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Total 186 results found since Jan 2013.
Articles Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): a randomised controlled trial
First mobilisation took place within 24 h for most patients in this trial. The higher dose, very early mobilisation protocol was associated with a reduction in the odds of a favourable outcome at 3 months. Early mobilisation after stroke is recommended in many clinical practice guidelines worldwide, and our findings should affect clinical practice by refining present guidelines; however, clinical recommendations should be informed by future analyses of dose–response associations.
Source: LANCET - April 16, 2015 Category: Journals (General) Authors: The AVERT Trial Collaboration group Tags: Articles Source Type: research
Series Oral anticoagulants for stroke prevention in atrial fibrillation: current status, special situations, and unmet needs
In patients with non-valvular atrial fibrillation, oral anticoagulation with vitamin K antagonists reduces the risk of stroke by more than 60%. But vitamin K antagonists have limitations, including causing serious bleeding such as intracranial haemorrhage and the need for anticoagulation monitoring. In part related to these limitations, they are used in only about half of patients who should be treated according to guideline recommendations. In the past decade, oral agents have been developed that directly block the activity of thrombin (factor IIa), as well as drugs that directly inhibit activated factor X (Xa), which is ...
Source: LANCET - March 14, 2015 Category: Journals (General) Authors: Freek W A Verheugt, Christopher B Granger Tags: Series Source Type: research
Correspondence Parenteral antibiotics are not enough to prevent pneumonia in stroke
The Preventive Antibiotics in Stroke Study (PASS; April 18, p 1519)1 reported that parenteral ceftriaxone did not significantly reduce pneumonia. We would like to comment on these results.
Source: LANCET - August 14, 2015 Category: Journals (General) Authors: Luciano Silvestri, Hendrick K F van Saene, Marco Milanese, Silvia Ros, Durk F Zandstra Tags: Correspondence Source Type: research
Articles Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603 838 individuals
Employees who work long hours have a higher risk of stroke than those working standard hours; the association with coronary heart disease is weaker. These findings suggest that more attention should be paid to the management of vascular risk factors in individuals who work long hours.
Source: LANCET - August 19, 2015 Category: Journals (General) Authors: Mika Kivimäki, Markus Jokela, Solja T Nyberg, Archana Singh-Manoux, Eleonor I Fransson, Lars Alfredsson, Jakob B Bjorner, Marianne Borritz, Hermann Burr, Annalisa Casini, Els Clays, Dirk De Bacquer, Nico Dragano, Raimund Erbel, Goedele A Geuskens, Mark H Tags: Articles Source Type: research
Correspondence Prophylactic antibiotics to reduce pneumonia after acute stroke
We read the Article by Lalit Kalra and colleagues1 with great interest but are concerned about some issues. In our opinion, STROKE-INF was a negative trial because of insufficient dysphagia management before randomisation to antibiotic treatment that was not able to prevent aspiration pneumonia.
Source: LANCET - January 30, 2016 Category: Journals (General) Authors: Hermann Neugebauer, Beate Lindner-Pfleghar, Eric Jüttler, Albert C Ludolph, Axel Riecker Tags: Correspondence Source Type: research
Correspondence Prophylactic antibiotics to reduce pneumonia after acute stroke – Author's reply
Ioan Milosevic and colleagues pointed out that the outcomes presented in our Article1 were different from those in the ISRCTN registry (number ISRCTN37118456). They stated that one pre-specified primary outcome (“hospital costs”) was not reported, and a new co-primary outcome (“physician diagnosed post-stroke pneumonia”) added. We have clarified in the Methods section that physician diagnosed pneumonia was not a primary outcome but was presented as an alternative to algorithm-based diagnosis to harmonise with diagnostic criteria used in previous studies.
Source: LANCET - January 30, 2016 Category: Journals (General) Authors: Lalit Kalra Tags: Correspondence Source Type: research
Comment New option for primary stroke prevention in sickle cell anaemia
The results of the TWiTCH trial1 establish a new standard of care for primary stroke prevention in children with sickle cell anaemia and high transcranial doppler (TCD) flow velocities (≥200 cm/s). In this high-risk group, the incidence of strokes per year is about
Source: LANCET - December 6, 2015 Category: Journals (General) Authors: Michael R DeBaun, Fenella J Kirkham Tags: Comment Source Type: research
Articles Association between age and risk of stroke or death from carotid endarterectomy and carotid stenting: a meta-analysis of pooled patient data from four randomised trials
In these RCTs, CEA was clearly superior to CAS in patients aged 70–74 years and older. The difference in older patients was almost wholly attributable to increasing periprocedural stroke risk in patients treated with CAS. Age had little effect on CEA periprocedural risk or on postprocedural risk after either procedure.
