43,087 results match your criteria Acute Stroke Management


Integrated MicroRNA and mRNA Profiling in Zika Virus-Infected Neurons.

Viruses 2019 Feb 16;11(2). Epub 2019 Feb 16.

Department of Biology, College of Arts and Sciences, Georgia State University, Atlanta, GA 30303, USA.

Zika virus (ZIKV) infections have caused a wide spectrum of neurological diseases, such as Guillain-Barré syndrome, myelitis, meningoencephalitis, and congenital microcephaly. No effective therapies currently exist for treating patients infected with ZIKV. MicroRNAs (miRNAs) are a group of small RNAs involved in the regulation of a wide variety of cellular and physiological processes. Read More

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http://dx.doi.org/10.3390/v11020162DOI Listing
February 2019

Readmissions following hospitalisations for cardiovascular disease: a scoping review of the Australian literature.

Aust Health Rev 2019 Feb 20. Epub 2019 Feb 20.

International studies suggest high rates of readmissions after cardiovascular hospitalisations, but the burden in Australia is uncertain. We summarised the characteristics, frequency, risk factors of readmissions and interventions to reduce readmissions following cardiovascular hospitalisation in Australia.A scoping review of the published literature from 2000-2016 was performed using Medline, EMBASE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases and relevant grey literature. Read More

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http://dx.doi.org/10.1071/AH18028DOI Listing
February 2019

The Unsolved Conundrum of Optimal Blood Pressure Target During Acute Haemorrhagic Stroke: A Comprehensive Analysis.

High Blood Press Cardiovasc Prev 2019 Feb 18. Epub 2019 Feb 18.

Unit of Nephrology and Hypertension, Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza (PROMISE), European Society of Hypertension Excellence Centre, Piazza delle Cliniche, 2, 90146, Palermo, Italy.

Intracerebral haemorrhage (ICH) is a devastating cerebrovascular disease, which accounts to 15% of all strokes. Among modifiable risk factors for ICH, hypertension is the most frequent. High blood pressure (BP) is detected in more than 75-80% of patients with ICH. Read More

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http://dx.doi.org/10.1007/s40292-019-00305-9DOI Listing
February 2019

Estimating Quality of Life Decrements Due to Diabetes Complications in the United States: The Health Utility Index (HUI) Diabetes Complication Equation.

Pharmacoeconomics 2019 Feb 19. Epub 2019 Feb 19.

Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 1900, New Orleans, LA, 70112, USA.

Objective: Health utility decrements associated with diabetes mellitus complications are essential for calculating quality-adjusted life-years (QALYs) in patients for use in economic evaluation of diabetes interventions. Previous studies mostly focused on assessing the impact of complications on health utility at event year based on cross-sectional data. This study aimed to separately estimate health utility decrements associated with current and previous diabetes complications. Read More

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http://dx.doi.org/10.1007/s40273-019-00775-8DOI Listing
February 2019

Optimizing Patient Discharge Management after Transfemoral Transcatheter Aortic Valve Implantation: The Multicentre European FAST-TAVI Trial.

EuroIntervention 2019 Feb 19. Epub 2019 Feb 19.

Cardiology Department, Policlinico-Vittorio Emanuele Hospital, University of Catania, Italy.

Aims: Treatment pathway optimization in TAVI should include timely patient discharge with a minimized risk for out-of-hospital adverse events.

Methods And Results: We defined and validated the adequacy of a set of discharge criteria and their ability to properly predict timely and safe discharge after the intervention in a prospective, European, multicentre registry. 502 unselected patients were enrolled at 10 sites in 3 countries. Read More

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http://dx.doi.org/10.4244/EIJ-D-18-01197DOI Listing
February 2019

Economics of Community Health Workers for Chronic Disease: Findings From Community Guide Systematic Reviews.

Am J Prev Med 2019 Mar;56(3):e95-e106

Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; IBM Watson Health, Bethesda, Maryland.

Context: Cardiovascular disease in the U.S. accounted for healthcare cost and productivity losses of $330 billion in 2013-2014 and diabetes accounted for $327 billion in 2017. Read More

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http://dx.doi.org/10.1016/j.amepre.2018.10.009DOI Listing

Effect of Workflow Improvements in Endovascular Stroke Treatment.

Stroke 2019 Feb 19:STROKEAHA118021633. Epub 2019 Feb 19.

From the Department of Neurology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands. (P.M.J., E.V., D.W.J.D.).

Background and Purpose- Rapid initiation of endovascular stroke treatment is associated with better clinical outcome. The effect of specific improvements is not well known. We performed a systematic review and meta-analysis on the effectiveness of specific workflow improvements on time to treatment and outcome. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.021633DOI Listing
February 2019

Sensitization in Heart Transplantation: Emerging Knowledge: A Scientific Statement From the American Heart Association.

