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https://www.readbyqxmd.com/read/27935977/the-effects-of-a-community-based-sodium-reduction-program-in-rural-china-a-cluster-randomized-trial
#1
Nicole Li, Lijing L Yan, Wenyi Niu, Chen Yao, Xiangxian Feng, Jianxin Zhang, Jingpu Shi, Yuhong Zhang, Ruijuan Zhang, Zhixin Hao, Hongling Chu, Jing Zhang, Xian Li, Jianhong Pan, Zhifang Li, Jixin Sun, Bo Zhou, Yi Zhao, Yan Yu, Michael Engelgau, Darwin Labarthe, Jixiang Ma, Stephen MacMahon, Paul Elliott, Yangfeng Wu, Bruce Neal
BACKGROUND: Average sodium intake and stroke mortality in northern China are both among the highest in the world. An effective, low-cost strategy to reduce sodium intake in this population is urgently needed. OBJECTIVE: We sought to determine the effects of a community-based sodium reduction program on salt consumption in rural northern China. DESIGN: This study was a cluster-randomized trial done over 18 months in 120 townships (one village from each township) from five provinces...
2016: PloS One
https://www.readbyqxmd.com/read/27926449/the-role-of-dopamine-in-the-pathophysiology-and-treatment-of-apathy
#2
T T-J Chong, M Husain
Disorders of diminished motivation, such as apathy, are common and prevalent across a wide range of medical conditions, including Parkinson's disease, Alzheimer's dementia, stroke, depression, and schizophrenia. Such disorders have a significant impact on morbidity and quality of life, yet their management lacks consensus and remains unsatisfactory. Here, we review laboratory and clinical evidence for the use of dopaminergic therapies in the treatment of apathy. Dopamine is a key neurotransmitter that regulates motivated decision making in humans and other species...
2016: Progress in Brain Research
https://www.readbyqxmd.com/read/27925894/prevention-of-herpes-zoster-and-its-complications-from-clinical-evidence-to-real-life-experience
#3
Giovanni Gabutti, Paolo Bonanni, Michele Conversano, Guido Fanelli, Elisabetta Franco, Donato Greco, Giancarlo Icardi, Marzia Lazzari, Alessandro Rossi, Silvestro Scotti, Antonio Volpi
Herpes zoster (HZ) is an acute viral illness characterized by a vesicular rash with unilateral distribution, which can also result in severe complications such as post-herpetic neuralgia (PHN), ophthalmic zoster, stroke or other neurological complications. The estimate incidence in Europe ranges between 2.0 and 4.6 cases per 1,000 person-years, with a sharp increase in >50 year-old subjects. Currently, treatment options for HZ are only partially effective in limiting the acute phase, while the management of complications is complex and often unsatisfactory...
December 7, 2016: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/27924429/cyp2c19-lof-and-gof-guided-antiplatelet-therapy-in-patients-with-acute-coronary-syndrome-a-cost-effectiveness-analysis
#4
Minghuan Jiang, Joyce H S You
PURPOSE: This study aimed to examine the cost-effectiveness of CYP2C19 loss-of-function and gain-of-function allele guided (LOF/GOF-guided) antiplatelet therapy in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). METHODS: A life-long decision-analytic model was designed to simulate outcomes of three strategies: universal clopidogrel (75 mg daily), universal alternative P2Y12 inhibitor (prasugrel 10 mg daily or ticagrelor 90 mg twice daily), and LOF/GOF-guided therapy (LOF/GOF allele carriers receiving alternative P2Y12 inhibitor, wild-type patients receiving clopidogrel)...
December 7, 2016: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/27924216/atrial-fibrillation-management-in-older-heart-failure-patients-a-complex-clinical-problem
#5
REVIEW
Giovanni Pulignano, Donatella Del Sindaco, Maria Denitza Tinti, Stefano Tolone, Giovanni Minardi, Antonio Lax, Massimo Uguccioni
BACKGROUND: Atrial fibrillation (AF) and heart failure (HF), two problems of growing prevalence as a consequence of the ageing population, are associated with high morbidity, mortality, and healthcare costs. AF and HF also share common risk factors and pathophysiologic processes such as hypertension, diabetes mellitus, ischemic heart disease, and valvular heart disease often occur together. Although elderly patients with both HF and AF are affected by worse symptoms and poorer prognosis, there is a paucity of data on appropriate management of these patients...
