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https://www.readbyqxmd.com/read/28431874/regional-disparities-in-the-quality-of-stroke-care
#1
Seth Seabury, Katalin Bognar, Yaping Xu, Caroline Huber, S Renee Commerford, Darren Tayama
BACKGROUND AND PURPOSE: There is widespread geographic variation in healthcare quality, but we often lack clear strategies for improving quality in underserved areas. This study characterized geographic disparities in stroke care quality to assess whether improved access to neurological services has the potential to bridge the care quality gap, particularly in terms of alteplase (rt-PA) administration. METHODS: This was a retrospective study using quality performance data from the 2015 Hospital Compare database linked to information on certification status from the Joint Commission and information on local access to neurological services from the Area Health Resources File...
March 19, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28431619/age-sex-and-race-ethnic-temporal-trends-in-metabolic-syndrome-prevalence-among-individuals-with-myocardial-infarction-or-stroke-in-the-united-states
#2
Alain Lekoubou, Bruce Ovbiagele, Daniela Markovic, Nerses Sanossian, Amytis Towfighi
INTRODUCTION: Metabolic syndrome (MetS), an independent risk factor for myocardial infarction (MI) and stroke, affects 1 in 3 adults in the United States. Recent trends in MetS prevalence among MI and stroke survivors are unknown. METHODS: We assessed age, sex, race/ethnicity, and socio-economic status specific trends in rates of MetS among adults ≥18years who participated in National Health and Nutrition Examination Surveys 1999-2010 and who fasted for 8h (n=12,502)...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28431610/duration-of-paroxysmal-atrial-fibrillation-in-cryptogenic-stroke-is-not-associated-with-stroke-severity-and-early-outcomes
#3
Chrissoula Liantinioti, Konstantinos Tympas, Aristeidis H Katsanos, John Parissis, Maria Chondrogianni, Christina Zompola, Georgios Papadimitropoulos, Michael Ioakeimidis, Sokratis Triantafyllou, Andromaxi Roussopoulou, Konstantinos Voumvourakis, John Lekakis, Gerasimos Filippatos, Leonidas Stefanis, Georgios Tsivgoulis
The current definition of paroxysmal atrial fibrillation (PAF) requires an arbitrary cut-off of >30s, but in clinical practice cryptogenic stroke (CS) patients with PAF duration of ≤30s are not usually excluded from anticoagulation therapy. We sought to evaluate the clinical relevance of short-duration (≤30s) PAF in CS. Consecutive CS patients with no prior AF history and sinus-rhythm on baseline electrocardiography (ECG) were prospectively evaluated over a three-year period. Baseline stroke severity was assessed by NIHSS-scores...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28431600/assessment-of-on-treatment-platelet-reactivity-and-relationship-with-cerebral-micro-embolic-signals-in-asymptomatic-and-symptomatic-carotid-stenosis
#4
Justin A Kinsella, W Oliver Tobin, Sean Tierney, Timothy M Feeley, Bridget Egan, Tara Coughlan, D Ronan Collins, Desmond O'Neill, Joseph A Harbison, Colin P Doherty, Prakash Madhavan, Dermot J Moore, Sean M O'Neill, Mary-Paula Colgan, Maher Saqqur, Raymond P Murphy, Niamh Moran, George Hamilton, Dominick J H McCabe
INTRODUCTION: The relationship between on-treatment platelet reactivity and cerebral micro-embolic signals (MES) is unknown, and has not been previously simultaneously assessed in asymptomatic and symptomatic carotid stenosis patients. METHODS: Consecutive eligible patients with ≥50% asymptomatic or recently symptomatic carotid stenosis (≤4weeks following TIA/ischaemic stroke) were recruited to this pilot study. Symptomatic patients were followed up to the 'late' phase (≥3months) following symptom onset or carotid intervention; longitudinal data were analysed from symptomatic patients with data available at both time-points...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28431593/high-on-treatment-platelet-reactivity-to-aspirin-and-clopidogrel-in-ischemic-stroke-a-systematic-review-and-meta-analysis
#5
Aidonio Fiolaki, Aristeidis H Katsanos, Athanassios P Kyritsis, Styliani Papadaki, Maria Kosmidou, Iraklis C Moschonas, Alexandros D Tselepis, Sotirios Giannopoulos
