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Total 3777 results found since Jan 2013.

Dual antiplatelet therapy in recurrent stroke prevention: do the benefits outweigh the risks?
This study assessed seven randomised controlled trials, comprising 39 574 patients and comparing dual versus single antiplatelet therapies. Medications used included aspirin (50–325 mg daily), clopidogrel (75 mg daily), aspirin plus dipyridamole (50/400 mg daily) and ticlopidine (100 mg daily). Patients had a history of ischaemic stroke (three trials) or TIA (four...
Source: Evidence-Based Medicine - July 18, 2014 Category: Internal Medicine Authors: Farooq, M. U., Gorelick, P. B. Tags: Clinical trials (epidemiology), Stroke Therapeutics Source Type: research

Using the Watchman device to close the left atrial appendage reduces risk of stroke in atrial fibrillation, compared to using warfarin
Commentary to: Reddy VY, Sievert H, Halperin J, et al.; PROTECT AF Steering Committee and Investigators. Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: a randomized clinical trial. JAMA 2014;312:1988–98 . Context Atrial fibrillation (AF) is a common arrhythmia in clinical practice. The major complication of AF is thromboembolic stroke. Patients with AF have a fivefold higher risk of stroke and a twofold increase in mortality.1 As complete cure for AF is never certain, the aims of AF therapy are symptom relief and prevention of thromboembolic events. The latter can be managed by vitami...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Swaans, M. J., Alipour, A., Boersma, L. V. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Arrhythmias Therapeutics/Prevention Source Type: research

Stroke: management and prevention
Cerebrovascular disease can be devastating for patients and their families, but much can be done to attenuate cerebral damage and reduce disability. Active intervention is in three phases: acute therapy, rehabilitation and secondary prevention. Thrombolysis within 4.5 hours of symptom onset substantially reduces morbidity from ischaemic stroke with no overall impact on mortality. Administration requires the use of clear protocols to rapidly triage, transport and investigate patients. Computed tomography remains an appropriate imaging technique in the early assessment of most stroke patients.
Source: Medicine - July 28, 2016 Category: Internal Medicine Authors: Ivie I. Gbinigie, Ian P. Reckless, Alastair M. Buchan Tags: Stroke Source Type: research

Atrial fibrillation is associated with an increased risk of cognitive impairment and dementia with or without a history of clinical stroke
Commentary on: Kalantarian S, Stern TA, Mansour M, et al.. Cognitive impairment associated with atrial fibrillation: a meta-analysis. Ann Intern Med 2013;158(5 Pt 1):338–46. Context Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice. The estimated US prevalence of 2.7–6.1 million is expected to increase to 5.6–12.1 million by the middle of the current century. In addition, AF prevalence dramatically increases with age: <1% in individuals aged 50–59 years are affected, whereas about 10% of those aged 80–84 years and 11–18% of those ≥85 ...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Forti, P. Tags: EBM Aetiology, Epidemiologic studies, Drugs: cardiovascular system, Dementia, Drugs: CNS (not psychiatric), Stroke, Memory disorders (psychiatry), Psychiatry of old age, Arrhythmias Source Type: research

Non-vitamin-K oral anticoagulants reduce mortality, stroke and intracranial haemorrhage when compared with warfarin in randomised trials of patients with non-valvular atrial fibrillation
Commentary on: Ruff CT, Giugliano RP, Braunwald E, et al.. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 2014;383:955–62. Context Historically, the standard medication for stroke prevention in atrial fibrillation (AF) has been a vitamin-K antagonist (warfarin). However, several non-vitamin-K oral anticoagulants (NOACs) have been developed and shown to be at least as effective as dose-adjusted warfarin in their respective phase-3 clinical trials.1–4 These include the direct thrombin inhibitor dabig...
Source: Evidence-Based Medicine - September 15, 2014 Category: Internal Medicine Authors: Steinberg, B. A. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Connective tissue disease, Musculoskeletal syndromes, Diabetes, Arrhythmias Therapeutics Source Type: research

Rate and rhythm control have comparable effects on mortality and stroke in atrial fibrillation but better data are needed
Commentary on: Al-Khatib SM, Allen LaPointe NM, Chatterjee R, et al.. Rate- and rhythm-control therapies in patients with atrial fibrillation: a systematic review. Ann Intern Med 2014;160:760–73. Context Atrial fibrillation (AF) represents a large and growing burden on cardiovascular healthcare and leads to a substantial impact on quality-of-life, increased cardiovascular events and a doubling of hospitalisation and death rates.1 Unlike many other cardiac conditions, the evidence base for treatment in AF remains patchy with clear gaps relating to a number of clinically important management strategies. Current practic...
Source: Evidence-Based Medicine - November 19, 2014 Category: Internal Medicine Authors: Kotecha, D., Kirchhof, P. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Radiology, Clinical diagnostic tests, Arrhythmias Therapeutics Source Type: research

The associations of stroke, transient ischemic attack, and/or stroke-related recurrent vascular events with Lipoprotein-associated phospholipase A2: A systematic review and meta-analysis
Conclusions:In patients with TIA and first ischemic stroke, elevated Lp-PLA2 activity levels were associated with recurrent vascular events. And in the general population elevated Lp-PLA2 levels were associated with the risk of stroke, although the association between Lp-PLA2 activity levels and the risk of stroke was less profound compared with the corresponding association of stroke risk with the Lp-PLA2 mass levels. Background: Studies on stroke and lipoprotein-associated phospholipase A2 (Lp-PLA2) have produced conflicting results. Objective: The aim of the study was to assess the associations of Lp-PLA2 levels ...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

