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https://www.readbyqxmd.com/read/28521763/assessment-of-neurologists-knowledge-regarding-intravenous-fibrinolytic-therapy-for-acute-stroke-in-shanxi-province-in-china
#1
Liansheng Ma, Xiaoyuan Niu, Wei Zhang, Yalan Fang, Jie Wang
BACKGROUND: Limitations in physicians' knowledge regarding fibrinolytic therapy for acute ischemic stroke may contribute to low rate of fibrinolytic therapy in China. Here physicians' knowledge was surveyed on intravenous fibrinolytic therapy for acute ischemic stroke. METHODS: Neurologists (n = 175) from 27 major general hospitals in Shanxi province, P. R. China, were invited to complete questionnaires regarding their basic knowledge of intravenous fibrinolytic therapy for acute ischemic stroke...
May 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28506979/impact-of-ezetimibe-on-the-rate-of-cardiovascular-related-hospitalizations-and-associated-costs-among-patients-with-a-recent-acute-coronary-syndrome-results-from-the-improve-it-trial-improved-reduction-of-outcomes-vytorin-efficacy-international-trial
#2
Yashashwi Pokharel, Khaja Chinnakondepalli, Katherine Vilain, Kaijun Wang, Daniel B Mark, Glenn Davies, Michael A Blazing, Robert P Giugliano, Eugene Braunwald, Christopher P Cannon, David J Cohen, Elizabeth A Magnuson
BACKGROUND: Ezetimibe, when added to simvastatin therapy, reduces cardiovascular events after recent acute coronary syndrome. However, the impact of ezetimibe on cardiovascular-related hospitalizations and associated costs is unknown. METHODS AND RESULTS: We used patient-level data from the IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) to examine the impact of simvastatin-ezetimibe versus simvastatin-placebo on cardiovascular-related hospitalizations and related costs (excluding drug costs) over 7 years follow-up...
May 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28481826/the-impact-of-nurse-staffing-on-in-hospital-mortality-of-stroke-patients-in-korea
#3
Wankyo Chung, Min Sohn
BACKGROUND: Stroke is one of the leading causes of death in Korea, and a well-qualified, adequate nursing force achieves better patient outcomes. STUDY PURPOSES: This study examined the association between nurse staffing and in-hospital mortality among stroke patients in a nationally representative sample. METHODS: This cross-sectional retrospective study was conducted using 2009 National Health Insurance claims data of stroke patients admitted to variously sized Korean hospitals...
May 5, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28460854/diagonal-earlobe-crease-frank-s-sign-a-predictor-of-cerebral-vascular-events
#4
Saleh Nazzal, Basem Hijazi, Luai Khalila, Arnon Blum
BACKGROUND: Frank's sign was first described in 1973 by an American physician (T. Frank). It is a diagonal crease in the earlobe which starts from the tragus to the edge of the auricle in an angle of 45 degrees in varying depths. Frank sign was described as a predictor of future coronary heart disease and peripheral vascular diseases. The aim of the study was to examine the association between Frank sign and the development of ischemic stroke. METHODS: A prospective study that enrolled consecutive patients admitted with an acute ischemic stroke...
April 28, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28419988/neutrophil-to-lymphocyte-ratio-is-an-independent-predictor-for-in-hospital-mortality-in-spontaneous-intracerebral-hemorrhage
#5
Antje Giede-Jeppe, Tobias Bobinger, Stefan T Gerner, Jochen A Sembill, Maximilian I Sprügel, Vanessa D Beuscher, Hannes Lücking, Philip Hoelter, Joji B Kuramatsu, Hagen B Huttner
BACKGROUND AND PURPOSE: Stroke-associated immunosuppression and inflammation are increasingly recognized as factors that trigger infections and thus, potentially influence the outcome after stroke. Several studies demonstrated that elevated neutrophil-to-lymphocyte ratio (NLR) is a significant predictor of adverse outcomes in patients with ischemic stroke. However, little is known about the impact of NLR on short-term mortality in intracerebral hemorrhage (ICH). METHODS: This observational study included 855 consecutive ICH-patients...
