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https://www.readbyqxmd.com/read/28727355/-perfusion-imaging-of-acute-ischemic-stroke
#1
Carlo W Cereda, Patrik Michel, Karl-Olof Lovblad, Emmanuel Carrera
Multi-modal imaging in acute ischemic stroke includes structural imaging, perfusion imaging and angiographic assessment of brain arteries. Perfusion imaging discriminates brain tissue that is critically hypo-perfused but salvageable (ischemic penumbra) from irreversibly injured tissue (ischemic core). In acute reperfusion therapies (intravenous or endovascular), patients who have substantial penumbra and a small core (target mismatch pattern) are most likely to have a good clinical outcome. Patient selection based on multi-modal imaging is not proven mandatory for acute treatment in patients admitted within the established time-window...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28727354/-endovascular-treatment-for-acute-ischemic-stroke
#2
Zsolt Kulcsar, Emmanuel Carrera, Patrik Michel
The benefit of endovascular treatment (ET) after acute ischemic stroke has long been debated. Recent studies have demonstrated the clinical benefit of ET up to approximately 8 hours after stroke onset, mainly in association with intranenous thrombolysis. The positive effect is higher if ET is initiated early and performed by an experienced team. Current ET techniques include thrombectomy with clot removal using stentretriever technques or local thromboaspiration of the clot. ET seems to be so efficient that stroke care networks have to be organised to offer ET as quickly as possible in all patients who could benefit from this therapy...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28727192/current-evidence-for-endovascular-therapy-in-stroke-and-remaining-uncertainties-r1
#3
REVIEW
Ronan Motyer, Hamed Asadi, John Thornton, Patrick Nicholson, Hong Kuan Kok
Class 1 level A evidence now supports endovascular thrombectomy as best practice in the management of large vessel occlusion acute ischemic stroke. However, significant questions pertaining to initial imaging, radiological assessment, patient selection and therapeutic limits remain unanswered. A specific cohort of patients who benefit from endovascular thrombectomy has been established, although current uncertainties regarding selection of those not meeting top-tier evidence criteria may potentially deny certain patients the benefit of intervention...
July 20, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28726587/repair-of-tympanic-membrane-perforations-with-customized-bioprinted-ear-grafts-using-chinchilla-models
#4
Che-Ying Kuo, Emmanuel Wilson, Andrew Fuson, Nidhi Gandhi, Reza Monfaredi, Audrey Jenkins, Maria Romero, Marco Santoro, John P Fisher, Kevin Cleary, Brian Reilly
The goal of this work is to develop an innovative method that combines bioprinting and endoscopic imaging to repair tympanic membrane perforations (TMPs). TMPs are a serious health issue because they can lead to both conductive hearing loss and repeated otitis media. TMPs occur in 3 to 5% of cases after ear tube placement as well as in cases of acute otitis media (the second most common infection in pediatrics), chronic otitis media with or without cholesteatoma, or as a result of barotrauma to the ear. About 55,000 tympanoplasties, the surgery performed to reconstruct TMPs, are performed every year and the commonly used cartilage grafting technique has a success rate between 43% to 100%...
July 20, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28726570/potential-biomarkers-for-predicting-hemorrhagic-transformation-of-ischemic-stroke
#5
Guanfeng Lu, Quanwei He, Yan Shen, Fei Cao
Reperfusion therapy contributes to better clinical outcomes in patients with acute ischemic stroke but carries a more significant risk of hemorrhagic transformation (HT) compared to supportive care. Once HT occurs, the outcome is usually poor and this causes a dilemma in the treatment of ischemic stroke. Consequently, early prediction of HT would be extremely helpful for guiding precise treatment of ischemic stroke. In this review, we focus on summarizing biomarkers of HT and elucidating possible mechanisms so as to identify potential biomarkers for predicting HT...
July 20, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28726122/beta-ketothiolase-deficiency-presenting-with-metabolic-stroke-after-a-normal-newborn-screen-in-two-individuals
#6
Monica H Wojcik, Klaas J Wierenga, Lance H Rodan, Inderneel Sahai, Sacha Ferdinandusse, Casie A Genetti, Meghan C Towne, Roy W A Peake, Philip M James, Alan H Beggs, Catherine A Brownstein, Gerard T Berry, Pankaj B Agrawal
Beta-ketothiolase (mitochondrial acetoacetyl-CoA thiolase) deficiency is a genetic disorder characterized by impaired isoleucine catabolism and ketone body utilization that predisposes to episodic ketoacidosis. It results from biallelic pathogenic variants in the ACAT1 gene, encoding mitochondrial beta-ketothiolase. We report two cases of beta-ketothiolase deficiency presenting with acute ketoacidosis and "metabolic stroke." The first patient presented at 28 months of age with metabolic acidosis and pallidal stroke in the setting of a febrile gastrointestinal illness...
