Latest & greatest articles for stroke

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Top results for stroke

41. Supported self-management improves quality of life and self-belief after stroke

Supported self-management improves quality of life and self-belief after stroke Signal - Supported self-management improves quality of life and self-belief after stroke Dissemination Centre Discover Portal NIHR DC Discover Supported self-management improves quality of life and self-belief after stroke Published on 1 November 2016 Training people to take an active role in managing the consequences of their stroke improves their quality of life. These self-management programmes are usually led (...) by health professionals. They cover a range of skills including problem solving, goal setting, and decision-making and provide advice about stroke. The improvement appears to act through “self-belief”. For example, promoting independence in people appeared to foster a greater belief in their own abilities. This Cochrane review pooled data from 14 trials comparing supported self-management with control interventions in people who had experienced a stroke one month to a year previously and lived

NIHR Dissemination Centre2018

42. Exercise therapy may still improve balance when started a long time after a stroke

Exercise therapy may still improve balance when started a long time after a stroke Signal - Exercise therapy may still improve balance when started a long time after a stroke Dissemination Centre Discover Portal NIHR DC Discover Exercise therapy may still improve balance when started a long time after a stroke Published on 15 November 2016 Exercise therapy may improve balance for people in the chronic phase of recovery six or more months after stroke. The most effective training regimens seem (...) to be those that focus on balance, weight shifting and gait training. Though significant, the improvements in function may still be small. Often little recovery can be expected beyond six months of stroke, and available treatments may be limited. This review found that exercise therapy in this population gave small improvements, generally in the scale of a few points on a scale of about 50, depending on the balance test used. This review included a large number of small trials, but most were high quality

NIHR Dissemination Centre2018

43. Mechanical clot removal may offer better outcomes for people with stroke

Mechanical clot removal may offer better outcomes for people with stroke Signal - Mechanical clot removal may offer better outcomes for people with stroke Dissemination Centre Discover Portal NIHR DC Discover Mechanical clot removal may offer better outcomes for people with stroke Published on 28 June 2016 Mechanical clot removal alongside standard clot-busting drug treatment may offer better functional outcomes for people who have suffered a stroke caused by a blood clot than drug treatment (...) is a highly skilled operation that should be performed within six to eight hours after the stroke. Patients would need early access to stroke units with the necessary diagnostics, technology and specialist expertise. Therefore a pragmatic NHS trial and cost-effectiveness analysis would be informative. Share your views on the research. Why was this study needed? Stroke is the UK’s third largest cause of death, after heart disease and cancer, and a major cause of adult disability. The health and social care

NIHR Dissemination Centre2018

44. Early aspirin reduces stroke recurrence following warning symptoms

Early aspirin reduces stroke recurrence following warning symptoms Signal - Early aspirin reduces stroke recurrence following warning symptoms Dissemination Centre Discover Portal NIHR DC Discover Early aspirin reduces stroke recurrence following warning symptoms Published on 7 July 2016 Aspirin taken as soon as possible after a stroke or symptoms of a stroke reduces the risk of further stroke within the next six weeks by about 60%. This is much better than the 13% reduction previously (...) estimated. People with warning strokes, where symptoms resolve within 24 hours, stand to benefit by self-administering aspirin even before a scan can be organised. This analysis of 12 large randomised controlled trials compared outcomes for adults taking aspirin, other drugs that prevent blood clots and no treatment. Aspirin importantly and significantly reduced the risk of early recurrent stroke in people with warning strokes and strokes perceived as less severe. The results support current

NIHR Dissemination Centre2018

45. Lowering blood pressure reduces the risk of heart disease, stroke and death

Lowering blood pressure reduces the risk of heart disease, stroke and death Signal - Lowering blood pressure reduces the risk of heart disease, stroke and death Dissemination Centre Discover Portal NIHR DC Discover Lowering blood pressure reduces the risk of heart disease, stroke and death Published on 23 February 2016 This meta-analysis showed that a 10 mm Hg reduction of systolic blood pressure reduced the risk of major cardiovascular disease events by 20%, coronary heart disease by 17 (...) %, stroke by 27%, heart failure by 28%, and death from all causes by 13%. This study strongly supports offering drug treatments to reduce systolic blood pressure levels to less than 130 mm Hg to all people regardless of whether or not they have a history of cardiovascular disease, diabetes or chronic kidney disease. This evidence is likely to be considered by guideline developers. Share your views on the research. Why was this study needed? High blood pressure is one of the biggest risk factors