Emerging studies highlight high on-treatment of platelet reactivity (HTPR) as a major hindrance to the secondary prevention of cardiovascular ischemic events. The aim of this systematic review and meta-analysis is to assess the prevalence of HTPR in patients with ischemic stroke (IS) or transient ischemic attack (TIA) and reveal a possible relation with a higher risk of cerebrovascular event recurrence. Studies were selected if they reported absolute numbers or percentages of HTPR with ASA or clopidogrel in IS/TIA patients at any time point after the cerebrovascular event onset and assessed with any type of platelet function tests...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28431068/self-reported-physical-activity-and-major-adverse-events-in-patients-with-atrial-fibrillation-a-report-from-the-eurobservational-research-programme-pilot-survey-on-atrial-fibrillation-eorp-af-general-registry
#6
Marco Proietti, Giuseppe Boriani, Cécile Laroche, Igor Diemberger, Mircea I Popescu, Lars H Rasmussen, Gianfranco Sinagra, Gheorghe-Andrei Dan, Aldo P Maggioni, Luigi Tavazzi, Deirdre A Lane, Gregory Y H Lip
Aims: Physical activity is protective against cardiovascular (CV) events, both in general population and in high-risk CV cohorts. However, the relationship between physical activity with major adverse outcomes in atrial fibrillation (AF) is not well-established. Our aim was to analyse this relationship in a 'real-world' AF population. Second, we investigated the influence of physical activity on arrhythmia progression. Methods and Results: We studied all patients enrolled in the EURObservational Research Programme on AF (EORP-AF) Pilot Survey...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28430885/lesion-mapping-of-stroke-related-erectile-dysfunction
#7
Klemens Winder, Frank Seifert, Martin Köhrmann, Carl Crodel, Stephan Kloska, Arnd Dörfler, Katharina M Hösl, Stefan Schwab, Max J Hilz
Acute ischaemic stroke in brain areas contributing to male sexual function may impair erectile function depending on the lesion site. This study intended to determine associations between stroke-related erectile dysfunction and cerebral ischaemic lesion sites using voxel-based lesion mapping. In 52 males (mean age 60.5 ± 10.5 years) with first-ever ischaemic strokes, we assessed erectile function after and retrospectively 3 months prior to the stroke using scores of the 5-item International Index of Erectile Function-5 questionnaire...
April 18, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28430614/features-and-risk-factors-of-carotid-atherosclerosis-in-a-population-with-high-stroke-incidence-in-china
#8
Yanqiu Zhang, Lingling Bai, Min Shi, Hongyan Lu, Yanan Wu, Jun Tu, Jingxian Ni, Jinghua Wang, Li Cao, Ping Lei, Xianjia Ning
Epidemiological studies have reported associations between traditional cardiovascular risk factors and carotid intima-media thickness (CIMT) or carotid plaque. However, definite risk factors at different phases of carotid atherosclerosis remain controversial. We aimed to explore risk factors and characteristics of carotid atherosclerosis at different stages in a low-income population with a high incidence of stroke in China. Between April 2014 and January 2015, we recruited 3789 stroke-free and cardiovascular disease-free residents aged ≥ 45 years...
February 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28428449/current-status-and-outcomes-of-direct-oral-anticoagulant-use-in-real-world-atrial-fibrillation-patients%C3%A3-fushimi-af-registry
#9
Yugo Yamashita, Ryuji Uozumi, Yasuhiro Hamatani, Masahiro Esato, Yeong-Hwa Chun, Hikari Tsuji, Hiromichi Wada, Koji Hasegawa, Hisashi Ogawa, Mitsuru Abe, Satoshi Morita, Masaharu Akao
BACKGROUND: The current status and outcomes of direct oral anticoagulant (DOAC) use have not been widely evaluated in unselected patients with atrial fibrillation (AF) in the real world.Methods and Results:The Fushimi AF Registry is a community-based prospective survey of AF patients who visited the participating medical institutions (n=80) in Fushimi, Kyoto, Japan. Follow-up data with oral anticoagulant (OAC) status were available for 3,731 patients by the end of November 2015. We evaluated OAC status and clinical outcomes according to OAC status...
April 19, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28428444/impact-of-atrial-fibrillation-on-the-clinical-course-of-apical-hypertrophic-cardiomyopathy
#10
Sang-Eun Lee, Jin-Kyu Park, Jae-Sun Uhm, Jong Youn Kim, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung
BACKGROUND: Apical hypertrophic cardiomyopathy (ApHCM) is considered a 'benign' form of hypertrophic cardiomyopathy, with limited data on the long-term outcome. However, the clinical impact of atrial fibrillation (AF) in ApHCM is largely unknown. The hypothesis was that AF is common and has a prognostic implication in ApHCM. METHODS: The occurrence of AF and outcome was assessed in 306 consecutive patients with ApHCM (68% male, 62±11 years). RESULTS: AF occurred in 77 patients with ApHCM (prevalence, 25...
