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Stroke outcomes

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https://www.readbyqxmd.com/read/28927193/timing-of-percutaneous-coronary-intervention-in-patients-with-non-st-elevation-myocardial-infarction-a-swedeheart-study
#1
Daniel Lindholm, Joakim Alfredsson, Oskar Angerås, Felix Böhm, Fredrik Calais, Sasha Koul, Bo Lagerqvist, Henrik Renlund, Giovanna Sarno, Christoph Varenhorst
Aims: Although routine invasive management is recommended in NSTEMI patients, the optimal timing of the procedure is not defined. The aim of this study was to assess outcomes in relation to timing of PCI in NSTEMI patients. Methods and results: This was an observational, prospective, multicentre cohort study from the SWEDEHEART registry including all Swedish PCI centres. We included 40 494 consecutive PCI-treated patients who were admitted to any coronary care unit from 2006 to 2013...
January 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28926782/enterprise-stent-in-recanalizing-non-acute-atherosclerotic-intracranial-internal-carotid-artery-occlusion
#2
Xiaofei Wang, Zhigang Wang, Yong Ji, Xuan Ding, Yizheng Zang, Chengwei Wang
OBJECTIVE: To investigate the safety and effectiveness of recanalization in non-acute occlusion of intracranial internal carotid arteries using the flexible Enterprise self-expanding stent. PATIENTS AND METHODS: From June 2014 to June 2016, 12 consecutive patients with non-acute occlusion of intracranial internal carotid arteries received endovascular recanalization with Enterprise stenting. All patients received medication for anti-platelet aggregation therapy before and after the operation...
June 27, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28926191/clinical-validation-of-the-nursing-outcome-swallowing-status-in-people-with-stroke-analysis-according-to-the-classical-and-item-response-theories
#3
Ana Railka de Souza Oliveira-Kumakura, Thelma Leite de Araujo, Alice Gabrielle de Sousa Costa, Tahissa Frota Cavalcante, Marcos Venícios de Oliveira Lopes, Emilia Campos Carvalho
AIMS AND OBJECTIVES: To validate clinically the nursing outcome "Swallowing status". METHODS: The adjustment of the nursing outcome was investigated according to the Classical and Item Response Theories. The models were compared regarding information loss, goodness-of-fit, and differential item functioning. Stability and internal consistency were examined. RESULTS: The nursing outcome has the best fit in the generalized partial credit model with different discrimination parameters...
September 19, 2017: International Journal of Nursing Knowledge
https://www.readbyqxmd.com/read/28926165/pre-stroke-physical-activity-is-associated-with-fewer-post-stroke-complications-lower-mortality-and-a-better-long-term-outcome
#4
Chi-Pang Wen, Chung-Hsiang Liu, Jiann-Shing Jeng, Shih-Pin Hsu, Chih-Hung Chen, Li-Ming Lien, An-Chih Chen, Jiunn-Tay Lee, Ping-Kun Chen, Chih-Shan Hsu, Chang-Ming Chern, Chien-Chung Chen, Ming-Chin Hsu, Kang Lu, Han-Jung Chen, Hao-Kuang Wang, Chih-Hsin Muo, Chung Y Hsu
BACKGROUND AND PURPOSE: Physical activity is associated with a reduced incidence of first-time stroke; however, few studies have examined the effect of pre-stroke physical activity on post-stroke complications and clinical outcomes. METHODS: A total of 39,835 cases of stroke registered in the nationwide stroke registry system of Taiwan between 2006 and 2009 were analyzed according to 5 levels of severity as determined by NIHSS (National Institutes of Health Stroke Scale) score upon hospital admission...
September 19, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28925479/relationship-between-lesion-patterns-of-single-small-infarct-and-early-neurological-deterioration-in-the-perforating-territory
#5
X-J Han
OBJECTIVE: To investigate the relationship between lesion patterns of single small infarct (SSI) in perforating territory of the vertebral-basilar artery and early neurological deterioration (end)/short-term functional outcome. PATIENTS AND METHODS: 126 patients with acute SSI in the perforating territory of the vertebral-basilar artery, admitted within 24 h after symptom onset, were recruited between August 2010 and May 2013. The patients were divided into proximal SSI and distal SSI according to the relationship between their lesion location and their parent artery...
