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Stroke australia

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https://www.readbyqxmd.com/read/28637036/differentiating-incident-from-recurrent-stroke-using-administrative-data-the-impact-of-varying-lengths-of-look-back-periods-on-the-risk-of-misclassification
#1
John Mark Worthington, Melina Gattellari, Chris Goumas, Bin Jalaludin
BACKGROUND/AIMS: Administrative data are widely used to monitor epidemiological trends in stroke and outcomes; yet there is scant empirical guidance on how to best differentiate incident from recurrent stroke. METHODS: We identified all hospital admissions in New South Wales, Australia, with a principal stroke diagnosis from July 1, 2013 to June 30, 2014, linked to 12 years of previous admissions. We calculated the proportion of cases identified with a prior stroke to determine the number of years of look-back required to minimise misclassification of incident and recurrent strokes...
June 22, 2017: Neuroepidemiology
https://www.readbyqxmd.com/read/28636854/cluster-randomized-crossover-trial-of-head-positioning-in-acute-stroke
#2
Craig S Anderson, Hisatomi Arima, Pablo Lavados, Laurent Billot, Maree L Hackett, Verónica V Olavarría, Paula Muñoz Venturelli, Alejandro Brunser, Bin Peng, Liying Cui, Lily Song, Kris Rogers, Sandy Middleton, Joyce Y Lim, Denise Forshaw, C Elizabeth Lightbody, Mark Woodward, Octavio Pontes-Neto, H Asita De Silva, Ruey-Tay Lin, Tsong-Hai Lee, Jeyaraj D Pandian, Gillian E Mead, Thompson Robinson, Caroline Watkins
BACKGROUND: The role of supine positioning after acute stroke in improving cerebral blood flow and the countervailing risk of aspiration pneumonia have led to variation in head positioning in clinical practice. We wanted to determine whether outcomes in patients with acute ischemic stroke could be improved by positioning the patient to be lying flat (i.e., fully supine with the back horizontal and the face upwards) during treatment to increase cerebral perfusion. METHODS: In a pragmatic, cluster-randomized, crossover trial conducted in nine countries, we assigned 11,093 patients with acute stroke (85% of the strokes were ischemic) to receive care in either a lying-flat position or a sitting-up position with the head elevated to at least 30 degrees, according to the randomization assignment of the hospital to which they were admitted; the designated position was initiated soon after hospital admission and was maintained for 24 hours...
June 22, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28622071/survival-in-out-of-hospital-rapid-sequence-intubation-of-non-traumatic-brain-pathologies
#3
Pieter Francsois Fouche, Paul Andrew Jennings, Karen Smith, Malcolm Boyle, Gabriel Blecher, Jonathan Knott, Mani Raji, Pamela Rosengarten, Michael Roberto Augello, Stephen Bernard
INTRODUCTION: Rapid sequence intubation (RSI) is not only used in traumatic brain injuries in the out-of-hospital setting, but also for non-traumatic brain pathologies (NTBP) such as brain tumors, meningitis, encephalitis, hypoxic/anoxic brain injury, stroke, arteriovenous malformations, tumors, aneurysms, brain hemorrhage, as well as brain injury due to diabetes, seizures and toxicity, metabolic conditions, and alcohol and drug overdose. Previous research suggests that RSI is common in non-traumatic coma, but with an unknown prevalence of NTBP in those that receive RSI...
June 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28576903/the-taking-charge-after-stroke-tacas-study-protocol-a-multicentre-investigator-blinded-randomised-controlled-trial-comparing-the-effect-of-a-single-take-charge-session-two-take-charge-sessions-and-control-intervention-on-health-related-quality-of-life-12-months
#4
Vivian Wai Yin Fu, Mark Weatherall, Harry McNaughton
INTRODUCTION: Stroke is one of the leading causes of disability worldwide. Recent data support the possibility that person-centred, self-management interventions can reduce dependence after stroke. However, there is limited information on the generalisability and optimum dose of these interventions. METHODS: The Taking Charge After Stroke (TaCAS) study is a multicentre, investigator-blinded, randomised controlled trial recruiting 400 participants following acute stroke from seven hospitals in New Zealand...
