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https://www.readbyqxmd.com/read/28822254/a-systematic-review-of-hypertension-outcomes-and-treatment-strategies-in-older-adults
#1
REVIEW
Julienne K Kirk, Julie Allsbrook, Maggie Hansell, Emily M Mann
OBJECTIVE: To evaluate the literature regarding blood pressure control and management in older adult patient population over 70 years of age. METHODS: A literature search was conducted using PubMed and capturing the data from 2006 to 2016. Terms used included MeSH headings for hypertension/therapy and antihypertension agents. A systematic review of published studies was performed. Articles including older patients (average age 70 years or older) being treated for hypertension were included...
July 25, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28809039/juvenile-melanomas-western-australian-melanoma-advisory-service-experience
#2
Jie Xin Xu, Sharnice Koek, Samantha Lee, Mark Hanikeri, Mark Lee, Trevor Beer, Christobel Saunders
BACKGROUND/OBJECTIVES: Juvenile melanoma (before 20 years of age) is a rare condition with poorly defined risk factors. We describe features of juvenile melanoma in Western Australia over the last two decades. METHOD: A retrospective review of juvenile melanomas was conducted from prospectively maintained databases, reviewed for patients' characteristics, clinical information, histology, treatment, recurrence and survival data. RESULTS: Altogether 95 cases of juvenile melanoma were reported to the Western Australian Cancer Registry between 2000 and 2013...
August 15, 2017: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/28808795/cerebral-venous-thrombosis-continental-disparities
#3
Laith Maali, Sheema Khan, Fares Qeadan, Mahmoud Ismail, Davana Ramaswamy, Vishnumurthy S Hedna
Cerebral venous thrombosis (CVT) usually accounts for < 1% of all strokes. Global disparity and diversity in their demographics, etiology, clinical features, radiological presentation, and mortality have not been previously explored. A systematic search was performed for publications in PubMed using key words "cerebral venous thrombosis," "Cerebral vein thrombosis," and "Cortical vein Thrombosis." A total of 600 relevant studies were abstracted with strict selection criteria, and a total of 7048 patient's data were used for the final analysis...
August 14, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28781025/changes-in-oral-anticoagulant-prescribing-for-stroke-prevention-in-patients-with-atrial-fibrillation
#4
Endalkachew Admassie, Leanne Chalmers, Luke R Bereznicki
Suboptimal guideline adherence and underuse of anticoagulants in patients with atrial fibrillation (AF) have been reported worldwide. This study aimed to compare anticoagulation practice in Australia during the pre- and postdirect oral anticoagulant (DOAC) eras. Between January 2011 and July 2015, patients with nonvalvular AF (NVAF) admitted to the Royal Hobart Hospital, Tasmania, Australia, were retrospectively reviewed. The pre- and post-DOAC era cohorts included admissions from January 2011 to July 2013 and August 2013 to July 2015, respectively...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28780550/improving-discharge-care-the-potential-of-a-new-organisational-intervention-to-improve-discharge-after-hospitalisation-for-acute-stroke-a-controlled-before-after-pilot-study
#5
Dominique A Cadilhac, Nadine E Andrew, Enna Stroil Salama, Kelvin Hill, Sandy Middleton, Eleanor Horton, Ian Meade, Sarah Kuhle, Mark R Nelson, Rohan Grimley
OBJECTIVE: Provision of a discharge care plan and prevention therapies is often suboptimal. Our objective was to design and pilot test an interdisciplinary, organisational intervention to improve discharge care using stroke as the case study using a mixed-methods, controlled before-after observational study design. SETTING: Acute care public hospitals in Queensland, Australia (n=15). The 15 hospitals were ranked against a benchmark based on a composite outcome of three discharge care processes...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28756617/antioxidant-vitamin-and-mineral-supplements-for-preventing-age-related-macular-degeneration
#6
REVIEW
Jennifer R Evans, John G Lawrenson
BACKGROUND: There is inconclusive evidence from observational studies to suggest that people who eat a diet rich in antioxidant vitamins (carotenoids, vitamins C, and E) or minerals (selenium and zinc) may be less likely to develop age-related macular degeneration (AMD). OBJECTIVES: To determine whether or not taking antioxidant vitamin or mineral supplements, or both, prevent the development of AMD. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 2), MEDLINE Ovid (1946 to 29 March 2017), Embase Ovid (1947 to 29 March 2017), AMED (Allied and Complementary Medicine Database) (1985 to 29 March 2017), OpenGrey (System for Information on Grey Literature in Europe) (www...
July 30, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28752255/the-representativeness-of-direct-oral-anticoagulant-clinical-trials-to-hospitalized-patients-with-atrial-fibrillation
#7
Laura Fanning, Jenni Ilomäki, J Simon Bell, Pēteris Dārziņš
PURPOSE: Trials of the direct oral anticoagulants (DOACs) dabigatran, rivaroxaban and apixaban provide the basis for prescribing for the prevention of stroke and systemic embolism in atrial fibrillation (AF). The objective of this study was to assess the representativeness of the three pivotal DOAC randomized controlled trials of dabigatran, rivaroxaban and apixaban for unselected hospitalized patients with AF. METHODS: A cross-sectional study was undertaken. All patients discharged with AF between 2012 and 2015 from a large public hospital network in Melbourne, Australia, were identified...
