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https://www.readbyqxmd.com/read/28741720/alteplase-for-acute-ischemic-stroke-after-heparin-reversal-with-protamine-a-case-report-and-review
#1
Gabriel V Fontaine, Shawn M Smith
BACKGROUND: Few patients presenting with acute ischemic stroke (AIS) are eligible for alteplase, especially those receiving ongoing anticoagulation. We describe the first reported case of a patient receiving full-dose intravenous (IV) alteplase for AIS after heparin reversal with protamine. CASE: A 73-year-old male presented with AIS. He was treated with IV heparin, tirofiban, loading-dose prasugrel, and aspirin prior to percutaneous coronary intervention (PCI) for placement of a right coronary artery stent...
July 25, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28740717/hybrid-repair-of-aortic-arch-aneurysms-a-comprehensive-review
#2
REVIEW
Steve Xydas, Christos G Mihos, Roy F Williams, Angelo LaPietra, Maurice Mawad, S Howard Wittels, Orlando Santana
Open total arch replacement (TAR) has become safer with refinements in cerebral protection techniques. The frequent extension of aortic arch aneurysms into the descending thoracic aorta customarily requires a two-staged conventional elephant trunk procedure, carrying relatively high mortality and morbidity risks and high rates of rupture in the interval between the two open surgeries. The technical demands and invasive nature of TAR has therefore precluded many high-risk patients from being surgical candidates for aneurysm repair...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28739036/meta-analysis-of-the-effect-of-obstructive-sleep-apnea-on-cardiovascular-events-after-percutaneous-coronary-intervention
#3
REVIEW
Yingke Zhao, Branda Yee-Man Yu, Yanfei Liu, Yue Liu
Increasing evidence proved that obstructive sleep apnea (OSA) is associated with a variety of diseases, especially cardiovascular diseases. This study systematically reviewed the existing publications to assess the influence of OSA on cardiovascular survival among patients who underwent percutaneous coronary intervention. Eleven eligible publications, including 3,008 participants, were finally evaluated. Eight studies conducted adjustment of risk ratio for potential cardiovascular risk factors, 5 studies defined OSA groups as AHI (apnea hypopnea index) ≥15/hour, whereas the remaining eligible studies used AHI ≥5/hour, AHI ≥10/hour, or AHI ≥30/hour as the criteria...
June 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28738735/clinician-perspectives-on-cross-education-in-stroke-rehabilitation
#4
William Russell, Lesley Pritchard-Wiart, Patricia J Manns
PURPOSE: Cross-education is a neural phenomenon where strength of an untrained muscle improves after unilateral training of the opposite homologous muscle. It has been extensively studied in healthy populations and shows promise for post-stroke rehabilitation. The purpose of this study is to understand current post-stroke upper extremity rehabilitation practice; clinician's perspectives on cross-education and; facilitators and barriers to implementation of a cross-education intervention...
July 24, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28738485/-impact-and-clinical-outcome-of-intra-aortic-balloon-pump-use-during-percutaneous-coronary-intervention
#5
J J Xu, Z Gao, Y Song, Y L Ma, X F Tang, Y Yao, C He, H H Wang, Y J Yang, R L Gao, S B Qiao, B Xu, J Q Yuan
Objective: To observe the impact and clinical outcome of intra-aortic balloon pump(IABP) use in patients underwent percutaneous coronary intervention (PCI). Methods: From January 2013 to December 2013, 10 724 consecutive patients undergoing PCI were enrolled.After 2 years' follow-up, the incidence of major adverse cardiovascular and cerebrovascular events such as death, myocardial infarction, stent thrombosis, revascularization, recurrent stroke were recorded, propensity score was used to match baseline data, and the clinical outcomes in patients with IABP and non-IABP were compared...
July 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28738483/-outcome-analysis-of-patients-undergoing-percutaneous-coronary-intervention-with-or-without-prior-coronary-artery-bypass-grafting-operation
#6
Y Song, J J Xu, X F Tang, H H Wang, R Liu, P Jiang, L Jiang, L J Gao, Y Zhang, L Song, L J Xu, X Y Zhao, Z Gao, J Chen, R L Gao, S B Qiao, Y J Yang, B Xu, J Q Yuan
Objective: To investigate the impact of previous coronary artery bypass grafting(CABG) on long-term outcomes in patients undergoing percutaneous coronary intervention(PCI). Methods: A total of 10 724 consecutive coronary heart disease patients undergoing PCI between January and December 2013 in Fuwai hospital were prospectively included in this research. According to CABG history, the patients were divided into CABG group(437 cases) and without CABG group(10 287 cases). The patients were followed up for 2 years...
