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https://www.readbyqxmd.com/read/28230899/shared-care-across-the-interface-between-primary-and-specialty-care-in-management-of-long-term-conditions
#1
REVIEW
Susan M Smith, Gráinne Cousins, Barbara Clyne, Shane Allwright, Tom O'Dowd
BACKGROUND: Shared care has been used in the management of many chronic conditions with the assumption that it delivers better care than primary or specialty care alone; however, little is known about the effectiveness of shared care. OBJECTIVES: To determine the effectiveness of shared care health service interventions designed to improve the management of chronic disease across the primary/specialty care interface. This is an update of a previously published review...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28229935/mice-deficient-in-l-12-15-lipoxygenase-show-increased-vulnerability-to-3-nitropropionic-acid-neurotoxicity
#2
Yan He, Rita C Akumuo, Yuan Yang, Sandra J Hewett
Considerable evidence supports a contributory role for leukocyte-type 12/15 Lipoxygenase (L-12/15 LO) in mediating hippocampal and cortical neuronal injury in models of Alzheimer's disease and stroke. Whether L-12/15 LO contributes to neuronal injury in a model of Huntington's disease (HD) has yet to be determined. HD is characterized by marked striatal neuronal loss, which can be mimicked in humans and animals by inhibition of mitochondrial complex II using 3-Nitropropionic acid (3-NP). Herein, we compared histological and behavioral outcomes between mice that were wild-type or null for L-12/15 LO following systemic injection of 3NP...
February 13, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28229894/mobile-stroke-units-for-prehospital-thrombolysis-triage-and-beyond-benefits-and-challenges
#3
REVIEW
Klaus Fassbender, James C Grotta, Silke Walter, Iris Q Grunwald, Andreas Ragoschke-Schumm, Jeffrey L Saver
In acute stroke management, time is brain. Bringing swift treatment to the patient, instead of the conventional approach of awaiting the patient's arrival at the hospital for treatment, is a potential strategy to improve clinical outcomes after stroke. This strategy is based on the use of an ambulance (mobile stroke unit) equipped with an imaging system, a point-of-care laboratory, a telemedicine connection to the hospital, and appropriate medication. Studies of prehospital stroke treatment consistently report a reduction in delays before thrombolysis and cause-based triage in regard to the appropriate target hospital (eg, primary vs comprehensive stroke centre)...
March 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28229893/safety-and-efficacy-of-natalizumab-in-patients-with-acute-ischaemic-stroke-action-a-randomised-placebo-controlled-double-blind-phase-2-trial
#4
Jacob Elkins, Roland Veltkamp, Joan Montaner, S Claiborne Johnston, Aneesh B Singhal, Kyra Becker, Maarten G Lansberg, Weihua Tang, Ih Chang, Kumar Muralidharan, Sarah Gheuens, Lahar Mehta, Mitchell S V Elkind
BACKGROUND: In animal models of acute ischaemic stroke, blocking of the leukocyte-endothelium adhesion by antagonism of α4 integrin reduces infarct volumes and improves outcomes. We assessed the effect of one dose of natalizumab, an antibody against the leukocyte adhesion molecule α4 integrin, in patients with acute ischaemic stroke. METHODS: In this double-blind, phase 2 study, patients with acute ischaemic stroke (aged 18-85 years) from 30 US and European clinical sites were randomly assigned (1:1) to 300 mg intravenous natalizumab or placebo with stratification by treatment window and baseline infarct size...
March 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28229398/stroke-chameleons-and-stroke-mimics-in-the-emergency-department
#5
REVIEW
Ava L Liberman, Shyam Prabhakaran
PURPOSE OF REVIEW: We discuss the frequency of stroke misdiagnosis in the emergency department (ED), identify common diagnostic pitfalls, describe strategies to reduce diagnostic error, and detail ongoing research. RECENT FINDINGS: The National Academy of Medicine has re-defined and highlighted the importance of diagnostic errors for patient safety. Recent rates of stroke under-diagnosis (false-negative cases, "stroke chameleons") range from 2-26% and 30-43% for stroke over-diagnosis (false-positive cases, "stroke mimics")...
