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Source: BMJ Open

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Total 555 results found since Jan 2013.

PCSK9 inhibition in patients with acute stroke and symptomatic intracranial atherosclerosis: protocol for a prospective, randomised, open-label, blinded end-point trial with vessel-wall MR imaging
Introduction Dual antiplatelet therapy and high-intensity statins are the mainstay treatment in patients with acute stage, symptomatic intracranial atherosclerotic stenosis (ICAS). Alirocumab is a monoclonal antibody that can inhibit proprotein convertase subtilisin–kexin type 9 and effectively lower low-density lipoprotein cholesterol levels with less side effects than statins. We hypothesise that alirocumab treatment in addition to statin therapy could stabilise intracranial plaque and reduce arterial stenosis. Methods and analysis In this prospective, randomised, open-label, blinded end-point study, we will use h...
Source: BMJ Open - April 29, 2022 Category: General Medicine Authors: Huang, Y.-C., Chang, C.-H., Tsai, Y.-H., Weng, H.-H., Lin, L.-C., Lee, J.-D. Tags: Open access, Neurology Source Type: research

Rationale design and efficacy of a smartphone application for improving self-awareness of adherence to edoxaban treatment: study protocol for a randomised controlled trial (adhere app)
This study was approved by the Seoul National University Bundang Hospital Institutional Review Board and will be conducted according to the principles of the Declaration of Helsinki. The study results will be published in a reputable journal. Trial registration number KCT0004754.
Source: BMJ Open - April 27, 2022 Category: General Medicine Authors: Kim, I.-C., Lee, J. H., Choi, D.-J., Park, S.-J., Lee, J.-H., Park, S. M., Kim, M., Kim, H.-L., Lee, S., Kim, I. J., Choi, S., Bang, J., Ali, B., Hussain, M., Ali, T., Lee, S. Tags: Open access, Cardiovascular medicine Source Type: research

Exploring the poststroke experiences and unmet needs of South Asian communities in high-income countries: a scoping review protocol
Conclusion and implications Findings will enhance knowledge of the poststroke experiences and needs of South Asian communities living in high-income countries and identify actionable opportunities for community-based resources to address needs. Ethics and dissemination Ethics approval was not required for this scoping review protocol. Community-based organisations will be consulted to provide insights into the analysis and assist with dissemination. Dissemination of findings will also occur through a publication and academic presentations.
Source: BMJ Open - April 27, 2022 Category: General Medicine Authors: Kokorelias, K. M., Nelson, M. L. A., Cameron, J. I., Colquhoun, H., Munce, S., Hitzig, S. L., Salbach, N. M., Martyniuk, J., Steele Gray, C., Tang, T., Wang, R. H., Lindsay, P., Bayley, M., Kaur, N., Singh, H. Tags: Open access, Health services research Source Type: research

Impact of COVID-19 pandemic on acute stroke admissions and case-fatality rate in lower-income and middle-income countries: a protocol for systematic review and meta-analysis
Introduction The current review primarily aims to ascertain the impact of COVID-19 on stroke admission as well as stroke case fatality in Low-income and Middle-Income Countries (LMICs). Methods and analysis Four international databases (PubMed/Medline, Google Scholar, African Journals Online, Latin American and Caribbean Health Sciences Literature) and one preprint database (medRxiv). Studies will be included if they are conducted in LMICs, all stroke types without age and language restriction, from December 2019 to 31 December 2021. Two authors will screen the titles and abstracts against the prespecified eligibility cri...
Source: BMJ Open - April 25, 2022 Category: General Medicine Authors: Ackah, M., Salifu, M. G., Ameyaw, L., Boakye, H., Yeboah, C. O. Tags: Open access, Global health, COVID-19 Source Type: research

