Effectiveness and Safety of Mechanical Thrombectomy in Large-Vessel-Occlusion Mild Stroke: Insights from the ASSIST Registry.

Background And Purpose: Mechanical thrombectomy (MT) is effective for acute ischemic stroke, yet its indication in mild stroke remains unclear. This study evaluates MT's effectiveness and safety in low NIHSS patients and assesses different MT strategies' impact on procedural success and clinical outcomes.

Materials And Methods: Data from the ASSIST Registry were analyzed, categorizing patients with large vessel occlusion of the anterior circulation into mild (NIHSS≤5) and moderate-severe (NIHSS>5) stroke groups.

Trevo 3 Mm and/or AXS Catalyst 5 for the Treatment of Medium Distal Vessel Occlusion Stroke-results from the ASSIST Registry.

Background: The effect of endovascular therapy (EVT) on the outcome of stroke patients with a medium distal vessel occlusion (MDVO) is unclear. We report the results of MDVO patients treated with the 3 mm Trevo stent retriever (SR) and/or the AXS Catalyst 5 distal access catheter.

Methods: Data was derived from a prospective, multicenter global registry (ASSIST registry) which enrolled patients treated with operator preferred EVT technique at 71 sites from January 2019 to January 2022.

Adult Development and Associated Health Risks.

Much has been learned about adult development in recent decades. Adults go through stages of development (emerging adulthood, young adulthood, middle adulthood, post-retirement, and very old age) with certain challenges at each stage. Viewing patients through a developmental lens is part of providing patient-centered care.

Spinal cord and brain corticospinal tract lesions are associated with motor progression in tumefactive multiple sclerosis.

Background: Spinal cord lesions have been associated with progressive disease in individuals with typical relapsing remitting MS (RRMS).

Objective: In the current study, we aimed to determine if progressive disease is associated with spinal cord lesions in those with tumefactive multiple sclerosis (MS).

Methods: Retrospective chart review of individuals presenting to Mayo Clinic with tumefactive MS with spinal cord MRIs available (n=159).

mG-FAST, a single pre-hospital stroke screen for evaluating large vessel and non-large vessel strokes.

Background: Several stroke scales have been implemented to enhance early recognition of large vessel occlusion (LVO) in the field. These scales necessitate a tiered approach requiring emergency medical services (EMS) to utilize two scales, one for identifying stroke and another for differentiating LVO from non-LVO. Ideally, a single stroke scale should be utilized by EMS for triage.

Seizures Associated With Bone Density Conservation Agents.

Objective: The purpose of this review is to discuss the existing literature regarding patients who have experienced seizures after administration of a bone density conservation agent (BDCA).

Data Sources: A comprehensive literature review was performed between September and October 2021 using the following keywords: osteoporosis/drug therapy, seizures/chemically induced, hypercalcemia, hypocalcemia, osteoporosis, seizure risk, osteoclast medication, seizures, bisphosphonates, risedronate, zoledronic acid, pamidronate, denosumab, Prolia, Xgeva, calcitonin, BDCAs.

Study Selection And Data Extraction: A total of 90 articles were identified, but only 6 articles met prespecified inclusion and exclusion criteria.

Clinical considerations for rapid administration of undiluted or minimally diluted levetiracetam bolus doses.

Introduction: The ability to administer medications via rapid intravenous bolus has the potential to allow for the rapid attainment of therapeutic drug levels and to limit the amount of unnecessary fluid volumes infused. The purpose of this review was to evaluate the efficacy and safety of undiluted or minimally diluted levetiracetam bolus doses.

Areas Covered: A total of six pieces of the literature were evaluated in this review.

Cerebrospinal fluid evaluation in patients with progressive motor impairment due to critical central nervous system demyelinating lesions.

Background: Elevated intrathecal immunoglobulin G (IgG; oligoclonal bands (OCBs)) or IgG in people with progressive motor impairment due to "critical" demyelinating lesions are of uncertain significance.

Objective: Compare clinical/radiological features of people with "critical" demyelinating lesion-induced progressive motor impairment with/without elevated intrathecal IgG synthesis.

Methods: A total of 133 people with progressive motor impairment attributable to "critical" demyelinating lesions (corticospinal tract location, consistent with the progressive motor deficit) were compared regarding clinical and radiological presentation with and without ≥2 unique cerebrospinal fluid (CSF) OCB and/or IgG index ≥0.

Outcomes of Mechanical Thrombectomy for Patients With Stroke Presenting With Low Alberta Stroke Program Early Computed Tomography Score in the Early and Extended Window.

