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https://www.readbyqxmd.com/read/27924216/atrial-fibrillation-management-in-older-heart-failure-patients-a-complex-clinical-problem
#1
REVIEW
Giovanni Pulignano, Donatella Del Sindaco, Maria Denitza Tinti, Stefano Tolone, Giovanni Minardi, Antonio Lax, Massimo Uguccioni
BACKGROUND: Atrial fibrillation (AF) and heart failure (HF), two problems of growing prevalence as a consequence of the ageing population, are associated with high morbidity, mortality, and healthcare costs. AF and HF also share common risk factors and pathophysiologic processes such as hypertension, diabetes mellitus, ischemic heart disease, and valvular heart disease often occur together. Although elderly patients with both HF and AF are affected by worse symptoms and poorer prognosis, there is a paucity of data on appropriate management of these patients...
January 2016: Heart International
https://www.readbyqxmd.com/read/27923277/reaction-time-for-processing-visual-stimulus-in-a-computer-assisted-rehabilitation-environment
#2
Yerly Sanchez, David Pinzon, Bin Zheng
PURPOSE: To examine the reaction time when human subjects process information presented in the visual channel under both a direct vision and a virtual rehabilitation environment when walking was performed. METHOD: Visual stimulus included eight math problems displayed on the peripheral vision to seven healthy human subjects in a virtual rehabilitation training (computer-assisted rehabilitation environment (CAREN)) and a direct vision environment. Subjects were required to verbally report the results of these math calculations in a short period of time...
December 7, 2016: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/27920399/anticoagulation-for-stroke-prevention-in-elderly-patients-with-non-valvular-atrial-fibrillation-what-are-the-obstacles
#3
C W Wong
The elderly with atrial fibrillation are more prone to stroke. Oral anticoagulants such as warfarin are effective in the prevention of atrial fibrillation-associated stroke and systemic embolism. The CHADS2 or CHA2D2-VASc score and HAS-BLED score were developed to stratify stroke risk associated with atrial fibrillation and bleeding risk in a patient with atrial fibrillation, respectively, to facilitate the decision for and safe use of oral anticoagulant. Nonetheless, the decision for anticoagulation is not straightforward and the elderly with non-valvular atrial fibrillation are often precluded from anticoagulant prescription...
December 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27919792/the-role-of-posturography-in-assessing-the-process-of-rehabilitation-in-poststroke-patients-a-case-study
#4
Witold Rongies, Bartosz Słomka, Angelika Duczek, Włodzimierz Dolecki
Stroke is one of the most common causes of death and disability both in Poland and around the world. Each year, 250 out of 100,000 people in Europe are diagnosed with a disruption of cerebral perfusion in the form of stroke. In Poland, approximately 65,000-70,000 people are affected each year, with the incidence steadily increasing. Stroke survivors suffer from impaired cognitive and motor functions. Moreover, they exhibit severe gait pattern abnormalities, which together with balance disorders, constitute the main factors increasing the risk of falls in this patient group...
December 2, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27913539/prevention-of-central-nervous-system-sequelae-in-sickle-cell-disease-without-evidence-from-randomized-controlled-trials-the-case-for-a-team-based-learning-collaborative
#5
Michael R DeBaun, Allison A King
Since 1998, the National Institutes of Health has funded 5 randomized controlled trials (RCTs) for primary and secondary prevention of strokes in children with sickle cell anemia (SCA). In a systematic fashion, these trials have significantly advanced the care of children with SCA. In the absence of an RCT, clinicians are often compelled to make decisions at the bedside, based on experience, observational studies, and principles of hematology. We will provide an initial example that describes how a team-based, learning collaborative developed a multisite standard care protocol with a low budget (<$10 000 per year) to overcome the intrinsic limitations of advancing the care of neurologic complications in sickle cell disease (SCD)...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27911316/risk-factors-for-mild-cognitive-impairment-in-german-primary-care-practices
#6
Louis Jacob, Jens Bohlken, Karel Kostev
BACKGROUND: Mild cognitive impairment (MCI) is a common mental disorder affecting around 16% of elderly people without dementia. MCI is considered an intermediate state between normal cognition and dementia. OBJECTIVE: To analyze risk factors for the development of MCI in German primary care practices. METHODS: In total, 3,604 MCI patients and 3,604 controls without MCI were included between January 2010 and December 2015. Several disorders potentially associated with MCI were determined...
