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Ischaemic stroke

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https://www.readbyqxmd.com/read/28932397/undiagnosed-and-diagnosed-diabetes-mellitus-among-hospitalised-acute-heart-failure-patients-in-botswana
#1
Julius Chacha Mwita, Mgaywa Gilbert Mjungu Damas Magafu, Bernard Omech, Billy Tsima, Matthew J Dewhurst, Monkgogi Goepamang, Yohana Mashalla
OBJECTIVE: The objective of this study was to determine the burden of diagnosed and undiagnosed type 2 diabetes mellitus among patients hospitalised with acute heart failure in Botswana. METHODS: The study enrolled 193 consecutive patients admitted with acute heart failure to the medical wards at Princess Marina Hospital in Gaborone. Patients were classified as previously known diabetics, undiagnosed diabetics (glycated haemoglobin ≥ 6.5%) or as non-diabetics (glycated haemoglobin < 6...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28927193/timing-of-percutaneous-coronary-intervention-in-patients-with-non-st-elevation-myocardial-infarction-a-swedeheart-study
#2
Daniel Lindholm, Joakim Alfredsson, Oskar Angerås, Felix Böhm, Fredrik Calais, Sasha Koul, Bo Lagerqvist, Henrik Renlund, Giovanna Sarno, Christoph Varenhorst
Aims: Although routine invasive management is recommended in NSTEMI patients, the optimal timing of the procedure is not defined. The aim of this study was to assess outcomes in relation to timing of PCI in NSTEMI patients. Methods and results: This was an observational, prospective, multicentre cohort study from the SWEDEHEART registry including all Swedish PCI centres. We included 40 494 consecutive PCI-treated patients who were admitted to any coronary care unit from 2006 to 2013...
January 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28925023/fibrinolysis-from-blood-to-the-brain
#3
Robert L Medcalf
We all know about classical fibrinolysis, how plasminogen activation by either tissue-type plasminogen activator (t-PA) or urokinase-type plasminogen activator (u-PA) promotes fibrin breakdown, and how this process was harnessed for the therapeutic removal of blood clots. While this is still perfectly true and still applicable to thromboembolic conditions today, another dimension to this system came to light over two decades ago that implicated the plasminogen activating system in a context far removed from the dissolution of blood clots...
September 19, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28923277/animal-models-of-ischaemic-stroke-and-characterisation-of-the-ischaemic-penumbra
#4
REVIEW
Christopher McCabe, Mariana M Arroja, Emma Reid, I Mhairi Macrae
Over the past forty years, animal models of focal cerebral ischaemia have allowed us to identify the critical cerebral blood flow thresholds responsible for irreversible cell death, electrical failure, inhibition of protein synthesis, energy depletion and thereby the lifespan of the potentially salvageable penumbra. They have allowed us to understand the intricate biochemical and molecular mechanisms within the 'ischaemic cascade' that initiate cell death in the first minutes, hours and days following stroke...
September 16, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28923240/national-survey-on-perioperative-anaesthetic-management-in-the-endovascular-treatment-of-acute-ischaemic-stroke
#5
O Romero Kräuchi, L Valencia, F Iturri, A Mariscal Ortega, A López Gómez, R Valero
OBJECTIVE: To assess the anaesthetic management of treatment for endovascular acute ischaemic stroke (AIS) in Spain. MATERIALS AND METHOD: A survey was designed by the SEDAR Neuroscience Section and sent to the Spanish anaesthesiology departments with a primary stroke centre between July and November 2016. RESULTS: Of the 47 hospitals where endovascular treatment of AIS is performed, 37 anaesthesiology departments participated. Thirty responses were obtained; three of which were eliminated due to duplication (response rate of 72...
