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Source: BMJ Open

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Total 555 results found since Jan 2013.

Impact of gender on event rates at 1 year in patients with newly diagnosed non-valvular atrial fibrillation: contemporary perspective from the GARFIELD-AF registry
Conclusions Women have a higher risk of stroke/SE and the reduction in stroke/SE events rates with AC treatment is less in women than in men. Trial registration number NCT01090362.
Source: BMJ Open - March 5, 2017 Category: Journals (General) Authors: Camm, A. J., Accetta, G., Al Mahmeed, W., Ambrosio, G., Goldhaber, S. Z., Haas, S., Jansky, P., Kayani, G., Misselwitz, F., Oh, S., Oto, A., Raatikainen, P., Steffel, J., van Eickels, M., Kakkar, A. K., for the GARFIELD-AF Investigators Tags: Open access, Cardiovascular medicine Research Source Type: research

Analysis of CYP2C19 genetic variants with ischaemic events in UK patients prescribed clopidogrel in primary care: a retrospective cohort study
Conclusions A substantial proportion of the UK population carry genetic variants that reduce metabolism of clopidogrel to its active form. In family practice patients on clopidogrel, CYP2C19 LoF variants are associated with substantially higher incidence of ischaemic events. Genotype-guided selection of antiplatelet medications may improve outcomes in patients carrying CYP2C19 genetic variants.
Source: BMJ Open - December 13, 2021 Category: General Medicine Authors: Pilling, L. C., Türkmen, D., Fullalove, H., Atkins, J. L., Delgado, J., Kuo, C.-L., Kuchel, G. A., Ferrucci, L., Bowden, J., Masoli, J. A. H., Melzer, D. Tags: Open access, Cardiovascular medicine Source Type: research

Prediction of individual combined benefit and harm for patients with atrial fibrillation considering warfarin therapy: a study protocol
This study has been approved by the KPCO Institutional Review Board and the Hamilton Integrated Research Ethics Board. Results from this study will be published in a peer-reviewed journal electronically and in print. The prediction models may aid in patient-physician shared decision-making when they are considering warfarin therapy.
Source: BMJ Open - November 5, 2015 Category: Journals (General) Authors: Li, G., Holbrook, A., Delate, T., Witt, D. M., Levine, M. A., Thabane, L. Tags: Open access, Cardiovascular medicine, Epidemiology, Pharmacology and therapeutics, Public health Protocol Source Type: research

Pregnancy hypertensive disease and risk of dementia and cardiovascular disease in women aged 65 years or older: a cohort study
Conclusions There was no increased risk of dementia after self-reported pregnancy hypertensive disease in our cohort. We found that the previously reported increased risk of CVD and stroke after pregnancy hypertensive disease persists in an older population.
Source: BMJ Open - January 21, 2016 Category: Journals (General) Authors: Nelander, M., Cnattingius, S., Akerud, H., Wikström, J., Pedersen, N. L., Wikström, A.-K. Tags: Open access, Cardiovascular medicine, Obgyn Research Source Type: research

Is poor oral health a risk marker for incident cardiovascular disease hospitalisation and all-cause mortality? Findings from 172 630 participants from the prospective 45 and Up Study
Conclusions Tooth loss and, to a lesser extent, self-rated health of teeth and gums, are markers for increased risk of IHD, PVD and all-cause mortality. Tooth loss is also a marker for increased risk of HF.
Source: BMJ Open - August 29, 2016 Category: Journals (General) Authors: Joshy, G., Arora, M., Korda, R. J., Chalmers, J., Banks, E. Tags: Open access, Cardiovascular medicine, Dentistry and oral medicine, Epidemiology, Health services research Source Type: research

Ultrasound and NICOM in the assessment of fluid responsiveness in patients with mild sepsis in the emergency department: a pilot study
Conclusions Our small pilot study suggests that at least 1000 mL saline is needed to induce a significant response in stroke volume in patients with sepsis and a high caval index. This amount seems to be safe, not leading to the development of fluid overload. Therefore, combining ultrasound and NICOM is feasible and may be valuable tools in the treatment of patients with sepsis in the ED. A larger trial is needed to confirm these results.
Source: BMJ Open - January 26, 2017 Category: Journals (General) Authors: Oord, M., Olgers, T. J., Doff-Holman, M., Harms, M. P. M., Ligtenberg, J. J. M., ter Maaten, J. C. Tags: Open access, Emergency medicine, Infectious diseases Research Source Type: research

