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https://www.readbyqxmd.com/read/29340036/the-association-between-elevated-fasting-plasma-glucose-levels-and-carotid-intima-media-thickness-in-non-diabetic-adults-a-population-based-cross-sectional-study
#1
Yalin Guan, Changshen Yu, Min Shi, Jingxian Ni, Yanan Wu, Hongfei Gu, Lingling Bai, Jie Liu, Jun Tu, Jinghua Wang, Xianjia Ning
We assessed the association between the mean carotid intima-media thickness (CIMT) and fasting plasma glucose (FPG) levels in a low-income population in rural China. Adults aged ≥45 years without a history of diabetes, stroke, or cardiovascular disease were recruited. All participants were categorized into four groups according to FPG level. A total of 3509 participants were analyzed in this study. In the univariate analysis, sex, age, education level, hypertension, central obesity, current smoking, alcohol consumption, and higher levels of FPG, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were associated with mean CIMT and frequency of increased CIMT...
December 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/29339351/high-target-vs-low-target-blood-pressure-management-during-cardiopulmonary-bypass-to-prevent-cerebral-injury-in-cardiac-surgery-patients-a-randomized-controlled-trial
#2
Anne G Vedel, Frederik Holmgaard, Lars S Rasmussen, Annika Langkilde, Olaf B Paulson, Theis Lange, Carsten Thomsen, Peter Skov Olsen, Hanne Berg Ravn, Jens C Nilsson
Background -Cerebral injury is an important complication following cardiac surgery with the use of cardiopulmonary bypass (CPB). The rate of overt stroke after cardiac surgery is 1-2%, whereas silent strokes, detected by diffusion-weighed magnetic resonance imaging (DWI), are found in up to 50% of patients. It is unclear if a higher versus a lower blood pressure during cardiopulmonary bypass reduces cerebral infarction in these patients. Methods -In a patient- and assessor-blinded randomized trial, we allocated patients to a higher (70-80 mmHg) or lower (40-50 mmHg) target for mean arterial pressure by the titration of norepinephrine during cardiopulmonary bypass...
January 16, 2018: Circulation
https://www.readbyqxmd.com/read/29339167/comparison-of-anticoagulant-therapy-for-atrial-fibrillation-novel-oral-anticoagulants-versus-vitamin-k-antagonists
#3
REVIEW
Sean T Chen, Manesh R Patel
In patients with non-valvular atrial fibrillation (NVAF), oral anticoagulation is important for prevention of stroke and systemic embolism (SE). While Vitamin K antagonists (VKAs) have historically been the standard of care, these medications are limited by numerous food and drug interactions with onerous requirements for frequent monitoring and dose adjustments. Over the past decade, several novel oral anticoagulants (NOACs) have been developed to directly inhibit factor IIa/thrombin (dabigatran) or activated factor X (apixaban, rivaroxaban, edoxaban)...
January 12, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29338750/reperfusion-therapy-in-acute-ischemic-stroke-dawn-of-a-new-era
#4
REVIEW
Sonu Bhaskar, Peter Stanwell, Dennis Cordato, John Attia, Christopher Levi
Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of patients with acute ischemic stroke (AIS). In this paper, we present an extensive overview of intravenous and endovascular reperfusion strategies, recent advances in AIS neurointervention, limitations of various treatment paradigms, and provide insights on imaging-guided reperfusion therapies. A roadmap for imaging guided reperfusion treatment workflow in AIS is also proposed...
January 16, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29337840/targeted-temperature-management-at-33%C3%A2-c-or-36%C3%A2-c-produces-equivalent-neuroprotective-effects-in-the-middle-cerebral-artery-occlusion-rat-model-of-ischemic-stroke
#5
Jung Ho Lee, Jisoo Lim, Yong Eun Chung, Sung Phil Chung, Incheol Park, Chul Hoon Kim, Je Sung You
Targeted temperature management (TTM, 32°C to 36°C) is one of the most successful achievements in modern resuscitation medicine. It has become standard treatment for survivors of sudden cardiac arrest to minimize secondary brain damage. TTM at 36°C is just as effective as TTM at 33°C and is actually preferred because it reduces adverse TTM-associated effects. TTM also likely has direct neuroprotective effects in ischemic brains in danger of stroke. It remains unclear, however, whether higher temperature TTM is equally effective in protecting the brain from the effects of stroke...
