Background: Prognosis after intracerebral hemorrhage (ICH) is poor and care-limiting decisions may worsen outcomes.
Aims: To determine whether in current UK stroke practice, key acute care decisions are associated with stroke subtype (ICH/ischemic) and whether these decisions are independently associated with survival.
Methods: We extracted data describing all stroke patients included in a UK quality register between 1 April 2013 and 31 March 2014. Key care decisions in our analyses were transfer to higher level care on admission and palliation in the first 72 h. We used multivariable regression models to test for associations between stroke subtype (ICH/ischemic), key care decisions, and survival.
Results: A total of 65,818 patients were included in the final analysis. After ICH (n = 7020/65,818, 10.7%), 10.5% were palliated on the day of admission and 19.3% by 72 h (vs. 0.7% and 3.3% for ischemic stroke). Although a greater proportion were admitted directly to higher level care after ICH (3.7% vs. 1.5% for ischemic stroke), ICH was not independently associated with the decision to admit to higher level care (adjusted odds ratio (OR): 1.12, 95% confidence interval (95%CI): 0.95-1.31, p = 0.183). However, ICH was strongly associated with the decision to commence palliative care on the day of admission (OR: 7.27, 95%CI: 6.31-8.37, p < 0.001). Palliative care was independently associated with risk of death by 30 days regardless of stroke subtype.
Conclusions: When compared to ischemic stroke, patients with ICH are much more likely to commence palliative care during the first 72 h of their care, independent of level of consciousness, age, and premorbid health.
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http://dx.doi.org/10.1177/1747493015620806 | DOI Listing |
J Glob Health
December 2024
Hunan Key Laboratory of Molecular Epidemiology, School of Medicine, Hunan Normal University, Changsha, Hu Nan, China.
Background: Since 2019, China has implemented Public Health and Social Measures (PHSMs) to manage the coronavirus disease 2019 (COVID-19) outbreak. As the threat from SARS-CoV-2 diminished, these measures were relaxed, leading to increased respiratory infections and strained health care resources by mid-2023.
Methods: The study utilised WHO's FluNet and Oxford's COVID-19 Government Response Tracker to assess how policy shifts have affected influenza.
Pain Rep
February 2025
Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russia.
Introduction: Back pain (BP) is a complex heritable trait with an estimated heritability of 40% to 60%. Less than half of this can be explained by known genetic variants identified in genome-wide association studies.
Objectives: We applied a powerful multi-trait and gene-based approach to association analysis of BP to identify novel genes associated with BP.
Pain Rep
February 2025
German Paediatric Pain Centre, Children's and Adolescents' Hospital Datteln, Datteln, Germany.
Introduction: Intensive interdisciplinary pain treatment (IIPT) is the best therapy available for children and adolescents affected by severe chronic pain. Psychosocial aftercare (PAC) offered for 6 months after IIPT can improve treatment outcomes for up to 12 months.
Objectives: The current study is the first to explore whether PAC is superior to treatment as usual at a long-term follow-up of 18 to 33 months after discharge-including when facing the coronavirus disease 2019 (COVID-19) pandemic.
Front Neurosci
December 2024
Department of Neurology, Center for Translational Neuro-and Behavioral Sciences (C-TNBS), University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Background: This study explored the potential of electrogastrography (EGG) and heart rate variability (HRV) as psychophysiological markers in experimental pain research related to the gut-brain axis. We investigated responses to the experience of pain from the visceral (rectal distension) and somatic (cutaneous heat) pain modalities, with a focus on elucidating sex differences in EGG and HRV responses.
Methods: In a sample of healthy volunteers (29 males, 43 females), EGG and ECG data were collected during a baseline and a pain phase.
Front Allergy
December 2024
Department of Otorhinolarynogology and Head/Neck Surgery, Amsterdam University Medical Centres, Location AMC, University of Amsterdam, Amsterdam, Netherlands.
The European Forum for Research and Education in Allergy and Airways diseases (EUFOREA) organized the first European Biologic Training Course (EBTC) in Brussels on 1st March 2024. The aim of this hybrid EBTC including both face-to-face and web-based participation was to address the educational needs of physicians dealing with asthma and Chronic Rhinosinusitis with Nasal Polyps (CRSwNP) on the clinically relevant aspects of diagnosing and treatment with biologics. EUFOREA is an international non-for-profit organization forming an alliance of all stakeholders dedicated to reducing the prevalence and burden of chronic respiratory diseases through the implementation of optimal patient care via educational, research, and advocacy activities.
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