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Total 1761 results found since Jan 2013.

Implementation of a Dedicated Cardiovascular and Stroke Unit in a Crowded Emergency Department of a Tertiary Public Hospital in Brazil: Effect on Mortality Rates / Implementación de una Unidad Destinada a Ictus y Patología Cardiovascular (Unidad Vascular) en un Servicio de Urgencias Saturado de un Hospital Público Terciario en Brasil: Impacto en los Porcentajes de Mortalidad
ConclusionsThe vascular unit strategy has the potential to reduce overall mortality for most acute vascular conditions. Resumen IntroducciónLa atención del servicio de urgencias (SU) a las enfermedades vasculares agudas se enfrenta al reto de la saturación. Una unidad vascular es una unidad protocolizada y especializada en el SU con un equipo formado para el manejo de los trastornos vasculares agudos, que incluye el ictus, los síndromes coronarios, el embolismo de pulmón (EP) y las enfermedades aórticas. ObjetivosComparar las tasas de mortalidad para las enfermedades cardiovasculares seleccionadas antes y después d...
Source: Academic Emergency Medicine - January 6, 2014 Category: Emergency Medicine Authors: Luiz A. Nasi, Andre L. Ferreira‐Da‐Silva, Sheila C.O. Martins, Mariana V. Furtado, Andrea G. Almeida, Rosane Brondani, Letícia Wirth, Marisa Kluck, Carisi A. Polanczyk Tags: Original Research Contribution Source Type: research

Stroke Incidence and Usage Rate of Thrombolysis in the Emergency Department
Stroke is one of the leading causes of morbidity and mortality worldwide . It is an emergency requiring early and rapid management of the patient in a suitable care pathway. Thrombolysis is currently the treatment of choice for ischemic stroke. It has been proven in terms of efficiency and safety by reducing the rates of morbidity and mortality of stroke. In Tunisia, the practice of thrombolysis is still a subject of controversy and its use remains underestimated.
Source: The Journal of Emergency Medicine - January 23, 2014 Category: Emergency Medicine Authors: H. Ghazali, R. Daoudi, S. Souissi, Y. Yahya, N. Mghaieth, A. Yahmadi, N. Elheni, A. Raddaoui Source Type: research

Implications of ECASS III Error on Emergency Department Treatment of Ischemic Stroke
Published in 2008, the European Cooperative Acute Stroke Study (ECASS) III trial data supported the use of thrombolytic therapy between 3 and 4.5 h after ischemic stroke . Originally, the authors described no significant difference in baseline characteristics between the thrombolytic study group and the placebo group; I repeated this chi-squared comparison for history of stroke between the two groups and determined that the authors understated this p value by a factor of 10 in favor of the thrombolytic group. The online version of the article was changed last year to reflect the actual p value of 0.003, as opposed to the o...
Source: The Journal of Emergency Medicine - November 9, 2012 Category: Emergency Medicine Authors: Bradley D. Shy Tags: Letters to the Editor Source Type: research

Nonconvulsive status epilepticus masquerading as stroke
This case describes a patient with multiple stroke risk factors—including prior stroke—who presented to the emergency department with symptoms suggestive of stroke and who received a rapid stroke work up but was later found to be in nonconvulsive status epilepticus (NCSE). This case report highlights the challenge and importance of making an accurate diagnosis in NCSE, and we have included teaching points to help clinicians understand the clinical manifestations and diagnosis of NCSE as well as how it may impact a patient's prognosis.
Source: The American Journal of Emergency Medicine - August 28, 2014 Category: Emergency Medicine Authors: Christopher Kennel, Andreas Michas-Martin, Brian D. Berman, Sharon Poisson Tags: Case Report Source Type: research

Factors associated with delayed evaluation of patients with potential stroke in US EDs
The American Heart Association/American Stroke Association guidelines recommend all patients presenting to emergency departments (EDs) with a potential stroke be seen within 10 minutes of arrival, although this may not be achieved in all patients. We sought to identify factors associated with delayed evaluation of ED patients with potential stroke.
Source: The American Journal of Emergency Medicine - August 26, 2014 Category: Emergency Medicine Authors: Jonathan Taylor, Ken Uchino, M. Shazam Hussain, Jestin N. Carlson Tags: Original Contribution Source Type: research

Stroke Incidence and Mortality Trends in us Communities, 1987 to 2011
Stroke is the fourth leading cause of death in the United States and is a major cause of morbidity among adults. Overall, there has been a decrease in stroke incidence in several countries, however, sex- and race-specific data have been inconsistent. In the United States, age-adjusted mortality after stroke has declined by 37% from 1999 to 2009. This decreased mortality was most apparent in white men and least apparent in black men.
Source: The Journal of Emergency Medicine - October 27, 2014 Category: Emergency Medicine Authors: Andrea Stember Tags: Abstract Source Type: research

Diagnostic value of plasma Signal Peptide-Cub-Egf domain-containing protein-1 (SCUBE-1) in an experimental model of acute ischemic stroke
Considering the critical role of early action in management of stroke, there is still a need for a biomarker that would reliably assist in the early diagnosis and patient selection for tissue plasminogen activator (t-PA) therapy, which has provided a considerable success in terms of mortality and morbidity of patients with stroke. This is particularly important if this novel biochemical marker that could give rapid results, specific for brain damage and that can be used in the emergency setting for early diagnosis and differentiation from other conditions that mimics some stroke findings [1,2].
Source: The American Journal of Emergency Medicine - December 2, 2014 Category: Emergency Medicine Authors: Turkmen Suha, Eryigit Umut, Karaca Yunus, Mentese Ahmet, Uzun Sumer Aysegul, Yulug Esin, Aksut Nurhak, Gazioglu Sibel, Gunduz Abdulkadir Tags: Original Contribution Source Type: research