July 20, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28726061/advances-in-psychotherapy-for-depressed-older-adults
#7
REVIEW
Patrick J Raue, Amanda R McGovern, Dimitris N Kiosses, Jo Anne Sirey
PURPOSE OF REVIEW: We review recent advances in psychotherapies for depressed older adults, in particular those developed for special populations characterized by chronic medical illness, acute medical illness, cognitive impairment, and suicide risk factors. We review adaptations for psychotherapy to overcome barriers to its accessibility in non-specialty settings such as primary care, homebound or hard-to-reach older adults, and social service settings. RECENT FINDINGS: Recent evidence supports the effectiveness of psychotherapies that target late-life depression in the context of specific comorbid conditions including COPD, heart failure, Parkinson's disease, stroke and other acute conditions, cognitive impairment, and suicide risk...
September 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28726048/is-ct-perfusion-helpful-in-the-treatment-allocation-of-patients-with-acute-ischemic-stroke-an-expert-opinion-analysis
#8
Laura Strada, Jonathan Y Streifler, Bruno Del Sette, Matteo Puntoni, Antonio Castaldi, Daria Bianchini, Massimo Del Sette
BACKGROUND: Intravenous tPA is the standard treatment for acute ischemic stroke within 4.5 hours of symptom onset. Neuroradiological selection is currently based upon non-contrast- brain CT scan (NCCT). AIMS: To verify, in an "expert-opinion setting", the possible usefulness of CT perfusion (CTP) in decision-making toward i.v. thrombolysis. PATIENTS AND METHOD: One hundred and three consecutive patients with acute ischemic stroke who underwent NCCT and CTP were re-evaluated by an expert in cerebrovascular disease, to verify if adding CTP information would have changed expert's opinion...
July 19, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28725968/microglial-mediated-pdgf-cc-activation-increases-cerebrovascular-permeability-during-ischemic-stroke
#9
Enming Joseph Su, Chunzhang Cao, Linda Fredriksson, Ingrid Nilsson, Christina Stefanitsch, Tamara K Stevenson, Juanjuan Zhao, Margret Ragsdale, Yu-Yo Sun, Manuel Yepes, Chia-Yi Kuan, Ulf Eriksson, Dudley K Strickland, Daniel A Lawrence, Li Zhang
Treatment of acute ischemic stroke with the thrombolytic tissue plasminogen activator (tPA) can significantly improve neurological outcomes; however, thrombolytic therapy is associated with an increased risk of intra-cerebral hemorrhage (ICH). Previously, we demonstrated that during stroke tPA acting on the parenchymal side of the neurovascular unit (NVU) can increase blood-brain barrier (BBB) permeability and ICH through activation of latent platelet-derived growth factor-CC (PDGF-CC) and signaling by the PDGF receptor-α (PDGFRα)...
July 19, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28725658/mesenchymal-stem-cells-overexpressing-interleukin-10-promote-neuroprotection-in-experimental-acute-ischemic-stroke
#10
Masataka Nakajima, Chikako Nito, Kota Sowa, Satoshi Suda, Yasuhiro Nishiyama, Aki Nakamura-Takahashi, Yuko Nitahara-Kasahara, Kiwamu Imagawa, Tohru Hirato, Masayuki Ueda, Kazumi Kimura, Takashi Okada
Interleukin (IL)-10 is a contributing factor to neuroprotection of mesenchymal stem cell (MSC) transplantation after ischemic stroke. Our aim was to increase therapeutic effects by combining MSCs and ex vivo IL-10 gene transfer with an adeno-associated virus (AAV) vector using a rat transient middle cerebral artery occlusion (MCAO) model. Sprague-Dawley rats underwent 90 min MCAO followed by intravenous administration of MSCs alone or IL-10 gene-transferred MSCs (MSC/IL-10) at 0 or 3 hr after ischemia reperfusion...
