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Stroke clinical trials

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https://www.readbyqxmd.com/read/28440589/prime-movers-advanced-practice-professionals-in-the-role-of-stroke-coordinator
#1
Nicholas A Rattray, Teresa M Damush, Cherie Luckhurst, Catherine J Bauer-Martinez, Barbara J Homoya, Edward J Miech
BACKGROUND AND PURPOSE: Following a stroke quality improvement clustered randomized trial and a national acute ischemic stroke (AIS) directive in the Veterans Health Administration in 2011, this comparative case study examined the role of advanced practice professionals (APPs) in quality improvement activities among stroke teams. METHODS: Semistructured interviews were conducted at 11 Veterans Affairs medical centers annually over a 3-year period. A multidisciplinary team analyzed interviews from clinical providers through a mixed-methods, data matrix approach linking APPs (nurse practitioners and physician assistants) with Consolidated Framework for Implementation Research constructs and a group organization measure...
April 25, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28440199/anti-hyperglycemic-agents-for-the-treatment-of-type-2-diabetes-mellitus-role-in-cardioprotection-during-the-last-decade
#2
Duygu Kocyigit, Kadri Murat Gurses, Muhammed Ulvi Yalcin, Lale Tokgozoglu
Type 2 diabetic patients are known to have a tendency to develop cardiovascular (CV) disease (CVD), and related unfavourable outcomes such as heart failure, myocardial infarction (MI), cerebrovascular events (eg. stroke), and related mortality. Long- term clinical trials have revealed contradictory findings regarding the relationship between glycemic control and CV benefits due to variations in the key characteristics of the study population. During the last decade, number of pharmacological agents used for glucose- lowering in the treatment of type 2 diabetes mellitus (T2DM) has increased owing to the introduction of dipeptidyl peptidase- IV (DPP- IV) inhibitors, glucagon- like peptide- 1 (GLP- 1) receptor agonists, and sodium-glucose co-transporter 2 (SGLT- 2) inhibitors...
April 23, 2017: Endocrine, Metabolic & Immune Disorders Drug Targets
https://www.readbyqxmd.com/read/28440126/transcranial-doppler-screening-for-stroke-risk-in-children-with-sickle-cell-disease-a-systematic-review
#3
Sara Mazzucco, Marina Diomedi, Amrana Qureshi, Laura Sainati, Soundrie T Padayachee
Background Sickle cell disease (SCD) is one of the most common causes of stroke in children worldwide. Based on the results of the Stroke Prevention Trial in Sickle Cell Anemia (STOP), annual transcranial Doppler ultrasound (TCD) screening for affected children is standard practice. However, the need for TCD surveillance programs could override the accuracy of the screening, affecting the correct stratification of stroke risk and subsequent clinical management of the target population. Aims To shed light on this issue, a systematic review of the literature on TCD screening for children and adolescents with SCD was carried out (CRD42016050549), according to a list of clinically relevant questions, with a particular focus on screening practices in European countries...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28440116/telemedical-strategies-for-the-improvement-of-secondary-prevention-in-patients-with-cerebrovascular-events-a-systematic-review-and-meta-analysis
#4
Peter Kraft, Steffi Hillmann, Viktoria Rücker, Peter U Heuschmann
Background Data from European countries consistently show that guideline-conform secondary prevention after stroke/transient ischemic attack is being realized in only 50-80% of patients. Use of telemedicine to support long-term secondary prevention has been effective in other cardiovascular diseases. Aims We reviewed current evidence for telemedical-supported strategies for the improvement of secondary prevention after stroke/transient ischemic attack. A systematic review was performed in accordance with the PRISMA statement searching MEDLINE, the Cochrane Central Register of Controlled Trials, and reference lists of articles published until 18 May 2016...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28440009/sodium-glucose-co-transporter-2-inhibitors-for-type-2-diabetes-mellitus-an-overview-for-the-primary-care-physician
#5
REVIEW
Paresh Dandona, Ajay Chaudhuri
AIMS: Sodium-glucose co-transporter type 2 (SGLT2) inhibitors are a new class of anti-hyperglycaemic agents in type 2 diabetes mellitus (T2DM). This review examines their mechanism of action and provides an overview of safety and efficacy from the main studies of SGLT2 inhibitors marketed in the United States and Europe, namely, canagliflozin, dapagliflozin and empagliflozin. METHODS: We searched the PubMed database to identify relevant publications on the mechanism of action of SGLT2 inhibitors and clinical trial reports...
