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Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial
Publication date: Available online 16 May 2018 Source:The Lancet Author(s): Nikola Sprigg, Katie Flaherty, Jason P Appleton, Rustam Al-Shahi Salman, Daniel Bereczki, Maia Beridze, Hanne Christensen, Alfonso Ciccone, Ronan Collins, Anna Czlonkowska, Robert A Dineen, Lelia Duley, Juan Jose Egea-Guerrero, Timothy J England, Kailash Krishnan, Ann Charlotte Laska, Zhe Kang Law, Serefnur Ozturk, Stuart J Pocock, Ian Roberts, Thompson G Robinson, Christine Roffe, David Seiffge, Polly Scutt, Jegan Thanabalan, David Werring, David Whynes, Philip M Bath Background Tranexamic acid can prevent death due to bleeding after trauma and p...
Source: The Lancet - May 17, 2018 Category: General Medicine Source Type: research

Ischaemic stroke management at Al-Shifa Hospital in the Gaza Strip: a clinical audit
Publication date: 21 February 2018 Source:The Lancet, Volume 391, Supplement 2 Author(s): Amir Abukaresh, Rami Al-Abadlah, Bettina Böttcher, Khamis El-Essi Background In the 2014 Palestinian annual health report, cerebrovascular accident was ranked as the third leading cause of death in the occupied Palestinian territory. Cerebrovascular accident is also one the most common causes of disability worldwide. Good management decreases mortality and morbidity. The aim of this study was to assess the current management of patients with ischaemic stroke at the Al-Shifa Hospital and to compare this with international guidelines....
Source: The Lancet - February 23, 2018 Category: General Medicine Source Type: research

Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial
Publication date: Available online 20 December 2017 Source:The Lancet Author(s): Philip M Bath, Lisa J Woodhouse, Jason P Appleton, Maia Beridze, Hanne Christensen, Robert A Dineen, Lelia Duley, Timothy J England, Katie Flaherty, Diane Havard, Stan Heptinstall, Marilyn James, Kailash Krishnan, Hugh S Markus, Alan A Montgomery, Stuart J Pocock, Marc Randall, Annemarei Ranta, Thompson G Robinson, Polly Scutt, Graham S Venables, Nikola Sprigg Background Intensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients with acute cerebral ischaemia. W...
Source: The Lancet - December 21, 2017 Category: General Medicine Source Type: research

Secondary prevention treatment after acute stroke in older South Asian, Chinese and other Canadians: a retrospective data analysis.
Abstract BACKGROUND: Little is known about whether there are differences in medication use between older patients of Chinese descent, those of South Asian descent and other Canadian patients after acute ischemic or primary intracerebral hemorrhagic stroke. The aim of this population-based study was to evaluate potential ethnic differences in secondary prevention pharmacotherapy after acute stroke. METHODS: Using health administrative data, we conducted a retrospective analysis of all patients aged 66 years or more admitted to hospital with acute stroke in Ontario (1997-2011) and British Columbia (1997-2009). ...
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Khan NA, McAlister FA, Pilote L, Palepu A, Quan H, Hill MD, Fang J, Kapral MK Tags: CMAJ Open Source Type: research

Age-specific risks, severity, time course, and outcome of bleeding on long-term antiplatelet treatment after vascular events: a population-based cohort study
Publication date: Available online 13 June 2017 Source:The Lancet Author(s): Linxin Li, Olivia C Geraghty, Ziyah Mehta, Peter M Rothwell Background Lifelong antiplatelet treatment is recommended after ischaemic vascular events, on the basis of trials done mainly in patients younger than 75 years. Upper gastrointestinal bleeding is a serious complication, but had low case fatality in trials of aspirin and is not generally thought to cause long-term disability. Consequently, although co-prescription of proton-pump inhibitors (PPIs) reduces upper gastrointestinal bleeds by 70–90%, uptake is low and guidelines are conflicti...
Source: The Lancet - June 15, 2017 Category: General Medicine Source Type: research

Oculomotor Nerve Palsy in a Patient with a Ruptured Middle Cerebral Artery Aneurysm.
We describe a case of acute oculomotor nerve palsy caused by a ruptured middle cerebral artery (MCA) aneurysm. A 59-year-old female presenting with headache and nausea was admitted to our hospital. Her consciousness was alert, and had no other neurological deficit without left oculomotor nerve palsy. A computed tomography (CT) showed SAH extending from left sylvian cistern to basal cistern. CT angiography revealed a left MCA aneurysm which protruded toward internal carotid artery. The patient was successfully treated with surgical clipping. The oculomotor nerve palsy resolved immediately after the surgery. Perioperative ra...
Source: Journal of Medical Investigation - April 5, 2017 Category: Journals (General) Tags: J Med Invest Source Type: research