January 2016: Heart International
https://www.readbyqxmd.com/read/27914920/can-lowering-the-guidance-force-of-robot-assisted-gait-training-induce-a-sufficient-metabolic-demand-in-subacute-dependent-ambulatory-stroke-patients
#6
So Young Lee, Eun Young Han, Bo Ryun Kim, Min Ho Chun, Yong Ki Lee
OBJECTIVE: To assess the effects of guidance force (GF) and gait speed (GS) on cardiorespiratory responses and energy cost in subacute dependent ambulatory stroke patients. DESIGN: Cross sectional study. SETTING: University rehabilitation hospital. PARTICIPANTS: Ten subacute stroke patients (mean age: 64.50±19.20), who were dependent ambulators (functional ambulation category [FAC] ≤2). INTERVENTIONS: Patients participated in cardiorespiratory tests during robot-assisted gait training...
November 30, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27912744/quality-of-life-after-stroke-in-pakistan
#7
Wardah Khalid, Shafquat Rozi, Tazeen Saeed Ali, Iqbal Azam, Michael T Mullen, Saleem Illyas, Qamar Un-Nisa, Nabila Soomro, Ayeesha Kamran Kamal
BACKGROUND: There is very little information about the quality of life (QOL) of stroke survivors in LMIC countries with underdeveloped non communicable health infrastructures, who bear two thirds of the global stroke burden. METHODOLOGY: We used a sequential mix methods approach. First, a quantitative analytical cross-sectional study was conducted on 700 participants, who constituted 350 stroke survivor and their caregiver dyads. QOL of stroke survivor was assessed via Stroke Specific Quality of Life Scale (SSQOLS) whereas QOL of caregivers was assessed through RAND-36...
December 3, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27909516/the-role-of-noacs-in-atrial-fibrillation-management-a-qualitative-study
#8
Katherine Kirley Md Ms, Goutham Rao Md, Victoria Bauer Bs, Christopher Masi Md PhD
Patients with atrial fibrillation (AF) benefit from anticoagulation to reduce stroke risk. However, 30-60% of patients with AF are not anticoagulated. This study explored physicians' reasons for under-treatment of AF, focusing on the role of the novel oral anticoagulants (NOACs). We interviewed primary care physicians and cardiologists involved in AF management in a variety of practice settings. We conducted interviews using a semi-structured format and analyzed the data using the Framework Method. Four themes emerged...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909482/the-cost-effectiveness-of-laa-exclusion
#9
REVIEW
Bahij Kreidieh, Moisés Rodríguez-Mañero, Sergio H Ibarra-Cortez, Paul Schurmann, Miguel Valderrábano
Left atrial appendage (LAA) exclusion strategies are increasingly utilized for stroke prevention in lieu of oral anticoagulants. Reductions in bleeding risk and long-term compliance issues bundled with comparable stroke prevention benefits have made these interventions increasingly attractive. Unfortunately, healthcare funding remains limited. Comparative cost economic analyses are therefore critical in optimizing resource allocation. In this review we seek to discourse the cost economics analysis of LAA exclusion over available therapeutic alternatives (warfarin and the new oral anticoagulants (NOACs))...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909470/clinical-and-economic-implications-of-af-related-stroke
#10
REVIEW
Dr Ali N Ali, Dr Ahmed Abdelhafiz
A major cause of morbidity and mortality among patients with atrial fibrillation (AF) relates to the increased risk of stroke. The burden of illness that AF imparts on stroke is likely to increase with our aging populations and increasingly sophisticated cardiac monitoring techniques. Understanding the clinical and economic differences between AF related ischaemic stroke and non-AF related stroke is important if we are to improve future cost effectiveness analyses of potential preventative treatments, but also to help educate clinical and policy decision makers on use or availability of treatments to prevent AF related stroke...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27902693/the-long-term-benefits-of-increased-aspirin-use-by-at-risk-americans-aged-50-and-older
#11
David B Agus, Étienne Gaudette, Dana P Goldman, Andrew Messali
BACKGROUND: The usefulness of aspirin to defend against cardiovascular disease in both primary and secondary settings is well recognized by the medical profession. Multiple studies also have found that daily aspirin significantly reduces cancer incidence and mortality. Despite these proven health benefits, aspirin use remains low among populations targeted by cardiovascular prevention guidelines. This article seeks to determine the long-term economic and population-health impact of broader use of aspirin by older Americans at higher risk for cardiovascular disease...
