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Atrial fibrilation stroke rehabilitation

Janet Prvu Bettger, Zixiao Li, Ying Xian, Liping Liu, Xingquan Zhao, Hao Li, Chunxue Wang, Chunjuan Wang, Xia Meng, Anxin Wang, Yuesong Pan, Eric D Peterson, Yilong Wang, Yongjun Wang
Background Stroke rehabilitation improves functional recovery among stroke patients. However, little is known about clinical practice in China regarding the assessment and provision of rehabilitation among patients with acute ischemic stroke. Aims We examined the frequency and determinants of an assessment for rehabilitation among acute ischemic stroke patients from the China National Stroke Registry II. Methods Data for 19,294 acute ischemic stroke patients admitted to 219 hospitals from June 2012 to January 2013 were analyzed...
April 2017: International Journal of Stroke: Official Journal of the International Stroke Society
A Subic, P Cermakova, B Norrving, B Winblad, M von Euler, M G Kramberger, M Eriksdotter, S Garcia-Ptacek
An estimated 10% of stroke patients have an underlying dementia. As a consequence, health professionals often face the challenge of managing patients with dementia presenting with an acute stroke. Patients with dementia are less likely to receive thrombolysis (0.56-10% vs. 1-16% thrombolysis rates in the general population), be admitted to a stroke unit or receive some types of care. Anticoagulation for secondary stroke prevention is sometimes withheld, despite dementia not being listed as an exclusion criterion in current guidelines...
April 2017: Journal of Internal Medicine
J A Moreno-Palacios, I Moreno-Martinez, A Bartolome-Nogues, E Lopez-Blanco, R Juarez-Fernandez, I Garcia-Delgado
INTRODUCTION: Recovery of the ability to walk and independence is fundamental for any patient who suffers a stroke, and it can be influenced by a number of factors. AIM: To determine what variables are more important to achieve a good functional recovery at one year after the stroke. PATIENTS AND METHODS: An observational, longitudinal prospective study was conducted with 231 patients diagnosed with a stroke in the year 2013. An analysis was performed of the clinical characteristics, socio-demographic data, neurological situation at the time of hospitalisation -National Institute of Health Stroke Scale (NIHSS)-, functional situation (Rankin Scale and Barthel Index) and ability to walk, both on hospitalisation and on discharge from rehabilitation and at one year...
January 16, 2017: Revista de Neurologia
Archana Hinduja, Kaustubh Limaye, Rahul Ravilla, Appalnaidu Sasapu, Xenofon Papanikolaou, Lai Wei, Michel Torbey, Sarah Waheed
OBJECTIVES: Patients with multiple myeloma (MM) are at increased risk of arterial thrombosis. Our aim was to determine the risk factors, mechanisms and outcome of strokes in these patients. METHODS: We conducted a retrospective matched case-control study from our database of MM patients enrolled in Total Therapy (TT) 2, TT3a and TT3b protocols who developed a vascular event (transient ischemic attack, ischemic stroke, or intracerebral hemorrhage) from October 1998 to January 2014...
2016: PloS One
Sana Salah, Mariem Rekik, Soumaya Boudokhane, Houda Migaou, Anis Jellad, Zohra Ben Salah Frih
OBJECTIVE: To assess the prevalence of sleep disorders (SD) in ischemic stroke (IS) patients followed in physical medicine and rehabilitation (PMR) and to compare this prevalence to that found in a control population. MATERIAL/PATIENTS AND METHODS: A cross-sectional study was conducted over a period of 8 months. We enrolled IS patients and case controls matched for age and sex and who met the inclusion criteria. The data studied were epidemiological and clinical...
September 2016: Annals of Physical and Rehabilitation Medicine
Graeme J Hankey
In the past decade, the definition of stroke has been revised and major advances have been made for its treatment and prevention. For acute ischaemic stroke, the addition of endovascular thrombectomy of proximal large artery occlusion to intravenous alteplase increases functional independence for a further fifth of patients. The benefits of aspirin in preventing early recurrent ischaemic stroke are greater than previously recognised. Other strategies to prevent recurrent stroke now include direct oral anticoagulants as an alternative to warfarin for atrial fibrillation, and carotid stenting as an alternative to endarterectomy for symptomatic carotid stenosis...
February 11, 2017: Lancet
Samuel L Chen, Isabella J Kuo, Roy M Fujitani, Nii-Kabu Kabutey
BACKGROUND: Acute aortic symptomatology is an unusual manifestation of Brucella melitensis infection. We present a rare case of acute multifocal thoracic and abdominal aortic ruptures arising from Brucellosis aortitis managed exclusively with endovascular surgery. METHODS: A 71-year-old Hispanic male with a history of atrial fibrillation and prior stroke on chronic anticoagulation presented with shortness of breath and malaise. In addition, he had been treated approximately 1 year previously in Mexico for B...
