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Source: BMJ Open

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Total 555 results found since Jan 2013.

Colchicine and high-intensity rosuvastatin in the treatment of non-critically ill patients hospitalised with COVID-19: a randomised clinical trial
Conclusions In this small, open-label, randomised trial of non-critically ill hospitalised patients with COVID-19, the combination of colchicine and rosuvastatin in addition to standard of care did not appear to reduce the risk of progression of COVID-19 disease or thromboembolic events, although the trial was underpowered due to a lower-than-expected event rate. The trial leveraged the power of electronic medical records for efficiency and improved follow-up and demonstrates the utility of incorporating electronic medical records into future trials. Trial registration NCT04472611.
Source: BMJ Open - February 24, 2023 Category: General Medicine Authors: Shah, T., McCarthy, M., Nasir, I., Archer, H., Ragheb, E., Kluger, J., Kashyap, N., Paredes, C., Patel, P., Lu, J., Kandel, P., Song, C., Khan, M., Huang, H., Ul Haq, F., Ahmad, R., Howes, C., Cambi, B., Lancaster, G., Cleman, M., Dela Cruz, C., Parise, H Tags: Open access, Infectious diseases, COVID-19 Source Type: research

Cohort profile: the Utrecht Cardiovascular Cohort-Second Manifestations of Arterial Disease (UCC-SMART) Study-an ongoing prospective cohort study of patients at high cardiovascular risk in the Netherlands
This article provides an update of the rationale, design, included patients, measurements and findings from the start in 1996 to date. Participants The UCC-SMART Study includes patients aged 18–90 years referred to the University Medical Center Utrecht, the Netherlands, for management of cardiovascular disease (CVD) or severe cardiovascular risk factors. Since September 1996, a total of 14 830 patients have been included. Upon inclusion, patients undergo a standardised screening programme, including questionnaires, vital signs, laboratory measurements, an ECG, vascular ultrasound of carotid arteries and aorta, ankle...
Source: BMJ Open - February 20, 2023 Category: General Medicine Authors: Castelijns, M. C., Helmink, M. A. G., Hageman, S. H. J., Asselbergs, F. W., de Borst, G. J., Bots, M. L., Cramer, M. J., Dorresteijn, J. A. N., Emmelot-Vonk, M. H., Geerlings, M. I., de Jong, P. A., van der Kaaij, N. P., Kappelle, L. J., Lely, A. T., van Tags: Open access, Cardiovascular medicine Source Type: research

Multidimensional analysis of sedentary behaviour and participation in Spanish stroke survivors (Part&Sed-Stroke): a protocol for a longitudinal multicentre study
Introduction Stroke survivors usually experience long-lasting functional, emotional and social consequences that might contribute to sedentary behaviour and participation restrictions, which are important targets to address during rehabilitation. However, the trajectory and inter-relationship between these factors are unknown. Methods and analysis Part&Sed is a research project based on an observational study design with 6 and 12 months of follow-ups in stroke survivors. In addition, a qualitative analysis of the impact of the stroke on the stroke survivor, validation of the Satisfaction with Daily Occupation-Occupati...
Source: BMJ Open - February 15, 2023 Category: General Medicine Authors: de Diego-Alonso, C., Alegre-Ayala, J., Buesa, A., Blasco-Abadia, J., Lopez-Royo, M. P., Roldan-Perez, P., Giner-Nicolas, R., Part&Sed-Stroke Collaborators Group, Gu&x0308;eita-Rodriguez, J., Fini, N. A., Domenech-Garcia, V., Bellosta-Lopez, P., Navarro, L Tags: Open access, Neurology Source Type: research

Registry for Evaluating Healthy Life Expectancy and Long-Term Outcomes after Catheter Ablation of Atrial Fibrillation in the Very Elderly (REHEALTH AF) study: rationale and design of a prospective, multicentre, observational, comparative study
Introduction Data are lacking on the extent to which patients with non-valvular atrial fibrillation (AF) who are aged ≥80 years benefit from ablation treatment. The question pertains especially to patients’ postablation quality of life (QoL) and long-term clinical outcomes. Methods and analysis We are initiating a prospective, registry-based, multicentre observational study that will include patients aged ≥80 years with non-valvular AF who choose to undergo treatment by catheter ablation and, for comparison, such patients who do not choose to undergo ablation (either according to their physician’s advice...
Source: BMJ Open - February 15, 2023 Category: General Medicine Authors: Okumura, Y., Nagashima, K., Watanabe, R., Yokoyama, K., Kato, T., Fukaya, H., Hayashi, H., Nakahara, S., Shimizu, W., Iwasaki, Y.-k., Fujimoto, Y., Mukai, Y., Ejima, K., Otsuka, T., Suzuki, S., Murakami, M., Kimura, M., Harada, M., Koyama, J., Okamatsu, H Tags: Open access, Cardiovascular medicine Source Type: research

