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https://www.readbyqxmd.com/read/29150698/surgical-techniques-for-left-atrial-appendage-exclusion
#1
REVIEW
Sacha P Salzberg, Maximilian Y Emmert, Etem Caliskan
The increasing prevalence of atrial fibrillation with the aging population and its associated major morbidity and mortality due to thromboembolic stroke have resulted in intensive research on stroke prevention or stroke risk reduction strategies. Several surgical techniques for left atrial appendage (LAA) occlusion have evolved over the past decades. Surgeons have been using different techniques leading to highly variable and, in particular, poor data on outcomes. LAA closure is performed either as a concomitant procedure during open-heart surgery or as a stand-alone surgical procedure as part of minimally invasive (mini-thoracotomy or thoracoscopy) arrhythmia surgery...
November 17, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29148960/how-to-do-a-systematic-review
#2
Alex Pollock, Eivind Berge
High quality up-to-date systematic reviews are essential in order to help healthcare practitioners and researchers keep up-to-date with a large and rapidly growing body of evidence. Systematic reviews answer pre-defined research questions using explicit, reproducible methods to identify, critically appraise and combine results of primary research studies. Key stages in the production of systematic reviews include clarification of aims and methods in a protocol, finding relevant research, collecting data, assessing study quality, synthesizing evidence, and interpreting findings...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29147720/anticoagulation-in-atrial-fibrillation-current-evidence-and-guideline-recommendations
#3
J W Erath, S H Hohnloser
Atrial fibrillation (AF) is the most frequently encountered sustained arrhythmia with a prevalence of 0.5-10%, depending predominantly on age. The arrhythmia is associated with significant morbidity and mortality, mainly due to thromboembolic events including stroke and systemic embolisms. These complications can be effectively prevented with anticoagulation therapy either with vitamin K antagonists (VKA) or with non-vitamin K antagonists (NOAC). VKA therapy is effective in preventing strokes but these medications are difficult to use, are associated with significant bleeding risk, and have pharmacokinetic/dynamic properties that make their use cumbersome...
November 17, 2017: Herz
https://www.readbyqxmd.com/read/29146683/pcsk9-variants-ldl-cholesterol-and-neurocognitive-impairment-the-reasons-for-geographic-and-racial-differences-in-stroke-regards-study
#4
Matthew T Mefford, Robert S Rosenson, Mary Cushman, Michael E Farkouh, Leslie A McClure, Virginia G Wadley, Marguerite R Irvin, Vera A Bittner, Monika M Safford, Ransi Somaratne, Keri L Monda, Paul Muntner, Emily B Levitan
Background -Despite concerns about adverse neurocognitive events raised by prior trials, pharmacologic PCSK9 inhibition was not associated with neurocognitive effects in a recent phase 3 randomized trial. PCSK9 loss-of-function (LOF) variants that result in life-long exposure to low LDL-C can provide information on the potential long-term effects of low LDL-C on neurocognitive impairment and decline. Methods -We investigated the association between PCSK9 LOF variants and neurocognitive impairment and decline among African-American REasons for Geographic and Racial Differences in Stroke (REGARDS) study participants with (n=241) and without (n=10,454) C697X or Y142X LOF variants...
November 16, 2017: Circulation
https://www.readbyqxmd.com/read/29146627/single-session-versus-staged-procedures-for-elective-multivessel-percutaneous-coronary-intervention
#5
Toshiaki Toyota, Takeshi Morimoto, Hiroki Shiomi, Kyohei Yamaji, Kenji Ando, Koh Ono, Satoshi Shizuta, Naritatsu Saito, Takao Kato, Shuichiro Kaji, Yutaka Furukawa, Yoshihisa Nakagawa, Kazushige Kadota, Minoru Horie, Takeshi Kimura
OBJECTIVES: To clarify the effect of single-session multivessel percutaneous coronary intervention (PCI) strategy relative to the staged multivessel strategy on clinical outcomes in patients with stable coronary artery disease (CAD) or non-ST-elevation acute coronary syndrome. METHODS: In the Coronary REvascularisation Demonstrating Outcome Study in Kyoto PCI/coronary artery bypass grafting registry cohort-2, there were 2018 patients who underwent elective multivessel PCI...
