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Extra-anatomic revascularization for preoperative cerebral malperfusion due to distal carotid artery occlusion in acute type A aortic dissection AORTIC SURGERY
CONCLUSION Extra-anatomic bypass for LCCA or RCCA occlusion allows for early selective cerebral perfusion during AADA repair, and may reduce the risk of neurological complications in patients with preoperative cerebral malperfusion.
Source: European Journal of Cardio-Thoracic Surgery - January 13, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Luehr, M., Etz, C. D., Nozdrzykowski, M., Lehmkuhl, L., Misfeld, M., Bakhtiary, F., Borger, M. A., Mohr, F.-W. Tags: Great vessels AORTIC SURGERY Source Type: research

Valacyclovir and Acyclovir Neurotoxicity With Status Epilepticus
We present the case of a 52-year-old man with hypertension, diastolic congestive heart failure, end-stage renal disease on hemodialysis 3 times a week and a remote history of a hemorrhagic stroke who presented to the emergency department with a vesicular rash on his left arm. The rash was observed to be in a dermatomal distribution, and a diagnosis of herpes zoster was made. The patient was discharged home on valacyclovir 1 g 3 times a day for a duration of 7 days. The patient took 2 doses of valacyclovir before presenting to the hospital again with irritability and hallucinations. Over the next several days, the patient's...
Source: American Journal of Therapeutics - January 1, 2016 Category: Drugs & Pharmacology Tags: Case Reports Source Type: research

Visit-to-visit variability of blood pressure and death, end-stage renal disease, and cardiovascular events in patients with chronic kidney disease
Conclusion: Higher VVV of BP is independently associated with higher rates of death and hemorrhagic stroke in patients with moderate to advanced CKD not yet on dialysis.
Source: Journal of Hypertension - December 23, 2015 Category: Cardiology Tags: ORIGINAL PAPERS: BP measurement Source Type: research

Warfarin use and incidence of stroke in Japanese hemodialysis patients with atrial fibrillation
Abstract Atrial fibrillation (AF) is one of the major risk factor for ischemic stroke, and oral anticoagulation is generally indicated for prevention of stroke. However, the utility of oral anticoagulation for AF in dialysis patients remains controversial. In this single-center, retrospective, observational study, data from 1120 patients on maintenance hemodialysis were analyzed. Baseline medical data were collected from dialysis records including age, gender, the cause of end-stage renal disease, dialysis vintage, and comorbidities. We evaluated outcomes including stroke, major hemorrhage, and death. A total of 1...
Source: Heart and Vessels - December 8, 2015 Category: Cardiology Source Type: research

Dialysis Requiring Acute Kidney Injury in Acute Cerebrovascular Accident Hospitalizations Clinical Sciences
Conclusions— Incidence of AKI-D complicating hospitalizations with cerebrovascular accident continues to grow and is associated with increased mortality and adverse discharge. This highlights the need for early diagnosis, better risk stratification, and preparedness for need for complex long-term care in this vulnerable population.
Source: Stroke - October 26, 2015 Category: Neurology Authors: Nadkarni, G. N., Patel, A. A., Konstantinidis, I., Mahajan, A., Agarwal, S. K., Kamat, S., Annapureddy, N., Benjo, A., Thakar, C. V. Tags: Cerebrovascular disease/stroke, Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Acute Stroke Syndromes Clinical Sciences Source Type: research

Risk of major cardiovascular events in patients with hemodialysis or peritoneal dialysis with special reference to stroke
Kim et al. determined the incidence rates of major adverse cardiac and cerebrovascular events (MACCE) and compared several types of events between hemodialysis (HD) patients and peritoneal dialysis (PD) patients [1]. The authors handled 22,892 HD patients and 7,387 PD patients in Korea by intention-to-treat method, and median follow-up period was 21.5 months. The risk of several cardiac events in PD patients was significantly higher than that in HD patients. In contrast, the incidence rate of non-fatal hemorrhagic stroke in HD patients showed significantly higher than that in PD patients, and there was no significant diffe...
Source: International Journal of Cardiology - September 21, 2015 Category: Cardiology Authors: Tomoyuki Kawada Source Type: research

Difference in stroke incidence between Korean and Japanese patients initiating dialysis — era or ethnic effect?
We thank Tomoyuki Kawada for the letter in response to our recent article [1]. First, we would like to focus on the differences in epidemiologic characteristics of stroke between our study population and those enrolled in a previous study conducted in Japan [2]. As indicated, the main difference in the findings between the two studies was that the proportion of hemorrhagic stroke among the total stroke events was substantially higher in the Japanese study than in our study (52% vs. 21%). Although the definite reasons for this difference remain uncertain, adding to the possible association kindly suggested by Kawada, some s...
Source: International Journal of Cardiology - September 18, 2015 Category: Cardiology Authors: Hyunwook Kim, Dong-Ryeol Ryu Tags: Correspondence Source Type: research

