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https://www.readbyqxmd.com/read/28730950/statistical-analysis-plan-for-the-head-position-in-stroke-trial-headpost-an-international-cluster-cross-over-randomized-trial
#1
Laurent Billot, Mark Woodward, Hisatomi Arima, Maree L Hackett, Paula Muñoz Venturelli, Pablo M Lavados, Alejandro Brunser, Bin Peng, Liying Cui, Lily Song, Stephane Heritier, Stephen Jan, Sandy Middleton, Verónica V Olavarría, Joyce Lim, Thompson Robinson, Octavio Pontes-Neto, Caroline Watkins, Craig S Anderson
Background There is evidence to indicate that the lying flat head position increases cerebral blood flow and oxygenation in patients with acute ischemic stroke, but how these physiological effects translate into clinical outcomes is uncertain. The Head Position in Stroke Trial aims to determine the comparative effectiveness of lying flat (0°) compared to sitting up (≥30°) head positioning, initiated within 24 h of hospital admission for patients with acute stroke. Design An international, pragmatic, cluster-randomized, crossover, open, blinded outcome assessed clinical trial...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28730849/treadmill-training-to-improve-mobility-for-people-with-sub-acute-stroke-a-phase-ii-feasibility-randomized-controlled-trial
#2
Gillian D Baer, Lisa G Salisbury, Mark T Smith, Jane Pitman, Martin Dennis
OBJECTIVE: This phase II study investigated the feasibility and potential effectiveness of treadmill training versus normal gait re-education for ambulant and non-ambulant people with sub-acute stroke delivered as part of normal clinical practice. DESIGN: A single-blind, feasibility randomized controlled trial. SETTING: Four hospital-based stroke units. SUBJECTS: Participants within three months of stroke onset. INTERVENTIONS: Participants were randomized to treadmill training (minimum twice weekly) plus normal gait re-education or normal gait re-education only (control) for up to eight weeks...
July 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28730267/phantom-based-standardization-of-ct-angiography-images-for-spot-sign-detection
#3
Andrea Morotti, Javier M Romero, Michael J Jessel, Andrew M Hernandez, Anastasia Vashkevich, Kristin Schwab, Joseph D Burns, Qaisar A Shah, Thomas A Bergman, M Fareed K Suri, Mustapha Ezzeddine, Jawad F Kirmani, Sachin Agarwal, Angela Hays Shapshak, Steven R Messe, Chitra Venkatasubramanian, Katherine Palmieri, Christopher Lewandowski, Tiffany R Chang, Ira Chang, David Z Rose, Wade Smith, Chung Y Hsu, Chun-Lin Liu, Li-Ming Lien, Chen-Yu Hsiao, Toru Iwama, Mohammad Rauf Afzal, Christy Cassarly, Steven M Greenberg, Renee' Hebert Martin, Adnan I Qureshi, Jonathan Rosand, John M Boone, Joshua N Goldstein
PURPOSE: The CT angiography (CTA) spot sign is a strong predictor of hematoma expansion in intracerebral hemorrhage (ICH). However, CTA parameters vary widely across centers and may negatively impact spot sign accuracy in predicting ICH expansion. We developed a CT iodine calibration phantom that was scanned at different institutions in a large multicenter ICH clinical trial to determine the effect of image standardization on spot sign detection and performance. METHODS: A custom phantom containing known concentrations of iodine was designed and scanned using the stroke CT protocol at each institution...
July 20, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28729178/elevated-cardiovascular-disease-risk-in-patients-with-chronic-myelogenous-leukemia-seen-in-community-based-oncology-practices-in-the-united-states
#4
Anna D Coutinho, Dinara Makenbaeva, Eileen Farrelly, Pamela B Landsman-Blumberg, Daniel Lenihan
INTRODUCTION: Current National Comprehensive Cancer Network guidelines recommend that comorbidities, including cardiovascular disease (CVD), be considered when selecting tyrosine kinase inhibitors for the treatment of chronic myelogenous leukemia (CML). We report here the prevalence of CVD and its risk factors in patients with CML treated by community-based United States (US) oncologists. PATIENTS AND METHODS: Adult patients with a confirmed diagnosis of CML and ≥ 1 encounter after the first date of CML diagnosis in an electronic medical record database between January 1, 2005 and October 31, 2014 were enrolled...