November 16, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29145207/determinants-prevalence-and-trajectory-of-long-term-post-stroke-cognitive-impairment-results-from-a-4-year-follow-up-of-the-auckland-stroke-regional-outcomes-study-iv-study
#6
Susan Mahon, Priya Parmar, Suzanne Barker-Collo, Rita Krishnamurthi, Kelly Jones, Alice Theadom, Valery Feigin
BACKGROUND: The long-term (>12 months) prevalence, predictors, and trajectory of post-stroke cognitive deficits are not well established, especially at a community level. This study investigated the longitudinal course and prevalence of cognitive impairment in an incidence cohort, identifying factors associated with declining cognition. METHODS: Two hundred fifty-seven participants (mean age = 67.93 ± 13.59) of first-ever stroke survivors, completed cognitive assessments within 2 weeks post stroke, and/or 1, 6, 12, and 48-month...
November 16, 2017: Neuroepidemiology
https://www.readbyqxmd.com/read/29143099/-left-atrial-appendage-clusure-in-nonvalvular-atrial-fibrillation-clinical-evidence-2017
#7
REVIEW
Steffen Gloekler, Bajram Hajredini, Simon Rycerz, Sebastian Jäckle, Werner Jung
Nonvalvular atrial fibrillation (AF) is the most common arrhythmia with a prevalence of 1-2% and affects approximately 15-20% of all octogenarians. Patients are at increased risk of thromboembolic stroke, with an overall risk of 5% per year. Thrombi form almost exclusively in the left atrial appendage (LAA), a blind sac-like heterogeneous structure trabeculated by pectinate muscles. In the past five decades, life-long oral anticoagulation (OAC) with vitamin K antagonists (VKA) has been the state-of-the art treatment to prevent stroke and systemic embolism from thrombi in AF...
November 15, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29141890/british-thoracic-society-clinical-statement-on-pulmonary-arteriovenous-malformations
#8
Claire L Shovlin, Robin Condliffe, James W Donaldson, David G Kiely, Stephen J Wort
Pulmonary arteriovenous malformations (PAVMs) are structurally abnormal vascular communications that provide a continuous right-to-left shunt between pulmonary arteries and veins. Their importance stems from the risks they pose (>1 in 4 patients will have a paradoxical embolic stroke, abscess or myocardial infarction while life-threatening haemorrhage affects 1 in 100 women in pregnancy), opportunities for risk prevention, surprisingly high prevalence and under-appreciation, thus representing a challenging condition for practising healthcare professionals...
December 2017: Thorax
https://www.readbyqxmd.com/read/29141857/contemporary-characteristics-and-outcomes-in-chagasic-heart-failure-compared-with-other-nonischemic-and-ischemic-cardiomyopathy
#9
Li Shen, Felix Ramires, Felipe Martinez, Luiz Carlos Bodanese, Luis Eduardo Echeverría, Efraín A Gómez, William T Abraham, Kenneth Dickstein, Lars Køber, Milton Packer, Jean L Rouleau, Scott D Solomon, Karl Swedberg, Michael R Zile, Pardeep S Jhund, Claudio R Gimpelewicz, John J V McMurray
BACKGROUND: Chagas' disease is an important cause of cardiomyopathy in Latin America. We aimed to compare clinical characteristics and outcomes in patients with heart failure (HF) with reduced ejection fraction caused by Chagas' disease, with other etiologies, in the era of modern HF therapies. METHODS AND RESULTS: This study included 2552 Latin American patients randomized in the PARADIGM-HF (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) and ATMOSPHERE (Aliskiren Trial to Minimize Outcomes in Patients With Heart Failure) trials...
