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https://www.readbyqxmd.com/read/29195575/twenty-five-year-outcomes-of-the-lateral-tunnel-fontan-procedure
#1
Thomas G Wilson, William Y Shi, Ajay J Iyengar, David S Winlaw, Rachael L Cordina, Gavin R Wheaton, Andrew Bullock, Thomas L Gentles, Robert G Weintraub, Robert N Justo, Leeanne E Grigg, Dorothy J Radford, Yves d'Udekem
The objective of this study was to characterize late outcomes of the lateral tunnel (LT) Fontan procedure. The outcomes of all patients who underwent an LT Fontan procedure in Australia and in New Zealand were analyzed. Original files were reviewed and outcomes data were obtained through a binational registry. Between 1980 and 2014, a total of 301 patients underwent an LT Fontan procedure across 6 major centers. There were 13 hospital mortalities, 21 late deaths, 8 Fontan conversions and revisions, 8 Fontan takedowns, and 4 heart transplantations...
2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29180456/body-mass-index-and-vascular-disease-in-men-aged-65%C3%A2-years-and-over-hims-health-in-men-study
#2
Ben Lacey, Bu B Yeap, Jonathan Golledge, Sarah Lewington, Kieran A McCaul, Paul E Norman, Leon Flicker, Osvaldo P Almeida, Graeme J Hankey
BACKGROUND: Understanding the relationship between body mass index (BMI) and vascular disease at older age has become increasingly important in the many countries where both average age and BMI are rising. METHODS AND RESULTS: In this prospective cohort study, 12 203 men (aged ≥65) were recruited in 1996-1999 from the general population in Perth, Australia. To limit reverse causality, analyses excluded those with past vascular disease and the first 4 years of follow-up...
November 27, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29157233/integrating-acute-stroke-telemedicine-consultations-into-specialists-usual-practice-a-qualitative-analysis-comparing-the-experience-of-australia-and-the-united-kingdom
#3
Kathleen L Bagot, Dominique A Cadilhac, Christopher F Bladin, Caroline L Watkins, Michelle Vu, Geoffrey A Donnan, Helen M Dewey, Hedley C A Emsley, D Paul Davies, Elaine Day, Gary A Ford, Christopher I Price, Carl R May, Alison S R McLoughlin, Josephine M E Gibson, Catherine E Lightbody
BACKGROUND: Stroke telemedicine can reduce healthcare inequities by increasing access to specialists. Successful telemedicine networks require specialists adapting clinical practice to provide remote consultations. Variation in experiences of specialists between different countries is unknown. To support future implementation, we compared perceptions of Australian and United Kingdom specialists providing remote acute stroke consultations. METHODS: Specialist participants were identified using purposive sampling from two new services: Australia's Victorian Stroke Telemedicine Program (n = 6; 2010-13) and the United Kingdom's Cumbria and Lancashire telestroke network (n = 5; 2010-2012)...
November 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29143435/risk-factors-for-falls-among-older-aboriginal-and-torres-strait-islander-people-in-urban-and-regional-communities
#4
Caroline Lukaszyk, Kylie Radford, Kim Delbaere, Rebecca Ivers, Kris Rogers, Catherine Sherrington, Anne Tiedemann, Julieann Coombes, Gail Daylight, Brian Draper, Tony Broe
OBJECTIVE: To examine associations between fall risk factors identified previously in other populations and falls among Aboriginal people aged 60 years and older, living in New South Wales, Australia. METHODS: Interviews were conducted with older Aboriginal people in five urban and regional communities. Associations between past falls and 22 fall predictor variables were examined using linear and multiple regression analyses. RESULTS: Of the 336 participants, 80 people (24%) reported at least one fall in the past year, and 34 (10%) reported two or more falls...