April 19, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28419982/resting-heart-rate-and-ischemic-stroke-in-patients-with-heart-failure
#6
Koki Nakanishi, Marco R Di Tullio, Min Qian, John L P Thompson, Arthur J Labovitz, Douglas L Mann, Ralph L Sacco, Patrick M Pullicino, Ronald S Freudenberger, John R Teerlink, Susan Graham, Gregory Y H Lip, Bruce Levin, Jay P Mohr, Richard Buchsbaum, Conrado J Estol, Dirk J Lok, Piotr Ponikowski, Stefan D Anker, Shunichi Homma
BACKGROUND: Although high resting heart rate (RHR) is known to be associated with an increased risk of mortality and hospital admission in patients with heart failure, the relationship between RHR and ischemic stroke remains unclear. This study is aimed at investigating the relationship between RHR and ischemic stroke in patients with heart failure in sinus rhythm. METHODS: We examined 2,060 patients with systolic heart failure in sinus rhythm from the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction trial...
April 19, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28416976/rationale-and-design-of-assaf-k-a-study-of-the-safety-and-efficacy-of-anticoagulant-therapy-in-the-treatment-of-atrial-fibrillation-in-kanagawa
#7
Yutaka Hatori, Hiroyuki Sakai, Tomoyuki Kunishima, Nobuo Hatori, Lin Chen, Tomoaki Ishigami, Naoki Satoh
BACKGROUND: Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias associated with substantially increased risks of ischemic stroke and thromboembolism. Oral anticoagulants (OACs) are the cornerstone of AF management and effectively prevent AF-related stroke. As new non-vitamin K antagonist OACs (NOACs) have become available, the landscape of stroke prevention in AF has changed. However, there are considerable gaps between daily clinical practice and current guideline-based recommendations for anticoagulant therapy in Japan...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28411038/long-term-impact-of-implementation-of-a-stroke-protocol-on-door-to-needle-time-in-the-administration-of-intravenous-tissue-plasminogen-activator
#8
Machteld E Hillen, Wenzhuan He, Zaid Al-Qudah, Weizhen Wang, Andrea Hidalgo, Jessy Walia
BACKGROUND: This study aims to evaluate the effectiveness of implementing a stroke protocol (SP) in improving door-to-needle time (DTNT) and door-to-computed tomography (DTCT) time from 2010 to 2014. Published data from the Get With The Guidelines-Stroke (GWTGS) participating hospitals showed that median DTNT = 75 minutes with 26.6% of the patients achieving the recommended DTNT of 60 minutes or less. Implementation of an SP, which specifies the role of nurses, physicians, and technicians during acute stroke evaluation, can improve DTNT...
April 11, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28408066/derivation-and-validation-of-a-scoring-system-for-intravenous-tissue-plasminogen-activator-use-in-asian-patients
#9
Leonard L L Yeo, Shih-Chao Chien, Jr-Rung Lin, Chia-Wei Liow, Jiann-Der Lee, Tsung-I Peng, Teoh Hock Luen, Vijay Sharma, Bernard Chan, Tsong-Hai Lee
BACKGROUND AND PURPOSE: As Chinese Asian populations have an increased risk of intracerebral hemorrhage (ICH) after intravenous tissue plasminogen activator (IV tPA), we aimed to design a rapid, clinically applicable risk scoring system to predict ICH and functional outcomes after IV tPA treatment in Asian ischemic stroke patients. METHODS: From January 2009 to December 2012, consecutive acute ischemic stroke patients treated with IV tPA recruited from the Stroke Registry in Chang Gung Healthcare System (SRICHS) in Taiwan and the National University Hospital of Singapore (NUHS) acute stroke database were used to create and validate a scoring system...
April 10, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28395423/-a-pilot-study-to-explore-a-registry-method-for-acute-cardiovascular-events
#10
L Hou, W Han, Y Tang, F Xue, S H Liang, W Z Wang, B Zhang, H Y Pang, Y Y Wang, Z X Wang, Y D Hu, L Wang, M T Zhang, J M Jiang
Objective: To explore a registry method for acute cardiovascular events in large-scale fields across China. Methods: This study was based on a community-based Kazakh cohort, including 1 668 persons with complete baseline data, conducted in Altay, Xinjiang. Acute cardiovascular events included acute myocardial infarction(ICD-10: I21-I22), sudden cardiac death (I46.1), and incident stroke (I60-I64) that occurred during the period from Oct 1, 2012 to Jun 30, 2016. There were three stages, a hospital-based search for checking medical records of inpatients in all four local hospitals, a community-based supplementary registry, and an extra survey for reducing false negatives, to complete this registry...