June 17, 2017: Clinical Lymphoma, Myeloma & Leukemia
https://www.readbyqxmd.com/read/28727727/a-comparative-study-of-patients-activities-and-interactions-in-a-stroke-unit-before-and-after-reconstruction-the-significance-of-the-built-environment
#5
Anna Anåker, Lena von Koch, Christina Sjöstrand, Julie Bernhardt, Marie Elf
Early mobilization and rehabilitation, multidisciplinary stroke expertise and comprehensive therapies are fundamental in a stroke unit. To achieve effective and safe stroke care, the physical environment in modern stroke units should facilitate the delivery of evidence-based care. Therefore, the purpose of this study was to explore patients' activities and interactions in a stroke unit before the reconstruction of the physical environment, while in a temporary location and after reconstruction. This case study examined a stroke unit as an integrated whole...
2017: PloS One
https://www.readbyqxmd.com/read/28725968/microglial-mediated-pdgf-cc-activation-increases-cerebrovascular-permeability-during-ischemic-stroke
#6
Enming Joseph Su, Chunzhang Cao, Linda Fredriksson, Ingrid Nilsson, Christina Stefanitsch, Tamara K Stevenson, Juanjuan Zhao, Margret Ragsdale, Yu-Yo Sun, Manuel Yepes, Chia-Yi Kuan, Ulf Eriksson, Dudley K Strickland, Daniel A Lawrence, Li Zhang
Treatment of acute ischemic stroke with the thrombolytic tissue plasminogen activator (tPA) can significantly improve neurological outcomes; however, thrombolytic therapy is associated with an increased risk of intra-cerebral hemorrhage (ICH). Previously, we demonstrated that during stroke tPA acting on the parenchymal side of the neurovascular unit (NVU) can increase blood-brain barrier (BBB) permeability and ICH through activation of latent platelet-derived growth factor-CC (PDGF-CC) and signaling by the PDGF receptor-α (PDGFRα)...
July 19, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28722777/nurses-and-nurse-assistants-beliefs-attitudes-and-actions-related-to-role-and-function-in-an-inpatient-stroke-rehabilitation-unit-a-qualitative-study
#7
Mia Ingerslev Loft, Ingrid Poulsen, Bente Appel Esbensen, Helle Klingenberg Iversen, Lone Lunbak Mathiesen, Bente Martinsen
AIMS AND OBJECTIVE: To explore nurses' and nurse assistants' beliefs, attitudes, and actions related to their function in an inpatient stroke rehabilitation unit. BACKGROUND: Several attempts have been made to describe nurses' roles and functions in inpatient neurorehabilitation. However, current understandings of the contributions that nurses and nurse assistants make to neurorehabilitation remain sparse. DESIGN: Descriptive, interpretive qualitative study...
July 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28722487/left-ventricular-hypertrophy-in-acute-stroke-patients-with-known-hypertension
#8
Askiel Bruno, Desiree D Brooks, Taryn A Abrams, Mitra D Poorak, Drew Gunio, Prianka K Kandhal, Aleena Lakhanpal, Arun K Nagabandi, Abiodun E Akinwuntan, Stephen Looney, Pascha E Schafer
BACKGROUND: Despite effective treatments, hypertension remains uncontrolled in nearly half of the people with hypertension in the United States. Uncontrolled hypertension leads to end organ damage, such as left ventricular hypertrophy (LVH). To identify reasons for uncontrolled hypertension, we interviewed acute stroke patients with a history of hypertension and evaluated for LVH. METHODS: Using a standardized questionnaire, we collected demographic, socioeconomic, and health-care data in 300 acute ischemic and hemorrhagic stroke patients in one hospital...
