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The article focuses on the diagnosis of patient with an acute neuroophthalmic disorder and the role of primary eye care providers. Topics discussed include neuro-ophthalmic emergencies, a condition that pose a threat to visual system function and or systemic wellbeing, giant cell arteritis (GCA) which is the medical emergency in eye care, and pituitary tumor apoplexy.

Acute stroke and transient ischaemic attack (TIA) are focal neurological syndromes of vascular origin and should be treated as medical emergencies. Brain imaging with computed tomography or magnetic resonance imaging is required to identify ischaemia from haemorrhage, recognize non-stroke pathologies that mimic stroke and guide investigation for underlying mechanism. Acute interventions of benefit in ischaemic stroke include intravenous thrombolysis with alteplase given within 4.5 hours of onset, stroke unit care and aspirin. Decompressive hemicraniectomy reduces mortality in ischaemic stroke complicated by severe brain swelling. Intracerebral haemorrhage accounts for 10% of strokes, and while specific treatments are lacking at present, patients benefit from general measures, notably stroke unit care. Transient ischaemic attack carries a high short-term risk of stroke, and immediate investigation and institution of secondary preventative treatment prevents a high proportion of these events. Secondary prevention for ischaemic stroke and TIA should be tailored according to mechanism in the individual patient and includes anti-platelet therapies, blood-pressure-lowering, statins, carotid endarterectomy and anticoagulation. [ABSTRACT FROM AUTHOR]

The article investigates treatment options for atrial fibrillation (AF). According to the author, AF is a strong risk factor for stroke and around 2.4 million people in the U.S. are believed to have AF. She reveals that prevention of stroke and thromboembolism is necessary when managing AF patients, with antithrombotic agents being the most common treatment option. She adds that aspirin is more effective compared with placebo, but less effective than warfarin in terms of preventing stroke.

The article discusses the study on the chronic diabetic complications in Africa based on available epidemiological data. It cites samples from referral clinics based on the aspects of retinopathy; the diabetic foot, diabetic neuro-pathy and peripheral vascular disease. The authors also presents the diabetic complications due to diabetic nephropathy; coronary artery disease; and cerebrovascular disease.

The article discusses anticoagulants or medications that control blood clotting. According to the article, medications such as warfarin or coumadin are used by patients at risk of a heart attack or stroke to control blood clotting. It adds that many companies have focused on the protease enzymes Factor Xa and thrombin to develop safer and more effective blood thinners. A description of a blood clot or thrombus is given.

Problem/Condition: Each year, approximately 795,000 persons in the United States experience a new or recurrent stroke. Data from the prototype phase (2001-2004) of the Paul Coverdell National Acute Stroke Registry (PCNASR) suggested that numerous acute stroke patients did not receive treatment according to established guidelines. Reporting Period: This report summarizes PCNASR data collected during 2005-2007 from Georgia, Illinois, Massachusetts, and North Carolina, the first states to have PCNASRs implemented in and led by state health departments. Description of System: PCNASR was established by CDC in 2001 to track and improve the quality of hospital-based acute stroke care. The prototype phase (2001-2004) registries were led by CDC-funded clinical investigators in academic and medical institutions, whereas the full implementation of the 2005-2007 statewide registries was led by CDC-funded state health departments. Health departments in each state recruit hospitals to collect data. To be included in PCNASR, patients must be aged >18 years and have a clinical diagnosis of acute ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, or transient ischemic attack (TIA) or an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code indicative of a stroke or TIA. Data for patients who are already hospitalized at the time of stroke are not included. The following 10 performance measures of care, based on established guidelines for care of acute stroke patients, were developed by CDC in partnership with neurologists who specialize in stroke care: 1) received deep venous thrombosis prophylaxis, 2) received antithrombotic therapy at discharge, 3) received anticoagulation therapy for atrial fibrillation, 4) received tissue plasminogen activator (among eligible patients), 5) received antithrombotic therapy within 48 hours of admission or by the end of the second hospital day, 6) received lipid level testing, 7) received dysphagia screening, 8) received stroke education, 9) received smoking cessation counseling, and 10) received assessment for rehabilitation services. Adherence to these performance measures of care was calculated using predefined inclusion and exclusion criteria. Results: A total of 195 hospitals from Georgia, Illinois, Massachusetts, and North Carolina contributed data to PCNASR during 2005-2007, representing 56,969 patients. Approximately half (53.3%) the cases of stroke in the registry occurred among females. A total of 2.5% of cases were among Hispanics; however, the proportion varied significantly by state. Cases among black patients ranged from 5.6% in Massachusetts to 35.8% in Georgia. The age at which patients experienced stroke varied significantly by state. On average, patients were oldest in Massachusetts (median age: 77 years) and youngest in Georgia (median age: 67 years). Overall, the clinical diagnosis for registry stroke cases was hemorrhagic stroke (13.8% of cases), ischemic stroke (56.2%), ill-defined stroke (i.e., medical record did not specify ischemic or hemorrhagic stroke; 7.3%), and TIA (21.6%). A total of 18.5% of patients with stroke symptoms arrived at the hospital within 2 hours of symptom onset; however, the time from onset of symptoms to hospital arrival was not recorded or was not known for the majority (57.8%) of patients. Of the 56,969 patients, 47.6% were transported by emergency medical services (EMS) from the scene of symptom onset, 11.1% were transferred by EMS from another hospital, and 39.4% used private or other transportation.… [ABSTRACT FROM AUTHOR]