January 2017: Annals of Vascular Surgery
Masachika Niimi, Masahiro Abo, Satoshi Miyano, Nobuyuki Sasaki, Takatoshi Hara, Naoki Yamada
BACKGROUND: Branch atheromatous disease (BAD) is differentiated from lacunar infarction (LI). BAD is often associated with neurological deterioration in the acute stage, but outcome of BAD patients in the chronic stage is unclear. We aimed to explore the outcome of BAD in the lenticulostriate artery (LSA) territory in comparison with those of LI from the viewpoint of activities of daily living (ADLs). METHODS: We retrospectively investigated patients who were admitted within 3 days after stroke onset...
September 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Guido Bigliardi, Maria Luisa Dell'Acqua, Stefano Vallone, Filippo Barbi, Roberta Pentore, Livio Picchetto, Paolo Carpeggiani, Paolo Nichelli, Andrea Zini
BACKGROUND: Internal carotid artery occlusion (ICAO) is defined as "untouchable" by all specialists; no treatment is indicated because intervention risks (carotid endarterectomy (CEA) or endovascular treatment) are usually much more than benefits.(1,2) We report the case of a patient admitted to our hospital with an atherothrombotic ischemic stroke due to symptomatic acute ICAO, who developed a recurrent stroke with hemispheric hypoperfusion and was treated in the emergency department with ICAO revascularization after 60 days of occlusion finding...
August 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Ken Okumura, Joji Hagii, Norifumi Metoki, Shin Saito, Hiroshi Shiroto, Minoru Yasujima, Hirofumi Tomita
Warfarin is used worldwide to prevent cardioembolic stroke (CES) in patients with atrial fibrillation even in the era of direct oral anticoagulant (DOAC). We evaluated clinical characteristics of the patients with CES and intracerebral hemorrhage (ICH) occurring during warfarin treatment, focusing on prothrombin time-international normalized ratio (PT-INR) at the occurrence. The consecutive 846 CES patients (78 ± 9 years) and 870 ICH patients (68 ± 13 years) admitted to the Hirosaki Stroke and Rehabilitation Center from April 2011 through March 2015 were studied...
May 31, 2016: Rinshō Shinkeigaku, Clinical Neurology
Palmira Bernocchi, Fabio Vanoglio, Doriana Baratti, Roberta Morini, Silvana Rocchi, Alberto Luisa, Simonetta Scalvini
BACKGROUND: After discharge from in-hospital rehabilitation, post-stroke patients should have the opportunity to continue the rehabilitation through structured programs to maintain the benefits acquired during intensive rehabilitation treatment. OBJECTIVE: The primary objective was to evaluate the feasibility of implementing an home-based telesurveillance and rehabilitation (HBTR) program to optimize the patient's recovery by reducing dependency degree. METHOD: Post-stroke patients were consecutively screened...
April 2016: Topics in Stroke Rehabilitation
Hee Jung Park, Tae Uk Kim, Jung Keun Hyun, Jung Yoon Kim
OBJECTIVE: To investigate the association of family history of stroke with functional outcomes in stroke patients in Korea. METHODS: A case-control study was conducted. A total of 170 patients who were admitted to a rehabilitation unit were included. Risk factors for stroke such as age, sex, diabetes mellitus, hypertension, atrial fibrillation, smoking, high blood cholesterol and homocysteine level, obesity, and family history of stroke were taken into account. Stroke subtypes were the following: large vessel infarct, small vessel infarct, embolic infarct, subarachnoid hemorrhage, and intracranial hemorrhage...
December 2015: Annals of Rehabilitation Medicine
Teresa Ullberg, Elisabet Zia, Jesper Petersson, Bo Norrving
BACKGROUND AND PURPOSE: Met care demands are key aspects in poststroke quality of care. This study aimed to identify baseline predictors and 12-month factors that were associated with perceived unmet rehabilitation needs 1 year poststroke. METHODS: Data on patients who were independent in activities of daily living, hospitalized for acute stroke during 2008 to 2010, and followed up 1 year poststroke through a postal questionnaire were obtained from the Swedish stroke register...
February 2016: Stroke; a Journal of Cerebral Circulation
Francois-Emery Cotté, Gwendoline Chaize, Anne-Françoise Gaudin, Adeline Samson, Alexandre Vainchtock, Laurent Fauchier
AIMS: Atrial fibrillation (AF) is associated with numerous cardiovascular complications. We sought to estimate the annual burden of cardiovascular complications in AF patients in French hospitals. METHODS AND RESULTS: All AF patients hospitalized in France in 2012 were identified from the national public/private hospital database. Comorbid conditions and medical histories were documented using medical records dating back 5 years. Reasons for hospitalization, type of admission (emergency or otherwise), length of stay, rehabilitation transfers, and death at discharge were identified and costs of acute and rehabilitation care determined (2012 Euros)...
