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https://www.readbyqxmd.com/read/29150535/disparities-in-management-of-cardiovascular-disease-in-rural-south-africa-data-from-the-haalsi-study-health-and-aging-in-africa-longitudinal-studies-of-international-network-for-the-demographic-evaluation-of-populations-and-their-health-communities
#1
Thiago Veiga Jardim, Sheridan Reiger, Shafika Abrahams-Gessel, Nigel J Crowther, Alisha Wade, F Xavier Gómez-Olivé, Joshua Salomon, Stephen Tollman, Thomas A Gaziano
BACKGROUND: Optimal secondary prevention is critical for the reduction of repeated cardiovascular events, and the control of cardiovascular risk factors in this context is essential. Data on secondary prevention of cardiovascular disease (CVD) in sub-Saharan Africa are needed to inform intervention strategies with a particular focus on local disparities. The aim of this study was to assess CVD management in a rural community in northeast South Africa. METHODS AND RESULTS: We recruited adults aged ≥40 years residing in the Agincourt subdistrict of Mpumalanga province...
November 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29149855/increasing-upper-limb-training-intensity-in-chronic-stroke-using-embodied-virtual-reality-a-pilot-study
#2
Daniel Perez-Marcos, Odile Chevalley, Thomas Schmidlin, Gangadhar Garipelli, Andrea Serino, Philippe Vuadens, Tej Tadi, Olaf Blanke, José D R Millán
BACKGROUND: Technology-mediated neurorehabilitation is suggested to enhance training intensity and therefore functional gains. Here, we used a novel virtual reality (VR) system for task-specific upper extremity training after stroke. The system offers interactive exercises integrating motor priming techniques and embodied visuomotor feedback. In this pilot study, we examined (i) rehabilitation dose and training intensity, (ii) functional improvements, and (iii) safety and tolerance when exposed to intensive VR rehabilitation...
November 17, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/29148960/how-to-do-a-systematic-review
#3
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/29148900/combined-interventional-and-surgical-treatment-of-tandem-middle-cerebral-artery-embolus-and-internal-carotid-artery-occlusion-case-report
#4
Mark B Frenkel, Jaclyn J Renfrow, Jasmeet Singh, Nitin Garg, Stacey Q Wolfe
Tandem internal carotid artery (ICA) origin occlusion and middle cerebral artery (MCA) thromboembolism is a life-threatening condition with poor neurological outcome. The authors report on a patient presenting with acute ischemic stroke from a tandem ICA and MCA occlusion with penumbra. Emergency MCA mechanical thrombectomy was performed through percutaneous cervical ICA access due to the inability to cross the cervical carotid occlusion. Emergency carotid endarterectomy to reperfuse the poorly collateralized hemisphere and repair the ICA access site was performed 2 hours after completion of tissue plasminogen activator (tPA) infusion...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29148156/long-term-outcomes-for-different-surgical-strategies-to-treat-left-ventricular-outflow-tract-obstruction-in-hypertrophic-cardiomyopathy
#5
Richard Collis, Oliver Watkinson, Constantinos O'Mahony, Oliver P Guttmann, Antonis Pantazis, Maria Tome-Esteban, Victor Tsang, Venkatachalam Chandrasekaran, Christopher G A McGregor, Perry M Elliott
AIMS: Surgical intervention is used to treat dynamic left ventricular outflow tract obstruction (LVOTO) in hypertrophic cardiomyopathy. This study assesses the effect of different surgical strategies on long-term mortality and morbidity. METHODS AND RESULTS: In total, 347 patients underwent surgical intervention for LVOTO (1988-2015). Group A (n = 272) underwent septal myectomy; Group B (n = 33), septal myectomy and mitral valve (MV) repair; Group C (n = 22), myectomy and MV replacement; and Group D (n = 20), MV replacement alone...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29148142/outcomes-of-primary-percutaneous-coronary-intervention-in-acute-myocardial-infarction-due-to-unprotected-left-main-thrombosis-the-asia-pacific-left-main-st-elevation-registry-aster
#6
Jonathan Yap, Gagan D Singh, Jung-Sun Kim, Krishan Soni, Kelvin Chua, Alvin Neo, Choong Hou Koh, Ehrin J Armstrong, Stephen W Waldo, Kendrick A Shunk, Reginald I Low, Myeong-Ki Hong, Yangsoo Jang, Khung Keong Yeo
INTRODUCTION: Prior studies of ULM STEMI have been confined to small cohorts. Recent registry data with larger patient cohorts have shown contrasting results. We aim to study the outcomes of patients with unprotected left main (ULM) ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). METHODS: The Asia-pacific left main ST-Elevation Registry (ASTER) is a multicenter retrospective registry involving 4 sites in Singapore, South Korea, and the United States...