July 19, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28719977/the-efficacy-of-interactive-motion-capture-based-rehabilitation-on-functional-outcomes-in-an-inpatient-stroke-population-a-randomized-controlled-trial
#9
John Cannell, Emelyn Jovic, Amy Rathjen, Kylie Lane, Anna M Tyson, Michele L Callisaya, Stuart T Smith, Kiran Dk Ahuja, Marie-Louise Bird
OBJECTIVE: To compare the efficacy of novel interactive, motion capture-rehabilitation software to usual care stroke rehabilitation on physical function. DESIGN: Randomized controlled clinical trial. SETTING: Two subacute hospital rehabilitation units in Australia. PARTICIPANTS: In all, 73 people less than six months after stroke with reduced mobility and clinician determined capacity to improve. INTERVENTIONS: Both groups received functional retraining and individualized programs for up to an hour, on weekdays for 8-40 sessions (dose matched)...
July 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28718257/risk-factors-for-heat-related-deaths-during-the-june-2015-heat-wave-in-karachi-pakistan
#10
Syed Ghazanfar Saleem, Tehreem Ansari, Ashraf Shamshad Ali, Sara Fatima, Mariam Hassan Rizvi, Muhammad Abdul Samad
BACKGROUND: Mortality as a consequence of heat related illness is a public health concern. Emergency department (ED) experiences increased patients' flow and decreased survival as a consequence of heat stroke during the episodes of heat wave. The present study was conducted to identify the risk factors for mortality among victims of heat wave (17th - 23rd June), 2015 evaluated in the Emergency Department of The Indus Hospital (TIH), Karachi. METHODS: In this cross-sectional study data was retrospectively collected...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28717986/thrombolysis-for-stroke-in-ireland-increasing-access-and-maintaining-safety-in-a-challenging-environment
#11
P McElwaine, J McCormack, C Brennan, H Coetzee, P Cotter, R Doyle, A Hickey, F Horgan, C Loughnane, C Macey, P Marsden, D McCabe, R Mulcahy, I Noone, E Shelley, T Stapleton, D Williams, P Kelly, J Harbison
BACKGROUND: In the setting of a national audit of acute stroke services, we examined the delivery of thrombolytic therapy for ischaemic stroke and whether current practice was achieving safe outcomes and consistent delivery for patients. METHOD: Data obtained from the recent national stroke audit was compared against previous Irish audit, the most recent SSNAP UK stroke audit and the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST) study...
July 17, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28717529/daily-variation-in-the-occurrence-of-different-subtypes-of-stroke
#12
Luciana Ripamonti, Roberto Riva, Fabiola Maioli, Corrado Zenesini, Gaetano Procaccianti
Three thousand two hundred and ninety-eight patients admitted to our Stroke Unit with hemorrhagic, large artery atherosclerosis, cardioembolic, small-vessel occlusion, and undetermined etiology-cryptogenic strokes were included in the study. The circadian variability in onset in each stroke subgroup and the associations with various risk factors were analyzed. In each subgroup, a significant minority of patients suffered from stroke during sleep. In the ischemic group, hypercholesterolemia, paroxysmal atrial fibrillation, and previous myocardial infarction facilitated the onset during waking...
2017: Stroke Research and Treatment
https://www.readbyqxmd.com/read/28716585/ascertainment-of-alaska-native-stroke-incidence-2005-2009-lessons-for-assessing-the-global-burden-of-stroke
#13
Bernadette Boden-Albala, James Allen, Eric T Roberts, Lisa Bulkow, Brian Trimble
BACKGROUND: Stroke is a critical public health issue in the United States and globally. System models to optimally capture stroke incidence in rural and culturally diverse communities are needed. The epidemiological transition to a western lifestyle has been associated with an increased burden of vascular risk factors among Alaska Native (AN) people. The burden of stroke in AN communities remains understudied. METHODS: The Alaska Native Stroke Registry (ANSR) was designed to screen and capture all stroke cases between 2005 and 2009 through its integration into the existing single-payer Alaska Tribal Health System infrastructure...