January 15, 2018: Shock
https://www.readbyqxmd.com/read/29337837/accidental-rivaroxaban-intoxication-in-a-boy-some-lessons-in-managing-new-oral-anticoagulants-in-children
#6
Julieta Weirthein, Dennis Scolnik, Nili Yanai Milshtein, Tali Capua, Miguel Glatstein
Novel oral anticoagulants offer equivalent or improved therapeutic profiles compared with warfarin, with less risk of bleeding, no interactions with food, and no need for routine laboratory monitoring. Caution must be exercised in using these drugs in certain patient populations, for example, renal insufficiency, those receiving additional antithrombotic therapy, those with questionable compliance, children, and those with a high risk of gastrointestinal bleeding. One of the novel oral anticoagulants, rivaroxaban, is a direct Factor Xa inhibitor, used to reduce risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, deep vein thrombosis, and pulmonary embolism...
January 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29337636/new-onset-cardiovascular-morbidity-in-older-adults-with-stage-i-to-iii-colorectal-cancer
#7
Kelly M Kenzik, Courtney Balentine, Joshua Richman, Meredith Kilgore, Smita Bhatia, Grant R Williams
Purpose We sought to determine the long-term risk of cardiovascular disease (CVD)-stroke and myocardial infarction-and congestive heart failure (CHF) in older patients with colorectal cancer, as well as to understand the roles that preexisting comorbidities and cancer therapy play in increasing this risk. Patients and Methods We evaluated individuals from the SEER-Medicare database with incident stage I to III colorectal cancer at age older than 65 years between January 1, 2000, and December 31, 2011 (n = 72,408) and compared these patients with a matched cohort of Medicare patients without cancer (n = 72,408)...
January 16, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29337268/the-double-sidedness-of-cough-in-the-elderly
#8
REVIEW
Ha-Kyeong Won, Sol-Ji Yoon, Woo-Jung Song
Cough is a physiological reflex to protect airways against aspiration, but also it is one of the most frequent problems that lead patients to seek medical care. Chronic cough is more prevalent in the elderly than younger subjects, and more challenging to manage due to frequent comorbidities and possible side effects from drug treatment. Meanwhile, cough reflex does not decrease with natural aging but is often impaired by pathologic conditions like stroke. The impairment in cough reflex may lead to fatal complication like aspiration pneumonia...
January 11, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29336710/consensus-statement-prehospital-care-of-exertional-heat-stroke
#9
Luke N Belval, Douglas J Casa, William M Adams, George T Chiampas, Jolie C Holschen, Yuri Hosokawa, John Jardine, Shawn F Kane, Michele Labotz, Renée S Lemieux, Kyle B McClaine, Nathaniel S Nye, Francis G O'Connor, Bryan Prine, Neha P Raukar, Michael S Smith, Rebecca L Stearns
Exertional heat stroke (EHS) is one of the most common causes of sudden death in athletes. It also represents a unique medical challenge to the prehospital healthcare provider due to the time sensitive nature of treatment. In cases of EHS, when cooling is delayed, there is a significant increase in organ damage, morbidity, and mortality after 30 minutes, faster than the average EMS transport and ED evaluation window. The purpose of this document is to present a paradigm for prehospital healthcare systems to minimize the risk of morbidity and mortality for EHS patients...
January 16, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29335013/fit-for-function-study-protocol-for-a-randomized-controlled-trial
#10
Julie Richardson, Ada Tang, Gordon Guyatt, Lehana Thabane, Feng Xie, Demetrios Sahlas, Robert Hart, Rebecca Fleck, Genevieve Hladysh, Louise Macrae
BACKGROUND: The current state of evidence suggests that community-based exercise programs are beneficial in improving impairment, function, and health status, and are greatly needed for persons with stroke. However, limitations of these studies include risk of bias, feasibility, and cost issues. METHODS/DESIGN: This single-blinded, randomized controlled trial (RCT) of 216 participants with stroke will compare the effectiveness of a 12-week YMCA community-based wellness program (FIT for FUNCTION) specifically designed for community-dwelling persons with stroke to persons who receive a standard YMCA membership...
