DR. RUSSELL J. CAVALLO, M.D.

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The study looked at how KPC-producing Klebsiella pneumoniae bacteria are becoming resistant to new antibiotic combinations used to treat infections. Researchers examined 178 samples and found that while most (86.5%) were still sensitive to these treatments, 11% were resistant to ceftazidime/avibactam, with a 21.7% death rate among those with resistant infections. This is important because rising resistance threatens our ability to effectively treat serious infections, making ongoing monitoring and careful antibiotic use crucial. Who this helps: This helps patients with bloodstream infections and their doctors.

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This study looked at the survival rates and chances of recovery for patients with skin cancer (melanoma) in Italy, examining data from over 13,000 patients. Researchers found that for thinner tumors (up to 4 mm thick), the chance of surviving for at least one year was greater than 98%. Furthermore, survival for five years increased significantly for men with thicker tumors, suggesting that new treatments introduced in 2013 are improving patient outcomes. Who this helps: This benefits patients with melanoma and their doctors by providing clearer insights into treatment effectiveness.

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This study looked at cancer survival rates in Italy for patients diagnosed between 2008 and 2017, analyzing over 1.4 million cases. It found that five-year survival rates were about 66.7% for women and 62.2% for men, with women generally faring better than men across most cancers. Notably, survival improved for both genders during this period, with women experiencing an increase from 69.9% to 74.1% and men from 65.7% to 70.7%. Who this helps: This research benefits patients and healthcare providers by highlighting trends in cancer survival and informing treatment approaches.

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This study examined the effectiveness and safety of a treatment called endovascular therapy (EVT) for patients with stroke caused by blockages in medium-sized blood vessels, compared to a standard treatment called intravenous thrombolysis (IVT). Researchers looked at data from 780 patients and found that around 60.6% of those who received EVT plus IVT achieved independence in daily activities after 90 days, which was nearly the same as the 60.9% of those who received only IVT. Additionally, while EVT was linked to a higher risk of bleeding in the brain (18.4% versus 11.2%), it did not show a significant benefit in improving long-term function compared to IVT alone, meaning doctors should be cautious when considering EVT for these patients. Who this helps: This research helps doctors make informed decisions about the best treatment options for stroke patients with medium-vessel blockages.

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The study examined the outcomes of Italian women with vulvar squamous cell carcinoma, a type of cancer, and it found that only 22 out of every 100,000 women were living with this cancer as of 2018. The chance of being “cured” has remained stagnant over the past decade, with only 32% of newly diagnosed patients expected to survive without dying from it. This is concerning because, despite some patients living longer than five years, many still face significant risks, highlighting the need for improved treatment approaches in Italy. Who this helps: This research benefits patients with vulvar cancer and their doctors by providing critical insights into survival and treatment effectiveness.

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This study looked at cancer rates in young adults in Italy from 2008 to 2017, focusing on people aged 20 to 49. It found that women in this age group had nearly double the cancer rates compared to men (202.2 vs 112.4 per 100,000), mainly due to rising cases of breast and thyroid cancers. Some cancers, like testicular cancer and skin melanoma, went up during this period, while others, like colorectal and cervical cancers, decreased or stayed stable, highlighting the need for more prevention strategies and screening for these age groups. Who this helps: This information helps patients and doctors to understand cancer trends and improve prevention and early detection efforts.

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This study looked at how well certain new antibiotics work against Klebsiella pneumoniae bacteria that produce a specific resistance factor called KPC, using samples from blood cultures in Italian hospitals. Researchers tested 264 samples and found that two antibiotics, meropenem/vaborbactam and imipenem/relebactam, were effective in over 93% of cases, while ceftazidime/avibactam was effective in about 94% of cases, though some bacteria were resistant due to specific genetic changes. These findings are important because they identify effective treatment options for serious infections caused by drug-resistant bacteria, which can be life-threatening. Who this helps: This helps patients with severe infections caused by Klebsiella pneumoniae and informs doctors on effective antibiotic choices.

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This study looked at different methods for quickly determining if Staphylococcus aureus bacteria in blood samples are resistant to methicillin, an important antibiotic. The best method was the EazyplexMRSA Plus test, which accurately identified resistance 100% of the time, while another method, MALDI-TOF MS, had much lower accuracy, detecting resistance only about 60% of the time. These findings are important because faster and more accurate testing can help doctors choose the right treatment for patients with bloodstream infections, potentially saving lives. Who this helps: Patients with bloodstream infections and their doctors.

