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Stroke clinical outcomes

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https://www.readbyqxmd.com/read/28635339/methods-for-estimating-costs-in-patients-with-hyperlipidemia-experiencing-their-first-cardiovascular-event-in-the-united-kingdom
#1
Mark D Danese, Michelle Gleeson, Robert I Griffiths, David Catterick, Lucie Kutikova
AIMS: Methods for integrating external costs into clinical databases are not well-characterized. The purpose of this research was to describe and implement methods for estimating the cost of hospitalizations, prescriptions, and general practitioner and specialist visits used to manage hyperlipidemia patients experiencing cardiovascular (CV) events in the United Kingdom (UK). METHODS: This study was a retrospective cohort study using the Clinical Practice Research Datalink and Hospital Episode Statistics data...
June 21, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28634500/stroke-performance-measures-do-not-predict-functional-outcome
#2
Eric E Adelman, Lynda D Lisabeth, Melinda A Smith, Jonggyu Baek, Erin C Case, Brisa N Sánchez, James F Burke, Lesli E Skolarus, Darin B Zahuranec, William J Meurer, Devin L Brown, Kevin A Kerber, Deborah A Levine, Nelda M Garcia, Morgan S Campbell, Lewis B Morgenstern
BACKGROUND AND PURPOSE: Poststroke functional outcome is critical to stroke survivors. We sought to determine whether adherence to current stroke performance measures is associated with better functional outcome 90 days after an ischemic stroke. METHODS: Utilizing the Brain Attack Surveillance in Corpus Christi cohort, we examined adherence to 7 ischemic stroke performance measures from February 2009 to June 2012. Adherence to the measures was analyzed in aggregate using a binary defect-free score and an opportunity score, representing the proportion of eligible measures met...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28634267/30-years-of-the-mineralocorticoid-receptor-the-role-of-the-mineralocorticoid-receptor-in-the-vasculature
#3
REVIEW
Jennifer J DuPont, Iris Z Jaffe
Since the mineralocorticoid receptor (MR) was cloned 30 years ago, it has become clear that MR is expressed in extra-renal tissues, including the cardiovascular system, where it is expressed in all cells of the vasculature. Understanding the role of MR in the vasculature has been of particular interest as clinical trials show that MR antagonism improves cardiovascular outcomes out of proportion to changes in blood pressure. The last 30 years of research have demonstrated that MR is a functional hormone-activated transcription factor in vascular smooth muscle cells and endothelial cells...
July 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/28634000/dose-dependent-effects-of-abobotulinumtoxina-dysport%C3%A2-on-spasticity-and-active-movements-in-adults-with-upper-limb-spasticity-secondary-analysis-of-a-phase-3-study
#4
Michael W O'Dell, Allison Brashear, Robert Jech, Thierry Lejeune, Philippe Marque, Djamel Bensmail, Ziyad Ayyoub, David M Simpson, Magali Volteau, Claire Vilain, Philippe Picaut, Jean Michel Gracies
BACKGROUND: AbobotulinumtoxinA has beneficial effects on spasticity and active movements in hemiparetic adults with upper limb spasticity (ULS). However, evidence-based information on optimal dosing for clinical use is limited. OBJECTIVE: To describe joint-specific dose effects of abobotulinumtoxinA in adults with ULS. DESIGN: Secondary analysis of a phase 3 study (NCT01313299). SETTING: Multi-center, international, double-blind, placebo-controlled clinical trial...
June 17, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28633675/acupuncture-treatment-on-the-motor-area-of-the-scalp-for-motor-dysfunction-in-patients-with-ischemic-stroke-study-protocol-for-a-randomized-controlled-trial
#5
Jun Wang, Jian Pei, Dhiaedin Khiati, Qinhui Fu, Xiao Cui, Yi Song, Minghang Yan, Lijun Shi, Yiwen Cai, Yuhong Ma
BACKGROUND: Scalp acupuncture has shown a remarkable treatment efficacy on motor dysfunction in patients with stroke in China, especially the motor area of Jiao's scalp acupuncture, which is the most widely used treatment. However, previous studies have summarized that the clinical curative effect of acupuncture treatment for stroke remains uncertain. Meanwhile, no randomized controlled trials on Jiao's scalp acupuncture have been performed. The aim of this study is to evaluate the efficacy and safety of Jiao's scalp acupuncture for motor dysfunction in ischemic stroke...
