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https://www.readbyqxmd.com/read/29355906/antibiotic-therapy-for-preventing-infections-in-people-with-acute-stroke
#1
REVIEW
Jan-Dirk Vermeij, Willeke F Westendorp, Diederik Wj Dippel, Diederik van de Beek, Paul J Nederkoorn
BACKGROUND: Stroke is the main cause of disability in high-income countries and ranks second as a cause of death worldwide. Infections occur frequently after stroke and may adversely affect outcome. Preventive antibiotic therapy in the acute phase of stroke may reduce the incidence of infections and improve outcome. In the previous version of this Cochrane Review, published in 2012, we found that antibiotics did reduce the risk of infection but did not reduce the number of dependent or deceased patients...
January 22, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29355808/endovascular-mechanical-thrombectomy-for-acute-ischemic-stroke-under-general-anesthesia-versus-conscious-sedation-a-systematic-review-and-meta-analysis
#2
Adeel Ilyas, Ching-Jen Chen, Dale Ding, Paul M Foreman, Thomas J Buell, Natasha Ironside, Davis G Taylor, M Yashar Kalani, Min S Park, Andrew M Southerland, Bradford B Worrall
OBJECTIVE: Endovascular mechanical thrombectomy (EMT) is the standard of care for eligible patients presenting with anterior circulation acute ischemic stroke (AIS) due to emergent large vessel occlusion (ELVO). The aim of this systematic review and meta-analysis is to compare the outcomes between patients undergoing general anesthesia (GA) versus conscious sedation (CS) for these procedures. METHODS: A literature review was performed to identify studies reporting the EMT outcomes of AIS patients who underwent GA or CS for the procedure...
January 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29354949/-tie-s-flying-acupuncture-for-acute-cerebral-infarction-hemiplegia-a-randomized-controlled-trial
#3
Haibo Chu, Shuangyong Zhang, Junli Fu, Huali Dong, Rui Guo, Gaofeng Zhao, Quanrong Lian, Zhen Feng, Baolin Yang
OBJECTIVE: To compare the efficacy difference between TIE 's flying acupuncture combined with conventional treatment and conventional treatment alone on acute cerebral infarction hemiplegia. METHODS: A total of 120 patients were randomly divided into an observation group and a control group, 60 cases in each one. The control group was treated with conventional treatment, including anti-platelet aggregation, lipid-lowering, formula of traditional Chinese medicine which could promote circulation and remove stasis, neurotrophic medication and symptomatic treatment; mannitol was used for cerebral infarction with large area or increased intracranial pressure...
November 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29354569/effects-of-overactive-bladder-symptoms-in-stroke-patients-health-related-quality-of-life-and-their-performance-scale
#4
Hannah Pyo, Bo Ra Kim, Mina Park, Jeong Hee Hong, Eun Joo Kim
Objective: To identify the effects of overactive bladder (OAB) symptoms on the health-related quality of life (HRQOL) in stroke patients since OAB symptoms are common in such patients, but their effects on stroke rehabilitation over time are unclear. Methods: This study included 30 post-acute stroke patients who had been admitted for rehabilitation treatments. All participants completed a questionnaire evaluating urinary symptoms, including the Overactive Bladder Symptom Score (OABSS) and general HRQOL with a Short-Form 36 (SF-36) health survey...
December 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29354229/gerstmann-s-syndrome-and-unilateral-optic-ataxia-in-the-emergency-department
#5
Breno José Alencar Pires Barbosa, Marcelo Houat de Brito, Júlia Chartouni Rodrigues, Gabriel Taricani Kubota, Jacy Bezerra Parmera
A 75-year-old right-handed woman presented to the emergency department with simultanagnosia and right unilateral optic ataxia. Moreover, the patient had agraphia, acalculia, digital agnosia and right-left disorientation, consistent with complete Gerstmann's syndrome. This case highlights the concurrence of Gerstmann's syndrome and unilateral optic ataxia in the acute phase of a left middle cerebral artery stroke.
October 2017: Dementia & Neuropsychologia
https://www.readbyqxmd.com/read/29353826/the-association-between-glomerular-filtration-rate-estimated-on-admission-and-acute-stroke-outcome-the-shiga-stroke-registry
#6
Aryandhito Widhi Nugroho, Hisatomi Arima, Itsuko Miyazawa, Takako Fujii, Naomi Miyamatsu, Yoshihisa Sugimoto, Satoru Nagata, Masaru Komori, Naoyuki Takashima, Yoshikuni Kita, Katsuyuki Miura, Kazuhiko Nozaki
AIM: Although renal dysfunction has been identified as a novel risk factor affecting stroke prognosis, few have analyzed the association within large-scale population-based setting, using wide-range estimated glomerular filtration rate (eGFR) category. We aimed to determine the association of admission eGFR with acute stroke outcomes using data from a registry established in Shiga Prefecture, Japan. METHODS: Following exclusion of patients younger than 18 years, with missing serum creatinine data, and with onset more than 7 days prior to admission, 2,813 acute stroke patients registered in the Shiga Stroke Registry year 2011 were included in the final analysis...
