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Total 72 results found since Jan 2013.
When does life end? New organ donation strategy fuels debate
On a chilly holiday Monday in January 2020, a medical milestone passed largely unnoticed. In a New York City operating room, surgeons gently removed the heart from a 43-year-old man who had died and shuttled it steps away to a patient in desperate need of a new one.
More than 3500 people in the United States receive a new heart each year. But this case was different—the first of its kind in the country. “It took us 6 months to prepare,” says Nader Moazami, surgical head of heart transplantation at New York University (NYU) Langone Health, where the operation took place. The run-up included oversight from an ethi...
Source: ScienceNOW - May 11, 2023 Category: Science Source Type: news
Best Practice Recommendations for Stroke Vascular Imaging During Iodinated Contrast Shortage
GE Healthcare© announced on April 19, 2022, that their main factory and distributor of iodinated contrast had experienced a temporary shutdown because of COVID-19 outbreak in Shanghai, China. This, along with other supply chain issues, led to a worldwide shortage of iodinated contrast agents, Omnipaque and Visipaque. Our Comprehensive Stroke Center was confronted with the cascading effect of this iodinated contrast material shortage. We took immediate steps to revise our protocols and processes to continue to provide high-quality care to our stroke patients. A multidisciplinary working group comprised of representativ...
Source: Neurology Clinical Practice - March 3, 2023 Category: Neurology Authors: Bhole, R., Solenski, N. J., Donahue, J. H., Kellogg, R. T., Roach, N. N., Chapman, S. N., Worrall, B. B., Evans, A. J., Patel, S. H., Mukherjee, S., Park, M. S., Southerland, A. M. Tags: Decision analysis, Medical care, All Cerebrovascular disease/Stroke, All Practice Management Commentary Source Type: research
Development and External Validation of Nomogram for Cerebral Infarction in Moyamoya Diseases
AbstractMore than 60% of moyamoya disease (MMD) patients suffers cerebral ischemia and preoperative cerebral infarction (CI) increases the risk of postoperative stroke and unfavorable outcome. We established a nomogram system for risk stratification of CI to help tailoring individualized management. We enrolled 380 patients including 680 hemispheres for the training cohort from our hospital and 183 patients including 348 hemispheres for the validation cohort from multicenter. A nomogram for CI was formulated based on the multivariable logistic regression analysis. The predictive accuracy and discriminative ability of nomog...
Source: Translational Stroke Research - January 19, 2023 Category: Neurology Source Type: research
A Case of Intracranial Vertebral Artery Stenosis Treated with Percutaneous Transluminal Angioplasty and Stenting Guided by Brain Oximetry
In this report, we were able to perform a minimally invasive evaluation of blood flow in the posterior circulation using the brain oximeter which might be useful for surgical revascularisation not only in CA but also in VBA.PMID:36527626 | DOI:10.1007/978-3-031-14190-4_22
Source: Advances in Experimental Medicine and Biology - December 17, 2022 Category: Research Authors: Yu Okuma Nobuyuki Hirotsune Umair Ahmed Santiago J Miyara Shigeru Daido Yukihide Kagawa Source Type: research
Regional cerebral blood perfusion changes in chronic stroke survivors as potential brain correlates of the functional outcome following gamified home-based rehabilitation (IntelliRehab) —a pilot study
Hospital-based stroke rehabilitation for stroke survivors in developing countries may be limited by staffing ratios and length of stay that could hamper recovery potential. Thus, a home-based, gamified rehabil...
Source: Journal of NeuroEngineering and Rehabilitation - August 24, 2022 Category: Rehabilitation Authors: Younis M. S. Firwana, Mohd Khairul Izamil Zolkefley, Hasnetty Zuria Mohamed Hatta, Christina Rowbin, Che Mohd Nasril Che Mohd Nassir, Muhammad Hafiz Hanafi, Mohd Shafie Abdullah, Bilgin Keserci, Natasha A. Lannin and Muzaimi Mustapha Tags: Research Source Type: research
E-055 Internal carotid artery reconstruction with flow diverting stents in the treatment of acute ischemic stroke: technical considerations and medical management
ConclusionsFDS appear to be a safe and effective tool for reconstruction of a symptomatic dissection in tortuous cervical ICAs. Their flexibility allows conformation to complex anatomies and they can be traversed multiple times by aspiration catheters/stentrievers. We found excellent patency at follow up. The unique challenges posed by utilization of high-profile stents in acute stroke require appropriate technical execution and medical management.Disclosures E. Orru: None. F. Bounni: None. M. Marosfoi: None. N. Patel: None. A. Wakhloo: 1; C; Philips medical. 2; C; Stryker, Phenox. 4; C; InNeuroCo, EpiEP, Neural Analytics, ThrombX.