February 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28229254/the-impact-of-post-procedural-complications-on-reimbursement-length-of-stay-and-mechanical-ventilation-among-patients-undergoing-transcatheter-aortic-valve-implantation-in-germany
#6
Klaus Kaier, Holger Reinecke, Huseyin Naci, Lutz Frankenstein, Martin Bode, Werner Vach, Philip Hehn, Andreas Zirlik, Manfred Zehender, Jochen Reinöhl
BACKGROUND: The impact of various post-procedural complications after transcatheter aortic valve implantation (TAVI) on resource use and their consequences in the German reimbursement system has still not been properly quantified. METHODS: In a retrospective observational study, we use data from the German DRG statistic on patient characteristics and in-hospital outcomes of all isolated TAVI procedures in 2013 (N = 9147). The impact of post-procedural complications on reimbursement, length of stay and mechanical ventilation was analyzed using both unadjusted and risk-adjusted linear and logistic regression analyses...
February 22, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28228657/repetitive-hyperbaric-oxygen-treatment-increases-insulin-sensitivity-in-diabetes-patients-with-acute-intracerebral-hemorrhage
#7
Qian Xu, Yi-Ting Wei, Shuang-Bo Fan, Liang Wang, Xiao-Ping Zhou
AIM: The role of hyperbaric oxygen therapy (HBOT) in the treatment of acute ischemic stroke is controversial. This study aims to investigate whether the peripheral insulin sensitivity of type 2 diabetes patients suffering from intracerebral hemorrhage can be increased after HBOT. METHODS: Fifty-two type 2 diabetes participants were recruited after being diagnosed with intracerebral hemorrhage in our hospital. Insulin sensitivity was measured by the glucose infusion rate during a hyperinsulinemic euglycemic clamp (80 mU m(-2) min(-1)) at baseline and 10 and 30 days after HBOT sessions...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28228578/proof-of-concept-randomized-trial-of-the-monoclonal-antibody-gsk249320-versus-placebo-in-stroke-patients
#8
Steven C Cramer, Lori A Enney, Colleen K Russell, Monica Simeoni, Thomas R Thompson
BACKGROUND AND PURPOSE: One class of poststroke restorative therapy focuses on promoting axon outgrowth by blocking myelin-based inhibitory proteins such as myelin-associated glycoprotein. The purpose of the current study was to extend preclinical and clinical findings of GSK249320, a humanized monoclonal antibody to myelin-associated glycoprotein with disabled Fc region, to explore effects on motor outcomes post-stroke. METHODS: In this phase IIb double-blind, randomized, placebo-controlled study, patients at 30 centers with ischemic stroke 24 to 72 hours prior and gait deficits were randomized to 2 IV infusions of GSK249320 or placebo...
February 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28228577/the-basilar-artery-on-computed-tomography-angiography-prognostic-score-for-basilar-artery-occlusion
#9
Fana Alemseged, Darshan G Shah, Marina Diomedi, Fabrizio Sallustio, Andrew Bivard, Gagan Sharma, Peter J Mitchell, Richard J Dowling, Steven Bush, Bernard Yan, Carlo Caltagirone, Roberto Floris, Mark W Parsons, Christopher R Levi, Stephen M Davis, Bruce C V Campbell
BACKGROUND AND PURPOSE: Basilar artery occlusion is associated with high risk of disability and mortality. This study aimed to assess the prognostic value of a new radiological score: the Basilar Artery on Computed Tomography Angiography (BATMAN) score. METHODS: A retrospective analysis of consecutive stroke patients with basilar artery occlusion diagnosed on computed tomographic angiography was performed. BATMAN score is a 10-point computed tomographic angiography-based grading system which incorporates thrombus burden and the presence of collaterals...
February 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28228574/delays-in-door-to-needle-times-and-their-impact-on-treatment-time-and-outcomes-in-get-with-the-guidelines-stroke
#10
Noreen Kamal, Shubin Sheng, Ying Xian, Roland Matsouaka, Michael D Hill, Deepak L Bhatt, Jeffrey L Saver, Mathew J Reeves, Gregg C Fonarow, Lee H Schwamm, Eric E Smith
BACKGROUND AND PURPOSE: Despite quality improvement programs such as the American Heart Association/American Stroke Association Target Stroke initiative, a substantial portion of acute ischemic stroke patients are still treated with tissue-type plasminogen activator (alteplase) later than 60 minutes from arrival. This study aims to describe the documented reasons for delays and the associations between reasons for delays and patient outcomes. METHODS: We analyzed the characteristics of 55 296 patients who received intravenous alteplase in 1422 hospitals participating in Get With The Guidelines-Stroke from October 2012 to April 2015, excluding transferred patients and inpatient strokes...
