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Specialty: General Medicine
Source: LANCET
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Total 186 results found since Jan 2013.
Department of Error Department of Error
Feigin VL, Forouzanfar MH, Krishnamurthi R, et al, on behalf of the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) and the GBD Stroke Experts Group. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet 2013; published online Oct 24. http://dx.doi.org/10.1016/S0140-6736(13)61953-4—In this Article, on line 7 of the Findings section of the Summary, the sentence should have read “…had significantly increased since 1990 (68%, 84%, 26%, and 12% increase, respectively)”.
Source: LANCET - January 17, 2014 Category: Journals (General) Authors: The Lancet Tags: Department of Error Source Type: research
Comment Warfarin or novel oral anticoagulants for atrial fibrillation?
Stroke prevention is central to the management of atrial fibrillation and, until recently, the focus was to identify high-risk patients who would be given a so-called inconvenient drug, warfarin. Nowadays, the landscape for stroke prevention has changed with the availability of novel oral anticoagulants, and an increased appreciation that vitamin K antagonists (eg, warfarin) work best with high-quality anticoagulation control (shown by the average individual time in therapeutic range at an international normalised ratio of 2·0–3·0).
Source: LANCET - March 14, 2014 Category: Journals (General) Authors: Torben Bjerregaard Larsen, Gregory Y H Lip Tags: Comment Source Type: research
Articles Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials
This meta-analysis is the first to include data for all four new oral anticoagulants studied in the pivotal phase 3 clinical trials for stroke prevention or systemic embolic events in patients with atrial fibrillation. New oral anticoagulants had a favourable risk–benefit profile, with significant reductions in stroke, intracranial haemorrhage, and mortality, and with similar major bleeding as for warfarin, but increased gastrointestinal bleeding. The relative efficacy and safety of new oral anticoagulants was consistent across a wide range of patients.
Source: LANCET - March 14, 2014 Category: Journals (General) Authors: Christian T Ruff, Robert P Giugliano, Eugene Braunwald, Elaine B Hoffman, Naveen Deenadayalu, Michael D Ezekowitz, A John Camm, Jeffrey I Weitz, Basil S Lewis, Alexander Parkhomenko, Takeshi Yamashita, Elliott M Antman Tags: Articles Source Type: research
Correspondence Management of brain arteriovenous malformations
The investigators of ARUBA (Feb 15, p 614) must be thoroughly applauded for conducting the first-ever randomised controlled trial of a therapeutic intervention to improve the prognosis of brain arteriovenous malformations. In view of the antagonism to the trial in some quarters, they were lucky to get even the 223 patient sample size they did, even though it was much smaller than the originally intended 800, subsequently modified to 400. However, they were not so lucky with their Data and Safety Monitoring Board who recommended halting randomisation at a mean of less than 3 years, before—possibly long before—enough fol...
Source: LANCET - May 9, 2014 Category: Journals (General) Authors: Charles Warlow Tags: Correspondence Source Type: research
Correspondence New oral anticoagulants in patients with atrial fibrillation
From a meta-analysis of four studies, Christian Ruff and colleagues concluded that use of new oral anticoagulants (NOACs) in patients with atrial fibrillation results in a decreased incidence of stroke and mortality when compared with warfarin. However, the mean time in therapeutic range (TTR) was less than 65% in the warfarin group (). A recent registry study reported a TTR of more than 75% with warfarin, indicating that medical care in these randomised trials was disappointing. In patients with atrial fibrillation, a 10% increase in the time spent out of the therapeutic range is associated with substantial increased risk...
Source: LANCET - July 4, 2014 Category: Journals (General) Authors: Rahman Shah, Omer Jamy, Khalid Matin Tags: Correspondence Source Type: research
Department of Error Department of Error
Bagot KL, Cadilhac DA, Hand PJ, Vu M, Bladin CF. Telemedicine expedites access to optimal acute stroke care. Lancet 2016; 388: 757 –58—the conflict of interest statement of this Correspondence piece (published Aug 20, 2016) should have stated “KLB, DAC, MV, and CFB report grants from The Windemere Foundation, The State Government of Victoria: Department of Business and Innovation and Department of Health, Commonwealth Gov ernment: Health and Hospitals Fund, and Telstra. KLB, DAC, MV, and CFB report non-financial support from Monash University, Ambulance Victoria, National Stroke Foundation, and Loddon Mallee Rural Health Alliance.
Source: LANCET - September 23, 2016 Category: Journals (General) Tags: Department of Error Source Type: research
Comment Family-delivered rehabilitation services at home: is the glass empty?
In low-income and middle-income countries, meeting inpatient and outpatient rehabilitation needs of stroke survivors with insufficient staff and facility resources is especially challenging. Family-delivered rehabilitation services might be an innovative way to augment intensity of practice.1 The ATTEND Collaborative Group's ATTEND trial,2 published in The Lancet, is to our knowledge the first appropriately powered trial to investigate the effect of family-delivered, home-based rehabilitation intervention for patients with stroke in a low-middle-income country.
