Hospital Quality Metrics: “America's Best Hospitals” and Outcomes After Ischemic Stroke

Background: Developing quality metrics to assess hospital-level care and outcomes is increasingly popular in the United States. The U.S. News&World Report ranking of “America's Best Hospitals” is an existing, popular hospital-profiling system, but it is unknown whether top-ranked hospitals in their report have better outcomes according to other hospital quality metrics such as the Centers for Medicare and Medicaid Services (CMS) publicly reported 30-day stro ke measures. Methods: The analysis was based on the 2015-2016 U.S.
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research

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Abdelali Agouni, Aijaz S. Parray, Naveed Akhtar, Fayaz A. Mir, Paula J. Bourke, Sujata Joseph, Deborah M. Morgan, Mark D. Santos, Muhammad F. Wadiwala, Saadat Kamran, Siveen K. Sivaraman, Ashfaq Shuaib
Source: Frontiers in Neurology - Category: Neurology Source Type: research
ConclusionsData from this meta-analysis suggest that, vs warfarin, the stroke prevention effectiveness and bleeding risk of direct oral anticoagulants may differ in real-life patients with atrial fibrillation.ResumenIntroducción y objetivosDeterminar la efectividad de los anticoagulantes orales directos frente a los antagonistas de la vitamina K en pacientes con fibrilación auricular de la práctica clínica.MétodosSe realizó una revisión sistemática acorde con los estándares metodológicos de Cochrane. Los resultados de la revisión se publicaro...
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research
Ischemic stroke is a predominant cause of disability worldwide, with thrombolytic or mechanical removal of the occlusion being the only therapeutic option. Reperfusion bears the risk of an acute deleterious calcium-dependent breakdown of the blood-brain barrier. Its mechanism, however, is unknown. Here, we identified type 5 NADPH oxidase (NOX5), a calcium-activated, ROS-forming enzyme, as the missing link. Using a humanized knockin (KI) mouse model and in vitro organotypic cultures, we found that reoxygenation or calcium overload increased brain ROS levels in a NOX5-dependent manner. In vivo, postischemic ROS formation, in...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
CD3+CD4−CD8− T cells (double-negative T cells; DNTs) have diverse functions in peripheral immune-related diseases by regulating immunological and inflammatory homeostasis. However, the functions of DNTs in the central nervous system remain unknown. Here, we found that the levels of DNTs were dramatically increased in both the brain and peripheral blood...
Source: Proceedings of the National Academy of Sciences - Category: Science Authors: Tags: Biological Sciences Source Type: research
Radiology, Ahead of Print.
Source: Radiology - Category: Radiology Authors: Source Type: research
Authors: Teufel J, Strupp M, Linn J, Kalla R, Feil K Abstract BACKGROUND AND PURPOSE: The initial diagnosis of medullary infarction can be challenging since CT and even MRI results in the very acute phase are often negative. METHODS: A retrospective, observer-blinded study of horizontal conjugate eye deviation was performed in 1) 50 consecutive patients [age 58±15 years (mean±SD), 74% male, National Institutes of Health Stroke Scale 2±1] with acute unilateral lateral medullary infarction as seen in MRI (infarction group), 2) 54 patients with transient brainstem symptoms [transient ischemic ...
Source: Journal of Clinical Neurology - Category: Neurology Tags: J Clin Neurol Source Type: research
CONCLUSIONS: Notwithstanding the small number of subjects in this study, providing EVT to eligible patients beyond 6 hours may improve their neurological outcomes. PMID: 30877694 [PubMed - as supplied by publisher]
Source: Journal of Clinical Neurology - Category: Neurology Tags: J Clin Neurol Source Type: research
This study included 1,205 consecutive noncardioembolic ischemic stroke patients as confirmed by brain MRI and simultaneously measured the bilateral brachial blood pressures. We investigated cerebral SVDs based on high-grade white-matter hyperintensities (HWHs), presence of cerebral microbleeds (CMBs), high-grade perivascular spaces (HPVSs), and asymptomatic lacunar infarctions (ALIs) on brain MRI. RESULTS: In multivariate logistic regression, an interarm systolic blood pressure difference (IASBD) ≥10 mm Hg was independently related to the existence of HWHs [odds ratio (OR)=1.94, 95% CI=1.32-2.84, p=0.011] and had a ...
Source: Journal of Clinical Neurology - Category: Neurology Tags: J Clin Neurol Source Type: research
ConclusionThis study suggested that MTR andMTHFRpolymorphisms may contribute to increase the risk of GC.
Source: Molecular Genetics & Genomic Medicine - Category: Genetics & Stem Cells Authors: Tags: ORIGINAL ARTICLE Source Type: research
AbstractMalnutrition predisposes to poor stroke outcome. In animal models, undernutrition protected against ischemic injury in some, but not in other studies. In view of diverse stroke models and food restriction paradigms, the consequences of undernutrition are poorly understood. Herein, we exposed mice to energy-reduced and protein-energy-reduced diets for 7 –30 days and subsequently induced intraluminal middle cerebral artery occlusion. Undernutrition phase dependently influenced ischemic injury. Short-lasting 7 days of protein-energy undernutrition, but not energy undernutrition, decreased post-ischemic...
Source: Translational Stroke Research - Category: Neurology Source Type: research
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