June 20, 2017: Trials
https://www.readbyqxmd.com/read/28633392/can-estimation-of-sodium-intake-be-improved-by-borrowing-information-from-other-variables
#6
Lawrence J Appel, David R Jacobs
Estimation of dietary sodium intake is problematic. The most accurate measure is average sodium excretion from multiple 24 hour urine collections, but such an approach is impractical. Using data from the Women's Health Initiative, Prentice and colleagues assessed the relationship of calibrated estimates of sodium and potassium excretion with cardiovascular outcomes. The calibrated estimates are a function of self-reported sodium/potassium ratio from a food frequency questionnaire, age, body mass index, race, supplement use, smoking status, education, income, and aspirin use...
June 14, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28633342/biomarker-calibrated-sodium-and-potassium-intake-and-cardiovascular-disease-risk-among-postmenopausal-women
#7
Ross L Prentice, Ying Huang, Marian L Neuhouser, JoAnn E Manson, Yasmin Mossavar-Rahmani, Fridtjof Thomas, Lesley F Tinker, Matthew Allison, Karen C Johnson, Sylvia Wassertheil-Smoller, Arjun Seth, Jacques E Rossouw, James Shikany, Laura D Carbone, Lisa W Martin, Marcia L Stefanick, Bernhard Haring, Linda Van Horn
Studies of sodium and potassium intake and cardiovascular disease incidence often rely on self-reported dietary data. Here self-reported intakes from postmenopausal women at 40 participating U.S. clinical centers are calibrated using 24-hour urinary excretion measures in Women's Health Initiative cohorts, with follow-up over 1993-2010. Hypertension incidence related positively to (calibrated) sodium intake and to the ratio of sodium-to-potassium. The sodium-to-potassium ratio was associated with cardiovascular disease incidence during a 12-year average follow-up period...
June 14, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28633329/mid-term-blood-pressure-variability-is-associated-with-clinical-outcome-after-ischemic-stroke
#8
Yibo Wang, Jin'e Wang, Pin Meng, Na Liu, Niu Ji, Guanghui Zhang, Bingchao Xu, Xinyu Zhou, Yong'an Sun, Yingda Xu, Rutai Hui, Mingli He
BACKGROUND: The aim of this study was to investigate the relation between mid-term blood pressure (BP) variability (BPV) within 7 days of onset and the prognosis in acute stroke patients. METHODS: Total 873 acute ischemic stroke patients were included in this study. Mid-term BPV was evaluated through the calculations of coefficient of variation (CV) of the systolic BP (SBP) and diastolic BP (DBP) within 7 days of onset. Clinical outcomes were assessed using the recovery situations of neurological function at 3 months, the primary outcome (symptomatic recurrent stroke) and the secondary outcomes (recurrent stroke, all-cause mortality, and the composite of cardiovascular events) within 12 months...
June 13, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28632543/stroke-volume-variation-guided-versus-central-venous-pressure-guided-low-central-venous-pressure-with-milrinone-during-living-donor-hepatectomy-a-randomized-double-blinded-clinical-trial
#9
Jiwon Lee, Won Ho Kim, Ho-Geol Ryu, Hyung-Chul Lee, Eun-Jin Chung, Seong-Mi Yang, Chul-Woo Jung
BACKGROUND: We previously demonstrated the usefulness of milrinone for living donor hepatectomy. However, a less-invasive alternative to central venous catheterization and perioperative contributors to good surgical outcomes remain undetermined. The current study evaluated whether the stroke volume variation (SVV)-guided method can substitute central venous catheterization during milrinone-induced profound vasodilation. METHODS: We randomly assigned 42 living liver donors to receive either SVV guidance or central venous pressure (CVP) guidance to obtain milrinone-induced low CVP...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28632329/postictal-hypoperfusion-hypoxia-provides-the-foundation-for-a-unified-theory-of-seizure-induced-brain-abnormalities-and-behavioral-dysfunction
#10
REVIEW
Jordan S Farrell, Roberto Colangeli, Marshal D Wolff, Alexandra K Wall, Thomas J Phillips, Antis George, Paolo Federico, G Campbell Teskey
A recent article by Farrell et al. characterizes the phenomenon, mechanisms, and treatment of a local and severe hypoperfusion/hypoxia event that occurs in brain regions following a focal seizure. Given the well-established role of cerebral ischemia/hypoxia in brain damage and behavioral dysfunction in other clinical settings (e.g., stroke, cerebral vasospasm), we put forward a new theory: postictal hypoperfusion/hypoxia is responsible for the negative consequences associated with seizures. Fortunately, inhibition of two separate molecular targets, cyclooxygenase-2 (COX-2) and l-type calcium channels, can prevent the expression of postictal hypoperfusion/hypoxia...