Circulation 2019 Feb 19:CIR0000000000000598. Epub 2019 Feb 19.

Sensitization, defined as the presence of circulating antibodies, presents challenges for heart transplant recipients and physicians. When present, sensitization can limit a transplantation candidate's access to organs, prolong wait time, and, in some cases, exclude the candidate from heart transplantation altogether. The management of sensitization is not yet standardized, and current therapies have not yielded consistent results. Read More

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http://dx.doi.org/10.1161/CIR.0000000000000598DOI Listing
February 2019

Spastic dystonia in stroke subjects: prevalence and features of the neglected phenomenon of the upper motor neuron syndrome.

Clin Neurophysiol 2019 Feb 6;130(4):521-527. Epub 2019 Feb 6.

Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Italy; Department of Neuroscience, IRCCS Ospedale Policlinico San Martino, Genova, Italy. Electronic address:

Objective: Spastic dystonia is one of the positive phenomena of the upper motor neuron syndrome (UMNS). It is characterised by the inability to relax a muscle leading to a spontaneous, although stretch-sensitive, tonic contraction. Although spastic dystonia is a recognized cause of muscle hypertonia, its prevalence among hypertonic muscles of stroke subjects has never been investigated. Read More

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http://dx.doi.org/10.1016/j.clinph.2019.01.012DOI Listing
February 2019

Traumatic brain injuries in New Zealand: National Insurance (Accident Compensation Corporation) claims from 2012 to 2016.

J Neurol Sci 2019 Feb 12;399:61-68. Epub 2019 Feb 12.

Australian College of Physical Education, Department of Sport Performance, Sydney Olympic Park NSW, Australia.

Aim: To provide epidemiological data and related costs to the national health insurance scheme for traumatic brain injury (TBI) in New Zealand.

Method: A retrospective analytical review utilising detailed descriptive minor and moderate-to-severe epidemiological TBI data obtained from the Accident Compensation Corporation (ACC) for 2012-2016. Injuries were analysed by three levels of increasing severity: moderate, moderate-to-serious (MSC) and severe claims categories. Read More

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http://dx.doi.org/10.1016/j.jns.2019.01.049DOI Listing
February 2019

Early Identification of Central Retinal Artery Occlusion Using Point-of-care Ultrasound.

Clin Pract Cases Emerg Med 2019 Feb 4;3(1):13-15. Epub 2019 Jan 4.

University of Washington School of Medicine, Department of Emergency Medicine, Seattle, Washington.

A 69-year-old woman with a history of untreated hypertension presented with acute-onset monocular vision loss. Initial workup was delayed due to lack of immediate specialty consultation and dilated funduscopic exam. Point-of-care ultrasound in the emergency department identified a small hyperechoic structure within the distal area of the central retinal artery; in conjunction with specialty ophthalmologic evaluation in a tertiary care center, the diagnosis of central retinal artery occlusion was made. Read More

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http://dx.doi.org/10.5811/cpcem.2018.11.39406DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366367PMC
February 2019

Cognitive Decline in Older Patients With Non- ST Elevation Acute Coronary Syndrome.

J Am Heart Assoc 2019 Feb;8(4):e011218

1 Institute of Cellular Medicine Newcastle University Newcastle upon Tyne United Kingdom.

Background Dementia is a growing health burden of an aging population. This study aims to evaluate the prevalence of cognitive impairment and the predictors of cognitive decline at 1 year in older patients with non-ST-elevation acute coronary syndrome undergoing invasive care. Methods and Results Older patients with non-ST-elevation acute coronary syndrome were recruited into the ICON1 study. Read More

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http://dx.doi.org/10.1161/JAHA.118.011218DOI Listing
February 2019

NT-pro-BNP correlates with disease severity and predicts outcome in cerebral haemorrhage patients: Cohort study.

J Neurol Sci 2019 Feb 8;399:51-56. Epub 2019 Feb 8.

Internal Medicine Department, São João Hospital Centre, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Stroke Unit, São João Hospital Centre, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal.

Background: Intracerebral haemorrhage (ICH) is a devastating condition, with more than half of patients dying or becoming dependent after such an event. Natriuretic peptides, frequently used in the management of heart failure, have been shown to correlate with disease severity and prognosis in brain disorders. The aim of this study was to test the hypothesis that NT-pro-BNP correlates with disease severity and is an independent prognostic marker for non-traumatic ICH patients. Read More

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http://dx.doi.org/10.1016/j.jns.2019.02.014DOI Listing
February 2019

Widening Time Disparities between Two Paradigms: Tama-REgistry of Acute Endovascular Thrombectomy.

J Stroke Cerebrovasc Dis 2019 Feb 13. Epub 2019 Feb 13.