February 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28228467/gender-differences-in-clinical-presentation-and-1-year-outcomes-in-atrial-fibrillation
#11
Renate B Schnabel, Ladislav Pecen, Francisco M Ojeda, Markus Lucerna, Nargiz Rzayeva, Stefan Blankenberg, Harald Darius, Dipak Kotecha, Raffaele De Caterina, Paulus Kirchhof
OBJECTIVES: Our objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort. METHODS: In 6412 patients, 39.7% women, of the PREvention oF thromboembolic events - European Registry in Atrial Fibrillation, we examined gender differences in symptoms, risk factors, therapies and 1-year incidence of adverse outcomes. RESULTS: Men with AF were on average younger than women (mean±SD: 70...
February 22, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28228462/identifying-strategies-to-reduce-poor-outcomes-in-women-with-stroke
#12
Tracy E Madsen, Lynda D Lisabeth
No abstract text is available yet for this article.
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28228454/sex-differences-in-long-term-mortality-after-stroke-in-the-instruct-international-stroke-outcomes-study-a-meta-analysis-of-individual-participant-data
#13
Hoang T Phan, Christopher L Blizzard, Mathew J Reeves, Amanda G Thrift, Dominique Cadilhac, Jonathan Sturm, Emma Heeley, Petr Otahal, Vemmos Konstantinos, Craig Anderson, Priya Parmar, Rita Krishnamurthi, Suzanne Barker-Collo, Valery Feigin, Yannick Bejot, Norberto L Cabral, Antonio Carolei, Simona Sacco, Nicolas Chausson, Stephane Olindo, Peter Rothwell, Carolina Silva, Manuel Correia, Rui Magalhães, Peter Appelros, Janika Kõrv, Riina Vibo, Cesar Minelli, Seana Gall
BACKGROUND: Women are reported to have greater mortality after stroke than men, but the reasons are uncertain. We examined sex differences in mortality at 1 and 5 years after stroke and identified factors contributing to these differences. METHODS AND RESULTS: Individual participant data for incident strokes were obtained from 13 population-based incidence studies conducted in Europe, Australasia, South America, and the Caribbean between 1987 and 2013. Data on sociodemographics, stroke-related factors, prestroke health, and 1- and 5-year survival were obtained...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28228305/clinical-presentation-management-and-outcomes-in-the-indian-heart-rhythm-society-atrial-fibrillation-ihrs-af-registry
#14
A Vora, A Kapoor, M Nair, Y Lokhandwala, C Narsimhan, A G Ravikishore, S K Dwivedi, N Namboodiri, R Hygriv, A Saxena, A Nabar, S Garg, N Bardoloi, R Yadav, A Nambiar, U Pandurangi, D Jhala, A Naik, Nagmallesh, S Rajagopal, R Selvaraj, V Arora, A Thachil, J Thomas, G Panicker
AIM: A national atrial fibrillation (AF) registry was conducted under the aegis of the Indian Heart Rhythm Society (IHRS), to capture epidemiological data-type of AF, clinical presentation and comorbidities, current treatment practices, and 1-year follow-up outcomes. METHODS: A total of 1537 patients were enrolled from 24 sites in India in the IHRS-AF registry from July 2011 to August 2012. Their baseline characteristics and follow-up data were recorded in case report forms and subsequently analyzed...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28228127/a-review-of-enhanced-paramedic-roles-during-and-after-hospital-handover-of-stroke-myocardial-infarction-and-trauma-patients
#15
Darren Flynn, Richard Francis, Shannon Robalino, Joanne Lally, Helen Snooks, Helen Rodgers, Graham McClelland, Gary A Ford, Christopher Price
BACKGROUND: Ambulance paramedics play a critical role expediting patient access to emergency treatments. Standardised handover communication frameworks have led to improvements in accuracy and speed of information transfer but their impact upon time-critical scenarios is unclear. Patient outcomes might be improved by paramedics staying for a limited time after handover to assist with shared patient care. We aimed to categorize and synthesise data from studies describing development/extension of the ambulance-based paramedic role during and after handover for time-critical conditions (trauma, stroke and myocardial infarction)...