November 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29138753/lesion-pattern-mechanisms-and-long-term-prognosis-in-patients-with-monoparetic-stroke-a-comparison-with-nonmonoparetic-stroke
#10
Seung-Jae Lee, Dong-Geun Lee, Hye-Jin Moon, Tae-Kyeong Lee
Background: Monoparetic stroke is rare but could be misdiagnosed as peripheral neuropathy. We investigated the prevalence, lesion pattern, stroke mechanism, and long-term prognosis in patients with monoparetic stroke. Methods: 586 acute ischemic stroke patients (including 31 with monoparesis) were studied. Monoparetic stroke was defined as a motor deficit in either an arm or a leg but without facial weakness or speech disturbance. Median follow-up period was 32...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29136228/opioid-prescription-use-in-nursing-home-residents-with-advanced-dementia
#11
Charlotte Griffioen, Bettina S Husebo, Elisabeth Flo, Monique A A Caljouw, Wilco P Achterberg
Background: Although proper pain treatment may require opioids, discussion continues about possible undertreatment or overtreatment in persons with advanced dementia. Objective: To investigate the prevalence of pain, frequency of opioid prescription use, and factors associated with strong opioid prescription use in nursing homes. Design: Cross-sectional study. Setting and Subjects: Eighteen Norwegian nursing homes; 327 persons with advanced dementia and behavioral disturbances participated...
November 9, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29135285/factors-associated-with-confidence-in-decision-making-and-satisfaction-with-risk-communication-among-patients-with-atrial-fibrillation
#12
Berith Hedberg, Dan Malm, Jan-Erik Karlsson, Kristofer Årestedt, Anders Broström
BACKGROUND: Atrial fibrillation is a prevalent cardiac arrhythmia. Effective communication of risks (e.g. stroke risk) and benefits of treatment (e.g. oral anticoagulants) is crucial for the process of shared decision making. AIM: The aim of this study was to explore factors associated with confidence in decision making and satisfaction with risk communication after a follow-up visit among patients who three months earlier had visited an emergency room for atrial fibrillation related symptoms...
November 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29133297/evaluating-the-triplet-hypothesis-during-rhythmic-mastication-in-primates
#13
Yashesvini Ram, Callum F Ross
Mammalian mastication involves precise jaw movements including transverse movement of the mandible during the power stroke. Jaw elevation and transverse movement are driven by asymmetrical jaw elevator muscle activity which is thought to include a phylogenetically primitive and conserved triplet motor pattern consisting of: triplet I-balancing side superficial masseter and medial pterygoid, working side posterior temporalis- which reaches onset, peak, and offset first; and triplet II-working side superficial masseter and medial pterygoid, balancing side posterior temporalis-which is active second...
November 13, 2017: Journal of Experimental Biology
https://www.readbyqxmd.com/read/29132836/prevalence-of-fabry-disease-in-young-patients-with-stroke-in-argentina
#14
Ricardo C Reisin, Julieta Mazziotti, Luciana León Cejas, Alberto Zinnerman, Pablo Bonardo, Manuel Fernández Pardal, Alejandra Martínez, Patricia Riccio, Sebastián Ameriso, Eduardo Bendersky, Pedro Nofal, Patricia Cairola, Lorena Jure, Andrea Sotelo, Paula Rozenfeld, Romina Ceci, Ignacio Casas-Parera, Analía Sánchez Luceros
BACKGROUND: Fabry disease (FD) is an underdiagnosed cause of stroke in young adults, but the frequency of this association is largely unknown. We estimated the prevalence of FD in a nationwide cohort of young adults who had stroke and transient ischemic attack (TIA) in Argentina. METHODS: This was a prospective, multicenter study of stroke and FD in young adults (18-55 years) conducted in Argentina between 2011 and 2015. Patients were enrolled if they had had a TIA or an ischemic or hemorrhagic stroke within the previous 180 days...
November 10, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29131434/five-year-impact-of-catheter-ablation-for-atrial-fibrillation-in-patients-with-a-prior-history-of-stroke
#15
T Jared Bunch, Heidi T May, Tami L Bair, Brian G Crandall, Michael J Cutler, John D Day, Victoria Jacobs, Charles Mallender, Jeffrey S Osborn, J Peter Weiss
BACKGROUND: Catheter ablation of atrial fibrillation(AF) is an established therapeutic rhythm approach. Patients with a prior history of a stroke(CVA) represent a unique high-risk population for recurrent thromboembolic events. The role of antiarrhythmic treatment on the natural history of stroke recurrence in these patients is not fully understood. METHODS: Three patient groups with a prior CVA and 5 years of follow-up were matched 1:3:3 by propensity score(±0...
