Assessment of the effects of dysphagia therapy in patients in the early post-stroke period: a randomised controlled trial.

CONCLUSIONS: A comprehensive therapy for dysphagia is effective and can reduce serious complications of swallowing disorders in clinical practice. CLINICAL IMPLICATIONS: The results of this study could improve the clinical treatment of dysphagia. PMID: 31724147 [PubMed - as supplied by publisher]
Source: Neurologia i Neurochirurgia Polska - Category: Neurology Authors: Tags: Neurol Neurochir Pol Source Type: research

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Leptomeningeal anastomoses or pial collateral vessels play a critical role in cerebral blood flow (CBF) restoration following ischemic stroke. The magnitude of this adaptive response is postulated to be controlled by the endothelium, although the underlying molecular mechanisms remain under investigation. Here we demonstrated that endothelial genetic deletion, using EphA4fl/fl/Tie2-Cre and EphA4fl/fl/VeCahderin-CreERT2 mice and vessel painting strategies, implicated EphA4 receptor tyrosine kinase as a major suppressor of pial collateral remodeling, CBF, and functional recovery following permanent middle cerebral artery occ...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
Review of English-language articles published from PubMed (MEDLINE) and Google Scholar between January 1, 1985, and January 1, 2019.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Crescendo transient ischemic attacks should be treated by carotid endarterectomy within two days – but with increased perioperative stroke risk Source Type: research
Multicenter retrospective analysis of patients entered in the prospective, randomized International Carotid Stenting Study between May 2001 and October 2008.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Open-cell stents used for carotid artery stenting are less likely to develop recurrent stenosis than closed-cell stents Source Type: research
Currently there is no definitive level I evidence regarding the appropriate management of asymptomatic moderate to severe carotid artery stenosis in the octogenarian patient. In this 5-year review of National Surgical Quality Improvement Program registry data, exceptional “real-world” results are reported with use of carotid endarterectomy (CEA) in this growing cohort.1 The combined stroke and death rate was 2% at 30-day follow-up (stroke rate 1%!), with the authors stating that “age alone should not interdict this modality.”
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Invited commentary Source Type: research
Conclusion The impact of sepsis on the gut is manifold, e.g., sepsis mediated alteration of the gut-blood barrier and increase in the intestinal permeability, which may correlate with the phenomena of bacterial translocation and lymphatic activation (“toxic-lymph”). Systemic consequences of sepsis are widespread and concern to the coagulative system, the microbiome as well as enzymes, such as pancreatic proteases, MMPs and IAPs. Nevertheless, the therapeutic approaches for modulating the mucosal immune system are still rarely effective in daily routine. Recent published studies showing that treatment with FMT,...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
By ANISH KOKA Part 1 Part 2 Physicians have been making up numbers longer than people have been guessing weights at carnivals.  How much does this statin lower the chances of a heart attack? How long do I have to live if I don’t get the aortic valve surgery? In clinics across the land confident answers emerge from doctors in white coats.  Most of the answers are guesses based on whatever evidence about the matter exists applied to the patient sitting in the room.  The trouble is that the evidence base used to be the provenance of experts and anecdotes that have in the past concluded leeches were good f...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs
Conclusions—There were insufficient RCT data to determine the effect of dysphagia screening protocols on reducing the rates of pneumonia, death, or dependency after stroke. Additional trials are needed to compare the validity, feasibility, and clinical effectiveness of different screening methods for dysphagia.
Source: Stroke - Category: Neurology Authors: Tags: Statements and Guidelines AHA/ASA Systematic Review Source Type: research
This study adds to this literature using propensity score matching to limit confounding and by examining the effects of selective and non-selective β-blockers. Prospective data from acute ischemic stroke admissions at a single center f rom July 2010–June 2015 were analyzed. Outcomes included infection (urinary tract infection [UTI], pneumonia, or bacteremia), discharge modified Rankin Score (mRS), and in-hospital death. Any selective and non-selective β-blocker use during the first 3 days of admission were investigated with pr opensity score matching. A sensitivity analysis was also performed. This stu...
Source: Neurological Sciences - Category: Neurology Source Type: research
Conclusions— This study indicates an increased risk for ischemic strokes in DMD patients. Regular cardiological assessment of all DMD patients is mandatory to evaluate the individual risk profile for cardioembolic events and to adapt therapeutic strategies.
Source: Stroke - Category: Neurology Authors: Tags: Cardiomyopathy, Ischemic Stroke Brief Reports Source Type: research
Conclusions In posterior fossa stroke patients with a GCS ≤ 6 at the time of intubation and who remain intubated for more than 1 week, extubation is less likely to be successful, and tracheostomy should be considered.
Source: Neurocritical Care - Category: Neurology Source Type: research
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