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https://www.readbyqxmd.com/read/28437372/heart-rate-modification-of-cardiac-output-following-cardiac-surgery-the-importance-of-cardiac-time-intervals
#1
Guido Tavazzi, Andy Kontogeorgis, Fabio Guarracino, Niels Bergsland, Ana Martinez-Naharro, John Pepper, Susanna Price
OBJECTIVES: Inadequate cardiac output is associated with a poor outcome following cardiac surgery and is generally modified by the use of positive inotropic agents, volume resuscitation, and pacing. Echocardiography-guided pacemaker optimization is used in the outpatient setting, using different variables including total isovolumic time and the Tei index. We sought to determine the acute impact of heart rate on cardiac electromechanics, cardiac output, and stroke volume in the perioperative setting...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437243/impact-of-pulmonary-hypertension-on-in-hospital-outcome-after-surgical-or-transcatheter-aortic-valve-replacement
#2
Anja Gutmann, Klaus Kaier, Holger Reinecke, Lutz Frankenstein, Andreas Zirlik, Wolfgang Bothe, Constantin von Zur Mühlen, Manfred Zehender, Jochen Reinöhl, Christoph Bode, Peter Stachon
AIMS: The impact of pulmonary hypertension (PH) on in-hospital outcome of either surgical (SAVR) or transcatheter aortic valve replacement (TAVR) was analyzed. METHODS AND RESULTS: Data from all 107,057 patients undergoing isolated SAVR or TAVR in Germany between 2007 and 2014 was provided by the German Federal Bureau of Statistics. About 18% of patients with aortic valve stenosis suffered from PH. Patients with PH had more co- morbidities with consequently increased EuroSCORE (TAVR without PH: 12...
April 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28436705/pharmacologically-increasing-collateral-perfusion-during-acute-stroke-using-a-carboxyhemoglobin-gas-transfer-agent-sanguinate%C3%A2-in-spontaneously-hypertensive-rats
#3
Marilyn J Cipolla, Italo Linfante, Abe Abuchowski, Ronald Jubin, Siu-Lung Chan
Similar to patients with chronic hypertension, spontaneously hypertensive rats (SHR) develop fast core progression during middle cerebral artery occlusion (MCAO) resulting in large final infarct volumes. We investigated the effect of Sanguinate™ (SG), a PEGylated carboxyhemoglobin (COHb) gas transfer agent, on changes in collateral and reperfusion cerebral blood flow and brain injury in SHR during 2 h of MCAO. SG (8 mL/kg) or vehicle ( n = 6-8/group) was infused i.v. after 30 or 90 min of ischemia with 2 h reperfusion...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28436307/choice-of-anesthesia-for-endovascular-treatment-of-acute-ischemic-stroke-protocol-for-a-randomized-controlled-canvas-trial
#4
Yuming Peng, Yan Li, Minyu Jian, Xiaoyuan Liu, Jian Sun, Bo Jia, Jia Dong, Min Zeng, Nan Lin, Li Zhang, Adrian W Gelb, Matthew Tv Chan, Ruquan Han
Background Observational studies indicate that the type of anesthesia, local or general, may be associated with the post-procedural neurological function in patients with acute ischemic stroke undergoing endovascular treatment. However, these results need further confirmation, and the causal relationship has not yet been established. Methods This is a randomized controlled equivalence trial. Permuted block randomization stratified by culprit vessels will be used. Six hundred and forty patients with acute ischemic stroke undergoing endovascular recanalization will be randomized one to one to receive either general anesthesia or local anesthesia...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28436305/quality-of-life-after-intra-arterial-treatment-for-acute-ischemic-stroke-in-the-mr-clean-trial-update
#5
Jennifer Schreuders, Lucie A van den Berg, Puck Ss Fransen, Olvert A Berkhemer, Debbie Beumer, Hester F Lingsma, Robert J van Oostenbrugge, Wim H van Zwam, Charles Blm Majoie, Aad van der Lugt, Paul Lm de Kort, Yvo Bwem Roos, Diederik Wj Dippel
Background Health-related quality of life measured with the EuroQol Group 5-Dimension Self-Report Questionnaire was one of the secondary outcomes in the Multicenter Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands (MR CLEAN). We reported no statistically significant difference in EuroQol Group 5-Dimension Self-Report Questionnaire score between the intervention and control groups, but deaths were not included. Aims Reanalyze the effect of intra-arterial treatment for large vessel occlusion in acute ischemic stroke patients on health-related quality of life in more detail...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28435652/stroke-in-a-child-with-hemoglobin-sc-disease-a-case-report-describing-use-of-hydroxyurea-after-transfusion-therapy
#6
Diana Fridlyand, Caroline Wilder, E Leila Jerome Clay, Bruce Gilbert, Betty S Pace
Children with hemoglobin SC (HbSC) disease suffer a significant incidence of silent cerebral infarcts but stroke is rare. A 2-year-old African American boy with HbSC disease presented with focal neurologic deficits associated with magnetic resonance imaging evidence of cerebral infarction with vascular abnormalities. After the acute episode he was treated with monthly transfusions and subsequently transitioned to hydroxyurea therapy. The benefits of hydroxyurea as a fetal hemoglobin inducer in HbSC disease, to ameliorate clinical symptoms are supported by retrospective studies...