April 4, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28342656/nurses-are-as-specific-and-are-earlier-in-calling-in-hospital-stroke-alerts-compared-to-physicians
#11
Pravin George, Dolora R Wisco, James Gebel, Ken Uchino, Christopher R Newey
INTRODUCTION: In-hospital stroke alerts are typically activated by nurses or physicians when a patient's neurological status acutely changes from baseline. It is unclear if knowledge of stroke symptoms translates to accurate activation of the acute stroke team. We hypothesized that nurses who activate the stroke alert system would correctly identify as great a proportion of acute strokes as physicians. We also investigated the time to activation of these in-hospital stroke alerts. METHODS: We retrospectively reviewed consecutive inpatient stroke team calls over a 12-month period at a single, tertiary care center...
March 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28228636/progressive-ischemic-stroke-due-to-thyroid-storm-associated-cerebral-venous-thrombosis
#12
Natsumi Tanabe, Eiji Hiraoka, Masataka Hoshino, Gautam A Deshpande, Kana Sawada, Yasuhiro Norisue, Jumpei Tsukuda, Toshihiko Suzuki
BACKGROUND Cerebral venous thrombosis (CVT) is a rare but fatal complication of hyperthyroidism that is induced by the hypercoagulable state of thyrotoxicosis. Although it is frequently difficult to diagnose CVT promptly, it is important to consider it in the differential diagnosis when a hyperthyroid patient presents with atypical neurologic symptoms. CASE REPORT A 49-year-old Japanese female with unremarkable medical history came in with thyroid storm and multiple progressive ischemic stroke identified at another hospital...
February 23, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28153014/towards-best-practice-in-acute-stroke-care-in-ghana-a-survey-of-hospital-services
#13
Leonard Baatiema, Michael Otim, George Mnatzaganian, Ama De-Graft Aikins, Judith Coombes, Shawn Somerset
BACKGROUND: Stroke and other non-communicable diseases are important emerging public health concerns in sub-Saharan Africa where stroke-related mortality and morbidity are higher compared to other parts of the world. Despite the availability of evidence-based acute stroke interventions globally, uptake in low-middle income countries (LMIC) such as Ghana is uncertain. This study aimed to identify and evaluate available acute stroke services in Ghana and the extent to which these services align with global best practice...
February 2, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28144702/endovascular-thrombectomy-in-acute-ischemic-stroke-outcome-in-referred-versus-directly-admitted-patients
#14
Philipp Bücke, Marta Aguilar Pérez, Elisabeth Schmid, Christian H Nolte, Hansjörg Bäzner, Hans Henkes
PURPOSE: Endovascular mechanical thrombectomy (mTE) in acute ischemic stroke due to large cerebral artery occlusion is effective and safe. The procedure is currently offered by specialized hospitals. Physicians from smaller hospitals need to refer patients to stroke centers. Secondary referrals involve delays for transportation. Little is known about effects of distant referrals on outcome and complications as compared to direct admittance. METHODS: To evaluate the effects of referral patterns on outcome and safety, we analyzed 941 patients with anterior circulation stroke receiving mTE between January 2010 and December 2015...
January 31, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28110987/outcomes-for-emergency-department-patients-with-recent-onset-atrial-fibrillation-and-flutter-treated-in-canadian-hospitals
#15
Ian G Stiell, Catherine M Clement, Brian H Rowe, Robert J Brison, D George Wyse, David Birnie, Paul Dorian, Eddy Lang, Jeffrey J Perry, Bjug Borgundvaag, Debra Eagles, Damian Redfearn, Jennifer Brinkhurst, George A Wells
STUDY OBJECTIVE: Recent-onset atrial fibrillation and flutter are the most common arrhythmias managed in the emergency department (ED). We evaluate the management and 30-day outcomes for recent-onset atrial fibrillation and flutter patients in Canadian EDs, where cardioversion is commonly practiced. METHODS: We conducted a prospective cohort study in 6 academic hospital EDs and enrolled patients who had atrial fibrillation and flutter onset within 48 hours. Patients were followed for 30 days by health records review and telephone...