September 15, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28915862/self-detection-of-atrial-fibrillation-in-an-aged-population-three-year-follow-up-of-the-lietoaf-intervention-study
#6
Jussi Jaakkola, Raine Virtanen, Tuija Vasankari, Marika Salminen, K E Juhani Airaksinen
BACKGROUND: Atrial fibrillation (AF) is often asymptomatic and undiagnosed until an ischaemic stroke occurs. An irregular pulse is a key manifestation of AF. We assessed whether pulse self-palpation is feasible in screening of AF. METHODS: Altogether 205 residents of Lieto municipality aged ≥75 years were randomized in 2012 to receive brief education on pulse palpation focusing on evaluating rhythm regularity. Self-detected pulse irregularity and new AF diagnoses were recorded, and the subjects' quality of life and use of health care services were assessed during a three-year follow-up...
September 16, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28914133/age-of-donor-of-human-mesenchymal-stem-cells-affects-structural-and-functional-recovery-after-cell-therapy-following-ischaemic-stroke
#7
Susumu Yamaguchi, Nobutaka Horie, Katsuya Satoh, Takeshi Ishikawa, Tsuyoshi Mori, Hajime Maeda, Yuhtaka Fukuda, Shunsuke Ishizaka, Takeshi Hiu, Yoichi Morofuji, Tsuyoshi Izumo, Noriyuki Nishida, Takayuki Matsuo
Cell transplantation therapy offers great potential to improve impairments after stroke. However, the importance of donor age on therapeutic efficacy is unclear. We investigated the regenerative capacity of transplanted cells focusing on donor age (young vs. old) for ischaemic stroke. The quantities of human mesenchymal stem cell (hMSC) secreted brain-derived neurotrophic factor in vitro and of monocyte chemotactic protein-1 at day 7 in vivo were both significantly higher for young hMSC compared with old hMSC...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28910807/cerebral-infarct-topography-and-early-outcome-after-surgery-for-symptomatic-carotid-stenosis-a-multicentre-study
#8
Caroline Kazandjian, Nicla Settembre, Fabien Lareyre, Benjamin Kretz, Agnès Soudry-Faure, Yannick Béjot, Sergueï Malikov, Reda Hassen-Khodja, Elixene Jean-Baptiste, Eric Steinmetz
INTRODUCTION: Although carotid stenosis can cause both territorial and border-zone (BZ) cerebral infarcts (CI), the influence of CI topography on postoperative complications after surgery remains unclear. We compared early outcomes after endarterectomy on the basis of CI location: territorial (T group) or BZ group. MATERIAL AND METHODS: During the period between 2009 and 2013, ischaemic stroke patients who had undergone surgery for symptomatic carotid stenosis were identified from prospective databases from 3 French centres...
September 15, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28905042/social-demographic-and-clinical-characteristics-of-patients-suffering-from-peripheral-vascular-disease-treated-surgically-compared-to-patients-treated-with-endovascular-angioplasty
#9
Renata Piotrkowska, Marek Dobosz, Janina Książek, Grzegorz Halena
INTRODUCTION: Atherosclerosis is the most common cause of chronic lower limb ischaemia. Many factors that have a crucial influence on the development of the disease, its course and prognosis have been identified. The risk factors seem to be subject to interventions due to their susceptibility to changes. It is important to increase the engagement of doctors and nurses performing the screening oriented on risk factors, medical consultation regarding giving up smoking, changing the diet and undertaking physical activity...