March 22, 2017: Pediatric Reports
https://www.readbyqxmd.com/read/28435630/association-of-insulin-like-growth-factor-i-with-the-severity-and-outcomes-of-acute-ischemic-stroke
#7
Masoud Mehrpour, Hessam Rahatlou, Negar Hamzehpur, Sahand Kia, Mahdi Safdarian
Background: The aim of this study was to evaluate whether higher serum levels of insulin-like growth factor-I (IGF-I) in the acute phase of ischemic stroke are associated with less severe strokes and better functional outcome in a period of 12-month follow-up. Methods: From October 2014 to August 2015, patients with the diagnosis of acute ischemic stroke admitted to the stroke unit of Firoozgar Hospital, Tehran, Iran, entered this prospective study. National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (MRS) for stroke scores were used to measure the severity and outcomes of an acute ischemic stroke at the time of admission and 1 year after the stroke, respectively...
October 7, 2016: Iranian Journal of Neurology
https://www.readbyqxmd.com/read/28435629/prognostic-value-of-hemoglobin-a1c-in-nondiabetic-and-diabetic-patients-with-acute-ischemic-stroke
#8
Mohammad Ali Shafa, Hosseinali Ebrahimi, Farhad Iranmanesh, Mojtaba Sasaie
Background: Diabetes is a well-known risk factor for acute ischemic stroke (AIS). Some recent studies point to hemoglobin A1c (HbA1c) may have prognostic value in nondiabetic and diabetic patients with ischemic stroke (IS). The aim of this study was to evaluate the prognostic value of HbA1c on mortality and morbidity in AIS patients with and without diabetic. Methods: In this prospective observational study, 150 diabetic and nondiabetic patients with AIS were evaluated for serum HbA1c level, hypertension (HTN), hyperlipidemia, and smoking in the first 24 hours of admission to determine their value to predict mortality and mortality at 30 and 90 days...
October 7, 2016: Iranian Journal of Neurology
https://www.readbyqxmd.com/read/28435627/outcome-of-acute-ischemic-stroke-after-intra-arterial-thrombolysis-a-study-from-india
#9
Jaydip Ray Chaudhuri, Randhir Kumar, Matapathi Umamahesh, Kandadai Rukmini Mridula, Suvarnal Alladi, Srinivasarao Bandaru
Background: Intravenous recombinant tissue plasminogen activator (rt-PA) is the currently standard treatment of acute ischemic stroke within 4.5 hours of the onset of stroke. Recent studies have looked at the benefits of administration of intra-arterial (IA) rt-PA within 8 hours onset of symptoms. Our objective was to assess the outcome of stroke after administration of IA rt-PA in patients with acute ischemic stroke. Methods: We recruited 10 consecutive acute ischemic stroke patients with onset of stroke from 4...
October 7, 2016: Iranian Journal of Neurology
https://www.readbyqxmd.com/read/28434994/transient-upregulation-of-nav1-6-expression-in-the-genu-of-corpus-callosum-following-middle-cerebral-artery-occlusion-in-the-rats
#10
Hongyan Zhu, Weide Lin, Yuxiao Zhao, Ziyi Wang, Wenwen Lao, Ping Kuang, Houguang Zhou
Focal ischemic stroke can lead to brain damage and cause human disability and death. Increased excitatory transmission and reduced neuronal inhibition are important pathological alterations in the cerebral ischemia, which can induce abnormal brain excitability. Nav1.6 is a key determinant of neuronal excitability in the nervous system. Here we investigate the expression of Nav1.6 at protein and mRNA levels in the rats subjected to middle cerebral artery occlusion (MCAO).Nav1.6 expression at mRNA levels in the ischemic and contralateral hemispheres of MCAO rats were persistently decreased at 6h, 12h and 24h after reperfusion compared to the sham-operated rats...
