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https://www.readbyqxmd.com/read/28727358/-antiplatelet-therapy-in-secondary-stroke-prevention
#1
Lorenz Hirt, Emmanuel Carrera
New studies have refined the role of antiplatelet therapy in secondary prevention after noncardioembolic strokes. The first line antiplatelet therapy remains Aspirin. Clopidogrel and the combination aspirine plus dipyridamole are suitable alternatives with a slightly better protection. Ticagrelor, a reversible P2Y12 receptor inhibitor used in cardiology, has not demonstrated its superiority to Aspirin. Early after stroke, a double antiplatelet therapy combining Aspirin and clopidogrel is increasingly administered as a recent study demonstrated a decrease in the incidence of cerebrovascular events after a minor stroke or high-risk TIA...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28727357/-spontaneous-carotid-and-vertebral-dissections
#2
Roman Sztajzel, Fabienne Perren, Patrik Michel
Dissections of the cervical arteries account for approximately 15-20 % of all strokes in young patients. Clinically they present with laterocervical and/or hemicranial pain associated to a Horner syndrome in case of carotid dissection and a posterior cervical pain associated to headache in the occipital area in case of vertebral dissection. A multifactorial origin is often suggested, resulting from the combination of a weakness of the arterial wall, hereditary or not, of environmental factors such minor trauma or a previous infection and also of the presence of a certain number of vascular risk factors such as high blood pressure or migraines...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28723649/observation-of-elevated-fasting-blood-glucose-and-functional-outcome-after-ischemic-stroke-in-patients-with-and-without-diabetes
#3
Wen-Yu Xue, Yan-Cheng Xu, Yu-Wen Wu, Miao Yang
During May 2015 to October 2016, this prospective study enrolled a total of 438 patients with acute ischemic stroke(AIS), meanwhile, records regarding the severity of initial stroke and neurological outcomes at three months, as well as other examination were completed in patients on admission, as well as the measurement and evaluation of fasting blood glucose(FBG) levels. At admission, the median FBG levels in patients with a minor stroke (n=124), [P<0.001]) was significantly lower than that observed in patients with other degrees of stroke...
July 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28721323/endovascular-management-of-stroke-patients-with-large-vessel-occlusion-and-minor-stroke-symptoms
#4
REVIEW
Saeed A Alqahtani, Andrew B Stemer, Michael F McCullough, Randy S Bell, Jeffrey Mai, Ai-Hsi Liu, Rocco A Armonda
Endovascular mechanical thrombectomy for stroke patients with large vessel occlusion (LVO) in the anterior circulation has become the standard of care based on several major randomized clinical trials. The successful result reported by these trials constitutes what may be the largest achievement in the history of neurological sciences. However, most of these mechanical thrombectomy trials (except for the multicenter randomized clinical trial of endovascular treatment for acute ischemic stroke in the Netherlands, i...
June 15, 2017: Curēus
https://www.readbyqxmd.com/read/28720568/serine-proteases-of-the-complement-lectin-pathway-and-their-genetic-variations-in-ischaemic-stroke
#5
Gohar Tsakanova, Ani Stepanyan, Karen Nahapetyan, Robert B Sim, Arsen Arakelyan, Anna Boyajyan
AIMS: The aim of the current study was to assess the proteolytic activities of collectin-bound MASP-1 and MASP-2 in the blood of patients with ischaemic stroke, as well as the association of their six genetic polymorphisms (rs3203210, rs28945070, rs28945073 in MASP1 gene and rs2273343, rs12711521, rs147270785 in MASP2 gene) with this pathology. METHODS: In total, 250 patients and 300 healthy subjects were involved in this study. MBL-associated serine protease (MASP)-1 and MASP-2 activities were measured using in-house developed immunofluorescent and enzyme-linked immunosorbent assays, respectively...
July 18, 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28717529/daily-variation-in-the-occurrence-of-different-subtypes-of-stroke
#6
Luciana Ripamonti, Roberto Riva, Fabiola Maioli, Corrado Zenesini, Gaetano Procaccianti
Three thousand two hundred and ninety-eight patients admitted to our Stroke Unit with hemorrhagic, large artery atherosclerosis, cardioembolic, small-vessel occlusion, and undetermined etiology-cryptogenic strokes were included in the study. The circadian variability in onset in each stroke subgroup and the associations with various risk factors were analyzed. In each subgroup, a significant minority of patients suffered from stroke during sleep. In the ischemic group, hypercholesterolemia, paroxysmal atrial fibrillation, and previous myocardial infarction facilitated the onset during waking...