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This study looked at the presence and resistance of anaerobic bacteria found in blood samples from hospitals across Europe between 2020 and 2023. Researchers analyzed 14,527 samples, identifying the most common types of bacteria, like Cutibacterium acnes (18.7%) and Bacteroides fragilis (16.3%), and found that many of these bacteria have high resistance to antibiotics—C. acnes, for example, showed up to 39% resistance to clindamycin. Understanding these bacteria's resistance patterns is crucial for improving treatment strategies and antibiotic use in hospitals. Who this helps: This helps doctors and healthcare providers in treating infections effectively.

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This study looked at the effects of a treatment called mechanical thrombectomy (MT) in patients who had some level of disability before having a stroke. Researchers found that among patients with a higher disability score (3 to 4), 23.3% maintained their ability to function after treatment, which is similar to the 22.1% for those with lower disability scores (0 to 2). However, those with higher disability experienced significantly higher death rates (37.1% vs. 18.4%) and lower success in restoring blood flow to the brain. Who this helps: This information helps doctors understand how effective MT can be for older patients with pre-existing disabilities after a stroke.

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This study focused on new antibiotic treatments for infections caused by certain resistant bacteria known as metallo-β-lactamase (MβL) producers, which are growing in number and can lead to more severe health issues. The research highlighted two recently developed drugs, cefiderocol and aztreonam/avibactam, and discussed ongoing evaluations of additional combinations of antibiotics designed to combat these resistant strains. It is important because these bacteria pose a significant threat in healthcare settings, and having effective treatment options can help reduce mortality rates. Who this helps: This benefits patients with serious bacterial infections and healthcare providers treating them.

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This study looked at infections caused by anaerobic bacteria in children, analyzing data from blood cultures across 44 hospitals in Europe over four years. Out of more than 14,500 samples, 186 were from children, with the most common bacteria being Cutibacterium acnes, which showed higher resistance to certain antibiotics compared to adults. This research emphasizes the need to monitor antibiotic resistance in different age groups to ensure effective treatment for young patients. Who this helps: This helps doctors and healthcare providers treating pediatric patients.

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This study explored the connection between the body’s immune response to the Epstein-Barr virus (EBV) and brain health in people living with HIV. Researchers found that among 123 participants, 21 people had signs of the immune response to EBV in their spinal fluid, and higher levels of this immune response were linked to worse cognitive function, which was measured using a Global Deficit Score. This matters because it suggests that the body’s reaction to EBV may worsen mental functioning in those with HIV, indicating a potential area for future treatment strategies. Who this helps: Patients living with HIV, particularly those experiencing cognitive issues.

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This study looked at a type of bacteria called Klebsiella pneumoniae that is resistant to a treatment called ceftazidime/avibactam and infected patients' blood between 2018 and 2022. Among 360 recorded infections, 38 cases (10.5%) were due to this resistant strain, with patients showing a high death rate of 22% during their hospital stay and 16.2% within 30 days after discharge. The research highlights important factors, like existing health problems, that increase the risk of death from these infections, which helps doctors better treat and manage affected patients. Who this helps: This helps patients and doctors treating bloodstream infections.

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The study looked at two methods for testing how effective the antibiotic cefiderocol is against various types of bacteria, including Enterobacterales and Pseudomonas aeruginosa. The results showed that the UMIC microdilution test correctly identified 96.2% of resistant bacteria and had a very high agreement rate of 93.7% for determining susceptibility, while disc diffusion also provided reliable results, though it struggled more with certain bacteria like Achromobacter xylosoxidans. This matters because accurate testing is crucial for guiding appropriate antibiotic treatment for infections. Who this helps: This benefits patients by ensuring they receive the most effective antibiotics for their infections.

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This study reports the first-ever case of a bloodstream infection caused by a bacteria called Chryseobacterium gallinarum in a 67-year-old woman with burns. The infection was identified using a specific genetic test and was successfully treated with antibiotics. This case highlights the growing presence of this emerging pathogen, which is especially important for the treatment of patients with weakened immune systems. Who this helps: This helps doctors and healthcare providers understand and manage infections caused by new and rare bacteria.