November 15, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29136634/treatment-and-outcomes-of-working-aged-adults-with-stroke-results-from-a-national-prospective-registry
#5
Natasha A Lannin, Craig S Anderson, Joosup Kim, Monique Kilkenny, Julie Bernhardt, Christopher Levi, Helen M Dewey, Christopher Bladin, Peter Hand, Helen Castley, Kelvin Hill, Steven Faux, Rohan Grimley, Brenda Grabsch, Sandy Middleton, Geoffrey Donnan, Dominique A Cadilhac
BACKGROUND: Given the potential differences in etiology and impact, the treatment and outcome of younger patients (aged 18-64 years) require examination separately to older adults (aged ≥65 years) who experience acute stroke. METHODS: Data from the Australian Stroke Clinical Registry (2010-2015) including demographic and clinical characteristics, provision of evidence-based therapies and health-related quality of life (HRQoL) post-stroke was used. Descriptive statistics and multilevel regression models were used for group comparisons...
November 14, 2017: Neuroepidemiology
https://www.readbyqxmd.com/read/29134926/influence-of-stroke-coordinators-on-delivery-of-acute-stroke-care-and-hospital-outcomes-an-observational-study
#6
Tara Purvis, Monique F Kilkenny, Sandy Middleton, Dominique A Cadilhac
Background Stroke coordinators have been inconsistently used in various countries to support stroke care in hospital. Aim To investigate the association between stroke coordinators and the provision of evidence-based care and patient outcomes in hospitals with acute stroke units. Methods Observational study using cross-sectional data from the 2015 National Acute Services Audit Program (Australia): including a retrospective medical record audit (40 records from each hospital) and a self-reported survey of organizational resources for stroke...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29130973/frequency-aetiology-and-outcome-of-small-cerebellar-infarction
#7
Zeljka Calic, Cecilia Cappelen-Smith, Ramesh Cuganesan, Craig S Anderson, Miriam Welgampola, Dennis J Cordato
BACKGROUND AND PURPOSE: Strokes due to small (<2 cm) cerebellar infarction are under-recognised, and their profile and aetiology have not been well characterised. We aimed to determine the frequency, clinical features, aetiology, and outcome of small as compared to large cerebellar infarction. METHODS: This study is a retrospective analysis of clinical and imaging features of a prospectively assessed series of 108 consecutive patients with acute cerebellar infarction admitted to Liverpool Hospital, Sydney, NSW, Australia, during 2011-2015...
November 2, 2017: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/29111960/the-aspirin-in-reducing-events-in-the-elderly-trial-statistical-analysis-plan
#8
Rory Wolfe, Anne M Murray, Robyn L Woods, Brenda Kirpach, David Gilbertson, Raj C Shah, Mark R Nelson, Christopher M Reid, Michael E Ernst, Jessica Lockery, Geoffrey A Donnan, Jeff Williamson, John J McNeil
Rationale Aspirin has positive and negative effects on a number of age-related chronic conditions and there is uncertainty regarding its role in primary prevention in people aged 70 years and over. Aims To assess whether daily active treatment of 100 mg enteric-coated aspirin will extend the duration of disability-free life in healthy older participants. Design A double-blind, randomized, placebo-controlled primary prevention trial undertaken in Australia and the United States with careful adjudication of endpoints including stroke...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29106523/combining-watchman-left-atrial-appendage-closure-and-catheter-ablation-for-atrial-fibrillation-multicentre-registry-results-of-feasibility-and-safety-during-implant-and-30-days-follow-up
#9
Karen P Phillips, Evgeny Pokushalov, Aleksandr Romanov, Sergey Artemenko, Richard J Folkeringa, Tamas Szili-Torok, Gaetano Senatore, Kenneth M Stein, Omar Razali, Nicole Gordon, Lucas V A Boersma
Aims: Long-term results from catheter ablation therapy for atrial fibrillation (AF) remain uncertain and clinical practice guidelines recommend continuation of long-term oral anticoagulation in patients with a high stroke risk. Left atrial appendage closure (LAAC) with Watchman has emerged as an alternative to long-term anticoagulation for patients accepting of the procedural risks. We report on the initial results of combining catheter ablation procedures for AF and LAAC in a multicentre registry...