April 20, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28427968/the-global-burden-of-atrial-fibrillation-and-stroke-a-systematic-review-of-the-clinical-epidemiology-of-atrial-fibrillation-in-asia
#11
Ying Bai, Yan-Liang Wang, Alena Shantsila, Gregory Y H Lip
BACKGROUND: Our previous review showed great variability on the incidence and prevalence of atrial fibrillation (AF) in non-Western cohorts, especially from Asian countries; in recent years, epidemiology studies on AF have been increasingly reported. METHODS: We therefore conducted an updated systematic review, to present the current knowledge base of AF epidemiology in Asian countries since our prior review. We also explored AF incidence and the risk of stroke in AF using meta-analysis, with I(2) testing the heterogeneity...
April 17, 2017: Chest
https://www.readbyqxmd.com/read/28424377/sex-differences-in-micro-and-macro-vascular-complications-of-diabetes-mellitus
#12
REVIEW
Christine Maric-Bilkan
Vascular complications are a leading cause of morbidity and mortality in both men and women with type 1 (T1DM) or type 2 (T2DM) diabetes mellitus, however the prevalence, progression and pathophysiology of both microvascular (nephropathy, neuropathy and retinopathy) and macrovascular [coronary heart disease (CHD), myocardial infarction, peripheral arterial disease (PAD) and stroke] disease are different in the two sexes. In general, men appear to be at a higher risk for diabetic microvascular complications, while the consequences of macrovascular complications may be greater in women...
May 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28421157/psoriatic-arthritis-is-an-indicator-of-significant-renal-damage-in-patients-with-psoriasis-an-observational-and-epidemiological-study
#13
Abidullah Khan, Iqbal Haider, Maimoona Ayub, Mohammad Humayun
Background. Psoriasis affects joints in around 30% of the patients. Recent studies have demonstrated an increased risk of essential hypertension, ischemic heart disease, and stroke in psoriatic patients. However, the prevalence of renal disease in patients with psoriasis has not been evaluated properly. Objectives. Objectives were to evaluate renal functions in patients with psoriasis and to assess any possible relationship of renal failure with psoriasis and psoriatic arthritis. Methods. In this cross-sectional study, 30 participants were recruited into the following three groups: group-A, psoriatic arthritis; group-B, psoriasis without arthritis; and group-C, healthy subjects...
2017: International Journal of Inflammation
https://www.readbyqxmd.com/read/28420835/macrovascular-complications-and-prevalence-of-urgency-incontinence-in-japanese-patients-with-type-2-diabetes-mellitus-the-dogo-study
#14
Shinya Furukawa, Takenori Sakai, Tetsuji Niiya, Hiroaki Miyaoka, Teruki Miyake, Shin Yamamoto, Sayaka Kanzaki, Koutatsu Maruyama, Keiko Tanaka, Teruhisa Ueda, Hidenori Senba, Masamoto Torisu, Hisaka Minami, Morikazu Onji, Takeshi Tanigawa, Bunzo Matsuura, Yoichi Hiasa, Yoshihiro Miyake
Objective Macrovascular diseases and urgency incontinence are common among Japanese patients with type 2 diabetes mellitus. However, little evidence exists regarding the association between stroke and urgency incontinence among patients with type 2 diabetes mellitus. We examined the associations between macrovascular complications and urgency incontinence among Japanese patients with type 2 diabetes mellitus. Methods The study subjects were 818 Japanese patients with type 2 diabetes mellitus. Urgency incontinence was defined as present when a subject answered "once a week or more" to the question: "Within one week, how often do you leak urine because you cannot defer the sudden desire to urinate?" We adjusted our analyses for sex, age, body mass index, duration of type 2 diabetes, current smoking, current drinking, hypertension, dyslipidemia, glycated hemoglobin, diabetic nephropathy, diabetic retinopathy, and diabetic peripheral neuropathy...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28420817/association-of-kidney-dysfunction-with-asymptomatic-cerebrovascular-abnormalities-in-a-japanese-population-with-health-checkups
#15
Kaori Hayashi, Michiyo Takayama, Takeshi Kanda, Kazuhiro Kashiwagi, Akihito Hishikawa, Yasushi Iwao, Hiroshi Itoh
BACKGROUND: Cerebrovascular disease is a major cause of mortality and morbidity. Chronic kidney disease (CKD) is prevalent in stroke patients. This study evaluated the correlation between kidney dysfunction and asymptomatic findings on carotid ultrasonography (US) and brain magnetic resonance imaging (MRI) in a Japanese population with health checkups.Methods and Results:In total, 1,716 subjects aged 40-80 years, who received health checkups from January 1 to December 31, 2015, were included...
