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  • 1
    Online Resource
    Online Resource
    Ticagrelor Added to Aspirin in Acute Ischemic Stroke or Transient Ischemic Attack in Prevention of Disabling Stroke : A Randomized Clinical Trial
    American Medical Association (AMA) ; 2021
    In:  JAMA Neurology Vol. 78, No. 2 ( 2021-02-01), p. 177-
    Details
    In: JAMA Neurology, American Medical Association (AMA), Vol. 78, No. 2 ( 2021-02-01), p. 177-
    Type of Medium: Online Resource
    ISSN: 2168-6149
    URL: Article
    DOI: 10.1001/jamaneurol.2020.4396
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2021
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  • 2
    Online Resource
    Online Resource
    Global Impact of COVID-19 on Stroke Care and IV Thrombolysis
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Neurology Vol. 96, No. 23 ( 2021-06-08), p. e2824-e2838
    Details
    In: Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 96, No. 23 ( 2021-06-08), p. e2824-e2838
    Abstract: To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. Methods We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. Results There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] −11.7 to −11.3, p 〈 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI −13.8 to −12.7, p 〈 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI −13.7 to −10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2–9.8, p 〈 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. Conclusions The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months.
    Type of Medium: Online Resource
    ISSN: 0028-3878 , 1526-632X
    URL: Article
    DOI: 10.1212/WNL.0000000000011885
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
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  • 3
    Online Resource
    Online Resource
    Bridging Therapy and Direct Thrombectomy for Acute Ischemic Stroke: A Prospective Cohort Study
    SAGE Publications ; 2020
    In:  Journal of Stroke Medicine Vol. 3, No. 2 ( 2020-12), p. 124-130
    Details
    In: Journal of Stroke Medicine, SAGE Publications, Vol. 3, No. 2 ( 2020-12), p. 124-130
    Abstract: It remains controversial if intravenous thrombolysis (IVT) prior to mechanical thrombectomy (MTE) is superior to MTE alone in patients with acute ischemic stroke caused by large vessel occlusion. We aim to compare functional outcomes, mortality, reperfusion, and intracranial hemorrhage rates in bridging therapy (IVT prior thrombectomy) and MTE alone groups within 6 h from symptom onset. Materials and Methods: Consecutive hospitalized patients (September 2017 and July 2018) with acute large artery occlusion within the anterior cerebral circulation eligible for MTE with or without prior IVT were included. A modified Rankin Scale score of 0 to 2 was considered as good functional outcome at 90 days. Successful reperfusion was defined as a Thrombolysis in Cerebral Infarction scale of 2b to 3. Results: Of the 124 patients included, 56 (45.2%) received bridging therapy and 68 (54.8%) received MTE alone. Patients receiving bridging therapy were younger (median, 56 vs 63, P = .045) and had shorter onset-to-groin time (median, 270 vs 370 min, P 〈 .001) than those receiving MTE alone. Successful reperfusion rate was significantly greater in the bridging therapy group (87.5% vs 72.1%, P = 0.03). There were no statistically significant differences between the 2 groups in functional independence (bridging 58.9% vs 75.0%, P = 0.07), mortality at 90 days (bridging 14.3% vs 7.4%, P = 0.22), parenchymal hematoma type 2 (bridging 3.6% vs 2.9%, P 〉 .99), and any hemorrhage (bridging 42.3% vs 26.5%, P = 0.07). Conclusion: Compared to MTE alone, bridging therapy with IVT improved the reperfusion rate but not other outcomes. Further clinical trials are needed to confirm our findings.