January 19, 2018: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/29353233/cardiovascular-safety-long-term-noncardiovascular-safety-and-efficacy-of-sodium-glucose-cotransporter-2-inhibitors-in-patients-with-type-2-diabetes-mellitus-a-systemic-review-and-meta-analysis-with-trial-sequential-analysis
#7
REVIEW
Xin-Lin Zhang, Qing-Qing Zhu, Yu-Han Chen, Xue-Ling Li, Fu Chen, Jian-An Huang, Biao Xu
BACKGROUND: The cardiovascular and long-term noncardiovascular safety and efficacy of SGLT2 (sodium-glucose cotransporter 2) inhibitors have not been well documented. METHODS AND RESULTS: For cardiovascular outcomes, we performed a meta-analysis with trial sequential analysis of randomized controlled trials and adjusted observational studies, each with a minimum of 26 weeks and 2000 patient-years of follow-up. For long-term noncardiovascular safety and efficacy outcome analyses, we included only randomized controlled trials with at least 2 years and 1000 patient-years of follow-up...
January 20, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29352217/bedside-assessment-of-regional-cerebral-perfusion-using-near-infrared-spectroscopy-and-indocyanine-green-in-patients-with-atherosclerotic-occlusive-disease
#8
Hiroshi Saito, Tatsuya Ishikawa, Jun Tanabe, Shinya Kobayashi, Junta Moroi
This pilot study aimed to investigate the utility of near-infrared spectroscopy/indocyanine green (NIRS/ICG) for examining patients with occlusive cerebrovascular disease. Twenty-nine patients with chronic-stage atherosclerotic occlusive cerebrovascular disease were included. The patients were monitored using NIRS at the bedside. Using ICG time-intensity curves, the affected-to-unaffected side ratios were calculated for several parameters, including the maximum ICG concentration (ΔICGmax), time to peak (TTP), rise time (RT), and blood flow index (BFI = ΔICGmax/RT), and were compared to the affected-to-unaffected side ratios of the regional cerebral blood flow (rCBF) and regional oxygen extraction fraction (rOEF) obtained using positron emission tomography with 15O-labeled gas...
January 19, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29352061/what-to-do-about-fibrin-rich-tough-clots-comparing-the-solitaire-stent-retriever-with-a-novel-geometric-clot-extractor-in-an-in-vitro-stroke-model
#9
Vernard S Fennell, Swetadri Vasan Setlur Nagesh, Karen M Meess, Liza Gutierrez, Rhys H James, Michael E Springer, Adnan H Siddiqui
BACKGROUND: Despite advances in revascularization tools for large vessel occlusion presenting as acute ischemic stroke, a significant subset of clots remain recalcitrant to current strategies. We assessed the effectiveness of a novel thrombectomy device that was specifically designed to retrieve resistant fibrin rich clots, the geometric clot extractor (GCE; Neuravi, Galway, Ireland), in an in vitro cerebrovascular occlusion stroke model. METHODS: After introducing fibrin rich clot analogues into the middle cerebral artery of the model, we compared the rates of recanalization between GCE and Solitaire flow restoration stent retriever (SR; Medtronic, Minneapolis, Minnesota, USA; control group) cases...
January 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29352059/increased-blood-pressure-variability-after-endovascular-thrombectomy-for-acute-stroke-is-associated-with-worse-clinical-outcome
#10
Alicia E Bennett, Michael J Wilder, J Scott McNally, Jana J Wold, Gregory J Stoddard, Jennifer J Majersik, Safdar Ansari, Adam de Havenon
BACKGROUND AND PURPOSE: Blood pressure variability has been found to contribute to worse outcomes after intravenous tissue plasminogen activator, but the association has not been established after intra-arterial therapies. METHODS: We retrospectively reviewed patients with an ischemic stroke treated with intra-arterial therapies from 2005 to 2015. Blood pressure variability was measured as standard deviation (SD), coefficient of variation (CV), and successive variation (SV)...
