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https://www.readbyqxmd.com/read/30025394/presentation-evaluation-management-and-outcomes-of-acute-stroke-in-low-and-middle-income-countries-a-systematic-review-and-meta-analysis
#1
REVIEW
Rasha Khatib, Yurany A Arevalo, Mark A Berendsen, Shyam Prabhakaran, Mark D Huffman
AIMS: We performed a systematic review to evaluate stroke presentation, evaluation, management, and outcomes among studies conducted in low- and middle-income countries (LMIC). METHODS: We searched MEDLINE (Ovid), Embase (Elsevier), and the Global Health (EBSCOhost) databases between January 2005 and June 2017 for studies conducted in LMICs defined by the World Bank. We pooled prevalence estimates using an inverse-variance weighting method and stratified by the country income group...
July 19, 2018: Neuroepidemiology
https://www.readbyqxmd.com/read/30024661/extremely-low-frequency-electromagnetic-field-reduces-oxidative-stress-during-the-rehabilitation-of-post-acute-stroke-patients
#2
Natalia Cichoń, Paulina Rzeźnicka, Michał Bijak, Elżbieta Miller, Sergiusz Miller, Joanna Saluk
BACKGROUND: One of the therapeutic methods used in stroke rehabilitation is magnetotherapy using extremely low frequency and variable pulse shape electromagnetic field (ELF-EMF). OBJECTIVES: The aim of our study was to investigate the effect of magnetotherapy on the condition of postacute stroke patients, as measured by plasma oxidative stress markers and clinical parameters which show the progress of rehabilitation. MATERIAL AND METHODS: The selected 57 post-stroke patients were divided into 2 groups, those with ELFEMF therapy and those without...
July 19, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/30024313/stroke-admission-outside-daytime-working-hours-delays-mechanical-thrombectomy-and-worsens-short-term-outcome
#3
Robert Hoepner, Ralph Weber, Gernot Reimann, Klaus Berger, Martin Kitzrow, Sebastian Fischer, Christian Weimar, Jens Eyding, Christos Krogias
Background and purpose Rapid therapeutic decisions in acute stroke patients leading to earlier initiation of revascularization therapies are associated with better outcome. An association between regular working hours and reduced time to initiation of intravenous thrombolysis has been reported. However, its influence on mechanical thrombectomy (MT) remains uncertain. We aimed to analyze the effects of admission time on door-to-groin time and stroke outcome in a large prospective stroke registry of the Neurovascular Net Ruhr in Germany...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/30023162/protocol-and-pilot-study-of-a-short-message-service-guided-training-after-acute-stroke-transient-ischemic-attack-to-increase-walking-capacity-and-physical-activity
#4
Birgit Vahlberg, Ulf Holmbäck, Staffan Eriksson, Tommy Cederholm
Physical activity in community-living individuals after a stroke is usually scarce. This protocol describes a study that will evaluate a method to increase physical activity by performing a 3-month outdoor walking and muscle strengthening program and will examine the 3-month and 1-year effects of this program on individuals with acute stroke (AS) or transient ischemic attack (TIA). In a prospective randomized controlled trial in Uppsala, Sweden, 80 individuals with AS or TIA who maintained cognitive and motor function will be randomized into groups for continuous training for three months or for regular standard care...
September 2018: Preventive Medicine Reports
https://www.readbyqxmd.com/read/30022798/dual-versus-mono-antiplatelet-therapy-for-acute-non-cardioembolic-ischaemic-stroke-or-transient-ischaemic-attack-a-systematic-review-and-meta-analysis
#5
Yingying Yang, Mengyuan Zhou, Xi Zhong, Yongjun Wang, Xingquan Zhao, Liping Liu, Yilong Wang
Objective: Recent years have seen new evidence on the efficacy and safety of dual antiplatelet therapy for secondary stroke prevention. We updated a meta-analysis of randomised controlled trials evaluating dual antiplatelet versus monotherapy for patients with acute non-cardioembolic ischaemic stroke (IS) or transient ischaemic attack (TIA). Methods: We searched PubMed and identified randomised controlled trials evaluating dual antiplatelet versus monotherapy for acute non-cardioembolic IS or TIA within 3 days of ictus up to May 2018...
June 2018: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/30022515/the-immune-system-and-stroke-from-current-targets-to-future-therapy
#6
REVIEW
Kyle Malone, Sylvie Amu, Anne C Moore, Christian Waeber
Stroke is a major cause of morbidity and mortality worldwide. Despite the intensive search for new therapies, hundreds of agents targeting various pathophysiological mechanisms have failed clinical trials, and the thrombolytic agent tissue plasminogen activator is currently the only FDA-approved medication for the treatment of acute ischaemic stroke (AIS). The immune system is involved in all stages of stroke, from the pathogenesis of risk factors to neurotoxicity, to tissue remodelling and repair. There is a bi-directional interaction between the brain and the immune system, with stroke-induced immunosuppression and subsequent infection a principal source of patient mortality...