Multimorbidity of cardiometabolic diseases: a cross-sectional study of patterns, clusters and associated risk factors in sub-Saharan Africa
Conclusion Our findings show that cardiometabolic multimorbidity and lifestyle risk factors cluster in distinct patterns with a disproportionate burden among women, middle-aged, persons in high socioeconomic positions, and those with sedentary lifestyles and obesity. These results provide insights for health systems response in SSA to focus on these clusters as potential targets for integrated care.
Source: BMJ Open - February 9, 2023 Category: General Medicine Authors: Otieno, P., Asiki, G., Wekesah, F., Wilunda, C., Sanya, R. E., Wami, W., Agyemang, C. Tags: Open access, Cardiovascular medicine Source Type: research

Recovery beyond functional restoration: a systematic review of qualitative studies of the embodied experiences of people who have survived a stroke
Conclusion The findings demonstrated that the embodied experiences of people who have survived a stroke progressed from feeling disconnected to reconnecting with themselves, others and the world. Stroke recovery should not only be limited to functional restoration. Approaching ‘re-embodiment’, the realignment between oneself and one’s body, is crucial in reintegrating with others and the world on the trajectory toward recovery. PROSPERO registration number CRD42020183125
Source: BMJ Open - February 9, 2023 Category: General Medicine Authors: Lo, T. L. T., Lee, J. L. C., Ho, R. T. H. Tags: Open access, Rehabilitation medicine Source Type: research

Efficacy and safety of pharmacological interventions for managing sickle cell disease in children and adolescents: protocol for a systematic review with network meta-analysis
This study refers to a systematic review, so no ethics approval is necessary. We intent to publish our findings in international, peer-reviewed journal. Data will also be presented to peers in scientific events. Additionally, the results obtained in this study may contribute towards the update of therapeutic guidelines and for the development of health policies for SCD. PROSPERO registration number CRD42022328471.
Source: BMJ Open - February 6, 2023 Category: General Medicine Authors: Tonin, F. S., Ginete, C., Fernandez-Llimos, F., Ferreira, J., Delgadinho, M., Brito, M. Tags: Open access, Haematology (incl blood transfusion) Source Type: research

Neurology care and the long-term outcomes of atrial fibrillation-related ischaemic stroke in China: median 3-year outcome from a high volume academic tertiary hospital
Conclusions Secondary stroke prevention in AF patients associated with neurology care is challenging in China, as manifested by a lower AF detection rate, significant underuse of OACs, high mortality and recurrent stroke rate. Efforts to increasing the AF detection rate and reinforce education on neurologists should be made to improve neurology care and intensify posthospital management in such patients.
Source: BMJ Open - February 2, 2023 Category: General Medicine Authors: Wang, Z., Wu, N., Wu, F., Zhang, L., Gao, X., Yang, Y., Li, M., Wan, Q., Chen, M. Tags: Open access, Health policy Source Type: research

Using body cameras to quantify the duration of a Code Stroke and identify workflow issues: a continuous observation workflow time study
Conclusions Codes are time intensive. Time spent on decision-making was a relatively small component of the overall Code duration. Data from body cameras can provide granular data on all aspects of Code workflow to inform potential areas for improvement at individual centres.
Source: BMJ Open - January 25, 2023 Category: General Medicine Authors: Wong, J. Z. W., Park, P. S. W., Frost, T., Stephens, K., Newk-Fon Hey Tow, F. K., Garcia, P. G., Senanayake, C., Choi, P. M. C. Tags: Open access, Neurology Source Type: research