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Researchers studied a new testing method called transcription-mediated amplification (TMA) for detecting Cytomegalovirus (HCMV) infections in patients with weakened immune systems. They compared TMA to the standard testing method, quantitative polymerase chain reaction (qPCR), using samples from 755 patients. The results showed that TMA was very accurate, agreeing with qPCR 99.27% of the time for positive results and 89.39% for negative results, making it a promising option for rapid and reliable diagnosis. Who this helps: This benefits immunocompromised patients, such as organ transplant recipients and those with HIV.

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This study examined strains of a group of bacteria known as ESCPM, found in blood cultures across 27 hospitals in Europe between 2020 and 2022. Out of 6,774 isolates, 15.7% showed resistance to certain antibiotics, with notable resistance to a new class of drugs (3GC) in specific strains like K. aerogenes, which had a 29.8% resistance rate. These findings are important because they help doctors understand current trends in bacterial resistance, which can improve treatment strategies and patient safety. Who this helps: Patients facing infections caused by resistant bacteria.

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This study looked at how many people in Italy are surviving and potentially cured of breast and colorectal cancer, based on when and at what stage they were diagnosed. It found that out of women diagnosed with breast cancer in 2010, 73% are likely cured, and this jumps to 99% if diagnosed at an early stage. For colorectal cancer, 56% are expected to be cured, with 90% not likely to die from the disease. Understanding these cure rates helps improve follow-up care for cancer survivors and ensures they receive proper support. Who this helps: This benefits patients and healthcare providers who manage cancer follow-up care.

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This study looked at the long-term survival rates and indicators of being cured for Italian women who had uterine or ovarian cancers. It found that in 2018, 0.4% of women diagnosed with uterine cancer, 0.2% with cervical cancer, and 0.2% with ovarian cancer were still alive. The study showed that over 90% of women with uterine cancers and 83% with ovarian cancers are unlikely to die from these cancers, indicating they are effectively cured, and many were cured within 10 years of diagnosis. Who this helps: This benefits patients and healthcare providers by improving follow-up care and support for women who have survived gynecological cancers.

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This research paper studied the impact of respiratory syncytial virus (RSV) on older adults, highlighting it as a major cause of hospitalizations and deaths due to respiratory illness. The authors found that the attention given to RSV in older patients has increased, and they emphasized the importance of developing new vaccines to reduce its burden. This matters because addressing RSV in this population could prevent many serious illnesses and save lives. Who this helps: Older adults and healthcare providers.

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This study looked at the amount of microplastics in the sediment along the shores of 14 different lakes in Northern Italy, particularly focusing on how their levels changed with altitude and human activity. The researchers found an average of about 14 microplastics per kilogram of dry sediment, with some lakes showing much higher levels, especially Lake Garda, which had significantly more microplastics than the others. Understanding these contamination levels is important because microplastics can harm aquatic ecosystems and potentially enter the food chain. Who this helps: This helps environmental scientists and conservationists working to protect freshwater ecosystems.

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The study investigated how access to free cancer screenings for breast, colorectal, and cervical cancers changed during the COVID-19 pandemic in the Province of Pavia, Italy. It found that screening coverage decreased by 16.3% for breast and colorectal cancers and by 8.5% for cervical cancer during the pandemic, with non-Italian residents and those living in rural areas facing greater barriers to access. This is important because it highlights how the pandemic worsened existing inequalities in healthcare access, making it essential to improve screening availability for those who need it most. Who this helps: This helps patients who are at higher risk of cancer and face obstacles in accessing screening programs.

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This study looked at a complication called acute graft pyelonephritis (AGPN) that can occur in kidney transplant patients. Researchers analyzed 939 kidney transplants over eight years and found that 130 cases were confirmed to have AGPN using MRI. They discovered that these patients had worse kidney function in the first year after the transplant—specifically, their kidney function decreased by 0.2 mL/min compared to a 6 mL/min decrease for those without AGPN—and that AGPN particularly impacted transplants from donors younger than 60 years. Who this helps: Patients receiving kidney transplants, especially those with younger donors.

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This study looked at how patients' expectations before starting treatment affect the results of immunosuppressive therapy in people with myasthenia gravis, a neuromuscular disorder. Researchers found that higher worry levels and negative expectations were linked to worse treatment side effects and poorer outcomes, with a positive correlation noted (rs = .699) between expected side effects and those actually experienced. Importantly, patients showed significant clinical improvement within three to six months, suggesting that managing patient expectations and anxiety can play an important role in treatment success. Who this helps: This helps patients with myasthenia gravis and their doctors.

