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Small Vessels Disease

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https://www.readbyqxmd.com/read/27908171/automated-detection-of-white-matter-hyperintensities-of-all-sizes-in-cerebral-small-vessel-disease
#1
Mohsen Ghafoorian, Nico Karssemeijer, Inge W M van Uden, Frank-Erik de Leeuw, Tom Heskes, Elena Marchiori, Bram Platel
PURPOSE: White matter hyperintensities (WMH) are seen on FLAIR-MRI in several neurological disorders, including multiple sclerosis, dementia, Parkinsonism, stroke and cerebral small vessel disease (SVD). WMHs are often used as biomarkers for prognosis or disease progression in these diseases, and additionally longitudinal quantification of WMHs is used to evaluate therapeutic strategies. Human readers show considerable disagreement and inconsistency on detection of small lesions. A multitude of automated detection algorithms for WMHs exists, but since most of the current automated approaches are tuned to optimize segmentation performance according to Jaccard or Dice scores, smaller WMHs often go undetected in these approaches...
December 2016: Medical Physics
https://www.readbyqxmd.com/read/27906755/optimal-blood-pressure-target-in-stroke-prevention
#2
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/27902730/spectrum-of-cerebrovascular-disease-in-patients-with-multiple-myeloma-undergoing-chemotherapy-results-of-a-case-control-study
#3
Archana Hinduja, Kaustubh Limaye, Rahul Ravilla, Appalnaidu Sasapu, Xenofon Papanikolaou, Lai Wei, Michel Torbey, Sarah Waheed
OBJECTIVES: Patients with multiple myeloma (MM) are at increased risk of arterial thrombosis. Our aim was to determine the risk factors, mechanisms and outcome of strokes in these patients. METHODS: We conducted a retrospective matched case-control study from our database of MM patients enrolled in Total Therapy (TT) 2, TT3a and TT3b protocols who developed a vascular event (transient ischemic attack, ischemic stroke, or intracerebral hemorrhage) from October 1998 to January 2014...
2016: PloS One
https://www.readbyqxmd.com/read/27899942/adiponectin-receptor-1-and-small-ubiquitin-like-modifier-4-polymorphisms-are-associated-with-risk-of-coronary-artery-disease-without-diabetes
#4
Hong Li, Ze Yang, Lian-Mei Pu, Xiang Li, Yang Ruan, Fan Yang, Shuai Meng, Duo Yang, Wei Yao, Hao Fu, Feng Zhang, Ze-Ning Jin
BACKGROUND: The genes encoding adiponectin receptor 1 (ADIPOR1) and small ubiquitin-like modifier 4 (SUMO4) have been linked to anti-atherogenic effects, but little is known about whether polymorphisms in the two genes, acting separately or interacting, affect risk of coronary artery disease (CAD) without diabetes. METHODS: We genotyped 200 CAD patients without diabetes and 200 controls without CAD or diabetes at three single-nucleotide polymorphisms (SNPs) in ADIPOR1 and one SNP in SUMO4, which were chosen based on previous studies...
September 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27898582/antithrombotic-therapy-in-patients-with-cerebral-microbleeds
#5
Duncan Wilson, David J Werring
PURPOSE OF REVIEW: Cerebral microbleeds (CMBs) are a radiological marker of cerebral small vessel disease corresponding to small haemosiderin foci identified by blood-sensitive MRI. CMBs are common in older community populations, and in individuals with ischaemic stroke or transient ischaemic attack (TIA), and intracerebral haemorrhage (ICH). We summarize how CMBs might contribute to assessing the future risk of ischaemic stroke and ICH to inform antithrombotic (antiplatelet or anticoagulant) decisions...
November 24, 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27897352/functional-magnetic-resonance-imaging-for-in-vivo-quantification-of-pulmonary-hypertension-in-the-sugen-5416-hypoxia-mouse
#6
Ellen C Breen, Miriam Scadeng, N Chin Lai, Fiona Murray, Timothy D Bigby
Pulmonary arterial hypertension (PAH) is characterized by elevated pulmonary artery pressures and right heart failure. PAH mouse models are instrumental in understanding disease pathophysiology. However, few methods are available to evaluate right cardiac function in small animals. In this study, magnetic resonance imaging (MRI) was used to measure in vivo cardiac dimensions in the Sugen 5416/hypoxia mouse model. Pulmonary hypertension (PH) was induced in C57BL/6 mice by three weeks of exposure to 10% oxygen and VEGF receptor inhibition (20 mg kg(-1) SU5416)...
