Cerebrovascular diseases
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Cerebrovascular diseases · Jan 2009
Meta AnalysisAssociation analysis of genes involved in the maintenance of the integrity of the extracellular matrix with intracranial aneurysms in a Japanese cohort.
An association between versican (CSPG2), perlecan (HSPG2), fibrillin 2 (FBN2) and collagen 4A1 (COL4A1) gene variants and intracranial aneurysms (IA) has been reported in 2 studies analyzing Dutch IA patients. The aim of this study was to verify these associations in a Japanese IA population. In addition, a meta-analysis on the association of these genes and IA for the combined Dutch and Japanese populations was performed. ⋯ By analyzing HSPG2, CSPG2, FBN2 and COL4A1, we were able to replicate the association of CSPG2 and show that there is a trend for HSPG2 towards association in the Japanese IA population by means of a meta-analysis combining the Dutch and Japanese results. The association of FBN2 and COL4A1 could not be replicated in the Japanese IA population.
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The lack of physicians with specialty stroke training represents a significant challenge to the future of stroke. This deficit limits both quality stroke care and clinical research initiatives. ⋯ Greater diffusion and long-term sustainability of telestroke systems will be dependent upon improvements in patient and hospital reimbursement for acute stroke and telestroke care.
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Cerebrovascular diseases · Jan 2009
Comparative StudyGender differences in mortality after hospital admission for stroke.
Differences between men and women in stroke symptoms, management and disability have been reported to be unfavorable for women. Yet, studies into differences between men and women in survival after a stroke yielded inconsistent results. We investigated whether gender was associated with all-cause mortality after hospital admission for stroke. ⋯ Women have lower 28-day case-fatality and long-term mortality risks after an ischemic stroke and lower 1-year and 5-year mortality risks after an intracerebral hemorrhage compared to men, whereas no differences in mortality risks were found for subarachnoid hemorrhage.
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Cerebrovascular diseases · Jan 2009
Multicenter StudyUtilization of intravenous tissue plasminogen activator for ischemic stroke: are there sex differences?
We evaluated whether there were sex-related differences in the administration of intravenous tissue plasminogen activator (IV-tPA) to patients with acute ischemic stroke admitted to US academic medical centers. ⋯ Women admitted to academic hospitals receive IV-tPA as often as men; however, a substantial percentage of both women and men are not arriving within the 3-hour time window required for diagnostic assessment and administration of intravenous thrombolytic therapy. Additional efforts are needed to improve the rapid identification, evaluation and treatment of stroke patients.
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Cerebrovascular diseases · Jan 2009
Multicenter StudyStroke in the very elderly: hospital care, case fatality and disposition.
The worldwide growing number of older people represents a new phenomenon. Considering that the prevalence of stroke increases with age and higher life expectancy, the prevalence of stroke will likely rise in the next decade. However, limited information is available about the burden of stroke in individuals over 90. ⋯ In our study, stroke patients over 90 had higher risk-adjusted mortality, longer hospitalization, and were less likely to be discharged to their original place of residence. In view of these findings, strategies need to be implemented to facilitate equal access to specialized stroke care for the elderly.