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Source: BMJ Open

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Total 555 results found since Jan 2013.

National trends in the outcomes of subarachnoid haemorrhage and the prognostic influence of stroke centre capability in Japan: retrospective cohort study
Conclusions The 6-year trends indicated lower in-hospital mortality for patients with SAH (attributable to better outcomes), increased use of coiling and multidisciplinary care for untreated patients. Further increasing CSC capabilities may improve overall outcomes, mainly by increasing the use of coiling. Additional studies are necessary to determine the effect of confounders such as aneurysm complexity on outcomes of clipped patients in the modern endovascular era.
Source: BMJ Open - April 10, 2023 Category: General Medicine Authors: Kurogi, R., Kada, A., Ogasawara, K., Nishimura, K., Kitazono, T., Iwama, T., Matsumaru, Y., Sakai, N., Shiokawa, Y., Miyachi, S., Kuroda, S., Shimizu, H., Yoshimura, S., Osato, T., Horie, N., Nagata, I., Nozaki, K., Date, I., Hashimoto, Y., Hoshino, H., N Tags: Open access, Neurology Source Type: research

Improving sleep and learning in rehabilitation after stroke, part 2 (INSPIRES2): study protocol for a home-based randomised control trial of digital cognitive behavioural therapy (dCBT) for insomnia
Introduction Consolidation of motor skill learning, a key component of rehabilitation post-stroke, is known to be sleep dependent. However, disrupted sleep is highly prevalent after stroke and is often associated with poor motor recovery and quality of life. Previous research has shown that digital cognitive behavioural therapy (dCBT) for insomnia can be effective at improving sleep quality after stroke. Therefore, the aim of this trial is to evaluate the potential for sleep improvement using a dCBT programme, to improve rehabilitation outcomes after stroke. Methods and analysis We will conduct a parallel-arm randomised c...
Source: BMJ Open - April 6, 2023 Category: General Medicine Authors: Weightman, M., Robinson, B., Fallows, R., Henry, A. L., Kyle, S. D., Garratt, E., Pick, A., Teal, R., Ajina, S., Demeyere, N., Espie, C. A., Seymour, B., Johansen-Berg, H., Fleming, M. K. Tags: Open access, Rehabilitation medicine Source Type: research

Statins for extension of disability-free survival and primary prevention of cardiovascular events among older people: protocol for a randomised controlled trial in primary care (STAREE trial)
Introduction The world is undergoing a demographic transition to an older population. Preventive healthcare has reduced the burden of chronic illness at younger ages but there is limited evidence that these advances can improve health at older ages. Statins are one class of drug with the potential to prevent or delay the onset of several causes of incapacity in older age, particularly major cardiovascular disease (CVD). This paper presents the protocol for the STAtins in Reducing Events in the Elderly (STAREE) trial, a randomised double-blind placebo-controlled trial examining the effects of statins in community dwelling o...
Source: BMJ Open - April 3, 2023 Category: General Medicine Authors: Zoungas, S., Curtis, A., Spark, S., Wolfe, R., McNeil, J. J., Beilin, L., Chong, T. T.-J., Cloud, G., Hopper, I., Kost, A., Nelson, M., Nicholls, S. J., Reid, C. M., Ryan, J., Tonkin, A., Ward, S. A., Wierzbicki, A., On behalf of STAREE investigator group Tags: Open access, Cardiovascular medicine Source Type: research

Impact of prestroke physical activity and citalopram treatment on poststroke depressive symptoms: a secondary analysis of data from the TALOS randomised controlled trial in Denmark
Conclusions A higher prestroke physical activity level was associated with fewer depressive symptoms 1 and 6 months after stroke. Citalopram treatment did not seem to modify this association. Trial registration numbers NCT01937182 (ClinicalTrials.gov) and 2013-002253-30 (EUDRACT).
Source: BMJ Open - March 30, 2023 Category: General Medicine Authors: Vestergaard, S. B., Damsbo, A. G., Blauenfeldt, R. A., Johnsen, S. P., Andersen, G., Mortensen, J. K. Tags: Open access, Neurology Source Type: research

Development and validation of dynamic models to predict postdischarge mortality risk in patients with acute myocardial infarction: results from China Acute Myocardial Infarction Registry
Conclusions We established dynamic risk prediction models incorporating adverse event and medications. The nomograms may be useful instruments to help prospective risk assessment and management of AMI. Trial registration number NCT01874691.
Source: BMJ Open - March 29, 2023 Category: General Medicine Authors: Lv, J., Wang, C., Gao, X., Yang, J., Zhang, X., Ye, Y., Dong, Q., Fu, R., Sun, H., Yan, X., Zhao, Y., Wang, Y., Xu, H., Yang, Y., on behalf of the China Acute Myocardial Infarction Registry study group Tags: Open access, Cardiovascular medicine Source Type: research

