56,118 results match your criteria Medical Treatment of Stroke


Pontine hemorrhage accompanied by neuromyelitis optica spectrum disorder.

J Neuroimmunol 2019 Feb 1;330:19-22. Epub 2019 Feb 1.

Department of Neurology, Juntendo University Faculty of Medicine, Japan.

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disorder caused by antibody to aquaporin-4 (AQP4). NMOSD can infrequently present as a complication of posterior reversible encephalopathy syndrome (PRES). Moreover, few cases of NMOSD patients with brain hemorrhage have been reported. Read More

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http://dx.doi.org/10.1016/j.jneuroim.2019.01.020DOI Listing
February 2019

Progressive brain atrophy in chronically infected and treated HIV+ individuals.

J Neurovirol 2019 Feb 14. Epub 2019 Feb 14.

Department of Public Health, Infection Unit, Tufts University School of Medicine, Boston, MA, USA.

Growing evidence points to persistent neurological injury in chronic HIV infection. It remains unclear whether chronically HIV-infected individuals on combined antiretroviral therapy (cART) develop progressive brain injury and impaired neurocognitive function despite successful viral suppression and immunological restoration. In a longitudinal neuroimaging study for the HIV Neuroimaging Consortium (HIVNC), we used tensor-based morphometry to map the annual rate of change of regional brain volumes (mean time interval 1. Read More

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http://dx.doi.org/10.1007/s13365-019-00723-4DOI Listing
February 2019

Atypical Thrombotic Thrombocytopenic Purpura Presenting as Stroke.

Case Rep Hematol 2019 14;2019:7425320. Epub 2019 Jan 14.

Division of Hematology, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6411 Fannin Street, Houston 77030, USA.

Here we report a case of atypical thrombotic thrombocytopenic purpura that presented as an ischemic cerebrovascular accident. A 56-year-old man with multiple cardiovascular risk factors presented with sudden left-sided weakness, slurred speech, and left facial droop. He showed mild improvement when he was treated with thrombolytic therapy according to the hospital stroke protocol. Read More

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http://dx.doi.org/10.1155/2019/7425320DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350572PMC
January 2019

Effectiveness of Robot-Assisted Upper Limb Training on Spasticity, Function and Muscle Activity in Chronic Stroke Patients Treated With Botulinum Toxin: A Randomized Single-Blinded Controlled Trial.

Front Neurol 2019 31;10:41. Epub 2019 Jan 31.

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

The combined use of Robot-assisted UL training and Botulinum toxin (BoNT) appear to be a promising therapeutic synergism to improve UL function in chronic stroke patients. To evaluate the effects of Robot-assisted UL training on UL spasticity, function, muscle strength and the electromyographic UL muscles activity in chronic stroke patients treated with Botulinum toxin. This single-blind, randomized, controlled trial involved 32 chronic stroke outpatients with UL spastic hemiparesis. Read More

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http://dx.doi.org/10.3389/fneur.2019.00041DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365972PMC
January 2019

Left Ventricular Unloading During Extracorporeal Membrane Oxygenation in Patients With Cardiogenic Shock.

J Am Coll Cardiol 2019 Feb;73(6):654-662

University of Ottawa Heart Institute, Ottawa, Ontario, Canada. Electronic address:

Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a widely used form of mechanical circulatory support in patients with refractory cardiogenic shock. A common drawback of this modality is a resultant increase in left ventricular afterload.

Objectives: The purpose of this meta-analysis was to examine the efficacy and safety of left ventricular unloading strategies during VA-ECMO in adult patients with cardiogenic shock. Read More

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http://dx.doi.org/10.1016/j.jacc.2018.10.085DOI Listing
February 2019

Twenty-and-a-half syndrome: a case report.

J Med Case Rep 2019 Feb 15;13(1):35. Epub 2019 Feb 15.

Department of Neurology, Sri Aurobindo Medical College & P.G. Institute, 4th Floor, Sanwer Road, Indore, MP, 453555, India.

Background: In the list of named numerical neuro-ophthalmological syndromes, such as one-and-a-half syndrome and others, we report for the first time twenty-and-a-half syndrome, which is characterized by one-and-a-half syndrome with bilateral seventh and right fifth nerve palsy (1.5 + 7 + 7 + 5 = 20.5) in a patient with ischemic stroke. Read More

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http://dx.doi.org/10.1186/s13256-019-1980-4DOI Listing
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

Comparison of conventional and modern methods in determining ischemic stroke etiology by general and stroke neurologists

Turk J Med Sci 2019 Feb 11;49(1):170-177. Epub 2019 Feb 11.

