Latest & greatest articles for stroke

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Top results for stroke

41. 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

42. 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

43. 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

44. 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

45. 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

46. 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

47. 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

48. 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

49. 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

50. Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study. Full Text available with Trip Pro

Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study. To examine the associations of vegetarianism with risks of ischaemic heart disease and stroke.Prospective cohort study.The EPIC-Oxford study, a cohort in the United Kingdom with a large proportion of non-meat eaters, recruited across the country between 1993 and 2001.48 188 participants with no history of ischaemic heart disease (...) , stroke, or angina (or cardiovascular disease) were classified into three distinct diet groups: meat eaters (participants who consumed meat, regardless of whether they consumed fish, dairy, or eggs; n=24 428), fish eaters (consumed fish but no meat; n=7506), and vegetarians including vegans (n=16 254), based on dietary information collected at baseline, and subsequently around 2010 (n=28 364).Incident cases of ischaemic heart disease and stroke (including ischaemic and haemorrhagic types) identified

2019 BMJ

51. Society of Interventional Radiology Training Guidelines for Endovascular Stroke Treatment Full Text available with Trip Pro

used for assessment of large-vessel occlusion and/or parenchymal infarction and ischemia. Since 2009, multiple randomized trials and meta-analyses have confirmed the safety and effectiveness of intraarterial catheter-directed treatment of acute ischemic stroke with the use of current-generation mechanical thrombectomy devices for emergent large-vessel occlusion stroke ( x 4 Berkhemer, O.A., Fransen, P.S., Beumer, D , and MR CLEAN Investigators. A randomized trial of intraarterial treatment (...) mimics and psychiatric disorders. 5. Ability to evaluate imaging criteria for appropriate patient selection for acute stroke treatment. 6. Ability to differentiate acute ischemic lesions as compared with chronic lesions and/or tumors, etc. 7. Ability to recognize etiology of transient ischemic attack and acute stroke, including stenosis and embolus. 8. Knowledge of cerebrovascular hemodynamics as it relates to perfusion imaging and clinical presentation. 9. Knowledge of pharmacologic agents used

2019 Society of Interventional Radiology

52. Organisation of the early management of acute ischaemic stroke using mechanical thrombectomy

Organisation of the early management of acute ischaemic stroke using mechanical thrombectomy Organisation of the early management of acute ischaemic stroke using mechanical thrombectomy - Technological assessment report

2019 Haute Autorite de sante

53. Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial Full Text available with Trip Pro

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral (...) . For this prespecified subgroup analysis, consultant neuroradiologists masked to treatment allocation reviewed brain CT or MRI scans performed before randomisation to confirm participant eligibility and rate features of the intracerebral haemorrhage and surrounding brain. We followed participants for primary (recurrent symptomatic intracerebral haemorrhage) and secondary (ischaemic stroke) outcomes for up to 5 years (reported elsewhere). For this report, we analysed eligible participants with intracerebral

2019 EvidenceUpdates

54. Intensive vs Standard Treatment of Hyperglycemia and Functional Outcome in Patients With Acute Ischemic Stroke: The SHINE Randomized Clinical Trial. Full Text available with Trip Pro

Intensive vs Standard Treatment of Hyperglycemia and Functional Outcome in Patients With Acute Ischemic Stroke: The SHINE Randomized Clinical Trial. Hyperglycemia during acute ischemic stroke is common and is associated with worse outcomes. The efficacy of intensive treatment of hyperglycemia in this setting remains unknown.To determine the efficacy of intensive treatment of hyperglycemia during acute ischemic stroke.The Stroke Hyperglycemia Insulin Network Effort (SHINE) randomized clinical (...) trial included adult patients with hyperglycemia (glucose concentration of >110 mg/dL if had diabetes or ≥150 mg/dL if did not have diabetes) and acute ischemic stroke who were enrolled within 12 hours from stroke onset at 63 US sites between April 2012 and August 2018; follow-up ended in November 2018. The trial included 1151 patients who met eligibility criteria.Patients were randomized to receive continuous intravenous insulin using a computerized decision support tool (target blood glucose

2019 JAMA Controlled trial quality: predicted high

55. Association Between Time to Treatment With Endovascular Reperfusion Therapy and Outcomes in Patients With Acute Ischemic Stroke Treated in Clinical Practice. Full Text available with Trip Pro

Association Between Time to Treatment With Endovascular Reperfusion Therapy and Outcomes in Patients With Acute Ischemic Stroke Treated in Clinical Practice. Randomized clinical trials suggest benefit of endovascular-reperfusion therapy for large vessel occlusion in acute ischemic stroke (AIS) is time dependent, but the extent to which it influences outcome and generalizability to routine clinical practice remains uncertain.To characterize the association of speed of treatment with outcome (...) among patients with AIS undergoing endovascular-reperfusion therapy.Retrospective cohort study using data prospectively collected from January 2015 to December 2016 in the Get With The Guidelines-Stroke nationwide US quality registry, with final follow-up through April 15, 2017. Participants were 6756 patients with anterior circulation large vessel occlusion AIS treated with endovascular-reperfusion therapy with onset-to-puncture time of 8 hours or less.Onset (last-known well time) to arterial

