A randomized trial on Hemodynamic Optimization of cerebral Perfusion after successful Endovascular therapy in patients with acute ischemic stroke (HOPE).

INTRODUCTION: In patients with acute ischemic stroke (AIS) secondary to intracranial large vessel occlusion (LVO), optimal blood pressure (BP) management following endovascular treatment (EVT) has not yet been established. The randomized trial on Hemodynamic Optimization of cerebral Perfusion after successful Endovascular therapy in patients with acute ischemic stroke (HOPE) (clinicaltrials.gov id: NCT04892511), aims to demonstrate whether hemodynamic optimization using different systolic BP targets following EVT according to the degree of final recanalization, is more effective than currently recommended BP management in improving functional outcomes of patients with AIS. METHODS: HOPE is an investigator-initiated multicentre clinical trial with randomized allocation, open label treatment, and blinded endpoint evaluation (PROBE). Patients with an anterior circulation AIS within 24h of symptom onset, treated with EVT, and showing successful recanalization (mTICI ≥2b) at the end of the procedure, are equally allocated (1:1) to hemodynamic optimization according to the study protocol vs. BP management according to current guidelines (≤180/105mmHg). The protocol includes two different targets of systolic BP depending on the recanalization status (mTICI=2b: 140-160 mmHg; mTICI=2c/3: 100-140 mmHg). The protocol is applied within the first 72h and includes BP lowering as well as vasopressor therapies when needed. The primary outcome is the proportion of favorable outcome (modified Rankin Scale [mRS] 0-2) at 90 days. Secondary outcomes include the shift on the mRS score, neurological deterioration, symptomatic intracerebral haemorrhage and mortality. CONCLUSION: The HOPE trial will provide new information on the safety and efficacy of different BP targets following EVT according to the degree of final recanalization in patients with AIS.

Information behaviour of the millennial generation: a scoping review of medical residents and their use of social media.

BACKGROUND: Medical residents can offer ideas for new information services, as most of them are 'digital natives', although reviews of the use of social media in health care settings do not provide data on their information behaviour. OBJECTIVE: A scoping review aimed at providing a research map for the information behaviour of medical residents and their use of social media, listing the aspects of the information behaviour studied and the theories and methods used. METHODS: A search was carried out in pubmed, embase, cinahl and lisa in April of 2018, with the results limited to the period from 2010 onwards. RESULTS: Thirty-nine relevant articles from 38 different studies were identified. The presence and use of social media was the most researched aspect, followed by information sharing, the relationships established and, finally, the search for and use of information. These aspects are researched mainly from the point of view of doctor-patient interactions. Only one study incorporated a theory of its design. Surveys were the most frequently used method. CONCLUSION: Research does not delve into medical residents' information behaviour on social media, despite the residents themselves using these media (in the context of everyday life, at least). More research is required.