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Stroke management

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https://www.readbyqxmd.com/read/29774736/will-stroke-volume-variation-be-a-parameter-to-manage-intraoperative-bleeding-in-the-functional-endoscopic-sinus-surgery
#1
Hiroyuki Kinoshita, Shinji Kawahito
No abstract text is available yet for this article.
May 15, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29774186/ring-enhancing-lesions-in-neonatal-meningitis-an-analysis-of-neuroradiology-pitfalls-through-exemplificative-cases-and-a-review-of-the-literature
#2
Mario Ganau, Kshitij Mankad, Uma Rami Srirambhatla, Zubair Tahir, Felice D'Arco
Very often the clinical course of neonatal meningitis (NM) is characterized by sudden worsening, at times associated with cerebrovascular complications and strokes or the formation of cerebral abscesses. The immediate recognition of these pathological patterns is pivotal in providing clinicians with useful information to differentiate between those different pathological entities, which may both present as ring-enhancing lesions on neuroradiology investigations. Understanding their natural history and diagnostic features is of paramount importance to timely adopt the most appropriate medical and surgical management...
April 2018: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/29772570/undertreatment-of-vascular-risk-factors-in-patients-with-monocular-ischaemic-visual-loss
#3
Angeliki Zarkali, Suk Fun Cheng, Agnes Dados, Robert Simister, Arvind Chandratheva
BACKGROUND AND PURPOSE: Ischaemic visual loss is often considered a lower risk factor than other transient ischaemic attacks (TIA). We aimed to determine the recurrence risk, prevalence and management of vascular risk factors in these patients. METHODS: The study took place in the University College Hospital London daily TIA clinic, main referral centre for North-Central London and Moorfields Eye Hospital. Consecutive records for patients with transient (< 24 h) or permanent (> 24 h) ischaemic visual loss were reviewed during the period January 2014-October 2016...
May 17, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29771897/is-general-practice-identification-of-prior-cardiovascular-disease-at-the-time-of-cvd-risk-assessment-accurate-and-does-it-matter
#4
Sue Wells, Katrina Poppe, Vanessa Selak, Andrew Kerr, Romana Pylypchuk, Billy Wu, Wing Cheuk Chan, Corina Grey, Suneela Mehta, Dudley Gr Gentles, Rod Jackson
AIMS: To determine the accuracy of general practice recording of prior cardiovascular disease (CVD) at the time of CVD risk assessment and whether recording impacts on CVD management. METHODS: Prior CVD status entered at the time of a first CVD risk assessment from 2002-2015 was compared to prior ischaemic CVD hospitalisations from national datasets using anonymous linkage with an encrypted National Health Index identifier. Clinical factors associated with inaccurate recording of prior events were identified using multivariable logistic regression...
May 18, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29770736/carotid-artery-stenosis-screening-where-are-we-now
#5
Rebecca Mortimer, Subramanian Nachiappan, David C Howlett
Stroke poses a significant burden on healthcare and is the second largest cause of death globally. Both medical and surgical interventions to reduce the risk of stroke in asymptomatic patients have been shown to be effective but identifying the target at risk population is more problematic. Screening for carotid artery stenosis offers one pathway for this, as there is some correlation between risk of stroke and extent of stenosis. Identification of patients who are at risk of cardiovascular disease as well as stroke, allows initiation of effective medical treatment of modifiable risk factors to address this risk...
