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Effectiveness of emergency physician determinations of the need for thrombolytic therapy in acute stroke.
Abstract An increased emphasis on stroke care has led to a proliferation of specialized stroke teams despite relatively few trials demonstrating their efficacy. Our academic stroke center incorporated a unique setup allowing for the comparison between stroke teams and emergency physicians. During weekday working hours, a stroke team would respond to the emergency department for stroke activations. During all other times, the emergency physician caring for the patient would make all treatment decisions. We sought to determine whether there was any difference in treatment and outcomes between these two groups. We co...
Source: Baylor University Medical Center Proceedings - September 30, 2019 Category: Universities & Medical Training Authors: Juergens AL, Barney J, Julakanti M, Allen L, Shaver C Tags: Proc (Bayl Univ Med Cent) Source Type: research

A Systematic Review of the Predictive Value of Plasma D-Dimer Levels for Predicting Stroke Outcome
Conclusion: The study provides preliminary evidence concerning the capacity of plasma D-dimer levels for predicting functional outcomes and mortality following stroke and reports that higher D-dimer levels of are associated with poorer functional outcomes and higher mortality.
Source: Frontiers in Neurology - July 6, 2021 Category: Neurology Source Type: research

Stroke Seasonality and Weather Association in a Middle East Country: A Single Tertiary Center Experience
Conclusions: In Riyadh, Saudi Arabia, our study found no impact of weather or seasonal variations on stroke incidence, hospital course, or outcomes. However, our findings warrant further research in different country regions.
Source: Frontiers in Neurology - October 18, 2021 Category: Neurology Source Type: research

Impact of the COVID-19 pandemic on acute stroke care: An  analysis of the 24-month data from a comprehensive stroke center in Shanghai, China
CONCLUSIONS: During the 24 months of COVID-19, a prolongation of stroke onset to hospital arrival and to intravenous rt-PA administration times were noted. Meanwhile, acute stroke patients needed to stay in the ED for a longer time before hospitalization. Educational system support and process optimization should be pursued in order to acquire timely delivery of stroke care during the pandemic.PMID:36890633 | DOI:10.1111/cns.14148
Source: CNS Neuroscience and Therapeutics - March 8, 2023 Category: Neuroscience Authors: Qimin Hu Yiming Hu Yue Gu Xiaoyan Song Yijue Shen Haiyan Lu Li Zhang Peifeng Liu Guodong Wang Chunni Guo Kan Fang Qiaoshu Wang Source Type: research

Abstract 238: Utilization and Safety of a Heparin Nomogram in Treating Thrombotic Comorbidities in Stroke Patients Poster Session II
CONCLUSION: The heparin stroke nomogram appears safe in that it does not increase risk of ICH. However, therapeutic aPTTs are not reached quickly with less than half of patients therapeutic at 24 hours, nor are they maintained at steady state. This nomogram could be too conservative in cases where clinical situation requires rapid anticoagulation.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Grantz, M. R., Proctor, P., Skalabrin, E., Pendleton, R. C., Majersik, J. J. Tags: Poster Session II Source Type: research

Early Access to a Neurologist Reduces the Rate of Missed Diagnosis in Young Strokes
Conclusions: Young adults with ischemic stroke seen at hospitals with a neurology residency had a lower missed diagnosis rate. The presence of an EM resident or a neurology teaching program was associated with a greater use of acute stroke therapies. These results support initiatives to triage young adults with suspected acute stroke to hospitals with access to neurologic expertise in the emergency department.
Source: Journal of Stroke and Cerebrovascular Diseases - February 18, 2013 Category: Neurology Authors: Wazim Mohamed, Pratik Bhattacharya, Seemant Chaturvedi Tags: Original Articles Source Type: research

Associations between Cardioembolic Stroke and Obstructive Sleep Apnea
Conclusions:There appears to be a strong association between obstructive sleep apnea (OSA) and cardioembolic (CE) stroke. In patients with OSA presenting with cryptogenic stroke, high clinical suspicion for CE is warranted. This may lead to consideration of diagnostic studies to identify CE risk factors such as paroxysmal atrial fibrillation (AF). CE strokes are more common in patients with OSA even after adjusting for AF. This finding may reflect a high rate of occult paroxysmal AF in this population; alternatively, OSA may lead to CE strokes through mechanisms independent of AF.Citation:Lipford MC, Flemming KD, Calvin AD...
Source: Sleep - October 31, 2015 Category: Sleep Medicine Source Type: research

Language, cognitive and school outcomes following childhood stroke
Discussion/conclusion Childhood stroke leads to severe language and cognitive impairments, with negative and long lasting consequences on academic achievement.
Source: Annals of Physical and Rehabilitation Medicine - September 20, 2016 Category: Rehabilitation Source Type: research

