Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Mar 2014
Long-term adherence to national guidelines for secondary prevention of ischemic stroke: a prospective cohort study in a public hospital in Chile.
Clinical guidelines for the secondary prevention of ischemic stroke have been developed, but their publication is insufficient to make them effective. Our aim was to investigate adherence to Chilean guidelines, its associated variables, and to determine prognosis at follow-up. ⋯ The observed significant decrease in adherence to oral anticoagulation in patients with cardioembolic stroke suggests a need for the implementation of specific strategies to achieve the desired secondary prevention goals in these patients. Future research into the evaluation of other factors that could be associated with the lack of adherence to these guidelines, measurements of therapeutic goals, and new therapeutic strategies that are easier to use and that are associated with less risk could improve the prognosis of these patients.
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J Stroke Cerebrovasc Dis · Mar 2014
Executive function and diffusion in frontal white matter of adults with moyamoya disease.
Cognitive impairment is a frequent complication of moyamoya disease (MMD) in adults. Chronic hypoperfusion in frontal lobes can lead to subtle brain injury, resulting in cognitive dysfunctions. Apparent diffusion coefficient (ADC) in normal-appearing white matter on conventional magnetic resonance imaging correlates with cerebral hemodynamics in the frontal lobe. ⋯ The association of ADC with executive function might suggest that ADC is useful in screening for executive dysfunction during follow-up in the outpatient setting.
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J Stroke Cerebrovasc Dis · Mar 2014
Case ReportsSubarachnoid hemorrhage after resuscitation from out-of-hospital cardiac arrest.
This study was undertaken to retrospectively investigate clinical features of subarachnoid hemorrhage (SAH) with cardiopulmonary arrest in patients achieving return of spontaneous circulation (ROSC) in order to explore the possibility of long-term survival. ⋯ Cardiac arrest caused by SAH is a disease state with a grave prognosis, but there is the possibility of a good survival outcome when the administration of a small dose of adrenaline results in the rapid recovery of brainstem reflexes.
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J Stroke Cerebrovasc Dis · Mar 2014
Speech-language pathologist-led fiberoptic endoscopic evaluation of swallowing: functional outcomes for patients after stroke.
Dysphagia is a common complication after stroke and is associated with the development of pneumonia. Early detection of dysphagia and specifically aspiration is, therefore, critical in the prevention of pneumonia. Fiberoptic endoscopic evaluation of swallowing (FEES) is a safe bedside instrumental tool for detecting dysphagia and aspiration and, therefore, has the potential to inform dysphagia management. This study investigated the clinical utility of a speech-language pathologist-led FEES service on functional outcomes for patients after acute stroke. ⋯ When used selectively, FEES services have potential for improving functional outcomes for patients after stroke.
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J Stroke Cerebrovasc Dis · Mar 2014
Comparative StudyThrombolysis for acute ischemic stroke: do patients treated out of hours have a worse outcome?
Previous studies on the impact of nonworking hours (NWH) have produced conflicting results. We aimed to compare the time to treatment with thrombolysis between NWH and working hours (WH) at an Australian comprehensive stroke center. ⋯ Our study showed that the "NWH effect" increased the door-to-needle time. The patients treated out of hours did not have a worse outcome.