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Source: BMJ Open

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Total 555 results found since Jan 2013.

Clinical features and novel technologies for prehospital detection of intracerebral haemorrhage: a scoping review protocol
Introduction The detection of intracerebral haemorrhage (ICH) in the prehospital setting without conventional imaging technology might allow early treatment to reduce haematoma expansion and improve patient outcomes. Although ICH and ischaemic stroke share many clinical features, some may help in distinguishing ICH from other suspected stroke patients. In combination with clinical features, novel technologies may improve diagnosis further. This scoping review aims to first identify the early, distinguishing clinical features of ICH and then identify novel portable technologies that may enhance differentiation of ICH from o...
Source: BMJ Open - May 3, 2023 Category: General Medicine Authors: Almubayyidh, M., Alghamdi, I., Parry-Jones, A. R., Jenkins, D. Tags: Open access, Emergency medicine Source Type: research

Effect and safety of C7 neurotomy at the intervertebral foramen in patients with chronic poststroke aphasia: a multicentre, randomised, controlled study protocol
This study will explore the efficacy of NC7 at the intervertebral foramen for improving chronic poststroke aphasia. Methods and analysis This study protocol reports a multicentre, randomised, assessor-blinded active-controlled trial. A total of 50 patients with chronic poststroke aphasia for over 1 year and with a aphasia quotient calculated by Western Aphasia Battery Aphasia Quotient (WAB-AQ) score below 93.8 will be recruited. Participants will be randomly assigned to 1 of 2 groups (25 individuals each) to receive NC7 plus intensive speech and language therapy (iSLT), or iSLT alone programme. The primary outcome is the ...
Source: BMJ Open - May 2, 2023 Category: General Medicine Authors: Li, T., Feng, J., Hu, R., Lv, M., Chang, W., Ma, X., Qi, W., Zhang, Y., Chen, X., Ding, L., Gu, Y., Xu, W. Tags: Open access, Neurology Source Type: research

Study protocol for a pilot randomised controlled trial evaluating the feasibility and effectiveness of non-pharmacological interventions to recover functionality after a transient ischaemic attack or a minor stroke: the 'Back to Normal trial
This study was approved by the Ethics Committee of the Local Health Unit of Matosinhos (Ref. 75/CES/JAS). Written informed consent will be required from all the participants; data protection and confidentiality will be also ensured. The findings of this project are expected to be submitted for publication in scientific articles, and the main results will be presented at relevant scientific meetings. Trial registration number NCT05369637.
Source: BMJ Open - April 28, 2023 Category: General Medicine Authors: Goncalves, M., Lima, M. J., Fonseca, A., Duque, C., Costa, A. R., Cruz, V. T. Tags: Open access, Neurology Source Type: research

Carbon dioxide flushing versus saline flushing of thoracic aortic stents (INTERCEPTevar): protocol for a multicentre pilot randomised controlled trial
Introduction Thoracic endovascular aortic repair (TEVAR) carries a 3%–6.1% stroke risk, including risk of ‘silent’ cerebral infarction (SCI). Stent-grafts are manufactured in room air and retain air. Instructions for use recommend saline flushing to ‘de-air’ the system prior to insertion, but substantial amounts of air are released when deploying them, potentially leading to downstream neuronal injury and SCI. Carbon dioxide (CO2) is more dense and more soluble in blood than air, without risk of bubble formation, so could be used in addition to saline to de-air stents. This pilot trial aims to...
Source: BMJ Open - April 27, 2023 Category: General Medicine Authors: Crockett, S., Hanna, L., Singh, A., Gunning, S., Nicholas, R., Bicknell, C., Hamady, M., Gable, D., Sallam, M., Modarai, B., Abisi, S., Lyons, O., Gibbs, R. Tags: Open access, Surgery Source Type: research