February 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28228074/lenticulostriate-artery-and-lenticulostriate-artery-neural-complex-new-concept-for-intracerebral-hemorrhage
#16
Rong Hu, Hua Feng
BACKGROUND: Spontaneous intracerebral hemorrhage (ICH) is the poorest prognosis of all stroke subtypes with a high mortality and morbidity. Although considerable progress has been made, no intervention is currently available to alter the outcome of patients with ICH, suggesting a new concept directing ICH study is urgently needed. METHODS: Most ICH occurs in the deep area of the brain, the basal ganglion, whose blood supply is mainly from lenticulostriate arteries (LSAs)...
February 20, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28227970/combining-a-hybrid-robotic-system-with-a-bain-machine-interface-for-the-rehabilitation-of-reaching-movements-a-case-study-with-a-stroke-patient
#17
F Resquin, J Ibanez, J Gonzalez-Vargas, F Brunetti, I Dimbwadyo, S Alves, L Carrasco, L Torres, Jose Luis Pons, F Resquin, J Ibañez, J Gonzalez-Vargas, F Brunetti, I Dimbwadyo, S Alves, L Carrasco, L Torres, Jose Luis Pons, S Alves, Jose Luis Pons, F Brunetti, J Gonzalez-Vargas, F Resquin, I Dimbwadyo, L Carrasco, L Torres, J Ibanez
Reaching and grasping are two of the most affected functions after stroke. Hybrid rehabilitation systems combining Functional Electrical Stimulation with Robotic devices have been proposed in the literature to improve rehabilitation outcomes. In this work, we present the combined use of a hybrid robotic system with an EEG-based Brain-Machine Interface to detect the user's movement intentions to trigger the assistance. The platform has been tested in a single session with a stroke patient. The results show how the patient could successfully interact with the BMI and command the assistance of the hybrid system with low latencies...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227561/mirror-therapy-combined-with-functional-electrical-stimulation-for-rehabilitation-of-stroke-survivors-ankle-dorsiflexion
#18
Ghadir Salhab, Ahmad Rifaii Sarraj, Soha Saleh, Ghadir Salhab, Ahmad Rifaii Sarraj, Soha Saleh, Ahmad Rifaii Sarraj, Ghadir Salhab, Soha Saleh
This study investigates the effect of combining both mirror therapy with Electrical Stimulation (ES) on improvement of the function of lower extremity compared to conventional therapy. 18 stroke survivors (sub acute stage) were recruited, 9 of them were randomly assigned to receive conventional treatment and another 9 started the mirror therapy combined with ES treatment. Duration of each session in both interventions was 50 minutes, done 4 times per week over two weeks. After 2 weeks, subjects took one week rest before switching they type of treatment; those started with conventional therapy continued with mirror therapy combined with ES, and vice versa...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227555/eeg-patterns-of-subacute-stroke-patients-performing-motor-tasks-correlate-with-motor-functional-outcome-preliminary-results
#19
Wanjoo Park, Yun-Hee Kim, Sung-Phil Kim, Laehyun Kim, Wanjoo Park, Yun-Hee Kim, Sung-Phil Kim, Laehyun Kim, Yun-Hee Kim, Sung-Phil Kim, Wanjoo Park, Laehyun Kim
If an early predictor of motor functional outcome after stroke were available, stroke patients would receive more appropriate treatments for motor recovery. We performed a correlation analysis of the electroencephalography (EEG) signal patterns of nine subacute stroke patients (recorded 22.9 ± 7.1 days after onset) and their motor recovery rates (measured 100.2 ± 8.9 days after onset). The beta band spectral power in the bilateral motor cortex after physical upper limb movement correlated significantly with the motor recovery rates [Fugl-Meyer assessment (FMA) scores; Pearson's linear correlation, p <; 0...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227088/detection-of-the-propagating-direction-of-electrical-wavefront-in-atrial-fibrillation
#20
Dongping Du, Yuncheng Du, Dongping Du, Yuncheng Du, Dongping Du, Yuncheng Du
Atrial Fibrillation (AF) is one of the most common sustained arrhythmia, which can increase the risk of heart failure and stroke. Understanding the complex electrical dynamics of AF and correctly targeting AF sources for ablation therapies remain challenging in clinical practice. This is due to the incapability to reconstruct the electrical dynamic of AF, and lack of efficient approach for AF source identification. This paper builds a multi-sale framework for modeling of the abnormal electrical propagation in AF initiated by triggers from Pulmonary Veins (PVs)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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