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https://www.readbyqxmd.com/read/28414666/just-a-puff-of-smoke
#1
A Leonard
CASE: A 44 year old woman with a history of stroke s/p aneurysm clipping, seizure, and substance abuse was brought to the hospital after a family member received a call from her friend saying she was acting unusual and may have had a seizure while hanging out on the street. At her baseline, she needed modest assistance in daily activities after her CVA and conversed without issue. Her mother died of a stroke. On exam the patient was afebrile, normotensive with mild tachycardia to 110...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28411747/the-impact-of-carotid-or-intracranial-atherosclerosis-on-perioperative-stroke-in-patients-undergoing-open-aortic-arch-surgery
#2
Ken-Ichi Imasaka, Eiki Tayama, Yukihiro Tomita
OBJECTIVES: This study aimed to clarify the impact of carotid or intracranial atherosclerosis on perioperative stroke in patients undergoing open aortic arch surgery. METHODS: Between 2008 and 2015, 200 consecutive patients underwent elective aortic arch surgery with selective antegrade cerebral perfusion and moderate hypothermic circulatory arrest. Nonselective screening for carotid or intracranial atherosclerosis was performed using carotid ultrasonography or magnetic resonance angiography...
May 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28408941/clinical-evaluation-of-acupuncture-as-treatment-for-complications-of-cerebrovascular-accidents-a-randomized-sham-controlled-subject-and-assessor-blind-trial
#3
Hsien-Yin Liao, Wen-Chao Ho, Chun-Chung Chen, Jaung-Geng Lin, Chia-Chi Chang, Liang-Yu Chen, De-Chih Lee, Yu-Chen Lee
Background and Purpose. The effect of acupuncture as treatment for poststroke complications is questionable. We performed a randomized, sham-controlled double-blind study to investigate it. Methods. Patients with first-time acute stroke were randomized to receive 24 sessions of either real or sham acupuncture during an eight-week period. The primary outcome measure was change in National Institute of Health Stroke Scale (NIHSS) score. Secondary outcome measures included changes in Barthel Index (BI), Instrumental Activities of Daily Living (IADL), Hamilton Depression Rating Scale (HAM-D), and Visual Analogue Scale (VAS) for pain scores...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28407414/association-of-glucagon-like-peptide-1-receptor-agonist-glp-1-ra-use-and-rates-of-acute-myocardial-infarction-stroke-and-overall-mortality-in-patients-with-type-2-diabetes-mellitus-in-a-large-integrated-health-system
#4
Robert S Zimmerman, Todd M Hobbs, Brian J Wells, Sheldon X Kong, Michael W Kattan, Jon Bouchard, Kevin M Chagin, Changhong Yu, Brian Sakurada, Alex Milinovich, Wayne Weng, Janine M Bauman, Kevin M Pantalone
AIMS: To assess the potential impact of GLP-1 RA exposure on cardiovascular disease (CVD) and mortality outcomes in patients with type 2 diabetes (T2D), using a large retrospective cohort. MATERIALS AND METHODS: Patients with T2D between 2005-2014 (N = 105,862) were identified in the electronic health record system at Cleveland Clinic using a validated electronic phenotype. A time-dependent, Cox, multiple regression analysis was used to assess the association between GLP-1 RA exposure and risk of acute myocardial infarction (AMI), stroke/cerebrovascular accident (CVA), and overall mortality, as well as the composite of all three outcomes...
April 13, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28390767/management-and-outcomes-of-carotid-artery-extension-of-aortic-dissections
#5
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...
April 5, 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
#6
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...
March 19, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28317472/psychological-health-of-caregivers-and-association-with-functional-status-of-stroke-patients
#7
Serda Em, Mehtap Bozkurt, Mehmet Caglayan, Figen Ceylan Cevik, Cemal Kaya, Pelin Oktayoglu, Kemal Nas
OBJECTIVE: Stroke does not only affect the physical state of patients but also the emotional state of their relatives, most effectively their caregivers. The study aims to examine the mood of caregivers experienced with care for patients with stroke who are highly dependent on the assistance and also to establish the relationship between the emotional state of caregivers and the severity of disability of the patients. METHODS: This study contained a total of 76 patients with sufficient cognitive functions and severe physical disabilities with hemiplegia caused by a cerebrovascular accident and their caregivers and 94 controls...
March 20, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28300953/language-and-functionality-of-post-stroke-adults-evaluation-based-on-international-classification-of-functioning-disability-and-health-icf
#8
Maria Tereza Maynard Santana, Regina Yu Shon Chun
Purpose: Cerebrovascular accident is an important Public Health problem because of the high rates of mortality and sequelae such as language disorders. The conceptual health changes have led to the incorporation of functional and social aspects in the assessments as proposed by the World Health Organization in the International Classification of Functioning, Disability and Health. The purpose was to evaluate and classify language aspects, functionality and participation of post-stroke individuals based on the concepts of the International Classification of Functioning, Disability and Health and characterize the sociodemographic profile of participants...
