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Source: JAMA

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Total 276 results found since Jan 2013.

Salt Substitute Cut Disease and Death Rates in Large Trial
A randomized trial recently reported in the New England Journal of Medicine focused on an important question for older adults with high blood pressure or a previous stroke: Can switching from regular salt to a 75% sodium chloride and 25% potassium chloride substitute help protect against stroke, major cardiovascular events, or death?
Source: JAMA - October 26, 2021 Category: General Medicine Source Type: research

Implantable vs Prolonged External Electrocardiographic Monitoring for Atrial Fibrillation Detection in Ischemic Stroke
To the Editor In a recent study, implantable electrocardiographic monitoring for 12 months resulted in detection of a significantly greater proportion of patients with atrial fibrillation compared with prolonged external monitoring for 30 days. The diagnostic yield of these 2 methods may be due to adherence as well as to the function of the monitoring device itself.
Source: JAMA - October 12, 2021 Category: General Medicine Source Type: research

Implantable vs Prolonged External Electrocardiographic Monitoring for Atrial Fibrillation Detection in Ischemic Stroke —Reply
In Reply Dr Ito notes that adherence to monitoring may affect the diagnostic yield for wearable electrocardiographic monitors and suggests that poor adherence to external monitoring is responsible for the lower incidence of atrial fibrillation we found among patients with a recent ischemic stroke randomized to an external loop recorder vs an implantable loop recorder. However, our study data do not support that notion.
Source: JAMA - October 12, 2021 Category: General Medicine Source Type: research

A First in Stroke Rehabilitation
The FDA has approved a first-of-its kind device that uses vagus nerve stimulation (VNS) along with rehabilitation exercises to help patients who are recovering from an ischemic stroke improve their arm and hand movements.
Source: JAMA - October 5, 2021 Category: General Medicine Source Type: research

Thrombectomy With Combined Contact Aspiration and Stent Retriever vs Stent Retriever Alone
This randomized clinical trial compares the effect of thrombectomy with contact aspiration and stent retriever combined vs stent retriever alone on revascularization in patients with acute ischemic stroke and large vessel occlusion.
Source: JAMA - September 28, 2021 Category: General Medicine Source Type: research

TAVR for Bicuspid Aortic Valve Stenosis
This registry-based cohort study compared rates of mortality and stroke at 30 days and 1 year among patients at low surgical risk with bicuspid vs tricuspid aortic stenosis undergoing transcatheter aortic valve replacement (TAVR).
Source: JAMA - September 21, 2021 Category: General Medicine Source Type: research

The USPSTF Recommendation Statement About Screening Asymptomatic Adults for Carotid Stenosis
To the Editor The USPSTF recommends against screening asymptomatic adults for carotid stenosis. However, we believe that detection of asymptomatic carotid stenosis might encourage treatment adherence to pharmacological —and nonpharmacological—primary prevention strategies. Demonstration of an objective lesion in the carotid artery may increase patient awareness of the presence of a risk factor for stroke. One article demonstrated that a higher rate of carotid stenosis detection was associated with better adher ence to statin and aspirin treatment in asymptomatic patients with vascular risk factors. A letter commenting ...
Source: JAMA - July 6, 2021 Category: General Medicine Source Type: research

Vagus Nerve Stimulation Restores Arm Function Years After Stroke
Vagus nerve stimulation (VNS) combined with rehabilitation improved function for patients with long-term moderate to severe arm impairment after an ischemic stroke, a trial in The Lancet reported.
Source: JAMA - June 22, 2021 Category: General Medicine Source Type: research

Effect of Implantable vs Prolonged External Electrocardiographic Monitoring on AF Detection in Ischemic Stroke
This randomized clinical trial compares 12 months of implantable loop recorder monitoring to detect atrial fibrillation vs conventional external loop recorder monitoring for 30 days in patients with a recent ischemic stroke.
Source: JAMA - June 1, 2021 Category: General Medicine Source Type: research

Effect of Continuous Cardiac Monitoring vs Usual Care on Detection of Atrial Fibrillation
This randomized clinical trial examines whether long-term cardiac monitoring with an insertable cardiac monitor was more effective than usual care for detection of atrial fibrillation in patients with stroke attributed to cervical or intracranial large artery atherosclerosis or small-vessel occlusion (large- or small-vessel disease).
Source: JAMA - June 1, 2021 Category: General Medicine Source Type: research

Detection of Subclinical Atrial Fibrillation After Stroke
Atrial fibrillation (AF), persistent or paroxysmal with high frequency, is present and assumed to be the cause or a contributing factor in more than 20% of ischemic strokes in the US. The prevalence of AF is accompanied by expanding evidence of infrequent and often shorter duration AF episodes in additional patients. Subclinical AF consists of asymptomatic, low-frequency episodes of AF detected on heart rhythm monitoring by implantable or external and wearable monitors and is often not identified at the time of initial stroke workup, but is found during extended rhythm monitoring.
Source: JAMA - June 1, 2021 Category: General Medicine Source Type: research

Helping Patients Improve Muscle Movement After Stroke
The FDA recently authorized a new device that helps to reeducate muscles to improve range of motion for patients who are recovering from a stroke.
Source: JAMA - June 1, 2021 Category: General Medicine Source Type: research

Preliminary Investigation of In situ Thrombus Within Patent Foramen Ovale in Patients With and Without Stroke
This study uses high-resolution optical coherence tomography to investigate whether patent foramen ovale could be the site of thrombus formation in patients with or without stroke.
Source: JAMA - May 25, 2021 Category: General Medicine Source Type: research

Functional Outcomes Among Patients With Acute Ischemic Stroke After Mechanical Thrombectomy With or Without Intravenous Thrombolysis
To the Editor In their randomized clinical trial, Dr Suzuki and colleagues reported that mechanical thrombectomy alone failed to demonstrate noninferiority compared with combined intravenous thrombolysis and mechanical thrombectomy with regard to favorable functional outcome at 90 days in patients with acute ischemic stroke. We have some concerns about this study.
Source: JAMA - May 18, 2021 Category: General Medicine Source Type: research

Functional Outcomes Among Patients With Acute Ischemic Stroke After Mechanical Thrombectomy With or Without Intravenous Thrombolysis —Reply
In Reply Dr Mai and colleagues describe some concerns with the SKIP study, including the balance of baseline characteristics between the 2 groups, the sample size, and the noninferiority margin for the secondary outcome.
Source: JAMA - May 18, 2021 Category: General Medicine Source Type: research