MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'International Journal of Stroke' source. Sat, 20 Mar 2010 14:41:11 +0100 http://www.medworm.com/index.php?rid=3340572&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00409.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340572 Mon, 08 Mar 2010 15:08:25 +0100 3340572 http://www.medworm.com/index.php?rid=3340589&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00419.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340589 Sun, 07 Mar 2010 00:00:00 +0100 3340589 http://www.medworm.com/index.php?rid=3340588&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00418.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340588 Sun, 07 Mar 2010 00:00:00 +0100 3340588 http://www.medworm.com/index.php?rid=3340587&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00401.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340587 Sun, 07 Mar 2010 00:00:00 +0100 3340587 http://www.medworm.com/index.php?rid=3340586&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00400.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340586 Sun, 07 Mar 2010 00:00:00 +0100 3340586 http://www.medworm.com/index.php?rid=3340585&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00417.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340585 Sun, 07 Mar 2010 00:00:00 +0100 3340585 http://www.medworm.com/index.php?rid=3340584&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00416.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340584 Sun, 07 Mar 2010 00:00:00 +0100 3340584 http://www.medworm.com/index.php?rid=3340583&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00399.x Stratification according to risk factors is crucial for secondary prevention after acute ischaemic stroke. Nonfasting triglyceride levels seem to be associated with stroke in the general population. However, the exact role of triglyceride levels for the risk of recurrent stroke is unknown. We hypothesise that the results of a standardised oral triglyceride tolerance test in the subacute setting (3[ndash]7 days) after the first ischaemic stroke are associated with the risk of recurrent stroke within 12 months after the index event. Prospective observational study. The primary end-point of the study is recurrent fatal or nonfatal stroke within 12 months. The secondary outcomes are myocardial infarction, coronary revascularisation, cardiovascular death (death due to any cardiovascular or cere... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340583 Sun, 07 Mar 2010 00:00:00 +0100 3340583 http://www.medworm.com/index.php?rid=3340582&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00420.x Inflammation is increasingly recognised as playing a central role in atherosclerosis, and peripheral blood markers of inflammation have been associated with incident and recurrent cardiac events. The relationship of these potentially modifiable risk markers to prognosis after ischaemic stroke is less clear. The Levels of Inflammatory Markers in the Treatment of Stroke (LIMITS) study will address hypotheses related to the role of inflammatory markers in secondary stroke prevention in an efficient manner using the well-established framework of the Secondary Prevention of Small Subcortical Strokes (SPS3) trial (NCT00059306). SPS3 is an ongoing Phase III multicentre secondary prevention trial focused on preventing recurrent stroke in patients with small vessel ischaemic stroke, or lacunes. In ... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340582 Sun, 07 Mar 2010 00:00:00 +0100 3340582 http://www.medworm.com/index.php?rid=3340581&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00415.x This article describes the design of the second, main phase, INTERACT2. To compare the effects of a management strategy of early intensive blood pressure lowering with a more conservative guideline-based blood pressure management policy in patients with acute intracerebral hemorrhage. INTERACT2 is a prospective, randomized, open label, assessor-blinded end-point (PROBE). Patients with a systolic blood pressure greater than 150 mmHg and no definite indication for or contraindication to blood pressure-lowering treatment are centrally randomised to either of two treatment groups within 6 h onset of intracerebral haemorrhage. Those allocated to intensive blood pressure lowering will receive primarily intravenous, hypotensive agents to achieve a systolic blood pressure target of (Source: Intern... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340581 Sun, 07 Mar 2010 00:00:00 +0100 3340581 http://www.medworm.com/index.php?rid=3340580&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00414.x The Virtual International Stroke Trials Archive was established to improve stroke care and trial design through the collation, categorization and potential access to data sets from clinical trials for the treatment of stroke. Virtual International Stroke Trials Archive currently provides access to a combined data set of 29 anonymised acute stroke trials and one acute stroke registry with data on >27 500 patients aged between 18 and 103 (mean 71) years. Virtual International Stroke Trials Archive has facilitated research across a broad canvas. The prognosis was poor in patients with very high blood pressure at the time of admission or with a wide variability of systolic blood pressure during the acute phase. The late occurrence of hyperthermia following an ischaemic stroke worsens the progn... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340580 Sun, 07 Mar 2010 00:00:00 +0100 3340580 http://www.medworm.com/index.php?rid=3340579&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00413.x Patent foramen ovale is found in 24% of healthy adults and 38% of patients with cryptogenic stroke. This ratio and case reports indicate that patent foramen ovale and stroke are associated, probably because of paradoxical embolism. In healthy people with patent foramen ovale, embolic events are not more frequent than in controls, and therefore no primary prevention is needed. However, once ischaemic events occur, the risk of recurrence is substantial and prevention becomes an issue. Acetylsalicylic acid and warfarin reduce this risk to the same level as in patients without patent foramen ovale. Patent foramen ovale with a coinciding atrial septal aneurysm, spontaneous or large right-to-left shunt, or multiple ischaemic events potentiates the risk of recurrence. Transcatheter device closure... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340579 Sun, 07 Mar 2010 00:00:00 +0100 3340579 http://www.medworm.com/index.php?rid=3340578&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00406.x Stroke is a leading public health problem, causing significant disability and premature mortality, particularly in low- and middle-income countries (LMIC). A public health strategy is required for the prevention and care of stroke in LMIC. Although specific estimates are difficult to calculate, increasing cost-effective interventions that reduce cardiovascular risk in the population can have a substantial impact on stroke burden. Public health interventions that address tobacco use, unhealthy diet (salt and transfat), and physical inactivity of the population need to be complemented with equitable stroke services. The main components of an equitable stroke service include:[bull] assessment and management of cardiovascular risk in primary care,[bull] assessment and follow-up of transient is... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340578 Sun, 07 Mar 2010 00:00:00 +0100 3340578 http://www.medworm.com/index.php?rid=3340577&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00412.x We examined the association between different polymorphisms frequently found in young patients with cryptogenic stroke [methylenetetrahydrofolate reductase (MTHFR) C677T, factor II (prothrombin) G20210A, factor V G1691A (Leiden), nitric oxide synthase 3 (NOS3) intron 4 VNTR, and apolipoprotein E (APOE) ɛ4 gene] in patients with a cerebral infarct caused by spontaneous cervical artery dissection. Forty-eight patients (27 males) and 96 matching control subjects were recruited. Clinical history, including cardiovascular risk factors, was assessed in all subjects. Genotypes were determined by a polymerase chain reaction with and without a restriction fragment length polymorphism. The genotypes and allele frequencies of the five genetic variants studied were compared between spontaneous ... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340577 Sun, 07 Mar 2010 00:00:00 +0100 3340577 http://www.medworm.com/index.php?rid=3340576&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00411.x We report our experience with new Putonghua- and Cantonese-Chinese language NIHSS (PC-NIHSS and CC-NIHSS) training and certification videos. A professional video production company was hired to create the training and certification videos for both PC-NIHSS and CC-NIHSS. Two training and certification workshops were held in Chengdu and Beijing, and two workshops in Hong Kong. The instruction, training and group A certification videos were presented to workshop attendees. Unweighted [kappa] statistics were used to measure the agreement among raters, and the inter-rater agreements for PC-NIHSS and CC-NIHSS videos were compared with those of original English language NIHSS (E-NIHSS) videos. The pass rates using PC-NIHSS and CC-NIHSS videos were 79% and 82%, respectively. All possible responses... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340576 Sun, 07 Mar 2010 00:00:00 +0100 3340576 http://www.medworm.com/index.php?rid=3340575&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00410.x Up to 25% of all acute ischaemic strokes occur during sleep. Because of the unclear time window, patients with stroke on awakening are usually not considered for acute therapy and excluded from most acute treatment trials. To evaluate the feasibility of magnetic resonance imaging-based intravenous thrombolysis in patients with stroke on awakening in a routine clinical setting. Forty-five patients with stroke on awakening clinically qualifying for intravenous thrombolysis and presenting within 6 h after symptom recognition were admitted to our institution between October 2006 and May 2008. Following an institutional protocol, patients received magnetic resonance imaging as a first-line imaging modality and were offered mismatch-based thrombolysis whenever possible. Baseline demographic data... