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Source: BMJ Open

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Total 555 results found since Jan 2013.

Predictive role of modifiable factors in stroke: an umbrella review
Discussion Diet with rich macronutrients and micronutrients, healthy dietary patterns and favourable physical, emotional health and environmental management should be promoted to decrease the burden of stroke. PROSPERO registration number CRD42021249921.
Source: BMJ Open - June 16, 2022 Category: General Medicine Authors: Wang, X., Liang, M., Zeng, F., Wang, Y., Yang, Y., Nie, F., Shang, M., Ta, N., Wen, L., Ou, L., Yang, Z., Liu, W. Tags: Open access, Neurology Source Type: research

Structured follow-up pathway to support people after transient ischaemic attack and minor stroke (SUPPORT TIA): protocol for a feasibility study and process evaluation
Introduction People who experience transient ischaemic attack (TIA) and minor stroke have limited follow-up despite rapid specialist review in hospital. This means they often have unmet needs and feel abandoned following discharge. Care needs after TIA/minor stroke include information provision (diagnosis and stroke risk), stroke prevention (medication and lifestyle change) and holistic care (residual problems and return to work or usual activities). This protocol describes a feasibility study and process evaluation of an intervention to support people after TIA/minor stroke. The study aims to assess the feasibility and ac...
Source: BMJ Open - June 16, 2022 Category: General Medicine Authors: Turner, G. M., Jones, R., Collis, P., Patel, S., Jowett, S., Tearne, S., Foy, R., Atkins, L., Mant, J., Calvert, M. Tags: Open access, Cardiovascular medicine Source Type: research

Safety and performance of oropharyngeal muscle strength training in the treatment of post-stroke dysphagia during oral feeding: protocol for a systematic review and meta-analysis
Introduction Dysphagia is a common functional disorder after stroke. Most patients post-stroke are incapable of oral feeding, which often leads to complications such as malnutrition, aspiration pneumonia and dehydration that seriously affect the quality of life of patients. Oropharyngeal muscle strength training is a major method of swallowing training, and recent studies have focused on healthy adults, elderly persons, and patients with head and neck cancer or neurodegenerative diseases; but there have been few studies on such training in patients with post-stroke dysphagia. Our study aims to systematically review the saf...
Source: BMJ Open - June 15, 2022 Category: General Medicine Authors: Gao, M., Wang, Y., Xu, L., Wang, X., Wang, H., Song, J., Yang, X., Zhou, F. Tags: Open access, Neurology Source Type: research

Relationship between serum insulin-like growth factor 1 levels and ischaemic stroke: a systematic review and meta-analysis
Conclusion Higher serum IGF-1 was significantly correlated with a lower risk of ischaemic stroke. In view of the high degree of heterogeneity, it may need more studies to confirm the prognostic value of serum IGF-1 levels in ischaemic stroke and explore the sources of heterogeneity.
Source: BMJ Open - June 15, 2022 Category: General Medicine Authors: Li, Y., Yang, W., Li, J., Zhang, Y., Zhang, L., Chen, S., He, L., Zhang, Y. Tags: Open access, Neurology Source Type: research

We Walk: a person-centred, dyadic behaviour change intervention to promote physical activity through outdoor walking after stroke--an intervention development study
Conclusions Our multilens intervention development approach ensured this novel intervention was evidence-informed, person-centred, theoretically coherent provided appropriate social support, and addressed issues of concern to PWS. This study established intervention components and structure and identified operational issues critical to future success. Future research will pilot and refine We Walk and evaluate acceptability, feasibility, effectiveness and cost-effectiveness. Trial registration number ISRCTN34488928.
Source: BMJ Open - June 14, 2022 Category: General Medicine Authors: Morris, J. H., Irvine, L. A., Dombrowski, S. U., McCormack, B., Van Wijck, F., Lawrence, M. Tags: Open access, Rehabilitation medicine Source Type: research

