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stroke randomized controlled trials

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https://www.readbyqxmd.com/read/28433830/spasticity-management-the-current-state-of-transcranial-neuromodulation
#1
REVIEW
Antonino Leo, Antonino Naro, Francesco Molonia, Provvidenza Tomasello, Ileana Saccà, Alessia Bramanti, Margherita Russo, Placido Bramanti, Angelo Quartarone, Rocco Salvatore Calabrò
This narrative review aims to provide an objective view of the non-invasive neuromodulation (NINM) protocols available for treating spasticity, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). On the basis of the relevant randomized controlled trials, we infer that NINM is more effective in reducing spasticity when combined with the conventional therapies than used as a stand-alone treatment. However, the magnitude of NINM aftereffects depends significantly on the applied hemisphere and the underlying pathology...
April 19, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28433215/meta-analysis-of-randomized-controlled-trials-of-percutaneous-coronary-intervention-with-drug-eluting-stents-versus-coronary-artery-bypass-grafting-in-left-main-coronary-artery-disease
#2
Aakash Garg, Sunil V Rao, Sahil Agrawal, Kleanthis Theodoropoulos, Marco Mennuni, Abhishek Sharma, Lohit Garg, Giuseppe Ferrante, Omar A Meelu, Davit Sargsyan, Bernhard Reimers, Marc Cohen, John B Kostis, Giulio G Stefanini
Few randomized controlled trials (RCTs) and observational studies had shown acceptable short-term efficacy and safety of percutaneous coronary intervention (PCI) with drug-eluting stents (DES) compared with coronary artery bypass grafting (CABG) in selected patients with left main coronary artery disease (LMCAD). We aimed to evaluate long-term outcomes of PCI using DES compared with CABG in patients with LMCAD. On November 1, 2016, we searched available databases for published RCTs directly comparing DES PCI with CABG in patients with LMCAD...
March 29, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28432658/does-supplementation-with-omega-3-pufas-add-to-the-prevention-of-cardiovascular-disease
#3
REVIEW
Evangelos C Rizos, Moses S Elisaf
PURPOSE OF REVIEW: Omega-3 fatty acids are increasingly used for the protection of cardiovascular disease. The main but not the sole mechanism of action is the reduction of triglyceride levels. In this review, we summarize the effect of omega-3 supplements on all-cause and cardiovascular mortality, myocardial infarction, and stroke from the relevant randomized controlled trials. RECENT FINDINGS: Twenty-one randomized controlled trials assessed omega-3 supplementation on mortality and cardiovascular-related outcomes...
June 2017: Current Cardiology Reports
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
#4
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/28430910/low-density-lipoprotein-cholesterol-targeting-with-pitavastatin-ezetimibe-for-patients-with-acute-coronary-syndrome-and-dyslipidaemia-the-hij-proper-study-a-prospective-open-label-randomized-trial
#5
Nobuhisa Hagiwara, Erisa Kawada-Watanabe, Ryo Koyanagi, Hiroyuki Arashi, Junichi Yamaguchi, Koichi Nakao, Tetsuya Tobaru, Hiroyuki Tanaka, Toshiaki Oka, Yasuhiro Endoh, Katsumi Saito, Tatsuro Uchida, Kunihiko Matsui, Hiroshi Ogawa
Aims: To elucidate the effects of intensive LDL-C lowering treatment with a standard dose of statin and ezetimibe in patients with dyslipidaemia and high risk of coronary events, targeting LDL-C less than 70 mg/dL (1.8 mmol/L), compared with standard LDL-C lowering lipid monotherapy targeting less than 100 mg/dL (2.6 mmol/L). Methods and Results: The HIJ-PROPER study is a prospective, randomized, open-label trial to assess whether intensive LDL-C lowering with standard-dose pitavastatin plus ezetimibe reduces cardiovascular events more than standard LDL-C lowering with pitavastatin monotherapy in patients with acute coronary syndrome (ACS) and dyslipidaemia...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28430363/cerebrolysin-for-acute-ischaemic-stroke
#6
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
https://www.readbyqxmd.com/read/28427926/effects-of-home-based-supportive-care-on-improvements-in-physical-function-and-depressive-symptoms-in-stroke-patients-a-meta-analysis
#7
REVIEW
Hui-Chuan Huang, Yi-Chieh Huang, Mei-Feng Lin, Wen-Hsuan Hou, Meei-Ling Shyu, Hsiao-Yean Chiu, Hsiu-Ju Chang
OBJECTIVE: To examine the effects of home-based supportive care on improvements in physical function and depressive symptoms in home-dwelling patients after a stroke. DATA SOURCES: Seven electronic databases (e.g., Medline, PubMed, CINAL, EMBASE, the Cochrane Central Register of Controlled Trials, ProQuest, and Google Scholar) and four Chinese database (e.g.,Wanfang med online, Chinese Electronic Periodical Services, China Integrated Knowledge Resources Database, and National Central Library) were fully searched for all relevant articles up to June 25, 2016...