Background/aim: This study aimed to investigate the consistency between stroke and general neurologists in subtype assignment using the Trial of ORG-10172 in Acute Stroke Treatment (TOAST) and Causative Classification of Stroke (CCS) systems.

Materials And Methods: Fifty consecutive acute ischemic stroke patients admitted to the stroke unit were recruited. Patients were classified by two stroke and two general neurologists, each from different medical centers, according to TOAST followed by the CCS. Read More

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http://dx.doi.org/10.3906/sag-1806-29DOI 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
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Development of a risk score for predicting the benefit versus harm of extending dual antiplatelet therapy beyond 6 months following percutaneous coronary intervention for stable coronary artery disease.

PLoS One 2019 14;14(2):e0209661. Epub 2019 Feb 14.

The Department of cardiology, Rabin Medical Center, Petah-Tikva, Israel.

Background: Decisions on dual antiplatelet therapy (DAPT) duration should balance the opposing risks of ischaemia and bleeding. Our aim was to develop a risk score to identify stable coronary artery disease (SCAD) patients undergoing PCI who would benefit or suffer from extending DAPT beyond 6 months.

Methods: Retrospective analysis of a cohort of patients who completed 6 months of DAPT following PCI. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0209661PLOS
February 2019

Anticoagulation in atrial fibrillation and cognitive decline: A systematic review and meta-analysis.

Medicine (Baltimore) 2019 Feb;98(7):e14499

Department of Ultrasonic Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning, China.

Background: It is well known that atrial fibrillation (AF) carried a high risk of cognitive decline, which is independent of stroke or transient ischemic attack (TIA). Whether anticoagulation is associated with reduced risk of cognitive decline in participants with AF still remains controversial. We conducted a systematic review and meta-analysis to explore the effect of anticoagulation on the risk of cognitive decline in patients with AF. Read More

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http://dx.doi.org/10.1097/MD.0000000000014499DOI Listing
February 2019

Efficacy and mechanism of acupuncture for ischemic poststroke depression: Study protocol for a multicenter single-blinded randomized sham-controlled trial.

Medicine (Baltimore) 2019 Feb;98(7):e14479

First Teaching Hospital of Tianjin University of Traditional Chinese Medicine.

Introduction: Poststroke depression is a serious and common complication of stroke, especially the ischemic poststroke depression. Antidepressants are used in poststroke depression, and acupuncture may be an alternative approach. However, the efficacy and mechanism of acupuncture for poststroke depression has not been confirmed. Read More

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http://dx.doi.org/10.1097/MD.0000000000014479DOI Listing
February 2019

FLAIR vascular hyperintensity in acute stroke is associated with collateralization and functional outcome.

Eur Radiol 2019 Feb 14. Epub 2019 Feb 14.

Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing, 210006, China.

Purpose: Fluid-attenuated inversion recovery vascular hyperintensity (FVH) is frequently found in stroke patients after intracranial arterial occlusion, but the prognostic value of FVH findings is unclear. We assessed whether FVH is associated with cerebral collateral status and functional outcome in patients with acute stroke patients receiving endovascular therapy.

Methods: FVH score, American Society of Interventional and Therapeutic Neuroradiology (ASITN) grade, the functional outcome at 3 months (modified Rankin Scale (mRS)), and other clinical data were collected for 37 acute stroke patients with large vessel occlusion (LVO) receiving MRI before and after endovascular therapy. Read More

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http://dx.doi.org/10.1007/s00330-019-06022-0DOI Listing
February 2019

Aphasia rehabilitation based on mirror neuron theory: a randomized-block-design study of neuropsychology and functional magnetic resonance imaging.

Neural Regen Res 2019 Jun;14(6):1004-1012

Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China.

When watching someone performs an action, mirror neurons are activated in a way that is very similar to the activation that occurs when actually performing that action. Previous single-sample case studies indicate that hand-action observation training may lead to activation and remodeling of mirror neuron systems, which include important language centers, and may improve language function in aphasia patients. In this randomized-block-design experiment, we recruited 24 aphasia patients from, Zhongda Hospital, Southeast University, China. Read More

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http://dx.doi.org/10.4103/1673-5374.250580DOI Listing

Nicotinamide adenine dinucleotide phosphate oxidase activation and neuronal death after ischemic stroke.

