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Source: The Lancet

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Total 200 results found since Jan 2013.

Effects of aspirin on risk and severity of early recurrent stroke after transient ischaemic attack and ischaemic stroke: time-course analysis of randomised trials
Publication date: Available online 18 May 2016 Source:The Lancet Author(s): Peter M Rothwell, Ale Algra, Zhengming Chen, Hans-Christoph Diener, Bo Norrving, Ziyah Mehta Background Aspirin is recommended for secondary prevention after transient ischaemic attack (TIA) or ischaemic stroke on the basis of trials showing a 13% reduction in long-term risk of recurrent stroke. However, the risk of major stroke is very high for only the first few days after TIA and minor ischaemic stroke, and observational studies show substantially greater benefits of early medical treatment in the acute phase than do longer-term trials. ...
Source: The Lancet - May 19, 2016 Category: Journals (General) Source Type: research

Prophylactic antibiotics after acute stroke for reducing pneumonia in patients with dysphagia (STROKE-INF): a prospective, cluster-randomised, open-label, masked endpoint, controlled clinical trial
This study assessed the effectiveness of antibiotic prophylaxis for reducing pneumonia in patients with dysphagia after acute stroke. Methods We did a prospective, multicentre, cluster-randomised, open-label controlled trial with masked endpoint assessment of patients older than 18 years with dysphagia after new stroke recruited from 48 stroke units in the UK, accredited and included in the UK National Stroke Audit. We excluded patients with contraindications to antibiotics, pre-existing dysphagia, or known infections, or who were not expected to survive beyond 14 days. We randomly assigned the units (1:1) by computer to ...
Source: The Lancet - September 5, 2015 Category: Journals (General) Source Type: research

Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study
Publication date: Available online 16 July 2016 Source:The Lancet Author(s): Martin J O'Donnell, Siu Lim Chin, Sumathy Rangarajan, Denis Xavier, Lisheng Liu, Hongye Zhang, Purnima Rao-Melacini, Xiaohe Zhang, Prem Pais, Steven Agapay, Patricio Lopez-Jaramillo, Albertino Damasceno, Peter Langhorne, Matthew J McQueen, Annika Rosengren, Mahshid Dehghan, Graeme J Hankey, Antonio L Dans, Ahmed Elsayed, Alvaro Avezum, Charles Mondo, Hans-Christoph Diener, Danuta Ryglewicz, Anna Czlonkowska, Nana Pogosova, Christian Weimar, Romaina Iqbal, Rafael Diaz, Khalid Yusoff, Afzalhussein Yusufali, Aytekin O...
Source: The Lancet - July 15, 2016 Category: Journals (General) Source Type: research

Perioperative covert stroke in patients undergoing non-cardiac surgery (NeuroVISION): a prospective cohort study
Publication date: Available online 15 August 2019Source: The LancetAuthor(s): Marko Mrkobrada, Matthew T.V. Chan, David Cowan, Douglas Campbell, Chew Yin Wang, David Torres, German Malaga, Robert D. Sanders, Manas Sharma, Carl Brown, Alben Sigamani, Wojciech Szczeklik, Mukul Sharma, Gordon Guyatt, Eric E. Smith, Ronit Agid, Adam A. Dmytriw, Jessica Spence, Nikesh R. Adunuri, Flavia K. BorgesSummaryBackgroundIn non-surgical settings, covert stroke is more common than overt stroke and is associated with cognitive decline. Although overt stroke occurs in less than 1% of adults after non-cardiac surgery and is associated with ...
Source: The Lancet - August 16, 2019 Category: General Medicine Source Type: research

Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials
Publication date: 29 November–5 December 2014 Source:The Lancet, Volume 384, Issue 9958 Author(s): Jonathan Emberson , Kennedy R Lees , Patrick Lyden , Lisa Blackwell , Gregory Albers , Erich Bluhmki , Thomas Brott , Geoff Cohen , Stephen Davis , Geoffrey Donnan , James Grotta , George Howard , Markku Kaste , Masatoshi Koga , Ruediger von Kummer , Maarten Lansberg , Richard I Lindley , Gordon Murray , Jean Marc Olivot , Mark Parsons , Barbara Tilley , Danilo Toni , Kazunori Toyoda , Nils Wahlgren , Joanna Wardlaw , William Whiteley , Gregory J del Zoppo , Colin Baigent , Peter Sandercock , Werner Hacke Background Altep...
Source: The Lancet - December 4, 2014 Category: Journals (General) Source Type: research

Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): a randomised controlled trial
Publication date: Available online 16 April 2015 Source:The Lancet Background Early mobilisation after stroke is thought to contribute to the effects of stroke-unit care; however, the intervention is poorly defined and not underpinned by strong evidence. We aimed to compare the effectiveness of frequent, higher dose, very early mobilisation with usual care after stroke. Methods We did this parallel-group, single-blind, randomised controlled trial at 56 acute stroke units in five countries. Patients (aged ≥18 years) with ischaemic or haemorrhagic stroke, first or recurrent, who met physiological criteria were randomly as...
Source: The Lancet - April 18, 2015 Category: Journals (General) Source Type: research

Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial
Publication date: Available online 6 February 2019Source: The LancetAuthor(s): Philip M Bath, Polly Scutt, Craig S Anderson, Jason P Appleton, Evind Berge, Lesley Cala, Mark Dixon, Timothy M England, Peter J Godolphin, Diane Havard, Lee Haywood, Trish Hepburn, Kailash Krishnan, Grant Mair, Alan A Montgomery, Keith Muir, Stephen J Phillips, Stuart Pocock, John Potter, Chris PriceSummaryBackgroundHigh blood pressure is common in acute stroke and is a predictor of poor outcome; however, large trials of lowering blood pressure have given variable results, and the management of high blood pressure in ultra-acute stroke remains ...
Source: The Lancet - February 7, 2019 Category: General Medicine Source Type: research

Efficacy of nitric oxide, with or without continuing antihypertensive treatment, for management of high blood pressure in acute stroke (ENOS): a partial-factorial randomised controlled trial
This study is registered, number ISRCTN99414122. Findings Between July 20, 2001, and Oct 14, 2013, we enrolled 4011 patients. Mean blood pressure was 167 (SD 19) mm Hg/90 (13) mm Hg at baseline (median 26 h [16–37] after stroke onset), and was significantly reduced on day 1 in 2000 patients allocated to glyceryl trinitrate compared with 2011 controls (difference −7·0 [95% CI −8·5 to −5·6] mm Hg/–3·5 [–4·4 to −2·6] mm Hg; both p<0·0001), and on day 7 in 1053 patients allocated to continue antihypertensive drugs compared with 1044 patients randomised to stop them (difference −9·5 [95% CI −11...
Source: The Lancet - February 13, 2015 Category: Journals (General) Source Type: research

Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603 838 individuals
Publication date: Available online 19 August 2015 Source:The Lancet Author(s): Mika Kivimäki, Markus Jokela, Solja T Nyberg, Archana Singh-Manoux, Eleonor I Fransson, Lars Alfredsson, Jakob B Bjorner, Marianne Borritz, Hermann Burr, Annalisa Casini, Els Clays, Dirk De Bacquer, Nico Dragano, Raimund Erbel, Goedele A Geuskens, Mark Hamer, Wendela E Hooftman, Irene L Houtman, Karl-Heinz Jöckel, France Kittel, Anders Knutsson, Markku Koskenvuo, Thorsten Lunau, Ida E H Madsen, Martin L Nielsen, Maria Nordin, Tuula Oksanen, Jan H Pejtersen, Jaana Pentti, Reiner Rugulies, Paula Salo, Martin J S...
Source: The Lancet - August 21, 2015 Category: Journals (General) Source Type: research

Extending thrombolysis to 4·5–9 h and wake-up stroke using perfusion imaging: a systematic review and meta-analysis of individual patient data
This study is registered with PROSPERO, number CRD42019128036.FindingsWe identified three trials that met eligibility criteria: EXTEND, ECASS4-EXTEND, and EPITHET. Of the 414 patients included in the three trials, 213 (51%) were assigned to receive alteplase and 201 (49%) were assigned to receive placebo. Overall, 211 patients in the alteplase group and 199 patients in the placebo group had mRS assessment data at 3 months and thus were included in the analysis of the primary outcome. 76 (36%) of 211 patients in the alteplase group and 58 (29%) of 199 patients in the placebo group had achieved excellent functional outcome a...
Source: The Lancet - May 24, 2019 Category: General Medicine Source Type: research

