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Source: Internal Medicine Journal

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Total 81 results found since Jan 2013.

Is telemedicine helping or hindering the delivery of stroke thrombolysis in rural areas? A qualitative analysis
ConclusionsAcceptability of telemedicine for acute stroke was multifaceted and closely aligned with regional clinician beliefs about the value of thrombolysis for stroke, highlighting an important area for education. Addressing beliefs about treatment efficacy and other perceived barriers is important for establishing a stroke telemedicine programme.
Source: Internal Medicine Journal - September 1, 2015 Category: Internal Medicine Authors: N. Moloczij, I. Mosley, K. M. Moss, K. L. Bagot, C. F. Bladin, D. A Cadilhac Tags: Original Article Source Type: research

Stroke physician versus stroke neurologist: can anyone thrombolyse? – a general hospital experience and perspective
Source: Internal Medicine Journal - September 1, 2015 Category: Internal Medicine Authors: T. R. Bates, A. C. Boudville, D. K. Ghia, L. K. Kho, P. L. Silbert, M. Lee Tags: Letter to the Editor Source Type: research

Advances in endovascular treatment of acute ischaemic stroke
Abstract Over the past decade, there have been rapid advancements in ischaemic stroke reperfusion treatments. However, clear clinical benefit is yet to be shown in large clinical trials. In this review, the major studies in different types of endovascular treatments including intra‐arterial thrombolysis, aspiration devices, mechanical clot retrievers and the new stent retrievers are discussed. First‐generation mechanical thrombectomy devices such as the MERCI Retriever (Stryker, Kalamazoo, MI, USA) and Penumbra aspiration device (Penumbra Inc., Alameda, CA, USA) demonstrated safety and higher rates of recanalisation in...
Source: Internal Medicine Journal - July 28, 2015 Category: Internal Medicine Authors: H. Asadi, R. Dowling, B. Yan, S. Wong, P. Mitchell Tags: Review Source Type: research

Decompressive hemicraniectomy in the management of extensive middle cerebral artery stroke: increased survival, at a price
Source: Internal Medicine Journal - July 1, 2015 Category: Internal Medicine Authors: D. J. Blacker, S. Honeybul Tags: Editorial Source Type: research

Victorian Stroke Telemedicine Project: Implementation of a new model of translational stroke care for Australia
ConclusionsThe VST pilot implementation provides evidence that telemedicine can enhance the quality of acute stroke care in a regional hospital. Expanding VST to 16 regional hospitals, Australia's largest telestroke program, will allow for a more comprehensive clinical and economic analysis.
Source: Internal Medicine Journal - May 26, 2015 Category: Internal Medicine Authors: CF Bladin, N Molocijz, S Ermel, KL Bagot, M Kilkenny, M Vu, DA Cadilhac, Tags: Original Article Source Type: research

Is telemedicine helping or hindering the delivery of stroke thrombolysis in regional areas? A qualitative analysis
ConclusionsAcceptability of telemedicine for acute stroke was multifaceted and closely aligned with regional clinician beliefs about the value of thrombolysis for stroke, highlighting an important area for education. Addressing beliefs about treatment efficacy and other perceived barriers is important for establishing a stroke telemedicine program.
Source: Internal Medicine Journal - April 22, 2015 Category: Internal Medicine Authors: Natasha Moloczij, Ian Mosley, Karen Moss, Kathleen Bagot, Christopher Bladin, Dominique A Cadilhac Tags: Original Article Source Type: research

Excessive range of statin dose in Western Australian primary care
ConclusionThe extraordinarily wide variation in statin dose is at odds with the more consistent doses of other drugs used in the management of arterial disease. Unnecessarily high statin dosing increases side effects and may not improve clinical outcomes appreciably. Rational prescribing of statins based on the pharmacodynamic evidence, with lower doses in most patients, combined with close attention to reduction of smoking, blood pressure and weight is likely to reduce arterial disease most efficiently and safely.
Source: Internal Medicine Journal - April 14, 2015 Category: Internal Medicine Authors: SB Dimmitt, A Moran, M Scartozzi, HG Stampfer, JB Warren Tags: Original Article Source Type: research

