Publications by authors named "Spears J"

Introduction: Mechanical thrombectomy (MT) efficacy in medium vessel occlusion (MeVO) stroke, particularly in patients with low Alberta Stroke Program Early Computed Tomography Score (ASPECTS), remains less explored.

Methods: This retrospective study analyzed data from 443 AIS patients treated with MT for MeVO and low ASPECTS (4-7) at 37 centers across North America, Asia, and Europe, from September 2017 to July 2021. Patients were categorized into ASPECTS of 4-5 and 6-7.

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Aging leads to nephron senescence and chronic kidney disease (CKD). In cats, indoxyl sulfate (IxS) has been previously quantified and associated with CKD, and little is known about tubular transporters. Two cohorts of cats aged 6 to 21 years were enrolled.

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Article Synopsis
  • The study examined the effectiveness of endovascular therapy (EVT) versus best medical therapy (BMT) for isolated anterior cerebral artery occlusions (ACAo) in acute stroke patients.
  • The analysis involved 108 patients from various countries, comparing outcomes like functional independence at 90 days, with results showing no significant difference in success rates between EVT and BMT.
  • Conclusions indicate that while EVT had a high success rate in procedures, it did not lead to better functional outcomes or lower mortality compared to BMT, suggesting a need for more randomized trials.
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Two experiments were conducted to determine: 1) the impact of strained rumen fluid (SRF) alone or SRF with particle-associated microorganisms (PAO) included and dilution on in vitro dry matter digestibility (DMD) and 2) the impact of trace mineral (TM) source on in vitro fermentation characteristics and TM solubility under simulated abomasal and intestinal conditions. In experiment 1, 3 cannulated steers were adapted to a diet formulated to meet the nutrient requirements for lactating dairy cows. Strained RF was obtained by straining rumen content through 2 layers of cheesecloth.

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Background: Despite the proven effectiveness of endovascular therapy (EVT) in acute ischemic strokes (AIS) involving anterior circulation large vessel occlusions, isolated posterior cerebral artery (PCA) occlusions (iPCAo) remain underexplored in clinical trials. This study investigates the comparative effectiveness and safety of EVT against medical management (MM) in patients with iPCAo.

Methods: This multinational, multicenter propensity score-weighted study analyzed data from the Multicenter Analysis of primary Distal medium vessel occlusions: effect of Mechanical Thrombectomy (MAD-MT) registry, involving 37 centers across North America, Asia, and Europe.

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  • There is a lack of evidence on the safety of flow diversion (FD) for treating aneurysms outside the circle of Willis, leading to a study on the Silk Vista Baby (SVB) device at a single medical center.
  • The study involved 57 patients with various types of aneurysms, mostly in the anterior circulation, and found a low complication rate (5.2% symptomatic ischemic) with no hemorrhagic incidents and an overall mortality rate of 1.8%.
  • The findings suggest that SVB is a safe option for treating both distal anterior and complex posterior fossa aneurysms, but further multicenter studies are necessary to validate these results.
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Introduction: The spore-forming bacterial species is commonly utilized in feed for livestock and aquaculture. In recent years, there has been increased interest in introducing . into human supplements and food.

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  • Medium vessel occlusion (MeVO) strokes, especially in the M2 segment of the middle cerebral artery, are a significant challenge in stroke management, necessitating effective prediction of patient outcomes after mechanical thrombectomy (MT).
  • This study analyzed data from the MAD-MT registry to evaluate the relationship between follow-up infarct volume (FIV) and 90-day functional outcomes, using the modified Rankin Scale (mRS) as a measurement.
  • Results showed that FIV is a strong predictor of outcomes, with specific volume thresholds indicating favorable prognosis; notably, an FIV of ≤15 ml had the best predictive capability, outperforming traditional recanalization scores.
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  • The study investigates the effectiveness and safety of two treatment methods for acute ischemic stroke (AIS) caused by distal medium vessel occlusion (DMVO): intravenous thrombolysis (IVT) with mechanical thrombectomy (MT) versus IVT alone.
  • Data was collected from 37 centers worldwide, involving over 1,000 patients, with the primary focus on functional independence at 90 days and secondary outcomes including mortality and intracerebral hemorrhage.
  • Findings suggest that both treatment options yield similar functional and mortality outcomes for DMVO patients, but the MT-IVT approach carries a higher risk of hemorrhagic complications, indicating that it may not provide significant advantages over IVT alone for every patient.
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Purpose: To assess whether the Modified 5 (mFI-5) and 11 (mFI-11) Factor Frailty Indices associate with postoperative mortality, complications, and functional benefit in supratentorial meningioma patients aged over 80 years.

Methods: Baseline characteristics were collected from eight centers. Based on the patients' preoperative status and comorbidities, frailty was assessed by the mFI-5 and mFI-11.

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  • - The Woven EndoBridge (WEB) device is used for treating wide-neck intracranial bifurcation aneurysms smaller than 10 mm, but there's limited data on its effectiveness for larger aneurysms.
  • - A study reviewed data from the WorldWide WEB Consortium involving 898 patients to compare outcomes between small and large aneurysms, using propensity score matching (PSM) for accuracy.
  • - Results showed that large aneurysms had significantly lower rates of adequate occlusion and higher rates of retreatment compared to small aneurysms, suggesting that these findings could influence treatment choices and patient discussions in the future.
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  • * Experiment 2 involved feeding steers two types of trace mineral sources (hydroxy and sulfate) and measuring how well zinc was bound in the digestive system over time.
  • * Results from both experiments suggest that the source of trace minerals can significantly influence their characteristics in water and their interactions in the rumen, potentially affecting mineral availability for absorption in livestock.
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Background: Acute ischemic stroke (AIS) from primary medium vessel occlusions (MeVO) is a prevalent condition associated with substantial morbidity and mortality. Despite the common use of mechanical thrombectomy (MT) in AIS, predictors of poor outcomes in MeVO remain poorly characterized.