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This study looked at a new way to quickly determine if bacteria in blood samples are resistant to antibiotics using the VITEK® REVEAL™ system. Researchers tested 128 positive blood cultures and found that the new method matched traditional testing in 97.6% of cases, with results ready in under 8 hours. This is important because faster results can help doctors make better treatment decisions for patients with severe infections caused by resistant bacteria. Who this helps: This helps doctors and patients dealing with serious bacterial infections.

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This study looked at the number of cancer survivors in Italy and projected future numbers from 2018 to 2030. In 2018, there were 3.3 million cancer survivors, which is about 5.6% of the population, and this number is expected to rise to 4 million by 2030, or 6.9% of the population. Most survivors will have lived with their diagnosis for over 10 years, and while the overall chance of being cured is high at 86%, certain cancers like breast, lung, kidney, and bladder still carry significant risks of death after survival. Who this helps: This benefits cancer patients, healthcare providers, and policymakers focused on cancer care.

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This study looked at how the introduction of anti-pneumococcal vaccines and the COVID-19 pandemic affected antibiotic resistance in serious infections in Piedmont, Italy. Researchers found that out of 2,076 bacteria samples collected, 21.9% were resistant to penicillin, and 40.3% were resistant to erythromycin. There was a notable increase in infections resistant to penicillin, especially in infants and the elderly, following the vaccination program, while COVID-19 did not significantly change these trends. Who this helps: This benefits patients, especially infants and the elderly, who are at higher risk for resistant infections.

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This study focused on identifying and understanding the spread of carbapenem-resistant Enterobacterales (CRE), dangerous bacteria that are becoming more common in hospitals, especially during the COVID-19 pandemic. They tested over 11,000 patients to see how many were carrying these bacteria when they were admitted and tracked the situation over several weeks. The findings showed that the number of patients colonized by CRE increased during the pandemic, particularly in Southern Italy, revealing the need for better screening and prevention strategies. Who this helps: This helps patients in hospitals, especially those in intensive care, by improving safety measures against infections.

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This study looked at factors that increase the risk of death in patients with bloodstream infections caused by a specific bacteria called KPC-producing Klebsiella pneumoniae. Researchers analyzed data from 196 patients and found that older age, recent kidney treatments, high illness severity, and additional infections were linked to higher mortality rates. They also found that the antibiotic treatment ceftazidime/avibactam, especially on its own, significantly lowered the chances of death, showing it’s an important option for treating these infections. Who this helps: Patients with KPC-Kp bloodstream infections and their doctors.

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This study looked at how Cytomegalovirus (CMV) affects kidney transplant patients, especially those who received transplants from older donors. Researchers found that 19.5% of the 929 kidney transplant patients developed CMV, which was linked to lower long-term success of the transplants. Specifically, patients who had grafts from donors younger than 70 experienced a significant risk of transplant failure when CMV was present, highlighting the need for careful monitoring and treatment in these cases. Who this helps: This helps kidney transplant patients and their doctors by providing important insights into managing the risks associated with CMV.

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This study looked at a new way to extract genetic material from samples taken from patients suspected of having COVID-19, using a method that was originally designed for veterinary use. Researchers tested this new method on 73 samples and found that it worked very well, showing a strong agreement with the standard method currently in use (with a high correlation score of 0.955). This new approach is important because it can streamline the testing process and work around shortages of traditional supplies, which helps speed up COVID-19 diagnosis. Who this helps: This helps patients by increasing the efficiency of COVID-19 testing and diagnosis.

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This study looked at the effects of a treatment called mechanical thrombectomy (MT) for patients who had strokes while already in the hospital, compared to those who had strokes outside the hospital. Researchers found that only 39% of in-hospital stroke patients had good recovery three months later, compared to 48% of those who had strokes outside, and in-hospital patients had a higher death rate of 30.1% versus 19.6%. Even though in-hospital patients received treatment faster, the results were still worse for them, indicating that being in the hospital at the time of the stroke doesn’t guarantee better outcomes. Who this helps: This information benefits doctors by highlighting the challenges faced by in-hospital stroke patients.