2016: PloS One
https://www.readbyqxmd.com/read/27902409/prevention-of-herpes-zoster-and-its-complications-from-the-clinic-to-the-real-life-experience-with-the-vaccine
#12
Giovanni Gabutti, Nicoletta Valente, Parvanè Kuhdari, Silvia Lupi, Armando Stefanati
The Herpes Zoster (HZ) is an acute viral illness characterized by a vesicular rash, with unilateral distribution, which can eventually cause severe complications, such as the post-herpetic neuralgia (PHN), the ophthalmic zoster, stroke or other neurological complications. In Europe, an incidence between 2.0 and 4.6 cases per 1,000 persons-year is estimated, with an increase after 50 years of age. Currently, the therapeutic options for HZ are only partially effective to limit the acute phase, while the management of complications is frequently complex and not satisfactory...
November 4, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27901325/asymptomatic-carotid-artery-stenosis-who-should-be-screened-who-should-be-treated-and-how-should-we-treat-them
#13
Djurre D DE Waard, Dylan Morris, Gert J DE Borst, Richard Bulbulia, Alison Halliday
Although stopping smoking, lowering blood pressure and reducing lipid levels will reduce global stroke risk and cardiovascular mortality, these remain leading causes of death and disability especially in ageing populations. Further prevention strategies are needed and, in the first part of this review, we explore the potential benefits of appropriate screening for carotid artery disease to reduce stroke and identify those who may have related cardiac disease. Although whole-population carotid screening is an inefficient and costly means of identifying candidates with tight carotid stenosis who might warrant intervention, it can identify many people with lower levels of stenosis who may benefit from cardiovascular risk reducing medications...
November 30, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27884193/reorganising-specialist-cancer-surgery-for-the-twenty-first-century-a-mixed-methods-evaluation-respect-21
#14
Naomi J Fulop, Angus I G Ramsay, Cecilia Vindrola-Padros, Michael Aitchison, Ruth J Boaden, Veronica Brinton, Caroline S Clarke, John Hines, Rachael M Hunter, Claire Levermore, Satish B Maddineni, Mariya Melnychuk, Caroline M Moore, Muntzer M Mughal, Catherine Perry, Kathy Pritchard-Jones, David C Shackley, Jonathan Vickers, Stephen Morris
BACKGROUND: There are longstanding recommendations to centralise specialist healthcare services, citing the potential to reduce variations in care and improve patient outcomes. Current activity to centralise specialist cancer surgical services in two areas of England provides an opportunity to study the planning, implementation and outcomes of such changes. London Cancer and Manchester Cancer are centralising specialist surgical pathways for prostate, bladder, renal, and oesophago-gastric cancers, so that these services are provided in fewer hospitals...
November 25, 2016: Implementation Science: IS
https://www.readbyqxmd.com/read/27882517/cost-effectiveness-of-apixaban-versus-warfarin-or-aspirin-for-stroke-prevention-in-patients-with-atrial-fibrillation-a-greek-perspective
#15
Kostas Athanasakis, Nadia Boubouchairopoulou, Eleftheria Karampli, Filippos Tarantilis, Paraskevi Savvari, Aikaterini Bilitou, John Kyriopoulos
BACKGROUND: Strokes attributed to atrial fibrillation (AF) represent a major cause of adult disability and a great burden to society and healthcare systems. OBJECTIVES: Our objective was to assess the cost effectiveness of apixaban, a direct acting oral anticoagulant (DOAC), versus warfarin or aspirin for patients with AF in the Greek healthcare setting. METHODS: We used a previously published Markov model to simulate clinical events for patients with AF treated with apixaban, the vitamin K antagonist (VKA) warfarin, or aspirin...
