50,072 results match your criteria Acute Stroke Management


The gluteus maximus V-Y advancement flap for reconstruction of extensive soft tissue loss following an advanced sacral pressure ulcer. A case report and mini review.

Int J Surg Case Rep 2020 Jun 17;73:15-21. Epub 2020 Jun 17.

Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon. Electronic address:

Background: The occurrence of pressure injuries (PIs) in an inpatient is a serious medical condition that requires a rigorous clinical evaluation. Management of these lesions should be comprehensive, including general measures and local care. Wound care occupies a large part of the treatment. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.06.060DOI Listing

Diagnosis and management of silent coronary ischemia in patients undergoing carotid endarterectomy.

J Vasc Surg 2020 Jul 2. Epub 2020 Jul 2.

HeartFlow,Inc. Redwood City, California.

Introduction: Coronary artery disease (CAD) is the primary cause of death in patients with carotid artery disease and silent ischemia is a marker for adverse coronary events. A new non-invasive cardiac diagnostic test, coronary CT-derived fractional flow reserve (FFR) can reliably identify ischemia-producing coronary stenosis in patients with CAD and help select patients for coronary revascularization. The purpose of this study is to determine the prevalence of silent coronary ischemia in patients undergoing carotid endarterectomy (CEA) and to evaluate the usefulness of FFR in selecting patients for coronary revascularization in order to reduce cardiac events and improve survival. Read More

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http://dx.doi.org/10.1016/j.jvs.2020.06.045DOI Listing

Spontaneous Visceral Artery Dissections in Otherwise Normal Arteries: Clinical Features, Management, Outcomes Compared to Fibromuscular Dysplasia.

J Vasc Surg 2020 Jul 2. Epub 2020 Jul 2.

Gonda Vascular Center, Mayo Clinic, Rochester, MN, 55905; Cardiovascular Department, Mayo Clinic, Rochester, MN, 55905. Electronic address:

Objectives: Visceral artery dissection with otherwise normally appearing arteries (VADNA), diagnosed on imaging and suggestive of segmental arterial mediolysis (SAM), is a poorly understood disease entity. Study objectives were to define the clinical features, management, and outcomes of patients with VADNA compared to patients with fibromuscular dysplasia (FMD).

Methods: In this single-center retrospective cohort study design, consecutive patients with a diagnosis of VADNA or FMD evaluated in the Mayo Clinic Gonda Vascular Center (1/1/2000-4/1/2017) were identified. Read More

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http://dx.doi.org/10.1016/j.jvs.2020.05.068DOI Listing

Clinical Outcomes in Older Patients Undergoing Percutaneous Coronary Intervention for Non-ST-Elevation Acute Coronary Syndromes.

Heart Lung Circ 2020 Jun 17. Epub 2020 Jun 17.

Department of Cardiology, The Alfred Hospital, Melbourne, Vic, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia; Department of Cardiology, Western Health, Melbourne, Vic, Australia. Electronic address:

Background: Distinguishing the subgroup of older, comorbid patients presenting with non-ST-elevation acute coronary syndromes (NSTEACS) who will benefit from percutaneous coronary intervention (PCI) remains challenging. Identifying risk factors for major adverse cardiac or cerebrovascular events (MACCE) post PCI may help define this cohort. The objective of this study was to describe contemporary outcomes of older patients with NSTEACS undergoing PCI and identify pre-procedural risk factors for MACCE. Read More

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http://dx.doi.org/10.1016/j.hlc.2020.05.102DOI Listing

Contemporary Management of Acute Ischemic Stroke Across the Continuum: From TeleStroke to Intra-Arterial Management.

Mayo Clin Proc 2020 Jul;95(7):1512-1529

Departments of Neurology and Neurologic Surgery, Mayo Clinic, Jacksonville, FL.

In this comprehensive contemporary review of acute ischemic stroke management, what is new and different will be highlighted beginning with prehospital stroke systems of care, emergency medical systems, and mobile stroke units, followed by hospital stroke teams, emergency evaluation, telemedicine, and brain and vascular imaging, and finishing with emergency treatments including thrombolysis and mechanical thrombectomy. Read More

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http://dx.doi.org/10.1016/j.mayocp.2020.04.002DOI Listing

Anesthesia management of atrial myxoma resection with multiple cerebral aneurysms: a case report and review of the literature.

BMC Anesthesiol 2020 Jul 4;20(1):164. Epub 2020 Jul 4.

Department of Anesthesiology, Peking University People's Hospital, No. 11 Xi Zhi Men Nan Da Jie, Xicheng District, Beijing, China.