November 29, 2016: Experimental Physiology
https://www.readbyqxmd.com/read/27893661/acute-coronary-vasospasm-in-a-patient-with-eosinophilic-granulomatosis-with-polyangiitis-following-nsaid-administration-a-case-report
#7
Naïl Benallegue, Pierre Lozach, Cristina Belizna, Christian Lavigne, Geoffrey Urbanski
Eosinophilic with polyangiitis (EGPA, formerly known as Churg-Strauss syndrome) is a rare systemic disease characterized by a small-vessel necrotizing vasculitis. Cardiac manifestations are broad-ranging and are associated with a poor prognosis. Coronary vasospasm is uncommon.Here, we report a case of an acute coronary vasospasm in a patient with EGPA after corticosteroids withdrawal and nonsteroidal antiinflammatory drug (NSAID) introduction. This patient was initially misdiagnosed as bradykinin-mediated angioedema...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27892636/impaired-retinal-vasoreactivity-an-early-marker-of-stroke-risk-in-diabetes
#8
Kerstin Bettermann, Julia Slocomb, Vikram Shivkumar, David Quillen, Thomas W Gardner, Mary E Lott
Diabetes is a common cause of small vessel disease leading to stroke and vascular dementia. While the function and structure of large cerebral vessels can be easily studied, the brain's microvasculature remains difficult to assess. Previous studies have demonstrated that structural changes in the retinal vessel architecture predict stroke risk, but these changes occur at late disease stages. Our goal was to examine whether retinal vascular status can predict cerebral small vessel dysfunction during early stages of diabetes...
November 28, 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/27891240/differences-in-the-clinical-manifestations-and-short-term-prognosis-of-acute-cerebral-infarction-after-exposure-to-agent-orange
#9
SangWoo Han, Inha Hwang, Seung Min Kim, Young Soon Yang, SangWon Ha, Jeong Ho Han, Tae Hwan Park
BACKGROUND: Agent Orange (AO) is the code name for one of the herbicides and defoliants used in the Vietnam War. Studies conducted thus far show a significant correlation between AO and the occurrence of cardiovascular diseases. But there is little data on the association between AO and stroke, and limited studies have targeted patient groups exposed to AO. METHOD: Bohun medical center Institutional Review Board (IRB) approved the study. (ID: 341) We studied patients with acute ischemic stroke within 7 days of onset in VHS medical center and 4 other general hospitals...
2016: Annals of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/27889950/retinopathy-a-sign-of-cerebral-small-vessel-disease-in-diabetes
#10
Toshitaka Umemura, Takahiko Kawamura
Cardio-cerebrovascular disease greatly influences the prognosis of diabetic patients. Silent lacunar infarcts, white matter lesions (WMLs), and cerebral microbleeds are magnetic resonance imaging (MRI) markers of cerebral small vessel disease (SVD) and as they are associated with stroke and dementia, prevention of their incidence and progression is important in clinical practice. The findings of previous autopsy and clinical studies suggest that lacunar infarcts are more prevalent in diabetic patients. On the other hand, the findings of studies on an association between diabetes and WMLs have been inconsistent...
November 27, 2016: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/27889190/diagnosis-of-multiple-sclerosis-progress-and-challenges
#11
REVIEW
Wallace J Brownlee, Todd A Hardy, Franz Fazekas, David H Miller
The diagnosis of multiple sclerosis is based on neurological symptoms and signs, alongside evidence of dissemination of CNS lesions in space and time. MRI is often sufficient to confirm the diagnosis when characteristic lesions accompany a typical clinical syndrome, but in some patients, further supportive information is obtained from cerebrospinal fluid examination and neurophysiological testing. Differentiation is important from other diseases in which demyelination is a feature (eg, neuromyelitis optica spectrum disorder and acute disseminated encephalomyelitis) and from non-demyelinating disorders such as chronic small vessel disease and other inflammatory, granulomatous, infective, metabolic, and genetic causes that can mimic multiple sclerosis...
