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https://www.readbyqxmd.com/read/28629575/outcome-of-patients-with-proximal-vessel-occlusion-of-the-anterior-circulation-and-dwi-pwi-mismatch-is-time-dependent
#1
Sibu Mundiyanapurath, Sascha Diatschuk, Sarah Loebel, Johannes Pfaff, Mirko Pham, Markus Alfred Möhlenbruch, Wolfgang Wick, Martin Bendszus, Peter A Ringleb, Alexander Radbruch
BACKGROUND AND PURPOSE: Patients with ischemic stroke and large vessel occlusion are assumed to benefit from endovascular therapy (ET) independent of the symptom onset-to-treatment time (OTT) if they present with a mismatch of diffusion- and perfusion-weighted imaging (DWI-PWI mismatch). We aimed at studying the influence of OTT on clinical outcome in these patients. METHODS: Retrospective database review in a tertiary care university hospital. All patients presented with proximal vessel occlusion of the anterior circulation and DWI-PWI mismatch...
June 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28620583/engineering-of-genetically-arrested-parasites-gaps-for-a-precision-malaria-vaccine
#2
REVIEW
Oriana Kreutzfeld, Katja Müller, Kai Matuschewski
Continuous stage conversion and swift changes in the antigenic repertoire in response to acquired immunity are hallmarks of complex eukaryotic pathogens, including Plasmodium species, the causative agents of malaria. Efficient elimination of Plasmodium liver stages prior to blood infection is one of the most promising malaria vaccine strategies. Here, we describe different genetically arrested parasites (GAPs) that have been engineered in Plasmodium berghei, P. yoelii and P. falciparum and compare their vaccine potential...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28465460/efficacy-of-stent-retriever-thrombectomy-in-magnetic-resonance-imaging-versus-computed-tomographic-perfusion-selected-patients-in-swift-prime-trial-solitaire-fr-with-the-intention-for-thrombectomy-as-primary-endovascular-treatment-for-acute-ischemic-stroke
#3
RANDOMIZED CONTROLLED TRIAL
Nicolas Menjot de Champfleur, Jeffrey L Saver, Mayank Goyal, Reza Jahan, Hans-Christoph Diener, Alain Bonafe, Elad I Levy, Vitor M Pereira, Christophe Cognard, Dileep R Yavagal, Gregory W Albers
BACKGROUND AND PURPOSE: The majority of patients enrolled in SWIFT PRIME trial (Solitaire FR With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke) had computed tomographic perfusion (CTP) imaging before randomization; 34 patients were randomized after magnetic resonance imaging (MRI). METHODS: Patients with middle cerebral artery and distal carotid occlusions were randomized to treatment with tPA (tissue-type plasminogen activator) alone or tPA+stentriever thrombectomy...
June 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28283606/predictive-value-of-rapid-assessed-perfusion-thresholds-on-final-infarct-volume-in-swift-prime-solitaire-with-the-intention-for-thrombectomy-as-primary-endovascular-treatment
#4
RANDOMIZED CONTROLLED TRIAL
Maxim Mokin, Elad I Levy, Jeffrey L Saver, Adnan H Siddiqui, Mayank Goyal, Alain Bonafé, Christophe Cognard, Reza Jahan, Gregory W Albers
BACKGROUND AND PURPOSE: Computed tomography perfusion imaging can estimate the size of the ischemic core, which can be used for the selection of patients for endovascular therapy. The relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) thresholds chosen to identify ischemic core influence the accuracy of prediction. We aimed to analyze the accuracy of various rCBV and rCBF thresholds for predicting the 27-hour infarct volume using RAPID automated analysis software from the SWIFT PRIME trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment) data...
