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Stroke management

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https://www.readbyqxmd.com/read/28640931/ischemia-responsive-protein-94-is-a-key-mediator-of-ischemic-neuronal-injury-induced-microglial-activation
#1
Rajiv Tikamdas, Sarthak Singhal, Ping Zhang, Justin A Smith, Eric G Krause, Stanley M Stevens, Sihong Song, Bin Liu
Neuroinflammation, especially activation of microglia, the key immune cells in the brain, has been proposed to contribute to the pathogenesis of ischemic stroke. However, the dynamics and the potential mediators of microglial activation following ischemic neuronal injury are not well understood. In this study, using oxygen/glucose deprivation and reoxygenation (OGD/R) with neuronal and microglial cell cultures as an in vitro model of ischemic neuronal injury, we set out to identify neuronal factors released from injured neurons that are capable of inducing microglial activation...
June 22, 2017: Journal of Neurochemistry
https://www.readbyqxmd.com/read/28637154/shoulder-pain-after-stroke-experiences-consequences-in-daily-life-and-effects-of-interventions-a-qualitative-study
#2
Ingrid Lindgren, Gunvor Gard, Christina Brogårdh
PURPOSE: To describe experiences of shoulder pain after stroke, how pain affects daily life and perceived effects of interventions. METHOD: A qualitative interview study including 13 community-dwelling persons (six women; median age 65 years) with persistent shoulder pain after stroke. RESULTS: Three categories emerged from the content analysis. In "Multiple pain characteristics" an insidious pain onset was reported. The pain existed both day and night and could be located around the shoulder girdle but also have radiation to the arm and hand...
March 3, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28636749/annual-direct-medical-costs-associated-with-diabetes-related-complications-in-the-event-year-and-in-subsequent-years-in-hong-kong
#3
F Jiao, C K H Wong, S C W Tang, C S C Fung, K C B Tan, S McGhee, R Gangwani, C L K Lam
AIM: To develop models to estimate the direct medical costs associated with diabetes-related complicationsin the event year and in subsequent years. METHODS: The public direct medical costs associated with 13 diabetes-related complications were estimated among a cohort of 128 353 people with diabetes over 5 years. Private direct medical costs were estimated from a cross-sectional survey among 1825 people with diabetes. We used panel data regression with fixed effects to investigate the impact of each complication on direct medical costs in the event year and subsequent years, adjusting for age and co-existing complications...
June 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28635339/methods-for-estimating-costs-in-patients-with-hyperlipidemia-experiencing-their-first-cardiovascular-event-in-the-united-kingdom
#4
Mark D Danese, Michelle Gleeson, Robert I Griffiths, David Catterick, Lucie Kutikova
AIMS: Methods for integrating external costs into clinical databases are not well-characterized. The purpose of this research was to describe and implement methods for estimating the cost of hospitalizations, prescriptions, and general practitioner and specialist visits used to manage hyperlipidemia patients experiencing cardiovascular (CV) events in the United Kingdom (UK). METHODS: This study was a retrospective cohort study using the Clinical Practice Research Datalink and Hospital Episode Statistics data...
June 21, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28635196/direct-oral-anticoagulants-in-patients-undergoing-cardioversion-insight-from-randomized-clinical-trials
#5
Stefania Angela Di Fusco, Furio Colivicchi, Nadia Aspromonte, Marco Tubaro, Alessandro Aiello, Massimo Santini
Anticoagulation, reducing the risk of thromboembolic events in patients undergoing cardioversion, is a cornerstone of peri-cardioversion management in patients with atrial fibrillation. We aimed to analyse published data on the efficacy and safety of direct oral anticoagulants (DOACs) in patients undergoing cardioversion. We performed a systematic review of randomized prospective clinical trials (RCTs) comparing DOACs with warfarin and reporting data on post-cardioversion outcomes of interest. Outcomes of interest were stroke, systemic thromboembolic events and major bleeding...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28634569/epidemiology-and-management-of-atrial-fibrillation-and-stroke-review-of-data-from-four-european-countries
#6
REVIEW
Andreea D Ceornodolea, Roland Bal, Johan L Severens
In Europe, 1-3% of the population suffers from atrial fibrillation (AF) and has increased stroke risk. By 2060 a doubling in number of cases and great burden in managing this medical condition are expected. This paper offers an overview of data on epidemiology and management of AF and stroke in four European countries as well as the interconnection between these dimensions. A search index was developed to access multiple scientific and "grey" literatures. Information was prioritised based on strength of evidence and date...
