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https://www.readbyqxmd.com/read/29141075/treatment-for-livedoid-vasculopathy-a-systematic-review
#1
Robert Micieli, Afsaneh Alavi
Importance: Livedoid vasculopathy is a painful, ulcerative condition of the lower extremities for which no established treatment exists. Current treatment paradigms rely on low levels of evidence, primarily case reports and case series. Objective: To systematically review the treatment for livedoid vasculopathy and synthesize the available clinical data. Evidence Review: A systematic review of the literature using Ovid MEDLINE (covering the period January 1, 1946, through June 9, 2017) and Ovid EMBASE (covering January 1, 1947, through June 9, 2017) databases was performed with a broad and inclusive search strategy along with a subsequent search of the references of retrieved articles...
November 15, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/29137061/low-free-triiodothyronine-levels-predict-symptomatic-intracranial-hemorrhage-and-worse-short-term-outcome-of-thrombolysis-in-patients-with-acute-ischemia-stroke
#2
Mingjing Qiu, Min Fang, Xueyuan Liu
The aim of the study was to determine whether thyroid hormones level on admission in patients with ischemic stroke, treated with intravenous recombinant tissue type plasminogen activator (rtPA), was associated with symptomatic intracranial hemorrhage (sICH) and worse outcomes at 3 months.Patients with acute ischemic stroke (AIS) receiving intravenous rtPA thrombolytic treatment on our stroke unit between January 2015 and June 2016 were included in this study. Serum-free triiodothyronine (fT3), free thyroxine (fT4), total triiodothyronine (tT3), total thyroxine (tT4), and thyroid-stimulating hormone (TSH) were detected on admission...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29134925/effects-of-ssri-exposure-on-hemorrhagic-complications-and-outcome-following-thrombolysis-in-ischemic-stroke
#3
Schellen Christoph, Ferrari Julia, Lang Wilfried, Sykora Marek
Background Selective serotonin reuptake inhibitors (SSRI) may interfere with platelet function, and pre-stroke SSRI treatment has been associated with increased hematoma volumes and mortality in hemorrhagic stroke patients. The effects of SSRI on the risk of hemorrhagic complications after thrombolysis in ischemic stroke patients are unclear. Aims To examine the effects of pre-stroke SSRI exposure on bleeding complications, functional outcome, and mortality following thrombolysis in ischemic stroke. Methods Data including standard demographic and clinical variables as well as baseline and follow-up stroke severity (measured by National Institutes of Health Stroke Score), functional outcome (measured by modified Rankin Scale) at 3 months, and mortality at 7 and 90 days were extracted from the Virtual International Stroke Trials Archive...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29133696/the-influence-of-initial-stroke-severity-on-mortality-overall-functional-outcome-and-in-hospital-placement-at-90-days-following-acute-ischemic-stroke-a-tertiary-hospital-stroke-register-study
#4
Sonu Bhaskar, Peter Stanwell, Andrew Bivard, Neil Spratt, Rhonda Walker, Gemma H Kitsos, Mark W Parsons, Malcolm Evans, Louise Jordan, Michael Nilsson, John Attia, Christopher Levi
BACKGROUND AND PURPOSE: Epidemiological studies on the extent of the interaction and/or influence of stroke severity on clinical outcomes are important. The aim of the present study was to investigate the putative (and degree of) impact of initial stroke severity in predicting the overall functional outcome, in-hospital placement, and mortality in acute ischemic stroke (AIS) in comparison with age, admission to the stroke unit and thrombolytic treatment. MATERIALS AND METHODS: The John Hunter Hospital acute stroke register was used to collect a retrospective cohort of AIS patients being assessed for reperfusion therapy and admitted between January 2006 and December 2013...
November 2017: Neurology India
https://www.readbyqxmd.com/read/29132832/the-proposed-concordance-statistic-for-benefit-provided-a-useful-metric-when-modeling-heterogeneous-treatment-effects
#5
David van Klaveren, Ewout W Steyerberg, Patrick W Serruys, David M Kent
OBJECTIVES: Clinical prediction models that support treatment decisions are usually evaluated for their ability to predict the risk of an outcome rather than treatment benefit - the difference between outcome risk with versus without therapy. We aimed to define performance metrics for a model's ability to predict treatment benefit. STUDY DESIGN AND SETTING: We analyzed data of the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) trial, and of 3 recombinant tissue plasminogen activator trials...
