Effects of a 3D-printed orthosis compared to a low-temperature thermoplastic plate orthosis on wrist flexor spasticity in chronic hemiparetic stroke patients: a randomized controlled trial Effects of a 3D-printed Orthosis Compared to a Low-Temperature Thermoplastic Plate Orthosis on Wrist Flexor Spasticity in Chronic Hemiparetic Stroke Patients: A Randomized Controlled Trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features (...) on Wrist Flexor Spasticity in Chronic Hemiparetic Stroke Patients: A Randomized Controlled Trial , , , , , , , , , , Affiliations Expand Affiliations 1 Department of Rehabilitation, Shanghai Xuhui Central Hospital, Shanghai, China. 2 School of Kinesiology, Shanghai University of Sport, Shanghai, China. 3 School of Mechatronic Engineering and Automation, Shanghai University, Shanghai, China. PMID: 31686529 DOI: Item in Clipboard Effects of a 3D-printed Orthosis Compared to a Low-Temperature

to hospital for patients with a stroke mimic or transient ischaemic attack (TIA) – this may include the rapid introduction of pre- hospital tele medicine, eg via apps such as GoodSam/Facetime. Work on the direct to CT pathway for patients with clear stroke symptoms and an onset time that makes them amenable to recanalisation therapy. Maintaining high standards of stroke care across the pathway Many facets of the stroke pathway are deemed important, but during this time of considerable pressure some (...) that should hold precedence: • early senior assessment on admission (<1 hour) – this may be face-to-face with PPE, but only one stroke specialist to consider, with secondary reviews done via video or telephone • early appropriate cerebral imaging (<1 hour) • rapid thrombolysis and referral for thrombectomy • early reversal of anticoagulation and management of raised BP in patients with intracerebral haemorrhage (<1 hour) • direct admission to stroke unit early swallow screen 3 | Clinical guide

Long term exposure to ambient fine particulate matter and incidence of stroke: prospective cohort study from the China-PAR project. To study the effect of long term exposure to ambient fine particulate matter of diameter ≤2.5 μm (PM2.5) on the incidence of total, ischemic, and hemorrhagic stroke among Chinese adults.Population based prospective cohort study.Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project carried out in 15 provinces across China.117 575 (...) Chinese men and women without stroke at baseline in the China-PAR project.Incidence of total, ischemic, and hemorrhagic stroke.The long term average PM2.5 level from 2000 to 2015 at participants' residential addresses was 64.9 μg/m3, ranging from 31.2 μg/m3 to 97.0 μg/m3. During 900 214 person years of follow-up, 3540 cases of incident stroke were identified, of which 63.0% (n=2230) were ischemic and 27.5% (n=973) were hemorrhagic. Compared with the first quarter of exposure to PM2.5 (<54.5 μg/m3

The Management of Stroke Rehabilitation: A Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline. In June 2019, the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) approved an update of the joint clinical practice guideline for rehabilitation after stroke. This synopsis summarizes the key recommendations from this guideline.In February 2018, the VA/DoD Evidence-Based Practice Work Group convened a joint (...) VA/DoD guideline development effort that included clinical stakeholders and stroke survivors and conformed to the National Academy of Medicine (formerly the Institute of Medicine) tenets for trustworthy clinical practice guidelines. The guideline panel identified key questions, systematically searched and evaluated the literature, and developed 2 algorithms and 42 key recommendations using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Stroke survivors

artery revascularization and transfemoral carotid artery stenting for carotid artery stenosis, from September 2016 to April 2019. The final date for follow-up was May 29, 2019.Transcarotid artery revascularization vs transfemoral carotid artery stenting.Outcomes included a composite end point of in-hospital stroke or death, stroke, death, myocardial infarction, as well as ipsilateral stroke or death at 1 year. In-hospital stroke was defined as ipsilateral or contralateral, cortical or vertebrobasilar (...) , and ischemic or hemorrhagic stroke. Death was all-cause mortality.During the study period, 5251 patients underwent transcarotid artery revascularization and 6640 patients underwent transfemoral carotid artery stenting. After matching, 3286 pairs of patients who underwent transcarotid artery revascularization or transfemoral carotid artery stenting were identified (transcarotid approach: mean [SD] age, 71.7 [9.8] years; 35.7% women; transfemoral approach: mean [SD] age, 71.6 [9.3] years; 35.1% women

