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https://www.readbyqxmd.com/read/28449276/the-efficacy-of-thrombolysis-in-lacunar-stroke-evidence-from-the-austrian-stroke-unit-registry
#1
C C J Eggers, C Bocksrucker, L Seyfang
BACKGROUND AND PURPOSE: Intravenous thrombolysis (ivT) with recombinant tissue plasminogen activator is established in acute ischaemic stroke. Little is known, however, about its efficacy in different stroke subtypes. METHODS: A retrospective analysis of 128 733 patients from the Austrian Stroke Unit Registry was performed. Patients were classified as lacunar (LacS) or non-lacunar ischaemic stroke (nonLacS) by use of the clinical syndrome and technical findings...
April 27, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28449186/the-risk-of-lower-gastrointestinal-bleeding-in-low-dose-aspirin-users
#2
W-C Chen, K-H Lin, Y-T Huang, T-J Tsai, W-C Sun, S-K Chuah, D-C Wu, P-I Hsu
BACKGROUND: Aspirin increases the risk of gastrointestinal bleeding. AIM: To investigate the risk of lower gastrointestinal bleeding (LGIB) in aspirin users. METHODS: Low-dose (75-325 mg daily) aspirin users and controls matched by age, gender and enrollment time in a 1:5 ratio were selected from 1 million randomly sampled subjects in the National Health Insurance Research Database of Taiwan. Cox proportional hazard regression models were developed to evaluate the predictors of LGIB with adjustments for age, gender, comorbidities including coronary artery disease, ischaemic stroke, diabetes, hypertension, chronic kidney disease, liver cirrhosis, chronic obstructive pulmonary disease, dyslipidemia, uncomplicated peptic ulcer disease, history of peptic ulcer bleeding, and concomitant use of clopidogrel, ticlopidine, warfarin, nonsteroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase-2 inhibitors, steroids, proton pump inhibitors (PPIs), histamine-2 receptor antagonists (H2RAs), nitrates, alendronate, selective serotonin reuptake inhibitors (SSRIs) and calcium channel blockers...
April 27, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28446116/risk-adjusted-hospital-mortality-rates-for-stroke-evidence-from-the-australian-stroke-clinical-registry-auscr
#3
Dominique A Cadilhac, Monique F Kilkenny, Christopher R Levi, Natasha A Lannin, Amanda G Thrift, Joosup Kim, Brenda Grabsch, Leonid Churilov, Helen M Dewey, Kelvin Hill, Steven G Faux, Rohan Grimley, Helen Castley, Peter J Hand, Andrew Wong, Geoffrey K Herkes, Melissa Gill, Douglas Crompton, Sandy Middleton, Geoffrey A Donnan, Craig S Anderson
OBJECTIVES: Hospital data used to assess regional variability in disease management and outcomes, including mortality, lack information on disease severity. We describe variance between hospitals in 30-day risk-adjusted mortality rates (RAMRs) for stroke, comparing models that include or exclude stroke severity as a covariate. DESIGN: Cohort design linking Australian Stroke Clinical Registry data with national death registrations. Multivariable models using recommended statistical methods for calculating 30-day RAMRs for hospitals, adjusted for demographic factors, ability to walk on admission, stroke type, and stroke recurrence...
May 1, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28441257/should-elevated-blood-pressure-be-lowered-in-the-acute-phase-of-ischaemic-stroke
#4
Eivind Berge
No abstract text is available yet for this article.
June 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28439921/impact-of-obstructive-sleep-apnoea-and-intermittent-hypoxia-on-cardiovascular-and-cerebrovascular-regulation
#5
Andrew E Beaudin, Xavier Waltz, Patrick J Hanly, Marc J Poulin
Obstructive sleep apnoea (OSA) is associated with increased risk of cardiovascular and cerebrovascular disease, a consequence attributed in part to chronic intermittent hypoxia (IH) resulting from repetitive apnoeas during sleep. Although findings from experimental animal, and human, models have shown that IH is detrimental to vascular regulation, the severity of IH used in many of these animal studies (e.g. inspired fraction of oxygen (FI O2 ) = 2-3%; oxygen desaturation index (ODI) = 120 events h(-1) ) is considerably greater than that observed in the majority of patients with OSA...
