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https://www.readbyqxmd.com/read/29789877/-meta-analyses-on-measurement-precision-of-non-invasive-hemodynamic-monitoring-technologies-in-adults
#1
G Pestel, K Fukui, M Higashi, I Schmidtmann, C Werner
An ideal non-invasive monitoring system should provide accurate and reproducible measurements of clinically relevant variables that enables clinicians to guide therapy accordingly. The monitor should be rapid, easy to use, readily available at the bedside, operator-independent, cost-effective and should have a minimal risk and side effect profile for patients. An example is the introduction of pulse oximetry, which has become established for non-invasive monitoring of oxygenation worldwide. A corresponding non-invasive monitoring of hemodynamics and perfusion could optimize the anesthesiological treatment to the needs in individual cases...
May 22, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29778671/international-study-of-comparative-health-effectiveness-with-medical-and-invasive-approaches-ischemia-trial-rationale-and-design
#2
David J Maron, Judith S Hochman, Sean M O'Brien, Harmony R Reynolds, William E Boden, Gregg W Stone, Sripal Bangalore, John A Spertus, Daniel B Mark, Karen P Alexander, Leslee Shaw, Jeffrey S Berger, T Bruce Ferguson, David O Williams, Robert A Harrington, Yves Rosenberg
BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only included participants in whom coronary anatomy was known prior to randomization and did not include sufficient numbers of participants with significant ischemia. It remains unknown whether a routine invasive approach offers incremental value over a conservative approach with catheterization reserved for failure of medical therapy in patients with moderate or severe ischemia...
April 21, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29768942/updated-meta-review-of-evidence-on-support-for-carers
#3
Jane Dalton, Sian Thomas, Melissa Harden, Alison Eastwood, Gillian Parker
Objective To update a 2010 meta-review of systematic reviews of effective interventions to support carers of ill, disabled, or older adults. In this article, we report the most promising interventions based on the best available evidence. Methods Rapid meta-review of systematic reviews published from January 2009 to 2016. Results Sixty-one systematic reviews were included (27 high quality, 25 medium quality, and nine low quality). The quality of reviews has improved since the original review, but primary studies remain limited in quality and quantity...
January 1, 2018: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/29754661/catheter-ablation-versus-antiarrhythmic-drug-therapy-for-atrial-fibrillation-cabana-trial-study-rationale-and-design
#4
Douglas L Packer, Daniel B Mark, Richard A Robb, Kristi H Monahan, Tristram D Bahnson, Kathleen Moretz, Jeanne E Poole, Alice Mascette, Yves Rosenberg, Neal Jeffries, Hussein R Al-Khalidi, Kerry L Lee
The Catheter Ablation Versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation (CABANA,NCT00911508)(1) trial is testing the hypothesis that the treatment strategy of percutaneous left atrial catheter ablation for the purpose of eliminating atrial fibrillation (AF) is superior to current state-of-the-art pharmacologic therapy. This international 140-center clinical trial was designed to randomize 2200 patients to a strategy of catheter ablation versus state-of-the-art rate or rhythm control drug therapy. Inclusion criteria include: 1) age> 65, or ≤65 with≥ 1 risk factor for stroke, 2) documented AF warranting treatment, and 3) eligibility for both catheter ablation and≥ 2 anti-arrhythmic or≥ 2 rate control drugs...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29752194/sex-specific-relevance-of-diabetes-to-occlusive-vascular-and-other-mortality-a-collaborative-meta-analysis-of-individual-data-from-980-793-adults-from-68-prospective-studies
#5
(no author information available yet)
BACKGROUND: Several studies have shown that diabetes confers a higher relative risk of vascular mortality among women than among men, but whether this increased relative risk in women exists across age groups and within defined levels of other risk factors is uncertain. We aimed to determine whether differences in established risk factors, such as blood pressure, BMI, smoking, and cholesterol, explain the higher relative risks of vascular mortality among women than among men. METHODS: In our meta-analysis, we obtained individual participant-level data from studies included in the Prospective Studies Collaboration and the Asia Pacific Cohort Studies Collaboration that had obtained baseline information on age, sex, diabetes, total cholesterol, blood pressure, tobacco use, height, and weight...
