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Deep learning algorithms for detection of critical findings in head CT scans: a retrospective study
Publication date: Available online 11 October 2018Source: The LancetAuthor(s): Sasank Chilamkurthy, Rohit Ghosh, Swetha Tanamala, Mustafa Biviji, Norbert G Campeau, Vasantha Kumar Venugopal, Vidur Mahajan, Pooja Rao, Prashant WarierSummaryBackgroundNon-contrast head CT scan is the current standard for initial imaging of patients with head trauma or stroke symptoms. We aimed to develop and validate a set of deep learning algorithms for automated detection of the following key findings from these scans: intracranial haemorrhage and its types (ie, intraparenchymal, intraventricular, subdural, extradural, and subarachnoid); ca...
Source: The Lancet - October 12, 2018 Category: General Medicine Source Type: research

Long-term mortality after blood pressure-lowering and lipid-lowering treatment in patients with hypertension in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) Legacy study: 16-year follow-up results of a randomised factorial trial
Publication date: Available online 26 August 2018Source: The LancetAuthor(s): Ajay Gupta, Judith Mackay, Andrew Whitehouse, Thomas Godec, Tim Collier, Stuart Pocock, Neil Poulter, Peter SeverSummaryBackgroundIn patients with hypertension, the long-term cardiovascular and all-cause mortality effects of different blood pressure-lowering regimens and lipid-lowering treatment are not well documented, particularly in clinical trial settings. The Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) Legacy Study reports mortality outcomes after 16 years of follow-up of the UK participants in the original ASCOT trial.MethodsASCOT was...
Source: The Lancet - August 26, 2018 Category: General Medicine Source Type: research

6-month versus 12-month or longer dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndrome (SMART-DATE): a randomised, open-label, non-inferiority trial
Publication date: Available online 12 March 2018 Source:The Lancet Author(s): Joo-Yong Hahn, Young Bin Song, Ju-Hyeon Oh, Deok-Kyu Cho, Jin Bae Lee, Joon-Hyung Doh, Sang-Hyun Kim, Jin-Ok Jeong, Jang-Ho Bae, Byung-Ok Kim, Jang Hyun Cho, Il-Woo Suh, Doo-il Kim, Hoon-Ki Park, Jong-Seon Park, Woong Gil Choi, Wang Soo Lee, Jihoon Kim, Ki Hong Choi, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuk Choi, Hyeon-Cheol Gwon Background Current guidelines recommend dual antiplatelet therapy (DAPT) of aspirin plus a P2Y12 inhibitor for at least 12 months after implantation of drug-eluting stents (DES) in patients...
Source: The Lancet - March 13, 2018 Category: General Medicine Source Type: research

Ischaemic stroke management at Al-Shifa Hospital in the Gaza Strip: a clinical audit
Publication date: 21 February 2018 Source:The Lancet, Volume 391, Supplement 2 Author(s): Amir Abukaresh, Rami Al-Abadlah, Bettina Böttcher, Khamis El-Essi Background In the 2014 Palestinian annual health report, cerebrovascular accident was ranked as the third leading cause of death in the occupied Palestinian territory. Cerebrovascular accident is also one the most common causes of disability worldwide. Good management decreases mortality and morbidity. The aim of this study was to assess the current management of patients with ischaemic stroke at the Al-Shifa Hospital and to compare this with international guidelines....
Source: The Lancet - February 23, 2018 Category: General Medicine Source Type: research

Subclinical leaflet thrombosis in surgical and transcatheter bioprosthetic aortic valves: an observational study
The objective of this study was to report the prevalence of subclinical leaflet thrombosis in surgical and transcatheter aortic valves and the effect of novel oral anticoagulants (NOACs) on the subclinical leaflet thrombosis and subsequent valve haemodynamics and clinical outcomes on the basis of two registries of patients who had CT imaging done after TAVR or SAVR. Methods Patients enrolled between Dec 22, 2014, and Jan 18, 2017, in the RESOLVE registry, and between June 2, 2014, and Sept 28, 2016, in the SAVORY registry, had CT imaging done with a dedicated four-dimensional volume-rendered imaging protocol at varying int...
Source: The Lancet - March 18, 2017 Category: Journals (General) Source Type: research

Thrombolytic removal of intraventricular haemorrhage in treatment of severe stroke: results of the randomised, multicentre, multiregion, placebo-controlled CLEAR III trial
This study is registered with ClinicalTrials.gov, NCT00784134. Findings Between Sept 18, 2009, and Jan 13, 2015, 500 patients were randomised: 249 to the alteplase group and 251 to the saline group. 180-day follow-up data were available for analysis from 246 of 249 participants in the alteplase group and 245 of 251 participants in the placebo group. The primary efficacy outcome was similar in each group (good outcome in alteplase group 48% vs saline 45%; risk ratio [RR] 1·06 [95% CI 0·88–1·28; p=0·554]). A difference of 3·5% (RR 1·08 [95% CI 0·90–1·29], p=0·420) was found after adjustment for intraventricular ...
Source: The Lancet - January 9, 2017 Category: Journals (General) Source Type: research

Occurrence of death and stroke in patients in 47 countries 1 year after presenting with atrial fibrillation: a cohort study
Publication date: Available online 8 August 2016 Source:The Lancet Author(s): Jeff S Healey, Jonas Oldgren, Michael Ezekowitz, Jun Zhu, Prem Pais, Jia Wang, Patrick Commerford, Petr Jansky, Alvaro Avezum, Alben Sigamani, Albertino Demasceno, Paul Reilly, Alex Grinvalds, Juliet Nakamya, Akinyemi Aje, Wael Almahmeed, Andrew Moriarty, Lars Wallentin, Salim Yusuf, Stuart J Connolly Background Atrial fibrillation is an important cause of morbidity and mortality worldwide, but scant data are available for long-term outcomes in individuals outside North America or Europe, especially in primary care settings. Methods We did a coh...
Source: The Lancet - August 8, 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

50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study
Publication date: Available online 7 May 2015 Source:The Lancet Author(s): Renate B Schnabel , Xiaoyan Yin , Philimon Gona , Martin G Larson , Alexa S Beiser , David D McManus , Christopher Newton-Cheh , Steven A Lubitz , Jared W Magnani , Patrick T Ellinor , Sudha Seshadri , Philip A Wolf , Ramachandran S Vasan , Emelia J Benjamin , Daniel Levy Background Comprehensive long-term data on atrial fibrillation trends in men and women are scant. We aimed to provide such data through analysis of the Framingham cohort over 50 years. Methods We investigated trends in incidence, prevalence, and risk factors for atrial fibrillat...
Source: The Lancet - May 9, 2015 Category: Journals (General) Source Type: research