bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Between Baseline Blood Pressure Parameters (Including Mean Pressure, Pulse Pressure, and Variability) and Early Outcome After Stroke
Authors: Geeganage Chamila , Tracy Michael , England Timothy , Sare Gillian , Moulin Thierry , Woimant France , Christensen Hanne , De Deyn Peter Paul , Leys Didier , O'Neill Desmond , Ringelstein E. Bernd , Bath Philip M.W. ,   for TAIST Investigators
Published: December 2010

Background and Purpose—
High blood pressure (BP) in acute stroke is associated independently with a poor outcome. Recent evidence suggests that other hemodynamic parameters may also be associated with outcomes following stroke.

Methods—
The relationship between baseline BP, heart rate, and other hemodynamic parameters, and early outcomes were assessed using data from TAIST trial.

Results—
Death or neurological deterioration at day 10 was associated, both in unadjusted and adjusted analyses, with systolic BP (adjusted OR, 1.02; 95% CI, 1.01–1.03), mean arterial pressure (OR, 1.02; 95% CI, 1.01–1.04), pulse pressure (OR, 1.02; 95% CI, 1.01–1.03), and BP variability (OR, 1.03; 95% CI, 1.01–1.05). Similar relationships were noted for deterioration alone, and recurrent stroke.

Conclusions—
Early death or neurologic deterioration, deterioration, and recurrent stroke are associated independently with high systolic BP, mean arterial pressure, pulse pressure, and BP variability. These measures offer potential therapeutic targets for improving early outcome after acute ischemic stroke.
Determinants of Quality of Life After Stroke in China
Authors: Delcourt Candice , Hackett Maree , Wu Yanfeng , Huang Yining , Wang Jiguang , Heeley Emma , Wong Lawrence , Sun Jian , Li Qiang , Wei Jade Wei , Liu Ming , Li Zhengyi , Wu Li , Cheng Yan , Huang Qifang , Xu En , Yang Qidong , Lu Chuanzhen , Anderson Craig S. ,   for the ChinaQUEST Investigators
Published: December 2010

Background and Purpose—
Limited information exists on the long-term consequences of stroke in China. We aimed to describe the profile and determinants of health-related quality of life among 12-month survivors of stroke.

Methods—
The ChinaQUEST (QUality Evaluation of Stroke care and Treatment) study was a prospective 62-hospital registry study of patients with acute stroke (ischemic stroke and intracerebral hemorrhage). Health-related quality of life was determined in 12-month survivors using a 35-item quality-of-life questionnaire (QOL-35) designed specifically for use in Chinese people. Proxy responses were used in those who were unable to personally complete the QOL-35.

Results—

A total of 4283 12-month stroke survivors completed assessments directly (1730 [40.4%]) or by a proxy (2553 [59.6%]). Mean (SD) health-related quality of life scores were higher in self-responders (70 [0.3] out of a best possible 100 score) than in proxy responders (60 [0.3];
P
<0.001). The strongest baseline variables that predicted “low” (below median) health-related quality of life scores in self-responders were having a lower income (income <10 000 Chinese Yuan Renminbi [CNY, approximately US $1428] versus >19 000 CNY [approximately US $2714]; OR, 2.06; 95% CI, 1.37 to 3.10) and being disabled at discharge (OR, 3.65; 95% CI, 2.72 to 4.91). Proxy responders had similar predictive factors, including being disabled at discharge (OR, 4.99; 95% CI, 4.00 to 6.21), but income was not significant.

Conclusions—
In China, the strongest predictor of 12-month health-related quality of life after stroke is level of disability at hospital discharge. Level of income was another important factor. Health insurance schemes that offset the economic impact of stroke could help improve the health and well-being of Chinese people affected by stroke.
Discriminating Carotid Atherosclerotic Lesion Severity by Luminal Stenosis and Plaque Burden
Authors: Zhao Xihai , Underhill Hunter R. , Zhao Qian , Cai Jianming , Li Feiyu , Oikawa Minako , Dong Li , Ota Hideki , Hatsukami Thomas S. , Chu Baocheng , Yuan Chun 
Published: December 2010

Background and Purpose—
To determine associations between stenosis, measures of plaque burden, and compositional features of carotid atherosclerosis, including high-risk features of intraplaque hemorrhage (IPH) and surface disruption.

