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https://www.readbyqxmd.com/read/27914158/causes-of-death-in-an-acute-psychiatric-inpatient-unit-of-a-portuguese-general-hospital
#1
Sofia Barbosa, Márcia Sequeira, Sara Castro, Rita Manso, Catarina Klut Câmara, Bruno Trancas, Nuno Borja-Santos, Teresa Maia
INTRODUCTION: Psychiatric patients are at increased risk of death from a number of natural and unnatural causes. This study examines the mortality causes of all psychiatric inpatients of an acute psychiatric unit at a general hospital in Portugal for sixteen years (1998 to 2013). MATERIAL AND METHODS: Twenty-one inpatients died at the inpatient unit between 1998 and 2013 (average 1.3 per year). A retrospective study through case-file review was carried to collect demographic characteristics, medical and psychiatry diagnosis...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27913972/in-hospital-diagnosis-of-sleep-apnea-in-stroke-patients-using-a-portable-acoustic-device
#2
Clodagh M Ryan, Kelly Wilton, T Douglas Bradley, Hisham Alshaer
PURPOSE: Sleep apnea (SA) is highly prevalent in post-stroke patients. Due to physical disability and relative inaccessibility of polysomnography (PSG) to test for SA, patients with stroke frequently remain undiagnosed and untreated. Portable SA monitoring can facilitate at-home or in-hospital testing for SA. However, portable SA monitoring is not recommended in those with complex medical conditions, such as stroke, due to the lack of validation of portable monitoring in such patients...
December 2, 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/27912776/improving-stroke-prevention-therapy-for-patients-with-atrial-fibrillation-in-primary-care-protocol-for-a-pragmatic-cluster-randomized-trial
#3
Theresa M Lee, Noah M Ivers, Sacha Bhatia, Debra A Butt, Paul Dorian, Liisa Jaakkimainen, Kori Leblanc, Dan Legge, Dante Morra, Alissia Valentinis, Laura Wing, Jacqueline Young, Karen Tu
BACKGROUND: The prevalence of atrial fibrillation (AF) is growing as the population ages, and at least 15% of ischemic strokes are attributed to AF. However, many high-risk AF patients are not offered guideline-recommended stroke prevention therapy due to a variety of system, provider, and patient-level barriers. METHODS: We will conduct a pragmatic, cluster-randomized controlled trial randomizing primary care clinics to test a "toolkit" of quality improvement interventions in primary care...
December 3, 2016: Implementation Science: IS
https://www.readbyqxmd.com/read/27912744/quality-of-life-after-stroke-in-pakistan
#4
Wardah Khalid, Shafquat Rozi, Tazeen Saeed Ali, Iqbal Azam, Michael T Mullen, Saleem Illyas, Qamar Un-Nisa, Nabila Soomro, Ayeesha Kamran Kamal
BACKGROUND: There is very little information about the quality of life (QOL) of stroke survivors in LMIC countries with underdeveloped non communicable health infrastructures, who bear two thirds of the global stroke burden. METHODOLOGY: We used a sequential mix methods approach. First, a quantitative analytical cross-sectional study was conducted on 700 participants, who constituted 350 stroke survivor and their caregiver dyads. QOL of stroke survivor was assessed via Stroke Specific Quality of Life Scale (SSQOLS) whereas QOL of caregivers was assessed through RAND-36...
December 3, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27909518/symptoms-in-atrial-fibrillation-a-contemporary-review-and-future-directions
#5
REVIEW
Steven T Heidt Bs, Anna Kratz PhD, Kayvan Najarian PhD, Afton L Hassett PsyD, Hakan Oral Md, Richard Gonzalez PhD, Brahmajee K Nallamothu Md Mph, Daniel Clauw Md, Hamid Ghanbari Md Mph
Atrial fibrillation (AF) is the most prevalent arrhythmia leading to hospital admissions in the United States. The majority of patients with AF report symptoms associated with this condition that can lead to a decrease in health related quality of life (HRQOL) and functional status. Therefore, along with reducing the risk of stroke and mortality, improvements in such symptoms are important therapeutic goals in the management of patients with AF. Our current understanding of how AF and symptoms are linked is hampered by the dominant assessment paradigm, where symptoms thought to be associated with AF are measured at a single point in time (frequently at a clinic visit)...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909370/development-of-a-telephone-interview-version-of-the-chedoke-mcmaster-stroke-assessment-activity-inventory
#6
Ruth Barclay, Patricia A Miller, Sepideh Pooyania, Paul Stratford
Purpose: To develop a telephone version of the Chedoke-McMaster Stroke Assessment Activity Inventory (CMSA-AI) and estimate the test-retest reliability, interrater reliability (between participant and proxy), and construct validity of the scores for individuals with stroke. Methods: Adults with stroke and their caregivers or proxies were included. Participants were assessed with the CMSA-AI at discharge from a stroke rehabilitation unit and interviewed using the telephone version (TCMSA-AI). Two months after discharge, participants were evaluated with the CMSA-AI and interviewed over the phone using the TCMSA-AI on two occasions 2-3 days apart...
