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Special MRI scan could identify stroke risk in people with atrial fibrillation
Atrial fibrillation is a heart rhythm disorder that affects millions of people. It can make you feel lousy. Even worse, it can cause potentially disabling or deadly strokes. A special MRI scan may — I stress the “may” — help identify people with atrial fibrillation who are at high risk of having a stroke. This could help many people with this condition to avoid taking warfarin or other clot-preventing medications for life. A normal heartbeat starts in a cluster of cells called the pacemaker. It sits in the heart’s upper right chamber (the right atrium). These cells generate a pulse of electricity that...
Source: New Harvard Health Information - April 28, 2015 Category: Consumer Health News Authors: Howard LeWine, M.D. Tags: Heart Health atrial fibrillation MRI prevention special MRI scan Stroke Stroke Risk Source Type: news

Pre-hospital imaging and thrombolysis in acute stroke in an urban US setting: results of the Cleveland Pre-Hospital Acute Stroke Treatment (PHAST) study group. (S21.002)
CONCLUSIONS: Close to a fifth of patients received acute stroke treatment on MSTU. These findings demonstrate the successful reduction in time to diagnosis and treatment of acute stroke patients using a MSTU. Study Supported by:Disclosure: Dr. Briggs has nothing to disclose. Dr. Taqui has nothing to disclose. Dr. Cerejo has nothing to disclose. Dr. Itrat has nothing to disclose. Dr. Donohue has nothing to disclose. Dr. Organek has nothing to disclose. Dr. Buletko has nothing to disclose. Dr. Sheikhi has nothing to disclose. Dr. Buttrick has nothing to disclose. Dr. Khawaja has nothing to disclose. Dr. Wisco has nothing to ...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Briggs, F., Taqui, A., Cerejo, R., Itrat, A., Donohue, M., Organek, N., Buletko, A., Sheikhi, L., Buttrick, M., Khawaja, Z., Wisco, D., Winners, S., Reimer, A., Frontera, J., Manno, E., Hustey, F., Kralovic, D., Peter, R., Hussain, M., Uchino, K. Tags: Cerebrovascular Disease and Interventional Neurology: Prehospital and Acute Ischemic Stroke Treatment Source Type: research

Outcome of men and women after atrial fibrillation and stroke
ConclusionsThere were no gender differences in long‐term mortality after stroke related to AF. Men were significantly more often prescribed anticoagulants before stroke, a finding that indicates the need for further studies.
Source: Acta Neurologica Scandinavica - February 1, 2015 Category: Neurology Authors: A.‐C. Jönsson, J. Ek, C. Kremer Tags: Original Article Source Type: research

Warfarin treatment and risk of stroke among primary care patients with atrial fibrillation.
Conclusions Warfarin is effective in preventing stroke in AF patients in primary health care. PMID: 27460750 [PubMed - as supplied by publisher]
Source: Scandinavian Cardiovascular Journal - July 28, 2016 Category: Cardiology Tags: Scand Cardiovasc J Source Type: research

Dabigatran etexilate: management in acute ischemic stroke.
Abstract A 54-year-old man treated with dabigatran experienced new onset of a stroke with a score of 9 on the National Institutes of Health Stroke Scale. Administration of recombinant tissue plasminogen activator (rtPA) was not recommended because of the dabigatran therapy. Angiography showed occlusion of the left middle cerebral artery by an embolic thrombus. Suction thrombectomy achieved flow through the inferior division of the artery. Computed tomography of the head showed possible intracranial hemorrhage, and dabigatran reversal was attempted with prothrombin complex concentrate and recombinant factor VIIa. C...
Source: American Journal of Critical Care - March 1, 2013 Category: Nursing Authors: Javedani PP, Horowitz BZ, Clark WM, Lutsep HL Tags: Am J Crit Care Source Type: research

Early introduction of direct oral anticoagulants in cardioembolic stroke patients with non-valvular atrial fibrillation
AbstractDirect oral anticoagulants (DOACs) are superior to warfarin in reduction of the intracranial bleeding risk. The aim of the present study was to assess whether early DOAC introduction (1 –3 days after onset) in stroke patients with non-valvular atrial fibrillation (nVAF) may be safe and effective, compared with DOAC introduction after 4–7 days. We conducted a prospective analysis based on data collected from 147 consecutive nVAF patients who started DOAC within 7 days after stro ke onset. In all patients, we performed pre-DOAC CT scan 24–36 h after onset and follow-up CT scan at 7 days after DOAC introduction...
Source: Journal of Thrombosis and Thrombolysis - September 3, 2016 Category: Hematology Source Type: research

An overlooked cause in a patient with recurrent ischemic stroke: A case report
Rationale: The majority of ischemic strokes are due to cardioembolism, large vessel atherothromboembolism, small vessel occlusive disease, or other unusual mechanisms. In most clinical settings, many strokes without a well-defined etiology requires a thorough diagnostic evaluation, otherwise the underlying cause might be easily overlooked. Here we report on the rare cause of a patient with recurrent stroke. Patient concerns: A 50-year-old female patient had a 4-year history of recurrent acute onset of neurological deficits. Diagnoses: Contrast transcranial Doppler ultrasound detected a typical “curtain” appeara...
Source: Medicine - March 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Anticoagulant-related intracranial haemorrhage: time to anticoagulant reversal improving but still slower than thrombolysis for ischaemic stroke.
CONCLUSION: Door-to-any-reversal-agent and scan-to-PCC times have improved over time, but they remain significantly longer than IS thrombolysis times. Monitoring of reversal is inadequate, particularly for WRICH receiving PCC. PMID: 33582709 [PubMed - in process]
Source: New Zealand Medical Journal - February 17, 2021 Category: General Medicine Tags: N Z Med J Source Type: research

