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Predicting the Risk of Ischemic Stroke among Patients with Rheumatoid Arthritis Using a Simplified RA-CHADSV Score Based on the CHA2DS2-VASc Score.
CONCLUSIONS: A simplified RA-CHADSV score, with comparable efficiency as the CHA2DS2-VASc score, but easier to use clinically was developed for predicting the risk of ischemic stroke among non-AF RA patients. PMID: 32059458 [PubMed - in process]
Source: Medicina (Kaunas) - February 11, 2020 Category: Universities & Medical Training Authors: Hsu CW, Ng KJ, Lu MC, Koo M Tags: Medicina (Kaunas) Source Type: research

Association of Neutrophil-to-Lymphocyte Ratio and Lymphocyte-to-Monocyte Ratio with Treatment Modalities of Acute Ischaemic Stroke: A Pilot Study.
Conclusions: The main finding of this pilot study was that NLR in IS patients treated using thrombectomy following thrombolysis was markedly higher than that in other treatment groups, which was associated with increased severity of the disease in these patients. Therefore, patients with higher NLR may be expected to have more severe stroke. The link between stroke severity and NLR deserves further study. PMID: 31284487 [PubMed - in process]
Source: Medicina (Kaunas) - July 4, 2019 Category: Universities & Medical Training Authors: Świtońska M, Słomka A, Korbal P, Piekuś-Słomka N, Sinkiewicz W, Sokal P, Żekanowska E Tags: Medicina (Kaunas) Source Type: research

Financial Burden of Stroke Reflected in a Pilot Center for the Implementation of Thrombolysis.
Abstract Stroke represents a serious illness and is extremely relevant from the public health point of view, implying important social and economic burdens. Introducing new procedures or therapies that reduce the costs both in the acute phase of the disease and in the long term becomes a priority for health systems worldwide. The present study quantifies and compares the direct costs for ischemic stroke in patients with thrombolysis treatment versus conservative treatment over a 24-month period from the initial diagnosis, in one of the 7 national pilot centres for the implementation of thrombolytic treatment. The ...
Source: Medicina (Kaunas) - January 27, 2020 Category: Universities & Medical Training Authors: Uivarosan D, Bungau S, Tit DM, Moisa C, Fratila O, Rus M, Bratu OG, Diaconu CC, Pantis C Tags: Medicina (Kaunas) Source Type: research

Role of Biological Markers for Cerebral Bleeding Risk STRATification in Patients with Atrial Fibrillation on Oral Anticoagulants for Primary or Secondary Prevention of Ischemic Stroke (Strat-AF Study): Study Design and Methodology.
Conclusions: The Strat-AF study may be an essential step towards the exploration of the role of a combined clinical biomarker or multiple biomarker models in predicting stroke risk in AF, and might sustain the incorporation of such new markers in the existing stroke prediction schemes by the demonstration of a greater incremental value in predicting stroke risk and improvement in clinical outcomes in a cost-effective fashion. PMID: 31548494 [PubMed - in process]
Source: Medicina (Kaunas) - September 22, 2019 Category: Universities & Medical Training Authors: Poggesi A, Barbato C, Galmozzi F, Camilleri E, Cesari F, Chiti S, Diciotti S, Galora S, Giusti B, Gori AM, Marzi C, Melone A, Mistri D, Pescini F, Pracucci G, Rinnoci V, Sarti C, Fainardi E, Marcucci R, Salvadori E Tags: Medicina (Kaunas) Source Type: research

New versus Old Oral Anticoagulants: How Can We Set the Scale Needle? Considerations on a Case Report.
We report the case of a 41-year-old woman with antiphospholipid syndrome who was unsuccessfully treated with Dabigatran, a new oral anticoagulant, as she developed a major stroke involving the right carotid artery, due to deep venous thrombosis with pulmonary embolism. We therefore suggest a closer monitoring of the safety and efficacy of dabigatran. Moreover, in the presence of multifactorial causes of pro-coagulation, we believe that warfarin should remain the mainstay of oral anticoagulation. PMID: 30884868 [PubMed - in process]
Source: Medicina (Kaunas) - March 16, 2019 Category: Universities & Medical Training Authors: Arcadi FA, Portaro S, Giorgianni R, Naro A, Casella C, Genovese C, Marino S, Calabrò RS Tags: Medicina (Kaunas) Source Type: research

Thromboembolic Events Following Atrial Fibrillation Cardioversion and Ablation: What's the Culprit?
Abstract Stroke is a rare but possible complication after atrial fibrillation (AF) ablation. However, its etiopathogenesis is far from being completely characterized. Here we report a case of stroke, with recurrent peripheral embolism after AF ablation procedure. In our patient, an in situ femoral vein thrombosis and iatrogenic atrial septal defect were simultaneously detected. A comprehensive review of multiple pathophysiological mechanisms of stroke in this context is provided. The case underlines the importance of a global evaluation of patients undergoing AF ablation. PMID: 31434315 [PubMed - in process]
Source: Medicina (Kaunas) - August 19, 2019 Category: Universities & Medical Training Authors: De Sensi F, Miracapillo G, Addonisio L, Breschi M, Cresti A, Baratta P, Paneni F, Limbruno U Tags: Medicina (Kaunas) Source Type: research