Background: Embolic stroke is a common complication of atrial myxoma, whereas multiple cerebral aneurysms associated with atrial myxoma is rare. The pathogenesis of the cerebral vascular disease related to an atrial myxoma is still not well known, and there are no guidelines to guide treatment and anesthesia management in such patients.

Case Presentation: In this report, we present a 38-year-old woman with occasional dizziness and headache diagnosed as multiple cerebral fusiform aneurysms, in whom transthoracic echocardiography revealed a mass attached to the interatrial septum in the left atrium. Read More

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http://dx.doi.org/10.1186/s12871-020-01055-1DOI Listing

A rare case of pancreatoblastoma with intracranial seeding.

World Neurosurg 2020 Jul 1. Epub 2020 Jul 1.

Department of Neurological Surgery, University of Virginia Health System, Charlottesville, VA 22908.

Background: Pancreatoblastoma is an extremely rare neoplasm that accounts for 0.5% of all pancreatic exocrine tumors. These rare entities typically manifest in the pediatric population but can rarely occur in adults. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.06.210DOI Listing

Endocrine Dysfunction Following Stroke.

J Neuroimmune Pharmacol 2020 Jul 3. Epub 2020 Jul 3.

Department of Pharmacology, University of Vermont College of Medicine, Burlington, VT, 05405-0068, USA.

Endocrine dysfunction is known to occur after traumatic brain injury. The purpose of this study was to examine the incidence of various endocrine dysfunctions after a stroke. The Taiwan National Health Insurance Research Database (NHIRD) was searched from 2001 to 2011 for patients with a diagnosis of stroke. Read More

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http://dx.doi.org/10.1007/s11481-020-09935-6DOI Listing

Gout epidemiology and comorbidities.

Semin Arthritis Rheum 2020 Jun;50(3S):S11-S16

Medicine Service, Birmingham VA Medical Center, Birmingham, AL, United States; School of Medicine, Department of Medicine, Division of Rheumatology, University of Alabama at Birmingham, AL, United States.

Objective: To review the epidemiology of gout and associated comorbidities.

Methods: We review the key published studies of the epidemiology of gout and associated comorbidities.

Results: The prevalence of gout ranged 1-4% worldwide and incidence ranged 0. Read More

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http://dx.doi.org/10.1016/j.semarthrit.2020.04.008DOI Listing

Effectiveness of a self-rehabilitation program to improve upper-extremity function after stroke in developing countries: a randomized controlled trial.

Ann Phys Rehabil Med 2020 Jun 30. Epub 2020 Jun 30.

NMSK lab, Institut de Recherche Expérimentale et Clinique (IREC), UCLouvain, Brussels, Belgium; Physical Medicine and Rehabilitation Department, Cliniques universitaires Saint-Luc, Brussels, Belgium; Louvain Bionics, UCLouvain, Louvain-La-Neuve, Belgium. Electronic address:

Background: About two-thirds of stroke patients present long-term upper-limb impairment and limitations of activity, which constitutes a challenge in rehabilitation. This situation is particularly true in developing countries, where there is a need for inexpensive rehabilitation solutions.

Objective: This study assessed the effectiveness of a self-rehabilitation program including uni- or bimanual functional exercises for improving upper-limb function after stroke with respect to the context in Benin, West Africa. Read More

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http://dx.doi.org/10.1016/j.rehab.2020.03.017DOI Listing

Cardioembolic stroke in a young male with cor triatriatum sinister: a case report.

Eur Heart J Case Rep 2020 Jun 3;4(3):1-6. Epub 2020 May 3.

Department of Cardiology, University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD 21201, USA.

Background: Cor triatriatum sinister (CTS) is a rare congenital cardiac anomaly defined by a fibromuscular membrane which bisects the left atrium. Cor triatriatum sinister has been associated with cardioembolic stroke through mechanisms including stagnation of blood flow within the left atrium, an association with atrial fibrillation (AF), and/or an accompanying atrial septal defect (ASD) or patent foramen ovale. We describe a case highlighting the role that CTS may play in cardioembolic stroke, provide high-quality computed tomography angiography and two- and three-dimensional echocardiography of the CTS membrane, and outline management strategies for this uncommon clinical scenario. Read More

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http://dx.doi.org/10.1093/ehjcr/ytaa096DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319846PMC

Perioperative mannitol intensive use may avoid the early complication of cerebral venous sinus stenting.

Ann Transl Med 2020 Jun;8(11):672

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.