Neural Regen Res 2019 Jun;14(6):948-953

Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA.

Nicotinamide adenine dinucleotide phosphate oxidase (NOX) is a multisubunit enzyme complex that utilizes nicotinamide adenine dinucleotide phosphate to produce superoxide anions and other reactive oxygen species. Under normal circumstances, reactive oxygen species mediate a number of important cellular functions, including the facilitation of adaptive immunity. In pathogenic circumstances, however, excess reactive oxygen species generated by NOX promotes apoptotic cell death. Read More

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http://dx.doi.org/10.4103/1673-5374.250568DOI Listing

Blood pressure variability and hemorrhagic transformation in patients with successful recanalization after endovascular recanalization therapy: a retrospective observational study.

Ann Neurol 2019 Feb 13. Epub 2019 Feb 13.

Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.

Objective: Although BP variability has been regarded as a risk factor for hemorrhagic transformation (HTF) after intravenous thrombolysis, its effect on HTF after endovascular recanalization therapy (ERT) remains to be elucidated. We aimed to study the relationship between BP variability and symptomatic intracerebral hemorrhage (sICH) after successful recanalization with ERT.

Methods: A total of 211 patients with acute ischemic stroke and successful recanalization (Thrombolysis in Cerebral Infarction 2b or 3) after ERT were included between January 2013 and May 2017. Read More

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http://dx.doi.org/10.1002/ana.25434DOI Listing
February 2019

Comparison of Clopidogrel and Ticlopidine/ in Patients With Clopidogrel Resistance and Carotid Stenting.

Front Neurol 2019 30;10:44. Epub 2019 Jan 30.

Department of Neurology, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, South Korea.

Patients undergoing carotid artery stenting (CAS) who show low responsiveness to clopidogrel may have a higher risk of peri-procedural embolic events. This study aimed to compare the effectiveness and safety of clopidogrel and ticlopidine plus in clopidogrel-resistant patients undergoing CAS. In this multi-center, randomized, controlled trial, we used platelet reactivity test to select patients undergoing CAS who showed clopidogrel resistance, and compared treatments using clopidogrel and ticlopidine plus ginkgo. Read More

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http://dx.doi.org/10.3389/fneur.2019.00044DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363652PMC
January 2019

Institutional and provider variations for mechanical thrombectomy in the treatment of acute ischemic stroke: a survey analysis.

J Neurointerv Surg 2019 Feb 13. Epub 2019 Feb 13.

Department of Neurology, Neurosurgery and Radiology, University of Minnesota, Minneapolis, MN, USA.

Introduction: Stent retriever combined with aspiration, or the 'Solumbra technique', has recently emerged as one of the popular methods of mechanical thrombectomy (MT). However, the variations in understanding and implementation of the Solumbra technique have not been reported.

Methods: An 18 part anonymous survey questionnaire was designed to extract information regarding technical variations of MT with a focus on the Solumbra technique. Read More

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http://dx.doi.org/10.1136/neurintsurg-2018-014614DOI Listing
February 2019

Rapid Alteplase Administration Improves Functional Outcomes in Patients With Stroke due to Large Vessel Occlusions.

Stroke 2019 Feb 14:STROKEAHA118021840. Epub 2019 Feb 14.

Calgary Stroke Program, Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, Health Science Centre, University of Calgary, Alberta, Canada (M.D.H.).

Background and Purpose- We report the relation of onset-to-treatment time and door-to-needle time with functional outcomes and mortality among patients with ischemic stroke with imaging-proven large vessel occlusion treated with intravenous alteplase. Methods- Individual patient-level data from the HERMES (Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke Trials) collaboration were pooled from 7 trials that randomized patients to mechanical thrombectomy added to best medical therapy versus best medical therapy alone. Analysis was restricted to patients who received alteplase directly at the endovascular hospital. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.021840DOI Listing
February 2019

Endocarditis, Meningitis and Pneumocystis Pneumonia.

Eur J Case Rep Intern Med 2017 27;4(3):000535. Epub 2017 Apr 27.

Intermediate Care Unit of the Emergency Department, Centro Hospitalar de São João, Porto, Portugal.

