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Total 186 results found since Jan 2013.

Comment The social sciences, humanities, and health
Humanities and social sciences have had many positive influences on health experiences, care, and expenditure. These include on self-management for diabetes, provision of psychological therapy, handwashing, hospital checklists, the Scottish Government's stroke guidelines, England's tobacco control strategy, the response to the Ebola outbreak in west Africa and Zika virus in Brazil, and many more.1 Researchers have shown time and time again the political, practical, economic, and civic value of education and research in disciplines like anthropology, history, and philosophy.
Source: LANCET - April 13, 2018 Category: General Medicine Authors: Martyn Pickersgill, Sarah Chan, Gill Haddow, Graeme Laurie, Devi Sridhar, Steve Sturdy, Sarah Cunningham-Burley Tags: Comment Source Type: research

Correspondence Safe travels during hurricanes
On the evening of Sept 10, 2017, in Miami (FL, USA), at a time when Hurricane Irma had reached category 4 status, a 91-year-old woman had a stroke. As per local hurricane protocol, emergency medical services are halted when storm winds reach category 3 status or higher. With no viable alternative transportation to navigate through strong winds and the substantial storm surge (appendix), the patient was brought to the emergency room in the backseat of her granddaughter's car.
Source: LANCET - March 9, 2018 Category: General Medicine Authors: Ayush Amin, Robert M Starke, Jason T Salsamendi Tags: Correspondence Source Type: research

Editorial Stroke —acting FAST at all ages
On Feb 1, Public Health England released new estimates for the incidence of first stroke in England and relaunched its Act FAST campaign. FAST is aimed at the public, encouraging them to call 999 —the UK's emergency number—if there are tell-tale signs of stroke in themselves or anyone they see. FAST stands for face, arms, speech, and time (to call). The new estimates showed that about 57 000 new strokes and 32 000 stroke-related deaths occur every year in England. Of those who have e xperienced a stroke, about a quarter leave hospital with moderate or severe disability.
Source: LANCET - February 9, 2018 Category: General Medicine Authors: The Lancet Tags: Editorial Source Type: research

Comment Learning from TARDIS: time for more focused trials in stroke prevention
Antithrombotic therapy immediately following stroke is important to minimise the risk of recurrence, but the optimum choice and number of drugs to use are unclear, and efficacy in preventing thrombosis needs to be weighed against bleeding risk. In The Lancet, the TARDIS investigators report findings from a randomised trial1 that tested intensive antiplatelet therapy with three agents (aspirin, clopidogrel, and dipyridamole) against therapy based on current UK guidelines2 (either clopidogrel, or aspirin plus dipyridamole) for 30 days in patients with transient ischaemic attack (TIA) or ischaemic stroke.
Source: LANCET - December 20, 2017 Category: General Medicine Authors: Pierre Amarenco Tags: Comment Source Type: research

Articles Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial
Among patients with recent cerebral ischaemia, intensive antiplatelet therapy did not reduce the incidence and severity of recurrent stroke or TIA, but did significantly increase the risk of major bleeding. Triple antiplatelet therapy should not be used in routine clinical practice.
Source: LANCET - December 20, 2017 Category: General Medicine Authors: Philip M Bath, Lisa J Woodhouse, Jason P Appleton, Maia Beridze, Hanne Christensen, Robert A Dineen, Lelia Duley, Timothy J England, Katie Flaherty, Diane Havard, Stan Heptinstall, Marilyn James, Kailash Krishnan, Hugh S Markus, Alan A Montgomery, Stuart Tags: Articles Source Type: research

Comment Secondary prevention shifts into second gear
Aspirin has been a mainstay in the secondary prevention of cardiovascular events since the 1990s.1 In the mid-1990s, the antiplatelet clopidogrel was tested against aspirin in patients with atherosclerotic vascular disease and was found to reduce vascular death, ischaemic stroke, and myocardial infarction by 8 ·7%.2 The combination of clopidogrel and aspirin for secondary prevention to reduce cardiovascular events was tested in patients with symptomatic atherothrombosis; however, no benefit was observed.
Source: LANCET - November 10, 2017 Category: General Medicine Authors: E Magnus Ohman Tags: Comment Source Type: research

Comment Antithrombotic therapy in peripheral artery disease
Peripheral artery disease is a systemic atherothrombotic disease in which plaque builds up in the arteries that carry blood to the limbs. If severe enough, impaired blood flow can cause critical limb ischaemia, which presents as resting pain, ulceration, or gangrene, and might require a limb amputation in the most extreme cases.1 People with peripheral artery disease often have plaque in other arterial beds, and thus are at increased risk for myocardial infarction, ischaemic stroke, and cardiovascular death.
Source: LANCET - November 10, 2017 Category: General Medicine Authors: Jeffrey S Berger Tags: Comment Source Type: research

