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https://www.readbyqxmd.com/read/28103118/park2-dependent-mitophagy-induced-by-acidic-postconditioning-protects-against-focal-cerebral-ischemia-and-extends-the-reperfusion-window
#1
Zhe Shen, Yanrong Zheng, Jiaying Wu, Ying Chen, Xiaoli Wu, Yiting Zhou, Yang Yuan, Shousheng Lu, Lei Jiang, Zhenghong Qin, Zhong Chen, Weiwei Hu, Xiangnan Zhang
Prompt reperfusion after cerebral ischemia is critical for neuronal survival. Any strategies that extend the limited reperfusion window will be of great importance. Acidic postconditioning (APC) is a mild acidosis treatment that involves inhaling CO2 during reperfusion following ischemia. APC attenuates ischemic brain injury although the underlying mechanisms have not been elucidated. Here we report that APC reinforces ischemia-reperfusion-induced mitophagy in middle cortical artery occlusion (MCAO)-treated mice, and in oxygen-glucose deprivation (OGD)-treated brain slices and neurons...
January 19, 2017: Autophagy
https://www.readbyqxmd.com/read/28094079/a-stroke-mimic-methotrexate-induced-neurotoxicity-in-the-emergency-department
#2
Patrick Rogers, Wilbur J Pan, Richard A Drachtman, Christopher Haines
BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common form of childhood leukemia. The treatment of ALL involves multimodality therapy, and methotrexate (MTX) remains a mainstay of treatment. A complication of MTX therapy includes acute, subacute, and chronic neurotoxocity. Signs and symptoms may range from headaches, dizziness, and mood disorders to seizures and stroke-like symptoms. CASE REPORT: An 18-year-old woman with a history of ALL presented to the emergency department with acute onset of right-sided facial paralysis, right upper extremity flaccid paralysis, and right lower extremity weakness after receiving MTX therapy 3 days earlier...
January 13, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28089562/sequential-multiple-assignment-randomized-trials-an-opportunity-for-improved-design-of-stroke-reperfusion-trials
#3
William J Meurer, Nicholas J Seewald, Kelley Kidwell
BACKGROUND: Modern clinical trials in stroke reperfusion fall into 2 categories: alternative systemic pharmacological regimens to alteplase and "rescue" endovascular approaches using targeted thrombectomy devices and/or medications delivered directly for persistently occluded vessels. Clinical trials in stroke have not evaluated how initial pharmacological thrombolytic management might influence subsequent rescue strategy. A sequential multiple assignment randomized trial (SMART) is a novel trial design that can test these dynamic treatment regimens and lead to treatment guidelines that more closely mimic practice...
January 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28075424/managing-challenging-patients-with-venous-thromboembolism-a-practical-case-based-approach
#4
James Douketis, Walter Ageno, Marc Carrier, Clive Kearon
The management of patients with venous thromboembolism is a common clinical scenario that, for the most part, involves well-established, evidence-based treatment pathways. However, important unanswered clinical questions remain that are the focus of ongoing research. The aim of this narrative review is to provide a practical, case-based approach to the following clinical scenarios in which therapeutic management pathways are less well established: How long to anticoagulated patients with a first unprovoked venous thromboembolism? How to manage complex patients with cancer-associated venous thromboembolism? When and how to treat patients with splanchnic vein thrombosis? When to use thrombolytic therapy for deep vein thrombosis?...