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340575 Sun, 07 Mar 2010 00:00:00 +0100 3340575 http://www.medworm.com/index.php?rid=3340574&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00407.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340574 Sun, 07 Mar 2010 00:00:00 +0100 3340574 http://www.medworm.com/index.php?rid=3340573&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2010.00408.x We report our preliminary experience with the portable computed tomography scanner in a remote community where Telemedicine was successfully used to evaluate and treat patients presenting with symptoms suggestive of an acute ischaemic stroke. The University of Alberta Hospital in Edmonton, Canada was the 'hub' site and Wainwright Community Hospital was the 'spoke' site. Over a 3-month period, 18 patients were evaluated in the emergency department of the remote hospital where the referring physician felt that symptoms indicated potential for thrombolysis. All patients were evaluated remotely by a stroke neurologist in a TeleStroke service situated 207 km from the rural site. After clinical examination, cranial computed tomography scans were obtained with the portable scanner and evaluated b... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3340573 Sun, 07 Mar 2010 00:00:00 +0100 3340573 http://www.medworm.com/index.php?rid=3150996&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00395.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3150996 Fri, 08 Jan 2010 14:35:05 +0100 3150996 http://www.medworm.com/index.php?rid=3151009&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00392.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3151009 Thu, 07 Jan 2010 00:00:00 +0100 3151009 http://www.medworm.com/index.php?rid=3151008&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00403.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3151008 Thu, 07 Jan 2010 00:00:00 +0100 3151008 http://www.medworm.com/index.php?rid=3151007&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00391.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3151007 Thu, 07 Jan 2010 00:00:00 +0100 3151007 http://www.medworm.com/index.php?rid=3151006&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00388.x One in three patients experience depression after stroke and this risk is consistent over time. A strategy to prevent depression that could be economically delivered to most stroke patients and ideally which also has a low likelihood of adverse events needs to be developed and evaluated. POST aims to determine whether a simple intervention (postcards) prevents depression (Hospital Anxiety and Depression rating Scale, HADS depression subscale score [ge]8) in patients with a recent stroke. Secondary end-points include reduced anxiety (HADS anxiety subscale score [ge]8) and improved health-related quality of life in patients with a recent stroke. A single-centre randomised, double-blind, pilot trial to prevent depression in patients with a recent (within 8 weeks) stroke presenting to hospital... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3151006 Thu, 07 Jan 2010 00:00:00 +0100 3151006 http://www.medworm.com/index.php?rid=3151005&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00404.x In this study we expect to randomize 20 patients. All participants (age 18[ndash]85) will receive customary rehabilitative treatment consistent of a standardized protocol (eight sessions, 60 min each, over a two-week period). The primary feasibility outcome is the total time receiving the intervention. The primary safety outcome is the proportion of patients experiencing intervention-related adverse events during the study period. Efficacy, a secondary outcome measure, will be measured by the Wolf Motor Function Test, Box and Block Test, and Stroke Impact Scale at the four-week follow-up visit. From November, 2008 to September, 2009 21 patients were randomized to VRWii or RT. Mean age, 61 (range 41[ndash]83) years. Mean time from stroke onset 25 (range 10[ndash]56) days. EVREST is the firs... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3151005 Thu, 07 Jan 2010 00:00:00 +0100 3151005 http://www.medworm.com/index.php?rid=3151004&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00405.x The objective is to compare the efficacy of CAS versus CEA in patients with symptomatic ([ge]50%) or asymptomatic ([ge]60%) extracranial carotid stenosis. The Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) is a prospective, randomized, parallel, two-arm, multi-center trial with blinded endpoint adjudication. Primary endpoints are analyzed using standard time-to-event statistical modeling with adjustment for major baseline covariates. Primary analysis is on an intent-to-treat basis. The primary outcome is the occurrence of any stroke, myocardial infarction, or death during a 30-day peri-procedural period, and ipsilateral stroke during follow-up of up to four years. Secondary outcomes include restenosis and health-related quality of life. (Source: International Journal o... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3151004 Thu, 07 Jan 2010 00:00:00 +0100 3151004 http://www.medworm.com/index.php?rid=3151003&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00402.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3151003 Thu, 07 Jan 2010 00:00:00 +0100 3151003 http://www.medworm.com/index.php?rid=3151002&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00398.x Stroke is potentially preventable through risk factor modification. Over the past decade, there has been considerable interest on microalbuminuria as a risk factor for chronic diseases. The concept of microalbuminuria was originally introduced, about 25 years ago, to clinical practice as a useful marker of nephropathy. Since then various studies reported an association of microalbuminuria with the increased risk of cardiovascular events and all cause of mortality in subjects with or without diabetes. The presence of microalbuminuria was related to left ventricular dysfunction, stroke, and myocardial infarction. Microalbuminuria may be a predictor of stroke but further studies are required. However data on prognostic significance and therapeutic consequence, particularly in haemorrhagic str... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3151002 Thu, 07 Jan 2010 00:00:00 +0100 3151002 http://www.medworm.com/index.php?rid=3151001&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00397.x This article analyses critically the role of dual antiplatelet therapy for stroke prevention in patients with atrial fibrillation. (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3151001 Thu, 07 Jan 2010 00:00:00 +0100 3151001 http://www.medworm.com/index.php?rid=3151000&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00394.x In some cases of hemiplegia, the initiation of yawning is associated with involuntary raising of the paralysed arm. Reports are scarce in the literature, probably because the phenomenon has largely been overlooked. We studied six patients from two neurologic units, and compared them with published cases from the last 200 years. Brain imaging typically shows a small vascular lesion most often located in the internal capsule. After comparison with experimental models in cats, we suggest that damage to the cortico-neocerebellar tract of the extrapyramidal system disinhibits the spino-archeocerebellar tract, enabling a motor stimulation of the arm by the lateral reticular nucleus, which harmonises both central respiratory and locomotor rhythms. When phylogenetically primitive structures are di... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3151000 Thu, 07 Jan 2010 00:00:00 +0100 3151000 http://www.medworm.com/index.php?rid=3150999&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00396.x This study examines the potential advantage of using high-sensitivity interleukin-6 as a possible biomarker at the early stages of acute stroke for identifying patients at a high risk for 12-month mortality. Inflammatory biomarkers and neurological scores were determined in 250 patients following mild to moderate acute ischaemic stroke within 24 h of hospital admission. Outcome data on mortality were collected after 12 months. The signal detection methodology was used to identify subgroups that were at a high risk for 12-month mortality. Twelve months following the event, 234 of the 250 stroke patients survived. Signal detection identified predictors that distinguished individuals likely to die from those with a better recovery prediction. Plasma interleukin-6 concentration emerged as the ... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3150999 Thu, 07 Jan 2010 00:00:00 +0100 3150999 http://www.medworm.com/index.php?rid=3150998&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00393.x Decompressive hemicraniectomy for malignant middle cerebral artery infarction has long been controversial. Recently, data from randomised-controlled trials have shown that the procedure is life-saving and improves outcome. However, these randomised-controlled trials were difficult to conduct, because of ethical considerations due to high mortality in control groups. While the use of historical comparators may not be ideal for phase III efficacy trials, these data may be useful to inform the selection of trial populations. We sought to replicate the findings of the DESTINY trial of decompressive surgery in malignant middle cerebral artery infarction using the Virtual International Stroke Trials Archive, to determine whether historical comparators could be used as an alternative to control g... