Novel Protocol Can Help to Rapidly Diagnose Eye Stroke
WEDNESDAY, Feb. 21, 2024 (HealthDay News) -- A novel protocol can be used to diagnose eye stroke and expedite treatment, according to a study published online Feb. 13 in Ophthalmology.
Gareth M.C. Lema, M.D., Ph.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues conducted a retrospective case series in adults who presented with painless monocular vision loss and were diagnosed with non-arteritic retinal artery occlusion. Optical coherence tomography (OCT) machines were placed in the stroke center or emergency department at three hospitals. Patients were evaluated by the stroke neurology service and underwent OCT; the images were interpreted remotely. Intra-arterial tissue plasminogen activator (IA-tPA) treatment was provided to eligible patients.
Fifty-nine patients were evaluated in the first 18 months since the protocol went live. Based on OCT and follow-up examination, the researchers found that 42 percent of patients had a confirmed retinal artery occlusion. Ten patients were eligible for treatment, and nine received IA-tPA. Within 24 hours after treatment, there was a significant improvement in mean visual acuity from LogMAR 2.14 to LogMAR 0.7; after four weeks, LogMAR was 1.04. Sixty-six percent of patients had clinically significant improvement within 24 hours, which was maintained through one month in 56 percent of treated patients. The mean time to treatment was 543 minutes from last known well and 146 minutes from presentation at the stroke center.
"We reported a novel protocol for the diagnosis of eye strokes that not only can save vision for these patients, but also demonstrates the potential to use remote consultation for time-sensitive ophthalmic emergencies," Lema said in a statement.
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Higher Exercise Volume After Concussion Tied to Lower Symptom Burden
TUESDAY, Feb. 20, 2024 (HealthDay News) -- For children with concussion, higher cumulative moderate-to-vigorous physical activity (cMVPA) during the first and second weeks postinjury is associated with lower symptom burden, according to a study published online Feb. 16 in JAMA Network Open.
Andrée-Anne Ledoux, Ph.D., from the Children's Hospital of Eastern Ontario Research Institute in Ottawa, Canada, and colleagues conducted a multicenter cohort study using data from a randomized clinical trial conducted from March 2017 to December 2019 at three Canadian pediatric emergency departments. The association between cMVPA over two weeks and subsequent symptom burden, measured using the Health and Behavior Inventory (HBI), was examined among 267 children.
The researchers found that participants with greater cMVPA had significantly lower HBI scores at one week and two weeks postinjury (75th versus 25th percentile difference [258.5 versus 90.0 and 565.0 versus 237.0 minutes], −5.45 and −2.85, respectively), but not at four weeks postinjury. At one and two weeks postinjury, symptom burden was not lower beyond the 75th percentile for cMVPA. The odds ratio was 0.48 for the association between the 75th and 25th percentile of cMVPA and persisting symptoms after concussion at two weeks.
"Among children and adolescents with acute concussions, engaging in higher volumes of MVPA within the first week postinjury (259 versus 90 minutes) or within the first two weeks postinjury (565 versus 237 minutes) was associated with lower symptom burden," the authors write.
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2020 to 2022 Saw Increase in Percentage of OD Deaths Involving Smoking
THURSDAY, Feb. 15, 2024 (HealthDay News) -- From 2020 to 2022, there was an increase in the percentage of overdose deaths with evidence of smoking, according to research published in the Feb. 15 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.
Lauren J. Tanz, Sc.D., from the CDC in Atlanta, and colleagues describe trends in routes of drug use in 27 states and the District of Columbia among overdose deaths occurring during January 2020 to December 2022.
The researchers found that from January-June 2020 to July-December 2022, there was a 29.1 percent decrease in the percentage of overdose deaths with evidence of injection, from 22.7 to 16.1 percent, and a 73.7 percent increase in the percentage with evidence of smoking, from 13.3 to 23.1 percent. A 109.1 percent increase was seen in the number of deaths with evidence of smoking, from 2,794 to 5,843; smoking was the most commonly documented route of use in overdose deaths by 2022. In all U.S. regions, the trends were similar. Among deaths with only illegally manufactured fentanyl and fentanyl analogs (IMFs), there was a 41.6 percent decrease in the percentage with evidence of injection (from 20.9 to 12.2 percent) and a 78.9 percent increase in the percentage with evidence of smoking (from 10.9 to 19.5 percent). Among deaths with both IMFs and stimulants detected, similar trends were seen.
"Although unsafe injection drug use practices might be most risky in terms of infectious disease transmission, other routes, particularly smoking, still carry substantial overdose risk," the authors write.
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