May 17, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29770118/neuroinflammation-as-a-target-for-intervention-in-subarachnoid-hemorrhage
#6
REVIEW
Airton Leonardo de Oliveira Manoel, R Loch Macdonald
Aneurysmal subarachnoid hemorrhage (SAH) is a sub-type of hemorrhagic stroke associated with the highest rates of mortality and long-term neurological disabilities. Despite the improvement in the management of SAH patients and the reduction in case fatality in the last decades, disability and mortality remain high in this population. Brain injury can occur immediately and in the first days after SAH. This early brain injury can be due to physical effects on the brain such as increased intracranial pressure, herniations, intracerebral, intraventricular hemorrhage, and hydrocephalus...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29769167/impact-of-sex-on-comparative-outcomes-of-bivalirudin-versus-unfractionated-heparin-in-patients-with-acute-coronary-syndromes-undergoing-invasive-management-a-pre-specified-analysis-of-the-matrix-trial
#7
Giuseppe Gargiulo, Bruno R da Costa, Enrico Frigoli, Cataldo Palmieri, Marco Stefano Nazzaro, Camillo Falcone, Armando Liso, Carlo Vigna, Fabio Abate, Marco Comeglio, Roberto Diletti, Gabriele Gabrielli, Emilio Di Lorenzo, Pietro Mazzarotto, Marco Zimarino, Claudio Moretti, Antonio Colombo, Carlo Penzo, Giampaolo Pasquetto, Salvatore Brugaletta, Fabio Ferrari, Gavino Casu, Vincenzo Guiducci, Antonio Dellavalle, Francesco Liistro, Ciro Mauro, Arnoud W J Van't Hof, Elmir Omerovic, Salvatore Curello, Jose Maria de la Torre Hernandez, Stefano De Servi, Flavia Belloni, Stephan Windecker, Marco Valgimigli
AIMS: To assess whether bivalirudin compared with unfractionated heparin (UFH) is associated with consistent outcomes in male and female patients with acute coronary syndrome (ACS) undergoing invasive management. METHODS AND RESULTS: In the MATRIX program,7213 patients were randomized to bivalirudin or UFH.Patients in bivalirudin group were subsequently assigned to receive or not to receive a post-PCI infusion.The 30-day coprimary outcomes were major adverse cardiovascular and cerebrovascular events (MACE),defined as death,myocardial infarction,or stroke,and net adverse clinical events (NACE),defined as MACE or major bleeding...
May 15, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29768323/efficacy-and-risks-of-anticoagulation-for-cerebral-venous-thrombosis
#8
Weilin Xu, Liansheng Gao, Tao Li, Anwen Shao, Jianmin Zhang
BACKGROUND AND PURPOSE: Cerebral venous thrombosis (CVT) is a rare but life-threatening disease. Timely and proper treatments are the keys in saving patients' life and preventing from permanent neurological deficits. We performed this network meta-analysis to evaluate the role of anticoagulation in CVT, especially for the patients accompanied with hemorrhagic stroke. METHODS: PubMed, Embase, Web of Science, Cochrane Database, and Chinese Biomedical (CBM) databases were searched comprehensively to select eligible articles (up to 30 June 2017)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29766275/implementing-cough-reflex-testing-in-a-clinical-pathway-for-acute-stroke-a-pragmatic-randomised-controlled-trial
#9
Makaela Field, Rachel Wenke, Arman Sabet, Melissa Lawrie, Elizabeth Cardell
Silent aspiration is common after stroke and can lead to subsequent pneumonia. While standard bedside dysphagia assessments are ineffective at predicting silent aspiration, cough reflex testing (CRT) has shown promise for identifying patients at risk of silent aspiration. We investigated the impact of CRT on patient and service outcomes when embedded into a clinical pathway. 488 acute stoke patients were randomly allocated to receive either CRT or standard care (i.e. bedside assessment). Primary outcomes included confirmed pneumonia within 3 months post stroke and length of acute inpatient stay...
May 15, 2018: Dysphagia
https://www.readbyqxmd.com/read/29765888/disability-measurement-for-korean-community-dwelling-adults-with-stroke-item-level-psychometric-analysis-of-the-korean-longitudinal-study-of-ageing
#10
Ickpyo Hong, Young Joo Kim, Mandi L Sonnenfeld, Emily Grattan, Timothy A Reistetter
Objective: To investigate the psychometric properties of the activities of daily living (ADL) instrument used in the analysis of Korean Longitudinal Study of Ageing (KLoSA) dataset. Methods: A retrospective study was carried out involving 2006 KLoSA records of community-dwelling adults diagnosed with stroke. The ADL instrument used for the analysis of KLoSA included 17 items, which were analyzed using Rasch modeling to develop a robust outcome measure. The unidimensionality of the ADL instrument was examined based on confirmatory factor analysis with a one-factor model...