Stroke physician versus stroke neurologist: can anyone thrombolyse?
ConclusionDue to the single‐centre, observational nature of this study, the equivalent outcomes between those thrombolysed by a stroke neurologist versus those thrombolysed by a stroke physician must be interpreted with caution pending further studies. Nevertheless, in the current setting, no signal for harm has been detected. This study is unique as it is the first to our knowledge comparing outcomes between a neurologist and non‐neurologist following thrombolysis.
Source: Internal Medicine Journal - March 3, 2015 Category: Internal Medicine Authors: A. Lee, A. Gaekwad, M. Bronca, L. Cheruvu, O. Davies, C. Whitehead, M. Agzarian, C. Chen Tags: Original Article Source Type: research

Determinants of Cerebral White Matter Changes in Patients With Stroke
ConclusionsOur results suggest a region‐specific pathogenesis of cerebral white matter in Asian patients with ischemic stroke that may differ from those in the general population.
Source: Internal Medicine Journal - February 2, 2015 Category: Internal Medicine Authors: Ping‐Song Chou, Chun‐Hung Chen, Meng‐Ni Wu, Yi‐Hui Lin, Chiou‐Lian Lai, Ruey‐Tay Lin, Yuan‐Han Yang Tags: Original Article Source Type: research

Stroke physician vs stroke neurologist – can anyone thrombolyse?
ConclusionDue to the single center, observational nature of this study, the equivalent outcomes between those thrombolysed by a stroke neurologist vs those thrombolysed by a stroke physician must be interpreted with caution pending further studies. Nevertheless, in the current setting, no signal for harm has been detected. This study is unique as it is the first to our knowledge comparing outcomes between a neurologist and non‐neurologist following thrombolysis.
Source: Internal Medicine Journal - December 23, 2014 Category: Internal Medicine Authors: Andrew Lee, Aaron Gaekwad, Michelle Bronca, Lata Cheruvu, Owen Davies, Craig Whitehead, Marc Agzarian, Celia Chen Tags: Original Article Source Type: research

Stroke thrombolysis remains unproven: per ardua, ad astra …
Source: Internal Medicine Journal - December 1, 2014 Category: Internal Medicine Authors: D. M. Fatovich, S. G. A. Brown Tags: Letters to the Editor Source Type: research

Advances in Endovascular Treatment of Acute Ischemic Stroke
ConclusionAlthough evidence regarding the efficacy of endovascular treatment in acute stroke has been equivocal, the recent publication of a large multicentre randomised controlled trial indicates benefit of intra‐arterial stent retriever reperfusion in patients selected by appropriate imaging treated early by experienced operators. Endovascular treatment remains an important adjunct to established medical treatment with intravenous tPA, and may have an expanding role dependent on several trials likely to report over the next 12 months.
Source: Internal Medicine Journal - December 1, 2014 Category: Internal Medicine Authors: H Asadi, R Dowling, B Yan, S Wong, P Mitchell Tags: Review Source Type: research

Pre‐hospital stroke management: an Australian perspective
Source: Internal Medicine Journal - December 1, 2014 Category: Internal Medicine Authors: D. J. Blacker, G. J. Hankey Tags: Editorial Source Type: research

Heparin‐based treatment to prevent symptomatic deep venous thrombosis, pulmonary embolism or death in general medical inpatients is not supported by best evidence
This study aims to determine whether current clinical guidelines for HVTEp are appropriate for medical patients. We searched medical databases for original randomised placebo‐controlled studies of HVTEp in medical patients, excluding those with stroke and in intensive care. From 401 potentially relevant studies, we selected eight, which included over 16 000 patients. HVTEp decreased the incidence of all deep venous thromboses (DVT): 4.3% in the placebo group versus 2.3% in the treatment group, P = 0.002, number needed to treat, 50. However, this treatment effect was not seen for symptomatic DVT: 1.2% versus 0.9%, P = 0...
Source: Internal Medicine Journal - November 4, 2014 Category: Internal Medicine Authors: A. Spencer, T. Cawood, C. Frampton, D. Jardine Tags: Current Controversies Source Type: research

Antithrombotic use following transient ischaemic attack or ischaemic stroke among older Australians with atrial fibrillation
Abstract Hospital audits may underestimate anticoagulant use among acute ischaemic stroke patients with atrial fibrillation (AF), as treatment may commence after discharge. To account for this, antithrombotic use in the 4 months after hospitalisation for transient ischaemic attack or ischaemic stroke among AF patients was assessed using claims data. Results suggest that treatment may be commenced soon after discharge and should be considered when assessing prevalence of use.
Source: Internal Medicine Journal - November 4, 2014 Category: Internal Medicine Authors: J. K. Sluggett, G. E. Caughey, M. B. Ward, A. L. Gilbert Tags: Brief Communications Source Type: research