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This study examined patients in an Intensive Care Unit (ICU) who had infections caused by a type of bacteria known as KPC-producing Klebsiella pneumoniae, which were resistant to a key antibiotic called ceftazidime/avibactam but still sensitive to another drug called meropenem. Researchers found that 17 patients were affected by these resistant strains, with 76.5% of the isolates appearing within just 60 days, indicating a rapid spread. This matter is urgent as these infections are difficult to treat and can lead to high rates of severe illness and death. Who this helps: This helps patients suffering from these hard-to-treat infections, as well as doctors who need effective treatment options.

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This study looked at how quickly doctors could identify certain bacteria (CTX-M ESBL-producers) in patients with bloodstream infections and how this affected their antibiotic treatment. Over two years, researchers found that for 199 infection cases, doctors changed antibiotic therapies in nearly 34% of cases with positive results, primarily switching to stronger medications. This rapid detection helped doctors make better treatment decisions on the same day the blood cultures were processed. Who this helps: This benefits patients with bloodstream infections by ensuring they receive the most effective antibiotics promptly.

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This study looked at how well two different methods could test if the antibiotic cefiderocol is effective against difficult-to-treat Gram-negative bacteria. Researchers tested 286 bacterial samples and found that the disc diffusion method correctly identified cefiderocol susceptibility in 78.6% to 100% of the samples, while the ComASPcefiderocol panel showed a 94% agreement in results. These findings are important because they offer reliable testing options for a challenging antibiotic, which can help guide effective treatment for infections. Who this helps: This helps doctors make better treatment decisions for patients with serious bacterial infections.

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This study looked at blood samples from six hospitals in Southern Europe during the COVID-19 pandemic to understand which fungal infections were present and how resistant they were to antifungal drugs. Researchers found that one type of fungus was most common (45.1% of cases) and resistance to antifungal medications like fluconazole increased significantly, especially in COVID-19 patients in intensive care units. For example, resistance to fluconazole rose from 0.7% to 4.5%, and some fungal strains showed resistance rates as high as 24.5%. Who this helps: This research helps doctors treating COVID-19 patients by highlighting the need for better antifungal management strategies.

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This study looked at how genetic differences in a part of our immune system called HLA influence the body's response to the mRNA COVID-19 vaccine from Pfizer (Comirnaty). Researchers found that people with certain genetic markers, like A*03:01 and B*40:02, had higher levels of antibodies, while those with A*24:02 and C*07:01 had lower responses. About 50% of vaccine recipients had a good cellular immune response to one part of the virus, and having specific genetic traits like DRB1*15:01 led to even stronger responses. Who this helps: This information benefits patients by helping to identify who may have a better or worse vaccine response based on their genetic makeup.

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This study looked at how to better measure cancer cure rates and survival outcomes using data from cancer registries covering 47% of the Italian population. The researchers found that for men aged 65-74 diagnosed with cancer, 41% were considered cured, while women showed similar patterns, particularly with breast cancer. Notably, 48% of colorectal cancer patients aged 55-64 were already cured, and by five years post-diagnosis, the chance of being cured rose to 97.5%. These findings are important because they provide clear, detailed metrics that can help inform treatment decisions and improve understanding of cancer outcomes. Who this helps: This helps patients, doctors, and healthcare providers.

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This study looked at a new way to predict which patients with bloodstream infections (BSIs) that they got outside the hospital are at high risk for having multi-drug-resistant (MDR) infections. Researchers developed a model that considers factors like age, gender, and recent medical treatments, and found it performed well, especially for those with a moderate chance of MDR infection (C-index of 70%). This model can help doctors choose the right antibiotics more effectively for these patients, ultimately improving treatment outcomes. Who this helps: This benefits patients with bloodstream infections and their doctors.

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This study looked at how well two automated systems, BD Phoenix and MicroScan WalkAway Plus, can test bacteria for resistance to fosfomycin, an important antibiotic for treating hard-to-treat infections. The results showed that BD Phoenix incorrectly identified 6.9% of samples as resistant, with a 69% agreement in results compared to a standard testing method, while MicroScan showed a lower false-resistance rate of 3.7% but still only 72% agreement. Because these automated systems did a poor job in detecting resistance, it's better to stick with the traditional testing method for reliable results, emphasizing the need for labs to review their current practices. Who this helps: This helps doctors and patients by ensuring they get accurate information about antibiotic resistance for effective treatment decisions.

