Stroke; a journal of cerebral circulation
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Comparative Study
Accuracy of emergency medical services-reported last known normal times in patients suspected with acute stroke.
The last known normal (LKN) time is a critical determinant of IV tissue-type plasminogen activator (IV tPA) eligibility; however, the accuracy of emergency medical services (EMS)-reported LKN times is unknown. We determined the congruence between neurologist-determined and EMS-reported LKN times and identified predictors of incongruent LKN times. ⋯ EMS-reported LKN times were largely congruent with neurologist-determined times. Focused EMS training regarding wake-up stroke symptoms may further improve accuracy.
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Clinical Trial
Incident stroke is associated with common carotid artery diameter and not common carotid artery intima-media thickness.
The common carotid artery interadventitial diameter is measured on ultrasound images as the distance between the media-adventitia interfaces of the near and far walls. It is associated with common carotid intima-media thickness (IMT) and left ventricular mass and might therefore also have an association with incident stroke. ⋯ http://www.clinicaltrials.gov. Unique identifier: NCT00063440.
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The benefits of intravenous tissue-type plasminogen activator in acute ischemic stroke are time dependent, and several strategies have been reported to be associated with more rapid door-to-needle (DTN) times. However, the extent to which hospitals are using these strategies and their association with DTN times have not been well studied. ⋯ Although the majority of participating hospitals reported using some strategy to reduce delays in tissue-type plasminogen activator administration for acute ischemic stroke, the strategies applied vary considerably and those most strongly associated with shorter DTN times were applied relatively less frequently.
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Acute renal failure (ARF) in setting of acute ischemic stroke (AIS) is associated with worse outcome. We sought to determine the prevalence of ARF and effect on outcomes of patients with AIS. ⋯ ARF in patients with AIS is associated with significantly higher rates of moderate to severe disability at discharge and in-hospital mortality.
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Optimizing prehospital stroke care is important because effective treatments for acute stroke require a narrow therapeutic time window. We developed a smartphone-assisted prehospital medical information system (SPMIS) to facilitate research on prehospital stroke care. ⋯ SPMIS enabled us to analyze the prehospital information of patients with stroke in a short time with little effort. More large-scale studies on prehospital stroke care will become feasible using SPMIS, which may lead to advances in stroke treatment.