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https://www.readbyqxmd.com/read/28651196/dancing-to-death-a-case-of-heat-stroke
#1
K Nadesan, Chandra Kumari, Mohd Afiq
Heat stroke is a medical emergency which may lead to mortality unless diagnosed early and treated effectively. Heat stroke may manifest rapidly, hence making it difficult to differentiate it from other clinical causes in a collapsed victim.(1) We are presenting a case report of twelve patients who were admitted to our emergency department from a music festival held on 13-15th of March 2014. They developed complications arising from a combination of severe adverse weather condition, prolonged outdoor physical exertion due to long hours of dancing and drug-use, resulting in heat stroke...
May 4, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28650000/andexanet-alfa-a-recombinant-mimetic-of-human-factor-xa-for-the-reversal-of-anticoagulant-therapies
#2
G Escolar, M Diaz-Ricart, E Arellano-Rodrigo
Activated coagulation factor X (FXa) is a common target for classic and newer anticoagulants. Parenteral anticoagulants with an indirect inhibitory action on FXa (low-molecular-weight heparins) have a well-established clinical efficacy in the prophylaxis and therapy of thromboembolic conditions. More recently developed direct oral anticoagulants (DOACs) have emerged as a new class of antithrombotic drugs. Rivaroxaban, apixaban and edoxaban are direct inhibitors of FXa approved for the management of venous thromboembolism and stroke prevention in atrial fibrillation...
May 2017: Drugs of Today
https://www.readbyqxmd.com/read/28649936/berlin-prehospital-or-usual-delivery-of-acute-stroke-care-study-protocol
#3
Martin Ebinger, Peter Harmel, Christian H Nolte, Ulrike Grittner, Bob Siegerink, Heinrich J Audebert
Rationale Prehospital stroke care in specialized ambulances increases thrombolysis rates, reduces alarm-to-treatment times, and improves the prehospital triage. Preliminary analyses suggest cost-effectiveness. However, scientific proof of better functional outcome compared to usual care is still lacking. Aim To prove better functional outcomes after deployment of the Stroke Emergency Mobile compared to regular ambulances. Sample size estimates A sample size of 686 patients will be required in each arm (Stroke Emergency Mobile group vs...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28647723/a-retrospective-cohort-study-of-high-impact-users-among-patients-with-cerebrovascular-conditions
#4
Ahsan Rao, Alice Jones, Alex Bottle, Ara Darzi, Paul Aylin
OBJECTIVE: To apply group-based trajectory modelling (GBTM) to the hospital administrative data to evaluate, model and visualise trends and changes in the frequency of long-term hospital care use of the subgroups of patients with cerebrovascular conditions. DESIGN: A retrospective cohort study of patients with cerebrovascular conditions. SETTINGS: Secondary care of all patients with cerebrovascular conditions admitted to English National Hospital Service hospitals...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28646851/development-of-an-education-campaign-to-reduce-delays-in-pre-hospital-response-to-stroke
#5
Caterina Caminiti, Peter Schulz, Barbara Marcomini, Elisa Iezzi, Silvia Riva, Umberto Scoditti, Andrea Zini, Giovanni Malferrari, Maria Luisa Zedde, Donata Guidetti, Enrico Montanari, Mario Baratti, Licia Denti
BACKGROUND: Systematic reviews call for well-designed trials with clearly described intervention components to support the effectiveness of educational campaigns to reduce patient delay in stroke presentation. We herein describe the systematic development process of a campaign aimed to increase stroke awareness and preparedness. METHODS: Campaign development followed Intervention Mapping (IM), a theory- and evidence-based tool, and was articulated in two phases: needs assessment and intervention development...
June 24, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28646558/neurology-concepts-young-women-and-ischemic-stroke-evaluation-and-management-in-the-emergency-department
#6
Bernard P Chang, Charles Wira, Joseph Miller, Murtaza Akhter, Bradley E Barth, Joshua Willey, Lauren Nentwich, Tracy Madsen
OBJECTIVE: Ischemic stroke is a leading cause of morbidity and mortality worldwide. While the incidence of ischemic stroke is highest in older populations, incidence of ischemic stroke in adults has been rising particularly rapidly among young (e.g. premenopausal) women. The evaluation and timely diagnosis of ischemic stroke in young women presents a challenging situation in the emergency department, due to a range of sex-specific risk factors and to broad differentials. The goals of this concepts paper are to summarize existing knowledge regarding the evaluation and management of young women with ischemic stroke in the acute setting...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28646492/prenatal-perinatal-and-neonatal-risk-factors-for-perinatal-arterial-ischaemic-stroke-a-systematic-review-and-meta-analysis
#7
REVIEW
C Li, J K Miao, Y Xu, Y Y Hua, Q Ma, L L Zhou, H J Liu, Q X Chen
The aim of the present study was to perform a meta-analysis of published data to determine the significance of clinical factors and exposures to the risk of perinatal arterial ischaemic stroke (PAIS) and provide guidance for clinical diagnosis and treatment. A comprehensive literature search of the PubMed, Embase, MEDLINE and Cochrane Library databases for relevant observational studies (cohort/case-control) from March 1984 to March 2016 was undertaken. Two review authors independently examined the full text records to determine which studies met the inclusion criteria and evaluated risk factors for PAIS...
