Pub Date : 2021-01-01DOI: 10.29011/2688-8734.000031
{"title":"Why the Nine Hole Peg Test should not Disappear from Clinical Stroke Routine","authors":"","doi":"10.29011/2688-8734.000031","DOIUrl":"https://doi.org/10.29011/2688-8734.000031","url":null,"abstract":"","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83762295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.29011/2688-8734.000029
{"title":"Characteristics of Stroke Associated Pneumonia by Stroke Subtypes: Incidence, Time Course, Potential Risk and Microbiological Pathogen","authors":"","doi":"10.29011/2688-8734.000029","DOIUrl":"https://doi.org/10.29011/2688-8734.000029","url":null,"abstract":"","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82062907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.29011/2688-8734.000040
C. Tham, Liqing Fu, W. M. Ng
Young adults aged 50 years and below with ischemic stroke or transient ischemic attack have significantly different risk factors from older stroke patients. As a result, they are often worked up extensively to evaluate for the underlying cause of the stroke. The aim of this retrospective study at our hospital was to determine how often tests for thrombophilic disorders are ordered for such patients and the yield of such tests. The results of this study showed that thrombophilic tests were frequently ordered by neurologists but the yield from such tests was low.
{"title":"Testing for Thrombophilic Disorders in Young Adults with Ischemic Stroke or Transient Ischemic Attack","authors":"C. Tham, Liqing Fu, W. M. Ng","doi":"10.29011/2688-8734.000040","DOIUrl":"https://doi.org/10.29011/2688-8734.000040","url":null,"abstract":"Young adults aged 50 years and below with ischemic stroke or transient ischemic attack have significantly different risk factors from older stroke patients. As a result, they are often worked up extensively to evaluate for the underlying cause of the stroke. The aim of this retrospective study at our hospital was to determine how often tests for thrombophilic disorders are ordered for such patients and the yield of such tests. The results of this study showed that thrombophilic tests were frequently ordered by neurologists but the yield from such tests was low.","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84848547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-25DOI: 10.29011/2688-8734.100018
{"title":"Reduction of Risk for Cardiovascular Disease in Non-Ambulatory Stroke Survivors Using an Assisted-Walking Aerobic Exercise: A Pilot Study","authors":"","doi":"10.29011/2688-8734.100018","DOIUrl":"https://doi.org/10.29011/2688-8734.100018","url":null,"abstract":"","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80609530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-28DOI: 10.29011/2688-8734.100014
{"title":"Increased Endothelial Activation in Patients with Mixed Connective Tissue Disease","authors":"","doi":"10.29011/2688-8734.100014","DOIUrl":"https://doi.org/10.29011/2688-8734.100014","url":null,"abstract":"","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76051207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.29011/2688-8734.100012
Hong Zhang, J. Leng, Yan-ping Wang, Xiao Chen, Liu Shi
Objective: To analyze the effects of ultra-early alteplase (rt-PA) intravenous thrombolysis in patients with Acute Cerebral Infarction (ACI) and the influencing factors of deterioration after improvement. Methods: A total of 70 patients with ACI treated by rt-PA intravenous thrombolysis in our hospital from January 2014 to December 2016 were selected as the observation group, and another 90 patients with ACI who only received conventional treatment were selected as the control group. The status of neurological impairment was evaluated with the National Institutes of Health Stroke Scale (NIHSS) and the prognosis was evaluated with the Barthel Index (BI) and modified Rankin Scale (mRS). The incidence of complications was statistically analyzed. Patients in the observation group were divided into the deterioration group (n=9) and the non-deterioration group (n=61). the clinical data were collected for univariate analysis and factors with significant differences were analyzed by Logistic regression analysis. Results: Before treatment, there were no significant differences between the two groups in NIHSS score, BI and mRS score, while after treatment, the above-mentioned indexes were significantly improved, and the improvement was more obvious in the observation group than the control group. Multivariable Logistic regression analysis showed that age, previous history of atrial fibrillation, late thrombolysis, high NIHSS score before thrombolysis, low white blood cell count and total anterior circulation infarction were independent risk factors for deterioration after improvement. Conclusion: Ultra-early rt-PA intravenous thrombolysis can quickly correct the status of cerebral ischemia and hypoxia and save the damaged neurological function in patients with ACI, and attention should be paid to the independent risk factors for deterioration after improvement.