2017: Stroke Research and Treatment
https://www.readbyqxmd.com/read/28716248/interleukin-6-il-6-rs1800796-and-cyclin-dependent-kinase-inhibitor-cdkn2a-cdkn2b-rs2383207-are-associated-with-ischemic-stroke-in-indigenous-west-african-men
#7
Rufus Akinyemi, Donna K Arnett, Hemant K Tiwari, Bruce Ovbiagele, Fred Sarfo, Vinodh Srinivasasainagendra, Marguerite Ryan Irvin, Abiodun Adeoye, Rodney T Perry, Albert Akpalu, Carolyn Jenkins, Lukman Owolabi, Reginald Obiako, Kolawole Wahab, Emmanuel Sanya, Morenikeji Komolafe, Michael Fawale, Philip Adebayo, Godwin Osaigbovo, Taofiki Sunmonu, Paul Olowoyo, Innocent Chukwuonye, Yahaya Obiabo, Onoja Akpa, Sylvia Melikam, Raelle Saulson, Raj Kalaria, Adesola Ogunniyi, Mayowa Owolabi
BACKGROUND: Inherited genetic variations offer a possible explanation for the observed peculiarities of stroke in sub - Saharan African populations. Interleukin-6 polymorphisms have been previously associated with ischemic stroke in some non-African populations. AIM: Herein we investigated, for the first time, the association of genetic polymorphisms of IL-6, CDKN2A- CDKN2B and other genes with ischemic stroke among indigenous West African participants in the Stroke Investigative Research and Education Network (SIREN) Study...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28708869/long-term-efficacy-and-safety-of-carotid-artery-stenting-versus-endarterectomy-a-meta-analysis-of-randomized-controlled-trials
#8
Yang Li, Jing-Jing Yang, Su-Hui Zhu, Biao Xu, Lian Wang
BACKGROUND: Many recent trials have investigated the long-term efficacy and safety of endarterectomy versus stenting in treating patients with carotid artery stenosis. We aimed to determine the long-term comparative efficacy and safety of both procedures by pooling this evidence in a meta-analysis. METHODS: We searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials for studies published until May 6, 2016. Randomized controlled trials, which reported outcomes of interest with a median follow-up of at least 4-year, were included...
2017: PloS One
https://www.readbyqxmd.com/read/28702120/inpatient-versus-outpatient-management-of-tia-or-minor-stroke-clinical-outcome
#9
Shahram Majidi, Christopher R Leon Guerrero, Kathleen M Burger, John F Rothrock
BACKGROUND: The management of patients with acute transient ischemic attack (TIA) or minor stroke is highly variable. Whether hospitalization of such patients significantly improves short-term clinical outcome is unknown. We assessed the short-term clinical outcome associated with inpatient versus outpatient management of patients with TIA or minor stroke. METHODS: We evaluated a consecutive series of patients with acute TIA or minor ischemic stroke (NIH Stroke Scale score ≤ 3) presenting to a single emergency department (ED)...
June 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/28700299/chronic-health-conditions-and-key-health-indicators-among-lesbian-gay-and-bisexual-older-us-adults-2013-2014
#10
Karen I Fredriksen-Goldsen, Hyun-Jun Kim, Chengshi Shui, Amanda E B Bryan
OBJECTIVES: To examine disparities in chronic conditions and health indicators among lesbian, gay, and bisexual (LGB) adults aged 50 years or older in the United States. METHODS: We used data from the 2013 and 2014 National Health Interview Survey to compare disparities in chronic conditions, health outcomes and behaviors, health care access, and preventive health care by sexual orientation and gender. RESULTS: LGB older adults were significantly more likely than heterosexual older adults to have a weakened immune system and low back or neck pain...
