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Audit of inpatient acute stroke services in a university teaching hospital, 2020
DiscussionUsing national and international  audit data as an institutional benchmark provides a standard with which a service can be compared to highlight areas for improvement. We identified mood screening, swallow screening, thrombectomy rates, length of stay and time to neuroimaging as key areas for development in our centre. We are cur rently completing a process map to determine cause, effect, and solutions, and we will implement change using PDSA methodology as per SQUIRE 2.0 guidelines. The results of the re-audit cycle for 2020 will be available in 2021 to inform our progress. Ongoing quality improvement is esse...
Source: Irish Journal of Medical Science - March 16, 2021 Category: General Medicine Source Type: research

Emergency diagnosis of the acute vestibular syndrome.
CONCLUSIONS: The new bedside oculomotor test is suitable for the diagnosis of posterior circulation stroke manifesting with isolated vertigo in early cases, when the routine neuroradiologic methods have a lower sensitivity or are not available. Orv Hetil. 2017; 158(51): 2029-2040. PMID: 29250967 [PubMed - in process]
Source: Orvosi Hetilap - December 1, 2017 Category: General Medicine Authors: Tamás TL, Garai T, Király I, Mike A, Nagy C, Paukovics Á, Schmidt P, Szatmári F, Tompos T, Vadvári Á, Szirmai Á Tags: Orv Hetil Source Type: research

In light of recently published clinical trials and their implication for clinical practice, does a large catchment area acute hospital require 24  hour CT neck and head angiography and/or neuro-interventional services in the setting of acute ischaemic stroke?
ConclusionUHL should provide routine CT angiography to all patients presenting with acute ischaemic stroke in line with current guidelines. The need for provision of neuro-interventional services on-site proved more difficult to assess and requires further analysis.
Source: Irish Journal of Medical Science - August 15, 2017 Category: General Medicine Source Type: research

Impact of resident and fellow changeovers on patient outcomes: a nationwide cross-sectional study
ConclusionOur findings provide some reassurance regarding cohort changeover and mortality even if they suggest a loss of efficiency in some cases.
Source: The European Journal of Public Health - May 25, 2017 Category: General Medicine Source Type: research

Investigation and diagnostic formulation in patients admitted with transient loss of consciousness.
Abstract Several commonly completed tests have low diagnostic yield in the setting of transient loss of consciousness (T-LOC). We estimated the use and cost of inappropriate investigations in patients admitted with T-LOC and assessed if these patients were given a definitive diagnosis for their presentation. We identified 80 consecutive patients admitted with T-LOC to a university teaching hospital. Eighty-eight percent (70/80) had a computerized topography (CT) brain scan and 49% (34/70) of these scans were inappropriate based on standard guidelines. Almost half (17/80) of electroencephalograms (EEG) and 82% (9/1...
Source: Ir Med J - May 10, 2017 Category: General Medicine Authors: Briggs R, Coughlan T, Doherty J, Collins DR, O'Neill D, Kennelly SP Tags: Ir Med J Source Type: research

Depression and dynamic balance recovery among stroke survivors: A preliminary investigation
Conclusions There is a high prevalence of post-stroke depression among stroke survivors and they have poor dynamic balance. However, owing to small sample of participants in the present study, its premature to draw conclusion on the relationship between depression and dynamic balance recovery among stroke survivors from the result of this study.
Source: Polish Annals of Medicine - September 10, 2016 Category: Journals (General) Source Type: research

Validation of Siriraj Stroke Score in southeast Nigeria
Innocent Ijezie Chukwuonye,1 Kenneth Arinze Ohagwu,2 Enoch Ogbonnaya Uche,3,4 Abali Chuku,5 Rowland Ihezuo Nw.e,2 Christopher Chukwuemeka Ohagwu,6 Ignatius U Ezeani,7 Collins Ogbonna Nwabuko,8 Martin Anazodo Nnoli,9 Efosa Oviasu,4,10 Okechukwu Samuel Ogah4,11 1Division of Nephrology, 2Division of Neurology, Department of Internal Medicine, Federal Medical Centre, Umuahia, Nigeria; 3Division of Neurosurgery, Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria; 4Federal Medical Centre, Umuahia, Nigeria; 5Department of Ophthalmology, Federal Medical Centre, Umuahia, Nigeria; 6Department of Radiograp...
Source: International Journal of General Medicine - October 23, 2015 Category: Journals (General) Tags: International Journal of General Medicine Source Type: research

Identification of stroke during the emergency call: a descriptive study of callers' presentation of stroke
Conclusions This study implicates that fall/lying position and altered mental status could be considered as possible symptoms of stroke during an emergency call. Checking for FAST symptoms in these patients might uncover stroke symptoms. Future studies are needed to evaluate if actively asking for FAST symptoms in emergency calls presenting falls or a lying position can improve the identification of stroke. Trial registration number Stroke2010/703-31/2.
Source: BMJ Open - April 28, 2015 Category: Journals (General) Authors: Berglund, A., von Euler, M., Schenck-Gustafsson, K., Castren, M., Bohm, K. Tags: Open access, Diagnostics, Emergency medicine Research Source Type: research

Association of the 2011 ACGME Resident Duty Hour Reforms With Mortality and Readmissions Among Hospitalized Medicare Patients
Conclusions and RelevanceAmong Medicare beneficiaries, there were no significant differences in the change in 30-day mortality rates or 30-day all-cause readmission rates for those hospitalized in more intensive relative to less intensive teaching hospitals in the year after implementation of the 2011 ACGME duty hour reforms compared with those hospitalized in the 2 years before implementation.
Source: JAMA - December 10, 2014 Category: Journals (General) Source Type: research

Prevalence, components and associated demographic and lifestyle factors of the metabolic syndrome in type 2 diabetes mellitus
Background: Adults with the metabolic syndrome (MetS) are twice as likely to die from and three times as likely to have a heart attack or stroke compared with people without the syndrome. About 70-80% of type 2 diabetes mellitus (type 2 DM) patients are diagnosed with the MetS. Investigating the occurrence of the MetS in type 2 DM patients is critical for cardiovascular disease prevention. We evaluated the prevalence and components of the MetS and its associated clinical and demographic factors in a Ghanaian adult population with DM 2. Methods: This cross-sectional study was conducted among 200 previously diagnosed type 2 ...
Source: BioMed Central - July 15, 2014 Category: Journals (General) Authors: Victor MogreZenabankara S SalifuRobert Abedandi Source Type: research

The Differential Diagnosis of Hypoglycorrhachia in Adult Patients.
CONCLUSIONS:: Many diagnoses, both infectious and noninfectious, lead to hypoglycorrhachia and must be considered in the differential diagnosis. PMID: 24326618 [PubMed - as supplied by publisher]
Source: The American Journal of the Medical Sciences - December 10, 2013 Category: Journals (General) Authors: Chow E, Troy SB Tags: Am J Med Sci Source Type: research