{"title":"Effects of Ultra-early Alteplase Intravenous Thrombolysis in Patients with Acute Cerebral Infarction and the Influencing Factors of Deterioration After Improvement","authors":"Hong Zhang, J. Leng, Yan-ping Wang, Xiao Chen, Liu Shi","doi":"10.29011/2688-8734.100012","DOIUrl":"https://doi.org/10.29011/2688-8734.100012","url":null,"abstract":"Objective: To analyze the effects of ultra-early alteplase (rt-PA) intravenous thrombolysis in patients with Acute Cerebral Infarction (ACI) and the influencing factors of deterioration after improvement. Methods: A total of 70 patients with ACI treated by rt-PA intravenous thrombolysis in our hospital from January 2014 to December 2016 were selected as the observation group, and another 90 patients with ACI who only received conventional treatment were selected as the control group. The status of neurological impairment was evaluated with the National Institutes of Health Stroke Scale (NIHSS) and the prognosis was evaluated with the Barthel Index (BI) and modified Rankin Scale (mRS). The incidence of complications was statistically analyzed. Patients in the observation group were divided into the deterioration group (n=9) and the non-deterioration group (n=61). the clinical data were collected for univariate analysis and factors with significant differences were analyzed by Logistic regression analysis. Results: Before treatment, there were no significant differences between the two groups in NIHSS score, BI and mRS score, while after treatment, the above-mentioned indexes were significantly improved, and the improvement was more obvious in the observation group than the control group. Multivariable Logistic regression analysis showed that age, previous history of atrial fibrillation, late thrombolysis, high NIHSS score before thrombolysis, low white blood cell count and total anterior circulation infarction were independent risk factors for deterioration after improvement. Conclusion: Ultra-early rt-PA intravenous thrombolysis can quickly correct the status of cerebral ischemia and hypoxia and save the damaged neurological function in patients with ACI, and attention should be paid to the independent risk factors for deterioration after improvement.","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82037528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.29011/2688-8734.100021
Kolby Redd, S. T. Phillips, Brittiny McMillian, L. Giamberardino, J. Hardin, S. Glover, A. Merchant, Christiano Susin, J. Beck, S. Offenbacher, S. Sen
Background Stroke remains more common in the "buckle" of the stroke belt, and disproportionately impacts African Americans. The reasons for this racial disparity are poorly understood and are not entirely explained by traditional stroke risk factors. The PeRiodontal treatment to Eliminate Minority InEquality and Rural disparities in Stroke (PREMIERS) study will evaluate the effect of periodontal treatment on recurrent vascular events and stroke risk factors among ischemic stroke and transient ischemic attack patients. Design Eligibility for the trial includes a non-disabling stroke confirmed by neuroimaging or Transient Ischemic Attack (TIA), being at least 18 years of age, having ≥ 5 natural teeth with ≥ 2 interproximal sites with ≥ 4 mm of clinical attachment loss and at least 2 sites with probing depth of ≥ 5 mm, and who are able to provide written informed consent. Within 90 days of the index event, patients are randomly assigned to intensive or initial standard cycle of supragingival mechanical scaling, polishing, and oral health instruction and followed for 1 year. The primary outcome is a composite of death, myocardial infarction and stroke or TIA. Secondary outcomes include A1C, fasting lipid profile, triglycerides, high sensitivity C-reactive protein, carotid intimal medial thickness, and blood pressure. A five year enrollment period followed by an addition one year of follow-up is planned.
