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https://www.readbyqxmd.com/read/29335335/closure-of-patent-foramen-ovale-versus-medical-therapy-in-patients-with-cryptogenic-stroke-or-transient-ischemic-attack-updated-systematic-review-and-meta-analysis
#1
George Ntaios, Vasileios Papavasileiou, Dimitrios Sagris, Konstantinos Makaritsis, Konstantinos Vemmos, Thorsten Steiner, Patrik Michel
BACKGROUND AND PURPOSE: Previous systematic reviews and meta-analyses compared the efficacy and safety of patent foramen ovale (PFO) closure versus medical treatment in patients with cryptogenic stroke or transient ischemic attack (TIA). Recently, new evidence from randomized trials became available. METHODS: We searched PubMed until September 24, 2017, for trials comparing PFO closure with medical treatment in patients with cryptogenic stroke/TIA using the items: stroke or cerebrovascular accident or TIA and patent foramen ovale or paradoxical embolism and trial or study...
January 15, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29222530/seizure-rates-in-enzalutamide-treated-men-with-metastatic-castration-resistant-prostate-cancer-and-risk-of-seizure-the-upward-study
#2
Susan Slovin, William Clark, Joan Carles, Andrew Krivoshik, Jung Wook Park, Fong Wang, Daniel George
Importance: The androgen receptor inhibitor enzalutamide prolongs survival in men with metastatic castration-resistant prostate cancer (mCRPC). In controlled clinical studies, 0.5% (10 of 2051) of patients experienced seizure, but patients with a history of or risk factors for seizure were excluded. Men with mCRPC and seizure risk factors have an estimated seizure rate of 2.8 per 100 patient-years without enzalutamide exposure. Objective: To assess seizure incidence in patients with seizure risk factors who were receiving enzalutamide for mCRPC...
December 7, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29210786/selective-serotonin-reuptake-inhibitors-and-serotonin-norepinephrine-reuptake-inhibitors-are-not-associated-with-bleeding-or-transfusion-in-cardiac-surgical-patients
#3
Mark M Smith, Bradford B Smith, Brian D Lahr, Gregory A Nuttall, William J Mauermann, Timothy J Weister, Joseph A Dearani, David W Barbara
BACKGROUND: Selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) use is known to alter platelet activation and aggregation leading to impairment in hemostasis. Previous studies are ambiguous with regard to bleeding, transfusion, and perioperative complications in patients undergoing cardiac surgery. The purpose of this study was to evaluate the risk of perioperative bleeding, transfusion, morbidity, and mortality in cardiac surgical patients taking SSRI/SNRIs compared with propensity-matched controls...
November 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29027610/risk-factors-for-and-incidence-of-seizures-in-metastatic-castration-resistant-prostate-cancer-a-real-world-retrospective-cohort-study
#4
Charles Dharmani, Machaon Bonafede, Andrew Krivoshik
BACKGROUND AND OBJECTIVE: This real-world study assessed the prevalence, risk factors for, and incidence of seizures in patients with metastatic castration-resistant prostate cancer (mCRPC). METHODS: Patients with mCRPC were selected from MarketScan Commercial and Medicare Supplemental Databases between 1 January 2009 and 31 July 2012. Prevalence of seizure risk factors were described separately and in combination with other risk factors. Seizure incidence was calculated overall and for each risk factor group...
December 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28983441/high-value-care-in-the-evaluation-of-stroke
#5
Prakrity Urja, Eric H Nippoldt, Virginia Barak, Carrie Valenta
Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs)...
August 1, 2017: Curēus
https://www.readbyqxmd.com/read/28845890/long-term-aspirin-does-not-lower-risk-of-stroke-and-increases-bleeding-risk-in-low-risk-atrial-fibrillation-ablation-patients
#6
Victoria Jacobs, Heidi T May, Tami L Bair, Brian G Crandall, Michael J Cutler DO, John D Day, Charles Mallender, Jeffrey S Osborn, J Peter Weiss, T Jared Bunch
BACKGROUND: Stroke risk is a significant concern in patients with atrial fibrillation (AF). Low stroke risk patients (CHADS2 VASc 0-2) are often treated long-term with aspirin after catheter ablation. Defining the long-term risks versus benefits of aspirin therapy, after an ablation, is essential to validate this common clinical approach. METHODS: A total of 4,124 AF ablation patients undergoing their index ablation were included in this retrospective observational study...
