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Carbon dioxide flooding to reduce postoperative neurological injury following surgery for acute type A aortic dissection: a prospective, randomised, blinded, controlled clinical trial, CARTA study protocol - objectives and design
This report describes the objectives and design of the CARTA trial, investigating whether carbon dioxide flooding reduces neurological injury following surgery for ATAAD. Methods and analysis The CARTA trial is a single-centre, prospective, randomised, blinded, controlled clinical trial of ATAAD surgery with carbon dioxide flooding of the surgical field. Eighty consecutive patients undergoing repair of ATAAD, and who do not have previous neurological injuries or ongoing neurological symptoms, will be randomised (1:1) to either receive carbon dioxide flooding of the surgical field or not. Routine repair will be performed r...
Source: BMJ Open - May 25, 2023 Category: General Medicine Authors: Ede, J., Teurneau-Hermansson, K., Moseby-Knappe, M., Ramgren, B., Bjursten, H., Ederoth, P., Larsson, M., Mattsson-Carlgren, N., Sjögren, J., Wierup, P., Nozohoor, S., Zindovic, I. Tags: Open access, Cardiovascular medicine Source Type: research

FIND Stroke Recovery Study (FIND): rationale and protocol for a longitudinal observational cohort study of trajectories of recovery and biomarkers poststroke
Introduction Comprehensive studies mapping domain-specific trajectories of recovery after stroke and biomarkers reflecting these processes are scarce. We, therefore, initiated an exploratory prospective observational study of stroke cases with repeated evaluation, the FIND Stroke Recovery Study. We aim to capture trajectories of recovery from different impairments, including cognition, in combination with broad profiling of blood and imaging biomarkers of the recovery. Methods and analysis We recruit individuals with first-ever stroke at the stroke unit at the Sahlgrenska University Hospital, Sweden, to FIND. The inclusio...
Source: BMJ Open - May 10, 2023 Category: General Medicine Authors: Brännmark, C., Klasson, S., Stanne, T. M., Samuelsson, H., Alt Murphy, M., Sunnerhagen, K. S., Aberg, N. D., Jalnefjord, O., Björkman-Burtscher, I., Jood, K., Tatlisumak, T., Jern, C. Tags: Open access, Neurology Source Type: research

Identifying factors explaining practice variation in secondary stroke prevention in primary care: a cohort study based on all patients with ischaemic stroke in the Stockholm region
Conclusions A high practice variation for dispensation of all secondary preventive drugs was observed. Patient and PCC level factors indicating good continuity of care and high level of general practitioner education were associated with higher use of statins. Findings are of importance to policymakers as well as individual providers of care, and more research and actions are needed to minimise inequality in healthcare.
Source: BMJ Open - November 21, 2022 Category: General Medicine Authors: Wolf, M., Hasselström, J. K., Carlsson, A., Euler, M. v., Hasselström, J. Tags: Open access, Neurology Source Type: research

Study protocol of a non-randomised controlled trial evaluating the effectiveness of the F@ce 2.0 programme: a person-centred, ICT-supported and interdisciplinary rehabilitation intervention after stroke
Introduction Knowledge is missing on use of information and communication technology (ICT), for example, mobile phones/tablets in rehabilitation after stroke. F@ce 2.0 is a person-centred, interdisciplinary intervention supported by ICT. The components of F@ce 2.0 intend to increase performance in daily activities and participation in everyday life for patients with stroke and their significant others. Based on previous feasibility studies, a full-scale evaluation is planned in Sweden. The aim is to implement and evaluate F@ce 2.0, regarding performance of daily activities and participation in everyday life, in comparison ...
Source: BMJ Open - August 4, 2022 Category: General Medicine Authors: Eriksson, G., Tistad, M., Elf, M., Fors, U., von Koch, L., Ytterberg, C., Guidetti, S. Tags: Open access, Rehabilitation medicine Source Type: research

Relationship between serum insulin-like growth factor 1 levels and ischaemic stroke: a systematic review and meta-analysis
Conclusion Higher serum IGF-1 was significantly correlated with a lower risk of ischaemic stroke. In view of the high degree of heterogeneity, it may need more studies to confirm the prognostic value of serum IGF-1 levels in ischaemic stroke and explore the sources of heterogeneity.
Source: BMJ Open - June 15, 2022 Category: General Medicine Authors: Li, Y., Yang, W., Li, J., Zhang, Y., Zhang, L., Chen, S., He, L., Zhang, Y. Tags: Open access, Neurology Source Type: research

