49,056 results match your criteria stroke outcomes

Multiple sclerosis is associated with higher comorbidity and healthcare resource use: a population-based, case-control study in a western Mediterranean region.

Eur J Neurol 2021 Jul 22. Epub 2021 Jul 22.

Servei de Neurología-Neuroimmunología, Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Vall d'Hebron Hospital Universitari, Barcelona, Spain.

Background: Comorbidities are common in multiple sclerosis (MS), and have been associated with worse outcomes and increased healthcare resource usage. We studied the frequency of comorbidities and adverse health behaviors (AHB) in MS patients in the Mediterranean region of Catalonia.

Methods: Population-based, case-control study using primary healthcare information covering 80% of Catalonia's population. Read More

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Intensive Blood Pressure Lowering and DWI Lesions in Intracerebral Hemorrhage: Exploratory Analysis of the ATACH-2 Randomized Trial.

Neurocrit Care 2021 Jul 22. Epub 2021 Jul 22.

Department of Neurology J. P. Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Background: With the increasing use of magnetic resonance imaging in the assessment of acute intracerebral hemorrhage, diffusion-weighted imaging hyperintense lesions have been recognized to occur at sites remote to the hematoma in up to 40% of patients. We investigated whether blood pressure reduction was associated with diffusion-weighted imaging hyperintense lesions in acute intracerebral hemorrhage and whether such lesions are associated with worse clinical outcomes by analyzing imaging data from a randomized trial.

Methods: We performed exploratory subgroup analyses in an open-label randomized trial that investigated acute blood pressure lowering in 1000 patients with intracerebral hemorrhage between May 2011 and September 2015. Read More

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Pericardial SCUBE1 levels may help predict postoperative results in patients operated on for coronary artery bypass graft surgery.

Cardiovasc J Afr 2021 Jul 5;32:1-5. Epub 2021 Jul 5.

Cardiovascular Surgery Department, Trakya University, Edirne, Turkey.

Introduction: Signal peptide-CUB epidermal growth factorlike domain-containing protein (SCUBE1) is a newly described, secretable and measurable cellular surface protein associated with atherosclerotic lesions in humans, which may be involved in hypertension and cardiovascular pathologies. We aimed to detect normal SCUBE1 levels in pericardial fluid and investigate the effects of SCUBE1 values on postoperative outcomes after coronary artery bypass surgery.

Methods: Between February 2016 and March 2017, 184 consecutive patients were included in the study. Read More

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Polydiacetylene Liposome Microarray toward Facile Measurement of Platelet Activation in Whole Blood.

ACS Sens 2021 Jul 22. Epub 2021 Jul 22.

Department of Materials Science and Engineering, University of Michigan, Ann Arbor, Michigan 48109, United States.

The necessity of a simple measurement of platelet activation has been increasing in clinical medicine to regulate the proper dose of the antiplatelet drugs for patients having clinical outcomes in acute situations such as angina pectoris, stroke, or peripheral vascular disease or procedures involving angioplasty or coronary thrombolysis. We developed a self-signaling polydiacetylene (PDA) liposome microarray to detect activated platelets from whole blood samples in a single step. A specific antibody, 9F9 antibody, to platelet-bound fibrinogen was selected and conjugated to the PDA liposome microarray to quantify the fibrinogen-bound platelets. Read More

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Wake-up strokes are linked to obstructive sleep apnea and worse early functional outcome.

Brain Behav 2021 Jul 21. Epub 2021 Jul 21.

Unit of Clinical Neurophysiology, Satakunta Hospital District, Faculty of Health and Welfare, Satakunta University of Applied Sciences, Pori, Finland.

Background And Aims: Presence of sleep-disordered breathing (SDB) and especially obstructive sleep apnea (OSA) is a known risk factor for ischemic stroke. Additionally, SDB effects negatively on recovery after stroke. Up to one fourth of strokes are present on awakening. Read More

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Adherence to a Healthy Lifestyle and the Risk of All-Cause Mortality and Cardiovascular Events in Individuals With Diabetes: The ARIC Study.

Front Nutr 2021 5;8:698608. Epub 2021 Jul 5.