November 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28825767/clinical-and-parental-status-of-patients-with-congenital-heart-disease-associated-pulmonary-arterial-hypertension
#7
Amiram Nir, Neville Berkman, Sagui Gavri
BACKGROUND: Pulmonary arterial hypertension (PAH) is a significant consequence of congenital heart disease (CHD). Its presence and severity is associated with increased morbidity and mortality. OBJECTIVES: To evaluate the clinical and demographic characteristics of adults with congenital heart diseases (ADCHD) and PAH at a single center. METHODS: A prospective registry of all patients with PAH was conducted between 2009 and 2015. RESULTS: Thirty-two patients were identified...
August 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28801954/an-analysis-of-inpatient-pediatric-sickle-cell-disease-incidence-costs-and-outcomes
#8
Laura M Bou-Maroun, Fabien Meta, Curtis J Hanba, Andrew D Campbell, Gregory A Yanik
OBJECTIVE: To identify characteristics of pediatric sickle cell disease (SCD) hospitalizations and to examine admission demographics and medical expenditures. METHODS: Admissions with SCD were identified from the 2009 and 2012 releases of the Healthcare and Cost Utilization Project's Kids Inpatient Database. Disease-specific secondary diagnoses including acute chest syndrome (ACS), vaso-occlusive pain crisis (VOC), splenic sequestration, and stroke/transient ischemic attack were analyzed for patient and hospital demographics...
August 12, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28737070/%C3%AE-blockers-on-discharge-from-acute-atrial-fibrillation-are-associated-with-decreased-mortality-and-lower-cerebrovascular-accidents-in-patients-with-heart-failure-and-reduced-ejection-fraction
#9
Charbel Abi Khalil, Mohammad Zubaid, Nidal Asaad, Wafa A Rashed, Adel Khalifa Hamad, Rajvir Singh, Jassim Al Suwaidi
The benefits of β-blockers in patients with heart failure (HF) with reduced ejection fraction (HFrEF) and atrial fibrillation (AF) are controversial. The Gulf Survey of Atrial Fibrillation Events was a prospective, multinational, observational registry of consecutive patients with AF recruited from the emergency department (ED). We studied the incidence of 6- and 12-month mortality, hospitalization for HF or AF, and stroke/transient ischemic attacks (TIAs) in patients with HFrEF, in relation to β-blockers on discharge from the ED or the subsequent hospital stay...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28714336/specific-plasma-oxylipins-increase-the-odds-of-cardiovascular-and-cerebrovascular-events-in-patients-with-peripheral-artery-disease
#10
Stephanie P B Caligiuri, Harold M Aukema, Amir Ravandi, Renée Lavallée, Randy Guzman, Grant N Pierce
Oxylipins and fatty acids may be novel therapeutic targets for cardiovascular disease. The objective was to determine if plasma oxylipins or fatty acids can influence the odds of cardiovascular/cerebrovascular events. In 98 patients (25 female, 73 male) with peripheral artery disease, the prevalence of transient ischemic attacks, cerebrovascular accidents, stable angina, and acute coronary syndrome was n = 16, 10, 16, and 24, respectively. Risk factors such as being male, diagnosed hypertension, diabetes mellitus, and hyperlipidemia were not associated with events...
August 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28657697/vascular-risk-factors-in-older-patients-with-depression-outcome-of-electroconvulsive-therapy-versus-medication
#11
Harm-Pieter Spaans, Rob M Kok, Filip Bouckaert, Julia F Van Den Berg, Orlaith C Tunney, Pascal Sienaert, Esmée Verwijk, King H Kho, Max L Stek
OBJECTIVE: Research suggests that in depression, vascular burden predicts a lower efficacy for medication (MED) and a more favourable outcome for electroconvulsive therapy (ECT). Therefore, we investigated the influence of the following vascular risk factors (VRF): hypercholesterolemia, hypertension, smoking, diabetes mellitus, cardiovascular disease, and cerebral vascular accident/transient ischemic attack, on remission from major depression after ECT versus MED. METHODS: The study sample consisted of 81 inpatients with a DSM-IV unipolar major depression diagnosis (mean age 72...
