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Specialty: Internal Medicine
Source: Internal Medicine Journal

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Total 81 results found since Jan 2013.

Are suspected stroke patients identified by paramedics transported to appropriate stroke centres in Victoria, Australia?
Abstract Emergency medical services (EMS) are vital to ensuring acute stroke patients are transported to thrombolysis and/or stroke unit centres. This 6‐month audit of Victorian EMS cases found the majority of suspected acute strokes are transported to appropriate stroke centres. However, there is still room for improvement, in particular, strategies to improve access to stroke services in some rural regions and to ensure patients/relatives are fully informed when requesting transport to a non‐stroke service hospital.
Source: Internal Medicine Journal - May 12, 2014 Category: Internal Medicine Authors: J. E. Bray, K. Coughlan, I. Mosley, B. Barger, C. Bladin Tags: Brief Communications Source Type: research

Advances in endovascular treatment of acute ischaemic stroke
Abstract Over the past decade, there have been rapid advancements in ischaemic stroke reperfusion treatments. However, clear clinical benefit is yet to be shown in large clinical trials. In this review, the major studies in different types of endovascular treatments including intra‐arterial thrombolysis, aspiration devices, mechanical clot retrievers and the new stent retrievers are discussed. First‐generation mechanical thrombectomy devices such as the MERCI Retriever (Stryker, Kalamazoo, MI, USA) and Penumbra aspiration device (Penumbra Inc., Alameda, CA, USA) demonstrated safety and higher rates of recanalisation in...
Source: Internal Medicine Journal - July 28, 2015 Category: Internal Medicine Authors: H. Asadi, R. Dowling, B. Yan, S. Wong, P. Mitchell Tags: Review Source Type: research

Enteral tube feeding of patients with acute stroke: When does the risk of diarrhoea increase?
ConclusionsThe length of time on ETF is associated with diarrhoea development in patients with acute stroke, demonstrating a temporal cut‐off point. Seven days or longer on ETF is related to the occurrence of diarrhoea, whereas less than 7 days on ETF does not show this effect.
Source: Internal Medicine Journal - September 16, 2014 Category: Internal Medicine Authors: Juan Jose Arevalo‐Manso, Patricia Martinez‐Sanchez, Belen Juarez‐Martin, Blanca Fuentes, Gerardo Ruiz‐Ares, Borja Enrique Sanz‐Cuesta, Pilar Parrilla‐Novo, Exuperio Diez‐Tejedor Tags: Original Article Source Type: research

Advances in Endovascular Treatment of Acute Ischemic Stroke
ConclusionAlthough evidence regarding the efficacy of endovascular treatment in acute stroke has been equivocal, the recent publication of a large multicentre randomised controlled trial indicates benefit of intra‐arterial stent retriever reperfusion in patients selected by appropriate imaging treated early by experienced operators. Endovascular treatment remains an important adjunct to established medical treatment with intravenous tPA, and may have an expanding role dependent on several trials likely to report over the next 12 months.
Source: Internal Medicine Journal - December 1, 2014 Category: Internal Medicine Authors: H Asadi, R Dowling, B Yan, S Wong, P Mitchell Tags: Review Source Type: research

Determinants of Cerebral White Matter Changes in Patients With Stroke
ConclusionsOur results suggest a region‐specific pathogenesis of cerebral white matter in Asian patients with ischemic stroke that may differ from those in the general population.
Source: Internal Medicine Journal - February 2, 2015 Category: Internal Medicine Authors: Ping‐Song Chou, Chun‐Hung Chen, Meng‐Ni Wu, Yi‐Hui Lin, Chiou‐Lian Lai, Ruey‐Tay Lin, Yuan‐Han Yang Tags: Original Article Source Type: research

An assessment of point‐of‐care measurement of INR using the Coaguchek®XS Plus system in the setting of acute ischaemic stroke
ConclusionPoint of care INR testing correlates well with laboratory values. The results in this study mostly relate to levels in the normal range. We suggest that it can be appropriately used to shorten door‐to‐needle time.
Source: Internal Medicine Journal - July 30, 2013 Category: Internal Medicine Authors: Dawn Nusa, Isabel Harvey, Abdulrahman Y Almansouri, Simogne Wright, Terry Neeman, Omar Ahmad, Andrew R. Hughes, Christian J. Lueck Tags: Original Article Source Type: research

Assessment of point‐of‐care measurement of international normalised ratio using the CoaguChek XS Plus system in the setting of acute ischaemic stroke
ConclusionPoint‐of‐care INR testing correlates well with laboratory values. The results in this study mostly relate to values in the normal range. We suggest that it can be used to try to shorten door‐to‐needle time.
Source: Internal Medicine Journal - November 15, 2013 Category: Internal Medicine Authors: D. Nusa, I. Harvey, A. Y. Almansouri, S. Wright, T. Neeman, O Ahmad, A. R. Hughes, C. J. Lueck Tags: Original Article Source Type: research