January 4, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28074981/-thrombolysis-in-stroke-mimics-experience-in-10-cases
#5
Alejandro M Brunser, Arnold Hoppe, Paula Muñoz, Pablo M Lavados, Sergio Illanes, Violeta Díaz, Verónica V Olavarría
BACKGROUND: The effectiveness of intravenous thrombolysis (IVT) in cerebral ischemia is time dependent. Stroke mimics (SM) are frequent in emergency rooms. The effort to reduce door to needle time, can lead to administer thrombolytics to SM. AIM: To describe the frequency and prognosis of SM treated with IVT. MATERIAL AND METHODS: Prospective analysis of all patients evaluated in a Chilean private clinic between December 2004 and July 2015 with a suspected acute ischemic stroke (AIS)...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28069786/portomesenteric-vein-thrombosis-after-laparoscopic-sleeve-gastrectomy-for-morbid-obesity
#6
Leslie S Anewenah, Mohammed Asif, Richard Francesco, Prashanth Ramachandra
Portomesenteric vein thrombosis (PMVT) is a rare, life-threatening pathology associated with increased prevalence in laparoscopic sleeve gastrectomy (LSG) versus other gastric bypass procedures. Gaining popularity, LSG is becoming the first choice of patients and physicians alike due to its low complication profile compared to the gastric bypass procedure. We present the case of a 34-year-old woman who underwent an uncomplicated LSG for the treatment of morbid obesity, and presented on postoperative day 13 with PMVT...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28064304/evaluation-of-ophthalmic-artery-branch-retrograde-intervention-in-the-treatment-of-central-retinal-artery-occlusion-crao
#7
Runsheng Wang, Lu Qian, Yi Wang, Yi Zheng, Shanshuang Du, Tao Lei, Peilin Lv, Tan Long, Wenjun Wang
BACKGROUND Central retinal artery occlusion (CRAO) is the occlusion of the central retinal artery resulting in retinal infarction and acute vision loss. Digital subtraction angiography (DSA)-guided superselective ophthalmic artery or selective carotid thrombolysis remains the preferred treatment method for CRAO. This study aimed to evaluate the safety and clinical efficacy of the novel ophthalmic artery branch retrograde thrombolytic intervention for CRAO. MATERIAL AND METHODS Fifty patients with monocular CRAO were enrolled, including 28 males and 22 females (mean age: 55...
January 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28057998/cisplatin-and-bleomycin-induced-acute-peripheral-vascular-stenosis-in-patient-with-testicular-cancer
#8
Tayyar Alp Ozkan, Ufuk Aydin, Derih Ay, I Oguz Ozden Cebeci
After cisplatin and bleomycin-containing chemotherapy (CTx) for testicular cancer, part of the patients may develop acute or long-term cardiovascular toxicity. In the present case, we reported that a 58-year-old male patient presenting with testicular tumors who developed acute peripheral arterial disease during combination CTx with bleomycin, etoposide, and cisplatin. Superficial femoral artery occlusion not responded to structure thrombolytic and anticoagulators treatment. Left lower extremity was amputated below knee...
October 2016: Urology Annals
https://www.readbyqxmd.com/read/28051251/observation-of-clinical-efficacy-of-rt-pa-intravenous-thrombolytic-treatment-for-patients-combined-with-grade-0-1-diabetic-foot-by-wagner-classification-and-acute-ischemic-stroke
#9
C-H Li, Y Chen, C-H Zhang, Z Dong, Z Wang, S-N Zhao, Y-X Wang, Z-Y Lv, P-L Zhang
OBJECTIVE: To evaluate the safety and efficacy of rt-PA intravenous thrombolytic treatment for patients with diabetic foot (DF) and acute ischemic stroke. PATIENTS AND METHODS: A retrospective analysis was performed on 76 patients admitted between June 2012 to December 2015 presenting with acute ischemic stroke and Grade 0-1 DF a (Wagner classification). The treatment group consisted of 44 patients who received rt-PA intravenous thrombolytic treatment, while 32 cases in the control group did not...