Source: Journal of NeuroInterventional Surgery - July 23, 2022 Category: Neurosurgery Authors: Orru, E., Bounni, F., Marosfoi, M., Patel, N., Wakhloo, A. Tags: SNIS 19th annual meeting electronic poster abstracts Source Type: research
Tenecteplase versus Alteplase for Stroke Thrombolysis Evaluation Trial in the Ambulance (Mobile Stroke Unit--TASTE-A): protocol for a prospective randomised, open-label, blinded endpoint, phase II superiority trial of tenecteplase versus alteplase for ischaemic stroke patients presenting within 4.5 hours of symptom onset to the mobile stroke unit
Introduction
Mobile stroke units (MSUs) equipped with a CT scanner are increasingly being used to assess and treat stroke patients’ prehospital with thrombolysis and transfer them to the most appropriate hospital for ongoing stroke care and thrombectomy when indicated. The effect of MSUs in both reducing the time to reperfusion treatment and improving patient outcomes is now established. There is now an opportunity to improve the efficacy of treatment provided by the MSU. Tenecteplase is a potent plasminogen activator, which may have benefits over the standard of care stroke lytic alteplase. Specifically, in the MSU ...
Source: BMJ Open - April 29, 2022 Category: General Medicine Authors: Bivard, A., Zhao, H., Coote, S., Campbell, B., Churilov, L., Yassi, N., Yan, B., Valente, M., Sharobeam, A., Balabanski, A., Dos Santos, A., Ng, F., Langenberg, F., Stephenson, M., Smith, K., Bernard, S., Thijs, V., Cloud, G., Choi, P., Ma, H., Wijeratne, Tags: Open access, Neurology Source Type: research
Impact of conventional vs. goal-directed fluid therapy on urethral tissue perfusion in patients undergoing liver surgery: A pilot randomised controlled trial
BACKGROUND
Although fluid administration is a key strategy to optimise haemodynamic status and tissue perfusion, optimal fluid administration during liver surgery remains controversial.
OBJECTIVE
To test the hypothesis that a goal-directed fluid therapy (GDFT) strategy, when compared with a conventional fluid strategy, would better optimise systemic blood flow and lead to improved urethral tissue perfusion (a new variable to assess peripheral blood flow), without increasing blood loss.
DESIGN
Single-centre prospective randomised controlled superiority study.
SETTING
Erasme Hospital.
PATIENTS
...
Source: European Journal of Anaesthesiology - March 3, 2022 Category: Anesthesiology Tags: Anaesthesia 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
BMJ Open. 2022 Feb 11;12(2):e055461. doi: 10.1136/bmjopen-2021-055461.ABSTRACTINTRODUCTION: 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) aim...
Source: Rural Remote Health - February 12, 2022 Category: Rural Health Authors: Annika Ryan Christine L Paul Martine Cox Olivia Whalen Andrew Bivard John Attia Christopher Bladin Stephen M Davis Bruce C V Campbell Mark Parsons Rohan S Grimley Craig Anderson Geoffrey A Donnan Christopher Oldmeadow Sarah Kuhle Frederick R Walker Rebecc 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
Neurologic Outcomes After Extracorporeal Cardiopulmonary Resuscitation: Recent Experience at a Single High-Volume Center
This study describes the recent ECPR experience at the University of Maryland Medical Center from 2016 through 2018, with attention to neurologic outcomes and predictors thereof. The primary outcome was dichotomized Cerebral Performance Category (≤2) at hospital discharge; secondary outcomes included rates of specific neurologic complications. From 429 ECMO runs over 3 years, 57 ECPR patients were identified, representing an increase in ECPR utilization compared with 41 cases over the previous 6 years. Fifty-two (91%) suffered in-hospital cardiac arrest, and 36 (63%) had an initial nonshockable rhythm. Median low-flow ti...
Source: ASAIO Journal - February 1, 2022 Category: Medical Devices Tags: Clinical Critical Care Source Type: research
E-010 Strict aspects cutoffs in endovascular therapy selection paradigms may harm patient outcomes
ConclusionASPECT scores at presentation in patients with LVO were associated with 90-day disability outcomes in a continuous fashion. In patients with ASPECTS close to 5, EST continued to provide significant treatment effect. These findings argue against the use of strict ASPECTS cutoffs for EST eligibility.Disclosures R. Abdelkhaleq: None. C. De la Garza: None. Y. Kim: None. S. Khose: None. S. Salazar Marioni: None. S. Sheth: None.
Source: Journal of NeuroInterventional Surgery - July 26, 2021 Category: Neurosurgery Authors: Abdelkhaleq, R., De la Garza, C., Kim, Y., Khose, S., Salazar Marioni, S., Sheth, S. Tags: Electronic poster abstracts Source Type: research
