Search Our Scientific Publications & Authors

Ann Transl Med 2021 Apr;9(8):626

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

Background: It is unknown about the influence of prestroke antiplatelet use on early outcomes in patients with and without the indication. We aimed to evaluate the in-hospital prognosis of first-ever noncardiogenic ischemic stroke patients with and without indications of antiplatelet use for primary prevention.

Methods: This was a retrospective, observational study based on a prospective hospital-based registry (Chinese Stroke Center Alliance). Read More

BMC Health Serv Res 2021 May 12;21(1):453. Epub 2021 May 12.

Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Precision Monitoring to Transform Care (PRIS-M) Quality Enhancement Research Initiative (QUERI), Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.

Background: The Protocol-guided Rapid Evaluation of Veterans Experiencing New Transient Neurologic Symptoms (PREVENT) program was a complex quality improvement (QI) intervention targeting transient ischemic attack (TIA) evidence-based care. The aim of this study was to evaluate program acceptability among the QI teams and factors associated with degrees of acceptability.

Methods: QI teams from six Veterans Administration facilities participated in active implementation for a one-year period. Read More

Case Rep Neurol 2021 Jan-Apr;13(1):239-245. Epub 2021 Apr 13.

Department of Neurology, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia.

Isolated pontine infarction accounts for 7% of all ischemic strokes. Millard-Gubler syndrome is a clinical syndrome which occurs following lesions involving the ventral portion of the caudal pons, resulting in classic clinical features such as ipsilateral abducens and facial nerve palsy and contralateral hemiparesis. We report the case of a 55-year-old male patient having presented to the Yehuleshet Specialty Clinic 6 years back with sudden-onset dysarthria and appendicular ataxia of 10 days duration. Read More

Acta Neurochir Suppl 2021 ;132:57-61

Department of Neurosurgery, Tohoku University, Sendai, Japan.

Objective: Surgical revascularization for moyamoya disease (MMD) prevents cerebral ischemic attack by improving cerebral blood flow (CBF) and could also reduce the risk of re-bleeding in hemorrhagic-onset patients. We sought to clarify the cerebral hemodynamic changes in the acute stage after revascularization surgery for adult MMD.

Materials And Methods: The present study includes 54 consecutive adult patients with MMD (21-76 years old, 43. Read More

Expert Rev Med Devices 2021 May 9. Epub 2021 May 9.

Operative Unit of Vascular Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.

Introduction: We aimed to review the safety and effectiveness of dual-layer micromesh stents for the endovascular treatment of carotid artery stenosis.

Methods: Electronic bibliographic databases were searched using the words "micromesh carotid stent". The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards. Read More

J Gastroenterol Hepatol 2021 May 7. Epub 2021 May 7.

Department of Gastroenterology, Kanazawa University Hospital.

Objective: This study aimed to reveal the timing of bleeding and thromboembolism associated with endoscopic submucosal dissection (ESD) for early gastric cancer (EGC).

Methods: We retrospectively reviewed 10,320 patients who underwent ESD for EGC during November 2013-October 2016. We evaluated overall bleeding rates and their inter-group differences. Read More

CJEM 2021 May 20;23(3):325-329. Epub 2021 Jan 20.

Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada.

Background: Atrial fibrillation increases the risk of stroke, which can be mitigated by anticoagulant prescription. We evaluated local emergency physician anticoagulation practice for patients discharged from the emergency department with atrial fibrillation, along with 90-day incidence of stroke and major bleeding.

Methods: This was a health record review of patients diagnosed with new onset atrial fibrillation in two emergency departments between 2014 and 2017. Read More

Front Aging Neurosci 2021 20;13:646961. Epub 2021 Apr 20.

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.

Background: The risk of recurrent stroke following a minor stroke or transient ischemic attack (TIA) is high, when inflammation might play an important role. We aimed to evaluate the value of neutrophil to lymphocyte ratio (NLR) in predicting composite cardiovascular events in patients with minor stroke and TIA.

