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Specialty: Internal Medicine
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Total 126 results found since Jan 2013.

Stroke: management and prevention
Cerebrovascular disease can be devastating for patients and their families, but much can be done to attenuate cerebral damage and reduce disability. Active intervention is in three phases: acute therapy, rehabilitation and secondary prevention. Thrombolysis within 4.5 hours of symptom onset substantially reduces morbidity from ischaemic stroke with no overall impact on mortality. Administration requires the use of clear protocols to rapidly triage, transport and investigate patients. Computed tomography remains an appropriate imaging technique in the early assessment of most stroke patients.
Source: Medicine - July 28, 2016 Category: Internal Medicine Authors: Ivie I. Gbinigie, Ian P. Reckless, Alastair M. Buchan Tags: Stroke Source Type: research

Neurophysiology tools to lower the stroke onset to treatment time during the golden hour: microwaves, bioelectrical impedance and near infrared spectroscopy
Ann Med. 2022 Dec;54(1):2658-2671. doi: 10.1080/07853890.2022.2124448.ABSTRACTReperfusion therapy administration timing in acute ischaemic stroke is the main determinant of patients' mortality and long-term disability. Indeed, the first hour from the stroke onset is defined the "golden hour", in which the treatment has the highest efficacy and lowest side effects. Delayed ambulance transport, inappropriate triage and difficulty in accessing CT scans lead to delayed onset to treatment time (OTT) in clinical practice. To date brain CT scan is needed to rule out intracranial haemorrhage, which is a major contraindication to t...
Source: Annals of Medicine - September 26, 2022 Category: Internal Medicine Authors: Lazzaro di Biase Adriano Bonura Maria Letizia Caminiti Pasquale Maria Pecoraro Vincenzo Di Lazzaro Source Type: research

Case report: Rapid improvement of crossed cerebellar diaschisis after intravascular laser irradiation of blood in a case of stroke
Rationale: Crossed cerebellar diaschisis (CCD) is a poor prognostic factor after stroke because without immediate cerebral reperfusion no further improvements in the patient's condition can be achieved. We investigated the clinical effects of intravascular laser irradiation therapy (ILIB) on CCD and evaluated the therapeutic effect in the sub-acute post-stroke stage. Patient concerns: The 77-year-old male with cerebral infarction in the territory of the right anterior cerebral artery only underwent conservative treatment including hydration and aspirin in the acute post-stroke stage. Diagnosis: He was diagnosed as stroke...
Source: Medicine - January 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Acute cholecystitis as a rare and overlooked complication in stroke patients: A retrospective monocentric study
This study aims to evaluate the clinical incidence, manifestations, and predictive factors of AC in stroke patients. A retrospective cohort study was conducted between January 2013 and December of 2017 of all stroke patients (n = 2699) who have been admitted to our stroke center of the university hospital. We evaluated patient demographics, presenting symptoms, vital signs, laboratory results, mean initial consecutive fasting time, mean total fasting time, modified Rankin Scale (mRS), as well as radiological findings of abdominal computed tomography (CT) or ultrasonography. AC was diagnosed in 28 of the 2699 patients...
Source: Medicine - March 1, 2019 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Minimising time to treatment: targeted strategies to minimise time to thrombolysis for acute ischaemic stroke
Abstract Time to thrombolysis is a critical determinant of favourable outcomes in acute ischaemic stroke. It is not infrequent that patient outcomes are compromised due to out‐of‐hospital and in‐hospital time delays. On the other hand, time delays could be minimised through the identification of barriers and the implementation of targeted solutions. This review outlines the different strategies in minimising treatment delays and offers recommendations. Literature search in PubMed, Medline and EBSCO Host was conducted to identify studies that are relevant to reduction of time to treatment from January 1995 to December...
Source: Internal Medicine Journal - November 15, 2013 Category: Internal Medicine Authors: Y. J. Tai, B. Yan Tags: Review Source Type: research