Background: Cerebral venous sinus (CVS) stenting has been widely applied for correcting CVS stenosis. However, there are still some potential complications. The purpose of this study is to investigate the impact of perioperative management on avoiding complications of CVS stenting. Read More

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http://dx.doi.org/10.21037/atm-20-3021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327372PMC

Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study.

Stroke Vasc Neurol 2020 Jul 2. Epub 2020 Jul 2.

Department of Neurology Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Background And Purpose: COVID-19 is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Apart from respiratory complications, acute cerebrovascular disease (CVD) has been observed in some patients with COVID-19. Therefore, we described the clinical characteristics, laboratory features, treatment and outcomes of CVD complicating SARS-CoV-2 infection. Read More

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http://dx.doi.org/10.1136/svn-2020-000431DOI Listing

Can Pay-for Performance Incentive Levels be Determined Using a Cost-Effectiveness Framework?

Circ Cardiovasc Qual Outcomes 2020 Jul 3:CIRCOUTCOMES120006492. Epub 2020 Jul 3.

Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA. (A.P., M.B.R.).

Background Healthcare payers in the United States are increasingly tying provider payments to quality and value using pay-for-performance policies. Cost-effectiveness analysis quantifies value in healthcare but is not currently used to design or prioritize pay-for-performance strategies or metrics. Acute ischemic stroke care provides a useful application to demonstrate how simulation modeling can be used to determine cost-effective levels of financial incentives used in pay-for-performance policies and associated challenges with this approach. Read More

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http://dx.doi.org/10.1161/CIRCOUTCOMES.120.006492DOI Listing

Intravenous Thrombolysis Guided by Perfusion CT with Alteplase in >4.5 Hours from Stroke Onset.

Cerebrovasc Dis 2020 Jul 2:1-6. Epub 2020 Jul 2.

Stroke Unit, University Hospital Virgen del Rocío, Sevilla, Spain,

Introduction: The benefit of intravenous thrombolysis (IVT) in wake-up stroke (WUS), stroke of unknown time of onset (SUKO), or when time exceeds 4.5 h from last-seen-normal (LSN) guided by CT perfusion (CTP) or MRI has been recently suggested. However, there is limited information of IVT in those patients in real-world studies. Read More

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http://dx.doi.org/10.1159/000509013DOI Listing

Negative Impact of Obesity on Ventricular Size and Function and Exercise Performance in Children and Adolescents with Repaired Tetralogy of Fallot.

Can J Cardiol 2020 Jun 29. Epub 2020 Jun 29.

Division of Cardiology, Department of Pediatrics, University of Toronto, Labatt Family Heart Centre, The Hospital for Sick Children, , Toronto, Ontario, Canada. Electronic address:

Background: Up to 25% of children with congenital heart disease are obese, which may have negative physiologic consequences for patients with repaired tetralogy of Fallot (rTOF).

Methods: Patients with rTOF who underwent cardiac magnetic resonance (CMR) and cardiopulmonary exercise testing from 2007-2018 were reviewed. Complex rTOF patients were excluded. Read More

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http://dx.doi.org/10.1016/j.cjca.2020.06.015DOI Listing

Prophylaxis with a multicomponent nutraceutical abates transient cerebral ischemia/reperfusion injury.

J Food Biochem 2020 Jul 2:e13351. Epub 2020 Jul 2.

Department of Biochemistry, The Federal University of Technology, Akure, Nigeria.

The effect of a multicomponent nutraceutical on cerebral ischemia/reperfusion injury in male Wistar rats was investigated. Animals were administered with the nutraceutical, Trévo™, for 7 days before 30 min of bilateral common carotid artery occlusion-induced cerebral ischemia and 24 hr of reperfusion. Behavioral assessment, biochemical estimations in the brain cortex, striatum, and hippocampus, and hippocampal histopathological evaluation were carried out after treatments. Read More

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http://dx.doi.org/10.1111/jfbc.13351DOI Listing

Costs structure of the inpatient ischemic stroke treatment using an exact costing method.

Heliyon 2020 Jun 23;6(6):e04264. Epub 2020 Jun 23.

Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.

Objectives: Most stroke care expenses are inhospital costs. Given the previously reported inaccuracy of conventional costing, the purpose of this study was to provide an accurate analysis of inpatient costs of stroke care in an acute care hospital.

Materials And Methods: We used activity-based costing (ABC) for calculating the costs of ischemic stroke patients. Read More

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http://dx.doi.org/10.1016/j.heliyon.2020.e04264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322047PMC

Acute management of a stroke-like episode in MELAS syndrome: What should we know?

eNeurologicalSci 2020 Sep 18;20:100249. Epub 2020 Jun 18.