July 19, 2018: Immunology and Cell Biology
https://www.readbyqxmd.com/read/30021732/caseous-calcification-of-the-mitral-valve-annulus-a-rare-cause-of-bilateral-cerebral-and-ocular-embolisation
#7
Artemis Matsou, Chrysanthos Symeonidis, Maria Dermenoudi, Vasileios Sachpekidis
A 65-year-old woman presented with sudden bilateral visual loss of recent onset. She was recently diagnosed with multiple acute stroke syndrome for which she was commenced on antiplatelet therapy. Funduscopic examination revealed bilateral inferotemporal retinal artery occlusions. The recent history of multiple cerebral infarcts combined with the current ocular findings prompted a transoesophageal echocardiogram which successfully revealed caseous calcification of the mitral valve annulus as the source of the numerous sequential emboli, a finding which the conventional transthoracic echocardiogram had failed to disclose as a result of suboptimal image quality...
July 18, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/30021503/canadian-stroke-best-practice-recommendations-for-acute-stroke-management-prehospital-emergency-department-and-acute-inpatient-stroke-care-6th-edition-update-2018
#8
J M Boulanger, M P Lindsay, G Gubitz, E E Smith, G Stotts, N Foley, S Bhogal, K Boyle, L Braun, T Goddard, Mks Heran, N Kanya-Forster, E Lang, P Lavoie, M McClelland, C O'Kelly, P Pageau, J Pettersen, H Purvis, M Shamy, D Tampieri, B vanAdel, R Verbeek, D Blacquiere, L Casaubon, D Ferguson, Y Hegedus, G J Jacquin, M Kelly, N Kamal, B Linkewich, C Lum, B Mann, G Milot, N Newcommon, P Poirier, W Simpkin, E Snieder, A Trivedi, R Whelan, M Eustace, E Smitko, K Butcher
The 2018 update of the Canadian Stroke Best Practice Recommendations for Acute Stroke Management, 6th edition, is a comprehensive summary of current evidence-based recommendations, appropriate for use by healthcare providers and system planners caring for persons with very recent symptoms of acute stroke or transient ischemic attack. The recommendations are intended for use by a interdisciplinary team of clinicians across a wide range of settings and highlight key elements involved in prehospital and Emergency Department care, acute treatments for ischemic stroke, and acute inpatient care...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/30021491/canadian-stroke-best-practice-consensus-statement-acute-stroke-management-during-pregnancy
#9
Noor Niyar N Ladhani, Richard H Swartz, Norine Foley, Kara Nerenberg, Eric E Smith, Gord Gubitz, Dariush Dowlatshahi, Jayson Potts, Joel G Ray, Jon Barrett, Cheryl Bushnell, Simerpreet Bal, Wee-Shian Chan, Radha Chari, Meryem El Amrani, Shital Gandhi, Michael D Hill, Andra James, Thomas Jeerakathil, Albert Jin, Adam Kirton, Sylvain Lanthier, Andrea Lausman, Lisa Rae Leffert, Jennifer Mandzia, Bijoy Menon, Aleksandra Pikula, Alexandre Poppe, Gustavo Saposnik, Mukul Sharma, Sanjit Bhogal, Elisabeth Smitko, M Patrice Lindsay
The Canadian Stroke Best Practice Consensus Statement Acute Stroke Management during Pregnancy is the second of a two-part series devoted to stroke in pregnancy. The first part focused on the unique aspects of secondary stroke prevention in a woman with a prior history of stroke who is, or is planning to become, pregnant. This document focuses on the management of a woman who experiences an acute stroke during pregnancy. This consensus statement was developed in recognition of the need for a specifically tailored approach to the management of this group of patients in the absence of any broad-based, stroke-specific guidelines or consensus statements, which do not exist currently...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/30021123/evaluation-of-neuregulin-1-s-neuroprotection-against-ischemic-injury-in-rats-using-diffusion-tensor-imaging
#10
Silun Wang, Yonggang Li, Ramesh Paudyal, Byron D Ford, Xiaodong Zhang
Stroke is a devastating neurovascular disorder that results in damage to neurons and white matter tracts. It has been previously demonstrated that neuregulin-1 (NRG-1) protects neurons from ischemic injury following stroke. Here, diffusion tensor imaging (DTI) was utilized to characterize the effects of NRG-1 treatment on cererbral infarction and integrity of white matter after ischemic insult using a permanent middle celebral artery occlusion (pMCAo) rat model. In the present study, sixteen Sprague-Dawley rats underwent pMCAo surgery and received either a single intra-arterial bolus (20 μg/kg) dose of NRG-1 or saline immediately prior to pMCAo...
