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Characterizing the Penumbras of White Matter Hyperintensities and Their Associations With Cognitive Function in Patients With Subcortical Vascular Mild Cognitive Impairment
Conclusion In this study, reduced CBF and FA and increased MD in the inner NAWM layers for both PVWMH and DWMH suggested extensive WM alterations beyond the visible WM lesions commonly observed on clinical MRI of svMCI subjects. CBF penumbras cover more extensive WM at risk than DTI penumbras, suggesting the likelihood that compromised CBF precedes white matter integrity changes, and CBF penumbras may be a potential target for the prevention of further microstructural white matter damage. The imaging parameters investigated, however, did not correlate to cognition. Author Contributions YZ, QX, and XG conceived and desig...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

Decompressive Craniectomy for Traumatic Brain Injury: Postoperative TCD Cerebral Hemodynamic Evaluation
Conclusion: There is a wide heterogeneity of postoperative cerebral hemodynamic findings among TBI patients who underwent DC, including hemodynamic heterogeneity between their cerebral hemispheres. DC was proved to be effective for the treatment of cerebral oligoemia. Our data support the concept of heterogeneous nature of the pathophysiology of the TBI and suggest that DC as the sole treatment modality is insufficient. Introduction Decompressive craniectomy (DC) may effectively decrease intracranial pressure (ICP) and increase cerebral perfusion pressure (CPP) in traumatic brain injury (TBI) patients with refracto...
Source: Frontiers in Neurology - April 11, 2019 Category: Neurology Source Type: research

The implications of the Canadian Stroke Best Practice Recommendations for design and allocation of rehabilitation after hospital discharge: a problematization.
CONCLUSION: An alternate vision of post-discharge rehabilitation could help resolve this tension. Post-discharge rehabilitation could be envisioned as a self-management intervention. Rather than primarily an expert-driven process of measuring impairment and applying procedures aimed at normalization, rehabilitation would be considered facilitation of self-management with the goal of reengaging in forms of participation that comprise a satisfying life. Implications for Rehabilitation Implicit assumptions within best practice guidelines powerfully influence recommendations. These ideas are difficult to examine because they s...
Source: Disability and Rehabilitation - April 10, 2019 Category: Rehabilitation Authors: Egan MY, Laliberté-Rudman D, Rutkowski N, Lanoix M, Meyer M, McEwen S, Collver M, Linkewich E, Montgomery P, Quant S, Donnelly B, Fearn J Tags: Disabil Rehabil Source Type: research

Collectivism Is Associated With Greater Neurocognitive Fluency in Older Adults
This study aimed to evaluate the impact of self-construal on neurocognitive functions in older adults. A total of 86 community-dwelling older adults 60 years and older were assessed with three common self-report measures of self-construal along individualism and collectivism (IC). A cognitive battery was administered to assess verbal and non-verbal fluency abilities. Latent profile analysis (LPA) was used to categorize individuals according to IC, and one-way analyses of covariance (ANCOVA), including relevant covariates (e.g., ethnicity, gender, linguistic abilities), were used to compare neurocognitive functions between ...
Source: Frontiers in Human Neuroscience - April 10, 2019 Category: Neuroscience Source Type: research

Influence of low income on return to participation following stroke.
CONCLUSION: This case study demonstrated that even in a universal healthcare system, post-stroke participation for those with low incomes was severely restricted. Changes at the clinical level and at the public policy level could facilitate participation. Implications for rehabilitation Income influenced the experience of return to participation for the low-income stroke survivors by limiting their ability to afford housing, goods, and services. The macro environment, which regulates the healthcare and social service systems, was the strongest influence on return to participation for low income stroke survivors. Findings p...
Source: Disability and Rehabilitation - February 14, 2019 Category: Rehabilitation Authors: Sauvé-Schenk KML, Egan MY, Dubouloz-Wilner CJ, Kristjansson E Tags: Disabil Rehabil Source Type: research

End-of-Life Care for Stroke
Stroke is a leading cause of disability and the third leading cause of death in Canada, according to the Heart and Stroke Association. Despite a high mortality rate, the experience of dying from a stroke has received limited attention from a palliative point of view. When attempting to make inferences from other specialties that have well researched methods of palliation, there was an obvious gap when considering the stroke population. Palliative stroke patients, at the Royal University Hospital, rarely have access to a bed on a specialized palliative care unit.
Source: Journal of Pain and Symptom Management - November 30, 2018 Category: Palliative Care Authors: Shelley Jolly, Ruth Whelan, Kimberly Davy Source Type: research

Effects on balance skills and patient compliance of biofeedback training with inertial measurement units and exergaming in subacute stroke: a pilot randomized controlled trial.
Authors: Lupo A, Cinnera AM, Pucello A, Iosa M, Coiro P, Personeni S, Gimigliano F, Iolascon G, Paolucci S, Morone G Abstract Stroke patients have reduced balance and postural control that limits their activities of daily living and participation in social life. Recently, many exergaming systems based on video-biofeedback have been developed for balance training in neurological conditions, however their efficacy remains to be proven. The aim of this study was to investigate the effects on balance skills and patient compliance of biofeedback training based on inertial measurement units and exergaming in subacute str...
Source: Functional Neurology - November 22, 2018 Category: Neurology Tags: Funct Neurol Source Type: research