November 10, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29128152/intravenous-thrombolytic-therapy-for-acute-anterior-ischemic-stroke-experience-at-the-french-military-teaching-hospital-in-toulon-from-2003-to-2014
#6
P Sahuc-Rodrigues, E Sagui, D Wybrecht, J-B Veyrières, S Gazzola, A Dagain, J Valance, P Alla, A Faivre
INTRODUCTION: Intravenous thrombolysis with rt-PA is the key treatment for acute ischemic stroke (IS), and has largely been developed at the Military Teaching Hospital in Toulon since 2003. This report is of the results of our practices compared with those in the literature, as well as our attempts to identify factors predictive of a favorable outcome after thrombolysis. METHODS: All patients treated with rt-PA for IS in the carotid territory between 2003 and 2014 were prospectively included...
November 8, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/29127268/sickle-mice-are-sensitive-to-hypoxia-ischemia-induced-stroke-but-respond-to-tissue-type-plasminogen-activator-treatment
#7
Yu-Yo Sun, Jolly Lee, Henry Huang, Mary B Wagner, Clinton H Joiner, David R Archer, Chia-Yi Kuan
BACKGROUND AND PURPOSE: The effects of lytic stroke therapy in patients with sickle cell anemia are unknown, although a recent study suggested that coexistent sickle cell anemia does not increase the risk of cerebral hemorrhage. This finding calls for systemic analysis of the effects of thrombolytic stroke therapy, first in humanized sickle mice, and then in patients. There is also a need for additional predictive markers of sickle cell anemia-associated vasculopathy. METHODS: We used Doppler ultrasound to examine the carotid artery of Townes sickle mice tested their responses to repetitive mild hypoxia-ischemia- and transient hypoxia-ischemia-induced stroke at 3 or 6 months of age, respectively...
November 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29122207/-massive-pulmonary-embolism-when-medical-treatment-is-not-enough
#8
B Gerardin, M Glorion, A Rodriguez, C Garcia, F Stephan, D Fabre, O Mercier, P Brenot, E Fadel
Emergency bedside veno-arterious ECMO implantation can be the only saving gesture in the suspicion of acute massive pulmonary embolism leading to haemodynamic failure, even before CT-scan imaging. Once the massive pulmonary embolism is confirmed it is possible to undergo surgical or percutaneous pulmonary thrombectomy, when thrombolytic therapy is contraindicated.
November 6, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29111332/floating-right-heart-thrombi-a-pooled-analysis-of-cases-reported-over-the-past-10years
#9
Lucrecia María Burgos, Juan Pablo Costabel, Victoria Galizia Brito, Alan Sigal, Daniela Maymo, Ana Iribarren, Marcelo Trivi
INTRODUCTION: Floating right heart thrombi (FRHTS) are a rare phenomenon associated with high mortality. Immediate treatment is mandatory, but optimal therapy is controversial. OBJECTIVE: To compare the clinical characteristics according to different treatment strategies and to identify predictors of mortality on patients with FRHTS. METHODS: We conducted a systematic search of reported clinical cases of TTRH from 2006 to 2016. RESULTS: 207 patients were analyzed, median age was 60years, 51...
October 19, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29107671/evaluation-of-the-effects-of-a-new-series-of-smtps-in-the-acetic-acid-induced-embolic-cerebral-infarct-mouse-model
#10
Keita Shibata, Terumasa Hashimoto, Keiji Hasumi, Kazuo Honda, Koji Nobe
We reported previously that Stachybotrys microspora triprenyl phenol-7 (SMTP-7) showed potential thrombolytic, anti-inflammatory and anti-oxidant effects that account for its excellent pharmacological activity such as having a wider therapeutic time window than tissue plasminogen activator (t-PA) and a significant protection against hemorrhage. The aim of the present study was to evaluate and compare the effect of a new series of SMTPs in the acetic acid-induced embolic cerebral infarct mouse model. Thrombotic occlusion was produced in mice by inducing the transfer of acetic acid-induced thrombi from the right common carotid artery into the brain...