November 23, 2016: Lancet
https://www.readbyqxmd.com/read/27885490/localized-cortical-chronic-traumatic-encephalopathy-pathology-after-single-severe-axonal-injury-in-human-brain
#12
Sharon B Shively, Sarah L Edgerton, Diego Iacono, Dushyant P Purohit, Bao-Xi Qu, Vahram Haroutunian, Kenneth L Davis, Ramon Diaz-Arrastia, Daniel P Perl
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease associated with repetitive mild impact traumatic brain injury from contact sports. Recently, a consensus panel defined the pathognomonic lesion for CTE as accumulations of abnormally hyperphosphorylated tau (p-tau) in neurons (neurofibrillary tangles), astrocytes and cell processes distributed around small blood vessels at sulcal depths in irregular patterns within the cortex. The pathophysiological mechanism for this lesion is unknown. Moreover, a subset of CTE cases harbors cortical β-amyloid plaques...
November 24, 2016: Acta Neuropathologica
https://www.readbyqxmd.com/read/27881570/excess-cardiovascular-risk-in-women-relative-to-men-referred-for-coronary-angiography-is-associated-with-severely-impaired-coronary-flow-reserve-not-obstructive-disease
#13
Viviany R Taqueti, Leslee J Shaw, Nancy R Cook, Venkatesh L Murthy, Nishant R Shah, Courtney R Foster, Jon Hainer, Ron Blankstein, Sharmila Dorbala, Marcelo F Di Carli
BACKGROUND: -Cardiovascular disease (CVD) fatality rates are higher for women as compared with men, yet obstructive coronary artery disease (CAD) is less prevalent in women. Coronary flow reserve (CFR), an integrated measure of large and small vessel CAD and myocardial ischemia, identifies patients at risk for CVD death, but is not routinely measured in clinical practice. We sought to investigate the impact of sex, CFR, and angiographic CAD severity on adverse cardiovascular events. METHODS: -Consecutive patients (N=329, 43% women) referred for invasive coronary angiography after stress testing with myocardial perfusion positron emission tomography (PET) and with left ventricular ejection fraction >40% were followed (median 3...
November 14, 2016: Circulation
https://www.readbyqxmd.com/read/27881154/targeted-next-generation-sequencing-identifies-novel-notch3-gene-mutations-in-cadasil-diagnostics-patients
#14
Neven Maksemous, Robert A Smith, Larisa M Haupt, Lyn R Griffiths
BACKGROUND: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic, hereditary, small vessel disease of the brain causing stroke and vascular dementia in adults. CADASIL has previously been shown to be caused by varying mutations in the NOTCH3 gene. The disorder is often misdiagnosed due to its significant clinical heterogeneic manifestation with familial hemiplegic migraine and several ataxia disorders as well as the location of the currently identified causative mutations...
November 24, 2016: Human Genomics
https://www.readbyqxmd.com/read/27879449/ethnic-comparison-of-clinical-characteristics-and-ischemic-stroke-subtypes-among-young-adult-patients-with-stroke-in-hawaii
#15
Kazuma Nakagawa, Cherisse S Ito, Sage L King
BACKGROUND AND PURPOSE: Native Hawaiians and other Pacific Islanders (NHOPI) with ischemic stroke have younger age of stroke onset compared with whites. However, ethnic differences in stroke subtypes in this population have been inadequately studied. METHODS: Consecutive young adult patients (aged ≤55 years) who were hospitalized for ischemic stroke between 2006 and 2012 at a tertiary center in Honolulu were studied. Clinical characteristics and stroke subtypes based on pathophysiological TOAST classification (Trial of Org 10172) of NHOPI and Asians were compared with whites...
