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Source: Neurology
Condition: Disability

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Total 221 results found since Jan 2013.

Population-based study of home-time by stroke type and correlation with modified Rankin score
Conclusions: We showed that home-time is an objective and graded indicator that is correlated with disability after stroke. It is obtainable from administrative data, applicable to different stroke types, and a valuable outcome indicator in population-based health services research.
Source: Neurology - November 6, 2017 Category: Neurology Authors: Yu, A. Y. X., Rogers, E., Wang, M., Sajobi, T. T., Coutts, S. B., Menon, B. K., Hill, M. D., Smith, E. E. Tags: Outcome research, Medical care, Infarction, Intracerebral hemorrhage ARTICLE Source Type: research

Oral antidiabetic drugs and dementia risk: Does treatment matter?
As the population ages, dementia grows as a public health problem. The rising life expectancy and the aging of the so-called baby boomer cohort translate to a substantial number of people reaching ages of high risk for age-related conditions like dementia. As a major cause of disability and dependency in elderly people, dementia puts social and economic burden on patients and their families and affects health care systems worldwide. In the absence of a cure, primary prevention will have the largest effect on the reduction of dementia occurrence.1 Thus, public health research should focus on the identification of modifiable...
Source: Neurology - October 30, 2017 Category: Neurology Authors: Fink, A., Haenisch, B. Tags: All Cognitive Disorders/Dementia, All epidemiology EDITORIALS Source Type: research

Striving to improve the quality of stroke care in the USA
Compelling evidence indicates that the organization and delivery of stroke care makes a difference in the chances of patients surviving, their level of disability, and the chances of further strokes. Most evidence-based interventions do not require expensive high-technology medicine but rather need well-organized basic care delivered by people with expertise in stroke. Yet there are many places in the world, including parts of the United States, where high-quality care cannot be guaranteed, resulting in higher than necessary levels of mortality and morbidity.
Source: Neurology - October 9, 2017 Category: Neurology Authors: Rudd, A., Bray, B. Tags: EDITORIALS Source Type: research

Quality improvement in neurology: Stroke and Stroke Rehabilitation Quality Measurement Set update
Stroke is the fifth leading cause of death in the United States and the second leading cause of disability worldwide.1,2 "On average, every 40 seconds, someone in the United States has a stroke, and someone dies of one approximately every 4 minutes."3 Each year, nearly 800,000 people experience stroke, with up to 185,000 experiencing recurrent stroke events.3 Strokes occur at any age, and risk increases with age.4 Nearly half of older stroke survivors experience moderate to severe disability.5
Source: Neurology - October 9, 2017 Category: Neurology Authors: Latorre, J. G. S., Flanagan, S., Phipps, M. S., Shenoy, A. M., Bennett, A., Seidenwurm, D. Tags: All Imaging, All Cerebrovascular disease/Stroke, All Rehabilitation, All Practice Management SPECIAL ARTICLE Source Type: research

Functional impairments for outcomes in a randomized trial of unruptured brain AVMs
Conclusion: Death or stroke with functional impairment in ARUBA after a median follow-up of 33 months was significantly lower for those in the MM arm both as randomized and as treated compared with those with IT. Functional severity of outcomes was lower in the MM arm, regardless of Spetzler-Martin grades. ClinicalTrials.gov identifier: NCT00389181. Classification of evidence: This study provides Class II evidence that for adults with unruptured brain AVMs, interventional management compared to MM increases the risk of disability and death over 3 years.
Source: Neurology - October 2, 2017 Category: Neurology Authors: Mohr, J. P., Overbey, J. R., von Kummer, R., Stefani, M. A., Libman, R., Stapf, C., Parides, M. K., Pile-Spellman, J., Moquete, E., Moy, C. S., Vicaut, E., Moskowitz, A. J., Harkness, K., Cordonnier, C., Biondi, A., Houdart, E., Berkefeld, J., Klijn, C. J Tags: All Clinical trials, All Cerebrovascular disease/Stroke, Arteriovenous malformation, Class II, Intracerebral hemorrhage ARTICLE Source Type: research

Trends in stroke incidence in the United States: Will women overtake men?
Stroke poses a heavy burden on health systems, with serious implications for societies and economies. At the global level, stroke is the second leading cause of death and the third most common cause of disability.1 In the United States, about 795,000 strokes occur every year: on average, someone has a stroke every 40 seconds and someone dies as a result of a stroke every 4 minutes.2 Stroke incidence and mortality rates have decreased in the last decades3; however, the aging of populations and improvements in stroke management have resulted in higher numbers of people experiencing a stroke, and more stroke survivors requiri...
Source: Neurology - September 4, 2017 Category: Neurology Authors: Koton, S., Rexrode, K. M. Tags: EDITORIALS Source Type: research

DNA methylation predicts stroke outcome better: The epigenetic clock is ticking
As a leading cause of disability worldwide, stroke renders people disabled through several mechanisms. Over half of patients have sensorimotor and cognitive deficits, one-third experience depression and social disability, and half never return to work. Our ability to predict recurrent stroke and disability poststroke remains poor despite modern medical advances.1 The uncertainty surrounding the recovery process creates critical knowledge gaps for clinicians deciding on the most appropriate care plan, and leads to substantial anxiety for patients and their families. Identification of factors that affect prognosis after stro...
Source: Neurology - August 21, 2017 Category: Neurology Authors: Wang, L., Pare, G., Rundek, T. Tags: EDITORIALS Source Type: research