    Type of Medium: Online Resource
    ISSN: 2516-6085 , 2516-6093
    URL: Article
    DOI: 10.1177/2516608520976275
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 3011515-2
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  • 4
    Online Resource
    Online Resource
    Twelve-Month Outcomes of the AFFINITY Trial of Fluoxetine for Functional Recovery After Acute Stroke: AFFINITY Trial Steering Committee on Behalf of the AFFINITY Trial Collaboration
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Stroke Vol. 52, No. 8 ( 2021-08), p. 2502-2509
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 52, No. 8 ( 2021-08), p. 2502-2509
    Abstract: The AFFINITY trial (Assessment of Fluoxetine in Stroke Recovery) reported that oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and seizures. After trial medication was ceased at 6 months, survivors were followed to 12 months post-randomization. This preplanned secondary analysis aimed to determine any sustained or delayed effects of fluoxetine at 12 months post-randomization. Methods: AFFINITY was a randomized, parallel-group, double-blind, placebo-controlled trial in adults (n=1280) with a clinical diagnosis of stroke in the previous 2 to 15 days and persisting neurological deficit who were recruited at 43 hospital stroke units in Australia (n=29), New Zealand (4), and Vietnam (10) between 2013 and 2019. Participants were randomized to oral fluoxetine 20 mg once daily (n=642) or matching placebo (n=638) for 6 months and followed until 12 months after randomization. The primary outcome was function, measured by the modified Rankin Scale, at 6 months. Secondary outcomes for these analyses included measures of the modified Rankin Scale, mood, cognition, overall health status, fatigue, health-related quality of life, and safety at 12 months. Results: Adherence to trial medication was for a mean 167 (SD 48) days and similar between randomized groups. At 12 months, the distribution of modified Rankin Scale categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio, 0.93 [95% CI, 0.76–1.14]; P =0.46). Compared with placebo, patients allocated fluoxetine had fewer recurrent ischemic strokes (14 [2.18%] versus 29 [4.55%] ; P =0.02), and no longer had significantly more falls (27 [4.21%] versus 15 [2.35%] ; P =0.08), bone fractures (23 [3.58%] versus 11 [1.72%] ; P =0.05), or seizures (11 [1.71%] versus 8 [1.25%] ; P =0.64) at 12 months. Conclusions: Fluoxetine 20 mg daily for 6 months after acute stroke had no delayed or sustained effect on functional outcome, falls, bone fractures, or seizures at 12 months poststroke. The lower rate of recurrent ischemic stroke in the fluoxetine group is most likely a chance finding. Registration: URL: http://www.anzctr.org.au/ ; Unique identifier: ACTRN12611000774921.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.120.033070
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1467823-8
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  • 5
    Online Resource
    Online Resource
    Sex disparity in stroke outcomes in a multicenter prospective stroke registry in Vietnam
    SAGE Publications ; 2023
    In:  International Journal of Stroke
    Details
    In: International Journal of Stroke, SAGE Publications
    Abstract: Although men have a higher rate of stroke than women, it is not clear whether women have a worse outcome after adjusting for confounders such as vascular risk factors, age, stroke severity, and reperfusion therapy. We evaluated sex differences on 90-day functional outcomes after stroke in a multicenter study in Vietnam. Methods: We recruited patients presenting with ischemic or hemorrhagic stroke at 10 stroke centers in Vietnam for a period of 1 month from 1 August 2022 to 31 August 2022. We reviewed the patient’s clinical demographics, time from symptom onset to hospital admission, stroke classification, stroke subtype, stroke severity, characteristics of reperfusion therapy, and 90-day clinical outcome. We compared functional outcomes and predisposing factors at day 90 between men and women after an ischemic and hemorrhagic stroke. Poor outcome was defined as modified Rankin Scale 3–6. Results: There were 2300 stroke patients included. Men accounted for 61.3% (1410) of participants. Compared to men, women were older (67.7 ± 13.9 vs 63.7 ± 13.3, P  〈  0.001), had a higher rate of diabetes mellitus (21.1% vs 15.3%, P  〈  0.001), a lower rate of tobacco use (1.0 % vs 23.6%, P  〈  0.001), and a lower body mass index (21.4 ± 2.70 vs 22.0 ± 2.72, P  〈  0.001). There was a higher rate of intracranial hemorrhage (ICH) in men (21.3% vs 15.6%, P = 0.001), whereas the rate of subarachnoid hemorrhage was higher in women (6.2% vs 3.0%, P  〈  0.001). For ischemic stroke, door-to-needle time (36.9 ± 17.6 vs 47.8 ± 35.2 min, P = 0.04) and door-to-recanalization time (113.6 ± 51.1 vs 134.2 ± 48.2, P = 0.03) were shorter in women. There was no difference in 90-day functional outcomes between sexes. Factors associated with poor outcomes included age ⩾50 years (adjusted odds ratio (aOR): 1.75; 95% confidence interval (CI): 1.16–2.66), history of stroke (aOR: 1.50; 95% CI: 1.15–1.96), large artery atherosclerosis (aOR: 5.19; 95% CI: 3.90–6.90), and cardioembolism (aOR: 3.21; 95% CI: 1.68–6.16). Factors associated with mortality in patients with acute ischemic stroke included a history of coronary artery disease (aOR: 3.04; 95% CI: 1.03–8.92), large artery atherosclerosis (aOR: 3.37; 95% CI: 2.11–5.37), and cardioembolism (aOR: 3.15; 95% CI: 1.20–8.27). Conclusion: There were no sex differences in the clinical outcome of stroke and ischemic stroke in this prospective cohort of hospitalized Vietnamese patients.
