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https://www.readbyqxmd.com/read/28102025/the-direct-referral-to-endovascular-center-criteria-a-proposal-for-pre-hospital-evaluation-of-acute-stroke-in-the-madrid-stroke-network
#1
J Rodríguez-Pardo, B Fuentes, M Alonso de Leciñana, Á Ximénez-Carrillo, G Zapata-Wainberg, J Álvarez-Fraga, F J Barriga, L Castillo, J Carneado-Ruiz, J Díaz-Guzman, J Egido-Herrero, A de Felipe, J Fernández-Ferro, L Frade-Pardo, Á García-Gallardo, A García-Pastor, A Gil-Núñez, C Gómez-Escalonilla, M Guillán, Y Herrero-Infante, J Masjuan-Vallejo, M Á Ortega-Casarrubios, J Vivancos-Mora, E Díez-Tejedor
BACKGROUND AND PURPOSE: For patients with acute ischaemic stroke due to large-vessel occlusion, it has recently been shown that mechanical thrombectomy (MT) with stent retrievers is better than medical treatment alone. However, few hospitals can provide MT 24 h/day 365 days/year, and it remains unclear whether selected patients with acute stroke should be directly transferred to the nearest MT-providing hospital to prevent treatment delays. Clinical scales such as Rapid Arterial Occlusion Evaluation (RACE) have been developed to predict large-vessel occlusion at a pre-hospital level, but their predictive value for MT is low...
January 19, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28100898/new-oral-anticoagulants-turkey-noac-turk-multicenter-cross-sectional-study
#2
Servet Altay, Özlem Yıldırımtürk, Hüseyin Altuğ Çakmak, Lütfü Aşkın, Ümit Yaşar Sinan, Feyzullah Beşli, Ömer Gedikli, Özge Özden Tok
OBJECTIVE: New oral anticoagulants (NOACs) are increasingly used both for prevention of stroke in non-valvular atrial fibrillation (NVAF) and the treatment of venous thromboembolism (VTE). In this study, we aimed to evaluate the current patterns of NOACs treatment in Turkey. Moreover, demographic and clinical parameters and bleeding and/or embolic events under NOACs treatment were analyzed. METHODS: The New Oral Anticoagulants-TURKey (NOAC-TURK) study was designed as a multicenter cross-sectional study...
January 17, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28100765/acute-transient-vestibular-syndrome-prevalence-of-stroke-and-efficacy-of-bedside-evaluation
#3
Jae-Hwan Choi, Min-Gyu Park, Seo Young Choi, Kyung-Pil Park, Seung Kug Baik, Ji-Soo Kim, Kwang-Dong Choi
BACKGROUND AND PURPOSE: The aim of this study was to determine the prevalence of stroke and efficacy of bedside evaluation in diagnosing stroke in acute transient vestibular syndrome (ATVS). METHODS: We performed a prospective, single-center, observational study that had consecutively recruited 86 patients presenting with ATVS to the emergency department of Pusan National University Yangsan Hospital from January to December 2014. All patients received a constructed evaluation, including HINTS plus (head impulse, nystagmus patterns, test of skew, and finger rubbing) and brain magnetic resonance imagings...
January 18, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28100764/drip-n-ship-versus-mothership-for-endovascular-treatment-modeling-the-best-transportation-options-for-optimal-outcomes
#4
Matthew S W Milne, Jessalyn K Holodinsky, Michael D Hill, Anders Nygren, Chao Qiu, Mayank Goyal, Noreen Kamal
BACKGROUND AND PURPOSE: There is uncertainty regarding the best way for patients outside of endovascular-capable or Comprehensive Stroke Centers (CSC) to access endovascular treatment for acute ischemic stroke. The role of the nonendovascular-capable Primary Stroke Centers (PSC) that can offer thrombolysis with alteplase but not endovascular treatment is unclear. A key question is whether average benefit is greater with early thrombolysis at the closest PSC before transportation to the CSC (Drip 'n Ship) or with PSC bypass and direct transport to the CSC (Mothership)...
January 18, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28100208/access-to-primary-health-care-for-acute-vascular-events-in-rural-low-income-settings-a-mixed-methods-study
#5
Shyfuddin Ahmed, Muhammad Ashique Haider Chowdhury, Md Alfazal Khan, Nafisa Lira Huq, Aliya Naheed
BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of global mortality. Among the CVDs, acute vascular events (AVE) mainly ischemic heart diseases and stroke are the largest contributors. To achieve 25% reduction in preventable deaths from CVDs by 2025, health systems need to be equipped with extended service coverage in order to provide person-centered care. The overall goal of this proposed study is to assess access to health care in-terms of service availability, care seeking patterns and barriers to access care after AVE in rural Bangladesh...