Brussel (control) with standard emergency care complemented with in-ambulance teleconsultation service by stroke experts (PreSSUB).The primary efficacy endpoint is the call-to-brain imaging time. Secondary endpoints for the efficacy analysis include the prevalence of medical events diagnosed and corrected during in-ambulance teleconsultation, the proportion of patients with ischemic stroke receiving recanalization therapy, the assessment of disability, functional status, quality of life and overall (...) PreSSUB II: The prehospital stroke study at the Universitair Ziekenhuis Brussel II. Stroke is a time-critical medical emergency requiring specialized treatment. Prehospital delay contributes significantly to delayed or missed treatment opportunities. In-ambulance telemedicine can bring stroke expertise to the prehospital arena and facilitate this complex diagnostic and therapeutic process.This study evaluates the efficacy, safety, feasibility, reliability and cost-effectiveness of in-ambulance

Feasibility and preliminary effects of an integrated hospital-to-home transitional care intervention for older adults with stroke and multimorbidity: A study protocol. Stroke is a major life-altering event and the leading cause of death and disability in Canada. Most older adults who have suffered a stroke will return home and require ongoing rehabilitation in the community. Transitioning from hospital to home is reportedly very stressful and challenging, particularly if stroke survivors have (...) adults (≥55 years) with a confirmed stroke diagnosis, ≥2 co-morbid conditions, and referred to a hospital-based outpatient stroke rehabilitation centre. The 6-month transitional care intervention will be delivered by an interprofessional (IP) team and involve care coordination/system navigation, self-management education and support, home visits, telephone contacts, IP team meetings and a web-based app. Primary evaluation of the intervention will be based on feasibility outcomes (e.g. acceptability

Cases in Precision Medicine: A Personalized Approach to Stroke and Cardiovascular Risk Assessment in Women. Cardiovascular disease is the leading cause of death among women in the United States, and stroke is third. This article uses a case scenario to examine female sex-specific cardiovascular risk factors across the lifespan and describes a precision medicine-based approach to risk factor modification and primary prevention. It also presents recent updates to the role of genetic testing (...) and polygenic risk scores for the prediction of stroke and cardiovascular disease.

Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Background and Purpose- The purpose of these guidelines is to provide an up-to-date comprehensive set of recommendations in a single document for clinicians caring for adult patients with acute arterial ischemic stroke. The intended audiences (...) are prehospital care providers, physicians, allied health professionals, and hospital administrators. These guidelines supersede the 2013 Acute Ischemic Stroke (AIS) Guidelines and are an update of the 2018 AIS Guidelines. Methods- Members of the writing group were appointed by the American Heart Association (AHA) Stroke Council's Scientific Statements Oversight Committee, representing various areas of medical expertise. Members were not allowed to participate in discussions or to vote on topics relevant

Essen Risk Score in Prediction of Myocardial Infarction After Transient Ischemic Attack or Ischemic Stroke Without Prior Coronary Artery Disease Background and Purpose- More intensive secondary prevention with newer drugs may be cost-effective in patients with coronary artery disease (CAD). Whether some subgroups of patients who had a transient ischemic attack (TIA) or ischemic stroke, but no prior CAD are at similar high risk of myocardial infarction as those with prior CAD remains unclear. We (...) determined whether the Essen score identified a subset of TIA/stroke patients without known prior CAD who, nevertheless, had a high risk of myocardial infarction on current secondary prevention management. Methods- In a population-based cohort (Oxford Vascular Study) of consecutive TIA or ischemic stroke patients recruited from 2002 to 2014, 10-year actuarial risks of myocardial infarction and of recurrent ischemic stroke were determined by face-to-face follow-up in patients with and without prior CAD

