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https://www.readbyqxmd.com/read/29034749/screening-of-older-patients-for-atrial-fibrillation-in-general-practice-current-evidence-and-its-implications-for-future-practice
#1
Matthew R Fay, David A Fitzmaurice, Ben Freedman
BACKGROUND: Individuals with atrial fibrillation (AF) face a fivefold increased risk of ischaemic stroke compared with those without the condition. Recent studies suggest that individuals with asymptomatic AF also face an increased risk of ischaemic stroke, but their condition is often not recognized and diagnosed until an ischaemic stroke event has occurred. Identification of individuals with undiagnosed AF at increased risk for stroke is critical in promoting optimal intervention with anticoagulants...
December 2017: European Journal of General Practice
https://www.readbyqxmd.com/read/29025962/therapeutic-hypothermia-in-acute-traumatic-spinal-cord-injury
#2
James Collis
Therapeutic hypothermia is already widely acknowledged as an effective neuroprotective intervention, especially within the acute care setting in relation to conditions such as cardiac arrest and neonatal encephalopathy. Its multifactorial mechanisms of action, including lowering metabolic rate and reducing acute inflammatory cellular processes, ultimately provide protection for central nervous tissue from continuing injury following ischaemic or traumatic insult. Its clinical application within acute traumatic spinal cord injury would therefore seem very plausible, it having the potential to combat the pathophysiological secondary injury processes that can develop in the proceeding hours to days following the initial injury...
October 12, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29018068/epidemiology-of-venous-thromboembolism-in-africa-a-systematic-review-and-meta-analysis-protocol
#3
Celestin Danwang, Mazou N Temgoua, Valirie Ndip Agbor, Aurel T Tankeu, Jean Jacques Noubiap
INTRODUCTION: Venous thromboembolism (VTE) is among the three major causes of cardiovascular diseases worldwide after ischaemic heart disease and stroke. Knowledge on the global epidemiology of this condition is deficient in Africa. Accurate data are needed to evaluate the burden of VTE in Africa to design effective preventive and treatment strategies. This systematic review and meta-analysis aims to summarise epidemiological data on VTE in Africa and to evaluate the use of prophylaxis in African patients at risk of VTE...
October 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28989807/red-blood-cell-distribution-width-and-ischaemic-stroke
#4
REVIEW
Gang-Hua Feng, Hai-Peng Li, Qiu-Li Li, Ying Fu, Ren-Bin Huang
The red blood cell distribution width (RDW) is a measure of red blood cell (RBC) size heterogeneity, which is easily calculated by dividing the SD of erythrocyte volumes for the mean corpuscular volume. Recent reporter suggested that, besides haematological diseases and anaemia, many human disorders may be closely associated with the elevated RDW. A literature review has revealed the RDW may be closely related to the development of ischaemic stroke, carotid artery atherosclerosis and cerebral embolism. Higher RDW could independently predict adverse outcomes in patients in these conditions...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28989805/migraine-and-stroke
#5
REVIEW
Yonghua Zhang, Aasheeta Parikh, Shuo Qian
Migraines are generally considered a relatively benign neurological condition. However, research has shown an association between migraines and stroke, and especially between migraine with aura and ischaemic stroke. Patients can also suffer from migrainous infarction, a subset of ischaemic stroke that often occurs in the posterior circulation of younger women. The exact pathogenesis of migrainous infarct is not known, but it is theorised that the duration and local neuronal energy level from cortical spreading depression may be a key factor...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28986862/beyond-the-embolus-do-not-miss-diffusion-abnormalities-of-ischaemic-and-non-ischaemic-neurological-disease
#6
REVIEW
Vivek Yedavalli, Eric M Nyberg, Daniel S Chow, Ashesh A Thaker
Given the rapid evolution and technological advances in the diagnosis and treatment of acute ischaemic stroke (AIS), including the proliferation of comprehensive stroke centres and increasing emphasis on interventional stroke therapies, the need for prompt recognition of stroke due to acute large vessel occlusion has received significant attention in the recent literature. Diffusion-weighted imaging (DWI) is the gold standard for the diagnosis of acute ischaemic stroke, as images appear positive within minutes of ischaemic injury, and a high signal-to-noise ratio enables even punctate infarcts to be readily detected...