{"title":"PeRiodontal Treatment to Eliminate Minority Inequality and Rural Disparities in Stroke (PREMIERS): A Multicenter, Randomized, Controlled Study.","authors":"Kolby Redd, S. T. Phillips, Brittiny McMillian, L. Giamberardino, J. Hardin, S. Glover, A. Merchant, Christiano Susin, J. Beck, S. Offenbacher, S. Sen","doi":"10.29011/2688-8734.100021","DOIUrl":"https://doi.org/10.29011/2688-8734.100021","url":null,"abstract":"Background Stroke remains more common in the \"buckle\" of the stroke belt, and disproportionately impacts African Americans. The reasons for this racial disparity are poorly understood and are not entirely explained by traditional stroke risk factors. The PeRiodontal treatment to Eliminate Minority InEquality and Rural disparities in Stroke (PREMIERS) study will evaluate the effect of periodontal treatment on recurrent vascular events and stroke risk factors among ischemic stroke and transient ischemic attack patients. Design Eligibility for the trial includes a non-disabling stroke confirmed by neuroimaging or Transient Ischemic Attack (TIA), being at least 18 years of age, having ≥ 5 natural teeth with ≥ 2 interproximal sites with ≥ 4 mm of clinical attachment loss and at least 2 sites with probing depth of ≥ 5 mm, and who are able to provide written informed consent. Within 90 days of the index event, patients are randomly assigned to intensive or initial standard cycle of supragingival mechanical scaling, polishing, and oral health instruction and followed for 1 year. The primary outcome is a composite of death, myocardial infarction and stroke or TIA. Secondary outcomes include A1C, fasting lipid profile, triglycerides, high sensitivity C-reactive protein, carotid intimal medial thickness, and blood pressure. A five year enrollment period followed by an addition one year of follow-up is planned.","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"2 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79037941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.29011/2688-8734.100010
Tareq S Almaghrabi, Mark M. McDonald, Chunyan C Cai, M. Rahbar, H. A. Choi, Kiwon Lee, N. Naval, J. Grotta, Tiffany Chang
Introduction 1.1.Cocaine use is a known risk factor for stroke and has been associated with worse outcomes. Cocaine may cause an altered coagulable state by a number of different proposed mechanisms, including platelet activation, endothelial injury, and tissue factor expression. This study analyzes the effect of cocaine use on Thrombelastography (TEG) in acute stroke patients. Patient and Methods 1.2.Patients presenting with Acute Ischemic Stroke (AIS) and spontaneous Intracerebral Hemorrhage (ICH) to a single academic center between 2009 and 2014 were prospectively enrolled. Blood was collected for TEG analysis at the time of presentation. Patient demographics and baseline TEG values were compared between two groups: cocaine and non-cocaine users. Multivariable Quantile regression models were used to compare the median TEG components between groups after controlling for the effect of confounders. Results 1.3.91 patients were included, 53 with AIS and 38 with ICH. 8 (8.8%) patients were positive for cocaine, 4 (50%) with AIS, and 4 (50%) with ICH. There were no significant differences in age, blood pressure, platelet count, or PT/PTT between the cocaine positive and cocaine negative group. Following multivariable analysis, and adjusting for factors known to influence TEG including stroke subtype, cocaine use was associated with shortened median R time (time to initiate clotting) of 3.8 minutes compared to 4.8 minutes in non-cocaine users (p=0.04). Delta (thrombin burst) was also earlier among cocaine users (0.4 minutes) compared with non-cocaine users (0.5 min, p=0.04). The median MA and G (measurements of final clot strength) were reduced in cocaine users (MA=62.5 mm, G=7.8 dynes/cm2) compared to non-cocaine users (MA=66.5 mm, G=10.1 dynes/cm2; p=0.047, p=0.04, respectively). Conclusion 1.4.Cocaine users demonstrate more rapid clot formation but reduced overall clot strength based on admission TEG values.
