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Kumar P, Salazar-Marioni S, Dhanjani S, Iyyangar A, Abdelkhaleq R, Tariq MB, Niktabe A, Ballekere AN, Le NM, Azeem H, McCullough L, Sheth SA, Lee E. System-level trends in ischemic stroke admissions after adding endovascular stroke capabilities in community hospitals. J Neurointerv Surg 2024:jnis-2024-022192. [PMID: 39214689 DOI: 10.1136/jnis-2024-022192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND There is substantial interest in adding endovascular stroke therapy (EST) capabilities in community hospitals. Here, we assess the effect of transitioning to an EST-performing hospital (EPH) on acute ischemic stroke (AIS) admissions in a large hospital system including academic and community hospitals. METHODS From our prospectively collected multi-institutional registry, we collected data on AIS admissions at 10 hospitals in the greater Houston area from January 2014 to December 2022: one longstanding EPH (group A), three community hospitals that transitioned to EPHs in November 2017 (group B), and six community non-EPHs that remained non-EPH (group C). Primary outcomes were trends in total AIS admissions, large vessel occlusion (LVO) and non-LVO AIS, and tissue plasminogen activator (tPA) and EST use. RESULTS Among 20 317 AIS admissions, median age was 67 (IQR 57-77) years, 52.4% were male, and median National Institutes of Health Stroke Scale (NIHSS) was 4 (IQR 1-10). During the first 12 months after EPH transition, AIS admissions increased by 1.9% per month for group B, with non-LVO stroke increasing by 4.2% per month (P<0.001). A significant change occurred for group A at the transition point for all outcomes with decreasing rates in admissions for AIS, non-LVO AIS and LVO AIS, and decreasing rates of EST and tPA treatments (P<0.001). CONCLUSION Upgrading to EPH status was associated with a 2% per month increase in AIS admissions during the first year post-transition for the upgrading hospitals, but decreasing volumes and treatments at the established EPH. These findings quantify the impact on AIS admissions in hospital systems with increasing EST access in community hospitals.
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Affiliation(s)
- Prateek Kumar
- Department of Neurology, McGovern Medical School at UTHealth, Houston, Texas, USA
| | | | | | - Ananya Iyyangar
- Department of Neurology, McGovern Medical School at UTHealth, Houston, Texas, USA
| | - Rania Abdelkhaleq
- Department of Neurology, McGovern Medical School at UTHealth, Houston, Texas, USA
| | - Muhammad Bilal Tariq
- Department of Neurology, McGovern Medical School at UTHealth, Houston, Texas, USA
| | - Arash Niktabe
- Department of Neurology, McGovern Medical School at UTHealth, Houston, Texas, USA
| | - Anjan N Ballekere
- Department of Neurology, McGovern Medical School at UTHealth, Houston, Texas, USA
| | - Ngoc Mai Le
- Department of Neurology, McGovern Medical School at UTHealth, Houston, Texas, USA
| | - Hussain Azeem
- Department of Neurology, McGovern Medical School at UTHealth, Houston, Texas, USA
| | - Louise McCullough
- Department of Neurology, McGovern Medical School at UTHealth, Houston, Texas, USA
| | - Sunil A Sheth
- Department of Neurology, McGovern Medical School at UTHealth, Houston, Texas, USA
| | - Eunyoung Lee
- Department of Neurology, McGovern Medical School at UTHealth, Houston, Texas, USA
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Nelson BJ, Bendok BR, Turcotte EL, Batjer HH. Remote magnetic navigation enables precision telesurgery. Sci Robot 2024; 9:eado3187. [PMID: 38416854 DOI: 10.1126/scirobotics.ado3187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 03/01/2024]
Abstract
Medical devices actuated by external magnetic fields can create opportunities for clinical adoption of precision telesurgery.
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Affiliation(s)
- Bradley J Nelson
- Multi-Scale Robotics Lab, Institute of Robotics and Intelligent Systems, ETH Zürich, Zürich, Switzerland
| | - Bernard R Bendok
- Department of Neurological Surgery, Mayo Clinic, Phoenix, AZ, USA
- Mayo Clinic College of Medicine and Science, Phoenix, AZ, USA
- Department of Radiology, Mayo Clinic, Phoenix, AZ, USA
- Department of Otolaryngology Head and Neck Surgery/Audiology, Mayo Clinic, Phoenix, AZ, USA
| | - Evelyn L Turcotte
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - H Hunt Batjer
- Department of Neurological Surgery, Mayo Clinic, Phoenix, AZ, USA
- University of Texas Southwestern Medical Center, Dallas, TX, USA
- University of Texas at Tyler School of Medicine, Tyler, TX, USA
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Siracusa C, Vono N, Morano MB, Sabatino J, Leo I, Eyileten C, Cianflone E, Postula M, Torella D, De Rosa S. Clinical Application of Circular RNAs as Biomarkers in Acute Ischemic Stroke. J Pers Med 2023; 13:jpm13050839. [PMID: 37241009 DOI: 10.3390/jpm13050839] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 05/28/2023] Open
Abstract
Despite the substantial improvement in diagnosis and treatment within the last decades, ischemic stroke still represents a challenge, responsible still for a high burden of morbidity and mortality. Among the unmet clinical needs are the difficulties in identifying those subjects with the greatest risk of developing a stroke, the challenges in obtaining a timely diagnosis, the prompt recognition of the different clinical forms of stroke, the assessment of the response to treatments and the prognostic assessment. All these issues might be improved with appropriate smart biomarkers that could better inform clinical management. The present article offers an overview of the potential role of circular RNAs as disease biomarkers in stroke. A systematic approach was adopted to gather all potentially relevant information in order to provide a panoramic view on this class of promising molecules.
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Affiliation(s)
- Chiara Siracusa
- Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy
| | - Niccolò Vono
- Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy
| | - Maria Benedetta Morano
- Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy
| | - Jolanda Sabatino
- Department of Children and Woman's Health, University of Padua, 35121 Padua, Italy
| | - Isabella Leo
- Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London SW3 5NP, UK
- Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy
| | - Ceren Eyileten
- Centre for Preclinical Research and Technology, Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02-097 Warsaw, Poland
- Genomics Core Facility, Center of New Technologies, University of Warsaw, 00-927 Warsaw, Poland
| | - Eleonora Cianflone
- Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy
| | - Marek Postula
- Centre for Preclinical Research and Technology, Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Daniele Torella
- Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy
| | - Salvatore De Rosa
- Department of Medical and Surgical Sciences, Magna Graecia University, 88100 Catanzaro, Italy
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