March 9, 2017: CoDAS
https://www.readbyqxmd.com/read/28267021/validity-of-measures-of-neurological-status-used-for-predicting-functional-independence-in-adults-after-a-cerebrovascular-accident-a-systematic-review-protocol
#9
Robert Ware, Mary Moore
Are the measures of neurologic status that are used in adults who have had a cerebrovascular accident valid in predicting functional independence?More specifically, the objective of this review is to assess the predictive validity of functional independence of the National Institutes of Health Stroke Scale and the Canadian Neurological Scale.
March 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28258876/the-use-of-tissue-plasminogen-activator-in-the-treatment-of-wallenberg-syndrome-caused-by-vertebral-artery-dissection
#10
Alexis Salerno, Bradford V Cotter, Michael E Winters
BACKGROUND: Acute cerebrovascular accident (CVA) is a devastating cause of patient morbidity and mortality. Up to 10% of acute CVAs in young patients are caused by dissection of the vertebral or carotid artery. Wallenberg syndrome results from a CVA in the vertebral or posterior inferior artery of the cerebellum and manifests as various degrees of cerebellar dysfunction. The administration of a thrombolytic medication has been recommended in the treatment of patients with stroke caused by cervical artery dissection...
February 28, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28253509/the-clinical-characteristics-of-acute-cerebrovascular-accidents-resulting-from-ovarian-hyperstimulation-syndrome
#11
Shuna Yang, Junliang Yuan, Wei Qin, Yue Li, Lei Yang, Wenli Hu
BACKGROUND AND PURPOSE: Ovarian hyperstimulation syndrome (OHSS) is a serious complication that occurs after the ovarian-induction treatment. Acute cerebrovascular accident is one of the most dangerous manifestations of the syndrome. However, the characteristics of stroke resulting from OHSS have so far not been well summarised in any study. METHODS: We reported 2 cases of acute cerebrovascular accidents secondary to OHSS. And then we performed a literature search for reports on this type of stroke, and summarised their characteristics...
March 3, 2017: European Neurology
https://www.readbyqxmd.com/read/28245798/left-atrial-appendage-morphology-and-risk-of-stroke-following-pulmonary-vein-isolation-for-drug-refractory-atrial-fibrillation-in-low-cha2ds2vasc-risk-patients
#12
Faith R Kelly, Robert A Hull, Takor B Arrey-Mbi, Michael U Williams, Joshua S Lee, Ahmad M Slim, Dustin M Thomas
BACKGROUND: Cardiac CT angiography (CCTA) has become an important adjunct in the structural assessment of the pulmonary veins (PV) prior to pulmonary vein isolation (PVI). Published data is conflicting regarding a relationship between left atrial appendage (LAA) and the risk of ischemic stroke (CVA) following PVI. We investigated the associations of volumetric and morphologic left atrial (LA) and LAA measurements for CVA following PVI. METHODS: We retrospectively reviewed 332 consecutive patients with drug refractory atrial fibrillation who obtained cardiac CT angiogram (CCTA) prior to PVI...
February 28, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28241354/effect-of-fibrinogen-concentrate-on-intraoperative-blood-loss-among-patients-with-intraoperative-bleeding-during-high-risk-cardiac-surgery-a-randomized-clinical-trial
#13
RANDOMIZED CONTROLLED TRIAL
Süleyman Bilecen, Joris A H de Groot, Cor J Kalkman, Alexander J Spanjersberg, George J Brandon Bravo Bruinsma, Karel G M Moons, Arno P Nierich
Importance: Fibrinogen concentrate might partly restore coagulation defects and reduce intraoperative bleeding. Objective: To determine whether fibrinogen concentrate infusion dosed to achieve a plasma fibrinogen level of 2.5 g/L in high-risk cardiac surgery patients with intraoperative bleeding reduces intraoperative blood loss. Design, Setting, and Participants: A randomized, placebo-controlled, double-blind clinical trial conducted in Isala Zwolle, the Netherlands (February 2011-January 2015), involving patients undergoing elective, high-risk cardiac surgery (ie, combined coronary artery bypass graft [CABG] surgery and valve repair or replacement surgery, the replacement of multiple valves, aortic root reconstruction, or reconstruction of the ascending aorta or aortic arch) with intraoperative bleeding (blood volume between 60 and 250 mL suctioned from the thoracic cavity in a period of 5 minutes) were randomized to receive either fibrinogen concentrate or placebo...
