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https://www.readbyqxmd.com/read/28110310/impact-of-an-expanded-hospital-recognition-program-for-stroke-quality-of-care
#1
Paul A Heidenreich, Xin Zhao, Adrian F Hernandez, Lee H Schwamm, Eric Smith, Mat Reeves, Eric D Peterson, Gregg C Fonarow
BACKGROUND: In 2009, the Get With The Guidelines-Stroke (GWTG-Stroke) program offered additional recognition if hospitals performed well on certain stroke quality measures. We sought to determine whether quality of care for all hospitals participating in GWTG-Stroke improved with this expanded recognition program. METHODS AND RESULTS: We examined hospital-level performance on 6 quality of care (process) measures and 1 defect-free composite quality measure for stroke following expansion of the existing performance measure recognition program...
January 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28108054/acute-respiratory-compromise-in-the-emergency-department-a-description-and-analysis-of-3571-events-from-the-get-with-the-guidelines-resuscitation%C3%A2-registry
#2
Carl Mathias Karlsson, Michael W Donnino, Hans Kirkegaard, Michael N Cocchi, Maureen Chase, Lars W Andersen
BACKGROUND: Respiratory events requiring the use of assisted ventilation are relatively common in the emergency department (ED), and can be associated with substantial morbidity and mortality. OBJECTIVE: The aim of this study was to describe and elucidate patient and event characteristics associated with mortality and progression to cardiac arrest in ED patients with acute respiratory compromise. METHODS: Data were obtained from the multicenter Get With the Guidelines-Resuscitation® registry...
January 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28105733/vitamin-d-supplementation-for-sickle-cell-disease
#3
REVIEW
Htoo Htoo Kyaw Soe, Adinegara Bl Abas, Nan Nitra Than, Han Ni, Jaspal Singh, Abdul Razzak Bin Mohd Said, Ifeyinwa Osunkwo
BACKGROUND: Sickle cell disease is a genetic chronic haemolytic and pro-inflammatory disorder. The clinical manifestations of sickle cell disease result from the presence of mutations on the beta globin genes that generate an abnormal haemoglobin product (called haemoglobin S) within the red blood cell. Sickle cell disease can lead to many complications such as acute chest syndrome, stroke, acute and chronic bone complications (including painful vaso-occlusive crisis, osteomyelitis, osteonecrosis and osteoporosis)...
January 20, 2017: Cochrane Database of Systematic Reviews
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/28100370/-associations-between-airflow-obstruction-and-total-and-cause-specific-mortality-in-adults-in-china
#5
F L Lan, J C Li, C Q Yu, Y Guo, Z Bian, Y L Tan, P Pei, J S Chen, Z M Chen, W H Cao, J Lyu, L M Li
Objective: To examine the prospective associations between airflow obstruction and total and cause-specific mortality. Methods: The study was based on China Kadoorie Biobank, in which 199 099 men and 287 895 women aged 30-79 years at baseline survey were included after excluding those with heart disease, stroke and cancer. The Global Initiative on Obstructive Lung Disease (GOLD) guideline was used to classify airflow obstruction. Cox regression models were used to estimate adjusted HR and 95%CI. Results: During 3 494 079 person-years of follow-up between 2004 and 2013 (median 7...
January 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
https://www.readbyqxmd.com/read/28099563/brazilian-guidelines-for-endovascular-treatment-of-patients-with-acute-ischemic-stroke
#6
Octávio Marques Pontes-Neto, Pedro Cougo, Sheila Cristina Ouriques Martins, Daniel G Abud, Raul G Nogueira, Maramélia Miranda, Luiz Henrique de Castro-Afonso, Leticia C Rebello, José Guilherme M Pereira Caldas, Rodrigo Bazan, Daniel C Bezerra, Marco Tulio Rezende, Gabriel R de Freitas, Alexandre Longo, Pedro Magalhães, João José Freitas de Carvalho, Francisco José Montalverne, Fabricio Oliveira Lima, Gustavo H V Andrade, Ayrton R Massaro, Jamary Oliveira-Filho, Rubens Gagliardi, Gisele Sampaio Silva
These guidelines are the result of a joint effort from writing groups of the Brazilian Stroke Society, the Scientific Department of Cerebrovascular Diseases of the Brazilian Academy of Neurology, the Brazilian Stroke Network and the Brazilian Society of Diagnostic and Therapeutic Neuroradiology. Members from these groups participated in web-based discussion forums with predefined themes, followed by videoconference meetings in which controversies and position statements were discussed, leading to a consensus...