July 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28737069/safety-of-radial-access-for-primary-percutaneous-intervention-in-patients-with-st-elevation-acute-myocardial-infarction-results-from-a-low-volume-center
#7
Yoshimasa Tsurumaki, Yumiko Haraguchi, Tomohiro Nakamura
Radial access for primary percutaneous coronary intervention (pPCI) in patients with ST-elevation acute myocardial infarction (STEMI) is recommended in high-volume experienced centers. This study investigated whether radial access for pPCI is safe even in a low-volume center. We performed radial access for pPCI in 171 patients. Major adverse cardiac events (total death, myocardial infarction, stroke) rate was 1.2%. The overall incidence of bleeding complications was 2.4%; there was no vascular complication at the access site...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28737064/the-effects-of-delirium-prevention-guidelines-on-elderly-stroke-patients
#8
Jihye Song, Minkyung Lee, Dukyoo Jung
This study aimed to evaluate the effectiveness of the delirium prevention interventions recommended by the Delirium Prevention Guidelines for Elderly Stroke Patients (DPGESP). The DPGESP comprises nine dimensions with 28 interventions, including risk factor assessment, orientation disorder prevention, sleeping pattern maintenance, sensory interventions, constipation, dehydration, hypoxia and infection prevention, pain management, and appropriate nutrition maintenance. This quasi-experimental study used a nonequivalent control group and a pretest-posttest design...
July 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/28736903/a-retrospective-analysis-of-impella-use-in-all-comers-1-year-outcomes
#9
Mohamad Lazkani, Shishir Murarka, Akihiro Kobayashi, Luke Seibolt, Tae Yang, Ashish Pershad
BACKGROUND: There are non-randomized data about the benefits of Impella use in the setting of cardiogenic shock. However, limited data exist to help guide clinicians about whether in the context of the intervention the device should be implanted early or late; how long the device should stay in; and how the mode of explant should be. METHODS: This is a retrospective, single center registry over 5 years comparing in-hospital outcomes and 1 year mortality in an all-comers in patients who had the Impella device placed early versus those who had the device placed late as a bailout...
July 24, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28736326/tone-inhibiting-insoles-enhance-the-reciprocal-inhibition-of-ankle-plantarflexors-of-post-stroke-hemiparetic-subjects-an-electromyographic-study
#10
Nobushige Takahashi, Hidetoshi Takahashi, Osamu Takahashi, Ryosuke Ushijima, Rie Umebayashi, Junji Nishikawa, Yasutomo Okajima
BACKGROUND: Spasticity is a common sequela of upper motor neuron pathology, such as cerebrovascular diseases and cerebral palsy. Intervention for spasticity of the ankle plantarflexors in physical therapy may include tone-inhibiting casting and/or orthoses for the ankle and foot. However, the physiological mechanism of tone reduction by such orthoses remains unclarified. OBJECTIVE: To investigate the electrophysiologic effects of tone-inhibiting insoles in stroke subjects with hemiparesis by measuring changes in reciprocal Ia inhibition (RI) in the ankle plantarflexor...
July 20, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28735954/endarterectomy-achieves-lower-stroke-and-death-rates-compared-with-stenting-in-patients-with-asymptomatic-carotid-stenosis
#11
REVIEW
Stavros K Kakkos, Ioannis Kakisis, Ioannis A Tsolakis, George Geroulakos
BACKGROUND: It is currently unclear if carotid artery stenting (CAS) is as safe as carotid endarterectomy (CEA) for patients with significant asymptomatic stenosis. The aim of our study was to perform a systematic review and meta-analysis of trials comparing CAS with CEA. METHODS: On March 17, 2017, a search for randomized controlled trials was performed in MEDLINE and Scopus databases with no time limits. We performed meta-analyses with Peto odds ratios (ORs) and 95% confidence intervals (CIs)...
August 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28735933/interventional-radiologists-and-endovascular-therapy-for-acute-ischemic%C3%A2-strokes
#12
David Sacks
No abstract text is available yet for this article.
August 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28735014/initial-clinical-experience-with-testosterone-undecanoate-therapy-aveed-%C3%A2-in-testosterone-deficient-men-in-the-united-states
#13
Abraham Morgentaler, Yonah Krakowsky, William Conners, Emily Davidson, Alex Rawji
OBJECTIVE: To report our initial experiences with TU 750mg in testosterone-deficient men. METHODS: All patients receiving TU 750mg at our center between July 1 2014 to August 1 2016 were identified. Clinical response was assessed via structured interviews and laboratory evaluations. Adverse events were documented, including increases in prostate specific antigen (PSA), hematocrit (Hct), and the development of post-injection cough. RESULTS: More than two injections were received by 147 men, with mean age 63...
July 19, 2017: Urology
https://www.readbyqxmd.com/read/28734936/rehabilitation-interventions-for-upper-limb-function-in-the-first-four-weeks-following-stroke-a-systematic-review-and-meta-analysis-of-the-evidence
#14
REVIEW
Kimberley A Wattchow, Michelle N McDonnell, Susan L Hillier
OBJECTIVE: To investigate the therapeutic interventions reported in the research literature, and synthesize their effectiveness in improving upper limb (UL) function in the first four weeks post-stroke. DATA SOURCES: Electronic databases, trial registries and hand searching was conducted, from inception until June 2016. STUDY SELECTION: Randomised controlled trials (RCTs), controlled trials and interventional studies with pre/post-test design were included for adults within four weeks of any type of stroke with UL impairment...