November 13, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29128327/clinical-predictors-of-stroke-mimics-in-patients-treated-with-recombinant-tissue-plasminogen-activator-according-to-a-normal-multimodal-computed-tomography-imaging
#16
Stephane Olindo, Martin Chardonnet, Pauline Renou, Cyrielle Coignion, Sabrina Debruxelles, Mathilde Poli, Sharmila Sagnier, François Rouanet, Igor Sibon
BACKGROUND: Multimodal computed tomography imaging (MCTI) is increasingly used for rapid assessment of acute stroke. We investigated characteristics and final diagnoses of patients treated with recombinant tissue plasminogen activator (rt-PA) while admission imaging was unremarkable. METHODS: From our prospectively collected stroke database (2013-2016), we identified consecutive patients treated with rt-PA on the basis of an unremarkable brain MCTI and assessed with a 24-hour follow-up brain magnetic resonance imaging (MRI)...
November 8, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29128265/atrial-flutter-has-less-left-atrial-spontaneous-contrast-and-higher-left-atrial-appendage-emptying-velocity-compared-with-atrial-fibrillation
#17
Jennifer J Huang, Sridhar Reddy, Tam H Truong, Prakash Suryanarayana, Joseph S Alpert
BACKGROUND: The risk of stroke and thromboembolism in atrial fibrillation is established. There are clear guidelines in anticoagulation management of patient's with atrial fibrillation, however, the evidence surrounding the risk of thromboembolism in patients with atrial flutter is not as clear. We hypothesized that atrial flutter would have indicators of less risk for thromboembolism compared with atrial fibrillation on transesophageal echocardiography (TEE); thereby possibly leading to a lower stroke risk...
November 8, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29127195/microcatheter-contrast-injection-in-stent-retriever-neurothrombectomy-is-safe-and-useful-insights-from-swift-prime
#18
Radoslav Raychev, Reza Jahan, Jeffrey L Saver, Raul G Nogueira, Mayank Goyal, Vitor M Pereira, Elad Levy, Dileep R Yavagal, Christophe Cognard, David Liebeskind
Microcatheter contrast injection (MCI) prior to stent retriever deployment for the treatment of acute ischemic stroke may be useful for evaluation of distal anatomy and flow patterns beyond the occlusion. However, prior data from intra-arterialthrombolysis suggested that MCI increases the risk of intracranial hemorrhage (ICH). The safety and utility of MCI has not been investigated in the setting of thrombectomy. METHODS: We analyzed the Solitaire With the Intention For Thrombectomy as Primary Endovascular Treatment (SWIFT PRIME) trial to correlate pre-intervention MCI flow with collateral flow, and to investigate its impact on ICH and clinical outcome after thrombectomy with the Solitaire device...
November 10, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29127059/hypertension-and-cardiovascular-risk-general-aspects
#19
REVIEW
Sverre E Kjeldsen
Hypertension is the strongest or one of the strongest risk factors for almost all different cardiovascular diseases acquired during life, including coronary disease, left ventricular hypertrophy and valvular heart diseases, cardiac arrhythmias including atrial fibrillation, cerebral stroke and renal failure. The continuous relationship between blood pressure and cardiovascular and renal events makes the distinction between high normal blood pressure and hypertension based on arbitrary cut-off values for blood pressures...
November 7, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29126762/association-between-abnormal-nocturnal-blood-pressure-profile-and-dementia-in-parkinson-s-disease
#20
Ryota Tanaka, Yasushi Shimo, Kazuo Yamashiro, Takashi Ogawa, Kenya Nishioka, Genko Oyama, Atsushi Umemura, Nobutaka Hattori
BACKGROUND: Circadian blood pressure alterations are frequently observed in Parkinson's disease, but the association between these changes and dementia in the condition remains unclear. Here, we assess the relationship between abnormal nocturnal blood pressure profiles and dementia in Parkinson's disease. METHODS: We enrolled 137 patients with Parkinson's disease, who underwent 24 h ambulatory blood pressure monitoring, following cognitive and clinical assessment...
October 20, 2017: Parkinsonism & related Disorders
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