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Chronic Stroke

Shu-Man Lin, Shih-Hsien Yang, Chung-Chao Liang, Huei-Kai Huang, Ching-Hui Loh
OBJECTIVES: To investigate the association between benzodiazepine (BZD) use and the risk of chronic-onset poststroke pneumonia. DESIGN: Population-based propensity-matched retrospective cohort study. SETTING: Taiwan's National Health Insurance Research Database. PARTICIPANTS: Patients newly diagnosed with stroke between 2000 and 2012 were identified and, after propensity score matching, 7516 patients were enrolled. Among these, 3758 patients received BZDs after stroke while 3758 did not...
January 25, 2019: BMJ Open
Jun-Jun Yeh, Cheng-Li Lin, Chung Y Hsu, Zonyin Shae, Chia-Hung Kao
BACKGOUND AND AIMS: We aimed at determining the effects of statin use on coronary artery disease (CAD) and stroke risks in patients with asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS). METHODS: We retrospectively enrolled patients with ACOS treated with (N = 916) and without (N = 6338) statins. The cumulative incidence of CAD and stroke (ischemic and hemorrhagic) was analyzed through time-dependent Cox proportional regression. After adjustment for sex, age, comorbidities, inhaled corticosteroid steroid (ICS) use, and oral steroid (OS) use, we calculated the adjusted hazard ratios (aHRs) and their 95% confidence intervals (CIs) for CAD or stroke in the statin users (long-term [>600 days] and short-term [≤600 days]) compared with the non-users...
February 11, 2019: Atherosclerosis
Bastian Cheng, Philipp Dietzmann, Robert Schulz, Marlene Boenstrup, Lutz Krawinkel, Jens Fiehler, Christian Gerloff, Götz Thomalla
Following acute ischemic stroke, isolated subcortical lesions induce gray matter atrophy in anatomically connected, yet distant cortical brain regions. We expand on previous studies by analyzing cortical thinning in contralesional, homologous regions indirectly linked to primary stroke lesions via ipsilesional cortical areas. For this purpose, stroke patients were serially studied by magnetic resonance imaging (diffusion tensor imaging and high-resolution anatomical imaging) in the acute (days 3-5) and late chronic stage one year after stroke...
February 20, 2019: Journal of Cerebral Blood Flow and Metabolism
Jen-Wen Hung, Chiung-Xia Chou, Yao-Jen Chang, Ching-Yi Wu, Ku-Chou Chang, Wen-Chi Wu, Stephen Howell
BACKGROUND: Virtual reality and interactive video games could decrease the demands on the time of the therapists. However, the cost of a virtual reality system and the requirement for technical support limits the availability of these systems. Commercial exergames are not specifically designed for therapeutic use, most patients with hemiplegic stroke are either too weak to play the games or develop undesirable compensatory movements. AIM: To develop Kinect2Scratch games and compare the effects of training with therapist-based training on upper extremity (UE) function of patients with chronic stroke...
February 15, 2019: European Journal of Physical and Rehabilitation Medicine
Suprawee Meelab, Itsara Bunupuradah, Jitrada Suttiruang, Salisa Sakulrojanawong, Nisanat Thongkua, Chattarin Chantawiboonchai, Prim Chirabandhu, Sasanpin Lertthanaporn, Krissada Suwanthip, Chindanai Songsaengthum, Boonyagorn Keattisaksri, Peeranut Trakulsuk, Apichat Pittapun, Naowanit Nata, Ram Rangsin, Boonsub Sakboonyarat
INTRODUCTION: Hypertension is a common cardiovascular disease at present. Uncontrolled blood pressure leads to further complications including heart attack, stroke and chronic kidney disease. In Thailand, most of the information related to this issue is collected by hospitals or hospital-based organizations rather than at the community level. The objectives of this study were to determine the prevalence of uncontrolled hypertension and to assess the relationship between patient characteristics (socio-behavioral and clinical) and uncontrolled blood pressure among hypertensive patients in the rural communities in the central areas in Thailand...
2019: PloS One
Nataliia Chemer, Volodymyr Bilanovskyi
INTRODUCTION: Recent studies show that spasticity occurs in 20-30% of all stroke victims, especially in younger patients. Botulinum toxin is a very effective treatment; however, it is not reimbursed in the Ukraine, thus leaving patients untreated and unable to use the paralyzed limb. Finally, this might result in long-term disability with economic consequences and negative impact on the psychological state of patients. Therefore, alternative and affordable treatment options are of high interest...