April 24, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28439778/dabigatran-etexilate-appropriate-use-in-patients-with-chronic-kidney-disease-and-in-the-elderly-patients
#6
REVIEW
Mauro Molteni, Mario Bo, Giovanni Di Minno, Giuseppe Di Pasquale, Simonetta Genovesi, Danilo Toni, Paolo Verdecchia
Dabigatran etexilate (DE) is a direct thrombin inhibitor, which has been approved for the treatment of non-valvular atrial fibrillation (AF), and for the prevention and treatment of venous thromboembolism (VTE). Despite large randomized clinical trials and independent observational studies providing robust data concerning DE safety and efficacy, some physicians still perceive mild-to-moderate renal impairment and old age as a relative contraindication to its use. In this article, we review the available scientific evidence supporting the use of DE in these clinical situations...
April 24, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28439774/albumin-induced-neuroprotection-in-focal-cerebral-ischemia-in-the-alias-trial-does-severity-mechanism-and-time-of-infusion-matter
#7
Rakesh Khatri, Mohammad Rauf Afzal, Gustavo J Rodriguez, Alberto Maud, Muhammad Shah Miran, Mohtashim Arbaab Qureshi, Salvador Cruz-Flores, Adnan I Qureshi
OBJECTIVE: To determine whether there is any differential benefit of albumin administration within 2 h of onset of ischemia and in settings (severe ischemia with reperfusion in cardioembolic strokes with National Institutes of Health Stroke Scale [NIHSS] ≥15), most representative of experimental models of cerebral ischemia in which albumin was effective in reducing neurological injury. BACKGROUND: High-dose intravenous (IV) albumin treatment for acute ischemic stroke (ALIAS) trial did not show overall clinical benefit in ischemic stroke patients in contrast to preclinical studies; however, models of preclinical studies were not completely followed...
April 24, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28439730/physiological-and-therapeutic-regulation-of-pcsk9-activity-in-cardiovascular-disease
#8
REVIEW
Simon Glerup, Rainer Schulz, Ulrich Laufs, Klaus-Dieter Schlüter
Ischemic heart disease is the main cause of death worldwide and is accelerated by increased levels of low-density lipoprotein cholesterol (LDL-C). Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a potent circulating regulator of LDL-C through its ability to induce degradation of the LDL receptor (LDLR) in the lysosome of hepatocytes. Only in the last few years, a number of breakthroughs in the understanding of PCSK9 biology have been reported illustrating how PCSK9 activity is tightly regulated at several levels by factors influencing its transcription, secretion, or by extracellular inactivation and clearance...
May 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/28438739/reporting-clinical-end-points-and-safety-events-in-an-acute-coronary-syndrome-trial-results-with-integrated-collection
#9
Patrícia O Guimarães, Renato D Lopes, Susanna R Stevens, André Zimerman, Lisa Wruck, Stefan K James, Ghazala Haque, Roberto Rocha C V Giraldez, John H Alexander, Karen P Alexander
BACKGROUND: End points and adverse events (AEs) are collected separately in clinical trials, yet regulatory requirements for serious AE reporting vary across regions, so classifying end points according to seriousness criteria can be useful in global trials. METHODS AND RESULTS: In the Apixaban for Prevention of Acute Ischemic Events 2 (APPRAISE-2) trial, patients with a recent acute coronary syndrome were randomized to apixaban or placebo for the prevention of recurrent ischemic events...
April 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28438354/coronary-artery-bypass-graft-surgery-versus-percutaneous-coronary-intervention-with-drug-eluting-stents-for-left-main-coronary-artery-disease-a-meta-analysis-of-randomized-trials
#10
Alessandro Putzu, Michele Gallo, Enrico Antonio Martino, Enrico Ferrari, Giovanni Pedrazzini, Tiziano Moccetti, Tiziano Cassina
BACKGROUND: Despite several clinical studies, efficacy of coronary artery bypass grafting (CABG) surgery versus percutaneous coronary intervention (PCI) in patients with left main (LM) disease remains controversial. The objective of this meta-analysis of randomized trials was to evaluate the clinical outcome of CABG versus PCI with drug-eluting stents in LM coronary disease. METHODS: We systematically searched online databases up to March 2017 for randomized trials comparing CABG to PCI with drug-eluting stents...
