Latest & greatest articles for stroke

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Top results for stroke

21. The impact of a patient-directed activity program on functional outcomes and activity participation after stroke during inpatient rehabilitation-a randomized controlled trial (Abstract)

The impact of a patient-directed activity program on functional outcomes and activity participation after stroke during inpatient rehabilitation-a randomized controlled trial Individuals post stroke are inactive, even during rehabilitation, contributing to ongoing disability and risk of secondary health conditions. Our aims were to (1) conduct a randomized controlled trial to examine the efficacy of a "Patient-Directed Activity Program" on functional outcomes in people post stroke during (...) inpatient rehabilitation and (2) examine differences three months post inpatient rehabilitation discharge.Randomized control trial.Inpatient rehabilitation facility.Patients admitted to inpatient rehabilitation post stroke.Patient-Directed Activity Program (PDAP) or control (usual care only). Both groups underwent control (three hours of therapy/day), while PDAP participants were prescribed two additional 30-minute activity sessions/day.Outcomes (Stroke Rehabilitation Assessment of Movement Measure

2020 EvidenceUpdates

22. The effect of dulaglutide on stroke: an exploratory analysis of the REWIND trial (Abstract)

random code with an interactive web response system with stratification by site. Participants, investigators, the trial leadership, and all other personnel were masked to treatment allocation until the trial was completed and the database was locked. During the treatment period, participants in both groups were instructed to inject study drug on the same day at around the same time, each week. Strokes were categorised as fatal or non-fatal, and as either ischaemic, haemorrhagic, or undetermined (...) . Stroke severity was assessed using the modified Rankin scale. Participants were seen at 2 weeks, 3 months, 6 months, and then every 3 months for drug dispensing and every 6 months for detailed assessments, until 1200 confirmed primary outcomes accrued. The primary endpoint was the first occurrence of any component of the composite outcome, which comprised non-fatal myocardial infarction, non-fatal stroke, or death from cardiovascular or unknown causes. All analyses were done according to an intention

2020 EvidenceUpdates

23. Effect of Intravenous Tenecteplase Dose on Cerebral Reperfusion Before Thrombectomy in Patients With Large Vessel Occlusion Ischemic Stroke: The EXTEND-IA TNK Part 2 Randomized Clinical Trial. (Abstract)

Effect of Intravenous Tenecteplase Dose on Cerebral Reperfusion Before Thrombectomy in Patients With Large Vessel Occlusion Ischemic Stroke: The EXTEND-IA TNK Part 2 Randomized Clinical Trial. Intravenous thrombolysis with tenecteplase improves reperfusion prior to endovascular thrombectomy for ischemic stroke compared with alteplase.To determine whether 0.40 mg/kg of tenecteplase safely improves reperfusion before endovascular thrombectomy vs 0.25 mg/kg of tenecteplase in patients with large (...) vessel occlusion ischemic stroke.Randomized clinical trial at 27 hospitals in Australia and 1 in New Zealand using open-label treatment and blinded assessment of radiological and clinical outcomes. Patients were enrolled from December 2017 to July 2019 with follow-up until October 2019. Adult patients (N = 300) with ischemic stroke due to occlusion of the intracranial internal carotid, \basilar, or middle cerebral artery were included less than 4.5 hours after symptom onset using standard intravenous

2020 JAMA

24. Management of acute ischemic stroke. Full Text available with Trip Pro

the data supporting pre-hospital and emergency stroke care, including use of emergency medical services protocols for identification of patients with stroke, intravenous thrombolysis in acute ischemic stroke including updates to recommended patient eligibility criteria and treatment time windows, and advanced imaging techniques with automated interpretation to identify patients with large areas of brain at risk but without large completed infarcts who are likely to benefit from endovascular (...) Management of acute ischemic stroke. Stroke is the leading cause of long term disability in developed countries and one of the top causes of mortality worldwide. The past decade has seen substantial advances in the diagnostic and treatment options available to minimize the impact of acute ischemic stroke. The key first step in stroke care is early identification of patients with stroke and triage to centers capable of delivering the appropriate treatment, as fast as possible. Here, we review

