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Stroke clinical trials

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https://www.readbyqxmd.com/read/27906117/carotid-artery-stenting-versus-no-stenting-assisting-thrombectomy-for-acute-ischaemic-stroke-protocol-for-a-systematic-review-of-randomised-clinical-trials-with-meta-analyses-and-trial-sequential-analyses
#1
Henrik Steglich-Arnholm, Markus Holtmannspötter, Christian Gluud, Derk Wolfgang Krieger
BACKGROUND: In patients with intracranial large vessel arterial occlusion, ipsilateral extracranial carotid artery occlusions or near-occlusions pose a significant hurdle in endovascular management of acute ischaemic stroke. Stenting of the carotid lesion may be beneficial in this situation to provide a stable access for introducing catheters through the carotid lesion into the intracranial vasculature and the target occlusion. Furthermore, carotid stenting may ensure ample blood flow for wash-out of clot material and reperfusion of the ischaemic penumbral tissue...
December 1, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27904911/effect-of-bihemispheric-anodal-transcranial-direct-current-stimulation-for-dysphagia-in-chronic-stroke-patients-a-randomized-clinical-trial
#2
Young Hyun Ahn, Hyun-Joo Sohn, Jin-Sung Park, Tae Gyu Ahn, Yong Beom Shin, Minsu Park, Sung-Hwa Ko, Yong-Il Shin
OBJECTIVE: To investigate whether bihemispheric anodal transcranial direct current stimulation (tDCS) with conventional dysphagia therapy could improve swallowing function in chronic stroke patients with dysphagia. DESIGN: Randomized controlled trial. SUBJECTS: Twenty-six patients with dysphagia for at least 6 months post-stroke were randomly assigned into: (i) bihemispheric anodal tDCS group; or (ii) sham group. METHODS: All patients underwent 10 tDCS sessions with simultaneous conventional swallowing therapy for 2 weeks...
November 30, 2016: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/27904156/effects-of-calcium-channel-blocker-benidipine-based-combination-therapy-on-target-blood-pressure-control-and-cardiovascular-outcome-a-sub-analysis-of-the-cope-trial
#3
Seiji Umemoto, Toshio Ogihara, Masunori Matsuzaki, Hiromi Rakugi, Yasuo Ohashi, Takao Saruta
We compared three benidipine-based regimens-that is, benidipine plus angiotensin receptor blocker (ARB), β-blocker (BB) or thiazide-and found that the benidipine-BB combination was less beneficial in reducing the risk of stroke than the benidipine-thiazide combination. This sub-analysis sought to compare the effects of reaching a target blood pressure (BP) (<140/90 mm Hg) on the cardiovascular outcomes among the three benidipine-based treatment groups in the Combination Therapy of Hypertension to Prevent Cardiovascular Events trial...
December 1, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/27903389/-dabigatran-versus-warfarin-for-the-prevention-of-stroke-in-chinese-patients-with-nonvalvular-atrial-fibrillation-chinese-subpopulation-analysis-of-re-ly
#4
X Gao, Y M Yang, J Zhu, Y Dai, H Q Tan
Objective: This analysis was performed to evaluate the efficacy in stroke prevention and safety of dabigatran in Chinese nonvalvular atrial fibrillation(NVAF) patients enrolled in RE-LY trial. Methods: RE-LY was an prospective, open-label, randomized, multicenter study. From March 2006 to March 2009, 541 atrial fibrillation patients at risk of stroke were recruited from 13 medical centers in China. Patients randomly received, in a blinded fashion, fixed doses of dabigatran-110 mg or 150 mg twice daily or, in an unblinded fashion, adjusted-dose warfarin...