To get to this level of adherence, there must be effective communication between the patient and pharmacist to ensure there is a clear understanding of why and how to take their medications.3 Automatic home medication dispensers, fixed-dose combination drugs, mobile health applications, and patient incentives can improve medication adherence for patients who have CVD or are at risk of having the disease. Counseling patients about adhering to these medications, even if they do not see an impact, is a crucial role for pharmacists.2 The 2 measures for medication adherence are pooled from prescription claims data: the medication possession ratio and the proportion of days covered (PDC). [Extracted from the article]

This article examines the importance of information giving and its role in gaining informed consent from patients with sickle cell disease requiring exchange blood transfusion for the management of stroke. The rationale for the use of exchange blood transfusion in patients with sickle cell disease who have had a stroke is explained. The impact of stroke on cognition is highlighted and the implications for informed decision making are considered. Other factors such as communicating risk are discussed. [ABSTRACT FROM AUTHOR]

The article offers information on various aspects of stroke and transient ischaemic attack. It refers its definition, short and long term management, referral, prescription, and risk factor management. Stroke is said to be a clinical syndrome characterized by the rapid onset of a focal cerebral deficit lasting at least 24 hours and for which there is no other cause than a vascular one, whereas transient ischaemic attack, differs from a stroke only in the deficit lasting time.

There are a wide variety of causes of stroke and as many different forms of presentation, depending on the area of the brain affected. This article describes how different types of stroke present and outlines the likely outcome for patients for each type. [ABSTRACT FROM AUTHOR]

This article provides an overview of transient ischaemic attack (TIA). It discusses the clinical presentation of TIA, its significance as a marker of vascular risk, key diagnostic interventions and management strategies. Trends and challenges in service provision and the roles of specialist and general nurses in managing patients with TIA are explored. [ABSTRACT FROM AUTHOR]

The article presents a case report of a 50-year-old white male with vertebrobasilar disease and cites ways of how to manage patients with this kind of disease. The examination shows remarkable hypertension, cerebrovascular accident and vertebrobasilar artery disease of the patient. A hypoperfusion retinopathy was being used to diagnose the patient. A discussion was made regarding the result of the examination. Instruments used for the treatment of this disease are offered. INSET: Anatomy of Blood Flow to the Brain.

Intermittent claudication is a common manifestation of peripheral arterial disease, its symptoms have a gradual onset and the patient may not notice them initially, instead accepting them as part of the ageing process. The main concern with intermittent claudication is the increased risk of cardiovascular or cerebrovascular events. This article highlights the relationship between these diseases and suggests ways to reduce risk and promote best practice. [ABSTRACT FROM AUTHOR]

The article presents information about the recognition of patients of transient ischaemic attack (TIA). Stroke is a clinical diagnosis, with the definition being a syndrome characterised by rapidly developing clinical symptoms and/or signs of focal loss of cerebral function, with symptoms lasting more than 24 hours or leading to death, and with no apparent cause other than that of vascular origin. TIA is defined in the same way as stroke but with the deficit lasting less than 24 hours. Amaurosis fugax is a TIA affecting the retinal artery, producing transient loss of vision in one eye.