January 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28098112/autosomal-dominant-polycystic-kidney-disease-study-of-clinical-characteristics-in-an-indian-population
#6
Sanjay Vikrant, Anupam Parashar
Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary form of kidney disease. Clinical data on this multisystem disorder are scarce from developing countries. We conducted a prospective observational study of the clinical profile of ADPKD patients at a single center over a period of six years. A total of 208 patients were studied. Majority were male (60.6%) and the mean age was 45.8 ± 14.5 years. About 61.5% had early stage (Stages 1-3) of chronic kidney disease (CKD) and 38.5% had advanced CKD (Stages 4 and 5)...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28097193/axillary-versus-femoral-arterial-cannulation-during-repair-of-type-a-aortic-dissection-an-old-problem-seeking-new-solutions
#7
Sotiris C Stamou, Derek Gartner, Nicholas T Kouchoukos, Kevin W Lobdell, Kamal Khabbaz, Edward Murphy, Robert C Hagberg
BACKGROUND: The goal of this study was to compare early postoperative outcomes and actuarial-free survival between patients who underwent repair of acute Type A aortic dissection with axillary or femoral artery cannulation. METHODS: A total of 305 patients from five academic medical centers underwent acute Type A aortic dissection repair via axillary (n = 107) or femoral (n = 198) artery cannulation between January 2000 and December 2010. Major morbidity, operative mortality, and 5-year actuarial survival were compared between groups...
August 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28096478/demographic-procedural-and-30-day-safety-results-from-the-web-intra-saccular-therapy-study-web-it
#8
David Fiorella, Andrew Molyneux, Alexander Coon, Istvan Szikora, Isil Saatci, Feyyaz Baltacioglu, Ali Sultan, Adam Arthur
INTRODUCTION: The Woven EndoBridge (WEB) represents a novel intrasaccular therapeutic option for the treatment of intracranial wide-necked bifurcation aneurysms (WNBAs). The WEB-IT Study is a pivotal Investigational Device Exemption (IDE) study to determine the safety and effectiveness of the WEB device for the treatment of WNBAs located in the anterior and posterior intracranial circulations. We present the patient demographics, procedural characteristics, and 30-day adverse event data for the US WEB-IT study...
January 17, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28096208/improving-door-to-needle-times-for-acute-ischemic-stroke-effect-of-rapid-patient-registration-moving-directly-to-computed-tomography-and-giving-alteplase-at-the-computed-tomography-scanner
#9
Noreen Kamal, Jessalyn K Holodinsky, Caroline Stephenson, Devika Kashayp, Andrew M Demchuk, Michael D Hill, Renee L Vilneff, Erin Bugbee, Charlotte Zerna, Nancy Newcommon, Eddy Lang, Darren Knox, Eric E Smith
BACKGROUND: The effectiveness of specific systems changes to reduce DTN (door-to-needle) time has not been fully evaluated. We analyzed the impact of 4 specific DTN time reduction strategies implemented prospectively in a staggered fashion. METHODS AND RESULTS: The HASTE (Hurry Acute Stroke Treatment and Evaluation) project was implemented in 3 phases at a single academic medical center. In HASTE I (June 6, 2012 to June 5, 2013), baseline performance was analyzed...
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28096203/hospital-variation-in-functional-recovery-after-stroke
#10
Janet Prvu Bettger, Laine Thomas, Li Liang, Ying Xian, Cheryl D Bushnell, Jeffrey L Saver, Gregg C Fonarow, Eric D Peterson
BACKGROUND: Functional status is a key patient-centric outcome, but there are little data on whether functional recovery post-stroke varies among hospitals. This study examined the distribution of functional status 3 months after stroke, determined whether these outcomes vary among hospitals, and identified hospital characteristics associated with better (or worse) functional outcomes. METHODS AND RESULTS: Observational analysis of the AVAIL study (Adherence Evaluation After Ischemic Stroke-Longitudinal) included 2083 ischemic stroke patients enrolled from 82 US hospitals participating in Get With The Guidelines-Stroke and AVAIL...
