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Regional disparities in the quality of stroke care
This study characterized geographic disparities in stroke care quality to assess whether improved access to neurological services has the potential to bridge the care quality gap, particularly in terms of alteplase (rt-PA) administration.
Source: The American Journal of Emergency Medicine - March 18, 2017 Category: Emergency Medicine Authors: Seth Seabury, Katalin Bognar, Yaping Xu, Caroline Huber, S. Renee Commerford, Darren Tayama Source Type: research

Effect of paracetamol (acetaminophen) on body temperature in acute stroke: A meta-analysis
The objective of this study was to assess the efficacy of paracetamol (acetaminophen) on body temperature in acute stroke.
Source: The American Journal of Emergency Medicine - March 17, 2017 Category: Emergency Medicine Authors: Junjie Fan, Chensong Cheng, Hongsen Cheng, Ren Wang, Linhao Ma Source Type: research

Usefulness of glycated hemoglobin A1c-based adjusted glycemic variables in diabetic patients presenting with acute ischemic stroke
The objective of the current study was to assess whether HbA1c-based adjusted glycemic variables were associated with unfavorable outcomes among patients admitted to the hospital for AIS.
Source: The American Journal of Emergency Medicine - March 21, 2017 Category: Emergency Medicine Authors: Chih-Jen Yang, Wen-I Liao, Jen-Chun Wang, Chia-Lin Tsai, Jiunn-Tay Lee, Giia-Sheun Peng, Chien-Hsing Lee, Chin-Wang Hsu, Shih-Hung Tsai Source Type: research

Pharmacoeconomic impact of an alternative workflow process for stroke
The objective of this study was to evaluate a new multidisciplinary process in which intravenous alteplase (tPA) waste, used for acute ischemic stroke (AIS), was salvaged in an attempt to maximize cost effectiveness without impacting door-to-needle (DTN) administration times.
Source: The American Journal of Emergency Medicine - October 16, 2018 Category: Emergency Medicine Authors: Brian W. Gilbert, Joel B. Huffman, Joe Slechta, Christine Porter, John M. Gallagher Source Type: research

Tenecteplase utility in acute ischemic stroke patients: A clinical review of current evidence
Acute ischemic stroke is leading cause of disability in the United States. Treatment is aimed at reducing impact of cerebral clot burden and life-long disability. Traditional fibrinolytic treatment with recombinant tissue plasminogen activator (tPA) has shown to be effective but at high risk of major bleeding. Multiple studies have evaluated tenecteplase as an alternative to tPA.
Source: The American Journal of Emergency Medicine - November 14, 2018 Category: Emergency Medicine Authors: Amelia Nelson, Gregory Kelly, Richard Byyny, Catherine Dionne, Candice Preslaski, Kevin Kaucher Source Type: research

Is prehospital supplemental oxygen effective for acute stroke?
Dr. Dylla and colleagues [1] performed a well-conducted cohort study concerning the efficacy and safety of prehospital supplemental oxygen for acute stroke. Despite the essential information provided, several issues must be resolved to draw confirmed conclusions.
Source: The American Journal of Emergency Medicine - February 23, 2020 Category: Emergency Medicine Authors: Kai Zhang Source Type: research

Prehospital oxygen for stroke victims
It was of great interest to read Dr. Dylla and colleagues' well-done retrospective cohort study investigating prehospital oxygen treatment in acute stroke patients [1]. It was also very informative to read Dr. Zhang's review [2] and the authors' response [3].
Source: The American Journal of Emergency Medicine - June 8, 2020 Category: Emergency Medicine Authors: John Collins, Michael Sumner, Mehwish Barlas, Pamela Ohman Strickland, Jonathan McCoy Source Type: research

Impact of creatinine screening on contrast-induced nephropathy following computerized tomography for stroke
This study sought to evaluate rates of acute kidney injury in patients undergoing contrast-enhanced computerized tomography for acute stroke in the emergency department (ED) before and after the cessation of creatinine screening.
Source: The American Journal of Emergency Medicine - September 18, 2020 Category: Emergency Medicine Authors: Brent A. Becker, Thomas Yeich, Jonathan T. Jaffe, Samuel Sun, Yidong Chen, Teri Rebert, Barbara A. Stahlman Source Type: research

Risk factors for acute stroke-associated pneumonia and prediction of neutrophil-to-lymphocyte ratios
This study aimed to analyze the risk factors for stroke-associated pneumonia (SAP) and assess the predictive effect of neutrophil-to-lymphocyte ratio (NLR) on acute SAP.
Source: The American Journal of Emergency Medicine - December 19, 2020 Category: Emergency Medicine Authors: Sara M. Witcraft, Laura J. Dixon, Patric Leukel, Aaron A. Lee Source Type: research

Effect of COVID19 on prehospital pronouncements and ED visits for stroke and myocardial infarction
In this study, our goal was to determine if there was an increase in prehospital ALS pronouncements and a decrease in ED visits for potentially serious conditions such as MI and stroke during the peak of the COVID-19 pandemic in northern NJ.
Source: The American Journal of Emergency Medicine - January 14, 2021 Category: Emergency Medicine Authors: Nikhil Jain, Michael Berkenbush, David C. Feldman, Barnet Eskin, John R. Allegra Source Type: research

Simultaneous thrombosis of 2 vascular territories: is thrombolytic therapy a better option?
We have read with great interest the article by Akyuz and colleagues in the American Journal of Emergency Medicine and congratulate them for their observation. Their case exemplifies the concurrent occurrence of ST-segment elevation myocardial infarction (STEMI) and posterior circulation stroke that was eventually managed with thrombolytic therapy. Simultaneous thrombosis of 2 distant vascular territories is a rare and complicated clinical scenario. In these instances, there is usually an underlying cause linking both thrombotic events rather than being a mere coincidence. We have previously described the myocardial infarc...
Source: The American Journal of Emergency Medicine - July 1, 2013 Category: Emergency Medicine Authors: Hesham R. Omar, Devanand Mangar, Enrico M. Camporesi Tags: Correspondence Source Type: research

Admission rates of ED patients with transient ischemic attack have increased since 2000
This study is conducted in 6 New Jersey EDs with annual ED visits from 25000 to 65000. Consecutive patients seen by ED physicians between January 1, 2000, and December 31, 2010, were included. We identified TIA visits using the International Classification of Diseases, Ninth Revision, code. We analyzed the admission rates for TIA testing for significant differences using the Student t test and calculated 95% confidence intervals.Results: Of the 2622659 visits in the database, 8216 (0.3%) were for TIA. Females comprised 57%. There was a statistically significant increase in the annual admission rates for TIA patients from 2...
Source: The American Journal of Emergency Medicine - July 31, 2013 Category: Emergency Medicine Authors: Siama Durrani-Tariq, Barnet Eskin, John R Allegra Tags: Original Contributions Source Type: research

The challenge of coprescription of antiplatelet therapy and oral anticoagulants
The coexistence of symptomatic carotid artery stenosis and nonvalvular atrial fibrillation (NVAF) in the recently reported 85year old man [1] bears out the findings of the study which documented a 24.3% prevalence of high-grade (50% or more) carotid artery stenosis among 103 consecutive NVAF patients (mean age 69) who presented with stroke [2]. Among these patients with high-grade stenosis 66.7% had stenosis ipsilateral to the cerebral infarct [2]. Given the fact that patients with symptomatic carotid artery stenosis are at high risk of stroke recurrence and/or worsening neurological disability during the first 14days foll...
Source: The American Journal of Emergency Medicine - May 22, 2017 Category: Emergency Medicine Authors: Oscar M.P. Jolobe Source Type: research

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