Filtered By:
Source: LANCET
This page shows you your search results in order of date. This is page number 9.
Order by Relevance | Date
Total 186 results found since Jan 2013.
Case Report Snowflakes in the heart: an ultrasonic marker of severe hypercoagulability
A 58-year-old woman with metastatic breast cancer and Coombs-positive autoimmune haemolytic anaemia presented in April, 2014, after developing right arm weakness 8 hours into a long-haul flight. ECG and telemetry showed normal sinus rhythm. Brain MRI showed multiple small foci of restricted diffusion in the anterior, middle, and posterior cerebral artery territories suggestive of cardioembolic stroke, with widespread microhaemorrhages. Carotid ultrasound showed normal carotid and vertebral artery anatomy.
Source: LANCET - January 16, 2015 Category: Journals (General) Authors: Louis W Wang, John J Grygiel, John H O'Neill, Diane Fatkin, Michael P Feneley Tags: Case Report 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
Comment Alteplase in acute ischaemic stroke: the need for speed
Doctors treating patients who have had an acute ischaemic stroke must feel the need for speed more feverishly than a racing driver. Stroke does not hurt. There is none of the pain that might be registered on the face of a patient with acute myocardial infarction or the visceral sight of blood in the case of trauma to evoke a sense of immediacy. Yet stroke is exactly like acute myocardial infarction and acute trauma in the need for very fast treatment.
Source: LANCET - November 28, 2014 Category: Journals (General) Authors: Michael D Hill, Shelagh B Coutts Tags: Comment Source Type: research
Correspondence Alteplase for ischaemic stroke
Roger Shinton's Correspondence (Aug 23, p 659) called into question the evidence supporting the safe use of alteplase in patients with acute ischaemic stroke. Ian Hudson, of the Medicines and Healthcare Products Regulatory Agency (MHRA), responded to this Correspondence by convening an expert working group to review the benefits and risks of this drug. A review of reports of spontaneous adverse drug reactions (ADR) should inform this query, but a substantial level of under-reporting might restrict its use.
Source: LANCET - October 25, 2014 Category: Journals (General) Authors: Daniel Burrage Tags: Correspondence Source Type: research
Comment Blood pressure in acute stroke: which questions remain?
In ENOS, one of the largest randomised trials of blood pressure-lowering in acute stroke now published in The Lancet, Philip Bath and colleagues1 assessed whether blood pressure could be safely lowered with a daily glyceryl nitrate patch for 7 days after acute stroke, and whether antihypertensive drugs should be continued or withdrawn. Blood pressure is increased in about 70% of patients with acute stroke and often falls spontaneously over the next few days.2 The potential causes of this transient rise include disturbed cerebral autoregulation, damage or compression of brain regions that regulate blood pressure, neuroendoc...
Source: LANCET - October 21, 2014 Category: Journals (General) Authors: Peter M Rothwell Tags: Comment Source Type: research
Articles Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial
In patients with acute stroke and high blood pressure, transdermal glyceryl trinitrate lowered blood pressure and had acceptable safety but did not improve functional outcome. We show no evidence to support continuing prestroke antihypertensive drugs in patients in the first few days after acute stroke.
Source: LANCET - October 21, 2014 Category: Journals (General) Authors: The ENOS Trial Investigators Tags: Articles Source Type: research
Comment Do we need to know whether nitrous oxide harms patients?
In The Lancet, Paul Myles and colleagues investigate the association between nitrous oxide exposure and cardiovascular complications such as non-fatal myocardial infarction, stroke, pulmonary embolism, cardiac arrest, and death, within 30 days of surgery, in patients with known or suspected coronary artery disease having major non-cardiac surgery under general anaesthesia. The rationale for this large, multicentre study, which involved more than 7000 patients from 45 centres, was the observation that short-term exposure to nitrous oxide led to significant increases in plasma homocysteine.
Source: LANCET - October 18, 2014 Category: Journals (General) Authors: Martin R Tramèr Tags: Comment Source Type: research
Articles Long-term outcomes after stenting versus endarterectomy for treatment of symptomatic carotid stenosis: the International Carotid Stenting Study (ICSS) randomised trial
Long-term functional outcome and risk of fatal or disabling stroke are similar for stenting and endarterectomy for symptomatic carotid stenosis.
Source: LANCET - October 13, 2014 Category: Journals (General) Authors: Leo H Bonati, Joanna Dobson, Roland L Featherstone, Jörg Ederle, H Bart van der Worp, Gert J de Borst, Willem P Th M Mali, Jonathan D Beard, Trevor Cleveland, Stefan T Engelter, Philippe A Lyrer, Gary A Ford, Paul J Dorman, Martin M Brown, for the Intern Tags: Articles Source Type: research
Clinical Picture Ischaemic scalp ulceration and hair loss
A 46-year-old woman presented to our outpatient clinic in June, 2013, with frequent collapse, ischaemic scalp ulcerations, and hair loss (). She had undergone carotid endarterectomy in 2005, after a small right hemispheric stroke, and had no other medical history apart from hypercholesterolaemia. She had no previous dermatological or scalp problems. She took clopidogrel 75 mg, aspirin 80 mg, and simvastatin 40 mg daily.
Source: LANCET - October 11, 2014 Category: Journals (General) Authors: Çağdaş Ünlü, Jean-Paul P M de Vries Tags: Clinical Picture Source Type: research
This Week in Medicine September 6–12, 2014
The US Preventive Services Task Force has recommended that health-care providers should offer intense behavioural counselling to overweight patients with risk factors for heart disease and stroke, consisting of an individualised diet and exercise plan. However, issues in implementation of this new framework include a lack of time, skill, and available resources.
Source: LANCET - September 5, 2014 Category: Journals (General) Authors: The Lancet Tags: This Week in Medicine Source Type: research
Editorial Evidence and doubt in the translation of research into care
If patients, health systems, and societies are to benefit from research, then research findings need to be incorporated into practice. That this has not yet happened widely for the treatment of acute ischaemic stroke, despite its increasing incidence in ageing populations, the ruinous sequelae without treatment, and a licensed medical intervention proven to improve outcomes, raises serious questions about the extent to which patients are actually benefiting from evidence.
Source: LANCET - August 23, 2014 Category: Journals (General) Authors: The Lancet Tags: Editorial Source Type: research
Correspondence Questions about authorisation of alteplase for ischaemic stroke
Stroke thrombolysis can cause potentially fatal intracerebral haemorrhage, but advocates claim the potential reduction in disability justifies this risk. Alteplase was authorised following the National Institute of Neurological Disorders and Stroke (NINDS) trial. A 2004 review raised concerns over the trial data. Outcomes across the centres differed considerably. Bias could explain the observation that the plot of outcome (modified Rankin score 0–1) against number of patients recruited does not resemble the expected symmetrical funnel ().
Source: LANCET - August 23, 2014 Category: Journals (General) Authors: Roger Shinton Tags: Correspondence Source Type: research
Correspondence Alteplase for ischaemic stroke—responses
Roger Shinton's Correspondence contains numerous factual inaccuracies and statements that are not consistent with the text of the cited references, and do not in our opinion merit a reconsideration of the authorisation of alteplase in acute ischaemic stroke.
Source: LANCET - August 23, 2014 Category: Journals (General) Authors: Peter Sandercock, Richard Lindley, Joanna M Wardlaw, Gordon Murray, Will Whiteley, Geoff Cohen Tags: Correspondence Source Type: research