June 20, 2017: Epilepsia
https://www.readbyqxmd.com/read/28630370/evidence-for-therapeutic-patient-education-interventions-to-promote-cardiovascular-patient-self-management-a-scientific-statement-for-healthcare-professionals-from-the-american-heart-association
#11
REVIEW
Susan Barnason, Connie White-Williams, Laura P Rossi, Mae Centeno, Deborah L Crabbe, Kyoung Suk Lee, Nancy McCabe, Julie Nauser, Paula Schulz, Kelly Stamp, Kathryn Wood
BACKGROUND: The burden of cardiovascular disease as a chronic illness increasingly requires patients to assume more responsibility for their self-management. Patient education is believed to be an essential component of cardiovascular care; however, there is limited evidence about specific therapeutic patient education approaches used and the impact on patient self-management outcomes. METHODS AND RESULTS: An integrative review of the literature was conducted to critically analyze published research studies of therapeutic patient education for self-management in selected cardiovascular conditions...
June 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28630233/motor-recovery-prediction-with-clinical-assessment-and-local-diffusion-homogeneity-after-acute-subcortical-infarction
#12
Gang Liu, Shuangquan Tan, Chao Dang, Kangqiang Peng, Chuanmiao Xie, Shihui Xing, Jinsheng Zeng
BACKGROUND AND PURPOSE: Initial clinical assessment or conventional diffusion tensor imaging parameters alone do not reliably predict poststroke recovery of motor function. Recently, local diffusion homogeneity (LDH) has been proposed to represent the local coherence of water molecule diffusion and can serve as a complementary marker for investigating white matter alterations of the brain. We aimed to determine whether a combination of initial clinical assessment and LDH could predict motor recovery after acute subcortical infarction...
June 19, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28629806/prevalence-of-bleeding-complications-following-ultrasound-guided-botulinum-toxin-injections-in-patiens-on-anticoagulation-or-antiplatelet-therapy
#13
Jeffrey Lavallee, Regan Royer, Geoffrey Smith
BACKGROUND: Patients on anticoagulation or antiplatelet therapy may be at higher risk of bleeding complications following intramuscular chemodenervation injections. Musculoskeletal ultrasound may be able to reduce the risk of bleeding complications by providing real time visualization of vascular structures and post-injection monitoring. Limited data exist addressing risk of bleeding complications following ultrasound-guided botulinum neurotoxin intramuscular chemodenervation procedures in the setting of anticoagulation or antiplatelet therapy...
June 16, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28629575/outcome-of-patients-with-proximal-vessel-occlusion-of-the-anterior-circulation-and-dwi-pwi-mismatch-is-time-dependent
#14
Sibu Mundiyanapurath, Sascha Diatschuk, Sarah Loebel, Johannes Pfaff, Mirko Pham, Markus Alfred Möhlenbruch, Wolfgang Wick, Martin Bendszus, Peter A Ringleb, Alexander Radbruch
BACKGROUND AND PURPOSE: Patients with ischemic stroke and large vessel occlusion are assumed to benefit from endovascular therapy (ET) independent of the symptom onset-to-treatment time (OTT) if they present with a mismatch of diffusion- and perfusion-weighted imaging (DWI-PWI mismatch). We aimed at studying the influence of OTT on clinical outcome in these patients. METHODS: Retrospective database review in a tertiary care university hospital. All patients presented with proximal vessel occlusion of the anterior circulation and DWI-PWI mismatch...
June 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28629445/effects-of-perioperative-statin-use-on-cardiovascular-complications-in-patients-submitted-to-non-cardiac-surgery-protocol-for-a-systematic-review-meta-analysis-and-trial-sequential-analysis
#15
Erica Aranha Suzumura, Rodrigo Antonini Ribeiro, Leticia Kawano-Dourado, Pedro Gabriel de Barros E Silva, Claudia Oliveira, Mabel Fernandes Figueiró, Alexandre Biasi Cavalcanti, Renato D Lopes, Otavio Berwanger
BACKGROUND: Preliminary evidence suggests statins may reduce major perioperative vascular events. However, evidence is limited to observational studies, underpowered trials, and non-comprehensive systematic reviews. This review aims to assess the effects of perioperative statin use on cardiovascular complications in patients submitted to non-cardiac surgery. METHODS: We will search MEDLINE/PubMed, EMBASE, LILACS, CENTRAL, Web of Science, and CINAHL for randomized controlled trials assessing the effects of perioperative statin use in adults undergoing non-cardiac surgery and reporting cardiovascular complications...
