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Incidence, characteristics and outcome of post-stroke recrudescence in the Chinese population: a single-centre observational study
Conclusions PSR is not uncommon in patients presenting with stroke symptoms and can be distinguished from TIA and SMs based on a combination of clinical features and trigger in the Chinese population. The neurological deficits of patients with PSR often resolve within several days following the resolution of the trigger.
Source: BMJ Open - September 13, 2023 Category: General Medicine Authors: Pu, M.-J., Yu, J.-L., Hu, X., Deng, L., Chen, C., Lv, X.-N., Li, Z.-Q., Wang, Z.-J., Xie, P., Li, Q. Tags: Open access, Neurology Source Type: research

Early identification and characterisation of stroke to support prehospital decision-making using artificial intelligence: a scoping review protocol
Introduction Stroke is a time-critical condition and one of the leading causes of mortality and disability worldwide. To decrease mortality and improve patient outcome by improving access to optimal treatment, there is an emerging need to improve the accuracy of the methods used to identify and characterise stroke in prehospital settings and emergency departments (EDs). This might be accomplished by developing computerised decision support systems (CDSSs) that are based on artificial intelligence (AI) and potential new data sources such as vital signs, biomarkers and image and video analysis. This scoping review aims to su...
Source: BMJ Open - May 22, 2023 Category: General Medicine Authors: Jalo, H., Seth, M., Pikkarainen, M., Häggström, I., Jood, K., Bakidou, A., Sjöqvist, B. A., Candefjord, S. Tags: Open access, Neurology Source Type: research

Tenecteplase versus Alteplase for Stroke Thrombolysis Evaluation Trial in the Ambulance (Mobile Stroke Unit--TASTE-A): protocol for a prospective randomised, open-label, blinded endpoint, phase II superiority trial of tenecteplase versus alteplase for ischaemic stroke patients presenting within 4.5 hours of symptom onset to the mobile stroke unit
Introduction Mobile stroke units (MSUs) equipped with a CT scanner are increasingly being used to assess and treat stroke patients’ prehospital with thrombolysis and transfer them to the most appropriate hospital for ongoing stroke care and thrombectomy when indicated. The effect of MSUs in both reducing the time to reperfusion treatment and improving patient outcomes is now established. There is now an opportunity to improve the efficacy of treatment provided by the MSU. Tenecteplase is a potent plasminogen activator, which may have benefits over the standard of care stroke lytic alteplase. Specifically, in the MSU ...
Source: BMJ Open - April 29, 2022 Category: General Medicine Authors: Bivard, A., Zhao, H., Coote, S., Campbell, B., Churilov, L., Yassi, N., Yan, B., Valente, M., Sharobeam, A., Balabanski, A., Dos Santos, A., Ng, F., Langenberg, F., Stephenson, M., Smith, K., Bernard, S., Thijs, V., Cloud, G., Choi, P., Ma, H., Wijeratne, Tags: Open access, Neurology Source Type: research

TACTICS - Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship: evaluating the effectiveness of an 'implementation intervention in providing better patient access to reperfusion therapies: protocol for a non-randomised controlled stepped wedge cluster trial in acute stroke
Introduction Stroke reperfusion therapies, comprising intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT), are best practice treatments for eligible acute ischemic stroke patients. In Australia, EVT is provided at few, mainly metropolitan, comprehensive stroke centres (CSC). There are significant challenges for Australia’s rural and remote populations in accessing EVT, but improved access can be facilitated by a ‘drip and ship’ approach. TACTICS (Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship) aims to test whether a multicomponent, multidisciplinary impleme...
Source: BMJ Open - February 11, 2022 Category: General Medicine Authors: Ryan, A., Paul, C. L., Cox, M., Whalen, O., Bivard, A., Attia, J., Bladin, C., Davis, S. M., Campbell, B. C. V., Parsons, M., Grimley, R. S., Anderson, C., Donnan, G. A., Oldmeadow, C., Kuhle, S., Walker, F. R., Hood, R. J., Maltby, S., Keynes, A., Delcou Tags: Open access, Health services research Source Type: research

