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Stroke clinical trials

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https://www.readbyqxmd.com/read/29777016/clinical-utility-of-electronic-alberta-stroke-program-early-computed-tomography-score-software-in-the-enchanted-trial-database
#1
Simon Nagel, Xia Wang, Cheryl Carcel, Thompson Robinson, Richard I Lindley, John Chalmers, Craig S Anderson
BACKGROUND AND PURPOSE: Clinical utility of electronic Alberta Stroke Program Early CT Score (e-ASPECTS), an automated system for quantifying signs of infarction, was evaluated in a large database of thrombolyzed patients with acute ischemic stroke. METHODS: All baseline noncontrast computed tomographic scans of patients with anterior circulation acute ischemic stroke who participated in the alteplase dose arm of the randomized controlled trial ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) were reviewed; poor quality and large (>6 mm) slice thickness were excluded...
May 18, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29776950/clinical-effects-and-safety-of-electroacupuncture-for-the-treatment-of-post-stroke-depression-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#2
Xue-Bin Li, Jie Wang, An-Ding Xu, Jian-Min Huang, Lan-Qing Meng, Rui-Ya Huang, Jing Xu
OBJECTIVE: The aim of this systematic review was to assess the efficacy/effectiveness and safety of electroacupuncture (EA) in the treatment of post-stroke depression (PSD). METHODS: A comprehensive literature search in the Pubmed, Embase, CENTRAL, ISI Web of Science, CNKI and Wanfang databases was conducted, and all relevant randomised controlled trials (RCTs) were screened for eligibility by two independent reviewers. The Cochrane Collaboration's tool and Jadad score were used to assess the risk of bias of included studies, and only RCTs scoring ≥3 were included in a meta-analysis...
May 18, 2018: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/29774055/immunotherapy-of-experimental-and-human-stroke-with-agents-approved-for-multiple-sclerosis-a-systematic-review
#3
REVIEW
Mirjam Dreikorn, Zeljko Milacic, Vladimir Pavlovic, Sven G Meuth, Christoph Kleinschnitz, Peter Kraft
Background: 'Thromboinflammation' describes a novel concept in stroke pathophysiology that has opened up the possibility of immunotherapeutic approaches which could become promising strategies for targeted stroke therapies in the future. Methods: We reviewed current evidence for agents approved for multiple sclerosis in preclinical and clinical stroke studies. 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 16 October 2017...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29773586/seafood-long-chain-n-3-polyunsaturated-fatty-acids-and-cardiovascular-disease-a-science-advisory-from-the-american-heart-association
#4
REVIEW
Eric B Rimm, Lawrence J Appel, Stephanie E Chiuve, Luc Djoussé, Mary B Engler, Penny M Kris-Etherton, Dariush Mozaffarian, David S Siscovick, Alice H Lichtenstein
Since the 2002 American Heart Association scientific statement "Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease," evidence from observational and experimental studies and from randomized controlled trials continues to emerge to further substantiate the beneficial effects of seafood long-chain n-3 polyunsaturated fatty acids and cardiovascular disease. A recent American Heart Association science advisory addressed the specific effect of n-3 polyunsaturated fatty acid supplementation on clinical cardiovascular events...
May 17, 2018: Circulation
https://www.readbyqxmd.com/read/29773497/indications-for-red-cell-transfusions-in-pediatric-patients
#5
REVIEW
Jill M Cholette, Suzie A Noronha, Jerard Seghatchian, Neil Blumberg
Red cell transfusions are amongst the most common therapeutic procedures in seriously ill children, particularly in the inpatient setting. This is despite the fact that there is no evidence base for most clinical settings, with the exception of patients with hemoglobinopathies, particularly thalassemia and sickle cell anemia. Obviously exsanguinating hemorrhage and life threatening anemia are urgent indications for which no other therapeutic approach is currently available. Most transfusions are, however, given prophylactically to prevent the complications of hypoxia or hemodynamic stability, based upon expert opinion and a faith in the oxygen carrying capacity and beneficial hemodynamic properties of transfused red cells...