NIHR Dissemination Centre2018

46. Two antiplatelet drugs may prevent further strokes but increase major bleeds

Two antiplatelet drugs may prevent further strokes but increase major bleeds Two antiplatelet drugs may prevent further strokes but increase major bleeds Dissemination Centre Discover Portal NIHR DC Discover Two antiplatelet drugs may prevent further strokes but increase major bleeds Published on 2 October 2018 doi: People experiencing a minor stroke or a transient ischaemic attack have a lower risk of further stroke within 90 days if given clopidogrel and aspirin, rather than aspirin alone (...) . However, taking both drugs doubles the risk of bleeding over the same period. Current UK guidelines recommend using clopidogrel alone. In this major international trial of nearly 5,000 people, those who took the dual treatment had fewer heart attacks or strokes than those who took aspirin only, particularly in the first 30 days of treatment. Major bleeding risk was fairly constant on combined treatment throughout 90 days, occurring in 0.9% compared with 0.4% on aspirin. This study provides more

NIHR Dissemination Centre2018

48. Ischaemic stroke

Ischaemic stroke Ischaemic stroke - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Ischaemic stroke Last reviewed: September 2018 Last updated: October 2018 Summary A leading cause of morbidity and mortality. Approximately 85% of strokes are ischaemic, caused by vascular occlusion. A clinical emergency: timely diagnosis, triage, and intervention can improve outcome. Care of patients in dedicated stroke units improves (...) survival and function. Intravenous recombinant tissue plasminogen activator is given within 4.5 hours of stroke onset. Endovascular interventions, such as clot retrieval devices or intra-arterial thrombolysis, can be used in carefully selected patients within 6 hours of ischaemic stroke onset. Definition Stroke is defined as an acute neurological deficit lasting more than 24 hours and caused by cerebrovascular aetiology. It is further subdivided into ischaemic stroke (caused by vascular occlusion

BMJ Best Practice2018

49. Very early versus delayed mobilisation after stroke.

Very early versus delayed mobilisation after stroke. BACKGROUND: Very early mobilisation (VEM) is performed in some stroke units and recommended in some acute stroke clinical guidelines. However, it is unclear whether very early mobilisation independently improves outcome after stroke. OBJECTIVES: To determine whether very early mobilisation (started as soon as possible, and no later than 48 hours after onset of symptoms) in people with acute stroke improves recovery (primarily the proportion (...) of independent survivors) compared with usual care. SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (last searched 31 July 2017). We also systematically searched 19 electronic databases including; CENTRAL; 2017, Issue 7 in the Cochrane Library (searched July 2017), MEDLINE Ovid (1950 to August 2017), Embase Ovid (1980 to August 2017), CINAHL EBSCO (Cumulative Index to Nursing and Allied Health Literature; 1937 to August 2017) , PsycINFO Ovid (1806 to August 2017), AMED Ovid (Allied

Cochrane2018

50. Intermittent pressure on the legs helps prevent leg clots in immobile people after stroke

Intermittent pressure on the legs helps prevent leg clots in immobile people after stroke Signal - Intermittent pressure on the legs helps prevent leg clots in immobile people after stroke Dissemination Centre Discover Portal NIHR DC Discover Intermittent pressure on the legs helps prevent leg clots in immobile people after stroke Published on 1 December 2015 This NIHR-funded trial found that using intermittent pneumatic compression sleeves around the legs was effective in preventing (...) deep vein thrombosis in immobile people after a stroke. When used on people admitted within three days of an acute stroke, this technique was inexpensive and also appeared to improve survival at six months. The results of this study were used in the 2015 update to the 2010 NICE guideline about the care and treatment of people who are at risk of developing deep vein thrombosis while in hospital. Healthcare staff working in UK stroke units may require training in the use of intermittent pneumatic compression devices

NIHR Dissemination Centre2018

51. Current practice and future directions in the diagnosis and acute treatment of ischaemic stroke.

Current practice and future directions in the diagnosis and acute treatment of ischaemic stroke. Even though stroke presents as a variety of clinical syndromes, neuroimaging is the most important biomarker to help differentiate between stroke subtypes and assess treatment eligibility. Therapeutic advances have led to intravenous thrombolysis with tissue-type plasminogen activator and endovascular treatment for proximal vessel occlusion in the anterior cerebral circulation being standard care (...) for acute ischaemic stroke. Providing access to this care has implications for existing systems of care for stroke and their organisation and has reintroduced the possibility of adjuvant and neuroprotective treatment strategies in acute ischaemic stroke. The use of neuroimaging for patient selection and speed of diagnosis and delivery of treatment are the dominant themes of modern ischaemic stroke care.