The PROGRAM study: awake mapping versus asleep mapping versus no mapping for high-grade glioma resections: study protocol for an international multicenter prospective three-arm cohort study
This study is an international, multicenter, prospective three-arm cohort study of observational nature. Consecutive HGG patients will be operated with awake mapping, asleep mapping or no mapping with a 1:1:1 ratio. Primary endpoints are: (1) proportion of patients with National Institute of Health Stroke Scale deterioration at 6 weeks, 3 months and 6 months after surgery and (2) residual tumour volume of the contrast-enhancing and non-contrast-enhancing part as assessed by a neuroradiologist on postoperative contrast MRI scans. Secondary endpoints are: (1) overall survival and (2) progression-free survival at 12 months af...
Source: BMJ Open - July 21, 2021 Category: General Medicine Authors: Gerritsen, J. K. W., Dirven, C. M. F., De Vleeschouwer, S., Schucht, P., Jungk, C., Krieg, S. M., Nahed, B. V., Berger, M. S., Broekman, M. L. D., Vincent, A. J. P. E. Tags: Open access, Neurology Source Type: research

Serum erythropoietin and outcome after ischaemic stroke: a prospective study
Conclusions The crude associations between EPO and worse stroke severity and outcome lost significance after multivariate modelling. However, in patients in whom EPO increased, the association with favourable outcome remained after adjustment for multiple covariates.
Source: BMJ Open - February 25, 2016 Category: Journals (General) Authors: Aberg, N. D., Stanne, T. M., Jood, K., Schiöler, L., Blomstrand, C., Andreasson, U., Blennow, K., Zetterberg, H., Isgaard, J., Jern, C., Svensson, J. Tags: Open access, Epidemiology, Neurology, Rehabilitation medicine Research Source Type: research

How common is isolated dysphasia among patients with stroke treated with intravenous thrombolysis, and what is their outcome? Results from the SITS-ISTR
Conclusions A low proportion of patients with isolated dysphasia are treated with IVT. Half of these patients were fully recovered at 7 days.
Source: BMJ Open - November 25, 2015 Category: Journals (General) Authors: Lundström, E., Zini, A., Wahlgren, N., Ahmed, N. Tags: Open access, Cardiovascular medicine, Neurology Research Source Type: research

Comparison of the university hospital and county hospitals in western Sweden to identify potential weak links in the early chain of care for acute stroke: results of an observational study
Conclusions System delay is still long and only a small fraction of patients received thrombolysis. Three of four used the EMS (more frequent in the county). They were given the highest priority at the dispatch centre in half of the cases. Stroke was suspected in two-thirds of the cases, but a prenotification was seldom sent to the hospital.
Source: BMJ Open - September 8, 2015 Category: Journals (General) Authors: Wireklint Sundstrom, B., Herlitz, J., Hansson, P. O., Brink, P. Tags: Open access, Cardiovascular medicine, Emergency medicine, Nursing Research Source Type: research

A randomised controlled trial to compare the clinical and cost-effectiveness of prism glasses, visual search training and standard care in patients with hemianopia following stroke: a protocol
This study has been developed and supported by the UK Stroke Research Network Clinical Studies Group working with service users. Multicentre ethical approval was obtained through the North West 6 Research ethics committee (Reference 10/H1003/119). The trial is funded by the UK Stroke Association. Trial Registration: Current Controlled Trials ISRCTN05956042. Dissemination will consider usual scholarly options of conference presentation and journal publication in addition to patient and public dissemination with lay summaries and articles. Trial Registration Current Controlled Trials ISRCTN05956042.
Source: BMJ Open - July 17, 2014 Category: Journals (General) Authors: Rowe, F. J., Barton, P. G., Bedson, E., Breen, R., Conroy, E. J., Cwiklinski, E., Dodridge, C., Drummond, A., Garcia-Finana, M., Howard, C., Johnson, S., MacIntosh, C., Noonan, C. P., Pollock, A., Rockliffe, J., Sackley, C., Shipman, T., VISION (vision im Tags: Open access, Neurology, Ophthalmology, Rehabilitation medicine Protocol Source Type: research

Imaging predictors of poststroke depression: methodological factors in voxel-based analysis
Conclusions This study provided inconclusive evidence for the association between infarcts in a specific region and poststroke depression.
Source: BMJ Open - July 7, 2014 Category: Journals (General) Authors: Gozzi, S. A., Wood, A. G., Chen, J., Vaddadi, K., Phan, T. G. Tags: Open access, Mental health, Neurology, Rehabilitation medicine Research Source Type: research