Safety of prolonged bilateral antegrade cerebral perfusion in aortic arch surgery with moderate hypothermia.

Objectives: This study investigates the impact of bilateral antegrade cerebral perfusion time on outcomes in aortic arch surgery.

Methods: In total, 961 patients underwent either hemi arch (n = 385) or total arch replacement (n = 576) with bilateral antegrade cerebral perfusion and moderate hypothermia management between 2006 and 2020 across 2 aortic centers. Antegrade cerebral perfusion time was categorized into 4 groups (≤30 min: n = 169, 30-60min: n = 298, 60-90min: n = 261, >90min: n = 233).

Left, Then Right Internal Carotid Artery Dissection: A Case Report.

Introduction: We present a unique case of a patient who presented to the emergency department with stroke-like symptoms found to have a spontaneous, left-sided internal carotid artery dissection (ICAD).

Case Report: The patient was treated successfully with thrombectomy and subsequently developed contralateral symptoms caused by a right-sided ICAD. This was managed with a second contra-lateral thrombectomy.

Autophagia in a Patient with Dementia and Hemineglect: A Case Report.

Introduction: Patients living with dementia as well as patients with neurological deficits are at significant risk for injury from multiple sources. Injuries may include falls, neglect, and, in some cases, self-injury. These patients require significant observation and closely monitored care.

Analysis of the current status of knowledge, attitudes, and practices among stroke-related healthcare professionals in the treatment of shoulder pain in hemiplegic patients.

Objective: To investigate the current status of knowledge, attitude, and practice (KAP) of healthcare professionals in stroke-related departments of primary-level tertiary hospitals regarding the prevention and treatment of hemiplegic shoulder pain, and to analyze influencing factors. This aims to provide a reference for further training, guidance, and management of hemiplegic shoulder pain.

Methods: A total of 123 healthcare professionals from stroke-related departments of two tertiary hospitals in a county-level city in Zhejiang province were selected as the research subjects from March 6, 2023, to March 14, 2023.

Frequency of Acute Kidney Injury in Patients Admitted With Acute Stroke at Hayatabad Medical Complex, Peshawar.

Background Patients hospitalized with acute stroke are at risk of developing acute kidney injury (AKI), and when both conditions occur together, patient outcomes are often worse. The relationship between stroke type, patient characteristics, and the development of AKI is not fully understood, particularly in tertiary care settings in Pakistan, where healthcare resources and patient characteristics may differ from Western populations. Objective To determine the frequency of AKI and identify associated risk factors, including stroke type, severity, and comorbidities, in patients presenting with acute stroke at a tertiary care center in Pakistan, the Hayatabad Medical Complex, Peshawar.

Beyond the Stroke: A Case Report of Multiple Sclerosis.

Multiple sclerosis is an inflammatory, autoimmune demyelinating condition and poses diagnostic challenges due to varied presentations. This case report presents a divergence from typical clinical presentations of multiple sclerosis (MS), as the initial presentation resembled symptoms of a brain stem stroke. Conventionally, MS suspicion arises in the presence of previous neurological deficits or signs of optic neuritis.

Prevalence and Risk Factors of Poststroke Cognitive Impairment: A Systematic Review and Meta-Analysis.

Background: Stroke is a common disease that poses a significant threat to human health. Approximately one-third of stroke patients experience poststroke cognitive impairment (PSCI), which severely impacts their quality of life and survival time. Although the prevalence and risk factors for PSCI have been widely reported, these results have not been synthesized.

Dual antiplatelet therapy after minor strokes or high-risk TIA: Evidence from the Austrian stroke registry.

Background And Purpose: Three large, randomized trials demonstrated the benefit of short-term dual antiplatelet therapy (DAPT) versus monotherapy after non-cardioembolic minor stroke or high-risk transient ischemic attack (TIA). The aim of this study was to evaluate effects of DAPT versus monotherapy on functional outcomes and safety in a real-life setting.