2016: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/27907956/intensive-care-management-of-the-endovascular-stroke-patient
#7
Julian Bösel
Acute ischemic stroke caused by the occlusion of large brain vessels can be treated effectively by mechanical thrombectomy, as proved by recent strong and consistent evidence from high-quality randomized trials. This new era of endovascular stroke treatment, however, poses particular challenges that go far beyond the so far gold standard of intravenous thrombolysis alone. Because these stroke patients usually present with severe neurologic deficits, may be unstable from cardiac or pulmonary instability, have to endure an invasive intervention of sometimes long duration, may suffer complications and require close postinterventional follow-up, they often demand intensive care measures...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907954/today-s-approach-to-treating-brain-swelling-in-the-neuro-intensive-care-unit
#8
Shreyansh Shah, W Taylor Kimberly
Brain swelling is an urgent clinical problem that frequently accompanies ischemic stroke, brain hemorrhage, and traumatic brain injury; it increases morbidity and mortality associated with them. It occurs due to failure of membrane transporters and leakage of the blood-brain barrier (BBB), resulting in combination of cytotoxic, ionic, and vasogenic edema. Currently, decompressive craniectomy and osmotherapy are the mainstays of management, but these therapies do not halt the underlying molecular cascade leading to brain swelling...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27899799/population-health-based-approaches-to-utilizing-digital-technology-a-strategy-for-equity
#9
Garth N Graham, MaryLynn Ostrowski, Alyse B Sabina
Health care disparities and high chronic disease rates burden many communities and disproportionally impact racial/ethnic populations in the United States. These disparities vary geographically, increase health care expenses, and result in shortened lifespans. Digital technologies may be one tool for addressing health disparities and improving population health by increasing individuals' access to health information-especially as most low-income U.S. residents gain access to smartphones. The Aetna Foundation partners with organizations to use digital technologies, including mobile applications, data collection, and related platforms, for learning and sharing...
November 2016: Journal of Public Health Policy
https://www.readbyqxmd.com/read/27898435/percutaneous-left-atrial-appendage-closure-current-state-of-the-art
#10
Mohammad-Ali Jazayeri, Venkat Vuddanda, Valay Parikh, Dhanunjaya R Lakkireddy
PURPOSE OF REVIEW: The authors reviewed the seminal and more recent literature surrounding the major modalities for percutaneous left atrial appendage closure used in contemporary practice, with particular emphasis on safety and efficacy, technical challenges, and future developments. RECENT FINDINGS: Along with the continued practice of surgical left atrial appendage closure, which has evolved substantially with the advent of clipping techniques, a number of percutaneous methods have been developed to close the left atrial appendage with endocardial, epicardial, and hybrid approaches...
January 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27898168/the-association-between-t-pa-administration-and-in-hospital-mortality-following-acute-ischemic-stroke-in-puerto-rican-patients
#11
Kevin Shah, Samuel Kohrman, Suehyb Alkhatib, Juan González, Fernando Santiago, Marcia Varella, Juan Zevallos
OBJECTIVE: Despite being the standard of care, thrombolytic therapy with tissue plasminogen activator (t-PA) is currently administered to only 5% of acute ischemic stroke (AIS) patients in the United States. Published scientific information regarding both the use of t-PA for AIS in Hispanic patients and its impact on short-term mortality is scarce. The objectives of this study are to investigate, among Puerto Rican patients hospitalized with AIS, the rate of t-PA administration, and the risk of in-hospital mortality in patients who received t-PA vs...