A Stitch in Time Saves 1.9 Million: How Advanced Imaging Solutions in Neuroradiology can Improve Outcomes for Stroke Patients
Stroke is the leading cause of disability in Canada and the third leading cause of death. Every year there are over 50,000 new strokes, with nearly 14,000 of cases resulting in death. For every minute delay in treating a stroke, the patient loses 1.9 million brain cells, and for each hour in which treatment does not occur, the brain loses as many neurons as it does in almost 3.6 years of normal aging. Thus, it is vital that the patient receives revascularization therapy as soon as possible. Despite this knowledge, there is still an inefficient use of time between stroke onset to revascularization.
Source: Journal of Medical Imaging and Radiation Sciences - September 1, 2018 Category: Radiology Authors: N.M. Cancelliere, J. Bracken, F. Nijnatten, T. Grunhagen, V.M. Pereira Source Type: research

Telehealth for Remote Stroke Management
Publication date: July 2018Source: Canadian Journal of Cardiology, Volume 34, Issue 7Author(s): Charlotte Zerna, Thomas Jeerakathil, Michael D. HillAbstractStroke is a leading cause of adult disability and the fourth leading cause of death in Canada. Most strokes are ischemic and functional outcome is highly time-dependent, making fast diagnosis and treatment initiation crucial. This poses a challenge in vast geographical areas where stroke neurology expertise is only available in urban centres. In this article we review the rationale for telestroke networks and their current implementation in Canada. Telestroke networks e...
Source: Canadian Journal of Cardiology - July 10, 2018 Category: Cardiology Source Type: research

Excessive sedentary time during in-patient stroke rehabilitation.
Conclusions In this sample of people attending inpatient stroke rehabilitation, institutional structure of rehabilitation rather than patient-related factors contributed to sedentary time. PMID: 29609499 [PubMed - as supplied by publisher]
Source: Topics in Stroke Rehabilitation - April 3, 2018 Category: Neurology Authors: Barrett M, Snow JC, Kirkland MC, Kelly LP, Gehue M, Downer MB, McCarthy J, Ploughman M Tags: Top Stroke Rehabil Source Type: research

Outcomes, experiences and palliative care in major stroke: a multicentre, mixed-method, longitudinal study.
Authors: Kendall M, Cowey E, Mead G, Barber M, McAlpine C, Stott DJ, Boyd K, Murray SA Abstract BACKGROUND: Case fatality after total anterior circulation stroke is high. Our objective was to describe the experiences and needs of patients and caregivers, and to explore whether, and how, palliative care should be integrated into stroke care. METHODS: From 3 stroke services in Scotland, we recruited a purposive sample of people with total anterior circulation stroke, and conducted serial, qualitative interviews with them and their informal and professional caregivers at 6 weeks, 6 months and 1 year. Interviews we...
Source: Canadian Medical Association Journal - March 7, 2018 Category: General Medicine Tags: CMAJ Source Type: research

“In this together”: Social identification predicts health outcomes (via self-efficacy) in a chronic disease self-management program
Conclusion The results are consistent with growing evidence of the value of a social identity-based approach in various health and clinical settings. The success of chronic disease self-management programs could be enhanced by attending to and augmenting group identification during and after the program.
Source: Social Science and Medicine - March 5, 2018 Category: Psychiatry & Psychology Source Type: research

Telehealth for remote stroke management
This article reviews the rationale for telestroke networks and their current implementation in Canada. Telestroke networks enable stroke-specific procedures to be performed by less experiences physicians under the guidance of stroke neurology experts. The article also presents evidence that the safety and effectiveness of intravenous alteplase in community hospitals in a telestroke network seems to be comparable to that achieved in dedicated stroke centres. It is thus a viable option to guarantee an aging population access to stroke care across large geographic regions with faster treatment and access to more advanced trea...
Source: Canadian Journal of Cardiology - December 27, 2017 Category: Cardiology Source Type: research

Ambient Ozone Pollution and Daily Mortality: A Nationwide Study in 272 Chinese Cities
Conclusions: Our findings provide robust evidence of higher nonaccidental and cardiovascular mortality in association with short-term exposure to ambient ozone in China. https://doi.org/10.1289/EHP1849 Received: 4 March 2017 Revised: 3 October 2017 Accepted: 20 October 2017 Published: 21 November 2017 Address correspondence to H. Kan, Department of Environmental Health, School of Public Health, Fudan University, P.O. Box 249, 130 Dong-An Road, Shanghai 200032, China. Telephone: 86 (21) 5423 7908. Email: kanh@fudan.edu.cn and M. Zhou, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chines...
Source: EHP Research - November 21, 2017 Category: Environmental Health Authors: Daniil Lyalko Tags: Research Source Type: research

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