Efficiency and effectiveness of intensive multidisciplinary follow-up of patients with stroke/TIA or myocardial infarction compared to usual monitoring: protocol of a pragmatic randomised clinical trial. DiVa (Dijon vascular) study
We describe the protocol of a randomised clinical trial that aims to evaluate the efficiency and effectiveness of an intensive multidisciplinary follow-up of patients compared with standard care. Methods and analysis The DiVa study is a randomised, prospective, controlled, multicentre trial including patients >18 years old with a first or recurrent stroke (ischaemic or haemorrhagic) or TIA, or a type I or II MI, managed in one of the participating hospitals of the study area, with a survival expectancy >12 months. Patients will be randomised with an allocation ratio of 1:1 in two parallel groups: one group assigned ...
Source: BMJ Open - April 26, 2023 Category: General Medicine Authors: Bejot, Y., Soilly, A.-L., Bardou, M., Duloquin, G., Pommier, T., Laurent, G., Cottin, Y., Vadot, L., Adam, H., Boulin, M., Giroud, M. Tags: Open access, Cardiovascular medicine Source Type: research

Barriers and enablers to healthcare system uptake of direct oral anticoagulants for stroke prevention in atrial fibrillation: a qualitative interview study with healthcare professionals and policy makers in England
Conclusions The findings contribute to the wider literature by providing a new and in-depth understanding on the uptake of DOACs. The findings may be applicable to other new medicines used in chronic health conditions.
Source: BMJ Open - April 25, 2023 Category: General Medicine Authors: Medlinskiene, K., Richardson, S., Petty, D., Stirling, K., Fylan, B. Tags: Open access, Qualitative research Source Type: research

Association of trajectories of non-high-density lipoprotein cholesterol concentration with risk of cardiovascular disease: the Kailuan Study
Conclusions Changes in non-HDL-C were significantly associated with subsequent risk of CVD events, and participants with a high-increasing pattern had a higher CVD risk. Long-term monitoring of non-HDL-C could be useful to improve the prediction of CVD risk. Trial registration number ChiCTR-TNC-1100148.
Source: BMJ Open - April 25, 2023 Category: General Medicine Authors: Ding, X., Zhou, H., Yue, Q., Shu, Z., Ma, X., Li, Y., Wu, S. Tags: Open access, Epidemiology Source Type: research

Oral anticoagulant switching in patients with atrial fibrillation: a scoping review
Conclusions OAC switching is common in patients with AF and patients often switch back to an OAC they have previously been on. There are aspects of OAC switching that have received little study, especially in switches from DOACs.
Source: BMJ Open - April 25, 2023 Category: General Medicine Authors: Adelakun, A. R., Turgeon, R. D., De Vera, M. A., McGrail, K., Loewen, P. S. Tags: Open access, Cardiovascular medicine Source Type: research

Population-based assessment of cardiovascular complications of rheumatic heart disease in Fiji: a record-linkage analysis
Conclusions Our study defines the burden of RHD-attributable morbidity in the general population of Fiji, potentially reflecting the situation in low-income and middle-income countries worldwide. Hospitalisation for an RHD complication is associated with markedly increased risk of death, re-emphasising the importance of effective early prevention.
Source: BMJ Open - April 24, 2023 Category: General Medicine Authors: Parks, T., Narube, L., Perman, M. L., Sakumeni, K., Fong, J. J., Engelman, D., Colquhoun, S. M., Steer, A. C., Kado, J. Tags: Open access, Cardiovascular medicine Source Type: research

Primary healthcare needs and service utilisation of people with disability: a data linkage protocol
Introduction General practitioners (GPs) play a crucial role in the early management and treatment of the comorbidities and complications experienced by people with disability. However, GPs experience multiple constraints, including limited time and disability-related expertise. Knowledge gaps around the health needs of people with disability as well as the frequency and extent of their engagement with GPs mean evidence to inform practice is limited. Using a linked dataset, this project aims to enhance the knowledge of the GP workforce by describing the health needs of people with disability. Methods and analysis This pro...
Source: BMJ Open - April 19, 2023 Category: General Medicine Authors: Douglas, J., Winkler, D., McLeod, A., Oliver, S., Gardner, K., Supple, J., Pearce, C. Tags: Open access, Health services research Source Type: research

Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) in adults with chronic stroke: protocol of a randomised controlled trial
This study will compare the effect of 50 hours of HABIT-ILE against usual motor activity and regular rehabilitation. HABIT-ILE will be provided in a 2-week, adult’s day-camp setting, promoting functional tasks and structured activities. These tasks will continuously progress by increasing their difficulty. Assessed at baseline, 3 weeks after and at 3 months, the primary outcome will be the adults-assisting-hand-assessment stroke; secondary outcomes include behavioural assessments for hand strength and dexterity, a motor learning robotic medical device for quality of bimanual motor control, walking endurance, question...
Source: BMJ Open - April 13, 2023 Category: General Medicine Authors: Ebner-Karestinos, D., Gathy, E., Carton de Tournai, A., Herman, E., Araneda, R., Dricot, L., Macq, B., Vandermeeren, Y., Bleyenheuft, Y. Tags: Open access, Rehabilitation medicine Source Type: research

Quality of life and its associated factors among home-dwelling older people residing in the District of Colombo, Sri Lanka: a community-based cross-sectional study
Conclusion The overall QOL of home-dwelling elders of the Colombo District is moderate, with the lowest score being in social relationships and the highest in the environmental domain. Educational status, engaging in religious activities and financial independence are key factors associated with a better QOL. Limitations in physical activity and chronic diseases are associated with a reduced QOL. Living with the spouse is a key factor associated with the psychological health domain.
Source: BMJ Open - April 12, 2023 Category: General Medicine Authors: Wijesiri, H. S. M. S. K., Wasalathanthri, S., De Silva Weliange, S., Wijeyaratne, C. N. Tags: Open access, Public health Source Type: research

Methods for evaluation of corneal nerve fibres in diabetes mellitus by in vivo confocal microscopy: a scoping review protocol
Introduction Globally, 422 million people have diabetes. Late complications of diabetes are blindness, kidney failure, heart attack, stroke and lower limb amputation. The prevalence of diabetic peripheral neuropathy and diabetic retinopathy is 50% and 35%, respectively. In vivo confocal microscopy (IVCM) is a rapid, non-invasive method to evaluate subbasal corneal nerve fibres, which are small fibres of the peripheral nervous system. Corneal nerve fibre changes can be a marker of diabetic peripheral neuropathy. There is currently no gold-standard procedure for IVCM imaging, image processing or quantitative analysis of the ...
Source: BMJ Open - April 12, 2023 Category: General Medicine Authors: Sandvik, S. A., Sundling, V., Lagali, N. Tags: Open access, Diabetes and Endocrinology Source Type: research

Physio-psycho-social interaction mechanism in dyadic health of young and middle-aged stroke survivors and their spousal caregivers: a longitudinal observational study protocol
Introduction In recent years, stroke has become more common among young people. Stroke not only has a profound impact on patients’ health but also incurs stress and health threats to their caregivers, especially spousal caregivers. Moreover, the health of stroke survivors and their caregivers is interdependent. To our knowledge, no study has explored dyadic health of young and middle-aged stroke survivors and their spousal caregivers from physiological, psychological and social perspectives. Therefore, this proposed study aims to explore the mechanism of how physiological, psychological and social factors affect dyad...
Source: BMJ Open - April 11, 2023 Category: General Medicine Authors: Xiang, D., Zhang, Z.-x., Ge, S., Wang, W. n., Lin, B.-l., Chen, S.-y., Guo, E.-f., Zhang, P.-b., Liu, Z.-w., Li, H., Mei, Y.-x. Tags: Open access, Nursing Source Type: research

Sex differences in neurology: a scoping review
Conclusions Sex and gender are important biological and social determinants of health. However, the more explicit recognition of these factors in clinical literature has not been adequately translated to significant change in neuroscience research regarding sex differences. This study illustrates the ongoing need for more urgent informed action to recognise and act on sex differences in scientific discovery and correct the use of sex and gender terminology. Trial Registration The protocol for this scoping review was registered with Open Science Framework.
Source: BMJ Open - April 11, 2023 Category: General Medicine Authors: Moores, G., Steadman, P. E., Momen, A., Wolff, E., Pikula, A., Bui, E. Tags: Open access, Neurology Source Type: research