August 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28697941/early-outcomes-of-the-conformable-stent-graft-for-acute-complicated-and-uncomplicated-type-b-aortic-dissection
#11
Ting Zhu, Yi Si, Yuan Fang, Bin Chen, Jue Yang, Junhao Jiang, Jianing Yue, Weiguo Fu
OBJECTIVE: The objective of this study was to evaluate the safety, efficacy, and outcomes of the conformable thoracic endograft (Conformable TAG Thoracic Endoprosthesis [CTAG]; W. L. Gore & Associates, Flagstaff, Ariz) for acute complicated and uncomplicated type B aortic dissection (TBAD). METHODS: Between February and October 2016, 52 consecutive patients with acute complicated or uncomplicated TBAD were treated with a CTAG device. We assessed safety, complications, and device conformability using intraoperative angiography and computed tomography angiography...
July 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28697574/tdcs-does-not-enhance-the-effects-of%C3%A2-robot-assisted-gait-training-in-patient-with%C3%A2-subacute-stroke
#12
Daniel Leon, Mar Cortes, Jessica Elder, Hatice Kumru, Sara Laxe, Dylan James Edwards, Josep Maria Tormos, Montserrat Bernabeu, Alvaro Pascual-Leone
BACKGROUND: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique, which can modulate cortical excitability and combined with rehabilitation therapies may improve motor recovery after stroke. OBJECTIVE: Our aim was to study the feasibility of a 4-week robotic gait training protocol combined with tDCS, and to study tDCS to the leg versus hand motor cortex or sham to improve walking ability in patients after a subacute stroke...
July 6, 2017: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/28691908/high-pressure-balloon-fracturing-of-small-dysfunctional-mitroflow-bioprostheses-facilitates-transcatheter-aortic-valve-in-valve-implantation
#13
Jens Erik Nielsen-Kudsk, Asger Andersen, Christian Juhl Therkelsen, Evald Høj Christensen, Kaare Troels Jensen, Lars Romer Krusell, Mariann Tang, Kim Allan Terp, Kaj-Erik Klaaborg, Jacob Raben Greisen, Bjarne Linde Nørgaard, Henning Rud Andersen
AIMS: Transcatheter valve-in-valve (VIV) implantation in small surgical tissue valves is challenged by the problem of residual stenosis. We report our first ten cases of fracturing small dysfunctional Mitroflow bioprostheses by high-pressure balloon dilatation to increase the internal diameter of the surgical valve before VIV (BF-VIV). METHODS AND RESULTS: BF-VIV was performed in 10 patients (mean age 84±4 years) with failing Mitroflow valves size 19 mm (n=3, threshold of fracture 15 atm) and 21 mm (n=7, threshold of fracture 13 atm)...
July 11, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28688833/balloon-aortic-valvuloplasty-in-the-transcatheter-valve-era-single-centre-indications-and-early-safety-data-in-a-high-risk-population
#14
Thomas J Ford, Katherine Nguyen, Joseph Brassil, Virag Kushwaha, Daniel Friedman, Roger Allan, Mark Pitney, Nigel Jepson
BACKGROUND: The introduction of transcatheter aortic valve implantation (TAVI) has generated a renewed interest in the techniques available to treat high-risk patients with severe aortic stenosis (AS). We report our single centre experience with balloon aortic valvuloplasty (BAV) focussing on indications, procedural success and 30-day outcomes. METHODS: We retrospectively reviewed all patients that underwent BAV procedures at our institution between August 2012 and August 2014...
June 2, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28687470/carotid-body-tumors-surgical-experience-in-215-cases
#15
Luis A Pacheco-Ojeda
INTRODUCTION: Carotid body tumors (CBT) are very unusual neck lesions. However, at high altitudes, they are less rarely found. This study intended to review our experience in diagnosis and surgical treatment of these lesions. MATERIALS AND METHODS: Among 242 clinically diagnosed CBT, 215 tumors, arising in and retrospectively studied. All patients came from the Andean plateaux. Mean age was 52.5 years, 180 were females, and mean size was 4.21 cm. Shamblin type distribution, described in 187 patients, was: Type I 29(15%), type II 118(63%) and type III 40(22%)...