Exploring the experiences and challenges for patients undergoing cranioplasty: a mixed-methods study protocol
This study hopes to understand some of these issues and therefore help inform clinicians of some of the difficulties and perceptions that patients and their relatives may have. Methods and analysis A mixed-methods study. Data will be collected through focus groups with healthcare professionals (HCPs) and semi-structured interviews with patients and their relatives, field notes, a researcher diary and a patient questionnaire. Different perspectives will be brought together through method triangulation. Patient and relative data will be analysed using interpretive phenomenological analysis, and HCPs data will be analysed th...
Source: BMJ Open - April 22, 2022 Category: General Medicine Authors: Mee, H., Clement, C., Anwar, F., Whiting, G., Timofeev, I., Helmy, A., Hutchinson, P. J., Kolias, A. G. Tags: Open access, Rehabilitation medicine Source Type: research

Renal safety evaluation of aspirin plus edaravone in patients with ischaemic stroke: a retrospective cohort study
Conclusions Our study indicated that edaravone in patients with ischaemic stroke didn’t increase the nephrotoxicity of aspirin, and even had a protective effect on mild renal deterioration. Nevertheless, there is a need to be cautious when patients are in bad pathophysiological conditions and at high risk of bleeding.
Source: BMJ Open - April 19, 2022 Category: General Medicine Authors: Yang, H.-q., Yin, W.-J., Liu, K., Liu, M.-C., Zuo, X.-c. Tags: Open access, Cardiovascular medicine Source Type: research

Public perceptions of brain health: an international, online cross-sectional survey
Conclusions Differences in perceptions of brain health were noted among specific segments of the population. Policies providing information about brain-friendly health behaviours and targeting people less likely to have relevant experience may be needed.
Source: BMJ Open - April 18, 2022 Category: General Medicine Authors: Budin-Ljosne, I., Mowinckel, A. M., Friedman, B. B., Ebmeier, K. P., Drevon, C. A., Carver, R. B., Zsoldos, E., Fredheim, N. A. G., Sorensen, O., Baare, W. F. C., Madsen, K. S., Fjell, A. M., Kievit, R. A., Ghisletta, P., Bartres-Faz, D., Nawijn, L., Sole Tags: Open access, Public health Source Type: research

Sex differences in outcomes after mechanical thrombectomy for acute ischemic stroke in the 'real world: protocol for a systematic review and meta-analysis study
Introduction Mechanical thrombectomy (MT) had been regarded as the first-line therapy for acute ischaemic stroke patients. The sex differences in post-MT treatment outcomes were analysed by randomised controlled trial (RCT) studies with inconsistent conclusions. We suggest the results from the real-world data may differ from RCT containing studies. Therefore, the sex difference in non-clinical trial populations needs to be clarified. Methods and analysis In order to obtain relative studies comprehensively, we will search the main document databases, consisting of Web of Science, Medline in Ovid, Embase in Ovid and Cochran...
Source: BMJ Open - April 15, 2022 Category: General Medicine Authors: Xu, L., Li, B., Zhang, X., Bai, X., Dmytriw, A. A., Wang, T., Wang, X., Yang, K., Min, X., Jiao, L. Tags: Open access, Neurology Source Type: research

Prevalence and associated relating factors in patients with hereditary retinal dystrophy: a nationwide population-based study in Taiwan
Conclusions 74% of the diagnosed HRD are retinitis pigmentosa. Population-based data suggested an increased incidence of cataract in younger patients, whereas older HRD patients are more susceptible to develop CME. Further work is needed to elucidate the mechanism between these ophthalmological disorders and HRD.
Source: BMJ Open - April 8, 2022 Category: General Medicine Authors: Woon, P. Y., Chien, J.-Y., Wang, J.-H., Chou, Y.-Y., Lin, M.-C., Huang, S.-P. Tags: Open access, Ophthalmology Source Type: research

