Clinical Practice Variation Needs to be Considered in Cost-Effectiveness Analyses: A Case Study of Patients with a Recent Transient Ischemic Attack or Minor Ischemic Stroke

Conclusions If important practice variation exists, hospital-level CEAs should be performed. These CEAs should include an assessment of the feasibility and costs of switching to a different strategy.
Source: Applied Health Economics and Health Policy - Category: Health Management Source Type: research

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Mil Med. 2022 Jan 22:usab564. doi: 10.1093/milmed/usab564. Online ahead of print.ABSTRACTMoyamoya is a rare and progressive cerebrovascular disease involving collateral small vessel formation associated with intracranial artery narrowing. It is a disease that frequently presents with stroke and transient ischemic attacks and has potential to affect our active duty service members and their families with its bimodal age of onset of 10 and 40. This case report describes a soldier with moyamoya whose diagnosis was unrecognized for over a year after seeing multiple medical providers regarding his symptoms. The goal of this cas...
Source: Military Medicine - Category: International Medicine & Public Health Authors: Source Type: research
Stud Health Technol Inform. 2022 Jan 14;289:439-442. doi: 10.3233/SHTI210952.ABSTRACTThe aim of this study was to calculate the average operational cost per sub-type of stroke patient and to investigate cost drivers (e.g. ALoS, NIHSS score, age) correlated to cost.METHODS: Direct medical costs (diagnostic imaging and clinical laboratory exams, overheads/bed cost, pharmaceuticals, ringers and other non-durables and inpatient rehabilitation) per patient were calculated from the providers' (hospitals') perspective. Resource use data derived from the "SUN4P" web-based registry and unit costs were retrieved from publi...
Source: Studies in Health Technology and Informatics - Category: Information Technology Authors: Source Type: research
CONCLUSIONS: These data are in accordance with current evidence and should be thoroughly assessed in order to ensure optimal therapeutic management of stroke patients.PMID:35062158 | DOI:10.3233/SHTI210925
Source: Studies in Health Technology and Informatics - Category: Information Technology Authors: Source Type: research
AbstractFluid-attenuated inversion recovery vascular hyperintensity (FVH) is frequently observed in patients with acute ischemic stroke (AIS). FVH is associated with functional outcome at 3  months in AIS patients receiving endovascular thrombectomy. In the present study, we assessed whether FVH predicted early neurological deterioration (END) and hemorrhagic transformation (HT) within 72 h in AIS patients receiving endovascular thrombectomy. We retrospectively analyzed 104 patients with acute internal-carotid-artery or proximal middle-cerebral-artery occlusion within 16 h after symptom onset. Before thrombe...
Source: Neurological Sciences - Category: Neurology Source Type: research
ConclusionsPatients with stroke and COVID-19 had higher mortality compared to patients without COVID-19. Among patients with COVID-19 those with out-of-hospital stroke had better outcome and fewer blood test abnormalities compared to patients with in-hospital stroke.
Source: Neurological Sciences - Category: Neurology Source Type: research
This study is a retrospective database review of all telestroke requests at one academic vascular neurology center telestroke network with seven remote sites in the USA between March 15 and April 30, 2020. Data were compared with historical cohort spanning same time frame in 2019 using parametric or nonparametric methods as appropriate. Among telestroke requests, characteristics of age, gender, race/ethnicity, National Institutes of Health Stroke Scale (NIHSS), primary diagnosis of AIS or transient ischemic attack (TIA), and number of patients receiving intravenous alteplase (IV-rtPA) and endovascular therapy (ET) were rec...
Source: Neurological Sciences - Category: Neurology Source Type: research
Bile acids (BAs) not only play an important role in lipid metabolism and atherosclerosis but also have antiapoptotic and neuroprotective effects. However, few studies have focused on the relationship of the to...
Source: Lipids in Health and Disease - Category: Lipidology Authors: Tags: Research Source Type: research
This study is aimed to delineate the molecular mechanistic actions by which sevoflurane protects against cerebral I/R injury. A rat model of cerebral I/R injury was established and pre-treated with sevoflurane, in which hippocampal neuron apoptosis was found to be repressed and the level of E2F transcription factor 1 (E2F1) was observed to be down-regulated. Then, the up-regulated expression of E2F1 was validated in rats with cerebral I/R injury, responsible for stimulated neuron apoptosis. Further, the binding of E2F1 to enhancer of zeste homolog 2 (EZH2) and EZH2 to tissue inhibitor of metalloproteinases-2 (TIMP2) was id...
Source: Molecular Neurobiology - Category: Neurology Source Type: research
ConclusionIschemic complications after BCVI are rare, occur within the first week and do not seem to impact independently the 1-year neurological prognosis.
Source: European Journal of Trauma and Emergency Surgery - Category: Emergency Medicine Source Type: research
ConclusionsImplementing GPMG for carotid revascularization resulted in better clinical results, with decreased neurological complications in patients that underwent angioplasty and endarterectomy.
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research
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