July 19, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28733710/a-matched-case-control-study-on-early-and-late-results-of-carotid-endarterectomy-performed-in-young-patients
#15
Walter Dorigo, Aaron Fargion, Elena Giacomelli, Giulia Bassoli, Raffaele Pulli, Giovanni Pratesi, Gabriele Piffaretti, Carlo Pratesi
OBJECTIVE: The aim of the study was to describe the perioperative and long-term results of carotid endarterectomy (CEA) in patients aged 60 or less and compare them to patients of more advanced age in a retrospective single-centre case-control study. METHODS: From January 1996 to December 2014, 5893 consecutive CEAs were performed in our institution. Data concerning these interventions were prospectively inserted in a dedicated database. A retrospective analysis of that database was performed and 457 interventions performed in patients aged 60 or less were found (group 1)...
July 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28733067/hospital-quality-variation-matters-a-time-trend-and-cross-section-analysis-of-outcomes-in-german-hospitals-from-2006-to-2014
#16
Christoph Pross, Reinhard Busse, Alexander Geissler
Awareness of care variation and associated differences in outcome quality is important for patients to recognize and leverage the benefits of hospital choice and for policy makers, providers, and suppliers to adapt initiatives to improve hospital quality of care. We examine panel data on outcome quality in German hospitals between 2006 and 2014 for cholecystectomy, pacemaker implantation, hip replacement, percutaneous coronary intervention (PCI), stroke, and acute myocardial infarction (AMI). We use risk-adjusted and unadjusted outcomes based on 16 indicators...
July 8, 2017: Health Policy
https://www.readbyqxmd.com/read/28730949/eric-acute-stroke-recanalization-a-study-using-predictive-analytics-to-assess-a-new-device-for-mechanical-thrombectomy
#17
Susanne Siemonsen, Nils D Forkert, Martina Bernhardt, Götz Thomalla, Martin Bendszus, Jens Fiehler
Aim and hypothesis Using a new study design, we investigate whether next-generation mechanical thrombectomy devices improve clinical outcomes in ischemic stroke patients. We hypothesize that this new methodology is superior to intravenous tissue plasminogen activator therapy alone. Methods and design ERic Acute StrokE Recanalization is an investigator-initiated prospective single-arm, multicenter, controlled, open label study to compare the safety and effectiveness of a new recanalization device and distal access catheter in acute ischemic stroke patients with symptoms attributable to acute ischemic stroke and vessel occlusion of the internal cerebral artery or middle cerebral artery...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28730895/incidence-treatment-strategies-and-outcomes-of-acute-coronary-syndrome-with-and-without-ongoing-myocardial-ischaemia-results-from-the-czech-3-registry
#18
Petr Tousek, Klara Staskova, Anna Mala, Martin Sluka, Alexandra Vodzinska, Radek Jancar, Denisa Maluskova, Jiri Jarkovsky, Petr Widimsky
BACKGROUND: Patients with acute coronary syndrome with signs of ongoing myocardial ischaemia at first medical contact should be indicated for immediate invasive treatment. AIM: To assess the incidence, treatment strategies and outcomes of acute coronary syndrome in a large unselected cohort of patients with respect to the signs of ongoing myocardial ischaemia. METHODS: The CZECH-3 registry included 1754 consecutive patients admitted for suspected acute coronary syndrome to 43 hospitals during a 2-month period in the autumn of 2015...
July 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28730849/treadmill-training-to-improve-mobility-for-people-with-sub-acute-stroke-a-phase-ii-feasibility-randomized-controlled-trial
#19
Gillian D Baer, Lisa G Salisbury, Mark T Smith, Jane Pitman, Martin Dennis
OBJECTIVE: This phase II study investigated the feasibility and potential effectiveness of treadmill training versus normal gait re-education for ambulant and non-ambulant people with sub-acute stroke delivered as part of normal clinical practice. DESIGN: A single-blind, feasibility randomized controlled trial. SETTING: Four hospital-based stroke units. SUBJECTS: Participants within three months of stroke onset. INTERVENTIONS: Participants were randomized to treadmill training (minimum twice weekly) plus normal gait re-education or normal gait re-education only (control) for up to eight weeks...
July 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28728960/effect-of-high-intensity-home-based-respiratory-muscle-training-on-strength-of-respiratory-muscles-following-a-stroke-a-protocol-for-a-randomized-controlled-trial
#20
Kênia Kiefer Parreiras De Menezes, Lucas Rodrigues Nascimento, Janaine Cunha Polese, Louise Ada, Luci Fuscaldi Teixeira-Salmela
BACKGROUND: Respiratory muscle training has shown to increase strength of the respiratory muscles following a stroke. However, low duration and/or intensity of training may be responsible for the small effect size seen and/or absence of carry-over effects to an activity, e.g., walking. Therefore, an investigation of the effects of long-duration, high-intensity respiratory muscle training is warranted. OBJECTIVE: This proposed protocol for a randomized clinical trial will examine the efficacy of high-intensity respiratory muscle training to increase strength and improve activity following a stroke...
July 3, 2017: Brazilian Journal of Physical Therapy
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