Methods—
Institutional Review Board approval and informed consent for all participants were obtained before study initiation. Patients with either carotid stenosis >50% by duplex ultrasound or suspected coronary artery disease underwent multi-contrast carotid MRI at 3.0 T. For each artery, stenosis, percent wall volume (PWV=100%×wall volume/total vessel volume), and mean wall thickness (MWT) were measured. Presence or absence of a lipid-rich necrotic core, calcification, IPH, and surface disruption were recorded.

Results—
One hundred eighty-one patients were included in the final analysis. The area under the curve (AUC) calculated from receiver-operating-characteristics analysis found the presence of IPH was similarly classified by stenosis (AUC=0.82), PWV (AUC=0.88), and MWT (AUC=0.88). Notably, IPH was present in the lowest category of each parameter. Prevalence of IPH in arteries with 0% stenosis was 4.4%. In arteries with PWV <40%, prevalence was 3.2%; in arteries with MWT <1.0 mm, prevalence was 2.3%. Strength of classification for surface disruption was similarly classified by stenosis (AUC=0.87), PWV (AUC=0.93), and MWT (AUC=0.94).

Conclusions—
Measures of plaque burden do not substantially improve disease assessment compared to stenosis. The finding of IPH in all categories of stenosis and plaque burden suggests that direct characterization of plaque composition and surface status is necessary to fully discriminate disease severity.
Activation of Epsilon Protein Kinase C-Mediated Anti-Apoptosis Is Involved in Rapid Tolerance Induced by Electroacupuncture Pretreatment Through Cannabinoid Receptor Type 1
Authors: Wang Qiang , Li Xuying , Chen Yanke , Wang Feng , Yang Qianzi , Chen Shaoyang , Min Yuyuan , Li Xin , Xiong Lize 
Published: December 2010

Background and Purpose—
Our previous study has demonstrated that the rapid tolerance to cerebral ischemia by electroacupuncture (EA) pretreatment was possibly mediated through an endocannabinoid system-related mechanism. The purpose of this study was to investigate whether activation of epsilon protein kinase C (εPKC) was involved in EA pretreatment-induced neuroprotection via cannabinoid receptor type 1 in a rat model of transient focal cerebral ischemia.

Methods—

The activation of εPKC in the ipsilateral brain tissues after EA pretreatment was investigated in the presence or absence of cannabinoid receptor antagonists. At 2 hours after the end of EA pretreatment, focal cerebral ischemia was induced by middle cerebral artery occlusion for 120 minutes in rats. The neurobehavioral scores, infarction volumes, neuronal apoptosis, and the expression of
Bcl-2
and
Bax
were evaluated after reperfusion in the presence or absence of εPKC-selective peptide inhibitor (TAT-εV1–2) or activator (TAT–ψεRACK).

Results—

EA pretreatment enhanced εPKC activation. Systemic delivery of TAT–ψεRACK conferred neuroprotection against a subsequent cerebral ischemic event when delivered 2 hours before ischemia. Pretreatment with EA reduced infarct volumes, improved neurological outcome, inhibited neuronal apoptosis, and increased the
Bcl-2
-to-
Bax
ratio after reperfusion, and the beneficial effects were attenuated by TAT-εV1–2. In addition, the blockade of cannabinoid receptor type 1, but not cannabinoid receptor type 2 receptor, reversed the increase in εPKC activation and neuroprotection induced by EA pretreatment.

Conclusion—
EA pretreatment may activate endogenous εPKC-mediated anti-apoptosis to protect against ischemic damage after focal cerebral ischemia via cannabinoid receptor type 1, which represents a new mechanism of EA pretreatment-induced rapid tolerance to focal cerebral ischemia in rats.
Association Between Carotid Artery Plaque Ulceration and Plaque Composition Evaluated With Multidetector CT Angiography
Authors: Homburg Philip J. , Rozie Sietske , van Gils Marjon J. , van den Bouwhuijsen Quirijn J.A. , Niessen Wiro J. , Dippel Diederik W.J. , van der Lugt Aad 
Published: December 2010

Background and Purpose—
Symptomatic carotid artery plaque ulceration is associated with distinct plaque components such as a large lipid-rich necrotic core (LR-NC) in ischemic stroke patients with a ≥50% carotid stenosis. We evaluated the associations between carotid artery plaque ulceration and plaque characteristics in ischemic stroke patients with ≥50% stenosis, as well as in those with a low degree of stenosis (0% to 49%).

