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https://www.readbyqxmd.com/read/29932775/influence-of-age-on-the-pharmacokinetics-pharmacodynamics-efficacy-and-safety-of-rivaroxaban
#1
Kenneth T Moore, Peggy Wong, Liping Zhang, Guohua Pan, JoAnne Foody
OBJECTIVE: Atrial fibrillation, peripheral and coronary artery disease and venous thromboembolism are major risk factors for stroke, disability, and death in the rapidly growing older (≥ 65 years.) population. In the absence of clear guidelines on the appropriate use of the newer non-vitamin K antagonist oral anticoagulants in this population, we specifically review the available literature for rivaroxaban and the impact of age that may affect the pharmacokinetics, pharmacodynamics, efficacy and safety of this anticoagulant...
June 22, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29930023/association-of-blood-pressure-measurements-with-peripheral-arterial-disease-events-a-reanalysis-of-the-allhat-data
#2
Nathan K Itoga, Daniel S Tawfik, Charles K Lee, Satoshi Maruyama, Nicholas J Leeper, Tara I Chang
Background -Current guidelines recommend treating hypertension in patients with peripheral arterial disease (PAD) to reduce the risk of cardiac events and stroke, but the effect of reducing blood pressure on lower extremity PAD events is largely unknown. We investigated the association of blood pressure with lower extremity PAD events using data from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Methods -ALLHAT investigated the effect of different antihypertensive medication classes (chlorthalidone, amlodipine, lisinopril, or doxazosin) on cardiovascular events...
June 21, 2018: Circulation
https://www.readbyqxmd.com/read/29922951/time-window-and-tissue-window-two-approaches-to-assist-decision-making-in-strokes
#3
REVIEW
XuYing Xiang, Fei Cao
Intravenous alteplase given in an appropriate time window has been recommended in guidelines and effects are on the decline over time. In general, the clinical decision is primarily based on whether ischemic stroke patients are sent to hospitals within the time window. However, some patients sent to the hospital over time limitations are eligible to receive intervention for recanalization due to good collateral circulation. In this dilemma, "tissue window" can be more reliable, which means using the penumbra as a major criterion for patient recruitment...
June 19, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29921357/cardiovascular-tests-for-risk-assessment-in-asymptomatic-adults-and-implications-for-pilots
#4
I Made Ady Wirawan, Robin F Griffiths, Peter D Larsen
BACKGROUND: This study aims to examine which marker or testing protocols have been suggested for cardiovascular disease (CVD) risk assessment in asymptomatic populations, at which CVD risk level, and how this can be implemented for CVD risk assessment in pilot populations. METHODS: A systematic search was performed using Systematic Reviews Subset on PubMed; the OvidSP interface, including all EBM reviews and EMBASE databases; and the G-I-N International Guideline Library...
July 1, 2018: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29920979/physical-fitness-interventions-for-nonambulatory-stroke-survivors-a-mixed-methods-systematic-review-and-meta-analysis
#5
REVIEW
Megan Lloyd, Dawn A Skelton, Gillian E Mead, Brian Williams, Frederike van Wijck
INTRODUCTION: Physical fitness training after stroke is recommended in guidelines across the world, but evidence pertains mainly to ambulatory stroke survivors. Nonambulatory stroke survivors (FAC score ≤2) are at increased risk of recurrent stroke due to limited physical activity. This systematic review aimed to synthesize evidence regarding case fatality, effects, experiences, and feasibility of fitness training for nonambulatory stroke survivors. METHODS: Eight major databases were searched for any type of study design...
June 19, 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29920522/yield-of-early-postoperative-computed-tomography-after-frontal-ventriculoperitoneal-shunt-placement
#6
Maria Kamenova, Jonathan Rychen, Raphael Guzman, Luigi Mariani, Jehuda Soleman
Despite being widely used, ventriculoperitoneal (VP) shunt placement is a procedure often associated with complications and revision surgeries. Many neurosurgical centers routinely perform early postoperative cranial computer tomography (CT) to detect postoperative complications (e.g., catheter malposition, postoperative bleed, over-drainage). Because guidelines are lacking, our study aimed to evaluate the yield of early routine postoperative CT after shunt placement for adult hydrocephalus. We retrospectively reviewed 173 patients who underwent frontal VP shunting for various neurosurgical conditions...