May 10, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29772946/safety-and-effectiveness-of-apixaban-in-comparison-to-warfarin-in-patients-with-nonvalvular-atrial-fibrillation-a-propensity-matched-analysis-from-japanese-administrative-claims-data
#6
Shun Kohsaka, Jun Katada, Kumiko Saito, Yasuo Terayama
OBJECTIVE: To investigate the risk of bleeding events and stroke/systemic embolism (SE) among Japanese patients with nonvalvular atrial fibrillation (NVAF), focusing on the initial dosage of apixaban and patient age. METHODS: This retrospective cohort study used de-identified electronic health records-based claims data from 314 acute-care hospitals in Japan. NVAF patients newly initiated on warfarin or apixaban, with no prescription during the 180-day blanking period, were eligible...
May 18, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29770768/treatment-of-femoro-popliteal-lesions-with-scoring-and-drug-coated-balloon-angioplasty-12-month-results-of-the-dcb-trak-registry
#7
Magnus Baumhäkel, Shalva Chkhetia, Michael Kindermann
PURPOSE: Debulking strategies prior to drug-coated balloon (DCB) angioplasty were suggested to improve clinical results in femoro-popliteal lesions. Currently, there are no data regarding plaque modification with a scoring balloon with subsequent DCB-angioplasty. Recently published 6-month results of the DCB-Trak registry in patients treated with scoring-balloon angioplasty and DCB-angioplasty were promising without any safety concerns. Herein, we report the 12-month follow-up data. METHODS: In a single center registry, 29 consecutive patients with 32 femoro-popliteal lesions were treated with a scoring-balloon (VascuTrak®) and a DCB subsequently...
May 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/29770118/neuroinflammation-as-a-target-for-intervention-in-subarachnoid-hemorrhage
#8
REVIEW
Airton Leonardo de Oliveira Manoel, R Loch Macdonald
Aneurysmal subarachnoid hemorrhage (SAH) is a sub-type of hemorrhagic stroke associated with the highest rates of mortality and long-term neurological disabilities. Despite the improvement in the management of SAH patients and the reduction in case fatality in the last decades, disability and mortality remain high in this population. Brain injury can occur immediately and in the first days after SAH. This early brain injury can be due to physical effects on the brain such as increased intracranial pressure, herniations, intracerebral, intraventricular hemorrhage, and hydrocephalus...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29769167/impact-of-sex-on-comparative-outcomes-of-bivalirudin-versus-unfractionated-heparin-in-patients-with-acute-coronary-syndromes-undergoing-invasive-management-a-pre-specified-analysis-of-the-matrix-trial
#9
Giuseppe Gargiulo, Bruno R da Costa, Enrico Frigoli, Cataldo Palmieri, Marco Stefano Nazzaro, Camillo Falcone, Armando Liso, Carlo Vigna, Fabio Abate, Marco Comeglio, Roberto Diletti, Gabriele Gabrielli, Emilio Di Lorenzo, Pietro Mazzarotto, Marco Zimarino, Claudio Moretti, Antonio Colombo, Carlo Penzo, Giampaolo Pasquetto, Salvatore Brugaletta, Fabio Ferrari, Gavino Casu, Vincenzo Guiducci, Antonio Dellavalle, Francesco Liistro, Ciro Mauro, Arnoud W J Van't Hof, Elmir Omerovic, Salvatore Curello, Jose Maria de la Torre Hernandez, Stefano De Servi, Flavia Belloni, Stephan Windecker, Marco Valgimigli
AIMS: To assess whether bivalirudin compared with unfractionated heparin (UFH) is associated with consistent outcomes in male and female patients with acute coronary syndrome (ACS) undergoing invasive management. METHODS AND RESULTS: In the MATRIX program,7213 patients were randomized to bivalirudin or UFH.Patients in bivalirudin group were subsequently assigned to receive or not to receive a post-PCI infusion.The 30-day coprimary outcomes were major adverse cardiovascular and cerebrovascular events (MACE),defined as death,myocardial infarction,or stroke,and net adverse clinical events (NACE),defined as MACE or major bleeding...