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This study looked at how to better identify different subspecies of a bacteria called Mycobacterium abscessus complex (MABSC), which can cause serious infections. Researchers used a technique called Fourier-Transform Infrared Spectroscopy (FT-IRS) and found that it effectively distinguished two subspecies—M. abscessus subsp. abscessus and M. abscessus subsp. massiliense—especially using a specific growth medium. This is important because knowing the exact subspecies can lead to more effective treatments for patients. Who this helps: This helps patients with MABSC infections.

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This study looked at how common certain drug-resistant bacteria were in COVID-19 patients in the hospital and how this affected their chances of dying. It found that about 30% of patients carried these harmful bacteria, and 20% developed serious infections like pneumonia from them. However, even with these infections, the bacteria didn't significantly increase the risk of death. Who this helps: This helps doctors understand the risks associated with treating COVID-19 patients and manage infections more effectively.

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This research looks at ways to treat cytomegalovirus (CMV), a virus that can cause serious health problems, especially for people with weakened immune systems. It highlights both existing antiviral treatments and new strategies being tested, like genetic editing, which have shown good results in lab studies. Improving treatment options is important because current medications often have side effects and some viruses can become resistant to them. Who this helps: This helps patients with weakened immune systems, such as organ transplant recipients and HIV-positive individuals.

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This study looked at rare bloodstream infections caused by specific types of bacteria in a hospital in Italy from 2018 to 2023. Out of nearly 5,000 cases of Gram-negative infections, only 19 (0.4%) were linked to these bacteria, with a low death rate of 5.3%. This is important because it shows these infections are not very common and that specific treatments are being used, highlighting the need for more research on how these bacteria cause illness. Who this helps: This helps doctors and patients by improving understanding of rare infections and guiding better treatment decisions.

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This research reviewed the issues lung transplant patients face with herpes virus infections, which can happen due to the immune-suppressing medications they need. It found that these viruses are responsible for nearly 30% of infections after lung transplants, with cytomegalovirus (CMV) being particularly dangerous because it increases the risk of lung failure. New tests and prevention strategies are being developed to help reduce these infections and improve patient outcomes. Who this helps: This benefits lung transplant patients who are at risk for viral infections.

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This study looked at how common it is for patients in Italy to carry carbapenem-resistant bacteria (CRE), which are hard to treat, before and during the COVID-19 pandemic. Researchers found that the number of patients with CRE increased significantly from 3.9% to 11.5% at admission and from 5.1% to 15.5% during their hospital stay between the two time periods studied. This is important because it highlights the growing threat of these bacteria, especially in Southern Italy, and underscores the need for better monitoring and targeted interventions to prevent their spread. Who this helps: This helps patients at risk of infections and healthcare providers aiming to improve hospital safety.

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This study looked at survival rates for women diagnosed with vulvar squamous cell carcinoma (VSCC) in Italy from 1990 to 2015, analyzing data from over 6,200 patients. It found that survival rates for one year decreased slightly from 83.9% to 81.9% and for two years from 72.2% to 70.5%, while five-year survival after two years showed a slight increase from 85.7% to 86.7%, but these changes were not significant. These findings highlight the need to rethink how vulvar cancer is treated because overall survival rates have not improved during this time. Who this helps: This information benefits patients and healthcare providers by highlighting areas for improvement in cancer treatment strategies.

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Researchers looked at melanoma, a type of skin cancer, in Italy by analyzing data from 40 cancer registries from the 1990s to the recent past. They found that while overall melanoma cases increased for both men and women, rates began to stabilize or decrease for those under 35. Treatment advancements have improved survival rates, especially for men with thick melanoma, and the gap in survival rates between men and women has narrowed. Who this helps: This benefits patients fighting melanoma and healthcare providers working on treatment strategies.

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This study looked at the effects of a procedure called mechanical thrombectomy, used to treat strokes, in patients with heart failure compared to those without. Out of nearly 9,000 patients studied, 642 had heart failure, and although the success in reopening blocked blood vessels was similar (about 77% for heart failure patients), those with heart failure faced higher risks; 30.7% died within three months compared to 18.5% of non-heart failure patients. This is important because it highlights that heart failure increases the risk of dying early after a stroke, even with treatment. Who this helps: This study benefits patients with heart failure and their doctors by providing important information about stroke outcomes.