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https://www.readbyqxmd.com/read/28820652/decreasing-stroke-code-to-ct-time-in-patients-presenting-with-stroke-symptoms
#1
Aleksandrs Kalnins, L Jake Mickelsen, Daisha Marsh, Christoph Zorich, Stephanie Casal, Waimei Amy Tai, Nirali Vora, Gennette Olalia, Max Wintermark, David B Larson
Guided quality improvement (QI) programs present an effective means to streamline stroke code to computed tomography (CT) times in a comprehensive stroke center. Applying QI methods and a multidisciplinary team approach may decrease the stroke code to CT time in non-prenotified emergency department (ED) patients presenting with symptoms of stroke. The aim of this project was to decrease this time for non-prenotified stroke code patients from a baseline mean of 20 minutes to one less than 15 minutes during an 18-week period by applying QI methods in the context of a structured QI program...
August 18, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28820038/comparison-of-clevidipine-and-nicardipine-for-acute-blood-pressure-reduction-in-patients-with-stroke
#2
Teresa A Allison, Stephanie Bowman, Brian Gulbis, Heather Hartman, Sara Schepcoff, Kiwon Lee
OBJECTIVE: The aim of this study was to determine whether clevidipine (CLEV) achieved faster blood pressure control compared to nicardipine (NIC) in patients presenting with either an acute ischemic stroke (AIS) or a spontaneous intracerebral hemorrhage (ICH). METHODS: This was a retrospective, observational, cohort study conducted in patients with AIS or ICH admitted to the emergency department of a Comprehensive Stroke Center from November 2011 to June 2013 who received CLEV or NIC continuous infusion for acute blood pressure management...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28818260/transcranial-doppler-monitoring-for-microemboli-a-marker-of-a-high-risk-carotid-plaque
#3
J David Spence
In the United States, 90% of carotid intervention is being performed for asymptomatic carotid stenosis, even though 90% of patients would be better treated with intensive medical therapy. This is being justified by comparing risks of stroke or death with medical therapy during clinical trials completed decades ago (approximately 2% per year) with risks of intervention with carotid artery stenting (CAS) versus carotid endarterectomy in recent trials that did not have a medical arm. Such extrapolations are, simply put, invalid...
March 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28816933/breast-cancer-endometrial-cancer-and-cardiovascular-events-in-participants-who-used-vaginal-estrogen-in-the-women-s-health-initiative-observational-study
#4
Carolyn J Crandall, Kathleen M Hovey, Christopher A Andrews, Rowan T Chlebowski, Marcia L Stefanick, Dorothy S Lane, Jan Shifren, Chu Chen, Andrew M Kaunitz, Jane A Cauley, JoAnn E Manson
OBJECTIVE: To determine the association between use of vaginal estrogen and risk of a global index event (GIE), defined as time to first occurrence of coronary heart disease (CHD), invasive breast cancer, stroke, pulmonary embolism, hip fracture, colorectal cancer, endometrial cancer, or death from any cause. METHODS: For this prospective observational cohort study, we used data from participants of the Women's Health Initiative Observational Study, who were recruited at 40 US clinical centers, aged 50 to 79 years at baseline and did not use systemic estrogen therapy during follow-up (nā€Š=ā€Š45,663, median follow-up 7...
August 14, 2017: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/28814457/direct-oral-anticoagulant-vs-vitamin-k-antagonist-related-nontraumatic-intracerebral-hemorrhage
#5
Georgios Tsivgoulis, Vasileios-Arsenios Lioutas, Panayiotis Varelas, Aristeidis H Katsanos, Nitin Goyal, Robert Mikulik, Kristian Barlinn, Christos Krogias, Vijay K Sharma, Konstantinos Vadikolias, Efthymios Dardiotis, Theodore Karapanayiotides, Alexandra Pappa, Christina Zompola, Sokratis Triantafyllou, Odysseas Kargiotis, Michael Ioakeimidis, Sotirios Giannopoulos, Ali Kerro, Argyrios Tsantes, Chandan Mehta, Mathew Jones, Christoph Schroeder, Casey Norton, Anastasios Bonakis, Jason Chang, Anne W Alexandrov, Panayiotis Mitsias, Andrei V Alexandrov
OBJECTIVE: To compare the neuroimaging profile and clinical outcomes among patients with intracerebral hemorrhage (ICH) related to use of vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs) for nonvalvular atrial fibrillation (NVAF). METHODS: We evaluated consecutive patients with NVAF with nontraumatic, anticoagulant-related ICH admitted at 13 tertiary stroke care centers over a 12-month period. We also performed a systematic review and meta-analysis of eligible observational studies reporting baseline characteristics and outcomes among patients with VKA- or DOAC-related ICH...