December 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28025592/mortality-related-risk-factors-in-high-risk-pulmonary-embolism-in-the-icu
#10
Begüm Ergan, Recai Ergün, Taner Çalışkan, Kutlay Aydın, Murat Emre Tokur, Yusuf Savran, Uğur Koca, Bilgin Cömert, Necati Gökmen
Introduction. We sought to identify possible risk factors associated with mortality in patients with high-risk pulmonary embolism (PE) after intensive care unit (ICU) admission. Patients and Methods. PE patients, diagnosed with computer tomography pulmonary angiography, were included from two ICUs and were categorized into groups: group 1 high-risk patients and group 2 intermediate/low-risk patients. Results. Fifty-six patients were included. Of them, 41 (73.2%) were group 1 and 15 (26.7%) were group 2. When compared to group 2, need for vasopressor therapy (0 vs 68...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28008093/arterial-obstruction-on-computed-tomographic-or-magnetic-resonance-angiography-and-response-to-intravenous-thrombolytics-in-ischemic-stroke
#11
Grant Mair, Rüdiger von Kummer, Alessandro Adami, Philip M White, Matthew E Adams, Bernard Yan, Andrew M Demchuk, Andrew J Farrall, Robin J Sellar, Eleni Sakka, Jeb Palmer, David Perry, Richard I Lindley, Peter A G Sandercock, Joanna M Wardlaw
BACKGROUND AND PURPOSE: Computed tomographic angiography and magnetic resonance angiography are used increasingly to assess arterial patency in patients with ischemic stroke. We determined which baseline angiography features predict response to intravenous thrombolytics in ischemic stroke using randomized controlled trial data. METHODS: We analyzed angiograms from the IST-3 (Third International Stroke Trial), an international, multicenter, prospective, randomized controlled trial of intravenous alteplase...
December 22, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28005024/a-global-perspective-on-mechanical-prosthetic-heart-valve-thrombosis-diagnostic-and-therapeutic-challenges
#12
Mustafa Ozan Gürsoy, Macit Kalçık, Mahmut Yesin, Süleyman Karakoyun, Emrah Bayam, Sabahattin Gündüz, Mehmet Özkan
Prosthetic valve thrombosis is one of the major causes of primary valve failure, which can be life-threatening. Multimodality imaging is necessary for determination of leaflet immobilization, cause of underlying pathology (thrombus versus pannus or both), and whether thrombolytic therapy attempt in the patient would be successful or surgery is needed. Current guidelines for the management of prosthetic valve thrombosis lack definitive class I recommendations due to lack of randomized controlled trials, and usually leave the choice of treatment to the clinician's experience...
December 2016: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28004056/fc-saxatilin-a-snake-venom-disintegrin-suppresses-hypoxia-induced-vascular-leakage-by-regulating-endothelial-occludin-expression
#13
Hyun-Jung Choi, Il Kwon, Na-Eun Kim, Jayoung Kim, Sunho An, Sungsoo Kang, Sung-Yu Hong, Hyo Suk Nam, Ji Hoe Heo
Vascular leakage due to compromised integrity of the endothelial barrier is closely associated with brain damage in several neurological disorders, including ischaemic stroke. Saxatilin, a snake venom disintegrin containing the Arg-Gly-Asp (RGD) motif, exerts thrombolytic and antiplatelet effects by interacting with multiple integrins on platelets. Integrin signalling is indispensable for regulation of endothelial permeability. Saxatilin may play a role in vascular leakage after ischaemia because it has high affinity for endothelial integrins...
December 22, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28002053/in-vitro-thrombolytic-efficacy-of-echogenic-liposomes-loaded-with-tissue-plasminogen-activator-and-octafluoropropane-gas
#14
Himanshu Shekhar, Kenneth B Bader, Shenwen Huang, Tao Peng, Shaoling Huang, David D McPherson, Christy K Holland
Echogenic liposomes loaded with the thrombolytic recombinant tissue-type plasminogen activator (rt-PA) are under development for the treatment of ischemic stroke. These agents are designed to co-encapsulate cavitation nuclei to promote bubble activity in response to ultrasound exposure, and to enable localized delivery of thrombolytic. Stable cavitation improves the efficacy of the thrombolytic through enhanced fluid mixing. Echogenic liposomes that encapsulate air-filled microbubbles nucleate scant stable cavitation activity in response to 120 kHz intermittent ultrasound exposure, and have demonstrated thrombolytic efficacy equivalent to rt-PA alone...
December 21, 2016: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28000492/successful-thrombolytic-therapy-in-a-patient-with-congenital-corrected-transposition-of-the-great-arteries
#15
Selcuk Ozturk, Fatma Erdem, Serkan Ozturk, Selim Ayhan
OBJECTIVE: The aim of this report is to emphasize the importance of thrombolytic therapy in selected patients, such as those with congenital heart defects in whom a coronary artery anomaly can be observed. CASE REPORT: We present here a 63 year-old female patient who was admitted to our emergency department with ST segment elevation myocardial infarction and a history of a congenital heart defect. We treated the patient successfully with thrombolytic therapy instead of primary percutaneous intervention, because of the suspicion of a coronary artery anomaly...