September 15, 2017: Molecular Therapy. Methods & Clinical Development
https://www.readbyqxmd.com/read/28724924/neuron-autonomous-transcriptome-changes-upon-ischemia-reperfusion-injury
#11
Jinlong Shi, Xia Chen, Haiying Li, Youjia Wu, Shouyan Wang, Wei Shi, Jian Chen, Yaohui Ni
Ischemic stroke and the following reperfusion, an acute therapeutic intervention, can cause irreversible brain damages. However, the underlying pathological mechanisms are still under investigation. To obtain a comprehensive, real-time view of the cell-autonomous mechanisms involved in ischemic stroke and reperfusion, we applied the next-generation sequencing (NGS) technology to characterize the temporal changes in gene expression profiles using primarily cultured hippocampal neurons under an oxygen-glucose deprivation/reperfusion (OGD/R) condition...
July 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28724745/seq-identifies-circulating-mir-125a-5p-mir-125b-5p-and-mir-143-3p-as-potential-biomarkers-for-acute-ischemic-stroke
#12
Steffen Tiedt, Matthias Prestel, Rainer Malik, Nicola Schieferdecker, Marco Düring, Veronika Kautzky, Ivelina Stoycheva, Julia Böck, Bernd H Northoff, Matthias Klein, Franziska Dorn, Knut Krohn, Daniel Teupser, Arthur Liesz, Nikolaus Plesnila, Lesca M Holdt, Martin Dichgans
Rationale: Currently, there are no blood-based biomarkers with clinical utility for acute ischemic stroke (IS). microRNAs (miRNAs) show promise as disease markers due to their cell-type specific expression patterns and stability in peripheral blood. Objective: To identify circulating miRNAs associated with acute IS, determine their temporal course up to 90 days post-stroke, and explore their utility as an early diagnostic marker. Methods and Results: We used RNA sequencing to study expression changes of circulating miRNAs in a discovery sample of 20 IS patients and 20 matched healthy control subjects (HCs)...
July 19, 2017: Circulation Research
https://www.readbyqxmd.com/read/28724170/circulating-insulin-like-growth-factor-1-and-insulin-like-growth-factor-binding-protein-3-predict-three-months-outcome-after-ischemic-stroke
#13
Moritz Armbrust, Hans Worthmann, Reinhard Dengler, Helmut Schumacher, Ralf Lichtinghagen, Christoph Cyrill Eschenfelder, Matthias Endres, Martin Ebinger
Reports on neuroprotective effects of Insulin-like growth factor-1 (IGF-1) and Insulin-like growth factor binding protein-3 (IGFBP-3) in ischemic brain tissue are inconsistent. The aim of this study was to determine if plasma levels of IGF-1 and IGFBP-3 in acute stroke patients are indicative of 3 months functional outcome. Plasma levels were measured via chemiluminescence immunoassay in heparin blood samples of patients included in the EARLY trial (NCT00562588). Plasma samples were drawn on admission and 8 days post-stroke...
July 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28723732/role-of-anesthesia-in-endovascular-stroke-therapy
#14
Arthur Wang, Apolonia E Abramowicz
PURPOSE OF REVIEW: Recent randomized clinical trials have demonstrated strong efficacy of endovascular therapy (EVT) for acute ischemic stroke (AIS) from large vessel occlusions; in the USA alone, tens of thousands of patients annually may benefit. The impact of the type of anesthesia used during mechanical thrombectomy on patient outcomes remains controversial. This review discusses the current literature on the effects of anesthesia type on patient outcome following endovascular stroke therapy...
July 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28723649/observation-of-elevated-fasting-blood-glucose-and-functional-outcome-after-ischemic-stroke-in-patients-with-and-without-diabetes
#15
Wen-Yu Xue, Yan-Cheng Xu, Yu-Wen Wu, Miao Yang
During May 2015 to October 2016, this prospective study enrolled a total of 438 patients with acute ischemic stroke(AIS), meanwhile, records regarding the severity of initial stroke and neurological outcomes at three months, as well as other examination were completed in patients on admission, as well as the measurement and evaluation of fasting blood glucose(FBG) levels. At admission, the median FBG levels in patients with a minor stroke (n=124), [P<0.001]) was significantly lower than that observed in patients with other degrees of stroke...
