Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · May 2009
Prior antiplatelet therapy, platelet infusion therapy, and outcome after intracerebral hemorrhage.
Recent studies examining the effect of prior antiplatelet therapy (APT) on outcome in patients with spontaneous intracerebral hemorrhage (ICH) have shown conflicting results. The effect of platelet infusion therapy (PIT) on outcome in patients with ICH taking APT is unknown. ⋯ In patients with ICH, APT is associated with an increased risk of hospital death. In the subgroup of patients on APT, PIT did not prevent death or improve outcome.
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J Stroke Cerebrovasc Dis · May 2009
The impact of Accreditation Council for Graduate Medical Education duty hours, the July phenomenon, and hospital teaching status on stroke outcomes.
Acute ischemic stroke (AIS) is common cause of hospital admission. The objective of this study was to determine the impact of the new Accreditation Council for Graduate Medical Education (ACGME) duty hour regulations on AIS outcomes including inhospital mortality. ⋯ There was no difference in AIS mortality after the implementation of the new ACGME duty hour standards. In addition, data support the lack of July phenomenon in neurology residency programs in regard to AIS mortality.
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J Stroke Cerebrovasc Dis · May 2009
Intermittent atrial fibrillation may account for a large proportion of otherwise cryptogenic stroke: a study of 30-day cardiac event monitors.
Despite extensive inpatient workup including telemetry monitoring, a significant proportion of stroke is classified as cryptogenic at hospital discharge. It is possible that a significant proportion of cryptogenic stroke is a result of intermittent atrial fibrillation (AF). Thirty-day cardiac event monitors (30-DEM) may increase the rate of AF detection compared with standard investigations that include a combination of electrocardiography, cardiac telemetry, and short-term Holter monitoring. ⋯ The 30-DEM changed the medical treatment of 20% of patients with otherwise cryptogenic stroke because of the detection of intermittent AF despite no detection of AF on electrocardiography and inpatient telemetry monitoring in the majority of patients. Further prospective studies of extended cardiac event monitors in the setting of cryptogenic stroke are warranted.