    Type of Medium: Online Resource
    ISSN: 1747-4930 , 1747-4949
    URL: Article
    DOI: 10.1177/17474930231177893
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2211666-7
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  • 6
    Online Resource
    Online Resource
    Processes of Stroke Unit Care and Outcomes at Discharge in Vietnam: Findings from the Registry of Stroke Care Quality (RES-Q) in a Major Public Hospital
    SAGE Publications ; 2019
    In:  Journal of Stroke Medicine Vol. 2, No. 2 ( 2019-12), p. 119-127
    Details
    In: Journal of Stroke Medicine, SAGE Publications, Vol. 2, No. 2 ( 2019-12), p. 119-127
    Abstract: Background: An essential strategy to reduce mortality and disability after stroke is to ensure access to evidence-based care. In developed countries, it has been shown that if hospitals improve the quality of care, the impact of stroke is attenuated. However, in developing countries, data on the processes of care and associated patient outcomes are scarce. We examined the care processes and outcomes among patients with acute stroke from a stroke unit in a major public hospital in Vietnam whereby there are approximately 15,000 hospital admissions for stroke per year. Methods: We included first-ever strokes admitted to the 115 People’s Hospital (June 2017-March 2018). Data were collected in the Registry of Stroke Care Quality which is used in 〉 50 countries. Baseline characteristics, stroke-related factors (e.g., type and severity), processes of care (e.g., thrombolysis), and outcomes at discharge were examined including mortality and functional outcome, assessed as the walking ability without assistance. Results: Data were available for 6601 patients with first-ever stroke (44% women, 80% ischemic stroke [IS], median age: 62 years, interquartile range [IQR] : 53-72) who received stroke unit care. The median time from stroke onset to hospital arrival was 15.7 hours (IQR: 5.6-37.5). At admission, the median National Institute of Health Stroke Scale score indicating stroke severity was 7 (IQR: 4-12). Among those with IS, 9% received intravenous thrombolysis. Over 90% of the participants received recommended process of care including dysphasia screening (99%), antihypertensive agents (92%), cholesterol-lowering medication (IS = 99%), and antithrombotic medication (IS = 98%). At discharge (median length of stay: 4 days, IQR: 3-6), 3% of all cases died and 46% were able to walk independently. Advanced age, stroke severity, and not receiving antihypertensive agent(s) were contributing factors to mortality and poorer functional outcome. Conclusion: There was a considerable delay in the time from stroke onset to hospital arrival. Evidence-based care at the stroke unit was consistently provided. It remains unclear whether other hospitals in Vietnam and other developing countries perform as well. Greater public awareness of stroke to reduce onset to arrival times and more stroke units are warranted to achieve the excellent outcomes in the major public hospital.
    Type of Medium: Online Resource
    ISSN: 2516-6085 , 2516-6093
    URL: Article
    DOI: 10.1177/2516608519869132
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 3011515-2
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  • 7
    Online Resource
    Online Resource
    Calculating gas turbine thermodynamic cycle using GateCycle TM software
    Viet Nam National University Ho Chi Minh City ; 2017
    In:  Science and Technology Development Journal Vol. 20, No. K5 ( 2017-08-31), p. 30-36
    Details
    In: Science and Technology Development Journal, Viet Nam National University Ho Chi Minh City, Vol. 20, No. K5 ( 2017-08-31), p. 30-36
    Abstract: Gas turbine engines are widely used in aviation and naval ships for their compactness and high mobility. In Vietnam, the researches and investigations for this type of engine are less interested. In this paper, the authors present methods of modeling and calculating gas turbine thermodynamic cycle by using the General Electric software – GateCycleTM. The results can be used for the study of gas turbine engines and for engine operation.
    Type of Medium: Online Resource
    ISSN: 1859-0128 , 1859-0128
    URL: Article
    DOI: 10.32508/stdj.v20iK5.1156
    Language: Unknown
    Publisher: Viet Nam National University Ho Chi Minh City
    Publication Date: 2017
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  • 8
    Online Resource
    Online Resource
    A Case of Successful Intravenous Thrombolysis Bridged with Repeated Endovascular Treatment in Acute Basilar Artery Occlusion
    S. Karger AG ; 2020
    In:  Case Reports in Neurology Vol. 12, No. Suppl. 1 ( 2020-12-14), p. 34-40
    Details
    In: Case Reports in Neurology, S. Karger AG, Vol. 12, No. Suppl. 1 ( 2020-12-14), p. 34-40
    Abstract: Acute basilar artery occlusion (BAO) is a neurological emergency that has a high rate of mortality and poor functional outcome. Endovascular therapy (ET) is the gold standard therapy for large vessel occlusion stroke of the anterior circulation. Whether ET can also be effectively and safely performed in early recurrent large vessel occlusion, especially in BAO, is unclear. We describe a case of successful recanalization and independent functional outcome of a BAO patient treated with intravenous thrombolysis combined with repeated ET. The patients was a 32-year-old man with a history of heavy smoking and drinking who presented to the Emergency Department with dizziness and hypertension, and progressed over the next 13 h to left hemiparesis and mild dysarthria with an NIHSS score of 7. CT angiography demonstrated occlusion of the proximal basilar artery (BA). Intravenous alteplase was given followed by ET. The first intervention failed and over the next 8 h, the patient’s NIHSS score increased to 12. A second attempt with balloon angioplasty managed to reconstitute arterial blood flow with a severe residual stenosis of the proximal BA. Subsequently, the patient progressed into deep coma with reocclusion of the BA demonstrated on transcranial Doppler. A third intervention with emergent stenting resulted in complete recanalization of the BA and excellent neurological recovery. This patient received three endovascular treatments within 24 h due to reocclusion of the BA and achieved good outcomes. In conclusion, repeated ET for early recurrent BAO is feasible in carefully selected patients.