August 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28924010/microrna-1906-a-novel-regulator-of-toll-like-receptor-4-ameliorates-ischemic-injury-after-experimental-stroke-in-mice
#6
Xiaomeng Xu, Zhuoyu Wen, Nan Zhao, Xiaohui Xu, Fang Wang, Jie Gao, Yongjun Jiang, Xinfeng Liu
Toll-like receptor 4 (TLR4) is a pro-inflammatory cascade initiator in post-stroke inflammation. In this study, miR-1906, a novel regulator of TLR4, was identified via in silico analysis and microRNA profiling in male adult mice, and its expression was then quantitated in the ischemic hemisphere. We found miR-1906 to be significantly brain-enriched in the ischemic hemisphere and even more drastically enriched in the peri-infarct regions. Furthermore, in vitro experiments demonstrated that during oxygen-glucose deprivation (OGD), miR-1906 expression was increased in glial cells but decreased in neurons...
September 18, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28923988/contemporary-management-of-cardiogenic-shock-a-scientific-statement-from-the-american-heart-association
#7
REVIEW
Sean van Diepen, Jason N Katz, Nancy M Albert, Timothy D Henry, Alice K Jacobs, Navin K Kapur, Ahmet Kilic, Venu Menon, E Magnus Ohman, Nancy K Sweitzer, Holger Thiele, Jeffrey B Washam, Mauricio G Cohen
Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality remain high, and there are few evidence-based therapeutic interventions known to clearly improve patient outcomes. This scientific statement on cardiogenic shock summarizes the epidemiology, pathophysiology, causes, and outcomes of cardiogenic shock; reviews contemporary best medical, surgical, mechanical circulatory support, and palliative care practices; advocates for the development of regionalized systems of care; and outlines future research priorities...
September 18, 2017: Circulation
https://www.readbyqxmd.com/read/28923530/transfer-of-stroke-patients-impairs-eligibility-for-endovascular-stroke-treatment
#8
Omid Nikoubashman, Franziska Pauli, Kolja Schürmann, Ahmed E Othman, Jan-Philipp Bach, Martin Wiesmann, Arno Reich
BACKGROUND: Many patients who are potentially eligible for endovascular stroke treatment (EST) receive intravenous rtPA in the closest stroke unit before being transferred to tertiary centres for EST. It has been shown that clinical outcome of transferred and EST-treated patients is comparable to that of patients with direct access to EST. We analysed clinical outcome of patients, who were transferred and eventually not treated due to clinical and/or radiological deterioration. METHODS: We retrospectively analysed our prospectively maintained stroke registry for patients who were transferred for stroke therapy...
September 15, 2017: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/28923500/priorities-for-closing-the-evidence-practice-gaps-in-post-stroke-aphasia-rehabilitation-a-scoping-review
#9
REVIEW
Kirstine Shrubsole, Linda Worrall, Emma Power, Denise A O'Connor
OBJECTIVE: To identify implementation priorities for post-stroke aphasia management relevant to the Australian healthcare context. DATA SOURCES: Using systematized searches of databases (CINAHL, Medline), guideline and stroke websites, and other sources, evidence was identified and extracted for seven implementation criteria for 13 topic areas relevant to aphasia management. These seven priority-setting criteria were identified in the implementation literature; strength of the evidence; current evidence-practice gap; clinician preference; client preference; modifiability; measurability; and health impact...
September 15, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28923492/rationale-and-design-of-the-atrial-fibrillation-health-literacy-information-technology-trial-af-litt
#10
Emily N Guhl, Courtney L Schlusser, Lori E Henault, Timothy W Bickmore, Everlyne Kimani, Michael K Paasche-Orlow, Jared W Magnani
BACKGROUND: Atrial Fibrillation (AF) is a common cardiac arrhythmia that is challenging for patients and adversely impacts health-related quality of life (HRQoL). Long-term management of AF requires that patients adhere to complex therapies, understand difficult terminology, navigate subspecialty care, and have continued symptom monitoring with the goal of preventing adverse outcomes. Continued interventions to ameliorate the patient experience of AF are essential. DESIGN: The Atrial Fibrillation health Literacy Information Technology Trial (AF-LITT; NCT03093558) is an investigator-initiated, 2-arm randomized clinical trial (RCT)...
