Medicine and Health Sciences Commons^™

New Technologies For Detection And Management Of Atrial Fibrillation, Adel K. Hamad

Journal of the Saudi Heart Association

Atrial fibrillation (AF) is a common and prevalent form of arrhythmia. It is associated with various morbidities with stroke being the major hazard. Since AF is often reported to be asymptomatic, many individuals remain unaware of their condition and may not receive the requisite treatment. Hence, screening for AF has gained substantial attention recently. Growing advancement in technology has paved way for numerous approaches for AF screening using medical-prescribed devices as well as consumer electronic devices. However, there still lies scope for large-scale randomized trials which would explore additional aspects associated with AF. This review very concisely summarizes AF, screening, …

Association Between Stroke Health Literacy And Insurance With Stroke Severity And Post-Stroke Depression, Callista Clairmont, Amelia Adcock, Lea Colantonio

Mountaineer Undergraduate Research Review

Health literacy and insurance are important aspects of healthcare, yet few studies assess the roles that each play in relation to strokes. The purpose of this study is to better understand the relationship that stroke health literacy and insurance coverage have on the development of post-stroke outcomes such as post-stroke depression and stroke severity. In this study, 47 patients receiving inpatient care for acute ischemic stroke were given a modified version of the Stroke Knowledge Test in order to assess their understanding of strokes. Stroke severity and depression levels were also measured using the National Institute of Health Stroke Scale …

A Qualitative Study Investigating Stroke Survivors’ Perceptions Of Their Psychosocial Needs Being Met During Rehabilitation, Robin A. Wenzel, Emily A. Zgoda, Mia C. St. Clair, Lisa J. Knecht-Sabres

The Open Journal of Occupational Therapy

Background: Depression and anxiety can negatively impact one’s recovery, outcomes, and quality of life. Even though therapists consider the mental health needs of their clients to be a priority, they are dissatisfied with their ability to completely address these needs. The purpose of this study was to examine the client’s perspective regarding the extent to which health care professionals addressed their psychosocial needs after a stroke.

Method: A phenomenological research design was used to collect data from six participants. Interviews and focus group were audiotaped, transcribed verbatim, and thematically analyzed. Member checks, peer-review, multiple coders, triangulation, and expert …

The Management Of Asymptomatic Carotid Stenosis: Is There A Benefit To Operate Elderly Patients?, Mohamed Nadjib Bouayed

Translational Medicine @ UniSa

We present a retrospective study of a series of 40 patients over the age of 75 operated for an asymptomatic carotid stenosis. The results were evaluated during an average of 3 years of follow-up. Material and method. The study is retrospective and monocentric. The series includes 40 patients aged over 75 years and with an average age of 78.5 years (range 75-82). Patients underwent surgery for an asymptomatic carotid stenosis of more than 80%. The technique in all case was a carotid endarterectomy. Results. There have been no postoperative deaths or neurological adverse events. During an average follow-up of 3 …

Effect Of Decompressive Hemicraniectomy In Patients With Acute Middle Cerebral Arteryinfarction, Hali̇l İbrahi̇m Süner, Anil Tanburoğlu, Emre Durdağ, Soner Çi̇vi̇, Ayli̇n Güneşli̇ Yeti̇şken, Özgür Kardeş, Çağatay Andi̇ç, Kadi̇r Tufan

Turkish Journal of Medical Sciences

Background/aim: We aimed to determine in which cases this procedure may be more effective based on the data of patients who underwent decompressive hemicraniectomy (DHC). Material and methods: Overall, 47 patients who underwent DHC due to acute middle cerebral artery (MCA) infarction between January 2014 and january 2019 were retrospectively investigated. These patients were divided into two groups: those who died after DHC (Group A) and those who survived DHC (Group B). The groups were compared in terms of various parameters. We investigated whether the patient's modified Rankin scale (mRS) status changed depending on age (> 60 and < 60 years). Results: The median age of all patients was 65 (37-80) years; groups A and B had median ages of 66.5 (37-80) and 61 (44-79) years (p = 0.111), respectively; 55.3% patients were male. The elapsed times until hospitalization after the onset of symptoms were 4.5 and 3 h in groups A and B, respectively (p = 0.014). The median GCS score at the time of admission was 7 (5-12) and 10 (8-14) in groups A and B, respectively (p = 0.0001). At the time of admission, 63.3% patients in group A had anisocoria, whereas no patient in group B had anisocoria (p = 0.0001). In postoperative period, 40% patients in group A and all patients in group B received AC/AA treatment. The survival of patients aged < 60 and > 60 years …