August 16, 2017: Neurology
https://www.readbyqxmd.com/read/28814039/evaluating-wearable-multimodal-sensor-insoles-for-motion-pattern-measurements-in-stroke-rehabilitation-a-pilot-study
#6
V David, M Forjan, J Martinek, S Kotzian, H Jagos, D Rafolt
The majority of stroke patients experience deficits in motoric functions, especially in gait and mobility. They need rehabilitation to regain walking independence, which is a major goal of rehabilitation after stroke. To document and assess the rehabilitation progress, instrumented motion analysis and clinical assessments are commonly used. In a clinical pilot study the applicability of an instrumented insole system in stroke rehabilitation is evaluated. Motion parameter of 35 stroke patients were gathered with the system while completing 90 s level walking and Timed Up & Go test at the beginning and end of four weeks inpatient rehabilitation...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813946/a-user-centered-design-approach-in-the-development-of-rehabilitation-devices-after-stroke
#7
Natalie Jankowski, Laura Schonijahn, Adina Kreitlow, Elsa Gotze, Michael Wahl
Involving users in iterative development processes is to be shown to increase the quality of health care devices and to prevent refusal. Successful use can only be achieved provided that the devices are accepted by its users. In this study potentials of user satisfaction surveys in the development of stroke rehabilitation devices are presented. The two arm-training devices Reha-Slide (RS) and Bi-Manu-Track (BMT) are assessed for patient satisfaction. The aim is to detect the satisfaction with the current state of certain aspects of the devices to obtain incentives for technical optimisation...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28812421/right-hemispatial-ipsilesional-neglect-with-chronic-right-hemisphere-strokes
#8
John B Williamson, Damon G Lamb, D Brandon Burtis, Salsabil Haque, Eduardo M Zilli, Tigran Kesayan, Michal Harciarek, Kenneth M Heilman
BACKGROUND: Patients who present with spatial neglect after stroke often perform normally on tests for neglect after a few weeks. Whereas tests for neglect are often performed directly in front of a patient, in their actual environments many important stimuli may be present within their left or right hemispace. The presence and severity of neglect often depends on the hemisphere injured. It is possible, in chronic stroke, for spatial judgments to be influenced by an interaction of stroke laterality and the spatial location of stimuli...
August 16, 2017: Journal of Clinical and Experimental Neuropsychology
https://www.readbyqxmd.com/read/28810251/a-prospective-randomized-open-label-blinded-endpoint-study-exploring-platelet-response-to-half-dose-prasugrel-and-ticagrelor-in-patients-with-the-acute-coronary-syndrome-hope-tailor-study
#9
Cai De Jin, Moo Hyun Kim, Junghee Bang, Victor Serebruany
BACKGROUND: The optimal dosing of novel oral P2Y12 receptor platelet inhibitors such as prasugrel or ticagrelor is unclear and especially challenging in East Asians. We hypothesize that half-dose prasugrel and ticagrelor may be sufficient for long-term maintenance management in Korean patients with the acute coronary syndrome (ACS) compared with conventional dosages. DESIGN: HOPE-TAILOR (Half Dose of Prasugrel and Ticagrelor in Platelet Response after Acute Coronary Syndromes) is a prospective, randomized, open-label, blinded, endpoint (PROBE) single-center, clinical trial...
August 16, 2017: Cardiology
https://www.readbyqxmd.com/read/28809939/a-cross-sectional-study-comparing-lateral-and-diagonal-maximum-weight-shift-in-people-with-stroke-and-healthy-controls-and-the-correlation-with-balance-gait-and-fear-of-falling
#10
Margaretha M van Dijk, Sarah Meyer, Solveig Sandstad, Evelyne Wiskerke, Rhea Thuwis, Chesny Vandekerckhove, Charlotte Myny, Nitesh Ghosh, Hilde Beyens, Eddy Dejaeger, Geert Verheyden
Impaired balance is common post stroke and can be assessed by means of force-platforms measuring center of pressure (COP) displacements during static standing, or more dynamically during lateral maximum weight shift (MWS). However, activities of daily life also include diagonal MWS and since force platforms are nowadays commercially available, investigating lateral and diagonal MWS in a clinical setting might be feasible and clinically relevant. We investigated lateral and diagonal MWS while standing in patients with stroke (PwS) and healthy controls (HC), evaluated MWS towards the affected and the non-affected side for PwS and correlated MWS with measures of balance, gait and fear of falling...
