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stroke randomized controlled trials

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https://www.readbyqxmd.com/read/28821470/design-of-the-drepagreffe-trial-a-prospective-controlled-multicenter-study-evaluating-the-benefit-of-genoidentical-hematopoietic-stem-cell-transplantation-over-chronic-transfusion-in-sickle-cell-anemia-children-detected-to-be-at-risk-of-stroke-by-transcranial
#1
Sylvie Chevret, Suzanne Verlhac, Elisabeth Ducros-Miralles, Jean-Hugues Dalle, Regis Peffault de Latour, Mariane de Montalembert, Malika Benkerrou, Corinne Pondarré, Isabelle Thuret, Corinne Guitton, Emmanuelle Lesprit, Maryse Etienne-Julan, Gisèle Elana, Jean-Pierre Vannier, Patrick Lutz, Bénédicte Neven, Claire Galambrun, Catherine Paillard, Camille Runel, Charlotte Jubert, Cécile Arnaud, Annie Kamdem, Valentine Brousse, Florence Missud, Marie Petras, Lydia Doumdo-Divialle, Claire Berger, Françoise Fréard, Olivier Taieb, Elise Drain, Monique Elmaleh, Manuela Vasile, Yacine Khelif, Myriam Bernaudin, Philippe Chadebech, France Pirenne, Gérard Socié, Françoise Bernaudin
BACKGROUND: Children with sickle cell anemia (SCA) have an 11% risk of stroke by the age of 18. Chronic transfusion applied in patients detected to be at risk by transcranial Doppler allows a significant reduction of stroke risk. However, chronic transfusion exposes to several adverse events, including alloimmunization and iron overload, and is not curative. Hematopoietic stem cell transplantation allows termination of the transfusion program, but its benefit has not been demonstrated...
August 15, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28820348/where-to-now-avert-answered-an-important-question-but-raised-many-more
#2
Mark T Bayley, Audrey Bowen, Coralie English, Robert Teasell, Janice J Eng
A Very Early Rehabilitation Trial (AVERT) was a Phase 3 randomized trial with over 2100 subjects post stroke that had unexpected results with better outcomes for usual care than those receiving very early mobilization. This review of published stroke clinical practice guidelines highlights that recommendations for mobilization have changed after publication of AVERT but also that developers have struggled to provide recommendations for appropriate dose, duration and intensity of mobilization in the acute post stroke period with available analyses from AVERT and other literature...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28819339/depression-after-stroke-in-sub-saharan-africa-a-systematic-review-and-meta-analysis
#3
REVIEW
Akin Ojagbemi, Onoja Akpa, Fisayo Elugbadebo, Mayowa Owolabi, Bruce Ovbiagele
OBJECTIVE: We aimed to conduct a systematic review and meta-analysis of prevalence and characteristics of poststroke depression (PSD) in sub-Saharan Africa (SSA). METHODS: We searched Medline, PsycINFO, and African Journals OnLine using keywords for stroke and depression and the .mp. operator for all 54 SSA countries/regions. Further information was retrieved through a manual search of references from relevant published and unpublished articles. We included only peer-reviewed original studies with epidemiological or experimental designs, conducted random-effect meta-analysis, and identified the most commonly associated factors by weight (inverse of variance method)...
2017: Behavioural Neurology
https://www.readbyqxmd.com/read/28817481/incorporating-dynamic-assessment-of-fluid-responsiveness-into-goal-directed-therapy-a-systematic-review-and-meta-analysis
#4
Joseph M Bednarczyk, Jason A Fridfinnson, Anand Kumar, Laurie Blanchard, Rasheda Rabbani, Dean Bell, Duane Funk, Alexis F Turgeon, Ahmed M Abou-Setta, Ryan Zarychanski
OBJECTIVE: Dynamic tests of fluid responsiveness have been developed and investigated in clinical trials of goal-directed therapy. The impact of this approach on clinically relevant outcomes is unknown. We performed a systematic review and meta-analysis to evaluate whether fluid therapy guided by dynamic assessment of fluid responsiveness compared with standard care improves clinically relevant outcomes in adults admitted to the ICU. DATA SOURCES: Randomized controlled trials from MEDLINE, EMBASE, CENTRAL, clinicaltrials...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28816346/homocysteine-lowering-interventions-for-preventing-cardiovascular-events
#5
REVIEW
Arturo J Martí-Carvajal, Ivan Solà, Dimitrios Lathyris, Mark Dayer
BACKGROUND: Cardiovascular disease, which includes coronary artery disease, stroke and peripheral vascular disease, is a leading cause of death worldwide. Homocysteine is an amino acid with biological functions in methionine metabolism. A postulated risk factor for cardiovascular disease is an elevated circulating total homocysteine level. The impact of homocysteine-lowering interventions, given to patients in the form of vitamins B6, B9 or B12 supplements, on cardiovascular events has been investigated...
