Latest & greatest articles for stroke

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Top results for stroke

101. Therapeutic-induced hypertension in patients with noncardioembolic acute stroke (Abstract)

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

2019 EvidenceUpdates

102. Association Between Intravenous Thrombolysis and Anaphylaxis Among Medicare Beneficiaries With Acute Ischemic Stroke (Abstract)

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

2019 EvidenceUpdates

103. Patent foramen ovale closure, antiplatelet therapy or anticoagulation therapy alone for management of cryptogenic stroke

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

2019 Norwegian Institute of Public Health

104. Prehospital CT for early diagnosis and treatment of suspected acute stroke or severe head injury

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

2019 Norwegian Institute of Public Health

105. Tissue inhibitor metalloproteinase-1 and clinical outcomes after acute ischemic stroke (Abstract)

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

2019 EvidenceUpdates

106. 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 '); } 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

2019 Appropriate Care Guides, Agency for Care Effectiveness (Singapore)

107. Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in people with stroke or transient ischaemic attack. Full Text available with Trip Pro

first published in January 2014 and subsequently updated in December 2017.To assess the efficacy and safety of PPAR-γ agonists in the secondary prevention of stroke and related vascular events for people with stroke or transient ischaemic attack (TIA).We searched the Cochrane Stroke Group Trials Register (30 July 2019), the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 7), MEDLINE (1949 to 30 July 2019), Embase (1980 to 30 July 2019), CINAHL (1982 to 30 July 2019), AMED (1985 (...) Peroxisome proliferator-activated receptor gamma agonists for preventing recurrent stroke and other vascular events in people with stroke or transient ischaemic attack. Peroxisome proliferator-activated receptor gamma (PPAR-γ) agonists are insulin-sensitising drugs used for the treatment of insulin resistance. In addition to lowering glucose in diabetes, these drugs may also protect against hyperlipidaemia and arteriosclerosis, which are risk factors for stroke. This is an update of a review

2019 Cochrane

108. Non-alcoholic fatty liver disease and risk of incident acute myocardial infarction and stroke: findings from matched cohort study of 18 million European adults. Full Text available with Trip Pro

Non-alcoholic fatty liver disease and risk of incident acute myocardial infarction and stroke: findings from matched cohort study of 18 million European adults. To estimate the risk of acute myocardial infarction (AMI) or stroke in adults with non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH).Matched cohort study.Population based, electronic primary healthcare databases before 31 December 2015 from four European countries: Italy (n=1 542 672), Netherlands (n=2 (...)  225 925), Spain (n=5 488 397), and UK (n=12 695 046).120 795 adults with a recorded diagnosis of NAFLD or NASH and no other liver diseases, matched at time of NAFLD diagnosis (index date) by age, sex, practice site, and visit, recorded at six months before or after the date of diagnosis, with up to 100 patients without NAFLD or NASH in the same database.Primary outcome was incident fatal or non-fatal AMI and ischaemic or unspecified stroke. Hazard ratios were estimated using Cox models and pooled

2019 BMJ

109. Interventions for preventing falls in people after stroke. Full Text available with Trip Pro

Interventions for preventing falls in people after stroke. Falls are one of the most common complications after stroke, with a reported incidence ranging between 7% in the first week and 73% in the first year post stroke. This is an updated version of the original Cochrane Review published in 2013.To evaluate the effectiveness of interventions aimed at preventing falls in people after stroke. Our primary objective was to determine the effect of interventions on the rate of falls (number (...) of falls per person-year) and the number of fallers. Our secondary objectives were to determine the effects of interventions aimed at preventing falls on 1) the number of fall-related fractures; 2) the number of fall-related hospital admissions; 3) near-fall events; 4) economic evaluation; 5) quality of life; and 6) adverse effects of the interventions.We searched the trials registers of the Cochrane Stroke Group (September 2018) and the Cochrane Bone, Joint and Muscle Trauma Group (October 2018

2019 Cochrane

110. Sex Differences in Long-Term Quality of Life Among Survivors After Stroke in the INSTRUCT Full Text available with Trip Pro

Sex Differences in Long-Term Quality of Life Among Survivors After Stroke in the INSTRUCT Background and Purpose- Women are reported to have poorer health-related quality of life (HRQoL) after stroke than men, but the underlying reasons are uncertain. We investigated factors contributing to the sex differences. Methods- Individual participant data on 4288 first-ever strokes (1996-2013) were obtained from 4 high-quality population-based incidence studies from Australasia and Europe. HRQoL (...) utility scores among survivors after stroke (range from negative scores=worse than death to 1=perfect health) were calculated from 3 scales including European Quality of Life-5 Dimensions, Short-Form 6-Dimension, and Assessment of Quality of Life at 1 year (3 studies; n=1210) and 5 years (3 studies; n=1057). Quantile regression was used to estimate the median differences in HRQoL for women compared to men with adjustment for covariates. Study factors included sociodemographics, prestroke dependency

