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https://www.readbyqxmd.com/read/29655630/is-varicella-vaccination-associated-with-pediatric-arterial-ischemic-stroke-a-population-based-cohort-study
#1
Shannon E MacDonald, Douglas C Dover, Michael D Hill, Adam Kirton, Kimberley A Simmonds, Lawrence W Svenson
BACKGROUND AND PURPOSE: Varicella disease is a risk factor for pediatric Arterial Ischemic Stroke (AIS). Isolated case reports have emerged suggesting that varicella vaccination may also pose a risk for AIS. METHODS: This retrospective population-based cohort study assessed the risk of AIS in children who received a varicella-containing vaccine, as compared to those who did not. The study cohort consisted of children born between January 1, 2006 and December 31, 2013, in the Canadian province of Alberta, where all routine childhood vaccinations are publicly-funded, and recorded in a central immunization repository...
April 11, 2018: Vaccine
https://www.readbyqxmd.com/read/29655461/metabolomics-and-lipidomics-of-ischemic-stroke
#2
Anthony Au
Ischemic stroke is a sudden loss of brain function due to the reduction of blood flow. Brain tissues cease to function with subsequent activation of the ischemic cascade. Metabolomics and lipidomics are modern disciplines that characterize the metabolites and lipid components of a biological system, respectively. Because the pathogenesis of ischemic stroke is heterogeneous and multifactorial, it is crucial to establish comprehensive metabolomic and lipidomic approaches to elucidate these alterations in this disease...
2018: Advances in Clinical Chemistry
https://www.readbyqxmd.com/read/29652731/obesity-and-cardiovascular-risk-a-call-for-action-from-the-european-society-of-hypertension-working-group-of-obesity-diabetes-and-the-high-risk-patient-and-european-association-for-the-study-of-obesity-part-b-obesity-induced-cardiovascular-disease-early-prevention
#3
Vasilios Kotsis, Konstantinos Tsioufis, Christina Antza, Gino Seravalle, Antonio Coca, Cristina Sierra, Empar Lurbe, Stella Stabouli, Bojan Jelakovic, Josep Redon, Pau Redon, Peter M Nilsson, Jens Jordan, Dragan Micic, Nicholas Finer, Deborah R Leitner, Hermann Toplak, Lale Tokgozoglu, Vasilios Athyros, Moses Elisaf, Theodosios D Filippatos, Guido Grassi
: Obesity predisposes for atrial fibrillation, heart failure, sudden cardiac death, renal disease and ischemic stroke, which are the main causes of cardiovascular hospitalization and mortality. As obesity and the cardiovascular effects on the vessels and the heart start early in life, even from childhood, it is important for health policies to prevent obesity very early before the disease manifestation emerge. Key roles in the prevention are strategies to increase physical exercise, reduce body weight and to prevent or treat hypertension, lipids disorders and diabetes earlier and efficiently to prevent cardiovascular complications...
April 12, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29651510/-vomiting-and-collapse-of-a-28-year-old-male-long-distance-runner-in-middle-european-summer
#4
J Herold, A Mitrasch, E Lorenz, U Lodes, I Tanev, R Braun-Dullaeus, F Meyer
BACKGROUND: Hyperthermia often ends fatally and must therefore be promptly recognized and adequately treated. CASE: A 28-year-old man participated in a long-distance race (3 km) on a hot summer day (28 °C). The runner collapsed, had to vomit but continued the run and reached the finish. Neurologically, the patient presented with intermittent cerebral seizures. External cooling batteries were immediately applied and cold infusions were started. The patient was admitted to the intensive care unit of the university hospital (body temperature 40...
April 12, 2018: Der Internist
https://www.readbyqxmd.com/read/29651371/tenecteplase-versus-alteplase-for-the-management-of-acute-ischemic-stroke-in-a-low-income-country-nepal-cost-efficacy-and-safety
#5
REVIEW
Gaurav Nepal, Ghanshyam Kharel, Shaik Tanveer Ahamad, Babin Basnet
Intravenous alteplase is the only approved treatment for acute ischemic stroke. Tenecteplase, a genetically engineered, mutant tissue plasminogen activator, is an alternative thrombolytic agent. The economic feasibility of stroke treatment has been a matter of huge debate and discussion thus far. The use of thrombolytics for the management of ischemic stroke has recently begun in Nepal. In low-income countries like Nepal, where the per capita income falls at just $691.7 and 25.2% of the population are under the poverty line, stroke patients cannot meet treatment expenses...