Methods: In this prospectively collected, retrospectively reviewed, multicenter, multinational study, data from the MAD-MT (Multicenter Analysis of primary Distal medium vessel occlusions: effect of Mechanical Thrombectomy) registry were analyzed.

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Article Synopsis
  • A study was conducted to compare the safety and effectiveness of endovascular treatment (EVT) versus best medical management (BMM) for patients with acute ischaemic stroke caused by distal medium vessel occlusion (DMVO).
  • The analysis involved 2,125 patients, showing no significant difference in achieving functional independence at 90 days between EVT and BMM, despite EVT being associated with higher rates of hemorrhagic complications.
  • The results suggest that EVT does not provide better functional outcomes than BMM in DMVO cases while increasing the risk of bleeding, indicating the need for cautious use of EVT and further research to improve treatment approaches.
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  • - The study compared the effectiveness and safety of four first-generation flow diverters (FDs) used for treating sidewall ICA intracranial aneurysms, which include Pipeline, Silk, FRED, and Surpass devices, using data from 444 patients across 18 institutions from 2009-2016.
  • - Analysis revealed no significant differences in retreatment rates or complications among the devices; however, the Surpass device showed the highest probability of achieving effective occlusion at follow-up, followed by FRED, Pipeline, and Silk.
  • - Although all devices had good clinical outcomes, the study highlights the need for prospective research to further clarify the differences and long-term effects of these flow diverters.
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  • Acute ischemic stroke (AIS) from distal medium vessel occlusions (DMVOs) is common, and while IV thrombolysis is standard, mechanical thrombectomy (MT) is becoming more prevalent for treatment.
  • A study reviewed data from 1708 DMVO patients treated with MT, finding that 8.7% experienced symptomatic intracerebral hemorrhage (sICH) and identified several risk factors, including older age, distal occlusion location, prior antiplatelet use, lower ASPECT scores, higher pre-op blood glucose, more passes during MT, and successful recanalization status.
  • Understanding these risk factors can help healthcare providers better assess and manage the risk of sICH in patients undergoing MT for DM
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  • Researchers aimed to identify factors predicting aneurysm occlusion and retreatment following WEB embolization due to limited existing studies.
  • The study reviewed data from 763 patients across 30 institutions, finding a 65.1% complete occlusion rate at follow-up and a 7.3% retreatment rate.
  • Key negative predictors for complete occlusion included smoking history, larger aneurysm size, and wall branch presence, while intraprocedural occlusion significantly improved long-term outcomes.
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Background: Antithrombin (AT) deficiency is a severe thrombophilia associated with increased rates of maternal morbidity, mortality, and greater healthcare resource utilization during pregnancy and postpartum.

Methods: Two large U.S.

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Objective: Intravenous contrast injection protocol for certain CT studies at our institution was revised in June 2022 in response to the global shortage of iohexol. This included CT head studies performed for neuro-navigation (contrast dose from 90 mL to 70 mL). The quality of these studies was assessed.

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Background: Hydrocephalus is a significant contributor to morbidity following aneurysmal subarachnoid hemorrhage (aSAH). We aimed to investigate the association between primary treatment modality and the incidence of hydrocephalus requiring CSF diversion, using a target trial approach for causal inference.

Methods: This cohort study used US administrative health claims data (Clinformatics Data Mart) and was conducted among aSAH patients undergoing primary treatment with either clipping or coiling, from January 1, 2004, to February 28, 2023.

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Despite impressive improvements in the care of patients with ST-segment elevation myocardial infarction, mortality remains high. Reperfusion is necessary for myocardial salvage, but the abrupt return of flow sets off a cascade of injurious processes that can lead to further necrosis. This has been termed myocardial ischemia-reperfusion injury and is the subject of this review.

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Endovascular interventions are increasingly becoming the preferred approach for treating strokes and cerebral artery diseases. These procedures rely on sophisticated angiographical imaging guidance, which encounters challenges because of limited contrast and spatial resolution. Achieving a more precise visualization of the underlying arterial pathology and neurovascular implants is crucial for accurate procedural decision-making.

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Background: Stroke remains a major health concern globally, with oral anticoagulants widely prescribed for stroke prevention. The efficacy and safety of mechanical thrombectomy (MT) in anticoagulated patients with distal medium vessel occlusions (DMVO) are not well understood.

Methods: This retrospective analysis involved 1282 acute ischemic stroke (AIS) patients who underwent MT in 37 centers across North America, Asia, and Europe from September 2017 to July 2023.

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Epstein-Barr virus, a herpesvirus, has been associated with a variety of cancers, including Burkitt, Hodgkin, and non-Hodgkin lymphomas; posttransplant lymphoproliferative disorders; gastric carcinoma; and nasopharyngeal carcinoma, in both immunocompetent and immunocompromised individuals. Previous studies have established a connection between Epstein-Barr virus and the development of smooth-muscle tumors. Smooth-muscle tumors of the brain are very rare and are often misdiagnosed as meningiomas on imaging.

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Article Synopsis
  • This study examined how taking antiplatelet medications before and after procedures affects the risk of thromboembolic complications (TECs) in patients treated with the Woven EndoBridge (WEB) device for specific brain aneurysms.
  • It analyzed data from multiple centers, involving a total of 1412 patients, to determine if antiplatelet drugs reduce the likelihood of TECs, finding that those who took them before the procedure had a significantly lower risk.
  • The study concluded that while preprocedural antiplatelet use significantly lowers the chances of TECs, the effect does not carry over when the medication is taken post-procedure.
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