May 8, 2018: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29749670/influence-of-water-depth-on-energy-expenditure-during-aquatic-walking-in-people-post-stroke
#6
Hyosok Lim, Daniel Azurdia, Brenda Jeng, Taeyou Jung
BACKGROUND AND PURPOSE: This study aimed to investigate the metabolic cost during aquatic walking at various depths in people post stroke. The secondary purpose was to examine the differences in metabolic cost between aquatic walking and land walking among individuals post stroke. DESIGN: A cross-sectional research design is used. METHODS: Twelve participants post stroke (aged 55.5 ± 13.3 years) completed 6 min of walking in 4 different conditions: chest-depth, waist-depth, and thigh-depth water, and land...
May 11, 2018: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
https://www.readbyqxmd.com/read/29749130/effects-of-coronary-artery-revascularization-with-a-polymer-free-biolimus-a9-coated-biofreedom-stent-versus-bypass-surgery-before-noncardiac-surgery
#7
Kyu Kim, Choongki Kim, Byeong Keuk Kim, Ji Yong Jang, Ae Young Her, Seunghwan Kim, Sung Jin Hong, Chul Min Ahn, Jung Sun Kim, Young Guk Ko, Donghoon Choi, Myeong Ki Hong, Yangsoo Jang
PURPOSE: The present study aimed to evaluate the efficacy and safety of polymer-free drug-coated BioFreedom stent implantation in comparison to coronary artery bypass graft (CABG) before major noncardiac surgery. MATERIALS AND METHODS: In a multicenter registry, 55 patients required revascularization before major noncardiac surgery that should not be delayed >6 months. Of them, 27 underwent BioFreedom stent implantation and 28 underwent CABG. Primary outcomes included rate of noncardiac surgery, time from revascularization to noncardiac surgery, and occurrence of composite outcomes (all-cause death, myocardial infarction, stent thrombosis, stroke, repeat revascularization, or major bleeding)...
June 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29743980/long-term-resveratrol-supplementation-as-a-secondary-prophylaxis-for-stroke
#8
Katalin Fodor, Delia Mirela Tit, Bianca Pasca, Cristiana Bustea, Diana Uivarosan, Laura Endres, Ciprian Iovan, Mohamed M Abdel-Daim, Simona Bungau
Stroke is a leading cause of mortality worldwide, as well as a source of long-term disabilities and huge socioeconomic costs. This study investigates the effects of resveratrol, an antioxidant supplement, on blood pressure, weight status, glucose, and lipid profile in patients who had a stroke in the last 12 months. Two hundred and twenty-eight patients were divided into three groups: group I received only allopathic treatment (control group), while groups II and III received allopathic treatment with a daily supplementation of oral resveratrol (100 and 200 mg, resp...
2018: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29743322/protocol-for-a-randomised-controlled-trial-to-evaluate-the-effectiveness-of-the-care-for-stroke-intervention-in-india-a-smartphone-enabled-carer-supported-educational-intervention-for-management-of-disabilities-following-stroke
#9
K Sureshkumar, G V S Murthy, Hannah Kuper
INTRODUCTION: The rising prevalence of stroke and stroke-related disability witnessed globally over the past decades may cause an overwhelming demand for rehabilitation services. This situation is of concern for low-income and middle-income countries like India where the resources for rehabilitation are often limited. Recently, a smartphone-enabled carer-supported educational intervention for management of physical disabilities following stroke was developed in India. It was found to be feasible and acceptable, but evidence of effectiveness is lacking...
May 9, 2018: BMJ Open
https://www.readbyqxmd.com/read/29741531/cost-effectiveness-of-physical-fitness-training-for-stroke-survivors
#10
M Collins, E Clifton, F van Wijck, G E Mead
Background Physical fitness is impaired after stroke, yet fitness training after stroke reduces disability. Several international guidelines recommend that fitness training be incorporated as part of stroke rehabilitation. However, information about cost-effectiveness is limited. Methods A decision tree model was used to estimate the cost-effectiveness of a fitness programme for stroke survivors vs. relaxation (control group). This was based on a published randomised controlled trial, from which evidence about quality of life was used to estimate Quality Adjusted Life Years...