August 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28815655/a-clinical-trial-design-using-the-concept-of-proportional-time-using-the-generalized-gamma-ratio-distribution
#6
Milind A Phadnis, James B Wetmore, Matthew S Mayo
Traditional methods of sample size and power calculations in clinical trials with a time-to-event end point are based on the logrank test (and its variations), Cox proportional hazards (PH) assumption, or comparison of means of 2 exponential distributions. Of these, sample size calculation based on PH assumption is likely the most common and allows adjusting for the effect of one or more covariates. However, when designing a trial, there are situations when the assumption of PH may not be appropriate. Additionally, when it is known that there is a rapid decline in the survival curve for a control group, such as from previously conducted observational studies, a design based on the PH assumption may confer only a minor statistical improvement for the treatment group that is neither clinically nor practically meaningful...
August 16, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28815562/treadmill-training-and-body-weight-support-for-walking-after-stroke
#7
REVIEW
Jan Mehrholz, Simone Thomas, Bernhard Elsner
BACKGROUND: Treadmill training, with or without body weight support using a harness, is used in rehabilitation and might help to improve walking after stroke. This is an update of the Cochrane review first published in 2003 and updated in 2005 and 2014. OBJECTIVES: To determine if treadmill training and body weight support, individually or in combination, improve walking ability, quality of life, activities of daily living, dependency or death, and institutionalisation or death, compared with other physiotherapy gait-training interventions after stroke...
August 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28814398/plasma-lipidomic-profiles-and-cardiovascular-events-in-a-randomized-intervention-trial-with-the-mediterranean-diet
#8
Estefanía Toledo, Dong D Wang, Miguel Ruiz-Canela López, Clary B Clish, Cristina Razquin, Yan Zheng, Marta Guasch-Ferré, Adela Hruby, Dolores Corella, Enrique Gómez-Gracia, Miquel Fiol, Ramón Estruch, Emilio Ros, José Lapetra, Montserrat Fito, Fernando Aros, Luis Serra-Majem, Liming Liang, Jordi Salas-Salvadó, Frank B Hu, Miguel A Martínez-González
Background: Lipid metabolites may partially explain the inverse association between the Mediterranean diet (MedDiet) and cardiovascular disease (CVD).Objective: We evaluated the associations between 1) lipid species and the risk of CVD (myocardial infarction, stroke, or cardiovascular death); 2) a MedDiet intervention [supplemented with extra virgin olive oil (EVOO) or nuts] and 1-y changes in these molecules; and 3) 1-y changes in lipid species and subsequent CVD.Design: With the use of a case-cohort design, we profiled 202 lipid species at baseline and after 1 y of intervention in the PREDIMED (PREvención con DIeta MEDiterránea) trial in 983 participants [230 cases and a random subcohort of 790 participants (37 overlapping cases)]...
August 16, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28814245/benefits-of-sglt2-inhibitors-beyond-glycemic-control-a-focus-on-metabolic-cardiovascular-and-renal-outcomes
#9
Molly G Minze, Kayley Will, Brian T Terrell, Robin L Black, Brian K Irons
BACKGROUND: Sodium-glucose co-transporter 2 (SGLT2) inhibitors are a new pharmacotherapeutic class for the treatment of type 2 diabetes mellitus (T2DM). OBJECTIVE: To evaluate beneficial effects of the SGLT2 inhibitors on metabolic, cardiovascular, and renal outcomes. METHODS: A Pub-Med search (1966 to July 2017) was performed of published English articles using keywords sodium-glucose co-transporter 2 inhibitors, canagliflozin, dapagliflozin, and empagliflozin...