February 18, 2019: Neurology and Therapy
Xiuli Zeng, Xuxuan Gao, Yu Peng, Qiheng Wu, Jiajia Zhu, Chuhong Tan, Genghong Xia, Chao You, Ruoting Xu, Suyue Pan, Hongwei Zhou, Yan He, Jia Yin
Objective: Gut microbiota is a newly identified risk factor for stroke, and there are no large prospective studies linking the baseline gut microbiome to long-term risk of stroke. We present here the correlation between the gut microbiota and stroke risk in people with no prior stroke history. Methods: A total of 141 participants aged ≥60 years without prior history of stroke were recruited and divided into low-risk, medium-risk, and high-risk groups based on known risk factors and whether they were suffering from chronic diseases...
2019: Frontiers in Cellular and Infection Microbiology
N R Bonetti, C Diaz-Cañestro, L Liberale, M Crucet, A Akhmedov, M Merlini, M F Reiner, S Gobbato, S Stivala, G Kollias, F Ruschitzka, T F Lüscher, J H Beer, G G Camici
Rheumatoid Arthritis (RA) is a chronic inflammatory disorder where incidence and severity of myocardial infarction are increased. Data on the incidence and outcome of stroke are conflicting. Thus, we investigated outcome after Ischemia/Reperfusion (I/R) brain injury in a mouse model of RA and assessed for the role of the tumour necrosis factor-α (TNF-α) inhibitor Infliximab herein. We used a TNF-α reliant mouse model of RA. RA and wildtype (WT) animals were treated with vehicle (RA/WT) or Infliximab (RA Infliximab) for 4 weeks, before undergoing I/R brain injury...
February 18, 2019: Scientific Reports
Besma Nejim, Devin Zarkowsky, Caitlin W Hicks, Satinderjit Locham, Hanaa Dakour Aridi, Mahmoud Malas
BACKGROUND: Endovascular aneurysm repair (EVAR) offered outstanding survival benefit but at the expense of cost, periodic radiographic monitoring, and higher reinterventions rates. Perioperative complications, although rare, can occur after EVAR, contributing to longer hospitalization, higher cost, and significant comorbidity and mortality. Therefore, the aim of this study was to identify the predictors of in-hospital events (IHEs) after elective EVAR. METHODS: The Vascular Quality Initiative database was explored from 2003 to 2017...
February 15, 2019: Journal of Vascular Surgery
Abdul Majeed Alwan Hammadi, Fizel Alhimyari
OBJECTIVES: This study aimed to show the positive effects of autologous bone marrow-derived mononuclear cells in the functional recovery of adult patients with subacute and chronic ischemic stroke. Stroke is a leading cause of morbidity and long-term disability in the world, with about one-third of survivors being permanently disabled. Bone marrowderived mononuclear cell concentrate is thought to improve cerebral blood flow and to speed recovery in animal models. Many types of stem cells have been used, including mesenchymal, cord blood cells, and embryonic, with different administration methods, including intrathecal, intravenous, intraarterial, and intracerebral, all with variable degrees of success...
January 2019: Experimental and Clinical Transplantation
Florian Posch, Cihan Ay, Herbert Stöger, Reinhold Kreutz, Jan Beyer-Westendorf
BACKGROUND: Chronic kidney disease (CKD), commonly described by estimated glomerular filtration rate (eGFR), is a frequent comorbidity in patients with atrial fibrillation (AF) and associated with thromboembolic and bleeding complications. Instead of single eGFR measurements, kidney function decline over time may better predict clinical outcomes but this has not been studied so far. METHODS: Patients with AF and stage 3/4 CKD were prospectively followed within a primary care electronic database from the United Kingdom (IMS-THIN)...
January 27, 2019: International Journal of Cardiology
Jing-Huan Deng, Kai-Yong Huang, Xiao-Xiao Hu, Xiao-Wei Huang, Xian-Yan Tang, Xiao Wei, Lei Feng, Guo-Dong Lu
Mild cognitive impairment (MCI), as a transitional stage between normal aging and dementia, causes cognitive decline among one-fifth of elders aged 65 years and older. Health-related lifestyles (HRL) are generally regarded as modifiable influencing factors of cognitive decline. The present study investigated how HRLs at two different life stages (one at midlife and the other at later life) affect MCI occurrence among community-dwelling elders, as part of the Diet and Healthy Aging (DaHA) study in Singapore...
2019: Journal of Alzheimer's Disease: JAD
JuHyung Park
[Purpose] The purpose of this study was to examine the effects of time-use intervention on the quality of life of outpatients with chronic stroke. [Participants and Methods] This study randomly allocated 31 chronic stroke outpatients into an experimental group (n=16) and a control group (n=15). The experiment group was given general rehabilitative therapy three times per week for eight weeks, and time-use intervention through counselling once per week for eight weeks. The control group was given general rehabilitative therapy only for three times per week for eight weeks...