Department of Stroke and Cerebrovascular Medicine, Kyorin University, Tokyo, Japan. Electronic address:

Background: The Tama-REgistry of Acute endovascular Thrombectomy (TREAT) is a multicenter registry of endovascular thrombectomy in the Tama area of Tokyo. The objective of this study was to confirm the real-world status of 2 paradigms of transportation.

Methods: This was a retrospective analysis of data from TREAT. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.01.021DOI Listing
February 2019

Efficacy of Direct Revascularization Surgery for Hemorrhagic Moyamoya Syndrome As a Late Complication of Cranial Irradiation for Childhood Craniopharyngioma.

J Stroke Cerebrovasc Dis 2019 Feb 13. Epub 2019 Feb 13.

Department of Neurosurgery, Tohoku University, Sendai, Japan.

Moyamoya syndrome (MMS) is an uncommon late complication after cranial irradiation. Its hemorrhagic presentation from the associated pseudo-aneurysm is extremely rare, and the optimal management strategy is undetermined. We herein report a 36-year-old man who developed intraventricular hemorrhage from a pseudo-aneurysm at the extended left anterior choroidal artery as an abnormal collateral of MMS 30 years after surgical removal and cranial irradiation for childhood craniopharyngioma. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.01.033DOI Listing
February 2019

Direct Aspiration versus Stent Retriever Thrombectomy for Acute Stroke: A Systematic Review and Meta-Analysis in 9127 Patients.

J Stroke Cerebrovasc Dis 2019 Feb 13. Epub 2019 Feb 13.

Department of Neurosurgery, University of South Florida, Tampa, Florida. Electronic address:

Background: The two most common approaches to thrombectomy of emergent large vessel occlusion (direct aspiration and primary stent retriever thrombectomy) have been extensively studied; however, the detailed benefit and risk comparison is largely unknown.

Objective: To conduct a systematic review and meta-analysis to compare radiographic and clinical outcomes between the use of primary stent retrievers and direct aspiration in management of acute ischemic stroke.

Methods: PubMed database was searched for studies between September 1, 2012 and December 31, 2017 with acute ischemic stroke patients. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.01.034DOI Listing
February 2019

Self-Reported Body Weight Changes, Perceptions, and Weight Loss Techniques among Stroke Survivors.

J Stroke Cerebrovasc Dis 2019 Feb 13. Epub 2019 Feb 13.

VARRD Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Atlanta, Georgia; Emory University, School of Medicine, Atlanta, Georgia. Electronic address:

Background: Little is known about the body weight goals and trends of stroke survivors, despite evidence that overweight and obesity can negatively influence poststroke rehabilitation outcomes. Thus, the purpose of this study was to identify self-reported body weight trends over time in stroke survivors and nonstroke controls (>50 years old) and describe the methods used to attempt to achieve body weight goals.

Methods: Self-reported body weight 1) at age 25 years, 2) 10 years prior to the current assessment, 3) 1 year prior to the current assessment, 4) current weight, and 5) age of heaviest body weight were collected from adults self-reporting a stroke in the 2011-2012 and 2013-2014 National Health and Nutrition Examination Surveys (stroke: N = 387 and nonstroke: N = 5085). Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.01.028DOI Listing
February 2019
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Stroke occurrence while on antiplatelet therapy may predict atrial fibrillation detected after stroke.

Atherosclerosis 2019 Jan 24;283:13-18. Epub 2019 Jan 24.

Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi City, Taiwan; Department of Information Management and Institute of Healthcare Information Management, National Chung Cheng University, Chiayi County, Taiwan. Electronic address:

Background And Aims: Stroke occurrence while on antiplatelet therapy, i.e., a breakthrough stroke, is often conveniently attributed to antiplatelet resistance. Read More

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http://dx.doi.org/10.1016/j.atherosclerosis.2019.01.007DOI Listing
January 2019

Frailty score for elderly patients is associated with short-term clinical outcomes in patients with ST-segment elevated myocardial infarction treated with primary percutaneous coronary intervention.

Neth Heart J 2019 Feb 15. Epub 2019 Feb 15.

Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands.

Objective: Consistent with the aging population in the Western world, there is a growing number of elderly patients with ST-segment elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI) is the recommended reperfusion strategy in elderly patients; risk models to determine which of these patients are prone to have poor clinical outcomes are, however, essential. The purpose of this study was to assess the association between frailty and short-term mortality and PCI-related serious adverse events (SAE) in elderly patients. Read More

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http://dx.doi.org/10.1007/s12471-019-1240-7DOI Listing
February 2019

[Comments on the guidelines (2018) of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) on the management of arterial hypertension].

Internist (Berl) 2019 Feb 15. Epub 2019 Feb 15.

Institut für Klinische Pharmakologie und Toxikologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, und Berlin Institute of Health, Charitéplatz 1, Berlin, 10117, Deutschland.

