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https://www.readbyqxmd.com/read/28087807/field-validation-of-the-los-angeles-motor-scale-as-a-tool-for-paramedic-assessment-of-stroke-severity
#1
Joon-Tae Kim, Pil-Wook Chung, Sidney Starkman, Nerses Sanossian, Samuel J Stratton, Marc Eckstein, Frank D Pratt, Robin Conwit, David S Liebeskind, Latisha Sharma, Lucas Restrepo, May-Kim Tenser, Miguel Valdes-Sueiras, Jeffrey Gornbein, Scott Hamilton, Jeffrey L Saver
BACKGROUND AND PURPOSE: The Los Angeles Motor Scale (LAMS) is a 3-item, 0- to 10-point motor stroke-deficit scale developed for prehospital use. We assessed the convergent, divergent, and predictive validity of the LAMS when performed by paramedics in the field at multiple sites in a large and diverse geographic region. METHODS: We analyzed early assessment and outcome data prospectively gathered in the FAST-MAG trial (Field Administration of Stroke Therapy-Magnesium phase 3) among patients with acute cerebrovascular disease (cerebral ischemia and intracranial hemorrhage) within 2 hours of onset, transported by 315 ambulances to 60 receiving hospitals...
January 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28087726/benefit-of-mineralocorticoid-receptor-antagonism-in-aki-role-of-vascular-smooth-muscle-rac1
#2
Jonatan Barrera-Chimal, Gwennan André-Grégoire, Aurelie Nguyen Dinh Cat, Sebastian M Lechner, Jérôme Cau, Sonia Prince, Peter Kolkhof, Gervaise Loirand, Vincent Sauzeau, Thierry Hauet, Frédéric Jaisser
AKI is a frequent complication in hospitalized patients. Unfortunately, there is no effective pharmacologic approach for treating or preventing AKI. In rodents, mineralocorticoid receptor (MR) antagonism prevents AKI induced by ischemia-reperfusion (IR). We investigated the specific role of vascular MR in mediating AKI induced by IR. We also assessed the protective effect of MR antagonism in IR-induced AKI in the Large White pig, a model of human AKI. In mice, MR deficiency in smooth muscle cells (SMCs) protected against kidney IR injury...
January 13, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28087295/postconditioning-induced-neuroprotection-mechanisms-and-applications-in-cerebral-ischemia
#3
REVIEW
Yan-Ying Fan, Wei-Wei Hu, Fang Nan, Zhong Chen
Ischemic postconditioning (PostC) is defined as a series of rapid intermittent interruptions of blood flow at the phase of reperfusion, which produces neuroprotection against cerebral ischemia/reperfusion injury via mobilizing the brain's own endogenous adaptive mechanisms. Now the concept of conventional ischemic PostC has been extended to limb remote ischemic PostC and chemical PostC with hypoxia, volatile anesthetic, CO2, etc. According to the different temporal profile of PostC, it is divided into rapid and delayed PostC...
January 10, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28079785/antiplatelet-agents-and-the-prevention-of-spontaneous-preterm-birth-a-systematic-review-and-meta-analysis
#4
Elvira O G van Vliet, Lisa A Askie, Ben W J Mol, Martijn A Oudijk
OBJECTIVE: Spontaneous preterm birth is an important cause of neonatal mortality and morbidity. An increasing body of evidence suggests that uteroplacental ischemia plays an important role in the etiology of spontaneous preterm birth. We aimed to study whether antiplatelet agents reduce the risk of spontaneous preterm birth. DATA SOURCES: We included data from an individual participant data meta-analysis of studies that had evaluated the effect of antiplatelet agents to reduce preeclampsia (Perinatal Antiplatelet Review of International Studies Individual Participant Data)...
January 9, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28076634/immediate-versus-delayed-treatment-for-recently-symptomatic-carotid-artery-stenosis
#5
Vladimir Vasconcelos, Nicolle Cassola, Edina Mariko Koga da Silva, José Carlos Costa Baptista-Silva
BACKGROUND: The timing of surgery for recently symptomatic carotid artery stenosis remains controversial. Early cerebral revascularization may prevent a disabling or fatal ischemic recurrence, but it may also increase the risk of hemorrhagic transformation, or of dislodging a thrombus. This review examined the randomized controlled evidence that addressed whether the increased risk of recurrent events outweighed the increased benefit of an earlier intervention. OBJECTIVES: To assess the risks and benefits of performing very early cerebral revascularization (within two days) compared with delayed treatment (after two days) for people with recently symptomatic carotid artery stenosis...
