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Source: BMJ Open

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Total 555 results found since Jan 2013.

Risk of cardiovascular events leading to hospitalisation after Streptococcus pneumoniae infection: a retrospective cohort LIFE Study
Conclusions S. pneumoniae infections elevate the risk of subsequent stroke and AF occurrence. These findings indicate that pneumococcal infections have short-term effects on patients’ health and increase their midterm to long-term susceptibility to serious cardiovascular events.
Source: BMJ Open - November 4, 2022 Category: General Medicine Authors: Nishimura, N., Fukuda, H. Tags: Open access, Cardiovascular medicine Source Type: research

Mechanical thrombectomy first versus direct angioplasty or stenting for the treatment of intracranial atherosclerotic stenosis-related large vessel occlusion: protocol for a systematic review and meta-analysis
This study seeks to provide direct and practical clinical evidence for clinicians. Methods and analysis The main databases of PubMed, the Cochrane library, Embase and Web of Science will be screened for related studies published after1 January 2015. Primary outcomes include successful recanalisation and 90-day favourable outcome. Secondary outcomes include puncture to revascularisation time, vascular complication (perforation, dissection and vasospasm), intracerebral haemorrhage, hospital-related complications and 90-day mortality. The Newcastle-Ottawa Scale will be adopted to assess risk bias of observational studies. Th...
Source: BMJ Open - October 31, 2022 Category: General Medicine Authors: Min, X., Li, W., Zhao, H., Chen, Q., Zheng, J., Zhao, X., Zhao, Q., Bai, X., Dmytriw, A. A., Patel, A. B., Feng, Y., Cao, W., Wang, X., Jiao, L. Tags: Open access, Neurology Source Type: research

Stroke prevention of thoracoscopic left atrial appendage clipping in patients with non-valvular atrial fibrillation at high risk of stroke and bleeding: study protocol for a non-randomised controlled clinical trial
Introduction Non-valvular atrial fibrillation (NVAF) is a high-risk factor for ischaemic stroke. The 2016 European Society of Cardiology Atrial Fibrillation Management guidelines recommend oral anticoagulants (OACs) to prevent stroke in men with CHA2DS2-VASc scores ≥2 and women ≥3. However, in patients with a high risk of stroke and a high risk of bleeding (HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly (> 65 years), Drugs/alcohol concomitantly) score≥3), OAC had a higher risk of bleeding. Left atrial appendage cl...
Source: BMJ Open - October 28, 2022 Category: General Medicine Authors: Ye, C., Han, X., Chen, Y., Liu, F., Ma, H., Yang, Y., Liu, Y., Hu, Q., Yao, Q., Xie, W., Xu, D. Tags: Open access, Surgery Source Type: research

Comparison between collateral status and DEFUSE 3 or DAWN criteria in patient selection for endovascular thrombectomy within 6-24 hours after stroke: a protocol for meta-analysis
Introduction Perfusion imaging according to the DEFUSE 3 or DAWN criteria has been applied to select patients with large vascular occlusive stroke undergo endovascular therapy (EVT) in the extended time window. Emerging studies have shown that collateral blood flow-based criteria may be as effective as DEFUSE 3 and DAWN criteria for the evaluation of EVT eligibility beyond 6 hours. We will conduct a meta-analysis to compare collateral status-based criteria with DEFUSE 3 or DAWN criteria. Methods and analysis We will conduct a search for the studies comparing collateral blood flow-based imaging with CT perfusion using the ...
Source: BMJ Open - October 26, 2022 Category: General Medicine Authors: Shen, Y., Li, M., Chen, Y., Liu, S., Liu, J., Yang, D. Tags: Open access, Public health Source Type: research

Effects of dry needling intervention on lower limb dysfunction after stroke: study protocol for a randomised controlled trial
This study aims to assess the short and interim-term efficacy of dry needling (DN) intervention on lower extremity function, balance and gait in lower limb dysfunction after stroke. Methods and analysis This protocol entails an assessor and statistician-blinded, single-centre study with a randomised controlled trial. Forty-four patients who had a poststroke will be randomly allocated (1:1) to either the conventional treatment group (n=22) or the DN group (n=22). The conventional treatment group will receive conventional rehabilitation treatment once a day for 40 min each time. The treatment will be performed five times a ...
Source: BMJ Open - October 26, 2022 Category: General Medicine Authors: Tang, L., Liu, S., Gan, L., Ding, H., Huang, Q.-M., Gao, F., Li, Y. Tags: Open access, Rehabilitation medicine Source Type: research