High Frequency Repetitive Transcranial Magnetic Stimulation Versus Sertraline In Treatment Of Poststroke Depression: A Pilot Study, Pim Terachinda, Anuphan Tantanatip, Krisna Piravej, Sookjareon Tangwongchai, Sunisa Srioum, Thipwimon Sillapachai, Pisamai Hongsachat, Yuda Chongpison

Chulalongkorn Medical Journal

Background: Poststroke depression (PSD) has impact on rehabilitation outcome. Repetitive transcranial magnetic stimulation (rTMS) has been proven as a treatment of depression and might reduce depressive symptoms after stroke.Objectives: To determine the effects of high frequency rTMS in treatment of PSD compared to sertraline. We also investigated the effects of rTMS combined with sertraline.Methods: Fourteen patients with PSD were randomly allocated into 3 groups: 1) the rTMS group received 10 sessions of 10 Hz rTMS; 2) the sertraline group obtained sertraline 50 mg daily and sham rTMS; and, 3) the combined group received 10 Hz rTMS combined with sertraline 50 …

A Systematic Reviewarticle On Discharge Destinations For Patients With Stroke, Lin-Fu Lee, Wen-Chih Lin, Willy Chou

Rehabilitation Practice and Science

Introduction: Complex and diverse factors affect the placement of patients with stroke after they are discharged from hospitals. In this study, a systematic reviewarticle of relevant literature was performed to compile related research data and explore the importance of individuals factors and the overall predictive power of multiple variables. Methods: Electronic resources from PubMed and the Cochrane Library were used along with keywords such as ＂stroke＂ and ＂discharge destination＂ to search for relevant articles published between 2005 and 2018. Only original research articles written in English were selected. Results: A total of 19 articles were selected to compile 10 factors, …

Effects Of An Anterior Ankle-Foot Orthosis On Static Standing Balance Control In Patients With Chronic Stroke Wearing The Orthosis For A Long Time, Min-Yuan Yu, Yu-Hsuan Tseng, Po-Chih Chen, Jen-Wen Hung

Rehabilitation Practice and Science

Aims: To investigate the effects of anterior ankle-foot orthosis (A-AFO) on static standing postural control in patients with chronic stroke wearing the A-AFO for a long time. Methods: We recruited patients with chronic stroke wearing an A-AFO for at least 5 months. Static standing balance control was evaluated using the Tetrax Balance System in eight positions: (1) eyes open on a solid surface [NO];(2) eyes closed on a solid surface [NC];(3) eyes open on a foam surface [PO];(4) eyes closed on a foam surface [PC];and head turned at 30° to (5) right [HR], (6) left [HL], (7) up [HB], and …

Kienböck's Disease In A Patient With Hemiparetic Stroke: A Casereport, Pao-Sheng Wu, Yen-Ting Cho

Rehabilitation Practice and Science

Kienböck's disease of the wrist is a multifactorial, progressive osteonecrosis of the lunate bone. Patients with this disease often complain of dorsal wrist pain and other wrist dysfunctions. Image studies are usually required for definite diagnosis; however, careful history taking and physical examination are also necessary. Treatment varies according to the stage of the disease; although surgery is needed in most of the cases, rehabilitation after the surgery seems helpful as well. Kienböck's disease is rarely seen in our daily practice, and even though we do recognize the disease, diagnosing it correctly in patients with comorbidities such as stroke is …

Acute Ischemic Stroke As The Presenting Feature Of Covid-19 In The Young And Pregnant, Nermila A. Ballmick, Jiri F. Kubac, Hossein Akhondi

HCA Healthcare Journal of Medicine

Introduction: Coronavirus disease (COVID-19) is an emerging and rapidly evolving public health issue that has become globally widespread and an overwhelming pandemic. Clinical manifestations of the disease include asymptomatic carrier states, acute respiratory distress syndrome, and even multiorgan dysfunction. Here, we present a unique and rare case of an acute ischemic stroke (AIS) in an asymptomatic pregnant woman with no predisposing medical illnesses.