November 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28075499/long-term-outcome-following-remote-ischemic-postconditioning-during-percutaneous-coronary-interventions-the-rip-pci-trial-long-term-follow-up
#6
Shahar Lavi, Nour Abu-Romeh, Sabrina Wall, Mistre Alemayehu, Ronit Lavi
The clinical value of ischemic conditioning during percutaneous coronary intervention (PCI) and mode of administration is controversial. Our aim was to assess the long-term effect of remote ischemic postconditioning among patients undergoing PCI. We randomized 360 patients undergoing PCI who presented with a negative troponin T at baseline into 3 groups: 2 groups received remote ischemic postconditioning (with ischemia applied to the arm in 1 group and to the thigh in the other group), and the third group acted as a control group...
January 11, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28073669/reoperation-rates-after-open-and-endovascular-abdominal-aortic-aneurysm-repairs
#7
Conor F Hynes, Kendal M Endicott, Sina Iranmanesh, Richard L Amdur, Robyn Macsata
OBJECTIVE: This study compared reoperation rates associated with open abdominal aortic aneurysm (AAA) repair (OR) outcomes vs endovascular AAA repair (EVAR). METHODS: A retrospective review of the Veterans Affairs Surgical Quality Improvement Project data was performed with inclusion criteria defined as all patients who underwent AAA repair from October 1, 2007, to October 1, 2013. The primary outcome was the incidence of reoperations. Reoperations included subsequent OR or EVAR procedures performed on the abdominal aorta or iliac arteries, surgical treatment of temporally related bowel obstruction, as well as treatment of abdominal or groin wound complications ≤6 months and treatment of bowel or lower limb ischemia ≤10 days...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28065616/experience-on-mechanical-thrombectomy-for-acute-stroke-treatment-in-a-brazilian-university-hospital
#8
Guilherme S Nakiri, Luis H Castro-Afonso, Lucas M Monsignore, Francisco A Dias, Frederico F Alessio-Alves, Soraia Ramos C Fabio, Millene R Camilo, Pedro T Cougo-Pinto, Octavio M Pontes-Neto, João Pereira Leite, Daniel G Abud
BACKGROUND: Brazil is a developing country struggling to reduce its extreme social inequality, which is reflected on shortage of health-care infrastructure, mainly to the low-income class, which depends exclusively on the public health system. In Brazil, less than 1% of stroke patients have access to intravenous thrombolysis in a stroke unit, and constraints to the development of mechanical thrombectomy in the public health system increase the social burden of stroke. OBJECTIVE: Report the feasibility of mechanical thrombectomy as part of routine stroke care in a Brazilian public university hospital...
January 5, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28065491/meta-analysis-of-randomized-trials-on-remote-ischemic-conditioning-during-primary-percutaneous-coronary-intervention-in-patients-with-st-segment-elevation-myocardial-infarction
#9
Ayman Elbadawi, Le Dung Ha, Ahmed S Abuzaid, Gabriele Crimi, Muhammad S Azzouz
Ischemia/reperfusion injury adversely affects the final infarct size (IS) after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Few studies have evaluated the role of remote ischemic conditioning (RIC) in reducing ischemia/reperfusion injury. However, the results of these studies were not consistent, and an overview of overall effectiveness of this technique in patients with STEMI is lacking. We conducted this meta-analysis to evaluate the available evidence in literature regarding the application of RIC in patients with STEMI who underwent primary PCI...
December 21, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28065453/protective-effects-of-l-carnitine-against-delayed-graft-function-in-kidney-transplant-recipients-a-pilot-randomized-double-blinded-placebo-controlled-clinical-trial
#10
Atefeh Jafari, Mohammad-Reza Khatami, Simin Dashti-Khavidaki, Mahboob Lessan-Pezeshki, Alireza Abdollahi, Azadeh Moghaddas
OBJECTIVE: Delayed graft function (DGF) is an early complication after deceased donor kidney transplantation with significant adverse effects on graft outcomes. Ischemia-reperfusion injury during transplantation is a major cause of DGF. Tissue concentrations of carnitine, an antioxidant and regulator of cellular energy supply, decrease in the kidney following ischemia-reperfusion insult. Based on promising animal data, this study evaluated the possible protective effect of L-carnitine against DGF...
January 3, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28064408/resveratrol-mediated-expression-of-klf15-in-the-ischemic-myocardium-is-associated-with-an-improved-cardiac-phenotype
#11
Russell G Rogers, Jeffrey S Otis
PURPOSE: Myocardial infarction results in physiological derangements that lead to structural and functional alterations to the myocardium. In addition, oxidative stress potentiates cardiac remodeling and drives disease progression. Unfortunately, treatment with antioxidants in clinical trials have failed to show any therapeutic benefits despite the positive results reported in animal studies, which warrants further investigation into their mechanism(s) of action. Accordingly, the aim of this study was to elucidate a previously unknown mechanism of action for the antioxidant, resveratrol, in the treatment of the ischemic heart...
