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Achieved Blood Pressures in the Secondary Prevention of Small Subcortical Strokes (SPS3) Study: Challenges and Lessons Learned.
CONCLUSIONS: These results show that it is possible to safely lower BP even to a SBP goal <130mm Hg in a variety of patients and settings, including private and academic centers in multiple countries. This provides further support for protocol-driven care in lowering BP and consequently reducing the burden of stroke. PMID: 24610884 [PubMed - as supplied by publisher]
Source: American Journal of Hypertension - March 7, 2014 Category: Cardiology Authors: Pergola PE, White CL, Szychowski JM, Talbert R, Brutto OD, Castellanos M, Graves JW, Matamala G, Pretell EJ, Yee J, Rebello R, Zhang Y, Benavente OR, for the SPS3 Investigators Tags: Am J Hypertens Source Type: research

Pathophysiology and neuroprotection of global and focal perinatal brain injury: lessons from animal models
Arterial ischemic stroke occurs most frequently in term newborns than in the elderly, and brain immaturity affects mechanisms of ischemic injury and recovery. The susceptibility to injury of the brain was assumed to be lower in the perinatal period as compared to childhood. This concept was recently challenged by clinical studies showing marked motor disabilities after stroke in neonates, with the severity of motor and cortical sensory deficits similar in both perinatal and childhood ischemic stroke.
Source: Pediatric Neurology - January 30, 2015 Category: Neurology Authors: Luigi Titomanlio, David Fernández-López, Lucilla Manganozzi, Raffaella Moretti, Zinaida S. Vexler, Pierre Gressens Tags: Topical Review Source Type: research

5 Scary Symptoms That Are Usually Harmless
SPECIAL FROM Next Avenue By Linda Melone After 50, aches, pains and the occasional muscle twinge become a fact of life. But some symptoms that may seem frightening or serious turn out to be far less than they appear. While you should always see a doctor if you experience something out of the ordinary, these signs generally are more smoke than fire: A Bloody Nose Nosebleeds can be particularly frightening due to the suddenness in which they occur and the sometimes large amount of blood involved. “People worry that it’s internal bleeding, but almost every time it’s not,” says Dr. Carlo Reyes, emergency room...
Source: Healthy Living - The Huffington Post - February 5, 2015 Category: Consumer Health News Source Type: news

A Gift From Jack
This morning, I was sitting in the courtyard next to our home working on my computer. The weather was terrific, clear and breezy. I was focused on a deadline that needed my full attention, but that didn't stop me from enjoying the terrific weather... and a wonderfully robust, rich brown-wrapped cigar. As I settled in, I noticed an older gentleman approaching out of the corner of my eye. On occasion, I've seen this same man walking around our neighborhood. He's tall and lanky, walking gingerly with a cane. By his gait, I suspect he may have had a stroke at some point. He continued walking towards me -- and the empty cha...
Source: Healthy Living - The Huffington Post - June 28, 2016 Category: Consumer Health News Source Type: news

4 Key Insights When Raising Money for Your Medtech Startup: Interview with Bruce Shook, CEO of Intact Vascular
Welcome to the Medsider interview series, a regular feature at MassDevice. All interviews are conducted by Scott Nelson, Founder of Medsider and Group Director for WCG. We hope you enjoy them! Bruce Shook joined Intact Vascular in 2014 as President and CEO. A highly-experienced, medical device executive with more than 30 years of industry experience, Bruce was previously Co-founder, Director, President, and CEO of Neuronetics, which is a privately held medical device company that markets a non-invasive brain stimulation technology for the treatment of depression. Previously, Shook was Co-founder, Director, President, an...
Source: Mass Device - February 27, 2017 Category: Medical Equipment Authors: Danielle Kirsh Tags: Blog medsider Source Type: news

Abstract 126: The Association Between Medication Aherence and Time in Therapeutic Range (TTR) Among Patients with Atrial Fibrillation Treated With Warfarin: Lessons From the Parkland Health and Hospital System Session Title: Poster Session I
Conclusions: TTR to Warfarin in this underserved population is suboptimal. Given that adherence to Warfarin is independently associated with poor TTR, in the absence of strong adherence interventions, a policy of universal NOAC adoption is unlikely to significantly improve outcomes. If patients are transitioned to NOACs, this data implies that a targeted adherence intervention will be necessary to ensure that the medication is effective in reducing the risk of stroke.
Source: Circulation: Cardiovascular Quality and Outcomes - March 31, 2017 Category: Cardiology Authors: Wang, J., Vigen, R., Clark, C., Das, S. Tags: Session Title: Poster Session I Source Type: research

ESC 2017 Roundup: Biotronik touts lowered mortality for AF patients treated with cath ablation
Biotronik today released results from the Castle-AF study exploring the use of catheter ablation to treat heart failure patients with atrial fibrillation, touting a 38% composite reduction in all-cause mortality and hospitalization for worsening heart failure. The 398-patient, 33-site study compared the results of catheter ablation treatment for AF in heart failure patients using implantable cardioverter defibrillators or cardiac resynchronization therapy defibrillators to standard-of-care pharmacological therapy, the company said. Biotronik touted it as the largest study of its kind to date. Results indicated a 47% reduc...
Source: Mass Device - August 28, 2017 Category: Medical Devices Authors: Fink Densford Tags: Cardiac Assist Devices Cardiac Implants Cardiovascular Clinical Trials Biotronik Medtronic Source Type: news