July 7, 2017: Oncotarget
https://www.readbyqxmd.com/read/28722696/hematocrit-and-serum-hemoglobin-do-not-influence-values-in-computed-tomography-perfusion-of-patients-with-acute-ischemic-stroke
#16
Grzegorz Marek Karwacki, Matthias Richard Benz, Anthony Joseph Tyndall, Stephan Ulmer
OBJECTIVE: There is a correlation between both serum hemoglobin (HGB) and hematocrit (HCT) and attenuation values of vessels in noncontrast-enhanced computed tomography (NECT), which could influence calculated perfusion maps in CT perfusion. METHODS: We retrospectively included 45 patients, who presented with acute new neurological symptoms and underwent NECT and CT perfusion (128-row multi detector scanner, coverage: 6.9 cm craniocaudally; 80 kV; 200 mAs; temporal resolution: 2 seconds using 40 mL Ultravist 370 at a flow rate of 5 mL/s) on admission and a follow-up MRI within 1 week of admission...
July 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/28722662/antibiotic-prophylaxis-for-infections-in-patients-with-acute-stroke-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#17
Yan-Guo Xi, Xu Tian, Wei-Qing Chen, Sai Zhang, Shan Zhang, Wei-Dan Ren, Qi-Jun Pang, Guo-Tao Yang, Zhi-Ming Yang
OBJECTIVE: Infections are frequent after stroke and lead to increased mortality and neurological disability. Antibiotic prophylaxis has potential of decreasing the risk of infections and mortality and improving poor functional outcome. Several studies evaluated antibiotic prophylaxis for infections in acute stroke patients have generated conflicting results. The systematic review of randomized clinical trials (RCTs) aimed at comprehensively assessing the evidence of antibiotic prophylaxis for the treatment of acute stroke patients...
July 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/28722487/left-ventricular-hypertrophy-in-acute-stroke-patients-with-known-hypertension
#18
Askiel Bruno, Desiree D Brooks, Taryn A Abrams, Mitra D Poorak, Drew Gunio, Prianka K Kandhal, Aleena Lakhanpal, Arun K Nagabandi, Abiodun E Akinwuntan, Stephen Looney, Pascha E Schafer
BACKGROUND: Despite effective treatments, hypertension remains uncontrolled in nearly half of the people with hypertension in the United States. Uncontrolled hypertension leads to end organ damage, such as left ventricular hypertrophy (LVH). To identify reasons for uncontrolled hypertension, we interviewed acute stroke patients with a history of hypertension and evaluated for LVH. METHODS: Using a standardized questionnaire, we collected demographic, socioeconomic, and health-care data in 300 acute ischemic and hemorrhagic stroke patients in one hospital...
July 19, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28722240/an-mri-hyperintense-acute-reperfusion-marker-is-related-to-elevated-peripheral-monocyte-count-in-acute-ischemic-stroke
#19
Zurab Nadareishvili, Marie Luby, Richard Leigh, Jignesh Shah, John K Lynch, Amie W Hsia, Richard T Benson, Lawrence L Latour
BACKGROUND AND PURPOSE: Blood-brain barrier (BBB) disruption detected on magnetic resonance imaging (MRI) in acute ischemic stroke as a hyperintense acute reperfusion marker (HARM) is associated with upregulation of matrix metalloproteinase-9 (MMP-9). Although activated leukocytes, including monocytes, are the main source of MMPs, limited data exist to support relationship between leukocyte activation and BBB disruption in patients with acute ischemic stroke. The goal of this study is to investigate the relationship between neutrophils, lymphocytes, and monocytes with BBB disruption detected as HARM (+) in patients with acute ischemic stroke...
July 19, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28721332/to-stent-or-not-to-stent-a-tale-of-two-occlusions
#20
Ali S Haider, Lyndon K Lee, Tijani Osumah, Saira Alli, Umair Khan, Steven Vayalumkal, Aida Kafai Golahmadi, Richa Thakur, Phu Nguyen, Kennith F Layton
Stenting and balloon angioplasty, along with mechanical thrombectomy, have gained notability as adjunctive treatment options to intravenous tissue plasminogen activator (IV-tPA) for tandem internal carotid artery (ICA) and middle cerebral artery (MCA) occlusions (TIM occlusions). Acute ischemic strokes (AISs) secondary to TIM occlusions are associated with poor patient outcomes primarily due to low recanalization rates following intravenous thrombolysis, consequently prompting the need for more invasive recanalization efforts...
June 17, 2017: Curēus
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