Risultati per: LBP (Low Back Pain): Cosa dicono le linee guida del mal di schiena

Il 2022 per l’epilessia potrebbe essere l’anno della svolta: a maggio l’Organizzazione Mondiale della Sanità dovrà ratificare il primo documento ufficiale sulla gestione dell’epilessia e di altri disturbi neurologici

Stroke, Volume 53, Issue Suppl_1, Page ATP37-ATP37, February 1, 2022. Introduction:The transitions of care can be stressful and challenging to the AIS survivors and their families as each adjusts to unfamiliar roles. During care transitions, patients are faced with self-care challenges that can often lead to unplanned readmission. Patient education is an essential component of supporting the patient and family in preventing secondary stroke and promoting self-management. However, 40-80% of the medical information during education sessions is forgotten immediately, and can be misunderstood.Hypothesis:The researcher hypothesized that age of ≥ 75 years old; LOS ≥ 5 days; the presence of multiple modifiable risk factors; a NIHSS score ≥ 5; discharge destination to a SNF; and/or a high LACE score are the characteristics that will be seen most often among AIS patients with a 30-day readmission. The researcher also hypothesized that patient education using the teach-back method will decrease all-cause 30-day hospital readmission rates of patients with AIS.Method:A chart review of 955 medical records over 2 years was collected using a researcher-designed spreadsheet. Data were analyzed through descriptive and inferential statistics using measures of central tendency, Mann-Whitney, and Chi-Square Comparison.Results:The research study showed a high readmission rate on patients with a LOS ≥ six days (p=.006), discharge destination to SNF (p=.008), NIHSS score of ≥ 6 points (p=.03), and high LACE score (p=.008). However, there is a weak correlation between each variable and readmission. There was no significant difference in readmission rate between the pre-intervention group (3.3%) and the post-intervention group (4.35%) (p = .40).Conclusion:The researcher concluded that patient characteristics such as a higher length of stay, discharge to a SNF, high NIHSS score, and high LACE score can influence the risk of readmission. Since the contributing factors to 30-day hospital readmission are complex and multifactorial, identification of high-risk patients may allow opportunities for specific interventions such as patient education using the teach-back method. However, interventions must be patient, and family-centered, and targeted at the transitions of care.

Stroke, Volume 53, Issue Suppl_1, Page AWP103-AWP103, February 1, 2022. Introduction:Size and location of the acute infarct is a major determinant of stroke outcome and eligibility for therapy. Recently, there have been efforts to train deep learning networks to detect lesions on Non-Contrast CT (NCCT) using concurrent DWI imaging as the gold standard. However, little is known about the radiological correspondence between concurrent NCCT and DWI lesion sizes. We performed an exploratory analysis comparing the stroke lesion volume on acute NCCT to that on DWI and FLAIR images performed shortly after.Methods:Population: DEFUSE 3 trial patients scanned 6-16h after last known well with DWI and NCCT

Stroke, Volume 53, Issue Suppl_1, Page AWP111-AWP111, February 1, 2022. Background and Aims:MRI is critical for diagnosing acute stroke and guiding candidate selection for potential reperfusion therapy. However, rapid stroke evaluation using MRI is often dissuaded by the time required for patients to travel to access-controlled, high-field (1.5-3T) systems. Advances in low-field MRI enable the acquisition of clinically valuable images at the bedside. We report neuroimaging in patients presenting to the Emergency Department (ED) with stroke symptoms using a low-field portable MRI (pMRI) device.Methods:A 64mT pMRI device was deployed in the Yale-New Haven Hospital ED from August 2020 to July 2021. Patients presenting as a “Stroke Code” or “Intracranial Hemorrhage Alert” with no MRI contraindications were scanned. Exams were performed at the bedside, in the vicinity of ED room equipment. Research staff acquired imaging via tablet, with images available immediately after acquisition. Sequences obtained and axial scan times (in minutes) included T1-weighted imaging (4:54), T2-weighted imaging (7:03), fluid-attenuated inversion recovery imaging (9:31), and diffusion-weighed imaging with apparent diffusion coefficient mapping (9:04). Patients’ demographic information, hours from the time of patients’ last known normal (LKN) to time of scan, and discharge diagnoses (determined from final imaging interpretation) were assessed.Results:pMRI exams were obtained on 54 patients (28 females, 51.9%; median age 71 years, 20-98 years). Discharge diagnoses included ischemic stroke (42.6%) no intracranial abnormality (31.5%), intraparenchymal hemorrhage (7.4%), atherosclerosis (7.4%), tumor (5.6%), subdural hematoma (3.7%), and intraventricular hemorrhage (1.9%). Patient LKN times ranged from 2 to 144 hours (median of 12 hours; 3 patients with no LKN excluded). The pMRI did not interfere with ED equipment and no significant adverse events occurred.Conclusion:We report the use of a pMRI for bedside neuroimaging in the ED. This approach suggests that pMRI may be viable for supporting rapid diagnosis and treatment candidate selection in patients presenting with stroke symptoms to the ED.