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Total 186 results found since Jan 2013.
Comment Platelets after intracerebral haemorrhage: more is not better
Spontaneous intracerebral haemorrhage has a disproportionally high burden of mortality and disability compared with other subtypes of stroke.1,2 As a clinician, when faced with a condition as devastating as intracerebral haemorrhage, one feels compelled to use any and all therapies available, even though at times evidence of effectiveness of those therapies is not yet established.1 This is particularly the case for many health-care providers on the front lines of emergency diagnosis and treatment for patients who have had an intracerebral haemorrhage while taking antiplatelet therapy.
Source: LANCET - May 9, 2016 Category: Journals (General) Authors: Calin I Prodan Tags: Comment Source Type: research
Articles Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial
Platelet transfusion seems inferior to standard care for people taking antiplatelet therapy before intracerebral haemorrhage. Platelet transfusion cannot be recommended for this indication in clinical practice.
Source: LANCET - May 9, 2016 Category: Journals (General) Authors: M Irem Baharoglu, Charlotte Cordonnier, Rustam Al-Shahi Salman, Koen de Gans, Maria M Koopman, Anneke Brand, Charles B Majoie, Ludo F Beenen, Henk A Marquering, Marinus Vermeulen, Paul J Nederkoorn, Rob J de Haan, Yvo B Roos, PATCH Investigators Tags: Articles Source Type: research
Department of Error Department of Error
Bray BD, Cloud GC, James MA, et al. Weekly variation in health-care quality by day and time of admission: a nationwide, registry-based, prospective cohort study of acute stroke care. Lancet 2016; 388: 170–77. In this Article, in the findings section of the Summary and in the third paragraph of the Results, “sleep and language therapist” should have been “speech and language therapist”. This change has been made to the online version as of May 17, 2016, and the printed Article is correct.
Source: LANCET - May 16, 2016 Category: Journals (General) Tags: Department of Error Source Type: research
Obituary Philip Majerus
Physician and biochemist who showed small doses of aspirin reduce the risk of heart attack and stroke. Born on July 10, 1936, in Chicago, IL, USA, he died with prostate cancer on June 8, 2016, in University City, MO, USA, aged 79 years.
Source: LANCET - July 29, 2016 Category: Journals (General) Authors: Alison Snyder Tags: Obituary Source Type: research
Correspondence Treating sickle cell anaemia: the TWiTCH trial
We read with interest the results of the TWiTCH trial1 comparing hydroxyurea with transfusions for the treatment of sickle cell disease. As a patient-support charity, we acknowledge the potential of this study to inform and change clinical practice geared towards reducing the risk of childhood stroke associated with sickle cell disease. As strong advocates for patient's choice, we believe informed choice should remain key to the use and interpretation of this research in clinical practice.
Source: LANCET - September 2, 2016 Category: Journals (General) Authors: Maureen Gwam, Carol Nwosu Tags: Correspondence Source Type: research
Correspondence The ABC risk score for patients with atrial fibrillation
The study by Ziad Hijazi and colleagues (June 4, p 2302)1 provides a comprehensive validation of the age, biomarkers, and clinical history (ABC)-bleeding score, using age, three biomarkers (haemoglobin, cardiac troponin T, and GDF-15), and clinical history of bleeding to predict major bleeding events in anticoagulated patients with atrial fibrillation. Although the clinical usefulness of this approach to tailor stroke and bleeding risk in individual patients awaits further validation in real-world cohorts, the study by Hijazi and colleagues1 is a great leap forward in precision medicine and risk stratification in atrial fibrillation.
Source: LANCET - October 21, 2016 Category: Journals (General) Authors: Andreas Charidimou Tags: Correspondence Source Type: research
Comment Should blood pressure reduction be aggressive in patients with hypertension and coronary artery disease?
In The Lancet, Emmanuelle Vidal-Petiot and colleagues1 show that in patients with hypertension and stable coronary artery disease included in the multicountry CLARIFY registry, non-fatal and fatal outcomes decreased as blood pressure was reduced to a 120 –139 mm Hg systolic or a 70–79 mm Hg diastolic range over 5 years of treatment. Blood pressure reductions to less than 120/70 mm Hg, however, were accompanied by a marked increase of cardiovascular risk that involved cause-specific events such as myocardial infarction and heart failure, only spa ring stroke, whose risk remained similar to that seen at the higher blood pressure values.