2018: PloS One
https://www.readbyqxmd.com/read/29916130/carotid-endarterectomy-in-patients-with-recurrent-symptoms-associated-with-an-ipsilateral-carotid-artery-near-occlusion-with-full-collapse
#7
A J A Meershoek, E P A Vonken, P J Nederkoorn, L J Kappelle, G J de Borst
OBJECTIVE: Near occlusion (NO) of the internal carotid artery (ICA) with full collapse (NOFC) is a rare condition, with a prevalence of around 1%. Guidelines on carotid stenosis recommend a conservative treatment in patients with a single-event ipsilateral to a NOFC, but the optimal treatment for patients with recurrent symptoms associated with NOFC remains uncertain. We describe a consecutive series of patients with recurrent symptoms associated with NOFC (RSNOFC) who underwent carotid endarterectomy (CEA)...
June 18, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29915809/patch-angioplasty-or-primary-closure-following-carotid-endarterectomy-for-symptomatic-carotid-artery-stenosis
#8
Eline Huizing, Cornelis G Vos, Robin G Hulsebos, Peter J van den Akker, Gert Jan de Borst, Çağdaş Ünlü
Objectives  Guidelines recommend routine patching to prevent restenosis following carotid endarterectomy, mainly based on studies performed many years ago with different perioperative care and medical treatment compared with current standards. Aim of the present study was to compare primary closure (PRC) versus patch closure (PAC) in a contemporary cohort of patients. Methods  Consecutive patients treated by carotid endarterectomy for symptomatic stenosis between January 2006 and April 2016 were retrospectively analyzed...
April 2018: Surgery Journal
https://www.readbyqxmd.com/read/29913488/guideline-the-aha-asa-made-217-recommendations-for-early-management-of-acute-ischemic-stroke-in-adults
#9
Adam G Kelly, Robert G Holloway
No abstract text is available yet for this article.
June 19, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29910583/practical-perspectives-on-the-use-of-non-vitamin-k-antagonist-oral-anticoagulants-for-stroke-prevention-in-patients-with-nonvalvular-atrial-fibrillation-a-view-from-the-middle-east-and-north-africa
#10
REVIEW
Ahmad S Hersi, Yahya S Alhebaishi, Omar Hamoui, Taher Hassan, Adel Khalifa Hamad, Mohamed Magdy, Hani Sabbour, Sameh Shaheen
Clinical guidelines for the prevention of stroke in patients with nonvalvular atrial fibrillation (NVAF) are available from several international cardiology associations. Patients with NVAF in the Middle East and North Africa (MENA) region present unique challenges and opportunities related to differences in geography, practice patterns, and patient demographics that are as yet unaddressed in practice guidelines. This review aims to offer a practical perspective on the management of NVAF in patients in MENA and draws on evidence-based guidelines as well as real-world evidence and expert opinion...
April 2018: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/29908420/ticagrelor-versus-clopidogrel-after-fibrinolytic-therapy-in-patients-with-st-elevation-myocardial-infarction-rationale-and-design-of-the-ticagrelor-in-patients-with-st-elevation-myocardial-infarction-treated-with-thrombolysis-treat-trial
#11
Otavio Berwanger, Jose C Nicolau, Antonio C Carvalho, Lixin Jiang, Shaun Goodman, Stephen J Nicholls, Alexander Parkhomenko, Oleg Averkov, Carlos Tajer, Germán Malaga, Jose F Kerr Saraiva, Francisco Fonseca, Helio P Guimaraes, Pedro G M de Barros E Silva, Lucas P Damiani, Denise M Paisani, Camila M R Lasagno, Carolina T Candido, Nanci Valeis, Diogo D F Moia, Leopoldo S Piegas, Christopher B Granger, Harvey White, Renato D Lopes
BACKGROUND: The safety and efficacy of ticagrelor in patients with ST-elevation myocardial infarction (STEMI) treated with fibrinolytic therapy remain uncertain. OBJECTIVES: The primary objective of the TicagRElor in pAtients with ST elevation myocardial infarction treated with Thrombolysis (TREAT) trial is to evaluate the short-term safety of ticagrelor when compared with clopidogrel in STEMI patients treated with fibrinolytic therapy. Key secondary objectives are to assess the safety and efficacy of ticagrelor compared with clopidogrel at 12-months...
