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Linking Australian Stroke Clinical Registry data with Australian government Medicare and medication dispensing claims data and the potential for bias
Aust N Z J Public Health. 2021 Apr 5. doi: 10.1111/1753-6405.13079. Online ahead of print.ABSTRACTOBJECTIVE: We aim to report the accuracy of linking data from a non-government-held clinical quality registry to national claims data and identify associated sources of systematic bias.METHODS: Patients with stroke or transient ischaemic attack admitted to hospitals participating in the Australian Stroke Clinical Registry (AuSCR) were linked with Medicare and medication dispensings through the Australian Medicare enrolment file (MEF). The proportion of registrants in the datasets was calculated and factors associated with a no...
Source: Australian and New Zealand Journal of Public Health - April 5, 2021 Category: International Medicine & Public Health Authors: Nadine E Andrew Dominique A Cadilhac Vijaya Sundararajan Amanda G Thrift Phil Anderson Natasha A Lannin Monique F Kilkenny Source Type: research

Age-Related Disparities in the Quality of Stroke Care and Outcomes in Rehabilitation Hospitals: The Australian National Audit
Stroke is a life-changing event affecting survivors, their families, communities and workplaces. About 75% of strokes occur in people 65 years or older,1 but the incidence is increasing in those aged 20-64,2,3 during the most productive years of people's live. This contributes substantially to the social and economic burden of stroke to society.2,4 Specialist inpatient rehabilitation is cost effective in working age adults, even with complex neurological conditions such as stroke.5 The characteristics and rehabilitative needs often differ between younger and older survivors of stroke.
Source: Journal of Stroke and Cerebrovascular Diseases - March 16, 2021 Category: Neurology Authors: Tara Purvis, Isobel J Hubbard, Dominique A Cadilhac, Kelvin Hill, Justine Watkins, Natasha A. Lannin, Steven G Faux, Monique F Kilkenny Source Type: research

COVID-19 Pandemic Impact on Care for Stroke in Australia: Emerging Evidence From the Australian Stroke Clinical Registry
We present information on acute stroke care for the first wave of the COVID-19 pandemic in Australia using data from the Australian Stroke Clinical Registry (AuSCR). The first case of COVID-19 in Australia was recorded in late January 2020 and national restrictions to control the virus commenced in March. To account for seasonal effects of stroke admissions, patient-level data from the registry from January to June 2020 were compared to the same period in 2019 (historical-control) from 61 public hospitals. We compared periods using descriptive statistics and performed interrupted time series analyses. Perceptions of stroke...
Source: Frontiers in Neurology - February 26, 2021 Category: Neurology Source Type: research

CNS Complications in Adult Patients Treated With Extracorporeal Membrane Oxygenation
Objectives: To describe the incidence and outcomes of radiologically confirmed acute CNS complications in extracorporeal membrane oxygenation patients at an Australian extracorporeal membrane oxygenation referral center and identify associated patient characteristics. Design: Retrospective cohort study. Setting: Single-center tertiary institution. Patients: Four-hundred twelve consecutive adult patients supported with extracorporeal membrane oxygenation from 2009 to 2017. Results: Fifty-five patients (13.3%) had a CNS complication confirmed by CT or MRI, including ischemic stroke (7.0%), int...
Source: Critical Care Medicine - January 16, 2021 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

The effectiveness of home-based therapy on functional outcome, self-efficacy and anxiety among discharged stroke survivors
This study will provide the information on the effectiveness of HBT in comparison to UP among stroke population who are discharged from rehabilitation. Findings from the study will enable rehabilitation professionals to design effective discharge care plan for stroke survivors in combating functional decline when no longer receiving hospital-based therapy. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12619001182189 (last updated 22/11/2019).
Source: Medicine - November 20, 2020 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research

Incidence of Hospitalization for Stroke in Queensland, Australia: Younger Adults at Risk
Background: Trends in the incidence of stroke are important for health care planning. Information is particularly scarce in Australia, due to the paucity of studies with access to recent, large-scale, longitudinal datasets. In this paper we investigated the incidence of hospitalization for stroke by sex, age, and subtype in the whole State of Queensland (Australia). Methods: We obtained data of all hospital admissions for stroke in Queensland from 2002 to 2015. Age standardized hospitalization rates for first-ever stroke were calculated along with WHO adjusted rates.
Source: Journal of Stroke and Cerebrovascular Diseases - April 8, 2020 Category: Neurology Authors: Deanna Anderlini, Guy Wallis, Welber Marinovic Source Type: research

Anticoagulant Initiation During Hospital Admissions for Atrial Fibrillation in South-East Queensland, Australia
Anticoagulation reduces stroke risk in patients with atrial fibrillation (AF) but under-prescribing in eligible patients has been commonly reported. Introduction of the direct acting oral anticoagulants (DOACs) was considered to potentially improve prescribing due to increased anticoagulant options. At the time of release to the Australian market, there were limited studies investigating anticoagulant usage during hospitalisations for AF. Therefore, the aim of this study was to investigate prescribing of oral anticoagulants during hospitalisation admissions for AF during the time of DOAC introduction to the Australian market.
Source: Heart, Lung and Circulation - March 31, 2020 Category: Cardiology Authors: Iniya Rathinam, Shailendra Anoopkumar-Dukie, Tony Badrick, Trudy Teasdale, Nijole Bernaitis Tags: Original Article Source Type: research

Effect of obstructive sleep apnoea and its treatment with continuous positive airway pressure on the prevalence of cardiovascular events in patients with acute coronary syndrome (ISAACC study): a randomised controlled trial
This study is registered with Clinicaltrials.gov, NCT01335087 and is now closed.FindingsBetween April 25, 2011, and Feb 2, 2018, a total of 2834 patients with ACS had respiratory polygraphy, of whom 2551 (90·01%) were recruited. 1264 (49·55%) patients had OSA and were randomly assigned to the CPAP group (n=633) or the UC group (n=631). 1287 (50·45%) patients did not have OSA, of whom 603 (46·85%) were randomly assigned to the reference group. Patients were followed up for a median of 3·35 years (IQR 1·50–5·31). The prevalence of cardiovascular events was similar in the CPAP and UC groups (98 events [16%] vs 108 ev...
Source: The Lancet Respiratory Medicine - December 14, 2019 Category: Respiratory Medicine Source Type: research

This Under-Utilized Drug Is Actually Critical for Treatment-Resistant Depression
Many people with clinical depression have tried an array of medication and still feel sick. Maybe they’ve tried different selective serotonin reuptake inhibitors (SSRIs) or selective norepinephrine reuptake inhibitors (SNRIs). Maybe they’ve taken these antidepressants along with an antipsychotic (a common strategy to boost effectiveness). Either way, the lack of improvement can make individuals feel even more hopeless and fear the darkness will never lift. If this sounds all-too familiar, you’re definitely not alone. In fact, up to 30 percent of people with depression don’t respond to the first few antidepressants ...
Source: Psych Central - November 27, 2019 Category: Psychiatry Authors: Margarita Tartakovsky, M.S. Tags: Antidepressants Depression Disorders ECT General Medications Treatment Atypical Depression difficult to treat depression Managing Depression MAOIs medication for depression Monoamine Oxidase Inhibitors Severe Depression Treatin Source Type: news

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