The Preventive Antibiotics in Stroke Study (PASS): a pragmatic randomised open-label masked endpoint clinical trial
Publication date: Available online 20 January 2015 Source:The Lancet Author(s): Willeke F Westendorp , Jan-Dirk Vermeij , Elles Zock , Imke J Hooijenga , Nyika D Kruyt , Hans J L W Bosboom , Vincent I H Kwa , Martijn Weisfelt , Michel J M Remmers , Robert ten Houten , A H C M (Tobien) Schreuder , Sarah E Vermeer , Ewout J van Dijk , Diederik W J Dippel , Marcel G W Dijkgraaf , Lodewijk Spanjaard , Marinus Vermeulen , Tom van der Poll , Jan M Prins , Frederique H Vermeij , Yvo B W E M Roos , Ruud P Kleyweg , Henk Kerkhoff , Matthijs C Brouwer , Aeilko H Zwinderman , Diederik van de Beek , Paul J Nederkoorn Background In a...
Source: The Lancet - January 21, 2015 Category: Journals (General) Source Type: research

Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials
Publication date: Available online 18 February 2016 Source:The Lancet Author(s): Mayank Goyal, Bijoy K Menon, Wim H van Zwam, Diederik W J Dippel, Peter J Mitchell, Andrew M Demchuk, Antoni Dávalos, Charles B L M Majoie, Aad van der Lugt, Maria A de Miquel, Geoffrey A Donnan, Yvo B W E M Roos, Alain Bonafe, Reza Jahan, Hans-Christoph Diener, Lucie A van den Berg, Elad I Levy, Olvert A Berkhemer, Vitor M Pereira, Jeremy Rempel, Mònica Millán, Stephen M Davis, Daniel Roy, John Thornton, Luis San Román, Marc Ribó, Debbie Beumer, Bruce Stouch, Scott Brown, Bruce C V Campbell, Robert J van ...
Source: The Lancet - February 19, 2016 Category: Journals (General) Source Type: research

Weekly variation in health-care quality by day and time of admission: a nationwide, registry-based, prospective cohort study of acute stroke care
Publication date: Available online 10 May 2016 Source:The Lancet Author(s): Benjamin D Bray, Geoffrey C Cloud, Martin A James, Harry Hemingway, Lizz Paley, Kevin Stewart, Pippa J Tyrrell, Charles D A Wolfe, Anthony G Rudd Background Studies in many health systems have shown evidence of poorer quality health care for patients admitted on weekends or overnight than for those admitted during the week (the so-called weekend effect). We postulated that variation in quality was dependent on not only day, but also time, of admission, and aimed to describe the pattern and magnitude of variation in the quality of acute s...
Source: The Lancet - May 11, 2016 Category: Journals (General) Source Type: research

Practice patterns and outcomes after stroke across countries at different economic levels (INTERSTROKE): an international observational study
Publication date: 19–25 May 2018 Source:The Lancet, Volume 391, Issue 10134 Author(s): Peter Langhorne, Martin J O'Donnell, Siu Lim Chin, Hongye Zhang, Denis Xavier, Alvaro Avezum, Nandini Mathur, Melanie Turner, Mary Joan MacLeod, Patricio Lopez-Jaramillo, Albertino Damasceno, Graeme J Hankey, Antonio L Dans, Ahmed Elsayed, Charles Mondo, Mohammad Wasay, Anna Czlonkowska, Christian Weimar, Afzal Hussein Yusufali, Fawaz Al Hussain, Liu Lisheng, Hans-Christoph Diener, Danuta Ryglewicz, Nana Pogosova, Romana Iqbal, Rafael Diaz, Khalid Yusoff, Aytekin Oguz, Xingyu Wang, Ernesto Penaherrera, Fernando Lanas, Okechukwu S Ogah...
Source: The Lancet - May 18, 2018 Category: General Medicine Source Type: research

Intensive blood pressure reduction with intravenous thrombolysis therapy for acute ischaemic stroke (ENCHANTED): an international, randomised, open-label, blinded-endpoint, phase 3 trial
Publication date: Available online 7 February 2019Source: The LancetAuthor(s): Craig S Anderson, Yining Huang, Richard I Lindley, Xiaoying Chen, Hisatomi Arima, Guofang Chen, Qiang Li, Laurent Billot, Candice Delcourt, Philip M Bath, Joseph P Broderick, Andrew M Demchuk, Geoffrey A Donnan, Alice C Durham, Pablo M Lavados, Tsong-Hai Lee, Christopher Levi, Sheila O Martins, Veronica V Olavarria, Jeyaraj D PandianSummaryBackgroundSystolic blood pressure of more than 185 mm Hg is a contraindication to thrombolytic treatment with intravenous alteplase in patients with acute ischaemic stroke, but the target systolic blood pressu...
Source: The Lancet - February 8, 2019 Category: General Medicine Source Type: research