INTRODUCTION Based on data from the Baden-Wuerttemberg stroke registry, we aimed to explore the diurnal variation of acute ischemic stroke (IS) care delivery. MATERIALS AND METHODS 92,530 IS patients were included, of whom 37,471 (40%) presented within an onset-to-door time ≤4.5 h. Daytime was stratified in 3-h time intervals and working vs. non-working hours. Stroke onset and hospital admiss...

REACH Medical University of South Carolina (MUSC) provides stroke consults via the internet in South Carolina. From May 2008 to April 2011 231 patients were treated with intravenous (IV) thrombolysis and 369 were transferred to MUSC including 42 for intra-arterial revascularization [with or without IV tissue plasminogen activator (tPA)]. Medical outcomes and hemorrhage rates, reported elsewhere...

The national service framework for coronary heart disease gives priority to reducing delays in the delivery of thrombolysis for acute myocardial infarction, aiming to achieve a “call to needle time” (from the initial call for help to treatment) of 60 minutes and a “door to needle time” (from arrival at the hospital to treatment) of 20 minutes or less by April 2003. We audited the delivery of th...

Parcel delivery is a complex logistic service, as it serves many small or medium-sized customers who may send or receive parcels. Modeling such delivery system needs to integrate two different research areas of hub location and vehicle routing. As it totally depends on the network and the linkage of the nodes, in this paper, some door-to-door service providers are taken into account to provide ...

OBJECTIVE To identify factors that delay the onset of thrombolysis in patients with acute myocardial infarction (AMI). METHODS A cohort study was carried out with 146 patients, each diagnosed with AMI and subjected to thrombolytic therapy. The data was extracted from medical records between January 2002 and December 2004. RESULTS The average age of the studied population was 57.5 +/- 9 year...

n a recent thought-provoking commentary, Terkelsen et al. (1) rom Denmark recommended that the committee responsible for urther updates to the American College of Cardiology/American eart Association (ACC/AHA) guidelines for ST-segment eleation myocardial infarction (STEMI) and the D2B (Door-toalloon) Alliance shift focus toward initiates that would reduce ystem delay in primary percutaneous co...

BACKGROUND AND PURPOSE The benefit of intravenous thrombolytic therapy in acute brain ischemia is strongly time dependent. METHODS The Get With the Guidelines-Stroke database was analyzed to characterize ischemic stroke patients arriving at hospital Emergency Departments within 60 minutes of the last known well time from April 1, 2003, to December 30, 2007. RESULTS During the 4.75-year stud...

   18F-FDG is the most commonly used radioisotope in PET scanning and is administered intravenously. When patients cannot cannulated, there are limited options available for functional tumour assessment. A fifty year old male presented for investigation of a suspected lung carcinoma identified during investigation of pneumonia. The patient had a severe needle phobia, intellectual dis...

BACKGROUND AND PURPOSE Timely intravenous (IV) thrombolysis for acute ischemic stroke is associated with better clinical outcomes. Acute stroke care implemented with "Stroke Code" (SC) may increase IV tissue plasminogen activator (tPA) administration. The present study aimed to investigate the impact of SC on thrombolysis. METHODS The study period was divided into the "pre-SC era" (January 20...