Department of Emergency Medicine and National Clinical Research Center for Geriatrics, Research Laboratory of Emergency Medicine, Disaster Medicine Center, West China Hospital, Sichuan University, Chengdu, China.

The relationship between combined healthy lifestyle and cardiovascular (CV) events in diabetes is unclear. We aim to investigate the association between a healthy lifestyle score (HLS) and the risk of mortality and CV events in diabetes. We examined the associations of six lifestyle factors scores (including healthy diet, moderate alcohol and regular coffee intakes, never smoking, physical activity, and normal weight) with diabetes in the Atherosclerosis Risk in Communities (ARIC) study of 3,804 participants with diabetes from the United States at baseline. Read More

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Sensory Stimulation of the Foot and Ankle Early Post-stroke: A Pilot and Feasibility Study.

Front Neurol 2021 5;12:675106. Epub 2021 Jul 5.

School of Allied Health Professions, Faculty of Medicine and Health Sciences, Keele University, Keele, United Kingdom.

Somatosensory stimulation of the lower extremity could improve motor recovery and walking post-stroke. This pilot study investigated the feasibility of a subsequent randomized controlled trial (RCT) to determine whether task-specific gait training is more effective following either (a) intensive hands-on somatosensory stimulation or (b) wearing textured insoles. Determine recruitment and attrition rates, adherence to intervention, acceptability and viability of interventions and outcome measures, and estimate variance of outcome data to inform sample size for a subsequent RCT. Read More

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Combination of Rescue Stenting and Antiplatelet Infusion Improved Outcomes for Acute Intracranial Atherosclerosis-Related Large-Vessel Occlusion.

Front Neurol 2021 5;12:608270. Epub 2021 Jul 5.

Department of Radiology, Seoul National University Bundang Hospital, Seongnam, South Korea.

Intracranial atherosclerosis-related large-vessel occlusion caused by thrombo-occlusion (ICAS-LVO) has been regarded an important reason for refractoriness to mechanical thrombectomy (MT). To achieve better outcomes for ICAS-LVO, different endovascular strategies should be explored. We aimed to investigate an optimal endovascular strategy for ICAS-LVO. Read More

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The PROGRAM study: awake mapping versus asleep mapping versus no mapping for high-grade glioma resections: study protocol for an international multicenter prospective three-arm cohort study.

BMJ Open 2021 Jul 21;11(7):e047306. Epub 2021 Jul 21.

Department of Neurosurgery, Erasmus MC, Rotterdam, The Netherlands.

Introduction: The main surgical dilemma during glioma resections is the surgeon's inability to accurately identify eloquent areas when the patient is under general anaesthesia without mapping techniques. Intraoperative stimulation mapping (ISM) techniques can be used to maximise extent of resection in eloquent areas yet simultaneously minimise the risk of postoperative neurological deficits. ISM has been widely implemented for low-grade glioma resections backed with ample scientific evidence, but this is not yet the case for high-grade glioma (HGG) resections. Read More

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Validation of an Automated System for Identifying Complications of Serious Pediatric Emergencies.

Hosp Pediatr 2021 Jul 21. Epub 2021 Jul 21.

Divisions of Emergency Medicine.

Background: Illness complications are condition-specific adverse outcomes. Detecting complications of pediatric illness in administrative data would facilitate widespread quality measurement, however the accuracy of such detection is unclear.

Methods: We conducted a cross-sectional study of patients visiting a large pediatric emergency department. Read More

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Association of Dyskalemias with Ischemic Stroke in Advanced Chronic Kidney Disease Patients Transitioning to Dialysis.

Am J Nephrol 2021 Jul 21:1-9. Epub 2021 Jul 21.

Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Introduction: Hypo- and hyperkalemia are associated with a higher risk of ischemic stroke. However, this association has not been examined in an advanced chronic kidney disease (CKD) population.

Methods: From among 102,477 US veterans transitioning to dialysis between 2007 and 2015, 21,357 patients with 2 pre-dialysis outpatient estimated glomerular filtration rates <30 mL/min/1. Read More

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Home infusions of natalizumab for people with multiple sclerosis: a pilot randomised crossover trial.

Ann Clin Transl Neurol 2021 Jul 21. Epub 2021 Jul 21.

Neurology & Stroke Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.

