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Total 555 results found since Jan 2013.

Stroke resource utilisation and all-cause mortality in Thailand 2017-2020: A retrospective, cross-sectional study
Conclusion The highest mean cost per patient was found in patients with haemorrhagic stroke. Receiving rehabilitation was associated with lower cost and mortality risk. Rehabilitation and disability outcomes should be improved to ensure an enhancement of health outcomes and efficient use of resources.
Source: BMJ Open - June 6, 2023 Category: General Medicine Authors: Kumluang, S., Wu, O., Langhorne, P., Geue, C. Tags: Open access, Health services research Source Type: research

Effects of intensive lipid lowering compared with moderate-intensity lipid lowering on coronary atherosclerotic plaque phenotype and major adverse cardiovascular events in adults with low to intermediate 10-year ASCVD risk (ILLUMINATION study): protocol for a multicentre, open-label, blinded-endpoint, randomised controlled trial
Introduction Current guidelines recommend moderate-intensity lipid lowering (low-density lipoprotein cholesterol, LDL-C of <2.6 mmol/L or 30%–49% reduction from the baseline) for patients with intermediate 10-year atherosclerotic cardiovascular disease (ASCVD) risk. The effects of intensive lipid lowering (LDL-C of <1.8 mmol/L) on coronary atherosclerotic plaque phenotype and major adverse cardiovascular events (MACE) in adults with both non-obstructive coronary artery disease (CAD) and low to intermediate 10-year ASCVD risk remain uncertain. Methods and analysis Intensive Lipid-lowering for Plaque and Major A...
Source: BMJ Open - June 5, 2023 Category: General Medicine Authors: Zheng, J., Hou, Z., Yuan, J., Zhao, X., Wang, Y., Li, J., Zhang, W., Dou, K., Lu, B. Tags: Open access, Cardiovascular medicine Source Type: research

Correction: 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
This article has been corrected since it was published online. The affiliation numbers 1 and 2 have been merged and updated to "Department of Cardiac Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China".
Source: BMJ Open - June 1, 2023 Category: General Medicine Tags: Open access Correction Source Type: research

Social bias in artificial intelligence algorithms designed to improve cardiovascular risk assessment relative to the Framingham Risk Score: a protocol for a systematic review
This study will employ an equity-lens to identify sources of bias (ie, race/ethnicity, gender and social stratum) in ML algorithms designed to improve CVD risk assessment relative to the FRS. A comprehensive literature search will be completed using MEDLINE, Embase and IEEE to answer the research question: do AI algorithms that are designed for the estimation of CVD risk and that compare performance with the FRS address the sources of bias inherent in the FRS? No study date filters will be imposed on the search, but English language filters will be applied. Studies describing a specific algorithm or ML approach that provid...
Source: BMJ Open - May 31, 2023 Category: General Medicine Authors: Garcha, I., Phillips, S. P. Tags: Open access, General practice / Family practice Source Type: research

Carbon dioxide flooding to reduce postoperative neurological injury following surgery for acute type A aortic dissection: a prospective, randomised, blinded, controlled clinical trial, CARTA study protocol - objectives and design
This report describes the objectives and design of the CARTA trial, investigating whether carbon dioxide flooding reduces neurological injury following surgery for ATAAD. Methods and analysis The CARTA trial is a single-centre, prospective, randomised, blinded, controlled clinical trial of ATAAD surgery with carbon dioxide flooding of the surgical field. Eighty consecutive patients undergoing repair of ATAAD, and who do not have previous neurological injuries or ongoing neurological symptoms, will be randomised (1:1) to either receive carbon dioxide flooding of the surgical field or not. Routine repair will be performed r...
Source: BMJ Open - May 25, 2023 Category: General Medicine Authors: Ede, J., Teurneau-Hermansson, K., Moseby-Knappe, M., Ramgren, B., Bjursten, H., Ederoth, P., Larsson, M., Mattsson-Carlgren, N., Sjögren, J., Wierup, P., Nozohoor, S., Zindovic, I. Tags: Open access, Cardiovascular medicine Source Type: research