June 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28557368/a-strategic-framework-improves-access-to-stroke-reperfusion-across-the-state-of-victoria-australia
#5
Janet E Bray, Sonia Denisenko, Bruce C V Campbell, Michael Stephenson, Jason Muller, Grant Hocking Grad, Peter J Hand, Christopher F Bladin
BACKGROUND: In 2010, rapid access to stroke thrombolysis centres was limited in some regional areas in the Australian state of Victoria. These results, and in planning for Endovascular Clot Retrieval (ECR), have led to the implementation of strategies by the Victorian Stroke Clinical Network, the Victorian Stroke Telemedicine Program and local health services to improve state-wide access. AIMS: This study aims to examine whether access to stroke reperfusion services (thrombolysis and ECR) in regional Victoria have subsequently improved...
May 30, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28537208/coding-of-significant-comorbidities-and-complications-for-stroke-in-rehabilitation
#6
Joanne Murray, Rhonda Pfeiffer, Ingrid Scholten
Background Comorbidities and complications of stroke have implications for level of care and hospital resources. It is critical, therefore, that hospital morbidity data accurately reflect the prevalence of these additional diagnoses. Objective This study aimed to measure and describe the concordance between stroke clinicians/researchers and medical record coders when recording stroke and related diagnoses. Method Diagnoses recorded prospectively, according to defined criteria by a clinical research team, were compared with the coding of stroke comorbidities and complications as per the Australian Coding Standards (ACS) from the separations of 100 inpatients from three rehabilitation facilities in South Australia...
January 1, 2017: HIM Journal
https://www.readbyqxmd.com/read/28522987/stroke-incidence-in-victoria-australia-emerging-improvements
#7
Benjamin B Clissold, Vijaya Sundararajan, Peter Cameron, John McNeil
BACKGROUND: Evidence of a decline in the incidence of stroke has emerged from population-based studies. These have included retrospective and prospective cohorts. However, in Australia and other countries, government bodies and stroke foundations predict a rise in the prevalence of stroke that is anticipated to increase the burden of stroke across the entire domain of care. This increase in prevalence must be viewed as different from the decline in incidence being observed, a measure of new stroke cases...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28487456/deriving-literature-based-benchmarks-for-surgical-complications-in-high-income-countries-a-protocol-for-a-systematic-review-and-meta-analysis
#8
Mary E Brindle, Derek J Roberts, Oluwatomilayo Daodu, Alex Bernard Haynes, Christy Cauley, Elijah Dixon, Claude La Flamme, Paul Bain, William Berry
INTRODUCTION: To improve surgical safety, health systems must identify preventable adverse outcomes and measure changes in these outcomes in response to quality improvement initiatives. This requires understanding of the scope and limitations of available population-level data. To derive literature-based summary estimates of benchmarks of care, we will systematically review and meta-analyse rates of postoperative complications associated with several common and/or high-risk operations performed in five high-income countries (HICs)...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28468840/selection-of-patients-for-intra-arterial-treatment-for-acute-ischaemic-stroke-development-and-validation-of-a-clinical-decision-tool-in-two-randomised-trials
#9
RANDOMIZED CONTROLLED TRIAL
Esmee Venema, Maxim J H L Mulder, Bob Roozenbeek, Joseph P Broderick, Sharon D Yeatts, Pooja Khatri, Olvert A Berkhemer, Bart J Emmer, Yvo B W E M Roos, Charles B L M Majoie, Robert J van Oostenbrugge, Wim H van Zwam, Aad van der Lugt, Ewout W Steyerberg, Diederik W J Dippel, Hester F Lingsma
Objective To improve the selection of patients with acute ischaemic stroke for intra-arterial treatment using a clinical decision tool to predict individual treatment benefit.Design Multivariable regression modelling with data from two randomised controlled clinical trials.Setting 16 hospitals in the Netherlands (derivation cohort) and 58 hospitals in the United States, Canada, Australia, and Europe (validation cohort).Participants 500 patients from the Multicenter Randomised Clinical Trial of Endovascular Treatment for Acute Ischaemic Stroke in the Netherlands trial (derivation cohort) and 260 patients with intracranial occlusion from the Interventional Management of Stroke III trial (validation cohort)...