Lancet2018

52. Prevention of stroke: a global perspective.

Prevention of stroke: a global perspective. Along with the rising global burden of disability attributed to stroke, costs of stroke care are rising, providing the impetus to direct our research focus towards effective measures of stroke prevention. In this Series paper, we discuss strategies for reducing the risk of the emergence of disease (primordial prevention), preventing the onset of disease (primary prevention), and preventing the recurrence of disease (secondary prevention). Our focus (...) of stroke. An effective collaboration between various health-care sectors, government policies, and campaigns can successfully implement secondary prevention strategies, through surveillance and registries, such as the WHO's non-communicable diseases programmes, across high-income and low-income countries.

Lancet2018

53. Haemorrhagic stroke

Haemorrhagic stroke Haemorrhagic stroke - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Haemorrhagic stroke Last reviewed: September 2018 Last updated: October 2018 Summary Approximately 15% of strokes are haemorrhagic. Computed tomography (CT) or magnetic resonance imaging (MRI) scans, with high sensitivity for intracerebral haemorrhage, are essential in diagnosis. Treatments for intracerebral haemorrhage (ICH (...) ) and ischaemic stroke differ radically. The primary treatment of haemorrhagic stroke involves supportive care and optimisation of intracranial haemodynamics. Surgical resection of intracerebral haematomas may be of benefit in select cases, but has yet to be demonstrated as effective in clinical trials. Newer minimally invasive surgical techniques are currently being investigated. Study results show that patients in dedicated stroke units have improved survival and reduced disability at 1 year. Definition

BMJ Best Practice2018

54. Electrical stimulation alongside other treatments may slightly improve ankle spasticity after stroke, but the clinical importance is uncertain

Electrical stimulation alongside other treatments may slightly improve ankle spasticity after stroke, but the clinical importance is uncertain Signal - Electrical stimulation alongside other treatments may slightly improve ankle spasticity after stroke, but the clinical importance is uncertain Dissemination Centre Discover Portal NIHR DC Discover Electrical stimulation alongside other treatments may slightly improve ankle spasticity after stroke, but the clinical importance is uncertain (...) Published on 5 November 2015 This systematic review and meta-analysis found that electrical stimulation produced a small, but statistically significant improvement, in tight muscles (spasticity) for people recovering from stroke. The clinical importance of the improvement is uncertain. For example, electrical stimulation improved joint flexibility by an average of 2.87 degrees and spasticity improved by 0.3 on a 5 point scale. Stimulation was only found to work when used alongside other therapies

NIHR Dissemination Centre2018

55. Telemedicine to Treat Rural Stroke Patients via a Hub-and-Spoke Model

Telemedicine to Treat Rural Stroke Patients via a Hub-and-Spoke Model "Telemedicine to Treat Rural Stroke Patients via a Hub-and-Spoke Model" by Matthew Heberling < > > > > > Title Author Date of Graduation Summer 8-11-2018 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies Rights . Abstract Background: Telemedicine is a model of care that is becoming known for its patient-centric and environmentally friendly applications. 1 Combining telemedicine (...) with a hub-and-spoke model is a method being used more frequently to disseminate vascular expertise and optimize recombinant tissue plasminogen activator (rt-PA) use. 2 Approximately 45% of Americans do not have immediate access to acute stroke centers within 60 minutes. 4 Due to this distance and time between onset and arrival, patients presenting to rural emergency departments are 10 times less likely to receive rt-PA than those same patients in urban settings. Telemedicine is one method that can

Pacific University EBM Capstone Project2018

56. Effects of MOTOmed movement therapy on the mobility and activities of daily living of stroke patients with hemiplegia: a systematic review and meta-analysis

Effects of MOTOmed movement therapy on the mobility and activities of daily living of stroke patients with hemiplegia: a systematic review and meta-analysis 30088421 2018 08 08 1477-0873 2018 Aug 08 Clinical rehabilitation Clin Rehabil Effects of MOTOmed movement therapy on the mobility and activities of daily living of stroke patients with hemiplegia: a systematic review and meta-analysis. 269215518790782 10.1177/0269215518790782 To estimate the effectiveness of MOTOmed ® movement therapy (...) in increasing mobility and activities of daily living in stroke patients with hemiplegia. Systematic review. English- and Chinese-language articles published from the start of database coverage through 20 June 2018 were retrieved from the Embase, Web of Science, PubMed, OVID, Cochrane Central Register of Controlled Trials, Cochrane Systematic Reviews, Wanfang, Chinese National Knowledge Infrastructure, VIP, and Chinese Biomedicine databases. Articles were also retrieved by manual searches of Rehabilitation

