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Source: LANCET
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Total 186 results found since Jan 2013.
Correspondence Metabolic mediators of body-mass index and cardiovascular risk
The Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration reported that nearly half of the excess risk of body-mass index (BMI) on coronary heart disease and three-quarters of that on stroke is mediated through blood pressure, cholesterol, and markers of glycaemia. Although these findings correctly support the idea that the adverse effects of high BMI can be substantially mitigated by targeting its metabolic mediators, the report's results underestimate by about 25% the extent to which these metabolic factors mediate the effects of BMI on cardiovascular risk.
Source: LANCET - June 13, 2014 Category: Journals (General) Authors: David Wormser, Angela M Wood, Emanuele Di Angelantonio, Simon G Thompson, John Danesh, for the Emerging Risk Factors Collaboration Tags: Correspondence Source Type: research
Correspondence New oral anticoagulants in patients with atrial fibrillation
Christian Ruff and colleagues' meta-analysis reports substantial reductions in stroke and all-cause mortality by use of the new oral anticoagulants (NOACs) compared with warfarin for atrial fibrillation, justifying their increasing use, but also the unequivocal increased risk of gastrointestinal bleeding. Furthermore, the trials included patients with a presumed low risk of gastrointestinal complications and therefore the true risk might be greater outside the clinical trial setting.
Source: LANCET - July 4, 2014 Category: Journals (General) Authors: Michael J R Desborough, Vipul Jairath Tags: Correspondence Source Type: research
Editorial Evidence and doubt in the translation of research into care
If patients, health systems, and societies are to benefit from research, then research findings need to be incorporated into practice. That this has not yet happened widely for the treatment of acute ischaemic stroke, despite its increasing incidence in ageing populations, the ruinous sequelae without treatment, and a licensed medical intervention proven to improve outcomes, raises serious questions about the extent to which patients are actually benefiting from evidence.
Source: LANCET - August 23, 2014 Category: Journals (General) Authors: The Lancet Tags: Editorial Source Type: research
Correspondence Alteplase for ischaemic stroke—responses
Roger Shinton's Correspondence contains numerous factual inaccuracies and statements that are not consistent with the text of the cited references, and do not in our opinion merit a reconsideration of the authorisation of alteplase in acute ischaemic stroke.
Source: LANCET - August 23, 2014 Category: Journals (General) Authors: Peter Sandercock, Richard Lindley, Joanna M Wardlaw, Gordon Murray, Will Whiteley, Geoff Cohen Tags: Correspondence Source Type: research
This Week in Medicine September 6–12, 2014
The US Preventive Services Task Force has recommended that health-care providers should offer intense behavioural counselling to overweight patients with risk factors for heart disease and stroke, consisting of an individualised diet and exercise plan. However, issues in implementation of this new framework include a lack of time, skill, and available resources.
Source: LANCET - September 5, 2014 Category: Journals (General) Authors: The Lancet Tags: This Week in Medicine Source Type: research
Clinical Picture Ischaemic scalp ulceration and hair loss
A 46-year-old woman presented to our outpatient clinic in June, 2013, with frequent collapse, ischaemic scalp ulcerations, and hair loss (). She had undergone carotid endarterectomy in 2005, after a small right hemispheric stroke, and had no other medical history apart from hypercholesterolaemia. She had no previous dermatological or scalp problems. She took clopidogrel 75 mg, aspirin 80 mg, and simvastatin 40 mg daily.
Source: LANCET - October 11, 2014 Category: Journals (General) Authors: Çağdaş Ünlü, Jean-Paul P M de Vries Tags: Clinical Picture Source Type: research
Comment Do we need to know whether nitrous oxide harms patients?
In The Lancet, Paul Myles and colleagues investigate the association between nitrous oxide exposure and cardiovascular complications such as non-fatal myocardial infarction, stroke, pulmonary embolism, cardiac arrest, and death, within 30 days of surgery, in patients with known or suspected coronary artery disease having major non-cardiac surgery under general anaesthesia. The rationale for this large, multicentre study, which involved more than 7000 patients from 45 centres, was the observation that short-term exposure to nitrous oxide led to significant increases in plasma homocysteine.
