Decision-Making Visual Aids for Late, Imaging-Guided Endovascular Thrombectomy for Acute Ischemic Stroke

Moshayedi, Pouria; Liebeskind, David S; Jadhav, Ashutosh P.; Jahan, Reza; Lansberg, Maarten G; Sharma, Latisha; Nogueira, Raul G; Saver, Jeffrey L.

doi:10.5853/jos.2019.03503

Cited by 5 publications

(3 citation statements)

References 21 publications

(55 reference statements)

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“…Most critically ill patients experience disturbance of consciousness, swallowing dysfunction, and metabolic exuberance; therefore, they have higher nutritional needs. However, limited intake leads to high stress response, resulting in malnutrition and reduced immune function[ 10 ]. Western medicine mainly relies on intestinal nutrition support in the aspect of supplemental nutrition; however, it can cause reproduction of pathogenic bacteria and formation of flora disorder, which would eventually lead to excessive activation of systemic inflammatory response.…”

Section: Discussionmentioning

confidence: 99%

Qixue Shuangbu decoction and acupuncture combined with Western medicine in acute severe stroke patients

Gou¹,

Li²

2023

World J Clin Cases

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BACKGROUND Stroke is a common and frequently occurring disease of the nervous system and one of the three major diseases leading to human death. The incidence and mortality of stroke in China increase with age. Overall, 70 % of patients with stroke have serious disability, which results in heavy burden to their families and the society. AIM To analyze the effects of Qixue Shuangbu decoction and acupuncture combined with Western medicine on immune indexes and digestive tract function in patients with acute severe stroke. METHODS A total of 68 patients with acute severe stroke admitted to Lanzhou Second People’s Hospital between March 2018 and September 2021 were selected and divided into the control and observation groups according to a random number table method. The control group was administered routine Western medicine treatment, such as dehydration, lowering intracranial pressure, anticoagulation, improving cerebral blood circulation and cerebral nerve protection according to the “Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke in China.” The observation group was administered Qixue Shuangbu decoction via nasal feeding tube on the basis of the routine Western medicine treatment with simultaneous acupuncture. The two groups were compared. RESULTS The acute physiology and chronic health evaluation II, organ dysfunction syndrome score, National Institutes of Health Stroke Scale, and traditional Chinese medicine syndrome scores of the two groups were significantly decreased compared with those measured before treatment, and the complements C3 and C4, and immunoglobulins (Ig) M and G were significantly increased compared with those observed before treatment ( P < 0.05). After treatment, the scores of the observation group were lower than those of the control group, and the complement and Ig levels were higher than those of the control group ( P < 0.05). The levels of diamine oxidase (DAO), D-lactic acid (D-LA), and calcitonin gene-related peptide (CGRP) in the two groups were significantly higher than those before treatment, while the levels of lipopolysaccharide, ubiquitin carboxyl-terminal hydrolase 1 (UCH-L1), tumor necrosis factor-α (TNF-α), interleukin (IL) -2, and IL-8 were significantly lower than those before treatment ( P < 0.05). After treatment, DAO, D-LA, and CGRP were higher in the observation group than in the control group, while lipopolysaccharide, UCH-L1, TNF-α, IL-2, and IL-8 were lower than in the control group ( P < 0.05). The hospitalization time of individuals in the observation group was shorter than that of the control group ( P < 0.05). CONCLUSION Qixue Shuangbu decoction and acupuncture combined with Western medicine for the treatment of acute severe stroke can regulate intestina...

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Section: Discussionmentioning

confidence: 99%

Qixue Shuangbu decoction and acupuncture combined with Western medicine in acute severe stroke patients

Gou¹,

Li²

2023

World J Clin Cases

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“…65 While caution must be exercised in generalizing from studies of acute stroke patients who did not have cancer, the data indicate that patients treated with thrombectomy for acute proximal MCA occlusion stroke lived the remainder of their lives with fewer neurologic impairments than if untreated and with reduced need for aggressive care and institutionalization following a sentinel cerebrovascular event. 64,66,67,68 While not a factor in this Mr J's case, do-not-intubate (DNI) orders are common and worthy of mention here. DNI orders should not independently influence stroke care decisions "unless otherwise explicitly indicated," as emphasized by an American Heart Association/American Stroke Association statement (Class IIa recommendation).…”

Section: Equity and Evolving Therapiesmentioning

confidence: 94%

When Should Neuroendovascular Care for Patients With Acute Stroke Be Palliative?