April 20, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28434774/myocardial-infarction-following-intravenous-thrombolysis-for-acute-ischemic-stroke-case-report-and-literature-review
#11
Marina Mannino, Salvatore Asciutto, Valeria Terruso, Matilde Gammino, Melchiorre Gilberto Cellura, Serena Monaco
Embolic complications of intravenous thrombolysis for acute ischemic stroke are increasingly recognized, and to date several cases of myocardial infarction soon after the administration of alteplase have been reported. We describe a case of early anterior myocardial infarction during intravenous thrombolysis for stroke and review the current literature.
April 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28434773/mstroke-mobile-stroke-improving-acute-stroke-care-with-smartphone-technology
#12
Benjamin Y Andrew, Colleen M Stack, Julian P Yang, Jodi A Dodds
OBJECTIVE: This study aimed to evaluate the effect of method and time of system activation on clinical metrics in cases utilizing the Stop Stroke (Pulsara, Inc.) mobile acute stroke care coordination application. METHODS: A retrospective cohort analysis of stroke codes at 12 medical centers using Stop Stroke from March 2013 to May 2016 was performed. Comparison of metrics (door-to-needle time [DTN] and door-to-CT time [DTC], and rate of DTN ≤ 60 minutes [goal DTN]) was performed between subgroups based on method (emergency medical service [EMS] versus emergency department [ED]) and time of activation...
April 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28434268/ubiquitin-c-terminal-hydrolase-l1-uch-l1-as-a-therapeutic-and-diagnostic-target-in-neurodegeneration-neurotrauma-and-neuro-injuries
#13
Kevin K Wang, Zhihui Yang, George Sarkis, Isabel Torres, Vijaya Raghavan
Since its discovery as a major CNS-abundant protein 25 years ago, Ubiquitin C-terminal hydrolase-L1 (UCH-L1) has emerged as an important enzyme in regulating brain protein metabolism, by coupling to the proteasome pathway of protein degradation. Areas covered: UCH-L1 is implicated in both familial and sporadic Parkinson disease and other chronic neurodegenerative diseases. Also, UCH-L1 has been recently emerging as a biofluid-based biomarker for various forms of acute neurotrauma and CNS injury. Expert opinion: The loss of UCH-L1 activity coupled with the gain of proteinopathy function are linked to neurodegeneration such as Parkinsonism and Alzheimer's disease...
April 24, 2017: Expert Opinion on Therapeutic Targets
https://www.readbyqxmd.com/read/28433970/simultaneous-transient-global-amnesia-and-right-mca-stroke-after-valsalva-manoeuvre
#14
Ariel Fernando Mariaca, Jose Manuel Valdueza, Christian Gaebel, Manuel Gomez-Choco
A 61-year-old man suffered an episode of transient confusion and anterograde amnesia after a Valsalva-related manoeuvre. The MRI diffusion weighted imaging (DWI) sequences showed a left hippocampal and two right parietal lesions that were deemed as acute. The MR angiography disclosed a high-grade stenosis in the right middle cerebral artery as was described by a transcranial colour-coded ultrasound as well. Ultrasound investigation of the jugular veins showed a right jugular venous reflux after a Valsalva manoeuvre...
April 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28433415/effects-of-transferring-to-the-rehabilitation-ward-on-long-term-mortality-rate-of-first-time-stroke-survivors-a-population-based-study
#15
Chien-Min Chen, Yao-Hsu Yang, Chia-Hao Chang, Pau-Chung Chen
OBJECTIVE: To assess the long-term health outcomes of acute stroke survivors transferred to the rehabilitation ward. DESIGN: Long-term mortality rates of first-time stroke survivors during hospitalization were compared among the following sets of patients: patients transferred to the rehabilitation ward (RR), patients receiving rehabilitation without being transferred to the rehabilitation ward (NtR), and patients receiving no rehabilitation (NoR). SETTING: We conducted a five-year, nationwide, population-based, retrospective, cohort study, using data from the Longitudinal Health Insurance Database 2005 in Taiwan...