April 17, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28427392/percutaneous-intervention-versus-coronary-artery-bypass-graft-surgery-in-left-main-coronary-artery-stenosis-a-systematic-review-and-meta-analysis
#8
Xin-Lin Zhang, Qing-Qing Zhu, Jing-Jing Yang, Yu-Han Chen, Yang Li, Su-Hui Zhu, Jun Xie, Lian Wang, Li-Na Kang, Biao Xu
BACKGROUND: The optimal revascularization technique in patients with left main coronary artery disease (CAD) remains controversial. We aimed to compare the long-term performance of percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) surgery in treatment of left main CAD. METHODS: PubMed, EMBASE, and the Cochrane Library were searched until November 16, 2016. RESULTS: Six randomized controlled trials and 22 matched observational studies including 22,487 patients and 90,167 patient-years of follow-up were included...
April 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28427299/effects-of-low-frequency-repetitive-transcranial-magnetic-stimulation-on-upper-extremity-motor-recovery-and-functional-outcomes-in-chronic-stroke-patients-a-randomized-controlled-trial
#9
Ayhan Aşkın, Aliye Tosun, Ümit Seçil Demirdal
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) was suggested as a preconditioning method that would increase brain plasticity and that it would be optimal to combine rTMS with intensive rehabilitation. OBJECTIVE: To assess the efficacy of inhibitory rTMS on upper extremity motor recovery and functional outcomes in chronic ischemic stroke patients. METHODS: In this randomized controlled trial, experimental group received low-frequency (LF) rTMS to the primary motor cortex of the unaffected side + physical therapy (PT), and control group received PT...
April 20, 2017: Somatosensory & Motor Research
https://www.readbyqxmd.com/read/28425349/clinical-characteristics-of-unknown-symptom-onset-stroke-patients-with-and-without-diffusion-weighted-imaging-and-fluid-attenuated-inversion-recovery-mismatch
#10
Götz Thomalla, Florent Boutitie, Jochen B Fiebach, Claus Z Simonsen, Salvador Pedraza, Robin Lemmens, Norbert Nighoghossian, Pascal Roy, Keith W Muir, Martin Ebinger, Ian Ford, Bastian Cheng, Ivana Galinovic, Tae-Hee Cho, Josep Puig, Vincent Thijs, Matthias Endres, Jens Fiehler, Christian Gerloff
Background Diffusion-weighted imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) mismatch was suggested to identify stroke patients with unknown time of symptom onset likely to be within the time window for thrombolysis. Aims We aimed to study clinical characteristics associated with DWI-FLAIR mismatch in patients with unknown onset stroke. Methods We analyzed baseline MRI and clinical data from patients with acute ischemic stroke proven by DWI from WAKE-UP, an investigator-initiated, randomized, placebo-controlled trial of MRI-based thrombolysis in stroke patients with unknown time of symptom onset...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28424039/endovascular-treatment-of-ischemic-stroke-an-updated-meta-analysis-of-efficacy-and-safety
#11
Simone Vidale, Elio Agostoni
BACKGROUND: Recent randomized trials demonstrated the superiority of the mechanical thrombectomy over the best medical treatment in patients with acute ischemic stroke due to an occlusion of arteries of proximal anterior circulation. In this updated meta-analysis, we aimed to summarize the total clinical effects of the treatment, including the last trials. METHODS: We performed literature search of Randomized Crontrolled Trials (RCTs) published between 2010 and October 2016, comparing endovenous thrombolysis plus mechanical thrombectomy (intervention group) with best medical care alone (control group)...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28422633/change-in-functional-arm-use-is-associated-with-somatosensory-skills-after-sensory-retraining-poststroke
#12