July 3, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29102689/early-experience-with-new-transcatheter-mitral-valve-replacement
#10
Vinayak Bapat, Vivek Rajagopal, Christopher Meduri, R Saeid Farivar, Antony Walton, Stephen J Duffy, Robert Gooley, Aubrey Almeida, Michael J Reardon, Neal S Kleiman, Konstantinos Spargias, Stratis Pattakos, Martin K Ng, Michael Wilson, David H Adams, Martin Leon, Michael J Mack, Sharla Chenoweth, Paul Sorajja
BACKGROUND: Transcatheter mitral valve replacement (TMVR) is a potential therapy for patients with symptomatic, severe mitral regurgitation (MR). The feasibility of this therapy remains to be defined. OBJECTIVE: We report our early experience with TMVR using a new valve system. METHODS: The valve is a self-expanding, nitinol valve with bovine pericardial leaflets that is placed using a transapical delivery system. Patients with symptomatic MR who were deemed high or extreme risk by the local heart teams were enrolled in a global pilot study at 14 sites (U...
October 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28994623/exploring-functional-outcomes-and-allied-health-staffing-levels-in-an-inpatient-paediatric-rehabilitation-unit
#11
Penelope J Ireland, Amanda Francis, Shani Jackman, Kim McLennan
PURPOSE: This study provides data from a paediatric tertiary hospital on the length of stay, functional improvement and allied health workload for children and adolescents on active inpatient rehabilitation programs. METHODS: An audit was conducted of records of patients managed through an inpatient rehabilitation program at a 359 bed tertiary children's hospital in Brisbane, Australia between December 2014 and December 2015. Data relating to diagnosis, length of stay, functional change, occasions of allied health service and hours of patient attributable allied health professional time were collected...
October 10, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28982808/cost-effectiveness-of-stroke-care-in-aboriginal-and-non-aboriginal-patients-an-observational-cohort-study-in-the-northern-territory-of-australia
#12
Yuejen Zhao, Steven Guthridge, Henrik Falhammar, Howard Flavell, Dominique A Cadilhac
OBJECTIVE: To assess cost-effectiveness of stroke care for Aboriginal compared with non-Aboriginal patients in the Northern Territory (NT), Australia. DESIGN: Cost-effectiveness analysis using data from a cohort-based follow-up study of stroke incidents. SETTING: Public hospitals in the NT from 1992 to 2013. PARTICIPANTS: Individual patient data were extracted and linked from the hospital inpatient and primary care information systems...
October 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28967376/a-very-early-rehabilitation-trial-after-stroke-avert-a-phase-iii-multicentre-randomised-controlled-trial
#13
Peter Langhorne, Olivia Wu, Helen Rodgers, Ann Ashburn, Julie Bernhardt
BACKGROUND: Mobilising patients early after stroke [early mobilisation (EM)] is thought to contribute to the beneficial effects of stroke unit care but it is poorly defined and lacks direct evidence of benefit. OBJECTIVES: We assessed the effectiveness of frequent higher dose very early mobilisation (VEM) after stroke. DESIGN: We conducted a parallel-group, single-blind, prospective randomised controlled trial with blinded end-point assessment using a web-based computer-generated stratified randomisation...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28951392/insights-into-variations-in-preferred-selection-criteria-for-acute-stroke-endovascular-therapy
#14
Feng Wang, Bruce C V Campbell, Leonid Churilov, Peter Mitchell, Richard Dowling, Ziyuan Chen, Stephen M Davis, Bernard Yan
BACKGROUND: Endovascular thrombectomy (ET) is safe, effective, and cost-effective for large artery occlusion ischemic stroke, even if under different selection criteria. PURPOSE: To study the preferences for ET selection criteria by surveying clinicians and consumers, where number needed to treat to achieve functional independence is the only factor being considered. METHODS: A survey providing visual representation of the proportion of patients treated and expected functional outcomes, based on the selection criteria in each of the recent randomized trials of ET, was distributed nationwide in Australia and New Zealand to clinicians and consumers...
September 26, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28946831/the-potential-health-and-economic-impact-of-improving-stroke-care-standards-for-australia
#15
Joosup Kim, Nadine E Andrew, Amanda G Thrift, Julie Bernhardt, Richard I Lindley, Dominique A Cadilhac
Background Evidence of the burden of suboptimal stroke care should expedite quality improvement. We aimed to estimate the health and economic impact of improving acute stroke management to best practice standards using Australia as a case study. Methods Hospital performance in Australia was estimated using data from the National Stroke Audit of Acute Services 2013. The percentage of patients provided evidence-based therapies in all hospitals was compared to that achieved in the aggregate of top performing benchmark hospitals (that included between them, a minimum contribution of 15% of all cases audited)...
