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Blood Cell-Bound C4d as a Marker of Complement Activation in Patients With the Antiphospholipid Syndrome
In conclusion the detection of complement activation products on circulating erythrocytes and platelets using a highly sensitive and specific assay further supports the view that APS is a complement-mediated disorder. Increased EC4d and PC4d percentages are associated with the active inflammatory disease in SLE. It is difficult to translate this finding to APS which is a non-acute inflammatory disorder. We failed to find an association with both the classification and non-classification criteria, including thrombocytopenia. However, we believe that this sensitive tool to evaluate complement activation may offer more inform...
Source: Frontiers in Immunology - April 11, 2019 Category: Allergy & Immunology Source Type: research

Management of paradoxical embolism in a patient with coexisting patent foramen ovale and masked pulmonary arteriovenous fistula: A case report
Rationale: Paradoxical embolism (PE) is an important cause of cryptogenic stroke, particularly in young patients, which usually have a relation with an unexpected route in circulation. Here we report a rare case of cryptogenic stroke carried 2 uncommon malformations. Patient concerns: A 48-year-old female experienced double neurological events in just 2 months. Diagnosis: Patent foramen ovale was diagnosed with transesophageal echocardiography and successfully occluded in the first admission due to stroke. In the second admission, chest tomographic angiography found a chordae shadow in the right middle lobe, was th...
Source: Medicine - April 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Can emerging technologies be effective in improving alexithymia due to brain lesion?: Lessons from a case report
Conclusions: Virtual reality, in addition to standard therapy, may be a valuable tool in improving emotional abnormalities due to brain lesions, such as alexithymia.
Source: Medicine - September 18, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Y-configuration double-stent-retriever thrombectomy for refractory thrombus in middle cerebral artery bifurcation: A case report
Rationale: Stent retriever mechanical thrombectomy is a recommended treatment for acute ischemic stroke. However, refractory thrombus in artery bifurcation can reduce the rate of successful revascularization. Patient concerns: A 72-year-old male, owing to the acute onset of almost complete right-sided hemiplegia and global aphasia, received bridging therapy. National Institutes of Health Stroke Scale score was 16 at the time of admission. Diagnoses: Cerebral digital subtraction angiography revealed occlusion of the M1 segment of the left MCA. Interventions: Thrombectomy with 3 passes of the Solitai...
Source: Medicine - March 19, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Changes in the prefronto-thalamic tract following cranioplasty: Case reports
We report on three women with hemorrhagic stroke who showed changes in the PTT following cranioplasty (C/P) using diffusion tensor tractography (DTT) images. Patient concerns: The 3 women with hemorrhagic stroke showed reductions of cognitive impairment following C/P. Mini-Mental State Examination scores (MMSE) were increased by 7-, 8-, and 5-point in patient 1, 2, and 3, respectively, after C/P compared with the patients’ pre-C/P MMSE scores. Diagnosis: Three patients were diagnosed with spontaneous intracerebral hemorrhage. Three patients underwent C/P using auto-bone at 7 (patient 1 and 3) and 13 (patien...
Source: Medicine - April 9, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

O-017 ADAPT front-line thrombectomy- lessons learned from over 1000 strokes
ConclusionThis study provides a longitudinal overview of the ADAPT MT technique. Medium bore catheters had better performance measures compared to small bore catheters. However, large bore catheters did not show significantly better performance results which suggest a plateau effect.Disclosures S. Al Kasab: None. E. Almallouhi: None. R. Chalhoub: None. A. Alawieh: None. M. Sattur: None. G. Porto: None. E. Bass: None. A. Spiotta: 1; C; Stryker, Penumbra, and Medtronic. 2; C; Stryker, Penumbra, and Terumo.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Al Kasab, S., Almallouhi, E., Chalhoub, R., Alawieh, A., Sattur, M., Porto, G., Bass, E., Spiotta, A. Tags: Oral abstracts Source Type: research

Lessons Learned from Managing Antithrombotic Therapy in Children Supported with Pediatric Ventricular Assist Devices
Stroke, thromboembolism, and bleeding are the most recognized complications associated with pediatric ventricular assist devices (VADs) and the leading cause of death and disability on VAD support. Recently, newer antithrombotic strategies like bivalirudin have emerged that appear to be associated with a reduction in the neurologic event rates, especially for smaller pediatric-specific VADs like the Berlin Heart and PediMag/CentriMag systems where the risk of stroke is the highest. While contemporary antithrombotic therapies have likely contributed to lowering adverse event rates, we speculate that clotting and bleeding ad...
Source: ASAIO Journal - November 1, 2022 Category: Medical Devices Tags: Review Source Type: research

The CASSISS Randomized Clinical Trial
Stroke. 2022 Nov 11. doi: 10.1161/STROKEAHA.122.041096. Online ahead of print.ABSTRACTThe CASSISS trial (China Angioplasty & Stenting for Symptomatic Intracranial Severe Stenosis), recently published in JAMA, is the most recent of several randomized controlled trials that have failed to show a benefit of percutaneous angioplasty and stenting over medical therapy for the prevention of stroke due to intracranial atherosclerotic stenosis. Current practice guidelines recommended that percutaneous angioplasty and stenting should not be performed routinely as a treatment for stroke prevention in patients with intracranial at...
Source: Atherosclerosis - November 11, 2022 Category: Cardiology Authors: Tanya N Turan Marios-Nikos Psychogios Source Type: research