Effects of a nurse-led peer support intervention for stroke survivors: protocol for a randomised controlled trial
This study aims to develop a nurse-led peer support intervention for stroke survivors based on the Person–Environment–Occupation–Performance Model and evaluate its effects on the psychosocial outcomes of stroke survivors. Methods and analysis This is an assessor-blinded two-arm randomised controlled trial. A convenience sample of 120 stroke survivors will be recruited from two community centres and one rehabilitation unit in Yangzhou, a medium-sized city in eastern China, with 60 participants each in the intervention and control groups. The participants allocated to the intervention group will receive th...
Source: BMJ Open - June 10, 2022 Category: General Medicine Authors: Wan, X., Chau, J. P. C., Wu, Y., Xu, L., Gong, W. Tags: Open access, Rehabilitation medicine Source Type: research

Community-based culturally tailored education programmes for black adults with cardiovascular disease, diabetes, hypertension and stroke: a systematic review protocol of primary empirical studies
The objectives of this review are to: (1) synthesise key programme characteristics and outcomes of culturally tailored community-based (CBCT) programmes that are designed to improve health outcomes in black adults with cardiovascular disease, hypertension, diabetes, or stroke and (2) identify which of the five categories of culturally appropriate programmes from Kreuter and colleagues have been used to implement CBCT programmes. Methods and analysis This is a protocol for a systematic review that will search Medline, Embase and Cumulative Index to Nursing and Allied Health Literature databases to identify studies of CBCT ...
Source: BMJ Open - June 10, 2022 Category: General Medicine Authors: Fulton, J. I., Singh, H., Pakkal, O., Uleryk, E. M., Nelson, M. L. Tags: Open access, Health services research Source Type: research

Association between hospital volume, processes of care and outcomes after acute ischaemic stroke: a prospective observational study
Conclusions We found no significant associations between hospital volume, processes of care at the hospital, and mortality, recurrent stroke, and combined vascular events in patients with ischaemic stroke. However, hospital volume may be associated with poor outcome at 1 year.
Source: BMJ Open - June 9, 2022 Category: General Medicine Authors: Zhang, R., Liu, G., Pan, Y., Zhou, M., Wang, Y. Tags: Open access, Neurology Source Type: research

Rehabilitation using virtual gaming for Hospital and hOMe-Based training for the Upper limb post Stroke (RHOMBUS II): protocol of a feasibility randomised controlled trial
Introduction Upper limb (UL) rehabilitation is most effective early after stroke, with higher doses leading to improved outcomes. For the stroke survivor, the repetition may be monotonous. For clinicians, providing a clinically meaningful level of input can be challenging. As such, time spent engaged in UL activity among subacute stroke survivors remains inadequate. Opportunities for the stroke survivor to engage with UL rehabilitation in a safe, accessible and engaging way are essential to improving UL outcomes following stroke. The NeuroBall is a non-immersive virtual reality (VR) digital system designed for stroke rehab...
Source: BMJ Open - June 7, 2022 Category: General Medicine Authors: Kilbride, C., Warland, A., Stewart, V., Aweid, B., Samiyappan, A., Ryan, J., Butcher, T., Athanasiou, D. A., Baker, K., Singla-Buxarrais, G., Anokye, N., Pound, C., Gowing, F., Norris, M. Tags: Open access, Rehabilitation medicine Source Type: research

Pairing regression and configurational analysis in health services research: modelling outcomes in an observational cohort using a split-sample design
Conclusions Configurational analysis and logistic regression represent different methods that can enhance our understanding of a data set when paired together. Configurational models optimise sensitivity with relatively few conditions. Logistic regression models discriminate cases from controls and provided inferential relationships between outcomes and independent variables.
Source: BMJ Open - June 7, 2022 Category: General Medicine Authors: Miech, E. J., Perkins, A. J., Zhang, Y., Myers, L. J., Sico, J. J., Daggy, J., Bravata, D. M. Tags: Open access, Health services research Source Type: research

Rationale and design of a prospective study evaluating population pharmacokinetics and pharmacodynamics of rivaroxaban in Chinese patients with non-valvular atrial fibrillation
Introduction Rivaroxaban is one of the most commonly used non-vitamin K antagonists for stroke prevention in patients with non-valvular atrial fibrillation (NVAF). Different individual exposures exist for Asian and non-Asian populations, and dose selection is different for Japanese and non-Japanese subjects. Few studies have investigated the pharmacokinetics (PK) and pharmacodynamics (PD) of rivaroxaban in Chinese patients and provided a solid reference for dose selection and individualised therapy. Methods and analysis This is a single-centre prospective study. Rivaroxaban-treated Chinese NVAF patients will be recruited ...
Source: BMJ Open - June 3, 2022 Category: General Medicine Authors: Liu, X.-Q., Zhang, Y.-F., Ding, H.-Y., Yan, M.-M., Zhong, M.-K., Ma, C.-L. Tags: Open access, Pharmacology and therapeutics Source Type: research