June 24, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28644924/intravenous-thrombolysis-for-acute-ischemic-stroke-a-bridge-between-two-centuries
#8
Georgios Tsivgoulis, Odysseas Kargiotis, Andrei Alexandrov
Intravenous tissue-plasminogen activator (tPA) remains the only approved systemic reperfusion therapy suitable for most patients presenting timely with acute ischemic stroke. Accumulating real-word experience for over 20 years regarding tPA safety and effectiveness lead to re-appraisal of original contraindications for intravenous thrombolysis (IVT). Areas covered: This narrative review focuses on fast yet appropriate selection of patients for safe administration of tPA per recently expanded indications. Novel strategies for rapid patient assessment will be discussed...
June 23, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28643577/an-assessment-of-advance-relatives-approach-for-brain-death-organ-donation
#9
Carine Michaut, Antoine Baumann, Hélène Gregoire, Corinne Laviale, Gérard Audibert, Xavier Ducrocq
BACKGROUND: Advance announcement of forthcoming brain death has developed to enable intensivists and organ procurement organisation coordinators to more appropriately, and separately from each other, explain to relatives brain death and the subsequent post-mortem organ donation opportunity. Research aim: The aim was to assess how potentially involved healthcare professionals perceived ethical issues surrounding the strategy of advance approach. RESEARCH DESIGN: A multi-centre opinion survey using an anonymous self-administered questionnaire was conducted in the six-member hospitals of the publicly funded East of France regional organ and tissue procurement network called 'Prélor'...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28641984/bi-objective-approach-for-placing-ground-and-air-ambulance-base-and-helipad-locations-in-order-to-optimize-ems-response
#10
Milad Shahriari, Ali Bozorgi-Amiri, Shayan Tavakoli, Abolghasem Yousefi-Babadi
Shortening the travel time of patient transfer has clinical implications for many conditions such as cardiac arrest, trauma, stroke and STEMI. As resources are often limited precise calculations are needed. In this paper we consider the location problem for both ground and aerial emergency medical services. Given the uncertainty of when patients are in need of prompt medical attention we consider these demand points to be uncertain. We consider various ways in which ground and helicopter ambulances can work together to make the whole process go faster...
June 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28637886/cardiovascular-disease-and-type-2-diabetes-has-the-dawn-of-a-new-era-arrived
#11
Muhammad Abdul-Ghani, Ralph A DeFronzo, Stefano Del Prato, Robert Chilton, Rajvir Singh, Robert E J Ryder
Hyperglycemia is the major risk factor for microvascular complications in patients with type 2 diabetes (T2D). However, cardiovascular disease (CVD) is the principal cause of death, and lowering HbA1c has only a modest effect on reducing CVD risk and mortality. The recently published LEADER and SUSTAIN-6 trials demonstrate that, in T2D patients with high CVD risk, the glucagon-like peptide 1 receptor agonists liraglutide and semaglutide reduce the primary major adverse cardiac events (MACE) end point (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke) by 13% and 24%, respectively...
July 2017: Diabetes Care
https://www.readbyqxmd.com/read/28637814/effective-assessments-of-electroencephalography-during-stroke-recovery-contemporary-approaches-and-considerations
#12
Kartik K Iyer
Stroke is one of the leading causes of permanent disability worldwide, relying conventionally on extended periods of physiotherapy to recover functional ability. While neuroimaging techniques and emerging neurorehabilitation paradigms have advanced our understanding of pathophysiological mechanisms underlying stroke, recent evidence has renewed focus on quantifying cortical features of electroencephalography to greatly enhance our understanding of stroke recovery. This Neuro Forum article reviews these key advances and discusses the importance of quantifying electroencephalography in future assessments of stroke survivors...
June 21, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28637460/healthcare-utilization-and-costs-for-patients-initiating-dabigatran-or-warfarin
#13
Shannon L Reynolds, Sameer R Ghate, Richard Sheer, Pranav K Gandhi, Chad Moretz, Cheng Wang, Stephen Sander, Mary E Costantino, Srinivas Annavarapu, George Andrews
BACKGROUND: Novel oral anticoagulants (NOAC) such as dabigatran, when compared to warfarin, have been shown to potentially reduce the risk of stroke in patients with non-valvular atrial fibrillation (NVAF) together with lower healthcare resource utilization (HCRU) and similar total costs. This study expands on previous work by comparing HCRU and costs for patients newly diagnosed with NVAF and newly initiated on dabigatran or warfarin, and is the first study specifically in a Medicare population...