March 2018: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/29741126/cost-effectiveness-of-mechanical-thrombectomy-for-acute-ischemic-stroke-an-australian-payer-perspective
#11
Nimita Arora, Koji Makino, Dominic Tilden, Kyriakos Lobotesis, Peter Mitchell, John Gillespie
AIMS: The goal of this study was to assess the cost-effectiveness of mechanical thrombectomy (MT) for acute ischemic stroke (AIS) from an Australian payer perspective. METHODS: We used a Markov model that employed a life-time time horizon, modelling patients from symptom onset of stroke until end of life. Clinical efficacy and safety data were taken from an individual patient level data (IPD) meta-analysis of clinical studies. The treatment effect of MT compared to usual care was measured by changes in modified Rankin Score (mRS)...
May 9, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29740750/comparing-the-cost-effectiveness-of-non-vitamin-k-antagonist-oral-anticoagulants-with-well-managed-warfarin-for-stroke-prevention-in-atrial-fibrillation-patients-at-high-risk-of-bleeding
#12
Alexa R Hospodar, Kenneth J Smith, Yuting Zhang, Inmaculada Hernandez
BACKGROUND: Several studies have compared the cost effectiveness of non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin using results from clinical trials evaluating NOACs. However, the time in therapeutic range (TTR) of warfarin groups ranged across clinical trials, and all were below the therapeutic goal of 70%. We compared the cost effectiveness of edoxaban 60 mg, apixaban 5 mg, dabigatran 150 mg, dabigatran 110 mg, rivaroxaban 20 mg, and well-managed warfarin with a TTR of 70% in preventing stroke among patients with atrial fibrillation at high risk of bleeding...
May 9, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29739915/cost-effectiveness-of-left-atrial-appendage-closure-with-the-watchman-device-compared-with-warfarin-or-non-vitamin-k-antagonist-oral-anticoagulants-for-secondary-prevention-in-nonvalvular-atrial-fibrillation
#13
Vivek Y Reddy, Ronald L Akehurst, Stacey L Amorosi, Meghan B Gavaghan, Deanna S Hertz, David R Holmes
BACKGROUND AND PURPOSE: Once a patient with atrial fibrillation experiences an embolic event, the risk of a recurrent event increases 2.6-fold. New treatments have emerged as viable treatment alternatives to warfarin for stroke risk reduction in secondary prevention populations. This analysis sought to assess the cost-effectiveness of left atrial appendage closure (LAAC) compared with warfarin and the non-vitamin K antagonist oral anticoagulants dabigatran 150 mg, apixaban and rivaroxaban in the prevention of stroke in nonvalvular atrial fibrillation patients with a prior stroke or transient ischemic attack...
May 8, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29738265/estimation-and-prediction-of-avoidable-health-care-costs-of-cardiovascular-diseases-and-type-2-diabetes-through-adequate-dairy-food-consumption-a-systematic-review-and-micro-simulation-modeling-study
#14
Mehdi Javanbakht, Ahmad Reza Jamshidi, Hamid Reza Baradaran, Zahra Mohammadi, Atefeh Mashayekhi, Farhad Shokraneh, Mohsen Rezai Hamami, Raziyeh Yazdani Bakhsh, Hossien Shabaninejad, Sajad Delavari, Arash Tehrani
BACKGROUND: Recent evidence from prospective cohort studies show a relationship between consumption of dairy foods and cardiovascular diseases (CVDs) and type 2 diabetes mellitus (T2DM). This association highlights the importance of dairy foods consumption in prevention of these diseases and also reduction of associated healthcare costs. The aim of this study was to estimate avoidable healthcare costs of CVD and T2D through adequate dairy foods consumption in Iran. METHODS: This was a multistage modelling study...
May 1, 2018: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/29736894/smoking-cessation-a-comparison-of-two-model-structures
#15
Becky Pennington, Alex Filby, Lesley Owen, Matthew Taylor
BACKGROUND: Most economic evaluations of smoking cessation interventions have used cohort state-transition models. Discrete event simulations (DESs) have been proposed as a superior approach. OBJECTIVE: We developed a state-transition model and a DES using the discretely integrated condition event (DICE) framework and compared the cost-effectiveness results. We performed scenario analysis using the DES to explore the impact of alternative assumptions. METHODS: The models estimated the costs and quality-adjusted life years (QALYs) for the intervention and comparator from the perspective of the UK National Health Service and Personal Social Services over a lifetime horizon...