Focuses on the clinical management of stroke patients in the U.S. Estimated number of U.S. citizens who will have a stroke by 2050; Role of technology in stroke treatment; Problems encountered in stroke treatment; Factors to consider in launching a stroke center.

In recent years stroke has been recognised as a national clinical, research and policy priority. Stroke nurses and stroke nursing are important contributors, but previous studies have highlighted lack of clarity and contradictions in the nursing role. A stroke nursing conference in 2002 offered the opportunity to explore nurses' vision for the future through a series of focus group meetings. Many examples of good practice were identified, for example, nursing contributions to risk factor management and secondary prevention, service co-ordination and development, follow-up and support of stroke patients and their families. However, areas for further development include realigning services to a patient focus and ensuring equitable access, integrating services, supporting development of the nursing research evidence base and providing career and educational frameworks for nurses in stroke care. Nurses set out a vision for stroke nursing in which current strengths and developments are consolidated and disseminated in a dynamic, multiprofessional, integrated patient-focused service. [ABSTRACT FROM AUTHOR]

The article presents information on stroke. Stroke is a clinical syndrome characterised by the sudden onset of a deficit in brain function or rapidly developing symptoms and signs of focal or global loss of cerebral function. The most common presentation is of sudden onset of hemiplegia. Patients, or their relatives on their behalf, complain of loss of limb function. There may also be signs of higher cerebral dysfunction, such as aphasia. Some patients have a hemisensory loss, visual field deficit or brainstem problem. The role of ramipril in the primary prevention of stroke is under scrutiny and it may be that patients at high risk of stroke should be on ramipril in addition to whatever treatment they are taking for hypertension. INSET: The new contract: stroke and TIA.

The article gives a practical strategy for managing cholesterol levels under the new General Medical Services (GMS) contract. A cholesterol target occurs in three clinical categories in the new GMS contract with a total of 21 points available. The new British Hypertension Society guidelines recommend statins for hypertensive patients aged up to 80 years with a total cholesterol of more than 3.5 mmol/1, who have an estimated 10-year cardiovascular risk of 20% or more. The Heart Protection Study monitored 20,536 adults aged 40-80 in Great Britain with a total cholesterol of more than 3.5 mmol/1 and a substantial 5-year risk of death from coronary heart disease (CHD). The implication of the Heart Protection Study is that patients with CHD, stroke or diabetes should be on a statin regardless of their total cholesterol level.

Stroke can have a devastating effect on a patient's life and that of his or her family. This article discusses the causes and effects of stroke and outlines the role of the nurse in the rehabilitation of a patient after stroke with reference to the National Clinical Guidelines for Stroke (RCP 2002). [ABSTRACT FROM AUTHOR]

The article discusses the effect of hypertension and diabetes which leads to the progressive vision loss of one's right eye. It mentions that macroaneurysm (MA) is commonly seen in older individuals and is more likely to be observed in females than in males. It cites some systemic risk factors which include cerebrovascular disease, hyperlipidemia, and hypertension. Moreover, treatment options for MA includes vitrectomy, laser photodisruption, and spontaneous resolution.

This article addresses the link between morning hypertension and cardiovascular events. Particular focus is given to two kinds of morning hypertension. It notes that cardiovascular events frequently occurs during the morning hours. The risk of ischemic stroke is four times higher in the morning period, while sudden cardiac death risk is 70% greater between 7 AM and 9 AM. Home blood pressure monitoring is recommended in patients with or suspected for hypertension.

The article focuses on cases of post-polio syndrome (PPS) in the U.S. In 2007, an estimated 1.6 million Americans have survived polio's acute infectious stage with disabilities ranging from weakness to paralysis. Polio survivors are now entering nursing homes for treatment of comorbidities, such as heart disease and stroke, and injuries such as hip fractures. Nursing home staff play a pivotal role in helping residents with PPS remain strong, with maximum functioning unimpeded by tile resurgence of their childhood disease.

