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https://www.readbyqxmd.com/read/28920554/a-pulmonary-embolism-response-team-s-initial-20-month-experience-treating-87-patients-with-submassive-and-massive-pulmonary-embolism
#1
Akhilesh K Sista, Oren A Friedman, Eda Dou, Brendan Denvir, Gulce Askin, Jamie Stern, Jaclyn Estes, Arash Salemi, Ronald S Winokur, James M Horowitz
Pulmonary Embolism Response Teams (PERTs) have emerged to provide rapid multidisciplinary assessment and treatment of PE patients. However, descriptive institutional experience and preliminary outcomes data from such teams are sparse. PERT activations were identified through a retrospective review. Only confirmed submassive or massive PEs were included in the data analysis. In addition to baseline variables, the therapeutic intervention, length of stay (LOS), in-hospital mortality, and bleeding rate/severity were recorded...
September 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28914594/salivary-neuropeptides-stress-and-periodontitis
#2
Hady Haririan, Oleh Andrukhov, Michael Böttcher, Eleonore Pablik, Gernot Wimmer, Andreas Moritz, Xiaohui Rausch-Fan
BACKGROUND: Scientific evidence for psychological stress as a risk factor for periodontitis is fragmentary relying mostly on either questionnaire-based or biomarker studies. The aim of this study was to investigate Brain Derived Neurotrophic Factor, Substance P, Vasoactive Intestinal Peptide (VIP), Neuropeptide Y (NPY), Calcitonin Gene Related Peptide and Adrenomedullin as well as cortisol in saliva and serum in periodontal health and disease combined with different aspects of stress and possible associations with clinical parameters...
September 15, 2017: Journal of Periodontology
https://www.readbyqxmd.com/read/28913708/emergency-neurological-life-support-intracerebral-hemorrhage
#3
J Claude Hemphill, Arthur Lam
Intracerebral hemorrhage (ICH) is a subset of stroke due to spontaneous bleeding within the parenchyma of the brain. It is potentially lethal, and survival depends on ensuring an adequate airway, proper diagnosis, and early management of several specific issues such as blood pressure, coagulopathy reversal, and surgical hematoma evacuation for appropriate patients. ICH was chosen as an Emergency Neurological Life Support (ENLS) protocol because intervention within the first hours may improve outcome, and it is critical to have site-specific protocols to drive care quickly and efficiently...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28894943/swirl-sign-in-traumatic-acute-epidural-hematoma-prognostic-value-and-surgical-management
#4
Cheng Guo, Lin Liu, Bing Wang, Zhigang Wang
The swirl sign is identified as a small area of low attenuation within an intracranial hyperattenuating clot on non-enhanced computed tomography (CT) scans of the brain, which represents active bleeding. The purpose of this study was to evaluate the incidence of the swirl sign among patients with acute epidural hematoma (AEDH) and to identify its prognostic value and impact on surgical treatment. A retrospective review was performed of patients with a diagnosis of traumatic EDH by CT scan who were surgically treated at the Department of Neurosurgery of the First People's Hospital of Jingmen between January 2010 and January 2014...