April 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28108793/effective-cerebrovascular-thrombectomy-requires-well-organized-structures-real-world-experiences-of-a%C3%A2-regional-stroke-network-between-2012-2015
#5
Maria Sophie Stockinger, Johannes Trenkler, Tim von Oertzen, Karin Nussbaumer, Michael Sonnberger, Wolfgang Schimetta, Anthony C Pereira, Gerhard Traxler, Claudia Dorninger, Hans-Peter Haring
BACKGROUND: The objective of this study was to analyse the Neurothrombectomy Network registry of the Neuromed Campus (NMC) of the Kepler University Hospital in Linz (Austria). The data were compared to the results of recently published thrombectomy trials (MR CLEAN, ESCAPE, EXTEND-IA, SWIFT-PRIME, REVASCAT and THRACE). METHODS: We retrospectively studied 246 patients with acute ischemic stroke who underwent thrombectomy between January 2012 and December 2015 at the NMC in Upper Austria...
February 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28038899/mechanical-thrombectomy-in-acute-ischemic-stroke-initial-single-center-experience-and-comparison-with-randomized-controlled-trials
#6
RANDOMIZED CONTROLLED TRIAL
Andreia Carvalho, André Cunha, Marta Rodrigues, Sofia Figueiredo, Ludovina Paredes, Tiago Gregório, Hugo Morais, Joaquim Pinheiro, Vítor Tedim Cruz, José Mário Roriz, João Pinho, Carla Ferreira, Edgar Torre, Joana Nunes, Sérgio Castro, Manuel Ribeiro, Miguel Veloso, Pedro Barros
BACKGROUND: Until recently, intravenous thrombolysis was the only reperfusion therapy with proven efficacy in patients with acute ischemic stroke. However, this treatment option has low recanalization rates in large-vessel occlusions. The search for additional treatments continued until 5 randomized trials (MR CLEAN, ESCAPE, EXTEND-IA, SWIFT PRIME, and REVASCAT) revealed the superiority of mechanical thrombectomy for anterior circulation large-vessel occlusion. After 1 year of performing thrombectomy with stent retrievers in our tertiary hospital, we intended to answer the question: is it possible to achieve similar results in a "real-world" setting? METHODS: We analyzed data from our prospective observational registry, compared it with the trials aforementioned, and concluded that the answer is affirmative...
March 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28028150/cost-effectiveness-of-solitaire-stent-retriever-thrombectomy-for-acute-ischemic-stroke-results-from-the-swift-prime-trial-solitaire-with-the-intention-for-thrombectomy-as-primary-endovascular-treatment-for-acute-ischemic-stroke
#7
RANDOMIZED CONTROLLED TRIAL
Theresa I Shireman, Kaijun Wang, Jeffrey L Saver, Mayank Goyal, Alain Bonafé, Hans-Christoph Diener, Elad I Levy, Vitor M Pereira, Gregory W Albers, Christophe Cognard, Werner Hacke, Olav Jansen, Tudor G Jovin, Heinrich P Mattle, Raul G Nogueira, Adnan H Siddiqui, Dileep R Yavagal, Thomas G Devlin, Demetrius K Lopes, Vivek K Reddy, Richard du Mesnil de Rochemont, Reza Jahan, Katherine A Vilain, John House, Jin-Moo Lee, David J Cohen
BACKGROUND AND PURPOSE: Clinical trials have demonstrated improved 90-day outcomes for patients with acute ischemic stroke treated with stent retriever thrombectomy plus tissue-type plasminogen activator (SST+tPA) compared with tPA. Previous studies suggested that this strategy may be cost-effective, but models were derived from pooled data and older assumptions. METHODS: In this prospective economic substudy conducted alongside the SWIFT-PRIME trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke), in-trial costs were measured for patients using detailed medical resource utilization and hospital billing data...