Methods: Consecutive patients with acute minor stroke or TIA admitted within 24 h of symptoms onset during a 5-year period in a prospective stroke registry were analyzed. Read More

BMJ Open 2021 May 6;11(5):e043862. Epub 2021 May 6.

Division of Cardiology, Department of Medicine, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.

Objective: To determine the effect of gender on clinical outcomes of Asian non-valvular atrial fibrillation patients.

Design: This is a cohort study.

Setting: 27 university and regional hospitals in Thailand. Read More

Clin Interv Aging 2021 28;16:707-719. Epub 2021 Apr 28.

Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Purpose: We aimed to compare the rate of clinical outcomes among three age groups (<65, 65-74, and ≥75 years) of adult patients with non-valvular atrial fibrillation (NVAF).

Patients And Methods: We prospectively enrolled NVAF patients from 27 Thailand medical centers. The following were collected at baseline: demographic data, risk factors, comorbid conditions, laboratory data, and medications. Read More

Stroke Vasc Neurol 2021 May 5. Epub 2021 May 5.

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

Background: In patients with a minor ischaemic stroke or transient ischaemic attack (TIA), separate trials have shown that dual antiplatelet therapy with clopidogrel plus aspirin (clopidogrel-aspirin) or ticagrelor plus aspirin (ticagrelor-aspirin) are more effective than aspirin alone in stroke secondary prevention. However, these two sets of combination have not been directly compared. Since clopidogrel was less effective in stroke patients who were loss-of-function (LOF) allele carriers, whether ticagrelor-aspirin is clinically superior to clopidogrel-aspirin in this subgroup of patients with stroke is unclear. Read More

BMJ Open 2021 May 5;11(5):e041566. Epub 2021 May 5.

Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

Objective: To investigate the long-term risk of developing hypertension and cardiovascular disease (CVD) among those women who suffered a postpartum haemorrhage (PPH) compared with those women who did not.

Design: Population-based longitudinal open cohort study.

Setting: English primary care (The Health Improvement Network (THIN)) and secondary care (Hospital Episode Statistics (HES)) databases. Read More

Ann Vasc Surg 2021 May 2. Epub 2021 May 2.

Vascular and Endovascular Surgery Unit, Department of Surgery, "Sapienza" University of Rome, Rome, Italy.

Introduction: Carotid artery stenting (CAS) has become a valid alternative to carotid endarterectomy in stroke prevention. However, female gender is still considered as an independent risk factor for CAS procedures, potentially limiting immediate and long-term benefits. Aim of present study was to evaluate gender differences in CAS submitted patients from an Italian high-volume center. Read More

Age Ageing 2021 May;50(3):744-757

Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.

Background: anticoagulation is integral to stroke prevention for atrial fibrillation (AF), but there is evidence of under-treatment in older people in long-term care (LTC).

Objective: to synthesise evidence on the prevalence and outcomes (stroke, mortality or bleeding) of AF in LTC and the factors associated with the prescription of anticoagulation.

Methods: studies were identified from Medline, CINAHL, PsycINFO, Scopus and Web of Science from inception to 31 October 2019. Read More

Stroke 2021 May 5:STROKEAHA120032809. Epub 2021 May 5.

Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston (L.H.S.).

Background And Purpose: Although most strokes present with mild symptoms, these have been poorly represented in clinical trials. The objective of this study is to describe multidimensional outcomes, identify predictors of worse outcomes, and explore the effect of thrombolysis in this population.

Methods: This prospective observational study included patients with ischemic stroke or transient ischemic attack, a baseline National Institutes of Health Stroke Scale (NIHSS) score 0 to 5, presenting within 4. Read More

Stroke 2021 May 5:STROKEAHA120032424. Epub 2021 May 5.

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (J.J., Y.S., A.W., Y.Z., Y.J., L.L., X.Z., Yilong Wang, Z.L., H.L., X.M., Yongjun Wang).

Background And Purpose: Whether imaging parameters would independently predict stroke recurrence in low-risk minor ischemic stroke (MIS) or transient ischemic attack (TIA) according to traditional score system (such as ABCD score, which was termed on the basis of the initials of the five factors: age, blood pressure, clinical features, duration, diabetes) remains unclear. We sought to evaluate the association between imaging parameters and 1-year stroke recurrence in patients with TIA or MIS in different risk stratum stratified by ABCD score.