National Implementation of Acute Stroke Care Centers in the Veterans Health Administration (VHA): Formative Evaluation of the Field Response
Conclusions The AIS Directive brought focused attention to reorganizing stroke care across a wide range of facility types. Larger VA facilities tended to follow established practices for organizing stroke care, but the unique addition of the LH designation presented some challenges. S facilities tended to report a lack of a coordinated stroke team and champion to drive process changes.
Source: Journal of General Internal Medicine - November 21, 2014 Category: Internal Medicine Source Type: research

CHADS2, CHA2DS2-VASc, ATRIA, and Essen stroke risk scores in stroke with atrial fibrillation: A nationwide multicenter registry study
The performance of scoring systems for risk stratification in patients with atrial fibrillation (AF) was not validated well in patients with stroke. The purpose of this study was to evaluate whether the risk scoring systems predict vascular outcomes in stroke patients with AF. Data were obtained from a nationwide multicenter registry for acute stroke with AF from January 1, 2013, to December 31, 2015. We investigated the predictive power of the CHADS2, CHA2DS2-VASc, ATRIA, and Essen stroke scores in stroke patients with AF. The subjects were further stratified into groups according to treatment with or without oral anti...
Source: Medicine - January 22, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

The SOAR stroke score predicts hospital length of stay in acute stroke: an external validation study
ConclusionThis external validation study confirms the usefulness of the SOAR stroke score in predicting LOS in patients with acute stroke especially in those who are likely to survive to discharge. This provides a simple prognostic score useful for clinicians, patients and service providers.
Source: International Journal of Clinical Practice - February 4, 2015 Category: Internal Medicine Authors: C. S. Kwok, A. B. Clark, S. D. Musgrave, J. F. Potter, G. Dalton, D. J. Day, A. George, A. K. Metcalf, J. Ngeh, A. Nicolson, P. Owusu‐Agyei, R. Shekhar, K. Walsh, E. A. Warburton, M. O. Bachmann, P. K. Myint, Tags: Original Paper Source Type: research

Peripheral Frequency of CD4+ CD28− Cells in Acute Ischemic Stroke: Relationship With Stroke Subtype and Severity Markers
Abstract: CD4+ CD28− T cells also called CD28 null cells have been reported as increased in the clinical setting of acute coronary syndrome. Only 2 studies previously analyzed peripheral frequency of CD28 null cells in subjects with acute ischemic stroke but, to our knowledge, peripheral frequency of CD28 null cells in each TOAST subtype of ischemic stroke has never been evaluated. We hypothesized that CD4+ cells and, in particular, the CD28 null cell subset could show a different degree of peripheral percentage in subjects with acute ischemic stroke in relation to clinical subtype and severity of ischemic stroke. The ai...
Source: Medicine - May 1, 2015 Category: Internal Medicine Tags: Article: Observational Study Source Type: research

Eicosapentaenoic Acid as long-term secondary prevention after ischemic stroke
Conclusion: Hemorrhagic stroke was not occurred in our observation of EPA prescribed patients. The clinical features of recurrent stroke patients were the existing complications of dyslipidemia and renal dysfunction.
Source: Clinical and Translational Medicine - June 11, 2015 Category: Internal Medicine Authors: Taizen NakaseMasahiro SasakiAkifumi Suzuki Source Type: research

In-hospital medical complications associated with stroke recurrence after initial ischemic stroke: A prospective cohort study from the China National Stroke Registry
We examined patients with initial ischemic stroke enrolled in CNSR between 2007 and 2008. Recurrent stroke at 3, 6, and 12 months post-stroke was used as stroke outcome. Medical complications were associated with stroke outcomes using multivariable logistic regression. Of the 7593 study patients, recurrent stroke occurred in 1115 (14.7%) within 12 months after stroke onset. In-hospital medical complications were independent risk factors for stroke recurrence in patients with initial ischemic stroke at 3 months (adjusted odds ratio (OR) = 2.19, 95% confidence interval (CI) 1.85 to 2.60), 6 months (adjusted OR = 2.0...
Source: Medicine - September 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Delayed diagnosis of atrial fibrillation after first ‐ever stroke increases recurrent stroke risk: A 5‐year nationwide follow‐up study
ConclusionDelayed diagnosis of AF after stroke increased the risk of recurrent stroke, particularly in men.
Source: Internal Medicine Journal - November 29, 2017 Category: Internal Medicine Authors: Ping ‐Song Chou, Bo‐Lin Ho, Yi‐Hsin Chan, Min‐Hsien Wu, Han‐Hwa Hu, A‐Ching Chao Tags: Original Article Source Type: research

Effectiveness and neural mechanisms of home-based telerehabilitation in patients with stroke based on fMRI and DTI: A study protocol for a randomized controlled trial
This study is designed to determine the efficacy and explore the mechanism of motor recovery after home-based telerehabilitation in stroke patients with motor deficits.Methods/Design:In a single-blinded randomized controlled pilot study, patients with acute subcortical stroke (n = 40) are assigned to receive home-based telerehabilitation or conventional rehabilitation. Task-based or resting-state functional magnetic resonance imaging (rs-fMRI), diffusion tensor imaging (DTI), and Fugl–Meyer assessment (FMA) score will acquired before and after rehabilitation. Activation volume of bilateral primary motor (M1), supplem...
Source: Medicine - January 1, 2018 Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research