Development and internal validation of a clinical risk score for in-hospital mortality after stroke: a single-centre retrospective cohort study in Northwest Ethiopia
Conclusions The prediction model was developed from eight easy-to-collect predictors. The model has excellent discrimination and calibration performance, similar to that of the risk score model. It is simple, easily remembered, and helps clinicians identify the risk of patients and manage it properly. Prospective studies in different healthcare settings are required to externally validate our risk score.
Source: BMJ Open - March 28, 2023 Category: General Medicine Authors: Abebe, T. G., Feleke, S. F., Dessie, A. M., Anteneh, R. M., Anteneh, Z. A. Tags: Open access, Cardiovascular medicine Source Type: research

Vestibular syndromes, diagnosis and diagnostic errors in patients with dizziness presenting to the emergency department: a cross-sectional study
Conclusions One-fourth of patients with dizziness in the ED presented with AVS with a high prevalence (10%) of vestibular strokes. EVS was more frequent; however, the rate of undiagnosed patients with dizziness and the number of patients receiving neuroimaging were high. Almost half of them still remained without diagnosis and among those diagnosed were often misclassified. Many unclear cases of vertigo could be diagnostically clarified after a follow-up visit.
Source: BMJ Open - March 24, 2023 Category: General Medicine Authors: Comolli, L., Korda, A., Zamaro, E., Wagner, F., Sauter, T. C., Caversaccio, M. D., Nikles, F., Jung, S., Mantokoudis, G. Tags: Open access, Ear, nose and throat/otolaryngology Source Type: research

ADVANCE-TBI study protocol: traumatic brain injury outcomes in UK military personnel serving in Afghanistan between 2003 and 2014 - a longitudinal cohort study
Introduction Outcomes of traumatic brain injury (TBI) are highly variable, with cognitive and psychiatric problems often present in survivors, including an increased dementia risk in the long term. Military personnel are at an increased occupational risk of TBI, with high rates of complex polytrauma including TBI characterising the UK campaign in Afghanistan. The ArmeD SerVices TrAuma and RehabilitatioN OutComE (ADVANCE)-TBI substudy will describe the patterns, associations and long-term outcomes of TBI in the established ADVANCE cohort. Methods and analysis The ADVANCE cohort comprises 579 military personnel exposed to m...
Source: BMJ Open - March 21, 2023 Category: General Medicine Authors: Graham, N. S. N., Blissitt, G., Zimmerman, K., Friedland, D., Dumas, M.-E., Coady, E., Heslegrave, A., Zetterberg, H., Escott-Price, V., Schofield, S., Fear, N. T., Boos, C., Bull, A. M. J., Cullinan, P., Bennett, A., Sharp, D. J., for the ADVANCE Study Tags: Open access, Neurology Source Type: research

Association of the COVID-19 pandemic on stroke admissions and treatment globally: a systematic review
Conclusions During the COVID-19 pandemic, many populations hesitated to seek medical attention, decreasing hospital admissions for less severe strokes and increasing hospitalisation of more severe cases and mortality. The effect of the pandemic on society and healthcare systems needs to be addressed to improve stroke treatment pathways and prepare for potential future epidemics. PROSPERO registration number CRD42021248564.
Source: BMJ Open - March 17, 2023 Category: General Medicine Authors: Van Dusen, R. A., Abernethy, K., Chaudhary, N., Paudyal, V., Kurmi, O. Tags: Open access, Cardiovascular medicine, COVID-19 Source Type: research

Qualitative study exploring heterogeneity in caregiving experiences post-stroke in Singapore
Conclusion Our findings illustrated the heterogeneity in factors affecting caregiving experience across spouse and adult-child caregivers. Practical implications include conducting a needs assessment for caregiver-stroke survivor dyads and providing tailored support, training and information to help caregivers cope better.
Source: BMJ Open - March 15, 2023 Category: General Medicine Authors: Tyagi, S., Luo, N., Tan, C. S., Tan, K. B., Tan, B. Y., Menon, E., Venketasubramanian, N., Loh, W. C., Fan, S. H., Yang, K. L. T., Swee Ling Chan, A., Farwin, A., Lukman, Z. B., Koh, G. C.-H. Tags: Open access, Neurology Source Type: research