Safety and effectiveness of appropriately and inappropriately dosed rivaroxaban or apixaban versus warfarin in patients with atrial fibrillation: a cohort study with nested case-control analyses from UK primary care
Conclusions Dosing appropriateness in NVAF was not associated with a significant difference in IS/SE risk or increase in ICB risk versus warfarin. These findings may reflect residual confounding and biases that were difficult to control, as also seen in other observational studies. They should, therefore, be interpreted with caution, and prescribers should adhere to the dosing instructions in the respective Summary of Product Characteristics. Further studies on this topic from real-world populations are needed.
Source: BMJ Open - June 2, 2022 Category: General Medicine Authors: Gonzalez-Perez, A., Roberts, L., Vora, P., Saez, M. E., Brobert, G., Fatoba, S., Garcia Rodriguez, L. A. Tags: Open access, Cardiovascular medicine Source Type: research

Acute kidney injury without need for dialysis, incidence, its impact on long-term stroke survival and progression to chronic kidney disease
Conclusions We found AKI during stroke admission was associated with increased mortality as compared with those without AKI on univariate analysis. AKI without need of renal replacement therapy was also associated with progression to CKD in this cohort. This suggests that patients with AKI need to have their renal function monitored longitudinally for development of CKD.
Source: BMJ Open - May 25, 2022 Category: General Medicine Authors: Pande, S. D., Roy, D., Khine, A. A., Win, M. M., Lolong, L., Shan, N. T., Tan, P. T., Tu, T. M. Tags: Open access, Neurology Source Type: research

Randomised placebo-controlled multicentre trial to evaluate the efficacy and safety of JTR-161, allogeneic human dental pulp stem cells, in patients with Acute Ischaemic stRoke (J-REPAIR)
Introduction JTR-161 is a novel allogeneic human cell product consisting of dental pulp stem cells isolated from the extracted teeth of healthy adults. It is currently under development as a cell-based therapy for ischaemic stroke. The aim of this study is to evaluate the safety and efficacy of JTR-161 in patients with acute ischaemic stroke when given as a single intravenous administration within 48 hours of symptom onset. Methods and analysis This is a first-in-human, randomised, double-blind, placebo-controlled, multicentre, phase 1/2 clinical trial to be conducted in Japan (from January 2019 to July 2021). Patients wi...
Source: BMJ Open - May 24, 2022 Category: General Medicine Authors: Suda, S., Nito, C., Ihara, M., Iguchi, Y., Urabe, T., Matsumaru, Y., Sakai, N., Kimura, K., on behalf of the J- REPAIR trial group, Okubo, Takeuchi, Takao, Takahashi, Morimoto, Akaiwa, Ishii, Kanzawa, Kanai, Yoshimura, Hara, Tsujino, Kamatsuka, Inoue, Iwa Tags: Open access, Neurology Source Type: research

Multicentre collection of uniform data on patients hospitalised for transient ischaemic attack or stroke in the Philippines: the Philippine Neurological Association One Database-Stroke (PNA1DB-Stroke) protocol
Introduction For scientific advances to translate into improved patient outcomes, systems of care must be in place to facilitate delivery of care. There is scarce information on quality of care and clinical outcome in our stroke patients. We aim to collect uniform data from patients with first or recurrent transient ischaemic attack (TIA) or ischaemic or haemorrhagic stroke to determine in-patient caseload, patient profile, types of diagnostic and therapeutic procedures, outcomes and overall quality of care among patients hospitalised for acute stroke in the Philippines. Methods and analysis This multicentre observational...
Source: BMJ Open - May 24, 2022 Category: General Medicine Authors: Philippine Neurological Association One Database - Stroke, Disease Study Management Group, Gan, Alvarez, Canete, Co, Collantes, Escabillas, Hiyadan, Juangco, Lokin, Macrohon-Valdez, Punsalan, Sarapuddin, Picar, Pascual V Tags: Open access, Neurology Source Type: research