2019 EvidenceUpdates

111. Portable Stroke Diagnosis Devices for Adults with Stroke Symptoms: Diagnostic Accuracy and Cost-Effectiveness

Portable Stroke Diagnosis Devices for Adults with Stroke Symptoms: Diagnostic Accuracy and Cost-Effectiveness Portable Stroke Diagnosis Devices for Adults with Stroke Symptoms: Diagnostic Accuracy and Cost-Effectiveness | CADTH.ca Find the information you need Portable Stroke Diagnosis Devices for Adults with Stroke Symptoms: Diagnostic Accuracy and Cost-Effectiveness Portable Stroke Diagnosis Devices for Adults with Stroke Symptoms: Diagnostic Accuracy and Cost-Effectiveness Last updated: June (...) 17, 2019 Project Number: RA1042-000 Product Line: Research Type: Devices and Systems Report Type: Reference List Result type: Report Question What is the diagnostic accuracy of portable stroke diagnostic devices for adults with stroke symptoms? What is the cost-effectiveness of portable stroke diagnostic devices for adults with stroke symptoms? Key Message One non-randomized study was identified regarding the diagnostic accuracy of portable stroke diagnostic devices for adults with stroke

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

112. Clinical Guidelines for Stroke Management

Clinical Guidelines for Stroke Management InformMe - Clinical Guidelines for Stroke Management Our websites {{ user.firstName }} {{ user.lastName }} Go back {{ user.firstName }} {{ user.lastName }} Where am I? Clinical Guidelines for Stroke Management The Clinical Guidelines for Stroke Management are evolving into , updated as new evidence emerges in accordance with the 2011 NHMRC Standard for clinical practice guidelines. They supersede the Clinical Guidelines for Stroke Management 2017 (...) of stroke care, across 8 chapters: Imaging Cardiac investigations Thrombolysis Neurointervention Medical interventions Surgical interventions Smoking Diet Physical activity Obesity Alcohol Weakness Loss of sensation Vision Amount of rehabilitation Cardiorespiratory fitness Sitting Standing up Standing balance Walking Upper limb activity Assessment of communication deficits Aphasia Dysarthria Apraxia of speech Cognitive communication disorder in right hemisphere stroke Assessment of cognition Executive

2019 Stroke Foundation - Australia

113. Portable Stroke Diagnosis Devices for Adults with Stroke Symptoms: A Review of Diagnostic Accuracy and Cost-Effectiveness

Portable Stroke Diagnosis Devices for Adults with Stroke Symptoms: A Review of Diagnostic Accuracy and Cost-Effectiveness Portable Stroke Diagnosis Devices for Adults with Stroke Symptoms: A Review of Diagnostic Accuracy and Cost-Effectiveness | CADTH.ca Find the information you need Portable Stroke Diagnosis Devices for Adults with Stroke Symptoms: A Review of Diagnostic Accuracy and Cost-Effectiveness Portable Stroke Diagnosis Devices for Adults with Stroke Symptoms: A Review of Diagnostic (...) Accuracy and Cost-Effectiveness Last updated: July 2, 2019 Project Number: RC1151-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the diagnostic accuracy of portable stroke diagnostic devices for adults with stroke symptoms? What is the cost-effectiveness of portable stroke diagnostic devices for adults with stroke symptoms? Key Message One relevant non-randomized study was identified regarding diagnostic accuracy

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

114. Portable Stroke Detection Devices for Patients with Stroke Symptoms: A Review of Diagnostic Accuracy and Cost-Effectiveness

Portable Stroke Detection Devices for Patients with Stroke Symptoms: A Review of Diagnostic Accuracy and Cost-Effectiveness Portable Stroke Detection Devices for Patients with Stroke Symptoms: A Review of Diagnostic Accuracy and Cost-Effectiveness | CADTH.ca Find the information you need Portable Stroke Detection Devices for Patients with Stroke Symptoms: A Review of Diagnostic Accuracy and Cost-Effectiveness Portable Stroke Detection Devices for Patients with Stroke Symptoms: A Review (...) of Diagnostic Accuracy and Cost-Effectiveness Last updated: August 7, 2019 Project Number: RC1167-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the diagnostic accuracy of portable stroke detection devices for patients with stroke symptoms? What is the cost-effectiveness of portable stroke diagnostic devices for patients with stroke symptoms? Key Message No relevant literature was identified regarding the diagnostic

2019 Canadian Agency for Drugs and Technologies in Health - Rapid Review

115. Do Calcium Antagonists Decrease Mortality or Dependency in Acute Ischemic Stroke? Full Text available with Trip Pro

of active treatment on the primary outcome, unpublished trials demonstrated a deleterious effect between treatment with a calcium antagonist and the primary outcome, suggesting publication bias. Commentary Stroke is the leading cause of disability worldwide and the second most common cause of mortality. x 2 Liu, M., Wu, B., Wang, W.-Z. et al. Stroke in China: epidemiology, prevention, and management strategies. Lancet Neurol . 2007 ; 6 : 456–464 Ischemic cerebrovascular accidents account for 87 (...) % of strokes. x 3 Chandra, A., Stone, C.R., Du, X. et al. The cerebral circulation and cerebrovascular disease III: stroke. Brain Circ . 2017 ; 3 : 66–77 Massive calcium influx into cells is the final common pathway for cell demise, and calcium antagonist therapy may be neuroprotective by decreasing calcium influx through voltage-gated channels. x 4 Siesjö, B.K. and Bengtsson, F. Calcium fluxes, calcium antagonists, and calcium-related pathology in brain ischemia, hypoglycemia, and spreading depression