Objective: The delivery of healthcare at home has expanded to intravenous infusions of monoclonal antibodies. A recently developed model of care for home infusions of natalizumab for people with relapsing-remitting multiple sclerosis was evaluated. This pilot study of home infusions of natalizumab and usual care (attendance in a hospital out-patients' clinic) compared safety, feasibility, patient satisfaction, effectiveness and costs. Read More

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Technical Note: Comparison of Convolutional Neural Networks for Detecting Large Vessel Occlusion on Computed Tomography Angiography.

Med Phys 2021 Jul 21. Epub 2021 Jul 21.

Department of Computer Science, Vanderbilt University, Nashville, TN, 37235, USA.

Purpose: Artificial intelligence diagnosis and triage of large vessel occlusion may quicken clinical response for a subset of time-sensitive acute ischemic stroke patients, improving outcomes. Differences in architectural elements within data-driven convolutional neural network (CNN) models impact performance. Foreknowledge of effective model architectural elements for domain-specific problems can narrow the search for candidate models and inform strategic model design and adaptation to optimize performance on available data. Read More

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Clinician Conceptualization of the Benefits of Treatments for Individual Patients.

JAMA Netw Open 2021 Jul 1;4(7):e2119747. Epub 2021 Jul 1.

Memorial Sloan Kettering Cancer Center, New York, New York.

Importance: Knowing the expected effect of treatment on an individual patient is essential for patient care.

Objective: To explore clinicians' conceptualizations of the chance that treatments will decrease the risk of disease outcomes.

Design, Setting, And Participants: This survey study of attending and resident physicians, nurse practitioners, and physician assistants was conducted in outpatient clinical settings in 8 US states from June 2018 to November 2019. Read More

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Selecting the right anticoagulant for stroke prevention in atrial fibrillation.

Eur Rev Med Pharmacol Sci 2021 Jul;25(13):4499-4505

Department of Functional Sciences, Physiology, Centre of Immuno-Physiology and Biotechnologies (CIFBIOTEH), "Victor Babes" University of Medicine and Pharmacy Timisoara, Romania.

Objective: The embolization of thrombi formed within the atria can occur in any form of atrial fibrillation (AF), i.e., paroxysmal, persistent, or permanent. Read More

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Kinetics of cerebral blood flow velocities during treatment for delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage.

Neurocrit Care 2021 Jul 20. Epub 2021 Jul 20.

Neurology and Neurosurgery Department, Federal University of São Paulo, São Paulo, Brazil.

Background: In aneurysmal subarachnoid hemorrhage (aSAH), one of the main determinants of prognosis is delayed cerebral ischemia (DCI). Transcranial Doppler (TCD) is used to monitor vasospasm and DCI. We aimed to better understand cerebral hemodynamics response to hypertension induction (HI) with norepinephrine (NE) and inotropic therapy with milrinone so that TCD can be a bedside tool in helping to guide DCI therapies. Read More

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Combined Approach to Stroke Thrombectomy Using a Novel Short Flexible Aspiration Catheter with a Stent Retriever : Preliminary Clinical Experience.

Clin Neuroradiol 2021 Jul 20. Epub 2021 Jul 20.

IDI-Radiology, University Hospital Dr Josep Trueta, Girona, Spain.

Background: Large-bore aspiration catheters enabling greater flow rates and suction force for mechanical thrombectomy might improve outcomes in patients with stroke secondary to large-vessel occlusion. Complete or near-complete reperfusion after a single thrombectomy pass (first-pass effect) is associated with improved clinical outcomes. We assessed the efficacy and safety of novel MIVI Q™ aspiration catheters in combination with stent-retriever devices. Read More

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Serum Hypoxia-Inducible Factor 1alpha Levels Correlate with Outcomes After Intracerebral Hemorrhage.

Ther Clin Risk Manag 2021 13;17:717-726. Epub 2021 Jul 13.

Department of Intensive Care Unit, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang Province, People's Republic of China.

Background: Serum hypoxia-inducible factor 1alpha (HIF-1α) is a key regulator in hypoxic and ischemic brain injury. We determined the relationship between serum HIF-1α levels and long-term prognosis plus severity of intracerebral hemorrhage (ICH).

