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Trends in post-discharge prophylactic anticoagulant use among stroke patients in the United States between 2006 and 2019
Stroke is an independent risk factor for venous thromboembolism (VTE). Although the risk of VTE persists after hospital discharge, information on the utilization of anticoagulants among stroke patients after discharge remains limited.
Source: Journal of Stroke and Cerebrovascular Diseases - August 12, 2022 Category: Neurology Authors: Ghadeer K. Dawwas, Adam Cuker, Aaron Rothstein, Sean Hennessy Source Type: research

Cardiac Imaging Within Emergency CT Angiography for Acute Stroke Can Detect Atrial Clots
This study was approved by the ethics committee of the medical faculty of the Ruhr University Bochum. FIGURE 1 Figure 1. Flow chart showing the selection of the study population. Results A total of 59 patients underwent emergency CCTA (Figure 2A) for suspected stroke, of which 44 received the final diagnosis ischemic stroke. There were 17 patients who had ischemic stroke or TIA and known or newly diagnosed atrial fibrillation (Table 1; mean age: 77.5 years, standard deviation: 8.4 years; 53% female). As hypothesized, intracardiac thrombi could be visualized: once in an artificially occluded left atrial appe...
Source: Frontiers in Neurology - April 9, 2019 Category: Neurology Source Type: research

Expansion of the dimensions in the current management of acute ischemic stroke
AbstractStroke is the fifth leading cause of death in the United States with a huge burden on health care. Acute ischemic stroke (AIS) accounts for 87% of all stroke. The use of thrombolytic agents in AIS treatment is well known since 1950 but no FDA approval until 1996, due to lack of strong evidence showing benefits outweigh the risk of intracranial hemorrhage. The NINDS trial led to the approval of intravenous tissue plasminogen activator treatment (IV recombinant tPA) within 3  h of stroke. Due to this limitation of 3–4.5 h. window, evolution began in the development of effective endovascular therapy (EVT). Multipl...
Source: Journal of Neurology - May 19, 2020 Category: Neurology Source Type: research

New Data From Two Large Studies Reinforce Effectiveness of Dual Pathway Inhibition (DPI) with XARELTO ® (rivaroxaban) Plus Aspirin in Patients with Coronary Artery Disease (CAD) and/or Peripheral Artery Disease (PAD)
RARITAN, N.J., May 23, 2022 – Findings from the XARELTO® (rivaroxaban) Phase 3 COMPASS Long-Term Open Label Extension (LTOLE) study and the XARELTO® in Combination with Acetylsalicylic Acid (XATOA) registry have been published in the European Society of Cardiology’s (ESC) European Heart Journal, Cardiovascular Pharmacotherapy. Additionally, the XATOA registry was presented at the American Congress of Cardiology’s 71st Annual Scientific Session (ACC.22). These studies provide further evidence supporting the role of dual pathway inhibition (DPI) with the XARELTO® vascular dose (2.5 mg twice daily plus aspirin 100 mg...
Source: Johnson and Johnson - May 23, 2022 Category: Pharmaceuticals Source Type: news

Poststroke venous thromboembolism and neutrophil activation: an illustrated review
Res Pract Thromb Haemost. 2023 Apr 29;7(4):100170. doi: 10.1016/j.rpth.2023.100170. eCollection 2023 May.ABSTRACTPatients with acute ischemic stroke are at a high risk of venous thromboembolism (VTE), such as deep vein thrombosis (DVT), estimated to affect approximately 80,000 patients with stroke each year in the United States. The prevalence of symptomatic DVT after acute stroke is approximately 10%. VTE is associated with increased rates of in-hospital death and disability, with higher prevalence of in-hospital complications and increased 1-year mortality in patients with stroke. Current guidelines recommend the use of ...
Source: Thrombosis and Haemostasis - June 5, 2023 Category: Hematology Authors: Nirav Dhanesha Junaid Ansari Nilesh Pandey Harpreet Kaur Chiranjiv Virk Karen Y Stokes Source Type: research

Not as Simple as Canker Sores
BY ​NANA P. MATSUMOTO, & DEREK MEEKS, DO​​A 16-year-old boy presented to a rural ED with a swollen jaw, painful blisters in the mouth, and earache for the past day. One week before, he had a fever with chills, sore throat, and dry coughs. He was not taking any medications, and his immunizations were up-to-date. He had a mild learning disorder but no significant past medical or surgical history.​An apthous ulcer, the most common and one of the earliest signs of Behçet's disease.The patient's vital signs were within normal limits, and his physical examination revealed anterior cervical lymphadenopathy, sinus con...
Source: The Case Files - October 11, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Fool Me Once: An Uncommon Presentation of PE
​BY FREDDIE IRIZARRY-DELGADO; VAROON KAKAIYA; & AHMED RAZIUDDIN, MDAn 86-year-old African-American woman was brought to the ED by her daughter after two days of nutritional neglect, abdominal pain, and altered mental status. Her daughter said her mother felt lightheaded, appeared dehydrated, and vomited nonbilious watery fluid once. The patient had a history of diabetes mellitus type 2, DVT/PE, dementia, and early signs of parkinsonism.Her vital signs were remarkable only for tachypnea (24 bpm). Her troponin I was markedly elevated at 1.7 ng/mL. A D-dimer was ordered because of her history of unprovoked DVT/PE, and i...
Source: The Case Files - November 27, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Increased Prevalence, Complications, and Costs of Smokers Undergoing Total Knee Arthroplasty
J Knee Surg DOI: 10.1055/s-0040-1713128Given a national push toward bundled payment models, the purpose of this study was to examine the prevalence as well as the effect of smoking on early inpatient complications and cost following elective total knee arthroplasty (TKA) in the United States across multiple years. Using the nationwide inpatient sample, all primary elective TKA admissions were identified from 2012 to 2014. Patients were stratified by smoking status through a secondary diagnosis of “tobacco use disorder.” Patient characteristics as well as prevalence, costs, and incidence of complications were compared. ...
Source: Journal of Knee Surgery - June 23, 2020 Category: Orthopaedics Authors: Rajaee, Sean S. Debbi, Eytan M. Paiement, Guy D. Spitzer, Andrew I. Tags: Original Article Source Type: research

Scientific Approach to Assess if Change Led to Improvement —Methods for Statistical Process Control Analysis in Quality Improvement
Quality improvement is an expectation in most hospitals and emergency departments throughout the United States. With hospitals requiring reporting on key metrics such as readmission rates, time to thrombolytic administration in stroke, or time to cardiac catheterization laboratory activation for ST-elevation myocardial infarctions, many emergency departments deploy quality improvement teams to monitor and improve these metrics and others to promote quality and safety. Emergency nurses and managers are key members and leaders of these quality improvement teams.
Source: Journal of Emergency Nursing: JEN - October 23, 2020 Category: Nursing Authors: Maegan S. Reynolds, Sandra P. Spencer, Ashley Dunaway, Don Buckingham, Thomas Bartman Tags: Understanding Research Source Type: research