April 24, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28437244/second-transcatheter-closure-for-residual-shunt-following-percutaneous-closure-of-patent-foramen-ovale
#6
Njomeza Susuri, Slayman Obeid, Mirjam Ulmi, George Cm Siontis, Andreas Wahl, Stephan Windecker, Fabian Nietlispach, Bernhard Meier, Fabien Praz
AIMS: Residual shunt following percutaneous patent foramen ovale (PFO) closure has been described in up to 49% of the patients and is associated with recurrent cerebrovascular events. Our aim was to evaluate the safety, feasibility, and mid-term outcomes of transcatheter residual shunt closure. METHODS AND RESULTS: From 1994 to July 2016, 2679 patients underwent transcatheter PFO closure for treatment of presumed paradoxical embolism at our institution. Among them, 100 patients (3...
April 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28436420/key-role-of-15-lo-15-hete-in-angiogenesis-and-functional-recovery-in-later-stages-of-post-stroke-mice
#7
Di Wang, Yu Liu, Li Chen, Pengyan Li, Youyang Qu, Yanmei Zhu, Yulan Zhu
This study sought to clarify the effects of 15-lipoxygenase/15-hydroxyeicosatetraenoic acid in angiogenesis and neurological functional recovery after cerebral ischaemic stroke in mice. In vivo, we performed behavioural tests to determine functional recovery after stroke. Double immunofluorescence staining of CD31 and Ki67/PCNA was performed to evaluate the effects of 15-lipoxygenase/15-hydroxyeicosatetraenoic acid on angiogenesis in an MCAO mouse model. In vitro, we investigated the effects of 15-hydroxyeicosatetraenoic acid on BMVEC proliferation and migration...
April 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28431835/variability-in-the-use-of-neuroimaging-techniques-for-diagnosis-and-follow-up-of-stroke-patients
#8
C Valcárcel-Nazco, D Alonso-Modino, F Montón-Álvarez, R Sabatel-Hernández, M S Pastor-Santoveña, P Mesa-Blanco, J C López-Fernández, P Serrano-Aguilar
INTRODUCTION AND OBJECTIVE: Imaging diagnosis is essential for treatment planning in stroke patients. However, use of these techniques varies due to uncertainty about their effectiveness. Our purpose was to describe the use of CT and MRI in stroke and transient ischaemic attack (TIA) over 5years in hospitals belonging to the Canary Islands Health Service and analyse interhospital variability based on routinely collected administrative data. PATIENTS AND METHOD: We gathered the minimum basic dataset (MBDS) from patients diagnosed with stroke or TIA between 2005 and 2010 in 4hospitals...
April 18, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28431669/after-the-leader-trial-and-sustain-6-how-do-we-explain-the-cardiovascular-benefits-of-some-glp-1-receptor-agonists
#9
B Vergès, B Charbonnel
Recent cardiovascular outcome trials - the LEADER with liragutide and SUSTAIN-6 with semaglutide - have shown significant reductions of major cardiovascular (CV) events with these glucagon-like peptide (GLP)-1 receptor agonists. Progressive separation of the treatment and placebo curves, starting clearly between 12 and 18 months of the trial period, and significant reductions in the risk of myocardial infarction and stroke, indicate that the beneficial CV effects observed with GLP-1 receptor agonists could be due to an antiatherogenic effect...