July 15, 2018: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/30020533/oral-administration-of-probiotic-lactobacillus-casei-shirota-decreases-pneumonia-and-increases-pulmonary-functions-after-single-rib-fracture-a-randomized-double-blind-placebo-controlled-clinical-trial
#11
Chunhua Guo, Min Lei, Yong Wang, Limei Hua, Sujuan Xue, Dan Yu, Chunhua Zhang, Dawei Wang
Considerate proportion of elderly patients with a rib fracture is susceptible to pulmonary complications, especially pneumonia. We aimed to assess the effect of oral administration of the probiotic Lactobacillus casei Shirota (LcS) on pneumonia and pulmonary functions among elderly patients with single rib fracture. The current study including 204 eligible elderly patients with a single rib fracture was conducted. Patients were randomly assigned to receive oral administration of skimmed milk containing either a commercial probiotic LcS or placebo daily for 1 mo after the fracture, followed by pneumonia assessments, pulmonary function testing including forced expiratory volume (FEV), negative inspiratory pressure (NIP), and forced vital capacity (FVC), as well as evaluation of potential adverse effects including myocardial infarction, acute kidney injury, nonunion of fractured bone, or stroke...
July 18, 2018: Journal of Food Science
https://www.readbyqxmd.com/read/30020204/care-and-discharge-outcome-of-acute-stroke-in-lebanon-a-hospital-based-study
#12
Nathalie Lahoud, Pascale Salameh, Hassan Hosseini, Nadine Saleh, Elias Rizk, Souheil Hallit, Marie Helene Abbas, Souheil Gebeily
The present study was conducted to assess stroke care and outcomes in two Lebanese hospitals. Patients admitted in 2012 and 2013 were retrospectively selected. Data were extracted from medical records for time to hospital arrival, stroke severity, management, and discharge outcomes. A Cox regression analysis was then conducted to predict time to in-hospital death. A total of 201 patients were included (mean age = 69.2 years), among whom 50% arrived within a delay of 3.75 hours. Half underwent brain imaging in the first hour, and nine patients received an acute intervention...
July 17, 2018: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/30019993/safety-feasibility-and-potential-efficacy-of-intraarterial-selective-cooling-infusion-for-stroke-patients-treated-with-mechanical-thrombectomy
#13
Chuanjie Wu, Wenbo Zhao, Hong An, Longfei Wu, Jian Chen, Mohammed Hussain, Yuchuan Ding, Chuanhui Li, Wenjing Wei, Jiangang Duan, Chunmei Wang, Qi Yang, Di Wu, Liqiang Liu, Xunming Ji
This is a prospective non-randomized cohort study of 113 consecutive patients to investigate the safety and efficacy of a short-duration intraarterial selective cooling infusion (IA-SCI) targeted into an ischemic territory combined with mechanical thrombectomy (MT) in patients with large vessel occlusion-induced acute ischemic stroke (AIS); 45/113 patients underwent IA-SCI with 350 ml 0.9% saline at 4℃ for 15 min at the discretion of the interventionalist. Key parameters such as vital signs and key laboratory values, symptomatic and any intracranial hemorrhage, coagulation abnormalities, pneumonia, urinary tract infections and mortality were not significantly different between the two groups...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/30019923/incidence-and-mortality-of-myocardial-infarction-among-catalonian-older-adults-with-and-without-underlying-risk-conditions-the-capamis-study
#14
M José Forcadell, Angel Vila-Córcoles, Cinta de Diego, Olga Ochoa-Gondar, Eva Satué
Background Population-based data about the epidemiology of acute myocardial infarction is limited. This study investigated incidence and mortality of acute myocardial infarction in older adults with specific underlying chronic conditions and evaluated the influence of these conditions in developing acute myocardial infarction. Design and methods This was a population-based cohort study involving 27,204 individuals ≥ 60 years of age in Tarragona (Catalonia, Spain). Data on all cases of hospitalised acute myocardial infarction were collected from 1 December 2008-30 November 2011...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/30019921/comparison-of-the-rates-of-stroke-and-acute-coronary-events-in-northern-france
#15
Dominique Cottel, Michèle Montaye, Nadine Marécaux, Philippe Amouyel, Jean Dallongeville, Aline Meirhaeghe
Background Although stroke and acute coronary events share several risk factors, few studies have compared population-level epidemiological surveillance indicators of the two diseases in the same age range and in the same geographical area. Design The objective of the present study was to compare the rate of acute coronary events with that of stroke among inhabitants aged from 35-74 years in Northern France (Lille). Methods All incident and recurrent acute coronary events and stroke events occurring in men and women over 2008-2014 were recorded using two population-based registries with several overlapping sources of case ascertainment for hospitalised/non-hospitalised and fatal/non-fatal events...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/30019673/acute-critical-illness-and-cancer-risk-implications-from-a-nationwide-population-based-study-in-asia
#16
Wei-Syun Hu, Cheng-Li Lin
OBJECTIVE: The objective of this study was to identify the risk of incident cancer among patients with acute critical illness. METHODS: The study applied the big database from the National Health Research Institutes in Taiwan. The risk of incident cancer over a 12-year period in patients with 4 types of newly diagnosed acute critical illness (septicemia/septic shock, acute myocardial infarction, hemorrhagic stroke and ischemic stroke) was investigated using Cox proportional hazards regression model with further controlling for the competing risk of death...