Protocol for validating cardiovascular and cerebrovascular ICD-9-CM codes in healthcare administrative databases: the Umbria Data Value Project
Introduction Administrative healthcare databases can provide a comprehensive assessment of the burden of diseases in terms of major outcomes, such as mortality, hospital readmissions and use of healthcare resources, thus providing answers to a wide spectrum of research questions. However, a crucial issue is the reliability of information gathered. Aim of this protocol is to validate International Classification of Diseases, 9th Revision—Clinical Modification (ICD-9-CM) codes for major cardiovascular diseases, including acute myocardial infarction (AMI), heart failure (HF), atrial fibrillation (AF) and stroke. Method...
Source: BMJ Open - March 29, 2017 Category: Journals (General) Authors: Cozzolino, F., Abraha, I., Orso, M., Mengoni, A., Cerasa, M. F., Eusebi, P., Ambrosio, G., Montedori, A. Tags: Open access, Cardiovascular medicine, Health informatics, Health services research, Public health Protocol Source Type: research

Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study
Publication date: Available online 16 July 2016 Source:The Lancet Author(s): Martin J O'Donnell, Siu Lim Chin, Sumathy Rangarajan, Denis Xavier, Lisheng Liu, Hongye Zhang, Purnima Rao-Melacini, Xiaohe Zhang, Prem Pais, Steven Agapay, Patricio Lopez-Jaramillo, Albertino Damasceno, Peter Langhorne, Matthew J McQueen, Annika Rosengren, Mahshid Dehghan, Graeme J Hankey, Antonio L Dans, Ahmed Elsayed, Alvaro Avezum, Charles Mondo, Hans-Christoph Diener, Danuta Ryglewicz, Anna Czlonkowska, Nana Pogosova, Christian Weimar, Romaina Iqbal, Rafael Diaz, Khalid Yusoff, Afzalhussein Yusufali, Aytekin O...
Source: The Lancet - July 15, 2016 Category: Journals (General) Source Type: research

Weekly variation in health-care quality by day and time of admission: a nationwide, registry-based, prospective cohort study of acute stroke care
Publication date: Available online 10 May 2016 Source:The Lancet Author(s): Benjamin D Bray, Geoffrey C Cloud, Martin A James, Harry Hemingway, Lizz Paley, Kevin Stewart, Pippa J Tyrrell, Charles D A Wolfe, Anthony G Rudd Background Studies in many health systems have shown evidence of poorer quality health care for patients admitted on weekends or overnight than for those admitted during the week (the so-called weekend effect). We postulated that variation in quality was dependent on not only day, but also time, of admission, and aimed to describe the pattern and magnitude of variation in the quality of acute s...
Source: The Lancet - May 11, 2016 Category: Journals (General) Source Type: research

Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial
Publication date: Available online 10 May 2016 Source:The Lancet Author(s): M Irem Baharoglu, Charlotte Cordonnier, Rustam Al-Shahi Salman, Koen de Gans, Maria M Koopman, Anneke Brand, Charles B Majoie, Ludo F Beenen, Henk A Marquering, Marinus Vermeulen, Paul J Nederkoorn, Rob J de Haan, Yvo B Roos Background Platelet transfusion after acute spontaneous primary intracerebral haemorrhage in people taking antiplatelet therapy might reduce death or dependence by reducing the extent of the haemorrhage. We aimed to investigate whether platelet transfusion with standard care, compared with standard care alone, re...
Source: The Lancet - May 11, 2016 Category: Journals (General) Source Type: research