July 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28716256/post-stroke-depression-in-ghana-characteristics-and-correlates
#14
Fred Stephen Sarfo, Carolyn Jenkins, Arti Singh, Mayowa Owolabi, Akin Ojagbemi, Nathaniel Adusei, Raelle Saulson, Bruce Ovbiagele
BACKGROUND: Poststroke depression (PSD) is prevalent and is an important determinant of functional recovery, quality of life and mortality after stroke. Scanty data on the nature of PSD among stroke survivors in sub-Saharan Africa prompted this study. OBJECTIVE: To assess the prevalence and predictors of depression in a convenience sample of Ghanaian stroke survivors. METHODS: We evaluated consecutive stroke survivors encountered at a comprehensive neurology clinic in a tertiary medical center in Ghana...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#15
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28714810/advances-in-cardiovascular-health-in-women-over-the-past-decade-guideline-recommendations-for-practice
#16
Pejman Raeisi-Giglou, Annabelle Santos Volgman, Hena Patel, Susan Campbell, Amparo Villablanca, Eileen Hsich
Cardiovascular disease (CVD) remains the number one cause of death in women. It is estimated that 44 million women in the United States are either living with or at risk for heart disease. This article highlights the recent significant progress made in improving care, clinical decision-making, and policy implications for women with CVD. We provide our perspective supported by evidence-based advances in cardiovascular research and clinical care guidelines in seven areas: (1) primary CVD prevention and community heart care, (2) secondary prevention of CVD, (3) stroke, (4) heart failure and cardiomyopathies, (5) ischemia with nonobstructive coronary artery disease, (6) spontaneous coronary artery dissection, and (7) arrhythmias and device therapies...
July 17, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28714342/a-multicentre-study-of-how-goal-setting-is-practised-during-inpatient-stroke-rehabilitation
#17
Sarah Plant, Sarah F Tyson
OBJECTIVE: To describe goal-setting during inpatient stroke rehabilitation. DESIGN: There were two stages: an electronic questionnaire for multidisciplinary teams and an analysis of goal-setting documentation for rehabilitation patients. SETTING: Five inpatient stroke units. PARTICIPANTS: Staff involved in goal-setting and patients undergoing stroke rehabilitation. RESULTS: A total of 13 therapists and 49 patients were recruited, and 351 documented goals were examined...
July 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28712618/would-a-large-tpa-trial-for-those-4-5-to-6-0-hours-from-stroke-onset-be-good-value-for-information
#18
Djøra I Soeteman, Nicolas A Menzies, Ankur Pandya
OBJECTIVES: To quantify the potential value of new research in patients treated with thrombolytic treatment (tissue-type plasminogen activator [tPA]) in the 4.5- to 6.0-hour time window after stroke onset and to determine the optimal size of a future trial using value of information analysis. METHODS: Expected value of partial perfect and sample information (EVPPI and EVSI) analyses were conducted using a probabilistic Markov model. Data for modified Rankin Scale (mRS) distributions in patients 4...
July 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28711292/perioperative-stroke-after-cerebral-aneurysm-clipping-risk-factors-and-postoperative-impact
#19
Ahmed I Kashkoush, Brian T Jankowitz, Chris Nguyen, Paul A Gardner, Daniel A Wecht, Robert M Friedlander, Yue-Fang Chang, Miguel Habeych, Donald Crammond, Jeffrey Balzer, Parthasarathy D Thirumala
Stroke is a devastating complication after intracranial aneurysm clipping. Understanding the risk factors that prognosticate perioperative stroke may help to identify patients that would benefit from neuroprotective therapy. This study assesses patient-specific independent predictors of perioperative stroke in relation to surgical aneurysm clipping. Additionally, this study evaluates the postoperative complications of stroke. We performed a retrospective chart review of 437 patients with ruptured and unruptured intracranial aneurysms, which underwent surgical clipping from 2006 to 2013...
July 12, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28708775/continuous-cardiac-autonomic-and-hemodynamic-responses-to-isometric-exercise
#20
Katrina A Taylor, Jonathan D Wiles, Damian D Coleman, Rajan Sharma, Jamie M Oʼdriscoll
PURPOSE: Elevated arterial blood pressure (BP) is associated with autonomic dysfunction and impaired hemodynamic control mechanisms. Isometric exercise (IE) training has been demonstrated effective at reducing BP; however, the continuous cardiovascular responses during IE are underinvestigated. We hypothesized that reflex autonomic cardiovascular control is an important mediator in reducing BP. To test our hypothesis, we investigated continuous cardiac autonomic modulation and baroreceptor reflex sensitivity (BRS) in response to IE...
August 2017: Medicine and Science in Sports and Exercise
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