May 3, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28446115/assessing-the-outcome-of-stroke-in-australia
#10
Graeme J Hankey
No abstract text is available yet for this article.
May 1, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28438901/systolic-blood-pressure-and-vascular-disease-in-men-aged-65-years-and-over-the-hims-health-in-men-study
#11
Ben Lacey, Jonathan Golledge, Bu B Yeap, Sarah Lewington, Kieran A McCaul, Paul E Norman, Leon Flicker, Osvaldo P Almeida, Graeme J Hankey
There is uncertainty about the relation between blood pressure and vascular disease at older age. We assessed the association of systolic blood pressure (SBP) and major vascular events in a prospective cohort study of 7564 men aged 65 to 94 years, recruited in 1996-1999 from the general population in Perth, Western Australia. SBP was measured at baseline and again at resurvey in 2001-2004. Participants were monitored for fatal and nonfatal vascular events. To limit the effect of reverse causality, analyses were restricted to men without previous vascular disease at baseline...
June 2017: Hypertension
https://www.readbyqxmd.com/read/28422448/the-benefits-of-clinical-facilitators-on-improving-stroke-care-in-acute-hospitals-a-new-program-for-australia
#12
Tara Purvis, Karen Moss, Linda Francis, Karen Borschmann, Monique F Kilkenny, Sonia Denisenko, Christopher F Bladin, Dominique A Cadilhac
BACKGROUND: Care gaps for stroke lead to preventable disability and deaths. The Victorian State Government implemented a program of employing clinical Facilitators on a fixed-term basis for up to three years (2008-2011) in eight hospitals to improve stroke care. The Facilitators were to establish stroke units where absent, implement evidence-based management protocols and provide staff education within an agreed work plan. The aim of this study was to determine if the Facilitator role was associated with improved stroke care, and to describe factors supporting or mitigating enhancements to care...
April 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28407069/managing-transient-ischaemic-attacks-in-australia-a-qualitative-study
#13
Andrew R Davey, Daniel S Lasserson, Christopher R Levi, Parker J Magin
Background.: Stroke risk after transient ischaemic attack (TIA) is highest in the first few days. It is greatly reduced by commencing commonly used medications. Current Australian guidelines recommend that all TIAs be managed urgently by secondary-care specialists (mandatory for high-risk TIAs). The majority of TIAs present to general practice which creates a dilemma when specialist care is not readily accessible. There is a lack of evidence relating to the determinants of general practitioners' (GPs) actions in this situation...
April 12, 2017: Family Practice
https://www.readbyqxmd.com/read/28389609/mortality-reduction-for-fever-hyperglycemia-and-swallowing-nurse-initiated-stroke-intervention-qasc-trial-quality-in-acute-stroke-care-follow-up
#14
Sandy Middleton, Kelly Coughlan, George Mnatzaganian, Nancy Low Choy, Simeon Dale, Asmara Jammali-Blasi, Chris Levi, Jeremy M Grimshaw, Jeanette Ward, Dominique A Cadilhac, Patrick McElduff, Janet E Hiller, Catherine D'Este
BACKGROUND AND PURPOSE: Implementation of nurse-initiated protocols to manage fever, hyperglycemia, and swallowing dysfunction decreased death and disability 90 days poststroke in the QASC trial (Quality in Acute Stroke Care) conducted in 19 Australian acute stroke units (2005-2010). We now examine long-term all-cause mortality. METHODS: Mortality was ascertained using Australia's National Death Index. Cox proportional hazards regression compared time to death adjusting for correlation within stroke units using the cluster sandwich (Huber-White estimator) method...