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28096032/creation-of-an-intensive-care-unit-and-organizational-changes-in-an-adult-emergency-department-impact-on-acute-stroke-management
#11
Laurent Puy, Chantal Lamy, Sandrine Canaple, Audrey Arnoux, Nicolas Laine, Ella Iacob, Jean-Marc Constans, Olivier Godefroy
BACKGROUND AND PURPOSE: Following the reorganization of a University Medical Center onto a single campus, an Intensive Care Unit was created within the adult Emergency Department (ED ICU). We assessed the effects of these organizational changes on acute stroke management and the intravenous administration of recombinant tissue plasminogen activator (IV rtPA), as characterized by the thrombolysis rate, door-to-needle time (DNT) and outcome at 3months. METHODS: Between October 2013 and September 2015, we performed a retrospective, observational, single-center, comparative study of patients admitted for ischemic stroke and treated with IV rtPA during two 321-day periods (before and after the creation of the ED ICU)...
January 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28095764/evaluation-of-the-carotid-artery-stenosis-based-on-minimization-of-mechanical-energy-loss-of-the-blood-flow
#12
Sheau Fung Sia, Xihai Zhao, Rui Li, Yu Zhang, Winston Chong, Le He, Yu Chen
BACKGROUND: Internal carotid artery stenosis requires an accurate risk assessment for the prevention of stroke. Although the internal carotid artery area stenosis ratio at the common carotid artery bifurcation can be used as one of the diagnostic methods of internal carotid artery stenosis, the accuracy of results would still depend on the measurement techniques. The purpose of this study is to propose a novel method to estimate the effect of internal carotid artery stenosis on the blood flow based on the concept of minimization of energy loss...
November 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28095755/changes-in-caregiver-burden-among-informal-caregivers-of-stroke-patients-in-mongolia
#13
Enkhzaya Chuluunbaatar, Christy Pu, Yiing-Jenq Chou
BACKGROUND: Modern therapeutics and health care improvements prolong stroke patients' survival; however, the degree of disability remains high. Stroke survivors often require caregivers, particularly in the first year after the onset of the stroke. Longitudinal assessment of and factors associated with caregiver burden (CGB) among caregivers of stroke patients has been scarcely discussed. This study aimed to define the changes in CGB in the first year of caregiving among the caregivers of stroke patients and to identify associated factors...
January 18, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28092254/-what-do-adults-die-in-mexico-impact-on-the-economic-and-social-development-of-the-nation-the-global-burden-of-cardiovascular-disease
#14
Martín Rosas-Peralta, Efraín Arizmendi-Uribe, Gabriela Borrayo-Sánchez
Noncommunicable diseases have been established as a clear threat, not only to human health but also to the development and economic growth. Claiming 63% of all deaths, these diseases are currently the main murderer worldwide. The increase in the prevalence and importance of noncommunicable diseases specifically of cardiovascular risk factors such as hypertension, diabetes, dyslipidemia and obesity is the result of a complex interplay between health, economic growth and development, which is strongly associated with universal trends such as the aging of the world population, rapid unplanned urbanization, and the globalization of unhealthy lifestyles...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28092139/content-of-conventional-therapy-for-the-severely-affected-arm-during-subacute-rehabilitation-after-stroke-an-analysis-of-physiotherapy-and-occupational-therapy-practice
#15
Lex D de Jong, Frederike van Wijck, Roy E Stewart, Alexander C H Geurts, Pieter U Dijkstra
BACKGROUND AND PURPOSE: Physiotherapy (PT) and occupational therapy (OT) are key professions providing treatment for the arm after stroke; however, knowledge about the content of these treatments is scant. Detailed data are needed to replicate interventions, evaluate their effective components, and evaluate PT and OT practice. This paper describes PT and OT treatment for the severely affected arm in terms of duration, content according to components and categories of the International Classification of Human Functioning, Disability and Health, and to analyze differences between professions...
January 16, 2017: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
https://www.readbyqxmd.com/read/28089997/the-impact-of-age-and-sex-on-in-hospital-outcomes-of-chronic-total-occlusion-percutaneous-coronary-intervention
#16
Aris Karatasakis, Rahel Iwnetu, Barbara A Danek, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, David E Kandzari, Nicholas J Lembo, Mitul Patel, Ehtisham Mahmud, William L Lombardi, R Michael Wyman, J Aaron Grantham, Anthony H Doing, Catalin Toma, James W Choi, Barry F Uretsky, Jeffrey W Moses, Ajay J Kirtane, Ziad A Ali, Manish Parikh, Judit Karacsonyi, Bavana V Rangan, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: We sought to determine the effect of age and sex on procedural outcomes and efficiency of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We examined the clinical and angiographic characteristics and outcomes of 1675 CTO-PCIs performed in 1644 patients between 2012 and 2016 at 15 United States centers. RESULTS: Mean age was 65.3 ± 10 years and 1408 (86%) were men. Overall technical and procedural success rates were 88% and 87%, respectively...