Methods—
Consecutive patients (n=346) with symptoms in the anterior circulation were evaluated with multidetector CT angiography (MDCTA) for the presence of atherosclerotic plaque, degree of stenosis, and plaque ulceration in the symptomatic carotid artery. Plaque volume and plaque component proportions of LR-NC, fibrous tissue, and calcification were measured. The associations between plaque ulceration and plaque characteristics were analyzed using logistic regression.

Results—
Atherosclerotic plaque was present in 185 patients. Plaque ulcerations were present in 38 (21%) patients, of which half had a low degree stenosis (0% to 49%). Plaque volume was significantly larger in ulcerated plaques. After adjustment for age, sex, and degree of stenosis, LR-NC proportion was strongly associated with plaque ulceration (odds ratio, 2.21; 95% CI, 1.49 to 3.27), whereas calcification proportion was inversely associated with plaque ulceration (odds ratio, 0.60; 95% CI, 0.40 to 0.89). These associations remained significant in patients with a low degree stenosis (0% to 49%).

Conclusion—
Plaque volume, degree of stenosis, and LR-NC proportion evaluated noninvasively with MDCTA are associated with carotid artery plaque ulceration, even in patients with a low degree stenosis (0% to 49%). Plaque volume and composition analysis with MDCTA may identify rupture prone plaques and improve risk stratification in ischemic stroke patients.
Decreased Kidney Function
Authors: van Lammeren Guus W. , Moll Frans L. , Blankestijn Peter J. , de Kleijn Dominique P.V. , Bots Michiel L. , Verhaar Marianne C. , de Vries Jean-Paul P.M. , Pasterkamp Gerard 
Published: December 2010

Background and Purpose—
Chronic kidney disease is an important risk factor for development and progression of atherosclerosis. The objective of the current study was to investigate the contribution of moderate kidney failure to cardiovascular (CV) mortality and morbidity after carotid endarterectomy (CEA). In addition, we investigated which proportion received optimal medical treatment or underwent diagnostic workup of the kidneys prior to CEA.

Methods—
Between 2002 and 2009, 1085 patients undergoing CEA were included in this study. Estimated glomerular filtration rate (eGFR) was assessed at baseline. Moderate kidney failure was defined as an eGFR 30–59 and compared with normal or mildly reduced kidney function (eGFR ≥60). Primary endpoint was CV death, composed of fatal myocardial infarction, fatal stroke, and ruptured abdominal aneurysm. Secondary endpoints were CV morbidity.

Results—
Moderate kidney failure (eGFR 30–59) was observed in 26.5% (288/1085) of the patients. During a median follow-up of 2.95 years (0.0 to 3.0 years), the adjusted hazard ratio for CV death with an eGFR 30–59 was 2.22 (1.27 to 3.89). Adjusted hazard ratio for MI with an eGFR 30–59 was 1.90 (1.04 to 3.47). No higher risk for stroke and peripheral interventions was observed. Of all patients with an eGFR 30–59, 38.3% (105/274) received angiotensin-converting enzyme inhibitors, 74.5% (204/274) received statins, and 34.4% (99/288) visited a nephrologist.

Conclusions—
Patients with an eGFR 30–59 have a 2.2-fold increased risk for CV death and 1.9-fold increased risk for myocardial infarction the 3 three years after CEA compared with patients with an eGFR ≥60, independent of other CV risk factors. A minority of these patients receive optimal medical treatment, which might explain the increased risk for progression of chronic kidney disease and CV morbidity and mortality.
Diagnostic Accuracy of the Barthel Index for Measuring Activities of Daily Living Outcome After Ischemic Hemispheric Stroke
Authors: Kwakkel Gert , Veerbeek Janne M. , Harmeling-van der Wel Barbara C. , van Wegen Erwin , Kollen Boudewijn J. 
Published: December 2010

Background and Purpose—
This study investigated the diagnostic accuracy of the Barthel Index (BI) in 206 stroke patients, measured within 72 hours, for activities of daily living at 6 months and determined whether the timing of BI assessment during the first days affects the accuracy of predicting activities of daily living outcome at 6 months.

Methods—
Receiver operating characteristic curves were constructed to determine the area under the curve and optimal cutoff points for BI at Days 2, 5, and 9. OR, sensitivity, specificity, positive predictive value, and negative predictive value were calculated to predict BI ≥19.

