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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
BMJ Open. 2022 Feb 11;12(2):e055461. doi: 10.1136/bmjopen-2021-055461.ABSTRACTINTRODUCTION: 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) aim...
Source: Rural Remote Health - February 12, 2022 Category: Rural Health Authors: Annika Ryan Christine L Paul Martine Cox Olivia Whalen Andrew Bivard John Attia Christopher Bladin Stephen M Davis Bruce C V Campbell Mark Parsons Rohan S Grimley Craig Anderson Geoffrey A Donnan Christopher Oldmeadow Sarah Kuhle Frederick R Walker Rebecc Source Type: research

Hemoglobin A1c-related histologic characteristics of symptomatic carotid plaques
Conclusions: Increased HbA1c values seem to contribute to plaque instability through the formation of a thin fibrous cup. Thus, of the carotid artery plaque parameters including fibrous cup thickness, plaque rupture, lipid core, inflammation, intraplaque hemorrhage, thrombus, calcification, necrotic core, and neovascularization, fibrous cup thickness is the only histomorphological feature that affected by HbA1c.
Source: Nigerian Journal of Clinical Practice - March 5, 2019 Category: Rural Health Authors: M Tecellioglu S Alan S Kamisli FS Tecellioglu O Kamisli C Ozcan Source Type: research

The Pattern of significant lesions found in computerized tomography scan of recurrent seizure patients at a center in Enugu, Nigeria
Conclusion: Computed tomography scan has a high diagnostic yield, especially in elderly patients with recurrent generalized seizures. Brain tumors, encephalomalacia, and HCP are most common causes of recurrent seizures in the adults.
Source: Nigerian Journal of Clinical Practice - December 1, 2017 Category: Rural Health Authors: AB Ezeala-Adikaibe SC Ohaegbulam CA Ndubuisi Source Type: research

Pattern and location of intracerebral hemorrhage in Enugu, South-East Nigeria: A review of 139 cases
Conclusion: Frequency of LH and DCH varied with age as LH peaked before the age of 40 while deep cerebral at 40–49 years. The age distribution of different types of ICH may suggest a higher role of other factors apart from hypertension. Further studies are required to establish the risk factors of LH and DCHs in our environment.
Source: Nigerian Journal of Clinical Practice - March 27, 2016 Category: Rural Health Authors: BA Ezeala-AdikaibeSC Ohaegbulam Source Type: research

Thrombolysis delivery by a regional telestroke network--experience from the U.K. National Health Service.
CONCLUSIONS: We demonstrate the safety and effectiveness of a horizontal networking approach for stroke telemedicine, which may be applicable to areas where traditional "hub-and-spoke" models may not be geographically feasible. PMID: 24572251 [PubMed - indexed for MEDLINE]
Source: Rural Remote Health - August 27, 2014 Category: Rural Health Authors: Agarwal S, Day DJ, Sibson L, Barry PJ, Collas D, Metcalf K, Cotter PE, Guyler P, O'Brien EW, O'Brien A, O'Kane D, Owusu-Agyei P, Phillips P, Shekhar R, Warburton EA Tags: J Am Heart Assoc Source Type: research

Appropriateness of CT Imaging to Support the Diagnosis of Stroke: A Review of the Clinical Evidence
The objective of this review is to summarize recent clinical evidence of CT and expert clinical assessment to support the diagnosis of stroke and TIAs. PMID: 24716258
Source: Rural Remote Health - April 14, 2014 Category: Rural Health Tags: Book Source Type: research

Recombinant tissue plasminogen activator (rt‐PA) utilisation by rural clinicians in acute ischaemic stroke: A survey of barriers and enablers
ConclusionsTo reduce barriers to rt‐PA utilisation in rural facilities physicians require education on the calculated risk of ICH as well as exposure and experience to improve their ability to confidently diagnose stroke patients who are eligible for rt‐PA treatment. Education for nurses on symptoms of stroke and rt‐PA utilisation and administration is recommended.
Source: Australian Journal of Rural Health - October 11, 2013 Category: Rural Health Authors: Jocelyn M. Williams, Martin R. Jude, Christopher R. Levi Tags: Original Research Source Type: research

Recombinant tissue plasminogen activator (rt-PA) utilisation by rural clinicians in acute ischaemic stroke: A survey of barriers and enablers.
CONCLUSIONS: To reduce barriers to rt-PA utilisation in rural facilities physicians require education on the calculated risk of ICH as well as exposure and experience to improve their ability to confidently diagnose stroke patients who are eligible for rt-PA treatment. Education for nurses on symptoms of stroke and rt-PA utilisation and administration is recommended. PMID: 24118148 [PubMed - as supplied by publisher]
Source: The Australian Journal of Rural Health - October 1, 2013 Category: Rural Health Authors: Williams JM, Jude MR, Levi CR Tags: Aust J Rural Health Source Type: research

Recombinant tissue plasminogen activator (rt‐PA) utilisation by rural clinicians in acute ischaemic stroke: An audit of current practice and clinical outcomes
ConclusionRecombinant tissue plasminogen activator can be delivered in rural Australian hospitals in a timely manner within recommended implementation guidelines. Acute stroke thrombolytic services in rural Australian facilities had comparable outcomes to metropolitan facilities. Small numbers of thrombolysed patients prevented a validation study of the well‐defined outcome benefits from rt‐PA. The need for ongoing data collection in regional settings is supported.
Source: Australian Journal of Rural Health - August 16, 2013 Category: Rural Health Authors: Jocelyn M. Williams, Tina J. Navin, Martin R. Jude, Christopher R. Levi Tags: Original Research Source Type: research

Recombinant tissue plasminogen activator (rt-PA) utilisation by rural clinicians in acute ischaemic stroke: An audit of current practice and clinical outcomes.
CONCLUSION: Recombinant tissue plasminogen activator can be delivered in rural Australian hospitals in a timely manner within recommended implementation guidelines. Acute stroke thrombolytic services in rural Australian facilities had comparable outcomes to metropolitan facilities. Small numbers of thrombolysed patients prevented a validation study of the well-defined outcome benefits from rt-PA. The need for ongoing data collection in regional settings is supported. PMID: 24033520 [PubMed - in process]
Source: The Australian Journal of Rural Health - August 1, 2013 Category: Rural Health Authors: Williams JM, Navin TJ, Jude MR, Levi CR Tags: Aust J Rural Health Source Type: research