February 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27781037/rescue-thrombectomy-in-large-vessel-occlusion-strokes-leads-to-better-outcomes-than-intravenous-thrombolysis-alone-a-real-world-applicability-of-the-recent-trials
#8
Raul G Nogueira, Osama O Zaidat, Alicia C Castonguay, Diogo C Haussen, Coleman O Martin, William E Holloway, Nils Mueller-Kronast, Joey English, Italo Linfante, Guilherme Dabus, Tim W Malisch, Franklin A Marden, Hormozd Bozorgchami, Andrew Xavier, Ansaar T Rai, Michael T Froehler, Aamir Badruddin, Thanh N Nguyen, M Asif Taqi, Michael G Abraham, Vallabh Janardhan, Albert J Yoo, Hashem Shaltoni, Alex Abou-Chebl, Peng R Chen, Gavin W Britz, Roberta Novakovic, Ashish Nanda, Ritesh Kaushal, Mohammad A Issa, Michael R Frankel, Rishi Gupta
BACKGROUND: The Interventional Management of Stroke III (IMS-III) trial demonstrated no benefit for intravenous recombinant tissue plasminogen activator (IV rt-PA) followed by endovascular therapy versus IV rt-PA alone. However, IMS-III mostly included earlier generation devices. The recent thrombectomy trials have incorporated the stent-retriever technology, but their generalizability remains unknown. METHODS: The North American Solitaire Acute Stroke (NASA) registry recruited patients treated with the Solitaire FR™ device between March 2012 and February 2013...
September 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27758942/cost-effectiveness-of-endovascular-stroke-therapy-a-patient-subgroup-analysis-from-a-us-healthcare-perspective
#9
Wolfgang G Kunz, M G Myriam Hunink, Wieland H Sommer, Sebastian E Beyer, Felix G Meinel, Franziska Dorn, Stefan Wirth, Maximilian F Reiser, Birgit Ertl-Wagner, Kolja M Thierfelder
BACKGROUND AND PURPOSE: Endovascular therapy in addition to standard care (EVT+SC) has been demonstrated to be more effective than SC in acute ischemic large vessel occlusion stroke. Our aim was to determine the cost-effectiveness of EVT+SC depending on patients' initial National Institutes of Health Stroke Scale (NIHSS) score, time from symptom onset, Alberta Stroke Program Early CT Score (ASPECTS), and occlusion location. METHODS: A decision model based on Markov simulations estimated lifetime costs and quality-adjusted life years (QALYs) associated with both strategies applied in a US setting...
November 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27664152/endovascular-treatment-of-thrombosis-and-embolism
#10
Ahmet Yigit Goktay, Cagin Senturk
Deep venous thrombosis (DVT) is a common disorder with a significant mortality rate. Successful endovascular treatment of acute DVT is most likely to be achieved in patients with recently formed thrombus, (<10-14 days) with acute iliofemoral DVT. Endovascular treatment options include: Catheter-directed thrombolysis (CDT), pharmacomechanical catheter-directed thrombolysis (PCDT), percutaneous aspiration thrombectomy (PAT), vena cava filter protection, venous balloon dilatation and venous stent implantation...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27634952/association-of-clot-burden-score-with-radiographic-and-clinical-outcomes-following-solitaire-stent-retriever-thrombectomy-analysis-of-the-swift-prime-trial
#11
Maxim Mokin, Elad I Levy, Adnan H Siddiqui, Mayank Goyal, Raul G Nogueira, Dileep R Yavagal, Vitor M Pereira, Jeffrey L Saver
BACKGROUND: The clot burden score (CBS) was developed as a tool to evaluate the extent of intracranial thrombus burden in patients with anterior circulation acute ischemic stroke. CBS is based on the presence or absence of contrast opacification on CT angiography (CTA). Its value in predicting radiographic and clinical outcomes in patients given endovascular stroke therapy remains unknown. OBJECTIVE: To evaluate the relationship between CBS and outcomes after stent retriever thrombectomy in the interventional arm of the SWIFT PRIME trial...