Utility of a smartphone application in assessing palmar circulation prior to radial artery harvesting for coronary artery bypass grafting: rationale and design of the randomised CAPITAL iRADIAL-CABG trial
Introduction There is emerging evidence supporting the use of the radial artery (RA) as a preferred secondary conduit for coronary artery bypass grafting (CABG) as it is associated with higher rates of graft patency at 5 years when compared with saphenous vein grafts (SVG). The modified Allen’s test (MAT) is traditionally regarded as the standard of care in the assessment of ulnar artery (UA) patency prior to RA harvesting. Unfortunately, due to high false-positive rates, a substantial number of pre-CABG patients are found to have an abnormal MAT despite normal UA patency, resulting in inappropriate exclusion from RA...
Source: BMJ Open - April 8, 2022 Category: General Medicine Authors: Goh, C. Y., Parlow, S., Di Santo, P., Simard, T., Jung, R., Ahmed, Z., Verreault-Julien, L., Kuhar, P., Chan, V., Al-Atassi, T., Toeg, H., Bernick, J., Wells, G. A., Ruel, M., Hibbert, B. Tags: Open access, Cardiovascular medicine Source Type: research

Experiences and actions related to living with type 1 diabetes during the COVID-19 pandemic in Norway: a qualitative study conducted during July to December 2020
Conclusions Patients experienced an increased psychosocial burden of T1DM and difficulties from a disrupted daily life affecting T1DM self-management routines. Uncertainty-reducing behaviours and actions to adapt to the situation provided a general sense of coping despite these difficulties. Tailored information and follow-up by telephone or video call was emphasised to reduce uncertainly distress and support adequate diabetes T1DM self-management.
Source: BMJ Open - April 7, 2022 Category: General Medicine Authors: Pleym, K., Iversen, M. M., Broström, A. Tags: Open access, Diabetes and Endocrinology, COVID-19 Source Type: research

Cost-effective analysis of mechanical thrombectomy alone in the treatment of acute ischaemic stroke: a Markov modelling study
Conclusions MT alone was cost-effective compared with MT with alteplase in China. However, cautions are needed to extend this conclusion to regions outside of China.
Source: BMJ Open - April 6, 2022 Category: General Medicine Authors: Han, M., Qin, Y., Tong, X., Ji, L., Zhao, S., Liu, L., Chen, J., Liu, A. Tags: Open access, Health economics Source Type: research

Expediting workflow in the acute stroke pathway for endovascular thrombectomy in the northern Netherlands: a simulation model
Conclusions In our region, the proposed workflow improvements might reduce time to treatment by about 1 hour and increase the number of patients regaining functional independence by 6%. Simulation modelling is useful for assessing the potential effects of interventions aimed at reducing time from onset to EVT.
Source: BMJ Open - April 6, 2022 Category: General Medicine Authors: Maas, W. J., Lahr, M. M. H., Uyttenboogaart, M., Buskens, E., van der Zee, D.-J., On behalf of CONTRAST investigators Tags: Open access, Neurology Source Type: research

Platelet transmission electron microscopy for the assessment of poor biological response to antiplatelet agent: pilot descriptive and prospective study - ELECTROSTROKE
Introduction Ischaemic stroke is the leading cause of adult disability. Thus, a strategy based on an efficient antiplatelet therapy has been developed. The monitoring of antiplatelet therapy is now limited to high risk and poor prognosis patients. Indeed, the biological monitoring of the antiplatelet therapy with available platelet function assays do not provide a global integrative approach. Platelet transmission electron microscopy, recently validated for assessing distinct ultrastructural abnormalities is a reliable morphological platelet structural analysis tool which could be used to collect all the ultrastructural pl...
Source: BMJ Open - April 4, 2022 Category: General Medicine Authors: Mallouk, N., Garcin, A., Li, G., Epinat, M., Szczepaniak, C., Hien, O. F., Mismetti, P., Garnier, P. Tags: Open access, Pathology Source Type: research

Prognostic significance of first-degree atrioventricular block in a large Asian population: a prospective cohort study
Conclusions Our results indicated that first-degree AVB was an independent risk factor for adverse events, suggesting that it should not be considered as inconsequential factor in general population. These results have potential clinical value for identifying individuals at high risk for adverse outcomes.
Source: BMJ Open - April 4, 2022 Category: General Medicine Authors: Liu, M., Du, Z., Sun, Y. Tags: Open access, Cardiovascular medicine Source Type: research