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Source: BMJ Open

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Total 555 results found since Jan 2013.

RECREATE: a study protocol for a multicentre pilot cluster randomised controlled trial (cRCT) in UK stroke services evaluating an intervention to reduce sedentary behaviour in stroke survivors (Get Set Go) with embedded process and economic evaluations
This study is a pragmatic, multicentre, two-arm, external pilot cluster randomised controlled trial with embedded process and economic evaluations. UK-based stroke services will be randomised 1:1 to the intervention (usual care plus Get Set Go) or control (usual care) arm. Fifteen stroke services will recruit 300–400 stroke inpatient and carer participants, with follow-up at 6, 12 and 24 months. The proposed primary endpoint is stroke survivor self-reported Nottingham Extended Activities of Daily Living scale at 12 months. Endpoint analyses will be exploratory and provide preliminary estimates of intervention effect....
Source: BMJ Open - July 30, 2023 Category: General Medicine Authors: Airlie, J., Burton, L.-J., Copsey, B., English, C., Farrin, A., Fitzsimons, C. F., Holloway, I., Horrocks, J., Johansson, J. F., Mead, G., Moreau, L. A., Ozer, S., Patel, A., Yaziji, N., Forster, A., on behalf of the RECREATE Programme Management Group, A Tags: Open access, Rehabilitation medicine Source Type: research

Discharge prescription patterns for antiplatelet and statin therapy following carotid endarterectomy: an analysis of the vascular quality initiative
Conclusions Although statin use has substantially improved following CEA, more than half of individuals not on a statin preprocedure remained this way at discharge. In addition, DAPT at discharge was frequent, a quarter of whom were on SAPT preprocedure. Further efforts are needed to improve rates of new statin prescriptions, ensure appropriate APT intensity at discharge and determine how different discharge APT regimens impact outcomes.
Source: BMJ Open - July 25, 2023 Category: General Medicine Authors: Eppler, M., Singh, N., Ding, L., Magee, G., Garg, P. Tags: Open access, Cardiovascular medicine Source Type: research

Simulation modelling to study the impact of adding comprehensive stroke centres. Can we deliver endovascular thrombectomy sooner?
Conclusions This study suggests that adding one or two CSCs in the north of the Netherlands would have modest impact. Improving workflow efficiencies seems to be more potent when aiming to improve existing acute stroke care systems.
Source: BMJ Open - July 24, 2023 Category: General Medicine Authors: Maas, W. J., van der Zee, D.-J., Buskens, E., Uyttenboogaart, M., Lahr, M. M., CONTRAST investigators, Dippel, Majoie, Beusekom, Cate, Dammers, Dijkhuizen, Kappelle, Klijn, Koudstaal, Lingsma, Lugt, Maat, Nederkoorn, Oostenbrugge, Roos, Vivian, Zwam Tags: Open access, Neurology Source Type: research

PerIoperative iNflammatory reSponse assessment In hiGH-risk patienTs undergoing non-cardiac surgery (INSIGHT): study protocol of a prospective non-interventional observational study
This study was approved by the ethics committees at the Medical University of Vienna (2458/2020) and at the Medical University of Graz (33-274 ex 20/21). Trial registration number NCT04753307.
Source: BMJ Open - July 19, 2023 Category: General Medicine Authors: Pichler, A., Kurz, A., Eichlseder, M., Graf, A., Eichinger, M., Taschner, A., Kabon, B., Fleischmann, E., Reiterer, C., for the INSIGHT study group, Pichler, Reiterer, Eichlseder, Graf, Eichinger, Kabon, Hantakova, Schallmeiner, Kuhrn, Kurz, Taschner, Fre Tags: Open access, Anaesthesia Source Type: research

TeleRehabilitation with Aims to Improve Lower extremity recovery in community-dwelling individuals who have had a stroke: protocol for a multisite, parallel group, assessor-blinded, randomised attention-controlled trial
Introduction Telerehabilitation is an accessible service delivery model that may support innovative lower extremity rehabilitation programmes that extend the stroke recovery continuum into the community. Unfortunately, there is limited evidence on the provision of exercises for lower extremity recovery after stroke delivered using telerehabilitation. In response, we developed the TeleRehabilitation with Aims to Improve Lower extremity recovery poststroke (TRAIL) programme, a 4-week progressive exercise and self-management intervention delivered synchronously using video-conferencing technology. Our primary hypothesis is th...
Source: BMJ Open - July 19, 2023 Category: General Medicine Authors: Sakakibara, B. M., Wiley, E., Barclay, R., Bayley, M., Davis, J. C., Eng, J. J., Harris, A., Inness, E. L., MacKay-Lyons, M., Monaghan, J., Pollock, C., Pooyania, S., Schneeberg, A., Teasell, R., Yao, J., Tang, A. Tags: Open access, Health services research Source Type: research