Arterial hypertension represents one of the most frequent chronic diseases that can lead to complications, such as stroke, dementia, heart attack, heart failure and renal failure. By 2025 the number of hypertensive patients will increase to approximately 1.6 billion people worldwide. Read More

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http://dx.doi.org/10.1007/s00108-019-0576-9DOI Listing
February 2019

Artificial intelligence in neuropathology: deep learning-based assessment of tauopathy.

Lab Invest 2019 Feb 15. Epub 2019 Feb 15.

Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.

Accumulation of abnormal tau in neurofibrillary tangles (NFT) occurs in Alzheimer disease (AD) and a spectrum of tauopathies. These tauopathies have diverse and overlapping morphological phenotypes that obscure classification and quantitative assessments. Recently, powerful machine learning-based approaches have emerged, allowing the recognition and quantification of pathological changes from digital images. Read More

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http://dx.doi.org/10.1038/s41374-019-0202-4DOI Listing
February 2019

Land of confusion: anaesthetic management during thrombectomy for acute ischaemic stroke.

Br J Anaesth 2019 Mar 17;122(3):300-304. Epub 2019 Jan 17.

Department of Anaesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

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http://dx.doi.org/10.1016/j.bja.2018.12.004DOI Listing

Cardiovascular Protection with Anti-hyperglycemic Agents.

Am J Cardiovasc Drugs 2019 Feb 15. Epub 2019 Feb 15.

Division of Cardiology, Department of Medicine, Sarver Heart Center, University of Arizona College of Medicine, Tucson, AZ, 85724-5037, USA.

Diabetes mellitus is a major risk factor for cardiovascular (CV) disease. Conversely, CV disease is responsible for a majority of the deaths in patients with diabetes. Many drug trials have concentrated on blood glucose (hemoglobin A) reduction. Read More

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http://dx.doi.org/10.1007/s40256-019-00325-9DOI Listing
February 2019

Identifying treatment related problems and associated factors among hospitalized post-stroke patients through medication management review: A multi-center study.

Saudi Pharm J 2019 Feb 19;27(2):208-219. Epub 2018 Oct 19.

School of Nursing, University of Jordan, Jordan.

Background: Stroke is a major cause of disability and one of the leading causes of death among the elderly. Treatment related problems can lead to undesirable consequences. The Medication Management Review (MMR) service is aimed at identifying, resolving and preventing TRPs, subsiding the undesirable outcomes associated with TRPs. Read More

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http://dx.doi.org/10.1016/j.jsps.2018.10.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6362176PMC
February 2019

The association of metabolic syndrome components and diabetes mellitus: evidence from China National Stroke Screening and Prevention Project.

BMC Public Health 2019 Feb 14;19(1):192. Epub 2019 Feb 14.

Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, China.

Background: The metabolic syndrome (MetS) is related with cardiovascular disease. However, its relationship with diabetes mellitus (DM) has not been examined in Chinese population with a larger sample. We aimed to assess the relationship between metabolic syndrome (MetS) and its components, and DM, and to determine the best one from the available definitions of Mets when assessing the risk of DM. Read More

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http://dx.doi.org/10.1186/s12889-019-6415-zDOI Listing
February 2019

Impact of Baseline Features and Risk Factor Control on Cognitive Function in the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Trial.

Cerebrovasc Dis 2019 Feb 14;47(1-2):24-31. Epub 2019 Feb 14.

Medical University of South Carolina, Charleston, South Carolina, USA.

Background: Cerebrovascular disease is an important cause of cognitive impairment. The aim of this study is to report the relationship between cognitive function and risk factors at baseline and during follow-up in the Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis (SAMMPRIS) trial.

Methods: Subjects in the SAMMPRIS trial were included in this study. Read More

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http://dx.doi.org/10.1159/000497245DOI Listing
February 2019

Lifetime Risk of Stroke and Coronary Heart Disease Deaths According to Blood Pressure Level: EPOCH-JAPAN (Evidence for Cardiovascular Prevention From Observational Cohorts in Japan)

Hypertension 2019 Jan 19;73(1):52-59. Epub 2018 Nov 19.

Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo

Lifetime risk (LTR) provides an absolute risk assessment during the remainder of one’s life. Few studies have focused on the LTRs of stroke and coronary heart disease (CHD), categorized by fine blood pressure in Asian populations. We aimed to assess it using a large database of a meta-analysis with the individual participant data. Read More

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https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.118.
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http://dx.doi.org/10.1161/HYPERTENSIONAHA.118.11635DOI Listing
January 2019
4 Reads

Risk of subsequent health disorders among living kidney donors.

Medicine (Baltimore) 2019 Feb;98(7):e14494

Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University.