November 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/27901325/asymptomatic-carotid-artery-stenosis-who-should-be-screened-who-should-be-treated-and-how-should-we-treat-them
#5
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/27901002/shorter-versus-longer-duration-dual-antiplatelet-therapy-in-patients-with-diabetes-mellitus-undergoing-drug-eluting-stents-implantation-a-meta-analysis-of-randomized-controlled-trials
#6
He Huang, Ya Li, Yu Chen, Guo-Sheng Fu
BACKGROUND: Patients with diabetes mellitus (DM) have a higher risk of thromboembolic events; however, the optimal duration of dual antiplatelet therapy (DAPT) remains unclear. The goal of this study was to assess the efficacy and safety of various DAPT durations in patients with DM undergoing drug-eluting stent implantation. METHODS: We conducted a literature search for randomized controlled trials (RCTs). We searched databases including EMBASE, PubMed, Cochrane Library, and Scopus up to June 2016...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27900868/-rivaroxaban-use-in-prevention-of-stroke-in-patients-with-non-valvular-atrial-fibrillation-in-clinical-practice-results-of-observational-studies-and-our-experience
#7
Filip Málek
Rivaroxaban is direct oral factor Xa inhibitor indicated for tromboembolic event rate reduction in patients with non-valvular atrial fibrillation. Knowledge of rivaroxaban efficacy and safety comes from a phase III randomized clinical trial ROCKET AF. In the present, we have more evidence of rivaroxaban efficacy from real-life clinical studies. XANTUS study was first international prospective observational real-life study documenting use of rivaroxaban in stroke prevention in a broad population of patients with non-valvular atrial fibrillation...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27900231/efficacy-and-safety-of-direct-oral-anticoagulants-compared-to-warfarin-in-prevention-of-thromboembolic-events-among-elderly-patients-with-atrial-fibrillation
#8
REVIEW
Shilpa D Kailas, Sirisha Reddy Thambuluru
Direct oral anticoagulants (DOACs), previously also known as novel oral anticoagulants (NOACs), have increased the therapeutic options for stroke prevention in atrial fibrillation (AF). Previous studies comparing their relative efficacy and safety do not address age-related differences, such as comorbidities and physical and social boundaries. This review aimed to summarize and compare the clinical and safety outcomes of DOACs and warfarin for stroke prevention in AF in the elderly population (≥ 65 years)...
October 18, 2016: Curēus
https://www.readbyqxmd.com/read/27899755/association-of-oxidized-low-density-lipoprotein-with-prognosis-of-stroke-and-stroke-subtypes
#9
Anxin Wang, Yuling Yang, Zhaoping Su, Wei Yue, Hongjun Hao, Lijie Ren, Yongjun Wang, Yibin Cao, Yilong Wang
BACKGROUND AND PURPOSE: The association between oxidized low-density lipoprotein (oxLDL) and the long-term prognosis of stroke is unclear. The aim of this study is to investigate whether oxLDL levels contribute to the prognosis of stroke and stroke subtypes. METHODS: All patients with ischemic stroke were recruited from the SOS-Stroke (Study of Oxidative Stress in Patients With Acute Ischemic Stroke) and classified into 5 different subtypes, according to the TOAST criteria (Trial of Org 10172 in Acute Stroke Treatment)...
November 29, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27899742/acute-endovascular-treatment-delivery-to-ischemic-stroke-patients-transferred-within-a-telestroke-network-a-retrospective-observational-study
#10
Jessica Barlinn, Johannes Gerber, Kristian Barlinn, Lars-Peder Pallesen, Timo Siepmann, Charlotte Zerna, Claudia Wojciechowski, Volker Puetz, Rüdiger von Kummer, Heinz Reichmann, Jennifer Linn, Ulf Bodechtel
BACKGROUND: Five randomized controlled trials recently demonstrated efficacy of endovascular treatment in acute ischemic stroke. Telestroke networks can improve stroke care in rural areas but their role in patients undergoing endovascular treatment is unknown. AIM: We compared clinical outcomes of endovascular treatment between anterior circulation stroke patients transferred after teleconsultation and those directly admitted to a tertiary stroke center. METHODS: Data derived from consecutive patients with intracranial large vessel occlusion who underwent endovascular treatment from January 2010 to December 2014 at our tertiary stroke center...
November 29, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27899408/percutaneous-coronary-intervention-using-drug-eluting-stents-versus-coronary-artery-bypass-grafting-for-unprotected-left-main-coronary-artery-stenosis-a-meta-analysis-of-randomized-trials
#11
Nitesh Nerlekar, Francis J Ha, Kunal P Verma, Martin R Bennett, James D Cameron, Ian T Meredith, Adam J Brown
BACKGROUND: Current guidelines suggest that coronary artery bypass grafting (CABG) should be the preferred revascularization method for unprotected left main coronary artery stenosis. In light of evidence from recent randomized trials, we assessed whether percutaneous coronary intervention (PCI) using drug-eluting stents is as safe and effective as CABG for the treatment of unprotected left main coronary artery disease. METHODS AND RESULTS: Digital databases and manual searches were performed for randomized trials comparing PCI and CABG for unprotected left main coronary artery stenosis...