July 27, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28719977/the-efficacy-of-interactive-motion-capture-based-rehabilitation-on-functional-outcomes-in-an-inpatient-stroke-population-a-randomized-controlled-trial
#8
John Cannell, Emelyn Jovic, Amy Rathjen, Kylie Lane, Anna M Tyson, Michele L Callisaya, Stuart T Smith, Kiran Dk Ahuja, Marie-Louise Bird
OBJECTIVE: To compare the efficacy of novel interactive, motion capture-rehabilitation software to usual care stroke rehabilitation on physical function. DESIGN: Randomized controlled clinical trial. SETTING: Two subacute hospital rehabilitation units in Australia. PARTICIPANTS: In all, 73 people less than six months after stroke with reduced mobility and clinician determined capacity to improve. INTERVENTIONS: Both groups received functional retraining and individualized programs for up to an hour, on weekdays for 8-40 sessions (dose matched)...
July 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28666682/family-led-rehabilitation-after-stroke-in-india-attend-a-randomised-controlled-trial
#9
(no author information available yet)
BACKGROUND: Most people with stroke in India have no access to organised rehabilitation services. The effectiveness of training family members to provide stroke rehabilitation is uncertain. Our primary objective was to determine whether family-led stroke rehabilitation, initiated in hospital and continued at home, would be superior to usual care in a low-resource setting. METHODS: The Family-led Rehabilitation after Stroke in India (ATTEND) trial was a prospectively randomised open trial with blinded endpoint done across 14 hospitals in India...
June 27, 2017: Lancet
https://www.readbyqxmd.com/read/28652029/dealing-with-the-left-atrial-appendage-for-stroke-prevention-devices-and-decision-making
#10
REVIEW
Karen P Phillips, Vince Paul
Left atrial appendage (LAA) device occlusion represents a major evolution in stroke prevention for atrial fibrillation (AF). Left atrial appendage device occlusion is now a proven strategy which provides long-term thromboembolic stroke prevention for patients with non-rheumatic AF. Evidence supports its benefit as an alternative to long-term anticoagulation while mitigating long-term bleeding risks and improving cardiovascular mortality. The therapy offers expanded options to physicians and patients negotiating stroke prevention (both primary and secondary prevention), but a good understanding of the risks and benefits is required for decision-making...
May 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28639436/a-high-hasbled-score-identifies-poor-warfarin-control-in-patients-treated-for-non-valvular-atrial-fibrillation-in-australia-and-singapore
#11
Nijole Bernaitis, Chi Keong Ching, Liping Chen, Jin Shing Hon, Siew Chong Teo, Tony Badrick, Andrew K Davey, Shailendra Anoopkumar-Dukie
Warfarin reduces stroke risk in atrial fibrillation (AF) patients. The quality of warfarin control, measured by time in therapeutic range (TTR), impacts outcome and adverse events. One tool evaluating risk of adverse events and potential warfarin control would simplify risk-benefit assessment of warfarin. Recently, HASBLED was demonstrated effective for this purpose, but this was in well-controlled patients with deep vein thrombosis. HASBLED as a predictor of warfarin control has not been validated in other populations including differing indications, warfarin control levels and ethnicities...
June 21, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28639262/interprofessional-collaboration-to-improve-professional-practice-and-healthcare-outcomes
#12
REVIEW
Scott Reeves, Ferruccio Pelone, Reema Harrison, Joanne Goldman, Merrick Zwarenstein
BACKGROUND: Poor interprofessional collaboration (IPC) can adversely affect the delivery of health services and patient care. Interventions that address IPC problems have the potential to improve professional practice and healthcare outcomes. OBJECTIVES: To assess the impact of practice-based interventions designed to improve interprofessional collaboration (IPC) amongst health and social care professionals, compared to usual care or to an alternative intervention, on at least one of the following primary outcomes: patient health outcomes, clinical process or efficiency outcomes or secondary outcomes (collaborative behaviour)...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28638365/motor-impairments-in-transient-ischemic-attack-increase-the-odds-of-a-subsequent-stroke-a-meta-analysis
#13
Neha Lodha, Jane Harrell, Stephan Eisenschenk, Evangelos A Christou
BACKGROUND AND PURPOSE: Transient ischemic attack (TIA) increases the risk for a subsequent stroke. Typical symptoms include motor weakness, gait disturbance, and loss of coordination. The association between the presence of motor impairments during a TIA and the chances of a subsequent stroke has not been examined. In the current meta-analysis, we examine whether the odds of a stroke are greater in TIA individuals who experience motor impairments as compared with those who do not experience motor impairments...
2017: Frontiers in Neurology
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
#14
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
#15
RANDOMIZED CONTROLLED TRIAL
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
#16
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
#17
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/strategic-framework-improves-access-to-stroke-reperfusion-across-the-state-of-victoria-australia
#18
Janet E Bray, Sonia Denisenko, Bruce C V Campbell, Michael Stephenson, Jason Muller, Grant Hocking, 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 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: To examine whether access to stroke reperfusion services (thrombolysis and ECR) in regional Victoria have subsequently improved...
August 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28537208/coding-of-significant-comorbidities-and-complications-for-stroke-in-rehabilitation
#19
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
#20
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
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