Few studies have investigated the risk of physiological sequelae in living kidney donors (KDs). We conducted a population-based cohort study using the National Health Insurance Research Database of Taiwan, which covers more than 99% of citizens.We comprehensively investigated the risk of medical disorders after kidney donation in living KDs using a maximum follow-up of 13 years. Read More

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http://Insights.ovid.com/crossref?an=00005792-201902150-0005
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http://dx.doi.org/10.1097/MD.0000000000014494DOI Listing
February 2019
1 Read

Delineation of Human Carotid Plaque Features In Vivo by Exploiting Displacement Variance.

IEEE Trans Ultrason Ferroelectr Freq Control 2019 Feb 11. Epub 2019 Feb 11.

While in vivo Acoustic Radiation Force Impulse (ARFI)-induced peak displacement (PD) has been demonstrated to have high sensitivity and specificity for differentiating soft from stiff plaque components in patients with carotid plaque, the parameter exhibits poorer performance for distinguishing between plaque features with similar stiffness. To improve discrimination of carotid plaque features relative to PD, we hypothesize that signal correlation and SNR can be combined, outright or via displacement variance. Plaque feature detection by displacement variance, evaluated as the decadic logarithm of the variance of acceleration and termed 'log(VoA)', was compared to that achieved by exploiting signal-to-noise ratio (SNR), cross-correlation coefficient (CC), and ARFI-induced peak displacement (PD) outcome metrics. Read More

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http://dx.doi.org/10.1109/TUFFC.2019.2898628DOI Listing
February 2019

Management of oral anticoagulation after intracerebral hemorrhage.

Int J Stroke 2019 Feb 14:1747493019828555. Epub 2019 Feb 14.

Department of Neurology, University Hospital Erlangen, Erlangen, Germany.

Background: The most recent years have significantly expanded knowledge regarding risks and benefits of resuming oral anticoagulation (OAC) after intracerebral hemorrhage (ICH). No randomized data is yet available, though several large observational studies and meta-analyses have investigated the impact of resuming OAC on thromboembolic versus hemorrhagic complications in these high-risk patients after ICH.

Aims: The present review will summarize the most important studies conducted over the last years and will focus on relevant factors help guiding on decision-making on whether to start OAC after ICH. Read More

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http://dx.doi.org/10.1177/1747493019828555DOI Listing
February 2019

Aspirin in childhood acute ischemic stroke: The evidence for treatment and efficacy testing.

Pediatr Blood Cancer 2019 Feb 14:e27665. Epub 2019 Feb 14.

Department of Pediatrics, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital, Cincinnati, Ohio.

Aspirin is the most commonly prescribed antiplatelet agent worldwide, but evidence supporting its use varies by age and disease process. Despite its frequent use in childhood acute ischemic stroke prevention and management, major knowledge gaps exist about optimal pediatric aspirin use, particularly in this setting, where high-quality clinical trials are urgently needed. This review focuses upon the evidence for aspirin use in childhood acute ischemic stroke, includes a summary of aspirin pharmacology to highlight misconceptions and common clinical situations which may limit its efficacy, and discusses the techniques and potential role of laboratory monitoring of aspirin efficacy in children. Read More

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http://dx.doi.org/10.1002/pbc.27665DOI Listing
February 2019

Incidence of post-stroke depression in Parakou in 2014.

Geriatr Psychol Neuropsychiatr Vieil 2019 Feb 12. Epub 2019 Feb 12.

Unité d'enseignement et de recherche de neurologie, FSS Université d'Abomey-Calavi, Bénin.

Depression is a frequent psychiatric complication after a stroke. In a Sub-Saharan Africa, the majority of the studies are about their prevalence, but the incidence of post-stroke depression was rarely estimated. We aimed to estimate this incidence in Parakou, Benin. Read More

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http://dx.doi.org/10.1684/pnv.2018.0777DOI Listing
February 2019

Absolute risk score for stroke, myocardial infarction, and all cardiovascular disease: Japan Arteriosclerosis Longitudinal Study.

Hypertens Res 2019 Feb 13. Epub 2019 Feb 13.

Department of Integrated Science and Engineering for Sustainable Society, Faculty of Science and Engineering, Chuo University, Tokyo, Japan.

To develop a risk chart or score that is based on recent data and applicable to the Japanese people, we need a large cohort study representative of the Japanese people without a need for long-term follow-up. The purpose of the present study was to develop a risk scoring system to estimate the 5- and 10-year absolute and cumulative incidence risk of stroke and acute myocardial infarction (AMI), composite outcome of stroke and AMI, and death from all cardiovascular disease (CVD). The cumulative incidence risk ratios were calculated using a multiple Poisson regression model and data from the Japan Arteriosclerosis Longitudinal Study, which included 67,969 men and women aged 40-89 years. Read More

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http://dx.doi.org/10.1038/s41440-019-0220-zDOI Listing
February 2019

Rural-Urban Differences in Stroke Risk Factors, Incidence, and Mortality in People With and Without Prior Stroke.