January 7, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28063671/meta-analysis-of-major-bleeding-events-on-aspirin-versus-vitamin-k-antagonists-in-randomized-trials
#12
P Ambrosi, A Daumas, P Villani, R Giorgi
BACKGROUND AND OBJECTIVES: The relative bleeding risk of aspirin versus vitamin K antagonists (VKA) is unclear. Most of previous meta-analyses included trials with target INR for VKA therapy far beyond usually recommended range (2-3). The aim of this study was to compare the bleeding risk of aspirin and VKA, as indicated by the aggregate body of clinical evidence including data from the recently published WARCEF trial. METHODS: In this meta-analysis we included randomized controlled trials that compared aspirin to VKA (1...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28060997/effect-of-hypercholesterolemia-on-myocardial-function-ischemia-reperfusion-injury-and-cardioprotection-by-preconditioning-postconditioning-and-remote-conditioning
#13
REVIEW
Ioanna Andreadou, Efstathios K Iliodromitis, Antigone Lazou, Anikó Görbe, Zoltán Giricz, Rainer Schulz, Péter Ferdinandy
Hypercholesterolemia is considered to be a principle risk factor for cardiovascular disease, having direct negative effects on the myocardium itself, in addition to the development of atherosclerosis. Since hypercholesterolemia affects global cardiac gene expression profile, among many other factors, increased myocardial oxidative stress, mitochondrial dysfunction and inflammation trigger apoptosis and this may account for myocardial dysfunction and increased susceptibility of the myocardium to infarction. In addition, numerous experimental and clinical studies revealed that hyperlcholesterolemia may interfere with the cardioprotective potential of conditioning mechanisms...
January 6, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28057839/niacin-promotes-cardiac-healing-after-myocardial-infarction-through-activation-of-the-myeloid-prostaglandin-d2-receptor-subtype-1
#14
Deping Kong, Juanjuan Li, Yujun Shen, Guihu Liu, Shengkai Zuo, Bo Tao, Yong Ji, Ankang Lu, Michael Lazarus, Richard M Breyer, Ying Yu
Niacin is a well-established drug used to lower cholesterol and prevent cardiovascular disease (CVD) events. However, niacin also causes cutaneous flushing side effects due to release of the proresolution mediator prostaglandin (PG) D2. Recent randomized clinical trials have demonstrated that addition of niacin with laropiprant (a PGD2 receptor subtype 1 [DP1] blocker) to statin-based therapies does not significantly decrease the risk of CVD events but increases the risk of serious adverse events. Here, we tested whether, and how, niacin beneficial effects in vivo myocardial ischemia requires the activation of the PGD2/DP1 axis...
January 5, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28057037/role-of-vasopressin-and-terlipressin-in-refractory-shock-compared-to-conventional-therapy-in-the-neonatal-and-pediatric-population-a-systematic-review-meta-analysis-and-trial-sequential-analysis
#15
Reem Masarwa, Gideon Paret, Amichai Perlman, Shimon Reif, Bruria Hirsh Raccah, Ilan Matok
BACKGROUND: Vasopressin (AVP) and terlipressin (TP) have been used as last-line therapy in refractory shock in children. However, the efficacy and safety profiles of AVP and TP have not been determined in pediatric refractory shock of different origins. We aimed to assess the efficacy and safety of the addition of AVP/TP therapy in pediatric refractory shock of all causes compared to conventional therapy with fluid resuscitation and vasopressor and inotropic therapy. METHODS: We conducted a systematic review, meta-analysis, and trial sequential analysis (TSA) comparing AVP and TP to conventional therapy...
January 5, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28050885/results-of-an-international-postmarketing-surveillance-study-of-pl-vegf165-safety-and-efficacy-in-210-patients-with-peripheral-arterial-disease
#16
Roman Deev, Igor Plaksa, Ilia Bozo, Artur Isaev
INTRODUCTION: The effective treatment of chronic lower limb ischemia is one of the most challenging issues confronting vascular surgeons. Current pharmacological therapies play an auxiliary role and cannot prevent disease progression, and new treatment methods are needed. pl-VEGF165, a gene therapy drug, was approved in Russia for the treatment of atherosclerotic peripheral arterial disease (PAD) after clinical studies in 2011. The study drug is an original gene construction in which pl-VEGF165 1...