Evaluation of the effect of sodium zirconium cyclosilicate on arrhythmia-related cardiovascular outcomes in patients receiving chronic haemodialysis with hyperkalaemia: protocol for the multicentre, randomised, controlled DIALIZE-Outcomes study
Introduction Patients with kidney failure receiving chronic haemodialysis have elevated risk of arrhythmias potentially increasing the likelihood of sudden cardiac death, stroke and hospitalisation. The DIALIZE study (NCT03303521) demonstrated that sodium zirconium cyclosilicate (SZC) was an efficacious and well-tolerated treatment for predialysis hyperkalaemia in patients undergoing haemodialysis. The DIALIZE-Outcomes study evaluates the effect of SZC on sudden cardiac death and arrhythmia-related cardiovascular outcomes in patients receiving chronic haemodialysis with recurrent hyperkalaemia. Methods and analysis Intern...
Source: BMJ Open - May 25, 2023 Category: General Medicine Authors: Fishbane, S., Jadoul, M., Dember, L., Kovesdy, C., Al-Shurbaji, A., Lisovskaja, V., Sekar, P., Katona, B., Guzman, N., Herzog, C. Tags: Open access, Renal medicine Source Type: research

Evaluating the implementation of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) in three rehabilitation settings in Quebec: a mixed-methods study protocol
The objectives are to: (a) describe the context of MPAI-4 implementation; (b) determine clinical teams’ readiness for change; (c) identify barriers and enablers to implementing the MPAI-4 and match the implementation strategies; (d) evaluate the MPAI-4 implementation outcomes including the degree of integration of the MPAI-4 into clinical practice and (e) explore participants’ experiences using the MPAI-4. Methods and analysis We will use a multiple case study design within an integrated knowledge translation (iKT) approach with active engagement from key informants. Each case is a rehabilitation centre implem...
Source: BMJ Open - May 23, 2023 Category: General Medicine Authors: Kengne Talla, P., Thomas, A., Ataman, R., Auger, C., McKerral, M., Wittich, W., Poncet, F., Ahmed, S. Tags: Open access, Rehabilitation medicine Source Type: research

Early identification and characterisation of stroke to support prehospital decision-making using artificial intelligence: a scoping review protocol
Introduction Stroke is a time-critical condition and one of the leading causes of mortality and disability worldwide. To decrease mortality and improve patient outcome by improving access to optimal treatment, there is an emerging need to improve the accuracy of the methods used to identify and characterise stroke in prehospital settings and emergency departments (EDs). This might be accomplished by developing computerised decision support systems (CDSSs) that are based on artificial intelligence (AI) and potential new data sources such as vital signs, biomarkers and image and video analysis. This scoping review aims to su...
Source: BMJ Open - May 22, 2023 Category: General Medicine Authors: Jalo, H., Seth, M., Pikkarainen, M., Häggström, I., Jood, K., Bakidou, A., Sjöqvist, B. A., Candefjord, S. Tags: Open access, Neurology Source Type: research

Effect of multicomponent rehabilitation on independence and functioning in elderly patients with common age-associated diseases: protocol for a scoping review (REHOLD)
Introduction Elderly patients after hospitalisation for acute events on account of age-related diseases (eg, joint or heart valve replacement surgery) are often characterised by a remarkably reduced functional health. Multicomponent rehabilitation (MR) is considered an appropriate approach to restore the functioning of these patients. However, its efficacy in improving functioning-related outcomes such as care dependency, activities of daily living (ADL), physical function and health-related quality of life (HRQL) remains unclarified. We outline the research framework of a scoping review designed to map the available evide...
Source: BMJ Open - May 18, 2023 Category: General Medicine Authors: Baritello, O., Stein, H., Wolff, L. L., Hamann, M., Völler, H., Salzwedel, A. Tags: Open access, Rehabilitation medicine Source Type: research

Efficacy and safety of carbon dioxide insufflation for brain protection for patients undergoing planned left-sided open heart valve surgery: protocol for a multicentre, placebo-controlled, blinded, randomised controlled trial (the CO2 Study)
Introduction Brain injury is common following open heart valve surgery. Carbon dioxide insufflation (CDI) has been proposed to reduce the incidence of brain injury by reducing the number of air microemboli entering the bloodstream in surgery. The CO2 Study will evaluate the efficacy and safety of CDI in patients undergoing planned left-sided open heart valve surgery. Methods and analysis The CO2 Study is a multicentre, blinded, placebo-controlled, randomised controlled trial. Seven-hundred and four patients aged 50 years and over undergoing planned left-sided heart valve surgery will be recruited to the study, from at lea...
Source: BMJ Open - May 17, 2023 Category: General Medicine Authors: Todd, R., Rogers, C. A., Pufulete, M., Culliford, L., Pretorius, P., Voets, N., Akowuah, E., Sayeed, R., Lazaroo, M., Kaur, S., Angelini, G. D., Gibbison, B. Tags: Open access, Surgery Source Type: research