April 2018: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29765873/characteristics-of-cricopharyngeal-dysphagia-after-ischemic-stroke
#11
Hyuna Yang, Youbin Yi, Yong Han, Hyun Jung Kim
Objective: To evaluate the characteristics of cricopharyngeal dysfunction (CPD), the frequency, and correlation with a brain lesion in patients with first-ever ischemic stroke, and to provide basic data for developing a therapeutic protocol for dysphagia management. Methods: We retrospectively reviewed the medical records of a series of subjects post-stroke who underwent a videofluoroscopic swallowing study (VFSS) from January 2009 to December 2015. VFSS images were recorded on videotape and analyzed...
April 2018: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29765392/carotid-stenting-for-treatment-of-symptomatic-carotid-webs-a-single-center-case-series
#12
Waleed Brinjikji, Ronit Agid, Vitor M Pereira
Background and Purpose: Carotid webs are an increasingly recognized cause of acute is-chemic stroke, particularly in younger adults. The optimal medical and surgical strategies for managing these lesions have not been well established. We report a single-center case series of carotid stenting for treatment of symptomatic carotid webs. Materials and Methods: Consecutive patients undergoing stent placement for treatment of symptomatic carotid webs were included. Carotid webs were defined as a thin intraluminal filling defect along the posterior wall of the carotid bulb just beyond the carotid bifurcation on CTA...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29764435/use-of-hospital-palliative-care-according-to-the-place-of-death-and-disease-one-year-before-death-in-2013-a-french-national-observational-study
#13
Claire Poulalhon, Laureen Rotelli-Bihet, Sébastien Moine, Anne Fagot-Campagna, Régis Aubry, Philippe Tuppin
BACKGROUND: Only limited data are available concerning the diseases managed before death and hospital palliative care (HPC) use according to place of death in France. We therefore conducted an observational study based on administrative health data in a large population to identify the diseases treated one year before death in 2013, the place of stay with or without hospital palliative care, and the place of death. METHODS: French health insurance general scheme beneficiaries were identified in the National Health data Information System (Snds) with a selection of information...
May 16, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29764278/eating-well-living-well-and-weight-management-a-co-produced-semi-qualitative-study-of-barriers-and-facilitators-experienced-by-adults-with-intellectual-disabilities
#14
A J Doherty, S P Jones, U Chauhan, Jme Gibson
Adults with intellectual disabilities in England experience health inequalities. They are more likely than their non-disabled peers to be obese and at risk of serious medical conditions such as heart disease, stroke and type 2 diabetes. This semi-qualitative study engaged adults with intellectual disabilities in a co-production process to explore their perceived barriers and facilitators to eating well, living well and weight management. Nineteen participants with intellectual disabilities took part in four focus groups and one wider group discussion...