Serum matrix metalloproteinase-9 levels and prognosis of acute ischemic stroke
Conclusions: Higher serum MMP-9 levels in the acute phase of ischemic stroke were associated with increased risk of mortality and major disability, suggesting that serum MMP-9 could be an important prognostic factor for ischemic stroke.
Source: Neurology - August 21, 2017 Category: Neurology Authors: Zhong, C., Yang, J., Xu, T., Xu, T., Peng, Y., Wang, A., Wang, J., Peng, H., Li, Q., Ju, Z., Geng, D., Zhang, Y., He, J., For the CATIS Investigators Tags: Stroke prevention, Prognosis, All Cerebrovascular disease/Stroke, Clinical trials Observational study (Cohort, Case control), Cohort studies ARTICLE Source Type: research

Physical activity, but not body mass index, predicts less disability before and after stroke
Source: Neurology - July 31, 2017 Category: Neurology Tags: CORRECTIONS Source Type: research

Aggressiveness of care following intracerebral hemorrhage in women and men
Conclusions: After ICH, women do not receive less aggressive care than men after controlling for the substantial comorbidity differences. Future studies on sex bias should include the presence of comorbidities, prestroke disability, and other factors that may influence management.
Source: Neurology - July 24, 2017 Category: Neurology Authors: Guha, R., Boehme, A., Demel, S. L., Li, J. J., Cai, X., James, M. L., Koch, S., Langefeld, C. D., Moomaw, C. J., Osborne, J., Sekar, P., Sheth, K. N., Woodrich, E., Worrall, B. B., Woo, D., Chaturvedi, S. Tags: All Cerebrovascular disease/Stroke, Intracerebral hemorrhage ARTICLE Source Type: research

Endovascular thrombectomy: Time is still brain
The "Time is brain" concept should be familiar to anyone who cares for patients with acute ischemic stroke. IV tissue plasminogen activator (tPA) reduces disability after stroke when administered within 4.5 hours of symptom onset, but the benefit of IV tPA is time-dependent.1 Earlier treatment improves functional outcomes. Quantified many ways, studies provide estimates in terms of functional outcome at 90 days, neurons saved, and days of disability-free life gained.1–3 As a result, door-to-needle time, defined as the time from hospital arrival to the initiation of IV tPA, has become an important quality metric for s...
Source: Neurology - May 29, 2017 Category: Neurology Authors: Mullen, M. T., Chaturvedi, S. Tags: Outcome research, Quality of life, All Cerebrovascular disease/Stroke, Models of care, Infarction EDITORIALS Source Type: research

Endovascular therapy for ischemic stroke: Save a minute--save a week
Conclusions: Small reductions in endovascular delays lead to marked health benefits over patients' lifetimes. Services need to be optimized to reduce delays to endovascular therapy.
Source: Neurology - May 29, 2017 Category: Neurology Authors: Meretoja, A., Keshtkaran, M., Tatlisumak, T., Donnan, G. A., Churilov, L. Tags: Outcome research, Quality of life, All Cerebrovascular disease/Stroke, Models of care, Infarction ARTICLE Source Type: research

Physical activity, but not body mass index, predicts less disability before and after stroke
Conclusions: Physical inactivity predicts a higher risk of being dependent both before and after stroke.
Source: Neurology - May 1, 2017 Category: Neurology Authors: Rist, P. M., Capistrant, B. D., Mayeda, E. R., Liu, S. Y., Glymour, M. M. Tags: All Cerebrovascular disease/Stroke, Cohort studies, Risk factors in epidemiology ARTICLE Source Type: research

Increase in Rate of Utilization of Withdrawal of Care in Acute Ischemic Stroke in USA (P1.209)
Conclusions:We found a considerable increase in rate of withdrawal of care with aggressive treatment, which may be due to disease severity and/or patient/family preference. Prognostic models and clinical experience for severe stroke patients may be biased by frequent withdrawal of care, leading to errors in prognostication with significant consequences including premature withdrawal of care, suboptimal outcomes and higher risk of short-term mortalityStudy Supported by: NADisclosure: Dr. Adil has nothing to disclose. Dr. Zweifler has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Adil, M., Zweifler, R. Tags: Pain and Palliative Care Source Type: research

Early Palliative Care Consultation Decreases Length of Stay in Severe Stroke Patients (P1.211)
Conclusions:Early PCC in severe stroke patients decreased hospital LOS by 3 days. This may be due to prompt clarification of goals of care and hastened discharge to hospice. Advanced age, poor pre-stroke functional status, and severe post-stroke deficits and disability warrant early PCC. In addition to decreasing LOS, further study is needed to determine whether early PCC also limits futile tests, procedures, and iatrogenic complications. Ultimately, timely identification of PCC candidates may produce higher satisfaction and decreased hospital costs.Disclosure: Dr. Schloss has nothing to disclose. Dr. Tversky has nothing t...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Schloss, E. R., Tversky, S., Katz, J. M., Wright, P. Tags: Pain and Palliative Care Source Type: research