Promoting adherence to stroke secondary prevention behaviours by imparting behaviour change skills: protocol for a single-arm pilot trial of Living Well After Stroke
Introduction Survivors of stroke have an elevated risk of recurrent stroke. Prompt intervention to support healthy lifestyle modification following an initial stroke is crucial for effective secondary prevention of stroke. However, many patients do not receive adequate postdischarge support for secondary prevention, particularly if not referred to inpatient rehabilitation. Living Well After Stroke is a health promotion programme based on the health action process approach (HAPA), which is designed to support this underserviced group to improve and self-manage secondary prevention behavioural performance (eg, diet, exercise...
Source: BMJ Open - January 24, 2023 Category: General Medicine Authors: Smith, S., Parkinson, J., Caitens, T., Sanders, A., Murphy, L., Hamilton, K. Tags: Open access, Public health Source Type: research

PREP Plus combined postrehabilitation programme to support upper limb recovery in community-dwelling stroke survivors: protocol for a mixed-methods, cluster-assigned feasibility study
This study has been approved by the Health and Social Care Research Ethics Committee A, IRAS project ID (278620). Participants will provide informed consent prior to participating in the study. Information outlining the purpose of the study, what data will be collected and how the data will be managed will be provided. Results will be published in peer-reviewed journals and any published data will be available on the university data repository. The project management group will advise on different avenues for dissemination to ensure it reaches appropriate audiences. Trial registration number NCT05090163.
Source: BMJ Open - January 20, 2023 Category: General Medicine Authors: Pedlow, K., McDonough, S., Klempel, N., Hylands, J., Hughes, N., Campbell, Z., Eng, J. J., Stephenson, A., Kennedy, N. Tags: Open access, Rehabilitation medicine Source Type: research

Effectiveness of cerebellar vermis intermittent theta-burst stimulation in improving trunk control and balance function for patients with subacute stroke: a randomised controlled trial protocol
This study will be a prospective single-centre double-blind randomised controlled clinical trial with a 3-week intervention and 3-week follow-up. Eligible participants will be randomly allocated to the experimental group or the control group in a 1:1 ratio. After routine conventional physical therapy, patients in the experimental group will receive cerebellar vermis iTBS, whereas patients in the control group will receive sham stimulation. The overall intervention period will be 5 days a week for 3 consecutive weeks. The outcomes will be measured at baseline (T0), 3 weeks postintervention (T1) and at the 3-week follow-up (...
Source: BMJ Open - January 11, 2023 Category: General Medicine Authors: Chen, Y., Su, W., Gui, C.-F., Guo, Q.-F., Tan, H.-X., He, L., Jiang, H.-H., Wei, Q.-C., Gao, Q. Tags: Open access, Rehabilitation medicine Source Type: research

Effect of CPAP on cognitive function in stroke patients with obstructive sleep apnoea: a meta-analysis of randomised controlled trials
Conclusions Early initiation of CPAP treatment might contribute to improvement in global cognition in stroke patients with OSA. This study had the following limitations: the sample size in each included study was relatively small; the scales related to cognitive assessment or subjective sleepiness were inconsistent; and the methodological quality was not high. Future trials should focus on including a greater number of stroke patients with OSA undergoing CPAP treatment. PROSPERO registration number CRD42020214709.
Source: BMJ Open - January 10, 2023 Category: General Medicine Authors: Yang, Y., Wu, W., Huang, H., Wu, H., Huang, J., Li, L., Wang, L. Tags: Open access, Neurology Source Type: research

Drivers of healthcare costs in patients with ischaemic stroke: a hospital-based retrospective cohort study
Conclusion The number of admitted days was the most important driver of costs in all subgroups of patients with ischaemic stroke. This implicates that to reduce healthcare costs for patients who had a stroke, focus should be on reducing length of hospital stay.
Source: BMJ Open - January 3, 2023 Category: General Medicine Authors: Mensing, L. A., Kappelle, L. J., Koffijberg, H., Ruigrok, Y. M. Tags: Open access, Neurology Source Type: research

Vitamin-K-antagonist phenprocoumon versus direct oral anticoagulants in patients with atrial fibrillation: a real-world analysis of German claims data
Conclusions The small superiority or non-inferiority of DOACs over warfarin seen in the RCTs might not translate into relevant advantages of DOACs over phenprocoumon. To confirm the hypothesis, an RCT with phenprocoumon is needed. Next to the safety and effectiveness assessments other factors might also play a substantial role in the decision on the right OAC for stroke prevention.
Source: BMJ Open - January 2, 2023 Category: General Medicine Authors: Warkentin, L., Klohn, F., Deiters, B., Kühlein, T., Hueber, S. Tags: Open access, Pharmacology and therapeutics Source Type: research