Megan Turville, Leeanne M Carey, Thomas A Matyas, Jannette Blennerhassett
OBJECTIVE: We investigated changes in functional arm use after retraining for stroke-related somatosensory loss and identified whether such changes are associated with somatosensory discrimination skills. METHOD: Data were pooled (N = 80) from two randomized controlled trials of somatosensory retraining. We used the Motor Activity Log to measure perceived amount of arm use in daily activities and the Action Research Arm Test to measure performance capacity. Somatosensory discrimination skills were measured using standardized modality-specific measures...
May 2017: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
https://www.readbyqxmd.com/read/28422628/occupational-performance-coaching-for-stroke-survivors-a-pilot-randomized-controlled-trial
#13
Dorothy Kessler, Mary Egan, Claire-Jehanne Dubouloz, Sara McEwen, Fiona P Graham
OBJECTIVE: We examined the feasibility of study procedures and explored the potential efficacy of Occupational Performance Coaching for stroke survivors (OPC-Stroke), an intervention designed to improve participation after stroke. METHOD: In this pilot randomized controlled trial, 21 participants were randomized to receive the intervention or usual care. Recruitment, retention, and outcome completion rates were calculated. Direction of change and effect sizes were examined for the outcomes of participation, goal performance and satisfaction, goal self-efficacy, emotional well-being, and cognition...
May 2017: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
https://www.readbyqxmd.com/read/28421732/comparison-of-absolute-fluid-restriction-versus-relative-volume-redistribution-strategy-in-low-central-venous-pressure-anesthesia-in-liver-resection-surgery-a-randomized-controlled-trial
#14
Jan Zatloukal, Richard Pradl, Jakub Kletečka, Tomáš Skalický, Václav Liška, Jan Benes
BACKGROUND: Lowering central venous pressure (CVP) can decrease blood loss during liver resection and it is associated with improved outcomes. Multiple CVP reducing maneuvers have been described, but direct comparison of their effectiveness and safety has never been performed. METHODS: Patients undergoing resections of 2 or more liver segments were equally randomized to absolute fluid restriction (AR, N = 17) or relative volume redistribution group (RR, N = 17)...
April 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28420648/association-of-magnet-status-with-hospitalization-outcomes-for-ischemic-stroke-patients
#15
Kimon Bekelis, Symeon Missios, Todd A MacKenzie
BACKGROUND: It is not clear whether Magnet recognition by the American Nurses Credentialing Center (nursing excellence program) is associated with improved patient outcomes. We investigated whether hospitalization in a Magnet hospital is associated with improved outcomes for patients with ischemic stroke. METHODS AND RESULTS: We performed a cohort study of patients with ischemic stroke from 2009 to 2013, who were registered in the New York Statewide Planning and Research Cooperative System database...
April 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28420282/exploring-predictors-of-treatment-outcome-in-cognitive-behavior-therapy-for-sleep-disturbance-following-acquired-brain-injury
#16
Sylvia Nguyen, Dean McKenzie, Adam McKay, Dana Wong, Shantha M W Rajaratnam, Gershon Spitz, Gavin Williams, Darren Mansfield, Jennie Ponsford
PURPOSE: To identify predictors of treatment response to cognitive behavior therapy (CBT) for sleep disturbance following acquired brain injury (ABI). METHODS: Classification and regression tree (CART) analysis was conducted on individual patient data from two pilot randomized controlled trials (RCTs): one in traumatic brain injury (TBI), the other in stroke. The combined sample comprised 32 participants; 15 receiving CBT and 17 allocated to treatment as usual (TAU)...