April 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28431600/assessment-of-on-treatment-platelet-reactivity-and-relationship-with-cerebral-micro-embolic-signals-in-asymptomatic-and-symptomatic-carotid-stenosis
#10
Justin A Kinsella, W Oliver Tobin, Sean Tierney, Timothy M Feeley, Bridget Egan, Tara Coughlan, D Ronan Collins, Desmond O'Neill, Joseph A Harbison, Colin P Doherty, Prakash Madhavan, Dermot J Moore, Sean M O'Neill, Mary-Paula Colgan, Maher Saqqur, Raymond P Murphy, Niamh Moran, George Hamilton, Dominick J H McCabe
INTRODUCTION: The relationship between on-treatment platelet reactivity and cerebral micro-embolic signals (MES) is unknown, and has not been previously simultaneously assessed in asymptomatic and symptomatic carotid stenosis patients. METHODS: Consecutive eligible patients with ≥50% asymptomatic or recently symptomatic carotid stenosis (≤4weeks following TIA/ischaemic stroke) were recruited to this pilot study. Symptomatic patients were followed up to the 'late' phase (≥3months) following symptom onset or carotid intervention; longitudinal data were analysed from symptomatic patients with data available at both time-points...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28430885/lesion-mapping-of-stroke-related-erectile-dysfunction
#11
Klemens Winder, Frank Seifert, Martin Köhrmann, Carl Crodel, Stephan Kloska, Arnd Dörfler, Katharina M Hösl, Stefan Schwab, Max J Hilz
Acute ischaemic stroke in brain areas contributing to male sexual function may impair erectile function depending on the lesion site. This study intended to determine associations between stroke-related erectile dysfunction and cerebral ischaemic lesion sites using voxel-based lesion mapping. In 52 males (mean age 60.5 ± 10.5 years) with first-ever ischaemic strokes, we assessed erectile function after and retrospectively 3 months prior to the stroke using scores of the 5-item International Index of Erectile Function-5 questionnaire...
April 18, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/28430363/cerebrolysin-for-acute-ischaemic-stroke
#12
REVIEW
Liliya Eugenevna Ziganshina, Tatyana Abakumova, Ludivine Vernay
BACKGROUND: Cerebrolysin is a mixture of low-molecular-weight peptides and amino acids derived from pigs' brain tissue, which has potential neuroprotective and neurotrophic properties. It is widely used in the treatment of acute ischaemic stroke in Russia, Eastern Europe, China, and other Asian and post-Soviet countries. OBJECTIVES: To assess the benefits and risks of cerebrolysin for treating acute ischaemic stroke. SEARCH METHODS: In May 2016 we searched the Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, Embase, Web of Science Core Collection, with Science Citation Index, LILACS, OpenGrey, and a number of Russian Databases...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28424785/the-impact-of-homocysteine-vitamin-b12-and-vitamin-d-levels-on-functional-outcome-after-first-ever-ischaemic-stroke
#13
Merdin Markišić, Aleksandra M Pavlović, Dragan M Pavlović
We explored the relationship between acute ischaemic stroke (IS) early functional outcome and serum levels of homocysteine, vitamin B12, and D in a noninterventional prospective clinical study. We enrolled 50 patients with first-ever IS and performed laboratory tests and functional assessment at three time points: on admission and three and six months after stroke. Modified Rankin Scale (mRS), NIHSS scale, and Barthel index (BI) scores were assessed in all participants by trained examiner blinded to laboratory data...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28424017/computed-tomography-perfusion-based-selection-of-endovascularly-treated-acute-ischaemic-stroke-patients-are-there-lessons-to-be-learned-from-the-pre-evidence-era
#14
Marios-Nikos Psychogios, Michael Knauth, Raya Bshara, Katharina Schregel, Ioannis Tsogkas, Ismini Papageorgiou, Ilko Maier, Jan Liman, Daniel Behme
Introduction Some of the latest groundbreaking trials suggest that noncontrast cranial computed tomography and computed tomography-angiography are sufficient tools for patient selection within six hours of symptom onset. Before endovascular stroke therapy became the standard of care, patient selection was one of the most useful tools to avoid futile reperfusions. We report the outcomes of endovascularly treated stroke patients selected with a perfusion-based paradigm and discuss the implications in the current era of endovascular treatment...
April 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28420049/the-spectrum-of-neuropsychiatric-lupus-in-a-black-caribbean-population-a-report-of-the-barbados-national-lupus-registry
#15
C Flower, I Hambleton, D Corbin, S Marquez, R Edghill
Objective The objective of this study was to examine neuropsychiatric lupus in a Black Caribbean population. Methods We reviewed Barbados National Lupus Registry patients with ≥4 American College of Rheumatology criteria and a diagnosis of neuropsychiatric lupus using the American College of Rheumatology 19 case definitions. Results From 366 patients with four or more American College of Rheumatology criteria for systemic lupus erythematosus, 55 (15%) had evidence of neuropsychiatric lupus. There were 51 females and four males (F:M = 13:1) with a median age of 31 years...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28418189/epileptic-manifestations-in-stroke-patients-treated-with-intravenous-alteplase
#16
C Bentes, H Martins, A R Peralta, C Morgado, C Casimiro, A C Franco, A C Fonseca, R Geraldes, P Canhão, T Pinho E Melo, T Paiva, J M Ferro
BACKGROUND AND PURPOSE: Intravenous alteplase (rtPA) may be associated with seizures and epileptic activity in the electroencephalogram (EEG). The aim of this work was to compare the frequency of seizures and EEG abnormalities between stroke patients treated and not treated with rtPA. METHODS: This was a prospective study of consecutive acute anterior circulation ischaemic stroke patients, with 1-year follow-up. Patients were previously independent, had an admission National Institute of Health Stroke Scale score ≥4, an acute ischaemic lesion and no previous seizures...