Association between recovery/occurrence of metabolic syndrome and rapid estimated glomerular filtration rate decline in middle-aged and older populations: evidence from the China Health and Retirement Longitudinal Study
Conclusions Over the 4-year follow-up period, we found that MetS recovery was associated with a reduced risk of rapid eGFR decline in middle-aged and older adults, while MetS occurrence was not related to rapid eGFR decline. Recovery from MetS appeared to protect against a rapid decline in eGFR.
Source: BMJ Open - October 19, 2022 Category: General Medicine Authors: Liu, P., Tang, L., Fang, J., Chen, C., Liu, X. Tags: Open access, Nutrition and metabolism Source Type: research

Characterising methamphetamine use to inform health and social policies in Manitoba, Canada: a protocol for a retrospective cohort study using linked administrative data
Introduction Rising use of methamphetamine is causing significant public health concern in Canada. The biological and behavioural effects of methamphetamine range from wakefulness, vigour and euphoria to adverse physical health outcomes like myocardial infarction, haemorrhagic stroke, arrhythmia and seizure. It can also cause severe psychological complications such as psychosis. National survey data point to increasing rates of methamphetamine use, as well as increasing ease of access and serious methamphetamine-related harms. There is an urgent need for evidence to address knowledge gaps, provide direction to harm reducti...
Source: BMJ Open - October 19, 2022 Category: General Medicine Authors: Nickel, N. C., Enns, J. E., Freier, A., McCulloch, S. C., Chartier, M., Casidsid, H. J. M., Balogun, O. D., Mulhall, D., Dragan, R., Sarkar, J., Bolton, J., Konrad, G., Phillips-Beck, W., Sanguins, J., Shimmin, C., McDonald, N., Mignone, J., Hinds, A., Me Tags: Open access, Public health Source Type: research

Using primary care data to assess comparative effectiveness and safety of apixaban and rivaroxaban in patients with nonvalvular atrial fibrillation in the UK: an observational cohort study
Conclusions Among patients with nonvalvular AFib, apixaban was as effective as rivaroxaban in reducing rate of stroke and safer in terms of major bleeding episodes. This head-to-head comparison supports conclusions drawn from indirect comparisons of DOAC trials against warfarin and demonstrates the potential for real-world evidence to fill evidence gaps and reduce uncertainty in both health technology assessment decision-making and clinical guideline development.
Source: BMJ Open - October 17, 2022 Category: General Medicine Authors: Jaksa, A., Gibbs, L., Kent, S., Rowark, S., Duffield, S., Sharma, M., Kincaid, L., Ali, A. K., Patrick, A. R., Govil, P., Jonsson, P., Gatto, N. Tags: Open access, Cardiovascular medicine Source Type: research

Effects of chronic disease diagnoses on alcohol consumption among elderly individuals: longitudinal evidence from China
Conclusion While CDDs reduced alcohol consumption among elderly Chinese individuals, they failed to stop all heavy drinkers from excessive drinking. Relevant policies and measures are thus needed to urge heavy drinking patients to quit excessive drinking.
Source: BMJ Open - October 11, 2022 Category: General Medicine Authors: Hu, Y., Chen, Q., Zhang, B. Tags: Open access, Public health Source Type: research

Protocol for Guos aortIc Arch recoNstrucTion: a prospective, multicentre and single-arm study to evaluate the safety and efficacy of the WeFlow-Arch modular inner branch stent-graft system for aortic arch lesions (GIANT study)
This study aims to evaluate the safety and efficacy of the novel modular branch stent-graft system in patients with aortic arch lesions who are unsuitable for open aortic arch replacement. Methods and analysis This prospective, multicentre, single-arm, clinical trial will enrol 80 patients with aortic arch lesions requiring intervention, namely, true aortic arch aneurysms, pseudo-aortic arch aneurysms and penetrating ulcers involving the aortic arch. Clinical information and CT angiography (CTA) images will be collected and analysed to investigate the safety and efficacy of the novel modular branch stent-graft system. Pat...
Source: BMJ Open - October 10, 2022 Category: General Medicine Authors: Liu, F., Zhang, H., Rong, D., Ge, Y., Jia, X., Xiong, J., Ma, X., Wang, L., Fan, T., Guo, W. Tags: Open access, Surgery Source Type: research

