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Comparison of Compensatory Reserve During Lower Body Negative Pressure and Hemorrhage in Non-human Primates.
Abstract Compensatory reserve was measured in baboons (n=13) during hemorrhage (Hem) and lower body negative pressure (LBNP) using a machine learning algorithm developed to estimate compensatory reserve by detecting reductions in central blood volume during LBNP. The algorithm calculates compensatory reserve index (CRI) from normovolemia (CRI=1) to cardiovascular decompensation (CRI=0). The hypothesis was that Hem and LBNP will elicit similar CRI values, and that CRI would have higher specificity than stroke volume (SV) in predicting decompensation. Blood was removed in four steps: 6.25%, 12.5%, 18.75%, and 25% of...
Source: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology - March 29, 2016 Category: Physiology Authors: Hinojosa-Laborde C, Howard JT, Mulligan J, Grudic GZ, Convertino VA Tags: Am J Physiol Regul Integr Comp Physiol Source Type: research

Rapid learning curve for Solitaire FR stent retriever therapy: evidence from roll-in and randomised patients in the SWIFT trial
Conclusions Thrombectomy in AIS using the Solitaire stent retriever device can be performed safely and effectively when used by experienced neurointerventionalists without previous experience with the device. Trial registration number The SWIFT study is registered with ClinicalTrials.gov, number NCT 01054560.
Source: Journal of NeuroInterventional Surgery - March 15, 2016 Category: Neurosurgery Authors: Sheth, S. A., Jahan, R., Levy, E. I., Jovin, T. G., Baxter, B., Nogueira, R. G., Clark, W., Budzik, R., Zaidat, O. O., Saver, J. L., for the SWIFT Trialists Tags: Ischemic stroke Source Type: research

Using stroke thrombolysis to describe the role of repetition in learning a cognitive skill
ConclusionsAccruing sufficient experience of a new cognitive clinical skill can be challenging for independent physicians, with expertise gradually emerging in a largely linear fashion only after much repetition.
Source: Medical Education - January 26, 2016 Category: Universities & Medical Training Authors: Christopher A K Y Chong Tags: Repetition ‐Based Learning Source Type: research

Lipoxin A4 Reduces Inflammation Through Formyl Peptide Receptor 2/p38 MAPK Signaling Pathway in Subarachnoid Hemorrhage Rats Basic Sciences
Conclusions— Exogenous LXA4 inhibited inflammation by activating FPR2 and inhibiting p38 after SAH. LXA4 may serve as an alternative treatment to relieve early brain injury after SAH.
Source: Stroke - January 25, 2016 Category: Neurology Authors: Guo, Z., Hu, Q., Xu, L., Guo, Z.-N., Ou, Y., He, Y., Yin, C., Sun, X., Tang, J., Zhang, J. H. Tags: Animal Models of Human Disease Basic Sciences Source Type: research

Compensatory Reserve Index Can Aid in Early Shock Detection
EARLY SHOCK DETECTION Convertino VA, Howard JT, Hinojosa-Laborde C. Individual-specific, beat-to-beat trending of significant human blood loss: The compensatory reserve. Shock. Jan. 6, 2015. [Epub ahead of print.] Hemorrhagic shock is the leading cause of death in trauma. The challenge is detecting shock early enough to intervene clinically. The human body is masterful at compensating with a variety of seemingly undetectable mechanisms, such as autonomic activity, vasoconstriction, increased stroke volume, improved cardiac filling and more efficient breathing. So by the time we see alterations in vital sign metrics, the p...
Source: JEMS Patient Care - August 10, 2015 Category: Emergency Medicine Authors: Alexander L. Trembley, NREMT P Tags: Resuscitation & Shock Special Topics Research Columns Patient Care Source Type: news

Spreading Depression, Spreading Depolarizations, and the Cerebral Vasculature
Spreading depression (SD) is a transient wave of near-complete neuronal and glial depolarization associated with massive transmembrane ionic and water shifts. It is evolutionarily conserved in the central nervous systems of a wide variety of species from locust to human. The depolarization spreads slowly at a rate of only millimeters per minute by way of grey matter contiguity, irrespective of functional or vascular divisions, and lasts up to a minute in otherwise normal tissue. As such, SD is a radically different breed of electrophysiological activity compared with everyday neural activity, such as action potentials and ...
Source: Physiological Reviews - July 1, 2015 Category: Physiology Authors: Ayata, C., Lauritzen, M. Tags: Reviews Source Type: research