October 6, 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/28984703/pathophysiology-of-ischaemic-heart-disease
#7
Mamatha O Pocock, Lucy Dorrell, Paola Cicconi
PURPOSE OF REVIEW: To summarize recent findings in the pathogenesis of ischemic heart disease (IHD) in people living with HIV (PLWH). RECENT FINDINGS: PLWH have an elevated risk of IHD. Although incidence is declining, this condition still represents a major cause of non-AIDS-related mortality. The cause is likely multifactorial: traditional risk factors play an important role and IHD risk might be reduced with greater emphasis on primary prevention. The contribution of specific antiretroviral agents to IHD risk is changing as antiretroviral coverage increases globally and as safer agents have replaced drugs with well-described metabolic toxicities...
November 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28969386/genetic-variants-influencing-elevated-myeloperoxidase-levels-increase-risk-of-stroke
#8
Chia-Ling Phuah, Tushar Dave, Rainer Malik, Miriam R Raffeld, Alison M Ayres, Joshua N Goldstein, Anand Viswanathan, Steven M Greenberg, Jeremiasz M Jagiella, Björn M Hansen, Bo Norrving, Jordi Jimenez-Conde, Jaume Roquer, Alexander Pichler, Christian Enzinger, Joan Montaner, Israel Fernandez-Cadenas, Arne Lindgren, Agnieszka Slowik, Reinhold Schmidt, Alessandro Biffi, Natalia Rost, Carl D Langefeld, Hugh S Markus, Braxton D Mitchell, Brad B Worrall, Steven J Kittner, Daniel Woo, Martin Dichgans, Jonathan Rosand, Christopher D Anderson
Primary intracerebral haemorrhage and lacunar ischaemic stroke are acute manifestations of progressive cerebral microvascular disease. Current paradigms suggest atherosclerosis is a chronic, dynamic, inflammatory condition precipitated in response to endothelial injury from various environmental challenges. Myeloperoxidase plays a central role in initiation and progression of vascular inflammation, but prior studies linking myeloperoxidase with stroke risk have been inconclusive. We hypothesized that genetic determinants of myeloperoxidase levels influence the development of vascular instability, leading to increased primary intracerebral haemorrhage and lacunar stroke risk...
October 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28963293/thiazide-diuretics-and-the-risk-of-hip-fracture-after-stroke-a-population-based-propensity-matched-cohort-study-using-taiwan-s-national-health-insurance-research-database
#9
Shu-Man Lin, Shih-Hsien Yang, Hung-Yu Cheng, Chung-Chao Liang, Huei-Kai Huang
OBJECTIVES: This study aimed to investigate the association between thiazide use and the risk of hip fracture after stroke. SETTING: A population-based, propensity-matched cohort study was conducted on the basis of Taiwan's National Health Insurance Research Database. PARTICIPANTS: Patients with newly diagnosed ischaemic stroke between 2000 and 2011 were included. After propensity score matching, 7470 patients were included, of whom 3735 received thiazides and 3735 did not...
September 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28959496/cerebral-misery-perfusion-due-to-carotid-occlusive-disease
#10
REVIEW
Mohana Maddula, Nikola Sprigg, Philip M Bath, Sunil Munshi
PURPOSE: Cerebral misery perfusion (CMP) is a condition where cerebral autoregulatory capacity is exhausted, and cerebral blood supply in insufficient to meet metabolic demand. We present an educational review of this important condition, which has a range of clinical manifestations. METHOD: A non-systematic review of published literature was undertaken on CMP and major cerebral artery occlusive disease, using Pubmed and Sciencedirect. FINDINGS: Patients with CMP may present with strokes in watershed territories, collapses and transient ischaemic attacks or episodic movements associated with an orthostatic component...