Infective endocarditis (IE) is associated with high morbidity and mortality despite advances in antibiotic and surgical treatment. Systemic embolism occurs in up to 49% of IE patients and may involve the major arteries, limb arteries, viscera and the central nervous system. In this report we describe a 60-year-old female patient with a history of acute lymphoblastic leukaemia who presented with endocarditis manifesting as stroke, acute limb ischaemia and meningitis. Read More

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http://dx.doi.org/10.12890/2016_000535DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346874PMC

Computed Tomography Perfusion Can Guide Endovascular Therapy in Bilateral Carotid Artery Dissection.

Eur J Case Rep Intern Med 2016 15;3(1):000295. Epub 2015 Dec 15.

The National Hospital of Neurology, Queen Square and MRC Unit for Lifelong Health and Ageing at UCL, London, UK.

Introduction: Carotid artery dissection (CAD) is a major cause of stroke in those under age 45, accounting for around 20% of ischaemic events. In the absence of known connective tissue disorders, most dissections are traumatic. First-line management is comprised of antiplatelet or anticoagulation therapy, but many traumatic dissections progress despite this and carry the risk of long-term complications from embolism or stenosis. Read More

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http://dx.doi.org/10.12890/2015_000295DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346824PMC
December 2015

Striatal spreading depolarization: Possible implication in levodopa-induced dyskinetic-like behavior.

Mov Disord 2019 Feb 13. Epub 2019 Feb 13.

Neurological Clinic, Department of Medicine, Hospital Santa Maria della Misericordia, University of Perugia, Perugia, Italy.

Objective: Spreading depolarization (SD) is a transient self-propagating wave of neuronal and glial depolarization coupled with large membrane ionic changes and a subsequent depression of neuronal activity. Spreading depolarization in the cortex is implicated in migraine, stroke, and epilepsy. Conversely, spreading depolarization in the striatum, a brain structure deeply involved in motor control and in Parkinson's disease (PD) pathophysiology, has been poorly investigated. Read More

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http://dx.doi.org/10.1002/mds.27632DOI 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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Antidepressant-like effects of paeoniflorin on post-stroke depression in a rat model.

Neurol Res 2019 Feb 13:1-10. Epub 2019 Feb 13.

e Department of Neurology, Shandong Provincial Qianfoshan Hospital , Shandong University , Jinan , China.

Background: Post-stroke depression (PSD) is one of the most prevalent emotional disorders after stroke and often results in poor outcomes. However, the underlying physiopathologic mechanism and effective treatment of PSD remain poorly elucidated.

Objective: To investigate whether paeoniflorin has antidepressant-like activity in a rat model of PSD. Read More

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http://dx.doi.org/10.1080/01616412.2019.1576361DOI Listing
February 2019

De-escalation versus standard dual antiplatelet therapy in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis.

Platelets 2019 Feb 13:1-11. Epub 2019 Feb 13.

b Department of Cardiology , The First Hospital of Lanzhou University , Lanzhou , Gansu , China.

Switching from a potent P2Y blocker to clopidogrel is not uncommon for antiplatelet therapy in patients undergoing percutaneous coronary intervention. This meta-analysis aimed to investigate the efficacy and safety of this de-escalation strategy. Medical literature databases were searched for analysis comparing continued potent antiplatelet therapy and switching to clopidogrel with no language restrictions from inception to 07/May/2018. Read More

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http://dx.doi.org/10.1080/09537104.2019.1574969DOI Listing
February 2019

Cost-utility analysis of mechanical thrombectomy between 6 and 24 hours in acute ischemic stroke.

Int J Stroke 2019 Feb 13:1747493019830587. Epub 2019 Feb 13.

2 Imaging Department, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.

Background: Recently, two randomized controlled trials demonstrated the benefit of mechanical thrombectomy performed between 6 and 24 h in acute ischemic stroke. The current economic evidence is supporting the intervention only within 6 h, but extended thrombectomy treatment times may result in better long-term outcomes for a larger cohort of patients.

Aims: We compared the cost-utility of mechanical thrombectomy in addition to medical treatment versus medical treatment alone performed beyond 6 h from stroke onset in the UK National Health Service (NHS). Read More

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http://dx.doi.org/10.1177/1747493019830587DOI Listing
February 2019

The association between education and risk of major cardiovascular events among prostate cancer patients: a study from the Diet, Cancer and Health study.

