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Multi‐modal CT in acute stroke: wait for a serum creatinine before giving intravenous contrast? No!
ConclusionsThe incidence of CIN is low when MMCT is used routinely to assess acute stroke patients. In this population, CIN was a biochemical phenomenon that did not have clinical manifestations, cause chronic kidney disease, require dialysis, or negatively impact on 90‐day mRS outcomes. Renal profiling and waiting for a baseline serum‐creatinine are an unnecessary delay to emergency reperfusion treatment.
Source: International Journal of Stroke - August 26, 2015 Category: Neurology Authors: Timothy E. Ang, Andrew Bivard, Christopher Levi, Henry Ma, Chung Y. Hsu, Bruce Campbell, Geoffrey Donnan, Stephen M. Davis, Mark Parsons Tags: Research Source Type: research

Neurons Over Nephrons Clinical Sciences
Background and Purpose—Because of the perceived risk of contrast-induced acute kidney injury (AKI), many centers require pre-imaging serum creatinine levels, potentially delaying care. We performed a systematic review and meta-analysis evaluating AKI rates in patients with acute ischemic stroke receiving computed tomographic angiography (CTA) and computed tomographic perfusion (CTP).Methods—We searched MEDLINE, EMBASE, and the Web of Science through December 2016 for studies reporting on AKI in patients with acute ischemic stroke receiving CTA/CTP. Using a random-effects model, estimates were pooled across studies. Out...
Source: Stroke - June 26, 2017 Category: Neurology Authors: Waleed Brinjikji, Andrew M. Demchuk, Mohammad H. Murad, Alejandro A. Rabinstein, Robert J. McDonald, Jennifer S. McDonald, David F. Kallmes Tags: Imaging, Cerebrovascular Disease/Stroke, Ischemic Stroke Original Contributions Source Type: research

Higher Levels of Cystatin C Are Associated with Extracranial Carotid Artery Steno-Occlusive Disease in Patients with Noncardioembolic Ischemic Stroke
Background: Large artery atherosclerosis is a major cause of ischemic stroke worldwide. Differential biomarker profiles associated with extra- and intracranial atherosclerosis are a topic of considerable interest. Cystatin C (CysC), a marker of renal function, is a risk factor for cardiovascular disease. Aim: We sought to determine whether CysC levels were associated with extra- and intracranial large artery stenosis (LAS) in patients with acute ischemic stroke. Methods: We retrospectively analyzed data of acute noncardioembolic ischemic stroke patients who were admitted to our stroke center within 5 days from symptom onse...
Source: Cerebrovascular Diseases Extra - January 19, 2016 Category: Neurology Source Type: research

Dabigatran Reversal with Idarucizumab Preceding Thrombolysis in an Octogenarian Patient with Chronic Kidney Disease and Acute Stroke: a Case Report.
CONCLUSION: Our case showed the effectiveness and safety of giving Idarucizumab followed by thrombolysis in Dabigatran-treated atrial fibrillation with ischemic stroke. Based on this case, the procedure can be performed in an elderly population with chronic kidney disease when administered close to the limit of threshold for thrombolysis. PMID: 32778345 [PubMed - as supplied by publisher]
Source: Clinical Therapeutics - August 6, 2020 Category: Drugs & Pharmacology Authors: Laxamana LC, Co COC, Yu JRT, Mojica CV, Iboleon-Dy MAM, Domingo AMC, Ilano KCS, Macrohon-Valdez MCZ Tags: Clin Ther Source Type: research

Predictors of unknown cancer in patients with ischemic stroke
AbstractStroke is the second most frequent neurologic finding in postmortem studies of cancer patients. It has also been described as the first expression of an occult cancer. We have studied patients diagnosed with cancer after an ischemic stroke (IS) and we analyze differences with non-tumor patients. Single cohort longitudinal retrospective study of patients admitted to our center with IS diagnosis from 1 January 2012 to 12 December 2014. All patients were followed for 18  months. Patients with transient ischemic infarction or cerebral hemorrhage, active cancer or in the last 5 years, inability to follow-up or absence...
Source: Journal of Neuro-Oncology - January 8, 2018 Category: Cancer & Oncology Source Type: research

Contrast-Induced Acute Kidney Injury in Radiologic Management of Acute Ischemic Stroke in the Emergency Setting INTERVENTIONAL
CONCLUSIONS: Patients with low baseline renal function had the highest incidence of postcontrast acute kidney injury after CTA and cerebral angiography, but no fatal adverse effects were documented. Thus, patients suspected of having a stroke should be actively managed with respect to neurovascular function.
Source: American Journal of Neuroradiology - April 8, 2020 Category: Radiology Authors: Myung, J. W., Kim, J. H., Cho, J., Park, I., Kim, H. Y., Beom, J. H. Tags: INTERVENTIONAL Source Type: research

Distal Vessel Imaging via Intra-arterial Flat Panel Detector CTA during Mechanical Thrombectomy INTERVENTIONAL
CONCLUSIONS: In acute ischemic stroke with large-vessel occlusion, flat panel detector CT angiographic images could successfully visualize vessels distal to the occlusion site with a small amount of contrast material.
Source: American Journal of Neuroradiology - February 9, 2021 Category: Radiology Authors: Nozaki, T., Noda, M., Ishibashi, T., Otani, K., Kogiku, M., Abe, K., Kishi, H., Morita, A. Tags: INTERVENTIONAL Source Type: research