April 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28438076/increased-work-and-social-engagement-is-associated-with-increased-stroke-specific-quality-of-life-in-stroke-survivors-at-3%C3%A2-months-and-12-months-post-stroke-a-longitudinal-study-of-an-australian-stroke-cohort
#11
Tamara Tse, Siti Zubaidah Binte Yusoff, Leonid Churilov, Henry Ma, Stephen Davis, Geoffrey Alan Donnan, Leeanne M Carey
BACKGROUND: There is a relative lack of longitudinal studies investigating stroke-specific outcomes and quality of life (QOL). This study aimed to identify which factors (level of disability, cognitive functioning, depressive symptoms, physical activity, and work and social engagement) were independently associated with each stroke-specific domain of QOL, adjusting for age and gender, at 3 months and 12 months post-stroke in an Australian cohort. METHOD: Survivors of ischemic stroke were recruited from 18 sites of the STroke imAging pRevention and Treatment (START) longitudinal cohort study...
April 24, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28436305/quality-of-life-after-intra-arterial-treatment-for-acute-ischemic-stroke-in-the-mr-clean-trial-update
#12
Jennifer Schreuders, Lucie A van den Berg, Puck Ss Fransen, Olvert A Berkhemer, Debbie Beumer, Hester F Lingsma, Robert J van Oostenbrugge, Wim H van Zwam, Charles Blm Majoie, Aad van der Lugt, Paul Lm de Kort, Yvo Bwem Roos, Diederik Wj Dippel
Background Health-related quality of life measured with the EuroQol Group 5-Dimension Self-Report Questionnaire was one of the secondary outcomes in the Multicenter Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands (MR CLEAN). We reported no statistically significant difference in EuroQol Group 5-Dimension Self-Report Questionnaire score between the intervention and control groups, but deaths were not included. Aims Reanalyze the effect of intra-arterial treatment for large vessel occlusion in acute ischemic stroke patients on health-related quality of life in more detail...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28434819/the-functional-test-of-the-hemiparetic-upper-extremity-a-rasch-analysis-with-theoretical-implications
#13
Veronica T Rowe, Carolee J Winstein, Steven L Wolf, Michelle L Woodbury
OBJECTIVE: To investigate the measurement properties of the Functional Test of the Hemiparetic Upper Extremity (FTHUE) and examine how its score may or may not inform design of a rehabilitation program. DESIGN: The FTHUE was recently used in the Interdisciplinary Comprehensive Arm Rehabilitation Evaluation Stroke (ICARE) Randomized Clinical Trial (RCT). This circumstance provided the opportunity to examine the psychometric properties of the FTHUE as it pertains to contemporary post-stroke rehabilitation and recovery models...
April 20, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28434467/abdominal-and-auricular-acupuncture-reduces-blood-pressure-in-hypertensive-patients
#14
Hamid Abdi, Maryam Tayefi, Seyed Reza Moallem, Baxiao Zhao, Mojtaba Fayaz, Hossein Mohaddes Ardabili, Akram-Alsadat Razavi, Mahsa Darbandi, Sara Darbandi, Parisa Abbasi, Gordon A Ferns, Majid Ghayour-Mobarhan
INTRODUCTION: Hypertension is an important risk factor of cardiovascular disease (CVD), which is associated with premature death, myocardial infarction, stroke, peripheral vascular disease, and renal disease. The goal of the present study was to use a randomized controlled clinical trial to explore and compare the effectiveness of abdominal and auricular acupuncture on blood pressure in 440 subjects with and without obesity. METHODS: Four hundred participants were recruited and randomized to one of four groups: cases and controls receiving auricular acupuncture (204 subjects) and cases and controls receiving abdominal electroacupuncture (196 subjects)...
April 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28432636/what-is-the-current-knowledge-about-the-cardiovascular-risk-for-users-of-cannabis-based-products-a-systematic-review
#15
REVIEW
Emilie Jouanjus, Valentin Raymond, Maryse Lapeyre-Mestre, Valérie Wolff
PURPOSE OF REVIEW: The purpose of the study was to examine the published evidence on the cardiovascular risk related to the use of cannabis-based products by performing a systematic review of recent literature. RECENT FINDINGS: The World Health Organization (WHO) emphasizes that cannabis use represents a risky behavior as it may lead to many adverse effects, and in particular, cardiovascular effects. A systematic review of articles published between January 1, 2011 and May 31, 2016 was performed in agreement with the PRISMA statement...