2019 JAMA

56. Stroke in Patients With Peripheral Artery Disease Full Text available with Trip Pro

Stroke in Patients With Peripheral Artery Disease Background and Purpose- Predictors of stroke and transient ischemic attack (TIA) in patients with peripheral artery disease (PAD) are poorly understood. The primary aims of this analysis were to (1) determine the incidence of ischemic/hemorrhagic stroke and TIA in patients with symptomatic PAD, (2) identify predictors of stroke in patients with PAD, and (3) compare the rate of stroke in ticagrelor- and clopidogrel-treated patients. Methods (...) - EUCLID (Examining Use of Ticagrelor in Peripheral Artery Disease) randomized 13 885 patients with symptomatic PAD to receive monotherapy with ticagrelor or clopidogrel for the prevention of major adverse cardiovascular events (cardiovascular death, myocardial infarction, or ischemic stroke). Ischemic/hemorrhagic stroke and TIA were adjudicated and measured as incidence rates postrandomization and cumulative incidence (per patient-years). Post hoc multivariable competing risk hazards analyses were

2019 EvidenceUpdates

57. Nurse-Initiated Acute Stroke Care in Emergency Departments Full Text available with Trip Pro

Nurse-Initiated Acute Stroke Care in Emergency Departments Background and Purpose- We aimed to evaluate the effectiveness of an intervention to improve triage, treatment, and transfer for patients with acute stroke admitted to the emergency department (ED). Methods- A pragmatic, blinded, multicenter, parallel group, cluster randomized controlled trial was conducted between July 2013 and September 2016 in 26 Australian EDs with stroke units and tPA (tissue-type plasminogen activator) protocols (...) . Hospitals, stratified by state and tPA volume, were randomized 1:1 to intervention or usual care by an independent statistician. Eligible ED patients had acute stroke <48 hours from symptom onset and were admitted to the stroke unit via ED. Our nurse-initiated T3 intervention targeted (1) Triage to Australasian Triage Scale category 1 or 2; (2) Treatment: tPA eligibility screening and appropriate administration; clinical protocols for managing fever, hyperglycemia, and swallowing; (3) prompt (<4 hours

2019 EvidenceUpdates

58. Dual antiplatelet therapy using cilostazol for secondary prevention in patients with high-risk ischaemic stroke in Japan: a multicentre, open-label, randomised controlled trial (Abstract)

Dual antiplatelet therapy using cilostazol for secondary prevention in patients with high-risk ischaemic stroke in Japan: a multicentre, open-label, randomised controlled trial Although dual antiplatelet therapy with aspirin and clopidogrel reduces early recurrence of ischaemic stroke, with long-term use this type of therapy is no longer effective and the risk of bleeding increases. Given that cilostazol prevents stroke recurrence without increasing the incidence of serious bleeding compared (...) with aspirin, we aimed to establish whether dual antiplatelet therapy involving cilostazol is safe and appropriate for long-term use.In a multicentre, open-label, randomised controlled trial across 292 hospitals in Japan, patients with high-risk non-cardioembolic ischaemic stroke identified on MRI were randomly assigned to two groups in a 1:1 ratio to receive monotherapy with either oral aspirin (81 or 100 mg, once per day) or clopidogrel (50 or 75 mg, once per day) alone, or a combination of cilostazol

2019 EvidenceUpdates

59. Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial. Full Text available with Trip Pro

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial. Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used (...) safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events.The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy

2019 Lancet Controlled trial quality: predicted high

60. Association Between Transcatheter Aortic Valve Replacement and Early Postprocedural Stroke. Full Text available with Trip Pro

including 101 430 patients who were treated with femoral and nonfemoral TAVR at 521 US hospitals in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapies Registry from November 9, 2011, through May 31, 2017. Thirty-day follow-up ended June 30, 2017.TAVR.The rates of 30-day transient ischemic attack and stroke were assessed. Association of stroke with 30-day mortality and association of antithrombotic medical therapies with postdischarge 30-day stroke were assessed (...) with a Cox proportional hazards model and propensity-score matching, respectively.Among 101 430 patients included in the study (median age, 83 years [interquartile range {IQR}, 76-87 years]; 47 797 women [47.1%]; and 85 147 patients [83.9%] treated via femoral access), 30-day postprocedure follow-up data was assessed in all patients. At day 30, there were 2290 patients (2.3%) with a stroke of any kind (95% CI, 2.2%-2.4%), and 373 patients (0.4%) with transient ischemic attacks (95% CI, 0.3%-0.4

2019 JAMA