December 1, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27910252/memory-performance-on-the-story-recall-test-and-prediction-of-cognitive-dysfunction-progression-in-mild-cognitive-impairment-and-alzheimer-s-dementia
#7
Jong-Hwan Park, Hyuntae Park, Sang Wuk Sohn, Sungjae Kim, Kyung Won Park
AIM: To determine the factors that influence diagnosis and differentiation of patients with mild cognitive impairment (MCI) and Alzheimer's dementia (AD) by comparing memory test results at baseline with those at 1-2-year follow up. METHODS: We consecutively recruited 23 healthy participants, 44 MCI patients and 27 patients with very mild AD according to the National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorder Association criteria for probable Alzheimer's disease and Petersen's clinical diagnostic criteria...
December 1, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27909476/atrial-fibrillation-and-risk-of-dementia-cognitive-decline
#8
REVIEW
Anand D Shah Md, Faisal M Merchant Md, David B Delurgio Md
Emerging evidence suggests a link between atrial fibrillation and subsequent development of dementia. While a majority of risk can be attributed to cardioembolic stroke secondary to atrial fibrillation, additional risk is apparent, and may be driven by vascular inflammation and changes in cerebral perfusion. Medical therapies including anticoagulation, statin therapy, and angiotensin-renin-aldosterone axis antagonists may reduce dementia risk. Procedural therapies such as atrial fibrillation catheter ablation and left atrial appendage closure may also prove to be important mediators of acute and long-term risk...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909458/the-association-between-post-stroke-depression-and-the-activities-of-daily-living-gait-balance-in-patients-with-first-onset-stroke-patients
#9
Geun-Young Park, Sun Im, Soo-Jung Lee, Chi-Un Pae
This study evaluated the association between post-stroke depression (PSD) and clinical outcomes, including activities of daily living (ADL) and gait balance, in patients with first-onset stroke. One hundred and eighty inpatients were recruited and followed-up for a 6-month. The depressive, cognitive, and stroke symptoms were assessed using the Beck Depression Inventory (BDI), the Global Deterioration Scale (GDS), the modified Rankin Scale (MRS), and the Berg Balance Scale (BBS). All patients were assessed at baseline and at the end of the observation (6-month)...
November 2016: Psychiatry Investigation
https://www.readbyqxmd.com/read/27906755/optimal-blood-pressure-target-in-stroke-prevention
#10
Alexandra Yannoutsos, Céline Dreyfuss Tubiana, Michel E Safar, Jacques Blacher
PURPOSE OF REVIEW: A generalized single blood pressure (BP) goal may appear not suitable to achieve an optimal stroke prevention at the individual level. The aim of the present review is to consider the clinical relevance of individualized BP goal according to patient's age, comorbidities and established cerebrovascular disease. RECENT FINDINGS: Observational and interventional data support heterogeneity in target organ prevention in that lower BP values than recommended by hypertension guidelines are associated with further stroke risk reduction...
November 30, 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27905386/-cognitive-impairment-in-patients-poluchennym-ischemic-stroke-in-the-acute-and-early-recovery-periods-in-the-process-of-neuroprotection-low-dose-drug-cortexin
#11
L A Belova, V V Mashin, V V Abramova, A N Proshin, A N Ovsyannikova
AIM: To study the effect of repeated low-dose course of neuroprotection by drug cortexin on cognitive impairment in the acute and early recovery periods of hemispheric ischemic stroke. MATERIAL AND METHODS: The study involved 90 patients with poluchennym ischemic stroke. Patients of the first group received cortexin 20 mg (10+10) intramuscularly on the background of basic therapy, patients of the second group (n=30) received cortexin 20 mg (10+10) two courses for 10 days each with a break in between of 10 days, the patients of the third group - only basic therapy...
