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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

Intensive speech and language therapy in patients with chronic aphasia after stroke: a randomised, open-label, blinded-endpoint, controlled trial in a health-care setting
This study is registered with ClinicalTrials.gov, number NCT01540383. Results We randomly assigned 158 patients between April 1, 2012, and May 31, 2014. The modified intention-to-treat population comprised 156 patients (78 per group). Verbal communication was significantly improved from baseline to after intensive speech and language treatment (mean difference 2·61 points [SD 4·94]; 95% CI 1·49 to 3·72), but not from baseline to after treatment deferral (−0·03 points [4·04]; −0·94 to 0·88; between-group difference Cohen's d 0·58; p=0·0004). Eight patients had adverse events during therapy or treatment deferra...
Source: The Lancet - March 1, 2017 Category: Journals (General) Source Type: research

A multifaceted intervention to improve treatment with oral anticoagulants in atrial fibrillation (IMPACT-AF): an international, cluster-randomised trial
This study was a two-arm, prospective, international, cluster-randomised, controlled trial. Patients were included who had atrial fibrillation and an indication for oral anticoagulation. Clusters were randomised (1:1) to receive a quality improvement educational intervention (intervention group) or usual care (control group). Randomisation was carried out centrally, using the eClinicalOS electronic data capture system. The intervention involved education of providers and patients, with regular monitoring and feedback. The primary outcome was the change in the proportion of patients treated with oral anticoagulants from bas...
Source: The Lancet - August 29, 2017 Category: General Medicine Source Type: research

Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study
Publication date: Available online 29 August 2017 Source:The Lancet Author(s): Victoria Miller, Andrew Mente, Mahshid Dehghan, Sumathy Rangarajan, Xiaohe Zhang, Sumathi Swaminathan, Gilles Dagenais, Rajeev Gupta, Viswanathan Mohan, Scott Lear, Shrikant I Bangdiwala, Aletta E Schutte, Edelweiss Wentzel-Viljoen, Alvaro Avezum, Yuksel Altuntas, Khalid Yusoff, Noorhassim Ismail, Nasheeta Peer, Jephat Chifamba, Rafael Diaz, Omar Rahman, Noushin Mohammadifard, Fernando Lana, Katarzyna Zatonska, Andreas Wielgosz, Afzalhussein Yusufali, Romaina Iqbal, Patricio Lopez-Jaramillo, Rasha Khatib, Annika Rosengren, V Raman Kutty, Wei Li...
Source: The Lancet - August 31, 2017 Category: General Medicine Source Type: research

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980 –2015: a systematic analysis for the Global Burden of Disease Study 2015
Publication date: 8–14 October 2016 Source:The Lancet, Volume 388, Issue 10053 Author(s): GBD 2015 Mortality and Causes of Death CollaboratorsHaidongWangMohsenNaghaviChristineAllenRyan MBarberZulfiqar ABhuttaAustinCarterDaniel CCaseyFiona JCharlsonAlan ZianChenMatthew MCoatesMeganCoggeshallLalitDandonaDaniel JDickerHolly EErskineAlize JFerrariChristinaFitzmauriceKyleForemanMohammad HForouzanfarMaya SFraserNancyFullmanPeter WGethingEllen MGoldbergNicholasGraetzJuanita AHaagsmaSimon IHayChantalHuynhCatherine OJohnsonNicholas JKassebaumYohannesKinfuXie RachelKulikoffMichaelKutzHmwe HKyuHeidi JLarsonJanniLeungXiaofengLiangS...
Source: The Lancet - October 6, 2016 Category: Journals (General) Source Type: research

Effectiveness of polypill for primary and secondary prevention of cardiovascular diseases (PolyIran): a pragmatic, cluster-randomised trial
Publication date: 24–30 August 2019Source: The Lancet, Volume 394, Issue 10199Author(s): Gholamreza Roshandel, Masoud Khoshnia, Hossein Poustchi, Karla Hemming, Farin Kamangar, Abdolsamad Gharavi, Mohammad Reza Ostovaneh, Alireza Nateghi, Masoud Majed, Behrooz Navabakhsh, Shahin Merat, Akram Pourshams, Mahdi Nalini, Fatemeh Malekzadeh, Masoumeh Sadeghi, Noushin Mohammadifard, Nizal Sarrafzadegan, Mohammad Naemi-Tabiei, Abdolreza Fazel, Paul BrennanSummaryBackgroundA fixed-dose combination therapy (polypill strategy) has been proposed as an approach to reduce the burden of cardiovascular disease, especially in low-income ...
Source: The Lancet - August 23, 2019 Category: General Medicine Source Type: research

Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study
We describe the prevalence, hazard ratios (HRs), and population-attributable fractions (PAFs) for cardiovascular disease and mortality associated with a cluster of behavioural factors (ie, tobacco use, alcohol, diet, physical activity, and sodium intake), metabolic factors (ie, lipids, blood pressure, diabetes, obesity), socioeconomic and psychosocial factors (ie, education, symptoms of depression), grip strength, and household and ambient pollution. Associations between risk factors and the outcomes were established using multivariable Cox frailty models and using PAFs for the entire cohort, and also by countries grouped ...
Source: The Lancet - September 3, 2019 Category: General Medicine Source Type: research