Diabetes status and other factors as correlates of risk for thrombotic and thromboembolic events during SARS-CoV-2 infection: A nationwide retrospective case-control study using Cerner Real-World Data™
Conclusions Risk of TTE during COVID-19 illness is substantially higher in patients with diabetes. Further, risk for TTEs is higher in those with T1DM versus T2DM. Confirmation of increased diabetes-associated clotting risk in future studies may warrant incorporation of diabetes status into SARS-CoV-2 infection treatment algorithms.
Source: BMJ Open - July 9, 2023 Category: General Medicine Authors: Tallon, E. M., Gallagher, M. P., Staggs, V. S., Ferro, D., Murthy, D. B., Ebekozien, O., Kosiborod, M. N., Lind, M., Manrique-Acevedo, C., Shyu, C.-R., Clements, M. A. Tags: Open access, Diabetes and Endocrinology, COVID-19 Source Type: research

Cognitive assessment after stroke: A qualitative study of patients experiences
Conclusions Stroke survivors require clear explanations about the purpose and outcomes of poststroke cognitive assessments, including constructive feedback, to promote engagement with the process and protect their psychological wellbeing.
Source: BMJ Open - June 29, 2023 Category: General Medicine Authors: Hobden, G., Tang, E., Demeyere, N. Tags: Open access, Neurology Source Type: research

Differences in acute ischaemic stroke in-hospital mortality across referral stroke hospitals in Spain: a retrospective, longitudinal observational study
Conclusions In the referral stroke hospitals of the Spanish National Health System, the overall adjusted in-hospital mortality decreased between 2003 and 2015. However, between-hospital variations in mortality persisted.
Source: BMJ Open - June 28, 2023 Category: General Medicine Authors: Estupinan-Romero, F., Pinilla Dominguez, J., Bernal-Delgado, E., on behalf of the Atlas VPM consortium Tags: Open access, Health services research Source Type: research

Acupuncture for gait disturbance of patients with subacute and chronic stroke: a systematic review and meta-analysis protocol
Introduction Hemiparetic gait is one of the most common sequelae of a stroke. Acupuncture has shown potential in correcting hemiplegic gait patterns and improving motor function recovery after stroke. However, controversial findings and a lack of supportive evidence on the effectiveness of acupuncture for post-stroke hemiplegia. The intelligent gait analysis system provides a new perspective for the study of hemiparetic gait. This systematic review aims to collect relevant studies and critically evaluate the efficacy and safety of acupuncture in alleviating gait disturbance of post-stroke hemiplegia based on quantified gai...
Source: BMJ Open - June 21, 2023 Category: General Medicine Authors: Sun, Z., Lin, Y.-r., Lu, M.-j., Huang, K.-y., Sun, K., Zhang, J.-b. Tags: Open access, Rehabilitation medicine Source Type: research

Stenting versus medical therapy alone for symptomatic intracranial arterial stenosis: protocol for a systematic review and individual patient data meta-analysis
Introduction Intracranial atherosclerotic stenosis (ICAS) is a common cause of stroke worldwide. However, whether the treatment options for symptomatic ICAS is stent placement or medical therapy alone is still controversial. At present, three multicentre randomised controlled trials (RCTs) have been published, but their research designs are also slightly different and the conclusions are not completely consistent. Therefore, we plan to conduct a systematic review and individual patient data (IPD) meta-analysis of randomised clinical trials to ascertain safety and efficacy of stenting versus medical therapy alone for sympto...
Source: BMJ Open - June 20, 2023 Category: General Medicine Authors: Wang, T., Xing, Z., Gong, H., Derdeyn, C. P., Zaidat, O. O., Almallouhi, E., Luo, J., Gao, P., Wang, H., Jiao, L. Tags: Open access, Neurology Source Type: research