Results—

The area under the curve ranged from 0.785 on Day 2 to 0.837 and 0.848 on Days 5 and 9. Comparison of the receiver operating characteristic curves showed that the area under the curve was significantly different between Days 2 and 5 (
P
<0.001) and between Days 2 and 9 (
P
<0.001). No significant difference was found between Days 5 and 9 (
P
=0.08). Using a BI cutoff score of 7, the positive predictive value gradually increased from 0.696 on Day 2 to 0.817 on Day 2 to 0.864 on Day 9, whereas negative predictive value declined from 0.778 on Day 2 to 0.613 on Day 9.

Conclusions—
Assessment of the BI early poststroke showed good discriminative properties for final outcome of BI at 6 months. However, Day 5 proved to be the earliest time for making an optimal prediction of final outcome of activities of daily living. The BI should be measured at the end of the first week in hospital-based stroke units for early rehabilitation management.
Recurrent Stroke Due to a Novel Voltage Sensor Mutation in Ca
v
2.1 Responds to Verapamil
Authors: Knierim Ellen , Leisle Lilia , Wagner Christiane , Weschke Bernhard , Lucke Barbara , Bohner Georg , Dreier Jens P. , Schuelke Markus 
Published: December 2010

Background and Purpose—
Familial hemiplegic migraine is characterized by recurrent migraine, hemiparesis, and ataxia. Causes may be mutations in calcium and sodium channels or in a subunit of the Na/K-ATPse. Migraine treatment with calcium channel blockers was only successful in some patients.

Summary of Case—

We describe a 6-year-old girl with recurrent ischemic strokes after minor head trauma associated with seizures, hemiparesis, fever, and altered consciousness. Genetic analysis revealed a spontaneous, novel dominant
CACNA1A
mutation (c.4046G→A, p.R1349Q) that removed a highly conserved arginine of the voltage sensing region of the P/Q-type Ca
v
2.1 channel. Because a homologous mutation in the
tottering-5J
mouse increased open probability of the channel as well as calcium influx, we treated the patient with the calcium channel blocker verapamil during characteristic prodromi after head trauma. Treatment was instantly effective and prevented a new stroke.

Conclusion—

CACNA1A
mutations should be considered in the diagnostic workup of childhood stroke, especially if associated with ataxia and migraine.
Rate of Neural Recovery in Implanted Children with Auditory Neuropathy Spectrum Disorder
Authors: Fulmer Susan L. , Runge Christina L. , Jensen Jamie W. , Friedland David R. 
Published: December 2010

ObjectivesThe study objectives were to compare the rate of neural recovery and speech perception performance in children with auditory neuropathy spectrum disorder (ANSD) and children with sensorineural hearing loss (SNHL) from other etiologies.Study DesignCohort study.SettingAcademic hospital and cochlear implant center.Subjects and MethodsTen children with ANSD were matched based on type of implant and age at implantation with peers diagnosed with SNHL. Electrically evoked compound action potential (ECAP) recovery functions were obtained to measure neural refractory behaviors in response to stimulation from the cochlear implant. Speech perception performance was measured using speech recognition thresholds (SRTs) for monosyllable and spondee word stimuli. These outcome measures were compared between groups.ResultsThere was no difference in average recovery function exponent in children with ANSD compared to children with SNHL. Similarly, there were no differences in average SRTs in quiet and in noise in children with ANSD compared to children with SNHL. Relationships between SRT and recovery rate were not present within groups or for all subjects for SRT in quiet, but a significant relationship was found for all subjects for SRT in noise (P =. 04).ConclusionsDyssynchronous neural activity in ANSD may affect temporal encoding of electrical stimulation from a cochlear implant. As a group, children with ANSD did not demonstrate slower neural recovery compared to those with SNHL, but there was slower neural recovery observed for some subjects. The utility of ECAP recovery functions on optimizing the stimulation rate for individual patients with ANSD requires further investigation.
Outcomes of Hyoid Myotomy and Suspension Using a Mandibular Screw Suspension System
Authors: Gillespie M. Boyd , Ayers Christopher M. , Nguyen Shaun A. , Abidin Michael R. 
Published: December 2010

