Background: Medical complications following stroke often result in significant morbidity. This study was designed to investigate the prevalence and risk of gastroesophageal reflux disease (GERD) between patients with stroke and those without stroke in Taiwan.
Methods And Results: This retrospective cohort study was conducted using the Taiwan National Health Insurance Research Database. The study included 18,412 patients newly diagnosed as having stroke during 2000-2006 and 18,412 patients without stroke frequency-matched by sex, age, and index year. All patients were followed from the index date to December 31, 2011. The Cox proportional hazards regression model was used to estimate the GERD risk. The GERD risk was approximately 1.51-times higher in the stroke group than in the nonstroke group, after adjustment for age, sex, and the cumulative incidence of some comorbidities. GERD was positively associated with stroke; the male sex (adjusted hazard ratio [HR] = 1.31); an age of 65 years or older (adjusted HR = 1.11); hyperlipidemia (adjusted HR = 1.14); ischemic heart disease (adjusted HR = 1.27); renal disease (adjusted HR = 1.45); and use of aspirin (adjusted HR = 2.34), clopidogrel (adjusted HR = 1.41), and dipyridamole (adjusted HR = 1.30).
Conclusions: This study indicates a significantly higher GERD risk in patients with stroke than in the nonstroke group. In clinical practice, neurologists should focus on the risk of GERD symptoms.
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http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2017.12.001 | DOI Listing |
Neurology
February 2025
Department of Neurology, Yale University School of Medicine, New Haven, CT.
Background And Objectives: The most effective antiseizure medications (ASMs) for poststroke seizures (PSSs) remain unclear. We aimed to determine outcomes associated with ASMs in people with PSS.
Methods: We systematically searched electronic databases for studies on patients with PSS on ASMs.
PLoS One
January 2025
Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.
Background: Aeromedical transfer of patients with ischemic stroke to access hyperacute stroke treatment is becoming increasingly common. Little is known about how rapid changes of altitude and atmospheric pressure can impact cerebral perfusion and ischemic burden. In patients with ischemic stroke, there is a theoretical possibility that this physiologic response of hypoxia-driven hyperventilation at higher altitude can lead to a relative drop in PaCO2.
View Article and Find Full Text PDFNeurosurgery
September 2024
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Background And Objectives: Vertebral artery injury (VAI) because of traumatic subaxial cervical spine injury is a rare but potentially devastating condition as it could lead to stroke. The aim of this study was to examine the incidence, risk factors, outcomes, and radiographic predictors of VAI in patients surgically treated for subaxial cervical spine injuries at a tertiary care trauma center.
Methods: This is a retrospective population-based cohort study, including all patients surgically treated for traumatic subaxial cervical spine injuries at the study center between 2006 and 2018.
J Clin Invest
January 2025
Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden.
Ischemic stroke is a major cause of adult disability. Early treatment with thrombolytics and/or thrombectomy can significantly improve outcomes; however, following these acute interventions, treatment is limited to rehabilitation therapies. Thus, the identification of therapeutic strategies that can help restore brain function in the post-acute phase remains a major challenge.
View Article and Find Full Text PDFCurr Opin Crit Care
January 2025
The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
Purpose Of Review: To review the evidence that supports the implementation of goal-directed care bundle protocols to improve outcomes from neurocritical conditions, and of the possible advantage of specific over generalized protocols.
Recent Findings: Articles from January 1, 2023 to July 31, 2024 were searched to evaluate the effectiveness of standardized management in neurological emergencies. The use of care bundles and standardized protocols with time- and target-related metrics has shown benefit in patients with acute stroke and traumatic brain injury.
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