2017: PloS One
https://www.readbyqxmd.com/read/28807486/gender-social-networks-and-stroke-preparedness-in-the-stroke-warning-information-and-faster-treatment-study
#11
Tracy E Madsen, Eric T Roberts, Heather Kuczynski, Emily Goldmann, Nina S Parikh, Bernadette Boden-Albala
BACKGROUND AND PURPOSE: The study aimed to investigate the effect of gender on the association between social networks and stroke preparedness as measured by emergency department (ED) arrival within 3 hours of symptom onset. METHODS: As part of the Stroke Warning Information and Faster Treatment study, baseline data on demographics, social networks, and time to ED arrival were collected from 1193 prospectively enrolled stroke/transient ischemic attack (TIA) patients at Columbia University Medical Center...
August 11, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28807045/a-randomized-multi-center-prospective-study-comparing-best-medical-treatment-versus-best-medical-treatment-plus-renal-artery-stenting-in-patients-with-hemodynamically-relevant-atherosclerotic-renal-artery-stenosis-radar-one-year-results-of-a-pre-maturely-terminated
#12
Thomas Zeller, Hans Krankenberg, Andrejs Erglis, Erwin Blessing, Torsten Fuss, Dierk Scheinert, Ralf Weser, Beatrix B Doerr, Wilfrid D Yollo, Joerg Radermacher
BACKGROUND: The indications for conservative "best medical treatment" (BMT) versus additional renal artery stenting are a matter of ongoing debate. The RADAR study aimed to evaluate the impact of percutaneous renal artery stenting on the impaired renal function in patients with hemodynamically significant atherosclerotic renal artery stenosis (RAS). METHODS: RADAR is an international, prospective, randomized (1:1) controlled study comparing BMT alone versus BMT plus renal artery stenting in patients with duplex sonographic hemodynamically relevant RAS...
August 14, 2017: Trials
https://www.readbyqxmd.com/read/28805343/rest-and-exercise-hemodynamic-and-metabolic-findings-in-active-duty-soldiers-referred-for-cardiac-catheterization-to-exclude-heart-disease-insights-from-past-invasive-cardiopulmonary-exercise-testing-using-multisensor-high-fidelity-catheters
#13
James A Watts, Faith R Kelly, Terry D Bauch, Joseph P Murgo, Bernard J Rubal
OBJECTIVE: This study describes results of iCPET from the past, which used submaximal stress and multisensor high-fidelity catheters to exclude heart disease in a unique population of young adults. BACKGROUND: There has been resurgence in comprehensive hemodynamic evaluation of complex cardiovascular patients. Although dynamic assessments during cardiac catheterization have become commonplace, there remains limited information regarding left and right heart hemodynamic changes during supine exercise in young adults...
May 8, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28804679/time-to-neurological-deterioration-in-ischemic-stroke
#14
James E Siegler, Karen C Albright, Alexander J George, Amelia K Boehme, Michael A Gillette, Andre D Kumar, Monica Aswani, Sheryl Martin-Schild
BACKGROUND: Neurological deterioration (ND) is common, with nearly one-half of ND patients deteriorating within the first 24 to 48 hours of stroke. The timing of ND with respect to ND etiology and reversibility has not been investigated. METHODS: At our center, we define ND as an increase of 2 or more points in the National Institutes of Health Stroke Scale (NIHSS) score within 24 hours and categorize etiologies of ND according to clinical reversibility. ND etiologies were considered non-reversible if such causes may have produced or extended any areas of ischemic neurologic injury due to temporary or permanent impairment in cerebral perfusion...
2017: Medical Student Research Journal
https://www.readbyqxmd.com/read/28803231/in-potential-stroke-patients-on-warfarin-the-international-normalized-ratio-predicts-ischemia
#15
Cathy Cao, Ashley Martinelli, Brian Spoelhof, Rafael H Llinas, Elisabeth B Marsh
BACKGROUND: Stroke can occur in patients on warfarin despite anticoagulation. Patients with a low international normalized ratio (INR) should theoretically be at greater risk for ischemia than those who are therapeutic. Therefore, INR may be able to indicate whether new neurological deficits are more likely strokes or stroke mimics in patients on warfarin. This study evaluates the association and predictive value of INR in determining the likelihood of ischemia. METHODS: Patients were identified using the acute stroke registry at a Primary Stroke Center from January 2013 through December 2014...
