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https://www.readbyqxmd.com/read/28329380/subclinical-thyroid-dysfunction-and-cardiovascular-diseases-2016-update
#1
Carmen Floriani, Baris Gencer, Tinh-Hai Collet, Nicolas Rodondi
Subclinical thyroid dysfunction comprises subclinical hypothyroidism (SHypo), defined as elevated thyroid-stimulating hormone (TSH) by normal free thyroxine (FT4), and subclinical hyperthyroidism (SHyper) with decreased or undetectable TSH and normal FT4. Up to 10% of the elderly have SHypo, which is usually asymptomatic. Individual participant data (IPD) analyses of prospective cohort studies from the international Thyroid Studies Collaboration show that SHypo is associated with increased coronary heart disease (CHD) mortality [hazard ratio (HR) 1,58 for TSH ≥ 10 mIU/L, 95% CI 1...
February 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28325524/current-status-of-lipid-management-in-acute-coronary-syndrome
#2
REVIEW
Koichiro Fujisue, Kenichi Tsujita
The development of coronary revascularization has dramatically improved early cardiovascular outcomes in patients with acute coronary syndrome (ACS). However, patients who have experienced myocardial infarction (MI) are at high risk of recurrence of cardiovascular events compared with those who are healthy or have stable coronary artery disease. Acute coronary events induce further inflammatory responses and plaque vulnerability in either a coronary culprit or whole vessels. The majority of data have supported the importance of coronary risk management to prevent secondary events...
March 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28324261/prophylactic-anticonvulsants-in-intracerebral-hemorrhage
#3
Jason Mackey, Ashley D Blatsioris, Elizabeth A S Moser, Ravan J L Carter, Chandan Saha, Alec Stevenson, Abigail L Hulin, Darren P O'Neill, Aaron A Cohen-Gadol, Thomas J Leipzig, Linda S Williams
BACKGROUND AND PURPOSE: Prophylactic anticonvulsants are routinely prescribed in the acute setting for intracerebral hemorrhage (ICH) patients, but some studies have reported an association with worse outcomes. We sought to characterize the prevalence and predictors of prophylactic anticonvulsant administration after ICH as well as guideline adherence. We also sought to determine whether prophylactic anticonvulsants were independently associated with poor outcome. METHODS: We performed a retrospective study of primary ICH in our two academic centers...
March 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28323928/physical-activity-vitamin-d-and-incident-atherosclerotic-cardiovascular-disease-in-whites-and-blacks-the-aric-study
#4
Kathleen Chin, Di Zhao, Martin Tibuakuu, Seth S Martin, Chiadi E Ndumele, Roberta Florido, B Gwen Windham, Eliseo Guallar, Pamela L Lutsey, Erin D Michos
Context: Physical activity (PA) is associated with 25-hydroxyvitamin D [25(OH)D] levels. Both are associated with atherosclerotic cardiovascular disease (ASCVD), but their joint association with ASCVD risk is unknown. Objective: To examine the dose-response between PA and 25(OH)D, and to assess effect modification of 25(OH)D and PA with ASCVD risk. Design: Cross-sectional and prospective study using Poisson and linear regression. Setting: Community-dwelling Atherosclerosis Risk in Communities cohort...
February 17, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#5
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28322423/uptake-of-non-vitamin-k-antagonist-oral-anti-coagulants-in-patients-with-atrial-fibrillation-a-prospective-cohort-study
#6
Matylda Zimny, Steffen Blum, Peter Ammann, Paul Erne, Giorgio Moschovitis, Marcello Di Valentino, Dipen Shah, Jürg Schläpfer, Cyrill Vogt, Alexandra Tabord, Michael Kühne, Christian Sticherling, Stefan Osswald, David Conen
AIMS: We aimed to assess the uptake of non-vitamin K antagonist oral anticoagulants (NOACs) among patients with atrial fibrillation between 2010 and 2015 in Switzerland. METHODS: We performed a prospective observational cohort study. At the baseline examination and during yearly follow-ups, we used questionnaires to obtain information about clinical characteristics and antithrombotic treatment. Stroke risk was assessed using the CHA2DS2-VASc score. RESULTS: 1545 patients were enrolled across seven centres in Switzerland...