January 15, 2018: Trials
https://www.readbyqxmd.com/read/29334333/are-people-at-high-risk-for-diabetes-visiting-health-facility-for-confirmation-of-diagnosis-a-population-based-study-from-rural-india
#11
Nikhil Srinivasapura Venkateshmurthy, Kathirvel Soundappan, Balaji Gummidi, Malipeddi Bhaskara Rao, Nikhil Tandon, K Srinath Reddy, Dorairaj Prabhakaran, Sailesh Mohan
BACKGROUND: India is witnessing a rising burden of type 2 diabetes mellitus. India's National Programme for Prevention and Control of Diabetes, Cancer, Cardiovascular diseases and Stroke recommends population-based screening and referral to primary health centre for diagnosis confirmation and treatment initiation. However, little is known about uptake of confirmatory tests among screen positives. OBJECTIVE: To estimate the uptake of confirmatory tests and identify the reasons for not undergoing confirmation by those at high risk for developing diabetes...
2018: Global Health Action
https://www.readbyqxmd.com/read/29334265/prevalence-and-covariates-of-uncontrolled-hypertension-in-ischemic-stroke-survivors-the-norwegian-stroke-in-the-young-study
#12
Åshild Oftedal, Eva Gerdts, Ulrike Waje-Andreassen, Annette Fromm, Halvor Naess, Anja Linde, Sahrai Saeed
PURPOSE: Hypertension is the most important modifiable risk factor for stroke. Few data are available on control of hypertension in younger ischemic stroke survivors. MATERIAL AND METHODS: We assessed clinic and ambulatory blood pressure (BP) measurements in 320 patients aged 15-60 years (mean 48 ± 10) included in the Norwegian Stroke in the Young Study during 3-months follow-up after the index stroke. Controlled hypertension was defined as ambulatory BP <130/80 mmHg...
January 15, 2018: Blood Pressure
https://www.readbyqxmd.com/read/29334161/the-role-of-neurosonology-in-the-diagnosis-and-management-of-patients-with-carotid-artery-disease-a-review
#13
REVIEW
Odysseas Kargiotis, Apostolos Safouris, Georgios Magoufis, Maria Georgala, Andromachi Roussopoulou, Eleftherios Stamboulis, Konstantinos G Moulakakis, Andreas Lazaris, George Geroulakos, Spyros Vasdekis, Georgios Tsivgoulis
Carotid artery disease (CAD) is a common cause of ischemic stroke with high rates of recurrence. Carotid endarterectomy (CEA) or carotid artery stenting (CAS) are highly recommended for the secondary prevention of symptomatic CAD during the first 14 days following the index event of transient ischemic attack or minor stroke. CEA or CAS may also be offered in selected cases with severe asymptomatic stenosis. Herein, we review the utility of neurosonology in the diagnosis and pre-/peri-interventional assessment of CAD patients who undergo carotid revascularization procedures...
January 15, 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/29332054/dementia-and-atrial-fibrillation-a-dangerous-combination-for-ischemic-stroke-and-mortality
#14
Daniele Pastori, Kazuo Miyazawa, Gregory Y H Lip
The risk of developing dementia is increased in patients with atrial fibrillation (AF), with the incidence of both conditions increasing with aging. Patients with dementia frequently do not receiving adequate thrombo-prophylaxis, because of the inability to monitor INR and/or to achieve and maintain good compliance with anticoagulant treatment. Under-treatment is therefore an important contributor to the increased risk of ischemic stroke and mortality in this subgroup of AF patients. In newly-diagnosed patients with AF starting oral anticoagulation, the presence of cognitive impairment should be considered in addition to the calculation of the SAMe-TT2R2 score, as part of an integrated decision management pathway to choose the most appropriate oral anticoagulant [i...
2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29330911/title-prognostic-significance-of-arterial-stiffness-and-osteoprotegerin-in-patients-with-stable-coronary-artery-disease
#15
Gerasimos Siasos, Evangelos Oikonomou, Konstantinos Maniatis, Georgios Georgiopoulos, Eleni Kokkou, Vasiliki Tsigkou, Marina Zaromitidou, Alexis Antonopoulos, Manolis Vavuranakis, Christodoulos Stefanadis, Athanasios G Papavassiliou, Dimitris Tousoulis
BACKGROUND: Arterial stiffness and vascular calcification significantly contribute to coronary atherosclerosis progression. The prognostic value of increased arterial stiffness and vascular calcification in subjects with stable coronary artery disease (CAD) after percutaneous coronary intervention(PCI) is currently under question. MATERIALS AND METHODS: We randomly enrolled 262 patients with stable CAD one month after successful PCI. Carotid femoral pulse wave velocity (PWV) was measured as a well-established index of central aortic stiffness...