Introduction1.1。可卡因的使用是中风的一个已知的危险因素，并且与更糟糕的结果有关。可卡因可能通过许多不同的机制引起凝血状态的改变，包括血小板活化、内皮损伤和组织因子表达。本研究分析可卡因使用对急性脑卒中患者血栓造影(TEG)的影响。患者与方法在2009年至2014年期间，前瞻性纳入单个学术中心的急性缺血性卒中(AIS)和自发性脑出血(ICH)患者。在出现时采集血液进行TEG分析。比较两组患者的人口统计数据和基线TEG值:可卡因使用者和非可卡因使用者。结果共纳入1.3.91例患者，其中AIS 53例，ICH 38例。可卡因阳性8例(8.8%)，AIS阳性4例(50%)，ICH阳性4例(50%)。可卡因阳性组和可卡因阴性组在年龄、血压、血小板计数或PT/PTT方面无显著差异。经过多变量分析，并调整已知影响TEG的因素，包括卒中亚型，可卡因使用与中位R时间(开始凝血时间)缩短3.8分钟相关，而非可卡因使用者为4.8分钟(p=0.04)。与非可卡因使用者(0.5分钟，p=0.04)相比，可卡因使用者的Delta(凝血酶爆发)也更早(0.4分钟)。与非可卡因使用者(MA=66.5 mm, G=10.1达因/cm2)相比，可卡因使用者(MA=62.5 mm, G=7.8达因/cm2)的中位MA和G(最终血块强度测量值)降低;p=0.047, p=0.04)。可卡因使用者表现出更快的凝块形成，但根据入院TEG值，整体凝块强度降低。
{"title":"Cocaine Use is Associated with More Rapid Clot Formation and Weaker Clot Strength in Acute Stroke Patients.","authors":"Tareq S Almaghrabi, Mark M. McDonald, Chunyan C Cai, M. Rahbar, H. A. Choi, Kiwon Lee, N. Naval, J. Grotta, Tiffany Chang","doi":"10.29011/2688-8734.100010","DOIUrl":"https://doi.org/10.29011/2688-8734.100010","url":null,"abstract":"Introduction 1.1.Cocaine use is a known risk factor for stroke and has been associated with worse outcomes. Cocaine may cause an altered coagulable state by a number of different proposed mechanisms, including platelet activation, endothelial injury, and tissue factor expression. This study analyzes the effect of cocaine use on Thrombelastography (TEG) in acute stroke patients. Patient and Methods 1.2.Patients presenting with Acute Ischemic Stroke (AIS) and spontaneous Intracerebral Hemorrhage (ICH) to a single academic center between 2009 and 2014 were prospectively enrolled. Blood was collected for TEG analysis at the time of presentation. Patient demographics and baseline TEG values were compared between two groups: cocaine and non-cocaine users. Multivariable Quantile regression models were used to compare the median TEG components between groups after controlling for the effect of confounders. Results 1.3.91 patients were included, 53 with AIS and 38 with ICH. 8 (8.8%) patients were positive for cocaine, 4 (50%) with AIS, and 4 (50%) with ICH. There were no significant differences in age, blood pressure, platelet count, or PT/PTT between the cocaine positive and cocaine negative group. Following multivariable analysis, and adjusting for factors known to influence TEG including stroke subtype, cocaine use was associated with shortened median R time (time to initiate clotting) of 3.8 minutes compared to 4.8 minutes in non-cocaine users (p=0.04). Delta (thrombin burst) was also earlier among cocaine users (0.4 minutes) compared with non-cocaine users (0.5 min, p=0.04). The median MA and G (measurements of final clot strength) were reduced in cocaine users (MA=62.5 mm, G=7.8 dynes/cm2) compared to non-cocaine users (MA=66.5 mm, G=10.1 dynes/cm2; p=0.047, p=0.04, respectively). Conclusion 1.4.Cocaine users demonstrate more rapid clot formation but reduced overall clot strength based on admission TEG values.","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75058018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.29011/2688-8734.100016
Thomas Schmidt Henriksen, C. Simonsen
Introduction: We aimed to examine trends in the diagnosis of Cerebral Venous Sinus Thrombosis (CVT) and the differences in symptomatology. Methods: We retrospectively examined all patients with a diagnosis of CVT discharged from our tertiary referral hospital in the period 2005-2016. We compared an earlier time period (2005-2013) to a later time period (2014-2016). We also compared clinical presentation with respect to age and sex. Results: We found a total of 64 patients. Thirty patients from the early time period were compared to 34 in the later time period. In the later time period, significantly more men (53%) were seen compared to the earlier period (13%), p = 0.001. Patients were also significantly older in the later time period (median age: 55 years, Interquartile Range (IQR): 27-69) than patients in the earlier period (median age: 32.5 years, IQR 24-49), p = 0.0047. Discussion: The average age of patients with CVT was higher in the later time period. We suggest that this can be due to either a decreasing incidence of CVT among young women using the oral contraceptive pill (OCP) or due to better diagnostics among elderly. If we disregard the young women using OCP, we achieve a more even distribution in sex and an older population.