Source: LANCET - August 29, 2016 Category: Journals (General) Authors: Giuseppe Mancia Tags: Comment Source Type: research
Correspondence Revising the ICD: stroke is a brain disease
The tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) was long overdue. The ICD-10 was based on outdated medical knowledge and concepts from the 1980s. Since then, science and practice have changed beyond recognition. The WHO neurology topic advisory group (TAG) for the revision of the ICD-10 was formed in 2009. In the ICD-10, cerebrovascular diseases were inconsistently and confusingly spread over several different chapters. In March, 2011, the Neurology and Circulatory TAGs, with contribution of WHO classification representatives and relevant WHO departments, ...
Source: LANCET - October 13, 2016 Category: Journals (General) Authors: Raad Shakir, Steve Davis, Bo Norrving, Wolfgang Grisold, William M Carroll, Valery Feigin, Vladimir Hachinski Tags: Correspondence Source Type: research
Correspondence Hypertension control and cardiovascular disease
On the basis of Omran's theory of epidemiological transition, Jacques Blacher and colleagues (July 30, p 530)1 provocatively propose six strategies to reduce the burden of hypertensive cardiovascular disease. Notably, missing from their list are strategies to minimise blood pressure variability. In several large randomised trials, such as ALLHAT2 and ASCOT,3 blood pressure variability has been identified as a powerful independent risk factor for stroke and cardiovascular events.4 –6 Of note, not all antihypertensive drugs are equally effective in reducing blood pressure variability.
Source: LANCET - January 13, 2017 Category: Journals (General) Authors: Franz H Messerli, Urs Fischer, Stefano F Rimoldi, Sripal Bangalore Tags: Correspondence Source Type: research
Obituary Wenner Dudley Johnson
Pioneering heart surgeon. He was born in Madison, WI, USA, on April 3, 1930, and died following a stroke in Milwaukee, WI, USA, on Oct 24, 2016, aged 86 years.
Source: LANCET - January 20, 2017 Category: Journals (General) Authors: Geoff Watts Tags: Obituary Source Type: research
Perspectives Towards a smart medical home
Julia is nudged awake at 0615 h, her optimum waking time as determined by patterns of her vital signs and body movements, which are all measured by her mattress as she sleeps. Although prone to orthostatic hypotension, the floor-based hallway sensors do not detect any unsteadiness as she walks to the bathroom. Upon sitting on the toilet, a rapid assessment of her blood pressure, cardiac stroke volume, bodyweight, urine, and stool assays takes place. When she looks in the mirror, a reminder of her medications appear.
Source: LANCET - January 27, 2017 Category: Journals (General) Authors: Evan D Muse, Paddy M Barrett, Steven R Steinhubl, Eric J Topol Tags: Perspectives Source Type: research
Department of Error Department of Error
Healey JS, Oldgren J, Ezekowitz M, et al. Occurrence of death and stroke in patients in 47 countries 1 year after presenting with atrial fibrillation: a cohort study. Lancet 2016; 388: 1161 –69—In this Article, the author's name Albertino Demasceno should have been spelled Albertino Damasceno. This correction has been made to the online version as of Oct 4, 2016.
Source: LANCET - October 3, 2016 Category: Journals (General) Tags: Department of Error Source Type: research
Seminar Spontaneous subarachnoid haemorrhage
Subarachnoid haemorrhage is an uncommon and severe subtype of stroke affecting patients at a mean age of 55 years, leading to loss of many years of productive life. The rupture of an intracranial aneurysm is the underlining cause in 85% of cases. Survival from aneurysmal subarachnoid haemorrhage has increased by 17% in the past few decades, probably because of better diagnosis, early aneurysm repair, prescription of nimodipine, and advanced intensive care support. Nevertheless, survivors commonly have cognitive impairments, which in turn affect patients' daily functionality, working capacity, and quality of life.
Source: LANCET - September 12, 2016 Category: Journals (General) Authors: R Loch Macdonald, Tom A Schweizer Tags: Seminar Source Type: research
Correspondence Stoop to conquer: preventing stroke and dementia together
The timely editorial in The Lancet (Dec 3, p 2713)1 calls for a broadening of our approaches to dementia research. Treatment and prevention of cerebrovascular diseases appear to be the most obvious examples. Covert cerebrovascular disease can contribute to or trigger neurodegeneration. Alzheimer's and other neurodegenerative diseases are common in the elderly, most of whom do not develop dementia. However, if an individual has a component of vascular disease, which occurs in 80% of patients with Alzheimer's disease, it doubles the chances of developing dementia.
Source: LANCET - April 14, 2017 Category: Journals (General) Authors: Vladimir Hachinski Tags: Correspondence Source Type: research