September 11, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28894414/hemodynamic-perturbations-in-deep-brain-stimulation-surgery-first-detailed-description
#5
Tumul Chowdhury, Marshall Wilkinson, Ronald B Cappellani
Background: Hemodynamic perturbations can be anticipated in deep brain stimulation (DBS) surgery and may be attributed to multiple factors. Acute changes in hemodynamics may produce rare but severe complications such as intracranial bleeding, transient ischemic stroke and myocardium infarction. Therefore, this retrospective study attempts to determine the incidence of hemodynamic perturbances (rate) and related risk factors in patients undergoing DBS surgery. Materials and Methods: After institutional approval, all patients undergoing DBS surgery for the past 10 years were recruited for this study...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28890692/white-matter-injury-after-intracerebral-hemorrhage-pathophysiology-and-therapeutic-strategies
#6
REVIEW
Chuanyuan Tao, Xin Hu, Hao Li, Chao You
Intracerebral hemorrhage (ICH) accounts for 10%-30% of all types of stroke. Bleeding within the brain parenchyma causes gray matter (GM) destruction as well as proximal or distal white matter (WM) injury (WMI) due to complex pathophysiological mechanisms. Because WM has a distinct cellular architecture, blood supply pattern and corresponding function, and its response to stroke may vary from that of GM, a better understanding of the characteristics of WMI following ICH is essential and may shed new light on treatment options...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28885491/pancreas-transplantation-with-grafts-from-donors-deceased-after-circulatory-death-dcd-5-years-single-center-experience
#7
Wouter Kopp, Hwai-Ding Lam, A F M Schaapherder, Volkert Huurman, Paul van der Boog, Eelco de Koning, Johan W de Fijter, Andrzej Baranski, Andries Braat
INTRODUCTION: Donation after circulatory death (DCD) pancreas transplantation has been shown to be an additional way to deal with donor organ shortages. The results of 5-year DCD pancreas transplantation are presented. METHODS: A retrospective, single center analysis (2011 - 2015) was performed to compare the results of donation after brain death (DBD) to DCD pancreas transplantation. RESULTS: During the study period, 104 pancreas transplantations (83 from DBD and 21 from DCD) were performed...
September 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28882607/efficacy-and-safety-in-frameless-robot-assisted-stereo-electroencephalography-seeg-for-drug-resistant-epilepsy
#8
I Ollivier, C Behr, H Cebula, A Timofeev, M Benmekhbi, M P Valenti, A M Staack, J Scholly, P Kehrli, E Hirsch, F Proust
INTRODUCTION: Stereo-electroencephalography (SEEG) is an invasive procedure, used to identify the epileptogenic zone that can be surgically removed in order to treat drug-resistant epilepsy. Frameless robot-assisted positioning of depth electrodes permits a 3D approach with different obliquities and trajectories. The objective of the present study was to evaluate the morbidity and the accuracy related to this frameless procedure. PATIENTS AND METHODS: Sixty-six patients were managed wherein 901 electrodes were implanted during a 6-year-period...
September 4, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28877919/high-lipoprotein-a-and-low-risk-of-major-bleeding-in-brain-and-airways-in-the-general-population-a-mendelian-randomization-study
#9
Anne Langsted, Pia R Kamstrup, Børge G Nordestgaard
BACKGROUND: The physiological role of lipoprotein(a) is unclear; however, lipoprotein(a) may play a role in hemostasis and wound healing. We tested the hypothesis that high lipoprotein(a) concentrations are associated with low risk of major bleeding in the brain and airways both observationally and causally (from human genetics). METHODS: We examined 109169 individuals from the Copenhagen City Heart Study and the Copenhagen General Population study, 2 similar prospective studies conducted in the Danish general population...
September 6, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28868910/-orbital-compartment-syndrome-the-most-frequent-cause-of-blindness-following-facial-trauma
#10
Gusztáv Klenk, József Katona, Gábor Kenderfi, János Lestyán, Katalin Gombos, Andor Hirschberg
INTRODUCTION: Although orbital compartment syndrome is a rare condition, it is still the most common cause of blindness following simple or complicated facial fractures. Its pathomechanism is similar to the compartment syndrome in the limb. Little extra fluid (blood, oedema, brain, foreign body) in a non-space yielding space results with increasingly higher pressures within a short period of time. Unless urgent surgical intervention is performed the blocked circulation of the central retinal artery will result irreversible ophthalmic nerve damage and blindness...
September 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28866062/presurgical-administration-of-mtor-inhibitors-in-patients-with-large-subependymal-giant-cell-astrocytoma-associated-with-tuberous-sclerosis-complex
#11
Tao Jiang, Jiang Du, Raynald Liu, Junmei Wang, Chunde Li
BACKGROUND: For patients with tuberous sclerosis complex (TSC) with large subependymal giant cell astrocytoma (SEGA), direct surgical resection remains the standard treatment. Rapamycin/everolimus were seldom used in these patients because of increased intracranial pressure and possibility of sudden death. CASE DESCRIPTION: Three TSC patients with large intracranial SEGA received oral rapamycin (0.5 mg/day) or everolimus (2.5 mg/day) prior to surgery. Tumor resection was subsequently performed...
