scholarly journals Critical issue on the extinction and inattention subtest of NIHSS scale: an analysis on post-acute stroke patients attending inpatient rehabilitation

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Benedetta Basagni ◽  
Bahia Hakiki ◽  
Silvia Campagnini ◽  
Emilia Salvadori ◽  
Antonello Grippo ◽  
...  
Keyword(s):  
Visual Field ◽  
Diagnostic Performance ◽  
Inpatient Rehabilitation ◽  
Critical Issue ◽  
Stroke Patients ◽  
Extreme Caution ◽  
Link Type ◽  
Rank 2 ◽  
Cognitive Screen

Abstract Objectives This study aims to evaluate the diagnostic performance of NIHSS extinction and inattention item, compared to the results of the Oxford Cognitive Screen (OCS) heart subtest. Additionally, the possible role of the NIHSS visual field subtest on the NIHSS extinction and inattention subtest performance is explored and discussed. Methods We analysed scores on NIHSS extinction and inattention subtest, NIHSS visual field subtest, and OCS heart subtest on a sample of 118 post-stroke patients. Results Compared to OCS heart subtest, the results on NIHSS extinction and inattention subtest showed an accuracy of 72.9% and a moderate agreement level (Cohen’s kappa = 0.404). Furthermore, a decrease in NIHSS accuracy detecting neglect (61.1%) was observed in patients with pathological scores in NIHSS visual field item. Conclusions Extreme caution is recommended for the diagnostic performance of extinction and inattention item of NIHSS. Signs of neglect may not be detected by NIHSS, and may be confused with visual field impairment. Trial registration This study refers to an observational study protocol submitted to ClinicalTrials.gov with identifier: NCT03968627. The name of the registry is “Development of a National Protocol for Stroke Rehabilitation in a Multicenter Italian Institution” and the date of the registration is the 30th May 2019.

scholarly journals Critical Issue On The Extinction and Inattention Subtest of NIHSS Scale. An Analysis on Post-Acute Stroke Patients Attending Inpatient Rehabilitation

2021 ◽  
Author(s):  
Benedetta Basagni ◽  
Bahia Hakiki ◽  
Silvia Campagnini ◽  
Emilia Salvadori ◽  
Antonello Grippo ◽  
...  
Keyword(s):  
Visual Field ◽  
Stroke Rehabilitation ◽  
Diagnostic Performance ◽  
Inpatient Rehabilitation ◽  
Critical Issue ◽  
Stroke Patients ◽  
Extreme Caution ◽  
Rank 2 ◽  
Cognitive Screen

Abstract Objectives This study aims to evaluate the diagnostic performance of NIHSS extinction and inattention item, compared to the results of the Oxford Cognitive Screen (OCS) heart subtest. Additionally, the possible role of the NIHSS visual field subtest on the NIHSS extinction and inattention subtest performance is explored and discussed. Methods We analysed scores on NIHSS extinction and inattention subtest, NIHSS visual field subtest, and OCS heart subtest on a sample of 118 post-stroke patients. Results Compared to OCS heart subtest, the results on NIHSS extinction and inattention subtest showed an accuracy of 77.1% and a moderate agreement level (Cohen’s kappa = 0.455). Furthermore, a decrease in NIHSS accuracy detecting neglect (55.6%) was observed in patients with pathological scores in NIHSS visual field item. Conclusions Extreme caution is recommended for the diagnostic performance of extinction and inattention item of NIHSS. Signs of neglect may not be detected by NIHSS, and may be confused with visual field impairment. Trial registration: This study refers to an observational study protocol submitted to ClinicalTrials.gov with identifier: NCT03968627 (URL: https://www.clinicaltrials.gov/ct2/show/NCT03968627?term=Cecchi&cond=Stroke&draw=2&rank =2). The name of the registry is “Development of a National Protocol for Stroke Rehabilitation in a

Abstract P50: IV Alteplase Use Predicts Favorable Discharge Disposition in Patients With Acute Ischemic Stroke: Insights From the UTHSC Houston Stroke Registry

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Nneka Ifejika-Jones ◽  
Nusrat Harun ◽  
Elizabeth Noser ◽  
James Grotta
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Status ◽  
Inpatient Rehabilitation ◽  
Level Of Care ◽  
Stroke Patients ◽  
Short Term ◽  
Post Stroke ◽  
Discharge Disposition