Exploring the poststroke experiences and unmet needs of South Asian communities in high-income countries: a scoping review protocol
Conclusion and implications Findings will enhance knowledge of the poststroke experiences and needs of South Asian communities living in high-income countries and identify actionable opportunities for community-based resources to address needs. Ethics and dissemination Ethics approval was not required for this scoping review protocol. Community-based organisations will be consulted to provide insights into the analysis and assist with dissemination. Dissemination of findings will also occur through a publication and academic presentations.
Source: BMJ Open - April 27, 2022 Category: General Medicine Authors: Kokorelias, K. M., Nelson, M. L. A., Cameron, J. I., Colquhoun, H., Munce, S., Hitzig, S. L., Salbach, N. M., Martyniuk, J., Steele Gray, C., Tang, T., Wang, R. H., Lindsay, P., Bayley, M., Kaur, N., Singh, H. Tags: Open access, Health services research Source Type: research

FAST-IT: Find A Simple Test -- In TIA (transient ischaemic attack): a prospective cohort study to develop a multivariable prediction model for diagnosis of TIA through proteomic discovery and candidate lipid mass spectrometry, neuroimaging and machine learning--study protocol
Introduction Transient ischaemic attack (TIA) may be a warning sign of stroke and difficult to differentiate from minor stroke and TIA-mimics. Urgent evaluation and diagnosis is important as treating TIA early can prevent subsequent strokes. Recent improvements in mass spectrometer technology allow quantification of hundreds of plasma proteins and lipids, yielding large datasets that would benefit from different approaches including machine learning. Using plasma protein, lipid and radiological biomarkers, our study will develop predictive algorithms to distinguish TIA from minor stroke (positive control) and TIA-mimics (n...
Source: BMJ Open - April 1, 2022 Category: General Medicine Authors: Milton, A. G., Lau, S., Kremer, K. L., Rao, S. R., Mas, E., Snel, M. F., Trim, P. J., Sharma, D., Edwards, S., Jenkinson, M., Kleinig, T., Noschka, E., Hamilton-Bruce, M. A., Koblar, S. A. Tags: Open access, Health services research Source Type: research

Using primary care data to assess comparative effectiveness and safety of apixaban and rivaroxaban in patients with nonvalvular atrial fibrillation in the UK: an observational cohort study
Conclusions Among patients with nonvalvular AFib, apixaban was as effective as rivaroxaban in reducing rate of stroke and safer in terms of major bleeding episodes. This head-to-head comparison supports conclusions drawn from indirect comparisons of DOAC trials against warfarin and demonstrates the potential for real-world evidence to fill evidence gaps and reduce uncertainty in both health technology assessment decision-making and clinical guideline development.
Source: BMJ Open - October 17, 2022 Category: General Medicine Authors: Jaksa, A., Gibbs, L., Kent, S., Rowark, S., Duffield, S., Sharma, M., Kincaid, L., Ali, A. K., Patrick, A. R., Govil, P., Jonsson, P., Gatto, N. Tags: Open access, Cardiovascular medicine Source Type: research

Risk of cardiovascular events leading to hospitalisation after Streptococcus pneumoniae infection: a retrospective cohort LIFE Study
Conclusions S. pneumoniae infections elevate the risk of subsequent stroke and AF occurrence. These findings indicate that pneumococcal infections have short-term effects on patients’ health and increase their midterm to long-term susceptibility to serious cardiovascular events.
Source: BMJ Open - November 4, 2022 Category: General Medicine Authors: Nishimura, N., Fukuda, H. Tags: Open access, Cardiovascular medicine Source Type: research