January 3, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28043669/long-term-clinical-outcomes-of-remote-ischemic-preconditioning-and-postconditioning-outcome-rispo-trial-in-patients-undergoing-cardiac-surgery
#17
Youn Joung Cho, Eun-Ho Lee, Kanghee Lee, Tae Kyong Kim, Deok Man Hong, Ji-Hyun Chin, Dae-Kee Choi, Jae-Hyon Bahk, Ji-Yeon Sim, In-Cheol Choi, Yunseok Jeon
BACKGROUND: Remote ischemic conditioning has been shown to confer myocardial protection. However, there is still no sufficient data on its long-term clinical outcomes. We analyzed the long-term results of the Remote Ischemic Preconditioning and Postconditioning Outcome (RISPO) trial in cardiac surgery patients. METHODS: In the RISPO trial, 1280 patients were randomized to receive remote ischemic preconditioning (RIPC) with postconditioning (RIPostC, upper arm ischemia by four cycles of 5-min inflation followed by 5-min deflation of a pneumatic cuff, N=644) or sham (N=636) during cardiac surgery...
December 23, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28039321/impact-of-cerebrovascular-events-older-than-one-year-on-ischemic-and-bleeding-outcomes-with-cangrelor-in-percutaneous-coronary-intervention
#18
Neal N Sawlani, Robert A Harrington, Gregg W Stone, Ph Gabriel Steg, C Michael Gibson, Christian W Hamm, Matthew J Price, Jayne Prats, Efthymios N Deliargyris, Kenneth W Mahaffey, Harvey D White, Deepak L Bhatt
BACKGROUND: Cangrelor is a potent intravenous adenosine diphosphate-receptor antagonist that in the CHAMPION trials reduced the 48-hour and 30-day rates of ischemic events during percutaneous coronary intervention without an increase in severe bleeding. METHODS AND RESULTS: CHAMPION PCI (A Clinical Trial to Demonstrate the Efficacy of Cangrelor), CHAMPION PLATFORM (Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition), and CHAMPION PHOENIX (A Clinical Trial Comparing Cangrelor to Clopidogrel Standard Therapy in Subjects Who Require Percutaneous Coronary Intervention) were 3 randomized, double-blind, double-dummy trials in which cangrelor was compared with clopidogrel during percutaneous coronary intervention...
January 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28038815/circadian-variation-in-acute-myocardial-infarct-size-assessed-by-cardiovascular-magnetic-resonance-in-reperfused-stemi-patients
#19
Heerajnarain Bulluck, Jennifer Nicholas, Gabriele Crimi, Steven K White, Andrew J Ludman, Silvia Pica, Claudia Raineri, Hector A Cabrera-Fuentes, Derek Yellon, Jose Rodriguez-Palomares, David Garcia-Dorado, Derek J Hausenloy
OBJECTIVE: Clinical studies using serum cardiac biomarkers to investigate a circadian variation in acute myocardial infarct (MI) size in ST-segment elevation myocardial infarction (STEMI) patients reperfused by primary percutaneous coronary intervention (PPCI) have produced mixed results. We aimed to investigate this phenomenon using acute MI size measured by cardiovascular magnetic resonance (CMR). METHODS: Patient-level data was obtained from 4 randomized controlled trials investigating the MI-limiting effects of cardioprotective therapies in this pooled analysis...
December 19, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28035779/reduction-of-intracerebral-hemorrhage-by-rivaroxaban-after-tpa-thrombolysis-is-associated-with-downregulation-of-par-1-and-par-2
#20
Ryuta Morihara, Toru Yamashita, Syoichiro Kono, Jingwei Shang, Yumiko Nakano, Kota Sato, Nozomi Hishikawa, Yasuyuki Ohta, Stefan Heitmeier, Elisabeth Perzborn, Koji Abe
This study aimed to assess the risk of intracerebral hemorrhage (ICH) after tissue-type plasminogen activator (tPA) treatment in rivaroxaban compared with warfarin-pretreated male Wistar rat brain after ischemia in relation to activation profiles of protease-activated receptor-1, -2, -3, and -4 (PAR-1, -2, -3, and -4). After pretreatment with warfarin (0.2 mg/kg/day), low-dose rivaroxaban (60 mg/kg/day), high-dose rivaroxaban (120 mg/kg/day), or vehicle for 14 days, transient middle cerebral artery occlusion was induced for 90 min, followed by reperfusion with tPA (10 mg/kg/10 ml)...
December 30, 2016: Journal of Neuroscience Research
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