A5053846091- Acute Ischemic Stroke Management
- Stroke Rehabilitation and Recovery
- Cerebrovascular and Carotid Artery Diseases
- Traumatic Brain Injury and Neurovascular Disturbances
- Intracerebral and Subarachnoid Hemorrhage Research
- Atrial Fibrillation Management and Outcomes
- Venous Thromboembolism Diagnosis and Management
- Clinical practice guidelines implementation
- Neurological Disorders and Treatments
- Healthcare Systems and Practices
- Antiplatelet Therapy and Cardiovascular Diseases
- Gout, Hyperuricemia, Uric Acid
- Cardiac, Anesthesia and Surgical Outcomes
- Cardiac Imaging and Diagnostics
- Neurosurgical Procedures and Complications
- Cardiac Arrhythmias and Treatments
- Intracranial Aneurysms: Treatment and Complications
- Sepsis Diagnosis and Treatment
- Climate Change and Health Impacts
- Thermal Regulation in Medicine
- S100 Proteins and Annexins
- Heart Rate Variability and Autonomic Control
- Long-Term Effects of COVID-19
- Cardiac Health and Mental Health
- Cerebral Palsy and Movement Disorders
King's College London
2012-2025
National Health Service
2010-2025
Guy's and St Thomas' NHS Foundation Trust
2013-2024
St Thomas' Hospital
2012-2024
Campbell Collaboration
2021
Mastercard (United States)
2020
Siemens Healthcare (United States)
2019
Stroke Association
2016
Kings Health Partners
2012
All India Institute of Medical Sciences
2009
Results of small trials indicate that fluoxetine might improve functional outcomes after stroke. The FOCUS trial aimed to provide a precise estimate these effects.FOCUS was pragmatic, multicentre, parallel group, double-blind, randomised, placebo-controlled done at 103 hospitals in the UK. Patients were eligible if they aged 18 years or older, had clinical stroke diagnosis, enrolled and randomly assigned between 2 days 15 onset, focal neurological deficits. allocated 20 mg matching placebo...
With recent advances in secondary prevention management, stroke recurrence rates may have changed substantially. We aim to estimate risks and trends of over the past 2 decades a population-based cohort patients with stroke.Patients first-ever between 1995 2018 South London, United Kingdom (n=6052) were collected analyzed. Rates recurrent 95% CIs stratified by 5-year period index etiologic TOAST (Trial ORG 10172 Acute Stroke Treatment) subtype. Cumulative incidences estimated multivariate Cox...
Cerebral microbleeds are a potential neuroimaging biomarker of cerebral small vessel diseases that prone to intracranial bleeding. We aimed determine whether presence can identify patients at high risk symptomatic haemorrhage when anticoagulated for atrial fibrillation after recent ischaemic stroke or transient attack.
Background and Purpose —Abnormal physiological parameters after acute stroke may induce early neurological deterioration. Studies of the effect dehydration on outcome are limited. We examined association raised plasma osmolality at 3 months change with hydration during first week stroke. Methods —Acute patients had their measured admission days 1, 3, 7. Maximum area under curve (AUC) were also calculated week. Patients stratified according to how they hydrated: orally, intravenously, or...
<h3>Objective:</h3> To compare in the Vertebral Artery Ischaemia Stenting Trial (VIST) risks and benefits of vertebral angioplasty stenting with best medical treatment (BMT) alone for symptomatic artery stenosis. <h3>Methods:</h3> VIST was a prospective, randomized, open-blinded endpoint clinical trial performed 14 hospitals United Kingdom. Participants stenosis ≥50% were randomly assigned (1:1) to angioplasty/stenting plus BMT or randomization stratified by site (extracranial vs...
Few population-based studies describing functional outcome between ischemic stroke and intracerebral hemorrhage (ICH) in the short- long-term are available. Knowledge of natural history factors associated with poor is important providing prognostic information resource allocation.Data were collected within South London Stroke Register 1995 2011. Baseline data collection sociodemographic factors, case mix, risk before stroke, acute processes, outcomes at 7 days, 3 months, 1 year, 5 years, 10...
Stroke can lead to physical, mental and social long-term consequences, with the incidence of stroke increasing age. However, there is a lack evidence how improve outcomes for people stroke. Resilience, ability 'bounce back', flourish or thrive in face adversity improves health quality life older adults. role resilience adjustment after has been little investigated. The purpose this study report on development preliminary evaluation novel intervention promote We applied first two phases...
