BackgroundLow adherence to secondary prevention guidelines in stroke survivors may increase the risk for recurrent stroke and adversely impact quality of life. We aimed to determine the feasibility of a self‐developed standardized post‐stroke pathway and its impact on secondary stroke prevention and long‐term outcome in patients with acute stroke.MethodsConsecutive patients with acute stroke were prospectively included in a standardized post‐stroke pathway accomplished through a single certified CM (case manager), which comprised educational discussions and quarterly checkups for vascular risk factors and adherence to antithrombotic/anticoagulant medication in addition to usual care. At 12 months, we compared achieved target goals for secondary prevention, functional outcome, stroke recurrence, and vascular death with age‐ and gender‐matched controls that received only usual care after stroke.ResultsWe included 45 cases and 45 controls. The following target goals were more frequently achieved in CM‐patients than in controls: blood pressure (100% vs. 46.2%, P < 0.001), cholesterol (100% vs. 74.4%, P < 0.001), and body mass index (67.4% vs. 46.2%, P = 0.052). The CM‐intervention emerged as an independent predictor of favorable functional outcome (mRS ≤ 2) at 12 months after adjusting for stroke severity and systemic thrombolysis (OR: 4.27; 95%CI:1.2–15.21; P = 0.025). Quality of life was rated significantly higher in CM‐patients than in controls (P = 0.049). As opposed to controls, none of the cases experienced a recurrent stroke (0% vs. 13.3%; P = 0.026) or suffered from vascular death (0% vs. 6.7%; P = 0.242).ConclusionsOur pilot data suggest that organized post‐stroke care enhances achievement of secondary prevention goals. Its possible effect on stroke recurrence, long‐term disability, and quality of life is currently investigated in a prospective cohort study.
Eine Berechnung des Oberflächenabriebs an angeströmten Betonoberflächen im Wasserbau wird bisher in der Regel nicht vorgenommen. Dabei ist bekannt, dass an Bauwerken des konstruktiven Wasserbaus oder auch des Siedlungswasserbaus regelmäßig Schäden durch Oberflächenverschleiß beobachtet und dokumentiert werden. Das im Folgenden beschriebene Verfahren erlaubt auf der Basis der von Bania [1] gefundenen Zusammenhänge eine Abschätzung der Oberflächenabtrags von neuem Beton in Abhängigkeit der vorhandenen Druckfestigkeit sowie der Abrasionsbeanspruchungszeit und der einwirkenden kinetischen Energie, denen die Betonoberfläche ausgesetzt ist. Hierbei spielen sowohl der Anströmwinkel auf die Betonoberfläche als auch die auftretenden Fließgeschwindigkeiten und der damit einhergehende Feststofftransport in natürlichen Gewässern eine maßgebliche Rolle.
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