November 2016: Acta Medica Academica
https://www.readbyqxmd.com/read/27992822/thrombolytic-treatment-to-stroke-mimic-patients-via-telestroke
#16
Ganesh Asaithambi, Amy L Castle, Michael A Sperl, Jayashree Ravichandran, Aditi Gupta, Bridget M Ho, Sandra K Hanson
OBJECTIVE: The safety and outcomes of intravenous thrombolysis (IVT) to stroke patients via telestroke (TS) is similar to those presenting to stroke centers. Little is known on the accuracy of TS diagnosis among those receiving IVT. We sought to compare the rate of patients receiving IVT with diagnosis of ischemic stroke as opposed to stroke mimic (SM) in our TS network to those who presented to our comprehensive stroke center (CSC). MATERIALS AND METHODS: Consecutive patients receiving IVT between August 2014 and June 2015 were identified at our CSC and TS network...
December 14, 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27984314/medical-management-of-pump-related-thrombosis-in-patients-with-continuous-flow-left-ventricular-assist-devices-a-systematic-review-and-meta-analysis
#17
Geetanjali Dang, Narendranath Epperla, Vijayadershan Mupiddi, Natasha Sahr, Amy Pan, Pippa Simpson, Lisa Baumann Kreuziger
Pump thrombosis is a dreaded complication of left ventricular assist device (LVADs). We completed a systematic review to evaluate the efficacy and complications associated with medical management of LVAD thrombosis. Databases were searched using the terms "vad*" or "ventricular assist device" or "heart assist device" and "thrombus" or "thrombosis" or "thromboembolism". Of 2383 manuscripts, 49 articles met the inclusion criteria. The risk of partial or no resolution of LVAD thrombosis did not significantly differ between thrombolytic and non-thrombolytic regimens (OR 0...
December 13, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27972016/effectiveness-and-safety-of-thrombolytic-agents-streptokinase-alteplase-and-tenecteplase-in-the-treatment-of-acute-myocardial-infarction
#18
B O Ascef, J B Izidoro, A M Almeida, A F Bahia Neto, A A Guerra Júnior, F A Acurcio
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27941589/treatment-of-stroke-with-early-imaging-and-revascularization-when-to-be-aggressive
#19
Danilo Toni, Alessio Pieroni
Neuroimaging has a key role in the assessment and treatment of acute stroke. Cerebral computer tomography is the first step to differentiate hemorragic from ischemic stroke and to detect, in the latter, early signs representative of the lesion severity and predicting a possible hemorrhagic infarction after thrombolytic treatment.Advanced neuroimaging techniques are relevant in the assessment of the ischemic and/or hypo-perfused area, being an essential tool in uncertain situations or when the time of symptoms onset is unavailable, increasing the efficacy and safety of endovenous thrombolysis by enlarging its therapeutic window and leading to more accurate selection of patients to be treated...
December 9, 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/27932197/crucial-role-of-carotid-ultrasound-for-the-rapid-diagnosis-of-hyperacute-aortic-dissection-complicated-by-cerebral-infarction-a-case-report-and-literature-review
#20
Eglė Sukockienė, Kristina Laučkaitė, Antanas Jankauskas, Dalia Mickevičienė, Giedrė Jurkevičienė, Antanas Vaitkus, Edgaras Stankevičius, Kęstutis Petrikonis, Daiva Rastenytė
Aortic dissection is a life-threatening rare condition that may virtually present by any organ system dysfunction, the nervous system included. Acute cerebral infarction among multiple other neurological and non-neurological presentations is part of this acute aortic syndrome. Rapid and correct diagnosis is of extreme importance keeping in mind the possibility of thrombolytic treatment if a patient with a suspected ischemic stroke arrives to the Emergency Department within a 4.5-h window after symptom onset...
2016: Medicina
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