Methods: We included patients with TIA and MIS (National Institutes of Health Stroke Scale score ≤3) with complete baseline vessel and brain imaging data from the Third China National Stroke Registry III. Read More

S Afr Med J 2021 03 31;111(4):338-342. Epub 2021 Mar 31.

Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.

Background: International guidelines recommend risk stratification to identify high-risk non-cardiac surgical patients. It is also recommended that all patients aged ≥45 years with significant cardiovascular disease should have preoperative natriuretic peptide (NP) testing. Abnormal preoperative B-type NPs have a strong association with postoperative cardiac complications. Read More

J Neuroimaging 2021 May 4. Epub 2021 May 4.

Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA.

Background And Purpose: It is unknown whether intracranial atherosclerotic disease (ICAD), in addition to causing stenosis, also associates with abnormal arterial enlargement, a condition known as intracranial dolichoectasia (IDE). Across symptomatic ICAD patients, we aim to determine IDE prevalence and IDE impact on cerebral hemodynamics and recurrent cerebral ischemia.

Methods: We analyzed 98 participants (mean age 63. Read More

Stroke 2021 May 4:STROKEAHA121034089. Epub 2021 May 4.

Department of Neurology and Department of Psychiatry, University of Massachusetts Medical Center, Worcester (N.H.).

Background And Purpose: Randomized trials demonstrated the benefit of dual antiplatelet therapy in patients with minor ischemic stroke or high-risk transient ischemic attack. We sought to determine whether the presence of carotid stenosis was associated with increased risk of ischemic stroke and whether the addition of clopidogrel to aspirin was associated with more benefit in patients with versus without carotid stenosis.

Methods: This is a post-hoc analysis of the POINT trial (Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke) that randomized patients with minor ischemic stroke or high-risk transient ischemic attack within 12 hours from last known normal to receive either clopidogrel plus aspirin or aspirin alone. Read More

J Vasc Surg 2021 Apr 30. Epub 2021 Apr 30.

Introduction: Spinal drain (SD) placement is an adjunct used in open and endovascular aortic surgery to mitigate the risk of spinal cord injury. SD placement can lead to subdural hematoma and intracranial hemorrhage (SDH/ICH). Previous studies have highlighted a correlation between incidence of SDH/ICH and amount of cerebrospinal fluid (CSF) drained. Read More

J Vasc Surg 2021 Apr 30. Epub 2021 Apr 30.

Vascular Surgery Unit, First Department of Propedeutic Surgery, National and Kapodistrian University of Athens, Hippocration Hospital, Athens, Greece.

Introduction: ExtraCranial Carotid artery Aneurysms (ECCAs) are rare, although they are associated with a high stroke and mortality risk if untreated. This review aims to compare major outcomes between open and endovascular repair of ECCAs.

Methods: We systematically searched PubMed, Embase, Scopus, and the Cochrane Library for clinical studies published online up to September 2020 that evaluated major outcomes after both open and endovascular repair of ECCAs. Read More

PLoS Med 2021 May 3;18(5):e1003601. Epub 2021 May 3.

Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium.

Background: Oral bleeding after dental extraction in patients on non-vitamin K oral anticoagulants (NOACs) is a frequent problem. We investigated whether 10% tranexamic acid (TXA) mouthwash decreases post-extraction bleeding in patients treated with NOACs.

Methods And Findings: The EXTRACT-NOAC study is a randomized, double-blind, placebo-controlled, multicenter, clinical trial. Read More

Front Neurol 2021 14;12:652941. Epub 2021 Apr 14.

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

To determine the association between serum phosphate level and 1-year clinical outcomes in patients with acute ischemic stroke and transient ischemic attack. We included 7,353 patients with acute ischemic stroke and transient ischemic attack from the China National Stroke Registry III for analysis. Participants were divided into 4 groups according to serum phosphate quartiles. Read More

Front Neurol 2021 15;12:613758. Epub 2021 Apr 15.