Introduction: Acute ischemic stroke patients receiving IV alteplase (t-PA) within 4.5 hours of symptom onset are 30% more likely to have minimal or no disability at 3 months. During hospitalization, short-term disability is subjectively measured by discharge disposition, whether to home or Inpatient Rehabilitation (IR), Skilled Nursing Facility (SNF) or Sub-acute Care (Sub). There are no studies assessing the role of IV t-PA as a predictor of short-term disability, evidenced by post-stroke disposition. Hypothesis: Low NIHSS is a predictor of high functional status. We assessed the hypothesis that similar to low NIHSS, t-PA predicts post-stroke disposition to a level of care suggestive of high functional status. Methods: All patients with acute ischemic stroke admitted to the UT Service between January 2004 and October 2009 were included. Stratification occurred for age>65, NIHSS and stroke risk factors. Using multivariate logistic regression, the data was analyzed to determine whether there were differences in post-stroke disposition among patients who received t-PA. Results: Patients with mild (NIHSS<8) and moderate (NIHSS 8 to 16) stroke were discharged to the highest level of care in each analysis. Home vs. Other Level of Care Of 2261 patients, 1032 were discharged home, 1229 to another level of care. Patients who received t-PA were 1.7 times more likely to be discharged home (P = <.0001, OR 1.663, 95% CI 1.326 to 2.085). IR vs. SNF Of 1111 patients, 731 patients were discharged to acute IR, 380 to SNF. There were no statistically significant differences in disposition between patients who received t-PA. (P = .0638, OR 1.338, 95% CI 0.983 to 1.822). SNF vs. Sub Of 498 patients, 380 were discharged to SNF, 118 to Sub. There were no significant differences in disposition between patients who received t-PA. Conclusion: Acute stroke patients who receive IV t-PA are more 1.7 times more likely to be discharged home. If post-stroke care is necessary, there is a trend toward rehabilitation at a level reflective of improved functional status (IR vs. SNF). This study is limited by its retrospective nature and the undetermined role of psychosocial factors related to discharge. Prospective studies of time to t-PA therapy in relation to post-stroke disposition are warranted.

The role of nursing in the rehabilitation of acute stroke patients: Toward a unified theoretical perspective

Pflege ◽  
1999 ◽  
Vol 12 (1) ◽  
pp. 21-27
Author(s):  
Marit Kirkevold
Keyword(s):  
Acute Stroke ◽  
Theoretical Perspective ◽  
Stroke Patients ◽  
Role Of Nursing ◽  
Rolle Der Pflegenden

Eine Übersicht der bestehenden Literatur weist auf Unsicherheiten bezüglich der spezifischen Rolle der Pflegenden in der Rehabilitation von Hirnschlagpatientinnen und -patienten hin. Es existieren zwei unterschiedliche Begrifflichkeiten für die Rolle der Pflegenden, keine davon bezieht sich auf spezifische Rehabilitationsziele oder Patientenergebnisse. Ein anfänglicher theoretischer Beitrag der Rolle der Pflege in der Genesung vom Hirnschlag wird als Struktur unterbreitet, um die therapeutischen Aspekte der Pflege im Koordinieren, Erhalten und Üben zu vereinen. Bestehende Literatur untermauert diesen Beitrag. Weitere Forschung ist jedoch notwendig, um den spezifischen Inhalt und Fokus der Pflege in der Genesung bei Hirnschlag zu entwickeln.

The Role of RDW in Mortality Rates of Stroke Patients

2020 ◽  
Vol 27 (2) ◽  
pp. 107-112
Author(s):  
Huseyin BUYUKGOL ◽  
◽  
Fatma Aysen EREN ◽  
Keyword(s):  
Mortality Rates ◽  
Stroke Patients

Role of dyslipidemia in ischemic stroke patients treated in the telestroke network