March 21, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28320168/a-systematic-comparison-of-key-features-of-ischemic-stroke-prevention-guidelines-in-low-and-middle-income-vs-high-income-countries
#7
REVIEW
Hernán Bayona, Mayowa Owolabi, Wuwei Feng, Paul Olowoyo, Joseph Yaria, Rufus Akinyemi, James R Sawers, Bruce Ovbiagele
BACKGROUND AND PURPOSE: Implementation of contextually appropriate, evidence-based, expert-recommended stroke prevention guideline is particularly important in Low-Income Countries (LMICs), which bear disproportional larger burden of stroke while possessing fewer resources. However, key quality characteristics of guidelines issued in LMICs compared with those in High-Income Countries (HICs) have not been systematically studied. We aimed to compare important features of stroke prevention guidelines issued in these groups...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28318443/cardiac-ct-imaging-for-ischemic-stroke-current-and-evolving-clinical-applications
#8
Jin Hur, Byoung Wook Choi
While the etiology of ischemic stroke is heterogeneous, approximately 20%-40% of all stroke cases result from cardiac or aortic origin. Transesophageal echocardiography (TEE) has become the reference standard modality for the detection of potential sources of cerebral embolism. Because of the advances in computed tomographic (CT) technology, cardiac CT can be used in the evaluation of potential cardioembolic sources. During the past decade, cardiac CT has been tested and compared with TEE for the diagnosis of cardioembolic sources...
April 2017: Radiology
https://www.readbyqxmd.com/read/28317478/homocysteine-and-non-cardiac-vascular-disease
#9
Niki Katsiki, Pablo Perez-Martinez, Dimitri P Mikhailidis
Elevated homocysteine (Hcy) levels are predictors of cardiovascular disease (CVD). Hyperhomocysteinemia has also been associated with total and CVD mortality. However, whether Hcy is just a marker or plays a causal role in CVD remains to be elucidated. In this narrative review, we discuss the associations between Hcy and non-cardiac vascular diseases, namely stroke, peripheral artery disease (PAD), carotid artery disease, chronic kidney disease (CKD), atherosclerotic renal artery stenosis (ARAS), abdominal aortic aneurysm (AAA) and erectile dysfunction (ED)...
March 17, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28316281/are-potentially-clinically-meaningful-benefits-misinterpreted-in-cardiovascular-randomized-trials-a-systematic-examination-of-statistical-significance-clinical-significance-and-authors-conclusions
#10
G Michael Allan, Caitlin R Finley, James McCormack, Vivek Kumar, Simon Kwong, Emelie Braschi, Christina Korownyk, Michael R Kolber, Adriennne J Lindblad, Oksana Babenko, Scott Garrison
BACKGROUND: While journals and reporting guidelines recommend the presentation of confidence intervals, many authors adhere strictly to statistically significant testing. Our objective was to determine what proportions of not statistically significant (NSS) cardiovascular trials include potentially clinically meaningful effects in primary outcomes and if these are associated with authors' conclusions. METHODS: Cardiovascular studies published in six high-impact journals between 1 January 2010 and 31 December 2014 were identified via PubMed...
March 20, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28315622/subclinical-atherosclerosis-statin-eligibility-and-outcomes-in-african-american-individuals-the-jackson-heart-study
#11
Ravi V Shah, Aferdita Spahillari, Stanford Mwasongwe, J Jeffrey Carr, James G Terry, Robert J Mentz, Daniel Addison, Udo Hoffmann, Jared Reis, Jane E Freedman, Joao A C Lima, Adolfo Correa, Venkatesh L Murthy
Importance: Modern prevention guidelines substantially increase the number of individuals who are eligible for treatment with statins. Efforts to refine statin eligibility via coronary calcification have been studied in white populations but not, to our knowledge, in large African American populations. Objective: To compare the relative accuracy of US Preventive Services Task Force (USPSTF) and American College of Cardiology/American Heart Association (ACC/AHA) recommendations in identifying African American individuals with subclinical and clinical atherosclerotic cardiovascular disease (ASCVD)...