September 15, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28923395/percutaneous-coronary-intervention-versus-surgery-in-left-main-stenosis-a-meta-analysis-and-systematic-review-of-randomised-controlled-trials
#11
REVIEW
Safi U Khan, Hammad Rahman, Adeel Arshad, Muhammad U Khan, Manidhar Lekkala, Tsujung Yang, Abhishek Mishra, Edo Kaluski
OBJECTIVE: To investigate the safety and efficacy of percutaneous coronary interventions (PCI) versus coronary artery bypass graft (CABG) surgery for left main coronary artery (LMCA) disease. METHODS: Six randomised controlled trials (RCTs) were reviewed by searching PubMed/Medline, Embase and the Cochrane Library. Estimates were pooled according to random effects model. Binary outcomes were reported as risk ratio (RR) and continuous outcomes were reported as mean difference (MD) with 95% confidence interval (CI)...
August 25, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28923278/can-adjunctive-therapies-augment-the-efficacy-of-endovascular-thrombolysis-a-potential-role-for-activated-protein-c
#12
REVIEW
Arun Paul Amar, Abhay P Sagare, Zhen Zhao, Yaoming Wang, Amy R Nelson, John H Griffin, Berislav V Zlokovic
In the management of acute ischemic stroke, vessel recanalization correlates with functional status, mortality, cost, and other outcome measures. Thrombolysis with intravenous tissue plasminogen activator has many limitations that restrict its applicability, but recent advances in the development of mechanical thrombectomy devices as well as improved systems of stroke care have resulted in greater likelihood of vessel revascularization. Nonetheless, there remains substantial discrepancy between rates of recanalization and rates of favorable outcome...
September 15, 2017: Neuropharmacology
https://www.readbyqxmd.com/read/28922886/intracranial-bypass-of-posterior-inferior-cerebellar-artery-aneurysms-indications-technical-aspects-and-clinical-outcomes
#13
David J Bonda, Mohamad Labib, Jeffrey M Katz, Rafael A Ortiz, David Chalif, Avi Setton, David J Langer, Amir R Dehdashti
BACKGROUND: For some posterior inferior cerebellar artery (PICA) aneurysms, there is no constructive endovascular or direct surgical clipping option. Intracranial bypass is an alternative to a deconstructive technique. OBJECTIVE: To evaluate the clinical features, surgical techniques, and outcome of PICA aneurysms treated with bypass and obliteration of the diseased segment. METHODS: Retrospective review of PICA aneurysms treated via intracranial bypass was performed...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28922885/patient-selection-and-clinical-efficacy-of-urgent-superficial-temporal-artery-middle-cerebral-artery-bypass-in-acute-ischemic-stroke-using-advanced-magnetic-resonance-imaging-techniques
#14
Hyun-Seok Park, Sang-Hyeon Kim, Hyun-Wook Nah, Jae-Hyung Choi, Dae-Hyun Kim, Myong-Jin Kang, Jae-Kwan Cha, Jae-Taeck Huh
BACKGROUND: Selected patients with acute ischemic stroke might benefit from superficial temporal artery-middle cerebral artery (STA-MCA) bypass, but the indications for urgent STA-MCA bypass are unknown. OBJECTIVE: To report our experiences of urgent STA-MCA bypass in patients requiring urgent reperfusion who were ineligible for other reperfusion therapies, using advanced magnetic resonance imaging (MRI) techniques. METHODS: The inclusion criteria for urgent STA-MCA bypass were as follows: acute infarct volume <70 mL with a ratio of perfusion/diffusion lesion volume ≥1...