Acta Oncol 2019 Feb 13:1-7. Epub 2019 Feb 13.

a Survivorship , Danish Cancer Society Research Center , Copenhagen , Denmark.

Background: High socioeconomic position is associated with better prognosis in prostate cancer patients but it is unknown if part of this association may be explained by socioeconomic differences in severe late effects. We investigated the association between education as an indicator for socioeconomic position and cardiovascular events after prostate cancer and if such associations were mediated by differences in lifestyle, cardiovascular risk factors and prostate cancer treatment.

Material And Methods: We identified 1980 men diagnosed with prostate cancer from 1993 to 2014 among participants in the Danish Diet, Cancer and Health study. Read More

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http://dx.doi.org/10.1080/0284186X.2019.1572924DOI Listing
February 2019

Nucleic Acid-Based Therapeutics for Parkinson's Disease.

Neurotherapeutics 2019 Feb 12. Epub 2019 Feb 12.

Robert Wood Johnson Medical School Institute for Neurological Therapeutics, and Department of Neurology, Rutgers Biomedical and Health Sciences, Piscataway, NJ, 08854, USA.

Parkinson's disease (PD) is a progressive neurodegenerative disorder that is diagnosed largely on clinical grounds due to characteristic motor manifestations that result from the loss of nigrostriatal dopaminergic neurons. While traditional pharmacological approaches to enhance dopamine levels, such as with L-dopa, can be very effective initially, the chronic use of this dopamine precursor is commonly plagued with motor response complications. Additionally, with advancing disease, non-motor manifestations emerge, including psychosis and dementia that compound patient disability. Read More

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http://dx.doi.org/10.1007/s13311-019-00714-7DOI Listing
February 2019

Cerebral Vasculitis Complicating Pneumococcal Meningitis.

Eur J Case Rep Intern Med 2018 25;5(5):000819. Epub 2018 May 25.

Medical Intensive Care Unit, Farhat Hached Hospital, Sousse, Tunisia.

Introduction: Cerebral vasculitis is an uncommon life-threatening complication of community-acquired bacterial meningitis.

Patient And Methods: We report the case of a 64-year-old woman with pneumococcal meningitis who developed parainfectious vasculitis causing ischaemic brain damage. Cerebral magnetic resonance imaging (MRI) confirmed the diagnosis. Read More

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http://dx.doi.org/10.12890/2018_000819DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346924PMC

Therapeutic targets for the anemia of predialysis chronic kidney disease: a meta-analysis of randomized, controlled trials.

J Investig Med 2019 Feb 11. Epub 2019 Feb 11.

Department of Nephrology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Anemia is one of the major complications in predialysis patients with chronic kidney disease (CKD). A clearer cognition of the prognostic impact of hemoglobin (Hb) or hematocrit (Hct) target on the outcomes of predialysis patients with CKD is significant. This article aims to establish the suitable hemoglobin target to provide clinical guidance. Read More

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http://dx.doi.org/10.1136/jim-2018-000915DOI Listing
February 2019

Paramedic Acute Stroke Treatment Assessment (PASTA): study protocol for a randomised controlled trial.

Trials 2019 Feb 12;20(1):121. Epub 2019 Feb 12.

Medical Sciences Division, University of Oxford, and Oxford University Hospitals NHS Foundation Trust, Level 3, John Radcliffe Hospital, Oxford, OX3 9DU, UK.

Background: Despite evidence from clinical trials that intravenous (IV) thrombolysis is a cost-effective treatment for selected acute ischaemic stroke patients, there remain large variations in the rate of IV thrombolysis delivery between stroke services. This study is evaluating whether an enhanced care pathway delivered by paramedics (the Paramedic Acute Stroke Treatment Assessment (PASTA)) could increase the number of patients who receive IV thrombolysis treatment.

Methods: Study design: Cluster randomised trial with economic analysis and parallel process evaluation. Read More

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http://dx.doi.org/10.1186/s13063-018-3144-zDOI Listing
February 2019
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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

Transcranial Doppler findings in antiphospholipid syndrome.

Lupus 2019 Feb 12:961203319828833. Epub 2019 Feb 12.

1 Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil.