October 28, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/29101990/acr-appropriateness-criteria-%C3%A2-iliac-artery-occlusive-disease
#11
Alexander Z Copelan, Baljendra S Kapoor, Ali F AbuRahma, Thomas R Cain, Drew M Caplin, Khashayar Farsad, M-Grace Knuttinen, Margaret H Lee, Joseph J McBride, Jeet Minocha, Stephen P Reis, Paul J Rochon, Colette M Shaw, Jonathan M Lorenz
Iliac artery occlusive disease can present as a sudden-onset acute thrombotic or thromboembolic event or as a chronic progressive atherosclerotic process that presents as claudication progressing to rest pain. Depending on the clinical presentation, the diagnosis is usually confirmed through Doppler vascular ultrasound, CT angiography, or MR angiography; the choice of imaging is usually based on modality availability and the presence of patient comorbidities such as chronic kidney disease. The Trans-Atlantic Inter-Society Consensus II classification system is commonly used to describe the extent of the peripheral vascular disease...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29097489/treatment-and-outcome-of-hemorrhagic-transformation-after-intravenous-alteplase-in-acute-ischemic-stroke-a-scientific-statement-for-healthcare-professionals-from-the-american-heart-association-american-stroke-association
#12
REVIEW
Shadi Yaghi, Joshua Z Willey, Brett Cucchiara, Joshua N Goldstein, Nicole R Gonzales, Pooja Khatri, Louis J Kim, Stephan A Mayer, Kevin N Sheth, Lee H Schwamm
PURPOSE: Symptomatic intracranial hemorrhage (sICH) is the most feared complication of intravenous thrombolytic therapy in acute ischemic stroke. Treatment of sICH is based on expert opinion and small case series, with the efficacy of such treatments not well established. This document aims to provide an overview of sICH with a focus on pathophysiology and treatment. METHODS: A literature review was performed for randomized trials, prospective and retrospective studies, opinion papers, case series, and case reports on the definitions, epidemiology, risk factors, pathophysiology, treatment, and outcome of sICH...
November 2, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29097267/spontaneous-neonatal-renal-vein-thromboses-should-we-treat-them-all-a-report-of-five-cases-and-a-literature-review
#13
François Niada, René Tabin, Simon Kayemba-Kay's
Renal vein thrombosis (RVT) is a rare but well-known neonatal entity for which several therapeutic modalities are reported in the literature because of the lack of consensus management guidelines. POPULATION AND METHODS: A retrospective study of the medical records of children managed between January 1990 and December 2013, and whose final diagnosis was RVT. The diagnosis was initially clinical and subsequently confirmed by the abdominal ultrasonography (AUS) and Doppler imaging if necessary...
October 9, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29095323/thrombolytic-therapy-in-acute-ischemic-stroke-in-patients-not-fulfilling-conventional-criteria
#14
Man Sum Chi, Lok Yiu Chan
INTRODUCTION: There are many exclusion criteria in early randomized control trials for intravenous recombinant tissue plasminogen activator use in acute ischemic stroke, thus, many patients were not eligible for the treatment. OBJECTIVE: This study aimed to compare the safety and short-term treatment outcome between those who fulfilled the criteria and those who did not. METHODS: All acute ischemic stroke patients treated with intravenous thrombolysis from 2004 to 2015 in Tuen Mun hospital were recruited...
November 2017: Neurologist
https://www.readbyqxmd.com/read/29071134/solitaire-stent-in-the-treatment-of-acute-ischemic-stroke-with-large-cerebral-artery-occlusion
#15
Wenbao Liang, Zhijie Ou, Rui Luo
OBJECTIVE: To investigate the effect of mechanical thrombectomy with solitaire stent in the treatment of acute ischemic stroke with large cerebral artery occlusion. METHODS: Fifteen acute ischemic stroke patients with a proximal intracranial occlusion in the anterior circulation were included within 6 hours after symptom onset (unknown time of onset allowed in wake upstroke). Patients with a large infarct core or poor collateral circulation on computed tomography (CT) and CT angiography were excluded...