Methods: Patients with minor stroke (NIHSS <4) or high-risk TIA (ABCD2 score ≥4) of non-cardioembolic origin without major vessel occlusion or revascularization therapy (thrombolysis or thrombectomy) treated between 2018 and 2023 were analyzed based on a prospective nationwide stroke unit registry.

Remote ischaemic conditioning for neurological disorders-a systematic review and narrative synthesis.

Introduction: Remote ischaemic conditioning (RIC) refers to the use of controlled transient ischemic and reperfusion cycles, commonly of the upper or lower limb, to mitigate cellular damage from ischaemic injury. Preclinical studies demonstrate that RIC may have a neuroprotective effect and therefore could represent a novel therapeutic option in the management of neurological disorders. The aim of this review is to comprehensively describe the current clinical evidence of RIC in neurological disorders.

Evaluating inter- and intra-rater reliability in assessing upper limb compensatory movements post-stroke: creating a ground truth through video analysis?

Background: Compensatory movements frequently emerge in the process of motor recovery after a stroke. Given their potential for unfavorable long-term effects, it is crucial to assess and document compensatory movements throughout rehabilitation. However, clinically applicable assessment tools are currently limited.

Implementation and sustainment of virtual reality stroke workflow training for physician trainees at comprehensive stroke centres: a quantitative and qualitative study.

Background: Variation in stroke treatment metrics highlight a need for approaches to improve clinical processes. Training interventions can improve outcomes, but Australian physician trainees do not currently receive formal process-directed stroke training. Virtual reality (VR) stroke workflow training has proven acceptable, usable, useful and feasible in trial contexts, but how to integrate VR training into physician training remains unclear.

Serum creatinine to cystatin C ratio in relation to heart failure with preserved ejection fraction.

Background: Sarcopenia was recognized to be one of the common comorbidities in heart failure (HF). The sarcopenia index (SI), based on serum creatinine to cystatin C ratio, was developed as a simple tool to evaluate skeletal muscle mass but has not been well-studied in the correlation of left ventricular ejection fraction (LVEF). The aim of this study is to analyze the SI in patients with HF, especially patients with HF with preserved ejection fraction (HFpEF), and to develop a prediction model for HFpEF.

Cardiovascular disease burden in the North Africa and Middle East region: an analysis of the global burden of disease study 1990-2021.

Aims: Cardiovascular diseases (CVD) are a leading cause of mortality and morbidity in the North Africa and Middle East (NAME) region. Due to the paucity of research on this issue, we aimed to estimate the burden of CVD and its attributable risk factors in the NAME region.

Methods And Results: Data from the Global Burden of Disease (GBD) were retrieved to estimate the incidence, prevalence, deaths, years of life lost, years lived with disability, disability-adjusted life years (DALYs) for CVD across 21 countries and both sexes.

Patient-oriented unsupervised learning to uncover the patterns of multimorbidity associated with stroke using primary care electronic health records.

Background: We aimed to identify and characterise the longitudinal patterns of multimorbidity associated with stroke.

Methods: We used an unsupervised patient-oriented clustering approach to analyse primary care electronic health records (EHR) of 30 common long-term conditions (LTC) in patients with stroke aged over 18, registered in 41 general practices in south London between 2005 and 2021.

Results: Of 849,968 registered patients, 9,847 (1.

Acute kidney injury and in-hospital outcomes after transcatheter aortic valve replacement in patients without chronic kidney disease: insights from the national inpatient sample.

Background: Acute kidney injury (AKI) complicates transcatheter aortic valve replacement (TAVR), leading to higher mortality. The incidence and effects of AKI on clinical outcomes in patients undergoing TAVR without chronic kidney disease (CKD) are unclear. We aimed to determine the association between AKI and in-hospital outcomes in patients with TAVR using propensity score matching (PSM).

Factors Affecting the Readmission of Patients with Stroke.

Background: Incidence of stroke is increasing annually in China, the readmission rate of patients with stroke remains high.

Method: In total, 441 patients were enrolled in this study. We described the incidence of stroke readmissions.