Emergency Department Companions of Stroke Patients: Implications on Quality of Care
Abstract: Acute care of stroke victims largely relies on the rapid identification and timely clinical and radiological assessment. We evaluated the effect of the number of patient companions on the efficiency of the diagnostic process in the emergency department (ED). Consecutive stroke patients admitted to the ED between August 2011 and October 2012 were evaluated. Clinical, epidemiological, and timeline data (symptoms onset, ED arrival, computed tomography [CT] scanning, and recombinant tissue plasminogen activator infusion), as well as the number of accompanying persons in the ED were prospectively recorded. We used mul...
Source: Medicine - March 1, 2015 Category: Internal Medicine Tags: Article: Observational Study Source Type: research

Stroke in the acute setting
Acute stroke and transient ischaemic attack (TIA) are focal neurological syndromes of vascular origin and should be treated as medical emergencies. Brain imaging with computed tomography or magnetic resonance imaging is required to distinguish ischaemic stroke from intracerebral haemorrhage, recognize non-stroke pathologies that mimic stroke and guide investigation into the underlying mechanism. Acute interventions of benefit in ischaemic stroke include intravenous thrombolysis with alteplase given within 4.5 hours of onset, endovascular thrombectomy within 6 hours of onset in selected patients, stroke unit care and aspirin.
Source: Medicine - January 22, 2017 Category: Internal Medicine Authors: Keith W. Muir Tags: Acute medicine II Source Type: research

Middle Cerebral Artery Calcification: Association With Ischemic Stroke
This study retrospectively included 354 subjects with ischemic stroke in the MCA territory and 1518 control subjects who underwent computed tomography (CT) of the brain. We recorded major known risk factors for ischemic stroke, including age, gender, hypertension, diabetes mellitus, smoking, hyperlipidemia, and obesity, along with the MCA calcium burden, measured with the Agatston calcium scoring method. Univariate and modified logistic regression analyses were performed to examine the association between the MCA calcification and ischemic stroke. The univariate analyses showed significant associations of ischemic stroke w...
Source: Medicine - December 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

The Abundance of Epicardial Adipose Tissue Surrounding Left Atrium Is Associated With the Occurrence of Stroke in Patients With Atrial Fibrillation
Abstract: Epicardial adipose tissue (EAT) is positively associated with risk factors for cardiovascular disease, but the role of EAT in the development of atrial fibrillation (AF)-related stroke and its association with the anatomical and functional remodeling of the left atrium (LA) have not been elucidated. This was a comparative cross-sectional study. Twenty-seven patients with paroxysmal or persistent AF and cardioembolic stroke were selected and compared with 68 age- and sex-matched AF patients without stroke. In addition, 20 controls without a history of AF or stroke were included. The periatrial EAT and the structu...
Source: Medicine - April 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Systematic review with network meta-analysis: Diagnostic values of ultrasonography, computed tomography, and magnetic resonance imaging in patients with ischemic stroke
Conclusion: This network meta-analysis provides supporting evidence to the idea that DWI has a higher diagnostic value regarding ischemic stroke among MRI methods, and CTP has a poor diagnostic value among CT methods, which provide therapeutic considerations for Ischemic stroke intervention.
Source: Medicine - July 1, 2019 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Ischemic stroke revealing COVID-19 infection: Case report
CONCLUSION: SARS-COV 2 infection can spread from the respiratory system to the central nervous system, resulting in an inflammatory response and excessive secretion of inflammatory markers, leading to ischemic stroke.PMID:34631044 | PMC:PMC8492013 | DOI:10.1016/j.amsu.2021.102912
Source: Annals of Medicine - October 11, 2021 Category: Internal Medicine Authors: Alkouh Rajae Merbouh Manal El Aidouni Ghizlane Bouabdlaoui Amine None I Zaid Bkiyar Houssam Mabrouk Yassine Housni Brahim Source Type: research