April 18, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28416587/cardiovascular-outcomes-with-an-inhaled-beta2-agonist-corticosteroid-in-patients-with-copd-at-high-cardiovascular-risk
#17
Robert D Brook, Julie A Anderson, Peter Ma Calverley, Bartolome R Celli, Courtney Crim, Martin A Denvir, Sheldon Magder, Fernando J Martinez, Sanjay Rajagopalan, Jørgen Vestbo, Julie Yates, David E Newby
OBJECTIVES: Cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD) often coexist. We assessed the effect of inhaled COPD treatments on CVD outcomes and safety in patients with COPD and at heightened CVD risk. METHODS: The SUMMIT (Study to Understand Mortality and MorbidITy) was a multicentre, randomised, double-blind, placebo-controlled, event-driven trial in 16 485 patients with moderate COPD who had or were at high risk of CVD. Here, we assessed the prespecified secondary endpoint of time to first on-treatment composite CVD event (CVD death, myocardial infarction, stroke, unstable angina or transient ischaemic attack (TIA)) by Cox regression and by clinician-reported CVD adverse events across the four groups: once-daily inhaled placebo (n=4111), long-acting beta2-agonist (vilanterol (VI) 25 µg; n=4118), corticosteroid (fluticasone furoate (FF) 100 µg; n=4135) and combination therapy (FF/VI; n=4121)...
April 17, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28408613/air-pollution-and-the-incidence-of-ischaemic-and-haemorrhagic-stroke-in-the-south-london-stroke-register-a-case-cross-over-analysis
#18
B K Butland, R W Atkinson, S Crichton, B Barratt, S Beevers, A Spiridou, U Hoang, F J Kelly, C D Wolfe
BACKGROUND: Few European studies investigating associations between short-term exposure to air pollution and incident stroke have considered stroke subtypes. Using information from the South London Stroke Register for 2005-2012, we investigated associations between daily concentrations of gaseous and particulate air pollutants and incident stroke subtypes in an ethnically diverse area of London, UK. METHODS: Modelled daily pollutant concentrations based on a combination of measurements and dispersion modelling were linked at postcode level to incident stroke events stratified by haemorrhagic and ischaemic subtypes...
April 13, 2017: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/28407109/cha2ds2-vasc-score-for-ischaemic-stroke-risk-stratification-in-patients-with-chronic-obstructive-pulmonary-disease-with-and-without-atrial-fibrillation-a-nationwide-cohort-study
#19
Wei-Syun Hu, Cheng-Li Lin
Aims: We conducted this nationwide cohort study to identify the performance of CHA2DS2-VASc score for ischaemic stroke risk stratification in chronic obstructive pulmonary disease (COPD) patients whether they had comorbid atrial fibrillation (AF) or not. Methods and results: Using the longitudinal health insurance database 2000, patients aged ≥20 years with newly diagnosed COPD from 2000 to 2011 with at least three claims for outpatient and/or hospitalization visits were identified...
April 12, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28407069/managing-transient-ischaemic-attacks-in-australia-a-qualitative-study
#20
Andrew R Davey, Daniel S Lasserson, Christopher R Levi, Parker J Magin
Background.: Stroke risk after transient ischaemic attack (TIA) is highest in the first few days. It is greatly reduced by commencing commonly used medications. Current Australian guidelines recommend that all TIAs be managed urgently by secondary-care specialists (mandatory for high-risk TIAs). The majority of TIAs present to general practice which creates a dilemma when specialist care is not readily accessible. There is a lack of evidence relating to the determinants of general practitioners' (GPs) actions in this situation...
April 12, 2017: Family Practice
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