Personalised simulation of hemodynamics in cerebrovascular disease: lessons learned from a study of diagnostic accuracy
In this study, we performed the first quantitative validation of a simulation-based precision medicine framework to assess cerebral hemodynamics in patients with ICAD against clinical standard perfusion imaging. In a retrospective analysis, we used a 0-dimensional simulation model to detect brain areas that are hemodynamically vulnerable to subsequent stroke. The main outcome measures were sensitivity, specificity, and area under the receiver operating characteristics curve (ROC AUC) of the simulation to identify brain areas vulnerable to subsequent stroke as defined by quantitative measurements of relative mean transit ti...
Source: Frontiers in Neurology - September 12, 2023 Category: Neurology Source Type: research

Lessons Learned From the Women's Health Initiative Trials of Menopausal Hormone Therapy.
Abstract We re-evaluate the Women's Health Initiative findings and their implications for clinical practice. Menopausal hormone therapy (HT) was effective for relief of vasomotor symptoms, and the risk of coronary heart disease (CHD) tended to be reduced in women close to menopause compared with the increased risk in women more distant from menopause. In recently menopausal women, short-term absolute risks of stroke and venous thromboembolism were small. Estrogen plus progestin therapy, but not estrogen therapy, increased the risk of breast cancer with a suggestion of greater risk when initiated close to the menop...
Source: Obstetrics and Gynecology - January 1, 2013 Category: OBGYN Authors: Rossouw JE, Manson JE, Kaunitz AM, Anderson GL Tags: Obstet Gynecol Source Type: research

Freedom in waiting: A ventricular assist device gives Aidan’s family independence
Aidan When Aidan was just 8 months old, his parents Patrick and Tavina received shocking news—their son had hypertrophic cardiomyopathy, a rare but serious disease that affects the muscle of the heart. Given his young age and severity of his condition, the early prognosis was bleak. “Things didn’t look good at first,” remembers Patrick. “We were steeling ourselves for the real possibility that Aidan wouldn’t make it to see his first birthday.” But, heart condition or not, little Aidan was a fighter, and with minimal medical management his condition stabilized. Over the years, he grew ...
Source: Thrive, Children's Hospital Boston - July 3, 2013 Category: Pediatrics Authors: Tripp Underwood Tags: All posts Heart conditions Our patients’ stories Christina VanderPluym Heart Center heart transplant hypertrophic cardiomyopathy MD VAD ventricular assist device Source Type: news

Limitations of within-person study designs
Within-person study designs have been increasingly used because they offer the potential to control for the confounding that arises from systematic differences between the characteristics of exposed and unexposed individuals. Our recent study illustrates several limitations of within-person study designs. Farrington's comment concurs with our assertion that the self-controlled case series (SCCS) study will generally be invalid when there is censoring on outcome for, as we note in the introduction to our article (p385), “Bias may arise if the outcome event leads to censoring.” Our results confirm empirically that “th...
Source: Journal of Clinical Epidemiology - September 5, 2013 Category: Epidemiology Authors: Jennifer M. Nicholas, Andrew P. Grieve, Martin C. Gulliford Tags: Letters to the Editor Source Type: research

Lessons From the Heart Troponin Elevations in Patients With Established Peripheral Artery Disease ∗
The prevalence of peripheral artery disease (PAD) is estimated to be approximately 4.3% among U.S. adults older than 40 years of age and close to 15% in those 75 years and older (1). Patients with established PAD have a high probability of atherosclerosis in other vascular beds (2) and are at increased risk for myocardial infarction, stroke, and death, as well as limb ischemic events that lead to peripheral revascularization procedures and amputations (3). Data from the international REACH (REduction of Atherothrombosis for Continued Health) registry indicate that the annual risk of cardiovascular death, myocardial infarct...
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - April 14, 2014 Category: Radiology Source Type: research

Ensuring medication adherence with direct oral anticoagulant drugs: Lessons from adherence with vitamin K antagonists (VKAs)
Abstract: Medication adherence (taking drugs properly) is uncommon among patients on warfarin. Poor adherence to warfarin leads to an increase in adverse medical events, including stroke in atrial fibrillation (AF). Factors related to patients, physicians and the health system account for poor adherence. Direct oral anticoagulants (DOACs) are easier to use than warfarin, with fewer drug and food interactions and no need for routine blood monitoring. A proper use of DOACs may reduce the risk of stroke in AF. However, in clinical settings where no laboratory monitoring is needed, a poor medication adherence is common and may...
Source: Thrombosis Research - February 12, 2014 Category: Hematology Authors: Alessandro Di Minno, Gaia Spadarella, Antonella Tufano, Domenico Prisco, Giovanni Di Minno Tags: Mini-Reviews Source Type: research