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Evidence-Based Medicine 2008;13:39; doi:10.1136/ebm.13.2.39
Copyright © 2008 by the BMJ Publishing Group Ltd.

EVIDENTLY

Evidently...

Richard Lehman

Department of Primary Care, University of Oxford; Oxford, UK

The first 150 words of the full text of this article appear below.

Stroke medicine could once be summed up as: "strokes happen: get used to it." It wasn’t really until the 1990s that these devastating events were given due attention and specialised care in stroke units was widely shown to improve outcomes. But how? Something was happening on these units which did not routinely happen on general medical wards, and the obvious place to look is at the prevention of complications, especially infection. A systematic review of 17 trials of stroke units has been further analysed (Stroke 2007;38:2536–40) to look for specific differences in care, and confirms this: most improvement in stroke outcomes has not come from high-tech interventions such as thrombolysis or neuroprotection, but from more attentive medical and nursing care. Nonetheless, the prevention of stroke remains even more important, and recently we have become more aware of the need to regard transient ischaemic attacks as a . . . [Full text of this article]


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