August 16, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28813943/conjunctive-rehabilitation-of-multiple-cognitive-domains-for-chronic-stroke-patients-in-virtual-reality
#10
Martina Maier, Nuria Leiva Banuelos, Belen Rubio Ballester, Esther Duarte, Paul F M J Verschure
Classically, cognitive deficits have been studied and treated in isolation from each other. A stroke patient is classified as being memory impaired, having executive dysfunction or showing attentional deficits after which a dedicated rehabilitation therapy is given. Studies seldom looked at the relationship between these different cognitive domains and syndromes, although, there is evidence that they might share common neuronal substrates and do not occur in isolation. Here, we propose a novel rehabilitation method in virtual reality to treat cognitive deficits in conjunction and report the preliminary results of an ongoing randomized controlled clinical trial...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813878/randomized-sham-controlled-trial-based-on-transcranial-direct-current-stimulation-and-wrist-robot-assisted-integrated-treatment-on-subacute-stroke-patients-intermediate-results
#11
Stefano Mazzoleni, Vi Do Tran, Laura Iardella, Paolo Dario, Federico Posteraro
The main goal of this study is to analyse the effects of combined transcranial direct current stimulation (tDCS) and wrist robot-assisted therapy in subacute stroke patients. Twenty-four patients were included in this study and randomly assigned to the experimental (EG) or control group (CG). All participants performed wrist robot-assisted training a) in conjunction with tDCS (real stimulation for patients in EG) or b) without tDCS (sham stimulation for patients in CG). Clinical scales and kinematic parameters recorded by the robot were used for the assessment...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813793/the-combined-action-of-a-passive-exoskeleton-and-an-emg-controlled-neuroprosthesis-for-upper-limb-stroke-rehabilitation-first-results-of-the-retrainer-project
#12
E Ambrosini, S Ferrante, J Zajc, M Bulgheroni, W Baccinelli, E d'Amico, T Schauer, C Wiesener, M Russold, M Gfoehler, M Puchinger, M Weber, S Becker, K Krakow, M Rossini, D Proserpio, G Gasperini, F Molteni, G Ferrigno, A Pedrocchi
The combined use of Functional Electrical Stimulation (FES) and robotic technologies is advocated to improve rehabilitation outcomes after stroke. This work describes an arm rehabilitation system developed within the European project RETRAINER. The system consists of a passive 4-degrees-of-freedom exoskeleton equipped with springs to provide gravity compensation and electromagnetic brakes to hold target positions. FES is integrated in the system to provide additional support to the most impaired muscles. FES is triggered based on the volitional EMG signal of the same stimulated muscle; in order to encourage the active involvement of the patient the volitional EMG is also monitored throughout the task execution and based on it a happy or sad emoji is visualized at the end of each task...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28813123/pharmacotherapy-for-hypertension-in-adults-aged-18-to-59-years
#13
REVIEW
Vijaya M Musini, Francois Gueyffier, Lorri Puil, Douglas M Salzwedel, James M Wright
BACKGROUND: Hypertension is an important risk factor for adverse cardiovascular events including stroke, myocardial infarction, heart failure and renal failure. The main goal of treatment is to reduce these events. Systematic reviews have shown proven benefit of antihypertensive drug therapy in reducing cardiovascular morbidity and mortality but most of the evidence is in people 60 years of age and older. We wanted to know what the effects of therapy are in people 18 to 59 years of age...
August 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28807582/comparative-efficacy-of-angiotensin-ii-antagonists-in-essential-hypertension-systematic-review-and-network-meta-analysis-of-randomised-controlled-trials
#14
Bernice Tsoi, Leo E Akioyamen, Ashley Bonner, Claudia Frankfurter, Mitchell Levine, Eleanor Pullenayegum, Ron Goeree, Daria O'Reilly
BACKGROUND: Evidence on the long-term clinical benefits of individual members of angiotensin II receptor blockers is limited given the lack of head-to-head studies. We conducted a network meta-analysis to determine the comparative efficacy of different members within this drug class with respect to outcomes of (i) blood pressure reduction (at 24 and 52 weeks) and (ii) prevention of cardiovascular disease (>104 weeks). METHODS: A systematic literature review was conducted - Protocol registration: (PROSPERO - CRD42014007067) - to identify relevant literature from the following databases: Cochrane Library, PubMed, MEDLINE and Embase; searched from inception to July 2016...