Do P2Y12 receptor inhibitors prescribed poststroke modify the risk of cognitive disorder or dementia? Protocol for a target trial using multiple national Swedish registries
This study has been approved by the Ethics Committee of the University of Gothenburg and Confidentiality Clearance at Statistics Sweden with Dnr 937-18, and an approved addendum with Dnr 2019-0157. The analysis and interpretation of the results will be heavily reliant on the structure, quality and potential for bias of the databases used. When we implement the protocol, we will consider and document any biases specific to the dataset and conduct appropriate sensitivity analyses. Findings will be disseminated to local stakeholders via conferences, and published in appropriate scientific journals.
Source: BMJ Open - May 9, 2022 Category: General Medicine Authors: Hinwood, M., Nyberg, J., Leigh, L., Gustavsson, S., Attia, J., Oldmeadow, C., Ilicic, M., Linden, T., Aberg, N. D., Levi, C., Spratt, N., Carey, L. M., Pollack, M., Johnson, S. J., Kuhn, G. H., Walker, F. R., Nilsson, M. Tags: Open access, Neurology Source Type: research

Person-centred care transitions for people with stroke: study protocol for a feasibility evaluation of codesigned care transition support
This study protocol describes the evaluation of a feasibility study using a non-randomised controlled design. The codesigned care transition support includes patient information using videos, leaflets and teach back; what-matters-to me dialogue; a coordinated rehabilitation plan; bridged e-meeting; and a message system for cross-organisational collaboration. Patients with stroke, first time or recurrent, who are to be discharged home from hospital and referred to a rehabilitation team in primary healthcare for continued rehabilitation in the home will be included. One week after stroke, data will be collected on the primar...
Source: BMJ Open - December 23, 2021 Category: General Medicine Authors: Flink, M., Lindblom, S., Tistad, M., Laska, A. C., Bertilsson, B. C., Wärlinge, C., Hasselström, J., Elf, M., von Koch, L., Ytterberg, C. Tags: Open access, Neurology Source Type: research

Prestroke physical activity and outcomes after intracerebral haemorrhage in comparison to ischaemic stroke: protocol for a matched cohort study (part of PAPSIGOT)
Introduction Piling evidence suggests that a higher level of prestroke physical activity can decrease stroke severity, and reduce the risk of poststroke mortality. However, prior studies have only included ischaemic stroke cases, or a majority of such. We aim to investigate how premorbid physical activity influences admission stroke severity and poststroke mortality in patients with intracerebral haemorrhage, compared with ischaemic stroke. A prespecified analysis plan counteract some inherent biases in observational studies, and promotes transparency. Methods and analysis This is a statistical analysis protocol for a mat...
Source: BMJ Open - November 19, 2021 Category: General Medicine Authors: Viktorisson, A., Buvarp, D., Sunnerhagen, K. S. Tags: Open access, Neurology Source Type: research

Potential effects on cardiometabolic risk factors and body composition by short message service (SMS)-guided training after recent minor stroke or transient ischaemic attack: post hoc analyses of the STROKEWALK randomised controlled trial
Conclusions No clear effect of 3 months daily mobile phone delivered training instructions was detected on body composition, cardiovascular biochemical risk factors or self-perceived health. Further research is needed to evaluate secondary prevention efforts in larger populations after recent stroke. Trial registration number NCT02902367.
Source: BMJ Open - October 18, 2021 Category: General Medicine Authors: Vahlberg, B. M., Lundström, E., Eriksson, S., Holmback, U., Cederholm, T. Tags: Open access, Rehabilitation medicine Source Type: research

Loss of height predicts total and cardiovascular mortality: a cohort study of northern European women
Conclusion Height loss is a marker for excess mortality in northern European women. Specifically the hazard of CVD mortality is increased in women with height loss during middle age, and the results suggest that the strongest cause-specific endpoint may be stroke mortality. The present findings suggest attention to height loss in early and mid-adulthood to identify women at high risk of CVD, and that regular physical activity may prevent early onset height loss.
Source: BMJ Open - August 9, 2021 Category: General Medicine Authors: Klingberg, S., Mehlig, K., Dangol, R., Björkelund, C., Heitmann, B. L., Lissner, L. Tags: Open access, Press releases, Epidemiology Source Type: research

Cohort profile: systemic lupus erythematosus in Sweden: the Swedish Lupus Linkage (SLINK) cohort
Purpose A cohort of individuals with systemic lupus erythematosus (SLE) was identified through linkage of several national registers to investigate important epidemiological questions using not only population-based data to minimise selection bias, but also to identify matched comparators from the general population to serve as controls. This cohort was established to overcome the general dearth of data in SLE epidemiology. Participants All individuals registered in Sweden with a personal identity number and who have obtained medical care at any hospital or public non-primary outpatient specialist care with suspected SLE ...
Source: BMJ Open - August 14, 2015 Category: Journals (General) Authors: Arkema, E. V., Simard, J. F. Tags: Open access, Epidemiology, Rheumatology Cohort profile Source Type: research