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3150998 Thu, 07 Jan 2010 00:00:00 +0100 3150998 http://www.medworm.com/index.php?rid=3150997&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00336.x The occurrence of atrial fibrillation after percutaneous closure of a patent foramen ovale for cryptogenic stroke has been reported in a variable percentage of patients. However, its precise incidence and mechanism are presently unclear and remain to be elucidated. Prospective follow-up study. Ninety-two patients undergoing a percutaneous patent foramen ovale closure procedure (closure group) for cryptogenic stroke were compared with a similar group of 51 patients, who were medically treated. A systematic arrhythmia follow-up protocol to assess the incidence of AF was performed including a 7-day event-loop recording at day 1, after 6 and 12 months in patients of the closure group and compared with those of the medically treated group. The incidence of AF was similar in both study groups du... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=3150997 Thu, 07 Jan 2010 00:00:00 +0100 3150997 http://www.medworm.com/index.php?rid=2961179&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00390.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2961179 Thu, 05 Nov 2009 14:37:08 +0100 2961179 http://www.medworm.com/index.php?rid=2961193&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00384.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2961193 Wed, 04 Nov 2009 00:00:00 +0100 2961193 http://www.medworm.com/index.php?rid=2961192&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00385.x In rat stroke models, sphenopalatine ganglion stimulation up to 24 h after stroke onset augments cerebral blood flow, reduces infarct volume and improves neurological deficits. The ischaemic stroke system 500 has been designed to stimulate the sphenopalatine ganglion in humans. (1) To determine the safety and tolerability of the ischaemic stroke system 500 in acute ischaemic stroke within 24 h of stroke onset. (2) To determine the effectiveness of ischaemic stroke system 500 in acute ischaemic stroke treatment. Implant for augmentation of cerebral blood flow trial-1 is a multi-national open-label study in patients of acute ischaemic stroke in the anterior circulation with National Institutes of Health Stroke Scales 7[ndash]20. The treatment initiation will be within 24 h of stroke onset. T... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2961192 Wed, 04 Nov 2009 00:00:00 +0100 2961192 http://www.medworm.com/index.php?rid=2961191&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00386.x The recent meta-analysis of NXY-059 in experimental stroke models using individual animal data found the drug to be an effective neuroprotective agent. However, the failure of translation of both this compound and many others from preclinical studies to the clinic indicates that new approaches must be used in drug discovery so that animal models become more reflective of the clinical situation, and studies using animal models of stroke mimic the design of studies performed in humans, as far as possible. In this review, we suggest that a fundamental paradigm shift is needed away from performing preclinical studies in individual laboratories to performing them in an organised group of independent laboratories. Studies should be run by a steering committee and should be supported by a coordin... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2961191 Wed, 04 Nov 2009 00:00:00 +0100 2961191 http://www.medworm.com/index.php?rid=2961190&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00387.x Stroke is one of the leading causes of mortality and morbidity, with astronomical financial repercussions on health systems worldwide. Ischaemic stroke accounts for approximately 80[ndash]85% of all cases and is characterised by the disruption of cerebral blood flow and lack of oxygen to the affected area. Oxidative stress culminates due to an imbalance between pro-oxidants and antioxidants and consequent excessive production of reactive oxygen species. Reactive oxygen species are biphasic, playing a role in normal physiological processes and are also implicated in a number of disease processes, whereby they mediate damage to cell structures, including lipids, membranes, proteins, and DNA. The cerebral vasculature is a major target of oxidative stress playing a critical role in the pathoge... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2961190 Wed, 04 Nov 2009 00:00:00 +0100 2961190 http://www.medworm.com/index.php?rid=2961189&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00382.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2961189 Wed, 04 Nov 2009 00:00:00 +0100 2961189 http://www.medworm.com/index.php?rid=2961188&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00350.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2961188 Wed, 04 Nov 2009 00:00:00 +0100 2961188 http://www.medworm.com/index.php?rid=2961187&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00389.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2961187 Wed, 04 Nov 2009 00:00:00 +0100 2961187 http://www.medworm.com/index.php?rid=2961186&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00346.x Abnormalities on acute magnetic resonance imaging predict outcome in minor stroke and transient ischaemic attack patients. We hypothesised that noncontrast computed tomography and computed tomography angiography findings in minor stroke and transient ischaemic attack patients would also predict functional outcome. We analysed consecutive patients with a transient ischaemic attack or a minor stroke with an National Institute of Health Stroke Scale [le]3 who were assessed with a noncontrast computed tomography and CT angiography of the circle of Willis and neck within 24 h of symptom onset. We assessed the association between clinical or imaging features and functional impairment on the modified Rankin Scale (mRS[ge]2) at 90 days. Among 457 patients, the median baseline National Institute of... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2961186 Wed, 04 Nov 2009 00:00:00 +0100 2961186 http://www.medworm.com/index.php?rid=2961185&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00349.x The aim of our study is to evaluate the frequency of aphasia and to describe the characteristics of aphasics among a large sample of acute stroke patients in Italy. Out of the 11 572 stroke patients hospitalised within 48 h from stroke onset, included in the PROSIT study, we selected 9594 alert cases for the estimation of aphasia frequency. The presence of aphasia was accepted when registered in the clinical records at the first neurological examination. All patients/caregivers underwent to a 2-year telephone follow-up evaluation. Twenty-eight per cent of alert acute stroke patients had aphasia, which was associated with arm and/or limb weakness in 74% of cases. In our series, aphasia was more frequent in females than males, in patients older than 75 years and was associated with more seve... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2961185 Wed, 04 Nov 2009 00:00:00 +0100 2961185 http://www.medworm.com/index.php?rid=2961184&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00348.x We examined whether the presence of complications 'unrelated' to index stroke at later time-points could confound outcome, and if this could be minimised through altering study end-points. We analysed 531 placebo-treated patients from the Virtual International Stroke Trials Archive who had experienced an acute ischaemic stroke and at least one poststroke complication during the 90-day follow-up period. We categorised complications into those deemed 'related' or 'unrelated' to index stroke severity. We examined modified Rankin Scale at 30 and 90 days, stratified by type of complication and assessed the impact of eliminating 'unrelated' complications on functional outcome (modified Rankin Scale) at 30 and 90 days using logistic regression (accounting for age and baseline National Institutes ... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2961184 Wed, 04 Nov 2009 00:00:00 +0100 2961184 http://www.medworm.com/index.php?rid=2961183&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00347.x To determine the predictors of efficacy, including magnetic resonance imaging information, for low-dose intravenous alteplase therapy for stroke patients. Seventy-eight patients were prospectively enrolled in a single Stroke Unit (SU) receiving alteplase at a dose of 0·6 mg/kg during the initial 27 months after its approval in Japan. Ischaemic changes and vascular lesions were identified using computed tomography, diffusion-weighted magnetic resonance imaging, and magnetic resonance angiography. Early ischaemic signs were assessed using the Alberta Stroke Program Early CT Score. The median baseline National Institutes of Health Stroke Scale score of 78 patients was 12. In 19 patients (24%), the National Institutes of Health Stroke Scale score improved by [ge]8 points at 24 h. After multiv... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2961183 Wed, 04 Nov 2009 00:00:00 +0100 2961183 http://www.medworm.com/index.php?rid=2961182&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00383.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2961182 Wed, 04 Nov 2009 00:00:00 +0100 2961182 http://www.medworm.com/index.php?rid=2961181&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00390_2.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2961181 Wed, 04 Nov 2009 00:00:00 +0100 2961181 http://www.medworm.com/index.php?rid=2961180&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00390_1.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2961180 Wed, 04 Nov 2009 00:00:00 +0100 2961180 http://www.medworm.com/index.php?rid=2798696&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00333.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798696 Wed, 16 Sep 2009 16:48:11 +0100 2798696 http://www.medworm.com/index.php?rid=2798719&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00344.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798719 Tue, 15 Sep 2009 23:00:00 +0100 2798719 http://www.medworm.com/index.php?rid=2798718&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00342.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798718 Tue, 15 Sep 2009 23:00:00 +0100 2798718 http://www.medworm.com/index.php?rid=2798717&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00343.