February 9, 2018: Curēus
https://www.readbyqxmd.com/read/29650712/outcome-prediction-in-acute-stroke-patients-by-continuous-glucose-monitoring
#6
Shinichi Wada, Sohei Yoshimura, Manabu Inoue, Takayuki Matsuki, Shoji Arihiro, Masatoshi Koga, Takanari Kitazono, Hisashi Makino, Kiminori Hosoda, Masafumi Ihara, Kazunori Toyoda
BACKGROUND: The purpose of this study was to examine the relationships between glucose parameters obtained by continuous glucose monitoring and clinical outcomes in acute stroke patients. METHODS AND RESULTS: Consecutive patients with acute ischemic stroke or intracerebral hemorrhage within 24 hours after onset were included. A continuous glucose monitoring device (iPro2) was attached for the initial 72 hours after emergent admission. Eight glucose parameters were obtained from continuous glucose monitoring: maximum, minimum, mean, and SD of blood glucose levels, as well as area under the curve more than 8 mmol/L of blood glucose, distribution time more than 8 mmol/L of blood glucose, coefficient of variation (%CV), and presence of time less than 4 mmol/L over 72 hours...
April 12, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29649151/dna-methylation-and-histone-modification-in-hypertension
#7
REVIEW
Shaunrick Stoll, Charles Wang, Hongyu Qiu
Systemic hypertension, which eventually results in heart failure, renal failure or stroke, is a common chronic human disorder that particularly affects elders. Although many signaling pathways involved in the development of hypertension have been reported over the past decades, which has led to the implementation of a wide variety of anti-hypertensive therapies, one half of all hypertensive patients still do not have their blood pressure controlled. The frontier in understanding the molecular mechanisms underlying hypertension has now advanced to the level of epigenomics...
April 12, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29648845/online-and-offline-awareness-deficits-anosognosia-for-spatial-neglect
#8
Peii Chen, Joan Toglia
PURPOSE/OBJECTIVE: Anosognosia for spatial neglect (ASN) can be offline or online. Offline ASN is general unawareness of having experienced spatial deficits. Online ASN is an awareness deficit of underestimating spatial difficulties that likely to occur in an upcoming task (anticipatory ASN) or have just occurred during the task (emergent ASN). We explored the relationships among spatial neglect, offline ASN, anticipatory ASN, and emergent ASN. Research Method/Design: Forty-four survivors of stroke answered questionnaires assessing offline and online self-awareness of spatial problems...
April 12, 2018: Rehabilitation Psychology
https://www.readbyqxmd.com/read/29645069/-childhood-ischemic-cerebrovascular-disease-in-a-paediatric-emergency-service-a-descriptive-study
#9
P Garcia-Sanchez, R Lopez-Lopez, L Rubio-Gordon, B Rosich-Del Cacho, L Tesouro-Rodriguez, M A Rivas-Paterna, M A Perez-Moneo Agapito, S Garcia-Garcia
AIM: To describe the clinical presentation, risk factors and complementary tests in patients of our paediatric emergency service with a final diagnosis of ischemic stroke. PATIENTS AND METHODS: Retrospective, analytical and observational study, performed in a Paediatric Emergency Service of a tertiary-level hospital. We included patients aged 1 month to 14 years during a 12-years period with a final diagnosis of ischemic cerebrovascular disease (CVD). We analyzed personal history, symptomatology and initial complementary tests...
April 16, 2018: Revista de Neurologia
https://www.readbyqxmd.com/read/29643681/mismatch-in-brain-perfusion-and-metabolism-detected-with-99m-tc-hexamethyl-propylene-amine-oxime-single-photon-emission-computed-tomography-and-18-f-fluorodeoxyglucose-positron-emission-tomography-in-moyamoya-disease
#10
Justo Serrano Vicente, Luis Fernández Prudencio, José Rafael Infante Torre, Juan Ignacio Rayo Madrid
We report a 47-year-old woman who developed an ischemic stroke with diplopia and dysarthria. Emergency computed tomography (CT) showed no pathological findings, and magnetic resonance (MR) showed mild ischemic-degenerative lesions. MR angiography and angiogram showed severe stenosis of both internal carotid and main intracranial arteries with plenty collateral vessels with "puff of smoke" suggesting a moyamoya disease (MMD). Brain perfusion single-photon emission CT showed global diminished perfusion in the brain lobes and a marked relative hyperperfusion in the cerebellum...