Circ Cardiovasc Qual Outcomes 2019 Feb;12(2):e004973

Division of General Internal Medicine, Department of Medicine (M.K.K., J.V.T.), University of Toronto, Toronto, Ontario, Canada.

Background Rural residence is associated with stroke incidence and mortality, but little is known about potential rural/urban differences in ambulatory stroke care. Methods and Results We used the CANHEART (Cardiovascular Health in Ambulatory Care Research Team) cohort, created from linked administrative databases from the province of Ontario, Canada, and divided into primary (N=6 207 032) and secondary (N=75 823) prevention cohorts based on the absence or presence of prior stroke. We defined rural communities as those with a population size of ≤10 000 and within each of the primary and secondary prevention cohorts, compared cardiovascular risk factors and care between rural and urban areas. Read More

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http://dx.doi.org/10.1161/CIRCOUTCOMES.118.004973DOI Listing
February 2019
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[Tremendous Increase of Home Care in Ventilated and Tracheostomized Patients - Reasons, Consequences, Solutions].

Authors:
Dieter Köhler

Dtsch Med Wochenschr 2019 Feb 13;144(4):282-285. Epub 2019 Feb 13.

Since 2005, invasive long-term ventilation in Germany has increased significantly from around 1000 to 20 000 patients in Germany. Due to complex home care, the health care system incurs additional costs of around 4 billion euros per year. In addition, in the last 2 - 3 years more tracheostomized patients have been discharged home without ventilation (usually after stroke), and they receive the same complex home care. Read More

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http://dx.doi.org/10.1055/a-0805-5284DOI Listing
February 2019

The VGVAPG Peptide Regulates the Production of Nitric Oxide Synthases and Reactive Oxygen Species in Mouse Astrocyte Cells In Vitro.

Neurochem Res 2019 Feb 13. Epub 2019 Feb 13.

Department of Clinical Biochemistry and Laboratory Diagnostics, Institute of Medicine, University of Opole, Oleska 48, 45-052, Opole, Poland.

The products of elastin degradation, namely elastin-derived peptides (EDPs), are detectable in the cerebrospinal fluid of healthy individuals and in patients after ischemic stroke, and their number increases with age. Depending on their concentrations, both nitric oxide (NO) and reactive oxygen species (ROS) take part either in myocardial ischemia reperfusion injury or in neurovascular protection after ischemic stroke. The aim of our study was to determine the impact of VGVAPG peptide on ROS and NO production and expression of endothelial nitric oxide synthase (eNos), inducible nitric oxide synthase (iNos) and neuronal nitric oxide synthase (nNos) in mouse cortical astrocytes in vitro. Read More

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http://dx.doi.org/10.1007/s11064-019-02746-zDOI Listing
February 2019

Rivaroxaban administration after acute ischemic stroke: The RELAXED study.

PLoS One 2019 13;14(2):e0212354. Epub 2019 Feb 13.

International University of Health and Welfare Director, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center, Tokyo, Japan.

The efficacy of early anticoagulation in acute stroke with nonvalvular atrial fibrillation (NVAF) remains unclear. We performed a study to evaluate the risk of recurrent ischemic stroke (IS) and major bleeding in acute IS patients with NVAF who started rivaroxaban. This observational study evaluated patients with NVAF and acute IS/transient ischemic attack (TIA) in the middle cerebral arterial territory who started rivaroxaban within 30 days after the index IS/TIA. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0212354PLOS
February 2019
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The weekend effect revisited: evidence from the Upper Austrian stroke registry.

Eur J Health Econ 2019 Feb 12. Epub 2019 Feb 12.

UMIT, University for Health Sciences, Medical Informatics and Technology, Institute for Management and Economics in Healthcare, Eduard-Wallnöfer-Zentrum 1, 6060 Hall in Tirol, Austria.

Empirical evidence on the so-called 'weekend-effect' on stroke mortality is mixed with some studies reporting significantly higher mortality for weekend admissions and others finding no difference. The aim of this paper is to enhance the evidence on the weekend-effect on stroke mortality using a rich stroke registry data set from Upper Austria and to discuss underlying reasons for the heterogeneity in results. Using logistic regressions and ordinary least squares regressions with hospital and year-fixed effects, the outcomes of weekend versus weekday admissions are compared for patients admitted to 16 hospitals in Upper Austria with transient ischemic attack (TIA), cerebral infarction or hemorrhage between 2007 and 2015. Read More

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http://dx.doi.org/10.1007/s10198-019-01035-4DOI Listing
February 2019

Cerebral Venous Air Embolism: A Rare Phenomenon.

Eur J Case Rep Intern Med 2019 23;6(1):001011. Epub 2019 Jan 23.

