Despite all efforts that have been made stroke is a burden and remains one of the most devastating neurological diseases. Treatment of patients on a Stroke Unit improves stroke prognosis and is recommended for all patients with acute stroke. In rural areas population-wide implementation of Stroke Units is extremely challenging. Therefore the Telemedical Project for integrated Stroke Care (TEMPiS) was established in 2003 as a TeleStroke network to overcome this barrier in Southeast Bavaria/Germany. TEMPiS was one of the very early telemedical stroke networks worldwide and was evaluated intensively during its implementation phase between February 2003 and December 2005. It was shown to be effective in providing safe and extended thrombolysis and in improving stroke outcome. TEMPiS hereby has always been concentrating on the key features of the network: 1. implementation of stroke wards in each hospital, 2. usage of standard operating procedures (SOP), 3. center-based and on-site training, 4. quality management and 5. 24/7 availability of teleconsultations. The TeleStroke Unit network TEMPiS is an example of how the challenges of area-wide implementation of Stroke Units in rural areas can be met. Stroke Units supported by telemedicine, so-called TeleStroke Units, can perform high quality level of acute stroke care and should always be considered in regions, where implementation of standard Stroke Units is not feasible.
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http://dx.doi.org/10.1055/s-0042-108417 | DOI Listing |
J Clin Med
December 2024
Department of Cardiology, Umberto I Hospital, 84014 Nocera Inferiore, Italy.
Heart and lung sharing the same anatomical space are influenced by each other. Spontaneous breathing induces dynamic changes in intrathoracic pressure, impacting cardiac function, particularly the right ventricle. In intensive care units (ICU), mechanical ventilation (MV) and therefore positive end-expiratory pressure (PEEP) are often applied, and this inevitably influences cardiac function.
View Article and Find Full Text PDFCrit Care Med
December 2024
Department of Psychiatry and Human Behavior, Brown University, Alpert Medical School, Providence, RI.
Objectives: Neurocritically ill patients are at high risk for developing delirium, which can worsen the long-term outcomes of this vulnerable population. However, existing delirium assessment tools do not account for neurologic deficits that often interfere with conventional testing and are therefore unreliable in neurocritically ill patients. We aimed to determine the accuracy and predictive validity of the Fluctuating Mental Status Evaluation (FMSE), a novel delirium screening tool developed specifically for neurocritically ill patients.
View Article and Find Full Text PDFAm J Perinatol
January 2025
Pediatrics, Duke University Health System, Durham, United States.
Objective: To characterize the cerebrospinal fluid (CSF) of infants with stroke and compare those findings to the CSF of infants with bacterial meningitis and neither condition in the first 14 postnatal days.
Study Design: Cohort study of 30,092 infants who received a lumbar puncture in the first 14 postnatal days discharged from >300 neonatal intensive care units from 1997-2020. CSF parameters were compared between infants with stroke and bacterial meningitis using non-parametric hypothesis testing and quantile regression.
Kardiologiia
December 2024
Research Institute of Cardiology, Branch of the Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk.
Aim: Comparative assessment of structural changes in cardiomyocyte mitochondria of the right atrial appendage and the mitochondrial respiratory function in peripheral blood leukocytes in a cohort of patients after acute decompensated heart failure (ADHF) and with stable chronic heart failure of ischemic etiology with reduced ejection fraction (CHFrEF) or moderately reduced ejection fraction (CHFmrEF) of the left ventricle.
Material And Methods: The study analyzed 40 micrographs of right atrial appendage cardiomyocytes obtained from 12 patients with CHFrEF and CHFmrEF. The study protocol was registered on ClinicalTrials.
Eur Stroke J
January 2025
Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy.
Introduction: The efficacy and safety of statins for secondary prevention in patients who have experienced a cardioembolic stroke are not well-defined. However, previous observational data reported hyperlipidemia as a risk factor for both ischemic and bleeding complications in patients with AF and previous stroke. Based on these premises, we conducted a sub-analysis of the RAF and RAF-NOAC studies to evaluate the efficacy and safety of statins in secondary prevention in patients with acute ischemic stroke and AF.
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