November 22, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27876017/increased-wnt5a-in-squamous-cell-lung-carcinoma-inhibits-endothelial-cell-motility
#16
J Rapp, E Kiss, M Meggyes, E Szabo-Meleg, D Feller, G Smuk, T Laszlo, V Sarosi, T F Molnar, K Kvell, J E Pongracz
BACKGROUND: Angiogenesis is important both in normal tissue function and disease and represents a key target in lung cancer (LC) therapy. Unfortunately, the two main subtypes of non-small-cell lung cancers (NSCLC) namely, adenocarcinoma (AC) and squamous cell carcinoma (SCC) respond differently to anti-angiogenic e.g. anti-vascular endothelial growth factor (VEGF)-A treatment with life-threatening side effects, often pulmonary hemorrhage in SCC. The mechanisms behind such adverse reactions are still largely unknown, although peroxisome proliferator activator receptor (PPAR) gamma as well as Wnt-s have been named as molecular regulators of the process...
November 23, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27874975/structural-and-functional-brain-alterations-in-a-murine-model-of-angiotensin-ii-induced-hypertension
#17
Anja Meissner, Jens Minnerup, Guadalupe Soria Rodriguez, Anna M Planas
Hypertension is a main risk factor for the development of cerebral small vessel disease (cSVD) - a major contributor to stroke and the most common cause of vascular dementia. Despite the increasing socio-economic importance arising from cSVD, currently only a few specific treatment strategies with proven efficacy are known. Fundamental to the lack of specific treatments is poor understanding of the disease pathogenesis and a lack of appropriate animal models resembling all symptoms of the human disease. However, chronic hypertensive rat models have been shown to bear similarities to most key features of cSVD...
November 22, 2016: Journal of Neurochemistry
https://www.readbyqxmd.com/read/27868334/consensus-on-the-standardization-of-terminology-in-thrombotic-thrombocytopenic-purpura-and-related-thrombotic-microangiopathies
#18
M Scully, S Cataland, P Coppo, J de la Rubia, K D Friedman, J Kremer Hovinga, B Lämmle, M Matsumoto, K Pavenski, E Sadler, R Sarode, H Wu
BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS) are two important acute conditions to diagnose. Thrombotic Microangiopathy is a broad pathophysiological process that leads to microangiopathic hemolytic anemia, thrombocytopenia and involves capillary and small vessel platelet aggregates. The most common cause being disseminated intravascular coagulation (DIC), which may be differentiated by abnormal coagulation. Clinically, a number of conditions present with microangiopathic hemolytic anemia and thrombocytopenia (MAHAT), including cancer, infection, transplantation, drugs, autoimmune disease and pre-eclampsia and HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet count) syndrome in pregnancy...
November 21, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27864848/age-related-small-vessel-disease-a-potential-contributor-to-neurodegeneration-in-multiple-sclerosis
#19
REVIEW
Ruth Geraldes, Margaret M Esiri, Gabriele C DeLuca, Jacqueline Palace
Multiple sclerosis (MS) is a chronic inflammatory demyelinating disorder of the central nervous system wherein, after an initial phase of transient neurological defects, slow neurological deterioration due to progressive neuronal loss ensues. Age is a major determinant of MS progression onset and disability. Over the past years, several mechanisms have been proposed to explain the key drivers of neurodegeneration and disability accumulation in MS. However, the effect of commonly encountered age-related cerebral vessel disease, namely small vessel disease (SVD), has been largely neglected and constitutes the aim of this review...
November 19, 2016: Brain Pathology
https://www.readbyqxmd.com/read/27863214/type-ii-natural-killer-t-cells-that-recognize-sterol-carrier-protein-2-are-implicated-in-vascular-inflammation-in-the-rat-model-of-systemic-connective-tissue-diseases
#20
Yusuke Nishioka, Madoka Yamaguchi, Ai Kawakami, Maya Munehiro, Sakiko Masuda, Utano Tomaru, Akihiro Ishizu
We previously generated a rat model that developed systemic connective tissue diseases, including synovitis, myositis, and small-vessel vasculitis (SVV), and established a vascular endothelial cell-reactive T-cell clone, VASC-1, from the model. VASC-1 was determined to be a type II natural killer T-cell clone. In this study, we attempted to identify the antigen recognized by VASC-1. The monkey-derived cell line COS-7 was used because VASC-1 does not bind naturally to COS-7, although the amino acid sequences are well conserved between monkey CD1d and rat CD1d...
November 15, 2016: American Journal of Pathology
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