2019 Annals of Emergency Medicine Systematic Review Snapshots

116. Stroke, Diagnosis and Initial Treatment of Ischemic Stroke

early care for persons with an onset of stroke symp- toms. The recommendations in this guideline are for early management of stroke due to ischemic brain ischemia/infarction. This guideline does not address stroke prevention, transient ischemic stroke (TIA) or management of hemorrhagic stroke. To increase access to appropriate early care for stroke, Minnesota passed legislation to authorize the Minnesota Department of Health (MDH) to designate hospitals as Acute Stroke-Ready Hospitals, Primary (...) infarct” present yes Return to Table of Contents www.icsi.org 2 Table of Contents Diagnosis and Initial Treatment of Ischemic Stroke Twelfth Edition/June 2019 Work Group Co-Leaders David Anderson, MD Neurology, University of Minnesota Physicians David Larson, MD Emergency Medicine, Ridgeview Medical Center Work Group Members HealthEast Care System Tess Sierzant, MS, RN Neurology Nursing Lakeview Hospital Bjorn Peterson, MD Emergency Medicine Mayo Clinic James Klaas, MD Neurology Minneapolis Clinic

2019 Institute for Clinical Systems Improvement

117. Behavioural activation therapy for post-stroke depression: the BEADS feasibility RCT Full Text available with Trip Pro

Behavioural activation therapy for post-stroke depression: the BEADS feasibility RCT Behavioural activation therapy for post-stroke depression: the BEADS feasibility RCT Journals Library An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website search above to find the information you need. >> >> >> >> Issue {{metadata .Issue

2019 NIHR HTA programme

118. Perioperative covert stroke in patients undergoing non-cardiac surgery (NeuroVISION): a prospective cohort study. (Abstract)

stroke or transient ischaemic attack at 1-year follow-up (HR 4·13, 1·14-14·99, absolute risk increase 3%; p=0·019).Perioperative covert stroke is associated with an increased risk of cognitive decline 1 year after non-cardiac surgery, and perioperative covert stroke occurred in one in 14 patients aged 65 years and older undergoing non-cardiac surgery. Research is needed to establish prevention and management strategies for perioperative covert stroke.Canadian Institutes of Health Research (...) stroke (ie, an acute brain infarct detected on an MRI after non-cardiac surgery in a patient with no clinical stroke symptoms) and cognitive decline 1 year after surgery.NeuroVISION was a prospective cohort study done in 12 academic centres in nine countries, in which we assessed patients aged 65 years or older who underwent inpatient, elective, non-cardiac surgery and had brain MRI after surgery. Two independent neuroradiology experts, masked to clinical data, assessed each MRI for acute brain

2019 Lancet

119. A newly designed intensive caregiver education program reduces cognitive impairment, anxiety, and depression in patients with acute ischemic stroke. Full Text available with Trip Pro

A newly designed intensive caregiver education program reduces cognitive impairment, anxiety, and depression in patients with acute ischemic stroke. This study aimed to evaluate the effect of a newly designed intensive caregiver education program (ICEP) on reducing cognitive impairment, anxiety, and depression in acute ischemic stroke (AIS) patients. One hundred and ninety-six AIS patients were divided into ICEP group and Control group in a 1:1 ratio using blocked randomization method

2019 Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas Controlled trial quality: uncertain

120. Physical Fitness Training in Patients with Subacute Stroke (PHYS-STROKE): multicentre, randomised controlled, endpoint blinded trial. Full Text available with Trip Pro

Physical Fitness Training in Patients with Subacute Stroke (PHYS-STROKE): multicentre, randomised controlled, endpoint blinded trial. To determine the safety and efficacy of aerobic exercise on activities of daily living in the subacute phase after stroke.Multicentre, randomised controlled, endpoint blinded trial.Seven inpatient rehabilitation sites in Germany (2013-17).200 adults with subacute stroke (days 5-45 after stroke) with a median National Institutes of Health stroke scale (NIHSS (...) , range 0-42 points, higher values indicating more severe strokes) score of 8 (interquartile range 5-12) were randomly assigned (1:1) to aerobic physical fitness training (n=105) or relaxation sessions (n=95, control group) in addition to standard care.Participants received either aerobic, bodyweight supported, treadmill based physical fitness training or relaxation sessions, each for 25 minutes, five times weekly for four weeks, in addition to standard rehabilitation therapy. Investigators

2019 BMJ