    Type of Medium: Online Resource
    ISSN: 1662-680X
    URL: Article
    DOI: 10.1159/000507752
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 2505302-4
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  • 9
    Online Resource
    Online Resource
    Perfusion-Based Decision-Making for Mechanical Thrombectomy in a Transient Ischemic Attack Patient with Middle Cerebral Artery Occlusion
    S. Karger AG ; 2020
    In:  Case Reports in Neurology Vol. 12, No. Suppl. 1 ( 2020-12-14), p. 41-48
    Details
    In: Case Reports in Neurology, S. Karger AG, Vol. 12, No. Suppl. 1 ( 2020-12-14), p. 41-48
    Abstract: A significant proportion of patients with large-vessel occlusion (LVO) initially present to the hospital with transient ischemic attack (TIA) and mild clinical manifestations such as low National Institutes of Health Stroke Scale (NIHSS) scores (≤5). However, due to the natural course of the disease, the individuals may subsequently develop worsening symptoms. To date, there is lack of evidence-based guidelines on mechanical thrombectomy (MT) among those patients. Therefore, the predicting factors associated with better or worse outcomes for acute stroke patients receiving MT compared to those not receiving the treatment are unknown. We describe a TIA case with LVO who was treated with MT; we used perfusion imaging as a decision aid. A 55-year-old male patient with a past medical history of TIA, hypertension, and hyperlipidemia was admitted to our hospital for evaluation of transient mild right hemiparesis and dysarthria lasting for 5 min 3 h before admission. He reported that he had experienced the same condition 1 day before. On admission, neurological examination showed normal function with an NIHSS score of 0. Computed tomography angiography revealed left proximal M1 occlusion. In addition, perfusion magnetic resonance imaging maps calculated by the RAPID software showed acute small lesions on the left hemisphere with core volume (0 mL) and a large ischemic penumbra (70 mL). Immediate endovascular thrombectomy was performed 5 h following symptom onset with complete recanalization and clinical recovery. The case suggests that MT in LVO patients with low NIHSS scores, even a score of 0, on presentation is potentially a safe and effective treatment. The use of perfusion imaging in the acute phase of stroke should be encouraged for the decision-making process.
    Type of Medium: Online Resource
    ISSN: 1662-680X
    URL: Article
    DOI: 10.1159/000507753
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 2505302-4
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  • 10
    Online Resource
    Online Resource
    Subarachnoid Hemorrhage due to Ruptured Spinal Artery Aneurysm: A Diagnostic Challenge
    S. Karger AG ; 2020
    In:  Case Reports in Neurology Vol. 12, No. Suppl. 1 ( 2020-12-14), p. 169-175
    Details
    In: Case Reports in Neurology, S. Karger AG, Vol. 12, No. Suppl. 1 ( 2020-12-14), p. 169-175
    Abstract: Subarachnoid hemorrhage (SAH) due to a solitary spinal aneurysm is extremely rare. Early diagnosis of spinal SAH is challenging, particularly when the spinal cord has not been compressed. We report a case of a 45-year-old male who presented with sudden onset of abdominal pain, followed by severe headache, vomiting, and generalized seizure. Three days after admission to the hospital, he developed progressive paraparesis. Magnetic resonance imaging (MRI) revealed spinal SAH with hematoma resulting in cord compression at the level of T9. Diagnostic spinal angiography identified a ruptured aneurysm of a radiculomedullary artery. In conclusion, rupture of a spinal aneurysm should be considered a possible cause of SAH in appropriate clinical settings, and clinicians must be aware of the possibility of cord compression.
    Type of Medium: Online Resource
    ISSN: 1662-680X
    URL: Article
    DOI: 10.1159/000507953
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 2505302-4
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