August 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28845297/discovery-of-a-rock-inhibitor-fpnd-which-prevents-cerebral-hemorrhage-through-maintaining-vascular-integrity-by-interference-with-ve-cadherin
#12
Shang Li, Nana Ai, Mingyun Shen, Yuanye Dang, Cheong-Meng Chong, Peichen Pan, Yiu Wa Kwan, Shun Wan Chan, George Pak Heng Leung, Maggie Pui Man Hoi, Tingjun Hou, Simon Ming-Yuen Lee
Hemorrhagic stroke occurs when a weakened vessel ruptures and bleeds into the surrounding brain, leading to high rates of death and disability worldwide. A series of complex pathophysiological cascades contribute to the risk of hemorrhagic stroke, and no therapies have proven effective to prevent hemorrhagic stroke. Stabilization of vascular integrity has been considered as a potential therapeutic target for hemorrhagic stroke. ROCKs, which belong to the serine/threonine protein kinase family and participate in the organization of actin cytoskeleton, have become attractive targets for the treatment of strokes...
2017: Cell Death Discovery
https://www.readbyqxmd.com/read/28842638/efficacy-of-laropiprant-in-minimizing-brain-injury-following-experimental-intracerebral-hemorrhage
#13
Abdullah Shafique Ahmad, Monique Mendes, Damian Hernandez, Sylvain Doré
Intracerebral hemorrhage (ICH) is one of the most devastating and disabling forms of stroke, yet effective treatments are still lacking. Prostaglandins and their receptors have been implicated in playing vital roles in ICH outcomes. Recently, laropiprant, a DP1 receptor antagonist, has been used in combination with niacin to abolish the prostaglandin D2-(PGD2)-induced flushing. Here, we test the hypothesis that laropiprant limits bleeding and rescues the brain from ICH. Wildtype (WT) and DP1(-/-) mice were subjected ICH and neurologic deficits and hemorrhagic lesion outcomes were evaluated at 72 hours after the ICH...
August 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28842354/fatal-stroke-after-bothrops-snakebite-in-the-amazonas-state-brazil-a-case-report
#14
Sâmella Silva de Oliveira, Luciana Aparecida Freitas-de-Sousa, Eliane Campos Alves, Luiz Carlos de Lima Ferreira, Iran Mendonça da Silva, Marcus Vinícius Guimarães de Lacerda, Hui Wen Fan, Ana Maria Moura-da-Silva, Wuelton Marcelo Monteiro
Bothrops atrox is the snake responsible for the majority of snakebites in the Brazilian Amazon. Patients generally evolve to local manifestations such as edema, pain and ecchymoses. Systemic effects of B. atrox venom are usually restricted to blood incoagulability and spontaneous bleeding. However, in a few cases, bleeding in the central nervous system may occur, which can lead to sequels and deaths. Here, we report a case of a 59 year-old woman who presented edema, pain and ecchymoses on the right foot, headache, nausea, diarrhea, hypertension and blood incoagulability after the bite by Bothrops snake in the Brazilian Amazon...
August 24, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/28841633/extracorporeal-circulatory-support-in-acute-coronary-syndromes-a-systematic-review-and-meta-analysis
#15
Rita Pavasini, Chiara Cirillo, Gianluca Campo, Miguel Nobre Menezes, Simone Biscaglia, Elisabetta Tonet, Roberto Ferrari, Brijesh V Patel, Susanna Price
OBJECTIVES: Extracorporeal circulatory support is a life-saving technique, and its use is increasing in acute coronary syndromes. A meta-analysis on pooled event rate of short-term mortality and complications of acute coronary syndrome patients treated with extracorporeal circulatory support was performed. DATA SOURCES: Articles were searched in MEDLINE, Cochrane Library, Google Scholar, and Biomed Central. STUDY SELECTION: Inclusion criteria were observational studies on acute coronary syndrome patients treated with extracorporeal circulatory support...