Spreading Depression, Spreading Depolarizations, and the Cerebral Vasculature.
Abstract Spreading depression (SD) is a transient wave of near-complete neuronal and glial depolarization associated with massive transmembrane ionic and water shifts. It is evolutionarily conserved in the central nervous systems of a wide variety of species from locust to human. The depolarization spreads slowly at a rate of only millimeters per minute by way of grey matter contiguity, irrespective of functional or vascular divisions, and lasts up to a minute in otherwise normal tissue. As such, SD is a radically different breed of electrophysiological activity compared with everyday neural activity, such as acti...
Source: Physiological Reviews - July 1, 2015 Category: Physiology Authors: Ayata C, Lauritzen M Tags: Physiol Rev Source Type: research

Thrombolysis in acute stroke: ongoing challenges based on a tertiary hospital audit and comparisons with other Australian studies.
Conclusion The proportion of eligible stroke patients who receive tPA in a timely manner remains less than ideal at our centre. More accurate patient selection and reductions in treatment delays serve as targets for quality improvement efforts that have broad applicability.What is known about the topic? Stroke unit care and tPA thrombolysis are two proven strategies to improve outcome in patients with ischaemic stroke. Although the stroke unit is gaining momentum of growth in Australia (especially in Queensland), little improvement has been achieved in thrombolysis rate and timeliness of treatment delivery, and little is k...
Source: Australian Health Review - June 29, 2015 Category: Hospital Management Authors: Lau AH, Hall G, Scott IA, Williams M Tags: Aust Health Rev Source Type: research

Blood pressure measurement in pregnancy
Key content Accurate blood pressure (BP) measurement is fundamental to early diagnosis of hypertensive disorders in pregnancy. Poor auscultatory technique and lack of training leads to inaccuracies in BP measurement using sphygmomanometry with mercury and aneroid devices. Automated devices limit user error but require validation of accuracy because they tend to underestimate BP in pre‐eclampsia. Systolic hypertension may better predict risk of adverse outcome (such as haemorrhagic stroke) than diastolic hypertension. Ambulatory/self‐monitoring increases the number of representative readings available on which to ...
Source: The Obstetrician and Gynaecologist - April 1, 2015 Category: OBGYN Authors: Hannah L Nathan, Kate Duhig, Natasha L Hezelgrave, Lucy C Chappell, Andrew H Shennan Tags: Review Source Type: research

Tissue hypoxia during ischemic stroke: Adaptive clues from hypoxia-tolerant animal models.
We describe specific physiological and molecular adaptations employed by different animals' models of hypoxia tolerance in aquatic and terrestrial environments. We highlight how these adaptations might provide potential clues on strategies to adapt for the clinical management of tissue hypoxia during conditions such as stroke where oxygen demand fails to match the supply. PMID: 25738761 [PubMed - as supplied by publisher]
Source: Brain Research Bulletin - March 1, 2015 Category: Neurology Authors: Nathaniel TI, Williams-Hernandez A, Hunter LA, Liddy C, Peffley DM, Imeh-Nathaniel A Tags: Brain Res Bull Source Type: research

Randomized Pilot Trial of Intensive Management of Blood Pressure or Volume Expansion in Subarachnoid Hemorrhage (IMPROVES)
CONCLUSION: This pilot study showed adequate feasibility and excellent retention to follow-up. Given the suggestion of possible worse neurobehavioral outcome with ABP, a larger trial to determine the optimal blood pressure management in this patient population is warranted. (ClinTrials.gov NCT01414894.) ABBREVIATIONS: ABP, augmented blood pressure CBP, conventional DCI, delayed cerebral ischemia GOSE, Glasgow Outcome Scale-Extended HV, volume expansion mRS, modified Rankin Scale NV, normovolemia PHQ-9, Patient Health Questionnaire RAVLT, Ray Auditory Verbal Learning Test SWLS, Satisfaction with Life scale TCD, transcranial...
Source: Neurosurgery - January 20, 2015 Category: Neurosurgery Tags: Research-Human-Clinical Trials Source Type: research

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