2017: Translational Neuroscience
https://www.readbyqxmd.com/read/29070134/-comparison-of-therapeutic-efficacy-of-anticoagulation-and-its-combination-with-catheter-directed-thrombolysis-for-deep-venous-thrombosis-of-lower-extremities
#16
Shao-Fei Su, Yu-Feng Tian, Lin-Bao Chen, Bo Yan
OBJECTIVE: To investigate the therapeutic efficacy of anticoagulation(AC) and its combination with catheter-directed thrombolysis(CDT) for deep venous thrombosis of lower extremities. METHODS: One hundred and thirty-nine patients with deep venous thrombosis of early lower extremities treated in our hospital from May 2011 to September 2013 were selected and randomly divided into the AC group(n= 66) and CDT+AC group(n= 73). The thrombolytic effects, adverse reactions, post-thrombotic syndrome (PTS) and quality of life were evaluated...
October 2017: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/29067093/stent-retriever-thrombectomy-combined-with-local-thrombolytic-therapy-for-cerebral-venous-sinus-thrombosis-a-case-report
#17
Chengwei Chen, Qiujing Wang, Xifeng Li, Ziming Lu, Jian He, Qinrui Fang, Xunchang Ke, Chuanzhi Duan, Tielin Li
The present study reports the effect of successful treatment of cerebral venous sinus thrombosis (CVST) with stent retriever thrombectomy combined with local thrombolytic therapy. Medical records of 29 patients were retrospectively analyzed following a diagnosis of CVST with magnetic resonance venography (MRV) or digital subtraction angiography (DSA). Systemic anticoagulation was the initial treatment in all patients following admission. In group A, stent retriever thrombectomy combined with local thrombolytic therapy was performed on 14 patients who met the criteria of endovascular therapy...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29058289/down-regulation-of-nox4-by-betulinic-acid-protects-against-cerebral-ischemia-reperfusion-in-mice
#18
Pei Lu, Chen-Chen Zhang, Xiao-Min Zhang, Hui-Ge Li, Ai-Lin Luo, Yu-Ke Tian, Hui Xu
Ischemic stroke leads to high potentiality of mortality and disability. The current treatment for ischemic stroke is mainly focused on intravenous thrombolytic therapy. However, ischemia/ reperfusion induces neuronal damage, which significantly influences the outcome of patients with ischemic stroke, and the exact mechanism implicated in ischemia/reperfusion injury remains unclear, although evidence shows that oxidative stress is likely to be involved. Betulinic acid is mainly known for its anti-tumor and anti-inflammatory activities...
October 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/29040276/the-impact-of-acute-kidney-injury-on-in-hospital-mortality-in-acute-ischemic-stroke-patients-undergoing-intravenous-thrombolysis
#19
Florica Gadalean, Mihaela Simu, Florina Parv, Ruxandra Vorovenci, Raluca Tudor, Adalbert Schiller, Romulus Timar, Ligia Petrica, Silvia Velciov, Cristina Gluhovschi, Flaviu Bob, Adelina Mihaescu, Bogdan Timar, Goce Spasovski, Viviana Ivan
INTRODUCTION: Acute kidney injury (AKI) increases the risk of death in acute ischemic stroke (AIS) patients. Intravenous thrombolytic therapy (iv. rt-PA) seems to be the most effective treatment for AIS patients. The effects of AKI on iv. rt-PA treated AIS cases is less studied. Our paper addresses this issue. METHODS: 45 consecutive stroke patients treated with iv. rt-PA (median age = 64 years; 29 male) and 59 age and sex matched controls not eligible for iv. rt-PA have been enrolled in our study...
2017: PloS One
https://www.readbyqxmd.com/read/29037581/pulmonary-embolism-due-to-exogenous-estrogen-intoxication
#20
Caner Çelik, Murat Carus, Fatih Büyükcam
OBJECTIVE: Pulmonary embolism is a relatively common clinical presentation of venous thromboembolism, which develops in relation to acute pulmonary arterial occlusion mostly caused by thrombi of the lower limbs. CASE REPORT: 29year old female admitted to emergency department with pulmonary thromboembolism due to an ingestion of 17 Diana 35 pills (2 mg cyproterone acetate and 0.035mg ethinyl estradiol) in a suicide attempt without any previously known predisposing factors...
August 18, 2017: American Journal of Emergency Medicine
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