简介:我们旨在探讨脑静脉窦血栓形成(CVT)的诊断趋势和症状学差异。方法:回顾性分析我院三级转诊医院2005-2016年间所有诊断为CVT的出院患者。我们比较了较早的时间段(2005-2013)和较晚的时间段(2014-2016)。我们还比较了年龄和性别方面的临床表现。结果:共发现64例患者。前期的30名患者与后期的34名患者进行比较。在后期，与前期(13%)相比，男性(53%)明显更多，p = 0.001。患者在后期(中位年龄:55岁，四分位间距(IQR): 27-69)也明显大于早期患者(中位年龄:32.5岁，IQR 24-49)， p = 0.0047。讨论:CVT患者的平均年龄越晚越高。我们认为，这可能是由于服用口服避孕药(OCP)的年轻女性CVT发病率下降，或者是由于老年人的诊断更好。如果我们忽略使用OCP的年轻女性，我们在性别和年龄较大的人群中实现了更均匀的分布。
{"title":"Temporal Trends in Incidence, Causes and Associated Factors in Cerebral Venous Thrombosis: A 12-Year Single Center Danish Study","authors":"Thomas Schmidt Henriksen, C. Simonsen","doi":"10.29011/2688-8734.100016","DOIUrl":"https://doi.org/10.29011/2688-8734.100016","url":null,"abstract":"Introduction: We aimed to examine trends in the diagnosis of Cerebral Venous Sinus Thrombosis (CVT) and the differences in symptomatology. Methods: We retrospectively examined all patients with a diagnosis of CVT discharged from our tertiary referral hospital in the period 2005-2016. We compared an earlier time period (2005-2013) to a later time period (2014-2016). We also compared clinical presentation with respect to age and sex. Results: We found a total of 64 patients. Thirty patients from the early time period were compared to 34 in the later time period. In the later time period, significantly more men (53%) were seen compared to the earlier period (13%), p = 0.001. Patients were also significantly older in the later time period (median age: 55 years, Interquartile Range (IQR): 27-69) than patients in the earlier period (median age: 32.5 years, IQR 24-49), p = 0.0047. Discussion: The average age of patients with CVT was higher in the later time period. We suggest that this can be due to either a decreasing incidence of CVT among young women using the oral contraceptive pill (OCP) or due to better diagnostics among elderly. If we disregard the young women using OCP, we achieve a more even distribution in sex and an older population.","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83555852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kolby T Redd, S T Phillips, Brittiny McMillian, Lauren Giamberardino, James Hardin, Saundra Glover, Anwar Merchant, Christiano Susin, James D Beck, Steven Offenbacher, Souvik Sen
Background: Stroke remains more common in the "buckle" of the stroke belt, and disproportionately impacts African Americans. The reasons for this racial disparity are poorly understood and are not entirely explained by traditional stroke risk factors. The PeRiodontal treatment to Eliminate Minority InEquality and Rural disparities in Stroke (PREMIERS) study will evaluate the effect of periodontal treatment on recurrent vascular events and stroke risk factors among ischemic stroke and transient ischemic attack patients.
Design: Eligibility for the trial includes a non-disabling stroke confirmed by neuroimaging or Transient Ischemic Attack (TIA), being at least 18 years of age, having ≥ 5 natural teeth with ≥ 2 interproximal sites with ≥ 4 mm of clinical attachment loss and at least 2 sites with probing depth of ≥ 5 mm, and who are able to provide written informed consent. Within 90 days of the index event, patients are randomly assigned to intensive or initial standard cycle of supragingival mechanical scaling, polishing, and oral health instruction and followed for 1 year. The primary outcome is a composite of death, myocardial infarction and stroke or TIA. Secondary outcomes include A1C, fasting lipid profile, triglycerides, high sensitivity C-reactive protein, carotid intimal medial thickness, and blood pressure. A five year enrollment period followed by an addition one year of follow-up is planned.
{"title":"PeRiodontal Treatment to Eliminate Minority Inequality and Rural Disparities in Stroke (PREMIERS): A Multicenter, Randomized, Controlled Study.","authors":"Kolby T Redd, S T Phillips, Brittiny McMillian, Lauren Giamberardino, James Hardin, Saundra Glover, Anwar Merchant, Christiano Susin, James D Beck, Steven Offenbacher, Souvik Sen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Stroke remains more common in the \"buckle\" of the stroke belt, and disproportionately impacts African Americans. The reasons for this racial disparity are poorly understood and are not entirely explained by traditional stroke risk factors. The PeRiodontal treatment to Eliminate Minority InEquality and Rural disparities in Stroke (PREMIERS) study will evaluate the effect of periodontal treatment on recurrent vascular events and stroke risk factors among ischemic stroke and transient ischemic attack patients.</p><p><strong>Design: </strong>Eligibility for the trial includes a non-disabling stroke confirmed by neuroimaging or Transient Ischemic Attack (TIA), being at least 18 years of age, having ≥ 5 natural teeth with ≥ 2 interproximal sites with ≥ 4 mm of clinical attachment loss and at least 2 sites with probing depth of ≥ 5 mm, and who are able to provide written informed consent. Within 90 days of the index event, patients are randomly assigned to intensive or initial standard cycle of supragingival mechanical scaling, polishing, and oral health instruction and followed for 1 year. The primary outcome is a composite of death, myocardial infarction and stroke or TIA. Secondary outcomes include A1C, fasting lipid profile, triglycerides, high sensitivity C-reactive protein, carotid intimal medial thickness, and blood pressure. A five year enrollment period followed by an addition one year of follow-up is planned.</p>","PeriodicalId":92795,"journal":{"name":"International journal of cerebrovascular disease and stroke","volume":"2 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7064156/pdf/nihms-1060091.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37726899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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