April 19, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28414562/a-review-of-cochrane-systematic-reviews-of-interventions-relevant-to-orthoptic-practice
#17
Fiona J Rowe, Sue Elliott, Iris Gordon, Anupa Shah
AIM: To present an overview of the range of systematic reviews on intervention trials pertinent to orthoptic practice, produced by the Cochrane Eyes and Vision group (CEV). METHODS: We searched the 2016 Cochrane Library database (31.03.2016) to identify completed reviews and protocols of direct relevance to orthoptic practice. These reviews are currently completed and published, available on www.thecochranelibrary.com (free to UK health employees) or via the CEV website (http://eyes...
April 17, 2017: Strabismus
https://www.readbyqxmd.com/read/28413990/effect-of-glucagon-like-peptide-1-receptor-agonists-on-all-cause-mortality-and-cardiovascular-outcomes-a-meta-analysis
#18
Shaylee Peterson, Arden Barry
BACKGROUND: Cardiovascular disease is the leading cause of death in patients with type 2 diabetes. OBJECTIVE: To assess the impact of glucagon-like peptide-1 receptor agonist (GLP1RA) therapy, compared to placebo, on clinically relevant outcomes including all-cause mortality, cardiovascular mortality, nonfatal myocardial infarction (MI), nonfatal stroke, and hospitalizations for heart failure, in patients with type 2 diabetes. METHOD: EMBASE, MEDLINE, and CENTRAL were searched (inception to September 2016) for randomized, double-blind, placebo-controlled trials of at least one year in duration that compared any GLP1RA to placebo in patients with type 2 diabetes...
April 14, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28409731/a-direct-aspiration-first-pass-technique-vs-stentriever-thrombectomy-in-emergent-large-vessel-intracranial-occlusions
#19
Christopher J Stapleton, Thabele M Leslie-Mazwi, Collin M Torok, Reza Hakimelahi, Joshua A Hirsch, Albert J Yoo, James D Rabinov, Aman B Patel
OBJECTIVE Endovascular thrombectomy in patients with acute ischemic stroke caused by occlusion of the proximal anterior circulation arteries is superior to standard medical therapy. Stentriever thrombectomy with or without aspiration assistance was the predominant technique used in the 5 randomized controlled trials that demonstrated the superiority of endovascular thrombectomy. Other studies have highlighted the efficacy of a direct aspiration first-pass technique (ADAPT). METHODS To compare the angiographic and clinical outcomes of ADAPT versus stentriever thrombectomy in patients with emergent large vessel occlusions (ELVO) of the anterior intracranial circulation, the records of 134 patients who were treated between June 2012 and October 2015 were reviewed...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28408941/clinical-evaluation-of-acupuncture-as-treatment-for-complications-of-cerebrovascular-accidents-a-randomized-sham-controlled-subject-and-assessor-blind-trial
#20
Hsien-Yin Liao, Wen-Chao Ho, Chun-Chung Chen, Jaung-Geng Lin, Chia-Chi Chang, Liang-Yu Chen, De-Chih Lee, Yu-Chen Lee
Background and Purpose. The effect of acupuncture as treatment for poststroke complications is questionable. We performed a randomized, sham-controlled double-blind study to investigate it. Methods. Patients with first-time acute stroke were randomized to receive 24 sessions of either real or sham acupuncture during an eight-week period. The primary outcome measure was change in National Institute of Health Stroke Scale (NIHSS) score. Secondary outcome measures included changes in Barthel Index (BI), Instrumental Activities of Daily Living (IADL), Hamilton Depression Rating Scale (HAM-D), and Visual Analogue Scale (VAS) for pain scores...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
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