2020 BMJ

25. Patent foramen ovale (PFO) closure in patients with cryptogenic ischaemic stroke

compared with women: odds ratio (OR) 1.50, 95% confidence interval (CI) 1.08 to 2.08, p=0.015 7 . SHTG Advice | 10 In a large population-based cohort study in Oxfordshire (OXVASC), consecutive patients with a first transient ischaemic attack (TIA) or ischaemic stroke were followed up for a period of 10 years 14 . Of 2,555 patients with a first ischaemic event, 32% were classed as cryptogenic. Incidence of cryptogenic ischaemic stroke in the OXVASC cohort was 0.36 per 1,000 population per year (95% CI (...) stroke or TIA has been indicated on clinical assessment and brain imaging. ? There is no significant atrial fibrillation requiring oral anticoagulant therapy. ? A full investigation has failed to identify known risk factors/explanations for the ischaemic stroke or TIA, such as vascular disease or hypertension. ? The presence of a PFO with a clinically significant right-to-left shunt or atrial septal aneurysm has been confirmed using bubble contrast transthoracic echocardiography, including

2020 SHTG Advice Statements

26. Heart Disease and Stroke Statistics—2020 Update Full Text available with Trip Pro

Heart Disease and Stroke Statistics—2020 Update Heart Disease and Stroke Statistics—2020 Update | Circulation Search Search Hello Guest! Login to your account Email Password Keep me logged in Search Search February 2020 January 2020 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free Access article Heart Disease and Stroke Statistics—2020 Update A Report From the American Heart Association , MD, PhD, FAHA (...) , annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical

2020 American Heart Association

27. Rural Health: A Presidential Advisory From the American Heart Association and American Stroke Association Full Text available with Trip Pro

Rural Health: A Presidential Advisory From the American Heart Association and American Stroke Association Call to Action: Rural Health: A Presidential Advisory From the American Heart Association and American Stroke Association | Circulation Search Search Hello Guest! Login to your account Email Password Keep me logged in Search Search February 2020 January 2020 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump (...) to Free Access article Call to Action: Rural Health: A Presidential Advisory From the American Heart Association and American Stroke Association , MD, FAHA, Chair , MD, Co-Chair , MD, MPH, DrPH , , MD, MBA , MD, MPH, MSEd , JD, LLM , MPH , MD, MPH MD, MPH Robert A. Harrington , Robert M. Califf , Appathurai Balamurugan , Nancy Brown , Regina M. Benjamin , Wendy E. Braund , Janie Hipp , Madeleine Konig , Eduardo Sanchez , Karen E. Joynt Maddox Originally published 10 Feb 2020 Circulation. ;0:CIR

2020 American Heart Association

28. Effect of Additional Rehabilitation After Botulin Toxin-A on Upper Limb Activity in Chronic Stroke: The InTENSE Trial Full Text available with Trip Pro

Effect of Additional Rehabilitation After Botulin Toxin-A on Upper Limb Activity in Chronic Stroke: The InTENSE Trial Effect of Additional Rehabilitation After Botulinum Toxin-A on Upper Limb Activity in Chronic Stroke: The InTENSE Trial - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Welcome to the new PubMed. For legacy PubMed go to . Clipboard, Search History, and several other advanced features are temporarily (...) : Unable to load your collection due to an error Add Cancel Add to My Bibliography My Bibliography Unable to load your delegates due to an error Add Cancel Actions Cite Share Permalink Copy Page navigation Stroke Actions , 51 (2), 556-562 Feb 2020 Effect of Additional Rehabilitation After Botulinum Toxin-A on Upper Limb Activity in Chronic Stroke: The InTENSE Trial , , , , , , , , , , Collaborators, Affiliations Expand Collaborators InTENSE Trial Group

2020 EvidenceUpdates

29. Clinical frailty independently predicts early mortality after ischaemic stroke

Clinical frailty independently predicts early mortality after ischaemic stroke Clinical Frailty Independently Predicts Early Mortality After Ischaemic Stroke - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Welcome to the new PubMed. For legacy PubMed go to . Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes of Health U.S. National Library of Medicine National (...) Bibliography Unable to load your delegates due to an error Add Cancel Actions Cite Share Permalink Copy Page navigation Age Ageing Actions 2020 Jan 17 [Online ahead of print] Clinical Frailty Independently Predicts Early Mortality After Ischaemic Stroke , , , , , Affiliations Expand Affiliations 1 Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK. 2 Department of Medicine, University of Cambridge, Cambridge, UK. 3 Department of Medicine for the Elderly, Addenbrooke's Hospital