June 19, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28628594/telehealth-wearable-sensors-and-the-internet-will-they-improve-stroke-outcomes-through-increased-intensity-of-therapy-motivation-and-adherence-to-rehabilitation-programs
#16
Jane H Burridge, Alan Chong W Lee, Ruth Turk, Maria Stokes, Jill Whitall, Ravi Vaidyanathan, Phil Clatworthy, Ann-Marie Hughes, Claire Meagher, Enrico Franco, Lucy Yardley
BACKGROUND AND PURPOSE: Stroke, predominantly a condition of older age, is a major cause of acquired disability in the global population and puts an increasing burden on health care resources. Clear evidence for the importance of intensity of therapy in optimizing functional outcomes is found in animal models, supported by neuroimaging and behavioral research, and strengthened by recent meta-analyses from multiple clinical trials. However, providing intensive therapy using conventional treatment paradigms is expensive and sometimes not feasible because of social and environmental factors...
July 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28628548/clinical-outcome-measures-for-lateropulsion-poststroke-an-updated-systematic-review
#17
Ryan Koter, Sara Regan, Caitlin Clark, Vicki Huang, Melissa Mosley, Erin Wyant, Chad Cook, Jeffrey Hoder
BACKGROUND AND PURPOSE: Contraversive Lateropulsion, also referred to as contraversive pushing, pusher behavior, and pusher syndrome, can be associated with increased hospital length of stay, increased health care costs, and delayed outcomes in persons with stroke. The purpose of this updated systematic review was to identify scales used to classify contraversive lateropulsion, investigate literature that addresses their clinimetric properties, and create a resource for clinicians recommending use in clinical practice...
July 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28628537/needs-of-stroke-survivors-as-perceived-by-their-caregivers-a-scoping-review
#18
Shilpa Krishnan, Monique R Pappadis, Susan C Weller, Marsja Stearnes, Amit Kumar, Kenneth J Ottenbacher, Timothy A Reistetter
OBJECTIVE: Caregivers usually are not involved while planning the stroke survivor's medical and rehabilitation goals and interventions. This review aimed to identify the needs of stroke survivors as perceived by their caregivers. DESIGN: A literature search from 2003 to 2014 was conducted using Medline, CINAHL, PsychINFO, and Google Scholar. Sixty-six studies were included. Most studies excluded did not encompass caregivers' perspectives. Four reviewers screened the titles, abstracts, and full texts of the articles for inclusion...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28628523/effectiveness-of-surgery-for-adults-with-hallux-valgus-deformity-a-systematic-review
#19
Jitka Klugarova, Victoria Hood, Fiona Bath-Hextall, Miloslav Klugar, Jana Mareckova, Zuzana Kelnarova
BACKGROUND: Hallux valgus (HV) is a common foot deformity. In severe stages of this condition, surgery is often necessary. Currently, there is no systematic review comparing the effectiveness of surgery over conservative treatment. OBJECTIVES: The objective of this review was to establish the effectiveness of surgery compared to conservatory management for adults with HV. INCLUSION CRITERIA TYPES OF PARTICIPANTS: The current review included adults (18 years or over) with HV deformity, excluding adults with neurological problems causing foot deformities, for example, cerebral palsy, neuropathy, stroke and multiple sclerosis...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28627862/feasibility-and-efficacy-of-wearable-devices-for-upper-limb-rehabilitation-in-patients-with-chronic-stroke-a-randomized-controlled-pilot-study
#20
Li-Fong Lin, Yi-Jia Lin, Zi-Hao Lin, Li-Yun Chuang, Wei-Chun Hsu, Yuan-Hsiang Lin
BACKGROUND: Wearable devices based on inertial measurement units through wireless sensor networks have many applications such as real-time motion monitoring and functional outcome assessment of stroke rehabilitation. However, additional investigations are warranted to validate their clinical value, particularly in detecting the synergy patterns of movements after stroke. AIM: To explore the feasibility and efficacy of wearable devices for upper limb rehabilitation in patients with chronic stroke and to compare the intervention effects (e...
June 19, 2017: European Journal of Physical and Rehabilitation Medicine
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