August 24, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28838368/cerebral-amyloid-angiopathy-diagnosis-clinical-implications-and-management-strategies-in-atrial-fibrillation
#16
REVIEW
Christopher V DeSimone, Jonathan Graff-Radford, Majd A El-Harasis, Alejandro A Rabinstein, Samuel J Asirvatham, David R Holmes
With an aging population, clinicians are more frequently encountering patients with atrial fibrillation who are also at risk of intracerebral hemorrhage due to cerebral amyloid angiopathy, the result of β-amyloid deposition in cerebral vessels. Cerebral amyloid angiopathy is common among elderly patients, and is associated with an increased risk of intracerebral bleeding, especially with the use of anticoagulation. Despite this association, this entity is absent in current risk-benefit analysis models, which may result in underestimation of the chance of bleeding in the subset of patients with this disease...
August 29, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28829216/leukoaraiosis-as-an-outcome-predictor-in-the-acute-and-subacute-phases-of-stroke
#17
Fabio Fierini, Anna Poggesi, Leonardo Pantoni
Leukoaraiosis (LA) is one of the neuroimaging features of cerebral small vessel disease and is associated with poor long-term prognosis. Areas covered: This narrative review focuses on the predictive role of LA on the evolution of the ischemic brain damage and on the clinical outcome in the subacute phase of stroke and in the short-term period afterwards. Expert commentary: LA predicts poorer tissue outcome and clinical prognosis also in acute and subacute stroke. In acute stroke, LA is associated with a less favorable fate of brain infarct and is a marker of increased risk of thrombolysis-related hemorrhagic transformation...
September 4, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28817446/bevacizumab-as-an-effective-treatment-for-radiation-necrosis-after-radiotherapy-for-melanoma-brain-metastases
#18
Isabella C Glitza, Nandita Guha-Thakurta, Neil M D'Souza, Rodabe N Amaria, Susan L McGovern, Ganesh Rao, Jing Li
Radiation necrosis (RN) is a potential late complication of radiotherapy for intracranial malignancy, which is often associated with significant neurological morbidity. Prolonged treatment with high-dose corticosteroids or surgical resection has been the standard care for RN, but protracted steroid use can lead to significant side effects and surgical resection is not always feasible. The antivascular endothelial growth factor monoclonal antibody bevacizumab induces clinical and radiographic improvements in RN, with overall good tolerance...
August 16, 2017: Melanoma Research
https://www.readbyqxmd.com/read/28816935/perimesencephalic-nonaneurysmal-subarachnoid-hemorrhage-caused-by-transverse-sinus-thrombosis-a-case-report-and-review-of-literature
#19
Fang-Wang Fu, Jie Rao, Yuan-Yuan Zheng, Liang Song, Wei Chen, Qi-Hui Zhou, Jian-Guang Yang, Jiang-Qiong Ke, Guo-Qing Zheng
RATIONALE: Perimesencephalic nonaneurysmal subarachnoid hemorrhage (PNSAH) is characterized by a pattern of extravasated blood restricted to the perimesencephalic cisterns, normal angiographic findings, and an excellent prognosis with an uneventful course and low risks of complication. The precise etiology of bleeding in patients with PNSAH has not yet been established. The most common hypothesis is that PNSAH is venous in origin. Intracranial venous hypertension has been considered as the pivotal factor in the pathogenesis of PNSAH...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28814709/spindle-cell-oncocytoma-of-the-anterior-pituitary-presenting-with-an-acute-clinical-course-due-to-intraventricular-hemorrhage-a-case-report-and-review-of-literature
#20
Mostafa Osman, Andrew Wild
BACKGROUND Spindle cell oncocytoma (SCO) is a rare nonfunctioning neoplasm of the adenohypophysis, and was first described in 2002. SCO has been categorized as a separate entity by the 2007 World Health Organization (WHO) and is classified as a Grade 1 tumor of the central nervous system (CNS). Review of the literature has shown that 33 cases of SCO have been reported to date, and most of them presented with a mass effect or with panhypopituitarism. However, all reported cases have described the tendency of SCO to be hypervascular on imaging and histology...
August 17, 2017: American Journal of Case Reports
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