2017: Stroke Research and Treatment
https://www.readbyqxmd.com/read/28634502/impact-of-neurological-follow-up-on-early-hospital-readmission-rates-for-acute-ischemic-stroke
#7
Alexander Allen, Todd Barron, Ashley Mo, Richard Tangel, Ruth Linde, Rodney Grim, John Mingle, Ellen Deibert
INTRODUCTION: Despite advances in stroke care, readmission rates for patients with ischemic stroke remain high. Although factors such as age, diabetes, and continuous use of antiplatelet agents have been found to predict readmission rates, the impact of after-hospital care has not been examined. METHODS: The present study reviewed the charts of 416 patients with acute ischemic stroke and recorded stroke-related comorbidities, neurology follow-up within 21 days, readmission at 0 to 30 days, readmission at 31 to 90 days, and any reasons for readmission...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#8
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28630370/evidence-for-therapeutic-patient-education-interventions-to-promote-cardiovascular-patient-self-management-a-scientific-statement-for-healthcare-professionals-from-the-american-heart-association
#9
REVIEW
Susan Barnason, Connie White-Williams, Laura P Rossi, Mae Centeno, Deborah L Crabbe, Kyoung Suk Lee, Nancy McCabe, Julie Nauser, Paula Schulz, Kelly Stamp, Kathryn Wood
BACKGROUND: The burden of cardiovascular disease as a chronic illness increasingly requires patients to assume more responsibility for their self-management. Patient education is believed to be an essential component of cardiovascular care; however, there is limited evidence about specific therapeutic patient education approaches used and the impact on patient self-management outcomes. METHODS AND RESULTS: An integrative review of the literature was conducted to critically analyze published research studies of therapeutic patient education for self-management in selected cardiovascular conditions...
June 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28629235/atrial-fibrillation-as-a-complication-of-ibrutinib-therapy-clinical-features-and-challenges-of-management
#10
Bronwyn C Thorp, Xavier Badoux
Ibrutinib is a Bruton's tyrosine kinase (BTK) inhibitor finding increasingly widespread use in non-Hodgkin lymphoma. Evidence of an increased risk of atrial fibrillation (AF) emerged in Phase III studies with a median incidence of approximately 6%. The mechanism remains unknown, but inhibition of a cardioprotective pathway has been proposed. Ibrutinib induces a platelet function defect, increasing the bleeding risk of anticoagulation for AF stroke prophylaxis. Multiple potential drug interactions are an added complication...
June 20, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28628523/effectiveness-of-surgery-for-adults-with-hallux-valgus-deformity-a-systematic-review
#11
Jitka Klugarova, Victoria Hood, Fiona Bath-Hextall, Miloslav Klugar, Jana Mareckova, Zuzana Kelnarova
BACKGROUND: Hallux valgus (HV) is a common foot deformity. In severe stages of this condition, surgery is often necessary. Currently, there is no systematic review comparing the effectiveness of surgery over conservative treatment. OBJECTIVES: The objective of this review was to establish the effectiveness of surgery compared to conservatory management for adults with HV. INCLUSION CRITERIA TYPES OF PARTICIPANTS: The current review included adults (18 years or over) with HV deformity, excluding adults with neurological problems causing foot deformities, for example, cerebral palsy, neuropathy, stroke and multiple sclerosis...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28627932/short-term-prognostic-effect-of-prior-cerebrovascular-and-peripheral-artery-disease-in-patients-with-acute-coronary-syndrome-can-we-do-better
#12
Filipa Cordeiro, Pedro S Mateus, Alberto Ferreira, Silvia Leao, Miguel Moz, J Ilidio Moreira
BACKGROUND: We sought to evaluate the impact of prior cerebrovascular and/or peripheral arterial disease (PAD) on in-hospital outcomes in patients with acute coronary syndromes. METHODS: From 1 October 2010 to 26 February 2016, 13,904 acute coronary syndrome patients were enrolled in a national multicentre registry. They were divided into four groups: prior stroke/transient ischaemic attack (stroke/TIA); prior PAD; prior stroke/TIA and PAD; none. The endpoints included in-hospital mortality and a composite endpoint of death, re-infarction and stroke during hospitalization...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28626412/congenital-bilateral-c2-transverse-foramina-stenosis-causing-adult-onset-vertebrobasilar-insufficiency-and-posterior-circulation-stroke
#13
Ajeet Gordhan, Catherine Lockhart
Vertebrobasilar insufficiency leading to posterior circulation infarcts caused by congenital hypoplasia of the bilateral transverse foramina at the C2 level, affecting the caliber and flow of the bilateral distal cervical vertebral arteries in an adult, has not been previously reported. A 41-year-old male presented with episodic dizziness for a period of 1 year prior to consultation. Computed tomography angiography of the head and neck demonstrated congenital hypoplasia of the bilateral C2 transverse foramina, with absence of the vertebral arteries in each of the foramina and collateral reconstitution of diminutive intracranial vertebral artery segments...
May 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/28626044/revascularisation-compared-with-initial-medical-therapy-for-non-st-elevation-acute-coronary-syndromes-in-the-elderly-a-meta-analysis
#14
Sonali R Gnanenthiran, Leonard Kritharides, Mario D'Souza, Harry C Lowe, David B Brieger
OBJECTIVE: Whether revascularisation is superior to medical therapy in older populations presenting with non-ST-elevation acute coronary syndromes (NSTEACS) remains contentious, with inconclusive evidence from randomised trials. We aimed to compare routine invasive therapy with initial medical management in the elderly presenting with NSTEACS. METHODS: MEDLINE, EMBASE and Cochrane Controlled Trial Register were searched for studies comparing routine invasive therapy with initial medical management in patients ≥75 years old presenting with NSTEACS...