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798717 Tue, 15 Sep 2009 23:00:00 +0100 2798717 http://www.medworm.com/index.php?rid=2798716&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00341.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798716 Tue, 15 Sep 2009 23:00:00 +0100 2798716 http://www.medworm.com/index.php?rid=2798715&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00340.x In this study a total of 1060 patients will be included and analysis of data will be completed in 2010. If positive, this trial will add an effective strategy to the treatment of acute ischaemic stroke. (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798715 Tue, 15 Sep 2009 23:00:00 +0100 2798715 http://www.medworm.com/index.php?rid=2798714&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00339.x Better methods of identifying which patients with asymptomatic carotid stenosis will develop stroke, are required to improve the risk[ndash]benefit ratio of carotid endarterectomy. A promising method is the detection of asymptomatic embolic signals using transcranial Doppler. Embolic signals predict stroke risk in symptomatic carotid stenosis, but their predictive role in asymptomatic carotid stenosis is uncertain. The Asymptomatic Carotid Emboli Study is a prospective observational study in patients with asymptomatic carotid stenosis[ge]70%. Two 1-h transcranial Doppler recordings from the ipsilateral middle cerebral artery are performed at baseline, and a single-hour recording is performed at 6, 12 and 18 months. Follow-up is for 2 years. All recordings are centrally blinded to subject i... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798714 Tue, 15 Sep 2009 23:00:00 +0100 2798714 http://www.medworm.com/index.php?rid=2798713&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00323.x Brunei Darussalam, located on the north-west coast of Borneo, has a total area of 5765 km2 (1). Divided into four districts [ndash] Brunei-Muara, Belait, Temburong and Tutong with the majority of the population living in the Brunei-Muara District, approximately 74% of the population is urban with an overall population of 390 000, male/female ratio 1·13 : 1 (2). The main ethnic group is Malay (66·6%), which comprises the different Brunei indigenous communities of Malay, Belait, Bisaya, Brunei, Dusun, Kedayan, Murut and Tutong. Chinese ethnicity comprises 11% while other undefined ethnicities 22·4%. Approximately, 39·2% are aged below 19 years, 2·8% over 65 years with a median age of 26 years. Brunei's gross national income per capita (PPP international $) is 49 900 (3). (Source: Intern... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798713 Tue, 15 Sep 2009 23:00:00 +0100 2798713 http://www.medworm.com/index.php?rid=2798712&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00321.x Pediatric stroke is significantly less common than stroke in adults, but represents a major challenge to public health authorities. The aim of this retrospective study was to identify the total and annual number of children younger than 18 years with arterial ischaemic stroke and transient ischaemic attack referred to the Children's Hospital Zagreb, which is a major national centre specialised for the treatment and prevention of stroke in children. We reviewed the medical records of the Department of Neuropediatrics database at the Children's Hospital Zagreb between 1998[ndash]2005 in order to provide demographic and clinical characteristics and neuroimaging findings in children with arterial ischaemic stroke. In the 7-year period, we identified a total of 124 children from different geogr... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798712 Tue, 15 Sep 2009 23:00:00 +0100 2798712 http://www.medworm.com/index.php?rid=2798711&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00327.x Stroke is a major public health problem in developing countries of South Asia. In this paper, we review the epidemiology of stroke in Pakistan. Most of the available data are based on hospital-centred case series addressing established stroke risk factors, stroke-related mortality and disability, functional status, and case fatality rates. There are limited population-based data regarding the prevalence of established stroke risk factors in the general population, and no epidemiologic studies have been conducted to specifically identify potential stroke risk factors unique to the region. The limited data that are available from Pakistan indicate that stroke epidemiology differs between Pakistan and Western populations [ndash] in Pakistan first stroke occurs at a younger age, particularly a... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798711 Tue, 15 Sep 2009 23:00:00 +0100 2798711 http://www.medworm.com/index.php?rid=2798710&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00326.x Stroke is the leading cause of death among Indonesians above five years of age, comprising 15·4% of all deaths, age[ndash]gender-standardised death rate 99/100 000, and age[ndash]gender-standardised disability-adjusted life years lost 685/100 000. Stroke prevalence is 0·0017% in rural Indonesia, 0·022% in urban Indonesia, 0·5% among urban Jakarta adults, and 0·8% overall. Frequent risk factors include hypertension, smoking and hypercholesterolaemia. The mean age of stroke patients is 58·8 years. Subarachnoid haemorrhage is found in 1·4% of patients, intracerebral haemorrhage in 18·5%, and ischaemic stroke in 42·9%. Only city hospitals have neurology, neurosurgery and neuroimaging services. Indonesia has 40 stroke units. Commonly used medications for stroke are easily available. Ho... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798710 Tue, 15 Sep 2009 23:00:00 +0100 2798710 http://www.medworm.com/index.php?rid=2798709&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00338.x For a long time, patients with severe stroke were facing therapeutic nihilism of the attending physicians. Implementation of do-not-resuscitate-orders may have lead to self-fulfilling prophecies and to a pessimistic overestimation of prognosis of severe stroke syndromes. However, there have been great advances in intensive care management of acute stroke patients and it has been shown that treatment on a specialised neurological intensive care unit improves outcome. In this review, we will present a summary of the current state-of-the-art intensive care management of acute stroke patients. After presenting an overview on general management of stroke intensive care patients, special aspects of neurological intensive care of acute large middle cerebral artery stroke, intracerebral haemorrhag... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798709 Tue, 15 Sep 2009 23:00:00 +0100 2798709 http://www.medworm.com/index.php?rid=2798708&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00337.x The introduction of brain imaging with computed tomography revolutionised the treatment of patients with acute ischaemic stroke. With the visual differentiation of haemorrhagic stroke from ischaemic stroke, thrombolytic therapy became feasible. The Alberta Stroke Program Early CT Score was devised to quantify the extent of early ischaemic changes in the middle cerebral artery territory on noncontrast computed tomography. With its systematic approach, the score is simple and reliable. However, the assessment of early ischaemic changes and Alberta Stroke Program Early CT scoring require training. The Alberta Stroke Program Early CT Score is a strong predictor of functional outcome. Furthermore, the effectiveness of intraarterial thrombolysis in patients with middle cerebral artery occlusion ... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798708 Tue, 15 Sep 2009 23:00:00 +0100 2798708 http://www.medworm.com/index.php?rid=2798707&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00319.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798707 Tue, 15 Sep 2009 23:00:00 +0100 2798707 http://www.medworm.com/index.php?rid=2798706&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00329.x Hyperglycaemia in the acute phase of stroke has been established as a predictor of higher mortality. But recent data regarding active treatment of hyperglycaemia showed no clinical benefit suggesting that hyperglycaemia may not have a detrimental effect in brain infarction. Additional data are needed to resolve this uncertainty and identify patients at higher risk if any. A total of 477 adult Caucasian patients with brain infarction and 395 age- and sex-matched controls admitted at the same centres for nonneurological causes were recruited consecutively from 12 neurological centres in France. Electrocardiographic, carotid ultrasonography, and transcranial Doppler studies were performed. Blood was drawn in the morning from fasting subjects for glucose measurement. Functional outcome was mea... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798706 Tue, 15 Sep 2009 23:00:00 +0100 2798706 http://www.medworm.com/index.php?rid=2798705&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00330.x It is well known that increasing age is the strongest risk factor of stroke. Therefore, it has been a common belief in many countries including Finland that the numbers of stroke patients will increase considerably during the next two decades because the population is rapidly ageing. The FINMONICA and FINSTROKE registers operated in Finland in the Kuopio area and city of Turku from 1983 to 1997. The results showed that the incidence, mortality and case fatality of stroke declined significantly during that period. Importantly, it was established that the trends in incidence and mortality were also declining among the elderly (>74 years). We used these results to create a model for the entire country. The model was based on the trends present in these registers from Turku and Kuopio area and... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798705 Tue, 15 Sep 2009 23:00:00 +0100 2798705 http://www.medworm.com/index.php?rid=2798704&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00332.x High stroke mortality in central[ndash]eastern European countries might be due to higher stroke incidence, more severe strokes or less effective acute care than in countries with lower mortality rate. Hospital databases usually yield more detailed information on risk factors, stroke severity and short-term outcome than population-based registries. The Debrecen Stroke Database, data of 8088 consecutively hospitalised patients with acute cerebrovascular disease in a single stroke centre in East Hungary between October 1994 and December 2006, is analysed. Risk factors were recorded and stroke severity on admission was scored by the Mathew stroke scale. The modified Glasgow outcome scale was used to describe patient condition at discharge. Mean age was 68±13 years, 11·4% had haemorrhagic str... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798704 Tue, 15 Sep 2009 23:00:00 +0100 2798704 http://www.medworm.com/index.php?rid=2798703&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00331.x The objective of our study was to assess clinical outcomes in patients with acute ischaemic stroke with respect to pre treatment medications. The Registry of the Canadian Stroke Network collected pre morbid and prospective outcome data on 5568 patients with ischaemic stroke. We applied multivariate analyses to correlate pre admission medications with stroke severity on presentation, in-hospital mortality, and modified Rankin at discharge. Analyses were adjusted for age, gender, medical history, tPA administration, blood pressure, and glucose on presentation. Pre admission treatment with ASA and clopidogrel was associated with less severe stroke upon presentation. A similar trend was seen with dipyridamole and ticlopidine, but did not reach statistical significance. Pre treatment with ASA a... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798703 Tue, 15 Sep 2009 23:00:00 +0100 2798703 http://www.medworm.com/index.php?rid=2798702&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00334.x Epidemiological data on subarachnoid haemorrhage incidence and case-fatality rates are scarce in the south-eastern Mediterranean region. We conducted a population-based study in Evros Province, located in north-eastern Greece, to determine subarachnoid haemorrhage incidence over a 5-year period (2001[ndash]2005). Evros Province has a well-defined, largely homogeneous population with healthcare organised around a single tertiary-care University Hospital. We organised a prospective computerised registry of permanent Evros residents admitted or transferred to our hospital with a diagnosis of subarachnoid haemorrhage. Standard World Health Organization definitions and overlapping case-finding methods were used to identify all cases of first ever in a lifetime subarachnoid haemorrhage in all ag... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798702 Tue, 15 Sep 2009 23:00:00 +0100 2798702 http://www.medworm.com/index.php?rid=2798701&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00325.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798701 Tue, 15 Sep 2009 23:00:00 +0100 2798701 http://www.medworm.com/index.php?rid=2798700&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00322.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798700 Tue, 15 Sep 2009 23:00:00 +0100 2798700 http://www.medworm.com/index.php?rid=2798699&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00345.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798699 Tue, 15 Sep 2009 23:00:00 +0100 2798699 http://www.medworm.com/index.php?rid=2798698&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00328.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798698 Tue, 15 Sep 2009 23:00:00 +0100 2798698 http://www.medworm.com/index.php?rid=2798697&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00335.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2798697 Tue, 15 Sep 2009 23:00:00 +0100 2798697 http://www.medworm.com/index.php?rid=2706853&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00299.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2706853 Tue, 18 Aug 2009 10:43:37 +0100 2706853 http://www.medworm.com/index.php?rid=2706869&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00310.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2706869 Sun, 16 Aug 2009 23:00:00 +0100 2706869 http://www.medworm.com/index.php?rid=2706868&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00309.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2706868 Sun, 16 Aug 2009 23:00:00 +0100 2706868 http://www.medworm.com/index.php?rid=2706867&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00308.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2706867 Sun, 16 Aug 2009 23:00:00 +0100 2706867 http://www.medworm.com/index.php?rid=2706866&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00298.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2706866 Sun, 16 Aug 2009 23:00:00 +0100 2706866 http://www.medworm.com/index.php?rid=2706865&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00307.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2706865 Sun, 16 Aug 2009 23:00:00 +0100 2706865 http://www.medworm.com/index.php?rid=2706864&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00306.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2706864 Sun, 16 Aug 2009 23:00:00 +0100 2706864 http://www.medworm.com/index.php?rid=2706863&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00305.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2706863 Sun, 16 Aug 2009 23:00:00 +0100 2706863 http://www.medworm.com/index.php?rid=2706862&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00304.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2706862 Sun, 16 Aug 2009 23:00:00 +0100 2706862 http://www.medworm.com/index.php?rid=2706861&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00303.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2706861 Sun, 16 Aug 2009 23:00:00 +0100 2706861 http://www.medworm.com/index.php?rid=2706859&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00302.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2706859 Sun, 16 Aug 2009 23:00:00 +0100 2706859 http://www.medworm.com/index.php?rid=2706855&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00301.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2706855 Sun, 16 Aug 2009 23:00:00 +0100 2706855 http://www.medworm.com/index.php?rid=2706854&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00300.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2706854 Sun, 16 Aug 2009 23:00:00 +0100 2706854 http://www.medworm.com/index.php?rid=2693631&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00320.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693631 Tue, 11 Aug 2009 23:00:00 +0100 2693631 http://www.medworm.com/index.php?rid=2693630&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00315.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693630 Tue, 11 Aug 2009 23:00:00 +0100 2693630 http://www.medworm.com/index.php?rid=2693629&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00290.x Moderate to severe ([ge]70%) asymptomatic stenosis of the extracranial carotid artery leads to an increased rate of stroke of approximately 11% in 5 years. Patients with asymptomatic carotid stenosis, however, are also at a higher risk of nonstroke vascular events. The estimated annual risks of such events in patients with asymptomatic stenosis are 7% for a coronary ischaemic event and 4[ndash]7% for overall mortality. The superiority of carotid endarterectomy compared with medical treatment in symptomatic carotid disease is established, provided that the surgical procedure can be performed with a perioperative morbidity and mortality of (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693629 Tue, 11 Aug 2009 23:00:00 +0100 2693629 http://www.medworm.com/index.php?rid=2693628&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00295.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693628 Tue, 11 Aug 2009 23:00:00 +0100 2693628 http://www.medworm.com/index.php?rid=2693627&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00289.x Abstract Caregiver burden following stroke is increasingly recognised as a significant health care concern. A growing number of studies have evaluated the patient, caregiver, and social support factors that contribute to increased caregiver burden. We conducted a systematic review of this literature to guide future research. A search of the MEDLINE, PsycINFO, CINAHL, and EMBASE databases (up to July 2008) and reference sections of published studies using a structured search strategy yielded 24 relevant articles. Studies were included if they evaluated predictors and/or correlates of caregiver burden in the setting of stroke. The prevalence of caregiver burden was 25[ndash]54% and remained elevated for an indefinite period following stroke. In studies that evaluated independent baseline pre... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693627 Tue, 11 Aug 2009 23:00:00 +0100 2693627 http://www.medworm.com/index.php?rid=2693626&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00317.x Hyperthermia frequently occurs in stroke patients. Hyperthermia negatively correlates with clinical outcome and adversely effects treatment regiments otherwise successful under normothermic conditions. Preclinical studies also demonstrate that hyperthermia converts salvageable penumbra to ischaemic infarct. The present article reviews the knowledge accumulated from both clinical and preclinical studies about hyperthermia and ischaemic brain injury, examines current treatment strategies and discusses future research directions. (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693626 Tue, 11 Aug 2009 23:00:00 +0100 2693626 http://www.medworm.com/index.php?rid=2693625&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00294.x The National Institutes of Health Stroke Scale (NIHSS) is a well known, reliable and valid stroke deficit scale. The NIHSS is simple, quick, and has shown significant reliability in diverse groups, settings, and languages. The NIHSS also contains items with poor reliability and redundancy. Recent investigations (include assessing a new training DVD, analyzing webbased or videotape certifications, and testing foreign language versions) have further detailed reliability issues. Items recurrently shown to have poor reliability include Level of Consciousness, Facial Palsy, Limb Ataxia, and Dysarthria. The modified NIHSS (mNIHSS) minimizes redundancy and eliminates poorly reliable items. The mNIHSS shows greater reliability in multiple settings and cohorts, including scores abstracted from reco... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693625 Tue, 11 Aug 2009 23:00:00 +0100 2693625 http://www.medworm.com/index.php?rid=2693624&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00312.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693624 Tue, 11 Aug 2009 23:00:00 +0100 2693624 http://www.medworm.com/index.php?rid=2693623&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00316.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693623 Tue, 11 Aug 2009 23:00:00 +0100 2693623 http://www.medworm.com/index.php?rid=2693622&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00318.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693622 Tue, 11 Aug 2009 23:00:00 +0100 2693622 http://www.medworm.com/index.php?rid=2693621&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00314.x The objective of this study was to evaluate the changes in circadian blood pressure patterns in patients with acute ischaemic stroke and their relation to the stroke subtype. We studied 98 consecutive patients who were admitted within 24 h after ischaemic stroke onset. All patients had a detailed clinical examination, laboratory studies and a CT scan study of the brain on admission. To study the circadian rhythm of blood pressure, a continuous blood pressure monitor (Spacelab 90217) was used. Patients were classified according to the percentage fall in the mean systolic blood pressure or diastolic blood pressure at night compared with during the day as: dippers (fall[ge]10[ndash]20%); extreme dippers ([ge]20%); nondipper ( (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693621 Tue, 11 Aug 2009 23:00:00 +0100 2693621 http://www.medworm.com/index.php?rid=2693620&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00292.x Attention has turned to neurorestorative therapies, including erythropoietin, for experimental ischaemic stroke and head injury. Treatments for intracerebral haemorrhage need to be developed, as this represents a particularly devastating and common form of neurological injury. The aim of this study is to investigate the therapeutic potential of erythropoietin after intracerebral haemorrhage in rats and to measure its effects on mechanisms of recovery and neurogenesis. Intracerebral haemorrhage was induced in 24 Wistar male rats by intrastriatal infusion of autologous blood. Recombinant human erythropoietin (5000 or 10 000 U/kg BW/day) or saline was administered starting 1 day after intracerebral haemorrhage and continued daily for 1 week (n=8 for each group). To label proliferating cells, ... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693620 Tue, 11 Aug 2009 23:00:00 +0100 2693620 http://www.medworm.com/index.php?rid=2693619&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00293.x We examined 12-year stroke registration data to evaluate the current trend in a Japanese population. Data were obtained from the Takashima Stroke Registry, covering approximately 55 000 residents of Takashima County in central Japan. We calculated the age-adjusted stroke incidence rates (/100 000 person-years) and 95% confidence intervals for 1990[ndash]1992, 1993[ndash]1995, 1996[ndash]1998, and 1999[ndash]2001. We applied the direct method to adjust for the age distribution among the four periods. The incidence time trend was determined by calculating the average annual change across the study years using negative binomial regression analysis. There were 1453 (men: 771 and women: 682) registered first-ever stroke cases during 1990[ndash]2001. The diagnosis was established by neuro-imagin... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693619 Tue, 11 Aug 2009 23:00:00 +0100 2693619 http://www.medworm.com/index.php?rid=2693618&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00313.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693618 Tue, 11 Aug 2009 23:00:00 +0100 2693618 http://www.medworm.com/index.php?rid=2693617&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00291.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693617 Tue, 11 Aug 2009 23:00:00 +0100 2693617 http://www.medworm.com/index.php?rid=2693616&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00273.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693616 Tue, 11 Aug 2009 23:00:00 +0100 2693616 http://www.medworm.com/index.php?rid=2693615&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00311.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2693615 Fri, 31 Jul 2009 23:00:00 +0100 2693615 http://www.medworm.com/index.php?rid=2444477&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00286.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2444477 Sat, 30 May 2009 17:57:31 +0100 2444477 http://www.medworm.com/index.php?rid=2444478&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.auindex_s1.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2444478 Wed, 27 May 2009 04:00:00 +0100 2444478 http://www.medworm.com/index.php?rid=2344038&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00266.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344038 Mon, 20 Apr 2009 04:00:00 +0100 2344038 http://www.medworm.com/index.php?rid=2344037&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00261.x Self-management is seen as a primary mechanism to support the optimization of care for people with chronic diseases such as symptomatic vascular disease. There are no established and evidence-based stroke-specific chronic disease self-management programs. Our aim is to evaluate whether a stroke-specific program is safe and feasible as part of a Phase II randomized-controlled clinical trial. Stroke survivors are recruited from a variety of sources including: hospital stroke services, local paper advertisements, Stroke South Australia newsletter (volunteer peer support organization), Divisions of General Practice, and community service providers across Adelaide, South Australia. Subjects are invited to participate in a multi-center, single-blind, randomized, controlled trial. Eligible partic... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344037 Mon, 20 Apr 2009 04:00:00 +0100 2344037 http://www.medworm.com/index.php?rid=2344036&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00268.x Disturbance of neurologic function in disorders of the central nervous system is expressed as an altered activation pattern in functional networks used by specific tasks and can be studied by functional imaging modalities, e.g., positron emission tomography and functional magnetic resonance imaging. Language, a complex brain function, is based on the interplay of a distributed network in which partial functions are executed in various centers, the primary language areas. These areas are hierarchically organized and activated according to the complexity of the specific language task. The specialization of different centers and the lateralization of integrative functions into the dominant (usually left) hemisphere are achieved by collateral and transcallosal inhibition of secondary language ... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344036 Mon, 20 Apr 2009 04:00:00 +0100 2344036 http://www.medworm.com/index.php?rid=2344035&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00267.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344035 Mon, 20 Apr 2009 04:00:00 +0100 2344035 http://www.medworm.com/index.php?rid=2344034&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00264.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344034 Mon, 20 Apr 2009 04:00:00 +0100 2344034 http://www.medworm.com/index.php?rid=2344033&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00260.x This article presents a comprehensive review of cerebral venous sinus thrombosis etiologies. (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344033 Mon, 20 Apr 2009 04:00:00 +0100 2344033 http://www.medworm.com/index.php?rid=2344032&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00253.x The potential application for stem cell therapy is vast, and development for use in ischaemic stroke is still in its infancy. Access to stem cells for research is contentious; however, stem cells are obtainable from both animal and human. Despite a limited understanding of their mechanisms of action, clinical trials assessing stem cells in human stroke have been performed. Trials are also underway evaluating haematopoietic precursors mobilised with granulocyte-colony stimulating factor, an approach offering an autologous means of administrating stem cells for therapeutic purposes. This review summarises current knowledge in regard to stem cells and their potential for helping improve recovery after stroke. (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344032 Mon, 20 Apr 2009 04:00:00 +0100 2344032 http://www.medworm.com/index.php?rid=2344031&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00263.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344031 Mon, 20 Apr 2009 04:00:00 +0100 2344031 http://www.medworm.com/index.php?rid=2344030&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00257.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344030 Mon, 20 Apr 2009 04:00:00 +0100 2344030 http://www.medworm.com/index.php?rid=2344029&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00254.x This study documents the outcome of patients admitted to the first multidisciplinary SU opened at a secondary hospital in Cape Town, South Africa. Patient outcomes including in-hospital mortality, resource utilization (length of hospital stay, CT brain scans performed, and tertiary hospital referral), and access to inpatient rehabilitation were recorded for all patients admitted to the hospital for 3 months before initiating multidisciplinary stroke care and for 3 months after implementing multidisciplinary stroke care. One hundred and ninety-five patients were studied; 101 of these were managed in the SU. Inpatient mortality decreased from 33% to 16% after initiating multidisciplinary stroke care (P=0·005). The length of hospital stay increased from a mean (SD, 95% CI) of 5·1 (6·5, 3·... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344029 Mon, 20 Apr 2009 04:00:00 +0100 2344029 http://www.medworm.com/index.php?rid=2344028&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00262.x Lacunar infarct associated with small vessel disease is a common stroke subtype in China and has a favorable short-term prognosis. Data on its long-term prognosis among Chinese patients are lacking. We aimed to study its long-term prognosis and predictors for poor outcomes. We followed up to 75 consecutive Chinese stroke patients who had a lacunar infarct for a period of 5 years. Clinical outcomes with respect to mortality and recurrent stroke were noted. We evaluated baseline clinical and imaging predictors for such outcomes using the Cox regression analysis. Sixteen (21·3%) patients died and 12 (16%) patients had recurrent stroke during follow-up. Twenty-one (28%) patients had combined events of either death and/or recurrent stroke. Univariate Cox regression analysis showed that age, li... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344028 Mon, 20 Apr 2009 04:00:00 +0100 2344028 http://www.medworm.com/index.php?rid=2344027&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00256.x Stroke is a leading cause of disease burden. The quality of care provided in hospitals can affect outcome. Therefore, examining adherence to clinically important processes of care can help improve care delivery and patient outcomes. However, knowing which process indicators to measure is essential. Systematically review process indicators used to evaluate acute stroke services, including early rehabilitation interventions, and assess whether published indicators conform to clinical guidelines. Publications (1985[ndash]2006) were identified by systematically searching databases (e.g. Medline and Cochrane Library), and the internet using free text terms: 'stroke unit', 'process', 'quality', 'mobilisation', 'acute', and 'early rehabilitation'. Publications describing process indicators relati... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344027 Mon, 20 Apr 2009 04:00:00 +0100 2344027 http://www.medworm.com/index.php?rid=2344026&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00259.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344026 Mon, 20 Apr 2009 04:00:00 +0100 2344026 http://www.medworm.com/index.php?rid=2344025&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00255.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344025 Mon, 20 Apr 2009 04:00:00 +0100 2344025 http://www.medworm.com/index.php?rid=2344024&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00265.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344024 Mon, 20 Apr 2009 04:00:00 +0100 2344024 http://www.medworm.com/index.php?rid=2344023&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00258_1.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344023 Mon, 20 Apr 2009 04:00:00 +0100 2344023 http://www.medworm.com/index.php?rid=2344022&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00258.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2344022 Wed, 01 Apr 2009 04:00:00 +0100 2344022 http://www.medworm.com/index.php?rid=2177186&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00249.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177186 Tue, 10 Feb 2009 05:00:00 +0100 2177186 http://www.medworm.com/index.php?rid=2177185&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00251.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177185 Tue, 10 Feb 2009 05:00:00 +0100 2177185 http://www.medworm.com/index.php?rid=2177184&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00250.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177184 Tue, 10 Feb 2009 05:00:00 +0100 2177184 http://www.medworm.com/index.php?rid=2177183&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00237.x This study tests the hypothesis that Neuroaid, a TCM widely used in China post-stroke, is superior to placebo in reducing neurological deficit and improving functional outcome in patients with acute cerebral infarction of an intermediate severity. This is a multicenter, randomised, double-blind, placebo-controlled study of Neuroaid in ischemic stroke patients with National Institute of Health Stroke Scale(NIHSS) 6[ndash]14 treated within 48 h of stroke onset. Neuroaid or placebo is taken (4 capsules) 3 times daily for 3 months. Treatments are assigned using block randomization, stratified for centers, via a central web-randomization system. With a power of 90% and two-sided test of 5% type I error, a sample size is 874. Allowing for a drop-out rate of up to 20%, 1100 individuals should be ... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177183 Tue, 10 Feb 2009 05:00:00 +0100 2177183 http://www.medworm.com/index.php?rid=2177182&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00245.x Intravenous (i.v.) recombinant tissue plasminogen activator (rtPA) remains the only approved therapy for acute ischemic stroke. However, the use of i.v. thrombolysis is restricted to a minority of patients by the rigid 3-h time window. Modern imaging-based selection algorithms that can identify penumbra have been proposed as methods to extend the window and to select patients more likely to respond favorably or unfavorably to i.v. thrombolysis. We aim to compare the safety and efficacy of multiparametric computed tomography (CT)-based i.v. thrombolysis after 3[ndash]9 h of symptom onset with standard CT-based thrombolysis within 3 h and with CT-based thrombolysis or placebo after 3[ndash]6 h from the pooled data of the large stroke rtPA trials. The imaging-based thrombolysis trial in acute... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177182 Tue, 10 Feb 2009 05:00:00 +0100 2177182 http://www.medworm.com/index.php?rid=2177181&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00243.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177181 Tue, 10 Feb 2009 05:00:00 +0100 2177181 http://www.medworm.com/index.php?rid=2177180&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00252.x This article describes the design of the Transcranial Ultrasound in Clinical SONolysis (TUCSON) trial. TUCSON is a phase I[ndash]II, randomized, placebo-controlled, open-label, safety, dose-escalation clinical trial of [mu]S+TCD ultrasound (sonolysis). Patients with acute ischemic stroke and arterial intracranial occlusions are enrolled within 3 h of symptom onset. All patients receive standard i.v.-tPA and will be randomized to 90 min of continuous 2-MHz TCD+[mu]S or 90 min of saline+brief TCD vessel assessments. The safety profile of four escalating dose tiers will be assessed. Arterial occlusions and recanalization are defined with the Thrombolysis in Brain Ischemia flow grades. Safety is determined by the rates of symptomatic intracerebral hemorrhage within 36 h. Neurological deficits ... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177180 Tue, 10 Feb 2009 05:00:00 +0100 2177180 http://www.medworm.com/index.php?rid=2177179&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00240.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177179 Tue, 10 Feb 2009 05:00:00 +0100 2177179 http://www.medworm.com/index.php?rid=2177178&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00246.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177178 Tue, 10 Feb 2009 05:00:00 +0100 2177178 http://www.medworm.com/index.php?rid=2177177&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00244.x The development of specialized stroke units has been a landmark innovation in acute stroke care. However, the high scientific evidence level for the recommendation for stroke units to provide clinical attention for acute stroke patients does not correspond to the level of stroke unit implementation. A narrative, nonsystematic review on published studies on stroke units was conducted, with special emphasis on those demonstrating their efficacy and effectiveness. We also attempt to provide some answers to several open questions regarding practical issues of stroke units. Stroke units represent the most efficacious model for care provision compared with general ward care and stroke teams. Every stroke patient can benefit from stroke unit care. These units are efficient, cost-effective and the... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177177 Tue, 10 Feb 2009 05:00:00 +0100 2177177 http://www.medworm.com/index.php?rid=2177176&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00235.x Systematic reviews followed by a meta-analysis are carried out in medical research to combine the results of two or more related studies. Stroke trials have struggled to show beneficial effects and meta-analysis should be used more widely throughout the research process to either speed up the development of useful interventions, or halt more quickly research with hazardous or ineffective interventions. This review summarises the clinical research process and illustrates how and when systematic reviews may be used throughout the development programme. Meta-analyses should be performed after observational studies, preclinical studies in experimental stroke, and after phase I, II, and III clinical trials and phase IV clinical surveillance studies. Although meta-analyses most commonly work wit... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177176 Tue, 10 Feb 2009 05:00:00 +0100 2177176 http://www.medworm.com/index.php?rid=2177175&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00242.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177175 Tue, 10 Feb 2009 05:00:00 +0100 2177175 http://www.medworm.com/index.php?rid=2177174&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00236.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177174 Tue, 10 Feb 2009 05:00:00 +0100 2177174 http://www.medworm.com/index.php?rid=2177173&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00248.