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Specialty: Emergency Medicine
Management: National Institutes of Health (NIH)

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Total 29 results found since Jan 2013.

Thrombolysis with alteplase 3 –4.5 hours after acute ischaemic stroke: trial reanalysis adjusted for baseline imbalances
In patients presenting to the emergency department with acute stroke, previous evidence from the Third European Cooperative Acute Stroke Study (ECASS III) recommended alteplase treatment within 3 to 4.5 hours of symptoms onset. Factors taken into consideration in the original report include time to treatment, history of smoking or hypertension, and an adjusted National Institute of Health Stroke Scale (NIHSS) score. However, it is unclear if accounting for history of stroke and baseline differences in NIHSS score on arrival may alter outcomes in patients given alteplase.
Source: The Journal of Emergency Medicine - October 1, 2020 Category: Emergency Medicine Authors: Anne Kathryn Watson, Amanda Young Tags: Abstract Source Type: research

The Trouble with Swallowing: Dysphagia as the Presenting Symptom in Lateral Medullary Syndrome
Posterior circulation strokes account for approximately one-fourth of all ischemic strokes, but are frequently misdiagnosed by emergency providers. Current standard stroke screening tools such as the National Institutes of Health Stroke Scale and the Cincinnati Prehospital Stroke Scale are weighted toward anterior circulation stroke diagnosis. Lateral medullary syndrome, a type of posterior circulation stroke, can be particularly challenging to diagnose due to nonspecific presenting symptoms, such as dysphagia.
Source: The Journal of Emergency Medicine - July 15, 2020 Category: Emergency Medicine Authors: Meaghan Frederick, Abhinav Rajpal, Charles Kircher, Kiran A. Faryar Tags: Selected Topics: Neurological Emergencies Source Type: research

Outcomes of reperfusion therapy for acute ischaemic stroke in patients aged 90 years or older: a retrospective study
AbstractThe benefits and risks of acute reperfusion therapy (RT) in acute ischaemic stroke (AIS) remain uncertain in older patients, especially in nonagenarians. We aimed to assess the impact of RT in this population. Single-center retrospective cohort study comparing patients  ≥ 90 years old admitted to a Stroke Unit (2008–2018) with AIS, submitted or not to RT [intravenous thrombolysis(IVT), mechanical thrombectomy(MT) or both]. Baseline characteristics, in-hospital complications and 3-month outcomes were compared. The primary outcome was 3-month “favorable o utcome”, defined as modified Rankin Scale score 0...
Source: Internal and Emergency Medicine - April 3, 2020 Category: Emergency Medicine Source Type: research

Can Prehospital Personnel Accurately Triage Patients for Large Vessel Occlusion Strokes?
The Field Assessment Stroke Triage for Emergency Destination (FAST-ED) score was developed in the hospital setting to be used in the prehospital setting. It has been shown to have higher predictive value than comparable stroke scales, including the National Institutes of Health Stroke Scale, for identifying large vessel occlusion strokes.
Source: The Journal of Emergency Medicine - March 20, 2020 Category: Emergency Medicine Authors: Blake C. Guillory, Arnav A. Gupta, Luigi X. Cubeddu, Laurie A. Boge Tags: Selected Topics: Prehospital Care Source Type: research

Intravenous Thrombolysis at 3.5 Hours From Onset of Pediatric Acute Ischemic Stroke
We report the case of a 14-year-old girl who presented with right-sided weakness and ataxia, loss of sensation, and altered mental status. Magnetic resonance imaging with diffusion-weighted imaging showed an acute lesion in the distribution of the left posterior cerebral artery, and magnetic resonance angiogram demonstrated occlusion of the third branch of the left posterior cerebral artery. With parental consent, clinicians decided to infuse an adult dose of weight-adjusted intravenous alteplase at 3.5 hours from onset of symptoms, with subsequent improvement in National Institutes of Health Stroke Scale score from 11 to ...
Source: Pediatric Emergency Care - January 1, 2020 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Lacunar stroke syndromes as predictors of lacunar and non-lacunar infarcts on neuroimaging: a hospital-based study
AbstractLacunar syndromes are usually caused by small ischemic lesions called lacunar infarcts. However, non-lacunar infarcts account for about 20% of lacunar syndromes. The aim of this study was to identify clinical predictors of lacunar syndromes led by non-lacunar infarcts. The following single centre, observational study was conducted on an analysis of the “Perugia hospital-based Stroke Registry” database enrolling consecutive patients admitted with ischemic stroke during the period 2010–2017. We evaluated patient risk factors and clinical features linked to stroke syndrome (lacunar/non-lacunar) and to cerebral i...
Source: Internal and Emergency Medicine - September 17, 2019 Category: Emergency Medicine Source Type: research

