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Stroke innovation

Karthik Vishwanathan, Deepak Ganjiwale
Splinting is a great domain of occupational therapy profession. Making a splint for the patient would depend on the need or requirement of the problems and deformities. Swan neck deformity is an uncommon condition, and it can be seen in rheumatoid arthritis, cerebral palsy, and after trauma. Conservative treatment of the swan neck deformity is available by different static splints only. There are very few reports of surgical correction of swan-neck deformity in benign hypermobility syndrome. This case report describes the result of novel surgical intervention and an innovative hand splint in a 20-year-old female with a history of cardiovascular stroke with no residual neurological deficit...
January 2018: Journal of Family Medicine and Primary Care
Juan Parodi, Mark C Bates, Takao Ohki, Claudio Schönholz
Innovation in medicine is often driven by the observations of imaginative physicians who are blessed with insatiable curiosity, coupled with the inability to accept technical boundaries, the status quo of patient care, or the acceptance of procedural morbidity. Few examples illustrate this truism better than the physician-originated clinical research that transformed the safety of carotid stent angioplasty over the last 2 decades. Initial clinical application of carotid stenting suggested that proximal protection may be a better approach to prevent embolic stroke during the angioplasty procedure...
March 2018: Seminars in Vascular Surgery
Roger Gassert, Volker Dietz
The past decades have seen rapid and vast developments of robots for the rehabilitation of sensorimotor deficits after damage to the central nervous system (CNS). Many of these innovations were technology-driven, limiting their clinical application and impact. Yet, rehabilitation robots should be designed on the basis of neurophysiological insights underlying normal and impaired sensorimotor functions, which requires interdisciplinary collaboration and background knowledge.Recovery of sensorimotor function after CNS damage is based on the exploitation of neuroplasticity, with a focus on the rehabilitation of movements needed for self-independence...
June 5, 2018: Journal of Neuroengineering and Rehabilitation
Jamuna Rani Appalasamy, Kyi Kyi Tha, Kia Fatt Quek, Siva Seeta Ramaiah, Joyce Pauline Joseph, Anuar Zaini Md Zain
INTRODUCTION: A substantial number of the world's population appears to end with moderate to severe long-term disability after stroke. Persistent uncontrolled stroke risk factor leads to unpredicted recurrent stroke event. The increasing prevalence of stroke across ages in Malaysia has led to the adaptation of medication therapy adherence clinic (MTAC) framework. The stroke care unit has limited patient education resources especially for patients with medication understanding and use self-efficacy...
June 2018: Medicine (Baltimore)
Lee H Schwamm
No abstract text is available yet for this article.
May 25, 2018: Lancet Neurology
Raffaele Serra, Andrea Barbetta, Francesco Fugetto, Noemi Licastro, Giovanni Aprea, Giuseppe Petrella, Michele Danzi, Aldo Rocca, Rita Compagna, Stefano De Franciscis, Bruno Amato
BACKGROUND: Stroke is one of the major causes of death in the world, but above all is the condition most associated with severe long-term disabilities. It is clear that this condition therefore requires the best therapeutic approach possible to minimize the consequences that this can lead to. The major issues concern the type of treatment to be used for revascularization [carotid endarterectomy (CEA) or stenting of the carotid artery (CAS)] and the timing of the treatment itself. Many studies have been conducted on this issue, but a definitive and unanimous verdict has not yet been reached on account of the great variety of results obtained from the various study group...
May 25, 2018: Minerva Chirurgica
Haixia Wen, Liu Liu, Lixuan Zhan, Donghai Liang, Luxi Li, Dandan Liu, Weiwen Sun, En Xu
Hypoxic postconditioning (HPC) is an innovative neuroprotective strategy with cytoprotective effects on the hippocampal neurons against transient global cerebral ischemia (tGCI) in adult rats. However, its molecular mechanisms have not yet been adequately elucidated. Neuroglobin (Ngb) is an endogenous neuroprotectant with hypoxia-inducible property, and its role in experimental stroke has been increasingly attractive. Hence, the purpose of this study is to explore the involvement of Ngb in HPC-mediated neuroprotection and to further investigate its underlying molecular mechanism...
May 25, 2018: Cell Death & Disease
Fidel Meira, Daiane Magalhães, Luiz Sérgio da Silva, Ana Clara Mendonça E Silva, Gisele Sampaio Silva
BACKGROUND AND PURPOSE: Stroke is a leading cause of death in Brazil. Knowledge about the clinical manifestations of stroke as well as its risk factors and its management is still poor in the country. We intended to assess the stroke knowledge of an urban population in Belo Ho-rizonte, Brazil. METHODS: Individuals assisted by a basic health unit were interviewed between February and August 2014. After demographic data collection, the participants were asked to watch a video that consisted of a person presenting stroke signals and they were asked to answer questions about the condition shown on the video...