2016: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/27901591/driving-restrictions-post-stroke-physicians-compliance-with-regulations
#12
Selina Mårdh, Pamela Mårdh, Anna Anund
Objective Suffering a stroke might lead to permanent cognitive and/or physical impairment. It has been shown that these impairments could have an impact on the individual's fitness to drive. In Sweden, as in many other countries, there are regulations on driving cessation post-stroke. The information on driving cessation should be given to all patients and noted in the journal. The present study sought to find out physician's compliance to driving regulations post-stroke as well as follow-up and gender aspects...
November 30, 2016: Traffic Injury Prevention
https://www.readbyqxmd.com/read/27899753/temporal-evolution-of-poststroke-cognitive-impairment-using-the-montreal-cognitive-assessment
#13
Britta Nijsse, Johanna M A Visser-Meily, Maria L van Mierlo, Marcel W M Post, Paul L M de Kort, Caroline M van Heugten
BACKGROUND AND PURPOSE: The Montreal Cognitive Assessment (MoCA) is nowadays recommended for the screening of poststroke cognitive impairment. However, little is known about the temporal evolution of MoCA-assessed cognition after stroke. The objective of this study was to examine the temporal pattern of overall and domain-specific cognition at 2 and 6 months after stroke using the MoCA and to identify patient groups at risk for cognitive impairment at 6 months after stroke. METHODS: Prospective cohort study in which 324 patients were administered the MoCA at 2 and 6 months post stroke...
November 29, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27899748/cannabinoid-type-2-receptor-drives-neurogenesis-and-improves-functional-outcome-after-stroke
#14
Isabel Bravo-Ferrer, María I Cuartero, Juan G Zarruk, Jesús M Pradillo, Olivia Hurtado, Víctor G Romera, Javier Díaz-Alonso, Juan M García-Segura, Manuel Guzmán, Ignacio Lizasoain, Ismael Galve-Roperh, María A Moro
BACKGROUND AND PURPOSE: Stroke is a leading cause of adult disability characterized by physical, cognitive, and emotional disturbances. Unfortunately, pharmacological options are scarce. The cannabinoid type-2 receptor (CB2R) is neuroprotective in acute experimental stroke by anti-inflammatory mechanisms. However, its role in chronic stroke is still unknown. METHODS: Stroke was induced by permanent middle cerebral artery occlusion in mice; CB2R modulation was assessed by administering the CB2R agonist JWH133 ((6aR,10aR)-3-(1,1-dimethylbutyl)-6a,7,10,10a-tetrahydro-6,6,9-trimethyl-6H-dibenzo[b,d]pyran) or the CB2R antagonist SR144528 (N-[(1S)-endo-1,3,3-trimethylbicyclo-[2...
November 29, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27899478/one-year-prospective-study-on-the-presence-of-chronic-diseases-and-subsequent-cognitive-decline-in-older-adults
#15
Hamzah Bakouni, Samantha Gontijo Guerra, Veronica Chudzinski, Djamal Berbiche, Helen-Maria Vasiliadis
BACKGROUND: The literature is inconsistent regarding the effect of the presence of chronic physical and mental diseases on cognitive decline in older adults. The objectives of this study were to explore the effect of chronic diseases on subsequent cognitive decline assessed via the Mini Mental State Examination (MMSE) in community living older adults. METHODS: We used data from individuals (n = 2010) participating in the ESA (Étude sur la Santé des Aînés) study...