E-067 Institutional trends in mechanical thrombectomy: lessons learned
Conclusions: Preliminary data suggest that thrombectomy is a safe procedure that results in extremely low mortality and significant decreases NIH score over time, which may point to better functional outcome. Overall, there was an improvement in NIHSS reduction with time. Additionally, achieving faster times to recanalization resulted in better improvements in NIHSS. There was a significant difference in the ability of different techniques to achieve first-pass recanalization, though this may reflect clinical judgments about when to use each technique. Producing a TICI score of 3 also improved over time, demonstrating incr...
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Trott, S., Vsevolozhskaya, O., Alhajeri, A., Fraser, J. Tags: Electronic Poster Abstracts Source Type: research

Changes in the corpus callosum during the recovery of aphasia: A case report
Rationale: The corpus callosum, which is the most important fiber pathway linking the bilateral hemispheres, plays a key role in information access, as well as the functional coordination and reorganization between the bilateral hemispheres. However, whether the corpus callosum will undergo structural changes during the recovery of aphasia is still unclear. In the current study, a Chinese aphasic patient with stroke was reported to develop changes in the corpus callosum after speech therapy. Patient concerns: A 33-year-old right-handed male patient had aphasia only without limb paralysis at 14 months after stroke. Di...
Source: Medicine - June 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Tangier disease may cause early onset of atherosclerotic cerebral infarction: A case report
Rationale: The present study explored the relationship between the adenosine triphosphate (ATP)-binding cassette A1 (ABCA1) gene, atherosclerosis, and cerebral infarction. The diagnosis and treatment ideas of stroke caused by Tangier disease via the summary of the diagnosis and treatment process of one case with juvenile stroke were explored. The relevant literature on the clinical manifestations, laboratory examinations, and treatment of Tangier disease was reviewed. Patient concerns: The brain magnetic resonance imaging (MRI) of a juvenile man with acute onset of sudden right limb weakness and speechlessness reveale...
Source: Medicine - September 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Acute vertigo and sensorineural hearing loss from infarction of the vestibulocochlear nerve: A case report
We present a case illustrating a rare but significant finding of vestibulocochlear nerve infarction revealed by DWI-MRI. Prompt imaging protocol enabled the detection of significant findings in this patient with acute unilateral audiovestibulopathy. Clinicians should be aware of the vestibulocochlear nerve and labyrinth on MRI in patients with cerebellar stroke.
Source: Medicine - October 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

FDA-Catalyst-Using FDA's Sentinel Initiative for large-scale pragmatic randomized trials: Approach and lessons learned during the planning phase of the first trial.
CONCLUSION:: Sentinel infrastructure generated preliminary data that supported planning and implementation of a large pragmatic trial embedded in health plans. This planning identified unanticipated challenges that must be addressed in similar trials. PMID: 30445835 [PubMed - as supplied by publisher]
Source: Clinical Trials - November 16, 2018 Category: Research Authors: Cocoros NM, Pokorney SD, Haynes K, Garcia C, Al-Khalidi HR, Al-Khatib SM, Archdeacon P, Goldsack JC, Harkins T, Lin ND, Martin D, McCall D, Nair V, Parlett L, Temple R, McMahill-Walraven C, Granger CB, Platt R Tags: Clin Trials Source Type: research

Delayed-onset central poststroke pain due to degeneration of the spinothalamic tract following thalamic hemorrhage: A case report
Rationale: Recent studies have used diffusion tensor tractography (DTT) to demonstrate that central poststroke pain (CPSP) was related to spinothalamic tract (STT) injury in patients with stroke. However, few studies have been reported about delayed-onset CPSP due to degeneration of the STT following a stroke. Patient's concerns: A 57-year-old female patient presented with right hemiparesis after stroke. Two weeks after onset, she did not report any pain. At approximately 6 months after onset, she reported pain in the right arm and leg, and the pain slowly intensified with the passage of time. At 14 months after onset...
Source: Medicine - December 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Resolution of left ventricular thrombus by edoxaban after failed treatment with warfarin overdose: A case report
Rationale: Although novel oral-anticoagulants are widely used in patients with atrial fibrillation (AF) for stroke prevention, there was only limited evidence for their use in left ventricular (LV) thrombus. Patient concerns: A 41-year-old man who presented with acute onset of right-hand clumsiness and aphasia even under high international normalized ratio (INR: 7.64) from warfarin use. He was previously treated with warfarin for the LV thrombus and non-valvular AF. Brain magnetic resonance imaging (MRI) showed multiple acute infarction in the cortex of the bilateral frontal lobes, left parietal lobe, and bilateral ce...
Source: Medicine - January 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Benefits of Motor Imagery for Human Space Flight: A Brief Review of Current Knowledge and Future Applications
Conclusion: How to Implement MI Into the Preparation and Mission of the Astronauts Motor imagery should ideally be performed before, during, and after exposure to microgravity to prepare for the lack of gravity, counteract the effects of weightlessness and promote the re-adaptation to normogravity. A quite similar theoretical viewpoint had been nicely proposed by Bock et al. (2015), who more specifically focused on the preparation period few days before landing. These authors developed two phases of individual MI training program to reach an optimal level of preparation before exposure to microgravity. In the first phase,...
Source: Frontiers in Physiology - April 10, 2019 Category: Physiology Source Type: research