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Referral Patterns of Central Retinal Artery Occlusion to an Academic Center Affiliated With a Stroke Center
Background: Central retinal artery occlusion (CRAO) is a medical emergency, and patients who present acutely should be immediately referred to the nearest stroke center. We evaluated practice patterns for CRAO management at one academic center over the last decade. Methods: This was a retrospective study on all adult patients diagnosed with a CRAO seen at one tertiary hospital and outpatient clinic affiliated with a comprehensive stroke center (“our institution”) from 2010 to 2020. Our electronic medical records were searched for CRAO diagnoses, and patient medical records were reviewed. The exclusion criter...
Source: Journal of Neuro-Ophthalmology - November 22, 2021 Category: Opthalmology Tags: Original Contribution Source Type: research

Young individuals with stroke in rehabilitation: a cohort study
Stroke in younger populations is a public health crisis and the prevalence is rising. Little is known about the progress of younger individuals with stroke in rehabilitation. Characterization of the course and speed of recovery is needed so that rehabilitation professionals can set goals and make decisions. This was a cohort study with data extracted from electronic medical records. Participants were 408 individuals diagnosed with stroke who participated in inpatient rehabilitation in an urban, academic medical center in the USA. The main predictor was age which was categorized as (18–44, 45–64, 65–74 and 75+). Outco...
Source: International Journal of Rehabilitation Research - November 8, 2021 Category: Rehabilitation Tags: Original articles Source Type: research

Characterizing Intraoperative Vasopressor Use in Total Knee Arthroplasty: A Retrospective Cohort Study
In conclusion, nearly 59% of patients undergoing TKA received intraoperative vasopressor support. History of stroke and older age were significantly associated with increased intraoperative vasopressor use. As the first study to examine vasopressor usage in a TKA patient population, we believe that understanding the association between patient characteristics and intraoperative vasopressor support will help orthopaedic surgeons select the appropriate surgical setting during preoperative optimization. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Ta...
Source: Journal of Knee Surgery - August 4, 2021 Category: Orthopaedics Authors: Lentine, Brandon Vaickus, Max Shewmaker, Grant Niu, Ruijia Son, Sung Jun Mustafa, Wissam Reist, Hailee Smith, Eric L. Tags: Original Article Source Type: research

Evaluation of Prescribing Practices and Outcomes Using Direct-Acting Oral Anticoagulants After Cardiac Surgery
Clin Ther. 2021 May 30:S0149-2918(21)00203-4. doi: 10.1016/j.clinthera.2021.04.009. Online ahead of print.ABSTRACTPURPOSE: Cardiac surgery patients frequently require anticoagulation. Warfarin remains the preferred agent, and a few trials have reported negative outcomes with the use of direct-acting oral anticoagulants (DOACs) in these patients. Therefore, limited literature exists that supports the dosing, safety, and efficacy of DOACs within the cardiac surgery population.METHODS: This single-center, retrospective analysis was conducted at a tertiary academic medical center. All data were extrapolated from electronic med...
Source: Clinical Therapeutics - June 3, 2021 Category: Drugs & Pharmacology Authors: Dareen M Kanaan Bryan M Cook Julie Kelly Rhynn Malloy Source Type: research

The Clinical and Imaging Profile of Skew Deviation: A Study of 157 Cases
Conclusions: The amplitude of misalignment in skew deviation varies widely but is generally 5 PD or less. When misalignment is 3 PD or less, patients report blurred vision rather than diplopia. Skew deviation is usually accompanied by other neurologic signs reflecting brainstem dysfunction. Yet there is a small subgroup in which vertical misalignment is an isolated sign, and there are no supporting brain imaging abnormalities. The main cause of skew deviation is ischemic stroke, which affects not only the brainstem but also the thalamus. Diplopia from skew deviation frequently persists, in which case prism spectacles m...
Source: Journal of Neuro-Ophthalmology - February 25, 2021 Category: Opthalmology Tags: Original Contribution Source Type: research

Medical therapy does not confer stroke prevention for all patients; identification of high-risk patients with asymptomatic carotid stenosis is still needed.
CONCLUSIONS: Prophylactic CR + BMT does not provide overall late stroke prevention compared with BMT alone. Diabetics with a history of stroke, in particular, are at an increased risk of stroke despite BMT. Timely CR + BMT for high-risk patients is still indicated. PMID: 31345008 [PubMed - as supplied by publisher]
Source: International Angiology - July 28, 2019 Category: Cardiology Tags: Int Angiol Source Type: research