June 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/30019633/recovernow-a-patient-perspective-on-the-delivery-of-mobile-tablet-based-stroke-rehabilitation-in-the-acute-care-setting
#17
Karen Mallet, Rany Shamloul, Michael Pugliese, Emma Power, Dale Corbett, Simon Hatcher, Michel Shamy, Grant Stotts, Lise Zakutney, Sean Dukelow, Dar Dowlatshahi
Background/aim We previously reported the feasibility of RecoverNow (a mobile tablet-based post-stroke communication therapy in acute care). RecoverNow has since expanded to include fine motor and cognitive therapies. Our objectives were to gain a better understanding of patient experiences and recovery goals using mobile tablets. Methods Speech-language pathologists or occupational therapists identified patients with stroke and communication, fine motor, or cognitive/perceptual deficits. Patients were provided with iPads individually programmed with applications based on assessment results, and instructed to use it at least 1 h/day...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/30019629/safety-and-predictors-of-stroke-mimics-in-the-norwegian-tenecteplase-stroke-trial-nor-test
#18
Christopher Elnan Kvistad, Vojtech Novotny, Halvor Næss, Guri Hagberg, Hege Ihle-Hansen, Ulrike Waje-Andreassen, Lars Thomassen, Nicola Logallo
Background Stroke mimics are frequently treated with thrombolysis in clinical practice and thrombolytic trials. Although alteplase in stroke mimics has proven to be safe, safety of tenecteplase in stroke mimics has not been assessed in an ischemic stroke study setting. We aimed to assess clinical characteristics and safety of stroke mimics treated with thrombolysis in the Norwegian Tenecteplase Stroke Trial. We also aimed to identify possible predictors of stroke mimics as compared to patients with acute cerebral ischemia...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/30019627/treatment-with-exenatide-in-acute-ischemic-stroke-trial-protocol-a-prospective-randomized-open-label-blinded-end-point-study-of-exenatide-vs-standard-care-in-post-stroke-hyperglycemia
#19
Claire Muller, N Wah Cheung, Helen Dewey, Leonid Churilov, Sandy Middleton, Vincent Thijs, Elif I Ekinci, Chris Levi, Richard Lindley, Geoffrey Donnan, Mark Parsons, Christopher Bladin
Rationale Post-stroke hyperglycemia occurs in up to 50% of patients presenting with acute ischemic stroke. It reduces the efficacy of thrombolysis, increases infarct size, and worsens clinical outcomes. Insulin-based therapies have generally not been beneficial in treating post-stroke hyperglycemia as they are difficult to implement, may cause hypoglycaemia, possibly increase mortality and worsen clinical outcomes. Exenatide may be a safer, simpler, and more effective alternative to insulin in acute ischemic stroke...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/30019463/continuation-versus-discontinuation-of-antiplatelet-therapy-for-bleeding-and-ischaemic-events-in-adults-undergoing-non-cardiac-surgery
#20
REVIEW
Sharon R Lewis, Michael W Pritchard, Oliver J Schofield-Robinson, Phil Alderson, Andrew F Smith
BACKGROUND: Antiplatelet agents are recommended for people with myocardial infarction and acute coronary syndromes, transient ischaemic attack or stroke, and for those in whom coronary stents have been inserted. People who take antiplatelet agents are at increased risk of adverse events when undergoing non-cardiac surgery because of these indications. However, taking antiplatelet therapy also introduces risk to the person undergoing surgery because the likelihood of bleeding is increased...
July 18, 2018: Cochrane Database of Systematic Reviews
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