March 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28314926/american-football-and-fatal-exertional-heat-stroke-a-case-study-of-korey-stringer
#12
Andrew Grundstein, John A Knox, Jennifer Vanos, Earl R Cooper, Douglas J Casa
On August 1, 2001, Korey Stringer, a Pro Bowl offensive tackle for the Minnesota Vikings, became the first and to date the only professional American football player to die from exertional heat stroke (EHS). The death helped raise awareness of the dangers of exertional heat illnesses in athletes and prompted the development of heat safety policies at the professional, collegiate, and interscholastic levels. Despite the public awareness of this death, no published study has examined in detail the circumstances surrounding Stringer's fatal EHS...
March 17, 2017: International Journal of Biometeorology
https://www.readbyqxmd.com/read/28314516/impact-of-an-intrahospital-mobile-thrombolysis-team-on-3-month-clinical-outcomes-in-patients-benefiting-from-intravenous-thrombolysis-for-acute-ischemic-stroke
#13
B Hebant, A Triquenot-Bagan, E Guegan-Massardier, O Ozkul-Wermester, L Grangeon, D Maltête
INTRODUCTION/OBJECTIVE: The benefits of thrombolysis in patients presenting with acute ischemic stroke (IS) are highly time-dependent. The aim of our study was to evaluate the clinical benefit, after 3 months, of an intrahospital mobile thrombolysis team (MTT) for thrombolysis in IS. PATIENTS AND METHODS: A total of 95 consecutive patients treated with IV tPA for acute IS at the neurology department of Rouen University Hospital between 1 January and 31 December 2015 were retrospectively identified...
March 14, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28303425/common-data-elements-for-clinical-research-in-mitochondrial-disease-a-national-institute-for-neurological-disorders-and-stroke-project
#14
Amel Karaa, Shamima Rahman, Anne Lombès, Patrick Yu-Wai-Man, Muniza K Sheikh, Sherita Alai-Hansen, Bruce H Cohen, David Dimmock, Lisa Emrick, Marni J Falk, Shana McCormack, David Mirsky, Tony Moore, Sumit Parikh, John Shoffner, Tanja Taivassalo, Mark Tarnopolsky, Ingrid Tein, Joanne C Odenkirchen, Amy Goldstein
OBJECTIVES: The common data elements (CDE) project was developed by the National Institute of Neurological Disorders and Stroke (NINDS) to provide clinical researchers with tools to improve data quality and allow for harmonization of data collected in different research studies. CDEs have been created for several neurological diseases; the aim of this project was to develop CDEs specifically curated for mitochondrial disease (Mito) to enhance clinical research. METHODS: Nine working groups (WGs), composed of international mitochondrial disease experts, provided recommendations for Mito clinical research...
March 16, 2017: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/28298840/the-need-for-a-population-based-dose-optimization-study-for-recombinant-tissue-plasminogen-activator-in-acute-ischemic-stroke-a-study-from-a-tertiary-care-teaching-hospital-from-south-india
#15
Siju V Abraham, Fazil Thaha, S Vimal Krishnan, Athulya Shajan, Jayaraj Mymbilly Balakrishnan, Babu Urumese Palatty
CONTEXT: The guideline recommended dose of intravenous (i.v) recombinant tissue-type plasminogen activator (rt-PA) for acute ischemic stroke is 0.9 mg/kg in the European and American populations. In Asiatic population, some studies have shown that a lower dose of i.v rt-PA is equally efficacious. AIMS: To assess if there is a need for a dose optimization for i.v rt-PA study among Indians. SETTING AND DESIGN: A prospective, observational database of acute stroke cases that presented to a tertiary care institute over a period of 1 year was made...
January 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28292859/-18-f-fluoride-and-18-f-fluorodeoxyglucose-positron-emission-tomography-after-transient-ischemic-attack-or-minor-ischemic-stroke-case-control-study
#16
Alex T Vesey, William S A Jenkins, Agnese Irkle, Alastair Moss, Greg Sng, Rachael O Forsythe, Tim Clark, Gemma Roberts, Alison Fletcher, Christophe Lucatelli, James H F Rudd, Anthony P Davenport, Nicholas L Mills, Rustam Al-Shahi Salman, Martin Dennis, William N Whiteley, Edwin J R van Beek, Marc R Dweck, David E Newby
BACKGROUND: Combined positron emission tomography (PET) and computed tomography (CT) can assess both anatomy and biology of carotid atherosclerosis. We sought to assess whether (18)F-fluoride or (18)F-fluorodeoxyglucose can identify culprit and high-risk carotid plaque. METHODS AND RESULTS: We performed (18)F-fluoride and (18)F-fluorodeoxyglucose PET/CT in 26 patients after recent transient ischemic attack or minor ischemic stroke: 18 patients with culprit carotid stenosis awaiting carotid endarterectomy and 8 controls without culprit carotid atheroma...