September 15, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27610120/systematic-review-and-pooled-analyses-of-recent-neurointerventional-randomized-controlled-trials-setting-a-new-standard-of-care-for-acute-ischemic-stroke-treatment-after-20-years
#12
Mohammed Hussain, Mohammad Moussavi, Daniel Korya, Siddhart Mehta, Jaskiran Brar, Harina Chahal, Ihtesham Qureshi, Tapan Mehta, Javaad Ahmad, Osama O Zaidat, Jawad F Kirmani
BACKGROUND: Recent advances in the treatment of ischemic stroke have focused on revascularization and led to better clinical and functional outcomes. A systematic review and pooled analyses of 6 recent multicentered prospective randomized controlled trials (MPRCT) were performed to compare intravenous tissue plasminogen activator (IV tPA) and endovascular therapy (intervention) with IV tPA alone (control) for anterior circulation ischemic stroke (AIS) secondary to large vessel occlusion (LVO)...
June 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27529062/prion-diseases-immunotargets-and-therapy
#13
REVIEW
Jennifer T Burchell, Peter K Panegyres
Transmissible spongiform encephathalopathies or prion diseases are a group of neurological disorders characterized by neuronal loss, spongiform degeneration, and activation of astrocytes or microglia. These diseases affect humans and animals with an extremely high prevalence in some species such as deer and elk in North America. Although rare in humans, they result in a devastatingly swift neurological progression with dementia and ataxia. Patients usually die within a year of diagnosis. Prion diseases are familial, sporadic, iatrogenic, or transmissible...
2016: ImmunoTargets and Therapy
https://www.readbyqxmd.com/read/27382268/methods-to-reduce-prescribing-errors-in-elderly-patients-with-multimorbidity
#14
REVIEW
Amanda H Lavan, Paul F Gallagher, Denis O'Mahony
The global population of multimorbid older people is growing steadily. Multimorbidity is the principal cause of complex polypharmacy, which in turn is the prime risk factor for inappropriate prescribing and adverse drug reactions and events. Those who prescribe for older frailer multimorbid people are particularly prone to committing prescribing errors of various kinds. The causes of prescribing errors in this patient population are multifaceted and complex, including prescribers' lack of knowledge of aging physiology, geriatric medicine, and geriatric pharmacotherapy, overprescribing that frequently leads to major polypharmacy, inappropriate prescribing, and inappropriate drug omission...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27366977/landmark-papers-in-cerebrovascular-neurosurgery-2015
#15
REVIEW
Justin M Moore, Christoph J Griessenauer, Raghav Gupta, Nimer Adeeb, Apar S Patel, Christopher S Ogilvy, Ajith J Thomas
The management of cerebrovascular disease has advanced considerably in 2015. Five randomized control trials have firmly established the role of endovascular thrombectomy for ischemic strokes due to large vessel occlusion. The randomized trial of intraarterial treatment for acute ischemic stroke (MR CLEAN) (Berkhemer et al. NEJM 2015;372:11-20) was the first of a series on the topic. There was a total of 5 randomized controlled trials published showing benefit in terms of functional outcomes at 90days for mechanical thrombectomy including the Endovascular Therapy for Ischemic stroke with perfusion-imaging selection (EXTEND IA) (Campbell et al...
September 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27325355/thrombectomy-for-ischemic-stroke-meta-analyses-of-recurrent-strokes-vasospasms-and-subarachnoid-hemorrhages
#16
REVIEW
Robert Emprechtinger, Brigitte Piso, Peter A Ringleb
Mechanical thrombectomy with stent retrievers is an effective treatment for patients with ischemic stroke. Results of recent meta-analyses report that the treatment is safe. However, the endpoints recurrent stroke, vasospasms, and subarachnoid hemorrhage have not been evaluated sufficiently. Hence, we extracted data on these outcomes from the five recent thrombectomy trials (MR CLEAN, ESCAPE, REVASCAT, SWIFT PRIME, and EXTEND IA published in 2015). Subsequently, we conducted meta-analyses for each outcome. We report the results of the fixed, as well as the random effects model...
