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  • 1
    Online Resource
    Online Resource
    Mobile Tablet-Based Stroke Rehabilitation: Using mHealth Technology to Improve Access to Early Stroke Rehabilitation
    International Association of Online Engineering (IAOE) ; 2017
    In:  International Journal of Interactive Mobile Technologies (iJIM) Vol. 11, No. 1 ( 2017-01-31), p. 148-
    Details
    In: International Journal of Interactive Mobile Technologies (iJIM), International Association of Online Engineering (IAOE), Vol. 11, No. 1 ( 2017-01-31), p. 148-
    Abstract: 〈 p class="Abstract" 〉 Mobile health (mHealth) technology represents a means through which more stroke survivors could access early stroke rehabilitation. Although rehabilitation is most effective when begun early post-stroke, limited resources (facilities, therapists) prevent survivors from initiating therapy. Furthermore, the coupling of an aging population with advances in acute therapy has led to an increase in the absolute number of individuals suffering from and surviving strokes which in turn has put further strain on already scarce rehabilitation resources. There is an urgency to conduct high-quality research exploring cost-effective and creative mHealth devices for early rehabilitation in the acute setting. Mobile technology allows therapists to prescribe apps based on standard cognitive/physical assessments in the acute setting, remotely monitor patient progress across individual carepaths, and update prescribed therapies based on patient feedback and recovery. Recognition of the growing problem of accessing early stroke rehabilitation, and the possibilities offered by mHealth technology led to the development of the RecoverNow platform for stroke rehabilitation in the acute setting. RecoverNow is a custom built, tablet-based stroke rehabilitation platform that houses a variety of previously existing apps with activities analogous or identical to exercises in speech language and/or occupational therapy. While RecoverNow represents how mobile technology can be utilized to address a growing public health issue, the feasibility, acceptability and efficacy of tablet-based stroke rehabilitation are unknown. Studies with the goal of establishing feasibility of early tablet-based stroke rehabilitation are needed and, if appropriate, a randomized controlled trial to establish efficacy. 〈 /p 〉
    Type of Medium: Online Resource
    ISSN: 1865-7923
    URL: Article
    DOI: 10.3991/ijim.v11i1.6234
    Language: Unknown
    Publisher: International Association of Online Engineering (IAOE)
    Publication Date: 2017
    detail.hit.zdb_id: 2406982-6
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  • 2
    Online Resource
    Online Resource
    Is This Contrast? Is This Blood? An Agreement Study on Post-thrombectomy Computed Tomography Scans
    Frontiers Media SA ; 2020
    In:  Frontiers in Neurology Vol. 11 ( 2020-12-22)
    Details
    In: Frontiers in Neurology, Frontiers Media SA, Vol. 11 ( 2020-12-22)
    Abstract: Background: Hemorrhagic transformation after acute ischemic stroke is a dreaded and severe complication of thrombolysis and thrombectomy. However, its detection on post-thrombectomy conventional non-contrast computed tomography (CT) scan can be complicated by the frequent (and sometimes concomitant) presence of contrast, resulting in changes in management. Aims: Our objective was to assess the inter- and intra-rater reliability for the detection of blood and/or contrast on day-1 post-thrombectomy CT scans. Methods: A total of 18 raters across 3 different specialties independently examined 30 post-thrombectomy CT scans selected from the Aspiration vs. STEnt-Retriever (ASTER) trial. They were asked to judge the presence of blood and contrast. Thirty days later, the same 18 raters again independently judged the 30 scans, in randomized order. Agreement was measured with Fleiss' and Cohen's K statistics. Results: Overall agreement on blood and/ or contrast presence was only fair, k = 0.291 (95% CI = 0.273–0.309). There were 0 scans with consensus among the 18 readers on the presence of blood and/or contrast. However, intra-rater global agreement across all 18 physicians was relatively high, with a median kappa value of 0.675. This intra-rater consistency was seen across all specialties, regardless of level of training. Conclusion: Physician judgment for the presence of blood and/or contrast on day-1 post-thrombectomy non-contrast CT scan shows limited inter-observer reliability. Advanced imaging modalities may then be warranted for challenging clinical cases.