December 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27896982/predictive-modeling-of-hospital-readmission-rates-using-electronic-medical-record-wide-machine-learning-a-case-study-using-mount-sinai-heart-failure-cohort
#12
Khader Shameer, Kipp W Johnson, Alexandre Yahi, Riccardo Miotto, L I Li, Doran Ricks, Jebakumar Jebakaran, Patricia Kovatch, Partho P Sengupta, Sengupta Gelijns, Alan Moskovitz, Bruce Darrow, David L David, Andrew Kasarskis, Nicholas P Tatonetti, Sean Pinney, Joel T Dudley
Reduction of preventable hospital readmissions that result from chronic or acute conditions like stroke, heart failure, myocardial infarction and pneumonia remains a significant challenge for improving the outcomes and decreasing the cost of healthcare delivery in the United States. Patient readmission rates are relatively high for conditions like heart failure (HF) despite the implementation of high-quality healthcare delivery operation guidelines created by regulatory authorities. Multiple predictive models are currently available to evaluate potential 30-day readmission rates of patients...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27896681/financial-impact-of-direct-acting-oral-anticoagulants-in-medicaid-budgetary-assessment-based-on-number-needed-to-treat
#13
Kathleen A Fairman, Lindsay E Davis, Courtney R Kruse, David A Sclar
BACKGROUND: Faced with rising healthcare costs, state Medicaid programs need short-term, easily calculated budgetary estimates for new drugs, accounting for medical cost offsets due to clinical advantages. OBJECTIVE: To estimate the budgetary impact of direct-acting oral anticoagulants (DOACs) compared with warfarin, an older, lower-cost vitamin K antagonist, on 12-month Medicaid expenditures for nonvalvular atrial fibrillation (NVAF) using number needed to treat (NNT)...
November 28, 2016: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/27896592/why-have-clinical-trials-of-antioxidants-to-prevent-neurodegeneration-failed-a-cellular-investigation-of-novel-phenothiazine-type-antioxidants-reveals-competing-objectives-for-pharmaceutical-neuroprotection
#14
Maike J Ohlow, Selina Sohre, Matthias Granold, Mathias Schreckenberger, Bernd Moosmann
PURPOSE: Only a fraction of the currently established low-molecular weight antioxidants exhibit cytoprotective activity in living cells, which is considered a prerequisite for their potential clinical usefulness in Parkinson's disease or stroke. Post hoc structure-activity relationship analyses have predicted that increased lipophilicity and enhanced radical stabilization could contribute to such cytoprotective activity. METHODS: We have synthesized a series of novel phenothiazine-type antioxidants exhibiting systematic variation in their lipophilicity and radical stabilization...
November 28, 2016: Pharmaceutical Research
https://www.readbyqxmd.com/read/27895574/robot-assisted-rehabilitation-of-ankle-plantar-flexors-spasticity-a-3-month-study-with-proprioceptive-neuromuscular-facilitation
#15
Zhihao Zhou, Yao Sun, Ninghua Wang, Fan Gao, Kunlin Wei, Qining Wang
In this paper, we aim to investigate the effect of proprioceptive neuromuscular facilitation (PNF)-based rehabilitation for ankle plantar flexors spasticity by using a Robotic Ankle-foot Rehabilitation System (RARS). A modified robot-assisted system was proposed, and seven poststroke patients with hemiplegic spastic ankles participated in a 3-month robotic PNF training. Their impaired sides were used as the experimental group, while their unimpaired sides as the control group. A robotic intervention for the experimental group started from a 2-min passive stretching to warming-up or relaxing the soleus and gastrocnemius muscles and also ended with the same one...