July 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28806430/a-randomized-controlled-trial-of-mastication-with-complete-dentures-made-by-a-conventional-or-an-abbreviated-technique
#15
Cristiane Machado Mengatto, Gustavo Hauber Gameiro, Mario Brondani, C Peter Owen, Michael I MacEntee
PURPOSE: The aim of this randomized clinical trial was to test the hypothesis that there are no statistically significant differences after 3 and 6 months in masticatory performance or chewing ability of people with new complete dentures made by an abbreviated or a conventional technique. MATERIALS AND METHODS: The trial included 20 edentulous participants at a dental school in Brazil assigned randomly to receive dentures made by either a conventional technique involving six clinical sessions or by an abbreviated technique involving three clinical sessions...
August 14, 2017: International Journal of Prosthodontics
https://www.readbyqxmd.com/read/28806209/refractory-intracranial-hypertension-the-role-of-decompressive-craniectomy
#16
Martin Smith
Raised intracranial pressure (ICP) is associated with worse outcomes after acute brain injury, and clinical guidelines advocate early treatment of intracranial hypertension. ICP-lowering therapies are usually administered in a stepwise manner, starting with safer first-line interventions, while reserving higher-risk options for patients with intractable intracranial hypertension. Decompressive craniectomy is a surgical procedure in which part of the skull is removed and the underlying dura opened to reduce brain swelling-related raised ICP; it can be performed as a primary or secondary procedure...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28805310/use-of-direct-oral-anticoagulants-for-stroke-prevention-in-elderly-patients-with-nonvalvular-atrial-fibrillation
#17
Lynn B Oertel, Annemarie E Fogerty
BACKGROUND AND PURPOSE: Four direct oral anticoagulants (DOACs) are available for the prevention of stroke in nonvalvular atrial fibrillation (NVAF): dabigatran (a direct thrombin inhibitor); and rivaroxaban, apixaban, and edoxaban (factor Xa inhibitors). This article summarizes the safety and efficacy of DOACs for the prevention of stroke in elderly NVAF patients. METHODS: PubMed was searched to identify published results of randomized, controlled trials evaluating DOACs for stroke prevention in elderly NVAF patients...
August 14, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28805107/effects-of-high-frequency-repetitive-transcranial-magnetic-stimulation-on-reducing-hemiplegic-shoulder-pain-in-patients-with-chronic-stoke-a-randomized-controlled-trial
#18
Gyu-Sik Choi, Min Cheol Chang
OBJECTIVE: To examine whether high-frequency (10 Hz) repetitive transcranial magnetic stimulation (rTMS), applied over the primary motor cortex of the affected hemisphere, could be used to manage hemiplegic shoulder pain (HSP). METHODS: Twenty-four chronic stroke patients with chronic HSP, randomly assigned into the rTMS group (10 sessions of high-frequency stimulation) or the sham group (sham stimulation), was performed. The Numeric Rating Scale (NRS) was used to evaluate the intensity of pain at pre-treatment, and at one day, and one, two, and four weeks after treatment...
August 12, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/28804959/head-to-head-comparison-of-prasugrel-versus-ticagrelor-in-patients-undergoing-percutaneous-coronary-intervention-a-meta-analysis-of-randomized-controlled-trials
#19
Ryota Sakurai, Ivana Burazor, Heidi N Bonneau, Hideaki Kaneda
OBJECTIVES: We sought to compare the efficacy and safety of prasugrel and ticagrelor in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI). BACKGROUND: Evidence from randomized head-to-head comparison between prasugrel and ticagrelor is rare regarding clinical endpoints. METHODS: PubMed, the Cochrane Library, and Web of Science were queried with the terms "prasugrel," "ticagrelor," and "randomized." Relevant randomized controlled trials (RCTs) or the same terms were also surveyed using clinicaltrials...
August 13, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28803535/robotic-assistance-for-training-finger-movement-using-a-hebbian-model-a-randomized-controlled-trial
#20
Justin B Rowe, Vicky Chan, Morgan L Ingemanson, Steven C Cramer, Eric T Wolbrecht, David J Reinkensmeyer
BACKGROUND: Robots that physically assist movement are increasingly used in rehabilitation therapy after stroke, yet some studies suggest robotic assistance discourages effort and reduces motor learning. OBJECTIVE: To determine the therapeutic effects of high and low levels of robotic assistance during finger training. METHODS: We designed a protocol that varied the amount of robotic assistance while controlling the number, amplitude, and exerted effort of training movements...
August 2017: Neurorehabilitation and Neural Repair
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