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Fatigue in stroke survivors: a 5-year follow-up of the Fall study of Gothenburg
In conclusion, half of the participants reported PSF 5 years after index stroke and higher body mass index was identified as a predictor. The findings from this study are important for healthcare professionals, for planning health-related efforts and rehabilitation of stroke survivors.ClinicalTrials.gov, Identifier NCT02264470.
Source: Journal of Neurology - September 20, 2023 Category: Neurology Source Type: research
Brain MRI correlations with disease burden and biomarkers in Fabry disease
ConclusionBrain MRI revealed progressive lacunar infarctions, white matter hyperintensities, and decreased brain volume in patients with Fabry disease. Brain MRI lesions were closely related to onset-age; disease duration, severity, burden; and plasma Lyso-Gb3. However, they were not associated with sex, α-galactosidase A activity, orGLA mutation type.
Source: Journal of Neurology - September 20, 2023 Category: Neurology Source Type: research
A typology of cerebral small vessel disease based on imaging markers
ConclusionThe study confirmed the existence of different SVD types with different relationships to stroke outcome. EPVS and WMH were identified as imaging features of presumably early progression. The number of microbleeds and WMH severity appear to be promising biomarkers for distinguishing clinical subgroups. Further understanding of SVD progression might require consideration of refined SVD features, e.g., for EPVS and type of lacunes.
Source: Journal of Neurology - September 20, 2023 Category: Neurology Source Type: research
Result of 48-Hour Approach to Symptomatic Carotid Lesions in Patients With Stable Neurologic Examinations
Timing of treatment for symptomatic carotid disease has a controversial history with current guidelines recommending carotid surgery within 48 hours up to 2 weeks. Advocating for earlier carotid endarterectomy (CEA) after stroke (cerebrovascular accident [CVA]) or while a patient is having transient ischemic attacks (TIA) can potentially provide additional benefit to acute stroke patients resulting in improved stroke and death outcomes.
Source: Journal of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Tigran Divanyan, Jeffrey Hnath, Amanda Kistler, Misak Harutyunyan, W John Byrne, Julia Kleene Tags: Carotid Artery Interventions Source Type: research
Impact of Race on Perioperative Outcomes Following Carotid Endarterectomy, Transfemoral Carotid Artery Stenting, and Transcarotid Artery Revascularization
Carotid artery revascularization is performed less frequently among Black and minority populations despite a higher incidence of stroke and greater cardiovascular and stroke risk profile. Limited data exists on what impact race has on outcomes following carotid interventions. We assessed racial differences in perioperative outcomes following carotid endarterectomy (CEA), transfemoral carotid artery stenting (tfCAS), and transcarotid artery revascularization (TCAR) using the Vascular Quality Initiative database.
Source: Journal of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Pavel Kibrik, Ajit Rao, Jerry Zhu, Halbert Bai, Jason Storch, Daniel Han, Windsor Ting, Michael Marin, Peter Faries Tags: Carotid Artery Interventions Source Type: research
Optimal management of carotid artery disease in patients undergoing coronary artery bypass
It is well-known that patients undergoing coronary artery bypass grafting (CABG) with coexisting carotid artery disease are at increased risk for perioperative stroke and death. The prevalence of carotid disease among patients undergoing CABG is 6% to 14%,1 and the risk of stroke following CABG increases from 3% for unilateral 50% to 99% stenosis to 5% for bilateral 50% to 99% stenoses and 10% for carotid occlusion.2 The risk of stroke and death are notably higher in patients with a history of transient ischemic attack (TIA)/stroke.
Source: Journal of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Christopher K. Zarins Tags: Invited commentary Source Type: research
Fibromuscular dysplasia incidentally identified with computed tomography angiography
A 78-year-old woman had presented to the emergency room with altered mental status after the inadvertent consumption of a cannabis product. A stroke workup was initiated, including computed tomography angiography, which demonstrated severe tortuosity and a beaded appearance of her bilateral internal carotid arteries (A/Cover and B). The radiographic imaging findings, including alternating areas of bulging and narrowing, were consistent with fibromuscular dysplasia (FMD; C). The patient denied any history of transient ischemic attack, cerebrovascular accident, amaurosis fugax, or chronic kidney issues.
Source: Journal of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Henry Lee, Bethany Lueck, Kevin M. Casey Tags: Vascular Image Source Type: research
How to improve the description of superior mesenteric artery occlusions in acute mesenteric ischemia: A new computed tomography anatomic segmentation
Acute mesenteric ischemia (AMI) is an intestinal vascular emergency and one of the most severe ischemic syndromes. For stroke or myocardial infarction, arterial segmentations were proposed as early as 1938 and 1975, respectively. These segmentations - used on a daily basis - made it possible to harmonize practices and standardize neurovascular and coronary studies. There is no such standardization in AMI, but the vital and functional prognostic challenge is of the same order. In addition, the lack of a standardized description of superior mesenteric artery (SMA) lesions limits the interpretation and comparability of the studies.
Source: Annals of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Lorenzo Garzelli, Iannis Ben Abdallah, Arnaud Tual, Alexandre Nuzzo, Jonathan Cortese Yves Panis, Olivier Corcos, Val érie Vilgrain, Yves Castier, Maxime Ronot Source Type: research
Do the technical features of carotid eversion affect early restenosis? Design of a prospective multicenter study
Myointimal hyperplasia restenosis remains a concern following carotid endarterectomy. It occurs in about 6% of people. The 3-year rate of stroke after restenosis is 5.2%. Several risk factors for restenosis have been identified, such as smoking, hypertension, female gender, diabetes, dyslipidemia, or small carotid diameter. The primary objective of this prospective multicenter study was to determine whether the technical characteristics of the eversion technique influence the 1-year rate of restenosis.