Interventions for dysarthria due to stroke and other adult-acquired, non-progressive brain injury.
CONCLUSIONS: We found no definitive, adequately powered RCTs of interventions for people with dysarthria. We found limited evidence to suggest there may be an immediate beneficial effect on impairment level measures; more, higher quality research is needed to confirm this finding.Although we evaluated five studies, the benefits and risks of interventions remain unknown and the emerging evidence justifies the need for adequately powered clinical trials into this condition.People with dysarthria after stroke or brain injury should continue to receive rehabilitation according to clinical guidelines. PMID: 28121021 [PubMe...
Source: Cochrane Database of Systematic Reviews - January 24, 2017 Category: Journals (General) Authors: Mitchell C, Bowen A, Tyson S, Butterfint Z, Conroy P Tags: Cochrane Database Syst Rev Source Type: research

Findings from the University of Minnesota Posterior Circulation Stroke Database (P3.262)
Conclusions:Our work adds to the meager literature on AIPCS. Further studies of medical and endovascular intervention in AIPCS secondary to LAA are particularly needed in order to define optimal treatment in this patient subset.Disclosure: Dr. Bell has nothing to disclose. Dr. Anderson has received personal compensation in an editorial capacity Neurology: Clinical Practice and Continuum Audio. Dr. Lakshminarayan has nothing to disclose. Dr. Jagadeesan has nothing to disclose. Dr. Reshi has nothing to disclose. Dr. Miller has nothing to disclose. Dr. Ezzeddine has received personal compensation for activities with Air Liqui...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Bell, C., Anderson, D., Lakshminarayan, K., Jagadeesan, B., Reshi, R. A., Miller, B., Ezzeddine, M., Streib, C. Tags: Cerebrovascular Disease Epidemiology Source Type: research

Improving Stroke Clinical Trial Enrollment via the Use of Telemedicine (S6.007)
Conclusions:Our results indicate it is feasible to enroll acute stroke patients into clinical trials through the use of remote telemedicine consultations. Telemedicine can increase the rate of enrollment in stroke clinical trials. As telemedicine is increasingly utilized, this novel approach can be used to successfully accelerate the completion of clinical trials.Disclosure: Dr. Noroozi has nothing to disclose. Dr. Sangha has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Noroozi, J., Sangha, N. Tags: Research Methdology and Education: Education Research Source Type: research

The Extended Treatment Window's Impact on Emergency Systems of Care for Acute Stroke.
This article is protected by copyright. All rights reserved. PMID: 30664306 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - January 21, 2019 Category: Emergency Medicine Authors: Miller JB, Heitsch L, Madsen TE, Oostema J, Reeves M, Zammit CG, Sabagha N, Sozener C, Lewandowski C, Schrock JW Tags: Acad Emerg Med Source Type: research

What Is the Dose-Response Relationship Between Exercise and Cardiorespiratory Fitness After Stroke? A Systematic Review.
CONCLUSIONS: Exercising at an intensity greater than 72% of heart rate reserve may be more effective in increasing cardiorespiratory fitness after stroke than exercising at lower intensities. More trials that compare exercise doses by manipulating only 1 parameter of dose at a time for people after stroke are needed. PMID: 30834439 [PubMed - as supplied by publisher]
Source: Physical Therapy - March 4, 2019 Category: Physiotherapy Authors: Galloway M, Marsden DL, Callister R, Erickson KI, Nilsson M, English C Tags: Phys Ther Source Type: research

The Association of Social Isolation on the Risk of Stroke among Middle-aged and Older Adults in China.
Abstract Given there is limited research examining the specific role social isolation plays in stroke risk, we aimed to estimate the controlled direct effect of social isolation on stroke risk in China. A nationally representative sample (n=12,662) of individuals aged 45 and older (at baseline, 2011; with corresponding follow-ups in 2013 and 2015), was taken from the China Health and Retirement Longitudinal Study. Stroke was assessed through self- or proxy-reported physician diagnosis. Social isolation was measured by incorporating marital status; frequency of contact with friends, family, and children; and partic...
Source: Am J Epidemiol - May 30, 2019 Category: Epidemiology Authors: Zhou Z, Lin C, Ma J, Towne SD, Han Y, Fang Y Tags: Am J Epidemiol Source Type: research

Factors Influencing the Delivery of Intensive Rehabilitation in Stroke: Patient Perceptions Versus Rehabilitation Therapist Perceptions.
CONCLUSIONS: People with stroke perceived no barriers regarding the implementation of higher intensity rehabilitation in practice and were positive towards working at more intense levels. Contrastingly, from the therapists' perspective, therapists' beliefs about quality of movement and issues around staffing and resources were perceived to be barriers. In addition, therapists and people with stroke perceived the contents of the intervention differently, highlighting the importance of involving patients and clinicians in the development and evaluation of rehabilitation interventions. PMID: 31711211 [PubMed - as supplied by publisher]
Source: Physical Therapy - November 10, 2019 Category: Physiotherapy Authors: Janssen J, Klassen TD, Connell LA, Eng JJ Tags: Phys Ther Source Type: research