ObjectiveTo review the outcomes of hyoid myotomy and suspension with a mandibular screw anchoring device.Study DesignCase series with chart review.SettingAcademic and private sleep surgery clinics.MethodsThe study is a consecutive case series of patients undergoing hyoid myotomy and suspension using a mandibular screw suspension device as part of multilevel treatment of obstructive sleep apnea (OSA). Outcomes of interest included complication rates, change in daytime sleepiness scores, and change in apnea‐hypopnea index (AHI).ResultsTen women and 23 men with a mean age of 54 years (range, 33‐73 years) underwent hyoid myotomy and suspension using a mandibular screw suspension device. Four (12%) patients experienced minor complications, including neck seroma (3 patients) and tongue edema (1 patient). Epworth Sleepiness Scale scores fell from a preoperative median of 12 to a postoperative median of 6 (P =. 002). Ten patients (30%) refused the postoperative sleep study. In the 23 patients who underwent postoperative sleep studies, AHI scores decreased from a preoperative mean ± SD of 40.9 ± 25.1 to 18.6 ± 21.2 postoperatively (P =. 001). Ten patients (30%) achieved a postoperative AHI below 10. The Repose system was initially applied using a standard hyoid dissection but was later modified using a minimally invasive small incision (<2 cm) approach that demonstrated significantly fewer complications (P =. 04).ConclusionHyoid myotomy and suspension with a mandibular screw anchor is an effective method with which to address hypopharyngeal collapse in multilevel surgery for OSA. The procedure can be performed with a small‐incision, minimally invasive approach with minimal complications and patient morbidity.
Retracted: Antiemetic Efficacy of Low‐Dose Midazolam in Patients Undergoing Thyroidectomy
Authors: Fujii Yoshitaka , Itakura Michiyo 
Published: December 2010

The article has been retracted as a result of notice received from the author, Yoshitaka Fujii, M.D., that the study described in the article was undertaken without the approval of an institutional ethics committee. The Editor‐in‐Chief and Publisher have therefore determined that the article failed to meet the ethical standards required by the Journal. Additionally, Toho University Faculty of Medicine, where Dr. Fujii was employed until February 29, 2012, issued a statement in March 2012 regarding its investigation of Dr. Fujii, finding that the study referenced in the article, as well as other studies reference by Dr. Fujii in his published articles, were conducted without the approval of any ethics committee, and therefore “did not conform to the global standard of ethics for clinical studies.”Additionally, the Publisher has been informed by Dr. Michiyo Itakura and Dr. Ken Takasaki, President of Ushiku Aiwa General Hospital, that Dr. Itakura did not participate in the authorship of the article. The Publisher has also been informed by Ushiku Aiwa General Hospital that Yoshitaka Fujii is not affiliated with the hospital. At the time of the article's publication, Dr. Fujii was affiliated with the Toho University School of Medicine.
Sampling and mass spectrometric analytical methods for five antineoplastic drugs in the healthcare environment
Authors: Pretty Jack R , Connor Thomas H , Spasojevic Ivan , Kurtz Kristine S , McLaurin Jeffrey L , B’Hymer Clayton , Debord D Gayle 
Published: December 2010

Context. Healthcare worker exposure to antineoplastic drugs continues to be reported despite safe handling guidelines published by several groups. Sensitive sampling and analytical methods are needed so that occupational safety and health professionals may accurately assess environmental and biological exposure to these drugs in the workplace. Objective. To develop liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) analytical methods for measuring five antineoplastic drugs in samples from the work environment, and to apply these methods in validating sampling methodology. A single method for quantifying several widely used agents would decrease the number of samples required for method development, lower cost, and time of analysis. Methods for measuring these drugs in workers’ urine would also be useful in monitoring personal exposure levels. Results. LC-MS/MS methods were developed for individual analysis of five antineoplastic drugs in wipe and air sample media projected for use in field sampling: cyclophosphamide, ifosfamide, paclitaxel, doxorubicin, and 5-fluorouracil. Cyclophosphamide, ifosfamide, and paclitaxel were also measured simultaneously in some stages of the work. Extraction methods for air and wipe samples were developed and tested using the aforementioned analytical methods. Good recoveries from the candidate air and wipe sample media for most of the compounds, and variable recoveries for test wipe samples depending on the surface under study, were observed. Alternate LC-MS/MS methods were also developed to detect cyclophosphamide and paclitaxel in urine samples. Conclusions. The sampling and analytical methods were suitable for determining worker exposure to antineoplastics via surface and breathing zone contamination in projected surveys of healthcare settings.