April 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Wenjuan Zhao, Zhongping An, Yan Hong, Guanen Zhou, Bin Liu, Jingjing Guo, Yuanju Yang, Xianjia Ning, Jinghua Wang
BACKGROUND: Diabetes has been shown to be significantly associated with poor outcome after stroke. However, the sex differences in stroke outcome among patients with diabetes are unknown. Therefore, we aimed to assess the sex differences in long-term prognosis among acute ischemic stroke patients with diabetes. METHODS: The ischemic stroke patients with diabetes were recruited to this study between May 2005 and September 2014 in Tianjin, China. Sex differences in mortality, dependency (modified rank scale > 2), and recurrence at 3, 12, and 36 months after stroke were analyzed...
2015: Biology of Sex Differences
Linda Brewer, Lisa Mellon, Patricia Hall, Eamon Dolan, Frances Horgan, Emer Shelley, Anne Hickey, David Williams
BACKGROUND: Survivors of ischaemic stroke (IS) are at high-risk for future vascular events. Comprehensive information on the adequacy of secondary prevention after IS is lacking despite the knowledge that appropriate secondary prevention improves long-term patient outcomes. ASPIRE-S (Action on Secondary Prevention Interventions and Rehabilitation in Stroke) aimed to prospectively assess secondary prevention in patients 6 months following IS. METHODS: Consenting patients admitted with IS to three Dublin hospitals were recruited over 1 year, from October 2011...
2015: BMC Neurology
Derek T Hayden, Niamh Hannon, Elizabeth Callaly, Danielle Ní Chróinín, Gillian Horgan, Lorraine Kyne, Joseph Duggan, Eamon Dolan, Killian O'Rourke, David Williams, Sean Murphy, Peter J Kelly
BACKGROUND AND PURPOSE: Demographic trends in atrial fibrillation (AF) incidence may yield a substantial rise in the societal burden of AF-related stroke (AF-stroke). Accurate population-wide outcome data are essential to inform health service planning to improve AF-stroke prevention, and provision of rehabilitation, nursing home, and community supports for AF-stroke survivors. METHODS: We investigated rates and determinants of 5-year fatality, stroke recurrence, functional outcomes, and prescribing of secondary prevention medications in AF-stroke in the North Dublin Population Stroke Study...
December 2015: Stroke; a Journal of Cerebral Circulation
Domenico Scrutinio, Vincenzo Monitillo, Pietro Guida, Roberto Nardulli, Vincenzo Multari, Francesco Monitillo, Gianluigi Calabrese, Pietro Fiore
BACKGROUND AND PURPOSE: Prediction of functional outcome after stroke rehabilitation (SR) is a growing field of interest. The association between SR and survival still remains elusive. We sought to investigate the factors associated with functional outcome after SR and whether the magnitude of functional improvement achieved with rehabilitation is associated with long-term mortality risk. METHODS: The study population consisted of 722 patients admitted for SR within 90 days of stroke onset, with an admission functional independence measure (FIM) score of <80 points...
October 2015: Stroke; a Journal of Cerebral Circulation
Durga Ghosh, Premalatha Karunaratne
INTRODUCTION: Early comprehensive geriatric assessment (CGA) with good history-taking is essential in assessing the older adult. CASE PRESENTATION: Our patient, a 75-year-old Caucasian woman, was originally admitted to hospital for investigation of iron deficiency anemia. During admission, she developed pneumonia and new intermittent atrial fibrillation in association with a right-sided weakness, which was felt to be new at the time. Following this episode, she was treated for a further chest infection and, despite clinical improvement, her inflammatory markers failed to settle satisfactorily...
April 30, 2015: Journal of Medical Case Reports
Zixiao Li, Liping Liu, Yilong Wang, Xingquan Zhao, David Z Wang, Chunxue Wang, Hao Li, Chunjuan Wang, Haiqiang Qin, Xianwei Wang, Yongjun Wang
OBJECTIVES: Little is known about the clinical practice of deep venous thrombosis (DVT) prophylaxis in patients with acute ischaemic stroke in China. We examined the factors that impact the adherence rate of DVT prophylaxis in stroke patients from the China National Stroke Registry (CNSR). METHODS: Records of 12 173 acute ischaemic stroke patients with follow-up admitted to 132 hospitals in CNSR from September 1, 2007 to August 30, 2008 were reviewed. Data from 4643 patients eligible for DVT prophylaxis were analysed...
May 2015: Neurological Research
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