January 1, 2018: Journal of Intellectual Disabilities: JOID
https://www.readbyqxmd.com/read/29762932/pulmonary-hypertension-as-a-possible-cause-of-paradoxical-low-flow-low-gradient-aortic-stenosis
#15
Yuta Watanabe, Haruhiko Higashi, Katsuji Inoue, Jun Aono, Takafumi Okura, Jitsuo Higaki, Shuntaro Ikeda
Paradoxical low-flow, low-gradient aortic stenosis (LFLG AS) is recognized as a subtype of aortic stenosis. A small left ventricular (LV) cavity with marked LV concentric remodeling leads to a reduced stroke volume in this condition. The case is reported of a paradoxical LFLG AS patient who was undergoing treatment for pulmonary hypertension (PH) and interstitial pneumonia associated with scleroderma. Echocardiography demonstrated enlargement of the right ventricle and a diminished LV cavity. Moreover, the aortic valve opening was restricted despite a preserved LV ejection fraction (61%)...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762229/what-is-the-optimal-blood-pressure-on-veno-arterial-extracorporeal-membrane-oxygenation-impact-of-mean-arterial-pressure-on-survival
#16
Daizo Tanaka, Shogo Shimada, Megan Mullin, Kristin Kreitler, Nicholas Cavarocchi, Hitoshi Hirose
Blood pressure management is crucial for patients on veno-arterial extracorporeal membrane oxygenation (VA ECMO). Lower pressure can lead to end-organ malperfusion, whereas higher pressure may compete with ECMO flow and cardiac output. The impact of mean arterial pressure (MAP) on outcomes of patients on VA ECMO was evaluated. Patients who were supported on VA ECMO from September 2010 to March 2016 were retrospectively analyzed for average MAP throughout their course on ECMO, excluding the first and last day...
May 11, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29762202/hypertension-guideline-update-a-new-guideline-for-a-new-era
#17
Sondra M DePalma, Cheryl Dennison Himmelfarb, Eric J MacLaughlin, Sandra J Taler
In the United States, hypertension affects about one-third of adults and contributes to one out of every seven deaths. Evidence-based treatment is associated with reductions in incidence of stroke, myocardial infarction, and heart failure as well as associated disability and death. This article reviews the ACC/AHA Task Force on Clinical Practice Guidelines' 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. Key changes include reclassification of BP stages and lowering of hypertension treatment goals...
May 8, 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29761012/an-overview-of-protective-strategies-against-ischemia-reperfusion-injury-the-role-of-hyperbaric-oxygen-preconditioning
#18
Ciprian Hentia, Alex Rizzato, Enrico Camporesi, Zhongjin Yang, Danina M Muntean, Dorel Săndesc, Gerardo Bosco
Introduction: Ischemia/reperfusion (I/R) injury, such as myocardial infarction, stroke, and peripheral vascular disease, has been recognized as the most frequent causes of devastating disorders and death currently. Protective effect of various preconditioning stimuli, including hyperbaric oxygen (HBO), has been proposed in the management of I/R. Methods: In this study, we searched and reviewed up-to-date published papers to explore the pathophysiology of I/R injury and to understand the mechanisms underlying the protective effect of HBO as conditioning strategy...
May 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29760852/altered-mental-status-current-evidence-based-recommendations-for-prehospital-care
#19
REVIEW
Ashley Sanello, Marianne Gausche-Hill, William Mulkerin, Karl A Sporer, John F Brown, Kristi L Koenig, Eric M Rudnick, Angelo A Salvucci, Gregory H Gilbert
Introduction: In the United States emergency medical services (EMS) protocols vary widely across jurisdictions. We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of a patient with an acute change in mental status and to compare these recommendations against the current protocols used by the 33 EMS agencies in the State of California. Methods: We performed a literature review of the current evidence in the prehospital treatment of a patient with altered mental status (AMS) and augmented this review with guidelines from various national and international societies to create our evidence-based recommendations...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29759774/assessment-of-left-atrial-fibrosis-by-late-gadolinium-enhancement-magnetic-resonance-imaging-methodology-and-clinical-implications
#20
REVIEW
Johannes Siebermair, Eugene G Kholmovski, Nassir Marrouche
Recently, studies using late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) to identify structural changes of atrial tissue have contributed significantly to understanding the pathophysiology and progression of atrial fibrillation (AF). Moreover, imaging of atrial fibrosis using MRI has evolved to be a tool to improve clinical outcome of AF ablation procedures by allowing a patient-specific individualized management approach. LGE-MRI has been shown to predict AF ablation outcome based on pre-procedural imaging to define the extent of atrial fibrosis...
August 2017: JACC. Clinical Electrophysiology
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