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Total 149 results found since Jan 2013.

Epidemiology, Risk Factors, and Outcomes of Out-of-Hospital Cardiac Arrest Caused by Stroke: A Population-Based Study
We examined the epidemiology, risk factors, and outcomes of stroke-related OHCA compared with cardiogenic OHCA. The primary outcome was neurologically favorable survival. Of the 243,140 eligible patients, 18,682 (7.7%) were diagnosed with stroke-related OHCA. Compared to OHCA with a presumed cardiac etiology, stroke-related OHCA patients had a greater chance of prehospital return of spontaneous circulation (ROSC) (9.9% vs 5.9%, P 
Source: Medicine - April 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Selection of Postacute Stroke Rehabilitation Facilities: A Survey of Discharge Planners From the Northeast Cerebrovascular Consortium (NECC) Region
The objective of this study was to better understand the factors that influence postacute care decisions by surveying stroke discharge planners. Requests were sent to discharge planners at 471 hospitals in the Northeast United States to complete an online survey regarding the factors impacting the selection of postacute care. Seventy-seven (16%) discharge planners completed the online survey. Respondents were mainly nurses and social workers and 73% reported ≥20 years healthcare experience. Patients and families were found to be significantly more influential than physicians (P 
Source: Medicine - April 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

The Effect of Anesthetic Type on Outcomes of Hip Fracture Surgery: A Nationwide Population-Based Study
Abstract: Hip fractures are a global public health problem. During surgery following hip fractures, both general and regional anesthesia are used, but which type of anesthesia offers a better outcome remains controversial. There has been little research evaluating different anesthetic types on mortality and readmission rates for hip fracture surgery using nationwide population-based data. We used nationwide population-based data to examine the effect of anesthetic type on mortality and readmission rates for hip fracture surgery. Retrospective observational study. General acute care hospitals throughout Taiwan. A total ...
Source: Medicine - April 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

The Relationships Among Regionalization, Processes, and Outcomes for Stroke Care: A Nationwide Population-based Study
We examined the association of regionalization with processes and outcomes, and the mediating effect of processes of care on the association between regionalization and mortality for acute stroke in Taiwan. We analyzed all 229,568 admissions with acute ischemic stroke from January 2004 to September 2012 through Taiwan's National Health Insurance Research Database. Regionalized care for acute stroke has been implemented since July 2009 in Taiwan. Rates of thrombolytic therapy within 3 hours after onset of ischemic stroke, average numbers of processes of care, and 30-day mortality rates at monthly intervals for baseline...
Source: Medicine - April 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Correlation Between the Integrity of the Circle of Willis and the Severity of Initial Noncardiac Cerebral Infarction and Clinical Prognosis
This study was designed to investigate the effect of different circles of Willis types on stroke severity and prognosis in patients with noncardiac stroke. A total of 376 patients with noncardiac ischemic stroke, who were treated by the specialty team of cerebrovascular diseases at the First Affiliated Hospital of Sun Yat-sen Hospital, were successively enrolled in this study. The detailed clinical characteristics of the patients were recorded upon admission, including risk factors of vascular disease and National Institutes of Health Stroke Scale (NIHSS) scores. The patients were divided into groups of different circles ...
Source: Medicine - March 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Beyond Volume: Hospital-Based Healthcare Technology for Better Outcomes in Cerebrovascular Surgical Patients Diagnosed With Ischemic Stroke: A Population-Based Nationwide Cohort Study From 2002 to 2013
We examined whether the level of hospital-based healthcare technology was related to the 30-day postoperative mortality rates, after adjusting for hospital volume, of ischemic stroke patients who underwent a cerebrovascular surgical procedure. Using the National Health Insurance Service-Cohort Sample Database, we reviewed records from 2002 to 2013 for data on patients with ischemic stroke who underwent cerebrovascular surgical procedures. Statistical analysis was performed using Cox proportional hazard models to test our hypothesis. A total of 798 subjects were included in our study. After adjusting for hospital volume o...
Source: Medicine - March 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