Young

Regenhardt

Sokol

et al. 2021

AMA Journal of Ethics

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Noncurative surgeries intended to relieve suffering during serious illness or near end of life have been analyzed across palliative settings. Yet sparse guidance is available to inform clinical management decisions about whether, when, and which interventions should be offered when ischemic stroke and other neurological complications occur in patients whose survival is extended by other novel disease-modifying interventions. This case commentary examines key ethical and clinical considerations in palliative neuroendovascular care of patients with acute stroke.The American Medical Association designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™ available through the AMA Ed Hub TM . Physicians should claim only the credit commensurate with the extent of their participation in the activity. CaseMr J is a 64-year-old man with metastatic non-small cell lung cancer (NSCLC), who, while eating, abruptly developed right hemiplegia and aphasia. He had been diagnosed 10 months earlier with NSCLC; his estimated life expectancy was approximately 1 year. After a course of chemotherapy with pemetrexed and carboplatin, Mr J started pembrolizumab, an antiprogrammed death-1 immune checkpoint inhibitor offered possibly to extend his life but not as a cure for his cancer. 1,2 Since diagnosis, Mr J has suffered multiple hematologic complications, including thrombosis and hemorrhage. When brought to an emergency department, he was confirmed as full code and intubated on arrival due to poor mental status and aspiration risk. Computed tomography (CT) imaging of his head and neck revealed normal brain parenchyma and occlusion of the proximal left middle cerebral artery (MCA), which supplies blood to most of the brain's left hemisphere, including areas critical for language and right-side sensorimotor function. 3 The mechanism of Mr J's left MCA occlusion was presumed to be thromboembolism, to which he was predisposed by hypercoagulability of malignancy, pembrolizumab, 4,5,6 and intracardiac hemostasis, given his known low left ventricular ejection fraction.

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“…In one meta-analysis, it was shown that the use of aids such as audiotape recordings or videos was shown to have more of a positive effect in quelling patient worries and increasing overall satisfaction [ 7 ]. Additionally, visual decision aids have been effective in acute mechanical thrombectomy in ischemic stroke patients, allowing for more efficient decision-making and overall better stroke outcomes [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of YouTube Videos in Patient Education for Coronary Artery Disease: A DISCERN-Based Cross-Sectional Analysis

Kahlam,

Sacher,

Singh

et al. 2024

Cureus

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Introduction Cardiovascular disease has one of the highest mortality rates and continues to grow. Therefore, it is important for the medical community to get involved in widespread patient education efforts. As technology has steadily advanced, YouTube (Google LLC, Mountain View, California, United States) has become a popular source for patients to gather medical information. In this study, we aim to assess the quality of YouTube videos pertaining to coronary artery disease. Methods We searched the following key terms on June 20, 2023, using the view count filter: coronary artery disease, coronary artery disease treatment, cardiac catheterization, and coronary artery bypass grafting (CABG). The top twenty videos for each keyword were recorded. After videos that were over 20 minutes, non-English, procedural videos without words, and duplicates were excluded, forty-five videos remained. Each video was assessed by three viewers using the DISCERN criteria ( http://www.discern.org.uk ). Numerical data was averaged into composite scores. Two-sided t-tests and one-way analysis of variance (ANOVA) tests were used to compare mean ratings between groups. A Spearman correlation was done to compare each of the following terms to one another: overall quality of videos, total likes a video received, and total views. Results The mean ratings for coronary artery disease, coronary artery disease treatment, cardiac catheterization, and CABG were 2.30, 2.60, 2.05, and 2.92, respectively, with an overall mean of 2.42. The means between coronary artery disease and coronary artery disease treatment were significantly different (p adj = 0.01). The overall rating for videos with board-certified physicians was significantly higher than those without a board-certified physician (p < 0.001). There was a low correlation between likes and overall ratings (0.03) and views and overall ratings (-0.068). Conclusion The videos on coronary artery disease, coronary artery disease treatment, cardiac catheterization, and CABG had poor overall quality based on DISCERN criteria. The overall ratings from videos with board physicians are higher than those from non-physicians, suggesting that physicians should be encouraged to create content about important medical conditions. There was also a low correlation between the overall quality of a video and the likes and views, respectively, indicating a disconnect between what the public values and the actual value of a video.

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Decision-Making Visual Aids for Late, Imaging-Guided Endovascular Thrombectomy for Acute Ischemic Stroke

Cited by 5 publications

References 21 publications

Qixue Shuangbu decoction and acupuncture combined with Western medicine in acute severe stroke patients

Qixue Shuangbu decoction and acupuncture combined with Western medicine in acute severe stroke patients

When Should Neuroendovascular Care for Patients With Acute Stroke Be Palliative?

Assessment of YouTube Videos in Patient Education for Coronary Artery Disease: A DISCERN-Based Cross-Sectional Analysis

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