May 22, 2018: Cerebrovascular Diseases Extra
Joseph E Andrews, J Brian Moore, Richard B Weinberg, Mysha Sissine, Sabina Gesell, Jacquie Halladay, Wayne Rosamond, Cheryl Bushnell, Sara Jones, Paula Means, Nancy M P King, Diana Omoyeni, Pamela W Duncan
Cluster randomised clinical trials present unique challenges in meeting ethical obligations to those who are treated at a randomised site. Obtaining informed consent for research within the context of clinical care is one such challenge. In order to solve this problem it is important that an informed consent process be effective and efficient, and that it does not impede the research or the healthcare. The innovative approach to informed consent employed in the COMPASS study demonstrates the feasibility of upholding ethical standards without imposing undue burden on clinical workflows, staff members or patients who may participate in the research by virtue of their presence in a cluster randomised facility...
May 2, 2018: Journal of Medical Ethics
Leslie W Miller, Joseph G Rogers
Importance: The mortality rate for the most advanced forms of heart failure with medical therapy alone remains unacceptably high at 30% to 80% at 1 year. In the past decade, left ventricular assist devices have assumed an increasingly prominent role in the management of these patients. This review included all English-language articles published over the past 15 years on left ventricular assist devices. Search topics focused on advanced heart failure and ventricular assist devices, including volume of implantations, patient selection, complications, cost, and recovery of function...
April 18, 2018: JAMA Cardiology
Diane E Hadley, Jennifer S Pitonyak, Kimberly D Wynarczuk, Sanchita Sen, Joan F Ward, Radha V Patel
BACKGROUND AND PURPOSE: This article describes the development, implementation, and evaluation of an interprofessional education (IPE) experience. EDUCATIONAL ACTIVITY AND SETTING: The IPE experience included 53 student learners from occupational therapy, pharmacy, physical therapy, and physician assistant programs at the University of the Sciences (USciences). This experience used an icebreaker activity and a stroke case-based activity as the activities within the workshop...
February 2018: Currents in Pharmacy Teaching & Learning
Vasiliki Katsi, Eleni Athanasiadi, Costas Tsioufis, Dimitris Tousoulis
Arterial hypertension is a disease that still affects a major part of the population worldwide, and leads to fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. From the CDC statistical analysis, as regarding to United States, 1 of every 3 adults has high blood pressure, and οnly about half (54%) of them have it under control. Furthermore, all that leads to a nation cost about $46 billion each year. Efforts to find new ways to regulate arterial hypertension are therefore imperative...
April 20, 2018: Current Hypertension Reviews
Jongseok Hwang, Yongil Shin, Ji-Ho Park, Young Joo Cha, Joshua Sung H You
BACKGROUND: The robotic-assisted gait training (RAGT) system has gained recognition as an innovative, effective paradigm to improve functional ambulation and activities of daily living in spinal cord injury and stroke. However, the effects of the Walkbot robotic-assisted gait training system with a specialized hip-knee-ankle actuator have never been examined in the paraplegia and quadriplegia population. OBJECTIVE: The aim of this study was to determine the long-term effects of Walkbot training on clinical for hips and knee stiffness in individuals with paraplegia or quadriplegia...
April 7, 2018: NeuroRehabilitation
Irene Simonetta, Antonino Tuttolomondo, Tiziana Di Chiara, Salvatore Miceli, Danai Vogiatzis, Francesca Corpora, Antonio Pinto
Fabry's disease is a genetic disorder of X-linked inheritance caused by mutations in the alpha galactosidase A gene resulting in deficiency of this lysosomal enzyme. The progressive accumulation of glycosphingolipids, caused by the inadequate enzymatic activity, is responsible of organ dysfunction and thus of clinical manifestations. In the presence of a high clinical suspicion, a careful physical examination and specific laboratory tests are required, finally diagnosis of Fabry's disease is confirmed by the demonstration of absence or reduced alpha-galactosidase A enzyme activity in hemizygous men and gene typing in heterozygous females; in fact the performance of enzymatic activity assay alone in women is inconclusive...