June 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28432266/baseline-blood-pressure-effect-on-the-benefit-and-safety-of-intra-arterial-treatment-in-mr-clean-multicenter-randomized-clinical-trial-of-endovascular-treatment-of-acute-ischemic-stroke-in-the-netherlands
#16
Maxim J H L Mulder, Saliha Ergezen, Hester F Lingsma, Olvert A Berkhemer, Puck S S Fransen, Debbie Beumer, Lucie A van den Berg, Geert Lycklama À Nijeholt, Bart J Emmer, H Bart van der Worp, Paul J Nederkoorn, Yvo B W E M Roos, Robert J van Oostenbrugge, Wim H van Zwam, Charles B L M Majoie, Aad van der Lugt, Diederik W J Dippel
BACKGROUND AND PURPOSE: High blood pressure (BP) is associated with poor outcome and the occurrence of symptomatic intracranial hemorrhage in acute ischemic stroke. Whether BP influences the benefit or safety of intra-arterial treatment (IAT) is not known. We aimed to assess the relation of BP with functional outcome, occurrence of symptomatic intracranial hemorrhage and effect of IAT. METHODS: This is a post hoc analysis of the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands)...
April 21, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28432265/artemida-trial-a-randomized-trial-of-efficacy-12-months-international-double-blind-actovegin-a-randomized-controlled-trial-to-assess-the-efficacy-of-actovegin-in-poststroke-cognitive-impairment
#17
Alla Guekht, Ingmar Skoog, Sally Edmundson, Vladimir Zakharov, Amos D Korczyn
BACKGROUND AND PURPOSE: Poststroke cognitive impairment is a debilitating consequence of stroke. The aim of this study was to assess whether Actovegin confers cognitive benefit in patients who have had an ischemic stroke. METHODS: This was a 12-month, parallel-group, randomized, multicenter, double-blind, placebo-controlled study. Eligible patients were ≥60 years of age with a Montreal Cognitive Assessment test score of ≤25 points. Patients were randomized into 2 groups within 1 week of acute supratentorial ischemic stroke in a 1:1 ratio: Actovegin (a deproteinized hemoderivative of calf blood, 2000 mg/d for ≤20 intravenous infusions followed by 1200 mg/d orally) or placebo for 6 months...
April 21, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28431475/validation-of-the-essen-stroke-risk-score-in-different-subtypes-of-ischemic-stroke
#18
Yi Liu, Yongjun Wang, William A Li, Aoshuang Yan, Yilong Wang
OBJECTIVE: Predictive scores are important tools for stratifying patients based on their risk of future vascular events and for selecting preventive therapies. The aim of this study is to validate the Essen Stroke Risk Score (ESRS) for stratifying stroke recurrence in different subtypes of non-atrial fibrillation ischemic stroke in a large Chinese cohort. METHODS: Data were derived from the Blood pressure and clinical Outcome in Stroke Survivors registry, which includes a cohort of 2204 stroke patients...
April 21, 2017: Neurological Research
https://www.readbyqxmd.com/read/28430838/elevated-pulse-pressure-levels-are-associated-with-increased-in-hospital-mortality-in-acute-spontaneous-intracerebral-hemorrhage
#19
Jason J Chang, Yasser Khorchid, Kira Dillard, Ali Kerro, Lucia Goodwin Burgess, Georgy Cherkassky, Nitin Goyal, Kristina Chapple, Anne W Alexandrov, David Buechner, Andrei V Alexandrov, Georgios Tsivgoulis
OBJECTIVES: Clinical outcome after intracerebral hemorrhage (ICH) remains poor. Definitive phase-3 trials in ICH have failed to demonstrate improved outcomes with intensive systolic blood pressure (SBP) lowering. We sought to determine whether other BP parameters-diastolic BP (DBP), pulse pressure (PP), and mean arterial pressure (MAP)-showed an association with clinical outcome in ICH. METHODS: We retrospectively analyzed a prospective cohort of 672 patients with spontaneous ICH and documented demographic characteristics, stroke severity, and neuroimaging parameters...
April 19, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28430363/cerebrolysin-for-acute-ischaemic-stroke
#20
REVIEW
Liliya Eugenevna Ziganshina, Tatyana Abakumova, Ludivine Vernay
BACKGROUND: Cerebrolysin is a mixture of low-molecular-weight peptides and amino acids derived from pigs' brain tissue, which has potential neuroprotective and neurotrophic properties. It is widely used in the treatment of acute ischaemic stroke in Russia, Eastern Europe, China, and other Asian and post-Soviet countries. OBJECTIVES: To assess the benefits and risks of cerebrolysin for treating acute ischaemic stroke. SEARCH METHODS: In May 2016 we searched the Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, Embase, Web of Science Core Collection, with Science Citation Index, LILACS, OpenGrey, and a number of Russian Databases...
April 21, 2017: Cochrane Database of Systematic Reviews
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