June 28, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28629626/left-atrial-accessory-appendages-diverticula-and-left-sided-septal-pouch-in-multi-slice-computed-tomography-association-with-atrial-fibrillation-and-cerebrovascular-accidents
#12
Mateusz K Hołda, Mateusz Koziej, Karolina Wszołek, Wiesław Pawlik, Agata Krawczyk-Ożóg, Danuta Sorysz, Piotr Łoboda, Katarzyna Kuźma, Marcin Kuniewicz, Jacek Lelakowski, Dariusz Dudek, Wiesława Klimek-Piotrowska
BACKGROUND: The aim of this study is to provide a morphometric description of the left-sided septal pouch (LSSP), left atrial accessory appendages, and diverticula using cardiac multi-slice computed tomography (MSCT) and to compare results between patient subgroups. METHODS: Two hundred and ninety four patients (42.9% females) with a mean of 69.4±13.1years of age were investigated using MSCT. The presence of the LSSP, left atrial accessory appendages, and diverticula was evaluated...
June 13, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28530081/-evaluation-of-the-association-between-antihypertensive-treatment-and-development-of-stroke
#13
Margarita Fraimovitch, Yosef Tzvi, Reuven Zimlichman
INTRODUCTION: An ischemic stroke is an event that occurs due to cerebral vascular disease and is directly related to the degree of vascular damage. This process is associated with atherosclerosis progression and is influenced by the presence of cardiovascular risk factors. AIMS: One of the goals of our research was to examine whether specific medications used for treating hypertension are associated with the development of strokes. METHODS: In a retrospective study of patients who were hospitalized between the years 2003-2008 due to a cerebrovascular accident (CVA) or a transient ischemic attack (TIA), 916 cases of stroke patients were reviewed...
September 2016: Harefuah
https://www.readbyqxmd.com/read/28514408/-asymptomatic-atherosclerosis-of-the-brachiocephalic-arteries-current-approaches-to-diagnosis-and-treatment
#14
F Yu Kopylov, A A Bykova, D Yu Shchekochikhin, Kh E Elmanaa, A N Dzyundzya, Yu V Vasilevsky, S S Simakov
Acute cerebrovascular accident (ACVA) and transient ischemic attack are among the leading causes of morbidity, disability, and mortality in the Russian Federation and the world. Ischemic strokes account for 70-80% of all ACVAs, with 20-30% of them being associated with stenotic atherosclerosis of the brachiocephalic arteries (BCA). The paper describes modern views on the problem of asymptomatic BCA atherosclerosis and considers the possibilities of identifying risk groups among the patients with asymptomatic atherosclerosis of the BCA...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28483209/the-population-based-long-term-impact-of-anticoagulant-and-antiplatelet-therapies-in-low-risk-patients-with-atrial-fibrillation
#15
MULTICENTER STUDY
Anjani Golive, Heidi T May, Tami L Bair, Victoria Jacobs, Brian G Crandall, Michael J Cutler, John D Day, Charles Mallender, Jeffrey S Osborn, Scott M Stevens, J Peter Weiss, Scott C Woller, T Jared Bunch
Among patients with atrial fibrillation (AF), the risk of stroke risk is a significant concern. CHADS2 and CHA2DS2-VASc ≤2 scoring have been used to stratify patients into categories of risk. Without randomized, prospective data, the need and type of long-term antithrombotic medications for thromboembolism prevention in lower risk AF patients remains controversial. We sought to define the long-term impact of anticoagulant and antiplatelet therapy use in AF patients at low risk of stroke. A total of 56,764 patients diagnosed with AF and a CHADS2 score of 0 or 1, or CHA2DS2-VASc score of 0, 1, or 2 were studied...
July 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28460854/diagonal-earlobe-crease-frank-s-sign-a-predictor-of-cerebral-vascular-events
#16
Saleh Nazzal, Basem Hijazi, Luai Khalila, Arnon Blum
BACKGROUND: Frank's sign was first described in 1973 by an American physician (Sonders T. Frank). It is a diagonal crease in the earlobe that starts from the tragus to the edge of the auricle in an angle of 45° in varying depths. Frank's sign was described as a predictor of future coronary heart disease and peripheral vascular diseases. The aim of the study was to examine the association between Frank's sign and the development of ischemic stroke. METHODS: This was a prospective study that enrolled consecutive patients admitted with an acute ischemic stroke...