Increased blood pressure variability during general anaesthesia is associated with worse outcomes after mechanical thrombectomy: a prospective observational cohort study
Conclusions Increased intraprocedural BPV was more likely to have poor functional outcome in patients with LVO following MT with general anaesthesia. This finding indicates that special precautions should be taken to minimise BP fluctuation during procedure.
Source: BMJ Open - October 5, 2022 Category: General Medicine Authors: Xu, C., Jin, T., Chen, Z., Zhang, Z., Zhang, K., Mao, H., Ye, S., Geng, Y., Shi, Z. Tags: Open access, Neurology Source Type: research

Transcutaneous auricular vagus nerve stimulation in poststroke cognitive impairment: protocol for a randomised controlled trial
Background As one of the most common stroke sequelae, poststroke cognitive impairment significantly impacts 17.6%–83% of survivors, affecting their rehabilitation, daily living and quality of life. Improving cognitive abilities among patients in stroke recovery is therefore critical and urgent. Transcutaneous auricular vagus nerve stimulation (TAVNS) is a non-invasive, safe, cost-effective treatment with great potential for improving the cognitive function of poststroke patients. This clinical research will evaluate the effectiveness, and help elucidate the possible underlying mechanisms, of TAVNS for improving posts...
Source: BMJ Open - October 5, 2022 Category: General Medicine Authors: Li, Z.-D., Qiu, H.-J., Wang, X.-Q., Zhang, C.-C., Zhang, Y.-J. Tags: Open access, Rehabilitation medicine Source Type: research

Peer-support interventions for women with cardiovascular disease: protocol for synthesising the literature using an evidence map
Introduction The leading cause of death for women is cardiovascular disease (CVD), including ischaemic heart disease, stroke and heart failure. Previous literature suggests peer support interventions improve self-reported recovery, hope and empowerment in other patient populations, but the evidence for peer support interventions in women with CVD is unknown. The aim of this study is to describe peer support interventions for women with CVD using an evidence map. Specific objectives are to: (1) provide an overview of peer support interventions used in women with ischaemic heart disease, stroke and heart failure, (2) identif...
Source: BMJ Open - October 5, 2022 Category: General Medicine Authors: Parry, M., Visintini, S., Johnston, A., Colella, T. J., Kapur, D., Liblik, K., Gomes, Z., Dancey, S., Liu, S., Goodenough, C., Hay, J. L., Noble, M., Adreak, N., Robert, H., Tang, N., O'Hara, A., Wong, A., Mullen, K.-A. Tags: Open access, Cardiovascular medicine Source Type: research

Effects of telemedicine interventions on essential hypertension: a protocol for a systematic review and meta-analysis
Introduction Essential hypertension is a major preventable risk factor for early cardiovascular disease, premature death and disability. It has been reported that telemedicine interventions can provide an innovative solution to essential hypertension to overcome the barriers that exist in traditional treatment or control. Nevertheless, this subject has not been thoroughly investigated. The goal of this study is to systematically evaluate and describe the impact of telemedicine interventions on essential hypertension. Methods and analysis To find relevant research, we will conduct a systematic literature search of three da...
Source: BMJ Open - September 29, 2022 Category: General Medicine Authors: Zhu, L., Li, D., Jiang, X.-L., Jia, Y., Liu, Y., Li, F., Chen, X., Lin, T., Diao, D., Gao, Y. Tags: Open access, Cardiovascular medicine Source Type: research

What is the feasibility and patient acceptability of a digital system for arm and hand rehabilitation after stroke? A mixed-methods, single-arm feasibility study of the 'OnTrack intervention for hospital and home use
Conclusions The intervention was found to be usable and acceptable by participants; study feasibility objectives were met and demonstrated that a definitive RCT would be viable and acceptable. Trial registration number NCT03944486.
Source: BMJ Open - September 28, 2022 Category: General Medicine Authors: Fusari, G., Gibbs, E., Hoskin, L., Lawrence-Jones, A., Dickens, D., Fernandez Crespo, R., Leis, M., Crow, J., Taylor, E., Jones, F., Darzi, A. Tags: Open access, Rehabilitation medicine Source Type: research