December 2016: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/27896982/predictive-modeling-of-hospital-readmission-rates-using-electronic-medical-record-wide-machine-learning-a-case-study-using-mount-sinai-heart-failure-cohort
#12
Khader Shameer, Kipp W Johnson, Alexandre Yahi, Riccardo Miotto, L I Li, Doran Ricks, Jebakumar Jebakaran, Patricia Kovatch, Partho P Sengupta, Sengupta Gelijns, Alan Moskovitz, Bruce Darrow, David L David, Andrew Kasarskis, Nicholas P Tatonetti, Sean Pinney, Joel T Dudley
Reduction of preventable hospital readmissions that result from chronic or acute conditions like stroke, heart failure, myocardial infarction and pneumonia remains a significant challenge for improving the outcomes and decreasing the cost of healthcare delivery in the United States. Patient readmission rates are relatively high for conditions like heart failure (HF) despite the implementation of high-quality healthcare delivery operation guidelines created by regulatory authorities. Multiple predictive models are currently available to evaluate potential 30-day readmission rates of patients...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27896146/determination-of-functional-prognosis-in-hospitalized-patients-following-an-intensive-care-admission
#13
Natália A Ferreira, Agnaldo José Lopes, Arthur S Ferreira, George Ntoumenopoulos, Jerffesson Dias, Fernando S Guimaraes
AIM: To investigate the factors associated with the functional progress of hospitalized patients following an intensive care admission. METHODS: Retrospective study including data from a cohort of 198 hospitalized patients following an intensive care admission and not requiring mechanical ventilation in a single tertiary referral hospital. A generalized linear model was used to identify the main effects of clinical and demographic variables on the outcomes of functionality (KATZ Index of Independence in Activities of Daily Living) and muscle strength (MRC Scale)...
November 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27894887/ultrasound-tissue-pulsatility-imaging-suggests-impairment-in-global-brain-pulsatility-and-small-vessels-in-elderly-patients-with-orthostatic-hypotension
#14
Julie Biogeau, Thomas Desmidt, Paul-Armand Dujardin, Redouane Ternifi, Charlotte Eudo, Emilie Vierron, Jean-Pierre Remenieras, Frédéric Patat, Vincent Camus, Thierry Constans
BACKGROUND: Orthostatic hypotension (OH) is highly prevalent in the elderly, and this population can be exposed to serious complications, including falls and cognitive disorders, as well as overall mortality. However, the pathophysiology of OH is still poorly understood, and innovative methods of cerebral blood flow (CBF) assessment have been required to accurately investigate cerebrovascular reactivity in OH. OBJECTIVES: We want to compare brain tissue pulsatility (BTP) changes during an orthostatic challenge in elderly patients over 80 with and without OH...
November 25, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27891826/ct-brain-perfusion-a-static-phantom-study-of-contrast-to-noise-ratio-and-radiation-dose
#15
Stewart M Midgley, Damien L Stella, Bruce Cv Campbell, Francesca Langenberg, Paul F Einsiedel
INTRODUCTION: Computed tomography perfusion (CTP) is increasingly employed in the diagnosis and management of ischaemic stroke but radiation dose can be significant and optimising contrast-to-noise ratio (CNR) is challenging. This study aimed to quantify and optimise the balance between CNR as a surrogate for image quality and radiation dose. METHODS: A perspex head phantom with vials of dilute contrast agent was scanned using a Siemens Definition Flash 128-slice scanner...
November 27, 2016: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/27886084/intracranial-thrombus-morphology-and-composition-undergoes-time-dependent-changes-in-acute-ischemic-stroke-a-ct-densitometry-study
#16
Slaven Pikija, Jozef Magdic, Vladimir Trkulja, Peter Unterkreuter, Johannes Sebastian Mutzenbach, Helmut F Novak, Friedrich Weymayr, Larissa Hauer, Johann Sellner
The aim of our study was to assess whether cerebral artery clots undergo time-dependent morphological and compositional changes in acute ischemic stroke. We performed a retrospective chart review of patients admitted within 5 h from symptom onset to three European stroke centers and evaluated non-contrast-enhanced CT (NECT) for hyperdense artery signs (HAS) in 2565 scans. The occlusion site, density of HAS expressed in Hounsfield units (HU), area of HAS, and relative density (rHU) (HU clot/HU non-affected artery) were studied and related to time from symptom onset, clinical severity, stroke etiology, and laboratory parameters...