May 8, 2018: PharmacoEconomics
https://www.readbyqxmd.com/read/29731350/the-cost-effectiveness-of-pcsk9-inhibitors-the-australian-healthcare-perspective
#16
Radya Kumar, Andrew Tonkin, Danny Liew, Ella Zomer
BACKGROUND: For patients in whom statins are not tolerated or effective as monotherapy, proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) represent a new class of lipid lowering therapies that may reduce low-density lipoprotein cholesterol (LDL-C) levels by up to 50% and lower cardiovascular events. While an important treatment option, the cost-effectiveness of PCSK9i in Australia remains unknown. This study aimed to determine the cost-effectiveness of PCSK9i compared to placebo in the prevention of atherosclerotic cardiovascular disease (CVD)...
April 26, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29729542/safety-and-cost-effectiveness-thrombolysis-by-diffusion-weighted-imaging-and-fluid-attenuated-inversion-recovery-mismatch-for-wake-up-stroke
#17
REVIEW
Tong Sun, Zhuan Xu, Shan-Shan Diao, Lu-Lu Zhang, Qi Fang, Xiu-Ying Cai, Yan Kong
Wake-up stroke, defined as patients who wake up with stroke symptoms which were not present prior to falling asleep, accounted for 14%-25% of acute ischemic stroke. Due to the unknown time of symptom onset, wake-up stoke was not in including criteria of intravenous thrombolysis. Several large randomized stroke trials using diffusion-weighted imaging(DWI)and fluid attenuated inversion recovery(FLAIR)mismatch patient selection may identify a subset of patients with wake-up stroke that can safely and effectively benefit from intravenous thrombolysis...
April 23, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29728903/tenecteplase-versus-alteplase-in-acute-ischemic-stroke-systematic-review-and-meta-analysis
#18
A Thelengana, Divya M Radhakrishnan, Manya Prasad, Amit Kumar, Kameshwar Prasad
Tenecteplase is a product of genetic modification of recombinant tissue plasminogen activator with superior pharmacodynamic and pharmacokinetic properties. This meta-analysis was to determine whether intravenous thrombolysis with tenecteplase in patients with acute ischemic stroke has better efficacy and safety outcomes than with intravenous alteplase. PubMed, Cochrane Central Register of Controlled Trials, WHO International clinical trials registry platform (ICTRP), Australian New Zealand Clinical Trials Registry (ANZCTR), EU Clinical Trials Register (EU-CTR) and ClinicalTrials...
May 4, 2018: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/29723207/benefit-risk-and-cost-of-new-oral-anticoagulants-and-warfarin-in-atrial-fibrillation-a-multicriteria-decision-analysis
#19
Jose Mendoza-Sanchez, Federico Silva, Lady Rangel, Linda Jaramillo, Leidy Mendoza, Jenny Garzon, Andrea Quiroga
INTRODUCTION: Warfarin and new oral anticoagulants are effective in reducing stroke in atrial fibrillation; however, the benefits and risks rates in clinical trials show heterogeneity for each anticoagulant, and is unknown the cost influence on a model considering most of the treatment consequences. We designed a benefit-risk and cost assessment of oral anticoagulants. DESIGN: We followed the roadmap proposed by IMI-PROTECT and the considerations of emerged good practice to perform Multi-Criteria Decision Analysis (MCDA)...
2018: PloS One
https://www.readbyqxmd.com/read/29721235/does-alpha-lipoic-acid-supplementation-modulate-cardiovascular-risk-factors-in-patients-with-stroke-a-randomized-double-blind-clinical-trial
#20
Vida Mohammadi, Fariborz Khorvash, Awat Feizi, Gholamreza Askari
Background: Stroke as a devastating condition is one of the major causes of death worldwide. It is accountable for long time disability with high personal and social cost in adults. There are several risk factors for stroke such as diabetes and hypertension. Alpha-lipoic acid (ALA) as an antioxidant can be a risk modifier in these patients. We designed this trial to scrutinize the possible effects of ALA consumption on some cardiovascular risk factors in patients experienced stroke. Methods: In this randomized, double-blind, placebo-controlled clinical trial, 67 patients experienced stroke were randomly allocated into two groups (taking a 600 mg ALA supplement or placebo daily for 12 weeks)...
2018: International Journal of Preventive Medicine
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