January 19, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28056095/ischemic-bowel-syndrome-in-patients-with-spinal-cord-injury-a-nationwide-study
#16
Chih-Wei Tseng, Cheng-Li Lin, Yu-Tso Chen, Long-Bin Jeng
PURPOSE: The aim of this study was to determine whether spinal cord injuries (SCI) is associated with increased risk of ischemic bowel syndrome (IBS) in an Asian population by analyzing data from the National Health Insurance Research Database (NHIRD) in Taiwan. METHODS: Patients aged ≥20 years in the inpatient database with newly identified SCI from 2000 to 2011 were selected as the SCI cohort. For the non-SCI cohort, patients were selected based on a 1:4 risk-set sampling...
2017: PloS One
https://www.readbyqxmd.com/read/28039855/use-of-oral-anticoagulant-therapy-in-older-adults-with-atrial-fibrillation-after-acute-ischemic-stroke
#17
Emer R McGrath, Alan S Go, Yuchiao Chang, Leila H Borowsky, Margaret C Fang, Kristi Reynolds, Daniel E Singer
OBJECTIVES: To explore barriers to anticoagulation in older adults with atrial fibrillation (AF) at high risk of stroke and to identify opportunities for interventions that might increase use of oral anticoagulants (OACs). DESIGN: Retrospective cohort study. SETTING: Two large community-based AF cohorts. PARTICIPANTS: Individuals with ischemic stroke surviving hospitalization (N = 1,405, mean age 79). MEASUREMENTS: Using structured chart review, reasons for nonuse of OAC were identified, and 1-year poststroke survival was assessed...
February 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27895242/availability-of-endovascular-therapies-for-cerebrovascular-disease-at-primary-stroke-centers
#18
Mark J Alberts, Jean Range, William Spencer, Vicki Cantwell, M J Hampel
Background Endovascular therapies (EVTs) are useful for treating cerebrovascular disease. There are few data about the availability of such services at primary stroke centers (PSCs). Our hypothesis was that some of these services may be available at some PSCs. Methods We conducted an internet-based survey of hospitals certified as PSCs by the Joint Commission. The survey inquired about EVTs such as intra-arterial (IA) lytics, IA mechanical clot removal, coiling of aneurysms, and cervical arterial stenting, physician training, coverage models, hospital type, and outcomes...
February 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27871433/regional-variation-in-acute-stroke-care-organisation
#19
Paula Muñoz Venturelli, Thompson Robinson, Pablo M Lavados, Verónica V Olavarría, Hisatomi Arima, Laurent Billot, Maree L Hackett, Joyce Y Lim, Sandy Middleton, Octavio Pontes-Neto, Bin Peng, Liying Cui, Lily Song, Gillian Mead, Caroline Watkins, Ruey-Tay Lin, Tsong-Hai Lee, Jeyaraj Pandian, H Asita de Silva, Craig S Anderson
BACKGROUND: Few studies have assessed regional variation in the organisation of stroke services, particularly health care resourcing, presence of protocols and discharge planning. Our aim was to compare stroke care organisation within middle- (MIC) and high-income country (HIC) hospitals participating in the Head Position in Stroke Trial (HeadPoST). METHODS: HeadPoST is an on-going international multicenter crossover cluster-randomized trial of 'sitting-up' versus 'lying-flat' head positioning in acute stroke...
December 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27768752/use-of-a-diagnostic-score-to-prioritize-computed-tomographic-ct-imaging-for-patients-suspected-of-ischemic-stroke-who-may-benefit-from-thrombolytic-therapy
#20
Wen Yea Hwong, Michiel L Bots, Sharmini Selvarajah, L Jaap Kappelle, Zariah Abdul Aziz, Norsima Nazifah Sidek, Ilonca Vaartjes
BACKGROUND: A shortage of computed tomographic (CT) machines in low and middle income countries often results in delayed CT imaging for patients suspected of a stroke. Yet, time constraint is one of the most important aspects for patients with an ischemic stroke to benefit from thrombolytic therapy. We set out to assess whether application of the Siriraj Stroke Score is able to assist physicians in prioritizing patients with a high probability of having an ischemic stroke for urgent CT imaging...
2016: PloS One
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