Internal Medicine Department, Hospital de Cascais, Cascais, Portugal.

Cerebral venous air embolism (CVAE) is an extremely rare phenomenon. Most reports of cerebral air embolism focus on the arterial territory, and consequently CVAE has remained poorly understood, especially regarding its pathophysiology and treatment. The authors describe an elderly male patient who was admitted through the Emergency Department with subacute confusion. Read More

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http://dx.doi.org/10.12890/2019_001011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372048PMC
January 2019
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Dabigatran Plasma Measurement to Guide the Management of Acute Bleeding and Thrombotic Complications.

Eur J Case Rep Intern Med 2018 27;5(9):000947. Epub 2018 Sep 27.

Haemostasis and Thrombosis Center, ASST Cremona, Cremona, Italy.

Oral anticoagulant therapy is recommended for the prevention and treatment of venous thromboembolism and to prevent stroke in non-valvular atrial fibrillation. Until a few years ago, vitamin K antagonists were the only drugs available, but direct oral anticoagulants have recently been introduced into clinical practice for the same clinical indications. Unlike the situation with VKAs, fixed-dose administration was proposed for DOACs, without the necessity for routine laboratory monitoring. Read More

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http://dx.doi.org/10.12890/2018_000947DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346816PMC
September 2018

Optimizing early enteral nutrition in severe stroke (OPENS): protocol for a multicentre randomized controlled trial.

BMC Neurol 2019 Feb 12;19(1):24. Epub 2019 Feb 12.

Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China.

Background: Malnutrition is one of the crucial factors associated with poor prognosis in critical ill patients, yet a significant evidence gap surrounds the management of initial enteral feeding in severe stroke. The Optimizing Early Enteral Nutrition in Severe Stroke (OPENS) trial will compare a strategy of modified full enteral nutrition (EN) (standard full EN in conjunction with prokinetic drug) and a strategy of permissive underfeeding (40 to 60% of estimated caloric requirements) with standard full EN (advancement to target nutrition goals) in patients with severe stroke.

Methods: The OPENS trial is a multicenter randomized controlled study. Read More

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http://dx.doi.org/10.1186/s12883-019-1253-2DOI Listing
February 2019
2.040 Impact Factor

Anticoagulation risk assessment for patients with non-valvular atrial fibrillation and venous thromboembolism: A clinical review.

Vasc Med 2019 Feb 12:1358863X18819816. Epub 2019 Feb 12.

1 Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USA.

Non-valvular atrial fibrillation and venous thromboembolism anticoagulation risk assessment tools have been increasingly utilized to guide implementation and duration of anticoagulant therapy. Anticoagulation significantly reduces stroke and recurrent venous thromboembolism risk, but comes at the cost of increased risk of major and clinically relevant non-major bleeding. The decision for anticoagulation in high-risk patients is complicated by the fact that many risk factors associated with increased thromboembolic risk are simultaneously associated with increased bleeding risk. Read More

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http://dx.doi.org/10.1177/1358863X18819816DOI Listing
February 2019

Sex-Related Differences in Patients Undergoing Thoracic Aortic Surgery: Evidence from the Canadian Thoracic Aortic Collaborative.

Circulation 2019 Feb 13. Epub 2019 Feb 13.

Surgery, London Health Sciences Center, Canada.

Background: Contemporary outcomes following surgical management of thoracic aortic disease have improved; however, the impact of sex-related differences is poorly understood.

Methods: A total of 1653 patients (498 (30.1%) female) underwent thoracic aortic surgery with hypothermic circulatory arrest between 2002 and 2017 in ten institutions of the Canadian Thoracic Aortic Collaborative. Read More

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http://dx.doi.org/10.1161/CIRCULATIONAHA.118.035805DOI Listing
February 2019
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Psychometric Testing of the Turkish Version of the Stroke Self-Efficacy Questionnaire.

J Nurs Res 2019 Feb 8. Epub 2019 Feb 8.

MD, Professor, Faculty of Medicine, Neurology Department, Dokuz Eylul University, Izmir, Turkey.

Background: When stroke survivors return to their lives in society, they often face issues such as physical or cognitive impairment, dependence on others, social isolation, and reduced self-esteem, which may lead to disastrous consequences in patients' self-perceived self-efficacy and self-confidence in everyday life. Self-efficacy plays an important role in the well-being of stroke patients. Accurate assessment of the stroke patients' self-efficacy by health professionals is critical to obtaining data regarding their functioning levels. Read More

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http://dx.doi.org/10.1097/jnr.0000000000000308DOI Listing
February 2019

The Epidemiology and Management of Exertional Heat Illnesses in High School Sports During the 2012/13-2016/17 Academic Years.

J Sport Rehabil 2019 Feb 12:1-24. Epub 2019 Feb 12.