Lipid management in ischaemic stroke or transient ischaemic attack in China: result from China National Stroke Registry III
Conclusions The LDL-C goal achievement rate has increased mildly in the stroke and TIA population in mainland China. Lowered baseline LDL-C level was significantly associated with a decreased short- and long-term risk of ischemic stroke among stroke and TIA patients. LDL-C<1.4mmol/L might be a safe standard for this population.
Source: BMJ Open - March 8, 2023 Category: General Medicine Authors: Xu, Y.-Y., Chen, W.-Q., Wang, M.-X., Pan, Y.-S., Li, Z.-X., Liu, L.-P., Zhao, X.-Q., Wang, Y.-L., Li, H., Wang, Y.-J., Meng, X., on behalf of the CNSR-III Investigators, Wang, Li, Wu, Zhang, He, Gong, Ouyang, Huang, Yu, Wang, Zhang, Wu, Wang, Yu, Zhang, A Tags: Open access, Medical management Source Type: research

Transcranial direct current stimulation combined with bodyweight support-tai chi footwork for motor function of stroke survivors: a study protocol of randomised controlled trial
This study will be an assessor-blinded randomised controlled trial involving 12-week intervention and 6-month follow-up. One hundred and thirty-five individuals with stroke will be randomly divided in a ratio of 1:1:1 into three groups. Control group A, control group B and intervention group C will receive tDCS and conventional rehabilitation programmes (CRPs), BWS-TC and CRP, tDCS-BWS-TC and CRP for 12 weeks, respectively. The primary outcome measures will include the efficacy (Fugl-Meyer Assessment), acceptability and safety of these interventions. The secondary outcome measures will include balance ability (ie, limits o...
Source: BMJ Open - March 7, 2023 Category: General Medicine Authors: Lai, M.-h., Xu, H.-c., Huang, M.-c., Lu, Y., Yang, K., Jiang, L.-m., Yu, X.-m. Tags: Open access, Rehabilitation medicine Source Type: research

Effects of integrated action and sensory observation therapy based on mirror neuron and embodied cognition theory on upper limb sensorimotor function in chronic stroke: a study protocol for a randomised controlled trial
This study protocol aims to explore the effectiveness and neural mechanism of the integration of action observation therapy (AOT) and sensory observation therapy (SOT) for post-stroke patients on upper limb sensorimotor function. Methods and analysis This is a single-centre, single-blind, randomised controlled trial. A total of 69 patients with upper extremity hemiparesis after stroke will be recruited and randomly divided into an AOT group, a combined action observation and somatosensory stimulation therapy (AOT+SST) group, and a combined AOT and SOT (AOT+SOT) group in a 1:1:1 ratio. Each group will receive 30 min of dai...
Source: BMJ Open - March 7, 2023 Category: General Medicine Authors: Zhou, Z., Chen, X., Li, Y., Chen, S., Zhang, S., Wu, Y., Shi, X., Ren, M., Shan, C. Tags: Open access, Neurology Source Type: research

Development of rapid and effective risk prediction models for stroke in the Chinese population: a cross-sectional study
Conclusion The five machine learning models all had good predictive and discriminatory performance for stroke. The performance of RF and XGBoost was slightly better than that of LR, which was easier to interpret and less prone to overfitting. This work provides a rapid and accurate tool for stroke risk assessment, which can help to improve the efficiency of stroke screening medical services and the management of high-risk groups.
Source: BMJ Open - March 1, 2023 Category: General Medicine Authors: Qiu, Y., Cheng, S., Wu, Y., Yan, W., Hu, S., Chen, Y., Xu, Y., Chen, X., Yang, J., Chen, X., Zheng, H. Tags: Open access, Public health Source Type: research

Association between seropositivity for toxocariasis and cognitive functioning in older adults: an analysis of cross-sectional data from the US National Health and Nutrition Examination Survey (NHANES), 2011-2014
Conclusions In our study, seropositive toxocariasis was independently and significantly associated with worse working memory, sustained attention, processing speed and global cognition in older adults. If this association is causal, public health measures to prevent human toxocariasis might help protect older adults’ cognitive function.
Source: BMJ Open - March 1, 2023 Category: General Medicine Authors: Song, G., Yang, C., Qu, Z., Lin, X., Liu, M., Wang, Y. Tags: Open access, Epidemiology Source Type: research