November 16, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29147858/community-interventions-to-increase-stroke-preparedness-and-acute-stroke-treatment-rates
#7
REVIEW
Kathleen M Kelly, Kathryn T Holt, Gina M Neshewat, Lesli E Skolarus
PURPOSE OF REVIEW: Acute stroke treatments reduce the risk of post-stroke disability. These treatments, tissue plasminogen activator (tPA) and intra-arterial treatment, are highly time-dependent; thus, one of the main barriers to treatment is pre-hospital delay. Stroke preparedness is defined as the ability to recognize stroke symptoms and the intent to activate emergency medical services (EMS). This review describes types of acute stroke treatment and preparedness interventions, including recent mass media interventions to increase acute stroke treatment rates, and adult and youth community interventions to increase stroke preparedness...
November 16, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29147720/anticoagulation-in-atrial-fibrillation-current-evidence-and-guideline-recommendations
#8
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/29146873/mobile-interventional-stroke-teams-lead-to-faster-treatment-times-for-thrombectomy-in-large-vessel-occlusion
#9
Daniel Wei, Thomas J Oxley, Dominic A Nistal, Justin R Mascitelli, Natalie Wilson, Laura Stein, John Liang, Lena M Turkheimer, Jacob R Morey, Claire Schwegel, Ahmed J Awad, Hazem Shoirah, Christopher P Kellner, Reade A De Leacy, Stephan A Mayer, Stanley Tuhrim, Srinivasan Paramasivam, J Mocco, Johanna T Fifi
BACKGROUND AND PURPOSE: Endovascular recanalization treatment for acute ischemic stroke is a complex, time-sensitive intervention. Trip-and-treat is an interhospital service delivery model that has not previously been evaluated in the literature and consists of a shared mobile interventional stroke team that travels to primary stroke centers to provide on-site interventional capability. We compared treatment times between the trip-and-treat model and the traditional drip-and-ship model...
November 16, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29146672/culprit-vessel-only-versus-multivessel-percutaneous-coronary-intervention-in-patients-with-cardiogenic-shock-complicating-st-segment-elevation-myocardial-infarction-a-collaborative-meta-analysis
#10
Dhaval Kolte, Partha Sardar, Sahil Khera, Uwe Zeymer, Holger Thiele, Matthias Hochadel, Dragana Radovanovic, Paul Erne, Kristina Hambraeus, Stefan James, Bimmer E Claessen, Jose P S Henriques, Darren Mylotte, Philippe Garot, Wilbert S Aronow, Theophilus Owan, Diwakar Jain, Julio A Panza, William H Frishman, Gregg C Fonarow, Deepak L Bhatt, Herbert D Aronow, J Dawn Abbott
BACKGROUND: The optimal revascularization strategy in patients with multivessel disease presenting with cardiogenic shock complicating ST-segment-elevation myocardial infarction remains unknown. METHODS AND RESULTS: Databases were searched from 1999 to October 2016. Studies comparing immediate/single-stage multivessel percutaneous coronary intervention (MV-PCI) versus culprit vessel-only PCI (CO-PCI) in patients with multivessel disease, ST-segment-elevation myocardial infarction, and cardiogenic shock were included...
November 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29146627/single-session-versus-staged-procedures-for-elective-multivessel-percutaneous-coronary-intervention
#11
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/29145767/addressing-geographic-confounding-through-spatial-propensity-scores-a-study-of-racial-disparities-in-diabetes
#12
Melanie L Davis, Brian Neelon, Paul J Nietert, Kelly J Hunt, Lane F Burgette, Andrew B Lawson, Leonard E Egede
Motivated by a study exploring differences in glycemic control between non-Hispanic black and non-Hispanic white veterans with type 2 diabetes, we aim to address a type of confounding that arises in spatially referenced observational studies. Specifically, we develop a spatial doubly robust propensity score estimator to reduce bias associated with geographic confounding, which occurs when measured or unmeasured confounding factors vary by geographic location, leading to imbalanced group comparisons. We augment the doubly robust estimator with spatial random effects, which are assigned conditionally autoregressive priors to improve inferences by borrowing information across neighboring geographic regions...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/29145410/the-influence-of-computer-based-cognitive-flexibility-training-on-subjective-cognitive-well-being-after-stroke-a-multi-center-randomized-controlled-trial
#13
Renate M van de Ven, Jaap M J Murre, Jessika I V Buitenweg, Dick J Veltman, Justine A Aaronson, Tanja C W Nijboer, Suzanne J C Kruiper-Doesborgh, Coen A M van Bennekom, K Richard Ridderinkhof, Ben Schmand
BACKGROUND: Stroke can result in cognitive complaints that can have a large impact on quality of life long after its occurrence. A number of computer-based training programs have been developed with the aim to improve cognitive functioning. Most studies investigating their efficacy used only objective outcome measures, whereas a reduction of subjective cognitive complaints may be equally important for improving quality of life. A few studies used subjective outcome measures but were inconclusive, partly due to methodological shortcomings such as lack of proper active and passive control groups...