2021 ◽  
Vol 66 (2) ◽  
pp. 254-261
Author(s):  
Leanne Brechtel ◽  
Nicolas Poupore ◽  
Margaret Monroe ◽  
Krista Knisley ◽  
Carolyn Sanders ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Stroke Patients

scholarly journals Does intervention with GLP-1 receptor agonist semaglutide modulate perception of sweet taste in women with obesity: study protocol of a randomized, single-blinded, placebo-controlled clinical trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mojca Jensterle ◽  
Simona Ferjan ◽  
Tadej Battelino ◽  
Jernej Kovač ◽  
Saba Battelino ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Neural Response ◽  
Taste Perception ◽  
Taste Bud ◽  
Controlled Clinical Trial ◽  
Food Cues ◽  
Link Type ◽  
Visual Food Cues ◽  
Taste Bud Cells

Abstract Background Preclinical studies demonstrated that glucagon-like peptide 1 (GLP-1) is locally synthesized in taste bud cells and that GLP-1 receptor exists on the gustatory nerves in close proximity to GLP-1-containing taste bud cells. This local paracrine GLP-1 signalling seems to be specifically involved in the perception of sweets. However, the role of GLP-1 in taste perception remains largely unaddressed in clinical studies. Whether any weight-reducing effects of GLP-1 receptor agonists are mediated through the modulation of taste perception is currently unknown. Methods and analysis This is an investigator-initiated, randomized single-blind, placebo-controlled clinical trial. We will enrol 30 women with obesity and polycystic ovary syndrome (PCOS). Participants will be randomized in a 1:1 ratio to either semaglutide 1.0 mg or placebo for 16 weeks. The primary endpoints are alteration of transcriptomic profile of tongue tissue as changes in expression level from baseline to follow-up after 16 weeks of treatment, measured by RNA sequencing, and change in taste sensitivity as detected by chemical gustometry. Secondary endpoints include change in neural response to visual food cues and to sweet-tasting substances as assessed by functional MRI, change in body weight, change in fat mass and change in eating behaviour and food intake. Discussion This is the first study to investigate the role of semaglutide on taste perception, along with a neural response to visual food cues in reward processing regions. The study may identify the tongue and the taste perception as a novel target for GLP-1 receptor agonists. Ethics and disseminations The study has been approved by the Slovene National Medical Ethics Committee and will be conducted in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines. Results will be submitted for publication in an international peer-reviewed scientific journal. Trial registration ClinicalTrials.govNCT04263415. Retrospectively registered on 10 February 2020

scholarly journals Correction to: Role of Bempedoic Acid in Clinical Practice

2021 ◽  
Author(s):  
Christie M. Ballantyne ◽  
Harold Bays ◽  
Alberico L. Catapano ◽  
Anne Goldberg ◽  
Kausik K. Ray ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Link Type

A Correction to this paper has been published: 10.1007/s10557-021-07188-w

scholarly journals Demonstrating the vital role of physiatry throughout the health care continuum: Lessons learned from the impacts of the COVID‐19 pandemic on inpatient rehabilitation

PM&R ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 554-562
Author(s):  
Jonathan H. Whiteson ◽  
Miguel Xavier Escalón ◽  
Susan Maltser ◽  
Monica Verduzco‐Gutierrez
Keyword(s):  
Health Care ◽  
Inpatient Rehabilitation ◽  
Vital Role ◽  
Lessons Learned ◽  
Care Continuum

The Psychologist-Educator Views the Relationship of Vision to Reading and Related Learning Disabilities

1981 ◽  
Vol 14 (10) ◽  
pp. 565-567 ◽  
Author(s):  
Jules C. Abrams
Keyword(s):  
Learning Disabilities ◽  
Visual Field ◽  
Visual Perception ◽  
Learning Disability ◽  
Visual Defects ◽  
Considerable Controversy ◽  
Visual Problems ◽  
Relationship Of ◽  
The Relationship

The role of visual problems in learning disability has been a source of considerable controversy for many years. One major issue in the continuing argument is the frequent confusion of labels and concepts in the visual field. It is important to view vision as a psychophysiologic mechanism and to differentiate it from a mechanistic orientation emphasizing the eyes. Most visual problems related to learning disability represent a breakdown in the ability of the eyes to function in an harmonious fashion, that is, some interference in binocular function. While visual defects should not be confused with defects in visual perception, the identification and treatment of visual problems is an important element in the diagnosis and remediation of learning disabilities.

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