May 15, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29768943/early-reduced-behavioral-activity-induced-by-large-strokes-affects-the-efficiency-of-enriched-environment-in-rats
#10
Anna-Sophia Wahl, Eva Erlebach, Biagio Brattoli, Uta Büchler, Julia Kaiser, Benjamin V Ineichen, Alice C Mosberger, Shirin Schneeberger, Stefan Imobersteg, Martin Wieckhorst, Martina Stirn, Aileen Schroeter, Bjoern Ommer, Martin E Schwab
The majority of stroke patients develop post-stroke fatigue, a symptom which impairs motivation and diminishes the success of rehabilitative interventions. We show that large cortical strokes acutely reduce activity levels in rats for 1-2 weeks as a physiological response paralleled by signs of systemic inflammation. Rats were exposed early (1-2 weeks) or late (3-4 weeks after stroke) to an individually monitored enriched environment to stimulate self-controlled high-intensity sensorimotor training. A group of animals received Anti-Nogo antibodies for the first two weeks after stroke, a neuronal growth promoting immunotherapy already in clinical trials...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29768352/effectiveness-of-trevo-stent-retriever-in-acute-ischemic-stroke-comparison-with-solitaire-stent
#11
Ho Jun Yi, Dong Hoon Lee, Sang Uk Kim
Recently, mechanical thrombectomy with stent retriever has achieved faster and higher rates of recanalization for intracranial major vessel occlusion. However, comparative studies of the most widely used Solitaire and Trevo stents have been rarely published.The authors retrospectively reviewed a total of 200 patients who performed mechanical thrombectomy at our center during 4 years and divided patients into 2 groups: mechanical thrombectomy with Solitaire stent (Group 1: Solitaire) and mechanical thrombectomy with Trevo stent (Group 2: Trevo)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29766750/clopidogrel-and-aspirin-in-acute-ischemic-stroke-and-high-risk-tia
#12
S Claiborne Johnston, J Donald Easton, Mary Farrant, William Barsan, Robin A Conwit, Jordan J Elm, Anthony S Kim, Anne S Lindblad, Yuko Y Palesch
Background Combination antiplatelet therapy with clopidogrel and aspirin may reduce the rate of recurrent stroke during the first 3 months after a minor ischemic stroke or transient ischemic attack (TIA). A trial of combination antiplatelet therapy in a Chinese population has shown a reduction in the risk of recurrent stroke. We tested this combination in an international population. Methods In a randomized trial, we assigned patients with minor ischemic stroke or high-risk TIA to receive either clopidogrel at a loading dose of 600 mg on day 1, followed by 75 mg per day, plus aspirin (at a dose of 50 to 325 mg per day) or the same range of doses of aspirin alone...
May 16, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29766335/ticagrelor-versus-clopidogrel-as-part-of-dual-or-triple-antithrombotic-therapy-a-systematic-review-and-meta-analysis
#13
Ioannis Andreou, Alexandros Briasoulis, Christos Pappas, Ignatios Ikonomidis, Dimitrios Alexopoulos
PURPOSE: Clopidogrel is the standard P2Y12 receptor inhibitor used in patients requiring both antiplatelet therapy and oral anticoagulation (OAC). We investigated the safety and efficacy of ticagrelor as an alternative to clopidogrel in patients on OAC. METHODS: A systematic electronic literature search was performed in MEDLINE, EMBASE, and the Cochrane Library for randomised controlled studies that examined the relative safety and efficacy of clopidogrel versus ticagrelor among patients requiring therapy with antiplatelet agents plus OAC...
May 15, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29766275/implementing-cough-reflex-testing-in-a-clinical-pathway-for-acute-stroke-a-pragmatic-randomised-controlled-trial
#14
Makaela Field, Rachel Wenke, Arman Sabet, Melissa Lawrie, Elizabeth Cardell
Silent aspiration is common after stroke and can lead to subsequent pneumonia. While standard bedside dysphagia assessments are ineffective at predicting silent aspiration, cough reflex testing (CRT) has shown promise for identifying patients at risk of silent aspiration. We investigated the impact of CRT on patient and service outcomes when embedded into a clinical pathway. 488 acute stoke patients were randomly allocated to receive either CRT or standard care (i.e. bedside assessment). Primary outcomes included confirmed pneumonia within 3 months post stroke and length of acute inpatient stay...
May 15, 2018: Dysphagia
https://www.readbyqxmd.com/read/29763641/ischemic-stroke-across-sexes-what-is-the-status-quo
#15
REVIEW
Luca Liberale, Federico Carbone, Fabrizio Montecucco, Cathérine Gebhard, Thomas F Lüscher, Susanne Wegener, Giovanni G Camici
Stroke prevalence is expected to increase in the next decades due to the aging of the Western population. Ischemic stroke (IS) shows an age- and sex-dependent distribution in which men represent the most affected population within 65 years of age, being passed by post-menopausal women in older age groups. Furthermore, a sexual dimorphism concerning risk factors, presentation and treatment of IS has been widely recognized. In order to address these phenomena, a number of issue have been raised involving both socio-economical and biological factors...
