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Total 389 results found since Jan 2013.

Functional outcomes of pre-hospital thrombolysis in a mobile stroke treatment unit compared with conventional care: an observational registry study
This study is registered with ClinicalTrials.gov, number NCT02358772. Findings Between Feb 5, 2011, and March 5, 2015, 427 patients were treated within the STEMO vehicle and their data were entered into a pre-hospital registry. 505 patients received conventional care and their data were entered into an in-hospital thrombolysis registry. Of these, 305 patients in the STEMO group and 353 in the conventional care group met inclusion criteria and were included in the analysis. 161 (53%) patients in the STEMO group versus 166 (47%) in the conventional care group had an mRS score of 1 or lower (p=0·14). Compared with conventio...
Source: The Lancet Neurology - July 15, 2016 Category: Neurology Source Type: research

Effects of alteplase on survival after ischaemic stroke (IST-3): 3 year follow-up of a randomised, controlled, open-label trial
We report the effect of intravenous alteplase on long-term survival after ischaemic stroke of participants in the Third International Stroke Trial (IST-3). Methods In IST-3, done at 156 hospitals in 12 countries (Australia, Europe, and the UK), participants (aged >18 years) were randomly assigned with a telephone voice-activated or web-based system in a 1:1 ratio to treatment with intravenous 0·9 mg/kg alteplase plus standard care or standard care alone within 6 h of ischaemic stroke. We followed up participants in the UK and Scandinavia (Sweden and Norway) for survival up to 3 years after randomisation using data...
Source: The Lancet Neurology - July 19, 2016 Category: Neurology Source Type: research

Promoting Evidence-Based Practice at a Primary Stroke Center: A Nurse Education Strategy.
DISCUSSION: This nurse education strategy increased RNs' confidence in ability to explain the path from evidence to bedside nursing care by demonstrating how evidence-based clinical practice guidelines provide current evidence used to create standardized order sets. Although further evaluation of the intervention's effectiveness is needed, this educational intervention has the potential for generalization to different types of standardized order sets to increase nurse confidence in utilization of evidence-based practice. PMID: 28570379 [PubMed - in process]
Source: Dimensions in Critical Care Nursing - June 2, 2017 Category: Nursing Tags: Dimens Crit Care Nurs Source Type: research

Assessment of healthcare personnel knowledge of stroke care at a large referral hospital in sub-Saharan Africa – A survey based approach
Publication date: August 2017 Source:Journal of Clinical Neuroscience, Volume 42 Author(s): Chen Lin, Ravi Vakani, Peter Kussin, Mary Guhwe, Alfredo E. Farjat, Kingshuk Choudhury, David Renner, Chrispine Oduor, Carmelo Graffagnino There is no published literature regarding sub-Saharan health-care providers’ understanding of stroke management patterns. Understanding current stroke management knowledge is important in formulating future education opportunities for providers to optimize patient outcomes. A cross-sectional survey of acute stroke diagnosis, hospital management, and secondary prevention questions was administ...
Source: Journal of Clinical Neuroscience - June 29, 2017 Category: Neuroscience Source Type: research

European Academy of Neurology – European Stroke Organisation consensus statement and practical guidance for pre‐hospital management of stroke
This article is protected by copyright. All rights reserved.
Source: European Journal of Neurology - December 7, 2017 Category: Neurology Authors: A. Kobayashi, A. Czlonkowska, G.A. Ford, A.C. Fonseca, G.J. Luijckx, J. Korv, N. P érez de la Ossa, C. Price, D. Russell, A. Tsiskaridze, M. Messmer‐Wullen, J. De Keyser Tags: Guidelines Source Type: research

Optimizing Prehospital Triage for Patients With Stroke Involving Large Vessel Occlusion
The past 20 years have witnessed a revolution in the paradigm of acute ischemic stroke treatment. In 1996, intravenous alteplase was shown to improve outcomes among patients treated within 3 hours of stroke onset. This finding upended the historical therapeutic nihilism about stroke, and with it the leisurely armchair approach to stroke treatment. The concept of so-called acute ischemic stroke emerged. This changed the nature and practice of vascular neurology, created a vigorous and sometimes controversial debate between vascular neurologists and emergency physicians about the merits of alteplase, and paved the way for mo...
Source: JAMA Neurology - September 4, 2018 Category: Neurology Source Type: research

Organizing stroke systems in the field for patients with suspected large vessel occlusion acute stroke.
Authors: Almekhlafi MA, Holodinsky JK, Hill MD, Kamal N, Goyal M Abstract INTRODUCTION: The dawn of endovascular stroke therapy has reshaped stroke care. Eligible patients need to be rushed to capable centers for intervention. This may entail bypassing closer hospitals that could confirm the diagnosis, administer thrombolytic therapy, then transfer patients for intervention. This has created a set of challenges: identifying endovascular candidates in the field, determining the best transport destination, and getting patients there quickly. Areas covered: This review provides a context for these emerging challenges....
Source: Expert Review of Cardiovascular Therapy - November 20, 2018 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