Department of Neurology, Galdakao University Hospital, Labeaga Auzoa S, /N 48960, Galdakao, Basque Country, Spain.

•Acute management of SLEs differs from usual therapy in classic stroke patients.•IV L-Arginine should be administered urgently in the setting of a SLE.•If mental status is altered, an EEG should be performed to rule out a non-convulsive status. Read More

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http://dx.doi.org/10.1016/j.ensci.2020.100249DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317663PMC
September 2020

Safety and Efficacy of Tirofiban in Rescue Treatment for Acute Intracranial Intraprocedural Stent Thrombosis.

Front Neurol 2020 16;11:492. Epub 2020 Jun 16.

Department of Neurology, Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

The incidence of acute intraprocedural stent thrombosis (AIST) during stenting of intracranial atherosclerotic stenosis (ICAS) has seldom been reported and evidence regarding the treatment of AIST is lacking. We aim to investigate the incidence of AIST during stenting of ICAS in our institute, assess the preliminary efficacy and safety of rescue treatment of tirofiban for these patients. From September 2016 to May 2019, all symptomatic ICAS patients who underwent intracranial stenting in our institute were prospectively registered into this study, of which patients with AIST were retrospectively reviewed to extract baseline characteristics, perioperative management, procedural details, angiographic, and clinical outcomes. Read More

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http://dx.doi.org/10.3389/fneur.2020.00492DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308481PMC

Effects of norepinephrine, propofol and hemoglobin concentration on dynamic measurements of cerebrovascular reactivity in acute brain injury.

J Neurotrauma 2020 Jul 1. Epub 2020 Jul 1.

Universitaire Ziekenhuizen Leuven, 60182, Department of Neurosurgery, Leuven, Belgium;

Effects of treatment-associated variables on cerebrovascular autoregulation (CA) in acute brain injury patients remain unclear. As deficient CA is associated with worse outcomes and ideas about CA-steered management are emerging, this question is relevant. We investigated effects of norepinephrine and propofol infusion rates and hemoglobin concentration on dynamic measurements of cerebrovascular reactivity as surrogate for CA. Read More

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http://dx.doi.org/10.1089/neu.2020.7160DOI Listing

Correlation of Body Composition and Nutritional Status with Functional Recovery in Stroke Rehabilitation Patients.

Nutrients 2020 Jun 29;12(7). Epub 2020 Jun 29.

Department of Rehabilitation Medicine, Dokkyo Medical University, 880, Kitakobayashi, Mibu, Shimotsuga, Tochigi 3210293, Japan.

Previous studies have suggested that the nutritional status after stroke is independently associated with long-term outcomes and that sarcopenia delays poststroke rehabilitation and worsens the prognosis. However, many stroke patients have a deteriorated nutritional status and a decreased muscle mass in the acute phase. This prospective study included 179 patients who were admitted to the stroke rehabilitation unit. Read More

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http://dx.doi.org/10.3390/nu12071923DOI Listing

Periprocedural Outcomes of Fluoroscopy-Guided Patent Foramen Ovale Closure With Selective Use of Intracardiac Echocardiography.

Can J Cardiol 2020 Jan 13. Epub 2020 Jan 13.

Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada. Electronic address:

Background: Recent randomized trials have confirmed the role of patent foramen ovale (PFO) closure in the secondary prevention of cryptogenic stroke. Guidelines have suggested a central role for intraprocedural imaging using intracardiac echocardiography (ICE). However, this modality may not be required to achieve safe and effective closure. Read More

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http://dx.doi.org/10.1016/j.cjca.2019.12.032DOI Listing
January 2020

Volume-Outcome Association of Mitral Valve Surgery in the United States.

JAMA Cardiol 2020 Jul 1. Epub 2020 Jul 1.

Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston.

Importance: Early surgery for severe primary degenerative mitral regurgitation is recommended, provided optimal outcomes are achievable. Contemporary national data defining mitral valve surgery volume and outcomes are lacking.

Objective: To assess national 30-day and 1-year outcomes of mitral valve surgery and define the hospital- and surgeon-level volume-outcome association with mitral valve repair or replacement (MVRR) in patients with primary mitral regurgitation. Read More

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http://dx.doi.org/10.1001/jamacardio.2020.2221DOI Listing

Can Clinical and Functional Outcomes Be Improved with an Intelligent "Internet Plus"-Based Full Disease Cycle Remote Ischemic Conditioning Program in Acute ST-elevation Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention? Rationale and Design of the i-RIC Trial.