April 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/29643259/cerebrovascular-accidents-during-mechanical-circulatory-support-new-predictors-of-ischemic-and-hemorrhagic-strokes-and-outcome
#11
Saef Izzy, Daniel B Rubin, Firas S Ahmed, Feras Akbik, Simone Renault, Katelyn W Sylvester, Henrikas Vaitkevicius, Jennifer A Smallwood, Michael M Givertz, Steven K Feske
BACKGROUND AND PURPOSE: Left ventricular assist devices (LVADs) have emerged as an effective treatment for patients with advanced heart failure refractory to medical therapy. Post-LVAD strokes are an important cause of morbidity and reduced quality of life. Data on risks that distinguish between ischemic and hemorrhagic post-LVAD strokes are limited. The aim of this study was to determine the incidence of post-LVAD ischemic and hemorrhagic strokes, their association with stroke risk factors, and their effect on mortality...
April 11, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29643111/cardiovascular-and-cerebrovascular-emergency-department-visits-associated-with-wildfire-smoke-exposure-in-california-in-2015
#12
Zachary S Wettstein, Sumi Hoshiko, Jahan Fahimi, Robert J Harrison, Wayne E Cascio, Ana G Rappold
BACKGROUND: Wildfire smoke is known to exacerbate respiratory conditions; however, evidence for cardiovascular and cerebrovascular events has been inconsistent, despite biological plausibility. METHODS AND RESULTS: A population-based epidemiologic analysis was conducted for daily cardiovascular and cerebrovascular emergency department (ED) visits and wildfire smoke exposure in 2015 among adults in 8 California air basins. A quasi-Poisson regression model was used for zip code-level counts of ED visits, adjusting for heat index, day of week, seasonality, and population...
April 11, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29627793/lifting-the-veil-on-stroke-outcomes-revisiting-stroke-centers-transparency-through-public-reporting-of-metrics
#13
REVIEW
Kyle M Fargen, James L West, J Mocco
Public reporting of healthcare metrics provides transparency that allows patients and emergency medical providers to make informed decisions about where patients should receive care. Most previous reports about public reporting of health metrics have demonstrated significant improvements in outcome metrics after implementation. However, no mechanism exists, voluntary or otherwise, for the public reporting of outcomes of stroke care. We review the components of public reporting of health outcomes data and its limited history in stroke outcomes...
April 7, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29627025/cerebrovascular-imaging-of-cerebral-ischemia-in-acute-type-a-aortic-dissection
#14
Soichiro Matsubara, Masatoshi Koga, Tomoyuki Ohara, Yasuyuki Iguchi, Kenji Minatoya, Yoshio Tahara, Tetsuya Fukuda, Yuichi Miyazaki, Katsufumi Kajimoto, Yuki Sakamoto, Naoki Makita, Naoki Tokuda, Kazuyuki Nagatsuka, Yukio Ando, Kazunori Toyoda
BACKGROUND AND PURPOSE: Stanford type A aortic dissection (AAD) sometimes causes acute ischemic stroke (AIS) or transient ischemic attack (TIA). There is little understanding of cerebrovascular imaging of AIS or TIA in patients with AAD. METHODS: Consecutive AIS/TIA patients with AAD who were admitted within 4.5 h of onset were reviewed. We compared findings of MRI/MRA between these and consecutive AIS/TIA patients without AAD within 4.5 h of onset. RESULTS: Seventeen AAD and 249 non-AAD patients were identified...
May 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29626136/evolution-of-a-us-county-system-for-acute-comprehensive-stroke-care
#15
Radoslav I Raychev, Dana Stradling, Nirav Patel, Joey R Gee, David A Lombardi, Johnson L Moon, David M Brown, Mayank Pathak, Wengui Yu, Samuel J Stratton, Steven C Cramer
BACKGROUND AND PURPOSE: In Orange County, California, patients with suspected acute stroke are taken to stroke neurology receiving centers that are designated by County Emergency Medical Services authorities as either hubs or spokes based on endovascular treatment capability. We examined relationships between stroke details, reperfusion therapies, hospital transfers, and their change over time. METHODS: All patients from January 1, 2013, to December 31, 2015, for whom 911 was called within 7 hours of onset in whom Emergency Medical Services personnel suspected acute stroke were evaluated...