January 2017: Arquivos de Neuro-psiquiatria
https://www.readbyqxmd.com/read/28096207/use-of-strategies-to-improve-door-to-needle-times-with-tissue-type-plasminogen-activator-in-acute-ischemic-stroke-in-clinical-practice-findings-from-target-stroke
#7
Ying Xian, Haolin Xu, Barbara Lytle, Jason Blevins, Eric D Peterson, Adrian F Hernandez, Eric E Smith, Jeffrey L Saver, Steven R Messé, Mary Paulsen, Robert E Suter, Mathew J Reeves, Edward C Jauch, Lee H Schwamm, Gregg C Fonarow
BACKGROUND: The implementation of Target: Stroke Phase I, the first stage of the American Heart Association's national quality improvement initiative to accelerate door-to-needle (DTN) times, was associated with an average 15-minute reduction in DTN times. TARGET: Stroke phase II was launched in April 2014 with a goal of promoting further reduction in treatment times for tissue-type plasminogen activator (tPA) administration. METHODS AND RESULTS: We conducted a second survey of Get With The Guidelines-Stroke hospitals regarding strategies used to reduce delays after Target: Stroke and quantify their association with DTN times...
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28096203/hospital-variation-in-functional-recovery-after-stroke
#8
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/28096031/the-effect-of-nurse-led-care-on-stability-time-in-therapeutic-range-of-inr-in-ischemic-stroke-patients-receiving-warfarin
#9
Mina Amiri, Marzieh Kargar, Afshin Borhanihaghighi, Fahimeh Soltani, Najafe Zare
PURPOSE: The current study is designed in order to investigate the effect of nurse-led care (the supportive and educational measurements by nurses) on stability time in therapeutic range of INR in ischemic stroke patients receiving Warfarin. METHOD: In this quasi-experimental study, 80 ischemic stroke patients were investigated, 40 patients in experimental group and 40 in the control group referred to the nurse-based warfarin clinics affiliated to Shiraz University of Medical Sciences...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28095412/intensive-versus-guideline-blood-pressure-and-lipid-lowering-in-patients-with-previous-stroke-main-results-from-the-pilot-prevention-of-decline-in-cognition-after-stroke-trial-podcast-randomised-controlled-trial
#10
Philip M Bath, Polly Scutt, Daniel J Blackburn, Sandeep Ankolekar, Kailash Krishnan, Clive Ballard, Alistair Burns, Jonathan Mant, Peter Passmore, Stuart Pocock, John Reckless, Nikola Sprigg, Rob Stewart, Joanna M Wardlaw, Gary A Ford
BACKGROUND: Stroke is associated with the development of cognitive impairment and dementia. We assessed the effect of intensive blood pressure (BP) and/or lipid lowering on cognitive outcomes in patients with recent stroke in a pilot trial. METHODS: In a multicentre, partial-factorial trial, patients with recent stroke, absence of dementia, and systolic BP (SBP) 125-170 mmHg were assigned randomly to at least 6 months of intensive (target SBP <125 mmHg) or guideline (target SBP <140 mmHg) BP lowering...