Cardiovasc Drugs Ther 2020 Jun 30. Epub 2020 Jun 30.

Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, No.300 Guangzhou Road, Nanjing, 210029, China.

Background: Acute ST-elevation myocardial infarction (STEMI) is associated with a high incidence of complications as well as a considerable hospitalization rate and economic burden. Preliminary evidence suggests that remote ischemic conditioning (RIC) is a promising non-invasive intervention that may effectively and safely reduce myocardial infarct size, subsequent cardiac events and complications, and mortality. However, RIC's cardio-protective effect remains under debate, especially for single timepoint RIC programs. Read More

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http://dx.doi.org/10.1007/s10557-020-07022-9DOI Listing

Developing Patients' Experiences Database After Hospital Discharge: Another Step in Improving Stroke Care.

Stud Health Technol Inform 2020 Jun;272:441-444

Center for Health Services Management and Evaluation, Nursing Department, National and Kapodistrian University of Athens, Athens Greece.

The aim of this study was to assess stroke patients' experiences in regards to hospital stay and during discharge. A cross-sectional study with retrospective data collection was conducted including patients (n=135) with first-ever acute stroke, who were admitted in seven Public Hospitals in Greece ("Stroke Units Necessity for Patients, SUN4P" registry). The translated version of the NHS-Stroke Questionnaire in the Greek was used. Read More

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http://dx.doi.org/10.3233/SHTI200590DOI Listing

Access of Stroke Patients' to Optimal Healthcare Technology in Greece: Messages to Policy Makers.

Stud Health Technol Inform 2020 Jun;272:421-424

Hellenic Stroke Organization, Greece.

The aim of this study was to evaluate accessibility of stroke patients to optimal healthcare technology in Greece. Methods: The study population consisted of 313 first ever stroke patients derived from the "Stroke Units Necessity for Patients, SUN4P" registry. Descriptive statistics were used, to present patients' characteristics and resources utilization Results: The vast majority of patients (91. Read More

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http://dx.doi.org/10.3233/SHTI200585DOI Listing

Sun4Patients Web Platform: Facilitating Long-Term Monitoring of Stroke Patients.

Stud Health Technol Inform 2020 Jun;272:411-412

Center for Health Services Management and Evaluation, Nursing Department, National and Kapodistrian University of Athens, Athens Greece.

SUN4Patients is an observational study for the monitoring of patients with first ever acute stroke. For the support of this study, an online platform has been developed which facilitates the collection of various information related to hospital discharge, health services utilization and loss of productivity of the patients. This paper presents the main characteristics of the platform and the methodology followed for its design and implementation. Read More

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http://dx.doi.org/10.3233/SHTI200582DOI Listing

Decompression illness type II with stroke: challenging situation in acute neurorehabilitation.

Int Marit Health 2020 ;71(2):105-108

Department of Neurorehabilitation, Leicester General Hospital, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.

A professional 55-year-old female experienced diver, who surfaced after the second dive, had a lucid interval before dropping Glasgow Coma Scale (GCS) to 3/15. She was admitted to intensive care unit and commenced on hyperbaric oxygen therapy. Her initial computed tomography of the head was normal but her magnetic resonance imaging of the brain at 48 hours showed extensive bilateral cortical watershed territory infarcts. Read More

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http://dx.doi.org/10.5603/IMH.2020.0019DOI Listing
January 2020

Trans-cranial Doppler predicts early neurologic deterioration in anterior circulation ischemic stroke after successful endovascular treatment.

Chin Med J (Engl) 2020 Jun 26. Epub 2020 Jun 26.

Department of Neurology, Liangxiang Hospital of Beijing Fangshan District, Beijing 102246, China.

Background: Early neurologic deterioration (END) may occur in patients with anterior circulation ischemic stroke (ACIS) after receiving endovascular treatment (EVT). Hemodynamic insufficiency, re-occlusion, and post-re-canalization hyper-perfusion are likely to play a critical role in END. We hypothesized that hemodynamic changes can predict END in patients with ACIS post-successful EVT using trans-cranial Doppler (TCD). Read More

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http://dx.doi.org/10.1097/CM9.0000000000000881DOI Listing

Prognostic value of chemokines in patients with newly diagnosed atrial fibrillation.

Int J Cardiol 2020 Jun 27. Epub 2020 Jun 27.

Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing 400038, People's Republic of China; Evidence-based Medicine and Clinical Epidemiology Center, Army Medical University (Third Military Medical University), Chongqing 400038, People's Republic of China. Electronic address:

Background: Chemokines play an important role in inflammation and atherosclerosis. However, little is known about the relationship between chemokines and the prognosis of atrial fibrillation (AF). This "real-world" cohort study was designed to observe the prognostic value of plasma CC motif chemokine ligand (CCL) 18, CCL23, CCL28, CXC motif chemokine ligand (CXCL) 14, CXCL16 in newly diagnosed AF patients. Read More

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http://dx.doi.org/10.1016/j.ijcard.2020.06.030DOI Listing

Neurological and Medical Complications in Brain Tumor Patients.

Curr Neurol Neurosci Rep 2020 Jun 29;20(8):33. Epub 2020 Jun 29.

Department of Neurology, University of Virginia, P.O. Box 800432, Charlottesville, VA, 22908, USA.

Purpose Of Review: Patients with brain tumors are susceptible to multiple complications that can affect their survival or quality of life. The scope of these complications is widening due to prolonged overall survival and improved therapies. In this review, we discuss the most common complications in this patient population focusing on the recent literature. Read More

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http://dx.doi.org/10.1007/s11910-020-01054-2DOI Listing

Heyde's Syndrome Complicating Management in a Patient With High Bleeding and Thrombotic Risks.

Cureus 2020 May 25;12(5):e8280. Epub 2020 May 25.

Internal Medicine/Cardiovascular Medicine/Interventional Cardiology, University of Maryland School of Medicine, Baltimore, USA.

The association of severe aortic stenosis and gastrointestinal (GI) bleeding is a well-known phenomenon. The pathogenesis involves an acquired deficiency of von Willebrand factor (vWF) due to shear stress resulting in alteration of vWF morphology. This results in in-appropriate cleavage of vWF multimers into smaller dysfunctional fragments. Read More

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http://dx.doi.org/10.7759/cureus.8280DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317131PMC

Improvement of long-term risks of cardiovascular events associated with community-based disease management in Chinese patients of the Xinjiang autonomous region of China.

BMC Public Health 2020 Jun 29;20(1):1034. Epub 2020 Jun 29.

Novartis Pharma AG, Fabrikstrasse 12-1.03.14A, 4056, Basel, Switzerland.

Background: A recent community-based disease management (CBDM) pilot study reported a 20.5% prevalence of hypertension and a 0.5 and 3. Read More

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http://dx.doi.org/10.1186/s12889-020-09157-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325287PMC

Indirect measurement of anterior-posterior ground reaction forces using a minimal set of wearable inertial sensors: from healthy to hemiparetic walking.

J Neuroeng Rehabil 2020 Jun 29;17(1):82. Epub 2020 Jun 29.

College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts, USA.

Background: The anterior-posterior ground reaction force (AP-GRF) and propulsion and braking point metrics derived from the AP-GRF time series are indicators of locomotor function across healthy and neurological diagnostic groups. In this paper, we describe the use of a minimal set of wearable inertial measurement units (IMUs) to indirectly measure the AP-GRFs generated during healthy and hemiparetic walking.

Methods: Ten healthy individuals and five individuals with chronic post-stroke hemiparesis completed a 6-minute walk test over a walking track instrumented with six forceplates while wearing three IMUs securely attached to the pelvis, thigh, and shank. Read More

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http://dx.doi.org/10.1186/s12984-020-00700-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7322880PMC

Management of Aortic Pseudoaneurysms: Evolving Concepts and Controversies.

Aorta (Stamford) 2020 Feb 29;8(1):1-5. Epub 2020 Jun 29.

Department of Cardiothoracic Surgery, John Fitzgerald Kennedy Medical Center, Atlantis, Florida.

Background:  Techniques to repair aortic pseudoaneurysms have been rapidly evolving. We present our results following open and endovascular repair of aortic pseudoaneurysms from 2009 to 2013.

Methods:  A total of nine patients underwent pseudoaneurysm repair from April 2009 to February 2013. Read More

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http://dx.doi.org/10.1055/s-0039-1700999DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7324250PMC
February 2020

Carotid blowout management in the endovascular era.

World Neurosurg 2020 Jun 26. Epub 2020 Jun 26.

Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania USA. Electronic address:

Background: Carotid blowout syndrome (CBS) is a potential complication of head and neck cancer (HNC) and its therapy associated with high morbidity and mortality. Recent advances in endovascular techniques have improved patient outcomes. In this study, we report outcomes of emergent endovascular intervention for CBS. Read More

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http://dx.doi.org/10.1016/j.wneu.2020.06.151DOI Listing

[Therapeutic aspects of the choice of antithrombotic therapy in patients with multifocal lesions of peripheral arteries].