January 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29352054/increased-blood-brain-barrier-permeability-in-contralateral-hemisphere-predicts-worse-outcome-in-acute-ischemic-stroke-after-reperfusion-therapy
#11
Chang Liu, Shenqiang Yan, Ruiting Zhang, Zhicai Chen, Feina Shi, Ying Zhou, Meixia Zhang, Min Lou
AIMS: We sought to investigate the risk factors of blood-brain barrier (BBB) disruption, and its potential impact on 90-day clinical outcome in acute ischemic stroke (AIS) patients after reperfusion therapy. METHODS: Consecutive acute anterior circulation AIS patients imaged with computed tomographic perfusion (CTP) before reperfusion therapy were included. Tmax >6 s was used for the volumetric measurement of the hypoperfusion area. BBB permeability (BBBP) was calculated as the average relative permeability-surface area product (rPS) within the hypoperfusion region (rPShypo-i) and its contralateral mirror region (rPShypo-c) on CTP-derived PS color maps...
January 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29351787/scl20a2-mutation-presenting-with-acute-ischemic-stroke-a-case-report
#12
Xiaoyu Zhang, Gaoting Ma, Zhangning Zhao, Meijia Zhu
BACKGROUND: Primary familial brain calcification (PFBC) is a rare disorder characterized by distinctive bilateral brain calcification and variable clinical presentations. However, cerebrovascular attack was rarely reported in PFBC patients. We here reported a SLC20A2 mutation patient presenting with acute ischemic stroke. CASE PRESENTATION: A 56 years old man was transferred to our hospital because of 6 days of melena and 3 days of somnolence, agitation and mood changes...
January 19, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29350878/perfusion-ct-in-posterior-circulation-stroke-predictors-and-prognostic-implications-of-focal-hypoperfusion
#13
Lars-Peder Pallesen, Dimitris Lambrou, Ashraf Eskandari, Jessica Barlinn, Kristian Barlinn, Heinz Reichmann, Vincent Dunet, Philippe Maeder, Volker Puetz, Patrik Michel
BACKGROUND: We aimed to determine predictors of focal hypoperfusion on CT Perfusion (CTP) in patients with acute posterior circulation stroke and its association with long-term outcome. METHODS: We selected patients with posterior circulation stroke from the Acute STroke Registry and Analysis of Lausanne (ASTRAL) who underwent CTP within 24 hours of stroke onset as part of the stroke imaging protocol. Hypoperfusion was defined as an area of visually well demarcated mean-transit-time (MTT) prolongation corresponding to an arterial territory on standard reconstruction CTP imaging maps...
January 19, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29350803/thrombectomy-outcomes-for-acute-stroke-patients-with-anterior-circulation-tandem-lesions-a-clinical-registry-and-an-update-of-systematic-review-with-meta-analysis
#14
Udi Sadeh-Gonik, Noam Tau, Tal Friehmann, Serge Bracard, René Anxionnat, Anne-Laure Derelle, Romain Tonnelet, Liang Lia, Sébastien Richard, Xavier Armoiry, Benjamin Gory
BACKGROUND AND PURPOSE: Although mechanical thrombectomy (MT) appears to be superior in stroke patients with extracranial carotid disease (ECD) compared to thrombolysis alone, the impact of emergent carotid stenting during MT remains unclear. We assessed the MT outcomes in anterior stroke patients with ECD, especially when combined with carotid stenting. METHODS: We performed a retrospective analysis of our registry and conducted an update of a systematic review and meta-analysis of MT studies with or without stenting for anterior circulation stroke with ECD published between November 2010 and April 2017...
January 19, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29350775/randomized-trial-of-transcranial-dc-stimulation-for-post-stroke-dysphagia
#15
Sonja Suntrup-Krueger, Corinna Ringmaier, Paul Muhle, Andreas Wollbrink, Andre Kemmling, Uta Hanning, Inga Claus, Tobias Warnecke, Inga Teismann, Christo Pantev, Rainer Dziewas
OBJECTIVE: We evaluated whether transcranial direct current stimulation (tDCS) is able to enhance dysphagia rehabilitation following stroke. Besides relating clinical effects with neuroplastic changes in cortical swallowing processing we aimed to identify factors influencing treatment success. METHODS: In this double-blind, randomized study 60 acute dysphagic stroke patients received contralesional anodal (1 mA, 20 min) or sham tDCS on four consecutive days. Swallowing function was thoroughly assessed before and after the intervention using the validated Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS) and clinical assessment...