June 21, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28637154/shoulder-pain-after-stroke-experiences-consequences-in-daily-life-and-effects-of-interventions-a-qualitative-study
#14
Ingrid Lindgren, Gunvor Gard, Christina Brogårdh
PURPOSE: To describe experiences of shoulder pain after stroke, how pain affects daily life and perceived effects of interventions. METHOD: A qualitative interview study including 13 community-dwelling persons (six women; median age 65 years) with persistent shoulder pain after stroke. RESULTS: Three categories emerged from the content analysis. In "Multiple pain characteristics" an insidious pain onset was reported. The pain existed both day and night and could be located around the shoulder girdle but also have radiation to the arm and hand...
March 3, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28636639/predictive-value-of-serum-transthyretin-for-outcome-in-acute-ischemic-stroke
#15
Wojciech Ambrosius, Slawomir Michalak, Radosław Kazmierski, Natalia Andrzejewska, Wojciech Kozubski
INTRODUCTION: The impact of choroid plexus with its blood-cerebrospinal fluid barrier in the ischemic stroke pathology is poorly explored. Transthyretin (TTR) is a protein synthesized in liver and just in choroid plexus. OBJECTIVES: The current study was designed to assess the prognostic value of serum TTR for functional outcome (at the time of hospital discharge) and long-term (one-year) overall mortality in ischemic stroke patients. PATIENTS AND METHODS: We conducted a prospective observational study...
2017: PloS One
https://www.readbyqxmd.com/read/28634421/the-role-of-von-willebrand-factor-in-vascular-inflammation-from-pathogenesis-to-targeted-therapy
#16
REVIEW
Felice Gragnano, Simona Sperlongano, Enrica Golia, Francesco Natale, Renatomaria Bianchi, Mario Crisci, Fabio Fimiani, Ivana Pariggiano, Vincenzo Diana, Andreina Carbone, Arturo Cesaro, Claudia Concilio, Giuseppe Limongelli, Mariagiovanna Russo, Paolo Calabrò
Beyond its role in hemostasis, von Willebrand factor (VWF) is an emerging mediator of vascular inflammation. Recent studies highlight the involvement of VWF and its regulator, ADAMTS13, in mechanisms that underlie vascular inflammation and immunothrombosis, like leukocyte rolling, adhesion, and extravasation; vascular permeability; ischemia/reperfusion injury; complements activation; and NETosis. The VWF/ADAMTS13 axis is implicated in the pathogenesis of atherosclerosis, promoting plaque formation and inflammation through macrophage and neutrophil recruitment in inflamed lesions...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#17
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28629510/screening-strategies-for-atrial-fibrillation-a-systematic-review-and-cost-effectiveness-analysis
#18
Nicky J Welton, Alexandra McAleenan, Howard Hz Thom, Philippa Davies, Will Hollingworth, Julian Pt Higgins, George Okoli, Jonathan Ac Sterne, Gene Feder, Diane Eaton, Aroon Hingorani, Christopher Fawsitt, Trudie Lobban, Peter Bryden, Alison Richards, Reecha Sofat
BACKGROUND: Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of thromboembolic events. Anticoagulation therapy to prevent AF-related stroke has been shown to be cost-effective. A national screening programme for AF may prevent AF-related events, but would involve a substantial investment of NHS resources. OBJECTIVES: To conduct a systematic review of the diagnostic test accuracy (DTA) of screening tests for AF, update a systematic review of comparative studies evaluating screening strategies for AF, develop an economic model to compare the cost-effectiveness of different screening strategies and review observational studies of AF screening to provide inputs to the model...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28629235/atrial-fibrillation-as-a-complication-of-ibrutinib-therapy-clinical-features-and-challenges-of-management
#19
Bronwyn C Thorp, Xavier Badoux
Ibrutinib is a Bruton's tyrosine kinase (BTK) inhibitor finding increasingly widespread use in non-Hodgkin lymphoma. Evidence of an increased risk of atrial fibrillation (AF) emerged in Phase III studies with a median incidence of approximately 6%. The mechanism remains unknown, but inhibition of a cardioprotective pathway has been proposed. Ibrutinib induces a platelet function defect, increasing the bleeding risk of anticoagulation for AF stroke prophylaxis. Multiple potential drug interactions are an added complication...
June 20, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28627938/-i-ve-got-somebody-there-someone-cares-what-support-is-most-valued-following-a-stroke
#20
Sarah Northcott, Katerina Hilari
PURPOSE: There is often a need for increased support following a stroke. This study explored what types of support are provided by different network members and what support functions are most valued. METHODS: Adults with first stroke were recruited from a stroke unit and participated in in-depth interviews 8-15 months poststroke. Framework Analysis was used to build thematic and explanatory accounts of the data. RESULTS: Twenty-nine participants took part...
June 19, 2017: Disability and Rehabilitation
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