Pre-eclampsia and cardiovascular risk: a long-term nationwide cohort study on over 120 000 Finnish women
Conclusion Pre-eclampsia-related significant elevations in CVD risks of Finnish women with inherently high risk for these diseases were of the same magnitude as reported previously from other countries. Thus, women with a history of pre-eclampsia should be screened and treated early for modifiable cardiovascular risk factors.
Source: BMJ Open - December 22, 2022 Category: General Medicine Authors: Venetkoski, M., Joensuu, J., Gissler, M., Ylikorkala, O., Mikkola, T. S., Savolainen-Peltonen, H. Tags: Open access Obstetrics and gynaecology Source Type: research

Vestibular syndromes, diagnosis and diagnostic errors in patients with dizziness presenting to the emergency department: a cross-sectional study
Conclusions One-fourth of patients with dizziness in the ED presented with AVS with a high prevalence (10%) of vestibular strokes. EVS was more frequent; however, the rate of undiagnosed patients with dizziness and the number of patients receiving neuroimaging were high. Almost half of them still remained without diagnosis and among those diagnosed were often misclassified. Many unclear cases of vertigo could be diagnostically clarified after a follow-up visit.
Source: BMJ Open - March 24, 2023 Category: General Medicine Authors: Comolli, L., Korda, A., Zamaro, E., Wagner, F., Sauter, T. C., Caversaccio, M. D., Nikles, F., Jung, S., Mantokoudis, G. Tags: Open access, Ear, nose and throat/otolaryngology Source Type: research

Evaluating the implementation of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) in three rehabilitation settings in Quebec: a mixed-methods study protocol
The objectives are to: (a) describe the context of MPAI-4 implementation; (b) determine clinical teams’ readiness for change; (c) identify barriers and enablers to implementing the MPAI-4 and match the implementation strategies; (d) evaluate the MPAI-4 implementation outcomes including the degree of integration of the MPAI-4 into clinical practice and (e) explore participants’ experiences using the MPAI-4. Methods and analysis We will use a multiple case study design within an integrated knowledge translation (iKT) approach with active engagement from key informants. Each case is a rehabilitation centre implem...
Source: BMJ Open - May 23, 2023 Category: General Medicine Authors: Kengne Talla, P., Thomas, A., Ataman, R., Auger, C., McKerral, M., Wittich, W., Poncet, F., Ahmed, S. Tags: Open access, Rehabilitation medicine Source Type: research

Integrative-interpersonal dynamic therapy for poststroke depression (INID): study protocol of a randomised controlled pilot trial
Introduction Depression is the most frequent psychiatric disorder following stroke, affecting about one-third of stroke survivors. Patients experience poorer recovery, lower quality of life and higher mortality compared with stroke survivors without depression. Despite these well-known malign consequences, poststroke depression (PSD) is regarded underdiagnosed and undertreated. Evidence of beneficial effects of psychotherapy to treat PSD remains scarce and inconclusive and is limited by heterogeneity in design, content and timing of the intervention. This pilot study aims to assess the feasibility of a newly developed inte...
Source: BMJ Open - August 8, 2023 Category: General Medicine Authors: Volz, M., Mundiyanapurath, S., Schauenburg, H., Meuth, S. G., Wild, B., Werheid, K., Barber, J. P., Schäfer, R., Beerbaum, L., Dinger, U. Tags: Open access, Rehabilitation medicine Source Type: research

Cardiovascular effects of rivaroxaban in heart failure patients with sinus rhythm and coronary disease with and without diabetes: a retrospective international cohort study from COMMANDER-HF
Conclusions In COMMANDER-HF a diagnosis of diabetes conferred higher rates of cardiovascular events that, with exception of ischaemic stroke, was not substantially reduced by rivaroxaban. Rivaroxaban was associated with reduced risk of ischaemic stroke for patients with and without diabetes. Trial registration number NCT01877915; Post-results.
Source: BMJ Open - August 11, 2023 Category: General Medicine Authors: Sharma, A., Caldeira, D., Razaghizad, A., Pinto, F. J., van Veldhuisen, D. J., Mehra, M. R., Lam, C. S. P., Cleland, J., Anker, S. D., Greenberg, B., Ferreira, J. P., Zannad, F. Tags: Open access, Cardiovascular medicine Source Type: research