April 19, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28432385/bioresorbable-vascular-scaffolds-in-coronary-chronic-total-occlusions-revascularization-safety-assessment-related-to-struts-coverage-and-apposition-in-6-month-oct-follow-up
#16
Rosa Alba Abellas-Sequeiros, Raymundo Ocaranza-Sanchez, Ramiro Trillo-Nouche, Carlos Gonzalez-Juanatey, Jose Ramon Gonzalez-Juanatey
Beneficial properties of bioresorbable vascular scaffolds (BVS) regarding to vasomotility restoration and no caging of the vessel make them attractive devices in chronic total occlusions (CTO) revascularization. However, more evidence is needed attending to their use in this specific setting. We aim to determine feasibility and safety of BVS use in CTO revascularization attending to struts coverage and apposition, as well as re-stenosis and stent thrombosis (ST) rates. 29 BVS were deployed in 9 CTO lesions revascularization (mean J-CTO score ≥3) with an acute procedural success rate of 100%...
April 21, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28432266/baseline-blood-pressure-effect-on-the-benefit-and-safety-of-intra-arterial-treatment-in-mr-clean-multicenter-randomized-clinical-trial-of-endovascular-treatment-of-acute-ischemic-stroke-in-the-netherlands
#17
Maxim J H L Mulder, Saliha Ergezen, Hester F Lingsma, Olvert A Berkhemer, Puck S S Fransen, Debbie Beumer, Lucie A van den Berg, Geert Lycklama À Nijeholt, Bart J Emmer, H Bart van der Worp, Paul J Nederkoorn, Yvo B W E M Roos, Robert J van Oostenbrugge, Wim H van Zwam, Charles B L M Majoie, Aad van der Lugt, Diederik W J Dippel
BACKGROUND AND PURPOSE: High blood pressure (BP) is associated with poor outcome and the occurrence of symptomatic intracranial hemorrhage in acute ischemic stroke. Whether BP influences the benefit or safety of intra-arterial treatment (IAT) is not known. We aimed to assess the relation of BP with functional outcome, occurrence of symptomatic intracranial hemorrhage and effect of IAT. METHODS: This is a post hoc analysis of the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands)...
April 21, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28432265/artemida-trial-a-randomized-trial-of-efficacy-12-months-international-double-blind-actovegin-a-randomized-controlled-trial-to-assess-the-efficacy-of-actovegin-in-poststroke-cognitive-impairment
#18
Alla Guekht, Ingmar Skoog, Sally Edmundson, Vladimir Zakharov, Amos D Korczyn
BACKGROUND AND PURPOSE: Poststroke cognitive impairment is a debilitating consequence of stroke. The aim of this study was to assess whether Actovegin confers cognitive benefit in patients who have had an ischemic stroke. METHODS: This was a 12-month, parallel-group, randomized, multicenter, double-blind, placebo-controlled study. Eligible patients were ≥60 years of age with a Montreal Cognitive Assessment test score of ≤25 points. Patients were randomized into 2 groups within 1 week of acute supratentorial ischemic stroke in a 1:1 ratio: Actovegin (a deproteinized hemoderivative of calf blood, 2000 mg/d for ≤20 intravenous infusions followed by 1200 mg/d orally) or placebo for 6 months...
April 21, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28432264/prediction-of-stroke-subtype-and-recanalization-using-susceptibility-vessel-sign-on-susceptibility-weighted-magnetic-resonance-imaging
#19
Dong-Wan Kang, Han-Gil Jeong, Do Yeon Kim, Wookjin Yang, Seung-Hoon Lee
BACKGROUND AND PURPOSE: The susceptibility vessel sign (SVS) is a hypointense signal visualized because of the susceptibility effect of thrombi, sensitively detected on susceptibility-weighted magnetic resonance imaging. The relationship of SVS parameters with the stroke subtype and recanalization status after endovascular treatment remains uncertain. METHODS: The data from 89 patients with acute stroke caused by anterior circulation infarcts who underwent susceptibility-weighted magnetic resonance imaging before endovascular treatment were examined...
April 21, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28432194/diagnostic-value-of-prehospital-ecg-in-acute-stroke-patients
#20
Tobias Bobinger, Bernd Kallmünzer, Markus Kopp, Natalia Kurka, Martin Arnold, Stefan Heider, Stefan Schwab, Martin Köhrmann
OBJECTIVE: To investigate the diagnostic yield of prehospital ECG monitoring provided by emergency medical services in the case of suspected stroke. METHODS: Consecutive patients with acute stroke admitted to our tertiary stroke center via emergency medical services and with available prehospital ECG were prospectively included during a 12-month study period. We assessed prehospital ECG recordings and compared the results to regular 12-lead ECG on admission and after continuous ECG monitoring at the stroke unit...
April 21, 2017: Neurology
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