Introduction: Transcranial Doppler is a method that enables the assessment of different cerebral hemodynamic parameters. It also allows for the evaluation of the presence of right-to-left circulation shunts (RLS) and for the detection of microembolic signals (MESs), which might be associated with an increased risk of cerebrovascular events. For instance, the presence of MESs on transcranial Doppler in patients with systemic lupus erythematous (SLE) and antiphospholipid syndrome (APS) is associated with an increased risk of stroke. Read More

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http://dx.doi.org/10.1177/0961203319828833DOI Listing
February 2019

Modulation of antioxidant enzyme gene expression by extremely low frequency electromagnetic field in post-stroke patients.

Scand J Clin Lab Invest 2018 Nov - Dec;78(7-8):626-631

a Department of General Biochemistry, Faculty of Biology and Environmental Protection , University of Lodz , Lodz , Poland.

Oxidative stress plays the most important role in the pathogenesis of stroke. Extremely low frequency electromagnetic field (ELF-EMF) therapy may be complementary in post-stroke therapy, as it modulates oxidative stress. The aim of this study was to evaluate the messenger ribonucleic acid (mRNA) levels of certain antioxidant genes in post-stroke patients given ELF-EMF therapy. Read More

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http://dx.doi.org/10.1080/00365513.2018.1542540DOI Listing
February 2019

Value of combined cardiopulmonary and echocardiography stress test to characterize the haemodynamic and metabolic responses of patients with heart failure and mid-range ejection fraction.

Eur Heart J Cardiovasc Imaging 2019 Feb 11. Epub 2019 Feb 11.

Cardiac, Thoracic and Vascular Department, University of Pisa, Via Paradisa, 2, Pisa, Italy.

Aims: To characterize heart failure (HF) with mid-range ejection fraction (HFmrEF), combining cardiopulmonary exercise test, and exercise stress echocardiography.

Methods And Results: We studied 169 consecutive subjects (age 62.3 ± 11 years; 74% male): 30 healthy controls, 45 patients with HF and preserved EF (HFpEF), 40 HFmrEF, and 54 with HF and reduced EF (HFrEF). Read More

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http://dx.doi.org/10.1093/ehjci/jez014DOI Listing
February 2019

Assessment of risk factors, cost of treatment and therapy outcome in stroke patients: evidence from cross-sectional study.

Expert Rev Pharmacoecon Outcomes Res 2019 Feb 12. Epub 2019 Feb 12.

c MM College of Pharmacy, MM Deemed to be University , Mullana, Ambala , Haryana , India , 133207.

Introduction: Increased prevalence of stroke, and the subsequent increased economic burden on the healthcare system and society is a raising concern in India. Objectives of this study were to assess risk factors, cost of treatment and therapy outcomes in stroke patients.

Methods: This cross-sectional study was conducted in 130 patients of either sex at a government tertiary care hospital of India. Read More

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http://dx.doi.org/10.1080/14737167.2019.1580574DOI Listing
February 2019
1 Read

[Transcatheter closure of patent foramen ovale in patients with cryptogenic stroke].

G Ital Cardiol (Rome) 2019 02;20(2):73-84

Cardiologia Pediatrica e dell'Età Evolutiva, Centro per il Trattamento del Cardiopatico Congenito Adulto, Policlinico S. Orsola-Malpighi, Università degli Studi, Bologna.

Treatment of patients with cryptogenic stroke and a patent foramen ovale (PFO) has always been a matter of discussion. A clear pathogenic relationship is difficult to demonstrate in most cases, also because of the high prevalence of a PFO in the general population (25-30%). Early randomized trials failed to demonstrate a superiority of PFO transcatheter closure with respect to medical therapy alone but more recent data, coming from new randomized trials, strongly suggest that PFO closure associated with antiplatelet therapy is more effective than antiplatelet therapy alone in preventing recurrent stroke, with no increased risk of major adverse cardiovascular events in the follow-up; only a higher incidence of atrial fibrillation has been reported after PFO closure. Read More

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http://dx.doi.org/10.1714/3093.30855DOI Listing
February 2019
1 Read

Improving Door-to-needle Times in the Treatment of Acute Ischemic Stroke Across a Canadian Province: Methodology.

Crit Pathw Cardiol 2019 Mar;18(1):51-56

From the Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB.