November 23, 2016: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/27881154/targeted-next-generation-sequencing-identifies-novel-notch3-gene-mutations-in-cadasil-diagnostics-patients
#16
Neven Maksemous, Robert A Smith, Larisa M Haupt, Lyn R Griffiths
BACKGROUND: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a monogenic, hereditary, small vessel disease of the brain causing stroke and vascular dementia in adults. CADASIL has previously been shown to be caused by varying mutations in the NOTCH3 gene. The disorder is often misdiagnosed due to its significant clinical heterogeneic manifestation with familial hemiplegic migraine and several ataxia disorders as well as the location of the currently identified causative mutations...
November 24, 2016: Human Genomics
https://www.readbyqxmd.com/read/27879532/myocardial-protection-and-financial-considerations-of-custodiol-cardioplegia-in-minimally-invasive-and-open-valve-surgery
#17
Brian W Hummel, Randall W Buss, Paul L DiGiorgi, Brittany N Laviano, Nalani A Yaeger, M Lee Lucas, George M Comas
OBJECTIVE: Single-dose antegrade crystalloid cardioplegia with Custodiol-HTK (histidine-tryptophan-ketoglutarate) has been used for many years. Its safety and efficacy were established in experimental and clinical studies. It is beneficial in complex valve surgery because it provides a long period of myocardial protection with a single dose. Thus, valve procedures (minimally invasive or open) can be performed with limited interruption. The aim of this study is to compare the use of Custodiol-HTK cardioplegia with traditional blood cardioplegia in patients undergoing minimally invasive and open valve surgery...
November 22, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27878613/intermittent-low-dose-bevacizumab-in-hereditary-hemorrhagic-telangiectasia-a%C3%A2-case-report
#18
Florian Huemer, Martin Dejaco, Christoph Grabmer, Thomas Melchardt, Daniel Neureiter, Georg Mayer, Alexander Egle, Richard Greil, Lukas Weiss
BACKGROUND: Hereditary hemorrhagic telangiectasia is an inherited autosomal dominant disease presenting with recurrent bleeding episodes and iron deficiency anemia due to vascular malformations. Hereditary hemorrhagic telangiectasia is associated with an increased risk of stroke, gastrointestinal bleeding and pulmonary hypertension and life expectancy is significantly reduced. Excess vascular endothelial growth factor (VEGF) plays a key role in the pathophysiology of the disease. CASE PRESENTATION: Here we report about a male patient with hereditary hemorrhagic telangiectasia presenting with pulmonary and central nervous system involvement experiencing repetitive nosebleeds, necessitating frequent local cauterization and transfusion of more than 100 units of packed red blood cells...
November 23, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27876695/modelling-projections-for-the-uptake-of-edoxaban-in-an-european-population-to-2050-effects-on-stroke-thromboembolism-and-health-economics-perspectives
#19
Andrew D Blann, Giuseppe Boriani, Gregory Y H Lip
AIMS: In the coming decades, the number of Europeans with atrial fibrillation (AF) is set to rise as the population ages, and so with it will the number of strokes. The risk of thromboembolism (principally stroke and systemic embolism) and death can be reduced by the use of the vitamin K antagonists (VKA, e.g. warfarin) and more so by non-VKA oral anticoagulants (NOACs) such as edoxaban. METHODS AND RESULTS: We modelled the effect of the increasing use of edoxaban in preference to warfarin in a European AF population from both clinical and economic perspectives...
October 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27876083/two-year-clinical-follow-up-of-the-multicenter-randomized-clinical-trial-of-endovascular-treatment-for-acute-ischemic-stroke-in-the-netherlands-mr-clean-design-and-statistical-analysis-plan-of-the-extended-follow-up-study
#20
Lucie A van den Berg, Marcel G W Dijkgraaf, Olvert A Berkhemer, Puck S S Fransen, Debbie Beumer, Hester Lingsma, Charles B M Majoie, Diederik W J Dippel, Aad J van der Lugt, Robert J van Oostenbrugge, Wim H van Zwam, Yvo B W E M Roos
BACKGROUND: MR CLEAN was the first randomized trial to demonstrate the short-term clinical effectiveness of endovascular treatment in patients with acute ischemic stroke caused by large vessel occlusion in the anterior circulation. Several other trials confirmed that endovascular treatment improves clinical outcome at three months. However, limited data are available on long-term clinical outcome. We aimed to estimate the effect of endovascular treatment on functional outcome at two-year follow-up in patients with acute ischemic stroke...
November 22, 2016: Trials
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