January 13, 2018: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29329286/is-the-proportional-recovery-rule-applicable-to-the-lower-limb-after-a-first-ever-ischemic-stroke
#16
Janne M Veerbeek, Caroline Winters, Erwin E H van Wegen, Gert Kwakkel
OBJECTIVE: To investigate (a) the applicability of the proportional recovery rule of spontaneous neurobiological recovery to motor function of the paretic lower extremity (LE); and (b) the presence of fitters and non-fitters of this prognostic rule poststroke. When present, the clinical threshold for fitting nor non-fitting would be determined, as well as within-subject generalizability to the paretic upper extremity (UE). METHODS: Prospective cohort study in which the Fugl-Meyer Assessment (FMA)-LE and FMA-UE were measured <72 hours and 6 months poststroke...
2018: PloS One
https://www.readbyqxmd.com/read/29326831/management-of-complications-in-anticoagulated-patients-with-atrial-fibrillation
#17
George D Katritsis, Demosthenes G Katritsis
Oral anticoagulation is mandatory for patients at high risk of thromboembolism, but the risk of bleeding should also be taken into account. Direct oral anticoagulants are now recommended for non-valvular AF as a potential alternative to warfarin. In this article we discuss methods to assess the anticoagulant effect of these agents, specific and general antidotes, and management of complications such as embolic and haemorrhagic stroke, and significant bleeding.
December 2017: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/29326296/intrathecal-baclofen-therapy-versus-conventional-medical-management-for-severe-poststroke-spasticity-results-from-a-multicentre-randomised-controlled-open-label-trial-sisters
#18
Michael Creamer, Geoffrey Cloud, Peter Kossmehl, Michael Yochelson, Gerard E Francisco, Anthony B Ward, Jörg Wissel, Mauro Zampolini, Abdallah Abouihia, Nathalie Berthuy, Alessandra Calabrese, Meghann Loven, Leopold Saltuari
BACKGROUND: Intrathecal baclofen (ITB) is a treatment option for patients with severe poststroke spasticity (PSS) who have not reached their therapy goal with other interventions. METHODS: 'Spasticity In Stroke-Randomised Study' (SISTERS) was a randomised, controlled, open-label, multicentre phase IV study to evaluate the efficacy and safety of ITB therapy versus conventional medical management (CMM) with oral antispastic medications for treatment of PSS. Patients with chronic stroke with spasticity in ≥2 extremities and an Ashworth Scale (AS) score ≥3 in at least two affected muscle groups in the lower extremities (LE) were randomised (1:1) to ITB or CMM...
January 11, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29326188/managing-cognitive-impairment-following-stroke-protocol-for-a-systematic-review-of-non-randomised-controlled-studies-of-psychological-interventions
#19
Niamh A Merriman, Eithne Sexton, Nora-Ann Donnelly, Grainne McCabe, Mary E Walsh, Daniela Rohde, Ashleigh Gorman, Isabelle Jeffares, Niall Pender, David Williams, Frances Horgan, Frank Doyle, Maev-Ann Wren, Kathleen E Bennett, Anne Hickey
INTRODUCTION: Stroke is one of the primary causes of death and disability worldwide, leaving a considerable proportion of survivors with persistent cognitive and functional deficits. Despite the prevalence of poststroke cognitive impairment, there is no established treatment aimed at improving cognitive function following a stroke. Therefore, the aims of this systematic review are to identify psychological interventions intended to improve poststroke cognitive function and establish their efficacy...
January 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29326112/epidemiology-of-new-onset-atrial-fibrillation-following-coronary-artery-bypass-graft-surgery
#20
Giovanni Filardo, Ralph J Damiano, Gorav Ailawadi, Vinod H Thourani, Benjamin D Pollock, Danielle M Sass, Teresa K Phan, Hoa Nguyen, Briget da Graca
OBJECTIVES: Postoperative atrial fibrillation (AF) following coronary artery bypass graft surgery (CABG) is significantly associated with reduced survival, but poor characterisation and inconsistent definitions present barriers to developing effective prophylaxis and management. We sought to address this knowledge gap. METHODS: From 2002 to 2010, 11 239 consecutive patients without AF underwent isolated CABG at five sites. Clinical data collected for the Society of Thoracic Surgeons (STS) Database were augmented with details on AF detected via continuous in-hospital ECG/telemetry monitoring to assess new-onset post-CABG AF (adjusted for STS risk of mortality); time to first AF; durations of first and longest AF episodes; total in-hospital time in AF; number of in-hospital AF episodes; operative mortality; stroke; discharge in AF; and length of stay (LOS)...
January 11, 2018: Heart: Official Journal of the British Cardiac Society
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