March 2017: Journal of Neurology
https://www.readbyqxmd.com/read/27276086/correction-estradiol-enhances-cd4-t-cell-anti-viral-immunity-by-priming-vaginal-dcs-to-induce-th17-responses-via-an-il-1-dependent-pathway
#17
Varun C Anipindi, Puja Bagri, Kristy Roth, Sara E Dizzell, Philip V Nguyen, Christopher R Shaler, Derek K Chu, Rodrigo Jiménez-Saiz, Hong Liang, Stephanie L Swift, Aisha Nazli, Jessica K Kafka, Jonathan Bramson, Zhou Xing, Manel Jordana, Yonghong Wan, Denis P Snider, Martin R Stampfli, Charu Kaushic
[This corrects the article DOI: 10.1371/journal.ppat.1005589.].
June 2016: PLoS Pathogens
https://www.readbyqxmd.com/read/27183620/privileged-antigen-presentation-in-splenic-b-cell-follicles-maximizes-t-cell-responses-in-prime-boost-vaccination
#18
Byram W Bridle, Andrew Nguyen, Omar Salem, Liang Zhang, Sandeep Koshy, Derek Clouthier, Lan Chen, Jonathan Pol, Stephanie L Swift, Dawn M E Bowdish, Brian D Lichty, Jonathan L Bramson, Yonghong Wan
Effector T cells (TEFF) are a barrier to booster vaccination because they can rapidly kill Ag-bearing APCs before memory T cells are engaged. We report in this study that i.v. delivery of rhabdoviral vectors leads to direct infection of follicular B cells in the spleen, where the earliest evidence of secondary T cell responses was observed. This allows booster immunizations to rapidly expand CD8(+) central memory T cells (TCM) during the acute phase of the primary response that is dominated by TEFF Interestingly, although the ablation of B cells before boosting with rhabdoviral vectors diminishes the expansion of memory T cells, B cells do not present Ags directly...
June 1, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/27150103/no-space-left-for-intravenous-thrombolysis-in-acute-stroke-pros
#19
Kateryna Antonenko, Valeria Caso
Five recently published RCTs (MR CLEAN, EXTEND-IA, SWIFT PRIME, REVASCAT and ESCAPE) employing mechanical thrombectomy with modern stent retriever devices clearly demonstrated the superiority of endovascular treatment compared to thrombolysis alone, which is now considered standard first-line therapy for selected patients with acute severe ischemic stroke and large vessel in the anterior circulation. RCT results led to recommendations outlined in "Mechanical thrombectomy in acute ischemic stroke by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN"...
August 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27148737/estradiol-enhances-cd4-t-cell-anti-viral-immunity-by-priming-vaginal-dcs-to-induce-th17-responses-via-an-il-1-dependent-pathway
#20
Varun C Anipindi, Puja Bagri, Kristy Roth, Sara E Dizzell, Philip V Nguyen, Christopher R Shaler, Derek K Chu, Rodrigo Jiménez-Saiz, Hong Liang, Stephanie Swift, Aisha Nazli, Jessica K Kafka, Jonathan Bramson, Zhou Xing, Manel Jordana, Yonghong Wan, Denis P Snider, Martin R Stampfli, Charu Kaushic
Clinical and experimental studies have shown that estradiol (E2) confers protection against HIV and other sexually transmitted infections. Here, we investigated the underlying mechanism. Better protection in E2-treated mice, immunized against genital HSV-2, coincided with earlier recruitment and higher proportions of Th1 and Th17 effector cells in the vagina post-challenge, compared to placebo-treated controls. Vaginal APCs isolated from E2-treated mice induced 10-fold higher Th17 and Th1 responses, compared to APCs from progesterone-treated, placebo-treated, and estradiol-receptor knockout mice in APC-T cell co-cultures...
May 2016: PLoS Pathogens
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