Discussion: An 18-year-old G2P1 African American woman at 7 weeks gestational age with no significant medical or family history presenting to the Emergency Department during the initial phases of the pandemic with complaints of new onset left …

Neutrophils-To-Lymphocyte Ratio In Acute Ischemic Stroke Patients, Eman S. Matar, Gelan M. M. Ali, Ibrahim E. Alahmar, Wafeek M. Elsheik

Menoufia Medical Journal

Objective The aim of this study was to evaluate the neutrophils-to-lymphocyte ratio (NLR) among patients with ischemic stroke and to determine the relationship between NLR and poststroke prognosis Background Inflammations play a role in the pathogenesis of cerebral infarction. Cytokines and adhesion molecules regulate the increased migration of leukocytes to the brain. Neutrophils are the first type of leukocytes to infiltrate ischemic brain (30 min of cerebral ischemia), peak earlier (days 1–3), and then decrease rapidly with time. Lymphocyte recruitment into the brain is involved in the later stages of ischemic brain injury. Patients and methods A retrospective study was …

Paroxysmal Nocturnal Hemoglobinuria: Pandora’S Box?, Mihnea Alexandru Găman, Iulia Ursuleac, Daniel Coriu

Journal of Mind and Medical Sciences

Introduction. Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired non-malignant hematological disorder which affects the pluripotent hematopoietic stem cell. The cause of PNH development is the occurrence of somatic mutations in the phosphatidylinositol glycan-A gene which encodes a protein necessary for the biosynthesis of glycosylphosphatidylinositol anchors. The diagnosis of PNH requires the presence of signs of intravascular hemolysis, thrombosis, and (or) bone marrow failure. Case Report. We report the case of a 42-year-old female, diagnosed with PNH at the age of 27, whose evolution was initially characterized predominantly by hemolytic attacks and whose disease pattern evolved towards thromboembolic episodes …

Physical Activity Interventions For Older Adults: Efficacy, Adherence And Sustainability For Stroke Prevention Outcomes, Agnieszka Suminski

DePaul Discoveries

Objective: To examine outcomes of older adults who participate in physical activity intervention programs, whether there is a significant difference in group and individual based physical activity interventions, and assess promise of older adult behavior change post-intervention. Methods: Literature review using seventeen previously published data on physical activity intervention programs for older adults. Results: Studies suggest that physical activity program intervention for older adults show improved physical and mental outcomes. Group-based interventions are more successful for program adherence. Discussion: Family and social support play a significant role in participant adherence to program physical adherence interventions, as well as sustained …

Stroke Management In The Time Of Covid, Marwa Elnazeir, Siddharth Narayanan, Kerri Remmel

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Ecg For All Patients In The Pacu: Some Say, Why? I Say, Why Not?, Paula Foran

Journal of Perioperative Nursing

Currently in many Australian hospitals, electrocardiogram (ECG) leads are removed after the operative process and, despite the machines being freely available in the Post Anaesthesia Care Unit (PACU), they are not connected to all patients.

There are many evidence-based reasons why an ECG would be advantageous for perioperative patient safety, including the detection of often asymptomatic conditions such as myocardial injury after non-cardiac surgery (MINS) and new-onset atrial fibrillation, which has been shown to increase the risk of stroke. Advantages may also be seen in saving precious minutes in a cardiac arrest, and the ability for nurses to constantly observe …

Assessing Unmet Needs Of Caregivers After Stroke: Occupational Therapist Practices And Perspectives, Deborah R. Clymer, Hadley A. Fields, Kathy Kniepmann

The Open Journal of Occupational Therapy

Background: Family caregivers of stroke survivors often feel unprepared and overwhelmed post discharge with numerous unmet needs. Occupational therapists can play an integral role in addressing family caregivers’ needs. Limited research exists on assessment practices of occupational therapists in identifying caregivers’ needs poststroke. This study explores the practices and perspectives of occupational therapists in assessing unmet caregivers’ needs.

