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Total 186 results found since Jan 2013.
Correspondence The INTERSTROKE study on risk factors for stroke – Authors' reply
Xianwei Zeng and collagues suggest our analysis of the INTERSTROKE study1 overestimated the population attributable for ten risk factors of stroke due to the selection of variables included. Although we did not include a variable for metabolic syndrome, we did include the key domains for metabolic syndrome, namely obesity, diabetes, hypertension, and apolipoproteins. Our analysis also included a measure of dietary quality, namely modified alternative healthy index (mAHEI). Variables for health education and hormones were not included, because these were not measured, although certain hormones could be measured in future an...
Source: LANCET - January 6, 2017 Category: Journals (General) Authors: Martin O'Donnell, Salim Yusuf Tags: Correspondence Source Type: research
Articles Intensive speech and language therapy in patients with chronic aphasia after stroke: a randomised, open-label, blinded-endpoint, controlled trial in a health-care setting
3 weeks of intensive speech and language therapy significantly enhanced verbal communication in people aged 70 years or younger with chronic aphasia after stroke, providing an effective evidence-based treatment approach in this population. Future studies should examine the minimum treatment intensity required for meaningful treatment effects, and determine whether treatment effects cumulate over repeated intervention periods.
Source: LANCET - February 27, 2017 Category: Journals (General) Authors: Caterina Breitenstein, Tanja Grewe, Agnes Fl öel, Wolfram Ziegler, Luise Springer, Peter Martus, Walter Huber, Klaus Willmes, E Bernd Ringelstein, Karl Georg Haeusler, Stefanie Abel, Ralf Glindemann, Frank Domahs, Frank Regenbrecht, Klaus-Jürgen Schlenc Tags: Articles Source Type: research
Correspondence Stroke in ICD-11: the end of a long exile
In 1955, cerebrovascular diseases were reclassified as circulatory system diseases in the 7th edition of the International Classification of Diseases and Related Health Problems (ICD). WHO's idea then was that stroke is a condition affecting blood vessels. This decision to reclassify cerebrovascular diseases seemed contrary to the pathophysiology and symptoms leading to mortality and morbidity, which are those of brain dysfunction. Moreover, the decision deviated from the principle of ischaemia of other organs (such as the intestines, kidneys, and the eye), which were listed under their respective organs in ICD-7.
Source: LANCET - June 16, 2017 Category: General Medicine Authors: Raad Shakir, Bo Norrving Tags: Correspondence Source Type: research
Correspondence Intensive speech and language therapy after stroke
Caterina Breitenstein and colleagues (April 15, p 1528)1 reported that 3 weeks of intensive speech and language therapy significantly enhanced verbal communication in people aged 70 years or younger with chronic aphasia after stroke. The primary outcome measure was assessed using the Amsterdam-Nijmegen Everyday Language Test (ANELT) A-scale, and the mean difference of the ANELT A-scale score improved 2 ·61 (SD 4·94) points from baseline to after intensive speech and language therapy, but not from baseline to after treatment deferral.
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Ryo Sakamoto, Asaka Higuchi, Kenji Tsuda, Tetsuya Tanimoto, Masahiro Kami Tags: Correspondence Source Type: research
Correspondence Intensive speech and language therapy after stroke – Authors' reply
We thank Ryo Sakamoto and colleagues for their Correspondence regarding our FCET2EC trial on the effectiveness of intensive speech and language therapy in chronic post-stroke aphasia.1 Their point regarding the minimal clinically important difference of the primary outcome measure (Amsterdam-Nijmegen Everyday Language Test [ANELT] A-scale) is of major concern, as already acknowledged in our Article ( “To our knowledge, no previously published studies exist on the association of change in ANELT scores with clinical effect.”).
Source: LANCET - July 14, 2017 Category: General Medicine Authors: Caterina Breitenstein, Peter Martus, Klaus Willmes, Wolfram Ziegler, Annette Baumgaertner Tags: Correspondence Source Type: research
Articles Family-led rehabilitation after stroke in India (ATTEND): a randomised controlled trial
Although task shifting is an attractive solution for health-care sustainability, our results do not support investment in new stroke rehabilitation services that shift tasks to family caregivers, unless new evidence emerges. A future avenue of research should be to investigate the effects of task shifting to health-care assistants or team-based community care.
Source: LANCET - June 27, 2017 Category: General Medicine Authors: The ATTEND Collaborative Group Tags: Articles Source Type: research
Comment A global coalition for the fight against heart disease and stroke
As political leaders prepare for the third UN High-level Meeting on Non-communicable Diseases (NCDs) in 2018, the World Heart Federation (WHF) is bringing together a global coalition of international, regional, and national stakeholders in cardiovascular diseases (CVDs) to drive the urgent action needed to combat heart disease and stroke.
