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Source: JAMA
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Total 276 results found since Jan 2013.
Article Selection and Possible Risk of Bias
To the Editor Dr Badhiwala and colleagues followed the Cochrane Collaboration standards to conduct a systematic review on the use of mechanical thrombectomy in acute ischemic stroke. Reviewing 8 randomized clinical trials, the authors concluded that, in selected patients, endovascular thrombectomy was associated with improved functional outcomes over standard medical care, without differences in adverse events.
Source: JAMA - April 26, 2016 Category: Journals (General) Source Type: research
Article Selection and Possible Risk of Bias—Reply
In Reply Dr Elgendy and colleagues suggest that the SYNTHESIS trial should have been excluded from our meta-analysis because the endovascular therapy group did not receive intravenous tPA. At the time SYNTHESIS and the Interventional Management of Stroke III (IMS III) were designed, there was limited data on combining intravenous tPA with endovascular thrombectomy. The rationale for combination therapy was the yet unproven assumption that endovascular thrombectomy and intravenous tPA could work in synergy; however, there was also concern about a possible higher risk of hemorrhagic transformation, especially at full doses o...
Source: JAMA - April 26, 2016 Category: Journals (General) Source Type: research
Task-Oriented Rehabilitation and Recovery Following Motor Stroke
This randomized trial assesses the efficacy of a structured, task-oriented motor training program vs usual and customary occupational therapy for patients with stroke with upper extremity motor deficits.
Source: JAMA - February 9, 2016 Category: Journals (General) Source Type: research
Every Little Anniversary
One of the things they tell you after they’ve informed you that you have cancer or that you’ve had a stroke—after they tell you about the resections and the radiation—after they tell you about the aspirin and the clopidogrel—after you’re stable medically but still more than a little unstable emotionally—is to look for a support group. I had the kind of cancer that you learn about in medical school and then never see. I was decades younger than most of my physicians’ patients with stroke. The local support groups didn’t seem to fit me. I looked online at first, but then—even though I found a few people w...
Source: JAMA - December 1, 2015 Category: Journals (General) Source Type: research
Approaches to Prevention of Cardiovascular Disease
In Reply Dr Feigin and colleagues raise 2 concerns regarding the CMS value-based payment model for primary prevention of myocardial infarction and stroke. First, they are concerned that the model continuously rewards only reduction in the highest decile of predicted 10-year cardiovascular event risk, although many events occur in patients at low to moderate risk. Second, they recommend that cardiac risks and management approaches be tailored based on patients’ individualized needs.
Source: JAMA - December 1, 2015 Category: Journals (General) Source Type: research
Screening for Asymptomatic Atrial Fibrillation
This Viewpoint proposes widespread screening for atrial fibrillation using accessible and inexpensive means as a public health intervention for preventing stroke.
Source: JAMA - November 9, 2015 Category: Journals (General) Source Type: research
Thrombectomy for Acute Ischemic Stroke
In this issue of JAMA, Badhiwala and colleagues report findings from a well-conducted systematic review and meta-analysis of randomized clinical trials (RCTs) of endovascular thrombectomy vs standard medical care for patients with acute ischemic stroke. The analysis included 8 trials invovled 2423 patients (1313 who underwent thrombectomy and 1110 who received standard medical care, including recombinant tissue plasminogen activator [rtPA] when indicated), published since 2013. The analysis showed that thrombectomy was associated with increased odds of a more favorable functional outcome (odds ratio [OR], 1.56; 95% CI, 1.1...
Source: JAMA - November 3, 2015 Category: Journals (General) Source Type: research
Endovascular Thrombectomy for Acute Ischemic Stroke
precis
Source: JAMA - November 3, 2015 Category: Journals (General) Source Type: research
Adverse Events Linked With LVADs
The 2 FDA-approved implantable left ventricular assist devices (LVADs) currently on the market have been linked with serious adverse events, including stroke and bleeding complications (http://1.usa.gov/1OQwgwX).
Source: JAMA - September 15, 2015 Category: Journals (General) Source Type: research
Assessing Eligibility for Anticoagulation After Atrial Fibrillation
To the Editor Some points in the review by Drs Lip and Lane about stroke prevention in atrial fibrillation deserve further discussion.
Source: JAMA - September 1, 2015 Category: Journals (General) Source Type: research
Incorrect Study Name
This article was corrected online.
Source: JAMA - August 25, 2015 Category: Journals (General) Source Type: research
Intervention for Acute Stroke
To the Editor In a review article on acute stroke intervention, Dr Prabhakaran and colleagues reported that intravenous thrombolysis is a “mainstay” and “standard of care” for patients with moderate to severe neurological deficits who present within 4.5 hours of acute ischemic stroke. However, the article did not report methods for article selection, critical appraisal, data extraction, or synthesis. Selective citation of supporting trials without commenting on all the available trials or the largest randomized trial supports a conclusion that does not match the totality of the data.
Source: JAMA - August 11, 2015 Category: Journals (General) Source Type: research
Thrombectomy After Stroke Improves Outcomes
Two recent multicenter randomized clinical trials demonstrated that, compared with tissue plasminogen activator (tPA) alone, endovascular thrombectomy using the Solitaire stent retriever decreased severity of global disability (as measured on the modified Rankin scale) and improved rates of functional independence (score of 0-2 on the modified Rankin scale) at 90 days for some patients who had an acute ischemic stroke. Both studies included only patients who had a confirmed occlusion of the proximal anterior intracranial circulation and who did not have a large infarct.
Source: JAMA - July 28, 2015 Category: Journals (General) Source Type: research
Preventing Stroke in People With Atrial Fibrillation
Atrial fibrillation is an abnormal heart rhythm that can disrupt the normal flow of blood in the heart.
Source: JAMA - July 21, 2015 Category: Journals (General) Source Type: research