The article focuses on the 1-year results from the Reduction of Atherothrombosis for Continued Health (REACH) Registry and the practical implications for identifying and managing patients at high risk of the cardiovascular (CV) disease, Atherothrombosis. Aherothrombosis, the unifying pathology underlying ischaemic stroke, transient ischaemic attack (TIA), myocardial infarction (MI) and peripheral arterial disease (PAD), is the leading global cause of morbidity and mortality.

The article presents questions and answers related to medicine including whether the new drugs for use in the first few hours of a stroke effective, what is current thinking on lowering high blood pressure at the time of the stroke, and how helpful is speech therapy.

This article discusses a screen for dysphagia that is performed on ischemic/hemorrhagic stroke patients before being given food, medication or fluids. Screening will determine whether dysphagia is present, whether it is safe to feed a patient orally, and whether a referral for nutritional support or hydration is warranted.

The article presents news related to the field of science. A Swedish study has suggested that smoking and human papillomavirus type 16 have a combined effect in increasing cervical cancer risk. Researchers from the Wolfson Institute of Preventive Medicine in London have found that 0.8mg folic add daily can reduce the relative risk of stroke. Professor Arie Nouwen, senior lecturer in clinical psychology has indicated that depression cases among diabetes patients remains undetected.

Recognising the symptoms of stroke is crucial to ensuring this life-threatening condition is treated quickly, writes Catharine Sadler. [ABSTRACT FROM AUTHOR]

The article presents information on stroke and its treatment. Stroke is known as a disease of death and disability and it rises steadily with age after 55 years. The article also offers findings of a research on stroke in Great Britain. Patients suffered from acute stroke should be admitted to hospital. Patients with stroke should undergo brain imaging within 24 hours. Smoking also increases the relative risk of stroke.

streamlining care can reduce morbidity and mortality from stroke. Nurses in Merseyside have organised services so that patients with suspected stroke are fast-tracked through the system. [ABSTRACT FROM AUTHOR]

Explores the issues and challenges associated with aphasia treatment. Poor understanding of the functional challenges of the brain during the non-acute stages of stroke; Treatment options for aphasia; Goals of treatment; Role of biological intervention in stimulating and repairing the injured brain area.

The article discusses the new diagnosis codes for hearing- and speech-related conditions under the updated International Classification of Diseases, 10th Revision, Clincial Modification (ICD-10-CM) in the U.S. as of November 2016. Under the new codes, Medicare allowed coding flexibilities. The new codes were developed by such organizations as the Academy of Doctors of Audiology, and the American Speech-Language-Hearing Association (ASHA).

The article offers news briefs related to scientific research in the U.S. The research team from the Pacific Northwest National Laboratory developed a laser-powered chemical analysis technique that takes samples from hair. The Clinical Proteomics Research Center used mass spectrometers in providing insight into key areas of stroke assessment and treatment. Professor Harvey Lui from the University of British Columbia is studying a diagnostic device that could detect skin cancer.

The article reports that researchers in Johns Hopkins University in Baltimore, Maryland found out that ranibizumab and bevacizumab is associated with high-risk of hemorrhagic cerebrovascular accidents when injected intravitereally to treat neovascular age-related macular degeneration (AMD). It states that the rationale behind the study was the risks of adverse events linked to both drugs. Emily Gower, associate professor of the University, reports that the drugs increases the risk of stroke.

This article explained how early interventions and clinical input from stroke specialists and multidisciplinary teams can save lives and prevent further damage to the brain following stroke. Nurses have an important role in ensuring that stroke patients are seen promptly during triage. [ABSTRACT FROM AUTHOR]

The article discusses the need for optometrists to determine if patients with migraine problems are suffering from a more serious neurological condition. Acknowledging that not all migraine complaints are eye-related, optometrists are advised to diagnose patients for symptoms such as increase in frequency of migraines, changes in personality or mental state, and quality and location of pain. Medical experts confirm that migraine can also be indicators of cerebrovascular disease, subarachnoid hemorrhage, and intracranial tumor.

The article discusses important megatrends in the field of medicine and their impact on the practice of optometry. It cites the need for optometrists to be proactive in informing their patients about the symptoms and signs of stroke and monitor them for possible risks. Optometrists are also advised to order laboratory testing and be able to discuss the results with their patients' personal doctors. The article explains the principles of evidence-based medicine which include pathophysiology, patient's history, and pharmacology.

