1,721,122 research outputs found
Hirnschlag: Akutbehandlung und Sekundärprophylaxe
No full textWelches sind die wichtigsten Massnahmen der Sekundärprophylaxe nach
einem Stroke? Was bringt eine intensive Nachbetreuung? Und warum ist
es so wichtig, dass Patienten mit Verdacht auf einen Hirnschlag möglichst rasch
ins Spital gelangen? Antworten auf diese Fragen lieferten am Symposium
«Neurologie für praktizierende Ärzte» PD Dr. med. Mirjam R. Heldner und
Prof. Dr. med. Simon Jung vom Inselspital Bern
Reader response: Optimizing in-hospital triage for large vessel occlusion using a novel clinical scale (GAI2AA).
No full textRecommended from our members
Cerebral venous sinus thrombosis associated with cancer: analysis of the ACTION-CVT study.
Full text linkNearly one fifth of patients with venous thromboembolism (VTE) have cancer. When both of these conditions occur, especially in cases of cerebral vein thrombosis (CVT), patient management is often challenging. The aim of this study was to compare the characteristics and event courses in patients affected by CVT with and without cancer. Consecutive patients with CVT from the ACTION-CVT cohort study were included if cancer status was reported. Risk factors as well as the clinical and radiological characteristics of patients were compared. Univariable and multivariable analyses were performed to assess variables associated with cancer. Kaplan-Meier method and log-rank test, logistic regression analysis, and propensity score matching were used to investigate any association between cancer-related CVT and study outcomes (primary outcome at 3-months: recurrent VTE or major hemorrhage; recurrent VTE; major hemorrhage; recanalization status; all-cause-death). Overall, 1,023 patients with CVT were included, of which 6.5% had cancer. Older age (adjusted odds ratio [aOR] 1.28 per decade increase; 95% confidence interval [CI] 1.08-1.52) and absence of headache (aOR 0.47; 95% CI 0.27-0.84) were independently associated with cancer. Patients with cancer had a higher risk of recurrent VTE or major hemorrhage (aOR 3.87; 95% CI 2.09-7.16), all-cause-death (aOR 7.56 95% CI 3.24-17.64), and major hemorrhage (aOR 3.70 95% CI 1.76-7.80). Recanalization rates, partial or complete, was not significantly different. CVT patients with cancer were more likely to be older, have no referred headache, and have worse outcomes compared to CVT patients without cancer
Reader Response: Thrombectomy vs Medical Management in Low NIHSS Acute Anterior Circulation Stroke.
No full textVascular Events, Vascular Disease and Vascular Risk Factors-Strongly Intertwined with COVID-19.
Full text linkPurpose of review
To elucidate the intertwining of vascular events, vascular disease and vascular risk factors and COVID-19.
Recent findings
Strokes are a leading cause of disability and death worldwide. Vascular risk factors are important drivers of strokes. There are unmodifiable vascular risk factors such as age and ethnicity and modifiable vascular risk factors. According to the INTERSTROKE study, the 10 most frequent modifiable vascular risk factors are arterial hypertension, physical inactivity, overweight, dyslipidaemia, smoking, unhealthy diet, cardiac pathologies, diabetes mellitus, stress/depression and overconsumption of alcohol. Also, infection and inflammation have been shown to increase the risk of stroke. There is high-quality evidence for the clinical benefits of optimal primary and secondary stroke prevention. The COVID-19 pandemic brought a new perspective to this field. Vascular events, vascular disease and vascular risk factors-and COVID-19-are strongly intertwined. An increased risk of vascular events-by multifactorial mechanisms-has been observed in COVID-19 patients. Also, a higher rate of infection with COVID-19, severe COVID-19 and bad outcome has been demonstrated in patients with pre-existing vascular disease and vascular risk factors.
Summary
At present, we suggest that regular interactions between healthcare professionals and patients should include education on COVID-19 and on primary and secondary vascular prevention in order to reduce the burden of disease in our ageing populations
Letter by Scutelnic et al Regarding Article, "Acute Neurological Deterioration in Large Vessel Occlusions and Mild Symptoms Managed Medically".
No full text
- …
