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Source: The Lancet
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Total 200 results found since Jan 2013.
An artificial intelligence-enabled ECG algorithm for the identification of patients with atrial fibrillation during sinus rhythm: a retrospective analysis of outcome prediction
Publication date: Available online 1 August 2019Source: The LancetAuthor(s): Zachi I Attia, Peter A Noseworthy, Francisco Lopez-Jimenez, Samuel J Asirvatham, Abhishek J Deshmukh, Bernard J Gersh, Rickey E Carter, Xiaoxi Yao, Alejandro A Rabinstein, Brad J Erickson, Suraj Kapa, Paul A FriedmanSummaryBackgroundAtrial fibrillation is frequently asymptomatic and thus underdetected but is associated with stroke, heart failure, and death. Existing screening methods require prolonged monitoring and are limited by cost and low yield. We aimed to develop a rapid, inexpensive, point-of-care means of identifying patients with atrial ...
Source: The Lancet - August 2, 2019 Category: General Medicine Source Type: research
Sphenopalatine ganglion stimulation after stroke, promising but not yet ready for adoption
Publication date: 20–26 July 2019Source: The Lancet, Volume 394, Issue 10194Author(s): Else Charlotte Sandset, Gary A Ford
Source: The Lancet - July 19, 2019 Category: General Medicine Source Type: research
Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017
Publication date: Available online 24 June 2019Source: The LancetAuthor(s): Maigeng Zhou, Haidong Wang, Xinying Zeng, Peng Yin, Jun Zhu, Wanqing Chen, Xiaohong Li, Lijun Wang, Limin Wang, Yunning Liu, Jiangmei Liu, Mei Zhang, Jinlei Qi, Shicheng Yu, Ashkan Afshin, Emmanuela Gakidou, Scott Glenn, Varsha Sarah Krish, Molly Katherine Miller-Petrie, W Cliff Mountjoy-VenningSummaryBackgroundPublic health is a priority for the Chinese Government. Evidence-based decision making for health at the province level in China, which is home to a fifth of the global population, is of paramount importance. This analysis uses data from the...
Source: The Lancet - June 25, 2019 Category: General Medicine Source Type: research
Dulaglutide and renal outcomes in type 2 diabetes: an exploratory analysis of the REWIND randomised, placebo-controlled trial
Publication date: Available online 9 June 2019Source: The LancetAuthor(s): Hertzel C Gerstein, Helen M Colhoun, Gilles R Dagenais, Rafael Diaz, Mark Lakshmanan, Prem Pais, Jeffrey Probstfield, Fady T Botros, Matthew C Riddle, Lars Rydén, Denis Xavier, Charles Messan Atisso, Leanne Dyal, Stephanie Hall, Purnima Rao-Melacini, Gloria Wong, Alvaro Avezum, Jan Basile, Namsik Chung, Ignacio CongetSummaryBackgroundTwo glucagon-like peptide-1 (GLP-1) receptor agonists reduced renal outcomes in people with type 2 diabetes at risk for cardiovascular disease. We assessed the long-term effect of the GLP-1 receptor agonist dulaglutide...
Source: The Lancet - June 10, 2019 Category: General Medicine Source Type: research
Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial
This study is registered with ClinicalTrials.gov, number NCT01394952.FindingsBetween Aug 18, 2011, and Aug 14, 2013, 9901 participants (mean age 66·2 years [SD 6·5], median HbA1c 7·2% [IQR 6·6–8·1], 4589 [46·3%] women) were enrolled and randomly assigned to receive dulaglutide (n=4949) or placebo (n=4952). During a median follow-up of 5·4 years (IQR 5·1–5·9), the primary composite outcome occurred in 594 (12·0%) participants at an incidence rate of 2·4 per 100 person-years in the dulaglutide group and in 663 (13·4%) participants at an incidence rate of 2·7 per 100 person-years in the placebo group (hazard ...
Source: The Lancet - June 10, 2019 Category: General Medicine Source Type: research
An injectable implant to stimulate the sphenopalatine ganglion for treatment of acute ischaemic stroke up to 24 h from onset (ImpACT-24B): an international, randomised, double-blind, sham-controlled, pivotal trial
Publication date: Available online 24 May 2019Source: The LancetAuthor(s): Natan M Bornstein, Jeffrey L Saver, Hans Christoph Diener, Philip B Gorelick, Ashfaq Shuaib, Yoram Solberg, Lisa Thackeray, Milan Savic, Tamar Janelidze, Natia Zarqua, David Yarnitsky, Carlos A Molina, Ashfaq Shuaib, Michael Hill, Daniel Vaclavik, David Skoloudik, Jan Fiksa, Grethe Andersen, Pekka Jakala, Turgut TatlisumakSummaryBackgroundSphenopalatine ganglion stimulation increased cerebral collateral blood flow, stabilised the blood–brain barrier, and reduced infarct size, in preclinical models of acute ischaemic stroke, and showed potential be...
Source: The Lancet - May 25, 2019 Category: General Medicine Source Type: research
The rise and fall of aspirin in the primary prevention of cardiovascular disease
Publication date: 25–31 May 2019Source: The Lancet, Volume 393, Issue 10186Author(s): Inbar Raber, Cian P McCarthy, Muthiah Vaduganathan, Deepak L Bhatt, David A Wood, John G F Cleland, Roger S Blumenthal, John W McEvoySummaryAspirin is one of the most frequently used drugs worldwide and is generally considered effective for the secondary prevention of cardiovascular disease. By contrast, the role of aspirin in primary prevention of cardiovascular disease is controversial. Early trials evaluating aspirin for primary prevention, done before the turn of the millennium, suggested reductions in myocardial infarction and stro...