October 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28922340/the-impact-of-continuous-non-invasive-arterial-blood-pressure-monitoring-on-blood-pressure-stability-during-general-anaesthesia-in-orthopaedic-patients-a-randomised-trial
#15
Agnes S Meidert, Johanna S Nold, Roman Hornung, Alexander C Paulus, Bernhard Zwißler, Stephan Czerner
BACKGROUND: In patients undergoing general anaesthesia, intraoperative hypotension occurs frequently and is associated with adverse outcomes such as postoperative acute kidney failure, myocardial infarction or stroke. A history of chronic hypertension renders patients more susceptible to a decrease in blood pressure (BP) after induction of general anaesthesia. As a patient's BP is generally monitored intermittently via an upper arm cuff, there may be a delay in the detection of hypotension by the anaesthetist...
September 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28922311/motor-imagery-training-after-stroke-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#16
Zaqueline Fernandes Guerra, Alessandra L G Lucchetti, Giancarlo Lucchetti
BACKGROUND AND PURPOSE: A number of studies have suggested that imagery training (motor imagery [MI]) has value for improving motor function in persons with neurologic conditions. We performed a systematic review and meta-analysis to assess the available literature related to efficacy of MI in the recovery of individuals after stroke. METHODS: We searched the following databases: PubMed, Web of Knowledge, Scopus, Cochrane, and PEDro. Two reviewers independently selected clinical trials that investigated the effect of MI on outcomes commonly investigated in studies of stroke recovery...
October 2017: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/28921837/coronary-artery-bypass-grafting-versus-percutaneous-coronary-intervention-in-patients-with-non-insulin-treated-type-2-diabetes-mellitus-a-meta-analysis-of-randomized-controlled-trials
#17
Yushu Wang, Meiqin Wen, Junteng Zhou, Yucheng Chen, Qing Zhang
INTRODUCTION: The outcomes and prognosis of revascularization by either coronary artery bypass grafting (CABG) surgery or percutaneous coronary intervention (PCI) in patients with non-insulin treated type 2 diabetes mellitus (NITDM) have not yet been well established. METHODS: Randomized controlled trials (RCTs) were identified by searching Pubmed, EMBASE and Cochrane library from inception until May 2016. Heterogeneity was evaluated and the pooled hazard ratio (HR) was calculated using a fixed-effect model...
September 15, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28920888/prediction-of-motor-recovery-after-stroke-advances-in-biomarkers
#18
REVIEW
Cathy M Stinear
Stroke remains a leading cause of adult disability, and the recovery of motor function after stroke is crucial for the patient to regain independence. However, making accurate predictions of a patient's motor recovery and outcome is difficult when based on clinical assessment alone. Clinical assessment of motor impairment within a few days of stroke can help to predict subsequent recovery, while neurophysiological and neuroimaging biomarkers of corticomotor structure and function can help to predict both motor recovery and motor outcome after stroke...
October 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28920887/the-chronic-and-evolving-neurological-consequences-of-traumatic-brain-injury
#19
REVIEW
Lindsay Wilson, William Stewart, Kristen Dams-O'Connor, Ramon Diaz-Arrastia, Lindsay Horton, David K Menon, Suzanne Polinder
Traumatic brain injury (TBI) can have lifelong and dynamic effects on health and wellbeing. Research on the long-term consequences emphasises that, for many patients, TBI should be conceptualised as a chronic health condition. Evidence suggests that functional outcomes after TBI can show improvement or deterioration up to two decades after injury, and rates of all-cause mortality remain elevated for many years. Furthermore, TBI represents a risk factor for a variety of neurological illnesses, including epilepsy, stroke, and neurodegenerative disease...
October 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28920550/sit-to-stand-activity-during-stroke-rehabilitation
#20
Andy Kerr, Jesse Dawson, Chris Robertson, Philip Rowe, Terence J Quinn
Objectives The sit to stand (STS) movement is key to independence and commonly affected by stroke. Repetitive practice is likely to improve STS ability during rehabilitation, however current practice levels are unknown. The objective of this study was simply to count the number of STS movements performed during the rehabilitation period of stroke patients using a physical activity monitor (PAM) and test whether being observed altered outcome. Methods Participants were medically stable patients referred for rehabilitation following stroke...
September 18, 2017: Topics in Stroke Rehabilitation
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