Race Differences in Gastrostomy Tube Placement After Stroke in Majority-White, Minority-Serving, and Racially Integrated US Hospitals
AbstractWe sought to determine individual and system contributions to race disparities in percutaneous endoscopic gastrostomy (PEG) tube placement after stroke. Ischemic stroke admissions were identified from the Nationwide Inpatient Sample between 2007 and 2011. Hospitals were categorized based on the percentage of ethnic/racial minority stroke patients ( 50% ethnic/racial minorities [“minority-serving hospitals”]). Logistic regression was used to evaluate the association between ethnicity/race and PEG utilization within and between the different hospital strata. Among 246,825 stroke admissions, patients receiving care in minority-serving hospi tals had higher odds of PEG compared to patients in majority-white hospitals, regardless of individual patient race (adjusted odds ratio [OR] 1.24, 95% CI 1.12–1.38). Ethnic/racial minorities had higher odds of PEG than whites in any hospital strata; however, this discrepancy was largest in majori ty-white hospitals (OR 1.62, 95% CI 1.48–1.76), and smallest in minority-serving hospitals (OR 1.22, 95% CI 1.11–1.33;p for interaction
Peng Gao, Liqiang Gui, Bin Yang, Timo Krings, Liqun Jiao
CONCLUSIONS: Caregivers of people with stroke experience mental disorders and burden negatively affecting their quality of life. Therefore, there is a need to implement strategies which should aim to the management of these problems for the welfare of both patients and their caregivers. PMID: 30315561 [PubMed - in process]
This article addresses ethical concerns pertinent to each phase. First, we discuss ethical issues regarding consent for thrombolysis and endovascular treatment for acute ischemic stroke, including a review of considerations regarding the provision of acute stroke treatment advice over the telephone. Next, we discuss capacity for consent and prognostication after ischemic stroke and intracranial hemorrhage, with a focus on the problems of the self-fulfilling prophecy. Finally, we discuss residual disability and patients' return to driving. Consideration of these ethical dimensions of cerebrovascular disease will assist neur...
DiscussionThis systematic review aims to clarify whether BPV is associated with elevated risk for dementia, cognitive impairment, and cognitive function. An evaluation of the etiological links between BPV with incident dementia might inform evidence-based clinical practice and policy concerning blood pressure measurement and hypertension management. The review will identify sources of heterogeneity and may inform decisions on whether it is feasible and desirable to proceed with an individual participant data meta-analysis.Systematic review registrationPROSPEROCRD42017081977
The migration of peripheral immune cells and splenocytes to the ischemic brain is one of the major causes of delayed neuroinflammation after permanent large vessel stroke. Other groups have demonstrated that l...
This study determines the association between PF4-H Ab and cardiovascular events including coronary artery disease (CAD), ischemic stroke (IS), and native arteriovenous fistula thrombosis (AVFT), in a longitudinal 7-year follow-up.Patients and methods84 hemodialysis patients were enrolled. Data collection included chart reviews and assessments of laboratory records. PF4-H Ab was evaluated by ELISA and a titer ≥ 0.4 was defined to have PF4-H Ab.Results30 patients were PF4-H Ab positive, 30 patients had CAD, 29 patients had IS, and 43 patients had AVFT. In Cox proportional hazard regression analysis, PF4-H ...
CONCLUSIONS: In contemporary practice, women with stable CAD had a poorer control of cardiovascular risk. However, at 5-year follow-up, cardiovascular outcomes were similar for both genders. PMID: 30311758 [PubMed - as supplied by publisher]
ConclusionTreating physicians should be aware of the rare but possible complication of ischemic stroke following a case of wasp sting.
Publication date: November 2018Source: Neuroimaging Clinics of North America, Volume 28, Issue 4Author(s): Lotfi Hacein-Bey, Jeremy J. Heit, Angelos A. Konstas
Publication date: November 2018Source: Neuroimaging Clinics of North America, Volume 28, Issue 4Author(s): Suresh K. Mukherji