January 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28089455/comparison-of-transcatheter-aortic-valve-implantation-with-the-newest-generation-sapien-3-vs-direct-flow-medical-valve-in-a-single-center-cohort
#17
Eberhard Schulz, Alexander Jabs, Alexander Tamm, Patrick Herz, Andreas Schulz, Tommaso Gori, Stephan von Bardeleben, Walter Kasper-König, Ulrich Hink, Christian-Friedrich Vahl, Thomas Münzel
BACKGROUND: The latest generation transcatheter heart valves including Edwards Sapien 3 (ES3) and Direct Flow Medical (DFM) were designed to allow precise implantation at the intended position and to minimize prosthesis dysfunction as well as procedural complications. Our aim was to compare short-term functional and clinical outcomes of these 2 transcatheter aortic valve systems. METHODS: Of 174 patients undergoing transfemoral transcatheter aortic valve implantation (TAVI) at our institution between August 2013 and June 2015, 113 were treated with ES3 and 61 with DFM...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28087825/incidence-and-predictors-of-epilepsy-after-pediatric-arterial-ischemic-stroke
#18
Lori L Billinghurst, Lauren A Beslow, Nicholas S Abend, Michael Uohara, Laura Jastrzab, Daniel J Licht, Rebecca N Ichord
OBJECTIVE: To determine the cumulative incidence and clinical predictors of remote symptomatic seizures and epilepsy after pediatric arterial ischemic stroke (AIS). METHODS: We performed a retrospective analysis of 218 participants with neonatal AIS (NAIS), presumed perinatal AIS (PPAIS), and childhood AIS (CAIS) from a single-center prospective consecutive cohort enrolled from 2006 to 2014. Medical records were reviewed for timing, semiology, and treatment of acute symptomatic seizures, remote symptomatic seizures (RSS), and epilepsy...
January 13, 2017: Neurology
https://www.readbyqxmd.com/read/28087804/clinical-selection-strategies-to-identify-ischemic-stroke-patients-with-large-anterior-vessel-occlusion-results-from-sits-istr-safe-implementation-of-thrombolysis-in-stroke-international-stroke-thrombolysis-registry
#19
Jan F Scheitz, Azmil H Abdul-Rahim, Rachael L MacIsaac, Charith Cooray, Heidi Sucharew, Dawn Kleindorfer, Pooja Khatri, Joseph P Broderick, Heinrich J Audebert, Niaz Ahmed, Nils Wahlgren, Matthias Endres, Christian H Nolte, Kennedy R Lees
BACKGROUND AND PURPOSE: The National Institutes of Health Stroke Scale (NIHSS) correlates with presence of large anterior vessel occlusion (LAVO). However, the application of the full NIHSS in the prehospital setting to select patients eligible for treatment with thrombectomy is limited. Therefore, we aimed to evaluate the prognostic value of simple clinical selection strategies. METHODS: Data from the Safe Implementation of Thrombolysis in Stroke International Stroke Thrombolysis Registry (January 2012-May 2014) were analyzed retrospectively...
January 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28086805/the-safety-of-introducing-a-new-generation-tavr-device-one-departments-experience-from-introducing-a-second-generation-repositionable-tavr
#20
Henrik Bjursten, Shahab Nozohoor, Malin Johansson, Igor Zindovic, Carl-Fredrik Appel, Johan Sjögren, Magnus Dencker, Göran Olivecrona, Jan Harnek, Sasha Koul, Ted Feldman, Michael J Reardon, Matthias Götberg
BACKGROUND: In the evolving field of transcatheter aortic valve replacements a new generation of valves have been introduced to clinical practice. With the complexity of the TAVR procedure and the unique aspects of each TAVR device, there is a perceived risk that changing or adding a new valve in a department could lead to a worse outcome for patients, especially during the learning phase. The objective was to study the safety aspect of introducing a second generation repositionable transcatheter valve (Boston Scientific Lotus valve besides Edwards Sapien valve) in a department...
January 13, 2017: BMC Cardiovascular Disorders
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