Transfusion strategy in hematological intensive care unit: study protocol for a randomized controlled trial
Background: Packed red blood cell (PRBC) transfusion is required in hematology patients treated with chemotherapy for acute leukemia, autologous (auto) or allogeneic (allo) hematopoietic stem cell transplantation (HSCT). In certain situations like septic shock, hip surgery, coronary disease or gastrointestinal hemorrhage, a restrictive transfusion strategy is associated with a reduction of infection and death. A transfusion strategy using a single PRBC unit has been retrospectively investigated and showed a safe reduction of PRBC consumption and costs. We therefore designed a study to prospectively demonstrate that the tra...
Source: Trials - November 23, 2015 Category: Journals (General) Authors: Sylvain ChantepieJean-Baptiste MearLydia GuittetBenoît DervauxJean-Pierre MarolleauFabrice JardinJean-Jacques DutheilJean-Jacques ParientiJean-Pierre VilqueOumedaly Reman Source Type: research

Safety of tirofiban for patients with acute ischemic stroke in routine clinical practice.
Authors: Zhu YQ, Zhang YJ, Ruan HL, Liu Q, Zhan Q, Li Q Abstract The aim of the present study was to investigate the safety of tirofiban alone and in combination with various treatments in acute ischemic stroke (AIS). A total of 120 patients with AIS were included in the study, and these patients were divided into three treatment groups: Group A (tirofiban alone, n=68), group B (tirofiban plus thrombolytic therapy, n=26), and group C (tirofiban as a 'bridging therapy', n=26). Risk factors, stroke severity, initial imaging, treatment regimens, complications and long-term outcomes were analyzed. In total, eight patie...
Source: Experimental and Therapeutic Medicine - November 18, 2015 Category: Journals (General) Tags: Exp Ther Med Source Type: research

Validation of Siriraj Stroke Score in southeast Nigeria
Innocent Ijezie Chukwuonye,1 Kenneth Arinze Ohagwu,2 Enoch Ogbonnaya Uche,3,4 Abali Chuku,5 Rowland Ihezuo Nw.e,2 Christopher Chukwuemeka Ohagwu,6 Ignatius U Ezeani,7 Collins Ogbonna Nwabuko,8 Martin Anazodo Nnoli,9 Efosa Oviasu,4,10 Okechukwu Samuel Ogah4,11 1Division of Nephrology, 2Division of Neurology, Department of Internal Medicine, Federal Medical Centre, Umuahia, Nigeria; 3Division of Neurosurgery, Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria; 4Federal Medical Centre, Umuahia, Nigeria; 5Department of Ophthalmology, Federal Medical Centre, Umuahia, Nigeria; 6Department of Radiograp...
Source: International Journal of General Medicine - October 23, 2015 Category: Journals (General) Tags: International Journal of General Medicine Source Type: research

Apixaban versus Antiplatelet drugs or no antithrombotic drugs after anticoagulation-associated intraCerebral HaEmorrhage in patients with Atrial Fibrillation (APACHE-AF): study protocol for a randomised controlled trial
Background: There is a marked lack of evidence on the optimal prevention of ischaemic stroke and other thromboembolic events in patients with non-valvular atrial fibrillation and a recent intracerebral haemorrhage during treatment with oral anticoagulation. These patients are currently treated with oral anticoagulants, antiplatelet drugs, or no antithrombotic treatment, depending on personal and institutional preferences.Compared with warfarin, the direct oral anticoagulant apixaban reduces the risk of stroke or systemic embolism, intracranial haemorrhage, and case fatality in patients with atrial fibrillation. Compared wi...
Source: Trials - September 4, 2015 Category: Journals (General) Authors: Koen van NieuwenhuizenH. van der WorpAle AlgraL. KappelleGabriel RinkelIsabelle van GelderRoger SchutgensCatharina Klijnon behalf of the APACHE-AF investigators Source Type: research

Head Position in Stroke Trial (HeadPoST) – sitting-up vs lying-flat positioning of patients with acute stroke: study protocol for a cluster randomised controlled trial
DiscussionHeadPoST is a large international clinical trial in which we will rigorously evaluate the effects of different head positioning in patients with acute stroke.Trial registrationClinicalTrials.gov identifier: NCT02162017 (date of registration: 27 April 2014); ANZCTR identifier: ACTRN12614000483651 (date of registration: 9 May 2014). Protocol version and date: version 2.2, 19 June 2014.
Source: Trials - June 5, 2015 Category: Journals (General) Authors: Paula Muñoz-VenturelliHisatomi ArimaPablo LavadosAlejandro BrunserBin PengLiying CuiLily SongLaurent BillotElizabeth BoadenMaree HackettStephane HeritierStephen JanSandy MiddletonVerónica OlavarríaJoyce LimRichard LindleyEmma HeeleyThompson RobinsonOct Source Type: research

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