November 23, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27884966/setting-up-a-neuroscience-stroke-and-rehabilitation-centre-in-brunei-darussalam-by-a-transcontinental-on-site-and-telemedical-cooperation
#17
U Meyding-Lamadé, B Bassa, E Craemer, C Jacobi, C Chan, W Hacke, B Kress
Due to the world-wide aging population, there is a need for specialist neurological knowledge, treatment and care. Stroke treatment is effective in reducing mortality and disability, but it is still not available in many areas of the world. We describe the set-up process of a specialized Neuroscience, Stroke and Rehabilitation Centre in Brunei Darussalam (BNSRC) in cooperation with a German hospital. This study details the setup of a stroke-, neurological intensive care- and neurorehabilitation unit, laboratories and a telemedical network to perform all evidence-based stroke treatments...
November 24, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27881427/ischemic-stroke-rate-increases-in-young-adults-evidence-for-a-generational-effect
#18
Joel N Swerdel, George G Rhoads, Jerry Q Cheng, Nora M Cosgrove, Abel E Moreyra, John B Kostis, William J Kostis
BACKGROUND: The incidence rates of ischemic stroke and ST-segment elevation myocardial infarction (STEMI) have decreased significantly in the United States since 1950. However, there is evidence of flattening of this trend or increasing rates for stroke in patients younger than 50 years. The objective of this study was to examine the changes in incidence rates of stroke and STEMI using an age-period-cohort model with statewide data from New Jersey. METHODS AND RESULTS: We obtained stroke and STEMI data for the years 1995-2014 from the Myocardial Infarction Data Acquisition System, a database of hospital discharges in New Jersey...
November 23, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27880819/risk-assessment-of-patients-undergoing-transfemoral-aortic-valve-implantation-upon-admission-for-post-interventional-intensive-care-and-surveillance-implications-on-short-and-midterm-outcomes
#19
Fadi Al-Rashid, Philipp Kahlert, Friederike Selge, Heike Hildebrandt, Polycarpos-Christos Patsalis, Matthias Totzeck, Petra Mummel, Tienush Rassaf, Rolf Alexander Jánosi
BACKGROUND: Several studies have found that standard risk scores inaccurately reflect risk in TAVI cohorts. The assessment of mortality risk upon post-interventional ICU admission is important to optimizing clinical management. This study sought to determine outcomes and factors affecting mortality in patients admitted to the intensive care unit (ICU) after transcatheter aortic valve implantation (TAVI), and to analyze and compare the predictive values of SAPS II and EuroSCORE. METHODS AND FINDINGS: 214 consecutive patients treated with transfemoral TAVI (2006-2012) admitted to the ICU in an academic tertiary-care university hospital, were included in this retrospective data analysis...
2016: PloS One
https://www.readbyqxmd.com/read/27878613/intermittent-low-dose-bevacizumab-in-hereditary-hemorrhagic-telangiectasia-a%C3%A2-case-report
#20
Florian Huemer, Martin Dejaco, Christoph Grabmer, Thomas Melchardt, Daniel Neureiter, Georg Mayer, Alexander Egle, Richard Greil, Lukas Weiss
BACKGROUND: Hereditary hemorrhagic telangiectasia is an inherited autosomal dominant disease presenting with recurrent bleeding episodes and iron deficiency anemia due to vascular malformations. Hereditary hemorrhagic telangiectasia is associated with an increased risk of stroke, gastrointestinal bleeding and pulmonary hypertension and life expectancy is significantly reduced. Excess vascular endothelial growth factor (VEGF) plays a key role in the pathophysiology of the disease. CASE PRESENTATION: Here we report about a male patient with hereditary hemorrhagic telangiectasia presenting with pulmonary and central nervous system involvement experiencing repetitive nosebleeds, necessitating frequent local cauterization and transfusion of more than 100 units of packed red blood cells...
November 23, 2016: Wiener Klinische Wochenschrift
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