June 13, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28686338/early-versus-late-applied-constraint-induced-movement-therapy-a-multisite-randomized-controlled-trial-with-a-12-month-follow-up
#16
Roland Stock, Gyrd Thrane, Audny Anke, Ragna Gjone, Torunn Askim
BACKGROUND AND PURPOSE: A direct comparison between the effects of constraint-induced movement therapy (CIMT) applied early after stroke and that of CIMT applied in the chronic phase has not been conducted. This study aimed to compare the long-term effects of CIMT applied 6 months after stroke with the results of CIMT applied within 28 days post-stroke. METHODS: This study was a single-blinded, multicentre, randomized controlled trial with a crossover design. Forty-seven patients received CIMT either early (within 28 days) or 6 months after stroke...
July 7, 2017: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
https://www.readbyqxmd.com/read/28680314/physical-activity-level-of-ambulatory-stroke-patients-is-it-related-to-neuropsychological-factors
#17
Burcu Ersöz Hüseyinsinoğlu, Gökşen Kuran Aslan, Devrim Tarakci, Arzu Razak Özdinçler, Hayriye Küçükoğlu, Sevim Baybaş
INTRODUCTION: Physical inactivity is an important risk factor for stroke and stroke recurrence. There is insufficient knowledge about the physical activity (PA) level in stroke patients who are ambulatory in the subacute phase. Our aim was to compare the PA level between ambulatory stroke patients and a population of the same age and to investigate neuropsychological factors that could affect the PA level in the same stroke group. METHODS: Eighty-five subacute stroke patients and 58 healthy subjects were included...
June 2017: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/28674626/implications-of-the-pegasus-timi-54-trial-for-us-clinical-practice
#18
Steven M Bradley, Gregory P Hess, Patrick Stewart, Ehrin J Armstrong, Steven A Farmer, Jason H Wasfy, Javier Alfonso Valle, Amneet Sandhu, Thomas M Maddox
OBJECTIVES: This study aims to determine the proportion of real-world patients with myocardial infarction (MI) who would have been eligible for the PEGASUS-TIMI 54 (Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54) trial, to characterise their current use of P2Y12 inhibitors and to explore the estimated costs and ischaemic event consequences of increasing P2Y12 inhibitor use among these patients...
2017: Open Heart
https://www.readbyqxmd.com/read/28674141/a-cohort-study-on-physician-documentation-and-the-accuracy-of-administrative-data-coding-to-improve-passive-surveillance-of-transient-ischaemic-attacks
#19
Amy Y X Yu, Hude Quan, Andrew D McRae, Gabrielle O Wagner, Michael D Hill, Shelagh B Coutts
BACKGROUND: Administrative health data are valuable in health research and disease surveillance, but have low to moderate sensitivity in identifying transient ischaemic attacks (TIA) in the emergency department (ED). We aimed to identify the predictors of coding accuracy for TIA. METHODS: The study population was obtained from two ongoing studies on the diagnosis of TIA, minor stroke and stroke mimic. ED charts were manually reviewed by a stroke neurologist to obtain the clinical diagnosis, patient characteristics and content of physician documentation...
July 2, 2017: BMJ Open
https://www.readbyqxmd.com/read/28673508/comparison-of-prasugrel-versus-clopidogrel-in-korean-patients-with-acute-myocardial-infarction-undergoing-successful-revascularization
#20
Keun-Ho Park, Myung Ho Jeong, Hyun Kuk Kim, Tae Hoon Ahn, Ki Bae Seung, Dong Joo Oh, Dong-Joo Choi, Hyo-Soo Kim, Hyeon Cheol Gwon, In Whan Seong, Kyung Kuk Hwang, Shung Chull Chae, Kwon-Bae Kim, Young Jo Kim, Kwang Soo Cha, Seok Kyu Oh, Jei Keon Chae
BACKGROUND: Although there have been several reports that prasugrel can improve clinical outcomes, the efficacy and safety of prasugrel is unknown in Korean patients with acute myocardial infarction (AMI) undergoing successful revascularization. METHODS: A total of 4421 patients [637 patients were prescribed prasugrel (60/10 or 5mg, loading/maintenance dose) and 3784 patients clopidogrel (600 or 300/75mg)] with AMI undergoing successful revascularization were enrolled from the core clinical cohort of Korea Acute Myocardial Infarction Registry-National Institute of Health...
June 30, 2017: Journal of Cardiology
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