Intramural hematoma of the esophagus after thrombolysis for ischemic stroke

We report the case of an 88-year-old woman who developed an intramural hematoma of the esophagus after intravenous thrombolysis for an acute ischemic stroke. Before thrombolysis, nasogastric intubation was attempted unsuccessfully. She was kept on nil by mouth, intravenous hydration, proton pump inhibitor, antiemetics, and an antibiotic initiated 2 days before for periodontal disease.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Case report Source Type: research

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CONCLUSIONS: Although CART analysis did not improve the prediction of an early return to hospital after stroke compared with logistic regression models, decision rules generated by CART can easily be interpreted and applied in clinical practice. PMID: 31544716 [PubMed - as supplied by publisher]
Source: Current Neurovascular Research - Category: Neurology Authors: Tags: Curr Neurovasc Res Source Type: research
Conclusion: This study highlights the importance of regular care and patient follow-up. Introduction Status epilepticus (SE) is a condition and most extreme form of epilepsy (1), which leads to abnormal and prolonged seizure (at least 5 min). In case SE persists over 30 min, it may have severe long-term consequences (2). Referring to the new classification scheme of SE, there are two operational dimensions of the definition: time point 1 (T1) is associated with abnormally prolonged seizure, when therapy should be initiated, while time point 2 (T2) is related to the time of on-going seizure activity involving a risk...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Authors: Beghi G, De Tanti A, Serafini P, Bertolino C, Celentano A, Taormina G Abstract Nosocomial or hospital acquired pneumonia (HAP) is an illness contracted during a hospital stay, generally with onset 48 hours or more after admission to hospital, or within 14 days of discharge from hospital. HAP is divided into subgroups: Ventilator-associated pneumonia (VAP), accounting for 86% of hospital acquired pneumonia, and stroke-associated pneumonia (SAP). The incidence of SAP in neurological intensive care units (NICUs) is 4.1-56.6%, in medical intensive care units (MICUs) it is 17-50%, in stroke units it is 3.9-44% ...
Source: Monaldi Archives for Chest Disease - Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research
Patient Presentation A 5-month-old male came to clinic for his health supervision visit and followup from his neonatal intensive care stay. He was born prematurely at 28 weeks gestation and his stay was complicated by a right sided Grade III intraventricular hemorrhage, a left-sided Grade IV intraventricular hemorrhage, neonatal seizures, respiratory distress and bronchopulmonary dysplasia, retinopathy of prematurity, acute kidney injury that had resolved, possible necrotizing enterocolitis incidents x 2, and herpes simplex encephalitis. He was on home oxygen, a nasogastric feeding tube because of aspiration risk and mult...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
ConclusionHigh prevalence and cost of complications associated with stroke highlights the complexity of providing nursing and allied health care to this patient population. This provides a snap shot of dysphagia related complications experienced by stroke patients.This article is protected by copyright. All rights reserved.
Source: Journal of Clinical Nursing - Category: Nursing Authors: Tags: Original Article Source Type: research
Conclusions:In our large cohort of patients with acute stroke and PEG tubes, nearly 9/10 had severe disability at discharge. From discharge to 1 year, there was no difference in mortality between PEG and NG patient cohorts. These results suggest that PEG tubes serve mainly to prolong survival in patients discharged with severe disability. Our study may help support guideline creation and facilitate discussions with patients and families regarding PEG tube placement after acute stroke.Disclosure: Dr. Joundi has nothing to disclose. Dr. Saposnik has nothing to disclose. Dr. Martino has nothing to disclose. Dr. Fang has nothi...
Source: Neurology - Category: Neurology Authors: Tags: Cerebrovascular Disease and Interventional Neurology Poster Discussion Session Source Type: research
Background and Purpose—Stroke guidelines recommend time-limited trials of nasogastric feeding prior to percutaneous endoscopic gastrostomy (PEG) tube placement. We sought to describe timing of PEG placement and identify factors associated with early PEG for acute ischemic stroke.Methods—We designed a retrospective observational study to examine time to PEG for ischemic stroke admissions in the Nationwide Inpatient Sample, 2001 to 2011. We defined early PEG placement as 1 to 7 days from admission. Using multivariable regression analysis, we identified the effects of patient and hospital characteristics on PEG ti...
Source: Stroke - Category: Neurology Authors: Tags: Health Services, Ischemic Stroke Original Contributions Source Type: research
CONCLUSIONS: In a selected population at risk of aspiration, the PHAD with a threshold of 70 assessed in the second week after stroke onset may be a valuable tool to predict prolonged impairment of deglutition for another 4 weeks and to guide the decision about switching from NG to PEG tube feeding after supratentorial ischaemic stroke. PMID: 27684427 [PubMed - as supplied by publisher]
Source: Swiss Medical Weekly - Category: Journals (General) Authors: Tags: Swiss Med Wkly Source Type: research
To identify the predictors of nasogastric tube (NGT) removal.
Source: Archives of Physical Medicine and Rehabilitation - Category: Rehabilitation Authors: Source Type: research
Objective: To measure the extent and timing of physicians' documentation of communication with patients and families regarding limitations on life-sustaining interventions, in a population cohort of adults who died within 30 days after hospitalization for ischemic stroke. Methods: We used the California Office of Statewide Health Planning and Development Patient Discharge Database to identify a retrospective cohort of adults with ischemic strokes at all California acute care hospitals from December 2006 to November 2007. Of 326 eligible hospitals, a representative sample of 39 was selected, stratified by stroke volume and...
Source: Neurology - Category: Neurology Authors: Tags: Outcome research, Quality of life, Infarction, Palliative care ARTICLE Source Type: research
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