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Source: BMJ Open

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Total 555 results found since Jan 2013.

Cardiovascular-related conditions and risk factors in primary care for deprived communities before and during the COVID-19 pandemic: an observational study in Northern England
Conclusion Recorded CVD-related risk factors and conditions remained comparable before and during COVID-19. These are higher in the Deep End than in England and similar or lower than the non-Deep End, with a higher optimal statin prescribing rate. However, it was not possible to control for age and sex. More work is needed to estimate the consequences of the pandemic on disadvantaged communities and to compare whether the findings are replicated in other areas of deprivation.
Source: BMJ Open - November 22, 2022 Category: General Medicine Authors: Fu, Y., Price, C., Haining, S., Gaffney, B., Julien, D., Whitty, P., Newton, J. L. Tags: Open access, Public health, COVID-19 Source Type: research

Identifying factors explaining practice variation in secondary stroke prevention in primary care: a cohort study based on all patients with ischaemic stroke in the Stockholm region
Conclusions A high practice variation for dispensation of all secondary preventive drugs was observed. Patient and PCC level factors indicating good continuity of care and high level of general practitioner education were associated with higher use of statins. Findings are of importance to policymakers as well as individual providers of care, and more research and actions are needed to minimise inequality in healthcare.
Source: BMJ Open - November 21, 2022 Category: General Medicine Authors: Wolf, M., Hasselström, J. K., Carlsson, A., Euler, M. v., Hasselström, J. Tags: Open access, Neurology Source Type: research

Scoping review protocol of the use of codesign methods in stroke intervention development
Introduction Codesign is an emerging research method to enhance intervention development by actively engaging non-researchers (eg, people who have had a stroke, caregivers and clinicians) in research. The involvement of non-researchers in research is becoming increasingly popular within health studies as it may produce more relevant and effective findings. The stroke population commonly exhibits challenges such as aphasia and cognitive changes that may limit their participation in codesign. However, the use of codesign within the stroke literature has not been comprehensively reviewed. This scoping review will determine: (...
Source: BMJ Open - November 21, 2022 Category: General Medicine Authors: Singh, H., Nelson, M. L., Martyniuk, J., Colquhoun, H., Munce, S., Cameron, J. I., Kokorelias, K. M., Pakkal, O., Kuluski, K. Tags: Open access, Health services research Source Type: research

Time intervals and distances travelled for prehospital ambulance stroke care: data from the randomised-controlled ambulance-based Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2)
Conclusion We completed a large prehospital stroke trial involving a simple-to-administer intervention across multiple ambulance services. The time from onset to randomisation and modest distances travelled support the applicability of future large-scale paramedic-delivered ambulance-based stroke trials in urban and rural locations. Trial registration number ISRCTN26986053.
Source: BMJ Open - November 21, 2022 Category: General Medicine Authors: Dixon, M., Appleton, J. P., Scutt, P., Woodhouse, L. J., Haywood, L. J., Havard, D., Williams, J., Siriwardena, A. N., Bath, P. M., on behalf of the RIGHT-2 Investigators Tags: Open access, Neurology Source Type: research

Chronic non-communicable diseases: Hainan prospective cohort study
Purpose The Hainan Cohort was established to investigate the incidence, morbidity and mortality of non-communicable diseases and their risk factors in the community population. Participants The baseline investigation of the Hainan Cohort study was initiated in five main areas of Hainan, China, from June 2018 to October 2020. A multistage cluster random-sampling method was used to obtain samples from the general population. Baseline assessments included a questionnaire survey, physical examination, blood and urine sample collection, and laboratory measurements, and outdoor environmental data were obtained. Findings to dat...
Source: BMJ Open - November 18, 2022 Category: General Medicine Authors: Gu, X., Lin, L., Zhao, C., Wu, L., Liu, Y., He, L., Lin, G., Lin, Y., Zhang, F. Tags: Open access, Public health Source Type: research

Measuring the burden of comorbidity for ischaemic heart disease and four common non-communicable diseases in Iran, 1990-2017: a modelling study based on global burden of diseases data
Conclusion Of the four comorbidities studied, the highest burden was due to the coexistence of MDD with IHD. Our results highlight the importance of addressing the burden of comorbidities when studying the burden of IHD or any other non-communicable disease.
Source: BMJ Open - November 17, 2022 Category: General Medicine Authors: Mansourian, M., Ghasemi, K., Haghdoost, A., Kopec, J. A., Sarrafzadegan, N., Islam, S. M. S. Tags: Open access, Epidemiology Source Type: research

New device multisegment Mechanical Thrombectomy System for endovascular treatment in acute ischaemic stroke: study protocol for a prospective, multicentre, randomised controlled trial
Introduction Endovascular treatment is the standard of care for acute large vessel occlusion (LVO) in the anterior circulation. However, successful complete recanalisation is considerably difficult when the vessels are severely tortuous. At the bend, the stent retriever can distort, collapse and lose its ability to capture the clot due to structural change. The aim of the present study is to evaluate the safety and efficacy of the new thrombectomy device multisegment Mechanical Thrombectomy (MT) System for endovascular treatment of acute ischaemic stroke (AIS). Methods and analysis The present study is a prospective, mult...
Source: BMJ Open - November 16, 2022 Category: General Medicine Authors: Zhong, H., Li, Z., Zhou, T., Li, T., He, Y. Tags: Open access, Neurology Source Type: research