2017: Arch Med Sci Atheroscler Dis
https://www.readbyqxmd.com/read/28902823/-comparing-the-risks-for-the-development-of-perioperative-complications-in-carotid-endarterectomy-and-carotid-angioplasty
#10
R A Vinogradov, K A Lashevich, V S Pykhteev
The article is a literature review presenting a comparative analysis of 30-day risks of mortality and complications after carotid endarterectomy and carotid angioplasty with stenting. The risks studied were as follows: myocardial infarction, stroke, transitory ischaemic attacks, bradycardia, hypotension, postoperative haematomas, and damages to the craniocerebral nerves. The authors analysed a series of recently published foreign studies and meta-analyses dedicated to the problem concerned. The obtained findings revealed that carotid endarterectomy turned out to be associated with a higher perioperative risk for the development of myocardial infarction, postoperative haematomas and damages to the craniocerebral nerves, whereas carotid angioplasty with stenting appeared to be associated with an increased risk for the development of stroke, bradycardia and hypotension within the first 30 postoperative days...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28902821/-outcomes-of-open-endovascular-operations-on-the-internal-carotid-artery-in-acute-stage-of-ischaemic-stroke
#11
A I Khripun, A D Priamikov, A B Mironkov, I N Tiurin, S A Asratian, V S Suriakhin, O V Simonov, O A Sazhina, V P Mikhaĭlenko
INTRODUCTION: The authors share their experience in diagnosis and treatment of patients with acute ischaemic stroke. PATIENTS AND METHODS: The study included a total of 33 patients. Of these, 20 patients (Study Group) were operated on at terms ranging from 2 to 7 days after onset of acute cerebral circulatory impairment. The Control Group was composed of 13 patients with ischaemic stroke, having refused surgical prevention of recurrent stroke. Both groups were matched by age, gender, level of neurological deficiency and size of cerebral ischaemic foci...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28898133/differential-impact-of-treadmill-training-on-stroke-induced-neurological-disorders
#12
Rasoul Rezaei, Maryam Nourshahi, Fariba Khodagholi, Abbas Haghparast, Sanaz Nasoohi, Mohammadreza Bigdeli, Ghorbangol Ashabi
OBJECTIVE: Physical exercise contributes to improving stability against nerve injury caused by ischaemic stroke. Here we aimed to preliminarily investigate the effects of continuous endurance training (CET) and high-intensity interval training (HIT) on stroke-associated anxiety, locomotion, neurological assessments and P70S6 Kinase (P70S6K) activation as well. To do this, rats were trained according to HIT and CET protocols for 2 months prior to being subject to middle cerebral artery occlusion surgery...
September 12, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28893482/comparison-of-early-outcomes-and-restenosis-rate-between-carotid-endarterectomy-and-carotid-artery-stenting-using-propensity-score-matching-analysis
#13
Seon-Hee Heo, Kyoung-Won Yoon, Shin-Young Woo, Yang-Jin Park, Young-Wook Kim, Keon-Ha Kim, Chin-Sang Chung, Oh-Young Bang, Dong-Ik Kim
OBJECTIVE/BACKGROUND: Despite randomised evidence, the debate continues about the preferred treatment strategy for carotid stenosis in routine clinical practice. The aim of this study was to compare early outcomes and restenosis rates after carotid endarterectomy (CEA) and carotid stenting (CAS) in unselected patients using propensity score matching (PSM). METHODS: The 30 day incidence of major adverse clinical events (MACE; defined as stroke, transient ischaemic attack, myocardial infarction, or death) and procedure related complications, as well as restenosis rates during follow-up were compared between unselected patients undergoing CEA or CAS between January 2002 and December 2015 at a single institution...
September 8, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28892278/reflection-on-stroke-deaths-and-end-of-life-stroke-care
#14
Syed Zujajuddin Quadri, Thang Huynh, Cecilia Cappelen-Smith, Nirupama Wijesuriya, Abul Mamun, Roy Beran, Alan Mcdougall, Dennis Cordato
BACKGROUND: The benefit of palliative care referral for severe stroke patients on end-of-life care pathways (EOLCP) is increasingly recognised. Palliative care provides assistance with symptom management and transition to end-of-life care. Advance care planning (ACP) may help accommodate patient/family expectations and guide management. METHOD: Retrospective study of all stroke deaths (2014-2015) at Liverpool Hospital, Sydney, Australia. Data examined included age, co-morbidities, living arrangements, pre-existing ACP, palliative care referral rates and 'survival time'...
September 11, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28875831/animal-models-of-focal-cerebral-ischaemia-and-haemorrhagic-transformation-considerations-in-experimental-stroke-study-design
#15
Jennifer A Shearer, Andrew S Douglas, Brian P Kirby, Turgut Tatlisumak, Karen M Doyle
Ischaemic stroke is often complicated with haemorrhage within the infarct zone or in a remote location especially when treated with intravenous thrombolysis and/or thrombectomy. While these early recanalisation treatments are highly effective, some of the benefit is lost because of haemorrhagic complications and consequential neurological deterioration of the patients. A number of mechanisms have been described that mediate the haemorrhagic changes and several agents have been tested in experimental models for inhibiting post stroke haemorrhage...