January 2019: Journal of Physical Therapy Science
Waseem A Abboud, Sahar Nadel, Sharon Hassin-Baer, Abigail Arad, Alex Dobriyan, Ran Yahalom
BACKGROUND: Drooling is the unintentional loss of saliva from the mouth, usually caused by poor coordination of the swallowing mechanism. It is commonly seen in patients with chronic neurologic disorders, such as Parkinson's disease, amyotrophic lateral sclerosis (ALS), cerebral palsy, and stroke, as well as in patients with cognitive impairment and dementia. OBJECTIVES: To evaluate the efficacy and safety of ultrasound-guided botulinum toxin injections into the parotid and submandibular salivary glands for the treatment of drooling...
February 2019: Israel Medical Association Journal: IMAJ
Laura Miller McPherson, Julius P A Dewald
OBJECTIVE: The flexion and extension synergies were quantified at the paretic elbow, forearm, wrist, and finger joints within the same group of participants for the first time. Differences in synergy expression at each of the four joints were examined, as were the ways these differences varied across the joints. METHODS: Twelve post-stroke individuals with chronic moderate-to-severe hemiparesis and six age-matched controls participated. Participants generated isometric shoulder abduction (SABD) and shoulder adduction (SADD) at four submaximal levels to progressively elicit the flexion and extension synergies, respectively...
January 31, 2019: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
F Mahfoud, M Böhm, C M Bongarth, R Bosch, R E Schmieder, H Schunkert, C Stellbrink, P Trenkwalder, O Vonend, J Weil, R Kreutz
Arterial hypertension represents one of the most frequent chronic diseases that can lead to complications, such as stroke, dementia, heart attack, heart failure and renal failure. By 2025 the number of hypertensive patients will increase to approximately 1.6 billion people worldwide. The new guidelines of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) on the management of arterial hypertension replace the guidelines of the ESC/ESH from 2013. The 2018 guidelines of the ESC/ESH were adopted by the German Cardiac Society and the German Hypertension League...
February 15, 2019: Der Internist
Nick S Ward, Fran Brander, Kate Kelly
OBJECTIVE: Persistent difficulty in using the upper limb remains a major contributor to physical disability post-stroke. There is a nihilistic view about what clinically relevant changes are possible after the early post-stroke phase. The Queen Square Upper Limb Neurorehabilitation programme delivers high-quality, high-dose, high-intensity upper limb neurorehabilitation during a 3-week (90 hours) programme. Here, we report clinical changes made by the chronic stroke patients treated on the programme, factors that might predict responsiveness to therapy and the relationship between changes in impairment and activity...
February 15, 2019: Journal of Neurology, Neurosurgery, and Psychiatry
Pouya Saeedi, Amin Shavandi, Paula M L Skidmore
Chronic diseases such as cancer, diabetes, and cardiovascular diseases (CVD) are the main health concerns in the 21st century, with CVD as the number one cause of mortality worldwide. Although CVD hard endpoints such as stroke or heart attack do not usually occur in children, evidence shows that the manifestation of CVD risk factors begins in childhood, preceding clinical complications of CVD in adulthood. Dietary intake is a modifiable risk factor that has been shown to make a substantial contribution to the risk of CVD in adulthood...
February 14, 2019: International Journal of Environmental Research and Public Health
Monika Ehrensberger, Daniel Simpson, Patrick Broderick, Catherine Blake, Frances Horgan, Paula Hickey, Joanne O'Reilly, Kenneth Monaghan
OBJECTIVE: This study aimed to investigate the feasibility and potential effectiveness of mirror-aided cross-education compared to cross-education alone in post-stroke upper limb recovery. DESIGN: A pilot randomized controlled parallel group study was carried out. Thirty-two chronic stroke patients followed a 4-week isometric strength-training programme performed with the less-affected upper limb 3 times per week. Participants in the mirror and strength training group observed the reflection of the exercising arm in the mirror; Participants in the strength training only group exercised without a mirror entirely...
February 13, 2019: American Journal of Physical Medicine & Rehabilitation
Lazar I Jovanovic, Naaz Kapadia, Lorna Lo, Vera Zivanovic, Milos R Popovic, Cesar Marquez-Chin
Functional electrical stimulation therapy (FEST) is a state-of-the-art treatment for retraining motor function following neurological injuries. Recent literature suggests that FEST can be further improved with brain-computer interface (BCI) technology. In this case study, we assessed the feasibility of using BCI-triggered FEST (BCI-FEST) to restore upper-limb function in a 57-year old male with severe left hemiplegia resulting from a stroke six years prior to enrollment in the study. The intervention consisted of two blocks of 40 one-hour BCI-FEST sessions (total of 80 sessions) for the left upper limb, with three sessions delivered weekly...
February 13, 2019: American Journal of Physical Medicine & Rehabilitation
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