To test the feasibility of conducting a controlled trial into effectiveness self-management programme integrated stroke rehabilitation.A cluster-randomised design was utilised with rehabilitation teams as units randomisation.Community-based in London.78 patients diagnosis requiring community based rehabilitation.The intervention consisted an individualised approach to on self-efficacy. Clinicians were trained integrate defined principles scheduled sessions, supported by patient-held...
The coronavirus disease 2019 (COVID-19) pandemic has potentially caused indirect harm to patients with other conditions via reduced access health care services. We aimed describe the impact of initial wave on admissions, quality, and outcomes in acute stroke United Kingdom.Registry-based cohort study admitted hospital England, Wales, Northern Ireland between October 1, 2019, April 30, 2020, equivalent periods 3 prior years.One hundred fourteen hospitals provided data for a 184 017 patients....
Policy makers require evidence on the costs and outcomes of different ways organizing stroke care. This study compared survival providing care.Hospitalized patients from 13 European centers were included, with demographic, case-mix, resource use variables measured for each patient. Unit collected converted into US dollars using purchasing power parity (PPP) index. Cox linear regression analyses used to compare between adjusting case mix.A total 1847 included in study. After case-mix...
There have been reductions in stroke mortality over recent decades, but estimates by aetiological subtypes are limited. This study time trends and functional dependence ischaemic (IS) subtype a 16-year period.The population was 357,308 2011; 50.4% were males, 56% white, 25% of black ethnic backgrounds. Population-based case ascertainment conducted, all participants who had their first-ever IS between 2000 2015 identified. Further classification concluded according to the underlying mechanism...
Background: in order to implement cost-effective stroke services for older patients, it is necessary identify how care currently provided these patients and provision relates outcome.
To investigate time trends in receipt of effective acute stroke care and to determine the factors associated with provision care.Population based register.South London.3800 patients first ever ischaemic or primary intracerebral haemorrhage registered between January 1995 December 2009.Acute interventions, admission hospital, on a unit, drugs, inequalities access care.Between 2007 2009, 5% (33/620) were still not admitted hospital after an stroke, particularly those milder strokes, 21%...
Importance Reducing the burden of stroke is a public health priority. While higher incidence among ethnic minority populations (defined in context this study as individuals who are not White) well established, reports on inequalities care or outcomes conflicting and often limited to hospital-admitted patients short-term outcomes. Objective To investigate differences up 5 years after describe temporal trends contributory factors. Design, Setting, Participants This population-based cohort...
Valuable information on the determinants of non-fatal stroke can be obtained from longitudinal observational cohort studies. Such studies often rely self-reported events, which are best validated with external medical evidence. The aim this paper is to compare incident events arising different sources. We carried out a validation stoke among participants in Whitehall II Study, large UK based study (baseline sample size 10,308 men and women). 106 were three self-administered questionnaires...
Background Acute stroke impairments often result in poor long-term outcome for survivors. The aim of this study was to estimate the trends over time prevalence these acute impairments. Methods and findings All first-ever patients recorded South London Stroke Register (SLSR) between 2001 2018 were included cohort study. Multivariable Poisson regression models with robust error variance used adjusted 8 impairments, across six 3-year cohorts. Prevalence ratios comparing also calculated,...
BackgroundCurrent evidence on the long-term natural history of post-stroke depression (PSD) is limited. We aim to determine prevalence, incidence, duration and recurrence rates 18-years after stroke assess differences by onset-time severity.MethodsData were from South London Stroke Register (1995–2019, N = 6641 at registration). Depression was defined using Hospital Anxiety scale (scores > 7 depression) 3-months, then annually stroke. compared early- (3-months post-stroke) vs late-onset...
Background and Purpose: In cerebral small vessel disease, blood flow autoregulation are impaired therefore excessive pressure reduction could possibly accelerate white matter damage worsen outcome. The trial determined, in severe symptomatic whether intensive lowering resulted progression of assessed using diffusion tensor imaging. Methods: Randomized, parallel, multicenter controlled, blinded-outcomes clinical trial. One hundred eleven participants with magnetic resonance imaging confirmed...