Source: The Lancet - May 24, 2019 Category: General Medicine Source Type: research
Upadacitinib as monotherapy in patients with active rheumatoid arthritis and inadequate response to methotrexate (SELECT-MONOTHERAPY): a randomised, placebo-controlled, double-blind phase 3 study
This study is active but not recruiting and is registered with ClinicalTrials.gov, number NCT02706951.FindingsPatients were screened between Feb 23, 2016, and May 19, 2017 and 648 were randomly assigned to treatment. 598 (92%) completed week 14. At week 14, an ACR20 response was achieved by 89 (41%) of 216 patients (95% CI 35–48) in the continued methotrexate group, 147 (68%) of 217 patients (62–74) receiving upadacitinib 15 mg, and 153 (71%) of 215 patients (65–77) receiving upadacitinib 30 mg (p<0·0001 for both doses vs continued methotrexate). DAS28(CRP) 3·2 or lower was met by 42 (19%) of 216 (95% CI 14–2...
Source: The Lancet - May 24, 2019 Category: General Medicine Source Type: research
Late thrombolysis for stroke works, but how do we do it?
Publication date: Available online 22 May 2019Source: The LancetAuthor(s): Shelagh B Coutts, Bijoy K Menon
Source: The Lancet - May 24, 2019 Category: General Medicine Source Type: research
Robot assisted training for the upper limb after stroke (RATULS): a multicentre randomised controlled trial
This study is registered with the ISRCTN registry, number ISRCTN69371850.FindingsBetween April 14, 2014, and April 30, 2018, 770 participants were enrolled and randomly assigned to either robot-assisted training (n=257), EULT (n=259), or usual care (n=254). The primary outcome of ARAT success was achieved by 103 (44%) of 232 patients in the robot-assisted training group, 118 (50%) of 234 in the EULT group, and 85 (42%) of 203 in the usual care group. Compared with usual care, robot-assisted training (adjusted odds ratio [aOR] 1·17 [98·3% CI 0·70–1·96]) and EULT (aOR 1·51 [0·90–2·51]) did not improve upper limb f...
Source: The Lancet - May 24, 2019 Category: General Medicine Source Type: research
Robotic-assisted training after stroke: RATULS advances science
Publication date: Available online 22 May 2019Source: The LancetAuthor(s): Julie Bernhardt, Jan Mehrholz
Source: The Lancet - May 24, 2019 Category: General Medicine Source Type: research
Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial
Publication date: Available online 22 May 2019Source: The LancetAuthor(s): Colin Baigent, Daniel Lasserson, Frank Sullivan, Johanna Carrie, Javier Rojas, Shannon Amoils, John Bamford, Jane Armitage, Gabriel Rinkel, Gordon Lowe, Jonathan Emberson, Karen Innes, Lynn Dinsmore, Jonathan Drever, Carol Williams, David Perry, Connor McGill, David Buchanan, Allan Walker, Aidan HutchisonSummaryBackgroundAntiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial hae...
Source: The Lancet - May 24, 2019 Category: General Medicine Source Type: research
Extending thrombolysis to 4·5–9 h and wake-up stroke using perfusion imaging: a systematic review and meta-analysis of individual patient data
This study is registered with PROSPERO, number CRD42019128036.FindingsWe identified three trials that met eligibility criteria: EXTEND, ECASS4-EXTEND, and EPITHET. Of the 414 patients included in the three trials, 213 (51%) were assigned to receive alteplase and 201 (49%) were assigned to receive placebo. Overall, 211 patients in the alteplase group and 199 patients in the placebo group had mRS assessment data at 3 months and thus were included in the analysis of the primary outcome. 76 (36%) of 211 patients in the alteplase group and 58 (29%) of 199 patients in the placebo group had achieved excellent functional outcome a...
Source: The Lancet - May 24, 2019 Category: General Medicine Source Type: research
Conventional and genetic evidence on alcohol and vascular disease aetiology: a prospective study of 500 000 men and women in China
Publication date: Available online 4 April 2019Source: The LancetAuthor(s): Iona Y Millwood, Robin G Walters, Xue W Mei, Yu Guo, Ling Yang, Zheng Bian, Derrick A Bennett, Yiping Chen, Caixia Dong, Ruying Hu, Gang Zhou, Bo Yu, Weifang Jia, Sarah Parish, Robert Clarke, George Davey Smith, Rory Collins, Michael V Holmes, Liming Li, Richard PetoSummaryBackgroundModerate alcohol intake has been associated with reduced cardiovascular risk in many studies, in comparison with abstinence or with heavier drinking. Studies in east Asia can help determine whether these associations are causal, since two common genetic variants greatly...
Source: The Lancet - April 6, 2019 Category: General Medicine Source Type: research
Aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion (COMPASS): a multicentre, randomised, open label, blinded outcome, non-inferiority trial
This study supports the use of direct aspiration as an alternative to stent retriever as first-line therapy for stroke thrombectomy.FundingPenumbra.
Source: The Lancet - March 9, 2019 Category: General Medicine Source Type: research