5 Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT.

Context:: Recent data on exertional heat illness (EHI) in high school sports is limited, yet warranted to identify specific settings with the highest risk of EHI.

Objective:: To describe the epidemiology of EHI in high school sports during the 2012/13-2016/17 academic years.

Setting:: Aggregate injury and exposure data collected from athletic trainers working in high school sports in the United States (US). Read More

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https://journals.humankinetics.com/doi/10.1123/jsr.2018-0364
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http://dx.doi.org/10.1123/jsr.2018-0364DOI Listing
February 2019
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Effects of Tai Chi on Cerebral Haemodynamics and Health-related Outcomes in Older Community Adults at Risk of Ischaemic Stroke: A Randomized Controlled Trial.

J Aging Phys Act 2019 Feb 12:1-27. Epub 2019 Feb 12.

5 Collaborative Innovation Center for Rehabilitation Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China.

This study investigated the effects of Tai Chi compared to no exercise control on the cerebral haemodynamic parameters and other health-related factors in community older adults at risk of ischemic stroke. 170 eligible participants were randomly allocated to Tai Chi or control group. The cerebral haemodynamic parameters and physical fitness risk factors of cardiovascular disease were measured at baseline, 12 weeks and 24 weeks. Read More

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http://dx.doi.org/10.1123/japa.2018-0232DOI Listing
February 2019
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Tales from the Trips: A Qualitative Study of Timely Recognition, Treatment, and Transfer of Emergency Department Patients with Acute Ischemic Stroke.

J Stroke Cerebrovasc Dis 2019 Feb 7. Epub 2019 Feb 7.

Vanderbilt University Medical Center, Department of Emergency Medicine, Nashville, Tennessee; Vanderbilt University Medical Center, Center for Clinical Quality and Implementation Research, Nashville, Tennessee. Electronic address:

Background And Objectives: Acute Ischemic stroke (AIS) is a time-sensitive emergency and patients frequently present to, and are transferred from emergency departments (EDs). We sought to evaluate potential factors, particularly organizational, that may influence the timeliness of interfacility transfer for ED patients with AIS.

Methods: We conducted semistructured interviews at 3 EDs that routinely transfer AIS patients. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.01.012DOI Listing
February 2019
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Cognitive impairment in patients with end-stage renal disease: Accelerated brain aging?

J Formos Med Assoc 2019 Feb 7. Epub 2019 Feb 7.

Institute of Public Health, School of Medicine, National Yang Ming University, Taipei, Taiwan; Preventive Medicine Research Center, National Yang-Ming University, Taipei, Taiwan. Electronic address:

Background: Chronic kidney disease exhibits a prominent premature aging phenotype in many different organ systems, including the brain. Nevertheless, a comprehensive characterization of brain aging in non-demented patients with end-stage renal disease (ESRD) is lacking and it remains unclear if the collective changes of cognitive functions and brain structures in ESRD is compatible with aging.

Methods: We compared 56 non-demented, independently living dialysis patients (mean age 59. Read More

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http://dx.doi.org/10.1016/j.jfma.2019.01.011DOI Listing
February 2019
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Magnetic Resonance Imaging or Computed Tomography Before Treatment in Acute Ischemic Stroke.

Stroke 2019 Feb 12:STROKEAHA118023882. Epub 2019 Feb 12.

From the Imaging Department, INSERM UMR S1266, Sainte-Anne Hospital, Paris Descartes University, France (C.P., L.L., W.B.H., J.B., M.E., G.B., O.N., C.O.).

Background and Purpose- The acute management of stroke patients requires a fast and efficient screening imaging modality. We compared workflow and functional outcome in acute ischemic stroke patients screened by magnetic resonance imaging (MRI) or computed tomography (CT) before treatment in the THRACE trial (Thrombectomie des Artères Cérébrales), with the emphasis on the duration of the imaging step. Methods- The THRACE randomized trial (June 2010 to February 2015) evaluated the efficacy of mechanical thrombectomy after intravenous tPA (tissue-type plasminogen activator) in ischemic stroke patients with proximal occlusion. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.023882DOI Listing
February 2019

[Assessment on the capacity for prevention and control programs for chronic non-communicable diseases in China, in 2014].

Zhonghua Liu Xing Bing Xue Za Zhi 2019 Feb;40(2):231-236

Division of Chronic Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

To assess the capacity of prevention and control on chronic non- communicable diseases (NCDs) in China. On-line questionnaire survey was adopted by 3 395 CDCs at provincial, municipal and county (district) levels and 3 000 primary health care units, and assess on capacity of policy, infrastructure, capacity of training and guidance, cooperation, surveillance, intervention and management, assessment and scientific research from September 2014 to March 2015. (1) Capacity of policy: 23 (71. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0254-6450.2019.02.020DOI Listing
February 2019