September 5, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28872355/the-role-of-stump-pressure-and-cerebral-oximetry-in-predicting-ischaemic-brain-damage-during-carotid-endarterectomy
#16
Kuzhuget Rossi, Starodubtsev Vladimir, Ignatenko Pavel, Starodubtseva Alexandra, Voroshilina Olga, Ruzankin Pavel, Karpenko Andrey
Objective is to compare the predictive value of stump pressure (SP) and cerebral oximetry (rSO2) levels in the evaluation of ischaemic injury of the cerebrum during clamping of the carotid artery (CCA) without temporary shunt (TS). Methods We included 84 patients with an asymptomatic stenosis (>70%) of the internal carotid artery (ICA) who underwent carotid endarterectomy (CEA) under GA. Cerebral ischaemic tolerance (CIT) was determined on the basis of SP, rSO2 and ∆rSO2 (↓rSO2 from baseline) during CCA...
September 5, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28872345/intra-cerebral-cannabidiol-infusion-induced-neuroprotection-is-partly-associated-with-the-tnf-%C3%AE-tnfr1-nf-%C3%B0%C2%BAb-pathway-in-transient-focal-cerebral-ischaemia
#17
Sepideh Khaksar, Mohammad Reza Bigdeli
BACKGROUND: Stroke is a neurological disease, which, in addition to high mortality, imposes many financial and mental burdens on families and the society. The main objective of this study was to investigate the effect of cannabidiol (CBD) on one of the major inflammatory pathways in cerebral ischaemia. METHOD: Using stereotaxic surgery, the cannula was implanted into the right lateral ventricle of rats. CBD (50, 100, and 200 ng/rat; i.c.v.) was administrated for five consecutive days...
September 5, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28871014/prevalence-of-stroke-and-associated-risk-factors-a-population-based-cross-sectional-study-from-northeast-china
#18
Fu-Liang Zhang, Zhen-Ni Guo, Yan-Hua Wu, Hao-Yuan Liu, Yun Luo, Ming-Shuo Sun, Ying-Qi Xing, Yi Yang
OBJECTIVES: Epidemiological studies aimed at stroke and its risk factors can help identify persons at higher risk and therefore promote stroke prevention strategies. We aimed to explore the current prevalence of stroke and its associated risk factors in northeast China. DESIGN: Population based cross sectional study. SETTING: Data were collected using a structured precoded questionnaire designed by the Stroke Screening and Prevention Programme of the National Health and Family Planning Commission of China, between January and March 2016...
September 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28869044/stroke-and-temporal-arteritis-a-study-of-6-cases
#19
A Lago, J I Tembl, G Fortea, L Morales, C Nieves, M Campins, F Aparici
INTRODUCTION: Though uncommon, ischaemic stroke due to temporal arteritis carries serious difficulties for diagnosis and subsequent management and requires a high level of suspicion. METHODS: We analysed a series of 6 patients with biopsy-proven temporal arteritis presenting with ischaemic stroke. We discuss clinical characteristics, difficulties of assessment, short- and long-term progression, treatment, and the usefulness of new diagnostic techniques. RESULTS: Our sample of 6 patients had a mean age of 68...
August 28, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/28867369/-oral-anticoagulation-in-atrial-fibrillation-what-is-the-guideline-for-using-new-drugs
#20
J A Ibáñez Pérez de Viñaspre, J Gómez Bitrian, R Royo Hernández, M de Azúa Jiménez, C Marco López, L Urieta González
OBJECTIVE: To assess whether there are differences between atrial fibrillation (AF) patients initiating new direct-acting oral anticoagulants (DOAC) therapy and vitamin K antagonist (VKA) therapy in an emergency service. METHODS: Descriptive, observational, prospective study. We enrolled patients with AF who were visited in a hospital emergency service over one year. RESULTS: This study included 492 patients with AF, and 189 subjects received anticoagulant therapy, 104 with VKA (55%), and 85 with DOAC (45%)...
August 31, 2017: Semergen
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