April 14, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28420576/prevalence-of-hypertension-and-prehypertension-in-adolescence-in-ahvaz-iran
#16
Armaghan Moravej Aleali, Seyed Mahmoud Latifi, Homeira Rashidi, Seyed Peyman Payami, Azar Sabet
BACKGROUND: High blood pressure is a risk factor for some disease like stroke, coronary heart disease, and renal failure. High blood pressure in children is an increasing health problem. OBJECTIVES: The aim of this study was to determine prevalence of hypertension and pre-hypertension age between 10 to 17 years old. PATIENTS AND METHODS: This descriptive analytic study was conducted using multiphase sampling method in Ahvaz (Southwest of Iran)...
April 7, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28420049/the-spectrum-of-neuropsychiatric-lupus-in-a-black-caribbean-population-a-report-of-the-barbados-national-lupus-registry
#17
C Flower, I Hambleton, D Corbin, S Marquez, R Edghill
Objective The objective of this study was to examine neuropsychiatric lupus in a Black Caribbean population. Methods We reviewed Barbados National Lupus Registry patients with ≥4 American College of Rheumatology criteria and a diagnosis of neuropsychiatric lupus using the American College of Rheumatology 19 case definitions. Results From 366 patients with four or more American College of Rheumatology criteria for systemic lupus erythematosus, 55 (15%) had evidence of neuropsychiatric lupus. There were 51 females and four males (F:M = 13:1) with a median age of 31 years...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28417454/prevalence-and-predictors-of-anxiety-in-an-african-sample-of-recent-stroke-survivors
#18
A Ojagbemi, M Owolabi, R Akinyemi, O Arulogun, J Akinyemi, O Akpa, F S Sarfo, E Uvere, R Saulson, S Hurst, B Ovbiagele
OBJECTIVES: Studies considering emotional disturbances in the setting of stroke have primarily focused on depression and been conducted in high-income countries. Anxiety in stroke survivors, which may be associated with its own unique sets of risk factors and clinical parameters, has been rarely investigated in sub-Saharan Africa (SSA). We assess the characteristics of anxiety and anxiety-depression comorbidity in a SSA sample of recent stroke survivors. MATERIALS AND METHODS: We assessed baseline data being collected as part of an intervention to improve one-year blood pressure control among recent (≤1 month) stroke survivors in SSA...
April 17, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28416976/rationale-and-design-of-assaf-k-a-study-of-the-safety-and-efficacy-of-anticoagulant-therapy-in-the-treatment-of-atrial-fibrillation-in-kanagawa
#19
Yutaka Hatori, Hiroyuki Sakai, Tomoyuki Kunishima, Nobuo Hatori, Lin Chen, Tomoaki Ishigami, Naoki Satoh
BACKGROUND: Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias associated with substantially increased risks of ischemic stroke and thromboembolism. Oral anticoagulants (OACs) are the cornerstone of AF management and effectively prevent AF-related stroke. As new non-vitamin K antagonist OACs (NOACs) have become available, the landscape of stroke prevention in AF has changed. However, there are considerable gaps between daily clinical practice and current guideline-based recommendations for anticoagulant therapy in Japan...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28416974/major-determinants-for-the-selecting-antithrombotic-therapies-in-patients-with-nonvalvular-atrial-fibrillation-in-japan-japaf-study
#20
Koichi Kusakawa, Kouji H Harada, Tatsuo Kagimura, Akio Koizumi
BACKGROUND: Oral anticoagulants (OACs) can help prevent stroke in patients with nonvalvular atrial fibrillation (NVAF). The aim of this study was to characterize the use of OACs other than direct thrombin inhibitors (DTIs) for NVAF. METHODS: Patients with NVAF taking antithrombotics other than DTIs were enrolled in this cross-sectional study. Patient demographics and medication history were collected, and the patients were classified as taking antiplatelet monotherapy (AP), anticoagulant monotherapy (AC), or combination therapy (AP+AC)...
April 2017: Journal of Arrhythmia
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