April 6, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29624537/feasibility-and-safety-of-intravascular-temperature-management-for-severe-heat-stroke-a-prospective-multicenter-pilot-study
#16
Shoji Yokobori, Yuichi Koido, Hajime Shishido, Toru Hifumi, Kenya Kawakita, Tomoya Okazaki, Shinichirou Shiraishi, Eiji Yamamura, Takashi Kanemura, Takanobu Otaguro, Gaku Matsumoto, Yasuhiro Kuroda, Yasufumi Miyake, Yasutaka Naoe, Kyoko Unemoto, Hiroshi Kato, Kiyoshi Matsuda, Hisashi Matsumoto, Hiroyuki Yokota
OBJECTIVES: Heat stroke is a life-threatening condition with high mortality and morbidity. Although several cooling methods have been reported, the feasibility and safety of treating heat stroke using intravascular temperature management are unclear. This study evaluated the efficacies of conventional treatment with or without intravascular temperature management for severe heat stroke. DESIGN: Prospective multicenter study. SETTING: Critical care and emergency medical centers at 10 tertiary hospitals...
April 5, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29623865/-stroke-mimicking-acute-peripheral-vertigo-how-to-avoid-misdiagnosis-importance-of-alarm-symptoms-and-assessment-of-eye-movements
#17
R B van Leeuwen, E van Wensen, B R Schudel
Identifying the occurrence of stroke in patients with isolated vertigo is difficult for general practitioners (GPs) as well as for physicians working in the Emergency Department. Three patients with acute vestibular syndrome are presented in this clinical lesson. The importance of an adequate neuro-otological examination is emphasised. However, many GPs lack knowledge of the nystagmus and the head impulse test. Alternative strategies for GPs are discussed.
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29623155/emergency-medicine-pharmacist-impact-on-door-to-needle-time-in-patients-with-acute-ischemic-stroke
#18
Joshua S Jacoby, Heather M Draper, Lisa E Dumkow, Muhammad U Farooq, G Robert DeYoung, Kasey L Brandt
Background and Purpose: Decreased door-to-needle (DTN) time with tissue plasminogen activator (tPA) for acute ischemic stroke is associated with improved patient outcomes. Emergency medicine pharmacists (EMPs) can expedite the administration of tPA by assessing patients for contraindications, preparing, and administering tPA. The purpose of this study was to determine the impact of EMPs on DTN times and clinical outcomes in patients with acute ischemic stroke who receive tPA in the emergency department...
April 2018: Neurohospitalist
https://www.readbyqxmd.com/read/29621071/back-to-basics-adherence-with-guidelines-for-glucose-and-temperature-control-in-an-american-comprehensive-stroke-center-sample
#19
Anne W Alexandrov, Paola Palazzo, Sharon Biby, Abbigayle Doerr, Wendy Dusenbury, Rhonda Young, Anne Lindstrom, Mary Grove, Georgios Tsivgoulis, Sandy Middleton, Andrei V Alexandrov
BACKGROUND: Variance from guideline-directed care for glucose and temperature control remains unknown in the United States at a time when priorities have shifted to ensure rapid diagnosis and treatment of acute stroke patients. However, protocol-driven nursing surveillance for control of hyperglycemia and hyperthermia has been shown to improve patient outcomes. METHODS: We conducted an observational pilot study to assess compliance with American guidelines for glucose and temperature control and association with discharge outcomes in consecutive acute stroke patients admitted to 5 US comprehensive stroke centers...
April 4, 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29619930/neurological-and-psychiatric-comorbidity-in-patients-with-heart-failure-risk-and-prognosis
#20
Kasper Adelborg
Heart failure is a complex clinical syndrome and one of the leading causes of morbidity and mortality with a prevalence of 1%-2% of the adult population. The prognosis is poor with a 5-year mortality rate of 50%, which partly can be attributed to the presence of concomitant comorbidity, including neurological and psychiatric comorbidities. However, the prognostic impact of depression and the role of heart failure as a risk factor for dementia and stroke are not fully understood.
 Denmark is well-known for its unique health registries...
April 2018: Danish Medical Journal
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