Background and Purpose-Acute stroke management requires minimization of prehospital time. This study addresses the value of helicopter transport compared with other means of transportation to a stroke unit and compares their rates of thrombolysis on a nationwide basis. Methods-Prospective data collection and prespecified evaluation of data from 32 stroke units between 2003 and 2009 were used. We distinguished between patients transported either directly to a stroke unit or transferred indirectly via a peripheral hospital. Thus, there were 6 transport groups: helicopter emergency service (HEMS) direct and indirect, ambulance accompanied by an emergency physician direct and indirect, and ambulance without physician direct and indirect. Demographic and clinical factors, time delays, and rates of thrombolysis of patients transported by helicopter were compared with factors of patients transported otherwise. Results-Of 21 712 ischemic stroke patients, 905 patients (4.1%) were transported by helicopter. Of these, 752 patients (3.4%) were transported by direct HEMS, and 153 patients (0.7%) were transported by indirect HEMS. Thrombolysis rates were highest for HEMS (24% direct, 29% indirect) transport, followed by ambulance accompanied by an emergency physician (18% direct, 15% indirect). The probability of receiving thrombolysis was highest for indirect HEMS transport (OR 3.6, 2.2-6.0), followed by indirect ambulance accompanied by an emergency physician transport (OR 1.5, 1.1-1.9). The shortest times, 90 minutes or less from stroke onset to hospital arrival, were achieved with direct AMBP and direct HEMS transport. Conclusions-The shortest hospital arrival times and highest thrombolysis rates were seen in ischemic stroke patients transported by helicopter. (Stroke. 2011;42:1295-1300.)

Purpose: Aim was to assess the frequencies of electrocardiographic (ECG) abnormalities, including QT prolongation, in acute stroke patients and their association with stroke severity, stroke subtype and location, and cardiovascular risk factors. Methods: Prospectively, admission 12-lead ECG findings, stroke characteristics, cardiovascular risk factors, and potential QT-prolonging factors were collected in 122 consecutive patients with acute stroke. Results: Eighty-four patients (69%) had ECG abnormalities, most frequently ST changes in 34%, QT prolongation in 31%, and atrial fibrillation in 27% of them. Insular involvement and prior stroke independently predicted QT prolongation in small infarcts (insular involvement OR 0.12, 95% CI 0.02–0.74, p = 0.022; prior stroke OR 0.20, 95% CI 0.06–0.70, p = 0.012). Conclusion: Continuous ECG monitoring and assessment of the QT interval should be mandatory in patients with acute stroke.

Twenty-one healthy males aged 20-36 years were examined for hemodynamic and metabolic parameters such as heart rate, oxygenation, lactate, blood pressure, under isokinetic and ergometric loadings. The healthy volunteers were tested by increased loads and constant times with an identical isokinetic and ergometric power. The important results are: Heart frequency and blood pressure are higher under isokinetic than under ergometric conditions. Oxygenation is equal in both tests. The lactate values show for the isokinetic maximal and for the ergometric submaximal loadings. The definitive factor for this variation is the relation between force and velocity. The higher tension of the muscles and the higher activity of the fast-twitch fibers seem to be responsible for the increasing of sympathicotonia. The clinical impact of this controlled study is: 1. Isokinetic testing might be dangerous for patients with cardiac diseases or circulatory disturbances. 2. Isokinetic training programs have to pay attention to joint and internal diseases at the same level. 3. During the first isokinetic test all precautions for a possible emergency case have to be taken.

The implementation of intravenous alteplase for acute stroke has been safe and efficacious in Austrian centres. OTT and mortality were significantly lower in Austrian patients compared to non-Austrian SITS centres.

Anterior cruciate ligament (ACL) injuries are considered of high prevalence in sports medicine and are of socio-economical relevance. Indications for operative treatment and the ability for physical activity after ACL injuries are discussed controversially. Although it is known that the ACL has neurosensory functions, no test system has been developed which takes this biological function into account. The first goal of this study was to determine the neurosensory function after ACL reconstruction, and the second goal was to develop predictive markers for functional results after surgery. 20 healthy athletes (10 male, 10 female) (control group) and twenty ACL deficient patients (10 male, 10 female) (study group) were included in a prospective, controlled study. Electromyograms (EMG) were performed under defined load conditions of the knee. Important results of our study are: 1. Previously described parameters can be reproduced with EMG techniques. Their validity was proved. Typical contraction patterns (m. quadriceps, hamstrings, m. gastrocnemius) for defined load conditions can be recorded. 2. Statistically significant differences can be shown between the control group and the study group as well as between the two legs (injured/noninjured) of the same patient in the study group. 3. The results suggest that the diminished innervation of the m. biceps femoris and m. gastrocnemius in down-ramp-running as an important parameter for ACL deficiency. 4. Distinct differences of innervation patterns of the muscles, which stabilise the knee in downramp walking suggest that despite a subjective stability, altered load conditions may result. Innervation patterns seem to vary from individual to individual. 5. Concluding from our findings, we suggest that clinical methods should be developed to allow a patient-specific assessment of physical activity.