2017: PloS One
https://www.readbyqxmd.com/read/28093900/who-is-responsible-for-metabolic-screening-for-mental-health-clients-taking-antipsychotic-medications
#11
Tamara Ward, Dianne Wynaden, Karen Heslop
Metabolic syndrome is common in mental health consumer populations, and is linked to cardiovascular disease, stroke and diabetes. Metabolic screening is a way of recognising consumers who are at risk of developing metabolic syndrome but internationally screening rates remain low. A retrospective audit was completed at one Australian public mental health service on the case files of 100 randomly selected consumers to determine nurses level of compliance with metabolic screening policies over a 12 month period...
January 17, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28092990/in-hospital-statin-underutilization-among-high-risk-patients-delayed-uptake-of-the-2013-cholesterol-guidelines-in-a-u-s-cohort
#12
Subeer K Wadia, Mark Belkin, Kelsey Chow, Jonathan Nattiv, Andrew Appis, Steven B Feinstein, Kim Allan Williams
OBJECTIVES: Clinician utilization of the 2013 cholesterol lowering guidelines remains variable and unknown. We sought to examine statin prescribing patterns and compare rates among specialists who treat high-risk cardiovascular patients admitted to the hospital. METHODS: We retrospectively (via chart review) examined four specialty groups: (i) Cardiology, (ii) Cardiovascular or Vascular (CV) Surgery, (iii) Neurology, and (iv) Internal Medicine. Adult patients were included based on a discharge diagnosis of acute coronary syndrome, coronary artery bypass graft surgery, carotid endarterectomy, acute ischemic stroke, transient ischemic attack, or high-risk chest pain...
January 17, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28089998/first-clinical-experience-with-targeted-renal-nerve-demodulation-trend-1-using-a-neurotropic-agent-for-the-treatment-of-sympathetic-hypertension
#13
Nicholas Kipshidze, Horst Sievert, Michael H Wholey, Konstantin Kipiani, Vakhtang Kipiani, Tea Mukhuradze, Mark Wholey, Emily Stein, K T Venkateswara Rao
AIMS: To evaluate the feasibility and safety of a novel targeted neuromodulatory treatment for sympathetic hypertension involving a one-time local injection of neurotropic agents near renal nerves. METHODS AND RESULTS: Seven patients suffering from uncontrolled hypertension per ESH-ESC guidelines were treated using a single dose of NW2013, a neurotropic Na+/K+ ATPase antagonist. A microneedle catheter was used to administer 1.2 mL of NW2013 (0.6 mL per artery) to the perivascular space surrounding renal arteries using percutaneous endovascular procedures under fluoroscopic guidance...
January 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28089562/sequential-multiple-assignment-randomized-trials-an-opportunity-for-improved-design-of-stroke-reperfusion-trials
#14
William J Meurer, Nicholas J Seewald, Kelley Kidwell
BACKGROUND: Modern clinical trials in stroke reperfusion fall into 2 categories: alternative systemic pharmacological regimens to alteplase and "rescue" endovascular approaches using targeted thrombectomy devices and/or medications delivered directly for persistently occluded vessels. Clinical trials in stroke have not evaluated how initial pharmacological thrombolytic management might influence subsequent rescue strategy. A sequential multiple assignment randomized trial (SMART) is a novel trial design that can test these dynamic treatment regimens and lead to treatment guidelines that more closely mimic practice...
January 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28086887/patients-and-physicians-perceptions-and-attitudes-about-oral-anticoagulation-and-atrial-fibrillation-a-qualitative-systematic-review
#15
Gemma Mas Dalmau, Elisenda Sant Arderiu, María Belén Enfedaque Montes, Ivan Solà, Sandra Pequeño Saco, Pablo Alonso Coello
BACKGROUND: Oral anticoagulant therapy reduces the risk of stroke in patients with atrial fibrillation, but many patients are still not prescribed this therapy. The causes of underuse of vitamin K antagonists oral anticoagulants are not clear but could be related, in part, to patients' and physicians' perceptions and attitudes towards the benefits and downsides of this treatment. The purpose of this systematic review was to evaluate and synthesize patients' and physicians' perceptions and attitudes towards the benefits and downsides of vitamin K antagonist, in order to explore potential factors related with its underuse...