A new marker identification of high risk stroke patients: Jugular saturation
The aim of this prospective study; to investigate in emergency patients with stroke the relationship between jugular saturation and National Institutes of Health Stroke Scale (NIHSS), lesion volume and mortality score.
Source: The American Journal of Emergency Medicine - March 26, 2019 Category: Emergency Medicine Authors: Mevlut Guven, Nazire Belgin Akilli, Ramazan Koylu, Vefa Oner, Merve Guven, Muhammed Rasit Ozer Source Type: research

Nearly Half of U.S. Adults have Heart or Blood Vessel Disease
A new report estimates that nearly half of all U.S. adults have some form of heart or blood vessel disease, a medical milestone that's mostly due to recent guidelines that expanded how many people have high blood pressure. The American Heart Association said Thursday that more than 121 million adults had cardiovascular disease in 2016. Taking out those with only high blood pressure leaves 24 million, or 9 percent of adults, who have other forms of disease such as heart failure or clogged arteries. Measuring the burden of diseases shows areas that need to improve, the heart association's chief science and medical officer, D...
Source: JEMS: Journal of Emergency Medical Services News - February 1, 2019 Category: Emergency Medicine Tags: News Patient Care Cardiac & Resuscitation Source Type: news

Effect of Alteplase vs Aspirin on Functional Outcome for Patients with Acute Ischemic Stroke and Minor Nondisabling Neurologic Deficits: The PRISMS Randomized Clinical Trial
Alteplase is the standard of care for large ischemic strokes, however there is little evidence for its use in patients with low National Institutes of Health Stroke Scale (NIHSS) scores, as this subgroup of patients has previously been excluded from large clinical trials. However, in view of initial underappreciated deficits and possible stroke progression, patients with low NIHSS scores at presentation could potentially benefit from a more aggressive treatment with alteplase administration.
Source: The Journal of Emergency Medicine - November 1, 2018 Category: Emergency Medicine Authors: Chelsea Dymond Source Type: research

Prophylactic Seizure Medication and Health-Related Quality of Life After Intracerebral Hemorrhage
Objectives: Prophylactic levetiracetam is currently used in ~40% of patients with intracerebral hemorrhage, and the potential impact of levetircetam on health-related quality of life is unknown. We tested the hypothesis that prophylactic levetiracetam is independently associated with differences in cognitive function health-related quality of life. Design: Patients with intracerebral hemorrhage were enrolled in a prospective cohort study. We performed mixed models for T-scores of health-related quality of life, referenced to the U.S. population at 50 ± 10, accounting for severity of injury and time to follow-up. ...
Source: Critical Care Medicine - August 16, 2018 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Cardiac Arrest Gets Little Research Funding Despite Huge Death Toll
Cardiac arrest is a leading cause of death in the U.S. but gets just a fraction of the government’s funding for medical research, according to a new study. Researchers aren’t sure exactly why there’s such a disparity in funding from the National Institutes of Health, but say more is definitely needed considering about 450,000 Americans die each year from cardiac arrest. Most cardiac arrest victims don’t survive. The new analysis of funding from 2007 to 2016 is the first to evaluate the annual trend of NIH cardiac arrest research funding over time, researchers said. The analysis was published Wednesday in the J...
Source: JEMS: Journal of Emergency Medical Services News - July 27, 2017 Category: Emergency Medicine Authors: American Heart Association Tags: Administration and Leadership Industry News Source Type: news

Epidemiology of acute kidney injury in patients with stroke: a retrospective analysis from the neurology ICU
AbstractAcute kidney injury (AKI) is proven to be an independent risk factor for adverse clinical outcomes in patients with stroke, but data about the epidemiology of AKI in these patients are not well characterized. Therefore, we investigated the incidence, risk factors, and the impact of AKI on the clinical outcomes in a group of Chinese patients with stroke. We retrospectively recruited 647 stroke patients from the neurology ICU between 2012 and 2013. AKI was identified according to the 2012 KDIGO criteria. Baseline estimated glomerular filtration rate (eGFR) was calculated using modified Chronic Kidney Disease Epidemio...
Source: Internal and Emergency Medicine - June 27, 2017 Category: Emergency Medicine Source Type: research

PreHospital Ambulance Stroke Test - pilot study of a novel stroke test
There is a need for a prehospital stroke test that in addition to high sensitivity for stroke, also is able to communicate stroke severity similar to the National Institute of Health Stroke Scale (NIHSS).
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - April 11, 2017 Category: Emergency Medicine Authors: Gunnar Andsberg, Magnus Esbj örnsson, Arne Olofsson, Arne Lindgren, Bo Norrving and Mia von Euler Source Type: research