2018: Current Gene Therapy
Marykay A Pavol, Clare C Bassile, Jennifer R Lehman, Emma Harmon, Nancy Ferreira, Brittany Shinn, Nancy St James, Jacqueline Callender, Joel Stein
OBJECTIVE: Training and implementation for a multidisciplinary stroke rehabilitation method emphasizing procedural memory. BACKGROUND: Current practice in stroke rehabilitation relies on explicit memory, often compromised by stroke, failing to capitalize on better-preserved procedural memory skills. Recruitment of procedural memory requires consistency and practice, characteristics difficulty to promote on inpatient rehabilitation units. We designed a method Modified Approach to Stroke Rehabilitation (MAStR) to maximize consistency and practice for transfer training with stroke patients...
April 3, 2018: Topics in Stroke Rehabilitation
Konstantinos V Voudris, Marc A Silver
IMPORTANCE: Heart failure (HF) is the leading cause of hospitalization among patients over the age of 65 in the United States and developed countries, posing a significant economic burden to the health care systems. More than half of the patients with HF will be readmitted to the hospital within 6 months from discharge, leading not only to increased health care related expenses but also functional decline, iatrogenic injuries and in-hospital infections. With the increasing prevalence of HF, there is a substantial need for innovative delivery care models that can provide hospital level of care at a patient's home...
March 28, 2018: Healthcare (Basel, Switzerland)
Chawannuch Ruaengsri, Matthew R Schill, Ali J Khiabani, Richard B Schuessler, Spencer J Melby, Ralph J Damiano
Atrial fibrillation (AF) is the most common cardiac arrhythmia and the treatment options include medical treatment and catheter-based or surgical interventions. AF is a major cause of stroke, and its prevalence is increasing. The surgical treatment of AF has been revolutionized over the past 2 decades through surgical innovation and improvements in endoscopic imaging, ablation technology and surgical instrumentation. The Cox-maze (CM) procedure, which was developed by James Cox and introduced clinically in 1987, is a procedure in which multiple incisions are created in both the left and the right atria to eliminate AF while allowing the sinus impulse to reach the atrioventricular node...
April 1, 2018: European Journal of Cardio-thoracic Surgery
José M Cogollor, Javier Rojo-Lacal, Joachim Hermsdörfer, Manuel Ferre, Maria Teresa Arredondo Waldmeyer, Christos Giachritsis, Alan Armstrong, Jose Manuel Breñosa Martinez, Doris Anabelle Bautista Loza, José María Sebastián
BACKGROUND: Neurological patients after stroke usually present cognitive deficits that cause dependencies in their daily living. These deficits mainly affect the performance of some of their daily activities. For that reason, stroke patients need long-term processes for their cognitive rehabilitation. Considering that classical techniques are focused on acting as guides and are dependent on help from therapists, significant efforts are being made to improve current methodologies and to use eHealth and Web-based architectures to implement information and communication technology (ICT) systems that achieve reliable, personalized, and home-based platforms to increase efficiency and level of attractiveness for patients and carers...
March 26, 2018: JMIR rehabilitation and assistive technologies
Cheryl D Bushnell, Pamela W Duncan, Sarah L Lycan, Christina N Condon, Amy M Pastva, Barbara J Lutz, Jacqueline R Halladay, Doyle M Cummings, Martinson K Arnan, Sara B Jones, Mysha E Sissine, Sylvia W Coleman, Anna M Johnson, Sabina B Gesell, Laurie H Mettam, Janet K Freburger, Blair Barton-Percival, Karen M Taylor, Janet Prvu-Bettger, Gladys Lundy-Lamm, Wayne D Rosamond
Many individuals who have had a stroke leave the hospital without postacute care services in place. Despite high risks of complications and readmission, there is no standard in the United States for postacute stroke care after discharge home. We describe the rationale and methods for the development of the COMprehensive Post-Acute Stroke Services (COMPASS) care model and the structure and quality metrics used for implementation. COMPASS, an innovative, comprehensive extension of the TRAnsition Coaching for Stroke (TRACS) program, is a clinician-led quality improvement model providing early supported discharge and transitional care for individuals who have had a stroke and have been discharged home...
March 23, 2018: Journal of the American Geriatrics Society
I L Maier, J R Leyhe, I Tsogkas, D Behme, K Schregel, M Knauth, M Schnieder, J Liman, M-N Psychogios
BACKGROUND AND PURPOSE: One-stop management of mechanical thrombectomy-eligible patients with large-vessel occlusion represents an innovative approach in acute stroke treatment. This approach reduces door-to-reperfusion times by omitting multidetector CT, using flat detector CT as pre-mechanical thrombectomy imaging. The purpose of this study was to compare the diagnostic performance of the latest-generation flat detector CT with multidetector CT. MATERIALS AND METHODS: Prospectively derived data from patients with ischemic stroke with large-vessel occlusion and mechanical thrombectomy were analyzed in this monocentric study...
May 2018: AJNR. American Journal of Neuroradiology
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