November 29, 2016: Journal of Public Health
https://www.readbyqxmd.com/read/27895449/cadasil-presenting-with-spontaneous-intracerebral-hemorrhage-report-of-a-case-and-description-of-the-first-family-in-northern-greece
#16
I Koutroulou, T Karapanayiotides, N Grigoriadis, D Karacostas
INTRODUCTION: CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy), the most common inherited cause of stroke and dementia in adults, has been described in six Greek families. Common presenting manifestations include migraine with aura, brain ischemia, mood disorders and cognitive decline. Spontaneous intracerebral hemorrhage (SICH) rarely occurs in CADASIL and only exceptionally as the first clinical manifestation. CASE DESCRIPTION: We have previously reported the sixth Greek family with CADASIL and in particular, two brothers in whom the genetic testing documented a classic mutation of the NOTCH3 gene (Arg169Cys)...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27895004/predictors-of-vascular-cognitive-impairment-poststroke-in-a-middle-eastern-bahrain-cohort-a-proposed-case-control-comparison
#17
Claire Donnellan, Mona Al Banna, Noor Redha, Adel Al Jishi, Isa Al Sharoqi, Safa Taha, Moiz Bakhiet, Fatema Abdulla, Patrick Walsh
BACKGROUND: Poststroke dementia and cognitive impairment are associated with poor long-term outcomes after stroke. The contribution of genetic factors such as the presence of apolipoprotein (ApoE) ɛ4 allele and its association with cognitive impairment poststroke remains inconclusive, particularly in Middle Eastern regions. OBJECTIVE: The aim of this study is to examine all correlates and potential predictors of cognitive impairment including self-awareness and regulation deficits in stroke patients and compare these functions with healthy older adults from a Middle Eastern population...
November 28, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27894887/ultrasound-tissue-pulsatility-imaging-suggests-impairment-in-global-brain-pulsatility-and-small-vessels-in-elderly-patients-with-orthostatic-hypotension
#18
Julie Biogeau, Thomas Desmidt, Paul-Armand Dujardin, Redouane Ternifi, Charlotte Eudo, Emilie Vierron, Jean-Pierre Remenieras, Frédéric Patat, Vincent Camus, Thierry Constans
BACKGROUND: Orthostatic hypotension (OH) is highly prevalent in the elderly, and this population can be exposed to serious complications, including falls and cognitive disorders, as well as overall mortality. However, the pathophysiology of OH is still poorly understood, and innovative methods of cerebral blood flow (CBF) assessment have been required to accurately investigate cerebrovascular reactivity in OH. OBJECTIVES: We want to compare brain tissue pulsatility (BTP) changes during an orthostatic challenge in elderly patients over 80 with and without OH...
November 25, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27893997/psychometric-properties-of-dual-task-balance-and-walking-assessments-for-individuals-with-neurological-conditions-a-systematic-review
#19
REVIEW
Lei Yang, Freddy Man Hin Lam, Lin Rong Liao, Mei Zhen Huang, Cheng Qi He, Marco Yiu Chung Pang
BACKGROUND: The ability of performing a balance or walking task in conjunction with a secondary cognitive or motor task, referred to as dual-task (DT) ability, is essential in daily living. While there is some evidence that DT performance is impaired in individuals with neurological conditions, using reliable and valid tools to measure DT performance is essential. This systematic review aimed to evaluate the psychometric properties of DT balance and walking assessments in individuals with different neurological conditions...
November 15, 2016: Gait & Posture
https://www.readbyqxmd.com/read/27887584/ratio-of-apob-ldl-a-potential-clinical-index-for-vascular-cognitive-impairment
#20
Cheng Qian, Fei Tan
BACKGROUND: Vascular cognitive impairment (VCI), compared to vascular dementia (VD), has a broader definition and highlights the effect of vascular disease in dementia, and stroke seems play an important role in the development of VCI. However, not all patients with brain infarcts suffer from VCI; unique risk factors appear to cause such progression. This study aimed to find potential risk factors of vascular cognitive impairment among patients with brain infarcts. METHODS: Thirty-seven dementia patients and 74 brain infarction patients were included; all had infarcts in both basilar ganglia...
November 25, 2016: BMC Neurology
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