Anesthesiological management in endovascular stroke treatment.

[Anesthesiological management in endovascular stroke treatment]. Anaesthesist. 2019 Jul 19;: Authors: Theilen HJ, Gerber JC Abstract Early recanalization of the closed cerebral arteries after acute ischemic stroke (AIS) is the only treatment to minimize long-term disability and to reduce the associated morbidity and mortality. For a long time the only proven causal treatment of AIS was intravenous thrombolysis; however, after the publication of a series of randomized prospective studies concerning endovascular mechanical thrombectomy using stent retriever systems after AIS, new guidelines were published. It was found that endovascular treatment (EVT) dramatically improves the outcome of eligible patients. The stent retriever enables high recanalization rates by clot removal from the cerebral arterial system by means of aspiration of the thrombus via the catheter and/or by entrapping it with a stent system. The management of anesthesia during the procedure is indispensable to prevent hypoxia and hemodynamic instability; however, which form of anesthesia (i.e. general anesthesia vs. conscious sedation) is advantageous for the patient during EVT is controversially discussed. In the first studies using retrospective data conscious sedation resulted in a better outcome compared to general anesthesia following EVT; however, in prospective studies this finding could not be confirmed. To obtain optimal neurological results after AIS and EVT w...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research

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This article is protected by copyright. All rights reserved. PMID: 31581363 [PubMed - as supplied by publisher]
Source: Biomed Res - Category: Research Authors: Tags: J Biomed Mater Res A Source Type: research
In conclusion, older adults exhibited decreased markers of UPR activation and reduced coordination with autophagy and SC-associated gene transcripts following a single bout of unaccustomed resistance exercise. In contrast, young adults demonstrated strong coordination between UPR genes and key regulatory gene transcripts associated with autophagy and SC differentiation in skeletal muscle post-exercise. Taken together, the present findings suggest a potential age-related impairment in the post-exercise transcriptional response that supports activation of the UPR and coordination with other exercise responsive pathways (i.e....
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Authors: Shiyovich A, Kornowski R Abstract BACKGROUND: Aortic stenosis (AS) is a common valvular pathology and is increasing in prevalence. Severe symptomatic AS is associated with serious outcomes if left untreated. Transcatheter aortic valve implantation (TAVI) is an innovative modality, which has revolutionized the treatment of AS. With growing experience and technological upgrades, TAVI has become a valid alternative to surgical valve replacement. However, TAVI is associates with increase non-negligible risks of mortality, stroke, physical disability, and healthcare expenditures. Furthermore, imaging modalities...
Source: The Israel Medical Association Journal - Category: General Medicine Tags: Isr Med Assoc J Source Type: research
Authors: Medeiros CSP, Pacheco TBF, Cavalcanti FADC, Cacho RO, Bezerra AMDS Abstract Primary Objective: To compare the level of motor, sensory and functional impairment of individuals hospitalized in a stroke unit in Brazil at the time of admission and the profile observed at hospital discharge. Design: Observational and longitudinal outcome study. Methods and Procedure: We assessed 41 patients with ischemic stroke at admission and hospital discharge by using the National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer Physical Performance Scale (FM), Functional Independence Measure (FIM) and Modified Rankin S...
Source: Brain Injury - Category: Neurology Tags: Brain Inj Source Type: research
Abstract Background and Objectives: Ischaemic stroke (IS) is the leading cause of death and disability worldwide. All stages of cerebral ischaemia, but especially acute phase, are associated with inflammatory response. Recent studies showed that neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) may be used to assess inflammation in IS. To test whether there is a relationship between these parameters and type of stroke treatment, we analysed NLR and LMR in IS patients treated with three different modalities. Materials and Methods: The study included 58 adults with acute IS. A total of 28 p...
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
Publication date: Available online 2 July 2019Source: Computational and Structural Biotechnology JournalAuthor(s): Jan Mican, Martin Toul, David Bednar, Jiri DamborskyAbstract:Myocardial infarction and ischemic stroke are the most frequent causes of death or disability worldwide. Due to their ability to dissolve blood clots, the thrombolytics are frequently used for their treatment. Improving the effectiveness of thrombolytics for clinical uses is of great interest. The knowledge of the multiple roles of the endogenous thrombolytics and the fibrinolytic system grows continuously. The effects of thrombolytics on the alterat...
Source: Computational and Structural Biotechnology Journal - Category: Biotechnology Source Type: research
This study sought to investigate what could be learned from how these men have fared. The men were born in 1925-1928 and similar health-related data from questionnaires, physical examination, and blood samples are available for all surveys. Survival curves over various variable strata were applied to evaluate the impact of individual risk factors and combinations of risk factors on all-cause deaths. At the end of 2018, 118 (16.0%) of the men had reached 90 years of age. Smoking in 1974 was the strongest single risk factor associated with survival, with observed percentages of men reaching 90 years being 26.3, 25.7, ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Publication date: September 2019Source: Biomedicine &Pharmacotherapy, Volume 117Author(s): Shilun Yang, Haigang Wang, Yinglin Yang, Rui Wang, Yuehua Wang, Chunfu Wu, Guanhua DuAbstractIschemic stroke is a cerebrovascular disease with high morbidity, high mortality, and high disability, representing a serious threat to human life and health. Clinically, the extensive injury caused by ischemic stroke results from ischemia-reperfusion (I/R) injury thrombolytic treatment. However, there are few reports on the use of medications in the subacute stage of cerebral I/R. Baicalein (5,6,7-trihydroxyflavone) is a biologically act...
Source: Biomedicine and Pharmacotherapy - Category: Drugs & Pharmacology Source Type: research
Abstract Ischemic stroke is a cerebrovascular disease with high morbidity, high mortality, and high disability, representing a serious threat to human life and health. Clinically, the extensive injury caused by ischemic stroke results from ischemia-reperfusion (I/R) injury thrombolytic treatment. However, there are few reports on the use of medications in the subacute stage of cerebral I/R. Baicalein (5,6,7-trihydroxyflavone) is a biologically active ingredient extracted from the root of Scutellaria baicalensis Georgi. In the present study, we investigated the therapeutic effect of baicalein administered in the su...
Source: Biomedicine and pharmacotherapy = Biomedecine and pharmacotherapie - Category: Drugs & Pharmacology Authors: Tags: Biomed Pharmacother Source Type: research
Publication date: Available online 24 May 2019Source: The LancetAuthor(s): Natan M Bornstein, Jeffrey L Saver, Hans Christoph Diener, Philip B Gorelick, Ashfaq Shuaib, Yoram Solberg, Lisa Thackeray, Milan Savic, Tamar Janelidze, Natia Zarqua, David Yarnitsky, Carlos A Molina, Ashfaq Shuaib, Michael Hill, Daniel Vaclavik, David Skoloudik, Jan Fiksa, Grethe Andersen, Pekka Jakala, Turgut TatlisumakSummaryBackgroundSphenopalatine ganglion stimulation increased cerebral collateral blood flow, stabilised the blood–brain barrier, and reduced infarct size, in preclinical models of acute ischaemic stroke, and showed potentia...
Source: The Lancet - Category: General Medicine Source Type: research
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