November 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28458067/effect-of-liberal-blood-transfusion-on-clinical-outcomes-and-cost-in-spine-surgery-patients
#17
Taylor E Purvis, C Rory Goodwin, Rafael De la Garza-Ramos, A Karim Ahmed, Virginie Lafage, Brian J Neuman, Peter G Passias, Khaled M Kebaish, Steven M Frank, Daniel M Sciubba
BACKGROUND CONTEXT: Blood transfusions in spine surgery are shown to be associated with increased patient morbidity. The association between transfusion performed using a liberal hemoglobin (Hb) trigger-defined as an intraoperative Hb level of ≥10 g/dL, a postoperative level of ≥8 g/dL, or a whole hospital nadir between 8 and 10 g/dL-and perioperative morbidity and cost in spine surgery patients is unknown and thus was investigated in this study. PURPOSE: This study aimed to describe the perioperative outcomes and economic cost associated with liberal Hb trigger transfusion among spine surgery patients...
September 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28394435/real-world-clinical-characteristics-and-treatment-patterns-of-individuals-aged-80-and-older-with-nonvalvular-atrial-fibrillation-results-from-the-real-life-multicenter-survey-evaluating-stroke-study
#18
MULTICENTER STUDY
Murat Biteker, Özcan Başaran, Volkan Doğan, İbrahim Altun, Fatma Özpamuk Karadeniz, Ahmet İlker Tekkesin, Yasin Çakıllı, Ceyhan Türkkan, Mehmet Hamidi, Vahit Demir, Mustafa Ozan Gürsoy, Müjgan Tek Öztürk, Gökhan Aksan, Sabri Seyis, Mehmet Ballı, Mehmet Hayri Alıcı, Serdar Bozyel
OBJECTIVES: To compare the clinical characteristics of and use of oral anticoagulant (OAC) therapy in individuals aged 80 and older with atrial fibrillation (AF) with those of individuals younger than 80 with AF in clinical practice. DESIGN: Observational study. SETTING: The ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in Turkey trial (NCT02344901), a national observational registry. PARTICIPANTS: Turkish adults with nonvalvular AF (NVAF)...
August 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28390767/management-and-outcomes-of-carotid-artery-extension-of-aortic-dissections
#19
Adriana Laser, Charles B Drucker, Donald G Harris, Tanya Flohr, Shahab Toursavadkohi, Rajabrata Sarkar, Bradley Taylor, Robert S Crawford
BACKGROUND: Aortic dissection (AD) is the most common aortic catastrophe. Carotid artery dissection due to extension of AD (CAEAD) is one severe complication of this condition. Despite years of refinement in the techniques for repair of AD, the optimal management strategy for CAEAD remains yet to be described. We hypothesized that CAEAD eventually resolves on antiplatelet therapy with a low but not insignificant risk of cerebrovascular accident (CVA). METHODS: This was a single-institution retrospective review of patients admitted with nontraumatic coincident aortic and carotid dissection between 2001 and 2013...
August 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28364953/comparison-of-morphologic-features-and-flow-velocity-of-the-left-atrial-appendage-among-patients-with-atrial-fibrillation-alone-transient-ischemic-attack-and-cardioembolic-stroke
#20
COMPARATIVE STUDY
Yonggu Lee, Hwan-Cheol Park, Youkyung Lee, Soon-Gil Kim
The left atrial appendage (LAA) is a major source of emboli responsible for cardioembolic stroke (CES). We hypothesized that there could be differences in the morphologic and functional features of LAAs among patients with atrial fibrillation (AF) alone, patients with cardioembolic transient ischemic attack (CETIA), and patients with CES. Patients with AF and CETIA/CES were included in either a CETIA group or a CES group. Patients with AF without past histories of stroke were included in an AF/non-CVA (cerebrovascular accident) group...
May 15, 2017: American Journal of Cardiology
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