A support programme for secondary prevention in patients with transient ischaemic attack and minor stroke (INSPiRE-TMS): an open-label, randomised controlled trial
Publication date: Available online 7 November 2019Source: The Lancet NeurologyAuthor(s): Michael Ahmadi, Inga Laumeier, Thomas Ihl, Maureen Steinicke, Caroline Ferse, Matthias Endres, Armin Grau, Sidsel Hastrup, Holger Poppert, Frederick Palm, Martin Schoene, Christian L Seifert, Farid I Kandil, Joachim E Weber, Paul von Weitzel-Mudersbach, Martin L J Wimmer, Ale Algra, Pierre Amarenco, Jacoba P Greving, Otto BusseSummaryBackgroundPatients with recent stroke or transient ischaemic attack are at high risk for a further vascular event, possibly leading to permanent disability or death. Although evidence-based treatments for ...
Source: The Lancet Neurology - November 8, 2019 Category: Neurology Source Type: research

Academic outcome in pediatric ischemic stroke.
Abstract An important cause of acquired brain injury in children, pediatric ischemic stroke can cause sequelae across a wide range of cognitive domains, including verbal reasoning and processing speed. As a result, survivors are especially vulnerable to academic difficulties and face unique challenges compared to their peers. Despite this knowledge, pediatric stroke remains an understudied neurological condition, and its impact on school functioning poorly understood. The present clinical study addressed academic outcome in this population using a multifaceted approach. Patients were recruited for participation fr...
Source: Child Neuropsychology - January 8, 2020 Category: Child Development Authors: Champigny CM, Deotto A, Westmacott R, Dlamini N, Desrocher M Tags: Child Neuropsychol Source Type: research

Mobile stroke units: taking stroke care to the patient
Purpose of review Since the development of intravenous tissue plasminogen activator (tPA) for acute ischemic stroke (AIS), functional outcome has improved when treatment occurs within 4.5 h of stroke onset and treatment benefits are greater with earlier treatment. Endovascular revascularization also is better the sooner it is delivered. Recent findings The Get with the Guidelines Stroke registry found that less than one-third of treatment-eligible AIS patients receive intravenous tPA within 60 min of hospital arrival. Initiatives have tried to improve public education and awareness of stroke symptoms to decrease t...
Source: Current Opinion in Critical Care - March 6, 2020 Category: Nursing Tags: ACUTE NEUROLOGICAL PROBLEMS: Edited by Peter Le Roux Source Type: research

Stroke Care Services in Singapore During COVID-19 Pandemic —A National Perspective
Stroke is a significant cause of admission to Singapore's acute care hospitals. Because of the current COVID-19 pandemic, there have been major changes in the stroke care system. On calling for the public ambulance, those suspected to have COVID-19 infection are taken to the National Center for Infectious Diseases. Otherwise, on arrival at the emergency room, all cases with fever or respiratory symptoms [COVID-19 suspect patients (CSPs)] are evaluated separately by staff wearing full personal protective equipment (PPE). Triage is not delayed. CSPs needing hyperacute therapies are sent to a specially prepared scanner; if no...
Source: Frontiers in Neurology - July 27, 2020 Category: Neurology Source Type: research

Evaluating remote facilitation intensity for multi-national translation of nurse-initiated stroke protocols (QASC Australasia): a protocol for a cluster randomised controlled trial
DISCUSSION: We will generate new evidence on the most effective facilitation intensity to support implementation of nurse-initiated stroke protocols nationwide, reducing geographical barriers for those in rural and remote areas.TRIAL REGISTRATION: ACTRN12622000028707. Registered 14 January, 2022.PMID:36703172 | DOI:10.1186/s13012-023-01260-9
Source: Rural Remote Health - January 26, 2023 Category: Rural Health Authors: O Fasugba S Dale E McInnes D A Cadilhac M Noetel K Coughlan B McElduff J Kim T Langley N W Cheung K Hill V Pollnow K Page E Sanjuan Menendez E Neal S Griffith L J Christie J Slark A Ranta C Levi J M Grimshaw S Middleton 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

"Time is brain" : Optimizing prehospital stroke management.
Abstract Acute stroke is one of the main causes of death and chronic disability. Thrombolysis, achieved by administering recombinant tissue plasminogen activator within 4.5 h, is an effective therapeutic option for ischemic stroke. However, less than 2-12 % of patients receive this treatment and a major reason is that most patients reach the hospital too late. Several time-saving measures should be implemented. Firstly, optimized and continual public awareness campaigns for patients should be initiated to reduce delays in notifying the emergency medical service. Secondly, emergency medical service personnel sho...
Source: Der Nervenarzt - November 27, 2013 Category: Neurology Authors: Haass A, Walter S, Ragoschke-Schumm A, Grunwald IQ, Lesmeister M, Khaw AV, Fassbender K Tags: Nervenarzt Source Type: research