A Case Report of Locked-in Syndrome Due to Bilateral Vertebral Artery Dissection After Cervical Spine Manipulation Treated by Arterial Embolectomy
Abstract: Cervical spine manipulation (CSM) is a commonly spinal manipulative therapies for the relief of cervical spine-related conditions worldwide, but its use remains controversial. CSM may carry the potential for serious neurovascular complications, primarily due to vertebral artery dissection (VAD) and subsequent vertebrobasilar stroke. Here, we reported a rare case of locked-in syndrome (LIS) due to bilaterial VAD after CSM treated by arterial embolectomy. A 36-year-old right-handed man was admitted to our hospital with numbness and weakness of limbs after treating with CSM for neck for half an hour. Gradually, alt...
Source: Medicine - February 1, 2016 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Impact of Previous Stroke on Short-Term Myocardial Reinfarction in Patients With Acute ST Segment Elevation Myocardial Infarction: An Observational Multicenter Study
Abstract: Myocardial reinfarction is frequent after ST-elevation myocardial infarction (STEMI). The incidence of previous stroke in STEMI patients is also high. We aim to evaluate the risk factors for short-term myocardial reinfarction in STEMI patients in a multicenter study. STEMI patients with chest pain onset within 12 hours in 247 hospitals in China were enrolled. Seven and 30-day follow-ups from admission to hospitals were performed. The primary outcome of our study was myocardial reinfarction at 30 days after STEMI. The study population was stratified into 2 groups: STEMI patients with mayocardial reinfarction an...
Source: Medicine - February 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Neuron-Specific Enolase, S100 Calcium-Binding Protein B, and Heat Shock Protein 70 Levels in Patients With Intracranial Hemorrhage
Abstract: The authors evaluated neuron-specific enolase (NSE), S100 calcium-binding protein B (S100B), and heat shock protein 70 (HSP 70) levels and their relationships with in-hospital mortality, Glasgow Coma Scale (GCS) scores, and National Institute of Health Stroke Scale (NIHSS) scores. In total, 35 patients older than 18 years were presented to our emergency department and were diagnosed with non-traumatic intracranial hemorrhage (ICH) and 32 healthy controls were included. Blood samples were drawn on days 0 and 5. S100 calcium-binding protein B and HSP levels were significantly higher in patients than in controls on ...
Source: Medicine - November 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Symptomatic Atherosclerotic Disease and Decreased Risk of Cancer-Specific Mortality: A Prospective, Population-Based Study (NEDICES)
Abstract: The few studies that have assessed the association between symptomatic atherosclerotic disease and risk of cancer have had conflicting results. In addition, these studies ascertained participants either from treatment settings (ie, service-based studies) or by using a records linkage system (ie, medical records of patients evaluated at clinics or hospitals) and, therefore, were prone to selection bias. Our purpose was to estimate the risk of cancer mortality in a large population-based sample of elderly people, comparing participants with symptomatic atherosclerotic disease (atherosclerotic stroke and coronary di...
Source: Medicine - August 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Cardiovascular Events in Systemic Lupus Erythematosus: A Nationwide Study in Spain From the RELESSER Registry
This article estimates the frequency of cardiovascular (CV) events that occurred after diagnosis in a large Spanish cohort of patients with systemic lupus erythematosus (SLE) and investigates the main risk factors for atherosclerosis. RELESSER is a nationwide multicenter, hospital-based registry of SLE patients. This is a cross-sectional study. Demographic and clinical variables, the presence of traditional risk factors, and CV events were collected. A CV event was defined as a myocardial infarction, angina, stroke, and/or peripheral artery disease. Multiple logistic regression analysis was performed to investigate the pos...
Source: Medicine - July 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Outcome of Frozen Elephant Trunk Technique for Acute Type A Aortic Dissection: As Systematic Review and Meta-Analysis
Abstract: Acute aortic dissections of Stanford type A require emergency surgery repair and present challenges to surgeons. The frozen elephant technique is one of several approaches used to treat aortic arch dissection. The purpose of this meta-analysis was to investigate the clinical effectiveness of the frozen elephant technique for treating acute type A aortic dissection. Medline, Cochrane, Google Scholar, and ClinicalTrials.gov databases were searched up to March 31, 2014, for studies that assessed the use of frozen elephant trunk technique for treating acute type A aortic dissection. The primary outcome was in-hospita...
Source: Medicine - April 1, 2015 Category: Internal Medicine Tags: Article: Systematic Review and Meta-Analysis Source Type: research

Comparison of Intranasal and Intravenous Diazepam on Status Epilepticus in Stroke Patients: A Retrospective Cohort Study
Abstract: Administering diazepam intravenously or rectally in an adult with status epilepticus can be difficult and time consuming. The aim of this study was to examine whether intranasal diazepam is an effective alternative to intravenous diazepam when treating status epilepticus. We undertook a retrospective cohort study based on the medical records of 19 stroke patients presenting with status epilepticus to our institution. We measured the time between arrival at the hospital, the intravenous or intranasal administration of diazepam, and the seizure termination. Intranasal diazepam was administered about 9 times faster ...
Source: Medicine - February 1, 2015 Category: Internal Medicine Tags: Article: Observational Study Source Type: research

Obstructive Sleep Apnea and Serious Adverse Outcomes in Patients with Cardiovascular or Cerebrovascular Disease: A PRISMA-Compliant Systematic Review and Meta-Analysis
Abstract: Obstructive sleep apnea (OSA) is seen in approximately 60% to 70% of patients with stroke or ischemic heart disease (IHD). The relationship between OSA and recurrent vascular events and all-cause mortality remains inconclusive. We aimed to systematically evaluate the associations between OSA and serious adverse outcomes following stroke or IHD by a meta-analysis of prospective cohort studies. We searched MEDLINE and EMBASE in August 2014 for studies that evaluated the prospective associations between OSA and the risk of stroke, IHD, and death among stroke or IHD patients. Outcome data were pooled using random eff...
Source: Medicine - December 1, 2014 Category: Internal Medicine Tags: Article: Systematic Review and Meta-Analysis Source Type: research