Methods: A total of 97 ICH cases and 97 healthy controls were enrolled. Read More

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Protocol for the economic evaluation of the China Salt Substitute and Stroke Study (SSaSS).

BMJ Open 2021 Jul 20;11(7):e045929. Epub 2021 Jul 20.

The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.

Introduction: Cardiovascular diseases (CVDs) are the leading causes of death and disability worldwide. Reducing dietary salt consumption is a potentially cost-effective way to reduce blood pressure and the burden of CVD. To date, economic evidence has focused on sodium reduction in food industry or processed food with blood pressure as the primary outcome. Read More

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NLRP3 inhibition attenuates early brain injury and delayed cerebral vasospasm after subarachnoid hemorrhage.

J Neuroinflammation 2021 Jul 20;18(1):163. Epub 2021 Jul 20.

Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL, 32610, USA.

Background: The NLRP3 inflammasome is a critical mediator of several vascular diseases through positive regulation of proinflammatory pathways. In this study, we defined the role of NLRP3 in both the acute and delayed phases following subarachnoid hemorrhage (SAH). SAH is associated with devastating early brain injury (EBI) in the acute phase, and those that survive remain at risk for developing delayed cerebral ischemia (DCI) due to cerebral vasospasm. Read More

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Venous Thromboembolism and Critical Limb Events in Patients with Atrial Fibrillation: A Nationwide Population-Based Cohort Study.

Angiology 2021 Jul 20:33197211033747. Epub 2021 Jul 20.

Department of Cardiology, 38014Chang Gung Memorial Hospital, Chiayi, Taiwan.

Little is known about whether venous thromboembolism (VTE) causes worse critical limb events in populations with atrial fibrillation (AF). A retrospective cohort study using claims data from Taiwan's National Health Insurance program between 2001 and 2013 compared AF patients with or without VTE. Outcomes were percutaneous transluminal angioplasty (PTA), amputation, systemic thromboembolism, all-cause mortality, cardiovascular death, ischemic stroke, and acute myocardial infarction. Read More

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Endovascular Therapy for Acute Ischemic Stroke in Patients With Prestroke Disability.

J Am Heart Assoc 2021 Jul 21:e020783. Epub 2021 Jul 21.

Department of Neurosurgery Hyogo College of Medicine Nishinomiya Japan.

Background Outcomes after stroke as a result of large-vessel occlusion in patients with prestroke disability were compared between endovascular therapy (EVT) and medical management. Methods and Results Of 2420 patients with acute stroke with large-vessel occlusion in a prospective, multicenter, nationwide registry in Japan, patients with prestroke modified Rankin Scale scores 2 to 4 with occlusion of the internal carotid artery, or M1 of the middle cerebral artery were analyzed. The primary effectiveness outcome was the favorable outcome, defined as return to at least the prestroke modified Rankin Scale score at 3 months. Read More

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Fluid-Attenuated Inversion Recovery Hyperintense Ischemic Stroke Predicts Less Favorable 90-Day Outcome after Intravenous Thrombolysis.

Cerebrovasc Dis 2021 Jul 20:1-8. Epub 2021 Jul 20.

Stroke Branch, National Institute of Neurological Diseases and Stroke, National Institutes of Health, Bethesda, Maryland, USA.

Introduction: The absence of an ischemic lesion on MRI fluid-attenuated inversion recovery (FLAIR) is helpful in predicting stroke onset within 4.5 h. However, some ischemic strokes become visible on FLAIR within 4. Read More

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Beyond Functional Impairment: Redefining Favorable Outcome in Patients with Subarachnoid Hemorrhage.

Cerebrovasc Dis 2021 Jul 20:1-9. Epub 2021 Jul 20.

Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany.

Background: For outcome assessment in patients surviving subarachnoid hemorrhage (SAH), the modified Rankin scale (mRS) represents the mostly established outcome tool, whereas other dimensions of outcome such as mood disorders and impairments in social life remain unattended so far.

Objective: The aim of our study was to correlate 12-month functional and subjective health outcomes in SAH survivors.

Methods: All SAH patients treated over a 5-year period received outcome assessment at 12 months, including functional scores (mRS and Barthel Index [BI]), subjective health measurement (EQ-5D), and whether they returned to work. Read More

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Examination of Rehabilitation Intensity According to Severity of Acute Stroke: A Retrospective Study.