Method: A cross-sectional, mixed methods research design was used to electronically survey 15 occupational therapists. Part 1 of the survey explored participant methods for identifying caregivers’ needs and their views on using formal caregiver assessment tools. Part 2 gathered participant perspectives on …

Accessing Young Black Stroke Survivors For Secondary Prevention, Mellanie V. Springer, James F. Burke, Devin L. Brown, Lesli E. Skolarus

Journal of Health Disparities Research and Practice

ABSTRACT

Background- Stroke rates and risk factors may be increasing in young adults aged 18-64, especially black individuals. We sought to identify whether young high risk stroke survivors could be found at community health centers.

Methods- This was a cross-sectional analysis of the National Ambulatory Medical Care Survey from 2006-2011. We used chi-square analyses, t-tests, and proportions to compare and describe stroke survivor visits at community health centers and private offices.

Results- Young stroke survivor visits comprise 48% of stroke survivor visits at community health centers compared to 31% of stroke survivor visits at the private office setting. Among young …

Low Dose Aspirin Use For Primary Cardiovascular Prevention Among Lebanese Population, Walid Maassarani, A. El Mallah, Thuraya Domyati

BAU Journal - Health and Wellbeing

In spite of the controversies regarding low-dose aspirin safety and efficacy, aspirin is widely used by individuals for the primary prevention of myocardial infarction and ischemic stroke. This study assess the appropriateness of low dose aspirin use in a sample of Lebanese population. A cross sectional study was conducted using a community based questionnaire to assess each patient’s risk factors for Myocardial Infarction and ischemic stroke and possible contraindications for aspirin use. WHO risk score was used to calculate the cardiovascular risk of patients and determine the appropriateness of aspirin use for the primary prevention of cardiovascular diseases accordingly. Data …

Silent Cerebral Infarct In Sickle Cell Anemia Patients Of Southern Turkey, Ezgi̇ Nafi̇le Sayman, Göksel Leblebi̇satan, Şeri̇fe Leblebi̇satan, Yunus Kenan Biçakci, Yurdanur Kilinç, Adnan Barutçu

Turkish Journal of Medical Sciences

Background/aim: Silent cerebral infarct (SCI) is an ischemic lesion seen before clinical signs of brain infarct and ischemic changes in brain tissue. This study aimed to detect SCI with noninvasive methods and to determine related risk factors in patients with sickle cell anemia (SCA). Materials and methods: Fifty-four SCA patients who had no history of cerebral infarct and whose neurological examinations were normal were included in this study. Brain magnetic resonance imaging (MRI) and diffusion MRI were taken and the acquired data was compared statistically. Results: SCI was detected in 11.1% (6/54) of the patients. No statistical differences in age, …

Peripheral Axonal Excitability In Hemiplegia Related To Subacute Stroke, Zeynep Turan, Murat Zi̇nnuroğlu

Turkish Journal of Medical Sciences

Background/aim: This study aims to investigate peripheral nerve excitability in patients with subacute stroke. Materials and methods: The study was performed in 29 stroke patients within the subacute period and 29 healthy controls using QTRAC software and TRONDNF protocol. The threshold electrotonus, recovery cycle, stimulus-response, strength-duration, and current-threshold relationships were recorded. Results: The membrane was more hyperpolarized, and excitability was decreased in the hemiplegic side. The impairment of inward rectifying channel function, degree of hyperpolarization, and decrease of excitability were directly related to the Brunnstrom stages, which were more pronounced in lower stages. Conclusion: The lower motor neurons were affected …

An Exploration Of Quality Of Life Contributors For Stroke Survivors: Potential Implications For Service Delivery Within The Community Rehabilitation Context, Gaylea Fritsch, Sarah Patterson, Anita Blight, Renaye Daniells