Training for Walking Efficiency With a Wearable Hip-Assist Robot in Patients With Stroke: A Pilot Randomized Controlled Trial Background and Purpose- The purpose of this study was to investigate the effects of gait training with a newly developed wearable hip-assist robot on locomotor function and efficiency in patients with chronic stroke. Methods- Twenty-eight patients with stroke with hemiparesis were initially enrolled, and 26 patients completed the randomized controlled trial (14 (...) parameters (P<0.05). Cardiopulmonary metabolic efficiency was strongly correlated with gait symmetry ratio in the experimental group (P<0.01). Conclusions- Gait training with Gait Enhancing and Motivating System was effective for improving locomotor function and cardiopulmonary metabolic energy efficiency during walking in patients with stroke. These findings suggest that robotic locomotor training can be adopted for rehabilitation of patients with stroke with gait disorders. Clinical Trial Registration

A support programme for secondary prevention in patients with transient ischaemic attack and minor stroke (INSPiRE-TMS): an open-label, randomised controlled trial Patients with recent stroke or transient ischaemic attack are at high risk for a further vascular event, possibly leading to permanent disability or death. Although evidence-based treatments for secondary prevention are available, many patients do not achieve recommended behavioural modifications and pharmaceutical prevention targets (...) in the long-term. We aimed to investigate whether a support programme for enhanced secondary prevention can reduce the frequency of recurrent vascular events.INSPiRE-TMS was an open-label, multicentre, international randomised controlled trial done at seven German hospitals with acute stroke units and a Danish stroke centre. Patients with non-disabling stroke or transient ischaemic attack within 2 weeks from study enrolment and at least one modifiable risk factor (ie, arterial hypertension, diabetes

stroke registries. We performed multivariable Cox regression analysis to identify predictors of stroke recurrence. Based on the coefficient of each covariate of the fitted multivariable model, we generated an integer-based point scoring system. We validated the score externally assessing its discrimination and calibration.In 3 registries (884 patients) that were used as the derivation cohort, age, leukoaraiosis, and multiterritorial infarct were identified as independent predictors of stroke (...) recurrence and were included in the final score, which assigns 1 point per every decade after 35 years of age, 2 points for leukoaraiosis, and 3 points for multiterritorial infarcts (acute or old nonlacunar). The rate of stroke recurrence was 2.1 per 100 patient-years (95% confidence interval [CI] 1.44-3.06) in patients with a score of 0-4 (low risk), 3.74 (95% CI 2.77-5.04) in patients with a score of 5-6 (intermediate risk), and 8.23 (95% CI 5.99-11.3) in patients with a score of 7-12 (high risk

in Patients with Stroke and Transient Ischemic Attack [23] Abbreviations: AHA: American Heart Association; ASA: American Stroke Association Sidebar 2: Assessment of Impairments and Disabilities ? Assessment of impairments • Auditory/hearing • Bowel and bladder function • Cognition • Communication • Emotion and behavior • Inattention/neglect • Motor/mobility • Swallowing and nutrition • Tactile/touch • Vision function and formal visual field ? Assessment of barriers to participation in therapy • Cognitive (...) in the form of medical, surgical, or rehabilitation interventions is essential to help reduce disability severity, decrease the risk of further complications, and lessen potentially life-long deficits.[5,6] Unfortunately, in approximately 30% of ischemic stroke cases, the cause of the stroke remains unknown.[7] Ischemic strokes with no obvious cause are labelled as “cryptogenic” strokes and are more common in younger patients than in the elderly.[8] This is largely due to the lack of comorbidities

Association Between Intravenous Thrombolysis and Anaphylaxis Among Medicare Beneficiaries With Acute Ischemic Stroke Background and Purpose- Allergic reactions, including anaphylaxis, can sometimes occur after intravenous thrombolysis in patients with acute ischemic stroke. However, it remains unclear whether patients with stroke who receive thrombolytic agents face a higher risk of anaphylaxis than those who do not receive thrombolytics. Methods- We performed a retrospective cohort study using (...) inpatient and outpatient claims between 2008 and 2015 from a nationally representative 5% sample of Medicare beneficiaries. We included patients who were ≥65 years old and hospitalized with acute ischemic stroke, defined by validated International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. Our exposure was treated with an intravenous thrombolytic agent during the index hospitalization (International Classification of Diseases, Ninth Revision, Clinical Modification