    Type of Medium: Online Resource
    ISSN: 1664-2295
    URL: Article
    DOI: 10.3389/fneur.2020.593098
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2020
    detail.hit.zdb_id: 2564214-5
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  • 3
    Online Resource
    Online Resource
    Table_1.docx
    Frontiers Media SA ; 2022
    In:  Frontiers in Neurology Vol. 13 ( 2022-9-20)
    Details
    In: Frontiers in Neurology, Frontiers Media SA, Vol. 13 ( 2022-9-20)
    Abstract: Patients newly diagnosed with cancer represent a population at highest risk for stroke. The objective of this systematic review and meta-analysis was to estimate the incidence of stroke in the first year following a new diagnosis of cancer. Methods We searched MEDLINE and EMBASE from January 1980 to June 2021 for observational studies that enrolled adults with a new diagnosis of all cancers excluding non-melanoma skin cancer, and that reported the incidence of stroke at 1 year. PRISMA guidelines for meta-analyses were followed. Two reviewers independently extracted data and appraised risk of bias. We used the Dersimonian and Laird random effects method to pool cumulative incidences after logit transformation, and reported pooled proportions as percentages. Statistical heterogeneity was assessed using the I 2 statistic. Results A total of 12,083 studies were screened; 41 studies were included for analysis. Data from 2,552,121 subjects with cancer were analyzed. The cumulative incidence of total stroke at 1 year was 1.4% (95% CI 0.9–2.2%), while the pooled incidence of ischemic stroke was 1.3% (95% CI 1.0–1.8%) and 0.3% (95% CI 0.1–0.9%) for spontaneous intracerebral hemorrhage (ICH), with consistently high statistical heterogeneity ( & gt;99% I 2 ). Conclusion The estimated incidence of stroke during the first year after a new diagnosis of cancer is 1.4%, with a higher risk for ischemic stroke than ICH. Cancer patients should be educated on the risk of stroke at the time of diagnosis. Future studies should evaluate optimal primary prevention strategies in this high-risk group of patients. Systematic review registration https://osf.io/ucwy9/ .
    Type of Medium: Online Resource
    ISSN: 1664-2295
    URL: Article
    URL: Article
    DOI: 10.3389/fneur.2022.966190
    DOI: 10.3389/fneur.2022.966190.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2564214-5
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  • 4
    Online Resource
    Online Resource
    Clinical prediction of delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage
    Journal of Neurosurgery Publishing Group (JNSPG) ; 2019
    In:  Journal of Neurosurgery Vol. 130, No. 6 ( 2019-06), p. 1914-1921
    Details
    In: Journal of Neurosurgery, Journal of Neurosurgery Publishing Group (JNSPG), Vol. 130, No. 6 ( 2019-06), p. 1914-1921
    Abstract: The aim of this study was to derive a clinically applicable decision rule using clinical, radiological, and laboratory data to predict the development of delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (aSAH) patients. METHODS Patients presenting over a consecutive 9-year period with subarachnoid hemorrhage (SAH) and at least 1 angiographically evident aneurysm were included. Variables significantly associated with DCI in univariate analysis underwent multivariable logistic regression. Using the beta coefficients, points were assigned to each predictor to establish a scoring system with estimated risks. DCI was defined as neurological deterioration attributable to arterial narrowing detected by transcranial Doppler ultrasonography, CT angiography, MR angiography, or catheter angiography, after exclusion of competing diagnoses. RESULTS Of 463 patients, 58% experienced angiographic vasospasm with an overall DCI incidence of 21%. Age, modified Fisher grade, and ruptured aneurysm location were significantly associated with DCI. This combination of predictors had a greater area under the receiver operating characteristic curve than the modified Fisher grade alone (0.73 [95% CI 0.67–0.78] vs 0.66 [95% CI 0.60–0.71] ). Patients 70 years or older with modified Fisher grade 0 or 1 SAH and a posterior circulation aneurysm had the lowest risk of DCI at 1.2% (0 points). The highest estimated risk was 38% (17 points) in patients 40–59 years old with modified Fisher grade 4 SAH following rupture of an anterior circulation aneurysm. CONCLUSIONS Among patients presenting with aSAH, this score-based clinical prediction tool exhibits increased accuracy over the modified Fisher grade alone and may serve as a useful tool to individualize DCI risk.
    Type of Medium: Online Resource
    ISSN: 0022-3085 , 1933-0693
    URL: Article
    DOI: 10.3171/2018.1.JNS172715
    RVK:
    XA 10000
    RVK:
    XA 55270
    Language: Unknown
    Publisher: Journal of Neurosurgery Publishing Group (JNSPG)
    Publication Date: 2019
    detail.hit.zdb_id: 2026156-1
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  • 5
    Online Resource
    Online Resource
    Men Are at Higher Risk of Screening Positive for Vascular Cognitive Impairment Compared to Women after Stroke and Transient Ischemic Attack
    IOS Press ; 2023
    In:  Journal of Alzheimer's Disease Vol. 94, No. 1 ( 2023-06-27), p. 89-94
    Details
    In: Journal of Alzheimer's Disease, IOS Press, Vol. 94, No. 1 ( 2023-06-27), p. 89-94
    Abstract: While women have greater incidence of dementia, men have higher prevalence of vascular risk factors. This study examined sex differences in risk of screening positive for cognitive impairment after stroke. Ischemic stroke/TIA patients (N = 5969) participated in this prospective, multi-centered study, which screened for cognitive impairment using a validated brief screen. Men showed a higher risk of screening positive for cognitive impairment after adjusting for age, education, stroke severity, and vascular risk factors, suggesting that other factors may be contributing to increased risk among men (OR = 1.34, CI 95% [1.16, 1.55], p  〈  0.001). The effect of sex on cognitive impairment after stroke warrants further attention.
    Type of Medium: Online Resource
    ISSN: 1387-2877 , 1875-8908
    URL: Article
    DOI: 10.3233/JAD-230021
    Language: Unknown
    Publisher: IOS Press
    Publication Date: 2023
    detail.hit.zdb_id: 2070772-1
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