January 19, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29350576/posterior-reversible-encephalopathy-syndrome-in-stroke-prone-spontaneously-hypertensive-rats-on-high-salt-diet
#16
Fanny Herisson, Iris Zhou, Jerome Mawet, E Du, Arnavaz H Barfejani, Tao Qin, Marilyn J Cipolla, Philip Z Sun, Natalia S Rost, Cenk Ayata
Stroke-prone spontaneously hypertensive rats (SHRSP) on high-salt diet are characterized by extremely high arterial pressures, and have been endorsed as a model for hypertensive small vessel disease and vascular cognitive impairment. However, rapidly developing malignant hypertension is a well-known cause of posterior reversible encephalopathy syndrome (PRES) in humans, associated with acute neurological deficits, seizures, vasogenic cerebral edema and microhemorrhages. In this study, we aimed to examine the overlap between human PRES and SHRSP on high-salt diet...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29350392/diagnostic-and-prognostic-micro-rnas-in-ischemic-stroke-due-to-carotid-artery-stenosis-and-in-acute-coronary-syndrome-the-4-year-prospective-study
#17
Jacek Gacoń, Rafał Badacz, Ewa Stępień, Izabela Karch, Francisco J Enguita, Krzysztof Żmudka, Tadeusz Przewłocki, Anna Kabłak-Ziembicka
BACKGROUND: Circulating microRNAs (miRs) levels are potentially important diagnostic and prognostic biomarkers in acute coronary syndrome (ACS) or cerebral ischemic event (CIE) resulting from internal carotid artery stenosis (ICAS). AIM: This 4-year prospective study aimed to compare the levels of circulating miRs in ACS vs CIE patients, and investigate miRs potentially associated with risk of recurrent cardiovascular event. METHODS: The circulating miRs levels (miR-1-3p, miR-16-5p, miR-34a-5p, mir-122-5p, miR-124-3p, miR-133a-3p, miR-133b, miR-134-5p, miR-208b-3p, miR-375 and miR-499-5p) were compared in 43 (34M, 57...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350380/patients-treated-with-bivalirudin-still-at-higher-risk-of-stent-thrombosis-a-comprehensive-meta-analysis-of-randomized-clinical-trials-of-bivalirudin-and-heparin-for-percutaneous-coronary-interventions
#18
Stefan Grajek, Michał Michlak, Adrian Gwizdała, Aleksander Araszkiewicz, Marek Grygier, Jarosław Hiczkiewicz, Maciej Lesiak
BACKGROUND: Although the current practice guidelines recommend using both heparin and bivalirudin for percutaneous coronary interventions (PCI), the research data are ambiguous. AIM: To compare the impact of bivalirudin- and heparin on major clinical endpoints in PCI patients with particular emphasis on periprocedural stent thrombosis. METHODS: Total of 18 randomised clinical trials involving 41752 subjects were included. The endpoints comprised: net adverse clinical event (NACE: death, myocardial infarction [MI], unscheduled revascularisation, major bleeding [MB]), major adverse cardiovascular event (MACE: death, MI or stroke), acute/subacute stent thrombosis (ST)...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350061/the-adverse-effects-of-environmental-noise-exposure-on-oxidative-stress-and-cardiovascular-risk
#19
Thomas Münzel, Mette Sørensen, Frank P Schmidt, Erwin Schmidt, Sebastian Steven, Swenja Kröller-Schön, Andreas Daiber
Epidemiological studies have provided evidence that traffic noise exposure is linked to cardiovascular diseases such as arterial hypertension, myocardial infarction and stroke. Noise is a non-specific stressor that activates the autonomous nervous system and endocrine signaling. According to the noise reaction model introduced by Babisch and colleagues, chronic low levels of noise can cause so called non-auditory effects, such as disturbances of activity, sleep and communication, which can trigger a number of emotional responses, including annoyance and subsequent stress...
January 19, 2018: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/29349824/reduced-left-ventricular-filling-following-blood-volume-extraction-does-not-result-in-compensatory-augmentation-of-cardiac-mechanics
#20
Rachel Lord, David MacLeod, Keith George, David Oxborough, Rob Shave, Mike Stembridge
An acute non-invasive reduction in preload has been shown to augment cardiac mechanics to maintain stroke volume and cardiac output. Such interventions induce concomitant changes in heart rate (HR), whereas blood volume extraction reduces preload without HR changes. Therefore, the purpose of this study was to determine whether a preload reduction in isolation resulted in augmented stroke volume achieved via enhanced cardiac mechanics. Nine healthy volunteers (4 female, age 29 ± 11 years) underwent echocardiography for the assessment of left ventricular (LV) volumes and mechanics in a supine position at baseline and end-extraction following the controlled removal of 25% of total blood volume (1062 ± 342 ml)...
January 18, 2018: Experimental Physiology
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