Impact of anemia on long-term outcomes in patients treated with first and second-generation drug-eluting stents Katowice-Zabrze Registry.
CONCLUSIONS: In patients with anemia is significant higher risk of death in the 12-month follow-up, while anemia has no impact on the incidence of MI, repeat revascularization, and stroke. There is no advantage DES II over DES I generation in terms of MACCE and TVR in patients with anemia. PMID: 26575311 [PubMed - as supplied by publisher]
Source: Polish Heart Journal - November 17, 2015 Category: Cardiology Authors: Wańha W, Kawecki D, Roleder T, Pluta A, Marcinkiewicz K, Dola J, Morawiec B, Krzych Ł, Pawłowski T, Smolka G, Ochała A, Nowalany-Kozielska E, Tendera M, Wojakowski W Tags: Kardiol Pol Source Type: research

Impact of Impaired Renal Function in Patients With Severely Calcified Coronary Lesions Treated With Orbital Atherectomy.
CONCLUSION: Despite higher-risk baseline characteristics, patients with CKD had no significant differences in MACCE. Orbital atherectomy represents a reasonable treatment strategy for the treatment of severe CAC in patients with CKD. A prospective randomized trial with long-term follow-up is needed to identify the optimal treatment for these patients. PMID: 28089999 [PubMed - as supplied by publisher]
Source: The Journal of Invasive Cardiology - January 18, 2017 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Contrast induced encephalopathy mimicking reperfusion injury (P3.285)
Conclusions:Diagnostic or therapeutic angiography is frequently performed for acute ischemic or hemorrhagic stroke. Clinicians should be aware of contrast induced encephalopathy and consider it in cases of neurologic deterioration after angiography in order to initiate appropriate treatment and avoid unnecessary invasive tests.Disclosure: Dr. Bakradze has nothing to disclose. Dr. Pasquale has nothing to disclose. Dr. Kirchoff-Torres has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Bakradze, E., Pasquale, D., Kirchoff-Torres, K. Tags: Cerebrovascular Disease Case Reports II Source Type: research

Plasma Metal Concentrations and Incident Coronary Heart Disease in Chinese Adults: The Dongfeng-Tongji Cohort
Conclusions: Our study suggested that incident CHD was positively associated with plasma levels of titanium and arsenic, and inversely associated with selenium. Additional research is needed to confirm these findings in other populations. https://doi.org/10.1289/EHP1521 Received: 22 December 2016 Revised: 17 September 2017 Accepted: 19 September 2017 Published: 19 October 2017 Address correspondence to T. Wu, or A. Pan, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hongkong Rd., Wuhan 430030, Hubei, China. Telephone: +86-27-83692347. Email: wut@mails.tjmu.edu.cn or p...
Source: EHP Research - October 20, 2017 Category: Environmental Health Authors: Daniil Lyalko Tags: Research Source Type: research

Severe Symptoms, but a Truly Treatable Disease
​BY NOURA MAHDI; DARRON LEWIS; JEREMY OSBORNE; & AHMED RAZIUDDIN, MDA 73-year-old man was brought to the emergency department from his nursing home for rectal bleeding and anemia. The patient mentioned he had had episodes of bright red rectal bleeding and constipation for a few months. A colonoscopy had been done prior to the visit, which revealed a large intestine tumor and biopsy confirming adenocarcinoma. He was awaiting an appointment with his surgeon.The patient reported bloody rectal leakage, and a CBC done at the nursing home showed a hemoglobin level of 7.2. He also complained of dyspnea but denied any other ...
Source: The Case Files - March 20, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Design, methods, baseline characteristics and interim results of the Catheter Sampled Blood Archive in Cardiovascular Diseases (CASABLANCA) study
Conclusions The CASABLANCA study will examine the role of novel biomarkers and metabolomics for predicting a wide range of cardiovascular, neurologic, and renal complications in patients undergoing angiography. Full results are expected in the latter half of 2014 (Clinical Trials.Gov # NCT00842868).
Source: IJC Metabolic and Endocrine - November 1, 2014 Category: Endocrinology Source Type: research

Circulating tumor necrosis factor receptors 1 and 2 predict contrast‐induced nephropathy and progressive renal dysfunction: a prospective cohort study
ConclusionMarkedly elevated concentrations of circulating TNFRs were correlated with the occurrence of CIN and significantly associated with prolonged renal dysfunction regardless of the development of CIN.
Source: Nephrology - March 1, 2015 Category: Urology & Nephrology Authors: Jung Nam An, Kyung Don Yoo, Jin Ho Hwang, Hack‐Lyoung Kim, Sang‐Hyun Kim, Seung Hee Yang, Jin Hyuk Kim, Dong Ki Kim, Yun Kyu Oh, Yon Su Kim, Chun Soo Lim, Jung Pyo Lee Tags: Original Article Source Type: research

Peripheral arterial disease and critical limb ischaemia: still poor outcomes and lack of guideline adherence
Conclusion Regardless of recent advances in PAD treatment, current outcomes remain poor especially in CLI. Despite overwhelming evidence for reduction of limb loss by revascularization, CLI patients still received significantly less angiographies and revascularizations.
Source: European Heart Journal - April 14, 2015 Category: Cardiology Authors: Reinecke, H., Unrath, M., Freisinger, E., Bunzemeier, H., Meyborg, M., Luders, F., Gebauer, K., Roeder, N., Berger, K., Malyar, N. M. Tags: Peripheral artery disease Source Type: research

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