Source: LANCET - June 27, 2017 Category: General Medicine Authors: Gert Kwakkel, Erwin E H van Wegen Tags: Comment Source Type: research
Articles A multifaceted intervention to improve treatment with oral anticoagulants in atrial fibrillation (IMPACT-AF): an international, cluster-randomised trial
A multifaceted and multilevel educational intervention, aimed to improve use of oral anticoagulation in patients with atrial fibrillation and at risk for stroke, resulted in a significant increase in the proportion of patients treated with oral anticoagulants. Such an intervention has the potential to improve stroke prevention around the world for patients with atrial fibrillation.
Source: LANCET - August 28, 2017 Category: General Medicine Authors: Dragos Vinereanu, Renato D Lopes, M Cecilia Bahit, Denis Xavier, Jie Jiang, Hussein R Al-Khalidi, Wensheng He, Ying Xian, Andrea O Ciobanu, Deepak Y Kamath, Kathleen A Fox, Meena P Rao, Sean D Pokorney, Otavio Berwanger, Carlos Tajer, Pedro G M de Barros Tags: Articles Source Type: research
Seminar The future of atrial fibrillation management: integrated care and stratified therapy
Atrial fibrillation is one of the major cardiovascular health problems: it is a common, chronic condition, affecting 2 –3% of the population in Europe and the USA and requiring 1–3% of health-care expenditure as a result of stroke, sudden death, heart failure, unplanned hospital admissions, and other complications. Early diagnosis of atrial fibrillation, ideally before the first complication occurs, remains a ch allenge, as shown by patients who are only diagnosed with the condition when admitted to hospital for acute cardiac decompensation or stroke.
Source: LANCET - April 28, 2017 Category: General Medicine Authors: Paulus Kirchhof Tags: Seminar Source Type: research
Seminar Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy is a common inherited cardiovascular disease present in one in 500 of the general population. It is caused by more than 1400 mutations in 11 or more genes encoding proteins of the cardiac sarcomere. Although hypertrophic cardiomyopathy is the most frequent cause of sudden death in young people (including trained athletes), and can lead to functional disability from heart failure and stroke, the majority of affected individuals probably remain undiagnosed and many do not experience greatly reduced life expectancy or substantial symptoms.
Source: LANCET - January 18, 2013 Category: Journals (General) Authors: Barry J Maron, Martin S Maron Tags: Seminar Source Type: research
Perspectives The singular science of John Snow
John Snow was a scientist of rare dedication, who published more than 100 contributions to the medical literature in a career entirely supported by clinical earnings and terminated by a lethal stroke when he was just 45 years old. The range of clinical and scientific topics covered by his research was wide, although he is most remembered for developing the scientific basis of anaesthesia practice and working out the epidemiology and preventability of cholera. Snow's science was singular in two senses: it was singularly creative and productive; and it reflected a singular, unified scientific approach to the problems he addressed.
Source: LANCET - April 13, 2013 Category: Journals (General) Authors: Nigel Paneth, Paul Fine Tags: Perspectives Source Type: research
Editorial Compassionate release in the USA
A man has suffered a massive stroke. The right side of his body is paralysed, he cannot speak, and needs total assistance with activities of daily living. The man is serving a life sentence in a US prison for cocaine and heroin distribution. In 2006, he appealed for early release, but was denied because his life expectancy could not be determined. This case is one of many highlighted in a new report by the US Department of Justice, which concludes that compassionate release programmes in the USA are poorly managed by the Federal Bureau of Prisons.
Source: LANCET - May 10, 2013 Category: Journals (General) Authors: The Lancet Tags: Editorial Source Type: research
Editorial Salt: friend or foe?
Dietary guidelines advise against the consumption of too much salt. A high intake of sodium causes raised blood pressure—an established risk factor for heart disease, stroke, and kidney disease. But how much salt is too much? And could a very low salt intake also be detrimental?
Source: LANCET - May 24, 2013 Category: Journals (General) Authors: The Lancet Tags: Editorial Source Type: research
Department of Error Department of Error
The SPS3 Study Group. Blood-pressure targets in patients with recent lacunar stroke: the SPS3 randomised trial. Lancet 2013; 382: 507–15— In this Article, C S Coffey should have been listed as a member of the writing committee and, in the list of clinical sites, University of Washington at St Louis should have been Washington University in St Louis. These corrections have been made to the printed report and to the online version as of Aug 9, 2013.
Source: LANCET - August 10, 2013 Category: Journals (General) Authors: The Lancet Tags: Department of Error Source Type: research
Comment Genetics of warfarin dosing—one polymorphism at a time
Few drugs define a narrow therapeutic index better than warfarin. With a typical therapeutic international normalised ratio (INR) of 2·0–3·0 for most indications (2·5–3·5 for mechanical heart valves), clinicians are challenged to define and implement dosing regimens that achieve therapeutic anticoagulation. The stakes could hardly be higher: too low a dose places the patient at an increased risk of a life-altering ischaemic event (ie, stroke or pulmonary embolism); and too high a dose can lead to a fatal cerebral or gastrointestinal haemorrhage.
Source: LANCET - August 30, 2013 Category: Journals (General) Authors: Mark J Alberts Tags: Comment Source Type: research