August 11, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/28802735/incidence-of-cardiovascular-events-and-vascular-interventions-in-patients-with-type-2-diabetes
#16
Suzanne E Engelen, Yolanda van der Graaf, Manon C Stam-Slob, Diederick E Grobbee, Maarten J Cramer, L Jaap Kappelle, Gert J de Borst, Frank L J Visseren, Jan Westerink
OBJECTIVE: Diabetes mellitus is associated with an increased risk for cardiovascular morbidity and mortality. The vascular burden in terms of incidence of cardiovascular events (CVE) and vascular interventions is however poorly quantified. In this study we evaluated the incidence rates of CVE and vascular interventions in patients with type 2 diabetes (T2DM) with and without cardiovascular disease (CVD) in comparison to patients without type 2 diabetes. RESEARCH DESIGN AND METHODS: In a cohort of 9...
July 23, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28800866/five-year-trends-of-critical-care-practice-and-outcomes
#17
Craig M Lilly, Sunil Swami, Xinggang Liu, Richard R Riker, Omar Badawi
BACKGROUND: Longitudinal analyses of large detailed adult critical care datasets provide insights into practice trends and generate useful outcome and process benchmarks. METHODS: Data representing 991,571 consecutive critical care visits to160 United States adult ICUs during 2009 to 2013 from the eICU Research Institute clinical practice database were used to quantitate patient characteristics, APACHE IV based acuity predictions, treatments, and outcomes. Analyses for changes over time were performed for patient characteristics, entry and discharge locations, primary admission diagnosis, treatments, adherence to consensus ICU best practices, length of stay (LOS), and inpatient mortality...
August 8, 2017: Chest
https://www.readbyqxmd.com/read/28800605/stroke-survivors-with-severe-mental-illness-are-they-at-risk-for-increased-non-psychiatric-hospitalizations
#18
Flavius Robert Lilly, Joel Culpepper, Mary Stuart, Donald Steinwachs
BACKGROUND: This study examined outcomes for two groups of stroke survivors treated in Veteran Health Administration (VHA) hospitals, those with a severe mental illness (SMI) and those without prior psychiatric diagnoses, to examine risk of non-psychiatric medical hospitalizations over five years after initial stroke. METHODS: This retrospective cohort study included 523 veterans who survived an initial stroke hospitalization in a VHA medical center during fiscal year 2003...
2017: PloS One
https://www.readbyqxmd.com/read/28799870/vitamin-d-status-and-3-month-glasgow-outcome-scale-scores-in-patients-in-neurocritical-care-prospective-analysis-of-497-patients
#19
Jian Guan, Michael Karsy, Andrea A Brock, Ilyas M Eli, Gabrielle M Manton, Holly K Ledyard, Gregory W J Hawryluk, Min S Park
OBJECTIVE Vitamin D deficiency has been associated with a variety of negative outcomes in critically ill patients, but little focused study on the effects of hypovitaminosis D has been performed in the neurocritical care population. In this study, the authors examined the effect of vitamin D deficiency on 3-month outcomes after discharge from a neurocritical care unit (NCCU). METHODS The authors prospectively analyzed 25-hydroxy vitamin D levels in patients admitted to the NCCU of a quaternary care center over a 6-month period...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28798267/pretreatment-predictors-of-malignant-evolution-in-patients-with-ischemic-stroke-undergoing-mechanical-thrombectomy
#20
Alessandro Davoli, Caterina Motta, Giacomo Koch, Marina Diomedi, Simone Napolitano, Angela Giordano, Marta Panella, Daniele Morosetti, Sebastiano Fabiano, Roberto Floris, Roberto Gandini, Fabrizio Sallustio
BACKGROUND: Few data exist on malignant middle cerebral artery infarction (MMI) among patients with acute ischemic stroke (AIS) after endovascular treatment (ET). Numerous predictors of MMI evolution have been proposed, but a comprehensive research of patients undergoing ET has never been performed. Our purpose was to find a practical model to determine robust predictors of MMI in patients undergoing ET. METHODS: Patients from a prospective single-center database with AIS secondary to large intracranial vessel occlusion of the anterior circulation, treated with ET, were retrospectively analyzed...
August 10, 2017: Journal of Neurointerventional Surgery
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