Patients experience of and participation in a stroke self-management programme, My Life After Stroke (MLAS): a multimethod study
Conclusions MLAS was a positive experience for participants but many stroke survivors did not feel it was appropriate for them. Participation in self-management programmes after stroke might be improved by offering them sooner after the stroke and providing a range of delivery options beyond group-based, face-to-face learning. Trial registration number NCT03353519, NIH.
Source: BMJ Open - November 15, 2022 Category: General Medicine Authors: Blatchford, E. G., Aquino, M. R. J., Grant, J., Johnson, V., Mullis, R., Lim, L., Mant, J. Tags: Open access, Public health Source Type: research

Benefit finding in first-ever young and middle-aged patients who had a stroke and their spousal caregivers in China: a longitudinal mixed-methods study protocol
This study is a longitudinal mixed-methods, multicentre study. A total of 142 patients who had a stroke and 142 spousal caregivers will be investigated. Participants will be recruited from four large public hospitals in northern China. Quantitative and qualitative data will be collected at five time points (near discharge and 1, 3, 6 and 12 months following discharge). Validated and reliable questionnaires will be used in quantitative studies. Information on sociodemographic data, BF, functional status, perceived stress, coping styles and mutuality will be collected from the dyads. Qualitative data will be collected via se...
Source: BMJ Open - November 14, 2022 Category: General Medicine Authors: Li, H., Zhang, L., Wang, W., Xiang, D., Zhang, Z., Mei, Y. Tags: Open access, Nursing Source Type: research

Cost-effectiveness of recombinant tissue-type plasminogen activator for acute ischaemic stroke with unknown time of onset: a Markov modelling analysis from the Chinese and US perspectives
Conclusions MRI-guided intravenous r-tPA for patients with AIS with an unknown time of onset is cost-effective in China and cost-saving in the USA.
Source: BMJ Open - November 14, 2022 Category: General Medicine Authors: Zhao, S., Cheng, Y., Tong, X., Han, M., Ji, L., Che, Y., Hu, W., Liu, A. Tags: Open access, Neurology Source Type: research

Multicentre registration of wake-up stroke in China (MCRWUSC): a protocol for a prospective, multicentre, registry-based cohort study
This study is approved by the ethics committee of Shanghai Pudong Hospital (Shanghai, China) and rest of all participating centres. The findings will be disseminated through peer-reviewed publications and conference presentations. PROSPERO registration number ChiCTR2100049133.
Source: BMJ Open - November 10, 2022 Category: General Medicine Authors: Zhang, Z., Yang, H., Tu, Z., Nepal, G., Ojha, R., Xi, Y., Qiao, J., Hu, M., Li, C., Lin, F., Zhou, L., Jin, P., Hou, S. Tags: Open access, Neurology Source Type: research

Incidence of stroke, systemic embolism and bleeding events in patients without anticoagulation based on real-world data in Japan: a retrospective cohort study
Conclusions Approximately one-third of the patients do not receive any anticoagulation in the modern DOAC era in Japan. The SSE rate increases by the CHADS2 score. The SSE rate is low in patients with a CHADS2 score <1, supporting no indication of anticoagulation in current guidelines. In patients with a CHADS2 score >1, the use of anticoagulant drug therapy is recommended because of a higher risk of stroke.
Source: BMJ Open - November 10, 2022 Category: General Medicine Authors: Tanizawa, K., Nishimura, Y., Sera, S., Yaguchi, D., Okada, A., Nishikawa, M., Tamaru, S., Nagai, N. Tags: Open access, Epidemiology Source Type: research

Efficacy and safety of human-derived neural stem cell in patients with ischaemic stroke: study protocol for a randomised controlled trial
Introduction Stroke is the most common cause of neurological disability in adults worldwide. Neural stem cell (NSC) transplantation has shown promising results as a treatment for stroke in animal experiments. The pilot investigation of stem cells in stroke phase 1 and phase 2 trials showed that transplantation of the highest dose (20 million cells) was well tolerated. Preliminary clinical benefits have also been observed. However, the trials were open-label and had a small sample size. Furthermore, human NSCs (hNSCs) were intracerebrally implanted, and some serious adverse events were considered to be related to the surgic...
Source: BMJ Open - November 8, 2022 Category: General Medicine Authors: Xie, C., Wang, K., Peng, J., Jiang, X., Pan, S., Wang, L., Wu, Y., Guan, Y. Tags: Open access, Neurology Source Type: research

Prevalence and associated factors of anxiety among the population in an urban area of China: a cross-sectional study
Conclusions Our findings showed an alarmingly high prevalence of anxiety in the population living in an urban area of China. Sleep time <6 hours and waking up suffocating had a significant association with anxiety. These findings suggest that future anxiety prevention programmes in urban areas should incorporate interventions targeted at these factors, such as improving residents’ sleep quality.
Source: BMJ Open - November 8, 2022 Category: General Medicine Authors: Wang, Q., Zhang, J., Yao, H., Jin, P., Zhao, F., Zhang, P. Tags: Open access, Mental health Source Type: research

What should nurses do on post-stroke depression? A global systematic assessment of clinical practice guidelines
Conclusions This study indicated deficiencies and variability in current available CPGs. Based on six high-quality CPGs, we developed an algorithm to facilitate nurses’ adherence to CPGs and contribute to evidence-based nursing. In the future, more nursing specialists should participate in the formulation of the CPGs to provide nursing insights.
Source: BMJ Open - November 8, 2022 Category: General Medicine Authors: Jiang, L., Cheng, L., Li, X., Yan, J. Tags: Open access, Nursing Source Type: research