Department of Neurology, Austin Health, Heidelberg, VIC, Australia.

Patent foramen ovale (PFO) is associated with ischemic stroke, especially in patients with embolic stroke of undetermined source. This study aims to evaluate the presence of atrial fibrillation (AF) in ischemic stroke patients with PFO. We systematically searched EMBASE and MEDLINE databases on May 21, 2020 for studies that analyzed the presence of AF in patients with PFO. Read More

JACC Clin Electrophysiol 2021 Apr 22. Epub 2021 Apr 22.

IHU LIRYC ANR-10-IAHU-04, Centre Hospitalier Universitaire Bordeaux, Bordeaux University, Bordeaux, France.

Objective: This study sought to determine whether durable pulmonary vein isolation (PVI) using pulsed field ablation (PFA) translates to freedom from atrial fibrillation recurrence without an increase in adverse events.

Background: PFA is a nonthermal ablative modality that, in preclinical studies, is able to preferentially ablate myocardial tissue with minimal effect on surrounding tissues. Herein, we present 1-year clinical outcomes of PFA. Read More

ESC Heart Fail 2021 May 1. Epub 2021 May 1.

Department of Cardiology, IIS-Fundación Jiménez Díaz, Avda. Reyes Católicos 2, Madrid, 28040, Spain.

Aims: There are controversial data on the ability of the components of mineral metabolism (vitamin D, phosphate, parathormone [PTH], fibroblast growth factor-23 [FGF23], and klotho) to predict cardiovascular events. In addition, it is unknown whether they add any prognostic value to other well-known biomarkers.

Methods And Results: In 969 stable coronary patients, we determined plasma levels of all the aforementioned components of mineral metabolism with a complete set of clinical and biochemical variables, including N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hs-TnI), and high-sensitivity C-reactive protein. Read More

Oper Neurosurg (Hagerstown) 2021 Apr 30. Epub 2021 Apr 30.

Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, USA.

Management options for carotid stenosis include medical management, carotid endarterectomy, carotid stenting with distal filter protection, or stenting with either flow arrest or flow reversal techniques.1 Flow reversal with transcarotid artery revascularization (TCAR) technique represents a hybrid approach with surgical access to the common carotid for endovascular placement of a stent in the internal carotid artery. This direct access to the carotid artery avoids navigating the challenging anatomy of the aortic arch with endovascular devices. Read More

Front Neurol 2021 13;12:661779. Epub 2021 Apr 13.

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

Polyvascular disease (PolyVD) and interleukin (IL)-6 are associated with poor outcomes in patients with stroke respectively. However, whether combined PolyVD and elevated IL-6 levels would increase the risk of poor outcomes of stroke patients is yet unclear. Data were obtained from the Third China National Stroke Registry (CNSR-III). Read More

J Neurosci Rural Pract 2021 Apr 3;12(2):273-280. Epub 2021 Mar 3.

Christian Medical College and Hospital, Ludhiana, Punjab, India.

 Migraine auras are transient neurological symptoms, usually lasting for approximately 5 to 30 minutes before the onset of migraine pain. Out of various types of auras, visual aura is the commonest and has variable manifestations, forming approximately 90% of auras. These visual auras may be of particular interest to the ophthalmologist as well as to the neurologist. Read More

Thromb J 2021 Apr 29;19(1):28. Epub 2021 Apr 29.

Cardiac Medical Unit, Grantham Hospital, 125 Wong Chuk Hang Road, Hong Kong SAR, China.

Background: For patients taking warfarin and undergoing pacemaker or implantable cardioverter-defibrillator surgery, clinical evidence and guidelines support continuation of warfarin therapy, as opposed to interruption of warfarin therapy with heparin bridging. Interruption of warfarin without post-operative bridging therapy may be a feasible alternative but data is sparse.

Methods: This is a single-arm observational study including adults who had interruption of warfarin therapy without post-operative bridging therapy for cardiac implantable electronic device (CIED) surgery performed between 2010 and 2019 in a tertiary referral hospital. Read More