Ter Arkh 2019 Sep 15;91(9):158-164. Epub 2019 Sep 15.

Lomonosov Moscow State University.

The article discusses the features of the development and course of the atherosclerotic process in various vascular basins. Variability of factors such as local hemodynamics, differences in the structure of the arteries can influence the formation of atherosclerotic plaque and the progression of the atherosclerotic process. A better understanding of the nature and causes of these differences can help improve the tactics of treatment and prevention of vascular complications. Read More

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http://dx.doi.org/10.26442/00403660.2019.09.000407DOI Listing
September 2019

Evaluating Postoperative Outcomes of Patients Undergoing Elective Procedures in an Ambulatory Surgery Center During the COVID-19 Pandemic.

Aesthet Surg J 2020 Jun 29. Epub 2020 Jun 29.

Plastic Surgery and the Director of the Aesthetic Surgery Fellowship, Department of Plastic Surgery, UT Southwestern Medical Center, Dallas, TX.

Background: Despite the rapid rise of publications pertaining to COVID-19, there is a lack of data examining patient outcomes following elective procedures performed during this pandemic.

Objectives: The purpose of this investigation is to: 1) examine the postoperative outcomes of patients that underwent elective procedures in an ambulatory surgery center during the COVID-19 pandemic; 2) share the preoperative screening and patient selection protocol implemented in our center.

Methods: Elective procedures performed in an ambulatory surgery center between March 1, 2020 and April 16, 2020 were retrospectively reviewed. Read More

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http://dx.doi.org/10.1093/asj/sjaa180DOI Listing

The Economic Burden of End-Organ Damage Among Medicaid Patients with Sickle Cell Disease in the United States: A Population-Based Longitudinal Claims Study.

J Manag Care Spec Pharm 2020 Jun 29:1-9. Epub 2020 Jun 29.

Johns Hopkins University, Baltimore, Maryland.

Background: The management of sickle cell disease (SCD), an inherited, chronic, and multifaceted condition, is associated with considerable health care resource utilization (HRU) and costs, especially for Medicaid. Anemia affects most patients with SCD and correlates with end-organ damage (EOD), such as stroke, chronic kidney disease (CKD), end-stage renal disease (ESRD), and pulmonary hypertension (PH). Limited research has been conducted to quantify the economic burden of EOD among patients with SCD. Read More

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http://dx.doi.org/10.18553/jmcp.2020.20009DOI Listing

Diagnosis and Management of 1:1 Atrial Flutter in the Setting of Aortic Valve Endocarditis and Embolic Stroke.

Cureus 2020 Jun 21;12(6):e8739. Epub 2020 Jun 21.

Cardiovascular Medicine, Richmond University Medical Center, Staten Island, USA.

Atrial flutter is a rapid, regular atrial tachyarrhythmia that occurs most commonly in patients with underlying structural heart disease. Spontaneous 1:1 conduction of atrial flutter is indeed rare, but its diagnosis and management is of critical importance. We describe a case of a 65-year-old man with hypertension, preserved ejection fraction heart failure, end-stage renal disease, Parkinson's disease, and Alzheimer's dementia, in whom atrial flutter was associated with 1:1 atrioventricular conduction. Read More

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http://dx.doi.org/10.7759/cureus.8739DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308918PMC

Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of stroke rehabilitation.

Stroke Vasc Neurol 2020 Jun 28. Epub 2020 Jun 28.

Department of Neurorehabilitation, China Rehabilitation Research Center, Beijing, China.

Stroke is the third leading cause of long-term disability. Effective stroke rehabilitation should be provided to patients with a moderate or severe stroke so as to achieve functional recovery. Also, stroke rehabilitation is moving towards more intense therapy models that incorporate technologies such as robotics and computer games. Read More

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http://dx.doi.org/10.1136/svn-2019-000321DOI Listing

Extracellular Vesicles for Treatment of Solid Organ Ischemia-Reperfusion Injury.

Am J Transplant 2020 Jun 28. Epub 2020 Jun 28.

Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, FL, 32224, USA.

As the incidence of ischemia reperfusion (I-R) injury has substantially increased, there is a pressing need to develop effective strategies to treat this global health issue. I-R injury can affect all organs and is associated with high morbidity and mortality rates. Pathological settings such as myocardial infarction, stroke, hemorrhagic shock, and solid organ transplantation are particularly prone to cause I-R injury. Read More

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http://dx.doi.org/10.1111/ajt.16164DOI Listing

Large artery ischemic stroke in severe COVID-19.