Source: LANCET - October 18, 2014 Category: Journals (General) Authors: Martin R Tramèr Tags: Comment Source Type: research
Case Report Snowflakes in the heart: an ultrasonic marker of severe hypercoagulability
A 58-year-old woman with metastatic breast cancer and Coombs-positive autoimmune haemolytic anaemia presented in April, 2014, after developing right arm weakness 8 hours into a long-haul flight. ECG and telemetry showed normal sinus rhythm. Brain MRI showed multiple small foci of restricted diffusion in the anterior, middle, and posterior cerebral artery territories suggestive of cardioembolic stroke, with widespread microhaemorrhages. Carotid ultrasound showed normal carotid and vertebral artery anatomy.
Source: LANCET - January 16, 2015 Category: Journals (General) Authors: Louis W Wang, John J Grygiel, John H O'Neill, Diane Fatkin, Michael P Feneley Tags: Case Report Source Type: research
Articles Long-term outcomes after stenting versus endarterectomy for treatment of symptomatic carotid stenosis: the International Carotid Stenting Study (ICSS) randomised trial
Long-term functional outcome and risk of fatal or disabling stroke are similar for stenting and endarterectomy for symptomatic carotid stenosis.
Source: LANCET - October 13, 2014 Category: Journals (General) Authors: Leo H Bonati, Joanna Dobson, Roland L Featherstone, Jörg Ederle, H Bart van der Worp, Gert J de Borst, Willem P Th M Mali, Jonathan D Beard, Trevor Cleveland, Stefan T Engelter, Philippe A Lyrer, Gary A Ford, Paul J Dorman, Martin M Brown, for the Intern Tags: Articles Source Type: research
Department of Error Department of Error
The ENOS Trial Investigators. Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial. Lancet 2015; 385: 617–28—In figure 1 in this Article, the number of patients assigned to the GTN patch who completed assessment on day 7 should have been 1996 rather than 1966. Data for TICS-M score and verbal fluency score for both analyses in table 2 were incorrect; the table has been corrected.
Source: LANCET - February 14, 2015 Category: Journals (General) Tags: Department of Error Source Type: research
Correspondence Thrombolysis in acute stroke
I read with interest the meta-analysis by Jonathan Emberson and colleagues,1 but would have appreciated heterogeneity assessments for the major outcomes in the meta-analysis.
Source: LANCET - April 10, 2015 Category: Journals (General) Authors: David H Newman Tags: Correspondence Source Type: research
Obituary John Arras
Leading US philosopher and bioethicist. Born on Aug 25, 1945, in San Mateo, CA, USA, he died from a stroke on March 9, 2015, in Galveston, TX, USA, aged 69 years.
Source: LANCET - May 8, 2015 Category: Journals (General) Authors: Alison Snyder Tags: Obituary Source Type: research
Articles Digoxin use in patients with atrial fibrillation and adverse cardiovascular outcomes: a retrospective analysis of the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF)
Digoxin treatment was associated with a significant increase in all-cause mortality, vascular death, and sudden death in patients with AF. This association was independent of other measured prognostic factors, and although residual confounding could account for these results, these data show the possibility of digoxin having these effects. A randomised trial of digoxin in treatment of AF patients with and without heart failure is needed.
Source: LANCET - March 6, 2015 Category: Journals (General) Authors: Jeffrey B Washam, Susanna R Stevens, Yuliya Lokhnygina, Jonathan L Halperin, Günter Breithardt, Daniel E Singer, Kenneth W Mahaffey, Graeme J Hankey, Scott D Berkowitz, Christopher C Nessel, Keith A A Fox, Robert M Califf, Jonathan P Piccini, Manesh R Pa Tags: Articles Source Type: research
Comment Gestational hypertension before term: observe or deliver?
Pre-eclampsia and other hypertensive disorders of pregnancy are common, and carry risks for both mother and baby. The only cure is delivery. Severe hypertension and severe pre-eclampsia are associated with increased risk of maternal morbidities such as stroke, coagulopathy, and eclampsia, and of maternal death.1 For these women, if gestation is over 34 weeks, the aim should be medical management with timely delivery. If gestation is less than 34 weeks, expectant care with stabilisation and careful monitoring of the woman to delay delivery might be better for the baby than immediate delivery.
Source: LANCET - March 25, 2015 Category: Journals (General) Authors: Jim Thornton, Lelia Duley Tags: Comment Source Type: research