Hospital Variation in Thrombolysis Times Among Patients With Acute Ischemic Stroke: The Contributions of Door-To-Imaging Time And Imaging-To-Needle Time
Prompt administration of intravenous tissue plasminogen activator (TPA) can substantially reduce disability associated with acute ischemic stroke. Practice guidelines recommend administration of TPA within 60 min of hospital arrival for acute ischemic stroke. Despite these guidelines, unfortunately, times until TPA treatment in acute ischemic stroke remain suboptimal.
Source: The Journal of Emergency Medicine - January 24, 2015 Category: Emergency Medicine Authors: Bartholomew Paull Tags: Abstract Source Type: research

Effects of Golden Hour Thrombolysis: A Prehospital Acute Neurological Treatment and Optimization of Medical Care in Stroke (PHANTOM-S) Substudy
The effectiveness of intravenous thrombolysis for acute ischemic stroke is thought to be highest when given during the first hour from onset of symptoms, termed the “golden hour.” In this post hoc analysis of data from the Prehospital Acute Neurological Treatment and Optimization of Medical Care in Stroke (PHANTOM-S) trial, researchers studied the effect of a specialized stroke ambulance (STEMO) on rates of golden hour thrombolysis, 7- and 90-day mortality, secondary intracerebral hemorrhage, and discharge home.
Source: The Journal of Emergency Medicine - May 1, 2015 Category: Emergency Medicine Authors: Taylor Burkholder Tags: Abstract Source Type: research

Safety of Intravenous Thrombolysis in Stroke Mimics: Prospective 5-Year Study and Comprehensive Meta-Analysis
With more emphasis now being placed on reducing door-to-needle times and time to intravenous thrombolysis (IVT) administration in acute ischemic stroke (AIS), there is growing concern about the safety of inadvertently giving IVT to patients with stroke mimics (SMs). The aim of this study was to determine the safety of IVT in SMs. This was a prospective study of consecutive patients treated with IVT at a tertiary care stroke center in Memphis, TN from 2009 to 2013. Initial diagnosis of AIS was compared to discharge diagnosis to identify patients who presented as SMs.
Source: The Journal of Emergency Medicine - June 19, 2015 Category: Emergency Medicine Authors: Andrea Stember Tags: Abstract Source Type: research

Risk factors for medical complications of acute hemorrhagic stroke
Conclusions Our study has assessed that hypertension followed by diabetes mellitus are the major risk factors for medical complications of hemorrhagic stroke. Female mortality rate was more when compared to males.\
Source: Journal of Acute Disease - August 4, 2015 Category: Emergency Medicine Source Type: research

Cerebral oximetry with cerebral blood volume index in detecting pediatric stroke in a pediatric ED
Despite pediatric stroke awareness and pediatric stroke activation systems, recognition and imaging delays along with activation inconsistency still occur. Reliable objective pediatric stroke detection tools are needed to improve detection and activations. Regional cerebral oxygen saturation (rcso2) with cerebral blood volume index (CBVI) can detect abnormal cerebral physiology.
Source: The American Journal of Emergency Medicine - July 22, 2015 Category: Emergency Medicine Authors: Thomas J. Abramo, Z. Leah Harris, Mark Meredith, Kristen Crossman, Rawle Seupaul, Abby Williams, Sheila McMorrow, Jennifer Dindo, Angela Gordon, Maria Melguizo-Castro, Zhuopei Hu, Todd Nick Tags: Original Contribution Source Type: research

Marked regional variation in acute stroke treatment among medicare beneficiaries
The administration of intravenous tissue-type plasminogen activator (tPA) and intra-arterial treatment (IAT) for the treatment of acute ischemic stroke is an ongoing field of debate and optimization in the medical literature. With acute ischemic stroke being a significant cause of morbidity and mortality, especially for the elderly population, the optimal treatment of stroke is an ongoing concern.
Source: The Journal of Emergency Medicine - November 1, 2015 Category: Emergency Medicine Authors: Angela Wright Tags: Abstract Source Type: research

Are all stroke patients eligible for fast alteplase treatment? An analysis of unavoidable delays.
CONCLUSIONS: Up to 31% of patients have delays due to medical or eligibility-related causes that may be legitimate reasons for providing alteplase later than the benchmark time of 60 minutes. This article is protected by copyright. All rights reserved. PMID: 26824684 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - January 29, 2016 Category: Emergency Medicine Authors: Choi PM, Desai JA, Kashyap D, Stephenson C, Kamal N, Vogt S, Bohm V, Suddes M, Bugbee E, Hill MD, Demchuk AM, Smith EE Tags: Acad Emerg Med Source Type: research

A case of stroke during cardiac catheterisation: It's not common, but it is a double whammy!
We report a case of a 57-year-old lady with acute myocardial infarction who developed stroke on the cardiac catheterisation table. The case illustrates the need for a protocol of care, vigilant cardiologist and staff who can recognise the symptoms and signs as well as good collaborative efforts between the cardiology, neurology and, at times, the interventional radiology teams.
Source: Journal of Acute Disease - April 1, 2016 Category: Emergency Medicine Source Type: research