Source: Annals of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Cl émentine Crepon, Cindy Vannier, Bahaa Nasr, Tom Le Corvec, Robert Martinez, Gregory Dessertenne, Christophe Robin, Nicolas Bague, Eva Deveze, Gautier Haupert, Jean Picquet Source Type: research
Effects of CYP2D6 and CYP2C19 genetic polymorphisms and cigarette smoking on the pharmacokinetics of tolperisone
Arch Pharm Res. 2023 Sep 20. doi: 10.1007/s12272-023-01462-1. Online ahead of print.ABSTRACTTolperisone, a muscle relaxant used for post-stroke spasticity, is metabolized to its main metabolite by CYP2D6 and to a lesser extent by CYP2C19 and CYP1A2. We investigated the effects of CYP2D6 and CYP2C19 genetic polymorphisms and cigarette smoking on tolperisone pharmacokinetics. A 150 mg oral dose of tolperisone was given to 184 healthy Korean subjects and plasma concentrations of tolperisone were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). A 3.14-fold significant increase in AUC0-∞ was observed in ...
Source: Archives of Pharmacal Research - September 20, 2023 Category: Drugs & Pharmacology Authors: Ji-Young Byeon Chang-Keun Cho Pureum Kang Se-Hyung Kim Choon-Gon Jang Seok-Yong Lee Yun Jeong Lee Source Type: research
Neuroprotective effects of oxytocin against ischemic stroke in rats by blocking glutamate release and CREB-mediated DNA hypermethylation
Biomed Pharmacother. 2023 Sep 18;167:115520. doi: 10.1016/j.biopha.2023.115520. Online ahead of print.ABSTRACTGlutamate plays a crucial role in cognitive impairments after ischemic stroke. There is a scarcity of information about how glutamate-induced activation of cAMP-response element binding (CREB) signaling pathway regulates both the negative and positive regulators of synaptic plasticity. Recent studies have demonstrated the involvement of prominent epigenetic repressors, such as MeCP2 and DNMTs, in stroke. Neuroprotective effects of oxytocin against ischemia have been previously reported, while the underlying mechani...
Source: Biomedicine and pharmacotherapy = Biomedecine and pharmacotherapie - September 20, 2023 Category: Drugs & Pharmacology Authors: Xin-Yu Fan Guang Shi Yun-Peng Zhao Jing-Jing Yang Juan Feng Source Type: research
Transport use limitations and its association with social participation among patients with stroke living in rural India
CONCLUSIONS: Independent use of different modes of transport, particularly public transportation, reduced among rural Indian stroke survivors. These transport limitations are significantly associated with reduced social participation, highlighting the need for interventions to improve accessibility and fostering greater community engagement for stroke survivors in this population.IMPLICATIONS FOR REHABILITATIONLimited transportation access limits social participation for stroke survivors in rural India.Study results show a significant decrease in independent transport use among stroke survivors, affecting their social part...
Source: Disability and Rehabilitation - September 20, 2023 Category: Rehabilitation Authors: Kajal Chavda V Prakash Source Type: research
Standardized circuit class group training versus individualized goal-directed group training to improve upper limb function in stroke survivors during in-patient rehabilitation: a pragmatic trial
CONCLUSIONS: A standardized training could reduce the mental workload for therapists, but patients seemed less engaged. A combination of both might be most beneficial.Trial registration: Dutch Trial Register: NL8844 and NL9471IMPLICATIONS FOR REHABILITATIONProviding a standardized training program after stroke reduces therapists' mental workload.Individualized goal-directed group training results in the best achievement of rehabilitation goals.A combination of standardized and individual training would use best of both intervention modalities.Patients should be involved in the co-creation developing process of training pro...
Source: Disability and Rehabilitation - September 20, 2023 Category: Rehabilitation Authors: S G Rozevink C M Beerepoot C K van der Sluis J M Hijmans Source Type: research
Nrf2 and Ferroptosis: A New Research Direction for Ischemic Stroke
Cell Mol Neurobiol. 2023 Sep 20. doi: 10.1007/s10571-023-01411-y. Online ahead of print.ABSTRACTIschemic stroke (IS) is one of the leading causes of death and morbidity worldwide. As a novel form of cell death, ferroptosis is an important mechanism of ischemic stroke. Nuclear factor E2-related factor 2 (Nrf2) is the primary regulator of cellular antioxidant response. In addition to alleviating ischemic stroke nerve damage by reducing oxidative stress, Nrf2 regulates genes associated with ferroptosis, suggesting that Nrf2 may inhibit ferroptosis after ischemic stroke. However, the specific pathway of Nrf2 on ferroptosis in ...
Source: Cellular and Molecular Neurobiology - September 20, 2023 Category: Cytology Authors: Xiaoman Deng Wenming Chu Hanrui Zhang Yongjun Peng Source Type: research
Protein kinase D2 confers neuroprotection by promoting AKT and CREB activation in ischemic stroke
In this study, we found that PKD2 expression and activity were significantly upregulated in the ipsilateral side of the brain after transient focal cerebral ischemia, which coincides with the upregulation of PKD2 in primary neurons in response to in vitro ischemia, implying a potential role of PKD2 in neuronal survival in ischemic stroke. Using kinase-dead PKD2 knock-in (PKD2-KI) mice, we examined whether loss of PKD2 activity affected stroke outcomes in mice subjected to 1 h of transient middle cerebral artery occlusion (tMCAO) and 24 h of reperfusion. Our data demonstrated that PKD2-KI mice exhibited larger infarction vo...
Source: Neurobiology of Disease - September 20, 2023 Category: Neurology Authors: Jaclyn A Connelly Xuejing Zhang Yuzhou Chen Yapeng Chao Yejie Shi Tija C Jacob Q Jane Wang Source Type: research