Importance: Limited data are available about the outcomes of mechanical thrombectomy (MT) for real-world patients with stroke presenting with a large core infarct.

Objective: To investigate the safety and effectiveness of MT for patients with large vessel occlusion and an Alberta Stroke Program Early Computed Tomography Score (ASPECTS) of 2 to 5.

Design, Setting, And Participants: This retrospective cohort study used data from the Stroke Thrombectomy and Aneurysm Registry (STAR), which combines the prospectively maintained databases of 28 thrombectomy-capable stroke centers in the US, Europe, and Asia.

Manganese Toxicity Associated With Total Parenteral Nutrition: A Review.

To review hypermanganesemia-induced toxicities in adult patients receiving parenteral nutrition (PN) therapy. A comprehensive literature review was conducted from June 2020 to May 2021 on PubMED, MEDLINE, Scopus, ProQuest, the Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Web of Science. Keyword and Boolean phrase searches were conducted using the following terminology: "manganese" OR "manganesemia" OR "manganism" or "hypermanganesemia" AND "total parenteral nutrition" OR "PN" or "parenteral nutrition" AND "toxicity" OR "accumulation.

Efficacy and Safety Considerations With Second-Generation Antipsychotics as Adjunctive Analgesics: A Review of Literature.

To determine the efficacy and safety of second-generation antipsychotics (SGAs) as adjunctive analgesics. A comprehensive literature review was conducted between August 2020 and January 2021 on PubMed, Scopus, and ProQuest Central. Keyword and Boolean phrase searches using the following terminology were conducted: "Quetiapine" OR "Risperidone" OR "Olanzapine" OR "Ziprasidone" AND "Analgesia" NOT "Psychosis" NOT "Psych.

Dosing Considerations for Combination Antistaphylococcal β-Lactam and Glyco/lipopeptide Salvage Therapy for Resistant Gram-Positive Infections: A Systematic Review.

Objective: The objective of this systematic review is to evaluate dosing regimens of combination salvage regimens used as part of infectious disease pharmacotherapy.

Data Sources: A systematic review was conducted on PubMed, MEDLINE, Scopus, ProQuest Central, and CINAHL through March 2021 using the following terminology: "combination" OR "Seesaw" OR "see-saw" OR "salvage" AND "infection" OR "resistant infection" OR "Gram-positive" AND "beta-lactam" OR "cephalosporin" OR "carbapenem" OR "monobactam" OR "glycopeptide" OR "lipopeptide."

Study Selection And Data Extraction: Following the application of inclusion and exclusion criteria, 8 pieces of literature were ultimately included in this review.

Neuroform Atlas Stent for Treatment of Middle Cerebral Artery Aneurysms: 1-Year Outcomes From Neuroform Atlas Stent Pivotal Trial.

Background: Heterogeneous effect of endovascular aneurysm therapy has been observed across different anatomic locations. There is a paucity of data for stent-assisted coiling of middle cerebral artery (MCA) aneurysms.

Objective: To present the results of the MCA aneurysm group from the Neuroform Atlas (Stryker Neurovascular) investigational device exemption (IDE) trial.

Pivotal Trial of the Neuroform Atlas Stent for Treatment of Anterior Circulation Aneurysms: One-Year Outcomes.

Background And Purpose: Stent-assisted coil embolization using the new generation Neuroform Atlas Stent System has shown promising safety and efficacy. The primary study results of the anterior circulation aneurysm cohort of the treatment of wide-neck, saccular, intracranial, aneurysms with the Neuroform Atlas Stent System (ATLAS trial [Safety and Effectiveness of the Treatment of Wide Neck, Saccular Intracranial Aneurysms With the Neuroform Atlas Stent System]) are presented.

Methods: ATLAS IDE trial (Investigational Device Exemption) is a prospective, multicenter, single-arm, open-label study of wide-neck (neck ≥4 mm or dome-to-neck ratio <2) intracranial aneurysms in the anterior circulation treated with the Neuroform Atlas Stent and approved coils.

Neuroform Atlas Stent System for the treatment of intracranial aneurysm: primary results of the Atlas Humanitarian Device Exemption cohort.

Background And Objective: Stent-assisted coil embolization is a well-established treatment of intracranial wide-necked aneurysms. The Neuroform Atlas Stent System is a new generation microstent designed to enhance coil support, conformability, deliverability, and improve deployment accuracy. We present the 1-year efficacy and angiographic results of the Humanitarian Device Exemption (HDE) cohort from the Atlas Investigational Device Exemption (IDE) clinical trial.