February 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28236921/targeting-the-most-important-complications-in-vascular-surgery
#14
Kyla M Bennett, K Craig Kent, Jessica Schumacher, Caprice C Greenberg, John E Scarborough
OBJECTIVE: This study was conducted to identify the most clinically relevant and costly perioperative complications occurring in vascular surgery patients. METHODS: The analysis included patients in the 2012 to 2014 National Surgical Quality Improvement Program database undergoing one of four high-risk vascular procedures. The procedures-aortic reconstruction, lower extremity bypass, lower extremity amputation, and carotid endarterectomy (CEA)-were selected because they have been established as high risk in the literature, rendering them natural targets for quality improvement initiatives...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28208901/a-comparative-study-of-neurological-complications-in-chronic-kidney-disease-with-special-reference-to-its-stages-and-haemodialysis-status
#15
S G Shyam Lakshman, P Ravikumar, Giridhari Kar, Dwijen Das, Kallol Bhattacharjee, Prithwiraj Bhattacharjee
INTRODUCTION: Globally, Chronic Kidney Disease (CKD) is a critical and rapidly growing health problem and also a major cause of mortality and morbidity. Neurological complications occur in all levels of the nervous system. Central nervous system complications include cerebrovascular accidents, posterior reversible encephalopathy syndrome, osmotic demyelization syndrome, cerebral infection and sinus vein thrombosis. Peripheral nervous system complications include polyneuropathy, mononeuropathy and carpal tunnel syndrome...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28151862/a-lower-baseline-glomerular-filtration-rate-predicts-high-mortality-and-newly-cerebrovascular-accidents-in-acute-ischemic-stroke-patients
#16
Kai Dong, Xiaoqin Huang, Qian Zhang, Zhipeng Yu, Jianping Ding, Haiqing Song
Chronic kidney disease (CKD) is gradually recognized as an independent risk factor for cardiovascular and cardio-/cerebrovascular disease. This study aimed to examine the association of the estimated glomerular filtration rate (eGFR) and clinical outcomes at 3 months after the onset of ischemic stroke in a hospitalized Chinese population.Totally, 972 patients with acute ischemic stroke were enrolled into this study. Modified of Diet in Renal Disease (MDRD) equations were used to calculate eGFR and define CKD...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28134030/recovery-from-spinal-cord-infarction-associated-with-cannabis-use
#17
Tamer Akel
CONTEXT: Cerebrovascular and cardiovascular accidents have been associated with illicit drug use. The most commonly used substance worldwide is cannabis. It has been related to acute ischemic cerebral stroke in multiple reports, with different mechanisms suggested. FINDINGS: This is a case of Acute Spinal Cord Ischemia Syndrome (ASCIS) in a 25-year-old male who presented 20 minutes after smoking cannabis. Although a direct causal relationship between cannabis and cerebrovascular accidents is difficult to establish, there might be an association...
January 30, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28126319/is-there-a-role-for-coronary-artery-calcification-scoring-in-primary-prevention-of-cerebrovascular-disease
#18
REVIEW
Kazuhiro Osawa, Rine Nakanishi, Matthew J Budoff
Cerebrovascular disease (CVA) is one of the most prevalent causes of death and disability in the United States, and its primary prevention is crucial. For the primary prevention of CVA, it is commonly recommended that all adults should initially undergo an office-based traditional risk assessment using established predictive models, such as the Framingham Stroke Profile Score or the atherosclerotic cardiovascular disease (ASCVD) risk calculator from the American College of Cardiology/American Heart Association (ACC/AHA)...
February 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28123618/comparison-of-neurological-clinical-manifestation-in-patients-with-hemorrhagic-and-ischemic-stroke
#19
Seyedhossein Ojaghihaghighi, Samad Shams Vahdati, Akram Mikaeilpour, Ali Ramouz
BACKGROUND: Cerebrovascular accident (CVA) is the third leading cause of death and disability in developed countries. Anyone suspected of having a stroke should be taken immediately to a medical facility for diagnosis and treatment. The symptoms that follow a stroke aren't significant and depend on the area of the brain that has been affected and the amount of tissue damaged. Parameters for predicting long-term outcome in such patients have not been clearly delineated, therefore the aim of this study was to investigate this possibility and to test a system that might practicably be used routinely to aid management and predict outcomes of individual stroke patients...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28116653/classical-and-additional-antiphospholipid-antibodies-in-blood-samples-of-ischemic-stroke-patients-and-healthy-controls
#20
Narin-Nard Carmel-Neiderman, David Tanne, Idan Goren, Pnina Rotman-Pikielny, Yair Levy
Classical antiphospholipid antibodies (aPLa) are found in 6-25% of blood samples from stroke patients. The frequency of novel aPLa antibodies in blood samples of CVA patients is not known. Enzyme-linked immunosorbent assays (ELISA) were performed on blood samples from 209 CVA patients (170 samples were obtained during the acute phase and 39 samples were from patients with complete carotid stenosis) and compared to 54 healthy controls. Subjects were tested for the presence of the classical aPL antibodies anticardiolipin (aCL) and anti-beta2-glycoprotein (aβ2gI), in addition to antiphosphatidylethanolamine (aPE), anti-phosphatidylserine (aPS), and Annexin V...
January 23, 2017: Immunologic Research
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