EvidenceUpdates2018

57. Electroconvulsive therapy and later stroke in patients with affective disorders

Electroconvulsive therapy and later stroke in patients with affective disorders 30106358 2018 08 14 1472-1465 2018 Aug 14 The British journal of psychiatry : the journal of mental science Br J Psychiatry Electroconvulsive therapy and later stroke in patients with affective disorders. 1-3 10.1192/bjp.2018.150 SummaryThe long-term effects of electroconvulsive therapy (ECT) on the risk of stroke are unknown. We examined the association between ECT and risk of incident or recurrent stroke. A cohort (...) of 174 534 patients diagnosed with affective disorder between 2005 and 2016 in the Danish National Patient Registry were followed for stroke until November 2016. The association between ECT and stroke was analysed using Cox regression with multiple adjustment and propensity-score matching on sociodemographic and clinical variables. In 162 595 patients without previous stroke, 5781 (3.6%) were treated with ECT. The total number of patients developing stroke during follow-up was 3665, of whom 165 had

EvidenceUpdates2018

58. Patent foramen ovale closure, antiplatelet therapy or anticoagulation in patients with patent foramen ovale and cryptogenic stroke: a systematic review and network meta-analysis incorporating complementary external evidence

Patent foramen ovale closure, antiplatelet therapy or anticoagulation in patients with patent foramen ovale and cryptogenic stroke: a systematic review and network meta-analysis incorporating complementary external evidence 30049703 2018 08 03 2044-6055 8 7 2018 Jul 25 BMJ open BMJ Open Patent foramen ovale closure, antiplatelet therapy or anticoagulation in patients with patent foramen ovale and cryptogenic stroke: a systematic review and network meta-analysis incorporating complementary (...) external evidence. e023761 10.1136/bmjopen-2018-023761 To examine the relative impact of three management options in patients aged <60 years with cryptogenic stroke and a patent foramen ovale (PFO): PFO closure plus antiplatelet therapy, antiplatelet therapy alone and anticoagulation alone. Systematic review and network meta-analysis (NMA) supported by complementary external evidence. Medline, EMBASE and Cochrane CENTRAL. Randomised controlled trials (RCTs) addressing PFO closure and/or medical

EvidenceUpdates2018 Full Text: Link to full Text with Trip Pro

59. Heart Failure After Ischemic Stroke or TIA in Insulin-Resistant Patients Without Diabetes Treated with Pioglitazone

Heart Failure After Ischemic Stroke or TIA in Insulin-Resistant Patients Without Diabetes Treated with Pioglitazone 29934374 2018 08 17 1524-4539 2018 Jun 22 Circulation Circulation Heart Failure After Ischemic Stroke or TIA in Insulin-Resistant Patients Without Diabetes Treated with Pioglitazone. CIRCULATIONAHA.118.034763 10.1161/CIRCULATIONAHA.118.034763 Background -The Insulin Resistance Intervention after Stroke (IRIS) trial demonstrated that pioglitazone reduced risk for both (...) cardiovascular events and diabetes in insulin resistant patients. However, concern remains that pioglitazone may increase risk for heart failure (HF) in susceptible individuals. Methods -In IRIS, patients with insulin resistance but without diabetes were randomized to pioglitazone or placebo (1:1) within 180 days of an ischemic stroke or TIA and followed for up to 5 years. To identify patients at higher HF risk with pioglitazone we performed a secondary analysis of IRIS participants without HF history at

EvidenceUpdates2018

60. Prognostic Value of BEFAST vs. FAST to Identify Stroke in a Prehospital Setting

Prognostic Value of BEFAST vs. FAST to Identify Stroke in a Prehospital Setting 30118372 2018 08 23 1545-0066 2018 Aug 23 Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors Prehosp Emerg Care Prognostic Value of BEFAST vs. FAST to Identify Stroke in a Prehospital Setting. 1-6 10.1080/10903127.2018.1490837 Use of prehospital stroke scales may enhance stroke detection and improve treatment rates (...) and delays. Current scales, however, may lack detection accuracy. As such, we examined whether adding coordination (Balance) and diplopia (Eyes) assessments increase the accuracy of the Face-Arms-Speech-Time (FAST) scale in a multisite prospective study of emergency response activations for presumed stroke. This was a prospective study of emergency response activations for presumed stroke in Santa Clara County, California. Emergency medical responders were trained in the Balance-Eyes-Face-Arms-Speech

EvidenceUpdates2018