Internet Journal of Allied Health Sciences and Practice

Purpose: Community rehabilitation services typically assist stroke survivors with function, participation, and quality of life. Many factors have been found to influence the overall quality of life including self-identity, control, social supports, personality, and participation in valued activities. This review explored the possible contributing quality of life factors for stroke survivors within a community rehabilitation context to assist with further development of service delivery within this clinical area. Method: A purposive sample of clients with stroke (n=20) was selected based on their overall quality of life change during their rehabilitation program as measured on the World Health Organisation Quality of …

Facilitating Upper Limb Function Using Assistive Technology In A Neurological Patient With Bilateral Upper Limb Impairment: A Case Report, Shelley Fulton, Laura Wilkinson, Kathy Stiller

Internet Journal of Allied Health Sciences and Practice

Purpose: A combination of a stroke and spinal cord injury adversely affecting both upper limbs is an unusual combination for a patient presenting for outpatient rehabilitation services. Although the management of these conditions in isolation is well documented, there is limited literature regarding rehabilitation for these conditions in combination, particularly the use of assistive technology in this setting. Methods: A case report is presented of a 53-year-old male referred for outpatient rehabilitation following a left-sided stroke, with resultant dense right sided hemiplegia. A pre-existing spinal cord injury had affected his left upper limb such that he had marked proximal weakness. …

The Utility And Value Of The Physiotherapy Eskills Training Online Resource During Work-Integrated Learning: A Mixed Methods Study., Elisabeth Preston, Cathy Chapple, Elizabeth Mayland, Louise Ada, Leigh Hale

Internet Journal of Allied Health Sciences and Practice

ABSTRACT

Purpose: The purpose of this study was to determine the use and value of the Physiotherapy eSkills Training Online resource during work-integrated learning in naïve physiotherapy students. Method: A mixed methods study design was used. Participants: Forty-four final year physiotherapy students participating in neurological work-integrated learning units of study participated in this study. Intervention: Students had access to the Physiotherapy eSkills Training Online resource during their 6-week neurological work-integrated learning unit of study, which includes video footage and written information about 25 practical skills related to the physiotherapy management of stroke. Outcome Measures: Use of the …

Effect Of Graded Repetitive Arm Supplementary Programme (Grasp) On Upper Limb Function Among Stroke Patients, Priyanka Noble Ms, Sindhu L Ms

Manipal Journal of Nursing and Health Sciences

Introduction: Stroke is the rapid loss of brain function due to disturbance in the blood supply to the brain. More than 70 % of individuals who have a stroke experience upper limb deficits that impact daily activities. The objective of this study was to evaluate the effect of GRASP on upper limb function among patients with stroke. Methods: It was a quasi-intervention pretest-posttest control group design. The sample consisted of 61 patients with stroke, 31 in the intervention and 30 in the control group attending the outpatient Department of Neurology, Medical College Hospital, Thiruvananthapuram. The upper limb function of patients …

Determinants Of Stroke Inpatient Charge In Chronic Rehabilitation Wards Of A Community Hospital In Taiwan, Allen C.L. Hsu, Miao-Ming Chen, Chih-Kuang Chen

Rehabilitation Practice and Science

Stroke is a disease with severe consequences which impose a considerable socio-economic burden on patients and society. In developed countries, stroke patients alone generate about 3-4% of the direct costs within the healthcare system. The costs of rehabilitation and long-term care of disabled stroke survivors are expected to rise even further because of the increasing number of the aging population and declining stroke case-fatality rates. The aims of the paper are to evaluate the factors that may influence costs of stroke patients in chronic rehabilitation wards for better management of medical resources. This study was conducted at a local general …

A Focal Survey Of Medical Professionals' Conceptions Of Gastrostomy In Patients With Dysphagia After Stroke In Taiwan, Sheng-Hao Cheng, Yi-Ching Chen, Ming-Yen Hsiao, Tyng-Guey Wang