October 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28939954/bleeding-related-admissions-in-patients-with-atrial-fibrillation-receiving-antithrombotic-therapy-results-from-the-tasmanian-atrial-fibrillation-taf-study
#16
Endalkachew Admassie, Leanne Chalmers, Luke R Bereznicki
PURPOSE: Limited data are available from the Australian setting regarding bleeding in patients with atrial fibrillation (AF) receiving antithrombotic therapy. We aimed to investigate the incidence of hospital admissions due to bleeding and factors associated with bleeding in patients with AF who received antithrombotic therapy. METHODS: A retrospective cohort study was conducted involving all patients with AF admitted to the Royal Hobart Hospital, Tasmania, Australia, between January 2011 and July 2015...
December 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28925418/mhealth-application-areas-and-technology-combinations-a-comparison-of-literature-from-high-and-low-middle-income-countries
#17
Haitham Abaza, Michael Marschollek
BACKGROUND: With the continuous and enormous spread of mobile technologies, mHealth has evolved as a new subfield of eHealth. While eHealth is broadly focused on information and communication technologies, mHealth seeks to explore more into mobile devices and wireless communication. Since mobile phone penetration has exceeded other infrastructure in low and middle-income countries (LMICs), mHealth is seen as a promising component to provide pervasive and patient-centered care. OBJECTIVES: The aim of our research work for this paper is to examine the mHealth literature to identify application areas, target diseases, and mHealth service and technology types that are most appropriate for LMICs...
August 8, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28914187/improving-quality-and-outcomes-of-stroke-care-in-hospitals-protocol-and-statistical-analysis-plan-for-the-stroke123-implementation-study
#18
Dominique A Cadilhac, Nadine E Andrew, Monique F Kilkenny, Kelvin Hill, Brenda Grabsch, Natasha A Lannin, Amanda G Thrift, Craig S Anderson, Geoffrey A Donnan, Sandy Middleton, Rohan Grimley
Rationale The effectiveness of clinician-focused interventions to improve stroke care is uncertain. Aims To determine whether an organizational intervention can improve the quality of stroke care over usual care. Sample size estimates To detect an absolute 10% difference in overall performance (composite outcome), a minimum of 21 hospitals and 843 patients per group was determined. Methods and design Before and after controlled design in hospitals in Queensland, Australia. Intervention Externally facilitated program (StrokeLink) using outreach workshops incorporating clinical performance feedback, patient outcomes (survival, quality of life at 90-180 days), local barrier assessments to best practice care, action planning, and ongoing support...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28892278/reflection-on-stroke-deaths-and-end-of-life-stroke-care
#19
Syed Zujajuddin Quadri, Thang Huynh, Cecilia Cappelen-Smith, Nirupama Wijesuriya, Abul Mamun, Roy Beran, Alan Mcdougall, Dennis Cordato
BACKGROUND: The benefit of palliative care referral for severe stroke patients on end-of-life care pathways (EOLCP) is increasingly recognised. Palliative care provides assistance with symptom management and transition to end-of-life care. Advance care planning (ACP) may help accommodate patient/family expectations and guide management. METHOD: Retrospective study of all stroke deaths (2014-2015) at Liverpool Hospital, Sydney, Australia. Data examined included age, co-morbidities, living arrangements, pre-existing ACP, palliative care referral rates and 'survival time'...
September 11, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28872449/the-pre-hospital-stroke-treatment-organization
#20
Heinrich Audebert, Klaus Fassbender, M Shazam Hussain, Martin Ebinger, Guillaume Turc, Ken Uchino, Stephen Davis, Anne Alexandrov, James Grotta
Background The PRE-hospital Stroke Treatment Organization was formed in 2016 as an international consortium of medical practitioners involved in pre-hospital treatment of patients with acute stroke. Aims PRE-hospital Stroke Treatment Organization's mission is to improve stroke outcomes by supporting research and advocacy for pre-hospital stroke treatment in Mobile Stroke Units. PRE-hospital Stroke Treatment Organization will provide a platform to enhance collaborative research across the spectrum of acute stroke management in the pre-hospital setting...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
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