VECTORS Study: Are We Going in the Right Direction?
Neurology Summary and Comment
Contrary to expectation, high-intensity constraint-induced therapy produced worse outcomes than lower-intensity constraint-induced therapy or conventional therapy when used early after stroke.
By Joel Stein, MD
October 27, 2009
Covering:
Dromerick AW et al., Neurology 2009 Jul 21; 73:195
Cramer SC., Neurology 2009 Jul 21; 73:170
Subarachnoid Hemorrhage Might Be a Common Cause of Out-of-Hospital Cardiac Arrest
Emergency Medicine Summary and Comment
In this Japanese study, 16% of survivors of out-of-hospital cardiac arrest had subarachnoid hemorrhage.
Getting Stroke Patients to the Hospital Sooner
Emergency Medicine Summary and Comment
Surprisingly, only women responded to an intervention aimed at recognizing stroke symptoms and calling emergency medical services.
Can Emergency Physicians Perform Dysphagia Screening in Acute Stroke Patients?
Emergency Medicine Summary and Comment
Free
A simple, easy screening test had a sensitivity of 96% when performed by EPs.
Smokeless Tobacco Increases Risk for Fatal MI and Fatal Stroke
Emergency Medicine Summary and Comment
A meta-analysis shows a modest increase in risk for both conditions.
PPIs and Clopidogrel: Data Trumps Fear
Gastroenterology Summary and Comment
Free
Antiplatelet function was diminished in PPI users, but cardiovascular outcomes were similar in PPI users and nonusers.
By David A. Johnson, MD
October 16, 2009
Covering:
O'Donoghue ML et al., Lancet 2009 Sep 19; 374:989
Patent Foramen Ovale and Risk for Stroke Recurrence
Neurology Summary and Comment
A meta-analysis finds a low risk but does not provide a definitive answer on whether PFO closure can reduce the risk in selected patients.
By Julien Bogousslavsky, MD
October 13, 2009
Covering:
Almekhlafi MA et al., Neurology 2009 Jul 14; 73:89
Screening Test for Stroke-Related Dysphagia
General Medicine Summary and Comment
Most patients who had problems swallowing in the ED had dysphagia on formal evaluations by speech pathologists.
By Allan S. Brett, MD
October 8, 2009
Covering:
Turner-Lawrence DE et al., Ann Emerg Med 2009 Sep; 54:344
Dabigatran for Atrial Fibrillation
Compared with warfarin, high-dose dabigatran was associated with fewer strokes but a higher rate of drug discontinuation.
By David Green, MD, PhD
October 6, 2009
Covering:
Connolly SJ et al., N Engl J Med 2009 Sep 17; 361:1139
Expanding the Window for Acute Stroke Treatment
Neurology Summary and Comment
Free
New recommendations from the American Heart Association/American Stroke Association on using t-PA between 3 and 4.5 hours after stroke onset
By James S. McKinney, MD
October 6, 2009
Covering:
del Zoppo GJ et al., Stroke 2009 Aug; 40:2945
Cardiac Surgery in Patients with Carotid Stenosis
General Medicine Summary and Comment
Combining endarterectomy with cardiac surgery did not prevent perioperative strokes.
By Allan S. Brett, MD
October 1, 2009
Covering:
Li Y et al., Arch Neurol 2009 Sep; 66:1091
CT Scanning for Cardiac Sources of Embolism
Neurology Summary and Comment
In patients with recent strokes, cardiac CT using 64-slice technology can detect most of the high-risk cardiac sources of embolism identified by transesophageal echocardiography.
By Richard T. Lee, MD
September 29, 2009
Covering:
Hur J et al., Stroke 2009 Jun; 40:2073
Long-Term Relief of Poststroke Depression
Psychiatry Summary and Comment
Brief interventions that educate patients and teach a problem-solving approach might have a long-lived effect.
By Jonathan Silver, MD
September 28, 2009
Covering:
Mitchell PH et al., Stroke 2009 Sep; 40:3073
Is Venous Thromboembolism a Risk Factor for Arterial Events?
Myocardial infarction and stroke were observed in patients with unprovoked pulmonary embolisms.
Warfarin for Stroke Prevention in Patients with Atrial Fibrillation
Cardiology Summary and Comment
Results of a large observational study provide current data for accurate risk-benefit estimation.
By Joel M. Gore, MD
September 16, 2009
Covering:
Singer DE et al., Ann Intern Med 2009 Sep 1; 151:297
Endocarditis and Brain Embolization
Infectious Diseases Summary and Comment
Free
Among persons with left-sided infective endocarditis, subclinical brain embolization occurs more often than previously believed.
By Larry M. Baddour, MD
September 9, 2009
Covering:
Cooper HA et al., Circulation 2009 Aug 18; 120:585
An Alternative to Warfarin in Patients with Atrial Fibrillation?
Cardiology Summary and Comment
Compared with warfarin, low-dose dabigatran performed better with regard to safety but not efficacy, and high-dose dabigatran performed better with regard to efficacy but not safety.
By Harlan M. Krumholz, MD, SM
September 1, 2009
Covering:
Connolly SJ et al. for the RE-LY Steering Committee and Investigators., N Engl J Med 2009 Aug 30
Smokeless Tobacco Use Is Associated with Fatal MI and Stroke
General Medicine Summary and Comment
Let patients who use smokeless tobacco know that it is not a "safe" alternative to cigarettes and cigars.
New Approach to Stroke Prevention in AF Patients
General Medicine Summary and Comment
An experimental device was used for percutaneous closure of the left atrial appendage.
By Bruce Soloway, MD
August 27, 2009
Covering:
Holmes DR et al., Lancet 2009 Aug 15; 374:534
The Enigma of Evening and Weekend Stroke
Neurology Summary and Comment
In a large database study, mortality was slightly higher with off-hours stroke admissions than with normal-hours admissions, despite similar treatment according to quality-of-care measures.
By Steven R. Levine, MD
August 25, 2009
Covering:
Reeves MJ et al., Stroke 2009 Feb; 40:569
Effect of Clopidogrel Added to Aspirin in Patients with Atrial Fibrillation
Neurology Summary and Comment
Free
In patients who were "unsuitable" for warfarin, clopidogrel plus aspirin prevented more ischemic strokes than aspirin alone.
By J. Philip Kistler, MD
August 11, 2009
Covering:
Connolly SJ et al. for the ACTIVE Investigators., N Engl J Med 2009 May 14; 360:2066
Go AS., N Engl J Med 2009 May 14; 360:2127
Patent Foramen Ovale and Risk for Recurrent Stroke
General Medicine Summary and Comment
PFO does not significantly raise risk for recurrent cerebral ischemic events.
By Allan S. Brett, MD
August 6, 2009
Covering:
Almekhlafi MA et al., Neurology 2009 Jul 14; 73:89
Transcranial Doppler Ultrasound for Primary Stroke Prevention in Sickle Cell Disease
Neurology Summary and Comment
An analysis of change in rates of use and barriers to screening
By Farzaneh A. Sorond, MD, PhD
August 4, 2009
Covering:
Armstrong-Wells J et al., Neurology 2009 Apr 14; 72:1316
"Drive-By" Closure of Patent Foramen Ovale
Cardiology Summary and Comment
In a retrospective, case-control series, repair of PFO found incidentally during cardiothoracic surgery conferred no short- or long-term benefit.
Cardiovascular Events in Canada, 1994–2004
Cardiology Summary and Comment
Findings from a nationwide study reveal significant declines in mortality and hospital admissions.