April 7, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28356438/googling-service-boundaries-for-endovascular-clot-retrieval-hub-hospitals-in-a-metropolitan-setting-proof-of-concept-study
#15
Thanh G Phan, Richard Beare, Jian Chen, Benjamin Clissold, John Ly, Shaloo Singhal, Henry Ma, Velandai Srikanth
BACKGROUND AND PURPOSE: There is great interest in how endovascular clot retrieval hubs provide services to a population. We applied a computational method to objectively generate service boundaries for such endovascular clot retrieval hubs, defined by traveling time to hub. METHODS: Stroke incidence data merged with population census to estimate numbers of stroke in metropolitan Melbourne, Australia. Traveling time from randomly generated addresses to 4 endovascular clot retrieval-capable hubs (Royal Melbourne Hospital [RMH], Monash Medical Center [MMC], Alfred Hospital [ALF], and Austin Hospital [AUS]) estimated using Google Map application program interface...
March 29, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28350246/frequency-presentation-and-outcome-of-takayasu-arteritis-in-western-australia
#16
Krista Makin, Maxine Isbel, Johannes Nossent
OBJECTIVES: Takayasu arteritis (TAK) is large-vessel vasculitis that predominantly affects young women. There is worldwide variation in the frequency of TAK depending on genetic and/or environmental factors. With Australian data lacking, we describe the epidemiology, clinical features and outcomes of TAK in Western Australia (WA). METHODS: Retrospective case cohort study of incident TAK cases between 1 January 2000 and 30 June 2015 in WA identified from multiple sources...
March 28, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28341580/efficacy-and-safety-of-sildenafil-in-men-with-sexual-dysfunction-and-spinal-cord-injury
#17
REVIEW
Dana A Ohl, Martin Carlsson, Vera J Stecher, Gregory A Rippon
INTRODUCTION: Spinal cord injury (SCI) is estimated to affect approximately 276,000 individuals in the United States. Since 2010, the mean age of individuals at the time of the SCI has been 42 years, with nearly 80% of cases involving men. This means that individuals with SCI generally are young men who typically place a great deal of importance on normal sexual and reproductive function. AIM: To assess the effect of sildenafil treatment on erectile function and the frequency of ejaculation in men with SCI...
March 21, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28320068/thoracic-electrical-bioimpedance-versus-suprasternal-doppler-in-emergency-care
#18
Mohammed H Elwan, Jeremy Hue, Samira J Green, Salah M Eltahan, Mark R Sims, Timothy J Coats
OBJECTIVE: There are a number of cardiac output (CO) monitors that could potentially be used in the ED. Two of the most promising methods, thoracic electrical bioimpedance and suprasternal Doppler, have not been directly compared. The aim of this study was to investigate the feasibility of CO monitoring using suprasternal Doppler and bioimpedance in emergency care and compare haemodynamic data obtained from both monitors. METHODS: Haemodynamic measurements were made on the same group of patients using bioimpedance (Niccomo, Medis, Germany) and suprasternal Doppler (USCOM, Sydney, Australia)...
March 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28302181/hospitals-admitting-at-least-100-patients-with-stroke-a-year-should-have-a-stroke-unit-a-case-study-from-australia
#19
Dominique A Cadilhac, Monique F Kilkenny, Nadine E Andrew, Elizabeth Ritchie, Kelvin Hill, Erin Lalor
BACKGROUND: Establishing a stroke unit (SU) in every hospital may be infeasible because of limited resources. In Australia, it is recommended that hospitals that admit ≥100 strokes per year should have a SU. We aimed to describe differences in processes of care and outcomes among hospitals with and without SUs admitting at least 100 patients/year. METHODS: National stroke audit data of 40 consecutive patients per hospital admitted between 1/7/2010-31/12/2010 and organizational survey for annual admissions were used...
March 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28288937/incidence-of-fatal-snake-bite-in-australia-a-coronial-based-retrospective-study-2000-2016
#20
Ronelle E Welton, Danny Liew, George Braitberg
INTRODUCTION: It has been over 20 years since a national review of recorded deaths from snake envenoming. The present study aimed to provide an updated review of the epidemiology of deaths from snake bites in Australia. METHODS: Deaths were identified from January 2000 to December 2016 from the National Coronial Information System. Cases identified due to snakes were extracted with data on coronial findings, autopsy and police records. RESULTS: Thirty five deaths (2...
June 1, 2017: Toxicon: Official Journal of the International Society on Toxinology
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