June 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28959429/elective-laparoscopic-repair-after-reduction-might-be-useful-strategy-for-incarcerated-obturator-hernia-a-case-report
#11
Atsushi Kohga, Akihiro Kawabe, Yuchen Cao, Kiyoshige Yajima, Takuya Okumura, Kimihiro Yamashita, Jun Isogaki, Kenji Suzuki
Obturator hernia is a rare clinical condition that causes intestinal obstruction. Recent reports have suggested that laparoscopic repair may be useful for incarcerated obturator hernia in select patients. The patient was a 64-year-old female who presented to our emergency department with a chief complaint of abdominal pain. Computed tomography (CT) imaging revealed an incarcerated obturator hernia on her right side, without apparent findings of irreversible ischaemic change or perforation. She had a previous history of cardiovascular surgery and was taking an anticoagulant medication...
September 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28958393/reliability-of-point-of-care-coagulometer-measurements-in-patients-with-acute-ischaemic-stroke-receiving-intravenous-fibrinolysis
#12
D Guisado-Alonso, F Fayos-Vidal, J Martí-Fàbregas, L Prats-Sánchez, R Marín-Bueno, A Martínez-Domeño, R Delgado-Mederos, P Camps-Renom
BACKGROUND: Speed of administration conditions the effectiveness of intravenous fibrinolysis in treating acute ischaemic stroke. To reduce the risk of haemorrhagic complications, the intervention is contraindicated in certain cases, such as where the International Normalised Ratio (INR) is ≥ 1.7. This study aimed to determine the reliability of point-of-care INR readings (POC-INR) taken using the CoaguChek(®) XS portable coagulometer compared to laboratory results (L-INR). METHODS: We conducted a retrospective observational study of consecutive patients admitted to our centre with acute ischaemic stroke and who were treated with intravenous fibrinolysis, over a period of 4 years...
September 25, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28957809/geniposide-attenuates-post-ischaemic-neurovascular-damage-via-glun2a-akt-erk-dependent-mechanism
#13
Baosheng Huang, Panhong Chen, Lei Huang, Shuai Li, Ronglan Zhu, Tao Sheng, Wan Yu, Zheng Chen, Tianlu Wang
BACKGROUND/AIMS: Calcium-permeable ionotropic NMDAR-mediated hyperactivity is regarded as the critical factor in modulating the development of ischaemic stroke. Recently, there has been increasing interest in preventing post-stroke neuronal death by focusing on intervening in the function of subpopulations of NMDARs and their downstream signalling. Geniposide, an iridoid glycoside, has been found to have cytoprotective functions in various conditions. However, it is still unclear whether and how geniposide affects neuronal insult under experimental stroke...
September 22, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28954496/territorial-variation-in-mortality-from-causes-amenable-to-medical-care-in-poland
#14
Wiktoria Wróblewska
INTRODUCTION AND OBJECTIVE: This study examines the geographical variation of amenable mortality in Poland, focusing primarily on the role of health care resources at the level of administrative districts and regions, and selected area socioeconomic characteristics as explanatory factors. The concept was used of amenable mortality, based on the assumption that deaths from certain causes should not occur in the presence of timely and effective health care. MATERIAL AND METHODS: Standardized death rates (SDR) from causes considered amenable to health care and, separately, for ischaemic heart disease (IHD), were calculated for each of 379 districts (NUTS 4 level) in Poland in 1991-1995 and 2006-2010, using unit mortality data from the National Causes of Death Register...