Multi‐modal CT in acute stroke: wait for a serum creatinine before giving intravenous contrast? No!
ConclusionsThe incidence of CIN is low when MMCT is used routinely to assess acute stroke patients. In this population, CIN was a biochemical phenomenon that did not have clinical manifestations, cause chronic kidney disease, require dialysis, or negatively impact on 90‐day mRS outcomes. Renal profiling and waiting for a baseline serum‐creatinine are an unnecessary delay to emergency reperfusion treatment.
Source: International Journal of Stroke - August 26, 2015 Category: Neurology Authors: Timothy E. Ang, Andrew Bivard, Christopher Levi, Henry Ma, Chung Y. Hsu, Bruce Campbell, Geoffrey Donnan, Stephen M. Davis, Mark Parsons Tags: Research Source Type: research

Risk of Stroke in Patients with ESRD.
CONCLUSIONS: People with ESRD have a substantially higher risk of stroke, particularly women and young people, and hemorrhagic stroke. Future work could investigate effective and safe interventions for primary and secondary prevention of stroke in people with ESRD. PMID: 26209158 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - July 24, 2015 Category: Urology & Nephrology Authors: Masson P, Kelly PJ, Craig JC, Lindley RI, Webster AC Tags: Clin J Am Soc Nephrol Source Type: research

A retrospective, longitudinal study estimating the association between interdialytic weight gain and cardiovascular events and death in hemodialysis patients
Conclusions: Greater IDWG is associated with an increased risk of CV morbid events. Strategies that mitigate IDWG may improve CV health and survival among hemodialysis patients.
Source: BMC Nephrology - July 22, 2015 Category: Urology & Nephrology Authors: Claudia CabreraSteven BrunelliDavid RosenbaumEmmanuel AnumKarthik RamakrishnanDonna JensenNils-Olov StålhammarBergur Stefánsson Source Type: research

Management of Bleeding Complications in Patients Taking Direct Oral Anticoagulants at a Large Tertiary Academic Medical Center
Abstract Direct oral anticoagulants (DOACs) offer a fixed-dose alternative to warfarin for stroke prevention in patients with atrial fibrillation. However, there is minimal evidence to guide the management of bleeding in patients taking a DOAC. We retrospectively evaluated the acute management of major bleeding in this patient population at a large, tertiary academic medical center. We evaluated various strategies of management including dialysis, transfusions, pharmacologic agents, surgical intervention, and reinitiation of anticoagulation. We also assessed length of intensive care unit and hospital stay, mor...
Source: Current Emergency and Hospital Medicine Reports - June 13, 2015 Category: Emergency Medicine Source Type: research

New aspects of cerebrovascular diseases in dialysis patients.
Authors: Naganuma T, Takemoto Y Abstract Growing evidence suggests that chronic kidney disease is a significant risk factor for stroke, subclinical cerebrovascular abnormalities, and cognitive impairment, independent of known cardiovascular risk factors. Cerebrovascular disease is also a major cause of death in dialysis patients, who have a much higher incidence of stroke compared to the normal population. Strokes in dialysis patients are also characterized by a higher incidence of hypertensive intracerebral hemorrhage compared with those in the general population. Recent studies on dialysis cohorts have shown that...
Source: Contributions to Nephrology - June 1, 2015 Category: Urology & Nephrology Tags: Contrib Nephrol Source Type: research

Reduced Stroke Risk After Parathyroidectomy in End-Stage Renal Disease: A 13-Year Population-Based Cohort Study
Abstract: Research information on the risk of stroke in patients with dialysis-dependent end-stage renal disease (ESRD) who have undergone parathyroidectomy (PTX) is scant. We used a nationwide health insurance claims database to select all patients with dialysis-dependent ESRD age 18 years and older for the study population. Of the patients with ESRD, we selected 1083 patients who had undergone PTX between 1998 and 2006 as the PTX group and frequency-matched 1083 patients with ESRD by sex, age, years since the disease diagnosis, and the year of undergoing PTX as the non-PTX group. We used a multivariate Cox proportional h...
Source: Medicine - June 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Fp721 * rising global incidence of hemorrhagic stroke in hemodialysis
Source: Nephrology Dialysis Transplantation - May 21, 2015 Category: Urology & Nephrology Authors: Power, A., Usvyat, L., Marcelli, D., Canaud, B., Guinsburg, A., Marelli, C., Pusey, C., Levin, N., Kotanko, P., MONDO Initiative Tags: DIALYSIS. EPIDEMIOLOGY, OUTCOME RESEARCH, HEALTH SERVICES RESEARCH - 1 Source Type: research

Sp378 * does the presence of chronic kidney disease influence haemorrhagic stroke outcomes?
Source: Nephrology Dialysis Transplantation - May 21, 2015 Category: Urology & Nephrology Authors: Thomas, P., Carr, P., Sandler, D., Baharani, J. Tags: CHRONIC KIDNEY DISEASE. CLINICAL EPIDEMIOLOGY - 2 Source Type: research

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