The Predictive Capacity of the Buffalo Concussion Treadmill Test After Sport-Related Concussion in Adolescents
Conclusion This study found that the ΔHR (HRt minus resting HR) correlated with duration of clinical recovery in participants who were prescribed relative rest or a placebo-stretching program but not for participants prescribed sub-threshold aerobic exercise. A ΔHR of ≤50 bpm on the BCTT was 73% sensitive and 78% specific for predicting delayed recovery in concussed adolescents prescribed the current standard of care (i.e., cognitive and physical rest). This has implications for planning team and school activities in adolescents who sustain SRC. Ethics Statement This study was carried out in acco...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Combination of Dexmedetomidine and Ketamine for Magnetic Resonance Imaging Sedation
Conclusions: The efficacy of DEX–KET sedation was comparable to that of midazolam for MRI examination. DEX–KET was related to shorter scan time and lower occurrence of complications compared to midazolam. Introduction Neurocritically ill patients often require brain magnetic resonance imaging (MRI) in addition to conventional neurological evaluations. Brain MRI can reveal structural lesions with a high sensitivity due to its excellent spatial resolution and enhanced soft tissue contrast (1–3). To acquire MRI images, patients' cooperation is imperative. However, keeping patients with ...
Source: Frontiers in Neurology - April 23, 2019 Category: Neurology Source Type: research

Interdisciplinary Models for Research and Clinical Endeavors in Genomic Medicine: A Scientific Statement From the American Heart Association AHA Scientific Statement
The completion of the Human Genome Project has unleashed a wealth of human genomics information, but it remains unclear how best to implement this information for the benefit of patients. The standard approach of biomedical research, with researchers pursuing advances in knowledge in the laboratory and, separately, clinicians translating research findings into the clinic as much as decades later, will need to give way to new interdisciplinary models for research in genomic medicine. These models should include scientists and clinicians actively working as teams to study patients and populations recruited in clinical settin...
Source: Circulation: Cardiovascular Genetics - May 29, 2018 Category: Cardiology Authors: Musunuru, K., Arora, P., Cooke, J. P., Ferguson, J. F., Hershberger, R. E., Hickey, K. T., Lee, J.-M., Lima, J. A. C., Loscalzo, J., Pereira, N. L., Russell, M. W., Shah, S. H., Sheikh, F., Wang, T. J., MacRae, C. A., On behalf of the American Heart Assoc Tags: Statements and Guidelines AHA Scientific Statement Source Type: research

Age, Gender and Racial Disparities in Acute Stroke Therapy in a Large Non-Academic Health System (P3.261)
Conclusions:We confirmed known disparities in ATT rates between PSC and AH. No disparity in age or gender were identified in this population. Racial disparity was problematic because of a small number of non-white patients and a number of patients with no racial data captured. Better racial data collection, analysis of access to care, and care process modeling might impact these findings.Disclosure: Dr. Taylor has nothing to disclose. Dr. Jones has received personal compensation for activities with Genentech as a speaker. Dr. Gosnell has nothing to disclose. Dr. Snyder has nothing to disclose. Dr. Schneider has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Taylor, R., Jones, R., Gosnell, J., Snyder, S., Schneider, A. Tags: Cerebrovascular Disease Epidemiology Source Type: research

Impact of Switching From Prasugrel to Clopidogrel Shortly After a Percutaneous Coronary Intervention Without a Loading Dose of Clopidogrel.
CONCLUSIONS: In this small, retrospective analysis, the results of loading patients with prasugrel for PCI and switching them to clopidogrel without a loading dose appear to be encouraging. PMID: 26378415 [PubMed - in process]
Source: The Journal of Invasive Cardiology - March 11, 2016 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

A Simple and Portable Algorithm for Identifying Atrial Fibrillation in the Electronic Medical Record
Atrial fibrillation (AF) is common and increases stroke risk and mortality. Many knowledge gaps remain with respect to practice patterns and outcomes. Electronic medical records (EMR) may serve as powerful research tools if AF status can be properly ascertained. We sought to develop an algorithm for identifying individuals with and without AF in the EMR and compare it to previous methods. Using a hospital network EMR (n=5,737,846), we randomly selected 8,200 individuals seen at a large academic medical center in January 2014 to derive and validate seven AF classification schemas (4 case and 3 control) in order to construct...
Source: The American Journal of Cardiology - November 5, 2015 Category: Cardiology Authors: Shaan Khurshid, John Keaney, Patrick T. Ellinor, Steven A. Lubitz Source Type: research