January 13, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28079666/intravenous-tissue-plasminogen-activator-administration-for-ischemic-stroke-1-hour-after-epidural-catheter-removal-a-case-report
#16
Anne M Baciewicz, Calvin Lee, Alon Ben-Ari, Hojoong Kim, Alex T Lee
Anticoagulation after a recent neuraxial procedure poses risk for development of spinal hematoma. Clinical evidence supports prompt IV tissue plasminogen activator administration after onset of ischemic stroke. There is an absence of data regarding emergency fibrinolytic therapy for patients experiencing a stroke with recent neuraxial procedures, resulting in highly disparate, nonevidence-based guidelines. This report describes a patient who developed ischemic stroke when receiving postoperative epidural analgesia...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28076631/targeting-stroke-risk-and-improving-outcomes-in-patients-with-atrial-fibrillation-in-latin-america
#17
Bruce Stambler, Fernando Scazzuso
CONTEXT AND OBJECTIVE: To examine stroke risk factors, including atrial fibrillation, management and prevention, and stroke outcomes across Latin America. DESIGN AND SETTING: Narrative review conducted at Piedmont Heart Institute, United States. METHODS: The PubMed, Embase and Cochrane databases were searched for stroke AND "Latin America" AND epidemiology (between January 2009 and March 2015). Further studies in the SciELO, World Health Organization and Pan-American Health Organization databases were used to address specific points...
November 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28075037/gauging-the-response-to-cardiac-resynchronization-therapy-the-important-interplay-between-predictor-variables-and-definition-of-a-favorable-outcome
#18
Milan Petrovic, Marija Petrovic, Goran Milasinovic, Bosiljka Vujisic Tesic, Danijela Trifunovic, Olga Petrovic, Ivana Nedeljkovic, Ivana Petrovic, Marko Banovic, Marija Boricic-Kostic, Jelena Petrovic, Ross Arena, Dejana Popovic
AIMS: Selection of patients who are viable candidates for cardiac resynchronization therapy (CRT), prediction of the response to CRT as well as an optimal definition of a favorable response, all require further exploration. The purpose of this study was to evaluate the interplay between the prediction of the response to CRT and the definition of a favorable outcome. METHODS: Seventy patients who received CRT were included. All patients met current guideline criteria for CRT...
January 11, 2017: Echocardiography
https://www.readbyqxmd.com/read/28073358/applying-openehr-s-guideline-definition-language-to-the-sits-international-stroke-treatment-registry-a-european-retrospective-observational-study
#19
Nadim Anani, Michael V Mazya, Rong Chen, Tiago Prazeres Moreira, Olivier Bill, Niaz Ahmed, Nils Wahlgren, Sabine Koch
BACKGROUND: Interoperability standards intend to standardise health information, clinical practice guidelines intend to standardise care procedures, and patient data registries are vital for monitoring quality of care and for clinical research. This study combines all three: it uses interoperability specifications to model guideline knowledge and applies the result to registry data. METHODS: We applied the openEHR Guideline Definition Language (GDL) to data from 18,400 European patients in the Safe Implementation of Treatments in Stroke (SITS) registry to retrospectively check their compliance with European recommendations for acute stroke treatment...
January 10, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28071808/structure-and-feasibility-of-extra-practice-during-stroke-rehabilitation-a-systematic-scoping-review
#20
REVIEW
Claire Stewart, Annie McCluskey, Louise Ada, Suzanne Kuys
BACKGROUND/AIM: Improved motor performance is related to the amount of practice completed after a stroke. Australian guidelines recommend that at least one hour of active practice should be completed per day. Yet active practice levels remain low. The aims of this scoping review were to describe how extra practice at the activity level is structured for stroke survivors, and explore the feasibility of participants completing extra practice. METHODS: A systematic search was conducted of five electronic databases up to August 2015...
January 10, 2017: Australian Occupational Therapy Journal
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