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https://www.readbyqxmd.com/read/28522987/stroke-incidence-in-victoria-australia-emerging-improvements
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/28265093/common-coding-variant-in-serpina1-increases-the-risk-for-large-artery-stroke
#15
Rainer Malik, Therese Dau, Maria Gonik, Anirudh Sivakumar, Daniel J Deredge, Evgeniia V Edeleva, Jessica Götzfried, Sander W van der Laan, Gerard Pasterkamp, Nathalie Beaufort, Susana Seixas, Steve Bevan, Lisa F Lincz, Elizabeth G Holliday, Annette I Burgess, Kristiina Rannikmäe, Jens Minnerup, Jennifer Kriebel, Melanie Waldenberger, Martina Müller-Nurasyid, Peter Lichtner, Danish Saleheen, Peter M Rothwell, Christopher Levi, John Attia, Cathie L M Sudlow, Dieter Braun, Hugh S Markus, Patrick L Wintrode, Klaus Berger, Dieter E Jenne, Martin Dichgans
Large artery atherosclerotic stroke (LAS) shows substantial heritability not explained by previous genome-wide association studies. Here, we explore the role of coding variation in LAS by analyzing variants on the HumanExome BeadChip in a total of 3,127 cases and 9,778 controls from Europe, Australia, and South Asia. We report on a nonsynonymous single-nucleotide variant in serpin family A member 1 (SERPINA1) encoding alpha-1 antitrypsin [AAT; p.V213A; P = 5.99E-9, odds ratio (OR) = 1.22] and confirm histone deacetylase 9 (HDAC9) as a major risk gene for LAS with an association in the 3'-UTR (rs2023938; P = 7...
April 4, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28211060/shifting-gears-an-inpatient-medical-record-audit-and-post-discharge-survey-of-return-to-driving-following-stroke-transient-ischaemic-attack
#16
Janet Frith, Helen Warren-Forward, Isobel Hubbard, Carole James
BACKGROUND/AIM: In Australia, all stroke survivors should not drive for four weeks and transient ischaemic attack (TIA) survivors should not drive for two weeks. This study investigates the provision of return-to-driving education in the acute hospital setting and the use of this education by a cohort of Australian patients who have experienced a mild stroke or TIA and who are discharged directly home from their acute hospital admission. METHODS: A medical record audit was conducted of stroke patients discharged home from a regional hospital in Australia...
February 16, 2017: Australian Occupational Therapy Journal
https://www.readbyqxmd.com/read/28198732/intensive-blood-pressure-lowering-in-chronic-kidney-disease-the-time-has-come
#17
Marcel Ruzicka, Swapnil Hiremath
PURPOSE OF REVIEW: Release of the findings from the Systolic Blood Pressure Intervention Trial has resulted in a renewed examination of intensive blood pressure (BP) lowering. Only a few national hypertension guidelines (Canada and Australia) have changed recommendations, but considerable heterogeneity still exists with respect to the patient population to whom intensive BP lowering may apply. RECENT FINDINGS: There is fairly robust evidence that lower BP targets in nondiabetic chronic kidney disease (CKD) results in a decrease in heart failure and mortality...
May 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28177198/the-tasmanian-atrial-fibrillation-study-transition-to-direct-oral-anticoagulants-2011-2015
#18
Endalkachew Admassie Alamneh, Leanne Chalmers, Luke R Bereznicki
INTRODUCTION: Contemporary Australian data regarding antithrombotic prescribing patterns following approval of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) are limited. AIM: The aim of the present study was to assess antithrombotic prescribing patterns before, during and after the clinical introduction of DOACs. METHODS: Using digital medical records, this retrospective cohort study included all patients with AF as a primary or secondary diagnosis who were admitted to the Royal Hobart Hospital, Tasmania, Australia, between January 2011 and July 2015...
February 8, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28150313/improved-outcomes-and-reduced-costs-associated-with-a-health-system-wide-patient-blood-management-program-a-retrospective-observational-study-in-four-major-adult-tertiary-care-hospitals
#19
Michael F Leahy, Axel Hofmann, Simon Towler, Kevin M Trentino, Sally A Burrows, Stuart G Swain, Jeffrey Hamdorf, Trudi Gallagher, Audrey Koay, Gary C Geelhoed, Shannon L Farmer
BACKGROUND: Patient blood management (PBM) programs are associated with improved patient outcomes, reduced transfusions and costs. In 2008, the Western Australia Department of Health initiated a comprehensive health-system-wide PBM program. This study assesses program outcomes. STUDY DESIGN AND METHODS: This was a retrospective study of 605,046 patients admitted to four major adult tertiary-care hospitals between July 2008 and June 2014. Outcome measures were red blood cell (RBC), fresh-frozen plasma (FFP), and platelet units transfused; single-unit RBC transfusions; pretransfusion hemoglobin levels; elective surgery patients anemic at admission; product and activity-based costs of transfusion; in-hospital mortality; length of stay; 28-day all-cause emergency readmissions; and hospital-acquired complications...
February 2, 2017: Transfusion
https://www.readbyqxmd.com/read/28121336/reduction-in-retained-activity-participation-is-associated-with-depressive-symptoms-3-months-after-mild-stroke-an-observational-cohort-study
#20
Tamara Tse, Jacinta Douglas, Primrose Lentin, Thomas Lindén, Leonid Churilov, Henry Ma, Stephen Davis, Geoffrey Donnan, Leeanne M Carey
OBJECTIVE: To quantify the association of depressive symptoms with retained activity participation 3 months post-stroke, after adjusting for neurological stroke severity and age. DESIGN: A cross-sectional observational study of retained activity participation and depressive symptoms in stroke survivors with ischaemic stroke. PARTICIPANTS: One hundred stroke survivors with mild neurological stroke severity. METHODS: One hundred stroke survivors were recruited from 5 metropolitan hospitals and reviewed at 3 months post-stroke using measures of activity participation, Activity Card Sort-Australia, and depressive symptoms, Montgomery-Asberg Depression Rating Scale Structured Interview Guide (MADRS-SIGMA)...
January 31, 2017: Journal of Rehabilitation Medicine
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