Optimal Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Patients with Multivessel Disease and Chronic Kidney Disease.

There is a scarcity of data on clinical outcomes after intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in patients with multivessel disease and chronic kidney disease (CKD). The OPTIVUS-Complex PCI study multivessel cohort was a prospective multicenter single-arm trial enrolling 1015 patients who underwent multivessel IVUS-guided PCI including left anterior descending coronary artery target with an intention to meet the prespecified OPTIVUS criteria for optimal stent expansion. We compared the clinical outcomes between patients with and without CKD.

Incidence and associated factors of pre-hospital care-seeking delay in people with acute ischemic stroke: a systematic review and meta-analysis.

Background: Despite decades of educational efforts, patients with acute ischemic stroke (AIS) remain delayed in seeking medical care, which becomes the greatest obstacle to the successful management of the condition.

Objective: To systematically explore the incidence and influencing factors of pre-hospital care-seeking delay in acute ischemic stroke patients.

Methods: We systematically searched the PubMed, Embase, Cochrane Library, Web of Science, and Cumulative Index to Nursing and Allied Health Literature from database inception to September 30, 2023.

Fibrinolytic uses in the emergency department: a narrative review.

Introduction: Several life-threatening conditions associated with thrombosis include acute ischemic stroke (AIS), acute myocardial infarction (AMI), and acute pulmonary embolism (PE). Fibrinolytics are among the treatment algorithms for these conditions.

Objective: This narrative review provides emergency clinicians with an overview of fibrinolytics for AIS, AMI, and PE in the emergency department (ED) setting.

Physical urban environment and cardiometabolic diseases in the five largest Bulgarian cities.

This study investigated the associations between residential environmental characteristics and the prevalence of cardiometabolic diseases in the five largest Bulgarian cities. Representative cross-sectional survey data (N = 4640 adults) was collected in Sofia, Plovdiv, Varna, Burgas, and Ruse. Participants self-reported diagnosis or medication intake for hypertension, ischemic heart disease (IHD), stroke, and diabetes mellitus, as well as domestic burning of solid fuel and having a domestic garden.

Predictive value of lncRNA DBH-AS1 for cardiovascular events in patients with type 2 diabetes mellitus with coronary heart disease.

Background: The frequency of type 2 diabetes mellitus (T2DM) is rising annually. Coronary heart disease (CHD) is a prevalent complication affecting individuals with T2DM.

Objective: The aim of this investigation was to assess the level of DBH-AS1 in T2DM with CHD, and to determine its potential role in forecasting the occurrence of significant cardiovascular events.

Implementation of a goal-directed Care Bundle for intracerebral hemorrhage: Results of embedded process evaluation in the INTERACT3 trial.

The third, stepped-wedge, cluster-randomized, Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT3), has shown that a goal-directed multi-faceted Care Bundle incorporating protocols for the management of physiological variables was safe and effective for improving functional recovery in a broad range of patients with acute intracerebral hemorrhage (ICH). The INTERACT3 Care Bundle included time- and target-based protocols for the management of early intensive lowering of systolic blood pressure (SBP, target <140mmHg), glucose control (target 6.1-7.

Insights into risk factors and outcomes of post-stroke seizures in Saudi Arabia: a multicenter analysis.

Post-stroke seizures present a global challenge, yet its frequency and factors associated with its incidence are poorly documented, particularly in the Middle East. Thus, this study aims to investigate post-stroke seizure frequency and stroke-associated factors among ischemic stroke patients in Saudi Arabia, addressing demographic, clinical, and comorbid aspects to improve prognosis, diagnosis, prevention, and management. A multicenter, cohort observational study included eligible ischemic stroke patients who were categorized into those who developed seizures after injury and those who did not.

[Management of acute ischemic stroke : Bridging vs. mothership].

Clinical Issue: Acute ischemic stroke remains one of the most common causes of death in Germany and affects around 16,000 people every year. With the begin of using of i.v.