Source: LANCET - October 16, 2017 Category: General Medicine Authors: David Wood, Jean-Luc Eisel é Tags: Comment Source Type: research
Correspondence Alteplase for ischaemic stroke—responses
In his Correspondence Roger Shinton raises concerns about the benefits of alteplase to treat acute ischaemic stroke. He refers to the Cochrane review of thrombolysis in acute ischaemic stroke, published in 2009, with data for 3977 patients treated with alteplase in randomised controlled trials (RCTs). Since then, the Third International Stroke Trial (IST-3) and an updated systematic review of all alteplase trials (7012 patients) have been published, and a complete update of all RCTs of all thrombolytic agents in acute ischaemic stroke (10 187 patients) in the Cochrane Database of Systematic Reviews has been very recently published.
Source: LANCET - August 23, 2014 Category: Journals (General) Authors: Joanna M Wardlaw, Veronica Murray, Eivind Berge, Gregory J Del Zoppo Tags: Correspondence Source Type: research
Comment Age and carotid intervention outcomes
In The Lancet, the Carotid Stenting Trialists' Collaboration (CSTC) present a meta-analysis of the effect of increasing age on perioperative death or stroke related and late ipsilateral stroke in 4754 symptomatic patients randomised to carotid endarterectomy (CEA) or carotid artery stenting (CAS) in three European randomised controlled trials (RCTs; EVA-3S, SPACE, and ICSS) and one North American RCT (CREST).1 Key findings were that once the perioperative period (between randomisation and 120 days) passed, there was no difference in late ipsilateral stroke between CEA and CAS, irrespective of age, and that increasing age h...
Source: LANCET - February 11, 2016 Category: Journals (General) Authors: A Ross Naylor Tags: Comment Source Type: research
Comment Does intensity matter in aphasia rehabilitation?
Aphasia is a serious acquired communication disability, that affects approximately 30% of stroke survivors.1 It is chronic in nature: 50% of people diagnosed with aphasia have persistent communication problems 1 year after stroke.2 Aphasia compromises an individual's ability to undertake many activities of daily living, resulting in reduced mood and quality of life.3,4 In addition to the personal cost of aphasia, health-care costs for people with aphasia are the highest in stroke care.5 Therefore, the recent identification of recovery from aphasia as one of the top ten research priorities related to life after stroke is unsurprising.
Source: LANCET - February 27, 2017 Category: Journals (General) Authors: Linda Worrall, Abby Foster Tags: Comment Source Type: research
Comment Cerebral amyloid angiopathy and implications for atrial fibrillation management
Atrial fibrillation, the most common arrhythmia in adults, will increase in prevalence as the population ages.1 The risk of embolic stroke in atrial fibrillation also increases with age. Treatments for the prevention of embolic stroke include warfarin, direct oral anticoagulant agents, and non-anticoagulation strategies such as left atrial appendage occlusion.1 Current scores to estimate the risk of ischaemic stroke (CHA2DS2-VaSc score) or haemorrhage (HAS-BLED score) help guide intervention, but do not account for cerebral amyloid angiopathy (CAA), a prevalent, but overlooked condition.
Source: LANCET - June 29, 2017 Category: General Medicine Authors: Christopher V DeSimone, Jonathan Graff-Radford, Majd A El-Harasis, Alejandro A Rabinstein, Samuel J Asirvatham, David R Holmes Tags: Comment Source Type: research
Department of Error Department of Error
Lopes RD, Al-Khatib SM, Wallentin L, et al. Efficacy and safety of apixaban compared with warfarin according to patient risk of stroke and of bleeding in atrial fibrillation: a secondary analysis of a randomised controlled trial. Lancet 2012; 380: 1749–58—In table 3 and table 5 of this Article (Nov 17), the %s per person-year in the ischaemic stroke (overall results) row were incorrect. The values should have been 0·84% (apixaban) and 0·82% (warfarin) in both tables. These corrections have been made to the online version as of Jan 18, 2013.
Source: LANCET - January 18, 2013 Category: Journals (General) Authors: The Lancet Tags: Department of Error Source Type: research
Comment Statins: new American guidelines for prevention of cardiovascular disease
Guidelines released on Nov 13, 2013, by the American Heart Association (AHA) and the American College of Cardiology (ACC) for the management of cholesterol are a major step in the right direction. These new guidelines emphasise prevention of stroke as well as heart disease, focus appropriately on statin therapy rather than alternative unproven therapeutic agents, and recognise that more intensive treatment is superior to less intensive treatment for many patients. Furthermore, the new ACC/AHA guidelines show that for individuals in whom statin therapy is clearly indicated (such as those with previous vascular disease or LD...
Source: LANCET - November 30, 2013 Category: Journals (General) Authors: Paul M Ridker, Nancy R Cook Tags: Comment Source Type: research