Impact of polyethylene glycol loxenatide on cardiovascular outcomes in patients with type 2 diabetes: study protocol for a multicentre, randomised, double-blind, placebo-controlled trial (BALANCE-3)
This study is a multicentre, randomised, double-blind, placebo-controlled trial. Patients with T2DM who fulfilled the inclusion criteria were randomly divided to receive weekly administration of either PEG-Loxe 0.2 mg or placebo (1:1 ratio). The randomisation was stratified according to utilisation of sodium-glucose cotransporter 2 inhibitors, history of CV disease and body mass index. The research period is expected to be 3 years, with a 1-year recruitment period and a 2-year follow-up period. The primary outcome is the occurrence of the first MACE, described as CV death, non-fatal myocardial infarction or non-fatal strok...
Source: BMJ Open - May 16, 2023 Category: General Medicine Authors: Xie, Y., Kuang, J., Li, Q., Hong, T., Ji, L., Kong, Y., Duan, Y., Chen, L. Tags: Open access, Diabetes and Endocrinology Source Type: research

Multimodal individualised intervention to prevent functional decline after stroke: protocol of a randomised controlled trial on long-term follow-up after stroke (LAST-long)
Introduction Multimodal interventions have emerged as new approaches to provide more targeted intervention to reduce functional decline after stroke. Still, the evidence is contradictory. The main objective of the Life After Stroke (LAST)-long trial is to investigate if monthly meetings with a stroke coordinator who offers a multimodal approach to long-term follow-up can prevent functional decline after stroke. Methods and analysis LAST-long is a pragmatic single-blinded, parallel-group randomised controlled trial recruiting participants living in six different municipalities, admitted to four hospitals in Norway. The pat...
Source: BMJ Open - May 10, 2023 Category: General Medicine Authors: Askim, T., Hokstad, A., Bergh, E., Dohl, O., Ellekjaer, H., Ihle-Hansen, H., Indredavik, B., Leer, A. S. M., Lydersen, S., Saltvedt, I., Seljeseth, Y., Thommessen, B. Tags: Open access, Rehabilitation medicine Source Type: research

FIND Stroke Recovery Study (FIND): rationale and protocol for a longitudinal observational cohort study of trajectories of recovery and biomarkers poststroke
Introduction Comprehensive studies mapping domain-specific trajectories of recovery after stroke and biomarkers reflecting these processes are scarce. We, therefore, initiated an exploratory prospective observational study of stroke cases with repeated evaluation, the FIND Stroke Recovery Study. We aim to capture trajectories of recovery from different impairments, including cognition, in combination with broad profiling of blood and imaging biomarkers of the recovery. Methods and analysis We recruit individuals with first-ever stroke at the stroke unit at the Sahlgrenska University Hospital, Sweden, to FIND. The inclusio...
Source: BMJ Open - May 10, 2023 Category: General Medicine Authors: Brännmark, C., Klasson, S., Stanne, T. M., Samuelsson, H., Alt Murphy, M., Sunnerhagen, K. S., Aberg, N. D., Jalnefjord, O., Björkman-Burtscher, I., Jood, K., Tatlisumak, T., Jern, C. Tags: Open access, Neurology Source Type: research

Association between bilirubin levels and risk of stroke: a systematic review and meta-analysis
Conclusions Elevated bilirubin levels were associated with a decreased risk of stroke among adults. PROSPERO registration number CRD42017071497.
Source: BMJ Open - May 10, 2023 Category: General Medicine Authors: Wang, G., Qiao, L., Tang, Z., Zhou, S., Min, J., Li, M. Tags: Open access, Neurology Source Type: research

Atorvastatin and the influence on postoperative atrial fibrillation after surgical aortic valve replacement (STARC) in adults at Odense University Hospital, Denmark: study protocol for a randomised controlled trial
Introduction Atrial fibrillation (AF) is the most common postoperative complication after surgical aortic valve replacement (SAVR) and occurs in up to 50% of the patients. Development of postoperative AF (POAF) is associated with a 2–3 fold increased risk of adverse events, including stroke, myocardial infarction and death. Several studies have implied that prophylactic Atorvastatin therapy could prevent POAF in patients undergoing coronary artery bypass graft. These studies suggest that Atorvastatin has rapid and significant pleiotropic actions that reduce the risk of POAF. However, prophylactic treatment with stati...
Source: BMJ Open - May 10, 2023 Category: General Medicine Authors: Krasniqi, L., Brandes, A., Mortensen, P. E., Dahl, J. S., Gerke, O., Ali, M., Riber, L. P. S. Tags: Open access, Cardiovascular medicine Source Type: research