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177173 Tue, 10 Feb 2009 05:00:00 +0100 2177173 http://www.medworm.com/index.php?rid=2177172&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00239.x To evaluate the effects of minimally invasive craniopuncture therapy compared with conservative treatment in treating intracerebral hemorrhage (25[ndash]40 ml) in the basal ganglion. A multicenter, randomized control clinical trial comprised 465 cases of hemorrhage in the basal ganglion from 42 hospitals in China. Three hundred and seventy-seven patients with hemorrhage were randomly assigned to receive minimally invasive craniopuncture therapy (n=195) or conservative control treatment (n=182). The main indices of evaluation were the degree of neurological impairment at the 14th day after treatment, activities of daily living at the end of the 3rd month and the case fatality within 3 months. Improvement of neurological function in the minimally invasive craniopuncture group was significant... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177172 Tue, 10 Feb 2009 05:00:00 +0100 2177172 http://www.medworm.com/index.php?rid=2177171&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00238.x A previous hospital clinic-based study estimated that 3·5% of minor strokes are due to primary intracerebral haemorrhage, but the confidence intervals were wide. Moreover this figure may be an underestimate in older patients, who are less likely to be referred to secondary care, and who may have higher rates of intracerebral haemorrhage. Further studies are required to validate and increase the precision of this estimate and to determine any association with age, in order to plan appropriate services for minor stroke. We determined the frequency of intracerebral haemorrhage and haemorrhagic transformation of infarction in consecutive patients presenting with minor stroke (National Institute of Health Stroke Scale[le]3) in two separate cohorts: a population-based study (Oxford Vascular Stu... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177171 Tue, 10 Feb 2009 05:00:00 +0100 2177171 http://www.medworm.com/index.php?rid=2177170&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00241.x As a research community, we have failed to demonstrate that drugs that show substantial efficacy in animal models of cerebral ischemia can also improve outcome in human stroke. Accumulating evidence suggests that this may be due, at least in part, to problems in the design, conduct and reporting of animal experiments, which create a systematic bias resulting in the overstatement of neuroprotective efficacy. Here, we set out a series of measures to reduce bias in the design, conduct and reporting of animal experiments modeling human stroke. (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177170 Tue, 10 Feb 2009 05:00:00 +0100 2177170 http://www.medworm.com/index.php?rid=2177169&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2009.00247.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=2177169 Sun, 01 Feb 2009 05:00:00 +0100 2177169 http://www.medworm.com/index.php?rid=1788108&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2008.00227.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=1788108 Sat, 13 Sep 2008 09:10:45 +0100 1788108 http://www.medworm.com/index.php?rid=1788122&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2008.00219.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=1788122 Fri, 12 Sep 2008 04:00:00 +0100 1788122 http://www.medworm.com/index.php?rid=1788121&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2008.00233.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=1788121 Fri, 12 Sep 2008 04:00:00 +0100 1788121 http://www.medworm.com/index.php?rid=1788120&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2008.00216.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=1788120 Fri, 12 Sep 2008 04:00:00 +0100 1788120 http://www.medworm.com/index.php?rid=1788119&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2008.00215.x The heterogeneity of the pathology of stroke has been a major difficulty in assessing new treatments for acute stroke, and contributes to the complexity of stroke medicine. Some underlying mechanisms are poorly understood, such as small vessel (lacunar) disease. New technology such as advanced brain imaging has transformed our knowledge of large vessel disease and we suggest that other new technology such as detailed analysis of retinal vessels may provide new insights into the pathology of small vessel (lacunar) stroke disease. We hypothesise that retinal microvascular signs differ by pathological stroke subtype, and we plan to test this hypothesis in over 1000 acute stroke patients. Eligible patients undergo a standardised neurological assessment followed by digital retinal photography. ... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=1788119 Fri, 12 Sep 2008 04:00:00 +0100 1788119 http://www.medworm.com/index.php?rid=1788118&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2008.00214.x Epidemiologic literature on stroke burden, patterns of stroke is almost non existent from Pakistan. However, several hospital-based case series on the subject are available, mainly published in local medical journals. Despite the fact that true stroke incidence and prevalence of stroke in Pakistan is not known, the burden is assumed to be high because of highly prevalent stroke risk factors (hypertension, diabetes mellitus, coronary artery disease, dyslipidemia and smoking) in the community. High burden of these conventional stroke risk factors is further compounded by lack of awareness, poor compliance hence poor control, and inappropriate management/treatment practices. In addition certain risk factors like rheumatic valvular heart disease may be more prevalent in Pakistan. We reviewed t... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=1788118 Fri, 12 Sep 2008 04:00:00 +0100 1788118 http://www.medworm.com/index.php?rid=1788117&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2008.00217.x Stroke is a leading cause of morbidity and mortality worldwide, and it is likely to worsen in developing countries over the next two decades based on the projections by the World Health Organization (WHO). With the current scourge of HIV/AIDS and the battle against other communicable diseases like multi-drug resistant malaria and tuberculosis; Nigeria, the most populous black nation in the world, stands to risk the further straining of its resources as a result of the increasing prevalence of stroke and other cardiovascular diseases due to epidemiological transition. The current prevalence of stroke in Nigeria is 1·14 per 1000 while the 30-day case fatality rate is as high as 40%. Management of the disease is largely conservative while there is little or no funding for high-quality resear... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=1788117 Fri, 12 Sep 2008 04:00:00 +0100 1788117 http://www.medworm.com/index.php?rid=1788116&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2008.00218.x Stroke care in China was less developed than in western countries but great headway has been made in recent years through unremitting efforts by a group of local neurologists working in this field. (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=1788116 Fri, 12 Sep 2008 04:00:00 +0100 1788116 http://www.medworm.com/index.php?rid=1788115&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2008.00224.x Intracranial aneurysms (IAs) are the dilatations of blood vessels in the brain and pose potential risk of rupture leading to subarachnoid hemorrhage. Although the genetic basis of IAs is poorly understood, it is well-known that genetic factors play an important part in the pathogenesis of IAs. Therefore, the identifying susceptible genetic variants might lead to the understanding of the mechanism of formation and rupture of IAs and might also lead to the development of a pharmacological therapy. To elucidate the molecular pathogenesis of diseases has become a crucial step in the development of new treatment strategies. Although extensive genetic research and its potential implications for future prevention of this often fatal condition are urgently needed, efforts to elucidate the suscepti... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=1788115 Fri, 12 Sep 2008 04:00:00 +0100 1788115 http://www.medworm.com/index.php?rid=1788114&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2008.00226.x Clinical trials and observational studies provide evidence for a wide range of interventions of proven value for preventing a first or recurrent stroke. The available data indicate that strategies for primordial, primary and secondary stroke prevention are not being optimally implemented. Although specific estimates are difficult to calculate, the impact of improving the use of the wide array of effective stroke preventive interventions would be substantial. (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=1788114 Fri, 12 Sep 2008 04:00:00 +0100 1788114 http://www.medworm.com/index.php?rid=1788113&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2008.00222.x Inflammatory and immune responses play important roles following ischaemic stroke. Inflammatory responses contribute to damage and also contribute to repair. Injury to tissue triggers an immune response. This is initiated through activation of the innate immune system. In stroke there is microglial activation. This is followed by an influx of lymphocytes and macrophages into the brain, triggered by production of pro-inflammatory cytokines. This inflammatory response contributes to further tissue injury. There is also a systemic immune response to stroke, and there is a degree of immunosuppression that may contribute to the stroke patient's risk of infection. This immunosuppressive response may also be protective, with regulatory lymphocytes producing cytokines and growth factors that are n... International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=1788113 Fri, 12 Sep 2008 04:00:00 +0100 1788113 http://www.medworm.com/index.php?rid=1788112&cid=s_32221_25_f&fid=32221&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1747-4949.2008.00225.x (Source: International Journal of Stroke) International Journal of Stroke journals http://www.medworm.com/rss/comments.php?id=1788112 Fri, 12 Sep 2008 04:00:00 +0100 1788112