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Source: JAMA
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Total 276 results found since Jan 2013.
Incorrect P Value and Figure Label Error
This article was corrected online.
Source: JAMA - May 4, 2021 Category: General Medicine Source Type: research
Depression and Incident Cardiovascular Disease —Reply
In Reply To characterize the association between depressive symptoms and CVD incidence, we analyzed individual participant data from 22 prospective studies that included baseline information about self-reported depressive symptoms in participants without a history of CVD. Our study demonstrated modest log-linear associations between baseline depressive symptoms and future risk of coronary heart disease, stroke, and CVD. Associations were present even with symptoms below the threshold indicative of depressive disorder and were unaffected by adjustment for several established CVD risk factors. These results are consistent wi...
Source: JAMA - April 27, 2021 Category: General Medicine Source Type: research
Group Name Omitted
This article was corrected online.
Source: JAMA - April 6, 2021 Category: General Medicine Source Type: research
Diagnosis and Management of Transient Ischemic Attack and Acute Ischemic Stroke
This narrative review provides an update on management of transient ischemic attack (TIA) and acute ischemic stroke, emphasizing advances in use of dual antiplatelet therapy and fibrinolysis vs mechanical thrombectomy for secondary and tertiary prevention.
Source: JAMA - March 16, 2021 Category: General Medicine Source Type: research
Maternal Cardiovascular Health
Historically, the focus on the development of atherosclerotic cardiovascular disease has been on individual risk factors. These factors, which are associated with increased risk of myocardial infarction and stroke, were identified in the Framingham Study and other longitudinal observational studies of adults. The traditional risk factors are hypertension, dyslipidemia, obesity, diabetes, and cigarette smoking. Subsequently, other potential risk factors, such as inflammation and insulin resistance, have been included in the discussion. The recognition of risk factors was a substantial advance because it provided clinical ta...
Source: JAMA - February 16, 2021 Category: General Medicine Source Type: research
To a Firstborn Son
Months we all gelled —pills, probes, we pried, we eyed you. Scouring echoes mottled like the Moon, I found your face. Eighteen weeks in, too soon to fly your flawed cocoon, our doctor spied your two feet thrust through. Though your mother tried a banked bed, buoying you, her water broke. The wits I lacked, her nurses lent. “Just stroke her hair, don't look,” they pled—so I complied. But when your cord got clamped, before you ceased your windless breaths, I should've made a stand: amidst those steel stirrups, laying a hand that said, “We love you Lincoln. Go in peace.” What now? Stroke prints inked by l ifeless ...
Source: JAMA - February 9, 2021 Category: General Medicine Source Type: research
Association Between Dispatch of Mobile Stroke Units and Functional Outcomes Among Stroke Patients in Berlin
This cohort study compares global disability at 3 months among Berlin patients with out-of-hospital ischemic stroke brought to care via a mobile stroke unit ambulance (with prehospital CT scanning with or without angiography, point-of-care laboratory testing, prehospital thrombolysis) vs conventional ambulance alone.
Source: JAMA - February 2, 2021 Category: General Medicine Source Type: research
Screening for Asymptomatic Carotid Artery Stenosis
In the Recommendation Statement published in this issue of JAMA, the US Preventive Services Task Force (USPTF) has reaffirmed its 2014 recommendation, stating that “The USPTF recommends against screening for asymptomatic carotid artery stenosis in the general adult population (D recommendation),” based on evidence that the harms of screening for carotid artery stenosis in asymptomatic adults outweigh the benefits, with no new evidence that would change the previous recommendation. The rationale for this confirmation is based on a combination of considerations, including the effects of false-positive results when screen...
Source: JAMA - February 2, 2021 Category: General Medicine Source Type: research
Improving Stroke Treatment and Outcomes With Mobile Stroke Units
Systemic thrombolysis with tissue plasminogen activator (tPA) improves outcome in patients with acute ischemic stroke. Twenty-five years of clinical research and experience have demonstrated that the sooner tPA is administered, the better the clinical outcomes. Five years ago, clinical trials demonstrating that endovascular thrombectomy can substantially improve outcomes for patients with large vessel occlusions further expanded acute ischemic stroke treatment. Taken together, these therapies provide important treatment options for clinicians, significant reduction in disability for patients, and reduced long-term costs fo...
Source: JAMA - February 2, 2021 Category: General Medicine Source Type: research
Incidence of Transient Ischemic Attack and Association With Long-term Risk of Stroke
This cohort study uses Framingham Heart Study (FHS) data to assess population-based incidence of transient ischemic attack (TIA), and the timing and long-term trends of stroke risk after TIA, among participants in the FHS Original, Offspring, and Third Generation cohorts from 1948 to 2017.
Source: JAMA - January 26, 2021 Category: General Medicine Source Type: research
Effect of Endovascular Treatment With vs Without IV Alteplase on Functional Independence After Acute Ischemic Stroke
This noninferiority trial compares the effects of endovascular treatment with vs without intravenous alteplase on 90-day functional independence among patients with acute ischemic stroke.
Source: JAMA - January 19, 2021 Category: General Medicine Source Type: research
Effect of Mechanical Thrombectomy Without vs With Intravenous Thrombolysis in Acute Ischemic Stroke
This noninferiority trial compares the effects of mechanical thrombectomy with vs without intravenous thrombolysis (0.6-mg/kg alteplase) on 90-day disability among patients with acute large vessel occlusive ischemic stroke.
Source: JAMA - January 19, 2021 Category: General Medicine Source Type: research
Intravenous Thrombolysis Before Endovascular Thrombectomy for Acute Ischemic Stroke
The 2 reperfusion therapies of proven benefit for acute ischemic stroke, mechanical endovascular thrombectomy (EVT) and pharmacologic intravenous thrombolysis (IVT), have complementary advantages. EVT, which involves mechanical debulking, works well for accessible sizeable thrombi that occlude large cerebral vessels and are resistant to rapid thrombolytic dissolution. IVT, which involves chemical dissolution, works well for smaller thrombi that occlude medium and small cerebral vessels inaccessible or poorly accessible to endovascular technology. An open, important question has been whether the modest efficacy of IVT for l...
Source: JAMA - January 19, 2021 Category: General Medicine Source Type: research
Postoperative Atrial Fibrillation After Noncardiac Surgery and Stroke —Reply
In Reply Dr Hu and colleagues argue that the CHA2DS2-VASc score rather than the Charlson Comorbidity Index should have been used for adjustment in the outcome comparisons between the groups with and without postoperative AF in our study. Conceptually, we selected the Charlson Comorbidity Index because it captures multimorbidity more comprehensively, as opposed to the CHA2DS2-VASc score, which incorporates only a few select variables. The effect of multimorbidity would be most important in a postoperative and elderly population such as the population in our cohort. It should also be noted that the CHA2DS2-VASc score was dev...
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research
Postoperative Atrial Fibrillation After Noncardiac Surgery and Stroke
To the Editor Dr Siontis and colleagues reported that among patients undergoing noncardiac surgery, long-term risks of stroke or transient ischemic attack (TIA), subsequent atrial fibrillation (AF), and all-cause death were higher in patients with new-onset postoperative AF than in those without postoperative AF. The differences were maintained after adjustment for age and Charlson Comorbidity Index. However, factors selected for adjustment might bias their findings.
Source: JAMA - January 12, 2021 Category: General Medicine Source Type: research
