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Source: JAMA
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Total 276 results found since Jan 2013.
Alteplase vs Aspirin and Functional Outcome in Ischemic Stroke With Minor Nondisabling Neurologic Deficits
This randomized trial compares the effects of intravenous alteplase vs oral aspirin treatment on functional outcomes in patients with minor nondisabling acute ischemic stroke.
Source: JAMA - July 10, 2018 Category: General Medicine Source Type: research
Stroke Rehab Lacking
Most US stroke survivors are not participating in poststroke outpatient rehabilitation, according to aCDC report.
Source: JAMA - July 10, 2018 Category: General Medicine Source Type: research
Patent Foramen Ovale and Risk of Perioperative Stroke
To the Editor Dr Ng and colleagues reported that having a patent foramen ovale (PFO) diagnosed preoperatively was associated with an increased risk of stroke occurring within 30 days after noncardiac surgery. The diagnosis of PFO was made only by transthoracic or transesophageal echocardiography without any evaluation of the magnitude of right-to-left shunting. Moreover, presence and severity of atrial septal aneurysm was not recorded as a risk factor. Large or permanent right-to-left shunting graded either by transcranial Doppler or transthoracic echocardiography bubble test has been associated with an increased risk of p...
Source: JAMA - June 26, 2018 Category: General Medicine Source Type: research
Patent Foramen Ovale and Risk of Perioperative Stroke —Reply
In Reply Dr Rigatelli and Mr Zuin suggest the need to further characterize PFO to identify subgroups of the population with PFO who are at increased risk of perioperative stroke and hence, targets for preoperative optimization.
Source: JAMA - June 26, 2018 Category: General Medicine Source Type: research
Left Atrial Appendage Occlusion and Stroke and Mortality Among Patients Undergoing Cardiac Surgery
This cohort study uses administrative data from a large US database to evaluate whether surgical occlusion of the left atrial appendage (LAAO) during CABG or valve surgery is associated with risk of stroke, mortality, and atrial fibrillation.
Source: JAMA - May 22, 2018 Category: General Medicine Source Type: research
Effects of Vasopressin With vs Without Catecholamine Vasopressors on Adverse Outcomes in Patients With Shock
This meta-analysis compares the effects of vasopressin with vs without catecholamine vasopressors on atrial fibrillation, mortality, stroke, and other adverse outcomes in patients with distributive shock.
Source: JAMA - May 8, 2018 Category: General Medicine Source Type: research
Precision Medicine and Progress in the Treatment of Hutchinson-Gilford Progeria Syndrome
Hutchinson-Gilford progeria syndrome (HGPS) is an ultrarare autosomal dominant genetic disorder, with an incidence of 1 in 4 million live births, for which there is no known cure. Children with HGPS appear normal at birth but present in infancy with severe failure to thrive, accompanied by a prematurely aged appearance, alopecia, and progressive lipoatrophy, joint contractures, skeletal dysplasia, and atherosclerosis, although intellectual development is normal. Accelerated cardiovascular disease results in death due to myocardial infarction or stroke at an average age of 14.6 years.
Source: JAMA - April 24, 2018 Category: General Medicine Source Type: research
Guidelines for Adult Stroke Rehabilitation and Recovery
This JAMA Clinical Guidelines Synopsis summarizes the 2016 American Heart Association/American Stroke Association guideline on adult stroke rehabilitation and recovery.
Source: JAMA - February 27, 2018 Category: General Medicine Source Type: research
Organ Dysfunction After Individualized or Standard Blood Pressure Management
To the Editor Dr Futier and colleagues concluded that management targeting an individualized SBP minimized the risk of postoperative organ dysfunction compared with standard management. The authors used a composite primary outcome. Composite outcomes should include components that are of comparable severity and occur with similar frequency. It was not appropriate to combine the less severe and more common RIFLE (risk, injury, failure, loss of kidney function, and end-stage kidney disease) stage risk with the more severe and less common myocardial infarction, nor a Glasgow Coma Scale score of 14 or less with stroke. The inc...
Source: JAMA - February 20, 2018 Category: General Medicine Source Type: research
Is Patent Foramen Ovale a Risk Factor for Perioperative Stroke?
Perioperative stroke is one of the most feared complications of any surgery or invasive medical procedure. Perioperative stroke occurs in less than 1% of patients undergoing general surgery, but the risk is several fold higher with cardiac surgery, carotid revascularization, other cerebrovascular procedures, and thoracic aortic repair. Given the volume of these interventions, perioperative and periprocedural stroke likely account for at least 5% of the approximately 800 000 strokes that occur each year in the United States, yet stroke in this setting remains understudied.
Source: JAMA - February 6, 2018 Category: General Medicine Source Type: research
Association of Preoperatively Diagnosed Patent Foramen Ovale With Perioperative Ischemic Stroke
This cohort study compares risk of ischemic stroke within 30 days postsurgery among adult noncardiac surgery patients with patent foramen ovale (PFO) vs without PFO.
Source: JAMA - February 6, 2018 Category: General Medicine Source Type: research
Prophylactic Low-Dose Oxygen for Patients With Acute Stroke
To the Editor Dr Roffe and colleagues reported that prophylactic low-dose oxygen therapy during the first 3 days after stroke in nonhypoxic adults did not reduce disability or death at 3 months.
Source: JAMA - February 6, 2018 Category: General Medicine Source Type: research
Prophylactic Low-Dose Oxygen for Patients With Acute Stroke —Reply
In Reply Dr Saber and colleagues note that many patients in SO2S had mild strokes and suggest that this may explain the lack of observed benefit (OR, 0.97 [95% CI, 0.89-1.05]) from low-dose oxygen supplementation for 72 hours after acute stroke. To support this argument, they highlight the nonsignificant improved functional outcome (OR, 1.28 [95% CI, 0.94-1.73] favoring oxygen) in patients with NIHSS scores of 15 to 20. While this might suggest potential benefit, the difference between oxygen and no oxygen in this subgroup was not statistically significant, nor was the test for heterogeneity between this result and that in...
Source: JAMA - February 6, 2018 Category: General Medicine Source Type: research
Left Atrial Appendage Occlusion for Prevention of Thromboembolic Events
More than 600 000 patients in the United States undergo cardiac operations each year, including coronary artery bypass graft operations, valve repair or replacement procedures, or other more complex operations. Patients with atrial fibrillation (AF) who undergo these procedures are at risk for postoperative th romboembolic complications, with the left atrial appendage being a common site of thrombus formation. Occlusion of the left atrial appendage may reduce the risk of thromboembolic stroke and can be performed intraoperatively at the time of cardiac operations. The most common surgical approaches to ac hieve left atr...
Source: JAMA - January 23, 2018 Category: General Medicine Source Type: research
Orpheus ’ Descent Into the Neurointensive Care Unit
This Arts and Medicine essay describes a 2014 staging of the operaOrph ée et Eurydice , directed by Romeo Castellucci, in which Eurydice ’s residence in the Underworld is represented by a patient with locked-in syndrome from a vertebrobasilar stroke.
Source: JAMA - January 23, 2018 Category: General Medicine Source Type: research
