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Total 186 results found since Jan 2013.
Articles Prophylactic antibiotics after acute stroke for reducing pneumonia in patients with dysphagia (STROKE-INF): a prospective, cluster-randomised, open-label, masked endpoint, controlled clinical trial
Antibiotic prophylaxis cannot be recommended for prevention of post-stroke pneumonia in patients with dysphagia after stroke managed in stroke units.
Source: LANCET - September 3, 2015 Category: Journals (General) Authors: Lalit Kalra, Saddif Irshad, John Hodsoll, Matthew Simpson, Martin Gulliford, David Smithard, Anita Patel, Irene Rebollo-Mesa, STROKE-INF Investigators Tags: Articles Source Type: research
Articles Effectiveness of intermittent pneumatic compression in reduction of risk of deep vein thrombosis in patients who have had a stroke (CLOTS 3): a multicentre randomised controlled trial
IPC is an effective method of reducing the risk of DVT and possibly improving survival in a wide variety of patients who are immobile after stroke.
Source: LANCET - August 10, 2013 Category: Journals (General) Authors: CLOTS (Clots in Legs Or sTockings after Stroke) Trials Collaboration Tags: Articles Source Type: research
Correspondence Thrombolysis in acute stroke – Authors' reply
We thank the correspondents for their interest in our meta-analysis of individual patient data from trials of alteplase for patients with acute ischaemic stroke.1
Source: LANCET - April 10, 2015 Category: Journals (General) Authors: Jonathan Emberson, Kennedy R Lees, Patrick Lyden, Colin Baigent, Peter Sandercock, Werner Hacke, on behalf of the Stroke Treatment Trialists' Collaboration Tags: Correspondence Source Type: research
Articles Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010
Although age-standardised rates of stroke mortality have decreased worldwide in the past two decades, the absolute number of people who have a stroke every year, stroke survivors, related deaths, and the overall global burden of stroke (DALYs lost) are great and increasing. Further study is needed to improve understanding of stroke determinants and burden worldwide, and to establish causes of disparities and changes in trends in stroke burden between countries of different income levels.
Source: LANCET - January 17, 2014 Category: Journals (General) Authors: Valery L Feigin, Mohammad H Forouzanfar, Rita Krishnamurthi, George A Mensah, Myles Connor, Derrick A Bennett, Andrew E Moran, Ralph L Sacco, Laurie Anderson, Thomas Truelsen, Martin O'Donnell, Narayanaswamy Venketasubramanian, Suzanne Barker-Collo, Carle Tags: Articles Source Type: research
Comment Preventive antibiotic therapy in stroke: PASSed away?
Stroke not only impairs neurological function but also leads to severe medical complications,1 of which infections, especially pneumonia, are the most important.2 In the past 10 years, epidemiological data have consistently shown that post-stroke infections are associated with increased mortality and poor neurological outcomes.3–5 Dysphagia and a stroke-induced immunodepressive state are risk factors for post-stroke infections.6 Despite general measures for infection prevention, pneumonia remains a common and severe clinical challenge, even for patients treated in specialised stroke units5,7 that are known to reduce the ...
Source: LANCET - January 20, 2015 Category: Journals (General) Authors: Andreas Meisel Tags: Comment Source Type: research
Correspondence Parenteral antibiotics are not enough to prevent pneumonia in stroke – Authors' reply
The susceptibility of patients with stroke to pneumonia has been well recognised,1 and its cause is multifactorial.2 Luciano Silvestri and colleagues rightly point out pathophysiological differences between early pneumonia after stroke, defined as within the first week after stroke onset, and late pneumonia, defined as after the first week. The Pneumonia In Stroke ConsEnsuS (PISCES) group has recently recommended reserving the term stroke-associated pneumonia for the spectrum of lower respiratory tract infections within the first 7 days after stroke onset.
Source: LANCET - August 14, 2015 Category: Journals (General) Authors: Diederik van de Beek, Matthijs Brouwer, Paul Nederkoorn Tags: Correspondence Source Type: research
Editorial Thrombolysis for stroke: clinical judgment at its apogee
In the Correspondence section of today's Lancet, we publish a selection of letters challenging the report by Jonathan Emberson and colleagues on the effect of treatment delay, age, and stroke severity on the effects of thrombolysis with alteplase for acute ischaemic stroke. Emberson and colleagues concluded from their meta-analysis of 6756 patients that despite early increases in fatal intracranial haemorrhage, alteplase improves the overall likelihood of a good stroke outcome at 3–6 months when delivered within 4·5 h of the initial stroke symptoms, with earlier treatment increasing proportional benefit, irrespective of...
Source: LANCET - April 10, 2015 Category: Journals (General) Authors: The Lancet Tags: Editorial Source Type: research
Comment AVERT: a major milestone in stroke research
Prevention of stroke is, of course, the ideal scenario, but with more than 10 million major strokes every year worldwide, acute treatment and rehabilitation should also be optimised. Organised acute stroke care within dedicated stroke units reduces death and dependency after stroke,1 but which elements of such care confer this benefit is uncertain. Systematic prevention of common complications and more expert nursing care undoubtedly contribute, but in the physiologically unstable setting of acute stroke, the benefits and harms of each specific element of care need to be reliably assessed.