March 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28291892/association-of-preceding-antithrombotic-treatment-with-acute-ischemic-stroke-severity-and-in-hospital-outcomes-among-patients-with-atrial-fibrillation
#17
Ying Xian, Emily C O'Brien, Li Liang, Haolin Xu, Lee H Schwamm, Gregg C Fonarow, Deepak L Bhatt, Eric E Smith, DaiWai M Olson, Lesley Maisch, Deidre Hannah, Brianna Lindholm, Barbara L Lytle, Michael J Pencina, Adrian F Hernandez, Eric D Peterson
Importance: Antithrombotic therapies are known to prevent stroke for patients with atrial fibrillation (AF) but are often underused in community practice. Objectives: To examine the prevalence of patients with acute ischemic stroke with known history of AF who were not receiving guideline-recommended antithrombotic treatment before stroke and to determine the association of preceding antithrombotic therapy with stroke severity and in-hospital outcomes. Design, Setting, and Participants: Retrospective observational study of 94 474 patients with acute ischemic stroke and known history of AF admitted from October 2012 through March 2015 to 1622 hospitals participating in the Get With the Guidelines-Stroke program...
March 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28291535/the-health-burden-and-economic-costs-averted-by-ambient-pm2-5-pollution-reductions-in-nagpur-india
#18
Tunde O Etchie, Saravanadevi Sivanesan, Gregory O Adewuyi, Kannan Krishnamurthi, Padma S Rao, Ayotunde T Etchie, Ajay Pillarisetti, Narendra K Arora, Kirk R Smith
National estimates of the health and economic burdens of exposure to ambient fine particulate matter (PM2.5) in India reveal substantial impacts. This information, often lacking at the local level, can justify and drive mitigation interventions. Here, we assess the health and economic gains resulting from attainment of WHO guidelines for PM2.5 concentrations - including interim target 2 (IT-2), interim target 3 (IT-3), and the WHO air quality guideline (AQG) - in Nagpur district to inform policy decision making for mitigation...
March 10, 2017: Environment International
https://www.readbyqxmd.com/read/28291427/incidence-clinical-features-and-treatment-of-familial-moyamoya-in-pediatric-patients-a-single-institution-series
#19
Jonathan Gaillard, Jennifer Klein, Daniel Duran, Armide Storey, R Michael Scott, Kristopher Kahle, Edward R Smith
OBJECTIVE Limited data exist on familial moyamoya in children. The purpose of this study was to characterize presentation and outcomes of pediatric moyamoya patients who have relatives diagnosed with moyamoya. METHODS The authors performed a single-institution retrospective analysis of a case series including all surgically treated children with moyamoya with first- or second-degree relatives with moyamoya. Clinical and radiographic characteristics were analyzed, along with surgical outcomes. RESULTS A total of 537 patients underwent surgery for moyamoya during the study period...
March 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28289789/-medical-care-of-patients-with-spasticity-following-stroke-evaluation-of-the-treatment-situation-in-germany-with-focus-on-the-use-of-botulinum-toxin
#20
L Kerkemeyer, G Lux, A Walendzik, J Wasem, A Neumann
BACKGROUND: Upper limb spasticity is a common complication following stroke. Cohort studies found 19% of post-stroke patients had upper limb spasticity at 3 months and 38% of patients at 12 months. For focal spasticity, intramuscular injections of botulinum toxin are indicated. In Germany, it is assumed that patients with the described indication are undersupplied with botulinum toxin. OBJECTIVE: The aim of the present study is to evaluate the medical care of patients with upper limb spasticity post-stroke with the focus on the use of botulinum toxin as one treatment option...
March 13, 2017: Der Nervenarzt
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