Background: Alteplase is a proven medical treatment for acute ischemic stroke; however, the effectiveness of this treatment is highly time dependent. Therefore, it is imperative that hospitals treat acute ischemic stroke patients as quickly as possible. The measure, door-to-needle time, is the time from hospital arrival to when alteplase administration begins. Read More

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http://dx.doi.org/10.1097/HPC.0000000000000173DOI Listing

The Acute Stroke or Transient Ischemic Attack Treated with Ticagrelor and Aspirin for Prevention of Stroke and Death (THALES) trial: Rationale and design.

Int J Stroke 2019 Feb 12:1747493019830307. Epub 2019 Feb 12.

7 Department of Neurology, Beijing Tiantan Hospital, Beijing, China.

Rationale: In patients with acute cerebral ischemia, the rate of stroke, myocardial infarction, or death during 90 days was reported to be non-significantly lower with ticagrelor compared with aspirin, with no increase in major hemorrhage. Dual antiplatelet therapy may be more effective in this setting.

Aim: To investigate whether ticagrelor combined with aspirin are superior to aspirin alone in preventing stroke or death in patients with non-severe, non-cardioembolic ischemic stroke or high-risk transient ischemic attack. Read More

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http://dx.doi.org/10.1177/1747493019830307DOI Listing
February 2019
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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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Transplantation of Directly Reprogrammed Human Neural Precursor Cells Following Stroke Promotes Synaptogenesis and Functional Recovery.

Transl Stroke Res 2019 Feb 12. Epub 2019 Feb 12.

Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, M5S 3E1, Canada.

Stroke is one of the leading causes of long-term disability. Cell transplantation is a promising strategy to treat stroke. We explored the efficacy of directly reprogrammed human neural precursor cell (drNPC) transplants to promote functional recovery in a model of focal ischemic stroke in the mouse sensorimotor cortex. Read More

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http://dx.doi.org/10.1007/s12975-019-0691-xDOI Listing
February 2019
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Classification of Mild Stroke: A Mapping Review.

PM R 2019 Feb 11. Epub 2019 Feb 11.

B.R.A.I.N. Laboratory (Better Rehabilitation and Assessment for Improved Neurorecovery); Division of Occupational Therapy, The Ohio State University, Columbus, OH.

Persons with mild stroke experience motor and cognitive impairments that negatively impact their health and quality of life. To address these deficits, it is essential for clinicians and researchers to precisely identify mild stroke survivors. Despite the fact that half of all strokes are categorized as mild, no standards exist on what constitutes a "mild" stroke. Read More

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http://dx.doi.org/10.1002/pmrj.12142DOI Listing
February 2019
1.662 Impact Factor

Characteristics of Japanese Patients with Nonvalvular Atrial Fibrillation on Anticoagulant Treatment: A Descriptive Analysis of J-dabigatran Surveillance and JAPAF Study.

Cardiol Ther 2019 Feb 11. Epub 2019 Feb 11.

Saiseikai Toyama Hospital, Toyama, Japan.

Introduction: Following approval of dabigatran and other antithrombotics in Japan, few studies have specifically evaluated the clinical characteristics of patients prescribed these antithrombotics for nonvalvular atrial fibrillation (NVAF) in real-world practice.

Methods: We conducted a descriptive analysis of data from two real-world studies [J-dabigatran surveillance and Japanese study on current Anticoagulation therapies for Patients with nonvalvular Atrial Fibrillation (JAPAF); conducted at sites common to both studies] to determine the characteristics of patients with NVAF initiated on dabigatran etexilate [110 mg twice daily (BID; DE110) or 150 mg BID (DE150)], warfarin, rivaroxaban, or antiplatelets as their first antithrombotic treatment. Inferential statistical analyses were not performed, and no statistical hypothesis was tested. Read More

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http://dx.doi.org/10.1007/s40119-019-0129-2DOI Listing
February 2019
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Multiple Exostoses Syndrome and Basilar Artery Aneurysm: A Case Report.

J Vasc Interv Neurol 2018 Nov;10(2):28-32

Department of Neurosurgery, University of Patras, Patras, Greece.

Background: Hereditary multiple exostoses (HME) is an inherited genetic condition, characterized by the formation of multiple osteochondromas, developing throughout childhood and into puberty. Vascular complications associated with HME are uncommon.