June 16, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28625938/language-disturbances-after-non-thalamic-subcortical-stroke-a-review-of-the-literature
#15
Liziane Bouvier, Bertrand Groulx, Vincent Martel-Sauvageau, Laura Monetta
Language disorders following subcortical non-thalamic stroke show great variability across literature and a well-defined profile in these aphasic disturbances is yet to be established. The lack of recent and consistent literature on the subject complicates the management of subcortical aphasia. The aim of this study is to review the literature describing oral language disturbances following subcortical non-thalamic stoke affecting the basal ganglia and the surrounding white matter. A review of the literature of three databases (PubMed, PsycNet and LLBA), identifying research articles from 1997 to 2015, was completed...
June 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28625901/the-effect-of-aspirin-in-the-postoperative-management-of-adult-ischemic-moyamoya-disease
#16
Yahui Zhao, Qian Zhang, Dong Zhang, Yuanli Zhao
Aspirin has been implicated in the postoperative management of moyamoya disease (MMD) in order to avoid bypass failure and decrease the incidence of subsequent stroke. However, the effect of it has not been completely determined yet. In this study, we retrospectively reviewed data of 184 adult patients (197 hemispheres) presented with ischemic-onset moyamoya disease that had undergone direct or combined revascularization in our hospital, to clarify the effect of postoperative aspirin therapy in the management of moyamoya disease...
June 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28625752/neurologic-complications-of-extracorporeal-membrane-oxygenation-a-review
#17
REVIEW
Ashleigh Xie, Phillip Lo, Tristan D Yan, Paul Forrest
OBJECTIVE: To review the evidence on neurologic complications in adult extracorporeal membrane oxygenation (ECMO) patients with regard to incidence, pathophysiology, risk factors, diagnosis, monitoring techniques, prevention, and management. DESIGN: Literature review. SETTING: Observational studies and case reports from a variety of institutions. PARTICIPANTS: Adult ECMO patients. INTERVENTIONS: Six electronic databases were searched from their dates of inception to October 2016...
March 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28625670/carotid-occlusion-is-associated-with-more-frequent-neurovascular-events-than-moderately-severe-carotid-stenosis
#18
Matthew Janko, Ryan Moore, Ann H Kim, Andrew J Shevitz, Katherine L Morrow, David J Johnson, Vikram S Kashyap
OBJECTIVE: Asymptomatic internal carotid artery occlusion (CO) presents a clinical dilemma, and presently, the natural history, stroke risk, and optimal management remain ill defined. This study compared outcomes, including neurovascular events (NVEs) and health care costs, between patients with CO and patients with asymptomatic carotid artery stenosis (CS). METHODS: A prospectively maintained database was queried to identify patients with CO and CS with at least >50% carotid stenosis by duplex...
June 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28625380/factors-associated-with-non-vitamin-k-antagonist-oral-anticoagulants-for-stroke-prevention-in-patients-with-new-onset-atrial-fibrillation-results-from-the-outcomes-registry-for-better-informed-treatment-of-atrial-fibrillation-ii-orbit-af-ii
#19
Benjamin A Steinberg, Peter Shrader, Laine Thomas, Jack Ansell, Gregg C Fonarow, Bernard J Gersh, Elaine Hylek, Peter R Kowey, Kenneth W Mahaffey, Emily C O'Brien, Daniel E Singer, Eric D Peterson, Jonathan P Piccini
BACKGROUND: Several non-vitamin K antagonist oral anticoagulant (NOAC) alternatives to warfarin are available for stroke prevention in atrial fibrillation (AF). We aimed to describe the factors associated with selection of NOACs versus warfarin in patients with new onset AF. METHODS: The ORBIT-AF II study is a national, US, prospective, observational, cohort study of anticoagulation treatment in patients with AF receiving NOACs or warfarin in the United States from 2013 to 2016...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28623949/hemoglobin-concentrations-and-rbc-transfusion-thresholds-in-patients-with-acute-brain-injury-an-international-survey
#20
Rafael Badenes, Mauro Oddo, José I Suarez, Massimo Antonelli, Jeffrey Lipman, Giuseppe Citerio, Fabio Silvio Taccone
BACKGROUND: The optimal hemoglobin (Hb) threshold at which to initiate red blood cell (RBC) transfusion in patients with acute brain injury is unknown. The aim of this survey was to investigate RBC transfusion practices used with these patients. METHODS: We conducted a web-based survey within various societies of critical care medicine for intensive care unit (ICU) physicians who currently manage patients with primary acute brain injury. RESULTS: A total of 868 responses were obtained from around the world, half of which (n = 485) were from European centers; 204 (24%) respondents had a specific certificate in neurocritical care, and most were specialists in anesthesiology or intensive care and had less than 15 years of practice experience...
June 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
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