J Neurol 2020 Jun 27. Epub 2020 Jun 27.

Department of Neurology, Hospital Universitario Infanta Leonor, Avenida Gran Vía del Este 80, 28031, Madrid, Spain.

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http://dx.doi.org/10.1007/s00415-020-09967-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320647PMC

The Promotoer, a brain-computer interface-assisted intervention to promote upper limb functional motor recovery after stroke: a study protocol for a randomized controlled trial to test early and long-term efficacy and to identify determinants of response.

BMC Neurol 2020 Jun 27;20(1):254. Epub 2020 Jun 27.

Fondazione Santa Lucia, IRCCS, Rome, Italy.

Background: Stroke is a leading cause of long-term disability. Cost-effective post-stroke rehabilitation programs for upper limb are critically needed. Brain-Computer Interfaces (BCIs) which enable the modulation of Electroencephalography (EEG) sensorimotor rhythms are promising tools to promote post-stroke recovery of upper limb motor function. Read More

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http://dx.doi.org/10.1186/s12883-020-01826-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320550PMC

Does citalopram effectively treat post-stroke depression?: A protocol for systematic review and meta analysis.

Medicine (Baltimore) 2020 Jun;99(26):e20608

Department of Neurology, Yan'an People's Hospital, Yan'an, China.

Background: This study aims to assess the efficacy and safety of citalopram for the treatment of patients with post-stroke depression (PSD).

Methods: We will comprehensively search Cochrane Library, PUBEMD, EMBASE, WorldSciNet, Web of Science, VIP Database, CBM database, and China National Knowledge Infrastructure. The search period is limited from the construction of each database to the February 1, 2020. Read More

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http://dx.doi.org/10.1097/MD.0000000000020608DOI Listing

Association Between Hospital Accreditation and Outcomes: The Analysis of Inhospital Mortality From the National Claims Data of the Universal Coverage Scheme in Thailand.

Qual Manag Health Care 2020 Jul/Sep;29(3):150-157

Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand (Dr Sriratanaban); King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand (Dr Ngamkiatpaisarn); and Sunpasitthiprasong Hospital, Office of the Permanent Secretary, Ministry of Public Health, Ubon Ratchathani, Thailand (Dr Charoenmukayananta).

Background: In Thailand, hospital accreditation (HA) is widely recognized as one of the system tools to promote effective operation of universal health coverage. This nationwide study aims to examine the relationship between accredited statuses of the provincial hospitals and their mortality outcomes.

Method: A 5-year retrospective analysis of the Universal Coverage Scheme's claim dataset was conducted, using 1 297 869 inpatient discharges from 76 provincial hospital networks under the Ministry of Public Health. Read More

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http://dx.doi.org/10.1097/QMH.0000000000000256DOI Listing

Precision Medicine in Acute Brain Injury: A Narrative Review.

J Neurosurg Anesthesiol 2020 Jun 23. Epub 2020 Jun 23.

Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences (A.I.I.M.S.), New Delhi, India.

Over the past few years, the concept of personalized medicine has percolated into the management of different neurological conditions. Improving outcomes after acute brain injury (ABI) continues to be a major challenge. Unrecognized individual multiomic variations in addition to multiple interacting processes may explain why we fail to observe comprehensive improvements in ABI outcomes even when applied treatments appear to be beneficial logically. Read More

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http://dx.doi.org/10.1097/ANA.0000000000000710DOI Listing

Letter to editor regarding "Acute Stroke Management During the Coronavirus Disease 2019 (COVID-19) Pandemic: From Trough of Disillusionment to Slope of Enlightenment".

World Neurosurg 2020 Jun 23. Epub 2020 Jun 23.

Department of Internal Medicine, Saint Vincent Hospital, and, University of Massachusetts Medical School, Worcester, Massachusetts, USA, 01608. Electronic address:

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http://dx.doi.org/10.1016/j.wneu.2020.06.111DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311329PMC
June 2020
2.417 Impact Factor

Body surface area calculation for dogs and cats using LiDCO and PICCO monitors.

J Vet Emerg Crit Care (San Antonio) 2020 Jun 26. Epub 2020 Jun 26.

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.

Background: Cardiac output, stroke volume, and measurement of other hemodynamic parameters can be useful in the management of critical patients. Given the broad size disparity of veterinary patients, the raw values can vary widely. Their indexed values, however, allow for quick assessment of hemodynamic status and a more standardized target setting by the veterinary care team. Read More

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http://dx.doi.org/10.1111/vec.12981DOI Listing