Methods: A case of a patient with HME who was admitted to hospital with subarachnoid hemorrhage (SAH), as a result of acute rupture of a basilar tip aneurysm (BTA), will be presented. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350870PMC
November 2018
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Antithrombotic Treatment May Reduce Mortality Among New-Onset Atrial Fibrillation Patients with Gray-Zone Risk of Stroke.

Int Heart J 2019 Feb 8. Epub 2019 Feb 8.

Division of Cardiology, Department of Medicine, Chung Shan Medical University Hospital and Chung Shan Medical University.

In clinical practice, some atrial fibrillation (AF) patients were classified as having low and moderate stroke risk by the CHADS score (≤ 1) in 2001 but in 2012 they were not truly classified as low risk of stroke according to the CHADS-VASc score (≥ 2) (defined gray zone). Therefore, a treatment gap exists in gray zone AF patients. This study aimed to evaluate whether gray zone AF patients could benefit from reduced all-cause mortality under antithrombotic treatment. Read More

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http://dx.doi.org/10.1536/ihj.18-174DOI Listing
February 2019

Use of modified intention-to-treat analysis in studies of direct oral anticoagulants and risk of selection bias: a systematic review.

BMJ Evid Based Med 2019 Feb 11. Epub 2019 Feb 11.

Internal Medicine, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada.

Background: Following their evaluation in randomised controlled trials (RCTs), direct oral anticoagulants (DOACs) have replaced warfarin for stroke prevention in atrial fibrillation (AF), and treatment and prevention of venous thromboembolism (VTE). To avoid selection bias, it is recommended that RCTs use an intention-to-treat (ITT) analysis strategy.

Objective: The objective of this study was to systematically review and compare reported analytical strategies, the proportion of randomised patients included in analyses and the reasons for participant exclusions. Read More

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http://dx.doi.org/10.1136/bmjebm-2018-111057DOI Listing
February 2019
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Disparities in the Use of Intravenous t-PA among Ischemic Stroke Patients: Population-based Recent Temporal Trends.

J Stroke Cerebrovasc Dis 2019 Feb 8. Epub 2019 Feb 8.

The Stroke Center and Department of Neurology, SUNY Downstate College of Medicine and Medical Center, Brooklyn, New York; Department of Neurology and Emergency Medicine, Kings County Hospital Center, Brooklyn, New York.

Objective: To explore a 5-year comparison of disparities in intravenous t-PA (IV t-PA) use among acute ischemic stroke (AIS) patients based on race, gender, age, ethnic origin, hospital status, and geographic location.

Methods: We extracted patients' demographic information and hospital characteristics for 2010 and 2014 from the New York Statewide Planning and Research Cooperative System (SPARCS). We compared disparities in IV t-PA use among AIS patients in 2010 to that in 2014 to estimate temporal trends. Read More

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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.01.013DOI Listing
February 2019

Medical and endovascular treatments of symptomatic intracranial stenosis. A Bayesian network meta-analysis.

J Clin Neurosci 2019 Feb 8. Epub 2019 Feb 8.

Department of Neurology, "G. Jazzolino" Hospital, Vibo Valentia, Italy.

Intracranial stenosis is a well-established stroke risk factor with an increase of stroke recurrence or TIA up to 12.6% at 1 year. Treatments are different: medical and endovascular. Read More

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http://dx.doi.org/10.1016/j.jocn.2019.01.040DOI Listing
February 2019

Real-world outcomes of the Xarelto Post-Authorization Safety & Effectiveness Study in Japanese Patients with Atrial Fibrillation (XAPASS).

J Cardiol 2019 Feb 7. Epub 2019 Feb 7.

Medical Affairs Thrombosis, Medical Affairs, Bayer Yakuhin, Ltd., Osaka, Japan.

Background: Although the efficacy and safety of the factor Xa inhibitor rivaroxaban for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF) were shown in global and Japanese phase III clinical trials, safety and effectiveness data from unselected patients in everyday clinical practice are limited. The objective of the XAPASS (Xarelto Post-Authorization Safety & Effectiveness Study in Japanese Patients with Atrial Fibrillation) is to investigate the safety and effectiveness of rivaroxaban in Japanese real-world clinical practice.

Methods: The XAPASS is a prospective, single-arm, real-world observational study mandated by the Japanese authority as post-marketing surveillance. Read More

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http://dx.doi.org/10.1016/j.jjcc.2019.01.001DOI Listing
February 2019

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