Articles Drug-eluting stents in elderly patients with coronary artery disease (SENIOR): a randomised single-blind trial
Among elderly patients who have PCI, a DES and a short duration of DAPT are better than BMS and a similar duration of DAPT with respect to the occurrence of all-cause mortality, myocardial infarction, stroke, and ischaemia-driven target lesion revascularisation. A strategy of combination of a DES to reduce the risk of subsequent repeat revascularisations with a short BMS-like DAPT regimen to reduce the risk of bleeding event is an attractive option for elderly patients who have PCI.
Source: LANCET - November 1, 2017 Category: General Medicine Authors: Olivier Varenne, St éphane Cook, Georgios Sideris, Sasko Kedev, Thomas Cuisset, Didier Carrié, Thomas Hovasse, Philippe Garot, Rami El Mahmoud, Christian Spaulding, Gérard Helft, José F Diaz Fernandez, Salvatore Brugaletta, Eduardo Pinar-Bermudez, Jos Tags: Articles Source Type: research

Comment Circadian rhythm and ischaemia –reperfusion injury
Every day, thousands of patients are exposed to ischaemia-reperfusion injury, either in uncontrolled circumstances (eg, acute myocardial infarction or ischaemic stroke) or under controlled conditions (eg, heart, kidney, or liver surgery, or transplantation). Whatever the clinical setting is, the extent of final tissue damage (ie, infarct size) is mainly determined by the duration of the ischaemic phase and the amount of jeopardised tissue.1 Experimental and proof-of-concept clinical trials have shown that infarct size results from the addition of an ischaemia-induced injury plus a reperfusion-induced injury, and that timel...
Source: LANCET - October 26, 2017 Category: General Medicine Authors: Thomas Bochaton, Michel Ovize Tags: Comment Source Type: research

Comment Hypertension in China: the gap between policy and practice
The high prevalence of hypertension in China is well known, with stroke being the most common cause of death and disability.1 Two large nationwide studies reported in The Lancet2,3 highlight that although the prevalence of hypertension in China is similar to that suggested in previous studies, it is simple deficiencies in the country's health system that make a large contribution to the disease burden. Both studies used data from the PEACE (Patient-Centred Evaluative Assessment of Cardiac Events) Million Persons Project (MPP), which enrolled 1 ·7 million adults aged 35–75 years from across China.
Source: LANCET - October 25, 2017 Category: General Medicine Authors: Therese Hesketh, Xudong Zhou Tags: Comment Source Type: research

Comment A global coalition for the fight against heart disease and stroke
As political leaders prepare for the third UN High-level Meeting on Non-communicable Diseases (NCDs) in 2018, the World Heart Federation (WHF) is bringing together a global coalition of international, regional, and national stakeholders in cardiovascular diseases (CVDs) to drive the urgent action needed to combat heart disease and stroke.
Source: LANCET - October 16, 2017 Category: General Medicine Authors: David Wood, Jean-Luc Eisel é Tags: Comment Source Type: research

Comment Physical activity lowers mortality and heart disease risks
In The Lancet, Scott A Lear and colleagues1 report results from a large cohort of 130  843 participants from 17 countries (including four low-income countries and seven middle-income countries) investigating the beneficial dose-dependent associations of all forms of physical activity with reduced mortality and cardiovascular disease risks.1 This is another confirmation that physica l activity has definite and dose-dependent benefits for lowering risks of all-cause mortality and cardiovascular disease (heart attacks, stroke, and heart failure).
Source: LANCET - September 21, 2017 Category: General Medicine Authors: Shifalika Goenka, I-Min Lee Tags: Comment Source Type: research

Obituary Gordon Ostlere, alias Richard Gordon
Anaesthetist and author of the successful series of Doctor books. Born in London on Sept 15, 1921, he died after a stroke in Kent, UK, on Aug 11, 2017, aged 95 years.
Source: LANCET - September 8, 2017 Category: General Medicine Authors: Barbara Casassus Tags: Obituary Source Type: research

Articles Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study
High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke. Global dietary guidelines should be reconsidered in light of these findings.
Source: LANCET - August 29, 2017 Category: General Medicine Authors: Mahshid Dehghan, Andrew Mente, Xiaohe Zhang, Sumathi Swaminathan, Wei Li, Viswanathan Mohan, Romaina Iqbal, Rajesh Kumar, Edelweiss Wentzel-Viljoen, Annika Rosengren, Leela Itty Amma, Alvaro Avezum, Jephat Chifamba, Rafael Diaz, Rasha Khatib, Scott Lear, Tags: Articles Source Type: research

Articles A multifaceted intervention to improve treatment with oral anticoagulants in atrial fibrillation (IMPACT-AF): an international, cluster-randomised trial
A multifaceted and multilevel educational intervention, aimed to improve use of oral anticoagulation in patients with atrial fibrillation and at risk for stroke, resulted in a significant increase in the proportion of patients treated with oral anticoagulants. Such an intervention has the potential to improve stroke prevention around the world for patients with atrial fibrillation.
Source: LANCET - August 28, 2017 Category: General Medicine Authors: Dragos Vinereanu, Renato D Lopes, M Cecilia Bahit, Denis Xavier, Jie Jiang, Hussein R Al-Khalidi, Wensheng He, Ying Xian, Andrea O Ciobanu, Deepak Y Kamath, Kathleen A Fox, Meena P Rao, Sean D Pokorney, Otavio Berwanger, Carlos Tajer, Pedro G M de Barros Tags: Articles Source Type: research