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Transforming Early Stroke Care Through Mobile Stroke Treatment Unit Rendezvous With Rural Emergency Medical Services.
Stroke
January 2025
Department of Neurology, College of Medicine, University of Florida, Gainesville (M.F., A.S., T.J.P., A.K.).
Background: Mobile stroke units, also sometimes called Mobile Stroke Treatment Units (MSTUs) are changing the paradigm of acute stroke care and are considered to be an extension of the time is brain concept. Of the <20 active Mobile Stroke Programs in the United States, most are rooted in urban settings. In July 2023, the first MSTU in Florida was launched in Alachua County, implementing a unique and innovative rendezvous process with rural emergency medical services (EMS).
View Article and Find Full Text PDFRipple Effects of Early Life Stress on Vascular Health.
Hypertension
January 2025
Cardio-Renal Physiology and Medicine, Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, AL (C.E.K., G.C.K., J.S.P.).
The term early life stress encompasses traumatic events occurring before the age of 18 years, such as physical abuse, verbal abuse, household dysfunctions, sexual abuse, childhood neglect, child maltreatment, and adverse childhood experiences. Adverse psychological experiences in early life are linked to enduring effects on mental and physical health in adulthood. In this review, we first describe the effects and potential mechanisms of early life stress on the components of the vasculature.
View Article and Find Full Text PDFTen-Year Trends in Last Known Well to Arrival Time in Acute Ischemic Stroke Patients: 2014 to 2023.
Stroke
January 2025
Northwell Health, New Hyde Park, NY (N.G.F., M.X.S., J.O.H., S.R.F., J.J.W., J.M.K., P.C.S.).
Background: Many national initiatives focus on promoting early hospital arrival of patients with acute ischemic stroke (AIS) because treatment effectiveness is time-dependent. However, several studies reported time-delays in hospital arrival, especially during the COVID-19 pandemic. Our purpose was to evaluate the 10-year trends in last known well to arrival (LKWA) time and assess disparities in patients with AIS.
View Article and Find Full Text PDFUltra-Early Hematoma Expansion Is Associated With Ongoing Hematoma Growth and Poor Functional Outcome.
Stroke
January 2025
Departments of Medicine and Neurology, Melbourne Brain Centre @ The Royal Melbourne Hospital, University of Melbourne, AUSTRALIA.
There is limited data on ultra-early hematoma growth dynamics and its clinical relevance in primary intracerebral hemorrhage (ICH). We aimed to estimate the incidence of hematoma expansion (HE) within the hyperacute period of ICH, describe hematoma dynamics over time, investigate the associations between ultra-early HE and clinical outcomes after ICH, and assess the effect of tranexamic acid on ultra-early HE. We performed a planned secondary analysis of the STOP-MSU international multicenter randomized controlled trial.
View Article and Find Full Text PDFTransfusion in trauma: empiric or guided therapy?
Res Pract Thromb Haemost
January 2025
Oxford Haemophilia and Thrombosis Centre, Department of Haematology, Oxford University Hospitals National Health Service Foundation Trust, Nuffield Orthopaedic Centre, Oxford, UK.
A state of the art lecture titled "Transfusion therapy in trauma-what to give? Empiric vs guided" was presented at the International Society on Thrombosis and Haemostasis Congress in 2024. Uncontrolled bleeding is the commonest preventable cause of death after traumatic injury. Hemostatic resuscitation is the foundation of contemporary transfusion practice for traumatic bleeding and has 2 main aims: to immediately support the circulating blood volume and to treat/prevent the associated trauma-induced coagulopathy.
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