2017: PloS One
https://www.readbyqxmd.com/read/29145321/acupuncture-and-constraint-induced-movement-therapy-for-a-patient-with-chronic-stroke-one-year-follow-up-case-report
#14
Yuanyuan Jin, Xiaoqing Jin, Yidan Chen, Jianfang Zhu
RATIONALE: Spasticity is a widespread problem in chronic stroke. To date, no study has reported the long-term (up to 1 year) outcomes of acupuncture in combination with constraint-induced movement therapy in patients with chronic stroke. This report describes the successful addition of acupuncture on spasticity and arm function in a patient with chronic stroke and arm paresis. PATIENT CONCERNS: At screening, the patient was unable to voluntarily extend her interphalangeal or metacarpophalangeal joints beyond the 10 degrees required for constraint-induced movement therapy...
November 2017: Medicine (Baltimore)
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
#15
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/29142090/virtual-reality-training-for-upper-extremity-in-subacute-stroke-virtues-a-multicenter-rct
#16
Iris Brunner, Jan Sture Skouen, Håkon Hofstad, Jörg Aßmus, Frank Becker, Anne-Marthe Sanders, Hanne Pallesen, Lola Qvist Kristensen, Marc Michielsen, Liselot Thijs, Geert Verheyden
OBJECTIVE: To compare the effectiveness of upper extremity virtual reality rehabilitation training (VR) to time-matched conventional training (CT) in the subacute phase after stroke. METHODS: In this randomized, controlled, single-blind phase III multicenter trial, 120 participants with upper extremity motor impairment within 12 weeks after stroke were consecutively included at 5 rehabilitation institutions. Participants were randomized to either VR or CT as an adjunct to standard rehabilitation and stratified according to mild to moderate or severe hand paresis, defined as ≥20 degrees wrist and 10 degrees finger extension or less, respectively...
November 15, 2017: Neurology
https://www.readbyqxmd.com/read/29141890/british-thoracic-society-clinical-statement-on-pulmonary-arteriovenous-malformations
#17
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/29141571/extra-virgin-olive-oil-and-cardiovascular-diseases-benefits-for-human-health
#18
Cristina Nocella, Vittoria Cammisotto, Luca Fianchini, Alessandra D'Amico, Marta Novo, Valentina Castellani, Francesco Violi, Roberto Carnevale
BACKGROUND AND OBJECTIVE: The cardioprotective properties of Mediterranean Diet were demonstrated for the first time from the Seven Country Study. In the last few decades, numerous epidemiological studies, as well as intervention trial, confirmed this observation, pointing out the close relationship between the Mediterranean diet and cardiovascular diseases. In this context, extra virgin olive oil (EVOO), the most representative component of this diet, seems to be relevant in lowering the incidence of cardiovascular events, including myocardial infarction and stroke...
November 14, 2017: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/29140826/effects-of-integrating-rhythmic-arm-swing-into-robot-assisted-walking-in-patients-with-subacute-stroke-a-randomized-controlled-pilot-study
#19
Tae-Woo Kang, Duck-Won Oh, Ji-Hyun Lee, Heon-Seock Cynn
This study aimed to identify the effects of rhythmic arm swing during robot-assisted walking training on balance, gait, motor function, and activities of daily living among patients with subacute stroke. Twenty patients with subacute stroke were recruited, and thereafter randomly allocated to either the experimental group that performed the robot-assisted walking training with rhythmic arm swing, or the control group that performed the training in arm fixation. In total, 30 training sessions were carried out...
November 14, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/29140555/withdrawn-electrical-cardioversion-for-atrial-fibrillation-and-flutter
#20
REVIEW
Gillian E Mead, Andrew Elder, Andrew D Flapan, John Cordina
BACKGROUND: Atrial fibrillation increases stroke risk and adversely affects cardiovascular haemodynamics. Electrical cardioversion may, by restoring sinus rhythm, improve cardiovascular haemodynamics, reduce the risk of stroke, and obviate the need for long-term anticoagulation. OBJECTIVES: To assess the effects of electrical cardioversion of atrial fibrillation or flutter on the risk of thromboembolic events, strokes and mortality (primary outcomes), the rate of cognitive decline, quality of life, the use of anticoagulants and the risk of re-hospitalisation (secondary outcomes) in adults (>18 years)...
November 15, 2017: Cochrane Database of Systematic Reviews
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