Estimate of the prevalence of subjects with chronic diseases in a province of Northern Italy: a retrospective study based on administrative databases
Conclusions Despite the difficulty of having a unique definition of chronic disease, the prevalence obtained was coherent with the estimates reported by other national surveillance systems such as Passi and Passi d’Argento. Underestimates were observed when international comparisons were done; however, when we used less stringent definitions of chronic diseases, similar results were obtained.
Source: BMJ Open - June 19, 2023 Category: General Medicine Authors: Airoldi, C., Pagnoni, F., Cena, T., Ceriotti, D., De Ambrosi, D., De Vito, M., Faggiano, F. Tags: Open access, Public health Source Type: research

Transcarotid versus transfemoral access for cerebrovascular intervention: protocol for a systematic review and meta-analysis
Introduction Cerebrovascular intervention is an excellent option to treat cerebrovascular diseases. Interventional access is a prerequisite and a foundation for cerebrovascular intervention, which is crucial to the success of an intervention. Although transfemoral arterial access (TFA) has become a popular and acceptable method of access for cerebrovascular angiography and intervention in clinical practice, it has some drawbacks that limit the usage in cerebrovascular interventions. Therefore, transcarotid arterial access (TCA) has been developed in cerebrovascular interventions. We aim to conduct a systematic review to co...
Source: BMJ Open - June 14, 2023 Category: General Medicine Authors: Luo, J., Liao, W., Lei, D., Xing, Z., Wang, T., Xu, W., Wang, X., Yang, R., Wang, J., Gong, H., Yang, B., Ma, Y., Jiao, L., Chen, Y. Tags: Open access, Neurology Source Type: research

What follow-up interventions, programmes and pathways exist for minor stroke survivors after discharge from the acute setting? A scoping review
Conclusion There is an increasing volume of research exploring how best to provide follow-up care to people after minor stroke. Personalised, holistic and theory-informed interdisciplinary follow-up is needed that balances education and support needs with adjustment to life after stroke.
Source: BMJ Open - June 13, 2023 Category: General Medicine Authors: Crow, J., Savage, M., Gardner, L., Hughes, C., Corbett, C., Wells, M., Malhotra, P. Tags: Open access, Neurology Source Type: research

Endovascular thrombectomy with or without thrombolysis bridging in patients with acute ischaemic stroke: protocol for a systematic review, meta-analysis of randomised trials and cost-effectiveness analysis
Introduction Current published guidelines and meta-analyses comparing endovascular thrombectomy (EVT) alone versus EVT with bridging intravenous thrombolysis (IVT) suggest that EVT alone is non-inferior to EVT with bridging thrombolysis in achieving favourable functional outcome. Because of this controversy, we aimed to systematically update the evidence and meta-analyse data from randomised trials comparing EVT alone versus EVT with bridging thrombolysis, and performed an economic evaluation comparing both strategies. Methods and analysis We will conduct a systematic review of randomised controlled trials comparing EVT w...
Source: BMJ Open - June 12, 2023 Category: General Medicine Authors: Morsi, R. Z., Zhang, Y., Carrion-Penagos, J., Desai, H., Tannous, E., Kothari, S., Khamis, A. M., Darzi, A. J., Tarabichi, A., Bastin, R., Hneiny, L., Thind, S., Coleman, E., Brorson, J. R., Mendelson, S., Mansour, A., Prabhakaran, S., Kass-Hout, T. Tags: Open access, Neurology Source Type: research

Validation of diagnosis of acute myocardial infarction and stroke in electronic medical records: a primary care cross-sectional study in Madrid, Spain (the e-MADVEVA Study)
Conclusion The validation results show that diagnoses of AMI and stroke in primary care EMRs constitute a helpful tool in epidemiological studies. The prevalence of AMI and stroke was lower than 2% in the population aged over 18 years.
Source: BMJ Open - June 12, 2023 Category: General Medicine Authors: de Burgos-Lunar, C., del Cura-Gonzalez, I., Cardenas-Valladolid, J., Gomez-Campelo, P., Abanades-Herranz, J. C., Lopez-de-Andres, A., Sotos-Prieto, M., Iriarte-Campo, V., Fuentes-Rodriguez, C. Y., Gomez-Coronado, R., Salinero-Fort, M. A. Tags: Open access, Cardiovascular medicine Source Type: research