2020 EvidenceUpdates

30. Unilateral vs Bilateral Hybrid Approaches for Upper Limb Rehabilitation in Chronic Stroke: A Randomized Controlled Trial (Abstract)

Unilateral vs Bilateral Hybrid Approaches for Upper Limb Rehabilitation in Chronic Stroke: A Randomized Controlled Trial To investigate the effects of unilateral hybrid therapy (UHT) and bilateral hybrid therapy (BHT) compared with robot-assisted therapy (RT) alone in patients with chronic stroke.A single-blind, randomized controlled trial.Four hospitals.Outpatients with chronic stroke and mild to moderate motor impairment (N=44).UHT combined unilateral RT (URT) and modified constraint-induced (...) therapy. BHT combined bilateral RT (BRT) and bilateral arm training. The RT group received URT and BRT. The intervention frequency for the 3 groups was 90 min/d 3 d/wk for 6 weeks.Fugl-Meyer Assessment (FMA, divided into the proximal and distal subscale) and Stroke Impact Scale (SIS) version 3.0 scores before, immediately after, and 3 months after treatment and Wolf Motor Function Test (WMFT) and Nottingham Extended Activities of Daily Living (NEADL) scale scores before and immediately after

2020 EvidenceUpdates

31. Thrombolysis for acute ischemic stroke in the unwitnessed or extended therapeutic time window

Thrombolysis for acute ischemic stroke in the unwitnessed or extended therapeutic time window Thrombolysis for Acute Ischemic Stroke in the Unwitnessed or Extended Therapeutic Time Window - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Welcome to the new PubMed. For legacy PubMed go to . Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes of Health U.S. National (...) Add to My Bibliography My Bibliography Unable to load your delegates due to an error Add Cancel Actions Cite Share Permalink Copy Page navigation Neurology Actions 2019 Dec 31 [Online ahead of print] Thrombolysis for Acute Ischemic Stroke in the Unwitnessed or Extended Therapeutic Time Window , , , , , , , , , , Affiliations Expand Affiliations 1 From the Second Department of Neurology (G.T., A.H.K.), "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens

2020 EvidenceUpdates

32. A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke. (Abstract)

A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke. The use of intensive lipid-lowering therapy by means of statin medications is recommended after transient ischemic attack (TIA) and ischemic stroke of atherosclerotic origin. The target level for low-density lipoprotein (LDL) cholesterol to reduce cardiovascular events after stroke has not been well studied.In this parallel-group trial conducted in France and South Korea, we randomly assigned patients with ischemic stroke (...) in the previous 3 months or a TIA within the previous 15 days to a target LDL cholesterol level of less than 70 mg per deciliter (1.8 mmol per liter) (lower-target group) or to a target range of 90 mg to 110 mg per deciliter (2.3 to 2.8 mmol per liter) (higher-target group). All the patients had evidence of cerebrovascular or coronary-artery atherosclerosis and received a statin, ezetimibe, or both. The composite primary end point of major cardiovascular events included ischemic stroke, myocardial infarction

2020 NEJM

33. 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 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

2020 EvidenceUpdates

34. Covid-19: Clinical guide for the management of stroke patients during the coronavirus pandemic

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

2020 Covid-19 Ad hoc guidelines

35. Long term exposure to ambient fine particulate matter and incidence of stroke: prospective cohort study from the China-PAR project. Full Text available with Trip Pro

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

2019 BMJ

36. 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. (Abstract)

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

2019 Annals of Internal Medicine

37. Association of Transcarotid Artery Revascularization vs Transfemoral Carotid Artery Stenting With Stroke or Death Among Patients With Carotid Artery Stenosis. Full Text available with Trip Pro

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

2019 JAMA

38. PreSSUB II: The prehospital stroke study at the Universitair Ziekenhuis Brussel II. Full Text available with Trip Pro

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

2019 Journal of translational internal medicine Controlled trial quality: uncertain

39. Feasibility and preliminary effects of an integrated hospital-to-home transitional care intervention for older adults with stroke and multimorbidity: A study protocol. Full Text available with Trip Pro

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

2019 Journal of comorbidity Controlled trial quality: uncertain

40. Cases in Precision Medicine: A Personalized Approach to Stroke and Cardiovascular Risk Assessment in Women. Full Text available with Trip Pro

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.

2019 Annals of Internal Medicine