Crucial role of carotid ultrasound for the rapid diagnosis of hyperacute aortic dissection complicated by cerebral infarction: A case report and literature review.
Abstract Aortic dissection is a life-threatening rare condition that may virtually present by any organ system dysfunction, the nervous system included. Acute cerebral infarction among multiple other neurological and non-neurological presentations is part of this acute aortic syndrome. Rapid and correct diagnosis is of extreme importance keeping in mind the possibility of thrombolytic treatment if a patient with a suspected ischemic stroke arrives to the Emergency Department within a 4.5-h window after symptom onset. Systemic intravenous thrombolysis in the case of an acute brain infarction due to aortic dissectio...
Source: Medicina (Kaunas) - November 18, 2016 Category: Universities & Medical Training Authors: Sukockienė E, Laučkaitė K, Jankauskas A, Mickevičienė D, Jurkevičienė G, Vaitkus A, Stankevičius E, Petrikonis K, Rastenytė D Tags: Medicina (Kaunas) Source Type: research

Diagnosis and Management of Left Atrium Appendage Thrombosis in Atrial Fibrillation Patients Undergoing Cardioversion.
Abstract Atrial fibrillation is the most common cardiac arrhythmia and is associated with an increased risk of stroke and thromboembolic complications. A rhythm control strategy with both electrical and pharmacological cardioversion is recommended for patients with symptomatic atrial fibrillation. Anticoagulant therapy for 3-4 weeks prior to cardioversion is recommended in order to avoid thromboembolic events deriving from restoring sinus rhythm. Transesophageal echocardiography has a pivotal role in this setting, excluding the presence of left atrial appendage thrombus before cardioversion. The aim of this review...
Source: Medicina (Kaunas) - August 20, 2019 Category: Universities & Medical Training Authors: Melillo E, Palmiero G, Ferro A, Mocavero PE, Monda V, Ascione L Tags: Medicina (Kaunas) Source Type: research

Cardiovascular Risk/Benefit Profile of MHT.
Conclusion: CV risk calculation should be considered by clinicians in order to exclude patients with high CV risk, in whom MHT is contraindicated. Assessing risks and benefits in a patient-centered approach according to individual's features, health status, and personal preferences is important in order to realize a safe and effective treatment. PMID: 31500138 [PubMed - in process]
Source: Medicina (Kaunas) - September 5, 2019 Category: Universities & Medical Training Authors: Villa P, Amar ID, Shachor M, Cipolla C, Ingravalle F, Scambia G Tags: Medicina (Kaunas) Source Type: research

Possible Interaction between Dabigatran and Ranolazine in Patients with Renal Failure.
Abstract Dabigatran etexilate is a direct oral anticoagulant (thrombin inhibitor) used for the prevention of stroke and systemic thromboembolic events in patients with permanent atrial fibrillation; prevention of venous thromboembolic events and deep veins thrombosis; treatment and prevention of pulmonary embolism. Dabigatran is a relatively new drug, and as a result, its interactions with other medications and their significance are not fully known. A 72 years old male, having a medical history of heart and renal failure, was hospitalized for pneumonia treatment. The patient was taking several drugs, including da...
Source: Medicina (Kaunas) - December 28, 2019 Category: Universities & Medical Training Authors: Gumbrevičius G, Damulevičienė G, Galaunė V, Gumbrevičiūtė M Tags: Medicina (Kaunas) Source Type: research

Implication of Hemodynamic Assessment during Durable Left Ventricular Assist Device Support.
Abstract Durable left ventricular assist device therapy has improved survival in patients with advanced heart failure refractory to conventional medical therapy, although the readmission rates due to device-related comorbidities remain high. Left ventricular assist devices are designed to support a failing left ventricle through relief of congestion and improvement of cardiac output. However, many patients still have abnormal hemodynamics even though they may appear to be clinically stable. Furthermore, such abnormal hemodynamics are associated with an increased risk of future adverse events including recurrent he...
Source: Medicina (Kaunas) - August 14, 2020 Category: Universities & Medical Training Authors: Imamura T, Narang N Tags: Medicina (Kaunas) Source Type: research

Are Three Weeks of Oral Anticoagulation Sufficient for Safe Cardioversion in Atrial Fibrillation?
Conclusions: In our study the incidence of SEC/LAT, particularly in AF with unknown duration, was not as low as we expected. The prevalence of SEC/LAT seemed to be dependent on factors not routinely evaluated in AF patients planned for cardioversion (indexed LA volume, LAA morphology and number of lobules, LAA emptying velocity, etc.). Our data suggested an individualized approach for DOAC duration in AF patients before an attempt for restoration of sinus rhythm is made, taking into consideration the LAA morphology and function.PMID:34072778 | DOI:10.3390/medicina57060554
Source: Medicina (Kaunas) - June 2, 2021 Category: Universities & Medical Training Authors: Stefan Naydenov Nikolay Runev Emil Manov Source Type: research

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