Source: LANCET - February 11, 2016 Category: Journals (General) Authors: George Howard, Gary S Roubin, Olav Jansen, Jeroen Hendrikse, Alison Halliday, Gustav Fraedrich, Hans-Henning Eckstein, David Calvet, Richard Bulbulia, Leo H Bonati, Jean-Pierre Becquemin, Ale Algra, Martin M Brown, Peter A Ringleb, Thomas G Brott, Jean-Lo Tags: Articles Source Type: research
Comment HERMES: messenger for stroke interventional treatment
The treatment approach for acute ischaemic stroke is straightforward: restore blood flow as soon as possible and do it as safely and completely as possible. The overlong path to confirming this simple and intuitive treatment plan leads to the HERMES collaboration, the meta-analysis from Mayank Goyal and colleagues—including principal investigators from the selected trials—published in The Lancet, which combines individual patient data from five trials of endovascular mechanical thrombectomy published in 2015.
Source: LANCET - February 17, 2016 Category: Journals (General) Authors: Keith W Muir, Philip White Tags: Comment Source Type: research
Articles Weekly variation in health-care quality by day and time of admission: a nationwide, registry-based, prospective cohort study of acute stroke care
The weekend effect is a simplification, and just one of several patterns of weekly variation occurring in the quality of stroke care. Weekly variation should be further investigated in other health-care settings, and quality improvement should focus on reducing temporal variation in quality and not only the weekend effect.
Source: LANCET - May 9, 2016 Category: Journals (General) Authors: Benjamin D Bray, Geoffrey C Cloud, Martin A James, Harry Hemingway, Lizz Paley, Kevin Stewart, Pippa J Tyrrell, Charles D A Wolfe, Anthony G Rudd, SSNAP collaboration Tags: Articles Source Type: research
Editorial Atrial fibrillation and stroke: unrecognised and undertreated
When did you or your primary care physician last palpate your wrist to check for a regular heart rate? This simple action, followed by an electrocardiogram if the heart rate is irregular, might be crucial in preventing death and disability from ischaemic stroke, heart failure, or myocardial infarction. In this week's issue, we publish a clinical Series of three papers on atrial fibrillation ahead of the annual European Society of Cardiology (ESC) meeting held in Rome, Italy, Aug 27 –31. Atrial fibrillation is estimated to affect 33 million people worldwide.
Source: LANCET - August 19, 2016 Category: Journals (General) Authors: The Lancet Tags: Editorial Source Type: research
Correspondence Telemedicine expedites access to optimal acute stroke care
In their meta-analysis of patient-level data from five randomised trials, Mayank Goyal and colleagues1 (April 23, p 1723) reported that endovascular thrombectomy was effective for patients with acute ischaemic stroke caused by large-vessel occlusions (number needed to treat, 2 ·6). Individuals that will benefit include older patients (age>80 years), those ineligible to receive tissue plasminogen activator (tPA), and those with internal carotid artery or M1 occlusion. We agree with the authors that the findings “have global implications on structuring systems of care”1 to ensure no eligible patient is missed under these expanded criteria.
Source: LANCET - August 19, 2016 Category: Journals (General) Authors: Kathleen L Bagot, Dominique A Cadilhac, Peter J Hand, Michelle Vu, Christopher F Bladin Tags: Correspondence Source Type: research
Articles Human neural stem cells in patients with chronic ischaemic stroke (PISCES): a phase 1, first-in-man study
Single intracerebral doses of CTX-DP up to 20 million cells induced no adverse events and were associated with improved neurological function. Our observations support further investigation of CTX-DP in stroke patients.
Source: LANCET - August 2, 2016 Category: Journals (General) Authors: Dheeraj Kalladka, John Sinden, Kenneth Pollock, Caroline Haig, John McLean, Wilma Smith, Alex McConnachie, Celestine Santosh, Philip M Bath, Laurence Dunn, Keith W Muir Tags: Articles Source Type: research
Comment Stroke and mortality after atrial fibrillation —a global struggle
Atrial fibrillation is a widely recognised health-care challenge with increasing prevalence across the world. Epidemiological observations mainly attribute this increase to an ageing population and better prognosis in distinguishing it from other cardiac disorders such as myocardial infarction.1 Research into atrial fibrillation has focused on antithrombotic management for stroke prevention and mortality, in the era of non-vitamin K antagonist oral anticoagulants.2 However, although these large, phase 3 trials enrolled patients from many centres in different countries and included broad populations, regional differences an...
Source: LANCET - August 7, 2016 Category: Journals (General) Authors: Torben Bjerregaard Larsen, Peter Br ønnum Nielsen Tags: Comment Source Type: research
Articles Occurrence of death and stroke in patients in 47 countries 1 year after presenting with atrial fibrillation: a cohort study
Marked unexplained inter-regional variations in the occurrence of stroke and mortality suggest that factors other than clinical variables might be important. Prevention of death from heart failure should be a major priority in the treatment of atrial fibrillation.
Source: LANCET - August 7, 2016 Category: Journals (General) Authors: Jeff S Healey, Jonas Oldgren, Michael Ezekowitz, Jun Zhu, Prem Pais, Jia Wang, Patrick Commerford, Petr Jansky, Alvaro Avezum, Alben Sigamani, Albertino Demasceno, Paul Reilly, Alex Grinvalds, Juliet Nakamya, Akinyemi Aje, Wael Almahmeed, Andrew Moriarty, Tags: Articles Source Type: research