September 21, 2017: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/28944999/systemic-redistribution-of-the-intramyocardially-injected-mesenchymal-stem-cells-by-repeated-remote-ischaemic-post-conditioning
#15
Qin Jiang, Tao Yu, Keli Huang, Hao Zhang, Zhe Zheng, Shengshou Hu
We investigated the effect of repeated remote ischaemic post-conditioning (RIPoC) on the organ distribution of the intramyocardially injected MSCs in rat myocardial ischemia model. Myocardial ischemia of adult female Sprague-Dawley rats was induced by 30-min. obstruction of the left anterior descending coronary artery. Repeated RIPoC was induced after ischemia with three cycles of 5-min. occlusion and reperfusion of the limb with the frequency of half a day, 1 or 2 days, respectively. Compared with that by single RIPoC, repeated RIPoC transiently reduced oxidative stress, lipid peroxidation and inflammation in ischaemic myocardium; the gene expression of stromal cell-derived factor-1 alpha (SDF-1α) was consistently induced by repeated RIPoC procedures...
September 25, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28932397/undiagnosed-and-diagnosed-diabetes-mellitus-among-hospitalised-acute-heart-failure-patients-in-botswana
#16
Julius Chacha Mwita, Mgaywa Gilbert Mjungu Damas Magafu, Bernard Omech, Billy Tsima, Matthew J Dewhurst, Monkgogi Goepamang, Yohana Mashalla
OBJECTIVE: The objective of this study was to determine the burden of diagnosed and undiagnosed type 2 diabetes mellitus among patients hospitalised with acute heart failure in Botswana. METHODS: The study enrolled 193 consecutive patients admitted with acute heart failure to the medical wards at Princess Marina Hospital in Gaborone. Patients were classified as previously known diabetics, undiagnosed diabetics (glycated haemoglobin ≥ 6.5%) or as non-diabetics (glycated haemoglobin < 6...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28932276/contemporary-best-practice-in-the-evaluation-and-management-of-stuttering-priapism
#17
REVIEW
Georgios Kousournas, Asif Muneer, David Ralph, Evangelos Zacharakis
Stuttering priapism is rare and under-investigated clinical entity. Although it shares similarities with ischaemic priapism, by definition, stuttering priapism has distinct characteristics that advocate for a different management in the clinical setting. Therefore, the management of stuttering priapism aims primarily to prevent recurrence rather than the resolution of spontaneous attacks. A multimodal approach and the individualization of each case are essential because of the diversity of the condition and the plethora of proposed therapeutic strategies...
September 2017: Therapeutic Advances in Urology
https://www.readbyqxmd.com/read/28925023/fibrinolysis-from-blood-to-the-brain
#18
Robert L Medcalf
We all know about classical fibrinolysis, how plasminogen activation by either tissue-type plasminogen activator (t-PA) or urokinase-type plasminogen activator (u-PA) promotes fibrin breakdown, and how this process was harnessed for the therapeutic removal of blood clots. While this is still perfectly true and still applicable to thromboembolic conditions today, another dimension to this system came to light over two decades ago that implicated the plasminogen activating system in a context far removed from the dissolution of blood clots...
September 19, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28919116/global-regional-and-national-age-sex-specific-mortality-for-264-causes-of-death-1980-2016-a-systematic-analysis-for-the-global-burden-of-disease-study-2016
#19
(no author information available yet)
BACKGROUND: Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends. METHODS: We estimated cause-specific deaths and years of life lost (YLLs) by age, sex, geography, and year...
September 16, 2017: Lancet
https://www.readbyqxmd.com/read/28915160/current-insights-in-obstetric-antiphospholipid-syndrome
#20
Karen Schreiber, Massimo Radin, Savino Sciascia
PURPOSE OF REVIEW: Antiphospholipid syndrome (APS) is defined as the association of thrombotic events and/or obstetric morbidity in patients persistently positive for antiphospholipid antibodies (aPL). In this review, we will highlight the most important clinical presentations of APS with a focus on the obstetric morbidity, the current management strategies and the outlook for the future. RECENT FINDINGS: The use of aspirin and heparin has improved the pregnancy outcome in obstetric APS and approximately 70% of pregnant women with APS have a successful pregnancy outcome...
September 14, 2017: Current Opinion in Obstetrics & Gynecology
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