Source: LANCET - May 10, 2015 Category: Journals (General) Authors: Peter M Rothwell Tags: Comment Source Type: research
Comment Prevention of stroke-associated pneumonia: where next?
Prevention and treatment of complications, such as infection, are a mainstay of post-stroke care.1,2 However, even with dedicated care in a stroke unit, disorders such as stroke-associated pneumonia are a major challenge;2,3 and since this disorder is a substantial contributor to mortality and morbidity after stroke, new therapeutic approaches are urgently needed.3,4 Experimental studies and phase 2b randomised controlled trials5,6 raised hope that preventive anti-infective treatment with antibiotics might not only control infections, but also improve outcomes after stroke.
Source: LANCET - September 3, 2015 Category: Journals (General) Authors: Andreas Meisel, Craig J Smith Tags: Comment Source Type: research
Comment The benefits of aspirin in early secondary stroke prevention
Aspirin is considered an affordable and widely available, if only modestly effective, thromboprophylactic for secondary stroke prevention. The two large randomised controlled trials of aspirin in acute ischaemic stroke reported that aspirin reduced the odds of early recurrent stroke at 2 –4 weeks by about 12% (odds ratio [OR] 0·88, 95% CI 0·79–0·97) and the odds of death or dependency at the end of follow-up by about 5% (OR 0·95, 0·91–0·99).1 The ten trials of aspirin for long-term secondary prevention in patients with previous transient ischaemic attack (TIA) or ischaem ic stroke reported that aspirin reduced ...
Source: LANCET - May 17, 2016 Category: Journals (General) Authors: Graeme J Hankey Tags: Comment Source Type: research
Comment Stroke is largely preventable across the globe: where to next?
Despite the ever-increasing disease burden of stroke in the world,1 accurate data on stroke risk factors are still scarce. In the first phase of the INTERSTROKE study,2 more than 90% of strokes (ischaemic stroke and intracerebral haemorrhage) were attributed to just ten risk factors. However, the study was restricted to developing countries only, and was not powered to explore age, sex, ethnicity, and regional variations in the effect of risk factors or pathological type of stroke, such as ischaemic stroke and intracerebral haemorrhage.
Source: LANCET - July 14, 2016 Category: Journals (General) Authors: Valery L Feigin, Rita Krishnamurthi Tags: Comment Source Type: research
Correspondence Risk of mortality and stroke after atrial fibrillation
Jeff Healey and colleagues1 reported that patients with rheumatic heart disease had a lower risk of stroke compared with patients without the disease, and that when risk factors and age were adjusted, their stroke risks were similar, which is contrary to traditional opinion. However, the order of events between rheumatic heart disease and atrial fibrillation might not have been considered properly in this paper. In patients with atrial fibrillation, stroke is mostly caused by red thrombus, whereas verrucous vegetation causes stroke in rheumatic heart disease; generally speaking, old red thrombus is more likely to fall off and cause stroke.
Source: LANCET - March 3, 2017 Category: Journals (General) Authors: Zitian Huo Tags: Correspondence Source Type: research
Correspondence Global burden of stroke: an underestimate – Authors' reply
We are pleased to respond to Desmond O'Neill's comments on our paper about the global burden of stroke. We fully agree that the burden of stroke goes far beyond the reported data on incidence, prevalence, mortality, and disability-adjusted life-years. Stroke also has a large physical, psychological, and financial effect on patients, their families, the health-care system, and society. Additionally, as rightly emphasised by O'Neill, stroke is just one of the many manifestations (although the most catastrophic) of cerebrovascular disease, and there are clinically silent minor strokes and occult cerebrovascular disorders that...
Source: LANCET - April 4, 2014 Category: Journals (General) Authors: Valery L Feigin, Mohammad H Forouzanfar, Rita Krishnamurthi, George A Mensah Tags: Correspondence Source Type: research
Comment Sex disparity in the risk of diabetes-associated stroke
In the general population, stroke is more prevalent in men than in women. Men also have a higher age-specific stroke incidence than women, except for women aged 35–44 years and those older than 85 years. Factors such as pregnancy and the use of oral contraceptives are believed to contribute to the increased risk of stroke in women in their mid-30s to mid-40s, and their relative longevity contributes to the higher risk of stroke in older women.
Source: LANCET - June 6, 2014 Category: Journals (General) Authors: Linong Ji Tags: Comment Source Type: research
Articles Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials
Irrespective of age or stroke severity, and despite an increased risk of fatal intracranial haemorrhage during the first few days after treatment, alteplase significantly improves the overall odds of a good stroke outcome when delivered within 4·5 h of stroke onset, with earlier treatment associated with bigger proportional benefits.
Source: LANCET - November 28, 2014 Category: Journals (General) Authors: Jonathan Emberson, Kennedy R Lees, Patrick Lyden, Lisa Blackwell, Gregory Albers, Erich Bluhmki, Thomas Brott, Geoff Cohen, Stephen Davis, Geoffrey Donnan, James Grotta, George Howard, Markku Kaste, Masatoshi Koga, Ruediger von Kummer, Maarten Lansberg, R Tags: Articles Source Type: research