May 12, 2018: Frontiers in Neuroendocrinology
https://www.readbyqxmd.com/read/29762085/association-between-comorbid-cancer-and-outcomes-among-admissions-for-acute-ischemic-stroke-receiving-systemic-thrombolysis
#16
Erin R Weeda, Nicole Bohm
Background The impact of cancer on outcomes was not assessed in major trials of systemic thrombolysis in acute ischemic stroke. Aims To evaluate the association between comorbid cancer and hospital outcomes among patients receiving systemic thrombolysis for the treatment of acute ischemic stroke. Methods The 2013 and 2014 United States National Inpatient Sample was used to identify adult patients hospitalized for acute ischemic stroke who received systemic thrombolysis. Identified admissions were stratified into two cohorts based on the presence or absence of comorbid cancer...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29761573/using-fat-to-fight-disease-a-systematic-review-of-non-homologous-adipose-derived-stromal-stem-cell-therapies
#17
REVIEW
Marjorie E Bateman, Amy L Strong, Jeffrey M Gimble, Bruce A Bunnell
OBJECTIVE: The objective of this review is to describe the safety and efficacy of ASC and SVF in treating common diseases and the next steps in research that must occur prior to clinical use. EVIDENCE REVIEW: Pubmed, Ovid Medline, Embase, Web of Science, and the Cochrane Library were searched for articles about use of SVF or ASC for disease therapy published between 2012 and 2017. One meta-analysis, 2 randomized controlled trials, and 16 case series were included, representing 844 human patients...
May 15, 2018: Stem Cells
https://www.readbyqxmd.com/read/29761128/brain-computer-interfaces-for-post-stroke-motor-rehabilitation-a-meta-analysis
#18
REVIEW
María A Cervera, Surjo R Soekadar, Junichi Ushiba, José Del R Millán, Meigen Liu, Niels Birbaumer, Gangadhar Garipelli
Brain-computer interfaces (BCIs) can provide sensory feedback of ongoing brain oscillations, enabling stroke survivors to modulate their sensorimotor rhythms purposefully. A number of recent clinical studies indicate that repeated use of such BCIs might trigger neurological recovery and hence improvement in motor function. Here, we provide a first meta-analysis evaluating the clinical effectiveness of BCI-based post-stroke motor rehabilitation. Trials were identified using MEDLINE, CENTRAL, PEDro and by inspection of references in several review articles...
May 2018: Annals of Clinical and Translational Neurology
https://www.readbyqxmd.com/read/29760204/model-based-meta-analysis-to-evaluate-optimal-doses-of-direct-oral-factor-xa-inhibitors-in-atrial-fibrillation-patients
#19
Hideki Yoshioka, Hiromi Sato, Hiroto Hatakeyama, Akihiro Hisaka
The noninferiority of direct oral factor Xa (FXa) inhibitors (rivaroxaban, apixaban, and edoxaban) in treatment of atrial fibrillation were demonstrated compared with warfarin by several large clinical trials; however, subsequent meta-analyses reported a higher risk of major bleeding with rivaroxaban than with the other FXa inhibitors. In the present study, we first estimated the changes of prothrombin time (PT) in 5 randomized trials based on reported population pharmacokinetic and pharmacodynamic models and then carried out a model-based meta-analysis to obtain models describing the relationship between PT changes and the event rates of ischemic stroke/systemic embolism (SE) and of major bleeding...
May 22, 2018: Blood Advances
https://www.readbyqxmd.com/read/29759774/assessment-of-left-atrial-fibrosis-by-late-gadolinium-enhancement-magnetic-resonance-imaging-methodology-and-clinical-implications
#20
REVIEW
Johannes Siebermair, Eugene G Kholmovski, Nassir Marrouche
Recently, studies using late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) to identify structural changes of atrial tissue have contributed significantly to understanding the pathophysiology and progression of atrial fibrillation (AF). Moreover, imaging of atrial fibrosis using MRI has evolved to be a tool to improve clinical outcome of AF ablation procedures by allowing a patient-specific individualized management approach. LGE-MRI has been shown to predict AF ablation outcome based on pre-procedural imaging to define the extent of atrial fibrosis...
August 2017: JACC. Clinical Electrophysiology
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