March 3, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29907995/fifteen-years-of-life-losartan-intervention-for-endpoint-reduction-in-hypertension-lessons-learned-for-losartan-an-old-dog-playing-good-tricks
#12
REVIEW
Niki Katsiki, Konstantinos Tsioufis, Dilek Ural, Massimo Volpe
There is an unmet need to prevent cardiovascular disease and chronic kidney disease development and progression worldwide. Losartan, the first angiotensin receptor blocker, was shown to exert significant cardioprotective and renoprotective effects in the LIFE (Losartan Intervention for Endpoint Reduction in Hypertension) and RENAAL (Reduction of Endpoints in NIDDM With the Angiotensin II Antagonist Losartan) trials. Losartan significantly prevented stroke and decreased serum uric acid levels and the rates of new-onset diabetes mellitus and atrial fibrillation...
June 15, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29907898/inpatient-glycemic-management-of-non-cardiac-cvd-focus-on-stroke-and-pvd
#13
REVIEW
Estelle Everett, Nestoras Mathioudakis
PURPOSE OF REVIEW: Hyperglycemia occurs frequently in hospitalized patients with stroke and peripheral vascular disease (PVD). Guidelines for inpatient glycemic management are not well established for this patient population. We will review the clinical impact of hyperglycemia in this acute setting and review the evidence for glycemic control. RECENT FINDINGS: Hyperglycemia in acute stroke is associated with poor short and long-term outcomes, and perioperative hyperglycemia in those undergoing revascularization for PVD is linked to increased post-surgical complications...
June 16, 2018: Current Diabetes Reports
https://www.readbyqxmd.com/read/29907089/temporarily-increased-stroke-rate-after-takotsubo-syndrome-need-for-an-anticoagulation
#14
Nadine Abanador-Kamper, Lars Kamper, Judith Wolfertz, Marc Vorpahl, Patrick Haage, Melchior Seyfarth
BACKGROUND: Previous studies have reported slightly higher stroke rates in Takotsubo Syndrome compared to acute myocardial infarction. Our goal was to evaluate the temporal course of stroke rates and left ventricular recovery in patients with Takotsubo Syndrome. METHODS: We retrospectively examined the clinical and imaging data of 72 patients with Takotsubo Syndrome. The data collected came from January 2005 to March 2017. Left ventricular performance was evaluated by cardiovascular magnetic resonance imaging (MRI) in all patients during the acute phase of Takotsubo Syndrome and in a follow-up scan 2 months later...
June 15, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29904443/critical-event-intervals-in-determining-candidacy-for-intravenous-thrombolysis-in-acute-stroke
#15
John S Garrett, Steven Sonnamaker, Yahya Daoud, Hao Wang, Dion Graybeal
Background: The aim of the study was to determine the optimal set point for the critical event benchmarks described in stroke guidelines and validate the ability of these goals to predict successful administration of intravenous thrombolysis within 60 min of hospital arrival. Methods: This was a retrospective cohort analysis of patients with acute ischemic stroke who received intravenous thrombolysis following presentation to the emergency department. The national benchmarks for time intervals associated with the completion of critical events required to determine candidacy for thrombolysis were evaluated for the ability to predict successful administration of thrombolysis within 60 min of hospital arrival...