Scale score ≥3) at 3 months after ischemic stroke, and secondary outcomes included major disability, death, and vascular events.A total of 843 participants (25.2%) experienced major disability or died within 3 months. After adjustment for age, sex, admission NIH Stroke Scale score, and other important covariates, odds ratios or hazard ratios (95% confidence intervals) of 1-SD (0.17 ng/mL) higher log-TIMP-1 were 1.17 (1.06-1.29) for the primary outcome, 1.13 (1.02-1.25) for major disability, 1.49 (...) Tissue inhibitor metalloproteinase-1 and clinical outcomes after acute ischemic stroke To prospectively investigate the relationships between serum tissue inhibitor metalloproteinase-1 (TIMP-1) and clinical outcomes in patients with acute ischemic stroke.We derived data from the China Antihypertensive Trial in Acute Ischemic Stroke. Baseline serum TIMP-1 concentrations were measured in 3,342 participants. The primary outcome was the combination of death and major disability (modified Rankin

Therapeutic-induced hypertension in patients with noncardioembolic acute stroke To evaluate the safety and efficacy of induced hypertension in patients with acute ischemic stroke.In this multicenter randomized clinical trial, patients with acute noncardioembolic ischemic stroke within 24 hours of onset who were ineligible for revascularization therapy and those with progressive stroke during hospitalization were randomly assigned (1:1) to the control and intervention groups. In the intervention (...) group, phenylephrine was administered intravenously to increase systolic blood pressure (SBP) up to 200 mm Hg. The primary efficacy endpoint was early neurologic improvement (reduction in NIH Stroke Scale [NIHSS] score of ≥2 points during the first 7 days). The secondary efficacy endpoint was a modified Rankin Scale score of 0 to 2 at 90 days. Safety outcomes included symptomatic intracranial hemorrhage/edema, myocardial infarction, and death.In the modified intention-to-treat analyses, 76 and 77

Botulinum toxin A for the management of focal spasticity of the upper limbs associated with stroke in adults '); } else { document.write(' '); } ACE | Botulinum toxin A for the management of focal spasticity of the upper limbs associated with stroke in adults Search > > Botulinum toxin A for the management of focal spasticity of the upper limbs associated with stroke in adults - Botulinum toxin A for the management of focal spasticity of the upper limbs associated with stroke in adults First (...) published on 16 October 2017 Guidance Recommendation The Ministry of Health's Drug Advisory Committee has recommended: Clostridium botulinum toxin type A neurotoxin complex (Botox) 50 U and 100 U injection vials for the management of focal spasticity of the upper limbs associated with stroke in adults who: have a score of 2 or more on the Modified Ashworth Scale at the target muscle intended for botulinum toxin A treatment, do not have the affected joint permanently fixed in position due to fibrotic

or anticoagulation therapy alone for management of cryptogenic stroke Order Download: Key message We are constantly trying to make our products better. On this publication we have tried out a new presentation: Patent foramen ovale (PFO) represents an opening in the heart placing people at risk of ischemic stroke. This report evaluates catheter-based PFO closure as an alternative treatment to antiplatelet therapy or anticoagulation for patients with a PFO having suffered a stroke. Our findings: PFO closure plus (...) antiplatelet therapy probably results in a large decrease in ischemic stroke, when compared to antiplatelet therapy alone (8.7% absolute risk reduction, moderate certainty evidence) There may be little or no difference in the risk for ischemic stroke when comparing PFO closure to anticoagulation (low certainty evidence) Compared to anticoagulation, PFO closure will probably result in fewer cases of major bleeding (2% absolute risk reduction, moderate certainty evidence) PFO closure comes with an increased

injury require urgent admission to a neurosurgical department. In acute stroke and severe head injuries, it is crucial that the patient is diagnosed and treated as soon as possible ("time is brain"). If acute stroke or severe head injury is suspected, rapid admission to a hospital to undertake a computed tomography (CT) scan is recommended. In stroke caused by blood clots (ischemic stroke or cerebral infarction), thrombolytic treatment should be given as soon as possible, at most within 4.5 hours (...) patient receiving thrombolysis through MSU care compared with conventional care. We performed an analysis quantifying the severity criterion by calculating absolute shortfall for patients with acute ischemic stroke who receive conventional care. The results show an absolute shortfall of 5.5 QALYs. We found that the expected cost per QALY is approximately 385,000 Norwegian kroner or lower if one MSU successfully reaches at least 35-40% (145-171) of thrombolysis patients per year. Summary Background