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Source: JAMA

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Total 276 results found since Jan 2013.

Stroke and Cognitive Decline
Stroke and cognitive impairment are common among older persons. It is estimated that the lifetime risk for stroke is approximately 1 in 5 for women and 1 in 6 for men, and almost one-third of persons with stroke, which typically may involve motor, sensory, or other deficits, may have a significant degree of cognitive impairment within several months of the event. Furthermore, silent strokes are more common than clinically manifest stroke events but pose significant danger because they are harbingers of both future stroke and cognitive dysfunction. It is estimated that as many as 1 in 10 adults experience a silent stroke by...
Source: JAMA - July 7, 2015 Category: Journals (General) Source Type: research

Trajectory of Cognitive Decline After Incident Stroke
This prospective cohort study reports that incident stroke among participants aged 45 years or older without cognitive impairment was associated with acute decline in cognitive function and also accelerated and persistent cognitive decline over 6 years.
Source: JAMA - July 7, 2015 Category: Journals (General) Source Type: research

Edoxaban (Savaysa), a New Oral Anticoagulant
This From the Medical Letter article reviews the pharmacokinetics and indications for edoxaban, an oral anticoagulant for the treatment of venous thromoboembolism and prevention of stroke in patients with AF.
Source: JAMA - July 7, 2015 Category: Journals (General) Source Type: research

Lowering Blood Pressure in Patients With Diabetes
To the Editor In their meta-analysis, Dr Emdin and colleagues stated that for persons with diabetes and a baseline systolic blood pressure lower than 140 mm Hg, they observed “lower risks of stroke, retinopathy, and progression of albuminuria,” and therefore recommended further blood pressure lowering for these patients “in contrast with the recommendations of the JNC 8 [eighth Joint National Committee] guidelines.” However, Figure 3 in the article showed no significant reduction in retinopathy with a blood pressure lower than 140 mm Hg, and it is clear from eFigures 4 and 8 that the findings for stroke and albumin...
Source: JAMA - June 2, 2015 Category: Journals (General) Source Type: research

Stroke Prevention in Atrial Fibrillation
This narrative review summarizes stroke risk prediction tools and strategies to prevent stroke in patients with atrial fibrillation.
Source: JAMA - May 19, 2015 Category: Journals (General) Source Type: research

ED Visits for Strokes Decline While Imaging Rates Increase
As mortality rates for stroke have declined, so too have emergency department (ED) visits for ischemic strokes or transient ischemic strokes (TIAs). At the same time, however, more stroke patients in the ED undergo advanced imaging or are transferred to another hospital than are patients with other diagnoses.
Source: JAMA - May 12, 2015 Category: Journals (General) Source Type: research

Pneumonia and Risk of Cardiovascular Disease
To the Editor The study by Dr Corrales-Medina and colleagues showed that hospitalization for pneumonia was associated with enhanced short-term and long-term risks of cardiovascular disease (CVD), including myocardial infarction, stroke, and fatal coronary artery disease. There are several methodological and clinical issues that need to be addressed to further examine the association between pneumonia and CVD.
Source: JAMA - May 5, 2015 Category: Journals (General) Source Type: research

Device May Replace Warfarin for Some Patients With Atrial Fibrillation
Patients with atrial fibrillation who are at high risk for stroke now have an alternative to long-term warfarin therapy.
Source: JAMA - April 21, 2015 Category: Journals (General) Source Type: research

Acute Stroke Intervention: A Systematic Review
This systematic review summarizes the pathophysiology of acute brain ischemia and infarction and available reperfusion treatments.
Source: JAMA - April 14, 2015 Category: Journals (General) Source Type: research

Aspirin for Cardiovascular Event Prevention in Older Japanese Adults
To the Editor The study by Dr Ikeda and colleagues on low-dose aspirin for primary prevention in patients who are at risk of cardiovascular events was stopped early for futility with regard to the primary outcome, which was “a composite of death from cardiovascular causes (myocardial infarction, stroke, and other cardiovascular causes), nonfatal stroke (ischemic or hemorrhagic, including undefined cerebrovascular events), and nonfatal myocardial infarction.”
Source: JAMA - April 14, 2015 Category: Journals (General) Source Type: research

Endovascular Therapy for Atherosclerotic Intracranial Arterial Stenosis Back to the Drawing Board
This Editorial discusses the need for more randomized clinical trials to evaluate therapeutic approaches for stroke prevention in patients with intracranial arterial stenosis.
Source: JAMA - March 24, 2015 Category: Journals (General) Source Type: research

Effect of a Balloon-Expandable Intracranial Stent vs Medical Therapy on Risk of Stroke in Patients With Symptomatic Intracranial Stenosis The VISSIT Randomized Clinical Trial
Conclusions and RelevanceAmong patients with symptomatic intracranial arterial stenosis, the use of a balloon-expandable stent compared with medical therapy resulted in an increased 12-month risk of added stroke or TIA in the same territory, and increased 30-day risk of any stroke or TIA. These findings do not support the use of a balloon-expandable stent for patients with symptomatic intracranial arterial stenosis.Trial Registrationclinicaltrials.gov Identifier: NCT00816166.
Source: JAMA - March 24, 2015 Category: Journals (General) Source Type: research

Neuroprotective Agent Given Soon After Stroke Shows No Benefit
Although more than 70 neuroprotective agents have failed to show unequivocal benefit in patients with acute ischemic stroke, none of those tested to date were delivered in the hyperacute phase of stroke. However, according to results from the recent Field Administration of Stroke Therapy–Magnesium (FAST-MAG) phase 3 clinical trial, administration of magnesium sulfate to patients with suspected stroke within 2 hours of symptom onset similarly failed to improve functional outcomes (Saver JL et al. N Engl J Med. 2015;372[6]:528-536).
Source: JAMA - March 24, 2015 Category: Journals (General) Source Type: research

Antiplatelet Therapy Duration Following Bare Metal or Drug-Eluting Coronary Stents The Dual Antiplatelet Therapy Randomized Clinical Trial
ImportanceDespite antirestenotic efficacy of coronary drug-eluting stents (DES) compared with bare metal stents (BMS), the relative risk of stent thrombosis and adverse cardiovascular events is unclear. Although dual antiplatelet therapy (DAPT) beyond 1 year provides ischemic event protection after DES, ischemic event risk is perceived to be less after BMS, and the appropriate duration of DAPT after BMS is unknown.ObjectiveTo compare (1) rates of stent thrombosis and major adverse cardiac and cerebrovascular events (MACCE; composite of death, myocardial infarction, or stroke) after 30 vs 12 months of thienopyridine in pati...
Source: JAMA - March 17, 2015 Category: Journals (General) Source Type: research

Mariner
Three minutes after pressing in with the scalpelA sea of yellow fat becomes my Faraway night and bow-crashing dip and swellA mist of chemicals washes over with each silver stroke
Source: JAMA - March 17, 2015 Category: Journals (General) Source Type: research