The article reports on studies presented during the American Heart Association Scientific Sessions held last November 13-17, 2010 in Chicago, Illinois. It focuses on the efficacy of anacetrapib in reducing low-density lipoprotein without increasing the blood pressure of patients taking statins. It explores the link of deficiency in vitamin D to high fatal stroke risk in Caucasians and the high mortality rate of African Americans who suffer a stroke. It compares the efficacy of rivaroxaban to that of warfarin as an anticlotting therapy.

The article discusses the role of transient monocular vision loss (TVML) in predicting risk for a major cerebrovascular or cadiovascular event. According to optometrist David M. Krumholz, TVML is often associated with atherosclerosis, which emphasizes the need for optometrists to evaluate patients for possible causes of transient vision loss and identify those who need to be referred for evaluation and treatment of an underlying medical condition. Krumholz suggests educating patients and their families on the warning signs and symptoms of stroke for early intervention.

The article presents a case study on stroke or cerebrovascular accident (CVA) rehabilitation, through the Sports Vision Trainer (SVT). A 51-year-old with a history of raised cholesterol, suffered CVA, but did not take any medications. It is stated that after the use of SVT, a significant improvement in coordination and confidence was achieved by the patient.

The article discusses the zoning bills that will mitigate the establishment of fast food restaurants in cities. The increasing fast food restaurants within the neighborhood of the cities contributed to rising risks suffering from health problems such as stroke by 13 percent, based on a study by the University of Michigan School of Public Health. The study also backs the revived yearlong restriction on new fast food diners in a 32-square-mile area in Los Angeles, California.

The article explores several ways to minimize the risk of recurrence of stroke and transient ischemic attack (TIA). Antiplatelet agents have been used to reduce the recurrent risk of stroke in patients with noncardioembolic ischemic stroke or TIA. Among the combined therapy options are aspirin plus clopidogrel and aspirin plus dipyridamole. Patients and clinicians are also advised to enhance their knowledge of the symptoms of a stroke.

Information about Specsavers' Professional Advancement Committee (PAC) Conference held in Great Britain in 2009 is presented. The conference offers two lectures covering eye care practitioners. Associate Professor Harrison Weisenberger discusses stroke and the visual system. Physician Robert Harper describes the best way in evaluating the optic disc.

The article reports on the move of the American Speech-Language-Hearing Association's (ASHA) Health Care Economics Committee (HCEC) to propose the revision and expansion codes to the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). It notes that the diagnostic code is for speech-language deficits and for the resonance disorders. It mentions that the revision is an improvement over the current classification of the cerebrovascular disease.

The article reports that silent cerebral infarct or minor stroke may be considered as an independent risk factor for visual field loss in patients who are newly diagnosed with normal-tension glaucoma (NTG). A prospective cohort study conducted by researchers at the Chinese University of Hong Kong has proven the risk of minor stroke in patients with NTG due to disturbances in blood supply leading to loss of some brain function. The study participants include 286 eyes from 286 patients with NTG.

The article reports on the association of inhaler treatment with heart attack and stroke to chronic obstructive pulmonary disease (COPD) patients. It mentions the involvement of inhalers such as anticholinergics apratropium and tiotropium though they are effective treatment for COPD. In addition, experts continue to study the impacts of inhalers to heart attack and stroke.

The article emphasizes the need for fire departments to create a comprehensive medical evaluation program for fire fighters. It relates the prevalence of heart attacks and strokes among fire fighters. Other conditions contributing to fire fighter mortality include diabetes and obesity. It stresses the value of encouraging fire fighters to get annual comprehensive medical evaluation and to participate in physical fitness programs.

A growing awareness of the prevalence of stroke in younger people has motivated changes in procedures at one acute NHS trust and spurred on survivors to set up their own support group. [ABSTRACT FROM AUTHOR]

The article presents information on emergency treatment for ischemic stroke. A brief information is given on the pathophysiology and mortality rate from stroke in the U.S. It discusses the use of alteplase, a tissue plasminogen activator, for treating stroke. It summarizes appropriate candidates who can undergo intravenous alteplase therapy. It also offers guidelines for the administration of alteplase.