Rehabilitation Practice and Science

Background and aims: People with dysphagia may require long-term tube feeding to maintain adequate nutrition. In Taiwan, nasogastric (NG) tubes are more commonly used than gastrostomy tubes. This practice is inconsistent with international treatment guidelines. Medical professionals' attitudes toward treatment may influence patients' decisions. Therefore, we designed a questionnaire to assess whether medical professionals' conceptions of gastrostomy are consistent with current international treatment principles. Methods: We used an online questionnaire hosted on ＂Google Forms＂ to collect medical professionals' conceptions of gastrostomy. Societies related to dysphagia distributed copies of the questionnaire to their members. The professionals included specialists (physiatrists, otolaryngologists, oral …

Is Vertical Orientation Ability And Visual Feedback Training Strategy Useful For Pusher Syndrome After Stroke: A System Reviewarticle, Chien-Hsun Lee

Rehabilitation Practice and Science

Stroke patients with pusher syndrome (PS) have a longer recovery time than those without this disorder. This special syndrome causes difficulty in maintaining balance when sitting or standing, with sufferers ＂pushing and leaning＂ automatically to hemi-side. PS patients may also have cognition impairment, hemi-neglect, or aphasia. Alleviating all these factors requires extensive training for therapists, however, few undergo such training. Wang et. al. published a reviewarticle article in Taiwan Journal of Physical Medicine and Rehabilitation in 2005, and the conclusions drawn were: 1) PS patients have abnormal subjective posture and vertical orientation ability; 2) training strategies that use visual feedback …

Cytokine Registry Database Of Stroke Patients (Crisp), Atif Zafar, Fares Qeadan, Asad Ikram, Mudassir Farooqui, Sajid Suriya, Surojit Paul

Journal of Health Disparities Research and Practice

Purpose/Background: The aim of the study is to identify molecular biomarkers involve in patients who present with stroke and to determine their clinical usefulness as potential biomarkers in stroke patients as compared to patients without stroke.

Materials & Methods: All patients presenting with ischemic stroke and hemorrhagic stroke at University of New Mexico Hospital (UNMH) will be screened for potential participation in this study based on following inclusion and exclusion criteria:

Inclusion criteria: male/female of ages ≥ 18 years, patients whose standard stroke admission order sets are obtained for clinical care.

Exclusion criteria: Patients <18 year, with the history of prior stroke or any neurodegenerative or neuroinflammatory disease except multiple sclerosis (MS), pregnant women and prisoners.

Cytokines will be measured in serum …

Comparison Of Long-Term Oral Anticoagulation Therapies Including Newly Approved Reversal Agent For Dabigatran, Mackenzie Devine, Natalie Lennartz, Michaela Wolford, Rebecca Worden, Joelle Farano, Erin Petersen

Pharmacy and Wellness Review

Anticoagulants are a well-known class of agents essential for the prevention of blood clots, which may further develop into deep vein thrombosis, pulmonary embolism or stroke. Individuals at a high risk of clotting, such as those with atrial fibrillation, multiple risk factors or recent hip/knee surgery, are in need of long-term anticoagulation therapy. The purpose of this review is to highlight the pros and cons for each available anticoagulant as well as discuss pivotal clinical trials that evaluated the safety and efficacy of these agents. Warfarin, the oldest anticoagulant, requires the patient to attend frequent appointments with a health care …

Use Of Standardized Assessments And Online Resources In Stroke Rehabilitation, Susan H. Lin, Pamela R. Bosch, Veronica T. Rowe, Susan E. Fasoli, Jeanne Langan

The Open Journal of Occupational Therapy

Background: The extent to which movement-related standardized assessments and online resources are used in stroke rehabilitation is unclear in the United States.

Method: The researchers used a cross-sectional descriptive survey that examined (a) therapists use of movement-related standardized assessments, (b) factors influencing learning of new assessments, and (c) use of frequency of online resources by occupational therapists and physical therapists in the United States.

Results: Of 151 respondents (46.4% occupational therapists, 53.6% physical therapists), the most frequently used movement-related assessments by occupational and physical therapists were the Berg and Fugl-Meyer Assessment, respectively. More physical therapists use motor-related …