J Stroke Cerebrovasc Dis 2021 Jul 17;30(9):105994. Epub 2021 Jul 17.

Department of Physical Therapy, Faculty of Health Sciences, Juntendo University, 3-2-12, Hongo Bunkyo-ku, Tokyo, Japan; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan.

Objectives: To investigate the intensity and effectiveness of rehabilitation in acute stroke patients according to the severity of functional impairments in them.

Materials And Methods: This retrospective cohort study included 294 patients with acute hemispheric stroke admitted to three acute-care hospitals who subsequently underwent an inpatient rehabilitation program. Stroke severity was classified according to neurological deficits and trunk dysfunction. Read More

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COVID-19 Lockdown Effects on Acute Stroke Care in Latin America.

J Stroke Cerebrovasc Dis 2021 Jul 3;30(9):105985. Epub 2021 Jul 3.

Departamento de Neurología Vascular, Centro Integral de Neurología Vascular, Fleni, Ciudad Autónoma de Buenos Aires, Argentina.

Objectives: COVID-19 pandemic has forced important changes in health care worldwide. Stroke care networks have been affected, especially during peak periods. We assessed the impact of the pandemic and lockdowns in stroke admissions and care in Latin America. Read More

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Changes in Health-Related Quality of Life After Transient Ischemic Attack.

JAMA Netw Open 2021 Jul 1;4(7):e2117403. Epub 2021 Jul 1.

Neurological Institute, Cleveland Clinic, Cleveland, Ohio.

Importance: Numerous studies have found that patients diagnosed with TIA have decreased health-related quality of life, which has been interpreted as suggesting that patients with TIA have residual symptoms after the event. Studies assessing health status in the same patients before and after an event are lacking but may allow a direct determination of the association of TIA with postevent health status.

Objective: To examine patient-reported health before transient ischemic attack (TIA) among individuals diagnosed with this event and evaluate change in patient-reported health after the event overall and by TIA characterization subgroups. Read More

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EXPRESS: Prehemorrhage antiplatelet use in aneurysmal subarachnoid hemorrhage and impact on clinical outcome.

Int J Stroke 2021 Jul 20:17474930211035647. Epub 2021 Jul 20.

University Hospital Zurich, Department of Neurosurgery, Zurich, Switzerland.

Background: Literature is inconclusive regarding the association between antiplatelet agents use and outcome after aneurysmal subarachnoid hemorrhage (aSAH).

Aims: To investigate the association between clinical outcome and prehemorrhage use in aSAH patients as well as the impact of thrombocyte transfusion on rebleed and clinical outcome.

Methods: Data were collected from prospective databases of two European tertiary reference centers for aSAH patients. Read More

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EXPRESS: A Randomized Controlled Trial to Optimize Patientâs Selection for Endovascular Treatment in Acute Ischemic Stroke (SELECT2): Study Protocol.

Int J Stroke 2021 Jul 20:17474930211035032. Epub 2021 Jul 20.

Stanford University, Neurology, Stanford, California, United States.

Rationale: Randomized evidence for endovascular thrombectomy(EVT) safety and efficacy in patients with large core strokes is lacking.

Aims: To demonstrate EVT efficacy and safety in patients with large core on non-contrast CT or perfusion imaging(CT/MR) and determine if there is heterogeneity of treatment effect in large cores based on the imaging modality.

Design: SELECT2 is a prospective, randomized, multi-center, assessor-blinded controlled trial with adaptive enrichment design, enrolling up to 560 patients. Read More

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EXPRESS: Frailty and Cerebrovascular Disease: Concepts and Clinical Implications for Stroke Medicine.

Int J Stroke 2021 Jul 20:17474930211034331. Epub 2021 Jul 20.

University of Cambridge, Department of Clinical Neurosciences, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland.

Frailty is a distinctive health state in which the ability of older people to cope with acute stressors is compromised by an increased vulnerability brought by age-associated declines in physiological reserve and function across multiple organ systems. Although closely associated with age, multimorbidity, and disability, frailty is a discrete syndrome that is associated with poorer outcomes across a range of medical conditions. However, its role in cerebrovascular disease and stroke has received limited attention. Read More

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