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Source: JAMA
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Total 276 results found since Jan 2013.
Prophylactic Low-Dose Oxygen for Patients With Acute Stroke —Reply
In Reply Dr Saber and colleagues note that many patients in SO2S had mild strokes and suggest that this may explain the lack of observed benefit (OR, 0.97 [95% CI, 0.89-1.05]) from low-dose oxygen supplementation for 72 hours after acute stroke. To support this argument, they highlight the nonsignificant improved functional outcome (OR, 1.28 [95% CI, 0.94-1.73] favoring oxygen) in patients with NIHSS scores of 15 to 20. While this might suggest potential benefit, the difference between oxygen and no oxygen in this subgroup was not statistically significant, nor was the test for heterogeneity between this result and that in...
Source: JAMA - February 6, 2018 Category: General Medicine Source Type: research
Guidelines for Adult Stroke Rehabilitation and Recovery
This JAMA Clinical Guidelines Synopsis summarizes the 2016 American Heart Association/American Stroke Association guideline on adult stroke rehabilitation and recovery.
Source: JAMA - February 27, 2018 Category: General Medicine Source Type: research
Clinical and Imaging Characteristics Associated With Thrombus Recanalization in Ischemic Stroke
This cohort study examines baseline clinical and biochemical variables, intracranial thrombus characteristics, and stroke workflow interval times associated with clot recanalization among patients with ischemic stroke treated with intravenous alteplase.
Source: JAMA - September 11, 2018 Category: General Medicine Source Type: research
Endovascular Reperfusion Therapy and Acute Ischemic Stroke Outcomes
This cohort study uses data from the Get With the Guidelines-Stroke registry to report associations between time to treatment and functional outcomes among patients in clinical practice with acute ischemic stroke treated with endovascular recanalization.
Source: JAMA - July 16, 2019 Category: General Medicine Source Type: research
Treatment of Hyperglycemia in Patients With Acute Stroke
To the Editor The multicenter Stroke Hyperglycemia Insulin Network Effort (SHINE) randomized clinical trial enrolled 1118 patients with acute ischemic stroke and hyperglycemia (923 with known diabetes) to test the effect of different blood glucose control strategies on neurological outcome. No difference in favorable functional outcome was found with intensive vs standard glucose control. We wish to highlight several issues.
Source: JAMA - December 10, 2019 Category: General Medicine Source Type: research
Door-to-Needle Time and Long-term Outcomes in Patients With Stroke
To the Editor We are interested in the relationship between door-to-needle time and 1-year outcomes in patients with acute ischemic stroke in the study by Dr Man and colleagues. We think potential correlation between door-to-needle time and stroke care quality might explain the association between door-to-needle time and outcomes.
Source: JAMA - October 13, 2020 Category: General Medicine Source Type: research
Intravenous Thrombolytic Therapy for Treatment of Acute Ischemic Stroke in Patients Taking NOACs
Intravenous thrombolytic therapy with recombinant tissue plasminogen activator (alteplase) is the cornerstone of acute ischemic stroke reperfusion therapy and is associated with significant improvements in outcomes. Historically, a number of exclusion criteria for use of alteplase had been in place, but over the past 20 years, some of these have been eliminated (eg, age>80 years, seizures at stroke onset) or have become less stringent (eg, exclusion criteria may not strictly apply to recent vitamin K antagonist treatment if the patient has an international normalized ratio<1.7, and treatment may be administered in an...
Source: JAMA - February 22, 2022 Category: General Medicine Source Type: research
Strategic Opportunities to Improve Stroke Systems of Care
Restoring reperfusion to the brain as quickly as possible during acute ischemic stroke is important to reduce long-term disability and optimize clinical outcomes for patients, although hospital and resource availability are frequently not well matched with patient location. Accordingly, many patients who may have large-vessel occlusion (LVO) lack rapid access to endovascular thrombectomy (EVT), a highly efficacious procedure with a number needed to treat of approximately 3 to 7 for regaining independence among carefully selected patients. Therefore, accurate out-of-hospital diagnosis and ensuring that the patient and the n...
Source: JAMA - May 10, 2022 Category: General Medicine Source Type: research
Early vs Standard Approach to Tracheostomy and Functional Outcome After Severe Stroke
To the Editor The optimal timing of tracheostomy in patients with severe stroke remains uncertain. Although studies have tried to identify potential benefits of early tracheostomy, most have reported negative results on mortality or neurological outcomes. A recent randomized trial including 382 patients with severe stroke reported that compared with standard tracheostomy (10 days after intubation), early tracheostomy (within 5 days after intubation) did not improve the neurological outcome at 6 months. Therefore, based on currently available evidence, early tracheostomy and late tracheostomy appear to be equivalent options...
Source: JAMA - September 13, 2022 Category: General Medicine Source Type: research
Ischemic Stroke in Patients With Asymptomatic Severe Carotid Stenosis Without Surgical Intervention
To the Editor In a recent study of the clinical outcomes of 3737 adults with asymptomatic severe carotid stenosis who did not undergo carotid revascularization, the 5-year ipsilateral stroke rate was 4.7%. The authors concluded that “these findings may inform decision-making regarding surgical and medical treatment for patients with asymptomatic severe carotid artery stenosis.” A multicenter randomized prospective trial from 2021 reported similar 5-year stroke rates for 3625 patients with asymptomatic severe carotid stenosi s who underwent carotid endarterectomy. Based on these studies, one could come to the conclusion...
Source: JAMA - September 27, 2022 Category: General Medicine Source Type: research
Stenting Plus Medical Therapy and Risk of Stroke and Death in Patients With Symptomatic Intracranial Stenosis
To the Editor The recently published CASSISS trial was a prospective randomized study of intracranial artery stenting vs medical therapy for symptomatic intracranial atherosclerotic stenosis. The clinical outcomes of stroke and death in the stenting group at 1 year are similar to the WEAVE and WOVEN trials, which demonstrated an 8.5% stroke and death rate at 1 year in 129 patients who had received stents.
Source: JAMA - December 27, 2022 Category: General Medicine Source Type: research
Accuracy of Stroke Risk Prediction Models by Race, Sex, and Age
This retrospective cohort study compares stroke-specific algorithms with pooled cohort equations developed for atherosclerotic cardiovascular disease for the prediction of new-onset stroke across different subgroups (race, sex, and age) and the added value of novel machine learning techniques.
Source: JAMA - January 24, 2023 Category: General Medicine Source Type: research
Door-in-Door-out Times for Transfer of Patients With Stroke
This retrospective study involving patients with acute stroke requiring transfers from hospitals in the Get With the Guidelines –Stroke registry assesses patient and hospital factors associated with door-in-door-out times.
Source: JAMA - August 15, 2023 Category: General Medicine Source Type: research
Extracranial-Intracranial Bypass and Risk of Stroke and Death in Patients With Symptomatic Artery Occlusion
This clinical trial compares the efficacy of extracranial-intracranial bypass surgery plus medical therapy vs medical therapy alone in symptomatic patients with internal carotid artery or middle cerebral artery occlusion and hemodynamic insufficiency on a composite of stroke or death within 30 days or ipsilateral ischemic stroke beyond 30 days through 2 years after randomization.
Source: JAMA - August 22, 2023 Category: General Medicine Source Type: research
Stroke Care Projected to Add Up to More Than Previously Thought
The long-term cost of treating stroke adds up to more than previous shorter-term estimates suggested, a recent study of Australian patients found.
Source: JAMA - December 3, 2014 Category: Journals (General) Source Type: research
