and destination therapy. We review our experience with TAH implantation during a period when axial flow pump became available. METHODS: We retrospectively analyzed the demographics, clinical characteristics and survival of all patients receiving the TAH. RESULTS: From September 2004 to November 2016, 13 patients (12 men, mean age 45 ± 13 yr) received the TAH for refractory cardiogenic shock secondary to idiopathic (56%) or ischemic (17%) cardiomyopathy and to other various causes (33%)...
October 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28929979/pharmacists-as-care-providers-for-stroke-patients-a-systematic-review
#18
Jade E Basaraba, Michelle Picard, Kirsten George-Phillips, Tania Mysak
BACKGROUND: Pharmacists have become an integral member of the multidisciplinary team providing clinical patient care in various healthcare settings. Although evidence supporting their role in the care of patients with other disease states is well-established, minimal literature has been published evaluating pharmacist interventions in stroke patients. The purpose of this systematic review is to summarize the evidence evaluating the impact of pharmacist interventions on stroke patient outcomes...
September 20, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28929836/the-relationship-between-blood-flow-impairment-and-oxygen-depletion-in-acute-ischemic-stroke-imaged-with-magnetic-resonance-imaging
#19
Alexander Seiler, Nicholas P Blockley, Ralf Deichmann, Ulrike Nöth, Oliver C Singer, Michael A Chappell, Johannes C Klein, Marlies Wagner
Oxygenation-sensitive spin relaxation time T2' and relaxation rate R2' (1/T2') are presumed to be markers of the cerebral oxygen extraction fraction (OEF) in acute ischemic stroke. In this study, we investigate the relationship of T2'/R2' with dynamic susceptibility contrast-based relative cerebral blood flow (rCBF) in acute ischemic stroke to assess their plausibility as surrogate markers of the ischemic penumbra. Twenty-one consecutive patients with internal carotid artery and/or middle cerebral artery occlusion were studied at 3...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28929697/-effects-of-berberine-on-serum-inflammatory-factors-and-carotid-atherosclerotic-plaques-in-patients-with-acute-cerebral-ischemic-stroke
#20
Ying Li, Pei Wang, Mei-Jing Chai, Fan Yang, Hong-Shan Li, Jing Zhao, Huan Wang, Dan-Dan Lu
This study aims to analyze the effect of berberine on serum inflammatory factors and carotid atherosclerotic plaques in ppatients with acute cerebral ischemic stroke(AIS). In the study, 120 patients with AIS were randomly divided into berberine group(n=60) and general group (n=60). The 60 cases in the general group were provided with general therapy according to the latest guidelines of diagnosis and treatment of AIS. The berberine group received berberine 300 mg(tid) in addition to the therapy of the general group...
November 2016: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
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