Stroke; a journal of cerebral circulation
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Review Meta Analysis
Delirium in acute stroke: a systematic review and meta-analysis.
Delirium is common in the early stage after hospitalization for an acute stroke. We conducted a systematic review and meta-analysis to evaluate the outcomes of acute stroke patients with delirium. ⋯ Stroke patients with development of delirium have unfavorable outcomes, particularly higher mortality, longer hospitalizations, and a greater degree of dependence after discharge. Early recognition and prevention of delirium may improve outcomes in stroke patients.
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Comparative Study
ACTIVLIM-Stroke: a crosscultural Rasch-built scale of activity limitations in patients with stroke.
This study describes the development of a Rasch-built scale measuring activity limitations in stroke patients, named ACTIVLIM-Stroke. ⋯ The ACTIVLIM-Stroke questionnaire has good psychometric qualities and provides accurate measures of activity limitations in patients with stroke. It is recommended for evaluating clinical and research interventions in patients with stroke, because it provides a higher discrimination and might be more sensitive to change.
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Netrin-1 (NT-1) stimulates endothelial cell proliferation and migration in vitro and promotes focal neovascularization in the adult brain in vivo. This in vivo study in mice investigated the effect of NT-1 hyperexpression on focal angiogenesis and long-term functional outcome after transient middle cerebral artery occlusion (tMCAO). ⋯ AAV-NT-1 induced NT-1 hyperexpression before tMCAO reduced infarct size, enhanced neovascularization, and improved long-term functional recovery.
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Review Meta Analysis
Patent foramen ovale closure and medical treatments for secondary stroke prevention: a systematic review of observational and randomized evidence.
Patients discovered to have a patent foramen ovale in the setting of a cryptogenic stroke may be treated with percutaneous closure, antiplatelet therapy, or anticoagulants. A recent randomized trial (CLOSURE I) did not detect any benefit of closure over medical treatment alone; the optimal medical therapy is also unknown. We synthesized the available evidence on secondary stroke prevention in patients with patent foramen ovale and cryptogenic stroke. ⋯ Although further randomized trial data are needed to precisely determine the effects of closure on stroke recurrence, the results of CLOSURE I challenge the credibility of a substantial body of observational evidence strongly favoring mechanical closure over medical therapy.