July 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29901241/evaluation-of-all-african-clinical-practice-guidelines-for-hypertension-quality-and-opportunities-for-improvement
#16
Patrick Mbah Okwen, Irene Maweu, Karen Grimmer, Janine Margarita Dizon
RATIONALE, AIMS, AND OBJECTIVES: Good-quality clinical practice guidelines (CPGs) provide recommendations based on current best-evidence summaries. Hypertension is a prevalent noncommunicable disease in Africa, with disastrous sequelae (stroke, heart, and kidney disease). Its effective management relies on good quality, current, locally relevant evidence. This paper reports on an all African review of the guidance documents currently informing hypertension management. METHODS: Attempts were made to contact 62 African countries for formal guidance documents used nationally to inform diagnosis and management of hypertension...
June 14, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29896419/why-not-intravenous-thrombolysis-in-patients-with-recurrent-stroke-within-3-months
#17
REVIEW
Chuanjie Wu, Di Wu, Jian Chen, Chuanhui Li, Xunming Ji
Acute ischemic stroke continues to be a very severe disorder that has significant impact on human health. Its treatment options are limited and alteplase remains the only American Food and Drug Administration-approved drug for patients with acute ischemic stroke. Furthermore, intravenous thrombolysis remains substantially underutilized, because it has rigorous indications and contraindications. Most patients simply do not meet these criteria and cannot receive thrombolytic treatment. Guidelines in many countries currently include a history of stroke within months as one of the exclusion criteria for intravenous thrombolysis...
April 2018: Aging and Disease
https://www.readbyqxmd.com/read/29896407/-campylobacter-fetus-prosthetic-valve-endocarditis-presenting-as-a-stroke
#18
Christina Petridou, Lenka Strakova, Ruan Simpson
Introduction: Campylobacter is a common pathogen of the gastrointestinal tract, but invasive disease is rare. Campylobacter fetus can play a role in osteomyelitis, meningitis and joint infection and has a prediliction for the vascular endothelium, causing mycotic aneurysms, thrombophlebitis and endocarditis. Here we present a case of prosthetic valve endocarditis caused by C. fetus and a review of the literature. Case presentation: An 85-year-old woman with a tissue aortic valve replacement and atrial fibrillation was admitted to hospital with tonic-clonic seizures, right-sided hemiparesis, facial droop and hemianopia...
May 2018: JMM Case Reports
https://www.readbyqxmd.com/read/29894410/experiences-of-stroke-survivors-their-families-and-unpaid-carers-in-goal-setting-within-stroke-rehabilitation-a-systematic-review-of-qualitative-evidence
#19
Anna Lloyd, Katrina Bannigan, Thavapriya Sugavanam, Jennifer Freeman
OBJECTIVE: The objective of the review was to synthesize the best available qualitative evidence regarding the experiences of stroke survivors, their families and unpaid carers, about goal setting within stroke rehabilitation. INTRODUCTION: Clinical guidelines recommend person-centered goal setting in stroke rehabilitation but many barriers exist to its implementation. Individual differences and preferences, of both the stroke survivor and practitioner, may influence involvement in goal setting...
June 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29893840/translating-guidelines-into-practice-for-the-management-of-atrial-fibrillation-results-of-an-european-heart-rhythm-association-survey
#20
Gheorghe-Andrei Dan, Konstantinos Iliodromitis, Daniel Scherr, Francisco Marín, Radoslaw Lenarczyk, Heidi L Estner, Marcin Kostkiewicz, Nikolaos Dagres, Gregory Y H Lip
Despite the huge progress made in the both understanding the mechanisms and the management of atrial fibrillation (AF) this arrhythmia still represents an important health and social burden. Atrial fibrillation is increasing in frequency and is a major cause of death, stroke, heart failure, cognitive decline, and hospitalizations. New data have emerged emphasizing the multidisciplinary approach to better management of this common arrhythmia. Despite the availability of AF management guidelines, practice among European centres may differ from the current guideline recommendations...
June 8, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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