Intravenous thrombolysis is unsafe in stroke due to infective endocarditis
We describe a patient with occult endocarditis who was treated with thrombolysis for acute stroke and review other cases reported in the literature.
Source: Internal Medicine Journal - February 17, 2014 Category: Internal Medicine Authors: W. J. Brownlee, N. E. Anderson, P. A. Barber Tags: Brief Communication Source Type: research

An audit of coagulation screening in patients presenting to the Emergency Department for potential stroke thrombolysis
ConclusionsA high proportion of laboratory specimens were unsuitable for testing and overall samples took an unacceptably long time to process. Point‐of‐care testing may potentially allow quicker decisions regarding whether thrombolysis is contra‐indicated but is likely to affect only a small proportion of patients.
Source: Internal Medicine Journal - October 31, 2016 Category: Internal Medicine Authors: Katie Thorne, Harry McNaughton, Mark Weatherall Tags: Original Article Source Type: research

Stroke thrombolysis in patients taking dabigatran
Abstract Stroke thrombolysis is becoming a common practice in Australian and New Zealand hospitals. There are no established guidelines for thrombolysis of patients who are taking dabigatran, and accurate medication reconciliation may not be possible. Patients with normal activated partial thromboplastin time are unlikely to have clinically significant dabigatran concentration in the blood. For safest outcomes, we suggest incorporating thrombin time assay for acute stroke patients suspected to be taking dabigatran.
Source: Internal Medicine Journal - July 11, 2013 Category: Internal Medicine Authors: S. Jayathissa, J. Gommans, P. Harper Tags: Brief Communication Source Type: research

Exertional heat stroke, rhabdomyolysis and susceptibility to malignant hyperthermia
We report a case of exertional heat stroke and rhabdomyolysis in a man later determined to have the malignant hyperthermia phenotype. We review the existing literature regarding this association and suggest future research that could address areas of remaining clinical uncertainty.
Source: Internal Medicine Journal - September 4, 2013 Category: Internal Medicine Authors: J. Thomas, T. Crowhurst Tags: Brief Communication Source Type: research

Twenty‐eight day Holter monitoring is poorly tolerated and insensitive for paroxysmal atrial fibrillation detection in cryptogenic stroke
Abstract This pilot study in a prospective cohort of 20 cryptogenic stroke patients showed that a significant proportion has paroxysmal atrial fibrillation undetected by 24‐h Holter monitoring. However, longer monitoring with 28‐day Holter was poorly tolerated and still insufficiently sensitive for paroxysmal atrial fibrillation detection. Further studies are urgently needed to elucidate the optimal timing, method and duration of cardiac rhythm monitoring following ischaemic stroke.
Source: Internal Medicine Journal - May 12, 2014 Category: Internal Medicine Authors: H. T. Tu, S. Spence, J. M. Kalman, S. M. Davis Tags: Brief Communications Source Type: research

Antithrombotic use following transient ischaemic attack or ischaemic stroke among older Australians with atrial fibrillation
Abstract Hospital audits may underestimate anticoagulant use among acute ischaemic stroke patients with atrial fibrillation (AF), as treatment may commence after discharge. To account for this, antithrombotic use in the 4 months after hospitalisation for transient ischaemic attack or ischaemic stroke among AF patients was assessed using claims data. Results suggest that treatment may be commenced soon after discharge and should be considered when assessing prevalence of use.
Source: Internal Medicine Journal - November 4, 2014 Category: Internal Medicine Authors: J. K. Sluggett, G. E. Caughey, M. B. Ward, A. L. Gilbert Tags: Brief Communications Source Type: research

The adoption of direct oral anticoagulants for stroke prevention in atrial fibrillation
ConclusionDOACs prescribing grew rapidly from 2013 to 2014, regionally and nationally. Warfarin prescriptions have remained stable, indicating that more patients are being appropriately anticoagulated for atrial fibrillation that previously were not. DOACs were found to be prescribed to patients with lower CHA2DS2VASc and HASBLED scores, younger age, and higher GFR. Aspirin therapy remains over utilised in AF.
Source: Internal Medicine Journal - April 3, 2016 Category: Internal Medicine Authors: David Baker, Bradley Wilsmore, Seshasayee Narasimhan Tags: Original Article Source Type: research

Adoption of direct oral anticoagulants for stroke prevention in atrial fibrillation
Conclusion DOAC prescribing grew rapidly from 2013 to 2014, regionally and nationally. Warfarin prescriptions have remained stable, indicating that more patients are being appropriately anticoagulated for AF who previously were not. DOAC were found to be prescribed to patients with lower CHA2DS2VASc and HAS‐BLED scores, younger age and higher glomerular filtration rates. Aspirin therapy remains over utilised in AF.
Source: Internal Medicine Journal - July 11, 2016 Category: Internal Medicine Authors: D. Baker, B. Wilsmore, S. Narasimhan Tags: Original Article Source Type: research