2016: Frontiers in Neurorobotics
https://www.readbyqxmd.com/read/27895487/combination-therapy-with-lercanidipine-and-enalapril-in-the-management-of-the-hypertensive-patient-an-update-of-the-evidence
#16
REVIEW
Christina Antza, Stella Stabouli, Vasilios Kotsis
Hypertension is an important risk factor for premature death as it increases the probability of stroke, myocardial infarction, and heart failure. Antihypertensive drugs can decrease cardiovascular (CV) morbidity and mortality. The majority of hypertensive patients need more than one antihypertensive agent to attain blood pressure (BP) targets. Monotherapy can effectively reduce BP only in 20%-40% of patients. Multiple mechanisms including increased peripheral vascular resistance, increased cardiac work, and hypervolemia are involved in the pathogenesis of hypertension...
2016: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/27892885/vitamin-k-antagonists-for-stroke-prevention-in-hemodialysis-patients-with-atrial-fibrillation-a-systematic-review-and-meta-analysis
#17
Hans Van Der Meersch, Dirk De Bacquer, An S De Vriese
BACKGROUND: The use of vitamin K antagonists (VKAs) in hemodialysis patients with atrial fibrillation (AF) is controversial. No randomized trials are available and observational studies have yielded conflicting results, engendering a large clinical practice variability and physician uncertainty. An unresolved but highly relevant question is whether AF poses a true risk of ischemic stroke in hemodialysis and whether any form of oral anticoagulation is therefore warranted. METHODS: We conducted a systematic review of studies that compared the incidence of ischemic stroke and bleeding in hemodialysis patients with AF taking VKA and those not taking VKA...
October 4, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27892884/%C3%AE-blocker-dosage-and-outcomes-after-acute-coronary-syndrome
#18
Jason E Allen, Stacey Knight, Raymond O McCubrey, Tami Bair, Joseph Brent Muhlestein, Jeffrey J Goldberger, Jeffrey L Anderson
BACKGROUND: Although β-blockers increase survival in acute coronary syndrome (ACS) patients, the doses used in trials were higher than doses used in practice, and recent data do not support an advantage of higher doses. We hypothesized that rates of major adverse cardiac events (MACE), all-cause death, myocardial infarction, and stroke are equivalent for patients on low-dose and high-dose β-blocker. METHODS: Patients admitted to Intermountain Healthcare with ACS and diagnosed with ≥70% coronary stenosis between 1994 and 2013 were studied (N = 7,834)...
October 22, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27890713/allogeneic-human-mesenchymal-stem-cells-in-patients-with-idiopathic-pulmonary-fibrosis-via-intravenous-delivery-aether-a-phase-i-safety-clinical-trial
#19
Marilyn K Glassberg, Julia Minkiewicz, Rebecca L Toonkel, Emmanuelle S Simonet, Gustavo A Rubio, Darcy Difede, Shirin Shafazand, Aisha Khan, Marietsy V Pujol, Vincent F LaRussa, Lisa H Lancaster, Glenn D Rosen, Joel Fishman, Yolanda N Mageto, Adam Mendizabal, Joshua M Hare
BACKGROUND: Despite recent FDA approval of two new drugs for idiopathic pulmonary fibrosis (IPF), curative therapies remain elusive and mortality remains high. Pre-clinical and clinical data support the safety of human mesenchymal stem cells as a potential novel therapy for this fatal condition. The AETHER trial was the first study designed to evaluate the safety of a single infusion of bone marrow-derived mesenchymal stem cells in patients with idiopathic pulmonary fibrosis. METHODS: Nine patients with mild to moderate IPF were sequentially assigned to one of three cohorts and dosed with a single intravenous infusion of 20, 100, or 200 x 10(6) human bone marrow-derived mesenchymal stem cells per infusion from young, unrelated, male donors...
November 24, 2016: Chest
https://www.readbyqxmd.com/read/27889397/comparative-effectiveness-of-dabigatran-and-rivaroxaban-versus-warfarin-for-the-treatment-of-non-valvular-atrial-fibrillation
#20
Lindsay G S Bengtson, Pamela L Lutsey, Lin Y Chen, Richard F MacLehose, Alvaro Alonso
BACKGROUND: Effectiveness data on novel oral anticoagulants (NOACs) versus warfarin for stroke prevention in non-valvular atrial fibrillation (NVAF) by prior warfarin use are limited. METHODS: We used data from the US MarketScan databases from 2009 to 2012. NVAF patients initiating dabigatran or rivaroxaban were matched with up to 5 warfarin users. Propensity score-adjusted Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) for relevant endpoints in NOACs versus warfarin users...
November 23, 2016: Journal of Cardiology
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