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Clinical features and novel technologies for prehospital detection of intracerebral haemorrhage: a scoping review protocol
Introduction The detection of intracerebral haemorrhage (ICH) in the prehospital setting without conventional imaging technology might allow early treatment to reduce haematoma expansion and improve patient outcomes. Although ICH and ischaemic stroke share many clinical features, some may help in distinguishing ICH from other suspected stroke patients. In combination with clinical features, novel technologies may improve diagnosis further. This scoping review aims to first identify the early, distinguishing clinical features of ICH and then identify novel portable technologies that may enhance differentiation of ICH from o...
Source: BMJ Open - May 3, 2023 Category: General Medicine Authors: Almubayyidh, M., Alghamdi, I., Parry-Jones, A. R., Jenkins, D. Tags: Open access, Emergency medicine Source Type: research

Stroke prevention of thoracoscopic left atrial appendage clipping in patients with non-valvular atrial fibrillation at high risk of stroke and bleeding: study protocol for a non-randomised controlled clinical trial
Introduction Non-valvular atrial fibrillation (NVAF) is a high-risk factor for ischaemic stroke. The 2016 European Society of Cardiology Atrial Fibrillation Management guidelines recommend oral anticoagulants (OACs) to prevent stroke in men with CHA2DS2-VASc scores ≥2 and women ≥3. However, in patients with a high risk of stroke and a high risk of bleeding (HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly (> 65 years), Drugs/alcohol concomitantly) score≥3), OAC had a higher risk of bleeding. Left atrial appendage cl...
Source: BMJ Open - October 28, 2022 Category: General Medicine Authors: Ye, C., Han, X., Chen, Y., Liu, F., Ma, H., Yang, Y., Liu, Y., Hu, Q., Yao, Q., Xie, W., Xu, D. Tags: Open access, Surgery Source Type: research

Sex differences in outcomes after mechanical thrombectomy for acute ischemic stroke in the 'real world: protocol for a systematic review and meta-analysis study
Introduction Mechanical thrombectomy (MT) had been regarded as the first-line therapy for acute ischaemic stroke patients. The sex differences in post-MT treatment outcomes were analysed by randomised controlled trial (RCT) studies with inconsistent conclusions. We suggest the results from the real-world data may differ from RCT containing studies. Therefore, the sex difference in non-clinical trial populations needs to be clarified. Methods and analysis In order to obtain relative studies comprehensively, we will search the main document databases, consisting of Web of Science, Medline in Ovid, Embase in Ovid and Cochran...
Source: BMJ Open - April 15, 2022 Category: General Medicine Authors: Xu, L., Li, B., Zhang, X., Bai, X., Dmytriw, A. A., Wang, T., Wang, X., Yang, K., Min, X., Jiao, L. Tags: Open access, Neurology Source Type: research

TACTICS - Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship: evaluating the effectiveness of an 'implementation intervention in providing better patient access to reperfusion therapies: protocol for a non-randomised controlled stepped wedge cluster trial in acute stroke
Introduction Stroke reperfusion therapies, comprising intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT), are best practice treatments for eligible acute ischemic stroke patients. In Australia, EVT is provided at few, mainly metropolitan, comprehensive stroke centres (CSC). There are significant challenges for Australia’s rural and remote populations in accessing EVT, but improved access can be facilitated by a ‘drip and ship’ approach. TACTICS (Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship) aims to test whether a multicomponent, multidisciplinary impleme...
Source: BMJ Open - February 11, 2022 Category: General Medicine Authors: Ryan, A., Paul, C. L., Cox, M., Whalen, O., Bivard, A., Attia, J., Bladin, C., Davis, S. M., Campbell, B. C. V., Parsons, M., Grimley, R. S., Anderson, C., Donnan, G. A., Oldmeadow, C., Kuhle, S., Walker, F. R., Hood, R. J., Maltby, S., Keynes, A., Delcou Tags: Open access, Health services research Source Type: research

Multicentre observational study on practice of ventilation in brain injured patients: the VENTIBRAIN study protocol
Introduction Mechanical ventilatory is a crucial element of acute brain injured patients’ management. The ventilatory goals to ensure lung protection during acute respiratory failure may not be adequate in case of concomitant brain injury. Therefore, there are limited data from which physicians can draw conclusions regarding optimal ventilator management in this setting. Methods and analysis This is an international multicentre prospective observational cohort study. The aim of the ‘multicentre observational study on practice of ventilation in brain injured patients’—the VENTIBRAIN study—is t...
Source: BMJ Open - August 11, 2021 Category: General Medicine Authors: Robba, C., Citerio, G., Taccone, F. S., Galimberti, S., Rebora, P., Vargiolu, A., Pelosi, P., VENTIBRAIN Enlarged Steering committee members, VENTIBRAIN, Mandelli, Mancebo, Stevens, Meyfroidt, Badenes, Torre, Helbok, Suarez, Stocchetti, Abreu, Schultz, Ci Tags: Open access, Intensive care Source Type: research

Protocol for validating cardiovascular and cerebrovascular ICD-9-CM codes in healthcare administrative databases: the Umbria Data Value Project
Introduction Administrative healthcare databases can provide a comprehensive assessment of the burden of diseases in terms of major outcomes, such as mortality, hospital readmissions and use of healthcare resources, thus providing answers to a wide spectrum of research questions. However, a crucial issue is the reliability of information gathered. Aim of this protocol is to validate International Classification of Diseases, 9th Revision—Clinical Modification (ICD-9-CM) codes for major cardiovascular diseases, including acute myocardial infarction (AMI), heart failure (HF), atrial fibrillation (AF) and stroke. Method...
Source: BMJ Open - March 29, 2017 Category: Journals (General) Authors: Cozzolino, F., Abraha, I., Orso, M., Mengoni, A., Cerasa, M. F., Eusebi, P., Ambrosio, G., Montedori, A. Tags: Open access, Cardiovascular medicine, Health informatics, Health services research, Public health Protocol Source Type: research