The dangerous gamble of heparinization within two weeks of nonoperative traumatic acute subdural hematoma in patients with increased stroke risk: A case series
Conclusion: Heparinization within two weeks of aSDH may cause SDH enlargement resulting in rapidly fatal neurologic deterioration. Further study is needed to more definitively address this issue.
Source: Journal of Postgraduate Medicine - May 13, 2014 Category: Internal Medicine Authors: S McClellandSJ MackeySS Kim Source Type: research

Safety of Mechanical Thrombectomy for Acute Ischemic Stroke in Patients on Novel Oral Anticoagulants (P1.196)
Conclusion: Patients on NOAC undergoing mechanical thrombectomy show a trend towards increased sICH compared to the warfarin group. This may warrant larger studies of safety of mechanical thrombectomy in the presence of NOACs.Disclosure: Dr. Sharma has nothing to disclose. Dr. Atchaneeyasakul has nothing to disclose. Dr. Ziayee has nothing to disclose. Dr. Malik has nothing to disclose. Dr. Guada has nothing to disclose. Dr. Khandelwal has nothing to disclose. Dr. Ramdas has nothing to disclose. Dr. Yavagal has received personal compensation for activities with Covidien/evV3 as a consultant and Steering Committee Member.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Sharma, P., Atchaneeyasakul, K., Ziayee, H., Malik, A., Guada, L., Khandelwal, P., Ramdas, K., Yavagal, D. Tags: Acute Endovascular Therapy: Outcomes and Safety Source Type: research

Prognostic significance of delayed intraventricular haemorrhage in the INTERACT studies
Conclusions Although linked to factors determining greater ICH growth including poor SBP control, dIVH is independently associated with poor outcome in acute small to moderate-size ICH. Trial registration numbers NCT00226096 and NCT00716079.
Source: Journal of Neurology, Neurosurgery and Psychiatry - December 14, 2016 Category: Neurosurgery Authors: Moullaali, T. J., Sato, S., Wang, X., Rabinstein, A. A., Arima, H., Carcel, C., Chen, G., Robinson, T., Heeley, E., Chan, E., Delcourt, C., Stapf, C., Cordonnier, C., Lindley, R. I., Chalmers, J., Anderson, C. S., for the INTERACT Investigators Tags: Stroke, Hypertension Cerebrovascular disease Source Type: research

How To Avoid China ’ s Medicine Monopoly
I want to share a shocking statistic with you… Around 80% of all the pharmaceuticals sold in America — both prescription and over-the-counter — are manufactured in China. I’m talking about drugs for Parkinson’s and Alzheimer’s, blood pressure and blood thinners, diuretics, aspirin, antibiotics, and a big chunk of the world’s insulin and diabetes drugs — just to name a few.1 We don’t even make penicillin anymore. The last penicillin plant in the U.S. closed its doors in 2004. Americans who rely on medicine are now almost entirely at the mercy of a country whose relations with the U.S. have become more ...
Source: Al Sears, MD Natural Remedies - September 19, 2023 Category: Complementary Medicine Authors: Jacob Tags: Health Source Type: news

Efficacy and Safety of Direct Oral Factor Xa Inhibitors in 795 Morbidly Obese Patients
Conclusions: Our study is the largest study examining morbidly obese patients on DOACS and provides further evidence of comparable efficacy and safety of the direct oral anti-Xa inhibitors, compared to warfarin, in morbidly obese patients with AF and VTE.DisclosuresKushnir: Janssen: Research Funding. Billett: Bayer: Consultancy; Janssen: Research Funding.
Source: Blood - November 21, 2018 Category: Hematology Authors: Kushnir, M., Choi, Y., Eisenberg, R., Rao, D., Tolu, S., Gao, J., Mowrey, W., Billett, H. H. Tags: 332. Antithrombotic Therapy: Management of Challenging Patients and Scenarios Source Type: research

Non-vitamin K oral anticoagulants in nonvalvular atrial fibrillation: A network meta-analysis.
CONCLUSIONS: This study adds an attempt for treatment ranking of both efficacy and safety outcomes. Future trials comparing directly NOACs are needed in order to provide conclusive proofs for these results and not only circumstantial evidence offered by a network meta-analysis. PMID: 30896311 [PubMed - as supplied by publisher]
Source: Scandinavian Cardiovascular Journal - March 23, 2019 Category: Cardiology Tags: Scand Cardiovasc J Source Type: research

Correlates and outcomes of warfarin initiation in kidney transplant recipients newly diagnosed with atrial fibrillation
In the kidney transplant population with atrial fibrillation (AF), evidence regarding the effectiveness and safety of warfarin treatment is lacking. We used fee-for-service Medicare claims to identify kidney transplant recipients with newly diagnosed AF from the United States Renal Data System. Warfarin use within 30 days of AF diagnosis was ascertained from Medicare Part D prescription claims (2007–11) or using a validated algorithm (1997–2011). The study end points were (i) the composite of death, stroke or gastrointestinal bleed, (ii) death and (iii) death-censored graft failure. Warfarin user and non-user g...
Source: Nephrology Dialysis Transplantation - January 28, 2015 Category: Urology & Nephrology Authors: Lenihan, C. R., Montez-Rath, M. E., Shen, J. I., Scandling, J. D., Turakhia, M. P., Chang, T. I., Winkelmayer, W. C. Tags: Renal Transplantation Source Type: research

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